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BACKGROUND: Narrative medicine (NM) encourages health care providers to draw on their personal experiences to establish therapeutic alliances with patients of prevention and care services. NM medicine practiced by nurses and physicians has been well documented, yet there is little understanding of how community health workers (CHWs) apply NM concepts in their day-to-day practices from patient perspectives. OBJECTIVE: To document how CHWs apply specific NM concepts in Brazil's Family Health Strategy (FHS), the key component of Brazil's Unified Health System. DESIGN: We used a semi-structured interview, grounded in Charon's (2001) framework, including four types of NM relationships: provider-patient, provider-colleague, provider-society, and provider-self. A hybrid approach of thematic analysis was used to analyze data from 27 patients. KEY RESULTS: Sample: 18 females; 13 White, 12 "Pardo" (mixed races), 12 Black. We found: (1) provider-patient relationship-CHWs offered health education through compassion, empathy, trustworthiness, patience, attentiveness, jargon-free communication, and altruism; (2) provider-colleague relationship-CHWs lacked credibility as perceived by physicians, impacting their effectiveness negatively; (3) provider-society relationship-CHWs mobilized patients civically and politically to advocate for and address emerging health care and prevention needs; (4) provider-self relationship-patients identified possible low self-esteem among CHWs and a need to engage in self-care practices to abate exhaustion from intense labor and lack of resources. CONCLUSION: This study adds to patient perspectives on how CHWs apply NM concepts to build and sustain four types of relationships. Findings suggest the need to improve provider-colleague relationships by ongoing training to foster cooperation among FHS team members. More generous organizational supports (wellness initiatives and supervision) may facilitate the provider-self relationship. Public education on CHWs' roles is needed to enhance the professional and societal credibility of their roles and responsibilities. Future research should investigate how CHWs' personality traits may influence their ability to apply NM.
Assuntos
Agentes Comunitários de Saúde , Medicina Narrativa , Brasil , Atenção à Saúde , Feminino , Educação em Saúde , Humanos , Pesquisa QualitativaRESUMO
Objective: This study aimed to estimate the prevalence of postmenopausal women at high risk of sarcopenia and to compare their quality of life (QOL) with those at low risk using the SARC-F questionnaire. Methods: We performed a cross-sectional study of postmenopausal women who attended a menopause clinic in Colombia. The risk of sarcopenia was determined through the SARC-F questionnaire; a score ≥4 was considered high risk. The Menopause Rating Scale, the International Physical Activity Questionnaire, and the Short Physical Performance Battery (SPPB) tool were applied. Results: A total of 112 postmenopausal women with an average age of 68.4 ± 8.5 years were included. The prevalence of women at high risk of sarcopenia was 15.2% (n = 17) (95% confidence interval: 9.7; 23.0). Among the high-risk group there was a higher proportion of women with severe symptoms in the three domains when compared to the low-risk group (somatic 7% vs. 24%, psychological 15% vs. 44%, and urogenital 28% vs. 53%; p < 0.05). A tendency to a lower physical performance was found in the high-risk group (SPPB: 8 [interquartile range: 6-11] vs. SPPB: 10 [interquartile range: 8-11), p = 0.059). Conclusion: Our results suggest that women with high risk of sarcopenia have a poor QOL. The SARC-F questionnaire is a brief and non-invasive screening tool to detect postmenopausal women at high risk of sarcopenia.
Assuntos
Pós-Menopausa , Sarcopenia/epidemiologia , Idoso , Colômbia/epidemiologia , Estudos Transversais , Exercício Físico , Feminino , Humanos , Qualidade de Vida , Fatores de Risco , Sarcopenia/etiologia , Inquéritos e QuestionáriosRESUMO
This paper reports a theoretical and experimental investigation on the recombinant protein rotavirus VP6 as a bioelectrochemical interface. Our motivation arises from the highly active zones of VP6 which can interact with biological structures and metals, as well as its useful features such as self-assembly, polymorphism, and active surface charge. A molecular simulation study was performed to analyze the charge transfer properties of theVP6 trimer under an applied electric field. The electrostatic properties were evaluated via the nonlinear second-order Poisson-Boltzmann equation, using finite element methods based on parameter discretization and calculation of solute/solvent interaction forces, which account for mean-field screening effects. The electrochemical study validated the theoretical predictions for VP6 in their different assemblies (trimers and nanotubes) when they are used as electrodes in 10â¯mMâ¯K3[Fe(CN)6], 1â¯M KCl. Applying a potential sweep promotes charge transfer, facilitates redox activity of the ferricyanide ion. Furthermore, protein assemblies decreased electrode electrical resistance and enabled gold particle electrodeposition on the protein VP6. These results suggest that VP6 is a promising conductive biomaterial that promotes charge transfer of redox probes and could be used as a new scaffold to create bio-electrochemical interfaces.
Assuntos
Antígenos Virais/química , Proteínas do Capsídeo/química , Proteínas Imobilizadas/química , Nanotubos/química , Rotavirus/química , Condutividade Elétrica , Técnicas Eletroquímicas , Eletrodos , Polímeros de Fluorcarboneto/química , Modelos Moleculares , Multimerização Proteica , Proteínas Recombinantes/química , Eletricidade EstáticaRESUMO
The use of tail chalk and estrus/heat expression scores (HEATSC) evaluation is instrumental in identifying cows with greater estrus expression and greater artificial insemination pregnancy rates (P/AI) in cows submitted to timed artificial insemination (TAI), and cows with low or no estrus expression present lower P/AI. It was intended in this study to improve the pregnancy rates in TAI for Bos indicus beef cows, and gonadotrophin-releasing hormone (GnRH) injection was hypothesized to increase pregnancy rates in a TAI program for cows submitted to progesterone-estradiol-based protocols with low or no estrus expression, evaluated by HEATSC. Cows (n= 2284) received a progesterone device and 2 mg estradiol benzoate, after 8 days the device was removed and 1 mg estradiol cypionate, 150 µg of d-cloprostenol and 300 IU equine chorionic gonadotropin was administered. All cows were marked with chalk and HEATSC evaluated (scales 1 to 3) at TAI performed on day 10. Animals with HEATSC1 and HEATSC2 (n= 937) received 100 µg de gonadorelin (GNRH group; n= 470), or 1 ml saline (Control group; n= 467), and cows with HEATSC3 (named HEAT group; n= 1347) received no additional treatment. The larger dominant follicle, evaluated on day 8and at TAI (day 10), was greater in HEAT group (P= 0.0145 and P <0.001, respectively). Corpus luteum (CL) area and progesterone concentration was evaluated on day 17, and CL area was larger in HEAT group, intermediary in Control and lower in GnRH group (Control= 2.68 cm2, GnRH= 2.37 cm2, HEAT group= 3.07 cm2, P <0.001). Greater progesterone concentrations were found in HEAT group than in Control and GnRH groups (Control= 4.74 ng/ml, GnRH= 4.29 ng/ml, HEAT group= 6.08 ng/ml, P<0.001). There was a difference in ovulation rate, greater in HEAT group than GnRH and Control groups (Control= 72.5%; GnRH= 81.25%; HEAT group= 90.71%; P= 0.0024). Artificial insemination pregnancy rates was greater in HEAT group (57.09% (769/1347) than in Control and GNRH groups, with positive effect of GnRH injection at the time of TAI in P/AI (Control= 36.18% (169/467), GnRH= 45.95% (216/470); P<0.0001). In conclusion, GnRH application in cows with low HEATSC (1 and 2) is a simple strategy, requiring no changes in TAI management to increase pregnancy rates in postpartum beef cows submitted to progesterone-estradiol-based TAI protocols, without reaching, however, the pregnancy rates of cows that demonstrate high estrus expression at the TAI.
Assuntos
Bovinos/fisiologia , Estradiol/administração & dosagem , Estrogênios/administração & dosagem , Progesterona/administração & dosagem , Reprodução/efeitos dos fármacos , Animais , Corpo Lúteo/efeitos dos fármacos , Estro/efeitos dos fármacos , Detecção do Estro , Feminino , Fertilidade/efeitos dos fármacos , Hormônio Liberador de Gonadotropina/administração & dosagem , Temperatura Alta , Inseminação Artificial/veterinária , Folículo Ovariano/efeitos dos fármacos , Ovulação/efeitos dos fármacos , Indução da Ovulação , Gravidez , Taxa de GravidezRESUMO
El cáncer de cuello uterino (CaCu) representa un problema de salud pública y es considerado la segunda causa de muerte por cáncer en mujeres. Se han descrito factores de riesgo, los cuales están relacionados con hábitos, conductas y agentes infecciosos tales como el Virus de Inmunodeficiencia humana, herpes virus, Chlamydia trachomatis y Virus del Papiloma Humano (VPH). Con el fin de establecer los factores de riesgo y detectar lesiones preinvasivas de cérvix, se seleccionaron 101 mujeres de tres etnias indígenas, a las cuales se les realizó una encuesta clínico-epidemiológica, además del estudio citológico. Del total de pacientes estudiadas un 66,34% presentaron algún tipo de alteración, siendo las Yukpa las más afectadas, así mismo 21 (20,79%) presentaron neoplasia intraepitelial cervical y se encontraron agentes infecciosos en un 56,51% de las mujeres. En un 26,21% de las pacientes se encontraron células coilocíticas sugestivas de VPH. Al analizar los factores de riesgo se encontró que el inicio de relaciones sexuales antes de los 15 años, y el consumo de alcohol fueron los más relevantes. Es de importancia el diagnóstico oportuno en estas comunidades que se encuentran desasistidas y sin acceso a centros de salud, ya sea por condiciones de vida o por implicaciones culturales.
The cervical cancer represents a problem of public health and is considered the second reason of death by cancer in women. There have been described factors associated, related to the conduct, habits and infectious agents, such as Human Immunodeficiency Virus, herpes virus, Chlamydia trachomatis and Human Papilloma Virus (HPV). In order to establish risk factors and detect preinvasive cervical lesions, 101 samples of women from three indigenous ethnic groups of Zulia State were selected; to which a clinical-epidemiological survey was carried out to study the predisposing factors, in addition to the cytological study. Of the total of patients studied 33.66% were negative to the cytological study, while 66.34% had some type of alteration, observing that the Yukpa the most affected, 21 (20.79%) presented Cervical intraepithelial neoplasia and related infectious agents were found in 56.51% of the women. Coelocytic cells suggestive of HPV were found in 26.21% of all patients. When we analyzed the risk factors, we found that, the onset of sexual intercourse before age 15 as well as alcohol consumption were the most relevant. According to the findings, it is important the timely diagnosis in these communities, which are disassociated, and without access to health centers, whether due to living conditions or cultural implications.
RESUMO
We have studied, by means of first-principles calculations, the electronic and optical properties of the sulvanite family: Cu3MX4 (M = V, Nb, Ta and X = S, Se), which, due to its broad range of gaps and chemical stability, have emerged as promising materials for technological applications such as photovoltaics and transparent conductivity. To address the reliability of those properties we have used semi-local and hybrid functionals (PBEsol, HSE06), many-body perturbation theory (G0W0 approximation and Bethe-Salpeter equation), and time-dependent density functional theory (revised bootstrap kernel) to calculate the quasi-particle dispersion relation, band gaps, the imaginary part of the macroscopic dielectric function and the absorption coefficient. The calculated valence band maximum and the conduction band minimum are located at the R and X-points, respectively. The calculated gaps using PBEsol are between 0.81 and 1.88 eV, with HSE06 into 1.73 and 2.94 eV, whereas the G0W0 values fall into the 1.91-3.19 eV range. The calculated dielectric functions and absorption coefficients show that all these compounds present continuous excitonic features when the Bethe-Salpeter equation is used. Contrarily, the revised bootstrap kernel is incapable of describing the excitonic spectra. The calculated optical spectra show that Cu3VS4 and Cu3MSe4 have good absorption in the visible, whereas Cu3NbS4 and Cu3TaS4 have it on the near ultraviolet.
RESUMO
First-principles quasi-particle theory has been employed to assess catalytic power of graphitic carbon nitride, g-C3N4, for solar fuel production. A comparative study between g-h-triazine and g-h-heptazine has been carried out taking also into account van der Waals dispersive forces. The band edge potentials have been calculated using a recently developed approach where quasi-particle effects are taken into account through the GW approximation. First, it was found that the description of ground state properties such as cohesive and surface formation energies requires the proper treatment of dispersive interaction. Furthermore, through the analysis of calculated band-edge potentials, it is shown that g-h-triazine has high reductive power reaching the potential to reduce CO2 to formic acid, coplanar g-h-heptazine displays the highest thermodynamics force toward H2O/O2 oxidation reaction, and corrugated g-h-heptazine exhibits a good capacity for both reactions. This rigorous theoretical study shows a route to further improve the catalytic performance of g-C3N4.
RESUMO
Near infrared (NIR) spectroscopy was used to determine the content of Klason lignin, acid-soluble lignin, total lignin, extractives, ash, acid-insoluble residue, glucose, xylose, rhamnose, galactose, arabinose, mannose and total sugars in coconut residues. The samples were analyzed at several processing stages: wet unground (WU), dried unground (DU) and dried and sieved (DS). Partial least squares models were built, and the models for the analytes exhibited R(2)>0.80, with the exceptions of rhamnose, arabinose, galactose, mannose and ash from all fractions, and the lignin content from the WU fraction, which were predicted poorly (R(2)<0.70). There were some significant differences between the models for the main lignocellulosic components at the various stages of biomass. These results proved that NIR spectroscopy is useful for analysis at biorefineries, and it can be used as a faster and more economical alternative to the standard methods.
Assuntos
Cocos/química , Análise de Alimentos/métodos , Lignina/análise , Extratos Vegetais/análise , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Análise MultivariadaRESUMO
Light-at-night exposure enhances the risk of cancer. Colon cancer is among the most dangerous tumors affecting humankind. Physical exercise has shown positive effects against colon cancer. Here, we investigated whether pineal gland modulates antipreneoplastic effects of physical exercise in the colon. Surgical and non-surgical pineal impairments were performed to clarify the relationship between the pineal gland activity and manifestation of colonic preneoplastic lesions. Next, a progressive swimming training was applied in rats exposed or not to either non-surgical pineal impairment or carcinogen treatment for 10 weeks. Both surgical and non-surgical pineal impairments increased the development of colon preneoplasia. It was further found that impairing the pineal gland function, higher rates of DNA damage were induced in colonic epithelial and enteric glial cells. Physical exercise acted positively against preneoplasia, whereas impairing the pineal function with constant light exposure disrupts its positive effects on the development of preneoplastic lesions in the colon. This was yet related to increased DNA damage in glial cells and enteric neuronal activation aside from serum melatonin levels. Our findings suggest that protective effects of physical exercise against colon cancer are dependent on the pineal gland activity.
Assuntos
Neoplasias do Colo/prevenção & controle , DNA/análise , Condicionamento Físico Animal/fisiologia , Glândula Pineal/fisiologia , Lesões Pré-Cancerosas/prevenção & controle , 1,2-Dimetilidrazina , Animais , Ciclo-Oxigenase 2/análise , Dano ao DNA/fisiologia , Sistema Nervoso Entérico/fisiologia , Luz/efeitos adversos , Masculino , Melatonina/sangue , Metalotioneína/análise , Neuroglia/química , Neurônios/química , Glândula Pineal/cirurgia , Lesões Pré-Cancerosas/induzido quimicamente , Lesões Pré-Cancerosas/química , Lesões Pré-Cancerosas/patologia , Proteínas Proto-Oncogênicas c-fos/análise , Ratos , Ratos WistarRESUMO
Escherichia coli é um importante patógeno envolvido em quadros de toxinfecção alimentar em humanos. Dentre os diversos tipos de queijos fabricados, o Minas Frescal tem ampla aceitação comercial em função de seu preço mais acessível (BARROS et al., 2004). Na maioria das vezes são comercializados em embalagem plástica comum e sem tratamento a vácuo. As amostras de queijo foram semeadas em ágar EMB-Levine e incubadas a 37ºC, por 24 horas. A extração de DNA das cepas de E. coli isoladas foi realizada pelo método térmico. A amplificação do DNA bacteriano foi feita em uma reação com volume final de 25μL. Os produtos amplificados foram visualizados por exposição do gel de agarose à luz ultravioleta. Foram visitados 12 estabelecimentos comerciais e destes coletados uma amostra de queijo minas frescal. Processada no dia da coleta e outro processamento após sete dias, totalizando 24 amostras e 120 isolados de Escherichia coli. Foram caracterizados geneticamente quatro isolados como VTEC, sendo identificada uma como stx1 e três como stx2, revelando uma prevalência de 3,33
RESUMO
Escherichia coli é um importante patógeno envolvido em quadros de toxinfecção alimentar em humanos. Dentre os diversos tipos de queijos fabricados, o Minas Frescal tem ampla aceitação comercial em função de seu preço mais acessível (BARROS et al., 2004). Na maioria das vezes são comercializados em embalagem plástica comum e sem tratamento a vácuo. As amostras de queijo foram semeadas em ágar EMB-Levine e incubadas a 37ºC, por 24 horas. A extração de DNA das cepas de E. coli isoladas foi realizada pelo método térmico. A amplificação do DNA bacteriano foi feita em uma reação com volume final de 25μL. Os produtos amplificados foram visualizados por exposição do gel de agarose à luz ultravioleta. Foram visitados 12 estabelecimentos comerciais e destes coletados uma amostra de queijo minas frescal. Processada no dia da coleta e outro processamento após sete dias, totalizando 24 amostras e 120 isolados de Escherichia coli. Foram caracterizados geneticamente quatro isolados como VTEC, sendo identificada uma como stx1 e três como stx2, revelando uma prevalência de 3,33
RESUMO
Porcine S100A12 is a member of the S100 proteins, family of small acidic calcium-binding proteins characterized by the presence of two EF-hand motifs. These proteins are involved in many cellular events such as the regulation of protein phosphorylation, enzymatic activity, protein-protein interaction, Ca2+ homeostasis, inflammatory processes and intermediate filament polymerization. In addition, members of this family bind Zn2+ or Ca2+ with cooperative effect on binding. In this study, the gene sequence encoding porcine S100A12 was obtained by the synthetic gene approach using E. coli codon bias. Additionally, we report a thermodynamic study of the recombinant S100A12 using circular dichroism, fluorescence and isothermal titration calorimetry. The results of urea and temperature induced unfolding and refolding processes indicated a reversible two-state process. Also, the ANS fluorescence studies showed that in presence of divalent ions the protein exposes hydrophobic sites which could facilitate the interaction with other proteins and trigger the physiological responses.
Assuntos
Dobramento de Proteína , Proteínas S100/química , Proteínas S100/metabolismo , Suínos/metabolismo , Animais , Cálcio/química , Cálcio/metabolismo , Calorimetria , Dicroísmo Circular , Expressão Gênica , Concentração de Íons de Hidrogênio , Ligação Proteica , Desnaturação Proteica , Proteínas Recombinantes/química , Proteínas Recombinantes/classificação , Proteínas Recombinantes/isolamento & purificação , Proteínas Recombinantes/metabolismo , Proteínas S100/classificação , Proteínas S100/isolamento & purificação , Temperatura , Termodinâmica , Zinco/química , Zinco/metabolismoRESUMO
La poscosecha del banano se acompaña de múltiples reacciones enzimáticas, causantes de la degradación de almidones y clorofila, de la síntesis de azúcares y carotenos, y de los cambios en la acidez, ablandamiento de tejidos y pardeamiento enzimático. Este pardeamiento es causado por la acción de la Polifenol Oxidasa (PFO) sobre fenoles contenidos en el fruto y es considerado un cambio indeseable por el consumidor. Con el objeto de determinar el momento de mínima actividad enzimática para lograr su óptimo color, textura, actividad de agua, humedad y grados Brix, y luego se midió la cinética enzimática aprovechando la formación de color café durante el pardeamiento, empleando un espectrofotómetro de UV-visible a 420nm. También se cuantificó la cantidad de proteína (enzima) mediante el método de Bradford (lectura a 595nm). Una vez identificadas las cinéticas de cada estado de maduración, se hizo una comparación entre cada uno de los grupos mediante la técnica estadística de Análisis de Varianza con Medidas Repetidas en el tiempo, que mostró una marcada diferencia, estadísticamente significativa, entre los bananos de menor y mayor estado de maduración en forma decreciente, y se encontró el punto mínimo de actividad de la enzima en los estados más avanzados de maduración
Assuntos
Manipulação de Alimentos/métodos , Musa/enzimologiaRESUMO
En este trabajo la Deshidratación Osmótica (DO) y el secado con aire caliente se combinan para producir mango cristalizado conservando las propiedades organolépticas de la fruta fresca. El mango se procesa en cilindros de 1.5cm de diámetro por 2cm de altura. Estos se deshidratan osmóticamente durante 72 horas y luego se secan con aire a 35ºC hasta alcanzar concentraciones de 68 grados Brix (ºBx) y 72ºBx. El tratamiento se inicia con un pretratamiento osmótico (PO), utilizando soluciones de sacarosa a 25, 35, 45, 55 y 65ºBx, aplicando un pulso de vacío (50 mbar) durante 10 minutos, después del cual las muestras se mantienen durante 20 minutos más a presión atmosférica. A continuación, las muestras se sumergen en solución de 65ºBx y se mantienen a presión atmosférica, hasta alcanzar 72 horas de tratamiento total. De la misma manera, se trata otra muestra usando una concentración de sacarosa de 45ºBx durante todo el proceso. Se caracterizan las muestras secas analizando masa, volumen, humedad y sólidos solubles. Las pérdidas de masa y volumen son más bajas para las muestras que se tratan con 25, 45 y 65ºBx durante el pretratamiento osmótico. También se observa que a 25ºBx las muestras ganan una cantidad más alta de sólidos solubles al compararlas con el resto de las muestras mientras que la difusividad de agua durante el proceso de secado es mayor para las muestras tratadas en soluciones menos concentradas durante el pretratamiento osmótico
Assuntos
Amostras de Alimentos , Frutas , Conservação de AlimentosRESUMO
BACKGROUND: The role of the Autonomous Nervous System in the immunologic and inflammatory response is still an issue of discussion. Furthermore, the physiopathologic mechanisms involved are still unknown. Acute pancreatitis (AP) does not escape this disconcert. In fact, like in every severe acute inflammatory process, its discontrol could be responsible of the high morbidity and mortality rates. OBJECTIVE: To assess to which degree bilateral splanchnicectomy changes the course of acute inflammatory response in AP. METHOD: Prospective research. RESULTS: The following parameters were evaluated: red blood cell count, white blood cell count, calcium, glucemia, urea, aminase, lypase and liver enzymes. Macroscopy and microscopy views of the pancreas were also obtained. The leucocitary response was abolished, and the calcium levels dropped to a lesser degree. CONCLUSIONS: Bilateral splanchnicectomy prior to unchaining AP had a beneficial effect, Its mechanism of action could have been through the disconnection of the respective reflex arches
Assuntos
Animais , Pancreatite , Esplenectomia , Doença Aguda , Reação de Fase Aguda , Amilases , Glicemia , Cálcio , Colesterol , Contagem de Eritrócitos , Hematócrito , Contagem de Leucócitos , Lipase , Gambás , Pâncreas , Pancreatite , Fator de Necrose Tumoral alfaRESUMO
Interferon alfa (IFN-alpha) is the only approved treatment for chronic hepatitis B (HBV) infection. In a non-controlled study 33 pediatric patients infected with HBV and in chronic phase of the disease were included and treated with 3 to 5 x 10(6) IU/m2 body surface of Interferon alpha 2b, 3 times per week, during 4 months. The objective was to evaluate the efficacy of the treatment in terms of the histological, biochemical and viral markers evolution of the patients. The patients were evaluated carrying out determinations of alanine aminotransferase (ALAT), HBsAg and HBeAg before treatment, at the end of the treatment and every 4 months during one year of follow-up. Liver biopsy and Knodell index determination were carried out at the beginning and upon concluding the follow-up. 39.3% of the patients concluded the treatment with normal ALAT values; 7% became HBsAg negative and 14.3% became HBsAg negative. These values ascended after follow-up to 51.5%, 11% and 37.5% respectively. The histological analysis evidenced a decrease of the Knodell index in 69% of the patients, an increase in 14.2%, and 13.8% did not show variation. Correlating the biochemical and histological responses, a favorable outcome was obtained in 36.4% of the patients, evidencing a remarkable reduction of the hepatic cytolysis. The treatment was well tolerated, being the fever the most frequent adverse events. The results confirm that interferon alfa seems to be an effective treatment for children with chronic hepatitis B.
Assuntos
Antivirais/uso terapêutico , Hepatite B Crônica/tratamento farmacológico , Interferon-alfa/uso terapêutico , Alanina Transaminase/sangue , Criança , Feminino , Seguimentos , Antígenos de Superfície da Hepatite B/sangue , Antígenos E da Hepatite B/sangue , Hepatite B Crônica/patologia , Humanos , Interferon alfa-2 , Masculino , Proteínas Recombinantes , Estatísticas não Paramétricas , Resultado do TratamentoRESUMO
Interferon alfa (IFN-alpha) is the only approved treatment for chronic hepatitis B (HBV) infection. In a non-controlled study 33 pediatric patients infected with HBV and in chronic phase of the disease were included and treated with 3 to 5 x 10(6) IU/m2 body surface of Interferon alpha 2b, 3 times per week, during 4 months. The objective was to evaluate the efficacy of the treatment in terms of the histological, biochemical and viral markers evolution of the patients. The patients were evaluated carrying out determinations of alanine aminotransferase (ALAT), HBsAg and HBeAg before treatment, at the end of the treatment and every 4 months during one year of follow-up. Liver biopsy and Knodell index determination were carried out at the beginning and upon concluding the follow-up. 39.3% of the patients concluded the treatment with normal ALAT values; 7% became HBsAg negative and 14.3% became HBsAg negative. These values ascended after follow-up to 51.5%, 11% and 37.5% respectively. The histological analysis evidenced a decrease of the Knodell index in 69% of the patients, an increase in 14.2%, and 13.8% did not show variation. Correlating the biochemical and histological responses, a favorable outcome was obtained in 36.4% of the patients, evidencing a remarkable reduction of the hepatic cytolysis. The treatment was well tolerated, being the fever the most frequent adverse events. The results confirm that interferon alfa seems to be an effective treatment for children with chronic hepatitis B
Assuntos
Humanos , Masculino , Feminino , Criança , Antivirais , Hepatite B Crônica , Interferon-alfa , Alanina Transaminase , Seguimentos , Antígenos E da Hepatite B , Antígenos de Superfície da Hepatite B , Fígado , Estatísticas não Paramétricas , Resultado do TratamentoRESUMO
Interferon alfa (IFN-alpha) is the only approved treatment for chronic hepatitis B (HBV) infection. In a non-controlled study 33 pediatric patients infected with HBV and in chronic phase of the disease were included and treated with 3 to 5 x 10(6) IU/m2 body surface of Interferon alpha 2b, 3 times per week, during 4 months. The objective was to evaluate the efficacy of the treatment in terms of the histological, biochemical and viral markers evolution of the patients. The patients were evaluated carrying out determinations of alanine aminotransferase (ALAT), HBsAg and HBeAg before treatment, at the end of the treatment and every 4 months during one year of follow-up. Liver biopsy and Knodell index determination were carried out at the beginning and upon concluding the follow-up. 39.3% of the patients concluded the treatment with normal ALAT values; 7% became HBsAg negative and 14.3% became HBsAg negative. These values ascended after follow-up to 51.5%, 11% and 37.5% respectively. The histological analysis evidenced a decrease of the Knodell index in 69% of the patients, an increase in 14.2%, and 13.8% did not show variation. Correlating the biochemical and histological responses, a favorable outcome was obtained in 36.4% of the patients, evidencing a remarkable reduction of the hepatic cytolysis. The treatment was well tolerated, being the fever the most frequent adverse events. The results confirm that interferon alfa seems to be an effective treatment for children with chronic hepatitis B (AU)
Assuntos
Humanos , Masculino , Feminino , Criança , Interferon-alfa/uso terapêutico , Antivirais/uso terapêutico , Hepatite B Crônica/tratamento farmacológico , Seguimentos , Estatísticas não Paramétricas , Alanina Transaminase/sangue , Antígenos de Superfície da Hepatite B/sangue , Antígenos E da Hepatite B/sangue , Fígado/patologia , Resultado do TratamentoRESUMO
The authors present two patients, with poorly controlled temporal lobe epilepsy, who received transplants of omental tissue on the anterior perforated space and left temporal lobe. At present, 26 months after the operation, the first patient has improved about 85 percent; whereas the second patient has complete control of seizures nine months after the operation. These clinical results indicate that epileptic seizures can be reduced or aborted with this new surgical modality (reconstructive technique).
Assuntos
Epilepsia do Lobo Temporal/cirurgia , Omento/transplante , Adulto , Epilepsia do Lobo Temporal/diagnóstico por imagem , Feminino , Humanos , Masculino , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
BACKGROUND: The role of the Autonomous Nervous System in the immunologic and inflammatory response is still an issue of discussion. Furthermore, the physiopathologic mechanisms involved are still unknown. Acute pancreatitis (AP) does not escape this disconcert. In fact, like in every severe acute inflammatory process, its discontrol could be responsible of the high morbidity and mortality rates. OBJECTIVE: To assess to which degree bilateral splanchnicectomy changes the course of acute inflammatory response in AP. METHOD: Prospective research. RESULTS: The following parameters were evaluated: red blood cell count, white blood cell count, calcium, glucemia, urea, aminase, lypase and liver enzymes. Macroscopy and microscopy views of the pancreas were also obtained. The leucocitary response was abolished, and the calcium levels dropped to a lesser degree. CONCLUSIONS: Bilateral splanchnicectomy prior to unchaining AP had a beneficial effect, Its mechanism of action could have been through the disconnection of the respective reflex arches.