RESUMO

Twelve multi-functional pyrrolizidinones, indolizidinones and pyrroliazepinones were prepared from formal aza-[3 + 2] and aza-[3 + 3] cycloadditions of five- to seven-membered heterocyclic enaminones as diverse ambident electrophiles. The antitumor activity of these alkaloid-like compounds was investigated through an initial screening performed on human glioblastoma multiform (GBM) cell lines (GL-15, U251), on murine glioma cells line (C6) and on normal glial cells. Of the compounds tested, the new pyrrolo[1,2a]azepinone, [ethyl (3-oxo-1,2-diphenyl-6,7,8,9-tetrahydro-3H-pyrrolo[1,2a]azepin-9a(5H)-yl)acetate] or (Compound-13) exhibited selective cytotoxic effects on GBM-temozolomide resistant cells. Compound-13 exerted dose-dependent cytotoxic activity by promoting arrest of cells in the G0/G1 phase of the cell cycle in the first 24 h. The apoptotic effect observed was in a time-dependent manner. Anti-migratory effect promoted by the treatment with compound-13 was also observed. Moreover, healthy mixed glial cell cultures from rat brain exhibited no cytotoxicity effect upon exposure to compound-13. Thus, the present study paves the way for the use of compound-13 as novel antitumor scaffold candidate for glioma cell therapy.

Assuntos

RESUMO

OBJECTIVE: To estimate the human resources and services needed to meet the demand of the Brazilian population who would benefit from palliative care, based on the population growth projection for 2040. METHODS: Population and mortality estimates and projections were obtained from the Brazilian Institute of Geography and Statistics. Service needs were estimated based on literature data. RESULTS: The expected increase in the Brazilian population for 2000-2040 is 31.5%. The minimum estimate of patients with palliative care needs was 662,065 in 2000 and 1,166,279 in 2040. The staff required for each hundred thousand inhabitants would increase from 1,734 to 2,282, the number of doctors needed would increase from 4,470 to 6,274, and the number of nurses from 8,586 to 11,294, for the same period. CONCLUSION: The definition of a national strategy predicting the increasing palliative care needs of the population is necessary. The expansion of the support network for chronic and non-transmissible diseases is necessary, but the training of existing human resources at all levels of attention to perform palliative actions can be a feasible alternative to minimize the suffering of the population.

Assuntos

RESUMO

SUMMARY OBJECTIVE: To estimate the human resources and services needed to meet the demand of the Brazilian population who would benefit from palliative care, based on the population growth projection for 2040. METHODS: Population and mortality estimates and projections were obtained from the Brazilian Institute of Geography and Statistics. Service needs were estimated based on literature data. RESULTS: The expected increase in the Brazilian population for 2000-2040 is 31.5%. The minimum estimate of patients with palliative care needs was 662,065 in 2000 and 1,166,279 in 2040. The staff required for each hundred thousand inhabitants would increase from 1,734 to 2,282, the number of doctors needed would increase from 4,470 to 6,274, and the number of nurses from 8,586 to 11,294, for the same period. CONCLUSION: The definition of a national strategy predicting the increasing palliative care needs of the population is necessary. The expansion of the support network for chronic and non-transmissible diseases is necessary, but the training of existing human resources at all levels of attention to perform palliative actions can be a feasible alternative to minimize the suffering of the population.

RESUMO OBJETIVO: Estimar as necessidades de recursos humanos e serviços necessários para o atendimento de pacientes que se beneficiariam de cuidados paliativos a partir da projeção de crescimento da população brasileira até 2040. MÉTODO: As estimativas e projeções populacionais e de mortalidade foram obtidas nos dados do Instituto Brasileiro de Geografia e Estatística e do Sistema Único de Saúde. As estimativas de estrutura de serviços e recursos humanos foram realizadas a partir de dados da literatura. RESULTADOS: A expectativa de aumento da população brasileira entre 2000 e 2040 é de 31,5%. A estimativa mínima de pacientes com necessidades de cuidados paliativos foi de 662.065 em 2000 e é de 1.166.279 em 2040. O número de equipes necessárias para cada 100 mil habitantes passaria de 1.734 para 2.282 no mesmo período; o número de médicos foi de 4.770 para 6.274 e o número de enfermeiros necessários para atender as demandas dessa população foi de 8.586 para 11.294 nesse espaço de tempo. CONCLUSÃO: A definição de uma estratégia nacional prevendo a necessidade de cuidados crescentes da população se torna necessária. A expansão da rede de assistência a doenças crônicas e não transmissíveis se mostra necessária, porém a capacitação de recursos humanos já existentes em todos os níveis de atenção para desempenhar ações paliativas pode ser uma alternativa factível para minimizar o sofrimento da população.

Assuntos

Assuntos

RESUMO

BACKGROUND: Many dialysis patients do not have the necessary conditions for construction of a native arteriovenous fistula (AVF). Expanded Polytetrafluoroethylene (ePTFE) vascular prostheses are the most widely-used option, but it is known that they are inferior to native vein AVFs. OBJECTIVES: To identify a graft with superior performance to ePTFE, comparing their results with those of AVFs made from bovine mesenteric arteries treated with L-Hydro technology (Labcor Laboratories ®). METHODS: A prospective and controlled study of 10 patients with AVFs constructed with ePTFE and 10 patients with L-Hydro bioprostheses, matched for comorbidities. The variables studied were: primary patency, assisted primary patency, and secondary patency, surgical manipulability, and prevalence of infections. The performance of prostheses was assessed by duplex-scan and repeated consultations with health professionals at hemodialysis clinics. The chi-square test was used for statistical analysis. RESULTS: After 1 year of postoperative follow-up, secondary and primary patency rates were higher for L-Hydro than ePTFE AVFs. Fewer interventions were needed to maintain AVF patency in the L-Hydro AVF group. The most common complication was graft thrombosis, which was more frequent in the ePTFE group. While the figures indicate more favorable outcomes in the L-Hydro AVFs, this could not be confirmed with the statistical treatment employed. CONCLUSIONS: The L-Hydro graft appears to be a valuable alternative option for AVFs, since it seems to require fewer interventions to maintain patency when compared to ePTFE grafts.

RESUMO

Os aneurismas venosos são raros, porém causam complicações tromboembólicas. Na maioria das vezes, são encontrados como achados de exame físico ou de imagem. Os aneurismas sintomáticos de veia poplítea são tratados por reparo cirúrgico, devido ao alto risco de recorrência de embolia pulmonar. A técnica mais utilizada é a aneurismectomia tangencial com venorrafia lateral. Na impossibilidade de se empregar esta técnica, faz-se a ressecção com reconstrução venosa. Os autores relatam o caso de uma paciente com aneurisma de veia poplítea, cujo diâmetro era de 44 mm, submetida à aneurismectomia tangencial e venorrafia lateral, com sucesso.

Venous aneurysms are rare; however, they are potential causes of thromboembolism. Most cases are found as clinical examination or by imaging methods. Symptomatic aneurysms of the popliteal vein are treated by surgical repair due to the high risk of recurrent pulmonary embolism. The most widely used procedure is tangential aneurysmectomy and lateral venorrhaphy. If this technique is not possible, the aneurysm should be removed and venous reconstruction should be performed. The authors report the case of a patient with popliteal vein aneurysm measuring 44 mm in diameter which was successfully treated by tangential aneurysmectomy and lateral venorrhaphy.

Assuntos

RESUMO

Este trabalho avaliou a evolução e os custos do tratamento de lesões de dermatite digital, em bovinos da raça Girolando submetidos a diferentes protocolos terapêuticos, empregando 42 fêmeas portadoras da enfermidade, em duas propriedades rurais. Em cada propriedade, os animais foram distribuídos em três grupos (GI, GII, e GIII) de sete animais cada, sendo 21 oriundos da propriedade A e os demais da propriedade B. Os animais do GI receberam antibioticoterapia parenteral, as feridas cirúrgicas tratadas com medicamento local e, após sete dias, passagem em pedilúvio contendo solução de sulfato de cobre a 3 por cento, intercalando-se, semanalmente, com solução de hipoclorito de sódio a 1 por cento. Nos animais de GII as feridas cirúrgicas foram apenas protegidas com algodão ortopédico e ataduras de crepom. A partir do sétimo dia da intervenção cirúrgica, foram submetidos ao mesmo manejo do GI. Nos bovinos do grupo GIII (controle), sete dias após tratamento cirúrgico, procedeu-se à retirada da atadura e passagem em pedilúvio contendo apenas água. Os animais foram avaliados com 7, 15, 30, 45 e 60 dias do pós-operatório, utilizando escores clínicos de cicatrização como parâmetros da evolução clínica das feridas cirúrgicas. Estimou-se os custos dos procedimentos baseando-se no material de consumo e mão-de-obra, entre outros. Observou-se maior número de animais recuperados no GI, mas não houve diferença estatística (p>0,05) quando comparados aos animais do GII, sendo os protocolos terapêuticos I e II apresentando a mesma eficácia. Apenas o tratamento cirúrgico não foi suficiente para recuperar os animais do GIII. O custo estimado, em dólares, por animal foi de US$ 69,41 para o tratamento GI, US$ 54,02 para o GII e US$ 51,96 para o GIII.

The scope of this study was to evaluate the response of early phase digital dermatitis wounds to different therapeutic protocols, in Gir breed cattle in two distinct farms subjected to the same management, and also to estimate the costs of the treatments proposed. The study was conducted simultaneously during the period of april 2004 and april 2005, in 42 female cattle bearing wounds clinically characteristic of early phase digital dermatitis. The animals were allocated in three groups (GI, GII, GIII) of seven animals, where 21 were from farm A, and the remaining from farm B. Animals of group one (GI) received parenteral antibiotic therapy, and their surgical wounds were treated with a local treatment protocol, and when the bandage was removed, on the seventh day, they passed in a footbath with three-percent copper solution, weekly and intercalated to a one-percent sodium hypochlorite solution. Animals from group two (GII) did not receive local or parenteral antibiotic therapy, having their surgical wounds protected with orthopedic cotton and bandage right after curettage, then being subjected to the same management of GI. The animals of group three (GIII) constituted the control group, therefore receiving neither local nor parenteral antibiotic therapy, and after the seventh day, after removing the bandage, passed in a footbath water only...

Assuntos

RESUMO

Este trabalho tem o objetivo de demonstrar como o bom uso das informações cadastrais, tanto de hospitais como dos pacientes, podem ajudar os gestores de saúde a fazer o bom uso na distribuição de recursos e na ajuda a tomada de decisões sobre como distribuir melhor a sua rede assistencial de saúde. Com isso, espera-se demonstrar como o paciente do bairro de Campo Grande no Rio de Janeiro, tem que se deslocar parra outros bairros para terem acesso a uma rede mais especializada de saúde

Assuntos