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RESUMO As doenças do fígado e das vias biliares são causas comuns de morbidade e mortalidade. Procedimentos invasivos com finalidade diagnóstica e terapêutica são frequentemente recomendados nos casos de doenças hepatobiliares. O reconhecimento das indicações e limitações das técnicas comumente empregadas é crucial para uma adequada seleção dos pacientes, maximizando os resultados positivos e reduzindo o risco de complicações. Em 2018, a Sociedade Brasileira de Hepatologia (SBH), em colaboração com a Sociedade Brasileira de Radiologia Intervencionista e Cirurgia Endovascular (SOBRICE) e a Sociedade Brasileira de Endoscopia Digestiva (SOBED) realizaram um encontro exclusivamente voltado para a discussão dos procedimentos invasivos nas doenças hepatobiliares. Este texto resume as principais recomendações discutidas durante o evento, e tem a intenção de auxiliar clínicos, gastroenterologistas, hepatologistas, radiologistas e endoscopistas no uso adequado dos procedimentos invasivos para manejo de pacientes com doenças hepatobiliares.

ABSTRACT Liver and biliary tract diseases are common causes of morbidity and mortality worldwide. Invasive procedures are usually performed in those patients with hepatobiliary diseases for both diagnostic and therapeutic purposes. Defining proper indications and restraints of commonly used techniques is crucial for proper patient selection, maximizing positive results and limiting complications. In 2018, the Brazilian Society of Hepatology (SBH) in cooperation with the Brazilian Society of Interventional Radiology and Endovascular surgery (SOBRICE) and the Brazilian Society of Digestive Endoscopy (SOBED) sponsored a joint single-topic meeting on invasive procedures in patients with hepatobiliary diseases. This paper summarizes the proceedings of the aforementioned meeting. It is intended to guide clinicians, gastroenterologists, hepatologists, radiologists, and endoscopists for the proper use of invasive procedures for management of patients with hepatobiliary diseases.

https://doi.org/10.1590/s0004-2803.201900000-42 2181 downloads

Land use dynamics in the Brazilian Cerrado in the period from 2002 to 2013
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Sano, Edson Eyi

; Rosa, Roberto

; Scaramuzza, Carlos Alberto de Mattos

; Adami, Marcos

; Bolfe, Edson Luis

; Coutinho, Alexandre Camargo

; Esquerdo, Júlio César Dalla Mora

; Maurano, Luís Eduardo Pinheiro

; Narvaes, Igor da Silva

; Oliveira Filho, Francisco José Barbosa de

; Silva, Elaine Barbosa da

; Victoria, Daniel de Castro

; Ferreira, Laerte Guimarães

; Brito, Jorge Luís Silva

; Bayma, Adriana Panhol

; Oliveira, Gustavo Henrique de

; Bayma-Silva, Gustavo

Pesquisa Agropecuária Brasileira

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2019, Volume 54 elocation e00138

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo: O objetivo deste trabalho foi analisar a dinâmica de uso das terras na região do Cerrado de 2002 a 2013. Essa análise foi baseada nas interpretações de imagens do satélite Landsat realizadas pelo Projeto de Conservação e Utilização Sustentável da Diversidade Biológica Brasileira (Probio) e pelo projeto TerraClass Cerrado 2013, coordenados pelo Ministério do Meio Ambiente. Em 2002, 38,9% do Cerrado eram cobertos por algum tipo de atividade antrópica. Em 2013, essa percentagem passou para 43,4%. Um dos grandes destaques é o surgimento de uma nova fronteira agrícola na região norte da área de estudo, conhecida como Matopiba.

Abstract: The objective of this work was to analyze land use dynamics in the Brazilian Cerrado region from 2002 to 2013. This analysis was based on the interpretation of Landsat satellite images carried out by the projects Projeto de Conservação e Utilização Sustentável da Diversidade Biológica Brasileira (Probio) and TerraClass Cerrado 2013, both coordinated by Ministério do Meio Ambiente. In 2002, 38.9% of the Cerrado was covered by some type of anthropic activity. In 2013, this percentage increased to 43.4%. One of the main highlights is the emergence of a new agricultural frontier in the northern region of the study area, known as Matopiba.

https://doi.org/10.1590/s1678-3921.pab2019.v54.00138 1955 downloads

Laparoscopic resection of prescral and obturator fossa schwannoma
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Tobias-Machado, Marcos

; Hidaka, Alexandre Kiyoshi

; Sato, Letícia Lumy Kanawa

; Silva, Igor Nunes

; Mattos, Pablo Aloisio Lima

; Pompeo, Antonio Carlos Lima

International braz j urol

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jun 2017, Volume 43 N. 3 Pages 566 - 566

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction Pelvic Schwannoma is an extremely rare event. Laparoscopic approach for radical resection on pelvic region already has been described in the literature. However, with better image quality provided by optic in the laparoscopy we can assure an improvement in this kind of approach for tumor resection. Objective Our goal is to describe and evaluate the results of one laparoscopic resection of presacral and obturator fossa tumor. Materials and Methods We present a case of a 60-year-old man with progressive congestion in the right inferior member and CT scan revealing a mass with miscellaneous content located behind of the right iliac vessels and right obturator nerve. Exploratory transperitoneal laparoscopy was indicated. During laparoscopy it was possible to see the mass between the spermatic cord and external iliac artery. We made the identification and preservation of iliac vessels and obturator nerve. Resection of the tumor was performed carefully, allowing the safe removal of the specimen with complete preservation of the iliac vessels and obturator nerve. Results Mean operative time of 150 minutes. No perioperative complications occurred. Two days of hospital stay. Posterior histopathological exam confirmed that the mass was a Schwannoma. Conclusion The maximization of the image in the laparoscopic surgery offers dexterity and capacity of dissection required for complex mass dissection on pelvic region.

https://doi.org/10.1590/s1677-5538.ibju.2015.0091 568 downloads

Plasma rico em plaquetas: estudo comparativo entre a dupla centrifugação e o filtro E-PET (Equine Platelet Enhancement Therapy)
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Conceição, Mariana L.

; Alvarenga, Marina L.

; Souza, Jaqueline B.

; Mattos, Luiz Henrique L.

; Rodrigues, Celso A.

; Watanabe, Marcos J.

; Hussni, Carlos Alberto

; Alves, Ana Liz G.

Pesquisa Veterinária Brasileira

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mar 2017, Volume 37 N. 3 Pages 215 - 220

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO: O plasma rico em plaquetas (PRP) consiste em uma alta concentração de plaquetas em um pequeno volume de plasma, sendo, em média, quatro vezes maior que a concentração sérica. O uso de PRP é justificado pela alta concentração de fatores de crescimento presentes em grânulos no interior das plaquetas, que possuem diversas funções como proliferação celular, quimiotaxia, angiogênese e diferenciação celular, que ampliam o poder de reparação tecidual. Há diversos protocolos para obtenção do PRP em equinos descritos na literatura, dentre os quais destacam-se os de dupla centrifugação, os automatizados e os filtros. Há diferenças substanciais no conteúdo do PRP dependendo do seu método de obtenção, principalmente no que se diz respeito à quantidade de leucócitos, plaquetas e concentração de fatores de crescimento. Sendo assim, o objetivo deste estudo foi comparar a utilização do concentrado de plaquetas obtido por protocolo de dupla centrifugação e o obtido pelo filtro E-PET (Equine Platelet Enhancement Therapy), levando-se em consideração a concentração plaquetária e leucocitária final, a quantificação de fatores de crescimento (TGFβ e PDGF-BB) e a facilidade de realização entre tais métodos. Utilizou-se nove animais para a obtenção de PRP por dupla centrifugação e através do filtro E-PET, não havendo diferença estatística (p>0,05) entre os métodos de obtenção em relação à concentração plaquetária e leucocitária, entretanto, houve diferença estatística (p=0,002; p=0,004, respectivamente) em relação a concentração de TGFβ e PDGF-BB. Dessa forma, concluiu-se que o filtro E-PET mostrou-se um método mais efetivo, sendo possível sua utilização à campo, além de proporcionar uma maior concentração de fatores de crescimento TGFβ e PDGF-BB.

ABSTRACT: The platelet-rich plasma (PRP) consists of a high concentration of platelets in a small volume of plasma, four times greater (average) than the serum concentration. The use of PRP is justified by the high concentration of growth factors present in granules in the platelets, which have several functions such as cell proliferation, chemotaxis, angiogenesis and differenciation, which extend the power of tissue repair. There are several protocols to obtain PRP in horses described in the literature, among which are highlighted the double centrifugation, automated and filters. There are substantial differences in the PRP content depending on its method of production, especially when it concerns the amount of leukocytes, platelets and concentration of growth factors. Thus, the aim of this study was to compare the use of platelet concentrates obtained by double centrifugation protocol and obtained by the filter E-PET (Equine Platelet Enhancement Therapy) taking into account the platelet and leukocyte final concentration, the quantification of growth factors (TGFβ and PDGF-BB) and the facility to do those methods. Nine horses were used to obtain PRP by double centrifugation and through the E-PET filter, with no statistical difference (p>0.05) between the methods relative to the platelet and leukocyte concentration; however, there was statistical difference (p=0.002 and p=0.004 respectively) compared with the concentration of TGFβ and PDGF-BB. It was concluded that the E-PET filter proved to be a more effective method possible to use in the field and to provide a higher concentration of growth factors (TGFβ and PDGF-BB).

https://doi.org/10.1590/s0100-736x2017000300003 2133 downloads

Transanal Minimally Invasive Surgery (TAMIS) to Treat Vesicorectal Fistula: A New Approach
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Tobias-Machado, Marcos

; Mattos, Pablo Aloisio Lima

; Reis, Leonardo Oliveira

; Juliano, César Augusto Braz

; Pompeo, Antonio Carlos Lima

International braz j urol

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oct 2015, Volume 41 N. 5 Pages 1020 - 1026

Abstract: En | Text: En | PDF: En

ABSTRACT Purpose: Vesicorectal fistula is one of the most devastating postoperative complications after radical prostatectomy. Definitive treatment is difficult due to morbidity and recurrence. Despite many options, there is not an unanimous accepted approach. This article aimed to report a new minimally invasive approach as an option to reconstructive surgery. Materials and Methods: We report on Transanal Minimally Invasive Surgery (TAMIS) with miniLap devices for instrumentation in a 65 year old patient presenting with vesicorectal fistula after radical prostatectomy. We used Alexis® device for transanal access and 3, 5 and 11 mm triangulated ports for the procedure. The surgical steps were as follows: cystoscopy and implant of guide wire through fistula; patient at jack-knife position; transanal access; Identification of the fistula; dissection; vesical wall closure; injection of fibrin glue in defect; rectal wall closure. Results: The operative time was 240 minutes, with 120 minutes for reconstruction. No perioperative complications or conversion were observed. Hospital stay was two days and catheters were removed at four weeks. No recurrence was observed. Conclusions: This approach has low morbidity and is feasible. The main difficulties consisted in maintaining luminal dilation, instrumental manipulation and suturing.

https://doi.org/10.1590/S1677-5538.IBJU.2014.0002 2008 downloads

Desenvolvimento da metodologia para síntese do poli(ácido lático-co-ácido glicólico) para utilização na produção de fontes radioativas
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Peleias Junior, Fernando dos Santos

; Zeituni, Carlos Alberto

; Rostelato, Maria Elisa Chuery Martins

; Fechine, Guilhermino José Macêdo

; Souza, Carla Daruich de

; Mattos, Fábio Rodrigues de

; Santana de Moura, Eduardo

; Moura, João Augusto

; Benega, Marcos Antônio Gimenes

; Feher, Anselmo

; Costa, Osvaldo Luiz da

; Rodrigues, Bruna Teiga

Polímeros

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jun 2015, Volume 25 N. 3 Pages 317 - 325

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

<title>Resumo</title><p>A Organização Mundial da Saúde (OMS) relata o câncer como uma das principais causas de morte no mundo. Uma modalidade de tratamento que vem sendo bastante utilizada no tratamento do câncer de próstata é a braquiterapia, que consiste na introdução de sementes com material radioativo no interior do orgão. Sementes de Iodo-125 podem ser inseridas soltas ou em cordas poliméricas fabricadas a partir do (poli(ácido lático-co-ácido glicólico)) (PLGA). Foi proposto neste trabalho, o estudo e desenvolvimento da metodologia de síntese do biopolímero PLGA. Os resultados obtidos demonstram que, através da metodologia utilizada, foi possível determinar os melhores parâmetros de reação (tempo e temperatura) para o PLGA na proporção 80/20 (lactídeo/glicolídeo). Com uma temperatura de 110 °C e tempo de reação 72h o rendimento da reação é superior a 90%. Os valores de massas moleculares obtidas entre os testes, ainda são baixos quando comparados com os valores obtidos por outros autores na literatura. Novos testes estão sendo conduzidos, utilizando dímeros preparados no laboratório. Testes substituindo o vácuo por uma atmosfera de nitrogênio também estão sendo realizados. Essas duas substituições podem aumentar o valor final da massa molecular do polímero. Em relação à caracterização, as técnicas utilizadas confirmaram a estrutura esperada do polímero.</p>

<title>Abstract</title><p>According to the World Health Organization, cancer is a leading cause of death worldwide. A radiotherapy method extensively used in prostate cancer is brachytherapy, where the area requiring treatment receives radioactive seeds. Iodine-125 seeds can be inserted loose or stranded in bioabsorbable polymers produced from poly(lactic-co-glycolic acid) (PLGA). We developed the synthesis methodology for PLGA and the results obtained show that it was possible to determine the optimal reaction parameters (time and temperature) for PLGA in 80/20 (lactide/glycolide) ratio. The yield was higher than 90% using a temperature of 110 °C and reaction time of 72 hours; however, the molecular weight values obtained are very low compared to those obtained by other authors. New tests using previously synthesized dimers and nitrogen atmosphere are being performed. These conditions could potentially increase the molar mass of PLGA. All techniques used confirmed the expected structure of the polymer.</p>

https://doi.org/10.1590/0104-1428.1428 2689 downloads

10.

Zingiber officinale (GENGIBRE) COMO FONTE ENZIMÁTICA NA REDUÇÃO DE COMPOSTOS CARBONÍLICOS
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Alves, Leonardo A.

; Bertini, Luciana M.

; Bizerra, Ayla Márcia C.

; Mattos, Marcos Carlos de

; Monte, Francisco José Q.

; Lemos, Telma L. G.

Química Nova

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may 2015, Volume 38 N. 4 Pages 483 - 487

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Various vegetables as biological catalysts were evaluated in enantioselective reduction of carbonyl compounds. The stereoselectivity of the process was in agreement with Prelog's rule for twelve of the vegetables, whereas okra and green peppers formed anti-Prelog products. Zingiber officinale exhibited the best results with 30% conversion and 89% ee. The parameters of the reaction such as time, solvent and other substrates investigated, as well as the specie, showed good chemo- and enantioselectivity.

https://doi.org/10.5935/0100-4042.20150028 2902 downloads

11.

Laparoscopic Treatment of Vesicovaginal Fistula
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Tobias-Machado, Marcos

; Mattos, Pablo Aloisio Lima

; Castro, Pedro Romanelli de

; Nishimoto, Ricardo Hissashi

; Pompeo, Antonio Carlos Lima

International braz j urol

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jun 2014, Volume 40 N. 3 Pages 435 - 436

Abstract: En | Text: En | PDF: En

Introduction Vesicovaginal fistula is a rare disease with great impact for the patients. Laparoscopic repair can be an interesting option in selected cases with goods results but few experience is reported.Objectives Detailed demonstration of our laparoscopic vesicovaginal fistula repair technique. Initial results for ten patients are provided Methods: We treated all cases by the same technique. The surgical steps were: Patient positioning in Lloyd-Davis; Cystoscopy and implant of guide wire on fistula and ureteral catheters (that was removed after procedure); Transperitoneal access and 4 or 5 ports in V or W shape; Opening the bladder wall; Dissection between bladder and vagina for tension free repair; Fistula resection; Vagina repair with Vicryl 3-0; Bladder repair with Vicryl 3-0; Peritoneum/omentum interposition; Positioning 20 Fr urethral catheter.Results Mean age was 50 years. Mean number of fistulas was 1,2. The most common etiology was gynecologic surgery (7). Mean operative time was 2,5 (1,8-3,2) hours. Mean blood loss was 150 (100-200)mL. Complication rate was 10% (one case of urinary infection treated conservatively). Mean hospital stay was 1,2 (1-2) days. Mean return to normal and activities was 20 (15-30) days. For nine patients mean sexual intercourse time was 3 (1-6) months. Success rate after 1 year was 90% (one case of recurrence in patient with previous radiotherapy). Mean follow-up was 36 (12-60) months.Conclusions Laparoscopic repair is feasible, reproducible and present all advantages of minimally invasive surgical procedure. Long term results are similar to conventional open approaches.

https://doi.org/10.1590/S1677-5538.IBJU.2014.03.23 1337 downloads

12.

Transluminal approaches to vesicorectal fistula repair
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Tobias-Machado, Marcos

; Mattos, Pablo Aloisio Lima

; Juliano, Cesar Augusto Braz

; Costa Jr, Renato Meirelles Mariano da

; Juliano, Roberto Vaz

; Pompeo, Antonio Carlos Lima

International braz j urol

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apr 2014, Volume 40 N. 2 Pages 283 - 284

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/S1677-5538.IBJU.2014.02.23 6922 downloads

13.

Aplicação do método de irradiação tridimensional no monitoramento de barragens
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Siguel, Alyne Raminelli

; Faggion, Pedro Luis

; Veiga, Luís Augusto Koenig

; Nadal, Carlos Aurélio

; Mattos, Marcelo da Silva

; Soares, Marcos Alberto

Boletim de Ciências Geodésicas

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sep 2013, Volume 19 N. 3 Pages 391 - 406

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Com a finalidade de verificar a estabilidade de pontos de monitoramento previamente selecionados e materializados a jusante da barragem da usina hidrelétrica Mauá, localizada no rio Tibagi, entre os municípios de Ortigueira e Telêmaco Borba, estado do Paraná, aplicou-se o método de irradiação topográfica tridimensional para determinar suas coordenadas. O estudo do comportamento se dá pela comparação das coordenadas dos pontos obtidas entre duas ou mais épocas distintas. Para isso, estabeleceu-se uma rede geodésica materializada por meio de pilares de concreto, dotados de um sistema de centragem forçada e construídos de forma que a fundação alcançasse a rocha da região. Estes, foram monitorados através de técnicas GNSS onde constatou-se sua estabilidade, servindo então como referência para o monitoramento dos pontos irradiados. Após distintas campanhas de levantamentos, realizadas antes e durante a formação do reservatório, utilizou-se um aplicativo em ambiente MatLab, desenvolvido para as finalidades deste projeto, onde são feitas análises e correções nos dados obtidos. Posteriormente, são calculadas as coordenadas tridimensionais dos pontos monitorados. Como resultados apresentam-se a variação das coordenadas utilizando-se a primeira campanha de levantamento, efetuada antes do início da formação do reservatório, como referência.

In order to check the stability of monitored points previously selected and materialized downstream of the Mauá hydroelectric plant dam, located in Tibagi river, between the cities of Ortigueira and Telêmaco Borba, state of Paraná, the 3D irradiation topographic method was held to determine the coordinates of these points. The study of the monitored point behavior is given by the comparison of their coordinates, between two or more distinct epochs. For this, it was established a geodetic network materialized by concrete pillars, equipped with a system of forced centering and constructed so that the foundation reached the rocks of the region. These were monitored using GNSS techniques where it was found stability, then serving as reference for monitoring points irradiated. After different surveys campaigns carried out before and during the formation of the reservoir, it was used an application in MatLab environment, developed for the purpose of this project, where analyses and corrections were done in the data obtained. Thereafter, the three-dimensional coordinates from monitored points were calculated. The results show the variation of the coordinates using the first campaign of surveying, made before the reservoir formation, as a reference.

https://doi.org/10.1590/S1982-21702013000300003 4503 downloads

14.

The cost of type 1 diabetes: a nationwide multicentre study in Brazil
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Cobas, Roberta Arnoldi

; Ferraz, Marcos Bosi

; Matheus, Alessandra Saldanha de Mattos

; Tannus, Lucianne Righeti Monteiro

; Negrato, Carlos Antonio

; Araujo, Luiz Antonio de

; Dib, Sergio Atala

; Gomes, Marilia Brito

Bulletin of the World Health Organization

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jun 2013, Volume 91 N. 6 Pages 434 - 440

Abstract: En Es Fr | Text: En Es Fr | PDF: En | PDF: Es | PDF: Fr

OBJECTIVE: To determine the direct medical costs of type 1 diabetes mellitus (T1DM) to the National Brazilian Health-Care System (NBHCS) and quantify the contribution of each individual component to the total cost. METHODS: A retrospective, cross-sectional, nationwide multicentre study was conducted between 2008 and 2010 in 28 public clinics in 20 Brazilian cities. The study included 3180 patients with T1DM (mean age 22 years ± 11.8) who were surveyed while receiving health care from the NBHCS. The mean duration of their diabetes was 10.3 years (± 8.0). The costs of tests and medical procedures, insulin pumps, and supplies for administration, and supplies for self-monitoring of blood glucose (SMBG) were obtained from national and local health system sources for 2010-2011. Annual direct medical costs were derived by adding the costs of medications, supplies, tests, medical consultations, procedures and hospitalizations over the year preceding the interview. FINDINGS: The average annual direct medical cost per capita was 1319.15 United States dollars (US$). Treatment-related expenditure - US$ 1216.33 per patient per year - represented 92.20% of total direct medical costs. Insulin administration supplies and SMBG (US$ 696.78 per patient per year) accounted for 52.82% of these total costs. Together, medical procedures and haemodialysis accounted for 5.73% (US$ 75.64 per patient per year) of direct medical costs. Consultations accounted for 1.94% of direct medical costs (US$ 25.62 per patient per year). CONCLUSION: Health technologies accounted for most direct medical costs of T1DM. These data can serve to reassess the distribution of resources for managing T1DM in Brazil's public health-care system.

OBJETIVO: Determinar los costes médicos directos de la diabetes mellitus de tipo 1 (DMT1) para el sistema nacional brasileño de atención sanitaria (NBHCS, según sus siglas en inglés) y cuantificar la contribución de cada componente individual al coste total. MÉTODOS: Se llevó a cabo un estudio multicéntrico retrospectivo transversal a nivel nacional entre los años 2008 y 2010 en 28 clínicas públicas de 20 ciudades brasileñas. El estudio incluyó 3180 pacientes con DMT1 (edad media de 22 años ± 11,8), que fueron entrevistados mientras recibían atención sanitaria del NBHCS. La duración media de su diabetes fue de 10,3 años (± 8,0). Los costes de las pruebas y procedimientos médicos, las bombas de insulina y provisiones para la administración, así como suministros para la automonitorización de la glucosa en sangre (AMG) se obtuvieron de las fuentes de los sistemas de salud nacionales y locales para el periodo 2010-2011. Los costes médicos directos anuales se obtuvieron sumando los costes de los medicamentos, suministros, pruebas, consultas y procedimientos médicos y hospitalizaciones durante el año anterior a la entrevista. RESULTADOS: El coste medio directo anual por cápita fue de 1319,15 dólares americanos (US$). Los gastos relacionados con el tratamiento, US$ 1216,33 por paciente y año, representaron el 92,20% del total de los costes médicos directos. Los suministros para la administración de insulina y la AMG (US$ 696,78 por paciente y año) significaron el 52,82% de esos costes totales. En conjunto, los procedimientos médicos y la hemodiálisis representaron el 5,73% (US$ 75,64 por paciente y año) de los costes médicos directos. Las consultas fueron el 1,94% de los costes médicos directos (US$ 25,62 por paciente y año). CONCLUSIÓN: Las tecnologías sanitarias representaron la mayoría de los costes médicos directos de la DMT1. Estos datos pueden servir para volver a examinar la distribución de los recursos para la gestión de la diabetes de tipo 1 en el sistema de salud pública de Brasil.

OBJECTIF: Déterminer les coûts médicaux directs du diabète gras de type 1 (DT1) pour le système de santé national brésilien (SSNB) et quantifier la contribution de chaque composante individuelle au coût total. MÉTHODES: Une étude rétrospective, transversale, multicentrique et à l'échelle nationale a été menée entre 2008 et 2010 dans 28 cliniques publiques de 20 villes brésiliennes. Cette étude incluait 3180 patients atteints de DT1 (moyenne d'âge de 22 ans ± 11,8) qui ont été interrogés alors qu'ils étaient pris en charge par le SSNB. En moyenne, ils étaient atteints par la maladie depuis 10,3 ans (± 8). Les coûts des tests et des interventions médicales, des pompes à insuline et des équipements pour son administration, ainsi que des fournitures pour l'autosurveillance du taux de glycémie (ASTG) ont été obtenus à partir de sources provenant du système de santé national et local sur 2010-2011. Les coûts médicaux directs annuels ont été calculés en ajoutant les coûts des médicaments, des fournitures, des consultations médicales, des interventions et des hospitalisations au cours de l'année précédant l'enquête. RÉSULTATS: La moyenne du coût médical direct annuel par habitant s'élevait à 1319,15 dollars. Les dépenses liées au traitement - 1216,33 dollars par patient et par an -ont représenté 92,20% du total des coûts médicaux directs. L'équipement nécessaire à l'administration d'insuline et à l'ASTG (696,78 dollars par patient et par an) a totalisé 52,82% du total de ces coûts. Dans l'ensemble, les interventions médicales et l'hémodialyse ont représenté 5,73% (75,64 dollars par patient et par an) des coûts médicaux directs, et les consultations ont représenté 1,94% de ces mêmes coûts (25,62 dollars par patient et par an). CONCLUSION: Les technologies de la santé ont constitué la majeure partie des coûts médicaux directs du DT1. Ces données peuvent être utilisées pour réévaluer la distribution des ressources pour la prise en charge du DT1 par le système de santé publique brésilien.

https://doi.org/10.2471/BLT.12.110387 1510 downloads Cited 3 times in SciELO

15.

Candida tropicalis CE017: a new Brazilian enzymatic source for the bioreduction of aromatic prochiral ketones
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Vieira, Gizelle A. B.

; Araujo, Daniel M. de Freitas

; Lemos, Telma L. G.

; Mattos, Marcos Carlos de

; Oliveira, Maria da Conceição F. de

; Melo, Vânia M. M.

; Gonzalo, Gonzalo de

; Gotor-Fernández, Vicente

; Gotor, Vicente

Journal of the Brazilian Chemical Society

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2010, Volume 21 N. 8 Pages 1509 - 1516

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A reatividade e estereosseletividade apresentadas por uma nova cepa de Candida tropicalis na redução de cetonas pró-quirais foram comparadas com cepas de microrganismos, estudadas em nosso laboratório, provenientes da biodiversidade brasileira. Neste caso, Candida tropicalis demonstrou-se como um agente redutor versátil e estereosseletivo na biorredução de uma série de cetonas aromáticas. Estes compostos pró-quirais foram convertidos aos correspondentes álcoois opticamente ativos com moderada a excelente estereopreferência dependendo da estrutura do substrato. Entre as cetonas utilizadas, as nitroacetofenonas foram enzimaticamente reduzidas aos correspondentes (S)-álcoois enantiopuros com completa conversão.

The reactivity and stereoselectivity showed by a new strain of Candida tropicalis in the reduction of prochiral ketones have been compared with the ones previously attained in our laboratory using microorganisms from the Brazilian biodiversity. In this manner, Candida tropicalis has demonstrated its versatility as stereoselective agent in the bioreduction of a series of aromatic ketones. These prochiral compounds were converted into their corresponding optically alcohols with moderate to excellent stereopreference depending on the substrate structure. Among ketones tested, nitroacetophenones were enzymatically reduced to enantiopure (S)-alcohol with complete conversion.

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