RCAAP Repository

Tese (doutorado)—Universidade de Brasília, Faculdade de Tecnologia, Departamento de Engenharia Civil e Ambiental, 2012.

Sob a perspectiva da “ética da proteção” e da “bioética de intervenção”, a pesquisa analisa a influência das peças publicitárias de medicamentos veiculadas à classe médica na prescrição de medicamentos. Estuda, ainda, a qualidade das informações nas propagandas de medicamentos de venda sob prescrição, antes e depois da Resolução da Diretoria Colegiada da Anvisa - RDC 102/2000, que regulamenta a propaganda de medicamentos no país, bem como discute o papel regulador do Estado na área. Primeiramente, foram entrevistados 50 médicos de Brasília, a fim de examinar como percebem os efeitos da propaganda sobre sua atividade profissional. Em seguida, foram avaliadas 10 peças publicitárias, 5 veiculadas antes e 5 depois da RDC 102/2000. Os resultados permitiram concluir que: a) 98% dos médicos recebem visitas regulares de representantes comerciais; b) 86% recebem brindes; c) 68% crêem na influência direta da propaganda sobre a prescrição; d) 14% disseram prescrever medicamentos em função do recebimento de prêmios; e) 68% acreditam existir inverdades nas informações das peças publicitárias; f) antes da RDC, as informações (contra-indicações, indicações, precauções, cuidados e advertência) nas propagandas representava 28% dos casos; após a RDC, foram encontradas informações em 79% dos casos.

Tese (doutorado)—Universidade de Brasília, Instituto de Física, 2012.

Artigo publicado do resultado do trabalho realizado no Hospital de Base do Distrito Federal e no Programa de Pós-Graduação em Ciências da Saúde da Universidade de Brasília, Brasília, DF.

Dissertação (mestrado)—Universidade de Brasília, Instituto de Ciência Política, Programa de Pós-Graduação em Ciência Política, 2012.

Tese (doutorado)—Universidade de Brasília, Departamento de Economia, 2012.

Trabalho realizado na Cátedra Unesco de Bioética da Universidade de Brasília e na Agência Nacional de Vigilância Sanitária do Ministério da Saúde – Anvisa, Brasília, DF.

Tese (doutorado)—Universidade de Brasília, Instituto de Relações Internacionais, Programa de Pós-Graduação em Relações Internacionais, 2008.

OBJETIVO: Descrever a percepção dos voluntários sobre os benefi ciários do trabalho voluntário no setor de saúde hospitalar e a infl uência que o tema dos benefícios exerce sobre as motivações. MÉTODOS: Estudo exploratório com abordagem qualitativa. Participaram 110 voluntários em serviços de saúde referências no tratamento de câncer no Rio de Janeiro (RJ), com coleta de dados de outubro a dezembro de 2001. Os dados foram obtidos por dois instrumentos: um questionário com perfi l socioeconômico e sobre motivações para atividade voluntária; e entrevista semi-estruturada para obtenção de dados complementares. RESULTADOS: A visão dos voluntários sobre os benefi ciários da atividade voluntária esteve centrada mais freqüentemente no paciente (50,5%), no voluntário (41,9%) e na instituição e sociedade (7,6%). Paciente e voluntário foram considerados simultaneamente benefi ciários, sendo o voluntário o que mais recebe benefícios. Foi relatada também uma compreensão do benefício social dessa atividade. CONCLUSÕES: Constatou-se que existe, entre os voluntários, uma noção da importância social do seu trabalho voluntário, faltando uma articulação maior entre motivações individuais e trabalho voluntário como espaço de enfrentamento de problemas sociais. _______________________________________________________________________________________ ABSTRACT

Tese (doutorado)—Universidade de Brasília, Faculdade de Economia, Administração, Contabilidade e Ciência da Informação e Documentação, Programa de Pós-Graduação em Economia da Universidade de Brasília, 2012.

INTRODUCTION: Paracoccidioidomycosis is a systemic infection caused by Paracoccidioides brasiliensis. METHODS: In this study, a semi-nested PCR for paracoccidioidomycosis diagnosis was developed. The primers ITS1 and ITS4 were used in the first reaction, while the primers MJ03 and ITS1 primer were used in the second reaction. The semi-nested PCR was used to investigate biopsies of five patients with oral lesions that resembled paracoccidioidomycosis. RESULTS: The semi-nested PCR was positive for four samples and negative for a sample from a patient later diagnosed with leishmaniasis. CONCLUSIONS: The new semi-nested PCR describe is useful for aracoccidioidomycosis diagnosis. ________________________________________________________________________________________________________________ RESUMO

Background: The prevalence of invasive fungal infections (IFIs) has increased steadily worldwide in the last few decades. Particularly, there has been a global rise in the number of infections among immunosuppressed people. These patients present severe clinical forms of the infections, which are commonly fatal, and they are more susceptible to opportunistic fungal infections than non-immunocompromised people. IFIs have historically been associated with high morbidity and mortality, partly because of the limitations of available antifungal therapies, including side effects, toxicities, drug interactions and antifungal resistance. Thus, the search for alternative therapies and/or the development of more specific drugs is a challenge that needs to be met. Genomics has created new ways of examining genes, which open new strategies for drug development and control of human diseases. Results: In silico analyses and manual mining selected initially 57 potential drug targets, based on 55 genes experimentally confirmed as essential for Candida albicans or Aspergillus fumigatus and other 2 genes (kre2 and erg6) relevant for fungal survival within the host. Orthologs for those 57 potential targets were also identified in eight human fungal pathogens (C. albicans, A. fumigatus, Blastomyces dermatitidis, Paracoccidioides brasiliensis, Paracoccidioides lutzii, Coccidioides immitis, Cryptococcus neoformans and Histoplasma capsulatum). Of those, 10 genes were present in all pathogenic fungi analyzed and absent in the human genome. We focused on four candidates: trr1 that encodes for thioredoxin reductase, rim8 that encodes for a protein involved in the proteolytic activation of a transcriptional factor in response to alkaline pH, kre2 that encodes for α-1,2-mannosyltransferase and erg6 that encodes for Δ(24)-sterol C-methyltransferase. Conclusions: Our data show that the comparative genomics analysis of eight fungal pathogens enabled the identification of four new potential drug targets. The preferred profile for fungal targets includes proteins conserved among fungi, but absent in the human genome. These characteristics potentially minimize toxic side effects exerted by pharmacological inhibition of the cellular targets. From this first step of post-genomic analysis, we obtained information relevant to future new drug development.

The annotation and comparative analyses of the genomes of Mycoplasma synoviae and Mycoplasma hyopneumonie, as well as of other Mollicutes (a group of bacteria devoid of a rigid cell wall), has set the grounds for a global understanding of their metabolism and infection mechanisms. According to the annotation data, M. synoviae and M. hyopneumoniae are able to perform glycolytic metabolism, but do not possess the enzymatic machinery for citrate and glyoxylate cycles, gluconeogenesis and the pentose phosphate pathway. Both can synthesize ATP by lactic fermentation, but only M. synoviae can convert acetaldehyde to acetate. Also, our genome analysis revealed that M. synoviae and M. hyopneumoniae are not expected to synthesize polysaccharides, but they can take up a variety of carbohydrates via the phosphoenolpyruvate-dependent phosphotransferase system (PEP-PTS). Our data showed that these two organisms are unable to synthesize purine and pyrimidine de novo, since they only possess the sequences which encode salvage pathway enzymes. Comparative analyses of M. synoviae and M. hyopneumoniae with other Mollicutes have revealed differential genes in the former two genomes coding for enzymes that participate in carbohydrate, amino acid and nucleotide metabolism and host-pathogen interaction. The identification of these metabolic pathways will provide a better understanding of the biology and pathogenicity of these organisms.

Background: Paracoccidioidomycosis is a systemic mycosis caused by Paracoccidioides brasiliensis (species S1, PS2, PS3), and Paracoccidioides lutzii. This work aimed to differentiate species within the genus Paracoccidioides, without applying multilocus sequencing, as well as to obtain knowledge of the possible speciation processes. Methodology/Principal Findings: Single nucleotide polymorphism analysis on GP43, ARF and PRP8 intein genes successfully distinguished isolates into four different species. Morphological evaluation indicated that elongated conidia were observed exclusively in P. lutzii isolates, while all other species (S1, PS2 and PS3) were indistinguishable. To evaluate the biogeographic events that led to the current geographic distribution of Paracoccidioides species and their sister species, Nested Clade and Likelihood Analysis of Geographic Range Evolution (LAGRANGE) analyses were applied. The radiation of Paracoccidioides started in northwest South America, around 11–32 million years ago, as calculated on the basis of ARF substitution rate, in the BEAST program. Vicariance was responsible for the divergence among S1, PS2 and P. lutzii and a recent dispersal generated the PS3 species, restricted to Colombia. Taking into account the ancestral areas revealed by the LAGRANGE analysis and the major geographic distribution of L. loboi in the Amazon basin, a region strongly affected by the Andes uplift and marine incursions in the Cenozoic era, we also speculate about the effect of these geological events on the vicariance between Paracoccidioides and L. loboi. Conclusions/Significance: The use of at least 3 SNPs, but not morphological criteria, as markers allows us to distinguish among the four cryptic species of the genus Paracoccidioides. The work also presents a biogeographic study speculating on how these species might have diverged in South America, thus contributing to elucidating evolutionary aspects of the genus Paracoccidioides.

Background: Phospholipase B (PLB) has been reported to be one of the virulence factors for human pathogenic fungi and has also been described as necessary for the early events in infection. Based on these data, we investigated the role of PLB in virulence and modulation of the alveolar pulmonary immune response during infection using an in-vitro model of host-pathogen interaction, i.e. Paracoccidioides brasiliensis yeast cells infecting alveolar macrophage (MH-S) cells. Results: The effect of PLB was analyzed using the specific inhibitor alexidine dihydrochloride (0.25 μM), and pulmonary surfactant (100 μg mL-1), during 6 hours of co-cultivation of P. brasiliensis and MH-S cells. Alexidine dihydrochloride inhibited PLB activity by 66% and significantly decreased the adhesion and internalization of yeast cells by MH-S cells. Genes involved in phagocytosis (trl2, cd14) and the inflammatory response (nfkb, tnf-α, il-1β) were down-regulated in the presence of this PLB inhibitor. In contrast, PLB activity and internalization of yeast cells significantly increased in the presence of pulmonary surfactant; under this condition, genes such as clec2 and the pro-inflammatory inhibitor (nkrf) were up-regulated. Also, the pulmonary surfactant did not alter cytokine production, while alexidine dihydrochloride decreased the levels of interleukin-10 (IL-10) and increased the levels of IL-12 and tumor necrosis factor-α (TNF-α). In addition, gene expression analysis of plb1, sod3 and icl1 suggests that P. brasiliensis gene re-programming is effective in facilitating adaptation to this inhospitable environment, which mimics the lung-environment interaction. Conclusion: P. brasiliensis PLB activity is involved in the process of adhesion and internalization of yeast cells at the MH-S cell surface and may enhance virulence and subsequent down-regulation of macrophage activation.

The CTLA-4 protein is expressed in activated T cells and plays an essential role in the immune response through its regulatory effect on T cell activation. Polymorphisms of the CTLA-4 gene have been correlated with autoimmune, neoplastic and infectious illnesses. This work aimed to verify possible associations between single nucleotide polymorphisms (SNPs) in CTLA-4, -318C/T in the promoter and +49A/G in exon 1 and paracoccidioidomycosis (PCM) caused by Paracoccidioides brasiliensis. For this purpose, 66 chronic form PCM patients and 76 healthy controls had their allele, genotype and haplotype frequencies determined. The genetic admixture structure of the patients and controls was evaluated to eliminate ancestral bias. The comparison of frequencies indicated no significant differences between patients and controls that could link the SNPs to PCM. Groups were admixture matched with no difference observed in population ancestry inference, indicating that the absence of association between CTLA-4 polymorphisms and PCM could not be attributed to ancestral bias. This study showed that there was no association between the CTLA-4 SNPs -318 and +49 and the resistance or susceptibility to PCM.

Background: Paracoccidioides brasiliensis is a human pathogen with a broad distribution in Latin America. The fungus is thermally dimorphic with two distinct forms corresponding to completely different lifestyles. Upon elevation of the temperature to that of the mammalian body, the fungus adopts a yeast-like form that is exclusively associated with its pathogenic lifestyle. We describe expressed sequence tags (ESTs) analysis to assess the expression profile of the mycelium to yeast transition. To identify P. brasiliensis differentially expressed sequences during conversion we performed a large-scale comparative analysis between P. brasiliensis ESTs identified in the transition transcriptome and databases. Results: Our analysis was based on 1107 ESTs from a transition cDNA library of P. brasiliensis. A total of 639 consensus sequences were assembled. Genes of primary metabolism, energy, protein synthesis and fate, cellular transport, biogenesis of cellular components were represented in the transition cDNA library. A considerable number of genes (7.51%) had not been previously reported for P. brasiliensis in public databases. Gene expression analysis using in silico EST subtraction revealed that numerous genes were more expressed during the transition phase when compared to the mycelial ESTs [1]. Classes of differentially expressed sequences were selected for further analysis including: genes related to the synthesis/remodeling of the cell wall/membrane. Thirty four genes from this family were induced. Ten genes related to signal transduction were increased. Twelve genes encoding putative virulence factors manifested increased expression. The in silico approach was validated by northern blot and semi-quantitative RT-PCR. Conclusion: The developmental program of P. brasiliensis is characterized by significant differential positive modulation of the cell wall/membrane related transcripts, and signal transduction proteins, suggesting the related processes important contributors to dimorphism. Also, putative virulence factors are more expressed in the transition process suggesting adaptation to the host of the yeast incoming parasitic phase. Those genes provide ideal candidates for further studies directed at understanding fungal morphogenesis and its regulation.

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Economia, Administração, Contabilidade e Ciência da Informação e Documentação, Departamento de Ciência da Informação e Documentação, 2007.

Na procura de respostas à questão teórica relativa à importação de conhecimento em ética prática, os autores utilizam, de forma instrumental, a metáfora. Essa figura de linguagem permite que se compare o idioma e suas variantes lingüísticas com a bioética e seus saberes. Segundo o registro dicionarizado, o idioma é a língua oficial de uma nação, o dialeto é uma variante regional de um idioma e o idioleto é uma variante individual de um dialeto. O idioma bioético é entendido, então, como um conjunto lingüístico que constitui a ‘nação bioética’ e que, por estar acima dos dialetos particulares, exerce um papel sobre-regulador na disciplina. Os dialetos correspondem às várias correntes ou teorias existentes e realizam a ponte entre o idioma e a prática. Os idioletos são frutos de tentativas críticas de adaptação de dialetos específicos a contextos sócio-culturais diferentes daqueles onde os dialetos surgiram. Neste artigo, com o objetivo de apontar para o processo de transmissão do conhecimento em bioética, os autores escolheram a obra do bioeticista Diego Gracia como referência paradigmática para a questão da transculturação de dialetos e das relações entre as bioéticas consideradas centrais e periféricas. _______________________________________________________________________________________ ABSTRACT

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Ciências da Saúde, 2012.