A teoria do risco e as novas tecnologias associadas à saúde: uma análise sobre o procedimento de incorporação e o dispositivo Essure no Brasil / The theory of risk and the new technologies associated with health: an analysis of the incorporation process and the Essurein Brazil / La teoría del riesgo y las nuevas tecnologías asociadas a la salud: un análisis del procedimiento de incorporación y el dispositivo Essureen Brasil

Objetivo: realizar uma análise sobre o procedimento de aprovação das novas tecnologias em saúde no Brasil, especificamente o Essure, à luz da teoria do risco proposta por Ulrich Beck. Metodologia: utilizou-se o método de pesquisa dedutivo, com procedimento descritivo e técnica de pesquisa de levantamento bibliográfico e documental. Resultado: observou-se que as empresas do setor de saúde cada vez mais lançam produtos no mercado sem realizarem testes suficientemente duradouros e, portanto, sem apresentarem aos consumidores os reais riscos de sua utilização, sobretudo no longo prazo. Discussão: os impactos que o dispositivo Essure ocasionou aos corpos de diversas mulheres no Brasil conduziu a um processo de desestruturação e judicialização de uma matéria cujos impactos ainda são desconhecidos, considerando que a maior parte das demandas no Judiciário giram em torno da retirada do dispositivo do mercado e a responsabilidade por danos morais à empresa. Conclusão: levanta-se a necessidade de uma reanálise da duração e da forma como as pesquisas de novas tecnologias e produtos de saúde são realizadas pelas empresas e do procedimento de incorporação que as agências governamentais preveem para sua inserção ao mercado, uma vez que é inconcebível que algo com o fim de promover a saúde de seu usuário acabe por causar danos inesperados e imprevistos pela falta de testes mais detalhados.

Objective: to conductan analysis of the approval procedure for new health technologies in Brazil, specifically on Essurewithin the scope of the risk theory proposed by Ulrich Beck. Methodology: the deductive research method was used, with a descriptive procedure and a bibliographic and documentary survey research technique. Result: it was observed that companies in the health sector increasingly launch products on the market without carrying out sufficiently long-lasting tests and, therefore, without presenting consumers with the real risks of their use, especially in the long term.Discussion: the impacts that the Essure provision caused to the bodies of several women in Brazil led to a process of disruption and judicialization of a matter whose impacts are still unknown, considering that most of the demands in the Judiciary revolvearound the removal of the provision from the market and liability for moral damages to the company. Conclusion: there is a need for a reanalysis of the duration and way in which research into new technologies and health products are carried out by companies and the incorporation procedure that government agencies provide for their incorporation into the market, since it is inconceivable that something to promote the health of its user ends up causing unexpected and unforeseen damage due to the lack of moredetailed tests.

Objetivo: realizar un análisis del procedimiento de aprobación de nuevas tecnologías sanitarias en Brasil, específicamente sobre el dispositivo Essurea la luzde la teoría del riesgo propuesta por Ulrich Beck. Metodología: se utilizó el método de investigación deductivo, con procedimiento descriptivo y técnica de investigación de encuesta bibliográfica y documental. Resultado: se observó que las empresas del sector salud lanzan cada vez más productos al mercado sin realizar pruebas suficientemente duraderas y, por tanto, sin presentar a los consumidores los riesgos reales de su uso, especialmente a largo plazo. Discusión: los impactos que el dispositivo Essure provocó enlos cuerpos de varias mujeres en Brasil llevaron a un proceso de desestructuración y judicialización de un asunto cuyos impactos aún se desconocen, considerando que la mayoría de las demandas en el Poder Judicial giran en torno a la supresión de la disposición. del mercado y responsabilidad por daño moral a la empresa. Conclusión: es necesario volver a analizar la duración y forma en que las empresas llevan a cabo la investigación de nuevas tecnologías y productos sanitarios y el procedimiento de incorporación que los organismos gubernamentales prevén para su incorporación al mercado, ya que es inconcebible que algo en El fin de promover la salud de su usuario termina provocando daños inesperados e imprevistos debido a la falta de pruebas más detalladas.

Is body mass index and obesity surgery mortality score important in perioperative complications of laparoscopic sleeve gastrectomy before discharge? / Os índices de mortalidade, de massa corporal e da cirurgia da obesidade são importantes nas complicações perioperatórias de gastrectomia vertical laparoscópica antes da alta?

ABSTRACT Background: Morbid obesity surgery and related complications have increased with time. Aim: To evaluate the relationship between perioperative complications before discharge and preoperative body mass index and obesity surgery mortality score in laparoscopic sleeve gastrectomy. Method: 1617 patients who met the inclusion criteria were evaluated retrospectively. The patients were examined in terms of demographic data, presence of comorbidities, whether there were complications or not, type of complications and obesity surgery mortality score. Results: Complications were seen in 40 patients (2.5%) and mortality wasn't seen in the early postoperative period before discharge. The mean age of patients with complications was 36.3±10.02 years (19-57) and without complications 34.12±9.54 (15-64) years. The preoperative mean BMI values of patients with and without complications were 45.05±3.93 (40-57) kg/m2 and 44.8±3.49 (35-67) kg/m2 respectively. According to BMI groups 40-45 kg/m2, 45-50 kg/m2 and 50 and over, there was not any statistical significance seen in three groups in terms of complication positivity and major-minor complication rates. There was not any statistical significance seen between the patients with and without major-minor complications and obesity surgery mortality score. Conclusion: There was not any relation between perioperative laparoscopic sleeve gastrectomy complication rates before discharge and BMI and obesity surgery mortality scores.

RESUMO Racional: A cirurgia da obesidade mórbida e complicações relacionadas aumentaram com o tempo. Objetivo: Avaliar a relação entre as complicações perioperatórias antes da alta e o índice de massa corporal pré-operatório e o escore de mortalidade da cirurgia de obesidade na gastrectomia vertical laparoscópica. Método: 1.617 pacientes que atenderam aos critérios de inclusão foram avaliados retrospectivamente. Os pacientes foram examinados quanto aos dados demográficos, presença de comorbidades, ocorrência ou não de complicações, tipo de complicações e escore de mortalidade cirúrgico da obesidade. Resultados: Complicações foram observadas em 40 pacientes (2,5%) e mortalidade não foi observada no período pós-operatório imediato antes da alta. A média de idade dos pacientes com complicações foi de 36,3±10,02 anos (19-57) e sem complicações de 34,12±9,54 (15-64) anos. Os valores médios de IMC pré-operatórios dos pacientes com e sem complicações foram 45,05±3,93 (40-57) kg/m2 e 44,8±3,49 (35-67) kg/m2, respectivamente. De acordo com os grupos de IMC 40-45 kg/m2, 45-50 kg/m2 e 50 e mais, não houve qualquer significância estatística observada em três grupos em termos de positividade de complicações e taxas de complicações maiores-menores. Não houve significância estatística entre os pacientes com e sem complicações maiores e menores e o escore de mortalidade da cirurgia de obesidade. Conclusão: Não houve qualquer relação entre as taxas de complicações da gastrectomia vertical laparoscópica perioperatória antes da alta e os escores de mortalidade da cirurgia de obesidade e IMC.

Post-transcriptional gene silencing: Basic concepts and applications

Post-transcriptional gene silencing (PTGS)-mediated gene silencing exploits the cellular mechanism whereintranscripts having sequence similarity to the double-stranded RNA (dsRNA) molecules present in the cell will besubjected to degradation. PTGS is closely related to natural processes such as RNA-mediated virus resistance andcross-protection in plants. Gene silencing and the cellular machinery for affecting this phenomenon might haveevolved as a natural protective measure against viral infection in plants. In PTGS, small interfering RNA (siRNA)molecules of 21–23 nucleotides length act as homology guides for triggering the systemic degradation of transcriptshomologous to the siRNA molecules. PTGS phenomenon, first discovered in transgenic petunia plants harbouringchalcone synthase gene and termed co-suppression, has been subsequently exploited to target specific gene transcripts for degradation leading to manifestation of desirable traits in crop plants. Targeted gene silencing has beenachieved either through the introduction of DNA constructs encoding dsRNA or antisense RNA or by deploying cosuppression constructs producing siRNAs against the transcript of interest. Understanding the mechanism of genesilencing has led to the development of several alternative strategies for inducing gene silencing in a precise andcontrolled way. This has paved the way for using PTGS as one ofthe chief functional genomicstools in plants and hashelped in unraveling the mechanism of many cellular processes and identifying the focal points in pathways, besides,opening new vistas in genetic engineering of plants for human benefits. PTGS has shown great potential in silencingthe deleterious genes efficiently so that value-added plant products could be obtained. Thus, PTGS has ushered in anew era in the genetic manipulation of plants for both applied and basic studies. In this review, we have outlined thebasics of RNAi-mediated gene silencing and summarized the work carried out at our institute using this approach, ascase studies. In particular, adopting RNAi-mediated gene silencing (a) as a method to restore fertility in transgenicmale sterile lines developed based on orfH522 gene from sunflower PET1-CMS source, (b) as a tool to suppress theproduction of toxic proteins, ricin and RCA, in castor, and (c) as an approach to induce bud necrosis virus resistancein sunflower has been discussed. Examples from other plant systems also have been mentioned to exemplify theconcept and utility of gene silencing in crop plants.

Classification of clinical risk in people with AIDS followed up in specialized care / Clasificación de riesgo clínico en personas con SIDA acompañadas de la atención especializada / Classificação de risco clínico em pessoas com aids acompanhadas na atenção especializada

ABSTRACT Aim: To develop a clinical risk stratification score for people living with AIDS and to analyze its association with clinical and sociodemographic aspects. Method: Cross-sectional study involving 150 adults with AIDS, in outpatient follow-up. A structured instrument was applied and, sequentially, inferential statistical techniques on the developed score. Results: 45.3% of the participants were classified as in high clinical risk. TL-CD4+ <500cel/mm3 count, detectable viral load, presence of opportunistic diseases, chronic diseases and clinical manifestations were associated with high clinical risk. There was a significant difference in the mean risk between the categories of variables employment status (p = 0.003) and economic class (p = 0.035). There was a higher risk for brown people (OR = 5.55), unemployed status (OR = 16,51) and belonging to classes C (OR = 20.07) and D (OR = 53,32), and a lower risk for individuals with higher schooling (OR = 0.02). Conclusion: The proposed score quantifies clinical situations and points out sociodemographic aspects that predispose to instability and aggravation of AIDS, supporting the qualification of care.

RESUMEN Objetivo: Elaborar una puntuación para estratificación de riesgo clínico de personas viviendo con sida y analizar su asociación con aspectos clínicos y sociodemográficos. Método: Estudio transversal que involucra a 150 adultos con sida, en seguimiento de ambulatorio. Se aplicó instrumento estructurado y, secuencialmente, técnicas estadísticas que interfieren en la puntuación elaborada. Resultados: El 45,3% de los participantes fueron clasificados en el riesgo clínico alto. La cuenta de LT−CD4+<500cel/mm3, la carga viral detectable, la presencia de enfermedades oportunistas, las enfermedades crónicas y manifestaciones clínicas se asociaron al riesgo clínico elevado. Se verificó una diferencia significativa en el riesgo medio entre las categorías de variables de empleo (p=0,003) y la clase económica (p=0,035). Se constató un mayor riesgo para las personas pardas (OR=5,55), alejadas del empleo (OR=16,51) y pertenecientes a las clases C (OR=20,07) y D (OR=53,32), y menor riesgo entre los individuos con mayor escolaridad (OR=0,02). Conclusión: La puntuación propuesta cuantifica situaciones clínicas y apunta aspectos sociodemográficos que predisponen a la inestabilidad y agudización del sida, subsidiando la calificación del cuidado.

RESUMO Objetivo: Elaborar um escore para estratificação de risco clínico de pessoas vivendo co.m Aids e analisar sua associação com aspectos clínicos e sociodemográficos. Método: Estudo transversal envolvendo 150 adultos com aids, em acompanhamento ambulatorial. Aplicou-se instrumento estruturado e, sequencialmente, técnicas estatísticas inferenciais sobre o escore elaborado. Resultados: 45,3% dos participantes foram classificados no risco clínico alto. A contagem de LT-CD4+<500cel/mm3, carga viral detectável, presença de doenças oportunistas, doenças crônicas e manifestações clínicas associaram-se ao risco clínico elevado. Verificou-se diferença significativa no risco médio entre as categorias das variáveis situação empregatícia (p = 0,003) e classe econômica (p = 0,035). Constatou-se maior risco para pessoas pardas (OR = 5,55), afastadas do emprego (OR = 16,51) e pertencentes às classes C (OR = 20,07) e D (OR = 53,32), e menor risco entre os indivíduos com maior escolaridade (OR = 0,02). Conclusão: O escore proposto quantifica situações clínicas e aponta aspectos sociodemográficos que predispõem a instabilidade e agudização da aids, subsidiando a qualificação do cuidado.

Investigation into the Possible Genetic Role of Serotonin and Dopamine Transporters in Psychological Resilience

OBJECTIVES: Psychological resilience is the ability to cope with stress. The genetic background behind psychological resilience is not much known. The serotonin transporter and dopamine transporter are implicated in stress related psychology and emotional processing. The aim of this study is to investigate a possible genetic role of functional polymorphisms of serotonin and dopamine transporters for psychological resilience. METHODS: A total of 951 healthy adult subjects were included. Psychological resilience was measured using Connor-Davidson Resilience Scale (CD-RISC). Genotyping was performed for serotonin transporter gene (SERT) promoter variable number tandem repeat (VNTR) and dopamine transporter gene (DAT1) 3'-untranslated region (UTR) VNTR. Genetic association analysis was conducted between genotypes and the CD-RISC score. RESULTS: No genetic association was observed for SERT promoter VNTR or DAT1 3'-UTR VNTR with CD-RISC score. No genetic interaction between SERT promoter VNTR and DAT1 3'-UTR VNTR with CD-RISC score was detected. CONCLUSIONS: Either serotonin or dopamine transporter did not seem to play a significant role for psychological resilience in this sample.

Propiedades psicométricas de la versión española de la escala de resiliencia de 10 ítems de Connor-Davidson (CD-RISC 10) en una muestra de desempleados / Psychometric properties of Spanish version of 10-item Connor-Davidson resilience scale (10-item CD-RISC) in an unemployed sample

El objetivo del estudio es analizar las propiedades psicométricas de la escala de resiliencia de Connor y Davidson (2003) en su versión reducida de 10 ítems (CD-RISC 10) desarrollada por Campbell-Stills y Stein (2007) y validada al español por Notario-Pacheco et al. (2011) en una muestra de 226 desempleados. Se llevó a cabo un análisis factorial confirmatorio (AFC) que corroboró el modelo unifactorial. Siguiendo las aportaciones teóricas, se propusieron las variables de salud psicológica, síntomas psicosomáticos y autoeficacia para analizar la validez de criterio. Las correlaciones entre las variables fueron estadísticamente significativas y siguieron la dirección teórica esperada. Se concluye que la versión española de 10 ítems de la CD-RISC de Connor y Davidson (2003) presenta adecuadas propiedades psicométricas para estimar la resiliencia en desempleados españoles.

The aim of this study was to analyze the psychometric properties of the Spanish adaptation of the scale of resilience CD-RISC by Connor and Davidson (2003), in its 10-item version developed by Campbell-Stills and Stein (2007), in a sample of 226 unemployed. We carried out a confirmatory factor analysis (CFA) which corroborated the univariate model. Following the theoretical contributions, we proposed psychological health, psychosomatic symptoms and self-efficacy as variables to analyze the criterion validity. The correlations between the variables were statistically significant and followed the expected theoretical direction. We concluded that the Spanish 10-item version of the CDRISC by Connor and Davidson (2003) presents adequate psychometric properties to estimate resilience in Spanish unemployed.

Análisis psicométrico del Connor-Davidson Resilience Scale (CD-RISC 10) en población universitaria colombiana / Psychometric analysis of the Connor-Davidson Resilience Sacle (CD-RISC 10) in college students in Colombia

Resumen Este estudio tuvo como objetivo analizar las propiedades psicométricas de la versión en español del cuestionario Connor-Davidson Resilience Scale (CD-RISC 10) en población colombiana. La muestra estuvo conformada por 265 estudiantes universitarios de Bogotá y Villavicencio. El análisis factorial exploratorio denota un solo factor, resiliencia, que explica el 41,139 % del total de la varianza acumulada, modelo verificado con el análisis factorial confirmatorio, y un alfa de Cronbach de 0,838. Los resultados muestran una alta confiabilidad y concordancia en la estructura factorial con la versión original, lo cual implica adecuada validez de la prueba en población colombiana.

Abstract The present study aimed to determine the psychometric characteristics of the Spanish version of the Connor-Davidson Resilience Scale (CD-RISC 10) in Colombian population. A total of 265 university students participated at the cities of Bogota and Villavicencio. Exploratory factor analysis indicates resilience as a single factor; we verified the model with confirmatory factor analysis, and a Cronbach's alpha of 0.838. The results show high reliability and factor structure in accordance with the original version, which implies adequate validity of this scale in Colombian population.

Propiedades psicométricas de la versión española de la escala de resiliencia de 10 ítems de Connor-Davidson (CD-RISC 10) en una muestra multiocupacional / Psychometric properties of the spanish version of the 10-item Connor-Davidson resilience scale (10-item CD-RISC) in a sample of workers

El objetivo del estudio es analizar las propiedades psicométricas de la adaptación española de la escala de resiliencia CD-RISC de Connor y Davidson (2003) en su versión de 10 ítems en una muestra multiocupacional. Se utilizaron dos muestras. En la primera completaron esta escala un total de 386 trabajadores y se realizó un análisis factorial exploratorio que arrojó un único factor que explica el 55.8% de la varianza total. La consistencia interna de la escala fue adecuada (alfa de Cronbach de 0.87) y la eliminación de ningún ítem mejoraba la Habilidad de la escala. Con el fin de ratificar el modelo obtenido en el AFE, se llevó a cabo un análisis factorial confirmatorio con los datos de la segunda muestra de 238 participantes que corroboró el modelo unifactorial. Para analizar la validez divergente se utilizó los datos de las dos muestras (N = 624); así, las correlaciones con las puntuaciones de las variables burnout, bienestar psicológico y satisfacción laboral fueron estadísticamente significativas y siguieron la dirección teórica esperada. Se concluye que la versión española de 10 ítems de la CD-RISC de Connor y Davidson presenta adecuadas propiedades psicométricas para estimar la resiliencia en trabajadores.

The aim of the study is to analyze the psychometric properties of the Spanish adaptation of the scale of resilience CD-RISC of Connor and Davidson (2003) in the 10-item version in a sample of workers. Two samples were used. In the first sample a total of 386 workers completed this scale. We carry out EFA to observe the factor structure of the scale which resulted in one main factor responsible for 55.8% of the total variance and containing the 10 items. The internal consistency was appropriate (Cronbach's alpha of 0.87). In order to ratify the model obtained in the AFE, a confirmatory factor analysis was conducted with data from sample 2 (N = 238) which corroborated the univariate model. As for the divergent validity, correlations with scores on the variable burnout, psychological health and job satisfaction were statistically significant and followed the theoretical direction (total sample= 624). It is concluded that the Spanish 10-item version of the CD-RISC by Connor and Davidson (2003) presents adequate psychometric properties to estimate resilience in workers.

Is there a link between upper gastrointestinal polyps and colonic polyps? A retrospective study from a Turkish cohort / Existe conexão entre pólipos gastrointestinais proximais e pólipos colônicos? Estudo retrospectivo de uma coorte turca

OBJECTIVE: To investigate the incidence and associated demographical and clinical factors related to lower GI polyps and neoplasms in patients with upper GI polyps and neoplasms. METHODS: We investigated 99 patients who had upper GI polyps and neoplasms and who were screened with colonoscopy: the following data were collected: demographical and clinical data consisting of age, sex, smoking status, presence of H. pylori infection, placement of upper GI polyps or neoplasms, presence of gastric atrophy, usage of proton pump inhibitors (PPI), presence of lower GI polyp or neoplasm, type of colon polyp, pathological grade of colon polyp. The patients were grouped according to having/not having lower GI polyps and neoplasms; data was compared between groups. RESULTS: Smoking rate was significantly higher in patients with lower GI polyps and neoplasms (χ2: 4.35, p: 0.03). Furthermore, there was a signifant association between presence of lower GI polyps and neoplasms vs. smoking (OR: 2.44 CI: 1.01-5.84, p: 0.04). CONCLUSIONS: Patients with upper GI polyps and neoplasms who are smokers should be considered as candidates for having lower GI polyps and neoplasms and should be screened and followed more carefully. Additionally, we believe that large sampled and prospective studies are needed to higligt the association between upper GI polyps and presence of lower GI polyps and neoplasms.

OBJETIVO: investigar a incidência, demografia associada e fatores clínicos relativos a pólipos e neoplasias gastrointestinais distais em pacientes com pólipos e neoplasias do trato gastrointestinal superior. MÉTODOS: Foram investigados 99 pacientes que apresentaram pólipos ou neoplasias gastrointestinais superiores selecionados através de colonoscopia: os seguintes dados foram coletados: dados demográficos e clínicos consistentes em idade, sexo, tabagismo, presença de infecção por H. pylori, a presença de pólipos ou neoplasias gastrointestinais proximais, presença de atrofia gástrica, uso de inibidores da bomba de prótons (IBP), presença de pólipo ou neoplasia gastrointestinal distal, tipo de pólipo de cólon, grau patológico de pólipo de cólon. Os pacientes foram agrupados de acordo com ter/não ter pólipos ou neoplasias distais; os dados foram comparados entre os grupos. RESULTADOS: A taxa de tabagismo foi significativamente maior nos pacientes com pólipos e neoplasias distais (χ2: 4.35, p: 0,03). Além disso houve uma associação significante entre a presença de pólipos e neoplasias distais e tabagismo (OR: 2,44 CI: 1,01-5,84, p: 0,04). CONCLUSÕES: Os pacientes fumantes com pólipos e neoplasias do trato gastrointestinal superior devem ser considerados candidatos a pólipos e neoplasias distais e devem ser rastreados e seguidos com mais cuidado. Adicionalmente, grandes amostras e estudos prospectivos são necessários para esclarecer a associação entre pólipos gastrointestinais superiores e a presença de pólipos e neoplasias gastrointestinais distais.

Validação fatorial da escala de resiliência de connor-davidson (CD-RISC-10) para brasileiros / Factorial validation and adaptation of the connor-davidson resilience scale (CD-RISC-10) for brazilians

Resiliência é defnida como a habilidade de um indivíduo para se recuperar das adversidades e se adaptar positvamente em situações de tensão e estresse. Estudiosos das relações entre indivíduo, organização e trabalho têm voltado a atenção para o fenômeno na tentatva de elucidar seus antecedentes e consequentes no contexto organizacional. Estudos sobre o assunto são incipientes e, dada a diversidade e os desacordos sobre o conceito, observa-se confusão e divergências na forma de avaliá-lo. Assim, o objetvo deste estudo foi avaliar as características psicométricas de uma versão brasileira da CD-RISC-10, medida bastante utlizada em estudos internacionais. Partciparam 463 pessoas com idade média de 28 anos (DP = 9,7) e, em sua maioria, com ensino médio completo. A análise fatorial exploratória confrmou estrutura unifatorial com os dez itens da escala e alfa de Cronbach de 0,82. Isso indica que a CD-RISC-10 é medida promissora para avaliar níveis de resiliência e ferramenta disponível para incrementar a investgação desse fenômeno. Destaca-se, entretanto, a necessidade de outros estudos de validade, fdedignidade e normatzação em amostras diversas.

Resilience is defned as an individual’s ability to recover from adversites and to adapt positvely in tense and stressful situatons. Researchers of the relatonship between individual, organizaton, and work have turned their atenton to this phenomenon in order to atempt to clarify its antecedents and efects in the organizatonal context. Studies regarding this subject are beginning to appear, and, in view of the diversity and disagreement over the concept, there is confusion and divergence on the way to evaluate it. Thus, the purpose of this study was to evaluate the psychometric characteristcs of a Brazilian version of the CD-RISC-10 - a widely used measure in internatonal studies. 463 people, on average 28 years of age (SD = 9,7) and mostly high school graduates, took part in this study. Exploratory factor analysis confrmed a one-factor structure with the ten scale items and a Cronbach’s alpha of 0.82. This indicates that the CD-RISC-10 is a promising measure for evaluatng levels of resilience, and an available tool for improving the investgaton of this phenomenon. However, it is important to emphasize the need for further studies regarding validity, reliability, and standardizaton in diverse samples.

Avaliação dos fatores associados a tromboembolismo pulmonar (TEP), em uma série de autópsias de dez anos / Evaluation on factors associated to pulmonary thromboembolism (PE) in a series of ten years of autopsies

INTRODUÇÃO: A literatura demonstra que tromboembolismo venoso permanece como uma doença subdiagnosticada entre os pacientes hospitalizados, com aproximadamente 25% dos casos associados à internação. OBJETIVOS: Avaliar as doenças associadas ao desenvolvimento de tromboembolismo pulmonar (TEP) diagnosticado em autópsias, e demonstrar a frequência de TEP como causa do óbito ou fator contributivo. MÉTODOS: Estudo caso-controle retrospectivo, realizado no Instituto Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, no período de 1995 a 2004. Revisamos os relatórios diagnósticos das autópsias, identificando TEP fatal, quando TEP foi a causa de morte, e TEP não fatal, quando TEP foi doença associada. RESULTADOS: 1.506 pacientes (502 casos e 1.004 controles), 18.359 óbitos no período, média 2.040; 71,2% desses submetidos a autópsias. Observou-se importante declínio nas taxas de autópsias. De 1995-1999 (87,2%) e 2000-2004 (54,4%); p = 0,016. Dos 502 casos (3,8%), em 328 (2,5%) TEP foi causa de morte e 174 (1,3%), causa contributiva. Gênero: 51,6% homens e 48,4% mulheres. Idade: TEP fatal (328) vs controles (1.004), diferença estatisticamente significativa (p = 0,013). Condições prevalentes: câncer grupo, 31,4%, pós-operatório grupo, 17,2%, infecção grupo, 11,7%, e AVC grupo, 11%. Câncer de pulmão, 3,5%, câncer de cérebro e linfoma, 2,8%. Tempo de internação foi utilizado como indicador de imobilização. Outras doenças: AVCH (7,7%), pós-operatório de abdome (6,7%), pneumonia (5,9%), AVCI (3,1%) e pós-operatório vascular (4%) foram frequentes no grupo controle. Em contrapartida, aterosclerose (1,4%), ITU (1,2%), pós-operatório de ginecologia (0,8%), pós-operatório de obstetrícia (0,6%) e doença falciforme (0,6%) foram frequentes no grupo TEP. Cirrose, média de 14,9 dias de internação dos controles vs TEP com 4,4 dias (p < 0,001). Análise multivariada incluiu as condições com p 0,20 da univariada, idade e tempo de internação...

INTRODUCTION: Literature shows that venous thromboembolism (VTE) remains as a sub-diagnostic disease among hospitalized patients, approximately 25% of all cases are associated to hospitalization. PURPOSE: Evaluate diseases associated to pulmonary thromboembolism (PE) development diagnosed in autopsies, and demonstrate the frequency of PE as cause of death or as a contributive factor. METHOD: The reports performed from 1995 to 2004 in a Brazilian tertiary referral medical school we reviewed for a retrospective study the autopsies diagnosis, identified as fatal PE, when PE was the cause of death and nonfatal PE, when PE was an associated disease. RESULTS: 1,506 patients (502 cases and 1004 controls), 18,359 deaths during the period, average 2,040; 71.2% of these were submitted to autopsies. It was observed an important decline in the autopsies rates. From 1995-1999 (87.2%) and 2000-2004 (54.4%) p = 0.016. From 502 cases (3.8%), 328 (2.5%) PE was the cause of death and 174 (1.3%) PE was contributive cause. Gender: 51.6% males and 48.4% females. AGE: fatal PE (328) vs controls (1,004) significant statistic difference (p = 0.013). Prevalent Conditions: cancer group, 31.4%, postsurgical group, 17.2%, infectious group, 11.7%, and CVA group, 11%. Pulmonary Cancer, 3.5%, Brain cancer and Lymphoma, 2.8%. Hospitalization period was taken as immobilization indicator. Other diseases: HCVA (7.7%), abdomen postsurgical (6.7%), pneumonia (5.9%), ICVA (3.1%) and vascular postsurgical (4%) were frequent in the control group. On the other hand, atherosclerosis (1.4%), UTI (Urinary Tract Infection) (1.2%), gynecology postsurgical (0.8%), obstetrics postsurgical (0.6%) and sickle cell anemia (0.6%) were frequent in the PE group. Cirrhosis, average of 14.9 hospitalization days of the controls vs PE with 4.4 days (p < 0.001). Logistic regression analysis includes the in univariated analysis with p 0.20, age and the hospitalization period. Protector factor for PE: Aortic...

Research progresses of RNA interference / 中国药理学通报

RNA interference is an evolutionarily conserved surveillance mechanism that responds to double-stranded RNA by sequence-specific silencing of homologous genes. Although it is a short time since the discovery of the phenomenon, the technology develops fastly for the character of easy operation, low investment, specificity and potentiality, and researchers have made some progress on the mechanism of RNA interference and application in functional genomics and disease treatment. This article reviews the history, mechanism, biological significance and application of RNA interference.