No mundo, mais pessoas morrem de tuberculose que de qualquer outra infecção curável. O Programa Nacional de Controle da Tuberculose (PNCT) tem como propósito fundamental promover o controle da tuberculose no Brasil. Busca a interrupção da transmissão da doença e a conseqüente diminuição dos riscos de adoecer e morrer por ela. Para isso, procura identificar precocemente todos os doentes, garantindo seu tratamento até o final. O Estado de São Paulo, seguindo a política nacional, muito tem investido em treinamentos para implantação da busca ativa do sintomático respiratório. Todos os funcionários de unidades de saúde vêm recebendo treinamentos e todos podem realizar a busca ativa, independente de sua profissão ou função na unidade. Entretanto, em estudo realizado no Município de Guarulhos, em 2005, constatou-se que mais de 90% dos sintomáticos respiratórios deixam de ser identificados pelos serviços de saúde, apesar de que 70% dos profissionais da rede básica de saúde do município receberam treinamento sobre busca ativa em 2004 e a mesma foi implantada em todas as unidades. O objetivo deste estudo foi de conhecer a percepção do profissional de saúde sobre a atividade de busca ativa do sintomático respiratório, no município de Guarulhos, através de entrevistas semi estruturadas e gravadas em fitas magnéticas, utilizando a estratégia metodológica do Discurso do Sujeito Coletivo. Na análise dos discursos ficou evidente que o profissional de saúde sabe o que é fazer busca ativa, a maioria se preocupa com quem está tossindo indo investigar, a atividade é reconhecida como um bom trabalho, é considerada simples apesar de desencadear várias etapas e trazer preocupações e reações tanto do usuário como do profissional de saúde, onde os fatores que inviabilizam a sua execução nas unidades de saúde que fizeram parte deste estudo são: a falta de recursos humanos, excesso de trabalho, falta de interesse e desmotivação aliados à inexistência de uma rotina implantada para que a mesma possa ser realizada. / More people die of tuberculosis than of any other curable infection worldwide. The National Tuberculosis Control Program (NTCP) is involved in the tuberculosis control in Brazil and halting disease transmission and consequently reduce the risk of people getting and dying of tuberculosis. Hence, the early identification is attempted in order to provide complete treatment of all cases. The State of Sao Paulo, in accordance with the National policy, has heavily invested in training professionals to introduce the active case finding of respiratory symptomatics as a routine activity in health care units. All healthcare professionals have been trained and are able to conduct active case findings, independent of their profession or function at the healthcare system. However, in a study conducted in the city of Guarullhos (State of Sao Paulo), in 2005, was observed that more than 90% of respiratory symptomatics are left unidentified in the healthcare units, in spite of 70% of professionals of the whole healthcare system of the municipality having received active case finding training in 2004, when the activity was introduced in all healthcare system. The objective of the present study is to appraise the perception of healthcare workers regarding the active case finding activity in the city of Guarulhos, by means of semistructured tape-recorded interviews, using the methodologic strategy of Speech of Collective Subject. In examining the speeches, it was found out that the healthcare worker is aware of what the active case finding means and most of them are concerned with people coughing and do start the necessary investigations. They recognize that the activity is simple and useful, although comprising several steps. Preoccupations and reactions of both patients and healthcare workers regarding factors that may render the activity not feasible in healthcare units are: lack of personnel, excessive amount of work, lack of interest and motivation added up to non-existing routines that would allow the work to be done.

In this study thermal and mechanical properties and chemical structure of four differentpolymers (PE, PP, polyASA and PVC) were investigated to find out if the recycled polymershad the same properties and can be used in the same applications as the virgins or not.FT-IR was used for investigation of chemical structure. TGA, DSC and thermal stability wereused to compare the thermal properties. Tensile test also used to examine the mechanicalproperties.All the tests showed the recycling process is not done completely well. The differences inresults for virgins and recycled samples are the reasons which verified this claim.The results obtained from this study clarifying that the amount of stabilizer in the recycledpolymers were considerably less than the amount in virgins, means that the company had notadded enough stabilizer during the recycling process.

No mundo, mais pessoas morrem de tuberculose que de qualquer outra infecção curável. O Programa Nacional de Controle da Tuberculose (PNCT) tem como propósito fundamental promover o controle da tuberculose no Brasil. Busca a interrupção da transmissão da doença e a conseqüente diminuição dos riscos de adoecer e morrer por ela. Para isso, procura identificar precocemente todos os doentes, garantindo seu tratamento até o final. O Estado de São Paulo, seguindo a política nacional, muito tem investido em treinamentos para implantação da busca ativa do sintomático respiratório. Todos os funcionários de unidades de saúde vêm recebendo treinamentos e todos podem realizar a busca ativa, independente de sua profissão ou função na unidade. Entretanto, em estudo realizado no Município de Guarulhos, em 2005, constatou-se que mais de 90% dos sintomáticos respiratórios deixam de ser identificados pelos serviços de saúde, apesar de que 70% dos profissionais da rede básica de saúde do município receberam treinamento sobre busca ativa em 2004 e a mesma foi implantada em todas as unidades. O objetivo deste estudo foi de conhecer a percepção do profissional de saúde sobre a atividade de busca ativa do sintomático respiratório, no município de Guarulhos, através de entrevistas semi estruturadas e gravadas em fitas magnéticas, utilizando a estratégia metodológica do Discurso do Sujeito Coletivo. Na análise dos discursos ficou evidente que o profissional de saúde sabe o que é fazer busca ativa, a maioria se preocupa com quem está tossindo indo investigar, a atividade é reconhecida como um bom trabalho, é considerada simples apesar de desencadear várias etapas e trazer preocupações e reações tanto do usuário como do profissional de saúde, onde os fatores que inviabilizam a sua execução nas unidades de saúde que fizeram parte deste estudo são: a falta de recursos humanos, excesso de trabalho, falta de interesse e desmotivação aliados à inexistência de uma rotina implantada para que a mesma possa ser realizada. / More people die of tuberculosis than of any other curable infection worldwide. The National Tuberculosis Control Program (NTCP) is involved in the tuberculosis control in Brazil and halting disease transmission and consequently reduce the risk of people getting and dying of tuberculosis. Hence, the early identification is attempted in order to provide complete treatment of all cases. The State of Sao Paulo, in accordance with the National policy, has heavily invested in training professionals to introduce the active case finding of respiratory symptomatics as a routine activity in health care units. All healthcare professionals have been trained and are able to conduct active case findings, independent of their profession or function at the healthcare system. However, in a study conducted in the city of Guarullhos (State of Sao Paulo), in 2005, was observed that more than 90% of respiratory symptomatics are left unidentified in the healthcare units, in spite of 70% of professionals of the whole healthcare system of the municipality having received active case finding training in 2004, when the activity was introduced in all healthcare system. The objective of the present study is to appraise the perception of healthcare workers regarding the active case finding activity in the city of Guarulhos, by means of semistructured tape-recorded interviews, using the methodologic strategy of Speech of Collective Subject. In examining the speeches, it was found out that the healthcare worker is aware of what the active case finding means and most of them are concerned with people coughing and do start the necessary investigations. They recognize that the activity is simple and useful, although comprising several steps. Preoccupations and reactions of both patients and healthcare workers regarding factors that may render the activity not feasible in healthcare units are: lack of personnel, excessive amount of work, lack of interest and motivation added up to non-existing routines that would allow the work to be done.

La transformation martensitique thermoélastique apparaissant dans les alliages à mémoire de forme (AMF) de type Nickel-Titane (NiTi) est un mécanisme de déformation conférant à ces matériaux des propriétés remarquables de plus en plus utilisées. Les forts phénomènes de localisation des déformations lors d'essais de traction superélastique remettent en cause l'utilisation de cet essai pour bâtir des lois de comportement, alors que d'autres essais comme la torsion et le cisaillement apparaissent comme plus homogènes.<br />Ce travail de thèse est dédié à l'analyse des mécanismes de déformation des AMF NiTi. Les comportements homogènes et localisés ont été étudiés en fonction des géométries d'échantillons, des types de sollicitations et des conditions d'essais. L'originalité de cette étude est d'utiliser deux méthodes de mesures de champs : (i) la corrélation d'images afin d'obtenir les champs cinématiques et d'observer les localisations de déformation ; (ii) la thermographie infrarouge pour mesurer les champs de température et analyser les phénomènes de changement de phase. Afin d'utiliser ces techniques simultanément, des outils de recalage spatial et temporel des données ainsi que des techniques d'estimation de sources de chaleur ont été développés. Lors d'essais superélastiques, cette étude a permis d'une part de mettre en évidence la présence de changement(s) de phase homogène en début de charge et de décharge, d'autre part de caractériser de manière quantitative les différentes morphologies de localisation. Les outils développés sont une première tentative pour disposer, à l'issue de ce travail, d'une DSC locale sous chargements mécaniques.

Ce travail a pour objectif principal d'étudier l'influence des paramètres des procédés de compaction à froid et de frittage sur la microstructure et les propriétés mécaniques des pièces en polytetrafluoréthylène (PTFE) ainsi fabriquées. Comme d'autres polymères à haute masse moléculaire, bien que faisant partie des polymères thermoplastiques, le PTFE présente une viscosité à l'état fondu trop élevée pour permettre sa mise en oeuvre par moulage par injection, ce qui conduit au procédé de fabrication par compaction à froid et frittage. La phase de frittage correspond à un traitement thermique au delà de la température de fusion qui induit des déformations finies, en général anisotropes et fonction de l'histoire du chargement mécanique subi par le matériau au cours de l'étape préalable de compaction à froid. Afin de développer des modèles de comportement thermomécaniques utilisables lors de la simulation numérique de l'ensemble du procédé de fabrication, différents essais ont été réalisés pour étudier les différents mécanismes responsables des évolutions microstructurales et des déformations lors de la compaction et du frittage. L'étude expérimentale du procédé de compaction a été menée grâce à des essais de compaction uniaxiale (oedométriques), des essais de compaction hydrostatique réalisés dans une presse hydraulique isostatique et des essais triaxiaux réalisés grâce à un dispositif original installé dans une machine d'essais électrohydraulique à six vérins. Ces essais ont permis d'identifier un modèle de comportement élasto-plastique de type "Drucker-Prager/cap" disponible dans la bibliothèque de lois de comportement du programme de calcul par éléments finis industriel ABAQUS™, ce qui a permis de simuler numériquement quelques cas simples. L'étude expérimentale du procédé de frittage a été menée grâce à la réalisation d'essais de thermogravimétrie (ATG), calorimétrie différentielle à balayage (DSC) et d'essais de dilatométrie réalisés sur des éprouvettes isotropes ou anisotropes avec différentes valeurs de la porosité. Ces essais ont permis de décomposer la déformation de frittage en une déformation thermique réversible, une déformation liée au changement de phase cristalline en phase amorphe -ou vice versa-, une déformation liée à la refermeture des pores et enfin une déformation dite de recouvrance. Cette étude a été réalisée sur deux poudres, de PTFE pur ou de PTFE chargé par environ 5wt% d'Ekonol™ et 5wt% de fibres de carbone, respectivement commercialisées sous le nom de Teflon™ 6407 et de Teflon™ 6507.

Les fluides employés lors du forage pétrolier pour la lubrification de l'outil de forage, l'évacuation des déblais et le maintien de la pression hydrostatique dans le puits sont composés de solides en suspension dans une huile minérale, qui contiennent également une solution aqueuse en émulsion. La formation d'hydrates de gaz dans ces fluides, rendue possible par les conditions de pression et de température du forage offshore, est suspectée d'être à l'origine de plusieurs accidents sérieux. L'objet de cette thèse est l'étude des conditions de formation et de stabilité des hydrates de gaz dans les fluides à base d'émulsion eau - dans - huile. La technique d'analyse calorimétrique différentielle a été retenue en raison de sa compatibilité avec les systèmes les plus complexes. La validité des mesures de températures de dissociation des hydrates de méthane dans les solutions de chlorure de sodium et de chlorure de calcium a été vérifiée pour des pressions comprises entre 4 et 12 MPa. L'application aux émulsions eau - dans - huile, représentant un modèle simplifié des fluides de forage, a permis de vérifier que l'état dispersé de la phase aqueuse n'influence pas de façon mesurable la thermodynamique des hydrates de méthane. Il accroît en revanche fortement la cinétique de formation et les quantités d'hydrate formé. L'application aux fluides réels confirme les résultats obtenus en émulsion. Les informations obtenues permettent de proposer un modèle phénoménologique du processus de formation des hydrates de gaz en émulsion. La modélisation a permis le calcul des limites de stabilité des hydrates de méthane en présence de divers inhibiteurs, à des pressions allant jusqu'à 70 MPa. Les diagrammes de phases isobares hydrate - sel, permettant de prédire l'efficacité de l'inhibition en fonction de la température et de la concentration, ont été établis pour le chlorure de sodium et le chlorure de calcium, pour des pressions allant de 0,25 à 70 MPa.

Apoptosis plays a crucial role in multicellular organisms by preserving tissue homeostasis and removing harmful cells. The anti-apoptotic B-cell CLL/lymphoma 2 (Bcl-2) and the pro-apoptotic Bcl-2-associated X protein (Bax) act as major regulators of the mitochondrial apoptotic pathway. Activation of Bax via stress signals causes its translocation to the mitochondrial outer membrane (MOM). There, Bax forms homo-oligomeric pores, leading to the release of apoptogenic factors, caspase activation and ultimately cell death. However, the underlying mechanism for the recruitment and pore forming activity of Bax is still not elucidated. Nevertheless, the mitochondrial membrane system seems to play an active and crucial role, presumably being directly involved in the onset of the mitochondrial apoptosis. Since the formation of reactive oxygen species (ROS) is a common stress signal and one of the hallmarks of the mitochondrial apoptosis, direct damage can occur to these membranes by the generation of oxidized phospholipids (OxPls), whose presence can crucially influence the pro-apoptotic action of Bax there. To better understand the impact of OxPls on membranes as well as their potential role in the mitochondrial apoptotic process, defined OxPl species were incorporated into phospholipid vesicles and studied with various biophysical techniques. Differential scanning calorimetry (DSC) and solid state nuclear magnetic resonance (NMR) spectroscopy were used to gain insight into changes in membrane properties in the presence of OxPls. In addition to circular dichroism (CD) spectroscopy, DSC and solid state NMR were furthermore performed to elucidate the impact of OxPls on Bax-membrane interactions. The occurrence of OxPls gave rise to dramatic changes in membrane organization and dynamics, manifested as lateral phase separation into OxPl-rich and -poor domains and modified hydration at the membrane interface. The presence of OxPls also had a great impact on the interaction between Bax and mitochondria-mimicking vesicles, strongly promoting the association of the protein with the membrane. At the MOM, Bax is believed to be inhibited by Bcl-2. How this inhibition occurs is still a mystery due to the lack of biophysical information on Bcl-2, in particular on the full-length protein variant. Since Bcl-2 is also one of the main culprits in the progression of various forms of cancer, knowledge of the structural and mechanistic properties of the full-length protein is essential for a fundamental understanding of its function at a molecular level. To this end, a method for the production of full-length Bcl-2 was developed. By performing cell-free protein synthesis, preparative amounts of the protein were obtained, which enabled a biophysical characterization of the putative interaction between Bax and Bcl-2 using CD and fluorescence spectroscopy. A protocol for the reconstitution of Bcl-2 into proteoliposomes was also developed, promising for future studies of the full-length protein in its native membrane environment; a prerequisite to fully understand its pro-survival functions as well as providing crucial information for the design of novel anti-cancer drugs.

Les méthodes de stérilisation qui existent à l'heure actuelle ne sont pas universelles, ce qui nous conduit à développer, sans cesse des procédés innovants. La décharge électrique à pression atmosphérique (décharge plasma) est l'une des voies qui nous semble actuellement, intéressante et prometteuse à explorer dans le domaine de la stérilisation des matériaux plastiques à usage médical. En effet, les gaz plasma permettent de combiner un cycle rapide, peu coûteux et non toxique tout en ayant la possibilité d'y soumettre les matériaux thermosensibles que sont la plupart des biomatériaux. Il est en effet important que le procédé de stérilisation ne modifie pas la surface et la structure des dispositifs médicaux réutilisables afin de ne pas altérer leur fonctionnalité. A ce titre, l'impact du traitement par le plasma sur les biomatériaux semble généralement moins important que celui des autres méthodes de stérilisation. Notre objectif est d'étudier la stabilité des matériaux polymères de type polyuréthane, très utilisés dans le domaine biomédical, lors d'un traitement de stérilisation par un plasma froid, préalablement développé et optimisé par le laboratoire de Physique des Gaz et des Plasmas d'Orsay. Ces polymères sont très fréquemment employés dans la fabrication des systèmes médicaux (dispositifs d'assistance cardiaque, pacemakers, cathéters, endoscopes, tubages endotrachéaux et d'oxygénation...) car ils possèdent de bonnes propriétés mécaniques, physiques et chimiques et biocompatibilité. Dans cette étude, nous nous sommes intéressés aux éventuelles modifications de tubes à base de Pellethane®, traités par plasma. Ces changements peuvent apparaître à deux niveaux : sur les propriétés du matériau et sur sa composition. C'est pourquoi différentes techniques analytiques ont été mises en oeuvre telles que la DSC, ATG, GPC pour caractériser le matériau globalement, la spectroscopie FTIR-ATR, les mesures de mouillabilité, le MEB et la microscopie optique, pour évaluer les modifications de surface. Par ailleurs, l'évolution de la composition a été suivie par RP-HPLC afin d'évaluer la présence d'extractibles, et de mettre en évidence leur éventuelle diffusion, car ils constituent une source potentielle de cytotoxicité. Enfin, nous avons évalué l'effet de ces différentes propriétés physico-chimiques sur l'adhésion d'une souche bactérienne (Staphylococcus aureus) très largement impliquée dans les infections nosocomiales.

The objective of this work is to determine the effect of four process variables on the properties of blends composed of bisphenol-A polycarbonate (PC) and poly (butylene terephthalate) (PBT) polymers which are compounded using a large scale commercial extruder. The four variables studied are blend composition, specific energy consumption, residence time and shear rate. The last three factors were varied using the extruder screw speed and feed rate. The PC/PBT blends, commercially known as XENOY, were compounded using a WP ZSK 58 mm co-rotating twin screw extruder at the facility of SABIC Innovative Plastics in Cobourg Ontario. The extruder was instrumented to measure online the die pressure, specific energy consumption and blend temperature. The blends were characterized using differential scanning calorimetry, (DSC), scanning electron microscopy, (SEM), gel permeation chromatography, (GPC), and melt volume flow rate, (MVR). After processing, the blend properties determined were melting temperature, glass transition temperature, crystallinity, amorphous phase weight fraction, amorphous phase composition, phase morphology, PBT-rich-phase size, blend molecular weight distribution, and MVR. Using principles available in the literature, a linear regression model was developed to relate the process variables with the online measured properties and output blend properties. Fitting this model allowed the relative importance of each process variable to be estimated for each property. An attempt was also made to identify the general type of PC/PBT blend studied and how it compares with published PC/PBT blend data. It was found that the blends studied were well stabilized since there was no evidence of significant co-polymer formation during processing. Small decreases in molecular weight were attributed to mechanical degradation. Blending increased the crystallization and melting temperatures, as well as blend crystallinity. No practically significant difference in melting temperatures was observed between the different processing conditions. Analysis of glass transitions indicated that the blend components were partially miscible. The amorphous phase compositions were unaffected by blend composition or processing; however, the weight fraction PC-rich-phase present in the blend was strongly influenced by the screw speed. The phase structure of as-extruded blends could not be resolved using the SEM. Therefore, the blends were annealed to coarsen the phases. After annealing, a continuous PC-rich-phase and a discrete PBT-rich-phase were observed. The PBT phase size increased with increasing PBT content. No other statistically significant effects on phase size were observed but this is not conclusive due to the large scatter in the measurements. MVR was primarily influenced by blend composition and specific energy consumption, with the effects of composition being dominant. Further study using higher imaging resolution is required if the phase structures of as received blend pellets are to be characterized. Contrary to current practice, it is recommended that the Utracki-Jukes equation be used rather than the Fox equation for determining amorphous phase composition from glass transition data in PC/PBT blends.

The objective of this work is to determine the effect of four process variables on the properties of blends composed of bisphenol-A polycarbonate (PC) and poly (butylene terephthalate) (PBT) polymers which are compounded using a large scale commercial extruder. The four variables studied are blend composition, specific energy consumption, residence time and shear rate. The last three factors were varied using the extruder screw speed and feed rate. The PC/PBT blends, commercially known as XENOY, were compounded using a WP ZSK 58 mm co-rotating twin screw extruder at the facility of SABIC Innovative Plastics in Cobourg Ontario. The extruder was instrumented to measure online the die pressure, specific energy consumption and blend temperature. The blends were characterized using differential scanning calorimetry, (DSC), scanning electron microscopy, (SEM), gel permeation chromatography, (GPC), and melt volume flow rate, (MVR). After processing, the blend properties determined were melting temperature, glass transition temperature, crystallinity, amorphous phase weight fraction, amorphous phase composition, phase morphology, PBT-rich-phase size, blend molecular weight distribution, and MVR. Using principles available in the literature, a linear regression model was developed to relate the process variables with the online measured properties and output blend properties. Fitting this model allowed the relative importance of each process variable to be estimated for each property. An attempt was also made to identify the general type of PC/PBT blend studied and how it compares with published PC/PBT blend data. It was found that the blends studied were well stabilized since there was no evidence of significant co-polymer formation during processing. Small decreases in molecular weight were attributed to mechanical degradation. Blending increased the crystallization and melting temperatures, as well as blend crystallinity. No practically significant difference in melting temperatures was observed between the different processing conditions. Analysis of glass transitions indicated that the blend components were partially miscible. The amorphous phase compositions were unaffected by blend composition or processing; however, the weight fraction PC-rich-phase present in the blend was strongly influenced by the screw speed. The phase structure of as-extruded blends could not be resolved using the SEM. Therefore, the blends were annealed to coarsen the phases. After annealing, a continuous PC-rich-phase and a discrete PBT-rich-phase were observed. The PBT phase size increased with increasing PBT content. No other statistically significant effects on phase size were observed but this is not conclusive due to the large scatter in the measurements. MVR was primarily influenced by blend composition and specific energy consumption, with the effects of composition being dominant. Further study using higher imaging resolution is required if the phase structures of as received blend pellets are to be characterized. Contrary to current practice, it is recommended that the Utracki-Jukes equation be used rather than the Fox equation for determining amorphous phase composition from glass transition data in PC/PBT blends.