INTRODUÇÃO: Os vírus das hepatites B (VHB) e C (VHC) são os principais causadores de hepatopatia crônica em todo mundo. Ambos compartilham vias semelhantes de transmissão. Em pacientes portadores crônicos de VHC com sorologia compatível com infecção pregressa pelo VHB (anti-HBcAg[+] e HBsAg [-]), o VHB DNA residual tem sido detectado por técnicas de biologia molecular altamente sensíveis no soro, em células linfomononucleares de sangue periférico e em hepatócitos (como cccDNA), de forma que o anti-HBcAg tem sido associado a pior prognóstico, tanto histológico quanto terapêutico. OBJETIVOS: Analisar a associação entre infecção pregressa pelo VHB nos portadores crônicos do VHC e o dano histológico hepático, além das características epidemiológicas, clínicas e laboratoriais destes pacientes em região de baixa prevalência para o VHB. MÉTODOS: A prevalência do anti-HBcAg foi avaliada em 574 pacientes portadores crônicos de VHC atendidos durante o ano de 2006 no ambulatório de Hepatites Virais do DMIP-HC FMUSP. Deste grupo, foram selecionados 215 pacientes (98 de 112 com anti-HBcAg[+] e 117 de 462 monoinfectados pelo VHC) para análise comparativa. Ainda, 145 indivíduos foram submetidos à análise estatística multivariada, por metodologia de Regressão Logística sequencial, para identificação de possíveis preditores de fibrose avançada. RESULTADOS: Foram avaliados 98 pacientes com marcadores sorológicos de infecção pregressa pelo VHB. Quarenta e seis indivíduos (47%) possuíam o anti-HBcAg de forma isolada. O principal fator de risco relacionado à infecção viral foi hemotransfusão (31,6%). Contudo, a freqüência de UDI foi maior no grupo com infecção pregressa pelo VHB, em relação aos 117 indivíduos monoinfectados pelo VHC (p<0,05). Não houve diferença estatisticamente significativa quanto ao estadiamento (p=0,40) ou à graduação necroinflamatória histológica (APP, p=0,70) entre esses dois grupos. O tempo de infecção e a taxa de progressão de fibrose também foram semelhantes (p=0,99 e p=0,61, respectivamente). A presença do anti-HBcAg não foi considerada preditora de fibrose hepática avançada (p=0,11), porém identificamos como variáveis independentes o tabagismo acentuado (OR 4,40; IC95%: 1,30-14,87), aumento da ALT (OR 1,01; IC95%: 1,00-1,03), de gamagt (OR 1,01; IC95%: 1,00-1,01) e leucopenia (OR 7,75; IC95%: 2,13-28,23). CONCLUSÃO: A prevalência de infecção pregressa pelo VHB em portadores de infecção crônica pelo VHC foi de 20%, sendo este valor compatível com outros estudos realizados em regiões de endemicidade semelhante. A freqüência do marcador anti-HBcAg isolado foi alta neste grupo, refletindo uma possível supressão da imunidade humoral contra o VHB frente a resposta dirigida ao VHC. A infecção pregressa pelo VHB não parece acentuar ou acelerar o dano histológico hepático no nosso meio. / INTRODUCTION: Hepatitis B (HBV) and C (HCV) virus are the main causers of chronic hepatic disease worldwide. Both viruses share similar transmission routes. In chronic HCV infected patients with serological markers of resolved HBV infection (anti-HBcAg [+] and HBsAg [-]), residual HBV-DNA has been detected through highly sensible techniques in serum, PBMC and hepatocytes (as cccDNA). In fact, anti-HBcAg has been associated with worse prognoses, severe histological liver damage and less sustained virological response to HCV treatment. OBJECTIVE: Assess the relationship between previous HBV infection (anti-HBcAg [+]; HBsAg [-]) in patients with chronic hepatitis C (HCV) and histological damage, considering epidemiological, clinical and laboratorial characteristics of this group in a region of low prevalence for HBV. METHODS: Anti-HBcAg prevalence was evaluated in 574 patients seen during a period of one year in a tertiary center (University of Sao Paulo General Hospital, Sao Paulo, Brazil). Of this group, 215 subjects addressed selection criteria and have been selected for evaluation (98 of 112 carriers of anti-HBcAg and 117 of 462 infected only by HCV). 145 individuals have undergone analysis for identification of predictors of advanced fibrosis through univariate and multivariate stepwise logistic regression. RESULTS: Nineteen-eight subjects with serological markers of previous HBV infection were evaluated. Forty-six (47%) patients had anti-HBcAg in isolated form. The main risk factor for infection was blood transfusion (31,6%). However, the IDU frequency was greater in this group (p<0.05). There was no difference regarding histological staging (fibrosis ranging from 0 to 4, p=0.40) or grading (portal inflammation, p=0.70) compared with subjects infected only by HCV with no markers of HBV infection. The rate of fibrosis progression (in units per year) and the infection length was similar in these two groups (p=0,61 and p=0,99, respectively). Anti-HBcAg was not considered a predictor for advanced fibrosis (p=0.11). However, we identified tobacco smoking (OR 4.40; CI 95%: 1.30-14.87), increased ALT (OR 1.01; CI 95%: 1.00-1.03), increased -gt (OR 1.01; CI 95%: 1.00-1.01) and leucopenia (OR 7.75; CI 95%: 2.13-28.23) as independent variables. CONCLUSION: The prevalence of resolved HBV infection in subjects with chronic hepatitis C was 20%. This result was equivalent to other studies carried out in regions of similar endemicity. The frequency of the isolated anti-HBcAg was higher in this group, reflecting a possible suppression of the humoral immunity against HBV caused by an active immune response directed to HCV. Former and resolved HBV infection does not seem to increase or accelerate histological damage in our geographical area.

En 1892, la toile Manao tupapau de Paul Gauguin présente, à l’arrière d’une vahiné dénudée, un petit personnage encapuchonné. L’artiste explique qu’il s’agit d’un tupapau, d’un revenant dans les traditions polynésiennes. Le motif en réalité est déjà apparu en France en 1888, sans référence à l’Océanie, et ne cessera de hanter l’œuvre jusqu’au décès de Gauguin en 1903. Cette figure thanatique, intrusive dans une œuvre qualifiée d’exotique et d’érotique, méritait réflexion, d’autant que la critique l’a souvent banalisée ou effacée. Ce personnage montre-t-il que l’artiste cède au fantastique fin-de-siècle ? S’agit-il d’alimenter l’exotisme, comme les Orientalistes, en faisant cohabiter cette entité ténébreuse avec la «belle des îles» ? Y a-t-il, de la part d’un homme exécrant l’Europe mercantiliste et racialiste, un intérêt sincère pour le surnaturel polynésien persécuté par les missions chrétiennes ? Notre travail a montré que l’excursion dans les îles du Pacifique pouvait virer à la descente aux Enfers. Face à la normalisation coloniale et chrétienne des mœurs et croyances polynésiennes, la peur de la damnation, la mortalité effrayante dû au mal vénérien, le démon à capuche est la mort qui gagne sur les plaisirs, la diabolisation de la liberté sexuelle. Mais il exprime aussi une ingression dans les ténèbres de la psyché, une tension entre volonté de jouissance dans la nouvelle Cythère et peur d’une sexualité féminine diabolisée et indomptée, entre désir de régression vers la mère et envie de fuir une figure tutélaire anxiogène. Le petit génie macabre contribue enfin à orienter l’œuvre vers une esthétique originale, mettant à mal les stéréotypes artistiques et idéologiques. / In 1892, Paul Gauguin’s painting Manao tupapau shows, behind a naked Tahitian woman, a little hooded character. The artist explains that this is a tupapau, that is to say a ghost in the Polynesian traditions. In reality the pattern already appeared in France in 1888, without any reference to Oceania, and it will haunt the work of Gauguin until he died in 1903. This figure, invasive in a so-called exotic and erotic work, deserves special attention, especially as most critics often trivialised or deleted it. Does this character prove that the artist is yielding to fin-de-siècle fantasy ? Is it a way to feed exotism, like the Orientalists painters, by the coexistence between this shadowy ghost and the « belle des îles » ? Knowing that Gauguin hated the mercantilist and racialist Europe, does he have a real interest in the Polynesian occult world and beliefs as they were fought by Christian missions ? Our dissertation showed that Gauguin’s excursion in the Pacific islands went a downward spiral. When the Polynesian customs and religion are standardized by colonialism and Christianism, when guilt of damnation and mortality caused by the syphilis are spreading, the hooded genius represents death prevailing over pleasure, the demonization of sexual freedom. This figure expresses also a descent into the dark room that is Gauguin’s psyche, his being torn between will of enjoyment in the new Cythère and fear of a demonized and untamed female sexuality, between his desire to come back to the mother image and his avoidance of a stressful domination figure. At last the little genius helps to give the work an original esthetics, challenging artistic and ideological stereotypes.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2014-10-29T14:55:41Z No. of bitstreams: 2 Dissertação - Marina Pedroso de Oliveira - 2013.pdf: 1546029 bytes, checksum: 047574069d3a0ee543cf485aa4e61edd (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2014-10-30T10:52:04Z (GMT) No. of bitstreams: 2 Dissertação - Marina Pedroso de Oliveira - 2013.pdf: 1546029 bytes, checksum: 047574069d3a0ee543cf485aa4e61edd (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2014-10-30T10:52:04Z (GMT). No. of bitstreams: 2 Dissertação - Marina Pedroso de Oliveira - 2013.pdf: 1546029 bytes, checksum: 047574069d3a0ee543cf485aa4e61edd (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2013-02-28 / Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG / It is estimated that about 10% of individuals infected with human immunodeficiency virus (HIV) throughout the world have chronic infection with hepatitis B virus (HBV). The HIV-HBV co-infection increases the risk for developing cirrhosis and hepatocellular carcinoma. Also, co-infected individuals have atypical serological profiles more often than monoinfected patients, many of whom may have occult hepatitis B (presence of HBV-DNA in serum and/or liver in the absence of HBsAg) in addition to mutations in the viral genome that may have implications for the prognosis and therapeutics of hepatitis B. This study aimed to estimate the prevalence of occult HBV infection in HIV-infected treatment-naive patients, in Goiânia, Goiás, to determine the viral load of HBV-DNA positive samples, to identify circulating genotypes/subgenotypes and to investigate the occurrence of mutations in P and S regions of the HBV genome. This is a cross-sectional study conducted in HIV-infected treatment-naive patients attended at a reference hospital for infectious diseases in the Goiania city. After serological screening of the population (n = 505), two groups of patients were selected for this study: (i) 99 anti-HBc positive/HBsAg negative and (ii) 29 HBsAg reactive individuals. HBV-DNA was detected by semi-nested PCR and quantified by real time PCR. The amplicons were genotyped by RFLP and nucleotide sequencing. The identification of mutations in the viral genome was made by deduction of the amino acid sequences from the nucleotides sequences. The search for occult HBV infection performed in 99 anti-HBc positive/HBsAg negative samples (Group 1) showed a prevalence of 16.2% (16/99, 95% CI: 9.8-25.2). Of 29 HBsAg positive patients (Group 2), HBV-DNA was detected in 69% (20/29). As expected, DNA levels in the HBsAg reactive patients were significantly higher than those found in patients with occult infection (mean 2.89 x 108 copies/ml vs 6.59 x 102 copies/ml, p < 0.01). The genotypes (subgenotypes) A (A1 and A2), D (D2 and D3) and F (F2) were identified, being A/A1 the most frequently found. Mutations in the S region of HBV were found in both groups of patients, whereas mutations in the P region were observed only in patients HBsAg positive. These results revealed a high prevalence of occult HBV infection, the predominance of genotype A (A1), and the presence of mutations in the viral genome of HBV-HIV co-infected treatment-naive patients in Goiânia, Goiás. / Estima-se que cerca de 10% dos indivíduos infectados pelo vírus da imunodeficiência humana (HIV) em todo o mundo apresentam infecção crônica pelo vírus da hepatite B (HBV). A coinfecção HIV-HBV aumenta o risco para desenvolvimento de cirrose e hepatocarcinoma. Ainda, indivíduos coinfectados apresentam perfis sorológicos atípicos mais frequentemente do que os monoinfectados, sendo que muitos deles podem apresentar hepatite B oculta (presença do HBV-DNA no soro e/ou fígado na ausência do HBsAg), além de mutações no genoma viral que podem ter implicações no prognóstico da hepatite B e na terapêutica. Este estudo teve como objetivos estimar a prevalência de infecção oculta pelo HBV em indivíduos infectados pelo HIV, virgens de tratamento, em Goiânia-Goiás, determinar a carga viral das amostras HBV-DNA positivas, identificar os genótipos/subgenótipos circulantes e investigar a ocorrência de mutações nas regiões S e P do genoma do HBV. Este é um estudo transversal conduzido em pacientes infectados pelo HIV, virgens de tratamento, atendidos em um hospital de referência para doenças infecciosas na cidade de Goiânia. Após triagem sorológica da população (n=505), dois grupos de pacientes foram selecionados para o presente estudo: (i) 99 anti-HBc positivos/HBsAg negativos e (ii) 29 indivíduos HBsAg reagentes. O HBV-DNA foi detectado por semi-nested PCR e quantificado por PCR em tempo real. Os amplicons foram genotipados por RFLP e sequenciamento de nucleotídeos. A identificação de mutações no genoma viral foi feita pela dedução de aminoácidos a partir de sequências de nucleotídeos. Ao pesquisar a infecção oculta para o HBV nas 99 amostras anti-HBc positivas/HBsAg negativas (Grupo 1), estimou-se uma prevalência de 16,2% (16/99; IC 95%: 9,8-25,2). Dos 29 pacientes HBsAg positivos (Grupo 2), o HBV-DNA foi detectado em 69% (20/29). Como esperado, os níveis de HBV-DNA nos pacientes HBsAg reagentes foram significativamente maiores do que os encontrados nos pacientes com infecção oculta (média: 2,89 x 108 cópias/mL vs 6,59 x 102 cópias/mL; p < 0,01). Os genótipos (subgenótipos) A (A1 e A2), D (D2 e D3) e F (F2) foram identificados, sendo A/A1 os mais frequentes. Mutações na região S do HBV foram encontradas nos dois grupos de pacientes, enquanto que as mutações na região P foram evidenciadas somente nos pacientes HBsAg positivos. Estes resultados revelaram uma prevalência alta de infecção oculta pelo HBV, a predominância do genótipo A (A1), bem como a presença de mutações no genoma viral dos pacientes HBV-HIV coinfectados, virgens de tratamento, em Goiânia-Goiás.

Introdução: O sangramento colorretal é considerado um sinal de alarme e não deve ser ignorado. A perda de sangue pode não ser identificada pelo paciente, o que caracteriza a presença de sangue oculto. Este diagnóstico pode ser confirmado por testes de Pesquisa de Sangue Oculto nas Fezes (PSOF), através de métodos químicos ou imunoquímicos de identificação da hemoglobina. O resultado positivo de um teste de PSOF requer investigação complementar com colonoscopia, exame invasivo, de alto custo e que exige preparo intestinal. Justifica-se, portanto, a aplicação de um teste diagnóstico mais sensível e específico. No presente estudo, foram avaliados quatro diferentes testes de PSOF em 176 pacientes submetidos à colonoscopia e seus resultados foram comparados. Objetivos: 1) avaliar o grau de concordância entre os testes de PSOF e a colonoscopia. 2) avaliar a sensibilidade, a especificidade e os valores de predição dos testes químico e imunoquímico de PSOF, em pacientes submetidos à colonoscopia. Métodos: Pacientes com indicação de realizar colonoscopia foram submetidos também à PSOF pelo método químico (o-toluidina) e pelo método imunoquímico, empregando três kits comerciais disponíveis no mercado. Os pacientes foram avaliados quanto à indicação do exame colonoscópico, resultado da colonoscopia e uso de alimentos e medicamentos que pudessem interferir no resultado dos testes fecais. Fundamentado nos achados endoscópicos, a colonoscopia foi categorizada em positiva ou negativa, de acordo com a possível fonte de sangramento colorretal. O grau de concordância entre os testes de PSOF foi avaliado pelo índice Kappa. Resultados: Dos 176 pacientes, houve predomínio do sexo feminino (64,8%), com média de idade de 55,5 anos. As indicações clínicas mais frequentes para realização de colonoscopia foram alteração do hábito intestinal, doença inflamatória intestinal, dor abdominal e anemia. Os principais achados foram pólipos < 1 cm, doença diverticular não complicada do cólon e exame normal. Quarenta e quatro (25%) colonoscopias foram categorizadas como positivas quanto à fonte de sangramento colorretal. Observou-se concordância (p<0,05) entre todos os testes avaliados e a colonoscopia. O teste da o-toluidina apresentou concordância pobre (Kappa 0,03), enquanto os demais testes apresentaram concordância moderada (Kappa entre 0,43-0,48). O teste da o-toluidina revelou menor sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo em comparação aos testes imunoquímicos. Conclusões: Os testes imunoquímicos apresentaram melhores índices de concordância com a colonoscopia, quando comparados ao teste da o-toluidina. Os testes imunoquímicos revelaram maior sensibilidade, especificidade e valores de predição na detecção de sangramento colorretal / Introduction: Colorectal bleeding is considered an alarm sign and should not be ignored. Blood loss can not be identified by the patient, which characterizes the presence of occult blood. This diagnosis can be confirmed by Faecal Occult Blood Testing (FOBT), through chemical or immunochemical methods. The positive outcome of a test requires complementary research FOBT with colonoscopy, an examination of invasive, costly and requires bowel preparation. It is justifiable, therefore, the application of diagnostic tests with better sensitivity and specificity. In the present study, we evaluated four different tests of PSOF in 176 patients undergoing colonoscopy and their results were compared. Objectives: 1) evaluate the degree of concordance between the PSOF tests and colonoscopy 2) assess the sensitivity, the specificity and the prediction values of the chemical and immunochemical FOBTs, in patients undergoing colonoscopy. Methods: Patients with indication of perform colonoscopy were subjected also to FOBT by the chemical method (toluidine test) and by the immunochemical method employing three commercial kits available in the market. Patients were evaluated regarding the indication of the colonoscopic examination, colonoscopy result, and use of foods and drugs that could interfere in the results of the faecal tests. Based on the endoscopic findings, the colonoscopy was rated as positive or negative, according to the possible colorectal bleeding source. The degree of accordance between FOBTs was evaluated by the Kappa index. Results: Among the 176 patients, there was a predominance of female gender (64.8%) with an average age of 55.5 years old. The most frequent clinical indication for colonoscopy were bowel habit changes, inflammatory bowel disease, abdominal pain and anemia. The main findings of colonoscopy were polyps <1 cm, uncomplicated colonic diverticular disease and normal exam. Forty-four (25%) colonoscopies were categorized as positive as to the possible source of colorectal bleeding. There was agreement (p<0.05) between all tests evaluated and the colonoscopy. The toluidine test presented poor accordance (Kappa 0.03), while the others showed moderate concordance (Kappa 0.43-0.48). The toluidine test showed less sensitivity, specificity, positive predictive value and negative predictive value compared to immunochemical tests. Conclusions: Immunochemical tests showed the best indexes of agreement with colonoscopy, when compared to the toluidine test. The immunochemical tests have shown greater sensitivity, specificity and predictive values in detecting colorectal bleeding

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2016-05-05T14:19:45Z No. of bitstreams: 2 Dissertação - Tatiane Cinquini Moraes - 2013.pdf: 1292881 bytes, checksum: 8bde8ffa9aa3405746532ae87b885225 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-05-05T14:23:46Z (GMT) No. of bitstreams: 2 Dissertação - Tatiane Cinquini Moraes - 2013.pdf: 1292881 bytes, checksum: 8bde8ffa9aa3405746532ae87b885225 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2016-05-05T14:23:46Z (GMT). No. of bitstreams: 2 Dissertação - Tatiane Cinquini Moraes - 2013.pdf: 1292881 bytes, checksum: 8bde8ffa9aa3405746532ae87b885225 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2013-04-17 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Hepatitis B is a major public health problem worldwide due to the number of individuals affected and the complications resulting from acute and chronic forms of infection. According to the literature, institutionalized individuals suffering from mental disorders represent a group at risk for acquisition of hepatitis B virus (HBV) infection. In this sense, the present study aimed to investigate the molecular and seroepidemiological profile of HBV infection in a population of institutionalized mentally disturbed in state of Goiás. Blood samples from 333 patients were collected in period of July/2011 to January/2012, and the samples were subjected to enzyme immunoassay for detection of HBV markers infection (HBsAg, anti-HBs, anti-HBc) using commercial kits. The overall prevalence of HBV infection was 12.9%, with an index of isolated positivity for anti-HBc marker of 4.2%. Only three individuals were positive for the marker of active HBV infection (HBsAg) resulting in a 0.9% positivity. Only 4.2% (14/333) of the study population had serologic evidence of previous vaccination against HBV and the susceptibility to HBV, characterized by the absence of any marker, was observed in 82.9% of the population. Multivariate analysis identified sex (male) and the inpatient unit - F (male patients, young adults, wheelchair users) and G (males patients, adults, psychiatric) - as a factor associated with HBV infection. In addition, we proceeded the HBV-DNA detection in the samples with profile anti-HBc alone (N = 14), HBsAg positive (N = 3), anti-HBc/anti-HBs (N = 26) and those anti-HBs alone (N = 14). Thus, 57 samples were subjected to PCR. Three samples with profile anti-HBc alone, one anti-HBc/anti-HBs and one anti-HBs alone were positive for HBV-DNA, resulting in an index of occult HBV infection of 9.2% (5/54). Phylogenetic analysis of HBV-DNA positive samples identified all as genotype A. The results show a significant prevalence of HBV infection in this population, highlighting the need for improvement in strategies for HBV infection prevention and control, as well as a continuous monitoring of HBV positive patients. / A hepatite B representa um grande problema de saúde pública no Brasil e no mundo, devido ao número de indivíduos acometidos e às complicações resultantes das formas aguda e crônica da infecção. Indivíduos institucionalizados portadores de doença mental representam um grupo em risco para aquisição da infecção pelo vírus da hepatite B (VHB). Neste sentido, o presente estudo objetivou investigar o perfil soroepidemiológico e molecular da infecção pelo VHB em uma população institucionalizada portadora de doença mental do Estado de Goiás. Foi realizada a coleta sanguínea de 333 pacientes, no perídodo de Julho/2011 a Janeiro/2012, sendo as amostras submetidas ao ensaio imunoenzimático para deteção dos marcadores de infecção pelo VHB (HBsAg, anti-HBs, anti-HBc) utilizando kits comerciais. A prevalência global da infecção pelo VHB foi de 12,9%, com um índice de positividade isolada para o marcador anti-HBc de 4,2%. Apenas três indivíduos foram reagentes para o marcador de infecção ativa pelo VHB (HBsAg), resultando em uma positividade de 0,9%. Somente 4,2% (14/333) da população estudada apresentaram evidência sorológica de vacinação prévia contra o vírus da hepatite B e, a suscetibilidade ao VHB, caracterizada pela ausência de qualquer marcador, foi observada em 82,9% da população. A análise multivariada mostrou o sexo (masculino) e as unidades de internações – F (pacientes do sexo masculino, adultos jovens, cadeirantes) e G (pacientes do sexo masculino, adultos, psiquiátricos) – como fatores associados à infecção pelo VHB. Em adição, procedeu-se a pesquisa do VHB-DNA nas amostras com perfil anti-HBc isolado (N=14), HBsAg positivas (N=3), anti-HBc/anti-HBs (N=26) bem como naquelas anti-HBs isoladas (N=14). Assim, 57 amostras foram submetidas à técnica de PCR. Três amostras com perfil anti-HBc isolado, uma anti-HBc/anti-HBs e uma anti-HBs isolado foram positivas para VHB-DNA, resultando em um índice de infecção oculta pelo VHB de 9,2% (5/54). A análise filogenética das amostras VHB-DNA positivas identificou todas como genótipo A. Os resultados encontrados demonstram uma importante prevalência da infecção pelo VHB na população estudada, destacando-se a necessidade de elaboração e adoção de estratégias de prevenção e controle da infecção pelo VHB, bem como de um contínuo monitoramento dos pacientes VHB-DNA positivos para acompanhamento e elucidação do estado da infecção.

Made available in DSpace on 2017-06-01T18:12:24Z (GMT). No. of bitstreams: 1 dissetacao_aerton_alexander.pdf: 2291305 bytes, checksum: 5691170904a5e04238ac5dfb50867a54 (MD5) Previous issue date: 2008-03-31 / The change of paradigms in the current society has reached the most varied fields of the human being life, from which we detach the religiosity. ln this context, the movement "New Age" has found fertile land for its development in the varied possible religious experiences. This work, through the concept of "invisible Religion" of Thomas Luckmann, who presents the subjectivity as the place of the options ánd the construction of the religious experience from the biography of each individual searchs the understanding of some aspects of the construction of the religious identity(s) in this movement that is characterized by a sacred without place, a nomadic religiosity, favoring floating identity(s) / A mudança de paradigmas na sociedade atual tem atingido os mais variados âmbitos da vida humana, dentre os quais destacamos a religiosidade. Nesse contexto, o movimento "Nova Era" tem encontrado terreno fértil para seu desenvolvimento em vivências religiosas das mais variadas possíveis. Este trabalho, partindo do conceito de "Religião Invisível" de Thomas Luckmann, que apresenta a subjetividade como lugar das opções e construção da experiência religiosa a partir da biografia de cada indivíduo, busca entender alguns aspectos da construção de identidade(s) religiosa(s) neste movimento que se caracteriza por um sagrado sem lugar, uma religiosidade errante, favorecendo identidade(s) flutuante(s)

MSc (Microbiology) / Department of Microbiology / See the attached abstract below

Marie Ogden's Home of Truth colony—a religious community that was located in southern Utah during the 1930s and 40s—was part of a segment of the American religious landscape that has largely been overlooked. As such, her movement points to a significant gap in the historiography of American religion. In addition to documenting the history of this obscure community, I situate Marie Ogden as part of what I call the early new age of American religion, an underdeveloped part of the broader categories of metaphysical religion or Western esotericism. This thesis also points to several other overlooked figures from the same era, suggesting several avenues for further study.

<p>Uvod. Rak debelog creva predstavlja 9,7% svih malignih bolesti u svetu, i drugi ili treći je po učestalosti u onkolo&scaron;koj strukturi obolevanja, u zavisnosti od pola. Skrining, ili sekundarna prevencija populacije u prosečnom riziku ima centralnu ulogu u kontroli kolorektalnog karcinoma. Cilj. Utvrditi nivo znanja, stavove i pona&scaron;anje u odnosu na rak debelog creva i njihov uticaj na odaziv na skrining raka debelog creva, u zavisnosti od primenjenog modela skrininga. Materijal i metode. U istraživanje je pozvano 1.213 osoba oba pola, starosti 50-74 godine, za uče&scaron;će u studiji znanja, stavova i pona&scaron;anja (KAP studija) u odnosu na rak debelog creva, popunjavanjem upitnika (Sessa A). Formirane su tri grupe prema modelu skrininga: populacioni - model 0; oportuni skrining uz kontakt ispitanika sa medicinskim osobljem, bez dodatnih informacija o bolesti, skriningu i testu &ndash; model 1; oportuni skrining kada se uz kontakt sa medicinskim osobljem dobija informacija o bolesti i skriningu, uz prikaz izvođenja testa - model 2. U ovoj studiji je kao skrining metoda kori&scaron;ćen imunolo&scaron;ki test stolice -Wondfo FOB.Obrada podataka je rađena statističkim programom SPSS (version 13). Značajnost razlika je testirana parametrijskim (t-test, ANOVA) i neparametrijskim (Mann-Whitney U test) testovima, dok se komparacija kategoričkih varijabli vr&scaron;ila &chi;&sup2; testom i Fisher Exact testom. Test-retest analiza je rađena Cohen&#39;s Kappa testom. Rezultati. Od 1.213 pozvanih, 666 (55%) osoba je prihvatilo uče&scaron;će u KAP studiji. Vi&scaron;e od polovine (54,5%) ispitanika ima ukupan skor znanja manji od 50%. Nivo znanja, sociodemografske karakteristike, procena sopstvenog rizika obolevanja, stav u odnosu na korist testa, stepen sopstvenog rizika obolevanja i mogućnosti prevencije raka debelog creva, nisu faktori koji utiči na participaciju u skriningu kolorektalnog karcinoma. Najvažniji faktor za uče&scaron;će u skriningu u ovom istraživanju je kontakt i razgovor sa lekarom o bolesti, prevenciji i skrining testu.Odaziv u skrining, u odnosu na celokupno pozvanu populaciju je 51,2%. Od ispitanika koji su popunili anketni upitnik, participacija u skriningu je 93,4%. Statistički značajno manji odaziv u skriningu je u modelu 0 (12%) i modelu 1 (6%) u odnosu na model 2 (1%). Zaključak. Poznavanje bolesti, faktora rizika i mogućnosti prevencije generalno je oskudno, ali ne utiče na participaciju u skriningu. Faktor koji utiče na visok odaziv u skrining kolorektalnog karcinoma je kontakt i razgovor sa medicinskim osobljem, pre svega sa lekarom.</p> / <p>Introduction. Colorectal cancer represents 9.7% of all malignancies in the world and it is second or third in frequency in oncological structure depending on the sex. Screening, or secondary prevention of the average risk in the population has a central role in the control of colorectal cancer. Aim. Determine the level of knowledge, attitudes and behaviour in relation to colon cancer and their impact on turnout for colorectal cancer screening, depending on the applied screening model. Material and method. There were 1213 people of both sexes aged 50-74 years participating in this study of knowledge, attitudes and practice (KAP studies) in relation to colorectal cancer, by filling in the questionnaire (Sessa A). Three groups were formed with respect to model screening: population - model 0; opportunistic screening involving the contact of patients and medical staff, without receiving additional information about the disease, screening and test - model 1; opportunistic screening involving the contact of patients and medical staff while receiving information about the disease and screening, and explaining the test performance - model 2. In this study, a screening method used was fecal occult blood test - Wondfo FOB. Data processing is performed by the statistical program SPSS (version 13). The significance of differences was tested by parametric (t-test, ANOVA) and nonparametric (Mann-Whitney U test) tests, while the comparison of categorical variables was performed with &chi;&sup2; test and Fisher Exact test. Test-retest analysis was performed with Cohen&rsquo;s Kappa test. Results. Out of all the 1213 participants, 666 (55%) of them accepted to participate in the KAP study. More than half of them (54.5%) have a total score of knowledge less than 50%. The level of knowledge, socio-demographic characteristics, assessment of the risk of the disease, the attitude towards the benefit of the test, degree of the risk of disease and opportunities for prevention of colorectal cancer, are not factors in deciding to participate in the screening of colorectal cancer. The most important factor for the participation in the screening in this study is the contact and conversation with the doctor about the disease, prevention and screening test. The turnout for the screening, in relation to the number of people who participated is 51.2%. Out of those who completed the questionnaire, participation in the screening is 93.4 %. Statistically significantly lower response in the screening is in model 0 (12%) and in model 1 (6%) in relation to model 2 (1%). Conclusion. Knowledge of the disease, risk factors and prevention opportunities are generally scarce, but do not affect the participation in screening. The factor influencing the high turnout for colorectal cancer screening is contact and conversation with the medical staff, primarily the doctor.</p>

In 1990 a small self-published journal/magazine called The Watcher was distributed among New Zealand's occult underground. The Watcher described itself as 'the New Zealand Voice of the Left Hand Path', and was published as the journal of the Order of the Left Hand Path. The Watcher and the Order directed its attentions towards those occultists who identified themselves as Satanists and, as such, the journal articulated a distinctly Satanic philosophy and perspective. However, as the journal evolved and developed, renaming itself as The Heretic and The Nexus in later years, there arose alongside Satanic philosophy an increasing emphases on what could be called esoteric Nazism or esoteric Nationalism. Given that the editor of The Watcher was Kerry Bolton, a man who has been immersed in New Zealand's Nationalist/neo-Nazi movement since the early 1970s, such an increasingly political orientation was perhaps unsurprising. This thesis examines the way in which the Order bought Satanic and neo-Nazi ideologies together and the resulting synthesis. It also looks at the transition from being a Satanic order led by a neo-Nazi to an openly neo-Nazi Order that uses Satanic philosophy to justify and popularise its conception of National Socialism.