sábado, 10 de julho de 2010

Vacina para HIV

A revista publicou sobre vacina contra HIV
AIDS Vaccine: What Promise Do HIV Antibodies Hold?


In the continuing search for the Achilles heel of HIV, researchers may finally be enjoying some success.

This week, government researchers at the Vaccine Research Center of the National Institute of Allergy and Infectious Diseases (NIAID) reported the discovery of two naturally occurring antibodies that may block HIV. Describing their work in two separate papers in the journal Science, AIDS experts said that in lab experiments, the antibodies had successfully prevented more than 90% of circulating HIV strains from infecting human cells.

This is not the first discovery of so-called broadly neutralizing antibodies. Last September, scientists at Scripps Research Institute and the International AIDS Vaccine Initiative (IAVI) identified two other antibodies that prevent against infection from 80% of existing HIV strains — the most potent known antibodies at the time. The findings were also published in Science.
(See pictures from an X-ray studio.)
The two sets of antibodies target different regions of the virus-cell interface — together they could help scientists develop a formidable vaccine against AIDS, says Dr. Anthony Fauci, director of NIAID. "The strategy is going to be to put the best antibodies together, and you are going to have a whopper against HIV," he says.

Antibodies are the first-line soldiers of the immune system. Produced by specialized cells in the body that recognize incoming viruses and bacteria, antibodies act as molecular barricades, latching onto and blocking pathogens from infecting healthy cells. This antibody response is the core of all vaccine-based disease prevention.

But HIV is notoriously changeable. The virus continuously alters the makeup of the proteins on its surface, eluding attack from antibodies created by the immune system and from the relatively weak vaccines that have been developed against the virus so far.

The two new antibodies described in the current Science paper work by blocking a protein on the surface of HIV that the virus normally uses like a key to access healthy cells. This key, which tends to remain constant across most strains of the virus, binds to an entry point on a healthy cell surface, called the CD4 receptor site. When antibodies attach to this region of HIV, it cannot interact with CD4 or get inside a host cell.

Because this particular site on HIV is so crucial and rarely mutates, the virus keeps it jealously hidden under convoluted folds of its protein coat, which makes most antibodies designed to latch onto it ineffective. Certain individuals, however, generate antibodies that recognize and bind to the site more easily, so when they are infected with HIV, they are able to fight off infection.
(See TIME's special report "How to Live 100 Years.")
NIAID scientists identified the new antibodies by screening the blood of one HIV-infected African American patient who produced them naturally. By lifting the obstructive protein covering that HIV uses to guard its CD4-binding site, and isolating only those antibodies that were tailor-made to attach to this gate, scientists zeroed in on just two antibodies that were able to neutralize an unprecedented 90% of circulating HIV strains.

Previous experiments on CD4 have identified other naturally occurring antibodies. But these were effective against only 40% to 50% of HIV strains in tests in the lab because they were less precisely targeted, acting on a combination of the actual binding site and the virus's surrounding protein coat.

In the 2009 study led by Dennis Burton of Scripps Research Institute, scientists focused on a different type of antibody involved in the actual process of viral entry. In order to infect a cell once HIV finds an entry point, the virus changes shape, folding itself into a form that allows it to slip inside the healthy cell. Burton's antibodies interrupt that action, blocking about 80% of circulating HIV strains from taking the shape necessary for infection. However, Burton says he and his team are still figuring out exactly how the process works.

Taken together, the recent discoveries boost the prospect of using broadly neutralizing antibodies as the backbone of an HIV vaccine, experts say. In Burton's study, the antibodies were isolated from a blood sample from Africa; in the current study, the antibodies cam from an African American man. In each case, the patients were infected with a different strain of HIV. That's important, Burton says, because it confirms that effective antibodies can be produced by people on different continents carrying different strains of the virus. "The more you see different people making antibodies, the more relaxed you become that different people can do it, and therefore given the right vaccine, that more people can make antibodies against HIV," he says.

So far, the newly discovered antibodies have been tested only in a lab dish. But Burton says he is a few months from beginning animal studies to determine whether his antibodies can prevent HIV infection in a living system as well they do in the lab.

Experts remain hopeful that this line of work will someday lead to the development of an AIDS vaccine than can be tested in humans. "I can guarantee that you're not going to get a vaccine unless you get good antibodies," says Fauci.

Innovation and education improve health in Rio's favelas

Tanto em educação como em saúde alguns programas localizados no Brasil tem dado bons resultados. Veja esse artigo publicado no Lancet





Access to health care in Brazil's favelas is poor, but several innovative projects in Rio de Janeiro are starting to improve the situation. Sharmila Devi reports.
Nanko van Buuren rushed back to the head office of the Brazilian Institute for Innovations in Social Healthcare, the non-profit group he started in 1989 that is best known by its Portuguese acronym of Ibiss. But his waiting colleagues are long-used to the erratic time-keeping of this tall Dutchman, whom the street children of Rio de Janeiro's favelas or slums call Paitrao, which combines the Portuguese words for father and boss. On this warm afternoon in mid-April, he was delayed because he had been touring some Ibiss projects with a delegation from Success for Kids, an educational charity backed by Madonna, the latest high-profile celebrity who wanted to tackle the entrenched poverty in the favelas. “Madonna called me personally last week to talk about how they can adapt Success for Kids to our own situation”, said van Burren. “They will have to adapt it because a lot of kids here are running around with guns because of organised crime and the drugs trade.”
Ibiss has grown into one of Rio de Janeiro's best-known non-governmental organisations through its many projects aimed at helping the city's most economically and socially excluded people. Since the beginning, its model has been to go into the favelas and ask the residents themselves not just what they need, but how they would organise it. If the programme is successful, Ibiss then lobbies the government to adopt it on a wider scale. Successful initiatives include leprosy-awareness programmes, helping children to leave or to avoid the drug gangs using football and music, and training favela residents to become community health-care workers. Ibiss has grown from just van Buuren and a handful of Brazilian staff to some 600 employees, mostly locally trained Brazilians, who work on about 62 projects.
Brazil will host the soccer World Cup in 2014 and the Olympic Games in 2016 and the government has promised to spend billions of dollars on infrastructure and security to ensure safety and enjoyment for the influx of international visitors. In Rio de Janeiro, a city of about 6 million people, the 1 million residents of some 1000 favelas hope they will benefit from the largesse too. Long neglected by government agencies, they have relied on their own efforts and the help of groups such as Ibiss to ensure access to basic health care and other services, such as electricity or waste collection.
The death toll from gun battles in the favelas between drug gangs, security forces and unofficial police militias is huge considering there is no actual insurgency or civil war. The UN has estimated the police murder three people a day on average in Rio de Janeiro, making them responsible for one in five killings in the city. Populated mostly by economic migrants from the north-east of Brazil, and caught between the drug gangs and the police, the favelas lack systematic access to the health-care system. There are high rates of tuberculosis and maternal and child mortality. Children are particularly vulnerable to diseases that spread in unsanitary conditions. Meanwhile, many Brazilian doctors and nurses are lured by higher salaries to the private sector.
Brazil accounts for about 17% of worldwide cases of leprosy, second only to India, which has about 54% of cases. The spread of leprosy is for the most part a consequence of migration to the favelas, since patients from rural areas often interrupt their 12—18 month course of treatment when they move to Rio's favelas, said Nancy Torres, an Ibiss health worker who helps to organise self-treatment groups. Ibiss also worked with the producers of a popular telenovela, or TV soap opera, to introduce a character with leprosy to help erode its social stigma.


Full-size image (75K) Getty ImagesDownload to PowerPoint
Incursions by heavily armed police are a regular feature of life in the favelas
Brazil does have one of the developing world's best programmes to combat HIV/AIDS, thanks in part to legislation guaranteeing universal access to antiretroviral treatments and the government's authorisation to local companies to produce the drugs without the consent of the patent-holder. But Joseph Amon, director of health and human rights at Human Rights Watch, said issues such as the treatment of drug dependency and the deinstitutionalisation of psychiatric care are still in need of urgent reform. Brazil is one of at least 115 countries that recognises a constitutional right to health. “We're just starting to see the start of advocacy efforts by the government, which needs to give meaning to the constitutional right to healthcare”, he said.
Some favelas have achieved progress in basic sanitation, education and roads. But many others are no-go areas for outsiders, including health workers and local journalists. Heavily armed police making a raid on drug gangs are often the only visitors. Even the more developed favelas provide a stark contrast to rich areas of Rio de Janeiro, such as Ipanema and Copacabana. The wealthiest 10% in Brazil are thought to control about 50% of the country's wealth.
van Buuren, a former WHO psychiatrist, first ventured into the favelas more than 20 years ago, building up trust with the heavily armed drug lords who rule by fear. “It's now very easy for us to do our work because we are very well-known in the slums, especially by the bosses of organised crime,” he said. “It took years of building up confidence. One of the main reasons is that I can't look at people as just criminals or murderers. I ask how are the kids and the man thinks not as a drugs boss but as the father of his children and he's proud to explain. If you are afraid when you talk to the boss, he smells that you're afraid and you're treated in that way.”
van Buuren now speaks better Portuguese than English, having fallen in love with Brazil and its people. Before moving to Brazil, he developed programmes to deliver psychiatric care to the homeless, immigrants, and other hard-to-reach populations in his native Netherlands. For WHO, he helped to train health professionals to cope with disaster and conflict situations. He said Brazilians thought he was crazy when he started Ibiss, with its ethos of enlisting people in the favelas to help to formulate solutions to their problems. “What is funny about Brazil is that people are very open. They looked at us and said you're crazy but go ahead if you want to do it”, he said. “In Holland, they've already created so many obstacles that you can't even start to experiment.”
Ibiss ran into strong opposition when it began distributing condoms, including among street children, but condom distribution is now routine in Brazil. “The church and other groups wanted to think that children had no sexuality and I don't know how they combined that thinking with young girls getting pregnant”, he said. One of Ibiss's biggest successes is its community health-care training programme, which has since been adopted by the Brazilian Government following strong advocacy by Ibiss. There are now more than 3000 health posts all over Brazil.
“In the early 1990s, we saw how the public health system didn't enter the slums”, he said. “So we took people, mostly women, from the slums and gave them training, one-and-a-half days a week for nine months, in the early detection of diseases, how to seek treatment and how to get a prescription.” He said the women felt greatly empowered. “Many would ask after they had referred someone to a medical post about the final diagnosis and they would feel incredibly proud when they found out they were right in their initial diagnosis.”
Brazil is also a source country for the international trafficking of people. The government is being urged, like that of South Africa before it hosted this summer's soccer World Cup, to adopt stricter measures so that offenders are brought to justice. According to the UN, over 75 000 Brazilian women are being sexually exploited in Europe. Rio de Janeiro is seen as one of the principal points of departure for these women to leave the country. Ibiss works on the streets with male and female prostitutes and transvestites and tries to map where and how people are gathered in the better-known areas of prostitution in Rio de Janeiro.
Security remains of paramount concern. The Brazilian Government has now embarked on a pacification programme in which police enter and stay in a favela to enforce law and order. Seven favelas have been occupied so far and dozens more occupations are planned in the run-up to the World Cup and Olympics.
Van Buuren fears the programme could become a victim of its own success, with favela residents selling their homes for a quick profit but unable to survive for long in new shantytowns further out of town. “Pacification has to include incentives for companies to settle in these areas and create jobs or else poor people will lose out.”

Site sobre Tb


Recomendo o site

http://www.tbevidence.org/

quarta-feira, 7 de julho de 2010

Células B e aterosclerose

B cell depletion reduces the development of atherosclerosis in mice

Hafid Ait-Oufella1,2, Olivier Herbin1, Jean-David Bouaziz3,4, Christoph J. Binder5,6, Catherine Uyttenhove7,8, Ludivine Laurans1, Soraya Taleb1, Emily Van Vré1, Bruno Esposito1, José Vilar1, Jérôme Sirvent1, Jacques Van Snick7,8, Alain Tedgui1, Thomas F. Tedder3, and Ziad Mallat1,9
+ Author Affiliations
1Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 970, Paris Cardiovascular Research Center, 75015 Paris, France
2Assistance Publique–Hôpitaux de Paris, Saint-Antoine Hospital, 75012 Paris, France
3Department of Immunology, Duke University Medical Center, Durham, NC 27710
4INSERM, Unit 976, Skin Research Center, Saint Louis Hospital, 75475 Paris, France
5Center for Molecular Medicine of the Austrian Academy of Sciences and 6Department of Laboratory Medicine, Medical University of Vienna, 1090 Vienna, Austria
7Ludwig Institute for Cancer Research and 8Cellular Genetics Unit, Université de Louvain, 1200 Brussels, Belgium
9Division of Cardiovascular Medicine, University of Cambridge, Addenbrooke’s Hospital, Cambridge CB2 2QQ, England, UK
CORRESPONDENCE Ziad Mallat: ziad.mallat@inserm.fr OR zm255@medschl.cam.ac.uk
H. Ait-Oufella and O. Herbin contributed equally to this paper.
ABSTRACT

B cell depletion significantly reduces the burden of several immune-mediated diseases. However, B cell activation has been until now associated with a protection against atherosclerosis, suggesting that B cell–depleting therapies would enhance cardiovascular risk. We unexpectedly show that mature B cell depletion using a CD20-specific monoclonal antibody induces a significant reduction of atherosclerosis in various mouse models of the disease. This treatment preserves the production of natural and potentially protective anti–oxidized low-density lipoprotein (oxLDL) IgM autoantibodies over IgG type anti-oxLDL antibodies, and markedly reduces pathogenic T cell activation. B cell depletion diminished T cell–derived IFN-γ secretion and enhanced production of IL-17; neutralization of the latter abrogated CD20 antibody–mediated atheroprotection. These results challenge the current paradigm that B cell activation plays an overall protective role in atherogenesis and identify new antiatherogenic strategies based on B cell modulation.

Acesse o artigo em pdf
http://jem.rupress.org/content/early/2010/06/30/jem.20100155.full.pdf

Blogs científicos tem algum papel


GeoTagged, [S13.00857, E38.50906]

No caso dos blogs locais de divulgação de atividades são interessantes, mas as informações vinculadas e comentadas são levadas a sério pelos cientistas?

Veja reportagem da Nature
NATURE | EDITORIAL

When blogs make sense

Nature 466, 8 (01 July 2010) doi:10.1038/466008a
Published online 30 June 2010
Biologists and astronomers approach data sharing differently, but both need better public outreach.


Astronomers are busier than ever: “I look at our students and ... there's less understanding and more rushing ... we're caught up in this rat race and I don't know what we're chasing.” Biologists too: “Technology has made me one of the most highly paid, under-talented secretaries on campus. I have to do a lot more than I've ever had to do before, badly.”

These quotes come from Assessing the Future Landscape of Scholarly Communication (http://go.nature.com/6Y4b1g), a survey of 160 academics published earlier this year by Diane Harley and her colleagues in the Center for Studies in Higher Education (CSHE) at the University of California, Berkeley. The quotes are representative of academic scientists these days, thanks not least to the unrelenting pressure to publish.

In the two major scientific disciplines covered by the study — biology and astronomy — peer-reviewed publications continue to be the primary markers of academic achievement. But the survey also found regrettable disparities between the two disciplines in less-formal peer-to-peer communication. The astronomy community effectively publishes by preprint. The process of formal publication is seen as a necessary step for the record, and formal peer review adds some value. But the preprint server http://arXiv.org is a highly trusted forum by which one can deposit the original version of a paper, thereby logging one's priority in a competitive area, and also receive private comments by e-mail that can complement the formal peer-review process. Respondents judge the level of error in astronomy preprints to be low.

Biologists tend to avoid such open sharing of first drafts. They acknowledge that the vastness of their community and its acute competitiveness make them reluctant to act in such a trusting fashion. That's regrettable, because it seems from astronomers' accounts that open sharing on preprint servers improves the standards of the literature.

But deposition in arXiv is about as far as the scientific openness of even astronomers goes. The discussion that ensues is private. As Nature's experiment in open peer review showed (http://go.nature.com/N67mFk), and as can be seen from the lack of commenting on papers in Nature and other journals that encourage it, researchers see little to be gained from open discourse before or after publication. Not only are they busy, as the above quotes attest, but there's no credit to be gained, and some risk if one makes an erroneous or critical statement in public. What is more, astronomers and biologists register active discouragement of blogging — a form of communication that in their eyes carries no stamp of reliability or prestige. That picture of resistance to interactive discussion of science on the Internet is further amplified in a new survey, If You Build It, Will They Come? How Researchers Perceive and Use Web 2.0, to be published later this month by the UK Research Information Network.

However, the astronomers and biologists interviewed in the CSHE survey expressed strong support for outreach and engagement, stating that they enjoyed giving public talks and contributing opinions to mass media. Here, surely, is an opportunity for blogging — or at least, for consistently displaying one's research in a comprehensible fashion on a lab website — to acquire value and peer recognition.

Institutions need to recognize and to encourage such outreach explicitly — not just as a matter of routine, but specifically highlighting and promoting it at times of relevant public debate or when the interests and voices of scientists need to be promoted. Web 2.0 doesn't yet have what it takes to add significant value to open academic discourse, but it can surely make a difference to the public accessibility of science.

terça-feira, 6 de julho de 2010

Avaliação Educação Básica

Embora tenhamos muito para melhorar, mas já é bom sinal os resultados apontados pelo IDEB

A qualidade da educação no Brasil avançou mais. O índice de desenvolvimento da educação básica (Ideb) do país cresceu em todas as etapas de ensino entre 2007 e 2009. No ensino fundamental, o indicador superou as metas propostas para o período e alcançou as de 2011. “O fantasma da queda de qualidade está ficando para trás”, disse o ministro da Educação, Fernando Haddad, durante a divulgação dos dados, nesta quinta-feira, 1º.

Nos anos iniciais do ensino fundamental, o Ideb subiu para 4,6 em 2009. A nota proposta para o período era 4,2 – índice já registrado na aferição de 2007. Nos anos finais, o indicador foi para 4,0 pontos, superando a meta de 3,7 para o ano. O mesmo ocorreu no ensino médio, que obteve índice de 3,6. O objetivo era registrar pelo menos 3,5 nessa etapa de ensino no período.

Haddad considera normal que a melhora no índice seja proporcionalmente maior nos anos iniciais do ensino fundamental. “Vínhamos de um período de recessão educacional, de queda de proficiência. Quando a educação começa a melhorar, é como uma onda; a arrancada mais forte se dá nos anos iniciais e se propaga, ao longo do tempo, nos finais e no ensino médio.”

O Ideb foi criado em 2005, como parte do Plano de Desenvolvimento da Educação (PDE), para medir a qualidade de cada escola e de cada rede de ensino. O índice utiliza escala de zero a dez pontos e é medido a cada dois anos. O objetivo é que o país, a partir do alcance das metas municipais e estaduais, chegue à nota seis em 2021 – correspondente à qualidade do ensino em países desenvolvidos.

“O Brasil está numa trajetória ascendente e consistente pelo quarto ano consecutivo. Ainda estamos distantes da meta de 2021, mas com a esperança renovada de que será alcançada”, afirmou Haddad. Entre os fatores que influenciam na melhoria da qualidade da educação, segundo o ministro, estão as ações que compõem o PDE – da creche à pós-graduação – e a mobilização natural das redes e escolas a favor do cumprimento das metas do Ideb estabelecidas para cada uma.

No indicador estão reunidos dois conceitos fundamentais para a qualidade da educação: o fluxo escolar (taxas de aprovação, reprovação e evasão obtidas no censo da educação básica) e as médias de desempenho nas avaliações Prova Brasil e Sistema Nacional de Avaliação da Educação Básica (Saeb).

A Prova Brasil é um teste de leitura e matemática para turmas de quarta e oitava séries (ou quinto e nono anos) do ensino fundamental. Os alunos do ensino médio fazem o Saeb, avaliação por amostra, que também avalia habilidades em língua portuguesa e matemática. No ano passado, as avaliações foram aplicadas a 2,5 milhões de alunos da quarta série (quinto ano), 2 milhões da oitava série (nono ano) e 56 mil do ensino médio.

Os dados divulgados nesta quarta-feira mostram que o desempenho dos estudantes nas avaliações foi o que mais pesou na composição do Ideb de 2009. Nos anos iniciais, por exemplo, foi responsável por 71% da composição da nota. Já no ensino médio, embora o desempenho tenha sido responsável pela maior parte da nota, a taxa de rendimento subiu em relação a 2007; teve 42% de importância no índice, comparado aos 29% da medição anterior.

quinta-feira, 1 de julho de 2010

Médicos pedem para parar financiamentos para Homeopatia


GeoTagged, [S23.62628, E46.68759]

Sempre houve controvérsia sobre a eficiência da terapia homeopática, mas mesmo assim havia ainda financiamentos para pesquisas nessa área. Agora médicos sua interrupção
Veja reportagem

Doctors call for NHS to stop funding homeopathy

Homeopathic remedies often contain few or no active ingredients. The NHS should stop funding homeopathy and it should no longer be marketed as a medicine in pharmacies, doctors say.
Medics voted on the issue at the British Medical Association's annual conference in Brighton.
They dismissed the highly-diluted remedies as "nonsense" and potentially harmful to patients as it can lead them to shunning conventional medicines.
The Department of Health homeopathy said treatment was under review.
Homeopathy is a 200-year-old system of treatment that uses highly diluted substances.
In some cases none of the original product is left. It is given orally in the belief that it will stimulate the body's self-healing mechanism.
The NHS is thought to spend about £4m a year on the treatment, helping to fund four dedicated homeopathic hospitals and numerous prescriptions.
Dr Mary McCarthy, a GP from Shropshire, said there was no evidence from hundreds of trials that homeopathy worked beyond the placebo effect - in which a patient gets better but only because they believe the treatment will work and their symptoms clear up because of the psychological boost.
She added: "It can do harm by diverting patients from conventional medical treatments."
Watery science
She was supported in the debate by a number of other doctors, despite dozens of supporters of the treatment gathering outside the conference centre urging them not to.
Dr Tom Dolphin, a member of the BMA's junior doctors committee, dismissed it as "nonsense on stilts".

WHAT IS HOMEOPATHY?

Continue reading the main story
Involves giving people very dilute amounts of a substance that in larger amounts might produce symptoms similar to the condition being treated
For example, one remedy which might be used in a person suffering from insomnia would be made from coffee
Supporters believe homeopathy helps relieve a range of minor ailments from bruising to insomnia
But critics say it is no better than sugar pills and people only get better because they believe the treatment will work - the so-called placebo effect
"We risk as a society slipping back into a state of magical thinking when made-up science passes for rational discourse."
Peter Bamber, from the BMA's consultants committee, added: "If you want to buy a bottle of water go to the supermarket."
However, other doctors spoke in favour of homeopathy.
Dr John Garner, a GP from Edinburgh, said: "This [a ban] would deprive patients who have had a benefit."
And Dr David Shipstone, a urologist from the East Midlands, said it would be unfair to pick on homeopathy as there were plenty of other treatments which were used by doctors despite a lack of categorical evidence they worked.
"What is valid scientific evidence? Academics can argue about it all day."
The call by doctors comes after the House of Commons' Science and Technology Committee in February called for a similar ban on NHS funding, saying it could not be justified.
The Society of Homeopaths said there was evidence the remedies worked.
And a spokeswoman also pointed out that the amount of public money spent on it was very low.
She said: "The cost of homeopathy on the NHS is low - just 0.001% of the £11 billion drugs budget."
But the Department of Health said it was looking into the issue.
"The department is considering issues to do with homeopathic remedies and hospitals as part of the government's response to the Science and Technology Committee's report on homeopathy. The response will be issued soon."