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INTRODUCTION: The endemic form (fogo selvagem-FS) of pemphigus foliaceus is an autoimmune disease characterized by the presence of IgG autoantibodies against desmoglein-1. Despite the array of findings, the role of chemokines and cytokines that dictate the immune response and disease outcome is still poorly investigated. MATERIALS AND METHODS: Serum from 64 patients diagnosed with FS was used to draw and establish the levels of these molecules on this disease and establish the levels of these molecules with the severity of FS, and influence of treatment. RESULTS: In comparison to healthy subjects, FS patients, newly diagnosed and still without therapeutic intervention, had higher levels of IL-22 and CXCL-8, and reduced levels of IFN-γ, IL-2, IL-15, and CCL-11. Furthermore, treatment using immunosuppressant drugs augmented the production of IFN-γ, IL-2, CCL-5, and CCL-11 besides reducing the levels of IL-22 and CXCL-10. Immunosuppressive therapy seemed to have long-lasting effects on the production of higher amounts of IFN-γ, IL-2, and CCL-5, besides keeping lowered the levels of IL-22 in remission FS patients. CONCLUSION: Taken together, our findings suggest a putative role of IL-22 in the pathogenesis of FS. Finally, data presented here may contribute for better understanding the immune aspects that control disease outcome.
RESUMO
INTRODUÇÃO: Marketing médico é um assunto controverso, principalmente no que concerne a princípios éticos. Portanto, frente à competição acirrada de mercado, é necessário o preparo profissional. Conhecer a percepção dos alunos de Medicina pode auxiliar na estruturação de alternativas de capacitação. METODOLOGIA: Inicialmente, identificaram-se crenças sobre marketing médico através de grupo focal composto por 12 alunos. Com base nesses dados, dez afirmações para avaliar atitudes foram aplicadas aos alunos de uma Faculdade de Medicina pública brasileira. RESULTADOS: Observou-se falta de clareza sobre o conceito de marketing, preocupação com princípios éticos e necessidade de marketing no mercado competitivo. Na fase de aplicação, foram obtidas 280 respostas de diversos estágios do curso. Apenas 16,8% admitiram contato com o tema. Houve clareza sobre ética em relação ao paciente, influenciada positivamente pela progressão no curso, mas houve divergência na ética entre profissionais. CONCLUSÕES: Marketing médico é uma área pouco compreendida e relegada ao currículo oculto, sendo influenciada por transposições inadequadas de métodos didáticos destinados à comunicação profissional para a população leiga. Novos métodos de ensino, como a educação tutorial, podem ser uma alternativa para lidar com essas situações.
BACKGROUND: Professional marketing is a controversial topic, mainly regarding ethical principles. Therefore, increasing market competion turns professional capacitation mandatory. To know under graduation medical student's perceptions could help to develop educational alternatives to face this problem. METODOLOGY: First, professional marketing believes were identified through focus group methodology including twelve students. Based on these results, ten affirmatives were constructed to evaluate attitudes and applied to the students of a Brazilian public medicine school. RESULTS: It was observed lack of a clear definition of marketing, preoccupation regarding ethical principles and need to employ marketing strategies in a competitive market. At the survey stage, 280 answers from different stages of the course were obtained. Only 16.8% admitted to have had previous contact with the topic. Clear ethical standards for medical-patient relationship were determined, increasing with course progression. However inter-professional ethical principles was more subject to confusion. CONCLUSION: Professional marketing is poorly understood and it is relegated to the occult curricula, being influenced by didactic methods inadequately transposed for marketing strategies. Newer educational methods, like mentoring, could be an alternative to deal with these situations.Tutoria.