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Search Results: 1 - 10 of 40 matches for " Beppino Giovanella "
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Sulfuric Acid Catalyzed Preparation of Alkyl and Alkenyl Camptothecin Ester Derivatives and Antitumor Activity against Human Xenografts Grown in Nude Mice  [PDF]
Zhisong Cao, Anthony Kozielski, Dana Vardeman, Beppino Giovanella
Open Journal of Medicinal Chemistry (OJMC) , 2012, DOI: 10.4236/ojmc.2012.21002
Abstract: Camptothecin-20-propinate (CZ48) and other camptothecin ester derivatives were prepared by the esterification reac-tions of camptothecin or 9-nitrocamptothecin with the corresponding acylating agents such as organic acid anhydride or chloride with concentrate sulfuric acid as the catalyst. The sulfuric acid-catalyzed reactions gave high yields of camptothecin ester products.Among the 11 compounds prepared by this method, camptothecin-20-O-propionate, camptothecin-20-O-crotonate, and 9-nitrocamptothecin-20-O-propionate showed good anticancer activity against various types of human tumors grown as xenografts in nude mice. The methodology developed for the preparation of camptothecin esters in this article can be applied to a wide scope of other ester derivatives.
Metabolic Difference of CZ48 in Human and Mouse Liver Microsomes
Xing Liu,Albert DeJesus,Zhisong Cao,Dana Vardeman,Beppino Giovanella
International Journal of Molecular Sciences , 2012, DOI: 10.3390/ijms13055498
Abstract: CZ48, chemically camptothecin-20- O-propionate hydrate, is currently under clinical investigation. The kinetics of the metabolite camptothecin (CPT) formation and of CZ48 depletion in mouse and human liver microsomes in the presence or absence of NADPH was examined. The formation rate of camptothecin in human liver microsomes was significantly higher than that in mouse with mean K ms of 1.9 and 0.5 nM and V maxs of 9.3 and 2.2 pmol/min/mg, respectively. However, the apparent intrinsic clearance ( V max/ K m) ratios for camptothecin in human and mouse liver microsomes were not significantly different from each other (4.9 versus 4.4) in the presence of NADPH. The depletion of CZ48 in human microsomes was four times faster with 4.55% of CZ48 remaining intact while in mouse 19.11% of the drug remained unchanged after 60 min. These results suggest that there is a remarkable species difference of CZ48 biotransformation between human and mouse. The depletion rate of CZ48 in human liver microsomes is considerably higher than that in the mouse.
A aten??o primária à saúde nos países da Uni?o Européia: configura??es e reformas organizacionais na década de 1990
Giovanella, Ligia;
Cadernos de Saúde Pública , 2006, DOI: 10.1590/S0102-311X2006000500008
Abstract: during the 1990s, proposals to contain health expenditures and demands raised by changes in the epidemiological profile led to organizational reforms in primary healthcare services in european union countries, aimed at promoting the coordination of services provided by the various levels of care. based on a literature review, document analysis, and interviews with key informants, the current study analyzes the institutional configurations for first-level healthcare and discusses the pre-coordination organizational reforms in the european union countries. first-level outpatient care is provided in these countries through a wide variety of institutional configurations, observing the different financing mechanisms, range of healthcare professionals, range of clinical services provided, and the position occupied by physicians in primary care within the healthcare system. reforms in the last decade were accompanied by a diversification in the outpatient care organizational models, with an expansion in the clinical, healthcare coordination management, and financing functions of primary care professionals, indicating a process in transition, with a redefinition of the roles played by general practitioners as the leaders of patient care.
Planejamento estratégico em saúde: uma discuss?o da abordagem de Mário Testa
Giovanella, Ligia;
Cadernos de Saúde Pública , 1990, DOI: 10.1590/S0102-311X1990000200003
Abstract: this article characterizes mario testa's propositions regarding health planning, on the basis of his recent theorethical analysis. the characterization doesn't imply the construction of a planning method, as testa only presents some elements for the understanding of health problems and planning processes. testa consideres health problems as socially determined, and therefore he emphasizes the analysis of social actor behaviour, power relationships and health practices taken as ideological practices giving orientation to actors. testa goes beyond the strategical health planning proposition and proposes a reflection on political action in health. testa's thinking is based on such categories as power and ideology. this article discusses how he understands these categories. this discussion concludes that health practices are social practices and also are ideological practices influencing actor's view so, it is difficult to know how these world's views are going to change, testa's propositions are inovating within the field of health planning, as they show that health actions have a power basis. the theses of mario testa regarding health planning are defended in light of their potential to transform reality, by revealing the role of social power in health related actions, and rendering explicit objectives regarding power relationships.
Redes integradas, programas de gest?o clínica e generalista coordenador: análise das reformas recentes do setor ambulatorial na Alemanha
Giovanella,Ligia;
Ciência & Saúde Coletiva , 2011, DOI: 10.1590/S1413-81232011000700040
Abstract: strengthening the role of the general practitioner in the conduction and coordination of specialized, inpatient and social care to ensure the continuity is a trend observed in recent health reforms in european countries. in germany, from the second half of the 1990s, driven by economic pressures, a specific legislation and initiatives of the providers themselves have developed new organizational structures and care models for the purpose of the integration of the health care system and the coordination of health care in the form of: physicians networks, practitioner coordinator model, diseases management programs and integrated care. from a literature review, document analysis, visits to services and interviews with key informants, this paper analyzes the dynamics of these organizational changes in the german outpatient sector. the mechanisms of integration and coordination proposed are examined, and the potential impacts on the efficiency and quality of new organizational arrangements are discussed. also it is analyzed the reasons and interests involved that point out the obstacles to the implementation. it was observed the process of an incremental reform with a tendency of diversification of the healthcare panorama in germany with the presence of integrated models of care and strengthening the role of general practitioners in the coordination of patient care.
A aten o primária à saúde nos países da Uni o Européia: configura es e reformas organizacionais na década de 1990
Giovanella Ligia
Cadernos de Saúde Pública , 2006,
Abstract: Propósitos de conten o de gastos em saúde e exigências de mudan as no perfil epidemiológico, impulsionaram durante a década de 90 reformas organizacionais dos servi os de aten o primária em países da Uni o Européia, com o objetivo de promover a coordena o dos servi os prestados pelos diversos níveis de aten o. Neste artigo, a partir de revis o bibliográfica, análise documental e entrevistas com informantes-chave s o analisadas as configura es institucionais do primeiro nível de aten o à saúde e discutidas as reformas organizacionais pró-coordena o nos países da Uni o Européia. A aten o ambulatorial de primeiro nível é prestada nesses países com grande variedade de configura es institucionais, observando-se diferenciados mecanismos de financiamento, gama de profissionais envolvidos, espectro de servi os clínicos oferecidos e posi o do profissional médico de aten o primária no sistema de saúde. Com as reformas da última década, ocorreu diversifica o de modelos organizacionais da aten o ambulatorial com amplia o das fun es clínicas, gerenciais de coordena o da aten o, e financeiras dos profissionais de aten o primária, indicando processo em transi o com redefini o das fun es do clínico geral como condutor dos cuidados ao paciente.
Entre o mérito e a necessidade: análise dos princípios constitutivos do seguro social de doen?a alem?o
Giovanella, Lígia;
Cadernos de Saúde Pública , 1999, DOI: 10.1590/S0102-311X1999000100014
Abstract: this article describes and analyzes the structural principles of social health insurance in germany and discusses their interrelations and current form. focusing on salaried work, social security in germany links rights and duties to the place occupied by workers in the production process and maintains a differentiation in their status. as a paradigm of social security, citizens' social rights in germany are organized according to principles of equivalence, subsidiarity, and solidarity. the coexistence of these contradictory principles generates a constant field of tension and conditions their effect, thus mediating how each one is implemented. this tension, which has always existed in the underlying system, is reedited each time the political context changes. while subsidiarity and equivalence prevailed in the original social security system, the solution to the conflict tended towards solidarity during the expansion of welfare states and social health insurance. at present, however, there is a call for reediting subsidiarity and equivalence.
As origens e as correntes atuais do enfoque estratégico em planejamento de saúde na América Latina
Giovanella, Lígia;
Cadernos de Saúde Pública , 1991, DOI: 10.1590/S0102-311X1991000100004
Abstract: following a brief historical review of economic and social planning in latin america, the author presents the origins of three tendencies in the strategic approach to health planning in: the debate over planning for latin american development, the strategic business administration, and the discussion and critique of the cendes/paho method of health planning.
Entre o mérito e a necessidade: análise dos princípios constitutivos do seguro social de doen a alem o
Giovanella Lígia
Cadernos de Saúde Pública , 1999,
Abstract: O artigo visa à descri o e análise dos princípios estruturais do seguro social de doen a alem o, à discuss o de suas inter-rela es e da forma atual de vigência dos mesmos. Centrada no trabalho assalariado, a prote o social alem vincula direitos e deveres à situa o ocupada pelos trabalhadores na produ o, preservando status diferenciados. Paradigmática do modelo de seguro social, a cidadania social alem organiza-se segundo os princípios da equivalência, subsidiariedade e solidariedade. A convivência desses princípios contraditórios gera um campo de tens o constante e condiciona a vigência dos mesmos, mediando a operacionaliza o de cada um. Essa tens o, sempre existente na base do sistema, reatualiza-se a cada conjuntura. Se a subsidiariedade e a equivalência prevaleceram na origem do seguro social, a solu o do conflito tendeu para a solidariedade no período de expans o dos welfare states e do seguro social de doen a. Atualmente, porém, apela-se para a reatualiza o da subsidiariedade e da equivalência.
Agenda regional da saúde no Mercosul: arquitetura e temas
Queiroz,Luisa Guimaraes; Giovanella,Ligia;
Revista Panamericana de Salud Pública , 2011, DOI: 10.1590/S1020-49892011000800011
Abstract: this article describes the shaping of institutional health spaces in the mercosur, with analysis of themes and results and considerations on the construction of the regional agenda and on the effects of regional economic integration processes on health policies and systems. we discuss the organization, operation, focus topics, and results achieved in specific health forums (meeting of ministers of health and sub-working group 11), seeking to analyze the architecture and issues addressed by the regional agenda and drawing parallels with the european experience. the aim of this reflection is to identify how the work done by mercosur structures contributes to building a regional agenda, with the expectation that the integration can contribute to reducing inequalities in access to health care in the region.
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