Buscar

Fisiopatologia das Doenças Hepáticas

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes
Você viu 3, do total de 9 páginas

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes
Você viu 6, do total de 9 páginas

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes
Você viu 9, do total de 9 páginas

Prévia do material em texto

)81d®(6�+(3È7,&$6
0HWDEyOLFDV
3URWHtQDV�
6tQWHVH�GH�SURWHtQDV�SODVPiWLFDV�H�IDWRUHV�GH�FRDJXODomRż
'HVDPLQDomR�GH�DPLQRiFLGRVż
&RQYHUVmR�GH�DP{QLD�HP�XUHLD
$�DP{QLD�p�PXLWR�OLSRVVRO~YHO��HQWmR�QmR�p�QRUPDOPHQWH�H[FUHWDGD��R�ItJDGR�
p�UHVSRQViYHO�SRU�FRQYHUWD�OD�HP�XUHLD��TXH�p�PHQRV�OLSRVVRO~YHO��2�REMHWLYR�
GHVVH�PHFDQLVPR�p�SHUPLWLU�TXH�D�DP{QLD�VHMD�H[FUHWDGD��3HUGD�GHVVD�IXQomR�
OHYD�DR�DF~PXOR�GH�DP{QLD�QR�VDQJXH�H�QRV�WHFLGRV��D�DP{QLD�p�Wy[LFD��H�
SRGH�OHYDU�D�XP�TXDGUR�GH�HQFHIDORSDWLD��SRU�H[HPSOR�
�
ż
ͻ
&DUERLGUDWRV�
6tQWHVH�GH�JOLFRVHż
6tQWHVH�GH�JOLFRJrQLRż
ͻ
/LStGHRV�
6tQWHVH�GH�OLSRSURWHtQDVż
&RQYHUVmR�GH�iFLGRV�JUD[RV�HP�FHWRQDV
&HWRQDV� �IRQWH�GH�HQHUJLD�QD�DXVrQFLD�GH�JOLFRVH��
ż
ͻ
%LRWUDQVIRUPDomR
+RUP{QLRV�H�PHGLFDPHQWRV�GURJDVż
+LGUR[LODomR��R[LGDomR�UHGXomR�H�FRQMXJDomRż
ͻ
([FUHWyULD
3URGXomR�H�H[FUHomR�GH�ELOH
%LOLUUXELQDż
&ROHVWHUROż
ÈFLGRV�ELOLDUHV�H�RXWURVż
ͻ
$UPD]HQDPHQWR
*OLFRJrQLRż
/LStGHRVż
$PLQRiFLGRVż
9LWDPLQDVż
)HUUR�H�RXWURV�PLQHUDLVż
ͻ
+,67Ï5,$�1$785$/�'$6�+(3$723$7,$6
'RHQoD� !�3HUGD�GH�IXQomR
'RHQoDV�+HSiWLFDV
ƋƵĂƌƚĂͲĨĞŝƌĂ͕�ϭϯ�ĚĞ�ŵĂŝŽ�ĚĞ�ϮϬϮϬ ϭϯ͗ϰϯ
4XDQGR�R�ItJDGR�p�FRPSURPHWLGR��SRU�LQIHFo}HV�YLUDLV��SDUDVLWRVHV��VXEVWkQFLDV�Wy[LFDV�����
WHPRV�XPD�OHVmR�KHSiWLFD�DJXGD��D�SDUWLU�GD�TXDO�SRGH�RFRUUHU�XPD�UHJHQHUDomR��FRP�
UHFXSHUDomR�FRPSOHWD��VHP�SHUGD�GH�IXQomR�H��LQFOXVLYH��VHP�PDQLIHVWDo}HV�FOtQLFDV�
VLJQLILFDWLYDV��RX�SRGH�RFRUUHU�XPD�IDOKD�QD�UHJHQHUDomR��QHVWH�FDVR�HYROXL�VH�FRP�KHSDWLWH�
IXOPLQDQWH��TXH�SRGH�FXOPLQDU�HP�PRUWH�RX�UHFXSHUDomR�GR�SDFLHQWH��FRP�UHHVWUXWXUDomR�GR�
WHFLGR�KHSiWLFR�H�VHP�VHTXHODV��
,QIHOL]PHQWH��JUDQGH�SDUWH�GDV�OHV}HV�KHSiWLFDV�DJXGDV�FDPLQKDP�SDUD�D�FURQLILFDomR��LVVR�
GHSHQGH�GH�IDWRUHV�FRPR�D�LPXQLGDGH��D�YLUXOrQFLD��D�KHUHGLWDULHGDGH������FRP�R�
HVWDEHOHFLPHQWR�GD�OHVmR�FU{QLFD��LQVWDOD�VH�D�ILEURVH�FRPR�IRUPD�GH�FLFDWUL]DomR��LVVR�
GHWHUPLQD�D�FLUURVH��TXH�VH�DFRPSDQKD�GH�KLSHUWHQVmR�SRUWDO��GH�FDUFLQRPD�KHSDWRFHOXODU�H�
DWp�PRUWH��
0$1,)(67$d®(6�&/Ë1,&$6�'$6�+(3$723$7,$6
,FWHUtFLDͻ
&ROHVWDVH��GLPLQXLomR�GR�IOX[R�ELOLDUͻ
+HSDWRPHJDOLDͻ
&LUURVH�KHSiWLFD��KLSHUWHQVmR�SRUWDO��DVFLWH�H�HGHPDͻ
(QFHIDORSDWLD�KHSiWLFDͻ
2XWUDV�
$OWHUDo}HV�PHWDEyOLFDV�H�QXWULFLRQDLVż
'LVW~UELRV�KHPRVWiWLFRV��GLPLQXLomR�GRV�IDWRUHV�GH�FRDJXODomRż
6DQJUDPHQWR�JDVWURLQWHVWLQDO��SRU�UXSWXUD�GDV�YDUL]HV�HVRIiJLFDVż
%LRWUDQVIRUPDomR�DOWHUDGD�GH�IiUPDFRV�GURJDVż
/LEHUDomR�GH�HQ]LPDV�KHSiWLFDV��7*2�H�7*3��LQGLFDP�OHVmR�KHSDWRFHOXODU�����K���ż
ͻ
&,5526(�+(3È7,&$
$QDWRPLFDPHQWH�p�GHILQLGD�FRPR�XP�DFRPHWLPHQWR�GLIXVR�GR�ItJDGR�FRP�ILEURVH�H�IRUPDomR�
GH�QyGXORV�GH�UHJHQHUDomR�
,QGHSHQGHQWHPHQWH�GH�VXD�HWLRORJLD��UHVXOWD�HP�GRLV�JUDQGHV�HYHQWRV��
,QVXILFLrQFLD�+HSiWLFD� LFWHUtFLD��HQFHIDORSDWLD��DVFLWH��UHGXomR�GD�DOEXPLQD�VpULFD�H�
DOWHUDo}HV�GD�FRDJXODomR��
ͻ
+LSHUWHQVmR�3RUWDO� HVSOHQRPHJDOLD��FLUFXODomR�FRODWHUDO�H�YDUL]HV�HV{IDJR�JiVWULFDV��ͻ
+,3(57(16­2�3257$/
)LVLRSDWRORJLD��
$�9HLD�3RUWD��9��(VSOrQLFD��9Y��0HVHQWpULFD�6XSHULRU�H�,QIHULRU��GUHQD�EDVLFDPHQWH�WRGR�
R�7*,��WRGRV�RV�QXWULHQWHV��KRUP{QLRV�H�VXEVWkQFLDV�VmR�OHYDGDV�DWUDYpV�GHOD�DWp�R�
ItJDGR��2�IOX[R�VDQJXtQHR�KHSiWLFR�p�WRGR�GLUHFLRQDGR�SDUD�RV�FDSLODUHV�VLQXVRLGHV��RX�
VHMD��D�9��3RUWD�DR�LQYpV�GH�VHJXLU�GLUHWR�SDUD�R�FRUDomR�YDL�VH�FDSLODUL]DU��(VVHV�
FDSLODUHV�SDVVDP�UHQWHV�DRV�KHSDWyFLWRV��ID]HP�WURFDV�GLUHWDV�FRP�HOHV��H�
SRVWHULRUPHQWH�VH�FRQIOXHP�SDUD�IRUPDU�D�9HLD�+HSiWLFD��TXH�GHVHPERFD�QD�&DYD�
,QIHULRU��
ͻ
1RWH�TXH��R�VLVWHPD�SRUWD�HQFRQWUD�VH�ORFDOL]DGR�HQWUH�GRLV�OHLWRV�FDSLODUHV��R�SULPHLUR�
IRUPDGR�SHORV�&DSLODUHV�(VSOkQFQLFRV��TXH�VH�FRQIOXHP�IRUPDQGR�D�3RUWD��H�R�VHJXQGR�
IRUPDGR�SHORV�&DSLODUHV�6LQXVyLGHV�+HSiWLFRV��
ͻ
2�FDSLODUHV�VLQXVyLGHV�VmR�IHQHVWUDGRV�H�SRVVXHP�DOWtVVLPD�SHUPHDELOLGDGH��LVVR�
SHUPLWH�EDVLFDPHQWH�R�FRQWDWR�tQWLPR�HQWUH�R�VDQJXH�QRV�FDSLODUHV�H�RV�KHSDWyFLWRV��
ͻ
TXH�p�R�TXH�JDUDQWH�DV�WURFDV�
2�VLVWHPD�YHQRVR�SRUWDO�p�XP�VLVWHPD�GH�XPD�SUHVVmR�EDL[D�H�GH�EDVWDQWH�
FRPSODFrQFLD��DFXPXODQGR�XP�JUDQGH�YROXPH�VDQJXtQHR��(VVD�SUHVVmR�p�EDL[D��PDV�R�
VXILFLHQWH�SDUD�PDQWHU�DV�WURFDV��/HPEUH�VH�TXH�R�VDQJXH�YDL�GR�OXJDU�GH�PDLRU�SDUD�R�
GH�PHQRU�SUHVVmR��HQWmR�QmR�H[LVWH�XPD�UHVLVWrQFLD�SUR�VDQJXH�HVFRDU��
ͻ
2�VLVWHPD�YHQRVR�SRUWDO�VH�FRQHFWD�FRP�D�FLUFXODomR�VLVWrPLFD�HP�DOJXPDV�UHJL}HV�
6LVWHPD�È]LJR�ż
6LVWHPD�8PELOLFDO�ż
6LVWHPD�5HWURSHULWRQHDO��Hż
6LVWHPD�5HQDO�ż
ͻ
(P�FRQGLo}HV�QRUPDLV��R�ItJDGR�UHFHEH�XP�IOX[R�VDQJXtQHR�GH�HP�WRUQR�GH�����P/�PLQ�
QR�MHMXP��HVVH�YROXPH�GREUD�QR�SHUtRGR�DEVRUWLYR��a����P/���0DV�FRPR�LVVR�p�
SRVVtYHO"�2V�YDVRV�SRUWD�KHSiWLFRV�VmR�EDVWDQWHV�FRPSODFHQWHV��HQWmR�VH�GLODWDP�SDUD�
DXPHQWDU�R�IOX[R�VDQJXtQHR��H�LVVR�VHP�DOWHUDU�GH�IRUPD�H[DJHUDGD�D�SUHVVmR�GR�
VLVWHPD��1R�MHMXP�D�SUHVVmR�p�GH�HP�WRUQR�GH���PP+J�H�SDVVD�SDUD���PP+J�QR�
SHUtRGR�SyV�SUDQGLDO
ͻ


-XVWLILFDWLYD��R�DXPHQWR�GD�SUHVVmR�p�GLVFUHWR�GHYLGR�D�GLODWDomR�SDVVLYD�GRV�YDVRV�H[WUD�
KHSiWLFRV��TXH�VmR�YDVRV�GH�EDL[D�UHVLVWrQFLD��
1D�FLUURVH�KHSiWLFD RV�YDVRV�LQWUD�KHSiWLFRV�ILFDP�ILEURVRV�H�SHUGHP�D�FRPSODFrQFLD��
DXPHQWDQGR�D�UHVLVWrQFLD�H��FRQVHTXHQWHPHQWH��D�SUHVVmR��,VVR�GHWHUPLQD�D�
+LSHUWHQVmR�3RUWDO�
3DUD�VH�WHU�XPD�QRomR�QD�FLUURVH�KHSiWLFD��D�SUHVVmR�QR�MHMXP�SDVVD�GH����SDUD�
���PP+J��H�QR�SHUtRGR�SyV�SUDQGLDO�SDVVD�GH����SDUD���PP+J��,VVR�WXGR�SRUTXH�
RV�YDVRV�LQWUD�KHSiWLFRV�VmR�LQFDSD]HV�GH�VH�GLODWDU�FRPR�QXP�ItJDGR�QRUPDO�
ż
ͻ
&RP�R�DXPHQWR�GD�SUHVVmR��R�IOX[R�ILFD�GLILFXOWRVR��HQWmR�R�VDQJXH�SDVVD�D�EXVFDU�YLDV�
DOWHUQDWLYDV��RQGH�D�UHVLVWrQFLD�VHMD�PHQRU��QR�FDVR��HVVDV�YLDV�VmR�DV�RXWUDV�FRQH[}HV�
GR�VLVWHPD�SRUWD�FRP�DV�FLUFXODomR�VLVWrPLFD��,VVR�YDL�GDU�RULJHP�jV�FLUFXODo}HV�
FRODWHUDLV�SRUWR�VLVWrPLFDV�
&RODWHUDLV�JDVWUR�HVRIDJHDQDVż
&RODWHUDLV�UHWURSHULWRQLDLVż
&RODWHUDLV�FRP�D�YHLD�XPELOLFDOż
&RODWHUDLV�KHPRUURLGiULDVż
ͻ


REV��p�SRVVtYHO�TXH�RXWURV�IDWRUHV�WDPEpP�LQWHUILUDP�QHVVH�DXPHQWR�GD�SUHVVmR��HOD�FLWRX�
D�SURGXomR�GH�FLWRFLQDV�YHQRFRQVWULWRUDV�SHOR�SURFHVVR�LQIODPDWyULR��
2V�YDVRV�TXH�IRUPDP�DV�FLUFXODo}HV�FRODWHUDLV�SDVVDP�D�ILFDU�LQJXUJLWDGRV��
GHWHUPLQDQGR�DV�YDUL]HV��4XDQGR�HVVDV�YDUL]HV�VH�URPSHP��RFRUUH�XPD�KHPRUUDJLD�
GLJHVWLYD�DOWD�TXH�QD�PDLRULD�GDV�YH]HV�FXOPLQD�HP�PRUWH��SRLV�SHOD�FLUURVH�R�ItJDGR�
SDUD�GH�VLQWHWL]DU�IDWRUHV�GH�FRDJXODomR��HQWmR�R�SDFLHQWH�HQWUD�HP�XP�TXDGUR�
KHPRUUiJLFR�TXH�GLILFLOPHQWH�p�UHYHUVtYHO�
ͻ
&ODVVLILFDomR� p�IHLWD�FRP�EDVH�QR�ORFDO�HP�TXH�HVWi�RFRUUHQGR�R�DXPHQWR�GD�UHVLVWrQFLD�

REV��HOD�GLVVH�TXH�QmR�FRVWXPD�FREUDU�LVVR�HP�SURYD
3Up�+HSiWLFD��WURPERVH�GH�YHLD�HVSOrQLFD�RX�GH�YHLD�SRUWD�ͻ
,QWUD�+HSiWLFD��HVTXLVWRVVRPRVH��FLUURVH�DOFRyOLFD�H�GRHQoDV�YHQR�RFOXVLYDV�
6XEGLYLGH�VH�HP�SUp�VLQXVRLGDO��VLQXVRLGDO�H�SyV�VLQXVRLGDO�ż
ͻ
3yV�+HSiWLFD��WURPERVH�GH�YHLD�KHSiWLFD�H�LQVXILFLrQFLD�FDUGtDFD�GLUHLWD�ͻ
6LVWHPD�&LUFXODWyULR�&RODWHUDO��
4XDQGR�VH�IRUPD�D�FLUFXODomR�FRODWHUDO��LQLFLD�VH�R�GHVHQYROYLPHQWR�GDV�YDUL]HV��HVVH�
TXDGUR�p�SUHRFXSDQWH��SRLV�SRGH�HYROXLU�FRP�R�URPSLPHQWR��OHYDQGR�j�KHPRUUDJLD��RX�
FRP�R�GHVYLR�GH�VDQJXH�SRUWDO�GR�ItJDGR��OHYDQGR�D�GLPLQXLomR�GR�FOHDUHQFH�KHSiWLFR�
&OHDUHQFH�+HSiWLFR��p�R�SURFHVVR�GH�ILOWUDomR�KHSiWLFD��6H�QmR�WHP�IOX[R�
VDQJXtQHR��QmR�WHP�FRPR�ILOWUDU��$V�IXQo}HV�KHSiWLFDV�GHSHQGHP�GD�SDVVDJHP�GR�
VDQJXH��
ż
ͻ
6HSVH� R�SDFLHQWH�FRP�UHGXomR�GR�FOHDUHQFH�KHSiWLFR��WHP�SURSHQVmR�D�GHVHQYROYHU�
VHSVH��
1RUPDOPHQWH�QR�LQWHVWLQR�H[LVWH�XPD�IORUD�EDFWHULDQD�TXH�p�HVVHQFLDO�SDUD�R�
GHVHQYROYLPHQWR�GH�IXQo}HV�GR�7*,��HOD�p�SHUIHLWD�QD�OX]�LQWHVWLQDO��(VVDV�EDFWpULDV�
SRVVXHP�DQWtJHQRV�SURWHLFRV�TXH�TXDQGR�FDHP�QD�FRUUHQWH�VDQJXtQHD�YmR�SDUD�R�
ItJDGR�DWUDYpV�GR�VLVWHPD�SRUWD��$R�FKHJDU�QR�ItJDGR��HVVH�DQWtJHQRV�VmR�
LPHGLDWDPHQWH�IDJRFLWDGRV�SHODV�&pOXODV�GH�.XSIIHU��PDFUyIDJRV�KHSiWLFRV���HQWmR�
QmR�JHUDP�GRHQoDV��
ż
&RP�D�H[LVWrQFLD�GD�FLUFXODomR�FRODWHUDO��R�VDQJXH�� FDUUHJDQGR�RV�DQWtJHQRV�� TXH�
HUD�SUD�LU�SDUD�R�ItJDGR�YDL�JDQKDU�D�FLUFXODomR�VLVWrPLFD��$�SUHVHQoD�GRV�
DQWtJHQRV�QD�FLUFXODomR�HVWLPXOD�R�ItJDGR�D�SURGX]LU�JUDQGH�TXDQWLGDGH�GH�
DQWLFRUSRV�JDPDJOREXOLQDV�
ż
(QWmR��QD�HOHWURIRUHVH�YHPRV�XPD�HOHYDomR�GD�JOREXOLQD�VpULFD�WRWDO��
HVSHFLDOPHQWH�GD�IUDomR�JDPD��,VVR�GHFRUUH�GD�LQFDSDFLGDGH�GR�ItJDGR�OHVDGR�GH�HOLPLQDU�DQWtJHQRV�GH�RULJHP�LQWHVWLQDO�
ż
(PERUD�D�UHVSRVWD�LPXQROyJLFD�H[LVWD��SRGH�RFRUUHU�GHOD�QmR�VHU�R�VXILFLHQWH�SDUD�
GHIHQGHU�R�RUJDQLVPR�GR�DWDTXH�DQWLJrQLFR��'Dt�D�SRVVLELOLGDGH�GH�HYROXomR�SDUD�
VHSVH��
ż
ͻ
$OWHUDo}HV�0HWDEyOLFDV�
1R�SHUtRGR�SyV�SUDQGLDO��R�ItJDGR�UHFHEH�VDQJXH�SURYHQLHQWH�GR�7*,�ULFR�HP�
QXWULHQWHV��GHQWUH�RV�TXDLV�HQFRQWUD�VH�D�JOLFRVH��2�ItJDGR�QRUPDO�QmR�SHUPLWH�TXH�
JUDQGH�FRQFHQWUDomR�GH�JOLFRVH�JDQKH�D�FLUFXODomR�VLVWrPLFD��HOH�Mi�ID]�D�FDSWDomR�
H�R�DUPD]HQDPHQWR�QR�PRPHQWR�TXH�D�JOLFRVH�FKHJD��LVVR�HYLWD�XPD�
KLSHUJOLFHPLD�
ż
1D�KLSHUWHQVmR�SRUWDO�Ki�XP�LPSHGLPHQWR�GD�FKHJDGD�GH�VDQJXH�GR�7*,�DR�
ItJDGR��FRP�LVVR��QR�SHUtRGR�SyV�SUDQGLDO�R�VDQJXH�ULFR�HP�QXWULHQWHV�QmR�SDVVD�
SHOR�ItJDGR�H�p�OHYDGR�GLUHWDPHQWH�j�FLUFXODomR�VLVWrPLFD��FRQVHTXHQWHPHQWH�Ki�
RFRUUrQFLD�GH�KLSHUJOLFHPLD�SyV�SUDQGLDO�
ż
ͻ
(P�VLWXDo}HV�QRUPDLV��R�ItJDGR��QR�SHUtRGR�GH�MHMXP�RX�QR�H[HUFtFLR�ItVLFR��RQGH�D�
GHPDQGD�HQHUJpWLFD�p�PXLWR�JUDQGH��OLEHUD�JUDQGHV�TXDQWLGDGHV�GH�JOLFRVH�DWUDYpV�
GD�KLGUROLVH�GH�JOLFRJrQLR�
ż
&RPR�QD�KLSHUWHQVmR�SRUWDO�QmR�Ki�UHVHUYD�GH�JOLFRJrQLR�KHSiWLFR��D�WHQGrQFLD�p�
TXH�QR�SHUtRGR�SyV�DEVRUWLYR�H�QR�H[HUFtFLR�ItVLFR�RFRUUD�KLSRJOLFHPLD�
ż
(QFHIDORSDWLD�+HSiWLFD��
e�XPD�DQRUPDOLGDGH�UHYHUVtYHO�GD�IXQomR�QHXUDO�DVVRFLDGD�FRP�H[SRVLomR�GR�61&�
D�VXEVWkQFLDV�QHXURWy[LFDV�GHYLGR�D�XPD�GRHQoD�KHSDWRFHOXODU�SULPiULD�
�LQVXILFLrQFLD�KHSiWLFD��H�GHVYLR�GD�FLUFXODomR�SRUWDO�GR�ItJDGR��GHVYLR�SRUWR�
VLVWrPLFR�
ż
6XEVWkQFLDV�HQYROYLGDV�
$P{QLD��p�SURYHQLHQWH�GD�PHWDEROL]DomR�GH�SURWHtQDV��WUDWD�VH�GH�XP�
FRPSRVWR�Wy[LFR�H�PXLWR�OLSRVVRO~YHO��3DUD�VHU�H[FUHWDGD��D�DP{QLD�p�
PHWDEROL]DGD�HP�XUHLD��XP�FRPSRVWR�PDLV�KLGURVVRO~YHO��TXH�p�H[FUHWDGR�
SHOD�XULQD��
�
)DOVRV�QHXURWUDQVPLVVRUHV��RFWDSWDQDV��PHUFDSWDQDV��WULSWRIDQR��iFLGRV�
JUD[RV�GH�FDGHLD�FXUWD��EHQ]RGLD]HStQLFRV�HQGyJHQRV���
�
*$%$�H�UHFHSWRUHV��TXDQGR�R�61&�p�H[SRVWR�j�VXEVWkQFLDV�QHXURWy[LFDV�SRU�
SHUtRGR�SURORQJDGR��YDL�SDVVDU�D�SURGX]LU�PDLV�*$%$��TXH�p�XP�
QHXURWUDQVPLVVRU�LQLELWyULR��1D�+3��Ki�XP�DXPHQWR�GD�GLVSRQLELOLGDGH�GH�
*$%$�H�GR�Q~PHUR�GH�UHFHSWRUHV��ORJR��DXPHQWD�VH�D�TXDQWLGDGH�GH�VLQDSVHV�
LQLELWyULDV��FDXVDQGR�VRQROrQFLD�H�SRVVtYHO�HYROXomR�SDUD�FRPD�SURIXQGR��
�
ż
(VWiJLRV�&ODVVLILFDomR�ż
2�FRPD�GD�HQFHIDORSDWLD�jV�YH]HV�DSDUHFH�DSyV�D�KHPRUUDJLD��,VVR�RFRUUH�SRUTXH�
GXUDQWH�D�KHPRUUDJLD�R�7*,�UHFHEH�JUDQGH�TXDQWLGDGH�GH�VDQJXH�GHJOXWLGR��LVVR�
DXPHQWD�R�PHWDEROLVPR�SURWHLFR�H��SRUWDQWR��D�JHUDomR�GH�DP{QLD��R�TXH�
GHVHQFDGHLD�R�PHFDQLVPR�GD�HQFHIDORSDWLD��
ż
6DEHQGR�GLVVR��KRMH�DGPLQLVWUD�VH�ODFWXORQD�H�DQWLELyWLFRV�QR�HSLVyGLR�KHPRUUiJLFR�
FRPR�IRUPD�GH�SURILOD[LD�SDUD�HQFHIDORSDWLD�
$�/DFWXORQD�JHUD�GLDUUHLD�H�GLPLQXL�D�DEVRUomR�GH�DP{QLD�SURWHtQDV��
2V�DQWLELyWLFRV�UHGX]HP�D�IORUD�LQWHVWLQDO��Mi�TXH�VmR�DV�EDFWpULDV�GR�LQWHVWLQR�
TXH�ID]HP�D�PHWDEROL]DomR�GD�SURWHtQD��OLEHUDQGR�DP{QLD�
�
ż
ͻ
$6&,7(��p�R�DF~PXOR�GH�OtTXLGR�QD�FDYLGDGH�DEGRPLQDO�
)LVLRSDWRORJLD�
1D�FLUURVH�KHSiWLFD�WHPRV����VLWXDo}HV��REVWUXomR�YDVFXODU�LQWUD�KHSiWLFD�H�DOWHUDo}HV�
QD�VtQWHVH�GH�DOEXPLQD��FRP�FRQVHTXHQWH�DXPHQWR�GD�SUHVVmR�SRUWDO�H�GLPLQXLomR�GD�
SUHVVmR�FRORLGRVPyWLFD�SODVPiWLFD��UHVSHFWLYDPHQWH��2�DXPHQWR�GD�SUHVVmR�SRUWDO��
DXPHQWD�D�SUHVVmR�GRV�FDSLODUHV�QD�FLUFXODomR�HVSOkQFQLFD��ORJR��DOWHUD�VH�R�HTXLOtEULR�
GH�6WDUOLQJ��DXPHQWR�GD�SUHVVmR�KLGURVWiWLFD���GLPLQXLomR�GD�SUHVVmR�FRORLGRVPyWLFD�
GR�SODVPD� �WUDQVXGDomR�GH�OtTXLGR�SDUD�IRUD�GR�YDVR�H�SDUD�GHQWUR�GD�FDYLGDGH�
DEGRPLQDO��GHWHUPLQDQGR�D�DVFLWH��
ͻ
3HOD�DVFLWH��WHP�VH�OtTXLGR�IRUD�GR�YDVR��LVVR�VH�DVVRFLD�j�YDVRGLODWDomR�HVSOkQFQLFD�
�SHOR�DXPHQWR�GD�VHFUHomR�GH�12�HP�FRQVHTXrQFLD�GD�FLUURVH�KHSiWLFD���OHYDQGR�D�
XPD�UHGXomR�GR�YROXPH�FLUFXODQWH�HIHWLYR�
1RV�YDVRV�GLODWDGRV�ILFD�UHSUHVDGD�XPD�TXDQWLGDGH�VLJQLILFDWLYD�GH�VDQJXH��HQWmR�
DOpP�GD�GLPLQXLomR�SHOR�H[WUDYDVDPHQWR��Ki�GLPLQXLomR�GR�YROXPH�FLUFXODQWH�SHOR�
DF~PXOR�GH�VDQJXH�QRV�YDVRV�HVSOkQFQLFRV�
ż
ͻ
$�GLPLQXLomR�GR�YROXPH�FLUFXODQWH�p�FDSWDGD�SHORV�UHFHSWRUHV�GH�YROXPH��HQWmR�Ki�
DWLYDomR�GH�PHFDQLVPRV�UHWHQWRUHV�GH�YROXPH�
65$$�ż
616��Hż
9DVRSUHVVLQD�ż
ͻ
+i�DXPHQWR�HQWmR�GD�UHDEVRUomR�GH�VyGLR�H�iJXD��DXPHQWDQGR�R�YROXPH��1R�HQWDQWR��
LVVR�QmR�UHHVWDEHOHFH�D�VLWXDomR�ILVLROyJLFD��SRUTXH�R�HVSDoR�LQWUDYDVFXODU�HVWi�DOWHUDGR��
HQWmR�R�OtTXLGR�FRQWLQXD�WUDQVXGDQGR��$TXL�WHPRV�XP�PHFDQLVPR�GH�)HHGEDFN�3RVLWLYR��
RV�UHFHSWRUHV�HQWHQGHP�TXH�KRXYH�GLPLQXLomR�GH�YROXPH��HQWmR�DWLYDP�PHFDQLVPRV�
SDUD�DXPHQWDU�HVWH�YROXPH��TXH�YDL�FRQWLQXDU�GLPLQXLQGR�SRU�QmR�ILFDU�UHWLGR�QR�HVSDoR�
LQWUDYDVFXODU��FRPR�D�VLWXDomR�QmR�YROWD�DR�QRUPDO��RV�UHFHSWRUHV�FRQWLQXDP�
HVWLPXODQGR�D�UHWHQomR�GH�YROXPH��FXOPLQDQGR�HP�XP�DXPHQWR�FDGD�YH]�PDLRU�GD�
DVFLWH�
ͻ
&RPR�LPSHGLU�LVVR"�,QLELU�D�UHWHQomR�GH�6yGLR�H�ÈJXD
%&&ż
$QWDJRQLVWD�GH�$OGRVWHURQD��(VSLURQRODFWRQD� !�LQLEH�D�DomR�GD�DOGRVWHURQD��PDV�
R�HIHLWR�GLXUpWLFR�p�GLVFUHWR��LVVR�p�ERP�SRUTXH�R�YROXPH�FLUFXODQWH�GH�VDQJXH�Mi�p�
EDL[R��VH�HVWLPXODUPRV�D�GLXUHVH�R�SDFLHQWH�FKRFD�
ż
ͻ
5HVXPLQGR�����D�LQFDSDFLGDGH�GR�ItJDGR�HP�VLQWHWL]DU�DOEXPLQD��OHYD�D�GLPLQXLomR�GD�SUHVVmR�
FRORLGRVPyWLFD�GR�SODVPD���KLSHUWHQVmR�SRUWDO��TXH�OHYD�D�DXPHQWR�GD�SUHVVmR�KLGURVWiWLFD�
 �H[WUDYDVDPHQWR�GH�OtTXLGR�SDUD�IRUD�GR�YDVR� !�GLPLQXLomR�GR�YROXPH�FLUFXODQWH�HIHWLYR�
FRP�DWLYDomR�GRV�PHFDQLVPRV�UHWHQWRUHV�GH�VyGLR�H�iJXD��65$$��$'+�H�616��
$/7(5$d®(6�6$1*8Ë1($6�1$�'2(1d$�+(3È7,&$
6HTXHVWUR�6DQJXtQHR�SHOR�%DoR��R�EDoR�DXPHQWD�HP�WDPDQKR��HVSOHQRPHJDOLD��H�
IXQo}HV��KLSHUHVSOHQLVPR���3HOR�KLSHUHVSOHQLVPR�RFRUUH�DXPHQWR�GD�FDSWDomR�H�GHVWUXLomR�
GH�FpOXODV�VDQJXtQHDV�FLUFXODQWHV��
+HPiFLDV� !�$QHPLDͻ
1HXWUyILORV� !�1HXWURSHQLDͻ
3ODTXHWDV� !�7URPERFLWRSHQLD�ͻ
$OWHUDo}HV�(ULWURFLWiULDV��
1R�SRUWDGRU�GH�GRHQoD�KHSiWLFD�QD�PDLRULD�GDV�YH]HV�DSDUHFH�DQHPLD�QRUPRFtWLFD�H�
QRUPRFU{PLFD��LVVR�SRUTXH�R�EDoR�DXPHQWD�D�FDSWDomR�GDV�KHPiFLDV��GLPLQXLQGR�D�
FRQFHQWUDomR�GH�KHPiFLDV�FLUFXODQWHV��PDV�QmR�Ki�QHQKXPD�DOWHUDomR�QR�SDGUmR�GD�
KHPiFLD��HOD�FRQWLQXD�QRUPDO��PDV�HP�PHQRU�YROXPH��2�PHVPR�RFRUUH�QR�TXDGUR�GH�
+HPRUUDJLD�'LJHVWLYD�$JXGD��
ͻ
$�DQHPLD�SRGH�VH�DSUHVHQWDU�QD�IRUPD�PLFURFtWLFD�H�KLSRFU{PLFD��SHOD�SHUGD�FU{QLFD�GH�
VDQJXH�QDV�IH]HV��SRU�H[HPSOR��7DPEpP�SRGH�VHU�PHJDOREOiVWLFD��QHVWH�FDVR�DSRQWD�
SDUD�HWLRORJLD�DOFRyOLFD�
ÈOFRRO��DOWHUD�D�DEVRUomR�GH�%���ż
ͻ
$OWHUDo}HV�/HXFRFLWiULDV�H�3ODTXHWiULDV�
/HXFRSHQLD�H�7URPERFLWRSHQLD�HP�FRQVHTXrQFLD�GR�DXPHQWR�GD�DWLYLGDGH�GR�EDoR�ͻ
2�)Ë*$'2�(�$�&2$*8/$d­2�6$1*8Ë1($
2�ItJDGR�p�R�SULQFLSDO�ORFDO�GH�VtQWHVH�GRV�IDWRUHV�GH�FRDJXODomR��FRP�H[FHomR�GR�)DWRU�;,,�H�
GH�SURWHtQDV�ILEULQROtWLFDV��7DPEpP�p�UHVSRQViYHO�SHOD�UHWLUDGD�GRV�IDWRUHV�GH�FRDJXODomR�
DWLYDGRV�GR�VDQJXH��
$YDOLDomR�GD�IXQomR�KHSiWLFD� H[LVWHP�SDUkPHWURV�GH�VtQWHVH�KHSiWLFD�TXH�QRV�SHUPLWH�
DYDOLDU�D�IXQomR�GH�VtQWHVH�GR�ItJDGR��RV�PDLV�LPSRUWDQWHV�VmR�D�$/%80,1$�H�RV�)$725(6�
'(�&2$*8/$d­2�
$OEXPLQD� D�GRVDJHP�GH�DOEXPLQD�QRV�SHUPLWH�DYDOLDU�D�IXQomR�KHSiWLFD��R�HVWDGR�
KtGULFR�H�R�HVWDGR�QXWULFLRQDO���$�GLPLQXLomR�GD�FRQFHQWUDomR�GH�DOEXPLQD�QR�VDQJXH�
FKDPDPRV�GH�+LSRDOEXPLQHPLD�
+LSRDOEXPLQHPLD� !�'LPLQXLomR�GD�3UHVVmR�2QFyWLFD� !�(GHPD�ż
ͻ
)DWRUHV�GH�&RDJXODomR� VmR�DYDOLDGRV�SHOR�7HPSR�GH�3URWURPELQD��73���TXH�p�R�PHOKRU�
PDUFDGRU�GH�VtQWHVH�KHSiWLFD��
ͻ


REV��R�73�p�FRQVLGHUDGR�R�PHOKRU�PDUFDGRU�SRUTXH�D�$OEXPLQD�GLPLQXL�HP�RXWUDV�
VLWXDo}HV��QmR�Vy�QD�LQVXILFLrQFLD�KHSiWLFD��SRU�H[HPSOR�TXDQGR�R�SDFLHQWH�HVWi�FRP�R�
HVWDGR�KtGULFR�RX�QXWULFLRQDO�DOWHUDGR��
3URORQJDPHQWR�GR�7HPSR�GH�3URWURPELQD��73���D�DYDOLDomR�p�IHLWD�DQWHV�H�GHSRLV�GD�
DGPLQLVWUDomR�GH���PJ�GH�9LWDPLQD�.�SRU�YLD�LQWUDPXVFXODU��
$�YLWDPLQD�.�p�HVVHQFLDO�SDUD�D�VtQWHVH�GRV�IDWRUHV�GH�FRDJXODomR��(QWmR�D�JHQWH�
DGPLQLVWUD�HOD�SRUTXH�R�SURORQJDPHQWR�GR�73�SRGH�VHU�SRU�XPD�GHILFLrQFLD�GH�YLWDPLQD�
.�
$�GHILFLrQFLD�GD�YLWDPLQD�.�SRGH�VHU�GHFRUUHQWH�GD�IDOWD�GH�LQJHVWD��RX�SHOD�Pi�
DEVRUomR��SRU�DOWHUDo}HV�GRV�VDLV�ELOLDUHV���RX�DLQGD�SRU�XPD�GLPLQXLomR�GD�VtQWHVH�
SRU�EDFWpULDV�LQWHVWLQDLV��
ż
6H�DSyV�D�DGPLQLVWUDomR�GD�YLWDPLQD�.��R�73�VH�QRUPDOL]D��D�FDXVD�HUD�D�
KLSRYLWDPLQRVH��LVVR�p�ERP��SRUTXH�VLJQLILFD�TXH�R�ItJDGR�DLQGD�IXQFLRQD��ż
ͻ
$�VHJXQGD�SRVVLELOLGDGH�GH�SURORQJDPHQWR�GR�73�p�D�DOWHUDomR�QD�VtQWHVH�KHSiWLFD��
(QWmR�VH�D�JHQWH�DGPLQLVWUD�YLWDPLQD�.�H�PHVPR�DVVLP�R�73�FRQWLQXD�DXPHQWDGR��R�
ͻ
SUREOHPD�p�KHSiWLFR��
73�SURORQJDGR�PHVPR�FRP�UHSRVLomR�GH�9LW��.� !�SURJQyVWLFR�VRPEULR��ż
2�SDFLHQWH��
,QGLYtGXR�VDXGiYHO� D�YLWDPLQD�.�p�SURYHQLHQWH�GD�GLHWD��SDVVD�SHOR�7*,��RQGH�QHFHVVLWD�
GD�SUHVHQoD�GH�VDLV�ELOLDUHV�SDUD�VHU�DEVRUYLGD��HQWmR�FDL�QD�FLUFXODomR�SRUWD��FKHJD�QR�
ItJDGR�H�YDL�VHU�XWLOL]DGD�SDUD�D�VtQWHVH�GRV�IDWRUHV�GH�FRDJXODomR��1HVVH�LQGLYtGXR�Ki�
IRUPDomR�GH�FRiJXORV�QRUPDOPHQWH��SRLV�WHPRV�XP�ItJDGR�IXQFLRQDQWH�HQWmR�WHPRV�
IRUPDomR�GRV�IDWRUHV�GH�FRDJXODomR��73�p�QRUPDO�
��
,FWHUtFLD�REVWUXWLYD� R�SDFLHQWH�LQJHUH�D�YLWDPLQD�.��PDV�Ki�XPD�REVWUXomR�TXH�LPSHGH�
D�HQWUDGD�GD�ELOH�QR�LQWHVWLQR��2�LQGLYtGXR�WHP�VDQJUDPHQWR�H�WHP�73�SURORQJDGR��
SRUTXH�D�YLWDPLQD�QmR�p�DEVRUYLGD�GHYLGR�D�DXVrQFLD�GRV�VDLV�ELOLDUHV��
��
$GPLQLVWUDomR�GH�9LWDPLQD�.�QD�LFWHUtFLD�REVWUXWLYD� DGPLQLVWUDPRV�YLWDPLQD�.�SRU�YLD�
SDUHQWHUDO��,0�� QmR�DGLDQWD�GDU�92��SRUTXH�DL�QmR�YDL�WHU�DEVRUomR�GR�PHVPR�MHLWR���
&RP�D�YLWDPLQD�.�GLUHWR�QD�FLUFXODomR��HOD�FKHJD�DR�ItJDGR��SHUPLWLQGR�D�VtQWHVH�GRV�
IDWRUHV�GH�FRDJXODomR��,VVR�p�UHSUHVHQWDGR�QD�ILJXUD�SHOD�IRUPDomR�GR�FRiJXOR��R�
SDFLHQWH�SDUD�GH�WHU�VDQJUDPHQWR�H�R�73�VH�QRUPDOL]D��
��
/HVmR�FHOXODU�KHSiWLFD� R�ItJDGR�DSUHVHQWD�PXLWRV�QyGXORV��LQGLFDQGR�FLUURVH��2�SDFLHQWH�
LQJHUH�D�YLWDPLQD�.��QHVWH�FDVR�Ki�XP�SUREOHPD�QD�DEVRUomR�GHYLGR�D�XPD�GHILFLrQFLD�
GH�ELOH��PDV�DLQGD�DVVLP�Ki�DEVRUomR��2�SDFLHQWH�VDQJUD�H�VHX�73�HVWi�DXPHQWDGR��
��
$GPLQLVWUDomR�GH�9LWDPLQD�.�QD�OHVmR�FHOXODU�KHSiWLFD� DGPLQLVWUDPRV�YLWDPLQD�.��,0���
2�SDFLHQWH�DLQGD�DSUHVHQWD�VDQJUDPHQWR�H�R�73�FRQWLQXD�DXPHQWDGR��LQGLFDQGR�
KHSDWRSDWLD��
��
$/7(5$d®(6�(1'Ï&5,1$6
$/7(5$d®(6�(1'Ï&5,1$6
+LSHUHVWURJHQLVPR� GLPLQXLomR�GD�PHWDEROL]DomR�GRV�KRUP{QLRV�HVWHUyLGHV�
1R�KRPHP� DV�DOWHUDo}HV�VmR�HP�GLUHomR�GD�IHPLQL]DomR�
+LSRJRQDGLVPR��RV�WHVWtFXORV�VmR�SHTXHQRV��Ki�SHUGD�GH�OLELGR�H�RFRUUH�
LPSRWrQFLD�VH[XDO�
ż
2V�SHORV�VH[XDLV�FDHP�ż
*LQHFRPDVWLDż
ͻ
1D�PXOKHU� DV�DOWHUDo}HV�VmR�PHQRUHV�H�RFRUUHP�QR�FLFOR�PHQVWUXDO��ͻ
2�ItJDGR�H�VXDV�IXQo}HV�FRQWURODGRUDV�KRUPRQDLV� 0HFDQLVPR�GR�
+LSHUHVWURJHQHPLVPR
2�ItJDGR�p�XPD�JUDQGH�IiEULFD�GH�SURWHtQDV��HQWUH�DV�TXDLV�HVWmR�SURWHtQDV�
WUDQVSRUWDGRUDV�GH�KRUP{QLRV��$�FLUFXODomR�GH�KRUP{QLRV�OLYUHV��TXH�VmR�RV�TXH�
H[HUFHP�D�DomR�KRUPRQDO��p�EDL[D�
1R�LQGLYtGXR�VDXGiYHO�p�FRPR�VH�KRXYHVVH�XPD��UHVHUYD��GH�KRUP{QLRV��SRLV�Ki�
XPD�JUDQGH�SRUomR�FLUFXODQGR�DVVRFLDGD�jV�SURWHtQDV�
ż
ͻ
1R�SDFLHQWH�FRP�OHVmR�KHSiWLFD�RV�KRUP{QLRV�FRQWLQXDP�VHQGR�SURGX]LGRV��PDV�QmR�Ki�
VtQWHVH�GRV�WUDQVSRUWDGRUHV��VH�Ki�GLPLQXLomR�GD�VtQWHVH�KHSiWLFD�GH�SURWHtQDV�OLJDQWHV�
GH�HVWHUyLGHV��Ki�XP�DXPHQWR�GD�GLVSRQLELOLGDGH�GH�WHVWRVWHURQD�OLYUH��ORJR��Ki�
DXPHQWR�GD�FRQYHUVmR�SHULIpULFD�HP�HVWUDGLRO��OHYDQGR�j�IHPLQL]DomR�QR�KRPHP��H�j�
DOWHUDo}HV�GR�FLFOR�PHQVWUXDO�QD�PXOKHU��
ͻ
2�H[FHVVR�GH�HVWURJrQLR�WDPEpP�SDUHFH�WHU�DomR�YDVRGLODWDGRUD��TXH�FXOPLQD�HP�
DOWHUDo}HV�FXWkQHDV�
$UDQKDV�6SLGHUV�YDVFXODUHVż
(ULWHPD�SDOPDUż
ͻ
2�)Ë*$'2�(�$�(;&5(d­2�'(�%,/,558%,1$�1$�%,/(
2�ItJDGR�p�XP�JUDQGH�yUJmR�H[FUHWRU��H�XP�GH�VHXV�SURGXWRV�p�D�ELOLUUXELQD��TXH�p�R�SURGXWR�
ILQDO�GD�GHJUDGDomR�GH�KHPiFLDV��2�ItJDGR�WHP�IXQomR�GH�FRQMXJDU�D�ELOLUUXELQD��WRUQDQGR�D�
PDLV�VRO~YHO��R�TXH�SHUPLWH�VXD�H[FUHomR��$�DXVrQFLD�GHVVD�FRQMXJDomR�OHYD�D�XP�DF~PXOR�
GH�ELOLUUXELQD�QD�SHOH��TXH�FKDPDPRV�GH�LFWHUtFLD
,FWHUtFLD��
&RORUDomR�DPDUHODGD�GDV�PXFRVDV��SHOH�H�HVFOHUyWLFDVͻ
&RQVHTXrQFLD�GD�GHSRVLomR�GH�ELOLUUXELQDͻ
+LSHUELOLUUXELQHPLD��ELOLUUXELQD�!��PJ�GO�QR�VRUR�
1RUPDO������� ����PJ�GOż
ͻ
(;$0(�)Ë6,&2
,FWHUtFLDͻ $VFLWHͻ
(ULWHPD�SDOPDUͻ 9DUL]HV�JDVWUR�HVRIiJLFDVͻ
*LQHFRPDVWLDͻ )ODSSLQJ�$VWHUL[LVͻ
6SLGHUV�YDVFXODUHVͻ 9DUL]HV�KHPRUURLGDLVͻ

Continue navegando