The nature and extent of myocardial ischemic injury (Mil) produced either by coronary artery ligation/reperfusion or by injection of isoproterenol (ISO) was studied in the 10-week alloxan-diabetic rabbit. Prior to the induction of ischemic injury, investigation of the left ventricles of the diabetic rabbit after 10-weeks revealed significant magnesium depletion and inhibition of myofibrillar and sarcoplasmic reticulum ATPase activities. In addition, the activity of the lysosomal enzyme, N-acetyl-β-glucosaminidase was significantly increased in diabetic left ventricular homogenates. Ultrastructural studies revealed significant lipid and glycogen accumulation, dilatation of the sarcoplasmic reticulum and damage to the mitochondria in left ventricles of the diabetic animals. Administration of ISO to both control and diabetic animals resulted in atrial tachycardias and ventricular fibrillation. The severity of the arrhythmias and the overall mortality was the same in both groups of animals. Serum analyses revealed significantly greater increases in blood glucose, free fatty acids, total cholesterol and creatine kinase activity in the ISO-treated diabetic animals relative to ISO-treated controls. ISO treatment of both control and diabetic animals produced similar increases in heart weight, left ventricular weight and myocardial water content. Analyses of various subcellular organelle marker enzyme activities indicated a significantly greater decrease in the K⁺ ,Ca²⁺ -stimulated sarcoplasmic reticulum ATPase of ISO-treated diabetic animal hearts. In addition, significantly greater increases in Ca and hydroxyproline and decreases in the levels of ATP were evident in the ISO-treated diabetic animal hearts. Ultra-structural studies revealed significant damage to the mitochondria in both ISO-treated control and diabetic hearts, the magnitude of the damage being greater in the diabetic animals. Mitochondria from both groups of animals showed swelling and fragmentation, myofibrils appeared as a homogeneous mass and did not show the characteristic Z-lines. Glycogen depletion and lipid accumulation was observed in both groups of animals. In addition, both groups of animals showed amorphous dense bodies in the mitochondria after ISO-treatment. After 40-minutes occlusion of the left circumflex coronary artery followed by 60-minutes of reperfusion, hemodynamic measurements revealed significant decreases in the left ventricular and systemic arterial pressures in the diabetic animals relative to controls. Analyses of subcellular organelle enzymes from the ischemic tissue revealed that sarcolemmal Na⁺ ,K⁺ -ATPase, mitochondrial ATPase and sarcoplasmic reticulum ATPase activities were decreased after coronary occlusion in both control and diabetic animals. However, upon reperfusion, unlike the control, no recovery of the mitochondrial ATPase was observed in the diabetic animals. In addition, a further depression of both the sarcolemmal and sarcoplasmic reticulum ATPase activities were seen in the diabetic animals compared to controls on reperfusion. Ion measurements revealed a significant accumulation of calcium in both control and diabetic animals, the magnitude of the increase being greater in the diabetic animals. Similarly, both tissue ATP levels and the ability of the mitochondria to generate ATP were depressed in the diabetic animals as compared to controls following coronary artery occlusion and reperfusion. Following coronary artery ligation and reperfusion, the diabetic animals showed a significantly higher incidence of ventricular fibrillation and cardiogenic shock as compared to controls. Ultrastructural studies revealed myocardial damage to both control and diabetic hearts following coronary artery ligation and reperfusion. However, the diabetic myocardium showed a higher incidence and frequency of hypercontraction bands, an increase in the amorphous dense bodies and slightly greater damage to the mitochondria. Coronary artery ligation in conscious control, 6 and 12 week-diabetic rats resulted in post-ligation arrhythmias (especially ventricular fibrillation), the incidence of which was much greater in the diabetic animals. The mortality rate of 12-week diabetic rats undergoing coronary ligation was 100% within 1-7 minutes following ligation. No differences in occluded or infarcted zones of the surviving 6-week diabetic and control rats were detected. Analyses of ionic composition revealed a significant magnesium deficiency in the diabetic hearts as compared to controls. These data indicate that the diabetic animals show a greater susceptibility of the myocardium to ischemic injury. Although numerous metabolic and chemical alterations are present in the diabetic myocardium, it is possible that magnesium deficiency may be a factor determining the higher incidence of arrhythmias and ischemic injury in diabetic animals. / Pharmaceutical Sciences, Faculty of / Graduate

Diabetes is known to result in a large number of alterations which affect various systems and organs. One of the more prominent disorders associated with diabetes is that of cardiac disease. Clinically, diabetics suffer from morbidity and mortality of cardiac origin to a greater extent than the nondiabetic population. Various functional studies have also revealed that the efficiency of diabetic hearts to function as pumps is lower than that of normal hearts. Experimentally, myocardial function of either rats or dogs made diabetic with either streptozotocin (STZ) or alloxan has been studied and a depression clearly demonstrated in both the species. The abnormalities of cardiac function in experimental diabetes are accompanied by depression of various enzyme systems in the heart. These include the ability of the sarcoplasmic reticulum (SR) to take up calcium; the myosin and actomyosin ATPase activities; and the Na⁺, K⁺ ATPase activity. All these changes can be prevented and reversed by insulin treatment suggesting that the myocardial problems seen in STZ or alloxan diabetic animals are due to diabetes and not direct toxicities of the drugs. It is not known whether the beneficial effects of in vivo insulin treatment are due to its direct myocardial effects or whether they are secondary to its effects mediated via normalisation of metabolism in diabetic animals. Thus, in the first part of the present investigation, we examined the direct effects of insulin on hearts from either control or diabetic rats using the isolated working heart preparation. Rats made diabetic with STZ (55 mg/kg) were sacrificed either 3 days or 6 weeks after induction of the disease and their hearts isolated and perfused in the working heart mode. Glucose concentrations varying from 5mM to 20mM were used in the perfusion medium, either in the presence or absence of insulin (5mU/mL). Left ventricular function was expressed as left ventricular developed pressure (LVDP) and the rates of contraction and relaxation (positive and negative dP/dt respectively) at various left atrial filling pressures. Three days after injecting STZ into rats, the animals exhibited hypoinsulinemia, hyperglycemia and their body weights although not significantly different from those of control animals, tended to be lower than the body weights of controls. Animals treated in this manner did not exhibit depression of cardiac function when compared with the myocardial function of control rats. Hearts from control rats exposed to regular insulin in the presence of 5mM glucose exhibited values of contractility which were significantly greater as compared with those obtained from control rat hearts not exposed to the hormone. When insulin was perfused along with a higher concentration of glucose (10mM), function of control rat hearts was affected to a significant extent. As opposed to the effects on control rat hearts, insulin failed to increase contractility in hearts from 3 day diabetic rats when either 5 or 10mM glucose was used in the perfusion medium. The study was then repeated using animals which had been diabetic for six weeks. At the time of sacrifice, these animals were hypoinsulinemic, hyperglycemic and weighed significantly less than their age-matched controls. Analysis of cardiac function revealed a significant depression in diabetic rats as compared with controls. Increasing glucose concentrations from 5 to 20mM in the perfusion medium did not affect the function of either control or diabetic rat hearts. Perfusion with regular insulin increased contractility in control rat hearts; the increase in contractility was not affected by increasing the glucose concentration from 5 to 10mM. However, contractility of diabetic rat hearts was not affected by insulin perfusion when either 5 or 10mM glucose was used in the perfusion medium. In order to eliminate the possibility of involvement of glucagon (which may contaminate commercial insulin preparations) in the effects of insulin on control rat hearts, part of the study was repeated using glucagon - free insulin. While the glucagon - free insulin increased contractility in control rat hearts, diabetic rat hearts were not affected. These results are identical to those obtained with regular insulin, suggesting that the effects of insulin observed were due to insulin itself. Although insulin treatment prevents and reverses diabetes - induced myocardial alterations in the rats, due to its widespread metabolic effects, it is not a good tool for investigating the specific factors which cause the cardiac abnormalities. In addition, a major problem with insulin treatment clinically is the fact that hypoglycemia can be associated with it, inadequate control occurs in some diabetics and secondary complications, such as myocardial problems, occur despite insulin treatment. It is thus desirable to have treatments which selectively affect certain aspects of diabetes so that the suspected underlying causes can be corrected specifically and their significance in causing the myocardial problems assessed. It would also be useful to have drug treatments which could either substitute for insulin or could be used in addition to the peptide. We have thus studied the effectiveness of certain treatments in preventing diabetes - induced myocardial alterations. The first one used was methyl palmoxirate, a fatty acid analog which is reported to reduce blood glucose levels in diabetic rats and dogs. The glucose - lowering effect is mediated via inhibition of fatty acid metabolism due to inhibition of carnitine acyl transferase resulting in inhibition of acyl carnitine formation and eventually inhibition of fatty acid transport across the mitochondrial membrane. Rats were treated with the drug (25mg/kg/day p.o.) three days after they were injected with either STZ or buffer. The treatment was carried out for 6 weeks and cardiac performance was then assesed. Untreated and treated diabetic rats were hypoinsulinemic, hyperglycemic and hyperlipedemic at the time of sacrifice. Cardiac function, which was depressed in diabetic animals, was still depressed despite the methyl palmoxirate treatment. However, the ability of the myocardial sarcoplasmic reticulum (SR) to take up calcium, which was depressed in diabetic rats, was normal in treated diabetic rats. Also, the levels of long chain acyl carnitines (LCAC) in the myocardial SR were normalised by methyl palmoxirate treatment in diabetic rats. In an effort to normalise diabetes - induced myocardial alterations in rats, we then attempted a combination of either methyl palmoxirate or carnitine (as both can prevent the depression of SR calcium uptake) with thyroid hormone treatment (as it can normalise myosin ATPase depression in diabetic rat hearts). The treatment protocol was identical to that described above (30µg/kg/day s.c. T₃ was used). Although the general features of both control and diabetic animals were not affected by either of the combination treatments, cardiac dysfunction in diabetic rats was prevented by methyl palmoxirate and T₃ treatment. Carnitine and T₃ treatment, on the other hand, affected the function of diabetic rat hearts only at the lower left atrial filling pressures. These results suggest that the combination treatment of methyl palmoxirate and T₃ affect parameters besides SR calcium uptake and myosin ATPase. This is because the combination of carnitine and T₃, which also supposedly affects same parameters as the other combination, could not prevent the myocardial alterations. One of the possible reasons for the effectiveness of the combination of methyl palmoxirate and T₃ could be that animals treated with methyl palmoxirate derived at least part of their metabolic energy (especially at higher left atrial filling pressures) from glucose and thus reduced the oxygen demand at higher filling pressures as opposed to the untreated diabetic rat hearts which depended completely on fatty acids for their metabolic energy demands. / Pharmaceutical Sciences, Faculty of / Graduate

Orientador: Antonio Ari Gonçalves / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-07-20T16:12:16Z (GMT). No. of bitstreams: 1 Giacomini_AnaCristinaVendramettoVarrone_M.pdf: 10703008 bytes, checksum: 5a65c64675ea012ba407bd05c15c6244 (MD5) Previous issue date: 1994 / Resumo: O sistema nervoso parassimpático está envolvido na modulação da secreção de insulina e no metabolismo de carboidratos no fígado e em outros tecidos. O presente trabalho teve como objetivo estudar os efeitos agudos e crônicos da vagotomia subdiafragmática seletiva sobre a sensibilidade das ilhotas de Langerhans aos segretagogos (glicose e carbamilcolina) in vitro, sobre a sensibilidade à insulina in vivo e sobre o armazenamento de glicogênio hepático. Os ratos foram anestesiados, submetidos à vagotomia nos ramos hepático e pancreático e, após 15, 30 e 60 dias foram utilizados nos protocolos descritos a seguir. Para estudar os efeitos da vagotomia sobre a sensibilidade das ilhotas destes ratos, essas foram isoladas por colagenase, incubadas com 86Rb+ (substituto do 42K+) e perfundidas para medir a taxa de efluxo como estimativa da permeabilidade ao K+ (PK). Ilhotas isoladas de ratos vagotomizados do ramo pancreático (15 e 30 dias) apresentaram alteração na sensibilidade à glicose (16, 7mM) e à carbamilcolina (CCh 100 µM). A PK foi reduzida na presença de glicose em ilhotas de ratos controle (1,95% min-1) e de ratos vagotomizados do ramo pancreático (2,51 % min-l e 2,43% min-1 após 15 e 30 dias, respectivamente) embora em menor intensidade nos últimos. Embora, a PK tenha sido inibida nas ilhotas de ratos submetidos à vagotomia hepática ao mesmo nível que nas ilhotas de ratos controle, durante a condição inicial (glicose ausente), a PK nos ratos vagotomizados foi menor que no controle. A CCh (100 µM) não aumentou PK na presença de glicose (5,6mM) nas ilhotas isoladas de ratos submetidos à vagotomia pancreática. Entretanto, nas i1hotas isoladas de ratos vagotomizados no ramo hepático, a CCh 100 µM aumentou o efluxo de forma semelhante ao verificado nas ilhotas de rato controle. A vagotomia também alterou o armazenamento de glicogênio hepático. Após a vagotomia hepática (15 e 60 dias) a concentração de glicogênio hepático foi reduzida. Todavia ratos submetidos à vagotomia pancreática exibiram diminuição na reserva hepática no período agudo (15 dias) enquanto que no período crônico (60 dias), ocorreu aumento dessa concentração. O teste de tolerância à insulina mostrou diferença significativa entre os valores iniciais de glicemia nos ratos vagotomizados (114,31 + 3,11 ramo hepático e 138,23 + 7,81 ramo pancreático) em relação ao grupo controle (91,17 + 5,19). A administração de insulina i.p. induziu uma rápida remoção da glicose (50% de remoção nos minutos 10 e 11) nos ratos vagotomizados dos ramos hepático e pancreático, respectivamente. Os dados obtidos nesse teste indicaram que os ratos vagotomizados são mais sensíveis à insulina. Este resultado é compatível com o baixo padrão de secreção de insulina relatado por outros autores. Nossos resultados sugerem um efeito trófico da inervação vaga pancreática sobre as ilhotas de Langerhans, especialmente sobre as células ß / Abstract: Parasympathetic nervous system is involved in the modulation of insulin secretion and in the balance of carbohydrate metabolism in liver and other tissues. This work was carried out to study the short and long time effects of se1ective subdiaphragtnatic vagotomy on events re1ated to glycemic control: "in vitro" sensitivity of is1ets of Langerhans to glucose and carbamy1cho1ine and "in vivo" sensitivity to insu1in and hepatic glycogen storage. The rats were anesthetized and hepatic or pancreatic vagotomy was performed. After 15,30 or 60 days of recovery, rats was submitted to experimental protoco1s as described bellow. Studies of the effects of vagotomy on the K + permeability (PK) was conducted on collagenase isolated islets of Langerhans using 86Rb+ as a substitute for 42K +. The islets iso1ated from pancreatic vagotomized rats (15 and 30 days) had their sensitivity to glucose (16,7mM) and carbamylcholine (CCh) (100 µM) altered. The PK was reduced by glucose (16, 7mM), but in a lesser extent that in the control islets (2,51 % min-l 15 days; 2,43% min-l 30 days; 1,95% min-1 control). On the other hand, CCh (100 µM) did not increased the PK in the presence of glucose (5,6 mM) as were seen in the islets for control group. However, in the hepatic vagotomized rats, CCh increased PK. As for the effect of glucose (16,7 mM) the data is conflicting. Although PK was inhibited by glucose (16,7 mM) to the same level as seen in the control, during the initial condition (i.e, no glucose) the PK of the vagotomized islets was lesser than the control. These results suggest that the vagotomy of the pancreatic branch alters the sensitivity of the islets to glucose and CCh. Vagotomy also affected the storage of glycogen on liver. Hepatic vagotomy (15 and 60 days) induced reduction of glycogen storage. In the pancreatic vagotomized group the glycogen storage was diminished 15 days after the surgery, but was increased after 60 days. Vagotomized rats presented higher initial glucose (114,31 + 3,11 mg/100mg in hepatic and 138,23 +7,81 mg/100mg in pancreatic) than control group. Exogenous i.p. insulin induced a fast removal of glucose from plasma (50% concentration) at the 10 and 11 min for hepatic and pancreatic, respectively. The vagotomized rats showed a high glucose removal rate, indicative of high sensitivity to insulin. This is compatible to a low insulin secretion pattern as reported by other authors. Taken together, these results suggest that the pancreatic vagal innervation exerts a trophic effect on the pancreatic islets, especially to the ß cell / Mestrado / Fisiologia / Mestre em Ciências Biológicas

Orientador: Vera Maria Santoro Belangero / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-07-20T19:39:24Z (GMT). No. of bitstreams: 1 Britto_AnnaCristinaGervasiode_M.pdf: 2910677 bytes, checksum: c8c413dd7402885eebaa91537dcecad5 (MD5) Previous issue date: 1995 / Resumo: Com o objetivo de se determinar os valores discriminatórios de normalidade para a excreção urinária de albumina em concentração não detectável por métodos habituais, designada de excreção de microalbuminúria, foram avaliadas 76 crianças de ambos os sexos, com 6 a 16 anos de idade. Para serem incluídas no estudo, além da permissão da família, era necessário que tivessem peso, altura e pressão arterial adequados à idade e sexo, não presentassem qualquer antecedente de doença renal, possuissem níveis séricos normais de creatinina e tivessem o sedimento urinário normal na época da coleta de urina para avaliação a microalbuminúria. Esta, foi avaliada em duas amostras noturnas através do método de radioimunoensaio de duplo anticorpo. Os resultados mostraram que a distribuição das frequências dos valores das amostras não apresentava um padrão de distribuição do tipo normal (teste de Kolmogorov Smimov- KS) o que foi modificado quando se utilizaram os respectivos valores dos 10garitmos (KS). Embora tenha.havido variação entre os valores das duas amostras para um mesmo indivíduo, estas diferenças não foram estatísticamente significativas, permitindo que se utilizasse a média aritmética dos valores das duas amostras para outras comparações. Desta forma não houve diferenças significativas entre os sexos, ocorrendo, no entanto, diferença significativa quanto à faixa etária. Considerando-se o percentil 95 como discriminatório, os valores de normalidade para crianças de 6 a 11 anos, inclusive, foi de 8,70 Ilglmin e para crianças de 12 a 16 anos inclusive, de ambos os sexos foi de 10,85 Ilglmin, ressaltando-se que estes são valores que correspondem à média de duas amostras. A aplicação destes resultados a um grupo de 42 crianças diabéticas de 6 a 16 anos de idade e com tempo de doença de 1 a 10 anos, acompanhadas no Ambulatório de Diabetes Infantil do HC-UNICAMP, mostrou que a prevalência de pacientes microalbuminúricos foi de 3/42 (7,1 %), sendo que nestes 3 casos o tempo de doença foi maior que 5 e menor que 10 anos e a idade mínima dos pacientes foi de 11 anos / Abstract: Seventy six healthy children aged 6 to 16 years were studied to estimate the discriminatory levels of urinary albumin excretion rate (AER). They all have normal weight, height, blood arterial pressure, serum creatinine and urinary sedimento The urinary albumin excretion was determined in two overnight urine samples, by double-antibody radioimmunoassay (Pharmacia, Albumin-RIA). Since the results of the urinary albumin excretion rate were not normally distributed, they were logarithmically transformed before statistical analysis. So, the Kolmogorov - Smirnov two sample test showed that the distribuition became as normal. To compare the samples by the same subject was used the Wilcoxon test. All tests used the significance level of 5%. Urinary albumin excretion rate was not related to the sex of the subjects, but there was significantly difference between children aged 6 to II and that ones 12 to 16 years. It was considered as discriminatory the values of the 95th percentil. So, for healthy children aged 6 to 11, for both sexes, this value was 8,70 ug/min and it was of 10,85 ug/min for those ones aged 12 to 16 years. These results were defmed as the mean of two samples of AER. Applying these results in a group of diabetics pacientes aged 6 to 16 years, with 1 to 10 years of disease, of the Diabetic Ambulatory of the Clinical Hospital of UNICAMP, it was met 3 pacients as "microalbuminurics". All of them were more than 11 years old and their disease last from 5 to 10 years / Mestrado / Pediatria / Mestre em Medicina

Orientador : Carlos Eduardo Negreiros de Paiva / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-07-16T07:03:54Z (GMT). No. of bitstreams: 1 Vieira_Auria_D.pdf: 2611580 bytes, checksum: a23ee1d5a5d9fb30d1e3244a1aa211fb (MD5) Previous issue date: 1984 / Resumo: Neste estudo, o pâncreas fetal de rato, cultivado, foi utilizado como órgão doador para o tratamento diabetes induzido por aloxana. O efeito deste tratamento foi comparado entre dois grupos experimentais: 1. doadores e receptores com um coeficiente de parentesco 37.5%, obtidos por endocruzamento de ratos da linhagem Wistar; 2. doadores e receptores sem grau de parentesco, da mesma linhagem. Os primeiros foram chamados de grupo "isogênico" e os outros, de grupo alogênico. Os pâncreas fetais foram enxertados em sítios intramusculares. O efeito desses enxertos sobre o estado diabético dos receptores foi avaliado, morfológica e fisiologicamente, após 30 dias de acompanhamento, e os resultados obtidos foram os seguintes: Quanto ao aspecto morfológico, apenas os enxertos "isogênicos" foram facilmente encontrados e a seguir examinados ao microscópio comum. Estes pareceram bem estabelecidos, com aglomerados de células ß, vascularização intrínsica sem aparente infiltração de células mononucleadas ou fibrose intersticial. Quanto ao aspecto funcional verificamos também, que os ratos do grupo "isogênico" responderam satisfatoriamente aos enxertos, pois recuperaram seu peso médio inicial apresentando uma diferença de apenas -5.9+-35,1g(P>0,05) significativa à 5% entre o peso mé- após os 30 dias de transplante. Quanto à glicemia média o"isogênico" apresentou uma redução significativa de -180.17+ - 110mg% (p < 0.001) após transplantes. No concernente ao grupo alogênico ocorreu o oposto, isto é, houve incremento significativo de 12,5mg% de glicemia (p < 0.001). Em resumo esse trabalho fala a favor de que fetos semelhantes de alto coeficiente de parentesco numa geração. poderão ser utilizados corno modelo de transplantes / Doutorado / Genetica / Doutor em Ciências

Orientador: Antonio Ari Gonçalves / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-07-17T07:48:59Z (GMT). No. of bitstreams: 1 Langone_Francesco_M.pdf: 6206901 bytes, checksum: 70637f306a943939bb36d161167b390f (MD5) Previous issue date: 1986 / Resumo: Neste trabalho nos propusemos estudar os efeitos do tiopental sobre a permeabilidade da célula beta do pâncreas ao 'K POT. +¿ e ao 'CA POT. 2+¿. Tal propósito advém do fato de que o tiopental afeta a permeabilidade a esses íons nas células nervosas, modificando sua fisiologia. Dessa maneira, esse barbitúrico pode vir a ser um instrumento de interesse ao estudo da fisiologia das células secretoras de insulina. Os experimentos constituíram-se do registro da atividade elétrica de células beta de ilhotas microdissecadas de camundongo e da avaliação de efluxo de 'CA SOB. 45¿ em ilhotas de ratos, isoladas pela técnica da colagenase. Para os estudos eletrofisiológicos, as ilhotas foram microdissecadas, introduzidas numa câmera (volume = 1 'MM POT. 3¿) e perfundidas constantemente, à razão de 1,4 ml/min. As soluções perfusoras foram mantidas em banho-maria a ¿37 GRAUS¿C. Para evitar a perda de calor, a solução passou através de cânulas no interior de uma câmera trocadora de calor. Os registros intracelulares foram obtidos através de microeletrodos, ligados a um sistema de amplificação e registro gráfico. Os resultados obtidos são resumidos a seguir: Preliminarmente, caracterizamos a atividade elétrica das células beta. Quando foi introduzido 11,1 mM de glicose à solução perfusora, as células apresentaram resposta bifásica típica, com uma freqüência de ¿bursts¿ que variou de 2 a 5 por minuto. A remoção da glicose interrompeu a atividade elétrica e hiperpolarizou a membrana da célula beta. ...Observação: O resumo, na íntegra, poderá ser visualizado no texto completo da tese digital / Abstract: Not informed. / Mestrado / Fisiologia / Mestre em Ciências Biológicas

Orientador : João Poterio Filho / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-07-18T07:25:20Z (GMT). No. of bitstreams: 1 Menezes_FabioHusemann_M.pdf: 1388418 bytes, checksum: 62556d72f442c7749bb42113b9309b88 (MD5) Previous issue date: 1993 / Resumo: Desenvolveu-se este estudo para comparar, em membros inferiores, o método Pós-capilar para medida não-invasiva de pressão arterial com o método do Doppler. Foram estudados dois grupos de indivíduos que não apresentavam diferença estatística em relação a sexo, idade e presença de fatores de risco para arteriosclerose: 36 pacientes diabéticos e 37 voluntários sem diabetes mellitus, todos com pulsos presentes nos pés. Mostrou-se que o método Pós-capilar tem correlação com o método do Doppler, mas hipoestima as pressões nos indivíduos com índice pressórico tornozelo/braço (pelo método do Doppler) menor ou igual a 1,2. Nos indivíduos com índice tornozelo/braço (pelo método do Doppler) elevado, o método Pós-capilar estima nos pés pressões mais próximas das pressões dos membros superiores. Conclue-se que o método Pós-capilar não se aplica como substituto ao método do Doppler para a medida de pressão em indivíduos sem endurecimento arterial, mas está indicado nos casos com artérias endurecidas e, especialmente, quando as artérias são incompressíveis, o que torna não confiável a leitura da pressão com o método do Doppler / Abstract: The purpose of this study was to compare the non invasive blood pressure determination techniques of the Doppler and Post-capillary, used for the lower limbs. Two groups of subjects were studied. There was no statistical difference between the groups in regard to sex, age and risk factors for atherosclerosis. The first group consisted of 36 patients with Diabetes Mellitus, and the second group of 37 volunteers with no history of Diabetes. All subjects had palpable pulses at the foot. There could be demonstrated that the Post-capillary technique correlated well with the Doppler in those subjects with a Doppler ankle/brachial index lower or equal to 1. 2, even though the new technique underestimated the pressure in this group. In those subjects with stiffened arteries, with a Doppler ankle/brachial index higher than 1.2, the Post-capillary technique estimated pressure values closer to the arm pressure values. We conclude that the Post-capillary technique can not be used as a substitute for the Doppler technique in those subjects with palpable pulses and without stiffened arteries. Nonetheless i t is indicated for the evaluation of those subjects with stiffened arteries, and it's best indication is for those subjects with calcified arteries, where the Doppler derived pressures can not be trusted / Mestrado / Cirurgia / Mestre em Cirurgia

Injeções intravítreas de agentes anti-VEGF (vascular endothelium growth fator) se constituem em um dos possíveis tratamentos para o edema macular diabético. Antes desse procedimento cirúrgico os pacientes devem ler e assinar um termo de consentimento livre e esclarecido apesar de apresentarem, devido à doença, considerável perda visual que impacta diretamente sua autonomia e capacidade decisória. O objetivo deste estudo é desenvolver um modelo eletrônico de termo de consentimento livre e esclarecido e compará-lo com o modelo tradicional em papel quanto à legibilidade e capacidade de informação, aplicado à pacientes diabéticos com indicação de tratamento com injeções intravítreas para edema macular. Os voluntários foram randomizados para o grupo TCLE eletrônico (teste) ou papel (controle). O desfecho foi o número de respostas corretas coletadas através de um questionário estruturado aplicado antes e após a leitura do termo de consentimento. Os resultados apontaram diferença estatisticamente significativa entre os dois grupos com superioridade do modelo eletrônico em termos de possibilidade de leitura (91% grupo e-TCLE vs 0% grupo papel) e melhora na compreensão de conteúdo, principalmente com relação a riscos e ao procedimento cirúrgico propriamente dito. A despeito de se tratar de uma amostra pequena e de um desenho transversal, esses resultados indicam que o uso de recursos multimídia no processo de consentimento informado pode promover a autonomia de pacientes com baixa acuidade visual através da possibilidade de leitura individual do termo de consentimento além de melhorar a compreensão de importantes informações que lhes são transmitidas. Estudos com amostra maior e longitudinais são importantes para o desenvolvimento desse modelo de transmissão de informação ampliando suas possibilidades de aplicação tanto na prática clínica e quanto pesquisa com seres humanos.

"I Concurso de Investigación, Proyectos de Intervención y de Emprendedurismo", evento académico desarrollado el 16 de diciembre de 2020 de manera virtual, Lima, Perú. Se presentaron los proyectos de intervención y de Emprendedurismo desarrollado por la comunidad de Odontología en UPC. / Evaluar el nivel de conocimiento y prácticas en salud oral de pacientes con Diabetes Mellitus mediante una revisión sistemática y meta análisis.

Orientador: José Elias Tomazini / Banca: Mauro Pedro Peres / Banca: Magda Francisca Gonçalves Rocha / Resumo: O presente estudo é uma interação interdisciplinar entre os conceitos da engenharia mecânica e a ciência da saúde, usada para rastrear alterações nos pés de portadores de Diabetes Mellitus, possibilitando, através de uma plataforma de força, a identificação do risco de formação de úlceras plantares secundárias à sobrecarga mecânica em áreas de sensibilidade diminuída. Para tal foi projetada e construída uma plataforma de força de fácil operação. O estudo em análise foi realizado com um grupo de 30 voluntários, de ambos os sexos, com idade entre 30 e 69 anos (com idade média de 50 anos) distribuídos entre portadores de Diabetes mellitus e não diabéticos. A amostra foi dividida em três grupos: diabéticos com e sem neuropatia diabética e não diabéticos. Todos participantes, possuem características antropométricas compatíveis e não apresentam deformidades articulares significativas nos pés e nem dificuldades de marcha. Cada participante foi avaliado três vezes, permanecendo em posição ereta e estática sobre a plataforma, num tempo de 20 segundos em cada coleta. Através da análise da distribuição da pressão plantar foi observado que os voluntários diabéticos com neuropatia diabética apresentaram desigualdade pressórica nas áreas de menor sensibilidade protetora dos pés o que indica risco de formação de úlceras plantares / Abstract: The following study is an interdisciplinary interaction between concepts of mechanic engineering and the health science, it is used to find disturbs in patients with Mellitus diabetic feet. It is possible through a force platform that recognizes the risk of appearing planter ulcers that are secondary from the mechanic overcharge in areas where the sensibility was decreased. So, it was projected and built a force platform which is cheap and easy to operate. The study of analyses has been realized with 30 volunteers, both gender, from 30 to 69 years old (average 50 years old) they were divided between Mellitus Diabetics and no diabetics. The sample divided was into three groups: Diabetic with neuropathy and without neuropathy and no diabetics. All of them have anthropometrics compatible characteristics and they do not present significant joint deformities in foot neither walk difficulties. Every patient was availed three times they were stand up and static on the platform during 20 seconds. Throughout the plant pressure analysis distribution it was noted the diabetic volunteers with diabetic neuropathy have presented unequal pressure value in the regions where the feet protection sensibility was decreased and it denotes risk of plants ulcer development / Mestre