Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-11-29T15:54:11Z No. of bitstreams: 1 DIS_GEISA_FINGER_COMPLETO.pdf: 2399270 bytes, checksum: 9c1955548b0d1cebf40305d870924ca5 (MD5) / Made available in DSpace on 2016-11-29T15:54:11Z (GMT). No. of bitstreams: 1 DIS_GEISA_FINGER_COMPLETO.pdf: 2399270 bytes, checksum: 9c1955548b0d1cebf40305d870924ca5 (MD5) Previous issue date: 2016-08-23 / The behavioral and psychological symptoms of dementia (BPSD), has been a concern among mental health services due to the high injury rate in functionality and quality of life of this population. However, still remains open understanding of the psychological and behavioral changes that characterize each stage of cognitive decline. This study aimed to evaluate each SCPD present in the Neuropsychiatric Inventory (NPI) in elderly patients with mild cognitive decline, mild and moderate dementia, and relate to gender, age, educational level and degree of cognitive decline. Methods: Cross-sectional descriptive and analytical study with retrospective data collection of 123 elderly from Pontifical Catholic University of Rio Grande does Sul (PUC-RS). Data were collected from medical records of patients submit the following completed instruments: (i) Cognitive Examination Addenbrooke (ACE-R); (ii) Clinical Staging of Dementia (CDR); (iii) the Neuropsychiatric Inventory (NPI). The description of variables was being conduct using frequencies, means and standard deviations. The association between categorical variables (gender, education, age and CDR) and the presence of behavioral and psychological symptoms will be analyzed. P values ? 0.05 will be considered significant. In assessing the association of the BPSD with sex, apathy showed a significant association (p = 0.027) in 44.4% of men and eating disorders (p = 0.019). The association of the BPSD and age, delusions corresponded to 13.3% in the age group of 60 to 69 years, 9.4% between 70 and 79 years and 32.5% after 80 years of age (p = 0.024). Depression was present in 66.7% of individuals between 60 to 69 years, 52.8% between 70-79 years and 42.5% in octogenarians (p = 0.047). In the association of the BPSD with education, delusions were present in 23.7% of the population illiterate or with up to 3 years of schooling, 11.4% between 4 and 7 years of study, no cases above 80 years of age (p = 0.021). Anxiety showed 32.9% in illiterate individuals or up to 3 years of study, 54.3% in those aged 4 to 7 years of study and 58.3% when above 8 years of study (p = 0.020). The euphoria was not present in illiterate and showed values of 8.6% in those with 4-7 years of schooling and 8.3% over 8 years of education (p = 0.019). By analyzing the association of the BPSD in relation to cognitive decline, delusions presented significant data with 5.0% in mild cognitive decline, 18.2% in mild dementia and 35.7% in moderate dementia (p = 0.001). Hallucinations represented 7.5% of the cases of mild cognitive decline, 21.8% in cases of mild dementia and mild dementia in 28.6% (p = 0.024). Apathy was 15% in mild cognitive decline, 32.7% in mild dementia and 35.7% in moderate dementia (p = 0.046). The disinhibition showed 5.0% in mild cognitive decline, 12.7% in mild dementia and 21.4% in moderate dementia (p = 0.042).Neuropsychiatric symptoms are common in individuals with dementia and tend to increase the prevalence over time of disease progression. The results are consistent with the literature, where the low education is a contributing factor for psychotic symptoms when faced with high education, which is protective for the existence of cognitive decline and its associated symptoms. The increase in years of life contributes to the emergence of BPSD at older ages, as octogenarians, age at which the disease can be in the moderate stage. The evaluation of SCDP at level or evidence, it must be performed in all patients. / Os sintomas comportamentais e psicol?gicos das dem?ncias (SCPD), tem sido uma preocupa??o entre os servi?os de sa?de mental, devido ao alto ?ndice de preju?zo na funcionalidade e qualidade de vida desta popula??o. Contudo, ainda permanece em aberto a compreens?o das altera??es psicol?gicas e de comportamento que caracterizam cada est?gio do decl?nio cognitivo. O presente trabalho teve como objetivo avaliar cada SCPD presente no Invent?rio neuropsiqui?trico (NPI) em idosos com decl?nio cognitivo leve, dem?ncia leve e dem?ncia moderada, e relacionar com sexo, faixa et?ria, escolaridade e grau de decl?nio cognitivo. M?todo: Estudo transversal, descritivo e anal?tico, com an?lise de dados retrospectiva. Os dados foram coletados de 123 prontu?rios de idosos do Ambulat?rio de Envelhecimento Cerebral da Pontif?cia Universidade Cat?lica do Rio Grande do Sul, que apresentassem os seguintes instrumentos preenchidos: (i) Exame Cognitivo de Addenbrooke (ACE-R); (ii) Estadiamento Cl?nico da Dem?ncia (CDR) e o (iii) Invent?rio Neuropsiqui?trico (NPI). Na descri??o das vari?veis foram utilizados frequ?ncias, m?dias e desvios padr?es. Foram analisadas as associa??es entre as vari?veis categ?ricas (sexo, escolaridade, faixa et?ria e CDR) e a presen?a dos sintomas comportamentais e psicol?gicos e considerados significativos valores para p ? 0,05. Na avalia??o da associa??o dos SCPD com sexo, a apatia apresentou associa??o significativa (p=0,027) em 44,4% dos homens bem como os dist?rbios alimentares (p=0,019). Quando avaliada a associa??o entre sintomas comportamentais e faixa et?ria, os del?rios corresponderam a 13,3% na faixa et?ria de 60 a 69 anos, 9,4% entre 70 e 79 anos e 32,5% ap?s 80 anos de idade (p=0,024). A depress?o estava presente em 66,7% dos indiv?duos entre os 60 a 69 anos, 52,8% entre 70 a 79 anos e 42,5% nos octogen?rios (p=0,047). Na associa??o entre sintomas comportamentais ou psicol?gicos com escolaridade, os del?rios estavam presentes em 23,7% na popula??o de analfabetos ou com at? 3 anos de escolaridade, em 11,4% entre 4 e 7 anos de estudo, sem nenhum caso acima dos 80 anos de idade (p=0,021). A ansiedade apresentou 32,9% nos indiv?duos analfabetos ou com at? 3 anos de estudo, 54,3% naqueles idosos com 4 a 7 anos de estudo e 58,3% quando acima de 8 anos de estudo (p=0,020). A euforia n?o se mostrou presente em analfabetos e apresentou valores de 8,6% nos indiv?duos com 4 a 7 anos de escolaridade e 8,3% acima dos 8 anos de escolaridade (p=0,019). Ao analisar os sintomas comportamentais em rela??o ao decl?nio cognitivo, os del?rios apresentaram dados significativos com 5,0% no decl?nio cognitivo leve, 18,2% na dem?ncia leve e 35,7% na dem?ncia moderada (p=0,001). As alucina??es representaram 7,5% dos casos de decl?nio cognitivo leve, 21,8% nos casos de dem?ncia leve e 28,6% na dem?ncia moderada (p=0,024). A apatia foi de 15% no decl?nio cognitivo leve, 32,7% na dem?ncia leve e 35,7% na dem?ncia moderada (p=0,046). A desinibi??o apresentou 5,0% no decl?nio cognitivo leve, 12,7% na dem?ncia leve e 21,4% na dem?ncia moderada (p=0,042). Os sintomas neuropsiqui?tricos foram frequentes em indiv?duos com dem?ncia e aumentaram a preval?ncia com o tempo de evolu??o da doen?a. O aumento dos anos de vida contribuiu para o surgimento de SCPD em idades mais avan?adas, como os octagen?rios, idade na qual a doen?a pode estar na fase moderada. A avalia??o dos SCPD apresenta n?vel de evid?ncia A, devendo ser realizada em todos os pacientes.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-12-09T12:24:56Z No. of bitstreams: 1 TES_ANDRE_POISL_FAY_COMPLETO.pdf: 12654104 bytes, checksum: ad2a22881e2edf0bfef5f136f9a5e457 (MD5) / Made available in DSpace on 2016-12-09T12:24:56Z (GMT). No. of bitstreams: 1 TES_ANDRE_POISL_FAY_COMPLETO.pdf: 12654104 bytes, checksum: ad2a22881e2edf0bfef5f136f9a5e457 (MD5) Previous issue date: 2016-02-22 / Objective: This study aims to characterize PD-L1 expression in tumor tissue from low incidence genitourinary malignancies and to correlate levels of PD-L1 expression with clinico-pathological features as well as survival outcomes. Methods: Formalin-fixed paraffin-embedded specimens were obtained from patients with non-clear cell renal cell carcinoma (non-ccRCC) and adrenocortical carcinoma (ACC). PD-L1 expression was evaluated by immunohistochemistry (IHC) in both tumor cell membrane and tumor infiltrating mononuclear cells (TIMC). Comparisons between PD-L1 expression and clinico-pathological features were evaluated using unpaired t-test and Fisher?s exact test. Kaplan-Meier method and log-rank test were used to assess association between PD-L1 expression and survival outcome in both histologies. Results: Among 101 patients with non-ccRCC, 11 (10.9%) were considered PD-L1+ in tumor cells: 2/36 (5.6%) of chromophobe RCC, 5/50 (10%) of papillary RCC, 3/10 (30%) of Xp11.2 translocation RCC and 1/5 (20%) of collecting duct carcinoma. On the other hand, PD-L1 positivity by TIMC was observed in 57 (56.4%) patients: 13/36 (36.1%) of chromophobe RCC, 30/50 (60%) of papillary RCC, 9/10 (90%) of Xp11.2 translocation RCC and 5/5 (100%) of collecting duct carcinoma). PD-L1+ in both tumor cell membrane and TIMC cells were associated with shorter time to recurrence (p=0.02 and p=0.03, respectively). Among 28 patients with surgically treated ACC, 3 (10.7%) were considered PD-L1 positive on tumor cell membrane. On the other hand, PD-L1 expression in TIMC was performed in 27 specimens and PD-L1 positive staining was observed in 19 (70.4%) patients. PD-L1 positivity in either tumor cell membrane or TIMC was not significantly associated with higher stage at diagnosis, higher tumor grade, excessive hormone secretion, or survival. Conclusion: In summary, Non-ccRCC and ACC can express PD-L1 on both tumor cell membrane and immune cells and it may represent a potential target for therapeutic interventions. / Objetivo: este estudo visa caracterizar a express?o de PD-L1 em amostras tumorais de pacientes com neoplasias genito-urin?rias de baixa incid?ncia e correlacionar seus n?veis de express?o com caracter?sticas e desfechos cl?nicos. M?todos: blocos de parafina foram obtidos de pacientes com carcinoma de c?lulas renais (CCR) de c?lulas n?o claras e carcinoma do c?rtex da adrenal. A express?o de PD-L1 foi avaliada por imuno-histoqu?mica na membrana das c?lulas tumorais e nas c?lulas mononucleares infiltradas no tumor (CMIT). Compara??es entre a express?o de PD-L1 e caracter?sticas cl?nico-patol?gicas foram analisadas utilizando teste t n?o pareado e teste exato de Fisher. Metodologia de Kaplan-Meier e teste de log-rank foram utilizados para avaliar a associa??o entre a express?o de PD-L1 e desfechos de sobrevida nas duas histologias. Resultados: Entre 101 pacientes com CCR de c?lulas n?o claras, 11 (10.9%) foram considerados PD-L1 positivo (+) na membrana das c?lulas tumorais: em 2/36 (5.6%) dos tumores de c?lulas crom?fobas, 5/50 (10%) de tumores papilares, 3/10 (30%) dos tumores com transloca??o Xp11.2 e em 1/5 (20%) dos tumores do ducto coletor. Por outro lado, positividade de PD-L1 em CMIT foram observadas em 57 (56.4%) dos pacientes: em 13/36 (36.1%) dos tumores de c?lulas crom?fobas, 30/50 (60%) de tumores papilares, 9/10 (90%) dos tumores com transloca??o de Xp11.2 e em 5/5 (100%) dos tumores do ducto coletor. PD-L1+ em ambos, membrana da c?lulas tumorais e CMIT, foram associados com um tempo mais curto at? recorr?ncia de doen?a em pacientes com CCR de c?lulas n?o claras (p=0.02 e p=0.03, respectivamente). Entre os 28 pacientes com tumores do c?rtex da gl?ndula adrenal, 3 (10.7%) foram considerados positivos na membrana das c?lulas tumorais. Por outro lado, a express?o de PD-L1 em CMIT foram realizadas em 27 pacientes e PD-L1+ foi observado em 19 (70.4%) pacientes. Positividade para PD-L1 em ambos, membrana da c?lulas tumorais e CMIT, n?o foi associado com maior est?gio cl?nico ao diagn?stico, alto grau tumoral, produ??o excessiva de horm?nios ou sobrevida. Conclus?o: Em suma, CCR de c?lulas n?o claras e carcinoma do c?rtex da adrenal expressam PD-L1 na membrana da c?lula tumoral e em infiltrados inflamat?rios e isto pode representar um poss?vel alvo para interven??es terap?uticas.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-12-13T13:59:21Z No. of bitstreams: 1 TES_FATIMA_IZABEL_DORNELLES_FARIAS_COMPLETO.pdf: 4020158 bytes, checksum: c64d4a081affdd7617873f2ed3be68a8 (MD5) / Made available in DSpace on 2016-12-13T13:59:21Z (GMT). No. of bitstreams: 1 TES_FATIMA_IZABEL_DORNELLES_FARIAS_COMPLETO.pdf: 4020158 bytes, checksum: c64d4a081affdd7617873f2ed3be68a8 (MD5) Previous issue date: 2016-08-29 / Introduction: Studies indicate that the population of elderly, of all places, the fracture occurring in the hip are the ones that have a higher impact on morbidity, higher rate of mortality, and high cost defendant for surgical treatment. The life expectancy of these patients can reduce by 15% in the first year and may reach 50% in the second year. Attention programs for the elderly with this profile of fragility can improve the clinically relevant results and reduce the high costs demanded by the treatments. Objective: Develop a program of attention to the elderly with hip fracture due to a fall, to be applied on a public network. Methods: a prospective cohort study on the implementation of the program and for the control group, retrospective of quantitative character. Results: were included in the study 182 elderly above 60 years diagnosed whit hip fracture. The sample was divided into two groups, the usual treatment (n=91) and treatment within the program (n=91). The treatment of choice is surgical. The average age was of 79,4 years, with prevalence of the female gender (74,2%). The most frequent morbidity was hypertension (72,5%). After the implementation of the program there was a reduction of the average time elapsed between the fracture and the beginning of the surgery (9 to 3 days), the average stay (from 16 to 7 days), the rate of infection of urinary tract (14,3% to 0,0%) and death rate (of 12,1% to 2,2%). There was no difference in the rate of readmissions within 30 days after discharge. Conclusion: The program of attention to the elderly with hip fracture applied in network modified the expected results, because reduced mortality, the average hospital stay, complications after surgery and the costs of the treatments during your stay. / Introdu??o: Estudos indicam que na popula??o de idosos dentre todos os s?tios de fratura, as que ocorrem no quadril s?o as que apresentam maior impacto na morbidade, maior taxa de mortalidade e alto custo demandado pelo tratamento cir?rgico. A expectativa de vida destes pacientes pode reduzir em 15% no primeiro ano, podendo chegar a 50% no segundo ano. Programas de aten??o a idosos com este perfil de fragilidade podem melhorar os resultados clinicamente relevantes e reduzir os custos altos demandados pelos tratamentos. Objetivo: Avaliar a efetividade de um programa de aten??o ao idoso com fratura de quadril decorrente de queda, para ser aplicado em uma rede p?blica de assist?ncia. M?todos: Estudo de coorte, prospectivo na aplica??o do programa e retrospectivo para o grupo controle, de car?ter quantitativo. Resultados: Foram inclu?dos no estudo 182 idosos acima de 60 anos com diagn?stico de fratura de quadril. A amostra foi dividida em dois grupos, de tratamento usual (n=91) e de tratamento dentro do programa (n=91). O tratamento de escolha foi cir?rgico. A m?dia de idade foi de 79,4 anos, com preval?ncia do g?nero feminino (74,2%). A morbidade mais frequente foi a hipertens?o (72,5%). Ap?s a implementa??o do programa houve redu??o do tempo m?dio decorrido entre a fratura e o in?cio da cirurgia (de 9 para 3 dias), da m?dia de perman?ncia (de 16 para 7 dias), da taxa de infec??o de trato urin?rio (de 14,3% para 0,0%) e da taxa de ?bito (de 12,1% para 2,2%). N?o houve diferen?a na taxa de readmiss?es em 30 dias ap?s a alta. Conclus?o: O programa de aten??o ao idoso com fratura de quadril, aplicado em rede, modificou os resultados esperados, porque reduziu a mortalidade, a m?dia de perman?ncia hospitalar, as complica??es p?s-operat?rias e os custos dos tratamentos durante a interna??o.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2017-03-07T17:56:28Z No. of bitstreams: 1 DIS_ANDRE_LUIZ_BECKER_PARCIAL.pdf: 253481 bytes, checksum: 8161f92176563892b9395f8946b40cb9 (MD5) / Made available in DSpace on 2017-03-07T17:56:28Z (GMT). No. of bitstreams: 1 DIS_ANDRE_LUIZ_BECKER_PARCIAL.pdf: 253481 bytes, checksum: 8161f92176563892b9395f8946b40cb9 (MD5) Previous issue date: 2016-08-31 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: The formation of memory T cells is critical in adaptive immunity, when re-exposure to an antigen, it allows immediate response in this new challenge. This condition is very important in infections, vaccines and cancer. CD8 T cells present specific characteristics among the other lymphocytes regarding the formation of its memory cell populations. Recently the complex mechanism of cytokines and transcription factors that direct to the different phenotypic outcomes has been studied. A relevant factor in this process is the activation of signal transducers to the nucleus (STATs), which activate the transcription of DNA. From this group STAT3 (Signaling Transducer and Activator of Transcription 3) seems to have a crucial role in the formation of memory CD8 T cells. Objectives: To deepen the knowledge about the formation of memory T cells, mostly CD8 T cell, through STAT3 protein in this process. Also to review the literature and expand with original experiments the clinical and laboratory approach of immunity to RSV regarding the CD8-STAT3 relationship. Methods: Review article: A search was made in the database using Boolean operators in PUBMED platform on the relationship between STAT3 and development of CD8 memory T cell subsets. The selected articles were analyzed and summarized. Original article: In vitro experiments were performed to analyze the effect of RSV in STAT3 and its relationship with the different memory CD8 T cell profiles. Results: STAT3 is an important part in defining the profile of memory CD8 T cells and undergoes significant changes during RSV infection. Conclusion: STAT plays a central role in the outcome of the memory CD8 T cell development. STAT3 activation and expression are indeed influenced by RSV infection in human and murine models, which suggests new possibilities for therapeutical interventions. / Introdu??o: A forma??o de c?lulas T de mem?ria ? fundamental na imunidade adaptativa, quando da reexposi??o a um dado ant?geno, pois permite uma resposta praticamente imediata neste novo desafio. Esta condi??o ? muito importante nas infec??es, vacinas e no c?ncer. As c?lulas T CD8 (LTCD8) apresentam caracter?sticas pr?prias dentre os demais linf?citos, tamb?m no tocante a forma??o de suas subpopula??es de c?lulas de mem?ria. O intrincado mecanismo de citocinas e fatores de transcri??o que definem os diferentes fen?tipos resultantes, vem sendo recentemente estudados. Um fator relevante neste processo ? a ativa??o dos transdutores de sinal para o n?cleo (STATs), que ativam a transcri??o do DNA. Deste grupo a STAT3 (Signaling Transducer and Activator of Transcription 3) parece ter papel crucial na forma??o de LTCD8 de mem?ria. Objetivos: Aprofundar o conhecimento sobre a forma??o de c?lulas T de mem?ria, em especial as LTCD8, atrav?s da prote?na STAT3 fundamental neste processo; revisar a literatura conhecida e ampliar com experimentos originais o enfoque cl?nico-laboratorial de imunidade ao VSR no tocante ? rela??o CD8-STAT3.Metodologia: Artigo de revis?o: Foi feita uma busca na base de dados utilizando operadores Booleanos na plataforma PUBMED, sobre a rela??o entre STAT3 e o desenvolvimento das c?lulas T CD8 de mem?ria. Os artigos foram analisados e resumidos neste trabalho. Artigo original: Foi realizada uma an?lise in vitro sobre o efeito do VSR na STAT3 e sua rela??o com os diferentes perfis de LTCD8 de mem?ria. Resultados: Artigo de revis?o: Foram selecionados dezessete arquivos, sendo que destes dois foram exclu?dos. Artigo original: O VSR reduziu a express?o de STAT3 no lavado nasal de crian?as infectadas, porem aumentou a ativa??o de STAT3 via fosforila??o in vitro em c?lulas mononucleares infectadas. Conclus?o: A STAT3 ? parte importante na defini??o do perfil dos LTCD8 de mem?ria e sofre altera??es relevantes quando da infec??o pelo VSR, indicando uma nova possibilidade de alvo para imunoterapia.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2017-03-10T15:09:55Z No. of bitstreams: 1 TES_JULIANO_SARTORI_COMPLETO.pdf: 9083435 bytes, checksum: 6cadde5ff4cace9cc886d4131547c873 (MD5) / Made available in DSpace on 2017-03-10T15:09:55Z (GMT). No. of bitstreams: 1 TES_JULIANO_SARTORI_COMPLETO.pdf: 9083435 bytes, checksum: 6cadde5ff4cace9cc886d4131547c873 (MD5) Previous issue date: 2016-12-02 / Despite the advances resulting from the molecular characterization of breast cancer that allowed the use of more selective therapeutic targets, the disease still causes different clinical outcomes with high rates of recurrence and mortality. In this context of complexity and heterogeneity of breast cancer, are important the investigations of new biomolecular markers related to breast oncogenesis that may contribute to know the prognosis and improve the clinical management of patients. The sirtuin-1 (SIRT-1) is a histone deacetylase implicated in various epigenetic critical functions into cells, among these, the maintenance of genomic stability, proliferation and cell aging. The aim of this study was to investigate the grade of expression of the sirtuin- 1 (SIRT-1) in a cohort of 457 women with breast cancer and verify the effect, independent or in combination with other variables in the prognosis of these patients. It is a survival analysis study based on hospital medical records of women with breast cancer undergoing treatment in Erechim-RS from 2003 to 2013 and followed until 31 July 2015. The analysis of the grade of SIRT-1 expression was performed by immunohistochemistry in 123 patients (26.9%) of the total cohort. Overall survival specific disease (OS) was estimated by the Kaplan-Meier method and the risk of death from breast cancer by the method of Cox proportional hazards. The research was approved by the Research Ethics Committee of PUC-RS as reported number 465.362. The median age was 57.4 years and the median estimate of breast cancer survival was 79.6% at 5 years and 69.1% at 10 years, with median follow-up time of 61.9 months. Risk factors associated with worse prognosis were: age between 60 and 69 years (HR = 1.88; 95% CI 1.02 - 3.44; p = 0.042); older than 70 years (HR = 2.92; CI 95% 1.70 - 5.01; p = 0.000); tumor size greater than 2 cm (HR = 1.86; CI 95% 1.04 -3.36; p = 0.038); metastasis in 4 or more axillary lymph nodes (HR = 2.37; CI 95% 1.38 - 4.08; p = 0.002); located clinical staging (CS II, TNM) (HR = 3.39; CI 95% 1.35 - 8.51; p = 0.009); advanced clinical staging (CS III, TNM) (HR = 6.32; CI 95% 2.49-16.08; p = 0.000); high histologic grade (HR = 6.32; CI 95% 1.63 - 29.99; p = 0.008); triple negative molecular profile (HR = 2.33; CI 95% 1.19 - 4.58; p = 0.014) and radical surgery (HR = 2.10; CI 95% 1.31 - 3.36; p = 0.002). The positive expression of progesterone receptor (HR = 0.52, CI 95% 0.34 - 0.79; p = 0.002) was a better prognostic factor for patients. The grade of overexpression of SIRT-1, defined as nuclear expression of SIRT-1 greater than 80% was observed in 6.5% of cases. The SIRT-1 overexpression characterized a subgroup of women who had a worse prognosis with shorter survival and increased risk of death from breast cancer (HR = 2.66; CI 95% 1.03 - 6.86; p = 0.043). Multivariate regressive models (Cox) were constructed and the overexpression of SIRT-1 remained significant statistic demonstrating independent factor associated with worse prognostic in breast cancer. Therefore, the evaluation of the grade of expression of the SIRT-1, in the cohort of Erechim-RS, proved to be an independent prognostic marker for analysis of the risk of death from breast cancer. / Apesar dos avan?os decorrentes da caracteriza??o molecular do c?ncer de mama que permitiram o emprego de alvos terap?uticos mais seletivos, a doen?a ainda ocasiona diferentes desfechos cl?nicos, com elevadas taxas de recidiva e mortalidade. Neste contexto de complexidade e heterogeneidade do c?ncer de mama, s?o importantes as investiga??es de novos marcadores biomoleculares relacionados ? oncog?nese mam?ria que possam contribuir para conhecer o progn?stico e aprimorar o manejo cl?nico das pacientes. A Sirtu?na-1 (SIRT-1) ? uma histona desacetilase implicada em diversas fun??es epigen?ticas cr?ticas para as c?lulas, dentre estas, a manuten??o da estabilidade gen?mica, a prolifera??o e o envelhecimento celular. O objetivo deste estudo foi investigar o grau de express?o da Sirtu?na-1 (SIRT-1) em uma coorte de 457 mulheres portadoras de c?ncer de mama e verificar o seu efeito, independente ou em associa??o a outras vari?veis, no progn?stico destas pacientes. Trata-se de um estudo de an?lise de sobrevida com base em registros de mulheres portadoras de c?ncer de mama submetidas a tratamento em Erechim-RS no per?odo de 2003 a 2013 com seguimento at? 31 de julho de 2015. A an?lise do grau de express?o de SIRT-1 foi realizada por t?cnica de imuno-histoqu?mica em 123 pacientes (26,9%) do total da coorte. A sobrevida global doen?a espec?fica foi estimada pelo m?todo de Kaplan-Meier e, o risco de morte, por c?ncer de mama, pelo m?todo de riscos proporcionais de Cox. A pesquisa foi aprovada no Comit? de ?tica e Pesquisa da PUC-RS, sob n? 465.362. A idade mediana foi de 57,4 anos e a estimativa mediana de sobrevida por c?ncer de mama foi de 79,6% em 5 anos e 69,1% em 10 anos, com tempo mediano de seguimento de 61,9 meses. Os fatores de risco associados a pior progn?stico foram: faixa et?ria entre 60 e 69 anos (HR=1,88; IC95% 1,02-3,44; p=0,042); faixa et?ria maior que 70 anos (HR=2,92; IC95% 1,70-5,01; p=0,000); tamanho tumoral acima de 2 cm (HR=1,86; IC95% 1,04-3,36; p=0,038); presen?a de met?stase em 4 linfonodos axilares ou mais (HR=2,37; IC95% 1,38-4,08; p=0,002); estadiamento cl?nico localizado (EC II,TNM) (HR=3,39; IC95% 1,35-8,51; p=0,009); estadiamento cl?nico avan?ado (EC III,TNM) (HR=6,32; IC95% 2,49-16,08; p=0,000); grau histol?gico alto (HR=6,32; IC95% 1,63-29,99; p=0,008); perfil molecular triplo negativo (HR=2,33; IC95% 1,19-4,58; p=0,014) e a cirurgia radical (HR=2,10; IC95% 1,31-3,36; p=0,002). A express?o positiva do receptor de progesterona (HR=0,52; IC95% 0,34- 0,79; p=0,002) foi um fator de melhor progn?stico para as pacientes. O grau de hiperexpress?o da SIRT-1, definida como express?o nuclear da SIRT-1 maior que 80%, foi verificada em 6,5% dos casos. A hiperexpress?o da SIRT-1 caracterizou um subgrupo de mulheres que apresentaram pior progn?stico, com menor sobrevida e maior risco de morte por c?ncer de mama (HR=2,66; IC95% 1,03-6,86; p=0,043). Foram elaborados modelos regressivos multivariados (Cox) e a hiperexpress?o de SIRT-1 manteve signific?ncia estat?stica demonstrando fator independente associado a pior progn?stico no c?ncer de mama. Portanto, a avalia??o do grau de express?o da SIRT-1, na coorte de Erechim-RS, demonstrou ser um marcador independente para determinar o progn?stico no c?ncer de mama.

Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2018-09-03T12:29:41Z No. of bitstreams: 1 GIORDANO_RAFAEL_TRONCO_ALVES.pdf: 4296387 bytes, checksum: 0ebd26ada0ccec344a04ffbbd329dfae (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-09-03T14:24:25Z (GMT) No. of bitstreams: 1 GIORDANO_RAFAEL_TRONCO_ALVES.pdf: 4296387 bytes, checksum: 0ebd26ada0ccec344a04ffbbd329dfae (MD5) / Made available in DSpace on 2018-09-03T14:30:50Z (GMT). No. of bitstreams: 1 GIORDANO_RAFAEL_TRONCO_ALVES.pdf: 4296387 bytes, checksum: 0ebd26ada0ccec344a04ffbbd329dfae (MD5) Previous issue date: 2018-08-13 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: The halo sign consists of an area of ground-glass opacity surrounding pulmonary lesions on chest computed tomography (CT) scans. Different diseases have already been described as causing this finding, though a larger and more objective analysis of this sign has not been conducted yet. Materials and methods: The authors compared CT images of immunocompetent and immunosuppressed patients in terms of halo sign features and seek to identify those of greatest diagnostic value. An observational study of exams performed between January of 2011 and May of 2015 was carried out. After initial database search with keywords, two thoracic radiologists reviewed the scans in order to determine the number of lesions, as well as their distribution, size, and contour, together with halo thickness and any other associated findings. The study obtained approval by the institutional ethics committee. The chi-squared test, Student t test and Mann-Whitney U test were adopted according to sample characteristics, with a bilateral level of significance of 0.05. Results: A total of 85 patients (46 male, 54%) were evaluated, with 53 (62%) immunocompetent and 32 (38%) immunosuppressed. The main diagnosis among immunocompetents was lung cancer (n=32, 64%), whereas aspergillosis was the main condition in immunosuppressed patients (n=25, 78%). Multiple and randomly distributed lesions were more frequent in the immunosuppressed group (p<0.001), with halo thickness also greater in this group (p<0.05). Conclusions: We concluded that the causes of the halo sign differ significantly according to immune status, and that halo thickness, the number and the distribution of lesions are the data with greatest diagnostic value. / Introdu??o: O sinal do halo consiste em uma ?rea de opacidade em vidro-fosco ao redor de les?es pulmonares em imagens de tomografia computadorizada (TC) de t?rax. Diferentes doen?as j? foram descritas como causadoras deste achado, por?m uma an?lise maior e mais objetiva deste sinal ainda n?o foi conduzida. Materiais e m?todos: Os autores compararam imagens tomogr?ficas de pacientes imunocompetentes e imunocomprometidos quanto a caracter?sticas do sinal do halo, a fim de identificar as de maior valor diagn?stico. Realizou-se um estudo observacional de exames realizados entre janeiro de 2011 e maio de 2015. Ap?s busca inicial em banco de dados com palavras-chave, dois radiologistas tor?cicos analisaram os exames para determinar o n?mero de les?es e sua distribui??o, tamanho e contorno, bem como a espessura do halo e outros achados associados. O estudo obteve aprova??o do comit? de ?tica institucional. Os testes de Qui-quadrado, t de Student e U de Mann-Whitney foram adotados de acordo com caracter?sticas amostrais, com um n?vel de signific?ncia de 0,05 bilateral. Resultados: Um total de 85 pacientes (46 homens, 54%), foram avaliados, sendo 53 (62%) imunocompetentes e 32 (38%) imunocomprometidos. O principal diagn?stico entre os imunocompetentes foi o de neoplasia pulmonar (n=32, 64%), enquanto a aspergilose foi a principal condi??o entre imunocomprometidos (n=25, 78%). Les?es m?ltiplas e de distribui??o rand?mica foram mais frequentes no grupo imunocomprometido (p<0,001), sendo a espessura do halo tamb?m maior neste grupo (p<0,05). Conclus?es: Conclui-se que as causas de sinal do halo diferem significativamente de acordo com o estado imunol?gico, sendo a espessura do halo, o n?mero e a distribui??o das les?es os dados de maior valor diagn?stico.

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-04-18T12:39:20Z No. of bitstreams: 1 PauladosSantosSilvaDissertacao2015.pdf: 1389629 bytes, checksum: b4af7cc03bec3563157504471bbec82e (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-04-18T12:39:29Z (GMT) No. of bitstreams: 1 PauladosSantosSilvaDissertacao2015.pdf: 1389629 bytes, checksum: b4af7cc03bec3563157504471bbec82e (MD5) / Made available in DSpace on 2017-04-18T12:39:29Z (GMT). No. of bitstreams: 1 PauladosSantosSilvaDissertacao2015.pdf: 1389629 bytes, checksum: b4af7cc03bec3563157504471bbec82e (MD5) Previous issue date: 2015-12-09 / Longevity has important implications for the quality of life and may cause problems with serious consequences in the different spheres of human life, such as physical, psychological and social. For the elderly with hypertension, uncontrolled, more years lived, can mean more years of suffering, since it becomes necessary to accept the disease and sudden change in lifestyle. Therefore, the objective of this study was to compare the quality of life in normotensive elderly and hypertensive elderly assisted in HIPERDIA Program. It is a quantitative survey of cross-sectional design. The participants were 80 elderly residents in the city of Barreiras-BA, aged over 60 years. Three instruments were used for data collection: WOQOL-OLD questionnaire validated in Brazil by Fleck in 2006, the IPAQ, validated and adapted for the elderly in Brazil Mazo; Benedetti in 2010 and CCEB proposed by the National Association of Companies Research (ANEP) that allowed to evaluate the economic classification of the participants. To compare the quality of life scores, as well as compare the weekly volume of each activity among the groups we used the unpaired t test. The result was that elderly hypertensive patients have impaired quality of life, which corroborates the hypothesis of this study and the two groups can be considered sedentary not shown correlation of physical exercise with the quality of life. As the economic classification, the elderly are poor, framed, therefore, in economy class D. Longevity has important implications for the quality of life and may cause problems with serious consequences in the different spheres of human life, such as physical, psychological and social. For the elderly with hypertension, uncontrolled, more years lived, can mean more years of suffering, since it becomes necessary to accept the disease and sudden change in lifestyle. Therefore, the objective of this study was to compare the quality of life and level of well-being in normotensive elderly and hypertensive elderly assisted in HIPERDIA Program. It is a quantitative survey of cross-sectional design. The participants were 80 elderly residents in the city of Barreiras-BA, aged over 60 years. Three instruments were used for data collection: WOQOL-OLD questionnaire validated in Brazil by Fleck in 2006, the IPAQ, validated and adapted for the elderly in Brazil Mazo& Benedetti in 2010 and CCEB proposed by the Associa????o Nacional de Empresas de Pesquisa (ANEP) that allowed to evaluate the economic classification of the participants. To compare the quality of life scores, as well as compare the weekly volume of each activity among the groups we used the unpaired t test. The result was that elderly hypertensive patients have impaired quality of life, which corroborates the hypothesis of this study and the two groups can be considered sedentary not shown correlation of physical exercise with the quality of life. As the economic classification, the elderly are poor, framed, therefore, in economy class D. / A longevidade possui implica????es importantes para a qualidade de vida, podendo acarretar problemas com consequ??ncias s??rias nas diferentes esferas da vida humana, como f??sica, ps??quica e social. Para o idoso com doen??a hipertensiva, n??o controlada, mais anos vividos, podem significar mais anos de sofrimento, uma vez que se torna necess??ria a aceita????o da doen??a e a mudan??a brusca no estilo de vida. Por tanto, o objetivo deste estudo, foi comparar a qualidade de vida de idosos normotensos com idosos hipertensos assistidos no Programa HIPERDIA. Trata-se de uma pesquisa de quantitativa de delineamento transversal. Participaram da pesquisa 80 idosos residentes no munic??pio de Barreiras-BA, com idade igual ou superior a 60 anos. Foram utilizados tr??s instrumentos para a coleta de dados: question??rio WOQOL-OLD, validado no Brasil por Fleck em 2006, o question??rio IPAQ, validado e adaptado para o idoso no Brasil por Mazo; Benedetti em 2010 e CCEB proposto pela Associa????o Nacional de Empresas de Pesquisa (ANEP) que permitiu avaliar a classifica????o econ??mica dos participantes. Para comparar os escores de qualidade de vida, bem como, comparar o volume semanal de cada atividade entre os grupos foi utilizado o teste t n??o pareado. O resultado foi que idosos hipertensos possuem qualidade de vida prejudicada, o que corrobora com a hip??tese deste estudo e os dois grupos podem ser considerados sedent??rios n??o apresentado correla????o do exerc??cio f??sico com a qualidade de vida. Quanto a classifica????o econ??mica, os idosos possu??am baixa renda, enquadrado, por tanto, na classe econ??mica D.

Submitted by Cristiane Chim (cristiane.chim@ucpel.edu.br) on 2016-12-09T17:48:05Z No. of bitstreams: 1 Tese Alethea Zago.pdf: 4690830 bytes, checksum: dda42a960bb91e36e5f456fca8a3e274 (MD5) / Made available in DSpace on 2016-12-09T17:48:05Z (GMT). No. of bitstreams: 1 Tese Alethea Zago.pdf: 4690830 bytes, checksum: dda42a960bb91e36e5f456fca8a3e274 (MD5) Previous issue date: 2016-10-04 / Thesis based on cross-sectional study in a population sample of young adults 18 to 35 years, in the city of Pelotas, Brazil. The study subjects were assessed for sociodemographic and psychiatric disorders characteristics. It evaluated the abuse of alcohol by CAGE instrument using the appropriate cut offs and also the presence of anxiety disorder, mood disorder and risk of suicide. Were measured by ELISA using a commercial kit, serum levels of inflammatory cytokines IL-6, IL-10 and TNF-α. All data were considered in two groups: individuals with disorders of alcohol and without alcohol abuse, for the purpose of obtaining the outcomes. The main outcomes were: alcohol abuse and its relationship with serum levels of inflammatory cytokines and measured the relationship of alcohol use disorder with mood disorder, anxiety and suicide risk. . / Tese com base em estudo transversal em amostra populacional de adultos jovens, de 18 a 35 anos, realizado na cidade de Pelotas, RS. Os indivíduos estudados foram avaliados quanto a características sócio-demográficas e transtornos psiquiátricos. Foi avaliado o uso abusivo de álcool através do instrumento CAGE, utilizando os devidos pontos de corte e também a presença de transtorno de ansiedade, transtorno do humor e risco de suicídio. Foram mensurados, pelo método de ELISA, usando kit comercial, os níveis séricos das citocinas inflamatórias IL-6, IL-10 e TNF-α. Todos os dados obtidos foram considerados em dois grupos: os indivíduos com transtorno de uso de álcool e os sem uso abusivo de álcool, para fins de obtenção dos desfechos. Os desfechos principais foram: uso abusivo de álcool e sua relação com o nível sérico das citocinas inflamatórias mensuradas e a relação do transtorno de uso de álcool com transtorno de humor, ansiedade e risco de suicídio.

Submitted by Cristiane Chim (cristiane.chim@ucpel.edu.br) on 2016-12-12T12:36:58Z No. of bitstreams: 1 sally silva.pdf: 947073 bytes, checksum: 78fc4de45ff559cfaf9148b66e2f0149 (MD5) / Made available in DSpace on 2016-12-12T12:36:58Z (GMT). No. of bitstreams: 1 sally silva.pdf: 947073 bytes, checksum: 78fc4de45ff559cfaf9148b66e2f0149 (MD5) Previous issue date: 2015-09-10 / This work was developed from a project "Quality of life in HIV-positive patients at a referral center in southern Brazil" and a cross-sectional study was designed to investigate the prevalence of indicative of anxiety and depressive disorders in HIV/AIDS patients at a regional reference center for treatment of HIV/AIDS in southern Brazil. We evaluated 671 patients on sociodemographic and clinical characteristics, substance abuse, indicative of anxiety and depression. Indicatives Anxious Disorders (AD) and Major Depressive Disorder (MDD) were evaluated by the Hospital Anxiety and Depression Scale (HADS). Poisson regression was performed in the multivariate analysis and was used hierarchical model. Of the total sample, the prevalence of indicative of AD was 46.9% and 34.4% TDM. In multivariate analysis, the variables that remained independently associated with indicative of TA were: women, youth, low socioeconomic status, abuse/dependence on tobacco, prior hospitalization for problems related to HIV and indicative of TDM. For indicative of TDM, the following variables remained statistically significant: young, low socioeconomic status, unemployed, without perception of social support and indicative of AD. The prevalence of indicative of AD and TDM were high. Strategies to identify possible interventions required and perform preventive actions should be strengthened in health services that meet the HIV/AIDS patients. Should receive particular attention those patients who are socially vulnerable, due to their greater association with symptoms of clinical significance in mental health. / Esta dissertação foi desenvolvida a partir do projeto “Qualidade de vida em pacientes soropositivos de um centro de referência no sul do Brasil” e em estudo transversal foi concebido para investigar a prevalência de indicativo de transtornos ansiosos e depressivos em pacientes HIV/AIDS de um centro regional de referência para tratamento de HIV/AIDS no sul do Brasil. Foram avaliados 671 pacientes sobre características sociodemográficas e clínicas, uso de substâncias psicoativas, indicativos de ansiedade e depressão. Indicativos de Transtornos Ansiosos (TA) e Transtorno Depressivo Maior (TDM) foram avaliados pela Hospital Anxiety and Depression Scale (HADS). Foi realizada Regressão de Poisson na análise multivariada e foi utilizado modelo hierárquico. Do total da amostra, a prevalência de indicativo de TA foi 46.9% e de TDM 34.4%. Na análise multivariada, as variáveis que mantiveram associação independente com indicativo de TA foram: mulheres, jovens, baixo nível socioeconômico, abuso/dependência de tabaco, hospitalização prévia por problemas relacionados ao HIV e indicativo de TDM. Para indicativo de TDM, as variáveis seguintes mantiveram significância estatística: jovens, baixo nível socioeconômico, desempregados, sem percepção de apoio social e indicativo de TA. As prevalências de indicativos de TA e TDM foram altas. Estratégias para identificar possíveis intervenções necessárias e realizar ações preventivas devem ser reforçadas nos serviços de saúde que atendem os pacientes HIV/AIDS. Devem receber atenção de modo especial aqueles pacientes que vivem em situação de vulnerabilidade social, devido a sua maior associação com sintomas de relevância clínica em saúde mental.

Submitted by Cristiane Chim (cristiane.chim@ucpel.edu.br) on 2016-12-13T16:07:10Z No. of bitstreams: 1 Gisele.pdf: 2510258 bytes, checksum: 88b2c38f213ed3582465052093b7853f (MD5) / Made available in DSpace on 2016-12-13T16:07:10Z (GMT). No. of bitstreams: 1 Gisele.pdf: 2510258 bytes, checksum: 88b2c38f213ed3582465052093b7853f (MD5) Previous issue date: 2015-03-18 / Introduction: Obesity is a global epidemic, representing a risk factor in the natural course of many other chronic diseases. In the latest years, there have been negative changes in the lifestyle of the population, with changes in dietary patterns and reduction in physical activity, even for the younger population. The importance of preventing childhood obesity is widely recognized, so that prevention strategies seek supporting and facilitating an increase in physical activity and healthier diets. Objective: To investigate eating habits and physical activity practices in eight-year-old children from a cohort in Pelotas, Rio Grande do Sul, Brazil. Methods: Between September 2002 and May 2003, all hospital births occurred in Pelotas were identified. The present study refers to a cross-sectional analysis of data collected while monitoring the cohort at eight years of age. Eating practices were assessed based on the Ten Steps to Healthy Eating (Dez Passos para uma Alimentação Saudável), proposed by the Brazilian Ministry of Health. The physical activity questionnaire for children and adolescents (PAQ-C) was used in order to assess the level of physical activity. Results: Of the 616 interviewed children at 8 years, it was observed that 50.3% were male; 70.3% were white and just over half belonged to economic class C. A sedentary lifestyle prevalence higher than 70% was found and the habit of watching television for over 2 hours a day was shown by 60% of sample. The daily time spent watching television was inversely associated with physical activity (p <0.05) and positively with overweight (p<0.01). The steps to Healthy Eating that had higher adhesion were 8 (do not add salt to ready and prepared foods); 4 (consumption of beans, at least 5 times per week) and 1 (have 3 meals and 2 snacks per day), respectively. Conclusion: The high prevalence of sedentary lifestyle and of children who watch television for an excessive period, as well as the low level of healthy eating habits, confirm the importance of strategies to support and encourage the practice of physical activity and healthy eating among children and the youth. / Introdução: A obesidade é uma epidemia mundial, sendo fator de risco no curso natural de várias outras doenças crônicas. Nos últimos anos ocorreram mudanças negativas no estilo de vida da população, com alterações nos padrões dietéticos e redução da atividade física, inclusive na população mais jovem. A importância da prevenção da obesidade infantil é amplamente reconhecida, de forma que estratégias de prevenção procuram apoiar e facilitar o aumento da atividade física e dietas mais saudáveis. Objetivo: Verificar as práticas alimentares e de atividade física em crianças com oito anos de idade, pertencentes a uma coorte na cidade de Pelotas, Rio Grande do Sul, Brasil. Métodos: Entre os meses de setembro de 2002 e maio de 2003, todos os nascimentos hospitalares ocorridos na cidade de Pelotas foram identificados. O presente estudo refere-se a uma análise transversal dos dados coletados no acompanhamento da coorte ocorrido aos 8 anos de idade. As práticas alimentares foram avaliadas com base nos Dez Passos para uma Alimentação Saudável, propostos pelo Ministério da Saúde Brasileiro. Para avaliar o nível de atividade física, foi utilizado o questionário de atividade física para crianças e adolescentes (PAQ-C). Resultados: Das 616 crianças avaliadas aos 8 anos, observou-se que 50,3% eram do sexo masculino; 70,3% de cor branca e pouco mais de metade pertencia à classe econômica C. Encontrou-se uma prevalência de sedentarismo superior a 70%, e o hábito de assistir TV por um período superior a 2 horas diárias em 60% da amostra. O tempo diário assistindo à televisão associou-se inversamente à prática de atividade física (p<0,05) e positivamente ao excesso de peso (p<0,01). Os passos da alimentação saudável com maior adesão foram o 8 (não acrescentar sal aos alimentos já prontos e preparados); o 4 (consumo de feijão, pelo menos, 5 vezes por semana) e o 1 (realização de 3 refeições e 2 lanches por dia), respectivamente. Conclusão: A prevalência elevada de sedentarismo e de crianças que assistem à TV por um período excessivo, bem como o baixo índice de hábitos alimentares considerados saudáveis ratificam a importância de estratégias de apoio e incentivo à prática de atividade física e à alimentação saudável entre crianças e jovens.