Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2017-08-04T17:20:34Z No. of bitstreams: 1 RANNA__DARLA_SILVANA_RISSON-DIS.PDF: 943217 bytes, checksum: 6c39d77c813573c8ee3b2519528a5e61 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-08-08T11:22:18Z (GMT) No. of bitstreams: 1 RANNA__DARLA_SILVANA_RISSON-DIS.PDF: 943217 bytes, checksum: 6c39d77c813573c8ee3b2519528a5e61 (MD5) / Made available in DSpace on 2017-08-08T11:26:30Z (GMT). No. of bitstreams: 1 RANNA__DARLA_SILVANA_RISSON-DIS.PDF: 943217 bytes, checksum: 6c39d77c813573c8ee3b2519528a5e61 (MD5) Previous issue date: 2012-03-20 / The fast aging of the population and the transformations in the family structure have created a gap in the attention of the elderly people. As an alternative to the care of the elderly, there are the Long Stay Institution for the Elderly (LSIE), but it is still unknown, the perception regarding the quality and functionality of these institutions and the respect for the will of the elderly in the case of an institutionalization. Therefore, were analyzed the main reasons that led to the institutionalization of the elderly, the expectations regarding LSIEs considering the aspects of current legislation, and their relation with the probable respect to the elderly's decision in case of institutionalization. A descriptive, cross-sectional study where were interviewed 98 potential decision makers, first or second degree relatives and / or legal representative of the elderly and over 18 years of age, interested in hiring an LSIE. The research instrument was elaborated based on health surveillance standards and the elderly?s statute, plus socioeconomic issues of the decision makers and of the elderly. Was performed a statistical analysis by the frequency or the means and standard deviation of both dependent variables and independent variables. The test was considered significant with a p <0.05. The main reasons for a possible institutionalization of the elderly were dependence on the daily activities, the will of the elderly and lack of family structure, with major concern regarding aspects of health care and care, more than aspects of legal and structural functioning of the institution. Was listed as important the formal training of caregivers, to the detriment of the presence of caregivers who were not formally trained. The elderly's decision in case of institutionalization would be respected when there was a feeling of guilt or fear of the negative reaction from neighbors, will and greater functional capacity of the elderly, financial support between family members and the largest number of children. And the decision would not be respected in cases of elderly people in situations of widowhood, without children or with up to two children, with difficulties for daily and behavioral activities, who lived under the care of caregiver and / or home care, with difficulties to walk, In wheelchairs or were bedridden, with Alzheimer's disease, and in cases that the monthly fee was higher than a minimum wage. The study concluded that the majority were women who decided in case of institutionalization of the elderly, did not have formed opinion regarding the LSIEs. The lack of family structure does not allow care in cases of dependency on the daily activities of the elderly, and this would be the main reason for institutionalization. The aspects of health care and care of the elderly were more relevant than the legal and structural functioning of the institution and there is a direct relation between the value of the retirement of the elderly and the price considered payable for LSIE monthly fee. Larger families and elderly individuals were determinants of respect for the elderly's decision in case of institutionalization. While elderly people with a high degree of cognitive-motor dependence, small families and monthly payments higher than the value of retirement were factors that would lead to a decision of institutionalization without respecting the will of the elderly. / O r?pido envelhecimento da popula??o e as transforma??es na estrutura das fam?lias gerou uma lacuna em rela??o ? aten??o da pessoa idosa. Como alternativa ao cuidado do idoso, existe as Institui??es de Longa Perman?ncia para Idosos (ILPIs), por?m ainda ? desconhecida, a percep??o referente ? qualidade e funcionalidade das mesmas e o respeito em rela??o ? vontade do idoso no caso de uma institucionaliza??o. Diante disso, foram analisados os principais motivos que levariam ? institucionaliza??o do idoso, as expectativas quanto ?s ILPIs levando em conta os aspectos da legisla??o vigente, e sua rela??o com o prov?vel respeito ? decis?o do idoso em caso de institucionaliza??o. Estudo descritivo, anal?tico transversal, onde foram entrevistados 98 potenciais tomadores de decis?o, parentes em primeiro ou segundo grau e/ou representante legal do idoso e maiores de 18 anos, interessados na contrata??o de uma ILPI. O instrumento de pesquisa foi elaborado a partir das normas da vigil?ncia sanit?ria e do estatuto do idoso, acrescido de quest?es socioecon?micas dos decisores e dos idosos. A an?lise estat?stica foi realizada atrav?s da frequ?ncia ou m?dias e desvio padr?o, tanto das vari?veis dependentes, quanto das vari?veis independentes, sendo considerado significativo o teste que obteve um p<0,05. Os principais motivos de uma poss?vel institucionaliza??o do idoso foram depend?ncia para as atividades di?rias, vontade do idoso e falta de estrutura familiar, com maior preocupa??o quanto aos aspectos de aten??o ? sa?de e cuidado do que os aspectos de funcionamento legal e estrutural da institui??o. A capacita??o formal dos cuidadores foi elencada como importante em detrimento a presen?a de cuidadores n?o capacitados formalmente. A decis?o do idoso em caso institucionaliza??o seria respeitada quando houvesse sentimento de culpa ou temor da rea??o negativa por parte de vizinhos, vontade e maior capacidade funcional do idoso, apoio financeiro entre os familiares e o maior n?mero de filhos. E a decis?o n?o seria respeitada nos casos de idosos em situa??es de viuvez, sem filhos ou com at? dois filhos, com dificuldades para as atividades di?rias e de comportamento, que vivessem sob a aten??o de cuidador e/ou atendimento domiciliar, com dificuldades de caminhar, em cadeira de rodas ou fossem acamados, portadores de doen?a de Alzheimer, e nos casos que valor da mensalidade fosse superior a um sal?rio m?nimo. O estudo concluiu que a maioria eram mulheres que decidiam em caso de institucionaliza??o do idoso, n?o possu?am opini?o formada sobre a sua percep??o em ?s ILPIs. A falta de estrutura familiar n?o possibilita o cuidado em casos de depend?ncia para as atividades di?rias do idoso e isso seria o principal motivo para institucionaliza??o. Os aspectos de aten??o ? sa?de e cuidado do idoso foram mais relevantes do que funcionamento legal e estrutural da institui??o e que existe uma rela??o direta entre a aposentadoria do idoso e pre?o considerado pag?vel para mensalidade da ILPI. Fam?lias maiores e, idosos independentes foram determinantes de respeito ? decis?o do idoso em caso de uma institucionaliza??o. Enquanto idosos com alto grau de depend?ncia cognitivo-motora, fam?lias pequenas e mensalidades superiores ao valor da aposentadoria foram fatores que levariam a uma decis?o de institucionaliza??o sem respeitar a vontade do idoso.

Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-10-19T16:20:52Z No. of bitstreams: 1 TES_GABRIELE_GOULART_ZANIRATI_PARCIAL.pdf: 3026560 bytes, checksum: 6f276f0eab68a1100bcdcb5009780036 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-10-19T16:21:06Z (GMT) No. of bitstreams: 1 TES_GABRIELE_GOULART_ZANIRATI_PARCIAL.pdf: 3026560 bytes, checksum: 6f276f0eab68a1100bcdcb5009780036 (MD5) / Made available in DSpace on 2017-10-19T16:21:32Z (GMT). No. of bitstreams: 1 TES_GABRIELE_GOULART_ZANIRATI_PARCIAL.pdf: 3026560 bytes, checksum: 6f276f0eab68a1100bcdcb5009780036 (MD5) Previous issue date: 2017-03-16 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / (Artigo : Efeito do transplante de c?lulas mononucleares da medula ?ssea sobre o metabolismo cerebral da glicose in vivo e o comportamento depressivo no modelo experimental de epilepsia cr?nica induzido por pilocarpina) Temporal lobe epilepsy (TLE) is one of the most common kind of epilepsy syndromes in the world population. Depression is an important comorbidity of epilepsy. It has been reported in patients with TLE and different experimental models of epilepsy. However, there is no established consensus about which brain regions are associated with the manifestation of depression in epilepsy. BMMC transplantation has been used for treatment of epilepsy and has showed a large number of benefit effects in this neuropathology. 18FFDG has been widely used to investigate the cerebral metabolism in patients with TLE or depression disorders, and recently in animal models using microPET imaging. We investigate longitudinally the alterations in cerebral glucose metabolism in rats submitted to the pilocarpine model and observe the effect of BMMC transplantation in cerebral FDG uptake to correlate it to depressive behavior during the chronic phase of epilepsy. Our results demonstrated that pilocarpine-treated rats showed depression-like behavior and reduced 18F-FDG uptake in several brain regions related to the pathophysiology of both epilepsy and depression during chronic phase. Besides, BMMC treatment reduced cognitive dysfunction and depressive-like behavior showed by chronically epileptic rats. However, the BMMC transplantation did not affect the brain glucose metabolism in those animals. Additionally, we found a hypersynchrony metabolic network in the chronically epileptic animals, and reduced connectivity in BMMC-treated animals, similar to Control rats. This study suggests further evidence of depressive behavior as a comorbidity in the pilocarpineinduced epilepsy model, and an important alteration of glucose metabolism and metabolic network among brain regions of interest for both pathologies. Additionally, this study suggested a potential effect of BMMC transplantation for reduction of seizure frequency, cognitive deficits and depressive-like behavior, as well as contribute to normalize the connectivity in the metabolic network in chronically epileptic animals. / (Artigo : Efeito do transplante de c?lulas mononucleares da medula ?ssea sobre o metabolismo cerebral da glicose in vivo e o comportamento depressivo no modelo experimental de epilepsia cr?nica induzido por pilocarpina) Multiple epileptogenic changes and incessant inflammation ensue after status epilepticus (SE) induced brain injury, which in due course result in chronic temporal lobe epilepsy typified by spontaneous recurrent seizures (SRS) and impairments in cognition, memory and mood. We tested whether early intervention after SE with grafting of hiPSC-derived neural stem cells (hNSCs) into hippocampi is efficacious for curbing SRS and thwarting cognitive, memory and mood dysfunction. Young male F344 rats first underwent kainic acid induced SE for two hours and then received grafts of hNSCs into hippocampi at 7 days post-SE (3 grafts/side, ~100,000 cells/graft). Other cohorts of rats underwent similar SE but received either sham-grafting surgery or maintained as epilepsy-only controls. Sixty-four hour observations in the 3rd month after SE revealed diminished SRS in grafted animals, in comparison to animals in sham-grafted or epilepsy only groups. Seven days of continuous video-EEG recordings in the 4th month after SE corroborated these findings. Furthermore, grafted animals displayed competence for discerning minor changes in the environment (pattern separation function), ability for forming recognition and location memories in novel object recognition, object location and object in place tests, and no anhedonia-like behavior in sucrose preference test. Contrastingly, epileptic rats in both sham-grafted and epilepsy-only groups showed pattern separation, recognition and location memory impairments and anhedonia. Histological analyses performed 4 months after grafting revealed robust yield and mostly (~87%) neuronal differentiation of hNSC graft-derived cells. Some GABA-ergic neurons (~12%), astrocytes (11-16%) and Ki-67+ proliferating cells (~1%) were also seen among graft-derived cells. Yet, grafts did not contain Oct-4+ PSCs. In addition, hNSC grafting maintained normal levels of hippocampal neurogenesis with reduced aberrant migration of newly born neurons, modulated the hypertrophy of astrocytes and activation of microglia and rescued host neuropeptide Y and parvalbumin positive interneurons. Thus, hiPSC-derived NSC grafting into the hippocampus early after SE considerably mitigates SE-induced chronic epilepsy and preserves cognitive, memory and mood function. / (Artigo : Efeito do transplante de c?lulas mononucleares da medula ?ssea sobre o metabolismo cerebral da glicose in vivo e o comportamento depressivo no modelo experimental de epilepsia cr?nica induzido por pilocarpina) V?rias altera??es epileptog?nicas e inflama??o cont?nua acontece ap?s induc??o de status epilepticus (SE), que pode resultar no desenvolvimento de epilepsia do lobo temporal (ELT) caracterizada por crises espont?neas e recorrentes (CERs) e preju?zos na cogni??o, mem?ria e humor. N?s testamos se a interven??o precoce ap?s SE com o transplante intrahipocampal de c?lulas-tronco neurais (NSC) derivadas de c?lulas-tronco pluripotentes induzidas humanas (hiPSC) ? eficaz para reduzir a frequ?ncia de CERs e a disfun??o cognitiva e comportamento depressivo. Ratos F344 machos foram utilizados para indu??o de SE por ?cido ca?nico (KA) durante duas horas. Ap?s 7 dias da indu??o de SE os animais receberam o transplante intrahipocampal de hNSCs (3 inje??es/bilateral, ~ 100.000 c?lulas). Animais do grupo Sham receberam transplante intrahipocampal de meio celular ao inv?s de hNSC, e animais do grupo SE receberam apenas a inje??o de KA, sem procedimentos cir?rgicos. A monitora??o das CERs de sessenta e quatro horas no 3? m?s ap?s o SE revelaram diminui??o das CERs nos animais transplantados, em compara??o com animais dos grupos Sham ou SE. Sete dias de grava??es cont?nuas de v?deo-EEG no quarto m?s ap?s SE corroboraram com esses achados. Al?m disso, os animais transplantados mostraram habilidade para discernir pequenas mudan?as no ambiente (fun??o de separa??o de padr?es), habilidade para formar mem?rias de reconhecimento e localiza??o de objetos, bem como redu??o da disfun??o humoral e depressiva no teste de prefer?ncia de sacarose e teste de alimenta??o relacionado ? depress?o. Em contraste, os ratos epil?pticos tanto do grupo Sham quanto do grupo SE mostraram disfun??o de separa??o de padr?es, dist?rbios de reconhecimento e mem?ria de localiza??o, bem como comportamento depressivo. As an?lises histol?gicas realizadas 4 meses ap?s o transplante revelaram excelente sobreviv?ncia das c?lulas transplantadas nos hipocampos e se diferenciaram na maior parte em neur?nios NeuN+ (~ 87%). Tamb?m foi encontrado nos hipocampos dos animais transplantados alguns neur?nios GABA-?rgicos (~ 12%), astr?citos (11-16%) e Ki-67+ c?lulas em prolifera??o (~1%). Contudo, as c?lulas diferenciadas a partir das hNSC transplantadas n?o apresentaram a presen?a de Oct-4+. Al?m disso, o transplante de hNSC aumentou a neurog?nese no hipocampo com migra??o aberrante reduzida dos novos neur?nios, modulou a hipertrofia dos astr?citos e a ativa??o da microglia e preservou interneur?nios positivos ao neuropept?deo Y e ? parvalbumina. Assim, o transplante precoce de NSC derivadas de hiPSC no hipocampo ap?s SE atenua consideravelmente a epilepsia cr?nica induzida e preserva a fun??o cognitiva e melhora o comportamento depressivo. / (Artigo : Efeito do transplante de c?lulas mononucleares da medula ?ssea sobre o metabolismo cerebral da glicose in vivo e o comportamento depressivo no modelo experimental de epilepsia cr?nica induzido por pilocarpina) A epilepsia do lobo temporal (ELT) ? um dos tipos mais comuns de epilepsia na popula??o mundial, e muitas vezes, consequentemente, ? acompanhada por comorbidades como a depress?o. A depress?o tem sido considerada uma importante comorbidade da epilepsia, sendo relatada tanto em pacientes com ELT quanto em modelos experimentais de epilepsia. No entanto, n?o h? um consenso estabelecido sobre quais regi?es cerebrais est?o associadas com a manifesta??o da depress?o na epilepsia. Com a alta refratariedade da ELT, novas alternativas terap?uticas t?m sido avaliadas como, por exemplo, a terapia celular. O transplante de c?lulas mononucleares da medula ?ssea (CMMO) vem sendo utilizado para o tratamento da epilepsia e tem mostrado um grande n?mero de efeitos ben?ficos nesta neuropatologia. A epilepsia afeta o consumo de glicose cerebral, bem como a rede metab?lica e a conectividade entre regi?es cerebrais. Por outro lado, o PET com 18F-FDG tem sido amplamente utilizado para investigar o metabolismo cerebral em pacientes com ELT ou dist?rbios depressivos e na investiga??o experimental em animais de pequeno porte avaliados por imagens obtidas no microPET. N?s investigamos longitudinalmente as altera??es no metabolismo cerebral da glicose no modelo de epilepsia induzido por pilocarpina e observamos o efeito do transplante das CMMO no comportamento depressivo e no metabolismo cerebral de FDG durante a fase cr?nica da epilepsia. Nossos resultados evidenciaram que os ratos tratados com pilocarpina apresentaram comportamento semelhante ?queles observados na depress?o associado a menor metabolismo de 18F-FDG em v?rias regi?es cerebrais relacionadas ? fisiopatologia da epilepsia e da depress?o durante a fase cr?nica. O tratamento com CMMO reduziu a disfun??o cognitiva e o comportamento depressivo mostrado pelos animais cronicamente epil?ticos. No entanto, o transplante CMMO parece n?o afetar o metabolismo cerebral da glicose nesses animais. Adicionalmente, encontramos uma rede metab?lica hipersincr?nica nos animais cronicamente epil?pticos e uma rede metab?lica reduzida em animais tratados com as CMMO, semelhante aos animais controles. Este estudo corrobora com evid?ncias adicionais de comportamento depressivo como comorbidade no modelo de epilepsia induzida pela pilocarpina associado a significativa altera??o do metabolismo da glicose e da rede metab?lica entre as regi?es cerebrais envolvidas em ambas as patologias. Al?m disso, este estudo sugeriu um potencial efeito do transplante de CMMO para redu??o da frequ?ncia de crises, d?ficit cognitivo e comportamento depressivo, bem como contribuiu para normaliza??o da rede metab?lica em animais cronicamente epil?ticos.

Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2017-08-17T13:48:58Z No. of bitstreams: 1 VASQUES_ADRIANA_MACHADO.pdf: 2518120 bytes, checksum: 7a0b3e0350846d9ac6cc0584973c0a19 (MD5) / Rejected by Caroline Xavier (caroline.xavier@pucrs.br), reason: Devolvido devido a falta de capa institucional. on 2017-08-21T12:19:24Z (GMT) / Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2017-08-21T17:07:52Z No. of bitstreams: 1 VASQUES_ADRIANA_MACHADO_TESE.pdf: 6462123 bytes, checksum: b1fc71519ef4d65f8d2f3ed44e760d5a (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-08-22T13:29:59Z (GMT) No. of bitstreams: 1 VASQUES_ADRIANA_MACHADO_TESE.pdf: 6462123 bytes, checksum: b1fc71519ef4d65f8d2f3ed44e760d5a (MD5) / Made available in DSpace on 2017-08-22T13:50:20Z (GMT). No. of bitstreams: 1 VASQUES_ADRIANA_MACHADO_TESE.pdf: 6462123 bytes, checksum: b1fc71519ef4d65f8d2f3ed44e760d5a (MD5) Previous issue date: 2017-06-21 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / With seniors increasing faster than younger populations, the average age of car drivers has gone up, and ageing-associated cognitive decline may interfere with the skills needed for safe driving. However, driving provides autonomy and quality of life, and being considered unfit to perform this task may restrict social life and lead to depression. As such, any restrictive measures should be based on careful assessment; however, the instruments available to evaluate the cognitive functions and the driving performance of the elderly need to be largely improved. Objective: To investigate the cognitive functions of elderly drivers and relate them to performance in a driving simulator, and to identify the most effective parameters of evaluation, thus contributing to traffic safety and to the creation of public policies. Method: This is a cross-sectional, descriptive-analytic study, involving 34 elderly drivers evaluated by a driving simulator and cognitive tests (Wechsler Intelligence Scale Codes, Divided Attention Test - TEADI, Trail Making test, Revised Addenbrooke Cognitive Examination - ACE-R and Rey Verbal Learning Test - RAVLT). Results: The tests that evaluate the cognitive functioning, especially those of verbal memory and the visuoconstructive abilities were the ones that demonstrated more relation with the performance in the driving simulator. Conclusions: The comparison between performance in cognitive tests and scores in the drive simulator shows a correlation between both, indicating that the worst performance in the simulator is associated with worse cognitive performance, proving to be a useful instrument to contribute to the evaluation of elderly drivers. / Com o aumento expressivo da popula??o idosa, cresce o n?mero de condutores automotivos em uma faixa et?ria frequentemente acometida por decl?nios cognitivos que podem interferir nas habilidades para uma condu??o segura. Sendo a condu??o automotiva essencial para a manuten??o da autonomia e qualidade de vida e sua interrup??o associada a efeitos negativos como restri??o ? vida social e aumento de sintomas depressivos, sua continuidade ou n?o deveria basear-se em uma avalia??o criteriosa. No entanto, apesar de relevante, ainda n?o foram estabelecidos os instrumentos mais eficazes para avaliar as fun??es cognitivas e o desempenho de idosos na condu??o automotiva. Objetivo: investigar as fun??es cognitivas de motoristas idosos e relacionar com o desempenho em um simulador de dire??o, buscando identificar os par?metros mais eficazes de avalia??o, contribuindo para seguran?a no tr?nsito e para a cria??o de pol?ticas p?blicas. M?todo: estudo do tipo transversal com abordagem descritivo-anal?tica, envolvendo 34 condutores idosos avaliados atrav?s de um simulador de dire??o e testes cognitivos (C?digos, da Escala de intelig?ncia Wechsler, Teste de aten??o Dividida-TEADI, Trail Making teste-TMT, Exame Cognitivo de Addenbrooke Revisado-ACE-R e Teste de aprendizado Verbal de Rey- RAVLT). Resultados: os testes que avaliam o funcionamento cognitivo, especialmente os de mem?ria verbal e as habilidades visuoconstrutivas foram os que mais demonstraram rela??o com o desempenho no simulador de condu??o. Conclus?es: a compara??o entre o desempenho nos testes cognitivos e os escores no simulador de dire??o, evidencia correla??o entre ambos, indicando que o pior desempenho no simulador associa-se ao pior desempenho cognitivo, revelando-se um instrumento ?til para contribuir na avalia??o de condutores idosos.

Submitted by PPG Pediatria e Sa?de da Crian?a (pediatria-pg@pucrs.br) on 2017-08-23T20:19:40Z No. of bitstreams: 1 Tese MClaraversaofinal.pdf: 1140193 bytes, checksum: 36fe50dffe28e4c997ea7042cbe7267f (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-08-24T12:24:03Z (GMT) No. of bitstreams: 1 Tese MClaraversaofinal.pdf: 1140193 bytes, checksum: 36fe50dffe28e4c997ea7042cbe7267f (MD5) / Made available in DSpace on 2017-08-24T12:28:33Z (GMT). No. of bitstreams: 1 Tese MClaraversaofinal.pdf: 1140193 bytes, checksum: 36fe50dffe28e4c997ea7042cbe7267f (MD5) Previous issue date: 2017-03-31 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: Cystic fibrosis is an autosomal recessive genetic disorder characterized mainly by obstruction and inflammation of the airways leading to the chronic establishment of microorganisms. Acute infections (exacerbations) and/or chronic colonization lead to a progressive decline in lung function that leads to respiratory failure, the main cause of death among these individuals. Despite advances in survival, aspects related to infections still need to be reviewed. Thus, the main objective of the study was to evaluate the impact of different bacterial colonizations on nutritional status, lung function and clinical severity in patients with cystic fibrosis (CF). Methods: This is a retrospective cohort study that included patients with a confirmed diagnosis of CF, aged > 3 years and presenting complete data in a reference database of cystic fibrosis and / or available medical records. Anthropometric information (weight and height for the purpose of calculating BMI) and nutritional status, clinical severity data, colonization of airway secretions in addition to lung function (FEV1, FVC and FEV1/FVC). All the data collected were the annual evaluation of these subjects, between the period from 2009 to 2013. For statistical purposes, the Friedman test (Dunn's post-test) and the Mann Whitney U test were used. Results: We included 68 patients with CF out of a total of 80 who are regularly followed by the service, with 57.4% being male with a mean age of 10.35 years at baseline. During the five-year follow-up (mean of 3.55 years), nutritional status (p = 0.743) and clinical severity score (p = 0.235) remained stable. There was a statistically significant reduction of FEV1/FVC ratio over the follow-up (from year 2 to year 3 and year 2 to year 5; p <0.05). The most frequent colonizations were oxacillin-sensitive Staphylococcus aureus (MSSA) (29.8-46.3%), followed by non-mucoid Pseudomonas aeruginosa (PA) (8.5-19.4%), Burkholderia Cepacia Complex CBC) (4.9-21.3%), mucoid PA (2,4-6,5 %) and oxacilina/meticilin-resistent Staphylococcus aureus (MRSA) (2,4- 16,1%). Patients who were colonized throughout the study by MRSA (p = 0.040) had a reduction in FEV1 (p = 0.004) and FVC (p = 0.005) in year 5 compared to those not colonized by this bacteria. In addition, individuals with non-mucoid BP had a reduction (p = 0.007) in FVC. Conclusions: Our findings demonstrate that bacterial colonization by oxacilina/meticilin-resistent Staphylococcus aureus and non-mucoid Pseudomonas aeruginosa is related to worsening lung function (FEV1 and FVC). However, the impact of the different colonizations on BMI and on the clinical severity of Shwachman-Kulczycki score over the 5 years was not observed. Key words: Microbiology, nutritional status, respiratory function tests, prognosis, cystic fibrosis. / Introdu??o: A fibrose c?stica ? uma doen?a gen?tica autoss?mica recessiva, caracterizada principalmente por obstru??o e inflama??o das vias a?reas que leva a instala??o cr?nica de microrganismos. As infec??es agudas e/ou coloniza??es cr?nicas levam a um progressivo decl?nio da fun??o pulmonar que evolui para fal?ncia respirat?ria, principal causa de morte entre estes indiv?duos. Apesar dos avan?os alcan?ados na sobrevida, aspectos relacionados a infec??es ainda necessitam ser revisados. Assim, o objetivo principal do estudo foi avaliar o impacto de diferentes coloniza??es bacterianas sobre o estado nutricional, fun??o pulmonar e gravidade cl?nica em pacientes com fibrose c?stica (FC). M?todos: Trata-se de um estudo de coorte, retrospectivo onde foram inclu?dos pacientes com diagn?stico confirmado de FC, com idade > 3anos e que apresentassem os dados completos em um banco de dados de um servi?o de refer?ncia em fibrose c?stica e/ou dispon?veis nos prontu?rios m?dicos. Foram coletadas informa??es antropom?tricas (peso e estatura para fins de c?lculo de IMC) e verifica??o do estado nutricional, dados cl?nicos de gravidade, coloniza??es presentes nas secre??es das vias a?reas al?m da fun??o pulmonar (VEF1, CVF e VEF1/ CVF). Todos os dados coletados se tratavam da avalia??o anual desses sujeitos, entre o per?odo de 2009 a 2013. Para fins estat?sticos, utilizou-se o teste de Friedman (p?s-teste de Dunn?s) e o teste U de Mann Whitney. Resultados: Foram inclu?dos 68 pacientes com FC de um total de 80 que s?o acompanhados regularmente pelo servi?o, sendo 57,4 % do sexo masculino com idade m?dia de 10,35 anos no in?cio do estudo. Ao longo do seguimento de cinco anos (m?dia de 3,55 anos) o estado nutricional (p=0,743) e o escore de gravidade cl?nica (p=0,235) permaneceram est?veis. Houve uma redu??o estatisticamente significativa da rela??o VEF1/CVF ao longo do acompanhamento (do ano 2 para o ano 3 e do ano 2 para o ano 5; p<0,05). As coloniza??es mais frequentes foram a Staphylococcus aureus sens?vel a Oxacilina (MSSA) (29,8-46,3%), seguidas da Pseudomonas aeruginosa (PA) n?o muc?ide (8,5-19,4%), Complexo Burkholderia Cepacia (CBC) (4,9-21,3%), PA mucoide (2,4-6,5 %) e Staphylococcus aureus resistente a oxacilina (2,4- 16,1%). Os pacientes que foram colonizados ao longo do estudo por MRSA (p=0,040) apresentaram uma redu??o do VEF1 (p=0,004) e da CVF (p=0,005) no ano 5, em compara??o aos n?o colonizados por essa bact?ria. Al?m disso, os indiv?duos com PA n?o mucoide apresentaram redu??o (p=0,007) da CVF. Conclus?es: Nossos achados demonstram que a coloniza??o bacteriana por Staphylococcus aureus resistente a oxacilina e por Pseudomonas aeruginosa n?o muc?ide est? relacionada a piora na fun??o pulmonar (VEF1 e CVF). Todavia, n?o foi observado impacto das diferentes coloniza??es sobre o IMC e sobre o escore de gravidade cl?nica de Shwachman-Kulczycki ao longo dos 5 anos. Palavras-chave: Microbiologia, estado nutricional, testes de fun??o respirat?ria, progn?stico, fibrose c?stica.

Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2017-08-24T12:28:10Z No. of bitstreams: 1 DIEGO_SILVEIRA_SIQUEIRA_DIS.pdf: 1193582 bytes, checksum: cad7014fa8412a61994647486edc8e93 (MD5) / Rejected by Caroline Xavier (caroline.xavier@pucrs.br), reason: Devolvido devido ? falta de capa institucional. on 2017-08-25T17:56:57Z (GMT) / Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2017-08-30T11:26:00Z No. of bitstreams: 1 DIEGO_SILVEIRA_SIQUEIRA_DIS.pdf: 1121335 bytes, checksum: f6f699bc9f8c699563be863b36e27d98 (MD5) / Approved for entry into archive by Marcelo Texeira (marcelo.texeira@pucrs.br) on 2017-08-30T13:18:13Z (GMT) No. of bitstreams: 1 DIEGO_SILVEIRA_SIQUEIRA_DIS.pdf: 1121335 bytes, checksum: f6f699bc9f8c699563be863b36e27d98 (MD5) / Made available in DSpace on 2017-08-30T13:19:58Z (GMT). No. of bitstreams: 1 DIEGO_SILVEIRA_SIQUEIRA_DIS.pdf: 1121335 bytes, checksum: f6f699bc9f8c699563be863b36e27d98 (MD5) Previous issue date: 2017-03-20 / Introduction: chronic kidney disease (CKD) is characterized by structural changes or kidney function present for more than three months with health implications. Faced with these changes and complications, the patients undergo stressors capable of influencing their coping with the disease and treatment perspectives. Objective: to characterize the coping profile of patients on the waiting list for renal transplantation based on the Jalowiec Coping Scale (CJD) and to evaluate quality of life using SF-36. Method: a cross-sectional quantitative study that took place at the hemodialysis unit of Hospital S?o Lucas PUCRS, patients on the waiting list for renal transplantation, who are over 18 years of age and literate were included. Data was collected through a questionnaire with patient socio demographic information, CJD and SF36. Results: 58 patients were included, 51.7% (n = 30 males, mean age of 44.6 (? 15.2) years, 12.3% (n = 7) were above 65 years of age, more than half, 57.9% (n = 33) had elementary education. Thirty-one (54.4%) patients were married, (n = 31); 37.5% (n = 21) had one children and were of the catholic religion 62,5% (n = 35). In relation to CJD, the predominant profile was self - confident (0.455) and optimistic (0.404) 42 and 6 patients, respectively, of which 54 were focused on emotion. The dimensions evaluated with the best quality of life were: pain (67.2), social aspects (66.6) and mental health (65.4). There was a weak significant negative correlation, (r <0.333), between palliative style and vitality (r = -0.288, p = 0.028) and palliative and social aspects (r = -0.283; p = 0.031). There was a moderate negative correlation between general well being and emotive style (R = -0.424, p = 0.025) and palliative (r = -0.524, p = 0.004), as well as between Vitality and Palliative style (r = -0.530; P = 0.004). In males, there was a significant, negative moderate correlation result with a (0.300 <r?0.600) beteween Pain dimension with the Confrontive style (r = -0.413; p = 0.023) and Emotive (r = -0.370). Conclusion: the coping profile of patients on hemodialysis and in waiting list for tranplant was mostly self-confident and optimistic. The best domains in the quality of life were Pain, Social Aspects and Mental Health, and the worst physical and emotional aspects. / Introdu??o: a doen?a renal cr?nica (DRC) ? caracterizada por altera??es estruturais ou da fun??o dos rins presentes por mais de tr?s meses com implica??es para a sa?de. Diante dessas altera??es e complica??es os pacientes sofrem a??o de estressores capazes de influenciar no seu enfrentamento em rela??o ? doen?a e perspectivas de tratamento. Objetivo: caracterizar o perfil de enfrentamento dos pacientes em lista de espera de transplante renal baseado na Escala de Jalowiec Coping Scale (ECJ) e avaliar a qualidade de vida SF-36. M?todo: trata-se de um estudo transversal de abordagem quantitativa desenvolvida na unidade de hemodi?lise do Hospital S?o Lucas da PUCRS, em pacientes em lista de espera para transplante renal, com mais de 18 anos de idade e alfabetizados. Os dados foram coletados por meio de question?rio com informa??es s?cio demogr?ficas sobre o paciente, ECJ e SF36. Resultados: foram inclu?dos 58 pacientes com preval?ncia do sexo masculino 51,7% (n=30), m?dia de idade de 44,6 ?15,2 anos, 12,3% (n=7 ) acima de 65 anos e mais da metade da amostra, 57,9% (n=33) apresentou o ensino fundamental. Trinta e um (54,4%) pacientes eram casados (n=31); com um filho, 37,5% (n=21) e de religi?o cat?lica 62,5% (n=35). Em rela??o ? ECJ, o perfil predominante foi o Autoconfiante (0,455) e Otimista (0,404) 42 e 6 pacientes, respectivamente, sendo que 54 focados na emo??o . As dimens?es avaliadas com a melhor qualidade de vida foram: a dor (67,2), aspectos sociais (66,6) e sa?de mental (65,4). Houve correla??o significativa, fraca e negativa( r<0,333), entre o estilo paliativo e vitalidade (r=- 0,288; p=0,028) e paliativo e aspectos sociais (r=-0,283; p=0,031) . houve correla??o significativa, negativa classificada como moderada entre o Estado Geral de Sa?de e os estilos Emotivo (r=-0,424; p=0,025) e Paliativo (r=-0,524; p=0,004), bem como, entre a Vitalidade e o estilo Paliativo (r=-0,530; p=0,004). No sexo masculino, ocorreu resultado significativo, negativo com grau moderado (0,300<r?0,600) na compara??o da dimens?o Dor com os estilos Confrontivo (r=-0,413; p=0,023) e Emotivo (r=-0,370; ;p=0,044). Conclus?o: o perfil de enfrentamento dos pacientes em hemodi?lise e em lista de espera de transplante renal, foi em sua maioria autoconfiante e otimista. Os melhores dom?nios na qualidade de de vida foram Dor, Aspectos sociais e Sa?de mental, e os piores aspectos os f?sicos e os emocionais.

Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2017-08-24T12:57:55Z No. of bitstreams: 1 ADRIANA_CONTI_DIS.pdf: 1862760 bytes, checksum: d04417c4b0e9dd7ce859909035772034 (MD5) / Rejected by Caroline Xavier (caroline.xavier@pucrs.br), reason: Devolvido devido ? falta de capa institucional no arquivo PDF. on 2017-08-25T18:09:08Z (GMT) / Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2017-08-29T11:31:27Z No. of bitstreams: 1 ADRIANA_CONTI_DIS.pdf: 1902344 bytes, checksum: 5866bfc2071b034ae6ff6dedc003d26f (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-09-08T17:28:07Z (GMT) No. of bitstreams: 1 ADRIANA_CONTI_DIS.pdf: 1902344 bytes, checksum: 5866bfc2071b034ae6ff6dedc003d26f (MD5) / Made available in DSpace on 2017-09-11T11:26:00Z (GMT). No. of bitstreams: 1 ADRIANA_CONTI_DIS.pdf: 1902344 bytes, checksum: 5866bfc2071b034ae6ff6dedc003d26f (MD5) Previous issue date: 2017-03-20 / Introduction: Peritonitis remains a major complication in peritoneal dialysis patients, with the predominant infectious agent being coagulase-negative Staphylococcus (CNS). Intraperitoneal administration of antibiotics is the required treatment, however, no consensus exists on the appropriate disinfection of the medication port (MP). Objective: To compare different disinfection techniques for the peritoneal dialysis bag MP. Methods: An experimental study was conducted testing different cleaning agents (70% alcohol vs 2% chlorhexidine) and time periods (5, 10 and 60seconds) for disinfection of the MP. Four microorganisms (S. aureus, E.coli, A. baumannii and C.parapsilosis) were prepared for use as contaminants of the MP. MP were incubated in Tryptic soybroth at 36?C for 24 h, after which, they were seeded on a Biom?rieux? blood agar plate and incubated for 24 h at 36?C. Results: A total of 240 PD bags were contaminated with four different microorganisms. Two positive cultures (E. coli and S. aureus) were identified, both after disinfection with alcohol after 5 and 10 seconds of friction, and none in the chlorhexidine group. Conclusion: although there was no statistical difference between the antiseptics used and the cleaning time, the use of chlorhexidine for 1 minute was the only one in which there was no bacterial growth, therefore we considered this recommendation. / Introdu??o: A Di?lise Peritoneal utiliza a membrana peritoneal para realizar trocas entre o sangue e a solu??o de di?lise. Peritonite ? a maior complica??o, e o germe predominante ? o Staphylococcus coagulase negativa (SCN). O tratamento para peritonite ? realizado com a administra??o de antibi?tico intraperitoneal. Durante o treinamento, o paciente e/ou familiar s?o capacitados a administrar antibi?tico via intraperitoneal, se necess?rio. No entanto, n?o existe consenso quanto ? maneira mais apropriada para a desinfec??o do tubo entrada de medica??o (TEM). Empresas que comercializam o material de DP recomendam que, para a administra??o de antibi?ticos e outros medicamentos, o TEM deve ser limpo durante cinco minutos com ?lcool a 70%, iodo povidine alc?olico ou clorexidina alco?lica. Objetivo: Comparar a efic?cia das t?cnicas e produtos de desinfec??o do TEM da bolsa de di?lise peritoneal. M?todo: Foi realizado um estudo experimental com diferentes agentes de limpeza (?lcool x clorexidina 2%) e per?odos de tempo (5, 10, 60 segundos) para a desinfec??o do TEM. Foram preparados quatro micro-organismos (S. aureus, E. coli, A. baumanni e C. parapsilosis) para utiliza??o como contaminantes e foram incubados em Caldo de Soja Tripticase?na a 36? C durante 24 horas, ap?s foram semeados por deple??o em placas de ?gar sangue (AS) e incubados durante 24 horas a 36? C. Resultados: No total, 240 bolsas PD foram contaminadas com quatro micro-organismos diferentes. Foram identificadas duas culturas positivas (E. coli e S. aureus), ambas ap?s desinfec??o com ?lcool 70% com o tempo de 5 e 10 segundos de atrito. Conclus?o: Embora sem diferen?a estat?stica entre os antiss?pticos utilizados e o tempo de limpeza, o uso de clorexidine por 1 minuto foi o ?nico em que n?o houve crescimento bacteriano, portanto achamos pertinente esta recomenda??o.

Submitted by PPG Pediatria e Sa?de da Crian?a (pediatria-pg@pucrs.br) on 2017-10-03T19:45:05Z No. of bitstreams: 1 TeseF?timaversaofinal.pdf: 880598 bytes, checksum: 689eb5cf56995aa9a6100e6827f43c4c (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-10-04T13:52:56Z (GMT) No. of bitstreams: 1 TeseF?timaversaofinal.pdf: 880598 bytes, checksum: 689eb5cf56995aa9a6100e6827f43c4c (MD5) / Made available in DSpace on 2017-10-04T13:56:23Z (GMT). No. of bitstreams: 1 TeseF?timaversaofinal.pdf: 880598 bytes, checksum: 689eb5cf56995aa9a6100e6827f43c4c (MD5) Previous issue date: 2017-03-22 / PROBOLSA / Introduction: Acute respiratory tract infections (ARTI) are one of the most important causes of mortality in children under 5 years old. In developed countries ARTI account for 20% of emergency consultations and 75% of antibiotic prescriptions. Children in attending day care are more prone to recurrence of respiratory infections. Bacterial immunostimulants, resulting from the chemical lysis of microorganisms associated with most respiratory tract infections, have been propagated as possibly useful intervention for prevention of recurrent respiratory infections. Objective: To analyze the effectiveness of OM-85 Broncho-vaxom (OM-85 BV) on the prevention of upper respiratory tract infections in healthy children attending preschool during the 6-month period. Methods: A randomized, double-blind, placebo controlled study was conducted in 54 healthy children aged between 6 months to 5 years attending in the School for Early Childhood Education between the months of April and September. Use of OM-85 BV for 3 months and observed for a further 3 months the following outcomes: upper respiratory tract infection, bronchopneumonia, other infections, use of antibiotics, emergency consultations, need for hospital stay, side effects of the medication. Results: Of the 54 children included, 57% were male. All completed the study and there were no significant differences between the groups. Of the 27 patients in group OM-85 BV, 19 (70,4%), attending daycare full-time and 16 (64,85%) half period, morning or evening. Breastfeeding was exclusive until 6 months in 6 patients (22,2%) on the OM-85 BV group and in 7 (25,9%) patients in the control group. Family history of smoking was positive in 11 (40,7%) patients in the OM-85 BV group and in 13 (48,1%) patients in the control group. Regarding the number of respiratory infections, the mean in the OM-85 BV group in the first 3 months was 0,92? 0,87 and in the placebo group was 0,74? 1,02 and in the 6 months was 1,62? 1,47 and 1,03?1,34, respectively. Antibiotic was used in 10 (37%) children of the OM-85BV group in the 3 months of treatment and in 13 (48,1%) of the placebo group, and in the 6 months of follow-up the use was 48,1% in both groups. The mean number of hospitalizations was very low in the period of the study. The mean number of emergency visits during the first 3 months was 0,81?1,21 in the OM-85 BV group and 1,29?1,48 in the placebo group and at 6 months was 1,77?1,80 in the OM-85 BV group and 2,03?1,76 in the placebo group. Conclusions: OM-85 BV was not effective as an intervention in daycare children with no history of IRR. No statistically significant difference was observed between the groups in the use of antibiotics, emergency consultations and hospitalizations. / Introdu??o: As infec??es agudas do trato respirat?rio est?o entre as causas mais importantes de mortalidade na faixa et?ria abaixo dos 5 anos, sendo, em pa?ses desenvolvidos, respons?veis por 20% das consultas nas emerg?ncias e 75% das prescri??es de antibi?ticos. Crian?as que frequentam creche s?o mais propensas ? recorr?ncia das infec??es respirat?rias. Os imunoestimulantes bacterianos, resultantes da lise qu?mica de microrganismos associados com a maioria das infec??es respirat?rias, t?m sido propagados como interven??o possivelmente ?til para a preven??o das infec??es respirat?rias recorrentes (IRR). Objetivo: Analisar a efic?cia do OM-85 Broncho Vaxom (OM-85 BV) na preven??o de infec??es respirat?rias do trato respirat?rio superior em crian?as h?gidas que frequentam pr?-escola, durante o per?odo de 6 meses. M?todos: Desenvolveu-se um estudo randomizado duplo cego placebo controlado em 54 crian?as previamente h?gidas, com idade entre 6 meses e 5 anos, que frequentavam a Escola de Educa??o Infantil entre os meses de abril e setembro. Usado OM-85 BV por 3 meses e observado por mais 3 meses os seguintes desfechos: presen?a de infec??o do trato respirat?rio superior, broncopneumonia, outras infec??es, uso de antibi?ticos, consultas na emerg?ncia, necessidade de interna??o hospitalar, dias de aus?ncia ? creche e efeitos colaterais da medica??o. Resultados: Das 54 crian?as inclu?das, 57% eram do sexo masculino. Todos completaram o estudo e n?o houve diferen?as significativas entre os grupos. Dos 27 pacientes do grupo OM-85 BV, 19 (70,4%), frequentavam a creche em turno integral e dos 27 pacientes do grupo controle, 16 (64,8%). O aleitamento materno, foi exclusivo at? o 6? m?s em 6 (22,2%) pacientes do grupo OM-85 BV em 7 (25,9%) pacientes do grupo controle. Quanto ? hist?ria familiar de fumo, foi positiva em 11 (40,7%) pacientes do grupo OM-85 BV e em 13 (48,1%) pacientes do grupo controle. Em rela??o ao n?mero de infec??es respirat?rias, a m?dia no grupo OM-85 BV nos primeiros 3 meses foi 0,92?0,87 e no grupo placebo foi 0,74?1,02 e nos 6 meses foi 1,62?1,47 e 1,03?1,34, respectivamente. Antibi?tico foi usado em 10 (37%) crian?as do grupo OM-85BV nos 3 meses de tratamento e em 13 (48,1%) do grupo placebo, j? nos 6 meses de acompanhamento o uso foi de 48,1% nos dois grupos. A m?dia de interna??es foi muito baixa no per?odo estudado. A m?dia de consultas na emerg?ncia nos primeiros 3 meses foi de 0,81?1,21 no grupo OM-85 BV e 1,29?1,48 no grupo placebo e nos 6 meses foi de 1,77?1,80 no grupo OM-85 BV e 2,03?1,76 no grupo placebo. Conclus?es: OM-85 BV n?o foi eficaz como interven??o em crian?as que frequentam creche, sem hist?ria de IRR. N?o houve diferen?a estatisticamente significativa no uso de antibi?ticos, consultas na emerg?ncia e interna??es hospitalares

Submitted by PPG Pediatria e Sa?de da Crian?a (pediatria-pg@pucrs.br) on 2017-10-09T17:27:41Z No. of bitstreams: 1 Disserta??o Cristina Manera.pdf: 1861857 bytes, checksum: 55d02acda533fde326a0ac0a092db0ed (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-10-10T13:01:18Z (GMT) No. of bitstreams: 1 Disserta??o Cristina Manera.pdf: 1861857 bytes, checksum: 55d02acda533fde326a0ac0a092db0ed (MD5) / Made available in DSpace on 2017-10-10T13:03:42Z (GMT). No. of bitstreams: 1 Disserta??o Cristina Manera.pdf: 1861857 bytes, checksum: 55d02acda533fde326a0ac0a092db0ed (MD5) Previous issue date: 2016-08-31 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Objective: To evaluate the technical quality of low-dose computed tomography without contrast and without the use of anesthesia in the diagnosis of lung diseases in children Materials and Methods: It reviewed 86 chest CT scans performed due to clinical indications of acute or chronic inflammatory lung diseases, cancer or congenital malformations in patients from 1 to 18 years of age who were subjected to a low dose of radiation dose bellow the dose recommended by the ALARA and using interactive image reconstruction filters performed without the use of anesthesia or sedation. The exams will be evaluated by two reviewers and age, gender, the radiation dose, image quality and image noise will be assessed. Image analysis will be quantitative. The variables will be the outside Roi diameter of trachea divided by the Roi of trachea, the percentage of axial images with motion artifacts, and identification of the tracheal, the main and segmental bronchi? 20 segments, the main and lobar pulmonary arteries and the ascending aorta artery. The presence of pleural effusion and the identification of paratracheal and subcarinal lymph node chains will also be assessed. Data will be analyzed by for mean, standard deviation and the correlation of the data will be analyzed by tests of Pearson and Spearman, considering significant a p<0.05. Results: The average age of the patients was 5.5 years. LSD as well with the LID, LSE and LIE were displayed in all tests. The middle lobe in almost all (n = 85) apical segment and the medial basilar segment were seen in almost all of the scans (n = 84). The aorta and pulmonary arteries were distinguished on all tomography examinations. The percentage of images with motion artifact introduced an average of 0.8 with IC: 0-2.9 (P25-P75) with p < 0.001. The noise of the image showed an average of 45.5 with 12.4DP. How much ROI the trachea and main bronchi were seen in all the CT scans. The image quality was considered excellent and blurring that didn't compromise the evaluation in almost all the tests. The DLP in mGy dose presented an average of 27.5 with DP ? 11.1. Conclusion: The dose used was significantly lower than the one used in children and allowed the visualization of lung structures in almost all patients, enabling the final diagnosis of cystic fibrosis, bronchiolitis and congenital malformations without difficulty of diagnosis by image artifact / Objetivo: Avaliar a qualidade t?cnica da Tomografia Computadorizada de baixa dose sem contraste e sem anestesia no diagn?stico de doen?as pulmonares em crian?as e adolescentes. Materiais e m?todos: Estudo descritivo retrospectivo em que foram analisadas 86 Tomografias Computadorizadas de t?rax em pacientes pedi?tricos e adolescentes. Os exames foram realizados por indica??o clinica de suspeita de patologias pulmonares com baixa dose de radia??o e com filtro de reconstru??o interativa da imagem sem uso de anestesia ou seda??o. Estes exames foram analisados por dois avaliadores independentes e as vari?veis medidas foram idade, o sexo, a dose de radia??o, a qualidade da imagem, o ru?do de imagem, o ROI externo dividido pelo um ROI na traqueia, identifica??o da traqueia, dos br?nquios principais e segmentares-20 segmentos , das art?rias pulmonares principais e lobares, aorta ascendente, presen?a de derrame pleural, cadeias linfonodais paratraqueais e subcarinal Todas as imagens tamb?m foram medidas quanto a artefato de movimento e foram descritos em porcentagem comparando com o total de imagens. Os dados foram analisados com m?dia, desvio padr?o. Para a an?lise da correla??o foram usados os ?ndices de Pearson e de Spearman considerando um p < 0,01 como significativo. Resultados: A visualiza??o da traqueia e dos br?nquios principais foi poss?vel em 100% dos exames. Os linfonodos paratraqueais e os subcarinais foram visto em todos os exames na bronquiolite e na malforma??o cong?nita. Os lobos superior, m?dio e inferior direito foram visualizados na totalidade das Tomografias Computadorizadas com baixa dose de radia??o nos pacientes com fibrose c?stica e bronquiolite. Na malforma??o cong?nita os lobos superior e inferior direitos foram visualizados em todos exames. Os lobos superior e inferior esquerdos foram identificados em todas as an?lises por TC. Os segmentos apicais foram vistos em 100% das imagens na FC, BO e malforma??o cong?nita.O segmento basilar apical foi visto em todas as imagens na FC. As art?rias aorta e pulmonar foram distinguidas no total dos exames Em nenhum exame houve comprometimento da qualidade da imagem. Na malforma??o cong?nita a percentagem de imagem com excelente qualidade e borramento leve sem comprometimento da avalia??o foram encontradas em todos os exames tomogr?ficos. A porcentagem de artefato de imagem foi de 0,3% na fibrose c?stica, 1,3 % na bronquiolite e 1,1% na malforma??o cong?nita. Conclus?o A dose utilizada foi significativamente menor do que a utilizada em crian?as e permitiu a visualiza??o das estruturas pulmonares em quase todos os pacientes possibilitando o diagn?stico final da fibrose c?stica, da bronquiolite e das malforma??es cong?nitas sem dificuldade de diagn?stico por artefato de imagem.

Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2017-10-02T11:32:32Z No. of bitstreams: 1 OLIVEIRA_CHARLENE_BRITO_TESE.pdf: 3750193 bytes, checksum: a5e5b863e98d3354e5af371cd1b063c2 (MD5) / Rejected by Caroline Xavier (caroline.xavier@pucrs.br), reason: Devolvido devido ? falta de capa institucional no arquivo PDF. on 2017-10-02T12:15:52Z (GMT) / Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2017-10-24T16:21:20Z No. of bitstreams: 1 OLIVEIRA_CHARLENE_BRITO_TESE.pdf: 5702628 bytes, checksum: 500180262884e19627b8da8d821de3da (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-10-26T16:20:49Z (GMT) No. of bitstreams: 1 OLIVEIRA_CHARLENE_BRITO_TESE.pdf: 5702628 bytes, checksum: 500180262884e19627b8da8d821de3da (MD5) / Made available in DSpace on 2017-10-26T16:26:50Z (GMT). No. of bitstreams: 1 OLIVEIRA_CHARLENE_BRITO_TESE.pdf: 5702628 bytes, checksum: 500180262884e19627b8da8d821de3da (MD5) Previous issue date: 2017-03-03 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Importance: The efficacy of combined body suspension with tilting exercises (Chordata Method) in Parkinson?s disease (PD) is unclear. Objective: Design a clinical study to assess the efficacy of body suspension with tilting exercises on functional and quality of life outcomes in PD. Design, Setting, and Participants: This is an assessor-blinded, randomized and controlled clinical trial. A total of 48 subjects with moderate PD were recruited from the Neurological Service of S?o Lucas Hospital, PUCRS, Brazil. Recruitment took place between September 2015 and May 2016. The entire protocol study lasted 16 weeks, with 8 weeks of exercise protocol and 8 weeks of follow-up. Interventions: Subjects were randomly assigned to either body suspension with tilting exercises (intervention group) or stretching exercises (control group). Main Outcomes and Measures: The primary outcome was the Timed Up and Go test at the 8th week. Secondary outcomes were Berg Balance Scale (BBS); Functional Reach Test (FRT); Unified Parkinson?s Disease Rating Scale (UPDRS) and Parkinson?s Disease Questionnaire (PDQ-39). These measures were assessed at baseline (before trial entry) and then at the 8th (end of exercise protocols) and 16th weeks (8 weeks of follow-up) after randomization. Results: Of the 48 subjects randomized in the study 20 received the intervention (71.3?6.3 years old) and 20 were controls (66.7?6.4 years old). Eight of them were lost during the trial (four per group). Analysis of co-variance, with adjustment for baseline measurement, revealed a between-group difference in the Timed Up and Go test at 8th week [CI95% difference of -4.90 (-5.80 a -4.00), p<0.0001] and in the follow-up [CI95% difference of -4.94 sec (-5.82 to -4.06), p<0.0001], which was our primary outcome. Significant between-groups differences were also found for all secondary outcomes (BBS, UPDRS-III, FRT, and PDQ-39) at 8th week and follow-up (16th week) assessments. Conclusions and relevance: We suggest the body suspension with tilting exercises protocol (the Chordata Method) improves functionality and quality of life in subjects with moderate PD. This evidence supports the Chordata method appears to be a new effective therapeutic option to treat Parkinson-related mobility and balance dysfunctions. / Import?ncia: A efic?cia da utiliza??o de exerc?cios de suspens?o e pendula??o corporal (m?todo Chordata) para o tratamento de sujeitos com a Doen?a de Parkinson ainda n?o foi testada. Objetivo: Realizar um estudo cl?nico para avaliar a efic?cia de um programa de exerc?cios de suspens?o e pendula??o corporal sobre a funcionalidade e qualidade de vida de sujeitos portadores da doen?a de Parkinson. Delineamento, M?todo e Participantes: Trata-se de um ensaio cl?nico, controlado e randomizado, com avaliador de desfecho alheio aos grupos experimentais. Um total de 48 sujeitos com diagn?stico m?dico de doen?a de Parkinson, de est?gio leve ? moderado, foram recrutados a partir do Servi?o de Neurologia do Hospital S?o Lucas da PUCRS, Brasil. O recrutamento ocorreu entre Setembro de 2015 e Maio de 2016. O protocol do estudo teve a dura??o de 16 semanas, sendo 8 semanas de pr?tica dos exerc?cios propostos, com iguais 8 semanas de seguimento (follow-up). Interven??o: Os sujeitos foram randomizados nos grupos interven??o (suspens?o e pendula??o corporal) e controle (alongamentos de grandes grupos musculares). Desfechos principais e medidas: O desfecho prim?rio do presente estudo foi o teste do Timed Up and Go ao final do protocolo de treinamento (8 semanas). Os desfechos secund?rios foram a Escala de Equil?brio de Berg (EEB); o teste do Alcance Funcional (TAF); a Escala Unificada da Doen?a de Parkinson, sess?o III (UPDRS-III) e o Question?rio de Qualidade de Vida na Doen?a de Parkinson (PDQ-39). Estes desfechos foram avalaidos nos momentos pr?-interven??o, ap?s, ao t?rmino do protocol de exerc?cios (8 semanas) e no per?odo de seguimento (16 semanas ap?s a randomiza??o). Resultados: De um total de 48 sujeitos randomizados, 20 participaram do grupo interven??o (71,3?6,3 anos de idade) e 20 do grupo controle (66,7?6,4 anos de idade). Oito sujeitos foram perdidos durante a execu??o do estudo (quarto em cada um dos grupos). A An?lise de co-vari?ncia, com ajuste para os dados basais, revelou uma diferen?a entre-grupos no teste do Timed Up and Go ao t?rmino do protocolo de exerc?cios (8 semanas) [diferen?a IC95%: -4,90 (-5,80 a -4,00), p<0,0001] e na avalia??o de seguimento [diferen?a IC95%: -4.94 sec (-5,82 to -4,06), p<0.0001], teste este estabelecido como o desfecho prim?rio. Diferen?as significativas tamb?m foram encontradas para todos os desfechos secund?rios (EEB, UPDRS-III, TAF e PDQ-39) em ambas as avalia??es p?s-interven??o (8 e 16 semanas ap?s a randimiza??o). Conclus?es e relev?ncia: Nossos resultados sugerem que os exerc?cios de suspens?o e pendula??o corporal s?o capazes de melhorar a funcionalidade e a qualidade de vida de sujeitos com a doen?a de Parkinson, em est?gio moderado. Esta evid?ncia suporta que o m?todo Chordata parece ser uma nova e efetiva interven??o terap?utica para o tratamento das desordens de mobilidade e equil?brio associadas ? doen?a de Parkinson.

Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2017-11-29T17:04:43Z No. of bitstreams: 1 VEDOVELLI_KELLEM_TESE.pdf: 2587462 bytes, checksum: 3fe069c3be1a03d543e406d18fdf3317 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-12-04T15:44:11Z (GMT) No. of bitstreams: 1 VEDOVELLI_KELLEM_TESE.pdf: 2587462 bytes, checksum: 3fe069c3be1a03d543e406d18fdf3317 (MD5) / Made available in DSpace on 2017-12-04T15:54:01Z (GMT). No. of bitstreams: 1 VEDOVELLI_KELLEM_TESE.pdf: 2587462 bytes, checksum: 3fe069c3be1a03d543e406d18fdf3317 (MD5) Previous issue date: 2017-08-25 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: Physical activity has been proposed as a promising intervention to improve cognition and decrease the risk of dementia in older adults. Brain-derived neurotrophic factor (BDNF) seems to mediate, at least partially, these effects of exercise. However, intervention studies of the effects of multimodal exercises on cognition and BDNF levels are scarce and composed by small samples. Thus, the generalization of the conclusions of these studies depends on the reproducibility of the results. Objective: to contribute to the knowledge on the field, the present study evaluated the effects of a physical activity intervention composed by muscle strengthening and aerobic conditioning on BDNF levels and cognition in older women. Methods: Twenty-two independent and non-demented subjects (? 75 years) were assigned to a three-month physical activity intervention (60 min exercise sessions three times a week, 30 min of muscle strengthening and 30 min of aerobic activity) or to a control condition (n= 10, no exercise). The clinical parameters (anxiety and depression symptoms), neuropsychological (Digit Span, Stroop, Trail Making and Contextual Memory tests), physical (upper and lower limb strength, aerobic conditioning) and physiological (serum BDNF) parameters were evaluated immediately before, one and three-months after starting intervention. Results: the control group had stable levels for all measured variables, whereas the intervention group improved on physical fitness, depressive symptoms, cognitive performance and BDNF levels. Moreover, a linear regression identified an association between aerobic conditioning and BDNF levels. Conclusion: The combination of muscle strengthening and aerobic conditioning was able to improve cognitive performance and increase BDNF levels. Aerobic conditioning seems to be an important mediator of these results. / Introdu??o: A atividade f?sica tem sido proposta como uma interven??o promissora para melhorar a cogni??o e diminuir o risco de dem?ncia em adultos mais velhos. O fator neurotr?fico derivado do c?rebro (BDNF) parece mediar, pelo menos parcialmente, esses efeitos do exerc?cio. Entretanto, os estudos de interven??o dos efeitos de exerc?cios multimodais sobre o desempenho cognitivo e os n?veis de BDNF s?o escassos e compostos por pequenas amostras. Assim, a generaliza??o das conclus?es destes estudos depende da reprodutibilidade dos resultados. Objetivo: avaliar os efeitos de uma interven??o de atividade f?sica composta pelo fortalecimento muscular e condicionamento aer?bico nos n?veis de BDNF e cogni??o em mulheres idosas, de modo a contribuir para o avan?o cient?fico na ?rea. M?todos: Idosas independentes e n?o demenciadas (? 75 anos) foram submetidas a uma interven??o de tr?s meses de atividade f?sica (n = 22, sess?es de exerc?cios de 60 min tr?s vezes por semana, sendo 30 min de fortalecimento muscular e 30 min de atividade aer?bia) ou a uma condi??o de controle (n = 10, sem exerc?cio). Foram avaliados os par?metros cl?nicos (sintomas de ansiedade e depress?o), neuropsicol?gicos (testes de Span de D?gitos, Stroop, Trail Making e Mem?ria Contextual), f?sicos (for?a dos membros superiores e inferiores, condicionamento aer?bico) e fisiol?gicos (BDNF s?rico) no in?cio do protocolo, 1 e 3 meses ap?s o in?cio da interven??o. Resultados: O grupo controle apresentou n?veis est?veis ao longo do tempo para todas as vari?veis medidas, ao passo que o grupo de interven??o melhorou a aptid?o f?sica, sintomas depressivos, desempenho cognitivo e n?veis de BDNF. Al?m disso, uma regress?o linear identificou uma associa??o entre o condicionamento aer?bio e os n?veis de BDNF. Conclus?o: A combina??o de fortalecimento muscular e condicionamento aer?bio foi capaz de melhorar o desempenho cognitivo e aumentar os n?veis de BDNF. O condicionamento aer?bio parece ser um importante mediador desses resultados.