Submitted by PPG Pediatria e Sa?de da Crian?a (pediatria-pg@pucrs.br) on 2018-03-19T10:57:55Z No. of bitstreams: 1 Tese Completa Sonia Manacero_21fev2018.pdf: 4706911 bytes, checksum: 69c66a334e78cd080b85788bdadf753d (MD5) / Approved for entry into archive by Tatiana Lopes (tatiana.lopes@pucrs.br) on 2018-04-03T12:27:53Z (GMT) No. of bitstreams: 1 Tese Completa Sonia Manacero_21fev2018.pdf: 4706911 bytes, checksum: 69c66a334e78cd080b85788bdadf753d (MD5) / Made available in DSpace on 2018-04-03T12:34:49Z (GMT). No. of bitstreams: 1 Tese Completa Sonia Manacero_21fev2018.pdf: 4706911 bytes, checksum: 69c66a334e78cd080b85788bdadf753d (MD5) Previous issue date: 2017-09-12 / Objective: To correlate motor development with characteristics of sleep during infancy in premature children with very low birth weight. Methods: An observational, longitudinal, prospective study was performed with 41 children with <32 weeks of gestational age at birth and birthweight ? 1,500 g who did not present neurological complications. At 6 and 12 months of corrected age, this group was evaluated regarding motor development (Denver Developmental Screening Test II [Denver II] and Alberta Infant Motor Scale [AIMS]) and sleep characteristics (Infant Sleep Questionnaire [BISQ]). At 4/5 years of age, the group of preterm children was again assessed regarding these aspects (using the Pediatric Evaluation of Disability Inventory [PEDI] and the Sleep Disturbance Scale for Children [SDSC]) and compared to a control group of randomly selected term infants evaluated with PEDI and SDSC. Results: AIMS showed atypical development in 65.9% of premature infants at 6 months and 63.4% at 12 months. According to Denver II, suspected delay was present in 73.2% and 70.7% of the sample at 6 and 12 months respectively. At 6 months, suspected delay (Denver II) and atypical development (AIMS) were associated with not sleeping sideways, greater number of awakenings, and longer awake periods. For AIMS, there was also an association between atypical development and having the child's sleep considered a problem by the parents at 6 months. At 12 months, there were no significant correlations between BISQ findings and the results of motor evaluations. At 4/5 years, the results of 32 preterm and 30 term children were considered. Motor delays (PEDI) were detected in 36.1% of preterm infants and 41.9% of controls, with no difference between the groups (p = 0.481). Sleep disorders were also statistically similar, observed in 56.3% of preterm children vs. 63.3% of controls (p = 0.757). At this age, the preterm group had an association with favorable scores in the PEDI self-care motor development domain and higher SDSC scores in sleep arousal and hyperhidrosis. For term children, total SDSC score and higher drowsiness scores were associated with worse motor assessment in the mobility domain. Conclusion: Motor development correlated with sleep quality at 6 months of corrected age and at 4/5 years of age in very low weight preterm infants. The observed association between higher self-care scores and presence of sleep arousal/hyperhidrosis at 4/5 years deserves further investigation. At 4/5 years, premature children were similar to full-term children both in terms of sleep disturbances and motor delay. / Objetivo: Correlacionar desenvolvimento motor com caracter?sticas do sono na primeira inf?ncia em prematuros de muito baixo peso ao nascer. M?todos: Foi realizado um estudo observacional, longitudinal e prospectivo com 41 crian?as nascidas com menos de 32 semanas de idade gestacional e peso ? 1.500 g, sem intercorr?ncias neurol?gicas. Ao 6 e 12 meses de idade corrigida, esse grupo foi avaliado quando ao desenvolvimento motor (Teste de Triagem de Desenvolvimento de Denver [TTDD-R] e Escala Motora Infantil de Alberta [AIMS]) e ?s caracter?sticas do sono (Avalia??o do Sono na Primeira Inf?ncia [BISQ]). Aos 4/5 anos de idade, os prematuros foram novamente avaliados quanto a esses aspectos (Invent?rio de Avalia??o Pedi?trica de Incapacidade [PEDI] e Escala de Dist?rbios do Sono [EDS]) e comparados a um grupo controle de 31 nascidos a termo selecionados aleatoriamente e avaliados com PEDI e EDS. Resultados: A AIMS detectou suspeita de atraso motor em 65,9% dos prematuros aos 6 meses e em 63,4% aos 12 meses. O TTDD-R detectou desenvolvimento anormal em 73,2% e 70,7% dos prematuros aos 6 e 12 meses, respectivamente. Aos 6 meses, desenvolvimento anormal (TTDD-R) e suspeita de atraso (AIMS) associaram-se a n?o dormir de lado, maior n?mero de despertares e maior tempo de vig?lia. Para a AIMS, houve ainda associa??o entre suspeita de atraso e ter o sono da crian?a considerado como um problema pelos pais aos 6 meses. Aos 12 meses, n?o houve correla??es significativas entre os resultados da BISQ e a avalia??o das escalas motoras. Aos 4/5 anos, foram considerados os resultados de 32 prematuros e 30 controles. Atraso motor (PEDI) foi detectado em 36,1% dos prematuros e em 41,9% dos controles, sem diferen?a entre os grupos (p = 0,481). Tamb?m n?o houve diferen?a estat?stica entre os grupos quanto aos dist?rbios do sono, observados em 56,3% dos prematuros e em 63,3% dos controles (p=0,757). Nessa idade, os prematuros tiveram associa??o entre melhor desenvolvimento motor do autocuidado e maiores escores nos dom?nios dist?rbios do despertar e hiperidrose do sono na EDS. Para os nascidos a termo, o escore total da EDS e escores maiores de sonol?ncia associaram-se a pior avalia??o motora no dom?nio de mobilidade. Conclus?o: O desenvolvimento motor correlacionou-se com a qualidade do sono aos 6 meses de idade corrigida e aos 4/5 anos em prematuros de muito baixo peso ao nascimento. As escalas motoras detectaram suspeita de atraso motor/desenvolvimento anormal em 2/3 dos prematuros tanto aos 6 como aos 12 meses de idade corrigida. Aos 4/5 anos, o sono dos prematuras foi semelhante ao das crian?as do grupo controle. A maioria dos prematuros teve desenvolvimento normal nessa idade, sem diferen?a significativa em rela??o ao grupo controle exceto pelo ?autocuidado?, que foi significativamente superior nos prematuros em compara??o aos nascidos a termo.

Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2018-03-28T12:58:45Z No. of bitstreams: 1 EDER_DE_MATTOS_BERG_DIS.pdf: 2245834 bytes, checksum: 6dc26fbfca633a45950f5bf64253410d (MD5) / Approved for entry into archive by Tatiana Lopes (tatiana.lopes@pucrs.br) on 2018-04-11T21:00:48Z (GMT) No. of bitstreams: 1 EDER_DE_MATTOS_BERG_DIS.pdf: 2245834 bytes, checksum: 6dc26fbfca633a45950f5bf64253410d (MD5) / Made available in DSpace on 2018-04-11T21:06:02Z (GMT). No. of bitstreams: 1 EDER_DE_MATTOS_BERG_DIS.pdf: 2245834 bytes, checksum: 6dc26fbfca633a45950f5bf64253410d (MD5) Previous issue date: 2016-09-29 / The teaching of Primary Health Care in undergraduate medical school has been a constant challenge for professors and educational institutions. It proposes an outpatient care distant from the students' day-to-day hospital practice and tends not to be a subject of greater interest to them. With the purpose of discussing the topic, this study evaluates the identification of the attributes of primary health care, the performance of a Family Health Unit in Porto Alegre, and the expectations and perception of what was performed by medical students before and after the completion of the Internship in Collective Health. In order to do so, the identification of primary care attributes, the evaluation of the integrality attribute through the questionnaire on Primary Health Care (PCA tools), and open-ended questions about the expectation and reality found in Family Health Units were used. Answer analysis was done using Bardin?s descriptive statistics and content analysis. As a result, at the end, students had identified more attributes of Primary Health Care, brought up important aspects in the evaluation of the Family Health Strategy Units, and their written answers to the open-ended questions about the internship evidenced the expectation and perception of what was performed in care and health education. / O ensino da Aten??o Prim?ria ? Sa?de na gradua??o do curso de Medicina tem sido um desafio constante para os docentes e institui??es. Prop?e uma medicina ambulatorial distante da pr?tica hospitalar cotidiana dos alunos e tende a n?o ser assunto de interesse maior dos mesmos. Com o objetivo de trazer a discuss?o para o tema, este estudo avalia a identifica??o dos atributos da aten??o prim?ria em sa?de, o desempenho de uma Unidade de Sa?de da Fam?lia em Porto Alegre, e as expectativas e percep??o do realizado em estudantes de medicina antes e ap?s a realiza??o do Internato em Sa?de Coletiva. Utiliza para isso a identifica??o dos atributos da Aten??o Prim?ria, a avalia??o do atributo integralidade pelo question?rio sobre Aten??o Prim?ria ? Sa?de (PCA tools) e quest?es abertas sobre a expectativa e realidade encontrada em Unidades de Sa?de da Fam?lia. A an?lise das respostas se fez por estat?stica descritiva e an?lise de conte?do, de Bardin. Como resultado, ao final, os alunos identificaram maior n?mero de atributos da Aten??o Prim?ria a Sa?de, trouxeram aspectos importantes na avalia??o das Unidades da estrat?gia de sa?de da fam?lia, e a leitura de suas falas em resposta ?s perguntas abertas sobre o est?gio evidenciou a expectativa e percep??o do realizado na aten??o e educa??o em sa?de.

Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2018-04-20T12:10:46Z No. of bitstreams: 1 Margutti_Karen_Mello_de_Mattos_ tese.pdf: 6049377 bytes, checksum: 724239d57250b5e008279fb0a6c837db (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2018-05-08T17:17:36Z (GMT) No. of bitstreams: 1 Margutti_Karen_Mello_de_Mattos_ tese.pdf: 6049377 bytes, checksum: 724239d57250b5e008279fb0a6c837db (MD5) / Made available in DSpace on 2018-05-08T17:23:52Z (GMT). No. of bitstreams: 1 Margutti_Karen_Mello_de_Mattos_ tese.pdf: 6049377 bytes, checksum: 724239d57250b5e008279fb0a6c837db (MD5) Previous issue date: 2017-12-18 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Sarcopenia is defined as the presence of low muscle mass associated with low muscle strength and/or low physical performance. The outset and evolution of sarcopenia is marked by Inflammation. Studies have shown that supplementation with polyunsaturated fatty acids (PUFAs) may modulate the inflammatory response, thereby aiding protein synthesis and muscle anabolism. Four articles are presented in this thesis, one a systematic literature review and three original articles (cross-sectional design, involving 400 elderly participants of community social groups). The first article, INFLAMMATORY MARKERS, SARCOPENIA AND ITS DIAGNOSTIC CRITERIA IN THE ELDERLY: A SYSTEMATIC REVIEW, sought to understand the relationship between inflammatory markers and sarcopenia and their diagnostic criteria in the elderly. Four of the 154 pre-selected articles were included. An association was found between the inflammatory markers only and the diagnostic criteria of sarcopenia. The second article, SARCOPENIA AND ITS DIAGNOSTIC CRITERIA IN THE ELDERLY: DESCRIPTION OF FREQUENCY AND ASSOCIATION WITH GENDER, AGE, NUTRITIONAL STATUS AND LEVEL OF PHYSICAL ACTIVITY, described the frequency of sarcopenia and its diagnostic criteria, and analyzed its association with gender, age, nutritional status and level of physical activity. The prevalence of sarcopenia was 27.8%, found more frequently in men (50.0%-P<0.001) and those ?80 years (46.3%-P=0.005). Low muscle mass was more common in men, while low muscle strength and low physical performance were more frequent in the elderly ?80 years. No association was found between sarcopenia and its diagnostic criteria with nutritional status and level of physical activity. The third article, POLYUNSATURATED FATTY ACIDS IN THE COMMUNITY ELDERLY: DESCRIPTION OF SERUM CONCENTRATIONS AND DIETARY INTAKE, AND ASSOCIATION WITH SARCOPENIA AND ITS DIAGNOSTIC CRITERIA, detailed the serum concentrations and dietary intake of PUFAs, and analyzed their association with sarcopenia and its diagnostic criteria. Serum PUFA concentrations were not associated with sarcopenia. Higher concentrations of dihomo-gamma-linolenic and adrenal acids were associated with low muscle strength and low physical performance, respectively. A lower consumption of PUFA was observed in relation to the recommended and lower omega 6/omega 3 ratio among people with sarcopenia. No association was found between PUFA consumption and diagnostic criteria. The fourth article, INFLAMMATORY BIOMARKERS, SARCOPENIA AND ITS DIAGNOSTIC CRITERIA IN THE SOCIALLY ACTIVE ELDERLY, described the serum concentrations of inflammatory markers and evaluated their association with sarcopenia and its diagnostic criteria. Sarcopenia was associated with lower concentrations of adiponectina. Low muscle mass and low muscle strength were associated with lower adiponectin concentrations and higher hs-CRP, respectively. Low physical performance was associated with lower concentrations of IL-10 and adiponectin, and higher concentrations of IL-6 and TNF-?. Women and the overweight elderly with sarcopenia presented lower concentrations of adiponectin. In conclusion, a high prevalence of sarcopenia was observed in the socially active elderly. The lower food intake of PUFA highlights the need for nutritional interventions. The relationship between sarcopenia and its diagnostic criteria with serum polyunsaturated fatty acid concentrations and inflammatory markers indicates the need to develop new research in order to clarify the mechanisms involved. Further studies are suggested to advance the investigation of PUFA and inflammatory marker interactions in sarcopenia. / A sarcopenia ? definida como a presen?a de baixa massa muscular associada ? baixa for?a muscular e/ou baixo desempenho f?sico. Na g?nese e evolu??o da sarcopenia, encontra-se a inflama??o. Estudos t?m demonstrado que a suplementa??o de ?cidos graxos poli-insaturados (PUFA) pode modular a resposta inflamat?ria, auxiliando a s?ntese proteica e o anabolismo muscular. Nesta tese, s?o apresentados quatro artigos, um de revis?o sistem?tica e tr?s originais (com delineamento transversal, no qual foram avaliados 400 idosos frequentadores de grupos de conviv?ncia). No primeiro artigo, MARCADORES INFLAMAT?RIOS, SARCOPENIA E SEUS CRIT?RIOS DIAGN?STICOS EM IDOSOS: UMA REVIS?O SISTEM?TICA, buscou-se conhecer a rela??o de marcadores inflamat?rios com sarcopenia e seus crit?rios diagn?sticos em idosos. De 154 artigos pr?-selecionados, foram inclu?dos quatro. Verificou-se associa??o de marcadores inflamat?rios somente com os crit?rios diagn?sticos de sarcopenia. No segundo artigo, SARCOPENIA E SEUS CRIT?RIOS DIAGN?STICOS EM IDOSOS: DESCRI??O DA FREQU?NCIA E ASSOCIA??O COM SEXO, IDADE, ESTADO NUTRICIONAL E N?VEL DE ATIVIDADE F?SICA, foi descrita a frequ?ncia de sarcopenia e de seus crit?rios diagn?sticos e analisada a associa??o com sexo, idade, estado nutricional e n?vel de atividade f?sica. A preval?ncia de sarcopenia foi 27,8%, sendo mais frequente nos indiv?duos masculinos (50,0%-P<0,001) e ?80 anos (46,3%-P=0,05). Baixa massa muscular foi mais frequente nos homens. Baixa for?a muscular e baixo desempenho f?sico foram mais frequentes nos idosos ? 80 anos. N?o houve associa??o de sarcopenia e seus crit?rios com estado nutricional e n?vel de atividade f?sica. No terceiro artigo, ?CIDOS GRAXOS POLI-INSATURADOS EM IDOSOS DA COMUNIDADE: DESCRI??O DAS CONCENTRA??ES S?RICAS E DO CONSUMO ALIMENTAR E ASSOCIA??O COM SARCOPENIA E SEUS CRIT?RIOS DIAGN?STICOS, foram descritas as concentra??es s?ricas e o consumo alimentar de PUFA e analisou-se a sua associa??o com sarcopenia e seus crit?rios diagn?sticos. Concentra??es s?ricas de PUFA n?o se associaram com a sarcopenia. Maiores concentra??es dos ?cidos di-homo-gama-linol?nico e adr?nico associaram-se com baixa for?a muscular e baixo desempenho f?sico, respectivamente. Houve menor consumo de PUFA, em rela??o ao preconizado, e menor raz?o ?mega 6/?mega 3 entre sarcop?nicos. N?o houve associa??o entre consumo de PUFA e crit?rios diagn?sticos. No quarto artigo, BIOMARCADORES INFLAMAT?RIOS, SARCOPENIA E SEUS CRIT?RIOS DIAGN?STICOS EM IDOSOS SOCIALMENTE ATIVOS, foram descritas as concentra??es s?ricas dos marcadores inflamat?rios e avaliada a sua associa??o com a sarcopenia e seus crit?rios diagn?sticos. A sarcopenia associou-se com menores concentra??es de adiponectina. Baixa massa muscular e baixa for?a muscular associaram-se com menores concentra??es de adiponectina e maiores de PCR-us, respectivamente. O baixo desempenho f?sico associou-se com menores concentra??es de IL-10 e adiponectina e maiores de IL-6 e TNF-?. Mulheres sarcop?nicas e idosos sarcop?nicos com sobrepeso apresentaram menores concentra??es de adiponectina. Concluindo, em idosos socialmente ativos, observou-se alta preval?ncia de sarcopenia. O menor consumo alimentar de PUFA salienta a necessidade de interven??es nutricionais. A rela??o entre sarcopenia e seus crit?rios diagn?sticos com as concentra??es s?ricas de ?cidos graxos poli-insaturados e marcadores inflamat?rios instiga o desenvolvimento de novas investiga??es a fim de elucidar os mecanismos envolvidos. Sugere-se a realiza??o de estudos adicionais para avan?ar na investiga??o da intera??o dos PUFA e marcadores inflamat?rios na sarcopenia.

Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2018-04-11T11:15:05Z No. of bitstreams: 1 ESTRELA_ANDR?_LUIZ_TESE.pdf: 1897914 bytes, checksum: bc738b6c1a1424f1afbfa49e4d8acac1 (MD5) / Rejected by Caroline Xavier (caroline.xavier@pucrs.br), reason: Devolvido devido ? data de defesa cadastrada na publica??o (21/02/2017) estar diferente da data de defesa que consta na folha de aprova??o da banca (26/01/2017) no arquivo PDF, e o ano que consta na ficha catalogr?fica (2016) est? diferente do restante do arquivo PDF (2017). on 2018-04-26T16:32:53Z (GMT) / Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2018-04-27T16:45:53Z No. of bitstreams: 1 ESTRELA_ANDRE_LUIZ_TESE.pdf: 2000480 bytes, checksum: 0cf023323652932ee9da95b8b9900817 (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-05-09T18:34:07Z (GMT) No. of bitstreams: 1 ESTRELA_ANDRE_LUIZ_TESE.pdf: 2000480 bytes, checksum: 0cf023323652932ee9da95b8b9900817 (MD5) / Made available in DSpace on 2018-05-09T18:55:27Z (GMT). No. of bitstreams: 1 ESTRELA_ANDRE_LUIZ_TESE.pdf: 2000480 bytes, checksum: 0cf023323652932ee9da95b8b9900817 (MD5) Previous issue date: 2017-02-21 / INTRODUCTION: To verify if there are differences in the hormonal, immunological, redox, chronotropic and physical performance thresholds between two levels of active elderly training induced at two maximum and consecutive sessions in the short term. METHODS: Forty marathon runners were divided based on training load: a higher volume group (n = 19, training ~ 480 min / week) and a smaller group volume (n = 21, training ~ 240 min / week). Inflammatory proteins (PRC, TNF-?, IL-6) and plasma oxidative stress biomarkers (protein carbonyls, total thiols), plasma antioxidant enzyme activity (superoxide dismutase, SOD, glutathione peroxidase, GPx) and testosterone and salivary cortisol, Were evaluated at rest (baseline) and in response to the cumulative effect of the two maximal exercise tests, separated by four hours of rest. RESULTS: Most of the parameters were similar between the groups at the beginning of the study, except the lower volume group exhibited higher CRP (+ 60%, p <0.05), higher protein carbonyls (+ 23%, p = 0, 07) and lower SOD activity (-4%, p = 0.06) compared to the higher volume group. TNF-? decreased in response to the cumulative effect of similar acute exercise in both groups (ie, baseline vs. one sample collected after the second exercise session), whereas CRP increased differently (+ 60% % Higher group volume, interaction effect p <0.05). IL-6 did not change in any of the groups. Protein carbonyls decreased and total thiols increased similarly in both groups in response to exercise (p<0.05), but SOD activity differentially declined (-14% lower volume, -20% of the higher volume group, Interaction effect p <0.05). GPx did not change in either group. Salivary testosterone decreased in response to exercise was similar in both groups (p <0.05), whereas cortisol did not change. CONCLUSION: Individuals involved in higher volume training have a lower inflammatory response induced by exercise, and a greater decline in the activity of some antioxidant enzymes in post-exercise plasma, compared with individuals engaging in low volume exercise. / INTRODU??O: Conhecemos muito pouco sobre os efeitos fisiol?gicos do treinamento pesado em atletas idosos. Nesse estudo, verificamos se h? diferen?as nos limiares hormonais, imunol?gicos, redox, cronotr?picos e de desempenho f?sico entre dois n?veis de treinamento de idosos ativos induzidos a duas sess?es m?ximas e consecutivas em curto prazo. M?TODOS: Quarenta maratonistas foram divididos com base na carga de treinamento: um grupo de maior volume (n = 19, treinamento ~ 480 min / semana) e um grupo menor volume (n = 21, treinamento ~ 240 min / semana). Prote?nas inflamat?rias [prote?na C reativa (PCR), fator de necrose tumoral (TNF)-?, interleucina (IL)-6] e biomarcadores de stress oxidativo plasmaticos (carbonilos proteicos, ti?is totais), a atividade da enzima antioxidante plasm?tica (super?xido dismutase, SOD; glutationa peroxidase, GPx) e testosterona e cortisol salivar, foram avaliados em repouso (linha de base) e em resposta ao efeito acumulado dos dois testes m?ximos de exerc?cio, separados por quatro horas de descanso. RESULTADOS: A maioria dos par?metros eram semelhantes entre os grupos no in?cio do estudo, exceto o grupo de menor volume exibiu maior PCR (+ 60%, p <0,05), carbonilos de prote?nas maiores (+ 23%, p = 0,07) e menor atividade SOD (-4%, p = 0,06) em compara??o com o grupo de maior volume. O TNF-? diminuiu em resposta ao efeito acumulado de exerc?cio agudo de maneira semelhante nos dois grupos (ou seja, linha de base vs. uma amostra coletada ap?s a segunda sess?o de exerc?cio), enquanto PCR aumentou diferencialmente (+ 60% menor volume; + 24% maior volume grupo, efeito de interac??o p <0,05). A citocina IL-6 n?o se alterou em qualquer dos grupos. Os carbonilos de prote?nas diminuiram e os ti?is totais aumentaram de maneira similar em ambos os grupos em resposta ao exerc?cio (p<0,05), mas a atividade da SOD declinou diferencialmente (-14% menor volume; -20% do grupo de maior volume, efeito de intera??o p <0,05). A GPx n?o se alterou em nenhum dos grupos. A testosterona salivar diminu?da em resposta ao exerc?cio foi semelhante em ambos os grupos (p <0,05), ao passo que o cortisol n?o se alterou. CONCLUS?O: Indiv?duos idosos envolvidos em treinamento de maior volume apresentam uma resposta inflamat?ria menor induzida pelo exerc?cio, e um decl?nio maior na atividade de algumas enzimas antioxidantes no plasma p?s-exerc?cio, em compara??o com os idosos envolvidos em exerc?cios de baixo volume.

Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2018-05-04T19:02:47Z No. of bitstreams: 1 CHRISTINA_PIMENTEL_OPPERMANN_KUSSLER.pdf: 1245692 bytes, checksum: dfe118de17f82c070a6bae2300e41933 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2018-05-14T12:19:33Z (GMT) No. of bitstreams: 1 CHRISTINA_PIMENTEL_OPPERMANN_KUSSLER.pdf: 1245692 bytes, checksum: dfe118de17f82c070a6bae2300e41933 (MD5) / Made available in DSpace on 2018-05-14T12:22:46Z (GMT). No. of bitstreams: 1 CHRISTINA_PIMENTEL_OPPERMANN_KUSSLER.pdf: 1245692 bytes, checksum: dfe118de17f82c070a6bae2300e41933 (MD5) Previous issue date: 2017-12-26 / Introduction: endometrial cancer is the most prevalent gynecological neoplasm in developed countries and the second most prevalent in Brazil, second only to cervical cancer. It corresponds to 5% of cancers in women worldwide. The majority of cases present as initial disease, and surgical treatment is curative. Few treatment options exist for patients with poor prognostic factors and advanced disease, and the process of carcinogenesis in endometrial cancer has not been fully elucidated. Sirtuins are proteins involved in several cellular processes. The family of these proteins is composed of seven sirtuins (SIRT1-SIRT7). They present specific cell locations, acting in a variety of processes, including regulation of gene transcription, genomic stability, metabolic control, cell cycle regulation, and cell survival. Few studies have evaluated the role of sirtuins in endometrial cancer as well as its association with prognostic factors. Objective: to evaluate the expression of SIRT1 and SIRT7 enzymes in histological samples of endometrial carcinoma of patients operated at Hospital S?o Lucas (Pontif?cia Universidade Cat?lica) between January 2000 and December 2015 and associate the expression of these proteins with the pathological staging and prognostic factors. Materials and Methods: we performed a retrospective study evaluating 66 samples of patients with endometrial cancer from January 2000 to December 2015. The expression of SIRT1 and SIRT7 proteins was identified by the immunohistochemical technique and quantified by the Allred score. The expression of these proteins in cancer samples was correlated with the prognostic factors: age, tumor grade, tumor size, myometrial invasion, lymphovascular invasion and pathological staging. Results: SIRT 1 expression was positive in 40.9% of samples and SIRT7 expression in 24.1% of cases. Expression of these proteins did not present a statistically significant association with any of the adverse prognostic factors in endometrial cancer. Conclusions: endometrial cancer samples were positive for both SIRT1 and SIRT7, but without correlation in the study with prognostic factors. Expression of these proteins in samples of endometrial cancer may represent a possible therapeutic target to be developed in future studies. / Introdu??o: O c?ncer de endom?trio ? a neoplasia maligna ginecol?gica mais prevalente nos pa?ses desenvolvidos e a segunda mais prevalente no Brasil, menos freq?ente apenas do que o c?ncer de colo uterino. Corresponde a 5% dos c?nceres em mulheres no mundo. A maioria dos casos se apresenta como doen?a inicial, sendo o tratamento cir?rgico curativo. Existem poucas op??es de tratamento para pacientes com fatores progn?sticos adversos e com doen?a avan?ada, sendo ainda pouco elucidado o processo de carcinog?nese no c?ncer de endom?trio. As sirtu?nas s?o prote?nas envolvidas em diversos processos celulares. Sua fam?lia ? composta por sete sirtu?nas (SIRT1-SIRT7). Apresentam localiza??es celulares espec?ficas, atuando em uma s?rie de processos, incluindo a regula??o da transcri??o g?nica, estabilidade gen?mica, controle metab?lico, regula??o do ciclo celular e sobreviv?ncia celular. Poucos estudos avaliaram o papel das sirtu?nas no c?ncer de endom?trio, bem como a sua associa??o com fatores progn?sticos. Objetivo: avaliar a express?o das enzimas SIRT1 e SIRT7 em amostras histol?gicas de carcinoma de endom?trio de pacientes operadas no Hospital S?o Lucas da Pontif?cia Universidade Cat?lica do Rio Grande do Sul (PUCRS) no per?odo de janeiro de 2000 a dezembro de 2015 e associar a express?o dessas prote?nas com o estadiamento patol?gico e fatores progn?sticos. M?todos: foi realizado um estudo retrospectivo com a avalia??o de 66 amostras de pacientes com c?ncer de endom?trio no per?odo de janeiro de 2000 at? dezembro de 2015. A express?o das prote?nas SIRT1 e SIRT7 foi identificada pela t?cnica de imunohistoqu?mica e quantificada pelo escore de Allred. A express?o dessas prote?nas nas amostras de neoplasia foi correlacionada com os fatores progn?sticos: idade, grau tumoral, tamanho do tumor, invas?o miometrial, invas?o linfovascular e estadiamento patol?gico. Resultados: a express?o de SIRT1 foi positiva em 40.9% das amostras e a de SIRT7 em 24.1% dos casos. A express?o dessas prote?nas n?o apresentou associa??o estatisticamente significativa com nenhum dos fatores progn?sticos adversos no c?ncer de endom?trio. Conclus?es: as amostras de c?ncer de endom?trio apresentaram positividade, tanto para SIRT1 quanto para SIRT7, mas sem correla??o com fatores progn?sticos. A express?o dessas prote?nas em amostras de neoplasia de endom?trio pode significar um poss?vel alvo terap?utico a ser estudado e desenvolvido em estudos futuros.

Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2018-05-04T19:10:28Z No. of bitstreams: 1 B?RBARA_FREIBERGER_SCHAEFER.pdf: 1176504 bytes, checksum: 78558bd375bc4c7f9afcb46a36c0d9a9 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2018-05-14T12:54:32Z (GMT) No. of bitstreams: 1 B?RBARA_FREIBERGER_SCHAEFER.pdf: 1176504 bytes, checksum: 78558bd375bc4c7f9afcb46a36c0d9a9 (MD5) / Made available in DSpace on 2018-05-14T12:59:21Z (GMT). No. of bitstreams: 1 B?RBARA_FREIBERGER_SCHAEFER.pdf: 1176504 bytes, checksum: 78558bd375bc4c7f9afcb46a36c0d9a9 (MD5) Previous issue date: 2018-02-26 / Introduction: The medical interview is fundamental for the approximation and recognition of the patient, and the physical examination usually increases the diagnostic possibility in the investigation. Technological development and immense diagnostic possibilities through complementary examinations have led to the idea of lesser importance of anamnesis and physical examination. Objective: To evaluate the undergraduate medical student's ability to perform a correct clinical diagnosis, from the presentation of clinical cases with information only from anamnesis or anamnesis and clinical examination together, without complementary exams. Methodology: A cross-sectional, exploratory study with quantitative data analysis of four clinical cases (two with isolated anamnesis and two with anamnesis and physical examination) answered by the students as a teaching task of the Medical Clinic discipline, with 97 academics from the School of Medicine of PUCRS from 2016 to 2017. Results: The findings showed that the majority of the students who participated in the study were female (54 subjects - 55.7%), predominantly white (94 - 96.9%), on average of 24.1 (+ 2.3) years old, having correctly determined 177 diagnoses (45.62%) in the first hypothesis. There was a significant difference (p <0.001) when compared the number of correct diagnosis in clinical cases with isolated anamnesis 108 (55.6%) to those with anamnesis and physical examination 69 (35.6%). Conclusion: It was verified that, for the undergraduate medical students of the fourth year from the School of Medicine, the correct answers in the first diagnosis were more frequent and with statistical significance, when clinical cases with isolated anamnesis were offered than when it was offered anamnesis and physical examination. / Introdu??o: A entrevista m?dica ? fundamental para a aproxima??o e reconhecimento do paciente, e o exame f?sico, habitualmente, aumenta a possibilidade diagn?stica na investiga??o. O desenvolvimento tecnol?gico e as imensas possibilidades diagn?sticas atrav?s dos exames complementares t?m levado ? ideia de menor import?ncia da anamnese e exame f?sico. Objetivo: Avaliar o n?mero de ocorr?ncias de diagn?sticos etiol?gicos adequados a partir da Anamnese e Exame F?sico, sem exames complementares, realizados por acad?micos do curso de gradua??o em Medicina. Metodologia: Estudo explorat?rio, transversal, com an?lise quantitativa dos dados, a partir de quatro casos cl?nicos (dois com anamnese isolada e dois com anamnese mais exame f?sico) preenchidos pelos alunos como tarefa de ensino aprendizagem da disciplina de Cl?nica M?dica, com 97 acad?micos de medicina da Escola de Medicina da PUCRS, no ano de 2016 e 2017. Resultados: Os achados evidenciaram que a maior parte dos acad?micos participantes do estudo eram do sexo feminino 54 (55,7%), predominantemente da ra?a branca 94 (96,9%), tinham em m?dia 24,1 (+ 2,3) anos, e que acertaram 177 diagn?sticos (45,62%) na primeira hip?tese. Houve diferen?a significativa (p<0,001) quando comparado o n?mero de acertos no diagn?stico em casos cl?nicos com anamnese isolada 108 (55,6%) comparado com aqueles com anamnese mais o exame f?sico 69 (35,6%). Conclus?o: Verificou-se que, para alunos de medicina do quarto ano de gradua??o da escola m?dica, os acertos com o primeiro diagn?stico foram mais frequentes e com signific?ncia estat?stica quando eram oferecidos casos cl?nicos com anamnese isoladamente do que quando se oferecia anamnese mais o exame f?sico.

Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2018-06-12T14:01:32Z No. of bitstreams: 1 EVANDRA_DURAYSKI.pdf: 1831041 bytes, checksum: 14177d40991ac101fe309c07dd96d0a7 (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-06-22T18:42:06Z (GMT) No. of bitstreams: 1 EVANDRA_DURAYSKI.pdf: 1831041 bytes, checksum: 14177d40991ac101fe309c07dd96d0a7 (MD5) / Made available in DSpace on 2018-06-22T18:51:12Z (GMT). No. of bitstreams: 1 EVANDRA_DURAYSKI.pdf: 1831041 bytes, checksum: 14177d40991ac101fe309c07dd96d0a7 (MD5) Previous issue date: 2018-03-07 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / Introduction: Crohn's disease (CD) is an idiopathic inflammatory bowel disease, which mainly affects the terminal ileum A biopsy colonoscopy with regard to the gold standard in the assessment of disease and the area of education costly and with anesthetic risks. Noninvasive methods of evaluation such as magnetic resonance enterography (MRE) have been developed in the last decade. Evaluation systems such as the magnetic resonance index of activity (MaRIA) and Clermont score are used in clinical studies to quantify inflammation in patients with CD. A diffusion-weighted magnetic resonance imaging (DWI) evaluates a restitution of the water molecules in the tissues. Studies have shown a correlation between a restriction of diffusion on the wall of the intestine with inflammation. However, few studies with MRE of 3 Tesla support analysis a apparent diffusion coefficient (ADC) correlactionan in inflammatory proces in the terminal ileum. Purpose: To determine the applicability of the sequence DWI in 3 Tesla MRE in the identification of inflammatory signs in the distal ileum in patients with Crohn?s disease. Materials and Methods: We retrospectively studied 38 individuals with CD, who underwent MRE between March 2014 to september 2017 and had an anatomopathological and endoscopic evaluation in the distal ileum. The following variables were evaluated: diffusion (DWI), quantitative ADC, wall thickening, intramural edema, ulcerations, stricture, segmental mural hyperenhancement, relativo contrast enchancement (RCE), MaRIA and Clermont score. Results: The mean duration of the disease was 7 ? 5 years, 19 patients (50%) were male. Eighteen patients (47%) had active inflammatory disease and twenthy (53%) had disease in remission in the terminal ileum. Patients with active inflammatory disease in the distal ileum had a greater restriction on DWI, intramural edema, wall thickening, MaRIA and Clermont score, when compared to the group of patients without inflammation. The correlation between MaRIA and Clermont score (r = 0.975) was strong. The Kappa coefficient of interobserver agreement was excellent for the MaRIA, Clermont score and restriction DWI, moderate for ADC and weak for RCE. The best cut-off point in this study for the inflammation identified by the colonoscopy for the ADC was 2.1x103mm2/s, with sensitivity of 88.8% and specificity of 95.0%. The DWI presented accuracy of 89.4%, sensitivity of 88.9% and specificity of 90.0% in relation to inflammation identified by colonoscopy. Conclusion: The quantitative values of ADC have a good sensitivity in detecting inflammation at colonoscopy. Analysis of the diffusion sequence of good accuracy in the detection of ileum inflammmation in patients with Crohn's disease. However, when in association with intramural enhancement, edema and wall thickening it has a strong correlation with severe inflammation identified at colonoscopy. / Introdu??o: A Doen?a de Crohn (DC) ? uma doen?a inflamat?ria intestinal idiop?tica, que acomete principalmente o ?leo terminal. A colonoscopia seguida de bi?psia, apesar de ser considerada o padr?o-ouro na avalia??o de doen?a ativa, ? uma ferramenta de monitoramento onerosa e com riscos anest?sicos. M?todos de avalia??o n?o invasivos, como a enterorresson?ncia (Entero-RM), foram desenvolvidos na ?ltima d?cada. Os sistema de pontua??o como o ?ndice MaRIA e escore de Clermont s?o utilizados em estudos cl?nicos para quantificar a inflama??o em pacientes com DC. A difus?o ? uma sequ?ncia da resson?ncia que avalia a restri??o das m?leculas de ?gua nos tecidos. Estudos demonstraram correla??o entre a restri??o da difus?o na parede do intestino com a inflama??o. Entretanto, poucos estudos com a Entero-RM de 3 Tesla avaliaram se a an?lise quantitativa do ADC (coeficiente de difus?o aparente) teria sensibilidade na avalia??o de processo inflamat?rio no ?leo terminal. Objetivos: Determinar a aplicabilidade da sequ?ncia de Difus?o na Entero-RM de 3 Tesla na identifica??o de sinais inflamat?rios no ?leo distal em pacientes com DC. Materiais e M?todos: Foram estudados retrospectivamente 38 indiv?duos com DC, submetidos a entero-RM no per?odo mar?o de 2014 a setembro de 2017 e que tinham avalia??o anatomopatol?gica e endosc?pica no ?leo distal. Foram avaliadas a seguintes vari?veis: difus?o, ADC quantitativo, espessamento parietal, edema, ulcera??es, estreitamento, realce pelo contraste, realce relativo ao contraste (RCE), ?ndice MaRIA e escore de Clermont. Resultados: A m?dia da dura??o da doen?a foi de 7 ? 5 anos, 19 pacientes (50%) eram do sexo masculino. Dezoito pacientes (47%) tinham doen?a inflamat?ria ativa e 20 (53%) tinham doen?a em remiss?o no ?leo terminal. Os pacientes que apresentavam doen?a inflamat?ria ativa no ?leo distal tiveram maior restri??o a difus?o, edema na mucosa, espessamento parietal, ?ndice de MaRIA e maior valor no escore de Clermont, quando comparados com o grupo de pacientes sem inflama??o. Foi forte a correla??o entre o ?ndice MaRIA com o escore de Clermont (r=0,975). O Coeficiente Kappa de concord?ncia interobservador foi excelente para ?ndice MaRIA, escore de Clermont e restri??o a difus?o, moderada para ADC e fraca para o RCE. O melhor ponto de corte neste estudo para a inflama??o identificada pela colonoscopia para o ADC foi de 2,1x10-3mm2/s, com sensibilidade de 88,8% e especificidade de 95,0%. A sequ?ncia da difus?o apresentou acur?cia de 89,4%, sensibilidade de 88,9% e especificidade de 90,0% em rela??o a inflama??o identificada pela colonoscopia. Conclus?o: Os valores quantitativos do ADC t?m uma boa sensibilidade na detec??o de inflama??o na colonoscopia. A an?lise da sequ?ncia da difus?o tem boa acur?cia na detec??o de segmentos intestinais ileais inflamados em pacientes com doen?a de Crohn. Em suma, quando a restri??o a difus?o tem associa??o com realce, edema e espessura da parede, aumenta a correla??o com a inflama??o severa identificada na colonoscopia.

Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2018-06-14T11:20:47Z No. of bitstreams: 1 CARLA_FERNANDA_FURTADO_GARDANI.pdf: 1897020 bytes, checksum: 89528b1ce682182124c46409102c1c92 (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-06-25T13:28:22Z (GMT) No. of bitstreams: 1 CARLA_FERNANDA_FURTADO_GARDANI.pdf: 1897020 bytes, checksum: 89528b1ce682182124c46409102c1c92 (MD5) / Made available in DSpace on 2018-06-25T13:36:30Z (GMT). No. of bitstreams: 1 CARLA_FERNANDA_FURTADO_GARDANI.pdf: 1897020 bytes, checksum: 89528b1ce682182124c46409102c1c92 (MD5) Previous issue date: 2018-03-28 / Prostate cancer (PC) is the second most diagnosed neoplasm in men, with the exception of non- melanocytic skin tumors. Its global incidence is 1.1 million cases per year and its mortality rate is around 307,000 deaths. Around the world, there are 3,850,000 CP survivors, since their survival in five years reaches values exceeding 80%. Therefore, adequate stratification in the diagnosis and follow-up of these patients is so relevant. In this study, we aimed of evaluating ATP / ADP / AMP hydrolysis as a prognostic biomarker in the CP; CD39 and CD73 enzymes are known to be responsible for the transformation of ATP or ADP into AMP and into adenosine, respectively. Blood samples were collected from 29 patients treated at the Cruz Alta Oncology and Hematology Center (COHCA) and 17 healthy controls (CS), in order to evaluate the hydrolysis activity of ATP, ADP and AMP and to correlate the data between the cases and controls. In addition, the results of hydrolysis were correlated with recognized prognostic factors as Gleason Score (EG), clinical stage (EC) and PSA levels. The mean age of the selected patients was 63.3 years, 71.4% presented PSA <10 at diagnosis, 82.7% were grouped as low in EG and 48.3% of patients belonged to EC IIB. The results demonstrated statistically significant differences in the nucleotide hydrolysis profiles of the cases and controls. In the CP patients the AMP hydrolysis was higher when compared to the hydrolysis of ATP and ADP. Regarding the clinical staging, it was observed that the hydrolysis of ATP was higher in the initial clinical stages, whereas the AMPase remained high regardless of clinical stage. Therefore, we can conclude that the understanding of the ectonucleotidases activities and their influence on tumor progression can collaborate for the diagnostic and improve the therapeutic approach for this neoplasia. / O c?ncer de pr?stata (CP) ? a segunda neoplasia mais diagnosticada no sexo masculino, excetuando-se os tumores de pele n?o melanoc?ticos, por ano sua incid?ncia mundial ? de 1,1 milh?es de casos e sua taxa de mortalidade de cerca de 307.000 ?bitos. Ao redor do mundo h? 3.850.000 sobreviventes de CP, visto que sua sobrevida em cinco 5 anos chega a valores superiores a 80%. Portanto, a estratifica??o adequada no diagn?stico e no seguimento destes pacientes ? muito relevante. Neste estudo objetivou-se avaliar a hidr?lise dos nucleot?deos ATP/ADP/AMP como biomarcadores progn?sticos no CP. Sabidamente as enzimas CD39 e CD73 s?o as principais respons?veis, respectivamente, pela transforma??o de ATP ou ADP em AMP, e este em adenosina. Foram coletadas amostras sangu?neas de 29 pacientes tratados no Centro de Oncologia e Hematologia de Cruz Alta ? COHCA e 17 controles sadios (CS), com o objetivo de avaliar a atividade de hidr?lise do ATP, ADP e AMP e correlacionar os dados entre os casos e controles. Al?m disso, os dados de hidr?lise foram correlacionados com fatores progn?sticos reconhecidos como escala de Gleason (EG), est?gio cl?nico (EC) e n?veis de PSA. A m?dia de idade dos pacientes selecionados foi de 63,3 anos, 71,4% apresentavam PSA < 10 no diagn?stico, 82,7% estavam agrupados como baixo grau na EG e 48,3% dos pacientes pertenciam ao EC IIB. Os resultados demonstraram diferen?as estatisticamente significativas nos perfis de hidr?lise de nucleot?deos entre casos e controles. Nos portadores de CP a hidr?lise do AMP foi mais elevada quando comparada com as hidr?lises de ATP e ADP. Em rela??o ao estadiamento cl?nico, observou-se que a hidr?lise de ATP foi maior nos est?gios cl?nicos iniciais, enquanto que a AMPase se manteve elevada independentemente do est?gio cl?nico. Portanto, pode-se concluir que o estudo da atividade das enzimas ectonucleotidases e o entendimento do CP pode colaborar na compreens?o dos fatores que influenciam a progress?o tumoral, visando melhorar o diagn?stico e a abordagem terap?utica para esta neoplasia.

Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2018-06-19T17:36:21Z No. of bitstreams: 1 GHENO_FLAVIA_PICOLI_DIS.pdf: 1195829 bytes, checksum: 156cb51070a991b8767db753c9f62ed5 (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-06-28T11:10:57Z (GMT) No. of bitstreams: 1 GHENO_FLAVIA_PICOLI_DIS.pdf: 1195829 bytes, checksum: 156cb51070a991b8767db753c9f62ed5 (MD5) / Made available in DSpace on 2018-06-28T11:15:02Z (GMT). No. of bitstreams: 1 GHENO_FLAVIA_PICOLI_DIS.pdf: 1195829 bytes, checksum: 156cb51070a991b8767db753c9f62ed5 (MD5) Previous issue date: 2018-03-05 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Studies have shown the relationship between diet quality and longevity. However, few instruments were developed for epidemiological evaluation of diet quality, and even fewer used those in people with more advanced ages. The Brazilian National Health Survey (BNHS), conducted by the IBGE in partnership with the Ministry of Health (MH) in 2013, used an eating habits questionnaire applied by interviewers, not necessarily health professionals. On the other hand, the Healthy Eating Guide Questionnaire (HEGQ) created by the MH in 2005, proved to be appropriate for the evaluation of diet quality in the oldest-old (80 years and older), but applied by nutritionists. The objective of this research is to compare the evaluation questionnaire results of the eating habits used by BNHS with the results of the HEGQ in oldest-old subjects, and in this study people with 90 years or more. The two questionnaires were applied to the oldest-old in his or her home, the questionnaire of BNHS by a professional not necessarily nutritionist and the HEGQ by a nutritionist. We observed that the overall PNS score presented a significant relationship (p <0.001) with a correlation coefficient of 26% with the overall score of the QGAS, when applied by a multiprofessional team. The overall PNS score had a higher correlation coefficient (34%) with the overall score of the QGAS when applied by a nutritionist. We conclude that the questionnaire of the eating habits of the PNS can be used in the evaluation of the quality of the diet in longevity, being more predictive when applied by nutritionist professionals. / Estudos t?m apontado a rela??o da qualidade da dieta e a longevidade. Entretanto, poucos instrumentos foram desenvolvidos para a avalia??o epidemiol?gica da qualidade da dieta e, em menor n?mero, utilizados em pessoas com idades mais avan?adas. A Pesquisa Nacional de Sa?de (PNS), realizada pelo IBGE em parceria com o Minist?rio da Sa?de em 2013, utilizou um question?rio de h?bitos alimentares aplicados por entrevistadores do pr?prio Instituto n?o necessariamente profissionais da ?rea da sa?de. Por outro lado, o Question?rio do Guia de Alimenta??o Saud?vel (QGAS), elaborado pelo Minist?rio da Sa?de em 2005, mostrou ser apropriado para a avalia??o da qualidade da dieta em longevos (80 anos ou mais), mas por profissionais nutricionistas. O objetivo desta pesquisa foi comparar os resultados do question?rio de avalia??o dos h?bitos alimentares utilizado pela PNS com os resultados do QGAS em longevos, sendo sujeitos de pesquisa pessoas com 90 anos ou mais. Foram aplicados os dois question?rios a domic?lio, o question?rio da PNS, por um profissional n?o necessariamente nutricionista, e o QGAS por um profissional dessa ?rea. Os resultados de cada item alimentar da PNS foram pontuados conforme os crit?rios do QGAS, gerando uma pontua??o global. Observamos que a pontua??o global da PNS apresentou uma rela??o significativa (p<0,001) com coeficiente de correla??o de 26% com a pontua??o global do QGAS, quando aplicada por equipe multiprofissional. A pontua??o global da PNS apresentou um coeficiente de correla??o maior (34%) com a pontua??o global do QGAS quando aplicada por profissional nutricionista. Conclu?mos que o question?rio dos h?bitos alimentares da PNS pode ser usado na avalia??o da qualidade da dieta em longevos, sendo mais preditora quanto aplicado por profissionais nutricionistas.

Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2018-06-22T19:59:08Z No. of bitstreams: 1 CLARICE_MARTINS_FEYH_BIRNFELD.pdf: 3318155 bytes, checksum: aa5476b4fe73fb5e7e0b2678aef02e4b (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-06-29T12:31:16Z (GMT) No. of bitstreams: 1 CLARICE_MARTINS_FEYH_BIRNFELD.pdf: 3318155 bytes, checksum: aa5476b4fe73fb5e7e0b2678aef02e4b (MD5) / Made available in DSpace on 2018-06-29T12:38:48Z (GMT). No. of bitstreams: 1 CLARICE_MARTINS_FEYH_BIRNFELD.pdf: 3318155 bytes, checksum: aa5476b4fe73fb5e7e0b2678aef02e4b (MD5) Previous issue date: 2014-10-31 / Objectives: To evaluate the expression of Hsp27 by immunohistochemistry in tissue samples of invasive ductal carcinoma in women with and without the presence of metastasis in sentinel axillary lymph node compared to samples from patients diagnosed with fibrocystic changes in breast tissue. In addition, to study the relationship between the rate of cell proliferation and apoptosis by evaluating the expression of Ki-67 protein and caspase-3 by immunohistochemistry. Material and Methods: A cross- sectional study was designed to select patients treated at Hospital S?o Lucas of PUCRS between September 2001 and October 2009. The patients were divided in three groups: 25 patients diagnosed with invasive ductal carcinoma of breast with axillary lymph node metastasis, 25 patients with invasive ductal carcinoma of breast without axillary lymph node metastasis and a control group composed by tissue samples of 25 patients diagnosed with fibrocystic change of the breast. The expression of Hsp27, Ki-67 and caspase 3 expression was evaluated by image analysis and the rate of proliferation (Ki-67) and apoptosis (caspase 3) was calculated for the three groups. Results: The present study showed an increased expression of Hsp27 in the group of invasive ductal carcinomas without metastasis as compared to the control group. There was no significant difference of expression of Hsp27 between the group of ductal carcinoma with axillary metastasis and the control group. The expression of Hsp27 was significantly higher in the group without axillary metastasis as compared to the group with metastasis in both the primary tumor (<0.001) and the respective lymph node tissue samples (=0.003). The expression of Ki-67 and the rate of proliferation (ki-67) and apoptosis (caspase 3) were significantly higher in the groups with invasive ductal carcinoma as compared to the control group. There was no difference in the expression of Ki-67 and the rate of proliferation and apoptosis between the two groups of invasive ductal carcinoma. There was no significant difference in the expression of caspase 3 among the three groups. Conclusion: The quantitative analysis of Hsp27 demonstrated increased expression of this protein in carcinomas without axillary metastases, with a significantly higher expression in the primary tumor and lymph node tissue samples of this group as compared to the group without axillary metastasis. Although the methodology employed and the number of cases evaluated in this work do not allow one to conclude that such behavior in metastatic ductal carcinomas of breast is constant, such finding warrants further investigation. / Objetivos: Avaliar a express?o de Hsp27 (HspB1) em amostras teciduais de carcinomas ductais invasores em mulheres com e sem presen?a de met?stase em linfonodo sentinela axilar e estudar a rela??o da taxa de prolifera??o celular e apoptose, atrav?s da avalia??o imunoistoqu?mica da express?o das prote?nas Hsp27, Ki-67 e caspase 3 em carcinomas ductais invasores de mulheres com e sem presen?a de met?stase linfonodal, tratadas em um hospital de ensino, comparado com amostras de pacientes diagnosticadas com altera??o fibroc?stica no tecido mam?rio. Material e M?todos: Foi realizado um estudo do tipo transversal, sendo selecionadas para este trabalho pacientes tratadas no Hospital S?o Lucas da PUCRS no per?odo entre setembro de 2001 e outubro de 2009 cujas bi?psias foram divididas em tr?s grupos: 25 pacientes com diagn?stico de carcinoma ductal invasor de mama com presen?a de met?stase linfonodal; e 25 pacientes com carcinoma ductal invasor de mama sem presen?a de met?stase linfonodal. Para constitui??o do grupo controle foi realizada a sele??o aleat?ria de 25 pacientes com diagn?stico de altera??o fibroc?stica da mama. Atrav?s da t?cnica de imunoistoqu?mica, tamb?m foram avaliadas as express?es de Hsp27, caspase 3 e Ki67 por an?lise de imagem digital e calculada a raz?o entre a taxa de prolifera??o (Ki-67) e apoptose (caspase 3) dos grupos estudados. Resultados: O presente estudo evidenciou a express?o aumentada da Hsp27 em carcinomas ductais invasores sem met?stase axilar, quando comparados ao grupo dos carcinomas ductais invasores com met?tase axilar e grupo controle. A express?o de Hsp 27 foi maior no grupo com carcinoma invasor sem met?stase axilar tanto no tecido da neoplasia prim?ria (p<0,001) quanto no respectivo tecido linfonodal comparado ao grupo com carcinoma com met?stase axilar (=0,003). Houve diferen?a na express?o da prote?na Ki-67 e raz?o entre prolifera??o celular e apoptose entre os grupos de pacientes com carcinoma ductal invasor com e sem met?stases quando comparados ao grupo controle, por?m n?o houve diferen?a significativa da express?o de Ki-67 e da raz?o entre prolifera??o e apoptose entre os grupos com carcinoma invasor com e sem met?stase, ou entre a express?o de caspase 3 nos tr?s grupos quando comparados entre si. Conclus?o: A an?lise quantitativa da Hsp27 demonstrou maior express?o da prote?na nos tecidos da neoplasia prim?ria e nos linfonodos em carcinomas sem met?stase em linfonodo sentinela axilar. Embora a metodologia empregada e o n?mero de casos estudados nesse trabalho n?o permitam concluir que esse comportamento na doen?a metast?tica seja um achado constante, esse resultado justifica a necessidade de avaliar esse achado em estudos futuros.