Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-05-12T13:01:46Z No. of bitstreams: 1 468410 - Texto Completo.pdf: 2047741 bytes, checksum: afaf70991c827a282ac9545f01d4a085 (MD5) / Made available in DSpace on 2015-05-12T13:01:46Z (GMT). No. of bitstreams: 1 468410 - Texto Completo.pdf: 2047741 bytes, checksum: afaf70991c827a282ac9545f01d4a085 (MD5) Previous issue date: 2015-03-11 / With the increase in life expectancy there is a higher prevalence of chronic diseases and functional limitations that are common in aging. Musculoskeletal disorders (MSD?s) are in the group of chronic diseases that most affect the elderly, being characterized by pain and decrease in function. When associated with pain these disorders are among the most disabling diseases and are associated with considerable functional, psychological and social limitations. To analyze the impact of musculoskeletal diseases is important to measure the problems associated with them, like pain, emotional factors and quality of life. Therefore, the goals of this study are to measure the levels of anxiety and depression symptoms and quality of life in elderly women with chronic musculoskeletal pain and compare them with elderly women without pain, and to measure the influence of pain?s intensity in these variables. This was a cross-sectional study among women who were 60 years old or older, who were members of mothers' clubs in the city of Caxias do Sul, Brazil. The elderly women were separated into two groups, group G1 consisted of women with chronic musculoskeletal pain for over three months and group G2 consisted of women with no musculoskeletal pain for over three months.To measure anxiety symptoms, depression symptoms, quality of life and pain intensity the following instruments were used, respectively: Beck Anxiety Inventory (BAI); Beck Depression Inventory- II (BDI-II); WHOQOL-bref; and visual analogue scale (VAS). 178 elderly women participated on this research, of which four were excluded since they did not meet all the inclusion criteria. Of the 174 remaining, 95 were included in G1 and 79 in G2. The mean age was 70 years old in G1 and 70,3 years old in G2. The G1 group showed higher levels of anxiety symptoms (p<0,001) and depression symptoms (p<0,001) and worse quality of life in all domains of WHOQOL-BREF (p<0,05) when compared with group G2. The pain intensity was negatively correlated with the levels of anxiety symptoms (p<0,001) and the physical domain of the WHOQOL-BREF (p <0.05). Therefore, it is concluded that chronic musculoskeletal pain is frequent in the elderly and is associated with higher incidence of depressive and anxiety symptoms, and it also affects negatively the quality of life. It is suggested that new researches explore more deeply this relation through longitudinal studies made with different populations. / Com o aumento da expectativa de vida h? maior preval?ncia de doen?as cr?nicas e limita??es funcionais pr?prias do envelhecimento humano. As doen?as musculoesquel?ticas (ME) est?o entre as patologias cr?nicas que mais acometem idosos, sendo caracterizadas por dor e diminui??o da fun??o. Quando associadas ? dor, est?o entre as doen?as mais incapacitantes e est?o relacionadas a consider?veis limita??es funcionais, psicol?gicas e sociais. Para analisar o impacto das doen?as ME ? importante mensurar os problemas associados com elas que s?o a dor, os fatores emocionais e a qualidade de vida. Sendo assim, este estudo teve como objetivo avaliar os n?veis de sintomas de ansiedade e depress?o e a qualidade de vida em idosas com dores ME cr?nicas e comparar com idosas sem dores, como tamb?m relacionar a intensidade ?lgica com essas vari?veis. Trata-se de um estudo transversal, realizado com mulheres com 60 anos ou mais, participantes dos clubes de m?es da cidade de Caxias do Sul/RS. As idosas foram separadas em dois grupos, grupo G1 composto por mulheres com dor ME cr?nica h? mais de tr?s meses e grupo G2 composto por mulheres com aus?ncia de dor ME h? mais de tr?s meses.Para avaliar os sintomas de ansiedade foi utilizado o Invent?rio de Ansiedade de Beck (BAI), para os sintomas de depress?o o question?rio de Depress?o de Beck II (BDI-II), para a qualidade de vida o WHOQOL-bref e para avaliar a intensidade ?lgica foi utilizada a escala visual anal?gica (EVA). Participaram do estudo 178 idosas, sendo que 4 idosas foram exclu?das por n?o se adequarem em todos os crit?rios de inclus?o. Das 174 restantes, 95 foram inclusas do grupo G1 e 79 no grupo G2. A m?dia de idade do G1 foi de 70 anos e do G2 de 70,3 anos. As mulheres do G1 apresentaram n?veis mais elevados de sintomas de ansiedade (p<0,001) e depress?o (p<0,001) e pior qualidade de vida em todos os dom?nios do WHOQOL-bref que as mulheres do G2 (p<0,05). A intensidade ?lgica correlacionou-se negativamente com os n?veis de sintomas de ansiedade (p<0,001) e com o dom?nio f?sico do WHOQOL-bref (p<0,05). Conclui-se, portanto, que a dor ME cr?nica ? frequente na popula??o idosa e est? associada com maior incid?ncia de sintomas depressivos e ansiosos, al?m de afetar negativamente a qualidade de vida dos indiv?duos acometidos. Sugerem-se novas pesquisas que aprofundem esta rela??o atrav?s de estudos longitudinais e que sejam realizados com diferentes popula??es.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-05-12T13:23:39Z No. of bitstreams: 1 468409 - Texto Parcial.pdf: 238946 bytes, checksum: 6a25850d96d7aa7cb5d5aca9f7acb414 (MD5) / Made available in DSpace on 2015-05-12T13:23:39Z (GMT). No. of bitstreams: 1 468409 - Texto Parcial.pdf: 238946 bytes, checksum: 6a25850d96d7aa7cb5d5aca9f7acb414 (MD5) Previous issue date: 2015-03-05 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / INTRODUCTION : Breast changes can have a significant impact on breastfeeding success. In Brazil the prevalence of breast surgery is higher among the population of private health system users. Another risk factor that can interfere in successful breastfeeding in these patients is the high rate of cesarean birth, which in turn may be associated with nipple trauma.OBJECTIVES : The aim of this study was to evaluate the influence of breast surgery and other breast changes on breastfeeding success in patients undergoing elective cesarean section at a private hospital.METHODS : We included in the study newborns undergoing elective cesarean section equal to or greater than 37 weeks' gestation. Data were obtained from hospital records, interviews with the mothers during their stay in the maternity ward and via telephone at the end of the second week and three months after delivery. The variables were gestational age, presence of partners, number of pregnancies, type of nipple, previous breastfeeding, pain during breastfeeding, complementary prescription, silicone breast implants, breast reduction surgery, and bleeding nipples fissures. A logistic regression model was adjusted considering exclusive breastfeeding response at three months as a variable and as dependent variables those significant at the 30% level in previous analysis.RESULTS : The study sample consisted of 1117 newborns and their mothers whose deliveries occurred consecutively and met the inclusion criteria. Of the 1117 mothers, 741 (66.34%) had exclusive breastfeeding at three months of life. All the variables studied represented significant risk factors for the lack of exclusive breastfeeding at three months, except pain during breastfeeding and presence of cracks. In multivariate analysis, the variables that remained significant after adjusting for confounding factors were use of food supplements in the first 24 hours of life (odds ratio [OR] 2.11, confidence interval [CI] 1.62 95% 2.75); flat nipple (OR 2.40, 95% CI 1.58 to 3.65); silicone breast implant (OR 1.88, 95% CI 1.24 to 2.85); and breast reduction surgery (OR 5.65, 95% CI 2.92 to 10.85).CONCLUSIONS : In this population of patients undergoing elective cesarean section in a private health service, breast surgeries, especially breast reduction, were important risk factors for the absence of exclusive breastfeeding at three months postpartum. Another important risk factor for early weaning was the type of flat nipples. / INTRODU??O : Altera??es da mama podem ter impacto significativo sobre o sucesso da amamenta??o. No Brasil, na popula??o usu?ria do sistema privado de sa?de, a preval?ncia de cirurgias mam?rias ? alta. Outro fator de risco que pode interferir no sucesso da amamenta??o nessas pacientes ? a alta taxa de parto ces?reo, que por sua vez pode estar associado a traumas mamilares.OBJETIVOS : O objetivo deste estudo foi avaliar a influ?ncia da cirurgia mam?ria e de outras altera??es da mama no sucesso da amamenta??o em pacientes submetidas ? cesariana eletiva em um hospital privado.M?TODOS : Foram inclu?dos no estudo rec?m-nascidos por cesariana eletiva, com idade gestacional igual ou maior que 37 semanas. Os dados foram obtidos do prontu?rio hospitalar, de entrevistas com as m?es durante a estadia na maternidade e por contatos telef?nicos no final da segunda semana e tr?s meses ap?s o parto. As vari?veis em estudo foram idade gestacional, presen?a de companheiro, n?mero de gesta??es, tipo de mamilo, amamenta??o pr?via, dor durante a amamenta??o, prescri??o de complemento, implante de silicone de mama, cirurgia de redu??o mam?ria, fissura mam?ria e sangramento mam?rio. Um modelo de regress?o log?stica foi ajustado tendo como vari?vel de resposta amamenta??o exclusiva aos tr?s meses e como vari?veis dependentes as significativas ao n?vel de 30% nas an?lises anteriores.RESULTADOS : A amostra do estudo foi composta por 1117 rec?m-nascidos e suas m?es, cujos partos ocorreram de forma consecutiva e que atendiam aos crit?rios de inclus?o. Das 1117 m?es, 741 (66,34%) mantiveram amamenta??o exclusiva aos tr?s meses de vida. Todas as vari?veis estudadas representaram fatores de risco significativos para aus?ncia de aleitamento materno exclusivo aos tr?s meses, exceto dor durante a amamenta??o e presen?a de fissuras. Na an?lise multivariada, as vari?veis que se mantiveram significativas ap?s o ajuste para fatores de confus?o foram uso de complemento alimentar nas primeiras 24 horas de vida (odds ratio [OR] 2,11, intervalo de confian?a [IC] 95% 1,62-2,75); mamilo plano (OR 2,40, IC95% 1,58-3,65); implante de silicone mam?rio (OR 1,88, IC95% 1,24-2,85); e cirurgia de redu??o de mama (OR 5,65, IC95% 2,92-10,85).CONCLUS?ES : Nessa popula??o de pacientes usu?rias do sistema privado de sa?de, submetidas a parto ces?reo, as cirurgias mam?rias, especialmente a redu??o de mama, foram importantes fatores de risco para aus?ncia de amamenta??o exclusiva aos tr?s meses p?s-parto. Outro importante fator de risco para desmame precoce foi o mamilo do tipo plano.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-05-20T12:21:59Z No. of bitstreams: 1 469008 - Texto Completo.pdf: 4229036 bytes, checksum: d331b75d3dd0ee53fcc0db664fcea5f4 (MD5) / Made available in DSpace on 2015-05-20T12:21:59Z (GMT). No. of bitstreams: 1 469008 - Texto Completo.pdf: 4229036 bytes, checksum: d331b75d3dd0ee53fcc0db664fcea5f4 (MD5) Previous issue date: 2015-03-11 / Background : The phenomenon of aging can affect muscle mass, muscle strength and functional independence. The decline of musculoskeletal tissue interferes significantly with the functional capacity of the elderly. However, the practice of regular resistance training can prevent and / or minimize these derived functional declines of aging. Objective : to verify the association among anthropometric variables and muscle thickness, functional independence and muscle strength in older adults who practice resistance training and those still physically active, but without practicing resistance training (RT). Method : Sectional study with a comparison group, observational and not probabilistic. The sample consisted of 114 elderly divided into two groups: resistance training group (RTG): 43 elderly individuals practicing RT; physically active group (GFA): 71 elderly considered physically active. The variables were collected: sociodemographic, anthropometric, functional independence and functionality. The instruments used were inelastic tape measure, caliper, ultrasound, test and sit-ups, dynamometer strength, TUG test. The sample was adjusted for sex, age, income and education. Results : Significant differences were found with regard to sex, marital status, income and education between investigated groups (p <0.001). No significant differences were observed between the groups regarding the anthropometric variables (p> 0.05) and muscle thickness (p> 0.05). However, the GTR elderly group had a lower average travel time on the tug test (6.24 ? 0.86 seconds) compared to the GFA which averaged 11.24 ? 4.26 seconds (p = 0.035). Conclusions : TR group elderly had significantly better performance in the TUG test, which is related to less risk of falls and fractures the elderly. / Introdu??o : O processo de envelhecimento pode afetar a massa e for?a muscular e independ?ncia funcional. O decl?nio do tecido musculoesquel?tico interfere significativamente na capacidade funcional dos idosos. Por?m, a pr?tica regular de treinamento resistido pode evitar e/ou minimizar estes decl?nios funcionais oriundos do processo de envelhecimento. Objetivo : verificar a associa??o entre vari?veis antropom?tricas, de espessura de massa muscular e gordura, independ?ncia funcional e for?a muscular em idosos que praticam treinamento resistido (TR) e idosos considerados fisicamente ativos, por?m sem praticar o treinamento resistido. M?todos : Estudo transversal com grupo de compara??o, observacional e n?o probabil?stico. A amostra foi composta por 114 idosos divididos em dois grupos: grupo TR (GTR): 43 idosos praticantes de TR; grupo fisicamente ativo (GFA): 71 idosos considerados fisicamente ativos. As vari?veis coletadas foram: sociodemogr?ficas, antropom?tricas e funcionalidade. Os instrumentos utilizados foram: fita m?trica inel?stica, adip?metro, ec?grafo, teste do senta e levanta, dinam?metro de for?a, AVD, TUG test. A amostra foi ajustada para sexo, idade, renda e escolaridade. Resultados : Encontrou-se diferen?as significativas em rela??o ao sexo, estado civil, renda e escolaridade entre os grupos investigados (p<0,001). N?o foram observadas diferen?as significativas entre os grupos em rela??o ?s vari?veis antropom?tricas (p>0,05) e espessuras musculares (p>0,05). Contudo, idosos do grupo GTR apresentaram uma m?dia menor de tempo de deslocamento no TUG test (6,24?0,86 segundos) em rela??o ao GFA que apresentou uma m?dia de 11,24?4,26 segundos (p= 0,035). Conclus?o : idosos que praticam o TR apresentaram significativamente melhor desempenho no TUG test, que est? relacionado com menor risco de quedas e fraturas em idosos.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-05-21T11:23:07Z No. of bitstreams: 1 469004 - Texto Completo.pdf: 391641 bytes, checksum: 766c8579a6848e6e0e849d934d317cd3 (MD5) / Made available in DSpace on 2015-05-21T11:23:07Z (GMT). No. of bitstreams: 1 469004 - Texto Completo.pdf: 391641 bytes, checksum: 766c8579a6848e6e0e849d934d317cd3 (MD5) Previous issue date: 2010-03-25 / This master's degree dissertation has as central focus the study of the effects caused by the retirement in the behavior of the military ones that you/they are directed for the paid reservation, after they render service to regulate from 35 years to the Brazilian Army, where to enjoy of inherent benefits to the positioning of his/her condition. The question that impelled the research looked for answers regarding the odds of the military to judge him or herself as prepared or no to face the new life and socioeconomic conditions imposed by the retirement, which may influence directly his/her life quality. The study drew as general objective to identify how the military at retirement planned their lives in this stage of life, specifically as concerning acquiring his/her own house, the preparation to engage in new job at civil market and to face the social changes happened after retirement. The used methodology was defined by a bibliographical research, to sustain the theoretical foundation and a descriptive exploratory research, using a quantitative approach in the analysis of the information. The rising of data, approved for the Committee of Ethics in Research of PUC, was accomplished in a military unit of health, in a period of thirty days, through a questionnaire, applied the a sample of thirty (30) individuals, defined for intentional criteria of inclusion. The results reached the main objectives ans we were able to conclude that most of the military professionals, when retiring, did not feel appropriately prepared to face that new stage of the life. / Esta disserta??o de mestrado tem como foco central o estudo dos efeitos causados pela aposentadoria no comportamento dos militares que s?o encaminhados para a reserva remunerada, ap?s prestarem servi?o regulamentar de 35 anos ao Ex?rcito Brasileiro, onde usufru?ram de benef?cios inerentes ao posicionamento de sua condi??o. O questionamento que impulsionou a pesquisa buscou respostas referentes ?s possibilidades de os militares se julgarem preparados, ou n?o, para o enfrentamento das novas condi??es de vida impostas pela aposentadoria, influenciando diretamente sua qualidade de vida. O estudo tra?ou como objetivo geral identificar como os militares da reserva planejaram suas vidas diante da aposentadoria, especificamente quanto ? preocupa??o em adquirir a casa pr?pria, a prepara??o para a inser??o em novo mercado de trabalho e no enfrentamento das mudan?as sociais ocorridas ap?s aposentadoria. A metodologia utilizada definiu-se pela pesquisa bibliogr?fica, que sustentou a fundamenta??o te?rica e incluiu pesquisa explorat?ria descritiva, em abordagem quantitativa na an?lise das informa??es. O levantamento de dados, aprovado pelo Comit? de ?tica em Pesquisa da PUC, foi realizado em unidade militar de sa?de, em um per?odo de trinta dias, atrav?s de question?rio pr?prio, aplicado a uma amostra de trinta (30) indiv?duos, definida por crit?rios intencionais de inclus?o. Os resultados alcan?ados atrav?s da an?lise efetuada foram considerados v?lidos, uma vez que permitiram atender ?s inten??es do estudo, e permitindo afirmar que a maioria dos profissionais militares, ao se aposent

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-05-28T11:22:05Z No. of bitstreams: 1 469523 - Texto Completo.pdf: 2017969 bytes, checksum: 65a18438020d006a68eb9d88965fefd4 (MD5) / Made available in DSpace on 2015-05-28T11:22:05Z (GMT). No. of bitstreams: 1 469523 - Texto Completo.pdf: 2017969 bytes, checksum: 65a18438020d006a68eb9d88965fefd4 (MD5) Previous issue date: 2015-03-04 / The general objective of this very present dissertation is to assess the agreeableness of medical students through validation of the Big Five Inventory - 10 (IBGFP-5) in Brazil. The IBGFP-5 is a brief self-report inventory, composed by 11 items and designed to assess dimensions of personality based upon Big Five Personality Factor model, which are: Openness to Experience, Conscientiousness, Extroversion, Agreeableness (in this study, as a synonym of empathy) and Neuroticism. Such model has been replicated in several countries in the world, including Brazil. The specific objectives of this study are: (1) validating IBGFP-5 through test and retest analysis (time reliability); (2) to do crossed correlation of the IBGFP-5 as a shorter version of the IGFP-5; (3) to do convergent validaty with the Interpersonal Reactivity Index of Davis (EMRI), which assess only empathy; (4) to assess the internal consistence of the five dimensions of the IBGPF-5 in the total sample of respondents and subsets represented by the five cohorts of students, from the first to the sixth year; (5) evaluate evidences of agreeableness based upon differences of IBGFP-5 factors scores, in social and demographic variables and concerning another personality traits; and (6) discuss possible factors that may influence the development of empathy along medical school at FAMED/PUCRS. The total sample, after eliminating missing data, was composed by 200 respondents, medical students at PUCRS, most of them are female (60,5%), with mean age of 22 years old. Using confirmatory factor analysis, the IBGFP-5 comes down to a 0,256 Cronbach?s alpha. According to time reliability, convergent validity and concurrent validity, data averaged in a general fashion low reliable psychological parameters. Concerning empathy features, in post hoc tests it were noticed differences between gender and spirituality level and empathy scores (p<0,05). Results in this study tend to construct validity of the Portuguese version of the IBGFP-5, even though it has restrictions and adjustment needs. Thus, results suggest the need of further investigation of empathy among students, since empathy is a multifactorial trait, and also communication skill training in medical school. Considering the fact that the IBGFP-5 is a brief inventory with a short application time it can easily be used in transcultural studies. The limitations of this study are featured, as well as a future research calendar. / A presente disserta??o tem como objetivo geral avaliar a empatia de alunos de gradua??o de Medicina atrav?s da valida??o do Big Five Inventory - 10 (Invent?rio Breve dos Cinco Grandes Fatores de Personalidade ? IBGFP-5) para o Brasil. O IBGFP-5 ? uma medida de auto relato breve, composta por 11 itens e designada a avaliar dimens?es da personalidade baseada no modelo dos Cinco Grandes Fatores da Personalidade, que s?o: ?Abertura?, ?Conscienciosidade?, ?Extrovers?o?, ?Amabilidade? (no estudo, tida como sin?nimo de empatia) e ?Neuroticismo?. Tal modelo tem apresentado replicabilidade em v?rios pa?ses do mundo, inclusive no Brasil. Os objetivos espec?ficos do estudo foram: (1) fazer a valida??o de teste e re-teste (consist?ncia temporal) do IBGFP-5; (2) fazer correla??o cruzada do IBGFP-5 enquanto fra??o do IGFP-5; (3) Fazer valida??o convergente com a Escala Multidimensional de Reatividade Interpessoal de Davis (EMRI); (4) avaliar a fidedignidade dos cinco fatores do IBGFP-5 a partir da amostra total de respondentes e de subamostras representadas pelas coortes de alunos do primeiro ao sexto ano; (5) verificar evid?ncias de amabilidade baseadas na diferencia??o de escores dos fatores do IBGFP-5 em vari?veis sociodemogr?ficas e em rela??o a outras caracter?sticas da personalidade; e (6) Discutir poss?veis fatores que influenciem no desenvolvimento de empatia na forma??o m?dica na FAMED/PUCRS. A amostra, ap?s a elimina??o dos dados ausentes, foi composta por 200 respondentes, alunos da Gradua??o em Medicina da PUCRS, a maioria do sexo feminino (60,5%), com idade m?dia de 22 anos. A partir da an?lise fatorial confirmat?ria, verificou-se que o IBGFP-5 mostrou um alfa de Cronbach de 0,256. Com base na valida??o de consist?ncia temporal, valida??o convergente e concorrente verificou-se, de forma geral, que os itens do IBGFP-5 apresentaram par?metros psicom?tricos pouco consistentes. Com rela??o ?s caracter?sticas e escores de empatia foram observadas em testes post hoc varia??es em rela??o ao g?nero e ao grau de espiritualidade em rela??o aos tra?os de empatia (p<0,05). Resultados obtidos neste estudo indicam a validade de construto da vers?o em L?ngua Portuguesa do Big Five Inventory para o Brasil ainda que com restri??es e necessidade de ajustes. Os resultados indicam ainda a necessidade de investiga??o adicional da empatia, dado que ? um atributo multifatorial. Por se tratar de uma medida reduzida e de r?pida aplica??o, ela pode ser facilmente utilizada em estudos transculturais. S?o explicitadas as limita??es do estudo, bem como uma agenda futura de pesquisa.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-05-28T11:40:36Z No. of bitstreams: 1 469525 - Texto Completo.pdf: 2925199 bytes, checksum: d0ce1f2f0c3cdc1d309d3f09e9a7d239 (MD5) / Made available in DSpace on 2015-05-28T11:40:36Z (GMT). No. of bitstreams: 1 469525 - Texto Completo.pdf: 2925199 bytes, checksum: d0ce1f2f0c3cdc1d309d3f09e9a7d239 (MD5) Previous issue date: 2015-03-02 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: Preeclampsia is a disease characterized as high maternal and fetal morbidity and mortality, diagnosed only after 20th gestational week, its etiology is not completely understood and healing is placental removal. It has been looking for biomarkers that allow early diagnosis for a better outcome of the disease. The 90 kDa isoform of Angiotensin Converting Enzyme (ACE), proposed as a new biomarker for hypertension, has not been studied in the preeclampsia syndrome so far. Objective: To evaluate the gene and protein expression, as well as enzymatic activity of ACE in pregnancy induced hypertension. Material and methods: It were included 69 normotensive and preeclampsia syndrome pregnant women at S?o Lucas Hospital/PUCRS, Porto Alegre/ RS- Brazil. Blood sample was collected to perform ACE genetic polymorphism, and three urine samples (during pregnancy, after delivery and at least 3 months after delivery) were taken to perform ACE protein polymorphism and enzymatic activity. This study was conducted through a partnership between Nephrology Service from PUCRS and Kidneys and Hormones from UNIFESP Laboratories research. Results: Scientific paper was published in Medical Hypotheses journal, entitled ?Angiotensin Converting Enzyme 90 kDa isoform: Biomarker for diagnosis of preeclampsia?? that described the hypotheses of this research. Comparing the participants clinical data among the groups (Normal pregnant, pure preeclampsia, superimposed preeclampsia), statistical significancy was observed between obstetric gestational age, blood pressure, newborn weight (p< 0.001) and placental weight (p= 0.030). Hypertension familial history compared with ACE genotypes (p= 0.017) suggests allele I involvement. Enzymatic activity ZPhe and Hhl ratio was different during the gestational period (p< 0.025), and also in relation to the ACE genotypes (p< 0.001). ZPhe and HhL isolated enzymatic activity also, in relation to the ACE genotypes, was not statistically different (p = 0.83 e p = 0.16, respectively). The protein polymorphism was not performed due to some technique problems, but this activity will be finished as soon as possible. Conclusion: It seems that allele I is associated with the hypertension familial history, and the genotypes that have this allele (ID, II) are predominantly present in pregnant women with preeclampsia. Enzymatic activity of Zphe/Hhl shows different behavior during the gestational period, and it also change according to genotypes classification. The data suggest that the mechanism involved in essential hypertension can be different from those involved in transient and spontaneous hypertension triggered pregnancy induced hypertension. / Introdu??o: Pr?-ecl?mpsia ? uma doen?a de alta morbimortalidade materna e fetal, diagnosticada somente ap?s a 20? semana gestacional, de etiologia n?o totalmente esclarecida e a cura consiste na retirada da placenta. Segue-se na busca de biomarcadores que possibilitem um diagn?stico precoce para um melhor desfecho da doen?a. A isoforma 90 kDa da Enzima Conversora de Angiotensina (ECA), proposta como novo marcador de hipertens?o, ainda n?o foi estudada na s?ndrome de pr?-ecl?mpsia. Objetivos: Avaliar a express?o gen?tica, proteica e enzim?tica da ECA na Doen?a Hipertensiva Gestacional. Materiais e m?todos: Foram inclu?das 69 gestantes normotensas e com S?ndrome de Pr?-ecl?mpsia (Pr?-ecl?mpsia Pura ou Sobreposta) no Hospital S?o Lucas da PUCRS, Porto Alegre/ RS- Brasil. Foram coletadas uma amostra de sangue para realizar o polimorfismo gen?tico da ECA e 3 amostras de urina (durante a gesta??o, ap?s o parto e pelo 3 meses ap?s o parto) para realizar a an?lise do polimorfismo proteico e a atividade enzim?tica da ECA. Este estudo teve parceria entre os laborat?rios de pesquisa de Nefrologia da PUCRS e Rins e Horm?nios da UNIFESP. Resultados: Foi publicado um artigo cient?fico na revista Medical Hypotheses, intitulado em Angiotensin Converting Enzyme 90 kDa isoform: Biomarker for diagnosis of preeclampsia?, descrevendo a hip?tese desta pesquisa. Comparando os dados cl?nicos das participantes entre os grupos analisados (Gestante normal, Pr?- ecl?mpsia Pura e Pr?- eclampsia Sobreposta), houve signific?ncia estat?stica entre idade gestacional obst?trica, n?veis press?ricos, peso do rec?m-nascido (p<0,001) e peso da placenta (p= 0,030). A hist?ria familiar de hipertens?o comparada com os gen?tipos da ECA (p= 0,017) sugere envolvimento do alelo I. A raz?o da atividade enzim?tica de Zphe e Hhl foi diferente durante o per?odo gestacional (p<0,025) e tamb?m em rela??o aos gen?tipos da ECA (p<0,001). Enquanto que a atividade enzim?tica isolada de Zphe e Hhl em rela??o aos gen?tipos da ECA n?o foi significativa (p = 0,83 e p = 0,16, respectivamente). A an?lise do polimorfismo proteico n?o foi realizada devido a problemas na execu??o da t?cnica, mas essa atividade ser? conclu?da assim que poss?vel. Conclus?o: O alelo I parece estar associado com a hist?ria familiar de hipertens?o e os gen?tipos que possuem esse alelo (ID, II) est?o predominantemente mais presentes nas gestantes que apresentam pr?-ecl?mpsia. A atividade enzim?tica de ZPhe/Hhl apresenta comportamento diferente durante o per?odo gestacional e tamb?m se altera conforme a classifica??o genot?pica da gestante. Os dados sugerem que os mecanismos envolvidos na hipertens?o essencial possam ser diferentes dos envolvidos na hipertens?o transit?ria e espont?nea desencadeada nas Doen?as Hipertensivas Gestacionais.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-05-28T12:17:14Z No. of bitstreams: 1 469509 - Texto Completo.pdf: 1433319 bytes, checksum: 69adb0d2b5f0bd949fea8c36366fca5a (MD5) / Made available in DSpace on 2015-05-28T12:17:14Z (GMT). No. of bitstreams: 1 469509 - Texto Completo.pdf: 1433319 bytes, checksum: 69adb0d2b5f0bd949fea8c36366fca5a (MD5) Previous issue date: 2015-03-02 / Background: Adequate control of extracellular volume is a major goal of hemodialysis (HD) in chronic kidney disease (CKD) patients. Fluid overload contributes significantly to the high morbidity and mortality rates of these patients. The body composition monitor by multifrequency bioimpedance (BCM) is equipment tool able to quantify objectively and accurately the hydration status of each patient. The aim of this study was to compare the efficacy between bioelectrical impedance analysis (BIA) and clinical evaluation to adjust dry weight (DW) in HD patients. Methods: A randomized crossover study. Patients were randomized in two groups: A, in which patients were evaluated by the clinical evaluation and B, wherein the dry weight of the patients was assessed by BIA, for four weeks. Following a wash-out period a crossover between the groups was performed and patients observed for 1 month. The study was approved by the ethics committee of Pontificia Cat?lica University of Rio Grande do Sul. Results: The study included 57 CKD in HD. Blood pressure, hydration parameters and DW were not significantly different between the groups indicating an equivalence between BIA and clinical evaluation treatments to determine DW in HD. Conclusion: The study shows that the BIA is similar than the clinical evaluation to guide ultrafiltration and determine DW in HD. / Introdu??o: O controle adequado do volume extracelular ? um dos principais objetivos da terapia renal substitutiva (TRS) em doentes renais cr?nicos (DRC), pois a sobrecarga h?drica contribui com as altas taxas de morbimortalidade destes pacientes. O monitor de composi??o corporal por bioimped?ncia multifrequencial (BCM) ? um equipamento capaz de quantificar de maneira objetiva o estado de hidrata??o de cada paciente, visando avaliar o peso seco (PS). O objetivo desse estudo foi comparar a efic?cia entre an?lise por bioimped?ncia el?trica (BIA) e avalia??o cl?nica (AC) para adequa??o de PS em pacientes em hemodi?lise (HD). M?todo: Estudo randomizado, do tipo crossover. Os pacientes foram randomizados em dois grupos: A, iniciou o estudo com o PS sendo determinado por AC e B, por BIA, por 1 m?s. Ap?s, foi realizado o cruzamento dos grupos e invers?o dos tratamentos, por mais 1 m?s. O estudo foi aprovado pelo comit? de ?tica da Pontif?cia Universidade Cat?lica do Rio Grande do Sul. Resultados: Participaram do estudo 57 DRC em HD. Comparando os dois tratamentos para dados de press?o arterial, par?metros de hidrata??o e PS, independente dos grupos, os resultados n?o detectaram diferen?as significativas, apontando uma equival?ncia entre os tratamentos de BIA e AC para determinar PS em HD. Conclus?o: Estudo demonstra que a BIA ? equivalente ? AC para guiar a ultrafiltra??o e determinar PS em HD.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-05-28T12:30:06Z No. of bitstreams: 1 469532 - Texto Completo.pdf: 772339 bytes, checksum: b1ca6d60639abd0248f0ea693f8f7d1f (MD5) / Made available in DSpace on 2015-05-28T12:30:06Z (GMT). No. of bitstreams: 1 469532 - Texto Completo.pdf: 772339 bytes, checksum: b1ca6d60639abd0248f0ea693f8f7d1f (MD5) Previous issue date: 2015-03-04 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: There has been a continuous search for safe tests that can predict antibody-mediated rejection in organ transplants, and the positive complement dependent cytotoxic crossmatch, developed in the 1960?s, was until recently considered the gold standard and the main test for prediction of rejection. The new methods for assessing humoral immunity, notably flow cytometric crossmatching and the Luminex? technology significantly increased the sensitivity of these assessments, but also the complexity in the interpretation of these results, as well as in the correlation of different methodologies. Despite the sensitivity of these methods, not any donor-specific antibody detected by solid phase assay results in positive or negative crossmatch. Information obtained with the specificities (such as fluorescence intensity) of anti-HLA antibodies may define the immunological risk for the patient, assisting in the selection of the ideal donor, as well as in the immunosuppressive regimen, for prophylactic and therapeutic uses. Objectives: The present study aimed to establish a cut-off point at the fluorescence intensity of antibodies detected by the panel Single Antigen Beads of class I and II that correlates to positive flow cytometric crossmatching (FCXM). It also aimed to assess whether there are differences between the use of DSAs with higher MFI alone and the sum of all the DSAs of a given patient. Methodology: A cross-sectional study of two databases of results of panels (Luminex?) and flow cytometric crossmatching of patients on a waiting list for kidney transplantation registered at the Laborat?rio de Imunologia de Transplantes da Santa Casa de Miseric?rdia, in Porto Alegre. Database 1 was composed of 1,316 crossmatches against deceased donors and panels of anti-HLA antibodies for loci A, B and DRB1 performed in 2010. Database 2 was composed of 2,288 crossmatches against deceased donors and panels of anti-HLA antibodies for loci C and DQB1 performed between July 2013 and July 2014. As an inclusion criterion for both databases, only samples with results available in the Panel on the same date of the serum tested in flow cytometry crossmatches were used resulting in 834 samples in database 1. Besides, for database 2 only samples with donor-specific antibody (DSA) for loci C and or DQB1, resulting in 348 crossmatches. Results and Conclusions: we demonstrated that 97.6% of the patients with DSAs anti-HLA- ABDRB1 with MFI ? 5000 resulted in positive FCXM. These were the optimal MFI cut-off values for donor selection when we assessed sensitivity and specificity for correlation with positive flow cytometric crossmatching. For DSAs HLA-DQB1, fluorescence intensities above 15,000 MFI offer high specificity (97.8%). Anti-HLA-C sensitization is less frequent (n=40). Only 5 patients showed MFI?5000. Of these, the crossmatch was positive in only one patient (20%). Virtual crossmatch is a resource that can assist in making pre-kidney transplantation decisions. / Introdu??o: A busca por testes seguros que possam prever a rejei??o mediada por anticorpo em transplantes de ?rg?os tem sido cont?nua e a prova cruzada por citotoxicidade dependente de complemento, desenvolvida na d?cada de 60, at? pouco tempo era considerada padr?o ouro e principal teste preditor de rejei??o. Os novos m?todos de aferi??o da imunidade humoral, notadamente a prova cruzada por citometria de fluxo e a tecnologia Luminex?, aumentaram significativamente a sensibilidade destas avalia??es, mas tamb?m a complexidade na interpreta??o destes resultados, assim como na correla??o das diferentes metodologias Embora bastante sens?vel, nem todo anticorpo doador espec?fico detectado pelo teste de fase s?lida resulta em uma prova cruzada positiva ou com rejei??o. As informa??es obtidas com as especificidades (assim como a intensidade de fluoresc?ncia) dos anticorpos anti-HLA podem definir o risco imunol?gico do paciente, auxiliando a escolha do doador ideal, bem como do esquema imunossupressor, tanto profil?tico quanto terap?utico. Objetivos: O objetivo deste trabalho foi estabelecer um ponto de corte no n?vel de fluoresc?ncia de anticorpos detectados pelo painel Single Antigen Beads de classe I e II que se correlacione com a prova cruzada positiva por citometria de fluxo (XMCF). Tamb?m objetivou-se avaliar se existem diferen?as entre o emprego de apenas DSAs com maior MFI e a soma de todos os DSAs de um determinado paciente. Metodologia: Foi realizado estudo transversal de dois bancos de dados de resultados de Paineis (Luminex?) e prova cruzada por citometria de fluxo de pacientes em lista de espera para transplante renal cadastrados no Laborat?rio de Imunologia de Transplantes da Santa Casa de Miseric?rdia de Porto Alegre. O banco n?mero 1 era composto de 1316 provas cruzadas contra doadores falecidos e pain?is de anticorpos anti-HLA dos loci A, B e DRB1, realizados no ano de 2010. O banco n?mero dois era composto de 2288 provas cruzadas contra doadores falecidos e pain?is de anticorpos anti-HLA dos loci C e DQB1 realizadas entre julho de 2013 e julho de 2014. Como crit?rio de inclus?o para ambos os bancos de dados foram utilizadas somente amostras que possu?am resultados de Painel na mesma data do soro testado nas provas cruzadas por citometria de fluxo, resultando em 834 amostras no banco de n?mero 1. Al?m disso, para o banco de dados n?mero 2 foram utilizados apenas amostras que possu?am anticorpo espec?fico contra o doador (DSA) dos loci C e ou DQB1, resultando em 348 provas cruzadas. Resultados e Conclus?es: demonstramos que 97,6% dos pacientes com DSAs anti-HLA- ABDRB1 com MFI?5000 resultaram em XMCF positiva. Os n?veis de MFI nesta faixa corresponderam aos melhores pontos de corte de escolha quando avaliamos a sensibilidade e especificidade para a correla??o com a prova cruzada positiva por citometria de fluxo. Para os DSAs HLA-DQB1, n?veis de fluoresc?ncia acima de 15.000 MFI ofereceram elevada especificidade (97,8%). A sensibiliza??o anti-HLA-C ? menos frequente (n=40). Apenas 5 pacientes apresentaram MFI?5000. Destes, apenas em um (20%) a prova cruzada foi positiva. A prova cruzada virtual ? um recurso que pode auxiliar na tomada de decis?es pr?-transplante renal.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-06-03T17:21:09Z No. of bitstreams: 1 469956 - Texto Parcial.pdf: 108495 bytes, checksum: b30cb1fb39e91dfd223ddaf3ce7c9496 (MD5) / Made available in DSpace on 2015-06-03T17:21:09Z (GMT). No. of bitstreams: 1 469956 - Texto Parcial.pdf: 108495 bytes, checksum: b30cb1fb39e91dfd223ddaf3ce7c9496 (MD5) Previous issue date: 2015-03-20 / In recent years, there have been significant changes in the socioeconomic and health conditions of the population and hence the demographic structure, resulting in a significant growth of the elderly population and causing an increased risk of acquiring neurological and psychiatric diseases. Among the psychiatric illness, bipolar disorder is responsible for a significant portion of the functional impairment around the world. However, international data show that affective disorders have a prevalence of approximately 11.3% of the population, or up to 25% of the elderly. Furthermore, it is one of the diseases that generates and social losses in family relationships, which can lead to suicide in approximately 15% of patients. The aim of this study was to evaluate the prevalence of Bipolar Affective Disorder (BD) in a random sample of elderly attended by the Family Health Strategy (Estrat?gia Sa?de da Fam?lia, ESF) in Porto Alegre. The study is cross-sectional with prospective data collection. The sample consisted of 550 randomly selected elderly 30 Family Health Teams in the Municipality of Porto Alegre (ESF / POA) randomized stratified mode for district. For diagnoses, psychiatrists with experience in assessment of older adults used the diagnostic criteria of DSM-5. Regarding the results: a total of 5.8% (n = 32) of the sample subjects presented the Bipolar Affective Disorder, 59.4% (n = 19) diagnosed with type I and 40.6% (n = 13 ) type II. Of this total, 1.5% (n = 8) have current frame TAB and 4.4% (n = 24) TAB board in the past. Among seniors who had the disorder, some significant associations can be highlighted: with suicide attempt in life (21.6%; p = 0.001) with the risk of suicide (15.7%; p = 0.001) and an association borderline between the elderly having a partner with TAB (8.3%; p = 0.053). Variables associated with THB are female, having a partner and suicide risk. In this study, there has been a significant prevalence of the disorder in the elderly and it was possible to identify predictors through analyzes.The findings of this study are worrisome, if need be replicated in other locations and samples. / Nos ?ltimos anos, ocorreram modifica??es significativas nas condi??es socioecon?micas e de sa?de da popula??o mundial e, consequentemente, na estrutura demogr?fica, acarretando um crescimento expressivo da popula??o idosa e provocando um aumento do risco de adquirir doen?as neurol?gicas e psiqui?tricas. Dentre as doen?as psiqui?tricas, o transtorno bipolar ? respons?vel por importante parcela do preju?zo funcional ao redor do mundo. Contudo, dados internacionais mostram que os transtornos afetivos t?m uma preval?ncia de, aproximadamente, 11,3% da popula??o, podendo atingir 25% dos idosos. Al?m disso, ? uma das doen?as que mais gera perdas sociais e nos relacionamentos familiares, podendo levar ao suic?dio em, aproximadamente, 15% dos pacientes. O objetivo do presente estudo foi avaliar a preval?ncia do Transtorno Afetivo Bipolar (TAB) em uma amostra aleat?ria de idosos atendidos pela Estrat?gia Sa?de da Fam?lia (ESF) de Porto Alegre. O estudo ? do tipo transversal com coleta prospectiva. A amostra constituiuse de 550 idosos randomicamente selecionados de 30 Equipes de Sa?de da Fam?lia do Munic?pio de Porto Alegre (ESF/POA) sorteadas de modo estratificado por Ger?ncia Distrital. Para os diagn?sticos, psiquiatras com experi?ncia na avalia??o de idosos utilizaram os crit?rios diagn?sticos de DSM-5. Em rela??o aos resultados: um total de 5,8% (n=32) dos idosos da amostra apresentaram o Transtorno Afetivo Bipolar, 59,4%( n= 19) com diagn?stico do tipo I e 40,6% (n=13) do tipo II. Desse total, 1,5% (n= 8) apresentam quadro atual de TAB e 4,4% (n= 24) quadro de TAB no passado. Dentre os idosos que apresentaram o transtorno, algumas associa??es significativas podem ser destacadas: entre tentativa de suic?dio na vida (21,6%; p=0,001), entre o risco de suic?dio (15,7%; p=0,001) e uma associa??o lim?trofe entre o idoso ter companheiro com TAB (8,3%; p= 0,053). Vari?veis associadas ao THB s?o sexo feminino, ter companheiro e risco de suic?dio. Neste estudo, notou-se uma significativa preval?ncia do transtorno no idoso e foi poss?vel identificar fatores preditores por meio das an?lises realizadas. Os achados do presente trabalho s?o preocupantes, sendo necess?rio serem reproduzidos em outras localidades e amostras.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-06-15T11:36:19Z No. of bitstreams: 1 469479 - Texto Completo.pdf: 2563289 bytes, checksum: 2184e2738a496b030cd61b0f8c50e376 (MD5) / Made available in DSpace on 2015-06-15T11:36:19Z (GMT). No. of bitstreams: 1 469479 - Texto Completo.pdf: 2563289 bytes, checksum: 2184e2738a496b030cd61b0f8c50e376 (MD5) Previous issue date: 2015-03-26 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / Chronic kidney disease is a progressive condition, with no healing prospect, yet extended upholding under adequate monitoring and treatment. Approximately 100,000 patients currently undergo dialysis therapy - ninety percent on hemodialysis. Mortality ratio varies between 15 to 20%, being cardiovascular events mainly responsible. Among mental ailments thwarting kidney disease patients, depression is the most frequently associated co-morbidity, and linked to increased mortality and morbidity rates. In patients undergoing hemodialysis, malnourishment may relate with depressive symptoms, besides inflammation and cardiovascular diseases. Life style changes induced by end-stage renal disease impose a number of limitations that end up affecting the quality of life. Protein depletion is commonly observed in patients submitted to hemodialysis, and is associated with higher mortality. Strangely enough, it may be accompanied by weight gain and central fat accumulation. The role of adipocytokines in chronic kidney disease has recently drawn attention: association of serum chemerin to metabolic syndrome indicators, inflammation and obesity has been suggested. The aim of this study was to longitudinally evaluate nutritional status, presence of depressive symptoms, quality of life and mortality of hemodialysis patients, in a cohort study at the S?o Lucas Hospital /PUCRS, Porto Alegre, Brazil. Stable patients, undergoing hemodialysis for at least three months, were enrolled and evaluated at twelve month-intervals, thereafter. Participants were assessed for: depressive symptoms using the Beck Depression Inventory and for quality of life perception by the WHOQOL-bref questionnaire. Anthropometric data: weight, height, waist circumference; blood collection: for biochemical determinations, high-sensitivity C-reactive protein, chemerin; body composition analysis by direct segmental multi frequency bioimpedance, were obtained at a mid week dialysis session. One hundred and five participants were included. Patients classified as having standard percentage of body fat predominated, although more than half of the enrolled participants presented with excess body fat. There was no significant difference in the rate of depressive symptoms or in the quality of life between groups, classified by nutritional status. The cause more often associated with the outcome death by any cause was cardiovascular event, followed by infection. Lean body mass had a protective effect on survival. Chemerin may have an anti-inflammatory effect, being associated with increased body fat percentage and augmented waist circumference, on end-stage renal disease patients. / A doen?a renal cr?nica ? uma doen?a progressiva, que n?o contempla expectativa de cura, mas o prolongamento da cronicidade, com acompanhamento e tratamento adequados. Quase 100.000 pacientes s?o submetidos a tratamento dial?tico, 90% em hemodi?lise. A taxa de mortalidade bruta varia entre 15 a 20%, sendo eventos cardiovasculares os principais respons?veis. Dentre os problemas mentais que acometem pacientes com doen?a renal, depress?o ? a comorbidade mais frequente, associada a aumento das taxas de morbimortalidade. Desnutri??o pode se relacionar com sintomas de depress?o, assim como inflama??o e doen?a cardiovascular, em pacientes tratados por hemodi?lise. As mudan?as de estilo de vida induzidas pela doen?a renal cr?nica terminal causam in?meras limita??es que afetam a qualidade de vida. Deple??o proteica em pacientes submetidos a hemodi?lise ? frequentemente observada, e se associa com elevada mortalidade. Curiosamente, pode se acompanhar por excesso de peso e ac?mulo de gordura central. O papel das adipocitocinas na doen?a renal cr?nica tem despertado interesse: associa??o de quemerina s?rica com indicadores de s?ndrome metab?lica, inflama??o e obesidade foram sugeridas. O objetivo do presente estudo ? correlacionar estado nutricional, sintomas de depress?o, qualidade de vida e mortalidade em hemodi?lise. Foi realizado estudo prospectivo de coorte com pacientes em hemodi?lise no Hospital S?o Lucas/PUCRS, Porto Alegre, Brasil. Os pacientes estavam h? tr?s ou mais meses em hemodi?lise, clinicamente est?veis. A cada doze meses, pacientes inclu?dos no estudo foram reavaliados para: sintomas de depress?o ? por question?rio Beck de depress?o; percep??o da qualidade de vida ? pelo question?rio WHOQOL-bref; medidas antropom?tricas ? peso, altura, circunfer?ncia da cintura; coleta de sangue - para dosagens de par?metros bioqu?micos, prote?na C-reativa e quemerina; an?lise da composi??o corporal ? por bioimped?ncia segmentar de multi-frequ?ncias. Foram inclu?dos 105 pacientes. Houve um predom?nio de pacientes com percentagem de gordura padr?o, mas mais da metade dos pacientes tinha excesso de gordura corporal. N?o houve diferen?a na presen?a de sintomas depressivos e na qualidade de vida entre os grupos classificados por estado nutricional. A principal causa associada ao desfecho ?bito por qualquer causa foi evento cardiovascular, seguida por infec??o. A massa muscular apresentou efeito protetor para sobrevida. Quemerina s?rica aparentemente tem a??o anti-inflamat?ria em pacientes com doen?a renal cr?nica terminal, e est? associada a percentual de gordura corporal e a circunfer?ncia da cintura aumentada.