Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-11-24T11:33:35Z No. of bitstreams: 1 476412 - Texto Parcial.pdf: 1327214 bytes, checksum: 641c0c6140859480f5f2d22d545e8ff8 (MD5) / Made available in DSpace on 2015-11-24T11:33:35Z (GMT). No. of bitstreams: 1 476412 - Texto Parcial.pdf: 1327214 bytes, checksum: 641c0c6140859480f5f2d22d545e8ff8 (MD5) Previous issue date: 2015-06-30 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Depression, along with cognitive disorders, has been a concern among mental health services due to the high injury rate in functionality and quality of life of this population. However, still remains open understanding of cognitive changes due to depression and difficult differential diagnosis with mild cognitive impairment (MCI). It is known that the performance on cognitive tests are strongly influenced by education, however, few studies have been conducted on very low education populations. Objective: To evaluate the performance Addenbrooke's Cognitive Examination-Revised (ACE-R) and his cognitive domains in low schooling elderly, without dementia, and compare those with a diagnosis of Major Current Depression Episode (MCDE) with those without depression.Method: analytical, retrospective cross-sectional study using the medical records of patients treated at the Brain Aging Clinic (BAC) of the Hospital S?o Lucas. It included 116 individuals with low education (<8 years of study) and aged between 60 and 84 years (69.6 ? 6.7) with MCDE (N = 41) and controls (N = 75). Results: When comparing the means of ACE-R, MMSE and from the five cognitive domains, between the control group and the group with MCDE, there was no significant difference. There was no difference between groups when analyzed separately the results of the clock drawing test, the categorical and phonological verbal fluency and naming test. Discussion: Unlike what happens with the more educated elderly, depressive symptoms do not change the values of the tests performed on ACE-R of older people with low education. / Depress?o, juntamente com os transtornos cognitivos, tem sido uma preocupa??o entre os servi?os de sa?de mental, devido ao alto ?ndice de preju?zo na funcionalidade e qualidade de vida desta popula??o. Contudo, ainda permanece em aberto a compreens?o das altera??es cognitivas decorrentes da depress?o e de dif?cil diagn?stico diferencial com o comprometimento cognitivo leve (CCL). Sabe-se que o desempenho nos testes cognitivos s?o fortemente influenciados pela escolaridade, no entanto, poucos estudos tem sido realizados em popula??es de muito baixa escolaridade. O presente trabalho teve como objetivo avaliar o desempenho no Addenbrooke?s Cognitive Examination-Revised (ACE-R) e seus dom?nios cognitivos em idosos de baixa escolaridade, sem dem?ncia, e comparar aqueles que possuem diagn?stico de Epis?dio de Depress?o Maior Atual (EDMA), com os que n?o apresentam tal diagn?stico.M?todo: Estudo transversal anal?tico, retrospectivo, atrav?s dos prontu?rios dos pacientes atendidos no Ambulat?rio de Envelhecimento Cerebral (AMBEC) do Hospital S?o Lucas da PUCRS. Foram inclu?dos 116 idosos com baixa escolaridade (< 8 anos de estudo) e idade entre 60 e 84 anos (69,6?6,7), 41 com EDMA e 75 controles. Na compara??o das m?dias do ACE-R e dos cinco dom?nios cognitivos e do MEEM, entre o grupo controle e o grupo com EDMA, n?o foi observada diferen?a significativa. Tamb?m n?o houve diferen?a entre os grupos quando analisado separadamente os resultados do teste do rel?gio, da flu?ncia verbal categ?rica e fonol?gica e do teste de nomea??o. Diferente do que acontece com os idosos mais escolarizados, os sintomas depressivos n?o modificam os valores dos testes realizados no ACE-R de idosos com baixa escolaridade.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-11-30T19:13:33Z No. of bitstreams: 1 476510 - Texto Completo.pdf: 3012262 bytes, checksum: b5e97de4106d22880792cf9db430ad7f (MD5) / Made available in DSpace on 2015-11-30T19:13:33Z (GMT). No. of bitstreams: 1 476510 - Texto Completo.pdf: 3012262 bytes, checksum: b5e97de4106d22880792cf9db430ad7f (MD5) Previous issue date: 2015-05-29 / Title: Prevalence of Sleep Disorders in Socially Vulnerable Teenagers and its Relation with Cognitive and Behavioral Disorder. Introduction: Sleep complaints are frequent in adolecents and can be associated with personal, behavioral and environmental problems. Sleep deprivation in this age group may affect school performance and results in behavioral changes. Insomnia, sleep phase delay and excessive daytime sleepiness are amongst the most common sleep problems in an adolescent population. Psychiatric diseases like anxiety disorder, depression and ADHD have also strong relation with sleep disorders at this age. The aim of this study is to investigate the prevalence of sleep disorders in socially vulnerable teenagers, to correlate such observations with cognitive problems and to verify the effectiveness of an educational intervention and of sleep hygiene. Methods: A cross and interventional study in which the sample was composed of 125 high school students in a school in Porto Alegre, that serves a highly vulnerable population. The tools used to evaluate sleep were two scales, Pittsburg Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). In the cognitive evaluation the Wechsler Abbreviated Scale of Intelligence (WASI) was used, which evaluates IQ, and the SNAP-V for ADHD diagnosis. An educational intervention and sleep hygiene routines were applied in order to access a possible improvement in students with sleep disorders. Results: From the 125 students included, 80% showed sleep alterations. From these, 44% presented excessive daytime sleepiness and 69,6% a poor sleep quality, this findings were associated to use of electronic media , noise and emotional issues as the main factors. The average time of sleep of the studied subjects was of approximately 6h30min, that being less than the recommended. No association was found between sleep problems and behavioral and cognitive disfunctions. Regarding the intervention study, there was a 17% (n = 53) improvement in sleep of the students who participated in the activities, however, there was no statistically significant difference between the different interventions. Conclusion: Data showed a high prevalence of sleep alterations in the studied population studied, however, this findings were not associated with cognitive and/or behavioral disfunctions. Environmental factors seem to have an influence in this poor quality of sleep. Educational interventions or sleep hygiene can be a way to address these problems. / T?tulo: Preval?ncia de Dist?rbios do Sono em Adolescentes em Situa??o de Vulnerabilidade Social e sua Rela??o com Transtornos Cognitivos e Comportamentais. Introdu??o: Queixas de sono s?o frequentes na adolesc?ncia e podem estar associadas a problemas intr?nsecos, comportamentais e ambientais. Restri??o de sono nesta faixa et?ria pode resultar em piora do desempenho escolar e altera??es comportamentais. A ins?nia, o atraso de fase e a sonol?ncia diurna excessiva est?o entre os mais frequentes. Doen?as psiqui?tricas como transtorno de ansiedade, depress?o e TDAH possuem importante rela??o com dist?rbios do sono. O objetivo deste estudo ? investigar a preval?ncia dos dist?rbios do sono em adolescentes em situa??es de vulnerabilidade social, correlacionar tais observa??es com problemas cognitivos e comportamentais e verificar a efetividade de uma interven??o educativa e de higiene do sono. M?todo: Estudo transversal e de interven??o em que a amostra foi composta por 125 estudantes do ensino m?dio de uma escola na cidade de Porto Alegre, que atende uma popula??o com grande vulnerabilidade social. Os instrumentos utilizados para avaliar o sono foram duas escalas, Pittsburgh Sleep Quality Index (PSQI) e a Epworth Sleepiness Scale (ESS). Na avalia??o cognitiva foi utilizado a Wechsler Abbreviated Scale of Intelligence (WASI), que avalia QI, e o SNAP-IV para diagn?stico de TDAH. Uma interven??o educativa e de higiene do sono foi realizada para avaliar poss?vel melhora em alunos com altera??es do sono. Resultados: Dos 125 estudantes inclu?dos, 80% apresentaram altera??es no sono. Destes 44% apresentaram sonol?ncia diurna excessiva e 69,6% sono de m? qualidade relatando uso de m?dia eletr?nica, barulho e quest?es emocionais como principais fatores que interferem no sono. O tempo m?dio de sono dos sujeitos do estudo foi aproximadamente de 6h30min, sendo inferior ao recomendado. N?o foram encontradas associa??es entre problemas do sono e problemas comportamentais e cognitivos. Em rela??o ao estudo de interven??o ocorreu uma melhora no sono de 17% (n=53) dos estudantes que participaram das atividades, por?m n?o houve diferen?a estatisticamente significativa entre as diferentes interven??es. Conclus?o: Foi observada uma alta preval?ncia de altera??es do sono na popula??o estudada, n?o havendo associa??o entre problemas cognitivos e/ou comportamentais. Entretanto, fatores ambientais externos parecem ter influ?ncia nesta m? qualidade de sono. Interven??es educativas ou de higiene do sono podem ser um meio para abordar estes problemas.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-12-01T10:30:54Z No. of bitstreams: 1 476508 - Texto Completo.pdf: 2272243 bytes, checksum: 4ba343814611baa515a889610cb2a13a (MD5) / Made available in DSpace on 2015-12-01T10:30:54Z (GMT). No. of bitstreams: 1 476508 - Texto Completo.pdf: 2272243 bytes, checksum: 4ba343814611baa515a889610cb2a13a (MD5) Previous issue date: 2015-09-29 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Study the medical education process is part of a worldwide movement of health review, motivating important initiatives, represented in Brazil by the national curriculum guidelines of the courses in this area, presented by the Ministry of Education in 2001. In order to compare the effects of content learning/retention (outcome) of dialogued lecture (factor under study), we carried out a randomized controlled trial by groups, blinded to the research subjects with medical students from the 7th and 8 th semester from a private university in southern Brazil, with grade five assigned by the Higher Education Personal Improvement Commission (CAPES). 150 subjects were evaluated between March 2012 and June 2014, average age 24.7 years and a predominance of females (62.7%); 69 (46%) allocated for dialogued lecture (intervention group) and 81 (54%) to traditional lecture (control group). The performance of groups was evaluated by the same theoretical knowledge test administered before and after class, where students in the control group showed greater variation between the first and second test (8.6 vs. 6.7 p = 0.0001) result reinforced by the magnitude of the effect also higher in this group (2,526 vs. 1,350). In the pretest, without distinction by group, the overall student achievement was 50%, with a higher average score of the intervention group (p = 0.003) and those students tested in the 7th semester. In this study, the expository dialogue-class determined final results similar to traditional classroom (20.2 vs. 20.0 points in the final test) no impairment in short-term learning was noticed. / Estudar o processo de educa??o m?dica ? parte de um movimento mundial de revis?o da sa?de, motivando iniciativas importantes, representadas no Brasil pelas diretrizes curriculares nacionais dos cursos desta ?rea, apresentadas pelo Minist?rio da Educa??o no ano de 2001. Com o objetivo de comparar os efeitos de aprendizagem/reten??o de conte?do (desfecho) da aula expositiva dialogada (fator em estudo), realizou-se um estudo controlado randomizado por grupos, cegado para os sujeitos de pesquisa com alunos do 7? e 8? semestre do curso de medicina de uma Faculdade privada do sul do Brasil, com conceito cinco atribu?do pela Comiss?o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES). Foram avaliados 150 sujeitos, entre mar?o de 2012 e junho de 2014, m?dia de idade de 24,7 anos e predom?nio do sexo feminino (62,7%); 69 (46%) alocados para a aula expositiva dialogada (grupo interven??o) e 81 (54%) para aula expositiva tradicional (grupo controle). O desempenho dos grupos foi avaliado por um mesmo teste te?rico de conhecimento aplicado antes e ap?s a aula, onde os alunos do grupo controle demonstraram maior varia??o entre o primeiro e segundo teste (8,6 vs. 6,7 p=0,0001) resultado refor?ado pela magnitude do efeito tamb?m maior neste grupo (2,526 vs. 1,350). No pr?-teste, sem distin??o por grupo, o aproveitamento geral dos alunos foi de 50%, sendo maior a pontua??o m?dia do grupo submetido ? interven??o (p=0,003) e daqueles alunos testados no 7? semestre. Neste estudo, a aula expositiva dialogada determinou resultados finais similares ? aula tradicional (20,2 vs. 20,0 pontos no teste final) n?o sendo observado preju?zo na aprendizagem de curto prazo.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-12-28T12:22:52Z No. of bitstreams: 1 458573 - Texto Completo.pdf: 3676265 bytes, checksum: 796a38fadce4a0d871cc457059630e2b (MD5) / Made available in DSpace on 2015-12-28T12:22:53Z (GMT). No. of bitstreams: 1 458573 - Texto Completo.pdf: 3676265 bytes, checksum: 796a38fadce4a0d871cc457059630e2b (MD5) Previous issue date: 2014-02-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: Peripheral nerve injury results in functional loss in the innervated organ, and recovery without surgical intervention is rare. Many surgical techniques can be used for nerve repair. Among these, the tubulization technique can be highlighted: this allows regenerative factors to be introduced into the chamber. Biomaterials and neurotrophic factors are indicated as a therapeutic alternative for reconstruction of peripheral nerves. Objective: To develop a nanotextured absorbable tube of poly(lactic-co-glycolic acid), and to evaluate its effect with and without tacrolimus on peripheral nerve regeneration in rats. Materials and Methods: Nanotextured absorbable PLGA tubes and films with and without incorporation of tacrolimus are developed, which were characterized in vitro and in vivo biocompatibility, biodegradability and effectiveness as technical tubing were fabricated. The in vivo experiment in which 88 rats were used, occurred in two stages: the copolymers with and without tacrolimus were implanted in 63 animals to evaluate the biocompatibility; a defect of 10mm sciatic nerve was created in the remaining 25 animals were divided into three groups according to treatment: autograft (5), tubulization with PLGA (10), tubulization with PLGA and tacrolimus (10). Walking Track and histomorphometric analyses were performed. Results: Nanotextured PLGA films, containing tacrolimus or not, differ from the negative control cell viability in vitro assays (p=0.000). The film containing tacrolimus was significantly improved, regardless of the time, when compared to the film without the drug (p=0.026). In vivo biocompatibility evaluation demonstrated a surrounding tissue to PLGA implants with acute inflammation, which was decreasing the long 90 days evaluation. It was evident less collagen deposition in both biomaterials, p ? 0.020 seven days after the implants were inserted. The PLGA tube without tacrolimus had smaller average response to the thickness of the myelin sheath compared to autograft and the tube containing tacrolimus in proximal, medial and distal segments (p<0.05). In functional assessment of the recovery of the sciatic nerve in rats, the group of PLGA without tacrolimus significantly differed from the 90 days autograft group (p= 0.0020). Conclusion: The present study suggests that the combination of tacrolimus and PLGA promoted the regeneration of rat sciatic nerves, and this can be a powerful alternative to clinical use in peripheral nerve injuries. / Introdu??o: Les?es em nervos perif?ricos resultam na perda de fun??o do ?rg?o inervado e raramente apresentam recupera??o sem a interven??o cir?rgica. Uma das formas de reparo ? a t?cnica de tubuliza??o, atrav?s da qual ? poss?vel acrescentar fatores com capacidade regenerativa. Nesse contexto, biomateriais e fatores neurotr?ficos s?o indicados como uma alternativa terap?utica para reconstru??o de nervos perif?ricos. Objetivo: Desenvolver tubo nanotexturizado absorv?vel composto por poli (?cido l?ctico-co-?cido glic?lico), e avaliar seu efeito sem e com incorpora??o de tacrolimus sobre a regenera??o de nervo perif?rico em ratos. Materiais e M?todos: Foram confeccionados tubos nanotexturizados absorv?veis de PLGA com e sem incorpora??o de tacrolimus, que foram caracterizados in vitro e in vivo quanto ? biocompatibilidade, biodegrada??o e efic?cia como t?cnica de tubuliza??o. O experimento in vivo, no qual foram utilizados 88 ratos, ocorreu em 2 etapas: os copol?meros sem e com incorpora??o de tacrolimus foram implantados em 63 animais para avaliar a biocompatibilidade; um defeito de 10mm no nervo ci?tico foi criado nos 25 animais restantes, os quais foram divididos em tr?s grupos conforme o tratamento: enxerto aut?logo (5), tubuliza??o com tubo PLGA (10) e tubuliza??o com tubo PLGA e tacrolimus (10). Foram realizados Teste de Marcha e an?lise histomorfom?trica. Resultados: As membranas de PLGA, contendo ou n?o tacrolimus, diferiram do controle negativo nos ensaios de viabilidade celular in vitro (p=0,000); a membrana contendo tacrolimus foi significativamente melhor, independentemente do tempo, quando comparada ? membrana sem o f?rmaco (p=0,026). Na avalia??o da biocompatibilidade in vivo, o tecido circunjacente aos implantes de PLGA apresentaram inflama??o aguda, que foi decrescendo ao longo dos 90 dias de avalia??o. Em 7 dias ap?s os implantes serem inseridos, evidenciou-se menor deposi??o de col?geno nos dois biomateriais quando comparado aos demais per?odos (p ? 0,020). O tubo de PLGA sem tacrolimus teve m?dia menor em rela??o ? espessura da bainha de mielina comparado ao enxerto aut?logo e ao tubo contendo tacrolimus nos segmentos proximal, medial e distal (p < 0,05). Na avalia??o funcional da recupera??o do nervo ci?tico de ratos, o grupo de PLGA sem tacrolimus diferiu significativamente do grupo enxerto aut?logo (em 90 dias | p= 0,0021), com menores ?ndices de fun??o ci?tica. Conclus?o: o presente estudo sugere que a combina??o de PLGA e tacrolimus favoreceu a regenera??o de nervo ci?tico de rato, e esta poder? ser uma potente alternativa para aplica??o cl?nica em les?es de nervos perif?ricos.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-12-28T17:28:07Z No. of bitstreams: 1 476880 - Texto Completo.pdf: 599451 bytes, checksum: cd9bc0981219eb2d393eed6f52e56c65 (MD5) / Made available in DSpace on 2015-12-28T17:28:07Z (GMT). No. of bitstreams: 1 476880 - Texto Completo.pdf: 599451 bytes, checksum: cd9bc0981219eb2d393eed6f52e56c65 (MD5) Previous issue date: 2015-03-27 / Objectives: To identify the variables related to morbidity and risk factors for death of patients that undergo to urgent myocardial revascularization surgery. Method: Historical cross sectional study. It included 232 patients aged ?18 years old that underwent to isolated myocardial revascularization surgery, with or without cardiopulmonary bypass. Those surgeries were urgents and were adopted as emergency measures. It happened from January 1996 to December 2014. The total of revascularization myocardial surgeries carried out in this period were 3772 Results: The frequency of death observed in this sample was 117 (50.4%). Multivariate analysis identified as risk predictors: age ?65 years old (OR: 2.34; 95% CI 1.35 to 5.27; P = 0.007), congestive heart failure class III and IV (OR: 2, 67, 95% CI 1.35 to 5.28; P = 0.005), cardiopulmonary bypass time> 90 minutes (OR: 2.52, 95% CI 1.21 to 4.17; P = 0.001), cardiogenic shock (OR: 3.47; 95% CI 1.70 to 7.07; P = 0.001), acute myocardial infarction (OR: 2.73, 95% CI 1.25 to 5.94, P = 0.011), bleeding (OR: 3.06, 95% CI 1.00 to 9.37; P = 0.049). Conclusion: Age, chronic obstructive pulmonary disease, class III and IV of congestive heart failure, cardiopulmonary bypass time, cardiogenic shock, acute myocardial infarction and bleeding they were independent predictors of in-hospital mortality in patients that undergo to myocardial revascularization surgery. / Objetivos: identificar as vari?veis relacionadas ? morbidade e os fatores de risco para o ?bito de pacientes submetidos ? revasculariza??o do mioc?rdio de urg?ncia e emerg?ncia. M?todos: Estudo de coorte hist?rica. Inclu?dos 232 pacientes com idade ?18 anos, submetidos ? cirurgia de revasculariza??o do mioc?rdio isolada, com ou sem uso de circula??o extracorp?rea, em car?ter de urg?ncia e emerg?ncia, de janeiro de 1996 a dezembro de 2014, de um total de 3772 cirurgias de revasculariza??o do mioc?rdio realizadas neste per?odo. Resultados: A frequ?ncia de ?bito observada nesta amostra foi de 50,4% (117 pacientes). A an?lise multivariada identificou como preditores de risco para mortalidade: idade maior que 65 anos (OR: 2,35; IC 95% 1,27?4,35; P= 0,007), insufici?ncia card?aca congestiva classe III e IV (OR: 2,67, IC 95% 1,36?5,28; P= 0,005), doen?a pulmonar obstrutiva cr?nica (OR: 2,49; IC 95% 1,21?5,11; P=0,013) e tempo de circula??o extracorp?rea maior que 90 minutos (OR: 2,52, IC 95% 1,22?4,17; P= 0,010). Conclus?o: Idade, doen?a pulmonar obstrutiva cr?nica, classe III e IV da insufici?ncia card?aca congestiva, tempo de circula??o extracorp?rea, foram preditores independentes de mortalidade intra-hospitalar de pacientes submetidos ? cirurgia de revasculariza??o do mioc?rdio de urg?ncia e de emerg?ncia.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-12-28T17:44:36Z No. of bitstreams: 1 476879 - Texto Parcial.pdf: 476549 bytes, checksum: 84c85b786c1790f36a0e48de56f5e382 (MD5) / Made available in DSpace on 2015-12-28T17:44:36Z (GMT). No. of bitstreams: 1 476879 - Texto Parcial.pdf: 476549 bytes, checksum: 84c85b786c1790f36a0e48de56f5e382 (MD5) Previous issue date: 2015-11-20 / Introduction: The etiology of sarcopenia is not well defined; studies suggest that different factors contribute to the development of this, including hormonal changes, loss of motor neurons, physical inactivity and use of medications. Another factor that may be associated together with oxidative stress is the frequency of micronucleus. However, to date it has not been reported in the literature studies investigating the association between the frequency of micronuclei and sarcopenia. Aim: to verify the association between biochemical markers, of redox metabolism, micronuclei frequency and sarcopenia in elderly residents in Uruguaiana city, RS. Methods: descriptive, comparative and exploratory cross-sectional study. The sample consisted of elderly treated at primary health care in the municipality of Uruguaiana, RS. The variables collected and investigated were divided into sociodemographic, anthropometric, haematological, biochemical (glucose, total cholesterol, triglycerides, high density lipoprotein linked to cholesterol (HDL-C), hepatic function (AST and ALT), renal function (urea, total protein and creatinine), and for REDOX metabolism (enzyme superoxide dismutase (SOD), catalase (CAT) activity, glutathione peroxidase (GPX), thiobarbituric acid-reactive substances (TBARS) and protein carbonylation), DNA damage (micronucleis frequency test). For determination of biomarkers venous blood samples were collected. For the anthropometric measurements were used: scale, stadiometer, tape measure and caliper. The tracking of sarcopenia was determined by the Lee formula: MM = height2 x (0.00744 x arm circumference2 + 0.00088 x thigh circumference2 + 0.00441 x calf circumference2) + 2.4 x sex - 0.048 x age + race + 7.8 and IMM = MM (kg)/ height (m) 2. And a correction was made to the subtraction of subcutaneous fat using the formula Cm = Climb_?S. To evaluate the functionality were applied tests: gait speed and grip strength with Jamar dynamometer. Results: the sample consisted of 168 elderly people, 62 men and 106 women, mean age 68.41 ? 6.13 years. Of these 49 (29.2%) were considered sarcopenic. The average levels of biochemical markers among non sarcopenic and sarcopenic groups were: Glucose 107.52 ? 49.46 and 103.57 ? 45.93 mg/ dL (p = 0648), total cholesterol 197.47 ? 46.93 and 177.43 ? 30.01 mg / dL (p = 0.010), HDL-C 47.53 ? 5.82 and 46.52 ? 6.55 mg / dL (p=0.354), triglycerides 160.30 ? 127.00 and 101.17 ? 66.55 mg / dl (p = 0.46). The means of REDOX metabolism markers among non sarcopenic and sarcopenic groups were: SOD = 0.1670 ? 0.05877 and 0.0916 ? 0.04585 U/ mg protein (p = 0.001), CAT = 2.0960 ? 0.48434 and 1.9720 ? 0.68767 U / mg protein (p = 0193), GPX = 1655.57 ? 191.61 and 1463.02 ? 228.11U / mg protein (p = 0.001), TBARS = 62.4983 ?16.07 e 83.2139 ? 21.50 nmol MDA / ml plasma (p = 0.001), protein carbonylation = 1.7019? 0.52 e 1.9506?0.67 nmol carbonyl / mg protein (p = 0.014), and the frequency of micronucleis = 5.50 ? 2.66 and 6.79 ? 2.84 (%) (p = 0.009). Conclusion: sarcopenic elderly have significantly higher average micronucleus frequency of lipid peroxidation (TBARS), protein carbonyls, on the other hand have also significantly lower average of antioxidant enzymes SOD, GPx, CAT and total cholesterol than non sarcop?ncios elderly. / Introdu??o: A etiologia da sarcopenia ainda n?o est? bem definida, estudos sugerem que diferentes fatores contribuem para o desenvolvimento desta, incluindo altera??es hormonais, perda de neur?nios motores, inatividade f?sica e uso de medicamentos. Outro fator que pode estar associado em conjunto com o estresse oxidativo ? a frequ?ncia de micron?cleo (FM). No entanto, at? o presente momento n?o foi relatado na literatura estudos que tenham investigado a associa??o entre a FM e a sarcopenia. Objetivo: verificar a associa??o entre marcadores bioqu?micos, do metabolismo REDOX, FM e sarcopenia em idosos residentes do Munic?pio de Uruguaiana, RS. M?todos: estudo transversal descritivo, comparativo e explorat?rio. A amostra foi composta por idosos atendidos na aten??o b?sica de sa?de do Munic?pio de Uruguaiana, RS. As vari?veis coletadas e investigadas foram divididas em sociodemogr?ficas, antropom?tricas, funcionais, hematol?gicas, bioqu?micas (glicose, colesterol total, triglicer?deos, lipoprote?na de alta densidade ligada ao colesterol (HDL-c), fun??o hep?tica (TGO e TGP), fun??o renal (ur?ia, prote?nas totais e creatinina) e do metabolismo REDOX (enzima super?xido dismutase (SOD), catalase (CAT), glutationa peroxidase (GPX), rea??o do ?cdio tiobarbit?rico (TBARS) e carbonila??o de prote?nas), dano de DNA (teste de FM). Para determina??o dos biomarcadores foram coletadas amostras de sangue venoso. Na avalia??o antropom?trica foram utilizados: balan?a, estadi?metro, fita m?trica e adip?metro. O rastreio da sarcopenia foi determinado pela f?rmula de Lee: MM= estatura2 x (0,00744 x circ. bra?o2+0,00088 x circ.coxa2+0,00441 x circ.panturrilha)2 + 2,4 x sexo ? 0,048 x idade + ra?a + 7,8) e IMM= MM(kg)/Estatura (m)2. E foi realizada uma corre??o para a subtra??o da gordura subcut?nea atrav?s da f?rmula Cm = Climb_?S. Para avalia??o da funcionalidade foram aplicados os testes: velocidade da marcha e for?a de preens?o manual com o dinam?metro Jamar. Resultados: A amostra foi composta por 168 idosos, 62 homens e 106 mulheres, com idade m?dia de 68,41?6,13 anos. Destes 49 (29,2%) foram considerados sarcop?nicos. A m?dia dos n?veis dos marcadores bioqu?micos, entre os grupos n?o sarcop?nico e sarcop?nico foram: glicose 107,52 ? 49,46 e 103,57 ? 45,93 mg/dL (p=0,648), colesterol total 197,47 ? 46,93 e 177,43 ? 30,01 mg/dL (p=0,010), HDL-c 47,53 ? 5,82 e 46,52 ? 6,55 mg/dL (0,354), triglicer?deos 160,30 ? 127,00 e 101,17 ? 66,55 mg/dL (p=0,46). As m?dias dos marcadores do metabolismo REDOX entre os grupos n?o sarcop?nico e sarcop?nico foram: SOD=0,1670 ? 0,05877 e 0,0916 ? 0,04585 U/mg prote?na (p=0,001), CAT= 2,0960 ? 0,48434 e 1,9720 ? 0,68767 U/mg prote?na (p=0,193), GPX= 1655,57? 191,61 e 1463,02 ? 228,11U/mg prote?na (p=0,001), TBARS= 62,4983 ?16,07 e 83,2139 ? 21,50 nmol MDA/mL plasma (p=0,001), carbonila??o de prote?nas= 1,7019 ? 0,52 e 1.9506?0.67 nmol carbonyl/mg prote?na (p=0,014), e FM = 5,50 ? 2,66 e 6,79 ? 2,84/1000 (p=0,009). Conclus?o: idosos sarcop?nicos apresentam significativamente m?dias maiores de freq??ncia de micron?cleo, de peroxida??o lip?dica (TBARS), carbonila??o de prote?nas, em contrapartida apresentam tamb?m significativamente menores m?dias das enzimas antioxidantes SOD, GPx, CAT e colesterol total do que idosos n?o sarcop?ncios.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-01-14T16:18:00Z No. of bitstreams: 1 DIS_ST?FANI_RIBEIRO_RODRIGUES_COMPLETO.pdf: 1850672 bytes, checksum: fb7fe168f40514a0d72f0f240c308fd2 (MD5) / Made available in DSpace on 2016-01-14T16:18:00Z (GMT). No. of bitstreams: 1 DIS_ST?FANI_RIBEIRO_RODRIGUES_COMPLETO.pdf: 1850672 bytes, checksum: fb7fe168f40514a0d72f0f240c308fd2 (MD5) Previous issue date: 2015-07-24 / The body balance is the capacity of standing or generate acceleration movements and body rotations without oscillations or falls. For this to happen, it is necessary the integrity of different structures and systems, especially visual, proprioceptive and vestibular systems. The aim of this study was to evaluate the sensorial systems involved in body balance maintenance in young, adults and old people using the Foam-Laser Dynamic Posturography. We evaluated 69 subjects, in which 34% of the sample represented by women, 34% by young, 34% by adults and 32% by old people. The elderly group performed significantly better in visual system than other groups. The young group showed visual preference significantly higher than other groups. We concluded that there are differences in the performance of the sensorial systems involved in body balance maintenance among the evaluated age groups, although those differences had a straighter relation with diseases and lifestyle than with the aging process itself. / O equili?brio corporal e?a capacidade do ser humano de manter-se ereto ou executar movimentos de acelerac?a?o e rotac?a?o do corpo sem oscilac?o?es ou quedas. Para que isso ocorra, v?rias estruturas e sistemas necessitam estar ?ntegros, entre eles o sistema vestibular, o proprioceptivo e a vis?o. O objetivo dessa pesquisa que foi avaliar as diferen?as no desempenho dos sistemas sensoriais envolvidos na manuten??o do equil?brio corporal de jovens, adultos e idosos. Utilizando a Posturografia Din?mica foam-laser, 69 sujeitos foram avaliados, sendo que as mulheres representavam 66,1% da amostra, os indiv?duos jovens representavam 34%, os adultos 34% e os idosos 32% da amostra estudada. Os sujeitos idosos apresentavam desempenho significativamente melhor do sistema visual que as pessoas jovens e adultas. O grupo dos jovens apresentava prefer?ncia visual significativamente maior que os demais grupos. Concluiu-se que existem diferen?as no desempenho dos sistemas sensoriais envolvidos na manuten??o do equil?brio corporal entre as faixas et?rias avaliadas, por?m estas diferen?as apresentam-se associadas muito mais as doen?as e h?bitos de vida que ao envelhecimento.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-02-10T12:59:12Z No. of bitstreams: 1 TES_VERA_ELIZABETH_CLOSS_PARCIAL.pdf: 344877 bytes, checksum: 83c1713273477d9c1c0fb821d224a93c (MD5) / Made available in DSpace on 2016-02-10T12:59:12Z (GMT). No. of bitstreams: 1 TES_VERA_ELIZABETH_CLOSS_PARCIAL.pdf: 344877 bytes, checksum: 83c1713273477d9c1c0fb821d224a93c (MD5) Previous issue date: 2015-08-27 / Population ageing has been the focus of many studies as it reflects an important transformation of society that creates a reality with new challenges to be faced. The ageing process can be categorized in two forms: normal ageing or ageing per se or senescence (with associated molecular, anatomical and physiological alterations) and usual ageing or senility (associated with diseases and disabilities). The frailty syndrome is among the most discussed current themes. Frailty is a condition in which the individual presents increased vulnerability to the development of dependency, hospitalization, institutionalization, fall-risk and mortality, among other adverse outcomes, when exposed to a stressor. Various pathophysiological processes involved in frailty are closely related to nutritional and body composition aspects, and anthropometry presents as a useful technique for evaluating these conditions. Given that frailty in its early stages is commonly seen in the elderly community and that available instruments for its identification (such as the widely used Fried Phenotype) are complex and difficult to apply in primary care, the search for simple tools becomes important. In this thesis, three original articles are presented. In the first, article, AGING INDEX DEVELOPMENT IN BRAZIL, REGIONS, AND FEDERATIVE UNITS FROM 1970 TO 2010, we sought to address the ageing index, the parameter through which to evaluate the expansion process of the elderly segment of total population in relation to the relative change in young age group. To this end, data from the Demographic Census and Social Indicators of the Brazilian Institute of Geography and Statistics (IGBE) were analysed. It was evidenced that the Brazilian population is undergoing a rapid ageing process. For the second article, DESCRIPTION OF ANTHROPOMETRIC MEASUREMENTS AND ANALYSIS OF THEIR ASSOCIATION WITH GENDER, AGE, AND FRAILTY SYNDROME IN ELDERLY ASSISTED AT THE FAMILY HEALTH STRATEGY: DATA FROM THE EMI-SUS, data from 583 elderly participants of a cross-sectional study ?Clinical and Epidemiological Study of the Elderly Attended at the Family Health Strategy (FHS) in the City of Porto Alegre (EMI-SUS)?, were analyzed. The frequency of frailty (diagnosed by Fried Phenotype) was observed to be 21.5% and pre-frailty 51.1%, and that only one of the 41 evaluated anthropometric measures was not associated with at least one of the investigated dependent variables (gender, age group or frailty). In the third article, PERFORMANCE OF ANTHROPOMETRIC MEASURES IN PREDICTING FRAILTY IN THE ELDERLY: LOGISTIC REGRESSION AND ARTIFICIAL NEURAL NETWORK MODELS, we sought to investigate the performance of 26 anthropometric measurements in predicting frailty and to develop a tool for their identification. Data from 583 participants of the EMI-SUS were analyzed, randomly divided into a learning sample (n=439) and test sample (n=144). Logistic regression and artificial neural network models were used. The neural network demonstrated a superior predictive performance to the logistic regression model and resulted in a reliable tool for identifying frailty in the elderly. The anthropometric measures of weight, biceps skinfold, sagittal abdominal diameter and waist circumference, grouped, proved to be good predictors of frailty in the elderly. / O envelhecimento da popula??o tem sido foco de muitos estudos por se tratar de uma transforma??o importante da sociedade e que implica uma realidade com novos desafios a serem enfrentados. O processo de envelhecimento pode ser categorizado em dois padr?es: o envelhecimento normal ou envelhecimento per se ou senesc?ncia (com altera??es moleculares, anat?micas e fisiol?gicas associadas) e o envelhecimento usual ou senilidade (associado a doen?as e incapacidades). Dentre as tem?ticas mais abordadas atualmente, encontra-se a s?ndrome da fragilidade. Fragilidade ? uma condi??o na qual o indiv?duo apresenta uma maior vulnerabilidade para o desenvolvimento de depend?ncia, hospitaliza??o, institucionaliza??o, queda e mortalidade, dentre outros desfechos negativos, quando exposto a um estressor. V?rios processos fisiopatol?gicos envolvidos na fragilidade t?m estreita rela??o com aspectos nutricionais e de composi??o corporal e que, na avalia??o destas condi??es, a antropometria se apresenta como uma t?cnica ?til. Considerando que est?gios iniciais de fragilidade s?o comumente observados em idosos da comunidade e que instrumentos dispon?veis para a identifica??o de fragilidade (como o fen?tipo de Fried que ? amplamente utilizado) s?o complexos e de dif?cil aplica??o na aten??o b?sica, a busca por ferramentas simples torna-se importante. Na presente tese, s?o apresentados tr?s artigos originais. No primeiro artigo, A EVOLU??O DO ?NDICE DE ENVELHECIMENTO NO BRASIL, NAS SUAS REGI?ES E UNIDADES FEDERATIVAS NO PER?ODO DE 1970 A 2010, buscou-se abordar o ?ndice de envelhecimento, par?metro atrav?s do qual se avalia o processo de amplia??o do segmento idoso na popula??o total em rela??o ? varia??o relativa no grupo et?rio jovem. Para tanto, foram pesquisados dados dos Censos Demogr?ficos e dos Indicadores Sociais do IBGE. Evidenciou-se que a popula??o brasileira se encontra em franco processo de envelhecimento. Para o segundo artigo, DESCRI??O DE MEDIDAS ANTROPOM?TRICAS E AN?LISE DE SUA ASSOCIA??O COM G?NERO, IDADE E S?NDROME DA FRAGILIDADE EM IDOSOS ASSISTIDOS NA ESTRAT?GIA SA?DE DA FAM?LIA: DADOS DO EMI-SUS, foram analisados os dados de 583 idosos participantes de um estudo transversal denominado ?Estudo Epidemiol?gico e Cl?nico dos Idosos Atendidos na Estrat?gia Sa?de da Fam?lia (ESF) do Munic?pio de Porto Alegre (EMI-SUS)?. Observou-se que a frequ?ncia de fragilidade (diagnosticada pelo Fen?tipo de Fried) foi 21,5% e de pr?-fragilidade, 51,1% e que, das 41 medidas antropom?tricas avaliadas, somente uma n?o se mostrou associada com pelo menos uma das vari?veis dependentes investigadas (sexo, faixa et?ria ou fragilidade). No terceiro artigo, PERFORMANCE OF ANTHROPOMETRIC MEASURES IN PREDICTING FRAILTY IN ELDERLY: LOGISTIC REGRESSION AND ARTIFICIAL NEURAL NETWORK MODELS, buscou-se investigar a performance de 26 medidas antropom?tricas na predi??o de fragilidade e formular uma ferramenta para sua identifica??o. Foram analisados os dados de 583 idosos participantes do EMI-SUS, divididos randomicamente em uma amostra de aprendizado (n=439) e uma amostra teste (n=144). Foram utilizados modelos de regress?o log?stica e rede neural artificial. A rede neural mostrou performance preditiva superior ? regress?o log?stica e resultou em uma ferramenta confi?vel na identifica??o de fragilidade em idosos. As medidas antropom?tricas peso, dobra cut?nea bicipital, di?metro abdominal sagital e circunfer?ncia da cintura, agrupadas, mostraram-se bons preditores de fragilidade em idosos.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-02-25T16:09:05Z No. of bitstreams: 1 TES_MILENE_AMARANTE_PUFAL_COMPLETO.pdf: 3351652 bytes, checksum: 18719dbe6ab9f8b91edc3ed601c97c67 (MD5) / Made available in DSpace on 2016-02-25T16:09:05Z (GMT). No. of bitstreams: 1 TES_MILENE_AMARANTE_PUFAL_COMPLETO.pdf: 3351652 bytes, checksum: 18719dbe6ab9f8b91edc3ed601c97c67 (MD5) Previous issue date: 2015-12-10 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Background: Bariatric surgery patients are counseled to change their lifestyle behaviors. It is reasonable to presume that, by sharing the same environment, the child will be exposed to a healthier environment. Objective: To compare phenotypic and behavioral characteristics between children born to obese mothers before (BMS) or after (AMS) bariatric surgery. Methods: This retrospective cohort study made comparisons between these two groups regarding phenotyping and behavioral data. Results: The sample consisted of 101 participants aged 0 - 12 years, 67 BMS and 34 AMS. All were predominantly sedentary and reported eating an excess of total energy above estimated needs, with no difference between groups (BMS median = 569 kcal, IQR = 1,185; AMS median = 245 kcal, IQR = 1,055; P =.18). Consequently, there was a high prevalence of overweight (Percentile ? 85) in both groups (BMS N = 40, 59.7%; AMS N = 18, 52.9%, P = .52), as well as elevated abdominal and arm circumferences. Additionally, children in both groups reported a deficit in daily calcium intake. Conclusions: Despite mothers? guidance for lifestyle changes after bariatric surgery, the children in our sample reported multiple obesogenic environmental conditions, such as poor behavioral characteristics and, high prevalence of overweight. / Introdu??o: Os pacientes submetidos ? cirurgia bari?trica s?o aconselhados e recebem orienta??es para mudar seus comportamentos de estilo de vida. ? razo?vel presumir que, dividindo o mesmo ambiente, a crian?a vai estar exposta a um ambiente familiar mais saud?vel. Objetivo: Comparar comportamentos das crian?as em rela??o a sua dieta e atividade f?sica para avaliar desfechos fenot?picos entre crian?as que nasceram antes da cirurgia materna (ACM) e depois da cirurgia materna (DCM) e verificar se o procedimento de perda de peso da m?e mudou comportamento da crian?a. Metodologia: Este estudo de coorte retrospectiva realizou compara??es entre os grupos ACM e DCM a respeito de dados antropom?tricos, alimentares e de atividade f?sica. Resultados: A amostra consistiu em 101 participantes com idades entre 0 e 12 anos, N = 67 ACM e N = 34 DCM. Todos eram predominantemente sedent?rios e reportaram ingerir um excesso de energia total acima das necessidades nutricionais recomendadas para a idade e g?nero baseadas nas refer?ncias de ingest?o diet?ticas (Dietary Reference Intakes, DRIs), sem diferen?a entre os grupos (ACM mediana = 569 kcal, AIQ = 1.185; DCM mediana = 245 kcal, AIQ = 1.055, P = 0,18). Consequentemente, observou-se uma alta preval?ncia de excesso de peso (Percentil ? 85) em ambos os grupos (ACM N = 40, 59,7%; DCM N = 18, 52,9%, P = 0,52), bem como elevadas circunfer?ncias abdominal e do bra?o. Conclus?o: Apesar das orienta??es ? m?e quanto as mudan?as necess?rias de estilo de vida ap?s a cirurgia bari?trica, os dados de nossa amostra relataram m?ltiplas condi??es obesog?nicas no ambiente familiar das crian?as, como pobres caracter?sticas comportamentais e, consequentemente, alta preval?ncia de excesso de peso.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-03-09T19:12:16Z No. of bitstreams: 1 DIS_SIMONE_BERWIG_MATIOTTI_PARCIAL.pdf: 452133 bytes, checksum: 47258d5a91f5d356de907f431651ce41 (MD5) / Made available in DSpace on 2016-03-09T19:12:16Z (GMT). No. of bitstreams: 1 DIS_SIMONE_BERWIG_MATIOTTI_PARCIAL.pdf: 452133 bytes, checksum: 47258d5a91f5d356de907f431651ce41 (MD5) Previous issue date: 2015-03-30 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Background: Athletes practicing medium to high impact sports, like soccer, are at a higher risk of developing articular injury, particularly of the knees and diagnosis can be made accurately by MRI. MRI scans performed in the knees of asymptomatic athletes have shown many imaging findings in previous studies. There are no studies performed using 3.0 T MRI to evaluate the knees of adolescent asymptomatic soccer players. Objective: The objective of this cross-sectional study was to evaluate the knees of asymptomatic adolescent soccer players using 3.0T MRI. Subjects and methods: We evaluated 87 knees of asymptomatic male adolescents 14-17 years old. Participants were divided into two groups and paired by age and weight: soccer players (46 knees) and control subjects (41 knees). All the examinations were performed using a 3.0T MRI unit and were evaluated by two experienced radiologists blinded to study groups. Bone marrow signal, articular cartilage, meniscus, tendons, ligaments, fat pad abnormalities and joint fluid were assessed. Results: In the soccer player group, 31 knees (67.4%) had one or more abnormalities, whereas in the control group 20 knees (48.8%) had one or more abnormalities. The prevalence of bone marrow edema was much higher in the soccer player group (19 knees, 41.3%) than in the control group (3 knees, 7.3%), p=0,001. Other abnormalities where found in the soccer player group such as patellar tendinopathy, however not statistically significant with regard to study groups. Small articular effusion, Hoffa?s fat pad edema, patellar cartilage abnormalities and cysts where found in both groups. Conclusion: Asymptomatic subjects, both soccer players and controls were found to have a high prevalence of abnormalities depicted by 3.0T MRI scan, being bone marrow edema much more prevalent in soccer players. Findings at 3.0T MRI scan in this study population where similar to those in previous study using 0.35T MRI. Further studies comparing both equipments in the same population can be performed to give support to these findings / Introdu??o: Atletas que praticam esportes de m?dio a alto impacto, como o futebol, tem maior risco de sofrer les?es articulares, particularmente do joelho, e seu diagn?stico pode ser feito acuradamente pela Resson?ncia Magn?tica (RM). No entanto, muitas altera??es detectadas pela RM em atletas s?o assintom?ticas. At? o momento somente estudos com equipamento de baixo campo foram realizados para avaliar o joelho de adolescentes jogadores de futebol assintom?ticos. Objetivos: O objetivo deste estudo caso-controle foi avaliar os joelhos de adolescentes assintom?ticos jogadores de futebol por RM em equipamento de 3.0T. Participantes e m?todos: Foram avaliados 87 joelhos de adolescentes assintom?ticos do sexo masculino entre 14 e 17 anos de idade. Os participantes foram divididos em dois grupos: jogadores de futebol (46 joelhos) e controles (41 joelhos). Os exames foram realizados utilizando equipamento de RM de 3.0T e foram avaliados por dois radiologistas com experi?ncia em musculoesquel?tico cegados para os grupos. Foi avaliada a presen?a de edema medular ?sseo, derrame articular, altera??es da cartilagem articular, altera??es dos meniscos, altera??es ligamentares, tend?neas e coxins gordurosos. Resultados: No grupo de jogadores de futebol, 31 joelhos (67,4%) tiveram pelo menos uma altera??o, enquanto no grupo controle 20 joelhos (48,8%) tiveram pelo menos uma altera??o. A preval?ncia de edema medular ?sseo foi significativamente maior no grupo de jogadores (19 joelhos, 41,3%) do que no grupo controle (3 joelhos, 7,3%), p=0,001. Outras altera??es foram encontradas no grupo de jogadores como tendinopatia patelar, por?m sem diferen?a estatisticamente significativa entre os dois grupos. M?nimo/pequeno derrame articular, edema da gordura de Hoffa, altera??o da cartilagem da patela e cistos gangli?nicos foram encontrados em ambos os grupos. Conclus?o: Indiv?duos adolescentes assintom?ticos tantos jogadores de futebol como n?o praticantes de esportes apresentam uma alta preval?ncia de altera??es detect?veis ao exame de RM de 3.0T sendo a presen?a de edema medular ?sseo marcadamente maior em atletas jogadores de futebol. Os achados ? RM de 3.0 T nesta popula??o foram superpon?veis ao de estudo pr?vio realizado com RM de 0.35T. Futuros estudos comparando os dois tipos de equipamento na mesma popula??o poderiam comprovar estes achados.