Made available in DSpace on 2015-04-14T13:35:12Z (GMT). No. of bitstreams: 1 431165.pdf: 850340 bytes, checksum: a2e688c3555bab8a8fa5c9cdf12fa3d4 (MD5) Previous issue date: 2011-03-29 / Introdu??o: A doen?a renal cr?nica ? um grave problema de sa?de p?blica no pa?s. D?ficit cognitivo ? comum em pacientes com insufici?ncia renal cr?nica terminal e depress?o ? uma condi??o prevalente na doen?a renal cr?nica terminal. Objetivo: avaliar a fun??o cognitiva de pacientes com insufici?ncia renal cr?nica submetidos ? di?lise peritoneal no Hospital S?o Lucas da PUC e Hospital Benefic?ncia Portuguesa de Pelotas. Materiais e M?todos: Estudo transversal controlado. Foram inclu?dos pacientes em tratamento para doen?a renal cr?nica terminal, em di?lise peritoneal h? pelo menos tr?s meses, com idade acima de 18 anos, e pontua??o no Mini Exame do Estado Mental acima de 18. Foram exclu?dos pacientes com dem?ncia pr?via conhecida, hist?ria de acidente vascular cerebral, doen?a aguda, e hospitalizado com dificuldades de aprendizagem conhecidas. O grupo controle incluiu parentes saud?veis de pacientes em Di?lise Peritoneal (DP) e Hemodi?lise (HD), mesma idade e n?vel s?cio-educativo. Todos os participantes foram submetidos a uma ?nica aplica??o de testes psicom?tricos no momento da consulta cl?nica ou agendados. Os testes utilizados foram a Escala de Intelig?ncia Wechsler para Adultos (WAIS-III), o Invent?rio de Depress?o Beck (BDI) e o Mini-Exame do Estado Mental (MEEM). Participaram 60 indiv?duos, 30 pacientes em DP e 30 indiv?duos saud?veis. Resultados: Os grupos n?o foram diferentes quanto a escores do MEEM (DP 25,9+5,4, Controle 26,8+3,3, p=0,462) e do WAIS-III, com exce??o do ?ndice da velocidade de processamento (DP 90 +19,6, controle 99 + 14,3, p=0,039). Os pacientes em DP apresentaram o escore BDI significativamente maior que os controles (DP=14, IIQ=6-23; Controle=9, IIQ=4-13; p=0,010). Ajustando os dados para presen?a de depress?o e atividade laboral, verificou-se que o ?ndice de velocidade de processamento dos pacientes foi 12,7 pontos menor que nos controles. Conclus?o: O ?ndice de velocidade de processamento da escala WAIS-III foi menor nos pacientes em DP do que nos controles. Os demais aspectos da fun??o cognitiva de pacientes em DP n?o foram diferentes de controles com mesma idade e n?vel s?cio-econ?mico-educacional

Made available in DSpace on 2015-04-14T13:35:58Z (GMT). No. of bitstreams: 1 459896.pdf: 592846 bytes, checksum: 987bda46314bc6c01e598cce8d88d1d5 (MD5) Previous issue date: 2009-03-03 / Introduction: The most frequent adverse events during dialysis are hypotension (20% to 30%) and muscle cramps (5% to 10%), and the most often prescribed treatment to these adverse events is the use of variable sodium (VNa) profiling. Objectives: The aim of the current study was to compare the frequency of adverse events during hemodialysis (HD), interdialytic weight gain, and blood pressure before and after dialysis, with and without the use of VNa, as well as with the use of two variable sodium models: stepwise (VNass) and linear (VNal). Methods: a randomized, cross-over, prospective study that enrolled 22 patients in two groups: one to receive VNas for 12 HD sessions, and the other VNal, for a similar period after 12 sessions without VNa. After a wash-out period of 12 sessions, groups were crossed over. The following parameters were analyzed: adverse events, interdialytic weight gain, and blood pressure (BP) before and after dialysis. Results: Mean age was 61.2?15.2 years; 11 (50%) patients were male. The occurrence of adverse events was significantly different between the period without VNa (48.5%) and those with VNas and VNal (33.7% and 36%; p<0.001). There were no significant differences in BP or interdialytic weight gain among treatment modalities. Conclusion: The use of VNa was associated with a reduction in the number of adverse events. VNas resulted in less episodes of symptomatic hypotension; while VNal may be associated with reduced muscle cramps. VNa modeling is beneficial for selected patients, and should be individually prescribed. / Introdu??o: Os eventos adversos que ocorrem com mais freq??ncia no per?odo transdi?lise s?o hipotens?o (20% a 30%) e c?imbras (5% a 10%), e entre as condutas mais indicadas para o tratamento destas complica??es est? a utiliza??o de s?dio vari?vel (NaV). Objetivos: comparar a ocorr?ncia de eventos adversos em hemodi?lise (HD), o aumento de peso interdial?tico e a press?o arterial pr? e p?s-di?lise, sem e com a utiliza??o de NaV e comparar a ocorr?ncia de eventos adversos em HD com a utiliza??o de duas modalidades de s?dio vari?vel: step (NaVs) e linear (NaVl). M?todo: estudo prospectivo, randomizado e com cross-over que incluiu 22 pacientes para dois grupos: um para tratamento com NaVs durante 12 sess?es de HD e outro para tratamento com NaVl durante o mesmo per?odo, precedidos por 12 sess?es sem NaV. Ap?s per?odo de wash-out, ocorreu o cross-over entre os grupos. Analisaram-se: ocorr?ncia de eventos adversos, ganho de peso interdi?lise e press?o arterial (PA), antes e ap?s o procedimento. Resultados: a m?dia de idade foi de 61,2?15,2 anos e 11(50%) eram do sexo masculino. A ocorr?ncia de eventos adversos foi significativamente diferente entre os per?odos sem a utiliza??o de NaV (48,5%) e com a utiliza??o de NaVs e NaVl, (33,7% e 36%, respectivamente; p<0,001). N?o houve diferen?a significativa de PA entre qualquer das modalidades de tratamento usadas; o mesmo ocorreu com o ganho de peso interdial?tico. Conclus?es: a utiliza??o de NaV reduz a ocorr?ncia de eventos adversos em HD. H? menos hipotens?o sintom?tica com NaVs e tend?ncia para redu??o de c?imbras com o uso de NaVl.. NaV pode ser ben?fico para alguns pacientes e sua prescri??o deve ser individualizada.

Submitted by Celso Magalhaes (celsomagalhaes@ufrrj.br) on 2017-05-16T10:57:04Z No. of bitstreams: 1 2016 - Amanda Lopes Blanco.pdf: 1031306 bytes, checksum: 3b4c7110e99453cb878356f6808b7fa2 (MD5) / Made available in DSpace on 2017-05-16T10:57:04Z (GMT). No. of bitstreams: 1 2016 - Amanda Lopes Blanco.pdf: 1031306 bytes, checksum: 3b4c7110e99453cb878356f6808b7fa2 (MD5) Previous issue date: 2016-08-11 / This dissertation aims to analyze some representations found in cronistico speech Fern?o Lopes and Gomes Eannes of Zurara. The choice of the respective chronicles is due to the fact, that the two used the same object in his chronicles, King D. John's Avis dinasty, for this reason, the job uses the comparative analysis. Thus, different representations are within the same company, these are divided into social groups, according to the perpective of the investigated chronicler. Thus, the possible social representations will be studied, in order to find a consensus in the different groups formed in society, based on this, the work is an interdisciplinary reading with Social Psychology, each representation posses a core to be investigated and identified. The work also dialgue with the theory of interdependence between the individual and society Norbert Elias, as selected representations are linked to this interdependent relationship of individual/society. To build the objectives presented were studied, two medieval chronicles, which were aimed at memory production of Avis, they are: the Cr?nica de El-Rei D. Jo?o I, written by Fern?o Lopes and A Cr?nica da Tomada de Ceuta, of Eannes Gomes Zurara. The method used in the chronicles is the content analysis, Laurence Bardin, for the selected material presents itself, representatively, in the universe study proposed for the dissertation, for related with the interdependence between the individual and society / Esta disserta??o tem por objetivo analisar algumas representa??es encontradas no discurso cron?stico de Fern?o Lopes e Gomes Eannes de Zurara. A escolha dos respectivos cronistas deve-se ao fato, de que os dois utilizaram o mesmo objeto em suas cr?nicas, o Rei D. Jo?o I da dinastia de Avis, por essa raz?o, o trabalho utiliza a an?lise comparativa. Dessa forma, encontram-se diferentes representa??es dentro da mesma sociedade, estas s?o divididas em grupos sociais, de acordo com a perspectiva do cronista que foi investigado. Assim, as poss?veis representa??es sociais ser?o estudadas, visando encontrar um consenso nos diferentes grupos constitu?dos na sociedade, baseando-se nisso, o trabalho faz uma leitura interdisciplinar com a Psicologia Social, em que cada representa??o possuir? um n?cleo central a ser investigado e identificado. O trabalho tamb?m dialogar? com a teoria de interdepend?ncia entre indiv?duo e sociedade de Norbert Elias, visto que as representa??es selecionadas est?o ligadas a essa rela??o interdependente de indiv?duo/sociedade. Para construir os objetivos apresentados, foram estudadas, duas cr?nicas medievais, que visavam a produ??o de mem?ria da dinastia de Avis, s?o elas: a Cr?nica de El-Rei D. Jo?o I, escrita por Fern?o Lopes e a Cr?nica da Tomada de Ceuta, de Gomes Eannes de Zurara. O m?todo utilizado nas cr?nicas ? o de an?lise de conte?do, de Laurence Bardin, visto que o material selecionado apresenta-se de, forma representativa, no universo de estudo proposto para a disserta??o, pois relaciona-se com a interdepend?ncia entre indiv?duo e sociedade

Made available in DSpace on 2014-12-17T14:46:54Z (GMT). No. of bitstreams: 1 SilvanaHNM_DISSERT.pdf: 798862 bytes, checksum: 714b2d8c0e6e3e7bcaa68e2efa23df0f (MD5) Previous issue date: 2011-12-15 / The demographic and epidemiological transition process caused by a declining in birth rates and in mortality, also changes occurred in morbidity and mortality is represented by the increasing of the aging population and the raising of chronic diseases. These diseases are characterized by multiple etiologies, risk factors, long latency period, a prolonged evolution, non-infectious origin and it has association with functional impairment and disability. Thus, elderly with chronic non-communicable disease has priority because they belong to a vulnerable group to get affection of comorbidities in aging, with increased demand and spending on health services. This study is aimed to analyse the understanding of elderly people with chronic non comunicable disease in the medium complexity service as a contribution to the improvement of health care in the city of Natal / RN. This is a descriptive and exploratory study with a quantitative approach, carried out at the Specialized Center for Elderly Health Care and at the Pescadores Hospital. The population was composed of 4,180 persons with a sample of 124 elderly aged above 60 years, attended in these medium complexity services. The instrument, a structured form, adapted from a questionnaire for monitoring risk and protective factors for chronic disease of the Ministry of Health. To collect data was was used the interview form containing demographic data, habits, health status and health care services. The results were processed using the Statistical Package for Social Science, version 18.0, analyzed by simple statistics. It was found that most seniors were female, predominantly between 70 and 74 years old, married, with a brown skin tone and Catholic religion, more than half had incomplete basic education, family income between one to two minimum wages and living with their families. Regarding the interviewers lifestyle, 94.4%, of them ate chicken and 97.6%, fruits, it was observed a reduction in smoking, alcoholism habits and physical activity according to the increasing age, 58.1 and 18.5% had insomnia18,5 % used sleeping pills. The elderly (51.6%) reported using services in times of sickness, seeking primary care at first (30.6%), 52% did not receive referral and was looking for free demand (38.7%). The most reported morbidity was hypertension, followed by musculoskeletal disorders. Regarding the difficulties in seeking health services, the delay in treatment and the waiting line were the most cited by the elderly. Almost all of them reported no activities to promote health in these services and those who received individual counseling on chronic diseases. Almost always, the health professionals who care of them, were mostly doctors followed by nurses. Based on the results presented, it is considered that the health services of medium complexity must undergone a more continuous dialogue with other attention level and focus on actions of health promotion and prevention. It is also recommended the necessity for qualified professionals to delivery health care to elderly and the implementation of protocols by a multidisciplinary health team, intending to provide better and continous care for the elderly with chronic diseases. The healthcare professionals who served them, were mostly physicians, followed by nurses. Through the results presented, it is considered that the medium complexity healthcare services need to perform a more continuous dialogue with the other levels of attention focusing attention to the health promotion and prevention actions. It is also recommended the necessity for qualified professionals to delivery healthcare for the elderly, in addition, a protocol implementation for the multidisciplinary health care team, to provide better care, and also the care continuity to elderly with chronic diseases / O processo de transi??o demogr?fica e epidemiol?gica causado pela diminui??o dos ?ndices de natalidade e mortalidade e modifica??o do perfil de morbimortalidade ? representado pelo aumento da popula??o idosa e das doen?as cr?nicas n?o transmiss?veis. Estas doen?as caracterizam-se por etiologia m?ltipla, fatores de risco, per?odo longo de lat?ncia, curso prolongado, origem n?o infecciosa e associa??o com defici?ncias e incapacidades funcionais. Desse modo, a pessoa idosa com doen?a cr?nica n?o transmiss?vel encontra-se em prioridade por tratar-se de um grupo vulner?vel para essas comorbidades no envelhecimento, com aumento da procura e gastos nos servi?os de sa?de. O objetivo deste estudo ? analisar o perfil da pessoa idosa com Doen?a Cr?nica N?o Transmiss?vel atendida em servi?os de m?dia complexidade. Trata-se de um estudo descritivo e explorat?rio, com abordagem quantitativa, realizado no Centro Especializado de Aten??o ? Sa?de do Idoso e no Hospital dos Pescadores. A popula??o foi de 4180 pessoas e com uma amostra aleat?ria simples de 124 idosos com idade igual ou acima de 60 anos, atendidos nesses servi?os de m?dia complexidade. O instrumento, um formul?rio estruturado, adaptado do question?rio de monitoramento para fatores de risco e prote??o para doen?a cr?nica do Minist?rio da Sa?de. Na coleta de dados usou-se a entrevista acompanhada de formul?rio contendo dados sociodemogr?ficos, h?bitos e condi??o de sa?de e o atendimento nos servi?os de sa?de. Os resultados foram processados no programa Statistical Package for the Social Science, vers?o 18.0, analisados atrav?s da estat?stica simples. Identificou-se que a maioria dos idosos era do sexo feminino, com predom?nio entre 70 e 74 anos, casados, de cor parda e cat?licos; mais da metade tinha ensino fundamental incompleto; renda familiar entre 1 a 2 sal?rio m?nimo e residia com a fam?lia. Quanto aos h?bitos de vida, 94,4% consumiam frango e, 97,6% frutas; observou-se haver redu??o do tabagismo, do alcoolismo e da atividade f?sica; 58,1% possu?am ins?nia e 18,5% utilizavam rem?dios para dormir. A procura pelo servi?o de sa?de deu-se devido adoecimento (51,6%), buscando a aten??o prim?ria no primeiro momento (30,6%); 52% n?o receberam encaminhamento e a procura era por livre demanda (38.7%). A morbidade mais referida foi a hipertens?o, seguida das doen?as musculoesquel?ticas. Sobre as dificuldades na procura pelos servi?os de sa?de, a demora no atendimento e as filas foram citadas pelos idosos. Quase todos relataram n?o haver atividades de promo??o ? sa?de nesses servi?os e que recebiam orienta??o individual sobre as doen?as cr?nicas. Os profissionais de sa?de que os atendiam, em sua maioria eram m?dicos, seguidos dos enfermeiros. Mediante os resultados apresentados, considera-se que os servi?os de sa?de de m?dia complexidade precisam exercer de forma mais cont?nua a interlocu??o com os demais n?veis de aten??o e enfocar no atendimento as a??es de promo??o e preven??o ? sa?de. Recomenda-se tamb?m a necessidade de qualifica??o dos profissionais para o atendimento ? pessoa idosa e a implanta??o de protocolos pela equipe multiprofissional de sa?de, de modo a proporcionar melhor atendimento e continuidade do tratamento ? pessoa idosa com doen?as cr?nicas n?o transmiss?veis

Made available in DSpace on 2014-12-17T14:16:26Z (GMT). No. of bitstreams: 1 MariaCAL_DISSERT.pdf: 1577232 bytes, checksum: 21520a348f865554e71416a87d0342f6 (MD5) Previous issue date: 2010-02-24 / Chronic lymphocytic leukemia (B-CLL) is a clonal proliferation of mature B lymphocytes characterized by indolent clinical course. Biologically this clonallity is characterized by low expression of surface immunoglobulin (sIg) with restriction to a single immunoglobulin light chain associated with high expression of CD5 antigen and positivity to B cell antigens lymphocytes such as CD19, CD20 and CD23 and negativity to FMC7. The immunological profile and morphological analysis of lymphoid cells are the main means for the differential diagnosis of B-CLL from other chronic lymphoproliferative diseases. The aim of this study was to evaluate the expression pattern of a variety of membrane antigens in leukemic cells originating from patients with B-CLL. In this study, peripheral blood samples from 80 patients with B-CLL were analyzed by multiparametric flow cytometry in addition to routine hematologic exams, using a panel of monoclonal antibodies (MoAb): CD45/CD14, CD3/CD19/CD45, CD4/CD8 / CD3, CD20/CD5/CD3, CD3/CD16-56/CD45, CD2/CD7, FMC7/CD23, CD103/CD22/CD20, HLADR/CD38, CD10/CD19, CD1a, CD11b and also IgM/gD, kappa and lambda immunoglobulin light chains for the detection of surface immunoglobulin and clonal restriction for immunoglobulin light chain. The Hematological data were obtained from the hematological analyzer and cytomorphological analysis in blood film stained by Leishmann. The study samples consisted of 45 men and 35 women, ages ranging from 55 to 84 years (mean 65 years). Complete white blood count showed count ranging from 10.0 to 42.0 x 109/l. (mean 50.0 x 109/l) and lymphocytes count greater than 5.0 x 109/l in all cases. The neoplastic cells displayed B-CLL phenotype (CD5+/CD19+/CD20+/HLADR+/CD23+) in the vast majority of the cases, associated to failed to stain for T cell markers (CD1a, CD2, CD4, CD3, CD7, CD8), CD103, CD14 and FMC7. Leukemic cells of most patients also expressed low intensity of IgM and IgD with restricted kappa light chain, in most cases (59,7%). This observation highlights the importance of immunophenotyping for correct diagnosis of chronic lymphoproliferative syndromes and the panel of MoAb used was sufficient for diagnostic confirmation of B-CLL / A leucemia linfoc?tica cr?nica (LLC-B) ? uma prolifera??o clonal de linf?citos B maduros caracterizada por curso cl?nico indolente. Biologicamente esta clonalidade ? caracterizada pela baixa express?o de imunoglobulina de superf?cie (sIg) com restri??o a uma ?nica cadeia leve de imunoglobulina, associada a alta express?o do ant?geno CD5 e positividade a ant?genos relacionados a linf?citos B tais como: CD19, CD20 e CD23 e negatividade ao FMC7. O perfil imunol?gico e a an?lise morfol?gica das c?lulas linf?ides s?o os principais meios para o diagn?stico diferencial LLC-B de outras doen?as linfoproliferativas cr?nicas. O objetivo deste estudo foi avaliar o padr?o de express?o de uma variedade de ant?genos de membrana em c?lulas leuc?micas procedentes de pacientes com LLC-B. No presente estudo, amostras de sangue perif?rico de 80 pacientes com LLC-B foram analisados por citometria de fluxo multiparam?trica juntamente com an?lises hematol?gicas de rotina, com um painel de anticorpos monoclonais (AcMo): CD45/CD14, CD3/CD19/CD45, CD4/CD8/CD3, CD20/CD5/CD3, CD3/CD16-56/CD45, CD2/CD7, FMC7/CD23, CD103/CD22/CD20, HLADR/CD38, CD10/CD19, CD1a, CD11b al?m de IgM/gD, e cadeias leves das imunoglobulinas kappa e lambda visando a detec??o sIg e do perfil de restri??o clonal das cadeia leves das imunoglobulinas. Os dados hematol?gicos foram obtidos a partir do analisador hematol?gico e as an?lises citomorfologicas em distens?o sangu?nea coradas pelo Leishmann. As amostras deste estudo foram procedentes de 45 homens e 35 mulheres, com idade variando entre 55 e 84 anos (m?dia de 65 anos). O hemograma revelou contagem total de c?lulas branca variando de 10,0-42,0 x 109/l. (m?dia de 50,0 x 109/l) e contagem de linf?citos superior a 5,0 x 109/l em todos os casos. As c?lulas neopl?sicas demonstraram um fen?tipo caracter?stico para LLC-B (CD5+/CD19+/CD20+/HLADR+/CD23+) na maioria dos casos, associados ? aus?ncia de express?o para marcadores de c?lulas T (CD1a, CD2, CD4, CD3, CD7, CD8), CD103, CD14 e FMC7. As c?lulas leuc?micas da maioria dos pacientes expressaram tamb?m IgM e IgD de baixa intensidade com predom?nio da restri??o da cadeia leve kappa, na maioria dos casos (59,7%). A presente observa??o destaca a import?ncia da imunofenotipagem para o correto diagn?stico das s?ndromes linfoproliferativas cr?nicas e sendo o painel de AcMo utilizado capaz de estabelecer a confirma??o diagn?stica da B-CLL

Made available in DSpace on 2014-12-17T15:16:11Z (GMT). No. of bitstreams: 1 karlaVRS_DISSERT.pdf: 884201 bytes, checksum: 2c1885530446114d5cb653706bf9e01c (MD5) Previous issue date: 2010-11-04 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Taking care for an impaired elderly is a hard and costly task that could affect directly the caregiver health. The purpose of this study was to evaluate the physical and mental health of elderly caregivers from the city of Santa Cruz-RN and analyze the potential correlated factors through an observational analytic design of a crosssectional. A multidimensional questionnaire was used to evaluation of the social demographics characteristics and those related to the care activity, as well as the caregivers? physical and mental health. It was realized a descriptive analyze using frequency distribution and measures of the central tendency and dispersion to description of the caregivers. To verify the magnitude of the association between the variables was used the bivariate analysis through the Pearson and Spearman correlations and qui-square test. To evaluation of the association of the correlated factors to the adverse outcome with the caregivers? physical and mental health was made a multivariate analysis by logistic binary regression and multiple linear regression models. The final sample was constituted by 304 persons, mostly women with a mean age of 50.3 ?16.8 years. The principal factors related to the physical health were age, stress and life satisfaction. Be a male caregiver, caring for a little while the elderly with cognitive deficit and not been spouse were related to worse mental health. Have worse physical health, high stress, depressive symptomatology, burden and low levels of satisfaction were also related to the mental health. After adjust through multiple linear regression was observed R2 values of R2=0,21 for Stress, R2 =0,17 for Depressive Symptomatology, R2 =0,21 for Burden and R2 =0,16 for Satisfaction. The attainment of the factors associated with caregiver?s health can help in the elaboration of specifics politics witch the goal is the integral attention to the elderly and his caregiver. The inability of continuous taking care could result in adverse outcomes such as institutionalization, impairment and death / A tarefa de cuidar de um idoso incapacitante ? uma atividade dif?cil e dispendiosa que pode afetar diretamente a sa?de do cuidador. Este estudo teve como objetivo avaliar a sa?de f?sica e emocional de cuidadores de idosos da cidade de Santa Cruz-RN, e analisar seus potenciais fatores associados atrav?s de um estudo observacional anal?tico do tipo transversal. Foi utilizado um question?rio multidimensional para avalia??o das caracter?sticas sociodemogr?ficas; das atividades relacionadas com o cuidar, assim como, das vari?veis ligadas ? sa?de f?sica e emocional dos cuidadores. Para descri??o dos cuidadores foi realizada uma an?lise descritiva utilizando a distribui??o de freq??ncias absolutas e relativas, e medidas de tend?ncia central e dispers?o. Para verifica??o da magnitude de associa??o entre vari?veis, utilizou-se an?lise bivariada atrav?s dos testes de correla??o de Pearson e Spearman, e teste de qui-quadrado. Para avalia??o da associa??o de fatores associados aos desfechos adversos ? sa?de f?sica e mental dos cuidadores, foi realizada an?lise multivariada mediante modelos de regress?o log?stica bin?ria e regress?o linear m?ltipla. A amostra foi constitu?da por 304 indiv?duos, em sua maioria por mulheres e a m?dia de idade foi de 50,3 ?16,8. Os principais fatores associados ? sa?de f?sica foram idade, n?veis de estresse e satisfa??o com a vida. Ser um cuidador homem, cuidando a pouco tempo do idoso com d?ficit cognitivo e n?o ser c?njuge desse idoso foram relacionados ? sa?de emocional ruim. Ter uma sa?de f?sica ruim, n?veis elevados de estresse, presen?a de sintomatologia depressiva, sobrecarga e n?veis baixos de satisfa??o tamb?m foram correlacionados ? sa?de emocional. Ap?s ajuste feito atrav?s da an?lise de regress?o linear observou-se valores de R2 =0,21 para estresse, R2 =0,17 para sintomatologia depressiva, R2 =0,21 para sobrecarga e R2 =0,16 para satisfa??o. O conhecimento dos fatores associados ? sa?de do cuidador pode auxiliar na elabora??o de pol?ticas espec?ficas cujo objetivo seja a aten??o integral ? sa?de do idoso e dos seus cuidadores. A impossibilidade de continuar a prover cuidados ao idoso pode resultar em desfechos adversos como institucionaliza??o, incapacidade e morte

Made available in DSpace on 2014-12-17T15:16:20Z (GMT). No. of bitstreams: 1 DiegoNA_DISSERT.pdf: 3427521 bytes, checksum: 8cca32583d3549111fe36c75cda96e2e (MD5) Previous issue date: 2014-02-04 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Venous wounds cause physical, psychological and financial problems that impact the quality of life of patients. Treatment alternatives are investigated in order to reduce healthcare costs and improve quality of life of people affected by this problem. Physical resources, such as therapeutic ultrasound (US), are being considered in the treatment of ulcers as a potential healing agent. This study aimed to investigate the application of US as a treatment for venous ulcers. Subjects were divided into two groups: US group, where treatment consisted of 5 sessions of pulsed US (3 MHz, 1W/cm?) associated with compression and kinesiotherapy; and sham group, where individuals went through the same procedures, but with sham US therapy. Subjects were evaluated for wound size by planimetry and digital photography, visual analogue scale for pain, quality of life by the questionnaires SF- 36 and VEINES-QoL/Sym and enzymatic activity of metalloproteinases 2 and 9 by zymography. It was observed mean reduction in wound area of 41.58?53.8% for the US group and 63.47?37.2% for the placebo group, maintenance of quality of life scores in the US group and significant improvement (p<0.05) in the placebo group by VEINES questionnaire. It was observed decreased perception of pain in the placebo group. Sample feasibility for analysis of the protein activity of metalloproteinases 2 and 9 by zymography collected by swab method was also confirmed. Our data did not give us evidence to support the theory that the US accelerates healing of venous ulcers in a short-term analysis. However, we observed that standard care associated with compression therapy and kinesiotherapy were able to significantly shorten the progression of chronic venous ulcers / As ?lceras cut?neas de origem venosa causam problemas f?sicos, psicol?gicos e financeiros que impactam a qualidade de vida dos pacientes. Alternativas de tratamento s?o investigadas no intuito de reduzir gastos com a sa?de e melhorar a qualidade de vida das pessoas acometidas com esse problema. Recursos f?sicos como o ultrassom (US) terap?utico vem sendo considerados no tratamento de ?lceras como potencial agente cicatrizador. O objetivo desse estudo foi investigar a aplica??o de US como terap?utica para a ?lcera venosa. Indiv?duos foram divididos em dois grupos: grupo US, onde o tratamento consistia de 5 sess?es de aplica??o de US pulsado (3 MHz, 1W/cm?) associadas ? terapia compressiva e cinesioterapia; e grupo placebo, onde os indiv?duos passavam pelos mesmos procedimentos, por?m com US placebo. Foram avaliados quanto ao tamanho do ferimento por planimetria e fotografia digital, dor por escala visual anal?gica, qualidade de vida pelos question?rios SF-36 e VEINES-QoL/Sym e atividade enzim?tica de metaloproteinases 2 e 9 por meio de zimografia. Foi observada redu??o m?dia da ?rea da ferida 41,58%?53,8 para o grupo US e 63,47%?37,2 para o grupo placebo, manuten??o dos escores de qualidade de vida no grupo US e melhora significativa (p<0,05) no grupo Placebo pelo question?rio VEINES. Observou-se diminui??o da percep??o de dor no grupo placebo. Confirmou-se viabilidade de amostra para an?lise da atividade proteica de metaloproteinases 2 e 9 por zimografia coletada por m?todo de swab. Diante dos dados, n?o obtivemos evid?ncias suficientes para suportar a teoria que o US acelera a cicatriza??o de ?lceras venosas em curto prazo. No entanto, pudemos observar que o tratamento padr?o associado ? terapia compressiva e ? cinesioterapia foram capazes de abreviar significativamente a progress?o das ?lceras venosas cr?nicas

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-03-13T13:00:59Z No. of bitstreams: 1 MabelleAlvesFerreiraDeLima_DISSERT.pdf: 1207975 bytes, checksum: 05ebcc203d3c42173700e4d39eb4bf9b (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-03-19T16:38:35Z (GMT) No. of bitstreams: 1 MabelleAlvesFerreiraDeLima_DISSERT.pdf: 1207975 bytes, checksum: 05ebcc203d3c42173700e4d39eb4bf9b (MD5) / Made available in DSpace on 2018-03-19T16:38:35Z (GMT). No. of bitstreams: 1 MabelleAlvesFerreiraDeLima_DISSERT.pdf: 1207975 bytes, checksum: 05ebcc203d3c42173700e4d39eb4bf9b (MD5) Previous issue date: 2017-12-04 / A hipovitaminose D tem sido demonstrada em doentes renais. Nos indiv?duos submetidos ao transplante renal, pode causar progress?o da albumin?ria, aumentando o decl?nio da fun??o renal e o risco de perda de enxerto. O objetivo do estudo ? avaliar o status da vitamina D em indiv?duos submetidos ao transplante renal e sua rela??o com os par?metros da fun??o renal no tempo zero, 3 meses e 6 meses p?s-transplante. Trata-se de um estudo longitudinal desenvolvido com 49 transplantados renais no per?odo de agosto de 2015 a janeiro de 2017. No tempo zero foram exclu?dos 3 indiv?duos devido a suplementa??o de vitamina D (n=46), nos 3 meses houve 1 ?bito, 1 desist?ncia e 2 rejei??es ajudas do enxerto (n=43) e aos 6 meses 1 paciente apresentou rejei??o aguda do enxerto (n=42). Os indiv?duos foram submetidos ? avalia??o antropom?trica, avalia??o da exposi??o solar, an?lises bioqu?micas, incluindo 25-hidroxivitamina D [25(OH)D], e coleta de urina para avaliar a rela??o albumina: creatinina (RAC) em todos os tempos estudados. A taxa de filtra??o glomerular (TFG) foi estimada pela equa??o da Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). A idade mediana dos indiv?duos foi de 44 anos, a maioria do sexo masculino (60,9%; n=28) e a etnia parda (73,9%; n=34). Houve uma predomin?ncia de indiv?duos com hipovitaminose D nos tr?s tempos estudados. Os indiv?duos com status de vitamina D adequado nos 6 meses p?s-transplante apresentaram exposi??o solar significativamente maior em compara??o aos indiv?duos com hipovitaminose D (p = 0,008). Nos 6 meses p?s-transplante, 45,2% dos indiv?duos (n = 19) apresentaram hipovitaminose D em todos os momentos e 19,1% (n = 8) desenvolveram hipovitaminose D aos 3 meses, totalizando 27 indiv?duos com esse perfil. Desses, 37,0% (n = 10) n?o apresentaram melhora na TFG. A RAC de indiv?duos com hipovitaminose D foi maior aos 6 meses p?s-transplante em rela??o ao grupo com status adequado (p = 0,037) e correlacionada negativamente com o 25(OH)D (r = - 0,358; p = 0,02). O paratorm?nio (PTH) apresentou uma influ?ncia negativa na TFG no tempo zero e correlacionou-se positivamente com a RAC aos 6 meses ap?s o transplante (r = 0,420; p = 0,007). Em conclusao, existe uma alta frequ?ncia de hipovitaminose D nos indiv?duos at? 6 meses ap?s o transplante renal, sendo este status poss?velmente relacionado as altera??es observadas na fun??o renal do enxerto.S?o necess?rios mais estudos que apoiem interven??es, tais como suplementa??o de vitamina D, a fim de suportar os resultados obtidos para os pacientes neste est?gio p?s-transplante renal. / Hypovitaminosis D has been a frequent finding in renal patients. In kidney transplant recipients, this may cause progression of albuminuria, increasing the decline in renal function and the risk of graft loss. The objective of this study was to evaluate the vitamin D status in kidney transplant recipients and its relation with renal function parameters at time zero, 3 months and 6 months post-transplantation. This is a longitudinal study with 46 kidney transplant recipients from August 2015 to January 2017. At zero time, 3 subjects were excluded due to vitamin D supplementation (n = 46), in 3 months there was 1 death, 1 (n = 43) and at 6 months 1 patient presented acute rejection of the graft (n = 42). The subjects were evaluated using anthropometric evaluation, a sun exposure questionnaire, biochemical evaluation, including 25-hydroxyvitamin D [25(OH)D], and urine collection to evaluate the albumin: creatinine ratio (ACR) at all times studied. The glomerular filtration rate (GFR) was computed by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. The median age of the subjects was 44 years, predominantly males (60.9%; n=28), and with brown ethnicity (73.9%; n=34). Most of the subjects had hypovitaminosis D during the three studied periods. In subjects with adequate Vitamin D status at 6 months post-transplant, the sun exposure was significantly lower. At 6 months post-transplant, 45.2% (n=19) presented with hypovitaminosis D at all times, and 19.1% (n=8) developed hypovitaminosis D at 3 months, totalizing 27 individuals with this profile. Of these, 37.0% (n=37) had no improvement in the GFR. The ACR of subjects with hypovitaminosis D were higher at six months post-transplant (p=0.037). This was negatively correlated with the 25(OH)D (r=- 0.358; p=0.02). The parathyroid hormone (PTH) had a negative influence on GFR at time zero but was positively correlated with ACR at six months post-transplantation (r=0.420; p=0.007). Therefore, there is a high frequency of hypovitaminosis D up to 6 months after renal transplantation, which may be related to greater changes in graft renal function. More studies are needed to support interventions, such as supplementation, in order to obtain better results after renal transplantation.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-03-21T00:44:25Z No. of bitstreams: 1 FrancinaldoAprigioDosSantos_DISSERT.pdf: 2510260 bytes, checksum: 0a4182397e14b3421a6e3859e963513c (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-27T21:11:18Z (GMT) No. of bitstreams: 1 FrancinaldoAprigioDosSantos_DISSERT.pdf: 2510260 bytes, checksum: 0a4182397e14b3421a6e3859e963513c (MD5) / Made available in DSpace on 2017-03-27T21:11:18Z (GMT). No. of bitstreams: 1 FrancinaldoAprigioDosSantos_DISSERT.pdf: 2510260 bytes, checksum: 0a4182397e14b3421a6e3859e963513c (MD5) Previous issue date: 2016-12-13 / Este trabalho de interven??o apresenta uma proposta de leitura com o g?nero textual cr?nica elaborada com o intuito de incentivar os alunos de uma turma do 9? ano a apreciarem a leitura e discorrerem sobre ela, uma vez que a maioria deles, nessa etapa do Ensino B?sico, apresenta dificuldade na leitura, compreens?o e produ??o de textos. Dessa forma, a pesquisa exp?e algumas interven??es para minimizar essa problem?tica com a aplica??o de estrat?gias pedag?gicas direcionadas a leituras atrav?s de Sequ?ncias Did?ticas (SD), utilizando como recursos metodol?gicos algumas cr?nicas. Optou-se por trabalhar o g?nero cr?nica, uma vez que os Par?metros Curriculares Nacionais (PCN) de L?ngua Portuguesa (2001) sugerem um trabalho com g?neros liter?rios privilegiados para a pr?tica de leitura e escrita de textos. Nessa perspectiva, o presente estudo tem como objetivo, de forma geral, refletir sobre as dificuldades de leitura e compreens?o de textos pelos alunos do Ensino Fundamental II, al?m de investigar como o g?nero textual cr?nica pode favorecer ao desenvolvimento da compet?ncia leitora do aluno, atrav?s de atividades diversificadas. Para isso, o trabalho se fundamentou em referenciais te?ricos direcionados ? leitura e a produ??o do texto como Koch (2009) e Villardi (1999) que focalizam a import?ncia da intera??o autor-texto-leitor e Antunes (2009), dentre outros que enfatizam os g?neros textuais como ponto de partida para o ensino da l?ngua materna e a aquisi??o do processo da leitura e compreens?o de textos; Bakhtin (1997) e Marcuschi (2008) sobre os g?neros na intera??o social; Dolz e Schneuwly (2004) que defendem uma proposta de ensino-aprendizagem centrada nos g?neros textuais, considerando a linguagem um instrumento de constru??o do conhecimento. Ainda, pode-se mencionar Sol? (1998) que afirma ser poss?vel utilizar diversas estrat?gias de leitura em sala de aula, tornando-a um recurso essencial ? aquisi??o do conhecimento. Quanto ? metodologia, a pesquisa se insere em uma abordagem qualitativa, com base na teoria de Trivi?os (1987) que ver esse tipo de pesquisa como um processo que se desenvolve em intera??o din?mica, reformulando-se constantemente. Foi a partir dessa reformula??o que se chegou ? constru??o de um livro intitulado Cr?nicas do mundo (in)real: o cotidiano na narrativa liter?ria constitu?do com as produ??es escritas pelos alunos. Produto esse n?o previsto no in?cio desta disserta??o, por?m delineado entre professor e alunos nas aulas de L?ngua Portuguesa, atrav?s de oficinas da SD. Nesse sentido, concluiu-se que as estrat?gias e as interven??es pedag?gicas, que enfocaram o g?nero textual cr?nica dentro da concep??o de linguagem como atividade interacional, contribu?ram para aumentar a motiva??o dos alunos em ler e produzir textos relacionados a esse g?nero. Assim, a pr?tica de ensino de L?ngua Portuguesa, com os g?neros textuais, especificamente, a cr?nica como narrativa liter?ria, pode ser um facilitador para o aperfei?oamento da leitura e da compreens?o textual, visto que ? poss?vel ampliar o conhecimento do aluno em rela??o ?s caracter?sticas estruturais, lingu?sticas e sociodiscursivas de determinado g?nero, e ao mesmo tempo, motiv?-lo quanto ? leitura. / This intervention work presents a reading proposal with the chronic textual genre elaborated with the intention of encouraging the students of a class of the 9th grade to appreciate the reading and to talk about it, since most of them, in this stage of Basic Education, Presents difficulty in reading, understanding and producing texts. In this way, the research exposes some interventions to minimize this problem with the application of pedagogical strategies directed to readings through Didactic Sequences (SD), using as methodological resources some chronicles. We chose to work on the chronic genre, since the National Curriculum Parameters (PCN) of Portuguese Language (2001) suggest a work with privileged literary genres for the practice of reading and writing texts. In this perspective, the present study has, as a general objective, to reflect on the difficulties of reading and comprehension of texts by Primary School students, in addition to investigating how the chronic textual genre can favor the development of student reading competence through Diversified activities. For this, the work was based on theoretical references directed to the reading and production of the text as Koch (2009) and Villardi (1999) that focus on the importance of the interaction author-text-reader and Antunes (2009), among others that emphasize the Textual genres as a starting point for the teaching of the mother tongue and the acquisition of the process of reading and understanding texts; Bakhtin (1997) and Marcuschi (2008) on genders in social interaction; Dolz and Schneuwly (2004) who defend a proposal of teaching-learning centered in the textual genres, considering the language an instrument of knowledge construction. Also, it can be mentioned that Sol? (1998) states that it is possible to use several reading strategies in the classroom, making it an essential resource for acquiring knowledge. Regarding the methodology, the research is inserted in a qualitative approach, based on the theory of Trivi?os (1987) that see this type of research as a process that develops in dynamic interaction, constantly reformulating. It was from this reformulation that the construction of a book entitled Chronicles of the world (in) real: the quotidian in the literary narrative constituted with the productions written by the students. This product was not foreseen at the beginning of this dissertation, but outlined between teacher and students in the Portuguese Language classes, through SD workshops. In this sense, it was concluded that pedagogical strategies and interventions, which focused on the chronic textual genre within the conception of language as an interactional activity, contributed to increase students' motivation to read and produce texts related to this genre. Thus, the practice of teaching Portuguese Language, with textual genres, specifically, the chronic as a literary narrative, can be a facilitator for the improvement of reading and textual comprehension, since it is possible to expand the student's knowledge regarding the characteristics Structural, linguistic and sociodiscursive of a certain genre, and at the same time motivate him to read.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-04-17T23:18:24Z No. of bitstreams: 1 PalommaRussellySaldanhaDeAraujoOliveira_TESE.pdf: 10724965 bytes, checksum: fb9786f1f1478cf8fcd17d5aeb59d620 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-04-20T23:10:05Z (GMT) No. of bitstreams: 1 PalommaRussellySaldanhaDeAraujoOliveira_TESE.pdf: 10724965 bytes, checksum: fb9786f1f1478cf8fcd17d5aeb59d620 (MD5) / Made available in DSpace on 2017-04-20T23:10:05Z (GMT). No. of bitstreams: 1 PalommaRussellySaldanhaDeAraujoOliveira_TESE.pdf: 10724965 bytes, checksum: fb9786f1f1478cf8fcd17d5aeb59d620 (MD5) Previous issue date: 2016-12-12 / Os m?sculos respirat?rios constituem um dos pilares essenciais da ventila??o. Altera??es na sua estrutura e morfologia em sujeitos com Doen?a Pulmonar Obstrutiva Cr?nica (DPOC) podem influenciar sintomas e sinais cl?nicos como dispneia, tosse ineficaz, intoler?ncia ao exerc?cio e insufici?ncia respirat?ria. O Treinamento Muscular Respirat?rio (TMR), especialmente dos m?sculos inspirat?rios na modalidade limiar de carga press?rica, tem sido utilizado h? mais de 30 anos como terapia coadjuvante em indiv?duos saud?veis e pacientes com DPOC. Ampla variedade de dispositivos para TMR est?o dispon?veis comercialmente, por?m s?o importados, possuem custo elevado e suas caracter?sticas s?o destinadas ao treino individual de grupos musculares ou possuem ajustes de cargas inadequados para pacientes com DPOC. Embora, diversas revis?es sistem?ticas tenham sido realizadas desde 1992 acerca do Treinamento Muscular Inspirat?rio (TMI) em sujeitos com DPOC e postuladas algumas evid?ncias sobre o TMI, falhas metodol?gicas na estrat?gia de busca das revis?es pr?vias e a baixa qualidade metodol?gica dos estudos inclu?dos contribu?ram para o estabelecimento de uma evid?ncia vol?til sobre os benef?cios do TMI. Objetivos: desenvolver um dispositivo de Treinamento do Ciclo Respirat?rio (TCR), integrado para m?sculos inspirat?rios e expirat?rios; verificar os efeitos agudos de diferentes combina??es de cargas inspirat?rias e/ou expirat?rias sobre a atividade muscular respirat?ria, cinem?tica da caixa tor?cica e din?mica dos volumes pulmonares em sujeitos saud?veis com dispositivo semelhante ao desenvolvido; bem como verificar as evid?ncias do TMI sobre a dispneia e capacidade do exerc?cio em sujeitos com DPOC. Metodologia: envolveu tr?s modalidades de pesquisa: i) o desenvolvimento tecnol?gico do dispositivo de TCR, ii) estudo transversal e iii) revis?o sistem?tica associada ? metan?lise. Resultados: i) cria??o de um produto de inova??o tecnol?gica aplicado ? sa?de, denominado ?Equipamento de Treinamento do Ciclo Respirat?rio (TCR) com resist?ncia tipo limiar de carga press?rica?, com dep?sito de patente de inven??o no INPI (BR 1020160253047); ii) mediante estudo transversal, o equipamento comercialmente dispon?vel para treinamento de m?sculos inspirat?rios e/ou expirat?rios n?o ? capaz de deflagrar adequadamente aumento na atividade el?trica dos m?sculos respirat?rios, embora provoque altera??es nos volumes correntes da parede tor?cica e seus compartimentos; e iii) artigo cient?fico intitulado ?Inspiratory muscle training for Chronic Obstructive Pulmonary Disease? evidenciando que, embora o TMI combinado ao cuidado padronizado sozinho versus cuidado padronizado sozinho proporcione melhora na qualidade de vida e que TMI combinado ? Reabilita??o Pulmonar versus Reabilita??o Pulmonar induza ? redu??o na dispneia em sujeitos com DPOC, n?o h? evid?ncia conclusiva para suportar ou refutar o TMI em pacientes com DPOC. Conclus?o: A presente pesquisa substancia a necessidade de constru??o de um novo equipamento de TMR para m?sculos inspirat?rios e expirat?rios, bem como fornece subs?dios para o desenvolvimento de estudos futuros para investiga??o de uma nova modalidade de TMR, denominada TCR, com produ??o de conhecimento na ?rea de biotecnologia. Adicionalmente, contribui para tomada de decis?o cl?nica, pol?tica e financeira sobre a inclus?o ou n?o do TMI como modalidade terap?utica para sujeitos com DPOC. / Respiratory muscles are one of the essential cornerstone of ventilation. Alterations in its structure and morphology in subjects with Chronic Obstructive Pulmonary Disease (COPD) could influence symptoms and signs such as dyspnea, ineffective coughing, exercise intolerance and respiratory failure. Respiratory Muscular Training (RMT), especially inspiratory muscles training, as a threshold modality, has been used for more than 30 years as adjuvant therapy in healthy individuals and patients with COPD. A wide variety of RMT devices are available commercially, but they are imported, have a high cost and their characteristics are intended for the individual training of muscle groups or have inadequate loads adjustments for COPD patients. Although several systematic reviews have been carried out since 1992 on the effects of IMT in subjects with COPD and some evidence has been proposed, some considerations should be made about these revisions.The methodological failures in the search strategy for previous reviews and the low methodological quality of the included studies contributed to the establishment of weak evidence on the benefits of the IMT. Aim: to develop a Respiratory Cycle Training (RCT) device, integrated for inspiratory and expiratory muscles, to verify the acute effects of different combinations of inspiratory and/or expiratory loads in the respiratory muscle activity, kinematics of the chest wall and dynamics of pulmonary volumes in healthy subjects with a device similar to that developed, as well as to analyze the evidence of the effects of IMT on dyspnea and exercise capacity in subjects with COPD. Methodology: involved three research modalities: i) the technological development of the RCT device, ii) cross-sectional study, and iii) systematic review associated with the meta-analysis. Results: i) creation of a technological innovation product applied to health, called "Respiratory Cycle Training equipment (RCT) with threshold load", with patent filing at INPI (BR 1020160253047); ii) through a cross-sectional study, commercially available equipment for inspiratory and / or expiratory muscle training is not capable of adequately triggering an increase in the electrical activity of respiratory muscles, although it causes changes in the current volumes of the chest wall and its compartments; and (iii) a scientific paper entitled "Inspiratory muscle training for Chronic Obstructive Pulmonary Disease", showing that although IMT combined with standardized care alone versus standardized care alone provides improved quality of life and that IMT combined with Pulmonary Rehabilitation versus Pulmonary Rehabilitation induces reduction in dyspnea in individuals with COPD, but there is not conclusive evidence to support or refute IMT in patients with COPD. Conclusion: The present study substantiates the need to construct a new RMT equipment for inspiratory and expiratory muscles, as well as provides subsidies for the development of future studies to investigate a new type of RMT, called TCR, with knowledge production in the area of biotechnology. In addition, it contributes to clinical, political and financial decision making regarding the inclusion or not of IMT as a therapeutic modality for subjects with COPD. / 2018-03-02