Made available in DSpace on 2017-06-01T18:08:32Z (GMT). No. of bitstreams: 1 dissertacao_solange_maria.pdf: 720710 bytes, checksum: 6c7bab44c7bbe20c23fb72b4d48df529 (MD5) Previous issue date: 2010-05-04 / Alzheimer's disease accounts for more than half of dementia and has no known your cure. So when it raises this diagnosis, patients and families faced with the implications of this disease, which presents a course of progressive decline and global cognitive function. This study aimed to study the general social and psychological impact that occur in families of patients with Alzheimer's disease. Specifically, we sought to identify the feelings experienced and the needs felt by the family. This is a qualitative research and the research sample was comprised of six family members of patients with Alzheimer's disease who were treated at the Cognitive Neurology and Behavior (ANCC), General Hospital Sands in Recife. The instrument was a structured interview containing questions related to the goals and socio-demographic data of the family. The technique used for data analysis was the Thematic Content Analysis. The results showed that the act of caring for a relative with Alzheimer's disease leads to feelings of anxiety, confusion, helplessness and sadness, which are intensified with the worsening of the condition. The main impact occurred in the family refers to a change in his routine and the relationship established between the patient and other family members. When care is taken by one person, the physical and mental health interferes in social life and, consequently, the quality of life of the caregiver. In this study, we realize how important to broaden the discussion and knowledge about Alzheimer's disease, focused on the family and especially the caregiver. It is hoped that it can provide useful answers to the professionals who deal with the subject, to develop interventions more targeted and effective, as well as families seeking guidance and help to minimize their distress / A doença de Alzheimer é responsável por mais da metade dos quadros de demência e ainda não se conhece a sua cura. Portanto, quando se levanta esta hipótese diagnóstica, os pacientes e as famílias se confrontam com as implicações desta doença, que apresenta um curso com declínio progressivo e global das funções cognitivas. A presente pesquisa teve como objetivo geral estudar as repercussões psicossociais que ocorrem na família de pacientes com a doença de Alzheimer. Especificamente, pretendeu-se identificar os sentimentos vivenciados e as necessidades sentidas pela família. Trata-se de uma pesquisa qualitativa e a amostra pesquisada foi composta por seis familiares de pacientes portadores da Doença de Alzheimer, que foram atendidos no Ambulatório de Neurologia Cognitiva e do Comportamento (ANCC), do Hospital Geral de Areias, em Recife. O instrumento foi um roteiro de entrevista contendo questões relacionadas aos objetivos e aos dados sóciodemográficos dos familiares. A técnica utilizada para análise dos dados foi a Análise de Conteúdo Temática. Os resultados apontaram que o ato de cuidar de um familiar com a doença de Alzheimer acarreta sentimentos de ansiedade, perplexidade, impotência e tristeza, os quais se intensificam com o agravamento do quadro. As principais repercussões ocorridas no contexto familiar referem-se a uma mudança na sua rotina e na relação estabelecida entre o paciente e os demais membros da família. Quando o cuidado é assumido por uma única pessoa, o desgaste físico e mental interfere na saúde, na vida social e, conseqüentemente, na qualidade de vida do cuidador. Neste estudo, percebemos a importância de que se ampliem a discussão e o conhecimento sobre a doença de Alzheimer, focalizados na família e, especialmente, no cuidador. Espera-se que ele possa oferecer respostas úteis aos profissionais que lidam com o tema, para elaborarem intervenções mais direcionadas e efetivas, assim como às famílias que buscam orientação e ajuda para minimizar seu sofrimento psíquico

Indiana University-Purdue University Indianapolis (IUPUI) / With effective antiretroviral therapy (ART), cardiovascular diseases (CVD), are emerging as a major cause of morbidity and death in the aging population with HIV infection. Although this increase in CVD could be partially explained by the toxic effects of combined anti-retroviral therapy (ART), more recently, HIV infection has emerged as an independent risk factor for CVD. However, it is unclear how HIV can contribute to CVD in patients on ART, when viral titers are low or non-detectable. Here, we provide several lines of evidence that HIV-Nef, produced in infected cells even when virus production is halted by ART, can lead to endothelial activation and dysfunction, and thus may be involved in CVD. We demonstrate that HIV-infected T cell-induced endothelial cell activation requires direct contact as well as functional HIV-Nef. Nef protein from either HIV-infected or Nef-transfected T cells rapidly transfers to endothelial cells while inducing nanotube-like conduits connecting T cells to endothelial cells. This transfer or transfection of endothelial cells results in endothelial apoptosis, ROS generation and release of monocyte attractant protein-1 (MCP-1). A Nef SH3 binding site mutant abolishes Nef-induced apoptosis and ROS formation and reduces MCP-1 production in endothelial cells, suggesting that the Nef SH3 binding site is critical for Nef effects on endothelial cells. Nef induces apoptosis of endothelial cells through both NADPH oxidase- and ROS-dependent mechanisms, while Nef-induced MCP-1 production is NF-kB dependent. Importantly, Nef can be found in CD4 positive and bystander circulating blood cells in patients receiving virally suppressive ART, and in the endothelium of chimeric SIV-infected macaques. Together, these data indicate that Nef could exert pro-atherogenic effects on the endothelium even when HIV infection is controlled and that inhibition of Nef-associated pathways may be promising new therapeutic targets for reducing the risk for cardiovascular disease in the HIV-infected population.

The diagnosis and treatment of respiratory tract infections in ambulatory adults is challenging. The prevalence of these conditions outstrips the medical profession's efficiency and effectiveness in dealing with them. However, selecting diagnostic techniques that identify causative organisms and therapeutic agents targeted to those organisms should lead to a reduction in the morbidity and mortality associated with these illnesses.