Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-08-10T11:59:48Z No. of bitstreams: 1 JanuseNogueiraDeCarvalho_TESE.pdf: 1542578 bytes, checksum: d631bdbfb1473cff64f0a8e95c3021da (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-08-11T15:41:56Z (GMT) No. of bitstreams: 1 JanuseNogueiraDeCarvalho_TESE.pdf: 1542578 bytes, checksum: d631bdbfb1473cff64f0a8e95c3021da (MD5) / Made available in DSpace on 2017-08-11T15:41:56Z (GMT). No. of bitstreams: 1 JanuseNogueiraDeCarvalho_TESE.pdf: 1542578 bytes, checksum: d631bdbfb1473cff64f0a8e95c3021da (MD5) Previous issue date: 2017-05-15 / A presen?a simult?nea de duas ou mais doen?as ou condi??es cr?nicas em um indiv?duo denomina-se multimorbidade. Conhecer a ocorr?ncia desta condi??o na popula??o ? relevante e tem sido objeto de estudo nos ?ltimos anos, uma vez que impacta na qualidade de vida da popula??o, al?m de ampliar a utiliza??o e os gastos dos servi?os de sa?de. Este estudo teve como base os dados da Pesquisa Nacional de Sa?de, inqu?rito domiciliar realizado no Brasil no ano de 2013 e teve como objetivo avaliar o perfil de multimorbidade da popula??o brasileira (?18 anos) e suas rela??es com vari?veis socioecon?micas, demogr?ficas, relacionadas ao estilo de vida e de uso de servi?os de sa?de. Foram inclu?dos dados de 60.202 participantes. Foi realizada uma an?lise descritiva para estimar as preval?ncias (%) de multimorbidade considerando um n?vel de confian?a de 95%. Para observar a rela??o entre a presen?a de multimorbidade e as vari?veis independentes realizou-se a an?lise multivariada mediante regress?o de Poisson com vari?ncia robusta. Para observar as combina??es entre as doen?as cr?nicas foi realizada uma an?lise de clusters. Os resultados mostram um contingente populacional consider?vel de pessoas com duas ou mais doen?as cr?nicas no Brasil. A preval?ncia de multimorbidade foi de 23,6% e foi maior entre mulheres (RP=1,46), pessoas da faixa et?ria de 60 anos ou mais (RP=6,44) , entre os que possuem planos privados de sa?de (RP= 1,19) e que n?o possuem ocupa??o (RP= 1,21). Observou-se tamb?m uma maior preval?ncia entre indiv?duos ex-fumantes (RP=1,38) e nas pessoas com obesidade (RP=1,74). O uso de servi?os de sa?de nos ?ltimos 12 meses foi significativamente maior para os indiv?duos com multimorbidade, entre os que realizaram consultas m?dicas (RP= 1,31), nos que tiveram interna??es (RP=2,12) e nos que tiveram atendimentos de urg?ncia e emerg?ncia em domic?lios (RP=3,75). A combina??o de doen?as cr?nicas mais frequente foi a hipertens?o com a hipercolesterolemia (7,2%). Na an?lise de conglomerados quatro clusters de doen?as foram identificados. Os padr?es de agrupamentos mais prevalentes tamb?m foram associados a fatores socioecon?micos, demogr?ficos e relacionados ao estilo de vida. O sexo feminino, o tabagismo e a obesidade foram fatores de risco comum a todos os clusters. A preval?ncia de multimorbidade da popula??o brasileira variou de acordo com fatores socioecon?micos, demogr?ficos, relacionados ao estilo de vida e tamb?m aumentou o uso servi?os de sa?de,e devem ser considerados no planejamento de servi?os de sa?de e desenvolvimento de estrat?gias de preven??o e tratamento das m?ltiplas doen?as ou condi??es cr?nicas. / The simultaneous occurrence of two or more chronic diseases in a person is called multimorbidity. Knowing the occurrence of this condition in the population has been the subject of researches in recent years, since it impacts on the quality of life of the population, in addition to expanding the use and spending of health services. This study was based on data from the National Health Survey, a household survey conducted in Brazil in the year 2013 and the objective was to evaluate the multimorbidity profile of the Brazilian population (?18 years) and its relations with socioeconomic, demographic, related to lifestyle variables and health services utilization. Data from 60,202 participants were included. A descriptive analysis was performed to estimate the prevalence (%) of multimorbidity considering a 95% confidence level. In order to observe the relationship between the presence of multimorbidity and the independents variables, the multivariate analysis was performed using Poisson regression with robust variance. To observe the combinations between chronic conditions, a cluster analysis was performed. The results show a considerable number of people with two or more chronic diseases in Brazil. The prevalence of multimorbity was 23.6% and was higher among women (PR = 1.46), people aged 60 years or older (PR = 6.44), among those with private health plans (PR = 1.19) and that they do not have occupation (PR = 1.21). It was also observed a higher prevalence among ex-smokers (PR = 1.38) and in those with obesity (PR = 1.74). The use of health services in the last 12 months was significantly higher for individuals with multimorbidity, among those who had medical appointments (PR = 1.31), those who had hospitalizations (PR = 2.12), and those who had Urgency and emergency at home (PR = 3.75). The most frequent combination of chronic conditions was hypertension with hypercholesterolemia (7.2%). In the conglomerate analysis four clusters of diseases were identified. The most prevalent cluster patterns were also associated with socioeconomic, demographic, and related to lifestyle variables. Female sex, smoking and obesity were common risk factors for all clusters. The prevalence of multimorbidity of the Brazilian population varied according to socioeconomic, demographic and related to lifestyle factors and also increased the use of health services, and should be considered in the planning of health services and development of strategies for prevention and treatment of multiple chronic diseases.

Submitted by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2016-01-04T13:44:09Z No. of bitstreams: 2 lauane_gomes_moreno.pdf: 1163569 bytes, checksum: 5bc267921309b4b4da2343951c77a04e (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2016-01-04T13:44:51Z (GMT) No. of bitstreams: 2 lauane_gomes_moreno.pdf: 1163569 bytes, checksum: 5bc267921309b4b4da2343951c77a04e (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-01-04T13:44:51Z (GMT). No. of bitstreams: 2 lauane_gomes_moreno.pdf: 1163569 bytes, checksum: 5bc267921309b4b4da2343951c77a04e (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2014 / Funda??o de Amparo ? Pesquisa do estado de Minas Gerais (FAPEMIG) / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq) / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (Capes) / Dado o crescente n?mero de doen?as cr?nicas n?o transmiss?veis (DCNT) que afetam a sa?de e a economia dos pa?ses, alternativas que visem ? diminui??o dos fatores de risco para essas doen?as s?o imprescind?veis. A ado??o de uma dieta equilibrada, que inclua alimentos com potencialidades funcionais, associada ? pr?tica de atividade f?sica regular s?o alternativas atualmente preconizadas. Dentre os alimentos com potencialidades funcionais est? o pequi (Caryocar brasiliense), muito utilizado no Brasil para fins aliment?cios, terap?uticos e cosm?ticos, e que apresenta como componentes majorit?rios lip?deos ricos em ?cidos graxos monoinsaturados, fibras e carotenoides. Estes componentes isoladamente, apresentam alguns efeitos semelhantes ao exerc?cio f?sico aer?bio sobre a redu??o de diversos fatores de risco para DCNT, de forma que associados podem fornecer efeitos potencializadores sobre a redu??o desses fatores de risco. Assim, este estudo teve como objetivo avaliar, em ratos, efeitos biol?gicos advindos da ingest?o da polpa de pequi associada ? pr?tica de exerc?cio f?sico aer?bio regular (EFAR), especificamente sobre vari?veis relacionadas ao crescimento, par?metros cardiovasculares, do metabolismo glic?dico e lip?dico, sobre a histomorfometria duodenal e o estado redox celular. O protocolo experimental consistiu de quatro grupos (n=8) de ratos Wistar machos: CS - animais que receberam ra??o; CT - receberam ra??o e EFAR; PS - receberam ra??o suplementada com polpa de pequi (3,26/100g = +50% do conte?do lip?dico da ra??o) e PT - receberam ra??o suplementada com polpa de pequi e EFAR. O EFAR foi realizado em piscina, em intensidades e cargas progressivas, e a dieta fornecida ad libitum durante quinze semanas. A ingest?o alimentar e o peso corporal foram monitorados durante o per?odo experimental para os c?lculos da ingest?o alimentar e cal?rica, do ganho de peso e dos coeficientes de efici?ncia alimentar (CEA) e energ?tica (CEE). As fezes foram coletadas nas ?ltimas 72 horas do experimento. A press?o arterial sist?lica (PAS) e a frequ?ncia card?aca (FC) foram aferidas no in?cio e na ?ltima semana do experimento. No ?ltimo dia do protocolo, os animais foram eutanasiados e foram determinados: (a) o comprimento da t?bia esquerda; (b) o peso absoluto e relativo do f?gado, p?ncreas e cora??o e da gordura das regi?es epididimal e retroperitoneal; (c) a concentra??o plasm?tica de colesterol total (COL), lipoprote?na de alta densidade (HDL), triglicer?deos (TG), glicose, insulina, o ?ndice HOMA-IR e o ?ndice aterog?nico; (d) a concentra??o hep?tica e fecal de COL e TG; (e) a umidade e o pH fecais; (f) a capacidade antioxidante total ? Ferring Reducing Antioxidant Power plasm?tica, e dos tecidos muscular (s?leo), hep?tico e card?aco; (g) os n?veis de peroxida??o lip?dica - Thiobarbituric acid reactive substances nos tecidos hep?tico, muscular e card?aco; (h) a atividade da enzima super?xido dismutase nos tecidos hep?tico e muscular; (i) a atividade da enzima catalase nos tecidos hep?tico, muscular e card?aco. Foram coletadas amostras de tecido duodenal para an?lises histomorfom?tricas. Observou-se que a associa??o da ingest?o da polpa de pequi ao EFAR n?o influenciou de maneira significativa no crescimento (ingest?o alimentar e cal?rica, peso corporal, CEA, CEE, peso de ?rg?os, comprimento da t?bia), na PAS e FC, na glicemia, na insulinemia ou no ?ndice HOMA-IR. Contudo, reduziu a deposi??o de gordura visceral (epididimal e retroperitoneal). Tamb?m n?o houve diferen?as entre os tratamentos para as concentra??es plasm?ticas de COL, HDL e TG. Contudo, a associa??o da ingest?o da polpa de pequi ao EFAR promoveu menor deposi??o hep?tica e maior excre??o fecal de lip?deos, al?m de preservar melhor a altura das vilosidades intestinais e promover aumento da profundidade das criptas. N?o houve impactos significativos dos tratamentos sobre as vari?veis relacionadas ao estado redox celular, somente a atividade da catalase foi aumentada pela associa??o entre EFAR e polpa de pequi no f?gado. Os efeitos fisiol?gicos advindos da ingest?o da polpa de pequi associada ao EFAR relacionados ao menor ac?mulo de lip?deos na regi?o visceral e f?gado, com a maior excre??o desses lip?deos, aumento da profundidade das criptas sem preju?zos ? estrutura do intestino e aumento da atividade antioxidante end?gena, bem como a aus?ncia de efeitos prejudiciais sobre as demais vari?veis analisadas, faz dessa associa??o uma poss?vel estrat?gia para redu??o do risco para DCNT e manuten??o da sa?de. / Disserta??o (Mestrado) ? Programa Multic?ntrico de P?s-gradua??o em Ci?ncias Fisiol?gicas, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2014 / ABSTRACT Given the increasing number of chronic non-communicable diseases (NCDs) affecting health and economy of countries, alternatives on reducing risk factors for these diseases are urged. A balanced diet that includes foods with functional properties associated with regular physical exercise is currently recommended. Among foods with functional potential, is pequi (Caryocar brasiliense), wich is widely used in Brazil for food, cosmetic and therapeutic purposes. It has as its major components, lipids high in monounsaturated fatty acids, fiber and carotenoids. These components have some similar effects as aerobic exercise on the reduction of several risk factors for NCDs, turning its association into a potential strategy for fighting NCDs risk factors. Therefore, this study aimed to evaluate, in rats, biological effects from the intake of pequi pulp associated to regular aerobic exercise (RAE), specifically on growth-related, glucose and lipid metabolism and cardiovascular variables, on duodenal histomorphometry and cellular redox state. The experimental protocol consisted of four groups (n = 8 ) of male Wistar rats: CS - animals fed chow; CT - animals feed chow and RAE; PS - animals feed chow plus pequi pulp (3.26/100g = +50 % of the lipid content of chow) and PT - animals feed chow plus pequi pulp and RAE. The RAE was held in pool at intensities and progressive loadings, and the animals were fed ad libitum for fifteen weeks. Food intake and body weight were monitored throughout the experimental period for calculation of food and energy intakes, weight gain, feed (FE) and energy efficiencies (EE). Feces were collected in last 72 hours of the experiment. Tail systolic blood pressure (SBP) and heart rate (HR) were measured at the beginning and in the last week of the experiment. On the last day, the animals were euthanized; the abdominal and thoracic cavities were opened for sampling. It was determined: (a) The left tibia length; (b) the absolute and relative liver, pancreas and hearts weights and all the retroperitoneal and epididymal fat pads; (c) plasma concentrations of cholesterol (COL), high density lipoprotein (HDL), triglycerides (TG), glucose, insulin, HOMA-IR index and atherogenic index; (d) the liver and fecal concentrations of COL and TG; (e) fecal moisture and pH; (f) plasma, muscle (soleus), liver and heart total antioxidant capacity - Ferring Reducing Antioxidant Power (FRAP); (g) liver, muscle and heart levels of lipid peroxidation - Thiobarbituric acid reactive substances (TBARS); (h) liver and muscle activity of superoxide dismutase (SOD); (i) liver, muscle and heart activity of catalase (CAT). Duodenal tissue samples were collected for histomorphometric analyses. It was observed the intake of pequi pulp associated to RAE did not influence significantly animal?s growth (food and caloric intake, body weight, FE, EE, organ weights, tibia length), SBP and HR, plasma glucose and insulin, HOMA-IR and atherogenic indexes. However, this association reduced visceral fat pad weights. There were no differences among treatments for plasma COL, HDL and TG. However, the intake of pequi pulp associated to RAE led to lower hepatic deposition and increased fecal output of lipids, in addition to better preserve the intestinal villi height and to promote increased crypt depth. There were no significant effects regarding redox state of all variables, although CAT activity was increased in the liver of the animals fed pequi pulp plus RAE. The reduction of visceral fat and hepatic lipid deposition with increased excretion, the increased cell renewal without damaging the structure of the intestine, the increased endogenous antioxidant activity, and the absence of harmful effects on other variables, point out that the intake of pequi pulp associated to RAE is a possible strategy for reducing the risk of non-communicable diseases and for health maintenance.

Submitted by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2016-01-04T13:53:16Z No. of bitstreams: 2 lidiane_guedes_oliveira.pdf: 705674 bytes, checksum: 7f2a8cdcec73417a5a58f7784fffca1d (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2016-01-04T13:53:48Z (GMT) No. of bitstreams: 2 lidiane_guedes_oliveira.pdf: 705674 bytes, checksum: 7f2a8cdcec73417a5a58f7784fffca1d (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-01-04T13:53:48Z (GMT). No. of bitstreams: 2 lidiane_guedes_oliveira.pdf: 705674 bytes, checksum: 7f2a8cdcec73417a5a58f7784fffca1d (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2014 / Funda??o de Amparo ? Pesquisa do estado de Minas Gerais (FAPEMIG) / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq) / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (Capes) / Evid?ncias cient?ficas cumulativas sugerem que os ?cidos graxos monoinsaturados (MUFAs) diet?ticos reduzem fatores de risco para o desenvolvimento de desordens metab?licas, as quais causam muitas doen?as cr?nicas n?o transmiss?veis (DCNT), tais como o diabetes n?o insulinodependente e as cardiovasculares. O ?leo de pequi (Caryocar brasiliense) apresenta em sua composi??o predom?nio de ?cidos graxos monoinsaturados e carotenoides antioxidantes, os quais t?m sido tamb?m relacionados ? redu??o do risco para DCNT. Entretanto, ainda s?o escassos na literatura estudos que avaliem efeitos fisiol?gicos do ?leo de pequi dentro da perspectiva de alimento funcional, ou seja, associado ? dieta usual e h?bitos saud?veis de vida, dentre os quais se destaca o exerc?cio f?sico regular. Diante desse contexto, o objetivo deste estudo foi pesquisar a influ?ncia da ingest?o do ?leo de pequi associada ao exerc?cio f?sico aer?bio regular (EFAR), sobre vari?veis relacionadas ao crescimento, ao metabolismo e par?metros cardiovasculares de ratos, desde est?gios iniciais de vida (p?s-desmame) at? o in?cio da vida adulta (20 semanas de vida). O protocolo experimental consistiu de quatro grupos (n=8) de ratos Wistar machos: CS - animais que receberam ra??o; CT - receberam ra??o e EFAR; OS - receberam ra??o suplementada com ?leo de pequi (2,25/100g = +50% do conte?do lip?dico da ra??o) e OT - receberam ra??o suplementada com ?leo de pequi e EFAR. O EFAR foi realizado em piscina, em intensidades e cargas progressivas, e a dieta fornecida ad libitum durante 15 semanas. A ingest?o alimentar e o peso corporal foram monitorados durante o per?odo experimental para os c?lculos da ingest?o alimentar e cal?rica, do ganho de peso, do coeficiente de efici?ncia alimentar (CEA%) e do ?ndice de massa corporal (IMC). A press?o arterial sist?lica (PAS) e a frequ?ncia card?aca (FC) foram aferidas no in?cio e na ?ltima semana do experimento. No ?ltimo dia, os animais foram eutanasiados, as cavidades abdominais e tor?cicas foram abertas para coleta de amostras. Os cora??es foram retirados e o ?ndice de contratilidade (+dP/dt) e relaxamento (-dP/dt) card?aco foram analisados pela t?cnica de cora??o isolado. Foram determinados: (a) o comprimento da t?bia esquerda; (b) os pesos absolutos e relativos do f?gado, p?ncreas e cora??o e de toda a gordura das regi?es epididimal e retroperitoneal; (c) as concentra??es plasm?ticas de colesterol (COL), lipoprote?na de alta densidade (HDL), triglicer?deos (TG), glicose, insulina, o ?ndice HOMA e a raz?o COL/HDL; (d) as concentra??es hep?ticas de COL e TG. Observou-se que a associa??o do ?leo de pequi ao EFAR n?o influenciou de maneira significativa par?metros relacionados ao crescimento (ingest?o alimentar e cal?rica, peso corporal, CEA, peso de ?rg?os, comprimento da t?bia), a PAS e FC, a glicemia e a raz?o COL/HDL. No entanto, foi essencial para evitar o ac?mulo de gordura na regi?o visceral, a eleva??o nos n?veis de insulina plasm?tica e no ?ndice HOMA-IR provocados pela ingest?o isolada do ?leo de pequi. Por outro lado, a associa??o da ingest?o do ?leo de pequi ao EFAR melhorou a capacidade de contra??o e relaxamento card?acos. Assim, podemos inferir que a ingest?o do ?leo de pequi, quando associada ? pr?tica regular de exerc?cios aer?bios, pode favorecer, sobretudo, a fun??o card?aca sem exercer efeitos delet?rios no crescimento e em vari?veis relacionadas ao metabolismo lip?dico e glic?dico. / Disserta??o (Mestrado) ? Programa Multic?ntrico de P?s-gradua??o em Ci?ncias Fisiol?gicas, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2014. / ABSTRACT Cumulative evidence suggests that dietary monounsaturated fatty acids (MUFAs) reduce risk factors for metabolic disorders, which lead to many chronic non-communicable diseases (NCDs), such as cardiovascular and non-insulin-dependent diabetes. Pequi oil (Caryocar brasiliense) is high in monounsaturated fatty acids and antioxidant carotenoids, which have also been associated to reduced risk for NCDs. However, there is lacking of studies evaluating pequi oil physiological effects from the perspective of being a functional food, which means, associated to a usual diet and a healthy lifestyle, being the regular physical exercise a part of it. In this context, the aim of this study was to investigate the influence of pequi oil intake, associated to regular aerobic physical exercise (RAPE) on variables related to growth, metabolism and on cardiovascular parameters of rats, from early stages of life (post weaning) to early adulthood (20 weeks old). The experimental protocol consisted of four groups (n = 8) of male Wistar rats: CS - animals fed chow; CT - received chow and RAPE; OS - received chow added pequi oil (2.25 / 100g =+50% of the chow lipid content) and OT - received chow added pequi oil and RAPE. The RAPE was held in a pool at intensities and progressive loading, and the diets were fed ad libitum for 15 weeks. Food intake and body weight were monitored throughout the experimental period to determine food and caloric intake, weight gain, feed efficiency ratio (FER%) and body mass index (BMI). Systolic blood pressure (SBP) and heart rate (HR) were measured at baseline and in the last week of the experiment. On the last day, animals were euthanized and the abdominal and thoracic cavities were opened for sampling. Hearts were removed and the contractility (+dP/dt) and relaxation (-dP/dt) indexes were analyzed by the isolated heart technique. It were determined: (a) The left tibia length (b) the relative liver, pancreas and hearts weights and the retroperitoneal and epididimal fat pad weights; (c) plasma concentrations of cholesterol (COL), high density lipoprotein (HDL), triglycerides (TG), glucose, insulin, HOMA-IR index and COL/HDL ratio; (d) hepatic TG and COL levels. The association of pequi oil intake to RAPE did not influence significantly growth (food and caloric intake, body weight, FER%, organ weights, tibia length), SBP and HR, blood glucose and COL/HDL ratio. However, it prevented fat accumulation in the visceral region and plasma insulin and HOMA-IR increases caused by the pequi oil intake solely. Moreover, the pequi oil intake associated to RAPE improved the heart contraction and relaxation ability. Thus, we can infer that pequi oil intake, when associated to RAPE can improve mainly cardiac function without exerting deleterious effects on growth and on glucose and lipid metabolism.