Submitted by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2014-12-17T14:07:27Z No. of bitstreams: 2 adriano_prado_simao.pdf: 14603272 bytes, checksum: 6a0e234b9d484325125c4f251d688d0b (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2014-12-17T14:08:37Z (GMT) No. of bitstreams: 2 adriano_prado_simao.pdf: 14603272 bytes, checksum: 6a0e234b9d484325125c4f251d688d0b (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2014-12-17T14:08:31Z (GMT) No. of bitstreams: 2 adriano_prado_simao.pdf: 14603272 bytes, checksum: 6a0e234b9d484325125c4f251d688d0b (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2014-12-17T14:09:21Z (GMT) No. of bitstreams: 2 adriano_prado_simao.pdf: 14603272 bytes, checksum: 6a0e234b9d484325125c4f251d688d0b (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) / Made available in DSpace on 2014-12-17T14:09:21Z (GMT). No. of bitstreams: 2 adriano_prado_simao.pdf: 14603272 bytes, checksum: 6a0e234b9d484325125c4f251d688d0b (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) Previous issue date: 2013 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (Capes) / Funda??o de Amparo ? Pesquisa do estado de Minas Gerais (FAPEMIG) / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq) / Introdu??o: Recentemente, a vibra??o de todo o corpo (VTC) tem sido um m?todo de exerc?cio f?sico indicado para aumentar o desempenho e a capacidade f?sico-funcional de idosos com osteoartrite (OA) de joelho. No entanto, os mecanismos relacionados aos efeitos produzidos por essa modalidade ainda n?o foram completamente investigados. Objetivos: O objetivo deste estudo foi investigar os efeitos da adi??o de VTC aos exerc?cios de agachamento na concentra??o plasm?tica de marcadores inflamat?rios e no desempenho e capacidade funcionais de idosos com OA de joelho na fase remissiva da doen?a (Estudo 1) e investigar os efeitos da adi??o do treinamento de VTC ao exerc?cio de agachamento em mulheres idosas com OA de joelho na fase remissiva da doen?a nos seguintes par?metros: 1) for?a isom?trica do m?sculo quadr?ceps; 2) concentra??o plasm?tica de BDNF; e 3) na concentra??o salivar da raz?o testosterona/cortisol (Estudo 2). Investigar a rela??o entre os n?veis plasm?ticos e no l?quido sinovial do TNF-? e seus receptores sol?veis (sTNFR1 e sTNFR2) assim como de BDNF em idosos com OA de joelho e ainda verificar a rela??o destes com a gravidade da OA e o autorrelato de dor, rigidez e fun??o f?sica com o WOMAC (Western Ontario and McMaster University Osteoarthritis Index) em idosos com OA de joelho na fase inflamat?ria aguda (Estudo 3). Metodologia: No estudo 1, trinta e dois idosos com OA de joelho foram divididos em tr?s grupos: grupo que realizou exerc?cio de agachamento associado a plataforma vibrat?ria (grupo plataforma N=11), grupo que realizou exerc?cio de agachamento sem vibra??o (grupo agachamento N=10) e o grupo controle (N=11). Um programa estruturado de exerc?cios de agachamento foi executado tr?s vezes por semana em dias alternados por doze semanas nos grupos plataforma e agachamento. A concentra??o plasm?tica de receptores sol?veis de TNF-? (sTNFR1 e sTNFR2) foi analisada usando a t?cnica de ELISA. O WOMAC foi usado para avaliar o autorrelato da fun??o f?sica, dor e rigidez. O teste de caminhada de 6 minutos, a escala de Berg e o teste de velocidade da marcha foram utilizados para avaliar a fun??o f?sica. No estudo 2, foram selecionadas quinze mulheres idosas com idade maior ou igual a 60 anos que tinham sido diagnosticadas com OA em pelo menos um joelho. A interven??o consistiu de doze semanas seguidas de exerc?cios de agachamento, 3 vezes por semana. O protocolo de exerc?cio foi similar em ambos os grupos diferindo apenas da presen?a de vibra??o. J? no estudo 3 participaram vinte e sete idosos diagnosticados com osteoartrite de joelho e dezenove idosos saud?veis. Radiografias ?ntero-posteriores do joelho foram realizadas para determinar a gravidade da doen?a no joelho afetado. A classifica??o radiogr?fica da OA do joelho foi realizada utilizando os crit?rios Kellgren-Lawrence. Os n?veis de TNF-?, sTNFR1, sTNFR2 e BDNF no plasma e no l?quido sinovial foram determinados por ELISA. Resultados: No estudo 1, o grupo que realizou exerc?cios de agachamento na plataforma vibrat?ria mostrou diminui??o nas concentra??es plasm?ticas dos marcadores inflamat?rios sTNFR1 e sTNFR2 (p<0,001 e p<0,05, respectivamente), no autorrelato da dor (p<0,05), melhora no equil?brio (p<0,05) e na velocidade e dist?ncia caminhada (p<0,05 e p<0,001, respectivamente) comparado com o grupo controle. O teste de velocidade da marcha tamb?m apresentou aumento no grupo plataforma quando comparado ao grupo agachamento (p<0,01). Os resultados do estudo 2 demonstraram uma varia??o (?) positiva dos valores da for?a isom?trica muscular do quadr?ceps (p=0,02) e da concentra??o plasm?tica de BDNF (p=0,03) no grupo vibra??o ap?s o per?odo de interven??o. A varia??o (?) na raz?o testosterona/cortisol (T/C) n?o diferiu significativamente, entre os grupos (p=0,61). No estudo 3, os n?veis de BDNF no l?quido sinovial correlacionou-se significativamente com dor autorrelatada [WOMAC] (rs = 0,39, p=0,04). Com rela??o aos receptores sol?veis para TNF-?, observou-se uma diferen?a entre os n?veis de sTNFR1 e de sTNFR2, tanto no plasma quanto no l?quido sinovial em pacientes com OA do joelho (1091 ? 99,48 pg / mL versus 2249 ? 126,3 pg / mL e 2587 ? 66,12 pg / mL versus 2021 ? 107,0 pg / mL, respectivamente). Al?m disso, os n?veis de sTNFR1 no l?quido sinovial foram, negativamente, correlacionadas com a dor e a fun??o f?sica autorrelatada (rs -0,6785, p<0,0001 e rs -0,4194; p=0,03, respectivamente). Ao passo que, os n?veis de sTNFR2 no l?quido sinovial foram negativamente correlacionadas com dor e rigidez articular (rs -0,5433, p=0,01 e rs -0,4249; p=0,02, respectivamente). Conclus?es: Os resultados dos estudos supracitados indicam que a adi??o da vibra??o de todo o corpo ao treinamento com exerc?cio de agachamento, nas condi??es experimentais propostas, melhora o equil?brio est?tico e din?mico e o desempenho da marcha e ao mesmo tempo reduz a autopercep??o de dor e a concentra??o de marcadores inflamat?rios (sTNFR1 e sTNFR2) em idosos com OA de joelho na fase de remiss?o da doen?a. Al?m disso, a associa??o da vibra??o de todo o corpo ao exerc?cio de agachamento promove uma melhora na for?a muscular de membros inferiores em mulheres idosas com OA de joelho na fase de remiss?o da doen?a e proporciona uma resposta adaptativa na concentra??o de BDNF sem altera??o na rela??o muscular de anabolismo/catabolismo. J? os resultados da rela??o entre sist?mico e local, indicam que os n?veis de BDNF sist?micos est?o associados com o mecanismo da dor articular na OA de joelho. Com rela??o aos receptores sol?veis de TNF-?, evidenciou-se a presen?a de receptores sol?veis para TNF-? no l?quido sinovial de pacientes com OA prim?ria de joelho e a rela??o destes receptores com par?metros cl?nicos. / Tese (Doutorado) ? Programa Multic?ntrico de P?s-Gradua??o em Ci?ncias Fisiol?gicas, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2013. / ABSTRACT Introduction: Recently, whole body vibration (WBV) has been an alternative method of exercise that has been indicated to improve the physical performance of the elderly with osteoarthritis (OA) knee. However, the mechanisms related to the effects produced by this training mode have not been fully elucidated in the literature. Objectives: 1) To investigate the effects of the adittion of whole-body vibration to squat exercises on the plasma concentration of inflammatory markers and the functional performance of elderly individuals with knee OA remission phase (Study 1) and investigate the effects of WBV in addition to squat exercise training in elderly women with knee OA remission phase on the following parameters: 1) isometric strength of the quadriceps muscle; 2) BDNF plasma concentration; and 3) the testosterone/cortisol salivary concentration ratio (Study 2). 3). To analyze the concentrations of TNF-?, soluble receptors (sTNFR1 and sTNFR2) and BDNF in both plasma and synovial fluid of patients with inflammatory acute phase primary knee osteoarthritis during inflammatory acute phase, and to determine the possible correlations of plasma and synovial fluid TNF-?, soluble receptors (sTNFR1 and sTNFR2) and BDNF with the radiographic grading of knee OA and with self-reported pain, stiffness and physical function (Study 3). Methods: In study 1 thirty-two elderly subjects with knee osteoarthritis were divided into three groups [i.e., squat exercises on a vibratory platform (platform group N= 11), squat exercises without vibration (squat group N= 10) and the control group (N=11)]. The structured program of squat exercises in the platform and squat groups was conducted three times per week, on alternate days, for twelve weeks. The plasma concentration of TNF-? soluble receptors (sTNFR1 and sTNFR2) were analyzed using ELISA. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC) questionnaire were used to evaluate self-reported physical function, pain and stiffness. The 6-minute walk test, the Berg balance scale, and gait speed were used to evaluate physical function. In study 2 the eligible patients were fifteen (15) elderly women ? 60 years of age who had been diagnosed with OA in at least one knee. The intervention consisted of uninterrupted squatting exercises for twelve weeks, 3x/week. The exercise protocol was similar in both groups differing only in the presence of vibration. In study 3 samples of plasma taken from the peripheral blood and of synovial fluid taken from the knee of patients with osteoarthritis (OA) were collected (n=27). Anteroposterior knee radiographs were taken to determine disease severity in the affected knee. Radiographic grading of OA in the knee was performed using the Kellgren-Lawrence criteria. Furthermore, plasma was collected from the peripheral blood of 19 healthy individuals, with no radiographic change in the hips and knees. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC) questionnaire was used to evaluate self-reported physical function, pain and stiffness. ELISA measured the TNF-?, sTNFR1, sTNFR2 and BDNF levels in the plasma and synovial fluid. Results: In the study 1 the group that performed squat exercises on a vibratory platform, there were significant differences in plasma concentrations of the inflammatory markers sTNFR1 and sTNFR2 (p<0.001 and p<0.05, respectively), self-reported pain (p<0.05), balance (p<0.05) and speed and distance walked (p<0.05 and p<0.001, respectively) compared with the control group. The gait speed test also showed significant differences between the squat and platform groups (p<0.01). In the results of the study 2, the VG group demonstrated a significantly greater change (?) in IQMS values (p = 0.02) and in BDNF plasma concentrations (p = 0.03) after the intervention period compared with the EG group. The change (?) in T/C ratio showed no difference between the groups (p = 0.61). In the results of the study 3, the plasma BDNF levels significantly correlated with self-reported pain [WOMAC] (rs=0.39, p=0.04). According to soluble receptors to TNF-?, there was a difference between sTNFR1 and sTNFR2 levels in plasma as well as in synovial fluid in patients with knee (1091 ? 99,48 pg / mL versus 2249 ? 126,3 pg / mL e 2587 ? 66,12 pg / mL versus 2021 ? 107,0 pg / mL, respectively). Synovial fluid sTNFR1 levels were negatively correlated with pain and physical function self-reported (rs-0.6785, p<0.0001 and rs-0.4194, p=0.03, respectively). Synovial fluid sTNFR2 levels were negatively correlated with pain and joint stiffness (rs-0.5433, p=0.01 and rs-0.4249, p=0.02, respectively). Conclusions: The results of the above studies indicate that the addition of vibration training the whole body to squat exercise in the experimental conditions resulted in improvement in static and dynamic balance and gait performance and reduced the self-perception of pain and the concentration of inflammatory markers (sTNFR1 and sTNFR2) in elderly patients with knee OA. We also demonstrate that the combination of vibration training the whole body to squat exercise can promote an improvement in lower limb muscle strength in elderly women with knee OA and still provide an adaptive response to the concentration of BDNF compared with no change in muscle anabolism/catabolism. The results of the relationship between systemic and local concentration indicate that the systemic BDNF levels are associated with the mechanism of joint pain in knee OA. With respect to TNF-? soluble receptors, the findings demonstrated the presence of soluble receptors for TNF-alpha, particularly sTNFR1, in the synovial fluid of patients with primary knee OA and the relationship between these receptors and clinical parameters.

Submitted by Jos? Henrique Henrique (jose.neves@ufvjm.edu.br) on 2017-03-02T20:23:00Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) ana_cristina_resende_camargos.pdf: 3572613 bytes, checksum: ed282931c95236a0305016db8c75f026 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2017-03-06T11:37:07Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) ana_cristina_resende_camargos.pdf: 3572613 bytes, checksum: ed282931c95236a0305016db8c75f026 (MD5) / Made available in DSpace on 2017-03-06T11:37:08Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) ana_cristina_resende_camargos.pdf: 3572613 bytes, checksum: ed282931c95236a0305016db8c75f026 (MD5) Previous issue date: 2016 / A obesidade infantil ? considerada um dos maiores problemas de sa?de p?blica do mundo. Estudos demonstram altera??o do padr?o de secre??o de adipocinas, cortisol e do fator neurotr?fico derivado do c?rebro (BDNF), bem como inflama??o cl?nica cr?nica sublimiar e desequil?brio redox em crian?as com sobrepeso e obesidade na idade escolar. Al?m disso, o excesso de peso tamb?m est? associado a reduzido desenvolvimento cognitivo e motor. Apesar da literatura indicar que os primeiros 24 meses de vida representam um per?odo importante para o desenvolvimento da obesidade infantil, n?o existem evid?ncias se crian?as com sobrepeso e obesidade nesta faixa et?ria j? apresentam altera??es em par?metros neuroend?crino-inflamat?rios, com poss?vel impacto no desenvolvimento infantil. Dessa forma, os objetivos deste estudo foram: 1) analisar as concentra??es plasm?ticas de adipocinas e BDNF, as concentra??es s?ricas de cortisol e o estado redox de crian?as com sobrepeso/obesidade entre seis e 24 meses de idade; 2) avaliar o desenvolvimento cognitivo e motor de crian?as com sobrepeso/obesidade entre seis e 24 meses de idade e; 3) verificar associa??es entre os biomarcadores avaliados com o desenvolvimento cognitivo e motor nessa faixa et?ria. Foi realizado um estudo transversal com crian?as com sobrepeso/obesidade e eutr?ficas entre seis e 24 meses de idade, cadastradas nas Estrat?gias de Sa?de da Fam?lia. As concentra??es plasm?ticas de leptina, adiponectina, resistina, receptores sol?veis do fator de necrose tumoral 1 e 2 (sTNFR1 e sTNFR1), BDNF e as concentra??es s?ricas de cortisol foram mensuradas pelo m?todo ELISA. As quimiocinas foram mensuradas pela t?cnica cytometric bead arrays e o estado redox foi determinado por meio da detec??o das concentra??es de subst?ncias reativas ao ?cido tiobarbit?rico (TBARS), da atividade das enzimas catalase (CAT) e super?xido dismutase (SOD) e da habilidade de redu??o do ferro (FRAP). O desenvolvimento infantil foi avaliado por meio do instrumento Bayley Scales of Infant and Toddler Development, 3? edi??o (Bayley-III). Foi utilizado teste t para amostras independentes para comparar os grupos e correla??o de Pearson ou Spearman para verificar a associa??o entre as vari?veis. Al?m disso, foi utilizado um modelo de regress?o linear m?ltipla stepwise para verificar a associa??o entre os biomarcardores selecionados com o desenvolvimento cognitivo e motor. As concentra??es plasm?ticas de leptina (p=0,0001), adiponectina (p=0,0007), BDNF (p=0,003) e as concentra??es s?ricas de cortisol (p=0,048) foram significativamente superiores no grupo de crian?as com sobrepeso/obesidade. Em contrapartida, as crian?as deste grupo apresentaram menores concentra??es de TBARS (p=0,004) e menor atividade das enzimas antioxidantes CAT (p=0,045) e SOD (p=0,02). N?o foram encontradas diferen?as significativas nas concentra??es de quimiocinas, sTNFR1, sTNFR2, resistina e FRAP entre os grupos (p>0,05). Al?m disso, as crian?as do grupo sobrepeso/obesidade apresentaram menores escores de desenvolvimento cognitivo (p=0,03) e motor (p=0,04). Foi ainda encontrada associa??o significativa entre as concentra??es plasm?ticas de leptina e sTNFR1 com o escore composto cognitivo (p=0,001) e das concentra??es plasm?ticas de sTNFR1 com o escore composto motor (p=0,003). Todos esses resultados apontaram a presen?a de altera??es neuroend?crino-inflamat?rias em crian?as com sobrepeso/obesidade entre seis e 24 meses de idade. Al?m disso, embora a maior parte das crian?as com sobrepeso/obesidade apresentem desenvolvimento infantil dentro dos limites de normalidade, evidencia-se pior desempenho cognitivo e motor. Por fim, foi demonstrado que maiores concentra??es de sTNFR1 e menores concentra??es de leptina foram associadas com melhores desfechos de desenvolvimento infantil nessa faixa et?ria. / Tese (Doutorado) ? Programa Multic?ntrico de P?s-Gradua??o em Ci?ncias Fisiol?gicas, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2016. / Childhood obesity is one of the world?s most serious public health issues. Studies have demonstrated dysregulated secretion pattern of adipokines, cortisol, brain-derived neurotrophic factor (BDNF), as well as chronic low-grade inflammation and redox imbalance in school-age overweight or obese children. Overweight/obese infants also had lower cognitive and motor development scores. Although the literature points out that the first 24 months of life represent an important period for the development of childhood obesity, it is not known whether overweight/obese infants in this age interval present alterations in neuroendocrine inflammatory parameters, with possible impact on child development. Then, the objectives of this study were: 1) to analyze the plasmatic levels of adipokines and BDNF, serum cortisol and redox status in overweight/obese infants between 6 and 24 months of age; 2) to evaluate the cognitive and motor development in overweight/obese infants between 6 and 24 months of age and; 3) to verify the association of the biomarkers evaluated with cognitive and motor development in this age interval. A cross-sectional study was conducted with infants with overweight/obesity and normal-weight between 6 and 24 months enrolled in Family Health Strategies. Plasma leptin, adiponectin, resistin, BDNF, soluble tumour necrosis factor receptors 1 and 2 (sTNFR1, sTNFR2), and serum cortisol levels were measured using conventional ELISA kits. Plasma chemokines were measured using the cytometric bead arrays kit, and oxidative stress was assessed by thiobarbituric acid reactive substances (TBARS) concentration, enzymes catalase (CAT) and dismutase superoxide (SOD) activity, as well by ferric reducing antioxidant power (FRAP). Infant development was performed using the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III). A t test for independent samples was performed to compare the groups and Pearson and Spearman correlation was used to verify the association between parameters. Multiple linear stepwise regression models were utilized to verify the association between the biomarkers selected and cognitive and motor composite scores. Plasma levels of leptin (p=0.0001), adiponectin (p=0.0007), BDNF (p=0.003) and serum cortisol (p=0.048) were significantly higher in overweight/obese infants. In contrast, concentration of TBARS (p=0.004), CAT (p=0.045) and SOD activity (p=0.02) were lower in overweight/obese infants. There were no differences in the levels of chemokines, sTNFR1, sTNFR2, resistin and FRAP between groups (p>0.05). Moreover, overweight/obese infants had lower cognitive (p=0.03) and motor (p=0.04) development scores than normal-weight infants. A significant association of plasma leptin and sTNFR1 levels with cognitive composite scores (p=0.001) were found and plasma sTNFR1 levels were associated with motor composite scores (p=0.003). All these results point out neuroendocrine inflammatory response changes in overweight/obese infants between 6 and 24 months. Moreover, although most of overweight/obese infants have presented cognitive and motor development within normal limits, there is evidence of worse cognitive and motor performance. Finally, high sTNFR1 and low leptin levels were associated with increase developmental outcomes in infants in this age interval.