Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-09-19T13:36:37Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) COLACAO FINAL.pdf: 6155295 bytes, checksum: 72b54a0d2d74622812225c02c45a9105 (MD5) / Made available in DSpace on 2016-09-19T13:36:37Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) COLACAO FINAL.pdf: 6155295 bytes, checksum: 72b54a0d2d74622812225c02c45a9105 (MD5) Previous issue date: 2016-02-05 / O anel na derivação gástrica em Y de Roux (DGYR) pode levar a intolerância alimentar, mesmo na ausência de estenose, sendo sua remoção cirúrgica o tratamento habitual. Objetivou-se avaliar a viabilidade, eficácia e segurança da dilatação endoscópica do anel com balão de acalasia – Rigiflex®, bem como a evolução ponderal que se segue ao procedimento. Procedeu-se a um estudo longitudinal retrospectivo, com avaliação de dados coletados prospectivamente. A coorte estudada foi submetida ao procedimento proposto no Hospital das Clínicas da UFPE, entre 2002 e 2011, sendo composta por pacientes advindos de serviços de cirurgia bariátrica, em diferentes regiões do Brasil. Foram incluídos 63 pacientes (45 mulheres e 18 homens), com média de idade de 42,4 anos, com quadro de vômitos pós-alimentares em frequência superior a quatro episódios semanais. A efetividade do método baseou-se na melhora dos sintomas obstrutivos, tendo sido empregadas até quatro sessões. Avaliou-se a evolução do índice de massa corporal (IMC), do percentual de excesso de peso (%EP) e do percentual de perda de excesso de peso (%PEP) da amostra em relação aos períodos pré-operatório, da dilatação e do seguimento tardio. Houve melhora completa da sintomatologia inicial em 59 casos (93,6%) e parcial, em dois casos (3,2%). Houve complicações leves em seis casos (9,6%), todos tratados clinicamente. Após seguimento mediano de 43 meses houve incremento médio no IMC de 2,5 kg/m². A dilatação endoscópica com balão, método minimamente invasivo, mostrou-se viável, segura e eficaz, observando-se pequeno aumento ponderal na avaliação tardia. / The placement of a ring on Roux-en-y gastric bypass (RYGB) can lead to food intolerance, even in the absence of stenosis, and its surgical removal is the usual treatment. The purpose of this retrospective, longitudinal study, which evaluated prospectively collected data, was to evaluate the feasibility, efficacy and safety of endoscopic ring dilation with achalasia balloon - Rigiflex®, as well as the weight gain following the procedure. The patients enrolled in this cohort came from different bariatric services in Brazil and underwent the proposed procedure at Hospital das Clínicas of UFPE, between 2002 and 2011. Sixty three patients (45 women and 18 men) with a mean age of 42.4 years who had more than four post-prandial vomiting episodes per week were included. The effectiveness of the method was based on the improvement in obstructive symptoms, after up to four sessions. The body mass index (BMI), the percentage of excess weight (% EW) and the percentage of excess weight loss (% EWL) of the subjects were evaluated in relation to the preoperative period, the dilation moment and the late follow-up. There was full improvement of the initial symptoms in 59 cases (93.6%) and partial, in two cases (3.2%). Minor complications were observed in six cases (9.6%), which were all treated clinically. After median follow-up of 43 months there was an average BMI increase of 2.5 kg / m². Endoscopic balloon dilation, which is a minimally invasive method, proved to be feasible, safe and effective with a slight weight gain in late evaluation.

Introdução: A má digestão de lactose detectada por testes respiratórios é bastante comum em pacientes com síndrome do intestino irritável (SII), e alguns pacientes com SII referem exacerbar seus sintomas após a ingestão de leite e produtos lácteos. A fim de uma melhor percepção sobre este tema, este trabalho investigou os efeitos da dieta isenta de lactose em pacientes com SII e teste respiratório de hidrogênio para avaliação da digestão de lactose normal ou anormal. Objetivo: Avaliar os efeitos de uma dieta isenta de lactose em pacientes de SII com ou sem teste positivo para má digestão de lactose (teste respiratório). Métodos: 80 pacientes atendidos no Ambulatório de Doenças Funcionais Intestinais do Serviço de Gastroenterologia Clínica do HCFMUSP foram recrutados para o estudo prospectivo. Os pacientes preencheram os critérios de Roma III para SII. Durante o ensaio do teste respiratório de hidrogênio todos os sintomas desencadeados pela ingestão de lactose foram anotados. Ambos os grupos de pacientes com e sem má digestão de lactose, foram submetidos a uma dieta isenta de lactose durante 4 semanas. A história prévia de intolerância ao leite e derivados também foi documentada. No final de cada semana, os pacientes foram solicitados a informar a respeito dos seus sintomas, e os resultados, foram devidamente marcados de acordo com a sua intensidade (Escore Global). Além disso, foi também obtida a Avaliação Global do Paciente no final do tratamento (AFG). Resultados: 33/80 (41,25%) pacientes com SII tiveram um teste respiratório anormal para a má digestão de lactose, e 47/80 dos pacientes (58,75%) com SII tiveram um teste respiratório normal (ns). Não houve diferença significativa na freqüência de queixas de intolerância prévia ao leite e derivados em ambos os grupos. No entanto, mais pacientes no grupo com má digestão de lactose referiram sintomas durante o teste respiratório com 25 g de lactose do que o grupo com digestão normal a lactose (p <0,001). Ambos os grupos igualmente melhoraram após uma dieta isenta de lactose, quando avaliados pelo escore geral e pelo AFG. Conclusões: Ambos os grupos de pacientes com SII, com e sem má digestão de lactose, melhoraram após 4 semanas de dieta isenta de lactose. Os nossos resultados sugerem que outros mecanismos, além da intolerância à lactose, devem ser levados em conta para explicar a melhora com uma dieta isenta de lactose em pacientes com SII / Introduction: Lactose intolerance detected by respiratory tests is rather common in patients with irritable bowel syndrome(IBS); also, some IBS patients refer their symptoms exacerbate after ingestion of milk and dairy products. In order to gain some insight into this topic we investigated the effects of a lactose-free diet in IBS patients with and without lactose intolerance diagnosed by means of the hydrogen respiratory test. Objective: To evaluate the effects of a lactose-free diet in IBS patients with and without lactose intolerance. Methodos: 80 patients who attended the outpatient clinic at the University of São Paulo School of Medicine Hospital, Brazil, were recruited for this prospective study. Patient met the Rome III criteria for IBS. During the hydrogen respiratory test all the symptoms triggered by lactose ingestion were taken down. Both groups of patients, with and without lactose intolerance, were submitted to a lactose-free diet for 4 weeks. Previous history of milk/dairy products intolerance was documented. At the end of each week, patients were asked to inform about their symptoms and the results were duly scored according to their intensity (Global Score). Also, the Patient Final Global Evaluation of the Treatment (PFGET) was obtained as well. Results: 33/80 (41.25%) IBS patients had an abnormal respiratory test for lactose intolerance; 47/80 (58.75%) IBS patients had a normal respiratory test (n.s.). There was no significant difference in the frequency of previous complaints after milk/dairy products ingestion in both groups. However, more patients in the lactose intolerant group referred symptoms during the respiratory test with 25 g of lactose than the lactose tolerant group (p<0,001). Both groups similarly improved after a lactose-free diet when evaluated by both the Global Score and the PFGET. Conclusions: Both groups of IBS patients, with and without lactose intolerance, improved after a 4-week lactose-free diet. Our results suggest that other mechanisms, in addition to lactose intolerance, should be taken into account to explain why IBS patients improve with a lactose-free diet

A crescente prevalência de diabetes mellitus (DM) em nível mundial, a sua incidência cada vez maior em crianças e adolescentes e resultados prévios obtidos em nosso laboratório (piora do quadro diabético em ratos na puberdade) nos levaram a investigar o metabolismo de glicose em tecido adiposo branco na puberdade em ratos controle (CO) e intolerantes à glicose (STZ). Parâmetros de desenvolvimento corporal e maturação sexual foram estudados entre a 5ª e a 10ª semanas de vida dos animais, identificando-se a 6ª e 7ª semanas como importante fase da puberdade. Desta forma, os estudos metabólicos foram realizados neste período. Os animais CO apresentaram franca resistência à insulina no período da puberdade, com prejuízos no metabolismo de glicose em adipócitos isolados. A injeção de estreptozotocina no quinto dia de vida produziu um quadro de intolerância à glicose em nossos animais, resultando em atraso no início do estirão de crescimento e desenvolvimento sexual. A resistência fisiológica à insulina da puberdade não produziu piora da resposta à insulina no tecido adiposo branco. / The growth in the prevalence of diabetes mellitus (DM), a larger incidence of type 1 and 2 DM in children and adolescents and the previous results of our laboratory (worsening of the metabolic picture in diabetic rats during puberty) motivate us to study the glucose metabolism in the puberty in order to assess the possible influence of the physiological insulin resistance characteristic of this period on the course of the diabetic status. Five-day old male Wistar rats were divided into two experimental groups: control group (CO) and streptozotocin group (STZ). Body development and sexual maturation were weekly evaluated between the 5th and 10th weeks of life. We identify the 6th and 7th weeks as an important early phase of the puberty. The insulin resistance and a slight degree of glucose intolerance were determined in non-diabetic rats. On the other hand, STZ group showed insulin resistance and it was impaired in the course of puberty suggesting that the developing of this resistance during the puberty presents a different characteristic of that seen in normal rats.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-06-24T13:36:03Z No. of bitstreams: 1 ivandiasdasilva.pdf: 984706 bytes, checksum: edc1274de7cce92f9e66af20480a35f6 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-07-13T15:44:51Z (GMT) No. of bitstreams: 1 ivandiasdasilva.pdf: 984706 bytes, checksum: edc1274de7cce92f9e66af20480a35f6 (MD5) / Made available in DSpace on 2016-07-13T15:44:52Z (GMT). No. of bitstreams: 1 ivandiasdasilva.pdf: 984706 bytes, checksum: edc1274de7cce92f9e66af20480a35f6 (MD5) Previous issue date: 2012-03-01 / Esta dissertação tem por objetivo geral apresentar as controvérsias entre as perspectivas teológicas liberal e fundamentalista ocorridas no âmbito da Southern Baptist Convention (SBC), nos EUA, iniciadas na década de 60, com seu ápice na década de 80 e desdobramentos que resultaram na cisão da referida Convenção no final do século XX. A SBC é a maior denominação do cristianismo protestante do mundo, com cerca de 16 milhões de membros e poderosa influência nos ambientes religioso e político norte-americano. Os conflitos intra-denominacionais tiveram como alvo o controle dos recursos e direção ideológica da SBC. De um lado estavam os fundamentalistas, que defendiam a Bíblia como inerrante e entendiam que a tendência modernista presente na denominação era um grande mal a ser extirpado. Do outro se encontravam os liberais, que valorizavam a abordagem histórico-crítica às Escrituras, a teoria da evolução, a filosofia existencialista e o estudo das religiões comparadas. A diferença entre estas perspectivas teológicas tornou a convivência no mesmo ambiente denominacional inviável, gerando um conflito que veio a culminar com a emergência fundamentalista ao poder na SBC, destituindo os outrora solidamente estabelecidos liberais de suas funções de comando na Convenção. / This Master’s thesis’ general goal is to present the controversies between the liberal and fundamentalist theological perspectives which have occurred within the Southern Baptist Convention (SBC), that have been initiated in the beginning of the 1960’s, with its apex in the 1980’s and developments that led to a split in the Convention at the end of the 20th century. The SBC is the largest world’s Christian protestant denomination, whith approximately 16 million members and powerful religious and politics influence in the USA. These denominational conflicts targeted to control the resources and the ideological direction of the Southern Baptist Convention. On the one hand were the fundamentalists, upholding the Bible as an inerrant book and believing that the modernist tendency was the great evil to be purged from the denomination. On the other were the liberals that appreciated the historical-critical approach to the Bible, the theory of evolution, the existentialist philosophy, and the study of comparative religions. For these different theological perspectives their coexistence at the same denominational scope became unfeasible, giving rise to a conflict that resulted in the fundamentalist’s emergence to the Conventions’ leadership, removing the liberals that once was well-established in charge in the SBC.

O risco aumentado de mortalidade e morbidade associado à obesidade tem sido alvo de muitos estudos que tentam elucidar os aspectos da Síndrome Metabólica, caracterizada por algumas doenças metabólicas como resistência à insulina, hipertensão, dislipidemia. Apesar de muitos estudos tentarem elucidar as alterações metabólicas decorrentes da obesidade, poucos trabalhos têm analisado as conseqüências da dieta hiperlipídica sobre o metabolismo de aminoácidos. Assim, o objetivo deste estudo foi verificar os possíveis mecanismos responsáveis pelo desenvolvimento da intolerância à glicose após a ingestão de dieta hiperlipídica em ratas saudáveis. Os animais alimentados com dieta hiperlipídica por 60 dias, apresentaram redução na expressão gênica de Glut 4 do receptor de insulina, além de redução na atividade da hexoquinase e aumento na atividade de citrato sintase, aspartato aminotransferase e BCAA transaminase, indicando adaptação nas vias metabólicas, com aumento da atividade do ciclo de Krebs e maior utilização de aminoácidos em reações anapleróticas. / The possible causes of increased mortality and morbidity associated with obesity have been focused by many studies that attempt to understand the metabolic syndrome, characterized by various metabolic disorders such as insulin resistance, hypertension and dyslipidemia. Thus, the aim of this study was to verify the possible mechanisms responsible for developing glucose intolerance after a high fat diet intake in healthy female rats. Female Wistar rats were fed either with high fat diet or with the control diet for several weeks. The rats fed with a high fat diet for 60 days presented impaired Glut 4 and insulin receptor gene expression. High fat diet promoted a reduced activity of hexokinase and increased activity of citrate synthase, aspartate aminotransferase and BCAA transaminase, indicating an adaptation in the metabolic pathway, with increase activity of Krebs cycle and increased usage of amino acids in anaplerotic reactions.

Intolerance of uncertainty concerns how one views and reacts touncertainty, where one who’s highly intolerant would find it verydiscomforting when confronted with uncertain situations. The purposeof this study was to examine the associations between intolerance ofuncertainty, pain catastrophizing, emotion regulation andpsychopathic traits. These variables were to be examined in thecontext of a Beads Task and a Cold Pressor Test (CPT). Wehypothesized that there would be a positive significant associationbetween intolerance of uncertainty, pain catastrophizing, emotionregulation, psychopathic traits. We also hypothesized that there wouldbe a difference depending on the difficulty of the Beads Task. To doso, data was collected from 60 university students (32 females and 28males). The results showed that there was a significant, positiveassociation between intolerance of uncertainty, pain catastrophizing,emotion regulation and the Beads Task measurements. Some of theseresults were similar to previous studies. / Intolerans mot osäkerhet berör hur en person uppfattar och reagerarpå osäkerhet, där någon som är intolerant upplever osäkra situationersom obehagliga. Syftet med denna studie var att undersökaassociationerna mellan intolerans mot osäkerhet,smärtkatastrofiering, känsloreglering och psykopatiskapersonlighetsdrag. Dessa variabler undersöktes i sammanhang medBeads Task och ett Kallvattentest. Där några av hypoteserna var attdet finns positiva signifikanta associationer mellan intolerans motosäkerhet, smärtkatastrofiering, känsloreglering och psykopatiskapersonlighetsdrag. Vi hade också en hypotes att det kommer finnas enskillnad beroende på svårighetsgraden av Beads Task. För att göradetta samlades data in från 60 universitetsstudenter (32 kvinnor och28 män). Resultaten visade på en signifikant, positiv associationmellan intolerans mot osäkerhet, smärtkatastrofiering,känsloreglering och Beads Task-måtten. Några av dessa resultat varlikt de i tidigare studier.

Although worry is a common source of distress in children and adolescents, relatively few studies have focused on understanding worry in both of these age groups (Cartwright-Hatton, 2006). This area of research is of particular relevance, as understanding worry in youth may have implications for the assessment and treatment of adolescent worry and other anxiety-related difficulties. Consequently, the focuses of this study were to examine the validity and relevance of metacognitive measures of worry in an adolescent sample, to determine the degree to which metacognitive worry is associated with worry in adolescents, and to examine the potential association between adolescent metacognitive worry and intolerance of uncertainty, another cognitive variable hypothesized to be associated with worry, in an adolescent sample. A total of 175 adolescents between the ages of 11-17 were recruited from local middle and high schools to complete a series of self-report measures, which included the following: the Metacognitive Questionnaire for Children, the Meta-Worry Questionnaire, the Intolerance of Uncertainty Scale for Children, the Penn State Worry Questionnaire for Children, and the Spence Children‘s Anxiety Scale. The findings of this study suggest that metacognition may play a role in the development and maintenance of excessive worry and related generalized anxiety disorder symptoms in adolescents. Further, current findings provide support for the combined influence of metacognitive beliefs and intolerance of uncertainty in the development and maintenance of worry.

Chronic exposure of humans or rodents to high calorie diets leads to hypertriglyceridemia and ectopic lipid deposition throughout the body, resulting in metabolic disease. Cellular lipids are stored in organelles termed lipid droplets (LDs) that are regulated by tissue-specific LD proteins. These proteins are critical for lipid homeostasis, as humans with LD protein mutations manifest metabolic dysfunction. Identification of novel components of the LD machinery could shed light on human disease mechanisms and suggest potential therapeutics for Type 2 Diabetes. Microarray analyses pinpointed the largely unstudied Hypoxia-Inducible Gene 2 (Hig2) as a gene that was highly expressed in obese human adipocytes. Imaging studies demonstrated that Hig2 localized to LDs in mouse hepatocytes and the human SGBS adipocyte cell line. Thus, this work examined the role of Hig2 as a LD protein in liver and adipose tissue. Hig2 deficiency reduced triglyceride deposition in hepatocytes; conversely, ectopic Hig2 expression promoted lipid deposition. Furthermore, liver-specific Hig2-deficient mice displayed improved glucose tolerance and reduced liver triglyceride content. Hig2 deficiency increased lipolysis and -oxidation, accounting for the reduced triglyceride accumulation. Similarly, adipocyte-specific Hig2-deficient mice displayed improved glucose tolerance, reduced adipose tissue weight and brown adipose tissue that was largely cleared of lipids. These improvements were abrogated when the animals were placed in thermoneutral housing and brown adipocyte-specific Hig2-deficient mice also displayed improved glucose tolerance, suggesting that active brown fat largely mediates the metabolic phenotype of Hig2 deletion. Thus, this work demonstrates that Hig2 localizes to LDs in liver and adipose tissue and promotes glucose intolerance.

No description available.

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