Diss. (sammanfattning) Umeå : Univ., 2007. / Härtill 4 uppsatser.

Thesis (DTh)--Stellenbosch University, 2006. / ENGLISH ABSTRACT: This dissertation seeks to develop further the theological interpretation of the books of Samuel, by examining I Samuel I: 1-2:10 in the context of fertility and barrenness as blessing and curse. This reading was related to the Karanga understanding of fertility and barrenness. The contribution shows how the Biblical narrative can become a resource for ethical reflection in African communities such as the Karanga women. The hypotheses that guided this study, were that: a-Fertility and barrenness in the Old Testament should be understood in close conjunction with blessing and cursing as theological concepts in ancient Israel. b-Fertility and barrenness could also be examined in a relevant and contextual manner by relating it to the culture and understanding of the Karanga people. In order to achieve this, two major tasks were attempted. One: An exegesis of I Samuel I: 12: 10 in which Vernon Robbins' method of Socio- Rhetorical criticism was used. The method helped to identify that the text is a narrative, and that the author might have been the Deuteronomistic historian, who wrote in the period of the decline of the Judean monarchy and when the Jews were in exile. The narrative is used to tell about the despair of the Jews, and to inform the Jews that there was hope for restoration if they obeyed God. This ideology is woven in the story of a barren woman Hannah who suffered the despair of barrenness and was later blessed with a child because of her prayer and obedience to God. In the narrative God is described as one who cares for the marginalised, and one who changes the lives of his people, from curse to blessing. The method also helped to realise tbe culture and context of Hannah, and made it possible to relate this culture and context to other cultures that are similar. Secondly an empirical survey was conducted amongst one hundred Karanga women. The findings were that Karanga consider fertility as blessing and barrenness as curse. The curse is experienced in the suffering of the barren women. Barrenness is used to inflict pain, to marginalise women, and has become a major cause of divorce and death through the spread of HIV and Aids. A reading of the story of Hannah helped the Karanga women to identify their barren problems with Hannah, and to find a new way of understanding their own problem in terms of hope. This study was able to prove its hypothesis both through the exegesis and the discussions of the research findings. It was found that the narrative form of the text appealed effectively to the understanding of Karanga women. This was possible because narrative is one of the methods of communication that is used effectively by the Karanga in their language. Through using Hannah as a paradigm of curse and blessing in relation to barrenness and fertility, Karanga women were challenged to view their barren situations in a different way that is open to accept change from curse to blessing. The study has also contributed to see how an old text of the time of Hannah could in the present day contextually influence Karanga women's barren experiences through holding the same culture and also by having similar experiences barren of women. / AFRIKAANSE OPSOMMING: Hierdie dissertasie poog om die teologiese interpretasie van die boeke van Samuel verder te ontwikkel by wyse van 'n ondersoek van I Samuel 1:1-2:10 in die konteks van vrugbaarheid en onvrugbaarheid as 'n seën en as 'n vervloeking. Hierdie ondersoek verwys na die Karangabevolking se begrip van vrugbaarheid en onvrugbaarheid. Die bydrae toon aan hoe die Bybelse verhaal 'n bron vir etiese nadenke onder Afrika-gemeenskappe, soos die Karangavroue, kan word. Die hipoteses wat hierdie studie gerig het, was dat: a-Vrugbaarheid en onvrugbaarheid in die Ou Testament behoort begryp te word in 'n noue verbintenis met seën en vervloeking as teologiese begrippe in antieke Israel. b-Vrugbaarheid en onvrugbaarheid kan ook ondersoek word in 'n relevante en kontekstuele wyse deur dit te verbind met die kultuur en begrip van die Karanga-mense. Om dit te vermag, is twee hooftake onderneem. Die eerste was 'n eksegese van I Samuel 1: 12: 10 waarin Vernon Robbins se metode van sosioretoriese kritiek aangewend is. Hierdie metode het gehelp om die teks as 'n narratief te identifiseer en dat die skrywer die Deuteronomiese historikus kon gewees het, wat in die periode van die monargie van Juda geskryf het en ook tydens die Jode se ballingskap. Die narratief word gebruik om aan te toon hoe wanhopig die Jode was en om hulle in te lig dat daar hoop op hul herstel was indien hulle God gehoorsaam. Hierdie ideologie is verweef in die verhaal van die onvrugbare vrou, Hanna, wat aan die wanhoop van onvrugbaarheid gely het en later met 'n kind geseën is op grond van haar gebede en gehoorsaamheid aan God. In die narratief word God as die een beskryf wat na die gemarginaliseerdes omsien en wat die lewens van sy mense vanaf vervloeking tot seën omvorm. Die metode het ook meegehelp om die kultuur en konteks van Hanna te begryp en dit moontlik gemaak om hierdie kultuur en konteks te verklaar ingevolge die van ander soortgelyke kulture. Tweedens is 'n empiriese studie onder 'n honderd Karanga-vroue onderneem. Die bevindinge was dat Karanga-vroue vrugbaarheid as 'n seën en onvrugbaarheid as 'n vervloeking beskou. Die vervloeking word in die lyding van die onvrugbare vroue ervaar. Onvrugbaarheid word aangewend om pyn en lyding te veroorsaak, om vroue te marginaliseer en het 'n belangrike bron van egskeiding en dood deur die verspreiding van HIV en Vigs geword. Deur die verhaal van Hanna te lees, het die Karanga-vroue gehelp om hul eie onvrugbaarheidsprobleme met die van Hanna te identifiseer en om nuwe wyses te vind om hul eie probleme te verstaan in terme van hoop. Hierdie studie was in staat om sy hipoteses te bewys sowel by wyse van die eksegese en ook deur die bespreking van die navorsingsbevindings. Dit is bevind dat die narratiewe vorm van die teks duidelik tot die begrip van die Karanga-vroue gespreek het. Dit was moontlik aangesien 'n verhalende trant een van die kommunikasiewyses is wat doeltreffend deur Karanga-vroue aangewend word in hul taal. Deur Hanna as 'n paradigma van vervloeking en as seën te gebruik met verwysing tot onvrugbaarheid en vrugbaarheid, is Karanga-vroue uitgedaag om hul beskouing van hul onvrugbare toestand op verskillende wyses te betrag wat oop is om 'n verandering te aanvaar vanaf vervloeking tot seën. Die studie het ook daartoe bygedra om te sien hoe 'n ou teks uit die tyd van Hanna tans kontekstueel die Karanga-vroue se onvrugbaarheidservarings kan beinvloed waar hulle uit 'n soortgelyke kultuur kom en ook soortgelyke ervarings as Hanna het as onvrugbare vroue.

Introdução: A gestação ectópica (GE) corresponde a 6% das mortes maternas no primeiro trimestre, seu diagnóstico está fundamentado em dois exames complementares: ultrassonografia transvaginal (USTV) e dosagem do β-hCG sérico. Contudo, um erro muito comum dos profissionais de saúde é apreciar somente o exame complementar, sem considerar o quadro clínico e os fatores de risco. Usando uma coorte teórica com mais de 800 pacientes com diferentes incidências de GE, Mol e col. propuseram dois modelos probabilísticos para seu diagnóstico: Modelo Fixo e Modelo Flexível. O Modelo Fixo propôs o uso de uma zona discriminatória para os valores de β-hCG sérico, ou seja, concentração acima de 1500 mIU/ml deve haver evidência de gravidez intra-uterina, caso contrário é considerado um caso de EP. Entretanto, entre os dois modelos o Modelo Flexível apresentou melhor desempenho para o diagnostico de GE. Para o diagnostico é necessário a análise dos resultados da USTV, valores de β-hCG sérico, sinais e sintomas, e fatores de risco que consistem em: GE prévia, história de cirurgia tubária, tabagismo, uso de dispositivo intrauterino (DIU), história de ≥ três abortos espontâneos, infertilidade feminina, história de doença inflamatória pélvica (DIP), história de infecções sexualmente transmissíveis (ISTs) e ter ≥ cinco parceiros sexuais Objetivo: Avaliar a incidência, os fatores de risco e a presença de sinais e sintomas das mulheres no primeiro trimestre gestacional, atendidas no Setor de Emergência Ginecológica do Hospital de Clínicas de Porto Alegre (HCPA).Método: Trata-se de um estudo de coorte prospectivo realizado no período de 14 de abril de 2011 a 31 de dezembro de 2013 com mulheres com <12 semanas de gestação atendidas no Setor de Emergência Ginecológica do HCPA.Resultados: Foram incluídos no estudo 845 mulheres. A taxa de GE confirmada nesta população foi de 8,5% (95%IC= 6.8 a 10.6). Os fatores de risco mais relevantes para GE foram GE prévia (RR=4; 95%IC= 2.4 a 6.5) e história de cirurgia tubária (RR=2.8; 95%IC= 1.5 a 5.2). Pacientes assintomáticas e sem fator de risco têm uma chance de 5% de ter uma GE. Uma mulher grávida com dor e sangramento presentes e com fator de risco tem 52% mais chances de ter uma GE. Conclusão: A incidência diagnóstica confirmada de GE foi de 8,5% (95%IC= 6.8 a 10.6). Entre os fatores de risco para GE, os que apresentaram maior risco relativo foram, respectivamente, GE prévia e história de cirurgia tubária. Os sinais e sintomas mais relevantes para o diagnóstico de GE foram dor mais sangramento, que estão fortemente, relacionadas ao diagnóstico de GE. / Background: Ectopic Pregnancy (EP) corresponds to 6% of maternal deaths in the first trimester. Its diagnosis is based on two complementary tests: transvaginal ultrasonography (TVUS) and serum β-HCG. However, very common mistake of health professionals is to appreciate only the complementary examination, without considering the clinical picture and the risk factors. Using a theoretical cohort with more than 800 patients with different incidences of EP, Mol et al. proposed two probabilistic models for diagnosis of EP: Fixed Model and Flexible Model. The Fixed Model proposed the use of a discriminatory zone for the values serum β-hCG, i.e., concentration above 1500 mIU/ml there should be evidence of intrauterine pregnancy, otherwise it is considered a case of EP. However, between the models the Flexible Model presented a better performance for diagnosis of EP. This form, it important to analyse of USTV results, serum β-hCG values, signs and symptoms, and risk factors consisting of: previous EP, history of tubal surgery, smoking, use of intrauterine devices (IUD), three or more miscarriage, female infertility, history of Pelvic Inflammatory Disease (PID), history of Sexually Transmitted Infections (STIs) and more than five sexual partners. These risk factors, however, present variations in different populations Study Design: In this prospective cohort, women between 14 and 49 year old, with a confirmed first trimester pregnancy (gestational age <12 weeks), attend in emergency room setting of HCPA between April 14th, 2011 and December 31st, 2013. Results: A total of 845 women were included in the study. The rate of confirmed EP in this population was 8.5% (n=72; 95% CI, 6.8 to 10.6). The most relevant risk factors for EP were previous EP (RR=4; 95% CI, 2.4 to 6.5) and history of tubal surgery (RR=2.8; 95% CI,1.5 to 5.2). Asymptomatic patients without a risk factor have 5% chance of having an EP. A pregnant woman present with pain and bleeding and if she has a risk factor, the chances of having an EP increase to 52%. Conclusion: A confirmed diagnosis incidence of ectopic pregnancy was 8.5% (95% CI, 6.8 to 10.6). Among the risk factors for EP, those presenting the highest relative risk were, respectively, history of EP and previous tubal surgery. The most relevant signs and symptoms for diagnosis of EP were pain plus bleeding, which are strongly related to the diagnosis of EP.

Introdução: A gestação ectópica (GE) corresponde a 6% das mortes maternas no primeiro trimestre, seu diagnóstico está fundamentado em dois exames complementares: ultrassonografia transvaginal (USTV) e dosagem do β-hCG sérico. Contudo, um erro muito comum dos profissionais de saúde é apreciar somente o exame complementar, sem considerar o quadro clínico e os fatores de risco. Usando uma coorte teórica com mais de 800 pacientes com diferentes incidências de GE, Mol e col. propuseram dois modelos probabilísticos para seu diagnóstico: Modelo Fixo e Modelo Flexível. O Modelo Fixo propôs o uso de uma zona discriminatória para os valores de β-hCG sérico, ou seja, concentração acima de 1500 mIU/ml deve haver evidência de gravidez intra-uterina, caso contrário é considerado um caso de EP. Entretanto, entre os dois modelos o Modelo Flexível apresentou melhor desempenho para o diagnostico de GE. Para o diagnostico é necessário a análise dos resultados da USTV, valores de β-hCG sérico, sinais e sintomas, e fatores de risco que consistem em: GE prévia, história de cirurgia tubária, tabagismo, uso de dispositivo intrauterino (DIU), história de ≥ três abortos espontâneos, infertilidade feminina, história de doença inflamatória pélvica (DIP), história de infecções sexualmente transmissíveis (ISTs) e ter ≥ cinco parceiros sexuais Objetivo: Avaliar a incidência, os fatores de risco e a presença de sinais e sintomas das mulheres no primeiro trimestre gestacional, atendidas no Setor de Emergência Ginecológica do Hospital de Clínicas de Porto Alegre (HCPA).Método: Trata-se de um estudo de coorte prospectivo realizado no período de 14 de abril de 2011 a 31 de dezembro de 2013 com mulheres com <12 semanas de gestação atendidas no Setor de Emergência Ginecológica do HCPA.Resultados: Foram incluídos no estudo 845 mulheres. A taxa de GE confirmada nesta população foi de 8,5% (95%IC= 6.8 a 10.6). Os fatores de risco mais relevantes para GE foram GE prévia (RR=4; 95%IC= 2.4 a 6.5) e história de cirurgia tubária (RR=2.8; 95%IC= 1.5 a 5.2). Pacientes assintomáticas e sem fator de risco têm uma chance de 5% de ter uma GE. Uma mulher grávida com dor e sangramento presentes e com fator de risco tem 52% mais chances de ter uma GE. Conclusão: A incidência diagnóstica confirmada de GE foi de 8,5% (95%IC= 6.8 a 10.6). Entre os fatores de risco para GE, os que apresentaram maior risco relativo foram, respectivamente, GE prévia e história de cirurgia tubária. Os sinais e sintomas mais relevantes para o diagnóstico de GE foram dor mais sangramento, que estão fortemente, relacionadas ao diagnóstico de GE. / Background: Ectopic Pregnancy (EP) corresponds to 6% of maternal deaths in the first trimester. Its diagnosis is based on two complementary tests: transvaginal ultrasonography (TVUS) and serum β-HCG. However, very common mistake of health professionals is to appreciate only the complementary examination, without considering the clinical picture and the risk factors. Using a theoretical cohort with more than 800 patients with different incidences of EP, Mol et al. proposed two probabilistic models for diagnosis of EP: Fixed Model and Flexible Model. The Fixed Model proposed the use of a discriminatory zone for the values serum β-hCG, i.e., concentration above 1500 mIU/ml there should be evidence of intrauterine pregnancy, otherwise it is considered a case of EP. However, between the models the Flexible Model presented a better performance for diagnosis of EP. This form, it important to analyse of USTV results, serum β-hCG values, signs and symptoms, and risk factors consisting of: previous EP, history of tubal surgery, smoking, use of intrauterine devices (IUD), three or more miscarriage, female infertility, history of Pelvic Inflammatory Disease (PID), history of Sexually Transmitted Infections (STIs) and more than five sexual partners. These risk factors, however, present variations in different populations Study Design: In this prospective cohort, women between 14 and 49 year old, with a confirmed first trimester pregnancy (gestational age <12 weeks), attend in emergency room setting of HCPA between April 14th, 2011 and December 31st, 2013. Results: A total of 845 women were included in the study. The rate of confirmed EP in this population was 8.5% (n=72; 95% CI, 6.8 to 10.6). The most relevant risk factors for EP were previous EP (RR=4; 95% CI, 2.4 to 6.5) and history of tubal surgery (RR=2.8; 95% CI,1.5 to 5.2). Asymptomatic patients without a risk factor have 5% chance of having an EP. A pregnant woman present with pain and bleeding and if she has a risk factor, the chances of having an EP increase to 52%. Conclusion: A confirmed diagnosis incidence of ectopic pregnancy was 8.5% (95% CI, 6.8 to 10.6). Among the risk factors for EP, those presenting the highest relative risk were, respectively, history of EP and previous tubal surgery. The most relevant signs and symptoms for diagnosis of EP were pain plus bleeding, which are strongly related to the diagnosis of EP.

Introdução: A gestação ectópica (GE) corresponde a 6% das mortes maternas no primeiro trimestre, seu diagnóstico está fundamentado em dois exames complementares: ultrassonografia transvaginal (USTV) e dosagem do β-hCG sérico. Contudo, um erro muito comum dos profissionais de saúde é apreciar somente o exame complementar, sem considerar o quadro clínico e os fatores de risco. Usando uma coorte teórica com mais de 800 pacientes com diferentes incidências de GE, Mol e col. propuseram dois modelos probabilísticos para seu diagnóstico: Modelo Fixo e Modelo Flexível. O Modelo Fixo propôs o uso de uma zona discriminatória para os valores de β-hCG sérico, ou seja, concentração acima de 1500 mIU/ml deve haver evidência de gravidez intra-uterina, caso contrário é considerado um caso de EP. Entretanto, entre os dois modelos o Modelo Flexível apresentou melhor desempenho para o diagnostico de GE. Para o diagnostico é necessário a análise dos resultados da USTV, valores de β-hCG sérico, sinais e sintomas, e fatores de risco que consistem em: GE prévia, história de cirurgia tubária, tabagismo, uso de dispositivo intrauterino (DIU), história de ≥ três abortos espontâneos, infertilidade feminina, história de doença inflamatória pélvica (DIP), história de infecções sexualmente transmissíveis (ISTs) e ter ≥ cinco parceiros sexuais Objetivo: Avaliar a incidência, os fatores de risco e a presença de sinais e sintomas das mulheres no primeiro trimestre gestacional, atendidas no Setor de Emergência Ginecológica do Hospital de Clínicas de Porto Alegre (HCPA).Método: Trata-se de um estudo de coorte prospectivo realizado no período de 14 de abril de 2011 a 31 de dezembro de 2013 com mulheres com <12 semanas de gestação atendidas no Setor de Emergência Ginecológica do HCPA.Resultados: Foram incluídos no estudo 845 mulheres. A taxa de GE confirmada nesta população foi de 8,5% (95%IC= 6.8 a 10.6). Os fatores de risco mais relevantes para GE foram GE prévia (RR=4; 95%IC= 2.4 a 6.5) e história de cirurgia tubária (RR=2.8; 95%IC= 1.5 a 5.2). Pacientes assintomáticas e sem fator de risco têm uma chance de 5% de ter uma GE. Uma mulher grávida com dor e sangramento presentes e com fator de risco tem 52% mais chances de ter uma GE. Conclusão: A incidência diagnóstica confirmada de GE foi de 8,5% (95%IC= 6.8 a 10.6). Entre os fatores de risco para GE, os que apresentaram maior risco relativo foram, respectivamente, GE prévia e história de cirurgia tubária. Os sinais e sintomas mais relevantes para o diagnóstico de GE foram dor mais sangramento, que estão fortemente, relacionadas ao diagnóstico de GE. / Background: Ectopic Pregnancy (EP) corresponds to 6% of maternal deaths in the first trimester. Its diagnosis is based on two complementary tests: transvaginal ultrasonography (TVUS) and serum β-HCG. However, very common mistake of health professionals is to appreciate only the complementary examination, without considering the clinical picture and the risk factors. Using a theoretical cohort with more than 800 patients with different incidences of EP, Mol et al. proposed two probabilistic models for diagnosis of EP: Fixed Model and Flexible Model. The Fixed Model proposed the use of a discriminatory zone for the values serum β-hCG, i.e., concentration above 1500 mIU/ml there should be evidence of intrauterine pregnancy, otherwise it is considered a case of EP. However, between the models the Flexible Model presented a better performance for diagnosis of EP. This form, it important to analyse of USTV results, serum β-hCG values, signs and symptoms, and risk factors consisting of: previous EP, history of tubal surgery, smoking, use of intrauterine devices (IUD), three or more miscarriage, female infertility, history of Pelvic Inflammatory Disease (PID), history of Sexually Transmitted Infections (STIs) and more than five sexual partners. These risk factors, however, present variations in different populations Study Design: In this prospective cohort, women between 14 and 49 year old, with a confirmed first trimester pregnancy (gestational age <12 weeks), attend in emergency room setting of HCPA between April 14th, 2011 and December 31st, 2013. Results: A total of 845 women were included in the study. The rate of confirmed EP in this population was 8.5% (n=72; 95% CI, 6.8 to 10.6). The most relevant risk factors for EP were previous EP (RR=4; 95% CI, 2.4 to 6.5) and history of tubal surgery (RR=2.8; 95% CI,1.5 to 5.2). Asymptomatic patients without a risk factor have 5% chance of having an EP. A pregnant woman present with pain and bleeding and if she has a risk factor, the chances of having an EP increase to 52%. Conclusion: A confirmed diagnosis incidence of ectopic pregnancy was 8.5% (95% CI, 6.8 to 10.6). Among the risk factors for EP, those presenting the highest relative risk were, respectively, history of EP and previous tubal surgery. The most relevant signs and symptoms for diagnosis of EP were pain plus bleeding, which are strongly related to the diagnosis of EP.

Orientadores: Aníbal Eugênio Vercesi, Flávio Vieira Meirelles / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-16T13:18:47Z (GMT). No. of bitstreams: 1 Chiaratti_MarcosRoberto_D.pdf: 26150066 bytes, checksum: 12cccf5f865b2ef08f186cad0c922cb6 (MD5) Previous issue date: 2010 / Resumo: O DNA mitocondrial (mtDNA) dos mamíferos é composto por cerca de 16.500 pares de bases, tem herança exclusivamente materna, e codifica 13 polipeptídios essenciais para a função mitocondrial. Centenas a milhares de cópias de mtDNA estão presentes nas células somáticas dependendo da necessidade energética do tecido. No entanto, oócitos contêm mais de 150.000 cópias, no mínimo uma ordem de magnitude maior que a quantidade presente na maioria das células somáticas. Além disso, uma vez que o mtDNA não é replicado durante o desenvolvimento inicial, a quantidade de mtDNA por célula diminui a cada ciclo celular. Portanto, o número de cópias presentes no oócito deve ser suficiente para atender às necessidade energéticas das células embrionárias até que a replicação do mtDNA seja restabelecida. Considerando que há uma grande variabilidade da quantidade de mtDNA entre oócitos e que alguns trabalhos têm relacionado infertilidade e cópias de mtDNA no oócito, a quantidade de mtDNA poderia ser utilizada para selecionar embriões mais competentes a se desenvolverem. Para testar esta hipótese utilizou-se como modelo experimental o bovino uma vez que o desenvolvimento embrionário desta espécie é muito mais similar ao do humano que o de camundongo. Para tanto, em um primeiro experimento foram utilizados oócitos bovinos provenientes de folículos de diferentes tamanhos. Oócitos oriundos de folículos pequenos, os quais são sabidamente menos competentes a se desenvolverem a blastocisto, continham menos mtDNA comparado com oócitos oriundos de folículos maiores. No entanto, devido a grande variabilidade do número de cópias, num segundo experimento embriões partenogenéticos no estádio de uma célula sofreram biópsia para se determinar o conteúdo de mtDNA antes de serem cultivados para acessar a capacidade de desenvolvimento. Em contraste com achados prévios, o número de cópias de mtDNA nas biópsias não diferiu entre embriões competentes e incompetentes, indicando que o conteúdo de mtDNA não está relacionado com a competência de desenvolvimento a blastocisto. Para confirmar este achado, embriões no estádio de uma célula foram depletados em mais de 60% do seu conteúdo de mtDNA por centrifugação seguido da remoção de parte da fração citoplasmática rica em mitocôndrias. Surpreendentemente, os embriões depletados desenvolveram-se normalmente a blastocisto, os quais continham número de cópias de mtDNA similar a controles não manipulados. O desenvolvimento dos embriões depletados foi acompanhado por um aumento na expressão de genes (TFAM e NRF1) que controlam a replicação e transcrição do mtDNA, indicando uma habilidade intrínseca do embrião bovino em restaurar o conteúdo de mtDNA no estádio de blastocisto. Em conclusão, embriões bovinos competentes são capazes de regular o conteúdo de mtDNA no estádio de blastocisto independentemente do número de cópias presente no oócito. Estes achados contrariam o que foi descrito em camundongos, ressaltando a necessidade de estudos com espécies mais semelhantes ao homem antes do uso clínico do mtDNA como ferramenta para o diagnóstico de fertilidade em mulheres. Além disso, este trabalho tem implicação na manipulação da herança mitocondrial e, portanto, na prevenção da transmissão de sérias patologias causadas por mutações no mtDNA / Abstract: The mammalian mitochondrial DNA (mtDNA) is composed by only about 16,500 base pairs, is exclusively inherited from the mother, and encodes 13 polypeptides essential for mitochondrial function. Hundreds to thousands mtDNA copies are found in somatic cells depending on the energetic requirement of the tissue. However, oocytes contain more than 150,000 copies, at least an order of magnitude greater than most somatic cells. Moreover, since replication of mtDNA is downregulated during early development, the mtDNA content per cell decreases after each cell cycle. Therefore, mtDNA copy number in oocytes should be enough to support the energetic requirement of embryonic cells until mtDNA replication to be restablished. Considering there is a wide variability of mtDNA copy number among oocytes and there are reports showing a link between infertility and oocyte mtDNA copy number, the content of mtDNA could be used to select embryos more competent to develop. To test this hypothesis we used the bovine as an experimental model since its embryonic development is more similar to human than the murine is. Therefore, in a first experiment bovine oocytes derived from follicles of different sizes were used. Oocytes obtained from small follicles, known to be less competent to develop into blastocysts, contained less mtDNA than those originated from larger follicles. However, due to the high variability in copy number, in a second experiment a more accurate approach was examined in which parthenogenetic one-cell embryos were biopsied to measure their mtDNA content and then cultured to assess development capacity. Contrasting with previous findings, mtDNA copy number in biopsies was not different between competent and incompetent embryos, indicating that mtDNA content is not related to early developmental competence. To further examine the importance of mtDNA on development, one-cell embryos were partially depleted of over than 60% of their mtDNA by centrifugation followed by the removal of the mitochondrial-enriched cytoplasmic fraction. Surprisingly, depleted embryos developed normally into blastocysts, which contained mtDNA copy numbers similar to non-manipulated controls. Development in depleted embryos was accompanied by an increase in the expression of genes (TFAM and NRF1) controlling mtDNA replication and transcription, indicating an intrinsic ability to restore the content of mtDNA at the blastocyst stage. In conclusion, competent bovine embryos are able to regulate their mtDNA content at the blastocyst stage regardless of the copy numbers present in oocytes. These findings are in disagreement with that reported for mice, highlighting the need for studies using species more similar to human before the clinical use of mtDNA as a diagnostic tool in woman fertility. Moreover, these findings are important to manipulate mitochondrial inheritance and, therefore, to prevent transmission of important disorders caused by mtDNA mutations / Doutorado / Biologia Estrutural, Celular, Molecular e do Desenvolvimento / Doutor em Fisiopatologia Medica

Submitted in partial fulfilment of the requirements for the Degree of Master of Arts (Clinical Psychology) in the School of Psychology, University of Zululand, 2007 / The purpose of this study was to investigate the psychological impact of infertility on well-being. This study has been contextualized within the broader public health paradigm which re-establishes a balanced view of both illness prevention and health promotion. This study was conducted in the Durban area of Kwa-Zulu Natal. The nature of the research is concerned with the emotional experience of infertile women with regard to positive relations with others, autonomy, environmental mastery, personal growth, purpose in life and self-acceptance. Date was collected as a quantitative component using Ryffs 3-item Psychological Weil-Being Scale (PWB). Fifty-six women who had been diagnosed with infertility and who were undergoing fertility treatment participated in the study (n=56). The age of the participants was between twenty-nine and fifty-five years. Ninety-eight percent (98.2%) of the participants resided in the cities of KwaZulu-Natal, while less than two percent (1.8%) were rural dwellers. Approximately sixty-six percent (66.1%) of the participants were from nuclear families, while approximately thirty-three percent (33.9%) came from extended families. Conclusion and recommendations for future research Statistical analysis revealed that the overall results were statistically non-significant. The correlation between self-acceptance and duration of infertility revealed the only significant result in this study (p=0.004), highlighting the emotions of dissatisfaction and disappointment with self as a result of prolonged fertility difficulties. The correlation between purpose in life and duration of infertility in years showed to be approaching statistical significance (p=0.021). Disappointment and loss of hope seem to be the products of continued failed attempts of conceiving. This is seen as causing severe insult to self-assessed femininity, as well as further stress, anxiety and depression (Domar, 2004). It is recommended that studies of this nature should include a larger sample, specifically from the rural area, as well divide the sample into racial groups and consider a control group. This is likely to yield more accurate and valid findings. A further recommendation would be to examine the participants' belief systems and explore alternate treatment modalities targeting infertility. Possible limitations of the study Only patients diagnosed with infertility, mostly from the city, participated in the study. The sample size was also not large enough to generalize the findings and offer an accurate representation of the population. The nature of questionnaire required that participants answer several questions pertaining to sensitive personal issues, which may have caused participants to answer in a more socially desirable manner, causing possible inaccuracy in findings. / National Research Funf

Infertilitet är ett relativt vanligt hälsoproblem i dagens samhälle. Infertilitet kan uppstå som resultat av en sjukdom där en störning av reproduktiva kroppsfunktioner hindrar uppkomsten av en graviditet och födsel av ett barn. Flertalet kvinnor som senarelägger starten på barnafödandet löper en större risk att drabbas av primär och sekundär infertilitet. Barnlöshet går inte alltid att förebygga och alla kvinnor som önskar att få barn kan inte alltid få barn. Syftet med det här arbetet var att belysa kvinnors upplevelse av ofrivillig barnlöshet efter misslyckade försök att bli mamma. Litteraturöversikt är den metod som har valts för att besvara syftet med det här arbetet. Integrerad analys är den dataanalysmetod som har används. Resultatet visar att isolering från omgivningen är vanlig förekommande bland kvinnor som är ofrivilligt barnlösa. Ofrivilligt barnlösa kvinnor kunde uppleva sin kropp som ett hinder för konception, vilket gav dem känslan av att vara ofullständiga i jämförelse med andra kvinnor. Sorgen över barnlösheten var ständigt närvarande hos kvinnorna. När kvinnorna accepterar sin situation som barnlös sker en personlig mognad och de börjar lägga fokus på sig själva och mål som är uppnåbara. Slutsatsen som framkommer i det här arbetet är att kvinnorna i den här litteraturöversikten oavsett kulturell bakgrund har liknande upplevelser i sin längtan efter ett barn. Att vara ofrivillig barnlös är en stor påfrestning för den som är drabbad. Det är av stor vikt att ofrivilligt barnlösa kvinnor erbjuds emotionellt stöd under sorgeprocessen som följer barnlösheten samt att stötta dem att identifiera strategier för att hantera sorgen.