Orientador: Germano Francisco Biondi / Banca: Noeme Sousa Rocha / Banca: Roberto de Oliveira Roça / Banca: Milton Hisashi Yamamura / Banca: Ademir Benedito da Luz Pereira / Resumo: O objetivo deste estudo foi determinar a freqüência de ocorrência de lesões hepáticas provocadas por larvas de helmintos em eqüídeos abatidos em matadouro-frigorífico no Paraná, diagnosticado durante o exame post mortem e estudo macro e microscópico das lesões hepáticas. Foram pesquisados nos meses de abril de 2003 a dezembro de 2004, 38.363 animais, procedentes de diversos estados da federação. A freqüência de ocorrência de granulomas no fígado foi revelada em 14.443 (37,64%), com aderências e manchas 6.645 (17,32%) e sem lesões macroscópicas 17.275 (45.03%). Macroscopicamente, foram verificados fígados com nódulos calcificados, presença de manchas esbranquiçadas, aderências e pontas soltas em forma de "linhas" sobre a cápsula hepática. Não foram encontradas larvas nos fígados. Histologicamente, os fragmentos hepáticos revelaram na microscopia óptica, células inflamatórias com o predomínio de eosinófilos ao redor dos granulomas, com moderada quantidade de macrófagos e presença de fibroblastos. / Abstract: The aim of this study was investigate the hepatic lesions caused by migratory larvae of the helminths. The diagnostic of the lesions were done at post mortem during the slaughter of the horses in Paraná State. The survey was developed during the april 2003 to april 2004. The horses came from diferent regions or states of Brazil. The frequency of occurrence reveled 14.443 (37,64%) hepatic lesions with parasitic granuloma, 6.645 (17,32%) with spot on the hepatic capsule and 17.275 (45.03%) without lesions. Macroscopic analysis reveled presence of calcifications nodules, adhesions, fibrous tags over widely distributed areas on the hepatic capsule. The most evidence observed on the tissue were widespread nodules many of which were coalesced. No larvae were found in the liver. Fragments hepatic were processed for histologic and reveled extensively infiltrated with eosinophils and fibrosis in tissue sections. / Doutor

Numerous studies suggest that modulation of the cholinergic system through the use of nicotinic agonists can improve motor function in humans or animals with motor disorders. Specifically, although there are no approved therapeutics for patients with ataxia, the nicotinic receptor agonist varenicline has demonstrated efficacy to improve coordination and gait in several groups of patients with different subtypes of ataxia. Importantly, the mechanism underlying the varenicline’s mechanism of action to improve motor function remains to be elucidated. Thus, the purpose of these experiments was to first quantify gait impairments in rats with olivocerebellar ataxia utilizing an objective treadmill-based system to investigate temporospatial aspects of animals’ gait. These results were used to calculate an index that characterizes deviations from ‘normal’ gait, as similarly employed in clinical studies. The translational validity of this method of gait assessment was investigated by comparing gait impairments between these animals and those reported for humans with ataxia. It was next investigated whether varenicline could attenuate any gait impairments and thus improve motor functioning in these animals, as suggested by clinical findings. Finally, varenicline’s mechanism of action was investigated by attempting to block its effects by pretreating animals with the nicotinic antagonist mecamylamine. Thus, these studies demonstrate the involvement of nicotinic acetylcholine receptors in the mechanism of varenicline’s effects to improve motor functioning. Moreover, these results provide translational methods by which the efficacy of other, more selective nicotinic agonists to improve motor functioning can be tested preclinically prior to their use in humans with ataxia.

O peso dos leitões ao desmame está positivamente relacionado com o desempenho posterior e sofre influência de diversos fatores relacionados ao ambiente, à matriz e aos próprios leitões. O peso ao nascimento, a presença de lesões orais, dentárias, umbilicais e no aparelho locomotor podem comprometer o ganho de peso dos leitões na maternidade. Foram acompanhados 2004 lactentes, os quais foram pesados e avaliados para a presença de lesões no primeiro dia e aos 7, 14 e 21 (desmame) dias de vida. Leitões nascidos com peso entre 600g e 900g tiveram mortalidade até o desmame superior àqueles pesando entre 901g e 1200g (P<0,05). Entre os leitões nascidos com peso acima de 1500g não houve diferença na mortalidade (P>0,05). O peso ao nascimento apresentou correlação positiva com o peso ao desmame (P<0,05). A ocorrência de lesões orais, umbilicais ou dentárias não comprometeu o desempenho. Por outro lado, a presença de lesões no aparelho locomotor afetou negativamente o peso ao desmame (P<0,05). Leitões com lesões no aparelho locomotor na segunda semana de vida apresentaram peso inferior àqueles com lesões na primeira semana (P<0,05). Leitões leves (≥600g - <1300g) com lesões no aparelho locomotor não sofreram redução do peso ao desmame (P>0,05), enquanto os leitões médios (≥1300g - <1800g) e pesados (≥1800g) com lesões tiveram peso inferior ao daqueles sem lesões (P<0,05). O peso ao nascimento e a ocorrência de lesões no aparelho locomotor podem comprometer a performance dos leitões lactentes. / Weaning weight of piglets is positively related with performance in later ages and is influenced by several factors connected with environment, the sow and the piglets. The birth weight, presence of oral, dental, umbilical or limb lesions can compromise the performance of suckling piglet. A total of 2004 suckled piglets were weighted and evaluated for the presence of lesions in the first day of life and on 7, 14 and 21 days. Pigs with birth weight between 600g and 900g presented preweaning mortality higher than those with weights between 901g and 1200g (P<0.05). Among piglets with birth weight above 1500g, there was no difference in mortality (P>0.05). Birth weight presented a positive correlation with weaning weight (P<0.05). Occurrence of oral, umbilical or dental lesions did not compromise performance. On the other hand, the presence of limb lesions affected negatively the weaning weight (P<0.05). Piglets with limb lesions in the second week of life presented smaller weight when compared with those with lesions only in the first week of life (P<0.05). Lighter piglets (≥600g - <1300g) with limb lesions did not show reduction in weaning weight (P>0.05), while those with intermediate weight (≥1300g - <1800g) and heavier (≥1800g) with lesions had smaller weight when compared to those without lesions (P<0.05). It is concluded that birth weight and the occurrence of limb lesions can compromise the performance of suckling piglets.

Submitted by (edna.saturno@ufrpe.br) on 2016-08-11T12:45:21Z No. of bitstreams: 1 Auxiliadora de Moraes Ostermann.pdf: 1065380 bytes, checksum: 7562bc6d4f94fe6fff4c90d431b36942 (MD5) / Made available in DSpace on 2016-08-11T12:45:21Z (GMT). No. of bitstreams: 1 Auxiliadora de Moraes Ostermann.pdf: 1065380 bytes, checksum: 7562bc6d4f94fe6fff4c90d431b36942 (MD5) Previous issue date: 2008-02-11 / The gastrointestinal helminths assume importance for the aetiology of gastroenteritis in dogs, being the canine helminthosis a global and high prevalence problem, showing many of them, important zoonotic potential. The stray dogs are an important point in a program to control helminth infection in urban centers. They are generally excluded from any program, although assume great importance in the maintenance and dissemination of these parasites in urban areas. The more accurate knowledge about the epidemiology and prophylaxis of the most important parasites of dogs, particularly about its impact and prevalence, are fundamental to the adoption of appropriate prophylactic measures to protect human. It was proposed in this paper to evaluate the gastrointestinal helminth infection and techniques of diagnosis of infection in stray dogs from the municipality of Recife - Pernambuco State - Brazil. Strays dogs captured by the Center for Environmental Surveillance of the City of Recife - PE were used, totalizing 96 dogs. The animals were subjected to euthanasia and necropsy, and fecal samples were collected and submitted to the techniques of simple fluctuation and spontaneous sedimentation. It was realized macroscopic examination of the intern organs, whose changes were noted in files of necropsy, and performed the collection of adult gastrointestinal helminths for identification. The results showed positivity of 96.8% (93/96), with 83.3%, 14.6%, 30.2%, 6.3%, 28.1%, 34.4% and 2.1%, respectively for Ancylostoma caninum, A. braziliense, Toxocara canis, Toxascaris leonina, Dypilidium caninum and Spirocerca lupi. The methods of Willis, sedimentation and necropsy were significantly different only in the detection of Ancylostoma spp. Willis and sedimentation showed no differences among themselves for the other helminths. Macroscopic lesions were found in all organs of the gastrointestinal tract or organs involved in the parasitic phase of the life cycle of helminths, becoming the majority of them in bleeding, predominantly in the small intestine. / Os helmintos gastrintestinais assumem importância significativa na etiologia das gastrenterites em caninos, sendo as helmintoses de origem canina um problema mundial e de prevalência elevada, apresentando, muitas delas, importante potencial zoonótico. Um ponto importante em um programa de controle de verminose nos centros urbanos são os cães errantes. Eles estão geralmente excluídos de qualquer programa, embora assumam grande importância na manutenção e disseminação dessas parasitoses no meio urbano. O conhecimento mais acurado sobre epidemiologia e a profilaxia dos parasitos mais importantes de cães, particularmente sobre as suas incidências e prevalências, são fundamentais para a adoção de medidas profiláticas adequadas para a proteção humana. Propôs-se neste trabalho avaliar a infecção por helmintos gastrintestinais e as técnicas de diagnóstico da infecção em cães errantes procedentes do município de Recife – PE. Foram utilizados 96 cães errantes, apreendidos pelo Centro de Vigilância Ambiental da Cidade do Recife – PE (CVA/PE). Os animais foram submetidos à eutanásia e necropsia, sendo coletadas amostras fecais que foram submetidas às técnicas de flutuação simples e sedimentação espontânea. Realizou-se exame macroscópico dos órgãos, cujas alterações foram anotadas em fichas de necropsia, efetuou-se, ainda a coleta de helmintos gastrintestinais adultos para identificação. Os resultados apontaram positividade de 96,9% (93/96), sendo 83,3%, 14,6%, 30,2%, 6,3%, 28,1%, 34,4%, 2,1%, respectivamente para Ancylostoma caninum, A. braziliense, Toxocara canis, Toxascaris leonina, Trichuris vulpis, Dypilidium caninum e Spirocerca lupi. Os métodos de Willis, sedimentação e necropsia foram significativamente diferentes entre si apenas na detecção de infecção por Ancylostoma spp. Willis e sedimentação não apresentaram diferenças entre si para os demais helmintos. Lesões macroscópicas foram evidenciadas em todos os órgãos do trato gastrintestinal ou em órgãos envolvidos na fase parasitária do ciclo biológico dos helmintos, constituindo-se a maioria delas em hemorragias, predominantemente no intestino delgado.

Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / Objective: To evaluate the protective effect of the heme-oxygenase 1 (HO-1)/biliverdin/CO pathway in models of gastropathy in mice, evaluating the role of the soluble guanylate cyclase (GCs) and of the constitutive NOS in this event. Methods: Protocol 1: Mice were pre-treated with hemin (HO-1 inducer; 1,3,10 mg/Kg, i.p.), biliverdin (HO-1 product; 1,3 or 10 mg/Kg., i.p.), DMDC (CO donor; 2.5, 7.5, 12.5 or 10 Âmol/Kg, i.p.) or ZnPP IX (HO-1 antagonist; 0,3, 1 or 3 mg/kg. i.p.), one hour before, gastric damage was induced by ethanol 50% (hemin, biliverdin, DMDC) or 25% (ZnPP IX). In another group, the animals were pre-treated with ODQ (12.5 mg/kg, v.o) or L-NAME (3 mg/Kg, v.o), thirty minutes before of the treatments cited previously. After 1h, the mice were sacrificed and the stomachs removed for evaluation of the gastric lesions (Image J). Protocol 2: Mice were pre-treated with hemin (3 mg/Kg, i.p.), biliverdin (3 mg/Kg., i.p.), DMDC (12,5 Âmol/Kg) or ZnPP IX (3,0 mg/kg), one hour before of the administration of INDO 30 mg/Kg (hemin, biliverdin, DMDC) or 10 mg/Kg (ZnPP IX). In another group, the animals were pre-treated with ODQ (12.5 mg/kg, v.o) or L-NAME (3 mg/Kg, v.o), thirty minutes before of the treatments cited previously. Three hours after, the mice were sacrificed and the stomachs removed for evaluation of the gastric lesions, utilizing a digital paquimetry. In all of the experimental groups, fragments of the gastric mucous were collected for determination of the concentration of MDA, GSH or bilirubin. Another samples of tissue was removed for microscopic analyzes and HO-1 expression by immunohistochemistry. The detection of the TNF-&#945;, IL-1&#946;, IL-10 and MPO activity were evaluated only in the INDO gastropathy. Results: Ethanol increased the expression of HO-1 and the levels of bilirrubin in the gastric tissue. Hemin, biliverdin and DMDC reduced gastric damage, MDA levels and GSH consume in ethanol 50%- induced gastropathy. The histological parameters, edema, hemorrhage and loses of epithelial cells, were diminished in the presence of hemin, biliverdin or DMDC. ZnPP IX amplified the ethanol-induced gastric lesion, increased MDA formation and decreased the GSH concentration in gastric mucosa. The histological parameters also were amplified after the handling with ZnPP IX. Bilirubin concentration was elevated during the protection induced by hemin and biliverdin, but not DMDC. INDO increased the HO-1 expression and the bilirrubin levels in the gastric mucosa. Hemin, biliverdin or DMDC reduced the gastric lesion, the MPO activity, and the MDA levels and increased the GSH concentration in the gastropathy INDO- induced. The histological parameters, edema, hemorrhage, loss of epithelial cells and the presence of inflammatory cells, were inhibited by hemin, biliverdin or DMDC. ZnPP IX amplified the effect of the INDO increasing the gastric lesion, the MPO activity, the MDA levels and the GSH consume. The histological parameters also were amplified after the handling with ZnPP IX. Bilirubin was shown elevated during the protection induced by hemin and biliverdin, but not DMDC. Hemin, biliverdin and DMDC diminished the TNF-&#945; and IL-1&#946; concentrations and increased the IL-10. ODQ and L-NAME completely abolished the DMDC protective gastric effect, but not biliverdin in the gastropathy ethanol or INDO- induced. Conclusion: HO-1/biliverdin/CO pathway plays a protective effect against ethanol or INDO-induced gastric damage. In the gastropathy by ethanol, the protection is dependent of the anti-oxidant action by bilirubin and CO. However, in the model of INDO gastropathy, we observe an anti-oxidant and anti-inflammatory action. The mechanism of gastro protective action of the CO, but not of the biliverdin, is dependent of the CO/ NOS/ GMPc pathway. / Objetivo: Avaliar o efeito protetor da via hemeoxigenase 1 (HO-1)/ biliverdina/ CO em modelos de gastropatia em camundongos e o papel da guanilato ciclase solÃvel (GCs) e da NOS constitutiva neste evento. MÃtodos: Protocolo 1: Camundongos foram prÃ-tratados hemina (indutor da HO-1; 1,3 ou 10mg/Kg, i.p.), biliverdina (produto da HO-1; 1,3 ou 10mg/Kg, i.p.), DMDC (doador de CO; 2,5, 7,5, 12,5 ou 25 &#956;mol/Kg, i.p.) ou ZnPP I(inibidor da HO-1; 0,3, 1,0 ou 3,0 mg/kg. i.p.) uma hora antes da administraÃÃo por gavagem de etanol 50% (hemina, biliverdina, DMDC) ou 25% (ZnPP IX). Em outro grupo, os animais foram prÃ-tratados com ODQ (12,5 mg/kg, v.o) ou L-NAME (3 mg/Kg, v.o), trinta minutos antes dos tratamentos citados anteriormente. Depois de 1h, os camundongos foram sacrificados e os estÃmagos removidos para avaliaÃÃo das lesÃes gÃstricas (Image J). Protocolo 2: Camundongos foram prÃ-tratados hemina (3,0 mg/kg), biliverdina (3,0 mg/kg), DMDC (12,5 &#956;mol/Kg) ou ZnPPIX (3,0 mg/Kg) uma hora antes da administraÃÃo de INDO 30 mg/Kg (hemina, biliverdina, DMDC) ou 10 mg/Kg (ZnPP IX). Em outro grupo os animais foram prÃ-tratados com ODQ (12,5 mg/kg, v.o) ou L-NAME (3 mg/Kg, v.o), trinta minutos antes dos tratamentos citados anteriormente. TrÃs horas depois, os camundongos foram sacrificados e os estÃmagos removidos para avaliaÃÃo das lesÃes gÃstrica, utilizando um paquÃmetro digital. Em todos os grupos experimentais, fragmentos da mucosa gÃstrica foram coletados para determinaÃÃo da concentraÃÃo de MDA, GSH e bilirrubina. Outra amostra de tecido foi retirada para analise microscÃpica e imunohistoquÃmica. A detecÃÃo das citocinas TNF-&#945;, IL-1&#946; e IL-10, bem como a atividade de MPO foram avaliados somente na gastropatia por INDO. Resultados: O etanol aumentou a expressÃo de enzima HO-1 e dos nÃveis de bilirrubina no tecido gÃstrico. Hemina, biliverdina ou DMDC reduziram a lesÃo gÃstrica, os nÃveis de MDA e o consumo de GSH induzido por etanol 50%. Os parÃmetros histolÃgicos, edema, hemorragia e perda de cÃlulas epiteliais, foram diminuÃdos na presenÃa de hemina, biliverdina ou DMDC. ZnPP IX amplificou o efeito do etanol 25%, aumentando a lesÃo gÃstrica, os nÃveis de MDA e o consumo de GSH. Os parÃmetros histolÃgicos tambÃm foram amplificados apÃs o tratamento com ZnPP IX. A concentraÃÃo de bilirrubina se mostrou elevada apenas na gastroproteÃÃo induzida por hemina e biliverdina, mas nÃo pelo DMDC. INDO aumentou a expressÃo da HO-1 e os nÃveis de bilirrubina na mucosa gÃstrica. Hemina, biliverdina ou DMDC reduziram a lesÃo gÃstrica, a atividade de MPO, os nÃveis de MDA e aumentaram a concentraÃÃo de GSH na gastropatia por INDO. Os parÃmetros histolÃgicos, edema, hemorragia, perda de cÃlulas epiteliais e a presenÃa de cÃlulas inflamatÃrias, foram inibidas pela hemina, biliverdina ou DMDC. ZnPP IX amplificou o efeito da INDO aumentando a lesÃo gÃstrica, a atividade de MPO, os nÃveis de MDA e o consumo de GSH. Os parÃmetros histolÃgicos tambÃm foram amplificados apÃs o tratamento com ZnPP IX. Bilirrubina se mostrou elevada apenas na gastroproteÃÃo induzida por hemina e biliverdina, mas nÃo pelo DMDC. Hemina, biliverdina e DMDC diminuÃram as concentraÃÃes de TNF-&#945; e IL-1&#946; e aumentaram a IL-10. ODQ e L-NAME reverteram o efeito protetor do DMDC, mas nÃo da biliverdina, na gastropatia induzida por etanol ou INDO. ConclusÃo: A via HO-1/biliverdina/CO participa do processo de defesa da mucosa gÃstrica contra lesÃes induzidas por etanol ou INDO. Na gastropatia por etanol, a proteÃÃo à dependente da aÃÃo antioxidante da bilirrubina e CO. Entretanto, no modelo de gastropatia por INDO, observamos uma aÃÃo antioxidante e antiinflamatÃria. Evidenciamos ainda que o mecanismo de aÃÃo gastroprotetor do CO, mas nÃo da biliverdina à dependente da via CO/GMPc/NOS.

O antantreno é um hidrocarboneto hexacíclico aromático (HPA) bastante difundido no meio ambiente e que não apresenta as regiões de baía ou fjord, que em geral, conferem alta reatividade a esses compostos após oxidação. Entretanto, sua mutagenicidade em bactérias após ativação metabólica é comparável à do Benzopireno (BP) e, com base na sensibilidade das linhagens de S. typhimurium utilizadas, os metabólitos do antantreno causam substituições de pares de base, trocas de fita e possivelmente dano oxidativo ao DNA. Alguns dos metabólitos que apresentam ação genotóxica em bactérias foram recentemente identificados, mas uma investigação mais ampla considerando a ligação desses e outros possíveis metabólitos a biomoléculas, com a identificação dos adutos formados, pode contribuir para um melhor esclarecimento das vias envolvidas em sua genotoxicidade. Neste trabalho investigamos a reação do antantreno (oxidado quimicamente e pelo sistema HRP/H2O2) com dG e DNA in vitro, tendo sido observada a formação de possíveis adutos nas análises por HPLC/ESI/MS, HPLC/UV/Fluorescência e espectrofluorimetria. Células de carcinoma hepatocelular humano (HepG2) e hepatócitos de fígado humano normal (THLE-2) foram incubadas com antantreno e seus produtos de oxidação (quinonas e hidroquinonas acetiladas), verificando-se citotoxicidade dose dependente em diferentes condições de cultura. Uma vez que a sobrevivência relativa das células THLE-2 cultivadas sobre filme de colágeno e em meio PFMR-4 se assemelhou à sobrevivência relativa das células HepG2 cultivadas em meio DME e sem filme de colágeno, utilizamos as células HepG2 para análise de dano oxidativo. Produtos de oxidação do antantreno (quinonas e hidroquinonas acetiladas) induziram a formação de 8-oxodGuo no DNA celular. Os dados obtidos nos indicam que duas vias podem estar envolvidas na genotoxicidade do antantreno observada nos estudos com S.typhimurium realizados por Platt et al. (2002): indução de dano oxidativo e formação de adutos com o DNA. / Anthanthrene is a polycyclic aromatic hydrocarbon (PAH) widely spread in the environment and does not have the bay or fjord regions, which in general provide high reactivity to these compounds after oxidation. However, its mutagenic activity to bacteria after metabolic activation is comparable to that of benzopyrene (BP) and, based on the sensitivity of the S. typhimurium strains used, anthanthrene metabolites cause base pair substitutions, DNA strand exchanges, and possibly DNA oxidative damage. Some of the metabolites that are genotoxic to bacteria have been recently identified, but a better investigation on how these and other possible metabolites react with biomolecules, identifying the generated adducts, can contribute to clarify the ways involved in its genotoxicity. In the present work we investigated the reaction of anthanthrene (chemically oxidized or oxidized by the HRP/H2O2 system) with dG and DNA in vitro. The formation of possible adducts was observed in the analyses by HPLC/ESI/MS, HPLC/UV/Fluorescence and spectrofluorimetry. Human hepatocelular carcinoma cell line (HepG2) and normal human liver hepatocytes (THLE-2) were incubated with anthanthrene and its oxidation products (quinones and acetyladet hidroquinones). Dose dependent cytotoxity was observed under different culture conditions. As the relative survival of the THLE-2 cells grown on a film of collagen in PFMR-4 medium was very close to the relative survival of the HepG2 cells grown in DME medium, without the collagen film, we used the HepG2 cells for analysis of oxidative damage. Anthanthrene oxidation products (quinones and acetylated hidroquinones) induced 8-oxodGuo formation in the cellular DNA. Data obtained indicate that two ways may be involved in the genotoxicity of anthanthrene observed in the S. typhimurium studies conducted by Platt et al. (2002): DNA oxidative damage and adducts formation.

Introdução: As feridas agudas e crônicas provocam alterações físicas, psíquicas, sociais e econômicas para o indivíduo e família. Embora bem estabelecidos os dados epidemiológicos sobre essas lesões no contexto internacional, ainda são incipientes no Brasil, principalmente na Região Amazônica. Objetivo: Identificar e analisar a prevalência e fatores demográficos e clínicos associados à ocorrência de algumas feridas agudas e crônicas (Lesão por Fricção LF, Dermatite Associada à Incontinência DAI, Ferida Operatória Complicada FOC, Lesão por Pressão LP e Úlcera Diabética - UD) em pacientes hospitalizados. Métodos: Trata-se de estudo epidemiológico, observacional, transversal, analítico e descritivo, realizado em sete hospitais da cidade de Manaus. Os dados foram coletados por meio de consulta aos prontuários, entrevistas com os pacientes ou responsáveis legais e exame físico de todos os pacientes internados, durante o período de março a junho de 2015. As lesões encontradas foram avaliadas utilizando-se os seguintes instrumentos: Sistema de Classificação STAR - Lesão por Fricção para as LF; Incontinence Associated Dermatitis Intervention Tool (IAD-IT) para DAI; Pressure Ulcer Scale for Healing PUSH pernas, para FOC, Pressure Ulcer Scale for Healing PUSH UP para LP e Classificação de Wagner para as UD. Ademais, instrumento para levantamento dos dados sociodemográficos e clínicos e a Escala de Braden também foram empregados. Os dados foram analisados por meio de: teste Qui-quadrado ou exato de Fisher para as variáveis categóricas e teste t para as numéricas. Modelo de árvore de decisão com o algoritmo Classification and Regression Tree (CART) foi utilizado para identificação dos fatores associados à presença das feridas, de maneira simultânea e isolada. Resultados: A amostra (n=775) foi predominantemente do sexo masculino (457/ 58,9%), com média de idade de 60,4 anos (DP=18,7) raça parda (240/30,9%); situação conjugal com companheiro (413/53,2%) e ensino fundamental (403/52,0%). Cento e setenta e oito pacientes apresentaram lesões durante a coleta de dados, acarretando prevalência pontual global de 23%. Com média de 1,1 ferida (DP=0,4) por paciente, predominaram as LP (n=80/ 10,3%), seguidas de UD (n=66/ 8,5%). Os demais tipos de feridas mostraram prevalências de 2,7% (n=21) para FOC; 0,9% (n=7) para LF e 0,5% (n=4) para DAI. A maior ocorrência das lesões quanto às regiões corporais foram o dorso da mão E para a LF; região dos grandes lábios para DAI; perna E para FOC; região sacra para LP e: planta do pé E para UD. O CART mostrou Diabetes Mellitus, uso de anticoagulante, presença de rigidez, escore de Braden sem risco (>18), presença de curativo e de hematoma como os fatores associados à presença de todas as feridas, de forma simultânea, repetindo-se algumas dessas condições para LP e UD. Conclusão: O estudo, inédito na região amazônica, possibilitou um diagnóstico mais acurado da epidemiologia de algumas das mais importantes e prevalentes feridas agudas e crônicas, em pacientes hospitalizados, como a LF (0,9%), DAI (0,5%), FOC (2,7%), LP (10,3%) e UD (8,5%). Com prevalências pontuais inferiores à maioria dos resultados de estudos nacionais e internacionais, o estudo suscita a necessidade de mais investigações na região, particularmente estudos de incidência, mesmo que a maioria dos fatores associados constatados nos pacientes hospitalizados amazonenses esteja também presente na literatura. / Introduction: Acute and chronic wounds provoke physical, psychological, social and economic changes for individuals and their families. While, in an international context, epidemiological data regarding these wounds and lesions is well established, it is still in an incipient stage in Brazil, particularly in the Amazon Basin Region. Objective: To identify and analyze the prevalence and demographic and clinical factors associated with the occurence of several acute and chronic wounds (frictional lesions - frictional keratosis, incontinence-associated dermatitis - IAD, post-operative wound complications, pressure sores and diabetic ulcers) in hospitalized patients. Methods: This is an observational, transverse, analytical and descriptive epidemiological study conducted in seven hospitals in the city of Manaus. The data was collected by consulting hospital records, interviews with patients or legal guardians and physical examinations of all hospitalized patients, during the period from March through June 2015. The lesions found were evaluated using the following instruments: Classification System STAR -- Frictional Lesion for frictional lesions; Incontinence Associated Dermititis Intervention Tool (IAD-IT) for IAD; Pressure Ulcer Scale for Healing - PUSH UP for pressure sores and Wagner Classification for diabetic ulcers. Moreover, an instrument for socio-demographic and clinical data collection and the Braden Scale were also employed. The data was analyzed by way of the Chi-squared distribution test or T-Test for numerical ones. The decisionmaking tree model using the Classification and Regression Tree (CART) algorithm was utilized in the identification of factors associated with the presence of lesions, simultaneously and in isolation. Results: The study sample (n=775) was predominantly of the male sex (457 / 58,9%) with an average age of 60.4 years (DP=18.7) mulatto (240/30.9%); marital situation with spouse (413/53.2 %) and elementary school complete (403/52.0%). One hundred and seventy-eight patients presented lesions during the datacollection period, leading to an overall point prevalence of 23%. With an average of 1.1 lesions (DP=0.4) per patient, pressure sores predominated (n=80/10.3%), followed by diabetic ulcers (n=66/8.5%). The remaining types of lesions showed a prevalence of 2.7% (n=21) for post-operative wound complications; 0.9% (n=7) for frictional lesions and 0.5% (n=4) for incontinence associated dermititis (IAD). The primary occurence of lesions to particular parts of the body were frictional lesions to the back of the left hand; incontinence associated dermititis lesions to the region of the outer labia; post-operative wound complications to the left leg; pressure sores to the sacrum; and diabetic ulcers to the sole of the left foot. CART showed Diabetes Mellitus, the use of anticoagulants, the presence of rigidness, the Braden score without risk (>18), the presence of bandages and bruises as factors simultaneously associated with the presence of lesions, repeating some of these conditions for pressure sores and diabetic ulcers. Conclusion: The study, unprecedented in the Amazon Basin region, made a more accurate epidemiological diagnosis possible of some of the most important and prevalent acute and chronic lesions in hospitalized patients, such as frictional lesions (0.9%), IAD (0.5%), post-operative wound complications (2.7%), pressore sores (10.3%) and diabetic ulcers (8.5%). With point prevalences inferior to the majority of national and international studies, despite the fact that the majority of the associated factors found in hospitalized Amazonian patients are the same as those present in a review of the literature, this study evokes the need for more investigation throughout the region,.particularly incidence studies.

By the discovery of the therapeutic properties of ultra-violet light, vast possibilities in the treatment of all tubercular lesions have been opened up. Not the least important of these lesions is lupus vulgaris, which until now has, in many cases, obstinately defied cure. The ultra-violet light universal bath, while still in its childhood regarding experience of technique, etc., has already proved itself the greatest curative agent yet discovered for lupus vulgaris, producing dramatic results in many an old-standing case which has resisted every other method of treatment. In this Thesis I shall endeavour to show the marvellous results of carbon arc-light baths in lupus vulgaris, and though the improvement may appear slow, we must allow for the amount of destruction of shin in the disease, and its many years' duration in most cases.

Magister Chirurgiae Dentium - MChD / Lesotho has the third highest prevalence of HIV in the world with an estimated 23% of the adult population infected. At least 70% of people living with HIV/AIDS (PLWHA) present with oral manifestations of HIV as the first sign of the disease. While Lesotho has a population of fewer than 2 million people, it is faced with the harsh reality of a dire shortage of health care workers including oral health care workers (OHCWs). The high prevalence of HIV is of major concern to oral health workers who regularly encounter patients presenting with oral lesions associated with HIV disease. Oral health care workers need to have adequate knowledge of these conditions for effective management thereof. To determine the knowledge, attitudes and practises of oral health care workers (OHCWs) of Lesotho regarding the management of oral manifestations of HIV/AIDS. A descriptive cross-sectional survey was conducted on all 46 OHCWs in 26 public and private care facilities in all ten districts of Lesotho. A self–administered questionnaire was used to gather information on demographic characteristics of OHCWs and their knowledge, attitudes and practices regarding the management of oral lesions associated with HIV. A visual aid depicting seven colour images of lesions strongly associated with HIV was used to assess knowledge. Data was analysed using Microsoft Excel® and the R statistical package. The outcome of the study was then presented using tables and charts as appropriate. Frequencies, means and 2x2 contingency tables were generated and Fisher‟s exact tests were used for associations. A significance level of (p<0.05) was used.

Magister Scientiae Dentium - MSc(Dent) / Introduction: South Africa has an estimated HIV prevalence rate of 29.5%, in Gauteng province, the prevalence rate in women attending ante-natal clinic is 28.7% and in the Johannesburg Metro District, the prevalence rate is 41%. The early identification of HIV in the HIV positive well patient or HIV positive unwell patient can lead to the commencement of early intervention and treatment, thus resulting in a higher quality of life for the patient and lower treatment costs for the State. Aim: To determine the oral health knowledge, practices and treatment patterns of nurses at ARV clinics in Johannesburg Metro District. Materials and Methods: The study design was a convenient cross-sectional survey conducted between May 2014 and January 2015 in the Johannesburg Metro District. The study population comprised of nursing staff at ARV clinics in the Johannesburg Metro District. 147 questionnaires were distributed among the nurses that were in contact with the patients. Only 100 (n=147) questionnaires came back completed. The data collected was entered into Microsoft Excel and imported to STATA 13.1 to determine statistical significance using chi-squared test. A p-value was regarded significant if <0.05. Results: The results of the study depicted poor knowledge on oral manifestations of HIV/AIDS from the nursing staff at the ARV clinics in the district. Although 85% could describe the oral lesions found in the oral cavity and 66% perceived that they could identify Oral Candidiasis (OC), only 47% could correctly identify the lesion. 57% perceived knowing the condition associated with OC and only 46% correctly named the condition (p- value=0.001). Only two thirds of 43% of nurses could manage OC using drugs from the protocol accessible at the clinics, 25% referred and 32% did not know how to manage the OC (p-value=0.001). Only 40% (n=100) of the nurses referred patients for oral health promotion. Almost all the nurses (81%) indicated repeatedly that they need more training on oral health and oral health promotion. Conclusions: There is a need to include the oral manifestations of HIV in the nursing curriculum. Continued professional development should include Oral Health Promotion. Further research is needed to explore means of incorporating an oral health and disease module in the nursing curriculum.