Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-12-12T19:38:30Z No. of bitstreams: 1 ReginaCarmenEsposito_TESE.pdf: 1609404 bytes, checksum: bbff08f10f8b71c6162cfba459bc5243 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-12-14T19:40:52Z (GMT) No. of bitstreams: 1 ReginaCarmenEsposito_TESE.pdf: 1609404 bytes, checksum: bbff08f10f8b71c6162cfba459bc5243 (MD5) / Made available in DSpace on 2017-12-14T19:40:52Z (GMT). No. of bitstreams: 1 ReginaCarmenEsposito_TESE.pdf: 1609404 bytes, checksum: bbff08f10f8b71c6162cfba459bc5243 (MD5) Previous issue date: 2017-09-29 / O aumento benigno da pr?stata, mais conhecido como hiperplasia benigna da pr?stata (HBP), leva a sintomas do trato urin?rio inferior (STUI), que contribuem para diminuir a qualidade de vida dos homens acima da quarta d?cada. O mesmo vem sendo tratado, na sua maioria, por medicamentos alop?ticos do grupo dos inibidores da 5-alfa-redutase e/ou alfa-bloqueadores e/ou fitoter?picos. A literatura cient?fica apresenta uma escassez de ensaios cl?nicos randomizados, controlados com cegamento sobre a efic?cia de medicamentos homeop?ticos que j? tenham mat?ria m?dica para esta doen?a, bem como de novos rem?dios homeop?ticos. O presente estudo visou a avaliar a efic?cia do produto homeop?tico, contendo Momordica charantia 12CH, no controle dos STUI, devido ? HBP em ensaio cl?nico, randomizado, duplo cego e placebo controlado. Foram aleatorizados 81 pacientes em grupo A - Placebo e grupo B - Momordica charantia 12CH e avaliados a cada consulta pela anamnese, com o Escore Internacional de Sintomas Prost?ticos (IPSS), pelos exames de imagem com mensura??o do Volume Prost?tico (PV) e do Volume de Urina Residual P?s-esvaziamento (PVR) e laboratoriais pelo Ant?geno Prost?tico Espec?fico (PSA), Prote?na C Reativa quantitativa (PCR) e Interleucina-6 (IL-6). Em 72 amostras, foram realizados imunofenotipagem de linf?citos e subpopula??es por citometria de fluxo. Tanto a vari?vel principal (IPSS) quanto as vari?veis secund?rias (PSA, PV, PVR e PCR) e acess?rias (IL-6, linf?citos totais, linf?citos B, linf?citos T, linf?citos T helper, linf?citos T citot?xico e rela??o CD4/CD8 e c?lulas Natural Killer) n?o apresentaram signific?ncia estat?stica nas m?dias entre os grupos tratado e Placebo. Quanto ?s vari?veis de seguran?a, o uso da medica??o homeop?tica, pelos pacientes, n?o trouxe interfer?ncia durante os seis meses do experimento, seja na taxa de glicemia de jejum, seja nas dosagens de alanina aminotransferase, aspartato aminotransferase, fosfatase alcalina, bilirrubinas totais e fra??es e creatinina, usadas para avalia??o hep?tica e da fun??o renal respectivamente. A aus?ncia de infec??o urin?ria, confirmada pelo sum?rio de urina dos pacientes, predominou em ambos os grupos A e B durante todo o per?odo do ensaio cl?nico. Pode-se concluir que o tratamento com a Momordica charantia 12CH n?o apresentou diferen?a significativa para o placebo, quanto ? efic?cia no controle dos STUI, por HBP, por?m mostrou-se seguro. Pesquisas de alta qualidade, que permitam a prescri??o, a partir da individualiza??o dos sintomas e com diferentes dinamiza??es, devem ser realizadas, para possibilitar uma interpreta??o mais decisiva. / The benign enlargement of the prostate, better known as benign prostatic hyperplasia (BPH) results in symptoms of the lower urinary tract (LUTS) that contributes to lower quality of life of men over the fourth decade, and is mostly treated by allopathic drugs of the group of 5-alpha-reductase inhibitors and / or alpha-blockers, and / or phytotherapics. The scientific literature shows lack research from randomised and doubleblind clinical trials on the efficacy of homeopathic medicinal products that already have homeopathic medical materia and new homeopathic medicinal for BPH.The present study aimed to evaluate the effectiveness of the homeopathic product containing Momordica charantia 12CH in the LUTS control caused by BPH in a clinical, randomized, double-blind and placebo-controlled trial.A total of 81 patients were randomized to group A - Placebo and group B - Momordica charantia 12CH and evaluated at each visit by anamnesis with the International Prostate Symptom Score (IPSS), by imaging tests measured prostate volume (PV) and post-void residual (PVR) and laboratory tests for prostate specific antigen (PSA), quantitative C-reactive protein (CRP) and interleukin-6 (IL-6), and in 72 samples, lymphocyte and subpopulation immunophenotyping were performed by flow cytometry.Both the main variable (IPSS) and the secondary variables (PSA, PV, PVR and CRP) and accessory variables (IL-6, total lymphocytes, B lymphocytes, T lymphocytes, T helper cells, cytotoxic T lymphocytes and CD4 / CD8 ratio and Natural Killer cells) did not present statistical significance in the means between the groups treated and Placebo.About the safety variables, the use of homeopathic medication by the patients did not interfere during the six months of research, either in the fasting glucose level, as well as in the dosages of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bilirubins and fractions and creatinine levels used for hepatic evaluation and renal function respectively.The absence of urinary infection confirmed by urinalysis of patients predominated in both groups A and B throughout the clinical trial period. It can be concluded that treatment with Momordica charantia 12CH did not show a significant difference for placebo in the efficacy in the control of STUI by BPH, but it demostrated to be safe. High quality researchs, which allows prescription, from the individualization of symptoms and with different dynamizations, must be performed, to enable more decisiveinterpretation of its effectiveness.

Made available in DSpace on 2014-12-17T15:32:20Z (GMT). No. of bitstreams: 1 AnaLDLA_DISSERT.pdf: 3287914 bytes, checksum: 244a318f2c60d05b41aef3b1d3d6d2a0 (MD5) Previous issue date: 2012-02-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Periapical lesions are chronic inflammatory conditions of periradicular tissues considered direct consequences of infectious diseases resulting from pulp necrosis and subsequent progression to periapical region. The participation of the immune response and bone resorption in the formation of these lesions has been investigated, so that different cell types and cytokines have been identified as contributors to this process. In this perspective, this study aimed to evaluate the immunohistochemical expression of IL-17, TGF-?1 and FoxP3 in periapical granulomas (PGs), radicular cysts (RCs) and residual radicular cysts (RRCs), seeking a better understanding of the etiopathogenesis these periapicopatias. To this end, we selected 20 cases of GPs, 20 CRs and 10 RRCs to undergo morphological analysis and immunohistochemistry for biomarkers above, the latter being performed quantitatively using scores and average percentages of immunostaining for the analysis of IL-17 and TGF- ?1, while for the FoxP3 were counted only the positive lymphocytes. The results showed statistically significant differences between TGF-?1 and FoxP3 imunoexpressions, in relation to the periapical lesions studied (p = 0.002, p <0.001, respectively) but not between IL-17 and these (p = 0.355). Furthermore, the analysis of lymphocytes FoxP3-positive revealed significant statistical differences in that refers to the intensity of inflammatory infiltrate (p = 0.003) and also regarding thickness of the epithelial lining (p = 0.009). Finally, it was observed in the case of PGs, strong positive correlation between the amount of FoxP3- positive lymphocytes and the immunohistochemical expression of TGF-?1 (r = 0.755, p<0.001), as well as moderate positive correlation between IL-17 and TGF-?1 imunoexpressions (r = 0.503, p = 0.024). Thus, we can conclude that interactions between Th17 and Treg cells seem to be established at the site of injury, suggesting the involvement of both pro-inflammatory and immunoregulatory cytokines in the pathogenesis of periapical lesions / Les?es periapicais cr?nicas s?o condi??es inflamat?rias dos tecidos perirradiculares consideradas sequelas diretas de processos infecciosos resultantes da necrose pulpar e consequente progress?o para a regi?o periapical. A participa??o da resposta imunol?gica e da reabsor??o ?ssea na forma??o destas les?es tem sido bastante investigada, de modo que diversos tipos celulares e citocinas foram apontados como colaboradores deste processo. Nesta perspectiva, o presente estudo objetivou avaliar a express?o imuno-histoqu?mica da IL- 17, TGF-?1 e FoxP3 em granulomas periapicais (GPs), cistos radiculares (CRs) e cistos radiculares residuais (CRRs), buscando um melhor entendimento sobre a etiopatog?nese destas periapicopatias. Para tanto, foram selecionados 20 casos de GPs, 20 de CRs e 10 de CRRs para serem submetidos ? an?lise morfol?gica e imuno-histoqu?mica para os biomarcadores supracitados, sendo esta ?ltima realizada quantitativamente atrav?s de escores e percentuais m?dios de imunomarca??o para a an?lise da IL-17 e do TGF-?1, enquanto que para o FoxP3 foram contados apenas os linf?citos positivos. Os resultados demonstraram diferen?as estatisticamente significativas entre as imunoexpress?es do TGF-?1 e do FoxP3 em rela??o as les?es periapicais pesquisadas (p = 0,002; p < 0,001, respectivamente), mas n?o entre a IL-17 e estas (p = 0,355). Al?m disso, a an?lise dos linf?citos FoxP3-positivos revelou diferen?as estat?sticas significativas no que se refere ? intensidade do infiltrado inflamat?rio (p = 0,003) e tamb?m quanto ? espessura do revestimento epitelial (p = 0,009). Por fim, observou-se nos casos de GPs, forte correla??o positiva entre a quantidade de linf?citos FoxP3-positivos e a imunoexpress?o do TGF-?1 (r = 0,755; p < 0,001), assim como moderada correla??o positiva entre as imunoexpress?es da IL-17 e do TGF-?1 (r = 0,503; p = 0,024). Destarte, pode-se concluir que intera??es entre c?lulas Th17 e Treg parecem ser estabelecidas no local da agress?o, sugerindo a participa??o de citocinas tanto pr?inflamat?rias como imunorregulat?rias na patogenia das les?es periapicais

Made available in DSpace on 2014-12-17T15:32:28Z (GMT). No. of bitstreams: 1 JanainaCL.pdf: 1946389 bytes, checksum: 9edf9a3e8f8e033293bf82a3b2344d4d (MD5) Previous issue date: 2009-02-28 / Host response plays a major role in the pathogenesis of periodontal disease. Mediators such as inflammatory cytokines which are secreted during the immune response to bacterial challenges have ambiguous functions that may or may not lead to protection of the attacked tissue. In this context, experimental evidence suggests that T-helper 1 (Th-1) and T-helper 2 (Th-2) mediated responses are potentially important during the disease process. The aims of this study therefore were to further clarify the role played by Th2 cells during different time points of the active phase of periodontal disease, as well as, to investigate whether there was any evidence of a Th1 response in the periodontal disease microenvironment. Experimental periodontitis was induced in 30 Wistar male rats by placing cotton ligatures around the mandibular first molars. The rats were then randomly divided into two groups. Group1 (G1=15) and Group 2 (G2=15). In G1 the ligatures were maintained for 2 days, whereas in G2 the ligatures were left for 15 days, a time point that corresponds to the advanced stage of periodontal disease The contra-lateral teeth served as controls (no ligatures). Immunohistochemical investigation for the presence in gingival tissue of Th2 specific transcription factor (GATA3) and the subunit of the IFN-&#947; receptor was carried out after the disease induction period. Light microscopy analysis revealed a decrease in the expression of GATA-3 as bone loss progressed. On the other hand, although IFN-&#947; R1 was detected at an early stage of the active phase of disease its expression remained unaltered during the remaining period of the study. These results indicate that the Th2 response have a protective role during the pathogenesis of periodontal disease and that the progression of the periodontal disease is related with the unbalance of the responses Th1/Th2 / A resposta do hospedeiro tem um importante papel na patog?nese da doen?a periodontal. Mediadores como as citocinas liberadas por c?lulas inflamat?rias durante a resposta imune, frente a um ataque bacteriano, desempenham pap?is antag?nicos que podem culminar com a prote??o ou n?o do tecido agredido, o que fundamenta o paradigma da resposta Th1/Th2 na doen?a periodontal. Na tentativa de esclarecer a participa??o das c?lulas Th2, em diferentes tempos, na fase ativa da doen?a periodontal, bem como observar se o microambiente encontrava-se preparado para uma resposta Th1, induziu-se doen?a periodontal experimental em 30 ratos Wistar machos, atrav?s da coloca??o de ligaduras de algod?o ao redor dos primeiros molares mandibulares. Os animais foram divididos, aleatoriamente, em dois grupos: Grupo 1 (G1 = 15) e Grupo 2 (G2 = 15). Em G1 as ligaduras foram mantidas por 2 dias, que configurou o est?gio inicial da doen?a periodontal e no G2, as ligaduras foram mantidas por 15 dias, que foi considerado o est?gio avan?ado da doen?a periodontal. Os dentes contralaterais serviram de controle (sem ligaduras). Avalia??o imuno-histoqu?mica para o fator de transcri??o espec?fico para c?lula Th2 (GATA-3) e da subunidade IFN- &#947; R1 do receptor para IFN-&#947; (principal citocina da resposta Th1) foram avaliados nos tecidos gengivais dos ratos ap?s o per?odo de indu??o da doen?a. Ap?s an?lise microsc?pica observamos que o fator de transcri??o GATA-3 teve sua express?o diminu?da com o avan?o da perda ?ssea induzida e a subunidade IFN-&#947; R1 passou a se expressar na fase ativa da doen?a experimental, contudo n?o se alterou com a progress?o da destrui??o tecidual. Estes resultados indicam que a resposta Th2 pode estar associada a uma resposta protetora na patog?nese da doen?a periodontal e que a progress?o da doen?a periodontal est? relacionada com o desequil?brio das respostas Th1/Th2

Made available in DSpace on 2014-12-17T15:32:21Z (GMT). No. of bitstreams: 1 EdilmarMS_DISSERT.pdf: 790528 bytes, checksum: 570c185c018d55b199d467de6ca18465 (MD5) Previous issue date: 2012-02-09 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The most common malignant neoplasm of the oral cavity and oropharynx are squamous cell carcinoma. Injuries to the same stage and subjected to the same treatment protocol have sometimes different evolutionary courses. The scope of this study was to investigate, through a retrospective cohort, associations between the number of CD8 + T cells and natural killer, identified immunohistochemically in the inflammatory infiltrate in a series of cases of oral squamous cell carcinoma and orofaringeano, and the level of tumor response to radiotherapy and chemotherapy, overall survival and relapse-free survival of patients. We identified 54 patients with unresectable disease were treated exclusively with radiotherapy and chemotherapy. The median follow-up was 22 months. The sample was characterized by the predominance of male subjects, median age 60 years, all were smokers. The most frequent site was the tongue and 81.5% were in stage IV. Patients with disease in the oral cavity had a worse response to treatment (p = 0.006), worse relapse-free survival (p = 0.007), worse overall survival (p = 0.007). The advanced T stage was shown a negative prognostic factor (p= 0.006) for the clinical treatment response made. Immunohistochemistry was performed to select CD8 + cells (anti-CD8) and NK cells (anti-CD57). Lymphocytes positive and negative markings were counted using the program ImageJ ?. Two groups were created for each marking evaluated: Group I patients with more than 50% cells positive, Group II: less than 50% of labeled cells. For CD8 + cells detected in 38 (70.3%) of Group I were CD8 + and 16 (29.7%) Group II CD8 +. For NK cells, 26 (48.15%) Group I NK and 28 (51.85%) Group II NK. Regarding the clinical response to treatment, we observed that 39% of patients achieved a complete response and 25.9% remained without recurrence at the end of follow-up. These results were better in Group I CD8 + (p = 0.2). Identified that 72.2% of patients progressed to death, this finding had no association with the immunohistochemical data. There was no statistically significant differences between the number of CD8 + and NK cells and the ability of tumor response to radiotherapy and chemotherapy, or with overall survival and relapse-free survival of patients. However, especially in relation to a learned response, we found that this group of patients with advanced disease have a low count of CD8 + T cells active. Believing in the role that the immune response plays in the local fight against neoplastic cells, however, our results do not support the use of quantitative analysis of CD8 + T cells and NK cells as a prognostic factors for oral squamous cell carcinoma and oropharynx / A neoplasia maligna mais frequente da cavidade oral e da orofaringe ? o carcinoma epiderm?ide. Les?es com o mesmo estadiamento e submetidas ao mesmo protocolo terap?utico apresentam, por vezes, cursos evolutivos diferentes. O escopo do presente trabalho foi investigar, atrav?s de um coorte retrospectivo, associa??es entre a quantidade de c?lulas TCD8+ e natural killer, identificadas imuno-histoquimicamente no infiltrado inflamat?rio de uma s?rie de casos de carcinoma epiderm?ide oral e orofaringeano, e o n?vel de resposta tumoral ao tratamento radioter?pico e quimioter?pico, a sobrevida global e sobrevida livre de recidiva dos pacientes. Foram identificados 54 pacientes com doen?a irressec?vel, tratados exclusivamente com radioterapia e quimioterapia. A mediana de seguimento foi de 22 meses. A amostra se caracterizou pelo predom?nio de indiv?duos masculinos, com idade mediana de 60 anos; todos eram tabagistas. O s?tio mais frequente foi a l?ngua oral e 81,5% encontravam-se no est?dio IV. Os pacientes com doen?a na cavidade oral tiveram uma pior resposta ao tratamento (p=0,006), pior sobrevida livre de recidiva (p=0,007), pior sobrevida global (p=0,007). O est?dio T avan?ado se demonstrou um fator progn?stico negativo (p=0,006) para a resposta ao tratamento cl?nico efetuado. Foi realizada imuno-histoqu?mica para marcar c?lulas CD8+ (anti-CD8) e c?lulas NK (anti-CD57). Os linf?citos positivos e negativos para as marca??es foram contados atrav?s do programa ImageJ?. Dois grupos foram criados para cada marca??o avaliada: Grupo I: pacientes com mais de 50% das c?lulas positivas; Grupo II: menos de 50% das c?lulas marcadas. Para as c?lulas CD8+ detectamos que 38 (70,3%) eram do Grupo I CD8+ e 16 (29,7%) do Grupo II CD8+. Para as c?lulas NK, 26 (48,15%) Grupo I NK e 28 (51,85%) Grupo II NK. Em rela??o ? resposta cl?nica ao tratamento, observamos que 39% dos pacientes obtiveram resposta completa e 25,9% permaneceram sem recidiva ao final do seguimento. Esses resultados foram melhores no Grupo I CD8+ (p=0,2). Identificamos que 72,2% dos pacientes evolu?ram para o ?bito, esse achado n?o teve associa??o com os dados imuno-histoqu?micos. N?o se observou diferen?as estatisticamente significantes entre a quantidade de c?lulas CD8+ e NK e a capacidade de resposta tumoral ao tratamento radioter?pico e quimioter?pico, nem com a sobrevida global e sobrevida livre de recidiva dos pacientes. Contudo, principalmente em rela??o a resposta adquirida, detectamos que este grupo de pacientes com doen?a avan?ada tem uma baixa contagem de c?lulas TCD8+ ativas. Acreditando no papel fundamental que a resposta imune exerce no combate local ?s c?lulas neopl?sicas; no entanto, nossos resultados n?o suportam a utiliza??o da an?lise quantitativa das c?lulas TCD8+ e NK como um dos fatores progn?sticos para o carcinoma epiderm?ide oral e de orofaringe