Tesis-Universitas Indonesia. / Summary in English. Includes bibliographical references (p. 225-240).

No description available.

Thesis (M.D.)--University of Adelaide, Dept. of Paediatrics, 1991. / Includes bibliographical references (leaves 287-310).

In this study the researcher explored and described the utilization of Gestalt play therapy concepts and techniques in order to strengthen the sense of self of the pediatric hematology/oncology patient. Literature studies were compiled to examine the concepts of the pediatric hematology/oncology patient, sense of self and Gestalt play therapy. These literature studies provided the theoretical frame in which the study was executed. During the empirical study qualitative data was gathered by means of unstructured interviews within an instrumental case study. Eight therapy sessions were conducted with the participant in order to explore how Gestalt play therapy concepts and techniques could be utilized to strengthen the sense of self of the pediatric hematology/oncology patient. Following the analysis of the data the researcher was able to describe how the Gestalt play therapy concepts and techniques were utilized to strengthen the sense of self of the pediatric hematology/oncology patient. / Social Work / M. Diac. (Play Therapy)

In this study the researcher explored and described the utilization of Gestalt play therapy concepts and techniques in order to strengthen the sense of self of the pediatric hematology/oncology patient. Literature studies were compiled to examine the concepts of the pediatric hematology/oncology patient, sense of self and Gestalt play therapy. These literature studies provided the theoretical frame in which the study was executed. During the empirical study qualitative data was gathered by means of unstructured interviews within an instrumental case study. Eight therapy sessions were conducted with the participant in order to explore how Gestalt play therapy concepts and techniques could be utilized to strengthen the sense of self of the pediatric hematology/oncology patient. Following the analysis of the data the researcher was able to describe how the Gestalt play therapy concepts and techniques were utilized to strengthen the sense of self of the pediatric hematology/oncology patient. / Social Work / M. Diac. (Play Therapy)

Bibliography: leaves 287-310 / 311 leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (M.D.)--University of Adelaide, Dept. of Paediatrics, 1991

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Objetivo: Avaliar a freqüência das células T reguladoras (Tregs) em crianças com diagnóstico novo de Púrpura Trombocitopênica Imune (PTI) e a sua associação com a contagem de plaquetas na ocasião, comparando os achados com os de controles saudáveis. Pacientes e Métodos: Foi realizado um estudo caso-controle, no qual foram incluídos 19 pacientes com diagnóstico novo de PTI e 19 controles. Para cada um dos casos, foram coletadas quatro amostras de sangue em períodos distintos, sendo eles ao diagnóstico – antes da instituição de qualquer terapêutica – e após um, três e seis meses do mesmo. Para os controles, utilizou-se amostra de sangue de 19 pacientes saudáveis, coletadas eletivamente. Em todas as amostras de sangue foi realizada contagem de plaquetas através de hemograma e avaliação dos linfócitos Tregs (CD4+ CD25+ Foxp3) por citometria de fluxo. Resultados: A idade média ao diagnóstico de PTI foi de 6,53 ± 4,14 anos. Dos 17 pacientes tratados, 13 receberam apenas corticosteróide oral e quatro pacientes receberam corticosteróide e imunoglobulina endovenosa associada em algum momento do tratamento. Em relação à evolução da doença, 14 crianças apresentaram remissão completa, duas remissão e três PTI crônica. Houve diferença estatisticamente significativa no número de plaquetas entre os grupos caso e controle nas amostras 1 e 4. Não houve diferença significativa na contagem de Tregs entre os casos e os controles em nenhum momento de coleta. Não foi encontrada correlação estatisticamente significativa entre Tregs e o número de plaquetas entre os casos e os controles, nem nos pacientes do grupo caso ou do grupo controle analisados separadamente. Não houve diferença na contagem de células Tregs entre os grupos de pacientes crônicos e não crônicos. Conclusão: Os achados deste estudo não nos permitiu evidenciar correlação estatisticamente significativa entre Tregs e o número de plaquetas nos grupos caso e controle. As células T CD4+ CD25+ Foxp3 (Tregs) parecem não desempenhar um papel crucial na regulação da auto-imunidade em pacientes pediátricos com diagnóstico de PTI, provavelmente, devido à existência de outros mecanismos responsáveis pela auto-imunidade em crianças, ainda não identificados. / Objective: To assess the frequency of regulatory T cells (Tregs) in children with a new diagnosis of Immune Thrombocytopenic Purpura (ITP), and its association with the counts of platelets on the occasion, and compare with healthy controls. Patients and Methods: A case-control study was conducted, in which 19 patients with new diagnosis of ITP and 19 controls were included. For each case, four blood samples were collected at different point times, that is, at the diagnosis – before the establishment of any treatment – and after one, three and six months. For the controls, electively collected blood samples from 19 healthy patients were used. For all blood samples, platelets were counted through a CBC and assessment of Treg lymphocytes (CD4+ CD25+ Foxp3) by flow cytometry. Results: The mean age at the ITP diagnosis was 6.53 ± 4.14 years. Of 17 treated patients, 13 received oral corticosteroid only, and four patients received corticosteroid and associated intravenous human immunoglobulin at some point in the treatment. Regarding the disease course, 14 children showed full remission, two partial remission, and three chronic ITP. There was a statistically significant difference in the number of platelets between the case and control groups in the samples 1 and 4. There was no significant difference in the counts of Tregs between cases and controls at any collection time. No statistically significant correlation was found between Tregs and number of platelets between cases and controls, neither in patients in the case group nor in the control group who were analyzed separately. There was no difference in the counts of Treg cells between the groups of chronic and non-chronic patients. Conclusion: The findings of this study did not show any statistically significant correlation between Tregs and number of platelets in the case and control groups. The T cells CD4+ CD25+ Foxp3 (Tregs) seems did not play a key role in the regulation of self-immunity in pediatric patients diagnosed with ITP. Other mechanisms, which aren’t still identified, are likely to account for self-immunity in children.

Objetivo: Avaliar a freqüência das células T reguladoras (Tregs) em crianças com diagnóstico novo de Púrpura Trombocitopênica Imune (PTI) e a sua associação com a contagem de plaquetas na ocasião, comparando os achados com os de controles saudáveis. Pacientes e Métodos: Foi realizado um estudo caso-controle, no qual foram incluídos 19 pacientes com diagnóstico novo de PTI e 19 controles. Para cada um dos casos, foram coletadas quatro amostras de sangue em períodos distintos, sendo eles ao diagnóstico – antes da instituição de qualquer terapêutica – e após um, três e seis meses do mesmo. Para os controles, utilizou-se amostra de sangue de 19 pacientes saudáveis, coletadas eletivamente. Em todas as amostras de sangue foi realizada contagem de plaquetas através de hemograma e avaliação dos linfócitos Tregs (CD4+ CD25+ Foxp3) por citometria de fluxo. Resultados: A idade média ao diagnóstico de PTI foi de 6,53 ± 4,14 anos. Dos 17 pacientes tratados, 13 receberam apenas corticosteróide oral e quatro pacientes receberam corticosteróide e imunoglobulina endovenosa associada em algum momento do tratamento. Em relação à evolução da doença, 14 crianças apresentaram remissão completa, duas remissão e três PTI crônica. Houve diferença estatisticamente significativa no número de plaquetas entre os grupos caso e controle nas amostras 1 e 4. Não houve diferença significativa na contagem de Tregs entre os casos e os controles em nenhum momento de coleta. Não foi encontrada correlação estatisticamente significativa entre Tregs e o número de plaquetas entre os casos e os controles, nem nos pacientes do grupo caso ou do grupo controle analisados separadamente. Não houve diferença na contagem de células Tregs entre os grupos de pacientes crônicos e não crônicos. Conclusão: Os achados deste estudo não nos permitiu evidenciar correlação estatisticamente significativa entre Tregs e o número de plaquetas nos grupos caso e controle. As células T CD4+ CD25+ Foxp3 (Tregs) parecem não desempenhar um papel crucial na regulação da auto-imunidade em pacientes pediátricos com diagnóstico de PTI, provavelmente, devido à existência de outros mecanismos responsáveis pela auto-imunidade em crianças, ainda não identificados. / Objective: To assess the frequency of regulatory T cells (Tregs) in children with a new diagnosis of Immune Thrombocytopenic Purpura (ITP), and its association with the counts of platelets on the occasion, and compare with healthy controls. Patients and Methods: A case-control study was conducted, in which 19 patients with new diagnosis of ITP and 19 controls were included. For each case, four blood samples were collected at different point times, that is, at the diagnosis – before the establishment of any treatment – and after one, three and six months. For the controls, electively collected blood samples from 19 healthy patients were used. For all blood samples, platelets were counted through a CBC and assessment of Treg lymphocytes (CD4+ CD25+ Foxp3) by flow cytometry. Results: The mean age at the ITP diagnosis was 6.53 ± 4.14 years. Of 17 treated patients, 13 received oral corticosteroid only, and four patients received corticosteroid and associated intravenous human immunoglobulin at some point in the treatment. Regarding the disease course, 14 children showed full remission, two partial remission, and three chronic ITP. There was a statistically significant difference in the number of platelets between the case and control groups in the samples 1 and 4. There was no significant difference in the counts of Tregs between cases and controls at any collection time. No statistically significant correlation was found between Tregs and number of platelets between cases and controls, neither in patients in the case group nor in the control group who were analyzed separately. There was no difference in the counts of Treg cells between the groups of chronic and non-chronic patients. Conclusion: The findings of this study did not show any statistically significant correlation between Tregs and number of platelets in the case and control groups. The T cells CD4+ CD25+ Foxp3 (Tregs) seems did not play a key role in the regulation of self-immunity in pediatric patients diagnosed with ITP. Other mechanisms, which aren’t still identified, are likely to account for self-immunity in children.