Title: Evaluation of the effect of exercise according to the Propriofoot concept and the methodology of Sensorimotor Training by Janda and Vávrová on foot pressure distribution Objectives: In this thesis the following three goals were set: First, to find out if and how does the percentual foot pressure distribution between the left and right foot in standing change after a four-week long exercise according to either the methodology of Sensorimotor training by Janda and Vávrová or the Propriofoot concept. Second, if and how will the segmental foot load change. Third, if the prospective changes of foot load will agree or differ between the two groups. Methods: A pilot study for quantitative research using experimental scientific method was conducted, with two groups consisting of ten members each, aged thirty to fifty and diagnosed with flat foot. At the beginning, all probands underwent diagnostic measurement using the "Plantograf V10" device. Then they attended a four-week long individual therapy with an exercise plan created according to one of the two methods in consideration. At the end the probands were again measured by the same device. Entrance and control measurements obtained for each participant and both groups were evaluated, compared and statistically analyzed. Results: Analysis of the...

INTRODUÇÃO: A nefrectomia radical está associada com algum grau de comprometimento da função do rim remanescente em pacientes com câncer renal. A etiologia da insuficiência renal crônica (IRC) nesses casos é complexa, tem prevalência relativamente alta e existem poucas alternativas terapêuticas quando ela se estabelece. Métodos que permitem prever o aparecimento desse quadro e possibilitem condutas terapêuticas que minimizem e retardem a perda de função renal são altamente desejáveis. OBJETIVOS: Em pacientes submetidos à nefrectomia radical: 1. Objetivo primário: Avaliar o impacto de alterações do parênquima renal não neoplásico, dados demográficos, clínicos e laboratoriais sobre o desenvolvimento de insuficiência renal crônica. 2. Objetivo secundário: Correlacionar alterações do parênquima renal não neoplásico, dados demográficos, clínicos e laboratoriais com a variação da taxa de filtração glomerular estimada pré e pós-operatória. MÉTODOS: Foram selecionados 65 pacientes submetidos à nefrectomia radical por quadros de carcinoma de células renais. Nesses casos, procedeu-se a análise histológica do parênquima renal não neoplásico e as alterações encontradas foram correlacionadas com o aparecimento subsequente de IRC. Para avaliação da função renal, foi utilizada a taxa de filtração glomerular estimada (TFGe) por meio da fórmula MDRD (Modification of Diet in Renal Disease) pré-operatória e última consulta. O estado do parênquima renal não neoplásico foi avaliado por meio de parâmetros histológicos: 1. Presença de glomerulosclerose, calculada pelo número total de glomérulos escleróticos dividido pelo número total de glomérulos avaliados, e expressa em porcentagem e presença de glomérulos hialinizados; 2. Alterações vasculares com a presença de arteriolosclerose. A extensão da oclusão arterial foi quantificada em três grupos: menos de 25%, 26% a 50% e acima de 50%. 3. Presença de fibrose intersticial e atrofia tubular. O impacto destas alterações no comportamento da função renal foi avaliado por meio do desenvolvimento IRC, definida com uma TFGe menor que 60ml/minuto/1,73m2 na avaliação mais recente e de acordo com os protocolos do Kidney Disease Outcomes Quality Initiative. RESULTADOS: Após um seguimento médio de 49,06 meses, foi observado uma queda média de 26,52% na função renal nos pacientes submetidos à nefrectomia radical. Trinta e cinco dos 65 pacientes evoluíram para IRC. Em uma análise univariada, presença de glomerulosclerose (OR=3,8), arteriosclerose (OR=3.3), fibrose intersticial (OR=3.8), hipertensão arterial (OR=3.7), Diabetes Mellitus (OR=11.6) e idade maior que 60 anos (OR=3.4) associaram-se à evolução para IRC (p < 0.05). Em uma regressão logística multivariada, índice de comorbidade de Charlson (OR= 2,3), GS (OR= 1,2) e TFGe pré-operatória (OR= 0,96) foram estatisticamente significantes. Para cada 2,5% de aumento de alterações glomérulos, houve uma diminuição percentual de 28% da TFGe. CONCLUSÕES: Alterações histológicas do parênquima renal não neoplásico e parâmetros clínicos podem ser utilizados para predizer pacientes que evoluirão para IRC após uma nefrectomia radical / INTRODUCTION: Radical nephrectomy is inevitably associated with a variable renal function decrease. Chronic Kidney disease (CKD) is highly prevalent and there are few options for treatment in end stage CKD. The goal, as urologist, should be on optimizing renal function after surgery and not just avoiding dialysis. OBJECTIVES: In patients submitted to radical nephrectomy: 1. Primary objective: Assess the association of histopathological parameters in non-neoplastic renal parenchyma with new onset chronic kidney disease after surgery. 2. Secondary objective: Assess the association of demographic and clinical parameters with new onset chronic kidney disease after surgery. METHODS: Data were extracted from 65 patients who underwent radical nephrectomy. Using The MDRD (Modification of Diet in Renal Disease) formula, we calculated the estimated glomerular filtration rate preoperatively and at last follow-up. The study end point was development of CKD, defined as an estimated glomerular filtration rate (eGFR) of less than 60ml/minute/1,73m2. A renal pathologist assessed three histological features in the nonneoplastic parenchyma, including global glomerulosclerosis, arteriosclerosis, interstitial fibrosis and tubular atrophy. For glomerulosclerosis assessment, the percent of affected glomeruli was determined. Arteriosclerosis or the extent of arterial luminal occlusion was graded into three groups, including 1-0% to 25%, 2-26% to 50% and 3-greater than 50%. Interstitial fibrosis and tubular atrophy were evaluated as absent/present. RESULTS: After a mean follow-up of 49,06 months, the eGFR rate decreased 26,52% after radical nephrectomy. Thirty five patients developed CKD. In a univariate analysis, the incidence of CKD was associated with glomerulosclerosis (OR=3,8), interstitial fibrosis (OR=3,8), arteriosclerosis (OR=3,3), hypertension (OR=3,7), Diabetes Mellitus (OR=11,6) and age (OR=3,4) after surgery. In a multivariate analysis, Charlson comorbidity index (OR= 2,3), glomerulosclerosis (OR= 1,2) and baseline eGFR(OR= 0,96) were associated with new onset CKD after radical nephrectomy. For each 2,5% increase in glomerular abnormality the eGFR rate decreased 28% from baseline. CONCLUSIONS: Histologic findings in the nonneoplasic tissue, in addition to clinical parameters, can be used to predict which patients are more likely to develop CKD after radical nephrectomy

Este trabajo de investigación presenta un estudio sobre el comportamiento de los puentes de dovelas de hormigón con pretensado exterior y juntas secas conjugadas, centrándose en el estudio de la respuesta a solicitaciones de flexión y cortante combinados, en servicio y en rotura. Se evalúa, asimismo, la posibilidad de sustituir total o parcialmente la armadura convencional de las dovelas tras la inclusión de fibras metálicas en el hormigón.Para ello se realizaron ensayos sobre paneles, para evaluar la resistencia de las juntas conjugadas, y ensayos de vigas con distinto grado de pretensado sometidas a flexión y a cortante. Tanto de vigas como de paneles, se fabricaron dos series paralelas, una realizada con hormigón convencional y otra con hormigón reforzado con fibras de acero. Tanto los resultados obtenidos en estos ensayos, como los de los ensayos encontrados en la bibliografía, se han comparado con la variada formulación existente para evaluar la capacidad resistente de las juntas secas conjugadas propuesta por distintos investigadores y normativas.De entre todos los modelos de junta estudiados, todos ellos basados en el Método de los Elementos Finitos, finalmente se han puesto a punto dos modelos para estudiar la transmisión de cortante entre juntas conjugadas. Un modelo elaborado con elementos tipo junta a los que se les confiere un comportamiento de rozamiento coulombiano y que modeliza la junta (y sus llaves conjugadas) con su geometría. Otro modelo de junta plana que modeliza el comportamiento medio de la junta en la zona de llaves con elementos tipo junta dotados de un modelo de comportamiento de rozamiento cohesivo. Estos modelos de junta han sido calibrados y aplicados al estudio de los ensayos. El primer modelo de junta ha sido aplicado al estudio de los ensayos de paneles. Los dos modelos de junta han sido aplicados al estudio de los ensayos realizados sobre vigas, de los que se ha realizado un completo análisis no lineal en teoría de segundo orden, incluyendo el comportamiento no lineal de los materiales. El modelo de junta plana ha sido usado en el estudio de dos ejemplos de puentes, uno isostático y otro continuo.De todo lo anterior se han extraído conclusiones referentes al modelo de análisis, a la resistencia de las juntas, al armado de las dovelas y al comportamiento global de este tipo de estructuras. / This work presents a study of the behaviour of segmental concrete bridges with external prestressing, focussing on the response under combined flexure and shear, in the service and ultimate limit states. The possibility of replacing entirely or partially the conventional reinforcement of the segments through the incorporation of steel fibres in the concrete is also evaluated.Tests have been performed on panels to evaluate the resistance of castellated dry joints, and on large-scale beams with different levels of prestressing for evaluating the response under flexure and shear. The tests were conducted on conventional and steel fibre reinforced concretes. The results obtained in these tests, as well as those found in the literature, have been compared with several design formulas for evaluating the load-carrying capacity of dry castellated joints. The formulas that gave the best predictions have been identified and used further in the analysis of bridge girders. Two models have been used within the framework of the Finite Element Method for simulating the transmission of shear along joints between match-cast segments. In one of the approaches, the geometry of the joints (and the shear keys) is represented with interface elements with Coulomb frictional behaviour. In the other approach, the global behaviour of the key zone of the joint is represented by flat interface elements with cohesive frictional behaviour. These joint models have been calibrated using the results of the experiments. A complete analysis was performed taking into account the geometric nonlinearities and the non-linear behaviour of the materials. The flat joint model has been used in the study of two bridges, one simply supported highway bridge and another five-span highway bridge.The results of the experimental and numerical analyses have led to significant conclusions regarding the modelling of the keys, load-carrying capacity of the joints, reinforcement detailing in the segments and the global behaviour of segmental structures with dry castellated joints.

Η ΒΥΠ διαθέτει αντίτυπο της διατριβής σε έντυπη μορφή στο βιβλιοστάσιο διδακτορικών διατριβών που βρίσκεται στο ισόγειο του κτιρίου της. / Εκτελώντας δυναμικές αναλύσεις με χρήση πεπερασμένων στοιχείων, αναλύεται η σεισμική απόκριση τεσσάρων τοίχων αντιστήριξης οπλισμένου εδάφους στην Ταϊβάν με στοιχεία πρόσοψης κυβόλιθους. Οι τοίχοι, των οποίων τα ύψη κυμαίνονται από 3.20 m έως 5.60 m και έχουν ως οπλισμούς στρώσεις γεωπλέγματος, υποβλήθηκαν στο σεισμό Chi-Chi (1999) και η συμπεριφορά τους κρίθηκε από επιτυχής έως ανεπιτυχής: δύο από αυτούς κατέρρευσαν, ένας υπέστη μόνο ελαφρές βλάβες, ενώ ο τέταρτος τοίχος παρέμεινε πρακτικά ανέπαφος. Η μη-γραμμική ανάλυση βασίσθηκε στα γνωστά γεωμετρικά και μηχανικά χαρακτηριστικά του κάθε τοίχου, του γεωπλέγματος, των γεωτεχνικών συνθηκών σε κάθε θέση, του είδους και των ιδιοτήτων του υλικού επίχωσης. Η συμπεριφορά του εδαφικού υλικού προσομοιώθηκε κάνοντας χρήση του κριτηρίου Mohr-Coulomb, ενώ ως διέγερση βάσης στις δυναμικές αναλύσεις πεπερασμένων στοιχείων χρησιμοποιήθηκαν τα καταγεγραμμένα επιταχυνσιογραφήματα κοντά στις θέσεις των τοίχων. Τα αποτελέσματα των αναλύσεων (και ειδικά η εκτιμώμενη παραμορφωμένη μορφή των τοίχων) επαλήθευσαν την παρατηρούμενη συμπεριφορά των τοίχων. Βασιζόμενοι στα αποτελέσματα, βρέθηκαν οι λόγοι της ανεπιτυχούς συμπεριφοράς των δύο τοίχων που κατέρρευσαν, ενώ εξηγήθηκε η διαφοροποίηση της συμπεριφοράς των δύο τοίχων που δεν υπέστησαν βλάβες. Επιπροσθέτως, πραγματοποιήθηκαν παραμετρικές αναλύσεις για να ευρεθεί η επίδραση σημαντικών παραμέτρων σχεδιασμού, όπως το βάθος θεμελίωσης του τοίχου, η απόσταση και το μήκος των οπλισμών, η συνεισφορά των ράβδων σύνδεσης στην ευστάθεια των στοιχείων πρόσοψης και η συνεισφορά της ανώτατης στρώσης οπλισμού στην ευστάθεια του τοίχου. Επίσης αναλύθηκε η ευστάθεια των τοίχων χρησιμοποιώντας ένα εμπορικά διαθέσιμο λογισμικό οριακής ισορροπίας, το οποίο βρέθηκε ικανό να προβλέψει την παρατηρούμενη επιτυχή και ανεπιτυχή συμπεριφορά των τεσσάρων τοίχων. / The seismic response of four reinforced soil segmental retaining walls in Taiwan, is analyzed using the dynamic finite element method. The walls – whose heights ranging from 3.20 m to 5.60 m and layers of geogrid reinforcement – were subjected to the Chi-Chi earthquake (1999) and their performance ranged from successful to unsuccessful: two of them were collapsed, one suffered only minor damage whereas the fourth wall remained practically intact. The non-linear analyses were based on the known geometrical and mechanical characteristics of each wall and of the geogrid reinforcement, the geotechnical conditions at each site and the type and properties of backfill material. The soil material behavior was modeled by using the Mohr-Coulomb failure criterion whereas recorded accelerograms in the vicinity of the sites of the walls were used as base excitation in the dynamic finite analyses. The results of the analyses (and especially the estimated deformed shape of the walls) showed a remarkable agreement with the observed performance of the walls. Based on these results the reasons for the unsuccessful performance of the two failed walls were identified whereas the differentiation of the behavior of the two undamaged walls was explained. Furthermore, parametric analyses were conducted to identify the effects of such important design parameters as the depth of the foundation of the wall, the spacing and length of reinforcement, the contribution of connecting pins to the stability of the facing elements as well as the contribution of the top layer of reinforcement to the stability of the wall. The stability of the walls were also analyzed by using a commercially available limit equilibrium software which was found to be able to predict the observed successful and unsuccessful performance of the four walls.

Darbo tikslas: įvertinti pacientų su lėtiniu juosmens skausmu, turinčių segmentinį nestabilumą, judėjimo sistemos funkcinę būklę. Pasirinktam darbo tikslui įgyvendinti buvo iškelti šie uždaviniai: 1. Įvertinti tiriamosios ir kontrolinės grupių asmenų juosmens aktyvių judesių amplitudę 2. Įvertinti tiriamosios ir kontrolinės grupių asmenų statinę liemens (pilvo ir nugaros) raumenų jėgos ištvermę. 3. Įvertinti tiriamosios ir kontrolinės grupių asmenų funkcinių judesių atlikties pajėgumą. 4. Įvertinti tiriamosios ir kontrolinės grupių asmenų skausmo kiekybines charakteristikas. Tyrimo metodai. Kontrolinę grupę sudarė 18 pacientų besiskundžiančių juosmens skausmu be stuburo segmentinio nestabilumo požymių. Tiriamąją grupę sudarė 12 pacientų, besiskundžiančių juosmens skausmu ir turinčių stuburo segmentinio nestabilumo požymių. Tyrimo metu pacientams buvo vertinama: skausmo intensyvumas naudojat skaičių analogijos skausmo skalę (SAS), funkcinis apatinės nugaros dalies pajėgumas (Roland – Morris klausimynas), judesio baimės (kinezifobijos) įvertinimo klausimynas (TAMPA), funkciniai judesių atlikties testai, juosmens aktyvių judesių amplitudė, statinė liemens raumenų jėgos ištvermė, stuburo segmentinio nestabilumo įvertinimo testas. Išvados: 1. Tiriamosios ir kontrolinės grupių asmenų juosmens aktyvių judesių amplitudė lenkiantis, tiesiantis, atliekant šoninį lenkimą į kairę statistiškai reikšmingai nesiskyrė (p>0,05), o kontrolinės grupės šoninio lenkimo į dešinę judesių... [toliau žr. visą tekstą] / Purpose of the scientific papper: to evaluate patients with chronical low back pain and segmental instability funcional state. To achieve the goal several tasks were raised: 1. To evaluate the active trunk range of motion of participants (controled group and researche group). 2. To evaluate the endurance of muscle’s static strength of the trunk (back and abdominal) of the controled group and the researche group. 3. To evaluate the ability of a personal functional movement of the controled group and the researche group. 4. To evaluate the quantitative pain characteristics of participants (controled group and researche group). Methods of the research. The control goup was made of eighteen patients complaining of a trunk pain without any spinal segmental instability sings. The researche group was made of twelve patients complaining of a trunk pain with spinal segmental instability sings. During the research patients were evaluated on: intensivity of pain using the numerical analogy pain scale (SAS), functional ability of low back (Roland-Morris questionnaire), fear of movement (kineziophobia) evaluation questionnaire (TAMPA), test of a functional movement ability, active range of motion of the trunk, endurance of static muscles strength of the trunk, prone instability test. Conclusions: 1. Difference between the controled group and the researche group active range of motion while bending, straightening, making the lateral flexion movement to the left was not statisticaly... [to full text]

Introduction : Cette étude vise à évaluer la stabilité de la chirurgie LeFort I multisegmentaire à moyen (fin du traitement orthodontique) et à long termes dans les trois plans de l'espace (transversal, antéro-postérieur et vertical). Matériel et méthodes : L'échantillon étudié est composé de 31 patients traités en clinique privée, ayant eu une chirurgie LeFort I multisegmentaire en deux, trois ou quatre morceaux, et ayant terminé leur traitement orthodontique. Parmi eux, 17 patients ayant terminé leur traitement orthodontique depuis plus de deux ans (moyenne de trois ans post-traitement) ont permis d'évaluer la stabilité de la procédure chirurgicale à long terme. La collecte des données a été réalisée sur des modèles et des radiographies céphalométriques latérales pris à des temps précis tout au long du traitement orthodontique, ainsi que pendant la période de contention. Concernant l'analyse statistique, des T-tests et des corrélations de Pearson ont été utilisés. Le test de Bland-Altman et le coefficient de corrélation intra-classe ont permis d'analyser les fiabilités intra-examinateur et inter-examinateurs. Résultats : Une récidive transverse significative, mais très faible cliniquement, est constatée aux niveaux prémolaires et molaires entre la chirurgie et la fin du traitement orthodontique. Elle est corrélée avec l’expansion totale réalisée. Cette récidive transverse est non significative suite au traitement orthodontique. Aucune corrélation statistiquement significative n'est mise en évidence entre le nombre de segments et la récidive transverse postchirurgicale. Une variation de certaines mesures antéro-postérieures et verticales statistiquement significative, mais faible cliniquement, est notée entre la chirurgie et la fin du traitement orthodontique (avancement et impaction postérieure). Pour les mesures antéro-postérieures et verticales, aucun changement n'est statistiquement significatif suite au traitement orthodontique. Conclusion : Pour l'échantillon étudié, la stabilité de l'ostéotomie de type LeFort I multisegmentaire est très bonne, dans les trois plans de l'espace étudiés. / Introduction : The aim of this study was to evaluate the medium and long term stability of segmented LeFort I surgery in all three planes of space (transverse, sagittal and vertical). Materials and methods : The sample consisted of 31 private practice patients that received a two, three, or four-piece segmented LeFort I surgery and who had finished their orthodontic treatment. Study models and cephalometric radiographs were analyzed before treatment, before surgery, after surgery, and at the end of the orthodontic treatment for the 31 patients as well as a minumum two years into retention for 17 patients (mean of 3 years post-treatment). T-tests and Pearson correlation tests were used. Intra and inter-examiner reliability were verified with Bland Altman and intraclass coefficient tests. Results : A statistically significant transverse relapse was seen at the premolars and molars between surgery and the end of orthodontic treatment, that has little clinical significance. The relapse is correlated with the effective expansion. There was no significant relapse after orthodontic treatment was completed. There was no correlation between the amount of relapse observed and the amount of segments. Statistically significant changes were measured in the post surgical phase for maxillary advancement and impaction cases, but were shown to be of limited clinical significance. After removal of fixed appliances, no significant changes were noted. Conclusion : Multisegmented Lefort I surgery appears to have good stability in all three planes of space in the studied sample.

See file

Identification of signatures of positive selection has long been a major issue for understanding the unique features of any given species. However, only a fraction of human genes have been interrogated. Genes within segmental duplications are usually omitted due to the limitations of draft genome assemblies and the methodological reliance on accurate gene trees. In this work, we show the feasibility of a new method that does not need accurate gene trees or individual high-quality assemblies. We applied the concept to study exon evolution in the human genome, identifying 74 exons with evidence for rapid coding sequence evolution during human and Old World monkey evolution. Our results suggest abundant accelerated coding sequence evolution within duplicated regions of the genome and provide a more comprehensive view of the role of selection on the human genome. / La identificación de señales debidas a la acción de la selección positiva es de gran relevancia para desvelar características únicas de las especies. A pesar de ello, solo una fracción de genes humanos han sido analizados. Los genes incluidos en duplicaciones segmentarias son normalmente ignorados debido a limitaciones impuestas por la naturaleza preliminar de los genomas distintos al humano, así como por la dependencia en adecuados árboles filogenéticos. En este proyecto, demostramos la viabilidad de un nuevo método que no necesita árboles filogenéticos correctos ni ensamblajes de genomas de alta calidad. Hemos aplicado el concepto al genoma humano y hemos identificado 74 exones que muestran evidencia de haber evolucionado más rápidamente desde la separación de los humanos y los monos del viejo mundo. Nuestros resultados sugieren que ha habido abundante evolución acelerada dentro de las regiones duplicadas y ofrece una visión más esclarecedora del rol de la selección en la evolución del genoma humano.

Made available in DSpace on 2016-12-23T13:46:57Z (GMT). No. of bitstreams: 1 Juliana Rodrigues Tovar.pdf: 1741530 bytes, checksum: 913d2b256e4e2c979121377774357410 (MD5) Previous issue date: 2013-03-27 / Introdução: A cirurgia conservadora já é considerada procedimento de escolha quando a mulher é acometida por um tumor em estágio inicial. Em consequência desta conservação do tecido mamário, a recorrência local do câncer é uma crescente preocupação. Objetivos: Descrever o perfil sociodemográfico e clínico das mulheres com recidiva local do câncer de mama, submetidas à cirurgia conservadora no Hospital Santa Rita de Cássia/Afecc, Vitória- ES, cadastradas no período de Janeiro de 2000 a Dezembro de 2010, examinar a associação entre as variáveis clínicas e sociodemográficas e a incidência de recidiva local e analisar a sobrevida livre da recidiva local dessas mulheres. Metodologia: Foram realizados dois estudos: o primeiro trata-se de um estudo de coorte retrospectiva e o segundo refere-se a um estudo de sobrevida com a utilização de dados secundários. A amostra compôs-se por 880 casos de mulheres com diagnóstico de câncer de mama e atendidas no Hospital Santa Rita de Cássia/Afecc. Utilizou-se o método Kaplan-Meier e o modelo multivariado de riscos proporcionais de Cox, enquanto testou-se a significância estatística pelo método log-rank. Resultados: A recidiva ocorreu em 60 pacientes (6,8%) e a média do tempo entre a cirurgia e a recidiva de 35,5 meses. Na análise multivariada do estudo de sobrevida livre de recidiva local, identificou-se relação de risco para a faixa etária até 39 anos (p=0,083 e HR=6,19), comprometimento positivo das margens cirúrgicas (p=0,001 e HR= 3,49) e Her-2 positivo (P=0,033 e HR=1,89). Conclusões: A seleção de cada paciente para a conduta mais adequada deve ser feita cuidadosamente, de forma a estabelecer as principais características sociodemográficas e clínicas que possam auxiliar na escolha do melhor tratamento. Do mesmo modo, a escolha da melhor técnica cirúrgica é fundamental no sentido de reduzir os gastos com tratamentos de resgate e diminuir o sofrimento físico e psicológico da mulher / Introduction: Conservative surgery is now considered the procedure of choice when a woman is affected by a tumor at an early stage. As a consequence of conservation of breast tissue, the local recurrence of cancer is a growing concern. Objectives: To describe the sociodemographic and clinical profiles of women with local recurrence of breast cancer, undergoing conservative surgery Santa Rita Hospital in Vitória, Espírito Santo State, Brazil, from January 2000 to December 2010, to examine the association between clinical and sociodemographic and the incidence of local recurrence and analyze local recurrence-free survival of these women. Method: Two studies were performed: the first one is a retrospective cohort study and the second refers to a survival study using secondary data. The sample consisted of 880 women. To estimate the survival period in general and by stratum, the Kaplan Meyer method was employed. The independent effect of variables was checked by Cox/ s model of multivariate proportional risk, while statistical significance was tested through the log-rank method Results: The breast recurrence occurred in 60 patients (6,8%) and the average time between surgery and recurrence of 35,5 months. In multivariate analysis, we identified hazard ratio for the age group up to 39 years (p=0.083 and HR=6.19), positive surgical margin involvement (p = 0.001 and HR = 3.49) and Her-2 positive (p=0.033 and HR=1.89). Conclusions: The selection of each patient to the most appropriate management must be done carefully in order to establish the main sociodemographic and clinical characteristics that might help to choose the best treatment. Similarly, the choice of the best surgical technique is essential to reduce spending on treatments rescue and decrease the psychological suffering of the patient

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-10-18T11:17:00Z No. of bitstreams: 1 priscyllaaparecidavieiradocarmo.pdf: 1470676 bytes, checksum: fd5e83ad78ccfe4675fb74294a6ad3a6 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-10-25T12:06:50Z (GMT) No. of bitstreams: 1 priscyllaaparecidavieiradocarmo.pdf: 1470676 bytes, checksum: fd5e83ad78ccfe4675fb74294a6ad3a6 (MD5) / Made available in DSpace on 2016-10-25T12:06:50Z (GMT). No. of bitstreams: 1 priscyllaaparecidavieiradocarmo.pdf: 1470676 bytes, checksum: fd5e83ad78ccfe4675fb74294a6ad3a6 (MD5) Previous issue date: 2008-02-15 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / As glomerulopatias persistem entre as principais causas de doença renal crônica dialítica em nosso país. Traçar um perfil destas doenças assume importância não só como fonte para investigações clínicas e epidemiológicas, como também constitui-se em importante passo para o conhecimento da história natural das doenças glomerulares. O presente estudo avaliou o perfil das doenças glomerulares na Zona da Mata Mineira, estabelecendo a distribuição e freqüência dos tipos histológicos das glomerulopatias primárias e secundárias, relacionando-os com os achados clínico laboratoriais. Foram realizadas 261 biópsias, sendo que 126 delas correspondiam a rins nativos de adultos e foram consideradas para análise. A síndrome glomerular mais freqüente foi a nefrótica (55,2%), seguida da síndrome de anormalidades urinárias (28,8%). As glomerulopatias primárias e secundárias predominantes foram a glomeruloesclerose segmentar e focal (40,8%) e a nefrite lúpica (80,7%), respectivamente. Considerando-se toda a população, a GESF foi a glomerulopatia predominante (n=31; 24,6%), seguida pela nefrite lúpica (n=21; 16,6%) e pela nefropatia por IgA (n=16; 12,6%). Dentre as principais causas de síndrome nefrótica, a 10 GESF foi a glomerulopatia mais freqüentemente encontrada (27,5%), seguida pela nefrite lúpica (23,1%). Na síndrome de anormalidades urinárias, os diagnósticos mais freqüentes foram o rim normal (27,7%) e a nefropatia por IgA (22,2%). A maioria dos pacientes avaliados apresentavam algum grau de cronicidade à biópsia renal (56,3%), que se relacionou com menores valores de filtração glomerular. Este estudo forneceu informações importantes sobre as glomerulopatias na nossa região, contribuindo não só para uma adequada documentação da distribuição destas doenças entre nós, mas sobretudo para definição de melhores condutas visando terapêuticas cada vez mais específicas para diferentes tipos histológicos. / Glomerulopathies are still among the main causes of chronic kidney diseases requiring dialysis in our country. It is important to establish a profile of these diseases not only as a source for clinical and epidemiological investigations, but also because this is an important step for the knowledge of the natural history of glomerular diseases. This study assessed the profile of glomerular diseases in the Zona da Mata region of Minas Gerais, and established the distribution and frequency of the histological types of primary and secondary glomerulopathies, comparing them to clinical-laboratorial results. 261 biopsies were carried out, 126 of which were native adult kidneys and which were submitted to analysis. The most common glomerular syndrome was nephrotic syndrome (55.2%), followed by urinary abnormality syndrome (28.8%). The predominant primary and secondary glomerulopathies were focal segmental glomerulosclerosis (40.8%) and lupus nephritis (80.7%), respectively. Considering the whole population, FSGS was the predominant glomerulopathy (n=31; 24.6%), followed by lupus nephritis (n=21; 16.6%) and IgA nephropathy (n=16; 12.6%). Among the main causes of nephrotic syndrome, FSGS was the most frequently found glomerulopathy (27.5%), followed by lupus nephritis (23.1%). In the urinary abnormality syndrome, the most common diagnoses 12 were normal kidney (27.7%) and IgA nephropathy (22.2%). The majority of the patients presented some degree of chronicity at the renal biopsy (56,3%), which correlated with lower values of glomerular filtration rate. This study supplied important information about glomerulopathies in our region, contributing not only to suitable documentation on the distribution of these diseases among us, but particularly to a definition of more appropriate conduct, aiming at therapies that are more and more specific for different histological types.