肌腱修復一直是一個難題，因為依靠現在的治療很難將肌腱功能恢復到正常水平，近年來肌腱幹細胞的分離和發現為肌腱修復提供了新的策略。但是在利用肌腱幹細胞修復肌腱之前，我們應該瞭解肌腱幹細胞的哪些方面呢？ / 不同來源的成體幹細胞雖然具備相似的幹細胞特性，但是他們仍然具有組織特異性和功能的差異。這就意味選擇合適的細胞來源對於肌腱再生和肌腱組織工程有特殊意義。所以我們認為與骨髓間充質幹細胞相比，肌腱幹細胞具備特殊的幹細胞特性。迄今為止，還沒有研究比較肌腱幹細胞和骨髓間充質幹細胞的幹細胞特性。臨床應用要求幹細胞在體外增殖培養，體外的微環境也會影響幹細胞的幹性和治療潛能，所以我們還並不清楚肌腱幹細胞的幹性在體外培養中維持多久。成功的幹細胞治療需要深入理解組織特異性幹細胞的體內特徵和他們在組織修復中的作用。肌腱幹細胞的体内特徵还有没详细研究过，而且也不知道這些內源性幹細胞是否參與肌腱修復。 / 所以為了更好地利用肌腱幹細胞進行肌腱修復，本研究的總體目標是比較肌腱幹細胞和骨髓間充質幹細胞的幹細胞特性，同時從臨床角度考慮研究肌腱幹細胞體外幹性的維持。進一步研究鑒定肌腱幹細胞的體內特徵，並且探索他們在肌腱癒合中的作用。本研究將會探討我們應該瞭解關於肌腱幹細胞的體內和體外特性。 / 在第一部分研究中， 我們從同一隻GFP大鼠中分離出肌腱幹細胞和骨髓間充質幹細胞。經過比較，我們發現肌腱幹細胞与骨髓間充質幹細胞相比具备更高的克隆形成能力，增殖速度，更強的多向分化能力和更高的肌腱相关的基因表达。所以肌腱幹細胞表現出更好的幹性，可能是比骨髓间充质干细胞更好的用于肌腱再生的细胞来源。 / 在第二部分研究中，我們發現肌腱幹細胞伴隨體外傳代培養細胞衰老β-半乳糖苷酶活性增高，而同時間充質幹細胞標誌物和多向分化能力降低，所以研究人員和臨床醫生在利用肌腱幹細胞進行組織工程時需要考慮在體外傳代培養中他們的幹性的變化。 / 在第三部分研究中，IdU標記滯留細胞方法用於在體內標記幹細胞。我們發現休眠的幹細胞以IdU標記滯留細胞的形式存在於肌腱中，相比肌腱本體更多標記滯留細胞位於和肌腱腱鞘和肌腱骨結合部位。其中我們發現在肌腱腱鞘中的標記滯留細胞位於血管周圍的微環境血管，所以血管周圍的微環境可能是肌腱幹細胞來源之一。肌腱損傷后，位於損傷區域的標記滯留細胞的數量，增殖標誌物，肌腱相關標誌物， 多能性標誌物，和微血管相關標誌物都有明顯增加，意味著標記滯留細胞可能通過遷移，增殖和分化參與肌腱修復。 / 綜上所述，我們的結果為理解肌腱幹細胞的體外幹性特徵和在體外培養中的幹性變化以及体内肌腱幹細胞的鑒定提供了新的解釋，這有利于未來促進肌腱幹細胞的組織工程應用於肌腱修復。 / Tendon repair remains a great challenge due to current therapies cannot restore normal tendon function. Tendon-derived stem cells (TDSCs) have been isolated from tendon tissues and characterized in vitro in recent studies and provide new strategies for tendon repair. But what should we know about tendon stem cells before we use them to repair injured tendon? / Although stem cells that originate from different tissues share some common stem cell characteristics, they might also exhibit some tissue unique properties and hence functional differences. Therefore, we hypothesized that TDSCs have unique stemness properties compared with bone marrow-derived stem cells (BMSCs). There has been no study to compare the stemness properties of TDSCs and BMSCs. Clinical applications often require the in vitro expansion of stem cells. In vitro microenvironment also affects the stemness properties and therapeutic potential of stem cells. It is not clear if the stemness properties of TDSCs can be maintained and how long that they can be preserved during in vitro expansion. Moreover, successful stem cell-based repair therapies will require an understanding of tissue specific stem cells in vivo and their roles in the tissue repair. Tendon stem cells have not been described in details in vivo and it is unknown whether these endogenous stem cells participate in the tendon healing. / Therefore, in order to better make use of TDSCs for tendon repair, the objective of this study is to characterize the stemness properties of TDSCs compared with BMSCs and also to investigate the stemness limitation of TDSCs during culture in vitro for clinical use purpose. Furthermore, this study aims to identify the putative tendon stem cells in vivo and their role in tendon healing. This study would tell how much we should know about tendon stem cells in vitro and in vivo. / In the first part of the study, TDSCs and BMSCs were isolated from the same GFP Sprague-Dawley rat. TDSCs showed higher mensenchymal and pluripotent stem cell makers; clonogenicity; proliferative capacity; and tenogenic, osteogenic, chondrogenic, and adipogenic differentiation markers and multi-lineage differentiation potential than BMSCs. Compared with BMSCs, TDSCs shows great stemness properties and might be an alternative cell source for tendon regeneration. / In the second part of this study, the senescence-associated β-galactosidase activity of TDSCs increased while their stem cell-related marker expression and the multi-lineage differentiation potential decreased during in vitro passaging. It suggests that researchers and clinicians need to consider the changes of stemness properties of TDSCs when multiplying them in vitro for tissue engineering. / In the third part of the study, IdU label-retaining method was used for the labeling of stem cells in vivo. We have identified quiescent stem cells as IdU label retaining cells (LRCs) at the peritenon, tendon mid-substance and tendon-bone junction. More LRCs were found at the peri-tenon and tendon-bone junction compared to the mid-substance. Some LRCs could be identified in the peri-vascular niche in the peri-tenon, suggesting that peri-vascular niche is one source of tendon stem cells. After injury, The LRC number and the expression of proliferative, tendon-related, pluripotency and pericyte-related markers in LRCs in the window wound increased, indicating that LRCs might be involved in tendon repair via cell migration, proliferation and differentiation. / In conclusion, our results have provided new findings about the understanding of tendon-derived stem cells including their stemness properties and their changes during the in vitro culture, as well as in vivo identity of tendon stem cells, which might facilitate the application of TDSCs in tissue engineering for tendon repair in the future. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Tan, Qi. / Thesis (Ph.D.) Chinese University of Hong Kong, 2014. / Includes bibliographical references (leaves 130-162). / Abstracts also in Chinese.

Estudo de natureza qualitativa, descritiva e exploratória, que teve como objeto o raciocínio clínico elaborado pelos enfermeiros ao cuidarem de feridas em clientes com afecções oncológicas. Os objetivos traçados para o estudo foram: identificar as estratégias cognitivas que os enfermeiros com especialização em área oncológica consideram adotar para o estabelecimento de um julgamento clínico na avaliação de feridas em clientes com afecções oncológicas e caracterizar as etapas de elaboração mental para construção do raciocínio clínico que os enfermeiros consideram percorrer quando da avaliação de feridas em cliente acometido por afecções oncológicas. O campo de pesquisa foi o Instituto Nacional do Câncer, no qual os cenários de coleta foi a unidade HC-I nas Seções de Oncologia Clínica, Neurocirurgia, Abdominopélvica, Centro de Tratamento Intensivo e Cirurgia de Cabeça e Pescoço. Os sujeitos do estudo foram treze enfermeiros com especialização em oncologia, que assistiam clientes com afecções oncológicas, há pelo menos cinco anos. A coleta dos dados aconteceu nos meses de junho e julho de 2009, sendo utilizado um roteiro de entrevista semi-estruturada para captar as informações. A análise dos dados foi realizada com base no método de análise de conteúdo, que ao ser aplicado possibilitou a apreensão de quatro categorias: (1) a afecção oncológica como fator expressivo na elaboração mental diagnóstica do enfermeiro; (2) a relevância do conhecimento teórico-prático avançado para a elaboração mental avaliativa do enfermeiro; (3) a construção da elaboração mental para o raciocínio clínico diagnóstico do enfermeiro; (4) a importância da interação humana no contexto avaliativo. Concluiu-se que, este estudo identificou, na discussão das categorias, as quatro principais estratégias cognitivas que os enfermeiros com especialização em área oncológica consideram adotar para o estabelecimento de um julgamento clínico na avaliação de feridas em clientes com afecções oncológicas e caracterizou as etapas de elaboração mental para construção do raciocínio clínico diagnóstico do tipo hipotético-dedutivo e intuitivo. Compreendeu-se que os sujeitos da pesquisa detêm qualidades intelectuais específicas e avançadas, quando elaboram diagnósticos e intervenções baseadas nas respostas humanas em situação de avaliação de feridas nos clientes com doença oncológica, e foi considerado que o ensino pode impulsionar o desenvolvimento das competências cognitivas no sentido de formar profissionais capazes de avaliar o próprio conhecimento, bem como a fomentação de novas pesquisas relativas a essa temática imprescindível para uma assistência de enfermagem qualificada. / This is a qualitative, descriptive and exploratory study about the clinical reasoning utilized from nurses when they take care wounds in clients with oncologic diseases. The purpose was identified the cognitive strategies which the oncologic specialized nurses utilize to define a clinical trial to evaluate the wounds in oncologic clients and characterize the stages of the mental elaboration that these nurses make to reach the reasoning trial when the evaluation of these wounds are taken. This study took place in the National Cancer Institute in the Unit HC-1 in the sections of Oncologic Clinic, Neurosurgery, Abdomem and Pelvic, Intensive Unit Care and Head and Neck surgery. The subject of this study was thirteen oncologic specialized nurses who are working in this field at least five years. The datas' collection was performed from June to July 2009 and was utilized a semi-structure interview. The datas' analysis was realized based in the analysis content method which allowed to reach four categories. (1) The oncologic disease as an expressive factor to the nurses in their mental elaboration of the diagnostic, (2) The relevance of the practical and theoric advanced knowledge to able the nurses to perform a mental evaluation, (3) The nurses steps of the mental elaboration to get the diagnostic clinical reasoning, (4) The human interaction in the evaluation context. It was concluded from the categories above, four main cognitives strategies which the oncologic specialized nurses utlilize to establish a clinical trial in the evaluation of the wounds in clients with oncologic diseases. Also this study characterized the mental steps elaboration to reach a diagnostic clinical reasoning as hypothetical-deductive and intuitive. It was understood that the subjects of this study who were evaluating the wound in clients with oncologic diseases have advanced and specific intellectual skills to perform a diagnostic and intervention in these clients. It was also considered that the education can promote the development of the cognitive proficiency to make the professionals able to evaluate their own knowledge as well as new researchs regarding at this thematic is indispensable to a qualified nursing assistance.

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Objetivos: Estudo sobre mortalidade por causas externas não intencionais divulgadas na literatura médica mundial em crianças e adolescentes, com verificação das principais causas externas fatais não intencionais e identificação de diferenças de causas externas de óbito entre países de diferentes desempenhos econômico-sociais. Método: Revisão sistemática da literatura mundial sobre mortalidade por causas externas não intencionais em crianças e adolescentes de julho de 2001 a junho de 2011, através das bases de dados de periódicos eletrônicos científicos PubMed, LILACS, EMBASE e pesquisa manual com dados de âmbito nacional de órgãos oficiais. Resultados: Selecionados 15 artigos de periódicos, um livro e os dados estatísticos de 2010 da base de dados do Ministério da Saúde do Brasil. A maioria de países envolvidos nas divulgações de dados apresentavam alto desempenho econômico-social, com preponderância de países de alta e média renda econômica e índice de desenvolvimento econômico muito alto. Dos óbitos por causas externas, as principais causas foram as não intencionais. Verificou-se predominância dos acidentes de transporte como principal causa de óbito nos países estudados, em especial a partir da idade pré-escolar. A seguir os afogamentos e submersões se sobressaem, seguidos pelas quedas, queimaduras e as intoxicações. As maiores taxas de mortalidade por causas externas não intencionais por faixa etária foram observadas nas crianças menores de um ano de idade, principalmente pelos riscos acidentais à respiração excluindo os afogamentos e as submersões. Foi identificado ainda um número expressivo de óbitos por causas externas de intenção indeterminada. No Brasil, esses fatos também se repetiram e observou-se que praticamente metade dos óbitos em crianças por acidentes de transporte ocorreram na própria via pública. Conclusões: O acidente de transporte foi identificado como causa predominante de óbito por causas externas não intencionais na infância nos países estudados, principalmente a partir da idade pré-escolar. A faixa etária dos lactentes foi especialmente susceptível aos riscos acidentais à respiração que excluem os afogamentos e as submersões acidentais. Investigações mais detalhadas dos óbitos por causas externas para reduzir o número de eventos por intenções indeterminadas devem ser consideradas. Mais divulgações de dados sobre a ocorrência de mortes por causas não intencionais em países com menor desenvolvimento econômico e social são necessárias para um maior conhecimento e conscientização desses eventos passíveis de prevenção / Objective: Report on the mortality rate of children and youths due to non-intentional external causes disclosed in the world medical literature, with analysis of the principal non-intentional external deadly causes and identification of differences related to the external causes of death in countries with different economic and social performances. Method: This was a systematic review of the literature on mortality from accidental injury in children and adolescents. We searched the PubMed, Latin-American and Caribbean Health Sciences Literature, and Excerpta Medica databases for articles published between July of 2001 and June of 2011. National data from official agencies, retrieved by hand searches, were also reviewed. Results: We reviewed 15 journal articles and 1 book, as well as 2010 statistical data from the Brazilian National Ministry of Health Mortality Database. Most of the data relate to countries with high economic and social performance, with predominance of countries with high and middle economic income and very high economic development rates. Deaths due to external causes were primarily the result of non-intentional causes. There was a predominance of transportation accidents as the principal cause of death in the countries surveyed, especially as from preschool age. Accidental drowning and submersion rank second, followed by falls, burns and poisoning. The highest rates of death from non-intentional external causes by age grade were observed in children below 1 year old, principally due to accidental threats to breathing, excluding drowning and submersion. A significant number of deaths due to undetermined external causes was also identified. This situation was also registered in Brazil, and nearly half of all childhood deaths from traffic accidents occurred at the scene. Conclusions: Traffic accidents were found to constitute the leading external cause of accidental death among children in the countries under study, principally among those of preschool age or older. Infants were found to be particularly vulnerable to accidental non-drowning threats to breathing. A detailed investigation about deaths due to external causes must be considered in order to reduce the number of deaths due to undetermined causes. Further studies investigating the occurrence of accidental deaths in countries with low social and economic development are needed in order to improve the understanding of these preventable events

Mok, Kam Ming. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 36-44). / Abstracts in English and Chinese. / Abstract --- p.ii / Chinese abstract --- p.iii / Acknowledgement --- p.iv / Table of contents --- p.V / List of figures --- p.vii / List of tables --- p.viii / Chapter Chapter 1: --- Introduction --- p.1 / Chapter Chapter 2: --- Review of literature --- p.3 / Chapter 2.1 --- Why prevent ankle ligamentous sprain? --- p.3 / Chapter 2.2 --- A sequence of injury prevention --- p.4 / Chapter 2.3 --- Biomechanical approaches in defining injury mechanism --- p.5 / Chapter 2.4 --- Injury mechanism of ankle ligamentous sprain in sports --- p.6 / Chapter 2.5 --- Model-Based Image-Matching motion analysis --- p.7 / Chapter Chapter 3: --- Development of an ankle joint Model-Based Image-Matching motion analysis technique --- p.9 / Chapter 3.1 --- Introduction --- p.9 / Chapter 3.2 --- Materials and method --- p.10 / Chapter 3.2.1 --- Cadaver test --- p.10 / Chapter 3.2.2 --- Model-Based Image-Matching motion analysis --- p.12 / Chapter 3.2.3 --- Statistical analysis --- p.14 / Chapter 3.3 --- Results --- p.15 / Chapter 3.3.1 --- Validity --- p.15 / Chapter 3.3.2 --- Intra-rater reliability --- p.16 / Chapter 3.3.3 --- Inter-rater reliability --- p.17 / Chapter 3.4 --- Discussion --- p.17 / Chapter 3.5 --- Conclusion --- p.21 / Chapter Chapter 4: --- Biomechanical motion analysis on ankle ligamentous sprain injury cases --- p.22 / Chapter 4.1 --- Introduction --- p.22 / Chapter 4.2 --- Materials and method --- p.24 / Chapter 4.2.1 --- Case screening --- p.24 / Chapter 4.2.2 --- Model-Based Image-Matching motion analysis --- p.24 / Chapter 4.3 --- Results --- p.28 / Chapter 4.3.1 --- High Jump Injury --- p.28 / Chapter 4.3.2 --- Field hockey Injury --- p.28 / Chapter 4.3.3 --- Tennis Injury --- p.29 / Chapter 4.4 --- Discussion --- p.30 / Chapter 4.5 --- Conclusion --- p.34 / Chapter Chapter 5: --- Summary and future development --- p.35 / References --- p.36 / List of publications --- p.42 / List of presentations at international and local conference --- p.43 / List of Awards --- p.44

Chan, Lai Shan. / Thesis submitted in: Dec. 2008. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 148-152). / Abstracts in English and Chinese. / ACKNOWLEDGEMENT --- p.I / PUBLICATIONS --- p.II / ABBREVIATION --- p.III-IV / INDEX OF FIGURES --- p.V-IX / INDEX OF TABLES --- p.X / ABSTRACT (English) --- p.XI-XIII / ABSTRACT (Chinese) --- p.XIV / Chapter CHAPTER 1 --- INTRODUCTION --- p.1-22 / Chapter CHAPTER 2 --- METHODOLOGY --- p.23-49 / Chapter CHAPTER 3 --- RESULTS --- p.50-97 / Chapter CHAPTER 4 --- DISCUSSION --- p.98-117 / BIBLIOGRAPHY / APPENDIX

Chan, Yue Yan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 36-40). / Abstracts in English and Chinese. / Abstract --- p.i / Chinese abstract --- p.ii / Acknowledgement --- p.iii / Table of Contents --- p.iv / List of figures --- p.vi / List of tables --- p.vii / Chapter Chapter 1: --- Introduction --- p.1 / Chapter Chapter 2: --- Review of literature --- p.4 / Chapter 2.1 --- Chapter introduction --- p.4 / Chapter 2.2 --- Anatomy and kinematics of the ankle --- p.4 / Chapter 2.3 --- Epidemiology of ankle sprain --- p.6 / Chapter 2.4 --- Grading system for classification of ankle sprain --- p.7 / Chapter 2.5 --- Previous measures of protecting ankle from sprain injury --- p.7 / Chapter 2.6 --- Usage of motion sensors in human motion detection --- p.9 / Chapter Chapter 3: --- A mechanical supination sprain simulator for studying ankle supination sprain kinematics --- p.11 / Chapter 3.1 --- Chapter Introduction --- p.11 / Chapter 3.2 --- Methods --- p.12 / Chapter 3.3 --- Results --- p.17 / Chapter 3.4 --- Discussion --- p.17 / Chapter Chapter 4: --- Identification of simulated ankle supination sprain from other normal motions by gyrometers and accelerometers --- p.19 / Chapter 4.1 --- Chapter introduction --- p.19 / Chapter 4.2 --- Methods --- p.20 / Chapter 4.2.1 --- Data collection --- p.20 / Chapter 4.2.2 --- Support Vector Machine for classification of human motion --- p.22 / Chapter 4.2.3 --- Training the Support Vector Machine --- p.23 / Chapter 4.2.4 --- Support Vector Machine verification --- p.24 / Chapter 4.2.5 --- Choose the optimal position of motion sensor --- p.25 / Chapter 4.3 --- Results --- p.25 / Chapter 4.4 --- Discussion --- p.29 / Chapter Chapter 5: --- Summary and future development --- p.34 / References --- p.36 / List of publications --- p.41 / List of presentations at international and local conferences --- p.41 / Appendix I: --- p.42 / Related publication: / "Chan, Y. Y., Fong, D. T. P., Yung, P. S. H., Fung, K. Y., & Chan, K. M (1998). A mechanical supination sprain simulator for studying ankle supination sprain kinematics. Journal of Biomechanics. 41(11), 2571-2574." / Appendix II: --- p.46 / Ethical approval of the investigation of ankle torque and motion signal pattern in foot segment during simulate sprain and other motion

escassez de estudos específicos acerca da Qualidade de Vida (QV) de pessoas com Úlceras Venosas Crônicas (UVC) motivou-nos a realizar este estudo, que objetivou: verificar as propriedades psicométricas do Índice de Qualidade de Vida de Ferrans e Powers (IQVFP); descrever as características sócio-demográficas (CSD) e às das úlceras venosas (CUVC); analisar os escores de QV segundo às CSD e as CUVC. O estudo é descritivo, exploratório, correlacional, de campo e transversal, realizado através de entrevistas junto a 89 pessoas com UVC em 3 ambulatórios públicos, utilizando-se a versão genérica do IQVFP. Este instrumento é compsoto por 68 itens e dividido em 4 domínios: Saúde/Funcionamento (DSF), Sócio-Econômico (DSE), Psicológico/Espiritual (DPE) e Família (Dfa). Atestou-se ao IQVFP a confiabilidade - alfa de 0,09 no IQV Total; a validade concorrente e a validade discriminante. No entanto, nesta última apenas para o IQV Total (p=0,029 e DSF )p=0,005). Houve predomínio de: mulheres (68,54%); idade média de 53,44 anos; católicos (65,86%), profissões que exigem ortostatismo anterior e posteriomente à UVC (90,36% e 89,78%) respectivamente. A respeito das CUVC constatou-se: média de 1,54 úlceras, 71,95% da amostra tiveram novas UVC após a primeira ulceração; 67,045% têm a ferida há menos de 5 anos e com 69,74% está com UVC atual localizadas na perna esquerda. Acerca da QV obteve-se: escore médio de 22,27% (DP= 5,05) para o IQVT e correlação dos domínios com o IQVT. Não houve correlação entre a idade, número de filhos, número de úlceras, tempo de ocorrência da primeira UVC e tempo com a UVC atual e os DSF, DSE e o IQVT. Houve correlação: negativa entre o DPE e número de UVC (r=-0,19) e entre o DFa e tempo com a UVC atual (r=-0,19); positiva entre o IQVT e seus domínios e os católicos, não confirmados na comparação para o DSF; positiva entre os DSF, DPE, DFa e o IQVT e ortostatismo antes da primeira UVC, confirmada na comparação nos DSF e DFa. Os pacientes sem companheiros tiveram melhor QV no DFa, evidenciado na correlação (r=-0,28; p=0,004) e comparação (p < 0,006) Em conclusão, constatou-se: o IQVFP é adequado para a população alvo; pessoas com baixo nível sócio-econômico e educacional e com boa qualidade de vida / The shortage of specific studies about Quality of Life (QOL) of people with Chronic Venous Ulcers (CVU) motivated us to accomplish this study, which aimed at verifying the psychometric properties of the Ferrans and Powers quality of Life Index (FPQOL); described to the socio-demographic characteristics (SDC) and the venous ulcers characteristics (CVUC); analyze the QLI scores based on the SDC and the CVUC. It is a descriptive, exploratory, co-related, field and transversal study performed through interviews with 89 people who had CVU, treated on 3 public ambulatories using the generic version of thje FPQLI. This scale consists of 68 items that are divided into 4 domais: Health/Functioning (HFD), Social and Economic (SED), Psychological/Spiritual (PSD) and Family (FaD). It was attested to the FPQLI the reliability (alpha of 0.99 to overall QOL); the concurring, validity and the discriminating validity, the last one only for the Overall QOL (p=0.029) and HFD (p=0.005). There was a higher number of women (68.54%); mean age of 53.44; catholics (65.86%) and standing professionals before and after the CVU (90,36 e 89,79%, respectively). About CVUC there was mean of 1.54 ulcers; 71.95% of the sample developed new CVU after the first ulceration; 67.04% people have had the wound for less than 5 years and 69.74% of the CVU is located on the left leg. About QOL, it was obtained the mean score of 22.27 (pd=5.05) ro Overall and correlation of all domains with the QLI. There was no correlation among age, number of children, number of ulcers, time of occurence of first CVU, time with today\'s CVU and the HFD, SED and Overall QOL. There was correlation: negative - between the PSD and the number of CVU (r=-0.19) and between the DaD and the time with today\'s CVU (r=-0.19); positive - among the Overall QOL and its domains and the cotholics, it was not confirmed in the HFD comparision; positive - among the HFD, PED, FaD and the QOL and standing position before the first CVU, confirmed in the HFD and Fad comparision. The patients without companions had better QOL in the FaD, shown crearly in the correlation (r=0.28, p=0.004) and comparision (p,0.006). In conclusion, it was attested to FPQOL is suitable for the target population; are people with low social-economic and educational level and show good QOL

A pele tem como principal função manter o isolamento do meio interior com o exterior. Quando esse órgão sofre uma lesão o organismo tenta reparar essa agressão ao promover a substituição do tecido por meio de um processo complexo dividido em fases. O ácido hialurônico está presente em todas as fases dessa reparação tecidual. Contudo a sua presença em adultos reduz cerca de 50% comparado ao recém-nascido, o que reduz a regeneração tecidual drasticamente. Este trabalho teve como objetivo analisar o efeito de uma pomada utilizando veículo comercial composto de lanolina e vaselina manipulada com ácido hialurônico, extraído da crista do frango, no processo cicatricial de feridas cutâneas em dorso de ratos. Para atingir o objetivo desse trabalho o ácido hialurônico foi extraído e purificado da crista do frango e foi acrescido ao veículo comercial composto de 10% lanolina e 90% vaselina. A pomada obtida foi analisada por meio de um reômetro de tensão controlada. Para os estudos in vivo, foram separados aleatoriamente 28 animais em 4 grupos. Em cada animal do grupo efetuou-se duas lesões em seu dorso, uma para a aplicação da pomada, com ou sem ácido, e a outra lesão para controle. A pomada foi aplicada diariamente durante 7 e 14 dias conforme protocolo estabelecido. Os resultados mostraram que as propriedades viscoelásticas da pomada, quando acrescentou o ácido hialurônico, tiveram pequenas alterações, porém não de forma significativa, o que possibilitou sua utilização. Como resultados dos testes in vivo, o grupo tratado com a pomada com ácido hialurônico durante 7 dias, obteve menor média da área da lesão com 0,07 cm² contra 0,11 cm² do seu controle, 0,09 cm² do grupo tratado com a pomada placebo e 0,10 cm² do controle do placebo. Ainda, os grupos tratados com a pomada com AH durante 7 e 14 dias obtiveram uma maior média na porcentagem de colágeno, e o grupo tratado com a pomada com AH por 14 dias, resultou em uma melhor cicatrização da lesão. / The skin has as main function to maintain the insulation of the inner tissues of the body from the external environment. When this organ is injured, the organism attempts to repair the damage with a tissue replacement, in a complex process divided into several stages. Hyaluronic acid is present in all phases of this process, although its expression in adults is reduced to approximately 50% compared to newborn individuals, leading to drastically reduced tissue regeneration. This study aimed to analyze the effect of an ointment composed of a commercial vehicle of lanolin and vaseline, manipulated with chicken crest-extracted hyaluronic acid, in skin wounds healing in rats. Hyaluronic acid was extracted and purified from chicken crests, and the extract was added to the commercial vehicle composed of 10% lanolin and 90% vaseline. The obtained ointment was analyzed using a controlled stress rheometer. For in vivo studies, 28 rats were randomly separated into four groups. Each animal was injured twice in the back, one lesion destined to the ointment application, and the other lesion as a control injury. The ointment was applied for 7 to 14 days according to the protocol established. Results showed that the viscoelastic properties of the ointment mixed with hyaluronic acid changed slightly, but not significantly, allowing its use in vivo. The group of animals treated with the ointment for seven days showed lower average lesion area, with 0.07 cm² against the control area of 0.11 cm². The animals treated with a placebo ointment showed an average lesion area of 0.09 cm² against a 0.10 cm² area of controls. The animals treated with the ointment with hyaluronic acid for 7 and 14 days had a higher average percentage of collagen, and the group treated for 14 days exhibited an improved wound healing.

O Brasil cada vez mais torna-se um país de cabelos brancos, e, este processo traz reflexos para a sociedade brasileira e para a assistência à saúde desta população. Destaca-se as causas externas como um problema de saúde pública que oferecem grande impacto na saúde dos idosos. Estes têm capacidade reduzida de recuperação e permanecem hospitalizados por maior tempo. Portanto, nesta investigação buscou-se identificar a relação entre o idoso vítima de trauma e os fatores de risco envolvidos no acidente. Objetivo Geral: Desenvolver indicadores de predição de risco para o trauma em idosos. Objetivos Específicos: Caracterizar o perfil dos idosos vitimas de trauma atendidos no pronto-socorro; Verificar quais os mecanismos de trauma sofrido pelos idosos; Conhecer os fatores que contribuíram para a ocorrência do trauma; Analisar os fatores de risco para a ocorrência do trauma em idosos. Estudo quantitativo, transversal realizado no prontosocorro (PS) de dois hospitais da cidade de Curitiba, sendo aprovada por suas Comissões de Ética em Pesquisa. Os critérios de inclusão foram os seguintes: pacientes com 60 anos ou mais, de ambos os gêneros, vítimas de trauma, que estavam sendo atendidos no PS e que aceitaram participar da pesquisa de maneira voluntária ou por autorização de cuidadores ou familiares, em caso de déficit cognitivo e/ou auditivo. A coleta de dados foi realizada à beira do leito por meio de uma entrevista estruturada; os dados obtidos foram organizados em planilha Excel e analisados por meio do programa computacional Statistical Package for the Social Sciences - SPSS versão 15.0. Os resultados foram descritos por frequências e percentuais. Para avaliação da associação entre duas variáveis qualitativas, foi considerado o teste de Qui-quadrado ou o teste exato de Fisher. Para avaliação conjunta da associação de fatores com o mecanismo do trauma (queda ou outros eventos), foi ajustado um modelo de Regressão Logística (stepwise backward). A partir do ajuste, foram estimados os valores de odds ratio com respectivos intervalos de confiança de 95%. Os sujeitos foram 261 idosos que atenderam aos critérios de inclusão, sendo 148 mulheres (56,7%) e 43,3% homens. A faixa de idade variou de 60 a 103 anos, e a média foi de 72,6 ± 9,3 anos. Grande parte da amostra tinha idade abaixo de 70 anos (44,8%). Com relação ao estado civil, 43,3% dos pacientes eram casados; 35,2%, viúvos; 13%, separados, amasiados; e 8,4%, solteiros. Os mecanismos de trauma mais frequentes foram: queda (75,9%), atropelamento (9,6%), trauma direto (5,4%) e acidente automobilístico (3,8%). O medicamento mais utilizado foi o anti-hipertensivo (45,2%). A análise multivariada permitiu afirmar que, independentemente das outras variáveis incluídas no modelo, o gênero feminino, a presença de cuidador, medicação de uso contínuo e a presença de problemas auditivos aumentam significativamente a probabilidade de trauma por queda. Problemas de visão sem uso de óculos e idosos com renda de até 3 salários mínimos tendem a 7 ter maior probabilidade de trauma por queda. Esses resultados permitem estabelecer que os fatores que mais interferem no trauma em idosos podem, se avaliados durante a consulta de enfermagem, possibilitar ações de saúde para a sua prevenção. / Brazil is becoming more and more a country of white hair and this process brings consequences for Brazilian society and the health care of its population. The highlights are the external causes as a matter of public health that offers great impact on the health of the elderly. The aged have their ability of recovery reduced and remain hospitalized for longer periods of time. Therefore, this research aimed to identify the relation between the aged victim of trauma and the risk factors involved in the accident. General objective: develop indicators of risk prediction for trauma in the aged. Specific objectives: describe the profile of aged victims of trauma seen in the emergency room; Check which mechanisms of trauma are suffered by the aged; Learn the factors that contributed to the occurrence of the trauma; Analyze the risk factors for the occurrence of the trauma in the aged. Quantitative cross study, held in the emergency department of two hospitals in Curitiba, which was approved by their Research Ethics Committees. The inclusion criteria were as follows: patients of 60 years old or more, both gender, victims of trauma that were being seen at the emergency room and accepted to participate in the research voluntarily or under authorization of caregiver or family in case of cognitive or/and hearing deficit. The data collection was made through a semi-structured interview by the bed; the data obtained were organized in an excel spreadsheet and analyzed by computer program Statistical Package for the Social Sciences - SPSS version 15.0. The results were described by frequencies and percentages. To evaluate the association between two qualitative variables, it was considered the Chisquare test or the Fishers exact test. To jontly evaluate the factors associated with the mechanism of trauma (fall and other events), it was adjusted a logistic regression model (stepwise backward). As from the ajustment, it were estimated the odds ratio values with respective confidence intervals of 95%. The subjects were 261 elderly people that met the inclusion criteria, 148 women (56,7%) and 43,3% men. The age ranged from 60 to 103 years old, and the average was 72,6 ± 9,3 years old. The great majority of the sample was under 70 years old (44,8%). Regarding to marital status, 43,3% of patients were married; 35,2%, widowed; 13%, separated, in cohabitation and 8,4%, single. The mechanisms of trauma more frequent were: fall (75,9%), running over (9,6%), direct trauma (5,4%) and car accident (3,8%). The medicament most used was the anti-hypertensive (45,2%). The multivariate analysis allowed to say that, independently of other variables included in the model such as the female gender, the presence of the caregiver, the continued use of medication and the presence of hearing problems increased significantly the probability of trauma by fall. Sight problems without wearing glasses and aged with incomes up to 3 minimal wages tend to have higher probability of trauma by fall. These results allowed establishing that the factors that most interfere in trauma in the aged may, if evaluated during the nursing consultation, enable health actions for its prevention.