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Avalia??o da efic?cia da t?cnica de relaxamento com imagem guiada em pacientes oncol?gicos submetidos a tratamento quimioter?picoLufiego, Claudia Adriana Facco 31 March 2017 (has links)
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Previous issue date: 2017-03-31 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / To evaluate the efficacy of the guided imaging relaxation technique in cancer
patients submitted to chemotherapy in relation to decreasing levels of depression,
anxiety and stress. Methods: Non-randomized clinical trial type study. The sample
consisted of participants of both sexes, and aged 30 years or more starting
chemotherapy treatment in a university hospital in Porto Alegre. The patients were
divided into two groups: Experimental Group, in which the relaxation technique was
applied, and Control Group, without the intervention. The relaxation sessions with the
guided imaging technique had a duration of 12 minutes and were performed during a
period of 16 weeks, always during the chemotherapy procedure. In order to evaluate
the levels of depression, anxiety and stress were applied the instruments Beck
Depression Inventory, Beck Anxiety Inventory and Distress Thermometer
respectively, in the initial and final period of the study. Data were analyzed in the
EpiInfo7.0 statistical software using Student's t-tests, Wilcoxon-Mann-Whitney and
Pearson's Chi-square. Values of p <0.05 were considered significant. Results: Onehundred
thirteen participants were included, with a mean age of 51.3 years, 62.8%
were female and 72.6% married. The most prevalent types of neoplasia were breast,
lung and intestine cancers. Fifty-seven patients participated in the Experimental
Group and 56 patients in the Control Group. There was a decrease in depression,
anxiety and stress levels in the Experimental Group, with a range of depression
scores ranging from 17.3 ? 9.04 to 14.5 ? 7.47 (p<0.0001), anxiety of 15.1 ? 8.84 to
12.9 ? 7.58 (p<0.0001) and for stress 5.1228 ? 1.8905 for 4.4386 ? 1.6905
(p<0.0001). In the Control Group, no significant difference was observed between
the initial and final evaluation. Conclusions: the intervention through the relaxation
technique with guided imagery showed efficacy in reducing the levels of depression,
anxiety and stress in this sample of cancer patients undergoing chemotherapy. / avaliar a efic?cia da t?cnica de relaxamento com imagem guiada em
pacientes oncol?gicos submetidos a tratamento quimioter?pico em rela??o ?
diminui??o dos n?veis de depress?o, ansiedade e estresse. M?todos: Estudo do tipo
ensaio cl?nico n?o randomizado. A amostra foi constitu?da de participantes de ambos
os sexos, com idade igual ou superior a 30 anos e que estavam iniciando tratamento
quimioter?pico em um hospital universit?rio de Porto Alegre. Os pacientes foram
divididos em dois grupos: Grupo Experimental, no qual foi aplicada a t?cnica de
relaxamento, e Grupo Controle, sem a interven??o. As sess?es de relaxamento com
a t?cnica de imagem guiada tiveram dura??o de 12 minutos e foram realizadas
durante um per?odo de 16 semanas, sempre durante o procedimento quimioter?pico.
Para avaliar os n?veis de depress?o, ansiedade e estresse foram aplicados os
instrumentos Invent?rio de Depress?o de Beck, Invent?rio de Ansiedade de Beck e
Term?metro de Distress respectivamente, no per?odo inicial e final do estudo. Os
dados foram analisados no software estat?stico EpiInfo7.0 utilizando os testes t de
Student,Wilcoxon-Mann-Whitney e Qui-quadrado de Pearson. Foram considerados
significativos valores de p<0,05. Resultados: Foram inclu?dos 113 participantes,
com m?dia de idade de 51,3 anos, sendo 62,8% do sexo feminino e 72,6% casados.
Os tipos de neoplasia mais prevalentes foram c?ncer de mama, pulm?o e intestino.
Foram alocados 57 pacientes no Grupo Experimental e 56 pacientes no Grupo
Controle. Houve diminui??o dos n?veis de depress?o, ansiedade e estresse nos
pacientes do Grupo Experimental, com varia??o dos escores de depress?o de
17,3?9,04 para 14,5?7,47 (p<0,0001), de ansiedade de 15,1?8,84 para 12,9?7,58
(p<0,0001) e de estresse 5.1228?1.8905 para 4.4386?1.6905 (p<0,0001). No Grupo
Controle n?o foi observada diferen?a significativa entre a avalia??o inicial e final.
Conclus?es: A interven??o atrav?s da t?cnica de relaxamento com imagem guiada
mostrou efic?cia em reduzir os n?veis dos sintomas de depress?o, ansiedade e
estresse nesta amostra de pacientes oncol?gicos em vig?ncia de quimioterapia.
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Efeitos do exerc?cio f?sico sobre a fun??o cognitiva e os n?veis plasm?ticos de BDNF em mulheres idosasVedovelli, Kelem 25 August 2017 (has links)
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Previous issue date: 2017-08-25 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: Physical activity has been proposed as a promising intervention to improve cognition and decrease the risk of dementia in older adults. Brain-derived neurotrophic factor (BDNF) seems to mediate, at least partially, these effects of exercise. However, intervention studies of the effects of multimodal exercises on cognition and BDNF levels are scarce and composed by small samples. Thus, the generalization of the conclusions of these studies depends on the reproducibility of the results. Objective: to contribute to the knowledge on the field, the present study evaluated the effects of a physical activity intervention composed by muscle strengthening and aerobic conditioning on BDNF levels and cognition in older women. Methods: Twenty-two independent and non-demented subjects (? 75 years) were assigned to a three-month physical activity intervention (60 min exercise sessions three times a week, 30 min of muscle strengthening and 30 min of aerobic activity) or to a control condition (n= 10, no exercise). The clinical parameters (anxiety and depression symptoms), neuropsychological (Digit Span, Stroop, Trail Making and Contextual Memory tests), physical (upper and lower limb strength, aerobic conditioning) and physiological (serum BDNF) parameters were evaluated immediately before, one and three-months after starting intervention. Results: the control group had stable levels for all measured variables, whereas the intervention group improved on physical fitness, depressive symptoms, cognitive performance and BDNF levels. Moreover, a linear regression identified an association between aerobic conditioning and BDNF levels. Conclusion: The combination of muscle strengthening and aerobic conditioning was able to improve cognitive performance and increase BDNF levels. Aerobic conditioning seems to be an important mediator of these results. / Introdu??o: A atividade f?sica tem sido proposta como uma interven??o promissora para melhorar a cogni??o e diminuir o risco de dem?ncia em adultos mais velhos. O fator neurotr?fico derivado do c?rebro (BDNF) parece mediar, pelo menos parcialmente, esses efeitos do exerc?cio. Entretanto, os estudos de interven??o dos efeitos de exerc?cios multimodais sobre o desempenho cognitivo e os n?veis de BDNF s?o escassos e compostos por pequenas amostras. Assim, a generaliza??o das conclus?es destes estudos depende da reprodutibilidade dos resultados. Objetivo: avaliar os efeitos de uma interven??o de atividade f?sica composta pelo fortalecimento muscular e condicionamento aer?bico nos n?veis de BDNF e cogni??o em mulheres idosas, de modo a contribuir para o avan?o cient?fico na ?rea. M?todos: Idosas independentes e n?o demenciadas (? 75 anos) foram submetidas a uma interven??o de tr?s meses de atividade f?sica (n = 22, sess?es de exerc?cios de 60 min tr?s vezes por semana, sendo 30 min de fortalecimento muscular e 30 min de atividade aer?bia) ou a uma condi??o de controle (n = 10, sem exerc?cio). Foram avaliados os par?metros cl?nicos (sintomas de ansiedade e depress?o), neuropsicol?gicos (testes de Span de D?gitos, Stroop, Trail Making e Mem?ria Contextual), f?sicos (for?a dos membros superiores e inferiores, condicionamento aer?bico) e fisiol?gicos (BDNF s?rico) no in?cio do protocolo, 1 e 3 meses ap?s o in?cio da interven??o. Resultados: O grupo controle apresentou n?veis est?veis ao longo do tempo para todas as vari?veis medidas, ao passo que o grupo de interven??o melhorou a aptid?o f?sica, sintomas depressivos, desempenho cognitivo e n?veis de BDNF. Al?m disso, uma regress?o linear identificou uma associa??o entre o condicionamento aer?bio e os n?veis de BDNF. Conclus?o: A combina??o de fortalecimento muscular e condicionamento aer?bio foi capaz de melhorar o desempenho cognitivo e aumentar os n?veis de BDNF. O condicionamento aer?bio parece ser um importante mediador desses resultados.
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Efic?cia do treinamento de reconhecimento de emo??es na qualidade da intera??o m?e-beb? em mulheres com depress?o p?s-partoRenner, Anelise Meurer 05 March 2018 (has links)
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Previous issue date: 2018-03-05 / Postpartum Depression (PPD) has a negative effect on newborns and their mothers,
and impairments to the mother-infant relationship seem to be harmful to the child?s
development. Despite the high prevalence of PPD in Brazil, there are no evaluation protocols
and interventions recognized by the country?s unified health service. In order to contribute to
an intervention adapted to Brazilian cultural issues and the reality of Brazilian mothers in the
postpartum period, two studies were carried out in this dissertation - a theoretical study and an
empirical study. The theoretical study aimed to describe two intervention protocols and the
respective materials necessary for their execution: a psychoeducation protocol and a training
protocol for facial expression recognition. The methodology applied the following steps: (1)
state of the art review, (2) preliminary proposal preparation, (3) specialized psychologists?
analysis, (4) pilot study. The study?s resulted in a psychoeducational protocol composed by
seven themed primers defining subjects to be addressed with the mothers, in addition to a
facial expression training protocol composed by six instruments. The empirical study?s
objective was to investigate the effectiveness of both interventions (the psychoeducation and
the facial expression training protocol) in the quality of mother-infant interaction. Preliminary
results are described in this study, The sample consisted of 14 dyads in which the mothers
were diagnosed with PPD by both the EPDS (cut-off point ?11) and SCID. Dyads were
assessed between four and twelve weeks postpartum and were randomized into three
conditions: psychoeducation, facial expression training, and waiting list. The results
suggested a significant effects of the training groups in maternal ability to recognize anger
faces, and a significant effect of the Psychoeducation group on mother-child interaction
(proximity and relaxation dimensions). Compared to the waiting list, the two intervention
groups produced positive effects, albeit only the Psychoeducation group had an effect on the
target primary outcome. Therefore, results suggest that psychoeducation was more effective in
increasing the quality of the mother-infant relationship when compared to the other two
groups. Further studies with a larger sample size and longer follow-up period are required to
investigate these effects further. / A Depress?o P?s-Parto (DPP) tem efeitos negativos na sa?de da m?e e do beb? e na
rela??o m?e-beb? e os preju?zos nesta rela??o parecem ser mediadores importantes dos
preju?zos no desenvolvimento infantil. Apesar da alta preval?ncia de DPP no Brasil, n?o
existem protocolos de avalia??o e interven??es reconhecidos pelo Servi?o ?nico de Sa?de.
Buscando contribuir com uma interven??o adaptada ?s quest?es culturais brasileiras e a
realidade das m?es no per?odo p?s-parto, foram realizados dois estudos nesta disserta??o,
sendo um estudo te?rico e um estudo emp?rico. O estudo te?rico visou descrever a elabora??o
de dois protocolos de interven??o e os respectivos materiais necess?rios para a execu??o
destes: um protocolo de psicoeduca??o e um protocolo de treinamento de reconhecimento de
express?es faciais. A metodologia utilizada seguiu os seguintes passos: (1) revis?o da
literatura, (2) elabora??o da proposta preliminar, (3) an?lise de psic?logas especialistas, (4)
estudo piloto. Os resultados deste estudo s?o um protocolo de psicoeduca??o com sete
cartilhas sobre as tem?ticas definidas para serem trabalhadas com as m?es, al?m de um
protocolo de treinamento de express?es faciais composto por seis instrumentos para a
execu??o deste. A partir desta constru??o, o estudo emp?rico teve como objetivo investigar a
efetividade das interven??es, tanto de psicoeduca??o quanto de treinamento de express?es
faciais no implemento da qualidade da rela??o m?e-beb?. A presente proposta apresenta os
dados preliminares do estudo. A amostra foi composta de 14 d?ades, tendo as m?es
diagn?stico de DPP pela EPDS (ponto de corte ?11) e pela SCID. As d?ades iniciaram a
avalia??o entre quatro e doze semanas ap?s o parto e foram randomizadas em tr?s condi??es:
psicoeduca??o, treinamento de express?es faciais e lista de espera. Os resultados apontam
efeitos positivos do aumento da acur?cia do reconhecimento de faces de raiva do grupo de
treinamento, e um efeito positivo nas dimens?es maternas de intera??o proximidade e
descontra??o no grupo de Psicoeduca??o. Em compara??o com a lista de espera, os dois
grupos de interven??o apresentaram efeitos positivos, ainda que apenas o grupo
Psicoeduca??o tenha apresentado efeitos significativos no desfecho prim?rio. Assim, os
resultados preliminares sugerem a psicoeduca??o como mais eficaz no aumento qualidade da
rela??o m?e-beb? ao comparada com os outros grupos de interven??o. S?o necess?rios futuros
estudos com um aumento do tamanho amostral e realiza??o de follow-ups com mais tempo
ap?s as sess?es para ser poss?vel confirmar os efeitos encontrados.
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Estudo da validade interna de um protocolo de terapia cognitivo-comportamental infantil para tratamento da sintomatologia depressiva e/ou ansiosaPaiva, Camila Bosse 11 January 2018 (has links)
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Previous issue date: 2018-01-11 / Mental disorders in childhood reach a prevalence of 13.4%, with 6.5% presenting with anxiety disorders and 2.6% with depressive disorder, the latter being the most prevalent in an isolated or comorbid form. The creation of programs to work these disorders in children becomes important for the non-progression of the symptoms in the later development. This study carried out a narrative review of the literature regarding the existing protocols for intervention with children based on cognitive-behavioral therapy. However, the main objective of this study was to evaluate the internal validity of the infant recycling therapy (TRI) protocol in reducing anxiety and / or depression symptoms in children aged 8 to 12 years. We also evaluated mental health problems among the participants and the intensity of cognitive distortions in the sample. The research consisted of a descriptive and explanatory study with a time series design. The TRI was applied in 22 children of both sexes with the purpose of comparing the symptoms of pre and post intervention children, as well as at the end of each stage of psychotherapy. The collection of symptomatic data was given by the application of SCARED and CDI, the cognitive distortions were monitored by the CATS questionnaire. Those responsible were assessed from the ASR. Of the participants who entered the study, 19 completed the protocol, which demonstrated good adherence to the treatment. The main symptomatology at admission was depression and the highest prevalence was in males. Participants presented a progressive reduction profile of both symptoms as well as negative automatic thoughts. Those responsible for the children presented clinical symptoms for internalizing problems. The data were analyzed by repeated measures ANOVA and to understand the differences of averages in each treatment step, Post Hoc analyzes were performed. The results suggest that the protocol contributed to the reduction of anxiety and depression significantly (p <0.005), as well as an improvement in the intensity of the cognitive distortions initially presented (p <0.005). The main symptom change occurred after the initial stage of the protocol, that is, the work with the emotions. These results suggest that TRI has proved to be a good clinical tool in the treatment of anxious and depressive symptoms in children and adolescents. Follow-up evaluations could indicate if these results were maintained over time, and this is a suggestion for future studies. In addition, we present the data from a conserved profile seen the absence of control group in this work, which could also be improved in other studies. / Os transtornos mentais na inf?ncia atingem uma preval?ncia de 13,4%, cuja 6,5% apresentam transtornos de ansiedade e 2,6% transtorno depressivo, sendo estes dois os mais prevalentes de forma isolada ou comorbida. A cria??o de programas para trabalhar estes transtornos em crian?as torna-se importante para a n?o progress?o dos sintomas no desenvolvimentoposterior. Este estudo realizou uma revis?o narrativa da literatura frente aos protocolos existentes para interven??o com crian?as com base na terapia cognitivo-comportamental. Entretanto, o principal objetivo deste trabalho esteve em avaliar a validade interna do
protocolo de Terapia de reciclagem infantil (TRI) em reduzir sintomas de ansiedade e/ou depress?o em crian?as de 8 a 12 anos. Tamb?m se avaliou problemas de sa?de mental nos respons?veis pelos participantes e intensidade de distor??es cognitivas da amostra. A pesquisa constituiu-se em um estudo descritivo e explicativo com delineamento de s?rie temporal. Aplicou-se a TRI em 22 crian?as de ambos os sexos com o objetivo de comparar a sintomatologia das crian?as pr? e p?s interven??o, bem como no final de cada etapa de psicoterapia. A coleta de dados sintomatol?gicos se deu pela aplica??o da SCARED e CDI, as distor??es cognitivas foram monitoradas pelo question?rio CATS. Os respons?veis foram avaliados a partir do ASR. Dos participantes que ingressaram no estudo, 19 conclu?ram o protocolo, o que demonstrou boa ades?o ao tratamento. A principal sintomatologia no ingresso foi depress?o e a maior preval?ncia esteve no sexo masculino. Os participantes apresentaram um perfil de redu??o progressiva de ambos os sintomas, bem como de pensamentos autom?ticos negativos. Os respons?veis pelas crian?as apresentaram sintomas cl?nicos para problemas internalizantes. Os dados foram analisados por ANOVAS de medidas repetidas e para ompreender as diferen?as de m?dias em cada etapa do tratamento, foram realizadas an?lises Post Hoc. Os resultados sugerem que o protocolo colaborou para a redu??o da ansiedade e depress?o significativamente (p<0,005), al?m de melhora na intensidade das distor??es cognitivas inicialmente apresentadas (p<0,005). A principal mudan?a sintomatol?gica ocorreu ap?s a etapa inicial do protocolo, ou seja, o trabalho com as emo??es.
Esses resultados sugerem que a TRI se mostrou uma boa ferramenta cl?nica no tratamento de sintomas ansiosos e depressivos no p?blico infanto-juvenil. Avalia??es de follow-up poderiam nos apontar se estes resultados foram mantidos ao longo do tempo, sendo esta uma sugest?o para futuros estudos. Al?m disso, apresenta-se os dados a partir de um perfil conservados visto a aus?ncia de grupo controle neste trabalho, o que tamb?m poderiam ser aprimorado em outros estudos.
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Efeito de antidepressivos sobre as enzimas envolvidas no controle da sinaliza??o purin?rgica e colin?rgica em c?rebro de peixe-zebra (Danio rerio)Oliveira, Renata da Luz 09 August 2012 (has links)
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Previous issue date: 2012-08-09 / The clinical depression treatment faces serious obstacles as the disease mechanism is not fully elucidated. In addition, there are no effective means to predict and prevent depression as well as any biological method of diagnosis. The use of antidepressants is still the basis of the treatments for depression. Lithium has been used clinically as effective drug to treat all phases of bipolar disorder, including major depression. The Selective serotonin re-uptake inhibitors (SSRIs), such as fluoxetine and citalopram, and Tricyclic antidepressant (TCA) as clomipramine are drugs constantly used for depression treatment. Recent evidence has shown an involvement of adenosine and its receptors in the pathophysiology of depression. ATP can be stored and co-released with other neurotransmitters like serotonin and can be hydrolyzed by a cell-surface enzyme family known as ectonucleotidases. Among these members, we highlight the nucleoside triphosphate diphosphohtdrolases (NTPDases) and ecto-5'-nucleotidase. They are able to control the availability of ligands such as ATP and adenosine to its specific receptors. Adenosine deaminase (ADA) can promote the hydrolytic deamination of adenosine to inosine, modulating the extracellulr levels of this neuromodulator. In cholinergic signaling, after its release, acetylcholine (ACh) promotes the activation of specific muscarinic or nicotinic receptors and thus, it promotes diverse cellular responses. ACh is hydrolyzed by acetylcholinesterase (AChE) in acetate and choline in synaptic cleft. The zebrafish has been used in research behavioral neuroscience and is also a choice model for elucidating the development and function of neuronal circuitry. Considering the cholinergic and purinergic signaling are important participation in the CNS and these neurotransmitter pathways have been identified and characterized in zebrafish, the objective of this study was to evaluate the effect of antidepressants on ectonucleotidases, ADA and ACh activities, which are essential enzymes in the modulation of these signaling pathways in the zebrafish brain. We evaluated the ex vivo effects of fluoxetine (1-10 ?M), clomipramine (1-10 ?M), citalopram (70-300 ?M) on ectonucleotidases and ADA activities. It has been also analyzed the in vitro (1 to 1000 ?M) and ex vivo (1 to 10mg/L) effect of lithium on ectonucleotidases and AChE activities and gene expression. There was a significant inhibition of ADP hydrolysis after ex vivo exposure to lithium at 5 and 10 mg/L, whereas an inhibitory effect was observed for AMP hydrolysis only at 10 mg/L. The same treatment decreased the AChE activity in a concentration of 10mg/L. Lithium did not induce significant changes in the analysis of gene expression patterns in the concentrations tested. In vivo treatment, there were no significant changes inectonucleotidases and AChE activities. Treatment with clomipramine promotes an inhibition ecto-5'-nucleotidase activities at the concentration of 5?M when compared to the control group. For ADA activity, we also observed a significant inhibition in the treatment with clomipramine at concentrations of 5 and 10 ?M in membrane fractions of zebrafish brain. However, treatment with fluoxetine and citalopram did not alter ectonucleotidases and ADA activities in the zebrafish brain. Our findings may contribute to a better understanding of pharmacology of antidepressants and their interaction with the cholinergic and purinergic neurotransmission. / O tratamento cl?nico da depress?o enfrenta s?rios obst?culos j? que o mecanismo da doen?a n?o ? totalmente elucidado. Al?m disso, n?o existem meios eficazes para prever e prevenir a depress?o bem como nenhum m?todo biol?gico de diagn?stico. O uso de f?rmacos antidepressivos ainda ? a base dos tratamentos para depress?o. O l?tio tem sido usado clinicamente como f?rmaco eficaz para tratar todas as fases do transtorno bipolar, incluindo depress?o aguda. Os inibidores seletivos da recapta??o de serotonina (ISRSs), como fluoxetina e citalopram, e os antidepressivos tric?clicos (TCA), como a clomipramina, s?o f?rmacos constantemente utilizados para o tratamento da depress?o. Evid?ncias recentes mostram o envolvimento da adenosina e seus receptores na patofisiologia da depress?o. O ATP pode ser armazenado e co-liberado, juntamente com outros neurotransmissores, como serotonina e noradrenalina, e pode ser hidrolisado at? adenosina por uma fam?lia de enzimas de superf?cie celular, conhecidas como ectonucleotidases. Dentre elas, destacam-se as Nucleos?deo Trifosfato Difosfoidrolases (NTPDases) e a ecto-5?-nucleotidase, capazes de controlar a disponibilidade de ligantes como ATP e adenosina aos seus receptores espec?ficos. A Adenosina desaminase (ADA) pode promover a desamina??o hidrol?tica da adenosina em inosina, modulando os n?veis extracelulares deste neuromodulador. Na sinaliza??o colin?rgica, a acetilcolina (ACh), ap?s liberada, promove a ativa??o de receptores muscar?nicos ou nicot?nicos, e desta maneira a ACh promove diversas respostas celulares. A ACh que permanece na fenda sin?ptica ? hidrolisada pela acetilcolinesterase (AChE) em acetato e colina. O peixe-zebra tem sido utilizado na pesquisa da neuroci?ncia comportamental, sendo tamb?m um modelo de escolha para elucidar o desenvolvimento e a fun??o do circuito neuronal. Considerando que as sinaliza??es purin?rgica e colin?rgica t?m importante participa??o no sistema nervoso central e que essas vias de neurotransmiss?o j? est?o caracterizadas em peixe-zebra, o objetivo desse estudo foi avaliar o efeito de f?rmacos antidepressivos na atividade das ectonucleotidases, ADA e AChE, enzimas essenciais na modula??o destas vias de sinaliza??o em c?rebro de peixe-zebra. Foram avaliados os efeitos ex vivo da fluoxetina (1-10 ?M), clomipramina (1-10 ?M) e citalopram (70-300 ?M) na atividade das ectonucleotidases e ADA. Foi analisado tamb?m o efeito in vitro (1 a 1000 ?M) e ex vivo (1-10mg/L) do l?tio sobre a atividade e express?o g?nica das ectonucleotidases e AChE.A exposi??o ao l?tio inibiu a hidr?lise de ADP nas concentra??es de 5 e 10mg/L e inibiu a hidr?lise de AMP na concentra??o de 10mg/L quando comparado ao grupo controle. Este mesmo tratamento diminuiu a atividade da AChE na concentra??o de 10mg/L.O l?tio n?o induziu altera??es significativas na an?lise do padr?o de express?o g?nica. No tratamento in vitro, n?o foram observadas altera??es na atividade das ectonucleotidases e AChE. O tratamento com a clomipramina mostrou uma inibi??o na atividade da ecto-5?-nucleotidase na concentra??o de 5 ?M quando comparado ao grupo controle. Na atividade da ADA tamb?m observamos uma inibi??o significativa no tratamento com a clomipramina nas concentra??es de 5 e 10 ?M em fra??es de membrana de c?rebro de peixe-zebra. Entretanto, o tratamento com fluoxetina e citalopram n?o alterou a atividade das ectonucleotidases e ADA no c?rebro do peixe-zebra. Nossos resultados podem contribuir para uma melhor compreens?o da farmacologia dos f?rmacos antidepressivos e a sua intera??o com a neurotransmiss?o colin?rgica e purin?rgica.
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Avalia??o do papel do sistema purin?rgico e dopamin?rgico no efeito antidepressivo promovido por MK-801 em peixe-zebra (Danio rerio)Souza, Raquel Bohrer da Silva 25 February 2015 (has links)
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Previous issue date: 2015-02-25 / Depression is a serious and recurrent disease characterized by anhedonia, loss of interest in daily activities, appetite, and sleep disturbances, reduced concentration and psychomotor agitation. Antidepressant drugs currently used have a very slow onset of action, with that comes the need for fast-acting treatments. Therefore, there is a growing interest in NMDA antagonists as a target for the development of new antidepressant drugs. Considering that the purinergic and dopaminergic systems are involved in anxiety, depression, and sleep, we characterize the role of these signaling pathways on antidepressant effects induced by MK-801 in zebrafish. The animals treated with MK-801 at 5, 10, 15, and 20 ?M during 15, 30, and 60 minutes showed higher permanence in the top area of the tank, in comparison with the control group, indicating an antidepressant effect induced by this drug. The animals treated with MK-801 remained within 2 hours in the top of the tank when treated with 5 ?M MK-801 and 4 hours when treated with 20 ?M MK-801, returning to basal levels 24 hours after exposure.The repeated treatment did not induce cumulative effects, since animals treated daily for seven days showed the same pattern of behavioral response observed from the first day until the 7th day. In order to investigate the action of agonists and antagonists of A1 and A2A receptors and the influence of modulation on adenosine levels in antidepressant effects induced by MK-801, animals were pretreated with Caffeine, DPCPX, CPA, ZM 241385, CGS 21680, AMPCP, EHNA, dipyridamole, and NBTI before the exposure to MK-801 for 30 minutes. The nonselective adenosine receptor antagonist Caffeine (50 mg/kg) and the selective A1 adenosine receptor antagonist DPCPX (15 mg/kg) blocked the behavioral changes induced by MK-801. Dipyridamole (10 mg/kg), a selective inhibitor of nucleoside transport (NT), exacerbates the behavioral changes induced by MK-801. Dopamine receptor antagonists (sulpiride and SCH23390) did not induce changes on the behavioral alterations induced by MK-801. Our results have shown that the antidepressant effects induced by MK-801 in zebrafish are mediated by the activation by A1 adenosine receptor. / A depress?o ? uma doen?a grave, recorrente, caracterizada por anedonia, perda de interesse em atividades di?rias, dist?rbios do apetite e do sono, concentra??o reduzida e agita??o psicomotora. Os f?rmacos antidepressivos utilizados atualmente t?m um in?cio de a??o muito lento, com isso, surge a necessidade de tratamentos de a??o r?pida. Portanto, h? um interesse crescente em antagonistas de receptores NMDA como um alvo para o desenvolvimento de novos f?rmacos antidepressivos. Considerando-se que os sistemas purin?rgicos e dopamin?rgicos est?o envolvidos na ansiedade, sono e depress?o, caracterizamos o papel destas vias de sinaliza??o sobre os efeitos antidepressivos induzidos por MK-801, um antagonista NMDA, em peixe-zebra. Os animais tratados com MK-801 em doses de 5, 10, 15 e 20 ?M durante 15, 30 e 60 minutos apresentaram maior perman?ncia na ?rea superior do aqu?rio, em compara??o com o grupo controle, indicando um efeito antidepressivo induzido por este composto.Os animais tratados com MK-801 permaneceram at? 2 horas na parte superior do aqu?rio quando tratados com 5 ?M de MK-801 e 4 horas quando tratados com 20 ?M MK-801, retornando aos par?metros basais ap?s 24 horas de exposi??o. O tratamento repetido n?o induziu efeitos cumulativos, uma vez que os animais tratados diariamente durante sete dias apresentaram o mesmo padr?o de resposta comportamental observada desde o primeiro at? o dia 7? dia. Com o objetivo de investigar a a??o dos agonistas e antagonistas dos receptores A1 e A2A e a influ?ncia da modula??o dos n?veis de adenosina nos efeitos antidepressivos induzidos por MK-801, os animais foram pr?-tradados com cafe?na, DPCPX, CPA, ZM 241385, CGS 21680, AMPCP, EHNA, Dipiridamol e NBTI por 30 minutos antes da exposi??o ao MK-801. O antagonista n?o seletivo de receptores de adenosina cafe?na (50 mg/kg) e o antagonista seletivo do receptor A1 DPCPX (15 mg/kg) bloquearam as altera??es comportamentais induzido pelo MK-801.O Dipiridamol (10 mg/kg), um inibidor n?o seletivo do transportador de nucleos?deo (NT), exacerbou as altera??es comportamentais induzidos pelo MK-801. Os antagonistas dos receptores de dopamina (sulpirida e SCH23390) n?o apresentaram modifica??es nas altera??es comportamentais induzidas por MK-801. Os nossos resultados sugerem que o efeito antidepressivo induzido por MK-801 em peixe-zebra ? mediado principalmente pela ativa??o do receptor de adenosina A1.
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Qualidade de vida e sintomas de ansiedade e depress?o em idosas com e sem dor musculoesquel?tica cr?nicaStorchi , Sarimam 11 March 2015 (has links)
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Previous issue date: 2015-03-11 / With the increase in life expectancy there is a higher prevalence of chronic diseases and functional limitations that are common in aging. Musculoskeletal disorders (MSD?s) are in the group of chronic diseases that most affect the elderly, being characterized by pain and decrease in function. When associated with pain these disorders are among the most disabling diseases and are associated with considerable functional, psychological and social limitations. To analyze the impact of musculoskeletal diseases is important to measure the problems associated with them, like pain, emotional factors and quality of life. Therefore, the goals of this study are to measure the levels of anxiety and depression symptoms and quality of life in elderly women with chronic musculoskeletal pain and compare them with elderly women without pain, and to measure the influence of pain?s intensity in these variables. This was a cross-sectional study among women who were 60 years old or older, who were members of mothers' clubs in the city of Caxias do Sul, Brazil. The elderly women were separated into two groups, group G1 consisted of women with chronic musculoskeletal pain for over three months and group G2 consisted of women with no musculoskeletal pain for over three months.To measure anxiety symptoms, depression symptoms, quality of life and pain intensity the following instruments were used, respectively: Beck Anxiety Inventory (BAI); Beck Depression Inventory- II (BDI-II); WHOQOL-bref; and visual analogue scale (VAS). 178 elderly women participated on this research, of which four were excluded since they did not meet all the inclusion criteria. Of the 174 remaining, 95 were included in G1 and 79 in G2. The mean age was 70 years old in G1 and 70,3 years old in G2. The G1 group showed higher levels of anxiety symptoms (p<0,001) and depression symptoms (p<0,001) and worse quality of life in all domains of WHOQOL-BREF (p<0,05) when compared with group G2. The pain intensity was negatively correlated with the levels of anxiety symptoms (p<0,001) and the physical domain of the WHOQOL-BREF (p <0.05). Therefore, it is concluded that chronic musculoskeletal pain is frequent in the elderly and is associated with higher incidence of depressive and anxiety symptoms, and it also affects negatively the quality of life. It is suggested that new researches explore more deeply this relation through longitudinal studies made with different populations. / Com o aumento da expectativa de vida h? maior preval?ncia de doen?as cr?nicas e limita??es funcionais pr?prias do envelhecimento humano. As doen?as musculoesquel?ticas (ME) est?o entre as patologias cr?nicas que mais acometem idosos, sendo caracterizadas por dor e diminui??o da fun??o. Quando associadas ? dor, est?o entre as doen?as mais incapacitantes e est?o relacionadas a consider?veis limita??es funcionais, psicol?gicas e sociais. Para analisar o impacto das doen?as ME ? importante mensurar os problemas associados com elas que s?o a dor, os fatores emocionais e a qualidade de vida. Sendo assim, este estudo teve como objetivo avaliar os n?veis de sintomas de ansiedade e depress?o e a qualidade de vida em idosas com dores ME cr?nicas e comparar com idosas sem dores, como tamb?m relacionar a intensidade ?lgica com essas vari?veis. Trata-se de um estudo transversal, realizado com mulheres com 60 anos ou mais, participantes dos clubes de m?es da cidade de Caxias do Sul/RS. As idosas foram separadas em dois grupos, grupo G1 composto por mulheres com dor ME cr?nica h? mais de tr?s meses e grupo G2 composto por mulheres com aus?ncia de dor ME h? mais de tr?s meses.Para avaliar os sintomas de ansiedade foi utilizado o Invent?rio de Ansiedade de Beck (BAI), para os sintomas de depress?o o question?rio de Depress?o de Beck II (BDI-II), para a qualidade de vida o WHOQOL-bref e para avaliar a intensidade ?lgica foi utilizada a escala visual anal?gica (EVA). Participaram do estudo 178 idosas, sendo que 4 idosas foram exclu?das por n?o se adequarem em todos os crit?rios de inclus?o. Das 174 restantes, 95 foram inclusas do grupo G1 e 79 no grupo G2. A m?dia de idade do G1 foi de 70 anos e do G2 de 70,3 anos. As mulheres do G1 apresentaram n?veis mais elevados de sintomas de ansiedade (p<0,001) e depress?o (p<0,001) e pior qualidade de vida em todos os dom?nios do WHOQOL-bref que as mulheres do G2 (p<0,05). A intensidade ?lgica correlacionou-se negativamente com os n?veis de sintomas de ansiedade (p<0,001) e com o dom?nio f?sico do WHOQOL-bref (p<0,05). Conclui-se, portanto, que a dor ME cr?nica ? frequente na popula??o idosa e est? associada com maior incid?ncia de sintomas depressivos e ansiosos, al?m de afetar negativamente a qualidade de vida dos indiv?duos acometidos. Sugerem-se novas pesquisas que aprofundem esta rela??o atrav?s de estudos longitudinais e que sejam realizados com diferentes popula??es.
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Composi??o corporal, depress?o, qualidade de vida e mortalidade em hemodi?liseBarros, Annerose 26 March 2015 (has links)
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Previous issue date: 2015-03-26 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / Chronic kidney disease is a progressive condition, with no healing prospect, yet extended upholding under adequate monitoring and treatment. Approximately 100,000 patients currently undergo dialysis therapy - ninety percent on hemodialysis. Mortality ratio varies between 15 to 20%, being cardiovascular events mainly responsible. Among mental ailments thwarting kidney disease patients, depression is the most frequently associated co-morbidity, and linked to increased mortality and morbidity rates. In patients undergoing hemodialysis, malnourishment may relate with depressive symptoms, besides inflammation and cardiovascular diseases. Life style changes induced by end-stage renal disease impose a number of limitations that end up affecting the quality of life. Protein depletion is commonly observed in patients submitted to hemodialysis, and is associated with higher mortality. Strangely enough, it may be accompanied by weight gain and central fat accumulation. The role of adipocytokines in chronic kidney disease has recently drawn attention: association of serum chemerin to metabolic syndrome indicators, inflammation and obesity has been suggested. The aim of this study was to longitudinally evaluate nutritional status, presence of depressive symptoms, quality of life and mortality of hemodialysis patients, in a cohort study at the S?o Lucas Hospital /PUCRS, Porto Alegre, Brazil. Stable patients, undergoing hemodialysis for at least three months, were enrolled and evaluated at twelve month-intervals, thereafter. Participants were assessed for: depressive symptoms using the Beck Depression Inventory and for quality of life perception by the WHOQOL-bref questionnaire. Anthropometric data: weight, height, waist circumference; blood collection: for biochemical determinations, high-sensitivity C-reactive protein, chemerin; body composition analysis by direct segmental multi frequency bioimpedance, were obtained at a mid week dialysis session. One hundred and five participants were included. Patients classified as having standard percentage of body fat predominated, although more than half of the enrolled participants presented with excess body fat. There was no significant difference in the rate of depressive symptoms or in the quality of life between groups, classified by nutritional status. The cause more often associated with the outcome death by any cause was cardiovascular event, followed by infection. Lean body mass had a protective effect on survival. Chemerin may have an anti-inflammatory effect, being associated with increased body fat percentage and augmented waist circumference, on end-stage renal disease patients. / A doen?a renal cr?nica ? uma doen?a progressiva, que n?o contempla expectativa de cura, mas o prolongamento da cronicidade, com acompanhamento e tratamento adequados. Quase 100.000 pacientes s?o submetidos a tratamento dial?tico, 90% em hemodi?lise. A taxa de mortalidade bruta varia entre 15 a 20%, sendo eventos cardiovasculares os principais respons?veis. Dentre os problemas mentais que acometem pacientes com doen?a renal, depress?o ? a comorbidade mais frequente, associada a aumento das taxas de morbimortalidade. Desnutri??o pode se relacionar com sintomas de depress?o, assim como inflama??o e doen?a cardiovascular, em pacientes tratados por hemodi?lise. As mudan?as de estilo de vida induzidas pela doen?a renal cr?nica terminal causam in?meras limita??es que afetam a qualidade de vida. Deple??o proteica em pacientes submetidos a hemodi?lise ? frequentemente observada, e se associa com elevada mortalidade. Curiosamente, pode se acompanhar por excesso de peso e ac?mulo de gordura central. O papel das adipocitocinas na doen?a renal cr?nica tem despertado interesse: associa??o de quemerina s?rica com indicadores de s?ndrome metab?lica, inflama??o e obesidade foram sugeridas. O objetivo do presente estudo ? correlacionar estado nutricional, sintomas de depress?o, qualidade de vida e mortalidade em hemodi?lise. Foi realizado estudo prospectivo de coorte com pacientes em hemodi?lise no Hospital S?o Lucas/PUCRS, Porto Alegre, Brasil. Os pacientes estavam h? tr?s ou mais meses em hemodi?lise, clinicamente est?veis. A cada doze meses, pacientes inclu?dos no estudo foram reavaliados para: sintomas de depress?o ? por question?rio Beck de depress?o; percep??o da qualidade de vida ? pelo question?rio WHOQOL-bref; medidas antropom?tricas ? peso, altura, circunfer?ncia da cintura; coleta de sangue - para dosagens de par?metros bioqu?micos, prote?na C-reativa e quemerina; an?lise da composi??o corporal ? por bioimped?ncia segmentar de multi-frequ?ncias. Foram inclu?dos 105 pacientes. Houve um predom?nio de pacientes com percentagem de gordura padr?o, mas mais da metade dos pacientes tinha excesso de gordura corporal. N?o houve diferen?a na presen?a de sintomas depressivos e na qualidade de vida entre os grupos classificados por estado nutricional. A principal causa associada ao desfecho ?bito por qualquer causa foi evento cardiovascular, seguida por infec??o. A massa muscular apresentou efeito protetor para sobrevida. Quemerina s?rica aparentemente tem a??o anti-inflamat?ria em pacientes com doen?a renal cr?nica terminal, e est? associada a percentual de gordura corporal e a circunfer?ncia da cintura aumentada.
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Doen?as cr?nicas n?o transmiss?veis e sinais e sintomas de depress?o e de decl?nio cognitivo em idosos na aten??o prim?ria ? sa?deSilva, Amanda Ramalho 30 March 2015 (has links)
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Previous issue date: 2015-03-30 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Objective: To investigate the non-communicable chronic diseases with symptoms of depression and of cognitive deficit in elders attended by family health strategy. Methods: It is conducted a cross-sectional, quantitative and descriptive study with 1.391 elders attended by 21 family health strategy under PUCRS jurisdiction, Porto Alegre. Data were collected from the formulary of PENCE. It was used for tracking of the symptoms of depression the geriatric depression scale (GDS15), and it was used the Vellore for the tracking of cognitive deficit symptoms. Results: Only 18,7% out of the analyzed did not present chronic disease and 47,5% presented 2 or more. It was noticed a greater frequency of chronic diseased with advanced age (P<0,001) and lower level of education (P=0,004) and lower frequency of chronic diseases among singles (P=0,001). The GDS result was normal in approximately 72% of the elder without chronic disease and 56% of those with some chronic disease (P<0,001). The Vellore result was normal in approximately 58% and 49% of the elders with or without chronic diseases respectively (P<0,001). The following diseases showed significant association (P<0,05) as the result of the depression symptoms scale as the cognitive symptoms scale: hypertension, diabetes, coronary disease, heart failure and cerebral vascular accident. Conclusion: The results suggest that, among the chronic diseases, cardiovascular and cerebrovascular have a clearer Independent association, both with depression as with cognitive decline, supporting the hypothesis of a possible relationship of depression as a risk factor for vascular disease and with this commitment brain associated with cognitive decline and perhaps also to depression. / Objetivos: Investigar as doen?as cr?nicas n?o transmiss?veis associadas com sintomas de depress?o e sinais de deficit cognitivo em idosos atendidos pela Estrat?gia Sa?de da Fam?lia. M?todos: Estudo transversal com 1.391 idosos atendidos no Programa de Envelhecimento Cerebral (PENCE) da Estrat?gia Sa?de da Fam?lia do Munic?pio de Porto Alegre (RS). Os dados foram coletados a partir do prontu?rio do PENCE, que cont?m informa??es sociodemogr?ficas e doen?as cr?nicas autorreferidas, al?m de instrumentos utilizados para triagem de depress?o e decl?nio cognitivo. Para o rastreio dos sintomas de depress?o, foi utilizada a Escala de Depress?o Geri?trica (GDS-15), e, para o rastreio dos sintomas de deficit cognitivo, foi utilizado o Vellore, que cont?m 10 quest?es para um informante e testagem breve realizada com o idoso. Resultados: Apenas 18,7% dos idosos n?o referiram doen?a cr?nica e 47,5% referiram duas ou mais. Foi observada maior frequ?ncia de doen?a cr?nica com idade avan?ada (P<0,001) e menor escolaridade (P=0,004); e menor frequ?ncia de doen?a cr?nica entre os solteiros (P=0,001). O resultado da GDS foi alterado em aproximadamente 28% dos idosos sem doen?a cr?nica e 44% daqueles com alguma doen?a cr?nica (P<0,001). J? o resultado do cognitivo foi alterado em aproximadamente 42% e 51% dos idosos sem e com doen?a cr?nica, respectivamente (P<0,001). A maior preval?ncia de sintomas depressivos foi no sexo feminino e nos idosos com doen?a coronariana, insufici?ncia card?aca e AVC; e menor preval?ncia naqueles com 1o grau completo, que vivem com parceiro e nos vi?vos. J? a presen?a de sinais de deficit cognitivo foi prevalente entre os que tinham 80 anos ou mais, nos idosos da ra?a negra e naqueles que apresentavam doen?a coronariana e acidente vascular encef?lico; e foi menos prevalente, quanto maior a escolaridade e entre os idosos que referiram reumatismo/artropatia. Conclus?o: Os resultados sugerem que, entre as doen?as cr?nicas, as cardiovasculares e as cerebrovasculares t?m associa??o independente mais evidente, tanto com depress?o quanto com decl?nio cognitivo, corroborando a hip?tese de uma poss?vel rela??o da depress?o como fator de risco para doen?a vascular e desta com comprometimento encef?lico associado ao decl?nio cognitivo e, talvez, tamb?m com a depress?o.
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Musicoterapia na qualidade de vida em idosos institucionalizadosLuz, Luiza Thom? da 19 July 2015 (has links)
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Previous issue date: 2015-07-19 / Introduction : The elderly population is growing at a rapid pace and the number of people living in institutions of Long-term care (LTC) is increasing in a representative manner, inferring the quality of life of older people. Music therapy is the one health engaged in promotion and prevention, assisting in the treatment of disease and its comorbidities. Objective : To investigate the effect of music therapy intervention on quality of life in elderly residents in two ILPIs. We evaluated the quality of life and depressive and anxiety symptoms before and after the sessions of music therapy. A screening test was used to identify the elderly with cognitive impairment. Methods : We conducted a controlled trial, in which were allocated 48 seniors, 24 participants in the group who underwent music therapy intervention (IG) and 24 elderly control group without intervention (CG). The instruments applied for the two groups were the Mini Mental State Examination (MMSE), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI) and Quality of Life Questionnaire (WHOQOL-BREF). For the IG, it applied the analysis protocol of the sessions during the group calls of music therapy. Results : When comparing the groups, the intervention of Music Therapy contributed to quality of life, especially in the physical domain (p=0.006) and in reducing depression levels (p=0.046). In the control group, there was a significant worsening of cognition (p=0.015). Conclusion : The results indicate that music therapy promoted improvement in depressive symptoms and quality of life and probably reduced the likelihood of cognitive decline in institutionalized elderly. / Introdu??o : A popula??o idosa vem crescendo a passos largos e o n?mero de pessoas residentes em Institui??es de Longa Perman?ncia (ILPIs) vem aumentando de maneira representativa, inferindo na qualidade de vida dos idosos. A Musicoterapia ? uma ?rea da sa?de que atua na promo??o e preven??o, auxiliando no tratamento de doen?as e suas comorbidades. Objetivo : Investigar o efeito da interven??o musicoterap?utica na qualidade de vida em idosos residentes em duas ILPIs. Foram avaliados a qualidade de vida e os sintomas depressivos e ansiosos antes e ap?s as sess?es de Musicoterapia. Um teste de rastreio foi utilizado para identificar os idosos com d?ficit cognitivo. M?todos : Foi realizado um ensaio cl?nico controlado, no qual foram alocados 48 idosos, sendo 24 participantes do Grupo que se submeteu a interven??o musicoter?pica (GI) e 24 idosos do Grupo Controle sem interven??o (GC). Os instrumentos aplicados para os dois grupos, foram o Mini Exame do Estado Mental (MEEM), Invent?rio de Depress?o de Beck (BDI-II), Invent?rio de Ansiedade de Beck (BAI) e Question?rio de Qualidade de Vida (WHOQOL-bref). Para o GI, foi aplicado o Protocolo de An?lise das Sess?es durante os atendimentos grupais de musicoterapia. Resultados : Na compara??o entre os grupos, a interven??o da Musicoterapia contribuiu na qualidade de vida, principalmente no dom?nio f?sico (p=0,006) e na redu??o dos n?veis de depress?o (p=0,046). No grupo controle, houve uma piora significativa da cogni??o (p=0,015). Conclus?o : Os resultados indicam que a Musicoterapia promoveu melhora nos sintomas depressivos e qualidade de vida e provavelmente reduziu a probabilidade de decl?nio cognitivo em idosos institucionalizados.
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