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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Study of therapeutic potential of acid caffeic protocols and diabetes in mice dyslipidemia / Estudo do potencial terapÃutico do Ãcido cafÃico em protocolos de diabetes e dislipidemia em camundongos

Vivianne Machado de AraÃjo 30 April 2014 (has links)
CoordenaÃÃo de AperfeÃoamento de Pessoal de NÃvel Superior / The diabetes and dyslipidemia are important in cardiovascular risk factors. When associated with oxidative stress may accelerate coronary artery disease and progression of atherosclerotic lesions. There are several natural products that stand out as potential therapeutic agents for treatment of such diseases, including caffeic acid, a phenolic compound that has a variety of biological and pharmacological activities described in the literature. Thus, the aim of this study was to evaluate the therapeutic potential of caffeic acid in experimental protocols of diabetes and dyslipidemia, as well as examine their modulating activity under oxidative stress. Hyperlipidemia was induced in male mice using two protocols by means of a single intraperitoneal administration of 400mg/kg Triton WR-1339 and 400mg/kg Poloxamer-407 in all animals, except for the normal control. The treated groups received doses caffeic acid 25 (CA25), 50 (CA50) and 100 mg/kg (CA100). The serum of these animals was analyzed on two different time intervals for total cholesterol, triglycerides and glucose. Liver tissue was analyzed after both protocols dyslipidemia for products of lipid peroxidation, the non-protein sulfhydryl groups (NP-SH) and the antioxidant enzyme superoxide dismutase (SOD). The hypoglycemic activity of caffeic acid was checked by the protocol of diabetes induced by alloxan. Treatment with three doses of caffeic acid and 200mg/Kg fenofibrate significantly reduced total cholesterol and triglyceride levels 24 and 48 hours after induction of dyslipidemia in both protocols dslipidemia. There was also reduced blood glucose at all doses used to induce dyslipidemia with Poloxamer -407. Furthermore, the treatment caused a reduction in the CA and an increase in lipid peroxidation levels of NP -SH in two models of dyslipidemia and in addition, increased levels of SOD-induced hyperlipidemia in Poloxamer-407. Regarding the induction protocol with alloxan diabetes, there was reduction in blood glucose and total cholesterol levels in the three groups treated with caffeic acid. Triglyceride levels were significantly reduced in animals in groups CA25 and CA100. The results suggest that caffeic acid has a beneficial effect in the treatment of dyslipidemia and diabetes, as well as an important antioxidant activity without the presence of adverse effects. However, most studies of chronic so they can ensure the safety and efficacy of its use are needed. / O diabetes e as dislipidemias constituem-se em importantes fatores de risco cardiovascular. Quando associados ao estresse oxidativo podem acelerar a doenÃa arterial coronariana e a progressÃo das lesÃes aterosclerÃticas. Existem vÃrios produtos de origem natural que despontam como potenciais agentes terapÃuticos para tratamentos de tais doenÃas, dentre eles o Ãcido cafeico, um composto fenÃlico que apresenta uma variedade de atividades biolÃgicas e farmacolÃgicas descritas na literatura. Desse modo, o objetivo do presente trabalho foi avaliar o potencial terapÃutico do Ãcido cafeico em protocolos experimentais de diabetes e dislipidemia, bem como analisar sua atividade moduladora sob o estresse oxidativo. A hiperlipidemia foi induzida em camundongos machos atravÃs de dois protocolos, sendo mediante uma Ãnica administraÃÃo intraperitoneal de 400mg/Kg de Triton WR-1339 e 400mg/Kg de Poloxamer-407 em todos os animais, exceto no controle normal.Os grupos tratados com Ãcido cafeico receberam as doses de 25 (AC25), 50 (AC50) e 100 mg/Kg (AC100). O soro desses animais foi analisado em dois intervalos de tempos diferentes para colesterol total, triglicerÃdeos e glicose. JÃ o tecido hepÃtico foi analisado apÃs ambos os protocolos de dislipidemia para os produtos de peroxidaÃÃo lipÃdica, os grupos sulfidrÃlicos nÃo-proteÃcos (NP-SH) e a enzima antioxidante superÃxido dismutase (SOD). A atividade hipoglicÃmica do Ãcido cafeico foi verificada atravÃs do protocolo de diabetes induzida por aloxano. O tratamento com as trÃs doses de Ãcido cafeico e fenofibrato 200mg/Kg reduziram significativamente os nÃveis de colesterol total e triglicerÃdeos 24 e 48 horas apÃs a induÃÃo da dislipidemia em ambos os protocolos de dslipidemia. Houve tambÃm reduÃÃo da glicose sanguÃnea em todas as doses utilizadas ao se induzir a dislipidemia com o Poloxamer-407. AlÃm disso, o tratamento com AC promoveu diminuiÃÃo da peroxidaÃÃo lipÃdica e aumento nos nÃveis de NP-SH nos dois modelos de dislipidemia e, adicionalmente, aumento nos nÃveis de SOD na hiperlipidemia induzida por Poloxamer-407. Em relaÃÃo ao protocolo de induÃÃo de diabetes com aloxano, verificou-se reduÃÃo da glicemia e do colesterol total nos trÃs grupos tratados com Ãcido cafeico. JÃ os nÃveis de triglicerÃdeos foram reduzidos significativamente nos animais dos grupos AC25 e AC100. Os resultados obtidos sugerem que o Ãcido cafeico possui um efeito benÃfico no tratamento das dislipidemias e do diabetes, alÃm de uma importante atividade antioxidante, sem a presenÃa de efeitos adversos durante o estudo. No entanto, sÃo necessÃrios mais estudos de forma crÃnica que possam garantir a seguranÃa e eficÃcia de sua utilizaÃÃo.
2

Association between free thyroid hormones values and the lipid profile in middle-aged women with chronic symptoms

Guarnizo-Poma, Mirella, Paico-Palacios, Socorro, Pantoja-Torres, Betzi, Lazaro-Alcantara, Herbert, Urrunaga-Pastor, Diego, Benítes-Zapata, Vicente A. 07 1900 (has links)
El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Aims: To determine the association between the thyroid hormones(FT3, FT4 and TSH) and the lipid profile markers(HDL-c, LDL-c and triglycerides) values in middle-aged women with no metabolic disorders and recurrent chronic symptomatology. Materials and Methods: We carried out an analytical cross-sectional study in euthyroid women with recurrent chronic symptoms of at least six months with no apparent diagnosis who attended the endocrinological gynaecology outpatient service of a private clinic in Lima-Peru during 2012–2014. Participants who met the eligibility criteria were evaluated according to their thyroid hormones(FT3, FT4 and TSH) and lipid profile markers(HDL-c, LDL-c and triglycerides) values. We elaborated univariate/multivariate linear regression models to evaluate the association between the thyroid markers and the lipid profile levels. The reported association measure was the beta coefficient(β) with its respective p-value. Results: We analyzed 211 participants, the average age was 44.9 ± 14.0(SD) years, the FT3 and FT4 mean levels were 3.2 ± 0.4 pg/mL and 1.2 ± 0.2 ng/dL respectively, while the TSH median was 2.8(IQR:1.9–4.0) μU/mL. The mean or median levels of LDL-c, HDL-c and triglycerides were of 137.5 ± 37.9 mg/dL, 54.0 ± 15.0 mg/dL and 118.5(IQR:79.5–169.5) mg/dL respectively. In the multivariate linear regression model between the FT3 and LDL-c levels, we found that for each increase in a FT3 unit, the LDL-c values decreased on average 30.85 mg/dL(p < 0.01). We found no statistically significant associations in the other multivariate models of linear regression, among the other thyroid hormones and lipid markers. Conclusion: We found an inverse association between the FT3 and LDL-c values in women with chronic gynaecological symptoms / Revisión por pares / Revisión por pares
3

PADRÃO ALIMENTAR E DISLIPIDEMIA EM ADOLESCENTES DE ESCOLAS PÚBLICAS DE UMA CAPITAL DO NORDESTE BRASILEIRO / FOOD STANDARD AND DISLIPIDEMIA IN ADOLESCENTS OF PUBLIC SCHOOLS IN A NORTHEAST BRAZILIAN CAPITAL

PIRES, Bruna Renata Fernandes 24 April 2017 (has links)
Submitted by Daniella Santos (daniella.santos@ufma.br) on 2017-08-11T14:58:42Z No. of bitstreams: 1 Bruna Pires.pdf: 4058602 bytes, checksum: 8405d2df0e834d76d15b26aaf9f64d85 (MD5) / Made available in DSpace on 2017-08-11T14:58:42Z (GMT). No. of bitstreams: 1 Bruna Pires.pdf: 4058602 bytes, checksum: 8405d2df0e834d76d15b26aaf9f64d85 (MD5) Previous issue date: 2017-04-24 / Studies developed in Brazil have shown that the lipid profile of adolescents is undergoing changes. Probably due to changes that the dietary patterns of this population have been suffering over the years. However, there are few studies on the relationship between dietary patterns and dyslipidemia in adolescents, especially in the Northeast of Brazil. Objective: To analyze the association between dietary patterns and dyslipidemia in adolescents. Material and methods: Cross-sectional study with 363 adolescents of both sexes, ages 17 to 18, from public schools of São Luís, Maranhão. Food consumption was evaluated by means of a Food Frequency Questionnaire (FFQ) and the dietary patterns were identified by Principal Component Analysis (PCA). Adolescents who had an alteration in at least one of the following conditions were considered dyslipidemia carriers: total cholesterol (TC), low density lipoprotein (LDL-c), high density lipoprotein (HDL-c), triglycerides (TG), Index of Castelli I and II and No HDL-c. For selection of the variables that were controlled in the analysis of the effect of dietary patterns on the dyslipidemias, we used the Directed Acyclic Graphs (DAG) and the final sample was weighted to the inverse of the probability of selection for these variables through doubly robust method. Results: Three dietary patterns were identified in this study: “Western” (stuffed cookie, cake, soft drinks, processed juices, coffee/ tea with sugar, red meat/ viscera, fast food, sugar/ sweets), “Healthy” (vegetables, fruits, natural juices, nonfat milk/ derivatives, coffee/ tea without sugar, legumes, light butter/ margarine and salad dressings), and “Traditional” (breads/ cookies without filling, butter/ margarine, whole milk/ milk products, beans, rice, cereals and eggs). Most of the adolescents showed dyslipidemia (59.23%), and the inadequacy of HDL-c levels was the primary dyslipidemia found (44.9%). There was no significant difference in the occurrence of dyslipidemia among the three identified dietary patterns (p>0.05). Conclusion: The study population had a high prevalence of dyslipidemia. However, the adolescents’ dietary pattern did not explain dyslipidemia. / Estudos desenvolvidos no Brasil têm demonstrado que o perfil lipídico de adolescentes está sofrendo alterações. Provavelmente, em decorrência de modificações nos padrões alimentares dessa população. No entanto, há poucos estudos sobre a relação entre os padrões alimentares e as dislipidemias em adolescentes, especialmente no nordeste brasileiro. Objetivo: Analisar associação entre padrões alimentares e dislipidemia em adolescentes. Material e métodos: Estudo transversal com 363 adolescentes de ambos os sexos, entre 17 e 18 anos de idade, de escolas públicas de São Luís, Maranhão. O consumo alimentar foi avaliado por meio de Questionário de Frequência Alimentar (QFA) e o padrão alimentar foi identificado por meio da Análise de Componentes Principais (ACP). Considerou-se portador de dislipidemia o adolescente que apresentasse alteração em pelo menos uma das seguintes condições: colesterol total (CT), lipoproteína de baixa densidade (LDL-c), lipoproteína de alta densidade (HDL-c), triglicerídeos (TG), Índice de Castelli I e II e Não HDL-c. Para seleção das variáveis que foram controladas na análise do efeito dos padrões alimentares sobre as dislipidemias foi elaborado o Directed Acyclic Graphs (DAG) e a amostra final do estudo foi ponderada pelo inverso da probabilidade de seleção para essas variáveis, através de método duplamente robusto. Resultados: Três padrões alimentares foram identificados: “Ocidental” (biscoito recheado, bolo, refrigerantes, sucos industrializados, café/chá com açúcar, carne vermelha/ vísceras, “fast food”, açúcar/doces), “Saudável” (hortaliças, frutas, sucos naturais, leite/derivados desnatados, café/chá sem açúcar, leguminosas, manteiga/margarina light e temperos para salada) e “Tradicional” (pães/biscoito sem recheio, manteiga/margarina comum, leite/derivados integrais, feijão, arroz, cereais e ovos). A maior parte dos adolescentes apresentou dislipidemia (59,2%), sendo a inadequação dos níveis de HDL-c a principal dislipidemia encontrada (44,9%). Não houve diferença significativa na ocorrência de dislipidemia entre os três padrões alimentares identificados (p>0,05). Conclusão: A população em estudo apresentou elevada prevalência de dislipidemia. No entanto, a dislipidemia não foi explicada pelo padrão alimentar dos adolescentes.
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Hipotiroidismo subclínico e risco cardiovascular em mulheres idosas = Subclinical hypothyroidism and cardiovascular risk in elderly women / Subclinical hypothyroidism and cardiovascular risk in elderly women

Peterson, José Carlos Bellini, 1947- 20 August 2018 (has links)
Orientador: Maria Elena Guariento / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-20T22:26:50Z (GMT). No. of bitstreams: 1 Peterson_JoseCarlosBellini_D.pdf: 887202 bytes, checksum: 3b69bb83a27c8b2d5522e68aa050dc6d (MD5) Previous issue date: 2012 / Resumo: Fundamento: O hipotireoidismo subclínico é mais prevalente em mulheres idosas e existe uma correlação direta entre esta condição e as dislipidemias, com um conseqüente potencial aterosclerótico para a ocorrência de doenças cardiovasculares. Objetivo: Verificar em mulheres idosas com hipotireoidismo subclínico a ocorrência de variações em seus perfis lipídicos e o consequente risco cardiovascular. Métodos: Foram estudadas 121 mulheres com idade ? 65 anos, 76 delas com hipotireoidismo subclínico (grupo 1), comparadas a um grupo controle de 45 mulheres eutireoideas (grupo 2). Foi estudada a relação entre hipotireoidismo subclínico e valores de colesterol total, suas frações e triglicérides. Os índices de Castelli I e II foram utilizados para avaliar o risco cardiovascular. Foram excluídas outras condições que causem dislipidemia. Resultados: Pacientes com hipotireoidismo subclínico apresentaram valores mais elevados de colesterol total, suas frações (exceto HDL-c) e triglicérides; e os índices de Castelli I e II, quando comparadas ao grupo controle (p < 0,01). No grupo 1 foram identificados dois subgrupos de pacientes, o primeiro com menores valores na elevação TSH e nos Índices Castelli I e II; o segundo com maiores valores na elevação de TSH, e nos Índices de Castelli I e II. Conclusão: O estudo demonstrou uma forte correlação entre dislipidemia e hipotireoidismo subclínico e que quanto mais elevado o TSH, mais alterado o perfil lipídico, e mais elevados os índices de Castelli I e II, com conseqüente aumento do risco cardiovascular / Abstract: Background: Subclinical hypothyroidism is more prevalent in elderly women. There is a direct correlation between this condition and dyslipidemia, with consequent arteriosclerotic potential for the occurrence of cardiovascular diseases. Objective: The objective of this study was to verify in elderly women with subclinical hypothyroidism lipid profile variation, with consequent modification in cardiovascular risk. Methods: There were included 121 female patients with age ? 65 years old, 76 with subclinical hypothyroidism (group 1). They were compared with a 45 group control of euthyroid patients (group 2). Other conditions that lead to dyslipidemia were excluded. The relation between subclinical hypothyroidism and the levels of total cholesterol and its fractions, and triglycerides were studied. Also, indexes of Castelli I and II were used to evaluate cardiovascular risk. Results: Patients with subclinical hypothyroidism presented higher levels of all the fractions of cholesterol (except HDL-c), triglycerides and indexes of Castelli I and II, when compared to control group (p<0.01). In group 1, there were identified two subgroups of patients, being the first one with less elevated levels of TSH e lower levels of Castelli I and II, and the second one with higher levels of TSH and with a higher variation of the indexes of Castelli I and II. Conclusions: This study demonstrated a strong correlation between dyslipidemia and subclinical hypothyroidism in elderly women; in addition, it showed that the higher the TSH, the worse the lipid profile, and the higher indexes of Castelli I and II / Doutorado / Clinica Medica / Doutor em Clínica Médica
5

Monitoring lipid and haematological abnormalities in paediatric patients on antiretroviral therapy at a Community Health Centre in the Cape Metropole

Nambatya, Winnie January 2014 (has links)
Magister Pharmaceuticae - MPharm / South Africa faces a huge Human Immunodeficiency Virus (HIV) burden with more than 400,000 children currently on antiretroviral therapy (ART). Studies on lipid and haematological profile changes in paediatrics are of particular interest since these children are exposed to ART in the course of a developmentally significant period and will possibly have longer collective exposure to ART. As such, monitoring for adverse effects, including lipid and haematological abnormalities, is essential for curtailing morbidity and mortality rates of children on ART. There is a dearth of studies assessing lipid and haematological abnormalities in the South African paediatric population on ART where genetic differences, co-morbidities, malnutrition and use of traditional medicines, all influence the safety profile of a drug. The goal of this study was twofold: Firstly to identify a suitable parameter for assessing lipid and haematological abnormalities in paediatrics on Antiretroviral (ARV) treatment using available secondary data and secondly, to assess prescriber adherence to routine monitoring tests in the ART guidelines. This study was a retrospective review of secondary data obtained from 168 patient clinical records at a Community Health Centre in the Cape Metropole, Western Cape and corresponding laboratory data from the National Health Laboratory Service (NHLS) database. Appropriate cholesterol, triglyceride, haemoglobin and neutrophil test results were compared against the standard reference ranges/values. The Chi-Squared test identified associations between total cholesterol (TC) /triglycerides and haemoglobin (Hb)/neutrophil and other independent variables. Evaluation of health care provider adherence to routine monitoring tests was assessed against relevant national ARV management guidelines. There was a paucity of baseline data for all laboratory markers and infrequent follow-up tests were ordered by healthcare providers. This precluded the measurement of changing lipid and haematological levels and an alternative parameter, viz., the highest available laboratory test value for each marker per patient, was assessed against reference values/ranges. Only nine out of the 36 (25%) patients on an AZT regimen had any Hb or neutrophil laboratory tests performed and 23 and two out of 97 (24% and 2%) patients, respectively, on a protease inhibitor (PI) had a TC and triglyceride laboratory test performed. Anaemia was detected in 45.5 % of children below five years of age, in 21.7% between ages of six and 11 and in 65.5 % between 12 and 14 years of age. Neutropenia was detected in 25.6% of children below five years of age and in 50% aged between six and 11. Hypercholesterolemia was found in 13.1% of patients. The only statistically statistical associations were found between the TC and CD4 count in children aged six to 14 years (χ2=5.000; p=0.025) and between neutrophil counts and viral load in children aged six to 14 years (χ2=6.4532; p=0.0240). A significant association was also found between Hb levels and viral load (χ2=7.000; p=0.008). In the absence of baseline test results and routine monitoring of haematological and lipid profiles, this study presents a potential alternative marker for assessing lipid and haematological abnormalities using the highest level of neutrophil, Hb, TC and triglycerides recorded for each patient.
6

Análise econômica e da Influência sobre a morbimortalidade cardiovascular de estatinas e fibratos utilizados no tratamento de portadores de dislipidemia em Ribeirão Preto-SP / Economic analysis and influence on cardiovascular morbimortality of statins and fibrates used to treat patients with dyslipidemia in Ribeirao Preto-SP.

Marsola, Ana Paula Zambuzi Cardoso 12 November 2010 (has links)
As dislipidemias são importantes fatores de risco para desenvolvimento de Doenças Cardiovasculares (DCV) comprovado através de grandes estudos observacionais. Estudos demonstraram que a prescrição regular de hipolipemiantes (estatinas e fibratos) pode reduzir a ocorrência de eventos cardiovasculares e diminuir a mortalidade. Objetivou-se realizar uma análise econômica e a influência de atorvastatina, sinvastatina, bezafibrato e ciprofibrato sobre a morbimortalidade cardiovascular em indivíduos que fizeram uso destes medicamentos em 2007 dispensados no Programa de Medicamentos Excepcionais do Ministério da Saúde distribuídos pela Farmácia Ambulatorial do Hospital das Clínicas da FMRP-USP. Trata-se de um estudo observacional, descritivo e de caráter transversal. A casuística foi composta por 332 (31,11%) indivíduos sorteados aleatoriamente dentre 1067 pacientes (erro padrão de 5%), de ambos os sexos, encaminhados pelo Sistema Único de Saúde (SUS) e consultórios particulares. Os indivíduos selecionados foram submetidos a uma entrevista e seus prontuários médicos analisados. Dos 310 pacientes entrevistados, 157 (51%) eram do sexo masculino. A faixa etária variou de 15 a 63 anos (X= 62,0 ± 12,23). Constatou-se 5 óbitos em 2007, sendo 100% do sexo masculino, com idade variando de 57 a 74 anos (X= 68,2 ± 6,95). 227 (73,22%) pacientes fizeram uso de estatinas, 54 (17,42%) de fibratos e 31 (10%) controles (sem uso de medicamentos). De 246 (79,35%) indivíduos analisados, a média do índice de massa corpórea (IMC) foi >28,7 Kg/m2; 121 (39%) pacientes fizeram uso de sinvastatina, 104 (34%) atorvastatina, 25 (8%) ciprofibrato, 29 (9%) bezafibrato. O perfil lipídico apresentou-se mais elevado no grupo atorvastatina e bezafibrato. Em relação aos eventos e/ou procedimentos, houve um total de 253. 132 (52,17%) pacientes apresentaram aterosclerose documentada, 60 (23,71%), angina pectoris, 28 (11,47%) insuficiência cardíaca, 6 (2,44%) infarto agudo do miocárdio, 6 (2,44%) aneurisma arterial e 4 (1,62%) acidente vascular encefálico. Quanto aos procedimentos, constatou-se a realização de 11 cateterismos cardíacos e 7 angioplastias. Quanto à análise econômica, o tratamento do grupo atorvastatina apresentou o maior custo (R$994,69 paciente/ano), já no grupo da sinvastatina (R$337,61 paciente/ano) houve maiores gastos com exames laboratoriais e complementares. Entre o grupo dos fibratos não houve diferenças importantes com relação ao custo do tratamento. Conclui-se que entre os indivíduos estudados, prevaleceu a população idosa, maior número de óbitos no sexo masculino; houve a prevalência de sobrepeso/obesidade (IMC > 25 kg/m2); aterosclerose documentada e angina pectoris foram os eventos cardiovasculares predominantes e o cateterismo cardíaco o procedimento mais realizado. O tratamento com atorvastatina foi o mais oneroso, entretanto, seus pacientes apresentaram menor ocorrência de eventos e procedimentos cardiovasculares, além do menor custo com exames laboratoriais. / Dyslipidemias are a major risk factor for the development of cardiovascular diseases. Several studies have shown that regular prescribing of lipid-lowering drugs (statins and fibrates) can reduce cardiovascular events and decrease overall mortality. The objectives of this study were to perform a economic analysis and the influence of atorvastatin, simvastatin, bezafibrate or ciprofibrate on the cardiovascular morbimortality in individuals who used these drugs during the year of 2007, dispensed by the Outpatient Pharmacy of Clinical Hospital of FMRP-USP according to the Exceptional Medicines Program of Ministry of Health. This is an observational and descriptive study of transversal character. The sample was composed of 332 (31,11%) individuals, randomly selected among 1067 patients (standard error of 5%), of both sexes, living in Ribeirão Preto-SP conveyed by the Single System of Health (SUS) and private clinics. Individuals were submitted to an interview and had their medical records examined. Among the 310 patients interviewed, 157 (51%) were males with ages ranging from 15 to 63 years old (X= 62,0 ± 12,23). Five deaths were reported in 2007, and of those patients, 100% were males, with ages ranging from 57 to 74 years old (X= 68,2 ± 6,95). 227 (73,22%) patients were using statins, 54 (17,42%) fibrates and 31 (10%) controls (no use of drugs). The average of body mass index (BMI) of 246 (79,35%) patients evaluated was above 28,7 Kg/m2; 121 (39%) patients were using simvastatin, 104 (34%) atorvastatin, 25 (8%) ciprofibrate and 29 (9%) bezafibrate. The lipid profile was more elevated in atorvastatin and bezafibrate groups. A total of 253 events and/or procedures were found. 132 (52,17%) patients had atherosclerosis documented, 60 (23,71%) angina pectoris, 28 (11,47%) heart failure, 6 (2,44%) acute myocardial infarction, 6 (2,44%) arterial aneurysm, 4 (1,62%) vascular brain accident. Regarding the procedures, 11 cardiac catheterism and 7 angioplasties were verified. Regarding the economic analysis, atorvastatin treatment group showed to be the most expensive one (R$ 994,69 patient/year). For the simvastatin group (R$337,61 patient/year), there were increased costs for lab and complementary tests, while among the group of fibrates there were no substantial differences in the cost of treatments. It is concluded that among the evaluated individuals, there was a prevalence of elderly people, deaths of male patients and overweight (BMI > 25kg/m2). The presence of atherosclerosis and angina pectoris were the predominant cardiovascular events and the cardiac catheterism procedure was the most performed. Although treatment with atorvastatin was the most expensive, patients in that treatment had a lower incidence of cardiovascular events and procedures, and lower costs with lab and complementary tests.
7

Efeito da ingestão de grãos processados de quinoa por pacientes coronariopatas dislipêmicos

Silva, Vanessa Oliveira 01 December 2015 (has links)
Submitted by Fabíola Silva (fabiola.silva@famerp.br) on 2016-06-21T17:35:47Z No. of bitstreams: 1 vanessaoliveirasilva_dissert.pdf: 429106 bytes, checksum: 44bf78bbec8e150eef1119e341151324 (MD5) / Made available in DSpace on 2016-06-21T17:35:47Z (GMT). No. of bitstreams: 1 vanessaoliveirasilva_dissert.pdf: 429106 bytes, checksum: 44bf78bbec8e150eef1119e341151324 (MD5) Previous issue date: 2015-12-01 / Introduction: Quinoa (Chenopodium quinoa Willd) is a gluten-free pseudocereal with high biological value protein, low glycemic carbohydrates, phytosterols and omega 3 and 6 fatty acids. It originates from the Andes, where it has been consumed for thousands of years.The aim of this study was to determine the rates of outpatient serum lipids in coronary patients after ingestion of processed grain quinoa.This is a prospective study of twenty-seven outpatients 48-70 years of age (64.0 ± 8.4 years) who were treated for an average of 120– 200 days.Blood samples were collected before and after consumption of the cereal to determine the dyslipidemic profile of the group and the exams were attended.The results showed a positive effect of the use of quinoa once it has been observed a significant reduction in total cholesterol levels (P = 0.0008), triglycerides (P = 0.001) and LDL-c (p = 0.008). We conclude that the use of quinoa in the diet can be considered beneficial in the prevention and treatment of risk factors of cardiovascular diseases that are among the leading causes of death in the globalized world. / Introdução: A quinoa (Chenopodium quinoa Willd) é um pseudocereal isento de glúten, com proteína de alto valor biológico, carboidratos de baixo índice glicêmico, fitosteróis e ácidos graxos ômega 3 e 6. É originária dos Andes, onde vem sendo consumida há milhares de anos. O objetivo deste trabalho foi verificar as taxas de lipídeos séricos em pacientes coronariopatas ambulatoriais após a ingestão de grãos processados de quinoa. Trata-se de um estudo prospectivo com vinte e sete pacientes com 48 a 70 anos de idade (64,0 ± 8,4 anos), que foram tratados por 120 a 200 dias. As amostras de sangue foram coletadas antes e após o consumo do cereal para determinar o perfil lipidêmico do grupo e os exames foram acompanhados. Os resultados mostraram efeitos positivos do uso da quinoa já que se observou redução significante nos valores de colesterol total (P=0,0008), triglicérides (P=0,001) e LDL-c (P=0,008). Conclui-se que o uso da quinoa na alimentação pode ser considerado benéfico na prevenção e controle de fatores de risco de doenças cardiovasculares (DC) que estão entre as principais causas de morte no mundo globalizado.
8

Dislipidemia em pacientes com dermatomiosite juvenil / Dyslipidemia in patients with juvenile dermatomyositis

Katia Tomie Kozu 04 September 2012 (has links)
OBJETIVO: Avaliar a presença de dislipidemia em pacientes com dermatomiosite juvenil (DMJ) e seus possíveis fatores de risco. MÉTODO: 25 pacientes com DMJ foram comparados a 25 controles de acordo com dados demográficos, composição corporal, perfil lipídico, glicêmico, autoanticorpos e enzimas musculares. Foram avaliados os instrumentos de atividade da DMJ: Disease Activity Score (DAS), Childhood Myositis Assessment Scale (CMAS), Manual Muscle Testing (MMT), Myositis Disease Activity Assessment Analogue Scale (MYOACT) e Myositis Intention to Treat Activity Index (MYTAX). RESULTADOS: Perfil lipídico alterado foi encontrado em nove pacientes e quatro controles (36% vs. 16%, p=0,196). Os pacientes com DMJ demonstraram níveis significativamente mais elevados de triglicérides (TG) [80 (31-340) vs. 61 (19-182) mg/dl, p=0,011] e maior freqüência de baixos níveis de lipoproteínas de alta densidade (HDL) (28% vs. 4%, p=0,04) quando comparados aos controles. A mediana dos níveis de HDL foi significativamente menor nos pacientes com DMJ com dislipidemia comparados aos DMJ com perfil lipídico normal [29 (0-49) vs. 50 (39-72) mg/dL, p=0,0005], enquanto os níveis TG [128 (31-340) vs. 69 (46- 138) mg/dL, p=0,011] foram significativamente mais elevados no primeiro grupo. Foi observada uma maior freqüência de baixos níveis de HDL (77% vs. 0%, p=0,001) e de níveis elevados de TG (44% vs. 0%, p=0,01) e de colesterol total (CT) (33 vs. 0%, p=0,03) no grupo de pacientes com DMJ com dislipidemia. O anticorpo anti-LPL foi positivo em apenas um paciente com perfil lipídico alterado. Pacientes com DMJ com dislipidemia apresentaram níveis significativamente mais elevados de velocidade de hemossedimentação (VHS) (26 vs. 14,5 mm/1a hora, p=0,006), proteína C reativa (PCR) (2,1 vs. 0,4 mg/dL, p=0,01), DAS (6 vs. 2, p=0,008), MYOACT (0,13 vs. 0,01, p=0,012) e MYTAX 0,06 vs. 0, p=0,018) e escores mais baixos de CMAS (47 vs. 52, p=0,024) e MMT (78 vs. 80, p=0,001) comparados aos pacientes com DMJ sem dislipidemia. Os níveis de TG apresentaram correlações positivas com PCR (r=0,697, p=0,001), DAS (r=0,610, p=0,001), MYOACT (r=0,661, p=0,001) e MYTAX (r=0,511, p=0,008) e correlações negativas com CMAS (r= - 0,506, p=0,009) e MMT (r= - 0,535, p=0,005). Nenhuma diferença entre estes grupos foi encontrada em relação ao IMC, composição corporal, presença de lipodistrofia, anticorpos anti-LPL e terapêutica (doses atuais e cumulativas de prednisona, metotrexato e cloroquina) (p>0,05), exceto pela frequência significativamente mais elevada do uso de ciclosporina nos pacientes com DMJ dislipidêmicos (33% vs. 0%, p=0,03). CONCLUSÃO: A dislipidemia em pacientes com DMJ se caracterizou por elevação de níveis séricos de TG e diminuição de HDL, sendo a atividade da doença e o uso da ciclosporina os principais fatores associados a esta alteração metabólica / OBJECTIVE: To evaluate the presence of dyslipidemia in JDM and its possible risk factors. METHODS: 25 JDM patients were compared to 25 healthy controls according to demographic data, body composition, fasting lipoproteins, glycemia, insulin, antibodies and muscle enzymes. The following JDM scores were assessed: Disease Activity Score (DAS), Childhood Myositis Assessment Scale (CMAS), Manual Muscle Testing (MMT), Myositis Disease Activity Assessment Analogue Scale (MYOACT) and Myositis Intention to Treat Activity Index (MYTAX). RESULTS: Abnormal lipid profile was found in nine patients (36%) and four controls (16%) (p=0.196). JDM patients demonstrated significant higher levels of triglycerides (TG) [80 (31- 340) vs. 61 (19-182) mg/dL, p=0.011] and higher frequency of abnormal levels of high density lipoproteins (HDL) (28 vs. 4%, p=0.04) when compared to controls. JDM patients with dyslipidemia demonstrated significant lower median HDL levels compared to those without this condition [29 (0-49) vs. 50 (39-72) mg/dL, p=0.0005] and also had significant higher TG levels [128 (31- 340) vs. 69 (46-138) mg/dL, p=0.011]. Higher frequency of low HDL levels (77% vs. 0%, p=0.0001), and also a higher frequency of increased levels of TG (44% vs. 0%, p=0.01), and TC (33% vs. 0%, p=0.03) were observed in JDM patients with dyslipidemia. Positive anti-LPL antibody was detected in just one JDM patient with abnormal lipid profile. JDM with dyslipidemia had higher ESR (26 vs 14.5mm/1sthour, p=0.006), CRP (2.1 vs 0.4mg/dL, p=0.006), DAS (6 vs. 2, p=0.008), MYOACT (0.13 vs. 0.01, p=0.012), MYTAX (0.06 vs. 0, p=0.018), and lower scores of CMAS (47 vs. 52, p=0.024) and MMT (78 vs. 80, p=0.001) compared to JDM without dyslipidemia. Positive correlations were detected between TG levels and CRP (r=0.697, p=0.001), DAS (r=0.610, p=0.001), MYOACT (r=0.661, p=0.001), MYTAX (r=0.511, p=0.008), and negative correlations with CMAS (r=-0.506, p=0.009) and MMT (r=-0.535, p=0.005). No differences were found between these groups regarding body mass index, body composition, lipodystrophy, anti-LPL antibodies, and treatment (current and cumulative doses of prednisone, methotrexate and hydroxichloroquine) (p>0.05), except by higher frequency of cyclosporine use in patients with dyslipidemia (33 vs. 0%, p=0.03). CONCLUSIONS: Dyslipidemia in JDM patients was characterized by increased levels of TG and low levels of HDL, and disease activity and cyclosporine use were the mainly factors associated to these metabolic abnormalities
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Quais fatores estão associados ao excesso de peso e à dislipidemia em crianças menores de 7 anos num pequeno município do interior caracteristicamente rural?

Sponchiado, Francieli Cristina January 2017 (has links)
INTRODUÇÃO: As doenças do aparelho circulatório representaram nos últimos anos a principal causa de mortalidade no Brasil. Com início silencioso na infância e manifestações clínicas somente na fase adulta, tem sido evidenciada a necessidade de que os fatores de riscos associados sejam investigados neste período, visando instituir planos de intervenção mais efetivos com a perspectiva de reduzir a morbimortalidade no futuro. O estudo teve como objetivo verificar a prevalência de excesso de peso e de dislipidemia e seus fatores associados na população infantil do município de Vicente Dutra, caracteristicamente de uma zona de produção agrícola no noroeste do estado do Rio Grande do Sul. METODOLOGIA: Estudo transversal tipo censo populacional, realizado entre agosto de 2015 e novembro de 2016, incluindo 297 crianças, com idade entre 6 meses e 6 anos, residentes no município, recrutadas durante os atendimentos de puericultura nas duas unidades básicas de saúde e por meio de busca ativa pelos agentes comunitários de saúde. Para avaliar a ingestão alimentar foi utilizado o questionário de frequência alimentar. A classificação do excesso de peso foi por meio das curvas de crescimento de referência para idade e sexo da OMS (2006/2007), sendo adotado como ponto de corte para excesso de peso escore-Z +2 para as crianças menores de cinco anos e escore-Z +1 para as acima. A análise descritiva apresentou medidas de média e desvio padrão ou mediana e amplitude interquartílica para as variáveis quantitativas e frequências absolutas e relativas para as categóricas. Os testes qui-quadrado de Pearson ou exato de Fisher foram utilizados para verificar associação entre as variáveis categóricas e testes t de Student ou Mann-Whitney para comparar as variáveis quantitativas com distribuição simétrica e assimétrica. Foi adotado um intervalo de confiança de 95%. O trabalho obteve a aprovação no Comitê de Ética em Pesquisa do Hospital de Clínicas de Porto Alegre (1.661.099/2015) e autorização da Secretaria Municipal de Saúde de Vicente Dutra. Todos os responsáveis assinaram o TCLE. RESULTADOS: A prevalência de excesso de peso foi de 16,8% e de dislipidemia, 78,0%, foi alta mesmo em crianças eutróficas, quando avaliada uma alteração em pelo menos um dos lípides. A alteração no colesterol HDL foi a mais prevalente, atingindo 59,4% da população estudada, seguidas de 27,8% de alteração de CT, 6,6% de Colesterol LDL e 6,2% de TG. CONCLUSÃO: o excesso de peso e, em especial, as alterações nos níveis de perfil lipídico, sem considerar valores limítrofes e considerando crianças eutróficas, são preocupantes, sobretudo, num município onde, predominantemente, a população reside em zona rural e disporia de acesso à alimentação mais saudável. / INTRODUCTION: Circulatory system diseases represented on the previous years the main cause of mortality in Brazil. Quietly starting on infancy, it has clinical manifestations only on the adult phase. It has been highlighted the necessity of investigating the risk associated factors from that period, with the aim of instituting intervention plans that are more effective, aiming also to reduce the morbimortality on the future. This study had as it main objective to verify the prevalence of overweight and dyslipidemia and its associated factors in the children population of Vicente Dutra (a Brazilian town) – the town is located on an agricultural production zone on Rio Grande do Sul State. METHODOLOGY: It is a cross-sectional population type study, which happened between August 2015 and November 2015, which included 297 children aging between 6 months and 6 years of living, who live on that town. They were recruited during the attendance of childcare on two Unidades Básicas de Saúde (Basic Health Centers) and by searching with community health agents. In order to assess food intake we used a questionnaire of eating consumption frequency. The classification of overweight was through the reference growth curves for age and sex of World Health Organization (WHO) (2006/2007), being adopted as a cut-off point for overweight Z-score +2 for children under five years and Z-score +1 to the above. The descriptive analysis presented measures of mean and standard deviation or median and interquartile range for quantitative variables and absolute and relative frequencies for categorical variables. Pearson's chi-square test or Fisher's exact test were used to verify association between categorical variables and Student's t-test or Mann-Whitney test to compare quantitative variables with symmetric and asymmetric distribution. We used confidence interval of 95%. The work was approved by the Ethics Committee of the Hospital das Clínicas de Porto Alegre (Porto Alegre Clinical Hospital) (1.661.099/2015) and authorization of Vicente Dutra Health Secretary. All of the responsible have signed the TCLE. RESULTS: The prevalence of overweight was 16.8% and dyslipidemia, 78.0%, was high even in eutrophic children, when a change was observed in at least one of the lipids. The change in HDL cholesterol was the most prevalent, reaching 59.4% of the studied population, followed by a 27.8% change in CT, 6.6% LDL cholesterol and 6.2% TG. CONCLUSION: Excess weight and, especially, changes in lipid profile levels, without considering borderline values and considering eutrophic children, are of particular concern in a municipality where, predominantly, the population resides in rural areas and would have access to food more healthy.
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Dislipidemia em pacientes com dermatomiosite juvenil / Dyslipidemia in patients with juvenile dermatomyositis

Kozu, Katia Tomie 04 September 2012 (has links)
OBJETIVO: Avaliar a presença de dislipidemia em pacientes com dermatomiosite juvenil (DMJ) e seus possíveis fatores de risco. MÉTODO: 25 pacientes com DMJ foram comparados a 25 controles de acordo com dados demográficos, composição corporal, perfil lipídico, glicêmico, autoanticorpos e enzimas musculares. Foram avaliados os instrumentos de atividade da DMJ: Disease Activity Score (DAS), Childhood Myositis Assessment Scale (CMAS), Manual Muscle Testing (MMT), Myositis Disease Activity Assessment Analogue Scale (MYOACT) e Myositis Intention to Treat Activity Index (MYTAX). RESULTADOS: Perfil lipídico alterado foi encontrado em nove pacientes e quatro controles (36% vs. 16%, p=0,196). Os pacientes com DMJ demonstraram níveis significativamente mais elevados de triglicérides (TG) [80 (31-340) vs. 61 (19-182) mg/dl, p=0,011] e maior freqüência de baixos níveis de lipoproteínas de alta densidade (HDL) (28% vs. 4%, p=0,04) quando comparados aos controles. A mediana dos níveis de HDL foi significativamente menor nos pacientes com DMJ com dislipidemia comparados aos DMJ com perfil lipídico normal [29 (0-49) vs. 50 (39-72) mg/dL, p=0,0005], enquanto os níveis TG [128 (31-340) vs. 69 (46- 138) mg/dL, p=0,011] foram significativamente mais elevados no primeiro grupo. Foi observada uma maior freqüência de baixos níveis de HDL (77% vs. 0%, p=0,001) e de níveis elevados de TG (44% vs. 0%, p=0,01) e de colesterol total (CT) (33 vs. 0%, p=0,03) no grupo de pacientes com DMJ com dislipidemia. O anticorpo anti-LPL foi positivo em apenas um paciente com perfil lipídico alterado. Pacientes com DMJ com dislipidemia apresentaram níveis significativamente mais elevados de velocidade de hemossedimentação (VHS) (26 vs. 14,5 mm/1a hora, p=0,006), proteína C reativa (PCR) (2,1 vs. 0,4 mg/dL, p=0,01), DAS (6 vs. 2, p=0,008), MYOACT (0,13 vs. 0,01, p=0,012) e MYTAX 0,06 vs. 0, p=0,018) e escores mais baixos de CMAS (47 vs. 52, p=0,024) e MMT (78 vs. 80, p=0,001) comparados aos pacientes com DMJ sem dislipidemia. Os níveis de TG apresentaram correlações positivas com PCR (r=0,697, p=0,001), DAS (r=0,610, p=0,001), MYOACT (r=0,661, p=0,001) e MYTAX (r=0,511, p=0,008) e correlações negativas com CMAS (r= - 0,506, p=0,009) e MMT (r= - 0,535, p=0,005). Nenhuma diferença entre estes grupos foi encontrada em relação ao IMC, composição corporal, presença de lipodistrofia, anticorpos anti-LPL e terapêutica (doses atuais e cumulativas de prednisona, metotrexato e cloroquina) (p>0,05), exceto pela frequência significativamente mais elevada do uso de ciclosporina nos pacientes com DMJ dislipidêmicos (33% vs. 0%, p=0,03). CONCLUSÃO: A dislipidemia em pacientes com DMJ se caracterizou por elevação de níveis séricos de TG e diminuição de HDL, sendo a atividade da doença e o uso da ciclosporina os principais fatores associados a esta alteração metabólica / OBJECTIVE: To evaluate the presence of dyslipidemia in JDM and its possible risk factors. METHODS: 25 JDM patients were compared to 25 healthy controls according to demographic data, body composition, fasting lipoproteins, glycemia, insulin, antibodies and muscle enzymes. The following JDM scores were assessed: Disease Activity Score (DAS), Childhood Myositis Assessment Scale (CMAS), Manual Muscle Testing (MMT), Myositis Disease Activity Assessment Analogue Scale (MYOACT) and Myositis Intention to Treat Activity Index (MYTAX). RESULTS: Abnormal lipid profile was found in nine patients (36%) and four controls (16%) (p=0.196). JDM patients demonstrated significant higher levels of triglycerides (TG) [80 (31- 340) vs. 61 (19-182) mg/dL, p=0.011] and higher frequency of abnormal levels of high density lipoproteins (HDL) (28 vs. 4%, p=0.04) when compared to controls. JDM patients with dyslipidemia demonstrated significant lower median HDL levels compared to those without this condition [29 (0-49) vs. 50 (39-72) mg/dL, p=0.0005] and also had significant higher TG levels [128 (31- 340) vs. 69 (46-138) mg/dL, p=0.011]. Higher frequency of low HDL levels (77% vs. 0%, p=0.0001), and also a higher frequency of increased levels of TG (44% vs. 0%, p=0.01), and TC (33% vs. 0%, p=0.03) were observed in JDM patients with dyslipidemia. Positive anti-LPL antibody was detected in just one JDM patient with abnormal lipid profile. JDM with dyslipidemia had higher ESR (26 vs 14.5mm/1sthour, p=0.006), CRP (2.1 vs 0.4mg/dL, p=0.006), DAS (6 vs. 2, p=0.008), MYOACT (0.13 vs. 0.01, p=0.012), MYTAX (0.06 vs. 0, p=0.018), and lower scores of CMAS (47 vs. 52, p=0.024) and MMT (78 vs. 80, p=0.001) compared to JDM without dyslipidemia. Positive correlations were detected between TG levels and CRP (r=0.697, p=0.001), DAS (r=0.610, p=0.001), MYOACT (r=0.661, p=0.001), MYTAX (r=0.511, p=0.008), and negative correlations with CMAS (r=-0.506, p=0.009) and MMT (r=-0.535, p=0.005). No differences were found between these groups regarding body mass index, body composition, lipodystrophy, anti-LPL antibodies, and treatment (current and cumulative doses of prednisone, methotrexate and hydroxichloroquine) (p>0.05), except by higher frequency of cyclosporine use in patients with dyslipidemia (33 vs. 0%, p=0.03). CONCLUSIONS: Dyslipidemia in JDM patients was characterized by increased levels of TG and low levels of HDL, and disease activity and cyclosporine use were the mainly factors associated to these metabolic abnormalities

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