Made available in DSpace on 2014-08-20T14:30:10Z (GMT). No. of bitstreams: 1 Dissertacao_alessandro_menna_alves.pdf: 813449 bytes, checksum: 43f43131b0d8e54633d172ea87ffa722 (MD5) Previous issue date: 2013-03-18 / This dissertation was divided into two distinct works, which can be summarized as follows: Article 1: The oral squamous cell carcinoma (OSCC) is the most prevalent malignance in mouth, being an important public health problem. The aim of this study was to evaluate the clinical and epidemiological profile of the OSCC cases registered in a center of clinical and histopathological diagnosis, located in Southern Brazil. Eight hundred and six individuals with OSCC and its variants were included in this study, over 1959-2012 period. The variables recorded from the files were: age, gender, skin color, tumor location, size and evolution time of the lesions (referred by the patients), as well as, the presence of pain lymph nodes, habits of tobacco and alcohol, and also the profession. OSSC was more frequent in males (76.6%), with the majority of cases distributed between 51 and 70 years old (53.9%). The most prevalent sites were lower lip vermilion [23.3% (20.4; 26.4)], followed by lateral border/ventral surface of the tongue [20.2% (17.5; 23.2)], gingiva/alveolar ridge [18.1% (15.5; 21.0)], and floor of the mouth [14.9% (12.5; 17.5)]. A strong association between outdoor occupation and OSCC in lower lip vermilion was found. The OSCC lesions located in tongue, gingiva/alveolar ridge and floor of the mouth were commonly more painful, bigger than 2 cm, and frequently presenting lymph nodes involvement. Most of the results confirm the data from literature. Mouth self-examination should be recommended and campaigns of prevention and early detection of OSCC should be periodically performed in order to increase people s feelings of personal risk. Article 2: Inside the tumor microenvironment (TM) the neoplastic cells are in dynamic crosstalk with the vascular and lymphatic endothelial cells in order to allow the tumor to growth and metastasize. Hypothesizing that there is a crosstalk between lymphatic endothelial cells and tumor cells from squamous cell carcinoma (SCC) that plays an important role in metastasis, we aimed to identify potential interactions between lymphatic endothelial cells and tumor cells lines from SCCs, through some in vitro assays. Primary adult human dermal lymphatic microvascular endothelial cells (HMVECs) and the human head and neck SCC cell lines like A431, UM-SCC-1, UM-SCC-22A and UM-SCC-22B were cultured in their specific media. UM-SCC cells lines were treated with rhIL-6, being VEGF-C expression checked by Elisa. Baseline IL-6 was evaluated in HMEVCs using the same assay. Also the IL-6 receptor (IL-6R) was analyzed by Western blot in UM-SCC cells. Conditioned media from HMVECs were prepared with different treatments and incubated with SCC A431 cells, in order to verify the MMPs enzymatic activities by gelatin zymography. Our results demonstrated that there are interactions between tumor cells and LECs, since the LECs-CM were able to enhance MMP-2 gelatinolytic activity. Moreover, we showed that LECs secrete IL-6, and different SCC lines have receptors for this cytokine. Therefore, our results indicate some potential interactions between LECs and TCs, being necessary other studies to elucidate the involved signaling pathways / Esta dissertação foi dividida em dois trabalhos distintos, os quais podem ser resumidos da seguinte maneira: Artigo 1: O carcinoma espinocelular oral (CEO) é o tumor maligno mais prevalente na cavidade oral, sendo um importante problema de saúde pública. O objetivo deste estudo foi avaliar o perfil clínico e epidemiológico dos casos registrados de CEO em um centro de diagnóstico clínico e histopatológico, localizado no Sul do Brasil. Oitocentos e seis indivíduos com CEO e suas variantes histológicas foram incluídos neste estudo, num período entre 1959 e 2012. As variáveis anotadas dos arquivos foram: idade, sexo, cor da pele, sítio, tamanho, tempo de evolução (relatado pelo paciente), assim como a presença de dor, linfonodos palpáveis, hábitos de tabagismo e etilismo, e a profissão. CEO foi mais prevalente em homens (76,6%), com a maioria dos casos distribuídos entre os 51 e 70 anos de idade (53,9%). Os sítios mais prevalentes foram vermelhão do lábio inferior [23,3% (20,4; 26,4)], seguido por borda lateral/ventre de língua [20,2% (17,5; 23,2)], gengiva/rebordo alveolar [18,1% (15,5; 21,0)], e assoalho bucal [14,9% (12,5; 17,5)]. Foi encontrada uma forte associação entre ocupações ao ar livre e CEO de vermelhão de lábio inferior. As lesões localizadas na língua, gengiva/rebordo alveolar e assoalho bucal foram comumente mais dolorosas, maiores que 2 cm, a frequentemente apresentavam envolvimento de linfonodos. A maioria dos nossos resultados confirmam os dados da literatura. O autoexame bucal deveria ser recomendado e campanhas de prevenção e detecção precoce do CEO deveriam ser realizadas periodicamente na tentativa de aumentar o sentimento pessoal em relação ao CEO. Artigo 2: Dentro do microambiente tumoral (MT), as células neoplásicas estão numa constante crosstalk com células endoteliais linfáticas (CELs) e sanguíneas a fim de permitir o crescimento tumoral e metástase. Supondo que haja um crosstalk entre as CELs e as células do carcinoma espinocelular (CE) que exerce um importante papel na metástase, nosso objetivo foi identificar potenciais interações entre as CELs e linhagens celulares de CE, através de alguns ensaios in vitro. Células endoteliais linfáticas primárias adultas humanas da microvasculatura dérmica (HMVECs) e as linhagens de CE A431, UM-SCC-1, UM-SCC-22A e UM-SCC-22B foram cultivadas nos seus meios específicos. UM-SCC foram tratadas com rhIL-6, sendo a expressão de VEGF-C verificada por Elisa. Produção natural de IL-6 pelas HMVECs foi avaliada da mesma maneira. A presença de receptor de IL-6 (IL-6R) foi analisada por Western Blot nas linhagens UM-SCC. Meios condicionados(MC) das HMVECs foram preparados com diferentes tratamentos e incubados com a linhagem A431, a fim de verificar a atividade genatinolítica das MMPs por zimografia. Nossos resultados demonstraram que há interações entre as células tumorais e as CELs, uma vez que MC-CELS foram capazes de aumentar a atividade genatinolítica da MMP-2. Além disso, nós mostramos que as CELs secretam IL-6, e diferentes linhagens de CE possuem receptores para esta citocina. Sendo assim, nossos resultados indicam potenciais interações entre as LECs e as células tumorais, sendo necessário outros estudos para elucidar as vias de sinalização envolvidas

Hur förändras gudsbilden vid svåra livshändelser? Vad innebär förändringen (för tron/för den troende)? Syftet med denna uppsats är att bidra till att undersöka frågeställningen genom en enkätundersökning, samt reflektera över frågan och resultatet i relation till systematiskt teologiska röster.Tolv präster och pastorer har generöst delat med sig av sina erfarenheter och tankar i en enkätundersökning. Resultatet av denna empiriska undersökning visar gemensamma drag för de svarande vad gäller förändringens riktning, även om det mellan svaren finns olikheter. Undersökningen stannar inte vid upplevelsen av Guds frånvaro som många upplever mitt i svåra livshändelser, utan tar upp gudsbildens förändring som den beskrivs över tid i relation till svåra livshändelser.Med utgångspunkt i Paul Tillich teologi om tro kan den empiriska undersökningens resultat beskrivas som trosutveckling. I resultatet finns riktningen från förklaring till upplevelse, teologerna Mäster Eckehart och Simone Weil har använts för att reflektera kring detta. En jämförande tolkning med Sofia Camnerin och C. S. Lewis självbiografiska berättelser visar att det finns paralleller till enkätundersökningens resultat. Den bild som framträder utifrån resultatet av 12 enkätsvar och systematisk teologisk analys är att det finns en väg mot tillit när en människa möter svåra livshändelser.

Som tandhygienist är det mycket intressant att studera karies-epidemiologiska undersökningar på både nationell och internationell nivå. Syftet med denna litteraturstudie är att beskriva och jämföra kariesstatus (DMFT) hos 12-åringar i Sverige och Irak, och några av de faktorer som kan påverka DMFT komponenternas roll och inverkan.För att besvara syftet användes information från litteratur och tidskrifter samt WHO:s databas om länderna. Resultatet visar att DMFT för 12-åringar i Irak var 1.7 (2003) och i Sverige 1.0 (2005). DT-komponenten, d.v.s. obehandlad karies, var hög hos irakiska barn medan FT- komponenten var hög för danska barn (inga data tillgängliga för Sverige). DMFT-medelvärde, sockerkonsumtion, ekonomiska resurser för tandvård, antal tandvårdpersonal och fluorprogram var mycket olika i Sverige och Irak, men differensen i DMFT var ändå inte markant. / As a dental hygienist it is relevant to study caries epidemiological studies on both national and international levels. The purpose of this literature study has been to describe and compare dental caries status (DMFT) of 12 years olds in Sweden and Iraq and the factors underlying the DMFT and DMFT components and facilitating role. To achieve the objective information from scientific literature and publications, and data from WHO database on these countries were used. Results showed that the DMFT for 12 year olds in Iraq and Sweden was 1.7(2003), 1.0 (2005) respectively. DT component was high among Iraqi children (untreated caries) while the FT component was high in Denmark, (no data was available for Sweden). DMFT mean, sugar consumption, economic resources for dental care, number of dental health professionals, and fluoride applications were very different in Sweden and Iraq, yet DMFT difference was not marked and serious.

Background: Numerous epidemiological studies have demonstrated a possible correlation between high temperature and mortality in different settings. Most of these studies have focused on urban settings in industrialized countries, concluding that urban populations are more vulnerable to heat effects than rural populations. This has mainly been attributed to the urban heat island (UHI) effect, a phenomenon which explains the elevated temperatures in urban areas. Others have contradicted this finding and concluded that rural residents are more vulnerable. For this study, we test the hypothesis that rural populations and sub-populations are also vulnerable to heat mortality. Method: A comprehensive literature search was conducted using PubMed, Web of Science and Google Scholar to identify peer-reviewed studies investigating heat mortality in rural settings. Using keywords and a set of rigorous inclusion and exclusion criteria, ten studies were selected. Meta-analysis was then performed using the Comprehensive MetaAnalysis V3.exe software. Results and discussion: The pooled relative risk (RR) was 1.191 (95% confidence interval: 1.130-1.251). Although rural populations may not be exposed to as high temperatures as urban populations, they remain vulnerable to heat effects. Conclusion: There is evidence of heat vulnerability in rural populations and subpopulations. Heat vulnerability is not only determined by heat exposure, but also by sensitivity and adaptive capacity. Rural populations and sub-populations may be vulnerable to heat mortality due to low adaptive capacity. Further studies are needed to assess risk factors that predispose rural populations and sub-populations to heat mortality in order to develop effective public health interventions.

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