Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

The objectives of this thesis are: a) To examine racial/ethnic differences in coronary artery calcification (CAC) and CAD, between symptomatic South Asians and Caucasians, matched for age, gender and conventional cardiovascular risk factors, b) To assess, using a meta-analysis model, the natural history of and stability of measurements of coronary artery calcium scoring (CACs) based on data collected from two large published trials: St Francis and EBEAT, c) To investigate the prevalence of coronary artery calcification in individuals with CT evidence for AVC, mitral valve calcification (MAC) or of both of them (AVC+MAC), d) To assess any potential association between premature CAD (<55 years in first-degree male relatives and <65 years in first-degree female relatives) and CAC in a large cohort of asymptomatic individuals. We found that coronary artery calcification is more extensive and diffuse in symptomatic patients of South Asian ethnic origin as compared to Caucasians, despite similar conventional risk factors for CAD. This is more evident in those >50 years of age, suggesting potential genetic or other risk factors yet to be determined. The natural history of coronary artery calcification was overtime progression in the majority of subjects, irrespective of gender. The higher variability in RCA measurements could be related to the low baseline CACs or exaggerated movement of the right side atrioventricular ring, whereas those for LCA brances are influenced by the branch allocation of the CACs. Valve calcification is not isolated but involve also and the coronary arteries. The presence of calcification in the aortic valve or combined aortic and mitral valves predicted coronary artery calcification. Additionally patients in whom both valves have become calcified tend to have severe coronary artery calcification. And finally, there is no relationship between the prevalence and extent of coronary artery calcification and the presence of family history of coronary heart disease in asymptomatic individuals with none of the conventional risk factors for atherosclerosis.

CoordenaÃÃo de AperfeÃoamento de Pessoal de NÃvel Superior / A tese parte da histÃria da famÃlia Sousa, durante meados do sÃculo XX e XXI, em Juazeiro do Norte, para reconstruir a histÃria da cidade, demarcando a presenÃa afrodescendente e sua importÃncia no desenvolvimento cultural, urbano de Juazeiro do Norte. Tem como objetivo contribuir para o desenvolvimento e a sistematizaÃÃo do campo teÃrico da AfrodescendÃncia, um campo de pesquisa que parte da particularidade, do local, em busca de construir uma histÃria da populaÃÃo afrodescendente produzida por ela mesma, e onde os protagonistas sejam esta populaÃÃo e seus ancestrais que construÃram e constroem a riqueza deste paÃs. A tese tem como objetivo principal ser mais um instrumento de luta e teÃrico para a implementaÃÃo da lei 10.639/2003, que estabelece a obrigatoriedade do ensino de histÃria e cultura afro-brasileira e africana na educaÃÃo bÃsica, na medida em que esta tese subsidia a produÃÃo de material didÃtico. Metodologicamente traÃamos um caminho particular que entrelaÃa as metodologias advindas da revoluÃÃo historiogrÃfica da escola dos Annales: autobiografia, histÃrias de vida, narrativas, oralidade, memÃrias de velhos, fotografias... ao uso das redes sociais virtuais para construir a histÃria do tempo presente, numa perspectiva fundamentada na importÃncia do desenvolvimento da AfrodescendÃncia como campo de saber. E neste sentido, rever a histÃria da populaÃÃo afrodescendente no CearÃ, inscrevendo-a num perÃodo em que a produÃÃo historiogrÃfica existente a invizibilizou.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2017-03-27T13:27:24Z No. of bitstreams: 2 Dissertação - Marilda Aparecida do Nascimento Souza - 2016.pdf: 2356436 bytes, checksum: a957e23bb1a3bdd13c4601abcd76f854 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-03-27T13:28:08Z (GMT) No. of bitstreams: 2 Dissertação - Marilda Aparecida do Nascimento Souza - 2016.pdf: 2356436 bytes, checksum: a957e23bb1a3bdd13c4601abcd76f854 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-03-27T13:28:08Z (GMT). No. of bitstreams: 2 Dissertação - Marilda Aparecida do Nascimento Souza - 2016.pdf: 2356436 bytes, checksum: a957e23bb1a3bdd13c4601abcd76f854 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-08-12 / INTRODUCTION: The main risks factors of dementia are: aging, medical comorbidities and genetic risk. Genetic factors are very important in the investigation of dementia. A positive family history and genetic factors associated can influence the age of onset of the disease. OBJECTIVES: To investigate the prevalence of family history in dementiating degenerative syndromes. To analyze the cognitive and functional performance of these patients to determine whether the positive FH is related to the early onset of the disease, to assess the prevalence of positive FH by dementia subtype, to compare the profile sociodemographic patients with degenerative dementia with family history and no family history and observe which group had more severe dementia. METHODS: This is a cross-sectional study, conducted in the memory clinic of a university hospital in Central Brazil . Were assigned 483 patients with a diagnosis of dementia, from May 2015 to May 2016. This study evaluated the sociodemographic variables, pre- existing diseases and FH of dementia, through a semi-structured interview. To analyze the cognitive level and functional capacity was used the Mini-mental state examination - MMSE and Pfeffer Questionnaire. The Clinical Dementia Rating - CDR was used to assess the severity of dementia. RESULTS: Of the 483 selected participants, 63.8% were women; the average age at evaluation was 74 years, most with low education (32.7%). We found that 45.5% of patients have an affected relative, mostly among simblings, and the age of onset of dementia is lower in people who have positive HF. Positive FH was greater in Huntington's disease 88.8%, followed by Semantic Dementia (66.7%) and primary progressive aphasia (66.7%). CONCLUSION: Family history proved very common in all types of dementia in our sample, mainly in Huntington's disease, followed by frontotemporal lobar degenerations. / INTRODUÇÃO: Entre os riscos para o surgimento das demências estão o envelhecimento, as comorbidades médicas e o risco genético. Fatores genéticos são muito relevantes na investigação das síndromes demenciais. História familiar (HF) positiva e fatores genéticos associados podem influenciar a idade de início da demência. OBJETIVOS: Investigar a prevalência de história familiar em síndromes degenerativas demenciantes; analisar o desempenho cognitivo e funcional desses pacientes; verificar se a HF positiva está relacionada com o inicio precoce da doença; avaliar a prevalência de HF positiva por subtipo de demência; comparar o perfil sociodemográfico de pacientes com demência degenerativa com HF e sem HF e verificar em qual grupo a demência foi mais grave. MÉTODOS: Trata-se de um estudo transversal, realizado no ambulatório de transtornos cognitivos de um hospital universitário, no Brasil Central, realizado em 483 pacientes com o diagnóstico de Demência, no período de maio de 2015 a maio de 2016. Foram avaliadas as variáveis sociodemográficas, as doenças pré-existentes e HF de demência, através de uma entrevista semiestruturada. Para análise do estado cognitivo e da capacidade funcional foram utilizados o Mini Exame do Estado Mental – MEEM e o questionário de atividades funcionais de Pfeffer. O Clinical Dementia Rating – CDR foi utilizado para verificar a gravidade da demência. RESULTADOS: Dos 483 participantes selecionados, 63,8% eram mulheres, com aproximadamente 74 anos, a maioria (32,7%) com baixíssima escolaridade. Do total de pacientes entrevistados, 45,5% possuem um familiar com a mesma doença, sendo o irmão o que mais apresentou alterações cognitivas semelhantes às do entrevistado. A idade de início da demência é menor em pessoas que possuem HF positiva. Entre os tipos de demências mais prevalentes, relacionadas à HF, foram identificadas a doença de Huntington (88,8%), seguida pela Demência Semântica (66,7%) e Afasia Primária Progressiva (66,7%). CONCLUSÃO: A HF positiva mostrou-se frequente nos casos de demência nesta amostra. O tipo de demência que mais apresentou essa herdabilidade foi a Doença de Huntington, seguida pelas degenerações lobares frontotemporais.

Made available in DSpace on 2016-03-15T19:39:44Z (GMT). No. of bitstreams: 1 Ana Ligia Andrade Silva Coelho.pdf: 492784 bytes, checksum: 7ecbb1692423dac9a848dd26cc1bcb24 (MD5) Previous issue date: 2011-08-01 / Fundo Mackenzie de Pesquisa / Education of Youth and Adults (EJA) is part of LDB 9.424/1996 and classified as part of Basic Education, presented in many cases as the only alternative of social inclusion for pupils out of mainstream education. Theoretical review was based in Vygotsky, who has shown the importance of social integration as a source of knowledge and mediation in learning processes and that mediators role may and must be played by parents and teachers. Features of Education of Youth and Adults in Brazil are analysed via interviews with four EJA pupils from a private institution in São Paulo city, presenting their history of learning difficulties. Investigation family and school life history of those pupils as well as recovering their experiences, it was possible to reference them to their present difficulties. Results may be used to help in improvement of educational practice and methodological proposals of EJA programs, to adequate them to its population reality. / A Educação de Jovens e Adultos (EJA) está prevista na LDB 9.424/1996 e classificada como parte integrante da Educação Básica, apresentando-se, em muitos casos, como a única alternativa de inclusão social para os alunos que já estão fora do sistema de ensino. O referencial bibliográfico deste estudo baseia-se em Vygotsky, que demonstrou a importância da integração social como fonte do conhecimento e da mediação no processo de aprendizagem, e que o papel de mediadores pode, e deve ser desempenhado pelos pais e professores. São analisadas aqui as características dos alunos da Educação de Jovens e Adultos no Brasil a partir de entrevistas com quatro alunos de EJA de uma instituição particular da cidade de São Paulo, destacando suas histórias de dificuldades de aprendizagem. Investigando a história de vida familiar e escolar desses alunos e resgatando suas experiências, foi possível referenciá-las com as dificuldades que enfrentam no presente. Os resultados obtidos devem servir de auxílio no aperfeiçoamento das práticas pedagógicas e propostas metodológicas dos Programas de EJA, a fim de adequá-las à realidade desse público-alvo.

Made available in DSpace on 2016-03-15T19:39:54Z (GMT). No. of bitstreams: 1 Rodrigo Romano de Araujo.pdf: 2203426 bytes, checksum: 9bae67b1181f0d77ed7c6f32a29480ca (MD5) Previous issue date: 2012-08-14 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The Identification of the signs and symptoms of Autism Spectrum Disorders (ASD) in childhood and the search for an accurate diagnosis by health professionals are key factors for early treatment for children with this condition. This study aimed to develop a methodology to analyze the trajectory of parents with children with ASD searching for diagnosis and treatment in health services in the city of Barueri, State of São Paulo. For this purpose, it was developed a quantitative and qualitative questionnaire, gradually improved by the application in a sample of 38 pilot cases, consisting of mothers or primary caregivers of children with ASD and involved in its making the participation of a multidisciplinary team. The composition of the instrument produced a final document, which enabled a definition of educational and socioeconomic profiles of the sample: 89% of families are among the classes D and C and allowed the analysis on the different aspects of this trajectory, such as: the time elapsed until a definitive diagnosis, which is generally delayed; the average number of health professionals involved in this process, which is five; the professional activity related to referrals and guidance, as well as the identification of medical specialty to raise the first suspicion of ASD: despite the pediatricians are the first professionals to observe the child, they are among the last to raise the diagnostic suspicion; the access for an appropriate treatment, which 44% believe that there were no significant difficulties; the degree of satisfaction in the use of public services, 73% are satisfied or completely satisfied; and to answering questions regarding the impact on the family of having a child with ASD, which includes the social isolation that especially mothers may be subject, 66% and the coping strategies used by the families in situations of adversity related to the child: the search for religious and/or spiritual support, 55%, is more frequent than compared to other sources of social support. / A identificação dos sinais e sintomas dos Transtornos do Espectro do Autismo (TEA) na infância e a busca de um diagnóstico preciso por parte dos profissionais da saúde são fatores fundamentais para o tratamento precoce para crianças com essa condição. O presente trabalho teve como objetivo geral desenvolver uma metodologia para a análise da trajetória de pais com filhos com TEA na busca de diagnóstico e tratamento em serviços de saúde no município de Barueri do Estado de São Paulo. Para tanto, desenvolveu-se um questionário quanti-qualitativo, gradativamente aprimorado pela aplicação em uma amostra composta por 38 casospiloto, constituída por mães ou principais responsáveis de filhos com TEA e que envolveu em sua confecção a participação de uma equipe multidisciplinar. A composição do instrumento produziu um documento final otimizado, que viabilizou uma definição do perfil educacional e socioeconômico dos sujeitos de pesquisa, constatando-se que 89% das famílias situam-se entre as classes D e C, e que possibilitou a análise de diversos aspectos componentes dessa trajetória, tais como: o tempo transcorrido até a definição diagnóstica, sendo este de modo geral tardio; a quantidade média de cinco profissionais da saúde envolvidos nesse processo; a atuação profissional referente aos encaminhamentos e orientações assim como a identificação da especialidade médica quanto à primeira suspeita diagnóstica de TEA, verificando-se que os pediatras são os primeiros profissionais a observarem a criança, mas estão entre os últimos a levantarem a suspeita diagnóstica; os desafios para a inserção em um tratamento adequado em que 44% consideram que não existiram dificuldades relevantes; o grau de satisfação na utilização dos serviços públicos e gratuitos onde 73% estão satisfeitos ou completamente satisfeitos; além de responder questões referentes ao impacto no âmbito familiar de se ter um filho com TEA, dentre as quais o isolamento social que especialmente as mães, 66% delas, podem estar sujeitas, e as estratégias de coping utilizadas pelas famílias para enfrentar situações de adversidade em relação ao filho, notando-se que 55% buscam por apoio religioso e/ou espiritual, característica mais frequente do que comparada a outras fontes de apoio social.

Abstract A non-ischemic etiology of sudden cardiac death (SCD), mostly due to various cardiomyopathies (CMP), accounts for about 20% of all SCDs. Most of the major studies of risk factors for SCD have focused on coronary artery disease (CAD). The aim of the present study was to clarify the characteristics of non-ischemic SCD in Northern Finland. In this study, consecutive victims of SCD (n=2661) were prospectively collected, and among whom post-mortem examinations were performed between 1998 and 2007. Information about the SCD victims was obtained from a combination of available medical records, postmortem examination reports, medication used at the time of SCD, and standardized questionnaire filled out by the closest family members of the victims of SCD. We also screened the candidate genes from a Finnish family in which fatal arrhythmias was first manifestation of a cardiac disease. The collagen content of the myocardium from histological samples in victims of SCD due to idiopathic myocardial fibrosis (IMF) was also evaluated. CAD was the most common cause of death (2082 victims, 78.2%). The prevalence of non-ischemic SCDs was 21.8% of all the SCDs. After sub-grouping the non-ischemic SCDs into various categories, the most common cause of death was CMP related to obesity (23.7%), followed by alcoholic CMP (19.0%), hypertensive CMP (15.5%) and IMF (13.6%). The association of SCD with IMF is notably frequent among victims <40 years old (28.3%). The prevalence of family history of SCD was significantly higher in the victims of ischemic (34.2%) than non-ischemic SCD (13.4%, P<0.001) or controls (17.6%, P<0.001). Lamin A/C gene mutation R541C was found from Finnish SCD family, in which the IMF was predominant pathologic-anatomic finding. Myocardial type I collagen synthesis was increased in victims of SCD due to IMF. In conclusion, the characteristics of non-ischemic SCD in Finland differ from those reported previously. Higher prevalences of CMP-associated SCDs related to obesity, IMF and alcoholic CMP were observed as clinical and/or pathologic bases for non-ischemic SCD. The family history of SCD is not significantly increased in victims of non-ischemic SCD, suggesting a larger role of sporadic occurrence than inherited traits as the cause of non-ischemic SCD. Replacement of cardiac myocytes by fibrosis can be responsible for fatal cardiac arrhythmias in subjects with the lamin A/C gene mutation. The victims of SCD due to IMF have increased myocardial type I collagen synthesis. / Tiivistelmä Ei-iskeeminen sydänperäinen äkkikuolema aiheuttaa noin 20 % kaikista sydänperäisistä äkkikuolemista. Suurin osa ei-iskeemisistä sydänperäisistä äkkikuolemista johtuu erilaisista sydänlihassairauksista, kardiomyopatioista. Useimmat sydänperäisen äkkikuoleman riskitekijöitä kartoittavista tutkimuksista ovat keskittyneet sepelvaltimotautiin. Tämän tutkimuksen tarkoituksena oli selvittää ei-iskeemisen sydänperäisen äkkikuoleman tunnuspiirteitä pohjoissuomalaisessa väestössä. Tutkimuksessa käytettiin potilasaineistona sydänperäiseen äkkikuolemaan menehtyneitä vainajia (n=2661), joille on tehty oikeuslääketieteellinen ruumiinavaus. Tiedot vainajista saatiin saatavilla olevista potilaskertomuksista, ruumiinavauspöytäkirjoista, äkkikuoleman aikaisesta lääkityksestä ja lähiomaisille lähetetystä standardisoidusta kyselylomakkeesta. Kandidaattigeenit tutkittiin pohjoissuomalaisesta perheestä, jossa ensimmäinen oire sydänsairaudesta oli hengenvaarallinen rytmihäiriö. Lisäksi sydänlihaksen kollageenikoostumus analysoitiin histologisista näytteistä potilailta, joiden sydänperäinen äkillinen kuolema johtui idiopaattisesta sydänlihaksen sidekudoskasvusta. Sepelvaltimotauti oli yleisin sydänperäisen äkkikuoleman aiheuttaja (n=2082, 78,2 %). Ei-iskeemisten sydänperäisten äkkikuolemien osuus oli 21,8 % (n=579) kaikista sydänperäisistä äkkikuolemista. Ei-iskeemiset sydänperäiset äkkikuolemat jaettiin alaryhmiin, joista yleisimmät olivat lihavuuteen assosioituva kardiomyopatia (23,7 %), alkoholikardiomyopatia (19,0 %), korkeaan verenpaineeseen assosioituva kardiomyopatia (15,5 %) sekä idiopaattinen sydänlihaksen sidekudoskasvu (13,6 %), joka myös oli yleisin ei-iskeemiseen sydänperäiseen äkkikuolemaan johtava syy alle 40-vuotiailla (28,3 %). Positiivinen sydänperäisen äkkikuoleman sukuhistoria oli tilastollisesti merkitsevästi yleisempää iskeemisillä (34,2 %) kuin ei-iskeemisillä (13,4 %) sydänperäisen äkkikuoleman uhreilla. Lamin A/C – geenin mutaatio löydettiin pohjoissuomalaisesta äkkikuolemaperheestä, jossa idiopaattinen sydänlihaksen sidekudoskasvu todettiin pääasialliseksi patologiseksi löydökseksi. Tyypin I kollageenin synteesi todettiin kohonneeksi idiopaattiseen sydänlihaksen sidekudoskasvuun menehtyneillä vainajilla. Yhteenvetona voidaan todeta, pohjoissuomalaisen väestön ei-iskeemisen sydänperäisen äkkikuoleman tunnuspiirteet eroavat aiemmin raportoiduista; lihavuuteen assosioituva kardiomyopatia, alkoholikardiomyopatia, sekä idiopaattinen sydänlihaksen sidekudoskasvu olivat aiempaa yleisempiä ei-iskeemisen äkkikuoleman aiheuttajia. Positiivinen sydänperäisen äkkikuoleman sukuhistoria ei ollut tilastollisesti merkitsevästi kohonnut ei-iskeemisen sydänperäiseen äkkikuolemaan menehtyneillä. Tämä tarkoittaa, että perinnöllinen syy ei-iskeemisen sydänperäisen äkkikuoleman aiheuttajana on luultua harvinaisempi. Lamin A/C – geenimutaation kantajilla sydänlihassolujen korvautuminen sidekudoksella todettiin hengenvaarallisen rytmihäiriön aiheuttajaksi. Lisäksi, tyypin I kollageenin synteesi todettiin kohonneeksi idiopaattiseen sydänlihaksen sidekudoskasvuun menehtyneillä vainajilla.

The objectives of the community-based Early Developmental Stages of Psychopathology (EDSP) Study are described along with a detailed account of the overall design, special design features, sample characteristics and instruments used. The EDSP employed a prospective-longitudinal design to study substance use and other mental disorders in a representative population sample of 3,021 subjects aged 14–24 years (birth cohorts 1970–1981) at ‘baseline’ – the outset of the study. Two follow-up investigations were conducted after the baseline investigation covering an overall period of 3–4 years. Special design features are the linkage with a family supplement (EDSP-FS) as well as neurobiological laboratory studies of high-risk subjects.

Obesity negatively affects quality of life of children and its high prevalence is a global problem. Obesity is a multifactorial disease, whose formation influence genetic and exogenous factors. Exogenous factors can act directly on obese individuals and can be defined by the markers of personal history, or may act within the family and then they are define by the markers of family history. The health risks associated with obesity are high and therefore you need to focus on the treatment of obesity in childhood. In childhood it is still possible to change unhealthy habits and lifestyle. The aim of this work is to describe the relationship of severity of obesity of obese children in the selected data from their personal and family history and analyze the success of reducing treatment of children in dependence selected aspects of their personal and family history. Monitored set includes 398 girls and 216 boys aged 6 to 18 years who were examined anthropometric at the beginning and in the end of the stay in the hospital, Dr. Philip in Poděbrady, and whose parents responded to the survey questions for parents of obese children. Data where colected between years 2000 and 2010. The following parameters were monitored: body weight, body height, BMI, skinfolds thickness, circumferential and width parameters...

No description available.