Bakgrund: Det är vanligt förekommande att patienter med hematologiskt maligna sjukdomar går från kurativ till palliativ vård. Hematologiska behandlingar beskrivs i litteraturen som högteknologiska, aggressiva och de mest förödande behandlingar människokroppen kan utsättas för. Tidigare studier visar att arbete inom cancervård, palliativ vård och vård i livets slutskede kan ha ogynnsam effekt på sjuksköterskors fysiska, psykiska och emotionella mående. Befintlig litteratur beskriver sjuksköterskors upplevelser av att vårda dessa patienter palliativt dock råder det avsaknad av beskrivning av sjuksköterskans upplevelse av att vårda patienter i övergången mellan kurativ vård och palliativ vård.   Motiv: Då det råder avsaknad av beskrivning av sjuksköterskors upplevelser av att vårda patienter i övergången mellan kurativ och palliativ vård ansåg författarna att det förelåg en kunskapsbrist gällande sjuksköterskors upplevelser samt hur dessa påverkar sjuksköterskan i den dagliga omvårdnaden av dessa patienter. Syfte: Syftet med studien var att beskriva och förstå sjuksköterskors upplevelser av att vårda patienter med hematologiskt maligna sjukdomar i övergången mellan kurativ och palliativ vård.Metod: Föreliggande studie utfördes som en kvalitativ semistrukturerad intervjustudie med induktiv ansats (n=8). Data analyserades enligt the Framework Analyzis. Resultat: Resultatet omfattar fyra teman som handlar om övergången mellan kurativ och palliativ vård: Konsekvenser av ovisshet i övergången, Kommunikation i övergången, Omvårdnad vid ovisshet i övergången och Sjuksköterskans upplevelser vid ovisshet i övergången. Konklusion: Övergången mellan kurativ och palliativ vård för patienter med hematologisk malignitet kan upplevas som otydlig och präglas av ovisshet, vilket leder till utmaningar i omvårdnaden av dessa patienter. Resultatet pekar på områden i behov av utveckling, till exempel behov av ett utökat teamarbete som i sin tur kan förbättra kommunikationen och öka personcentrering i vården av dessa patienter. / Background: It is common for patients with hematological malignancies to go from curative to palliative care. Hematological treatments are described in the literature as high-tech, aggressive and the most devastating treatments the human body can be subjected to. Previous studies show that work in cancer care, palliative care and end-of-life care can have an adverse effect on nurses' physical, mental and emotional well-being. Existing literature describes nurses' experiences of caring for these patients palliatively, however, there is a lack of description of the nurses' experience of caring for patients in the transition between curative care and palliative care. Motive: As there is a lack of description of the nurses' experience of caring for patients in the transition between curative and palliative care, the authors believed that there was a lack of knowledge regarding nurses' experiences and how these affect the nurse in the daily care of these patients. Aim: The aim of the study was to describe and understand nurses' experiences of caring for patients with hematological malignancies in the transition between curative and palliative care. Methods: The present study was conducted as a qualitative semi-structured interview study with an inductive approach (n=8). Data were analyzed with Framework Analysis. Result: The result includes four themes relating to the transition between curative and palliative care: Consequences of uncertainty in the transition, Communication in the transition, Nursing in the event of uncertainty in the transition and The nurses' experiences in the event of uncertainty in the transition. Conclusion: The transition between curative and palliative care for patients with hematological malignancies can be experienced as unclear and characterized by uncertainty, which leads to challenges in the care of these patients. The results point to areas in need of development, for example the need for increased teamwork which in turn can improve communication and increase person-centered care in the care of these patients.

Introduction: There have been few well controlled altitude and hypoxic training studies to date. This thesis investigated the effects of altitude and (sham controlled) intermittent hypoxic training (IHT) on exercise capacity, and the associated physiological adaptations. Methods: Chapter 3 investigated how living and training at 2320 m or at sea level affected total haemoglobin mass (tHb) and race performance in highly trained swimmers. Chapter 4 investigated how IHT or normoxic training affected cardiopulmonary variables and the incremental exercise limit of tolerance (T-Lim), in highly trained runners. Chapter 5 investigated how single-legged IHT or normoxic training affected phosphorus-31 nuclear magnetic resonance spectroscopy assessed muscle energetics. Results: In Chapter 3, tHb increased significantly more after altitude (+0.6 ± 0.4 g•kg-1, or +4.4 ± 3.2%) than after sea level (+0.03 ± 0.1 g•kg-1, or +0.3 ± 1.0%), but the changes in swimming performances were not different between groups, and there were no correlations between tHb and performance changes. In Chapter 4, submaximal heart rate in normoxia decreased significantly more after IHT than after normoxic training (-5 ± 5 vs. -1 ± 5 b∙min-1), and submaximal "V" ̇O2 in hypoxia significantly decreased, only after IHT. T-Lim in hypoxia significantly increased post-IHT, but there were no between group differences. In Chapter 5, the phosphocreatine recovery time constant was speeded significantly more in the IHT compared to the normoxic trained leg, when tested in hypoxia (-25 ± 8% vs. -13 ± 6%), but not in normoxia (-16 ± 15% vs. -9 ± 10%). Conclusions: Altitude training likely increases tHb, but this is not necessarily associated with improved athletic performance. IHT may induce other non-haematological adaptations; potentially an enhanced skeletal muscle oxidative capacity, but evidence for exercise capacity gains is lacking. The precise underlying causes for these adaptations require further investigation, as does any translation to athletic performance.

In this work experimental design and tests were established to determine whether antibody production in guinea pigs injected with a bacterial antigen is Influenced by the environment of simulated high altitude with normoxic conditions. Hematological and electrophoretic studies were simultaneously run with the antibody determinations as a check on related responses of the animals.

Orientador: Margarida Maria Barros / Resumo: O objetivo do presente estudo foi avaliar os efeitos do concentrado de melão rico em SOD (superóxido dismutase) sobre o desempenho produtivo, perfil hematológico e atividade das enzimas antioxidantes da tilápia-do-Nilo submetidas a desafio por estresse térmico e hipóxia. Um grupo de 462 tilápias revertidas sexualmente (8,87 g ± 0,12) foi distribuído aleatoriamente em 42 aquários de 250 L (11 peixes/aquário) e alimentado com sete dietas práticas contendo níveis de concentrado de melão 0; 0,1; 0,2; 0,3; 0,4; 0,5 e 1,0% por 60 dias. As dietas foram formuladas para conter 29% de proteína digestível e 18 MJ de energia digestível kg-1. Após 60 dias de alimentação, determinou-se o desempenho produtivo, parâmetros hematológicos e atividade das enzimas do sistema antioxidante. Em seguida, os peixes foram submetidos a desafio térmico e hipóxia (34°C/1,87 mg/L-1 de oxigênio dissolvido) por dois dias e os mesmos parâmetros hematológicos e atividade de enzimas do sistema antioxidantes foram determinados após esse período. No presente estudo, o concentrado de melão foi capaz de manter a eritropoiese e a capacidade antioxidante sob estresse térmico e hipóxia, porém não houve efeito no desempenho produtivo. A concentração de malonaldeído presente no filé de peixes alimentados com dietas suplementadas com concentrado de melão diminuiu 1,5 vezes após o estresse. Os resultados do presente estudo sugerem o nível de suplementação entre 0,4 e 0,5% de concentrado de melão capaz de manter a saúde do... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This study evaluated the effects of SOD-rich melon pulp concentrate (SOD-rich MPC) on growth performance, hematological profile and antioxidant enzyme activity of Nile tilapia subjected heat/dissolved oxygen-induced stress (HDOIS). A group of 462 male Nile tilapia (8.87 g ± 0.12) was randomly distributed in 42 250-L aquaria (11 fish/tank) and fed seven practical diets with graded levels of SOD-rich MPC at 0, 0.1, 0.2, 0.3, 0.4, 0.5 and 1.0% for 60 days. The diets were formulated to contain 30% crude protein and 18 MJ kg-1 crude energy. After the feeding period, growth performance was evaluated and six fish per treatment were sampled for hematological profile and antioxidant enzyme activity. Then, fish were subjected to HDOIS (34°C/1.87 mg/L-1 dissolved oxygen) for two days and the same hematological profile and antioxidant enzyme activity were determined. In the present study, SOD-rich MPC was able to keep erythropoiesis and antioxidant capacity under HDOIS, but did not affect growth performance. The concentration of MDA in fish fed diets supplemented with SOD-rich MPC decreased by 1.5 fold after HDOIS. The results of the present study suggest that 0.5% SOD-rich MPC dietary supplementation was appropriate to maintain Nile tilapia health and improve their antioxidant capacity under HDOIS. / Mestre

Bakgrund: Patienter med hematologisk sjukdom erhöll en tunnellerad central venkateter i lokal anestesi inför behandling. Det är vanligt att patienter som är vakna under operation upplever oro. Syfte: Syftet med studien var att undersöka hur patienter med hematologisk sjukdom upplever att få en tunnelerad CVK i lokalanestesi samt hur de anser att upplevelsen kan förbättras. Metod: Studien har en deskriptiv design med kvalitativ metod. Semistrukturerade intervjuer genomfördes med 10 patienter där en intervjuguide med öppna frågor användes. Intervjuerna analyserades med hjälp av systematisk textkondensering enligt Malterud. Resultat: Gemensamt för samtliga patienter i studien var att CVK-ingreppet överlag var en positiv upplevelse. Patienterna beskrev att kontinuerlig information och ett gott omhändertagande på operation bidrog till en positiv upplevelse av att få en tunnelerad CVK. I resultatet framkom fyra teman; 1- mental styrka hjälpte patienterna att känna sig redo, 2- att vara utsatt i en miljö där smärta och obehag förekom, 3- omhändertaget av professionell och erfaren personal bidrog till en lugn stämning, 4- tidigare erfarenheter och information minskade oro och gav patienterna ökad trygghet. Slutsats: Studien visar att det finns potential att göra upplevelsen av att få en tunnelerad CVK bättre med enkla medel. Förbättringen kan ske genom tydligare information, varmare temperatur inne på operationssalen och genom att anestesisjuksköterskan stödjer patienten vid oro. Informationen och vården behöver således bli mer personcentrerad och vårdpersonal behöver öva för att bli bättre på att ge denna vård. / Background: Prior to treatment, patients with haematological disease receives a tunnelled central venous catheter in local anesthesia. It is common for patients who are awake during surgery to experience anxiety. Aim: The aim of this study was to describe how patients suffering from hematological diseases experience tunelled central venous cathetrization in local anesthesia and how their experience could be improved. Design: Semistructured interviews using an interview guide with open-ended questions where performed with 10 patients. Data were analysed with systematic text condensation according to Malterud. Result: The included patients had an overall positive experience from recieving a tunelled central venous catheter. The patients described how continuous information and good care improved their experience of recieving a tunelled central venous catheter. Four themes were identified in the result; 1- having mental a strenght made the patients feel relieved and prepared, 2- being exposed to an environment where pain and discomfort were present, 3- being taken care of by experienced professionals contributed to a calm atmosphere, 4- previous experiences and information reduced anxiety and promoted an increased feeling of safety Conclusion: The present study shows the potential to make patients experiences better by simple means, for example by giving more distinct information, raising the temperature in the operating room and by the nurse anesthetist acting more supportive when patients feel anxiety. The information and nursing care need to be more personalized and professionals need to practice in order to improve.

Submitted by admin tede (tede@pucgoias.edu.br) on 2016-08-17T14:35:39Z No. of bitstreams: 1 Sandra Maria Rosa de Aguiar.pdf: 937813 bytes, checksum: 3dc0508cafece93cb858ec9e505c2c38 (MD5) / Made available in DSpace on 2016-08-17T14:35:39Z (GMT). No. of bitstreams: 1 Sandra Maria Rosa de Aguiar.pdf: 937813 bytes, checksum: 3dc0508cafece93cb858ec9e505c2c38 (MD5) Previous issue date: 2008-04-09 / The chemotherapic adjuvant treatment is associated to neutropenia, complications of organic defense, alterations in the nutritional status, and negative impact on quality of life, which compromises the physical, emotional, and social aspects of cancer patients. Not controlled clinical trial, the type before and after, this work is a first attempt to analyze the impact of food supplementation with immunomodulatory nutrients on the hematological profile of patients with breast neoplasia submitted to chemotherapic adjuvant treatment. This research was carried out in HEMOLABOR, an oncology/hematology center in Goiânia, state of Goiás, from November 2007 to January 2008. The dietary supplement was offered before a chemotherapy cycle, using the following formulations: FAC (a combination of fluorouracil, adriblastin, and cyclofosfamide) and CMF (a combination of cyclofosfamide, metotrexate, and 5-fluorouracil). Pre- or postmenopause patients between 18 and 62 years old, presenting Karnofsky index 70 participated in the study. Patients presenting associated neoplasia, chronic transmittable (HIV) or non-transmittable diseases (diabetes, hepatic or renal insufficiency), neurologic or psychiatric problems were excluded. Case inclusion occurred regardless of the number of chemotherapy cycles already performed and according to the appointment scheduling of the institution. The sociodemographic, cultural, and clinic profile of the patients was designed using the WHOQOLbref( WHO) questionnaire, based on the analysis of their medical records and oriented interview. The questions were answered aiming at stratifying the importance of the disease on quality of life according to the patient’s opinion. The food supplement used is described as an enteral formula for oral supplementation, nutritionally complete, adequate for special metabolic situations, enriched with immunomodulatory nutrients (arginine, glutamin, nucleotids, omega-3 fatty acids), which was consumed during the week preceding a new chemotherapy cycle. The hematological profile was designed based on the results of complete blood counts evaluated at three different moments: one cycle before the food supplement intake, one cycle including the offer of the food supplement, and one cycle after the food supplement intake. The difference among these hematological profiles was used as an indicator of food supplementation impact on the patient’s immune status according to the standard of the World Health Organization, in the analysis of hematological toxicity. The results showed recovery of total white blood cells and, specially, of neutrophils after the food supplement intake. An association between the increase or decrease of cellular levels in the complete blood counts and the variables age, Karnofsky index, chemotherapy regime, and quality of life as a whole was not perceived. The data presumably indicate that the gain is lower when the disease staging is more advanced and induces the thought that the positive balance of hematological indicators may represent gain as a function of the nutritional support used. / O tratamento quimioterápico adjuvante está associado à neutropenia com complicações das defesas orgânicas, alterações no estado nutricional e impacto negativo na qualidade de vida, comprometendo os aspectos físico, emocional e social de portadoras de câncer. Ensaio clínico não controlado, do tipo antes e depois, este trabalho é uma primeira aproximação na análise do impacto da suplementação alimentar com nutrientes imunomoduladores sobre o perfil hematológico de pacientes com neoplasia mamária, submetidas à quimioterapia adjuvante. Foi realizado no HEMOLABOR, centro especializado em oncologia e hematologia, em Goiânia, Goiás, no período compreendido entre os meses de novembro de 2007 a janeiro de 2008. A oferta do suplemento dietético foi feita antes de um ciclo de quimioterapia, nas formulações: FAC (combinação de fluorouracil, adriblastina e ciclofosfamida) e CMF (Combinação de ciclofosfamida, metotrexate e 5-fluorouracil). Participaram do estudo pacientes com idade entre 18 e 62 anos, pré ou pós-menopausadas e com índice de Karnofsky igual ou maior que 70. Foram excluídas aquelas que apresentaram neoplasia associada, afecção crônica transmissível (HIV) ou não transmissível (diabetes, insuficiência hepática ou renal), problemas neurológicos ou pisquiátricos. A inclusão dos casos foi independente do número de ciclos quimioterápicos já realizados e foi feita na medida dos agendamentos da instituição. Desenhou-se o perfil sócio–econômico, cultural e clínico das pacientes, utilizando-se o questionário WHOQOL-bref(OMS), a partir da análise de seus prontuários e de entrevista orientada. As questões foram respondidas de forma a estratificar o peso da doença sobre a qualidade de vida na opinião da própria paciente. O suplemento alimentar utilizado é descrito como fórmula enteral para suplementação oral, nutricionalmente completa, própria para situações metabólicas especiais; enriquecida com nutrientes imunomoduladores (arginina, glutamina, nucleotídeos, ácidos graxos ômega 3). Foi ingerido durante a semana que antecedeu um novo ciclo de quimioterapia. O perfil hematológico foi desenhado a partir dos resultados de hemograma completo avaliado em três momentos: um ciclo prévio à suplementação alimentar; um ciclo que incluiu a oferta do suplemento alimentar e um terceiro ciclo posterior à suplementação. A diferença entre estes perfis hematológicos foi utilizada como indicador do impacto da suplementação alimentar sobre o estado imunológico da paciente, de acordo com a padronização da Organização Mundial de Saúde, na análise da toxicidade hematológica. Os resultados mostraram uma recuperação de leucócitos totais e, em particular, de neutrófilos, após a ingestão do suplemento. Não se pressente associação entre aumento ou redução nos níveis celulares do hemograma e as variáveis idade, índice de Karnosfik, regime de quimioterapia e nem mesmo com a qualidade de vida, quando examinada de forma global. Os dados parecem indicar também que os ganhos são menores quando o estadiamento da doença está mais avançado e induz ao pensamento de que o saldo positivo nos indicadores hematológicos possa representar um ganho em função do suporte nutricional utilizado.

Submitted by Sandra Pereira (srpereira@ufrrj.br) on 2018-01-26T12:38:56Z No. of bitstreams: 1 2010 - Juberlan Silva Garcia.pdf: 6866273 bytes, checksum: 77b115c7b87deb998b7440f5ecb87940 (MD5) / Made available in DSpace on 2018-01-26T12:38:56Z (GMT). No. of bitstreams: 1 2010 - Juberlan Silva Garcia.pdf: 6866273 bytes, checksum: 77b115c7b87deb998b7440f5ecb87940 (MD5) Previous issue date: 2010-12-03 / The trematode Echinostoma paraensei parasitizes the small intestine of rodents, being its natural definitive host Nectomys squamipes. In spite of the great importance of echinostomatides, there are few studies on morphology, biology and physiology of E. paraensei and its interaction with their intermediate and definitive hosts. In the present study 50 Rattus norvegicus (Wistar),adult females were used, 35 were individually infected with 150 E. paraensei metacercariae (Sumidouro strain) and 15 were maintained uninfected, as control group. Weekly, seven infected and three uninfected rodents were euthanized using CO2.The blood was collected to hematological analysis, and serum obtained by centrifugation and used to aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALKP), gamma-glutamyl transferase (GGT), bilirubin, glucose, total proteins and fractions determinations. Fragments of liver were collected to glycogen determination and histophatological analysis. Adult worms were loaded until third week of infection, being the higher number of worms loaded at first week of inection. The hepatocytes had rounded edges, with signs of impaired nuclear, mild infiltration of polymorphonuclear and sinusoids slightly expanded. The hepatocytes were vacuolated with discrete perivascular and periportal lymphocytic infiltration. The serum biochemical parameters analyzed were increased at the first week of infection, varying onward. Hematological analysis revealed the development of normocytic and normocromic anaemia with anisocytic alteration. In the white blood cells, only a leukopenia was observed at the third week of infection. The present results are discussed. / O tremat?deo Echinostoma paraensei ? um parasito de intestino delgado de roedores, sendo seu hospedeiro definitivo natural Nectomys squamipes. No presente estudo, foram utilizadas 50 f?meas adultas de Rattus norvegicus (Wistar), 35 animais infectados individualmente com 150 metacerc?rias de E. paraensei (linhagem Sumidouro) e 15 animais n?o infectados (controle). Semanalmente, sete animais infectados e tr?s animais controle foram submetidos ? eutan?sia com CO2. O sangue foi coletado para an?lise hematol?gica, e o soro obtido por centrifuga??o, para as determina??es de aspartato aminotransferase (AST), alanina aminotransferase (ALT), gamaglutamiltransferase (GGT), fosfatase alcalina (ALKP), bilirrubina, glicose, prote?nas totais e fra??es. Fragmentos de f?gado foram coletados para a determina??o de glicog?nio e para a an?lise histopatol?gica. Vermes adultos foram recuperados at? a terceira semana de infec??o, sendo o maior n?mro de vermes recuperados na primeira semana. Os hepat?citos apresentavam-se com bordos arredondados e alguns sinais de comprometimento nuclear, infiltra??o por polimorfonucleares nos sinus?ides, vacuoliza??o, discreta infiltra??o linfoplasmocit?ria perivascular e periportal com poucas c?lulas mononucleares presentes na luz do ducto biliar, alguns hepat?citos estavam hipotrofiados. As an?lises hematol?gicas revelaram o desenvolvimento de uma anemia normoc?tica normocr?mica, com anisocitose. N?o foram observadas altera??es significativas na s?rie branca, havendo apenas uma leucopenia na terceira semana de infec??o. Os resultados obtidos s?o discutidos.

<p>Istraživanje je sprovedeno u cilju utvrđivanja uticaja ukrštanja mangulice sa durokom&nbsp; na proizvodne i zdravstvene parametre, kao i na kvalitet mesa, a sve to uporedo sa jednom modernom plemenitom rasom svinja &ndash; veliki jorkšir. U tu svrhu formirane su tri grupe &ndash; genotipa svinja, čista rasa bela mangulica (BM), melezi duroka i bele mangulice (DBM), i čista rasa veliki jorkšir (VJ), koji su smešteni u iste uslove ishrane, nege i držanja. Svinje iz grupa DBM i VJ su znatno brže prirasle do ciljane telesne mase od 150 kg u odnosu na svinje BM. Tako je melezima duroka i bele mangulice trebalo u proseku 168 dana manje, a svinjama iz grupe VJ 288 dana manje kako bi dostigli ciljanu telesnu masu u odnosu na svinje bele mangulice u čistoj rasi. Po pitanju zdravstvenog stanja i nalaza na trupovima zaklanih svinja post mortem nisu utvrđene značajne razlike. Značajne razlike su utvrđene u hematološkim i biohemijskim parametrima i to između sve tri ispitivane grupe, ali i između različitih starosnih kategorija u okviru iste ispitivane grupe, što nam ukazuje na značaj tačnijeg utvrđivanja referentnih parametara normalnih fizioloških vrednosti hematoloških i biohemijskih parametara ne samo posebno za pojedine vrste životinja, već dakako i za različite starosne kategorije u okviru iste vrste. Meso poreklom od svinja iz grupe BM imalo je najveći sadržaj intramuskularne masnoće, i tamniju i crveniju boju, dok za njima odmah slede melezi sa značajnim razlikama između sva tri ispitivana genotipa. Nadalje, meso svinja rase bela mangulica je imalo značajno veću krajnju vrednost pH, bolju sposobnost vezivanja vode, veći sadržaj kalcijuma, cinka, gvožđa, bakra i mangana, u poređenju sa druga dva genotipa. Ukrštanje bele mangulice i duroka je imalo značajan uticaj na pojedinačni sastav masnih kiselina u mesu. Međutim, zbir zasićenih, mononezasićenih i polinezasićenih masnih kiselina je ostao nepromenjen. Meso svinja rase bela mangulica i meleza dobijenih ukrštanjem svinja rasa bela mangulica i durok značajno je nežnije &ndash; mekše. Mononezasićene masne kiseline su najzastupljenije u mesu poreklom od svih životinja, dok za njima slede zasićene i na kraju polinezasićene masne kiseline. Meso poreklom od BM i DBM je imalo značajno veći sadržaj mononezasićenih masnih kiselina, i značajno manji sadržaj zasićenih masnih kiselina u odnosu na VJ. Generalno, na osnovu svih ispitanih parametara kvaliteta polutki i mesa može se konstatovati da svinje rase bela mangulica karakteriše manja mesnatost polutki, ali i meso koje ima odličan senzorski, tehnološki i nutritivni kvalitet, dok meleze svinja dobijenih ukrštanjem svinja rasa bela mangulica i durok karakteriše veća mesnatost polutki i nešto slabiji, ali još uvek veoma dobar, kvalitet mesa, te su neophodna dodatna istraživanja kako bi smo dobili i podatake o kvalitetu suvomesnatih proizvoda. Takođe, potrebna su dodatna<br />istraživanja, preciznijeg karaktera u pogledu kvaliteta i ekonomičnosti proizvodnje kod autohtonih rasa, kao i preispitivanje kriterijuma selekcije koji se primenjuju kod mangulice, te parametara genetskog progresa, tj. efekta selekcije, kako bi iako autohtona uhvatila korak za opstanak ili prestiž u odnosu na moderne rase svinja.</p> / <p>The research was carried out in order to determine the effect of the cross-breeding of mangulets with durok on production and health parameters, as well as on the quality of meat, all along with a modern, noble breed of pigs - a large Yorkshire. For this purpose, three groups - pig genotypes, pure breeds of white mangulica (BM), meliaceae and white manguns (DBM), and pure breed, Yorkshire (VJ), were placed in the same conditions of nutrition, care and keeping. Pigs from the DBM and VJ groups increased significantly to a target bodyweight of 150 kg compared to BM pigs. Thus, mulberry and white mangulets were average 168 days less, and 288 days lower for pigs from the VJ group in order to reach their target body mass compared to white mangun pigs in a clean race. There are no significant differences in terms of health status and findings on carcases of slaughtered pigs post-mortem. Significant differences were established in the hematological and biochemical parameters, among all three groups studied, but also between different age categories within the same investigated group, which points to the importance of more precise determination of the reference parameters of normal physiological values of hematologic and biochemical parameters not only for individual species of animals, but also for different age categories within the same species. Meat originating from pigs from the BM group had the highest content of intramuscular fat, and the darker and redder color, followed by moles with significant differences between all three investigated genotypes. Furthermore, the pig meat of the white mangulce had a significantly higher end value of pH, better water binding capacity, higher content of calcium, zinc, iron, copper and manganese, compared to the other two genotypes. The crossing of white mangulce and durok had a significant effect on the individual composition of fatty acids in the meat. However, the sum of saturated, monounsaturated and polyunsaturated fatty acids remained unchanged. Meat of pig breeds white mangulica and molasses obtained by crossing the pig race white mangulica and durok is significantly more gentler - softer. Monounsaturated fatty acids are the most common in meat originating from all animals, followed by saturated and at the end of polyunsaturated fatty acids. Meat originating from BM and DBM had a significantly higher content of monounsaturated fatty acids, and significantly lower saturated fatty acid content than VJ. In general, on the basis of all the tested parameters of the quality of the halves and flesh, it can be concluded that the pig breeds of white mangulets are characterized by lower meatiness of the hemispheres, but also meat that has excellent sensory, technological and nutritive quality, while the piglets of pigs obtained by crossing the pig rasa white mangulica and durok are characterized by larger lean meat and slightly weaker but still very good quality of meat, and further research is needed in order to obtain data on the quality of the cream products. Also, additional ones are needed<br />research, a more precise character in terms of quality and cost-effectiveness in autochthonous breeds, as well as the reconsideration of selection criteria applied to mangulas and parameters of genetic progress, i.e. the effect of the selection, in order to take an autochthonous step in survival or prestige in relation to modern pig breeds.</p>

Les cellules Natural Killer (NK) sont des lymphocytes cytotoxiques innés qui jouent un rôle important dans le contrôle immunitaire de la formation de cellules tumorales et de l'infection virale. Chez les personnes en bonne santé, les cellules NK représentent des populations hétérogènes définies par différents marqueurs phénotypiques et exécutant des fonctions spécifiques. Les cellules NK provenant de patients présentant des tumeurs malignes néoplasiques et une infection virale sont cependant typiquement distinctes des personnes en bonne santé par l'apparition de sous-ensembles de cellules NK, qui sont différenciées par leur profil d'isoformes CD45. CD45 est une tyrosine phosphatase leucocytaire commune abondamment exprimée sur toutes les cellules immunitaires hématopoïétiques nucléées. Un variant d'épissage alternatif a entraîné la génération de l'isoforme CD45RA longue et de l'isoforme courte CD45RO, qui s'expriment différemment sur les cellules T naïves et effectrices / mémoires. L'expression des isoformes CD45 sur les cellules NK est largement inconnue. Nous avons précédemment montré que l'expression différentielle des isoformes CD45RA et CD45RO a identifié des sous-ensembles de cellules NK spécifiques dans les maladies hématologiques. Une question reste floue: comment ces cellules CD45RARO + NK changent-elles lorsque leurs cellules cibles disparaissent? Nous avons utilisé des cellules NK de patients traités avec Lenalidomide et l'anticorps anti-CD20 Obinutuzumab pour étudier cela et montré une réduction des cellules CD45RARO / CD45RO + NK après la clairance des cellules tumorales (Chater 4). Nous avons observé la même chose chez les patients atteints de LMA après une chimiothérapie. Dans ce cas, le sous-ensemble de cellules CD45RARO + NK est fortement corrélé avec la trogocytose du marqueur monocyte / macrophage CD14 (Chapitre 5). L'immunophénotypage de cellules NK provenant de patients infectés par le VIH a révélé la présence de cellules CD45RAdim et CD45RO + avec une expression réduite de CD16 et une diminution de la modulation NKG2D totale. En résumé, les cellules NK des cancers hématologiques et l'infection par le VIH présentaient des caractéristiques dysfonctionnelles et l'analyse du profil isoforme CD45 dans ces conditions pathologiques dévoile ces caractéristiques.Enfin, afin de retrouver la réponse immunitaire anti-tumorale chez les patients cancéreux, nous présentons une méthode efficace pour l'expansion in vitro de cellules NK hautement activées à partir du sang du cordon ombilical (UCB). Ces cellules NK prouvent une cytotoxicité cellulaire dépendante des anticorps (ADCC) importante lorsqu'elles sont utilisées en combinaison avec des anticorps monoclonaux approuvés sur le plan clinique ciblant divers antigènes tumoraux. Ceci ouvre leur utilisation dans les immunothérapies à base de cellules NK allogéniques. / Natural Killer (NK) cells are innate cytotoxic lymphocytes that play an important role in immune control of tumor cell formation and virus infection. In healthy people, NK cell represents heterogeneous populations defined by different phenotypical markers and performing specific functions. NK cells from patients with neoplastic malignancies and viral infection are however typically distinctive from healthy people by the appearance of NK cell subsets, which are differentiated by their CD45 isoform profile. CD45 is a common-leukocyte tyrosine phosphatase abundantly expressed on all nucleated hematopoietic immune cells. Alternative splicing variant resulted in generation of the long-isoform CD45RA and the short-isoform CD45RO, which express differently on naïve and effector/memory T cells. Expression of CD45 isoforms on NK cells is largely unknown. We have previously shown that differential expression of CD45RA and CD45RO isoforms identified specific NK cell subsets in hematological diseases. One question remained unclear: how do these CD45RARO+ NK cell changes when their target cells disappeared? We used NK cells from patients treated with Lenalidomide and the anti-CD20 antibody Obinutuzumab to investigate this and showed a reduction in CD45RARO/CD45RO+ NK cells upon clearance of tumor cells (Chater 4). We observed the same in AML patients after chemotherapy. In this case the CD45RARO+ NK cell subset strongly correlates with trogocytosis of the monocyte/macrophage marker CD14 (Chapter 5). Immunophenotyping of NK cells from HIV-infected patients revealed the presence of CD45RAdim and CD45RO+ cells with reduced CD16 expression and total NKG2D down-modulation. In summary, NK cell from hematological cancers and HIV infection displayed dysfunctional hallmarks and analyzing CD45 isoform profile in these pathological conditions unveils these hallmarks.Finally, in order to regain the anti-tumor immune response in cancer patients, we present an efficient method for expansion of highly activated NK cells from umbilical cord blood (UCB) in vitro. These NK cells prove substantial antibody-dependent cell cytotoxicity (ADCC) when used in combination with clinical-approved monoclonal antibodies targeting various tumor antigens. This paves their use in allogeneic NK cell-based immunotherapies.

A neutropenia induzida pela quimioterapia é o mais comum efeito adverso da quimioterapia sistêmica para o câncer e é frequentemente complicada por neutropenia febril (NF). O uso profilático de fatores de crescimento hematopoiéticos pode reduzir o risco, a severidade e a duração da NF. Na prática clínica atual, a decisão de administrar ao paciente profilaxia com fatores de crescimento é baseada principalmente no potencial mielotóxico dos esquemas de QT, mas riscos específicos dos regimes não são definidos. Em muitos estudos, a toxicidade da quimioterapia é analizada em termos de alta dosagem versus baixa dosagem, sem uma regra geral que considere os diferentes esquemas de QT em uma única escala. O objetivo desse estudo é validar uma classificação de toxicidade de um esquema de QT e avaliar sua utilidade em um modelo de predição de risco de neutropenia febril em pacientes com câncer hematológico no começo de um ciclo de quimioterapia. Foram avaliados prospectivamente duzentos e sessenta e oito pacientes e acompanhados durante 1053 ciclos de quimioterapia na Bélgica, entre 2001 e 2005. Informações relevantes foram coletadas no começo do primeiro ciclo e o número de dias de neutropenia febril foi contabilizado no acompanhamento dos pacientes [dicotomizada (sem neutropenia versus >= dia de NF)]. A relação entre o desfecho e as co-variáveis foi analisada usando a Equação de Estimativa Generalizada (GEE). Um regime de quimioterapia agressiva é o maior preditor de NF [razão de chances (OR) 5.2 (3.2-8.4)]. Os outros preditores independentes são: doença subjacente, o comprometimento de medula óssea, superfície corporal <= 2m², uma contagem pré-tratamento de monócitos <150µl e a interação entre o primeiro ciclo na mesma linha de tratamento e uma dosagem de hemoglobina pré-tratamento. Usando as estimativas dos coeficientes de regressão, uma regra de predição clínica de NF foi desenvolvida com essas características: sensibilidade 78.6%, especificidade 62.3%, valor preditivo positivo de 42.7%% e um valor preditivo negativo de 89.1%. Estudos posteriores são necessários para validar esse escore bem como investigar novos potenciais fatores com o intuito de melhor prever a NF. / Chemotherapy-induced neutropenia is the most common adverse effect of chemotherapy and is often complicated by febrile neutropenia (FN). As prophylactic use of colonystimulating factors (CSF) can reduce the risk, severity, and duration of FN, it is of great importance to identify as soon as possible after or even before the start of chemotherapy, the patients who will develop FN. In the current clinical practice, the decision to give to the patient a colony-stimulating factor (CSF) prophylaxis is mainly based on the myelosuppressive potential of the chemotherapy regimen. The objective of this study is to validate a classification of aggressiveness of a chemotherapy regimen and to evaluate its usefulness in a risk prediction model of FN in patients with hematological cancer at the beginning of a chemotherapy cycle. Two hundred and sixty-six patients were prospectively enrolled and followed during 1053 cycles. Relevant patient informations were collected at the beginning of the first cycle and the number of days of FN were counted in the follow-up [dichotomized (no FN versus>= 1 day of FN)]. Aggressive chemotherapy regimen is the major predictor of FN [odds ratio 5.2 (3.2 - 8.4)]. The other independent predictors are the underlying disease, an involvement of bone marrow, body surface<= 2m², a baseline monocyte count <150/µl and the interaction between the first cycle in the same treatment line and a baseline hemoglobin dosage. A rule of prediction of FN was computed with these characteristics: sensitivity 78.6%, specificity 62.3%, positive predictive value 42.7% and negative predictive value 89.1%. Further studies are needed to validate this score.