Orientador: Lilia Freire Rodrigues de Souza Li / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T02:50:47Z (GMT). No. of bitstreams: 1 Rezek_GabrielleSormantiSchnaider_M.pdf: 1259989 bytes, checksum: d38a761f5d97cc30224aa5a2b57d9c7c (MD5) Previous issue date: 2011 / Resumo: Introdução: Pacientes adultos com hiperplasia adrenal congênita (HAC) por deficiência de 21-hidroxilase apresentam maior incidência de obesidade, adiposidade visceral, hiperinsulinismo, resistência insulínica e hiperandrogenismo que indivíduos normais. A disfunção adrenomedular e o hipercortisolismo intermitente parecem estar associados a estas anormalidades, o que predispõe estes pacientes a um risco aumentado de desenvolvimento de síndrome metabólica e doença aterosclerótica. Objetivo: Avaliar a presença de resistência insulínica e dislipidemia em pacientes adultas jovens com HAC e investigar a associação com o índice de massa corporal (IMC) e a dose de glicocorticóide prescrita. Metodologia: Foram estudadas 18 pacientes entre 15 e 23 anos, avaliadas com medidas de IMC, circunferência abdominal, dose de glicocorticoide, glicemia, insulinemia, colesterol total e frações e triglicérides. Resultados: O IMC estava normal em 12 pacientes, cinco apresentavam sobrepeso e uma obesidade. A circunferência abdominal estava aumentada em sete pacientes. A insulinemia de jejum e o HOMA IR estavam aumentados em 7 e 8 pacientes, respectivamente. Apenas duas das pacientes apresentaram aumento de colesterol total e/ou de triglicérides, e duas diminuição dos níveis de HDL-colesterol. A resistência insulínica não apresentou associação com o IMC, a circunferência abdominal ou a dose de glicocorticoide prescrita. Conclusão: Mulheres jovens com hiperplasia adrenal congênita não apresentaram dislipidemia mas mostraram uma alta incidência de resistência insulínica e obesidade central, independente do IMC e da dose de glicocorticóide prescrita / Abstract: Introduction: Adult patients with congenital adrenal hyperplasia (CAH) due to classical 21-hydroxylase deficiency (21OHD) present higher incidence of obesity, visceral adiposity, hyperinsulinism, insulin resistance and hyperandrogenism compared to normal individuals. The adrenomedular dysfunction and the intermitent hypercortisolism tend to be associated to these abnormalities, what predispose these patients to metabolic syndrome and atherosclerosis disease. Aim: To evaluate insulin resistance and lipid profile in patients with 21OHD CAH and its association with Body Mass Index (BMI) and corticosteroid dosage prescribed. Methods: Eighteen young women (19.3 + 3.0 years) with 21OHD CAH were evaluated with measures of BMI, waist circumference, glucocorticoid dosage, glucose, insulin and lipid profile. Results: BMI was normal in 12 patients, 5 were overweight and 1 obesity. Waist circumference was high in 7. Fasting insulin and HOMA-IR were elevated in seven and eight patients, respectively. Total cholesterol and triglycerides levels were high in only one patient and HDL-cholesterol was low in two. Insulin resistance was not associated with BMI, waist circumference or glucocorticoid dosage. Conclusions: Young women with 21OHD CAH did not show dyslipidemia, but presented high incidence of insulin resistance and central obesity independent of BMI or corticosteroid dosage / Mestrado / Saude da Criança e do Adolescente / Mestre em Saude da Criança e do Adolescente

Orientador: Maria Beatriz Duarte Gavião / Tese (Doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-21T20:44:05Z (GMT). No. of bitstreams: 1 Mahn_PauloAngelo_D.pdf: 1050386 bytes, checksum: ef8373c5f769d1390c9bdc9435b72528 (MD5) Previous issue date: 2013 / Resumo: Dentre os diversos fatores psicológicos que influenciam o desempenho dos atletas no esporte de alto rendimento, a ansiedade tem sido um dos mais determinantes. No tênis de campo, a alta competitividade entre os atletas, associado com a individualidade desta modalidade constitui uma fonte geradora de ansiedade. Os hábitos relativos ao sono podem influenciar o desempenho do atleta. O hormônio cortisol é considerado um importante indicador da ansiedade competitiva, pois sua produção e secreção aumentam antes, durante e após situações ocasionadas por eventos competitivos. O objetivo do presente estudo foi avaliar os níveis de ansiedade psicológica e fisiológica e a qualidade de sono em jovens atletas de tênis de campo, do sexo masculino, durante dois treinos e na primeira rodada de um torneio regional e de um torneio estadual. A amostra foi constituída por vinte tenistas do sexo masculino de 15 a 18 anos de idade. Foram aplicadas as versões brasileiras do Inventário da Ansiedade de Beck e do Mini Questionário do Sono antes do 1º treino para avaliação da ansiedade psicológica e da qualidade do sono; e os níveis de cortisol salivar para avaliação da ansiedade fisiológica. As coletas de saliva foram realizadas em 4 momentos: 1º no treino; 2º no campeonato regional; 3º no treino; 4º no campeonato estadual, obtendo-se três amostras em cada uma: 1- Ao despertar; 2 - Cinco minutos antes do torneio ou treino; 3 - Entre o 1º e 2º set. O cortisol foi quantificado pela técnica imunoenzimática. Os resultados mostraram que a ansiedade psicológica variou de mínima a leve. A qualidade do sono apresentou grande variabilidade. Não houve diferença significativa nos valores de cortisol salivar entre os três tempos de coleta no 1º treino e no torneio regional. No 2º treino, os valores, 5 minutos antes da partida foram similares ao acordar, com declínio significativo entre o 1º e 2º set em relação às concentrações prévias. Na comparação entre o 1º treino e o 2º treino houve diferença significativa nos valores do cortisol salivar aos 5 minutos antes da partida, com valor superior no 2º treino, diferença que não foi percebida como significativa ao acordar e entre o 1º e o 2º set. No torneio estadual, 5 minutos antes da partida e entre o 1º e 2º set, os valores do cortisol foram similares entre si, e significativamente maiores do que ao acordar. As concentrações do cortisol salivar aos 5 minutos antes da partida e entre o 1º e 2º set foram significativamente maiores no torneio estadual em relação ao regional. Não houve associação da qualidade do sono e níveis de ansiedade e o fato de ter sido derrotado em pelo menos um treino e/ou campeonato. Concluiu-se que os tenistas podem ter sido afetados pelo desafio, demonstrado pela maior concentração de cortisol salivar durante o torneio estadual em relação à concentração ao acordar e em relação ao torneio regional / Abstract: Among the various psychological factors that influence the performance of athletes of high rate sport performances, anxiety has been one of the most crucial. In tennis, the high competitiveness among athletes, associated with the individuality, is a generator of anxiety. The sleep-related habits can influence an athletes' performance. The hormone cortisol is considered an important indicator of anxiety in competitions, since its production and secretion are increased before, during and after competitive events. The aim of this study was to assess levels of psychological and physiological anxiety and the quality of sleep in young tennis players, in two trainings and in the first round of the regional tournament and in the first round of the state tournament. The sample was composed by 20 males adolescent players aged from 15 to 18 years. The Brazilian versions of the Beck Anxiety Inventory and the Mini Sleep Questionnaire were applied before the 1st training for psychological assessment of anxiety and sleep quality; and levels of salivary cortisol were used to assess the physiological anxiety. The saliva samples were collected in 4 periods: 1st - training; 2nd - regional tournament; 3rd - training; 4th - state tournament, obtaining three samples in each period: 1 - Upon awakening, 2 - Five minutes before the tournament or training; 3 - Between the 1st and 2nd sets. The cortisol was measured by enzyme immunoassay. The results showed that the psychological anxiety ranged from minimal to moderate. The quality of sleep reported great variability. There was no significant difference in salivary cortisol values among the three sampling times in the first training and in the regional tournament. During the 2nd training, the values of salivary cortisol, 5 minutes before the match were similar to those at awakening with a significant decline of the 1st and 2nd sets compared with the previous concentrations. The comparison between the 1st and the 2nd trainings showed no significant difference in the values of salivary cortisol at 5 minutes before match, but with a higher value in the 2nd training. This difference was not perceived as significant at waking up and between the 1st and the 2nd set. In the state tournament before the match and between the 1st and 2nd sets, the cortisol values were similar to each other, and significantly higher than those at awakening. The salivary cortisol concentrations at 5 minutes before the match and xii between the 1st and 2nd sets were significantly higher in the state tournament compared with the regional one. There was no association among sleep quality and anxiety levels and the fact of having been defeated at least in one training and/or one tournament. Concluding, it can be suggested that athletes may have been affected by the challenge, since the cortisol concentrations were higher in the state tournament and training in relation to the values upon awakening and in relation to the regional one / Doutorado / Anatomia / Doutor em Biologia e Patologia Buco-Dental

Glucocorticoids known to be such powerful agents that cell growth, differentiation and cell death are influenced in the brain of mammals throughout life. Despite this, relatively little toxicological information regarding prenatal exposure is available. The aim of this study was to determine the effect of prenatal hydrocortisone exposure on cell viability and cell morphology in chick embryonic neurons. Four different histological staining techniques namely, Hematoxylin and Eosin (H&E), Cresyl Fast Violet, Silver impregnation and a combination of Gold Chloride and Toluidine Blue were used to evaluate chick embryo neural tissue exposed to 0.137ƒÝM or 0.685ƒÝM hydrocortisone on day 3.75 (Carnegie stage 16) and day 5.5 (Carnegie stage 18) of development. Histological processing was optimized and neural tissue evaluated for any changes in neuron morphology and cell number. Specific ultrastructural changes to membraneous structures were evaluated by transmission electron microscopy (TEM). Fixation procedures that resulted in little to no disruption of these structures were optimized and used in studies evaluating the effect of hydrocortisone on neuron morphology. Primary chick embryonic neuronal cultures were prepared and increasing concentrations of hydrocortisone (26.3nM, 0.16ƒÝM, 0.63ƒÝM, 3.8ƒÝM, and 22.8ƒÝM) added. Fluorescence microscopy was applied to the in vitro hydrocortisone exposed primary neuronal cultures. A combination of fluorescein diacetate (FDA) and propidium iodide (PI) was used to evaluate the effect of hydrocortisone on cell viability, whereas dichlorodihydrofluorescein diacetate (DCH2FDA) was used to visualize reactive oxygen species (ROS) generation in neurons. Histological evaluation of the neural tissue of chick embryos exposed to 0.137ƒÝM and 0.685ƒÝM hydrocortisone showed reduced neuron density and morphological changes associated with cell death. Glutaraldehyde with added magnesium chloride (MgCl2) as stabilizing chemical and potassium permangenate were two fixatives that caused minimal disruption to neural tissue. These two fixating methods were applied to control neural tissue as well as tissues exposed to 0.137ƒÝM and 0.685ƒÝM hydrocortisone. When evaluated by TEM, the control tissue appeared to be intact with no displacement. Exposure of neurons to 0.137ƒÝM hydrocortisone appeared to have severe effects on the morphology of the mitochondria, endoplasmic reticulum (ER), nuclear and plasma membranes. More extensive damage was noted with 0.685ƒÝM hydrocortisone, leaving almost no cellular structure. Both concentrations of hydrocortisone indicated cell death associated with apoptosis and necrosis. In vitro studies using primary cultures of chick neurons indicated that hydrocortisone is non-toxic at low concentrations (26.3nM ¡V 3.8ƒÝM) with the percentage viability ranging between 73% and 88%. A more toxic effect was seen at high concentrations (22.8ƒÝM). Cell death at the higher concentrations (22.8ƒÝM and 3.8ƒÝM) of hydrocortisone occurred due to ROS generation, as indicated by DCH2FDA fluorescence In conclusion, hydrocortisone indicated neurotoxicity at high concentrations of exposure. Although cell death could be detected, the exact mechanism (apoptosis or necrosis) still needs to be investigated. Since the developing brain is so susceptible to chemical insults care should be taken when administering this drug to pregnant mothers or young children. / Dissertation (MSc (Cell Biology)))--University of Pretoria, 2007. / Anatomy / unrestricted

O trabalho noturno e a alternância de turnos são identificados como fatores de maximização de efeitos negativos na saúde do trabalhador, como o estresse e a fadiga, por dificultarem a adaptação do ritmo circadiano do cortisol ao de trabalho. Objetivo: investigar o efeito do esquema de trabalho em turnos fixo e alternante e noturno de enfermeiros nos índices de estresse ocupacional e fadiga e na expressão circadiana do cortisol salivar. Método: estudo observacional de corte transversal e abordagem quantitativa dos dados estruturado com base no referencial teórico de Cooper. Realizado com 104 enfermeiros das Unidades de Emergência e Bloco Cirúrgico de hospital de ensino público do Estado de São Paulo e outro de Minas Gerais, no período de janeiro a março de 2017. Índices de estresse e fadiga foram mensurados por meio da aplicação de dois instrumentos: o Inventário de Estresse em Enfermeiros e a Escala de Avaliação de Fadiga, ambos validados para utilização no Brasil. A quantificação do cortisol salivar foi realizada por meio da técnica de ELISA. O projeto foi aprovado pelo Comitê de Ética em pesquisa sob protocolo. 55695416.7.0000.5393. Resultados: 66,67% dos enfermeiros trabalhavam em esquema de turnos alternantes e 39,39% eram fixos no turno matutino. Constatou-se 50,8% apresentaram alto índice de estresse e 46,03% fadiga. Não foram observadas associações estatisticamente significativas entre índices de cortisol salivar, turno de trabalho, esquema de turno fixo ou alternante, estresse e fadiga. Entretanto, profissionais de enfermagem de unidades críticas que trabalhavam em esquema de turnos alternante e matutino apresentaram tendência a mais altos índices de estresse e fadiga e menor secreção de cortisol ao longo do dia de trabalho do que aqueles dos turnos fixo e noturno. A fadiga mostrou-se significativa e positivamente correlacionada com a secreção total de cortisol no período da manhã. Conclusão: Os achados do presente estudo fornecem evidências de uma dessincronização do eixo HipotálamoHipófise-Adrenal em enfermeiros dos turnos alternante e matutino e, consequentemente, maior susceptibilidade destes ao desenvolvimento de doenças cardíacas, metabólicas e imunológicas / Night-work and shiftwork are identified as maximizing negative effects on worker health, such as stress and fatigue, by making it difficult to adapt the circadian rhythm of cortisol to work. Objective: to investigate the effect of the fixed and alternating and nocturnal shifts of nurses on the occupational stress index, fatigue and circadian expression of salivary cortisol. Method: observational, cross-sectional and quantitative study based on Cooper\'s theoretical framework. Performed with 104 nurses from the emergency units and surgical center of a public teaching hospital in the State of São Paulo and another from Minas Gerais, from January to March, 2017. Stress and fatigue indexes were measured using two instruments, the Nurses\' Stress Inventory and the Fatigue Assessment Scale, both of which were validated and salivary cortisol quantification was performed by ELISA assay. The project was approved by the Research Ethics Committee under protocol. 55695416.7.0000.5393. Results: 66.67% of the nurses worked on alternating shifts and 39.39% were fixed on the morning shift. It was found that 50.8% of the nurses had a high stress index and 46.03% presented fatigue. There were no statistically significant associations between salivary cortisol index, shiftwork, fixed or alternating shift scheme, stress and fatigue. However, nursing professionals from critical units who worked in an alternating and morning shift schedule showed a trend towards higher levels of stress and fatigue and lower cortisol secretion throughout the workday than fixed and night shift workers. Fatigue was significantly and positively correlated to overall morning cortisol. Conclusions: The findings of the present study provide evidence of a hypothalamic-pituitary-adrenal axis desynchronization in nurses of the alternating and morning shift and, consequently, a greater susceptibility of these to the development of cardiac, metabolic and immunological diseases

The establishment of physiological norms for psychologically hardy vs. non-hardy individuals was attempted by examination of levels of salivary cortisol and urinary norepinephrine before and after a mid-term examination stressor. Normative data was collected on the reported frequency of stressors and their severity one week prior to the examination, and self-reported ratings of stress immediately prior to the examination. Performance on the examination as a function of hardiness was explored. Associations between demographic variables and psychological hardiness were also studied. Results from this study were inconclusive in establishing physiological norms for psychologically hardy individuals. Associations were found between: 1) hardiness and frequency of stressors; 2) hardiness and age; and 3) self-reported ratings of stress and anxiety as measured by the State-Trait Anxiety Inventory (STAI).

No description available.

Over recent years the delivery of nanosized drug particles has shown potential in improving bioavailability. Drug nanosizing is achieved by ¿top-down¿ and by ¿bottom-up¿ approaches. Owing to limitations associated with the top-down techniques, such as high energy input, electrostatic effects, broad particle size distributions and contamination issues, great interest has been directed to alternative bottom up technologies. In this study, the hypothesis that microreactors can be used as a simple and cost-effective technique to generate organic nanosized products is tested using three steroids (hydrocortisone, prednisolone and budesonide). Arrested antisolvent nanoprecipitation using ethanol (solvent) and water (antisolvent) was conducted within the microreactors. To enable experimental design for the microreactor studies, solubility profiles in different ethanol-water combinations at 25 °C were explored. All three drugs¿ solubility increased with increasing ethanol concentration showing maxima at 80-90 % v/v ethanol-water mixtures. Because of the complex multivariate microfluidic process, artificial neural network modelling was then employed to identify the dominant relationships between the variables affecting nanoprecipitation (as inputs) and the drug particle size (as output). The antisolvent flow rate was found to have the major role in directing drug particle size. Based on these successful findings, the potential of preparing pharmaceutical nanosuspensions using microfluidic reactors was researched. A hydrocortisone (HC) nanosuspension (NS) was prepared by introducing the generated drug particles into an aqueous solution of stabilizers stirred at high speed with a propeller mixer. A tangential flow filtration system was then used to concentrate the prepared NS. Results showed that a stable narrow sized HC NS of amorphous spherical particles 500 ± 64 nm diameter and zeta potential ¿18 ± 2.84 mV could be produced. The ocular bioavailability of a microfluidic precipitated HC NS (300 nm) was assessed and compared to a similar sized, milled HC NS and HC solution as a control. The precipitated and the milled NS achieved comparable AUC0-9h of 28.06 ± 4.08 and 30.95 ± 2.2, respectively, significantly (P < 0.01) higher than HC solution (15.86 ± 2.7). These results illustrate the opportunity to design sustained release ophthalmic formulations. Going nano via microfluidic precipitation was also exploited to tailor budesonide (BD) NS for pulmonary administration. The in vitro aerosolization by nebulization of a BD NS was studied in comparison with a commercial BD microsuspension. Overall, the fine particle fraction generated from BD NS (56.88 ± 3.37) was significantly (P < 0.05) higher than the marketed BD (38.04 ± 7.81). The mean mass aerodynamic diameter of BD NS aerosol (3.9 ± 0.48 ¿m) was significantly smaller (P < 0.05) than the microsuspension (6.2 ± 1.09 ¿m) indicating improved performance for BD NS. In conclusion, findings of this study support the hypothesis of using microfluidic nanoprecipitation as a promising and economical technique of drug nanosizing. / Egyptian Government (Ministry of High Education)

Syfte: Syftet var att utvärdera om experimentell psykologisk stress påverkar smärtkänsligheten i massetermuskeln, kortisolkoncentrationen i saliv, blodtryck och puls hos kvinnor. Material&Metod: 15 friska kvinnor deltog i studien (medelålder 23.7±2.3 år). Studien var en enkelblind randomiserad longitudinell studie, som sträckte sig över två besök. Deltagarna var randomiserat tilldelade att börja med kontroll- eller experimentellt besök. Experimentell stressuppgift utgjordes av aktivt deltagande i Paced Auditory Serial Addition Task och kontrolluppgiften av passivt deltagande. Kortisolkoncentration i saliv, upplevd stress och smärtkänsligheten mättes vid baseline och efter uppgiften. Smärtkänslighet, smärttröskel och smärttolerans, mättes med Painmatcher, Algometer och Palpometer på massetermuskel. Puls och blodtryck mättes regelbundet under hela besöket. Resultat: Ingen signifikant skillnad mellan experimentella- och kontrollbesöket kunde noteras för kortisolkoncentration i saliv, puls, blodtryck, smärta vid palpation, smärttröskel för tryck, smärttolerans för tryck och smärttröskel för elektricitet. Signifikant ökning av upplevd stress (P<0.01), smärttröskel för elektricitet (P<0.05), smärttolerans för elektricitet (P<0.05), smärttröskel för tryck (P<0.01)och smärttolerans för tryck (P<0.01) noterades däremot över tid i det experimentella besöket men ej i kontrollbesöket. Slutsats: Experimentell psykologisk stress, hos friska kvinnor, inducerade analgesi över tid. Detta tros bero på opioidhämmande systemet. Experimentell psykologisk stress hade ingen signifikant påverkan på kortisolkoncentration i saliv, blodtryck eller puls hos friska kvinnor. Fler studier krävs för att utreda psykologiska stressens roll i etiologin för orofacial smärta.

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