Introdução: Vários modelos experimentais para o estudo da síndrome do desconforto respiratório do tipo agudo (SDRA) foram desenvolvidos, sendo o modelo de lavagem pulmonar o mais utilizado. No entanto, a técnica originalmente descrita foi modificada por outros autores, tornando difícil a reprodutibilidade deste modelo experimental. Objetivos: Avaliar os efeitos do recrutamento pulmonar, do uso de volumecorrente fixo e do uso de diferentes volumes de lavagem na instalação do modelo experimental de SDRA, em relação ao número de lavagens necessárias para a obtenção do modelo experimental, a mortalidade e a estabilidade hemodinâmica durante o procedimento. Metodologia: Coelhos adultos da raça New-Zealand-White, foram divididos em 5 grupos de estudo, de acordo com a técnica utilizada para a lavagem pulmonar: 1- Volume-corrente (Vt) fixo de 10 ml/kg, volume de lavagem de 30 ml/kg, sem recrutamento pulmonar; 2- Pressão inspiratória (Pinsp) fixa, com um volume de lavagem de 30 ml/kg, sem recrutamento pulmonar; 3- Vt fixo, com um volume de lavagem de 25 ml/kg sem recrutamento pulmonar; 4- Pinsp fixa, com volume de lavagem de 25 ml/kg sem recrutamento pulmonar; 5- Vt fixo, com volume de lavagem de 30 ml/kg, com recrutamento pulmonar antes da primeira lavagem. Os animais foram submetidos a repetidas lavagens pulmonares com soro fisiológico aquecido em intervalos de 5 minutos, até se atingir o critério de definição de SDRA, estabelecido como uma relação PaO2/FiO2 <= 100. Resultados: Não foram encontradas diferenças entre os grupos em relação ao número de lavagens necessárias para a instalação do modelo experimental. O uso de recrutamento alveolar prévio e a utilização de pressão inspiratória fixa com volume de lavagem de 25 ml/kg foi associado a uma tendência à maior mortalidade. Embora não se tenha observado diferenças na estabilidade hemodinâmica entre os grupos de estudo, os animais ventilados com Pinsp fixa apresentaram uma pior ventilação alveolar com valores mais baixos de pH em relação aos animais ventilados com Vt fixo. Conclusões: A utilização de manobra de recrutamento alveolar, a uso de um volume-corrente fixo ou pressão inspiratória fixa entre as lavagens, e a utilização de diferentes volumes de lavagem (25 e 30 ml/kg) não modificaram o número de lavagens necessárias para a obtenção do modelo experimental de SDRA, assim como não modificaram a estabilidade hemodinâmica dos animais durante a realização do procedimento. Foi observada uma tendência à maior mortalidade com a realização da manobra de recrutamento alveolar e com o uso de pressão inspiratória fixa associado ao volume de lavagem de 25 ml/kg. / Background: Many experimental models were developed for the study of the acute respiratory distress syndrome (ARDS), and the lung lavage model is the more frequently used. The original technique was modified by many authors, resulting in difficulties for this experimental model reproducibility. Objectives: To evaluate the effects of the pulmonary recruitment, the use of fixed tidal-volume and different lavage volumes at the experimental ARDS model installation, regarding to the number of lung lavages necessary to obtain the experimental model, the mortality and the hemodynamic stability during the procedure. Methods: New-Zealand-White adult rabbits were divided into 5 study groups, according to the technique used: 1- Fixed tidal-volume (Vt) of 10 ml/kg, lavage volume of 30 ml/kg, no pulmonary recruitment; 2- Fixed inspiratory pressure (IP), lavage volume of 30 ml/kg, no pulmonary recruitment; 3- Fixed Vt, lavage volume of 25 ml/kg, no pulmonary recruitment; 4- Fixed IP, lavage volume of 25 ml/kg, no pulmonary recruitment; 5- Fixed Vt, lavage volume of 30 ml/kg, using pulmonary recruitment. The animals were submitted to repeated lung lavages with warm saline at 5 min interval until the ARDS definition(PaO2/FiO2 <= 100) be reached. Results: There was no differences among the study groups regarding the number of lung lavages necessary to obtain the experimental model. The use of alveolar recruitment before the first lavage and the use of fixed ventilatory pressure with 25 ml/kg lavage volume were associated with trend to a higher mortality rate. Although there were no differences regarding the hemodynamic stability among the study groups, animals ventilated with fixed inspiratory pressure had worse alveolar ventilation with higher levels of PaCO2 and lower pH. Conclusions: The use of alveolar recruitment maneuvers, the use of a fixed tidal-volume or inspiratory pressure between the lung lavages and the utilization of different lavage volumes did not change the number of lung lavages necessary to obtain the experimental model of ARDS or the hemodynamic stability of the animals during the procedure. It was observed a trend to an increased mortality rate with the recruitment maneuver and with the use of a fixed inspiratory pressure associated to the lavage volume of 25 ml/kg.

Nós investigamos o perfil inflamatório do lavado broncoalveolar (LBA) em crianças portadoras de asma de difícil controle apesar do tratamento com corticóide oral e sua relação com parâmetros clínicos e funcionais. O LBA foi realizado em 24 crianças com asma de difícil controle (13M/11F; idade média de 13 anos) e 5 controles. Houve aumento do número de neutrófilos em 15 das 24 crianças (60%) portadoras de asma de difícil controle (mediana 15%, 5-43%) e aumento de eosinófilos em 5 pacientes (mediana 9%, 6.5%-18.5%). Observou-se uma correlação entre a necessidade de corticóide oral e o número de internações e o percentual de eosinófilos no LBA. Ocorreu uma tendência de maiores números de neutrófilos no lavado e uma pior função pulmonar. Nós identificamos dois subgrupos de crianças portadoras de asma de difícil controle com características clínicas e funcionais distintas. Pacientes com aumento do percentual de neutrófilos tendem a apresentar uma pior função pulmonar. Um pequeno número de pacientes apresentou um padrão eosinofílico no lavado broncoalveolar com função pulmonar normal, porém sinais de instabilidade clínica. / Therapy resistant asthma is a major clinical problem in childhood. We investigated the inflammatory cell profile in the airways of children with severe asthma despite systemic steroid treatment and the relationship with clinical and functional severity. Bronchoalveolar lavage (BAL) was performed in 24 children with severe asthma (13M/11F; mean age 12.5 yrs, range 5-l4 yrs), and 5 controls. All received prednisolone prior to BAL. Neutrophils were the predominant inflammatory cell type in BAL in 15/24 (60%) children with asthma (median 15%, 5-43%).and only 5 patients had increases in eosinophils (median 9%, 6.5%-18,5%). There was a correlation between higher BAL eosinophils and more admissions Patients with higher BAL neutrophils showed a trend for lower pre-BAL lung function. We identified subgroups of children with severe asthma presenting different clinical and functional characteristics. Patients with increased percentages in BAL neutrophils showed a trend for lower lung function. A small number of patients presented eosinophilic airway inflammation in BAL with virtually normal lung function but showing signs of clinical instability.

Introdução: Vários modelos experimentais para o estudo da síndrome do desconforto respiratório do tipo agudo (SDRA) foram desenvolvidos, sendo o modelo de lavagem pulmonar o mais utilizado. No entanto, a técnica originalmente descrita foi modificada por outros autores, tornando difícil a reprodutibilidade deste modelo experimental. Objetivos: Avaliar os efeitos do recrutamento pulmonar, do uso de volumecorrente fixo e do uso de diferentes volumes de lavagem na instalação do modelo experimental de SDRA, em relação ao número de lavagens necessárias para a obtenção do modelo experimental, a mortalidade e a estabilidade hemodinâmica durante o procedimento. Metodologia: Coelhos adultos da raça New-Zealand-White, foram divididos em 5 grupos de estudo, de acordo com a técnica utilizada para a lavagem pulmonar: 1- Volume-corrente (Vt) fixo de 10 ml/kg, volume de lavagem de 30 ml/kg, sem recrutamento pulmonar; 2- Pressão inspiratória (Pinsp) fixa, com um volume de lavagem de 30 ml/kg, sem recrutamento pulmonar; 3- Vt fixo, com um volume de lavagem de 25 ml/kg sem recrutamento pulmonar; 4- Pinsp fixa, com volume de lavagem de 25 ml/kg sem recrutamento pulmonar; 5- Vt fixo, com volume de lavagem de 30 ml/kg, com recrutamento pulmonar antes da primeira lavagem. Os animais foram submetidos a repetidas lavagens pulmonares com soro fisiológico aquecido em intervalos de 5 minutos, até se atingir o critério de definição de SDRA, estabelecido como uma relação PaO2/FiO2 <= 100. Resultados: Não foram encontradas diferenças entre os grupos em relação ao número de lavagens necessárias para a instalação do modelo experimental. O uso de recrutamento alveolar prévio e a utilização de pressão inspiratória fixa com volume de lavagem de 25 ml/kg foi associado a uma tendência à maior mortalidade. Embora não se tenha observado diferenças na estabilidade hemodinâmica entre os grupos de estudo, os animais ventilados com Pinsp fixa apresentaram uma pior ventilação alveolar com valores mais baixos de pH em relação aos animais ventilados com Vt fixo. Conclusões: A utilização de manobra de recrutamento alveolar, a uso de um volume-corrente fixo ou pressão inspiratória fixa entre as lavagens, e a utilização de diferentes volumes de lavagem (25 e 30 ml/kg) não modificaram o número de lavagens necessárias para a obtenção do modelo experimental de SDRA, assim como não modificaram a estabilidade hemodinâmica dos animais durante a realização do procedimento. Foi observada uma tendência à maior mortalidade com a realização da manobra de recrutamento alveolar e com o uso de pressão inspiratória fixa associado ao volume de lavagem de 25 ml/kg. / Background: Many experimental models were developed for the study of the acute respiratory distress syndrome (ARDS), and the lung lavage model is the more frequently used. The original technique was modified by many authors, resulting in difficulties for this experimental model reproducibility. Objectives: To evaluate the effects of the pulmonary recruitment, the use of fixed tidal-volume and different lavage volumes at the experimental ARDS model installation, regarding to the number of lung lavages necessary to obtain the experimental model, the mortality and the hemodynamic stability during the procedure. Methods: New-Zealand-White adult rabbits were divided into 5 study groups, according to the technique used: 1- Fixed tidal-volume (Vt) of 10 ml/kg, lavage volume of 30 ml/kg, no pulmonary recruitment; 2- Fixed inspiratory pressure (IP), lavage volume of 30 ml/kg, no pulmonary recruitment; 3- Fixed Vt, lavage volume of 25 ml/kg, no pulmonary recruitment; 4- Fixed IP, lavage volume of 25 ml/kg, no pulmonary recruitment; 5- Fixed Vt, lavage volume of 30 ml/kg, using pulmonary recruitment. The animals were submitted to repeated lung lavages with warm saline at 5 min interval until the ARDS definition(PaO2/FiO2 <= 100) be reached. Results: There was no differences among the study groups regarding the number of lung lavages necessary to obtain the experimental model. The use of alveolar recruitment before the first lavage and the use of fixed ventilatory pressure with 25 ml/kg lavage volume were associated with trend to a higher mortality rate. Although there were no differences regarding the hemodynamic stability among the study groups, animals ventilated with fixed inspiratory pressure had worse alveolar ventilation with higher levels of PaCO2 and lower pH. Conclusions: The use of alveolar recruitment maneuvers, the use of a fixed tidal-volume or inspiratory pressure between the lung lavages and the utilization of different lavage volumes did not change the number of lung lavages necessary to obtain the experimental model of ARDS or the hemodynamic stability of the animals during the procedure. It was observed a trend to an increased mortality rate with the recruitment maneuver and with the use of a fixed inspiratory pressure associated to the lavage volume of 25 ml/kg.

Background Idiopathic pulmonary fibrosis (IPF) is a devastating form of chronic lung injury of unknown aetiology characterised by progressive lung scarring. A diagnosis of definite IPF requires High Resolution Computed Tomography (HRCT) appearances indicative of usual interstitial pneumonia (UIP), or in patients with 'possible UIP' CT appearances, histological confirmation of UIP. However the proportion of such patients that undergo SLB varies, perhaps due to a perception of risk of biopsy and additive diagnostic value of biopsy in individual patients. We hypothesised that an underlying UIP pathological pattern may result in increased risk of death and aimed to explore this by comparing the risk of SLB in suspected idiopathic interstitial pneumonia, stratified according to HRCT appearance. Additionally we sought to determine the positive-predictive value of biopsy to diagnose IPF in patients with 'possible UIP HRCT' in our population. In patients with possible UIP who are not biopsied, the clinical value of bronchoalveolar lavage (BAL) is uncertain. We aimed to prospectively study the diagnostic and prognostic value of BAL differential cell count (DCC) in suspected IPF and determine the feasibility of repeat BAL and the relationship between DCC and disease progression in two successive BALs. We hypothesised that BAL DCC between definite and possible IPF was different and that baseline DCC and change in BAL DCC predicted disease progression. Alveolar macrophages (AMs) are an integral part of the lung's reparative mechanism following injury, however in IPF they contribute to pathogenesis by releasing pro-fibrotic mediators promoting fibroblast proliferation and collagen deposition. Expansion of novel subpopulations of pulmonary monocyte-like cells (PMLCs) has been reported in inflammatory lung disease. We hypothesised that a distinct AM polarisation phenotype would be associated with disease progression. We aimed to perform detailed phenotyping of AM and PMLCs in BAL in IPF patients. Several prognostic scoring systems and biomarkers have been described to predict disease progression in IPF but most were derived from clinical trial patients or tertiary referral centres and none have been validated in separate cohorts. We aimed to identify a predictive tool for disease progression utilising physiological, HRCT and serum biomarkers in a unique population of incident treatment naïve IPF patients. Methods Between 01/01/07 and 31/12/13, 611 consecutive incident patients with suspected idiopathic interstitial pneumonia (IIP) presented to the Edinburgh lung fibrosis clinic. Of these patients 222 underwent video-assisted thoracoscopic lung biopsy and histological pattern was determined according to ATS/ERS criteria. Post-operative mortality and complication rates were examined. Fewer than 2% received IPF-directed therapy and less than 1% of the cohort were lost to follow-up. Disease progression was defined as death or ≥10% decline in VC within 12 months of BAL. Cells were obtained by BAL and a panel of monoclonal antibodies; CD14, CD16, CD206, CD71, CD163, CD3, CD4, CD8 and HLA-DR were used to quantify and selectively characterise AMs, resident PMLCs, inducible PMLCs, neutrophils and CD4+/CD8+ T-cells using flow cytometry. Classical, intermediate and non-classical monocyte subsets were also quantified in peripheral blood. Potential biomarkers (n=16) were pre-selected from either previously published studies of IPF biomarkers or our hypothesis-driven profiling. Linear logistic regression was used on each predictor separately to assess its importance in terms of p-value of the associated weight, and the top two variables were used to learn a decision tree. Results Based on the 2011 ATS/ERS criteria, 87 patients were categorised as 'definite UIP', of whom 3 underwent SLB for clinical indications. IPF was confirmed in all 3 patients based on 2013 ATS/ERS/JRS/ALAT diagnostic criteria. 222 patients were diagnosed with 'possible UIP'; 55 underwent SLB, IPF was subsequently diagnosed in 37 patients, 4 were diagnosed with 'probable IPF' and 14 were considered 'not IPF'. In this group, 30 patients were aged 65 years or over and 25/30 (83%) had UIP on biopsy. 306 patients had HRCTs deemed 'inconsistent with UIP', SLB was performed in 168 patients. Post6 operative 30-day mortality was 2.2% overall, and 7.3% in the 'possible UIP' HRCT group. Patients with 'definite IPF' based on HRCT and SLB appearances had significantly better outcomes than patients with 'definite UIP' on HRCT alone (P=0.008, HR 0.44 (95% CI 0.240 to 0.812)). BAL DCC was not different between definite and possible UIP groups, but there were significant differences with the inconsistent with UIP group. In the 12 months following BAL, 33.3% (n=7/21) of patients in the definite UIP group and 29.5% (n=18/61) in the possible UIP group had progressed. There were no significant differences in BAL DCC between progressor and non-progressor groups. Mortality in patients with suspected IPF and a BAL DCC consistent with IPF was no different to those with a DCC inconsistent with IPF (P=0.425, HR 1.590 (95% CI 0.502 to 4.967)). There was no difference in disease progression in either group (P=0.885, HR 1.081 (95% CI 0.376 to 3.106)). There was no statistically significant difference in BAL DCC at 0 and 12 months in either group. There was no significant change in DCC between 0 and 12 month BALs between progressors and non-progressors. Repeat BAL was well tolerated in almost all patients. There was 1 death within 1 month of a first BAL and 1 death within 1 month of a second BAL; both were considered 'probably procedure-related'. AM CD163 and CD71 (transferrin receptor) expression were significantly different between groups (P < 0.0001), with significant increases in the IPF group vs non fibrotic ILD (P < 0.0001) and controls (P < 0.0001 and P < 0.001 respectively). CD71 expression was also significantly increased in the IPF progressor vs non-progressor group (P < 0.0001) and patients with high CD71 expression had significantly poorer survival than the CD71low group (P=0.040, median survival 40.5 and 75.6 months respectively). CD206 (mannose receptor) expression was also significantly higher in the IPF progressor vs non-progressor group (P=0.034). There were no differences in baseline BAL neutrophil, eosinophil or lymphocyte percentages between IPF progressor or non-progressor groups. The percentage of rPMLCs was significantly increased in BAL fluid cells of IPF patients compared to those with non-fibrotic ILD (P < 0.0001) and healthy controls (P < 0.05). Baseline rPMLC percentage was significantly higher in IPF progressors vs IPF non-progressors (P=0.011). Baseline BAL iPMLC:rPMLC ratio was also significantly different between IPF progressor and non-progressor groups (P=0.011). Disease progression was confidently predicted by a combination of clinical and serological variables. In our cohort we identified a predictive tool based on two key parameters, one a measure of lung function and one a single serum biomarker. Both parameters were entered into a decision tree, and when applied to our cohort yielded a sensitivity of 86.4%, specificity of 92.3%, positive predictive value of 90.5% and negative predictive value of 88.9%. We also applied previously reported predictive tools such as the GAP Index, du Bois score and CPI Index to the Edinburgh IPF cohort. Conclusions SLB can be of value in the diagnosis of ILD, however perhaps due to the perceived risks associated with the procedure, only a small percentage of patients undergo SLB despite recommendations that patients have histological confirmation of the diagnosis. Advanced age is a strong predictor for IPF, and in our cohort 83% of patients aged over 65 years with 'possible UIP' HRCT appearances, had UIP on biopsy. BAL and repeat BAL in IPF is feasible and safe (< 1.5% mortality). Of those that underwent repeat BAL, disease progression was not associated with a change in DCC. However, 22% of lavaged patients died or were deemed too frail to undergo a second procedure at 12 months. These data emphasise the importance of BAL in identifying a novel human AM polarisation phenotype in IPF. Our data suggests there is a distinct relationship between AM subtypes, cell-surface expression markers, PMLC subpopulations and disease progression in IPF. This may be utilised to investigate new targets for future therapeutic strategies. / Disease progression in IPF can be predicted by a combination of clinical variables and serum biomarker profiling. We have identified a unique prediction model, when applied to our locally referred, incident, treatment naïve cohort can confidently predict disease progression in IPF. IPF is a heterogeneous disease and there is a definite clinical need to identify 'personalised' prognostic biomarkers which may in turn lead to novel targets and the advent of personalised medicines.

Background: Tobacco smoking is the main cause of chronic obstructive pulmonary disease, COPD, but the mechanisms by which cigarette smoke induces COPD are still elusive. T lymphocytes have been implicated in the pathogenesis of the disease, but their role in the airway inflammation in COPD is not fully understood. The aim of this thesis was therefore to address T lymphocyte subsets and their activation in the airways of subjects with COPD, in comparison to smokers with normal lung function (S) and never smokers (NS). Methods: Subjects with moderate to severe COPD were recruited along with controls. They were all non-atopic and clinically stable, without any exacerbation during at least three months prior to inclusion. Only medication with short-acting β2-agonists and/or anti-cholinergic drugs was permitted. All subjects underwent bronchoscopy with endobronchial mucosal biopsy sampling as well as bronchial wash, BW, and bronchoalveolar lavage, BAL, collection. Biopsies were immunohistochemically stained for inflammatory cells and markers. BW and BAL fluids were prepared for differential cell counts. Soluble markers were measured in BW and lymphocyte subsets were determined in BAL using flow cytometry. Results: In biopsies, an increase in epithelial CD3+ and CD8+ cells was found in COPD, compared to NS. In BAL fluid, CD8+ cells were enhanced, whereas CD4+ cells were reduced in subjects with COPD and S, compared to NS. Furthermore, CD4+ and CD8+ cells were more activated both in COPD and S, in terms of increased expression of CD25, CD69 and HLA-DR. NKG2D-expressing CD8+ T cells in BAL fluid were enhanced in both COPD and S. CD4+CD25bright cells were upregulated in COPD and S, suggesting the presence of regulatory T cells. Further analyses of T cell subsets with the more specific markers for regulatory T cells, FoxP3 and CD127, indicated a smoking-induced expansion of non-regulatory T cells, which tended to normalize after smoking cessation in COPD. Currently smoking subjects with COPD still expressed high proportions of activated non-regulatory CD4+ T cells. The data on FoxP3 expression further indicated that the increase in CD25 expression in COPD and S was not only associated with the expansion of regulatory T cells. As CD127 expression is reported to be inversely associated with FoxP3, the data indicate the expansion of a non-regulatory CD25+ population in smokers and patients with stable COPD. The immunohistochemical staining for the NKG2D ligands MICA and MICB on epithelial cells was unchanged. Conclusion: The results of this thesis suggest a role for CD4+ and CD8+ T-cells in clinically stable COPD, indicating that T-cells are of importance in the long-term inflammatory response in COPD. Regardless of current smoking habits, activated CD8+ T lymphocytes were found to be increased in BAL fluid from subjects with COPD, suggesting that changes in CD8+ T cells are associated with a persistent immune response and, thus, of importance in COPD pathogenesis. In contrast, the expansion of non-regulatory CD25+CD4+ cells in BAL fluid seemed to be preferentially smoke-related. In summary, the data indicate that, among airway T cells, changes in CD8+ cells seem to be highly associated with COPD pathogenesis, whereas changes in CD4+ cells appear to be related to cigarette smoke-induced responses. Further, a non regulatory population of helper T cells was identified in BAL fluid of COPD patients, which may contribute to the persistent cytotoxic T cell responses.

Puumala hantavirus (PUUV) causes hemorrhagic fever with renal syndrome in Europe. After inhalation of virus shed by bank voles, the virus systemically targets the vascular endothelium leading to vascular dysfunction and leakage. Many patients with PUUV infection experience cardiopulmonary manifestations but the underlying mechanisms have not been determined. The aims of the studies presented were to describe cardiopulmonary manifestations, investigate pathogenetic mechanisms including presence of virus in the lungs and the local immune response in PUUV infection. The results showed cardiopulmonary involvement of varying severity in almost all studied patients. High-resolution computed tomography frequently revealed vascular leakage into the lungs or pleural cavities. Pulmonary function tests generally showed reduced gas diffusing capacity, evidenced in patients as dyspnea, poor oxygenation and frequent need of oxygen treatment. Among patients who were not fully recovered at 3 months follow-up, remaining decreased gas diffusing capacity was highly common. Echocardiography revealed mainly right heart dysfunction which was related to manifestations within the lungs, in terms of increased estimated pulmonary vascular resistance, mild to moderate pulmonary hypertension, and reduced right ventricular systolic function in patients with more pronounced lung involvement, as indicated by need of oxygen treatment. Analyses on bronchoalveolar lavage (BAL) and bronchial biopsies revealed a highly activated cytotoxic T cell (CTL) response in the lungs. The CTL response was not balanced by the expansion of regulatory T cells and high numbers of CTLs were associated with more severe disease. PUUV RNA was detected in almost all patients’ BAL samples and the viral load was inversely correlated to the number of CTLs. Three patients presenting with severe and fatal cardiopulmonary distress were also described. Autopsies revealed PUUV protein in vascular endothelium in all investigated organs, including the heart and lungs, along with a massive CTL response mainly in the lungs. In conclusion, cardiopulmonary involvement of varying severity was present in almost all patients with PUUV infection. Cytotoxic immune responses could contribute to disease development but also help in clearing the infection. Long lasting fatigue after hantavirus infection may be explained by remaining manifestations within the lungs.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

Submitted by Carol Fantinel (fantinel.caroline@gmail.com) on 2014-06-05T16:07:57Z No. of bitstreams: 1 Caroline Fantinel_Dissertação de Mestrado_PósCultura.pdf: 10671743 bytes, checksum: 248cf21e2ecadc3df8d31af915523ba2 (MD5) / Approved for entry into archive by Rodrigo Meirelles (rodrigomei@ufba.br) on 2014-06-06T21:09:10Z (GMT) No. of bitstreams: 1 Caroline Fantinel_Dissertação de Mestrado_PósCultura.pdf: 10671743 bytes, checksum: 248cf21e2ecadc3df8d31af915523ba2 (MD5) / Made available in DSpace on 2014-06-06T21:09:10Z (GMT). No. of bitstreams: 1 Caroline Fantinel_Dissertação de Mestrado_PósCultura.pdf: 10671743 bytes, checksum: 248cf21e2ecadc3df8d31af915523ba2 (MD5) / A presente dissertação analisa de que forma se dá a transnacionalização de um bem simbólico, no contexto desterritorializante e reterritorializante da globalização. No caso desta pesquisa, o “bem simbólico” é representado por uma festa popular, mais especificamente, a Lavage de la Madeleine – que acontece em Paris, capital da França e tem sua inspiração na Lavagem do Bonfim, festa popular-religiosa baiana. Para compreender esse deslocamento territorial e cultural, foi utilizado, principalmente, o ferramental da metodologia qualitativa, com consulta à fontes relevantes, bem como a observação direta das duas festas em questão. O método comparativo também foi essencial para relacionar essas duas ocasiões festivas e compreender o processo de reterritorialização da lavagem que acontece em Paris. A pesquisa sustenta-se nos eixos temáticos dos estudos da festa, globalização e transnacionalização cultural. Objetiva-se, com isso, situar a referida representação cultural neste contexto teórico, com fins de compreendê-la pela via do processo diaspórico que a forma. A conquista desse entendimento passa, também, pela análise e compreensão da noção de cultura e identidade na contemporaneidade, sobretudo, pelas suas características de fronteiras hibridizantes e mestiçagem cultural. Os resultados obtidos revelaram que a Lavage de la Madeleine, assim como indicam as teorias da transnacionalização e do transculturalismo, é formada, essencialmente, pela hibridez característica deste quadro complexo e diaspórico que a faz existir. Ainda, faz-se necessário que ela traduza a composição festiva tradicional baiana no qual se inspira, ressignificando-a com o objetivo de que seja possível a sua sobrevivência em território estrangeiro. / This dissertation examines how occurs the transnationalism of a symbolic asset, in a globalization’s context based on the processes of deterritorialization and reterritorialization. In the case of this research, the "symbolic asset" is represented by a popular festival, more specifically, The Lavage de la Madeleine - which happens in Paris, capital of France and has its inspiration in the Lavagem do Bonfim, a brazilian folk- religious festival, that happens in the state of Bahia. In order to understand this territorial and cultural displacement, the research used, primarily, a qualitative methodology, by making use of relevant sources as well as the direct observation of the two festivals at issue. The comparative method was also essential to relate these two festive occasions and understand the Lavag de la Madeleine’s process of reterritorialization that happens in Paris. The research is supported from studies of popular festivities, globalization and cultural transnationalism. The objective is, therefore, to place the Lavage de la Madeleine in such theoretical context, by understanding it through its diasporic process. The achievement of this understanding also involves the analysis and comprehension of the concept of culture and identity in the contemporaneity, especially, due to its characteristics of fluid boundaries and cultural mixing. The research’s results revealed that the Lavage de la Madeleine, as well as indicate the theories of transnationalism and transculturalism, is essentially formed by its complex hybridity and diasporic configuration that enables the Lavage de la Madeleine exists. Furthermore, it is necessary that the Lavage reflects the traditional bahian festival - which is its inspiration - redefining it with the intent of making it to survive in foreign lands.

Submitted by Karina Calciolari null (karinaveterinaria@hotmail.com) on 2016-04-18T19:09:55Z No. of bitstreams: 1 Dissertação_Karina Calciolari.pdf: 3537872 bytes, checksum: 25bdb76342a16861139075d0c9e32394 (MD5) / Approved for entry into archive by Felipe Augusto Arakaki (arakaki@reitoria.unesp.br) on 2016-04-19T17:12:27Z (GMT) No. of bitstreams: 1 calciolari_k_me_jabo.pdf: 3537872 bytes, checksum: 25bdb76342a16861139075d0c9e32394 (MD5) / Made available in DSpace on 2016-04-19T17:12:27Z (GMT). No. of bitstreams: 1 calciolari_k_me_jabo.pdf: 3537872 bytes, checksum: 25bdb76342a16861139075d0c9e32394 (MD5) Previous issue date: 2016-02-22 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / As afecções do sistema respiratório são a segunda causa de queda de desempenho e afastamento dos equinos do esporte ou trabalho, as quais estão atrás somente das desordens musculoesqueléticas. A estabulação e alimentação a base de fenos predispõe os equinos a inalação de grande número de agentes irritantes as vias aéreas. No intuito de mensurar a influência dos tipos de cama utilizado em baias de equinos nas respostas alérgicas das vias aéreas estudou-se 3 grupos com 5 equinos cada sendo dois mantidos em cocheiras com diferentes tipos de forração à base de madeira (maravalha de pinus autoclavada-MA e serragem-SE) e por último um grupo controle à pasto por 45 dias com avaliações quinzenais (D0, D15, D30 e D45). Foi realizado nestes momentos o exame físico, coleta de amostras de sangue venoso e arterial para realização de hemograma e hemogasometria respectivamente, lavado broncoalveolar com análise citológica e mensuração de fosfatase alcalina, além de amostras das camas (limpa e suja) e feno pré-secado para análise micológica. No exame físico foi notado tosse e espirros em maior intensidade e número nos equinos do grupo SE. A análise hematológica permaneceu dentro dos padrões de normalidade. Já nos achados hemogasométricos os maiores valores de pH foram observados nos equinos à pasto (7,47 ± 0,02). Nos grupos embaiados foi observado valores de pressão parcial de dióxido, de D15 à D45, inferiores (valores entre 38,3 a 43,7 mmHg) ao grupo a pasto (valores entre 43,7 a 46,5 mmHg), sendo os valores de pressão parcial de oxigênio inversamente proporcionais (MA e SE: valores entre 103,6 a 127,78 mmHg e à pasto: 88,2 a 103,6 mmHg). Os principais achados no lavado broncoalveolar basearam-se na contagem de células nucleadas totais no que apresentou maiores valores em todos os momentos nos animais à pasto (251,0 a 336,8 x 103/ µL), seguido do grupo SE (197,0 a 248,6 x 103/ µL) e por último o MA (140,6 à 270,2 x 103/ µL). Dentre as células nucleadas os macrófagos representaram maior porcentagem seguidos dos linfócitos (51,2 a 80,8% e 6,6 a 33,2% respectivamente). Um padrão inesperado foi observado na população de neutrófilos, os quais com os passar dos momentos houve decréscimo, com excessão do grupo MA que apresentou um pico no D30 (35%), relacionado ao pico de fosfatase alcalina (27,6 ± 14,98 UI/L) neste mesmo momento. Foram identificados cerca de 12 gêneros fúngicos em ambas camas e 17 no alimento volumoso, sendo neste último encontrado gêneros patogênicos como Aspergillus (0,85 ± 2,2%), Fusarium (5,35 ± 9,23%) e Penicílium (4,81 ± 9,53%), porém em baixas porcentagens. A principal diferença entre as camas baseou-se na capacidade da produção e dispersão de partículas finas passíveis de inalação, a qual foi maior para a serragem (MA: 15,29 % e SE: 18,28%). Concluiu-se que a cama de maravalha além de ter manejo mais fácil, apresentou menor capacidade irritativa das vias aéreas superiores do que a serragem. As condições de manejo e estabulações utilizadas foram ideais, servindo de modelo quanto a ventilação e higienização das baias. / Horse respiratory diseases is second most commom cause of poor performance and premature retirement, which the one are musculoskeletal disorders. The stabling and poor quality feedings may the favor predispose of diseases in airways. In order we measure the influence of the types of bedding used in the horse stalls about responses allergic airway. Three groups of five horses each are formated, two groups kept in stables but each group with a different type of bedding (autoclaved wood- MA shaving and sawdust-SE) . The third group is the control and stays at pasture. The groups remained in this condition for 45 days with biweekly reviews (D0, D15, D30 and D45). It was realize the physical examination, venous and arterial blood samples collection to realize hemogram and hemogasometry analysis, the bronchoalveolar lavage samples was colected to realize the cytological analysis and to measure alkaline phosphatase. In addition, samples of the beds (clean and dirty) and haylage was collected to realize mycological analysis. In the physical examination was noticed higher intensity of coughing and sneezing at SE group. Hematological analysis remained within the normal standards. Findings of hemogasometric analysis were observed the biggest pH values at horses to pasture (7.47 ± 0.02). At stables horses was observed smaller values of partial pressure dioxide (D15 to D45), (values between 38.3 to 43.7 mmHg) to horses to pasture (values between 43.7 to 46.5 mmHg). The values oxygen partial pressure it was inversely proportional to partial pressure dioxide (MA and SE: values between 103.6 to 127.78 mmHg and pasture: 88.2 to 103.6 mmHg). It was observate higher values of nucleated cells of bronchoalveolar lavage, at all times, in animals to pasture (251.0 to 336.8 x 103 / mL), followed by the SE group (197.0 to 248.6 x 103 / mL) and finally MA group (140.6 to 270.2 x 103 / mL). The macrophages cells represented the biggest percentage of nucleates cells on bronchoalveolar lavage followed by lymphocytes (51.2 to 80.8% and 6.6 to 33.2% respectively). An unexpected pattern was observed in percentange of neutrophils cells, that it was a decrease over the time. One exception it was with MA group that had the biggest percentage values in D30 (35%), it was related to alkaline phosphatase peak at same time (27.6 ± 14.98 IU / L). Were identified about 12 fungi genres in both beds and 17 fungi genres at haylage. We indentified pathogenic genres in haylage as Aspergillus (0.85 ± 2.2%), Fusarium (5.35 ± 9.23%) and Penicillium (4 , 81 ± 9.53%), however in lower percentages. It was observate a difference production capacity and fine particle dispersion between the bed, that the biggest it was notice at sawdust (MA: 15.29% and SE: 18.28%). It was concluded that wood shavings bed is easier to use and showed less irritative capacity upper airway to que sawdust. As management and stabling conditions used were ideals and it was a ideal model of stables.

Orientador: Roberto Calderon Gonçalves / Banca: Alice Maria Melville Paiva / Banca: Simone Biagio Chiacchio / Resumo: Os estudos das secreções traqueobrônquicas são amplamente utilizados nas pesquisas de condições patológicas pulmonares nas diversas espécies animais, inclusive no homem. Os objetivos desta pesquisa foram a viabilização da técnica de colheita de lavado traqueobrônquico na espécie ovina e o estudo da relação clínico-citológica do lavado de ovinos portadores de afecções respiratórias e clinicamente sadios. Foram utilizados neste estudo 19 ovinos sem sintomatologia respiratória e 23 portadores de enfermidade respiratória com sinais clínicos e envolvimento de vias aéreas, divididos nos respectivos grupos. Após o exame físico foi realizado o lavado traqueobrônquico por via nasotraqueal. A colheita do lavado foi feita com a inoculação e aspiração de solução fisiológica estéril. As amostras foram processadas citologicamente através de citocentrifugação e coradas pelos métodos Giemsa, Shorr e Gram. Nos animais sadios notou-se predomínio de macrófagos, seguido por células epiteliais cilíndricas, neutrófilos e linfócitos. No grupo de animais doentes notou-se redução no número de macrófagos e aumento da freqüência cardíaca. Embora não tenha ocorrido diferença estatística significativa entre os grupos avaliados, notou-se tendência ao aumento de neutrófilos nos animais doentes. A técnica estudada mostrou-se eficaz na obtenção de fluidos traqueobrônquicos, por ser de fácil realização por médicos veterinários no campo, pouco dispendiosa, e obter material representativo da região traqueobrônquica. / Abstract: The studies of the tracheobrochial secretions are very useful in the research of the lung pathological conditions in different animal's species and in humans. The purposes of this research are to enable the collection technique of the tracheobronchial lavage in ovine and the study of the clinical cytology relationship of the lavage in ovines with respiratory disease and clinically healthy. In this study there were used 19 ovines without respiratory symptoms and 23 with respiratory disease with symptoms and airway involvement, separated in respective groups. After physical examination the tracheobronchial lavage was performed by nasotracheal via. The tracheobronchial lavage was performed by injection and aspiration of sterile saline. Cytology of the samples was proceeding by centrifugation and collored by Giemsa, Shorr and Gram methods. In the healthy animals was noted prevalence of macrophages, followed by cylindric epithelial cells, neutrophils and lymphocytes. In the ill animals group there was reduction in the macrophages and higher heart rate. Despite there was no considerable statistic difference between the analyzed groups, a tendency in the increase of the neutrophils number in the ill group was noted. The evaluated technical showed itself to be efficient to obtain tracheobronchial fluid, considering its easy proceeding by veterinarians in the field, no expensive and obtaining representative volume of the samples from the tracheobronchial region. / Mestre