Orientador : Roosevelt Moises Smeke Cassorla / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-07-28T22:35:58Z (GMT). No. of bitstreams: 1 Gabriel_ClaudiaAdalgisaAzevedoRomero_M.pdf: 26188909 bytes, checksum: 4ed3df4fdef3a24fa69fa3b6e30edb4b (MD5) Previous issue date: 2001 / Resumo: Procurou-se investigar e compreender os aspectos psicológicos dos pacientes portadores da doença de Crohn, doença inflamatória crônica, de causa desconhecida, que pode acometerqualquer parte do tubo digestivo(desde a boca até o ânus) e que até o momento não tem cura. O fato de se tratar de uma doença crônica, recidivante e de dificil diagnóstico, traz grandes repercussões na vida de tais pacientes. Através da Pesquisa Qualitativa, usando o método descritivo coletaram-se os dados utilizando-se como instrumento a entrevista semi-estruturada com questões abertas aplicada em nove (9) pacientes do Ambulatório de Doenças Inflamatórias do Intestino, do Serviço de Colo-Proctologia do Hospital das Clínicasda UNICAMP. A Análise dos Conteúdos foi realizada a partir do material coletado nas entrevistas e observações do cenário e das pessoas. Procurou-se valorizar a vivência do adoecer, considerando-se os aspectos da singularidade de cada entrevistado como elementos fundamentais para interpretação dos dados. A realidade da doença desperta sentimentos de impotência e aniquilamento. Sintomas como dores abdominais e diarréia contribuem para o rebaixamento da auto--estima. A imagem corporal muitas vezes não corresponde à imagem internalizada, contribuindo de modo significativo no isolamento dos pacientes, afastando-os de seu grupo social, profissional e até mesmo familiar. Encontrou-se outras repercussões como idéias suicidas, sentimentos de discriminação, amargura, ressentimentos, entre outros. Concluíu-se que o processo de adoecer acarreta mudanças inevitáveis na maneIra de viver destes pacientes, interferindo diretamente em seu cotidiano, exigindo adaptações em seu estilo de vida, dependentes de seus recursos internos de enftentamento e também do apoio recebido por parte da família, da equipe médica e dos amigos. Encontrou-se vivências permeadas de intenso sofrimento, sentimentos de desamparo e desalento, em que suas limitações fisicas e psíquicas fazem eco em suas relações familiares, sociais e profissionais, acarretando um isolamento voluntário, numa tentativa de evitar o 'olliar do outro', deixando-os mais vulneráveis a sentimentos de rejeição, solidão, raiva e medo. Sabe-se que a instabilidadedo quadro clínico favorece, e até mesmo mantém, o contato constante dos pacientes com suas limitações, impossibilitados de exercer sua rotina. Acredita-se que o acompanhamento por uma equipe multidisciplinar destes pacientes, já no início da manifestação dos sintomas, favorecerá o fortalecimento de recursos de ementamento em todo o processo de adoecer, considerando-se aqui o indivíduo como um ser biopsicossocial, na sua singularidade, e merecendo um olhar específico no manejo de sua enfermidade / Abstract: This work aimed to investigate and discuss the psychological aspects of patients with Crohn's syndrome. This syndrome is a chronic inflammatory disease of unknown etiology that may affect any section of the digestive tract (from mouth to anus) and impossible to be cured until the present. To treat such chronic, episodically disease with bad diagnosis affect deeply the patients lives. The method used was qualitative and descriptive, and data were collect using semi-guided interviews with open questions of nine patients of the health service of inflammatory diseases of intestines attached to the service of colo-rectum of the Hospital das Clínicas,Unicamp, Campinas, Brazil. The analysis of data and observations collected in the interviews was made especially on the experience of getting ill and considering the aspects of the each interviewee as main elements for the interpretation. The reality of this disease causes feelings of hopelessness and annihilation. Symptoms like abdominal pains, diarrhea does contribute in the fIattering of self-esteem. The body image of the subject many times does not match to the internalized image, increasing the isolation of these patients from their social, professional and even family groups. Among other feelings, it was found suicida! ideas and feelings of being socially discriminated, bittemess and resentment. We concluded that the process of getting ill provoke inevitable changes in the way of life of these patients, affecting their daily lives and demanding adaptations of their life styles according to the inner personal resources of coping and, also of the family, friends and health staff support obtained. We found personal experiences of severe suffering, hopelessness and despair when their physical withdrawal symptoms echo in their family, social and professional relations causing voluntary isolation in an attempt of avoidance "others look", and this reaction make patients more vulnerable to feelings of rejection, loneliness,anger and fear. We know that the clinical instability of the disease helps, and even maintain, patients in continua! contact with personal limitations, hampered of living the routine normally. We believe that multidisciplinary follow-up since the beginning of the manisfestation of symptoms would help to strengthen their coping resources along a1lthe process, considering that the person is a singular bio-psycho-social being that deserves individualized care / Mestrado / Saude Mental / Mestre em Ciências Médicas

Orientadores : Elemir Macedo de Souza, Maria Leticia Cintra / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-01T20:39:47Z (GMT). No. of bitstreams: 1 Gomes_AnnaAntonio_D.pdf: 15863759 bytes, checksum: 5c4d1982f79f6dd3593c4545f3e04ca2 (MD5) Previous issue date: 2001 / Resumo: Fotoenvelhecimento e fotodano são temas desafiadores e inesgotáveis. A maioria dos estudos enfatiza os aspectos epidérmicos, enquanto outros os dérmicos. Todavia, há poucos trabalhos referentes à íntima correlação entre estes dois compartimentos, que devem ser considerados como um todo: a unidade dermoepidérmica. o estudo foi baseado em 61 trabalhadores com mais de dez anos de fotoexposição, acima de 45 anos, que apresentavam dois padrões básicos de fotodano cutâneo: atrofia e elastose, dentro dos mesmos fototipos de pele I, 11 e m, segundo Fitzpatrick. Biópsias com "punch" de 5mm foram realizadas nas áreas livres de tumor ou de outras lesões na área exposta (1/3 proximal do antebraço), parcialmente exposta (1/3 médio interno do braço) e não-exposta (raiz lateral da coxa). Medidas da área da epiderme e derme foram avaliadas mediante análise de imagem computadorizada, com desenho à mão livre. O estudo estereológico da derme foi feito por meio da retícula de ciclóides (para fibras elásticas) e retícula segmentada (para fibras colágenas). A membrana basal foi estudada por imunoistoquímica. Foram avaliados os seguintes aspectos: espessura e área da epiderme e da derme, quantidade de tecido elastótico, quantidade de fibras colágenas, número de queratinócitos melanizados, número de camadas de células granulosas, espessura e continuidade da membrana basal e avaliação da faixa subepidérmica. Resultados: Na amostra examinada de indivíduos caucasóides crônica e intensamente expostos ao sol, a análise estatística revelou correlação significante entre: a) padrão clínico e fototipo: quanto menor o fototipo, maior a atrofia da pele; b) sexo e queratinócitos melanizados na área exposta: a pele cronicamente exposta ao sol apresenta pigmentação de distribuição irregular, significativamente mais acentuada nos indivíduos do sexo masculino; c) presença de neoplasias e idade: a fteqüência das neoplasias cutâneas é progressiva com a idade; o efeito deletério solar é cumulativo nos caucasóides de qualquer fototipo e de qualquer padrão clínico de fotodano; d) idade e espessura da epiderme: confon ne já está bem documentado, ad epiderme cronicamente exposta ao sol é mais espessa que a semi-exposta ou a coberta;i porém, foi observada correlação negativa entre a idade e a sua espessura na região cronicamente exposta ao sol. Ou seja, mesmo na área fotodanificada, ocorre atrofia epidérmica progressiva com a idade; e) área da epiderme e área da derme: a área total epidennodérmica da pele do braço mostrou-se menor do que a do antebraço e esta menor do que a da coxa, sendo a medida da epidenne inversamente proporcional à da denne. Ou seja: nos locais em que a derme é mais espessa, a epidenne é mais delgada; f) padrão clínico e colágeno na área não exposta: na pele coberta, o número de fibras colágenas da denne reticular é significativamente menor nos indivíduos de padrão atrófico, relativamente aqueles de padrão elastótico; g) idade e área dérmica na porção interna do braço: quanto maior a idade, menor a área da denne, ou seja, nesta região anatômica, ocorre atrofia progressiva da derme, com o avançar da idade. Não foi observada correlação entre: a) o padrão clínico (atrófico ou elastótico) e: 1- a idade; 2- o sexo; 3- quaisquer das contagens ou medidas epidérmicas ou dérmicas: uma vez que as diferenças entre os padrões (atrófico ou elastótico), tão aparentes à clínica, não se embasaram nem na espessura ou área da epidenne ou denne e nem no teor de fibras colágenas ou elásticas, pode-se cogitar que haja uma diferença na configuração espacial da pele elastótica, que seria, eventualmente, mais ondulada que a atrófica; b) o fototipo (I, fi, 111)e: 1- a idade; 2- o sexo; 3- quaisquer das contagens ou medidas epidérmicas ou dérmicas; c) presença de neoplasias e fototipo ou padrão clínico: não houve diferença significativa entre a presença ou a ausência de tumor e: 1- fototipo (1, lI, IlI); 2- padrão clínico (atrófico ou elastótico); d) medida da zona da membrana basal e fotoexposição: não foi encontrada diferença significativa entre a espessura da zona da membrana basal na pele das áreas exposta, semi-exposta e coberta. Todos os demais achados estão conformes ao que está descrito na literatura. Conclusão: Na amostra estudada (pele crônica e intensamente exposta ao sol), foi observado que: a) indivíduos caucasóides apresentam propensão crescente a desenvolver neoplasias cutâneas, à medida que o tempo de exposição se prolonga e não há diferença significativa de risco entre os diferentes fototipos (I, li, lil) e padrões clínicos (elastótico ou atrófico); b) a pele fotodanificada apresenta modificações de espessura e textura dos seus vários elementos, que não diferem, significativamente, entre os diferentes fototipos e padrões clínicos / Abstract: Photoaging and photodamage are chalIenging and endless themes. Most of the studies focus on the epidermal features while, others, emphasizes the dermis. However, there have been few studies concerning the intimate correlation between these compartments, which should be considered as a whole: the dermal-epidermal unit, as welI as its relation to skin malignancy. The purpose of the present study was to investigate the association between clinical and histological features of the dermal-epidermal unit on the exposed skin, comparatively to the unexposed skin of the same individuaIs with Milian's citrine skin or its atrophic variant, within Fitzpatrick's phototypes I, lI, and III. The study was based on outdoor workers, who presented two basic clinical patterns of skin photodamage, atrophic and elastotic, with phototypes varying ttom I to Ill. There were 61 volunteers over 45 years , and alI signed an informed consent. Five-mm punch biopsies of tumor-ttee exposed (dorsal aspect of the forearm), partially exposed (the inner aspect of the arm), and non-exposed (upper thigh) skin were performed. The subjects were screened, and divided into groups, according to their phototypes, clinical features of their sun damaged skin (atrophic or elastotic), and the presence or absence of skin tumors on any other skin site. Measurement of the epidermal and dermal areas were evaluated by means of a computer-assisted image analysis (KS 300, Carl Zeiss Inc). Stereological study ofthe dermis was made through a cyc1oidreticulum (for elastic fibers) and a segmented reticulum (for colIagen fibers), settled on a lOx Zeiss ocular lens. The basement membrane zone was studied through PAS and immunohistochemical stain (collagen IV) . The folIowing aspects were evaluated: epidermal thickness and area, dermal area, elastic tissue amount, collagen fiber amount, melanin-rich keratinocyte number, granular layer cell number, and basement membrane thickness and continuity. The variables analized were: clinical pattem (trend to elastosis or to atrophy), age, seXophototype, and presence or absence of skin tumors. Results: On the subset of caucasoid individuaIs examined, which were chronically and intensely sun-exposed, the statistic analisys revealed significant correlation between: a) clinical pattern and phototype: the smaller the phototype, the higher the intensity of skin atrophy; b) sex and melanin-enriched keratinocytes at the exposed area: thechronically sun-exposed skin presents irregular distribution of pigmentation, significantly enhanced among male individuaIs; c) presence of neoplasias and age: the ftequence of cutaneous neoplasias is progressive with ageing; the deleterial effect of the sun is cumulative among caucasoids of any phototype and any clinical pattem of photodamage; d) age and skin thickness: in conformity with what is already well documented, the chronically sun-exposed epidermis is thicker than the partially-exposed or the unexposed one; however, there was a negative correlation between age and its thickness at the chronically sun-exposed region. In other words, even at the photodamaged area, progressive epidermal atrophy occurs with age; e) epidermal area and dermal area: the total epidermal-dermal area of the arm's skin was smaller than the area ofthe forearm, and this one smaller than the thigh's, and the epidermal measures were inversely proportional to the dermis. In other way, in areas where the dermis is thicker, the epidermis is slimmer; 1) clinical pattern and collagen content at the unexposed area: at the covered skin, the number of collagen fibers ofthe reticular dermis is significant1ysmaller at the individuaIs with atrophic pattern, relatively to the elastotic ones; g) age and dermal area at the inner portion of the arm: the older the age, the smaller the dermal area; in other words, at this anatomic site, progressive dermal atrophy occurs with ageing. There was no correlation between: a) clinical pattern (atrophic or elastotic) and : 1- age; 2- sex; 3- any other counting or dermal and epidermal measures: once the differences between the patterns (atrophic or elastotic), so clinically apparent, did not have thickness or dermal or epidemial areas' embasement , neither at the coUagen, nor at the elastic content, one can suppose that there is a dilference at the spatial configuration of the elastotic skin, which would have, eventually, a wavier aspect than the atrophic skin; b) the phototype (1,11,111)and: 1- age; 2- sex; 3- any other countings or dermal or epidermal measures; c) the presence of neoplasias and phototype or clinical pattern: there was no significant difference between the presence or absence of tumor and: 1- phototype (I,II,III); 2- clinical pattem (atrophic or elastotic); d) basement membrane zone measures and photoexposion: there was no significant dilference between the basement membrane zone' s thickness at the exposed, partially-exposed and unexposed skin areas. AlI ofthe other findings are in conformity with the descriptions in the literature. Conclusion: On the studied subset (chronic and intensely sun-exposed skin), it was observed that: a) caucasoid individuaIs present increasing propension to develop cutaneous tumors as time exposion lengthens and there is no significant risk among the dilferent phototypes (I,II,fi) and clinical patterns (atrophic or elastotic); b) the photodamaged skin shows thickness modifications and textureof its various elements, which do not differ, significantly, among the different phototypes and c1inicalpatterns / Doutorado / Anatomia Patologica / Doutor em Ciências Médicas

Orientadores: Aarão Mendes Pinto Neto, Ellen Hardy / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-07-25T10:38:24Z (GMT). No. of bitstreams: 1 Pedro_AdrianaOrcesi_D.pdf: 1213225 bytes, checksum: 9ff41e82989a1850499025a7d3f72d81 (MD5) Previous issue date: 1999 / Doutorado

Orientador : Miguel Ignacio Tobar Acosta / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-07-14T07:14:25Z (GMT). No. of bitstreams: 1 Binder_MariaCeciliaPereira_D.pdf: 1762652 bytes, checksum: a964e062ad30d22aa8995c745719c426 (MD5) Previous issue date: 1976 / Resumo: A presente investigação destinou-se a verificar a prevalência de estreptococos beta-hemolíticos na população escolar de Botucatu (alunos matriculados em nove grupos escolares localizados na zona urbana). Desta população foram obtidas duas amostras casuais estratificadas: uma em junho e outra em novembro de 1972, com tamanhos calculados para 95% de confiabilidade. Todos os escolares foram submetidos ao exame clínico do oro faringe e gânglios submandibulares e cervicais, que precedeu a obtenção da secreção de garganta. As amostras de secreção foram imediatamente semeadas em caldo (TSB) e agar sangue. Os estreptococos beta-hemoliticos isolados foram grupados sorologicamente e, os pertencentes ao grupo A de Lancefield, foram tipados pela técnica de T-aglutinação para determinação do tipo de Griffith. Em junho foram realizadas 216 culturas das quais 31 (14,35*0 foram positivas para estreptococos beta-hemolíticos do grupo A e em novembro foram realizadas 221 culturas das quais IS (6,791) foram positivas. Houve associação estatisticamente significante entre o período em que foram realizadas as culturas e o resultado obtido. Do total de amostras de estreptococos beta-hemolíticos obtidas, 47,4% pertenceram ao grupo A, 20,6% ao grupo C, 2 5,8% ao grupo G e 6',21 não foram grupadas. Das amostras do grupo A, 82,6% foram tipadas. Não foi observada associação estatisticamente significante (a = 5%) entre o resultado das culturas e o sexo ou o grupo etário dos escolares, bem como a amigdalectomia prévia e a presença de sinais clínicos de infecção observados no momento da colheira da secreção. / Abstract: Not informed. / Doutorado

Dissertation submitted in partial compliance with the requirements of the Masters Degree in Technology: Homoeopathy, Durban Institute of Technology, 2003. / The purpose of this randomised double-blind placebo-controlled study was to evaluate the efficacy of Oioscorea vil/osa cream in the treatment of menopausal syndrome in terms of subjective and objective data; and to compare the subjective data with that obtained from a concurrent study of ProgestoNat\xAE cream (McTeer, 2003). / M

目的：國內中藥材品種混亂的現象普遍，而香港的中藥材大多是由國內進口，其中相當部分將轉口至世界各地，中藥材品種混亂的問題對本港乃至各地都有影響。本課題旨在對香港藥食兩用中藥材進行調研整理和鑒別研究。通過市場調查獲得香港市場流通過程中的藥食兩用的中藥材、中藥飲片品種的商品規格、價格、產地資訊。獲取藥食兩用中藥材和中藥飲片的代用品、偽劣品種和品種混淆的情況。通過品種考證鑒定香港市面流通中藥材混淆品種的基源。發現存在的問題並提出解決意見。 方法：通過實地走訪調查、詢問、填寫調查表等方式，對香港十八個行政區的中藥批發商、中藥零售企業、食品零食商進行調查，並拍攝被調查的藥材和飲片、替代品、混淆品的照片作為影像記錄。 結果：1）香港藥食兩用藥材價格差異大，質量參差不齊 2）中藥規格等級劃分混亂，價格透明度低。3）香港部份市售的中藥材小薊、枳椇子、金銀花、青果、昆布、薏苡仁、酸棗仁、鮮白茅根、枸杞子、山藥基原與藥典存在差異。4 ）根據大棗的歷史沿革，推斷案（大棗、黑棗）為鼠李科植物棗Ziziphus jujuba Mi11.的成熟果實。 討論：1）香港藥食兩用中藥材存在基原混亂、規格劃分不統一、質量不穩定等問題。2）為保證中藥材質量，建議《香港中藥材標準》強制實施。3）開展基礎研究，開發新資源，尋找中藥代用品。4）完善中醫藥相關法律法規，嚴格監控中藥生產、購進、銷售各環節。5）發展高質量、高附加值的中藥產業。 關鍵詞：藥食兩用、中藥材、調查整理、性狀鑒別。

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No description available.

Dissertation submitted in partial compliance with the requirements for the Master‟s Degree in Technology: Homoeopathy, Durban University of Technology, 2011. / Until recently, various attempts have been made to simplify the prescription process in homoeopathic prescribing. The doctrine of signatures, miasmatic theory, the homoeopathic repertory and more recently, kingdom analysis by authors such as Sankaran (1994) and Scholten (1993) are some of the attempts that have been made to understand the materia medica. With the materia medica constantly expanding and considering that plants make up a significant percentage of the materia medica (Kayne, 2006), it is evident that new systems of homoeopathic prescribing are continually needed to help practitioners both study the remedies and prescribe more accurately. Aim The Solanaceae plant family are an important and well utilised plant family in homoeopathy (Vermeulen, 2004). Considering this, it was felt that a study investigating the relationship of the natural history of the family to its general and mental symptoms be conducted in order to apply a previously unexplored research paradigm in order to create a greater understanding of Solanaceae remedies utilised in homoeopathy. The study conducted was a non empirical correlation study of the Solanaceae plant family‟s natural history and general and mental symptoms manifested in Solanaceae remedies utilised in homoeopathy. The aims of the study were to establish if commonalties existed between general and mental symptoms of individual remedies belonging the Solanaceae family and their natural histories, as well as to establish if collective commonalities and correlations existed between the general and mental symptoms and the natural history of the Solanaceae family as a whole. Methodology The homoeopathic remedies obtained from the Solanaceae family of plants for the study were analysed in terms of rubric representation (size) using homoeopathic software packages, Radar 10.4 (Archibel, 2009b) and v Encyclopedia Homoeopathica (Archibel, 2009a) a sample selection was chosen. This selection was analysed in terms of general and mental rubrics. Qualitative thematic analysis was used to establish commonalities in keyword concepts between the respective natural histories of the studied family and their respective general and mental symptoms. Keywords obtained from data tables which included criteria such as habitat and distribution, plant description, active principles (primary alkaloids), uses, physiological action if ingested, historical significance, mythology and toxicology were subjected to thesaurus consultation and tabulated in an attempt to identify synonyms relating to the general and mental symptoms of individual remedies of the sample group in the study. This facilitated in the grouping of similar themes. Once commonalities pertaining to each individual species and remedy was further tabulated and discussed in terms of keywords relating to their natural histories, a collective analysis of common correlations between the plant family as a whole was performed. Results Common themes related to general and mental symptoms and to the natural histories of species in the study included “aggression” found in Atropa belladonna, “depression” found in Solanum dulcamara, “anxiety” found in Datura stramonium, “confusion” found in Hyoscyamus niger, “burns” found in Capsicum annuum, “ convulsions” found in Nicotiana tabacum , “ hallucinations” found in Mandragora officinarum and “delirium” found in Solanum nigrum. Common themes relating to general and mental symptoms and the natural history of the Solanaceae plant family as a whole included convulsions, hallucinations, confusion and anxiety. These themes were further compared to themes exhibited in Solanaceae studies conducted by Mangialavori (2007) and Sankaran (2002).

Mini-dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Homoeopathy, Durban University of Technology, 2010. / Introduction The aim of the study was to determine the effect of Acridotheres tristis 30CH on healthy volunteers (provers) and to record the clearly observable signs and symptoms produced, so that Acridotheres tristis 30CH may be prescribed according to the Law of Similars, as required by homoeopathy. Methodology The proving of Acridotheres tristis took the form of a randomised, placebocontrolled trial on 30 healthy volunteers who met inclusion criteria. The 30th centesimal potency of the tail feather was administered as lactose powders and fifty percent of provers were randomly administered an identical placebo-control substance. The collection of the data from the provers took the form of a journal in which each prover‟s symptoms were recorded for six weeks, including a one-week observation period prior to taking the powders, and a proving period of five weeks after administration of powders. On completion of the proving, each journal was assessed by the researcher to determine the suitability of the recorded symptoms for inclusion in the materia medica of Acridotheres tristis. These symptoms were then translated into the language of the materia medica and repertory and the remedy picture then formulated. Data from case histories, physical examinations and group discussions were also taken into account during the analysis of the proving symptoms. Results The homoeopathic drug proving of Acridotheres tristis, conducted as a doubleiii blind, randomised and placebo-controlled study produced a wide range of symptoms. In the collated edited data arising from the proving 396 journal entries were extracted and 595 rubrics in total were formulated, of which 56 rubrics were new. The main symptoms belonging to the mental and emotional spheres of this remedy include depression, anxiety, memory weakness and isolation accompanied by a need for solitude. The characteristic physical symptoms include headaches, dizziness, extreme fatigue, skin eruptions especially pimples and rashes, haemorrhoids, numbness and severe dysmenorrhoea. Other symptoms indicate a possible use in the treatment of gastro-intestinal complaints which include nausea, abdominal cramps, abdominal distention and heartburn. Conclusion The investigation supported the hypothesis that Acridotheres tristis would produce clearly observable signs and symptoms in healthy volunteers. It is essential that the proving symptoms be verified and expanded through clinical trials and further provings of Acridotheres tristis in various potencies, so that it becomes well-utilized remedy in the future.