Submitted by Suzana Dias (suzana.dias@famerp.br) on 2018-11-07T18:03:55Z No. of bitstreams: 1 VanessaAparecidaRosa_dissert.pdf: 394628 bytes, checksum: 878a17ef13ab650c50b5bf2b5d76f970 (MD5) / Made available in DSpace on 2018-11-07T18:03:55Z (GMT). No. of bitstreams: 1 VanessaAparecidaRosa_dissert.pdf: 394628 bytes, checksum: 878a17ef13ab650c50b5bf2b5d76f970 (MD5) Previous issue date: 2017-12-13 / Throughout the history of the humanity, diverse disturbances have marked the life of the human beings, causing physical and psychic damages. Burnout syndrome is not a twenty first century problem, however, it has been gaining visibility in recent times. All people, regardless of gender, age, religion, profession or social class can develop burnout. One subject that has been highlighted in the studies carried out in the last decades is the burnout syndrome in physicians, due to the strong psychological pressures that these professionals suffer in the day to day of their work. Objective: To study the prevalence of burnout syndrome among physicians in an outpatient clinic of a school hospital in the northwest of São Paulo and possible associated factors. Methods: The Maslach burnout Inventory - Human Services Survey (MBI - HSS) and a sociodemographic data questionnaire were applied to physicians who agreed to participate in the study. Results: 100 physicians participated in the study. Burnout syndrome was detected in 5% of them, and the high level of burnout in each of the three dimensions alone was 20% for overextended; 17% for disengaged and 16% for personal fulfillment(ineffective profile); low level in the three dimensions (engagement) was 38%. Conclusions: There was a low prevalence of burnout syndrome among the physicians of the studied school hospital; on the other hand, the high level of burnout in each of the three dimensions alone was considerable and should alert to the need for intervention due to the possibility of sequential progression of the dimensions until the syndrome develops. The factors associated with the occurrence of burnout were: not feeling happy in the professional life, desire to change profession and absence of physical activity. / Ao longo da história da humanidade, diversos distúrbios marcaram a vida dos seres humanos, causando danos físicos e psíquicos. A síndrome de burnoutnão é um problema do século XXI, contudo, vem ganhando visibilidade nos últimos tempos. Todas as pessoas, independentemente do gênero, idade, religião, profissão ou classe social podem desenvolver burnout. Um tema que tem merecido destaque nos estudos realizados nas últimas décadas é a síndrome de burnoutem médicos, devido às fortes pressões psicológicas que esses profissionais sofrem no dia a dia de seu trabalho. Objetivo: Estudar a prevalência da síndrome de burnoutentre médicos de um ambulatório de um hospital escola no noroeste paulista e possíveis fatores associados. Métodos:Foram aplicados o Instrumento MaslachburnoutInventory - Human Services Survey (MBI - HSS) e um questionário de dados sociodemográficosaos médicos que concordaram em participar do estudo. Resultados: Participaram do estudo 100 médicos.Detectou-se síndrome de burnoutem 5% deles, e o nível alto de burnoutem cada uma das trêsdimensões isoladamenteforam, 20% para exaustão emocional (overextended); 17%para despersonalização (disengaged); 16% pararealização pessoal (ineffective) e nível baixo nas três dimensões (engagement)38%. Conclusões:Houve baixa prevalência de síndrome deburnoutentre os médicos do hospital escola pesquisado; por outro lado, o alto nível de burnout em cada uma das três dimensões isoladamente foi considerável e deve alertar para a necessidade de intervenção, devido à possibilidade de progressão sequencial das dimensões até que se desenvolva a síndrome. Os fatores associados à ocorrência de burnoutforam: não se sentir feliz na vida profissional; desejo de trocar de profissão e ausência de atividade física.

Alzheimer’s disease (AD), identified over 100 years ago and intensively studied since the 1970s, has no effective treatments or mechanistic understanding of the underlying neurodegenerative process. Most investigators believe accumulation or aggregation of amyloid beta (Ab) proteins plays a causative role. Aβ peptides (~39-43 residues) are generated by proteolysis of the transmembrane protein APP. One reason we know so little about AD is an incomplete understanding of the cellular mechanisms responsible for Ab proteotoxicity. Human ES and iPSC models of AD are recent additions to many other models used to investigate these mechanisms. AD, however is a chronic progressive condition of old age and cultured neurons may not live long enough to model what goes wrong in neurons from AD patients. In my research, I used hESCs which directly express Ab peptides thus avoiding the time it takes to process APP. One App allele in H9 hESCs was previously edited using TALEN. A homologous recombination cassette coding directly for a secretory form of either Ab1-42 or Ab1-40 and containing a stop codon, was inserted into the first exon of App upstream of the normal translational start site. I used multiple independently isolated clones of edited cells with 3 genotypes: App/App (unedited), App/Aβ1-40 and App/Aβ1-42. Expression of Ab from edited alleles was confirmed by qRT-PCR using primers specific for the edit. I first sought to establish if editing changed any aspects of neuronal differentiation in culture. All 3 genotypes have similar embryoid body (EB) development, and similar numbers and sizes of neuronal clusters (NC) up to 34 days after EB dissociation and neural differentiation. Immunostaining of neuronal markers, NeuN and DCX (doublecortin), likewise revealed no difference among edited and unedited cells, suggesting that the edits do not affect the ability of my stem cells to differentiate into neurons. I next measured accumulation of aggregated Ab using an aggregate specific antibody, 7A1a. Data at 34-days post EB dissociation indicates NCs in the Aβ1-42 edited cells accumulate significantly more aggregates relative to either unedited or Ab1-40 edited lines, a result consistent with the increased ability for Ab1-42 to form aggregates. Aβ aggregates also appear to be concentrated around fragmented nuclei within neuronal clusters suggesting that intracellular accumulation may play a key role in proteotoxicity. Additionally, I observed a significant decrease in the number of synapsin1 puncta, a marker of synapses, another feature of AD. I documented a nearly 3-fold greater neuronal cell death in both the Aβ1-40 and Aβ1-42 neurons at 70 days after differentiation. RNA sequencing data also shows independently isolated clones group together and show differential expression of genes related to memory and neuronal cell death. The early presence of Aβaggregation and subsequent cell death is in line with the chronic and progressive nature of AD and this is the first known model to exhibit a neurodegenerative phenotype. These isogenic cell lines thus appear to be useful to screen for therapeutics that may prevent or slow Ab1-42 dependent neurodegeneration and a tool to investigate Ab-dependent mechanisms with relevance to AD.

Diss. (sammanfattning)--Göteborg : Göteborgs universitet, 2009. / Härtill 4 uppsatser.

published_or_final_version / Mechanical Engineering / Master / Master of Philosophy

Methylmercury (MeHg) is a neurotoxic global pollutant that accumulates at high levels in predatory fish and marine mammals. The dietary intake of these animals is the main source of MeHg exposure in humans. At high levels, MeHg is known to damage the sensory and motor systems in both adults and children. Due to the complexity and inaccessibility of the central nervous system (CNS), early dysfunction is difficult to detect. Biochemical markers in the CNS have been used to identify MeHg neurotoxicity in animal models. Analogues of these biochemical targets are also present in peripheral blood tissue and may reflect early CNS dysfunction in human populations. The proposed peripheral biomarkers include (1) lymphocyte muscarinic acetylcholine (mACh) receptor, (2) serum cholinesterase (ChE) and (3) platelet monoamine oxidase (MAO). This thesis evaluates the effects of mercury (Hg) compounds on these CNS and peripheral biochemical markers in laboratory and epidemiological studies. In vitro studies showed that inorganic Hg (HgCl2) and MeHg inhibited mACh receptor binding in human, rat, and mouse brain tissue. Additionally, studies demonstrated that a low-level gestational exposure to MeHg reduced MAO activity in the developing embryo and in adult female offspring. Combined, these studies provide a framework for the assessment of biochemical targets of Hg compounds in humans. A cross sectional study was conducted to evaluate the association between peripheral biochemical markers and MeHg exposure in fish-eating adults (n=129) from Lac St-Pierre, Quebec. Blood-Hg concentrations were used as a marker of exposure and ranged from 0.2 to 17.0 mug/L. Multiple linear regression analysis demonstrated that both blood-Hg (p=0.011) and heavy smoking (p=0.001) were associated with reduced platelet-MAO activity. However, neither lymphocyte mACh receptor nor serum ChE was related to blood-Hg. These results suggest that exposure to MeHg may result in reduced plat

Parkinson’s disease, the second most common neurodegenerative disease, is characterized by the loss of dopaminergic neurons within the substantia nigra. Currently, the treatments available for PD are symptomatic treatments that do not stop the progression of the disease. Trophic molecules, such as glial cell-line derived neurotrophic factor (GDNF), have been evaluated as potential therapeutic molecules that could stop the loss of neurons and potentially restore some of the neurons that have already been lost. However, these trophic molecules are large making them difficult to produce and delivery. Here we characterize three peptides (DNSP-5, DNSP-11, and DNSP-17) to determine it they are stable and offer protective effects similar to GNDF allowing them to be potential therapeutic molecules. The data presented here involves the evaluation of the molecular and cellular mechanism of DNSP-5, DNSP-11, and DNSP-17, which are derived from prosequence of GDNF. Initial studies were carried out to evaluate the physical characteristics of these three peptides to determine their viability as potential therapeutic molecules. The structure and stability of these peptides were evaluated. Based on the data it was determined that the three peptides do not interact in vitro, allowing for further individual evaluations of the peptides. It was also determined that the peptides were stable when stored at both -80°C and 37°C for one month, allowing them to both potentially be stored during treatment. Cell culture assays and proteomic profiling were utilized to determine binding partners and potential mechanisms through which DNSP-11 may be able to mediate apoptosis. It was determined that DNSP-11 was able to interact with a variety of binding partners that are involved in metabolism. These studies have aided in the understanding of neurotrophic factor prosequence function, but will also serve as a starting point for the development of novel trophic factors for PD treatment. Finally, the interaction between DNSP-11 and GAPDH was evaluated as a potential anti-apoptotic mechanism. GAPDH has previously shown to play a role in mediating apoptotic pathways. It was hypothesized that the observed interaction between DNSP-11 and GAPDH could mediate that role of GAPDH in apoptosis and afford DNSP-11 its observed anti-apoptotic effects. It was observed that while DNSP-11’s interaction with GAPDH may play a role in its anti-apoptotic effects, it does not appear to be the only mechanism involved. Based on this data, it is likely that the other metabolic binding partners play a role in DNSP-11’s anti-apoptotic mechanisms and therefore, these interactions should be further evaluated.

520 L $$aIn the CNS, myelination of axons is essential for the rapid conduction of impulses down the nerve. In demyelinated or failing axons however, conduction is less efficient and requires more energy. The principal function of mitochondria is to provide energy for the axon but in doing so they generate most of the intra-axonal reactive oxygen species (ROS). Therefore and increased energy requirement will promote an increased production of ROS which could lead to significant damage to essential DNA, proteins and lipids and could eventually damage the axon. This thesis investigates the mitochondrial involvement in axonal pathology in the CNS diseases, multiple sclerosis (MS), autosomal dominant optic atrophy (ADOA) and tosomal dominant optic atrophy with cataract (ADOAC).

The biological mechanisms proposed to underlie primary mood disorder do not usually include a neuropathological component. Over recent years, a significant imaging literature attests to structural abnormalities in various brain regions in mood disorder, and has encouraged neuropathological investigations. Although the neuropathological understanding of mood disorder is still rudimentary, structural correlates have begun to emerge. The studies described in this thesis investigate the neuropathology of the anterior cingulate cortex in mood disorder. The anterior cingulate cortex is extremely diverse and complex, particularly in respect to its cytoarchitecture and functional organisation. These details are important when considering the precise localisation and clinical correlates of the neuropathological changes of this region in disease. Accordingly, I performed a detailed analysis of the cytoarchitecture of the human anterior cingulate cortex, as a prelude to investigations of this region in mood disorder. I measured several morphometric parameters within different anatomical levels and both hemispheres of the anterior cingulate cortex. Overall I found a clear distinction in the cellular composition of the supragenual and subgenual regions of the anterior cingulate cortex. The subgenual region demonstrated a lower glial density and smaller neurons in comparison to the supragenual region. A modest difference in neuronal density was also observed, with a higher density in the deep layers of the subgenual cortex compared to the deep layers of the supragenual cortex. Total cortical depth was also thinner in the subgenual region. This work may have important implications for the interpretation of imaging and pathological data in mood disorder. To assess the cytoarchitecture of this brain region in mood disorder, I examined several morphometric indices in addition to various parameters of gene expression in post mortem brains. I found a range of cytoarchitectural abnormalities in the supragenual anterior cingulate cortex in mood disorder. The most prominent change included a reduction in glial density, which was evident in all layers of the cortex. Glial fibrillary acidic protein was also reduced, providing some evidence for astrocyte involvement. Various neuronal changes were also observed in the mood disorder group. These included layer-specific reductions in pyramidal neuron density and a modest change in the density of cairetinin-immunoreactive neurons. I did not find any evidence supporting synaptic pathology in the anterior cingulate cortex in mood disorder. These findings extend previous evidence of cytoarchitectural alterations in the anterior cingulate cortex in mood disorder and in particular emphasise the prominent involvement of glial cells in the neuropathology of this disease. The origins of the glial (and neuronal) deficits in mood disorder remain to be established, but they are likely to have pathophysiological consequences.

Thesis (Ph. D.)--University of Washington, 2006. / Vita. Includes bibliographical references (leaves 219-228).

Thesis (Master's Diploma(Technology (Medical Technology))-- Cape Technikon, 1997 / Meningitis in children is a common and serious disease. Bacterial and tuberculous meningitis often lead to neurological complications. A sensitive marker to predict brain damage in children with meningitis could be of great importance. Frithz F et aI, 1982 suggested that increased adenylate kinase values could indeed be used as a marker for brain damage. Adenylate kinase (AK) is an enzyme present in brain tissue. Low concentrations are present in normal cerebrospinal fluid (CSF) « 1 uti). Increased concentrations were found in cases of ischemic brain damage (Frithz et aI, 1982), malignant brain tumours (Ronquist G et aI, 1977) and bacterial meningitis. As AK has a low molecular weight (22,00 Daltons), in comparison to other kinases (40,000 Daltons) it is one of the first enzymes that can be detected in the CSF after brain damage and it can thus be used as a reliable marker for brain cell damage. The aim of this study was to quantify the AK values in CSF of children with bacterial and tuberculous meningitis and to evaluate their use to predict the neurological outcome in children with bacterial and tuberculous meningitis. Eighty eight children with tuberculous meningitis (TBM) and thirty three children with bacterial meningitis were included in the study. Sixty children with suspected meningitis but who were later diagnosed with urinary tract infections, gasto-enteritis, bronchitis, febrile convulsions or other non-neurological infections were used as controls. The results showed raised AK values in the CSF of children with bacterial- and TB meningitis. There was a statistically significant difference of AK values between stage III and II TBM AK values in patients at week 1 after diagnosis (p=0,03). There was also a statistically significant correlation between CSF AK values and lactate concentrations (P=0,001) which reflected hypoxic brain metabolism. Although AK values did not always correlate directly with the patients’ clinical outcome, there is proof that increased AK values in CSF can be used to predict neurological outcome.