Made available in DSpace on 2015-04-14T13:35:19Z (GMT). No. of bitstreams: 1 433622.pdf: 643872 bytes, checksum: 21a222dc14b2e23cb481fc34a34b6bfc (MD5) Previous issue date: 2005-08-09 / Racional: A apropriada indica??o de terapia adjuvante no c?ncer de mama est? atualmente embasada em fatores progn?sticos cl?nico-patol?gicos. A busca de fatores mais precisos e confi?veis para a identifica??o de pacientes em que a indica??o de tratamento complementar ? imprescind?vel, ? de grande import?ncia nos dias atuais. A mamaglobina (hMAM) e o ant?geno carcinoembri?nico (CEA) t?m sido alvos de estudos como marcadores de micromet?stases de c?ncer de mama. O objetivo principal deste estudo foi avaliar a capacidade de detec??o de micromet?stases de c?ncer de mama pelo m?todo de RT-PCR para hMAM e CEA.M?todos: Quarenta e nove pacientes com c?ncer de mama EC I a III, foram avaliadas no momento da cirurgia de mama com coleta de amostras de tecido mam?rio normal, tumor, linfonodo, sangue e medula ?ssea. Realizou-se RT-PCR para CEA e hMAM nos respectivos tecidos.Resultados: A maioria dos tumores expressaram CEA (37/ 44 casos) e hMAM (40/44 casos). Seis pacientes (27.3%) com histologia negativa nos linfonodos axilares expressaram CEA nos mesmos e 2 (8,7%) pacientes com esta situa??o expressaram hMAM nos linfonodos.Duas (5,7%) pacientes expressaram CEA no sangue e cinco (13,9%) expressaram hMAM. A medula ?ssea teve express?o de CEA em 3 (14,3%) pacientes e de hMAM em 5 (23,8%).Conclus?o: A t?cnica de RT-PCR ? capaz de detectar transcritos de CEA e hMAM em pacientes com c?ncer de mama. O significado cl?nico deste achado ainda deve ser esclarecido. A detec??o em linfonodos para estes marcadores parece estar mais fortemente associada ao progn?stico que a detec??o em sangue e medula ?ssea.

Made available in DSpace on 2015-04-14T13:35:34Z (GMT). No. of bitstreams: 1 439241.pdf: 787581 bytes, checksum: 694a1c96909ef78e31343f07b4121e83 (MD5) Previous issue date: 2012-03-29 / Introduction: Few studies have evaluated the chronic kidney disease (CKD) risk factors for in black populations. This study aimed to determine the prevalence of renal disease (RD), risk factors for CKD and compare the estimated glomerular filtration rate (eGFR) by three methods in a group of black workers in the health field. Methods: We evaluated in a cross sectional observational study 313 individuals from the black staff of a university hospital, workers from different health professions. Was defined RD bearing individuals with GFR below 90ml/minute or protein/creatinine index in urine sample up to or greater than 0.3. We estimated the glomerular filtration using three equations: Crockoft-Gault, MDRD and CKD EPI. For data collection was used a structured questionnaire containing demographic data, risk factors for CKD, serum creatinine, blood pressure (BP) and GFR. Results: In the 313 participants 80.8% were female. The risk factors were present in this proportion: 26.8% with a diagnosis of hypertension (HA), 8.3% diabetes mellitus (DM), 79.9% with a family history (FH) of hypertension, 49.2% FH and DM, 6.45% FH for dyslipidemia, and 19.8% FH with CKD, BMI with or greater than 30 kg /m?. The prevalence of RD ranged between 12.5% (CKD-EPI) and 18.8% (MDRD). The higher prevalence of RD was observed at the stage of eGFR between 60 and 89 mL/minute. In individuals with RD, there was difference between the eGFR for the CG or MDRD and CKDEPI equations (P<0.001) difference among the three formulas for the total group analysis (P <0.001). Conclusion: RD was present in at least 12.2% of the studied group. The prevalence of RD was lower when using the CKD-EPI equation, compared to the CG and MDRD equations. It was demonstrated statistical significance (P <0.05) for the highest average age of patients with RD compared the diagnosis by eGFR by the three equations used with other individuals in the study. Among the associations of risk in the total group the most frequent were HA and FH with HA. Among the variables examined, only the mean of systolic BP was different and higher, when comparing individuals with risk factor for RD and those without this risk factor / Introdu??o: Poucos estudos t?m avaliado os fatores de risco da Doen?a Renal Cr?nica (DRC) em popula??es negras. Esta investiga??o teve como objetivo conhecer a preval?ncia da doen?a renal (DR), de fatores de risco para DRC e comparar a filtra??o glomerular estimada (FGE) por tr?s m?todos em um grupo de trabalhadores negros na ?rea da sa?de. M?todos: Em um estudo observacional transversal, foram avaliados 313 indiv?duos negros do quadro funcional de um hospital universit?rio, trabalhadores de diferentes profiss?es da sa?de. Definiu-se portadores de DR os indiv?duos com a FGE abaixo de 90ml/minuto ou com ?ndice proteina/creatinina em amostra de urina igual ou maior que 0,3. Estimou-se a filtra??o glomerular utilizando-se tr?s equa??es: Crockoft-Gault, MDRD e CKD EPI. Para a coleta dos dados, foi estruturado um question?rio, contendo dados demogr?ficos, fatores de risco para DRC, creatinina s?rica, press?o arterial (PA) e FGE. Resultados: Dos 313 participantes 80,8% foram do sexo feminino. Os fatores de risco estiveram presentes nesta propor??o: 26,8% tinham diagnostico de hipertens?o arterial (HA), 8,3% de diabetes mellitus (DM), 79,9% de hist?ria familiar (HF) de HA, 49,2% de HF de DM, 6,45% HF de dislipidemia, 19,8% HF de DRC, IMC igual ou maior que 30Kg/m?. A preval?ncia de DR variou entre 12,5% (CKD-EPI) e 18,8% (MDRD). A maior preval?ncia de DR foi evidenciada no est?gio de FGE entre 60 e 89 mL/minuto. Nos indiv?duos com DR, houve diferen?a para a FGE entre as f?rmulas CG ou MDRD e CKD-EPI (P<0,001) havendo diferen?a entre as tr?s f?rmulas para o grupo total analisado (P<0,001). Conclus?o: DR esteve presente em no m?nimo 12,2% do grupo estudado. A preval?ncia da DR foi menor quando utilizamos a equa??o CKD-EPI, comparada ?s equa??es CG e MDRD. Foi evidenciada signific?ncia estat?stica (para P<0,05) para a maior m?dia de idade dos indiv?duos com DR, quando comparado o diagn?stico atrav?s da FGE pelas tr?s equa??es utilizadas com os demais indiv?duos em estudo. Entre as associa??es de risco no grupo total as mais freq?entes foram HAS e HF de HAS. Entre as vari?veis examinadas, apenas a m?dia de PA sist?lica foi diferente e maior, quando comparamos os indiv?duos com fator de risco para DR e aqueles sem este fator de risco.

Made available in DSpace on 2015-04-14T13:35:39Z (GMT). No. of bitstreams: 1 447433.pdf: 1084376 bytes, checksum: 6e6c93e4b9ee50a3d7f69bfd07cc16b1 (MD5) Previous issue date: 2012-12-21 / Oral anticoagulation has been shown to be effective in the prevention and treatment of thromboembolic events. Vitamin K antagonists (VKA) are the drugs of choice for over 50 years in treatment for prevention of thromboembolic events and the most commonly used are warfarin and phenprocoumon. Currently there are new oral anticoagulants, the direct factor Xa inhibitors, and direct thrombin inhibitors which demonstrate similar efficacy to VKA and low bleeding risk and do not require monitoring because they have low interaction with other drugs and foods. Despite these advantages, the AVK still widely used due to the long experience of its use, the possibility of monitoring through the control of international normalized ratio (INR), the existence of an antidote to reverse its effect (vitamin K) and at low cost . The main difference between the AVK is pharmacological half-life, which is shorter for warfarin, approximately 30 hours versus 216 hours for phenprocoumon. There are few data in the literature that compare the efficacy, stability and drug interactions of these two drugs. Changes in therapeutic levels of AVK and the difficulty of keeping it stable due to interactions with drugs and food is a limiting factor for the efficacy and safety of these drugs. Due to the lack of evidence comparing the stability of the therapeutic level of warfarin and phenprocoumon, it is necessary that studies comparing these two drugs in relation to maintaining therapeutic level of anticoagulation. / A anticoagula??o oral tem se mostrado efetiva na preven??o e no tratamento de eventos tromboemb?licos. Os antagonistas da vitamina K (AVK) s?o as drogas de escolha a mais de 50 anos no tratamento para preven??o de eventos tromboemb?licos e os mais comumente utilizados s?o a varfarina e a femprocumona. Atualmente existem novos anticoagulantes orais, os inibidores diretos do fator Xa, e os inibidores diretos da trombina os quais demonstram efic?cia semelhante aos AVK e baixo risco de sangramento e n?o necessitam de monitoramento por apresentarem baixa intera??o com outras drogas e alimentos. Apesar dessas vantagens, os AVK continuam sendo amplamente utilizado devido ? longa experi?ncia de seu uso, possibilidade de monitoriza??o atrav?s do controle da raz?o normatizada internacional (RNI), pela exist?ncia de um ant?doto para revers?o de seu efeito (vitamina K) e pelo baixo custo. A principal diferen?a farmacol?gica entre os AVK ? sua meia-vida, a qual ? mais curta para a varfarina, aproximadamente 30 horas, versus 216 horas para a femprocumona. Existem poucos dados na literatura que comparem a efic?cia, estabilidade e intera??es medicamentosas dessas duas drogas. As varia??es dos n?veis terap?uticos dos AVK e a dificuldade de mant?-lo est?vel devido a intera??es com os medicamentos e com a alimenta??o ? um fator limitante da efic?cia e seguran?a dessas drogas. Devido ? aus?ncia de evid?ncias comparando a estabilidade do n?vel terap?utico entre a varfarina e femprocumona, ? necess?rio que existam estudos que comparem essas duas drogas em rela??o ? manuten??o de anticoagula??o em n?vel terap?utico.

Made available in DSpace on 2015-04-14T13:35:40Z (GMT). No. of bitstreams: 1 447910.pdf: 2718272 bytes, checksum: 970052e8ca9abce5d0dd93f2976d56d7 (MD5) Previous issue date: 2013-03-15 / The emergence and spread of resistance mechanisms in Gram-negative bacilli have complicate the treatment of serious nosocomial infections. Due to the ineffectiveness of the automated detection of KPC producer isolates there is a need to develop better methodologies. One possibility is to evaluate the ertapenem resistance, which has greater sensitivity to detect the expression of KPC producing isolates. However, the specificity may be reduced due to the resistance attributed to other mechanisms, such as AmpC gene expression or ESBL production associated with the loss of porin. This study included 128 samples of Gram-negative bacilli of Klebsiella pneumoniae and Enterobacter spp. resistant to ertapenem. Disk diffusion and E-test? method were applied to determine the susceptibility to imipenem, meropenem and ertapenem. Isolates intermediate and resistant to ertapenem were evaluated and additional resistance mechanisms conferred by blaTEM, blaSHV, blaCTX-M, blaCTX-M-2 and blaKPC for Klebsiella pneumoniae and Enterobacter cloacae genes were investigated by PCR technique. The presence of outer membrane protein (OMP) was investigated by dot blot. The gene blaTEM was detected in 52.9% and 10.3%; blaSHV in 29.4% and 0.94%; blaCTX-M in 41.4% and 1.9%, and blaCTX-M-2 in 23.5% and 1.9% of K. pneumoniae and Enterobacter cloacae isolates, respectively. blaKPC gene was present in 12.6% of Enterobacter spp. isolates. The OmpC and OmpF were present in 3.8% of Enterobacter cloacae isolates. Resistance genes and outer membrane proteins carbapenemases producing strains indicates that several resistance mechanisms contribute to therapeutic failure and point to the need for better detection methods and surveillance strategies. / A emerg?ncia e dissemina??o dos mecanismos de resist?ncia em bacilos Gram-negativos t?m complicado o tratamento de s?rias infec??es nosocomiais. Devido ? inefic?cia dos sistemas automatizados na detec??o de isolados produtores de KPC (Klebsiella pneumoniae produtora de carbapenemase) h? a necessidade do desenvolvimento de melhores metodologias. Uma possibilidade ? avaliar os isolados quanto ? resist?ncia ao ertapenem, o qual tem maior sensibilidade para detectar a express?o dos isolados produtores de KPC. Contudo, a especificidade pode ser reduzida devido ? resist?ncia conferida por outros mecanismos, tais como a express?o do gene AmpC ou a produ??o de ESBL associado a perda de porina. Este estudo incluiu 128 amostras de bacilos Gram-negativos de Klebsiella pneumoniae e Enterobacter spp. resistentes ao ertapenem. O m?todo de disco difus?o e E-test? foram aplicados para determinar a suscetibilidade para imipenem, meropenem e ertapenem. Os isolados com suscetibilidade intermedi?ria e resistentes para ertapenem foram avaliados e posteriormente foram investigados os mecanismos de resist?ncia atrav?s da presen?a dos genes blaTEM, blaSHV, blaCTX-M, blaCTX-M-2 e blaKPC para Klebsiella pneumoniae e Enterobacter spp., por meio da t?cnica de PCR. A presen?a de prote?na da membrana externa (OMP) foi investigada por meio de dot blot. O gene blaTEM foi detectado em 52,9% e 10,3%; blaSHV em 29,4% e 0,94%; blaCTX-M em 41,4% e 1,9% e blaCTX-M-2 em 23,5% e 1,9% dos isolados de K. pneumoniae e Enterobacter spp., respectivamente. O gene blaKPC estava presente em 12,6% dos isolados de Enterobacter spp. As porinas OmpC e OmpF estavam presentes, concomitantemente, em 3,8% dos isolados de Enterobacter cloacae. A detec??o da presen?a dos genes de resist?ncia e as prote?nas da membrana externa nos isolados produtores de carbapenemases indica que eles podem estar associados aos diversos mecanismos de resist?ncia, contribuindo para a falha terap?utica e apontando para a necessidade de melhores m?todos de detec??o e estrat?gias de vigil?ncia.

Made available in DSpace on 2015-04-14T13:35:55Z (GMT). No. of bitstreams: 1 457609.pdf: 908457 bytes, checksum: 4face2ee7aed14459bb47a89ca31f82a (MD5) Previous issue date: 2013-11-29 / Background: The current study aims to test and a vancomycin protocol based on the initial hemodialysis patients weight and to describe drug peak and through serum levels. Methods: A study enrolling 16 ESRD adult patients cohort undergoing hemodialysis received a uniform vancomycin administration schedule: 20 mg/kg initial dose, infused during the last dialysis hour; blood sample collection 30 minutes post-dialysis and, subsequently, before every dialysis session. Additionally, a fixed schedule to adjust every new dose was used. Anthropometric, clinical and laboratory variables were collected. Descriptive statistics was used; Spearman correlation coefficient was used to verify associations. Results: No significant correlation between vancomycin peak serum level and trough levels and the initial dose, nor any trough level and the following doses were uncovered. However, total serum protein strong and positively correlated with the initial Vancomycin dose and the first trough serum level (rs = 0.608, P = 0.016 and rs= 0.641; P = 0.010, respectively). Initial dose positively correlated with albumin too (rs= 0.572, P = 0.02). A strong correlation between the first and second trough levels was also found (rs = 0.608; P = 0.021). Conclusion: As applied, the vancomycin administration protocol was ineffective in reaching and maintaining therapeutic peak and trough levels. It is possible that a significant loss of vancomycin free-fraction by dialysis accounted for such a finding. Correlation of vancomycin serum levels between total serum proteins should be further investigated. / Objetivo Descrever os n?veis s?ricos de vancomicina em amostras coletadas nos vales em pacientes em hemodi?lise, a partir de um protocolo de administra??o deste antimicrobiano com dose inicial de 20mg/kg seguida de 10mg/kg e ajustes nas doses subsequentes, conforme a faixa de vancocinemia obtida e correlacionar com par?metros fisiol?gicos para verificar poss?veis associa??es. M?todos Estudo de coorte onde foram inclu?dos pacientes em hemodi?lise ambulatorial, com idade igual ou superior a 18 anos que realizaram tratamento com vancomicina, emp?rico ou com germe isolado. O medicamento foi administrado por infus?o intravenosa numa concentra??o de 10mg/mL na ?ltima hora da sess?o de hemodi?lise. O protocolo proposto baseia-se em doses administradas a cada sess?o de di?lise, realizadas tr?s vezes na semana, considerando o peso do paciente, uma dose inicial e define ajustes de dose a cada vancocinemia, com o objetivo de mant?-la nos n?veis terap?uticos estabelecidos de 10 a 20mg/L. Resultados: N?o houve correla??o significativa entre as concentra??es de vancomicina s?rica no pico e vales com as doses definidas pelo protocolo. Entretanto, o primeiro vale e as prote?nas plasm?ticas apresentaram forte correla??o positiva (rs = 0.608, P = 0.01), al?m da dose inicial tamb?m se correlacionar positivamente com as prote?nas plasm?ticas e albumina (rs = 0.641, P = 0.01 e rs= 0.572, P = 0.02). Os n?veis s?ricos de vancomicina entre o primeiro e o segundo vales apresentam forte correla??o positiva (rs = 0.608, P = 0.02) e o volume de distribui??o apresenta forte correla??o inversa ao valor de pico de vancomicina (rs = - 0.990; P < 0.001). Conclus?o Embora o estudo n?o tenha sido capaz de determinar um protocolo, identificamos uma variabilidade muito grande entre os resultados de vancocinemia. Doses mesmo ajustadas pelo peso seco do paciente e n?veis s?ricos de vancomicina n?o foram suficientes para manter os n?veis terap?uticos de vancomicina. ? poss?vel que haja perda significativa de vancomicina durante a hemodi?lise. A correla??o com as prote?nas plasm?ticas pode ser sugestiva quanto ? prote??o na remo??o durante a di?lise, por?m necessita ser investigada.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-06-27T20:00:58Z No. of bitstreams: 1 DIS_DANIELE_LINDERN_PARCIAL.pdf: 1742576 bytes, checksum: 219ac7953476d97332da350cfaebc57e (MD5) / Made available in DSpace on 2016-06-27T20:00:58Z (GMT). No. of bitstreams: 1 DIS_DANIELE_LINDERN_PARCIAL.pdf: 1742576 bytes, checksum: 219ac7953476d97332da350cfaebc57e (MD5) Previous issue date: 2016-03-01 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / Young soccer athletes suffer pressure for high performance and face intense workout routines. These youth also have to deal with their own expectations toward their career as well as their family expectations. The fault routine of these soccer players is characterized by the sports practices and school tasks and, in many cases, they have few social interaction, besides of being physically distant from their family and hometown. The life of these youth may be influenced by many risk factors, at the same time protective factors may also be diminished. This dynamic justifies the need for preventive intervention programs focusing on social and coping skills. In this sense, this study - part of a Master Degree thesis- aimed to understand the meaning of soccer in the lives of young athletes from a Brazilian soccer club and to develop an intervention based on Cognitive-Behavioral Therapy and Positive Psychology for young soccer players of a football club in Brazil And was presented in two manuscripts. The design of the manuscript I was cross-qualitative, and individual semi structured interviews with four athletes from the soccer club were held, aiming to achieve athletes' perceptions in order To respect and attend their demands to develop the intervention. Data analysis was performed using Content Analysis. The results of the manuscript I point to the many adversities that these athletes go through to achieve the dream of being a soccer player. Thus, it is emphasized the important role of psychology in this context, that should value and reinforce, beyond the risk factors, the personal meanings that these youth attribute to their practice and role as soccer players. From the manuscript I results, an intervention was planned, which effects Were assessed and described in the second manuscript of this thesis. The manuscript II design was quasi-experimental with pre-and post-test. Twenty soccer athletes aged between 15 and 16 years, allocated in an experimental group (n=10) and control group (n=10) participants at the study. Manuscripts I and II included different participants. The intervention took place through eight meetings of 90 minutes each, once a week. The elements of the well-being of Positive Psychology, resilience, social skills, cognitive distortions and coping skills were the intervention focus. Participants answered the Inventory of Social Skills for Adolescents, Athletic Coping Skills Inventory, Screen for Child Anxiety Related Emotional Disorders, Life Satisfaction Global Scale and Positive and Negative Affect Scale for Adolescents pre and post-intervention. The control group didn't received any treatment. There was no significant difference between the experimental and control group pre and post intervention. However, the athletes of the experimental group showed significant difference in the coping skills ?Under Pressure Performance?, ?Trust? and ?Freedom of Concerns?, and significant increase of the frequency of total score of social skills and of the ability to ?Affective approach? after the intervention. The results of this study point to the importance of interventions that aim, the learning of other life skills beyond sports for these athletes, as promotion their mental health. / Atletas de futebol sofrem press?es por elevado desempenho e rotinas de treino intensas. Esses jovens tamb?m t?m de lidar com as suas pr?prias expectativas em rela??o ? sua carreira, bem como as expectativas de seus familiares. A rotina destes jogadores ? caracterizada por cobran?as tanto na pr?tica esportiva quanto nas obriga??es escolares e em muitos casos estes t?m pouca intera??o social, al?m de estarem fisicamente distantes de sua fam?lia e cidade natal. A vida destes jovens ? permeada por muitos fatores de risco, ao mesmo tempo em que os fatores de prote??o podem estar diminu?dos. Esta din?mica justifica a necessidade de programas de interven??o de cunho preventivo e com foco em habilidades sociais e de coping. Neste sentido, este estudo desta disserta??o de mestrado teve como objetivo compreender o significado do futebol na vida de jovens atletas de um clube de futebol do Brasil, bem como desenvolver uma interven??o baseada na Terapia Cognitivo-Comportamental e na Psicologia Positiva para esta popula??o e foi apresentado em dois manuscritos. O delineamento do manuscrito I foi qualitativo transversal, e foi realizada uma entrevista individual semiestruturada com quatro atletas do clube de futebol, visando a conhecer as percep??es destes para, posteriormente, respeitar e contemplar estas demandas no desenvolvimento da interven??o. A an?lise dos dados foi realizada atrav?s da An?lise de Conte?do. Os resultados do manuscrito I apontam para as muitas adversidades que estes atletas passam para alcan?ar o sonho de ser jogador de futebol. Assim, ressalta-se o importante papel da Psicologia neste contexto, que deve reconhecer, para al?m dos fatores de risco, os significados pessoais que estes jovens atribuem a sua pr?tica e papel enquanto atletas de futebol. A partir dos resultados do manuscrito I, foi planejada uma interven??o cujo impacto foi avaliado e descrito no manuscrito II. O manuscrito II teve delineamento quantitativo quase experimental com avalia??o pr? e p?s-interven??o. Vinte atletas de futebol com idades entre 15 e 16 anos foram alocados em um grupo de interven??o (n=10) e um grupo de compara??o (n=10). Os manuscritos I e II contaram com participantes diferentes. A interven??o teve 8 encontros de 90 minutos, com freq??ncia semanal. Os elementos do bem-estar da Psicologia Positiva, resili?ncia, habilidades sociais, distor??es cognitivas e habilidades de coping foram o foco da interven??o. Os participantes responderam ao Invent?rio de Habilidades Sociais para Adolescentes, Athletic Coping Skills Inventory, Screen for Child Anxiety Related Emotional Disorders, Escala Global de Satisfa??o de Vida e ? Escala de Afetos Positivos e Negativos para Adolescentes, antes e ap?s a interven??o. O grupo de compara??o n?o passou por nenhuma forma de interven??o. Os atletas do grupo de interven??o apresentaram diferen?a significativa nas habilidades de coping ?Desempenho sob press?o?, ?Confian?a? e ?Liberdade de preocupa??es?, e aumento significativo da freq??ncia total das habilidades sociais, bem como da habilidade ?Abordagem afetiva? ap?s a interven??o. N?o houve diferen?a significativa pr? e p?s-interven??o entre os grupos de interven??o e compara??o. Os resultados deste estudo apontam para a import?ncia de interven??es que visem a aprendizagem de outras habilidades para a vida al?m das esportivas para estes atletas, como a promo??o de sua sa?de mental.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-07-04T19:38:22Z No. of bitstreams: 1 TES_CRISTIANE_RIOS_PETRARCA_COMPLETO.pdf: 2589282 bytes, checksum: 52270debca013b954c56d75d899d3ff8 (MD5) / Made available in DSpace on 2016-07-04T19:38:22Z (GMT). No. of bitstreams: 1 TES_CRISTIANE_RIOS_PETRARCA_COMPLETO.pdf: 2589282 bytes, checksum: 52270debca013b954c56d75d899d3ff8 (MD5) Previous issue date: 2016-03-18 / Introduction: Colorectal cancer is the third most common cancer in men and the second in women worldwide. It presents multifactorial, heterogeneous and complex etiopathogeny, still not fully elucidated. The evolution of the disease is often distinct from the exhaustive surgical and pathological staging, eventually (possibly) patients with focal disease develop an aggressive pattern presenting poor prognosis. Recent evidence shows the molecular heterogeneity of colorectal cancer. In this context the microRNAs (miRNAs), small non-coding RNAs (containing 19-25 nucleotides) capable of regulating gene expression in post-transcriptional level, have been identified with different expressions for numerous diseases, including cancer. Colorectal cancer shows change in expression of several miRNAs. These changes have been associated with the diagnosis, prognosis, gene expression, chemosensitivity and staging, being a potential biomarker. Methods: Clinical and pathological data of patients submited to surgical resection of the primary tumor and regional lymph nodes diagnosed from September 2002 to October 2011 have been reviewed and analyzed, and included in the colorectal cancer tumor bank of the S?o Lucas Hospital's Oncology Department - PUCRS. The analysis of the expression of miRNAs was performed in the laboratory of the Institute of Biotechnology of the Catholic University of Brasilia where they were analyzed in primary tumor and regional lymph nodes for descriptive purposes and versus the clinical-pathological data of the cases studied. The quantification analysis of the following miRNA (mir-570, mir-16, mir-338, Let-7, miR-1, miR-150, mir-183, mir-650 and mir-31) were determined by qPCR. Statistical analysis tests: Fisher's, Wilcoxon and Kruskal Wallis Exact, considered a significance level of 5%. Results: Of the 28 cases studied, 28.6% were less than 60 years old at diagnosis and 71.4% aged 60 or over. The average age was 66.7 years (26 to 86). The mean (average) follow-up (period, age) was 3.9 years (0 to 9), SD= 2.8 and a median of 4 years. The expression of miRNAs in the primary tumor (N=28) showed more homogeneous pattern, with a tendency to overexpression; whereas, in ill lymph nodes (N=15) this pattern was more heterogeneous, with mir-570, mir-338, mir-1, mir-183 and mir-31 being presented overexpressed and mir-16, Let-7, mir-150 and mir-650 with a more repressed expression. The suppressed expression of mir-570 was associated with mortality when evaluated in the primary tumor (N=28), where the prevalence of death in individuals with suppressed expression was 63.64% and those overexpressed was 17.65%, with p=0.020. In the primary tumor of patients with lymph node metastasis (N=15) the median expression of mir-183 was 4.42 with interquartile range (IQR) p25 of 1,66 and p75 of 43.01; whereas in the samples from patients with no ill lymph nodes (N=13) the median expression of mir-183 was 54.17 with IQR p25 of 13.12 and p75 of 223.14, with p=0.01, suggesting focal disease at diagnosis. In the subgroup of patients with lymph node metastasis (N=15), the expression of mir-650 in lymph node was associated with the prevalence of recurrence. The expression of mir-650 showed suppressed expression in 25% of the recurrence cases and was overexpressed in 85% of cases, with p=0.04. Conclusions: The expression pattern of miRNAs differs depending on the site of the disease studied (primary tumor or metastatic disease). The suppressed expression of mir-570 in the primary tumor is likely to be predictor of mortality. Overexpression of mir-183 in the primary tumor suggests focal disease at diagnosis. The overexpression of mir-650 in the metastatic lymph node is a recurrence predictor. New studies including functional tests and meta-analyzes may confirm these findings and optimize the use of these miRNAs in clinical practice. / Introdu??o: O c?ncer colorretal ? o terceiro c?ncer mais comum em homens e o segundo em mulheres no mundo. Apresenta etiopatogenia multifatorial, heterog?nea e complexa, ainda n?o totalmente elucidada. A evolu??o da doen?a ? muitas vezes distinta do exaustivo estadiamento cir?rgico e patol?gico, eventualmente pacientes com doen?a localizada evoluem com padr?o agressivo apresentando mal progn?stico. Evid?ncias recentes demonstram a heterogeneidade molecular do c?ncer colorretal. Neste contexto os microRNAs (miRNAs), pequenos RNAs com 19-25 nucleot?deos n?o codificadores, que s?o capazes de regular a express?o de genes em n?vel p?s-transcricional, t?m sido identificados com diferentes express?es em diversas doen?as, inclusive no c?ncer. O c?ncer colorretal apresenta altera??o na express?o de diversos miRNAs. Estas altera??es t?m sido associadas ao diagn?stico, progn?stico, express?o de genes, quimiossensibilidade e estadiamento, sendo potencial biomarcador. M?todos: Foram revisados e analisados dados cl?nicos e anatomopatol?gicos de pacientes submetidos a ressec??o cir?rgica do tumor prim?rio e linfonodos regionais diagnosticados de setembro de 2002 ? outubro de 2011 e inclu?dos no banco de tumores de c?ncer colorretal do Servi?o de Oncologia do Hospital S?o Lucas ? PUCRS. A an?lise da express?o dos miRNAs foi realizada no laborat?rio do Instituto de Biotecnologia da Universidade Cat?lica de Bras?lia onde foram analisadas nos tumores prim?rios e nos linfonodos regionais, com fins descritivos e frente aos dados cl?nico-patol?gicos dos casos estudados. A an?lise da quantifica??o dos seguintes miRNA (mir-570, mir-16, mir-338, Let-7, mir-1, mir-150, mir-183, mir-650 e mir-31) foi realizada por qPCR. Para an?lise estat?stica os testes: Exato de Fisher, Wilcoxon e de Kruskal Wallis, considerado n?vel de signific?ncia de 5%. Resultados: Dos 28 casos estudados, 28,6% tinham menos de 60 anos na ocasi?o do diagn?stico e 71,4% 60 anos ou mais. A idade m?dia foi de 66,7 anos (26 ? 86). A m?dia de seguimento foi de 3,9 anos (0 ? 9), DP=2,8 e mediana de 4 anos. A express?o dos miRNAs no tumor prim?rio (N=28) apresentou padr?o mais homog?neo, com uma tend?ncia a superexpress?o; enquanto que, nos linfonodos doentes (N=15) este padr?o foi mais heterog?neo, com o mir-570, mir-338, mir-1, mir-183 e mir-31 apresentando-se superexpressos e mir-16, Let-7, mir-150 e mir-650 com express?o reprimida. A express?o reprimida do mir-570 apresentou associa??o com mortalidade quando avaliado no tumor prim?rio (N=28), onde a preval?ncia de ?bito nos indiv?duos com express?o reprimida foi de 63,64% e naqueles superexpressos foi de 17,65%, com valor p=0,020. No tumor prim?rio dos pacientes com met?stase linfonodal (N=15) a mediana de express?o do mir-183 foi de 4,42 com intervalo interquartil p25 de 1,66 e p75 de 43,01; enquanto que, nas amostras de pacientes com linfonodos n?o doentes (N=13) a mediana de express?o do mir-183 foi de 54,17 com intervalo interquartil p25 de 13,12 e p75 de 223,14, com valor p= 0,01, sugerindo doen?a localizada ao diagn?stico. No subgrupo de pacientes com met?stase linfonodal (N=15), a express?o do mir-650 no linfonodo foi associada a preval?ncia de recidiva. A express?o do mir-650 esteve reprimida em 25% dos casos que recidivaram e superexpresso em 85% dos casos, com valor p=0,04. Conclus?es: O padr?o de express?o dos miRNAs difere conforme o s?tio da doen?a estudada (tumor prim?rio ou doen?a metast?tica). A express?o reprimida do mir-570 no tumor prim?rio provavelmente seja preditora de mortalidade. Superexpress?o do mir-183 no tumor prim?rio sugere doen?a localizada ao diagn?stico. A superexpress?o do mir-650 no linfonodo metast?tico ? preditor de recidiva. Novos estudos incluindo testes funcionais e metan?lises poder?o ratificar estes achados e otimizar a utiliza??o destes miRNAs na pr?tica cl?nica.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-07-21T18:39:03Z No. of bitstreams: 1 DIS_MARIA_MERCEDES_CARACCIOLO_PICARELLI_COMPLETO.pdf: 1479254 bytes, checksum: 1fc931d06c940f809dbcf8825a640251 (MD5) / Made available in DSpace on 2016-07-21T18:39:03Z (GMT). No. of bitstreams: 1 DIS_MARIA_MERCEDES_CARACCIOLO_PICARELLI_COMPLETO.pdf: 1479254 bytes, checksum: 1fc931d06c940f809dbcf8825a640251 (MD5) Previous issue date: 2016-03-31 / Introduction: Recent advances in juvenile idiopathic arthritis (AIJ) treatment promoted free disease survival. Cardiovascular disease (DCV) may emerge as an important cause of morbidity and mortality. Pulse wave velocity (VOP) and telomere length (TL) are considered as potential predictors of cardiovascular DCV. There are growing evidences of chronic and persistent inflammatory activity role on these processes. VOP and TL are potential early predictors of DCV and its outcomes. Objective: Access VOP and TL in a sample of AIJ patients, without cardiovascular risk factors, compare them with a group of healthy individuals sex and age matched and to test the correlation of these variables. Patients and Methods: 24 AIJ patients and 21 controls for TL and 20 controls for VOP were included. VOP was estimated by an oscillometric device (CardioSDyna ? MAPA +). TL was accessed by polimerase chain reaction in real time (qPCR). Inflammatory activity was accessed by Juvenile Disease Activity Score (JADAS-27).Obesity, systemic hypertension, diabetes mellitus, impaired renal function and other inflammatory diseases were excluded. Results: Oligoarticular (65, 2%) and polyarticular subtypes were included, with 73,9% females and 82,6% were Caucasian. The average age was 15,5 + 6,3 years and the median disease duration was 9 [5-19] years. Between cases and controls for LTL there was significant difference in age no differences in sex, ethnics and BMI. The JADAS median was 8 [0, 00 ? 20, 1], considered active when above 1, 0. PWV was normal in all patients, JIA and control (5.1 + 0.20 m/s vs. 4.98 + 0.06 m/s, P = 0, 66). TL expressed by T/S ratio (amplification telomere product and single copy gene) was significantly reduced between JIA patients and controls (0. 85 + 0, 34 vs. 1, 67 + 1, 38, Mann-Whitney test P = 0.025). When age adjusted by ANCOVA, the difference remained significant (P= 0,032). There was no correlation between TL and age (P =0, 449, r=0, 166), sex (P=0, 521), disease duration (P =0, 358, r=-0, 318), JADAS (P = 0, 184, r=-0, 287) e VOP (P = 0, 843, r=0, 044) in patients with AIJ. Conclusions: TL was significantly shorter in long disease duration and high to moderate disease activity with no DCV risk factors AIJ patients and compared to controls.VOP was normal and no significant difference between controls were found. No correlations were observed between TL or VOP and disease duration, age and sex. / Introdu??o: os avan?os na terap?utica da artrite idiop?tica juvenil (AIJ) promoveram o prolongamento da sobrevida livre de doen?a. A doen?a cardiovascular (DCV) pode emergir como importante causa de morbimortalidade. A velocidade de onda de pulso (VOP) e o comprimento de tel?meros (TL) s?o vistos como potenciais preditores de DCV. H? evid?ncias crescentes da import?ncia do papel da atividade inflamat?ria cr?nica e persistente nesses processos. VOP e TL s?o potenciais preditores precoces de DCV e seus desfechos. Objetivo: Avaliar a VOP e TL em uma amostra de pacientes com AIJ, sem fatores de risco para DCV, compar?-los com um grupo de indiv?duos saud?veis pareados por sexo e idade e testar a correla??o destas vari?veis. Pacientes e M?todos: 24 pacientes com AIJ e 21 controles para TL e 20 controles para VOP foram inclu?dos. A VOP foi estimada por um equipamento de an?lise oscilom?trica (CardioSDyna ? MAPA +). O TL foi avaliado atrav?s da rea??o em cadeia da polimerase em tempo real (qPCR). A atividade inflamat?ria foi medida atrav?s do Juvenile Disease Activity Score (JADAS-27). Pacientes com obesidade, hipertens?o arterial sist?mica, diabetes mellitus e perda de fun??o renal e outras doen?as inflamat?rias foram exclu?dos. Resultados: Foram inclu?dos os subtipos oligoarticular (65, 2%) e poliarticular, sendo que 73,9% eram meninas, 82,6% eram caucasianos. A m?dia de idade foi 15,5 + 6, 3 anos e a mediana de dura??o da doen?a foi de 9 [5-19] anos. Entre casos e controle para TL, houve diferen?a significativa em rela??o ? idade e n?o foi encontrada diferen?a quanto a sexo, etnia, IMC, peso e altura. A mediana do JADAS foi 8 [0,00 ? 20,1],considerado ativo acima de 1 . Os valores da VOP foram normais em todos os pacientes (5,1 + 0,2 vs.4,98 + 0,06 m/s) (P = 0,66). TL expresso pela raz?o T/S (produto da amplifica??o dos tel?meros e gene de c?pia ?nica) estava reduzido nos pacientes com AIJ (0, 85 + 0, 34 vs.1,67 ? 1,38), Teste de Mann-Whitney: P=0, 025. Quando ajustado para idade atrav?s da ANCOVA, a diferen?a permaneceu significativa (P=0, 032). N?o houve correla??o entre TL e idade (P =0, 449, r=0, 166), sexo (P=0, 521) , dura??o da doen?a (P =0, 358, r=-0, 318), JADAS (P = 0, 184, r=-0, 287) e VOP (P = 0, 843, r=0, 044) em crian?as com AIJ. Conclus?o: O TL foi significativamente menor nessa amostra de pacientes com AIJ de longa dura??o e com atividade da doen?a alta a moderada e sem fatores de risco para doen?a cardiovascular em compara??o aos controles. A VOP foi normal e sem diferen?a significativa em rela??o aos controles. N?o foram observadas correla??es significativas do TL ou do VOP com atividade e dura??o da doen?a, idade e sexo.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-08-01T16:54:22Z No. of bitstreams: 1 DIS_JULIANA_JASPER_PARCIAL.pdf: 388351 bytes, checksum: 6af0aff0490b73b53ede7bf4fe93485c (MD5) / Made available in DSpace on 2016-08-01T16:54:22Z (GMT). No. of bitstreams: 1 DIS_JULIANA_JASPER_PARCIAL.pdf: 388351 bytes, checksum: 6af0aff0490b73b53ede7bf4fe93485c (MD5) Previous issue date: 2016-04-18 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Radiation-induced oral mucositis (OM) is a highly debilitating side effect, which affects almost all patients with head and neck malignancies undergoing radiotherapy (RT). The severity of this injury is directly related to factors associated with the therapy itself and the individual characteristics of each patient. To date, there is no standard treatment protocol for this condition. Therefore, the present study aimed to evaluate clinically and histologically the effect of granulocyte colony-stimulating factor (G-CSF) on the healing of traumatic ulcers produced in the tongue of Wistar rats undergoing RT. The animals were randomly divided into 4 groups: 1) RT + traumatic ulcer + Filgrastim; 2) RT + traumatic ulcer + saline; 3) no RT + traumatic ulcer + Filgrastim; 4) no RT + traumatic ulcer. Filgrastim (r-metHuG-CSF), a recombinant G-CSF, was injected subcutaneously into the animals once daily, beginning 1 day after a single-dose radiation protocol (30 Gy), immediately after the traumatic ulcer was made. At the end of a 7-day experimental period, animals were euthanized and had their tongue surgically removed, processed, and stained with hematoxylin and eosin (HE). Clinically, all groups differed significantly in presence and size of traumatic ulcers, and the irradiated groups also differed significantly in severity of radiation-induced OM. Filgrastim-treated groups, submitted or not to RT, showed a better performance in this aspect. Histologically, there was an increased inflammatory response in the nonirradiated groups, with no statistically significant difference between the study drug and the respective control groups. Based on the present clinical results, we conclude that the use of Filgrastim reduced the manifestation and severity of trauma-induced ulcers and radiation-induced OM. This condition has a complex pathogenesis, which requires further detailed investigations on the actual role of G-CSF in its management before a formal recommendation regarding its use for this purpose can be made. / A mucosite oral (MO) radioinduzida ? um efeito colateral altamente debilitante, que afeta a quase totalidade dos indiv?duos portadores de neoplasias malignas na regi?o de cabe?a e pesco?o, submetidos ? radioterapia (RT). A gravidade desta inj?ria est? diretamente relacionada a fatores pertinentes ? terapia em si e ?s caracter?sticas individuais de cada paciente. N?o h?, at? o momento, um protocolo padr?o para o tratamento desta enfermidade. Sendo assim, o presente estudo objetivou analisar clinica e histologicamente a a??o do fator estimulador de col?nias de granul?citos (G-CSF) em ?lceras traum?ticas confeccionadas na l?ngua de ratos Wistar submetidos ? RT. Os animais foram alocados randomicamente em quatro grupos distintos: 1) RT + ?lcera traum?tica + Filgrastim; 2) RT + ?lcera traum?tica + soro fisiol?gico; 3) sem RT + ?lcera traum?tica + Filgrastim; 4) sem RT + ?lcera traum?tica. O Filgrastim (r-metHuG-CSF), um G-CSF recombinante, foi injetado diariamente nos animais pela via subcut?nea, iniciando um dia depois do protocolo ?nico de irradia??o (30 Gy), imediatamente ap?s a confec??o da ?lcera traum?tica. Uma vez conclu?do o tempo experimental de sete dias, os animais foram eutanasiados e tiveram a l?ngua excisada, processada e corada com hematoxilina e eosina (HE). A avalia??o cl?nica diferiu significativamente entre todos os grupos quanto ? presen?a e ao tamanho da ?lcera traum?tica, al?m do grau de severidade da MO radioinduzida, entre os grupos irradiados. Os grupos tratados com Filgrastim, submetidos ou n?o ? RT, apresentaram uma melhor performance neste quesito. Histologicamente, houve maior resposta inflamat?ria nos grupos n?o irradiados, sem diferen?a estatisticamente significante entre a medica??o estudada e os respectivos grupos controle. Baseado nos resultados cl?nicos encontrados, pode-se concluir que o uso do Filgrastim reduziu a manifesta??o e o grau de severidade da ?lcera confeccionada e da MO radioinduzida. Esta ? uma doen?a de patogenia complexa, a qual necessita investiga??es mais detalhadas sobre o real papel do G-CSF no seu manejo, para que uma indica??o formal do seu uso possa ser recomendada com esta finalidade.

Made available in DSpace on 2016-04-28T14:58:58Z (GMT). No. of bitstreams: 1 2007- Luiz Aurelio Peres Martelleto.pdf: 2127585 bytes, checksum: 81c879a6537f8e53170021781a03c57a (MD5) Previous issue date: 2007-01-19 / A study was conducted at the Integrated System of Agroecological Production (a Research Farm, located in Serop?dica, State of Rio de Janeiro), to evaluate the cycle development and the agronomic performance of papaya under organic management, comparing two ways of growing the plant (with and without trunk bifurcation) in three types of protected environment. Papaya seedlings, cv. Baixinho de Santa Am?lia ("Solo" group), were transplanted to contiguous structures as follows: (a) greenhouse (plastic covering), (b) shadowed greenhouse ('sombrite' net - 30%, over the plastic sheet), and (c) screenhouse ('sombrite' net - 30%, exclusively), side-by-side to an area for papaya cultivation under natural conditions. The greenhouse lateral and frontal parts were protected with anti-aphid screen. In these four treatments, 50% of the hermaphrodite plants were submitted to an incision of the apical bud, soon after sex determination. For a 12 months period of cultivation: temperature, relative air humidity and light radiation were measured in each environment. Regarding to development of papaya: plant height, basal trunk diameter, number of leaves per plant, foliar area, and periods of time to complete phases of the cycle were determined. A study of floral biology and of fruits characteristics also corried out. Cultural practices agreed with technical rules of organic agriculture. For comparisons among differents environments, the jointly experiment analysis" method was adopted. Trunk bifurcation reduced plant height thus extending the time period of papaya production cycle under covered environments. However, there was negative influence in number and average weight of harvested fruits. In the greenhouses (plastic and plastic plus sombrite coverings) there were increases with respect to: plant height, number of leaves, foliar area and time- life of leaves in the plant. In addition, there were reductions in the incidence of black spot (leaves and fruits) and of fruit skin freckles. In the shaded environments, percents of pentandric and carpeloid fruits were lower, opposite to that of estaminate flowers. In the screnhouse (only sombrite net), a decreased proportion of fruits reaching commercial standart occurred. In the greenhouse (plastic covering), other benefitial effects were noticed, such as: anticipation of flowering and fruit harvesting, due to the acceleration of fruit ripening in the plant. Although an increase in the number pentandric, carpeloid and deformed, fruits was observed cultivation in the greenhouse also induced a highly significant increment in yield of marketable fruits (around 67%) compared with the natural environment. The results obtained indicated potential for organic papaya cultivation under greenhouse conditions, as judging by the expressive gain in productivity and plant health, besides the acceleration of the cycle. / O estudo foi conduzido no Sistema Integrado de Produ??o Agroecol?gica - S.I.P.A. (Fazendinha Agroecol?gica Km 47), situado em Serop?dica,RJ, tendo como objetivos acompanhar o desenvolvimento do ciclo e avaliar o desempenho agron?mico do mamoeiro sob manejo org?nico, comparando duas formas de condu??o da planta (com e sem bifurca??o do tronco), em ambiente natural e em tr?s tipos de ambiente protegido. Para tanto, mudas de mamoeiro da cultivar Baixinho de Santa Am?lia, grupo Solo , foram transplantadas para tr?s estruturas cont?guas: (a) estufa (cobertura de pl?stico), (b) estufa sombreada (cobertura adicional de sombrite 30% sobre o pl?stico) e (c) telado (cobertura de sombrite 30%); estabelecendo-se, ao lado, uma ?rea de cultivo em ambiente natural. Nas estufas (a e b), as laterais e frentes foram revestidas com tela anti-af?dica. Nesses quatro tratamentos, 50% das plantas hermafroditas tiveram o tronco bifurcado por meio de incis?o da gema apical, logo ap?s a determina??o do sexo. Registraram-se, ao longo de 12 meses de cultivo: temperatura, umidade relativa do ar e luminosidade em cada ambiente. Quanto ao desenvolvimento do mamoeiro: altura da planta, di?metro do tronco, n?veis de enfolhamento, ?rea foliar e per?odos de tempo para cumprimento de fases do ciclo, foram monitorados. Realizou-se, ainda, estudo da biologia floral e das caracter?sticas dos frutos produzidos. Os tratos culturais empregados obedeceram ?s normas t?cnicas da produ??o org?nica. Para compara??o entre ambientes de cultivo, adotou-se o m?todo da an?lise conjunta de experimentos . A bifurca??o do tronco reduziu a altura da planta prolongando o cultivo do mamoeiro nos ambientes cobertos. No entanto, teve influ?ncia negativa no n?mero e no peso m?dio dos frutos. Nas estufas (coberturas de pl?stico e de pl?stico mais sombrite) houve aumentos em rela??o a: altura da planta, n?vel de enfolhamento, ?rea foliar e sobrevida das folhas. Por outro lado, ocorreram redu??es da incid?ncia da var?ola (folhas e frutos) e da mancha fisiol?gica nos frutos. Nos ambientes sombreados, os percentuais de frutos pent?ndricos e carpel?ides foram mais baixos, ao contr?rio de flores estaminadas. No telado, registrou-se menor propor??o de frutos atingindo padr?o comercial. Na estufa, ocorreram benef?cios do ponto de vista agron?mico, destacando-se: antecipa??o do florescimento e do in?cio da colheita, al?m da acelera??o do amadurecimento dos frutos na planta. Embora tenha havido aumento do n?mero de frutos pent?ndricos, carpel?ides e aplastados, o cultivo na estufa proporcionou aumento altamente significativo da produ??o de frutos comercializ?veis (em torno de 67%) em compara??o ao ambiente natural. Os resultados obtidos indicaram potencial para o cultivo org?nico do mamoeiro sob condi??es de estufa, em fun??o dos ganhos expressivos de produtividade e sanidade, al?m de precocidade e acelera??o da colheita.