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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
381

Evid?ncias epidemiol?gicas sobre maus-tratos na inf?ncia e modelo experimental de estresse precoce

Viola, Thiago Wendt 04 March 2015 (has links)
Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-07-07T12:04:40Z No. of bitstreams: 1 471704 - Texto Parcial.pdf: 246433 bytes, checksum: 3ed824369fb247b1ed0ddae39f0e7053 (MD5) / Made available in DSpace on 2015-07-07T12:04:40Z (GMT). No. of bitstreams: 1 471704 - Texto Parcial.pdf: 246433 bytes, checksum: 3ed824369fb247b1ed0ddae39f0e7053 (MD5) Previous issue date: 2015-03-04 / Introduction : Early-life stress is thought to increase risk for developing cocaine addiction. However, the mechanisms and mediators of this relationship still not completely understood, particularly during adolescence, which is the period that drug use usually initiates.Objectives : To examine the effects of postnatal maternal separation (MS) on cocaineinduced conditioned place preference (CPP) paradigm in periadolescent mice. Additionally, to investigate if MS affects short-term spatial memory, as well as drug-free exploratory activity and anxiety-related behavior.Methods : BALB/c litters were randomly assigned to one of two groups: MS or standard rearing (SR - controls). The MS animals were subjected to a procedure that pups were separated from their dams daily for 180 minutes, from postnatal (PND) 2 to 15. The CPP was performed following three sequential phases: habituation (PND 34), conditioning (PND 35 to PND 44) and post-conditioning test (PND 45). For all phases, mice were placed into the chambers for a total of 30 minutes each day. Cocaine was administered at a dose of 20 mg/kg (i.p.). Animals also performed the open field and object recognition tasks. Behavioral data was analyzed using ANY-Maze video-tracking system.Results : MS selectively affected cocaine-induced CPP in adolescent mice, increasing the time spent in the drug-paired chamber, but exerted no influence on exploratory activity, anxiety-related behavior and short-term spatial memory.Conclusions : Separation from the primary caregiver during early life can increase reactivity to cocaine paired cues, such as a particular environment, in a developmental period with increased drug abuse vulnerability. / Introdu??o : Acredita-se que o estresse no in?cio da vida aumenta o risco de desenvolvimento de adi??o a coca?na. Entretanto, os mecanismos e mediadores desta rela??o ainda n?o foram completamente entendidos, particularmente durante a adolesc?ncia, que ? o per?odo em que o uso de drogas usualmente se inicia.Objetivos : Examinar os efeitos da separa??o materna p?s-natal (MS) no paradigma do condicionamento de prefer?ncia por lugar (CPP) induzido por coca?na em camundongos periadolescentes. Al?m disso, investigar se a separa??o materna afeta a mem?ria espacial de curto-prazo, bem como a atividade explorat?ria e comportamento de ansiedade na aus?ncia de droga.M?todos : As ninhadas de BALB/c foram randomicamente destinadas a um dos grupos: MS ou desenvolvimento normal (SR - controles). Os animais de MS foram submetidos a um procedimento no qual os filhotes s?o separados da m?e diariamente por 180 minutos, do dia p?s-natal (PND) 2 ao PND 15. O CPP foi realizado seguindo tr?s fases sequenciais: habitua??o (PND 34), condicionamento (PND 35 ao PND 44) e teste p?s-condicionamento (PND 45). Para todas as fases os camundongos foram colocados nas c?meras de CPP por um total de 30 minutos todos os dias. A coca?na foi administrada intraperitonealmente a uma dose de 20mg/kg. Os animais tamb?m realizaram as tarefas de campo aberto e reconhecimento de objetos. Os dados comportamentais foram analisados utilizando o sistema de v?deo do ANY-Maze.Resultados : A MS afetou seletivamente o CPP induzido por coca?na nos camundongos adolescentes, aumentando o tempo dispendido na c?mera pareada ? droga, mas n?o influenciou a atividade explorat?ria, o comportamento ansioso e a mem?ria espacial de curto-prazo.Conclus?es : A separa??o do cuidador prim?rio durante o in?cio da vida pode aumentar a reatividade a pistas pareadas a coca?na, como um ambiente espec?fico, em um per?odo cr?tico do desenvolvimento, com alta vulnerabilidade ao abuso de drogas.
382

Efeitos do exerc?cio f?sico na mem?ria e comportamento ansioso de camundongos expostos ? separa??o materna

Wearick-Silva, Luis Eduardo 27 February 2015 (has links)
Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-07-16T11:47:41Z No. of bitstreams: 1 472323 - Texto Parcial.pdf: 121966 bytes, checksum: 2381428855b2dc0b8ef271a500527bef (MD5) / Made available in DSpace on 2015-07-16T11:47:41Z (GMT). No. of bitstreams: 1 472323 - Texto Parcial.pdf: 121966 bytes, checksum: 2381428855b2dc0b8ef271a500527bef (MD5) Previous issue date: 2015-02-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: The exposure to early life stress (ELS) has been associated with different psychopathologies in adulthood such as mood- and anxiety-related behaviors. In animal research, the maternal separation paradigm has been widely used to investigate the longterm effects of ELS. Considering the negative effects of ELS on development, evidences suggesting that exercise could attenuate or even reverse such effects are beginning to emerge. This article aimed to investigate the impact of physical exercise on anxiety-like behavior and spatial memory in mice exposed to maternal separation. Method: Litters were assigned to one of 4 groups: The MS animals were subjected to a procedure where pups were separated from their dams daily for 180 minutes, from postnatal days (P) 2 to 15. The exercise protocol was performed at P24 and consisted of one week of habituation to treadmill and 3 weeks of exercise, with 60 min of duration at 10 m/min for 5 days a week. The performance in an open field test was evaluated to assess locomotor activity and anxiety-like behavior. Object recognition was also performed to investigate the effects of MS and exercise on spatial memory. Results: Both maternal separation and exercise increased locomotor activity in the open field. However, anxiety-like behavior was not affected by MS or exercise. In object recognition, all groups presented the same exploratory behavior. However, MS impaired the capability to recognize the new object, suggesting impairment in spatial memory. In time, MS mice that exercised were able to reverse the negative effects of MS, showing a performance similar to the control group (AFR). Taken together, our results suggest that the disruption of the normal development course?here via maternal separation paradigms?is harmful to a good development and may result in cognitive and behavioral difficulties in adulthood. Furthermore, the early engagement in a program of exercise can be effective in reversing the impairments of ELS. / Introdu??o: A exposi??o ao estresse no in?cio da vida est? associada com diferentes psicopatologias na fase adulta como transtornos de humor e ansiedade. Em pesquisas com modelos animais, o paradigma de separa??o materna ? amplamente utilizado para investigar os efeitos de longo prazo do estresse no in?cio da vida. Considerando os efeitos negativos do estresse no desenvolvimento, come?am a surgir evid?ncias que o exerc?cio poderia atenuar ou at? mesmo reverter os efeitos delet?rios do estresse. Este trabalho se prop?s a investigar o impacto do exerc?cio f?sico no comportamento ansioso e mem?ria espacial de camundongos f?meas expostas a separa??o materna. M?todo: Os filhotes foram expostos a um protocolo de separa??o materna no qual eram separados da m?e diariamente por 180 minutos, do segundo dia p?s natal (P2) ao P15. O protocolo de exerc?cio f?sico foi realizado no P24, e consiste em uma semana de habitua??o a esteira el?trica e tr?s semanas de exerc?cio, com 5 sess?es por semana de 60 minutos cada, a uma velocidade de 10m/min. O comportamento no teste de campo aberto foi avaliado para investigar a atividade locomotora e o comportamento ansioso. O teste de reconhecimento de objetos foi realizado para investigar o efeito do exerc?cio e da separa??o materna na mem?ria espacial. Resultados: A separa??o maternal e o exerc?cio aumentaram a atividade locomotora dos animais no teste de campo aberto. O comportamento ansioso n?o foi afetado pela separa??o materna ou exerc?cio. No reconhecimento de objetos, todos os grupos apresentaram o mesmo comportamento explorat?rio. Entretanto, a separa??o materna prejudicou a capacidade de reconhecimento do objeto novo, sugerindo um preju?zo na mem?ria espacial. Ainda, os animais separados da m?e que realizaram o protocolo de exerc?cio foram capazes de reverter os efeitos negativos da separa??o materna, onde mostraram um resultado semelhante ao grupo controle. Conclus?es: Nossos resultados sugerem que a interrup??o do curso normal do desenvolvimento, aqui realizados atrav?s da separa??o materna ? prejudicial para um bom desenvolvimento e pode levar a dificuldades cognitivas e comportamentais na vida adulta. Al?m disso, a participa??o precoce em um programa de exerc?cios f?sicos pode ser efetivo para reverter os preju?zos causados pelo estresse no in?cio da vida.
383

Intervenção fonoaudiológica ambulatorial em crianças pequenas com distúrbio alimentar: um estudo de caso

Farias, Patrícia Trinta e 25 November 2008 (has links)
Made available in DSpace on 2016-04-27T18:12:38Z (GMT). No. of bitstreams: 1 Patricia Trinta e Farias.pdf: 1110472 bytes, checksum: 1739798374fb2dd30939aeadadc88368 (MD5) Previous issue date: 2008-11-25 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The present paper had the objective of describing the transformation in the clinical-therapeutical perspective occurred during the ambulatory speechlanguage treatment of a young child with feeding problems that used an exclusive alternative feeding via gastrotomy. The difficulty concerning the feeding dynamic was understood beyond the organical and functional aspects, considering the patient s familial context. Being applied a clinical exploratory methodology, to collect the data there were used registrations (handbooks) of the attendances, including the parents interviews. In order to reflect about the transformation in the attendance process contemplating the child s life history, there were applied concepts of the Winnicottian theory, namely: holding, object management and presentation. Finally, it was possible to conclude that the speech-language therapist that deals with feeding problems, based on a favorable setting, may offer the patient conditions to a safe pleasant feeding / O presente estudo teve como objetivo descrever a transformação na perspectiva clínico-terapêutica ocorrida durante o tratamento fonoaudiológico ambulatorial de uma criança pequena com problema alimentar que utilizava uma via de alimentação alternativa exclusiva gastrostomia. A dificuldade em torno da dinâmica da alimentação foi compreendida para além dos aspectos orgânicos e funcionais, considerando-se o contexto familiar da paciente. Sendo a metodologia clínica exploratória, para a coleta dos dados foram utilizados registros (prontuário) dos atendimentos, incluindo as entrevistas com os pais. Para refletir sobre a transformação no processo de atendimento, contemplando a história de vida da criança, foram abordados conceitos da teoria winnicottiana, a saber: holding, manejo e apresentação de objeto. Por fim, foi possível concluir que o fonoaudiólogo que atua com problemas alimentares, a partir de um setting favorável, pode oferecer ao paciente condições para uma alimentação segura e prazerosa
384

Ensaio cl?nico randomizado, controlado, comparando os resultados da bromoprida, metoclopramida e ondansetron aplicados intramuscular em dose ?nica para o tratamento de v?mitos em um pronto socorro pedi?trico

Portela, Janete de Lourdes 02 July 2015 (has links)
Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-08-13T19:35:39Z No. of bitstreams: 1 473454 - Texto Parcial.pdf: 755327 bytes, checksum: 9e3264a8362ab0aeb4b4514a2de60490 (MD5) / Made available in DSpace on 2015-08-13T19:35:40Z (GMT). No. of bitstreams: 1 473454 - Texto Parcial.pdf: 755327 bytes, checksum: 9e3264a8362ab0aeb4b4514a2de60490 (MD5) Previous issue date: 2015-07-02 / Objective: To compare the effectiveness of single-dose intramuscular bromopride, metoclopramide, and ondansetron for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency for the treatment of vomiting in a pediatric emergency department setting. department setting. department setting. department setting. department setting. department setting.department setting. Methods: Randomized controlled trial of children who presented with vomiting due to gastroenteritis at the pediatric emergency department of Hospital Universit?rio de Santa Maria from August 2013 to June 2014. Children aged 1 to 12 years were randomized to receive a single intramuscular dose of bromopride or metoclopramide (up to 10 mg) or ondansetron (up to 8 mg) 0.15 mg/kg. After administration of the antiemetic drug, children remained under observation for at least 1 hour. Children who were discharged after the observation period were subsequently monitored by their parents or caregivers at home for 24 hours and contacted via telephone for assessment of the results of antiemetic therapy. The following parameters were compared across treatment groups: time to cessation of vomiting within 1, 6, and 24 hours; acceptance of oral rehydration therapy; intravenous fluid replacement; return to hospital; and adverse effects attributable to the antiemetic. All parents or caregivers were given information on the antiemetic treatment that would be provided and signed an informed consent form authorizing the child's participation in the study. Results: Of 180 children randomized, 175 completed the trial. Within 1 hour of antiemetic administration, cessation of vomiting had been achieved in 96.6% of children given bromopride, 94.8% of those given metoclopramide, and 100% of those given ondansetron (p=0.312). Six hours after administration, bromopride was found to cease vomiting in 216?114 minutes, metoclopramide in 150?168 minutes, and ondansetron in 72?54 minutes (p=0.011). Cessation of vomiting at 24 hours was achieved in 67.8% of children given bromopride, 67.2% of those given metoclopramide, and 96.6% of those given ondansetron (p=0.002). Children in the ondansetron group accepted more fluid replenishment orally (200 ml) than those given bromopride or metoclopramide (150 ml and 100 ml respectively) (p=0.034). Eleven children ultimately required intravenous fluids: five in the bromopride group and six in the metoclopramide group. Within 1 hour of antiemetic administration, only 24.1% of children in the ondansetron group reported adverse effects (somnolence, diarrhea, fatigue, restlessness, feeling hot) fatigue, restlessness, feeling hot) fatigue, restlessness, feeling hot)fatigue, restlessness, feeling hot)fatigue, restlessness, feeling hot)fatigue, restlessness, feeling hot) fatigue, restlessness, feeling hot) fatigue, restlessness, feeling hot) fatigue, restlessness, feeling hot)fatigue, restlessness, feeling hot) fatigue, restlessness, feeling hot) fatigue, restlessness, feeling hot)fatigue, restlessness, feeling hot)fatigue, restlessness, feeling hot) fatigue, restlessness, feeling hot)fatigue, restlessness, feeling hot) , whereas 42.4% and 44.8% of children in the bromopride and metoclopramide groups respectively reported somnolence (p=0.034). At 24 hours, there were no significant differences in adverse effects across the three groups (p=0.357). Conclusion: In a pediatric emergency department setting, ondansetron is superior to bromopride and metoclopramide for treatment of vomiting. Ondansetron was associated with cessation or reduction of vomiting both within 1 hour of administration and at 6 and 24 hours. Bromopride and metoclopramide were both effective, but were associated with somnolence, an adverse effect that can prolong observation time in the emergency department and thus increase hospital costs. / Objetivo: Avaliar os resultados dos antiem?ticos aplicados via intramuscular, bromoprida, metoclopramida e ondansetron em dose ?nica para o em dose ?nica para o em dose ?nica para o em dose ?nica para o em dose ?nica para o em dose ?nica para o em dose ?nica para o em dose ?nica para o em dose ?nica para o em dose ?nica para o tratamento de v?mitos em um pronto tratamento de v?mitos em um pronto tratamento de v?mitos em um pronto tratamento de v?mitos em um pronto tratamento de v?mitos em um pronto tratamento de v?mitos em um pronto tratamento de v?mitos em um pronto tratamento de v?mitos em um pronto tratamento de v?mitos em um pronto tratamento de v?mitos em um pronto tratamento de v?mitos em um pronto tratamento de v?mitos em um pronto tratamento de v?mitos em um pronto tratamento de v?mitos em um pronto socorro socorro socorro pedi?trico. pedi?trico. pedi?trico. pedi?trico. M?todos: Ensaio cl?nico randomizado e controlado, envolvendo crian?as que consultaram por v?mitos, devido ? gastroenterite, no servi?o de Emerg?ncia Pedi?trica no Hospital Universit?rio de Santa Maria, no per?odo de agosto de 2013 a junho de 2014. Foram randomizadas crian?as com idades entre 1 a 12 anos, para receber dose ?nica de bromoprida via intramuscular ou metoclopramida via intramuscular (m?ximo 10mg); ou ondansetron (m?ximo 8mg) na dose de 0,15mg/kg via intramuscular. A crian?a ap?s receber o antiem?tico permanecia em observa??o por no m?mimo 1 hora. Ap?s a reavaliac?o cl?nica as crian?as que recebiam alta eram monitorizadas pelo familiar no domic?lio durante 24 horas, e contactados por via telef?nica para avaliar o resultado do tratamento antiem?tico recebido. Os grupos foram comparados em rela??o a tempo para cessar os v?mitos dentro de 1, 6 e 24 horas; aceita??o de l?quidos orais; reidrata??o endovenosa; retorno ao hospital e efeitos colaterais relacionados aos antiem?ticos. Os familiares ap?s devidamente informados sobre o tratamento antiem?tico que a crian?a seria submetida, assinaram o Termo de Consentimento Livre e Esclarecido, permitindo a participa??o do filho no estudo. Resultados: Das 180 crian?as randomizadas, 175 completaram o estudo. Na primeira hora ap?s medicar, a bromoprida teve 96,6% de efic?cia na cessa??o dos v?mitos, a metoclopramida, 94,8% e o ondansetron 100%, (p= 0,312). Em 6 horas, ? bromoprida cessou o v?mito em 216?114 minutos, ? metoclopramida em 150?168 minutos e o ondansetron 72?54 minutos, (p=0,011). Em 24 horas, a cessa??o dos v?mitos ocorreu em 67,8% com bromoprida, 67,2% com metoclopramida e 96,6% com ondansetron (p=0,002). O grupo ondansetron aceitou melhor os l?quidos orais, 200 ml, comparado ? bromoprida, 150 ml e ? metoclopramida, 100 ml (p=0,034). Onze crian?as necessitaram de hidrata??o endovenosa: 5 no grupo bromoprida e 6 no metoclopramida. Sessenta minutos ap?s medicar, apenas 24,1% do grupo ondansetron apresentaram efeitos colaterais (sonol?ncia, diarreia, cansa?o, cansa?o, cansa?o, cansa?o, cansa?o, cansa?o, cansa?o, cansa?o, inquieta??o, sensa??o de calor) inquieta??o, sensa??o de calor)inquieta??o, sensa??o de calor) inquieta??o, sensa??o de calor)inquieta??o, sensa??o de calor) inquieta??o, sensa??o de calor)inquieta??o, sensa??o de calor)inquieta??o, sensa??o de calor) inquieta??o, sensa??o de calor)inquieta??o, sensa??o de calor)inquieta??o, sensa??o de calor) inquieta??o, sensa??o de calor)inquieta??o, sensa??o de calor)inquieta??o, sensa??o de calor)inquieta??o, sensa??o de calor)inquieta??o, sensa??o de calor)inquieta??o, sensa??o de calor) inquieta??o, sensa??o de calor) , enquanto que os grupos bromoprida e metoclopramida apresentaram associa??o com sonol?ncia, 42,4% e 44,8%, respectivamente, p=0,034. Os efeitos colaterais em 24hs n?o apresentaram diferen?a estat?stica significativa entre os tr?s grupos, p=0,357. Conclus?o: Existem benef?cios nos resultados para tratamento de v?mito em pronto socorro pedi?trico com o uso do ondansetron em rela??o ? bromoprida e ? metoclopramida. O ondansetron mostrou-se associado na cessa??o ou redu??o dos v?mitos ap?s medicar tanto na primeira hora, quanto nas pr?ximas 6 e 24 horas. A bromoprida e a metoclopramida foram consideradas eficazes, mas apresentava associa??o com sonol?ncia, efeito colateral que pode determinar um maior tempo de observa??o em sala de emerg?ncia e aumentar os custos hospitalares.
385

Efeitos do estresse pr?-natal sobre a fun??o pulmonar e par?metros inflamat?rios em camundongos expostos a um modelo de asma

Vargas, Mauro Henrique Moraes 17 July 2015 (has links)
Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-08-13T19:56:16Z No. of bitstreams: 1 473453 - Texto Parcial.pdf: 147318 bytes, checksum: 8b1be3dea81a4df762bc1507d7a4fe9a (MD5) / Made available in DSpace on 2015-08-13T19:56:16Z (GMT). No. of bitstreams: 1 473453 - Texto Parcial.pdf: 147318 bytes, checksum: 8b1be3dea81a4df762bc1507d7a4fe9a (MD5) Previous issue date: 2015-07-17 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / Introduction: Adversities faced during the prenatal period can be related to the onset of diseases in adulthood. However, little is known about its effects on the respiratory system. Aims: To assess the effects of restraint prenatal stress, in two different moments of pregnancy, on pulmonary function and inflammatory profile in male and female mice exposed to a ovalbumin (OVA) induced asthma model. Methods: Male and female BALB/c mice were divided into 3 groups: control (CON), prenatal stress from the second week of pregnancy (PNS1) and prenatal stress on the last week of pregnancy (PNS2). Pups were weighted on 3 different moments (days 1, 10 and 21). As adults, the fear/anxiety behavior was evaluated in the open field (between days 50? and 54?). The ovalbumin-induced asthma model was performed at day 56, followed by the analysis of lung function (airway resistance, tissue damping and elastance), collection of bronchoalveolar lavage fluid, total and differential cell count and inflammatory cytokines evaluation. The left lung was removed and processed for histological analysis. Results: There was a significant decrease (p<0.05) in the number of entries and time spent in the central quadrant only in PNS1 group compared to controls. Females (PNS1) also presented an improvement in the lung function, measured as airway resistance, tissue damping and pulmonary elastance (p<0.05). When female differential cell count was analyzed, PNS1 group showed a significant increase in the percentage of neutrophils (p<0.01), lymphocytes (p<0.05) and a significant decrease of eosinophils (p<0.05) when compared to the control group. There was also a decrease in the BAL inflammatory cytokines, including a significant reduction in IL-5 and IL-13 in males of PNS1 (p<0.001 and p<0.01) and PNS2 (p<0.01 and p<0.01) when compared to controls. In females, a significant reduction in the secretion of IL-4, IL-5 and IL-13 in both PNS1 (p<0.05, p<0.001 and p<0.01) and PNS2 (p<0.01, p<0.001 and p<0.05) were demonstrated. Conclusion: The results of this study indicate that prenatal stress, from the second week of pregnancy (PNS1), reduces the impact of asthma development in adult female mice, showing an improved pulmonary function and a lower allergic inflammatory response in the lungs. / Introdu??o: Adversidades enfrentadas no per?odo pr?-natal podem estar implicadas na programa??o fetal e no surgimento de doen?as na vida adulta. No entanto, pouco se sabe sobre os efeitos do estresse neste per?odo sobre o sistema respirat?rio. Objetivos: Avaliar os efeitos do estresse pr?-natal por conten??o, em dois diferentes momentos da prenhez, sobre a fun??o pulmonar e o perfil inflamat?rio em camundongos machos e f?meas, expostos a um modelo de asma induzida por ovalbumina (OVA). Materiais e m?todos: Foram utilizados camundongos BALB/c machos e f?meas divididos em tr?s diferentes grupos controle (CON), estresse pr?-natal a partir da 2? semana (PNS1) e estresse pr?-natal na ?ltima semana (PNS2). A pesagem da prole foi feita em 3 diferentes momentos (dias 1, 10 e 21). Quando adultos, foi avaliado o comportamento de medo/ansiedade no campo aberto (entre o 50? e 54? dia). No 56? dia foi realizada a aplica??o do modelo de asma por ovalbumina com posterior an?lise do teste de fun??o pulmonar (resist?ncia das vias a?reas, amortecimento do tecido e elast?ncia), al?m da coleta de lavado broncoalveolar para contagem total e diferencial de c?lulas e avalia??o de citocinas inflamat?rias. O pulm?o esquerdo foi retirado e processado para an?lise histol?gica. Resultados: Houve diminui??o significativa (p<0,05) do n?mero de entradas e tempo despendido no quadrante central somente no grupo PNS1 quando comparado aos controles. Melhora na fun??o pulmonar das f?meas nos par?metros de resist?ncia das vias a?reas, amortecimento do tecido e elast?ncia pulmonar (p<0,05). Na contagem diferencial de c?lulas das f?meas, o grupo PNS1 apresentou um aumento percentual significativo dos neutr?filos (p<0,01) e linf?citos (p<0,05) e uma diminui??o significativa de eosin?filos (p<0,05), quando comparados ao grupo controle. Tamb?m houve diminui??o das citocinas inflamat?rias com redu??o significativa na secre??o de IL-5 e IL-13 no LBA dos machos do grupo PNS1 (p<0,001 e p<0,01) e PNS2 (p<0,01 e p<0,01), quando comparados com o grupo controle. Nas f?meas houve uma redu??o significativa na secre??o de IL-4, IL-5 e IL-13 nos grupos PNS1 (p<0,05, p<0,001 e p<0,01) e PNS2 (p<0,01, p<0,001 e p<0,05) Conclus?o: Os resultados deste estudo indicam que o estresse pr?-natal, a partir da segunda semana de prenhez (PNS1), reduziu o impacto do desenvolvimento da asma em camundongos f?meas na idade adulta, mostrando uma melhor fun??o pulmonar e menor resposta inflamat?ria al?rgica no pulm?o.
386

An?lise da express?o de fatores de transcri??o caracter?sticos de TH1, TH2, TH17 e TREG em c?lulas TCD4+ de crian?as asm?ticas

Ara?jo, Patr?cia Dias de 31 March 2015 (has links)
Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-08-13T20:17:59Z No. of bitstreams: 1 473456 - Texto Parcial.pdf: 768622 bytes, checksum: 552f69a1d4c4b1b7e4906070b478b964 (MD5) / Made available in DSpace on 2015-08-13T20:17:59Z (GMT). No. of bitstreams: 1 473456 - Texto Parcial.pdf: 768622 bytes, checksum: 552f69a1d4c4b1b7e4906070b478b964 (MD5) Previous issue date: 2015-03-31 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: Asthma is a disease that affects most children, characterized by inflammation and airway hyperresponsiveness. Asthma has two main phenotypes depending on the presence of atopy. In addition to Th2 cells, Th17 cells, Th1 and Treg cells are involved in disease pathology by secreting cytokines. CD4 T cells have plasticity, which are influenced by environmental and genetic factors. Aim: To assess the phenotypic profile of CD4 T cells in asthmatic children of school age, with or without the presence of atopy and healthy controls and correlate the data with disease severity. In addition, analyze cells expressing more than one transcription factor in the blood of atopic asthmatic children to D.pteronyssinus stimulating mononuclear cells with DerP1 protein. Methods: This was a cross-sectional case-control study, where 8-14 years-old asthmatic and healthy children were recruited of public schools in Porto Alegre/RS. Mononuclear cells were isolated by Histopaque peripheral blood of children and cultured with anti-CD3/CD28 or DerP1 protein. After 24 hours the cells were stained with antibodies specific for transcription factors for analysis of Th2, Th17, Th1 and Treg cells by flow cytometry. Moreover, it was analyzed in plasma allergen-specific IgE specific. Results: The results showed that children with asthma have a higher frequency of CD4+ GATA-3+ compared to controls. Frequency of CD4+GATA-3+ROR?t+ cells correlated with disease severity, except with severe therapy resistant asthma (STRA). Atopic patients showed a higher proportion of co-expressing more than one transcription factor cells compared to non-atopic individuals. Stimulation with DerP1 protein enhances the frequency of CD4 + Foxp3 +ROR?t+ compared with the control and stimulation with anti-CD3/ CD28. Conclusion: In general, the results presented in this thesis allowed us to conclude that the allergens play an important role in the development of cells expressing more than one transcription factor in atopic patients. In addition, our study was the first to demonstrate that STRA children have a distinct expression profile of regulatory transcription factors of CD4 T cells Th1, Th2, Th17 and Treg compared to other severity levels of the disease. / Introdu??o: A asma ? uma doen?a prevalente em crian?as, tendo como principal caracter?stica a inflama??o e hiperresponsividade das vias a?reas. Al?m das c?lulas Th2, as c?lulas Th17, Th1 e Treg s?o envolvidas na patologia da doen?a pela fun??o que elas e as citocinas por elas secretadas exercem. A asma apresenta dois fen?tipos principais, os quais dependem da presen?a de atopia. As c?lulas TCD4 apresentam plasticidade, que s?o influenciadas por fatores ambientais e gen?ticos. Objetivos: Avaliar o perfil fenot?pico de c?lulas TCD4 de crian?as em idade escolar asm?ticas, com ou sem a presen?a de atopia e de controles saud?veis. Correlacionar os dados obtidos com a severidade da doen?a. Al?m disso, avaliar as c?lulas que co-expressam mais de um fator de transcri??o no sangue de crian?as asm?ticas at?picas para D.pteronyssinus estimulando as c?lulas com a prote?na Derp1. Materiais e m?todos: Este foi um estudo transversal caso-controle, onde crian?as de 8 a 14 anos foram recrutadas de escolas p?blicas de Porto Alegre/RS, asm?ticas e controles. As c?lulas mononucleares foram isoladas por Histopaque do sangue perif?rico destas crian?as e colocadas em cultura com anti-CD3/CD28 ou com prote?na Derp1. Ap?s 24hs as c?lulas foram marcadas com anticorpos espec?ficos para os fatores de transcri??o para an?lise do perfil Th2, Th17, Th1 e Treg por citometria de fluxo. Al?m disto, foi analisado no plasma a IgE espec?fica para um painel de alergenos. Resultados: Os resultados obtidos mostraram que as comparado com os controles. As c?lulas duplo-positivas CD4+GATA-3+ROR?t+ correlacionaram com o grau de severidade da doen?a, exceto com asma severa de dif?cil controle (ADC). Pacientes at?picos apresentaram uma propor??o maior de c?lulas co-expressando mais de um fator de transcri??o comparados com indiv?duos n?o-at?picos. Estimula??o de c?lulas provenientes de pacientes at?picos com a prote?na Derp1 aumenta a frequ?ncia de c?lulas CD4+Foxp3+ROR?t+ quando comparados com o controle e estimula??o com anticorpos anti-CD3 e anti-CD28. Conclus?o: De uma maneira geral, os resultados apresentados nesta tese nos permitem concluir que os al?rgenos desempenham um papel importante no desenvolvimento das c?lulas que expressam mais de um fator de transcri??o em pacientes at?picos. Al?m disso, nosso estudo foi o primeiro a demonstrar que crian?as com ADC apresentam um perfil distinto de express?o de fatores de transcri??o reguladores de c?lulas TCD4 do tipo Th1, Th2, Th17 e Treg quando comparado com crian?as com doen?a menos severa.
387

Desempenho de marcadores de sepse pedi?trica e sua rela??o com a gravidade

Tonial, Cristian Tedesco 31 July 2015 (has links)
Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-09-02T21:43:53Z No. of bitstreams: 1 474473 - Texto Parcial.pdf: 302673 bytes, checksum: 9ceddc2f45fb0380acddb0ec584f59e6 (MD5) / Made available in DSpace on 2015-09-02T21:43:54Z (GMT). No. of bitstreams: 1 474473 - Texto Parcial.pdf: 302673 bytes, checksum: 9ceddc2f45fb0380acddb0ec584f59e6 (MD5) Previous issue date: 2015-07-31 / Introduction : Sepsis is a systemic condition of intense inflammation, caused by an infectious agent that serves as the "trigger" of the entire process. Finding tools that allow the healthcare professional to anticipate or accompany an adverse outcome is important in the setting of the Pediatric Intensive Care Unit (PICU). Because of this, several sepsis markers have been studied. The objective of this study is to evaluate the progress and performance of pediatric sepsis markers and their relation with severity. Methods : A prospective cohort study of patients admitted to the PICU of a university hospital from March to December 2014. We included all patients with suspected sepsis who had between 28 days and 18 years, and were requiring mechanical ventilation for more than 48 hours and cardiovascular support by vasoactive drugs. We collected serum levels of C-reactive protein (CRP), ferritin, leukocyte count, triglycerides (TGC), total cholesterol, LDL cholesterol (LDL), growth hormone (GH) and Insulin-like Growth Factor 1 (IGF-1) on the first day (D0), 24 hours (D1) and 72 hours (D3) after recruitment. The Pediatric Index of Mortality 2 (PIM2) was obtained on the first day of admission in the PICU. Patients underwent transthoracic echocardiography to determine the ejection fraction (EF) and shortening fraction (FENC) of the left ventricle on D1 and D3. The outcome measures were length of hospitalization, PICU stay; duration of mechanical ventilation (MV) and ventilator-free hours; duration of use of inotropic and maximum score of inotropic agents; PIM2 and mortality. A value of p < 0.05 was considered significant. Results : During the study period there were 337 hospitalizations. A total of 20 patients completed the study protocol. In terms of demographic, clinical and laboratory characteristics in recruitment, we noted that only ferritin was higher (mean and standard deviation, 454.4 ? 309.7 versus 91.9 ? 6 ng / ml, p = 0.005) in severe patients (PIM2 ? 6%). Patients with cardiac dysfunction by echocardiography in D1 had higher hospital stay (p = 0.047), PICU stay (p = 0.020), duration of mechanical ventilation (p = 0.011), maximum inotropic score (p = 0.001), PIM2 (p <0.001) and lower ventilator-free hours (p = 0.020). Patients with elevated ferritin levels in D0 had also less ventilator-free hours (p = 0.046), higher maximum inotropic score (p = 0.009) and PIM2 (p <0.001). The PIM2 differentiated the most severely ill patients by less ventilator-free hours (p = 0.012) and higher maximum inotropic score (p = 0.033). The 2 patients who died during the study had cardiac dysfunction by echocardiography, hyperferritinemia and elevated PIM2. Conclusion : Among the analyzed markers, cardiac dysfunction by echocardiogram (ejection fraction <55% and FENC <28%), ferritin (? 300 ng / ml) and (PIM2 ? 6%) had the best performance as markers of severity in pediatric patients with sepsis. / Introdu??o : A sepse ? uma condi??o sist?mica, de intensa inflama??o, desencadeada por um agente infeccioso que serve como o ?gatilho? de todo processo. Achar ferramentas que possibilitem para o profissional da ?rea da sa?de antecipar ou acompanhar uma evolu??o desfavor?vel ? de suma import?ncia no ambiente da Unidade de Terapia Intensiva Pedi?trica (UTIP). Por conta disso, diversos marcadores de sepse t?m sido estudados. O objetivo deste estudo ? avaliar o desempenho de marcadores de sepse pedi?trica e sua rela??o com a gravidade. M?todos : Estudo de coorte prospectivo, de pacientes internados na UTIP de um hospital universit?rio do per?odo de mar?o a dezembro de 2014. Foram inclu?dos todos os pacientes com suspeita de sepse que possu?am entre 28 dias e 18 anos, que estavam necessitando ventila??o mec?nica por mais de 48 horas e suporte cardiovascular atrav?s de drogas vasoativas. Foram coletados n?veis s?ricos de prote?na C reativa (PCR), ferritina, contagem de leuc?citos, triglicer?deos (TGC), colesterol total, colesterol LDL (LDL), Horm?nio de crescimento (GH) e Fator de crescimento semelhante a insulina (Insulin-like Growth Factor 1 ou IGF-1) no primeiro dia (D0), 24 horas (D1) e 72 horas (D3) ap?s o recrutamento. Tamb?m foi calculado o Pediatric Index of Mortality 2 (PIM2) no primeiro dia de interna??o na UTIP. No D1 e no D3 os pacientes foram submetidos a ecocardiograma transtor?cico, para determina??o da Fra??o de Eje??o (FE) e da Fra??o de Encurtamento (FEnc) do ventr?culo esquerdo. Os desfechos avaliados foram tempo de interna??o hospitalar e UTIP; dura??o da ventila??o mec?nica (VM) e horas livres de VM; dura??o do uso de inotr?picos e escore m?ximo de inotr?picos; PIM2 e mortalidade. Foi considerado como significativo um p < 0,05. Resultados : Durante o per?odo de estudo houveram 337 interna??es. Um total de 20 pacientes completaram o protocolo do estudo. Em rela??o ?s caracter?sticas demogr?ficas, cl?nicas e laboratoriais no recrutamento, notamos que apenas a ferritina estava mais elevada (m?dia e desvio padr?o de 454,4 ? 309,7 versus 91,9 ? 6 ng/mL; p=0,005) nos pacientes mais graves (PIM2 ? 6%). Pacientes com disfun??o card?aca pelo ecocardiograma no D1 tiveram maior tempo de interna??o hospitalar (p = 0,047), de UTIP (p = 0,020), VM total (p = 0,011), escore de inotr?pico m?ximo (p = 0,001), PIM2 (p < 0,001) e menor tempo livre de VM (p = 0,020). Pacientes com ferritina elevada no D0 tamb?m tiveram menor tempo livre de ventila??o (p = 0,046), maior escore de inotr?pico m?ximo (p = 0,009) e PIM2 (p < 0,001). O PIM2 tamb?m diferenciou os pacientes mais graves com menor tempo livre de VM (p= 0,012) e maior escore de inotr?pico m?ximo (p = 0,033). Os 2 pacientes que morreram durante o estudo possu?am disfun??o card?aca pelo ecocardiograma, ferritina e PIM2 elevados. Conclus?o : Dentre os marcadores analisados, a disfun??o card?aca pelo ecocardiograma (FE < 55% e FEnc < 28%), a ferritina (? 300 ng/ml) e o (PIM2 ? 6%) obtiveram o melhor desempenho como marcadores de gravidade em pacientes pedi?tricos com sepse.
388

Associa??o entre hipovitaminose D e frequ?ncia de exacerba??es pulmonares em crian?as e adolescentes com fibrose c?stica

Ongaratto, Renata 31 July 2015 (has links)
Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-10-09T20:00:24Z No. of bitstreams: 1 475666 - Texto Parcial.pdf: 421018 bytes, checksum: 08ee6322735a0efb306735f02b198a26 (MD5) / Made available in DSpace on 2015-10-09T20:00:24Z (GMT). No. of bitstreams: 1 475666 - Texto Parcial.pdf: 421018 bytes, checksum: 08ee6322735a0efb306735f02b198a26 (MD5) Previous issue date: 2015-07-31 / Introduction: recent evidence has linked vitamin D to benefits in lung health. Little is known, however, about the impact of vitamin D on clinical outcomes in children with cystic fibrosis (CF). In this study, we evaluated the association between vitamin D levels and nutritional status, pulmonary function (PF) and pulmonary exacerbations in children and adolescents with CF. Methods: 25-hydroxyvitamin D (25[OH]D) levels of 37 children and adolescents were evaluated retrospectively. Pulmonary function data, albumin, body mass index (BMI), height for age (H/A) and pulmonary exacerbations episodes were associated with vitamin D levels divided into two groups: normal (?30ng/ml) and insufficient (<30ng/ml). Results: hypovitaminosis D (25[OH]D <30ng/ml) was observed in 54% of patients. The mean of 25(OH)D was 30,53?12,14ng/ml. Pulmonary function and nutritional status were not associated with vitamin D levels. The number of pulmonary exacerbations over a period of two years (p=0,007) and post-dosing period of 25(OH)D (p=0,002) was significantly higher in patients with hypovitaminosis D. There was a trend of lower 25(OH)D levels during autumn and winter (p=0,067). Conclusion: vitamin D deficiency was associated with higher rates of pulmonary exacerbation in children and adolescents with CF. Vitamin D can be a marker of disease severity or be a significant causal factor for a higher number of pulmonary exacerbations. Prospective studies can help to clarify the causality of this association. / Introdu??o: recentes evid?ncias t?m associado a vitamina D a benef?cios na sa?de pulmonar. Pouco se sabe, entretanto, sobre o impacto da vitamina D em desfechos cl?nicos na popula??o pedi?trica com fibrose c?stica (FC). Neste estudo, avaliamos as associa??es entre os n?veis de vitamina D e o estado nutricional, a fun??o pulmonar (FP) e as exacerba??es pulmonares (EP) em crian?as e adolescentes com FC. M?todos: n?veis de 25-hidroxivitamina D (25[OH]D) de 37 crian?as e adolescentes foram avaliados retrospectivamente. Dados de fun??o pulmonar, albumina, ?ndice de massa corporal (IMC), estatura para idade (E/I) e epis?dios de exacerba??o pulmonar foram associados com n?veis de vitamina D divididos em dois grupos: normal (?30ng/ml) e insuficiente (<30ng/ml). Resultados: a hipovitaminose D (25[OH]D <30ng/ml) foi observada em 54% dos pacientes. A m?dia de 25(OH) D foi 30,53?12,14ng/ml. Fun??o pulmonar e estado nutricional n?o se associaram com os n?veis de vitamina D. O n?mero de exacerba??es pulmonares em um per?odo de dois anos (p=0,007) e no per?odo p?s-dosagem da 25(OH)D (p=0,002) foi significativamente maior em pacientes com hipovitaminose D. Houve uma tend?ncia de menores n?veis de 25(OH)D nos per?odos de outono e inverno (p=0,067). Conclus?o: a hipovitaminose D se associou com maiores taxas de exacerba??o pulmonar em crian?as e adolescentes com FC. A vitamina D pode ser um marcador de gravidade da doen?a ou ainda ser um fator causal relevante para um n?mero mais elevado de exacerba??es pulmonares. Estudos prospectivos podem contribuir para esclarecer a causalidade desta associa??o.
389

Avalia??o de mecanismos relacionados com a diferencia??o de C?lulas T CD8 de mem?ria durante a infec??o pelo v?rus sincicial respirat?rio

Freitas, Deise do Nascimento de 29 July 2015 (has links)
Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-10-28T21:42:44Z No. of bitstreams: 1 475919 - Texto Parcial.pdf: 381957 bytes, checksum: c63b236b74973994f585b6bd7db08855 (MD5) / Made available in DSpace on 2015-10-28T21:42:44Z (GMT). No. of bitstreams: 1 475919 - Texto Parcial.pdf: 381957 bytes, checksum: c63b236b74973994f585b6bd7db08855 (MD5) Previous issue date: 2015-07-29 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction : Respiratory Syncytial Virus (RSV) is a major cause of viral lower respiratory tract infection in children under two years of age. Memory CD8 T cell response to VSR does not provide an efficient and long-lasting immune response, so there are recurrent infections throughout life. The role of mTOR (mammalian target of rapamycin) and the purinergic receptor P2X7 in the memory CD8 T cell response during RSV infection has not been investigated. Objectives : To analize the effect of rapamycin on dendritic cells (DCs) during RSV infection, as well as to evaluate the role of P2X7 purinergic receptor in CD8 memory T cells response during RSV infection. Methodology : Bone marrow derived dendritic cells (BMDCs) differentiated from C57BL/6 P2X7-/- and C57BL/6 mice were infected with VSR virus and used to activate T cells purified from C57BL/6 P2X7-/- and C57BL/6 mice in vitro for 96 hours. In addition, BMDCs differentiated from C57BL/6 mice received 20ng/ml rapamycin during 1h prior infection. The following parameters were evaluated: BMDC cell death by apoptosis, memory cells markers by flow cytometry and RNA viral quantitation was performed by real time PCR. Results : Rapamycin treatment in RSV infected BMDCs decreases the frequency of CD8+CD44high cells and increases the level of viral RNA in DCs, but the rapamycin does not affect the viability of the infected dendritic cells. Furthermore, when BMDCs were treated with rapamycin, an increase of BMDC survival occurred, depending on the contact with the T cells. The absence of purinergic receptor P2X7 in T cells leads to a decrease in the frequency of CD8+CD122+KLRG1-, however the absence of purinergic receptor in infected BMDCs increases the frequency of CD8+CD122+ KLRG1- T cells. Conclusion : Our study suggests that P2X7 receptor is involved in memory CD8 T cell response. In addition our data indicated that mTOR inhibition increases the survival of BMDCs in a mechanism dependent on T-cell contact and also suggests that rapamycin treatment on dendritic cells during VSR infection affect CD8 T cell differentiation. / Introdu??o : O V?rus Sincicial Respirat?rio (VSR) ? um dos principais causadores de infec??o viral do trato respirat?rio inferior em crian?as menores de dois anos de idade. A resposta de c?lulas T CD8 de mem?ria para VSR n?o apresenta uma resposta imune eficiente e duradoura, por isso s?o recorrentes as infec??es durante a vida. At? o momento n?o se tem o conhecimento sobre o envolvimento do mTOR (mammalian target of rapamycin) e do receptor purin?rgico P2X7 na resposta de c?lulas T CD8 de mem?ria durante a infec??o de VSR. Objetivos : Investigar o efeito da rapamicina nas c?lulas dendr?ticas (DCs) durante a infec??o viral, bem como, avaliar o efeito do receptor purin?rgico P2X7 nas c?lulas dendr?ticas (DCs) infectadas com o v?rus VSR na resposta de c?lulas T CD8 de mem?ria. Metodologia : C?lulas dendr?ticas diferenciadas de medula ?ssea (BMDCs) de camundongos C57BL/6 P2X7-/- e C57BL/6 infectadas com VSR foram utilizadas para ativar c?lulas T purificadas de camundongos C57BL/6 P2X7-/- e C57BL/6 durante 96 horas. Al?m disso, um grupo de BMDCs de camundongos C57BL/6 recebeu 20ng/mL de rapamicina durante 1h antes da infec??o. As DCs foram marcadas para investiga??o de morte celular por apoptose, as c?lulas T marcadas para an?lise c?lulas de mem?ria e a quantifica??o do RNA viral foi realizada atrav?s de PCR em tempo real. Resultados : O tratamento com o inibidor de mTOR nas BMDCs infectadas pelo VSR diminuiu a gera??o de c?lulas T CD8+ CD44high e aumentou os n?veis de RNA viral nas DCs, por?m a rapamicina n?o influenciou a viabilidade das c?lulas dendr?ticas infectadas. Quando as BMDCs foram tratadas com rapamicina, houve um aumento de sobreviv?ncia das c?lulas, dependente do contato com as c?lulas T. Na aus?ncia do receptor purin?rgico P2X7 nas c?lulas T, ocorreu uma diminui??o na frequ?ncia das c?lulas T CD8+CD122+KLRG1-, entretanto a aus?ncia do receptor purin?rgico nas BMDCs infectadas aumentou a frequ?ncia destas c?lulas T CD8+CD122+KLRG1-. Conclus?o : Nosso estudo sugere que o receptor P2X7 est? envolvido na resposta de c?lulas T CD8 de mem?ria durante a infec??o pelo VSR. Al?m disso, sugere-se que as c?lulas dendr?ticas tratadas com rapamicina durante a infec??o com VSR prejudica a diferencia??o de c?lulas T CD8.
390

Avalia??o por resson?ncia magn?tica em equipamento de 3,0T do joelho de adolescentes assintom?ticos praticantes de futebol

Matiotti, Simone Berwig 30 March 2015 (has links)
Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-03-09T19:12:16Z No. of bitstreams: 1 DIS_SIMONE_BERWIG_MATIOTTI_PARCIAL.pdf: 452133 bytes, checksum: 47258d5a91f5d356de907f431651ce41 (MD5) / Made available in DSpace on 2016-03-09T19:12:16Z (GMT). No. of bitstreams: 1 DIS_SIMONE_BERWIG_MATIOTTI_PARCIAL.pdf: 452133 bytes, checksum: 47258d5a91f5d356de907f431651ce41 (MD5) Previous issue date: 2015-03-30 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Background: Athletes practicing medium to high impact sports, like soccer, are at a higher risk of developing articular injury, particularly of the knees and diagnosis can be made accurately by MRI. MRI scans performed in the knees of asymptomatic athletes have shown many imaging findings in previous studies. There are no studies performed using 3.0 T MRI to evaluate the knees of adolescent asymptomatic soccer players. Objective: The objective of this cross-sectional study was to evaluate the knees of asymptomatic adolescent soccer players using 3.0T MRI. Subjects and methods: We evaluated 87 knees of asymptomatic male adolescents 14-17 years old. Participants were divided into two groups and paired by age and weight: soccer players (46 knees) and control subjects (41 knees). All the examinations were performed using a 3.0T MRI unit and were evaluated by two experienced radiologists blinded to study groups. Bone marrow signal, articular cartilage, meniscus, tendons, ligaments, fat pad abnormalities and joint fluid were assessed. Results: In the soccer player group, 31 knees (67.4%) had one or more abnormalities, whereas in the control group 20 knees (48.8%) had one or more abnormalities. The prevalence of bone marrow edema was much higher in the soccer player group (19 knees, 41.3%) than in the control group (3 knees, 7.3%), p=0,001. Other abnormalities where found in the soccer player group such as patellar tendinopathy, however not statistically significant with regard to study groups. Small articular effusion, Hoffa?s fat pad edema, patellar cartilage abnormalities and cysts where found in both groups. Conclusion: Asymptomatic subjects, both soccer players and controls were found to have a high prevalence of abnormalities depicted by 3.0T MRI scan, being bone marrow edema much more prevalent in soccer players. Findings at 3.0T MRI scan in this study population where similar to those in previous study using 0.35T MRI. Further studies comparing both equipments in the same population can be performed to give support to these findings / Introdu??o: Atletas que praticam esportes de m?dio a alto impacto, como o futebol, tem maior risco de sofrer les?es articulares, particularmente do joelho, e seu diagn?stico pode ser feito acuradamente pela Resson?ncia Magn?tica (RM). No entanto, muitas altera??es detectadas pela RM em atletas s?o assintom?ticas. At? o momento somente estudos com equipamento de baixo campo foram realizados para avaliar o joelho de adolescentes jogadores de futebol assintom?ticos. Objetivos: O objetivo deste estudo caso-controle foi avaliar os joelhos de adolescentes assintom?ticos jogadores de futebol por RM em equipamento de 3.0T. Participantes e m?todos: Foram avaliados 87 joelhos de adolescentes assintom?ticos do sexo masculino entre 14 e 17 anos de idade. Os participantes foram divididos em dois grupos: jogadores de futebol (46 joelhos) e controles (41 joelhos). Os exames foram realizados utilizando equipamento de RM de 3.0T e foram avaliados por dois radiologistas com experi?ncia em musculoesquel?tico cegados para os grupos. Foi avaliada a presen?a de edema medular ?sseo, derrame articular, altera??es da cartilagem articular, altera??es dos meniscos, altera??es ligamentares, tend?neas e coxins gordurosos. Resultados: No grupo de jogadores de futebol, 31 joelhos (67,4%) tiveram pelo menos uma altera??o, enquanto no grupo controle 20 joelhos (48,8%) tiveram pelo menos uma altera??o. A preval?ncia de edema medular ?sseo foi significativamente maior no grupo de jogadores (19 joelhos, 41,3%) do que no grupo controle (3 joelhos, 7,3%), p=0,001. Outras altera??es foram encontradas no grupo de jogadores como tendinopatia patelar, por?m sem diferen?a estatisticamente significativa entre os dois grupos. M?nimo/pequeno derrame articular, edema da gordura de Hoffa, altera??o da cartilagem da patela e cistos gangli?nicos foram encontrados em ambos os grupos. Conclus?o: Indiv?duos adolescentes assintom?ticos tantos jogadores de futebol como n?o praticantes de esportes apresentam uma alta preval?ncia de altera??es detect?veis ao exame de RM de 3.0T sendo a presen?a de edema medular ?sseo marcadamente maior em atletas jogadores de futebol. Os achados ? RM de 3.0 T nesta popula??o foram superpon?veis ao de estudo pr?vio realizado com RM de 0.35T. Futuros estudos comparando os dois tipos de equipamento na mesma popula??o poderiam comprovar estes achados.

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