Peritoneal dialysis is one of the possibilities of the chronic renal failure treatment. Its advantage is that the patient is treated alone in his home environment. The main indication of this method is the inability to secure vascular access for hemodialysis. Contraindications include damage to the peritoneum and adhesions in the abdominal cavity. The principle of the method is the exchange of solutes between blood and dialysis solution filled into the peritoneal cavity. Timely and proper education by the nurse is the most important precondition for successful treatment with peritoneal dialysis. The thesis is focused on the role of nurses in the education of patients with peritoneal dialysis. It deals mainly with issues of patient education in connection with the occurrence of complications during their treatment. The first section describes the problems of peritoneal dialysis, including technical aspects, complications and their treatment. Furthermore, the attention is focused on the automated peritoneal dialysis, which takes place mostly at night and therefore the patient has more time to care about his normal daily activities. The second section of the theoretical part is devoted to education. The first target of the research was the examination of the effect of educational activities on the occurence of complications. Before starting treatment, patients have always been educated about the issues of this kond of treatment. The informative materials about the treatment and its related complications were also provided. Some of them did look up the information on the internet, and they discussed it further with the nurse. All of the respondents were able to name and describe the symptoms of complications occurring at the beginning and during the therapy. The second goal was to compare awareness among patients with frequent complications compared to those with the least complications. We did not find any benchmark to determine, whether the inconvenience was caused y the degree of unawareness of the patients, or their attitude to the treatment. The discussion will reflect on the question, which errors did subsequently led to the complications. The third objective was to compare the incidence of complications on patients with APD compared to patients on CAPD. With CAPD, the patient opens and closes the transfer set at least 4 times a day, thereby increasing the risk of infection through the peritoneal catheter. The research shows that among respondents undergoing the APD treatment method, the number of complications is lower. It is not possible to determine, whether the numer of complications on APD is lower due to minimal use of the peritoneal catheter, or because some patients on CAPD have already suffered the complications and have been instructed to approach the APD more responsibly. The empirical part of the thesis is presented by a qualitative research. The survey was carried out in the form of non-standardized interview based on prepared questions, which were extended during interviews. The research group consists of ten patients from dialysis clinics in Tabor, Ceske Budejovice and Jindrichuv Hradec. The patients on CAPD and APD were of different ages and with different duration of treatment. Peritoneal dialysis is the elimination method of replacing the kidneys function, and it is performed by the patient himself, in their own social environment. A prerequisite for successful treatment is high-quality patient education, which is mainly provided by the nurse. This introductory education continues with ongoing reeducation. The results of this thesis may be used as the basis for further research. They can also be used as study material for students of nursing fields. Created brochure can help the patients to decide, how to select the treatment method, or mastering the problems of this treatment.

Two murine models of acute inflammation, namely thioglycollate-induced peritonitis and carrageenan-induced paw edema, were optimized using non-steroidal anti-inflammatory drug indomethacin and corticosteroid dexamethasone. During the optimization phase, the presence of neutrophils, monocytes, macrophages, eosinophils, B cells and T cells in the peritoneal cavity at various time points after injection of thioglycollate medium was assessed via multicolor flow cytometry. Moreover, two different thioglycollate media (suppliers BD and Sigma-Aldrich) were compared for their ability to induce an inflammatory response. The optimization of thioglycollate-induced peritonitis and carrageenan-induced paw edema was followed by the evaluation of the anti-inflammatory activity of Ixodes ricinus cystatins G1 and G9 in both mouse models.

Made available in DSpace on 2014-06-11T19:23:46Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-03-01Bitstream added on 2014-06-13T19:30:22Z : No. of bitstreams: 1 nogueira_afs_me_jabo.pdf: 474641 bytes, checksum: fa1d22177f28628ebd508fc2adfc16f4 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A síndrome cólica é uma das urgências mais frequentes na clínica de equinos. Os estágios iniciais da reação inflamatória incluem alterações denominadas resposta de fase aguda. Com o objetivo de avaliar esta resposta realizou-se o perfil eletroforético das proteínas séricas e do líquido peritoneal de equinos submetidos obstrução intestinal experimental. Utilizaram-se 21 equinos, cuja obstrução intestinal foi instituída em segmentos de duodeno - GD (n=6), íleo - GI (n=6) ou cólon dorsal esquerdo - GM (n=6). Além disso, instituiu-se um grupo controle instrumentado - GC (n=3). As colheitas das amostras de sangue e de líquido peritoneal foram realizadas antes (T0), durante as obstruções (T1-T3) e, após as desobstruções (T4-T174). A proteína total foi determinada pelo método do biureto e as frações protéicas obtidas por eletroforese em SDS-PAGE identificaram as proteínas de fase aguda (PFA) IgA, ceruloplasmina, transferrina, albumina, IgG-CP, haptoglobina, alfa-1-glicoproteína ácida, IgG-CL e P24. Houve aumento nas concentrações sérica e peritoneal de todas as PFA nos quatro grupos. Os resultados foram associados à lesão entérica, resultante do modelo de obstrução e à laparotomia. O fracionamento eletroforético das PFA, no líquido peritoneal, foi padronizado de modo a estabelecer a curva padrão para equinos hígidos; ademais, verificou-se que o referido fracionamento protéico mostrou-se mais sensível e eficaz no diagnóstico de processos inflamatórios abdominais e, portanto, deve ser priorizado no monitoramento da evolução do processo de cura abdominal e no diagnóstico de complicações pós-operatórias em equinos com cólica / The colic syndrome is one of the most frequent urgencies in the clinic of horses. The initial stages of the inflammatory reaction include a series of modifications called the acute phase reaction. Aiming to evaluate this kind of reaction the electrophoretic profile of the serum proteins and peritoneal fluid of horses submitted to experimental obstruction of the intestine was performed. Twenty one horses were submitted to intestinal obstruction at the duodenal portion - GD (n=6), ileum GI (n=6) or dorsal left colon GM (n=6). A control group was also instituded - GC (n=3). The blood and peritoneal fluid samples were obtained before (T0), during the obstructions (T1-T3) and after the desobstructions (T4-T174). The total protein was determined by the biuret method and the protein fractions were obtained by electrophoresis in SDS-PAGE wich identified the acute phase proteins (APP) IgA, ceruloplasmin, transferrin, albumin, IgGCP, haptoglobin, alpha-1-acid glycoprotein, IgG-CL and P24. There was an elevation in all acute phase proteins studied in the serum and peritoneal fluid of all four groups observed. The results were associated to hepatic lesion due to the kind of experimental model of obstruction adopted and laparotomy. The electrophoretic fractioning of the APP in the peritoneal fluid was standardized to establish a standard curve to healthy horses. It was also verified that the protein fractioning showed to be more sensitive and efficient in the diagnosis of abdominal inflammatory processes therefore it should be prioritized in the monitoring of the process of abdominal healing evolution and in the diagnose of post-operative intercurrence in horses with colic

Made available in DSpace on 2014-12-17T14:03:38Z (GMT). No. of bitstreams: 1 DayseSA_DISSERT.pdf: 846190 bytes, checksum: eef38ab14de25ca6c9fac44eeac25ae1 (MD5) Previous issue date: 2011-08-05 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / In the last years, heparin has become target of many studies related to inflammation due its ability of biding to proteins involved on immune response. Recently, it was demonstrated, at our laboratory, using a thIoglycollate-induced peritonitis model, heparin s capacity of reduce cellular influx into the peritoneal cavity, 3 hours after the inflammatory stimulus. Once neutrophilic infiltration is highest around 8 hours after the inflammatory stimulus, at the present work, using the same peritonitis model, it was assessed heparin s ability of keeping the interference on leukocyte infiltration, 8 hours after inflammation induction. Moreover, using cellular differential count, it was evaluated how the cellular populations involved in the inflammatory process would be affected by the treatment. Eight hours after the inflammatory stimulus, only heparin dosage of 1 &#956;g/Kg was able to reduce the cellular influx to peritoneum, 62.8% of reduction when compared to positive control (p < 0.001). Furthermore, heparin dosage of 15 &#956;g/Kg presented a pro-inflammatory effect in whole blood verified by the increase of 60.9% (p < 0.001) and 117.8% (p < 0.001) on neutrophils and monocytes proportion, respectively, when compared to positive control. In addition, this dosage also presented a neutrophilic proportion on peritoneal fluid 27.3% higher than positive control (p < 0.05). This duality between anti- and pro-inflammatory effects at different times corroborates studies that attribute a pleiotropic immunomodulator role to heparin. / Nos ?ltimos anos, a heparina vem sendo alvo de v?rios estudos relacionados ? inflama??o, devido sua capacidade de se ligar a diversas prote?nas envolvidas com a resposta imune. Recentemente, em nosso laborat?rio, foi demonstrada, em modelo de peritonite induzida por tioglicolato, a capacidade da heparina em reduzir o influxo celular ? cavidade peritoneal, 3 horas ap?s o est?mulo inflamat?rio. No presente trabalho, utilizando o mesmo modelo, foi avaliada a capacidade da heparina em interferir na infiltra??o leucocit?ria ap?s 8 horas da indu??o da inflama??o, momento em que a infiltra??o neutrof?lica ? m?xima. Utilizando contagem diferencial celular, avaliou-se a influ?ncia da heparina sobre as popula??es celulares envolvidas na inflama??o. Oito horas ap?s o est?mulo inflamat?rio, apenas a dosagem de heparina de 1 &#956;g/Kg, manteve a capacidade de interferir na migra??o leucocit?ria, apresentando 62,8% de diminui??o (p < 0,001) no influxo celular, quando comparada ao controle positivo. Enquanto para a dosagem de heparina de 15 &#956;g/Kg foi observado efeito pr?-inflamat?rio no sangue total verificado pelos aumentos de 60,9% (p < 0,001) e 117,8% (p < 0,001) na propor??o de neutr?filos e mon?citos, respectivamente, em compara??o ao controle positivo. Al?m disso, essa dosagem tamb?m apresentou propor??o neutrof?lica no l?quido peritoneal 27,3% maior que o controle positivo (p < 0,05). Essa dualidade entre efeitos anti- e pr?-inflamat?rio nos diferentes tempos e doses analisados corroboram dados da literatura que atribuem ? heparina um papel como imunomodulador pleiotr?pico.

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Agradecemos a compreensão. on 2017-04-19T13:52:24Z (GMT) / Submitted by GABRIELA DE CARVALHO BEDUSCHI null (gabybeduschi@hotmail.com) on 2017-04-24T15:17:58Z No. of bitstreams: 2 Gabriela de Carvalho Bedusch Doutorado - 04 (2).pdf: 2240121 bytes, checksum: 2771533927d2ef461c5e58be003530e4 (MD5) Gabriela de Carvalho Bedusch Doutorado - 04 (2).pdf: 2456181 bytes, checksum: 233d4c4938431e845e9e0e5cbed51438 (MD5) / Approved for entry into archive by Luiz Galeffi (luizgaleffi@gmail.com) on 2017-04-25T14:52:36Z (GMT) No. of bitstreams: 1 beduschi_gc_dr_bot.pdf: 2456181 bytes, checksum: 233d4c4938431e845e9e0e5cbed51438 (MD5) / Made available in DSpace on 2017-04-25T14:52:36Z (GMT). No. of bitstreams: 1 beduschi_gc_dr_bot.pdf: 2456181 bytes, checksum: 233d4c4938431e845e9e0e5cbed51438 (MD5) Previous issue date: 2017-02-24 / Introdução: A terapia renal substitutiva por diálise peritoneal (DP) na doença renal crônica pode ser realizada manualmente pela DP ambulatorial contínua (CAPD) ou pala utilização de cicladoras automatizadas (APD). O impacto da modalidade de DP nos resultados clínicos, sobrevida do paciente, da técnica de diálise e risco de peritonite não foi avaliado por ensaios clínicos randomizados com alto número de pacientes. Estudos observacionais não mostraram de modo consistente, superioridade de um desses métodos. Objetivos: Comparar os resultados e desfechos clínicos do tratamento por CAPD e APD, em coorte de pacientes incidentes adultos e incluídos no Estudo Multicêntrico Brasileiro de Diálise Peritoneal (BRAZ-PD). Métodos: Estudo nacional de coorte prospectivo multicêntrico no qual foi incluídos pacientes incidentes com pelo menos 90 dias em DP. Os pacientes foram alocados em dois grupos, tratados exclusivamente por CAPD ou APD, utilizando-se o escore de propensão para pareamento dos mesmos, de acordo com as variáveis: idade, etnia, sexo, diabetes mellitus, índice de massa corporal, experiência do centro, biênio de início da DP, doença arterial coronária, doença arterial periférica, hipertensão arterial, presença de neoplasia maligna, tempo de escolaridade, renda familiar, tempo de acompanhamento pré-diálise e hemodiálise prévia. Os desfechos clínicos foram avaliados utilizando o modelo de risco proporcional de Cox e análise para riscos competitivos de Fine e Gray. A evolução dos dados bioquímicos, hemoglobina e pressão arterial foi comparada pelo teste t ou teste de Wilcoxon. Resultados: Após o pareamento, 1445 pacientes incidentes foram incluídos em cada grupo. O risco de morte por todas as causas (SHR1.44 CI95%1.21-1.71) e por causa cardiovascular (SHR1.34 CI95%1.03-1.73) foi maior nos pacientes em CAPD, mas não observamos diferença na sobrevida da técnica e tempo para o primeiro episódio de peritonite. As médias de concentração sérica de potássio e de fósforo foram menores nos pacientes em CAPD na maioria das avalições, não se observando diferenças no controle pressórico e das demais variáveis. Conclusão: Com base em um grande estudo de coorte, randomizado e prospectivo, não foram encontradas diferenças na falência da técnica e tempo para o primeiro episódio de peritonite entre a CAPD e APD. Por outro lado, a APD se associou a maior sobrevida do paciente em comparação com CAPD. Esses achados podem influenciar a escolha da modalidade e estimular uma mais ampla utilização da APD. / Introduction: Renal substitutive therapy by peritoneal dialysis (PD) in chronic kidney disease patients can be performed manually by continuous ambulatory PD (CAPD) or using automated cyclers (APD).The impact of PD modality on patient survival, technique failure and peritonitis rates is not fully understood, and no large-scale randomized clinical trial is available. Observational studies have failed to show superiority of one of PD modalities. Objective: The aim of this study is to compare the clinical results and endpoints between CAPD and APD, in a large nation-wide PD cohort, BRAZ-PD. Methods: This is a prospective cohort study that included all incident PD patients with at least 90 days of PD recruited in the BRAZ-PD study. All patients who were treated exclusively with either CAPD or APD were matched for different covariates (age, diabetes, BMI, center-experience, coronary artery disease, cancer, literacy, hypertension, race, previous hemodialysis, gender, pre-dialysis care, family income, peripheral artery disease and year of starting PD) using a propensity score calculated with the nearest neighbor method. Clinical outcomes analyzed were overall mortality, technique failure and time to first peritonitis. For all analysis we also adjusted the curves for the presence of competing risks with the Fine and Gray analysis. Biochemical data, blood pressure and hemoglobin levels were compared by test or Wilcoxon test. Results: After the matching procedure, 1,445 patients were included in each group. General (SHR1.44 CI95%1.21-1.71) and cardiovascular mortality risk (SHR1.34 CI95%1.03-1.73) were higher in CAPD patients, but no difference was observed for technique failure nor for time till the first peritonitis episode. The mean of serum and phosphorus concentration were lower in CAPD group in the majority of measurements. Conclusion: In the first large PD cohort study with groups balanced for several covariates using propensity score matching, PD modality was not associated with differences in neither time to first peritonitis nor in technique failure. Nevertheless, patient survival was significantly better in APD patients. These findings can influence the PD modality choice and encourage a greater APD utilization.

Made available in DSpace on 2014-12-17T14:10:26Z (GMT). No. of bitstreams: 1 AnaKAS_DISSERT.pdf: 2143361 bytes, checksum: 1112be0ef8c651c4a88c8115ff69d508 (MD5) Previous issue date: 2012-05-17 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Fucans is a name used for sulfated polysaccharides, which is most characteristic structure of the presence of sulfated L-fucose, are found in brown seaweed (Phaeophyceae) and echinoderms (sea urchins and sea cucumbers). These polysaccharides have been reported to possess anticoagulant, antitumor, anti-viral, anti-proliferative and anti-inflammatory activities. Therefore, in the present study was evaluate the effect of the fucan from the brown seaweed Spatoglossum schroederii in models of peritonitis and non-septic shock induced by zymosan, as well as in a murine model of colitis induces by DSS. So, the mice treatment by intravenous route with the fucan was able to reduce the exudate formation and the cell migration in the model of acute peritonitis induced by zymosan during the kinetic of 6, 24 and 48 hours. Similarly, in the model of non-septic shock induced by zymosan the fucan demonstrated a protector effect to inhibited the cellular migration to the peritoneo, to decrease the levels of IL-6 in the serum and in the peritoneal exudate, to attenuate the lose of weight in the mice; beside to reduce the serum levels of hepatic transaminases and as well as the liver injury. In the model of murine colitis, the treatment with the fucan reduced the lose of weight of the animals, decreased the levels of IL-17 and IFN-&#61543; produced in the gut and decrease the intestinal lesion induced by DSS. In conclusion, the fucan used in this study presented a significant protector effect in the murine models of inflammation / Fucana ? uma denomina??o utilizada para polissacar?deos sulfatados, que tem como caracter?stica estrutural mais marcante a presen?a de L-fucose sulfatada, sendo encontrados em algas pardas (Phaeophyceae) e em equinodermos (ouri?os e pepinos do mar). Esses polissacar?deos tem sido descritos por possuir atividade anticoagulante, anti-tumoral, anti-viral, antiproliferativa e anti-inflamat?ria. Portanto, no presente estudo foi avaliado o efeito da fucana da alga parda Spatoglossum schroederii em modelos de peritonite e choque n?o s?ptico induzido por zimosan, bem como em um modelo murino de colite induzida por DSS. Dessa forma, o tratamento de camundongos pela via intravenosa com a fucana foi capaz de reduzir a forma??o do exsudato e a migra??o celular no modelo de peritonite aguda induzida por zimosan durante a cin?tica de 6, 24 e 48 horas. De maneira semelhante, no modelo de choque n?o-s?ptico induzido por zimosan a fucana demonstrou efeito protetor ao inibir a migra??o celular para o perit?nio, diminuir os n?veis de IL-6 s?rico e no exsudato peritoneal, ao atenuar a perda de peso do animais, al?m de reduzir os n?veis s?ricos das transaminases hep?ticas, assim como a les?o no f?gado. No modelo murino de colite, o tratamento com a fucana reduziu a perda de peso dos animais, diminuiu os n?veis de IL-17 e IFN- &#61543;&#61472;produzidos no intestino e diminuiu a les?o intestinal ocasionada pela DSS. Conclui-se ent?o, que a fucana usada nesse estudo apresentou efeito protetor significativo diante dos modelos murinos de inflama??o

Resumo: A síndrome cólica é uma das urgências mais frequentes na clínica de equinos. Os estágios iniciais da reação inflamatória incluem alterações denominadas resposta de fase aguda. Com o objetivo de avaliar esta resposta realizou-se o perfil eletroforético das proteínas séricas e do líquido peritoneal de equinos submetidos obstrução intestinal experimental. Utilizaram-se 21 equinos, cuja obstrução intestinal foi instituída em segmentos de duodeno - GD (n=6), íleo - GI (n=6) ou cólon dorsal esquerdo - GM (n=6). Além disso, instituiu-se um grupo controle instrumentado - GC (n=3). As colheitas das amostras de sangue e de líquido peritoneal foram realizadas antes (T0), durante as obstruções (T1-T3) e, após as desobstruções (T4-T174). A proteína total foi determinada pelo método do biureto e as frações protéicas obtidas por eletroforese em SDS-PAGE identificaram as proteínas de fase aguda (PFA) IgA, ceruloplasmina, transferrina, albumina, IgG-CP, haptoglobina, alfa-1-glicoproteína ácida, IgG-CL e P24. Houve aumento nas concentrações sérica e peritoneal de todas as PFA nos quatro grupos. Os resultados foram associados à lesão entérica, resultante do modelo de obstrução e à laparotomia. O fracionamento eletroforético das PFA, no líquido peritoneal, foi padronizado de modo a estabelecer a curva padrão para equinos hígidos; ademais, verificou-se que o referido fracionamento protéico mostrou-se mais sensível e eficaz no diagnóstico de processos inflamatórios abdominais e, portanto, deve ser priorizado no monitoramento da evolução do processo de cura abdominal e no diagnóstico de complicações pós-operatórias em equinos com cólica / Abstract: The colic syndrome is one of the most frequent urgencies in the clinic of horses. The initial stages of the inflammatory reaction include a series of modifications called the acute phase reaction. Aiming to evaluate this kind of reaction the electrophoretic profile of the serum proteins and peritoneal fluid of horses submitted to experimental obstruction of the intestine was performed. Twenty one horses were submitted to intestinal obstruction at the duodenal portion - GD (n=6), ileum GI (n=6) or dorsal left colon GM (n=6). A control group was also instituded - GC (n=3). The blood and peritoneal fluid samples were obtained before (T0), during the obstructions (T1-T3) and after the desobstructions (T4-T174). The total protein was determined by the biuret method and the protein fractions were obtained by electrophoresis in SDS-PAGE wich identified the acute phase proteins (APP) IgA, ceruloplasmin, transferrin, albumin, IgGCP, haptoglobin, alpha-1-acid glycoprotein, IgG-CL and P24. There was an elevation in all acute phase proteins studied in the serum and peritoneal fluid of all four groups observed. The results were associated to hepatic lesion due to the kind of experimental model of obstruction adopted and laparotomy. The electrophoretic fractioning of the APP in the peritoneal fluid was standardized to establish a standard curve to healthy horses. It was also verified that the protein fractioning showed to be more sensitive and efficient in the diagnosis of abdominal inflammatory processes therefore it should be prioritized in the monitoring of the process of abdominal healing evolution and in the diagnose of post-operative intercurrence in horses with colic / Orientador: Aureo Evangelista Santana / Coorientador: Paula Alessandrta Di Filippo / Banca: José Correa lacerda Neto / Banca: Alessandra Kataoka / Mestre

Submitted by (edna.saturno@ufrpe.br) on 2016-11-04T11:29:39Z No. of bitstreams: 1 Tatiana Marques de Albuquerque.pdf: 421451 bytes, checksum: 704421ac294f7976eefb1da5b1fc6163 (MD5) / Made available in DSpace on 2016-11-04T11:29:39Z (GMT). No. of bitstreams: 1 Tatiana Marques de Albuquerque.pdf: 421451 bytes, checksum: 704421ac294f7976eefb1da5b1fc6163 (MD5) Previous issue date: 2008-04-04 / The Cryptostegya grandiflora R. Br. is a member of the family os Asclepiadaceae has found is Northest Brazil. Its presents the potential of multiporposes, as an example of material-raw to industry and in the pop medicine for its antibacterial potential, stimulant and anti-inflammatory. This paper may suggest an biotecnical applying to latex of C. grandiflora as a substance to manufactor alternative medicines with anti-inflammatory porposes and/or pro-inflammatory to several pathological and fisiological conditions. The objective of this work was to evaluated the mechanism and possible mediators envolvible to the induced inflammatory response by fraction LP the latex of C. grandiflora. The model used have been: peritonitis, paw edema, air pouch e model of cutaneous wounds. Its has been used Swiss mice (38,0 ± 3,0 g) or Wistar Rats (170,0 ± 33,0). Its has been checked that the fraction LP latex induced the migration of neutrophhils to peritoneal cavity so that dose and time dependent in the peritonitis model, paw edema and air pouch. The increasing number of macrophages through pre- treatement of the animals with thiglycolate potencialized the migration of neutrophils induced by fraction LP the latex of C. grandiflora; The depletion of mast cells through the treatment with substance 4880 did not interfere in the migration of neutrophils induced by fraction LP the latex. This way, if supposes the involvement of the macrophages and not mast cells in the induced inflame response by fraction LP the latex. The pro-inflammatory activity in the model of peritonitis has been inhibited through the pre-treatment of the animals with tthalidomide, dexamethasone, indomethacine and celecoxib. The fraction LP latex a applied by endovenous may reduced the migration of neutrophils by carrageenan in rats and increased the presence of inflammatory signals oedema, hyperemia, exudative characteristics and crust in cutaneous wounds of mice and was not capable to stimulate the process of repaiting of these cutaneous injuries. / A Cryptostegia grandiflora R.Br. é um membro da família Asclepiadaceae encontrada no Nordeste do Brasil. Apresenta amplo potencial de utilização, a exemplo de matéria-prima para a indústria e na Medicina popular por sua ação antibacteriana, estimulante e antiinflamatória. Este trabalho pode sugerir uma aplicabilidade biotecnológica para o látex de Cryptostegya grandiflora como substância na construção de medicamentos alternativos com propriedades antiinflamatórias e/ou pró-inflamatórias para várias condições fisiológicas e patológicas. O objetivo desta pesquisa foi estudar o mecanismo e possíveis mediadores químicos envolvidos na resposta inflamatória induzida pela fração LP do látex de Cryptostegia grandiflora. Os modelos experimentais realizados foram: peritonite, edema de pata, bolsa de ar subcutânea e modelo de feridas cutâneas. Foram utilizados camundongos Swiss (38,0 ± 3,0 g) ou Ratos Wistar (170,0 ± 33,0). Verificou-se que a fração LP do látex induziu migração de neutrófilos para a cavidade peritoneal de forma dose-e tempo-dependente no modelo de peritonite, edema de pata e bolsa de ar subcutânea em ratos. O aumento do número de macrófagos através do pré-tratamento dos animais com tioglicolato potencializou a migração de neutrófilos induzida pela fração LP do látex de C. grandiflora; a depleção de mastócitos através do tratamento com o composto 48/80 não interferiu na migração de neutrófilos induzida pela fração LP do látex. Sendo assim supõe-se o envolvimento de macrófagos e não de mastócitos na resposta inflamatória induzida pela fração LP. A atividade pró-inflamatória no modelo de peritonite foi inibida através do prétratamento dos animais com talidomida, dexametasona, indometacina e celecoxib. A fração LP do látex de Cryptostegia grandiflora aplicada por via endovenosa reduziu a migração de neutrófilos induzida por carragenina em ratos e aumentou a presença de sinais inflamatórios- edema, hiperemia, exsudação e crosta em feridas cutâneas de camundongos e não foi capaz de estimular o processo de reparação dessas lesões cutâneas.

Rapid diagnosis of peritonitis remains a significant goal in the management of peritoneal dialysis patients. Several attempts to use leukocytes esterase strips to diagnose peritonitis have been described. This study evaluated the usefulness of Multistix® 10 SG, a urine reagent strip, for diagnosis of peritonitis in peritoneal dialysis patients. Reference standard for peritonitis diagnosis was International Society Peritoneal Dialysis ISPD criteria. A hundred-fifty-two peritoneal effluents were obtained from 96 patients maintained on peritoneal dialysis program, in a single renal replacement therapy center. There were 28 suspected patient specimens and 124 asymptomatic one. White cell count, culture and gram stain were obtained from 28 suspected patient specimens and from 35 asymptomatic one. In 89 asymptomatic patient specimens were obtained only white cell count. Reagent strip was used in all specimens. Prevalence of peritonitis in this sample was 18,41 %. Sensibility, specificity, positive predictive value and negative predictive value of the reagent strip for the diagnosis of peritonitis was 92,86 %, 100 %, 100 % and 98,41 %, respectively. Multistix® 10 SG reagent strip is a sensitive, specific and rapid tool for the diagnosis of peritonitis in peritoneal dialysis patients. Widespread use in peritoneal dialysis would aid in the early recognition and treatment of peritonitis. / O diagnóstico rápido de peritonite continua sendo uma meta importante no manejo de pacientes em diálise peritoneal. Diversas tentativas de utilizar fitas reagentes para esterase leucocitária no diagnóstico de peritonite já foram descritas. Nesse estudo, foi avaliada a utilidade da fita reagente de urina Multistix® 10 SG para o diagnóstico de peritonite em pacientes submetidos a diálise peritoneal. O padrão de referência para o diagnóstico de peritonite considerado foram os critérios diagnósticos da ISPD International Society of Peritoneal Dialysis.Foram estudados 152 efluentes peritoneais obtidos de 96 pacientes mantidos em programa crônico de diálise peritoneal nas modalidades DPAC diálise peritoneal ambulatorial contínua, DPA diálise peritoneal automática e DPI diálise peritoneal intermitente, em um único centro de terapia renal substitutiva. A distribuição das coletas correspondeu a 28 casos sintomáticos e 124 casos assintomáticos. Das 28 coletas de pacientes sintomáticos de peritonite foram analisados citometria, pesquisa direta com coloração de Gram e cultura. Das 124 coletas em pacientes assintomáticos, em 35 coletas foram analisadas citometria, pesquisa direta com coloração de Gram e cultura e em 89 coletas, foram analisadas somente citometria. Em todas as coletas foi realizado o teste com a fita reagente de urina. Segundo os critérios da ISPD, a prevalência de peritonite na amostra foi 18,41 % (28/152). Os resultados de sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo da fita reagente de urina para o diagnóstico de peritonite foram, respectivamente, 92,86 %, 100 %, 100 % e 98,41 %. A fita reagente de urina Multistix® 10 SG é uma ferramenta sensível, específica e rápida para o diagnóstico de peritonite em pacientes em diálise peritoneal. A sua utilização ajudaria no reconhecimento rápido da peritonite e em seu pronto tratamento.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Tendo em vista a prevalÃncia de doenÃas inflamatÃrias reumÃticas tais como a artrite reumatÃide em nosso meio e a necessidade constante de novas terapias alternativas Ãs drogas esterÃides e nÃo esteroidais, que apresentam tantos efeitos nocivos em uso prolongado, decidimos investigar a aÃÃo do lÃtex de Calotropis procera em modelos experimentais de inflamaÃÃo, com foco na artrite. O lÃtex dessa planta da famÃlia Asclepiadaceae, vastamente encontrada no Nordeste brasileiro, tem efeitos sabidamente antiinflamatÃrios em algumas situaÃÃes, notadamente a sua fraÃÃo protÃica majoritÃria, nÃo dialisÃvel (FNDL), menos tÃxica e desprovida de borracha. A fraÃÃo foi obtida a partir de um protocolo estabelecido por nossos colaboradores, que, em suma envolve vÃrias etapas de centrifugaÃÃo e diÃlise atà o produto final liofilizado. Utilizamos ratos Wistar machos com peso entre 230 e 280g e camundongos, Balb/c e Swiss, pesando entre 18 e 35g, em grupos de seis indivÃduos nos quais um controle, outro sham em que foi induzido o evento inflamatÃrio (artrite por Zy - AZy, artrite induzida por antÃgeno - AIA ou peritonite infecciosa - PI) e o experimental no qual foi tratado com FNDL. O grupo AZy foi submetido a teste de incapacitaÃÃo articular pelo modelo de tempo de suspensÃo da pata (TSP) e, apÃs sacrifÃcio, à contagem de cÃlulas total e diferencial no lavado articular, estudo histopatolÃgico da articulaÃÃo, avaliaÃÃo de permeabilidade vascular, dosagem de ADA e TNF-&#945;. Os resultados foram expressos em mÃdia  e.p.m. e comparados em testes estatÃsticos ANOVA/Bonferroni, admitindo-se P<0.05 para significÃncia. A FNDL inibiu o TSP na AZy com efeito mÃximo na dose de 3mg/kg no t = 4h. Houve tambÃm reduÃÃo significativa da permeabilidade vascular, nos nÃveis sÃricos de TNF-&#945; e de ADA, e melhora no quadro histopatolÃgico. TambÃm reduziu o influxo celular sinovial na AZy e AIA, sobretudo de neutrÃfilos. Na PI, inibiu a migraÃÃo celular e os nÃveis de ADA. Dessa forma, os resultados confirmaram o efeito antiinflamatÃrio da FNDL nestes modelos de artrite e peritonite e sugeriram um possÃvel mecanismo de aÃÃo relacionado a um aumento da adenosina, por conta da reduÃÃo dos nÃveis de ADA, ou por inibiÃÃo do TNF-&#945;. Por fim procedemos a avaliaÃÃo da toxicidade da droga em tratamento crÃnico, constatando que a dose de 10mg/Kg apresenta bons efeitos farmacolÃgicos sem alteraÃÃes significativas nos parÃmetros selecionados / The objective of this dissertation was to investigate the effect of the latex from Calotropis procera in experimental models of inflammation, with special focus on arthritis. The plant belongs to Asclepiadaceae family and is largely found in Northeast of Brazil. The plant latex presents clear anti-inflammatory effects, which is kept by its non-dialyzable protein fraction (NDPF), a less toxic and rubber free fraction. NDPF was obtained according to a procedure established by our group, which, in short, involves several steps of centrifugation and dialysis. Male Wistar rats (230 â 280g) and Balb/c and Swiss male mice (18 â 35g) were organized in groups of 6 animals: a control group (no treatment), a sham group, in which only the inflammatory event was induced (arthritis by zymosan â AZy), an antigen-induced arthritis group (AIA), an infectious peritonitis group (IP) and an experimental group, treated with NDPF. The AZy group was submitted to an articular incapacitation test to measure the paw elevation time (PET, in seconds) and, after sacrifice, total and differential cell count in the intra-articular fluid, histopathological study of the articulation, vascular permeabilization, ADA and TNF-&#945; assays. The results were expressed in means + S.E.M. and significative differences were accepted if p<0.05 (ANOVA/Bonferroni). NDPF inhibited PET in AZy with a maximum effect in the dose of 3mg/kg, at 4h after inflammation induction. There was also a significative reduction of vascular permeability, TNF-&#945; and ADA serum levels and an improvement of the histopathological profile. NDPF also reduced the intra-articular influx of cells in AZy and AIA, especially of neutrophils. In IP, NDPF inhibited the cellular migration and the levels of ADA. So, the results confirmed the expected anti-inflammatory effect of NDPF in arthritis and peritonitis models and suggested a possible mechanism of action involving either an increase of adenosine concentration due to the reduction of ADA levels or an inhibition of TNF-&#945; or both events. Finally, the NDPF chronical toxicity was evaluated confirming that the dose of 10mg/Kg presents well defined pharmacological effects without significant alterations on the animal parameters. The characteristics of NDPF open an interesting possibility for alternative therapy to substitute the toxic effects of steroidal and some non-steroidal drugs, used in rheumatoid diseases, so prevalent among our population