Made available in DSpace on 2016-03-22T17:26:40Z (GMT). No. of bitstreams: 1 juliana roth.pdf: 240395 bytes, checksum: 9b92834586cbce747f4f0d4faa4c67e9 (MD5) Previous issue date: 2005-06-30 / Patients with renal chronic disease have an increased incidence of cancer. It is well known that long periods of hemodialysis treatment are linked to DNA damage due to the oxidative stress. This genotoxic effect may cause loss of chromosome fragments, or even entire chromosomes, which form micronucleus (MN) after cell division, and can be detected by the micronucleus test. In the present case-control study we evaluated the genotoxic effect of hemodialysis treatment in 20 patients undergoing hemodialysis (HD), and 20 subjected to peritoneal dialysis (DP), matched for sex and age with 40 controls. Genetic damage was assessed by examining the frequency of micronuclei in 2,000 exfoliated buccal cells per individual. Our results revealed that patients undergoing hemodialysis treatment have a significantly higher frequency of micronucleated cells (5.60±5.31 MNC) compared to control subjects (1.50±2.01 MNC, p<0.01). Interestingly, the same was not observed for the peritoneal dialysis patients, who presented no significant differences in MNC (2.85±2.96) frequency compared to control individuals (3.25±3.85). In addition, we evaluated the possible association between creatine levels, smoking, alcoholic intake, age, time of treatment, incomes of the individuals (separately analyzed according to their gender) and the frequency of micronuclei. The results reported here indicate that the period of treatment is the only factor associated with increased MNC frequency among HD patients (Spearman coefficient 0.414, p=0.01). The number of MN cells found in individuals under six years or less of treatment was significantly lower (2.91±2.74 MN) compared to patients under seven or more years of treatment (8.89±5.96 MN, p<0.05). Overall, peritoneal dialysis may be a safer choice of treatment, but further studies need to be performed to investigate the risks and benefits of both treatments. / n

Made available in DSpace on 2016-04-28T20:40:11Z (GMT). No. of bitstreams: 1 Veronica Alves Borges.pdf: 1013807 bytes, checksum: d2013353a0cab172061e6e306b0530da (MD5) Previous issue date: 2009-11-12 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / The process of becoming the main caregiver of the renal chronic hemodialysis patient was pursued by means of a qualitative investigation, which was made upon the results got from 8 female, adult participants above 19 years old, who were family bounds to the patients and to who were in charge of taking care of them. The main caregiver remains invisible to the public politics, for there are not any programs that cover such audience in Brazil. Private initiatives try to provide the creation of support groups; however, there are not enough groups to cover such a huge demand for them. The data have been collected by means of a semistructured interview containing questions that were shaped according to the validated version of the Burden Interview scale (SCAZUFCA, 2002) and of the Maslach s Burnout Inventory - Human Services Survey (MASLACH & LEITER, 1997), in a Brazilian validated version (CARLOTTO & CÂMARA, 2007). The analysis of those data was made based on the Attachment Theory by John Bowlby, and it shows that there is a great positive impact (such as daily routine, health, social common family living, job, finance), as well as a subjective impact (mental stress) acting upon the life of the caregiver. Besides, the burnout syndrome might be considered as a helpful diagnosis for the set of symptoms reported by the main caregiver of the renal chronic patient. Further studies are necessary in order to increase the knowledge concerning the burnout syndrome on the caregivers of renal chronic patients, for each disease demands proper, individual responses concerning the care-giving / O processo de se tornar cuidador principal do paciente renal crônico em hemodiálise foi estudado por meio de uma investigação de natureza qualitativa, realizada com oito participantes do sexo feminino, acima de 19 anos, com laços biológicos e a principal responsabilidade do cuidado. O cuidador principal ainda é invisível às políticas públicas, pois não há programas que atendam a esse público no Brasil. As iniciativas privadas buscam promover a criação de grupos de apoio; porém, elas são insuficientes para atender à demanda que, no âmbito brasileiro, é muito grande. Os dados foram coletados por meio de entrevista semiestruturada com perguntas elaboradas a partir da versão brasileira validada da escala Burden Interview (SCAZUFCA, 2002) e do Inventário de Burnout de Maslach - Human Services Survey (MASLACH & LEITER, 1997), versão brasileira validada (CARLOTTO & CÂMARA, 2007). A análise dos dados ocorreu a partir da Teoria do Apego de John Bowlby, e indica que há grande impacto objetivo (tais como rotina diária, saúde, convivência familiar e social, profissão, finanças) e subjetivo (estresse mental) na vida do cuidador. Além disso, a síndrome de burnout pode ser considerada como diagnóstico possível para o conjunto dos sintomas encontrados no cuidador principal do paciente renal crônico. Novos estudos são necessários para ampliar o conhecimento sobre burnout nos cuidadores de pacientes crônicos em geral, pois cada doença exige respostas individualizadas do cuidado