Thesis (Ph.D)--Materials Science and Engineering, Georgia Institute of Technology, 2010. / Committee Chair: Barbara Boyan; Committee Member: Andres Garcia; Committee Member: Anthony Norman; Committee Member: Nael McCarty; Committee Member: Zvi Schwartz. Part of the SMARTech Electronic Thesis and Dissertation Collection.

Thesis (Ph. D.)--University of Wisconsin--Madison, 1969. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliography.

Thesis (Ph.D. in Epidemiology) -- University of Colorado, 2006. / Typescript. Includes bibliographical references (leaves 134-160). Free to UCDHSC affiliates. Online version available via ProQuest Digital Dissertations;

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2007. / Title from title screen (site viewed July 10, 2007). PDF text: vii, 130 p. : ill., map. UMI publication number: AAT 3254332. Includes bibliographical references. Also available in microfilm and microfiche formats.

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Orientador: Sérgio Alberto Rupp de Paiva / Coorientador: Lìgia Yukie Sassaki / Banca: Renata Maria Galvão de Campos Cintra / Banca: Erick Parado de Oliveira / Resumo: Introdução: Modificações na massa muscular esquelética e a deficiência de vitamina D têm sido relatadas frequentemente na literatura em pacientes com doenças inflamatórias intestinais (DII). Entretanto, a associação entre vitamina D e alterações musculares na DII são desconhecidas. O objetivo do presente estudo foi verificar se as modificações na massa muscular esquelética são explicadas pelo estado nutricional de vitamina D em pacientes com doenças inflamatórias intestinais. Métodos: Foi conduzido estudo observacional em que foram avaliados 73 pacientes ambulatoriais, com Doença de Crohn e Retocolite Ulcerativa da Faculdade de Medicina de Botucatu, Brasil, que tiveram diagnóstico confirmado da doença por meio dos parâmetros clínicos, endoscópicos e histológicos. A composição corporal total e segmentar foi estimada por absortiometria por raios-X de dupla energia. Para a definição de sarcopenia foram utilizados critérios do European Working Group on Sarcopenia in Older People. Amostras sanguíneas foram coletadas para avaliação das concentrações de hemoglobina, hematócrito, velocidade de hemossedimentação, proteína C-reativa, albumina e 25-hidroxivitamina D sérica (25(OH)D). Para avaliação da capacidade física foi realizado o teste de caminhada de 6 minutos, com base nas diretrizes estabelecidas pela American Thoracic Society (2002). A força isométrica de preensão manual dos indivíduos foi obtida da mão não dominante dos indivíduos por um dinamômetro hidráulico manual. O Questionário Internacional de Atividade Física foi utilizado para avaliar o nível de atividade física. O estado nutricional de vitamina D foi avaliado por meio de recordatório alimentar de 24horas e questionário de exposição solar. Todos os participantes foram questionados quanto ao consumo de bebidas alcoólicas e fumo. Os resultados foram expressos em média ± DP ou mediana e quartil 1 e quartil 3 ou... / Abstract: Background: Changes in skeletal muscle mass and vitamin D deficiency have been frequently reported in the literature in patients with inflammatory bowel disease. However, the association between vitamin D and muscle changes in patients with inflammatory bowel diaseases is unclear. This study aimed to verify if changes in skeletal muscle mass are explained by nutritional status of vitamin D in patients with inflammatory bowel diseases. Methods: This observational study assessed 73 outpatients with Crohn's Disease and Ulcerative Colitis from Botucatu Medical School, Brazil, who have confirmed the diagnosis of their disease trough the clinical, endoscopic and histological parameters. Whole body and regional body composition was obtained by dual-energy X-ray absorptiometry. Criteria of European Working Group on Sarcopenia in Older People were used to define sarcopenia. Peripheral blood samples were obtained for measurements of hemoglobin, hematocrit, erythrocyte sedimentation rate, C-reactive protein, albumin, and serum 25-hydroxyvitamin D (25(OH)D). The 6-minute walk test was performed for evaluation of physical capacity, based on the guidelines established by the American Thoracic Society (2002). Grip strength of the subject's non-dominant hand was assessed with a hydraulic hand dynamometer, which measures isometric grip force. The International Physical Activity Questionnaire was used to evaluate the physical activity. The nutritional status of vitamin D was assessed by 24hour dietary recall and sun exposure questionnaire. All participants were asked about their alcohol intake and smoking. Results were expressed as mean ± SD or median with quartile 1 and quartile 3 ranges or percentage. We used the Fisher exact test for the associations between categorical variables, the Student t-test or Mann-Whitney test for differences between patients with sarcopenia or not and Multiple Logistic Regression. We adopted a significance level of 5% ... / Mestre

OBJETIVO: Avaliar a expressão dos perfis de citocinas Th1, Th2 e Th17 em pacientes com LES e verificar possíveis associações com os níveis séricos de vitamina D. MÉTODOS: Estudo transversal com inclusão de 172 pacientes acompanhados no ambulatório de reumatologia do Hospital de Clínicas de Porto Alegre. Os níveis de vitamina D foram medidos por quimiluminescência. Níveis séricos <20 ng/ml foram considerados como deficiência de vitamina D e níveis ≥20 ng/ml foram considerados normais. As citocinas foram medidas no soro após o descongelamento das amostras em uma única ocasião, usando Kit CBA (cytometric beads array) Th1/Th2/Th17. RESULTADOS: Cento e sessenta e um (94%) pacientes eram mulheres e 128 (74,4%) foram classificados como euro-descendentes. A idade média foi de 40,5±13,8 anos e a idade média no momento do diagnóstico foi de 31,5±13,4 anos. Na entrada do estudo, os pacientes tiveram mediana (intervalo interquartil) de atividade da doença (SLEDAI- systemic lupus erythematosus disease activity index) de 2 (1-4) e cronicidade (SLICC damage index- systemic lupus international collaborating clinics) de 0 (0-1). O nível médio de vitamina D foi de 25,4±11,04 ng/ml. Cinquenta e nove (34,3%) pacientes apresentavam deficiência de vitamina D e 113 (65,7%) tinham níveis considerados normais. Nenhuma associação e correlação estatisticamente significativa foram encontradas. Os níveis de INF-α e SLEDAI mostraram uma correlação positiva fraca (rs=0,22, p=0,04). Análise de regressão linear foi realizada para controlar possíveis fatores de confusão. CONCLUSÃO: A deficiência de vitamina D é prevalente em pacientes com LES, entretanto, não foram encontradas correlações e associações entre níveis de vitamina D e perfil de citocinas. Confirmamos a correlação existente entre o IFN-α e SLEDAI, conforme a literatura. Efeito in vitro de vitamina D no perfil de citocinas não foi reproduzido no presente estudo. Estudos longitudinais podem ajudar a esclarecer a influência da vitamina D na fisiopatogenia do LES. / OBJECTIVES: To evaluate the expression of Th1, Th2 and Th17 cytokine profiles in SLE patients and verify possible associations with serum vitamin D levels. METHODS: Cross-sectional study with 172 SLE patients, followed at the outpatient clinic of rheumatology at Hospital de Clínicas de Porto Alegre were included. The levels of vitamin D were measured by chemiluminescence. Serum levels <20 ng/ml were considered as vitamin D deficiency. Normal vitamin D levels were defined as ≥20ng/ml. Cytokines were measured in serum after thawing the samples on a single occasion, using Kit CBA (cytometric beads array) Th1/Th2/Th17. RESULTS: One hundred sixty one (94%) patients were women and 128 (74.4%) were classified as European derived. The mean age of patients was 40.5±13.8 years and the mean age at diagnosis was 31.5±13.4 years. At the time of study entry, patients had median (IQR) of active disease (SLEDAI- systemic lupus erythematosus disease activity index) of 2 (1-4) and chronicity (SLICC damage index- systemic lupus international collaborating clinics) of 0 (0-1). Mean vitamin D levels were 25.4±11.04 ng/ml. Fifty-nine (34.3%) patients had vitamin D deficiency and 113 (65.7%) had normal levels. No association and statistically significant correlations was found. The levels of INF-α and SLEDAI showed a weak positive correlation (rs=0.22, p=0.04). Linear regression analysis was performed to control for possible confounding factors. CONCLUSION:Vitamin D deficiency is prevalent in patients with SLE, however, no statistically significant correlations and associations between vitamin D levels and cytokine profile were found. We confirm the correlation between IFN-α and SLEDAI, according to the literature. In vitro effect of vitamin D on the cytokine profile was not reproduced in this study. Longitudinal studies may help clarify the influence of vitamin D in the pathogenesis of SLE.

Todo indivíduo nasce com um potencial genético de crescimento, que poderá ou não ser atingido, dependendo das condições de vida a que esteja submetido. Pode-se dizer que o crescimento sofre influência de fatores intrínsecos (genéticos e metabólicos) e extrínsecos (fatores ambientais como a alimentação, a saúde, a higiene, a habitação e o acesso aos serviços de saúde). Entre fatores nutricionais destacam-se as deficiências de vitaminas e oligoelementos que podem associar-se à desnutrição ou depender da absorção insuficiente dos mesmos. Sendo o cálcio um dos principais componentes do tecido mineral ósseo, podemos sugerir que este seja o principal nutriente para a adequada formação óssea e, considerando que a vitamina D desempenha papel importante no metabolismo do cálcio, uma dieta insuficiente nestes nutrientes pode influenciar a formação do esqueleto. Esta revisão da literatura visa enfatizar a importância nutricional do cálcio e vitamina D no processo de crescimento e desenvolvimento, auxiliando profissionais da área da saúde na atualização quanto às recomendações e fontes dietéticas de ambos nutrientes. Assim, em crianças e adolescentes, a baixa ingestão ou baixa absorção de cálcio e vitamina D pode limitar seu desenvolvimento estatural, sendo necessário fornecer quantidades suficientes de ambos na fase critica do crescimento. / Every individual is born with a genetic potential for growth, which may or not be attained, depending on their living conditions. It could be said that growth is influenced by intrinsic (genetic and metabolic) and extrinsic factors (environmental factors such as diet, health, hygiene, housing and access to health services). Outstanding among the nutritional factors are vitamin and oligoelement deficiencies which may be associated with malnutrition or depend on insufficient absorption. Since calcium is the one of main mineral bone tissue component, we suggest that this is the main nutrient for adequate bone formation and, considering that vitamin D plays an important role in calcium metabolism, a diet with an insufficient amount of these nutrients can influence the formation of the skeleton. This review of the literature aims to emphasize the nutritional importance of calcium and vitamin D in the growth and development process, helping health care professionals update the recommendations and dietary sources of both nutrients. Thus, in children and adolescents, the low intake or low absorption of calcium and vitamin D may limit their stature development, and it will be necessary to supply sufficient amounts of both during the critical growth phase.

Resumo: A obesidade é uma doença crônica e de caráter epidemiológico, repercutindo de maneira importante na saúde do indivíduo e na sociedade. Atualmente, a cirurgia bariátrica, em especial a Bypass gástrico em Y de Roux (BGYR), vem se popularizando como uma forma de tratamento dessa condição, garantindo perda do excesso de peso superior às terapias convencionais, com manutenção em longo prazo. Contudo, observa-se que, por se tratar de uma cirurgia com componentes restritivos e disabsortivos, o BGYR, pode levar a redução na absorção e ingestão de nutrientes essenciais a homeostase corporal e em especial, a homeostase óssea. Com isso, podem ocorrer alterações no metabolismo ósseo e, consequentemente na estrutura óssea. Os objetivos do presente estudo foram avaliar o efeito da referida cirurgia sobre a ingestão de nutrientes e parâmetros relacionados à remodelação óssea de pacientes obesas antes e após três e seis meses do procedimento, averiguando se existe associação entre a ingestão alimentar e a evolução destes parâmetros. Neste estudo, prospectivo e observacional, foram estudadas 25 mulheres, submetidas ao procedimento de BGYR, no período de maio de 2009 a maio de 2010, no Hospital das Clínicas da Faculdade de Medicina de Botucatu, Unesp. Para avaliação da ingestão energética e de cálcio, magnésio, fósforo, vitamina D e macronutrientes, foi aplicado um registro alimentar de 72 horas, nos três momentos de avaliação, calculando-se as variáveis por meio do software de nutrição Dietpro 5.i Profissional. Os dados comportamentais foram coletados por meio de um protocolo de avaliação, desenvolvido pela equipe, considerando-se uso de tabaco, álcool e prática de atividade física. Foi realizada avaliação antropométrica, aferindo-se circunferências da cintura, abdominal e quadril, além do peso corporal e seus componentes, analisados pelo método... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Obesity is a chronic disease and an epidemic, resulting in a significant way in the health of the individual and society. Nowadays, bariatric surgery in special gastric bypass Roux-Y (BGYR) has become popular as a treatment, ensuring loss of overweight superior to conventional therapies, with long term maintenance. However, it was observed that, because it is a surgery with disabsorptive and restrictive components, the RYGB may lead to reduced absorption and intake of essential nutrients, necessary for the body homeostasis and, specially, bone homeostasis. Thus, changes in bone metabolism may occur and, consequently, changes in bone structure. The objectives of the present study were to evaluate the effect of the surgery on nutrients intake and on parameters related to bone remodeling in obese patients, before and after three and six months of the procedure, by examining the association between food intake and evolution of these parameters. A prospective and observational study evaluated 25 women who underwent the RYGB procedure, from May 2009 to May 2010, at the Hospital of the Medical School of Botucatu, UNESP. For evaluation of energy, calcium, magnesium, phosphorus, vitamin D and macronutrients consumption, a 3 days food record was carried out before and after surgery, and calculated on DietPro 5.i Professional nutrition software. Behavioral data were collected by an assessment protocol, developed by the team, considering use of tobacco, alcohol and physical activity. Anthropometric assessment was performed by measuring waist circumference, waist, hip and body weight, and components of body weight were analyzed by bioelectrical impedance method. Laboratory tests of bone metabolism were also conducted, such as: calcium (urine and serum), serum magnesium and phosphorus, total alkaline phosphatase and bone specific alkaline phosphate (BSAP), parathyroid hormone (PTH), carboxy-te... (Complete abstract click electronic access below) / Orientador: Gláucia M. F. Mazeto / Coorientador: Adriana Mendes / Coorientador: Celso Vieira Leite / Banca: Célia Regina Nogueira / Banca: José Gilberto Henriques Vieira / Mestre

Background: Colorectal cancer is one of the most frequently diagnosed cancers today. Dlg is a tumor suppressor gene commonly silenced in cancer cells. Many colorectal cancer patients are subject to vitamin D3 deficiency and/ or an altered microbiome. Treatment using vitamin D3 or probiotics shown decreased cellular proliferation, invasiveness and induction of apoptosis. This study aimed to knockdown Dlg and map genetic interactions coupled to Dlg downregulation using a Drosophila model. Vitamin D3 and probiotic treatments were performed to investigate mechanism of action and capacity for Dlg rescue. Result and discussion: After vitamin D3 treatment, PGRP-SB1 (p&lt;0.0001) and Drsl2 (p&lt;0.0003) expression was significantly increased. These genes are part of the immune related Toll pathway suggesting its activation. Dlg and Veli (p=0.0042) upregulation could tentatively be through vitamin D receptor regulation of Wnt-signaling pathway, or direct VDR interaction. Traf6 and MPK2 (p38α) (p=0.0049) expression increased after vitamin D3 treatment suggesting MPK2 activation through Traf6. Pro-apoptotic pathways through Fas or Bax and decreased survival through inhibition of Pi3K/Akt and Ras/Raf pathways are also possible outcomes of MPK2 activation. Probiotic treatment increased PGRP-SB1 (p&lt;0.0001) without enhanced Drsl2 expression, possibly activating the Imd pathway. JNK-induced apoptosis through Erg (p&lt;0.0001) induction was speculated and increased Dlg (p=0.0113) expression was seen after probiotic treatment. Conclusion: Vitamin D3 and probiotic treatments increased Dlg expression. Genes linked to polarity, growth and apoptosis were also enhanced suggesting various mechanisms of action. Further studies concerning knockdown and treatments are needed to fully understand the true mechanisms of action and interactions.