Dissertations/Thesis

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2022
Dissertations
1
  • DANIEL TORRES PEREIRA
  • QUALITY BY DESIGN (QBD) BASED APPROACH FOR DEVELOPMENT OF MICROEMULSION CONTAINING PASSIFLORA SETACEA OIL

  • Advisor : ERYVALDO SOCRATES TABOSA DO EGITO
  • COMMITTEE MEMBERS :
  • ALDO DA CUNHA MEDEIROS
  • ERYVALDO SOCRATES TABOSA DO EGITO
  • HENRIQUE RODRIGUES MARCELINO
  • Data: Apr 13, 2022


  • Show Abstract
  • Microemulsions are nanoscale systems, particularly between 10 and 100 nm, capable of transporting natural oils and improving their organoleptic characteristics. The fixed oil obtained from Passiflora setacea stands out among others for its composition rich in unsaturated fatty acids of the omega family, endowed with therapeutic potential, such as wound healing. Thus, the aim of this work was to use the ideals of QbD for the development of a formulation based on microemulsified systems. Initially, the fixed oil from P. setacea seeds was extracted using the Soxhlet method and had its chemical composition characterized using GC-MS. Then, designs of experiments were used to identify the ideal composition of oil, surfactants, and ratio of surfactants in relation to hydrodynamic droplet diameter, polydispersity index and visual classification. The exploratory linear planning models were not significant, indicating the possible presence of curvature. The Box-Behnken design was satisfactory in predicting the influence of factors and their interactions, the model has r2 of 0.99, 0.91 and 0.97, for hydrodynamic diameter, PDI and visual classification, respectively. Through the response surface and the desirability profile, it was possible to develop an optimized system, followed by its improvement for the topical route. These systems retained their physicochemical stability for 60 days, with a good prognosis to be further investigated for activity and toxicity.

2
  • GALTIERI OTAVIO CUNHA DE MEDEIROS
  • MUSCLE CHARACTERISTICS ASSESSMENT BY COMPUTED TOMOGRAPHY IMAGE: COMPARISON BETWEEN ANATOMICAL LANDMARKS.

  • Advisor : ANA PAULA TRUSSARDI FAYH
  • COMMITTEE MEMBERS :
  • FRANCISCO ABAETE DAS CHAGAS NETO
  • ANA PAULA TRUSSARDI FAYH
  • JOSE BARRETO CAMPELLO CARVALHEIRA
  • Data: Apr 18, 2022


  • Show Abstract
  • Studies evaluating low muscle mass (or sarcopenia) by computed tomography (CT) images often evaluate the third lumbar vertebrae (L3). However, lower limbs appendicular muscles are more involved in balance, physical function, locomotion, and daily activities. This study aimed to compare the assessment of skeletal muscle area (SMA in cm²), skeletal muscle index (SMI in cm²/m²) and skeletal muscle density (SMD in HU) between third lumbar vertebra (L3) and thigh landmarks, and the agreement in diagnosing low muscle mass and low SMD (L3 as the reference method). This was multicenter cross-sectional study including healthy individuals (≥ 18 years old) of both sexes, who had an elective CT exam including abdominal and pelvic regions. CT images were analyzed to evaluate SMA, SMI and SMD. Muscle abnormalities (low SMA, SMI, and SMD) were defined as values below the 5th percentile from a subsample of healthy young individuals (n=111; 18-39 years; 55,9% female). Correlation coefficients, Bland-Altman graphs and receiver operating characteristic (ROC) curves were calculated for the total sample and stratified by sex and age. A total of 268 individuals (44.3 ± 15.2 years) were evaluated (53% female). Significant (p <0.001 for all analysis) and strong correlations between SMA (rho = 0.896), SMI (rho = 0.853), and SMD (rho = 0.864) compared to L3 and thigh landmarks were observed. For the ROC curves, similar AUC values were obtained for males (0.981), females (0.895), younger (0.902) and older adults (0.894). Muscle characteristics between L3 and thigh landmarks have a strong correlation. This suggests that images of the thigh can be used to characterize muscle characteristics. Image acquisition and analysis of thigh region is simpler, with less radiation exposure, and consequently more appropriate for longitudinal analysis.

3
  • THAIS ALVES CUNHA
  • BODY COMPOSITION OF DUCHENNE MUSCULAR DYSTROPHY PATIENTS SUPPLEMENTED WITH ZINC: A CLINICAL TRIAL

  • Advisor : JOSE BRANDAO NETO
  • COMMITTEE MEMBERS :
  • BRUNA ZAVARIZE REIS
  • FATIMA APARECIDA CAROMANO
  • SANCHA HELENA DE LIMA VALE
  • Data: Apr 27, 2022


  • Show Abstract
  • Duchenne muscular dystrophy (DMD) is a neuromuscular disease characterized by progressive muscle weakness. Increased total fat mass and reduced lean body mass are side effects of the disease. The methods of assessing the nutritional status of boys with DMD may be imprecise, and the techniques applied in the general population are inadequate and difficult to interpret due to their altered body composition. Zinc is an essential mineral for lean body mass synthesis. Data on zinc content in adipose tissue in obesity are still limited. Zinc supplementation affects body composition, however, this increase occurs especially in children with pre-existing growth deficits. To date, there are no studies evaluating body composition in boys with DMD before and after zinc supplementation. Therefore, three studies were conducted. Study 1 was descriptive and cross-sectional, evaluating 49 boys through anthropometric parameters and body composition. For Study 2, an integrative review on zinc and body composition was conducted to understand what the literature had on the subject. And Study 3 composed a clinical trial that evaluated dietary, biochemical, and body composition parameters before and after zinc supplementation of boys with DMD. We observed an increase in fat mass and decreased lean body mass as age/disease progressed. In previous studies, zinc and body composition were associated, despite the methodological heterogeneity. Zinc supplementation in our population was not enough to preserve lean mass, and it was possible to observe only maintenance of lean and fat muscle mass in boys with the previous deficiency of serum zinc.

4
  • MARIA LUISA NOBRE MEDEIROS E SILVA GUIMARAES
  • SINUSITIS, NASAL SURGICAL PROCEDURES, COMPUTER-ASSISTED SURGERY, SYSTEMATIC REVIEW.

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • JOSE DINIZ JUNIOR
  • AMALIA CINTHIA MENESES DO REGO
  • Data: Jun 28, 2022


  • Show Abstract
  • Objective: This work aims to compare quality of life and complication of endoscopic sinus surgery (ESS) with and without image guided surgery (IGS) in patients with chronic rhinosinusitis (CRS).

    Data Sources: PubMed, Embase, Scopus, Web of Science, Scielo, Cochrane Central Register of Controlled Trials, LILACS, and Clinicaltrials.gov.

    Review Methods: A search strategy was used to retrieve clinical trials comparing quality of life and complication of ESS with and without IGS from databases. Two independent authors screened and selected the articles by title, abstract and full text to meet eligibility criteria. Data synthesis was being performed using the Review Manager Software V.5.4.1. Preferred Reported Items for Systematic Review and Meta-Analysis was followed. The Grading of Recommendation Assessment, Development, and Evaluation method evaluated the strength of the evidence.

    Results: 3.281 articles were retrieved by the search strategy from the databases. Six studies met the inclusion criteria and five could be combined by meta-analysis. IGS showed improved efficiency in opening diseased paranasal sinuses compared with conventional ESS (RR:0.19; 95% confidence interval [CI], 0.04-0.85; p = 0.03). There is a trend in reduction of complications with IGS, although it did not reach statistical significance.

    Conclusion: IGS is an important tool that helps improve results and increase safety for ESS in patients with CRS.

5
  • ONY ARAÚJO GALDINO
  • THE NEPHROPROTECTIVE ACTION OF PASSIFLORA EDULIS IN STREPTOZOTOCIN-INDUCED DIABETES

  • Advisor : ADRIANA AUGUSTO DE REZENDE
  • COMMITTEE MEMBERS :
  • ADRIANA AUGUSTO DE REZENDE
  • IVANISE MARINA MORETTI REBECCHI
  • JEFFERSON ROMÁRYO DUARTE DA LUZ
  • Data: Jul 28, 2022


  • Show Abstract
  • In the present study, we aimed to evaluate the therapeutic effect of Passiflora edulis fruit peel aqueous (AFA) extract as an adjuvant to insulin to confer nephroprotection against streptozotocin-induced diabetes. Male Wistar rats were divided into four groups based on treatment received for 60 days: diabetic (DB), control (CTL), insulin (INS), and insulin + AFA extract (INS+AFA). mRNA and protein expression levels of podocyte (nephrin, podocin, and WT1) and tubular (megalin) proteins were measured in kidney tissue specimens and urine. Biochemical parameters and kidney histopathology were also examined. Herein, the INS+AFA group showed superior glycemic control, which resulted in the reduction of urinary albumin/creatinine ratio, maintenance of baseline levels of Nphs1, Nphs2, Wt1, and Lrp2 mRNA expression, prevention of protein loss from the kidney tissue into the urinary space, along with the maintenance of glomerular basement membrane thickness, hyalinization, glomerular and tubulointerstitial fibrosis at values approximating those of the CTL group and significantly lower than those in the DB group. Therefore, these results suggest that, as an anti-diabetic agent, the AFA extract adjuvant to insulin could reduce and potentially prevent diabetic kidney disease.

Thesis
1
  • SAMARA KELLY SILVA CHAVES FERNANDES MOURA
  • THERMOSENSITIVE IBUPROFEN-LOADED NANOGEL APPLIED AS ANTI-INFLAMMATORY AGENT IN TOOTH BLEACHING: AN IN VIVO STUDY

  • Advisor : HEBEL CAVALCANTI GALVAO
  • COMMITTEE MEMBERS :
  • ANA RAFAELA LUZ DE AQUINO MARTINS
  • CIRO DANTAS SOARES
  • FABIO ROBERTO DAMETTO
  • HEBEL CAVALCANTI GALVAO
  • JOSÉ LAMARTINE SOARES SOBRINHO
  • Data: Feb 3, 2022


  • Show Abstract
  • The in vivo ability of thermosensitive nanogel containing ibuprofen for bioadhesion on the surface of teeth submitted to bleaching and drug delivery through dentinal tubules to the dental pulp are evaluated in Wistar rats. Drug-loaded self-assembled oil in water nanoemulsions present droplet size < 150 nm and negative zeta potential. Nanoemulsions containing poloxamer 407 in the aqueous phase exhibit reduced droplet size, improved physical stability, controlled the thermosensitive viscosity, and slow drug release. Different treated animals’ groups included a control group (CTRL); bleached animals (BLE) (37.5% H2O2, Pola Office Plus®, SDI); bleached animals treated with a conventional ibuprofen-loaded hydrogel (BLE+IBF-GEL), and bleached animals treated with thermosensitive ibuprofen-loaded nanogel (BLE+IBF-NEG). Compared to the BLE+IBF-GEL group, scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM) images show the superior ability of BLE+IBF-NEG group to offer a physical barrier on the tooth surface, pores occlusion, and transport the fluorescent dye rhodamine B to dental pulp. Morphological analysis revealed the lowest inflammatory infiltrate scores and absence of necrosis for BLE+IBF-NEG group after 24 hours and 14 days. Immunohistochemical studies reinforced this hypothesis. The experimental data presented in this study confirm the incredible potential for topical and easy application of a novel and smart nanogel, as analgesic and anti-inflammatory treatment for bleaching procedure. The multidisciplinary nature of the study enabled its development and improvement of the results obtained.

2
  • ANA LUIZA CABRAL DE SÁ LEITÃO OLIVEIRA
  • MAXIMIZING THE POTENCY OF OXALIPLATIN COATED NANOPARTICLES WITH FOLIC ACID FOR MODULATING TUMOR PROGRESSION IN COLORECTAL CANCER

  • Advisor : RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • COMMITTEE MEMBERS :
  • RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • LUIZ HENRIQUE DA SILVA GASPAROTTO
  • LUIS J. CRUZ
  • LIOE-FEE DE GEUS-OEI
  • RENATA FERREIRA DE CARVALHO LEITÃO
  • Data: Mar 24, 2022


  • Show Abstract
  • One of the challenges of nanotechnology is to improve the efficacy of treatments for diseases, in order to reduce morbidity and mortality rates. Following this line of study, we made a nanoparticle formulation with a small size, uniform surfaces, and a satisfactory encapsulation coefficient as a target for colorectal cancer cells. The results of binding and uptake prove that using the target system with folic acid works: Using this system, cytotoxicity and cell death are increased when compared to using free oxaliplatin. The data show that the system maximized the efficiency of oxaliplatin in modulating tumor progression, increasing apoptosis and decreasing resistance to the drug. Thus, for the first time, our findings suggest that PLGA-PEG-FA increases the antitumor effectiveness of oxaliplatin by functioning as a facilitator of drug delivery in colorectal cancer.

3
  • Cícera Renata Diniz Vieira Silva
  • DIGITAL HEALTH IN PRIMARY HEALTH CARE IN THE TIME OF COVID-19: PERSPECTIVES FOR QUALITY ASSESSMENT AND IMPROVEMENT

  • Advisor : SEVERINA ALICE DA COSTA UCHOA
  • COMMITTEE MEMBERS :
  • SEVERINA ALICE DA COSTA UCHOA
  • JOSE DINIZ JUNIOR
  • RENAN CIPRIANO MOIOLI
  • ALUISIO GOMES DA SILVA JUNIOR
  • LUIZ AUGUSTO FACCHINI
  • Data: Mar 30, 2022


  • Show Abstract
  • The COVID-19 pandemic brought social, economic and health impacts, which required rapid adaptation of health systems not only from a quantitative point of view, but also in terms of quality. In this context, digital health has gained strength in Primary Health Care (PHC) and has significantly highlighted the importance of timely and accurate information as a decision-making instrument for short, medium and long-term needs. This study aimed to highlight the scope of digital health strategies and relevant aspects for their evaluation in PHC, from the COVID-19 pandemic. With the development of a literature review of the scoping review type, and a methodological study with a qualitative approach, we sought to apprehend the state of the art of digital health and its impact on the quality of care in PHC in the world, and to develop a model for its evaluation in Brazil. The scoping review was based on the Joanna Briggs Institute manual, guided by the PRISMA Extension for Scoping Reviews. A systematic and comprehensive, three-step search was performed in June and July 2021 in multidisciplinary health sciences and gray literature databases and eligible data were analyzed using thematic analysis. The methodological study, carried out between June 2021 and March 2022 followed the steps of literature review, model elaboration, model validation and elaboration of the indicator matrix. The review included 44 studies. Six thematic groupings were identified: Characterization and geographical distribution of studies; Nomenclatures of the adopted digital strategies; Types of Information and Communication Technologies; Characteristics of digital strategies in Primary Health Care; Impacts on the quality of care; Benefits, limitations and challenges of digital strategies in Primary Health Care. The results revealed positive and negative impacts of remote strategies on the quality of care in PHC, but above all some inability to take advantage of the potential of technologies, which can demonstrate differences in the organization of the rapid and emergency implementation of digital strategies in the world. The modeling took as assumptions the context, antecedents in digital health, delimitation of the evaluative research and qualifying attributes of PHC. It incorporated into its activities, technical (scope of actions and accuracy), organizational (organization of care and management) and relational (interpersonal) dimensions in the care and management processes of care. Thus, given the importance of digital health in the current global health situation, and the possibility of integrating and advancing this strategy after the pandemic, primary care must strengthen its response capacity, expand the use of information and communication technologies, managing changeable challenges in an adaptive and evidence-based way. It is reinforced that the guidance, planning and execution of actions that gear digital health need to be evaluated in order to reach an understanding of how decisions, actions and investments are contributing to the improvement of access and quality of services and the health of populations.

4
  • EDILANE RODRIGUES DANTAS DE ARAÚJO
  • ANALYSIS OF CHROMATOGRAPHIC PROFILE, MARKER CONTENT, AND EVALUATION OF ANTI-ULCER AND WOUND HEALING ACTIVITIES AND TOXICITY OF THE AQUEOUS EXTRACT OF BRYOPHYLLUM PINNATUM (LAM.) LEAVES PERS. AND KALANCHOE LACINIATA (L.) DC.: POTENTIAL APPLICATION OF INPUT DEVELOPMENT

  • Advisor : SILVANA MARIA ZUCOLOTTO LANGASSNER
  • COMMITTEE MEMBERS :
  • DEBORA ARAUJO ESPOSITO
  • LEANDRO DE SANTIS FERREIRA
  • RAND RANDALL MARTINS
  • REGGIANI VILELA GONCALVES
  • SILVANA MARIA ZUCOLOTTO LANGASSNER
  • Data: May 4, 2022


  • Show Abstract
  • Bryophyllum pinnatum and Kalanchoe laciniata (Crassulaceae), popularly known as “coirama” and “saião”, are used in folk medicine to treat gastric ulcers and in the healing of cutaneous wounds. The present study aims to evaluate the chromatographic profile and the chemical marker content, in vivo anti-ulcer activities (oral route) and in vivo wound healing activities (topical route) of the aqueous extract of its leaves against a model of chronic ulcer induced by acetic acid and an induction model of skin wounds, respectively, as well as to evaluate the acute and subchronic toxicity of B. pinnatum and K. laciniata leaf extracts (freeze dried extract) and the gastroprotective activity of the major flavonoid of B. pinnatum leaf extract, quercetin 3-O-α-L-arabinopyranosyl-(1→2)-O-α-L -rhamnopyranoside against acute gastric lesions induced by ethanol and indomethacin. Regarding the content of total phenols, B. pinnatum and K. laciniata extracts showed, respectively, levels of 80.87 and 72.07 mg (gallic acid/g of dried extract) and total flavonoids of 38.97 and 33 .83 mg (quercetin/g of dried extract). While the gel formulation contains B. pinnatum leaf extract at 5% had a total phenolic content of 2.77 mg (gallic acid/g of dried extract) and total flavonoids of 1.58 mg (quercetin/g of dried extract). Leaf extracts were analyzed by ultrafast liquid chromatography and the major flavonoids were identified. However, only the analytical method for B. pinnatum extract was validated according to national legislation and their major flavonoids quercetin 3-O-α-L-arabinopyranosyl-(1→2)-α-L-rhamnopyranoside (Bp1), kaempferol 3- O-α-L-arabinopyranosyl-(1→2)-α-L-rhamnopyranoside (Bp2) and quercetin-3-O-rhamnopyranoside (Bp3) showed, respectively, a content of 33.12 ± 0.056, 3.98 ± 0.049 and 4.26 ± 0.022 mg per g of dried extract. Both extracts did not show signs of acute or subchronic toxicity and estimated lethal dose was defined as > 2,000 mg/kg, according to the OECD guide. B. pinnatum and K. laciniata extrats (250 and 500 mg/kg) significantly reduced the ulceration index (p < 0.0001 for doses) in chronic gastric ulcer in vivo model. This effect was accompanied by a rebalancing of gastric oxidative stress with increased levels of glutathione and expression of superoxide dismutase (SOD), in addition to reduced levels of malonaldehyde (MDA). Modulation of inflammatory markers was also observed with the reduction of myeloperoxidase (MPO) activity, of interleukin-1β (IL 1-β) and tumor necrosis factor-α (TNF-α) levels, increased interleukin-10 (IL 10), decreased expression of cyclooxygenase-2 and transcription factor NF-kB (p65). Additionally, treatment with K. laciniata extract stimulated healing of gastric tissue with increased expression of vascular endothelial growth factor (VEGF) and stimulated restoration of mucus content observed in the periodic acid schiff staining technique. Pre-treatment with Bp1 (5 mg/kg) reduced gastric lesions induced by ethanol (p < 0.0001) and indomethacin (p < 0.001), increased GSH levels in gastric tissue and decreased MDA levels, reduced MPO activity reduced IL 1-β and TNF-α levels, increased IL 10 levels and presented a cytoprotective effect observed in histopathological analysis. The gel formulations contains the extracts stimulated the healing of cutaneous wounds through a reduction in the wound area accompanied by a decrease in edema and inflammatory infiltrate, a reduction in tissue levels of IL 1-β and TNF-α, stimulation of angiogenesis and an increase in the expression of VEGF These findings may support the development of a new inputs or herbal medicine from B. pinnatum and K. laciniata leaf extrat as gastroprotective or in ulcers treatment and for topical use to stimulate the healing of skin wounds.

5
  • JOSÉ RODOLFO TORRES DE ARAÚJO
  • MOBILITY DURING WALKING AND INCIDENCE ANDA RISK FACTORS FOR MOBILITY DECLINE AMONG INSTITUTIONALIZED OLDER ADULTS: A TWO-YEAR LONGITUDINAL STUDY.

  • Advisor : KENIO COSTA DE LIMA
  • COMMITTEE MEMBERS :
  • ARTHUR DE ALMEIDA MEDEIROS
  • JULIANA MARIA GAZZOLA
  • KENIO COSTA DE LIMA
  • TAMIRES CARNEIRO DE OLIVEIRA MENDES
  • YAN NOGUEIRA LEITE DE FREITAS
  • Data: Jun 3, 2022


  • Show Abstract
  • Objective: To analyze the trajectory of changes in mobility during walking (i.e., maintenance and recovery) of institutionalized older adults and verify the incidence and risk factors for mobility decline.

    Methods: A two-year longitudinal prospective study was conducted with 358 participants aged ≥ 60 years and institutionalized in ten nursing homes in Natal-RN (Brazil). Mobility was assessed using the "walking" item of the Barthel index. Sociodemographic, institution-related, and health-related variables were considered at baseline. Poisson regression was used to build a multiple model.

    Results: The incidence of mobility decline during walking was 10.6% (95% confidence interval [95% CI] = 7.4 to 13.8) after 12 months and 37.7% (95% CI = 18.0 to 26.6) after 24 months. Age ≥ 83 years (relative risk = 1.58; 95% CI = 1.24 to 2.02; p < 0.001) and hospitalization (relative risk = 3.16; 95% CI = 1.55 to 6.45; p = 0.002) were predictors of mobility decline. The rate of mobility maintenance was 31.8% after 12 months (95% CI = 31.8 to 42.9) and 23.2% after 24 months (95% CI = 26.8 to 38.5). Also, the rate of recovery was 2.5% (95% CI = 1.0 to 5.0) and 1% (95% CI = 0.2 to 2.6) after 12 and 24 months, respectively.

    Conclusion: The trajectory of mobility during walking of institutionalized older adults in northeastern Brazil was dynamic (i.e., increasing incidence of mobility decline after 24 months) and associated with advanced age and hospitalization. The chances of recovering walking performance are minimal, and maintenance of independent mobility is challenging.

     

6
  • ALMARIA MARIZ BATISTA
  • QUALITY AND SAFETY OF DRUGS PRESCRIPTIONS IN THE SCOPE OF PRIMARY HEALTH CARE

  • Advisor : DYEGO LEANDRO BEZERRA DE SOUZA
  • COMMITTEE MEMBERS :
  • RUI PEDRO PEREIRA DE ALMEIDA
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • MARENI ROCHA FARIAS
  • SANCHA HELENA DE LIMA VALE
  • Data: Jul 1, 2022


  • Show Abstract
  • Prescribing errors are one of the main patient safety issues in primary care and may be caused by weaknesses in clinical-pharmacological and/or medication prescription writing criteria, but there is a lack of validated instruments to assess the quality of the writing of this prescription. This study aimed to develop and validate an instrument to assess the quality of drug prescription writing in primary care and to evaluate the quality of this prescription using this validated instrument. Initially, a validation study was developed via four steps: 1) Validity analysis of each indicator (relevance, adequacy and criterion); 2) Reliability analysis via intra- and inter-evaluator agreement of each indicator; 3) Analysis of the usefulness of each indicator; 4) Construction and reliability analysis of a weighted composite indicator based on the effectiveness and safety scores of each indicator. Then, a cross-sectional observational study was carried out in a municipality in the Northeast of Brazil in which QualiPresc was applied to a representative sample of prescriptions prepared by physicians from all 24 family health teams in the municipality in January/2021. The compliance of the indicators and their 95% confidence intervals were estimated in aggregate and stratified by dispensing units and prescriber. This included 29 indicators, but only 13 were approved for reliability, reliability, and usefulness. 12 indicators were removed for validity (validity index <90%) and 4 for not being useful in the context of the study. Three composite weighted indicators were tested, but only one was approved for reliability and utility. The validated instrument contains 13 indicators and 1 composite weighted indicator. The mean prescription quality level on a scale of 0-100 was 60.2 (95%CI 57.8-62.6). As for the compliance of prescriptions, the best were administration frequency (98.9%), prescriber identification (98.9%) and pharmaceutical form (85.6%). On the other hand, allergy reporting (0.0%), patient's date of birth (1.7%), non-pharmacological recommendations (1.7%) and directions on the use of the drugs (25%) were the indicators. with a lower prevalence of compliance, contributing with 69% of the non-compliances found. The mean prescription quality level on a scale of 0-100 was 60.2 (95%CI 57.78-62.55). QualiPresc's validity, reliability and usefulness are evidenced for evaluating the quality of drugs prescriptions writing in the context of primary care. The level of quality of the prescriptions evaluated is medium, but priorities were identified that should be considered in future studies and interventions for the quality of prescriptions in primary care.

2021
Dissertations
1
  • SÁVIO FERREIRA CAMARGO
  • MOVEMENT BEHAVIOR DURING PREGNANCY AND ADVERSE MATERNAL-FETAL OUTCOMES IN WOMEN WITH GESTATIONAL DIABETES: A PILOT CASE-CONTROL STUDY

  • Advisor : EDUARDO CALDAS COSTA
  • COMMITTEE MEMBERS :
  • EDUARDO CALDAS COSTA
  • MARIA THEREZA ALBUQUERQUE BARBOSA CABRAL MICUSSI
  • MARLOS RODRIGUES DOMINGUES
  • Data: Feb 3, 2021


  • Show Abstract
  • Gestational diabetes mellitus (GDM) is a major complication in pregnancy. GDM is associated with a higher risk for adverse maternal-fetal outcomes. Associations between movement behavior, including physical activity (PA) and sedentary behavior (SB) with maternal-fetal outcomes are still unclear. The objective of this study was to investigate associations between movement behavior with adverse maternal-fetal outcomes in women with GDM. A total of 68 women with GDM (20-35 weeks; 32.1±5.8 years) were included in this pilot case-control study. The cases were defined by the presence of an adverse composite maternal-fetal outcome (preterm birth, newborn large-for-gestational-age, and neonatal hypoglycemia). Controls were defined as no adverse maternal-fetal outcome. PA intensities and domains, steps/day (pedometer), and SB were analyzed. A total of 35.3% of participants showed adverse maternal-fetal outcomes (n=24). The controls showed a higher moderate-intensity PA level than the cases (7.5, 95%CI 3.6–22.9 vs. 3.1, 95%CI 0.4–10.3 MET-h/wk; p=0.04). The moderate-intensity PA level was associated with lower risk for adverse maternal-fetal outcomes (OR 0.21, 95%CI 0.05–0.91). No significant associations were observed for other PA and SB measures (p > 0.05). In conclusion, moderate-intensity PA during pregnancy seems to have a protective role against adverse maternal-fetal outcomes in women with GDM.

2
  • RAIANE MEDEIROS COSTA
  • INFLUENCE OF THE WORKERS’ FOOD PROGRAM (WFP) ON THE ANTHROPOMETRIC NUTRITIONAL STATUS OF WORKERS IN MANUFACTURING INDUSTRIES.

  • Advisor : ANTONIO MANUEL GOUVEIA DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANTONIO MANUEL GOUVEIA DE OLIVEIRA
  • NILA PATRÍCIA FREIRE PEQUENO
  • FLÁVIA EMÍLIA LEITE DE LIMA FERREIRA
  • Data: Apr 5, 2021


  • Show Abstract
  • The study objective was to compare the weight status and nutrient consumption between workers from companies participant and non-participant in the Workers’ Food Program (WFP) in Brazil. This was an observational, prospective, cross-sectional study, based on a probability sample representative of the population of manufacturing workers in the state of Rio Grande do Norte, in Brazil, obtained by a proportional stratified and two-stage sampling, comparative between WFP and non-WFP participating companies. Measurements were made of weight and height to determine the body mass index (BMI), and of waist circumference (WC), and the 24-hour recall food survey method was used to quantify the consumption of nutrients. The statistical analysis was performed separately in each sex, using the mixed effects multilevel linear and logistic regression models for the between groups comparison of the main study variables. A total of 929 workers (484 from non-WFP and 445 from WFP companies) in 33 companies were evaluated. Compared with non-participants in the WFP, men in the WFP group had a higher BMI (+1.08 kg / m², p <0.001), greater WC (+3.27 cm, p <0.001) and greater prevalence of obesity (OR 1.67, p <0.001). In females, no statistical significant differences were observed in anthropometric parameters, but the WFP Group had a lower prevalence of obesity (OR 0.49, p = 0.05). On the companies’ provided lunch, males have greater consumption of carbohydrates (+39.5 kcal, p=0.02) and protein (+11.1 kcal, p=0.08), while females have lower protein consumption (-14.2kcal, p=0.04). In conclusion, participation in the WFP is associated with increased BMI and WC among male workers but not among females, while, women in the WFP group showed a qualitatively more adequate nutrients consumption when compared to non-WFP, with lower daily consumption of energy (-92.5, p = 0.03), of all macronutrients and of sodium. 

3
  • RODOLFO DANIEL DE ALMEIDA SOARES
  • PREVALENCE EVALUATION OF LEISHMANIA INFANTUM INFECTION IN STEM CELL TRANSPLANTED PATIENTS

  • Advisor : SELMA MARIA BEZERRA JERONIMO
  • COMMITTEE MEMBERS :
  • FERNANDO BARROSO DUARTE
  • ELIANA LUCIA TOMAZ DO NASCIMENTO
  • SELMA MARIA BEZERRA JERONIMO
  • Data: May 24, 2021


  • Show Abstract
  • Hematopoietic stem cell transplantation (HSCT) procedures are increasing in endemic areas for human visceral leishmaniasis (VL) in Brazil and elsewhere. In addition, the number of VL cases is increasing in immunosuppressed individuals and these cases tend to present a higher case-fatality rate. We reviewed the registry of HSCT subjects in a highly VL endemic area in Northeast Brazil and performed a cross sectional study to determine their rate of Leishmania infantum infection. Among the 337 subjects transplanted in the state of Rio Grande do Norte, between 2009 and 2016, there were no prior VL cases associated with the transplant. We studied 73 (21.6%) individuals who were over 2 years after HSCT. Twelve of 73 (16.4%) had positive anti- Leishmania antibodies and 11 of 66 (16.6%) tested positive when using Leishmania qPCR assay. After a median follow up of 16 months, none progressed to VL and they became anti- Leishmania antibody negative. We conclude that transplanted subjects residing in VL endemic areas can frequently become infected with Leishmania. Although none progressed to active disease, it would be wise to follow up those individuals since there is a risk of Leishmania persistence and eventual risk of VL due to the post-transplant management therapy.

4
  • GISLANI ACÁSIA DA SILVA TOSCANO
  • VITAMIN C AND D SUPPLEMENTATION AND THE SEVERITY OF COVID-19: A PROTOCOL FOR SYSTEMATIC REVIEW AND META-ANALYSIS

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • THAIZA TEIXEIRA XAVIER NOBRE
  • FELISMINA ROSA PARREIRA MENDES
  • Data: Jun 28, 2021


  • Show Abstract
  • Context: The COVID-19 pandemic has rapidly spread to other countries, causing numerous deaths and challenges for organizations and health professionals. Diet and nutrition invariably influence the competence of the immune system and determine the risk and severity of infections. Studies have already been published on the relationships through which vitamins C and D can mitigate the severity of infections such as COVID-19. In this context, this protocol describes a systematic review intended to analyze if vitamin C and D supplementation can reduce the severity of Covid-19. Methods: This protocol was developed based on the recommendations of PRISMA-P. In order to accomplish the systematic review, we will carry out searches in the PubMed, Web of Science, Scopus, Cochrane and ScienceDirect databases in the quest for control case studies that analyze the supplementation and evolution of patients with COVID-19. There will be no limitations related to language or publication time. The searches will be carried out by two independent researchers who will select the articles, and then the duplicate studies will be removed, while the suitable ones will be selected using the Rayyan QCRI application. In order to assess the risk of bias, we will use the instrument proposed by the National Heart, Lung and Blood Institute. Moreover, we will carry out meta-analyses and subgroup analyses according to the conditions of the included data. Results: This review will assess the association between vitamin C and D supplementation and the reduction in the severity of COVID-19. Conclusion: The findings of this systematic review will summarize the latest evidence for the association between vitamin C and D supplementation and COVID-19 through a systematic review and meta-analysis.

5
  • EVANILSON FRANCISCO DE MOURA
  • ASSOCIATIONS OF OBJECTIVELY MEASURED MOVEMENT BEHAVIOR AND CARDIORESPIRATORY FITNESS WITH MENTAL HEALTH AND QUALITY OF LIFE IN OLDER ADULTS WITH HYPERTENSION: AN EXPLORATORY ANALYSIS DURING THE COVID-19 PANDEMIC

  • Advisor : EDUARDO BODNARIUC FONTES
  • COMMITTEE MEMBERS :
  • EDUARDO BODNARIUC FONTES
  • GILSON DE VASCONCELOS TORRES
  • ANDREA CAMAZ DESLANDES
  • Data: Aug 13, 2021


  • Show Abstract
  • Herein, we explored the associations of pre-pandemic COVID-19 physical activity (PA), sedentary behavior (SB) and cardiorespiratory fitness (CRF) with mental health and quality of life in older adults with hypertension. Objectively measured PA and SB, perceived stress, depression symptoms, and quality of life were assessed before and during the pandemic in seventeen older adults with hypertension. CRF was assessed before the pandemic by cardiopulmonary exercise testing. Longitudinal and cross-sectional associations were analyzed using the mixed linear model. Pre-pandemic light PA (positive association) and SB (negative association) were associated with quality of life during the pandemic. Higher pre-pandemic CRF was associated with less negative changes in perceived stress, depression symptoms, and quality of life during the pandemic.  Our preliminary findings suggest that a healthier pre-pandemic movement behavior (more PA, less SB) and better CRF can mitigate the negative impact of the COVID-19 pandemic on mental health and quality of life in older adults with hypertension.

6
  • DÉBORA BATISTA
  • TOXICOLOGICAL AND MUTAGENIC EVALUATION OF THE AQUEOUS EXTRACT OF Licania rigida BENTH LEAVES IN ASSOCIATION WITH PROTECTIVE EFFECTS ON OXIDATIVE STRESS.

  • Advisor : MARIA DAS GRACAS ALMEIDA THORNTON
  • COMMITTEE MEMBERS :
  • HERYKA MYRNA MAIA RAMALHO
  • MARCELA ABBOTT GALVAO URURAHY
  • MARIA DAS GRACAS ALMEIDA THORNTON
  • Data: Oct 25, 2021


  • Show Abstract
  • Medicinal plants present bioactive substances that help in the treatment of the most diverse diseases and their use for therapeutic purposes is as old as human civilization. In Brazil, the use of medicinal plants for primary health care is widespread due to its large plant biodiversity, low cost, easy access, and wide popular knowledge about their use. However, it is worth noting that most species used in traditional medicine do not present scientific studies proving their efficacy, safety, chemical composition, or possible toxicity. In this context, the species Licania rigida Benth belonging to the Chrysobalanaceae family is a plant species found in the semiarid northeastern Brazil, being used in folk medicine for the treatment of inflammatory processes and diabetes. However, despite its use, there are few studies to validate its pharmacological and toxicological potential. As a result, the objective of this study was to evaluate the toxicological properties of the aqueous extract of Licania rigida through standardized methods of acute and subchronic oral toxicity, mutagenicity and cytotoxicity, as well as its possible protective effect against oxidative stress. The extract did not show any toxic or genotoxic effect in the in vivo and in vitro assays after exposure to different concentrations. Regarding the antioxidant effect, the extract exhibited a possible protective effect by decreasing the level of malondialdehyde (MDA) in the treated animals; no considerable change was observed for the levels of reduced glutathione (GSH), superoxide dismutase (SOD) and glutathione peroxidase (GPX). Therefore, it is proposed that Licania rigida leaf extract may become a future herbal medicine, however, further studies are needed to validate its pharmacological application and for the development of new herbal formulations. 

7
  • AURÉLIO DE OLIVEIRA BENTO
  • THE SPREAD OF CAT-TRANSMITTED SPOROTRICHOSIS DUE TO SPOROTHRIX BRASILIENSIS IN BRAZIL TOWARDS THE NORTHEAST REGION

  • Advisor : GUILHERME MARANHAO CHAVES
  • COMMITTEE MEMBERS :
  • OLIANE MARIA CORREIA MAGALHAES
  • GUILHERME MARANHAO CHAVES
  • PAULA RENATA LIMA MACHADO
  • Data: Oct 26, 2021


  • Show Abstract
  • Sporotrichosis is a worldwide subcutaneous mycosis caused by Sporothrix spp. In the past, this infection was associated with armadillo hunting, horticulturists, miners, and gardeners, being considered an implantation mycosis acquired by plant debris injury. Nevertheless, since the late nineties, it has been considered a zoonotic disease in Brazil. Here we report a case series of 121 patients with cat-transmitted sporotrichosis seen in Northeast Brazil. Patient’s demographic, clinical data, and length of treatment were recorded. In addition, a mycological examination and further PCR confirmation of species identification were performed. One hundred and twenty two patients were diagnosed with subcutaneous sporotrichosis from October 2016 to December 2019, while PCR revealed that 71 of them were due to S. brasiliensis. The majority of the individuals were female (n = 86; 70.5%). Patient’s age ranged from 5 to 87 years old. The clinical forms found were lymphocutaneous (58.2%) and fixed cutaneous (39.4%). Interestingly, 115 patients reported previous contact with cats diagnosed with sporotrichosis. Patients were successfully treated with itraconazole and potassium iodide. Our study adds important contributions for the investigation of the spread of cat-transmitted subcutaneous sporotrichosis in Brazil, specifically towards the Northeast region of a continental-size country. It will also help clinicians to be aware of the existence and importance to accurately diagnose sporotrichosis and treat patients with this infectious disease in the lowest income region of Brazil.

8
  • FABIA JULLIANA JORGE DE SOUZA
  • HYDROGEL-BASED OPHTHALMIC CONTACT LENSES CONTAINING AMPHOTERICIN B: STATISTICAL OPTIMIZATION AND PHYSICO-CHEMICAL CHARACTERIZATION

  • Advisor : ERYVALDO SOCRATES TABOSA DO EGITO
  • COMMITTEE MEMBERS :
  • ERYVALDO SOCRATES TABOSA DO EGITO
  • ROSANGELA DE CARVALHO BALABAN
  • THAIS NOGUEIRA BARRADAS
  • Data: Oct 28, 2021


  • Show Abstract
  • Cornea Fungal infections are among the main causes of blindness in the world. The drawbacks displayed by formulations used to treat these diseases are contributing factors for the establishment of this worriesome scenario. Among such biopharmaceutical limitations, one could mention the low absorption and retention of the drug in the target tissue, which results in a poor local bioavailability and, by consequence, therapeutic failure. Therefore, the aim of this work was to develop hydrogels based on poly (vinyl alcohol) (PVA) containing amphotericin B (AmB) to be used as therapeutic contact lenses. For this purpose, a central composite design (CCD) was used, wherein the influence of the sodium hydroxide concentration ([NaOH]), temperature (Cº) and STMP concentration were assessed regarding the degree of swelling response (GI %) and encapsulation efficiency (EE %). In addition, mathematical models were developed to predict the behavior of the response variables, as well as to determine the necessary formulation parameters to obtain a system with desirable characteristics to the ocular route. The chosen formulation was characterized in terms of swelling kinetics, Fourier transform infrared spectroscopy (FTIR), differential scanning calorimetry (DSC) and transmittance. Hydrogels with GI % between 125 to 181 and EE % between 39 to 72 were obtained. Additionally, it was possible to determine that only [NaOH] demonstrated a significant effect on the response variables. Accordingly, an appropriate model predictive for GI % and EE % was obtained. Additionally, the characterization results showed that the crosslinking reaction was effective. This was inferred by the absence of the characteristic peaks of the phosphate ring from STMP in the FTIR spectra. FTIR and DCS analyses demonstrated that AmB is probably located between the polymeric networks of the hydrogel. Therefore, it was possible to infer that the developed contact lenses are potential candidates to become a new therapeutic alternative for the delivery and drug release modulation directly in the cornea. These results suggest that this formulation could display an increase in therapeutic effectiveness and possible compliance compared to traditional ocular formulations. 

Thesis
1
  • CARLA GLENDA SOUZA DA SILVA
  • ADHERENCE TO TREATMENT FOR PEOPLE LIVING WITH VIH/AIDS

  • Advisor : JOAO CARLOS ALCHIERI
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • HELOISA KARMELINA CARVALHO DE SOUSA
  • JOAO CARLOS ALCHIERI
  • MARISE REIS DE FREITAS
  • MÔNICA CRISTINA BATISTA DE MELO
  • Data: Feb 8, 2021


  • Show Abstract
  • Adverse events related to the use of antiretrovirals have undergone significant changes with advances in clinical research. It is believed that the side effects of ARVs, together with the pathogenesis of the virus itself and lifestyle can have a significant negative impact on treatment adherence. We sought to identify the psychosocial processes competing for adherence to treatment for HIV / AIDS. This was an exploratory observational study with assessment of adherence to treatment in PLWHA. Participants were men (53%) and women (47%), with an average age of 44.7 years, an average body weight of 66.4 kg and an average income of 1.2 minimum wages. In the first stage of the study, they were divided into groups regarding the time of ART use: Group 1 less than 1 year of treatment (9.4%), Group 2 less than 5 years of treatment (32.1%), and Group 3 more than 5 years of treatment (58.5%). When applying CEAT-HIV, it was observed that 84.9% were promising in their treatments regarding adherence and the Self-Efficacy Expectation instrument corroborated the results found. In the results of the ANOVA test and the “t” test, performed to verify differences between the means of adherence to the expectation of self-efficacy according to the items of the CEAT-HIV instrument of patients with HIV, at the significance level of 5%, it was observed that there is a difference between the averages of the assessment items. In the second stage, where interviews were conducted aimed at applying the intervention using the Theory of Planned Action (TAP), 64% of the sample made themselves available to participate in the group intervention and 36% opted for individual assistance. At the end of this stage, only 7 (13.2%) patients attended individual interviews, the groups did not occur, the sample loss was around 86.8%. However, there was a positive relationship between the levels of adherence and the Expectation of Self-efficacy, as it seeks strategies for the patient to develop personal skills and abilities to control the circumstances that may hinder the regular follow-up of drug treatment for the patient. HIV, the central mechanism of actions taken intentionally.

2
  • JANINY LIMA E SILVA
  • ASSESSMENT OF PSYCHOMETRIC PROPERTIES OF BRAZILIAN VERSION OF PRENATAL SELF-EVALUATION QUESTIONNAIRE (PSEQ)

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • MARIA DA CONCEICAO DE MESQUITA CORNETTA
  • MARIA THEREZA ALBUQUERQUE BARBOSA CABRAL MICUSSI
  • DIEGO DE SOUSA DANTAS
  • JOSÉ ELEUTÉRIO JÚNIOR
  • Data: Mar 19, 2021


  • Show Abstract
  • Psychosocial well-being deviates from the inherent vulnerability of the gestational period and is depicted by the control of risks that can affect maternal and child health, as aspects that are independent of the woman’s choice. Thus, it is essential to monitor and evaluate the various factors related to gestational development, including maternal psychosocial adaptation. Taking into account that the Prenatal Self-Evaluation Questionnaire (PSEQ) is recognized as a complete instrument for the evaluation of maternal psychosocial adaptation, concerning dimensions such as the Well-being of self and baby (WSB); Acceptance of pregnancy (AP); Identification with a motherhood role (IMR); Preparation for labor (PL); Control in labor (CL); Relationship with mother (RM) and Relationship with partner (RP), this study intends to analyze the psychometric properties of this instrument with pregnant women in Brazil. The protocol was applied with 409 adult and teenage pregnant women, of public health services in Rio Grande do Norte state, under obstetric care of low and high risk. The final sample of the study was of 400 volunteers. The Cronbach’s α score for the overall score was 0.89. The construct validity analysis showed positive and significant correlations between all PSEQ domains ranging from 0.14 to 0.56. The correlation between the domains and the general score was as follows: WSB (r=0.64), AP (r=0.60), IMR (r=0.57), PL (r=0.55), CL (r=0.73), RM (r=0.62), RP (r=0.62), with all correlations being significant at p<0.01. Discriminant validity analysis showed that older age, higher education, employment, and planned pregnancy were associated with high psychosocial adaptation to pregnancy. PSEQ addresses the main factors related to maternal psychosocial adaptation during pregnancy and can be considered as a useful and reliable assessment tool for use in Brazil in professional practice in all areas of obstetrical practice.

     

3
  • ALEXANDRE MEDEIROS DE FIGUEIREDO
  • MEDICAL SCHOOL EXPANSION POLICIES: EDUCATIONAL ACCESS AND PHYSICIAN DISTRIBUTION

  • Advisor : GEORGE DANTAS DE AZEVEDO
  • COMMITTEE MEMBERS :
  • GEORGE DANTAS DE AZEVEDO
  • JANETE LIMA DE CASTRO
  • ADRIANO MASSUDA
  • HENRY DE HOLANDA CAMPOS
  • NAOMAR MONTEIRO DE ALMEIDA FILHO
  • Data: Mar 29, 2021


  • Show Abstract
  • INTRODUCTION Many countries are employing strategies intended to reduce maldistribution of health workers and inequities. The purpose of this study was to analyse the impact of expansion policies of medical schools on regional inequalities in the distribution of undergraduate class sizes, and the capacity to attract and retain doctors and to expand health facilities.

    METHODS We conducted a descriptive analysis to compare the distribution of undergraduate places in 2007 and 2016 to determine the impact of targeted expansion policies on inequalities in access to medical education in Brazil. A group of municipalities with new medical schools (n = 54) and a control group without medical schools   (n = 408) were  compared to analyse impacts of expansion in the health sector. We compared the increase in the number of physicians per 1000 inhabitants and health establishments per inhabitants between 2007 and 2016 based on these two groups. We also analysed the relationship between geographic distance from the state capital and capacity to attract physicians.

    RESULTS There was a decrease in the regional inequalities of undergraduate places in medical schools; the greatest increase in the places per 1000 inhabitants was in municipalities of between 50 000 and 100 000 inhabitants. Municipalities with new medical schools showed an increase in physicians per 1000 inhabitants and in health establishments per inhabitant ratio, demonstrating the potential to attract and retain doctors, as well as strengthening the health infrastructure. Municipalities more distant from state capitals showed a greater increase in physician : inhabitant ratio.

    DISCUSSION Countries with health workforce shortages and inequalities in their distribution might consider public financing and regulation policies for expansion of medical schools as a strategy to attract and retain professionals. Early results in Brazil showed that such strategies could strengthen service networks in deprived areas, supporting implementation of Universal Healthcare Coverage.

4
  • RAFAELA CATHERINE DA SILVA CUNHA DE MEDEIROS
  • PHYSICAL FITNESS, POSTURAL CONTROL AND PHYSICAL ACTIVITY LEVEL OF CHILDREN AND ADOLESCENTS WITH HIV

  • Advisor : PAULO MOREIRA SILVA DANTAS
  • COMMITTEE MEMBERS :
  • PAULO MOREIRA SILVA DANTAS
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • GRASIELA PIUVEZAM
  • JOSÉ ÂNGELO BARELA
  • RONALDO VAGNER THOMATIELI DOS SANTOS
  • Data: Apr 30, 2021


  • Show Abstract
  • Introduction: The negative changes that affect children and adolescents living with HIV and using ART can influence the performance of postural control and physical fitness related to the health of this population. Objective: to assess and monitor over time the physical fitness, postural control and level of physical activity of children and adolescents with HIV, while comparing with uninfected peers. Methods: This is a mixed method study in two phases. In the observational cross-sectional study (first phase); 32 children and adolescents participated; 18 in the HIV + group and 14 with negative serology; and in the second phase, a prospective (longitudinal) cohort study took place with three analyzes (1st, 2nd and 3rd) where the initial sample was 18 children and adolescents with HIV, but sample loss resulted in 10 participants. Children and adolescents of both sexes were included in medical follow-up, and those with negative responses to the Physical Activity Readiness Questionnaire were excluded. The following were applied: structured anamnesis containing sociodemographic and clinical data; questionnaire on level of habitual physical activity; body composition was assessed by anthropometry and DXA; biological maturation by mathematical equations and Tanner's scale; postural control, using a force platform, where a bipedal erect posture was maintained with the following conditions: with vision; without vision and with vision and on foam; flexibility using Wells Bench; strength by handgrip test with a dynamometer; and cardiorespiratory capacity on a treadmill with ramp test. Results: in phase 1, comparing the physical fitness of HIV + children and adolescents with HIV- it was identified that only the ventilatory threshold 1 showed a significant difference, indicating that the HIV + group has lower values in cardiorespiratory fitness when compared to their peers; also, when the postural control of both groups (HIV + and HIV-) was compared, in the time domain variables, higher values were observed for the HIV + group in the mean anterior-posterior (p = 0.001) and medium-lateral speed (p = 0.001), as well as in the anteroposterior (p = 0.001) and medium-lateral perimeter (p = 0.001). For the condition factor, a difference was observed for mean amplitude of anteroposterior oscillation (0.039); and when the spectral domain was analyzed, for the group factor, higher values were observed in the HIV + group in the predominant mid-lateral frequency (p = 0.04) and mean anteroposterior frequency (p = 0.001). For the condition factor, a difference was found only in the predominant anteroposterior frequency (p = 0.001); the highest values were in the condition without vision, when compared to the condition with foam. In phase 2, during the long-term follow-up of the HIV + group, it was found that the level of physical activity was maintained over time. The postural control underwent positive changes in the condition without vision, where differences were found between the 1st analysis in relation to the 2nd and 3rd in the mean mediate-lateral (p = 0.01), anteroposterior-posterior (p = 0.04) and mean speed -lateral (p = 0.00); this was also found in the 2nd and 3rd analyzes, and from the moment of the 2nd analysis in relation to the 3rd. In the foam condition, there was a difference in the area (p = 0.02) and medium-lateral perimeter (p = 0.03), both from the moment of the 1st analysis in relation to the 2nd and 3rd. Between the 2nd and 3rd analyzes, there was a difference only in the variable medium-lateral perimeter (p = 0.03). There was also a difference in the optimal cardiorespiratory point in the period of the 1st analysis in relation to the 2nd and 3rd analyzes (p = 0.01). Conclusion: It is concluded that parameters of growth and development, especially body mass and Body Mass Index, influence physical fitness, indicating impairments in the cardiorespiratory fitness of children and adolescents with HIV; and that the postural control performance of the HIV group is inferior to their peers without infection. However, the maintenance of the level of physical activity has a positive influence over time on parameters of postural control and cardiorespiratory optimum point of children and adolescents with HIV infection.

5
  • ISIS KELLY DOS SANTOS
  • EFFECT OF HIGH INTERVAL INTENSITY TRAINING AND DESTRAINING ON MENTAL HEALTH OF WOMEN WITH POLYCYSTIC OVARY SYNDROME: RANDOMIZED CLINICAL TRIALS

  • Advisor : PAULO MOREIRA SILVA DANTAS
  • COMMITTEE MEMBERS :
  • PAULO MOREIRA SILVA DANTAS
  • TECIA MARIA DE OLIVEIRA MARANHAO
  • BRENO GUILHERME DE ARAUJO TINOCO CABRAL
  • MARIA THEREZA ALBUQUERQUE BARBOSA CABRAL MICUSSI
  • MARIA IRANY KNACKFUSS
  • RODRIGO GOMES DE SOUZA VALE
  • Data: Jul 23, 2021


  • Show Abstract
  • Introduction: Differents training protocols with exercises have been carried out with women with Polycystic Ovary Syndrome (PCOS), in different contexts and applicability, showing positive results on the clinical and metabolic alterations related to PCOS. However, there are some gaps in the psychological and clinical responses derived from high-intensity interval training (TIAI). Objective: To investigate the effects of High Intensity Interval Training (TIAI) and detraining on the quality of life and mental health of women with Polycystic Ovary Syndrome (PCOS), and to describe the psychophysiological responses (i.e, subjetive perception of effort and response affective) of this population throughout the TIAI sessions. Methods: This study was conducted in two stages: in the first, it was characterized as a cross-sectional and descriptive study, in which 12 women with PCOS participated (mean age 26.2 ± 4.1); and the second included a pilot randomized clinical trial with 23 women with PCOS (mean age 26.0 ± 3.92) who were allocated to a control group (n = 11) and a supervised TIAI group (n = 12). Women with PCOS were included; no use of medications for at least 3 months; without exercising in the past six months or sedentary. Exclusion criteria were: pregnant women; cardiovascular diseases; positive response on PAR-Q; and any other contraindication for the practice of physical activity. Anamnesis, physical activity level questionnaires (IPAQ), health-related quality of life (SF-36), depression, anxiety and stress scale (DASS-21), perceived exertion assessment (PSE, Borg CR scale) were applied. -10) and affective responses (FS, feeling scale), body composition (DXA), anthropometry and metabolic profile analysis. The interventions consisted of 10 50-min TIAI running sessions [intervals of 10 x 1 min at 90% of maximum heart rate (HRmax) interspersed with 3 min of active recovery periods at 70% of HRmax], including 5 minutes of warm-up and cool down at 48 hour intervals (first step). In the second stage, the TIAI intervention lasted 12 weeks and 4 weeks of detraining (30 days). Results: Participants were classified as overweight, had a high percentage of body fat and irregular menstrual cycles (amenorrhea). The TIAI group showed improvements in the domains of functional capacity (P = 0.022; ES = 1.7), physical aspects (P = 0.027; ES = 1.7), general status (P = 0.021; ES = 3.1), anxiety (P = 0.025; ES = 1.0,) and depression (P = 0.031; ES = 1.7) (pre-post). We observed that improvements were not maintained after the 30-day detraining period in the quality of life domains. Conclusion: The TIAI program promoted an improvement in the quality of life and mental health in women with PCOS; additionally, it was observed that after 4 weeks of detraining there was a reduction in quality of life, however, the mental health domains (anxiety and depression) presented stability in the TIAI group, differents from the control group.

6
  • MARINA SAMPAIO DE MENEZES CRUZ
  • ANALYSIS OF GENE EXPRESSION IN VENTRICULAR DYSFUNCTION AFTER ACUTE MYOCARDIAL INFARCTION

  • Advisor : ANDRE DUCATI LUCHESSI
  • COMMITTEE MEMBERS :
  • ANDRE DUCATI LUCHESSI
  • KARINE CAVALCANTI MAURICIO DE SENA EVANGELISTA
  • MARCELA ABBOTT GALVAO URURAHY
  • LUCIANA SACILOTTO FERNANDES
  • JOAO FELIPE BEZERRA
  • Data: Aug 4, 2021


  • Show Abstract
  • Heart failure (HF) is a progressive syndrome characterized by the heart's inability to pump enough blood to other tissues, and its main cause is acute myocardial infarction (AMI). Despite advances in identifying markers associated with left ventricular (LV) remodeling, the ideal marker for early and accurate detection of ischemic HF has not yet been found. Therefore, this study aims to evaluate the expression of 13 genes previously associated with AMI in patients with ischemic HF, comparing them with those who had no complications after AMI. In addition, this study sought to summarize the miRNAs most frequently cited in the literature as they are related to the development of ischemic HF and to verify their influence on the expression of the 13 genes. Patients who suffered previous AMI were classified into two groups: LV dysfunction [LV ejection fraction (LVEF) ≤ 40%, n = 14] and normal LV function (LVEF > 40%, n = 14). Expression of ALOX15, AREG, BCL2A1, BCL2L1, CA1, COX7B, ECHDC3, IL18R1, IRS2, KCNE1, MMP9, MYL4 and TREML4 were updated by RT-PCR. Only KCNE1 expression decreased in the LVEF ≤ 40% group (p = 0.007). A positive correlation was found between KCNE1 and ejection fraction (r = 0.557; p = 0.001). There was a 12.25-fold risk (95% CI: 1.33 - 113.06; p = 0.027) of LV dysfunction for patients with lower expression of KCNE1. KCNE1 expression showed high AUROC (AUROC: 0.811, 95% CI: 0.642-0.979, p = 0.007), indicating KCNE1 expression as a good predictor of cardiac outcomes. Literature analysis showed that miR-499, miR-1, miR-133a, and miR-208b are the miRNAs most associated with the development of ischemic HF. According to miRNet public database, miR-1 is already described as a regulator of KCNE1 expression. Thus, this study suggests that the expression of KCNE1, as well as its regulatory mechanisms such as miR-1, may be related to LVEF levels and, therefore, to the establishment of post-AMI HF.

7
  • KLEYTON SANTOS DE MEDEIROS
  • COVID-19 AND EVIDENCE-BASED MEDICINE: clinical, laboratory, therapeutic and prognostic guidelines

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ADRIANA AUGUSTO DE REZENDE
  • AMALIA CINTHIA MENESES DO REGO
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • JANAINA CRISTIANA DE OLIVEIRA CRISPIM FREITAS
  • Data: Aug 27, 2021


  • Show Abstract
  • Introduction: The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has been increasing and has become a public health emergency. There is limited evidence on the outcomes of COVID-19 in patients when associated with other clinical conditions.

    Objective: To detect clinical, laboratory, therapeutic and prognostic guidelines, through evidence-based medicine, in situations involving patients infected with SARV-COV-2 associated with other clinical conditions.

    Methods: These are seven systematic reviews and meta-analyses, which followed the guidelines of PRISMA and MORSE, being registered in PROSPERO. PubMed, Web of Science, Embase, CINAHAL, LILACS, clinictrials.gov, SCOPUS, Google Scholar, and Cochrane, was the study bases used for articles published from December 2019 to February 2021. The primary outcomes were morbidity and mortality. Three independent reviewers selected the studies and extracted data from the original publications. The risk of bias was assessed using the Newcastle-Ottawa Scale for observational studies and RoB 2 for a randomized clinical trial. To assess the strength of evidence of the data included, the Assessment, Development, and Assessment of Classification of Recommendation (GRADE) method were used. Data synthesis was performed qualitatively. To assess heterogeneity, he calculated I2 (Higgins test). When applicable, quantitative synthesis was performed using R statistical software.

    Result: COVID-19 and Pregnancy: 70 articles were included involving 10047 pregnant women with COVID-19. The most common symptoms were: fever, cough, chest pain, dyspnea, nasal congestion, sore throat, headache, myalgia, anosmia, ageusia, nausea, vomiting, diarrhea, tachypnea, tachycardia, fatigue and oxygen desaturation. The main type of delivery was cesarean (42% [CI 95%; 0.38; 0.47]; I2 = 92%). There were 108 deaths (2% [CI 95%, 0.01; 0.03]; I2 = 46%) and 50 abortions (15% [CI 95%; 0.11; 0.21]; I2 = 73%] Ventilatory support, ICU admission, and pneumonia were unfavorable outcomes. Lymphopenia, increased CRP, and liver were complications during pregnancy. Of the neonatal outcomes: fetal distress (11% [CI 95%; 0.06; 0.19; I2 = 91 %], birth weight (15% [CI 95%; 0.10; 0.21; I2 = 76%]; APGAR less than 7 (9% [CI 96%; 0.03; 0.27; I2 = 26%], admission to the NICU (25% [CI 95%; 0.15; 0.39; I2 = 90%] and fetal stress (11% [CI 95%; 0.06; 0.19; I2 = 91 %] were more prevalent. There is no evidence of COVID-19 in placenta, breast milk, umbilical cord, and amniotic fluid.

    COVID-19 and HIV/AIDS: Chest CT has been observed in patients with SARS-CoV-2 pneumonia with findings of multiple ground-glass opacities (GGO) in the lungs, requiring supplemental oxygenation. One patient developed complicated encephalopathy and tonic-clonic seizures; four patients were transplanted (two liver; two kidneys), one patient developed severe SARS-CoV-2 pneumonia, and 30 patients died (mortality rate, 11%).

    COVID-19 and Guillain Bare Syndrome (GBS): The main manifestations were fever, cough, dyspnea, sore throat, ageusia, anosmia, and respiratory failure, in addition to upper and lower limb anesthesia, tetraparesis, facial diplegia, coldness, asthenia, mastoid pain, back pain, dizziness and back pain.

    Conclusion: The outcomes of COVID-19 in patients when associated with other clinical conditions (Pregnancy, HIV, and GBS) are similar to healthy individuals. However, there are relevant differences in morbidity and mortality.

8
  • JEFFERSON ROMÁRYO DUARTE DA LUZ
  • CHEMICAL AND TOXICOLOGICAL CHARACTERIZATION OF EXTRACTS OBTAINED FROM VEGETABLE SPECIES FROM THE CAATINGA BIOMA AND ITS EFFECTS ON INFLAMMATORY RESPONSE AND HEMOSTASIS

  • Advisor : MARIA DAS GRACAS ALMEIDA THORNTON
  • COMMITTEE MEMBERS :
  • DAMIAO PERGENTINO DE SOUSA
  • ELIZEU ANTUNES DOS SANTOS
  • HERYKA MYRNA MAIA RAMALHO
  • MARIA DAS GRACAS ALMEIDA THORNTON
  • RAFAEL BARROS GOMES DA CAMARA
  • Data: Aug 30, 2021


  • Show Abstract
  • Inflammation is composed of a vascular and a cellular reaction, conferring different tissue and cell reactions, both in the intravascular and extravascular environments. As the inflammatory process occurs, coagulation proteases, especially thrombin (FIIa), can trigger several cellular responses in vascular biology and, therefore, activation of other biological systems is often observed, leading to complications during an event inflammatory, such as thrombosis. Thus, molecules that positively interfere in these events are interesting models for the development of new anti-inflammatory drugs. In this context, secondary metabolites of medicinal plants stand out, which interact with several proteins involved in important biological processes, including inflammation and coagulation. For this reason, this study aimed to chemically and toxicologically characterize the plant extracts of two species of the Caatinga Biome (Turnera subulata and Licania rigida Benth), as well as to evaluate the anti-inflammatory and anticoagulant potentials of the extracts. The extracts were obtained from the collection and drying of plant material with subsequent aqueous and alcoholic extraction, being then rotaevaporated and lyophilized. Turnera subulata and Licania rigida Benth extracts showed flavonoids as the main phytocomponents and low toxicity, in addition to showing an interesting anticoagulant effect by APTT, PT, direct inhibition of thrombin and indirect inhibition through heparin cofactor II. On inflammation, the extracts showed a significant inhibitory effect with a reduction of pro-inflammatory cytokines (TNF-α and IL-1β) and a stimulatory effect on IL-10, in addition to being able to reduce prostaglandin E2 and nitric oxide. Thus, the results exhibited by the extracts point to these as a pharmacological target with perspectives for the development of new anti-inflammatory drugs.

9
  • EVELLYN CAMARA GRILO
  • BODY COMPOSITION OF PATIENTS WITH DUCHENNE MUSCULAR DYSTROPHY AND THE EFFECT OF ZINC SUPPLEMENTATION ON BONE PARAMETERS IN THIS POPULATION.

  • Advisor : JOSE BRANDAO NETO
  • COMMITTEE MEMBERS :
  • ANA HELONEIDA DE ARAUJO MORAIS
  • DÉBORA KURRLE RIEGER VENSKE
  • FATIMA APARECIDA CAROMANO
  • LUCIA DE FATIMA CAMPOS PEDROSA
  • SANCHA HELENA DE LIMA VALE
  • Data: Sep 29, 2021


  • Show Abstract
  • Duchenne Muscular Dystrophy (DMD) is a neuromuscular disease that results in progressive muscle atrophy. The available therapy to slow the progression of DMD is the use of steroids. However, this therapy has side effects, including changes in body composition, growth deficit and bone demineralization. Methods for assessing the nutritional status of the healthy population may be imprecise and inapplicable for the population with DMD. In addition, the assessment and management of bone health is important for the population with DMD. Zinc is an important micronutrient for bone health and no studies were found involving zinc supplementation in patients with DMD. Given these health demands of the population with DMD, this doctoral thesis had as its main objectives: to verify the validity of the BIA as a practical method for assessing body composition in patients with DMD and to investigate the effect of supplementation with zinc on the serum zinc and bone parameters in this population. To this end, two studies were carried out: the first observational cross-sectional study including 46 patients with DMD (Study 1) and the second study with an interventional design nested within a cohort including 34 patients with DMD (Study 2). The studies were carried out at Neurology Outpatient facility at HUOL in Natal/RN. The main finding of Study 1 was that BIA is a viable method to estimate % fat-free mass (%FFM) in children and adolescents with DMD. Among the eight predictive equations evaluated, five equations were accurate to estimate %FFM by BIA in patients with DMD, respecting the age range of each equation. The main findings of Study 2 were that oral zinc supplementation increased serum zinc levels in DMD patients who had prior deficiency. However, zinc supplementation had no effect on bone density and mineral content of patients with DMD. These studies will serve as a basis for the assessment of body composition using BIA in patients with DMD and for possible interventions with zinc in patients with DMD who are deficient in this micronutrient.

10
  • BRUNO ARAÚJO DA SILVA DANTAS
  • QUALITY OF LIFE AND DEPRESSIVE SYMPTOMS IN PRIMARY HEALTH CARE ELDERLY: INTERVENTION AND COMPARATIVE STUDY IN BRAZIL AND PORTUGAL

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • MARINA DE GÓES SALVETTI
  • Meiry Fernanda Pinto Okuno
  • ROSANA LUCIA ALVES DE VILLAR
  • VILANI MEDEIROS DE ARAUJO NUNES
  • Data: Oct 11, 2021


  • Show Abstract
  • Within the context of mental health, depression is among the most frequent disorders in the world population, affecting the individual in a way that interferes with their well-being and causing them physical and mental suffering. Listed by the World Health Organization (WHO) as one of the main public health problems, depression affects more than 121 million people worldwide, representing the fourth largest global cause of disease in 2000 and projected to become the second largest global disease in the coming years. Given its importance within the context of public health and its worsening due to aging, depression directly interferes with the Quality of Life (QL), described by the WHO as the perception of the individual in relation to their position in life, whether in the cultural context or values in which it lives, in view of its goals and expectations. This research aimed to propose multidimensional interventions in QoL and depressive symptoms, assess their impact among Brazilian elderly and compare their aspects with Portuguese elderly people assisted in Primary Health Care. The research was carried out in two stages, represented by the two articles present in this work, being Article 1 with a longitudinal cut, which tested the impact of multidimensional interventions applied to elderly Brazilians, users of Primary Health Care (PHC). Article 2 was an observational study, carried out with a cross-sectional view, which, in turn, compared the association and risk of depression on aspects of QoL among elderly PHC users residing in Brazil and Portugal. The instruments used in data collection were the Socioeconomic and Health Data Questionnaire, Medical Outcomes Short-Form Health Survey-36 (SF-36) which assessed the levels of QOL, Geriatric Depression Scale, version with 30 questions that measured symptoms depressive symptoms (Article 1), Beck Inventory with comprehensive assessment of depressive symptoms (Article 2), Mini Mental State Examination (MMSE), which served as a mental and psychological aptitude test for participation in the study, since the participant himself was who provided the information. For the treatment and tabulation of data in tables, the Microsoft® Excel 2016 program (Microsoft Corporation, Washington, WA, USA) and the Statistical Package for Social Sciences (SPSS) version 20.0 (IBM, Armonk, NY, USA). Prior ethical approval was obtained after an evaluation in Brazil by the Research Ethics Committee of the University Hospital Onofre Lopes, CEP / HUOL, with opinion No. 562.318 and CAAE: 21996313.7.0000.5537, and in Portugal by the Research Ethics Committee of the University of Évora (opinion no. 14011) and by the Ethics Committee for Scientific Research in the Areas of Health and Human Well-Being of the University of Évora (no. 17.006 / 2018). In article 1, the changes observed after the administration of multidimensional interventions converged to a favorable outcome in the intervention group compared to the control group. There was a reduction in depressive symptoms, as well as an improvement in the domains of Mental Health, General Health and Physical Health and Quality of Life in the GI participants. Considering that these elderly people are affected by many limiting factors, such as low income and low education, this is a promising result. Article 2 highlighted the association, correlation and risk between depression and aspects related to the emotional, physical, functional, and mental health components. The data were more expressive in Portugal compared to Brazil, despite having also presented similar results, but with less relevance. In this sense, we accept our study hypothesis.

11
  • LANA SARITA DE SOUZA OLIVEIRA
  • COMPARISON OF CRYPTOCOCCUS GATTII/NEOFORMANS SPECIES COMPLEX TO RELATED GENERA (PAPILIOTREMA AND NAGANISHIA) REVEAL VARIANCES IN VIRULENCE ASSOCIATED FACTORS AND ANTIFUNGAL SUSCEPTIBILITY.

  • Advisor : GUILHERME MARANHAO CHAVES
  • COMMITTEE MEMBERS :
  • GUILHERME MARANHAO CHAVES
  • ADRIANA AUGUSTO DE REZENDE
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • DANIELLE PATRICIA CERQUEIRA MACEDO
  • TEREZINHA INEZ ESTIVALET SVIDZINSKI
  • Data: Oct 18, 2021


  • Show Abstract
  • Cryptococcosis is an infectious disease of worldwide distribution, caused by encapsulated yeasts belonging to the phylum Basidiomycota. The genus Cryptococcus includes several species distributed around the world. The C. gattii/neoformans species complex is largely responsible for most cases of cryptococcosis. However, clinical series have been published of infections caused by Papiliotrema (Cryptococcus) laurentii and Naganishia albida (Cryptococcus albidus), among other related genera. Here, we examined the pathogenic potential and antifungal susceptibility of Cryptococcus spp. and related genera isolated from environmental and clinical samples. P. laurentii and Naganishia spp. strains produced higher levels of phospholipase and hemolysins, whereas the C. gattii/C. neoformans species complex strains had markedly thicker capsules, produced more biofilm biomass and melanin, which are known virulence attributes. Interestingly, more strains of non-C. gattii/C. neoformans species complex exhibited non-wild type phenotypes in response to fluconazole, itraconazole and amphotericin B. Finally, all the non-C. gattii/C. neoformans clinical isolates produced more melanin and this might reflect their particularly enhanced need for melanin during in vivo protection. It is very clear that clades I and II strains, in general, show more similar virulence phenotypes among each other when compared to clades III to V isolates and vice versa. These findings, together with the fact that P. laurentii and Naganishia spp. strains were collected from the outside of a University Hospital, may be important for environmental and patient colonization and further risk for infections.

12
  • VINÍCIUS BARRETO GARCIA
  • ENVIRONMENTALLY COMPATIBLE THERANOSTIC GOLD NANOPARTICLES AS EFFICIENT CONTRAST AGENTS FOR INFLAMMATION-INDUCED CANCER IMAGING

  • Advisor : RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • COMMITTEE MEMBERS :
  • RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • ALDO DA CUNHA MEDEIROS
  • BENTO JOAO DA GRACA AZEVEDO ABREU
  • RAFAEL RODRIGUES LIMA
  • RENATA FERREIRA DE CARVALHO LEITÃO
  • Data: Nov 23, 2021


  • Show Abstract
  • For many cancers, early detection is the key to improve survival and reduce the morbidity, which is associated with radical resections due to late diagnosis. Here, we describe the efficiency of primary antibody-conjugated gold nanoparticles (AuNPs) to specifically target chronic inflammatory processes, specially M2 macrophages, in tissue sections of ulcerative colitis (UC) and steatohepatitis in rats which may lead to colorectal cancer and liver carcinoma, respectively. In this study, we demonstrate that AuNPs synthesized by a simple, inexpensive, and environmentally compatible method can be easily conjugated with the antibodies anti-COX-2, anti-MIF, and Alexa Fluor® 488 (ALEXA) to perform immunofluorescence staining in inflamed tissues. Moreover, we showed that primary antibody-conjugated gold nanoparticles (AuNPs) can be used to target M2 macrophages by flow cytometry. We designed three immunofluorescence staining protocols of tissue section with AuNPs for 30 min and overnight incubation, as well as one flow cytometry protocol of M2 macrophage labeling with AuNPs for 30min. Immunofluorescence and flow cytometry results suggest that conjugation was achieved by direct adsorption of antibodies on the AuNPs surface. When compared to the standard ALEXA protocol in immunofluorescence (IF) and flow cytometry (FC), our 30-min incubation protocol using AuNPs instead of ALEXA decreased from approximately 23h to 5h for IF and from 4h to 1h for FC, proving to be less laborious, which makes the method eligible for inflammation-induced cancer diagnostic.

13
  • RODRIGO ALBERTO VIEIRA BROWNE
  • MOVEMENT BEHAVIOR AND LIFE-SPACE MOBILITY OF OLDER ADULTS WITH HYPERTENSION DURING THE COVID-19 PANDEMIC

  • Advisor : EDUARDO CALDAS COSTA
  • COMMITTEE MEMBERS :
  • EDUARDO CALDAS COSTA
  • ANA PAULA TRUSSARDI FAYH
  • RICARDO OLIVEIRA GUERRA
  • CLARICE MARIA DE LUCENA MATINS
  • DANILO RODRIGUES PEREIRA DA SILVA
  • Data: Nov 26, 2021


  • Show Abstract
  •  

    The aim of this thesis was to investigate the movement behavior and life-space mobility during different moments of the new Coronavirus pandemic (COVID-19) in older adults with hypertension and their associations with housing characteristics. Thirty-five participants were included in this exploratory longitudinal study. The evaluations occurred at three moments over 18 months: i) before the first case of COVID-19 in Natal-RN (January-March, 2020); ii) during the social distancing policy and without vaccination (June, 2020); iii) ~2 months after the vaccination (July, 2021). Physical activity (PA) and sedentary behavior (SB) were measured by accelerometry. Life-space mobility was assessed by the Life-Space Assessment Questionnaire. The following housing characteristics were assessed: housing type, housing surface area, and household size. Generalized linear mixed model was used for data analyses, with adjustment for age, sex, education and accelerometer wear use. During the social distancing policy without vaccination there was a decrease in steps/day (β = –886, p = 0.018), in moderate-vigorous PA (β = –0.4 %, p = 0.001), and in light PA (β = –3.7 %, p = 0.004), in addition to an increase in SB (β = 4.1 %, p = 0.001). The magnitude of changes was greater on the weekend, mainly for steps/day (β= –1,739, p < 0.001) and SB pattern (more time in prolonged bouts and less breaks). Older adults who resided in apartment and row housing showed a greater decrease in PA and a greater increase in SB compared to those who resided in detached house (p < 0.05). After the vaccination, older adults who resided in apartment and row housing showed an increase in life-space mobility and PA, in addition to a decrease in SB (p < 0.05). In conclusion, the movement behavior and life-space mobility of older adults with hypertension seem to change during the COVID-19 pandemic, especially in those who reside in limited houses. While the social distancing policy without vaccination is associated with a reduction in PA and an increase in SB, the immunization is associated with an increase in life-space mobility and PA, in addition to a reduction in SB.

14
  • ROMILSON DE LIMA NUNES
  • INTERVENTIONS IN THE STYLE AND QUALITY OF LIFE OF WOMEN WITH POLYCYSTIC OVARY SYNDROME: PROTOCOL AND SYSTEMATIC REVIEW

  • Advisor : PAULO MOREIRA SILVA DANTAS
  • COMMITTEE MEMBERS :
  • PAULO MOREIRA SILVA DANTAS
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • BRENO GUILHERME DE ARAUJO TINOCO CABRAL
  • MARIA IRANY KNACKFUSS
  • RODRIGO GOMES DE SOUZA VALE
  • Data: Dec 10, 2021


  • Show Abstract
  • Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders in women of childbearing age. PCOS has a significant negative impact on the Health-Related Quality of Life (HRQOL) and psychological function of women, of which there are reports of high levels of depression in women with PCOS compared to those without PCOS. However, evidence around the effects of exercise and/or participation in dietary intervention on the HRQoL of women with PCOS is limited. Objective: To analyze the effects of lifestyle interventions (definition includes only exercise, diet, exercise + diet and behavioral or combined) on the quality of life of women with PCOS. Methods: A systematic review was conducted following the recommendations and guidelines of the Cochrane Manual for Systematic Reviews and Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol (PRISMA-P). Results: 07 randomized controlled trials that included 612 women aged 18 to 44 years old women with PCOS diagnosed using the Rotterdam criteria. Lifestyle interventions (diet + exercise) lasted between 20 sessions and 05 months. Most interventions were based on protein intake, carbohydrate reduction and aerobic exercise. Lifestyle interventions alone or combined with other interventions improved the domains and the total value of HRQOL, and some studies pointed to improvements in the mental health of women with PCOS. Conclusions: There is evidence that lifestyle interventions (diet + exercise) can improve the quality of life and mental health of women with PCOS. However, our findings must be interpreted with caution due to the risk of bias and small sample sizes.

15
  • TALITA ARAUJO DE SOUZA
  • HEALTH CONDITIONS OF THE BLACK POPULATION: ANALYSIS OF RACIAL INEQUALITIES IN CHRONIC NON-COMMUNICABLE DISEASES AND THE COVID-19 PANDEMIC

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • THAIZA TEIXEIRA XAVIER NOBRE
  • VILANI MEDEIROS DE ARAUJO NUNES
  • MARIA MANUELA FREDERICO FERREIRA
  • THALYTA CRISTINA MANSANO SCHLOSSER
  • Data: Dec 13, 2021


  • Show Abstract
  • This study aims to analyze the health conditions of the black population in chronic non-communicable diseases and inequalities evidenced in the Covid-19 pandemic. It is divided into 3 productions of scientific articles, adopting two different elaboration methodologies. The first two productions refer to the development of systematic review protocols that have been published in international journals. The two protocols were registered in the International Prospective Register of Systematic Reviews Platform (PROSPERO) obtaining a favorable opinion for publication and development of the reviews. The first systematic review protocol was designed to assess racial differences in illness and death from Covid-19, while the second protocol aims to carry out a systematic review to assess the prevalence of Covid-19 in black people cared for in primary care units. health care units, hospital units and intensive care units. The development of the two reviews will be in accordance with the declaration of items in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), respecting each step of the development of a review. The third article aimed to analyze the prevalence of chronic non-communicable diseases in Brazil according to race/skin color based on the results of the National Health Survey. To analyze the outcomes, issues related to chronic diseases were considered. Race/skin color was determined as the dependent variable and sociodemographic variables as adjustment variables. Poisson regression was applied to estimate the prevalence ratio (PR) and the respective 95% confidence interval (95%CI) using the sample weight and incorporating the effect of the sample design. The results showed a higher prevalence of arterial hypertension and multimorbidity. Black race/skin color was shown to be a risk factor for hypertension, diabetes and stroke. Socioeconomic inequalities, structural racism, and cultural differences can result in immediate and long-term barriers to adequate health care for these populations. Policy makers in all nations must formulate policies and strategies that can reach this population, thus making health care equitable for all.

2020
Dissertations
1
  • AYANE CRISTINE ALVES SARMENTO
  • IMPACT OF MICROABLATIVE FRACTIONAL RADIOFREQUENCY ON VAGINAL HEALTH, MICROBIOTA, AND CELLULARITY OF POSTMENOPAUSAL WOMEN

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • MARIA THEREZA ALBUQUERQUE BARBOSA CABRAL MICUSSI
  • RICARDO NEY OLIVEIRA COBUCCI
  • Data: Mar 6, 2020


  • Show Abstract
  • Inglês OBJECTIVES: We aimed to evaluate the effects of microablative fractional radiofrequency (MAFRF) as a possible option in the non-hormonal treatment of genitourinary syndrome of menopause. METHODS: We studied 55 healthy postmenopausal women before and after treatment regarding vaginal health index (VHI), vaginal microbiota, vaginal pH, and cell maturation. Three applications of MAFRF were performed in the vagina/vaginal introitus. During all the treatment, five vaginal smears were obtained and stained by UNIVERSIDADE FEDERAL DO RIO GRANDE DO NORTE CENTRO DE CIÊNCIAS DA SAÚDE PROGRAMA DE PÓS-GRADUAÇÃO EM CIÊNCIAS DA SAÚDE Av. Gal. Gustavo Cordeiro de Farias, s/n – Natal-RN, CEP 59012-570 Telefax: (84) 3342-9776 E-mail: ppgcsa@ccs.ufrn.br the Papanicolaou technique for determining the degree of maturation of the vaginal epithelium, stained according to the Gram procedure for classification of vaginal flora, following the criteria of Spiegel and Amsel. For vaginal pH determination, the pH indicator strips were applied against the vaginal wall. Statistical analysis was performed using SPSS for Windows (version 17.0). Data presented were reported as mean ± standard deviation. Differences were analyzed using the statistical method of generalized estimation equations with autoregressive correlation structure "1" and robust standard errors RESULTS: The mean age was 59.8 ± 4.2 years, and the time of menopause was 15.4±4.5 years. After treatment, there was an increase in the percentage of lactobacilli. (p<0.001). Consequently, there was a progressive decrease in vaginal pH during the treatment (p<0.001). Regarding cell maturation, there was a decrease in the percentage of parabasal cells (p=0.001) and an increase in the percentage of superficial cells (p<0.001). Additionally, there was also improvement in the (p<0.001). CONCLUSION: These findings suggest that MAFRF is well tolerated and leads to significant improvement in the vaginal microenvironment

2
  • JÚLIO SÓCRATES PEIXOTO DA SILVA
  • SELF-SELECTED EXERCISE INTENSITY: A SIMPLE APPROACH TO ENCOURAGE NA ACTIVE LIFESTYLE IN HYPERTENSIVE OLDER WOMEN

  • Advisor : EDUARDO CALDAS COSTA
  • COMMITTEE MEMBERS :
  • EDUARDO CALDAS COSTA
  • DANIEL UMPIERRE DE MORAES
  • TONY MEIRELES DOS SANTOS
  • Data: Jun 10, 2020


  • Show Abstract
  • A defesa ocorrerá em ambiente virtual, utilizando a ferramenta de conferência do Google Meet, acessando a Sala Virtual pelo link https://conferenciaweb.rnp.br/webconf/eduardo-60.
     
    Será permitido o acesso considerando o seguinte cronograma:
    30 minutos antes: o aluno e orientador, para organizar virtualmente a atividade;
    10 minutos antes, os membros da banca;
    5 minutos antes, o público externo (vagas limitadas).

     

    Purpose: We analyzed the heart rate (HR), rating of perceived exertion (RPE) and affective response of inactive older women with hypertension during two self-selected exercise (SSE) intensity sessions. Moreover, we assessed the reproducibility of these responses. Methods: Thirteen participants (64.5 ± 4.1 years) performed two 30-minute SSE sessions outdoors. HR reserve, RPE and affective response were assessed. Paired t-test, intraclass correlation coefficient (ICC) and typical error (TE) were used for the analyzes. Results: Twelve participants (92%) exercised at moderate-vigorous intensity (≥ 40% of HR reserve) and all participants reported RPE light-moderate and positive affective response during both SSE sessions. No differences between sessions were found for HR (56.5 ± 8.0% vs. 59.1 ± 10.6% of HR reserve), RPE (11.3 ± 1.1 vs. 11.0 ± 1.5) and affective response (3.5 ± 1.1 vs. 3.4 ± 1.2) (p > 0.05). RPE presented excellent reliability (ICC = 0.82; 95% CI: 0.42 to 0.94; p < 0.01), but there was no reliability for HR (ICC = 0.40; 95% CI: -0.97 to 0.82; p = 0.43) and affective response (ICC = 0.19; 95% CI: -2.10 to 0.76; p = 0.37) between sessions. The TE between sessions for HR, RPE, and affective response were 8.1 bpm, 0.8 a.u. and 1.1 a.u., respectively. Conclusion: Inactive hypertensive older women choose a moderate-vigorous intensity when they exercise at a self-selected pace and report it as light-moderate and pleasant. These results seem to support the use of the SSE intensity as a simple approach to encourage an active lifestyle in this population.

3
  • KARINA GOMES TORRES
  • LONG-TERM EFFECT OF THE BRAZILIAN WORKERS’ FOOD PROGRAM ON THE NUTRITIONAL STATUS OF MANUFACTURING WORKERS

  • Advisor : ANTONIO MANUEL GOUVEIA DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANTONIO MANUEL GOUVEIA DE OLIVEIRA
  • FABIO RESENDE DE ARAUJO
  • ANA CLAUDIA CAVALCANTI PEIXOTO DE VASCONCELOS
  • Data: Jul 6, 2020


  • Show Abstract
  • The Workers Food Program (WFP), implemented in Brazil for over 40 years, is a public policy of food and nutritional assistance to low-income workers whose main objective is to improve the nutritional conditions of workers through the provision of meals in the workplace. However, several cross-sectional studies have observed higher prevalence of overweight and obesity in populations of workers. The aim of this study was to compare with a longitudinal study the long-term variation in anthropometric indicators of the nutritional status and dietary intake between workers of manufacturing industries adherent to and non-adherent to the WFP. A prospective longitudinal study in a closed cohort selected by a combined stratified and multistage sampling was conducted, with evaluations in two waves with a 4-year interval, in 2014 and 2018. The change in body mass index (BMI), waist circumference (WC) and dietary intake at lunch by the 24-hour recall method were compared between groups with analysis of covariance. A total of 273 workers in 16 industries, from an initial cohort of 1069 workers in 26 industries of the State of Rio Grande do Norte in Brazil, were evaluated in the two waves. The mean age was 37±10 years and 53.1% were male, with no differences between groups in age and sex distribution. BMI increased in both groups (0.44 kg/m2 in non-WFP, p=0.003, and 0.56 kg/m2 in WFP, p=0.0006) and WC increased in the WFP group (1.50 cm, p=0.0006). BMI change over time did not show statistical differences between groups (p=0.54) but WC had a greater increase in the WFP group (difference 1.37 cm, p=0.047). There were no statistically significant differences between groups in the change over time of the dietary intake. The results obtained evidence the weight gain with a statistically significant increase in BMI in both groups and WC in the WFP group, and that the increase in WC was greater in the WFP group. These findings support the hypothesis of a causal nexus between worker participation in the WFP and increased WC and, possibly, BMI. These findings suggest the need for periodic monitoring of nutritional indicators in these workers. The relevance of the WFP is recognized for this portion of society and it is understood that the results of the present study may be helpful for the formulation and implementation of strategies for the promotion of workers’ health through the provision of a healthy diet that is adequate to the energetic-nutritional demands of this population, in addition the development of other health actions, with positive repercussions for productivity and the welfare of the workers.

4
  • GABRIELA SANTANA PEREIRA
  • RISK OF METABOLIC SYNDROME IN WORKERS ADHERENT AND NOT ADHERENT BY THE WORKERS’ FOOD PROGRAM

  • Advisor : ANTONIO MANUEL GOUVEIA DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANTONIO MANUEL GOUVEIA DE OLIVEIRA
  • TELMA MARIA ARAUJO MOURA LEMOS
  • SANDRA MARIA NUNES MONTEIRO
  • Data: Aug 28, 2020


  • Show Abstract
  • Studies have reported an increase in cardiometabolic risk among workers assisted by the Brazilian Worker’s Food Program (WFP), the only Public Food and Nutritional Security Policy aimed at this public in country, due to a higher frequency of overweight and greater waist circumference (WC) in these individuals. Thus, the aim of this study was to estimate the prevalence of Metabolic Syndrome (MetS) and its individual components among manufacturing workers and their relationship to the WFP. To this end, we conducted a prospective cross-sectional two-stage survey comparative of manufacturing workers from companies adherent and non-adherent to the WFP stratified by sector of activity and company size. After written informed consent, workers were interviewed at the workplace, where socioeconomic, bio-demographic and anthropometric data were collected, in addition to health information and blood pressure measurement. Blood samples were taken (12h fasting) to determine serum glucose, triglycerides and HDL-cholesterol. Mixed effects multilevel logistic regression was used to compare WFP and non-WFP groups separately in each sex. The survey included 332 workers from 16 WFP companies and 344 workers from 17 non-WFP companies. The general prevalence of MetS was high, but without statistical differences between the sexes (39.8% in females versus 28.5% in males, p = 0.16). When comparing groups, men in the WFP group had a significantly higher prevalence of MetS (33.0% versus 23.9% non-WFP, p = 0.008) and for the individual components, a higher prevalence of increased WC (47.0% versus 29.4% non-WFP, p <0.001) and high fasting blood glucose (8.9% versus 6.3% non-WFP, p <0.001) was also observed. For women, no statistically significant results were observed in the prevalence of MetS and its individual components between groups. Thus, it is concluded that food assistance programs are associated with an increase in the prevalence of MetS in male workers, but possibly not in women, suggesting an influence of food insecurity on the effects of food assistance programs in low-income populations.

5
  • ANISSA MELO DE SOUZA
  • RELATIONSHIPS BETWEEN MOTIVATIONS FOR FOOD CHOICES AND CONSUMPTION OF FOOD GROUPS: A PROSPECTIVE CROSS-SECTIONAL SURVEY IN MANUFACTURINGWORKERS IN BRAZIL

  • Advisor : ANTONIO MANUEL GOUVEIA DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANTONIO MANUEL GOUVEIA DE OLIVEIRA
  • SEVERINA CARLA VIEIRA CUNHA LIMA
  • ILANA NOGUEIRA BEZERRA
  • Data: Sep 29, 2020


  • Show Abstract
  • Motivations for food choices may determine consumption, and understanding that relationship may help direct strategies for formulating diets. This study aimed to identify associations between motivations for food choices and consumption of food groups. An observational cross-sectional survey was conducted in 921 manufacturing workers from 33 companies in Brazil, based on a stratified two-stage probability sample. Motivations for food choices were assessed with the Food Choice Questionnaire, and intake of food groups was measured using 24-h dietary recall. Consumption was classified into 31 food groups defined according to their nutritional value and the NOVA classification. Data were analyzed with multilevel mixed-e_ects regression. The results showed that sensory appeal and price were the most important motivations for food choices, while ethical concern was less important. Sensory appeal was positively associated with consumption of industrialized condiments (p = 0.022), price showed a negative correlation with consumption of plant oils (p = 0.022), ethical concern showed positive correlation within consumption white meat (p = 0.065) and negative correlation within pasta dishes (p < 0.001). Regarding the NOVA classification, health correlated with an increase in consumption of unprocessed foods (p = 0.017) and weight control with a decrease in consumption of processed culinary ingredients (p = 0.057).

6
  • JANICE FRANÇA DE QUEIROZ
  • SEXGYNCARE: A MOBILE APP SYSTEM FOR GYNECOLOGICAL AND SEXUAL CARE

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • MARIA THEREZA ALBUQUERQUE BARBOSA CABRAL MICUSSI
  • LUCIA ALVES DA SILVA LARA
  • Data: Oct 16, 2020


  • Show Abstract
  • Background

    Sexual risk behaviors, pregnancy, and sexually transmitted infections are diseases related to female sexual expression. The use of mobile apps can help women in gynecological and sexual health care. We developed the GynecoCare mobile app.

    Methods

    The development of GynecoCare was divided into three stages. The first was to understand the problem, survey the needs of women about maternity in high-risk pregnancies, define the objectives and functions of the application. The second stage involved the preparation, production of informative content, selection of the form of media, the definition of the navigation structure, and the design of the interface. In the third stage, GynecoCare was developed.

    Results

    GynecoCare was developed for the management of gynecological health, menstrual cycle, contraceptive methods, sex, sexually transmitted infections, and access to emergency gynecological services by users. Data can be registered and receive tips on the topics of the application.

    GynecoCare aims to improve monitoring of intimate and sexual health care, preventing unwanted pregnancies, risky sexual behavior and sexually transmitted infections

    Conclusion

    It can be a powerful technological tool and used to assist in the management of intimate health, health promotion, as well as in adherence to appropriate behaviors, improving the quality of life of users. 

7
  • CIJARA LEONICE DE FREITAS
  • INCIDENCE AND CAUSES DE MATERNAL NEAR MISS: BASED-POPULATION STUDYDY

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • MARIA DA CONCEICAO DE MESQUITA CORNETTA
  • PATRICIA FROES MEYER
  • Data: Nov 25, 2020


  • Show Abstract
  •  Background: every day, throughout the world, women die from preventable causes related to pregnancy and childbirth. Thus, the World Health Organization (WHO) recognizes as cases of women who survived serious complications during pregnancy or up to 42 days after delivery as maternal near miss (MNM) and recommends that they be identified and studied, as it considers that these cases are often a precursor of maternal mortality. This study aimed to estimate the incidence and factors associated with maternal near miss

    Methods: a population-based study was carried out at a reference maternity for obstetric and neonatal care of high complexity to women attended exclusively by the public health service. Data were collected from all pregnant women in labor who gave birth or in labor who gave birth or had complications within 42 days after delivery, who was admitted to the Maternity Hospital. The comparison between socio-demographic and health-related variables for maternal near miss (MNM) cases and Severe Maternal Complications (SMC) were performed with Pearson chi-square (X2) for categorical and the Mann – Whitney test for continuous of socio-demographic and health-related.

    Results: a total of 729 women were identified as a case of the Maternal Near-Miss Miss (MNM) and 2011 had Severe Maternal Complications (SMC) . Thus, the total population was composed of 2740 cases. The maternal near miss incidence of 185.07 cases per 1000 live births and an incidence among high-risk research pregnancies of 26.67% (95% CI: 24.8 - 28.4).

    Conclusion: oligohydramnios and low numbers of prenatal consultations were associated conditions for the development of maternal near miss.

8
  • BARTOLOMEU SANTOS DE SOUZA
  • WATER-IN-WATER EMULSION AS A NEW APPROACH TO PRODUCE MESALAMINE-LOADED XYLAN-BASED MICROPARTICLES

  • Advisor : ERYVALDO SOCRATES TABOSA DO EGITO
  • COMMITTEE MEMBERS :
  • ERYVALDO SOCRATES TABOSA DO EGITO
  • ADLEY ANTONINI NEVES DE LIMA
  • KATTYA GYSELLE DE HOLANDA E SILVA
  • Data: Dec 16, 2020


  • Show Abstract
  • The water-in-water emulsion method has been reported as a technique able to prepare microparticles without using harmful solvents. However, there are few reports showing the encapsulation of small molecules into microparticles produced within this technique. The probable reason relays on the rapid diffusion of these molecules from the discontinuous phase to the continuous phase. In the present study, xylan microparticles containing mesalamine were produced and the doubled crosslinking approach, used to promote higher encapsulation rates, which was disclosed. To achieve this goal, a 23 full factorial design was carried out. The results revealed that all formulations presented spherical-shaped microparticles. However, at specific conditions, only few formulations reached up to 50% of drug loading. In addition, the new xylan-based microparticles formulation retained almost 40% of its drug content after 12 hours of a dissolution assay likely due to the degree of crosslinking. Thus, the doubled crosslinking approach used was effective on the encapsulation of mesalamine and may pave the way to successfully produce other polysaccharide-based carriers for clinical use.

9
  • ADRIANA OLIVEIRA DE SOUZA
  • ANTI-TRYPANOSOMA CRUZI SILVER NANOPARTICLES CONTAINING FUCAN FROM SEAWEED SPATOGLOSSUM SCHRÖEDERI: SYNTHESIS AND CHARACTERIZATION

  • Advisor : HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • COMMITTEE MEMBERS :
  • HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • PAULO MARCOS DA MATTA GUEDES
  • VALQUIRIA PEREIRA DE MEDEIROS
  • Data: Dec 18, 2020


  • Show Abstract
  • The brown seaweed Spatoglossum schröederi synthesizes three types of bioactive heterofucans, the most abundant of which is fucan A. Silver nanoparticles containing fucan A (AgFuc) were produced using an environmentally friendly method. Fucan was extracted from S. schröederi and its identity was confirmed by chemical analysis, Fourier transform infrared spectroscopy (FTIR) and agarose gel electrophoresis. The synthesis of AgFuc was analyzed by UV-vis spectroscopy at kmax = 440 nm and FTIR, which confirmed the presence of silver and fucan A in the product AgFuc. Dynamic light scattering (DLS), X-ray diffraction, scanning electron microscopy and atomic force microscopy revealed that the AgFuc particles were approximately 180.0 nm in size and spherical shape. DLS also produced that AgFuc was stable for 5 months and optical coupled plasma emission spectrometry (ICP-OES) showed that the AgFuc particles contained 5% silver. AgFuc can also be more effective in inhibiting the parasites' ability to reduce MTT than fucan A or silver, regardless of treatment time. In addition, AgFuc induced the death of ~ 60% of the parasites by necrosis and ~ 17% by apoptosis. Therefore, AgFuc induces damage to the parasites' mitochondria, which must be an anti-Trypanosoma cruzi agent. This is the first study to analyze silver nanoparticles containing fucana as an anti-Trypanosoma cruzi agent. Our data indicate that AgFuc nanoparticles have therapeutic applications, which must be determined through pre-clinical studies in vitro and in vivo

10
  • ADRIANO LUÍS DE CARVALHO ARAÚJO
  • DESIGN AND CLINICAL VALIDATION OF A SOFTWARE PROGRAM FOR AUTOMATED MEASUREMENT OF MAMMOGRAPHIC BREAST DENSITY

  • Advisor : ANTONIO MANUEL GOUVEIA DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • ANTONIO MANUEL GOUVEIA DE OLIVEIRA
  • FRANKLIN DE FREITAS TERTULINO
  • Data: Dec 21, 2020


  • Show Abstract
  • Background: Mammographic breast density is an important predictor of breast cancer, but its measurement has limitations related to subjectivity of visual evaluation or to difficult access for automatic volumetric measurement methods. Herein, we describe the design and clinical validation of Aguida, a software program for automated quantification of breast density from flat mammography images.

    Materials and methods: The software program was developed in MatLab. After image segmentation separating the background from the breast image, the operator positions a cursor defining a region of interest on the pectoralis major muscle from the mediolateral oblique view. Then, in the craniocaudal view, the threshold for separation of the dense tissue is based on the optical density of the pectoral muscle, and the proportion of dense tissue is calculated by the program. Mammograms obtained from 2 different occasions in 291 women were used for clinical evaluation.

    Results: The intraclass correlation coefficient (ICC) between breast density measurements by the software and by a radiologist was 0.96, with a bias of only 0.67 percentage points and a 95% limit of agreement of 13.5 percentage points; the ICC was 0.94 in the interobserver reliability assessment by two radiologists with different experience; and the ICC was 0.98 in the intraobserver reliability assessment. The distribution among the density classes was close to the values obtained with the volumetric software.

    Conclusions: Measurement of breast density with the Aguida program from flat mammography images showed high agreement with the visual determination by radiologists, and high inter- and intra-observer reliability.

Thesis
1
  • JESSICLEY FERREIRA DE FREITAS
  • Professional competencies of the nutritionist to act in Collective Food: an Integrative review.

  • Advisor : JOAO CARLOS ALCHIERI
  • COMMITTEE MEMBERS :
  • JOAO CARLOS ALCHIERI
  • DINARA LESLYE MACEDO E SILVA CALAZANS
  • THAIZA TEIXEIRA XAVIER NOBRE
  • LUIZ GUSTAVO VIEIRA CARDOSO
  • POLIANA CARDOSO MARTINS
  • Data: Feb 5, 2020


  • Show Abstract
  • The changes that have occurred in the scientific, political and labor spheres have a direct impact on the training of health professionals, and in this scenario, the role of the nutritionist in the management of collective food requires well-established professional skills, whose relevance lies in health promotion and disease prevention, therefore, the absence of research that deals with the theme of competences regarding the studied area motivated the present investigation. The objective was to analyze the evidence of validation of the standard of professional competences of the nutritionist in the Management of Collective Food. The study was approved by the Research Ethics Committee of Hospital Universitário Onofre Lopes under opinion No. 1,251,497. This is a qualitative and quantitative methodological research carried out from February 2017 to November 2019, in three sequential stages. Initially, the dimensions related to professional competences were mapped, then the Standards and Professional Performance for Registered Dietitian Nutritionists in Management of Food and Nutrition Systems (SSOP) were translated and adapted, related to the standard of service provision

    In the third round, the instrument was sent again to the judges and asked to assign points for each item, with a variation of 1 to 10 points for each item, considering its degree of importance for the Management of Collective Food. The items were grouped at administrative levels (strategic, tactical and operational) and the statistical treatment was carried out to adjust the score, eight judges answered the request. The data were organized in electronic spreadsheets and analyzed using descriptive and inferential statistics, using the Microsoft Excel program. To assess content validity, the Content Validity Index (CVI) was used, considering CVI ≥ 0.80 as acceptable. Before content validation, the instrument contained 119 items. After the judges' suggestions (exclusion and addition of items), the final instrument totaled 63 items. The composition of the instruments was considered accepted by the judges, using the indexes applied, suggesting evidence of content validation
2
  • VIRGÍNIA KELMA DOS SANTOS SILVA
  • ACCURACY OF COMPUTER-ASSISTED IMAGE ANALYSIS IN THE DIAGNOSIS OF MAXILLOFACIAL RADIOLUCENT LESIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS

  • Advisor : HEBEL CAVALCANTI GALVAO
  • COMMITTEE MEMBERS :
  • EMELINE DAS NEVES DE ARAUJO LIMA
  • HEBEL CAVALCANTI GALVAO
  • MANUEL ANTONIO GORDON NUNEZ
  • PATRICIA TEIXEIRA DE OLIVEIRA
  • ROSEANA DE ALMEIDA FREITAS
  • Data: Mar 17, 2020


  • Show Abstract
  • Objectives: This study aimed to search for scientific evidence concerning the accuracy of computer-assisted analysis for diagnosing maxillofacial radiolucent lesions. Methods: A systematic review was conducted according to the statements of PRISMAP and considering ten databases, including the grey literature. Protocol was registered in PROSPERO (CRD [Blinding]). The PICO strategy was used to define the eligibility criteria and only diagnostic test studies were included. Their risk of bias was assessed by the Joanna Briggs Institute Critical Appraisal tool. Random-effects model metaanalysis was performed and heterogeneity among the included studies was estimated using the I2 statistic. The GRADE tool assessed the quality of evidence and strength of recommendation across included studies. Results: Out of 715 identified citations, four papers, published between 2009 and 2017, fulfilled the criteria and were included in this systematic review. A total of 191 lesions, classified as periapical granuloma and cyst, dentigerous cyst, or keratocystic odontogenic tumor, were analyzed. All selected articles scored low risk of bias. The pooled accuracy estimation, regardless of the classification method used, was 88.75%

    (95% CI = 85.19-92.30). Heterogeneity test reached moderate values (I2 = 57.89%).

    According to the GRADE tool, the analyzed outcome was classified as having low level of certainty. Conclusions: The overall evaluation showed all studies presented high accuracy rates of computer-aided diagnosis systems in classifying radiolucent maxillofacial lesions compared to histopathological biopsy. However, due to the moderate heterogeneity found among the studies included in this meta-analysis, a pragmatic recommendation about the use of computer-assisted analysis is not possible.

3
  • CYNTHIA MEIRA DE ALMEIDA GODOY
  • RELATIONSHIP OF FOOD INTOLERANCE 2 YEARS AFTER ROUX-EN-Y GASTRIC BYPASS SURGERY FOR OBESITY WITH MASTICATORY EFFICIENCY AND PROTEIN CONSUMPTION

  • Advisor : ANTONIO MANUEL GOUVEIA DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANTONIO MANUEL GOUVEIA DE OLIVEIRA
  • HIPOLITO VIRGILIO MAGALHAES JUNIOR
  • RENATA VEIGA ANDERSEN CAVALCANTI
  • FLÁVIO KLEIMER
  • LEANDRO DE ARAUJO PERNAMBUCO
  • Data: Jun 10, 2020


  • Show Abstract
  • A defesa ocorrerá em ambiente virtual, utilizando a ferramenta de conferência do Google Meet, acessando a Sala Virtual pelo link https://meet.google.com/hcp-rszn-qes.
     
    Será permitido o acesso considerando o seguinte cronograma:
    30 minutos antes: o aluno e orientador, para organizar virtualmente a atividade;
    10 minutos antes, os membros da banca;
    5 minutos antes, o público externo (vagas limitadas).


    Background: Bariatric surgery has been shown to be effective in weight reduction of obese subjects, and Roux-en-Y gastric bypass (RYGB) surgery. is one of the most commonly performed surgeries, accounting for about 30% of all bariatric procedures One known complication of RYGB is food intolerance, which may limit the intake of some foods such as protein.
    Objective: To investigate the relationship between food intolerance after RYGB and masticatory efficiency, chewing time and cycles, and protein and red meat consumption.
    Methods: Case-control study in subjects over 18 years-old who underwent RYGB more than 2 years previously, with absence of no more than 2 dental units and normal oral motor system evaluation, with (cases) and without (controls) food intolerance (regurgitation and/or vomiting more than once a week). Masticatory efficiency was evaluated by a sieving technique to determine the granulometry of red meat chewed by the study subject according to a predefined protocol and classified from very bad to excellent. Protein and red meat consumption were evaluated by usual food recall and 3-day dietary diary. The target sample size was defined as 44 subjects per group, which would afford a power of 70% to detect an odds-ratio greater than 3.0 in the comparison of very poor masticatory efficiency between groups, assuming that its prevalence among controls is about 25%. Patient characteristics in both study groups were described by mean ± standard deviation or number (percent). The statistical tests for between-group comparisons included, for proportions, the chi-square test and the Fisher’s exact test, and for continuous variables the Student’s t-test and, for variables not normally distributed, the Mann-Whitney ranksum test. The main study variable was the ordinal scaled masticatory efficiency which was compared between groups with the non-parametric Mann-Whitney test. Analysis of variance was used to test the association of masticatory efficiency with protein and red meat consumption, chewing time and number of chewing cycles. The 5% significance level was adopted as evidence of a significant difference. All analyses were performed using Stata 15 software (Stata Corporation, College Station, TX, USA).. Results: The study population consisted of 24 cases (37.7±7.57 years-old, 79.2% females) and 68 controls (38.0±8.75 years-old, 61.8% females). There was a statistically significant association (p=0.001) between masticatory efficiency and food intolerance, with 58.3% of cases and 23.5% of controls showing very bad masticatory efficiency. No evidence was found of an association between food intolerance, chewing time, chweing cycles, and low protein or red meat intake.
    Conclusion: One factor that leads the patient after BGYR to have difficulty in food adaptation and complain of food intolerance may be related to masticatory inefficiency.

4
  • MARQUIONY MARQUES DOS SANTOS
  • FRAGILITIES IN PRIMARY HEALTH CARE FAVORS INCREASED TRENDS IN ACQUIRED SYPHILIS IN BRAZIL

  • Advisor : KENIO COSTA DE LIMA
  • COMMITTEE MEMBERS :
  • KENIO COSTA DE LIMA
  • MARISE REIS DE FREITAS
  • RICARDO ALEXSANDRO DE MEDEIROS VALENTIM
  • CASSIANO FRANCISCO WEEGE NONAKA
  • MANUEL ANTONIO GORDON NUNEZ
  • Data: Jun 12, 2020


  • Show Abstract
  • Acquired syphilis is a sexually transmitted infection that affects the general population and has been growing exponentially in recent years, making it one of the most neglected in Brazil. This study is part of a larger project aimed at tackling syphilis in the country from the project called “No Syphilis”. A study was developed to analyze the factors that are related to the acquired syphilis trends in Brazil, from 2011 to 2018. This is an ecological study that used secondary data from the national notification systems of the 5570 Brazilian municipalities and a database of 37,350 primary health care teams, besides municipal socioeconomic and demographic indicators. Trends in municipally acquired syphilis were calculated from log-linear regression, intersecting them with indicators of primary health care and socioeconomic and demographic factors. Finally, it was building a multiple model from logistic regression. Data were analyzed using SPSS 20.0 software, respecting a level of statistical significance of 95%. After the analysis, the predictor variables for ascending acquired syphilis were statistically significant in the multiple model: not all primary health care teams apply penicillin (RPaj = 1.13; 1.02-1.25); higher proportion of primary health care teams with poor / fair grades (RPaj = 1.18; 1.07-1.30); population size> 100000 inhabitants (RPaj = 1.98; 1.52-2.57); partially available female condom (RPaj = 1.10; 1.01-1.20). Thus, it is concluded that the fragility of primary health care linked to the structure in large municipalities are the main factors that favor the growth of the acquired syphilis epidemic in Brazilian municipalities.

5
  • DIANA LUZIA ZUZA ALVES SILVA
  • MOLECULAR IDENTIFICATION, GENOTYPING AND GENE EXPRESSION OF CANDIDA TROPICALIS ENVIRONMENTAL AND CLINICAL ISOLATES, WITH EMPHASIS ON VIRULENCE FACTORS AND CELL STRESS

  • Advisor : GUILHERME MARANHAO CHAVES
  • COMMITTEE MEMBERS :
  • GUILHERME MARANHAO CHAVES
  • ALDO DA CUNHA MEDEIROS
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • RAQUEL DE MELO BARBOSA
  • REGINALDO GONÇALVES DE LIMA NETO
  • Data: Jun 17, 2020


  • Show Abstract
  • Candida tropicalis is one of the main Candida species, being considered the second most virulent of the genus. Virulence factors related to this species include strong biofilm production, adhesion to human oral epithelial cells, lytic enzyme secretion, morphogenesis and phenotypic switching. In addition to all these characteristics, C. tropicalis is described as an osmotolerant microorganism and this ability to survive in high salt concentrations may be important for fungal persistence in saline environments. This yeast is closely related to C. albicans and is described as the second or third most common etiological agent of candidemia, especially in Latin America and Asia. This fact, combined with the increasingly reported antifungal resistance, demonstrates the need for a better understanding of the genetic variability patterns of this important Candida species in the tropics. Therefore, we made an update of C. tropicalis, focusing on all the subjects mentioned, as well as evaluating the genotypic and phenotypic variability of 62 isolates of C. tropicalis obtained from the coastal environment of Northeast Brazil, using microsatellite and MALDI-TOF / MS. There was a relatively low correspondence between these two typing techniques, so further studies are needed to consolidate the use of MALDI-TOF / MS as a yeast typing tool. However, both methods showed heterogeneity of C. tropicalis in the coastal environment. We also found relative maintenance of population structure in the same climate season, which may reinforce the idea that this species has the potential to remain in the environment for a long period of time. In addition, highly related strains were found at different geographic collection points, demonstrating that this species can disperse over long distances, probably influenced by anthropogenic actions and driven by tides and wind.

6
  • JOÃO FERREIRA DE MELO NETO
  • CEREBRAL VENOUS DRAINAGE IN PATIENTS WITH DURAL ARTERIOVENOUS FISTULAS – CORRELATION WITH CLINICAL PRESENTATION

  • Advisor : ANTONIO MANUEL GOUVEIA DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • CARLOS CLAYTON MACEDO DE FREITAS
  • KOSHIRO NISHIKUNI
  • ANTONIO MANUEL GOUVEIA DE OLIVEIRA
  • MARIO EMILIO TEIXEIRA DOURADO JUNIOR
  • ROBERTO BEZERRA VITAL
  • Data: Aug 6, 2020


  • Show Abstract
  • Background: Dural arteriovenous fistulas (DAVFs) are abnormal, acquired arteriovenous connections within the dural leaflets.  Symptoms may be mild or severe and are related to the patient’s venous anatomy.

    Objective: Our hypothesis is that the patient’s venous anatomy determines development of symptoms. The aim is to identify which venous anatomy elements are important in the development of major symptoms in patients with a DAVF. Methods: Multicenter study based on the retrospective analysis of cerebral angiographies with systematic assessment of brain drainage pathways (including fistula drainage) in patients over 18 years of age with single DAVF. The patients were divided into two groups, with minor  (group 1, n=112) and with major symptoms (group 2, n=89). Group 2 was subdivided into 2a – hemorrhage (n=47) and 2b- severe non-hemorrhagic symptoms (n=42). Results: The prevalence of stenosis in DAVF venous drainage and identification of tiny anastomoses between venous territories was significantly higher in group 2 (32.6% and 19.1%, respectively) when compared to group 1 (2.68% and 5.36%, respectively). Stenosis of DAVF venous drainage was significantly more frequent in group 2a than in group 2b (51.1% vs. 11.9%, p<0.001). Group 2b patients had increased prevalence of shared use of the cerebral main drainage pathway (85.0% vs. 53.2%, p=0.002), absence of an alternative route (45.0% vs. 17.0%, p=0.004) and presence of contrast stagnation (62.5% vs. 29.8%, p=0.002) when compared to group 2a. In patients with high-grade fistula the group with major symptoms had increased prevalence of a single draining direction (31.3% vs. 8.33%, p=0.003), stenosis in the draining vein (35.0% vs. 6.25%, p=0.000), absence of an alternative pathway for brain drainage (31.3% vs. 12.5%, p=0.017) and presence of contrast stagnation (48.8% vs. 22.9%, p=0.004). Conclusions: Major symptoms were observed when normal brain tissue venous drainage was impaired by competition with DAVF (predominance in group 2b) or when DAVF venous drainage had anatomical characteristics that hindered drainage, with consequent venous hypertension on the venous side of the DAVF (predominance in group 2a). The same findings were observed when comparing two groups of patients with high-grade lesions, those with major versus those with minor symptoms.

7
  • VESCIA VIEIRA DE ALENCAR CALDAS
  • LIFE-SPACE AND COGNITIVE DECLINE IN ELDERLY PEOPLE LIVING IN DIFFERENT SOCIAL AND ECONOMIC CONTEXTS: LONGITUDINAL RESULTS OF IMIAS STUDY  

  • Advisor : RICARDO OLIVEIRA GUERRA
  • COMMITTEE MEMBERS :
  • RICARDO OLIVEIRA GUERRA
  • EDUARDO CALDAS COSTA
  • FABRICIA AZEVEDO DA COSTA CAVALCANTI
  • ARMELE DE FATIMA DORNELAS DE ANDRADE
  • ETIENE OLIVEIRA DA SILVA FITTIPALDI
  • Data: Aug 17, 2020


  • Show Abstract
  • Background: Psychosocial, socioeconomic and sociocultural aspects can influence cognitive function among community-dwelling older adults. Life-space restriction is potentially related to cognitive status. We examined the longitudinal association between life-space mobility and changes in cognitive function in community-dwelling older adults in different social settings of North and South America and Europe. Methods: We used data from 1486 participants of the International Mobility in Aging Study (IMIAS) conducted at five sites: Tirana (Albania), Natal (Brazil), Manizales (Colombia), Kingston and Saint-Hyacinthe (Canada). The IMIAS study methodology has been previously described (Gomez, 2018). Central tendency and dispersion measures were used to describe the sample at the baseline and in the segment. To analyze the relationship between cognition and the use of living space, quantile regression (RQ) was used. The analysis evaluated factors related to cognitive function in 2016, by adjusting the score obtained in 2012. For this analysis, two models were made: an initial model with socioeconomic characteristics, living arrangements and social support; and a second model with the same previous variables adding measures of physical performance, depressive symptoms and chronic conditions (group of clinical variables). The use of living space was assessed using the Life-Space Assessment (LSA), applied at the baseline (2012) and the Leganés Cognitive Test (PCL) was used to assess the cognitive function at the baseline and at the follow- up (2016). Results: Women had a more restricted use of living space than men (p <0.001), and these gender differences were present in all research sites. The gender difference becomes even more evident than in the boundary categories (categories I and V). A larger number of women were classified in category I (p <0.001) and this gender difference was greater in Natal, Manizales and Saint-Hyacinthe. Results: A decrease in the cognitive function was observed at all research sites, except in Manizales. Participants with more restricted life-space at baseline had a decrease in their cognitive function 4 years later (β=-0.79, 95% CI: -1.400 to -0.18, p-value<0.01) compared to those with the highest level. This decrease was independent of gender, age, research site, education, income sufficiency, social support, depression, cognitive function at baseline, chronic conditions and physical performance. Conclusions: Restriction in life-space is an important prognostic factor for cognitive function. Maintaining life-space can be a goal in public policies aimed at encouraging healthy aging, and might be useful in clinical practice to promote health status and to monitor older people at higher risk of cognitive decline.

8
  • RENATO FERREIRA DE ALMEIDA JUNIOR
  • CHLOROQUINE NANOPARTICLES IN TYPE 1 DIABETES MELLITUS: A NEW IMMUNOMODULATORY THERAPY

  • Advisor : ADRIANA AUGUSTO DE REZENDE
  • COMMITTEE MEMBERS :
  • ADRIANA AUGUSTO DE REZENDE
  • JOAO FELIPE BEZERRA
  • Juliano Carlo Rufino de Freitas
  • MARCELA ABBOTT GALVAO URURAHY
  • MARCELO DE SOUSA DA SILVA
  • Data: Sep 18, 2020


  • Show Abstract
  • Inflammation associated with type 1 Diabetes mellitus (T1DM), contribute to the development of micro and macrovascular complications. In this context, chloroquine (CQ), an anti-inflammatory drug, appears as a potential adjunctive treatment in control inflammation. In addition, the use of this drug incorporated in nanoparticles will increase its bioavailability, improving the pharmacological response. This study aimed to evaluate the effect of CQ and chloroquine nanoparticles (CQ NP) on proinflammatory cytokine mRNA expressions in peripheral blood mononuclear cells (PBMC) of T1DM patients. Twenty-five normoglycemic individuals and 25 T1DM patients both aged 10-16 years were selected. Then PBMC of all of the individuals were isolated, and divided into 2 groups: normoglycemic (NG) and diabetic type 1 (T1DM). Successively, T1DM was subdivided into 3 groups: untreated (NT), CQ treated (CQ) and treated with CQ NP (CQ NP). Subsequently the cells were incubated for a period of 48 hours and up to 24 hours the mRNA expressions of IL1B, IFNG, TNFA, IL12 and IL10 were determined by relative quantification in real time PCR. Analysis of cytokine mRNA expression showed that administration of CQ reduced gene expression of inflammatory cytokines. In conclusion, CQ and CQ NP has been shown to be an adjuvant in the treatment of T1DM.

9
  • RÔMULO DOS SANTOS CAVALCANTE
  • IMMUNOMODULATION OF BREAST CANCER MICROENVIRONMENT BY HA-PEI-PLGA-MTX NANOPARTICLES COMBINED WITH ANTI-PD-L1 VIA SUPPRESSION OF IL-10/STAT3/NF-ΚB SIGNALING AXIS

  • Advisor : RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • COMMITTEE MEMBERS :
  • ADRIANA AUGUSTO DE REZENDE
  • KARUZA MARIA ALVES PEREIRA
  • PAULO MARCOS DA MATTA GUEDES
  • RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • RENATA FERREIRA DE CARVALHO LEITÃO
  • Data: Oct 2, 2020


  • Show Abstract
  •  

     

    Inflammation associated with the tumour microenvironment (TME) in breast cancer is closely related to the development and progression of the tumour. In this sense understand the involved mechanisms, as well as ways to combat the inflammatory process is challenging and has been widely investigated. In this study, a novel immunotherapeutic approach using PLGA-based drug nanocarrier (methotrexate - MTX), covered with polyethyleneimine (Pei) and hyaluronic acid (HA), combined with anti-PD-L1 immune checkpoint inhibitor is suggested as way to reduce the development and progression of breast cancer through immunomodulating its tumour microenvironment. From the allographic model of orthotopic breast cancer development, the tumours were evaluated by qRT-PCR and immunohistochemistry. Complementary analysis of biocompatibility and internalization of nanoparticles, as well as the investigation of cell death profile, cells migration and polarization of macrophages were evaluated in vitro. Naked or HA-coated PeiPLGA-MTX nanoparticles, alone or combined with anti-PD-L1, promoted immunomodulation of the tumour microenvironment and consequent alteration in the tumorigenic course with significant reduction of the primary tumour and metastasis. In addition, the same treatments were able to considerably reduce the M2 macrophages population, as well as promoting downregulation of IL-10 / STAT3 / NF-κB signalling axis in the tumour microenvironment. The suppression of this signalling axis, especially in M2 macrophages, appears to have disrupted the crosstalk between immune and malignant cells, thus reducing critical pro-tumour events, such as: immune escape; cell survival; drug and apoptosis resistance, as well as some key mechanisms in the epithelial-mesenchymal transition. Such results shed light on the understanding of immunological mechanisms that underlie tumour progression and brings up a promising drug nanocarrier capable of satisfactorily modulating the immunological tumour microenvironment of breast cancer.

10
  • OLÍVIA DAYSE LEITE FERREIRA
  • VALIDITY EVIDENCE OF THE PREFRONTAL SYMPTOMS INVENTORY FOR THE ELDERLY POPULATION WITH AND WITHOUT DEMENTIA

  • Advisor : JOAO CARLOS ALCHIERI
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • JOAO CARLOS ALCHIERI
  • LEOPOLDO NELSON FERNANDES BARBOSA
  • NELSON TORRO ALVES
  • THAIZA TEIXEIRA XAVIER NOBRE
  • Data: Oct 14, 2020


  • Show Abstract
  • Aging causes a series of psychological, biological and social changes in the life of individuals. Constantly, a decline in cognitive functions is observed, which can be a possible risk factor for the development of Alzheimer’s disease (AD). For the diagnosis of AD one of the resources used by clinicians has been cognitive screening tests. The use of clinical interviews and behavioural inventories are also seen as relevant, in this aspect, an instrument of Spanish origin stands out, naming Prefrontal Symptoms Inventory (PSI). Therefore, the aim of this study was to adapt this instrument to Brazilian Portuguese and to look for evidences of validity for the elderly population with and without dementia. For this, the PSI-20 was initially adapted idiomatically and culturally and subsequently applied to 256 elderly with and without the diagnosis of probable AD, aged over 60 years of both sexes, and at least one year of formal schooling. The participants also answered a clinical interview, the Mini Mental State Examination (MMSE), the Frontal Assessment Battery (FAB) and the Geriatric Depression Scale (GDS). The results showed satisfactory adjustment indexes and adequate reliability (Ω of 0.83 and α = 0.80) for the unifactorial model. The non clinical group exhibited significant correlations between the PSI-16, the GDS-15, the MMSE, the FAB and their six subtests, however in the clinical group there were negative correlation only among the PSI-16, the MMSE, the BAF and the conceptualization subtest. In the comparison between the groups, statistic differences were found, with the clinical sample showing higher punctuation in the PSI-16. When checking the accuracy of the PSI to the diagnosis of probable AD. In the total sample, the cutting point of the PSI-16 was >19 points, with sensibility (SE) of 72%, and specificity (ES) of 68% (moderate). The accuracy of the FAB was similar to the one of the PSI-16 and the MMSE displayed SE (80%) and ES (72%) higher. The accuracy, the SE and the ES in the group with high schooling level was superior for all the instruments, when compared with the low schooling level. Regarding the division between the ages of the participants, the accuracies of the PSI-16 and of the MMSE remained similar, the SE of all the instruments increased and the ES obtained a decline, considering elderly people aged more than 70 years old. Therefore, the PSI-16 may be used as a valid and reliable tool for the clinical use in the population of elderly people with and without pathology, being a self report suitable instrument to track behavioural problems related to the prefrontal cortex.

11
  • MICHELLE VASCONCELOS DE OLIVEIRA BORGES
  • CARDIORRESPIRATORY FITNESS, BODY COMPOSITION AND BIOCHEMICAL PARAMETERS IN MONOZYGOTH AND DIZIGOT TWINS

  • Advisor : PAULO MOREIRA SILVA DANTAS
  • COMMITTEE MEMBERS :
  • ANDRE DUCATI LUCHESSI
  • GERALDO BARROSO CAVALCANTI JUNIOR
  • PAULO MOREIRA SILVA DANTAS
  • RODOLFO DE ALKMIM MOREIRA NUNES
  • VINÍCIUS CUNHA DE OLIVEIRA
  • Data: Oct 16, 2020


  • Show Abstract
  • Introduction: The relationship between the Cardiorespiratory Optimal Point with body composition measures and biochemical variables is unknown, as well as the influence of genetic and environmental factors on this variable. In addition, research that uses discordant twins for physical exercise and evaluates their effects on metabolic risk factors is rare. Aim: To evaluate cardiorespiratory fitness, body composition and biochemical parameters in concordant and discordant twins for physical exercise. Methods: Cross-sectional study with adult twins. The sample consisted of 102 twins, 72.5% females and 27.5% males, with a mean age of 25.4 ± 5.69. Data collection was carried out between the years 2016 and 2018. On day 1, an assessment of the fitness of the whole body was not found, including anthropometric measures, body composition by Dual-Energy X-ray Absorptiometry, and Cardiorespiratory Exercise Test. On day 2, a 10 ml blood sample was collected (overnight fasting) to determine the lipid profile and fasting blood glucose. Spearman's correlation was used to verify heritability and to relate the variables to the Cardiorespiratory Optimal Point. The monozygote twins were separated into three groups: active concordant twins, inactive concordant twins and discordant pairs for physical exercise. The ANOVA test (p <0.001) was used for analysis between the groups and the Wilcoxon test (p <0.05) for an intrapar analysis. Results: There were no associations between Cardiorespiratory Optimal Point and body composition variables. The biochemical variables HDL, LDL, GLI and TG dissipated, but moderate. Differences were observed between pairs of discordant twins and groups for variables of body composition and metabolic profile including maximum oxygen consumption (VO2max), oxygen consumption corresponding to the first and second ventilatory threshold, lipid profile and fasting blood glucose. Conclusion: The Cardiorespiratory Optimal Point and the biochemical variables in general, showed a greater tendency to be influenced by environmental factors. Body composition, on the other hand, had a greater influence on heritability and compliance was not correlated with the cardiorespiratory optimum. In addition, the practice of physical exercises was sufficient to generate changes in body composition and VO2max in monozygotic twins, but not in the lipid profile or fasting glucose.

12
  • LENILTON SILVA DA SILVEIRA JUNIOR
  • STUDY OF ACUTE MYELOID LEUKEMIAS: CELL MARKERS AND PROGNOSTIC FACTORS.

  • Advisor : GERALDO BARROSO CAVALCANTI JUNIOR
  • COMMITTEE MEMBERS :
  • ALDO DA CUNHA MEDEIROS
  • AMALIA CINTHIA MENESES DO REGO
  • ANA CLAUDIA GALVAO FREIRE GOUVEIA
  • CARLOS ROBERTO ALVES
  • GERALDO BARROSO CAVALCANTI JUNIOR
  • Data: Oct 26, 2020


  • Show Abstract
  • Acute myeloid leukemia (AML) is a clonal disease of hematopoietic tissue and accounts for 80% of leukemia cases in adults. It is divided into seven subtypes (M0 to M7), according to the classification of the Franco-American-British group. Despite great advances in chemotherapy, there are still cases of acute leukemias refractory to treatment or recurrence of the disease, triggered by mechanisms of multiple drug resistance (MDR), with the extrusion of chemotherapy agents by drug efflux pumps, one of the main mechanisms. The analysis of glycoprotein P (PgP) and protein associated with resistance to multiple drugs (MRP), by flow cytometry, was the target of this study, which showed that both the expression of both was prevalent in older patients and the incidence was showed greater in cases of refractoriness, recurrence and secondary disease when compared to cases of AML “de novo”. The use of these markers as a parameter of the MDR profile helps in the diagnosis and treatment of acute leukemias, in addition to being a prognostic marker for patients with AML.

13
  • ITALO MEDEIROS DE AZEVEDO
  • DIAGNOSTIC ACCURACY OF 18F-FDG-PET IN ABDOMINALSEPSIS IN RATS

  • Advisor : ALDO DA CUNHA MEDEIROS
  • COMMITTEE MEMBERS :
  • ALDO DA CUNHA MEDEIROS
  • AMALIA CINTHIA MENESES DO REGO
  • CIPRIANO DA CRUZ FORMIGA
  • FRANCISCO IROCHIMA PINHEIRO
  • GERALDO BARROSO CAVALCANTI JUNIOR
  • Data: Oct 30, 2020


  • Show Abstract
  • Objective: The objective of this study was to investigate the accuracy of 18F-FDG-PET in the diagnosis of multibacterial abdominal sepsis by ligation and puncture of the cecum in rats. Methods: Adult male rats (Rattus norvegicus) from the Wistar strain, weighing 227±35g, were divided into a sepsis group by ligation and puncture of the cecum (n = 10) and control (n = 10). Positron emission tomography using microPET was performed on all rats after 24 hours of observation. Results: Results: All animals survived until the end of the observation period. The ratio of the SUV percentage captured in the abdomen and liver was significantly higher in the sepsis group than in the control group (p=0.004). The ROC curve showed an accuracy of 18F-FDG-PET to detect abdominal sepsis of 88.9% (p=0.001), with a sensitivity of 90% and a specificity of 88.9%. When a cut-off point of 79% of the ratio between the uptake on the abdominal region and liver was established, the sensitivity was 90%, specificity of 88.9%; positive and negative predictive values of 90.0% and 88.9%, respectively. Conclusion: In conclusion, the diagnostic accuracy of 18F-FDG-PET in rats with abdominal sepsis was very high. It also demonstrated the predictive ability of the uptake relationship between the infected area and the liver. It can be useful to locate abdominal septic foci by using full body screening.

14
  • ARTHUR SÉRGIO AVELINO DE MEDEIROS
  • DEVELOPMENT OF CATIONIC NANOEMULSION FOR VENOM-LOAD OF TITYUS SERRULATUS SCORPION AND EVALUATION OF EFFICACY FROM SERUM PRODUCED BY IMMUNIZED MICE

  • Advisor : ARNOBIO ANTONIO DA SILVA JUNIOR
  • COMMITTEE MEMBERS :
  • ARNOBIO ANTONIO DA SILVA JUNIOR
  • ERYVALDO SOCRATES TABOSA DO EGITO
  • MATHEUS DE FREITAS FERNANDES PEDROSA
  • CAROLINA ALOISIO
  • ANSELMO GOMES DE OLIVEIRA
  • Data: Nov 18, 2020


  • Show Abstract
  • Scorpion stings are major cause of envenoming by animals for endemic countries, like Brazil. The antivenom is a neutralizing drug to protect susceptible people, but its production is subject of improvements, like adjuvant innovations and the difficulty of venom extraction from captive animals and its toxicity. Scorpion venom has a complex composition and an adjuvant for crude venom presents a challenge that can be possibly fulfilled with drug delivery systems based on nanotechnology. In this research, we seek for innovation developing new nanoemulsion formulations to act as drug delivery system for Tityus serrulatus scorpion venom and to evaluate immunizing Balb/C mice. The nanotechnology development covered features that positively affected adjuvant activity. We demonstrated that low energy techniques for obtainment nanoemulsions allowed long term stability to the formulations with reduced and uniform droplet size (below 200 nm). The developed formulations were also robust to pH and saline adjustment and to cationic covering with poly(ethyleneimine) (PEI) maintaining stability. The formulations demonstrated capable to nonspecifically adsorb crude venom, as showed through FTIR spectroscopy technique as intermolecular interactions between nanoemulsions and crude venom. Nanoemulsions venom-load also could reduce toxicity related to venom hemolytic activity and to present low toxicity against macrophage cells (RAW 264.7). Adjuvant activity was demonstrated in comparison with aluminum hydroxide adjuvant, which scored for nanotechnology feature of act as crude venom adjuvant more efficiently to induce specific anti-IgG immunoglobulins using PEI-covered nanoemulsions.

15
  • MICHELLY NOBREGA MONTEIRO
  • EFFECT OF PHYSIOTHERAPY ON SEXUAL FUNCTION OF WOMEN IN THE POSSIBLE VAGINAL AND CESARIAN PARLIAMENT: RANDOMIZED CLINICAL TRIAL

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • JANAINA CRISTIANA DE OLIVEIRA CRISPIM FREITAS
  • ROBINSON DIAS DE MEDEIROS
  • JOSÉ ELEUTÉRIO JÚNIOR
  • LUCIA ALVES DA SILVA LARA
  • Data: Dec 4, 2020


  • Show Abstract
  • Pregnancy is an extremely important phase in a woman's life and her experience is influenced by some factors, including hormonal, physical and psychological changes. During this period, these transformations have a great impact on their own concept of what sexuality is, generally leading to problems in their life together.

    Many uncertainties and anxieties permeate and sometimes impact the daily lives of women, and consequently their sexual partners, especially in relation to the period of pregnancy-puerperium. Some studies indicate that both pregnancy and the puerperium are an important phase for the appearance of sexual problems and / or urinary incontinence (UI), and some women may have decreased sexual interest in general, at this stage of life.

    The presence of sexual dysfunction can be a factor resulting from a sum of factors, which promote total or partial barriers in the woman's sexual response related to desire, excitement and orgasm. The World Health Organization (WHO) considers sexual dysfunction to be an important public health problem and, due to the damage it has been proven to cause to quality of life, should be investigated.

    This study is a randomized clinical trial conducted between July and December 2019, where data were collected on 56 women admitted to the Puerperio Wards of the Maternidade Escola Januário Cicco, which were divided into four groups: vaginal delivery without Intervention Physiotherapy - IF (n = 14), vaginal delivery with IF (n = 14), cesarean delivery without IF (n = 14) and cesarean delivery with IF (n = 14). The IF consisted of a physiotherapy training program in pelvic floor musculature, including pelvic floor exercises with manual awareness, pelvic floor exercise with dissociation of adductors, exercises with the sitting patient and standing exercises. In addition, the FSFI (Female Sexual Function Index) questionnaires were applied in order to assess the female sexual response in the postpartum period and the ICIQ-SF (International Consultation on Incontinence Questionnaire - Short Form), to assess the impact of Incontinence Urinary quality of life and qualifies urinary loss. The volunteers

    signed the Free and Informed Consent Form (ICF) and were evaluated during the 48 hours after delivery (still hospitalized), and in the second and third months postpartum, this monitoring was carried out at the Ambulatory of Puerperium of the referred maternity .

    The data collection of the two groups not submitted to FI occurred in four stages: (1) Application of the evaluation form, questionnaires (sociodemographic, FSFI and ICIQ-SF) and physical examination of the parturient women with vaginal manometry; (2) Assistance during the immediate postpartum period, consisting of four Physiotherapy sessions in the first 48 hours after delivery; (3) Revaluation 2nd month: reevaluation of the puerperal woman between 40 and 60 days after the date of delivery; (4) Revaluation 3rd month: reevaluation of the puerperal woman 90 to 100 days after the date of delivery. Data collection from the other two groups submitted to FI also took place in four stages: (1) Application of the evaluation form, questionnaires and physical examination to parturients; (2) Assistance during the immediate puerperium period, consisting of four Physiotherapy sessions in the first 48 hours after delivery and delivery of a booklet with exercises for the Pelvic Floor and postpartum care; (3) Revaluation 2nd month: reevaluation of the puerperal woman between 40 and 60 days after the date of delivery, with delivery of a booklet with other exercises for the Pelvic Floor; (4) Revaluation 3rd month: reevaluation of the puerperal woman 90 to 100 days after the date of delivery.

    A database was created in an Excel / Office 2000 software spreadsheet with all study variables. The cases were listed chronologically, attributing inherent variables to each one. The database was exported to EPI INFO, where initial data typing consistency was carried out through manual listing of the listing. Descriptive statistics were performed to present the socio-epidemiological characteristics of the research volunteers. Inferential statistics were used to establish the possible differences between the groups, and for the analysis of the primary outcome (sexual function) and the secondary outcomes (UI and vaginal manometry), the repeated measures anova tests and the 2x2 anova tests were used in order to to establish differences between groups, exceptionally, for vaginal manometry since only 2 evaluations were possible.

    This research was approved by the Research Ethics Committee of Hospital Onofre Lopes (CEP-HUOL), linked to the Federal University of Rio Grande do Norte (UFRN), following the rules recommended by the “Declaration of Helsinki” and its modifications (DECLARATION OF HELSINKI, 2000) and Resolution 466/12 of the National Health Council (BRASIL, 2012).

    In general, the observed result was that over time there was an improvement in all outcomes, but there was no time versus group interaction.

    Improvement in sexual function was observed (p = 0.000), impact of urinary incontinence on quality of life (p = 0.000) and pressure of the muscles of the pelvic floor muscles (p = 0.000) over time (Figure 1). On the other hand, no time versus group interaction for sexual function was observed F (2, 52) = 0.13, p = 0.87, impact of urinary incontinence on quality of life F (2, 52) = 0.12, p = 0.88 and pressure of the pelvic floor muscles (p = 0.66).

    The evaluation of the degree of sexual satisfaction of women is a current and constant problem, since numerous variables, such as social, human, biological, psychological, physiological, cultural taboos, which can influence the degree of final sexual satisfaction.

    The sexual complaint is one of the most frequent problems in the daily practice of the tocogynecologist, and unfortunately it continues to be approached in a very simplistic way most of the time. Considering that sexual dysfunction may be associated with an increased risk of conflicts between the couple during pregnancy, the etiological diagnosis of this condition is important, so that appropriate treatment can be instituted when necessary, thus avoiding the many emotional problems, the non-acceptance of sexual relations during pregnancy, the fear of resuming this activity, among others, assessing the correlation of the mode of delivery with sexual dysfunction in the puerperium.

    The motivation and benefit of this study was to investigate Physiotherapy as a facilitating agent in the puerperium, progressively improving sexual function. With the results of the study, it shows that the training of the pelvic floor muscles can emerge as an important alternative for the prevention and treatment of this type of woman's condition, reducing possible physical and emotional complications. 

16
  • JEANE FRANCO PIRES
  • EVALUATION OF VITAMIN D SUPPLEMENTATION IN GENE EXPRESSION AND PHYSICAL FITNESS IN TWINS

  • Advisor : ANDRE DUCATI LUCHESSI
  • COMMITTEE MEMBERS :
  • ANDRE DUCATI LUCHESSI
  • PAULO MOREIRA SILVA DANTAS
  • KARINE CAVALCANTI MAURICIO DE SENA EVANGELISTA
  • MARIA DA CONCEICAO RODRIGUES GONCALVES
  • RAUL HERNANDES BORTOLIN
  • Data: Dec 11, 2020


  • Show Abstract
  • The presence of the vitamin D receptor in various human cells and tissues, relating vitamin D to several non-skeletal physiological processes has been generating interest in research that helps to better understand this relationship.  In addition, prophylactic supplementation with this nutrient is growing every day, in all age groups. Thus, the aim of this study was to evaluate the effect of vitamin D3 supplementation on VDR gene expression, body composition, cardiorespiratory fitness and muscle strength in healthy adults. It was a study carried out in adult monozygotic twins, of the longitudinal randomized clinical trial type, divided into two groups: control group (without treatment) and supplemented group (with individual daily supplementation of 2000 IU / day of vitamin D3 for 60 days). Biochemical analyzes, body composition analyzes were performed using double beam absorptiometry, analysis of cardiorespiratory fitness in a Cortex Ergospirometer, evaluation of muscle strength by the handgrip and scapular strength test and gene expression by real-time PCR.  The statistical analysis was performed using the statistical software IBM SPSS version 20.0 for Windows. Our results showed that there was a significant increase in serum vitamin D levels in the supplemented group compared to those who did not use the supplement. (65% increase), as well as the expression of the VDR gene (p = 0.001). We observed improvements in physical fitness parameters, with reduced body fat and increased VO2max after supplementation. Thus, we conclude that the increase in serum vitamin D levels above 30 ng / mL can bring benefits to the health of the population.

17
  • MARCO AURÉLIO VIANELLO
  • BACTERIAL RESISTANCE TO FLUORQUINOLONES IN INDIGENOUS INDIVIDUALS FROM THE BRAZILIAN AMAZON

  • Advisor : ERYVALDO SOCRATES TABOSA DO EGITO
  • COMMITTEE MEMBERS :
  • ALESSANDRO CONRADO DE OLIVEIRA SILVEIRA
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • ERYVALDO SOCRATES TABOSA DO EGITO
  • GUILHERME MARANHAO CHAVES
  • NILTON ERBET LINCOPAN HUENUMAN
  • RODRIGO DE ALMEIDA VAUCHER
  • Data: Dec 16, 2020


  • Show Abstract
  • The global dissemination of multidrug-resistant Escherichia coli lineages belonging to high- risk clones poses a significant public health threat. Herein we report the identification and genomic profiling of two multidrug-resistant E. coli strains [BL-II-03(2) and BL-II-11(3)] belonging to the O15:H1‐ D‐ ST393 (clonal complex 31) worldwide spread clone, isolated from fecal samples of indigenous peoples belonging to two different ethnic groups of remote communities of Brazilian Amazon. Agreement of genotype-phenotype prediction of antimicrobial resistance was confirmed. In this regard, genomic analysis revealed genes and mutations conferring resistance to β-lactams [bla EC , bla TEM-1 ], aminoglycosides [aadA5, aph(3'')-Ib, aph(6)-Id], tetracyclines [tetB], sulfamethoxazole/trimethoprim [sul1, sul2, dfrA17], and fluoroquinolones [gyrA (D87N, S83L), parC (S80I, S57T), parE (L416F)]. On the other hand, phylogenomics of globally reported E. coli ST393 assigned E. coli strains BL- II-03(2) and BL-II-11(3) to a cluster comprising human isolates from Australia, Canada, China, Sweden, and United States of America. These results might provide valuable information for understanding dissemination of intercontinental multidrug-resistant clones in remote communities with low levels of antibiotic exposure.

18
  • SILVANA CARTAXO DA COSTA URTIGA
  • DEVELOPMENT OF XYLAN MICROPARTICLES CONTAINING MESALAMINE FOR COLON DRUG RELEASE

  • Advisor : ERYVALDO SOCRATES TABOSA DO EGITO
  • COMMITTEE MEMBERS :
  • ARNOBIO ANTONIO DA SILVA JUNIOR
  • ELQUIO ELEAMEN OLIVEIRA
  • ERYVALDO SOCRATES TABOSA DO EGITO
  • FRANCELINE REYNAUD
  • FRANCISCO HUMBERTO XAVIER JUNIOR
  • RAQUEL BRANDT GIORDANI
  • Data: Dec 18, 2020


  • Show Abstract
  • Xylan is an important biopolymer that can be extracted from several agro-wastes in the world and has been receiving a great attention in the production of colon drug delivery systems. This polymer has the ability to pass through the digestive tract unchanged and its complex structure requires enzymes that are produced specifically by the human colonic microflora, which makes it an interesting raw material in the production of targeted drug delivery systems. In this work, xylan extracted from corn cobs was used to produce mesalamine-loaded xylan microparticles (XMP5-ASA) by cross-linking polymerization using a non-hazardous cross-linking agent. The microparticles were characterized by thermal analysis (DSC/TG), X-ray diffraction (XRD), Infrared spectroscopy (FTIR-ATR) and scanning electron microscopy (SEM). A comparative study of the in vitro drug release from XMP5-ASA and from gastro-resistant capsules filled with XMP5-ASA (XMPCAP5-ASA) or 5-ASA was also performed. NMR, FTIR-ATR, XRD and DSC/TG studies indicated molecularly dispersed drug in the microparticles with increment on drug stability. The release studies showed that XMPCAP5-ASA allowed more efficient drug retention in the simulated gastric fluid and a prolonged drug release lasting up to 24 h. XMPCAP5-ASA retained approximately 48 % of its drug content after 6 h on the drug release assay. Thus, the encapsulation of 5-ASA into xylan microparticles together with gastro-resistant capsules allowed a better release control of the drug during different simulated gastrointestinal medium.

2019
Dissertations
1
  • KLEYTON SANTOS DE MEDEIROS
  • NEW TECHNOLOGIES OF HEALTH CARE: USE OF MOBILE APPLICATIONS IN GYNECOLOGY AND ONCOLOGY

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • JANAINA CRISTIANA DE OLIVEIRA CRISPIM FREITAS
  • PAULO CESAR GIRALDO
  • Data: Mar 22, 2019


  • Show Abstract
  • Introduction: About 25% of new antineoplastic agents in development are estimated to be oral drugs, and the number of oral chemotherapy medications is expected to more than double over the next few years. However, the average rate of non-adherence to oral anti-cancer therapy is estimated to be around 21%, that is, poor adherence is a barrier to completing the treatment. Many factors can affect the treatment adherence:  complex dosing regimens, administration of other potentially interacting medications, visual and cognitive impairment, memory deficits or forgetfulness can pose other difficulties. In this context, it is necessary to verify if the use of mobile applications can help the patient to overcome those difficulties and improve the adherence to treatment. We describe the mobile ChemoDaily a novel tool which integrates manage care and oncology treatment with oral drug chemotherapy. Methods: It is applied research in the production modality technological was divided into three steps. First,  this phase involved the needs of the patients in a cancer center  treatment,  search for similar applications in the 'App Store' and 'Play store,' search bibliographic references and the definition of the aims and functions of the App. Second, The design involved the planning and the production of the content, description of the topics of the writing about health education, selection of the forms of media and the design of the interface (layout). Third, the mobile app (ChemoDaily) was developed. The development included the selection of the tools of the multimedia application, the definition of the navigation structure and the planning of the configuration of environments. ChemoDaily was developed as a mobile device application (app) on android platform for Nursing orientations in the use of oral anti-neoplastic chemotherapy.  Results: ChemoDaily is an app designed for patients taking oral chemotherapy at home to clarify doubts such as oral taking chemotherapy and control of side effects. Additionally aims to improve patient communication with health professionals; monitor the symptoms in the chemotherapy diary; clarify uncertainties in the use of chemotherapy; facilitate access to contacts hospital phone calls; collaborate in shared decision-making among health professionals and the patient who uses the chemotherapy diary; access to package inserts. Conclusion: Modern communication technology can be utilized to improve both the self-care and the management of the patient’s long distance. ChemoDaily provides a secure, reliable, easy-to-use tool for patients to monitor your health and record patients’ clinical progress, treatment history; and their intercurrences; their state of humor; manage the stock of medicines; know how to use the medication and nursing care with manipulation and storage; and agenda of consultations. We believe that ChemoDaily will prove to be a powerful and widely used tool, which will enhance both research and clinical practice, as well as adherence to oncologic treatment and patients' quality of life. Anyway, adherence to novel oral therapies is a significant issue, and further research is warranted to improve long-term adherence in oncology practice.

2
  • MAÍRA MARIA DE MENEZES
  • A low molecular weight galactofucan from seaweed Spatoglossum schröederi binds fibronectin and inhibits capillary-like tube formation in vitro.

  • Advisor : HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • COMMITTEE MEMBERS :
  • DEBORAH YARA ALVES CURSINO DOS SANTOS
  • GIULIANNA PAIVA VIANA DE ANDRADE SOUZA
  • HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • Data: Mar 23, 2019


  • Show Abstract
  • A low molecular weight (LMW) heterofucan (named fucan B) was obtained from the brown seaweed Spatoglossum schröederi and its activity as inhibitor on endothelial cell (EC) capillary-like tube formation was analyzed. Chemical, infrared and electrophoresis analysis confirmed the fucan B identity. In contrast to other LMW fucans, the fucan B (from 0.012 to 0.1 mg/mL) was able to inhibit EC capillary-like tube formation in a dose-dependent way. In addition, fucan B (from 0.01 to 0.05 mg/mL) did not affect EC proliferation. Fucan B also inhibits EC migration when fibronectin was substrate, but fail when laminin or collagen was substrate. This fucan was biotinylated and used as a probe to identify its action sites. When biotinylated fucan was assayed in confocal experiments, it did not show binding to the cell surface, but rather only to fibronectin. We suggested that fucan B inhibits EC capillary-like tube formation and EC migration because binds directly to fibronectin, and blocking fibronectin sites that are recognized by cell surface ligands. Our data indicate that further studies are needed to evaluate the in vivo effect of fucan B.  

3
  • KARINA MARQUES VERMEULEN
  • Relationship between zinc and functional parameters in healthy children and in boys with Duchenne Muscular Dystrophy
  • Advisor : JOSE BRANDAO NETO
  • COMMITTEE MEMBERS :
  • KARINE CAVALCANTI MAURICIO DE SENA EVANGELISTA
  • MARIA JOSÉ DE CARVALHO COSTA
  • SANCHA HELENA DE LIMA VALE
  • Data: May 23, 2019


  • Show Abstract
  • Childhood is a period of rapid growth and development. Zinc is a micronutrient that exerts important structural functions and acts in the maintenance of cellular functionality. Functional indicators of nutritional status for the evaluation of children include anthropometric indices and measures of body composition assessment. The parameters derived from bioelectrical impedance, phase angle (AP) and bioelectrical impedance vector analysis (BIVA) have been associated to the integrity of the cell membrane and cellular body mass. In addition, BIVA has been shown to be useful in evaluating other clinical conditions, where traditional assessment methods are not reliable. Duchenne Muscular Dystrophy (DMD) is a disease characterized by progressive loss of functional muscle mass followed by changes in body composition. To date, there are no studies evaluating the influence of different doses of oral zinc supplementation on cell integrity and functionality, using AF and BIVA as evaluation methods. The aim of this dissertation was to analyze the influence of zinc on functional and serum zinc parameters in healthy children and in children with DMD. For this to happen, two studies were conducted. The first one evaluated changes in the functional parameters of 71 healthy children supplemented orally with zinc at different concentrations (Study 1) and the second described the functional parameters in 41 boys with DMD (Study 2). As a result, we have seen that for healthy children supplementation with 10 mg Zn / day promoted changes in the integrity of the cell membrane associated with increased cell mass. We also found that, in comparison with the reference population, boys with DMD had lower levels of body cell mass. Understanding that zinc plays an important role in the cell membrane, the results of this dissertation will serve as the basis for a future study evaluating oral zinc supplementation in other populations.
4
  • VAGNER DEUEL DE OLIVEIRA TAVARES
  • CARDIORESPIRATORY FITNESS

    PREDICTS REACTION TIME ON INHIBITORY CONTROL IN PATIENTS WITH SUBSTANCE USE DISORDER

  • Advisor : EDUARDO BODNARIUC FONTES
  • COMMITTEE MEMBERS :
  • EDUARDO BODNARIUC FONTES
  • VANESSA DE PAULA SOARES RACHETTI
  • RODRIGO HOHL
  • Data: Jul 19, 2019


  • Show Abstract
  • Background: Impaired inhibitory control has been related in individuals with substance use disorder (SUD). Cardiorespiratory fitness has been shown to improve cognition in different populations. Aims: Investigate the relationship between cardiorespiratory fitness and inhibitory control.  Methods: Sixty-two male participants under treatment for SUD performed a general and drug-specific inhibitory control test (Go/No go) and a cardiorespiratory fitness test. Results: Cardiorespiratory fitness, age and time of use of substance were inversely associated with reaction time for both specific (r=-0.472, p<0.001) and general inhibitory control (r=-0.430, p<0.001). Regressions sho w that cardiorespiratory fitness controlling for age and time of drug use predicts specific [F (8.7; 3); t = -3.22; β = -0.420; p < 0.002] and general inhibitory control [F (6.6; 3); t = -3.06; β = -0.415; p < 0.003]. Conclusions: These findings suggest that cardiorespiratory fitness is an independent predictor of cognitive inhibitory control in individuals with SUD.

Thesis
1
  • KARLA SIMONE COSTA DE SOUZA
  • Evaluation of nephrine and podocin as early biomarkers of proteinuria associated with the use of mTOR inhibitors in renal transplant patients

  • Advisor : ADRIANA AUGUSTO DE REZENDE
  • COMMITTEE MEMBERS :
  • ADRIANA AUGUSTO DE REZENDE
  • BENTO JOAO DA GRACA AZEVEDO ABREU
  • CELSO CARUSO NEVES
  • ROSARIO DOMINGUEZ CRESPO HIRATA
  • TEREZA NEUMA DE SOUZA BRITO
  • Data: Feb 22, 2019


  • Show Abstract
  • (Nephrin; podocin; mTOR inhibitors; kidney transplantation)

2
  • LUIZ FERNANDO DE FARIAS JUNIOR
  • Physiological and psychological responses to high-intensity interval exercise and moderate-intensity continuous exercise in overweight/obese inactive adults: A crossover trial

  • Advisor : EDUARDO CALDAS COSTA
  • COMMITTEE MEMBERS :
  • ALEXANDRE SERGIO SILVA
  • EDUARDO CALDAS COSTA
  • EDUARDO ZAPATERRA CAMPOS
  • HASSAN MOHAMED ELSANGEDY
  • PAULO MOREIRA SILVA DANTAS
  • Data: Feb 22, 2019


  • Show Abstract
  • Purpose: To compare the physiological and psychological responses during and following (24 and 48 h) a single session of low-volume high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) in overweight/obese inactive adults. Methods: Twenty males (29.0 ± 5.0 years, 29.0 ± 3.7 kg.m-2) performed a single session of HIIE and MICE with one-week interval in a randomized and crossover order: i) HIIE (10 x 1 min at 85% of VO2max, 1 min passive recovery); ii) MICE (20 min at 40-60% of VO2max). The exercise sessions were isocaloric. During the exercise sessions the rating of perceived exertion (RPE), basic affect, perceived activation, self-efficacy, and oxygen uptake (VO2) were assessed. Immediately post-exercise the attentional focus, enjoyment, and future intention to engage in HIIE and MICE were measured. Before, 24 h, and 48 h post-exercise creatine kinase (CK), lactate dehydrogenase (LDH), interleukin-6 (IL-6), IL-10, and tumor necrosis factor alpha (TNF-α), pain threshold, tolerance and intensity in rectus femoris, biceps femoris, and gastrocnemius were assessed. Results: During the exercise, RPE, perceived activation, VO2, and distress thoughts were higher in the HIIE than in the MICE (P ≤ 0.02). Basic affect and self-efficacy were lower in the HIIE than in the MICE (P < 0.01). There was no difference in the enjoyment (P = 0.30) and future intention to engage in HIIE and MICE (P = 0.26). Also, there were no diferences in CK, LDH, IL-6, IL-10, TNF-α, and pain threshold, tolerance and intensity in all muscle analyzed 24 and 48 h post-exercise between HIIE and MICE (P ≥ 0.19). Conclusion: HIIE elicits aversive psychological responses in overweigth/obese adults, which does not occur during MICE. However, 24 and 48 h the muscle damage, inflammatory response, and delayed-onsed muscle soreness is similar between HIIE and MICE in these individuals.

3
  • JEFFERSON DA SILVA BARBOSA
  • In vitro Immunostimulatory Activity of Sulfated Polysaccharides from Caulerpa cupressoides var. flabelata.

  • Advisor : HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • COMMITTEE MEMBERS :
  • HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • SILVANA MARIA ZUCOLOTTO LANGASSNER
  • MARCELO DE SOUSA DA SILVA
  • DANIEL CHAVES DE LIMA
  • VALQUIRIA PEREIRA DE MEDEIROS
  • Data: May 24, 2019


  • Show Abstract
  • Green seaweeds are rich sources of Sulfated Polysaccharides (SP) with potential biomedical and biotechnological applications. The aim of this work was to evaluate the immunostimulatory activity of PS from seaweed Caulerpa cupressoides var. flabelata on murine macrophages RAW264.7. PS were extracted and fractionated by acetone precipitation and evaluated for the ability to modify cell viability and to stimulate the production of inflammatory mediators such Nitric Oxide (NO), Intracellular Oxygen Reactive Species (ROS) and cytokines. Additionally, its effect on Nitric Oxide Synthase (iNOS) and Cyclooxygenase 2 (COX-2) genes expression, as well as the mode of interaction of PS and macrophages, was evaluated. The results revealed that the PS were not cytotoxic and were able to promote a strong increase in the production of NO, ERO and the cytokines Tumor Necrosis Factor alpha (TNF-α) and Interleukin 6 (IL-6). It was also observed that treatment with the PS increased the gene expression of  iNOS and COX-2. Through flow citometry and confocal microscopy was verified that SP was internalized and deposited near the nuclei of the cells. Together, these results indicate that C. cupressoides var flabelata PS have a strong immunostimulatory activity with potential biomedical applications

4
  • LUCAS AMARAL MACHADO
  • A TECHNOLOGICAL APPROACH TO INCREASE THE CYTOTOXIC EFFECT OF BULLFROG (Rana catesbeiana Shaw) OIL, in natura, AGAINST A2058 MELANOMA CELLS (AN in vitro EVIDENCE)

  • Advisor : ERYVALDO SOCRATES TABOSA DO EGITO
  • COMMITTEE MEMBERS :
  • ERYVALDO SOCRATES TABOSA DO EGITO
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • ELISSA ARANTES OSTROSKY
  • ANSELMO GOMES DE OLIVEIRA
  • DANIEL CRISTIAN FERREIRA SOARES
  • Data: Jun 4, 2019


  • Show Abstract
  • The aim of this work was to investigate the in vitro cytotoxic effect of previously developed nanocapsules, nanoemulsion and microemulsion systems based on bullfrog oil (BFO) against human melanoma cells (A2058). The nanosystems were produced as described in previous studies and characterized according to droplet/particle distribution and zeta potential. The biocompatibility was evaluated by the determination of the hemolytic potential against human erythrocytes. The cytotoxicity assessment was made based on MTT and cell death assays, determination of the Reactive Oxygen Species (ROS) levels and cell uptake. The three nanosystems were successfully reproduced and showed hemolytic potential smaller than 10 % at all oil concentrations (50 and 100 µg.mL-1 ). The MTT assay revealed that the nanosystems decreased the mitochondrial activity up to 92 ± 2 %. The study showed that the free BFO induced cell apoptosis, while all nanostructured systems caused cell death by necrosis, associated to a ROS overproduction and increased ability to deliver the BFO across all cellular compartments (membrane, cytoplasm and nucleus). Finally, these results elucidate the in vitro BFO nanosystems cytotoxic effect against human melanoma cells, suggesting that these systems can be further investigated as safe and promising pharmaceutical products able to improve the therapeutic arsenal against melanoma.

5
  • FABIANO HENRIQUE RODRIGUES SOARES
  • PSYCHOPHYSIOLOGICAL AND INFLAMMATORY RESPONSES TO ACUTE AEROBIC EXERCISE AT SELF-SELECTED INTENSITY

  • Advisor : MARIA BERNARDETE CORDEIRO DE SOUSA
  • COMMITTEE MEMBERS :
  • AMILTON DA CRUZ SANTOS
  • GRASIELA PIUVEZAM
  • MARIA BERNARDETE CORDEIRO DE SOUSA
  • PAULO MOREIRA SILVA DANTAS
  • RADAMES MACIEL VITOR MEDEIROS
  • Data: Jun 28, 2019


  • Show Abstract
  • The prevalence of obesity has increased worldwide over the past three decades. The burden of obesity-related diseases is heavier among women, since obesity and its degree of severity are higher in women than in men of all age groups. Regular physical activity is the basis of behavioral treatment of obesity. However, overweight and obese individuals tend to avoid physical activity, not attending to the imposed regimes, with dropout rates ranging from 71% to almost 100%. Physical activity performed at self-selected intensity could represent a valid alternative to the imposed regimes to improve adherence. This study was divided into two stages. In the first step, a cross-sectional descriptive study was carried out to investigate to what extent anthropometric measures could identify the autonomic dysfunction of cardiac control with 65 sedentary women (18 to 45 years of age) categorized as eutrophic, overweight or obese. This study generated one article. In the second step, we performed an experimental study with a randomized controlled trial to evaluate the acute effects of aerobic exercise at self-selected intensity on psychophysiological markers, stress, inflammation, muscle damage and pain. Healthy inactive women with obesity (n = 46; age range 18-45 years) exercised for 60 min on treadmill at an imposed or self-selected velocity that could be changed every 5 minutes. In the observational article, we concluded that anthropometric measurements of obesity were associated with HRV and with autonomic imbalance of cardiac control. In the first article of the experimental phase, we identified that inactive women with obesity reach moderate to vigorous intensity when exercising in self-selected velocity, feeling positive affection throughout the session. The perceived exertion goes from "light" to "moderate" for most of the session. There is a decrease in serum cortisol with theoretical relation with positive affection. A peak of biomarkers of muscle damage associated with muscle pain occurred 24 hours after the intervention and returned to pre-exercise values after 48 hours. On the other hand, there is unclear effect of the exercise session on acute phase inflammatory biomarkers. In the second article of the experimental phase we concluded that a moderate exercise in self-selected intensity is related with higher intensity, better affective responses and a similar reduction in stress level when compared to the imposed intensity exercise, which may influence directly the adherence to physical activity, when it comes to overweight and obese women.

6
  • DAISY VIEIRA DE ARAUJO

  • CONSTRUCTION AND VALIDATION OF INSTRUMENT TO EVALUATE WOMEN'S HEALTH IN PRIMARY CARE

  • Advisor : IRIS DO CEU CLARA COSTA
  • COMMITTEE MEMBERS :
  • IRIS DO CEU CLARA COSTA
  • MARIA ANGELA FERNANDES FERREIRA
  • MARIA DJAIR DIAS
  • THAIZA TEIXEIRA XAVIER NOBRE
  • WAGLÂNIA DE MENDONÇA FAUSTINO
  • Data: Jul 5, 2019


  • Show Abstract
  • The increase in population and life expectancy, coupled with the broad expansion and strengthening of Primary Health Care, competes for new aspects of longitudinal and integral care to be drawn, and in the meantime, mention is made of the construction and validation of an instrument that presents characteristics peculiar to the area of women's health and that is guiding to a public assistance with quality in the primary services in Brazil. This study aimed to gather evidence of validity based on the content of the text, the response process, the internal structure and the reliability of the Women's Health Assessment Tool in Primary Care, in order to be used by health professionals and researchers to evaluate important indicators of women's health and, through public management, for the purpose of planning and evaluating actions aimed at the public. For that, a validation study was conducted, whose guidelines and methodology were anchored in the Standards for Educational and Psychological Testing. The Instrument for Assessment of Women's Health in Primary Care presented acceptable psychometric properties of content validity and response process, which shows its conceptual and semantic quality, is valid and the answers are reliable for women in the age group of 18 to 69, since it was designed to assess the health needs of women within the organization logic of Primary Health Care, which considers the essential attributes and derivatives.
7
  • LUÍS EDUARDO BARBALHO DE MELLO
  •  


    Genomic Study for Risk Loci Identification for Familial Non-Spinal Thyroid Carcinoma

  • Advisor : JOSE BRANDAO NETO
  • COMMITTEE MEMBERS :
  • ADRIANA BEZERRA NUNES
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • JANETE MARIA CERUTTI
  • PAULA FRASSINETTI VASCONCELOS DE MEDEIROS
  • TIRZAH BRAZ PETTA
  • Data: Jul 19, 2019


  • Show Abstract
  • The incidence of differentiated carcinomas in Rio Grande do Norte, Brazil, is relatively high. Casually, we observed a remarkable occurrence of cases of papilliferous carcinomas in members of the same families identified in our series, based on routine clinical observations. In some families we detected three or more cases of papillary carcinomas diagnosed between first and second degree relatives. Thus, we decided to deepen the study regarding the etiopathogenesis of these tumors in order to establish if there is any expression among these individuals, that can justify such a prevalence and to draw a clinical and molecular profile from the analysis of the exoma sequencing through a study of DNA extracted from collections of blood samples from these patients and their relatives. With the information generated by the new generation genetic sequencing, indicating genes associated with differentiated thyroid carcinoma, it will be possible to improve the diagnosis, treatment and tracking of family members affected by thyroid nodular disease, impacting on the various indices of gauging the results of health promotion. This project is original since it addresses a research topic not yet clarified in the literature and unpublished in our country.
8
  • MARIANA ARAÚJO PAULO DE MEDEIROS
  • Epidemiology and prognostic factors of nosocomial candidemia in Northeast Brazil: A six-year retrospective study

  • Advisor : GUILHERME MARANHAO CHAVES
  • COMMITTEE MEMBERS :
  • DANIEL ARCHIMEDES DA MATTA
  • ANA CAROLINA BARBOSA PADOVAN
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • EVELINE PIPOLO MILAN
  • GUILHERME MARANHAO CHAVES
  • Data: Jul 30, 2019


  • Show Abstract
  • Candidemia has been considered a persistent public health problem with great impact on hospital costs and high mortality. We aimed to evaluate the epidemiology and prognostic factors of candidemia in a tertiary hospital in Northeast Brazil from January 2011 to December 2016. Demographic and clinical data of patients were retrospectively obtained from medical records and the antifungal susceptibility profile was performed using the broth microdilution method. A total of 68 episodes of candidemia were evaluated. We found an average incidence of 2.23 episodes /1000 admissions and a 30-day mortality rate of 55.9%. The most prevalent species were Candida albicans (35.3%), Candida tropicalis (27.4%), Candida parapsilosis (21.6%) and Candida glabrata (11.8%). The main predisposing factors were the previous use of antibacterial agents (97.1%), the presence of central venous cateter (79.4%), corticosteroid therapy (55.9%) and previous surgery (55.9%). Higher mortality rates were observed in cases of candidemia due to C. albicans (61.1%) and C. glabrata (100%), especially in relation to C. parapsilosis (27.3%). Some variables significantly increased the probability of death at univariate analysis: older age (P = 0.022; odds ratio [OR] = 1.041), severe sepsis (P < 0.001; OR = 8.571), septic shock (P = 0.035; OR = 3.792), hypotension (P = 0.003; OR = 9.120), neutrophilia (P = 0.046; OR = 3.080), thrombocytopenia (P = 0.002; OR = 6.800), mechanical ventilation (P = 0.009; OR = 8.167) and greater number of surgeries (P = 0.037; OR = 1.920). At multivariate analysis, older age (P = 0.040; OR = 1.055), severe sepsis (P = 0.009; OR = 9.872) and hypotension (P = 0.031; OR = 21.042) were independently associated with worse prognosis. There was no resistance to amphotericin B, micafungin or itraconazole and a low rate of resistance to fluconazole (5.1%). However, 20.5% of the Candida isolates were susceptible dose-dependent (SDD) to fluconazole and 7.7% to itraconazole. In conclusion, our results could assist in the adoption of strategies to stratify patients at higher risk for developing candidemia and worse prognosis, in addition to improve antifungal management.

9
  • KELL GRANDJEAN DA COSTA
  • Inhibitory control, brain function and exercise in special populations

  • Advisor : EDUARDO BODNARIUC FONTES
  • COMMITTEE MEMBERS :
  • EDUARDO BODNARIUC FONTES
  • BRUNO LOBAO SOARES
  • VANESSA DE PAULA SOARES RACHETTI
  • MENNA PRICE
  • RODRIGO HOHL
  • Data: Aug 9, 2019


  • Show Abstract
  • Inhibitory control is an executive function based on the prefrontal cortex (PFC) and is suggested to play a key role in healthy behaviors. Impairment of this cognitive function has been described in individuals with substance use disorder (SUD) or obesity. On the other hand, aerobic exercise and cardiorespiratory fitness has been shown to improve cognition suggesting its potential role in preventing and treating impulsivity and unhealthy behaviors. Here we present four studies that investigated the interaction between inhibitory control, brain function, and exercise in individuals with substance use disorder and children with different body composition. In the first study, we showed the acute effects of aerobic exercise on inhibitory control and PFC oxygenation in individuals with SUD. On the second study, we review the chronic effects of aerobic exercise in individuals with SUD and propose a psychobiological model of exercise for future clinical trials in this population. On the third study, we showed how fat mass in children was associated with poorer food-specific inhibitory control, independent of the cardiorespiratory fitness. And, in the fourth study, using an MRI scanner, we have identified the neural correlates associated with the food-specific inhibitory control in children. Together, our studies show the potential benefits of keeping healthy behaviors, such as aerobic exercising and decreased levels of fat mass, on cognitive and brain function in special populations.

10
  • JOVELINA SAMARA FERREIRA ALVES
  • Obtaining, characterization and evaluation of antidepressant activity of free flavonoid-rich extract of nanoparticles polymers from leaves of Passiflora edulis fo. flavicarpa (yellow passion fruit)
  • Advisor : SILVANA MARIA ZUCOLOTTO LANGASSNER
  • COMMITTEE MEMBERS :
  • SILVANA MARIA ZUCOLOTTO LANGASSNER
  • ADLEY ANTONINI NEVES DE LIMA
  • VANESSA DE PAULA SOARES RACHETTI
  • GEISON MODESTI COSTA
  • EDUARDO PEREIRA DE AZEVEDO
  • Data: Aug 30, 2019


  • Show Abstract
  • Species of the genus Passiflora sp. have the ability to produce a variety of neuroactive flavonoids and antioxidants,
     which can prevent brain damage caused by disorders depressive. However, due to the low bioavailability, 
    clinical application of these assets is still a challenge for pharmaceutical technology. Within this context, 
    we highlight the Passiflora edulis fo. flavicarpa (Passifloraceae), popularly known as yellow passion fruit. 
    So the objectives of this paper are: i. develop a method of obtaining an extract rich in flavonoids (FRE) 
    from the Passiflora edulis fo. flavicarpa; ii. purify and characterize flavonoids from FRE extract; iii. 
    develop a FRE extract loaded nanoparticles system; iv. evaluate the biocompatibility and antidepressant 
    activity of FRE extract in free and nanoparticulate form. The leaves used in the study were collected at the place 
    of cultivation and dried for use in optimization of extraction by surface response methodology. 
    FRE extract was used to isolate the substances majority by HPLC-UV-DAD-Prep. Subsequently, 
    it was a system of charged cationic nanoparticles of FRE extract produced with polymethyl methacrylate
     polymer (PMMA), which was characterized by size measurement, zeta potential, encapsulation 
    efficiency, ATR-FTIR and AFM microscopy. Additionally, the biocompatibility (through acute oral toxicity model)
     and antidepressant effect (using swim models open field) after oral administration of FRE extract
    in free and nanoparticulate form and the substance isoorientina, in in vivo models. 
    Quantitative analysis showed that the FRE extract has total flavonoid content of 11.42 mg / g 
    and a content of 5.21 mg / g isoorientine. 13 identified glycosylated flavonoids derived from luteoline,
     chrysin and apigenin by HPLC-ESI-IT-MS / MS analysis. Subsequently, the content of the flavonoids vicenin-2 
    was evaluated. (5.20 mg / g), orientin (0.59 mg / g), vitexin (0.20 mg / g) and isovitexin (0.96 mg / g) in
     the FRE extract by analysis by CLAE-QqQ-MS / MS system. Physicochemical analysis showed that FRE extract
     loaded nanoparticles are spherical with positive surface charge, size 65.6 nm, positive zeta potential and 
    high encapsulation efficiency of isoorientin (E.E = 100%) and stable over six months. At histopathological
     and biochemical analyzes of tissues and serum of animals showed the biocompatibility of nanoparticles in
     white, free FRE extract (2 g / kg kg; p.o.) and nanoparticulate (5 mg / kg; p.o.). The antidepressant-like
     effect after administration oral route of free FRE extract (50 and 100 mg / kg; P <0.01 and P <0.001)
     and nanoparticulate (5 mg / kg; P <0.01) and isoorientine (1-10 mg / kg, P <0.001) was investigated 
    in the swim test and similar to the nortriptyline antidepressant, promoted a reduction in the immobility
     time of the animals. Thus, the extraction method optimization increased by 10 times the antidepressant 
    potential e. encapsulation promoted the maintenance of antidepressant activity with the reduction of
     extract dose in 10 times. Also, this work was the first to demonstrate the antidepressant effect of the 
    substance isoorientina, suggesting a marker. The experiments confirm that active pharmaceutical ingredients 
    in free and edulis leaf nanoparticles are a strategy promising for herbal medicine production with action 
    antidepressant.
11
  • TALITA KATIANE DE BRITO PINTO
  • Trypanosomicidal activity evaluation of silver-formed nanoparticles and the xylan polysaccharide against epimastigote forms of Trypanosoma cruzi
  • Advisor : HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • COMMITTEE MEMBERS :
  • HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • VALTER FERREIRA DE ANDRADE NETO
  • ANA KATARINA MENEZES DA CRUZ SOARES
  • ARIANE FERREIRA LACERDA
  • NATHALIA KELLY DE ARAUJO
  • Data: Aug 30, 2019


  • Show Abstract
  • Chagas disease or American trypanosomiasis is caused by the protozoan Trypanosoma cruzi. The current treatment comprises the use of at least two drugs, benzonidazole (Bnz) and nifurtimox, which present high toxicity and inefficiency in the chronic phase of the disease, which induces the search for more effective therapeutic alternatives. Studies have shown that the green synthesis of silver nanoparticles with polysaccharides has potentiated the biological activity of both polysaccharides and silver. Therefore, the xylan polysaccharide was extracted from corn cob using an environmentally friendly method and was used for the synthesis of silver nanoparticles (NX). Atomic force microscopy, infrared and Raman spectroscopy studies, and coupled plasma atomic emission spectrometry have shown the presence of silver (~ 19%) and xylan in NX, as well as their round shape and average size (~ 40 nm). . Parasites T. cruzi lost 95% of their ability to reduce MTT (3-bromide (4,5-dimethylthiazol-2-yl) -2,5-diphenyltetrazolium) when incubated with nanoxylan (100 µg / mL). Flow cytometric analysis showed that 98% of the parasites were positive for propidium iodide when incubated for 24 h with NX (100 µg / mL), while Bnz at the same concentration was unable to induce this effect. The data show that nanoxylan induces parasite necrosis and is a strong candidate for preclinical studies with T. cruzi infected animals.
12
  • RENATA VEIGA ANDERSEN CAVALCANTI
  • SCREENING FOR MASTICATORY DISORDERS IN OLDER ADULTS (SMDOA): VALIDITY EVIDENCE OF THE SELF-REPORTED EPIDEMIOLOGICAL DIAGNOSTIC INSTRUMENT
  • Advisor : KENIO COSTA DE LIMA
  • COMMITTEE MEMBERS :
  • ADRIANA DA FONTE PORTO CARREIRO
  • ANA KARÉNINA FREITAS DO AMARAL
  • GIORVAN ANDERSON DOS SANTOS ALVES
  • KENIO COSTA DE LIMA
  • LIDIANE MARIA DE BRITO MACEDO FERREIRA
  • Data: Sep 20, 2019


  • Show Abstract
  • Aging causes changes in the stomatognathic system which influence the masticatory function, and promote disorders that may affect the eating process, oral phase of swallowing, and nutrition status, compromising the older adult population quality of life. Thus, this study aims to construct and validate the instrument for screening for masticatory disorders in older adults (SMDOA). This is a non-randomized and sectional validation study, and the method followed the traditional guidelines of the Standards for Educational and Psychological Testing. The study population consisted of older adults of both genders, aged 60 or over, recruited by convenience. In the first stage of the study, the validity evidence based on the content was obtained through a panel of four experts who defined the construct and content of the instrument and considered the evaluation of 28-experts-committee in relation to the representativeness and relevance of the items of the construct on the first version of SMDOA with 16 questions. The analysis performed through the Content Validity Index by Items (CVI-I) and the Content Validity Index (CVI) was satisfactory. Only one question has been deleted. The second version of SMDOA with 15 items was applied to the target population of 40 older adults to obtain validity evidence based on response processes. After quantitative and qualitative analysis of the answers, it was found that the instrument was well evaluated by the older adults requiring minor morphosyntax adjustments. The third version of RAMI, still with 15 questions, was applied to 295 older adults to obtain validity evidence based on the internal structure. Confirmatory factor analysis was performed to adjust the model. The SMDOA was adjusted in its internal structure, resulting in the model of 9 questions in two factors, masticatory function and perception (c2 = 48,7, p = 0,004, c2/gl =1,76, RMSEA = 0,05, WRMR = 0,75, CFI = 0,98 e TLI = 0,98). The fourth version of SMDOA was submitted to obtaining validity evidence based on relation to other variables in a population of 196 older adults and considered the analysis of Spearman's correlation coefficient (r). The convergent validity was confirmed by the moderate correlation between SMDOA results and four validated instruments with outcomes related to temporomandibular disorders (r= 0,330; p<0,001), hyposalivation (r= 0,442; p<0,001), oropharyngeal dysphagia (r= 0,456; p<0,001) and oral health (r= -0,681; p<0,001). Discriminant validity was confirmed by the weak correlation between SMDOA and a validated self-esteem scale (r= -0,269; p<0,001). Reliability analysis was performed by applying the test-retest in 124 elderly, through weighted Kappa, intraclass correlation coefficient (ICC), standard error of measurement (SEM), smallest real difference (SRD) and Cronbach's alpha. A significance level of 5% was considered. The 9-question SMDOA has good reliability indices (ICC = 0,87, IC 0,82-0,91, p <0,001; SEM = 1,90; SRD = 5,25) and high internal consistency (a = 0,93). SMDOA presented valid and reliable responses to identify masticatory disorders in community-dwelling older adults.

13
  • HEGLAYNE PEREIRA VITAL DA SILVA
  • Identification of chromosomal changes representative of a molecular diagnosis of cleft lip and palate, using microarray genomic hybridization.

  • Advisor : ADRIANA AUGUSTO DE REZENDE
  • COMMITTEE MEMBERS :
  • ADRIANA AUGUSTO DE REZENDE
  • ANDRE DUCATI LUCHESSI
  • LEONARDO CAPISTRANO FERREIRA
  • JULIANA FORTE MAZZEU DE ARAÚJO
  • APARECIDO DIVINO DA CRUZ
  • Data: Nov 12, 2019


  • Show Abstract
  • Non-syndromic orofacial clefts (OFC) consist of craniofacial malformations characterized by the presence of abnormal spaces or gaps in the upper lip, alveolus and/or palate, which may have effects on speech, hearing, appearance and cognition, as well as long-term adverse outcomes health and social integration. Despite the various environmental agents already identified, genetic susceptibility is in fact the main component of the etiology of non-syndromic OFC. However, despite decades of genetic research and the different types of genetic studies, it is still unclear exactly how many genes can control the risk or how they act to influence the risk of orofacial clefts. Large-scale studies of the entire genome using high throughput technologies as comparative genomic hybridization (CGH-array) have been shown to be an important tool in the study of complex and heterogeneous diseases, since it allows mapping of wide structural variations of a reference genome, including deletions and duplications, collectively referred to as Copy Number Variations (CNVs). Thus, the present study aimed to identify and describe rare CNVs in non-syndromic OFC patients using array-CGH to explore the implication of overlapping CNV genes for the genetic etiology of OFC. Five rare CNVs were identified in five OFC patients: a 220kb deletion located in the 1p12 region, overlapping the three GDAP2, WDR3, SPAG17 genes; a 326kb doubling in the 3p22.3 region, spanning the CCR4 and GLB1 genes and the doubling in the 4q32.3, 10p14, 15q13.3 regions overlapping the SPOCK3, CELF2, CHRNA7 genes, respectively. Only the 440kb duplication on chromosome 15 involving the cholinergic neuronal nicotinic receptor gene, alpha 7 polypeptide (CHRNA7) was previously described in a patient with OFC phenotype. All evidenced genes participate in cellular events essential to the embryological development of the lip and palate and, therefore, may represent potential candidate genes of the patients studied.

14
  • TÁBATA LOÍSE CUNHA LIMA
  • NANOTECHNOLOGY APPLIED TO INCREASE AGENT ACTIVITY WITH ANTIMICROBIAN POTENTIAL: AN ANTIVIRAL APPROACH AND ANTIFUNGAL
  • Advisor : ARNOBIO ANTONIO DA SILVA JUNIOR
  • COMMITTEE MEMBERS :
  • ARNOBIO ANTONIO DA SILVA JUNIOR
  • HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • FABIO ROCHA FORMIGA
  • MARGARETE MORENO DE ARAUJO
  • WALICYRANISON PLINIO DA SILVA ROCHA
  • Data: Nov 14, 2019


  • Show Abstract
  • Nanoparticles have the ability to improve pharmacological properties of molecules such as chloroquine (CQ) and phytol (PHY). Organic nanoparticles can be made from polymers or lipids. Polymeric nanoparticles (NP) and solid lipid nanoparticles (SLN) have been widely studied as a source of an alternative therapeutic for viral and fungal diseases. Herpes simplex virus type 1 (HSV-1) and Candida yeast are known to be microorganisms that cause severe infections in immunocompromised patients and can lead to fatalities. The aim of our study was to develop and monitor chloroquine-loaded poly (lactic acid) (PLA) NP (CQ-NP) to improve the effectiveness of CQ in anti-HSV-1 activity; as well as, phytol-loaded NLS (SLN-PHY) produced from the lipid naturally occurring 1,3-distearyl-2-oleyl glycerol (TG1) and then evaluate anti-Candida activity by determining minimum inhibitory concentration (MIC). The nanoparticles produced were monitored using dynamic light scattering (DLS), atomic force microscopy (AFM) and encapsulation efficiency (EE) of CQ and PHY. As results we have that all systems size is <300 nm, PdI <0.2 and encapsulation efficiency> 60%. Antiviral tests were performed by plaque reduction assay using acyclovir (ACV) as positive control. The anti-Candida assays were performed against seven reference strains and eight clinical strains and fluconazole was used as a positive control. Antiviral tests revealed greater efficacity of CQ-NP compared to CQ and ACV at concentrations less than 20 µg/m (p <0.001). MIC tests revealed that SLN-PHY were able to improve phytol activity and MIC 100% were achieved at concentrations ranging from 0.24 and 0.40 µg/mL for both types of strains. Therefore, it can be inferred that the formulation of different nanoparticles was successfully employed, and that NP-CQ being able to increase CQ antiviral activity and SLN-PHY being able to increase phytol's anti-Candida activity.

15
  • CLÁUDIA NUNES OLIVEIRA

  • Influence of the ileum and colon on liver regeneration. Comparative study

  • Advisor : ALDO DA CUNHA MEDEIROS
  • COMMITTEE MEMBERS :
  • ALDO DA CUNHA MEDEIROS
  • JOABE DOS SANTOS PEREIRA
  • REJANE ANDRADE DE CARVALHO
  • CIPRIANO DA CRUZ FORMIGA
  • MARIA GORETTI FREIRE DE CARVALHO
  • Data: Nov 20, 2019


  • Show Abstract
  • Abstract

    AIM

    The aim of this study was to investigate and compare the effects of ileum and colon resection on liver regeneration.

    METHODS

    Wistar rats (Rattus norvegicus) weighing 261 ± 34g were randomly allocated to four groups of six animals each. In group I (sham), only laparotomy was performed; in group II, 70% hepatectomy; in group III 70% hepatectomy + ileal resection; and in group IV, 70% hepatectomy + partial colectomy. On the sixth postoperative day, blood was collected by cardiac puncture, followed by euthanasia. Serum dosages of aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin, alkaline phosphatase (AF), hepatocyte growth factor (HGF) and transforming growth factor-alpha (TGF-α) were measured. The hepatic regeneration rate was estimated by liver weight per 100 g of body weight at euthanasia/preoperative projected liver weight per 100 g of  body weight × 100. The liver samples were submitted to the Ki-67 immunohistochemical reaction.

     

    RESULTS

    ALT, AST and AF levels were significantly higher in group III rats when compared to group I, III and IV (p<0.001). In group IV, the levels were significantly lower than in groups II and III (p<0.001). Albuminemia showed significantly lower levels in group III rats when compared to groups I, II and IV. (p<0.001). There was no difference in albuminemia between groups I (sham) and IV (70% hepatectomy + colectomy) rats (p>0.05). HGF and TGF-α levels in group IV rats were significantly higher than in groups I, II and III (p<0.001). Group IV animals exhibited a higher liver regeneration rate than in groups II and III, but the difference was not significant (p>0.05). The liver cell expression of Ki-67 was significantly higher in the remnant liver of group IV rats than in group III (p=0.002). There was no difference in Ki-67 expression between group II and IV rats (p>0.05).

     

    CONCLUSION

    Ileum and colon resection have different effects on liver regeneration. Colon resection positively influences liver regeneration, while ileum resection has a negative influence on the regenerative process, in a rat model.

16
  • KEYLA BORGES FERREIRA ROCHA
  • Mitigation of dimethyl-benzanthracene-induced breast cancer through Arrabidaea chica extract in Wistar rats
  • Advisor : ALDO DA CUNHA MEDEIROS
  • COMMITTEE MEMBERS :
  • ALDO DA CUNHA MEDEIROS
  • GERALDO BARROSO CAVALCANTI JUNIOR
  • LIDIANE MARIA DE BRITO MACEDO FERREIRA
  • AMALIA CINTHIA MENESES DO REGO
  • EDUARDO PEREIRA DE AZEVEDO
  • Data: Nov 20, 2019


  • Show Abstract
  • Objective: The aim of this study was to examine the effects of Arrabidaea chica (crajiru) extract, native plant of the Amazon, on a dimethyl benzanthracene-induced mammary carcinoma (DMBA) model in Wistar rats. Method: The response of mammary carcinoma to the injected A. chica stratum (EAC) v.o. for 16 weeks, whether or not associated with vincristine. Groups of experimental design: normal control; DMBA group without treatment; EAC-treated DMBA (300 mg / kg); DMBA + Vincristine group injected i.p. 500µg / kg; DMBA + EAC + Vincristine 250µg / kg. Imaging using microPET and fluorescence, biochemistry, oxidative stress, hematology and histopathology were used to validate the treatments. Results: All animals survived. There was a gradual weight gain in all groups for 16 weeks, with no significant difference between them (p> 0.05). The injection v.o. EAC and EAC + vincristine 50% significantly reduced (p <0.001) the incidence of breast tumors examined with PET-18FDG and fluorescence. Significantly reduced serum transaminases, oxidative stress and haematological toxicity. Antioxidant enzyme levels in the breast tissue were significantly higher compared to the DMBA and DMBA + vincristine groups. Conclusion: These results clearly demonstrate for the first time that A. chica extract exerts herbal efficacy in a DMBA-induced breast cancer model, suppressing abnormal cell proliferation and inducing reduction of chemotherapy toxicity and oxidative stress. A. chica extract may have clinical implication and be developed as a drug to reduce mortality and mitigate the toxicity of chemotherapy for breast cancer.

     
17
  • CIRO ALEXANDRE MERCES GONCALVES
  • Effect of acute and chronic aerobic exercise on immunological markers

  • Advisor : GERALDO BARROSO CAVALCANTI JUNIOR
  • COMMITTEE MEMBERS :
  • ALDAIR DE SOUSA PAIVA
  • AMALIA CINTHIA MENESES DO REGO
  • BRENO GUILHERME DE ARAUJO TINOCO CABRAL
  • GERALDO BARROSO CAVALCANTI JUNIOR
  • RICARDO OLIVEIRA GUERRA
  • Data: Dec 10, 2019


  • Show Abstract
  • Introduction: The effects of aerobic exercise on the immune system are not yet fully defined in the scientific literature. This fact demonstrates the need to investigate their influence on existing immunological markers, classifying and quantifying their acute and chronic effects. Objective: To investigate the effects of acute and chronic aerobic exercise on inflammatory markers in healthy adults. Methods: This study is a systematic review according to PRISMA recommendations. The following databases were searched: MEDLINE (via PubMed), Science Direct, Scopus, Web of Science, SciELO, Bireme and Cochrane Library and article references. The latest research was conducted in March 2019. We included randomized controlled trials (RCTs) and uncontrolled randomized controlled trials (NRCTs) investigating the acute and chronic effects of aerobic exercise on immunological markers in healthy adult men and women aged 20 to 45 years. , without language restriction or year of publication. Two authors analyzed the studies independently, reading the title, the abstract and the full texts. Study bias risk was analyzed using the Cochrane bias risk tool. Results: We analyzed 5925 articles, 15 articles included in this systematic review, 13 of which were acute intervention and two chronic. There were 296 participants, 196 men and 100 women, all healthy individuals. Conclusion: Acute intervention causes changes in most immunological markers, while chronic intervention interferes with a lower propensity.

18
  • ANA PAULA FERREIRA COSTA
  • HUMAN PAPILOMAVIRUS: IMMUNE RESPONSE TO INFECTION AND

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • GUILHERME MARANHAO CHAVES
  • GUSTAVO MAFALDO SOARES
  • JOSÉ ELEUTÉRIO JÚNIOR
  • JOSÉ HUMBERTO BELMINO CHAVES
  • Data: Dec 10, 2019


  • Show Abstract
  • Interest in immunoglobulin G / A (IgG / IgA) antibodies has greatly increased since human papillomavirus (HPV) vaccines became available worldwide. The objectives of the studies were to describe the course of the IgG / IgA immune response in women immunized with divalent vaccine and those infected with HPV and to describe the course of IgG / IgA responses in cervical and serum secretions one year after the first dose of the vaccine. intramuscular administration of the adjuvant vaccine HPV16 / 18 AS04. Serum and cervical mucus samples were collected for detection of anti-HPV / VLP IgG / IgA by enzyme linked immunosorbent assay (ELISA). The results found show that anti-HPV-VLP IgG in immunized serum was higher (p <0.01), while anti-HPV-VLP-IgA was detected in cervical mucus of virus-infected (p <0.01). Detection of serum antibodies coincides with the induction of high levels of post-vaccine IgG antibodies. IgA antibodies in unvaccinated women were characterized as a possible transudation of the systemic circulation to the cervical mucosa. IgG is a long-term response to any viral infection; thus, anti-HPV-VLPIgG proves the efficacy of the divalent vaccine in protecting against HPV infection. We also observed that immune responses were significant one year after immunization but decreased in cervical and serum samples when compared to levels observed one month after the last dose. This suggests that a vaccine booster may be required to increase antibody titers.

2018
Dissertations
1
  • JOSÉ IVAN MARQUES DE MEDEIROS
  • Tabernaemontana catharinensis: A phytochemical study and evaluation of anti-inflammatory activity in vivo.

  • Advisor : SILVANA MARIA ZUCOLOTTO LANGASSNER
  • COMMITTEE MEMBERS :
  • HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • MARIANNA VIEIRA SOBRAL CASTELO BRANCO
  • SILVANA MARIA ZUCOLOTTO LANGASSNER
  • Data: Apr 25, 2018


  • Show Abstract
  • The use of plant extracts in the treatment of diseases is
    widely diffused in Brazil, which can be explained by the
    least at least because of the lower cost and the belief that such
    products do not promote toxic effects. The species
    Tabernaemontana catharinensis (Apocynaceae), the object of this
    study, is popularly known as "goat's grain" and "weathervane",
    and is native to South America. In Brazil, this species
    has predominance in the south and northeast regions. Because it is a
    popularly used to treat problems
    inflammatory and lacking pharmacological evidence, the
    The objective of this study was to evaluate the anti-inflammatory potential of
    extracts and the fractions of the leaves of T. catharinensis in
    in vivo and perform a phytochemical study of the extract. To this end, the
    leaf extract was prepared by the maceration method
    water: alcohol (70:30, v / v) and analyzed by Chromatography
    Thin Layer and High Performance Liquid Chromatography
    with high resolution mass detector with
    electrospray. Part of the extract was submitted to the liquid-liquid partition
    with increasing polarity solvent to obtain
    fractions enriched in phenolic compounds. And after the analysis
    phytochemistry was observed in the presence of glycosylated flavonoids
    as major compounds in the extract and fractions. About the
    pharmacological study, we used the edema models of
    carrageenan-induced paw with pre and post treatment and bag
    of zymosan-induced air, with post-treatment at doses (50,
    100 and 150 mg / kg, orally). In the paw edema model,
    evaluated the anti-nematode potential by decreasing the
    edema and myeloperoxidase-MPO activity. For the model
    of the air bag was evaluated the leukocyte migration (total and
    differential), cytokine levels (IL-1 and IL-6) and MPO. As
    As a result, in the paw edema model it was possible to observe
    that the extract and fractions have anti-nematode potential in the
    and post-treatment, presenting the best results for the
    doses of 100 and 150 mg / kg (*** p <0.001, ** p <0.01,
    respectively). The extracts and fractions presented
    better results on the inhibition of MPO activity in the
    after treatment. In the airbag model it was possible to observe
    intense leukocyte inhibition (*** p <0.001) and inhibition of levels of
    FEDERAL UNIVERSITY OF RIO GRANDE DO NORTE
    HEALTH SCIENCES CENTER
    POSTGRADUATE PROGRAM IN HEALTH SCIENCES
    Av. Gal. Gustavo Cordeiro de Farias, s / n - Natal-RN, CEP 59012-570
    Telefax: (84) 3342-9776 E-mail: ppgcsa@ccs.ufrn.br
    cytokines for both the extract and the (EtOAc fraction) in
    dose 50 mg / kg. The extract and fractions did not present
    cytotoxicity. The results demonstrate an anti-inflammatory potential
    for extract and fractions of T. catharinensis, giving
    support for the popular use of the species and providing subsidies for
    development of an herbal medicine with anti-inflammatory properties.

2
  • GISELE CORREIA PACHECO LEITE

  • CARDIOVASCULAR ALTERATIONS IN PATIENTS WITH LIP SCREENING: CLINICAL-ECOCARDIOGRAPHIC STUDY

  • Advisor : ADRIANA AUGUSTO DE REZENDE
  • COMMITTEE MEMBERS :
  • ADRIANA AUGUSTO DE REZENDE
  • ISABELLA LOPES MONLLEO
  • VIVIAN NOGUEIRA SILBIGER
  • Data: Jun 19, 2018


  • Show Abstract
  • Objective: to describe the clinical-epidemiological and cardiological profile of a group of patients with oral slit (FO) of Rio Grande do Norte. Project: analysis of clinical evaluation data with pediatric cardiologist and complementary exams. Scenario: Multidisciplinary Attendance Program for Patients with Fissures Labiopalatais of Hospital Universitário Onofre Lopes. Patients: FO patients seen in the Program and evaluated by a pediatric cardiologist, from March / 2013 to September / 2014. Interventions: clinical, electrocardiographic and echocardiographic evaluation. Main results: patients were evaluated for age, gender, type of FO, clinical evidence of probability of heart disease (complaints, comorbidities, antecedents) and echocardiographic findings. Results: Of 81 patients included, we observed an age range varying from neonate to 35 years; 50 (61.7%) were male and 45 (55.6%) of the patients had a cleft lip and palate. 42 (51.9%) patients had more than one consultation with a pediatric cardiologist, with 31 (38.3%) having complaints at the time of the consultation. Comorbidities were present in 38 (46.9%) patients. Positive gestational history was observed in 47 (58%) patients, neonatal in 25 (30.9%), family in 54 (66.7%), and personal in 22 (27.2%). Among the family history, the most frequent were Arterial Hypertension (24 / 20,1%), Dyslipidemia (19/16%) and Diabetes Mellitus (15 / 12,6%); and personal, respiratory (20 / 57.1%) and neurological (4 / 11.4%). There was one case of atrioventricular block. Echocardiogram was performed in 74 (91.4%) patients, of which 46 (62.2%) were normal and 28 (37.8%) were altered. A case of mitral valve prolapse by rheumatic carditis was confirmed. Conclusions: A complete cardiologic evaluation (clinical, electrocardiographic and echocardiographic) is suggested as one of the diagnostic criteria complementary to patients with FO, due to the susceptibility to cardiovascular malformations in this group of patients. In this way, improvements in the care of patients with FO are obtained by intervening in their evolutionary history and prognosis, with a positive impact on their overall health, and therefore on public health.
3
  • HUGO MARCUS AGUIAR DE MELO RODRIGUES
  • Comparative prevalence of Burnout Syndrome among medical residencies: Systematic Review.

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • ERYVALDO SOCRATES TABOSA DO EGITO
  • PAULO CESAR GIRALDO
  • Data: Jul 10, 2018


  • Show Abstract
  • Context: Burnout is a psychological syndrome much prevalent in medical residents. It consists of emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). Goal: to estimate burnout syndromeprevalence among different medical residencies specialties.

    Methods:systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Were accessed: Embase, PubMed, Web of Science, Google Scholar, and Scopus, and 3.575 studies were found. Methodological quality was evaluatedbyAgency for Healthcare Research and Quality Methodology Checklist for Cross-Sectional/Prevalence Study. In the final analysis, 26 papers were included.

    Results:4.664 medical residents were included. High DP, EE and low PA proportions were compared. Specialties are distributed into three different levels burnout prevalence groups: general surgery, anesthesiology, obstetrics/gynecologyand orthopedics(40.8%); internal medicine, plastic surgery and pediatrics(30.0%); otolaryngology and neurology (15.4%). Overall burnout prevalence found for all specialties was 35.7%.

    Conclusions: It was identified a high prevalence among surgical/urgency residencies.

4
  • THAÍS GOMES DE CARVALHO
  • Spherical neutral Gold nanoparticles improve anti-inflammatory response, oxidative stress and fibrosis in alcohol-methamphetamine-induced liver injury in rats

  • Advisor : RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • COMMITTEE MEMBERS :
  • RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • CAROLINE ADDISON CARVALHO XAVIER DE MEDEIROS
  • LEÔNIA MARIA BATISTA
  • Data: Aug 3, 2018


  • Show Abstract
  • This study aimed to elucidate the anti-inflammatory, anti-oxidant and antifibrotic effects of gold nanoparticles (GNPs) in rats subjected to liver injury with ethanol and Methamphetamine (METH). The liver injury was induced by gavage administrations of 55 30% alcoholic solution (7 g/kg) once a day during 28 days, followed by METH (10 mg/kg) on the 20th and 28th days of treatment. GNPs treatment (724.96 µg/kg) during the ethanol and METH exposure was associated with reduced steatosis, hepatic cord degeneration, fibrosis and necrosis. Furthermore, there was a reduction in biochemical markers of liver damage and oxidative stress, and pro-inflammatory cytokines IL-1β and TNF-α, compared to ethanol + METH group alone. A decrease of FGF, SOD-1 and GPx-1 expression was also observed. GNPs down-regulated the activity of Kupffer cells and hepatic stellate cells affecting the profile of their pro-inflammatory cytokines, oxidative stress and fibrosis through modulation of signaling pathways AKT/PI3K and MAPK in ethanol + METH induced liver injury in a rat model

5
  • FERNANDO BASTOS PRESA
  • The protective role of sulfated polysaccharides from

    green seaweed Udotea flabellum in cells exposed to

    oxidative damage

  • Advisor : HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • COMMITTEE MEMBERS :
  • HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • PAULO RICARDO PORFIRIO DO NASCIMENTO
  • RANILSON DE SOUZA BEZERRA
  • Data: Aug 31, 2018


  • Show Abstract
  • Seaweed is a rich source of bioactive sulfated polysaccharides. We obtained six sulfated polysaccharide-rich fractions (UF-0.3, UF-0.5, UF-0.6, UF-0.7, UF-1.0, and UF-2.0) from the green seaweed Udotea flabellum (UF) by proteolytic digestion followed by sequential acetone precipitation. Biochemical analysis of these fractions showed that they were enriched with sulfated galactans. The viability and proliferative capacity of 3T3 fibroblasts exposed to FeSO4 (2 µM), CuSO4 (1 µM) or ascorbate (2 mM) was not affected. However, these cells were exposed to oxidative stress in the presence of FeSO4 or CuSO4 and ascorbate, which caused the activation of caspase-3 and caspase-9, resulting in apoptosis of the cells. We also observed increased lipid peroxidation, evaluated by the detection of malondialdehyde and decreased glutathione and superoxide dismutase levels. Treating the cells with the fractions protected the cells from the oxidative damage caused by the two salts and ascorbate. The most effective protection against the oxidative damage caused by iron was provided by UF-0.7 (1.0 mg/mL); on treatment with UF-0.7, cell viability was 55%. In the case of copper, cell viability on treatment with UF-0.7 was ~80%, but the most effective fraction in this model was UF-2.0, with cell viability of more than 90%. The fractions, mainly UF-0.7 and UF-2.0, showed low iron chelating activity, but high copper chelating activity and total antioxidant capacity (TAC). These results suggested that some of their protective mechanisms stem from these properties.

6
  • CHRISTIAN MELO DE OLIVEIRA
  • Hydrophobin-stabilized nanoemulsion as a promising delivery system for cancer cells.

  • Advisor : ERYVALDO SOCRATES TABOSA DO EGITO
  • COMMITTEE MEMBERS :
  • ERYVALDO SOCRATES TABOSA DO EGITO
  • ADLEY ANTONINI NEVES DE LIMA
  • ELQUIO ELEAMEN OLIVEIRA
  • Data: Oct 22, 2018


  • Show Abstract
  • Hydrophobin II (HFBII) is a protein able to produce emulsion systems that could be applied in the cancer therapy. This study reports the production of HFBII-stabilized oil-in-water nanoemulsion containing copaiba oil by the spontaneous emulsification method. HFBII was extracted by CO2, isolated by RP-HPLC, and characterized by electrophoresis, mass spectrometry and surface tension analyses. A 23 full factorial design was used to optimize the formulation, using HFBII, copaiba oil and organic-to-aqueous phase ratio as independent variables. The short-term stability of the nanoemulsion was investigated under different ionic strength and pH. In vitro cellular uptake of the nanoemulsion was evaluated in the human breast cancer (MCF-7) cells by flow cytometry. Isolated HFBII showed a molar mass of 7 kDa with a specific surface activity of 46.5 mN.m-1.µg-1. Optimal nanoemulsion formulation with droplet size of 154.2 ± 2.6, PDI of 0.153 ± 0.025 and zeta potential of -29.1 ± 3.2 was obtained using 0.005 wt% HFBII, 0.02 wt% copaiba oil and 10% (v/v) organic-to-aqueous phase ratio. Nanoemulsion was stable at low salt concentration (<25 mM) and pH close to neutrality. The HFBII-stabilized nanoemulsion was significantly internalized by MCF-7 cells. Moreover, HFBII is a promising biopolymer to stabilize nanoemulsion systems for the cancer therapy purposes.

7
  • SUSIANE DE SANTANA MOREIRA OLIVEIRA DA SILVA
  • Buccal Bullfrog (Rana Catesbeiana Shaw) Oil Emulsion: A Mucoadhesive System Intended For Treatment Of Oral Candidiasis

  • Advisor : ERYVALDO SOCRATES TABOSA DO EGITO
  • COMMITTEE MEMBERS :
  • ERYVALDO SOCRATES TABOSA DO EGITO
  • RODRIGO DOS SANTOS DINIZ
  • TOSHIYUKI NAGASHIMA JUNIOR
  • Data: Nov 19, 2018


  • Show Abstract
  • Oral candidiasis (OC) is an infectious disease caused by microorganisms of the genus Candida, leading to lesions in the buccal cavity. Its treatment consists on the administration of topical or systemic antifungal agents, which may compromise the patient compliance due to its side effects, highlighting the need for alternative treatments able to remove this infection and avoid the side effects of the current treatment. In this scenario, the bullfrog oil, an animal oil composed by a pool of saturated and unsaturated fatty acids, is introduced as a potential antifungal raw material. Thus, the aim of this work was to produce a mucoadhesive emulsified system able to deliver the bullfrog oil in the buccal cavity to treat the OC. The emulsion was produced and characterized by visual inspection, droplet size, polydispersivity index (PdI) and zeta potential and its stability was assayed over 60 days. In addition, its mucoadhesive ability was evaluated using an in vitro mucin model. The antifungal activity by broth microdilution assay and biocompatibility against human erythrocytes were also performed. The emulsion showed droplet size of 320.79 ± 35.60 nm, PdI of 0.49 ± 0.08 and zeta potential of -38.53 ± 6.23 mV, which showed no significant changes over 60 days. The mucoadhesive properties of the system were improved by the use of pharmaceutical excipients and the antifungal activity showed that the bullfrog oil and the emulsion were able to inhibit the growth of different Candida species. Furthermore, the emulsion showed no significant hemolytic effect. Overall, the system showed suitable physicochemical characteristics and biocompatibility, with substantial in vitro antifungal activity, suggesting that this emulsion can be further investigated for OC treatment.

8
  • ROBERTO MORENO MENDONCA
  • ROLE OF BREAST VASCULAR CALCIFICATION IN PREDICTING

    CARDIOVASCULAR RISK

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • ROBINSON DIAS DE MEDEIROS
  • JOSÉ ELEUTÉRIO JÚNIOR
  • Data: Nov 28, 2018


  • Show Abstract
  • Cardiovascular diseases (CVD) are the leading cause of death worldwide among women, resulting in 8.6 million deaths annually. Computed tomography (CT) has been used to evaluate the coronary arteries calcifications by quantifying the Coronary Calcium Score (CCS), validated as marker of cardiovascular risk. Additionally, mammography is the only method for population screening of breast cancer, but also could identify atherosclerosis, known as breast vascular calcification (BVC). We verified if there is an association between the BVC and high CCS, thus predicting cardiovascular risk in women whose mammograms revealed BVC.

    An observational, analytical study included women submitted to mammography and CCS-CT. Patients with incomplete exams or interval over 12 months were excluded. A systematic random sampling was employed to select the 51 patients, retrieved and reassessed for the presence of BVC and CCS. Being pilot study, sample size was based on convenience, preserving randomness. Aggravating factor of cardiovascular risk was considered to be a CCS greater than 100 (Agatston Score) and/or percentile above 75%. Being pilot study, sample size was based on convenience, preserving randomness. Aggravating factor of cardiovascular risk was considered to be a CCS greater than 100 (Agatston Score) and/or percentile above 75%. The mean age was 56.47(±9.16) years. Of the 51 patients, 16(31.4%) presented and 35(68.6%) did not present BVC on mammograms. In regard to the CCS evaluation, 14(27.4%) of patients presented values> 100 and/or percentile> 75%, and 37(72.6%) presented CCS below this cut off. In patients who did not present BVC, it was observed that 29(83.0%) presented CCS compatible with low cardiovascular risk. In patients with BVC, there was equal distribution between the CCS considered low and high cardiovascular risk (8 subjects each group). The prevalence of high cardiovascular risk among exposed individuals (BVC present) was 50.0%, while the prevalence among the non-exposed (BVC absent) was 17.1%, with a prevalence ratio=2.91 and prevalence OR=4.83 (P=0.015, CI95%=1.07-22.1), confirming the positive association. Additionally, specificity of 82.9% was observed, together with negative predictive value of 78.4%, and accuracy of 72.5%. In our preliminary study, positive association between mammary vascular calcifications and the coronary calcium score is evident. Absence of BVC is statistically associated with low cardiovascular risk and may directly reflect a less intense atherosclerotic process.

9
  • NEIDJANY PATRÍCIA LIMA TORRES
  • IMPACT OF INTERVENTIONS ON THE QUALITY OF LIFE AND NUTRITIONAL PARAMETERS OF THE ELDERLY

  • Advisor : EULALIA MARIA CHAVES MAIA
  • COMMITTEE MEMBERS :
  • EULALIA MARIA CHAVES MAIA
  • THAIZA TEIXEIRA XAVIER NOBRE
  • SANDRA MARIA DA SOLIDADE GOMES SIMÕES DE OLIVEIRA TORRES
  • Data: Nov 29, 2018


  • Show Abstract
  • The present study sought to correlate nutritional interventions with the quality of life and nutritional parameters of the elderly of Primary Health Care. This is an intervention study with a quantitative approach. Eleven Brazilian elderly enrolled in the Family Health Strategy (ESF) in Natal / RN and Santa Cruz / RN participated. There were 4 nutritional interventions: Simulated market, Healthy choices, Food bingo and Recipes with full use of food. The research was approved by the Ethics Committee, and was used for the collection of data from the Mini Mental State Examination (MMSE), sociodemographic, SF-36 short-form, Mini Nutritional Assessment (MAN), and Body Mass Index (BMI) at the first moment (before the interventions) and at the second moment (after the interventions). For the statistical analysis of the data, we used descriptive statistics and Wilcoxon and Speraman tests. It was obtained that those present in the interventions presented higher values of the median in the second moment, as well as association and positive correlations were found for aspects of mental health, social function and general state of health, however the aspect of pain in the body, physical dimension and BMI were negative. It is perceived that food and nutrition education has had positive effects on the quality of life and, consequently, on the health of individuals in the community
10
  • LUCIANA MAGALHÃES PINTO
  • Candida species isolated from pigeon (Columbia livia) droppings may express virulence factors and resistance to azoles

  • Advisor : GUILHERME MARANHAO CHAVES
  • COMMITTEE MEMBERS :
  • EVELINE PIPOLO MILAN
  • GUILHERME MARANHAO CHAVES
  • RAQUEL DE MELO BARBOSA
  • WALICYRANISON PLINIO DA SILVA ROCHA
  • Data: Dec 20, 2018


  • Show Abstract
  • Even though it is widely known that Cryptococcus spp. may transmit cryptococcosis trough aerosol formed when dried birds (mainly pigeons) droppings are dispersed and become airborne, little is known about the role of these birds in harboring other pathogenic yeasts in their gastrointestinal tract, feathers and beaks, specifically because these animals often stay and reproduce close or even above air conditioner units. Here we evaluated the prevalence of pathogenic yeasts isolated from pigeon droppings collected in the outside area of a University Hospital in Brazil. We also aimed to investigate the pathogenic potential and antifungal susceptibility of Candida species of medical interest isolated from these samples. Therefore, we performed the evaluation of virulence factors attributes expression in vitro, including the ability to adhere to human buccal epithelial cells and biofilm formation and to produce lytic enzymes, such as phospholipases, proteinases and hemolysins. Antifungal susceptibility testing against fluconazole, itraconazole, amphotericin and micafungin was also performed. The Candida genus was the most prevalent in our study, with several medically important species being isolated. Of note, these strains were able to express several virulence factors in vitro, clearly showing their pathogenic potential. Our study was able to demonstrate that Candida spp. isolated from pigeon droppings may express virulence factors in the same manner of clinical isolates, suggesting a pathogenic potential for these yeasts. The fact these strains were collected from the outside area of a tertiary hospital may be of interest, because they may be a source of infection, specifically to immunocompromised hosts.

11
  • MAXSUELL LUCAS MENDES MARQUES
  • Sulfated polysaccharides from tropical seaweeds have anticoagulant activity: High anticoagulant sulfated galactans from green seaweed Udotea flabellum

  • Advisor : HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • COMMITTEE MEMBERS :
  • CARLOS AUGUSTO GALVAO BARBOZA
  • HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • VALQUIRIA PEREIRA DE MEDEIROS
  • Data: Dec 21, 2018


  • Show Abstract
  • Many papers show the importance of anticoagulant compounds in the treatment of cancer, not only preventing blood clotting, but also inhibiting the activity of thrombin and factor Xa. These two molecules are activated by tumor factors and are involved in the proliferation and migration of tumor cells. Therefore, there is a search for anticoagulant agents that are inhibitors of these molecules. Seaweed synthesizes sulfated polysaccharides with several properties, including anticoagulant activity. Therefore, in this paper, sulfated polysaccharide-rich extracts were obtained from 21 tropical marine algae (4 red, 11 brown, and 6 green) found in northeastern Brazil and evaluated as anticoagulant agents. 15 extracts presented anticoagulant activity, including all extracts of green seaweed. Udotea flabellum extract was the most potent, which required only 3 µg to double the plasma coagulation time in the APTT test. Similar result was obtained with 1 µg of heparin. Two sulfated galactans with high anticoagulant activity were obtained from this extract using several bio-guided purification steps. These polysaccharides were named F-I (130 kDa) and F-II (75 kDa). They presented anticoagulant activity with intensity close to that of heparin. F-I and F-II (from 0.5 to 10 μg/mL) were not able to directly inhibit thrombin. In the presence of antithrombin, F-I (0.5 μg/mL) was more effective than heparin (0.5 μg/mL) as inhibitor of trombin, while F-II showed similar effect to heparin. Taken together, the results presented in the current study provide strong evidences of the anticoagulant/antitumor potential of the Udotea sulfated galactans and make these compound an interesting molecular tool to be used in future investigations that aimed at the design of new anticoagulant/antitumor agents.

Thesis
1
  • JOSE QUEIROZ FILHO
  • -Assessment of 100% Rapid Review as an Effective Tool for Internal Quality Control in Cytopathological Services

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • GUILHERME MARANHAO CHAVES
  • GUSTAVO MAFALDO SOARES
  • MARIA CLARA PEDRO BICHO
  • NEILA DE GOIS SPECK
  • Data: Feb 21, 2018


  • Show Abstract
  • -Objective: The aim of this study was to evaluate the 100% rapid review (100%-RR) as an effective tool for internal quality control (IQC) in gynecological cytopathology services. Study Design: A total of 8,677 swabs were analyzed; the negative results were submitted to 100%-RR. Divergent cases were discussed in a consensus meeting to reach a conclusion on the final diagnosis. The data were entered into SAS statistical software, and the agreement of the 100%-RR results with the final diagnosis was tested with the weighted kappa statistic. Results: Of the 8,155 smears characterized as negative, 255 (3.13%) were abnormal smears, and 552 (6.77%) unsatisfactory smears were deemed negative. Regarding the results on the 8,155 smears subjected to 100%-RR when compared with the final diagnosis, there was agreement in 7,063 (86.60%) of them, and there were 1,092 (13.40%) discordant results (65.6%, unsatisfactory; 5.47%, atypical squamous cells of undetermined significance [ASC-US]). The κ index had an agreement of 0.867, with κ = 0.734 ( p < 0.0001).Compared with the final diagnosis, the sensitivity of 100%-RR was 99.91% and its specificity was 99.4% for severe abnormalities. The sensitivity for high-grade squamous intraepithelial lesions was 88.2%, with a specificity of 100.00%. For abnormalities considered borderline, such as ASC-US, the sensitivity was 94.50% and the specificity was 99.5%. Conclusion: The 100%-RR was considered efficient when used as an IQC method

2
  • JULIANA FERNANDES DE CARVALHO
  • EFFECT OF ANTIBIOTIC VETORIZED WITH MAGNETIC NANOPARTICLES FOR TREATMENT OF INFECTION BY Staphylococcus aureus MULTI RESISTANT

  • Advisor : ARTUR DA SILVA CARRICO
  • COMMITTEE MEMBERS :
  • ARTUR DA SILVA CARRICO
  • MAIZA ROCHA DE ABRANTES
  • FABRICIA LIMA FONTES
  • LEONARDO LINHARES OLIVEIRA
  • MICHELLE DE MEDEIROS AIRES
  • Data: Mar 29, 2018


  • Show Abstract
  • Objective: To evaluate the effect of oxacillin bound to magnetic nanoparticles on the model of local infection in rats.

    METHODS: Twelve Wistar rats weighing 290 ± 18g were randomly divided into four groups (n = 6, each) and all rats had a magnetic ring sutured to the right thighs. In the bioavailable distribution group, 0.1mL of 99mTc-magnetite (0.66 MBq) was injected i.v and after 30 minutes, the biodistribution of 99mTc-magnetite was evaluated in the right and left thighs. The other groups were inoculated with MRSA on each thigh muscle. The rats of group 1 were injected i.v. with magnetite, group 2 with magnetite-Oxacillin, group 3 with saline, all administered twice daily. After 24 hours, muscle secretion samples were collected for microbiological analysis; muscles, lungs and kidneys for histology.

    Results: The uptake of 99mTc-magnetite was three times greater in the muscles of the right thigh (with external magnet) than in the left. In the groups administered magnetite and magnetite-Oxacillin, the samples collected in the thigh muscles, the amount of colony forming units (CFU) of the bacterium was significantly lower than in the saline controls. The inflammatory reaction in muscles and lungs was significantly lower in rats receiving magnetite-Oxacillin than in the other groups (p <0.001).

    Conclusion: This study confirms the potential antimicrobial activity of magnetic nanoparticles for methicillin resistant strains of S. aureus, which in addition to concentrating the antibiotic at the site of infection, positively influenced the treatment.

3
  • JANA DARA FREIRES DE QUEIROZ
  • EVALUATION OF BIOMATERIALS FOR BONE REGENERATION PURPOSES

  • Advisor : SILVIA REGINA BATISTUZZO DE MEDEIROS
  • COMMITTEE MEMBERS :
  • SILVIA REGINA BATISTUZZO DE MEDEIROS
  • CARLOS AUGUSTO GALVAO BARBOZA
  • MATHEUS DE FREITAS FERNANDES PEDROSA
  • ALEXANDRE MALTA ROSSI
  • MELISSA CAMASSOLA
  • Data: Apr 27, 2018


  • Show Abstract
  • Different types of biomaterials have been developed over the years with various biomedical applications mainly for bone regeneration purposes. Technological evolution has led to the development of new and better biomaterials. Among the various types of biomaterials currently available, the nano and microstructured surfaces and nano and micrometric scale materials have gained prominence. LASER beam treatment is a controllable and flexible approach to modifying surfaces that creates a complex nano and micro-structured topography and thanks to its properties various types of particles have been widely developed. Although many studies have been conducted to evaluate the response to differentiation, little attention was paid to the genotoxic potential during this process. Therefore, assays to evaluate biocompatibility, including genotoxic studies, should be performed. The behavior of human mesenchymal stem cells was analyzed after exposure to surface modified laser discs and hydroxyapatite particles. Titanium disks were evaluated by electron microscopy, x-ray diffraction and contact angle measurement. The surface generated by the creep of 235 J / cm2 was used in the biological assays: MTT, mineralization, alkaline phosphatase activity and qRT-PCR for osteogenic markers. The nanoparticles (nanoXIM • HAp102®, Fluidinova, S.A.) and commercially available hydroxyapatite microparticles (Biotal Plasma) at concentrations of 0.1, 1 and 10 μg / ml were used and analyzed after 1, 3 and 7 days. The analysis of the data of the modified laser titanium a cell type dependent behavior reducing the proliferation of the mesenchymal stem cells and increasing the expression of the osteogenic markers and alkaline phosphatase activity in these cells. Particle evaluation showed that these did not affect the viability of hMSC (p <0.05), however, the higher concentrations used seem to induce an early osteogenic differentiation. This was evidenced by anticipation of the expected maximum levels of alkaline phosphatase activity (p <0.05) and extracellular matrix mineralization (p <0.01). No significant changes were observed in the oxidative state and the evaluated genotoxic potential. Interestingly, the frequencies of nucleoplasmic bridges (NPB) and DNA damage by the comet test were higher after 7 days under control conditions, suggesting that these bridges are characteristic of isolated hMSCs and tend to disappear during the differentiation process. Our findings show that laser irradiated titanium can modulate cell behavior in a cell type dependent manner and stimulate osteogenic differentiation. In addition, particle data suggest that the exposure induces a sufficient cellular response to prevent genetic instability and does not have prolonged genotoxic effects during osteogenic differentiation. Thus, the analyzed biomaterials demonstrate potential for its use in regenerative medicine and insofar as the particles appear to be safe in relation to genotoxicity

4
  • MARIA SOCORRO MEDEIROS DE MORAIS
  • BODY IMAGE AND QUALITY OF LIFE IN MIDDLE AND OLDER WOMEN: A CROSS-SECTIONAL STUDY

  • Advisor : MARIA DAS GRACAS ALMEIDA THORNTON
  • COMMITTEE MEMBERS :
  • DEYSE DE SOUZA DANTAS
  • MARIA DAS GRACAS ALMEIDA THORNTON
  • RAND RANDALL MARTINS
  • RICARDO NEY OLIVEIRA COBUCCI
  • RICARDO OLIVEIRA GUERRA
  • Data: Apr 27, 2018


  • Show Abstract
  • INTRODUCTION: The successive increase in female life expectancy has fostered a gradual interest in issues related to female aging. Among them, the perception of body image can have important consequences on health and quality of life, being related to conditions such as depression, eating disorders, low self-esteem and self-confidence. Thus, knowing the relationship in which the women’s aging maintains with her body and its possible implications on her quality of life are fundamental for health professionals to consider, in their routines, the impact that this can cause on the physical, psychological, emotional and mental, dimensions aiming, always, the best health carefor women in the aging process. OBJECTIVES: 1) To analyze the relationship between body image and quality of life in middle-aged women; 2) To investigate the relationship between weight gain and body image perception in menopausal and elderly women. METHODS: A cross-sectional study was carried out with a sample of women aged between 40 to 80 years old, living in Parnamirim/RN and Santa Cruz/RN. Sociodemographic data, anthropometric and body composition measurements, hormonal and biochemical measurements, hypertension, depression, reproductive history, physical activity, quality of life and body image perception were collected. For the statistical analysis, Multiple Linear Regression Analysis was performed for the UQoL domains and the total score was adjusted by the covariables who presented p <0.20 in the bivariate analysis. In addition, the identification of possible factors associated with poor perception of body image was performed by binary logistic regression analysis, with a corresponding odds ratio (OR) calculation. It was considered p <0.05 at all stages of the statistical analysis. RESULTS: Body image perception was related to all domains of quality of life, including total score, except for the occupational domain. Women who were dissatisfied due to the low weight, when compared to those satisfied with their body image, presented significantly lower scores in the health, emotional and total Uqol scores. Those who were unsatisfied with excess weight had lower Uqol scores for the health, emotional, sexual domains as well as the total score compared to those satisfied with body image. Regarding the variables that relate to poor perception of body image, we have: BMI, total cholesterol, physical activity and parity, all with p values lower than 0.05. The results show that with each increase in BMI, women were 1.27 times more likely to be dissatisfied with their body image, as well as women with borderline and high cholesterol (OR = 2.48). In addition, women who do not regularly exercise were 2.35 times more likely to be dissatisfied with their body image, while the highest number of children was a protection factor in relation to poor body image perception OR = 0,83. CONCLUSION: The dissatisfaction with body image is related to poorer quality of life in middle-aged and elderly women. In addition, those women with higher BMI, borderline and high cholesterol and those who do not practice physical activity are more likely to be dissatisfied with their body image.

5
  • GUSTAVO HENRIQUE DE MEDEIROS OLIVEIRA
  • (Application of high-resolution array platform for genome-wide Copy Number Variation (CNV) analysis in patients with nonsyndromic cleft lip and palate

  • Advisor : ADRIANA AUGUSTO DE REZENDE
  • COMMITTEE MEMBERS :
  • ADRIANA AUGUSTO DE REZENDE
  • GERALDO BARROSO CAVALCANTI JUNIOR
  • IVANISE MARINA MORETTI REBECCHI
  • MARIA LEILA CARDOSO
  • TARSIS ANTONIO PAIVA VIEIRA
  • Data: Apr 27, 2018


  • Show Abstract
  • Although more than 14 loci may be involved with the development of Nonsyndromic Cleft lip and/or palate, the precise etiology has not been fully elucidated and there is a confounding with syndromic forms. The traditional genetic mapping strategies have recently been complemented by the powerful tool of array-CGH, able to scan the whole genome at once and detect copy-number variants (CNVs). Although previous studies report that common benign CNVs are often smaller in size, with the majority of benign CNVs smaller than 20 kb here we reveal exonic small CNVs based on the importance of the encompassed genes to CLP. Array-CGH analysis of 15 DNA samples from oral cleft individuals identified 11 exonic CNVs affecting at least one exon of the candidate genes. Thirteen candidate genes (COL11A1, IRF6, MSX1, TERT, MIR4457, CLPTM1L, ESR1, GLI3, FGFR1, TBX1, OFD1, PHF8, and FLNA) were overlapped with the CNVs identified. Taking into account criteria such as size, number of markers and frequency in our-house control group and in DGV database, the microdeletions that encompass the MSX1 gene; the microduplications over the three genes TERT, MIR4457, CLPTM1L; and the microduplication on PHF8 gene stood out. The individual significance of genome-wide small CNVs has not been well elucidated in a clinical context, in oral clefts studies, little is known about the importance of small CNVs detected by array-CGH for genetic diagnosis and gene discovery. Our findings represent an initial search of the clinical significance of small CNVs and its relationship with genes implicate in the development of Nonsyndromic Cleft lip and/or palate.

6
  • ALDAIR DE SOUSA PAIVA
  • CLINICAL RELEVANCE OF FLOW CYTOMETRY IMMUNOPENOTYPING AND
    HEMATOLOGICAL FIND IN DIAGNOSIS AND CLASSIFICATION OF CHRONIC
    LYMPHOPROLIFERATIVE DISEASES.

  • Advisor : GERALDO BARROSO CAVALCANTI JUNIOR
  • COMMITTEE MEMBERS :
  • ALDO DA CUNHA MEDEIROS
  • AMALIA CINTHIA MENESES DO REGO
  • CARLOS ROBERTO ALVES
  • GERALDO BARROSO CAVALCANTI JUNIOR
  • MARIA ZELIA FERNANDES
  • Data: May 18, 2018


  • Show Abstract
  • Background: Chronic lymphoproliferative disorders (CLPD) constitute a group of lymphatic
    malignancies that are characterized by proliferation of neoplastic mature lymphocytes, and
    may be sourced B, T and natural killer cells (NK). Flow cytometric (FC) immunophenotyping is
    a routine practice in the differential diagnosis of these tumors, contributing to greater accuracy
    and new therapeutic perspectives. Methods: Patients (n= 500) with CLPD were investigated
    by FC. In addition, we also gathered patient information such as age, sex and hematologic
    data. Results: The results showed that 408 (81,6%) of cases were B-cell and 92 (18,4%)
    were T lymphocytes and NK cells. B-cells CLPD distribution was: 265 B-cell chronic
    lymphocytic leukemia, 17 B-cell prolymphocytic leukemia, 11 Hairy cell leukemia, 3 Follicular
    lymphoma in leukemic phase, 3 Splenic lymphoma with villous lymphocytes, 12 mantle cell
    lymphoma, one Waldenstrong macroglobulinemia, 47 multiple myeloma, 12 plasma cell
    leukemia, 9 Burkitt lymphoma and 37 B-cell CLPD with non-specific immunoclassification. The
    T/NK CLPD classification were: 11 Large granular lymphocyte leukemia (10 of T lymphocytes
    and one NK cells), 47 T-cell prolymphocytic leukemia, 10 Adult T-cell leukemia lymphoma, 8
    Sezary syndrome and 24 T-cell peripheral lymphoma. Conclusion: The data suggest that
    immunophenotyping is an important method in diagnosis, monitoring and prognosis when
    determining the pathological mechanisms of CLPD evolution.

7
  • ROSILENE RODRIGUES SANTIAGO
  • NANOSTRUCTURED LIPID CARRIERS CONTAINING AMPHOTERICIN B: DEVELOPMENT, IN VITRO RELEASE ASSAY, AND STORAGE STABILITY.

  • Advisor : ERYVALDO SOCRATES TABOSA DO EGITO
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • ERYVALDO SOCRATES TABOSA DO EGITO
  • LOURENA MAFRA VERISSIMO
  • NEILA DE PAULA PEREIRA
  • TOSHIYUKI NAGASHIMA JUNIOR
  • Data: Jul 9, 2018


  • Show Abstract
  • Nanostructured-lipid-carriers (NLC) can improve the encapsulation rate and the stability of drugs. The aim of this study was to develop an amphotericin B (AmB)-containing NLC (AmB-NLC). An experimental design was applied in order to determine the component concentration within the final formulation. The prepared NLC had their stability assessed on the basis of particle size, polydispersity index (PDI), zeta potential, and AmB recovery rate. NLC were also lyophilized (LYO) and optimized in order to improve their shelf-life. The experimental design presented the optimal component concentration as 7:3 (w/w) solid:liquid lipid ratio and 3% of surfactants. The produced NLC were white translucent, becoming yellow translucent when AmB was incorporated. For lyophilization, maltose was the best cryoprotectant using a 48 h freeze-drying cycle. Both the LYO-AmB-NLC and LYO-NLC were readily dispersible in water. The dried systems had slightly different physicochemical properties; however, they maintained their high encapsulation efficiency of above 90%. Additionally, DSC and XRD exhibited the crystallinity state of the particles. The in vitro release profile, assessed 24 h after particle preparation, fitted the Baker-Lonsdale model. In conclusion, all the results together revealed that the developed NLC can be an available alternative as a drug delivery system for AmB.

8
  • ANNE DA COSTA ALVES
  • Quality of life related to the installation of the total prosthesis

  • Advisor : JOAO CARLOS ALCHIERI
  • COMMITTEE MEMBERS :
  • ANA KARÉNINA FREITAS DO AMARAL
  • GILSON DE VASCONCELOS TORRES
  • HANNALICE GOTTSCHALCK CAVALCANTI
  • JOAO CARLOS ALCHIERI
  • KARINNA VERISSIMO MEIRA TAVEIRA
  • Data: Aug 15, 2018


  • Show Abstract
  • Full edentulism is characterized by the permanent loss of permanent teeth, resulting in aesthetic, structural and functional changes, which can negatively impact the quality of life, being minimized through rehabilitation with the dental prosthesis. The objective of this study was to compare the quality of life related to oral health in patients with the complete mandibular complete denture three months after the installation of the new prosthesis and two years after the new removable bimaxillary prosthesis was made. In this longitudinal comparative study, 15 volunteers, aged between 50 and 82 years, of both sexes, who sought treatment in the Department of Dentistry of the Federal University of Rio Grande do Norte, participated in the preparation of new prostheses. The Brazilian version of the Oral Health Impact Profile for edentulous patients (OHIP-EDENT) was used to evaluate the quality of life. Data analysis was performed descriptively and analytically with the Friedman and Wilcoxon tests, with a significance level of 5%. In relation to the domains of OHIP-EDENT, there was a difference for discomfort and masticatory incapacity between the initial evaluation and after two years. In the areas of pain and orofacial discomfort, Psychological Disability and Social Disability, there were no differences between the evaluated periods. Indicators of improvement in patients' quality of life were observed, in the discomfort and masticatory incapacity domain between the evaluation and 2 years.

9
  • EWERTON DANTAS CORTÊS NETO
  • The Resilience of Adolescent Participants in Social Projects for Sport

  • Advisor : EULALIA MARIA CHAVES MAIA
  • COMMITTEE MEMBERS :
  • EULALIA MARIA CHAVES MAIA
  • GILSON DE VASCONCELOS TORRES
  • HENIO FERREIRA DE MIRANDA
  • RODRIGO DA SILVA MAIA
  • SONIA CRISTINA FERREIRA MAIA
  • Data: Aug 24, 2018


  • Show Abstract
  • Introduction: The Social Projects for Sport, destined for the young people from the lower economic group financed both by private and governmental institutions, looks to ensure safety measures for the adolescents that are subjected daily to situations of risk and vulnerability. The resilience refers to the adaptive capability of the subject due to daily events and consist of individual variations in response to risk factors. Objective: The main objective of this research is to evaluate the resilience of adolescent participants in social projects for sport. Materials and Methods: Cross-section Study, comparative and analytical, covered 134 adolescents, from ages 12 to 17, domiciled in a social zone of high vulnerability located in a Northeastern Brazilian city. The data collect was obtained through structured interviews and a questionnaire/ resilience scale, developed by Wagnild and Young (1993), instrument used to measure the positive psychosocial adaptation levels in the face of determined life events. The descriptive and inferential statistical analysis were utilized, especially the Student ‘T’ Test for the independent samples and the chi-square test. In both cases, the statistical significance level adopted was p<0.05. Results: Among the subjects of the research, 53.7% were participants in social projects for sport and 46.3% of non- participants in social projects for sport. A significant statistical difference was found of the resilience between boys and girls, not representing significant statistical differences of resilience among participants, and non-participants, the girls have almost 57% higher risks of lower resilience and 
    the younger (up to age 14) have approximately 77% higher risk of low resilience when compared to young people of 15 and older. Final Considerations: The adolescents presented a high level of resilience as an overall group, but it was not observed differences between the participant and non-participants groups of Social Projects for Sport.

10
  • EWERTON DANTAS CORTÊS NETO
  • The Resilience of Adolescent Participants in Social Projects for Sport

  • Advisor : EULALIA MARIA CHAVES MAIA
  • COMMITTEE MEMBERS :
  • EULALIA MARIA CHAVES MAIA
  • GILSON DE VASCONCELOS TORRES
  • ISABEL MARIA FARIAS FERNANDES DE OLIVEIRA
  • RODRIGO DA SILVA MAIA
  • SONIA CRISTINA FERREIRA MAIA
  • Data: Aug 24, 2018


  • Show Abstract
  • Introduction: The Social Projects for Sport, destined for the young people from the lower economic group financed both by private and governmental institutions, looks to ensure safety measures for the adolescents that are subjected daily to situations of risk and vulnerability. The resilience refers to the adaptive capability of the subject due to daily events and consist of individual variations in response to risk factors. Objective: The main objective of this research is to evaluate the resilience of adolescent participants in social projects for sport. Materials and Methods: Cross-section Study, comparative and analytical, covered 134 adolescents, from ages 12 to 17, domiciled in a social zone of high vulnerability located in a Northeastern Brazilian city. The data collect was obtained through structured interviews and a questionnaire/ resilience scale, developed by Wagnild and Young (1993), instrument used to measure the positive psychosocial adaptation levels in the face of determined life events. The descriptive and inferential statistical analysis were utilized, especially the Student ‘T’ Test for the independent samples and the chi-square test. In both cases, the statistical significance level adopted was p<0.05. Results: Among the subjects of the research, 53.7% were participants in social projects for sport and 46.3% of non- participants in social projects for sport. A significant statistical difference was found of the resilience between boys and girls, not representing significant statistical differences of resilience among participants, and non-participants, the girls have almost 57% higher risks of lower resilience and 
    the younger (up to age 14) have approximately 77% higher risk of low resilience when compared to young people of 15 and older. Final Considerations: The adolescents presented a high level of resilience as an overall group, but it was not observed differences between the participant and non-participants groups of Social Projects for Sport.

11
  • MÁRCIA CRISTINA SALES

  • Zinc in plasma and correlation with metabolic markers of institutionalized elderly in Natal / RN

  • Advisor : LUCIA DE FATIMA CAMPOS PEDROSA
  • COMMITTEE MEMBERS :
  • BRUNA LEAL LIMA MACIEL
  • DILINA DO NASCIMENTO MARREIRO
  • ILMA KRUZE GRANDE DE ARRUDA
  • LUCIA DE FATIMA CAMPOS PEDROSA
  • RICARDO OLIVEIRA GUERRA
  • Data: Aug 24, 2018


  • Show Abstract
  • The objective of this study was to evaluate plasma zinc concentrations and associations with sociodemographic, biochemical, dietary and immunological indicators in institutionalized elderly. A cross - sectional study involving 255 elderly individuals enrolled in 13 Long - Term Institutions for the Elderly (ILPI) in the city of Natal / RN. The associations between zinc plasma concentrations, zinc in the diet, as well as sociodemographic indicators and biomarkers with a glycemic, lipid and inflammatory profile were evaluated. The independent variables were analyzed according to the quartiles of plasma zinc concentration (μg / dL) (Q1: <71.1, Q2: 71.1-83.3, Q3: <83.3-93.7; Q4:> 93.7). The correlation between plasma zinc concentration and predictor variables was also tested. In Q1, higher concentrations of the following variables were observed compared to the other quartiles: total cholesterol and LDL-c (Q1> Q2, Q3, Q4, all p <0.001); triacylglycerols (Q1> Q3, Q4, all p <0.001); IL-6 (Q1> Q3, Q4, p = 0.024, p = 0.010, respectively); and TNF-α (Q1> Q3, p = 0.003). There was a significant reduction in plasma zinc concentration as the time of institutionalization adjusted for age (Δ = -0.10, CI95%: -0.18, -0.01) and total cholesterol concentrations ( Δ = -0.19, CI95%: -0.23, -0.15), LDL-c (Δ = -0.19, CI95%: -0.23, -0.15), triacylglycerols (Δ = -0.11, 95% CI: -0.16, -0.06), IL-6 (Δ = -1.41, 95% CI: -2.64, -0.18) and TNF-α (Δ = -1.04, 95% CI: -1.71, - 0.36). Thus, data from the present study suggest that a decrease in plasma zinc concentration is associated with longer institutionalization time and changes in the lipid and inflammatory profile in institutionalized older adults. In a second study, the prevalence of metabolic syndrome (MS) was evaluated in 202 elderly people, according to the criteria of the National Cholesterol Education Program - Adult Treatment Panel III, as well as the associated factors. The prevalence of MS was 29.2% (95% CI: 23.0-36.0%). The occurrence of MS was higher in women, in the elderly with institutionalization time adjusted for age> 50%, and in the presence of high concentrations of IL-6 and TNF-α (p <0.05). Thus, the results point to a moderate prevalence of MS, which was associated with demographic factors, institutional care and immunological changes.

     
12
  • JOANNA DE ANGELIS DA COSTA BARROS GOMES
  • In Vivo Evaluation Of Antioxidant Activity And Protective Action Of The Seaweed Gracilaria birdiae

  • Advisor : HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • COMMITTEE MEMBERS :
  • ANA KATARINA MENEZES DA CRUZ SOARES
  • DANIELLE SOARES BEZERRA
  • HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • HERYKA MYRNA MAIA RAMALHO
  • RANILSON DE SOUZA BEZERRA
  • Data: Aug 30, 2018


  • Show Abstract
  • In recent years, the seaweeds have attracted attention of researchers because their antioxidant properties. The red seaweed Gracilaria birdiae is farmed and used as food in Brazilian northeast. However, the economic potential of this seaweed is little explored. To occur direct consumption and/or product diversification from G. birdiae it is necessary, for instance, evaluate its effect in vivo. In this study mice had its feed improved with G. birdiae. After 21 days, the seaweed reduce the weight gain and blood glucose of mice. In addition, it increases Trolox Equivalent Antioxidant Capacity (TEAC), glutathione, and catalase levels in comparison to control group.  Besides, some groups also received carbon tetrachloride (CCl4). In this case, histological, enzymatic and antioxidant tests showed the seaweed capacity of protecting animals from damages caused by this toxic agent. The results of the present study indicate that the alga G. birdiae protected the mice from the damages caused by CCl4, indicating that the seaweed studied exhibits protective action in vivo.

13
  • DALIANA CALDAS PESSOA DA SILVA
  • Up-expression of TCD8+ cells associated with oncogenic high-risk HPV in women with
    low squamous intraepithelial lesions.

  • Advisor : GERALDO BARROSO CAVALCANTI JUNIOR
  • COMMITTEE MEMBERS :
  • AMALIA CINTHIA MENESES DO REGO
  • ANA CLAUDIA GALVAO FREIRE GOUVEIA
  • GERALDO BARROSO CAVALCANTI JUNIOR
  • MAIZA ROCHA DE ABRANTES
  • SARAH DANTAS VIANA MEDEIROS
  • Data: Nov 9, 2018


  • Show Abstract
  • Objective: To compare the quantitative expression of T lymphocytes and subsets T-helper

    (CD3+/CD4) and T-cytotoxic (CD3+/CD8+), B lymphocytes (CD19+) as well as NK cells
    (CD16-56+) and NKT (CD3/CD16-56+) cells in HPV-infected woman’s, correlated with the
    presence of low-risk and oncogenic HPV-DNA. Methods: Were analyzed 30 healthy women
    and 30 patients with Low Squamous Intraepithelial Lesions undergoing HPV genotype
    detection by hybrid capture. The presence of T lymphocytes (CD4 and CD8 subsets), CD19,
    NK, and NKT cells were investigated by flow cytometry immunophenotyping. The average
    number of cells in each group was verified using the Student t-test. A significance level of 5%
    was adopted in all the tests carried out. The graph pad statistical program was used to
    calculate the values. Results: We found a sharp increase in TCD8+ T lymphocytes among
    patients with oncogenic HPV DNA and a statistically significant reduction in the expression of
    NK and NKT cells in all groups of patients analyzed when compared with the healthy control
    group. Furthermore, the quantitative evaluation of the CD19 was normal in patients exhibiting
    LSIL and HPV when compared with the healthy control group. Conclusions: These
    preliminary data suggest a correlation between the increased number of TCD8 lymphocytes
    and oncogenic HPV DNA.

14
  • DANIELE MARIA LOPES PINHEIRO
  • Resveratrol regulates inflammatory response through chromatin remodeling

  • Advisor : LUCYMARA FASSARELLA AGNEZ LIMA
  • COMMITTEE MEMBERS :
  • LUCYMARA FASSARELLA AGNEZ LIMA
  • ADRIANA FERREIRA UCHOA
  • RODRIGO JULIANI SIQUEIRA DALMOLIN
  • ANDRE QUINCOZES DOS SANTOS
  • TATJANA KEESEN DE SOUZA LIMA CLEMENTE
  • Data: Nov 9, 2018


  • Show Abstract
  • Resveratrol, Antioxidant, Inflammation, Chromatin, Transcription

15
  • TATIANE ANDREZA LIMA DA SILVA
  • Influence of curcumin on energy metabolism, body composition and lipid profile of people living with HIV/AIDS

  • Advisor : PAULO MOREIRA SILVA DANTAS
  • COMMITTEE MEMBERS :
  • PAULO MOREIRA SILVA DANTAS
  • GERALDO BARROSO CAVALCANTI JUNIOR
  • SANCHA HELENA DE LIMA VALE
  • ANDERSON MARLIERE NAVARRO
  • RONALDO VAGNER THOMATIELI DOS SANTOS
  • Data: Nov 20, 2018


  • Show Abstract
  • Objective: To evaluate the influence of curcumin supplementation on the substrate oxidation at rest, body composition and lipid profile of people living with HIV/AIDS (PLHA) under antiretroviral therapy.  Methods: This double-blind, crossover, randomized clinical trial was comprised by 20 subjects arranged in experimental group (EG) and control group (CG), receiving 1,000mg curcumin/day and placebo, respectively, during 30 days. The substrate oxidation at rest was assessed by indirect calorimetry, the body composition was measured by Dual-energy X-ray Absorptiometry, and the lipid profile was evaluated by biochemical tests. Data analysis was performed by independent samples and paired t-tests to compare the difference between groups and times. A p value < 0.05 was accepted as significant.  Results: There was no difference between groups regarding substrate oxidation at rest and body composition. Regarding the lipid profile, an increase in serum triglyceride levels was observed after curcumin supplementation (182 vs. 219mg/dL; p=0.004). Conclusion: Curcumin supplementation (1.000mg/day during 30 days) promoted elevation of serum triglyceride levels in PLHA. Considering the scientific evidence of the potential anti-inflammatory and antioxidant properties of curcumin and its positive effect on the modulation of serum triglycerides, we highlighted the need for additional studies to better understand the impact of curcumin supplementation and its effects on metabolic pathways of lipid metabolism on PLHA. 

16
  • STENIO MEDEIROS QUEIROZ
  • CORRELATION OF RADIOMORPHOMETRIC INDICES OF THE MANDIBLE AND BIOCHEMICAL PARAMETERS IN PATIENTS WITH SECONDARY HYPERPARATHYROIDISM DUE TO CHRONIC KIDNEY DISEASE

  • Advisor : HEBEL CAVALCANTI GALVAO
  • COMMITTEE MEMBERS :
  • HEBEL CAVALCANTI GALVAO
  • ERICKA JANINE DANTAS DA SILVEIRA
  • PATRICIA TEIXEIRA DE OLIVEIRA
  • ANA LUIZA DIAS LEITE DE ANDRADE
  • MANUEL ANTONIO GORDON NUNEZ
  • Data: Nov 30, 2018


  • Show Abstract
  • Objective: The objective was to correlate radiomorphometric indices and biochemical analyzes as an auxiliary method in bone evaluation in male and female patients with chronic kidney disease - bone and mineral disorder (BMD-CKD) and controls. Materials and biochemicals were obtained: Mental index (MI), Mental foramen height (HMF), Total mandibular height (MM), Panoramic mandibular index (PMI), Original height of the mandible (OHM), Alveolar bone resorption distance from the mental foramen to the alveolar bone crest (MF-ABC), cortical mandibular index (MCI), trabecular bone pattern, parathyroid hormone (PTH), calcium (Ca), phosphorus (P) and CaxP product. The Mann-Whitney U test, the chi-square test and the Spearman correlation were applied at a significance level of 95%. Results: There was a moderate and significant negative correlation between MI, PMI and PTH in female patients with DCM BMD, as well as enter THM, MF-ABC and CaxP. The CCm and trabecular pattern indicated alteration in bone quality in the male patients. Conclusions: Radiomorphometric evaluation was considered a useful and noninvasive auxiliary method to detect possible alterations in the mandibular bone trabeculation and bone trabeculation and patients with CKD-BMD
17
  • ARLINETE SOUZA DE MEDEIROS
  • NATURAL TRANSOVARIAL TRANSMISSION OF DENGUE VIRUS TYPE 4 BY AEDES AEGYPTI IN BRAZIL

  • Advisor : SELMA MARIA BEZERRA JERONIMO
  • COMMITTEE MEMBERS :
  • FABÍOLA DA CRUZ NUNES
  • JOSE VERISSIMO FERNANDES
  • JOSELIO MARIA GALVAO DE ARAUJO
  • MARIA DE FATIMA FREIRE DE MELO XIMENES
  • RAFAEL MACIEL DE FREITAS
  • SELMA MARIA BEZERRA JERONIMO
  • Data: Dec 4, 2018


  • Show Abstract
  • In this study, we investigated whether there was transovarial transmission of dengue virus in Aedes aegypti and Aedes albopictus in Natal, Rio Grande do Norte, Brazil. Mosquito larvae were sampled monthly from April 2011 to March 2012. Viral RNA was extracted from 140 µL original suspension of mosquito larvae by the QIAamp Viral RNA Mini Kit and RT-PCR for detecting and typing DENV was performed. During the study period, 1,333 larvae were collected—1,186 (89%) Ae. aegypti and 147 (11%) Ae. albopictus. Dengue virus type 4 was identified in 4 pools of Aedes aegypti larvae in four districts of Natal, Brazil. DENV infection rate in Ae. aegypti larvae was expressed as minimum infection rate (MIR=3.37). Dengue viruses were not identified in Aedes albopictus larvae. This finding further confirms the importance of larval control since the immature stages may become the reservoir of the virus during the inter-epidemic periods as well as the main reservoir of the virus.

2017
Dissertations
1
  • MANOELLA DO MONTE ALVES
  • IMMUNOLOGICAL PROFILE OF INDIVIDUALS WITH HIV/LEISHMANIA INFANTUM COINFECTION

  • Advisor : SELMA MARIA BEZERRA JERONIMO
  • COMMITTEE MEMBERS :
  • SELMA MARIA BEZERRA JERONIMO
  • LARA DE MELO BARBOSA ANDRADE
  • LUCAS PEDREIRA DE CARVALHO
  • Data: Mar 17, 2017


  • Show Abstract
  • The risk to develop visceral leishmaniasis (VL) in subjects with HIV+ (Human
    immunodeficiency virus) is greater than for immunocompetent people with
    asymptomatic Leishmania infantum. The hypothesis of this study was that persistent
    T cell activation in HIV co-infected persons and asymptomatic Leishmania infection
    increases the risk of progression to VL and to relapse. To test this hypothesis, a crosssectional
    study of subjects HIV+ was carried out between May 2014 and August 2016
    in an endemic area for LV, in the state of Rio Grande do Norte, northeast Brazil, with
    the goal to determine the rate of asymptomatic L. infantum infection in HIV-infected
    persons (HIV +) and the immunological status of this co-infection. A total of 1,134 HIV+
    subjects was recruited. A subgroup of HIV/L. infantum was followed to determine the
    level of T cell activation, senescence, anergy, exhaustion and regulation and clinical
    follow up and compared to a HIV+, AIDS/VL, VL alone and healthy individuals. The
    rate of L. infantum asymptomatic infection was 23.6%. Of the 268 HIV/L. Infantum, 2
    developed VL and died. Subjects with HIV/L. infantum, AIDS/VL and VL group
    presented higher expression of CD38HLA-DR and PD1 in CD8 cells than subjects with
    only HIV. For all groups, there was an increased expression of CD57 in T CD8
    lymphocytes. HIV/L. infantum group presented the higher CD25FoxP3 expression in T
    CD8 lymphocytes. People infected with L. infantum had a greater activation of CD8 T
    lymphocytes. This persistent activation may lead to possible immunologic deficits that
    in individuals with immunosuppressive diseases would increase the risk to develop VL.
    Therefore, prophylaxis with leishmanicidal drugs should be considered.

2
  • LIZIE EMANUELLE EULALIO BRASILEIRO
  • ESTUDO DA ASSOCIAÇÃO ENTRE SÍNDROME DA FRAGILIDADE E DEPRESSÃO EM IDOSOS DOMICILIARES

     
  • Advisor : IRIS DO CEU CLARA COSTA
  • COMMITTEE MEMBERS :
  • BERNARDINO FERNANDEZ CALVO
  • IRIS DO CEU CLARA COSTA
  • IVANOR VELLOSO MEIRA LIMA
  • Data: Apr 12, 2017


  • Show Abstract
  • O envelhecimento da população brasileira, ou a nomeada transição demográfica, tem sido enunciada nas últimas décadas. A ciência acompanha esta premissa a partir das demandas socioculturais, políticas e econômicas. Assim sendo, estudos que visam evidenciar fatores associados ou correlacionados a um determinado agravo têm aumentado. A depressão no idoso tem sido considerada um importante tema, por agregar nuances filosóficas e bio-psicológicas, relacionando desde o sofrimento da proximidade do fim da vida até a alta prevalência de doenças crônicas não transmissíveis. Sabe-se que a depressão é uma doença com sintomatologia psíquica e física, oriunda de alterações em nível de neurotransmissores, bem como alterações inflamatórias. Ainda, está relacionada à perda de autonomia e incapacidades, quedas e hospitalizações, diminuindo a qualidade de vida. Além da depressão, a síndrome de fragilidade tem sido cada vez mais estudada, inclusive por apresentar forte impacto nas vivências de idosos. Objetivou-se estudar a associação entre os indicadores da fragilidade e a depressão no idoso, avaliando a magnitude através das razões de prevalência (RP). Trata-se de um estudo seccional, derivado de um estudo multicêntrico- Rede FIBRA (Fragilidade em idosos brasileiros) - em um município no interior do nordeste brasileiro. Foi utilizada uma amostra de idosos domiciliares com mais de 65 anos de idade que pontuassem acima do ponto de corte em exame cognitivo. Utilizou-se análise bivariada de Poisson, bem como análise multivariada. Observou-se que características sóciodemográficas como ser viúvo e não ser alfabetizado apresentam associação significativa com os sintomas depressivos. Dentre os indicadores de fragilidade, perda de peso, fadiga e falta de atividade física apresentaram p inferior a 0,05. Estas observações permitem observar a sobreposição entre os sintomas depressivos e indicadores de fragilidade, o que suscita a conjectura acerca da suficiência de apenas indicadores físicos serem utilizados para a constatação de fragilidade, sem a inclusão de um indicador que avalie aspectos afetivos. Percebe-se que muitos estudos ainda necessitam ser realizados, especialmente com metodologia que permita inferência de causalidade.

3
  • MARIA HELENA VIEIRA DE MELO
  • PELVIC FLOOR MUSCLE THICKNESS IN WOMEN WITH POLYCYSTIC OVARY SYNDROME

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • ROBINSON DIAS DE MEDEIROS
  • ANA CARLA GOMES CANARIO
  • Data: May 5, 2017


  • Show Abstract
  • OBJECTIVE: to evaluate pelvic floor muscle (PFM) thickness in women with polycystic ovary syndrome (PCOS) group and compare it to those with normal menstrual cycle (control group). MATERIALS AND METHODS: transperineal ultrasound examination was used to evaluate the thickness of the bilateral pelvic floor muscles RESULTS: The mean age was 25.1(± 2.1) and 24.2(± 1.9) years in PCOS and control groups, respectively (p> 0.05). Body mass index averaged 22.5(± 0.9) in the control group and 27.8(± 2.6) in the PCOS group (p = 0.03). There was no difference between the thickness of the pelvic floor muscles (PCOS Group: Right 1.12(± 0.5), Left 1.0 (± 0.6) and control group: Right 0.89(± 0.6); Left 0.94(± 0.4)). CONCLUSIONS: there was no differences in pelvic floor muscle thickness identified by ultrasound. However, the PCOS group exhibited a tendency to greater thickness. This may be due to the state of hyperandrogenism or abdominal overload.

4
  • TIAGO FELIPE DE SENES LOPES
  •  

    Efeito Tóxico-Genético de Extratos Vegetais de Plantas Medicinais do Nordeste Brasileiro

  • Advisor : MARIA DAS GRACAS ALMEIDA THORNTON
  • COMMITTEE MEMBERS :
  • CELINA MARIA PINTO GUERRA DORE
  • JOANA CRISTINA MEDEIROS TAVARES MARQUES
  • MARIA DAS GRACAS ALMEIDA THORNTON
  • Data: Jun 6, 2017


  • Show Abstract
  • As plantas medicinais são usadas para os cuidados de saúde primários através de um conhecimento que passa ao longo das gerações. Assim, as espécies Turnera subulata e Spondias mombin × Spondias tuberosa estão incluídas neste contexto, devido ao seu uso pela medicina popular no Nordeste brasileiro para o tratamento de várias doenças. Dessa forma, o objetivo deste estudo foi avaliar as propriedades genotóxicas de extratos foliares dessas espécies pelo teste SMART em células somáticas de asas de Drosophila melanogaster. Assim, os experimentos foram realizados utilizando o cruzamento padrão (ST) e o cruzamento de alta bioativação (HB) com três concentrações diferentes do extrato aquoso (EAT e EAS) a 5,0; 10,0 e 20,0 mg/mL, extrato etanólico (EET e EES) e fração de acetato de etilo (FAET e FAES) a 0,625; 1,25 e 2,5 mg/mL. Os resultados indicaram que os extratos e as frações induziram frequências espontâneas de manchas mutantes em ambos os cruzamentos com D. melanogaster. No entanto, as concentrações mais elevadas dos agentes vegetais testados foram os responsáveis pelo efeito genotóxico estatisticamente significativo. Portanto, T. subulata e S. mombin × S. tuberosa apresentaram efeito genotóxico sob as condições experimentais. Estes dados são importantes porque indicam o efeito deletério, bem como o efeito adverso, considerando o uso indiscriminado de extratos destas plantas para o tratamento de doenças.

5
  • DANIELE DE SOUZA MARINHO DO NASCIMENTO
  • A planta Baccharis trimera (Less.) DC possui atividade anti-adipogênica por inibir a expressão de proteínas envolvidas na diferenciação adipocitária 

  • Advisor : HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • COMMITTEE MEMBERS :
  • HERYKA MYRNA MAIA RAMALHO
  • HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • KARLA DANIELLY DA SILVA RIBEIRO RODRIGUES
  • Data: Jun 22, 2017


  • Show Abstract
  • A obesidade é um problema de saúde pública em todo o mundo, principalmente em países desenvolvidos e em desenvolvimento. A Baccharis trimera (Less.) DC (carqueja) é uma planta medicinal utilizada na medicina tradicional em várias partes do Brasil. Para tal, infusões, decocções e tinturas de suas folhas são produzidas e utilizadas para o tratamento da obesidade e da diabetes, e também como diuréticos, agentes digestivos, antiinflamatórios, dentre outros. Neste trabalho, com intuito de respaldar o potencial medicinal da carqueja, extratos de folhas de Baccharis trimera foram obtidos, caracterizados química e fitoquimicamente e avaliadas com relação a suas atividades antioxidante e antiadipogênica. Foram obtidos três extratos: aquoso (AE), decoco (AE-D) e metanólico (ME); a partir destes, foram realizados seis diferentes ensaios antioxidantes in vitro: ensaio do radical superóxido e hidroxila, poder redutor, capacidade antioxidante total e quelação dos íons ferro e cobre. Bem como, foi avaliada sua possível atividade antiadipogênica com os testes de oil red O, glicerol livre e mensuração de fatores de transcrição adipogênicos C/EBPα, C/EBPβ e PPARγ. Na caracterização fitoquímica, revelou-se a presença de flavonoides (ácido clorogênico e apigenina) e compostos fenólicos nos extratos AE e AE-D. Quanto a atividade antioxidante, verificou-se uma atividade dose-dependente. Em relação à atividade antiadipogênica, a Baccharis trimera inibiu significantemente a diferenciação e acúmulo de gordura nos adipócitos pelo MDA numa relação dose-dependente e reduziu significantemente a expressão dos fatores de transcrição C/EBPα, C/EBPβ e PPARγ, durante a adipogênese numa relação dose-dependente também. Este trabalho sugere-se que Baccharis trimera possui ótima atividade antioxidante, prevenindo o estresse oxidativo, podendo contribuir para a diminuição da adipogênese, além de possuir ótima atividade antiadipogênica. Este foi o primeiro trabalho que demonstrou o potencial efeito de extratos de Baccharis trimera na diferenciação de adipócitos 3T3-L1 em adipócitos.

6
  • ANDREZA CONCEIÇÃO VÉRAS DE AGUIAR GUERRA
  • AVALIAÇÃO DAS ATIVIDADES ANTITUMORAL E ANTIOXIDANTE IN VITRO DE EXTRATOS DE Libidibia ferrea EM CÉLULAS DE CÂNCER COLORRETAL

  • Advisor : RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • COMMITTEE MEMBERS :
  • JEYMESSON RAPHAEL CARDOSO VIEIRA
  • RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • SERGIO ADRIANE BEZERRA DE MOURA
  • Data: Jun 23, 2017


  • Show Abstract
  • O câncer colorretal tem se destacado por ser um dos tumores mais frequentes, com índices de morbidade e mortalidade expressivos. Na descoberta de novas drogas, produtos derivados de plantas se destacam por ser uma fonte segura e capaz de originar compostos de alta eficiência. Bastante conhecida na medicina popular brasileira, Libidibia ferrea (Mart. ex Tul.) L.P. Queiroz var. ferrea, tem sido utilizada no tratamento de um amplo espectro de condições e na prevenção do câncer. Nesse estudo, extratos bruto de L. ferrea (EF20T, EF40T, EF60T e EF80T) foram avaliados por 24 h e/ou 48 h pela capacidade de inibição da proliferação celular; indução de apoptose através da avaliação de Bcl-2, caspase-3 e Apaf-1; atividade antioxidante e efeito sobre alvos importantes relacionados a proliferação celular (EGFR e AKT) na linhagem colorretal humana HT-29, por meio de metodologias que envolveram ensaios de citometria de fluxo, espectrofotometria e RT-qPCR. Os resultados demostram que os extratos tiveram grande potencial antiproliferativo comparado ao controle, indução de apoptose através da via intrínseca e provável ação de inibição tumoral com a mediação de alvos importantes na tumorigênese. Além disso, possui efeito antioxidante e anti-peroxidação lipídica, bem como quimioprotetor nas células saudáveis. Portanto, derivados de L. ferrea possuem importantes efeitos anticâncer podendo ser considerados candidatos moleculares promissores para inovação do tratamento do câncer colorretal.

7
  • VINÍCIUS BARRETO GARCIA
  • Análise dos efeitos anti-inflamatórios, antioxidantes e anti-fibróticos do carvedilol em modelo de esteato-hepatite alcoólica induzida em ratos Wistar.

  • Advisor : RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • COMMITTEE MEMBERS :
  • GERLANE COELHO BERNARDO GUERRA
  • JEYMESSON RAPHAEL CARDOSO VIEIRA
  • RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • Data: Jun 23, 2017


  • Show Abstract
  •  

    Aim: To evaluate the anti-inflammatory, anti-oxidant and antifibrotic effects of carvedilol (CARV) in rats with ethanol-induced liver injury.

    Methods: Liver injury was induced by gavage administration of alcohol (7 g/kg) for 28 consecutive days. Eighty Wistar rats were pretreated with oral CARV at 1, 3, or 5 mg/kg or with saline 1 h before exposure to alcohol. Liver homogenates were assayed for interleukin (IL)-1β, IL-10, and tumor necrosis factor (TNF)-α level as well as for myeloperoxidase (MPO) activity and malonyldialdehyde (MDA) and glutathione (GSH) levels. Serum aspartate aminotransfer-ase (AST) activity and liver triglyceride (TG) levels were also assayed. Immunohistochemi-cal analyses of cyclooxygenase 2 (COX-2), receptor activator of nuclear factor kappa-B/ ligand (RANK/RANKL), suppressor of cytokine signalling (SOCS1), the Kupffer cell marker IBA-1 (ionized calcium-binding adaptor molecule 1), intercellular adhesion molecule 1 (ICAM-1), superoxide dismutase (SOD-1), and glutathione peroxidase (GPx-1) expression were performed. Confocal microscopy analysis of IL-1β and NF-κB expression and real-time quantitative PCR analysis for TNFα, PCI, PCIII, and NF-κB were performed.

    Results:CARV treatment (5 mg/kg) during the alcohol exposure protocol was associated with reduced steatosis, hepatic cord degeneration, fibrosis and necrosis, as well as reduced levels of AST (p < 0.01), ALT (p < 0.01), TG (p < 0.001), MPO (p < 0.001), MDA (p < 0.05), and proinflammatory cytokines (IL-1β and TNF-α, both p < 0.05), and increased levels of the anti-inflammatory cytokine IL-10 (p < 0.001) and GSH (p < 0.05), compared to the alco-hol-only group. Treatment with CARV 5 mg/kg also reduced expression levels of COX-2, RANK, RANKL, IBA-1, and ICAM-1 (all p < 0.05), while increasing expression of SOCS1, SOD-1, and GPx-1 (all p < 0.05) and decreasing expression of IL-1β and NF-κB (both, p < 0.05). Real-time quantitative PCR analysis showed that mRNA production of TNF-α, procollagen type I (PCI), procollagen type III (PCIII), and NF-κB were decreased in the alcohol-CARV 5 mg/kg group relative to the alcohol-only group.
    Conclusions: CARV can reduce the stress oxidative, inflammatory response and fibrosis in ethanol-induced liver injury in a rat model by downregulating signalling of Kuppfer cells and hepatic stellate cells (HSCs) through suppression of inflammatory cytokines.

8
  • JÉSSICA MARIA AROUCA DE MIRANDA

  • Quality of life of the elderly in the Family Health Strategy: health demands and proposition of multidimensional interventions

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • EULALIA MARIA CHAVES MAIA
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • Data: Jul 17, 2017


  • Show Abstract
  • The significant change in the demographic profile of the world shows an accelerated process of global aging. To obtain an active and healthy aging is necessary to maintain a good physical, psychological and social functioning along to this, one should invest in interventions to reduce the incidence of health demands and propitiate the quality of life. The research objective is to develop multidimensional interventions from health demands, to improve the quality of life of elderly enrolled in the Family Health Strategy. This is a quantitative, descriptive and methodological study, involving elderly enrolled in the Health Family Strategy Christmas and Santa Cruz, both in Rio Grande do Norte. The sample consisted of 120 elderly individuals who met the inclusion criteria. The study was developed in three phases. Data collection, data analysis and planning of multidimensional and multidisciplinary interventions. Non-parametric tests (Chi-square, Mann Whitney and Spearman's correlation) were used to analyze the data. The research was approved by the Research Ethics Committee of the University Hospital Onofre Lopes and asked the participants to sign the Informed Consent Term. It was observed that the elderly present three main health demands (functional, nutritional and depressive symptoms, respectively) and their total QOL score was considered satisfactory. However, the main health demands that correlated with QoL were depressive symptoms, followed by functional health demand. From these health demands it was possible to plan multidimensional and multidisciplinary interventions. It was planned six strategies (market simulation, exercise, nutrition lecture, bingo food, introduction to technology, use of technology involving nutrition and physical activity evolving) for use in the group with an average of an hour and a half. It was verified the importance of intervention with the elderly to keep them active, independent, with social and healthy contact. In order to do this, it is necessary to increase the involvement of Family Health Strategies, since it is the gateway to health services that aims to promote health and prevent injuries.
9
  • LEONARDO DANTAS REBOUÇAS DA SILVA

  • Low-cost assessment device for lower limb discrepancy

  • Advisor : PAULO MOREIRA SILVA DANTAS
  • COMMITTEE MEMBERS :
  • PAULO MOREIRA SILVA DANTAS
  • GILSON DE VASCONCELOS TORRES
  • LUIZ ALBERTO BATISTA
  • Data: Aug 25, 2017


  • Show Abstract
  • Many physical limitations are observed in the population, and asymmetries appear as a relevant factor for the inefficiency of motor gestures, both in daily activities and in sports. Member discrepancies are an example of these asymmetries, and this condition in which the limbs are visibly unequal when paired, is most often shown in the lower limbs. The objective of this study was to describe the instrument and to identify the correlation and the statistical difference between a low-cost lower limb discrepancy method and the gold-standard method for this. This is a cross-sectional study in which the lower limb discrepancies of five subjects were evaluated using this low-cost Legmeter device and compared with the results reported by radiography. For the data normality, we used the Shapiro-Wilk test, the Student's T test and the pearson correlation test for the level of distribution and correlation of the data, respectively. The results showed that the two methods did not present statistical differences (p = 0.598) and presented a high positive correlation (r = 0.917; p = 0.029). In this way, the Legmeter low cost discrepancy evaluation method is shown as a reliable and more accessible resource for this type of evaluation. Further studies are being performed with larger sample sizes for more consistent results.
10
  • JOSÉ RODOLFO TORRES DE ARAÚJO
  • PREVALENCE OF MOBILITY LIMITATIONS AND FACTORS ASSOCIATED WITH INSTITUTIONALIZED ELDERLY PERSONS

  • Advisor : KENIO COSTA DE LIMA
  • COMMITTEE MEMBERS :
  • KENIO COSTA DE LIMA
  • JULIANA MARIA GAZZOLA
  • IGOR CONTERATO GOMES
  • Data: Nov 29, 2017


  • Show Abstract
  • The objective of this work is to determine the prevalence of mobility limitations in institutionalized older adults and their associated factors. This is a cross-sectional study carried out on January 2015 in 10 nursing homes for older adults in Brazil. Individuals aged ≥ 60 years were included in the study, excluding those hospitalized, those who were absent in the data collection period and those who did not live full-time in the institution. Sociodemographic information related to the institutions and the health conditions of the elderly was collected. Mobility limitations were checked based on information given by the main caregiver using the Barthel Scale. The Chi-square test and a multiple logistic regression were used in the statistical analysis at a significance level of 5%. The sample consisted of 305 older adults, mostly women, with a mean age of 81.5 years (SD 8.47). The prevalence of mobility limitations was 65.6% (95% CI: 59.6-70.4), and 26.9% of the older adults were wheelchair users. The final model revealed a statistically significant association of these limitations with malnutrition or risk for malnutrition (p < 0.001, 1.86: 1.54-2.26) and age ≥ 81 years (p = 0.002, 1.35: 1.12 – 1.63). We conclude that mobility limitations have a high prevalence among institutionalized older adults associated with longevity and nutritional status.

11
  • VIVIANE BRITO NOGUEIRA
  • CajaDB: A knowledgebase for molecular data of common marmosets (Callithrix jacchus) and transcriptomics analysis

  • Advisor : MARIA BERNARDETE CORDEIRO DE SOUSA
  • COMMITTEE MEMBERS :
  • FABIOLA DA SILVA ALBUQUERQUE
  • JOAO PAULO MATOS SANTOS LIMA
  • MARIA BERNARDETE CORDEIRO DE SOUSA
  • Data: Dec 14, 2017


  • Show Abstract
  •  

     The common marmoset (Callithrix jacchus), a small New World monkey, has been widely used as a biological model not only in an attempt to elucidate brain dysfunction in neuropsychiatric disorders but also for deciphering neural circuits involved in human social behaviors. In this regard, the availability of gene expression data derived from next-generation sequencing (NGS) technologies represents an opportunity for deeper studies on the genetic and epigenetic architecture of this species. One of the frontiers in neuroscience field requires handling omics large-scale data sets for connecting molecular pathways to nervous system behavior. To make these omics datasets more accessible for the scientific community without a solid bioinformatics background, we have created CajaDB, a knowledgebase that provides a friendly interface for genomic, expression and alternative splicing data, including tools for biological analyses. Using the processed data two analysis were conducted: (1) Differential expression between right and left hemispheres, once lateralization is a crucial aspect of the functional brain architecture for cognitive abilities. It was found 49 differentially expressed genes, where 24 genes had left hemisphere bias and 25 genes had right hemisphere bias. (2) Sex-biased gene expression with focus in frontal comparing to humans. It was found that genes whose expression is male biased are conserved between marmosets and humans and enriched with "house-keeping" functions. On the other hand, female-biased genes are more related to neural plasticity functions involved in remodeling of synaptic circuits, stress cascades and visual behavior.  Based on knowledge of dimorphic social behavior of male and female common marmosets we discuss that these differences might be linked to particular neuronal circuitry underlying the expression of the adaptive strategies in each sex and related to survival and reproductive behavior traits. Hence, it is expected that data available in the knowledgebase associated with available biological tools will facilitate generation of hypotheses and interpretation of results on brain functioning, facilitating improvements in neurological diseases treatment in the future. CajaDB is available at cajadb.neuro.ufrn.br.

12
  • RAFAEL RODOLFO TOMAZ DE LIMA
  • HEALTH TRAINING AGAINST THE NEEDS OF PEOPLE ELDERLY
  • Advisor : KENIO COSTA DE LIMA
  • COMMITTEE MEMBERS :
  • KENIO COSTA DE LIMA
  • MARCELO VIANA DA COSTA
  • ROSANA LUCIA ALVES DE VILLAR
  • Data: Dec 15, 2017


  • Show Abstract

  • This dissertation aims to analyze the training of ESF and NASF to meet the needs of the elderly. It is of a qualitative research, carried out in two stages and with different methodological procedures. In the first stage, to analyze how the approach of the subject of human aging occurs the training of professionals working in the ESF and NASF through the documentary research. The second step consisted in understanding, with the focus groups, the perception of the elderly about their needs, as well as to understand their perception of the professional skills required for care that this portion of the population needs under the ESF and the NASF. The results of the documental research revealed that professional training for care with the health of the elderly is based exclusively on the care and of chronic-degenerative diseases, as well as in the identification and prevention of harm to health. In addition, the operationalization of the perception of the elderly people participating in the study. study on their needs, classifying them into two themes: The need for good living conditions and the need for access to health services. According to the participants, the professionals of the ESF and the NASF are well qualified to serve them, however, they do not have autonomy to solve the needs listed. For the resolution of needs, qualify the managers (municipal, state and local federal) of the health sector would be the priority path. With the study, it is noticed that the discussion about the theme of aging in the process of training human resources in health is still incipient and disassociated with the health needs of the elderly. Thus, if makes it necessary to prepare people who pay adequate attention to the population, as well as to formulate and manage public policies for the population that is a SUS user.

Thesis
1
  • LUCILA CORSINO DE PAIVA
  • *BURNOUT SYNDROME IN HEALTH CARE PROFESSIONALS IN A UNIVERSITARY HOSPITAL

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANA ELZA OLIVEIRA DE MENDONCA
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • IGOR CONTERATO GOMES
  • IVONETE BATISTA DE ARAUJO
  • TERESA DE LISIEUX LOPES FROTA
  • Data: Mar 7, 2017


  • Show Abstract
  • OBJECTIVE: to evaluate Professional Achievement and factors associated with occupational burnout among health professionals. METHODS: An institution based cross-sectional study was conducted on 436 health care providers, consisting of 101 nurses, 81 doctors and 254 nursing technicians, all meeting the pre-established inclusion criteria. Occupational burnout was detected using Maslach occupational burnout Inventory tool. Data was collected by means of self-administered questionnaires comprised of questions concerning socio demographics, education and training and then followed by the Maslach occupational burnout Inventory, used to identify the level of Emotional Exhaustion, Depersonalization and Professional Achievement. RESULTS: Emotional Exhaustion was associated with education level and work place of nursing technicians. Depersonalization was associated with gender in nursing technicians. For nurses, Depersonalization showed a significant correlation with education level, whereas for doctors Depersonalization was associated with number of jobs. Lower levels of Professional Achievement were observed in unspecialized doctors when compared to those with further training, higher levels of Professional Achievement were associated with post graduated professionals, when compared to those without post-graduation. CONCLUSIONS: High Emotional Exhaustion was found in professionals from the maternity unit, as well as in professionals with lower educational levels. Depersonalization was found to be higher in Physicians with several jobs and in female nurses, while low Professional Achievement was found in unspecialized docto s. Higher Professional Achievement was associated with post graduated professionals.

2
  • CHRISTIANE KELEN LUCENA DA COSTA
  • Study of techniques of quantification and efficacy of an exercise program on functionality of the pelvic floor and its impact on the female sexual function

     

  • Advisor : MARIA BERNARDETE CORDEIRO DE SOUSA
  • COMMITTEE MEMBERS :
  • ALINE DO NASCIMENTO FALCAO FREIRE MONTE
  • MARIA BERNARDETE CORDEIRO DE SOUSA
  • MARIA THEREZA ALBUQUERQUE BARBOSA CABRAL MICUSSI
  • NEIDE MARIA GOMES DE LUCENA
  • TECIA MARIA DE OLIVEIRA MARANHAO
  • Data: Mar 10, 2017


  • Show Abstract
  • Aim. Pelvic floor muscle (PFM) force seems to be associated to better performance in sexual response in women. However, the benefits for a short intervention using training program for FPM on sexual response of young healthy women are not yet demonstrated. Therefore, the aim of this study was to evaluate the sexual response in young healthy women before and 4 and 8-weeks after a training program of pelvic floor muscles (PFM) evaluated by three psychometric instruments.

    Methods. Thirty –one in young healthy women were Training program includes 4 contexts (bipedal, dorsal laying, quadrupedal and seated postures) but participants best performed bipedal exercises (adherence varies from 100% to 54%) and only this type was considered for analysis. Data for pelvic musculature was collected using PERFECT method in the initial and final sessions, and analyzed by T-paired test. Sexual response questionnaires, FSFI, SQ-F and GRISS, were completed before and after 4 and 8 weeks the introduction of training program and tested by ANOVA, for both individual domains and total scores. For the three instruments were also analyzed the accuracy measured by the area under the ROC curve (AUC) for individual domains within each questionnaire as well as to estimate the cross accuracy, two-by-two, for the three instruments.

    Results. Participants showed a better performance in PERFECT after 8- week’s period of training program comparing to initial performance, for both fast and slow switch fibers (T-Value= -15.39, p< 0.001; T-Value= -4.23; p < 0.001). They also showed a positive impact on the sexual function (ANOVA, p<0.02; FSSI: desire, excitation and orgasm/SQ-F: sexual interest, preliminaries/GRISS: orgasm). All three questionnaires showed a fair-good-optimal accuracy (ROC analysis) in assessing the domains (IFSF:AUC = 0,74-0,891 in six domains; GRISS:AUC=  0,706- 0,933 in seven domains and SQ-F:AUC = 0,882-0,821, but poor agreement for two domains= 0.594 and 0.580. ROC curve to compare the predictive value for one instrument in relation to the other show the best accuracy for FSFI x SQ-F (AUC= 0.891). 

    Conclusion.  Many evidences are available showing a growing body of data to support the involvement of PFM in the improvement of sexual female response. This study shows the positive impact of a training program for PFM with the increase of force in both fast and slow switch perineal muscle fibers although performed during 8-weeks period. Also, the program also improved some scores evaluated by the  three different instruments (FSSI, SQF-F and GRISS) analysis showing significant differences associate to optimal- good accuracy across the monitoring. These data are promising to build short-term physical therapy Programs to young healthy women contributing for increase their pelvic functions, and quality of life.

    Key Words.; Pelvic Floor Muscles; Physical Therapy; Dyspareunia; Orgasm; FSSI; SQ-F; GRISS

3
  • WALICYRANISON PLINIO DA SILVA ROCHA
  • Efeito do extrato de Eugenia uniflora na expressão global de proteínas durante a morfogênese de Candida albicans

  • Advisor : GUILHERME MARANHAO CHAVES
  • COMMITTEE MEMBERS :
  • ANALY SALLES DE AZEVEDO MELO
  • ANDRE DUCATI LUCHESSI
  • GUILHERME MARANHAO CHAVES
  • MARCELO DE SOUSA DA SILVA
  • WAGNER LUIZ BATISTA
  • Data: Mar 30, 2017


  • Show Abstract
  • Em certas circunstâncias, Candida albicans pode passar de colonizante para infectante e, como na candidíase oral. A morfogênese de C. albicans, bem como sua capacidade de combater o estresse oxidativo no interor de células fagocíticas, é um fator essencial para a invasão tecidual e estabelecimento da infecção. Devido ao baixo arsenal antifúngico disponível no mercado e o constante surgimento de cepas resistentes, faz-se necessária a pesquisa de novas fontes terapêuticas, principalmente oriundas de produtos naturais. No presente estudo foram selecionados 48 isolados clínicos de C. albicans oriundos da cavidade bucal de pacientes transplantados renais. A fração acetato de etila de Eugenia uniflora foi utilizada na concentração de 1000 µg/mL para avaliar a ação comparativa (tratada e não tratada com extrato) sobre a fagocitose e morfogênese de C. albicans. Foi realizado o ensaio de resistência ao ataque de neutrófilos polimorfonucleares. O isolado 111R, de alta capacidade filamentação foi utilizado para avaliação do perfil protéico por meio de análise proteômica, bem como da interação com proteínas diretamente associadas à morfogênese. A resposta à infecção foi observada em modelo murino de candidíase oral e a ação tóxica do extrato de E. uniflora foi observada em ensaio de MTT. O extrato de E. uniflora reduziu significativamente a capacidade de fagocitose de C. albicans (média total de 120.36 ± 36.71 vs. 44.68 ± 19.84). Trinta e nove proteínas foram identificadas na análise proteômica, relacionadas à geração de energia, metabolismo de proteínas e glicose, divisão celular, transporte citoplasmático, metabolismo de ácidos nucléicos, estrutura celular e resposta ao estresse. Importantes proteínas relacionadas com a formação do citoesqueleto foram reguladas negativamente nas células tratadas. Houve instalação de infecção na cavidade oral dos camundongos e a infecção foi atenuada quando C. albicans foi pré-incubada na presença do extrato de E. uniflora e quando o extrato foi aplicado na cavidade oral após a instalação da infecção. Este resultado foi condizente com a redução na contagem de UFC (2.36 vs. 1.85 Log10 CFU/ml) e a atenuação dos danos teciduais observados na análise histopatológica. O extrato de E. uniflora não foi tóxico para células humanas mesmo em concentrações 8x acima da utilizada nos experimentos. A fração acetato de etila de E. uniflora poderá causar danos à parede celular e proteínas essenciais ao metabolismo de C. albicans, afetando proteínas relacionadas à estrutura celular, reduzindo a capacidade plástica de filamentação, atenuando a ação invasiva em modelo animal, sem causar efeito tóxico em células humanas, podendo ser uma futura alternativa terapêutica para o tratamento de infecções por Candida.

4
  • JOAO FELIPE BEZERRA
  • Associação de polimorfismos do gene IRF6 em pacientes com fendas orais não-sindrômicas

  • Advisor : ADRIANA AUGUSTO DE REZENDE
  • COMMITTEE MEMBERS :
  • ADRIANA AUGUSTO DE REZENDE
  • LEONARDO CAPISTRANO FERREIRA
  • TIRZAH BRAZ PETTA
  • GABRIELA FERRAZ LEAL
  • TARSIS ANTONIO PAIVA VIEIRA
  • Data: Apr 3, 2017


  • Show Abstract
  • As fendas orais constituem um problema de saúde publica atingindo cerca de 15% de todas as malformações, caracterizando-se pela formação incompleta das estruturas que separam a cavidade nasal e a cavidade oral com fatores genéticos e ambientais que contribuem para sua etiologia. Atualmente, estudos de microarray, utilizando pacientes fissurados identificaram diversas regiões de susceptibilidade para o desenvolvimento das fendas orais não-sindrômicas, dentre essas alguns estudos demonstraram a região do gene IRF6 associado ao aumento de risco para o desenvolvimento das fendas. O objetivo do presente trabalho é pesquisar polimorfismos do gene IRF6 e as possíveis correlações com o desenvolvimento das fendas orais não-sindrômicas. Para isso, um total de 368 individuos (186 pacientes FL/P e 182 controles) foram selecionados no Serviço de Atendimento ao Paciente Fissurado - HUOL/UFRN. Amostras de sangue foram coletadas para extração do DNA e análise dos polimorfismos do gene IRF6 (rs2235371, rs642961, rs2236907, rs861019, e rs1044516) por PCR em tempo real. . Os pacientes foram classificados nos grupos CLP, CL e CP e foi observada uma associação significativa de rs2235371 (OR: 11,24, 95% CI: 1.97-64.22, p = 0,016) no grupo com a fendas palatinas isoladas (CP). Além disso, a análise da combinação alélica mostrou um aumento do risco de fendas associado aos polimorfismos rs1044516 e rs2236907, uma vez que estavam presentes em todas as combinações significativas. Assim, a associação do rs2235371 com pacientes do grupo CP mostra-se como um fator de risco para CP em nossa população. A análise das combinações alélicas mostram a influência de polimorfismos do IRF6 combinadas, principalmente (rs1044516 e rs2236907) sugerem que cada polimorfismo pode contribuir minimamente para aumentar o risco de desenvolver fendas orais não-sindrômicas em uma população brasileira de Rio Grande do Norte .

5
  • CARLA ISMIRNA SANTOS ALVES
  • CONFIABILIDADE DA ESCALA DE SAINT-ANNE DARGASSIES INTERAVALIADORES NA AVALIAÇÃO DO PADRÃO NEUROLÓGICO EM RECÉM-NASCIDO PRÉ-TERMO SEM COMPLICAÇÕES COM ULTRASSOM CRANIANO SERIADO NORMAL.

  • Advisor : AUREA NOGUEIRA DE MELO
  • COMMITTEE MEMBERS :
  • AUREA NOGUEIRA DE MELO
  • ANA RAQUEL RODRIGUES LINDQUIST
  • CLAUDIA RODRIGUES SOUZA MAIA
  • GISELDA FÉLIX COUTINHO
  • SEBASTIAO FRANCO DA SILVA
  • Data: May 12, 2017


  • Show Abstract
  • Objetivos: estudar a confiabilidade da Escala de Saint-Anne Dargassies [13] na avaliação do padrão neurológico em RNPT com ultrassom craniano seriado normal, a partir da determinação do grau de concordância entre os avaliadores e o avaliador considerado Padrão Ouro para estabelecer os limites de concordância dos itens da ESD durante o período da prematuridade. Métodos: avaliou-se 20 RNPT, não complicados, nascidos e atendidos na Unidade de Terapia Intensiva da Maternidade Escola Januário Cicco (MEJC), Natal/Brasil, no período de agosto de 2012 a dezembro de 2013. A avaliação de cada grupo foi feita independentemente por dois avaliadores em cada grupo (I; II) e todos os RN foram avaliados pelo Padrão Ouro. Resultados: foi observado alta concordância entre os avaliadores do grupo I e do grupo II em relação ao Padrão Ouro para avaliação do padrão postural, reflexos primitivos, tônus passivo e tônus ativo. Ainda foi observado probabilidade de igualdade entre as medidas do perímetro cefálico nos dois grupos. Conclusão: a Escala de Saint-Anne Dargassies demonstrou alta confiabilidade e homogeneidade, podendo ser considerada uma escala com alta reprodutibilidade e ser utilizada como instrumento de avaliação para o RNPT com ou sem complicações clínico/neurológicas durante o período de prematuridade até a idade de termo.

6
  • MIGUEL ADELINO DA SILVA FILHO
  • Physico-chemical study, Pharmacotoxycology and PKPD modeling for the development of a new micelle formulation of amphotericin B

  • Advisor : ERYVALDO SOCRATES TABOSA DO EGITO
  • COMMITTEE MEMBERS :
  • ERYVALDO SOCRATES TABOSA DO EGITO
  • ALDO DA CUNHA MEDEIROS
  • ANSELMO GOMES DE OLIVEIRA
  • ELQUIO ELEAMEN OLIVEIRA
  • FRANCELINE REYNAUD
  • Data: May 19, 2017


  • Show Abstract
  • The increasing incidence of systemic fungal infections along with the growth of clinical isolates resistant to first line clinical treatment is a challenging epidemiological scenario in clinical practice. The development of new strategies is of paramount importance for the control of this rampant problem. Micellar amphotericin B (AmB-D) has a satisfactory activity profile, but its toxicity is pronounced. An alternative to reduce its toxicity is the controled heating of AmB-D resulting in superaggregates (AmB-H). Aiming a new therapeutic alternative, it was evaluated as structural modifications of AmB-H by accessing its physico-chemical characteristics, “in vitro” toxicity profile in red blood cells, “in vitro” activity in Candida sp strains and designed a semi-mechanistic PKPD model. A spectroscopy screening showed that there is a blue shift at the aggregate band from 327nm to 323nm, AmB-D and AmB-H respectively. The dilution study showed that AmB-H acts as the reservoir for the amphotericin B monomeric forms. Red blood cell toxicity studies have demonstrated that at high concentrations of AmB-H (5mg.L-1 and 50mg.L-1) presents around 2% of hemoglobin leakage whereas AmB-D presents the 100%, proving the profile of low toxicity by this experiment model. The activity evaluation, the AmB-H presented similar results to AmB-D against C. albicans and C. parapsiloses. The evaluation of the critical steps of the freeze-drying process, AmB-H has proven no changing during the process making it a good manufacturing strategy. Regarding the pharmacometrics, the semi-mechanistic PKPD model demonstrated that AmB-H is about 25% more potent than AmB-D and the model also provides quantitative parameters estimates that corroborate with a scientific literature and it provides a support to the development of clinical trials. All these data demonstrate that AmB-H is a promising system and together with scientific literature, it produces solid scientific subsidies to initiate clinical trials and finally the development of a new therapeutic strategy.

7
  • ISABEL KAROLYNE FERNANDES COSTA
  • CONSTRUÇÃO E VALIDAÇÃO DE UM CURSO A DISTÂNCIA DE SUPORTE BÁSICO DE VIDA.

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • EULALIA MARIA CHAVES MAIA
  • GILSON DE VASCONCELOS TORRES
  • RENATA SILVA SANTOS
  • RODRIGO ASSIS NEVES DANTAS
  • THALYTA CRISTINA MANSANO SCHLOSSER
  • Data: Jul 7, 2017


  • Show Abstract
  • O objetivo dessa investigação foi analisar as evidências de validação de um curso de Suporte Básico de Vida (SBV) na modalidade de ensino a distância (EAD) para acadêmicos e profissionais de saúde de um Hospital Universitário. Trata-se de uma pesquisa metodológica, quantitativa, utilizando enquanto método a teoria psicométrica de Pasquali. O estudo desenvolveu-se em duas etapas: construção e validação do conteúdo de três ferramentas: instrumento de avaliação de conhecimento em suporte básico de vida (ACSBV); conteúdo do curso de Suporte Básico de Vida (CSBV) e roteiro do jogo educativo simulado de Suporte Básico de Vida (JESBV). A amostra para validação do instrumento de avaliação do conhecimento foi composta por 29 juízes e seis juízes para o curso e roteiro do jogo. A coleta de dados foi realizada entre agosto e setembro de 2016. O estudo foi aprovado (Parecer nº 1.709.004 e CAAE: 58511516.0.0000.5292) pelo Comitê de Ética em Pesquisa do Hospital Universitário Onofre Lopes. Os dados foram analisados por meio de estatística descritiva e inferencial, utilizando os programas Microsoft-Excel e SPSS 20.0, com uso do índice Kappa (K) e Índice de Validade de Conteúdo (IVC), considerando aceitável K ≥0,65 e IVC>0,80. O nível de significância estatística estabelecido para o valor de ρ foi < 0,05. O ACSBV continha inicialmente 13 questões. Na validação do ACSBV, verificou-se que das 33 sugestões realizadas, 18 foram acatadas, 3 rejeitadas e 12, após análise de valores de IVC e Kappa, serviram de orientação para a exclusão de três questões. Assim, ao final foram removidas as questões (5, 6 e 13) com índice K ou IVC menores que o estabelecido nesse estudo, sendo a clareza o requisito com menores valores de adequação. Na avaliação global, após retirada das três questões, o instrumento final ficou com 10 questões e obteve IVC de 0,95 e K de 0,81. Quanto ao processo de validação do CSBV, verificou-se que das 16 sugestões realizadas, 14 foram acatadas e apenas 2 rejeitadas. A maioria das sugestões esteve relacionada aos requisitos avaliação geral do conteúdo, utilidade, clareza, objetividade e vocabulário. Desse modo, o CSBV foi validado com índices satisfatórios pelos juízes (IVC – 0,94; K - 0,87; nota média 9,50). Quanto ao JESBV, esse foi desenvolvido em 13 telas, das quais 9 apresentaram conteúdos de SBV, e as demais orientações gerais para o avançar do jogo. A elaboração do roteiro priorizou a complexidade gradativa dos conhecimentos em SBV com cuidados minuciosos na organização dos textos e na proposta das animações. Das cinco sugestões realizadas, todas foram acatadas, sendo a maioria relacionada aos requisitos de organização, clareza e vocabulário. Nenhum item foi considerado inadequado, apresentando o jogo um valor médio de 0,95 de IVC; 0,81 de Kappa e nota média de 9,67. O desenvolvimento de todas as ferramentas que compõe o Curso de Suporte Básico de Vida (CSBV) em EAD apesar de ter se mostrado um processo complexo e desafiador é válido para apoiar o ensino de urgência (nessa temática) para acadêmicos e profissionais de saúde.

8
  • KARLA VANESSA RODRIGUES SOARES MENEZES
  • Impact oh hospitalization in functional and mobility capacity o folder adults

  • Advisor : RICARDO OLIVEIRA GUERRA
  • COMMITTEE MEMBERS :
  • ANA CAROLINA PATRICIO DE ALBUQUERQUE SOUSA
  • ARMELE DE FATIMA DORNELAS DE ANDRADE
  • IRAMI ARAUJO FILHO
  • MAYLE ANDRADE MOREIRA
  • RICARDO OLIVEIRA GUERRA
  • Data: Jul 13, 2017


  • Show Abstract
  • Introduction As people get older remains a challenge maintaining functional
    capacity. Functional capacity defined as the ability to perform self-care
    activities (i.e. activities of daily living - ADLs) is classified inside the level of
    “activity and participation” of the International Classification of Functioning,
    Disability and Health (ICF). Previous studies have identified different risk
    factors for worsening functional capacity during hospitalization, including older
    age, sociodemographic characteristics, preexisting disability, comorbidity,
    cognitive loss and depression. In-hospital mobility has received particular
    attention due to its important relation to loss of functional capacity. Few
    studies about hospitalization effects on older adults were done in Brazil and in
    an attempt to fill this gap this study was developed. Identify older adults at risk
    for loss in functional capacity during hospitalization will help researchers and
    clinicians in order to make informed decisions. Objectives This study has
    three objectives. First: to provide an updated review to identify and appraise
    relevant instruments for the measurement of older adults’ mobility based on
    the ICF conceptual framework in the context of an acute care or intensive
    geriatric rehabilitation unit and to appraise and compare their measurement
    properties. Second: to evaluate if in-hospital mobility assessed at admission is 

    predictive of loss in functional capacity during hospitalization of older adults.
    Third: to assess functional changes since pre admission (baseline) until
    discharge of hospitalized older adults and identify predictors of loss in
    functional capacity. Methods This cohort prospective study was conducted at
    University Hospital Onofre Lopes (HUOL), Natal/RN, Brazil, between January
    1, 2014 and April 30, 2015. The study enrolled all consecutive patients aged
    60 years and older who were acutely admitted and fill the following inclusion
    criteria: 1) ability to provide informed consent; 2) admitted directly from the
    community; 3) screening for study eligibility performed in first 24 hours of
    admission. Independent variables included personal characteristics, domestic
    live activities (i.e. instrumental activities of daily living – IADL) evaluated by
    Lawton and Brody´s scale, cognition evaluated by Leganés cognitive test,
    depression assessed by Geriatric Depression Scale (GDS-15), in-hospital
    mobility evaluated by Short Physical Performance Battery (SPPB). The
    dependent variable functional capacity was assessed by Katz scale. Those
    instruments were applied at two different times: at admission (within first 24
    hours) and at discharge (12-24 hours before). Analysis included descriptive
    statistics, bivariate and multivariate, by means of frequencies, means ±
    standard error, receiver-operating characteristic (ROC), logistic binary
    regression and Generalized Estimating Equation (GEE). Data were entered
    into the Statistical Package for Social Sciences (SPSS) version 18.0 for
    Windows. Results At discharge from the 1256 included 65 (5.1%) died during
    the hospitalization and final sample consisted of 1191 older adults. The mean
    age was 70.02 (±7.34), 684 (57.4%) participants were men and 790 were
    married (66.3%). The mean length of hospital stay was 7.65 days (±9.94). Our
    sample had a high prevalence of surgery (˃70%). Regarding to the best
    instruments to assess mobility De Morton Mobility Index (DEMMI) and SPPB
    presented the best balance between mobility coverage, measurement
    properties and applicability to acute care and intensive geriatric rehabilitation
    units. SPPB cutoff point of 6.5 (62% sensitivity, 54% specificity) identified 593
    (49.8%) patients at risk for loss in functional capacity. In logistic regression
    SPPB alone presented statistically significant prediction loss of functional
    capacity between admission and discharge. Finally regarding to changes in
    functional capacity 52.5% of the older adults were discharged with worse
    functional capacity than baseline. Be dependent in domestic life activities,
    presence of depressive symptons, low levels of cognition and in-hospital
    mobility were risk factors for greater loss in functional capacity after a
    hospitalization event. Conclusion We concluded that DEMMI and SPPB
    were the best instruments to assess mobility in hospitalized older adults.

    Regarding to functional capacity half of the sample presented loss in
    functioning between baseline and discharge and in-hospital mobility evaluated
    by SPPB can predict loss of function in hospitalized older adults. In addition to
    in-hospital mobility, dependence for domestic life activities, low levels of
    cognition and depression improve the detection of cases at risk of loss in
    functional capacity.

9
  • DAYANNE LOPES GOMES
  • INTERAÇÃO DE POLISSACARÍDEOS SULFATADOS DA MACROALGA MARINHA Caulerpa cupressoides var. flabellata COM CRISTAIS DE OXALATO DE CÁLCIO

  • Advisor : HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • COMMITTEE MEMBERS :
  • HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • JULLIANE TAMARA ARAUJO DE MELO CAMPOS
  • VANESSA DE PAULA SOARES RACHETTI
  • HERYKA MYRNA MAIA RAMALHO
  • LUCIANA NUNES MENOLLI LANZA
  • Data: Jul 20, 2017


  • Show Abstract
  • A urolitíase afeta aproximadamente 10% da população mundial e está associada fortemente aos cristais de oxalato de cálcio (CaOx). Atualmente não existe nenhum composto eficiente que pode ser utilizado para prevenir esta doença. No entanto, os polissacarídeos sulfatados (SPs) de algas possuem a capacidade de alterar a carga superficial dos cristais de CaOx e assim modificar a dinâmica da cristalização, devido a interação das cargas negativa desse polímero com a superfície do cristal durante sua síntese. Observamos que as frações polissacarídicas de C. cupressoides modifica a morfologia e o tamanho desses cristais, bem como altera a carga superficial dos cristais, tornando-os negativos, o que pode diminuir a interação desses cristais com as células renais. Análises de infravermelho comprovaram a ligação dos SPs e a tese de que eles atuam não somente diminuindo a supersaturação de Ca2+ no meio, mas também interagindo diretamente com os cristais. Além disso, através de análises de composição atômica (EDS), miscroscopia de fluorescência e citometria de fluxo (SPs conjugados com FITC), foi proposto um modelo de interação que esquematiza as interações entre os SPs de Caulerpa e com os cristais de CaOx para gerar as morfologias de cristais COD arredondados ou em forma de halteres e COM ovais e achatados. Este estudo é o primeiro passo para o entendimento das interações entre os SPs, que são moléculas promissoras para o tratamento da urolitíase, e os cristais de CaOx que são os principais causadores do cálculo renal.

10
  • VANESSA DE FÁTIMA LIMA DE PAIVA MEDEIROS

  • EFFECTS OF HYPERTENSIVE COCONUT WATER AND SINVASTATIN IN TREATMENT OF SEPSE AND HYPOVOLEMIC SHOCK IN RATS

  • Advisor : ALDO DA CUNHA MEDEIROS
  • COMMITTEE MEMBERS :
  • ALDO DA CUNHA MEDEIROS
  • DEBORAH DE MELO MAGALHÃES PADILHA
  • GERALDO BARROSO CAVALCANTI JUNIOR
  • REJANE ANDRADE DE CARVALHO
  • ROBSON DE MACEDO FILHO
  • Data: Jul 28, 2017


  • Show Abstract
  • Resuscitation and treatment of shock and sepsis are controversial and challenging. The objective of this study was to examine the effects of coconut water + 3% NaCl + simvastatin on resuscitation in a murine model of sepsis and hemorrhagic shock. Adult male Wistar rats were submitted to sepsis by ligature and cecal puncture and hemorrhagic shock, divided into four hydroelectrolytic replacement groups. 1. 0.9% saline solution; 2. coconut water + 3% NaCl; 3. coconut water + 3% NaCl + simvastatin (microemulsion) 10 mg / kg i.v; 4. Normal coconut water. Clinical scores, histology, and lung fluorescence were evaluated in this study. Serum cytokine levels of TNF-α, IL-1β and IL-6 and leukocyte counts were determined. Treatment with coconut water + NaCl 3% + simvastatin resulted in significantly better survival, biochemical and histopathological results compared to the animals submitted to the other treatments. In conclusion, i.v. use of coconut water with 3% NaCl + simvastatin had a positive effect on the treatment of rats with hemorrhagic shock and sepsis in all parameters studied. The clinical implication of anti-inflammatory effects in the treatment of inflammation associated with sepsis and hemorrhagic shock needs to be better evaluated in future studies.
11
  • THALYNE YURI ARAUJO FARIAS
  • Quality of life of people with venous ulcer measured by CIVIQ-20
  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • DANIELE VIEIRA DANTAS
  • EULALIA MARIA CHAVES MAIA
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • ROBERTA AZOUBEL
  • Data: Aug 30, 2017


  • Show Abstract
  • Objective: To evaluate the quality of life of people with venous ulcer through CIVIQ20. Method: cross-sectional, quantitative, non-probabilistic sample, Composed of 30 people with CVD who had active ulcer CEAP Clinical 6, Performed at the angiology outpatient clinic of a university hospital in Natal / RN, Through a structured interview form with characteristics Sociodemographic and health indicators and a related Quality of Life instrument To Health, CIVIQ-20. Main results: All dimensions of CIVIQ (Physics, Pain, Social and Psychological) and total score of the instrument, all obtained averages and Medians with values that approximate the scores of worse quality of life, With statistically significant variations (p <0.001). What can demonstrate a Impact of these factors that make up the instrument's dimensions in the Quality of life of patients with CVD in this study, For the physical dimension with a mean of 71.0 and Pain with a mean of 67.0. Conclusion: The results demonstrate an important impact of the dimensions of the instrument In the quality of life of patients with CVD participating in this study.
12
  • JULIANA MOTA FERREIRA
  • PRIMARY HEALTH CARE: ASSESSMENT OF ATTRIBUTES AND IDENTIFICATION OF QUALITY AND SERVICE IMPROVEMENT STRATEGIES
  • Advisor : IRIS DO CEU CLARA COSTA
  • COMMITTEE MEMBERS :
  • IRIS DO CEU CLARA COSTA
  • AURIGENA ANTUNES DE ARAUJO
  • FLAVIA CHRISTIANE DE AZEVEDO MACHADO
  • DANIELA MENDES DA VEIGA PESSOA
  • MARIA DO CARMO EULÁLIO
  • Data: Sep 15, 2017


  • Show Abstract
  • Primary Health Care (PHC) is the first level of care within the of the health system, and has four essential attributes: first contact, continuity and integrality of care, and coordination of the assistance. It also adds three other characteristics (attributes derivatives), which qualify actions in PHC: family-centered attention, community orientation, and cultural competence. Identifying the presence and extension of these attributes is important in order to define a service as really oriented towards PHC, and allows to verify the association between these and he results - effectiveness - of the health care of the population. In this way, the evaluative process acquires an essential role for the effectiveness and quality of health actions and services, and consists of the initial stage of the qualification process and should be followed by development of interventions and strategies aimed at improving quality indicators. Within this context, this The purpose of this study was to evaluate the attributes of PHC in a Northeast of Brazil; identify health quality indicators; and describe strategies used at the national and international levels to improvement of services. First, a descriptive cross-sectional study with the purpose of evaluating the presence and extension of APS attributes, instrument of PCATool-Brazil. In a second At the same time, a systematic review was carried out, in the period from 2011 to 2015, describing international experiences related to advances and improvements in PHC; identify which indicators are used to qualify the APS; and to describe interventions or strategies used in Brazil to improve the quality of results. The analysis of the attributes showed that the The mean total score was 6.88 ± 0.91. The average score for the attribute essential was 6.61 ± 0.91 and for the derived attribute was 7.80 ± 1.30. O first-contact component showed low mean (3.76 ± 1.11), whereas the information coordination system presented the highest average score (8.06 ± 1.60). The review of strategies used in several countries showed that the majority of the studies were related to coordination of care, programs or models to manage practices, and technology tools. As for the quality indicators, compiled 18 domains. Interventions or strategies related to quality indicators were, for the most part, directed towards promotion of health and prevention of diseases, using health education, pharmaceutical and nutritional guidance and technological resources. It was concluded that the evaluation of the attributes showed a strong orientation towards primary health care, considering accessibility as a major challenge of APS in Brazil. The review of international practices and experiences has proved to be a relevant mechanism to identify possible solutions for overcome obstacles and achieve better results. The recognition of quality indicators essential for improving care delivery It also provides additional support for monitoring the quality of the APS. It highlights the multidisciplinarity involved in studies that health systems, and a broader view of planning, quality of services, public policies, health process, among others, for a better understanding of reality.

13
  • WERUSKA ALCOFORADO COSTA
  • THE INFLUENCE OF PAIN AND SPIRITUALITY IN THE QUALITY OF LIFE OF WOMEN WITH BREAST CANCER

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • IVONETE BATISTA DE ARAUJO
  • GUSTAVO MAFALDO SOARES
  • JOSÉ MARIA SOARES JUNIOR
  • MARIA AMELIA DE ROLIN RANGEL
  • Data: Nov 23, 2017


  • Show Abstract
  • Breast cancer can lead to symptoms such as pain, fatigue, decreased functional capacity, anxiety, and stress which can compromise patients' quality of life (QoL). Through the illness process spirituality can be a coping resource that could be associated with better QoL. In this context, the overall study objective is to evaluate the influence of pain and spirituality on QoL in women living with breast cancer. This is an observational, cross-sectional and quantitative study, carried out from July 2014 to April 2015, in a hospital cancer center reference at Natal / RN. A sample of 400 women with breast cancer was evaluated in three groups: 118 without metastasis (MTX), 160 with locoregional MTX and 122 with MTX at a distance.  A complementary questionnaire addressing sociodemographic and clinical variables and Instruments were applied: the European Organization for Research and Treatment for Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and a disease-specific module for Breast Cancer BR23 to evaluate QoL, Spiritual Perspective Scale to assess spirituality and Short-Form McGill Pain Questionnaire was used to to describe pain. Data were analyzed by descriptive and inferential statistics. The Fisher and Chi-square tests were used to verify the existence of dependence relationship between spirituality and sociodemographic and clinical variables; ANOVA assessed the association between QoL and clinical variables, and the Tukey test was applied to indicate the magnitude of this association. The results showed a high prevalence of pain (71.7%) in patients and identified an association between the presence of pain and QoL. In the Global Health Scale (GHS) by the EORTC QLQC30 the group without MTX, mean 55.3 (SD=24.8) for those who had pain, 69.7 (SD=19.2) for no pain (p = 0.001); MTX locoregional, with pain had score 59.1 (SD=21.3), and those without pain 72.4 (SD=18.6) (p<0.001). In the MTX distance group, patients with mean pain 48.6 (SD=23.1) and 67.6 (SD=20.4) without pain (p=0.002). Considering spirituality, regardless of disease status, evangelical women showed greater spirituality: in the group without MTX (p=0.013), with locoregional MTX (p=0.011) and in the MTX group at a distance (p = 0.009). When the level of spirituality was analyzed associated with the EORTC scales, 39.8% of patients without MTX had a higher level of spirituality, both in the Symptom Scale (p=0.04) and GHS (p=0.02). The results showed that patients with higher levels of spirituality had higher values of QOL, regardless of the presence or absence of MTX.

14
  • ALEXANDRE COELHO SERQUIZ
  • OBTAINING AQUEOUS EXTRACTS FROM PULP, SHELL AND SEED OF ATEMOIA FRUIT (ANNONA CHERIMOLA X ANNONA SQUAMOSA L.): IDENTIFICATION OF ACTIVE COMPONENTS AND EVALUATION OF SOME OF THEIR IN VITRO AND IN VIVO PROPERTIES

  • Advisor : HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • COMMITTEE MEMBERS :
  • HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • ADRIANA FERREIRA UCHOA
  • RAQUEL BRANDT GIORDANI
  • MARIA APARECIDA MEDEIROS MACIEL
  • THALES ALLYRIO ARAUJO DE MEDEIROS FERNANDES
  • Data: Nov 27, 2017


  • Show Abstract
  • Exposure to the environment, elevated xenobiotic levels in the diet and even the biochemical reactions performed
     by human metabolism, increase the generation of reactive oxygen species (ROS) and nitrogen (RN) .
    This increase in ROS and RNA creates an oxidative stress, and it can generate a series of pathophysiological
    problems. Biochemical studies report that dietary antioxidants have benefits in the prevention of diseases,
    fruits are distinguished by the large amount of bioactive substances with this beneficial activity.
    it is not possible to know its chemical components (nutrients) and their effects on the metabolism after its
    ingestion. Therefore, it is very important to understand the mechanisms of the reaction of the antioxidants
    present in the atemoia fruit with the reactive species, of which the formation of aqueous extract and flour of
     the parts of the sem proteins, carbohydrates and phenolic compounds, as well as the evaluation of the
     presence of inhibitors of proteases and hemagglutinins, in addition to the antioxidant tests; total antioxidant
    capacity (CAT), hydroxyl radical sequestration (SRH), superoxide radical scavenging (SRS), metal chelation
    (QM), and oxidative stress evaluation by biochemical and histological parameters in animals fed the atemoia
     parts. The presence of protease inhibitors and agglutinins in atemoia extracts have been detected. These
     substances have the potential to be used in the biotechnology or biomedical area, helping to prevent diseases
     or even to improve the genetic quality of fruits. The extracts present proteins, carbohydrates and phenolic
    compounds in their composition, a fact that suggests a synergy between these compounds in the
     antioxidant effect, it is worth mentioning that the study supposes the presence of other substances not
    known, which may be influencing these effects. In vivo studies, however, show a nontoxic effect of the
    extracts. The best in vivo results were obtained with seed extract. Thus, it is proposed that the extracts of
     atemoia have functional properties. And future studies should be carried out in order to elucidate specific
     pathways and compounds that can act on these benefits.
15
  • ANTONIO ARILDO REGINALDO DE HOLANDA
  • MAMMARY PHYSIOLOGICAL CHANGES DURING NORMAL GASTATION AND LACTATION: ULTRASONOGRAPHIC AND DOPPLERFLUXOMETRIC ASPECTS
  • Advisor : TECIA MARIA DE OLIVEIRA MARANHAO
  • COMMITTEE MEMBERS :
  • TECIA MARIA DE OLIVEIRA MARANHAO
  • ANA CRISTINA PINHEIRO FERNANDES DE ARAUJO
  • MARIA THEREZA ALBUQUERQUE BARBOSA CABRAL MICUSSI
  • CLÉBER DE MESQUITA ANDRADE
  • CRISTYANNE SAMARA MIRANDA DE HOLANDA DA NÓBREGA
  • Data: Dec 6, 2017


  • Show Abstract
  • During pregnancy and lactation breasts undergo important changes that are not fully understood. Ultrasound and magnetic resonance are the most suitable methods to assess breast alterations during pregnancy and lactation, making a solid knowledge of anatomy and breast diseases essential. Moreover, there are few articles on breast imaging, relating anatomy and physiology during the pregnancy-postpartum cycle. The present study aimed to assess physiological breast changes using ultrasound and dopper flowmetry of mammary arteries in normal pregnant and lactating women, compared to a group of non-pregnant women evaluated in the folicular and luteal phases of the menstrual cycle. This cross-sectional observational study was conducted between August 2013 and August 2016, with 203 women. The dependent variables were measures of skin, subcutaneous adipose tissue, fibroglandualr tissue, retromammary adipose tissue, duct diameter, as well as pulsatility (PI) and resistive indices (RI) of internal mammary arteries. The independent variables were the different assessment moments, represented by the five groups established. Statistical analysis involved calculating the means and standard deviations using two MANOVA models (Multivariate Analysis of Variance) to assess the group effect on the average values obtained. ANOVA models were individually fit to the mean values. The Tukey-Kramer multiple comparisons test was applied to analyze intergroup differences and characteristics, at a 5% significance level. 

    Based on the data collected,  one article with partial results, assessing only groups of pregnant women, was published in the Revista Brasileira de Ginecologia e Obstetrícia (RBGO) and a review article in the journal Radiologia Brasileira. A third article, submitted and accepted for publication by the jornal Clinical and Experimental Obstetrics and Gynecology, showed changes in women during the pregnancy-lactation cycle that exhibed diferences in the measures of skin, fibroglandular tissue, subcutaneous adipose tissue and duct diameter,   when compared to non-pregnant women. Data analysis revealed no significant differences between the groups of pregnant and lactating women. 

16
  • MARILIA DANIELA FERREIRA DE CARVALHO MOREIRA
  • INFLUENCE OF THE COLON ON THE HEPATIC REGENERATION OF RATS SUBMITTED TO HEPATECTOMY AND COLECTOMY
  • Advisor : ALDO DA CUNHA MEDEIROS
  • COMMITTEE MEMBERS :
  • ALDO DA CUNHA MEDEIROS
  • CIPRIANO DA CRUZ FORMIGA
  • DEBORAH DE MELO MAGALHÃES PADILHA
  • GERALDO BARROSO CAVALCANTI JUNIOR
  • VALERIA SORAYA DE FARIAS SALES
  • Data: Dec 12, 2017


  • Show Abstract
  • Objetivo: Examinar se a colectomia associada à hepatectomia 70% influencia a regeneração do fígado em ratos. Métodos: Foram utilizados 18 ratos Wistar distribuídos em 3 grupos (6 animais cada). No grupo I (sham) foi realizada laparotomia; no grupo II colectomia + hepatectomia 70%; no grupo III apenas hepatectomia 70%. No 6° dia pós-operatório colhido sangue por punção cardíaca sob anestesia, seguido de eutanásia. Realizadas dosagens séricas de ALT, AST, fosfatase alcalina, albumina, fator de crescimento de hepatócitos (HGF), fator de crescimento transformador-α (TGF-α). A regeneração do fígado foi calculada pela fórmula: (razão peso do fígado por 100g do peso corporal no momento da eutanásia/peso do fígado no pré-operatório projetado por 100g de peso corporal)×100. Os testes ANOVA e Tukey foram usados, significância p<0,05. Resultados: Os níveis de ALT e AST foram significativamente menores no grupo II comparados com o grupo III (p<0,001). A albuminemia mostrou níveis significativamente mais elevados no II que no III. Os níveis de HGF (408±18,2 pg/mL) e TGF-α (3,8±0,3 ng/mL) no grupo II foram significativamente mais elevados que no grupo III HGF (360±58,6 pg/mL), TGF-α (2,3±0,4 ng/mL), respectivamente (p<0,001). O percentual de regeneração hepática foi significativamente mais elevado no grupo II, do que no grupo III (p=0,003). Conclusão: O estudo demonstrou que a colectomia realizada simultaneamente à hepatectomia 70% influenciou positivamente na regeneração do fígado em ratos. Pesquisas adicionais são necessárias para revelar os mecanismos moleculares deste efeito e para caracterizar a influência do cólon na fisiologia do fígado. 

17
  • MARIA JOSE DE BRITTO COSTA FERNANDES
  • TUBERCULOSIS ASSOCIATED WITH AIDS: SPACE AND TEMPORAL ANALYSIS DOS COINFECTADOS, IN THE STATE OF RIO GRANDE DO NORTE, BRAZIL (2001-2011)
  • Advisor : IRIS DO CEU CLARA COSTA
  • COMMITTEE MEMBERS :
  • DANIELA MENDES DA VEIGA PESSOA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • FLAVIA CHRISTIANE DE AZEVEDO MACHADO
  • IRIS DO CEU CLARA COSTA
  • MARIA DO CARMO EULÁLIO
  • Data: Dec 12, 2017


  • Show Abstract
  • The synergy between tuberculosis and human immunodeficiency virus (HIV) has been making a major impact on the epidemiology of tuberculosis in the Americas, whether in developed countries or in developing an emerging problem throughout the world. continent. Co-infection with Micobacterium tuberculosis and HIV being studied in several countries, where the two infections an important public health problem. The infection can be considered, at present, one of the main factors of risk that causes an individual with latent tuberculosis to (TBL) to develop active tuberculosis. The study population consisted of all cases of TB and TB / AIDS coinfection, occurred in the State of Rio Grande do Norte, notified to the data from the Notification of Injury Information System (SINANMS), in the period from 2001 to 2011. For a more detailed consistent, maps were constructed considering the triennium 2001 - 2003 and the quadrenniums 2004 - 2007 and 2008 - 2011. Partner information demographic variables were obtained based on the 2010 - IBGE census at the of municipality. For the statistical analysis, GIS tools were used using QGIS software version 2.0.1 Dufour (www.qgis.org), techniques of spatial statistical analysis for area data using software R-System version 2.15.0 (www.r-project.gov), in addition to the SPSS version 18. The standard form of presentation of area data was made by thematic maps of the incidence rate (IT), allowing to observe the spatial variation pattern. It was found temporal variation with upward trend in TB / AIDS coinfection; with a higher incidence in the age group of 20 to 49 years; followed by age range ≥ 50 years; pulmonary form was the most frequent; the sex was predominant. Search collected, contribute with indicators that can better target resources in the routine treatment of coinfected patients in the State of Rio Grande do Norte, Brazil. AUTHORIZATION OF COORDINATION Signature / Guidance Stamp Signature / Coordination Stamp NOTE
18
  • IRIGRÁCIN LIMA DINIZ BASÍLIO

  • HELICOBACTER PYLORY AND URBAN AREA AND ITS RELATIONSHIP WITH GASTRIC DISEASE

  • Advisor : SELMA MARIA BEZERRA JERONIMO
  • COMMITTEE MEMBERS :
  • SELMA MARIA BEZERRA JERONIMO
  • LARA DE MELO BARBOSA ANDRADE
  • NILMA DIAS LEAO COSTA
  • ADRIANO AZEVEDO DE MELLO
  • MARIA GORETTI FREIRE DE CARVALHO
  • Data: Dec 14, 2017


  • Show Abstract
  • Infection by Helicobacter pylori affects half of the world`s population and persistence of this pathogen is the main cause of gastric diseases, and eventual cancer development. There are several virulent factors associated with H. pylori outcome. The purpose of the study was to estimate the prevalence of H. pylori infection in an adult population in northeast Brazil and to identify the risk factors for dyspeptic symptoms. We evaluated 200 subjects from Campina Grande, a city in Northeast Brazil. All subjects presented with dyspeptic complaints. They underwent physical examination and endoscopy, followed by Gastric biopsies. Urease test wasperformed for all participants. Fragments of biopsies were examined for histology and DNA was extracted from all fragments. DNA samples were tested for H. pylori by Polymerase Chain Reaction. Females composed 72.5% (145/200) of subjects. Only 17.5% (35/200) of the elderly were exposed to infection and 65% (78/200) used city water. Lack of hand washing, exposure to city water and smoking were considered risk factors for H. pylori infection. Belching was the most common symptom associated with infection and gastritis, regardless of grade. Presence of H. pylori increased the severity of gastritis. Prevalence of H. pylori infection was higher in people with symptoms of gastritis and the severity of symptoms was associated with infection.
19
  • ADILA LORENA MORAIS LIMA
  • FACTORS ASSOCIATED WITH HUMAN INFECTION BY Leishmania infantum AND ITS SPATIAL PATTERN IN A NORTHEAST DENMARK AREA OF BRAZIL

  • Advisor : SELMA MARIA BEZERRA JERONIMO
  • COMMITTEE MEMBERS :
  • LARA DE MELO BARBOSA ANDRADE
  • MARIA GORETTI FREIRE DE CARVALHO
  • NILMA DIAS LEAO COSTA
  • SELMA MARIA BEZERRA JERONIMO
  • WANESKA ALEXANDRA ALVES
  • Data: Dec 15, 2017


  • Show Abstract
  • Visceral leishmaniasis (VL) or kala-azar, is one of the most deadly parasitic diseases and tends to affect mainly the poorest and most vulnerable populations. In Brazil, the disease had a predominantly rural distribution, but from the 1980s was its expansion to urban and peri-urban areas of medium and large, like Natal-RN. The aim of this study was to evaluate the factors associated with human infection with Leishmania infantum and its spatial distribution in Natal-RN municipality. This is an exploratory descriptive epidemiological study, ecological analysis, considering as the unit of analysis neighborhoods (n = 36) that make up the municipality.  A temporal analysis was performed (1990-2014) for the demographic characteristics of cases of human VL and VL-HIV coinfection, and spatial analysis (2007-2014) and correlation with socioeconomic and environmental factors, canine infection and potentially influencing entomological indicators transmission of Leishmania. The data of human infection show strong endemism of VL in Natal. Were observed high density Lu. longipalpis and high Leishmania infection in dogs over the years. Human VL, measured by the number of case rate per 100,000 population, showed heterogeneous distribution and spatial expansion over time, with the highest concentration of cases in the north of the city. Males under the age of 4 years were the most affected and there was a growing number of cases of VL-HIV coinfection. Socio-economic and structural variables, which increase implies improving the standard of the neighborhood, such as garbage collection, earning more than three minimum wages and literate population, led to a reduction in the incidence rate of VL, while lack of sanitation and income below the minimum wage, promoted its increase. VL in Natal has its expansion associated with poverty and people in more vulnerable population, such as children and immunocompromised, dwelling areas of recent development with poor public infrastructure and the presence of infected dogs.
20
  • IRACI DUARTE DE LIMA
  • Influence of social and environmental factors on the epidemiological pattern of visceral leishmaniasis and HIV-AIDS in Rio Grande do Norte, RN
  • Advisor : SELMA MARIA BEZERRA JERONIMO
  • COMMITTEE MEMBERS :
  • ADRIANA FERREIRA UCHOA
  • BRUNA LEAL LIMA MACIEL
  • IGOR THIAGO BORGES DE QUEIROZ E SILVA
  • SELMA MARIA BEZERRA JERONIMO
  • WANESKA ALEXANDRA ALVES
  • Data: Dec 15, 2017


  • Show Abstract
  • Introduction: Visceral leishmaniasis (VL) is a serious disease and the risks of its development are associated with factors related to co morbidities, environmental transformations and socioeconomic aspects of the geographical area of occurrence. The understanding of these factors is crucial for the redesign of intervention measures to control this endemic disease. General objective. To analyze the epidemiological pattern of Visceral Leishmaniasis in "time space" and the factors associated with the occurrence of the disease, in the period from 1990 to 2014, identify in the State Microregions the social and environmental factors of greatest risk for the occurrence of VL, and propose a intervention protocol for specific areas in order to contribute to the eventual control of the disease. Methodology. A quantitative and retrospective ecological study was carried out with space-time analysis of the existence of spatial dependence of social and environmental factors influencing the incidence of VL. Results: LV settled in the microregions of Natal, Macaíba and Litoral Norte from 1990 to 1994. Between 2000 and 2004, it spread to other microregions of the State, establishing itself between 2010 and 2014 in the microregions of Mossoró and Açu. Concomitant to the increase in endemic areas for LV, HIV-AIDS spread in the NB in a disordered manner, with areas of HIV-AIDS and LV overlapping, favoring the correlation of LV / HIV-AIDS coinfection between 1990 and 1994 ( p = 0.0006) and 2010 to 2014 (p = 0.0094), respectively.
    A negative association was observed in the incidence of VL with increased garbage collection. At the same time, it was observed that the incidence of HIV-AIDS is positively associated with better levels of income, education and population density. Conclusion: The incidence of VL is decreasing, but it prevails in male adults, in areas with low litter collection coverage and good water supply. There was reduction in children associated with the improvement of the Nutritional Status Index and the vaccine coverage. The spread of LV and HIV-AIDS determined the setting up of LV / HIV-AIDS coinfection. The incidence of HIV is increasing and its dispersion is associated with microregions with urbanized profile with good coverage of social indicators of garbage collection, public cleanliness, education, income and high population density.
2016
Dissertations
1
  • ALINE TUANE OLIVEIRA DA CUNHA
  • AVALIAÇÃO DO CONSUMO HABITUAL DE NUTRIENTES EM PACIENTES COM SÍNDROME METABÓLICA

  • Advisor : LUCIA DE FATIMA CAMPOS PEDROSA
  • COMMITTEE MEMBERS :
  • FLÁVIA EMÍLIA LEITE DE LIMA FERREIRA
  • LUCIA DE FATIMA CAMPOS PEDROSA
  • URSULA VIANA BAGNI
  • Data: Feb 19, 2016


  • Show Abstract
  • A avaliação do consumo alimentar e dietético de uma população é uma medida importante na prevenção e tratamento da síndrome metabólica (SM). O objetivo deste estudo foi avaliar o consumo habitual de nutrientes em pacientes com SM. Foi realizado um estudo transversal com 103 pacientes com SM atendidos no Ambulatório de Endocrinologia do Hospital Universitário Onofre Lopes, Natal, RN. A ingestão habitual de energia e nutrientes foi estimada por meio de dois recordatórios de 24 horas (R24h). A adequação dos macronutrientes foi avaliada segundo a I Diretriz Brasileira de Diagnóstico e Tratamento da Síndrome Metabólica. A prevalência de inadequação de micronutrientes foi estimada pela Estimated Average Requirement (EAR) como ponto de corte, com ajustes pelas variâncias intra e interpessoal e de energia. O ferro foi avaliado por abordagem probabilística. A idade média dos participantes foi de 50±13,2 anos (82% do sexo feminino). Os valores médios do índice de massa corporal e circunferência abdominal foram respectivamente 33,5±7,3 kg/m2 e 106,7±13,6 cm. O consumo médio de energia foi 1523,1±592,2 kcal/d, sendo maior no sexo masculino (1884,0 kcal/d vs. 1441,5 kcal/d; p=0,003). A ingestão percentual de proteína foi superior ao recomendado (18% e 19%; sexo feminino e masculino, respectivamente). A ingestão de fibra foi mais elevada no sexo masculino (18,8 g/d vs. 13,3 g/d; p=0,011), porém abaixo da recomendação. Maior consumo de gordura total foi observado no sexo feminino (47,6 g/d vs. 41,3 g/d; p=0,007). Prevalências de inadequação superiores a 80% foram observadas para a vitamina D e cálcio, em ambos os sexos. O mesmo foi observado para o magnésio nos pacientes com idade superior a 30 anos. Vitamina E, riboflavina e zinco apresentaram inadequações entre 50-75% no sexo masculino. A prevalência de inadequação foi inferior a 50% para as vitaminas A, C, tiamina, piridoxina (B6); e os minerais, cobre e selênio, em ambos os sexos. Pacientes do sexo feminino (>50 anos) apresentaram baixa inadequação de ferro (7,8%). Em conclusão, os pacientes com SM apresentaram ingestão de proteína superior ao recomendado, baixo consumo de fibra e elevadas prevalências de inadequação de micronutrientes, principalmente vitamina D, magnésio e cálcio em ambos os sexos.

2
  • MARIA DO PERPÉTUO SOCORRO NOBRE MEDEIROS E SILVA
  • ABNORMAL ANAL CYTOLOGY RISK IN WOMEN WITH KNOWN GENITAL SQUAMOUS INTRAEPITHELIAL LESION

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • IVONETE BATISTA DE ARAUJO
  • MARIA GORETTI FREIRE DE CARVALHO
  • Data: Apr 19, 2016


  • Show Abstract
  • The purpose of this study was to assess the risk of abnormal anal cytology in women with known genital squamous intraepithelial lesion (SIL). This study evaluated 200 women with and without genital SIL who were recruited for anal Pap smears. Women who had abnormal results on equally or over atypical squamous cells of undetermined significance were classified as having abnormal anal cytology. A multiple logistic regression analysis (stepwise) was performed to identify the risk for developing abnormal anal cytology. Data were analyzed using the SPSS 20.0 program. The average age was 41.09 (±12.64). Of the total participants, 75.5% did not practice anal sex, 91% did not have HPV-infected partners, 92% did not have any anal pathology, and 68.5% did not have anal bleeding. More than half (57.5%) had genital SIL and a significant number developed abnormal anal cytology: 13% in the total sample and 17.4% in women with genital SIL. A significant association was observed between genital SIL and anal SIL (PR=2.46; p=0.03). In the logistic regression model, women having genital intraepithelial lesion were more likely to have abnormal anal Pap smear (aPR=2.81; p=0.02). This report shows that women with genital SIL must be more closely screened for anal cancer.

3
  • LUCIANA DA SILVA REVORÊDO
  • -

  • Advisor : EULALIA MARIA CHAVES MAIA
  • COMMITTEE MEMBERS :
  • BERNARDINO FERNANDEZ CALVO
  • EULALIA MARIA CHAVES MAIA
  • IZABEL AUGUSTA HAZIN PIRES
  • Data: Jul 22, 2016


  • Show Abstract
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4
  • MICHELLY NOBREGA MONTEIRO
  • *

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • IVONETE BATISTA DE ARAUJO
  • MARIA GORETTI FREIRE DE CARVALHO
  • Data: Aug 19, 2016


  • Show Abstract
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5
  • MÔNICA DE OLIVEIRA ROCHA AMORIM
  • -

  • Advisor : HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • COMMITTEE MEMBERS :
  • HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • VANESSA DE PAULA SOARES RACHETTI
  • LUCIANA NUNES MENOLLI LANZA
  • Data: Sep 30, 2016


  • Show Abstract
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6
  • SONIA MARIA DE MEDEIROS BARRETO
  • *

  • Advisor : SELMA MARIA BEZERRA JERONIMO
  • COMMITTEE MEMBERS :
  • HELENA BONCIANI NADER
  • IVONETE BATISTA DE ARAUJO
  • SELMA MARIA BEZERRA JERONIMO
  • Data: Oct 31, 2016


  • Show Abstract
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7
  • JEFFERSON ROMÁRYO DUARTE DA LUZ
  • *

  • Advisor : MARIA DAS GRACAS ALMEIDA THORNTON
  • COMMITTEE MEMBERS :
  • MARIA DAS GRACAS ALMEIDA THORNTON
  • SILVANA MARIA ZUCOLOTTO LANGASSNER
  • CELINA MARIA PINTO GUERRA DORE
  • Data: Nov 17, 2016


  • Show Abstract
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8
  • MARIA QUITERIA BATISTA MEIRELLES
  • *

  • Advisor : KENIO COSTA DE LIMA
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • ANA MARIA DE BRITO
  • KENIO COSTA DE LIMA
  • Data: Nov 28, 2016


  • Show Abstract
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Thesis
1
  • MARCIA MARILIA GOMES DANTAS LOPES
  • NUTRITIONAL ASSESSMENT METHODS FOR ZINC SUPPLEMENTATION IN PREPUBERTAL NONZINC-DEFICIENT CHILDREN

  • Advisor : JOSE BRANDAO NETO
  • COMMITTEE MEMBERS :
  • ADRIANA BEZERRA NUNES
  • BRUNA LEAL LIMA MACIEL
  • JAILANE DE SOUZA AQUINO
  • MARIA JOSÉ DE CARVALHO COSTA
  • SELMA SOUSA BRUNO
  • Data: Feb 19, 2016


  • Show Abstract
  • Background: Zinc is an essential nutrient that is required for numerous metabolic functions, and zinc deficiency results in growth retardation, cellmediated immune dysfunction, and cognitive impairment. Objective: This study evaluated nutritional assessment methods for zinc supplementation in prepubertal nonzinc- deficient children. Design: We performed a randomised, controlled, triple-blind study. The children were divided into a control group (10% sorbitol, n = 31) and an experimental group (10 mg Zn/day, n = 31) for 3 months. Anthropometric and dietary assessments as well as bioelectrical measurements were performed in all children. Results: Our study showed (1) an increased body mass index for age and an increased phase angle in the experimental group; (2) a positive correlation between nutritional assessment parameters in both groups; (3) increased soft tissue, and mainly fat-free mass, in the body composition of the experimental group, as determined using bioelectrical impedance vector analysis; (4) increased consumption of all nutrients, including zinc, in the experimental group; and (5) an increased serum zinc concentration in both groups (p < 0.0001). Conclusions: Given that a reference for body composition analysis does not exist for intervention studies, longitudinal studies are needed to investigate vector migration during zinc supplementation. These results reinforce the importance of employing multiple techniques to assess the nutritional status of populations.

2
  • ALMIR MIRANDA FERREIRA
  • PREVALÊNCIA E FATORES ASSOCIADOS A LESÕES ORAIS POTENCIALMENTE MALIGNAS  ASSOCIADOS EM  UMA POPULAÇÃO DE TRABALHADORES RURAIS.

  • Advisor : KENIO COSTA DE LIMA
  • COMMITTEE MEMBERS :
  • ANA MIRYAM COSTA DE MEDEIROS
  • GUSTAVO PINA GODOY
  • KENIO COSTA DE LIMA
  • MANUEL ANTONIO GORDON NUNEZ
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: Mar 11, 2016


  • Show Abstract
  • As lesões orais potencialmente malignas (LOPMs) são objeto de estudos realizados pela Organização Mundial de Saúde (OMS) e, no Brasil, pelo Instituto Nacional do Câncer (INCA). Dentre esses estudos, as LOPMs são classificadas como desordens clinicamente evidentes, sendo as principais: leucoplasia, eritroplasia e queilite actínica. Neste estudo descritivo, exploratório, quantitativo do tipo seccional, objetivou-se estimar a prevalência de lesões orais potencialmente malignas e malignas e verificar associações entre estas e os fatores de risco e aspectos sócio-demográficos, exposição a fatores etiológicos como o fumo, álcool e o grau de exposição ao sol em um grupo de trabalhadores rurais da Região do Seridó/RN. Para a pesquisa de campo utilizou-se um questionário previamente validado e uma ficha clínica empregada na anamnese dos trabalhadores atendidos. Foram realizados exames clínicos bucais para identificação de lesões suspeitas e malignas na população alvo. Aqueles trabalhadores acometidos de lesões suspeitas foram encaminhados para biópsia, tanto na Faculdade de Odontologia da UFRN, quanto na UERN e também para um consultório odontológico particular situado em Currais Novos, onde um odontólogo colaborador desse projeto atendeu gratuitamente os trabalhadores residentes em municípios circunvizinhos a esta cidade. De 1.385 trabalhadores pesquisados, 53,2% eram do sexo feminino e 48,8% do sexo masculino, com média de idade igual a 53 anos; 57% destes não estudaram ou cursaram até o primário; 73,2% tinha renda familiar mensal de aproximadamente 300 dólares. A maioria exibiu pele clara (49,2%). A prevalência de LOPMs foi igual a 29,6% (27,2; 32,0). Os resultados obtidos na análise bivariada evidenciaram associação estatisticamente significativa entre a variável presença de lesão e as variáveis independentes: sexo, idade, escolaridade, cor da pele, exposição acumulada aos raios solares, uso de proteção, a condição de ex-fumantes e consumidores de bebidas alcoólicas. Todas essas variáveis que apresentaram significância estatística ingressaram no modelo logtístico múltiplo que, através do método Backward-Stepwise, revelou apenas 3 (três) variáveis que permaneceram com significância, independentemente das outras variáveis: sexo, cor da pele e tempo de exposição prolongada aos raios solares. Os achados deste estudo reforçam a importância da promoção de políticas públicas em saúde bucal e a disseminação de informações que levem indivíduos que trabalham expostos aos raios solares a se protegerem adequadamente para minimizar a prevalência das lesões orais potencialmente malignas e malignas e consequentemente reduziu a incidência do câncer oral. 

3
  • HENRIQUE RODRIGUES MARCELINO
  • -

  • Advisor : ERYVALDO SOCRATES TABOSA DO EGITO
  • COMMITTEE MEMBERS :
  • CHRISTINE VAUTHIER
  • ERYVALDO SOCRATES TABOSA DO EGITO
  • FRANCELINE REYNAUD
  • GHANIA HAMDI DEGOBERT
  • Gilles Ponchel
  • PHILIPPE LEGRAND
  • Data: Apr 8, 2016


  • Show Abstract
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4
  • MICHELLE DE MEDEIROS AIRES
  • ANÁLISE DE DIFERENTES SUPERFÍCIES DE TI TRATADAS TERMOQUIMICAMENTE POR PLASMA NA RESPOSTA CELULAR E BACTERIANA

  • Advisor : CLODOMIRO ALVES JUNIOR
  • COMMITTEE MEMBERS :
  • CLODOMIRO ALVES JUNIOR
  • CARLOS AUGUSTO GALVAO BARBOZA
  • KARILANY DANTAS COUTINHO
  • CARLOS EDUARDO BEZERRA DE MOURA
  • REGINA CELIA DE SOUSA
  • Data: Apr 20, 2016


  • Show Abstract
  • Superfícies de Ti foram modificadas termoquimicamente por plasma em atmosfera de N2+H2 (nitretação) e Ar+N2+O2 (oxinitretação), com o objetivo de avaliar as respostas biológicas sobre as mesmas.  Após o tratamento por plasma, as superfícies foram caracterizadas quanto às fases cristalinas, topografia, rugosidade e molhabilidade. A partir de ensaios in vitro foram determinadas a adesão, proliferação, formação de biofilme e viabilidade bacteriana. As condições que resultaram na maior resistência ao crescimento bacteriano foram utilizadas para estudo de cultura de células e determinação da adesão e proliferação celular. Dentre estas condições está a superfície nitretada durante 1 h.  Os resultados mostraram que não houve formação de grumos ou microcolónias mas também o número de células aderentes é baixo. Já na superfície oxinitretada, foi observado que existe uma concentração ideal de O2 para o qual, além do crescimento microbiano não ocorrer, as bactérias dispersam, sem a presença de um estresse químico (tal como antibiótico), o que significa que o ambiente formado após o tratamento termoquímico da superfície não é favorável ao crescimento e desenvolvimento de um biofilme. Por outro lado, amostras tratadas nessas condições teve adesão celular bastante significativa. Verificou-se que em apenas 15 min de cultivo de células osteoblásticas, essas amostras oxinitretadas já apresentavam muitas células aderidas à superfície. Além disso, os resultados indicaram que essas superfícies apresentaram maior proliferação no tempo de 24h em relação às amostras sem tratamento. Foi observado que a porcentagem de sobrevivência celular é maior nas amostras tratadas. Os discos tratados não apresentaram células em necrose, apesar da amostra sem tratamento possuir uma baixíssima porcentagem de células nesse estágio. Isso infere que o titânio não é citotóxico e que as alterações superficiais causadas pela formação de nitreto e de oxinitreto de titânio apresentaram um papel fundamental na adesão e proliferação celular. Estes resultados são relevantes para a prática clínica, pois mostra o potencial de aplicação destes tratamentos em superfícies de Ti com interesse biomédico anti-infectivos. Desse modo, essa pesquisa de caráter multidisciplinar tem permitido novas estratégias de análises alternativas nessa área, onde a participação do profissional da área de ciências exatas, engenharias e biomédica se faz importante para o sucesso no desenvolvimento de novos biomateriais.

5
  • MARIA REGINA MACEDO COSTA
  • -

  • Advisor : KENIO COSTA DE LIMA
  • COMMITTEE MEMBERS :
  • KENIO COSTA DE LIMA
  • AURIGENA ANTUNES DE ARAUJO
  • RUTHINEIA DIOGENES ALVES UCHOA LINS
  • EDJA MARIA MELO DE BRITO COSTA
  • JOZINETE VIEIRA PEREIRA
  • Data: Sep 28, 2016


  • Show Abstract
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6
  • SANDRA MARIA DA SOLIDADE GOMES SIMÕES DE OLIVEIRA TORRES
  • -

  • Advisor : EULALIA MARIA CHAVES MAIA
  • COMMITTEE MEMBERS :
  • EULALIA MARIA CHAVES MAIA
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • THAIZA TEIXEIRA XAVIER NOBRE
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • ROBERTA AZOUBEL
  • Data: Sep 30, 2016


  • Show Abstract
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7
  • JOSIVAN GOMES DE LIMA
  • *

  • Advisor : SELMA MARIA BEZERRA JERONIMO
  • COMMITTEE MEMBERS :
  • SELMA MARIA BEZERRA JERONIMO
  • ADRIANA AUGUSTO DE REZENDE
  • EDDA LISBOA LEITE
  • FRANCISCO ALFREDO BANDEIRA E FARIAS
  • JOHN EDUARD DONELSON
  • Data: Oct 24, 2016


  • Show Abstract
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8
  • SONIA MARIA FERNANDES DA COSTA SOUZA
  • *

  • Advisor : KENIO COSTA DE LIMA
  • COMMITTEE MEMBERS :
  • KENIO COSTA DE LIMA
  • IRIS DO CEU CLARA COSTA
  • RENATA ALEXANDRA MOREIRA DAS NEVES
  • CELINA MARIA PINTO GUERRA DORE
  • PRISCILA VANINI DANTAS DE MEDEIROS
  • Data: Nov 30, 2016


  • Show Abstract
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9
  • ANGELA CRISTINA PINTO DE PAIVA CUNHA
  • *

  • Advisor : KENIO COSTA DE LIMA
  • COMMITTEE MEMBERS :
  • KENIO COSTA DE LIMA
  • HEBEL CAVALCANTI GALVAO
  • ANTONIO DE LISBOA LOPES COSTA
  • ALEXANDRE DURVAL LEMOS
  • GUSTAVO PINA GODOY
  • Data: Dec 1, 2016


  • Show Abstract
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10
  • FABRICIA LIMA FONTES
  • INHIBITION OF APE1/REF-1 REDOX FUNCTION BY E3330 REGULATES THE CELLULAR GROWTH AND RIBOSOME BIOGENESIS IN INFLAMMATION MODEL

  • Advisor : LUCYMARA FASSARELLA AGNEZ LIMA
  • COMMITTEE MEMBERS :
  • ANDRE DUCATI LUCHESSI
  • CARLOS RENATO MACHADO
  • JENIFER SAFFI
  • LUCYMARA FASSARELLA AGNEZ LIMA
  • RIVA DE PAULA OLIVEIRA
  • Data: Dec 9, 2016


  • Show Abstract
  • The multifunctional protein APE1/REF-1 plays an important role in the oxidative stress due to its DNA repair and transcriptional regulatory activities. Several studies have identified APE1/REF-1 related to cell growth, apoptosis, DNA damage, intracellular redox state, mitochondrial function, and cytoskeletal structure. However, it still remains a gap in the literature about how APE1/REF-1 regulates each activity. To identify genes preferentially regulated by redox function of APE1/REF-1, in this study was performed an extensive genome-wide survey using the high throughput RNA-Seq analysis of the LPS-stimulated U937 cells and subsequently treatment with E3330, a known inhibitor of the redox function of APE1/REF-1. Comparative transcriptome analysis revealed 1250 gene expression changes, 620 downregulated and 630 upregulated genes with absolute fold change ≥3 or ≤-3. The downregulated genes were found to be primarily involved in the regulation of ribosome biogenesis, gene expression and immune response, while the upregulated genes showed to be related with cellular response to stress, DNA repair and positive regulation of apoptosis. Further, the treatment with E3330 also promoted the reduction of several inflammatory modulators during time kinetics and cell viability decrease after 48 hours of treatment. Altogether, data point out a set of new purposes associated to the redox inhibition of APE1/REF-1 by E3330, such as difficulties the processing of rRNA, decreased transcription of RelA(p65), c-Myc, ribossomal genes leading to deficiency of ribosomal biogenesis and consequent growth arrest.

11
  • MARIA DO SOCORRO TEIXEIRA DE AMORIM
  • *

  • Advisor : IVONETE BATISTA DE ARAUJO
  • COMMITTEE MEMBERS :
  • ADRIANA BEZERRA NUNES
  • AUREA NOGUEIRA DE MELO
  • CLAUDIA RODRIGUES SOUZA MAIA
  • IVONETE BATISTA DE ARAUJO
  • NEIR ANTUNES PAES
  • Data: Dec 13, 2016


  • Show Abstract
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2015
Dissertations
1
  • JULIANA MENDONCA FREIRE

  • Analysis of the clinical, hematological and antigen expression profile of patients with acute myeloid leukemia in the state of Rio Grande do Norte

  • Advisor : GERALDO BARROSO CAVALCANTI JUNIOR
  • COMMITTEE MEMBERS :
  • GERALDO BARROSO CAVALCANTI JUNIOR
  • MARIA GORETTI DO NASCIMENTO SANTOS
  • AMALIA CINTHIA MENESES DO REGO
  • Data: Jun 10, 2015


  • Show Abstract
  • Acute leukemias are a heterogeneous group of hematologic diseases characterized by rapid and abnormal proliferation of blood precursors in the bone marrow. The objective of this study was to analyze a group of 338 patients with Acute Myeloid Leukemia (AML), based on morphological, clinical and immunophenotypic criteria by flow cytometry, as well as investigate the correlation between these data and the subtypes of AML. Of the 338 patients studied, 182 (53.8%) were male and 156 patients (46.2%) females, aged 1-90 years. The splenomegaly was predominantly clinical manifestations compared with 270 cases. Leukocytosis was present in 298 (88.1%) and 302 (89.3%) had platelet counts below 100,000 / mm3. Hemoglobin ranged from 2.5g / dL to 12g / dL. Regarding the subtypes of AML, 4 (1.2%) were AML-M0, 110 (32.5%) were AML-M1, 82 (24.3%) AML-M2, 38 (11.2%) AML-M3, 53 (15.7%) AML -M4, 35 (10.3%) AML-M5 9 (2.7%) AML-M6 and 7 (2.1%) AML-M7. The expression of aberrant phenotypes was observed with positivity for lymphoid antigens such as CD7 in 34 (10.6%) patients and CD19, present in 22 (6:53%). The analysis of the worldwide incidence of leukemia subtypes showed significant changes in relation to the geographical distribution, gender, age, ethnicity and socioeconomic status, suggesting that there are multiple etiological factors. These data demonstrate the importance of differential diagnosis and characterization of AML to provide better treatment and monitoring of this neoplasm.
2
  • ELZA MARIA FERNANDES SEABRA DE MELO
  • *

  • Advisor : EDUARDO CALDAS COSTA
  • COMMITTEE MEMBERS :
  • EDUARDO CALDAS COSTA
  • JOCELINE CASSIA FEREZINI DE SA
  • FILIPE FERREIRA DA COSTA
  • Data: Jul 3, 2015


  • Show Abstract
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3
  • CHRISTIAN ASSUNÇÃO DA SILVA
  • ELUCIDAÇÃO MOLECULAR E MICELAR DOS SUPERAGREGADOS DE ANFOTERICINA B

  • Advisor : ERYVALDO SOCRATES TABOSA DO EGITO
  • COMMITTEE MEMBERS :
  • ADLEY ANTONINI NEVES DE LIMA
  • ERYVALDO SOCRATES TABOSA DO EGITO
  • FRANCELINE REYNAUD
  • Data: Jul 20, 2015


  • Show Abstract
  • A Anfotericina B (AmB) é amplamente utilizada no tratamento de infecções fúngicas sistêmicas. No entanto, a sua utilização é limitada devido a sua elevada toxicidade aguda e crônica. Os superagregados de AmB (H-AmB) obtido pelo processo de aquecimento controlado apresentam um potencial reduzido de toxicidade quando comparados à Anfotericina B micelar não aquecida (M-AmB). Diante do exposto, o objetivo deste estudo foi avaliar as características físico-químicas do processo de formação dos superagregados após a liofilização do H-AmB, por meio de técnicas tais como a calorimetria de exploratória diferencial (DSC), termogravimetria (TG) e análise térmica diferencial (DTG), ressonância magnética nuclear (RMN), espalhamento dinâmico de luz (DLS) e difração de raios X (DRX). Os dados de DLS indicaram um tamanho de aproximadamente 260 nm deste novo sistema, sendo este tamanho compatível e viável para administração intravenosa. A análise de DRX demonstrou a formação de um novo estado cristalino do sistema micelar, podendo este estar relacionado a presença de grande proporção de desoxicolato de sódio (NaDC) na formulação. O aquecimento do NaDC resulta na formação de uma estrutura helicoidal intermolecular, promovendo desta forma o aumento da agregação micelar e consequentemente aumento de seu tamanho. Os estudos das análises térmicas demonstraram que o processo de aquecimento não influência no comportamento das amostras. Os dados de RMN da H-AmB demonstraram a presença de ácido desoxicólico além do NaDC. O ácido desoxicólico é formado após o processo de aquecimento e sugere-se que o equilíbrio entre ambas as moléculas seja responsável pela redução da toxicidade da AmB. Os resultados aqui apresentados sugerem que o processo de aquecimento controlado altera a organização estrutural das micelas, resultando na diminuição da toxicidade, na melhoria da estabilidade térmica e na manutenção da atividade.

4
  • HENNES GENTIL DE ARAÚJO
  • Aplicação De Duas Fontes De Radiação Eletromagnética Não Ionizante Em Ciências Da Saúde

  • Advisor : MARIO BERNARDO FILHO
  • COMMITTEE MEMBERS :
  • CECILIA MARIA DE CARVALHO XAVIER HOLANDA
  • MARIO BERNARDO FILHO
  • SEBASTIAO FRANCO DA SILVA
  • Data: Aug 3, 2015


  • Show Abstract
  • Segundo critérios radiobiológicos, as radiações eletromagnéticas podem ser classificadas como ionizante e não ionizante. Essas radiações são também empregadas para fins terapêuticos nas ciências da saúde. O Objetivo da pesquisa é avaliar a aplicação de duas fontes de radiação eletromagnética não ionizante em ciências da saúde, o LASER e o LED. Através de uma revisão sistemática avaliou-se a aplicação do LASER associado à acupuntura no tratamento de dor lombar. As publicações analisadas foram selecionadas através de quatro bases de dados PubMed, Scopus, Science Direct e PEDro. O efeito de fonte de LED em hemácias foi avaliado através de estudo da fragilidade osmótica com sangue de rato Wistar. De acordo com as palavras-chave "LASER", "acupuncture", "LASER acupuncture" e "low back pain" foi verificado que o número de publicações (NP) na base de dados PEDro é inferior as demais. Mais de um milhão de publicações foram encontradas para LASER na base de dados SCOPUS. Segundo os critérios de inclusão quatro artigos foram considerados relevantes para análise do efeito da acupuntura com laser (AL) em dor lombar. Foi observado que mais investigações são necessários para verificar se a AL tem eficácia para tratar dor lombar. Todos os comprimentos de onda do LED foram capazes de promover hemólise e o comprimento de onda de 515 - 570 nm foi o que promoveu mais hemólise nos eritrócitos. Conclui-se que (i) existe interesse científico em AL, pois esse procedimento é não invasivo e é aceito por pacientes com medo de agulhas, assim como por crianças. Mas ainda, é importante o desenvolvimento de protocolos de AL com comprimentos de onda e dose de laser controlados para tratamento de dor lombar, e que (ii) a radiação LED possivelmente é capaz de promover alterações na membrana eritrocitária acarretamento aumento da fragilidade das hemácias.

5
  • GEORGE ALEXANDRE LIRA
  • ESTUDO DA CORRELAÇÃO DAS CARACTERÍSTICAS CLÍNICO-PATOLÓGICAS DO CÂNCER COLORRETAL COM A EXPRESSÃO IMUNOHISTOQUÍMICA DE PROTEÍNAS DA PROGRESSÃO TUMORAL

  • Advisor : RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • COMMITTEE MEMBERS :
  • RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • AURIGENA ANTUNES DE ARAUJO
  • JEYMESSON RAPHAEL CARDOSO VIEIRA
  • Data: Aug 31, 2015


  • Show Abstract
  • Excluindo-se os tumores de pele não-melanoma, o câncer colorretal é o segundo mais comum no sudeste do Brasil; o terceiro na região sul e na região Centro-Oeste. Já no norte do Brasil, é o quarto e, na região Nordeste, o quinto. Avaliar variáveis clinico-patológicos do câncer colorretal é de fundamental importância para se conhecer possíveis desfechos na sobrevida dos pacientes portadores e pontuar características na progressão tumoral como o perfil da invasão tumoral e angiogênese. O objetivo desse trabalho é estudar as características clínico-patológicas dos pacientes portadores do câncer colorretal (CCR) na Liga Norte Riograndense contra o câncer em Natal-RN/BR, analisando as variáveis clínicas e patológicas como parâmetros de prognóstico e determinando o nível de expressão de proteínas, tais sejam: E-caderina (E-cad), Beta-catenina (β-cat), Galectina-3 (Gal-3), Metaloproteinases de matriz (MMP) 2 e 9 e o Fator alfa de crescimento vásculo-endotelial (VEGF-α) nos tecidos tumorais.  Foi realizado um estudo retrospectivo dos casos de câncer colorretal da Liga Norte-Riograndense contra o Câncer no período de 1995 a 2005 em Natal-RN / Brasil. As variáveis clínico-patológicas, tais como: idade, sexo, etnia, hábitos de vida, história familiar, local do tumor primário, grau de diferenciação, estadiamento TNM, Dukes’ modificado, tratamento e sobrevida foram analisadas. Os dados clínico-patológicos foram coletados dos prontuários médicos através de um formulário específico e os dados foram armazenados em uma planilha do Excel. Um total de 534 pacientes foi selecionado do arquivo do setor da patologia dessa instituição, mas 176 pacientes foram excluídos. 358 pacientes foram incluídos para análise epidemiológica e suas correlações clínico-patológicas foram realizadas. 180 pacientes foram selecionados para estudos histológicos e imunohistoquímicos. Proteínas participantes da progressão tumoral E-caderina, Beta-catenina, Galectina-3, Metaloproteinases 2 e 9 e o Fator alfa de crescimento endotelial vascular foram analisadas. Os blocos de parafina dessas amostras foram tratados pela técnica de Tissue Microarray e suas lâminas submetidas a imunohistoquímica para avaliar a intensidade de marcação dessas proteínas nos tecidos tumorais. Os resultados dessa análise foram correlacionados às variáveis clínico-patológicas dos pacientes. Análise estatística pelo Teste de qui-quadro de Pearson e análise de sobrevida pela Curva de Kaplan-Meier foram utilizados. Valores de p<0,05 foram considerados estatisticamente significativos.  A média de idade da nossa amostra foi de 58,8 anos e 51,7% foram do sexo feminino. O consumo de álcool aumentou em 1,71 vezes o risco de morte pelo CCR (p=0,034). Já o tabaco aumentou 2,7 vezes a chance de desenvolver tumores de alto estágio TNM (p=0,001). Os pacientes com histórico familiar de câncer teve 3,833 vezes a chance de desenvolver o CCR (p=0,002). A expressão da MMP-2 mostrou uma associação significativa com os tumores de alto estágio TNM (p<0,046) e mortalidade (p=0,041). A expressão do α VEGF teve correlação estatisticamente significante com o alto estágio TNM (p<0,009), grau de indiferenciação celular (p<0,025) e mortalidade (p<0,035). As expressões da E-caderina e Beta-catetina mostraram associação do tumor com alto estágio TNM (p=0,0001) e Dukes’ modificado (p=0,05), lesão em reto (p=0,03 e p=0,007, respectivamente), tabaco (p=0,05) e indiferenciação (p=0,001). A expressão das Gal-3 apresentou relevância estatística com pacientes de alto estágio TNM (p=0,01), fumantes (p=0,01), etilista (p=0,03), indiferenciação (p=0,0001) e mortalidade (p=0,0001). Frente aos resultados, pode-se perceber que o estilo de vida e histórico familiar teve correlação no prognóstico do CCR, assim como a expressão de MMP-2, MMP-9, VEGF alfa, E-caderina, Beta–catenina e Galectina-3 foram importantes marcadores de prognóstico na progressão tumoral no câncer colorretal.

6
  • SARA IASMIN VIEIRA CUNHA LIMA
  • Racionalidade nas Prescrições de Antimicrobianos e Perfil de Seus Usuários a Partir de Informações Coletadas em Farmácias ComunitáriasRacionalidade das Prescrições de Antimicrobianos e Perfil de Seus Usuários a Partir de Informações Coletadas em Farmácias Comunitárias

  • Advisor : IVONETE BATISTA DE ARAUJO
  • COMMITTEE MEMBERS :
  • IVONETE BATISTA DE ARAUJO
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • AMALIA CINTHIA MENESES DO REGO
  • Data: Nov 26, 2015


  • Show Abstract
  • Fundamento: Embora haja um conflito entre os benefícios de um tratamento para um único indivíduo e para a sociedade, restrições na utilização de antimicrobianos são necessárias para reduzir a prevalência de resistência à esses medicamentos, resultado do uso irracional. O Brasil, catalogado como um país farmacêutico emergente, implementou medidas restritivas para o consumo de antimicrobianos. O objetivo deste estudo foi investigar a qualidade de prescrições de antimicrobianos e o conhecimento de usuários sobre seus tratamentos com esses medicamentos.

    Métodos e Resultados: Foi conduzida uma amostragem combinada estratificada e em dois estágios de usuários de antimicrobianos em farmácias comunitárias entre Maio e Novembro de 2014. Um farmacêutico analisou cada prescrição quanto à legibilidade e completude, e aplicou um questionário estruturado em usuários ou seus cuidadores, sobre o conhecimento em relação ao tratamento e dados sociodemoráficos. Estimou-se que 29,3% das prescrições tinham um ou mais itens ilegíveis, 91,3% tinham um ou mais itens incompletos, e 29,0% tinham itens ilegíveis e incompletos. Esquema de dosagem e identificação do paciente foram os itens mais comumente ilegíveis nas prescrições,18,81% e 12,14%, respectivamente. A falta de identificação completa do paciente ocorreu em 90,53% das prescrições. Estima-se que 40,3% dos usuários têm utilizado antimicrobianos sem receita médica e que 46,49% não receberam qualquer orientação sobre a administração do medicamento.

    Conclusões: Apesar das medidas tomadas pelas autoridades de saúde para restringir o uso indevido de antimicrobianos, observou-se que os prescritores ainda não seguem os critérios da legislação em vigor, especialmento no que se refere aos itens necessários para a completude da prescrição. Além disso, os usuários recebem pouca informação sobre o seu tratamento com antimicrobiano. Dessa forma, os resultados obtidos a partir desse estudo permitem uma contribuição para a atividade de vários profissionais da saúde, em especial médicos, odontólogos, enfermeiros e farmacêuticos, por estarem envolvidos no processo de medicação do paciente.

Thesis
1
  • ANA CAROLINA PATRICIO DE ALBUQUERQUE SOUSA
  • Desempenho Físico em Idosos com Diferenciados Perfis Epidemiológicos: Análise do Estudo IMIAS (International Mobility in Aging Study) sob a Perspectiva Epidemiológica do Curso da Vida e de Biomarcadores da Inflamação e do Estresse

  • Advisor : RICARDO OLIVEIRA GUERRA
  • COMMITTEE MEMBERS :
  • ALVARO CAMPOS CAVALCANTI MACIEL
  • DANIELE SIRINEU PEREIRA
  • LEANI SOUZA MAXIMO PEREIRA
  • RICARDO OLIVEIRA GUERRA
  • SELMA SOUSA BRUNO
  • Data: Feb 5, 2015


  • Show Abstract
  • O presente estudo analisou a associação entre a adversidade no curso da vida e o desempenho físico em idosos comunitários de diferentes sociedades. Além disso, avaliou a influência de biomarcadores de inflamação e do estresse no desempenho físico desses idosos.

    Métodos: Foram utilizados dados do Estudo Internacional de Mobilidade no Envelhecimento (pesquisa de base), composto por 1.995 indivíduos entre 65 e 74 anos de idade e residentes na comunidade. Desempenho físico foi avaliado através do Short Physical Performance Battery (SPPB) e da força de preensão manual. Adversidades econômica e social foram estimada a partir de eventos adversos na infância, baixo nível de educação, ocupação laboral semi-qualificada durante a idade adulta, morar sozinho e ter renda insuficiente na velhice.

    A proteína c-reativa foi considerada como o biomarcador inflamatório e o cortisol como o biomarcador de estresse.

    Resultados: o baixo desempenho físico foi associado a ter sofrido adversidade social e econômica na infância ter tido ocupação semi-qualificada na idade adulta, morar sozinho e possuir renda insuficiente na velhice. O baixo desempenho físico também foi associado com os altos índices de inflamação e de estresse. Além disso,o desempenho físico foi menor nos participantes que vivem na Colômbia, Brasil e Albânia do que nos que vivem no Canadá, apesar de ajuste para a adversidade no curso da vida, idade e sexo. Conclusões: Os resultados evidenciaram uma associação entre inflamação, estresse e desigualdades sociais e econômicas na infância sobre o desempenho físico durante a velhice em populações distintas.

2
  • RAUL HERNANDES BORTOLIN
  • PROTEÇÃO CONTRA A PERDA ÓSSEA INDUZIDA PELO DIABETES TIPO 1 ATRAVÉS DA SUPLEMENTAÇÃO COM ZINCO: ANÁLISES BIOMECÂNICA, HISTOMORFOMÉTRICA E MOLECULAR EM RATOS DIABÉTICOS INDUZIDOS POR STZ.

  • Advisor : ADRIANA AUGUSTO DE REZENDE
  • COMMITTEE MEMBERS :
  • ADRIANA AUGUSTO DE REZENDE
  • DANILO ALVES PINTO NAGEM
  • FRANCISCO JOSÉ ALBUQUERQUE DE PAULA
  • JOÃO MARTINS PIZAURO JÚNIOR
  • NAISANDRA BEZERRA DA SILVA FARIAS
  • Data: Feb 6, 2015


  • Show Abstract
  • Diversos estudos tem estabelecido a associação entre diabetes e alterações no metabolismo do osso; no entanto, os mecanismos subjacentes não são totalmente elucidados. Embora o zinco seja reconhecido como um potencial agente na prevenção contra a perda óssea induzida pelo diabetes, não há evidência mostrando este efeito em condições crónicas de diabetes. Assim o presente estudo avaliou os efeitos da suplementação de zinco em modelo de crônico de diabetes associado a perda óssea (90 dias). Foram utilizados ratos Wistar machos no qual foram igualmente distribuídos em três grupos (n=15): Controle; Diabetes mellitus tipo 1 (TDM1); e Diabetes mellitus tipo 1 associados a suplementação com zinco (T1DMS). Bioquímica sérica, análises biomecânicas, histomorfométricas e conteúdo de colágeno nas tíbias, bem como análises de expressão de RNAm em fémur foram avaliados. Em relação ao controle, TDM1 mostrou uma perda óssea através de: diminuição parâmetros histomorfométricos, tais como a espessura e área do osso trabecular e aumentou a separação trabecular óssea; diminuição de parâmetros biomecânicos representados por carga máxima, rigidez, máxima deformação em flexão, e módulo de elasticidade; diminuição do conteúdo de colágeno tipo 1. Além disso, aumentos na expressão genica da osteoprotegerina (OPG), colágeno tipo 1 (COL1A), e metaloproteinase do tipo 9 (MMP9) foram observadas em TDM1. Estes resultados representam uma menor resistência e flexibilidade óssea associada ao TDM1. A suplementação com zinco mostrou um significativo efeito protetor contra a perda óssea, uma vez que valores semelhantes foram observados para os parâmetros histomorfométricos e biomecânicos entre grupos T1DMS e controle. O zinco também apresentou uma manutenção dos valores de expressão genica dos genes estudados quando comparado com TDM1. Adicionalmente, os efeitos anabólicos do zinco foram evidenciados através do aumento da expressão genica da osteocalcina (OC) e atividade da fosfatase alcalina sérica, ambos relacionados com osteoblastogênese, demonstrando, assim, uma efeito positivo na formação óssea. Em conclusão, o zinco mostrou um efeito positivo sobre a manutenção da arquitetura óssea e parâmetros biomecânicos. Em relação aos parâmetros moleculares, a suplementação conduziu a uma hiperexpressão da OC e um controle na expressão da OPG, COL1A, e MMP9 em condições crônicas de hiperglicemia, suportam o efeito protetor e anabólico de zinco. Os resultados sugerem ainda que o zinco pode representar uma terapia adjuvante na perda óssea associada ao Diabetes mellitus tipo 1 em condições crônicas.

3
  • DIMITRI TAURINO GUEDES
  • PREVALÊNCIA, FATORES ASSOCIADOS E EFEITOS DA VIOLÊNCIA DOMÉSTICA NA MOBILIDADE EM IDOSOS: EVIDÊNCIAS DO ESTUDO IMIAS (INTERNATIONAL MOBILITY IN AGING STUDY) SOB A PERSPECTIVA EPIDEMIOLÓGICA DO CURSO DA VIDA

  • Advisor : RICARDO OLIVEIRA GUERRA
  • COMMITTEE MEMBERS :
  • ALVARO CAMPOS CAVALCANTI MACIEL
  • DAMIAO ERNANE DE SOUZA
  • KARLA CRISTINA GIACOMIN
  • RICARDO OLIVEIRA GUERRA
  • ZENEWTON ANDRÉ DA SILVA GAMA
  • Data: Feb 6, 2015


  • Show Abstract
  • INTRODUÇÃO: A capacidade de mover-se com independência e segurança é fundamental para a execução das atividades de vida diária e manutenção da qualidade de vida do indivíduo. Diversos fatores, dentre eles o envelhecimento podem contribuir para seu declínio. Estudos têm demonstrado associação entre experiências de violência doméstica (VD) e diversos problemas de saúde física e mental. Até o momento, não há estudos que tenham avaliado a associação entre experiências de VD no curso de vida e limitações de mobilidade na senescência. OBJETIVOS: estimar a prevalência da VD (física e psicológica) em idosos, e avaliar o impacto da VD no curso de vida na limitação de mobilidade. MATERIAIS E MÉTODO: Estudo observacional analítico a partir da primeira coleta de dados do estudo longitudinal International Mobility in Aging Study (IMIAS). Idosos (n = 1995) de ambos os sexos entre 65 e 74 anos de cinco localidades distintas (Kingston e Saint-Hyacinthe, Canadá; Tirana, Albânia; Maniazales, Colômbia; e Natal, Brasil) participaram do estudo. Dados sobre variáveis sociodemográficas, econômicas, condições de saúde e experiências de VD (física e psicológica) durante o curso de vida foram coletados. A limitação de mobilidade na senescência foi avaliada pelo Short Physical Performance Battery (SPPB) e pela dificuldade de andar 400 metros e/ou subir um lance de escadas. As prevalências foram avaliadas mediante frequências absolutas e relativas das exposições à VD, limitação de mobilidade e co-variáveis. Diferenças de gênero, bem como entre cidades foram analisadas utilizando o teste de qui-quadrado. Associação entre exposição à VD e limitação de mobilidade foi avaliada utilizando a regressão logística binária multivariada, ajustando pelas co-variáveis. Análise de mediação foram utilizadas, para avaliar possíveis caminhos entre a exposição à VD no curso de vida e a limitação de mobilidade. RESULTADOS: A violência física foi rara, com valores entre 0,63 e 0,85%. Relatos de violência psicológica variaram entre 3,2% e 23,5% (homens) e de 9% para 26% (mulheres). Mulheres experimentaram mais violência do que os homens em Saint-Hyacinthe (homens: 3,2% vs mulheres: 14%, p <0,001), Tirana (homens: 4,3% vs mulheres: 10,3%, p = 0,017), em Manizales (homens: 8,3 % vs mulheres: 18,3%, p = 0,004) e Natal (homens: 11,1% vs mulheres: 26%, p = 0,002). Em geral, o baixo suporte social pelo parceiro foi associado com a VD. Estar trabalhando foi associado a vitimização entre os homens, enquanto o oposto foi verdade para as mulheres. Arranjos de vida Multi-familiares e baixo suporte pelos parceiros, filhos e família foram associados com a VD. Baixo suporte social foi da maior importância para as mulheres do que os homens. A VD física foi associada tanto com o SPPB < 8 (OR 1,623 95%IC 1,161-2,269) como com a dificuldade para andar 400 metros e/ou subir um lance de escadas (OR 1,394 95%IC 1,063-1,829). A limitação de mobilidade decorrente da violência física no curso de vida pelo parceiro íntimo foi mediada pelas condições crônicas (efeito 25,56% 95%IC 0,036-0,277) e depressão (efeito 33,05% 95%IC 0,087-0,333). No caso da violência física por outros familiares, a limitação de mobilidade foi mediada pelas condições crônicas (efeito 20,85% 95%IC 0,022-0,202), não adesão à prática de atividades físicas (efeito 34,14% 95%IC 0,076-0,351) e depressão (efeito 44,40% 95%IC 0,144-0,315). CONCLUSÕES: A violência doméstica no curso de vida é uma realidade, que pode acarretar consequências que favorecem a limitação de mobilidade em idosos. São necessárias políticas públicas que combatam efetivamente a violência doméstica, garantindo um envelhecimento mais digno e independente funcionalmente.

4
  • ROSANE COSTA GOMES
  • O iceberg celíaco: do espectro clínico e marcadores sorológicos à histologia em crianças e adolescentes com diabetes mellitus tipo 1 e síndrome de Down.

  • Advisor : HELCIO DE SOUSA MARANHAO
  • COMMITTEE MEMBERS :
  • HELCIO DE SOUSA MARANHAO
  • CLAUDIA RODRIGUES SOUZA MAIA
  • SEVERINA CARLA VIEIRA CUNHA LIMA
  • ROCKSANE DE CARVALHO NORTON
  • VERA LÚCIA SDEPANIAN
  • Data: Feb 10, 2015


  • Show Abstract
  • Analisaram-se a ocorrência de sintomas gastrointestinais e extraintestinais em crianças e adolescentes com diabetes mellitus tipo 1 (DM1) e com síndrome de Down (SD), sua associação a marcadores sorológicos e alterações histopatológicas da doença celíaca (DC), representando suas formas clínicas no iceberg celíaco. Realizou-se estudo de corte transversal no período de novembro/2009 a dezembro/2012, em unidade ambulatorial pediátrica de hospital da Universidade Federal do Rio Grande do Norte (UFRN), que incluiu DM1=111 e SD=77 pacientes. Coletaram-se dados clínico-demográficos. Anticorpos IgA antiendomísio (EmA) e anti-transglutaminase tecidual (anti-tTG) e IgA sérica foram determinados, assim como anti-tTG/IgG, quando a IgA sérica foi baixa. Pacientes com anticorpos positivos foram submetidos à biópsia de intestino delgado (BID). Classificaram-se as formas da DC segundo critérios ESPGHAN-2012 e representadas no iceberg celíaco. Aplicaram-se os testes qui-quadradode Pearson, Fisher, “t” de Student e Mann-Witney, com “p” significante  ≤ 5. Sintomas gastrointestinais ocorreram em 53,7%, extraintestinais em 4,3% e anticorpos foram positivos em 28,2%(n=53). Houve associação dos anticorpos com sintomas gastrointestinais, mas não com alterações histopatológicas da DC. Dos que realizaram BID (n=40), os achados foram compatíveis com DC em 37,5%, sendo DM1=05/111(4,5%) e SD=10/77(12,9%). Identificaram-se as formas clínicas: gastrointestinal (32,5%), silenciosa (5,0%) e potencial (62,5%). A alta ocorrência de sintomas gastrointestinais e sua associação a marcadores sugeriu possível influência destes na seleção de pacientes com marcadores positivos. No entanto, a falta de associação com achados histopatológicos da DC revelou a inconsistência dos sintomas para o reconhecimento da doença. Apesar da predominância da forma gastrointestinal nos casos de DC ativa, sua contribuição no iceberg celíaco foi menor do que a forma potencial, que determinou sobremaneira a base larga e submersa do iceberg celíaco nos grupos de risco estudados.

5
  • ANA NUNES PAIVA
  • SUPLEMENTAÇÃO ORAL COM PICOLINATO DE CROMO EM DIABETES TIPO2: UM ENSAIO CLÍNICO RANDOMIZADO

  • Advisor : MARIA DAS GRACAS ALMEIDA THORNTON
  • COMMITTEE MEMBERS :
  • ANDRE GUSTAVO PIRES DE SOUSA
  • JORGE ALBERTO LOPEZ RODRIGUEZ
  • KARINE CAVALCANTI MAURICIO DE SENA EVANGELISTA
  • MARIA DAS GRACAS ALMEIDA THORNTON
  • SANDRA MARIA NUNES MONTEIRO
  • Data: Feb 27, 2015


  • Show Abstract
  • Diante da importância do papel do cromo no mecanismo da sensibilidade à insulina tem sido estudada a suplementação com este mineral em pacientes diabéticos. Assim, o objetivo deste estudo foi avaliar o efeito da suplementação oral com picolinato de cromo (PicCr) nas concentrações glicêmicas, lipidêmicas, perfil antioxidante e parâmetros antropométricos em pacientes com diabetes mellitus tipo 2 (DM2) mal controlados(hemoglobina glicada A1c (HbA1c) ≥ 7%). Para tanto, foi conduzido um ensaio clínico controlado, randomizado, com 71 pacientes, de ambos os sexos, divididos em dois grupos: controle (usando placebo n=32) e experimental (n=39) suplementado com 600µg/dia de PicCr, durante 4 meses. Os pacientes recebiam orientação nutricional e mantinham o uso das suas medicações. Todos os parâmetros foram analisados antes e após os 4 meses de suplementação. A suplementação com PicCr reduziu significativamente a glicemia de jejum (p<0,05), a glicemia pós-prandial (p<0,05). A HbA1c foi reduzida significativamente (p<0,001) em ambos os grupos, placebo e PicCr. No entanto, essa redução foi significativamente maior (p<0,05) no grupo PicCr (-1,90) em comparação com o grupo Pl (-1,00).. Foi observada ainda a diminuição significativa (p<0,05) da Circunferência da Cintura e do Índice de Conicidade nos pacientes suplementados. Não foram observadas alterações significativas nos demais parâmetros antropométricos, perfil lipídico e perfil antioxidante, após a intervenção A suplementação com picolinato de cromo trouxe um efeito benéfico sobre o controle glicêmico dos pacientes com DM2 mal controlada, porém sem efeito sobre as variáveis dos perfil lipídico. Apesar dos resultados promissores encontrados, mais estudos são necessários para investigar o efeito desta suplementação em longo prazo.

6
  • ARDIGLEUSA ALVES COELHO
  • O Controle Da Tuberculose No Contexto Da Atenção Primária À Saúde No Brasil

  • Advisor : SEVERINA ALICE DA COSTA UCHOA
  • COMMITTEE MEMBERS :
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • ERIKA SIMONE GALVAO PINTO
  • PAULO DE MEDEIROS ROCHA
  • PEDRO FREDEMIR PALHA
  • SEVERINA ALICE DA COSTA UCHOA
  • Data: Mar 4, 2015


  • Show Abstract
  • O Brasil é um dos países que concentram 80% da carga de tuberculose no mundo. No contexto da atenção primária brasileira, fatores interferem para que as equipes de saúde da família possam incorporar as atividades de controle da doença no processo de trabalho. O controle da doença depende da forma como os serviços de saúde estão organizados para garantir o acesso ao diagnóstico precoce e ao tratamento. Esse estudo tem como objetivo geral analisar o controle da tuberculose no contexto da atenção primária à saúde no Brasil. Os objetivos específicos são comparar o tratamento diretamente observado com o regime autoadministrado em pessoas com tuberculose; Verificar se o Programa Nacional de Controle da Tuberculose é avaliável e elaborar um modelo teórico e lógico para avaliação deste programa; avaliar a relação entre porte populacional dos municípios e as características de estrutura e processo de cuidado a pacientes de tuberculose na atenção primária no Brasil. Realizou-se uma revisão sistemática, seguida de um estudo de avaliabilidade e de um estudo transversal. Os achados da revisão sistemática revelam que não houve diferença significativa entre os  grupos de tratamento (observado e não observado) para cura (OR 1,06. IC95% 0,75 – 1,50) e para conclusão do tratamento (OR 1,64, IC 95% 0,79 – 3,42). Menor abandono no grupo com tratamento supervisionado e não houve diferença estatisticamente significativa entre os grupos (OR 0,73, CI 95% 0,58-0,92). O risco de morte foi maior no regime de tratamento autoadministrado (OR 1,49 IC 95% 1,03 – 2,45). A hetorogeinadade entre os estudos analisados não permite afirmar que nao há diferença estatisticamente significativa para cura e tratamento concluído. A pré-avaliação do Programa de Controle de Tuberculose possibilitou a descrição do Programa, elaboração e pactuação do modelo lógico e a matriz de relevância dos indicadores. Caracterizou-se os seus elementos estruturantes, definição de indicadores de estrutura e processo, além das perguntas avaliativas. Uma avaliação somativa com enfoque na análise dos efeitos da intervenção de controle da tuberculose é recomendada. A avaliação das características de estrutura e processo de cuidado à pessoa com tuberculose revelou melhor desempenho para as equipes de atenção básica de municípios classificados como metrópole no acesso, coordenação do cuidado e qualidade técnica da atenção. Em relação ao acesso: 98,5% acolhimento a demanda espontânea; 95,8% programação de consultas. Na coordenação do cuidado, 93,2% existência de protocolo para tuberculose. Quanto a qualidade técnica da atenção à tuberculose verifica-se que 93,4% acompanhamento de tratamento diretamente observado, 95,8% com busca ativa de faltosos ao tratamento, 64,0% oferta de ações educativas, 91,3% busca ativa de sintomáticos respiratórios. Cabe destacar que metrópoles apresentaram maior tempo médio de espera para escuta/acolhimento (24,41 minutos); para consulta previamente agendada (23,52 dias); para consulta em pneumologia (87,12 dias). Percebem-se fragilidades na estrutura e processo da atenção à tuberculose, principalmente no controle especializado da doença e na qualidade técnica entre os municípios. Recomenda-se reforço, particularmente na qualidade técnica para aumentar a cobertura de acompanhamento do tratamento, busca de sintomáticos respiratórios e das ações educativas.

7
  • MARIZE BARROS DE SOUZA
  • O TRABALHO EM EQUIPE NA ATENÇÃO PRIMÁRIA À SAÚDE: situação de Portugal e do Brasil

  • Advisor : SEVERINA ALICE DA COSTA UCHOA
  • COMMITTEE MEMBERS :
  • SEVERINA ALICE DA COSTA UCHOA
  • JACILEIDE GUIMARAES
  • NADJA DE SA PINTO DANTAS ROCHA
  • ANA LUIZA D''''ÁVILA VIANA
  • PAULO ROBERTO DE SANTANA
  • Data: Mar 10, 2015


  • Show Abstract
  • Desenho: estudo com delineamento transversal, de abordagem quantitativa. Realizado a partir dos dados obtidos da “Pesquisa realizada na fase III – Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica”, no Brasil em 2013. Objetivo: Avaliar o trabalho em equipe no acesso e na qualidade da Atenção Primária em Saúde no Brasil. Método: Amostra composta de 17.202 profissionais e 65.391 usuários. Utilizou-se entrevista estruturada com análise estatística realizada pelas frequências absolutas e relativas das variáveis através do programa Statistic Package for Social Sciences. O trabalho em equipe foi analisado nas dimensões: organização do processo de trabalho e interação.

    Resultados: no processo de trabalho realizam planejamento e programação das ações e conta com apoio da gestão. O território está definido, existem prontuários familiares. É destaque a agenda compartilhada e pactuada entre os profissionais. As equipes realizam acolhimento e reuniões, cujos temas discutidos giram em torno do processo de trabalho e planejamento. Os desafios enfrentados estão relacionados ao agendamento dos usuários; ao número de pessoas sob a responsabilidade das equipes; à existência de população descoberta nas áreas adscritas à Unidade de Saúde; à incipiência na ação intersetorial e no não envolvimento da comunidade pelas equipes. Conclusões: constatou-se o trabalho em equipe como elemento central no processo de mudança na APS brasileira, o qual ampliou o acesso e a qualidade na oferta de serviços de saúde e obteve ainda o reconhecimento social. Mesmo não tendo avançado na coordenação do cuidado; no estímulo à participação social.

8
  • CLAUDIA SANTOS MARTINIANO SOUSA
  • A PRESCRIÇÃO DE MEDICAMENTOS POR ENFERMEIROS NA ATENÇÃO PRIMÁRIA À SAÚDE NO BRASIL: CARACTERIZAÇÃO, NORMATIZAÇÃO, FORMAÇÃO E LIÇÕES APRENDIDAS


  • Advisor : SEVERINA ALICE DA COSTA UCHOA
  • COMMITTEE MEMBERS :
  • ALTAMIRA PEREIRA DA SILVA REICHERT
  • BERTHA CRUZ ENDERS
  • HELENA MARIA SCHERLOWSKI LEAL DAVID
  • PAULO DE MEDEIROS ROCHA
  • SEVERINA ALICE DA COSTA UCHOA
  • Data: Mar 11, 2015


  • Show Abstract
  • O papel do enfermeiro como prescritor vem se ampliando em muitos países nos últimos anos, em diferentes situações e amplitudes de ação, se configurando como prática avançada na enfermagem. No Brasil, a prescrição de medicamentos por enfermeiros está prevista na Lei do Exercício Profissional desde 1986, e permite a esse profissional, a prescrição de medicamentos estabelecidos em programas de saúde pública. Esse estudo tem como objetivo geral analisar as determinações e perspectivas da prescrição de medicamentos por enfermeiros nos protocolos da Estratégia Saúde da Família. Os objetivos específicos são: apreender a atual situação internacional da prescrição de medicamentos por enfermeiros em comparação a essa prática no Brasil identificando semelhanças e diferenças; identificar os contornos legais e normativos da prescrição de medicamentos por enfermeiros no Brasil apontando sua história, tendências e desafios; caracterizar o modelo de prescrição de medicamentos por enfermeiros nos protocolos de Atenção Primária à Saúde no Brasil; investigar possíveis lacunas entre formação, capacitação, autoavaliação e prática da prescrição de medicamentos na Atenção Primária à Saúde na perspectiva do enfermeiro. Trata-se de Estudo de Caso Exemplar com abordagem qualitativa através de Revisão Bibliográfica, Análise Documental e Grupo Focal com enfermeiros.  A análise dos dados deu-se por meio da Análise de Conteúdo e Análise Qualitativa de Conteúdo. Os resultados revelam que a categoria da enfermagem contribuiu para a legalização da prescrição, porém não para a sua legitimação; na Atenção Primária à Saúde, essa atribuição está consolidada por meio de protocolos e legislação, embora sem estratégia clara de acompanhamento pelo Ministério da Saúde; observa-se resistência em algumas normatizações dentro do setor saúde. Quanto aos protocolos, observou-se não há exigência de pré-requisitos na maioria deles; há possibilidade de diagnóstico pelo enfermeiro na gravidez, nutrição infantil e doenças sexualmente transmissíveis; observou-se variados graus de autonomia; amplo grupo de medicamentos prescritos por enfermeiros. Dos 37 participantes do Grupo Focal, 97,3% eram do sexo feminino; 54% formados há menos de 10 anos, 27% entre 10 e 20 anos, 16,2% há mais de 20 anos; 83,8% com especialização em Saúde Pública. Todos os enfermeiros relataram insuficiência da disciplina de farmacologia para instrumentalizar a prática prescritiva. Destacou-se a necessidade de pós-graduação; a importância da experiência clínica; falta de discussões e capacitação. Apenas alguns se autoavaliaram como competentes para prescrever, outros revelam medo de reação adversa a medicamentos. Conclui-se que há tendência da prescrição de medicamento por enfermeiros permanecer apenas na legalidade e o principal desafio é alcançar a legitimidade. Confirma-se uma prática prescritiva sem requisitos, diversidade de orientações induzindo a multiplicidade de ações que pode afetar a qualidade da prescrição. Há lacunas entre formação, capacitações e exigências cotidianas da prescrição de medicamentos por enfermeiros na Atenção Primária à Saúde. No Brasil se faz premente pesquisa para avaliar o impacto, a qualidade e a segurança da prescrição de medicamentos por enfermeiros. A experiência internacional sugere também que essa prescrição deve ser apoiada pelo coletivo de enfermeiros, com robusto plano de capacitação nacional, além de governança e apoio local.

9
  • CLÉBER DE MESQUITA ANDRADE
  • Doença de Chagas: Caracterização de formas Clínicas e Estratificação do Risco de Morte no Oeste do estado do Rio Grande do Norte, Brasil.

  • Advisor : LUCIA MARIA DA CUNHA GALVAO
  • COMMITTEE MEMBERS :
  • LUCIA MARIA DA CUNHA GALVAO
  • JOSE BRANDAO NETO
  • KERGINALDO PAULO TORRES
  • DALMO CORREIA FILHO
  • JOÃO CARLOS PINTO DIAS
  • Data: Mar 12, 2015


  • Show Abstract
  • O perfil clínico com classificação das formas clínicas e a gravidade da doença de Chagas foram avaliados em indivíduos sororreativos para o Trypanosoma cruzi procedentes da mesorregião Oeste Potiguar. Neste estudo transversal foram incluídos 186 indivíduos adultos, entre 23 a 78 anos de idade. Todos os indivíduos foram submetidos à avaliação clínica, aplicado um questionário clínico-epidemiológico e realizados eletrocardiograma de repouso, ecocardiograma transtorácico, radiografia simples de tórax e contrastadas de esôfago e cólon. O Holter foi realizado em 98 pacientes e aplicado escores de risco de acidente vascular encefálico isquêmico e morte. A forma clínica indeterminada foi detectada em 51,6% (96/186) dos pacientes, a cardíaca em 32,2% (60/186), a digestiva em 8,1% (15/186) e a cardiodigestiva em 8,1% (15/186). Dos pacientes com a forma clínica digestiva, 7,0% (13/186) apresentaram diferentes grupos de megaesôfago (I a IV) e 12,9% (24/186) megacólon de grau 1 a 3. Destes, 29,2% (7/24) com ambos os órgãos afetados. As alterações eletrocardiográficas foram observadas em 48,1% (91/186) dos pacientes e a arritmia ventricular complexa presente em 41,8% (41/98). Desses pacientes, 10,2% (19/186) apresentaram cardiomegalia enquanto o aneurisma apical foi diagnosticado em 10,8% (20/186) e as alterações da contratilidade miocárdica segmentar do ventrículo esquerdo em 33,9% (63/186). Em 7,5% (14/186) dos pacientes foi detectada insuficiência cardíaca com classes funcionais que variam de I a IV. A classificação da insuficiência cardíaca por estádios demonstrou que 36,4% (24/66), 30,3% (20/66), 15,2% (10/66), 13,6% (9/66) e 4,5% (3/66) dos pacientes apresentaram estágios A, B1, B2, C e D, respectivamente. O escore de estratificação de risco de acidente vascular encefálico isquêmico identificou 80,6% (150/186) dos pacientes em baixo risco, 15,6% (29/186) em moderado e 3,8% (7/186) em alto risco. O escore de risco de morte foi aplicado em 84 pacientes e 69,0% (58/84) mostraram baixo risco, 25,0% (21/84) intermediário e 6,0% (5/84) alto risco. Os resultados demonstraram a existência das três principais formas clínicas da doença de Chagas em diferentes estágios de evolução e o registro da forma digestiva isolada e, que um quarto dos pacientes com a forma indeterminada deveria ser considerado cardiopatas subclínicos, o que aumentaria a abordagem terapêutica nesta população e, consequente diminuição das complicações da doença uma vez que os sintomas apresentados pelos pacientes podem não ser suficientes para determinar ou excluir a forma cardíaca e/ou envolvimento digestivo da doença de Chagas crônica. Demonstramos também que existe uma correlação positiva entre o escore de risco de morte e seus principais determinantes, insuficiência cardíaca, morte súbita e acidente vascular encefálico isquêmico, oferecendo mais um elemento para a difícil tomada de condutas frente ao chagásico cardiopata

10
  • MARIO EMILIO TEIXEIRA DOURADO JUNIOR
  • Síndrome de Guillain-Barré: epidemiologia, prognóstico e fatores de risco

  • Advisor : SELMA MARIA BEZERRA JERONIMO
  • COMMITTEE MEMBERS :
  • ACARY SOUZA BULLE DE OLIVEIRA
  • JOAO PAULO MATOS SANTOS LIMA
  • MARCOS ROMUALDO COSTA
  • OSVALDO JOSE MOREIRA NASCIMENTO
  • SELMA MARIA BEZERRA JERONIMO
  • Data: Mar 17, 2015


  • Show Abstract
  • Indrodução. A Síndrome de Guillain-Barré (SGB) é uma polineuropatia imuno-mediada e a principal causa de paralisia aguda neuromuscular. As principais variantes da síndrome são: polineuropatia desmielinizante inflamatória aguda (PDIA), a neuropatia axonal motora aguda (NAMA), a neuropatia axonal motora e sensitiva aguda (NAMSA) e a síndrome de Miller-Fisher. Há diferenças na distribuição geográfica das variantes em diferentes partes do mundo. A imunopatogênese não está totalmente esclarecida, mas há evidências de uma resposta imune aberrante induzida por infecção, resultante de mimetismo molecular, com formação de autoanticorpos, participação de ativação do complemento e citocinas, além de fatores individuais de susceptibilidade. Três subclasses de receptores da porção Fc das imunoglobulinas (FcγRIIa, FcγRIIIa e FcγRIIIb) apresentam polimorfismos bialélicos que afetam a afinidade para as subclasses de IgG e eficiência na resposta imune celular. Essas observações sugerem que a susceptibilidade individual é importante no desenvolvimento da doença. Não está definido se indivíduos portando diferentes alelos de FcγR têm risco para desenvolver a SGB e/ou uma forma severa desta doença. No Brasil, há poucos estudos epidemiológicos sobre a SGB, e nenhum determinou a frequência das variantes e suas manifestações clínicas. Neste estudo, caracterizamos a SGB e descrevemos as manifestações clínicas de um coorte de pacientes com SGB no Estado do Rio Grande do Norte, avaliamos se a variabilidade genotípica/fenotípica do FcγR está envolvida na SGB e determinamos a expressão gênica durante a fase sintomática e pós-recuperação.
    Metodologia. Foram recrutados 149 casos de SGB diagnosticados entre 1994-2007, sendo avaliados os dados clínicos e laboratoriais de todos os participantes. O ADN foi extraído a partir do sangue periférico e anticorpos antigangliosídeos foram determinados no soro. Além disso, 141 pacientes e 364 doadores de sangue foram genotipados para FCGRIIA e FCGRIIIA, por PCR em tempo real TaqMan® SNP Genotyping Assays (C_9077561_20 and C_25815666_10, respectivamente), Applied Biosystems, CA, USA. A expressão gênica foi determinada usando RNAseq em 12 pessoas com doença, sendo avaliada a fase sintomática e pós-recuperação. Resultados. A incidência de GBS foi de 0,3/100 mil para o Estado do Rio Grande do Norte, sem aparente presença de sazonalidade e os casos ocorreram em uma idade mais jovem. A SGB foi precedida por infecções em 63,7%, sendo a diarréia associada a variante axonal (P=0,025). A polineuropatia desmielinizante inflamatória aguda (PDIA) foi a variante mais freqüente (81,8%) da SGB, seguida de neuropatia axonal motora aguda (AMAN) (14,7%) e neuropatia axonal motora e sensitiva aguda (NAMSA) (3,3%). A distribuição da fraqueza muscular correlacionou com as variantes, a fraqueza proximal ocorreu mais freqüentemente na PDIA e a fraqueza distal predominou na variante axonal. O nadir < 10 dias ocorreu em 84,6% dos indivíduos com a variante axonal comparados com 42,4% dos casos com PDIA (P<0,0001). A forma desmielinizante apresentou uma recuperação na deambulação mais rápida do que a variante axonal (P<0,0001). A mortalidade de GBS foi de 5,3%. O mau prognóstico aos 12 meses estava associado com a variante axonal (OR 17,063; P = 0,03) e com o tempo de melhorar um ponto na escala funcional de Hughes (OR 1,028; P = 0.03). A distribuição dos diferentes genótipos FcγRIIA em SGB e controles era: H ⁄ H genótipo 26 (18.57%) e 74 (20.44%), R ⁄ R genótipo 40 (28.57%) e 106 (29.28%), H ⁄ R genótipo 74 (52.86%) e 182 (50.28%), respectivamente. Para a distribuição dos genótipos de FcγRIIA em SGB, 66 (47.14%) tinham o genótipo P ⁄ P, 14 (10.00%) tinham o genótipo V ⁄ V e 60 (42.86%) eram heterozigotos com o genótipo P ⁄ V158. Nos controles, 180 (49.59%) tinham o genótipo P⁄P, 35 (9.64%) apresentavam o genótipo V ⁄ V e 148 (40.77%) eram heterozigotos com o genótipo P ⁄ V158. A frequência dos genótipos e dos alelos dos FcγR não foram diferentes entre os pacientes os controles (FCGRIIA p=0,367 e FCGRIIIA p=0,2430). Há diferenças na expressão gênica global na fase sintomática com identificação de possíveis vias gênicas envolvidas na patogênese. Conclusão. A incidência média anual da SGB foi de 0.3/100.000, sem sazonalidade. Houve um predomínio da variante desmielinizante e 50% dos casos tinham idade inferior a 20 anos. A variante axonal estava associada ao mal prognóstico. O diagnóstico precoce e a identificação da variante, acompanhara de intervenções adequados, resulta em diminuição da morbidade a longo prazo. Por último, o polimorfismo dos FCGR não influencia na susceptibilidade e nem no curso da SGB. Vias gênicas expressas diferencialmente parecem estar envolvidas na patogênese da doença.




11
  • CRISTYANNE SAMARA MIRANDA DE HOLANDA DA NÓBREGA
  • CICLO GRAVÍDICO PUERPERAL: AVALIAÇÃO DA ASSISTÊNCIA NO SERVIÇO PÚBLICO DE SAÚDE.

  • Advisor : TECIA MARIA DE OLIVEIRA MARANHAO
  • COMMITTEE MEMBERS :
  • ELVIRA MARIA MAFALDO SOARES
  • JANETE LIMA DE CASTRO
  • ROSELI MIEKO YAMAMOTO NOMURA
  • TECIA MARIA DE OLIVEIRA MARANHAO
  • WOGELSANGER OLIVEIRA PEREIRA
  • Data: May 8, 2015


  • Show Abstract
  • Apesar dos avanços na cobertura e qualidade do acompanhamento obstétrico, o atendimento à mulher no ciclo gravídico puerperal ainda está marcado por imperícia, falta de humanização e ausência de integração na rede de assistência. Diante deste cenário, o estudo objetiva avaliar a assistência prestada à mulher no ciclo gravídico puerperal pelo serviço público obstétrico de saúde na região Seridó do estado do Rio Grande do Norte. Pesquisa do tipo exploratória e descritiva, com abordagem quali-quantitativa, realizada nos municípios de Caicó, Currais Novos e Parelhas. A pesquisa aconteceu em duas fases distintas: Primeiramente, através da técnica qualitativa de grupo focal foi feito um levantamento de elementos que possibilitaram ao investigador a avaliação da assistência obstétrica; Posteriormente, foi construído e validado um questionário de pesquisa que foi aplicado às mulheres dos municípios selecionados para o estudo. As informações colhidas durante o grupo focal foram transcritas e submetidas ao ALCESTE com o intuito de organizar os discursos em tópicos.  A análise dos discursos possibilitou a construção de um instrumento para avaliação da assistência durante o ciclo. O questionário passou pelo processo de validação aparente, antes de ser administrado. Utilizou-se a análise múltipla de regressão logística para identificação dos fatores preditores que influenciam a insatisfação da assistência. O resultado revelou um cenário inquietante e desafiador que remete à constante avaliação dos serviços em busca da melhoria da assistência. Enfatiza ainda a importância de indicadores que refletem a realidade do serviço público de saúde ser introduzidos nos instrumentos avaliativos, para nortear cientificamente a mudança das práticas assistenciais. O estudo idenfificou que 41% das participantes avaliaram negativamente a assistencia recebida pelo serviço público. Os indicadores que estão associados à satisfação das mulheres foram: a participação da mulher na escolha do parto, a visita clínica e a comunicação da alta hospitalar feita pelo profissional médico, a visita puerperal realizada pela ESF na primeira semana após alta hospitalar e o acesso as orientação sobre os cuidados com o recém-nascido na primeira semana de vida. 

12
  • TATIANA OLIVEIRA SOUZA
  • AVALIAÇÃO DO EFEITO ANTI-INFLAMATÓRIO DOS FÁRMACOS: ATORVASTATIN, CARVEDILOL, OLMESARTAN E TELMISARTAN, EM MODELO EXPERIMENTAL DA DOENÇA PERIODONTAL INDUZIDA EM RATOS.

  • Advisor : RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • COMMITTEE MEMBERS :
  • ALDO DA CUNHA MEDEIROS
  • ANA MIRYAM COSTA DE MEDEIROS
  • JEYMESSON RAPHAEL CARDOSO VIEIRA
  • MAGNUS REGIOS DIAS DA SILVA
  • RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • Data: Jun 3, 2015


  • Show Abstract
  • A periodontite é uma doença crônica inflamatória mediada por marcadores inflamatórios, tais como as citocinas: IL-1β, IL-10 e TNF-α, que provoca a destruição dos tecidos gengivais e osso alveolar, causando perda de inserção dentária e posterior perda dental. A perda óssea é causada pela ativação de prostaglandinas oriundas do ácido araquidônico, através da ação da enzima ciclooxigenase 2 (COX-2), promovendo a liberação de enzimas proteolíticas, as metaloproteinases de matriz, principalmente a MMP-2 e MMP-9, que promovem reabsorção óssea. Além disso, ocorre o desequilíbrio entre a ação de RANKL e OPG, havendo uma maior ativação de RANKL, e por consequência a maior ativação de osteoclastos e maior reabsorção óssea. Mediadores inflamatórios e espécies reativas de oxigênio (ROS) produzidos localmente possuem potencial para disseminar na corrente sanguínea e iniciar ou exacerbar doenças sistêmicas como as cardiovasculares. O tratamento atual da doença consiste em terapêutica local, mas a necessidade de estudos sobre fármacos de atuação sistêmica culminou nesta pesquisa, que realizou a avaliação dos fármacos: atorvastatin, carvedilol, olmesartan e telmisartan, quanto a sua ação anti-inflamatória sobre a doença periodontal induzida por ligadura em ratos Wistar. Os animais foram divididos em 5 grupos, para cada fármaco, separadamente: (NL) grupo não ligado, (L) grupo ligado sem tratamento, (1mg/Kg) grupo ligado que recebeu dose de 1mg/Kg de fármaco, (5 ou 6 mg/Kg) grupo ligado que recebeu dose de 5 ou 6 mg/Kg de fármaco, (10 mg/Kg) grupo ligado que recebeu dose de 10mg/Kg de fármaco. Foram realizadas avaliações: histopatológica, perda óssea alveolar, imuno-histoquímica (para COX-2, MMP-2, MMP-9, RANK-L, RANK e OPG), e ELISA (para mieloperoxidase, glutationa, malonaldeído e as citocinas: IL-1β, IL-10 e TNF-α). Os grupos tratados com olmesartana a 6 mg/Kg, e atorvastatin, carvedilol e telmisartan a 10mg/Kg, mostraram diminuição da perda óssea, redução de: MPO, MDA, IL-1β, TNF-α, MMP-2, MMP-9, COX-2, RANKL/RANK, e aumento na expressão da OPG e da IL-10. 

13
  • JOSÉ GIOVANI NOBRE GOMES
  • *

  • Advisor : IVONETE BATISTA DE ARAUJO
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • ANDRE DUCATI LUCHESSI
  • JANAINA CRISTIANA DE OLIVEIRA CRISPIM FREITAS
  • EUDES EULER DE SOUZA LUCENA
  • THALES ALLYRIO ARAUJO DE MEDEIROS FERNANDES
  • Data: Jun 12, 2015


  • Show Abstract
  • *

14
  • ELIANA BARRETO FIXINA
  • BEHAVIOR OF DEATH BY EXTERNAL CAUSES IN ELDERLY, BRAZIL
  • Advisor : EULALIA MARIA CHAVES MAIA
  • COMMITTEE MEMBERS :
  • EULALIA MARIA CHAVES MAIA
  • GILSON DE VASCONCELOS TORRES
  • BERNARDINO FERNANDEZ CALVO
  • FATIMA RAQUEL ROSADO MORAIS
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • Data: Jun 15, 2015


  • Show Abstract
  • This thesis had as its general object of study the mortality of the elderly due to external causes and the objective of identifying the behavior of external causes deaths in Brazil over a period of 16 years, from 1995 to 2010. Initially, a database was built using the Mortality Information System (SIM), with all numbers of deaths from external causes aged over 60 years. From these data an ecological study and an integrative review of the literature currently available on the subject were formed. Finally a polynomial model was applied because it presents a series design better adjustable to the straight line of the produced time series. Thus, it was identified that the mortality due to external causes among the elderly presents a growing behavior with some sudden flexions with descent, descent and stability. The results point to a logic of information quality. There is no relationship with better social conditions. Weaknesses in the quality of public policies aimed at that public. The results of the integrative review show that the occurrence of deaths from external causes of the elderly in all states and regions of the country. Most of these studies point to the fragility of public policies that demand protective measures for the elderly, as well as the increasing presence of violence in different regions and in the country. It is also necessary to reflect on the lack of studies in some regions of the country, such as the North, which does not have as many publications as the Southeast region, so we realize the need for further discussions in order to clarify the violent deaths in the elderly population. Concluding that dying may seem in old age, but it scares.

     
15
  • ANA CARLA GOMES CANARIO
  • Physical activity, fatigue and quality of life in breast cancerpatients

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • GUSTAVO MAFALDO SOARES
  • MARIA GORETTI FREIRE DE CARVALHO
  • ROBINSON DIAS DE MEDEIROS
  • TERESA DE LISIEUX LOPES FROTA
  • Data: Jun 17, 2015


  • Show Abstract
  • Objective: Evaluate the relationship between levels of physical activity, fatigue and quality of life (QOL) in women diagnosed with breast cancer. Methods: 215 women between the ages of 40 and 65 were recruited at a cancer clinic. Physical activity levels were assessed by using the International Physical Activity Questionnaire (IPAQ), fatigue levels by using the revised Piper scale, and QOL by means of EORTC QLQ-C30 and WHOQOL-BREF. Statistical analysis was performed using Minitab statistical software, version 16. Results: The mean age of subjects was 52.66 years (SD=8.6), mostly white (58.14%) and overweight (55.81%). Most women were fatigued (72.09%) while physically active women showed lower symptoms of fatigue (p<0.001). Mean scores for QOL were significantly lower for fatigued women (p<0.001). More active women scored higher on all scales of QOL (EORTC), mainly in a functional capacity (p<0.001), when compared with the sendentary. A significant association was found between level of physical activity and overall QOL (WHOQOL-Bref) for all domains (p<0.001). Climacteric symptoms ranged from mild to strong and did not show any statistically significant results, however the most active women had the fewest symptoms. Conclusion: Physical activity appears to positively influence fatigue and QOL in women diagnosed with breast cancer.

    Conclusão: A atividade física parece ter impacto positivo sobre a fadiga e a qualidade de vida de mulheres diagnosticadas com câncer de mama.

16
  • DANIELA MENDES DA VEIGA PESSOA
  • Desigualdades em Saúde Bucal em Idosos brasileiros e catalães

  • Advisor : KENIO COSTA DE LIMA
  • COMMITTEE MEMBERS :
  • CÉLIA PEREIRA CALDAS
  • GUSTAVO PINA GODOY
  • IRIS DO CEU CLARA COSTA
  • KENIO COSTA DE LIMA
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: Jun 19, 2015


  • Show Abstract
  • A saúde bucal é um dos aspectos relevantes para a saúde do idoso, pois uma má condição de saúde bucal causa um impacto negativo em sua qualidade de vida e torna-se uma importante questão de saúde pública. Assim, objetivou-se avaliar as condições de saúde bucal de idosos institucionalizados e não institucionalizados, do Brasil e da Região Sanitária de Barcelona-Espanha, a partir de base de dados secundária, no que concerne à prevalência e severidade de cárie dentária, doença periodontal, uso e necessidade de prótese dentária, edentulismo e edentulismo funcional. A pesquisa caracteriza-se como estudo transversal, observacional e de abordagem exploratória. A população do estudo foi constituída por 7.619 idosos não institucionalizados de 65 a 74 anos residentes no Brasil; 1.192 idosos institucionalizados de 65 anos e mais, residentes em instituições de todas as regiões brasileiras e por 422 idosos de 65 anos e mais residentes em instituições da região sanitária de Barcelona-Espanha. Os dados da pesquisa foram extraídos de bases secundárias, tais como banco de dados do Levantamento Epidemiológico em Saúde Bucal – SB Brasil 2010, o banco de dados da Pesquisa intitulada “Saúde bucal de idosos institucionalizados no Brasil” e o banco de dados da pesquisa “Oral Health-Related Quality of Life in institutionalized elderly in Barcelona(Spain)”. Em todas as pesquisas, como fonte de dados, foram utilizados exames bucais preconcebidos pela Organização Mundial de Saúde (OMS, 1998) para a construção de indicadores de saúde bucal, bem como questionários sobre a condição socioeconômica e utilização de serviços odontológicos pelos idosos pesquisados. Os dados foram analisados por estatística descritiva, inferencial bivariada a partir dos testes de Qui-quadrado de Pearson, ANOVA , Mann-Whitney e  estatística inferencial multivariada a partir da Análise de agrupamentos e Regressão Robusta de Poisson multivariada. Foram obtidas as Razões de Prevalência brutas e ajustadas (RPa) com seus respectivos Intervalos de Confiança (IC), considerando-se um nível de significância de 5%. Entre os idosos não institucionalizados brasileiros, foram observados alta prevalência de dentes afetados pela cárie dental, com CPO-D médio 27,53(±7,00), alta prevalência de edentulismo (47,7%) e edentulismo funcional (73,8%). Também foi verificado alta prevalência no uso de prótese superior(75%), necessidade de prótese superior (85%) e inferior (92,4%). Os piores indicadores de saúde bucal, bem como maiores necessidades de reabilitação protética foram encontrados em idosos residentes em municípios brasileiros de pequeno porte populacional, do interior do país, pertencentes às regiões Norte e Nordeste e entre os idosos com baixa condição socioeconômica (p<0,001). Em relação aos idosos institucionalizados do Brasil e de Barcelona-ES, foi observado uma maior prevalência de doença periodontal entre os idosos catalães através da presença de cálculo (RPa: 1,5; IC:1,08-2.19 em homens e  RPa: 2,4; IC: 1,77-3,24 em mulheres) e de bolsa periodontal (RPa:2,05; IC:1,43-2.93 em homens e (RPa: 3,2; IC: 2,29-4,53) em mulheres), bem como menores prevalência de perda dentária parcial (RPa: 0,49; IC: 0,40-0,60 em homens e RPa:0,42; IC: 0,30-0,49 em mulheres) e perda dentária total (RPa: 0,49; CI: 0,37-0,65 em homens e RPa:0,49; CI: 0,41-0,58 em mulheres). Diante dos resultados, verifica-se que a saúde bucal tanto da população idosa brasileira não institucionalizada e institucionalizada quanto os idosos institucionalizados catalães é precária, refletida pela alta perda de dentes, necessidade de reabilitação e para aqueles idosos que ainda possuem dentes na boca, os mesmos são acometidos severamente pela doença periodontal. Esse contexto exige das políticas públicas de saúde um maior investimento na prestação de serviços de saúde bucal para esta população tanto no Brasil, quanto na Espanha.

17
  • KARYNA MYRELLY OLIVEIRA BEZERRA DE FIGUEIREDO RIBEIRO
  • EFEITOS DA REABILITAÇÃO VESTIBULAR EM IDOSOS COM VERTIGEM POSTURAL PAROXÍSTICA BENIGNA (VPPB): ensaio clínico controlado e randomizado

  • Advisor : RICARDO OLIVEIRA GUERRA
  • COMMITTEE MEMBERS :
  • ANDRÉ LUÍS DOS SANTOS SILVA
  • FLÁVIA DONÁ SIMONE
  • JOSE DINIZ JUNIOR
  • JULIANA MARIA GAZZOLA
  • RICARDO OLIVEIRA GUERRA
  • Data: Jun 22, 2015


  • Show Abstract
  • O presente ensaio clínico controlado, aleatorizado e cego objetivou avaliar a eficácia da Reabilitação Vestibular (RV) em pacientes idosos com Vertigem Posicional Paroxística Benigna (VPPB). Participaram do estudo 14 idosos (7 para o grupo experimental e 7 para o grupo controle) de ambos os sexos com idade igual ou superior a 65 anos e com diagnóstico clínico de VPPB. Ambos os grupos foram submetidos a Manobras de Reposição Canalítica (MRC) para VPPB e somente o grupo experimental a exercícios de Reabilitação Vestibular (RV) associados às MRC. Os efeitos da RV foram mensurados por testes clínicos, de auto-relato e laboratoriais do equilíbrio estático e dinâmico, bem como da Qualidade de Vida (QV). Os idosos foram avaliados antes das MRC, uma semana após às MRC e em cinco, nove e treze semanas. Em todas as avaliações o teste de Dix-Hallpike foi realizado com o auxílio do sistema de Videonistagmoscopia (SVNC) da Contronic - Brasil, e em caso positivo, nova MRC foi empregada. Os resultados deverão repercutir nas estratégias de reabilitação baseadas em evidências nos pacientes idosos com disfunções otoneurológicas.

18
  • CINTHIA BEATRICE DA SILVA TELLES
  • Efeito imunomodulador e atividade antimicrobiana de heterofucanas de Sargassum filipendula

  • Advisor : HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • COMMITTEE MEMBERS :
  • DANILO JOSE AYRES DE MENEZES
  • HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • JOSE VERISSIMO FERNANDES
  • TOSHIYUKI NAGASHIMA JUNIOR
  • VALTER FERREIRA DE ANDRADE NETO
  • Data: Jun 26, 2015


  • Show Abstract
  • Macroalgas marinhas constituem uma fonte extremamente rica de compostos bioativos, dentre eles, polissacarídeos sulfatados. Sargassum filipendula (SF), alga pertencente à ordem Phaeophycea, é fonte de heterofucanas conhecidas pela capacidade de modular uma série de funções biológicas. Considerando a necessidade de encontrar fármacos mais eficientes no combate a infecções microbianas, as heterofucanas de SF foram avaliadas como agentes imunomoduladores e antimicrobianos. As heterofucanas SF0.5V, SF0.7V e SF1.0V apresentaram uma forte atividade imunomoduladora intensificando a liberação de óxido nítrico (NO) por macrófagos murinos (RAW 264.7), bem como, por macrófagos originados de monócitos primários humanos. Além disso, quando macrófagos humanos foram infectados por Leishmania infantum e tratados com SF0.5V, SF0.7V e SF1.0V ocorreu um aumento significativo na liberação extracelular de NO. Como a citotoxicidadede de macrofágos contra a forma intracelular de leishmanias é mediada pela produção de NO, avaliamos a atividade leishmanicida sobre a forma amastigota intracelular de L. infantum e observamos que macrófagos infectados e tratados com SF0.5V, SF0.7V e SF1.0V diminuíram o percentual de infecção. Apesar das heterofucanas que se mostraram com capacidade leishmanicida também apresentarem melhor taxa de produção de NO, a correlação da produção de NO e o combate à forma amastigota do parasita não parece ser a ferramenta principal no combate a esse protozoário. A heterofucana SF0.5V, além de apresentar excelente capacidade imunomuduladora, apresentou atividade inibitória da formação de biofilme (~ 50%) frente a bactéria Staphylococcus epidermidis, e SF0.7V e 1.0V inibiram quase que totalmente a sobrevivência do protozoário T. vaginalis. Resultados como esse refletem o grande espectro de ação desses polissacarídeos sulfatados obtidos de algas marinhas, especialmente, da espécie SF.

19
  • ARNOBIO DA PENHA PACHECO
  • IMUNOBIOLÓGICOS NA PSORÍASE GRAVE: Avaliação do impacto terapêutico na qualidade de vida dos pacientes

  • Advisor : RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • COMMITTEE MEMBERS :
  • ALDO DA CUNHA MEDEIROS
  • PEDRO BEZERRA DA TRINDADE NETO
  • CARLA WANDERLEY GAYOSO
  • JADER FREIRE SOBRAL FILHO
  • RICARDO ROMITI
  • Data: Jun 26, 2015


  • Show Abstract
  • Fundamentos: A psoríase é uma doença inflamatória crônica imunomediada, multifatorial, podendo estar associada a comorbidades, interferindo na qualidade de vida4,5. Nas placas eritêmato-escamosas psoriásicas ocorre ativação de linfócitos Th1 e Th17 que liberam citocinas pró-inflamatórias como TNF-α e Interleucinas8. Objetivos: Avaliar o perfil e a qualidade de vida dos pacientes tratados com os imunobiológicos Infliximabe, Adalimumabe, Etanercepte e Ustekinumabe. Métodos: O levantamento de dados clínicos epidemiológicos, terapêuticos e o impacto na qualidade de vida dos 61 pacientes foram realizados através de avaliações clínicas, aplicação de questionários, entrevistas, depoimentos e análise dos prontuários do Ambulatório de Dermatologia do Hospital Universitário Onofre Lopes, da Universidade Federal do Rio Grande do Norte de março de 2014 a março de 2015. Os pacientes incluídos no estudo foram tratados com imunobiológicos de março de 2008 a março de 2015. Resultados: Dos pacientes estudados, 17 iniciaram o tratamento com Adalimumabe, 15 com Infliximabe e 5 com Etanercepte. Os resultados mostraram que 37 pacientes (60,7%) controlaram a psoríase com um único imunobiológico; 15 pacientes (24,6%) com um segundo imunobiológico; 6 pacientes (9,8%) com o terceiro imunobiológico e apenas 3 pacientes (4,9%) precisaram utilizar o quarto imunobiológico, o Ustequinumabe, para obter efetiva resposta terapêutica.

    Conclusões: Os imunobiológicos representam recurso terapêutico importante para as formas graves de psoríase. A perda de resposta terapêutica pode requerer mudanças desses medicamentos. Neste estudo, constatou-se, em relação a todos os pacientes, excelente resultado terapêutico, com escassos efeitos adversos e elevado índice de adesão ao tratamento, proporcionando-lhes reabilitação pessoal, reintegração familiar, social e profissional.

20
  • PAULO ALFREDO SIMONETTI GOMES
  • PARÂMETROS IMUNOLÓGICOS EM CRIANÇAS DESNUTRIDAS DE UMA REGIÃO DO NORDESTE DO BRASIL

  • Advisor : IVONETE BATISTA DE ARAUJO
  • COMMITTEE MEMBERS :
  • EVELINE PIPOLO MILAN
  • HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • OLÍVIA ANDREA ALENCAR COSTA BESSA
  • THALES ALLYRIO ARAUJO DE MEDEIROS FERNANDES
  • VALERIA SORAYA DE FARIAS SALES
  • Data: Jun 26, 2015


  • Show Abstract
  • Objetivo: Desnutrição é uma importante causa de imunodeficiência e pode resultar em doença e morte devido a infecções. O objetivo deste trabalho foi avaliar parâmetros imunológicos em crianças com desnutrição leve e moderada. Metodologia: Estudo de casos-controles em crianças com idade de dois meses a dez anos, de ambos os sexos, em Unidades Básicas de Saúde. Após obtenção da história clínica de cada criança, foi realizada avaliação antropométrica e coleta de amostras sanguíneas para avaliação da imunidade inata (complemento C3 e C4, células NK e NKT), imunidade humoral (linfócitos B, imunoglobulinas IgA, IgG, IgM e anticorpos de memória IgG anti-rubéola e IgG anti-sarampo) e imunidade celular (linfócitos T e subpopulações CD4 e CD8). O estado nutricional das crianças foi avaliado pelos índices antropométricos da OMS (2006-2007) e classificado quanto ao grau de desnutrição em leve e moderada. Os dados foram analisados por regressão linear múltipla de cada parâmetro laboratorial sobre a presença ou não de desnutrição, com ajuste por idade e gênero, e correção para multiplicidade de Holm-Bonferroni. Resultados: Foram avaliadas 93 crianças, 51 desnutridas (41 com desnutrição leve e 10 com moderada) e 42 eutróficas. Não se observaram diferenças estatisticamente significativas entre os grupos nos parâmetros avaliados da imunidade inata e humoral. Porém, comparativamente com as eutróficas, as crianças com desnutrição apresentam diminuição do número médio de linfócitos (p=0,048), linfócitos T CD3 (p=0,02) e T CD3/CD4 (p=0,046). Conclusão: Crianças com desnutrição leve a moderada apresentam alteração quantitativa na resposta imune celular. Não se observaram diferenças para as crianças eutróficas em parâmetros de imunidade inata e humoral.

21
  • ELLANY GURGEL COSME DO NASCIMENTO
  • .

  • Advisor : JOAO CARLOS ALCHIERI
  • COMMITTEE MEMBERS :
  • JOAO CARLOS ALCHIERI
  • GILSON DE VASCONCELOS TORRES
  • THAIZA TEIXEIRA XAVIER NOBRE
  • FATIMA RAQUEL ROSADO MORAIS
  • MÔNICA CRISTINA BATISTA DE MELO
  • Data: Jun 29, 2015


  • Show Abstract
  • .

22
  • LIBNE LIDIANNE DA ROCHA E NOBREGA
  • Efeito do ácido lipóico e do exercício físico nos biomarcadores do sistema antioxidante e sintomas menupausicos:ensaio clínico randomizado

  • Advisor : MARIA DAS GRACAS ALMEIDA THORNTON
  • COMMITTEE MEMBERS :
  • ADRIANA AUGUSTO DE REZENDE
  • ALVARO CAMPOS CAVALCANTI MACIEL
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • EUDES EULER DE SOUZA LUCENA
  • THALES ALLYRIO ARAUJO DE MEDEIROS FERNANDES
  • Data: Jun 30, 2015


  • Show Abstract
  • A pós-menopausa é descrita clinicamente por diversos sinais e sintomas (fogachos, sudorese aumentada, nervosismo, depressão, palpitação, insônia, dispareunia, entre outros) que correspondem à deficiência estrogênica. A diminuição da concentração de Estrogênio (E2) conduz ao aumento do estresse oxidativo (EO) entre as mulheres, podendo levar ao surgimento de danos à saúde. Esta afirmação parte da concepção de que o E2 tem propriedades antioxidantes atribuídas, geralmente, à influência do mesmo no sistema antioxidante enzimático endógeno e/ou a sua importante ação como varredor de espécies reativas. Daí, ser relevante conhecer estratégias que possam aumentar a produção de antioxidantes, diminuindo o EO relacionado com o surgimento da pós-menopausa. Há evidências de que o exercício físico moderado reduz o EO. O ácido lipóico – AL tem sido conhecido por ter fortes propriedades antioxidantes. O presente trabalho objetiva avaliar o benefício do uso do ácido lipóico e do exercício físico, isolados e associados, sobre biomarcadores do sistema de defesa antioxidante e sobre sintomas menopáusicos. Estudo clínico, randomizado, duplo cego e controlado. 33 mulheres pós-menopáusicas foram divididas em 4 grupos de intervenções: Controle – C (9), Ácido Lipóico - AL (13), Exercício Físico – E (5) e Ácido Lipóico + Exercício - ALE (6). O período de acompanhamento dos grupos durou 4 meses. Uma dose oral diária de 600mg de AL foi oferecida. As caminhadas aconteceram 3 vezes por semana, com duração de 1 hora/dia. Antes do início do protocolo experimental, os biomarcadores do sistema de defesa antioxidante (Superóxido Dismutase - SOD, Glutationa Reduzida e Substâncias Reativas ao Ácido Tiobarbitúrico - SRAT) foram investigados. Foram medidos também o E2 e o Hormônio Folículo Estimulante e os níveis séricos de colesterol total e frações, triglicerídeos, glicemia de jejum, transaminases hepáticas (ALT e AST), gama-glutamil transferase, hormônio estimulante da tireóide, ferro, creatinina, uréia, proteínas totais, albumina e proteína C-reativa. Ao final dos 4 meses, nova medição foi realizada. Antes da primeira coleta de sangue e mensalmente, durante 4 meses, foram realizadas as medidas antropométricas: peso, altura, Índice de Massa Corpórea (IMC), circunferência da cintura (CC), circunferência do quadril (CQ) e Relação Cintura/Quadril (RCQ) e foram avaliados os sintomas climatéricos através do Índice Menopausal de Kupperman e Blatt-IMBK e da Escala Climatérica de Greene. A análise estatística foi realizada a partir do programa estatístico Stata 11.0 (Stata Corporation, College Station, TX, USA). Os dados foram expressos em média ± desvio padrão, frequência simples e porcentagem. Valores de p < 0.05 foram considerados significativos. Os testes estatísticos teste t de Student e o teste de qui quadrado foram utilizados para detectar heterogeneidade na distribuição das características dos sujeitos entre os grupos. Na análise de eficácia do ácido lipóico e do exercício, utilizou-se a análise de covariância. Para as variáveis medidas apenas na avaliação basal e final, utilizou-se, para cada variável, um modelo de regressão linear múltipla. Para as variáveis medidas na avaliação basal e às 4, 8, 12 e 16 semanas, utilizou-se o modelo de equações de estimação generalizadas (GEE) com família normal, link identidade e estrutura de correlação autorregressiva tipo 1. As seguintes médias foram obtidas: idade 52.4 anos ± 4.1; tempo de menopausa 3.5 anos ± 2.2; idade em que entrou na menopausa 49.0 anos ± 3.2. Não foi encontrada evidência de efeito do ácido lipóico e do exercício sobre os marcadores de defesa oxidante e variáveis hormonais. Não encontramos evidência de efeito do ácido lipóico e do exercício sobre IMC e a CC. O exercício aumenta o escore da escala de Blatt e Kupperman (p=0.003). O ácido lipóico diminui a pontuação no escore sintoma sexual (p=0.001) e o exercício físico resulta num aumento da pontuação nos escores sintomas psicológico (p=0.007), sintomas somáticos (p=0.001), ansiedade (p=0.003), sintomas vasomotores (p=0.002) e sintomas de depressão (p=0.028) da Escala de Greene. Estudos com amostras maiores são necessários para avaliar o efeito isolado e a interação do AL e do Exercício sobre o sistema antioxidante pós-menopáusico. AL melhora sintomas sexuais e genitais. Efeito do Exercício sobre as escalas de sintomas menopáusicos difere de outras pesquisas.

23
  • CAMILA XAVIER ALVES
  • Zinc status based on biochemical, dietary and functional indicators in young, healthy children

  • Advisor : JOSE BRANDAO NETO
  • COMMITTEE MEMBERS :
  • ALCIDES DA SILVA DINIZ
  • BRUNA LEAL LIMA MACIEL
  • JOSE BRANDAO NETO
  • KENIA MARA DE BAIOCCHI CARVALHO
  • SELMA SOUSA BRUNO
  • Data: Aug 7, 2015


  • Show Abstract
  • Objectives: To determine the zinc status and reference intervals for serum zinc concentration considering biochemical parameters, dietary and functional indicators, in a population of healthy young children in the Brazilian Northeast. Design and Methods: The study included 131 healthy children, 72 girls and 59 boys, between 6-9 years old. Anthropometric assessment was made by BMI/age; dietary assessment by prospective 3-day food register, and evaluation of total proteins was performed. Zinc in serum samples were analyzed in triplicate in the same assay flame using atomic absorption spectrophotometry. Results: All subjects were eutrophic according to BMI/age classification. With respect to dietary assessment, only the intake of fiber and calcium were below the recommendations by age and gender. Biochemical parameters were all within the normal reference range. Reference ranges for basal serum zinc concentration (95% CI) for serum zinc concentrations were 0.94-1.00 and 0.91-0.98 μg/mL in girls and boys, respectively. Conclusions: This study presents pediatric reference values for serum zinc concentrations, which are useful to establish the risk of zinc deficiency in the population.

24
  • ANNA FERLA MONTEIRO SILVA
  • Associações de variáveis sócio demográficas, saúde, funcionais, psicológicas, estilos e hábitos de vida com a Síndrome da Fragilidade em Idosos

  • Advisor : IRIS DO CEU CLARA COSTA
  • COMMITTEE MEMBERS :
  • ANA ALAYDE WERBA SALDANHA PICHELLI
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • IRIS DO CEU CLARA COSTA
  • TATYANA MARIA SILVA DE SOUZA ROSENDO
  • WALDA VIANA BRÍGIDO DE MOURA
  • Data: Sep 4, 2015


  • Show Abstract
  • A Síndrome da Fragilidade é um estado clínico geriátrico de vulnerabilidade que resulta no declínio das reservas fisiológicas, caracterizada por consequências de alto risco como: quedas, incapacidade funcional, hospitalização, institucionalização e morte. Embora a presença de comorbidades associadas não seja sempre acompanhada da fragilidade, essa presença poderia também indicar um aumento do risco de eventos adversos à saúde, levando o idoso a uma maior probabilidade de torna-se frágil, devido às limitações físicas que podem ocorrer com o surgimento das doenças, as quais são fortemente preditoras da Síndrome da Fragilidade. Esse estudo teve como objetivo geral identificar a prevalência da Síndrome da Fragilidade em idosos e os fatores associados. Os objetivos específicos foram: identificar a prevalência da Síndrome da Fragilidade e suas associações com variáveis demográficas, econômicas, de saúde, funcionais e psicológicas; verificar as associações da síndrome da fragilidade com os estilos e hábitos de vida dos idosos. O estudo foi transversal e composto por 385 idosos com 65 anos ou mais. Foram utilizados modelos de regressão de Poisson multivariada, para verificar condições associadas à fragilidade e determinar a razão de prevalência (α = 0,05). A prevalência de fragilidade foi de 8,7% e pré- fragilidade de 50,4%. Os idosos frágeis e pré-frágeis apresentaram, maiores e crescentes razão de prevalência para estado civil, dificuldade para realizar as atividades instrumentais da vida diária, idade avançada, perda involuntária de fezes, depressão e afetos negativos. Idosos com mais idade, com perda de peso, aqueles que demoram a pegar no sono e quedas nos últimos 15 dias apresentaram maior prevalência de fragilidade. Considera-se que os resultados, juntamente a outros disponibilizados na literatura, possam contribuir para o entendimento da epidemiologia da fragilidade e também na implementação de programas específicos que visem reduzir a prevalência da fragilidade, otimizando a qualidade de vida. Sugere-se que futuros programas tenham especial atenção aos perfis de idosos que ainda não tenham desenvolvidos fragilidade, ou seja, os pré-frágeis. Isso poderia evitar que os idosos se tornassem frágeis.

25
  • OSWALDO GOMES CORREA NEGRAO
  • AVALIAÇÃO DO SERVIÇO DE ATENDIMENTO  MÓVEL DE URGENCIA ÀS VÍTIMAS DE VIOLENCIA EM NATAL, BRASIL

  • Advisor : SEVERINA ALICE DA COSTA UCHOA
  • COMMITTEE MEMBERS :
  • NILMA DIAS LEAO COSTA
  • PAULO GERMANO DE FRIAS
  • RODRIGO ASSIS NEVES DANTAS
  • SEVERINA ALICE DA COSTA UCHOA
  • SUZANA CARNEIRO DE AZEVEDO FERNANDES
  • Data: Sep 10, 2015


  • Show Abstract
  • Os acidentes e violências estão entre as principais causas de mortalidade e morbidade da população jovem, em todo o mundo, em especial nos países em desenvolvimento e trazem grande demanda aos serviços de saúde.

    OBJETIVOS. O objetivo deste trabalho é avaliar o Serviço de Atendimento Móvel de Urgência (SAMU), considerando os seguintes aspectos: examinar a viabilidade de construção de um modelo avaliativo do SAMU, no município de Natal.  Identificar avanços e desafios da atenção pré-hospitalar às vítimas de acidentes e violências a partir de três perspectivas distintas: a dos gestores, a dos profissionais e a das vítimas, usuárias do serviço.

    MÉTODOS: Trata-se de um estudo qualitativo do tipo estudo de caso, na perspectiva de Yin. A primeira etapa foi constituída por um estudo de avaliabilidade do SAMU. Para a coleta de dados utilizou-se a análise documental e entrevistas do tipo semi-estruturadas, com informantes-chave. Para a validação dos indicadores optou-se pela utilização da Técnica de Consenso Delphi. A população do estudo foi constituída por gestores/chefias, trabalhadores e usuários do SAMU. As entrevistas foram semiestruturadas, no grupo dos usuários foram entrevistados 49 sujeitos e no grupo de profissionais foram 21 sujeitos, além de 3 gestores.        

    As entrevistas foram gravadas, transcritas e posteriormente analisadas através da ultilização do software ALCESTE® que fez a análise lexical quantitativa e a análise hierárquica descendente. Também foi utilizada a análise de conteúdo de Bardin. As coletas ocorram entre dezembro de 2014 e fevereiro de 2015.

    RESULTADOS. O programa foi descrito e foram elaborados o modelo lógico e a matriz de relevância dos indicadores caracterizando os elementos estruturantes do mesmo, ocorreu a definição de indicadores de estrutura e de processo, além das perguntas avaliativas. O corpus foi categorizado em quatro classes: desafios da regulação e encaminhamento das vítimas, desafio de políticas educacionais, protocolos e fragilidades dos registros e educação permanente.

    CONCLUSÕES. O SAMU na atenção às vítimas de acidentes e violências é avaliável. Algumas limitações na operacionalização de vários dos componentes elencados foram detectadas como: a ausência de mecanismos de mobilização social, ações pontuais de promoção em saúde e a utilização incipiente de indicadores de saúde produzidos pelo próprio serviço e, por fim a ausência de mecanismos de controle social. A disponibilidade observada tanto na gestão municipal, quanto na equipe de profissionais que compõe o serviço, contribuíram com o desenvolvimento do estudo. A população na sua grande maioria relatou grande satisfação pelo atendimento recebido, elogiaram a atenção, o acolhimento e a atitude profissional das equipes. Quanto às dificuldades, alguns usuários relataram angústia e sofrimento na espera pelo resgate e desconforto no deslocamento pelo calor no interior dos veículos. Os profissionais mostraram-se comprometidos e satisfeitos apontando avanços na existência de equipes completas, equipamentos e infraestrutura adequados. Apresentam como desafios: a necessidade de políticas educacionais voltadas à prevenção de acidentes e violência, implantação de protocolos clínicos, fortalecimento da regulação e articulação com a rede hospitalar e valorização e fixação dos recursos humanos. 

26
  • CHRISTIANA SOUTO SILVA
  • AVALIAÇÃO DO DESEMPENHO DA ESTRATÉGIA SAÚDE DA FAMÍLIA NO CONTROLE DA HIPERTENSÃO ARTERIAL SISTÊMICA EM MUNICÍPIOS DO ESTADO DA PARAÍBA

  • Advisor : NEIR ANTUNES PAES
  • COMMITTEE MEMBERS :
  • CÉSAR CAVALCANTI DA SILVA
  • EGMAR LONGO HULL
  • MARIA HELENA CONSTANTINO SPYRIDES
  • NEIR ANTUNES PAES
  • TANIA MARIA RIBEIRO MONTEIRO DE FIGUEIREDO
  • Data: Sep 10, 2015


  • Show Abstract
  • O Ministério da Saúde do Brasil preconiza o controle da Hipertensão Arterial Sistêmica através de ações da Estratégia Saúde da Família. Faz-se, assim, necessário avaliações e análises do desempenho e impacto dessas ações para o controle da doença nos serviços de saúde. Neste contexto teve-se como objetivo avaliar o desempenho dos serviços prestados nas unidades de saúde para o controle da HAS nos municípios de João Pessoa e Campina Grande da Paraíba por meio da percepção dos atores: usuários, gestores e profissionais. A interface multidisciplinar da pesquisa se manifesta pela articulação das áreas de epidemiologia, estatística e saúde pública. Trata-se de um estudo de coorte retrospectiva realizado em 2009, 2010 e 2011, de base populacional, de caráter descritivo e analítico por meio da amostragem aleatória e probabilística, para cada um dos atores das Unidades de Saúde da Família dos municípios estudados. Adotou-se como referencial teórico-metodológico as dimensões essenciais da atenção primária propostas por Starfield: Acesso, Vínculo, Elenco de serviços, Coordenação, Enfoque na família e Orientação para a comunidade, por meio da aplicação de questionários validados para os atores. Os resultados foram apresentados em três artigos que avaliaram, respectivamente: a adesão/vínculo do usuário e o controle pressórico; o grau de satisfação com o serviço dos três atores e uma comparação que procurou medir o grau de satisfação de usuários e profissionais entre os dois municípios estudados. Os resultados principais mostraram: um alto percentual de usuários com graus de satisfação elevados, todavia com níveis pressóricos não controlados; usuários e profissionais com graus de satisfação mais elevados do que os gestores e diferenças significativas nos graus de satisfação entre profissionais e usuários do mesmo município para algumas dimensões e entre os municípios. O estudo enfatizou a importância do acompanhamento e monitoramento rotineiros das ações desenvolvidas nos serviços e atividades pelos profissionais de saúde, bem como reforçou a importância do acompanhamento do hipertenso. Defendeu-se que a importância da avaliação não é somente uma questão localizada, mas que extrapola as fronteiras dos municípios estudados ao aplicar instrumentos que permitiram a medição da percepção dos três atores envolvidos com cuidado dos hipertensos da Estratégia Saúde da Família

27
  • EWERTON WILLIAM GOMES BRITO
  • AVANÇOS E DESAFIOS DA ATENÇÃO PRIMÁRIA À TUBERCULOSE NO RIO GRANDE DO NORTE/BRASIL

  • Advisor : SEVERINA ALICE DA COSTA UCHOA
  • COMMITTEE MEMBERS :
  • ELIS REGINA DALLA COSTA
  • IRIS DO CEU CLARA COSTA
  • NILMA DIAS LEAO COSTA
  • REINALDO ANTÔNIO DA SILVA SOBRINHO
  • SEVERINA ALICE DA COSTA UCHOA
  • Data: Sep 10, 2015


  • Show Abstract
  • Introdução: O Programa Nacional de Controle da Tuberculose (PNCT) privilegia a descentralização das ações de controle da doença para os serviços de Atenção Primária em Saúde (APS) com estratégia de ampliação do acesso da população as ações do programa. Objetivo: Avaliar os avanços e desafios da atenção primária à tuberculose no Rio Grande do Norte.  Especificamente, visa analisar a organização do cuidado no estado, o desempenho dos serviços de saúde na atenção à tuberculose (TB) em Natal, o compromisso político da gestão com as ações de controle da TB em Natal/RN e identificar os aspectos que fortalecem e fragilizam as ações de diagnóstico e controle da TB na Estratégia Saúde da Família. Metodologia: Trata-se de um Estudo de Caso com triangulação de múltiplas técnicas e fontes. Na avaliação da organização do cuidado o estudo foi transversal com dados secundários da Avaliação Externa do Programa de Melhoria de Acesso e da Qualidade da Atenção Básica (PMAQ-AB) no Rio Grande do  Norte, realizada em 2012. O banco de dados contou com 412 questionários de profissionais de nível superior das Equipes de Atenção Básica e de 1650 usuários.  A análise descritiva incluiu variáveis relativas ao perfil dos entrevistados, à organização do cuidado, à atenção ao usuário, à promoção da saúde, ao acesso à unidade de saúde, ao acolhimento e à demanda espontânea. Para avaliação das equipes e da gestão, a coleta foi realizada em Natal no período de agosto de 2011 a abril de 2012 com aplicação de questionários e entrevistas.   Os questionários sobre estrutura e processo incluíram 240 profissionais da Saúde da Família. A análise foi descritiva com significância, blox-plot e diagrama de Pareto. As entrevistas semi-estruradas arrolaram 11 enfermeiras responsáveis pelas ações de controle da tuberculose nas unidades de saúde cujos dados foram organizados e analisados com o software Alceste. Para análise do compromisso da gestão recorreu-se a análise dos documentos da secretaria municipal de saúde e entrevista em profundidade com 9 coordenadores de Atenção e Vigilância à Saúde. O roteiro contemplou planejamento e orçamento, atenção à saúde, informação estratégica, desenvolvimento humano e institucional, comunicação e mobilização social e pesquisa. Utilizou-se Análise de Contéudo. A pesquisa foi aprovada no Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte. Resultados: Os dados do PMAQ-AB revelaram que no Rio Grande do Norte 27,7% dos serviços de saúde avalaidos não possuem protocolos assistenciais, 97,3% das equipes solicitam baciloscopia e 95,6%, radiografia de tórax; 63,1% acompanham o tratamento diretamente observado (TDO), e apenas 57,3% realizam a busca ativa dos faltosos.  Em Natal, a análise da estrutura constatou envolvimento na atenção à tuberculose de 100% dos enfermeiros, médicos e agentes comunitários e 73,9% dos técnicos de enfermagem.  Participaram de capacitação 96,6% dos enfermeiros, 84,1% dos médicos, 13,6% dos técnicos de enfermagem e 38,7% dos agentes comunitários. O relato de acesso à ficha diária de TDO foi de 63,7%, ao livro de registro de 69,9%; a disponibilidade de potes de escarro de 78,2%; articulação com outros níveis de atenção, 83,4%; dificuldade de apoio a TDO, 65,2%. Para processos, as informações sobre a doença alcançou 99,7%; oferta de TDO nas unidades, 51,5%; ações educativas, apenas 31,5%. A maior variabilidade foi na capacitação dos profissionais com amplitude 17,4 - 89,4 e intervalo interquartil 44,8 - 66,2. Houve diferença significativa (p<0,05) para envolvimento dos profissionais no atendimento, capacitação profissional e acesso aos instrumentos de registro e TDO. As entrevistas com enfermeiros reafirmam: retardo no diagnóstico e apoio laboratorial, dificuldades dos usuários no acesso aos exames laboratoriais e retorno oportuno dos resultados; carência de capacitações, e dificuldade no uso da informação no planejamento e atribuições dos profissionais nas ações de controle. A análise documental e as entrevistas com gestores indicaram que as ações planejadas contemplam superficialmente os componentes Atenção à Saúde e Informação Estratégica, e se apresentam de maneira incipiente ou ausente nos componentes Planejamento e Orçamento, Comunicação e Mobilização Social e Pesquisa. Conclusão: Há avanços traduzidos na incorporação sistemática das ações de atenção aos doentes de tuberculose à rotina de trabalho das equipes de saúde. Entretanto, a baixa realização de ações preventivas e educativas, debilidades no acompanhamento do TDO, na busca ativa dos faltosos e no registro dos casos foram comuns ao estado e município. São acrescidas as dificuldades de padronização na distribuição de insumos e no uso de instrumentos de registro para diagnóstico epidemiológico e operacional da TB. Os aspectos mais preocupantes foram a falta de prioridade e compromisso da gestão com a atenção à TB em Natal e a ausência de protocolos assistenciais em parte dos serviços de saúde do estado. Recomenda-se que a gestão adote um planejamento baseado no diagnóstico epidemiológico e operacional, que traduza as necessidades reais vivenciadas pelos profissionais e usuários e respeite a variabilidade de desempenho entre as diversas unidades de saúde do município. Ressalta-se a importância do fortalecimento da regulação da rede laboratorial e adequação das atividades de educação permanente contemplando as diversas categorias profissionais.

28
  • RIGOBERTO GADELHA CHAVES
  • CONSANGUINITY AND FOUNDER EFFECT FOR GAUCHER DISEASE MUTATION G377S IN A POPULATION FROM TABULEIRO DO NORTE, NORTHEASTERN BRAZIL

  • Advisor : GERALDO BARROSO CAVALCANTI JUNIOR
  • COMMITTEE MEMBERS :
  • ALDO DA CUNHA MEDEIROS
  • AMALIA CINTHIA MENESES DO REGO
  • CARLOS ROBERTO ALVES
  • GERALDO BARROSO CAVALCANTI JUNIOR
  • MARIA ZELIA FERNANDES
  • Data: Sep 28, 2015


  • Show Abstract
  • Gaucher’s disease (GD) is caused by a β-glucocerebrosidase deficiency, leading to the accumulation of glucocerebroside in the reticuloendothelial system. The prevalence of GD in Tabuleiro do Norte (TN) (1:4000) is the highest in Brazil. The purpose of this study was to present evidence of consanguinity and founder effect for the G377S mutation (c.1246G>A) among GD patients in TN based on enzyme, molecular and genealogical studies. Between March 2009 and December 2010, 131 subjects at risk for GD (GC in dried blood ≤2.19 nmol/h/ml) and 5 confirmed GD patients from the same community were submitted for molecular analysis to characterize the genetic profile of the population. Based on the enzymatic and molecular analysis, the subjects were classified into three categories: affected (n=5), carrier (n=20) and non-carrier (n=111). All carriers were (G377S/wt). Affected subjects were homozygous (G377S/G377S). The identification of a single mutation in carriers and homozygotes from different generations, the history of the community and the genealogy study suggest that the high prevalence of GD in this population may be due to a combination of consanguinity and founder effect for the G377S mutation

29
  • ROBSON DE MACEDO FILHO
  • EFEITOS CARDÍACOS E SISTÊMICOS DO PRÉ-TRATAMENTO COM ESTATINA EM MODELO DE SEPSE ABDOMINAL EM RATOS: AVALIAÇÃO ATRAVÉS DA BIODISTRIBUIÇÃO DO SESTAMIBI-Tc99m

  • Advisor : ALDO DA CUNHA MEDEIROS
  • COMMITTEE MEMBERS :
  • ALDO DA CUNHA MEDEIROS
  • AMALIA CINTHIA MENESES DO REGO
  • GERALDO BARROSO CAVALCANTI JUNIOR
  • IVONETE BATISTA DE ARAUJO
  • MARIA GORETTI FREIRE DE CARVALHO
  • Data: Sep 30, 2015


  • Show Abstract
  • Estudo com o objetivo de avaliar se o tratamento prévio com sinvastatina tem efeito sobre a biodistribuição cardíaca e sistêmica do sestamibi-Tc99m, utilizando modelo experimental de sepse abdominal em ratos. Ratos wistar foram randomicamente divididos em 4 grupos (n=6 por grupo): 1) sepsis e tratamento prévio com sinvastatina, 2) sepsis e tratamento prévio com solução salina 0,9%, 3) controle e tratamento prévio com sinvastatina and 4) controle e tratamento prévio com solução salina 0,9%. 24 horas após lligadura e punção do ceco (LPC) cecal, os ratos receberam 1.0MBq de sestamibi-Tc-99m i.v. e após 30min, foram sacrificados para contagem tecidual ex-vivo e análise histológica do miocárdio. Após 24 horas da sepse, não foram detectados alterações histológicas no miocárdio. Houve aumento significativo da atividade cardíaca do sestamibi-Tc99m no grupo sepsis que recebeu tratamento prévio com sinvastatina (1.9±0.3%ID/g, P<0.001) quando comparado com o grupo sepsis + solução salina (1.0±0.2%ID/g), controle + sinvastatina (1.2±0.3%ID/g), controle + solução salina (1.3±0.2%ID/g). Aumento significativo da atividade hepática, renal e pulmonar do sestamibi-Tc99m também foi detectado no grupo sepsis tratado previamente com sinvastatina quando comparado com os outros grupos. Em conclusão, o tratamento com estatina alterou a biodistribuição do sestamibi-Tc99m, aumentando a atividade cardíaca e de órgãos sólidos em ratos com sepsis abdominal, sem impacto em controles. O aumento da atividade cardíaca do sestamibi-Tc99m pode ser resultado de provável efeito protetor secundário a aumento da perfusão tecidual mediada por estatinas. Mais experimentos confirmatórios serão necessários para entender o mecanismo terapêutico na sepse.

30
  • HYLARINA MARIA MONTENEGRO DINIZ SILVA
  • *

  • Advisor : GEORGE DANTAS DE AZEVEDO
  • COMMITTEE MEMBERS :
  • MARIA JOSE PEREIRA VILAR
  • BERTHA CRUZ ENDERS
  • ELZA MARIA DO SOCORRO DUTRA
  • EMILIA INOUE SATO
  • GILDA APARECIDA FERREIRA
  • Data: Oct 29, 2015


  • Show Abstract
  • *

31
  • ALICE RODRIGUES DE OLIVEIRA ARARUNA
  • Micropartículas Biodegradáveis Contendo Metotrexato Para Uso Parenteral

  • Advisor : ARNOBIO ANTONIO DA SILVA JUNIOR
  • COMMITTEE MEMBERS :
  • ARNOBIO ANTONIO DA SILVA JUNIOR
  • DANILO CÉSAR GALINDO BEDOR
  • EDUARDO PEREIRA DE AZEVEDO
  • HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • MARCIA RODRIGUES PEREIRA
  • Data: Nov 27, 2015


  • Show Abstract
  • O metotrexato (MTX) é um fármaco utilizado na quimioterapia de alguns tipos de câncer, doenças autoimunes e uveítes não inflamatórias. No entanto, sua rápida eliminação plasmática limita o sucesso terapêutico. Uma estratégia de minimizar as limitações clínicas apresentadas pelo MTX consiste do desenvolvimento de sistema de liberação de fármacos (SLFs) tais como as micropartículas. Diante disso, o objetivo desse trabalho foi desenvolver um sistema microparticulado biodegradável a base de Ácido Poli-(D,L-lático-co-glicólico) (PLGA) contendo diferentes proporções fármaco/polímero por “spray drying” para liberação prolongada do MTX. Após obtenção, as micropartículas foram esterilizadas por irradiação-gama e em seguida, foi realizada a caracterização físico-química por diferentes técnicas, as quais permitiram o envolvimento de diversas áreas do conhecimento caracterizando um trabalho multidisciplinar. Além da caracterização, o perfil e mecanismo de liberação in vitro foram avaliados, assim como a atividade biológica em diferentes linhagens celulares. Na sequência, foi escolhido o sistema contendo 27% de MTX para o estudo de liberação in vivo – farmacocinética e de biodegradação/histopatológico. Os resultados das caracterizações realizadas permitiram observar a obtenção de micropartículas com alto teor de fármaco incorporado e perfil de liberação in vitro prolongado. O método utilizado para esterilização não alterou significativamente a estrutura química, molecular e a atividade de liberação in vitro e biológica das diferentes micropartículas testadas. Os ensaios do estudo farmacocinético confirmaram o perfil de liberação prolongada das micropartículas in vivo à medida que aumentou seis vezes o período de detecção do MTX em amostra biológica quando comparado com o fármaco puro. As análises histopatológicas mostraram a biocompatibilidade das micropartículas após administração na tela subcutânea do dorso dos animais. Em adição, o sistema microparticulado apresentou melhores condições terapêuticas à medida que adotou maior tempo de permanência média e menor oscilação da concentração plasmática. Portanto, o sistema de liberação desenvolvido apresentou potencial para uso na área farmacêutica o que permite o delineamento de propostas futuras para testes de eficácia aliado ao regime terapêutico adequado.

32
  • FRED SIZENANDO ROSSITER PINHEIRO
  • Emission of non-ionizing electromagnetic radiation in urban area of the city of Natal: Charactherization, evaluation and modeling based in the Electric Field intensity and exposore ratio.


  • Advisor : GEORGE DANTAS DE AZEVEDO
  • COMMITTEE MEMBERS :
  • TECIA MARIA DE OLIVEIRA MARANHAO
  • ANTONIO LUIZ PEREIRA DE SIQUEIRA CAMPOS
  • TIRZAH BRAZ PETTA
  • MARIA GORETTI FREIRE DE CARVALHO
  • ANDRE PEDRO FERNANDES NETO
  • Data: Dec 17, 2015
  • View Dissertation/Thesis  

  • Show Abstract
  • The electromagnetic waves used in the telecommunication systems until the 1980’s were considered by the governments environmental control organs as apparently “clean” forms of energy, whose effects weren’t considered any harmful to people’s health. The development of the mobile cellular telecommunication, beginning in the 1990’s, and the frenetic construction of antennas in the cities’ urban areas scared the
    population in general and turned the attention of the world’s scientific community to the theme. In a poor Brazilian State, such as Rio Grande do Norte – RN (GDP:R$ 51,4 billion in 2013) , the amount of cellular phones in operation went from 340.000 in 2002 to 4.6 million phones in 2014. In RN the number of cellular lines overcomes its own population, with a density of 128.98 accesses for each 100 inhabitants. Natal, the
    capital city of the State, with 850.000 inhabitants, already has 885 radio base stations of the cellular systems in 167.26 km² of urban area. The data is from ANATEL (august 2015). The objective of this work is to make a diagnosis about the actual situation of the emission of non-ionizing electromagnetic radiation in all urban area of the city of Natal. The methodology used took into account measurements of the intensity of the radiation taken in 160 different sites throughout the city. This radiation was measured in the range of 88MHz to 2.400 MHz. The collected data was compared to the limits of exposure of the ICNIRP (International Commission on Non Ionization Protection). The ICNIRP parameters used as reference were: “intensity of electric field” and “exposure ratio”. The telecommunication services researched were: TV broadcasting, FM radio broadcasting, cellular systems and WLAN (IEE 802.11bg). The obtained results
    allowed the drawing of a map comparing the data between the measured values and the limits of exposure to RNI defined by ICNIRP and ANATEL. The evaluation criteria used was the parameters Intensity of Electric Field and Exposure Ratio (ER). Results: according to the measurements taken, 48.48% of the outdoor electromagnetic exposure in the municipality of Natal are originated from TV transmitters. Similarly, in
    77.2% of the researched locations, the intensity of the electric field originated from TVs overcomes all the rest of the wireless telecommunication services, including the cellular system. Based on the information that the radiation emitted by the TV transmitters is the most relevant in the city, a model to estimate the intensity of the electric field resulting from this service in any point in town was developed. This model
    was developed based on multivariate regression techniques. The final equations xi obtained allowed the estimative of the electric field with a level of precision R2> 0,9 and p<0,1. It was found that the exponent RF propagation attenuation in Natal varies between 2.6 and 2.8.The average Exposure Rate (ER) to NIR observed in the researched frequency rate was of 4.43.10-3, while the maximum value was of 7.67. 10-
    Conclusions: The results of the study demonstrated that the levels of electromagnetic exposure to NIR in outdoor environments in the city of Natal are lower than the security limits set by ICNIRP and ANATEL. The services that contribute most to NIR in Natal are 1-TV, 2- Cellular System and 3-FM Radios.

33
  • RODRIGO DOS SANTOS DINIZ
  • ESTUDO DE UTILIZAÇÃO DE BENZODIAZEPÍNICOS A PARTIR DE INFORMAÇÕES COLETADAS EM FARMÁCIAS COMUNITÁRIAS 

  • Advisor : IVONETE BATISTA DE ARAUJO
  • COMMITTEE MEMBERS :
  • AMALIA CINTHIA MENESES DO REGO
  • IVONETE BATISTA DE ARAUJO
  • LINDOMAR DE FARIAS BELÉM
  • RAND RANDALL MARTINS
  • SEVERINA CARLA VIEIRA CUNHA LIMA
  • Data: Dec 18, 2015


  • Show Abstract
  • A prescrição de medicamentos psicotrópicos tem aumentado nas últimas décadas e os benzodiazepínicos (BZD) mantêm-se frequentemente utilizados, principalmente, no tratamento da ansiedade e insônia. Os objetivos desse estudo foram: (1) investigar a utilização de benzodiazepínicos a partir de informações coletadas em farmácias comunitárias e (2) analisar a opinião dos farmacêuticos comunitários sobre as mudanças após a implantação do Sistema Nacional de Gerenciamento de Produtos Controlados (SNGPC). Para tanto, um plano de amostragem estratificada foi conduzido nos bairros do Distrito Sanitário Leste da cidade de Natal-RN, realizado em 29 farmácias comunitárias (FC), com 257 usuários de benzodiazepínicos, ou seus cuidadores, e 29 farmacêuticos responsáveis técnicos. Para a obtenção dos dados, foram utilizados questionários estruturados. A análise estatística foi realizada por meio de regressão logística, bem como utilizou-se a análise temática-categorial para analisar a opinião dos farmacêuticos. Houve correlação significativa entre o tempo de uso de BZD e ser do sexo masculino (p = 0,043). Sobre não seguir a dose prescrita, esta tendência é menor quanto maior o tempo de utilização (p = 0,007). Dos farmacêuticos entrevistados, 75,9% informaram que o controle sobre a informação tornou-se mais eficaz após o SNGPC, embora considerem que houve um aumento da burocracia e da carga de trabalho. Para 82,8%, a ilegibilidade nas prescrições continua e o contato com o usuário tournou-se ainda menos frequente. Os farmacêuticos confirmaram a continuidade dos erros em prescrições de psicotrópicos mesmo após a implatação do SNGPC e o seu distanciamento do usuário, o que pode contribuir para o uso inadequado dos medicamentos. É necessário promover o seguimento da legislação sanitária para minimizar o uso abusivo dessas substâncias, viabilizando mais segurança aos seus usuários. Além disso, possibilitar a aproximação entre profissional e usuário. Dessa forma, os resultados obtidos a partir desse estudo possibilitam uma contribuição para a atividade de vários profissionais da saúde, em especial médicos e farmacêuticos, por estarem envolvidos no processo de uso de medicamentos pelos usuários. O uso dos BZD excede a duração máxima segura para utilização, sendo a insônia o principal motivo de uso dos medicamentos. Além disso, após a implantação do SNGPC, os erros de prescrição continuam.

    Descritores: Psicotrópicos; Benzodiazepínicos; Farmácia Comunitária; Farmacêutico Comunitário; Melhoria de Qualidade

2014
Dissertations
1
  • ALDAIR DE SOUSA PAIVA
  • AVALIAÇÃO DOS PARAMETROS HEMATOLOGICO E IMUNOFENOTÍPICOS DE PACIENTES COM DOENÇAS LINFOPROLIFERATIVAS CRÔNICAS NO RIO GRANDE DO NORTE

  • Advisor : GERALDO BARROSO CAVALCANTI JUNIOR
  • COMMITTEE MEMBERS :
  • GERALDO BARROSO CAVALCANTI JUNIOR
  • ANA CLAUDIA GALVAO FREIRE GOUVEIA
  • AMALIA CINTHIA MENESES DO REGO
  • Data: Feb 26, 2014


  • Show Abstract
  • The chronic lymphoproliferative diseases (CLPD) are disorders of lymphoid sistens characterized by abnormal proliferation of mature lymphocytes that assaut more B cells, to be also occur in T lymphocyts an natural killer cells. In this study, we studied 445 patients (243 male and 202 female) with CLD. They were immunophenotyped using the flow cytometry with the panel of monoclonal antibody constituted by CD2, CD3 CD7, CD4, CD5, CD8, CD10, CD19, CD22, CD23, CD25, CD38, CD45, CD16/CD56, CD200, FMC7, HLADR and anti light and heavy chain of immunoglobulin. In addition, we also investigated information refer to patients as age, sex and laboratorial date such as: leucometry and cytomorphological analysis of cells in peripheral blood, platelet count and hemoglobim determination. The results demonstrated that 386 cases were B-cell disorders and 59 T and NK CLPD. The B cell CLPD distribution were: 245 cases of B-cell chronic lymphocytic leukemia, 17 B-cell Pro-Lymphocytic Leukemia (B-PLL), 08 Hairy Cell leukemia (HCL),14 Mantle Cell Lymphoma, 02 Splenic Lymphoma with Villous Lymphocytes, 30 Multiple Myeloma, 12 Plasma Cell Leukemia, 09 Burkitt Lymphoma and 37 non-Hodgkin lymphoma in leukemic phase.The T-cell disorders were:13 cases of T-cel of Pro-Lymphocytic leukemia, 10 case of LGL leukemia, 08 case of Adult T-Cell Leukemia, 05  Sezary sindrome (SS) and 22  T-cell peripheral lymphoma. In conclusion, the use of panel MoAb proved useful in the diagnosis and classification of immune CLPD and, combined with a careful cytomorphological analysis, was adequate for diagnosis and immunological characterization of the different subtypes of these tumors.

2
  • DJANINE ANDRADE OLIVEIRA
  • Manifestações auditivas em indivíduos com hipertensão arterial sistêmica.

  • Advisor : ROSIANE VIANA ZUZA DINIZ
  • COMMITTEE MEMBERS :
  • ROSIANE VIANA ZUZA DINIZ
  • MARIA JOSE PEREIRA VILAR
  • PRISCILLA CARLA SILVEIRA MENEZES
  • Data: Feb 27, 2014


  • Show Abstract
  • A hipertensão arterial constitui um grave problema de saúde pública. Tentando demonstrar a relação entre manifestações auditivas e hipertensão arterial sistêmica, este estudo tem como objetivo determinar a prevalência de MA - manifestações auditivas em indivíduos com hipertensão arterial sistêmica; Correlacionar a manifestação auditiva MA com a hipertensão arterial sistêmica; Avaliar o impacto da  MA na qualidade de vida destes pacientes. Trata-se de estudo prospectivo, observacional, realizado de fevereiro de 2010 a dezembro de 2012, no Hospital Universitário Onofre Lopes, na cidade de Natal, Brasil, incluindo 120 pacientes de ambos os sexos. A caracterização da amostra em relação a perda auditiva, cuja prevalência foi 82,5%. Em relação ao tipo de perda, a mais comum foi a perda auditiva neurossensorial com 48,5% dos casos. A maioria teve perda de grau leve a moderado (33,7%) e a principal queixa auditiva foi de hipoacusia (50,8%), seguida de otalgia (14,2%).Concluímos que os indivíduos hipertensos apresentaram maior comprometimento auditivo, quando comparados aos limiares auditivos dentro dos padrões de normalidades, com a perda auditiva  neurossensorial. Com isso mostra-se a importância de processos preventivos que minimizem os mecanismos de degeneração do aparelho auditivo ocasionados por problemas circulatórios e em especial pela hipertensão arterial.

3
  • GEORGE ALEXANDRE DE BARROS LUCENA
  • Microbiological profile of the internal surface of dental implants

  • Advisor : DELANE MARIA REGO
  • COMMITTEE MEMBERS :
  • DELANE MARIA REGO
  • HEBEL CAVALCANTI GALVAO
  • MARIA GORETTI FREIRE DE CARVALHO
  • Data: Jun 4, 2014


  • Show Abstract
  • Introduction: Infiltration of organic fluids and microorganisms at the abutment/implant interface may result in bacterial infection of peri-implant tissues. Internal colonization of periodontal pathogens may be caused by bacteria trapped during installation or penetration of abutment/implant leakage. The aim of this study was to detect periodontal pathogens in the internal area of dental implants before loading.

    Materials and Methods: Seventy-eight implants in 32 partially edentulous subjects were selected for this evaluation. A bacterial biofilm sample of the internal surface of each implant was taken and analyzed for the presence of 40 microorganisms by checkerboard DNA-DNA hybridization, prior to installation of healing or any other prosthetic abutment.

    Discussion: Bacteria were detected in 20 patients (62.5%), distributed in 41 implants (52.6%). Forty-seven percent of implants showed no bacterial detection. Spontaneous early implant exposure to oral cavity during the healing period was not significant (P >0.05) to increase bacterial prevalence, but implants placed at mandible had higher bacterial prevalence than maxillary ones.

    Conclusion: The internal surface of dental implants can serve as a reservoir of periodontal pathogens for future implant/abutment interface.

4
  • LETICIA CASTELO BRANCO PEROBA DE OLIVEIRA
  • Propriedades bioativas dos polissacarídeos sulfatados da alga comestível Gracilaria birdiae

  • Advisor : HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • COMMITTEE MEMBERS :
  • HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • SILVIA REGINA BATISTUZZO DE MEDEIROS
  • VALQUIRIA PEREIRA DE MEDEIROS
  • Data: Jul 31, 2014


  • Show Abstract
  • As algas marinhas vermelhas do gênero gracilaria sintetizam polissacarídeos sulfatados (PS) bioativos. Porém muitos destes PS ainda não foram devidamente avaliados, como é caso dos PS sintetizados pela alga comestível Gracilaria birdiae. Estudos anteriores mostraram que galactanas sulfatadas dessa alga tem efeito antiinflamatorio. Neste trabalho uma galactana (GB) de G. birdiae foi obtida e avaliada por diferentes testes. GB apresentou atividade anticoagulante no teste de APTT. Gb não apresentou toxicidade para células normais (3T3), mas inibiu a sobrevivência de células de adenocarcinama de colo de útero (HeLa) e human pancreatic carcinoma (Panc-1) em cerca de 80 % (1.5 mg/mL). GB não foi capaz de sequestrar o radical OH nem o radical superoxido. Contudo, apresentou atividade doadora de elétrons em dois testes diferentes e apresentou atividade quelante de ferro (70% a 1.0 mg/mL) e de cobre (70% a 0.5 mg/mL). A presença de GB promove uma maior formação de cristais de oxalato de cálcio dihidratado de pequeno tamanho, que é a forma menos agressiva, isso porque GB é capaz de interagir com o cristal e estabilizar essa forma. Além disso, GB (2.0 mg/mL) não foi citotóxico para células renais humanas (HEK-293). Os dados obtidos nós levam a propor que GB apresenta um grande potencial para o tratamento de urolitíase.

     

5
  • KATIA CRISTINA ARAUJO NASCIMENTO DE OLIVEIRA
  • IMPACTO DA FIBROMIALGIA SOBRE A QUALIDADE DE VIDA, FUNÇÃO SEXUAL E SINAIS E SINTOMAS CLIMATÉRICOS NA FASE DO CLIMATÉRIO.

  • Advisor : GEORGE DANTAS DE AZEVEDO
  • COMMITTEE MEMBERS :
  • GEORGE DANTAS DE AZEVEDO
  • MARCOS HENRIQUE FERNANDES
  • MARIA DA CONCEICAO DE MESQUITA CORNETTA
  • Data: Sep 15, 2014


  • Show Abstract
  • OBJETIVO: analisar o impacto da fibromialgia sobre os sinais e sintomas climatéricos, qualidade de vida e função sexual em mulheres na fase do climatério. MÉTODOS: O estudo foi observacional descritivo do tipo transversal, envolvendo 165 mulheres na fase do climatério. As participantes foram submetidas ao preenchimento do Utian Quality of Life (UQOL), questionário do Quociente Sexual - versão feminina (QS-F) e Índice menopausal de Kupperman e Blatt  no período de junho de 2010 a julho de 2013. Na análise estatística, foi realizada análise inferencial através do método de modelos lineares generalizados. Para análise do UQOL e seus domínios assim como o QS-F e IMBK, utilizamos uma função de ligação linear de Log Poisson com exposição de contrastes para os níveis dos fatores de exposição e diferença de médias das interações entre grupo. Os dados foram analisados no SPSS®,versão 20.0, adotando-se um nível de significância de 5%. RESULTADOS: Em relação aos domínios da qualidade de vida analisados por meio do instrumento UQOL, foram observados valores maiores, estatisticamente significante, no domínio ocupacional (p  0,01) e UQOL total (p = 0,02) para o grupo não fibromialgia. Ao analisar a gravidade dos sinais e sintomas climatéricos através do IMBK, observa-se que houve diferença estatisticamente significante entre os grupos (p ˂0,01), em que o grupo sem fibromialgia apresenta menor gravidade dos sinais e sintomas. Na avaliação da função sexual, observa-se que o grupo com fibromialgia apresenta escores significativamente inferiores ao do grupo sem fibromialgia (p = 0,01). CONCLUSÃO: Diante dos resultados obtidos no presente estudo, conclui-se que o diagnóstico de fibromialgia na fase do climatério apresenta-se como influencia negativa no domínio ocupação da qualidade de vida, sinais e sintomas climatéricos e função sexual.

     

6
  • DANIELLE COUTINHO DE MEDEIROS
  • O treinamento concorrente para pessoas vivendo com hiv e a repercussão na adesão ao tratamento

  • Advisor : PAULO MOREIRA SILVA DANTAS
  • COMMITTEE MEMBERS :
  • EULALIA MARIA CHAVES MAIA
  • PAULO MOREIRA SILVA DANTAS
  • RONALDO VAGNER THOMATIELI DOS SANTOS
  • Data: Sep 30, 2014


  • Show Abstract
  • Os avanços da terapia antirretroviral promoveram o controle do sistema imunológico e supressão da carga viral, aumentando a expectativa de vida de pessoas vivendo com HIV/AIDS, porém seus efeitos colaterais são inevitáveis e causam diversos prejuízos físicos e psicológicos, destacando-se a lipodistrofia como um dos efeitos mais relevantes. Sendo assim, o objetivo desse estudo foi avaliar os efeitos produzidos pelo programa de treinamento concorrente nos aspectos físicos e psicológicos relacionados à lipodistrofia em PVHA. Para tanto, realizamos um estudo de corte longitudinal durante 16 semanas, envolvendo um programa de treinamento concorrente associado à orientação nutricional. Participaram do estudo 6 indivíduos:5 mulheres com idade média de 47,8±6,53 anos e 1 homem de  48 anos soropositivos, em tratamento com Terapia Antirretroviral de Alta Atividade (HAART), com lipodistrofia. Foram realizadas avaliações da composição corporal através da antropometria; o desenho da conformação corporal através do somatotipo; a resposta imunlógica e virológica que foi utilizado também como parâmetro de adesão ao tratamento e; avaliação da imagem corporal. O tratamento estatístico utilizado foi o descritivo utilizando os valores de tendência central e seus derivados, e como critério de parametria, o teste de Shapiro-Wilk. Como inferência, utilizou-se o percentual de Mudança Corporal (%MC) e do Índice Médio de Mudança (%IMM), além da observação do espaço bi e tridimensional do somatotipo através do DDS (bidimensional) e o DES (tridimensional) com seus índices de dispersão, respectivamente IDS e IDES, utilizando como ponto de corte para determinação das diferenças DDS ≥ 2,0 e DES ≥ 1,0.  Como resultado foi apresentado reduções nas espessuras de dobras cutâneas e perimetrias, manutenção da massa muscular, aumento da contagem de linfócitos TCD4+ e manutenção da carga viral em parâmetros indetectáveis, além de diferença significativa para a análise da distância de dispersão entre somatotipos (DDS) na 1º semana (DDS = 2,63) e 16º semana (DDS = 2,96) de intervenção, quando avaliado pelas médias; e quando avaliado individualmente, diferença significativa tanto na DDS quanto na Distância espacial entre somatotipos (DES) nos casos 1, na 8º semana (DDS = 3,20 e DES = 1,01 ) e 16º semana (DDS = 2,73); e caso 3, na 1º semana (DDS = 9,25 e DES = 1,44 ) e 16º semana (DDS = 8,06 e DES = 1,37 ). Quanto à imagem corporal, observou-se a aproximação da imagem atual à imagem ideal (Imagem Atual Inicial = 6; Imagem Atual Final = 5; e Imagem Ideal Inicial e Final = 3).  Assim, concluímos que o treinamento concorrente mostrou-se um método efetivo como terapia não medicamentosa para soropositivos em terapia com a HAART, atuando no controle da lipodistrofia, melhorando a percepção da imagem corporal e influenciando diretamente na adesão ao tratamento.

7
  • KEYLLA DAYANNE COELHO MARINHO DE MELO
  • RESPOSTA BIOLÓGICA DE CÉLULAS PULPARES SOBRE SUPERFÍCIES DE TITÂNIO MODIFICADAS POR PLASMA

  • Advisor : CLODOMIRO ALVES JUNIOR
  • COMMITTEE MEMBERS :
  • CLODOMIRO ALVES JUNIOR
  • CARLOS EDUARDO BEZERRA DE MOURA
  • JULIANA CARVALHO SA
  • Data: Nov 18, 2014


  • Show Abstract
  • Nesse trabalho multidisciplinar, englobado principalmente pelos conhecimentos de ciências dos materiais e ciências biológicas, mas não restrito a esses, foi investigada a adesão, proliferação e produção de fosfatase alcalina de células primárias da polpa dentária coronária e radicular sobre superfícies de titânio nitretadas a plasma. A caracterização físico-química da superfície de TiN (nitreto de titânio) foi realizada por Difratômetria de Raios-X (DRX), Microscopia de Força Atômica (AFM) e ensaios de Molhabilidade por determinação do ângulo de contato estático. Os ensaios biológicos foram conduzidos por Cristal Violeta, MTT (brometo de 3-[4,5-dimetil-tiazol-2-il]-2,5-difeniltetrazólio), Fosfatase Alcalina e coloração por Picrocirius Red. Os resultados dos ensaios de viabilidade e proliferação evidenciaram uma adaptação superior das células da polpa coronária quando comparadas as células da polpa radicular. Além disso, a superfície nitretada por gaiola catódica favorece a produção de fosfatase alcalina pelas células pulpares coronária e radicular, antecipando esse período quando comparados com o controle negativo. Por fim, a deposição das fibras colágenas associada à produção de fosfatase alcalina na superfície de titânio polido e nitretado a plasma nos permite inferir que houve uma diferenciação das células em células osteoblásticas

8
  • ANDREA DE ALBUQUERQUE MAIA
  • Efeitos da suplementação com zinco sobre o colesterol HDL, plaquetas e avaliação dietética em crianças jovens saudáveis

  • Advisor : JOSE BRANDAO NETO
  • COMMITTEE MEMBERS :
  • JOSE BRANDAO NETO
  • BRUNA LEAL LIMA MACIEL
  • MARIA JOSÉ DE CARVALHO COSTA
  • Data: Dec 19, 2014


  • Show Abstract
  • O zinco é um micronutriente essencial à vida. Ele atua no sistema imunológico, hematopoiético, reprodutivo e endócrino, interage com o metabolismo de proteínas, carboidratos e lipídios, além de modular a olfação, paladar e apetite. Na infância existe maior risco de deficiência de zinco, pois o crescimento e desenvolvimento aumentam a demanda deste micronutriente. O presente trabalho relata os efeitos da suplementação oral de zinco na lipoproteína de alta densidade que transporta o colesterol (HDL-c), plaquetas e ingestão alimentar de crianças saudáveis. Foram selecionadas cinquenta e cinco crianças, de ambos os sexos, com idade entre 6-9 anos, divididas em dois grupos: controle (η = 25, usando placebo) e experimental (η = 30, usando 10 mg/dia de zinco). O estudo teve a duração de três meses. As avaliações laboratorial, dietética e antropométrica foram realizadas no início e no final do estudo. No final do estudo a concentração sérica de zinco, assim como o peso, altura, índice de massa corporal e a ingestão dos macro e micronutrientes, aumentou significativamente em ambos os grupos. No entanto, as concentrações de plaquetas diminuíram e as de HDL-c aumentaram significativamente apenas no grupo experimental, sem apresentar correlação com os níveis séricos de zinco. Os resultados indicam que a suplementação com zinco contribuiu para aumentar significativamente o consumo dos macro e micronutrientes em crianças jovens e saudáveis. A diminuição de plaquetas é um achado desfavorável e o aumento de HDL-c é um achado favorável à integridade da saúde de crianças, os quais podem ter um grande impacto na saúde pública de escolares.

Thesis
1
  • MARCELA ABBOTT GALVAO URURAHY
  • ESTUDO DA ASSOCIAÇÃO DOS GENES TLR2, TLR4, MYD88 E DE CITOCINAS PRÓ-INFLAMATÓRIAS COM A NEFROPATIA DIABÉTICA EM PACIENTES COM DIABETES TIPO 1

  • Advisor : ADRIANA AUGUSTO DE REZENDE
  • COMMITTEE MEMBERS :
  • ADRIANA AUGUSTO DE REZENDE
  • ANDRE GUSTAVO PIRES DE SOUSA
  • JOSE BRUNO DE ALMEIDA
  • LIDIO GONCALVES LIMA NETO
  • LUÍS HENRIQUE SANTOS CANANI
  • Data: Feb 17, 2014


  • Show Abstract
  • Os objetivos do presente trabalho foram estudar a associação de polimorfismos e da expressão do mRNA dos genes TLR2, TLR4, MYD88, IL1B, IL6 e TNFA com a nefropatia diabética em crianças e adolescentes com Diabetes mellitus tipo 1 (DM1), assim como investigar o potencial papel do WT-1 nos exossomos urinários como um biomarcador sensível e não invasivo de dano glomerular nestes pacientes. No total, foram incluídos no estudo 144 crianças e adolescentes com DM1 e 173 indivíduos normoglicêmicos (NG) da mesma faixa etária. Foram pesquisados os polimorfismos dos genes IL6 (-634C>G e -174G>C), IL1B (3954C>T e -511C>T), TNFA (-308G>A) e TLR2 (1350T>C), determinadas as expressões gênicas de IL6, IL1B, TNFA, MYD88, TLR2 e TLR4, e quantificado o WT-1 em exossomos urinários. Além disso, foram avaliados o controle glicêmico, os lipídios séricos e parâmetros laboratoriais de função renal. Os indivíduos com DM1 apresentaram um controle glicêmico insatisfatório e valores aumentados de colesterol total, LDL-colesterol e da relação albumina:creatinina (RAC), quando comparados com os NG (p<0,05). O polimorfismo IL6 -174G>C foi associado com susceptibilidade ao DM1 (p<0,05). Estudando apenas os indivíduos com DM1, foi observado que os carreadores do genótipo IL6 -174CC apresentaram maiores concentrações de RAC, colesterol total e LDL-colesterol, no modelo recessivo (p<0,05); já os carreadores do genótipo TNFA -308AA apresentaram um aumento nas concentrações séricas de HDL-colesterol, também no modelo recessivo (p<0,05). A relação WT-1:creatinina apresentou-se significativamente aumentada nos indivíduos com DM1 e microalbuminúria quando comparados com ambos os grupos DM1 sem microalbuminúria e NG (p<0,05). Esses resultados sugerem que o polimorfismo IL6 -174G>C pode contribuir para o desenvolvimento do DM1 e da nefropatia diabética, que o TNFA -308G>A pode conferir proteção contra a doença renal induzida pelo DM1 e que o WT-1 nos exossomos urinários seria um indicador precoce de dano em podócitos.

2
  • SARAH DANTAS VIANA MEDEIROS
  • Immunohistochemical evaluation of venous ulcer treated with glucan

  • Advisor : VALERIA SORAYA DE FARIAS SALES
  • COMMITTEE MEMBERS :
  • FERNANDA GUEDES LUIZ
  • MARIA GORETTI FREIRE DE CARVALHO
  • RENATO MOTTA NETO
  • VALERIA SORAYA DE FARIAS SALES
  • VILANI MEDEIROS DE ARAUJO NUNES
  • Data: Feb 17, 2014


  • Show Abstract
  • Glucan is a polymer of glucose that has been reported to accelerate wound healing through the activation of immune cells. Venous ulcers are cutaneous wounds that result from chronic venous insufficiency; they are difficult to heal and responsible for 80-85% of ulcers that occur on the lower limbs. The purpose of this study was to assess the role of the β-glucan in the induction of venous ulcers healing, especially through the identification and quantification of macrophages (CD68+ cells) and T-lymphocytes (CD3+ CD4+ cells and CD3+ CD8+ cells). A nonrandomized clinical trial with intragroup comparisons over time was performed. The study was approved by the Research Ethics Committee of the University Hospital Onofre Lopes (Nº147/09), Federal University of Rio Grande do Norte. Water-insoluble β-glucan was isolated from Saccharomyces cerevisiae and was dispersed in cream with crodabase CR2 to a final concentration of 3%; the cream was applied directly to the ulcer. A venous ulcer biopsy was taken before therapy initiation (day 0) and after 30 days of glucan treatment for detection and quantification of macrophages (CD68+ cells), and T-lymphocytes (CD3+ CD4+ cells, and CD3+ CD8+ cells) by immunohistochemistry. We followed 12 patients; nine were women and three were men. The median of the age was 59 years. Topical immunotherapy was applied to 13 venous ulcers. The duration of these ulcers was from 8 to 264 months, and the majority (61.5%) was recurrent wounds. Histomorphometric analysis showed a decrease of the macrophage number in all the cases after the treatment with glucan (p=0.001), and an increase of T-lymphocytes number (p=0.600). Among the cases showed an increase of CD3+, 7 (87.5%) also increased CD4+ marker, and CD8+ marker. Initially, the venous ulcers area varied from 8.38 to 66.89 cm2, and after the treatment with glucan the ulcers area varied from 4.84 to 58.02 cm2. We concluded that the glucan was able to modulate the immune response, accelerating the healing process of venous ulcers treated. 

3
  • JAILMA ALMEIDA DE LIMA
  • SÍNTESE E AVALIAÇÃO DA ATIVIDADE ANTITUMORAL DE NANOGÉIS DE FUCANA A EXTRAÍDA DA ALGA MARROM Spatoglossum schröederi (C.Agardh) Kützing

  • Advisor : HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • COMMITTEE MEMBERS :
  • ARTUR DA SILVA CARRICO
  • HUGO ALEXANDRE DE OLIVEIRA ROCHA
  • NORMA MARIA BARROS BENEVIDES
  • VALERIA SORAYA DE FARIAS SALES
  • VALQUIRIA PEREIRA DE MEDEIROS
  • Data: Mar 21, 2014


  • Show Abstract
  • Fucanas são polissacarídeos sulfatados encontrados em algas marrons e equinodermos. Tem sido demonstrado que uma fucana denominada de fucana A extraída da alga marrom Spatoglossum schröederi apresenta uma série de efeitos biológicos, em particular, a atividade antitumoral. Com intuito de se potencializar esta atividade nanogéis de fucana A foram sintetizados através da adição de grupamentos tióis a sua estrutura, obtendo-se assim fucana A tiolada. Posteriormente, os nanogéis foram sintetizados pela formação de nanocomplexos entre a fucana A tiolada e o polietileno glicol (PEG) em várias relações 2.5, 5.0, 10, 15 e 30. Os nanogéis com a relação de 10 e 15 (FucA:PEG10 e FucA:PEG15) foram os que se apresentaram com os menores tamanhos, mais esféricos, com diâmetro em torno de 186,95 ± 10,62 nm e carga de superfície ligeiramente negativo. Após a síntese dos nanogéis estes foram submetidos aos ensaios antiproliferativos com células da linhagem tumoral 786-0 nas concentrações 8,0 a 64 µg/mL. As células foram analisadas durante um período de 24, 48 e 72 horas. Os dados mostraram que, em todas as concentrações de nanogéis de fucana A, a atividade antiproliferativa foi tempo e dose dependente, o mesmo não sendo observado para a fucana A sozinha. Além disso, o nanogel FucA:PEG15 também induziu apoptose por mecanismos dependente e independentes de caspases. FucA:PEG15 foi marcado fluorescentemente e utilizado como sonda em ensaios de microscopia confocal e citometria de fluxo. Observou-se que após 15 minutos de incubação FucA:PEG15 se encontrava no interior celular, na região pericelular. Após uma hora de incubação todo o nanogel de FucA:PEG15 se encontrava no interior celular. Além disso, FucA:PEG15 apresentou as atividades antioxidante e  antiangiogênica. Estes resultados indicam que os nanogéis de fucana A tem um uso potencial contra a terapêutica do câncer. Em um futuro próximo, nós intencionamos aprofundar os estudos para desvendar os mecanismos pelos quais os nanogéis de fucana exercem seus efeitos antineoplásicos. 

4
  • RITA DE CASSIA BARRETO DA SILVA
  • CARACTERIZAÇÃO DE UMA NOVA EXONUCLEASE IDENTIFICADA EM UMA BIBLIOTECA METAGENÔMICA

  • Advisor : LUCYMARA FASSARELLA AGNEZ LIMA
  • COMMITTEE MEMBERS :
  • LUCYMARA FASSARELLA AGNEZ LIMA
  • ADRIANA FERREIRA UCHOA
  • KATIA CASTANHO SCORTECCI
  • CARLOS RENATO MACHADO
  • JOAO ANTONIO PEGAS HENRIQUES
  • Data: Mar 27, 2014


  • Show Abstract
  • A abordagem metagenômica tem permitido o acesso ao material genético de microrganismos não cultivados e tem sido usada para identificação de novos genes. Apesar da importância dos mecanismos de reparo de DNA para a manutenção da integridade genômica nosso conhecimento sobre mecanismos de reparo de DNA é baseado em organismos modelo como E. coli e pouco é conhecido sobre os organismos de vida livre e não cultivados. Neste trabalho, a abordagem metagenômica foi aplicada para descobrir novos genes envolvidos com a manutenção da integridade genômica. Um clone positivo foi identificado por replicar a biblioteca metagenômica em meio seletivo contendo H2O2. O clone metagenômico foi capaz de complementar parcialmente a deficiência em reparo de DNA de cepas simples e duplo-mutantes de E.coli (recA e xthA nfo, respectivamente) submetidas ao estresse gerado por H2O2 e MMS.A análise de sequência mostrou uma ORF codificando para uma proteína hipotética membro da superfamília Exo_Endo_Phos (PF03372) e, a filogenia indicou que a mesma não está inclusa em nenhuma das subfamílias EEP. Assim, uma nova nuclease foi identificada e experimentalmente caracterizada in vivo e in vitro. Ensaios específicos utilizando a nuclease purificada e oligonucleotideos fluorescentemente marcados revelaram sua atividade 3´-5´exonuclease, em substratos simples e dupla-fita, dependente de Magnésio e sensível a EDTA. Uma vez que este é o primeiro relato e caracterização de uma enzima obtida a partir de abordagem metagenômica mostrando uma atividade exonuclease, foi nomeada EXOMEG1

5
  • MARCELO VIANA DA COSTA
  • A EDUCAÇÃO INTERPROFISSIONAL COMO UMA ABORDAGEM PARA A REORIENTAÇÃO DA FORMAÇÃO PROFISSIONAL EM SAÚDE

  • Advisor : MARIA JOSE PEREIRA VILAR
  • COMMITTEE MEMBERS :
  • HENRY DE HOLANDA CAMPOS
  • MARIA JOSE PEREIRA VILAR
  • MARINA PEDUZZI
  • ROSIANE VIANA ZUZA DINIZ
  • SIMONE DA NOBREGA TOMAZ MOREIRA
  • Data: Mar 28, 2014


  • Show Abstract
  • A Educação Interprofissional (IPE) se apresenta como abordagem necessária às reflexões sobre o Processo de  Reorientação da Formação Profissional em Saúde, na realidade brasileira. A pesquisa fornece detalhes sobre a relevância dessa abordagem em duas universidades pesquisadas, tendo como escopo explorar o uso da Educação Interprofissional em Saúde como uma estratégia capaz de fortalecer a reorientação da Educação Profissional de Saúde com vistas à qualificação dos profissionais para o trabalho colaborativo. O estudo adotou uma abordagem de métodos mistos sequenciais para estudo de casos, a partir das técnicas de grupo focal e questionários aplicados aos estudantes e entrevistas individuais para os professores de duas universidades. Os dados foram analisados a partir da Análise de Conteúdo Temática Categorial e Análise Estatística Descritiva. Os resultados demonstram que estudantes e professores reconhecem a necessidade de melhorar as habilidades para a colaboração de futuros profissionais; estudantes se apresentam dispostos a vivenciar experiências de aprendizagem compartilhadas e expressam as limitações atuais na comunicação entre alunos e profissionais de diferentes categorias; ambos os sujeitos arrolados sentem a necessidade de ampliar e consolidar o debate sobre Educação Interprofissional e Trabalho Colaborativo. As duas realidades apresentam  importantes fragilidades, tais como estrutura física que dificulta ações interprofissionais, dificuldades nas relações interpessoais e interprofissionais. Há nas duas universidades pesquisadas, iniciativas de IPE, no entanto algumas apresentam maiores limitações na execução das mesmas. Na realidade brasileira, embora haja importantes políticas de reorientação da formação profissional em saúde, ficou evidente as limitações das instituições formadoras na formação de habilidades e competências para o trabalho colaborativo. Assim, o debate sobre Educação Interprofissional e Trabalho Colaborativo se mostra como necessário para atribuir maior envergadura às atuais políticas. A inserção dessa discussão não se configura como tarefa simples diante das características identificadas. No entanto, a realidade de produção dos serviços de saúde apresenta demandas ao processo de formação que não podem ser negligenciadas sob pena de fragilizar a proposta de um sistema de saúde centrado nas necessidades sociais, produzidas no seio das grandes e importantes transformações históricas.

6
  • MELINA BEZERRA LOUREIRO
  • Estudo da associação dos genes RANk, RANKL e OPG com a osteopatia diabética

  • Advisor : ADRIANA AUGUSTO DE REZENDE
  • COMMITTEE MEMBERS :
  • ADRIANA AUGUSTO DE REZENDE
  • ANDRE DUCATI LUCHESSI
  • BENTO JOAO DA GRACA AZEVEDO ABREU
  • MARIVÂNIA DA COSTA SANTOS
  • SERGIO ATALA DIB
  • Data: Mar 31, 2014


  • Show Abstract
  • O objetivo do presente trabalho foi avaliar a expressão de RNAm e os polimorfismos dos genes RANK, RANKL e OPG de crianças, adolescentes e adultos jovens com DM1, bem como estudar a associação dos mesmos com o desenvolvimento de alterações no metabolismo ósseo.No total, foram incluídos no estudo 119 crianças e adolescentes com DM1 e 161 indivíduos normoglicêmicos (NG) da mesma faixa etária. Foram pesquisados os polimorfismos dos genes OPG (1181 G>C e 163 A>G), RANK (575 C>T e 3'UTR C>A) e RANKL (Íntron A>G) e determinadas as expressões gênicas de OPG, RANK e RANKL. Além disso, foram avaliados o controle glicêmico e parâmetros laboratoriais de função óssea, além da densitometria óssea. Os indivíduos com DM1 apresentaram um controle glicêmico insatisfatório e valores diminuidos de cálcio total, propeptídeo do colágeno tipo 1 (CTX), como também baixa densidade mineral óssea, quando comparados com os NG (p<0,05). O polimorfismo OPG 1181 G>C pode estar associado com susceptibilidade ao DM1 (p=0,054). Estudando apenas os indivíduos com DM1, foi observado que os carreadores do genótipo OPG 1181 GG apresentaram maiores concentrações de cálcio ionizado no modelo recessivo (p<0,05). Esses resultados sugerem que o polimorfismo OPG 1181 G>C pode contribuir para o desenvolvimento do DM1 e da osteopatia diabética.

7
  • IARA MEDEIROS DE ARAUJO
  • INFLUÊNCIA DAS MEDIDAS ANTROPOMÉTRICAS SOBRE A PRESSÃO ARTERIAL SISTÊMICA DE HIPERTENSOS ATENDIDOS NAS UNIDADES DE SAÚDE DA FAMÍLIA NO MUNICÍPIO DE JOÃO PESSOA-PB

  • Advisor : NEIR ANTUNES PAES
  • COMMITTEE MEMBERS :
  • NEIR ANTUNES PAES
  • MARIA DO SOCORRO COSTA FEITOSA ALVES
  • MARDONE CAVALCANTE FRANCA
  • KÁTIA SUELY QUEIROZ SILVA RIBEIRO
  • RODRIGO PINHEIRO DE TOLEDO VIANNA
  • Data: Apr 25, 2014


  • Show Abstract
  • Este trabalho objetiva avaliar a influência das medidas antropométricas sobre a pressão arterial sistêmica de uma coorte de hipertensos atendidos nas Unidades de Saúde da Família (USF) no município de João Pessoa-PB durante o período de 2008 a 2011. Para verificar as diferenças de níveis pressóricos entre as medidas realizadas nas consultas referentes ao cadastro, e a ultima pressão obtida no período de acompanhamento foram utilizadas informações sobre a identificação, dados clínicos do paciente, fatores de risco e doenças concomitantes. Testes estatísticos de comparabilidade entre grupos foram empregados. Para investigar os padrões de associação dos fatores de risco das variáveis antropométricas e sociodemográficas com a hipertensão dos pacientes, foi empregado o Modelo de Regressão Logística. Foram encontradas associações significativas (p<0,005) da hipertensão com a obesidade e o sedentarismo. Com os resultados desta pesquisa pretende-se: fornecer indicadores sobre a efetividade da Estratégia Saúde da Família; avaliar a qualidade das informações antropométricas; contribuir para a definição de estratégias que garantam o melhoramento dos acompanhamentos dos hipertensos e fornecer elementos científicos de apoio para outras USF e instituições governamentais. 

8
  • VALDECY FERREIRA DE OLIVEIRA PINHEIRO
  • Avaliação da eficácia analgésica da associação entre anestesia geral e raquianestesia com morfina combinada à ropivacaína a 0,5% em relação à anestesia geral e analgesia multimodal no pós-operatório de revascularização do miocárdio.

  • Advisor : IVONETE BATISTA DE ARAUJO
  • COMMITTEE MEMBERS :
  • ANA CRISTINA MANCUSSI E FARO
  • IRAMI ARAUJO FILHO
  • IVONETE BATISTA DE ARAUJO
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • SILVIA REGINA SECOLI
  • Data: May 9, 2014


  • Show Abstract
  • Objetivo: Avaliar a eficácia analgésica da associação entre anestesia geral e raquianestesia com morfina combinada à ropivacaína a 0,5% em relação à anestesia geral no pós-operatório de revascularização do miocárdio. Método: Ensaio clínico, randomizado, controlado, envolvendo 58 pacientes, de ambos os sexos, com idade média de 59,8 ± 8,9 anos, estado físico ASA II e III. Os participantes foram alocados em dois grupos, sendo o GI composto por indivíduos submetidos à anestesia geral combinada à raquianestesia com morfina 400µg e 6 ml (30mg) a 8 ml (40mg) de ropivacaína a 0,5% e analgesia multimodal; e o GII, por indivíduos submetidos à anestesia geral associada à analgesia multimodal. Foi avaliada a dor, ao despertar, nas primeiras 24 horas e ao realizar exercício respiratório, tempo para extubação e ao retirar drenos de tórax . A análise estatística foi realizada pelos testes do Qui-quadrado, Teste t de Student, ou Teste Exato de Fisher e o Teste de Mann-Whitney (U). Resultado: O GI apresentou menor intensidade de dor ao despertar (p = 0,001), nas primeiras 24 horas (p=0,001) e durante a realização dos exercícios respiratórios (p=0,004). Houve maior necessidade de analgesia complementar no grupo GII, com maior consumo de morfina (p=0,05). Efeitos colaterais leves, como náuseas (p=0,001), vômito (p= 0,002), prurido (p= 0,030), predominaram no GI. Conclusão: O estudo sugere que a anestesia geral combinada à raquianestesia com morfina associada à ropivacaína oferece melhor efeito analgésico no pós-operatório de cirurgia cardíaca.

9
  • JOAO AFONSO RUARO
  • Proposição e aplicação de um core set da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) para saúde física de idosos

  • Advisor : RICARDO OLIVEIRA GUERRA
  • COMMITTEE MEMBERS :
  • RICARDO OLIVEIRA GUERRA
  • ALVARO CAMPOS CAVALCANTI MACIEL
  • ROBERTA DE OLIVEIRA CACHO
  • CÁSSIA MARIA BUCHALLA
  • TANIA ROSANE BERTOLDO BENEDETTI
  • Data: May 16, 2014


  • Show Abstract
  • Para aumentar a viabilidade do uso da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF), core sets começaram a ser desenvolvidos, e objetivam estabelecer uma seleção de categorias adaptada para representar os padrões de avaliação multiprofissional de grupos específicos de pacientes. Com o objetivo de propor um core set da CIF para classificar a saúde física de idosos, formou-se uma comissão de especialistas para julgar o instrumento por meio da técnica Delphi, o que mostra a interface multidisciplinar do projeto. Finalizada a participação da comissão, o core set foi proposto contendo 30 categorias. Após aplicação em uma amostra com 340 idosos dos municípios de Natal/RN e Santa Cruz/RN, o core set foi submetido à análise fatorial, tendo ficado com 19 categorias. A análise ainda proporcionou gerar uma pontuação para cada idoso por meio do escore fatorial, tendo provado ser uma forma fidedigna e confiável de se pontuar um core set.

10
  • JOZEMAR PEREIRA DOS SANTOS
  • FATORES ASSOCIADOS DA MORTALIDADE DOS IDOSOS COM AS CONDIÇÕES DE VIDA DA POPULAÇÃO DO NORDESTE DO BRASIL

  • Advisor : NEIR ANTUNES PAES
  • COMMITTEE MEMBERS :
  • NEIR ANTUNES PAES
  • MARDONE CAVALCANTE FRANCA
  • MARIA HELENA CONSTANTINO SPYRIDES
  • FRANCISCO JOSÉ DA COSTA
  • PERY TEIXEIRA
  • Data: May 16, 2014


  • Show Abstract
  • As condições de vida são usualmente consideradas como fatores intervenientes das causas básicas de mortalidade, que explica e fornece subsídios para as ações na formulação de políticas de saúde e promoção da qualidade de vida da população. Desde o desencadeamento das transições demográfica e epidemiológica iniciadas nos anos 80 no Brasil, o processo de envelhecimento populacional foi desencadeado, tendo como principal causa de morte as doenças cardiovasculares. A escassez desses estudos para regiões como a do Nordeste brasileiro motivou traçar como principal objetivo estudar a associação da mortalidade dos idosos por doenças cardiovasculares com indicadores que expressem as condições de vida e de saúde da população do Nordeste durante o período 2000-2010. Foi utilizada a Modelagem de Equações Estruturais (MEE) para explicar essas associações, tomando como base as estatísticas de óbitos por doenças cardiovasculares (construto endógeno) e variáveis socioeconômicas e demográficas (construtos exógenos) das microrregiões do Nordeste. Aplicou-se ademais o Método dos Componentes Principais para a construção de um índice sintético que permitiu classificar as mesorregiões em 2000 e 2010. Os resultados da aplicação do MEE sugerem uma forte associação da variável desfecho, taxa de mortalidade por doenças cardiovasculares dos homens idosos, com o construto exógeno condições de vida composto pelos indicadores: anos de estudo dos homens idosos, percentual de idosos em domicílios com banheiro/água encanada e probabilidade de sobrevivência aos 60 anos. No estudo para as mulheres, dois modelos foram comparados para o mesmo conjunto de variáveis com a variável desfecho, sendo observada diretamente no modelo-1 e estimada por quatro principais causas básicas no modelo-2. A MEE apontou melhores ajustes para o modelo final-1. A construção do índice permitiu identificar os diferentes ritmos de envelhecimento populacional entre as regiões e distintos processos de evolução dos níveis de mortalidade pelas doenças cardiovasculares, muitas compatíveis com as condições de vida. Sugere-se que, o construto condições de vida foi fortemente associado por esta causa de morte entre os idosos para ambos os sexos no Nordeste do Brasil. Este fato deve fortemente ser levado em conta pelas políticas de saúde voltadas para este contingente populacional.

11
  • DANIELLA ANTUNES POUSA FARIA
  • Resiliência e Adesão ao Tratamento em Pacientes com Lúpus Eritematoso Sistêmico

  • Advisor : EULALIA MARIA CHAVES MAIA
  • COMMITTEE MEMBERS :
  • DIVANISE SURUAGY CORREIA
  • EULALIA MARIA CHAVES MAIA
  • LUCIANA CARLA BARBOSA DE OLIVEIRA
  • MARIA DE FÁTIMA LOBATO DA CUNHA
  • SIMONE DA NOBREGA TOMAZ MOREIRA
  • Data: May 30, 2014


  • Show Abstract
  • Objetivo: Avaliar a capacidade de resiliência e os comportamentos de adesão ao tratamento auto-relatados, em pacientes com LES, investigando quais destes fatores encontram-se associados à resiliência. Método: Estudo de caráter transversal, multidisciplinar, realizado com a ajuda da equipe de médicos reumatologistas do Hospital Universitário Onofre Lopes, a equipe de psicologia da base de pesquisa “Grupo de Estudos de Psicologia” e a estística. O estudo foi realizado com 40 mulheres com Lúpus Eritematoso Sistêmico (LES). Utilizou-se um questionário de informações sócio-demográficas e histórico de saúde e a Escala de Resiliência de Wagnild & Young. Resultados: 62,5% realizam o tratamento medicamentoso adequadamente, porém, 55% sente dificuldade em segui-lo. 27,5% dos pacientes apresentaram resiliência baixa, 57,5% moderada e 15% alta. No teste Qui-quadrado a resilência associou-se (p-valor < 0,05) com as variáveis trabalho; compreensão do LES; procurou saber sobre o LES; faz o tratamento  corretamente; dificuldade de seguir o tratamento; com o fato de deixar de fazer alguma  atividade devido a doença. Na análise de correlação a resiliência associou-se com: idade (-0,3960), carga horária de trabalho (0,5533),  tempo  de  doença   após   diagnóstico  (-0,8014)  e  duração   de   tratamento  especializado (-0,8103). Conclusão: Pacientes com alta resiliência tendem a seguir o tratamento corretamente, buscando compreender a doença e se aderir ao tratamento, de forma a evitar riscos e promover fatores de proteção. Neste processo, se faz importante que o Estado possa tomar as medidas necessárias para facilitar o acesso ao tratamento, a assistência médica e a programas de educação em saúde. Promover o conhecimento da doença e aconselhamento podem contribuir para que estes pacientes possam promover as capacidades individuais para aprender a lidar com a doença.O apoio psicológico da família e dos médicos podem desempenhar um papel importante neste processo.

12
  • RICARDO NEY OLIVEIRA COBUCCI
  • NEOPLASIAS DO COLO UTERINO: RASTREAMENTO, MARCADORES BIOLÓGICOS E POLIMORFISMO GENÉTICO

  • Advisor : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • ALDO DA CUNHA MEDEIROS
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • JOSÉ ELEUTÉRIO JÚNIOR
  • PAULA RENATA LIMA MACHADO
  • PAULO CESAR GIRALDO
  • Data: May 30, 2014


  • Show Abstract
  • Até o momento, há fortes evidências de que os programas de rastreamento baseados em citologia resultaram em uma diminuição significativa da incidência e mortalidade por câncer do colo do útero, no entanto, um excesso substancial de tratamento de lesões intraepiteliais de baixo grau que dificilmente progrediriam para carcinoma cervical resulta da baixa especificidade do tradicional rastreio citológico. A detecção precoce das lesões através do rastreamento citológico e a avaliação do grau histológico em espécimes cervicais são fundamentais, contudo não permitem identificar quais pacientes terão maior probabilidade de progressão para lesões de alto grau e carcinoma invasivo. A busca de potencias biomarcadores de prognóstico e/ou diagnóstico para o entendimento das bases de progressão das lesões intraepiteliais é de suma importância.  Acredita-se que fatores imunoregulatórios, imunogenéticos e proteínas do ciclo celular estejam intimamente envolvidos no processo de carcinogênese. Portanto, investigar se a análise da expressão proteica do fator inibitório de macrófagos (MIF), das metaloproteinases 2 e 9 (MMP2 e MMP9), do fator de crescimento endotelial (VEGF), da proteína do ciclo celular P63 (P63) e do polimorfismo do gene do fator de transcrição FOXP3 associada a citologia e a biópsia de colo uterino é capaz de melhorar a avaliação diagnóstica e prognóstica do câncer de colo de útero foi o objetivo do presente trabalho. Realizou-se estudo comparativo do tipo observacional estratificado em três grupos: Grupo 1: 17 casos com diagnóstico histopatológico de metaplasia/cervicite, considerados normais, Grupo 2: 10 casos com lesão de baixo grau (LSIL) e Grupo 3: 15 casos com lesão de alto grau (HSIL) ou carcinoma epidermoide de colo. Um total de 42 participantes respondeu a um questionário epidemiológico padronizado sobre as características demográficas, hábitos pregressos, história reprodutiva e de comportamento sexual. Amostras de sangue foram coletadas para extração do polimorfismo do gene FOXP3. Após exame colposcópico, foram coletados múltiplos fragmentos de espécimes cervicais para a pesquisa de DNA-HPV, que foi identificada através da técnica da Reação em Cadeia da Polimerase (PCR), além da expressão proteica por imunohistoquímica dos biomarcadores. Através dos nossos resultados acreditamos que será possível uma melhor compreensão dos fatores imunogenéticos e dos marcadores moleculares envolvidos na carcinogênese induzida pelo HPV e na progressão das lesões cervicais para câncer de colo. Além disso, esperamos que apontem alternativas ao rastreamento citológico e ao diagnóstico histopatológico passíveis de melhorar a detecção de neoplasias intraepiteliais com pior prognóstico e de reduzir a morbimortalidade do carcinoma cervical.

13
  • ERLANE MARQUES RIBEIRO
  • ESTUDO GENÉTICO-CLÍNICO DE MUCOPOLISSACARIDOSES NO ESTADO DO CEARÁ

  • Advisor : CARLOS ANTONIO BRUNO DA SILVA
  • COMMITTEE MEMBERS :
  • CARLOS ANTONIO BRUNO DA SILVA
  • DELANE MARIA REGO
  • IDA VANESSA DOEDERLEIN SCHWARTZ
  • JOSE BRANDAO NETO
  • JOSE WELLINGTON DE OLIVEIRA LIMA
  • Data: Jun 2, 2014


  • Show Abstract
  • As mucopolissacaridoses (MPS) são doenças genéticas raras decorrente da deficiência de enzimas lisossomais envolvidas no catabolismo de glicosaminoglicanos, resultando em um amplo espectro de manifestações clínicas, progressivas e multissistêmicas. Embora o Nordeste brasileiro seja uma região com grande taxa de consangüinidade e um efeito fundador envolvendo MPS, não há estudos caracterizando os pacientes dessa região. Nosso objetivo foi determinar o perfil epidemiológico, clínico e genético de casos não publicados com MPS provenientes do Ceará, identificando as diferenças entre outros estudos com MPS e possíveis problemas a serem enfrentados para a realização do diagnóstico precoce. O estudo foi seccional, descritivo, com amostra de pacientes com MPS em acompanhamento no Hospital Infantil Albert Sabin e Hospital Geral Cesar Cals no período de 2006-2013. Os dados foram obtidos a partir da avaliação clínica, revisão de prontuários médicos e entrevista com os pacientes e/ou familiares realizadas pelo investigador principal. Cinquenta e três pacientes foram incluídos no estudo (36 do sexo masculino), sendo 6 MPS I, 17 MPS II, 7 MPS III (3 MPSIII-A, 3 MPS III-B, 1 MPS III-C), 7 MPS IV-A, 16 de MPS VI. O óbito ocorreu em 16 casos (3 MPS I, 6 MPS II, 1 MPS IIIA , 1 IIIB, 1 MPS IV, 4 MPS VI). A amostra foi composta principalmente por crianças. Houve elevada taxa de consangüinidade e recorrência familiar. Os tipos mais comuns foram MPS II e MPS VI. Exceto para macrossomia em MPS II, os dados de nascimento indicam que não houve risco para desenvolvimento de complicações perinatais. Na maioria dos casos, os sintomas iniciais ocorreram em crianças com menos de 2 anos. As manifestações clínicas foram heterogêneas exceto para atraso no desenvolvimento neurológico em MPS III e manifestações esqueléticas em MPS IV. As principais características clínicas foram macrocefalia, baixa estatura, alterações odontológicas, respiratórias, cardíacas, hepatoesplenomegalia, hérnia umbilical, rigidez articular e anormalidades esqueléticas. A terapia de reposição enzimática foi instituída em 26 casos (4 MPS I, 10 MPS II, 12 MPS VI). Os problemas sócio-econômicos das famílias, o amplo espectro de sintomas e a gravidade da doença foram causas das dificuldades em realizar a avaliação periódica com especialistas, além de exames complementares de maior custo para determinar as complicações da doença. Concluímos que este foi maior estudo transversal sobre MPS no Nordeste do Brasil. Detectamos uma maior incidência da MPS II e VI, em contraste com MPS I, mais frequente em populações ocidentais. As alterações respiratórias foram um dos principais contribuintes para a mortalidade precoce, exceto em MPS I, com menor expectativa de vida em relação aos outros tipos e onde a cardiomiopatia foi prevalente. O envolvimento cognitivo foi comum em casos graves e o maior número de órgãos envolvidos representou maior risco de morrer. Para o diagnóstico precoce, sugerimos a busca de indivíduos afetados em famílias em que há parentes com MPS, além do maior reconhecimento de sinais e sintomas de MPS por profissionais de saúde.

14
  • ERIKA DANTAS DE MEDEIROS ROCHA
  • Zinc supplementation on GH, IGF1, IGFBP3, and OCN in non-zinc-deficient children

  • Advisor : JOSE BRANDAO NETO
  • COMMITTEE MEMBERS :
  • ERYVALDO SOCRATES TABOSA DO EGITO
  • KARINE CAVALCANTI MAURICIO DE SENA EVANGELISTA
  • SELMA SOUSA BRUNO
  • ALCIDES DA SILVA DINIZ
  • MARIA JOSÉ DE CARVALHO COSTA
  • Data: Jun 6, 2014


  • Show Abstract
  • Objective: Zinc is an important micronutrient for numerous biochemical processes in humans and animal models and is an essential nutritional factor in the growth. As almost all publications were reported in children with zinc deficiency, we decided to study the effects of this micronutrient on the secretion of GH, IGF1, IGFBP3, and OCN in healthy children and eutrophic. Methods: The children were divided in control group (20 schoolchildren using 10% sorbitol) and experimental group (20 schoolchildren using zinc). These schoolchildren were submitted to oral zinc supplementation (10 mg Zn/day) and venous zinc administration (0.06537 mg Zn/kg of body weight). Blood samples were collected at 0, 60, 120, 180, and 210 min. And all children were also submitted to anthropometric and dietetic assessments. Results: Zinc supplementation in the experimental group (i) increased values of energy, protein and fat (p = 0.0007, p < 0.0001, p < 0.0001, respectively), (ii) increased basal serum zinc (p < 0.0001), (iii) increased plasma alkaline phosphatase (p = 0.0270), and (iv) showed positive correlation for IGF1, IGFBP3, and OCN, comparing before and after supplementation (p = 0.0011, p < 0.0001, p < 0.0446, respectively). During zinc infusion, plasma IGF1 and IGFBP3 increased significantly in the experimental group (p = 0.0468, p < 0.0001, respectively). Conclusions: Zinc supplementation increased total energy, protein, and fat intake, as well as basal serum zinc and plasma alkaline phosphatase. Zinc administration increased serum zinc profiles and IGF1 and IGFBP3 in the experimental group.

15
  • ROBERTA AZOUBEL
  • EFETIVIDADE DA TERAPIA FÍSICA DESCONGESTIVA NA CICATRIZAÇÃO DE ÚLCERAS VENOSAS

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • EULALIA MARIA CHAVES MAIA
  • GILSON DE VASCONCELOS TORRES
  • ISABELLE KATHERINNE FERNANDES COSTA
  • LUCIANA ARAUJO DOS REIS
  • MARIA KATIA GOMES
  • Data: Jun 6, 2014


  • Show Abstract
  • A úlcera venosa é a manifestação clínica mais grave da insuficiência venosa crônica, e a mais freqüente das úlceras em membros inferiores, representando em torno de 70% de todas as úlceras. Pacientes portadores dessa enfermidade podem conviver com essa situação durante vários anos, sem obter a cicatrização da lesão. O objetivo dessa investigação foi avaliar a influencia dos aspectos sociodemográficos, de saúde, assistenciais e clínicos da lesão na efetividade da terapia física descongestiva utilizada para cicatrização das úlceras venosas. Trata-se de um estudo quase-experimental, com amostra não probabilística, desenvolvido na Clínica Escola de Fisioterapia da Universidade Estadual do Sudoeste da Bahia. A amostra foi composta por 67 pacientes, distribuídos em dois grupos, por meio de estratégia de pareamento: Grupo de intervenção (GI), composto por 31 sujeitos e Grupo controle (GC), composto por 36 indivíduos. Ambos os grupos foram tratados durante seis meses com curativo diário e receberam orientações para repouso três vezes ao dia associado à elevação de membros inferiores. O GI foi submetido também à terapia física descongestiva: elevação dos membros inferiores, drenagem linfática manual, enfaixamento compressivo, exercícios miolinfocinéticos. O estudo foi aprovado (Parecer nº 59/2007) pelo Comitê de Ética em Pesquisa da Universidade Estadual do Sudoeste da Bahia. Os dados foram analisados por meio de estatística descritiva e inferencial, considerando nível de significância estatística de ρ-valor < 0,05. Entre os 67 participantes, observou-se predomínio de pessoas com mais de 59 anos (67%), sexo masculino (52%), escolaridade baixa (92%) e sem fonte de renda (60%). Em relação aos hábitos de saúde a maior parte dos participantes referiu não ser tabagista (99%), nem etilista (97%) e dormir mais de 6h (79%). Não se observou diferença significativa quanto às características sociodemográficas, de saúde, assistenciais e clínicas da lesão entre os grupos intervenção e controle. Essas mesmas características não influenciaram a efetividade da terapia física descongestiva. O principal fator responsável pela redução da dor, edema e contração da ferida foi a terapia física descongestiva, que explicou 74% da redução do edema (p=0,0001), 75% da redução da dor (p<0,0001) e 62% da contração da ferida (p=0,020). A avaliação da área da ferida mostrou que independente da terapia descongestiva, as demais variáveis (sociodemográficas, de saúde, assistenciais e clínicas da lesão) explicaram 60% da redução da área (p=0,020). Ao avaliar a influência de todas as variáveis incluindo a terapia física descongestiva nota-se que este modelo explica 66% da redução da área da lesão (p=0,005). Vale dizer que a evolução da área também sofreu influência da atividade laboral (p=0,010) e do local da úlcera (p<0,0001). Reforçando esses achados, a comparação das variáveis de desfecho dor (p<0,0001), edema (p<0,0001), área (p<0,0001) e contração da úlcera (p=0,0015) apresentaram diferença significativa entre os grupos intervenção e controle, denotando a efetividade da terapia física descongestiva na cicatrização das ulceras venosas. É importante conhecer os fatores que influenciam positivamente ou negativamente o processo de cicatrização, para desenvolver planos de tratamentos mais eficazes e melhorar a qualidade de vida dos pacientes e seus familiares. 

16
  • ANA ELZA OLIVEIRA DE MENDONCA
  • Análise da efetividade do transplante renal na qualidade de vida dos receptores no estado do Rio Grande do Norte.