Disertación/Tesis

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2024
Disertaciones
1
  • BIANCA CAROLINE DA CUNHA GERMANO
  • USE OF ACETYLSALICYLIC ACID, EXPRESSION OF PRE-ECLAMPSIA MARKERS AND UTERINE ARTERY DOPPLER IN THE SECOND GESTATIONAL TRIMESTER

  • Líder : RICARDO NEY OLIVEIRA COBUCCI
  • MIEMBROS DE LA BANCA :
  • RICARDO NEY OLIVEIRA COBUCCI
  • MARCELA ABBOTT GALVAO URURAHY
  • DEYLA MOURA RAMOS
  • Data: 28-feb-2024


  • Resumen Espectáculo
  • Preeclampsia (PE) occurs in pregnancy with hypertension and proteinuria, or target organ failure, and is associated with maternal and fetal morbidity and mortality. Among the risk factors for PE is maternal obesity. In pathophysiology, vascular and placental inflammatory dysfunction occurs, altering serum and biophysical markers. Acetyl Salicylic Acid (AAS) can prevent the disease by reducing the inflammatory process. The objective of the study was to analyze, in pregnant women in the second trimester of pregnancy, whether the use of AAS interferes with the Doppler of the uterine arteries and serum PE markers, and observe how they behave in obese pregnant women. This was a cross-sectional study, involving 71 pregnant women between 20 and 24 weeks and 06 days of gestation, recruited in two municipalities in Rio Grande do Norte between December 2022 and October 2023. Questionnaires were applied to characterize the population; morphological ultrasound of the 2nd trimester with Doppler assessment of the uterine arteries and measurement of serum PlGF (Placental Growth Factor) levels. The data were tabulated in SPSS (Statistical Package for the Social Sciences – version 4.2.2) to perform descriptive analysis, Shapiro-Wilk test and Spearman correlation. The significance level was 5%. The average body mass index (BMI) of the sample was 31.02. 38 pregnant women confirmed the use of AAS and in this group the mean pulsatility index (PI) values of the uterine arteries were 1.03 and PlGF 307.80, and in those who did not use it, the values were 0.95 and 325. 3, respectively. In this study, using AAS did not contribute to reducing the PI of the uterine arteries and there was no significant difference in the mean PIGF. Larger studies are important to confirm these results. 

2
  • GEORGIA HACKRADT REGO
  • PREVALENCE OF SEXUAL DYSFUNCTION IN WOMEN UNDERGOING PAP SMEAR COLLECTION AND MOLECULAR DETECTION OF HPV IN UNIVERSITY HOSPITAL OF RIO GRANDE DO NORTE

  • Líder : RICARDO NEY OLIVEIRA COBUCCI
  • MIEMBROS DE LA BANCA :
  • ANA ANDREA BARBOSA MAUX
  • DEYSE DE SOUZA DANTAS
  • RICARDO NEY OLIVEIRA COBUCCI
  • Data: 29-feb-2024


  • Resumen Espectáculo
  • Satisfactory sexual function in women is closely linked to their health and quality of life. Diagnoses such as HPV can have a negative impact on a woman’s emotional health, interfering with the expression of sexuality and causing feelings of shame or fear, exacerbating anxiety and stress. A cross-sectional study was conducted with the aim of assessing the prevalence of sexual dysfunction in adult women treated at a university hospital in Natal/RN. Sixty-eight sexually active women in stable relationships, aged between 18 and 45 years, were included in the study and recruited from the gynecology outpatient clinic for cervical cytology and molecular detection of Papillomavirus (HPV). Two validated instruments, the Female Sexual Function Index (FSFI) and the Sexual Quotient – Female Version (SQ-F), were used to identify sexual dysfunction, along with a sociodemographic data sheet collecting information on age, race, education, length of union/marriage, number of sexual partners, among others. Data analysis was performed using the SPSS software (Statistical Package for the Social Sciences, Chicago, USA) version 28. The prevalence of sexual dysfunction was 47.1% considering the scores obtained by FSFI and 25% with the scores of SQ-F. There was a significant correlation only with the education variable, indicated by a higher prevalence of sexual dysfunction among women who completed high school compared to those with incomplete or complete higher education. Therefore, in this observational study, the prevalence of sexual dysfunction was high, with almost half of the women presenting a disorder when evaluated with FSFI. Furthermore, the prevalence ratio of dysfunction was significantly higher in the group of women with education up to high school, regardless of the instrument used for identification. Thus, it is demonstrated that women seeking routine gynecological care may present sexual dysfunctions. However, they often do not receive a diagnosis, as doctors focus on prevention and control of infections or lesions, rarely investigating sexual behavior. The conduct of multicenter observational studies is necessary to establish a more accurate epidemiology and to develop strategies for including protocols for assessing sexual function in women’s health.

3
  • VERONICA LARYSSA SMITH
  • ELECTROMYGRAPHIC ANALYSIS OF THE FUNCTION OF THE PELVIC FLOOR MUSCLES OF POST-PELVIC MOBILITY PREGNANT WOMEN

  • Líder : RICARDO NEY OLIVEIRA COBUCCI
  • MIEMBROS DE LA BANCA :
  • LARISSA RAMALHO DANTAS VARELLA
  • RICARDO NEY OLIVEIRA COBUCCI
  • SILVANA ALVES PEREIRA
  • Data: 13-mar-2024


  • Resumen Espectáculo
  • Understanding the intricate relationship between pregnancy and the pelvic floor is crucial to managing potential problems related to pelvic floor dysfunction during and after pregnancy. Appropriate prenatal care, including exercises and interventions to support pelvic health, can help mitigate complications and promote overall well-being for pregnant women. The objective of this case series was to analyze the function of the pelvic floor muscles of pregnant women after pelvic mobility exercises using surface electromyography (EMG). The methodology was a cross-sectional, case series observational study, which evaluated seven (7) pregnant women in the third trimester. Data collection consisted of functional assessment of the pelvic floor through surface electromyography, with the following protocol: thirty seconds of rest to record basal activity, three maximal voluntary contractions maintained for two seconds, with a one-minute interval between each one. and three sustained contractions, maintained for six seconds, with a one-minute interval between each one. After the evaluation, pelvic exercises of lateral hip tilt, pelvic antero- and retroversion and circumduction were performed and, subsequently, all were reevaluated by EMG following the same evaluation protocol. The collected data were analyzed using SPSS software, version 13.0. The results indicated a significant improvement in maximum voluntary contraction, in the adjusted mean variable (p 0.040). In the other parameters evaluated, although there was no significant statistical difference, the values found may indicate an improvement in the functionality of the pelvic floor muscles after pelvic movement exercise. The pelvic exercise applied in this series of cases caused changes in all variables evaluated in the studied group, considering the myoelectric response and the functionality of the pelvic floor muscles in pregnant women in the third trimester. Studies with a larger sample and higher level of evidence are needed to confirm these results.

2023
Disertaciones
1
  • MARIA LETÍCIA DE LIMA MACHADO
  • COMPARISON OF HISTOPATHOLOGICAL FINDINGS IN PLACENTAS FROM PARTURIENTS INFECTED OR NOT BY SARS-COV-2.

  • Líder : RICARDO NEY OLIVEIRA COBUCCI
  • MIEMBROS DE LA BANCA :
  • DEBORAH DE MELO MAGALHÃES PADILHA
  • MARCELA ABBOTT GALVAO URURAHY
  • RICARDO NEY OLIVEIRA COBUCCI
  • Data: 18-ene-2023


  • Resumen Espectáculo
  • The immune response of pregnant women with COVID-19, as well as the histopathological changes in the placenta caused by the infection, have not yet been elucidated. The characterization of lymphocyte subpopulations and natural killer (NK) cells, via flow cytometry, in the peripheral blood of pregnant and postpartum women infected or not by SARS-CoV-2, together with placental histopathological analysis, can contribute with more evidence on the effects caused by COVID-19 during the puerperal pregnancy period. In this cross-sectional study, the peripheral levels of total T lymphocytes, TCD4+ lymphocytes (ThL), TCD8+ lymphocytes (TcL), B lymphocytes and NK cells, in pregnant and postpartum women with positive and negative PCR for SARS-CoV-2 were compared. In addition, a comparison of placental histopathological findings was performed, using the Hematoxylin/Eosin staining method, of part of the parturients included in the study. The collection of peripheral blood and placental tissue samples took place between May 2021 and March 2022, in a teaching hospital in the northeast region of Brazil. Immunophenotyping was performed in 99 women, of which 78 (78.8%) had a confirmed diagnosis of COVID-19. Pregnant women and postpartum women infected with SARS-CoV-2 had higher levels of cytotoxic T cells, median (ME) = 574.2; interquartile range (IIQ) = 382.4, when compared with uninfected patients, ME = 404.7; IIQ = 363.5); p = 0.032. Histopathological analysis was performed on 30 placentas, of which 10 parturients had a diagnosis of COVID-19 confirmed by PCR (33.3%). Results revealed higher levels of congestion, focal chronic villitis, and acute funisitis in placentas from COVID-19 positive parturients. Negative parturients had a higher percentage of intervillous hemorrhage with thrombus formation, dystrophic calcification, placental infarction except marginal and acute capsular deciduitis. However, there was no statistically significant difference between the groups, nor a predominant histopathological pattern in pregnant women infected by the virus in the sample studied for comparison of placental findings. Pregnant women and postpartum women with COVID-19 had significantly higher levels of cytotoxic T cells in peripheral blood, but there was no difference in placental histopathological findings, although the group with confirmed infection had a higher percentage of congestion, focal chronic vilitis and acute funisitis.

2
  • JESSICA DAYANNA LANDIVAR COUTINHO
  • Clinical, sociodemographic and behavioral indicators in Genetic Counseling in Oncology. 

  • Líder : DANIELLA REGINA ARANTES MARTINS SALHA
  • MIEMBROS DE LA BANCA :
  • DANIELLA REGINA ARANTES MARTINS SALHA
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • KLEYTON SANTOS DE MEDEIROS
  • Data: 23-mar-2023


  • Resumen Espectáculo
  • Genetic counseling (GC) has become a pivotal health preventive strategy service to manage high-risk patients for hereditary cancer in the genomic era. Identifying high-risk cancer variants in asymptomatic carriers and controlling their risk has been shown to reduce breast cancer and mortality. Brazil is a continental middleincome country with an admixture population that are suggested to have the highest internal genetic variation of sampled populations. The present study aims to evaluate clinical, sociodemographic and behavioral indicators in high-risk patients undergoing GC for hereditary cancer since 2009, in a cancer care hospital. The service has received 139 patients, where 63.3% of patients did not have higher education, 69.3% had less than 60 y; 91% had breast cancer as a primary diagnosis and 23.7% carries a germline variant in high-risk genes. The 5 years overall survival was 88.6%, with no significant difference between patients with germline mutation (95% CI, p = 0.138). After GC, 90.9% and 73.3% of the patients had mild/normal score for depression and anxiety, respectively, and regardless of age at diagnosis. Moreover, the decision of undergoing risk-reducing mastectomy (RRM) was not influenced by the depressive or anxious symptoms. However, 44.4% of women aged more than 60y did not present willingness to undergo RRM. Among patients with pathogenic variant, 58% state that the diagnosis of germline mutation was able to modify unhealth habits, 91.7% of the women could understand the meaning of germline mutation and the implications to their and family’s health, however, this was directly related to the education level. These results reaffirm the challenges of GC in an underdeveloped region of the country with high parental consanguinity, phenotypic heterogeneity and highlight the cancer health disparity that exists for the high-risk population.

3
  • FERNANDA CATARINA RIBEIRO
  • COMPARATIVE ANALYSIS OF THE EFFECTIVENESS OF TOPICAL AND ORAL POLYPHENOLS ON SKIN AGING IN WOMEN: A SYSTEMATIC REVIEW.
  • Líder : RAND RANDALL MARTINS
  • MIEMBROS DE LA BANCA :
  • RAND RANDALL MARTINS
  • RODRIGO DOS SANTOS DINIZ
  • FRANCISCA SUELI MONTE MOREIRA
  • Data: 26-abr-2023
    Ata de defesa assinada:


  • Resumen Espectáculo
  • Introduction: Skin aging in women is mainly correlated with exposure to solar radiation with menopausal events, such as hypoestrogenism. In parallel with the increase in life expectancy, both are associated with the induction of oxidative stress, motivating the signs and symptoms of senescence. The development of phytotherapics based on polyphenols can minimize the unwanted effects of skin wear, highlighting flavonoids. Despite its probable beneficial potential, there are limitations in the literature. Objective: To develop a systematic review of clinical trials, addressing the effectiveness of polyphenol compounds in delaying skin aging in women, comparing oral and topical routes. Methodology: A literature search was carried out in the electronic databases MEDLINE (via PubMed), Cochrane, Embase and Web of Science, published between the years 2012 and 2022. Eligible studies were randomized, double-blind, controlled trials, with the exception of one study that did not include a comparator group. Studies were selected that evaluated the effectiveness of an isolated or combined herbal medicine, which reported the following outcomes: elasticity (R2) and roughness or volume of wrinkles (visiometer or Primos). Results: After retrieving the articles, 13 studies were selected, with a total number of participants ranging from 20 to 120 individuals, composed of healthy women aged between 30 and 65 years, with the predominant inclusion criterion being the presence of wrinkles (usually the Wrinkles score ≥ 3) and with intervention protocol applied on the face. Four studies with low risk of bias and high heterogeneity regarding the plants used were identified. Favorable results were shown in elasticity and roughness, being attested after eight weeks of topical administration, and twelve orally. Conclusion: We emphasize that herbal medicines based on polyphenols have a positive impact on skin elasticity and roughness. In addition to the biomolecule, we emphasize the importance of time and route of administration to achieve the expected effect, since the topical route revealed brevity in the response compared to the oral route. Furthermore, we identified in the literature the diversity of tested compounds and methodological weaknesses, making more methodologically consolidated tests necessary.

4
  • LISIEUX DE LOURDES MARTINS NOBREGA
  • LASERTHERAPY IN THE TREATMENT OF GENITOOURINARY SYNDROME OF MENOPAUSE: SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CLINICAL TRIALS.

  • Líder : RICARDO NEY OLIVEIRA COBUCCI
  • MIEMBROS DE LA BANCA :
  • RICARDO NEY OLIVEIRA COBUCCI
  • MARIA THEREZA ALBUQUERQUE BARBOSA CABRAL MICUSSI
  • MARIA IRANY KNACKFUSS
  • Data: 27-abr-2023


  • Resumen Espectáculo
  • Laser therapy has been proposed to improve the symptoms of genitourinary syndrome of menopause (GSM), especially in women who do not accept or have a high risk of complications if they undergo hormonal therapy. However, studies evaluating the efficacy and safety of laser treatment for GSM have shown controversial results. Therefore, the objective of the study is to evaluate the effects of laser therapy in menopausal patients with GSM. A systematic review and meta-analysis of randomized clinical trials (RCTs) was carried out based on a protocol published in a scientific journal, prospectively registered through the International Prospective Register of Systematic Reviews (PROSPERO/CRD42021253605) and following the Preferred Reporting Items for Systematic Review and Meta-analysis Protocol, using the PICOS strategy to find studies with postmenopausal women without treatment, or undergoing laser therapy, placebo, or vaginal estrogen for GSM. According to the protocol, randomized and quasi-randomized clinical trials, regardless of the language of publication, were searched in databases using keywords, and 12 were included whose results were systematically evaluated for vaginal atrophy, pH, dryness, dyspareunia, itching, burning, dysuria, frequency, urgency, and urinary incontinence. The review provided evidence that carbon dioxide (CO2) laser increases the Vaginal Health Index (VHI) score and decreases dyspareunia, dryness, and burning, especially when compared to placebo, but with low certainty of evidence.

5
  • STEPHANY ANN COSTA ROSARIO
  • Association of the presence of proteinuria in preeclampsia with the maternal and neonatal outcomes.
  • Líder : MARCELA ABBOTT GALVAO URURAHY
  • MIEMBROS DE LA BANCA :
  • MARCELA ABBOTT GALVAO URURAHY
  • DANIELLA REGINA ARANTES MARTINS SALHA
  • JEFFERSON ROMÁRYO DUARTE DA LUZ
  • Data: 11-may-2023


  • Resumen Espectáculo
  • Preeclampsia (PE) for a long time was diagnosed based on the triad of edema, proteinuria and hypertension; with the advance of studies, edema and proteinuria became criteria related to severity and not necessarily to diagnosis, thus the presence of hypertension together with isolated proteinuria are not decisive criteria for the diagnosis of PE. In this sense, this study aimed at identifying the correlation between worsening of the clinical picture of pregnant women diagnosed with preeclampsia and neonates, considering that proteinuria is nowadays an unnecessary diagnostic criterion for the disease.

    This is a longitudinal, prospective, observational study carried out from January to October 2022 at the Januário Cicco Maternity School. The study population consisted of 32 pregnant women and their newborns (NB), classified according to the assessment of qualitative proteinuria in the strip, being Proteinuria negative or traces (n=13) and Proteinuria ≥ 1+ (n=19). Blood samples were collected from fasting pregnant women in a tube without anticoagulant for biochemical evaluation (10ml), analyzed using the Dimension RxL equipment (Siemens, São Paulo, SP, Brazil) and collected (4ml) in a tube with anticoagulant ethylenediaminetetraacetic acid (EDTA) in order to assess hematological parameters, analyzed by Advia 2120i equipment (Siemens, São Paulo, SP, Brazil). Proteinuria was measured at admission by qualitative evaluation in isolated urine sample (Uri-Color Check reactive strip from WAMA Diagnóstica, São Carlos, SP, Brazil).

    Data were collected from the electronic medical records of pregnant women and their respective neonates in the University Hospitals Management Application (AGHU). The distribution of continuous variables was assessed by the Shapiro-Wilk test, and all variables were considered nonparametric. Non-parametric data were 

    analyzed by the Mann-Whitney test and correlated by Spearman. Regarding differences between categorical variables, these were tested by chi-square analysis.  The evaluations were performed using SPSS Statistics version 20.0 (IBM, New York, USA). P values lower than 0.05 were considered statistically significant.

     Among the results obtained we can highlight that 28 (87.5%) of the pregnant women were admitted to the high-risk sector, 12 (92.3%) from the negative or trace proteinuria group and 16 (84.2%) from the proteinuria ≥1+ group, the predominant route of delivery was cesarean section, most of the NB presented prematurity, low birth weight, and most of them required hospitalization (p=0.007). In addition, 15 (78.9%) RNs in the proteinuria ≥ 1+ group required ventilatory support (p=0.020). Differences were observed between groups regarding diastolic blood pressure at the time of delivery (p<0.018), uric acid (p<0.012), urea (p<0.030), AST (p<0.001), ALT (p<0.033), LDH (p<0.005), total protein (p<0.004), albumin (p<0.001). The main positive correlations observed were between maternal age and total proteins (r=0.404; p<0.024), birth weight and total protein (r=0.511; p<0.009) and LDH and AST (r=0.727;p=0.001), the negative correlations observed were blood pressure at delivery and total proteins (r=0.670; p=0.001), total proteins and AST (r=0.719;p=0.001), albumin and AST (r=0.728;p=0.001), Albumin and total proteins (r=0.882;p=0.001), urea and GI at birth (r=0.721;p=0.001), Urea and birth weight (r=0.667;p<0.001).Thus, proteinúria was associated to poorer mother and neonatal outcomes.

6
  • MARIA APARECIDA FELICIANO DE SOUZA
  • Dual-stainig expression of p16/ Ki-67 in liquid-based cytology in cervical cancers: a scoping review.

  • Líder : JANAINA CRISTIANA DE OLIVEIRA CRISPIM FREITAS
  • MIEMBROS DE LA BANCA :
  • DEYSE DE SOUZA DANTAS
  • JANAINA CRISTIANA DE OLIVEIRA CRISPIM FREITAS
  • KLEYTON SANTOS DE MEDEIROS
  • Data: 16-oct-2023


  • Resumen Espectáculo
  • This review aims to present an overview of p16/Ki-67 dual-staining (DS) expression in Liquid Based Cytology (LBC) in samples from patients with cervical cancer (CC). Material and Methods: This scoping review was developed following the guidelines for systematic reviews and meta-analyses for scoping reviews (PRISMA-ScR). A literature search using PubMed, Lilacs, Web of Science and Scopus electronic databases was conducted to identify studies that used DC for expression of p16/Ki-67 in CC in immunocytochemistry in LCB. The process of selecting and extracting data in a paired and independent way. The quality of included studies was assessed using the Joanna Briggs Institute Levels of Evidence. The review was registered in the Open Science Framework (OSF): DOI 10.17605/OSF.IO/9MUBQ. Results: Of the 149 studies analyzed, 7 studies, published between January 2018 and May 2023, were included in the qualitative synthesis. As expression parameters, p16/Ki-67 has been reported for DS in CBL in CC. Furthermore, we found that p16/Ki-67 in the CBL sample were expressed in squamous cell carcinoma (SCC). Conclusions: The study suggested that DC p16/Ki-67 is more frequently related to the CC group when compared to the HSIL and NILM group.

7
  • SUERDA EMILIANA CAVALCANTI DANTAS
  • Situational diagnosis of surgical congenital heart diseases in the state of Rio Grande do Norte.

  • Líder : VIVIANE SOUZA DO AMARAL
  • MIEMBROS DE LA BANCA :
  • CIPRIANO MAIA DE VASCONCELOS
  • DANIELLA REGINA ARANTES MARTINS SALHA
  • VIVIANE SOUZA DO AMARAL
  • Data: 20-oct-2023


  • Resumen Espectáculo
  • Introduction - Congenital heart defects are the most common congenital anomalies and account for 8% of infant mortality, causing a great impact on morbidity and mortality in the pediatric age group. However, in Brazil, underreporting of cardiac malformations suggests that the diagnosis is made late, which prevents early surgical treatment. In Rio Grande do Norte (RN) the dimension of this situation is unknown, requiring greater detail, so that public policies to reduce morbidity and mortality due to cardiac malformations can be implemented at the state level. Given this scenario, the objective of this study was to describe the prevalence of surgical congenital heart defects in children from the cases observed at Hospital Rio Grande, the only reference center in pediatric cardiac surgery in the state. Methodology - After approval by the Research Ethics Committee, a cross-sectional study was started with analysis of electronic medical records of patients with surgical congenital heart disease admitted to the state's pediatric cardiology ICU, which operates at Hospital Rio Grande, from October 2018 to December 2022. The collected data were analyzed, firstly, through descriptive statistics using the JAMOVI 2.3.21 software. The frequency of cases by municipality and Health Region (HR) was represented by maps, using the Qgis 3.22.6 software. A generalized linear model using binomial distribution was also performed. Results –There were 594 admissions of children, with a mean age at admission of 2 years and 1 month, with 86% of the procedures performed by the SUS. It was observed that 41.7% of the patients resided in the VII HR, which includes the state capital and adjacent municipalities. There was a higher prevalence of surgical congenital heart diseases in the Health Regions located in the territorial strip to the south of the state. There was a predominance of procedures classified as severity score RACHS-1 categories 2 (38.6%) and 3 (33.7%). There were 59 deaths, 77.9% of which were patients with cyanotic defects, with a mean age of 6.9 months. Higher mortality was observed in category 6 RACHS-1 procedures. Risk factors for postoperative death were length of stay in the ICU (p<0.001), level of surgical complexity (p<0.01), need for reoperation (p<0.005) and diagnosis of cyanotic heart disease (p<0.05). On the other hand, municipal HDI and distance to the service were not associated with risk of death. The total length of hospital stay was a protective factor for death. Evaluation of DATASUS data from 2019 to 2022 indicated a scenario of underreporting and deficit of surgical procedures in RN. Conclusion – The results found serve as potential support for the development and implementation of public policies that allow improving care for children with heart defect, from prenatal care to clinical and surgical treatment, in the state of RN and in other locations in Brazil. Furthermore, the finding of a specific territorial area with a higher prevalence of surgical congenital heart disease calls for further investigation into the genetic and environmental factors involved in the etiology of congenital heart defect in this region and in adjacent territorial areas of the semi-arid region in other states.

8
  • ANDREIA SUELLE MOURA FONSECA
  • Trigger tool for optimizing pharmacotherapeutic follow-up in high-risk pregnant women: development and validation.

  • Líder : RAND RANDALL MARTINS
  • MIEMBROS DE LA BANCA :
  • FRANCISCA SUELI MONTE MOREIRA
  • RAND RANDALL MARTINS
  • RODRIGO DOS SANTOS DINIZ
  • Data: 25-oct-2023


  • Resumen Espectáculo
  • Introduction: clinical pharmacy seeks to improve pharmacotherapy care and uses strategies and tools for this purpose. However, there are no tools aimed at pharmaceutical care for high-risk pregnant women. Objective: to develop and validate a trigger tool to optimize the identification of drug-related problems (DRP) in hospitalized pregnant women. Methods: descriptive observational study developed in a Brazilian maternity hospital from September 2019 to July 2022. Based on the profile and frequency of prescription, the main parameters for monitoring effectiveness and safety were used to develop triggers. The trigger tool was validated with 150 pregnant women simultaneously evaluated using the SOAP method by two groups: test group (only applied the SOAP method if at least one positive trigger) and standard group (all patients evaluated). The investigation involved identification and characterization of PRMs via PCNE. The tool was characterized in terms of accuracy, sensitivity, specificity and predictive values, in addition to using the Brier method for validation. Results: The trigger tool had a sensitivity of 74.1% (95%CI 67.7 - 81.1), specificity of 70.7% (95%CI63.4 - 78.0) and accuracy of 73.2% ( 95%CI65.3 - 79.7). Internal validation showed a Brier score of 0.269. Conclusion: The evaluated tool showed moderate sensitivity and predictive value acceptable positive, making it a useful tool in the initial screening and identification of possible DRPs in patients.

9
  • RENATA POLLIANA DE OLIVEIRA NASCIMENTO
  • EFFICACY OF PHYSIOTHERAPY FOR TREATING VULVODYNIA: A SYSTEMATIC REVIEW

  • Líder : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • MIEMBROS DE LA BANCA :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • MICHELLY NOBREGA MONTEIRO
  • ANA PAULA FERREIRA COSTA
  • Data: 27-oct-2023


  • Resumen Espectáculo
  • Background: Vulvodynia is described as pain in the vulvar region that impacts dramatically women's lives leading to sexual dysfunction, reduction in self-esteem and decrease in the quality of life. Neurologic (central and peripheral) mechanisms may be associated to this condition, thus systematic reviews focusing the efficacy and benefits of physiotherapy on this population are necessary for consolidated evidence to aid clinical practice. Objectives: To assess the efficacy of physiotherapy for vulvodynia. Methods: The present systematic review was designed and reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). PubMed, Embase, Scopus, Web of Science, SciELO, PEDro, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched on February 2023. Two authors selected and extracted the data independently. The risk of bias was assessed using the Cochrane Risk of Bias tool (Rob 2). Due to the high heterogeneity presented between the studies, it was not possible to carry out the qualitative analysis. The results were presented in narratively. PROSPERO registration: CRD42023394207. Results: A total of 2.274 articles were retrieved from the databases. Seven studies met the criteria and were included in a systematic review, a total of 477 patients. The interventions included were electromyography biofeedback (n= 2), Transcutaneous electrical nerve stimulation TENS (n= 1), Transcranial direct current stimulation (TDSC) (n= 1), LowIntensity Shockwave (LISWT) (n= 1), physiotherapy treatment (n= 1), and pelvic floor exercise more behavioral modifications (n= 1). Of the seven studies present in the article, all evaluated pain reduction, five evaluated sexual function, and two evaluated qualities of life. All interventions were effective for the main outcomes; only the TDSC intervention had no significant difference when compared to the placebo group (Sham). Three studies presented a high risk of bias due to the lack of studies blinding. Conclusions: The studied interventions (electromyography biofeedback, TENS, Shockwave, physiotherapy, and pelvic floor exercise) seem to improve pain, sexual function, and quality of life. However, the heterogeneity of the studies prevented the metaanalysis. Additionally, well-designed trials are needed to improve the certainty of the evidence.

10
  • MARCELA QUEIROZ LOPES DE MELO MARTINS
  • Evaluation of cytokines in patients undergoing in vitro fertilization before and after ovarian stimulation protocol in women with infertility.

  • Líder : JANAINA CRISTIANA DE OLIVEIRA CRISPIM FREITAS
  • MIEMBROS DE LA BANCA :
  • JULIANA MEOLA LOVATO
  • DANIEL CARLOS FERREIRA LANZA
  • JANAINA CRISTIANA DE OLIVEIRA CRISPIM FREITAS
  • Data: 30-oct-2023


  • Resumen Espectáculo
  • The search for biomarkers that have a predictive and prognostic value in the pathophysiology of the infertility process between couples is one of the objectives of reproductive immunobiology studies. It is known that immunoregulatory molecules and expression of pro/anti-inflammatory mediators have a contribution in reproductive medicine. However, the role of these molecules in the physio pathogenesis of infertility is still unknown. This study aims to evaluate the protein expression of the cytokine axis of Th1, Th2 and Th17 responses in women who present infertility before and after ovarian stimulation protocol. A prospective cohort pilot study was conducted with 20 women followed by the assisted reproduction outpatient clinic from September 2021 to September 2022 at a University Hospital. As an inclusion criterion, we selected women over 18 years of age diagnosed with infertility due to different etiologies and causes with clinical indication for the treatment of in vitro fertilization (IVF). Women with autoimmune diseases, immunodeficiencies, chronic diseases and genetic syndromes linked to sex chromosomes did not participate in the study. 5ml of whole blood was collected by venous puncture for the quantification of cytokines by flow cytometry at two different times: Time 0: Before the start of the ovarian stimulation protocol (without medication) and at time 1: On the day of ovarian puncture for collection of oocytes (after medication for ovarian stimulation). For statistical analysis, Spearman correlation with p&lt;0.05 values was performed. We observed a negative correlation between the fertilization rate and the production of TNF-α (p0.041) independent of the Th17 response. In this context, we observed a modulation of the Th1 response, suggesting a contribution of the adaptive immune response, as well as modulation of pro-inflammatory cytokines in the process of oocyte maturation and fertilization, suggesting a contribution of the immune response in fertility. Strategies to regulate this immunomodulation are still poorly studied.

11
  • AMANDA GABRIELA ARAUJO DA SILVA
  • ASSOCIATION BETWEEN THE CONSUMPTION OF ULTRA-PROCESSED FOODS AND THE GLYCEMIC PROFILE OF WOMEN WITH GESTATIONAL DIABETES MELLITUS AND THEIR NEWBORN

  • Líder : KARLA DANIELLY DA SILVA RIBEIRO RODRIGUES
  • MIEMBROS DE LA BANCA :
  • FERNANDA RAUBER
  • DANIELLE SOARES BEZERRA
  • KARLA DANIELLY DA SILVA RIBEIRO RODRIGUES
  • Data: 29-nov-2023


  • Resumen Espectáculo
  • The high consumption of ultra-processed foods (UPF) has caused unfavorable effects on the health of the population and on the nutritional quality of the diet, however, there are still few studies that evaluate the impact of this consumption on metabolic outcomes of mother-child pairs in Gestational Diabetes Mellitus (DMG). Thus, the objective of the study was to evaluate the association between UPF consumption and the glycemic profile of women with GDM followed at a high-risk prenatal clinic and the occurrence of hypoglycemia in their newborns. The study was observational, longitudinal, prospective, cohort, with women diagnosed with GDM and their newborns. Data collection took place at least two times during prenatal care (during the 2nd and 3rd trimester of pregnancy) and immediately after birth. The assessment of food consumption was carried out according to the NOVA classification, with pairs grouped according to tertiles of energy contribution of UPF in the diet. The glycemic profile was assessed by fasting blood glucose, self-monitoring of capillary blood glucose (fasting, one hour after breakfast, one hour after lunch and one hour after dinner) in pregnant women, and according to capillary blood glucose levels in their newborns in the first 48 hours of life. Binary logistic regression analyzes were performed to evaluate the relationship between the increase in UPF participation, considering the highest tertile of UPF consumption as a reference category, in the control of glycemia in women with GDM at the time of the research and the occurrence of hypoglycemia in their neonates (&lt;50 mg/dL). 94 couples participated in the study, whose average caloric intake for women was 1,936 Kcal (1228 – 3124 Kcal), with 15% of the energy coming from UPF. Regarding the glycemic profile, 33.3% (n=30) and 52.3% (n=45) of them presented hyperglycemia in the second and third trimester of pregnancy, respectively. It was observed that UPF consumption had no significant association with maternal glycemic control, but showed a positive association with the occurrence of neonatal hypoglycemia (OR: 1.14; 95% CI: 1.037-1.262; p=0.007). Thus, the data suggest that the consumption of UPF can impact the occurrence of neonatal hypoglycemia in newborns of high-risk pregnant women, reinforcing the inclusion of guidelines for promoting healthy eating during pregnancy in nutritional assistance protocols for pregnant women with GDM.

12
  • HÍVILA NAYANNA DA SILVA MOREIRA
  • Wilms’ Tumour 1 as biomarker in preeclampsia.

  • Líder : MARCELA ABBOTT GALVAO URURAHY
  • MIEMBROS DE LA BANCA :
  • JEFFERSON ROMÁRYO DUARTE DA LUZ
  • MARCELA ABBOTT GALVAO URURAHY
  • VICTOR HUGO REZENDE DUARTE
  • Data: 21-dic-2023


  • Resumen Espectáculo
  • Preeclampsia (PE) is a pregnancy multisystemic injury characterized associated to hypertension, since the 20th week of pregnancy. Other signal and symptoms may be present, including proteinuria, thrombocytopenia, and/or hemolysis, kidney and liver injury, epigastric pain, headache and visual injuries. According to the moment of onset, PE may be classified in early or late, with different associated pathophysiological processes. In recent years, studies of PE related kidney damage have shown an association with podocytes. Therefore, podocyte biomarkers, such as Wilms’ Tumour 1 (WT-1), have been studied. Given this, the present study sought to evaluate the expression of WT-1, present in urinary extracellular vesicles (EVs), in order to investigate its potential as a biomarker in pre-eclampsia. 23 pregnant women with preeclampsia and 9 normotensive pregnant women were included in the study. Pregnant women with PE were also classified according to the period of development of PE, as well as whether they had resistant hypertension or not. Quantification of WT-1 present in EVs was performed by Western-blot, after isolation of the vesicles by ultracentrifugation. In addition, serum biochemical parameters were determined and demographic data was collected to characterize the studied population. Although significant differences were found for WT-1 in the PE groups compared to the control group, no difference was observed between the PE groups. Thus, it is suggested that WT-1 has potential as a disease marker.

13
  • MARIA CLARA DE ARAUJO SILVA CAVALCANTI
  • Association between 25-hydroxyvitamin D concentrations in pregnant women with preeclampsia and neonatal outcomes.

  • Líder : MARCELA ABBOTT GALVAO URURAHY
  • MIEMBROS DE LA BANCA :
  • ANNA CHRISTINA DO NASCIMENTO GRANJEIRO BARRETO
  • DANIELLA REGINA ARANTES MARTINS SALHA
  • MARCELA ABBOTT GALVAO URURAHY
  • Data: 22-dic-2023


  • Resumen Espectáculo
  • Preeclampsia is a multifactorial and multisystem disease, specific to pregnancy, which manifests itself in previously normotensive pregnant women after the 20th week of pregnancy. Due to its systemic character, it is associated with maternal, perinatal and neonatal severity situations. Hypovitaminosis D is related to preeclampsia, increases the risk of premature birth, low birth weight, metabolic bone disease, bronchopulmonary dysplasia,  respiratory distress syndrome and neonatal sepsis, suggesting a protective role for this vitamin in the maternal-fetal interface. The aim of the study is to determine the association between 25-hydroxyvitamin D concentrations in pregnant women with preeclampsia and neonatal outcomes. So far, 7 pregnant women and their newborns have been included in the study, whose mothers, aged over 18 years, were previously diagnosed with preeclampsia and were followed up by the research group. Vitamin D was measured by chemiluminescence and data collected from electronic medical records. For statistical analysis, Spearman's aid was applied. For continuous variables, the median value was determined within the interquartile range referring to the 25th and 75th percentiles. P value < 0.05 was considered statistically significant. As the maternal profile data had a mean age of 28.4 years. The pregnant women's body mass index was classified as obese and the average time of sun exposure was 2.7 hours. The mean serum concentration vitamin D in pregnant women was 29.1 ng/mL. All newborns were born by cesarean delivery, 57.1% were female, gestational age and mean birth weight were 35.4 weeks and 2580g, respectively. All RNs were admitted to the MEJC. The mean length of stay in the NICU and in the other wards was 32.3 and 7.4 days, respectively. No deaths were recorded among maternal and neonatal participants. Due to insufficient sample size to date, it has not been possible to correlate maternal vitamin D levels with preeclampsia and neonatal deaths. Thus, the characterization of the sample was carried out.

2022
Disertaciones
1
  • MAIARA COSTA DE OLIVEIRA
  • Rumo À Maternidade: Validation Of A Telemonitoring Mobile Application For Pregnant Women.

  • Líder : MARIA THEREZA ALBUQUERQUE BARBOSA CABRAL MICUSSI
  • MIEMBROS DE LA BANCA :
  • MARIA THEREZA ALBUQUERQUE BARBOSA CABRAL MICUSSI
  • ANNA GISELLE CAMARA DANTAS RIBEIRO RODRIGUES
  • BELISA DUARTE RIBEIRO
  • Data: 27-sep-2022


  • Resumen Espectáculo
  • Pregnancy, the latent phase of labor, labor, and the puerperiumare are periods of
    increased expectancy not only of the woman but also of the complete family. This
    phase of life is expected to be marked by anxiety, which may favor the anticipation of
    hospital departure before the active phase of labor. Therefore, this study aimed to
    develop and validate a telemonitoring mobile application for pregnant women in their
    last gestational trimester. This validation study involved 40 volunteers, of whom 10
    were obstetrician professionals, 10 were professionals of technology, and 20 were
    pregnant women of at least 36 weeks of gestation. The health professionals evaluated
    the app content through the Content Validity Index, the technology professionals
    through the software appearance questionnaire, and the pregnant volunteers through
    the System Usability Scale to evaluate the app usability. The “Rumo à maternidade”
    app was developed with React Native technology and is composed of three interfaces
    as follows: Educational, Symptoms Record, and My Pregnancy. The final score of the
    Content Validity Index was 0.91 for content and 0.78 for appearance. Additionally,
    the usability score was 0.85. Once all obtained scores were in the expected range for
    the app usage, additional interviews were not necessary. To conclude, the mobile app
    “Rumo à Maternidade,” which was developed and validated in the Portuguese
    language in Brazil, is a helpful tool with good usage acceptance to promote health
    education during the third trimester of pregnancy and facilitate labor identification.

2
  • JÉSSIKA ALINE DO NASCIMENTO MEDEIROS
  • Characterization of Th17, Th1 and Th2 axis cytokine profile and gene polymorphism in patients with cervical cancer.

  • Líder : JANAINA CRISTIANA DE OLIVEIRA CRISPIM FREITAS
  • MIEMBROS DE LA BANCA :
  • JANAINA CRISTIANA DE OLIVEIRA CRISPIM FREITAS
  • PAULA RENATA LIMA MACHADO
  • MARCIA EDILAINE LOPES CONSOLARO
  • Data: 24-oct-2022


  • Resumen Espectáculo
  • Cervical cancer (CCU) is a public health problem that affects many women around the world and its etiology and pathogenesis are intrinsically linked to Human Papillomavirus (HPV), representing the fourth cause of death among women. Estimates report that about 80% of sexually active women will acquire an infection in their lifetime. It is known that the host's immune system, in most cases, is able to eliminate the HPV virus, but in some cases the patient will develop a persistent infection, which will culminate in the emergence of cervical cancer. Considering the importance of the immune system in this process, it is necessary to understand the cells and mechanisms involved. Therefore, evaluating the T helper cell pattern 1, 2 and 17 (Th1, Th2 and Th17) via cytokine quantification and associating the gene polymorphism of the IL-17-RA17 axis is the objective of the present study. This is a case-control observational study, with retrospective data and samples acquisition, having been collected from 2015 to 2019, and the study population consisted of 428 samples from a group of patients with indication of intraepithelial lesion and cervical cancer at the Cervical Pathology and Oncology outpatient clinic of the Januário Cicco Maternity School and the Hospital Luiz Antônio da Liga Contra o Câncer, they were stratified into 104 (24 %) with cervical cancer (CC), 125 (29 % ) with high-grade lesions, 86 (20%) with low-grade lesions, 104 (24%) were NILM, and 9 (3%) had indeterminate lesions, and the patients identified as NILM were classified as controls in this study. The execution of this work involves carrying out the gene polymorphism of IL17A and IL17RA in the following steps: DNA extraction and quantification; Polymerase Chain Reaction (PCR); and electrophoresis, while cytokine quantification was performed using the BD™ Cytometric Bead Array (CBA) Human Th1/Th2/Th17 cytokine kit. In our series, the data showed that there seems to be no association between the gene polymorphism of the IL-17-RA17 axis and the diagnosis of CC, in addition, in our study, the cytokines presented values below the detection limit, which can be justified by the action of HPV being a little cytopathic virus, imperceptible to the immune system.

3
  • ARTHUR NORONHA COSTA DO NASCIMENTO
  • PERINATAL TRANSMISSION OF CYTOMEGALOVIRUS IN PREMATURE NEWBORNS THROUGH BREAST MILK

     

  • Líder : PAULA RENATA LIMA MACHADO
  • MIEMBROS DE LA BANCA :
  • PAULA RENATA LIMA MACHADO
  • NAYARA GONÇALVES BARBOSA
  • KLEBER JUVENAL SILVA FARIAS
  • Data: 27-oct-2022


  • Resumen Espectáculo
  •  

    Human cytomegalovirus (CMV) is a double-stranded linear DNA virus and has a wide distribution worldwide, with its seroprevalence varying according to several epidemiological factors. Breastfeeding represents an important route of transmission of several infections from mother to child, including perinatal CMV infection. The present study is justified by the need for studies that address the incidence of cases of perinatal transmission and the correlation with risk factors and clinical outcome of premature neonates, contributing to the best decision to be made regarding breastfeeding, weighing the risks and benefits and, therefore, adopting the best medical conduct in Neonatal Intensive Care Units (NICU) regarding the safety of breast milk. The overall objective of this study was to evaluate the perinatal transmission of CMV in premature newborns (NB) from a NICU through breastfeeding. The study was observational, longitudinal cohort, prospective, involving premature newborns admitted to the NICU of the Januário Cicco Maternity School (MEJC) during the period from September 30, 2021 to June 2, 2022 with gestational age less than 33 weeks or birth weight less than 1500g, excluding cases of severe birth defects. All mothers underwent postpartum blood draws and were tested for CMV seropositivity. The biological samples of preterm infants' urine and breast milk were submitted to molecular biology techniques (extraction, PCR, and electrophoresis). Clinical and laboratory data were obtained from medical records obtained by the Neonatology team of the maternity ward. Partial results showed seropositivity for IgG anti-CMV antibodies in 76/77 mothers (98.70%) and IgM in 3/77 patients (3.90%). The rate of virus detection in breast milk was analyzed in 21/63 (33%) mothers with available milk samples. The incidence of perinatal infection via breast milk was analyzed in 3/45 (6.66%) RNs with available urine samples. It was not possible to associate perinatal infection with clinical symptoms and risk factors for disease development due to the limited incidence of perinatal infection cases.

4
  • AURORA TATIANA SOARES DA ROCHA
  • Success prediction in inserted of the peripherally central catheter insertion in newborns.

  • Líder : SILVANA ALVES PEREIRA
  • MIEMBROS DE LA BANCA :
  • SILVANA ALVES PEREIRA
  • CECILIA OLIVIA PARAGUAI DE OLIVEIRA SARAIVA
  • EDIENNE ROSANGELA SARMENTO DINIZ
  • Data: 31-oct-2022


  • Resumen Espectáculo
  • Introduction: Newborns in critical condition hospitalized in Neonatal Intensive Care Units often need prolonged intravenous therapy for the recovery of their health and the peripherally inserted central catheter is the most indicated for the safe infusion of these solutions. However, the placement of this catheter in newborns can be difficult, becoming a challenge for the nursing team, predisposing the baby to multiple peripheral punctures, stress and pain. A particularly important aspect for this population is the lack of data on prediction equations for successful insertion of this device. Thus, this study aims to develop a prediction equation for success in peripherally inserted central catheter insertion in newborns. Methods: This is an observational, retrospective study carried out with the medical records of newborns admitted to the neonatal intensive care unit who used peripherally inserted central catheters between August 2018 and July 2021, whose sample was 359 newborns. Data on duplicated or incompletely and/or incorrectly completed newborns were excluded. Catheter insertion was considered successful when the tip of the catheter was inserted into the lower third of the superior vena cava from an upper extremity and into the upper third of the inferior vena cava from a lower extremity. Binary association tests and logistic regression were applied. Variables with p<0.05 remained in the final regression model. Results: 359 newborns were included between 23 and 41 weeks (median of 31 weeks and 4 days), 284 were on mechanical ventilation (invasive or non-invasive) and 70 progressed to successful PICC insertion. Being extremely premature, very premature and premature reduced the probability of PICC success by an average of 31.2% (95%CI: 25.5 to 38.1%), 21.4% (95%CI: 17.8 to 25. 7%) and 16.7% (95%CI: 14.0 to 19.8%) respectively. In addition, being on invasive and noninvasive ventilation reduced the probability of PICC success by an average of 82.4% (95%CI: 72.3 to 93.9%) and 85.3% (95%CI: 75.0 to 97.1%), respectively. The newborn's weight above 1500 grams and the access performed in the upper body region favored the success of the PICC in 2.5 and 2.93 times, respectively. Weight classification, gestational age, insertion site and being or not on mechanical ventilation were variables that were kept in the equation. The predictive equation for PICC success found was: OR PICC success = 0.178 x (IG classification) x (region) x (sup. vent.) x (weight classification). Conclusion: Gestational age classification and being on mechanical ventilation reduce the probability of successful introduction of PICC. While weight > 1500 grams and insertion of the catheter in the upper region increase the chance of success of the PICC. The predictive equation found is a practical and reproducible tool that can reduce the risk and complications related to unsuccessful catheter insertion.

5
  • IVETE MATIAS XAVIER
  • MATERNAL/FETAL OUTCOMES IN HYPERTENSIVE PREGNANCY SYNDROMES.

  • Líder : ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • MIEMBROS DE LA BANCA :
  • ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
  • ROBINSON DIAS DE MEDEIROS
  • KLEYTON SANTOS DE MEDEIROS
  • Data: 31-oct-2022
    Ata de defesa assinada:


  • Resumen Espectáculo
  • Objective: To assess and compare maternal/fetal outcomes among women with hypertensive disorders in pregnancy (DHGs). Methods: Cross-sectional observational study, carried out at the Januário Cicco Maternity School (MEJC). Maternity of the Federal University of Rio Grande do Norte (UFRN), a reference for the care of high-risk pregnant women. The population will be composed of women hospitalized with a diagnosis of Gestational Hypertensive Disorders. As inclusion criteria for the cohort will be adopted: All women with gestational hypertensive disorders. Will be excluded: Patients diagnosed with gestational hypertensive disorders associated with other comorbidities, smokers, chemical dependents and unable to respond to the questionnaire. Information will be collected from the medical records of women and their newborns assisted at the MEJC, from June 2020 to June 2021, after the project is registered with the Teaching and Research Management (GEP) of the MEJC and after approval by the Committee of Ethics and Research of the Onofre Lopes University Hospital (CEP/HUOL). Results: Data analysis will be performed using the SPSS 17.0 statistical software, which will be presented in the form of tables, graphs and/or tables. Pearson&#39;s Chi-square test and Fisher&#39;s exact test, when relevant, will be used to compare the results. The research will follow the ethical and legal norms recommended by Resolution 466/12 of the National Health Council. Conclusion: It is hoped, with the knowledge of the determining factors of Gestational Hypertensive Disorders, can contribute to an improvement in care, in order to reduce the occurrence of complications of these problems, benefiting the pregnant woman and the newborn, as well as the health team. , with the improvement of clinical care for the maternal/fetal binomial.

6
  • TATIANA CAMILA DE LIMA ALVES DA SILVA
  • ASSESSMENT OF THE FATIGUE LEVEL OF WOMEN IN THE PUERPERIA: A COHORT STUDY

  • Líder : MARIA THEREZA ALBUQUERQUE BARBOSA CABRAL MICUSSI
  • MIEMBROS DE LA BANCA :
  • MARIA THEREZA ALBUQUERQUE BARBOSA CABRAL MICUSSI
  • ADRIANA GOMES MAGALHAES
  • GUILHERME PERTINNI DE MORAIS GOUVEIA
  • Data: 31-oct-2022


  • Resumen Espectáculo
  • The puerperium is a period of vulnerability due to the emotional and physical changes that occur after childbirth and that can influence a woman's quality of life. In this context, the decrease in physical andmental capacity associated with a persistent lack of energy, deficiencies in concentration, decreased rest and sleep time can favor the installation of physical and mental fatigue. The prevalence and incidence of postpartum fatigue has not been studied extensively and is considered an inevitable, temporary and frequently experienced symptom. This study aims to assess the level of fatigue of women in the immediate and late postpartum period and to associate it with sociodemographic and clinical factors. Through a prospective cohort study, 469 women were recruited from a public maternity hospital in the city of Natal-RN, from May to December 2021. The evaluations took place in the immediate postpartum period (between 24-48 hours) and in the puerperium. late (in the 1st and 3rd month after delivery). An evaluation form containing information on sociodemographic, clinical, gynecological-obstetric and newborn data was applied in the first evaluation along with three questionnaires for fatigue assessment: Global Short Form of selfreported global health from the Information System of Measurement of Outcomes by patient (PROMIS-GSF); multidimensional fatigue inventory (MFI) and fatigue pictogram. These data, with the exception of sociodemographic information, were applied one month after the assessment (AV2) and three months after delivery (AV3). Descriptive analysis of variables was used with mean, standard deviation, median, 25th and 75th percentiles, absolute and relative frequencies. Repeated measures ANOVA was used to compare the results of the three fatigue assessments. The multivariate model was adjusted for independent variables with significance ≤ 0.20 in the bivariate analysis and considering the clinical relevance for the occurrence of the outcome. The most prevalent age group was 26 to 34 years old, 59.5% completed elementary school, 47.6% had a salary income of up to one minimum wage and 76.1% reported having a partner. In obstetric information, 70.6% were multiparous with a median gestational age of 38 weeks, 60.5% had normal delivery, 95.7% breastfed after delivery, and 80.2% breastfed in past pregnancies. in the three evaluations showed a significant difference in the PROMIS-GSF (p < 0.01), general fatigue domains, physical fatigue and reduced motivation of the MFI (p < 0.01) and the fatigue pictogram (p < 0.01). In AV3, the PROMIS-GSF showed an association between fatigue and premature births (RR = 1.18; 95%CI: 1.02–1.37), absence of a support network (RR = 1.14; 95%CI: 1, 02–1.27), poor breastfeeding performance (RR = 1.16; 95%CI: 1.03– 1.31) and higher body mass index (BMI), (RR = 1.01; 95%CI: 1.005 –1.018). From the analysis of the results of this study, one can observe the presence of fatigue in the immediate postpartum period and its increase over three months postpartum. Prematurity, lack of a support network, poor performance in breastfeeding and higher BMI were factors associated with the persistence of fatigue in the late postpartum period.

7
  • JÉSSICA ESCOREL CHAVES CAVALCANTI
  • Adverse drug reactions in hospitalized diabetic and hypertensive pregnant women.
  • Líder : RAND RANDALL MARTINS
  • MIEMBROS DE LA BANCA :
  • RAND RANDALL MARTINS
  • RODRIGO DOS SANTOS DINIZ
  • SARA IASMIN VIEIRA CUNHA LIMA
  • Data: 06-dic-2022
    Ata de defesa assinada:


  • Resumen Espectáculo
  • Introduction: Pregnant women are particularly vulnerable to adverse drug reactions (ADRs), especially those with diabetes and hypertension. The occurrence of ADRs is a problem for patient safety and quality of health care. Objective: To detect the incidence and factors associated with ADRs in hospitalized diabetic and hypertensive pregnant women. Method: Observational, longitudinal and prospective study with the aim of evaluating the incidence of ADRs in diabetic and hypertensive pregnant women, their characteristics and factors related to their occurrence, involving 572 diabetic and hypertensive pregnant women. To determine the factors associated with the ADRs, a multivariate model by logistic regression will be used. Results:The incidence rate of ADRs was 634.4 ADR per 1,000 patient days (95%CI: 522.7 - 787.1) and 21.5% of patients had at least one. Hyperglycemia, blurred vision and increased transaminases were the ADRs most related to the use of systemic corticosteroids, antimetheic and anti-nausea drugs, and centrally acting anti-adrenal drugs. Longer hospitalization time (OR 1052, 95%CI: 1010 – 1097, p = 0.016) and greater number of prescribed medications (OR 1200, 95%CI: 1099 – 1310, p < 0.001) were related to the occurrence of ADRs. Conclusion: In general, we observed that ADRs are affected in the first 24 hours and that pregnant women with longer hospital stays and using more medications are at greater risk of ADR.

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