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Dissertations |
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PAULA ARARUNA BERTAO
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ASSOCIATION BETWEEN CARDIOTOXICITY RISK AND ELECTROCARDIOGRAPHIC FINDINGS IN PATIENTS SUBMITTED TO ANTHRACYCLINE CHEMOTHERAPY.
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Advisor : BRIVALDO MARKMAN FILHO
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COMMITTEE MEMBERS :
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MARCELO RENATO GUERINO
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SANDRO GONCALVES DE LIMA
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SIMONE CRISTINA SOARES BRANDAO
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Data: Jul 19, 2022
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Show Abstract
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Introduction: Anthracycline chemotherapy treatment is associated with cardiotoxicity. Echocardiography is a useful tool in the detection of early myocardial injury. The electrocardiogram still has no established role in this scenario. Objective: To analyze the association between electrocardiographic changes and the development of subclinical cardiotoxicity in cancer patients undergoing treatment with anthracycline. Methods: Prospective cohort of cancer patients treated with anthracycline. Transthoracic echocardiograms with global longitudinal strain and electrocardiogram were performed before the start of treatment, at 3 and 6 months of follow-up to assess the presence or absence of subclinical cardiotoxicity, defined by a relative drop in global longitudinal strain greater than 15% in relation to the initial measurement. on at least one echocardiogram. Fisher's exact test was applied to assess this association. Results: Of the 33 patients included (mean age = 49 ± 9.5 years), 23 had breast cancer. Eight (24.24%) had incipient cardiotoxicity. QTc in women was higher than baseline at 6 months by both Bazett and Fridericia (p = 0.011 and p =0.038, respectively). There was an association, in women, between QTc > 460ms (corrected by Bazett) at 3 months and a drop in global longitudinal strain >15% in this period (p=0.043). Conclusion: The presence of QTc > 460ms at 3 months in women was associated with subclinical cardiotoxicity.
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2
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LARISSA CAROLINE DE ALMEIDA SOUSA LIMA
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EVALUATION OF THE EFFECT OF A BIOPRODUCT OBTAINED FROM Parkinsonia aculeata ON COMPONENTS OF THE RENIN-ANGIOTENSIN SYSTEM (RAS) IN THE RENAL TISSUE OF RATS WITH EVIDENCE OF METABOLIC SYNDROME
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Advisor : MARIA BERNADETE DE SOUSA MAIA
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COMMITTEE MEMBERS :
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GUSTAVO PINA GODOY
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BELMIRA LARA DA SILVEIRA ANDRADE DA COSTA
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ERYVELTON DE SOUZA FRANCO
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Data: Aug 24, 2022
Ata de defesa assinada:
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Show Abstract
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Obesity is recognized as a global public health problem, associated with the development of several non-communicable chronic diseases that can cause disorders and alterations such as those observed in metabolic syndrome (SM). Thus, the objective was to evaluate the effect of the polar fraction obtained from the aerial parts of Parkinsonia aculeata (PfrHEPA), the expression of the AT1 receptor for angiotensin II in the renal tissue in an experimental model of SM. For SM induction, 24 male Wistar rats were fed a Western diet (DO) for 150 days, divided into 4 groups (n=6) and the control group (n=6) was fed a standard diet (SD). During the 150 days, the animals were monitored weekly for weight gain, and at the end of this period, the systemic blood pressure (SBP) was evaluated and blood was collected to evaluate the lipid, glycemic and hematological profile, to verify the establishment of SM in these animals. The MS groups maintained their DO and were treated for 30 consecutive days with PfrHEPA 70mg/kg, PfrHEPA 140mg/kg), metformin 500mg/kg or vehicle 10mL/kg, orally. At the end of treatment, PAS was determined and blood was collected for biochemical and hematological evaluation. Subsequently, the animals were euthanized under anesthetic depth to collect the renal tissue in order to analyze the expression of the AT1 receptor for angiotensin II by means of immunohistochemistry. It was evidenced that all animals submitted to DO developed SM, presenting obesity, dyslipidemia, hyperglycemia and arterial hypertension. After treatment, the animals that received PfrHEPA (70mg/kg or 140mg/kg) showed a significant reduction in serum levels of total cholesterol (22% and 32%); triglycerides (44% and 51%) and blood glucose (27% and 43%) respectively; in relation to blood pressure levels, treatments at the same doses reduced by 22% and 24%, respectively. This result is in line with the immunohistochemical findings, where there was a reduction in the expression of the AT1 type receptor of angiotensin II in the glomerulus and renal tubule of the treated animals. In the histopathological analysis of the renal tissue, no morphostructural changes were observed. Thus, it is concluded that PfrHEPA, regardless of the doses tested, was able to reduce the expression of the AT1 receptor and modulate blood pressure in Wistar rats with SM.
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3
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DIEGO RAFAEL FREITAS BERENGUER
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18F-FDG PET/CT IN THE EARLY DIAGNOSIS OF CARDIOTOXICITY: EVALUATION OF THE BEST SITE TO OBTAIN THE CARDIAC SUV INDEX
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Advisor : BRIVALDO MARKMAN FILHO
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COMMITTEE MEMBERS :
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DINALDO CAVALCANTI DE OLIVEIRA
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ANDREA BEZERRA DE MELO DA SILVEIRA LORDSLEEM
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MARIA INES REMIGIO DE AGUIAR
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Data: Aug 26, 2022
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Show Abstract
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The diagnosis of cardiotoxicity has been a challenge in the daily routine of the oncologist. Today's diagnostic methods are not capable of detecting this clinical condition early enough. In this context, studies indicate that 18F-FDG PET/CT is a complementary test that can identify cardiotoxicity earlier. In this way, cardioprotection measures can be started earlier, improving the chances of increasing patient survival. Objective: To evaluate the behavior of the standardized uptake value (SUV) of the radiopharmaceutical 18F-FDG before, during and after chemotherapy (QT) at different cardiac sites, as well as to measure the degree of reproducibility for the method in the context of cancer treatment follow-up. Materials and Methods: Retrospective cohort including lymphoma patients who underwent 18F-FDG PET/CT before, during and/or after chemotherapy. The uptake behavior through the mean and maximum SUVs was evaluated in four cardiac sites and in control sites in the aorta and liver. Twenty exams were randomized for reproducibility analysis by two examiners who were blinded to each other's results. Each one of them did the evaluation in a second moment to elucidate the intra-observer reproducibility. Results: A significant increase in SUVs was observed in all cardiac sites in the interim and final moments (post-terminus of QT) when compared with pre-QT SUVs. The left ventricular (LV) free wall was the cardiac region with the greatest increase in 18F-FDG uptake. As for the reproducibility, it was possible to verify substantial results for the reliability of the measurement of SUVs, both intra and inter-observer. Conclusions: Cardiac uptake of 18F-FDG increased along QT, with the LV free wall being the site with the greatest increase. The reproducibility analysis showed high intra- and inter-observer correlation values.
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4
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JULIANNA RIBEIRO DO VALE SILVA
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EFFECTS OF RADIOFREQUENCY AND MICRONEEDLING ON THE QUALITY OF LIFE IN WOMEN WITH ALBA STREAKS: A RANDOMIZED BLIND CLINICAL TRIAL
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Advisor : MARCELO RENATO GUERINO
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COMMITTEE MEMBERS :
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MARIO RIBEIRO DE MELO JUNIOR
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JULIANA NETTO MAIA
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MARIA DAS GRACAS RODRIGUES DE ARAUJO
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Data: Aug 30, 2022
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Show Abstract
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The stretch marks are lesions of the dermal layer of the skin, commonly caused by a sudden stretching of the skin, being aggravated by hormonal, extrinsic and intrinsic factors. They are classified as rubras and alba, caused by an acute lesion and chronic, respectively. This study aims to verify the effects of the association of non-ablative bipolar radiofrequency with microneedling in the treatment of alba streaks. This is a blind randomized clinical trial, carried out in the electrothermophototherapy laboratory of the Federal University of Pernambuco. The sample was divided into two groups, group MICRO and RF+MICRO, performed microneedling therapy, and group radiofrequency associated with microneedling, respectively. Both groups had a total of three sessions. The evaluations were made with conventional and thermographic photographs, application of a quality-of-life questionnaire, anamnesis, physical evaluation, and a final questionnaire about the participant's vision after the end of the research. There was no significant difference between groups regarding the increase in local temperature. Pain and the final score of the dermatology quality of life questionnaire also showed no distinction. The results analyzed from conventional photographs were also not significant. Thus, there was no difference between the microneedling compared to the association of radiofrequency and microneedling in the alba streaks treatment.
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5
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LAISA WANESSA SANTOS LIMA
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EVALUATION OF THE EFFECT OF THE POLAR FRACTION OF THE EXTRACT OF AERIAL PARTS OF Parkinsonia aculeata L. ON COMPONENTS OF THE RENIN-ANGIOTENSIN SYSTEM (RAS) AND ON MARKERS OF OXIDATIVE STRESS IN THE HEART TISSUE OF RATS WITH METABOLIC SYNDROME
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Advisor : MARIO RIBEIRO DE MELO JUNIOR
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COMMITTEE MEMBERS :
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IVONE ANTONIA DE SOUZA
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GLORIA ISOLINA BOENTE PINTO DUARTE
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SINARA MÔNICA VITALINO DE ALMEIDA
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Data: Nov 16, 2022
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Show Abstract
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Changes in eating habits and a sedentary lifestyle over the last few years have influenced the increase in obesity, considered a worldwide epidemic. The increase in energy supply through a diet rich in simple carbohydrates, lipids and low in fiber, linked to the reduction of physical activity, called contemporary western lifestyle, triggers metabolic disorders such as dyslipidemia, type 2 diabetes mellitus, cardiovascular diseases, among others. In this context, the purpose of the study was to analyze the effect of the polar fraction of the extract of aerial parts of Parkinsonia aculeata L. (PfrEHPA) on RAS components and on oxidative stress markers in the cardiac tissue of male Wistar rats after weaning ( 21 days) initially divided into two groups that received a standard diet for rodents (Presence ®) or a “Westernized” diet (OD) for 150 days. Then, these animals were divided into 5 subgroups which were treated orally for 30 consecutive days with PfrEHPA (70 or 140 mg/kg/day), metformin (500 mg/kg/day) or distilled water (10 mL/day). kg/day). During the 150 days of diet consumption, the weekly food consumption, weight evolution, body dimensions and lipid profile of the animals were recorded. These same parameters were determined again after the treatment described above. At the end of the experiment (180 days) blood samples were collected to determine the hematological and biochemical profile. Subsequently, the animals were euthanized under anesthesia and decapitation and then the organs were weighed and stored, part in formalin (10%) for later histological and immunohistochemical analysis, and part stored in a freezer with a temperature maintained at -80ºC, which was used for the analysis of oxidative extraction. Our results showed that animals submitted to the Westernized Diet showed signs of metabolic syndrome (increased waist circumference, hyperlipidemia, hyperglycemia). The change in the lipid profile of the DO group was evidenced by a significant (p<0.05) increase in serum levels of total cholesterol (91 ± 1.57), LDL (37.2 ± 2.05) and triglycerides (135, 67 ± 2.09) in relation to the PD group (64.67 ± 1.16 ; 23.67 ± 1.88 and 75 ± 4.01, respectively). These animals also showed a significant (p<0.05) increase in fasting glucose (mg/dl) compared to animals that ingested PD. The treatment with PfrEHPA (140 mg/kg), even with the continued consumption of the westernized diet by the animals (150th – 180th days), promoted a significant reduction in the levels of total cholesterol (62.33±0.80), LDL (21 .70±0.63) and triglycerides (68.16±0.79) in relation to the untreated OD group (92±0.73; 37.77±1.45 and 141.17±1.14, respectively). Additionally, treatment with PfrEHPA (140 mg/kg) also reduced serum glucose levels, systolic blood pressure and levels of oxidative stress in the cardiac tissue of these animals.
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LEONORA CASTRO TENÓRIO
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EFFECTS OF OSTEOPATHIC MANIPULATIVE TREATMENT IN THE MUSCULOSKELETIC MANIFESTATIONS OF CHRONIC PHASE CKIUNGUNYA FEVER: RANDOMIZED CLINICAL TRIAL
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Advisor : CLAUDIA DINIZ LOPES MARQUES
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COMMITTEE MEMBERS :
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GUSTAVO PINA GODOY
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ALINE RANZOLIN
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PAULO HENRIQUE ALTRAN VEIGA
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Data: Dec 12, 2022
Ata de defesa assinada:
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Show Abstract
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The Chikungunya Fever (FC) is an epidemic illness with high morbidity rate and presents disabling arthralgia as its main clinical characteristic. Studies indicate an elevated intake of analgesic and low satisfaction during the treatment of the chronic stage. Osteopathic manipulative treatment (OMT) is a manual therapy technique, which uses mobilization and manipulation of body tissues for pain relief, improvement of musculoskeletal manifestations as well as improvement of joint functionality, presenting itself as a treatment strategy for rheumatologic diseases. The aim of this study was to evaluate the effects of OMT on the reduction of chronic musculoskeletal manifestations (pain and functional disability) in CF patients. A randomized, controlled, blind for the evaluators trial was carried out, in which 44 patients were included for analysis, divided into two groups: intervention group,which received OMT, with 24 patients; and placebo control group, with 20 patients. The osteopathy group (OG) underwent 4 sessions of OMT intervention and was reassessed within 15 days and 30 days since theirlast session, at the rheumatology clinic of the Hospital das Clínicas de Pernambuco, with protocol elaborated by the researcher. These being the inclusion criteria: men and women aged 18 years old or more; to be monitored by the CF clinic at the Hospital das Clínicas; clinical serology diagnosis for CF; present pain and rigidity in superior limbs, having more than three months of duration of the symptoms, and consenting to participate of the study. These being the exclusion criteria: patients with inflammatory joint diseases, prior to CHIKV infection; diseases that compromise functionality of the upper limbs; cognitive, auditory and visual impairment preventing the application of assessment instruments; diagnosis of neoplasia, chronic infectious diseases or other rheumatologic illnesses,and have been undergoing physical therapy treatment within the previous 2 months. The sample was obtained by spontaneous demand and recruitment. The outcome variables were: pain measured with the Visual Analog Scale (VAS), the Brief Pain Inventory Questionnaire (BPI) besides Algometer and functionality, collected with the aid of the Disabilities of the Arm, Shoulder, Hand Questionnaire (DASH) and the nine-hole peg test (9HPT). The data were analyzed quantitatively, analytically and measured in effect size. For analysis of the results, the significance level adopted was p=0.05. The average age of the sample was 53.55 (16.5) years, most of them female (95.0%). Regarding pain intensity, during the analysis of the primary endpoint, an efficacy of 77.3% was observed, the 15-day follow up showed continued improvement with efficacy of 91.5%, and 81.2% within 30 days, after the intervention with OMT, p≤0.05. In the analysis between the groups, a statistically significant reduction in pain for the OG was observed with differences in the last session (S4) = 1.2, within the 15-day follow-up (S5) = 1.84, and within 30 days (S6) = 1.45 point when compared to the control group (CG). In the intra-group analysis, when comparing the initial session to the last one and follow-ups, only the OG presented a significant statistical reduction. Regarding the secondary endpoint, of pain and functionality, it was observed an efficacy in all the evaluated instruments as well as in both 15-day and 30-day follow-ups after undergoing the OMT, except for the algometry and the 9HPT test, where there was no statistically significant improvement in both intra-group and inter-group analysis for the OG (p<0.05). It can be concluded that OMT has proved to be effective in reducing pain besides improving the functionality of patients with musculoskeletal manifestations in the chronic stage of CF.
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