TEDE Coleção:http://www.bdtd.uerj.br/handle/1/35412024-03-28T21:55:08Z2024-03-28T21:55:08ZTransmissão vertical do HIV em uma maternidade pública de referência no nordeste do BrasilFigueredo, Vaneça Santos Lealhttp://www.bdtd.uerj.br/handle/1/209922024-02-26T18:59:55Z2023-08-04T00:00:00ZTítulo: Transmissão vertical do HIV em uma maternidade pública de referência no nordeste do Brasil
Autor: Figueredo, Vaneça Santos Leal
Primeiro orientador: Monteiro, Denise Leite Maia
Abstract: This thesis aimed to estimate the Vertical Transmission (VT) rate of HIV in a reference university hospital in São Luís, in addition to evaluating the factors related to VT. For this, two studies were developed. The first was a retrospective cohort study with the objective of estimating the vertical transmission rate of HIV in university hospital in the period from 2013 to 2017. Retrospective cohort study based on data from the notification/investigation forms of children exposed to HIV from the Notifiable Diseases Information System (SINAN). The analysis considered all HIV-exposed children reported from 2013 to 2017 at the university hospital. The study variables were described as proximal, intermediary and distal, according to the weight on the outcome variable found in the literature. Factors associated with VT were evaluated using Chi-square and crude and adjusted prevalence ratios obtained by Poisson regression. The study population consisted of 725 children exposed, of which 672 children were exposed and not infected and 53 were infected. Therefore, the estimated rate of VT in the period from 2013 to 2017 was 7.3% (53/725). Most pregnant women were ≥20 years old (86.9%), schooling ≥8 years of study (53.2%), black race (92.7%), paid/autonomous work (46.9%) and resident in another municipality in Maranhão (61.7%). Regarding assistance, 86.3% had prenatal care, 74.6% had prophylaxis with Antiretroviral Therapy (ART) during pregnancy, 81.8% used prophylaxis with ART during childbirth and 78.1% had a cesarean delivery. Among Newborns (NB) 92.8% underwent prophylaxis with HAART and 94.3% were not breastfed. Among the distal variables, maternal education (p-value=0.048) and maternal ethnicity (p-value=0.017) were associated with VT; Among the intermediate variables, prenatal care (p-value=<0.001) and antiretroviral therapy prophylaxis during prenatal care (p-value=<0.001) were associated with VT and in relation to the proximal variables, intravenous ART prophylaxis at labor and delivery (p- value=0.042), prophylaxis in the neonate (p-value=0.002) and prophylaxis duration in the neonate (p-value=<0.001) were associated with VT. The second article was also a retrospective cohort study with the objective of evaluating the use of prophylactic measures recommended by the Ministry of Health (MS) to reduce vertical transmission. The analysis considered children exposed to HIV who were notified between 2013 and 2017 at the university hospital and who gave birth at the institution and residence in São Luís. The study population consisted of 205 children exposed during that period. Regarding the prophylactic measures of the ACTG protocol, the majority (85.8%) took prophylaxis during pregnancy, the majority (92.7%) took prophylaxis at birth and had a cesarean section (86.8%). Regarding the NB, the majority (99.0%) underwent prophylaxis and were not breastfed (99.5%). It is concluded that the estimated VT rate in this study was 7.3%, showing that there are still weaknesses in adopting the interventions recommended in the Ministry of Health protocols in their entirety to achieve the reduction and/or elimination of vertical HIV transmission
Instituição: Universidade do Estado do Rio de Janeiro
Tipo do documento: Tese2023-08-04T00:00:00ZAtividade de Orbignya phalerata (babaçu) na prevenção da úlcera péptica em ratos Wistar: estudo morfológico e de citocinasLoureiro, Vanisse Portela Ramos Bulcãohttp://www.bdtd.uerj.br/handle/1/209742024-02-26T18:59:54Z2022-11-22T00:00:00ZTítulo: Atividade de Orbignya phalerata (babaçu) na prevenção da úlcera péptica em ratos Wistar: estudo morfológico e de citocinas
Autor: Loureiro, Vanisse Portela Ramos Bulcão
Primeiro orientador: Domingues, Gerson Ricardo de Souza
Abstract: Peptic ulcer disease has increased in incidence in recent years; it is believed to be due to the high prevalence of H. Pylori infection in the world and the misuse of NSAIDs by the population. Currently, gastroprotective drugs are used for the prevention and treatment of peptic ulcers, however no drug is free from side effects. The use of plants as medicine is probably as old as the appearance of man himself. The concern with curing diseases has always been present throughout human history. The properties of babassu (Orbignya phalerata) have been studied, as it has already been incorporated by the population of northeastern Brazil for its benefits in the prevention and treatment of diseases, but with little scientific evidence. The objective of this study was to evaluate the capacity of babassu extract on prevent inflammatory response in Wistar rats’ gastric tissue, exposed to Indomethacin, against positive and negative control. The animals were distributed in three groups of five rats each. Group I received the babassu extract, Group II received omeprazole, as positive control, and Group III received distilled water, as negative control. Those three substances were administrated by intragastric gavage. 24 hours after the ulcer induction, with intragastric indomethacin, blood samples were collected, and total gastrectomy was performed. The gastric samples were rinsed with 0,9% saline, then gastric lavage and gastric tissue were systematic analyzed. The parameter for evaluation were presence or absence of Inflammation, Necrosis, Fibrosis, Reepithelization, Neocapillary and Ulcer extension on histologic analysis of the gastric sample, as well as Interleukin-6 (IL-6) and Tumor necrosis factor alpha (TNF-α) levels in gastric lavage and plasma. The histologic assessment has found significantly higher signals of tissue damage, in number, on distilled water group when compared with Babassu group and Omeprazole. The gastric lavage analysis has also shown significant statistically higher concentrations of IL-6 and TNF-α in gastric lavage(p=0,032) in negative control group than in both Babassu and Omeprazole groups. Finally, this study has found that Aqueous Babassu Extract has the property of prevent gastric damage tissue in rats exposed to indomethacin, such property was found to be equivalent to the Omeprazole property, the establish pharmaceutical treatment for preventing
Instituição: Universidade do Estado do Rio de Janeiro
Tipo do documento: Tese2022-11-22T00:00:00ZAssociação dos níveis séricos e urinários de magnésio com a composição corporal e marcadores inflamatórios em portadores de doença renal crônica não dialíticaDias, Raimunda Sheyla Carneirohttp://www.bdtd.uerj.br/handle/1/209662024-02-26T18:59:55Z2022-11-11T00:00:00ZTítulo: Associação dos níveis séricos e urinários de magnésio com a composição corporal e marcadores inflamatórios em portadores de doença renal crônica não dialítica
Autor: Dias, Raimunda Sheyla Carneiro
Primeiro orientador: Bernardo-Filho, Mario
Abstract: Reduced magnesium (Mg) levels may be associated with mortality or adverse cardiovascular outcome in chronic kidney disease (CKD). The aim of this study was to evaluate the association of serum and urinary Mg levels with body composition and inflammatory markers in patients with non-dialysis dependent CKD. Longitudinal, prospective study for a period of 24 months, with a sample of patients with CKD on non-dialysis treatment, in stages 3A, 3B and 4, of both sexes and aged 20 years or older. Data collection occurred in three steps: t1 (inclusion), t2 (12 months) and t3 (24 months). At each moment of the study, sociodemographic, lifestyle, anthropometric, body composition, clinical and laboratory data were collected. Sociodemographic, lifestyle, anthropometric, body composition, clinical, and laboratory data were collected. Venous samples were collected after a 12-hour night fast and included: creatinine, Mg, calcium, sodium, uric acid, phosphorus, parathormone, vitamin D, triglycerides, cholesterol, high density lipoprotein, low density lipoprotein, fasting glycemia, alkaline phosphatase, complete blood count, interleukin 6 (IL6) and ultrasensitive C-reactive protein. The 24-hour urine was used to dose urinary excretion of Mg and creatinine. The dietary intake of magnesium was estimated by means of the 24-hour food recall. The anthropometric evaluation was performed by measuring body mass, height, abdominal sagittal diameter and waist circumference (WC), calf circumference and neck circumference. To evaluate body composition, Dual-energy X-ray absorptiometry and Air Displacement Plethysmography were used. A linear regression model with random effects was ajusted to investigate the impact of serum and urinary Mg levels on body composition and inflammatory status. The final study sample consisted of 134 patients with a mean age of 60.2±12.0 years and 52.2% were female. The prevalence of excess weight according to the body mass index was 57.1% and the percentage of body fat (%BF) was high at 66.9%. Women had a higher prevalence of high %BF (77.5% vs 56.6%; p=0.005). Men had a higher average consumption of calories (p<0.001). As for the intake of macro and micronutrients, no statistically significant difference was observed between genders. There was no statistically significant difference between serum and urinary Mg levels with CKD stages. In the adjusted model, percentage of lean mass and dietary intake of magnesium were positively associated with serum magnesium. Triglyceride levels, uric acid, WC and fat mass percentage were negatively associated with serum magnesium. For urinary Mg, in the adjusted model, estimated glomerular filtration rate, IL6, dietary Mg intake and lean mass percentage showed a positive association. The results of this study demonstrated that serum and urinary levels of Mg were positively associated with lean body mass. Total and core body fat were negatively associated with serum magnesium. Furthermore, a positive correlation was shown between urinary magnesium and the inflammatory state. A low dietary intake of Mg was identified in the surveyed population
Instituição: Universidade do Estado do Rio de Janeiro
Tipo do documento: Tese2022-11-11T00:00:00ZQualidade de vida de usuários transexuais atendidos em ambulatório de um hospital universitário no nordeste do BrasilRamos, Aline Sharlon Maciel Batistahttp://www.bdtd.uerj.br/handle/1/209612024-02-26T18:59:55Z2022-12-23T00:00:00ZTítulo: Qualidade de vida de usuários transexuais atendidos em ambulatório de um hospital universitário no nordeste do Brasil
Autor: Ramos, Aline Sharlon Maciel Batista
Primeiro orientador: Taquette, Stella Regina
Abstract: Health care for the Lesbian, Gay, Bisexual, Transvestite, Transgender and Transgender (LGBTTT) population, within the scope of the Unified Health System (SUS), has specific needs, both for the qualification of health team professionals and for the doors access to care at different levels of care. The objective of the study was to evaluate the quality of life (QoL) of transsexual users monitored at the sexuality and gender outpatient clinic of the University Hospital of the Federal University of Maranhão (HUUFMA) and to analyze their perception of the experience of transsexuality. To this end, a mixed quantitative and qualitative study was carried out between March 2018 and December 2021. Three questionnaires were used to collect data in the quantitative stage: one with identification, social and demographic data, another from the Brazilian Association of Research Companies, for economic classification; and the third, the WHOOQL-Bref, for measuring QoL, from the World Health Organization, all analyzed using the SPSS 21.0® statistical program. In the qualitative stage, data were collected through individual interviews with a script of open questions about QoL and transsexuality. The data were recorded, transcribed in full and submitted to Content Analysis. We interviewed 71 individuals, the majority between 18 and 26 years old (67.6%), with complete secondary education (71.8%), single (76.1%), unemployed (54.9%), living in the capital of the state (63.4%), brown (57.7%) and from social class D to E (50.7%). Low QoL rates were observed, with worse results for the Psychological Domain (12.5%) and Environment (37.5%), with no statistical significance for differences between trans men and women. In the qualitative study, three thematic categories were highlighted: discovering transsexuality: trans(training) and identity; the right to exist: obstacles to citizenship; and body transformation: feelings involved in the search for the desired and socially accepted body. For the participants, transsexuality is understood as a complicated and difficult process, which generates different feelings such as happiness, fear and shame. The perception of gender identity, different from biological sex, occurs since childhood, which causes suffering in social relationships and difficulties in having their rights respected. Living transsexuality means being able to exist as a unique individual and to guarantee this right it is necessary to deepen the debate on the sexuality of transgender people. It was concluded that the experience of transsexuality is associated with suffering and low QoL. There is a clear need to expand multidisciplinary discussions on sexuality and gender, public policies that encourage institutional/local actions, and the strengthening of support networks for vulnerable populations
Instituição: Universidade do Estado do Rio de Janeiro
Tipo do documento: Tese2022-12-23T00:00:00Z