Monografias, Dissertações e Teses
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Resultados da Pesquisa
Item Ensaio clínico sobre o efeito da Fotobiomodulação e da Terapia Fotodinâmica na cicatrização de lesões crônicas(Universidade Brasil, 2021) Moreira, Isabel Cristina Cavalcante Carvalho; Nunez, Silvia CristinaIntroduction: Chronic wounds can be defined as those that do not advance in relation to the orderly tissue repair process and compromise anatomical integrity and tissue repair time. Neuropathic ulcers are chronic lesions and one of the most stigmatizing sequelae of diabetic foot and leprosy-associated wounds, their presence is quite impairing for the individual and can lead to deformation and/or amputation of the affected limb. For the treatment of these wounds, there are a variety of existing topical products, including hydrogel. Besides, treatment through the use of photobiomodulation therapy (PBM) and photodynamic therapy (PDT) has shown positive results in the repair process. Objective: To evaluate the effects of PBM and PDT with methylene blue, associated or not with urea, on the healing of chronic wounds caused by diabetes and leprosy. Methodology: This is a blind randomized clinical trial. There were 17 volunteers with chronic diabetes wounds that were divided into 4 groups: Group I hydrogel with alginate (n=3), Group II PBM with diode laser λ= 660 nm, power of 100 mW, with 4J applied every 1 cm (n=6), Group III PDT with methylene blue at 100 µM associated with red emission diode laser λ = 660 nm, power of 100 mW with 9 J every 1 cm (n=5), and Group IV methylene blue 100 µM PDT associated with 2M urea (n=4) and the same irradiation parameters as G III. And 13 volunteers with chronic leprosy lesions divided into 4 groups: Group I hydrogel with alginate (n=3); Group II PBM with diode laser λ= 660 nm, power of 100 mW, with 4J applied every 1 cm (n=4) ; Group III PDT with methylene blue at 100 µM associated with red emission diode laser λ = 660 nm, power of 100 mW with 9 J every 1 cm (n=3) and Group IV PDT with methylene blue at 100 µM associated with 2M urea and the same irradiation parameters as G III. For the intervention protocol, the volunteers underwent 8 sessions, comprising 2 sessions a week, on alternate days. Photographic records were used for the macroscopic evaluation throughout the sessions and the measurement of the wound was related to the greatest length versus the greatest width. For all groups, the Pressure Ulcer Scale for Healing (PUSH), was applied to assess the healing process. Results: This study found that diabetic individuals undergoing hydrogel therapy (G I) did not present a reduction in chronic wound size. As measured by the PUSH score, it was not statistically significant (p value = 0.317). However, it was observed that there was a significant reduction in the size of the 9 chronic lesion measured by the PUSH Score between days 1 and 8 in individuals with diabetes for groups G II (p<0.001), G III (p=0.004) and G IV (p=0.001). It was found that in individuals with leprosy undergoing hydrogel therapy, the reduction of chronic wound, measured by the PUSH score, was not statistically significant (p value = 0.096). However, it was observed that there was a significant reduction in the size of the chronic lesion measured by the PUSH score between days 1 and 5 in individuals with leprosy for G II (p value = 0.021), G III (p value = 0.005 ) and G IV PDT+AM 100 µM associated with 2M urea (p value = 0.034). Conclusion: The therapies with PBM and PDT with methylene blue, and PDT with methylene blue associated with urea reduce the size of the chronic wound in diabetic patients, requiring 3 applications. All light therapies evaluated in the study reduced the size of chronic wounds in leprosy patients after five applications.Item Análise temporal da incidência de hanseníase e suas reações em Cáceres-MT(Universidade Brasil, 2020) Dias, Bárbara Klein Bisinella Dias; Amaral, Marcelo Magri; Cortela, Denise CostaLeprosy is a highly prevalent infectious disease in tropical regions and in low to medium income countries, with social inequality and poverty being important risk factors. As it is a contagious infectious disease whose prolonged contact is a primary factor for the transmission of this communicating pathway, the analysis of the distribution of the disease and its determinants in populations, space and time are fundamental aspects. The aim of the present study was to analyze the incidence of leprosy and its reactions in an endemic area of the disease. This is a retrospective observational cross-sectional cut, with data obtained from the Health Surveillance Database, from the National Medical Service System, in the municipality of Cáceres between 2008 to 2018. The variables analyzed were: sex, age, type of leprosy (Paucibacillary or Multibacillary), type of leprosy reaction and location of the notified patient for geoprocessing. In all, 398 cases were reported, 59.11% were male, mean age 44,7 ± 16,9 years and the most common clinical form was multibacillary (53,3%), mostly male (58,8%). Of the total, 50 patients had leprosy reactions, 46% of which were type 1, 36% of type 2 and 18% had both type 1 and type 2 reactions. The neighborhoods with the highest incidence of cases were Rodeio, Vitória Régia, Cavalhada 3 and Jardim Guanabara. From the use of geoprocessing in individuals diagnosed with leprosy, it was possible to find areas with a higher density of cases, which helps in directing public policies for treatment and prevention of the disease.Item Doenças tropicais negligenciadas: caracterização dos indivíduos e distribuição espacial em um município no semiárido do Piauí(Universidade Brasil, 2020) Macedo, Juliana Bezerra; Costa, Adriana Pavinatto da; Rodrigues, Bruno V. M.The study of the occurrence of neglected tropical diseases (NTDs) based on the location of cases and local epidemiology provides data on their distribution, allowing the identification of clusters and understanding at an expanded level, constituting a important management tool in the control and elimination programs. Considering that the majority of NTDs found in the worldoccur in Brazil, a country that has millions of people living at the level of extreme poverty concentrated in Northeast region, this study aimed to perform spatial analysis and characterize individuals diagnosed with NTDs from 2013 to 2018 in the city of Picos, which is a municipality in the semi-arid region of the state of Piauí, northeast region of Brazil. Thus, this research is an ecological, analytical and exploratory study carried out through access to compulsory notification forms contained in the municipality's Epidemiological Surveillance.The final population consisted of 1,532 cases in which descriptive statistics were performed, such as absolute and relative frequencies, proportion ratios and incidence calculations. After verifying the global autocorrelation through the Moran index, the local autocorrelation was evaluated through the LISA (Local Indicators of Spatial Association) using Moran Maps for the spatial representation of the Moran scattering diagram.The results were presented in four axes according to methodological specifications and analyzed diseases. A higher percentage of notified cases of dengue was observed, followed by leprosy and tuberculosis. There was a predominance of cases in female in the reports of dengue, leprosy and schistosomiasis. As for the age group, there is a predominance among adults (20 - 59 years). Most of the notifications pointed out as incomplete elementary schooling, however, the high percentage of ignored in the notifications of dengue cases stands out. The brown race was identified as the majority in all NTD notifications. Only for dengue cases were reported in pregnant women. The reported cases of NTD were concentrated in the urban residence area; however, the incidence is higher in the rural area. Although the highest percentage of cases of tuberculosis and leprosy has been verified in primary care points, thelarge number of notifications in secondary care points stands out. The municipality of showed hyper endemic for leprosy. Regarding dengue, most notifications occurred at the tertiary level. The spatial analysis of the cases located in the urban network showed a cluster of neighborhoods with similar incidence rates in neighborhoods close to the city center. A high-risk cluster was identified in the central neighborhoods of the city, which can help to define the priority areas for specific interventions. The information evidenced in the study on local epidemiology and spatial analysismay contribute to the definition of actions aimed at improving the control and reducing the incidence of NTD cases in the city.Item Estudo clínico cego e randomizado sobre o efeito da fotobiomodulação e da terapia fotodinâmica na cicatrização de lesões crônicas(Universidade Brasil, 2021) Moreira, Isabel Cristina Cavalcante Carvalho; Nuñez, Silvia CristinaChronic wounds can be defined as those that do not advance in relation to the orderly tissue repair process and compromise anatomical integrity and tissue repair time. Neuropathic ulcers are chronic lesions and one of the most stigmatizing sequelae of diabetic foot and leprosy-associated wounds, their presence is quite impairing for the individual and can lead to deformation and/or amputation of the affected limb. For the treatment of these wounds, there are a variety of existing topical products, including hydrogel. Besides, treatment through the use of photobiomodulation therapy (PBM) and photodynamic therapy (PDT) has shown positive results in the repair process. Objective: To evaluate the effects of PBM and PDT with methylene blue, associated or not with urea, on the healing of chronic wounds caused by diabetes and leprosy. Methodology: This is a blind randomized clinical trial. There were 17 volunteers with chronic diabetes wounds that were divided into 4 groups: Group I hydrogel with alginate (n=3), Group II PBM with diode laser λ= 660 nm, power of 100 mW, with 4J applied every 1 cm (n=6), Group III PDT with methylene blue at 100 µM associated with red emission diode laser λ = 660 nm, power of 100 mW with 9 J every 1 cm (n=5), and Group IV methylene blue 100 µM PDT associated with 2M urea (n=4) and the same irradiation parameters as G III. And 13 volunteers with chronic leprosy lesions divided into 4 groups: Group I hydrogel with alginate (n=3); Group II PBM with diode laser λ= 660 nm, power of 100 mW, with 4J applied every 1 cm (n=4) ; Group III PDT with methylene blue at 100 µM associated with red emission diode laser λ = 660 nm, power of 100 mW with 9 J every 1 cm (n=3) and Group IV PDT with methylene blue at 100 µM associated with 2M urea and the same irradiation parameters as G III. For the intervention protocol, the volunteers underwent 8 sessions, comprising 2 sessions a week, on alternate days. Photographic records were used for the macroscopic evaluation throughout the sessions and the measurement of the wound was related to the greatest length versus the greatest width. For all groups, the Pressure Ulcer Scale for Healing (PUSH), was applied to assess the healing process. Results: This study found that diabetic individuals undergoing hydrogel therapy (G I) did not present a reduction in chronic wound size. As measured by the PUSH score, it was not statistically significant (p value = 0.317). However, it was observed that there was a significant reduction in the size of the 9 chronic lesion measured by the PUSH Score between days 1 and 8 in individuals with diabetes for groups G II (p<0.001), G III (p=0.004) and G IV (p=0.001). It was found that in individuals with leprosy undergoing hydrogel therapy, the reduction of chronic wound, measured by the PUSH score, was not statistically significant (p value = 0.096). However, it was observed that there was a significant reduction in the size of the chronic lesion measured by the PUSH score between days 1 and 5 in individuals with leprosy for G II (p value = 0.021), G III (p value = 0.005 ) and G IV PDT+AM 100 µM associated with 2M urea (p value = 0.034). Conclusion: The therapies with PBM and PDT with methylene blue, and PDT with methylene blue associated with urea reduce the size of the chronic wound in diabetic patients, requiring 3 applications. All light therapies evaluated in the study reduced the size of chronic wounds in leprosy patients after five applications.