https://repositorio.unimontes.br/handle/123456789/30 2026-04-30T12:52:49Z https://repositorio.unimontes.br/handle/1/2577 Título: Diversidade genética de Trypanosoma cruzi em indivíduos com doença de Chagas crônica no Norte de Minas e Vale do Jequitinhonha: uma abordagem integrada com ações de uma só saúde Autor(es): Xavier, Emanuelle de Moura Santos Abstract: Chagas disease is one of the main parasitic endemics in Latin America, affecting millions of people. Caused by the protozoan Trypanosoma cruzi, the disease is characterized by considerable genetic diversity in the parasite, which can influence the clinical progression of the disease in individuals. Given this genetic variability, it is essential to investigate how different T. cruzi isolates impact disease progression. This study is composed of four scientific outputs. The first aimed to assess the genetic diversity of Trypanosoma cruzi in individuals with chronic Chagas disease from endemic municipalities in the North of Minas Gerais and the Jequitinhonha Valley, Minas Gerais, Brazil. The research sought to correlate the identified genotypes with age, parasite load, antibody levels, and cardiac severity in participants from the SaMi- Trop cohort. Molecular typing was performed using conventional multilocus PCR on blood samples from individuals with the cardiac form of the disease. Of the 80 samples analyzed, 37 (46%) were successfully genotyped. The most frequent of the genotypes observed were TcII/TcVI (40.54%) and TcII (16.21%), followed by similar frequencies for TcVI and TcI (13.51% each) and TcV (8.10%). Three individuals presented mixed infections. Most DTUs (67.6%) were identified in individuals over 61 years old, although no statistically significant difference was observed. Parasite load varied widely among individuals, ranging from 0.06 to 667 parasite equivalents/mL. Participants infected with TcV showed higher mean parasite loads and elevated anti-T. cruzi antibody titers. A significant association was found between DTUs and levels of B-type natriuretic peptide (BNP), a marker of heart failure. Understanding DTU diversity is critical for improving diagnostic approaches, optimizing treatments, and strengthening epidemiological control strategies for Chagas disease. The second product aimed to report the experience of conducting a health education activity on Chagas disease in endemic areas in Minas Gerais, specifically in Espinosa and São Francisco municipalities. The activity included dialogued banner presentations, displays of vector insects, T. cruzi microscopy, human anatomical models, distribution of pamphlets and booklets, and educational activities for children. A multidisciplinary team addressed topics related to the disease's transmission, lifecycle, diagnosis, treatment, and prevention. The activity reached approximately 500 participants in each municipality. It modes and clinical manifestations and had difficulty identifying the vector. The educational activity demonstrated that public knowledge of Chagas disease is limited or nonexistent even in endemic areas. The third and fourth scientific products, a pitch and a children's booklet were developed to raise awareness about Chagas disease. The pitch is available on different digital platforms, providing feedback to the community. The booklet, used in the health education activity, presents Chagas disease playfully and interactively, with activities specifically designed for children, who act as knowledge multipliers by disseminating information about the disease in an accessible and educational manner, contributing to increased awareness about Chagas disease. In summary, this thesis contributed to understanding the eco- epidemiology of Chagas disease and promoted educational activities aligned with the One Health approach 2024-12-20T00:00:00Z https://repositorio.unimontes.br/handle/1/2576 Título: Laserterapia e qualidade de vida de pacientes com úlceras vasculogênicas e pé diabético Autor(es): Souto, Simone Guimarães Teixeira Abstract: Skin lesions represent an important global public health problem, as they entail high costs to health services, social, social security and individual impacts, in addition to being frequently related to recurrences and prolonged and complex treatments, impairing the quality of life of affected patients. In this sense, the general objective of the study was to compare the influence of adjuvant laser therapy versus treatment with spcial dressings alone on the healing score and parameters lesion area, amount of exudate, and tissue type of venous ulcer and diabetic foot lesions. 32 patients with difficult-to-heal wounds participated in the research, undergoing treatment at the wound clinic In the study referring to the u1 product, a single-center, randomized clinical trial was conducted. In product 2 a descriptive-exploratory and cross sectional study was conducted with a quantitative approach, the studies were carried out in the municipality of Montes Claros - Minas Gerais - Brazil, at the wound outpatient clinic of the municipality's care network, the study population related to product 1 was composed of 17 patients with venous ulcers and 15 with a diagnosis of diabetic foot attended in a service, They were divided into the intervention group, which received the laser intervention associated with the conventional treatment used by the service, and the control group, which received only the conventional treatment already used by the service. The study population related to product 2 consisted of 18 patients diagnosed with venous ulcers who underwent conventional treatment and laser therapy in the years 2021 to 2023, the inclusion criteria were to have had a skin lesion of the venous or diabetic foot ulcer type for at least four weeks, to be 18 years of age or older, and to be regularly attending treatment on the days scheduled for care and as criteria Participants with chronic lesions of other etiologies were adopted. In relation to product 1, the variables investigated were: sociodemographic characteristics (gender, age, skin color, marital status, years of schooling, professional activity and income), behavioral characteristics (performed physical exercises in the last three months and participates in religious activity), clinical conditions (BMI [body mass index], associated diseases, type of treatment and lifestyle), characteristics of the lesion (time and region) and PUSH scale with its components (area, amount of exudate and type of tissue). In relation to the study associated with product 2, the variables investigated were: sociodemographic characteristics (gender, age, skin color and years of schooling), behavioral characteristics (performed physical exercises in the last three months, participated in religious activities and ingested alcoholic beverages), clinical conditions (type of treatment and intensity of pain) and characteristics of the lesion (time, region, area, amount of exudate and type of tissue). Sociodemographic and behavioral variables, clinical conditions, and lesion characteristics were considered independent variables. The variable quality of life (Wound-Qol) was the dependent variable, categorized by ≤ mean and > mean. The studies were approved by the Research Ethics Committee of the State University of Montes Claros. Two scientific articles were prepared, in the first one comparing the influence of adjuvant laser therapy versus conventional treatment alone on the healing score and parameters lesion area, amount of exudate and type of tissue of skin lesions such as venous ulcer and diabetic foot. After the use of laser therapy, the clinical conditions of the wounds, total lesion area, amount of exudate and type of tissue improved at the end of the treatment, in relation to the score of the PUSH instrument there were better averages on day 30, the final period of treatment, also indicating better healing with the use of laser, although no significant difference was recorded between the components of the scale and the use of adjuvant laser therapy showed better healing outcomes in the intervention group of patients with diabetic foot. The second article aimed to evaluate the quality of life of patients with venous ulcers and associated factors, thus, the daily life and psychological domains obtained the highest levels of impairment, impairing the overall score of general quality of life, and the highest scores were concentrated in the "body and financial" domain. Self-reported lack of physical activity, alcoholism, and injury exudate were associated with quality of life. The results of the studies can contribute to a better organization of care services for people with skin lesions based on an efficient technology capable of being handled by properly trained professionals, also considering the impact of lesions on the quality of life of these people 2025-06-26T00:00:00Z https://repositorio.unimontes.br/handle/1/2575 Título: Inflamação, Exercício Físico e Armadilhas de Neutrófilos Extracelulares (NETs) no tecido adiposo e Avaliação dos efeitos crônicos do Exercício Físico intenso no tecido adiposo de camundongos obesos Autor(es): Sousa, Berenilde Valéria de Oliveira Abstract: Obesity results from the excessive accumulation of body fat and chronic low-grade inflammation. Physical exercise, at different intensities, modulates metabolic and inflammatory pathways, establishing itself as a therapeutic strategy. From this perspective, the present study aimed to evaluate inflammation, physical exercise, and neutrophil extracellular traps (NETs) in adipose tissue, as well as the chronic effects of intense physical exercise on the adipose tissue of obese mice. The first product of this thesis consisted of a review with bioinformatics analysis, which explored the relationship between physical exercise, obesity, and NETs. The review showed that NET formation, although essential for combating pathogens, can contribute to the worsening of chronic inflammation and metabolic dysfunction in obesity. The in silico analysis identified genes and signaling pathways associated with NETs that are modulated by exercise, including TNF-α, IL-6, and TLR4, all of which are related to inflammatory activation, oxidative stress, and metabolic regulation. These findings indicate that regular physical exercise may reduce the exacerbated activation of these structures, thereby attenuating systemic inflammatory processes. The study also highlighted the difference between the acute and chronic effects of physical exercise, where acute stimuli tend to increase the release of pro-inflammatory cytokines and NET formation, whereas chronic exercise exerts a regulatory effect, reducing low grade inflammation associated with obesity. This product reinforces the importance of physical exercise as a non-pharmacological strategy to modulate immune and inflammatory responses. The second product experimentally evaluated the impact of high-intensity continuous aerobic exercise on the adipose tissue of mice with diet induced obesity. To this end, the study investigated the signaling pathways mTORC, AKT, GATOR2, SESN2, and GPX1, which are related to energy metabolism, oxidative stress, and adaptive responses to exercise. Three groups of SWISS mice were used in the experiment: the control group (standard diet), the HFD group (obese without exercise), and the HFD + HICT group (obese fed a high-fat diet and subjected to a high-intensity continuous aerobic training protocol for eight weeks). During the treatment period, body weight was measured. At the end of the experiment, glucose tolerance and insulin sensitivity tests were performed to assess glycemic metabolism. The animals were then sacrificed by decapitation, and blood samples were collected for biochemical analyses. The study was approved by the Experimental Research Ethics Committee of the State University of Montes Claros. The main findings showed that trained mice had a significant reduction in body weight, total cholesterol, and HDL. In addition, high-intensity training decreased adipocyte size in epididymal adipose tissue and reduced adiposity. Significant modulation was also observed in the expression of genes essential for the regulation of metabolism and the response to oxidative stress, such as MTOR, AKT, GATOR2, SESN2, and GPX1. This study contributed to the understanding of the metabolic effects of HICT in obesity, demonstrating a possible mechanism of action via mTOR signaling, with impacts on energy metabolism and oxidative stress response. In conclusion, this thesis demonstrated that physical exercise can modulate NETs and inflammation, in addition to promoting adipose tissue remodeling and activating metabolic pathways, thus representing a promising strategy for the management of obesity 2025-09-09T00:00:00Z https://repositorio.unimontes.br/handle/1/2574 Título: Qualidade de vida, fadiga por compaixão e prevenção quinquenária: interfaces com a saúde do trabalhador Autor(es): Silva Junior, Rene Ferreira da Abstract: Occupational health refers to a field of public health that aims to understand the relationship between work and the health/disease process. In this sense, studies that evaluate this relationship are essential for proposing measures to promote, protect, restore, and assist workers' health, as they can lead to an understanding of how a professional's quality of life is affected and its intersection with the work performed. Specifically in the case of healthcare professionals, there is a constant state of overload, conflicts with patients, colleagues, and management, insufficient infrastructure, as well as feelings of fear and anguish due to the experience of frequent suffering and pain among the patients receiving care. Consequently, these emotional repercussions can cause significant mental suffering for professionals, which, when related to feelings of compassion and difficulty in dealing with these repercussions, can lead to compassion fatigue, defined as a state of exhaustion, as well as biological, psychological, and social dysfunction. Recently, considering the discussions regarding the emotional repercussions of healthcare work, a new preventive level of healthcare was proposed, referred to as quinquennary prevention, which concerns the biopsychosocial care of healthcare professionals so that they can provide more effective and higher quality care. To research these interfaces, four studies were conducted, which will be presented as scientific products. In product 1, the quality of life and associated factors among healthcare professionals working in highly complex hospital sectors for critical and chronic patients were evaluated. A cross-sectional and analytical epidemiological study was conducted with 490 professionals from a macro-regional healthcare system in northern Minas Gerais, Brazil. The lowest quality of life mean scores were found in the environment domain, while the highest mean scores were found in the social relations domain. The lowest perceptions of quality of life were associated with the 30-39 age group, the occupations of nutritionist and physical therapist, depressive symptoms, and being overweight, while having two or more jobs, hypertension, and being a nurse were identified as protective factors. Product 2 aimed to understand the feelings experienced by healthcare professionals affected by compassion fatigue when providing care to cancer patients in referral hospitals located in the northern region of the state of Minas Gerais, Brazil. A descriptive qualitative research study was conducted using a phenomenological approach based on Husserlian analysis. The intentional sample was identified by a previous assessment of the variable compassion fatigue in healthcare professionals working in oncology departments via the Professional Quality of Life Scale instrument. The results reflected the following feelings: pain, anguish, and compassion; attachment and empathy; suffering and defense mechanisms; affective ambivalence and satisfaction; and reframing. Regarding product 3, the aim was to construct and validate a multiprofessional educational booklet on compassion fatigue for healthcare professionals. A methodological study was conducted based on the construction and validation of an educational booklet on compassion fatigue for healthcare professionals, with the technology entitled “Compassion fatigue: what do we need to know?” which achieved a satisfactory content validity index for all aspects of objective, structure/presentation, and relevance of the material after analysis by specialist judges. Thus, this technology can be used in continuing education for healthcare professionals to help them deal with compassion fatigue and the emotional repercussions of healthcare work. Product 4 aimed to map the concepts and support strategies associated with quinquennary prevention in the healthcare professionals' work setting. For this purpose, a historical-conceptual review of quinquennary prevention was conducted. The studies synthesized the theme as a new level of prevention based on biopsychosocial care for professionals, which is reflected in patient care and individual and systemic support measures. A counterpoint to the previously established view of quinquennary prevention can be thought of as a more comprehensive, multiprofessional concept. The outcomes and discussions evidenced from the scientific products presented can contribute to advancements in the fields of collective and occupational health as they enable reflections, meaningful discussions, and the possibility of developing pioneering strategies directed at healthcare professionals, based on perspectives and data collected from them, that is, sensitive to the reality of these professionals 2025-08-06T00:00:00Z