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Influência da Fissura Labiopalatina no Desenvolvimento Motor em Crianças na Região Oeste do Paraná - Brasil

2026-04-15T12:55:39Z

Title: Influência da Fissura Labiopalatina no Desenvolvimento Motor em Crianças na Região Oeste do Paraná - Brasil Autor: BERTOLDO, Maria Goreti Weiand Primeiro orientador: Costa, Rose Meire Abstract: Cleft lip and palate (CLP) is the most prevalent congenital craniofacial anomaly worldwide; its correction must begin early and requires multiple procedures and prolonged treatment periods, often leading to various complications that may affect infant motor development (MD). Since the literature on this topic is still incipient, this research was conducted in two stages. The first consisted of an integrative review to identify a possible relationship between CLP and delays in MD, and the second investigated the impact of this condition on the motor performance of infants up to 18 months of age. For the review, primary and secondary studies published between 1990 and 2020 were analyzed with no language restrictions. Of the 360 articles extracted using defined criteria from relevant databases, 8 studies were included. The results indicate significant delays in children with CLP, especially in language and fine motor skills, as well as impairments in cognitive, social, and personal domains. The severity and anatomical type of the cleft appeared to be potential modulators of the profile and intensity of delays, although this association was not consistently observed across studies. The observational research with a cross sectional design was conducted at a specialized craniofacial anomaly center in a public hospital in the western macroregion of Paraná, Brazil. Data collection took place between 2020 and 2025, during which 204 infants were assessed, and the type of cleft was classified using the Spina scale, and MD was measured using the Alberta Infant Motor Scale (AIMS). Analyses were performed in R software (version 4.5.1), and homogeneity between categories was assessed using Pearson’s chi square test. Differences in performance between postures in each trimester were analyzed using one-way ANOVA, followed by Tukey’s test (p < 0.05). The results showed that most children with clefts were male (53,4%), with an equivalent distribution among cleft types (pre-foramen 33,3%, , post-foramen 31.0%, trans foramen 37.1%) and a predominance of unilateral clefts (56.0%). It was found that 50.2% of the children scored below the 50th percentile on the AIMS, indicating risk or clear motor delay. The analysis revealed that the supine posture showed early stabilization, whereas the other postures exhibited gradual progression and greater variability, reflecting an increase in biomechanical complexity and postural control demands. Moreover, the study validates the use of the AIMS for this population, providing a useful tool to quantify deficits and support early interventions aimed at ensuring the full motor development of children with clefts. Publisher: Universidade Estadual do Oeste do Paraná Tipo do documento: Tese

Oclusão seletiva e permanente da artéria cerebral média em ratos: uma abordagem experimental para o estudo de déficits motores e de memória espacial

2026-04-15T12:36:43Z

Title: Oclusão seletiva e permanente da artéria cerebral média em ratos: uma abordagem experimental para o estudo de déficits motores e de memória espacial Autor: ALMEIDA, Leandro Pelegrini de Primeiro orientador: Balbo, Sandra Lucinei Abstract: Introduction: Ischemic stroke (IS) has high clinical relevance and demands experimental approaches capable of enabling the development of novel adjuvant therapies. Due to the similarity of cerebral vascular anatomy to that of humans, rats are widely used as experimental models of IS. However, there remains a need for methods that generate an ischemic environment more closely resembling that observed in humans, using an approach that prioritizes selective occlusion of the middle cerebral artery (MCA), the vessel most commonly employed in experimental occlusion models. Objective: To establish a reproducible method for performing craniectomy followed by permanent and selective occlusion of the middle cerebral artery (MCA) in rats, aiming to standardize the procedure, reduce technical challenges, and enable its application in studies of motor deficits and spatial memory impairment. Methods: Twenty-eight Wistar rats (N = 28) were equally allocated into two groups: a craniectomy-only group (SHAM) and a craniectomy combined with selective MCA occlusion group (SMCAO). On postoperative days 7 and 8, animals underwent the postural test and the object location recognition memory test, respectively. After euthanasia, brain tissues were sectioned and processed using Nissl staining. A detailed surgical protocol was developed to demonstrate the feasibility and effectiveness of the method, encompassing preoperative preparation, anesthesia, positioning, craniectomy, MCA occlusion, and closure. Results: The method produced significant deficits in the SMCAO group, as evidenced by the postural test (p = 0.015) and the object location recognition memory test (p < 0.001). Histological examination confirmed the selectivity of the approach, with injury localized to regions associated with the hippocampal network—such as the perirhinal, entorhinal, and piriform cortices—and the external capsule, while deeper brain structures remained preserved. Conclusions: This protocol proved to be a reproducible and effective method for inducing selective MCA ischemia in rats. It represents a valid and technically accessible experimental tool for studies investigating the pathophysiological mechanisms and potential therapeutic strategies in ischemic stroke. Publisher: Universidade Estadual do Oeste do Paraná Tipo do documento: Dissertação

ASSOCIAÇÃO ENTRE A PREVALÊNCIA DE LESÕES POR PRESSÃO EM PACIENTES CRÍTICOS E SUPLEMENTAÇÃO ALIMENTAR HIPERPROTEICA: ESTUDO TRANVERSAL

2026-03-03T19:43:48Z

Title: ASSOCIAÇÃO ENTRE A PREVALÊNCIA DE LESÕES POR PRESSÃO EM PACIENTES CRÍTICOS E SUPLEMENTAÇÃO ALIMENTAR HIPERPROTEICA: ESTUDO TRANVERSAL Autor: Camargo, Nathan Iori Primeiro orientador: Costa, Rose Meire Abstract: Pressure injuries (PI) are localized damage to the skin and underlying tissues, caused by sustained pressure of the epidermis against an external surface or by the combination of pressure and shear forces, and may progress to tissue ischemia, necrosis, and, in severe cases, ulcers and amputations. Hospitalized individuals, especially those admitted to intensive care units (ICUs), are particularly susceptible to these injuries due to reduced mobility, nutritional impairment, and compromised health status. This results in prolonged hospital stays, increased costs, and higher morbidity and mortality. Preventive strategies include systematic risk assessment and specific nutritional care. In this context, nutritional supplementation—especially hyperproteic formulations—has been used as an adjuvant nutritional strategy with potential to contribute to the prevention of PI. This cross-sectional study aimed to analyze the association between PI prevalence and hyperproteic nutritional supplementation in critically ill patients. Data were collected between February and October 2025 through the analysis of secondary data from patients receiving nasoenteral tube feeding who were classified as being at high risk for PI development according to the Braden scale, during ICU hospitalization at a public teaching hospital in western Paraná, Brazil. The sample consisted of electronic medical record data from 152 patients, including sociodemographic, clinical, nutritional, and laboratory variables, analyzed using Jamovi software version 2.4.8. The sample had a mean age of 54.2 ± 19.2 years, with a predominance of adults (56%), males (69%), and a PI prevalence of 44%, with a mean time to injury onset of 9 ± 2.9 days. Neurology was the most frequent medical specialty (49%), and traumatic brain injury was the main cause of hospitalization (21%). Regarding comorbidities, hypertension (37%) and diabetes (23%) were the most prevalent. Among patients who received nutritional supplementation, most did not develop PI (71%, n = 54), and those who did (29%, n = 22) had a mean time of 11 ± 2.4 days until injury onset. In contrast, among patients who did not receive supplementation, 59% (n = 45) developed PI during hospitalization, with a mean time of 8 ± 2.7 days until injury development. These descriptive findings were corroborated by adjusted logistic regression analysis, in which non-use of nutritional supplementation was associated with a higher likelihood of developing PI during hospitalization (adjusted OR = 3.45; 95% CI: 1.54–7.75; p = 0.003). Additionally, achievement of nutritional targets was identified as a protective factor associated with a lower likelihood of PI occurrence, independently of supplement use (OR = 0.18; 95% CI: 0.08–0.39; p < 0.001). Longitudinal analysis of laboratory parameters demonstrated progressive improvement in total protein, albumin, and globulin levels throughout hospitalization, predominantly associated with achievement of nutritional targetsIn conclusion, hyperproteic supplementation was associated with a lower occurrence of PI in critically ill patients, reflecting its preferential use in individuals with greater clinical severity and nutritional risk. Moreover, achievement of nutritional targets was consistently associated with a lower prevalence of PI and improvement in laboratory parameters, reinforcing the central role of adequate nutritional support in the care of critically ill patients. Publisher: Universidade Estadual do Oeste do Paraná Tipo do documento: Dissertação

A HOMEOSTASE FÉRRICA EM ADULTOS COM EXCESSO DE PESO E SUA RELAÇÃO COM COMPLICAÇÕES METABÓLICAS E HEPÁTICAS

2026-02-27T17:36:17Z

Title: A HOMEOSTASE FÉRRICA EM ADULTOS COM EXCESSO DE PESO E SUA RELAÇÃO COM COMPLICAÇÕES METABÓLICAS E HEPÁTICAS Autor: Zanuzo, Késia Primeiro orientador: Grassiolli, Sabrina Abstract: Introduction: Alterations in iron homeostasis, evidenced by elevated serum ferritin (SF) levels, are present in individuals with excess weight and negatively affect insulin sensitivity as well as glucose and lipid homeostasis. These imbalances increase the risk of Metabolic Syndrome (MetS) and Metabolic-Associated Steatotic Liver Disease (MASLD). Factors such as adiposity, sex, diet, and metabolic parameters influence both SF concentrations and the severity of MASLD. However, the relationship among these factors remains poorly understood in the adult population of Paraná, Brazil. Objective: To evaluate the association between SF concentrations and changes in adiposity, nutritional status, metabolic status, and hepatic complications in adult residents of Paraná. Methods: This was a quantitative, descriptive, cross-sectional study with non-probabilistic consecutive sampling, approved by an institutional Research Ethics Committee. Data were collected at a Nutrition outpatient clinic in Southwestern Paraná between 2023 and 2024. A total of 163 adults were evaluated, with collection of socioeconomic data (age, sex, education, income), lifestyle factors (physical activity, alcohol consumption, smoking), anthropometric measurements (weight, height, and adiposity), laboratory tests (glucose, lipid profile, hepatic parameters, SF, complete blood count, inflammatory markers), and dietary information (food frequency questionnaire and 24-hour dietary recall). The prevalence of MetS, the Hepatic Steatosis Index (HSI), and the Fibrosis-4 Index (FIB-4) were also calculated. Results: In the first stage, 79 adults were analyzed, with a median age of 34 (25–44) years. Among them, 67.09% were overweight, which was associated with greater visceral adiposity, hypertension, hyperglycemia, dyslipidemia, and insulin resistance, resulting in a higher prevalence of MetS (30.39%) and increased cardiovascular risk (54.43%) compared to individuals without excess weight (p<0.05). Significant hematological alterations were also identified (p<0.05), including increased hemoglobin, erythrocytes, hematocrit, leukocytes, and platelets, as well as reduced mean corpuscular volume and mean corpuscular hemoglobin. Principal component analysis showed a significant association between visceral adiposity, metabolic and hematological alterations, and elevated SF concentrations in overweight individuals (p<0.05). In the second stage, 113 adults (>18 years) were evaluated and categorized into normal SF and high SF groups. Individuals with high SF were predominantly male (47.4%), married or in a stable union (65.7%), had lower educational attainment (42.1%), higher obesity prevalence (55.3%), and alterations in glycemic, lipid, and blood pressure parameters (p<0.05). Hepatic findings showed that adults with high SF had increased alanine aminotransferase (21.6%), uric acid (29%), and HSI (67.6%) (p<0.05). Logistic regression indicated a higher likelihood of elevated SF among men (OR=16.82) and individuals with high adiposity (OR=7.5). Diet did not influence SF concentrations. PERMANOVA analysis confirmed that adults with high SF present a distinct sociodemographic profile, greater adiposity, and more metabolic and hepatic complications, with no dietary impact. Conclusions: Adults from Paraná with excess weight, high visceral adiposity, and metabolic complications exhibited higher SF concentrations, particularly men. SF appears to be a potential marker of health status and risk of hepatic complications. Publisher: Universidade Estadual do Oeste do Paraná Tipo do documento: Tese