TEDE Coleção: Programa Pós Graduação em Ciências da Saúde

A influência da infecção viral em mulheres grávidas na patologia do transtorno do espectro autista: uma revisão sistemática com metanálise

2026-07-03T04:00:31Z

Título: A influência da infecção viral em mulheres grávidas na patologia do transtorno do espectro autista: uma revisão sistemática com metanálise Autor: Mantovani, Priscila Vieira de Lucena Primeiro orientador: Keller, Rogéria Abstract: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by difficulties in social communication, restricted interests, and repetitive behaviors. Infection is a common environmental factor that can influence the development of ASD and, when caused by viruses, is highly prevalent in all age groups, including the intrauterine period. The etiology of ASD has been the subject of intense research, but there are gaps to be filled. Objective: To analyze the interaction between viral infection during pregnancy and ASD. Methods: A systematic review with meta-analysis was conducted to answer the following question: What is the influence of viral infection in pregnant women on the development of Autism Spectrum Disorder? Articles were from the period of 1979 until 2023. The articles were observational, retrospective, prospective, case-control, and cohort studies that described the clinical outcome of children whose mothers were exposed to infections during pregnancy, focusing on the development or not of psychological disorders. The methodology used followed PRISMA, and Review Manager 5.4 software was used for meta-analysis calculations. Results: A total of 32 studies were included, and after analysis, the combined result yielded an OR of 0.29, demonstrating that viral infection during pregnancy increased the probability of ASD in offspring by 71%, a statistically significant result, since the confidence interval does not cross the value 1. Conclusion: In fact, this systematic review with meta-analysis found an increased risk of ASD in cases of maternal infection during pregnancy. These results may be useful for the preparation and development of prophylactic measures against ASD, as we may be close to discovering its etiology. Instituição: Universidade do Oeste Paulista Tipo do documento: Dissertação

Impacto da pandemia por COVID-19 no perfil de pacientes da unidade de terapia intensiva coronariana de um hospital público terciário

2026-07-03T04:00:38Z

Título: Impacto da pandemia por COVID-19 no perfil de pacientes da unidade de terapia intensiva coronariana de um hospital público terciário Autor: Bosso, Carlos Eduardo da Costa Nunes Primeiro orientador: Carneiro, Luiz Euribel Prestes Abstract: Introduction: The COVID-19 pandemic, which began in 2019, has overwhelmed healthcare systems globally, significantly impacting Intensive Care Units (ICUs), including Coronary Care Units (CCUs). This study analyzes the impact of the pandemic on the patient profile and performance of the CCU at the Regional Hospital of Presidente Prudente (HR), a tertiary public hospital of reference in the western region of São Paulo state. Objectives: To analyze the profile of patients admitted to the HR CCU before, during, and after the COVID-19 pandemic, evaluating changes concerning severity, unit performance indicators, and clinical outcomes. Materials and Methods: This is a retrospective observational study using data from patients admitted to the HR CCU between June 2019 and December 2023. The study was divided into three periods: pre-pandemic (June 2019 to June 2020), pandemic (July 2020 to December 2022), and post-pandemic (January 2023 to December 2023). Demographic, clinical, and unit performance indicator data, such as occupancy rate, average length of stay, bed turnover, and mortality, were collected. Binary logistic regression was performed to assess mortality in each period. Results: A cohort of 3,657 patients was assessed, comprising 919 in the pre-pandemic group, 1,884 in the pandemic group, and 854 in the post-pandemic group. During the pandemic, there was a reduction in the average monthly admissions to the CCU, with pre-pandemic admissions averaging 70.7, pandemic admissions at 62.8, and post-pandemic admissions at 71.2. There was a notable decrease in admissions due to cardiovascular reasons (86.2% pre-pandemic versus 73.6% during the pandemic, p<0.05). Additionally, an increase in the severity of admitted patients was observed, as indicated by the SAPS 3 score (pre-pandemic 44.2, pandemic 48.3, and post-pandemic 45.9; p=0.001). The mortality rate remained consistent throughout the pandemic period. Logistic regression analysis revealed higher mortality rates in the CCU among older patients (OR 1.03; 95% CI: 1.02-1.04), females (OR 1.40; 95% CI: 1.08-1.82), those requiring assistance for daily activities, and those who were bedridden (OR 1.50; 95% CI: 1.08-2.08 and OR 2.69; 95% CI: 1.70-4.25, respectively), as well as patients without a prior acute myocardial infarction (AMI) (OR 1.86; 95% CI: 1.25-2.78). Conclusion: We concluded that the COVID-19 pandemic altered the profile of the CCU. A decrease in cardiovascular admissions was observed during the pandemic period, along with an increase in all-cause hospital mortality among patients post-discharge from the CCU during and after the pandemic. However, there was no observed increase in mortality within the CCU itself. Instituição: Universidade do Oeste Paulista Tipo do documento: Dissertação

Impactos da exposição prolongada a uma mistura ambientalmente relevante de desreguladores endócrinos no testículo de ratos

2026-07-03T04:00:36Z

Título: Impactos da exposição prolongada a uma mistura ambientalmente relevante de desreguladores endócrinos no testículo de ratos Autor: Silveira, Raissa Souza Lima Bruno Primeiro orientador: Mendes, Leonardo de Oliveira Abstract: Endocrine disruptors (EDs) are environmental contaminants commonly found in personal care products, food preservatives, domestic and agricultural pesticides, construction materials, plastics, and cleaning products. These compounds interfere with hormone dependent organs such as the testes, negatively affecting male fertility. This study aimed to evaluate testicular histoarchitecture in rats chronically exposed to an environmentally relevant mixture of EDs from gestation through adulthood. Pregnant Sprague Dawley rats were randomly assigned to two groups: Control (corn oil, 2 mL/kg) and ED Mix (32.11 mg/kg/day of a mixture of 12 compounds, including phthalates, pesticides, UV filters, bisphenol A, and butylparaben, in corn oil, 2 mL/kg). Dosing by oral gavage occurred from gestational day 7 (GD7) to postnatal day 21 (PND21). After weaning (PND22), male offspring (F1 generation) continued to receive the ED mixture until PND220. Testes were collected, fixed in Metacarn, and processed for histological analysis. Sections were stained with hematoxylin eosin and picrosirius red for morphometric assessment and collagen quantification. Chronic exposure to the ED mixture significantly reduced seminiferous tubule diameter and germinal epithelium height, and decreased the number of Sertoli and Leydig cells compared to control animals. Notably, the proportion of seminiferous tubules in early spermatogenic stages (I–VI) increased from 53.17 ± 1.98 in controls to 61.00 ± 0.87 in the exposed group (p = 0.002), while stages VII–VIII decreased from 46.5 [38.25–48.0] to 37.0 [33.0–39.0] (p = 0.017), indicating delayed spermatogenic progression. The incidence of abnormal tubules also increased significantly (from 0 [0–1] to 2 [1–3], p = 0.002), characterized primarily by vacuolization and the presence of immature germ cells. In contrast, no significant difference was observed in relative interstitial collagen volume between groups (p = 0.0603). These findings demonstrate that chronic ED exposure from prenatal life through adulthood induces substantial structural and functional alterations in the testis, consistent with evidence showing that endocrine active compounds disrupt steroidogenesis and spermatogenesis in male reproductive systems. Instituição: Universidade do Oeste Paulista Tipo do documento: Dissertação

Associação da resistência à insulina e deficiência de vitamina D em mulheres na pós-menopausa com e sem síndrome metabólica

2026-07-03T04:00:35Z

Título: Associação da resistência à insulina e deficiência de vitamina D em mulheres na pós-menopausa com e sem síndrome metabólica Autor: Menezes, Ana Cristina Lira de Primeiro orientador: Orsatti, Cláudio Lera Abstract: The relationship between insulin resistance and vitamin D (vitD) deficiency in postmenopausal women, with and without metabolic syndrome (MetS), represents an expanding field of research. Assessing the Homeostatic Model Assessment for Insulin Resistance (HOMA- IR) index and serum vitD levels is essential to identify women at higher risk of developing MetS. Methods: A total of 132 postmenopausal women (78 without MetS and 54 with MetS) attending the School of Medicine of Jaú, Universidade do Oeste Paulista (UNOESTE), were evaluated. Clinical and laboratory data included fasting glucose, glycated hemoglobin, insulin, HOMA-IR index, lipid profile, waist circumference, blood pressure, and serum vitamin D levels. Insulin levels were quantified by solid-phase chemiluminescent immunoassay. Data were analyzed using parametric or nonparametric statistical tests, depending on variable distribution. Results: Women with MetS showed significantly higher levels of glucose, glycated hemoglobin, insulin, HOMA- IR, and waist circumference (p < 0.001). They also presented higher triglyceride levels and systolic blood pressure (p < 0.01). No significant differences were observed between groups for total cholesterol, LDL, HDL, BMI, or age. Mean vitD levels were lower in the MetS group, but the difference was not statistically significant (p = 0.063). The chi-square test showed no significant association between vitamin D deficiency and MetS (χ² = 3.98; p = 0.137). Conclusion: Insulin resistance, as assessed by the HOMA-IR index, was significantly associated with the presence of MetS in postmenopausal women. However, no significant association was found between vitD deficiency and MetS in this sample. These findings highlight the importance of continuous monitoring of metabolic risk factors to prevent cardiovascular complications in postmenopausal women. Instituição: Universidade do Oeste Paulista Tipo do documento: Dissertação