TEDE Communidade:

Implementação de um protocolo de avaliação biopsicossocial via videochamada em pacientes com doença pulmonar intersiticial: análise da viabilidade, satisfação, barreiras e facilitadores da aplicação por avaliação remota

Wed, 10 Jun 2026 00:00:00 GMT

Título: Implementação de um protocolo de avaliação biopsicossocial via videochamada em pacientes com doença pulmonar intersiticial: análise da viabilidade, satisfação, barreiras e facilitadores da aplicação por avaliação remota Autor: Silva, Wallace Pereira Primeiro orientador: Silva, Soraia Micaela Abstract: Introduction: Telehealth, including telerehabilitation, enables the remote delivery of care for individuals with Interstitial Lung Disease (ILD), improving access to and adherence to healthcare services. However, its implementation requires the assessment of factors such as connectivity, technological resources, and user satisfaction. Objective: To evaluate the usability of a biopsychosocial protocol delivered via video calling in individuals with ILD, considering feasibility, satisfaction, and factors associated with remote assessment. Methods: A mixed-methods study was conducted in two phases. Initially, clinical and psychosocial data were collected using self-reported instruments to assess body function, emotional status, activities, participation, and environmental factors. Subsequently, open-ended questions were administered to explore barriers and facilitators to remote assessment, followed by an evaluation of usability using the TUQ-Brazil. Quantitative analysis included means, standard deviations, frequencies, and participation and completion rates. Qualitative analysis was conducted using thematic analysis, involving data familiarization, coding, and categorization. Results: Remote assessment demonstrated high usability, acceptability, and feasibility among individuals with ILD. Most participants considered the approach feasible (93.5%), reported having internet access, and experienced minimal difficulty using technology. Usability perceptions were favorable across all TUQ-Brazil domains, although greater variability was observed in responses related to equivalence with in-person care and video quality. Usability was significantly associated with income (rho = 0.437; p = 0.014), perceived feasibility of the approach (rho = −0.397; p = 0.027), and the perceived intensity of access barriers (rho = −0.428; p = 0.016). The main challenges included connectivity issues, the absence of a physical examination, limited digital literacy and digital security, and the need for assistance from a third party when using the technology. Key facilitators included time and cost savings, accessibility, communication with the healthcare professional, and interaction with the system. Overall, remote assessment was perceived as a complementary strategy to in-person care, particularly for follow-up and triage, rather than as a complete substitute for face-to-face assessment. Conclusion: Remote assessment delivered via video call demonstrated generally positive perceptions of usability, as well as acceptability and feasibility, among individuals with ILD. The findings suggest that this approach may improve access to healthcare services and inform the cautious implementation of hybrid assessment models, particularly for triage, follow-up, symptom monitoring, and biopsychosocial assessment using PROMs in the presence of geographic or logistical barriers. However, its implementation should consider factors related to connectivity, digital literacy, technical 12 support, and the need for an in-person physical examination, supporting its use as a complementary rather than substitutive strategy for in-person care. Instituição: Universidade Nove de Julho Tipo do documento: Dissertação

Métodos não invasivos e minimamente invasivos indutores de apoptose adipocitária lipodistrofia localizada: uma revisão de escopo

Fri, 19 Jun 2026 00:00:00 GMT

Título: Métodos não invasivos e minimamente invasivos indutores de apoptose adipocitária lipodistrofia localizada: uma revisão de escopo Autor: Novais, Priscila Silva Duarte Primeiro orientador: Politti, Fabiano Abstract: Localized lipodystrophy is characterized by the regional accumulation of subcutaneous adipose tissue and represents one of the main concerns related to body contouring. Several non-invasive and minimally invasive technologies have been used for its reduction and are frequently associated with the induction of adipocyte apoptosis. However, the evidence supporting this mechanism remains heterogeneous. Objective: To map and describe the scientific evidence on non-invasive and minimally invasive interventions investigated for their potential to induce adipocyte apoptosis in the reduction of localized lipodystrophy in adults. Methods: A scoping review was conducted according to the Joanna Briggs Institute (JBI) methodology and reported following the PRISMA-ScR guidelines. Searches were performed in MEDLINE/PubMed, Embase, Scopus, Web of Science Core Collection, Virtual Health Library, and Google Scholar. Studies published from 2015 onward that evaluated non-invasive or minimally invasive methods for reducing localized fat in adults were included. Results: Sixteen studies involving 528 participants were included. Identified interventions comprised cryolipolysis, radiofrequency, ultrasound, high-intensity electromagnetic technologies, combined protocols, and the injectable agent CBL-514. The main clinical outcomes were reductions in fat thickness and abdominal circumference, improved body contour, and high patient satisfaction. Evidence consistent with adipocyte apoptosis was observed in a subset of studies through histological, immunohistochemical, and molecular analyses, including caspases, Bax/Bcl-2 ratio, perilipin, CD68, and TNF-α. However, direct confirmation of apoptosis was inconsistent across the different therapeutic modalities. Conclusion: The evaluated interventions demonstrated favorable clinical outcomes for localized fat reduction and body contour improvement. Nevertheless, the biological evidence supporting adipocyte apoptosis as the primary mechanism of action remains limited and heterogeneous. Future studies using standardized protocols and specific biological markers are needed to better elucidate the underlying mechanisms. Instituição: Universidade Nove de Julho Tipo do documento: Dissertação

Alterações cardíacas da prole de animais expostos à poluição do ar: impacto do treinamento físico

Tue, 07 Apr 2026 00:00:00 GMT

Título: Alterações cardíacas da prole de animais expostos à poluição do ar: impacto do treinamento físico Autor: Neves, Pietra Petrica Primeiro orientador: Angelis, Kátia de Abstract: Air pollution poses one of the main threats to public health and is associated with cardiorespiratory diseases. Although some gestational effects of exposure to fine particulate matter (PM2.5) have already been described, its impacts on the cardiovascular system of offspring, as well as the role of exercise training in this context, remain unknown. This study aimed to investigate the effects of exercise training on cardiac, autonomic, and inflammatory morphofunctional parameters in the offspring of both sexes of Wistar rats exposed to PM2.5 during pregnancy. The mothers were exposed to PM2.5 in a particle concentrator from the 5th to the 21st day of gestation. The offspring were divided into male (M) and female (F) groups (n=6–8 per sex/group): controls (CM, CF), exposed (EM, EF), and exposed-trained (TM, TF). Exercise training (8 weeks, 40–60% of maximum speed) was initiated after weaning, followed by assessments of cardiac morphology and function by echocardiography, heart rate variability (HRV) using linear and nonlinear methods, and systemic inflammation by ELISA. Prenatal exposure led to a reduction in left ventricular end-diastolic diameter (LVEDD;d) and increased IL-6 and IL-6/IL-10 ratio in both sexes. In the EM group, a reduction was observed in left ventricular (LV) mass as assessed by echocardiography and tissue wet weight, as well as in mitral annular velocity during systole (S’) and during late ventricular filling (A’), accompanied by an increase in the LV early-to-late filling ratio (E/A). In the EF group, there was a reduction in pulse interval variance (Var IP). Exercise training increased functional capacity, ejection fraction (EF), Var IP, and the vagal component (HF), while reducing TNF-alpha, IL-6, the IL-6/IL-10 ratio, and the SD2/SD1 ratio (instantaneous/long-term standard deviation) in both sexes. Specifically in the TM group, there was an increase in the thickness of the septum (IVS;d) and the posterior wall (PPVE;d) of the LV, with a reduction in isovolumetric relaxation time (IVRT) and the myocardial performance index (MPI). In the TF group, an increase in IVS;d, S’, and IL-10 was observed. In Pearson correlation analyses, a negative correlation was observed between Var IP and IL-6/IL-10 (r = -0.62; p = 0.0014), as well as between IL-6/IL-10 and LV mass (r = -0.76; p = 0.0001) and with IPM (r = -0.79; p = 0.0001), suggesting an interaction between autonomic dysfunction, inflammatory imbalance, and structural and functional cardiac impairment. Prenatal exposure to PM2.5 caused persistent morphofunctional and inflammatory changes, with males showing greater susceptibility. Aerobic exercise training attenuated these dysfunctions, exerting a cardioprotective and preventive role in the offspring. Instituição: Universidade Nove de Julho Tipo do documento: Tese

Efeitos agudos da estimulação transcutânea auricular do nervo vago sobre a pressão arterial e a modulação autonômica cardíaca em jovens adultos e idosos hipertensos

Mon, 30 Mar 2026 00:00:00 GMT

Título: Efeitos agudos da estimulação transcutânea auricular do nervo vago sobre a pressão arterial e a modulação autonômica cardíaca em jovens adultos e idosos hipertensos Autor: Souza, Paulo Henrique Leite Primeiro orientador: Corrêa, Fernanda Ishida Abstract: Introduction: Arterial hypertension (AH) is associated with cardiovascular autonomic changes, characterized by sympathetic hyperactivation and reduced vagal modulation. Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a promising non-invasive strategy for cardiovascular modulation and acute blood pressure (BP) reduction. However, the effects of aging on cardiovascular responsiveness to taVNS remain poorly understood, especially in hypertensive individuals. Objective: To compare the acute response of BP and heart rate variability (HRV) to taVNS on the cymba concha between young and older hypertensive adults. Methodology: Young hypertensive adults (18–39 years) (n=21) and older hypertensive adults (≥60 years) (n=17) underwent a single session of taVNS on the cymba concha region. Hemodynamic variables, including systolic blood pressure (SBP), diastolic blood pressure (DBP) and HR, were assessed before and after stimulation. Additionally, HRV parameters, including high-frequency band (HFnu), low-frequency band (LFnu), LF/HF ratio, standard deviation of normal-to-normal RR intervals (SDNN), root mean square of successive differences between adjacent RR intervals (RMSSD), percentage of adjacent RR intervals with a difference greater than 50 ms (pNN50), standard deviation perpendicular to the line of identity (SD1), standard deviation along the line of identity (SD2), and sample entropy (SampEn), were analyzed to assess cardiac autonomic modulation. The acute cardiovascular response was determined by changes in variables between pre and post-stimulation periods, comparing young and older hypertensive adults. Results: A significant reduction in systolic and diastolic blood pressure was observed after a single session of taVNS on the cymba concha in both young and older hypertensive adults (p < 0.05). Regarding heart rate variability, significant changes were identified only in the older hypertensive group, characterized by a reduction in the LFnu band and an increase in the HFnu band after the intervention, suggesting a mild parasympathetic modulation. In the young hypertensive adult group, no significant changes in autonomic parameters were observed after taVNS. Conclusion: taVNS on the cymba concha promoted a significant acute reduction in SBP and DPB in both young and older hypertensive adults. Furthermore, mild autonomic changes were observed only in older hypertensive adults, suggesting greater vagal responsiveness in this group. These findings indicate that taVNS has an acute hypotensive potential effect in hypertensive individuals, regardless of age group, although the effects on autonomic modulation appear more evident in older adults. Instituição: Universidade Nove de Julho Tipo do documento: Tese