TEDE Coleção: Programa de mestrado com caráter interdisciplinar.

Efeito do ILIB transcutâneo na perfusão tissular periférica de pessoas com diabetes mellitus tipo 2: Um estudo quase experimental

Mon, 30 Mar 2026 00:00:00 GMT

Título: Efeito do ILIB transcutâneo na perfusão tissular periférica de pessoas com diabetes mellitus tipo 2: Um estudo quase experimental Autor: LIMEIRA, Bárbara dos Santos Primeiro orientador: PASCOAL, Livia Maia Abstract: This study aimed to evaluate the effect of transcutaneous Intravascular Laser Irradiation of Blood (ILIB) photobiomodulation therapy on the peripheral circulation of people with type 2 diabetes mellitus (DM2) who have a nursing diagnosis of Ineffective Peripheral Tissue Perfusion (IPTP). This is a quasi-experimental study, conducted in four primary health care units with 20 people with DM2, diagnosed with IPTP and without contraindications for transcutaneous ILIB therapy. Before the start of the interventions, a questionnaire was applied to characterize the sociodemographic and clinical characteristics of the participants. The intervention consisted of applying transcutaneous ILIB to the vascular bundle in the radial artery region, in 25-minute sessions, performed daily for ten days, with a two-day break at the weekend. At the end of the 10 sessions, there was a 23-day break before repeating the protocol, totaling two intervention cycles. In each cycle, on the first and tenth day, instruments were applied to assess the diagnosis of PTPI, screen for diabetic neuropathy, and evaluate the nursing outcome of NOC (Peripheral Tissue Perfusion). On the fifth day, a new assessment of the NOC outcome was performed. Descriptive statistical analysis of sociodemographic and clinical variables was conducted. McNemar's exact test was used to assess NANDA-I and neuropathy; Friedman's test with Dunn's post-hoc test and Bonferroni correction for the NOC outcome; Wilcoxon test for inter-cycle comparisons; and paired t-test for daily parameters. The research was approved by the Research Ethics Committee. The sample was composed mainly of women (70%), adults (55%), with a mean age of 57 years and a DM2 diagnosis time equal to or greater than 10 years (55%). In the integrated intra-cycle and inter-cycle analysis of the defining characteristics of the PTPI diagnosis, a favorable response to the intervention was observed, with a reduction in the following defining characteristics: cold extremities, extremity pain, paresthesia, extremity sweating, altered motor function, and intermittent claudication, as well as an associated condition, dyslipidemia. In the intra-cycle analysis of the NOC result, significant overall differences were observed in the systolic blood pressure of the right upper limb (RUL) and left upper limb (LUL), in the pedal pulse strength in the left lower limb (LLL), and in the mean arterial pressure of the LUL. In the inter-cycle NOC evaluation, significant differences were identified in the diastolic blood pressure indicators of the RUL and skin rupture of the LLL, both with a large magnitude of effect. In the daily follow-up, in cycle 1 there was a significant increase in peripheral oxygen saturation of the LLL and a reduction in arterial pulse in the right and left lower limbs. In cycle 2, a significant reduction in diastolic blood pressure of the RUL and arterial pulse of the right and LLL was identified. Although not statistically significant, a reduction in cases suggestive of neuropathy was observed in diabetic neuropathy screening, along with improvement in circulatory deficit and generalized asthenia. The findings suggest that transcutaneous ILIB may act as a safe adjuvant therapy, with the potential to improve peripheral tissue perfusion in people with type 2 diabetes, contributing to clinical management and the prevention of peripheral vascular complications. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação; Trabalho sob sigilo. Motivo: A disponibilização parcial da dissertação justifica-se pela necessidade de preservação da originalidade do conteúdo, visando à futura publicação dos resultados em formato de artigo científico. Prazo previsto para disponibilização total: 3 anos.

Aplicativo MAMAprev no Conhecimento, Atitude e Prática de Profissionais de Saúde: Ensaio Clínico Randomizado não Farmacológico

Tue, 30 Sep 2025 00:00:00 GMT

Título: Aplicativo MAMAprev no Conhecimento, Atitude e Prática de Profissionais de Saúde: Ensaio Clínico Randomizado não Farmacológico Autor: PINHEIRO, Wiliane Freire Primeiro orientador: FERREIRA, Adriana Gomes Nogueira Abstract: Introduction: Evaluating the effectiveness of applications is important so that these technologies can be introduced into routine patient care, in addition to demonstrating the potential educational impacts of these technologies. Given this scenario, the hypothesis was defined that professionals who use the MAMAprev mobile application effectively learn about secondary prevention, with a positive influence on their level of knowledge, attitude, and practice. Objective: To evaluate the effectiveness of educational technologies on breast cancer in the knowledge, attitude, and practice of primary health care professionals. Method: This is a randomized, non-pharmacological, blinded, controlled, and pragmatic clinical trial. Professionals from family health teams and multidisciplinary teams in the state of Maranhão participated in the study, allocated to a control group and an experimental group. The study was conducted in six phases: (1) recruitment of participants; (2) randomization and allocation to groups; (3) application of the pre-test; (4) application of interventions; (5) application of the post-test; and (6) data analysis. Participants in the control group received digital educational material in Portable Document Format, while those in the experimental group received the intervention, which was the MAMAprev app. The data were tabulated using Microsoft Office Excel and then exported and analyzed using Statistical Package for the Social Sciences version 25.0 software, adopting a significance level of 5%. The study is registered on the platform. Results: 111 health professionals participated in the study. The groups were homogeneous in terms of sociodemographic profile and training (p> 0.05), thus ensuring comparability between the groups and the validity of the interventions applied. In the knowledge analysis, there was no statistically significant difference between the groups in the pre-test (p=0.81), demonstrating initial equivalence. In the post-test period, the educational material in PDF format performed better than the experimental group (p = 0.04). Regarding attitude, no statistically significant intragroup differences were observed in the pre-test; however, in the post-test, the educational material in PDF format demonstrated greater effectiveness (p = 0.02) in promoting positive attitudes. Regarding practice, it was not possible to observe statistically significant results, and similarly, in the stratified evaluation by professional category (doctors and nurses), there was no difference between the pre-test and post-test moments of the groups. However, in the stratified sample, the group that used the MAMAprev app showed a significant increase in average scores. In addition, the participants' satisfaction assessment found that the total average score for the MAMAprev app was 78.6% and for the educational material in PDF format was 73.4%, classifying them as having excellent usability. Conclusion: The results indicate that the educational technologies evaluated have the potential to support teaching processes in PHC. However, their effectiveness in promoting significant changes in knowledge, attitude, and practice may depend on several factors, such as duration of use, professional profile, integration into care routines, pedagogical design, and digital familiarity. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação; Trabalho sob Sigilo. Motivo: Publicação do Artigo. Data Provável de Liberação: 3 anos.

Nanoemulsões de óleos essenciais de Ocimum gratissimum, Cymbopogon citratus e Lippia alba e atividade antibacteriana

Mon, 29 Apr 2024 00:00:00 GMT

Título: Nanoemulsões de óleos essenciais de Ocimum gratissimum, Cymbopogon citratus e Lippia alba e atividade antibacteriana Autor: BRITO, Gabriel Sousa Primeiro orientador: FIDELIS, Queli Cristina; Documento sob sigilo. Prazo provável para disponibilização total: 29/04/2027. Motivo do sigilo: não informado Abstract: Nanoemulsions are colloidal dispersions that can be divided into three types, Oil/Water, Water/Oil and bicontinuous, depending on whether oil or water is used as the dispersed phase. The formation of nanoemulsions with essential oils (NE-OE) presents advantages, such as protection against chemical reactions involving oxygen in the degradation of EOs, increased solubility in the aqueous phase, controlled release of bioactive compounds and increased bioactivity due to the increase in surface area of the emulsion. The present study includes an integrative review of the literature and the development of an essential oil nanoemulsion from three aromatic species, Lippia alba, Cymbopogon citratus and Ocimum gratissimum. The integrative review aimed to identify scientific evidence that corroborates the antimicrobial action of essential oil nanoemulsions against antibiotic-resistant pathogenic microorganisms. By applying the integrative review methodology, eleven scientific articles on the antibacterial or antifungal evaluation of essential oil nanoemulsions were selected. The synthesis of the identified evidence showed that essential oil nanoemulsions are effective in combating multi- resistant microorganisms and in the formation of their biofilms. Factors such as nanoemulsion droplet size, chemical composition of essential oils and the association of nanoemulsions with antibiotics are discussed. Furthermore, essential oil nanoemulsions showed satisfactory results in in vitro and in vivo evaluations against resistant clinical isolates. Nanoemulsions of essential oils from Ocimum gratissimum, Lippia alba and Cymbopogon citratus were formed using phase inversion temperature methodology. A rotational composite experimental design was used to produce the nanoemulsions of each oil and response surface methodology (RSM) was used to optimize the nanoemulsion preparation conditions. In this study, the effects of essential oil concentration (0.5-2.0 g/L), surfactant concentration (0.2-5 g/L) and temperature (26-94 °C) on the response variable φ (ɛmax/λmax) were investigated. using RSM based on central compound planning (CCD), to evaluate the significance of production parameters and identify the ideal condition that significantly impacted the production of nanoemulsions. The optimization of essential oil nanoemulsions revealed that the concentration of essential oil, surfactant and temperatures for Ocimum gratissimum (1.38 g/L, 0.83 g/L and 54 oC), Lippia alba (1.72 g/L, 0.68 g/L and 54 oC) and Cymbopogon citratus (1.20 g/L, 0.78 g/L and 54 oC) produced ideal nanoemulsions. The optimized C. citratus NE showed an average particle size of 287.9 nm, PDI of 0.42 and Zeta potential of – 8.94 mV. Furthermore, essential oils and optimized nanoemulsions were evaluated for antibacterial activity, where NEs exhibited more potent antibacterial activity than pure essential oil against the pathogenic strains Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa and Enterococcus faecali, showing greater effect bacteriostatic and inhibitory. Among the strains, E. faecali was more susceptible to NEs from C. citratus and O. gratissimum with a minimum inhibitory concentration of 0.075 mg/mL and 0.172 mg/mL, respectively. The nanoemulsions enhanced the bactericidal effect of L. alba essential oils, reducing the MIC of the pure essential oil from 8 mg/mL to 0.445 mg/mL. Furthermore, they showed low cytotoxicity in RAW 264.7 macrophages. The results of this research can provide useful information in the development of nanoemulsions using phase inversion methodology and the antibacterial activity data of essential oils can be useful in the development of a potential antibacterial agent. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

Efeito da Terapia a Laser de Baixa Intensidade no Manejo da Neuropatia Periférica Diabética: Ensaio Clínico Randomizado

Wed, 28 May 2025 00:00:00 GMT

Título: Efeito da Terapia a Laser de Baixa Intensidade no Manejo da Neuropatia Periférica Diabética: Ensaio Clínico Randomizado Autor: COSTA, Debora Ellen Sousa Primeiro orientador: PASCOAL, Lívia Maia Abstract: This study aimed to evaluate the effects of local application of low-intensity laser therapy associated with modified Intravascular Laser Irradiation of Blood (ILIB) and local application alone in the management of diabetic peripheral neuropathy in patients with type 2 diabetes mellitus. This is a randomized clinical trial conducted in four basic health units. The sample consisted of 30 participants, equally distributed into two intervention groups, with Intervention Group 1 receiving local application of low-intensity laser therapy (LLLT) associated with modified ILIB and Intervention Group 2 receiving local application of LLLT alone. The local application of LLLT was performed with an infrared laser source, using a fluence of 3 joules/cm2, applied punctually to six specific points on each foot, with each point receiving 30 seconds of application, totaling 3 minutes on each foot and 6 minutes of bilateral local intervention. The modified ILIB technique was applied transcutaneously to the radial artery, under red light, in continuous mode, lasting 20 minutes per session. In both intervention groups, 12 sessions were held on Mondays, Wednesdays, and Fridays for four weeks. Data collection took place between June 2024 and March 2025. In S1, sociodemographic and clinical information, presence of neuropathic pain symptoms, clinical manifestations of DPN, and assessment of the lower limbs were collected, focusing on the Nursing Outcome Indicators (NOC) Peripheral Neurological Status. In S2, information on the participants' quality of life was obtained. In S3, S6, and S9, the lower limb assessments described above were performed. In S12, the S1 instruments were reapplied and the lower limbs were assessed. Vital data were collected before and after each session. To verify changes between the pre-intervention and post-intervention moments in continuous variables with paired measures, the Wilcoxon test was applied, and 95% confidence intervals and a significance level of p < 0.05 were adopted. The study was approved by the Ethics Committee of the Federal University of Maranhão (opinion 6,842,223) and registered in the Brazilian Registry of Clinical Trials. The sample consisted mainly of females (66.7%), brown race/skin color (56.7%), married or in a stable union (66.7%), and aged over 60 years (56.7%). Most participants had incomplete elementary school education (33.3%). The outcomes with significant improvement in Intervention Group 1 were: sensation of numb legs and/or feet, presence of muscle cramps, improvement in the left Achilles reflex and in the NOC indicators regarding peripheral neurological status such as Sensitivity and Hyperesthesia in the left lower extremity, Pain in both lower extremities, and Paresthesia in the right lower extremity. In Intervention Group 2, improvements were observed in variables such as burning or stinging pain and stinging in the legs and/or feet, dryness and cracks in the skin of the feet, an NOC indicator related to the peripheral neurological state Paresthesia in both lower extremities, in addition to the Pain domain related to quality of life for people with foot problems assessed by the Neuroqol instrument. The intervention protocols in Intervention Groups 1 and 2 did not show statistically significant differences in the intergroup comparison regarding the management of DPN. However, it was observed that Intervention Group 1 stood out in several clinical outcomes related to pain, neurological sensitivity and functional parameters. The study findings reinforce the importance of expanding the use of these technologies in the context of primary care and of promoting new controlled clinical trials that contribute to the advancement of evidence-based practice. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação; Trabalho sob sigilo. Motivo: Não esclarecido pelo autor. Data Provável de Liberação: 3 anos.