https://repositorio.ufu.br/handle/123456789/5475 2026-04-04T03:52:43Z 2026-04-04T03:52:43Z https://repositorio.ufu.br/handle/123456789/48574 2026-03-25T06:21:13Z 2026-02-20T00:00:00Z

Title: Associação entre o uso de clorexidina ou cetilpiridínio oral para prevenção de pneumonia associada à ventilação e a ocorrência de lesão pulmonar aguda em pacientes vítimas de traumatismo cranioencefálico: um ensaio clínico randomizado Abstract: Introduction: Oral hygiene for critically ill patients on mechanical ventilation (MV) is an important strategy for preventing ventilator-associated pneumonia (VAP), and worldwide, the use of chlorhexidine in this procedure has been recommended and disseminated as routine. However, meta-analyses of double-blind randomized clinical trials have reported an association between the use of chlorhexidine in oral hygiene and increased mortality, and no reduction in VAP rates. The mechanism suggested to explain this increase in mortality is the occurrence of acute lung injury, since chlorhexidine is an acidic substance and, when aspirated, could cause direct pulmonary toxicity. Objectives: To evaluate whether there is an association between the use of chlorhexidine (CHX) in the oral hygiene of critically ill patients on mechanical ventilation and the occurrence of ALI, and whether cetylpyridinium chloride (CCP) is a safe option. Methods: This study is a randomized controlled clinical trial, registered under number RBR-7p6568 in the Brazilian Registry of Clinical Trials. The experimental protocols were approved by the local ethics committee and comply with the CONSORT (CONsolidated Standards of Reporting Trials) guidelines. Of the 59 eligible patients, 34 consented and were randomly allocated to three different groups: (A) oral hygiene with 0.12% chlorhexidine digluconate; (B) 0.075% cetylpyridinium chloride; (C) sterile water. The primary outcome was the occurrence of acute lung injury. Secondary outcomes were all-cause mortality, duration of mechanical ventilation, length of stay in the Intensive Care Unit (ICU), ICU-acquired infections, and antimicrobial resistance. The collected data were pooled and compared. Results: The use of chlorhexidine for oral hygiene in critically ill patients on mechanical ventilation showed a non-statistically significant association with an increased occurrence of acute lung injury and ICU-acquired infections. Statistical analysis showed no differences in prevalence percentages between groups for any variable, applying the Z-test of proportions with Bonferroni correction. In addition, the patients’ daily P/F ratio was collected for 14 days, and this data was analyzed using a Mixed Linear Model, in which no statistically significant differences were observed between the three groups in the daily P/F values throughout the follow-up period. Discussion: Considering that international guidelines have modified their recent recommendations and no longer 11 recommend chlorhexidine for oral hygiene in all critically ill patients, it is imperative to evaluate alternatives to chlorhexidine. In this study, the results showed no evidence of harm with the use of CCP, corroborating the fact that, unlike CHX, it is not an acidic substance. Conclusion: In institutions whose protocols guide the use of oral chlorhexidine only when specifically prescribed, CCP remains a possible alternative. Further investigations will be necessary to assess whether cetylpyridinium chloride in oral hygiene is a safe and effective strategy for preventing VAP and could, therefore, be recommended by guidelines for routine use in all critically ill patients on mechanical ventilation.

2026-02-20T00:00:00Z https://repositorio.ufu.br/handle/123456789/48237 2026-02-10T06:30:19Z 2025-12-16T00:00:00Z

Title: Investigação de soro e saliva por espectroscopia ATR-FTIR e avaliação de biomarcadores inflamatórios sistêmicos como estratégia de análise do câncer de mama Abstract: Introduction: Breast cancer is the most common malignant neoplasm among women worldwide and represents a significant public health challenge due to its molecular heterogeneity and prognostic impact. Therefore, the search for non-invasive and cost-effective methods of diagnosis and prognostic stratification becomes essential. Objective: To evaluate the clinical applicability of complementary approaches for the diagnosis and prognosis of breast cancer, investigating the usefulness of profiles obtained from biological fluids and systemic inflammatory and immunological biomarkers, as well as their correlations with clinicopathological characteristics and overall survival of women with breast cancer, including advanced cases. Materials and methods: In the first article, a cross-sectional study was conducted involving 73 participants: 31 with breast cancer, 18 with benign breast disease, and 24 healthy controls. Serum and saliva samples were analyzed by Attenuated Total Reflectance Fourier Transform Infrared Spectroscopy (ATR-FTIR), and spectral differences between groups were statistically evaluated. In the second article, a prospective study was conducted with 33 patients with advanced breast cancer followed in a palliative care program in Brazil between 2021 and 2024. Systemic inflammatory biomarkers were quantified by blood count and enzyme-linked immunosorbent assay (ELISA), and correlated with overall survival using Kaplan-Meier analyses and Cox regression models. Results: In the first article, the intragroup spectral analysis between breast cancer and benign breast disease, serum spectra showed no statistical differences. In saliva, only the peak at 2930 cm⁻¹, associated with C–H stretching vibration of lipids, differentiated breast cancer from benign breast disease (p = 0.0391). In the comparison between breast cancer and healthy controls, serum showed a significant difference at 1295 cm⁻¹ (related to nucleic acid cytokines). Saliva showed significant differences at 1241 cm⁻¹ (nucleic acid phosphate), 1541 cm⁻¹ and 1644 cm⁻¹ (protein amides II and I), and 2930 cm⁻¹ (lipids). In the intergroup analysis, comparing breast cancer, benign breast disease, and healthy controls, it was shown that the biochemical components present in serum and saliva, including lipids, nucleic acids, proteins, and carbohydrates, presented distinct absorbance patterns according to the type of biological fluid analyzed. The 2930 cm⁻¹ peak, related to C–H stretching of lipids in saliva, was able to differentiate the three groups studied. In the second article, the elevated levels of interleukin-1BETA (IL-1BETA) (> 76.03 pg/mL) were associated with worse overall survival (p = 0.018), increasing the risk of death by 8.84 times; and elevated levels of interleukin-10 (IL-10) (> 24.21 pg/mL) were also associated with worse overall survival (p = 0.046), increasing the risk of death by 7.17 times. Red blood cell distribution width (RDW), RDW/platelet ratio (RPR), neutrophil/lymphocyte ratio (N/L), lymphocyte/monocyte ratio (L/M), and interleukin-6 (IL-6) did not show a significant association with prognosis. Conclusions: The results demonstrate that ATR-FTIR spectroscopy is a promising tool for detecting breast cancer from saliva samples, offering advantages such as speed, reproducibility, and non-invasiveness. In parallel, the cytokines IL-1BETA and IL-10 emerge as relevant prognostic biomarkers in advanced disease, reflecting the interaction between systemic inflammation and tumor progression. The integration of these diagnostic and prognostic approaches in the clinical management of breast cancer can contribute to the development of personalized and accessible strategies.

2025-12-16T00:00:00Z https://repositorio.ufu.br/handle/123456789/48191 2026-02-05T13:15:15Z 2026-01-21T00:00:00Z

Title: Impacto do treinamento aeróbio de baixa intensidade na função cardíaca e em biomarcadores plasmáticos em modelo murino de toxicidade induzida pela doxorrubicina Abstract: Introduction: Doxorubicin is an important drug used in chemotherapy treatment, but its toxic effect compromises patient survival. In this scenario, aerobic training has been studied as a non-pharmacological therapy in the search for attenuation of the toxic effects caused by doxorubicin. Objectives: The objective of this thesis was to evaluate whether low-intensity aerobic training has a reparative effect on toxicity already caused by doxorubicin, through the analysis of cardiac functional parameters and associated molecular evidence. Materials and Methods: Forty-eight Wistar rats with a mean age of six months and a mean body weight of 500 g were randomly divided into four groups identified as Control (C), Doxorubicin (D), Training (T), and Doxorubicin + Training (DT). The animals in the D and DT groups received intraperitoneal injections of doxorubicin hydrochloride once a week at a dose of 2 mg/kg over four weeks, reaching a total cumulative dose of 8 mg/kg; the other groups received intraperitoneal injections of saline solution in a similar volume. Groups T and DT underwent aerobic training after drug administration. Results: The results of the thesis will be presented in two articles. In the first article, doxorubicin administration significantly increased myocardial fibrosis in group D compared to groups C, DT, and T, and reduced cardiac functional parameters in group D, with lower values of parietal S waves (0.041 vs. 0.065; p=0.01) and septal S waves (0.04 vs. 0.064; p=0.01) compared to the control group. A marked decrease in exercise tolerance was observed in group D (62%), followed by groups DT (26.3%) and C (23%). In the second article, relevant changes were observed in the plasma spectral profile, characterized by an increase in lipid bands (~1451, 1738, 2860 cm⁻¹), a reduction in proteins (~1531 cm⁻¹), and an elevation of nucleic acid-associated markers (~1069 cm⁻¹) in animals from groups D and DT. However, low-intensity aerobic training partially attenuated these effects, highlighting that the wave number 1451cm-1 was able to significantly differentiate groups D and DT. Furthermore, ROC curve analysis investigated the discriminatory performance of each vibrational mode through spectra processed by the second derivative, showing high accuracy and significant sensitivity and specificity values in the comparison of groups D and C, DT and C (>82%). Conclusion: The results demonstrate that doxorubicin induces significant cardiotoxicity, evidenced by increased myocardial fibrosis, impaired cardiac function, and reduced tolerance to physical exertion. Low-intensity aerobic training, applied after exposure to the chemotherapeutic agent, exerted a partially reparative effect, attenuating the structural and functional cardiac alterations, the loss of physical performance, and the molecular modifications observed in the plasma. This work demonstrated that low-intensity aerobic exercise constitutes a non-pharmacological strategy that contributes to the preservation of cardiovascular function with potential adjuvant application in clinical contexts, in addition to demonstrating the potential of plasma biomarkers as useful tools for the early monitoring of these damages.

2026-01-21T00:00:00Z https://repositorio.ufu.br/handle/123456789/48079 2026-01-27T06:19:30Z 2023-04-25T00:00:00Z

Title: Análise de biomarcadores salivares por espectroscopia ATR-FTIR e expressão de microRNAs plasmáticos em indivíduos treinados frente a diferentes protocolos de exercício físico Abstract: Introduction: Analysis of the alterations in the different biological fluids induced by exercise can lead to the discovery of new biomarkers, that can enhance our understanding of the mechanisms related to the training status and performance of athletes. In this way, the Fourier Transform Infrared Spectroscopy (FTIR) technique has been widely applied for the determination of new salivary markers, since this analytical method allows the characterization of different molecules with high sensitivity and cost-effectiveness. In addition, molecular studies involving the analysis of microRNAs (miRNAs) (small non-coding RNA molecules involved in the process of post-transcriptional regulation of gene expression), have gained prominence in sports medicine, since their plasmatic levels can change in response to acute exercise and training, making these molecules classified as mediators of adaptive exercise responses. However, it is not clear how the levels of these markers change according to the type, duration and intensity of exercise. Objective: To determine biomarkers through the analysis of alterations in the vibrational modes of salivary samples and expression of plasmatic miRNAs in trained individuals following different protocols of physical exercise. Material and methods: Saliva and blood samples were collected from male individuals at the moments: pre-exercise, post-exercise and 3 hours post-exercise. Protocols included acute bouts of continuous exercise (CE), high-intensity interval exercise (HIIE), and resistance exercise (RE). Salivary samples were analyzed by ATR- FTIR and the RT-qPCR technique was used to determine the expression of different miRNAs. Results: It was observed through the ATR-FTIR analysis that the salivary biochemical components were altered according to the exercise protocol performed, suggesting some specific spectral peaks as their biomarkers. CE showed a salivary spectrum pattern similar to HIIE, while RE showed minor changes. An algorithm capable of determining a spectrum range related to the determination of exercise intensity was also developed. Regarding the expression of the different analyzed miRNAs, an increase in miR-23a levels was observed following CE. Conclusion: to our knowledge, the present work is the first to evaluate miR-23a expression in plasma samples after continuous exercise, contributing to a better understanding of this modality in relation to circulating miRNAs and possible effects on mitochondrial pathways, since this miRNA targets peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α). Regarding the results obtained with FTIR, this is the first study that compared changes in salivary spectra after different exercise protocols, suggesting spectrum peaks as biomarkers and the first to develop the referred algorithm. Therefore, we highlight infrared spectroscopy as a useful, fast and efficient tool to evaluate the metabolic alterations promoted by exercise, allowing the use of saliva as a cost-effective alternative for studying the state of training and performance of athletes.

2023-04-25T00:00:00Z