DSpace Communidade:

Efeitos da auriculoterapia no estresse percebido e nos níveis de cortisol salivar em trabalhadores de saúde: ensaio clínico controlado randomizado

Wed, 17 Dec 2025 00:00:00 GMT

Título: Efeitos da auriculoterapia no estresse percebido e nos níveis de cortisol salivar em trabalhadores de saúde: ensaio clínico controlado randomizado Autor(es): Damasceno, Kairo Silvestre Meneses Primeiro Orientador: Pimentel, Magno Merces Weyll Abstract: Introduction: Healthcare workers are subject to work-related stressors that can lead to physical, psychological, social, and behavioral problems, making stress management at work extremely important. Integrative and Complementary Health Practices can contribute to this process, such as auriculotherapy, which demonstrates a good cost benefit ratio for controlling mental disorders such as stress and anxiety. Objectives: To evaluate the effects of auriculotherapy on perceived stress levels and salivary cortisol levels in primary healthcare workers in the municipality of Salvador, Bahia, Brazil; to identify non-pharmacological therapies used in stress management in healthcare workers and their effects on self-reported stress and physiological stress; to measure and correlate self-reported stress and cortisol levels in primary healthcare workers; to identify factors associated with perceived stress and salivary cortisol levels in primary healthcare workers; to estimate the prevalence of burnout and its associated factors in primary healthcare workers; to identify the prevalence and types of violence experienced by primary healthcare workers. Methods: Epidemiological survey followed by a randomized controlled clinical trial. A sociodemographic, occupational, and human biology questionnaire, the Perceived Stress Scale (ESP-10), and the Maslach Burnout Inventory (MBI) were applied to healthcare workers in the Family Health Strategy. Approximately 1 milliliter of saliva was also collected in Salivette® tubes to measure salivary cortisol levels. Measures of central tendency and frequencies were used for descriptive analysis, correlation measures between cortisol levels, burnout, and perceived stress; logistic regression with the dependent variable burnout (binary) and linear regression with the numerical dependent variables perceived stress and burnout dimensions were used. For the clinical trial, workers with perceived stress above the overall average and with cortisol levels above the median were randomized into two groups: auriculotherapy, with application of the therapy to the Shenmen, kidney, heart, sympathetic, and brainstem points, and a placebo group, with application to the external ear and wrist points. After 4 sessions, a paired t-test (before and after therapy) was performed in case of normal sample distribution, and the Wilcoxon test was used for non-parametric distribution. The Mann-Whitney test was also used for comparison between groups. Results: there are few studies in the literature on the use of auriculotherapy to reduce physiological and perceived stress in healthcare workers. Among the workers, 58.54% presented high perceived stress, 17.48% presented burnout, 76.4% had low professional self-esteem, 58.8% had suffered some type of violence at work, and 78.8% were dissatisfied with their economic situation. The correlation between salivary cortisol and perceived stress was positive, but weak and statistically insignificant (r = 0.036 and p-value = 0.534). Perceived stress was associated with age (β=-0.11 and p=0.001), economic dissatisfaction (β=2.98 and p<0.001), and not engaging in physical activity (β=2.29 and p=0.005). Cortisol levels were associated with not having experienced violence (p=0.038) and moderate alcohol consumption (p=0.005). Burnout was associated with age (β=-0.04 and p=0.04) and economic dissatisfaction (β=1.12 and p=0.026). The emotional exhaustion dimension of burnout was associated with age (β=-0.09 and p=0.007), economic dissatisfaction (β=3.15 and p<0.001), and having experienced workplace violence (β=2.85 and p<0.001). Low self-esteem was associated with age (β=0.06 and p=0.012) and salary dissatisfaction (β=-2.061 and p<0.001). In the clinical trial, the auriculotherapy group reduced perceived stress from 24.8±3.44 to 17.6±5.59, p<0.001. The comparison with the placebo group also showed statistical significance (p<0.001). The effect size of the therapy was considered large in relation to perceived stress (Cohen's d = 1.59). There were no significant effects in relation to salivary cortisol levels. Conclusion: Salivary cortisol levels did not have a significant correlation with perceived stress, which shows still conflicting results in the literature and the existing methodological diversity. Economic dissatisfaction was associated with perceived stress, burnout and its dimensions of emotional exhaustion and low professional self-esteem, which reflects the need for professional recognition through financial appreciation of these workers. Most workers have already suffered some type of violence in the workplace. In this context, institutional policies are urgently needed to protect these workers and the work environment. Auriculotherapy has proven effective in reducing perceived stress in primary healthcare workers and could be applied within the Brazilian Unified Health System (SUS) for stress management and quality of life at work. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Tese

A obesidade e o tecido adiposo na patogênese e gravidade da Leishmaniose cutânea

Wed, 01 Jan 2025 00:00:00 GMT

Título: A obesidade e o tecido adiposo na patogênese e gravidade da Leishmaniose cutânea Autor(es): Nassri, Kelly Morais Lima Primeiro Orientador: Carvalho Filho, Edgar Marcelino de Abstract: Obesity is associated with worse clinical outcomes in cutaneous leishmaniasis (CL). Here, we evaluated the influence of obesity on the systemic, dermal, and adipose tissue immune responses in CL. A total of 39 obese and 43 individuals with normal BMI with ulcerated CL caused by Leishmania braziliensis confirmed by PCR were enrolled, along with 8 healthy subjects (HS), 4 with normal BMI and 4 obese. Peripheral blood mononuclear cells (PBMC) were cultured for 72 hours in the presence or absence of soluble Leishmania antigen (SLA, 5 μg/mL). Skin and adipose tissue biopsies were analyzed histologically, and cytokines and adipokines were quantified after 72-hour incubation. All patients were treated with meglumine antimoniate. The cure rate was lower in obese patients (41%) compared to those with normal BMI (70.4%) (p < 0.05). No significant differences in proinflammatory cytokine production were observed in PBMC supernatants. However, cytokines (IL-1β, IL-17, Granzyme B) and leptin were significantly higher in skin biopsies of obese compared to normal BMI CL patients (p < 0.05), and leptin levels correlated directly with these cytokines in both groups. Adipose tissue was infiltrated by inflammatory cells, with larger inflammatory areas in obese CL patients (p < 0.05). Cytokines were largely undetectable in adipose tissue, except for elevated CCL2. Notably, leptin and adiponectin levels were markedly increased in CL patients compared to HS, suggesting infection-driven modulation of adipocyte function. These findings demonstrate that CL enhances adipokine production and that obesity amplifies local inflammatory responses, contributing to greater disease severity and therapeutic failure in obese individuals. Editora / Evento / Instituição: UNIVERSIDADE FEDERAL DA BAHIA Tipo: Dissertação

Tenho asma, e agora?

Wed, 01 Jan 2025 00:00:00 GMT

Título: Tenho asma, e agora? Autor(es): Pinheiro, Gabriela P.; Santos, Carolina B. S.; Magalhães, Bianca M.; Coelho, Ana Carla C.; Cruz, Álvaro A.; Franceschini, Juliana; Honda, Angela Abstract: Asthma is a very common disease, affecting approximately 339 million people worldwide and more than 20 million Brazilians. It manifests in highly diverse ways from one individual to another and varies across different stages of life. Asthma is a chronic condition with no cure—much like diabetes or hypertension—but it can be effectively treated and well controlled. With proper management, people with asthma can lead completely normal lives and even participate in high-level athletic activities. Despite this, many individuals still lack adequate access to diagnosis and treatment, and preventable deaths due to asthma continue to occur. This should not happen. Through the booklet “I Have Asthma, Now What?”, we aim to support people with asthma by promoting appropriate treatment and preventive care, helping to control symptoms, improve quality of life, and ensure full participation in daily, educational, and professional activities. Editora / Evento / Instituição: Fundação PROAR Tipo: Livro

Ressonância magnética na avaliação da redução progressiva da área medular em indivíduos infectados pelo HTLV-1 com ênfase na associação entre atrofia lombar e disfunção urinária sem comprometimento motor

Mon, 24 Nov 2025 00:00:00 GMT

Título: Ressonância magnética na avaliação da redução progressiva da área medular em indivíduos infectados pelo HTLV-1 com ênfase na associação entre atrofia lombar e disfunção urinária sem comprometimento motor Autor(es): Carvalho, João Marcos da Silva Primeiro Orientador: Carvalho, Edgar Marcelino de Abstract: Introduction: The primary neurological manifestation of definitive HTLV-1-associated myelopathy (HAM) is spastic paraparesis, but it occurs in only 5% of patients. In contrast, approximately 40% of individuals infected with HTLV-1 present symptoms of urinary dysfunction, including nocturia, urgency, and incontinence, which may progress to an inability to urinate. Since these patients do not exhibit motor dysfunction, they are classified as probable HAM. Thoracic spinal cord (SC) atrophy is the main abnormality observed in magnetic resonance imaging (MRI) in patients with definitive HAM, but SC damage has not been reported in patients with probable HAM. Objective: To describe spinal cord features in individuals infected with HTLV-1 through magnetic resonance imaging (MRI). Methods: HTLV-1 infection was diagnosed by Western blot, and MRI was performed using a 1.5 Tesla scanner. Atrophy was defined when the SC area was less than 25% of the intrathecal area. Results: We observed a progressive reduction in all SC area segments among HTLV-1 carriers, patients with probable HAM, and definitive HAM. Notably, 48.3% of patients with probable HAM exhibited lumbar region atrophy. Conclusion: This study demonstrates, using MRI metrics, atrophy of the lumbar SC segments in patients presenting urinary symptoms associated with HTLV-1 but without motor dysfunction. Our findings suggest that spinal cord evaluation through MRI should be considered in clinical practice for the early monitoring of HTLV-1-infected patients, especially those with probable HAM. Early detection of SC atrophy may enable timely therapeutic interventions, potentially slowing disease progression and improving clinical outcomes. The impact of SC atrophy on functionality and quality of life highlights the need for more precise diagnosis and systematic follow-up. Editora / Evento / Instituição: UNIVERSIDADE FEDERAL DA BAHIA Tipo: Tese