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Prevalência de fadiga por compaixão e sua associação com a exposição ocupacional à violência e o risco de adoecimento psíquico entre policiais da perícia forense do Ceará

Thu, 01 Jan 2026 00:00:00 GMT

Título: Prevalência de fadiga por compaixão e sua associação com a exposição ocupacional à violência e o risco de adoecimento psíquico entre policiais da perícia forense do Ceará Autor(es): Oliveira, Marizangela Lissandra de Abstract: Occupational exposure to violence represents a risk factor for mental illness among public safety professionals, especially in the context of forensic science. Continuous work with trauma victims can cause mental disorders, notably compassion fatigue (CF), a phenomenon composed of Burnout (BO) and Secondary Traumatic Stress (STS). This condition can be mitigated by Compassion Satisfaction (CS), which arises when the professional feels fulfilled by helping others, and is associated with self-compassion and emotional regulation. This study analyzed the prevalence of CF and its association with exposure to violence and the risk of mental illness among police officers of the Forensic Science Department of Ceará (PEFOCE). This is a cross-sectional, analytical study, a subset of the research project "Experienced Violence, Health Conditions and Illness among Civil and Military Police Officers in the State of Ceará," conducted with police officers from PEFOCE. A structured online questionnaire was used, encompassing the FC (outcome) and sociodemographic variables, work characteristics, lifestyle habits, exposure to violence, common mental disorders (CMD), suicidal ideation, and substance use disorder (SUD). Absolute and relative frequencies were obtained; the prevalence ratio (PR) was calculated to analyze the association between exposures and the outcome; multivariate analysis of factors associated with FC was performed; and Spearman's correlation test was used between the BO, ETS, and SC scales. The analysis was performed taking into account the sampling design, using SPSS 21.0 software, considering a 95% confidence interval. The results indicated a predominance of men (67.1%), Black/mixed-race individuals (56.0%), an average age of 39.4 years, religious beliefs (84.1%), and postgraduate education (66.8%). The majority worked in Fortaleza (53.5%), on shift work (88.1%), with more than six years of service (55.3%). Almost half had another job and intended to change jobs (45.3%). Despite a relatively healthy lifestyle (fruit consumption: 82%; physical activity: 79.5%), 39.8% engaged in excessive screen time during their free time. The work environment was marked by high exposure to violence (93.1%), mainly in assisting victims and their families (75.3%). The prevalence of chronic violence was 58.9%, predominantly influenced by police reports (moderate level in 55.2%). Social security showed a favorable profile (only 3% with a low level), acting as a moderating factor. There was a moderate negative correlation between BO and SC (-0.38), and a moderate positive correlation between BO and ETS (0.36). In the bivariate analysis, factors such as living with up to two people and the absence of chemical dependency were protective; while poor financial health, intention to rotate jobs, harmful use of screens, lack of mental health activities, police victimization, risk of injury/death, victim care, mental distress, and suicide risk were risk factors. In the multivariate analysis, the risk factors for CF were: attending to victims of violence (PR=1.407), harmful use of screens (PR=1.326), activities with high cognitive and psychosocial demands (PR=1.504), mental distress (PR=1.672), and intention to rotate jobs (PR=1.280). It is concluded that compassion fatigue is an important health problem among forensic experts, directly associated with occupational exposure to violence and the risk of other mental disorders. The findings reinforce the urgent need to implement institutional strategies focused on prevention, monitoring, and mental health care for this vulnerable population. Tipo: Tese

Avaliação de risco cardiovascular em pacientes com artrite reumatoide: possível associação com atividade da doença, citocinas e a via NRF2/HO-1

Thu, 01 Jan 2026 00:00:00 GMT

Título: Avaliação de risco cardiovascular em pacientes com artrite reumatoide: possível associação com atividade da doença, citocinas e a via NRF2/HO-1 Autor(es): Nobre, Christiane Aguiar Abstract: Cardiovascular risk assessment in patients with rheumatoid arthritis: possible association with disease activity, cytokines, and the NrF2/HO-1 pathway. Christiane Aguiar Nobre. Mirna Marques Bezerra. Doctoral thesis. Graduate Program in Translational Medicine. Center for Research and Development of Medicines, School of Medicine, UFC. Fortaleza, 2026. Introduction: Inflammation contributes to cardiovascular risk (CVR) in rheumatoid arthritis (RA), and oxidative stress mediated by erythroid factor 2 (Nrf2)/heme oxygenase 1 (HO-1) may also contribute to this process. Objective: To evaluate CVR, disease activity, serum cytokine levels, and Nrf2/HO-1 pathway expression in RA. Methods: Cross-sectional study with 120 participants, divided into RA and control groups. Clinical, laboratory, and ultrasound (US) data were collected from the heart and carotid arteries; cytokines were measured by ELISA (TNF- α, IL-1β, IL-6, IL-4, IL-10) and gene expression (mRNA) of Nrf2 and HO-1 by qRT-PCR. Disease activity was measured by DAS28, SDAI, and CDAI, while CVR was measured by serum pro-BNP, US, and clinical scores (Framingham and SCORE). Analyses were performed using SPSS v26.0 (p<0.05). Results: The sample was predominantly female (90%), with a mean age of 52 years. The control group had higher values for dyslipidemia (p=0.027), abdominal circumference (p=0.017), BMI (p=0.010), and blood glucose (p<0.001). In the RA group, the mean duration of the disease was 10.4 ± 7.5 years, with 63.3% positive for rheumatoid factor and/or anti-CCP. Regarding treatment, 91.7% used DMARDs, 21.7% used biologics, and 11.7% used target-specific agents. No differences were observed between the groups in clinical CVR scores and US findings. However, pro-BNP levels were higher in RA (p=0.009). We observed higher levels of IL-6 (p=0.002) and IL-10 (p=0.004), with a reduction in IL-1β (p=0.001). We found an increase in mRNA-Nrf2 (p<0.001) and a reduction in mRNA-HO-1 (p=0.030). Disease lasting more than 10 years was associated with hypertension (p=0.023), higher DAS28-ESR (p=0.017) and SDAI (p=0.025), as well as more frequent use of antihypertensive drugs (p<0.001), statins (p=0.011), hypoglycemic agents (p=0.038), and higher blood glucose levels (p=0.029). CDAI correlated with higher IL-6 levels (p=0.033) and DAS28-PCR with lower education (p=0.038), longer disease duration (p=0.012), ventricular dysfunction (p=0.044), and elevated triglycerides (p=0.030). Conclusion: Patients with RA presented with Nrf2/HO-1 pathway dysregulation and elevated pro-BNP. Higher disease activity and longer disease duration were associated with a higher prevalence of comorbidities and cardiovascular complications in RA. Tipo: Tese

Estudo prospectivo da resposta a quimioterapia neoadjuvante na determinação do tratamento cirúrgico conservador em pacientes com câncer de mama

Mon, 01 Jan 1996 00:00:00 GMT

Título: Estudo prospectivo da resposta a quimioterapia neoadjuvante na determinação do tratamento cirúrgico conservador em pacientes com câncer de mama Autor(es): Machado, Francisco Heine Ferreira Abstract: This present prospective study mtended to evaluate the contribution of neoadjuvant chemotherapy upon the reduction of breast malignant tumors with views to perform conservative operation as oposed to a more aggressive radical surgical procedure. Thirty two patients with mfiiltrating carcinoma of the breast stages I, IIa, lib, DIa and DIb eligible to underço radical inastectomy were included in this work. All patients studied were submited to fisical examination with measure of tumor size using tumorimeter, mammography, mammary ltrasonography, citology and core biopsy of the tuinor using tru-cut needle. With confirmed carcinoma of the breast upon results either from citology or core biopsy, aU patients received combmed neoadjuvant chemotherapy with 5- fluorouracü SOOmg/m , epirrubicine 50mg/m and cyclophophamide 500mg/m (FEC), every 21 days for three consecutive cycles as their initial therapy. After tree cycles of chemotherapy, patients were subjected again to the previous applied set of investigations including fisical examination with new measure of the tumor, mammography, mammary ultrasonography, citology and core biopsy of remaining tumor. Surçical local treatment m the form of either radical mastectomy (Madden operation) or quadrantectomy plus axilary clearence was performed. The mean tumor volumes before and after adjuvant chemotherapy were according to dsical exammatíon 24.23cm and 7.53cm , measured by mammography 10.81cm and 5.93cm3 and evaluated through mammary ultrasonography 5.70cm3 and 2.67 Objective response (OR) based on results from the above performed investigations was considered when patients presented either complete tumor size reduction (100%) or tumor size reduction equal or superior to 50%. Objective response (OR) based on fisical examination was observed m 84.5% of patients. When mammography was applied as the anaUzing method 81.2% of patients also presented objective response (OR). Accordmg mammary ultrasonography 80.0% of patients presented objective response (OR). These results were therefore very simuar irrespective of the method of evaluation applied. The rate of breast sakage was 81.2% which means that twenty six out of thirty two patients previously etígible to radical mastectomy underwent conservative surçery. The esthetic results obtained from conseryative surçery were considered good and excellent. The neoadjuvant Qt was efective to promove significance response, without stimulate important agressive m the pacients. The toxicity induced by neoadjuvant chemotherapy caused a high percentage of alopecia and a moderate incidence of nausea and vomits. These resuhs indicate that neoadjuvant chemotherapy can modify the use of radical mastectomy to a nnore conservative surçical treatment in the majority of patients studied. Futhermore, neoadjuvant chemotherapy response may be used to select patients with aggresive non-responsive breast tumors to receive other combmations of chemotherapy drugs which may be more efifective during post operative chemotherapy. Tipo: Dissertação

Avaliação da expressão dos genes do ritmo circadiano como potenciais biomarcadores em pacientes portadores de leucemia mielóide aguda

Thu, 01 Jan 2026 00:00:00 GMT

Título: Avaliação da expressão dos genes do ritmo circadiano como potenciais biomarcadores em pacientes portadores de leucemia mielóide aguda Autor(es): Cunha, Leidivan Sousa da Abstract: Acute myeloid leukemia (LMA) is an aggressive hematological malignancy, common in adults, characterized by high mortality and marked genetic heterogeneity. Growing evidence indicates that dysregulation of the circadian rhythm (RC) and its core genes, the Clock Genes (CG), CLOCK, BMAL1, NPAS2, and the negative regulator CIPC, interferes with key oncogenic processes, including cell proliferation, DNA repair, and energy metabolism. In this context, this study aims to evaluate the expression of CG as potential biomarkers in adults with LMA in the state of Ceará. This is a prospective, observational, and analytical study including 90 patients with LMA (mean age 56.6 years; predominantly male) treated at referral centers in Ceará, and 40 healthy controls. Paired peripheral blood (SP) and bone marrow (MO) samples were collected for RNA extraction, cDNA synthesis, and gene expression quantification by RT-qPCR. Diagnostic performance was assessed using ROC curves, logistic regression models, and a Random Forest algorithm. No significant differences were observed in CG expression between SP and MO, supporting the use of SP as a surrogate tissue. Patients with LMA showed a marked reduction in the expression of NPAS2, BMAL1, CLOCK, and CIPC compared to controls (p<0.001). Among individual markers, NPAS2 demonstrated the best discriminative performance (AUC 0.925; 95% CI: 0.87–0.98), explaining 65.1% of the outcome variability in the logistic model. The combined four-gene model achieved an AUC of 0.946, with no statistically significant improvement over the model with NPAS2 alone (p=0.183). The Random Forest model showed 74% sensitivity and 100% specificity, highlighting NPAS2 as the most important predictive variable. Thus, LMA is associated with a marked dysregulation of CG expression. NPAS2 stands out as a robust diagnostic biomarker, with high discriminative performance and potential clinical applicability. These findings expand the understanding of leukemogenesis from a circadian perspective and support the exploration of biological clock pathways as diagnostic and therapeutic targets. Tipo: Dissertação