http://repositorio.ufc.br/handle/riufc/184 Sun, 31 May 2026 08:31:47 GMT 2026-05-31T08:31:47Z http://repositorio.ufc.br/handle/riufc/86326 Título: Investigação da relação do polimorfismo de nucleotídeo único (rs187238) no gene da interleucina-18 e do tempo de isquemia fria com a função do enxerto em receptores de transplante renal de um Hospital Universitário de Fortaleza Autor(es): Duque, Bruna Ribeiro Abstract: Renal dysfunction is a common complication among recipients of organs from deceased donors and can be caused by ischemia-reperfusion injury, which affects the therapeutic success of the transplant. Cold ischemia time (CIT) refers to the period of organ transport, from its removal from the donor to its implantation in the recipient. Prolonged periods of CIT can influence renal graft survival, causing irreversible renal injury. In the search for early biomarkers of renal function, urinary neutrophil gelatinase-associated lipocalin (NGAL) and interleukin-18 (IL-18) may be potential predictors of graft dysfunction. IL-18 is a proinflammatory cytokine that may be involved in modulating the immune response related to acute kidney injury. The single nucleotide polymorphism rs187238 (-137G/C), located in the gene for this interleukin, is known to cause an increase in the expression of this cytokine, which may influence the individual's inflammatory profile. The present study sought to investigate the influence of the rs187238 polymorphism and CIT on graft function in kidney transplant recipients. The work is structured in three articles. The first is a narrative review on the influence of CIT on delayed graft renal function. The other articles are cross-sectional studies including renal allograft recipients from a university hospital in Fortaleza between 2023 and 2025. These studies evaluated the influence of CIT, urinary IL-18 levels, and rs187238 polymorphism genotypes on graft renal function one month after transplantation. It was observed that prolonged periods of cold ischemia are related to longer hospital stays and graft renal dysfunction, reflected in higher serum creatinine levels, lower estimated glomerular filtration rate (eGFR), and higher urinary NGAL levels. Urinary IL-18 levels and rs187238 polymorphism genotypes had no influence on clinical parameters of renal function one month post-transplant. It is concluded that urinary IL-18 is not characterized as a biomarker of renal injury in this period, and its rs187238 polymorphism did not impact the markers of renal function of the allograft. In addition, the findings demonstrate that CIT can determine the patient's prognosis and the therapeutic success of the transplant. Tipo: Dissertação Thu, 01 Jan 2026 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/86326 2026-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/85909 Título: Avaliação do conhecimento sobre metotrexato e da adesão ao tratamento em pacientes ambulatoriais com artrite reumatóide: das análises e correlações a uma estratégia educativa Autor(es): Andrade, Samylia Mota de Abstract: Rheumatoid arthritis (RA) is a chronic inflammatory disease that can affect extra-articular joints. The prevalence of RA in Brazil ranges from 0.2% to 1% and is three times more prevalent in middle-aged women. The objective of this study was to analyze knowledge about methotrexate (MTX) and medication adherence in RA. This was a cross-sectional and prospective study with collection of sociodemographic and clinical data, adherence to rheumatoid arthritis treatment using the Brazilian version of the Compliance Questionnaire Rheumatology (bCQR) and assessment of knowledge about MTX with the Methotrexate Questionnaire (bMTXQ). The sample consisted of 69 patients, with a mean age of 55.11 years and a predominance of females (95.65%). Most participants had been diagnosed with RA for ten years or more (49.28%) and had a family history of the disease (65.22%). Systemic arterial hypertension (47.83%) and diabetes mellitus (27.54%) were the most prevalent comorbidities. The analysis of adherence revealed that 62.3% of patients presented satisfactory adherence, while 37.7% were classified as having unsatisfactory adherence. The knowledge assessment showed that only 18.84% of participants answered all the essential questions for the safe use of the medication correctly. Critical items presented low accuracy rates, such as interaction with trimethoprim (23.99%), hematologic risk (28.99%) and maximum recommended weekly dose (44.93%). The analysis identified a significant association between essential knowledge about MTX and adherence to treatment (p=0.013). Patients with better knowledge demonstrated greater adherence to therapy. In addition, the presence of caregivers was associated with a higher level of knowledge about MTX (p=0.027), suggesting the positive impact of support on therapeutic management. However, the correlation between knowledge and adherence, although positive, was considered weak (r=0.210; p=0.084), indicating the influence of other factors on adherence. The correlation between knowledge about methotrexate and patient adherence to therapy showed that the level of adherence was more satisfactory when the results of knowledge about methotrexate were also higher, which corroborates data from the literature that knowledge about the treatment, such as its risks and benefits, can increase adherence and obtain better results in therapy. The literature reinforces that educational actions improve adherence and reduce the risk of treatment discontinuation. Thus, this study highlights the need for continuous, personalized and accessible educational interventions to optimize the management of RA and the safety of MTX use. Tipo: Dissertação Wed, 01 Jan 2025 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/85909 2025-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/85594 Título: Cuidado farmacêutico em terapia intensiva: avaliação de dez anos de recomendações farmacêuticas Autor(es): Furtado, Ingrid Peixoto Abstract: Clinical Pharmacy is the area of ​ ​ pharmacy where pharmacists provide patient care in order to optimize pharmacotherapy and promote the rational use of medications through the provision of pharmaceutical services (PS), which are essential in a hospital unit, especially in Intensive Care Units (ICU) where clinical and therapeutic complexity increases the risk of medication-related problems (MRP). MRP can be solved through pharmaceutical recommendations (PR) made during the provision of PS. A crosssectional, descriptive, retrospective, single-center study was conducted to evaluate the PR performed in the clinical ICU of a teaching hospital in the state of Ceará. Information regarding PR performed from January 2015 to December 2024 was collected from the service's database.Study approved by the ethics committee under number: 7.994.509. A total of 18.017 PR were performed on 1.439 patients, with an average of 12.5 PR per patient and an overall acceptance rate of 90.1%. The most frequent MRP were "necessary medication not prescribed" (21.1%), followed by "unnecessary medication prescribed" (15.5%). The most frequently performed PR were "medication inclusion" (21.1%) and "dose (adequacy)" (19.4%). Regarding the most involved drug class (ATC level 1), antiinfectives for systemic use received (33,3%), followed by alimentary tract and metabolism (18,8%), with vancomycin being the main drug (8.5%), followed by potassium chloride (4.5%) and meropenem (4.3%). During the COVID-19 period, the main MRP found for patients admitted to beds exclusively designated for patients with this disease were "necessary medication not prescribed" 19.9% and "dilution/reconstitution" 11.6%, and the PR were "inclusion of medication" 19.9% and "dose (adequacy)" 19.0%. The most frequently involved drug class (ATC level 1) was antiinfectives for systemic use (41.3%), with vancomycin (10.4%) and hypromellose/dextran (8.2%) being the most involved medications. These results demonstrate the fundamental role of the pharmacist in the ICU in resolving MRP, contributing significantly to patient safety and the optimization of pharmacotherapy. The high number of PR and the high acceptance rate demonstrate the consolidation and relevance of pharmacy services, even in challenging scenarios such as during the COVID-19 pandemic, reinforcing their essential role in the multidisciplinary team. Tipo: Dissertação Thu, 01 Jan 2026 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/85594 2026-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/84936 Título: Nanopartículas poliméricas de azul de metileno associadas a filmes de carragenana para potencial tratamento de feridas crônicas empregando terapia fotodinâmica Autor(es): Carvalho, Genuína Stephanie Guimarães Abstract: Skin lesions are a global health challenge, as they can result in physical, psychosocial, and financial harm to the community. The healing process, physiologically, is capable of promoting wound recovery, but in cases where the healing stages are interrupted, the risks to patients can be fatal. In this sense, the present work is based on the fact that carrageenan-based polymeric films containing polymeric nanoparticles with methylene blue, associated with photodynamic therapy, can overcome several limitations of conventional treatments, such as antimicrobial resistance, risk of infections, and secondary lesions. For this purpose, films based on carrageenan (2.5%) with glycerol (35% w/w in relation to carrageenan) and tween 20 (0.5% w/w in relation to carrageenan) were obtained. Then, polymeric nanoparticles with particle size of 164.7 nm, PDI of 0.153 and zeta potential of -9.83 mV and encapsulation efficiency (%EE) of 98.70% were incorporated. The films were characterized in terms of thickness, mechanical properties, water vapor permeability, wettability and optical properties. Regarding thickness, values of 0.024 ± 0.004 mm were observed, close to those described in the literature. Regarding mechanical properties, the film containing nanoparticles with methylene blue (FNPAM) presented stress at break and deformation values of 14.77 ± 3.71 MPa and 15.47%, respectively, similar to other studies, with a Young's modulus of 198.4 ± 102.03 MPa, demonstrating some rigidity of the material. The films presented acceptable values of water vapor transmission (WVTP) and water vapor permeability (WPV) at 96.12 ± 11.75 g/h.m² and 0.52093 ± 0.10 g.mm/kPa.h.m², respectively, demonstrating their possible ability to maintain moisture balance. With wettability around 45.66 ± 3.41°, the hydrophilic character of the films was confirmed. DSC, FTIR and SEM tests were also performed. FTIR, DSC and SEM confirmed the compatibility between the constituents of the formulation. Morphologically, the polymeric films did not present such a relevant difference after the inclusion of nanoparticles, suggesting a good accommodation of the nanocarriers in the polymeric matrix and efficient dispersion. Microbiological assays demonstrated the role of photodynamic therapy (PDT) associated with methylene blue nanoparticles incorporated into polymeric films as a differential in controlling the formation of Candida albicans (ATCC 928 and ATCC 14053) biofilms, based on the evaluation of biomass by crystal violet. Morphological evaluation by scanning electron microscopy (SEM) supported previous findings, in which treatments with formulation associated with PDT demonstrated a clear capacity to reduce the production of C. albicans biofilms, indicating antimicrobial efficacy, as expected. Therefore, it is possible to conclude that polymeric films, based on carrageenan, containing methylene blue nanoparticles were appropriately developed as promising delivery systems and potential wound dressings. Tipo: Dissertação Thu, 01 Jan 2026 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/84936 2026-01-01T00:00:00Z