• JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
 
  Bookmark and Share
 
 
Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2017.tde-10012017-113618
Document
Author
Full name
Thaysa Moura Dias
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2016
Supervisor
Committee
Passerotti, Carlo Camargo (President)
Azevedo, Patrícia Féra de
Iscaife, Alexandre
Title in Portuguese
Bexiga neurogênica em crianças e adolescentes: impacto familiar e biomarcadores
Keywords in Portuguese
Adolescentes
Bexiga neurogênica
Biomarcadores
Crianças
Família
Qualidade de vida
Abstract in Portuguese
INTRODUÇÃO: Bexiga neurogênica (BN) é um distúrbio da função vesical que pode causar danos renais irreversíveis. O diagnóstico precoce e o tratamento visam proteger a função renal e promover a independência do portador de BN. Já os biomarcadores urinários NGF e BDNF tem desempenhado um papel fundamental no tratamento e na avaliação clínica desses pacientes. Devido as limitações da própria patologia, como as alterações físicas e dificuldades sociais que prejudicam o aspecto emocional, crianças e adolescentes portadores de BN tendem a ter a qualidade de vida (QV) prejudicada em relação a outras crianças. OBJETIVO: Avaliar a QV entre os participantes do grupo Bexiga Neurogênica (G1) e o grupo Controle (G2) e analisar as concentrações dos biomarcadores NGF e BDNF entre os grupos. METODOLOGIA: Avaliamos 168 pessoas sendo 84 pacientes com idade entre 0 e 16 anos que são acompanhadas no Ambulatório de Urologia do HC-FMUSP e 84 responsáveis. Esses pacientes foram divididos em dois grupos sendo o G1 composto por 44 pacientes e seus responsáveis; e o G2 com 40 pacientes sem diagnóstico de BN e seus responsáveis. Os participantes da pesquisa responderam ao questionário validado PedsQLTM e um questionário socioeconômico. Foram coletadas 84 amostras de urina para análise dos biomarcadores NGF e BDNF. Os dados dos questionários após organização em planilhas de excel, foram enviados para análise estatística e as amostras de urina foram analisadas pelo teste ELISA (Enzyme-linked immunosorbent assay). Para análise estatística dos dados foi realizado o Teste T - Student e Mann-Whitney. RESULTADOS: Encontramos a mãe sendo a principal acompanhante durante as entrevistas, predominando o estado civil casada e com mais de 2 filhos sem diferença significativa entre os grupos. A renda familiar concentrou-se entre 1 e 3 salários mínimos, não tendo diferença entre os grupos. Quanto a escolaridade das crianças, a maioria estuda (77,3 do G1 e 97,5 do G2), e o nível de escolaridade predominante é o primário incompleto. O início do acompanhamento com urologista foi mais precoce no G1 (p=0,005). Houve diferença significativa entre os grupos na altura (p=0,02), peso (p=0,008), incontinência miccional (p=0,002) e intestinal (p=0,005) e no uso de medicamentos (p=0,018). O CIL foi encontrado apenas no G1 e o tipo de BN mais prevalente foi a hiperativa. Na análise estatística das respostas ao questionário PedsQLTM demonstrou que no grupo G1 os aspectos físico, social e escolar tiveram diferença significativa (p < 0,0001) em relação ao G2. Já nas amostras de urina não houve diferença significativa na concentração das proteínas NGF e BDNF entre os grupos. CONCLUSÃO: O estudo demonstrou que a QV dos portadores de BN e sua família é afetada em relação a pacientes com diagnóstico de outras patologias urológicas e a aplicação do questionário PedsQL confirmou ser eficiente apontando semelhança nos resultados de diferentes trabalhos de QV que utilizaram outros instrumentos de avaliação. Já em relação a concentração dos biomarcadores, não encontrou-se diferença significativa entre os grupos. Pesquisas futuras em crianças com BN poderão verificar a relação entre os biomarcadores e os tratamentos utilizados
Title in English
Neurogenic Bladder in children and adolescents: family impact and biomarkers
Keywords in English
Adolescent
Biomarkers
Child
Family
Quality of life
Urinary bladder neurogenic
Abstract in English
INTRODUCTION: Neurogenic bladder (NB) is a disorder of bladder function which can cause irreversible kidney damage. Early diagnosis and treatment are intended to protect kidney function and promote the NB carrier independence. As for the urinary biomarkers NGF and BDNF has played a key role in the treatment and clinical evaluation of these patients. Because of the limitations of the disease, such as physical changes and social problems that undermine the emotional aspect, children and adolescents with NB tend to have impaired QoL in relation to other children without this anomaly. OBJECTIVE: To evaluate the quality of life among the members of the group Neurogenic Bladder (G1) and the control group (G2) and analyze the concentrations of NGF and BDNF biomarkers between groups. METHODS: 170 people participated in the study and 85 patients aged 0 to 16 who are accompanied in the Urology Clinic of HC-FMUSP and 85 guardians. These patients were divided into two groups G1 is composed of 44 patients and 44 surrogates; and G2 with 41 patients without a diagnosis of BN and 41 guardians. The participants answered the questionnaire validated PedsQLTM and socioeconomic questionnaire. They collected 85 urine samples of children and adolescents participating in the study for analysis of NGF and BDNF biomarkers. Questionnaire data were organized in spreadsheets and urine samples were analyzed by ELISA (Enzyme-linked immunosorbent assay). Statistical analysis was performed Student's t-test and Mann-Whitney Test. OUTCOME: We found the mother is the primary caregiver during the interviews, predominating the married marital status and with more than 2 children with no significant difference between groups. Family income is concentrated between 1 and 3 minimum wages, with no difference between groups. Most of children are attending to school (77.3 G1 and 97.5 G2) and the incomplete primary level of education are majoritary. The beginning of the follow-up with urologist was earlier in G1 (p = 0.005). There was a significant difference between the groups in height (p = 0.02), weight (p = 0.008), urinary incontinence (p = 0.002) and bowel (p = 0.005) and the use of medications (p = 0.018). The CIL was found only in G1 and the most prevalent type of BN was overactive. Statistical analysis of the responses to the questionnaire demonstrated that PedsQLTM in G1 physical, social and educational aspects had significant difference (p < 0.0001) compared to G2. However, in urine samples there was no significant difference in the concentration of NGF and BDNF proteins between groups. CONCLUSION: The study showed that the QOL of patients with BN and your family is affected compared to patients with other urological diseases. The application of PedsQL questionnaire confirmed to be efficient and it points similarity in the results of different QOL studies using other instruments evaluation. Regarding the concentration of NGF and BDNF, it wasn´t found a significant difference between the groups. Therefore, further research can verify the relationship to the biomarkers and applied treatment in children with NB
 
WARNING - Viewing this document is conditioned on your acceptance of the following terms of use:
This document is only for private use for research and teaching activities. Reproduction for commercial use is forbidden. This rights cover the whole data about this document as well as its contents. Any uses or copies of this document in whole or in part must include the author's name.
ThaysaMouraDias.pdf (1.77 Mbytes)
Publishing Date
2017-01-10
 
WARNING: Learn what derived works are clicking here.
All rights of the thesis/dissertation are from the authors
CeTI-SC/STI
Digital Library of Theses and Dissertations of USP. Copyright © 2001-2024. All rights reserved.