Trabalhos de Conclusão de Curso

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https://repositorio.unifev.edu.br/handle/123456789/17

Biomedicina

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AVALIAÇÃO DA QUALIDADE DA ÁGUA DE POÇOS DE USO INDEPENDENTE NA REGIÃO DO NOROESTE PAULISTA
(2024-12-03) Nathália Ferreira da Silva; João Victor Marques
It is well-established that high-quality water is indispensable for optimal human health. Given water scarcity, groundwater has been increasingly used for various purposes, including domestic supply, agriculture, and industry. This study aimed to assess the quality of groundwater in wells located in the Votuporanga-SP region by comparing analysis results with the limits set by Brazilian legislation (Portaria GM/MS No. 888 of 2021).Forty individual wells were analyzed from January to October 2024. Physico-chemical and microbiological analyses were conducted by LaborLab following the Standard Methods for the Examination of Water and Wastewater. Results indicated that 7.5% of the wells exceeded the permitted nitrate limit (10 mg/L), 55% contained total coliforms, and 10% presented thermotolerant bacteria. In summary, 70% of the samples were unsuitable for human consumption. The results highlight the need for rigorous monitoring and appropriate treatment of groundwater in the region to ensure its potability. It is crucial to adopt measures beyond conventional techniques, with a closer focus on guaranteeing water quality and public health.
ERROS PRÉ-ANALÍTICOS ASSOCIADOS À COLETA SANGUÍNEA
(2024-12-03) ÉLLEN CLEMENTE DOS REIS
Diagnostic medicine aims to ensure efficient and safe care for patients. Therefore, it is essential that clinical laboratories provide fast and reliable results, as these are essential in decision-making and disease prognosis. The pre-analytical phase covers all the steps that precede the exam. It is known that this phase is responsible for approximately 68% of laboratory errors. The objective, then, was to present the main errors in blood collection, analyze the factors contributing to the occurrence of these errors, proposing strategies to minimize pre-analytical errors. The methodology used was through a bibliographic survey using scientific articles published from 2003 onwards, available on virtual platforms, such as SciELO, PubMed and Google Scholar. The research showed that the most frequent pre-analytical errors associated with blood collection include incorrect patient identification, inadequate tube order, inadequate sample handling and prolonged transportation time to the laboratory. Such failures compromise the quality of the results. And the standardization of processes contributes positively, generating more reliability in the information associated with laboratory test results and reducing complications. It is concluded that this phase is more susceptible to errors due to the majority of processes being manual. To reduce these errors, it is necessary to implement continuing education programs in clinical laboratories, in addition to continuously monitoring team practices. The adoption of standardized protocols and training of professionals are essential to guarantee the reliability of results and patient safety.
OS PRINCIPAIS ERROS PRÉ-ANALÍTICOS E SUAS INTERFERÊNCIAS LABORATORIAIS: UMA REVISÃO BIBLIOGRÁFICA
(2024-12-03) RAFAELA FERNANDES PESSOA; RAFAELA MATTIAZZO GOMES
Os procedimentos laboratoriais são realizados por três fases, a pré-analítica, analítica e pós- analítica. A fase pré-analítica é o período entre a solicitação do exame médico até a sua realização no laboratório clínico. Esta fase, possui grande parte de erros laboratoriais, é a fase mais importante nos processos de testes laboratoriais clínicos, sendo ela também a fase que mais acomete erros, por muitos deles não estarem sob controle direto do laboratório, como amostras hemolisadas, volume insuficiente, falta de identificação correta, tempo de jejum inadequado, flebotomia incorreta, entre outros erros que podem prejudicar o resultado para o diagnóstico final. Os laudos laboratoriais são de suma importância para as decisões médicas, entretanto é imprescindível que todas as etapas sejam realizadas corretamente, a fim de evitar tais erros, podendo atrapalhar no diagnóstico e até mesmo algum tratamento de determinado paciente. De acordo com o tempo. o avanço da tecnologia chegou aos laboratórios, proporcionando uma melhora significativa nos diagnósticos, como exemplo essa tecnologia diminuiu grande parte dos erros da fase analítica, pois nela, grande parte é realizada através de automação. Na fase pré-analítica corresponde aproximadamente a 68% dos erros laboratoriais. Literaturas atuais apontam que os erros são referentes ao laboratório, embora o paciente não seja anulado deste padrão. O trabalho teve como objetivo principal relatar os principais erros da fase pré-analítica e também como a má administração da coleta, transporte, armazenamento, podem impactarem problemas no diagnóstico laboratorial. O presente trabalho, foi realizado como uma revisão bibliográfica, onde foi pesquisado em bancos de dados como SciElo, PubMed, Medline as principais interferências que ocorrem durante a fase pré-analítica, selecionando os artigos dos últimos 20 anos, utilizando descritores como: erros pré-analíticos, interferências laboratoriais. Durante as pesquisas, foi observado que a fase pré-analítica apresentou uma porcentagem de erros equivalentes a 70% das interferências laboratoriais, tendo como os principais hemólise, amostras insuficientes e amostras coaguladas, também foi observado que a implementação dos programas de controle de qualidade reduziu os erros, que no início era de 75% para 24%. Muitos diferentes tipos de erros estão relacionados à fase pré- analítica. Sendo a fase mais importante e a mais propícia a erros, sendo erros diretamente relacionados ao processo manual e com o paciente. De acordo com a revisão da literatura os erros mais frequentes que ocorrem na fase pré-analítica foram hemólise de 40 a 70%, amostras insuficientes 0,04 a 5,71% e amostras coaguladas sendo 0,2 a 10,7%. Conclui-se, portanto, que a fase pré-analítica, mesmo com os avanços tecnológicos é uma fase que depende muito dos trabalhos manuais, diferente das outras fases que possui procedimentos automatizados, esta fase também é difícil de obter controle dos erros. Diante desses problemas expostos, um bom treinamento dos profissionais para priorizar a qualidade do trabalho e uma gestão de controle de qualidade seriam essenciais para diminuição de erros pré-analíticos. Contudo os laudos estariam de acordo com a situação clínica do paciente, buscando um diagnóstico preciso e confiável, trazendo confiabilidade para os laboratórios, profissionais e pacientes.
ERROS NA FASE ANALÍTICA NA REALIZAÇÃO DE EXAMES LABORATORIAIS
(2024-12-03) MORIELLI RIBEIRO DE MENDONÇA DE MORAIS; YASMIN ROBERTA DA CENA
Laboratory tests are essential for the diagnosis, prognosis, and monitoring of various diseases. The laboratory process includes three phases: pre-analytical (obtaining the biological material), analytical (performing the analyses), and post-analytical (issuing the report). Laboratory errors can occur at any stage, from the medical request to the interpretation of results, potentially leading to incorrect diagnoses or inadequate clinical interpretations. Most errors occur in the pre-analytical phase (46% to 68%) and post-analytical phase (19% to 47%). Objective: To investigate the main errors committed in the analytical phase and analyze their impact on post-analytical results. Methods: Data will be collected from books and scientific articles on the PubMed and Scielo platforms. The analysis will include reading abstracts and, subsequently, the full texts of the most relevant articles. Development: The review identified the main errors in the analytical phase, such as inadequate calibration of equipment, lack of internal controls, incorrect sample identification, cross-contamination between samples, loss or exchange of samples, unvalidated analytical systems, quality control failures, pressure for quick results, and instrument malfunctions. These errors are often caused by human failures. It is crucial for clinical laboratories to ensure the correct execution of all stages to avoid errors in the results. Conclusion: Each phase of the laboratory process is crucial, as errors at any stage can compromise test results. The literature review showed that the most frequent errors in the analytical phase are inadequate equipment calibration and lack of internal control. Technological advancements and automation have helped reduce errors and improve the quality of tests.
ANEMIA FALCIFORME: UMA REVISÃO DE LITERATURA
(2024) KESLYE VITÓRIA MADRID DE CAMPOS; MARIA EDUARDA SOUZA DELAGO
Sickle cell anemia (SCA) is a genetically inherited condition with an autosomal recessive pattern, manifesting in individuals who are homozygous for hemoglobin S. This leads to the deformation of red blood cells into a sickle or crescent shape, resulting in recurring and intense symptoms throughout life. The pathogenesis of this condition is due to an alteration in the beta-globin gene of hemoglobin, caused by a genetic mutation on chromosome 11. In SCA, glutamic acid is replaced by valine at position 6 of the codon, causing red blood cells to lose their biconcave structure, undergo polymerization, and deoxygenation; consequently, the cell takes on a sickle shape, which leads to structural changes in the cell membrane. Sickle-shaped cells are prematurely eliminated by the spleen, leading to chronic anemia and the need for blood transfusions in more severe cases. Individuals with the disease exhibit a wide range of symptoms that can vary in intensity from moderate to severe, depending on the amount of HbS in the body and the level of oxygen to which the red cells are exposed. The objective of this research was to conduct a literature review on SCA, describing its cause, disease characteristics, cellular alterations, treatments, and laboratory diagnostic methods. Electronic literature searches were conducted in the following databases: SciELO (Scientific Electronic Library Online), RBAC (Brazilian Journal of Clinical Analysis), , Academic Google, Medline, PubMed, as well as books and websites (ANVISA, Ministry of Health, and World Health Organization). Inclusion criteria for articles in the research were publications mentioned within the last twelve years and published in Portuguese, English, and Spanish.
COLETA VENOSA EM UM HOSPITAL DO NOROESTE PAULISTA: INTERFERENTES PRÉ-ANALÍTICOS
(2024) AMIÊ MORAIS MARANA
Laboratory medicine results are essential and represent a critical point in diagnosis, treatment, monitoring, patient care, and safety. It is important to investigate and improve procedures and processes stemming from venous blood collection, whether conducted directly by the laboratory or by other healthcare professionals; most errors in laboratory medicine occur in the pre-analytical phase. All errors should be measured and controlled through indicators that provide an objective assessment of the issue, with results used as a means for learning and continuous quality improvement. This study aimed to identify, characterize, and quantify the prevalence of errors resulting from collections carried out by an Emergency Service in the city of Votuporanga, São Paulo. The methodology used included a qualitative, quantitative, and comparative evaluation of recollections before and after conducting training for hospital professionals. The results of this research showed that, regardless of the Unit’s number of patients and provided training, errors persisted, underscoring the need to implement a quality management system and improvement actions in the pre-analytical phase. These actions include maintaining a continuous education system to reinforce good collection practices and sample integrity, as well as practices that reduce staff turnover.
HPV E CÂNCER DE COLO UTERINO
(2024-12-15) Ariane Cardoso Alves; Renata Braz de Lima
The Human Papillomavirus (HPV) is a causative agent of various lesions, including cervical cancer. HPV types 16 and 18 are primarily responsible for the development of this type of cancer, as well as other malignant pathologies, such as anal and vulvar cancers. Globally, HPV accounts for 4.5% of cancer cases, with 8.6% affecting women. In Brazil, cervical cancer is the third most common type among women. This study aimed to describe the characteristics of HPV, transmission modes, associated pathologies, diagnostic methods, and prevention strategies, focusing on vaccination and its impact on reducing cervical cancer. A narrative literature review was conducted using databases such as SciELO, MEDLINE, and PubMed. The review included articles published in the last ten years, as well as documents from health organizations, such as ANVISA, the Ministry of Health, and the World Health Organization. Clinical diagnosis includes visual assessment, colposcopy, and biopsy to confirm suspicious lesions. The clinical diagnosis of HPV lesions begins with visual inspection, with colposcopy being essential for a detailed evaluation of the cervix, allowing the identification of suspicious lesions and abnormal epithelial areas. Examinations like peniscopy and anoscopy are also crucial for detecting lesions in anogenital areas, particularly in high-risk patients. Biopsy is indicated in cases where neoplasia is suspected, allowing histopathological confirmation of the lesions. Laboratory diagnosis is based on cytological and molecular methods, with the Papanicolau test being the most widely used for cervical lesion screening, despite its limitations in sensitivity, the Papanicolau test is a crucial tool for early detection of cellular changes. Additionally, the HPV DNA test is an advanced technique that offers higher sensitivity, enabling the detection of high-risk HPV infections, such as types 16 and 18. The hybrid capture technique has also proven effective in detecting these infections, using specific probes to identify viral DNA. The combination of these methods provides a more comprehensive assessment, increasing the chances of early detection and effective treatment of precancerous cervical lesions. HPV vaccination, introduced in Brazil in 2014, is highly effective in preventing cervical cancer, especially when administered before the onset of sexual activity. However, the impact on reducing incidence and mortality remains limited due to the recent implementation of the vaccine, the long development period of the disease, and low vaccination coverage, which still faces challenges such as vaccine hesitancy and restricted access to healthcare services. HPV vaccination is a crucial tool for preventing cervical cancer. However, vaccine uptake and access to healthcare need to be strengthened to maximize its impact. Continuous awareness campaigns and efficient public policies are essential to achieve a significant reduction in the burden of this type of cancer in Brazil.
DIABETES MELLITUS TIPO 1 NA INFÂNCIA: REVISÃO DE LITERATURA
(2024-12-15) Bárbara Eduarda da Silva Correia; Mayla Fernanda Derossi da Silva
Diabetes Mellitus (DM) is a metabolic syndrome characterized by deficiency in insulin secretion by pancreatic beta cells and/or resistance of target tissues to the actions of this hormone, culminating in several impairments in the control of carbohydrate, lipid and protein metabolism. In addition to hyperglycemia, other changes are observed in DM, such as: high circulating levels of triglycerides, increased fatty acids, cholesterol and low-density lipoprotein (LDL), and decreased levels of high-density lipoprotein (HDL). Among the main clinical manifestations described are: glycosuria, polyuria, weight loss, polydipsia, polyphagia and blurred vision. The objective of this study was to describe the importance of early diagnosis of type 1 DM in childhood, aiming to understand its impacts on the development and quality of life of affected children, in addition to promoting greater awareness of the need for preventive measures and appropriate interventions. The pathophysiology of DM, clinical and laboratory diagnosis were also addressed. This study was carried out through a descriptive narrative literature review, which described the pathophysiology of DM1, clinical and laboratory diagnosis, treatment, and monitoring by the SUS. Data collection for this study was carried out from February to November 2024. To carry out this research, the following guiding question was formulated: How important is the early diagnosis of type 1 diabetes mellitus in childhood? An electronic search was carried out in the Scientific Electronic Library Online (SciELo), MEDLINE, PubMed, and Ministry of Health databases. Children with type 1 DM may present signs such as polyuria, polydipsia, and weight loss, but these may be masked in children who wear diapers and breastfeed. Therefore, attention should be paid to the signs and symptoms that are presented, such as weight loss, irritability, and dehydration. Lack of long-term control of glucose levels can lead to chronic complications in the blood vessels, such as neuropathy, amputations, retinopathy, kidney disease, and cardiovascular disease. These complications may arise during puberty or five to ten years after the onset of the disease. Other serious complications include episodes of hypoglycemia and hyperglycemia that, when combined with inadequate control of the condition, may result in hospitalizations and even death. It is concluded that attention should be paid to the initial and classic symptoms that go unnoticed due to the daily routine of parents. Currently, the use of electronic devices causes children to lack physical activity, becoming obese, which contributes to the development or worsening of DM. Educational and prevention programs for children to change their lifestyle are necessary within schools to highlight the importance of the disease and thus reach adulthood in a healthy state.
DIAGNÓSTICO E MANEJO DO DIABETES MELLITUS TIPO 1 EM CRIANÇAS
(2024-12-12) Lívia Garcez Machado
Type 1 diabetes mellitus (type 1 DM) is a metabolic disorder characterized by high and persistent blood glucose levels, caused by deficiency in insulin production or its action. Persistent increased blood glucose levels are associated with chronic micro and macrovascular complications, reduced quality of life, increased morbidity, and increased mortality rates. The objective was to describe the clinical and laboratory diagnosis of type 1 DM, the aspects of type 1 DM management in children, highlighting the most relevant factors for adequate management, as well as the participation of family members in this process. This work was developed through a literature review, of the narrative type, using the following descriptors: Type 1 Diabetes Mellitus, laboratory diagnosis of Type 1 Diabetes Mellitus, child development, family involvement in Type 1 Diabetes Mellitus. Articles from 2015 to 2024 were used, and this work was carried out from February to November 2024. DM is a health condition with high incidence worldwide. DM can be classified as: type 1 DM, type 2 DM and gestational DM. Type 1 DM is an autoimmune disease in which the immune system attacks and destroys the beta cells of the pancreas, resulting in a reduction in insulin production by the pancreas. This type is more common in children and young people. Type 1 DM is recognized as the second most prevalent chronic condition among children. The clinical diagnosis of type 1 DM involves the detection of typical signs and symptoms, in addition to performing specific laboratory tests. The tests for laboratory diagnosis are Fasting Blood Glucose, Oral Glucose Tolerance Test (OGTT) and Glycated Hemoglobin (HbA1c). To confirm the diagnosis of DM, some parameters are considered, and it is recommended that more than one dosage be performed to confirm the diagnosis, especially if the person is asymptomatic. The criteria include: Fasting blood glucose ≥ 126 mg/dL and random blood glucose (obtained at any time of the day) ≥ 200 mg/dL, glycated hemoglobin ≥ 6.5% and blood glucose 2 hours after oral ingestion of 75 g of glucose ≥ 200 mg/dL, in patients with typical symptoms of DM. The management of type 1 DM in Brazil involves a multidisciplinary and integrated approach, taking into account the specifications of the health system and the diversity of the population; it is a collaborative effort involving health professionals, patients and their families. Family participation, offering support to the child from the diagnosis and cultivating a healthy family environment, is essential for adherence to treatment and control of glucose levels. However, active involvement of family members is essential to ensure that the child receives the necessary support to deal with the daily demands of DM. Success in the management of type 1 DM in children depends significantly on family involvement.
IMUNOTERAPIA CONTRAS CÉLULAS DO CÂNCER
(2024-12-12) Bianca Prado Borges; Eduarda Laura Teixeira Lima
Immunotherapy is an innovative therapeutic approach dedicated to the treatment and immunoprophylaxis of cancerous and infectious diseases, among others. This field has grown and has been innovating with the advancement of technology, which reveals new prophylactic perspectives. It is an alternative biological treatment that aims to strengthen the immune system so that it can fight infections and diseases such as cancer, blocking certain factors that lead to an increase in the immune response, stimulating the activity of the body's defense cells so that these cells recognize the tumor as an invader. This study aimed to describe the main immunotherapeutic agents for the treatment of cancer, their techniques and procedures of the immunotherapeutic methods used against malignant neoplasms. The methodology used was a narrative literature review, through electronic search in the databases: Scientific Electronic Library Online (SciELo), MEDLINE, PubMed, with original articles published in the last ten years; articles published in Portuguese, English and Spanish, as well as books and websites (ANVISA, INCA, PAHO, Instituto Butantan, Ministério da Saúde and National Cancer Institute, World Health Organization, American Cancer Society). Although immunotherapy is little known by the population, its effectiveness has been increasing in scientific research, gaining more and more market share. This therapeutic field is promising and has great potential to be explored. Researchers suggest that it would be possible to carry out an effective and economical treatment using more efficient diagnostic tools, such as genetic mapping and artificial intelligence, which would enable more treatments. In immunotherapy treatments, immunotherapeutic agents are used, such as monoclonal antibodies (mABs), which are developed in the laboratory to interact with specific antigens of certain cell types, allowing the preservation of healthy cells compared to conventional therapies; CAR-T cell therapy, based on the use of CD8+ T lymphocytes extracted from the patient, which are genetically modified to recognize antigens on the tumor surface; Vaccines, which can be prophylactic, which aim to prevent certain types of cancer related to viruses and infections, or therapeutic, used as a treatment strategy for existing malignancies, are designed to induce the patient's T cells to respond to cancer antigens, interrupting the tolerance acquired by tumor cells; immune checkpoint inhibitors, which enhance anticancer immune responses, are drugs that target specific receptors on the surface of T lymphocytes; and cytokines, where they play the role of messenger molecules, with their crucial role in the direct stimulation of immune effector cells and stromal cells at the tumor site, in addition to increasing the recognition of tumor cells by cytotoxic effector cells. However, the importance and versatility of immunotherapy in combating malignant tumors has been verified, aiming at improving the quality of life of cancer patients. Although immunotherapy offers clear benefits, its implementation in the SUS faces problems due to the demand for essential financial resources for treatment. It is important to mention that the SUS has available therapies: monoclonal antibodies (e.g. trastuzumab, rituximab), therapeutic vaccine against prostate cancer, checkpoint inhibitors (e.g. nivolumab, pembrolizumab). It was concluded that cancer treatment using immunotherapy is effective in several types of cancer, providing patients with a better quality of life compared to conventional treatments.
ACIDENTES OFÍDICOS E PLANTAS MEDICINAIS: UMA REVISÃO ABRANGENTE DA LITERATURA
(2024-12-12) LUANA CARDENAS DE AQUINO; MIQUÉIAS HENRIQUE PAZINI GARCIA
In Brazil, the direct and daily contact with nature by individuals from isolated communities implies a higher probability of snakebite accidents, mainly caused by snakes of the genera Bothrops sp (“jararaca”), Crotalus sp (“rattlesnake”), Lachesis sp (“bushmaster”), and Micrurus sp (“true coral snake”). This suggests the need for developing new methods and strategies useful in the therapeutic management of snakebite accidents, especially for these individuals. Various medicinal plants from Brazilian flora possess antivenom properties and are used by individuals from isolated communities as antidotes for snakebites. However, some of these antidotes do not have their composition disclosed by users, and data on their therapeutic efficacy and safety are scarce in the literature.The objective of this study was to gather data through a bibliographic review and propose a comparison between common and scientific knowledge regarding the potential antivenom properties of these plants so they can be used as complementary treatments for snakebite accidents. To achieve this, an electronic search was conducted in the following databases: Scientific Electronic Library Online (SciELO), Medline, PubMed, and ResearchGate. The descriptors used for the literature search were: “Snakebite accidents,” “antivenoms,” “medicinal plants,” “secondary metabolites,” “traditional knowledge,” and their respective equivalents in English.To ensure the scientific quality of the present work, only publications indexed in the mentioned databases were included. Articles, theses, dissertations, and monographs that had titles, abstracts, and scientific content relevant to the theme of this study were included (even if published more than 10 years ago). Otherwise, they were excluded. Different plants, native to Brazil or not, have shown effectiveness in the palliative treatment of snakebite symptoms. Among these, Bellucia dichotoma, Marsypianthes chamaedrys, Serjania erecta, and Anacardium humile stand out for their antivenom capabilities. Thus, it is concluded that the medicinal plants presented in this study can be considered a safe and beneficial therapeutic alternative, with no significant adverse effects. Furthermore, the inclusion of medicinal plants in snakebite treatment can represent an advancement in palliative therapy based on natural compounds, providing an accessible and effective approach to this public health issue.
PODEM AS PLANTAS MEDICINAIS E/OU SEUS CONSTITUINTES REPRESENTAREM UMA OPÇÃO TERAPÊUTICA NO TRATAMENTO DOTRANSTORNO DE DÉFICIT DE ATENÇÃO E HIPERATIVIDADE? UMA REVISÃO ABRANGENTE DA LITERATURA
(2024-12-11) EDUARDO JUNIO DURAN; GIULIANA OKAJIMA COSTA LEMES
Attention Deficit Hyperactivity Disorder (ADHD) is a neurobiological disorder that affects both children and adults, characterized by symptoms such as inattention, hyperactivity and impulsivity. The decrease in basal catecholamine levels in the prefrontal cortex is directly related to ADHD symptoms. Psychostimulant drugs have beneficial effects in the treatment of ADHD, however, these drugs can often cause serious adverse effects that can outweigh their therapeutic effects. The amount of research into medicinal plants, aimed at discovering new active ingredients of natural origin that represent an effective and safer option in the treatment of ADHD, has increased substantially in recent years. The objective of the present work was to carry out a comprehensive review of the literature with the purpose of describing the main medicinal plants useful in the treatment of ADHD and their main therapeutic implications. The review was carried out based on U.S. PubMed. National Library of Medicine (https://pubmed.ncbi.nlm.nih.gov/) using pre-defined keywords: “Natural compounds”, “Medicinal plants”, “Attention deficit/hyperactivity disorder”, “Secondary metabolites”, “Psychostimulants”. To ensure the good quality of this work, only publications indexed in the aforementioned database were included. In this way, articles that present a title, abstract and scientific content that fit the theme of this work were included, otherwise they were rejected.

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