Memorial descritivo

CNPq - Conselho Nacional de Desenvolvimento Científico e TecnológicoConsiderando o Despacho Nº 38/2021 de 30 de novembro de 2021 do Processo nº 23117.066684/2021-33 do Conselho da Faculdade de Medicina Veterinária da Universidade Federal de Uberlândia, de 2021, de acordo com os critérios da Universidade Federal de Uberlândia (UFU) e do Ministério da Educação (MEC), estou apta a defender meu Memorial Descritivo ou Tese inédita, com a finalidade de obter a Promoção na carreira de Professor Associado IV para Professor Titular. Há quatro anos atrás, quando comecei a pensar na promoção para o cargo de Professor Titular, aventei a hipótese de defender a Tese inédita sobre o uso de estirpes locais de Leptospira spp. na produção de vacinas (estirpes essas isoladas em pesquisa de uma orientada de doutorado). Inclusive submetemos e tivemos aprovação de um projeto em 2017 junto Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG), porém até o presente momento a verba não foi liberada. Durante quatro anos, com o resultado de mais duas outras orientadas de doutorado obtivemos características de peptídeos de proteína hipotética e, proteínas identificadas como imunogênicas in silico respectivamente. Aí a ideia de Tese inédita se ampliou para o uso in vivo (ensaios clínicos) de estirpes locais, peptídeos de proteína hipotética e proteínas identificadas in silico para que futuramente seja possível propormos alvos viáveis para o desenvolvimento de vacinas de diferentes espécies animais, susceptíveis à leptospirose. Já temos resultados promissores, porém sabemos que é a etapa mais longa e a mais cara do processo de pesquisa e desenvolvimento de uma vacina. Também estamos contactando empresas privadas para parcerias futuras com transferência de tecnologia. Acredito que isso vai ser objeto de pesquisa da nossa equipe para os próximos anos. Diante do exposto acima decidi optar por escrever o meu Memorial Descritivo, apesar de achar que essa defesa poderia me constranger, por me considerar ainda, uma eterna aprendiz. Peço licença para prestar contas do que fiz no desenvolvimento da minha carreira profissional até o momento, sem que haja vaidade. Escrever nossa história de desenvolvimento e crescimento profissional, sob nossa própria perspectiva, requer muita reflexão. E essa nos possibilita extrair o que foi bom, o que poderia ter sido melhor, e o que ainda se faz necessário, através de uma reorientação de vida. Isso fiz com verdade, simplicidade e coerência para submeter a avaliação de colegas titulares. Segue então o meu Memorial Descritivo demonstrando que sou uma professora universitária que tem exercido seu trabalho com responsabilidade, compromisso e dedicação ao ensino, a pesquisa, a extensão e quando necessário, as atividades administrativas e de gestão. Com gratidão, reafirmo aqui o meu compromisso com a sociedade, com atenção à saúde única, ao bem-estar animal, a formação de novos profissionais e, orientação de tutores de pequenos animais e produtores rurais, por meio de uma Universidade pública, gratuita e de qualidade. O presente Memorial está organizado conforme a resolução No. 03/2017, de 09 de junho de 2017, do Conselho Diretor da Universidade Federal de Uberlândia em atendimento à Portaria do MEC n 982 de 03 de outubro de 2013

Evaluation of two systems of broiler production: a multidisciplinary focus

Orientador: Irenilza de Alencar NääsTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia AgricolaResumo: O aumento de produção que levou o Brasil a ocupar a posição de segundo maior produtor de frangos de corte do mundo se deve a intensificação de criação. Essa intensificação teve como base vários aspectos que foram cuidadosamente controlados, dentre eles a nutrição e o manejo (sistemas de criação, ambiência, sanidade etc). Atualmente o que se observa em várias partes do mundo é a tendência em produzir frangos de corte, com bem estar animal. Paralelamente no Brasil, vem ressurgindo em nova versão a criação de frangos caipiras. O objetivo desse estudo foi avaliar índices zootécnicos obtidos durante a produção de dois sistemas de frango de corte em escala comercial (In situ), um intensivo, convencional (granja A) e outro semi-extensivo, caipira (granja B), para verificar as inter-relações entre bem-estar animal, manejo, saúde animal e qualidade da carne. Na granja A foram alojados 14000 pintos enquanto que na granja B foram 7150. Observou-se que frangos da granja A apresentaram mais problemas locomotores: calos de pés, discondroplasia tibial quando comparados com frangos provenientes da granja B. Os frangos da granja A apresentaram alta prevalência de necrose da cabeça do fêmur, melhor conversão alimentar e ganho de peso, embora tenham apresentado maior mortalidade A e B, foram respectivamente 5,32 e 1,34%. Quanto a Salmonella sp. e Mycoplasma sp. não houve presença de frangos reagentes nas duas granjas. Quanto à qualidade da carne em termos físico-químicos, o pH do peito apresentou-se menor significativamente para carcaças de frangos provenientes da granja A, enquanto o pH da coxa não apresentou diferença significativa. A força de cisalhamento da carne de frango proveniente da granja A apresentou-se menor, quando comparada à de carcaças de frangos da granja B (1,972 para carcaças de A e 2,462 para as de B). A capacidade de retenção de água não diferiu entre as carcaçaa provenientes das granjas. Em termos microbiológicos a Salmonella sp. não foi encontrada em nenhuma carcaça de frango, embora a Listeria sp. tenha sido encontrada em 50% das carcaças analisadas. Os frangos da granja B estiveram em melhores condições de bem-estar animal. Com base nesses resultados foi possível estimar que os índices zootécnicos da granja A foram melhores que os da granja B, entretanto os problemas locomotores foram maiores nos frangos provenientes da granja AAbstract: The increase in production technology was the major factor that lead Brazil to be the second largest world poultry producer. This production technology had the basis several aspects that were carefully controlled, among them nutrition and management (environment, health and rearing systems). Nowadays it is observed a world¿s tendency to produce animal searching good welfare conditions. In parallel in Brazil is growing a new version of extensive produced broilers (free-range broiler). The objective of this study was to evaluate the production indexes from two distinct industrial scale broiler productions (in situ): one intensive (farm A) and other semi-extensive (farm B) for verifying the inter-relations among welfare, management, health and meat quality (14000 broilers in farm A and 7150 broilers in farm B). It was observed that birds from farm A showed more leg weakness (foot burn and tibial dyschondroplasia) when compared with broiler from farm B. The broilers from farm A presented high prevalence of femur necrosis, higher feed conversion, and higher gain weight, although they had presented higher mortality (5,32 in farm A and 1,34% in farm B.). Regarding Salmonella sp and Mycoplasma sp it was not found serological reagent birds in neither of the studied farms. Regarding meat quality (in the physical chemistry analysis) the breast meat pH from farm A¿s birds presented values significantly smaller than the bird¿s carcass from farm B. The shearing force on meat from broiler reared at farm A were smaller than the ones from birds reared at farm B (1,972 farm A e 2,462 farm B).. Water holding capacity did not differ from the carcasses from both farms. In microbiological terms Samonella sp was not found the studied carcasses, however Listeria sp was found in 50% of the analyzed carcasses. About welfare conditions broilers from farm B were better. Based on these results it was possible to estimate that production index was better in farm A than in farm B, however leg weakness problems were higher in broilers from farm BDoutoradoConstruções Rurais e AmbienciaDoutor em Engenharia Agrícol

Production and Evaluation of Immunoglobulin Y Anti-Brucella abortus (Vaccinal Strain B19)

Background: The immunoglobulin Y is a principal antibody current in the blood of hens, which are transferred from the maternal blood serum to the egg yolk. The extraction of IgY from the egg yolk apply animal welfare when compared to the extraction of IgG, reducing the number of animals and prevent a bleeding of hens through the extraction of the IgY from eggs, besides that IgY presenting high specificity for antigenic binding. The objective of this study was to produce specific polyclonal IgY antibodies anti-Brucella abortus by immunizing hens with B19 vaccine and evaluate their reactivity through Buffered Acidified Plate Antigen (BAPA), 2-Mercaptoethanol (2-ME) and indirect ELISA diagnostic tests.Materials, Methods & Results: Four 25-week-old White Leghorn hens were immunized, two of them comprising the control group (Group 1) with phosphate-buffered saline (PBS) with adjuvant, and the others two immunized with B19 vaccine (Brucella abortus vaccine strain B19), representing the Group 2. The immunizations occurred six times with a 15-day interval between each. Blood samples were taken biweekly (seven times); and daily, the eggs were collected for 13 weeks, the first collection of blood and eggs, performed one week before the first immunization of each group. The IgY was purified from egg yolk, using the method of dilution in acid water and precipitation with ammonium sulfate for delipidation. BAPA, 2-ME and ELISA tests performed to verify the specificity of IgY confirmed the reactivity of polyclonal antibodies specific to the antigen used both in blood serum samples and in the purified egg yolks. The hens from the control group did not present reactivity in the diagnostic tests used, which was already expected, since no antigen was used in any of their immunizations. Hens immunized with the Brucella abortus B19 vaccine produced detectable reactive antibodies in the three tests used on blood serum and IgY samples extracted from the egg yolk. In Group 2 (vaccine B19), blood serum samples started to react one week after the first inoculation, and the IgY samples extracted from the egg yolk were reagent two weeks after serum IgY appear reactivity, showing the transfer of specific antibodies to the egg yolk, was late.Discussion: Although the transfer of serum Igy to egg yolk was late when compared to others authors which found that the transovarian passage of immunoglobulin Y occurred in approximately three to six days after IgY being detected in blood serum, the results of this study showed the occurrence of the transfer of blood serum IgY anti-Brucella abortus to egg yolk of hens immunized with B19 vaccine, the same found by others researches found the same results with others antigens. Thus, it can be concluded that immunoglobulins Y produced in this study can be used as specific antibodies in diagnostic tests for the detection of the Brucella abortus antigen, in addition, this process guarantees the welfare of the animal, since it avoids bleeding and it is possible to obtain high concentrations of antibodies directly from the hen egg, which is a great advantage, because IgY can be easily isolated from the egg yolk by the precipitation technique discarding the need of invasive and painful procedures that involve bloody interventions to obtain the serum antibodies like occur in mammals for extraction of IgG

Green Anaconda (Eunectes murinus) with Bacterial Clinical Stomatitis

Background: Stomatitis is an infectious disease common in serpents and responsible for high mortality rates. It is characterized by the infection of the oral mucosa and neighboring tissues, related to the opportunistic character of bacteria present in the normal microbiota, pathogenic in stressful situations. Few studies have described the profile of sensibility of these agents in serpents of the Brazilian fauna. Therefore, this study has aimed at describing the isolation and identification of the infectious agents involved in the clinic stomatitis in a specimen of green anaconda (Eunectes murinus), and the profile of susceptibility to antimicrobial agents.Case: The serpent has been rescued in an urban environment, without previous records and featured erosive injuries in its oral cavity, with the presence of secretion. In a clinical evaluation, it has been assessed that the specimen had erosive injuries in its oral cavity, with hyperemic points in its mucosa and serous secretion. Then the specimen went through a collection of the secretion from its oral cavity for microbiological analysis. Typical colonies of Enterococcus, Citrobacter and Enterobacter were identified by the colony morphology and their typical odor. The results of these tests were able to confirm and identify the Citrobacter freundii, Enterobacter spp. and Enterococcus spp. The profile of sensibility to antimicrobials of the isolated microorganisms has been determined through the method of diffusion in the disk of Kirby-Bauer. There was not any sensitive antimicrobial drug for the three agents.Discussion: Immunodepression, malnutrition, and temperatures and humidity outside the animal thermal comfort zone, are predisposing factors for the development of bacterial diseases in reptiles. Little information about pathogen agents affecting constrictor serpents in their native area is available. Most reports on stomatitis in serpents approach cases occurred in captive animals, differently from what has been presented in this case, which is about a free animal rescued when invading an urban area. The bacteria isolated from the oral cavity of the serpent here reported belong to the normal microbiota of the oral cavity of these animals. Notwithstanding, these bacteria may become pathogenic in certain circumstances. Conditions of undernutrition, stress and oral trauma are considered as predisposing factors to the occurrence of stomatitis in serpents, what can be correlated to the occurrence of the disease in this case. The gram-negative agents causing bacterial diseases in serpents are generally resistant to medicines of the most common spectrum used in the clinical routine of wild animals. This way, veterinarians often deal with these diseases in reptiles empirically, using a wide range of antibiotics. This practice might result in the development of resistant bacterial stumps, what stands out due to the potential that resistant bacteria have to generate infections and zoonoses in humans

Canine Cystitis - Biofilm Formation by Bacterial Isolates

Background: Biofilms have been reported as important virulent markers associated with drug resistance in urinary tract infections (UTIs) in humans and dogs. However, in veterinary medicine, researches involving biofilm formation, treatments and preventions have been limited; yet, it is still possible to find few studies demonstrating biofilm-forming bacteria associated with different comorbidities such as otitis, wound infections, UTIs, and endometritis. These studies generally select dogs with chronic and recurrent infections, which could be an important factor in antibiotic resistance. We aimed to evaluate biofilms in sporadic cystitis regarding prevalence and drug resistance.Materials, Methods & Results: Urine samples were collected by cystocentesis from 36 client-owned dogs under clinical and laboratory suspicion of non-recurrent urinary bladder infection (cystitis). Urine was aseptically plated onto blood agar, MacConkey, and CLED, followed by incubation for 24 to 48 h. Definitive identification of a potential pathogen was made by subculture collected from an isolated colony to obtain a pure culture. The gram staining method and specific biochemical tests (phenol red fermentation, lysine, phenylalanine, citrate, sulfide-indole-motility, and urease) were used to distinguish and classify the bacteria. After identification, the bacteria were tested for antimicrobial susceptibility by a standard disk diffusion method, using the following antimicrobials: amoxicillin with clavulanic acid, ampicillin, ceftriaxone, ciprofloxacin, clindamycin, cefazolin, cephalothin, erythromycin, gentamicin, norfloxacin, and sulfamethoxazole-trimethoprim. The biofilm-forming ability was determined based on a culture in Congo red agar (CRA), where biofilm producer strains formed black colonies with a dry crystalline surface, while non-biofilm producer strains formed red colonies with a smooth surface. A crystal violet dye assay was used to confirm the CRA results. Of the 36 urine samples collected from dogs with suspected cystitis, a total of 37 isolates were obtained, from mixed or pure cultures. The most prevalent bacteria were Escherichia coli (11/37), followed by Staphylococcus spp. (8/37), Proteus spp. (7/37), and Enterococcus spp. (5/37). Other less prevalent bacteria were Klebsiella spp., Streptococcus spp., and Enterobacter spp. As for biofilm-forming ability, 67.6% (25/37) of the 37 bacterial isolates had biofilm formation in CRA and 54.05% (20/37) on the microplates containing crystal violet dye. There was no statistical difference in antimicrobial susceptibility between biofilm producer and non-biofilm producer bacteria.Discussion: We found a high proportion (> 54%) of in vitro biofilm-forming ability by different bacteria, which may indicate that biofilms may also be formed in vivo, in simple cystitis. Antimicrobial resistance was not noticed in bacteria capable of forming a biofilm; however, in a future study it is important to evaluate bacterial resistance in vivo, considering the possibility of having a different response than in vitro. In addition, the problem of the presence of a biofilm in vivo is that it can nullify the antimicrobial efficacy of therapeutic agents even with in vitro susceptibility. Besides the possibility of slow or incomplete diffusion of antibiotics through the extracellular matrix of the biofilm, aspects like hydration level, pCO2, pO2, pH, pyrimidine, and divalent cation concentration that negatively influence antimicrobial activity in vitro can also cause undesirable effects at the profound layers of the biofilm. In conclusion, all of the genera of bacteria isolated from dog’s sporadic cystitis in this study were able to form a biofilm in vitro. The pathogenicity and antibiotic resistance of bacteria appears unrelated to biofilm formation in vitro.Keywords: sessile bacteria, urine, simple cystitis, antibiotic resistance

Caseous Stomatitis Caused by Pseudomonas aeruginosa in Boa constrictor amarali

Background: Pseudomonas aeruginosa is a bacterium that belongs to the microbiota of snakes, but it may also be an opportunistic pathogen and contaminate humans through fecal contact, bites, and injuries. In snakes, this microorganism may present high pathogenicity at certain conditions and have been associated with high morbidity and mortality. Reports of infection of Boa constrictor by this pathogen are rare. Thus, this study aimed to describe the P. aeruginosa oral infection in a snake specimen (Boa constrictor amarali), approaching the isolation and identification of the infectious agents involved, the antimicrobial sensitivity and resistance, and the therapeutic protocol adopted.Case: A free-living adult female specimen of Boa constrictor amarali (Amaral's boa), with no described previous history was rescued in an urban area by the Environmental Police. Clinical evaluations showed structures of caseous aspect in the oral cavity, with hyperemia spots in the mucosa. Samples of these lesions were sent for mycological examination, and fungal forms were not found. Samples were collected for isolation and culture. The antimicrobial susceptibility of the isolated microorganisms was determined by the modified Kirby-Bauer disk diffusion method. P. aeruginosa was isolated and showed susceptibility to amikacin, gentamicin, and polymyxin-B; intermediate susceptibility to azithromycin, and ciprofloxacin; and resistance to cephalexin, ceftiofur, chloramphenicol, and enrofloxacin. The treatment consisted of cleaning of the oral cavity, local infiltration of lidocaine for debridement of the caseous area that were later cauterized with iodine. Systemic antibiotic therapy was used, with intramuscular administration of amikacin (5 mg/kg) for the first dose and (2.5 mg/kg) for the other doses with intervals of 72 h, and oral administration of metronidazole (20 mg/kg) with intervals of 48 h, both during 21 days. Daily subcutaneous fluid therapy was performed as support treatment, using Lactated Ringer's solution (25 mg/kg) and Vitamin C (10 mg/kg) with intervals of 24 h, being the cure observed at the end of treatment.Discussion: This paper presents the pathological findings of the Pseudomonas aeruginosa oral infection in a B. constrictor amarali. This bacterium is an opportunistic pathogen that is commonly found  in snakes, thus, humans in contact with these animals may be contaminated with this pathogen. However, oral cavity lesions associated with P. aeruginosa had not yet been related to Boa constrictor amarali, which is a non-venomous species. Few bacteria associated with reptile diseases are primary causative agents. Clinical bacterial infections generally tend to be secondary to viral infections. Predisposing factors for the development of bacterial diseases in these reptiles include immunodepression, malnutrition, poor adaptation to captivity, and the maintenance of these animals at temperatures and humidities outside their thermal comfort range. In the present study, the P. aeruginosa behaved as an opportunistic pathogen, resulting in clinical manifestations with caseous lesions in the oral cavity, probably due to an imbalance of the microbiota caused by stress or immunodepression. The antibiogram allowed the adoption of a correct therapeutic protocol based on the susceptibility of the pathogen, resulting in remission of lesions and clinical signs after 21 days of treatment

Susceptibilidade e resistência a antimicrobianos de Staphylococcus aureus em condições de biofilme

Staphylococcus is an important agent of mastitis, especially when biofilm producers are related to a number of mechanisms of resistance to different types of infections. The objective of this research was to evaluate the susceptibility and resistance of Staphylococcus aureus strains isolates from cases of bovine mastitis and milking environment under conditions of biofilm, compared to three different concentrations in different antimicrobials. Thirty-two strains used were S. aureus that, due to the inhibition tests, minimal biofilm eradication concentration were tested using cephalexin, amoxicillin and rifampin at concentrations of 30 mg/mL, and 50 mg/mL 100 mg/mL for 12 hours, and efficiency of tests evaluated by counting the colony forming units and the microplate test. The results revealed that among the tested antibiotics cephalexin showed the best efficiency at the three concentrations tested, and rifampin and amoxicillin were more efficient at concentrations of 50 and 100 mg/mL. These data demonstrate the importance of targeted antibiotic therapy associated with the correct cleaning of milking equipment, thus, preventing the formation of biofilm, avoiding persistent microbial adhesion in equipment, and the spread of microorganisms by ascending channel teats among herd animals.Os Staphylococcus, principais agentes causadores da mastite, quando em biofilmes, estão relacionados a uma série de mecanismos de resistência em diferentes tipos de infecções. O presente trabalho avaliou a susceptibilidade e resistência dos Staphylococcus aureus, isolados de casos de mastite bovina e do ambiente de ordenha, em condições de biofilme, frente a três antimicrobianos distintos em diferentes concentrações. Foram utilizadas trinta e duas estirpes de S. aureus testadas frente aos testes de inibição da concentração mínima de erradicação de biofilmes, utilizando cefalexina, amoxicilina e rifampicina, nas concentrações de 30 mg/mL, 50 mg/mL e 100 mg/mL, por doze horas de contato, e a eficiência dos testes avaliada pela contagem das unidades formadoras de colônias e pelo teste de microplacas. Os resultados revelaram que, entre os antimicrobianos testados, a cefalexina foi o que apresentou melhor eficiência nas três concentrações testadas, e a rifampicina e amoxacilina tiveram maior eficiência nas concentrações de 50 e 100 mg/ mL. Esses dados demonstram a importância sobre antibioticoterapia orientada associada com a correta higienização dos equipamentos de ordenha, evitando-se, assim, a formação de biofilmes, a adesão microbiana persistente em equipamentos, e a difusão dos microrganismos pelo canal ascendente dos tetos entre os animais do rebanho

Leptospirosis in slaughtered cows in the Triangulo Mineiro, Minas Gerais: prevalence, serological profile and renal lesions

Leptospirosis is a zoonosis that affects several species of domestic and wild animals and is an important cause of economic losses in cattle in Brazil. In this study, we determined the prevalence of bovine leptospirosis in the Triângulo Mineiro region, Minas Gerais, Brazil, identified the most frequent serovars of Leptospira interrogans, and examine the renal pathological changes associated with the disease. Samples of blood serum and kidney fragments from 100 bovine females were collected in cattle abattoir. In the serological investigation 48% of the cows were positive. The serovars for which there were more reactive animals were Wolffi (24%), Hardjo (21%) and Hebdomadis (18%). Among the positive samples, 14/48 showed antibody titers greater than 1:100, and 70.83% of the seropositive animals responded to more than one Leptospira interrogans serovar. Only one farm did not have seropositive cows and in nine farms studied, six (66.66%) presented seropositive animals to the Hebdomadis serovar. At the histopathological examination, the most frequent microscopic lesions in positive animals were hyalinization (81.25%), congestion (81.25%) and hydropic degeneration (70.83%). However, these histopathological alterations were also found in kidneys of animals negative to serology, such as hyalinization (80.77%), congestion (48.07%) and hydropic degeneration (55.77%) and these findings are unrelated to positivity. Histopathological examination of the kidneys is not indicated to replace the serological diagnosis of leptospirosis, and may be used only as a complementary examination. Despite the low frequency of seropositive animals in the Triângulo Mineiro region, the disease is present in a large number of farms. Noteworthy is the high frequency of serovar Hebdomadis and it can be considered an emerging serovar in the region. The evaluation of the frequency of this serovar in other regions becomes important, and once verified should result in the recommendation of the inclusion of this serovar in the leptospirosis control

Evaluation of response to anti-leptospira bacterin vaccination in pregnant ewes and the passive transfer of antibodies to their offspring

Leptospirosis in sheep is often underestimated, and leads to great economic losses for the sheep farming industry. The aim of this study was to evaluate the humoral immune response in pregnant ewes, after the injection of a commercial polyvalent vaccine for leptospirosis, and to observe the transmission of anti-Leptospira antibodies through the colostrum to the offspring. For this, 24 pregnant ewes were vaccinated for leptospirosis.  Blood samples were collected prior to vaccination and then 7, 14, 21, 28, 35, 42 and 49 days after vaccination. In order to evaluate passive immunity transfer, blood samples of 32 lambs were collected during the first 48 hours after birth, and another collection was performed 10 to 21 days after birth. The lambs were placed into 2 groups: Group A (n=16): singleton lambs; and group B (n=16): twins. The sera samples were submitted to the Microscopic Agglutination Test (MAT), in which 21 Leptospira serovars were tested. The results were analyzed in a descriptive form. The number of sheep reactive to MAT gradually increased until 21 days after vaccination, and decreased right after. Of all the serovars contained in the vaccine, the largest proportion of animals were seroconverted to Hardjoprajtino serovar, Serjoe serogroup. Anti-Leptospira antibodies transferred through colostrum to lambs were detected by MAT in the serum collected 24-48 hours after birth.  It was observed that 65.6% (21 out of 32) of the lambs were reactive. In the subsequent collections that occurred from 10 to 21 days after birth, a decrease in the number of animals reactive to the MAT was detected. There was no significant statistical difference for the passive transfer of antibodies between single or twin lambs

Suplementação de vitamina D na asma: uma revisão narrativa dos efeitos na gravidade dos sintomas e frequência de exacerbações

Considerando a prevalência global da asma e a necessidade de estratégias de manejo eficazes, este estudo visa investigar os efeitos da suplementação de vitamina D na gravidade dos sintomas e na frequência de exacerbações em pacientes com asma. A justificativa reside na busca por terapias complementares que possam melhorar o controle da doença e a qualidade de vida dos pacientes asmáticos. Os objetivos incluem revisar e sintetizar estudos recentes sobre o tema, avaliar a eficácia da suplementação de vitamina D e identificar lacunas de conhecimento para futuras pesquisas. A metodologia envolverá uma revisão narrativa da literatura, abrangendo ensaios clínicos randomizados, meta-análises e revisões sistemáticas. Os resultados serão analisados em termos de impacto da suplementação de vitamina D nos sintomas e exacerbações da asma. Conclui-se que a suplementação de vitamina D pode desempenhar um papel importante no manejo da asma, oferecendo potenciais benefícios na redução dos sintomas e na prevenção de exacerbações