http://hdl.handle.net/11422/25224 2026-08-01T16:44:07Z 2026-08-01T16:44:07Z http://hdl.handle.net/11422/29877 2026-07-31T11:47:02Z 2025-11-01T00:00:00Z

Title: O desafio diagnóstico e terapêutico das bolsites nas doenças inflamatórias intestinais: uma revisão de literatura Author(s)/Inventor(s): Garcia, Raphael Calero Faria Advisor: Souza, Heitor Siffert Pereira de Abstract: Pouchitis is a frequent inflammatory complication of ileal pouch–anal anastomosis (IPAA), a surgical procedure primarily indicated for patients with ulcerative colitis undergoing total proctocolectomy. This study aimed to review the main pathophysiological, diagnostic, and therapeutic aspects of pouchitis, emphasizing the complexity of its management. The literature review demonstrated that pouchitis has a multifactorial aetiology involving genetic, environmental, immunological, and microbiological factors, particularly intestinal dysbiosis and altered innate immune responses. Diagnosis relies on the correlation of clinical, endoscopic, histologic, and laboratory findings, with PDAI and mPDAI scores widely used to quantify inflammatory activity. Treatment should be individualized, with antibiotics as the first-line therapy and escalation to immunomodulators and biologic agents in cases that are refractory. Ciprofloxacin and metronidazole remain the preferred initial antibiotics, while probiotics and budesonide serve as adjuvant options. Advances in biologic therapies, particularly anti-TNF and anti-IL12/23 agents, have expanded therapeutic options for chronic or refractory pouchitis. Proper management requires a multidisciplinary approach and continuous medical updatings, given the disease’s impact on patients’ quality of life and the importance of preventing structural and infectious complications associated with IPAA. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização

2025-11-01T00:00:00Z http://hdl.handle.net/11422/29876 2026-07-31T11:22:36Z 2025-11-19T00:00:00Z

Title: Espiroquetose intestinal: uma revisão bibliográfica Author(s)/Inventor(s): Mangueira, Iuri Moura Advisor: Sampaio, Ana Paula Noguères Abstract: Human intestinal spirochetosis (HIS) is defined as the colonization of the luminal surfaceof colonic and appendiceal epithelial cells by anaerobic spirochetes of the genus Brachyspiraspp. This study is a literature review of 21 articles published between 2005 and 2025. Theprevalence of intestinal spirochetosis varies globally but appears to be higher in low- and middleincome countries, possibly due to poor sanitation and living standards. Comparatively, theprevalence is lower in developed countries; however, the prevalence of HIS is significantlyhigher in men who have sex with men. The clinical presentation can range from assymptomaticindividuals to chronic diarrhea, which is the main manifestation. Abdominal pain, hematochezia,and other symptoms may be associated. Diagnosis is made by visualizing intestinal spirochetesclustered on the surface of the intestinal epithelium, forming the classic "false brush border"finding. There are many antibiotic regimens available, but metronidazole is the most used. Inconclusion, further studies are needed to understand the epidemiology and pathophysiology ofthe disease, as symptom recurrence rates are high despite proper treatment. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização

2025-11-19T00:00:00Z http://hdl.handle.net/11422/26119 2026-05-16T03:08:55Z 2024-01-01T00:00:00Z

Title: Terapia imunobiológica dupla na doença inflamatória intestinal refratária à terapia de primeira linha Author(s)/Inventor(s): Troncoso, Augusto Torres Advisor: Santos, Isabel Fonseca Abstract: The study of Inflammatory Bowel Diseases (IBD) involves the comprehension of a complex interaction between genetic factors, gut microbiota, diet, and the immune system. The treatment of IBD, including Crohn's disease and ulcerative colitis, has evolved with the growing use of combined immunobiological therapies (CoT). These therapies aim to treat severe and refractory forms of the disease, in which conventional treatments have failed. Biological therapies such as anti-tumor necrosis factor therapy (anti-TNF), anti-integrins (such as vedolizumab) and anti-interleukins (such as ustekinumab) have shown good results when used as monotherapy, but combining these treatments may lead to higher rates of clinical remission and mucosal healing. Reviewed studies indicate that combinations such as anti-TNF with vedolizumab or ustekinumab have proven effective in inducing remission, with endoscopic improvements observed in up to 93% of patients. Despite their promising results, CoT still faces challenges, such as the lack of conclusive data on safety and the risk of adverse events. Although initial results suggest that these therapies may reduce the need for more aggressive interventions, such as surgeries, the data remain limited and require further follow-up. CoT has shown particularly good responses in patients with severe IBD, whether with uncontrolled luminal or extra-intestinal manifestations. However, the choice of therapeutic combination should be carefully considered due to the potential for severe adverse effects, such as infections and allergic reactions. Therefore, while combined biological therapies represent a promising strategy, more studies are needed to define their long-term efficacy and safety in the treatment of IBD. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização

2024-01-01T00:00:00Z http://hdl.handle.net/11422/25784 2026-05-16T03:08:52Z 2024-01-01T00:00:00Z

Title: Tumor neuroendócrino esofagiano: um relato de caso raro Author(s)/Inventor(s): Paula, Mariana Martins de Mello Advisor: Peixoto, Eduardo Antônio Pereira Abstract: Esophageal neuroendocrine tumor (NET-e) is considered the rarest gastrointestinal tract neuroendocrine tumor (NET-TGI), with a prevalence of 4.9% amongst the NET-TGI, varying according to the geographic region. NET-e has an aggressive behavior and fast dissemination, so, early diagnosis is very important. Diagnosis can be a challenge because there are no specific symptoms. Patients may either be asymptomatic or they may present a range of symptoms, like dysphagia, chest pain, weight loss, odynophagia and digestive bleeding. Upper gastrointestinal endoscopy is a diagnostic tool that allows visualization of the tumor and obtainance of material for histopathological analysis. NET-e is characterized by a single polypoid lesion in the distal esophagus. Once diagnosed, it is important to follow up with an oncologist to initiate specific treatment. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização

2024-01-01T00:00:00Z