http://hdl.handle.net/11422/10 Inclui trabalhos de conclusão de cursos de especialização produzidos na UFRJ. 2026-07-31T13:03:39Z http://hdl.handle.net/11422/29877 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 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/11422/29871 Title: Experiências de abordagem comunitária na atenção primária à saúde no Estado do Rio de Janeiro: uma análise à luz da educação popular em saúde e do cuidado emancipatório Author(s)/Inventor(s): Zanardo, Luiza Wolf Advisor: Borret, Rita Helena do Espírito Santo Abstract: This study examined community-based interventions implemented within Primary Health Care (PHC) in the state of Rio de Janeiro between 2015 and 2025, analyzing them through the frameworks of Popular Health Education (PHE) and emancipatory care. A scoping review was conducted using the BVS and BDTD-UERJ databases, identifying 17 publications describing territorial initiatives predominantly structured as group activities, educational sessions, waiting-room interventions, campaigns, and workshops. Findings indicate that, despite the presence of some participatory strategies, a predominantly deposit-based and behaviorist political-pedagogical model prevails, characterized by vertical information delivery, limited community engagement in agenda-setting, and strong alignment with managerial imperatives and performance indicators. These patterns suggest that community-oriented actions are frequently shaped by technicist and biologicist professional training, constraining their potential to foster critical participation, collective agency, and context-sensitive health practices. Such limitations are further reinforced by the institutional capture of PHC by productivity-driven management models and by the erosion of territorial work due to increasing assistential demands. Strengthening community-based approaches therefore requires redefining their practical purpose, expanding community participation, investing in critical-reflective professional development, ensuring protected time for territorial engagement, and recognizing care as an inherently political practice. By advancing these dimensions, PHC can reaffirm its role in promoting autonomy, citizenship, and social transformation, in alignment with the ethical and political principles underpinning Brazil’s Unified Health System (SUS). Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização 2025-01-01T00:00:00Z http://hdl.handle.net/11422/29788 Title: Hipertermia maligna: uma revisão da literatura em Anestesiologia Author(s)/Inventor(s): Neves, Marcos Vinícius Paulino; Menezes, Paulo César Júnior Advisor: Vieira, Márcio Carneiro Abstract: Malignant hyperthermia (MH) is a rare and potentially fatal autosomal dominant pharmacogenetic myopathy triggered by halogenated inhaled anesthetic agents and succinylcholine. The objective of this study is to review the scientific literature on malignant hyperthermia in the context of anesthesiology. To understand the nature of this rare, potentially fatal pharmacogenetic syndrome, identify risk factors, such as anesthetic agents, and its pathophysiology, related to impaired calcium homeostasis. The review seeks to identify the list of triggering agents and the population at risk; analyze clinical manifestations and diagnostic criteria; establish treatment and perioperative management strategies; and discuss national and international prevention protocols. Search sources include PubMed, SciELO, ScienceDirect, LILACS, and Google Scholar, covering publications from the last 15 years. The keywords used were: “malignant hyperthermia”, “dantrolene”, “anesthesia complications” and “hypermetabolic crisis”. Original articles, theses, reviews, and guidelines were included, and isolated case reports or articles not directly relevant to MH were excluded. Malignant hyperthermia is a potentially fatal genetic disease related to excessive muscle metabolism that occurs after exposure to inhalational anesthetics. The literature indicates that, despite its low incidence, MH remains a feared complication in anesthesia due to its fulminant progression. The availability of dantrolene and team training are critical factors in reducing mortality. Early recognition, combined with prompt administration of dantrolene, is crucial for survival. National and international protocols should be widely disseminated and implemented to ensure the safety of anesthetized patients. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização 2025-11-25T00:00:00Z