http://hdl.handle.net/11422/10 Inclui trabalhos de conclusão de cursos de especialização produzidos na UFRJ. 2026-07-31T06:27:21Z 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 http://hdl.handle.net/11422/29784 Title: Alteração dos índices hematimétricos após amputação de membro inferior a nível supra e infra patelar em um hospital universitário: análise observacional retrospectiva Author(s)/Inventor(s): Cerqueira, Newton Furtado Advisor: Ugenti, Viviana Abstract: Peripheral arterial occlusive disease (PAOD) is the term used to define chronic atherosclerotic obstruction of the arteries. PAOD may have a prevalence in the population ranging from 3.4% to 5.4%, according to data obtained in Europe. It is a condition that can lead to significant physical limitation and, in severe cases, to lower-limb amputation. Evidence shows that patients with PAOD and anemia have a higher risk of amputation, and that perioperative transfusion may add risks to the patient. In this context, this observational, retrospective, single-center study analyzed 41 patients who underwent lower-limb amputation at the supra- or infrapatellar level. Hemoglobin and hematocrit levels were measured before the procedure and up to a maximum of 72 hours after surgery, along with information related to the type of anesthesia, chronic medication use, and type of surgery. A median preoperative hemoglobin level of 9 g/dL (IQR 2.5) was observed, whereas the median postoperative hemoglobin level was 8 g/dL (IQR 2). The median preoperative hematocrit was 27.3% (IQR 6), while the median postoperative hematocrit was 24% (IQR 3.7). The use of aspirin did not increase the likelihood of hemoglobin drop after supra- or infrapatellar amputation (p = 0.863). Multiple logistic regression showed that the type of amputation (suprapatellar vs. infrapatellar) was not associated with the occurrence of a significant drop in hemoglobin (p = 0.578 and p = 0.970, respectively). These findings may help support decision-making regarding perioperative transfusion in these patients. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização 2025-11-30T00:00:00Z http://hdl.handle.net/11422/29612 Title: Importância da ecocardiografia na abordagem da estenose aórtica grave associada à síndrome de Heyde: relato de caso Author(s)/Inventor(s): Alvarenga, Maria Tolet Barreto de Advisor: Garcia, Marcelo Iorio Abstract: An 89-year-old male patient with severe aortic stenosis, a history of gastric angiodysplasia, and recurrent episodes of gastrointestinal bleeding was admitted due to upper gastrointestinal hemorrhage and symptoms of heart failure. Transthoracic echocardiography revealed preserved biventricular systolic function, a calcified aortic valve with restricted opening, a maximum left ventricle–aortic gradient of 76 mmHg and a mean gradient of 47 mmHg, an indexed valve area of 0.5 cm²/m2, and a jet velocity of 4.3 m/s, confirming severe aortic stenosis. Given the patient’s functional limitation and high surgical risk, transcatheter aortic valve implantation (TAVI) was indicated. This case illustrates the interrelationship between aortic stenosis and gastrointestinal angiodysplasia (Heyde’s syndrome), emphasizing the fundamental role of echocardiography in the diagnosis and management of this condition. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização 2025-11-28T00:00:00Z