http://hdl.handle.net/11422/10 Inclui trabalhos de conclusão de cursos de especialização produzidos na UFRJ. Thu, 16 Jul 2026 21:12:03 GMT 2026-07-16T21:12:03Z 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 Fri, 28 Nov 2025 00:00:00 GMT http://hdl.handle.net/11422/29612 2025-11-28T00:00:00Z http://hdl.handle.net/11422/29609 Title: Coagulação química do peróxido de hidrogênio x hemostasia com eletrocautério na blefaroplastia Author(s)/Inventor(s): Silva, Wendel Ribeiro da Advisor: Cláudio-da-Silva, César da Silveira Abstract: Unavailable. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização Tue, 18 Nov 2025 00:00:00 GMT http://hdl.handle.net/11422/29609 2025-11-18T00:00:00Z http://hdl.handle.net/11422/29589 Title: Uso de gefitinibe como primeira linha no câncer de pulmão não pequenas células com mutação de EGFR no sistema público de saúde brasileiro: revisão de literatura Author(s)/Inventor(s): Pinheiro, Jaqueline da Silva Costa Advisor: Rodrigues, Carlos Eduardo Nogueira Abstract: Non-small cell lung cancer (NSCLC) remains one of the greatest challenges in modern oncology, particularly within public healthcare systems. Gefitinib, a first-generation tyrosine kinase inhibitor (TKI), was incorporated into the Brazilian Unified Health System (SUS) in 2013 for patients harboring EGFR mutations. However, more than a decade later, effective access to this therapy remains limited. Objective: To review the scientific evidence on the use of gefitinib as first-line treatment for patients with EGFR-mutated NSCLC within the context of the SUS, discussing clinical outcomes and the main barriers to its implementation. Method: A narrative literature review was conducted through searches in the PubMed, SciELO, and LILACS databases, covering publications from 2010 to 2024. Included studies comprised clinical trials, systematic reviews, observational studies, and official documents from the Brazilian Ministry of Health and CONITEC. Results: The literature demonstrates that gefitinib provides significant improvement in progression-free survival (PFS) and presents a more favorable toxicity profile compared with conventional chemotherapy. Nevertheless, the benefit in overall survival (OS) was not consistently observed in pivotal trials, mainly due to the high rate of treatment crossover. Pharmacoeconomic analyses suggest that gefitinib is a cost-effective option in Brazil; however, the SUS reimbursement model, with payments considerably lower than the actual treatment cost, along with the limited availability of molecular testing for EGFR mutations, largely restrict its real-world use. Conclusions: Although gefitinib represents a meaningful advance in personalized oncology, its incorporation into the SUS has not yet translated into equitable access for most patients. This scenario highlights a persistent gap between public health policy and clinical practice, underscoring the need for strategies that ensure the effective implementation of targeted therapies within the Brazilian public healthcare system. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização Sat, 01 Nov 2025 00:00:00 GMT http://hdl.handle.net/11422/29589 2025-11-01T00:00:00Z http://hdl.handle.net/11422/29582 Title: Rastreio de metástase cerebral em pacientes com câncer de mama metastático assintomáticos: uma revisão narrativa Author(s)/Inventor(s): Silva, Bárbara Lima da Advisor: Nogueira, Carlos Eduardo Abstract: Despite the high incidence of brain metastasis in patients with metastatic breast cancer, imaging-based screening in asymptomatic patients remains controversial and lacks clear consensus across clinical guidelines. Central nervous system involvement varies according to molecular subtype and disease stage, with the risk of brain metastasis estimated to be 2 to 5 times higher in HER2-positive and triple-negative subtypes compared with luminal subtypes. Most cases are diagnosed only after the onset of neurological symptoms, at which point interventions such as radiotherapy, surgery, or systemic therapies are considered. Therefore, this study aims to review the literature in the form of a narrative review in order to summarize and update current knowledge regarding the impact of brain metastasis screening in asymptomatic patients with metastatic breast cancer. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização Wed, 01 Jan 2025 00:00:00 GMT http://hdl.handle.net/11422/29582 2025-01-01T00:00:00Z