TEDE Coleção:

Craniotomia versus craniectomia em cirurgias de tumores da fossa posterior: revisão sistemática e metanálise

2026-03-30T16:45:00Z

Título: Craniotomia versus craniectomia em cirurgias de tumores da fossa posterior: revisão sistemática e metanálise Autor: Correa, Eduardo Mendes Primeiro orientador: Pinto, Pedro Henrique da Costa Ferreira Abstract: Surgery for posterior fossa tumors carries a high risk of cerebrospinal fluid (CSF)-related complications, particularly CSF leak and pseudomeningocele, which increase morbidity, prolong hospital length of stay, and raise healthcare costs. Despite advances in dural closure techniques, uncertainty remains regarding the comparative effectiveness of craniotomy with bone flap replacement versus craniectomy without replacement. This study compared postoperative outcomes between these techniques, focusing on CSF-related complications, infection, and hospital length of stay. A systematic review and meta-analysis were conducted according to PRISMA guidelines, with the protocol registered in PROSPERO (CRD420251038861). PubMed, Embase, and Web of Science were searched through March 2025. Comparative studies reporting CSF leak, pseudomeningocele, hydrocephalus, wound or central nervous system infection, or hospital length of stay were included. Risk of bias was assessed using the Newcastle–Ottawa Scale and certainty of evidence using the GRADE framework. Four studies comprising 385 patients met the inclusion criteria. Craniotomy significantly reduced the risk of CSF leak (odds ratio [OR] = 0.19; 95% confidence interval [CI]: 0.07–0.48) and pseudomeningocele (OR = 0.27; 95% CI: 0.13–0.57), corresponding to an absolute risk reduction of 11% and a number needed to treat of 9. Hospital length of stay was reduced by a mean of 3.35 days in the craniotomy group (95% CI: –5.71 to –0.99). No significant differences were observed for hydrocephalus or infection outcomes. Certainty of evidence was moderate for CSF-related outcomes and hospital length of stay and low for infection-related outcomes. In conclusion, craniotomy is associated with fewer CSF-related complications and shorter hospital length of stay than craniectomy in posterior fossa tumor surgery, although the available evidence is limited by the observational nature of the included studies. Instituição: Universidade do Estado do Rio de Janeiro Tipo do documento: Dissertação

Análise epidemiológica dos casos de sífilis gestacional em adolescentes e sífilis congênita em seus filhos no município do Rio de Janeiro – 2011-2020

2026-03-20T18:00:55Z

Título: Análise epidemiológica dos casos de sífilis gestacional em adolescentes e sífilis congênita em seus filhos no município do Rio de Janeiro – 2011-2020 Autor: Araújo, Hanna Diniz Dos Santos Primeiro orientador: Taquette, Stella Regina Abstract: Sexually transmitted infections continue to be a significant source of morbidity worldwide. Syphilis stands out as one of the most common, even though it has effective and low-cost treatments. In Brazil, cases of acquired, gestational and congenital syphilis have been increasing progressively in recent years, which demonstrates flaws in the epidemiological surveillance systems and prenatal care services. The city of Rio de Janeiro, despite having a good health service structure, occupies a negative position in national statistics on congenital syphilis. Urban complexity, marked by territorial inequalities, makes it even more difficult to guarantee adequate prenatal care, especially for adolescents. This study aimed to conduct an epidemiological analysis of cases of gestational syphilis in adolescents and congenital syphilis in their children in the city of Rio de Janeiro between 2011 and 2020. This is a descriptive quantitative study based on secondary data from the Notifiable Diseases Information System (SINAN). The analysis includes the sociodemographic characteristics of pregnant adolescents reported with gestational and congenital syphilis, the spatial distribution of cases, and aspects of the quality of prenatal care. The results show a profile of greater vulnerability among pregnant adolescents, especially non-white women, with low levels of education, living in areas with limited primary care coverage, high population density, and low human development indices. The research points to important flaws in the diagnosis, treatment, and reporting processes, which contribute to the persistence of congenital syphilis. The study reinforces the urgency of public policies that articulate health, education and social justice to break the cycle of vertical transmission and guarantee dignified care for young people. Instituição: Universidade do Estado do Rio de Janeiro Tipo do documento: Dissertação

Relação entre índice de massa corporal e endometriose intestinal

2026-03-10T19:00:03Z

Título: Relação entre índice de massa corporal e endometriose intestinal Autor: Corrêa, Tereza Carolina Fonseca Primeiro orientador: Oliveira, Marco Aurelio Pinho de Abstract: The present study aimed to investigate the association between obesity and intestinal involvement of endometriosis, defined as lesions greater than one centimeter, in patients with surgically confirmed deep endometriosis. This was a cross-sectional observational study conducted at the endometriosis outpatient clinic of Hospital Universitário Pedro Ernesto, a large tertiary care center located in Rio de Janeiro, Brazil. Participants were diagnosed with intestinal involvement based on the analysis of surgical specimens and corresponding histopathological reports between September 2023 and December 2024. Obesity was defined according to body weight and Body Mass Index (BMI) classification, following the criteria established by the World Health Organization. Statistical analysis was performed using multiple logistic regression adjusted for clinical and sociodemographic variables. Among the variables analyzed, body weight showed a statistically significant association with the outcome (p = 0.031), suggesting an inverse relationship. However, it is well established that body weight alone does not adequately reflect obesity per se. BMI did not demonstrate statistical significance in the final logistic model, indicating that this measure may not reliably represent body fat distribution, in line with current literature. Additionally, a history of previous cesarean sections was negatively associated with the presence of intestinal lesions (p = 0.002). These findings suggest that BMI did not play an important role and that both obesity/weight and prior cesarean delivery may be associated with a lower frequency of intestinal involvement in patients with deep endometriosis. Instituição: Universidade do Estado do Rio de Janeiro Tipo do documento: Dissertação

Techbalance® como ferramenta de avaliação de equilíbrio em pacientes com indicação de artroplastia total do joelho: estudo transversal metodológico de análise psicométrica

2026-03-09T19:14:17Z

Título: Techbalance® como ferramenta de avaliação de equilíbrio em pacientes com indicação de artroplastia total do joelho: estudo transversal metodológico de análise psicométrica Autor: Costa, Fernanda Barros Primeiro orientador: Oliveira, Liszt Palmeira de Abstract: Knee osteoarthritis (KOA) is a chronic degenerative disease whose prevalence increases with aging. There is an association between this condition and an increased risk of falls. Falls are considered both a cause of trauma and a risk factor for increased morbidity and mortality in older adults. Techbalance® is a tool designed to assess fall risk and postural balance through an anamnesis questionnaire and sensorimotor analysis using a smartphone application. The use of mobile devices for balance assessment may help identify patients at higher risk of falling, thereby enhancing awareness and optimizing care. The aim of this study is to evaluate the psychometric properties of TechBalance® as an instrument for assessing balance and fall risk in patients with KOA who are candidates for total knee arthroplasty (TKA). A cross-sectional methodological study was conducted to evaluate the following psychometric properties: construct validity, internal consistency, test-retest reliability, agreement, and the presence of ceiling and floor effects. Patients over 50 years of age, diagnosed with primary KOA, and in the preoperative phase for TKA at Pedro Ernesto University Hospital were included. A total of 102 participants were assessed through the application of TechBalance®, in association with the balance domain of the Performance Oriented Mobility Assessment (POMA-B) and the Timed Up and Go (TUG) test. Among these participants, 64 underwent TechBalance® retesting. Construct validity showed a positive convergent correlation with the TUG (rho = 0.705; p < 0.05) and a negative convergent correlation with the POMA-B (rho = –0.743; p < 0.05). The sensorimotor analysis demonstrated satisfactory internal consistency (Cronbach’s ⍺ = 0.902; McDonald’s ω = 0.904). Test-retest reliability (ICC = 0.972; 95% CI = 0.957–0.982) and agreement (MDC95 = 6,986; MDC90 = 5.864) were considered satisfactory. No ceiling or floor effects were observed in the sample. The study findings suggest that TechBalance® provides satisfactory validity evidence for balance assessment in this population. A structural analysis using factor analysis or item response theory may contribute to its further refinement. Future research may explore its longitudinal performance through responsiveness analysis. Instituição: Universidade do Estado do Rio de Janeiro Tipo do documento: Dissertação