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

Thu, 22 Jan 2026 00:00:00 GMT

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

Thu, 29 May 2025 00:00:00 GMT

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

O Impacto da Exposição aos BTEX nos Telômeros dos Trabalhadores de Postos de Combustíveis e as Implicações nas Mudanças Climáticas

Wed, 07 May 2025 00:00:00 GMT

Título: O Impacto da Exposição aos BTEX nos Telômeros dos Trabalhadores de Postos de Combustíveis e as Implicações nas Mudanças Climáticas Autor: Silvestre, Rafaele Tavares Primeiro orientador: Souza, Maria Helena Faria Ornellas de Abstract: The composition of gasoline contains the BTEX solvents (benzene, toluene, ethylbenzene, and xylene), with benzene classified as a Group 1 carcinogen in humans by the International Agency for Research on Cancer (IARC). Occupational exposure to benzene poses a significant health risk to fuel station workers, contributing to genomic instability and increasing the risk of cancer development. Several alterations in laboratory parameters have been documented in these workers, including changes in telomere length, telomerase activity, and genotoxic effects. The aim of this study was to evaluate the clinical and genetic impact of these substances on fuel station workers, comparing them with a control group. This cross-sectional study was conducted at five fuel stations near the State University of Rio de Janeiro (UERJ) in the municipality of Rio de Janeiro. Healthy individuals with no prior exposure to BTEX were used as controls. Peripheral blood samples were collected for routine laboratory tests (complete blood count, total and fractionated bilirubin), relative telomere length analysis, telomerase activity quantification, and comet assay. Alterations suggesting reduced mean corpuscular hemoglobin and leukocyte count were observed in the workers' samples, along with subtle changes in monocyte numbers and direct and indirect bilirubin concentrations. No significant differences were observed in the comet assay when comparing directly (n=6) and indirectly exposed workers (n=5), although all individuals exhibited some degree of DNA damage. However, one worker displayed significantly higher DNA damage rates (p<0.05). The relative telomere length (T/S ratio) was measured by quantitative PCR (qPCR) in samples from 58 BTEX-exposed workers and 58 unexposed controls. No significant difference in T/S ratio was found between the groups (p = 0.26), although a subtle elongation of telomeres was noted in the workers’ samples. When stratified by duration of BTEX exposure, workers with prolonged exposure (>100 months) exhibited significantly longer telomeres compared to the unexposed group (p = 0.04). Telomerase activity in leukocytes from exposed workers (n = 9) was found to be eight times higher than in the unexposed group (n = 9), which may account for the observed telomere elongation. Regarding TERRA expression, the subtelomeric region of chromosome 10q demonstrated elevated expression levels in the workers’ samples. These findings suggest that alterations in telomere length may contribute to increased genomic instability in workers occupationally exposed to benzene. The transition from gasoline to biofuels in automobiles is highly recommended to protect the health of these workers and help mitigate the environmental impacts associated with fossil fuel combustion. Instituição: Universidade do Estado do Rio de Janeiro Tipo do documento: Tese

Perfil genético da doença psoriásica: associação dos antígenos leucocitários humanos (HLA) classe I e classe II e dos polimorfismos de nucleotídeo único (SNPs) do TNF-alfa (rs361525), IL17RA (rs4819554) e do Act1/TRAF (rs33980500) em pacientes do Rio de Janeiro

Mon, 24 Nov 2025 00:00:00 GMT

Título: Perfil genético da doença psoriásica: associação dos antígenos leucocitários humanos (HLA) classe I e classe II e dos polimorfismos de nucleotídeo único (SNPs) do TNF-alfa (rs361525), IL17RA (rs4819554) e do Act1/TRAF (rs33980500) em pacientes do Rio de Janeiro Autor: Sampaio, Ana Luisa Primeiro orientador: Abulafia, Luna Azulay Abstract: This study investigates associations between Human Leukocyte Antigen (HLA) alleles and single nucleotide polymorphisms (SNPs) with psoriasis in a highly admixed cohort from Southeastern Brazil. Using a case–control design, 144 patients and 720 controls were genotyped for HLA, and SNPs in IL17RA (rs4819554), TNF-238 (rs361525), and ACT1/TRAF3 (rs33980500) were analyzed in a matched subset (121 cases and 121 controls). Disease severity was classified using PASI scores, incorporating prior or current use of systemic therapy as a marker of moderate to severe disease. Stratification was also performed according to age at onset. Hardy–Weinberg equilibrium, linkage disequilibrium, Bonferroni correction, and Principal Component Analysis (PCA) were applied. A robust association between HLA-C*06:02g and disease susceptibility was confirmed (OR = 2.13; p = 0.0001; pC = 0.007), with no relationship to disease severity or age at onset. Initial risk alleles were identified in both class I and II loci; however, after Bonferroni correction, only C*06:02g remained significant. A novel protective effect of DRB1*15:03g was observed (pC = 0.027). Phenotypic analysis revealed a higher frequency of A*34:02g and B*50:01g in mild disease, whereas DRB1*01:01g occurred exclusively in moderate to severe disease. Regarding age at onset, late-onset psoriasis (>30 years) was associated with A*23:01g, A*30:01g, B*15:03, and DQB1*03:03g, while early-onset disease was linked to B*44:03g and C*07:02g (the latter being five times more frequent in younger patients). PCA revealed clusters consistent with risk and protective profiles, with DQB1 positioned at an extreme pole, while the DRB1~DQB1 linkage disequilibrium pattern remained similar between cases and controls. The SNPs analyzed did not show significant associations with disease susceptibility or severity, although a trend was noted for the IL17RA A/G genotype in moderate to severe disease. These findings demonstrate that the genetic architecture of psoriasis in Brazil combines the classical C*06:02g signal with protective class II signatures, phenotype modulators, and certain class I haplotypes, outlining a distinctive pattern in this admixed population. Instituição: Universidade do Estado do Rio de Janeiro Tipo do documento: Tese