http://repositorio.ufc.br/handle/riufc/389 2026-04-27T06:11:17Z http://repositorio.ufc.br/handle/riufc/86013 Título: Resultados clínico-cirúrgicos e sobrevida de pacientes submetidos a gastroduodenopancreatectomias em um hospital universitário Autor(es): Martins, Tarso Buaiz Pereira Abstract: Pancreaticoduodenectomy (PD), a highly complex procedure, is the main treatment for resectable tumors of the pancreatic head and periampullary region. Advances in surgical and anesthetic techniques, together with perioperative intensive care, have reduced patient mortality over the past decades, although morbidity remains high. The main objectives of this study were to analyze the clinical and epidemiological characteristics, as well as the survival, of patients undergoing PD. This was a longitudinal, observational, and analytical study, with retrospective data collection from the medical records of 110 patients operated on between 2015 and 2023 at Hospital Universitário Walter Cantídio (HUWC/UFC). Logistic regression analysis identified the following as significant risk factors for death: male sex, dyslipidemia, smoking, histological diagnosis of pancreatic adenocarcinoma or cholangiocarcinoma, and the presence of positive lymph nodes. Perioperative mortality (30 days) was 3.63%, and estimated overall survival was 75.5% at 6 months, 68% at 12 months, 64% at 3 years and 58% at 5 years, with a median overall survival of 48.53 months. Regarding postoperative complications, a high morbidity rate was observed, affecting 83.6% of patients. The main complications identified were infections (60.9%), pancreatic fistula (41.8%), delayed gastric emptying (25.4%), and bleeding (22.7%). Less frequent complications included pulmonary complications (6.3%) and biliary fistula (4.5%). The results of this case series, with in-hospital mortality below 5%, were similar to those reported by major international centers. HUWC is a center for teaching, research, and patient care, and these data are essential to support protocols and contribute to optimizing survival and reducing morbidity in these major surgical procedures. Tipo: Dissertação 2026-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/86005 Título: Triagem auditiva em crianças nascidas durante a pandemia de Covid-19 em Fortaleza (Ce). Autor(es): Aragão, Juliana Alves Abstract: Newborn Hearing Screening (NHS) aims to identify hearing impairments early, allowing access to information and support necessary to prevent delays in language acquisition and development due to hearing loss. During the COVID-19 pandemic, declared in March 2020 by the World Health Organization, pregnant women were exposed to a viral infection caused by the SARS-CoV-2 virus, belonging to a family of coronaviruses responsible for causing respiratory syndromes. Viral infections, such as cytomegalovirus, rubella, and measles, can damage the structures of the fetus's inner ear and/or induce immune-mediated damage in the host. Since COVID-19 is a viral disease, it was speculated whether it could also affect the inner ear structures and have negative consequences for the hearing health of these babies. The objective of this study was to characterize the findings of neonatal hearing screening performed on newborns and infants during the first two years of the COVID-19 pandemic. A cross-sectional, descriptive, quantitative study was conducted. Participants in this study were 3,655 babies born in Fortaleza (CE), who underwent the hearing screening test at the Early Treatment and Stimulation Center (NUTEP) between January 2020 and December 2022. Data collection was performed by consulting the audiology service database. The data were transferred from Microsoft Excel® to Stata/IC 16.0 software, and Fisher's exact test and chi-square test were applied to analyze the association between risk factors and the aforementioned outcomes. For binary outcomes, logistic regression analysis was performed to estimate the Odds Ratio. Of the 125 newborns whose mothers had COVID-19 during pregnancy, 88.8% did not have a Risk Indicator for Hearing Impairment (RIH) and presented normal test results. Of the 12 babies with COVID-19 during pregnancy and RIH, 58.3% presented normal results. The most prevalent risk factor among the 9 identified in the study was a stay in the Neonatal ICU for more than five days, with a relevance of 7%. The findings of this study indicate that maternal COVID-19 infection during pregnancy, in isolation, did not constitute a significant risk factor for hearing impairments detected in newborn hearing screening, but when combined with other risk factors it may increase the likelihood of hearing impairments detected by the newborn hearing screening test. This study was approved by the Research Ethics Committee (CEP) under approval number 7.681.483 and CAEE number 88698825.2.0000.5050. Tipo: Dissertação 2026-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/85991 Título: Efeito antifúngico do anlodipino em cepas de Candida spp. e em biofilmes mistos com Staphylococcus aureus resistente à meticilina (SARM): avaliação in vitro Autor(es): Queiroz, Helaine Almeida Abstract: Antimicrobial resistance (AMR) has become one of the main threats to global public health, driven by the excessive and inappropriate use of antimicrobials , which favors the emergence and spread of multidrug-resistant strains. In this context, invasive fungal infections caused by Candida yeasts have become a growing problem, with candidemia associated with high mor-tality rates (30-40%). Simultaneously, Methicillin-Resistant Staphylococcus aureus (MRSA) remains an important bacterial pathogen, responsible for infections ranging from skin condi-tions to potentially fatal situations. The management of these infections is even more challen-ging due to the ability of these microorganisms to form biofilms, communities adhered to sur-faces, which offer significant protection and confer antimicrobial tolerance up to a thousand times greater than in planktonic cells. Medical devices, widely used in clinical procedures, re-present environments conducive to the formation of these biofilms, especially when there is colonization by Candida spp. and MRSA. The objective of this study was to investigate the antifungal activity of amlodipine against Candida spp. strains in planktonic and biofilm forms, to elucidate its possible mechanism of action, and to evaluate its effect on mixed biofilms of Candida spp. and MRSA, both in 96-well polystyrene plates and in Peripheral Venous Cathe-ters (PVCs). To this, an Antifungal Susceptibility Test was performed to determine the Mi-nimum Inhibitory Concentrations (MICs). The action of amlodipine against Candida spp. and Candida spp. plus MRSA biofilms was determined by the MTT assay, and its possible me-chanism of action was investigated through flow cytometry tests. The results demonstrated that amlodipine exhibited Minimum Inhibitory Concentrations (MICs) ranging from 62.5 to 250μg/mL, as well as significant action on mature and pre-formed and forming biofilms, promoting reductions between 50% and 90%. Additionally, the drug increased phosphatidyl-serine externalization and reduced fungal cell viability, suggesting induction of apoptosis. It was also observed that amlodipine reduced metabolic viability by approximately 90% in “in vitro’ polymicrobial biofilms at a concentration equivalent to 8xMIC (1000-2000 μg/mL), in all combinations tested, as well as exerting a potent action on mixed biofilms in CVPs, with a reduction in the number of colonies between 60% and 90%. Furthermore, the morphology was evaluated by light microscopy, confirmed by Scanning Electron Microscopy (SEM). Ba-sed on these findings, amlodipine emerges as a potential candidate for the treatment of fungal and mixed infections. However, additional in vivo studies are needed to validate and expand these results Tipo: Tese 2026-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/85968 Título: Mastectomia radical modificada com drenagem por sucção contínua versus sem drenagem Autor(es): Juaçaba, Ricardo Carvalho Abstract: This research was conducted in order to analyze the results of seroma formation after modified radical mastectomy using suction drain versus no suction drain with a wound closure tecnique. This prospective study included seventy-two (72) patients who had operable breast cancer. All patients underwent modified radical mastectomy (Madden surgery) followed by wound closure using inabsorvent stitch between the skin and the chest wall musculature. The axila was also closed and the suction drains were placed beneath the skin and in the axila. The drains were removed 24 hours after surgery. Of the seventy-two (72) patients in the study, thirty-seven underwent the surgery and had drains placed. Thirty-five patients had no drains place following surgery. Evaluations factors included: age, weigth, clinical stage, number of axillary lymph nodes removed and positive lymph nodes. Complications (thus are of study) in both groups of patients included: seroma, infected seroma, skin necroses, hematoma and wound infection. The results of these seventy-two patients showed no significant statistical difference between the two groups in relation to: age (p=0.59), weight (p=0.25), height (p=0.83), clinical stage (p=0.44), lymph nodes removed (p=0.63) and positive lymph nodes (p=0.94). Surgical complications occurred in 10 patients (27%) in the first group (with drains) and in 12 patients (34,3%) in group two (without drains). Seroma formation was present in 8 patients in group 1 (21,6%) and in 10 patients in group 2 (28,6%). No significant statistical difference was noted between the two groups in relationship to the total number of complications (p=0.50) and seroma (p=0.49). The author concluded that modified radical mastectomy (associated with wound closure) and without drains can be safely performed without increasing surgical complications Tipo: Dissertação 2001-01-01T00:00:00Z