TEDE Communidade: O Programa de Pós-Graduação em Saúde do Adulto - PPGSAD, nômina adotada a partir de maio/2017, anteriormente chamado "Saúde do Adulto e da Criança" e ainda anteriormente de "Materno-Infantil" foi criado em 2005. Desde 2013, o PPGSAD encontra-se instalado no Campus Universitário Dom Delgado, Bacanga, São Luís-Maranhão, e está dotado de estímulos em cumprimento às competências esperadas dos egressos nos campos da pesquisa, ensino e extensão.

CUSTO EFETIVIDADE DE TERAPIAS CELULARES EM ÚLCERAS VASCULARES: UMA REVISÃO NARRATIVA

2026-03-27T00:00:00Z

Título: CUSTO EFETIVIDADE DE TERAPIAS CELULARES EM ÚLCERAS VASCULARES: UMA REVISÃO NARRATIVA Autor: NEIVA NETO, Euclides Carneiro Primeiro orientador: CARTAGENES, Maria do Socorro de Sousa Abstract: Introduction: Chronic vascular ulcers represent a significant public health problem, associated with high healthcare costs and a negative impact on quality of life. Objective: Given the emergence of cell therapies as a therapeutic alternative, this narrative review aimed to synthesize and critically evaluate the available evidence on the cost-effectiveness of these interventions in the treatment of chronic vascular ulcers, compared to standard care. Methodology: The review was conducted through a systematic search in the main research databases such as PubMed/MEDLINE, Lilacs, Embase, Cochrane Library, Web of Science, and Scopus databases, from January to December 2025. Studies that evaluated economic analyses of cell therapies in adults with venous, arterial, or diabetic ulcers were included. Results: After an initial screening of 11 publications, two studies fully met the eligibility criteria and presented detailed economic data. The results demonstrated that cell therapies were cost-effective in relation to standard care. For venous ulcers, the ECM product (extracellular matrix - OASIS®) proved to be economically dominant, with cost of US$86 per ulcer-free week. For diabetic ulcers, vCPM (viable cryopreserved placental membrane - Grafix®) was dominant, presenting lower cost and greater gain in QALYs. Despite the methodological limitations identified, the findings support the potential of cell therapies as cost-effective strategies in the management of chronic vascular ulcers. Conclusion: Selected cell therapies emerge as cost-effective strategies for managing chronic vascular ulcers, with the capacity to guide clinical decision-making processes and policies on technology incorporation. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

ESPERMIDINA ATENUA DÉFICITS COGNITIVOS E NEURODEGENERAÇÃO HIPOCAMPAL POR MODULAÇÃO DE BDNF E APOPTOSE EM MODELO DE DOENÇA DE ALZHEIMER ESPORÁDICA

2026-05-12T00:00:00Z

Título: ESPERMIDINA ATENUA DÉFICITS COGNITIVOS E NEURODEGENERAÇÃO HIPOCAMPAL POR MODULAÇÃO DE BDNF E APOPTOSE EM MODELO DE DOENÇA DE ALZHEIMER ESPORÁDICA Autor: RODRIGUES, Nathalia Késsia Corrêa Primeiro orientador: PINTO, Bruno Araújo Serra Abstract: Introduction: Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by progressive impairment of memory and cognition, associated with molecular, structural, and functional alterations in the central nervous system. In this context, compounds capable of modulating multiple pathophysiological mechanisms have been investigated, with emphasis on spermidine, an endogenous polyamine with neuroprotective properties described in the literature. Objective: To evaluate the effects of spermidine on behavioral, histological, molecular, and metabolic alterations in an experimental model of AD. Methodology: Male Wistar rats (n = 31) were allocated into control, AD, and spermidine-treated groups. Experimental AD was induced by intracerebroventricular administration of streptozotocin (3 mg/kg). The treated group received spermidine (50 mg/kg, oral gavage) daily for 21 days. Behavioral tests assessing learning and memory were performed, including the Morris water maze and novel object recognition test. In addition, hippocampal histomorphometric analyses and gene expression evaluation of BDNF and CASP3 by qPCR were conducted. Data were expressed as mean ± standard error of the mean (SEM) and analyzed using ANOVA followed by Newman–Keuls post hoc test, considering p ≤ 0.05 as statistically significant. Results: Initially, STZ-induced experimental AD promoted metabolic alterations associated with insulin resistance and dyslipidemia, including glucose intolerance, increased total cholesterol, triglycerides, TyG index, and Lee Index, all of which were reversed by spermidine treatment. Furthermore, the experimental model induced cognitive deficits, hippocampal structural alterations, and dysregulation of genes related to neuroplasticity and apoptosis. In the Morris water maze, AD animals showed impaired task acquisition and reduced spatial memory compared to the control group (p < 0.05), whereas spermidine treatment significantly restored these parameters (p < 0.05 vs. AD). Similarly, spermidine prevented the impairment of episodic memory observed in the novel object recognition test (p < 0.05). Histologically, reduced cellularity was observed in the dentate gyrus hilus of the AD group (p < 0.05), which was partially reversed by treatment. Moreover, spermidine increased hippocampal BDNF expression and reduced CASP3 expression compared to the AD group (p < 0.05). Conclusion: Spermidine exhibited neuroprotective effects in the experimental AD model, acting on behavioral, structural, molecular, and metabolic alterations associated with the disease. These findings reinforce its potential as a promising therapeutic strategy, although further studies are required to elucidate its mechanisms of action and clinical applicability. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

DESESPERANÇA E IDEAÇÃO SUICIDA ENTRE ANESTESIOLOGISTAS, NO BRASIL. UM INQUÉRITO ELETRÔNICO NACIONAL

2026-05-04T00:00:00Z

Título: DESESPERANÇA E IDEAÇÃO SUICIDA ENTRE ANESTESIOLOGISTAS, NO BRASIL. UM INQUÉRITO ELETRÔNICO NACIONAL Autor: SOUSA, Dayane Fernandes Primeiro orientador: GARCIA, João Batista Santos Abstract: Introduction: Healthcare professionals, especially anesthesiologists, constitute a highrisk group for suicidal behaviors, combining specific occupational characteristics with easy access to lethal means. Anesthesiology is a medical specialty that demands high technical precision, rapid decision-making, and operation in environments of constant pressure. Professionals in this field face occupational characteristics that exacerbate specific psychological vulnerabilities. Understanding the prevalence and factors associated with hopelessness and suicidal ideation in anesthesiologists is essential for public policies of prevention and care. Objective: To investigate the prevalence of hopelessness and suicidal ideation among active Brazilian anesthesiologists, as well as to identify associated demographic, occupational, and mental health contexts. Materials and methods: This is a national cross-sectional and analytical electronic survey. Sociodemographic, occupational, and clinical data were collected from anesthesiologists from all Brazilian regions, applying the Beck Hopelessness Scale (BHS) and the Beck Suicide Ideation Scale (BSI). Comparative analyses used Mann-Whitney and KruskalWallis tests. Binary logistic regression in hierarchical blocks identified risk and protective factors. Results: The sample, comprised of 920 anesthesiologists, showed a male predominance (58.0%), a mean age of 47.1 ± 11.7 years, and a predominance of Millennials (48.4%) and Generation X (35.1%). The prevalence of hopelessness was 37.1% (mild to severe). Among those evaluated, 52.8% exhibited suicidal ideation, of which 40.8% were between mild and severe levels and 4.4% were intense. 4.6% of participants reported a suicide attempt. Hopelessness was strongly associated with suicidal ideation (p < 0.001). In the logistic regression for severe ideation, protective factors were: having children (OR = 0.540; p < 0.001, 46% reduction), and anxiety (OR = 0.580; p = 0.047). Risk factors included: weekly hours > 60h (OR = 1.434; p < 0.001), psychiatric condition (OR = 2.876; p < 0.001), and depression (OR = 2.219; p = 0.003). The ROC curve identified a BSI cutoff point ≥ 5 with an AUC = 0.89 (sensitivity 81%, specificity 79%) for predicting suicide attempts. Conclusion: This study identified high prevalence of hopelessness and suicidal ideation among Brazilian anesthesiologists. Psychiatric factors, particularly depression, emerged as independent predictors. Paradoxically, having children, and the presence of anxiety acted as protective factors. The findings reinforce the urgency of institutionalized policies for psychological support, reduced working hours, and periodic screening programs for suicide prevention in this population. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

Sarcopenia na doença renal crônica

2026-04-24T00:00:00Z

Título: Sarcopenia na doença renal crônica Autor: OI, Samira Shizuko Parreão Primeiro orientador: SALGADO FILHO, Natalino Abstract: Background: Sarcopenia has emerged as a significant complication in Chronic Kidney Disease (CKD), particularly among younger age groups, where it is associated with worse clinical and functional prognoses. However, studies focusing on this pediatric population remain scarce. Objective: To evaluate sarcopenia in adolescents with CKD and its relationship with clinical and laboratory variables. Additionally, to analyze the agreement between diagnostic methods for sarcopenia in this population. Methods: A cross sectional and analytical study was conducted with 20 patients aged 10 to 19 years, undergoing conservative treatment (CT group) in stages G3a-G5, or hemodialysis (HD group), attended at the Pediatric Nephrology Service of the University Hospital of UFMA. Sarcopenia was defined by assessing lean mass and muscle strength using the gold standard method (ALMI, Appendicular Lean Mass Index, and Saehan dynamometer) and an alternative screening method (AMBc - Corrected Arm Muscle Area and DM-90 dynamometer). The 30-second chair stand test was used to evaluate the patients’ physical performance. ALMI was measured using dual-energy X-ray absorptiometry (DXA). Clinical and laboratory variables were collected through electronic medical records and questionnaires. Results: Among the included patients, eight belonged to the CT group and twelve to the HD group. The median age was 12 years, with a female predominance (65%). The HD group presented a higher percentage of height deficit compared to the CT group. The prevalence of sarcopenia was 78.9% (gold standard) and 73.6% (alternative method). When assessed using the DM-90 dynamometer, the HD group showed significantly lower strength compared to the CT group (p=0.035). Similarly, the values for AMB, AMBc, ALM, and ALMI were lower in the HD group (p=0.021; p=0.011; p=0.003; p<0.001, respectively). ALMI and the strength tests using DM-90 and Saehan demonstrated a significant correlation with height, weight, and hemoglobin levels. All muscle mass tests showed significant correlations with one another and with the strength tests. The strongest correlation was found between ALMI and AMBc (r=0.839; p<0.001). Strong agreement was reported between the DM-90 and Saehan devices (Kappa=0.857), with a difference of 1.3 kgf between the two. Conclusion: The study highlighted the relevance of sarcopenia in the growth, nutritional status, and development of adolescents with CKD, particularly in those undergoing dialysis. Additionally, it emphasized the feasibility of assessing sarcopenia using simple and accessible screening tools, as well as the necessity of early strategies to control modifiable factors such as anemia and uremia. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação