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Tradução, adaptação transcultural e validação do Chronic Pain Acceptance Questionnaire - 8 em brasileiros com dor crônica oncológica

Mon, 06 Apr 2026 00:00:00 GMT

Título: Tradução, adaptação transcultural e validação do Chronic Pain Acceptance Questionnaire - 8 em brasileiros com dor crônica oncológica Autor: MORAIS, Daniel Nunes Primeiro orientador: DIBAI FILHO, Almir Vieira Abstract: Introduction: Chronic cancer-related pain is common and negatively affects functioning, emotional status, and quality of life. It may result from tumor progression, invasion or compression of neural structures, and antineoplastic treatments themselves, presenting nociceptive, neuropathic, or mixed components. Pain acceptance is a central psychological process in contemporary pain management models, associated with engagement in important activities despite pain and willingness to experience pain without attempting to control it. In Brazil, psychometric evidence for the Chronic Pain Acceptance Questionnaire–8 (CPAQ-8) remains scarce. Objectives: To translate, cross‑culturally adapt and validate the CPAQ‑8 for patients with chronic cancer‑related pain. Methods: This methodological study was conducted according to COSMIN guidelines. The eight CPAQ-8 items, grouped into Activity Engagement and Pain Willingness, were translated, back-translated, reviewed by experts, and administered to 136 adults diagnosed with cancer and chronic pain. After pretesting, confirmatory factor analysis, internal consistency (Cronbach’s alpha), test retest reliability (intraclass correlation coefficient), standard error of measurement, minimal detectable change, and correlations with measures of quality of life (EORTC QLQ-C30), functionality (Barthel Index), emotional symptoms (HADS), catastrophizing (PCS), and pain intensity were analyzed. Results: The two‑factor structure was partially confirmed, although one item showed a low loading. Internal consistency was low in both domains, probably due to the small number of items and the heterogeneity of the sample, but test–retest reliability was good to excellent. The Activity Engagement domain correlated moderately with functionality, quality of life and emotional symptoms, and negatively with anxiety, depression and catastrophizing. There was no significant correlation with pain intensity. Conclusion: The Brazilian version of the CPAQ‑8 provides initial evidence of construct validity and temporal reliability in patients with chronic cancer‑related pain, although the low internal consistency requires further studies to deepen its psychometric properties. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

ASSOCIAÇÃO ENTRE NÍVEIS DE MMP-9 NO FLUIDO CREVICULAR GENGIVAL E OS PARÂMETROS CLÍNICOS PERIODONTAIS EM INDIVÍDUOS ADULTOS COM PERIODONTITE DURANTE TRATAMENTO NÃO CIRÚRGICO

Tue, 28 Apr 2026 00:00:00 GMT

Título: ASSOCIAÇÃO ENTRE NÍVEIS DE MMP-9 NO FLUIDO CREVICULAR GENGIVAL E OS PARÂMETROS CLÍNICOS PERIODONTAIS EM INDIVÍDUOS ADULTOS COM PERIODONTITE DURANTE TRATAMENTO NÃO CIRÚRGICO Autor: LIMA, Andréia Martins Primeiro orientador: LOPES, Fernanda Ferreira Abstract: Introduction: Periodontitis is a multifactorial chronic inflammatory disease associated with dysbiotic biofilm and characterized by the progressive destruction of the toothsupporting tissues. Among the mediators involved in its pathogenesis, matrix metalloproteinase-9 (MMP-9) stands out as an enzyme associated with extracellular matrix degradation and the progression of periodontal tissue destruction. Objective: To analyze MMP-9 levels in the gingival crevicular fluid of adult patients with periodontitis undergoing non-surgical periodontal therapy through full-mouth ultrasonic debridement without the use of adjunctive antimicrobial agents, as well as to evaluate its association with clinical periodontal parameters. Methodology: This longitudinal study included a convenience sample of 20 patients treated at the Dental Clinic of the Federal University of Maranhão (UFMA). The clinical parameters probing depth (PD) and clinical attachment level (CAL) were assessed to establish periodontitis staging as stages I, II, and III, based on an adapted form of the classification proposed by Tonetti et al. (2018). Gingival crevicular fluid (GCF) samples were collected from three sites per participant, including two diseased sites (PD ≥ 4 mm) and one healthy site, all interproximal and nonadjacent. MMP-9 concentration was determined using the enzyme-linked immunosorbent assay (ELISA) and evaluated at baseline, 24 hours, and 60 days after non-surgical periodontal therapy through full-mouth ultrasonic debridement without the use of adjunctive antimicrobial agents. Statistical analysis was performed using the D’Agostino–Pearson, Kruskal–Wallis, Dunn, one-way ANOVA, Sidak, and Holm–Sidak tests, adopting a significance level of 5%. Results: Higher values of probing depth, clinical attachment level, and MMP-9 were observed in the more advanced stages of periodontitis. Following non-surgical periodontal therapy, a reduction in clinical parameters was observed across all stages, with a more pronounced and statistically significant decrease (p < 0.05) in stage III. Regarding MMP-9, a progressive reduction in its levels was observed over time, particularly in stages II and III, with a statistically significant difference (p < 0.05) at 60 days compared with baseline. Conclusion: Nonsurgical periodontal therapy through full-mouth ultrasonic debridement was effective in improving clinical periodontal parameters and reducing MMP-9 levels after 60 days. Furthermore, an association was observed between clinical parameters and the levels of this enzyme, indicating its potential as a complementary biomarker for assessing inflammatory activity and monitoring the response to non-surgical periodontal treatment. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

Estudo clínico randomizado comparativo entre bloqueio de plexo braquial via interescalênico e costoclavicular quanto aos efeitos respiratórios e analgésicos em paciente submetidos à artroscopia de ombro

Thu, 16 Apr 2026 00:00:00 GMT

Título: Estudo clínico randomizado comparativo entre bloqueio de plexo braquial via interescalênico e costoclavicular quanto aos efeitos respiratórios e analgésicos em paciente submetidos à artroscopia de ombro Autor: BRAGA, Hiago Parreão Primeiro orientador: LEAL, Plínio da Cunha Abstract: Introduction: Interscalene block (ISB) is considered the gold standard for analgesia in shoulder arthroscopy, providing excellent postoperative pain control. However, it has significant limitations due to hemidiaphragmatic paralysis, resulting in respiratory compromise. Costoclavicular block (CCB), a more recent technique, offers a potentially safer alternative by allowing access to the brachial plexus cords farther away from the phrenic nerve. Objective: To compare the prevalence of diaphragmatic paralysis between costoclavicular and interscalene brachial plexus blocks in the postoperative period of shoulder arthroscopy, evaluating the analgesic effects and respiratory safety profile. Methodology: Prospective, randomized, double-blind clinical trial conducted with 92 patients (18-80 years, ASA I-III) undergoing shoulder arthroscopy. Participants were randomized into the CCB Group (n=46) and ISB Group (n=46), receiving 20 mL of 0.375% ropivacaine under ultrasound guidance. The primary outcome was hemidiaphragmatic paralysis assessed by ultrasound at 30 minutes post-blockade, 30 minutes, and 180 minutes post-anesthesia. Secondary outcomes included pain scores at 48 hours, time to first pain complaint, morphine consumption, and complications. Statistical analysis was performed using SPSS 26, considering p<0.05. Results: BCC demonstrated a significantly lower incidence of hemidiaphragmatic paralysis at all assessed time points: 30 minutes after block performance (56.5% vs. 91.3%, p<0.001), 30 minutes (47.8% vs. 91.3%, p<0.001), and 180 minutes after admission to the postanesthesia care unit (PACU) (47.8% vs. 91.3%, p<0.001). However, the BCC group showed higher initial morphine consumption (p=0.008) and higher pain scores at PACU admission (p=0.002) and at discharge from the post-anesthesia care unit (p=0.012). No differences were observed in pain scores at other time points, time to first pain complaint, or complication rates. Patient satisfaction was 100% in both groups. Conclusion: BCC demonstrated an advantage in preserving respiratory function, establishing itself as a safer alternative for patients with respiratory comorbidities. Although associated with a greater initial need for analgesic rescue, the subsequent analgesic equivalence supports BCC as an effective technique. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

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

Fri, 27 Mar 2026 00:00:00 GMT

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