https://tedebc.ufma.br/jspui/handle/tede/2033 Mon, 20 Apr 2026 01:20:57 GMT 2026-04-20T01:20:57Z https://tedebc.ufma.br/jspui/handle/tede/6913 Título: Perfil das Pacientes com Dor Pélvica Crônica e Endometriose em São Luis do Maranhão Autor: MELO, Marilu Marques de Primeiro orientador: LEAL, Plinio da Cunha Abstract: Introduction: Chronic pelvic pain associated with endometriosis is a frequent, multifactorial, and debilitating condition that compromises quality of life, functional performance, and reproductive health. Despite its clinical relevance, there are still few national studies that comprehensively describe the clinical, epidemiological, and psychosocial profile of these patients, as well as the overlap of comorbidities and central pain sensitization mechanisms. Objective: To outline the sociodemographic, reproductive, clinical, and psychosocial profile of women with chronic pelvic pain treated at a high-complexity hospital in São Luís, Maranhão, comparing those with and without endometriosis, and characterizing the intensity, mechanisms, and pain centralization. Methods: This was a prospective, analytical, observational study with a quantitative approach, conducted in the gynecology outpatient clinic of a highcomplexity hospital in São Luís, Maranhão, Brazil, between August 2022 and July 2025. Participants included women ≥18 years old with chronic pelvic pain who underwent investigation with imaging exams and/or videolaparoscopy for the diagnosis of endometriosis. Results: A total of 174 women were included, with a prevalence of endometriosis of 67.2%. Among patients with endometriosis, deep endometriosis in the uterosacral ligaments was observed in 50.5%, with 45.5% in stages 3-4 of the disease. Women with endometriosis had higher levels of education and a higher rate of nulliparity. Dysmenorrhea was widely present among women with endometriosis, while painful and functional comorbidities showed high frequencies in both groups, such as migraine, irritable bowel syndrome, myofascial pain, vulvodynia, and neuropathic pain. Pain centralization showed a predominant distribution of severe to extreme degrees, and most women exhibited symptoms of depression, anxiety, and stress of varying intensities, mainly extremely severe anxiety in 31.3% of patients with endometriosis and 41.9% of those without the disease. Conclusion: Chronic pelvic pain associated with endometriosis is characterized by a strong relationship with dysmenorrhea and nulliparity, as well as an overlap of painful comorbidities and psychological distress. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação Tue, 17 Mar 2026 00:00:00 GMT https://tedebc.ufma.br/jspui/handle/tede/6913 2026-03-17T00:00:00Z https://tedebc.ufma.br/jspui/handle/tede/6905 Título: Papilomatose respiratória recorrente em adultos: uma revisão de escopo Autor: BEZERRA, Andressa Lima Castro Primeiro orientador: CABRAL, Flávia Castello Branco Vidal Abstract: Introduction: Recurrent respiratory papillomatosis is a rare and chronic condition characterized by benign papillomatous lesions in the respiratory tract, commonly associated with human papillomavirus (HPV) genotypes 6 and 11. Adult-onset disease presents a variable clinical course, with frequent recurrence and significant functional impact. Objective: To map the available scientific evidence on adult-onset recurrent respiratory papillomatosis, focusing on epidemiological, clinical, and therapeutic aspects. Methods: This scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) extension (Tricco et al., 2018). Searches were performed between July and September 2025 across PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, LILACS, ProQuest, and Google Scholar, yielding 2,079 records. Study selection was performed in two stages, followed by standardized data extraction. Results: The included studies were predominantly observational, mainly conducted in tertiary care settings, and characterized by small to moderate sample sizes. Adult-onset recurrent respiratory papillomatosis predominantly affected young to middle-aged males. Clinically, the disease was marked by dysphonia, frequent recurrence, and the need for repeated surgical interventions. Surgical management remained the cornerstone of treatment, while adjuvant therapies, such as bevacizumab and cidofovir, showed potential benefits despite heterogeneous and limited evidence. Conclusion: The current evidence on adult-onset recurrent respiratory papillomatosis remains fragmented and predominantly observational, with significant gaps in population- based epidemiology, standardized outcomes, and comparative therapeutic effectiveness. There is a need for multicenter studies with robust methodological designs, as well as clinical validation of emerging therapeutic strategies, including immunotherapy and HPV vaccination approaches, which may contribute to reducing recurrence rates and improving patient outcomes. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação Fri, 13 Mar 2026 00:00:00 GMT https://tedebc.ufma.br/jspui/handle/tede/6905 2026-03-13T00:00:00Z https://tedebc.ufma.br/jspui/handle/tede/6807 Título: Análise da associação entre a carga de hipersinal na substância branca e o acidente vascular encefálico isquêmico Autor: SOUSA, Márcia Beatriz Oliveira de Primeiro orientador: OLIVEIRA, Caio Márcio Barros de Abstract: Introduction: Cerebral white matter hyperintensities, which is part of the spectrum of small vessel disease, has been described in the literature as a biomarker for lacunar ischemic stroke. Some studies question its association with more extensive non- lacunar ischemic infarcts. The main objective was to understand this association in a population in the state of Maranhão. Additionally, to observe the association of high signal intensity in cerebral white matter with its main risk factors such as hypertension, obesity, diabetes, and advanced age. Method: Retrospective analysis of 176 brain magnetic resonance imaging (MRI) scans performed at a tertiary public hospital, in a cross-sectional study. The study was conducted between January 2022 and September 2024, including patients of both sexes aged 55 years or older, after approval by the ethics committee. Data were cataloged in an Excel spreadsheet and processed using StataNow 1.8 BE-Basic edition and Jamovi, employing Fisher's exact test, Kruskal-Wallis test, ANOVA with Tukey post-hoc analysis for the parametric variable identified in the Shapiro-Wilk test, logistic regression, and Fleiss's Kappa to verify inter-observer agreement. Results: A statistically significant association was observed between higher hypersignal load in the white matter and lacunar infarcts, but not with more extensive cerebral infarcts. Furthermore, a statistically significant association with age was also detected. Conclusion: In patients with a higher hypersignal load in the cerebral white matter, a greater number of lacunar infarcts are detected, especially in older patients. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação Thu, 05 Feb 2026 00:00:00 GMT https://tedebc.ufma.br/jspui/handle/tede/6807 2026-02-05T00:00:00Z https://tedebc.ufma.br/jspui/handle/tede/6790 Título: RNAs intergênicos não codificantes longos (lincRNAs) associados a mecanismos de invasão no câncer cervical: uma revisão sistemática e análise in silico. Autor: SOUSA, Larissa Rodrigues de Primeiro orientador: ANDRADE, Marcelo Souza de Abstract: Introduction: Long intergenic non-coding RNAs (lincRNAs) are long non-coding transcripts that regulate gene expression through different mechanisms. lincRNAs participate in essential processes such as chromatin remodeling and the organization of cellular complexes. Their dysregulation is associated with the development and progression of cervical cancer (CC). For this reason, they have been investigated as potential biomarkers and therapeutic targets in cancer research. Objective: To summarize the main studies on lincRNAs associated with invasion mechanisms in CC through a systematic literature search and in silico analysis. Methodology: The study consisted of a systematic review registered in PROSPERO and conducted according to PRISMA guidelines. Searches were performed in PubMed, ScienceDirect, and Scopus, and the methodological quality of the studies was assessed using the JBI checklist. The characterization of lincRNAs and the prediction of their interactions and functions involved in silico analyses, including genomic identification (HGNC), prediction of chemosensitivity/chemoresistance (ncRNAdrug), and lincRNA–mRNA interaction (ENCORI). Functional analyses (GO and KEGG) were conducted using ClusterProfiler, and targets were integrated into STRING to generate the PPI network, which was later refined and visualized in Cytoscape. Results: The systematic search resulted in 26 eligible studies in which 23 lincRNAs related to CC were identified, mainly associated with invasion, proliferation, and EMT mechanisms. Among these, 17 acted in invasion, 20 in proliferation, and 6 in EMT, while only two showed an association with HPV. A total of 17 lincRNAs function as ceRNAs, and three are linked to lymph node metastasis, with one also associated with distant metastasis. In silico analyses revealed possible chemoresistance mediated by TUG1 (cisplatin) and LINC00511 (paclitaxel). The predicted interactions revealed central proteins such as HSP90AB1, RPS27A, and CAV1, which stood out as hubs in the PPI network. Functional analyses showed enrichment in pathways related to ovarian steroidogenesis, cAMP signaling, and cellular regulation processes, reinforcing the role of these lincRNAs in tumor progression and potential mechanisms of therapeutic resistance. Conclusion: These findings reinforce the potential of lincRNAs as biomarkers and therapeutic targets, considering their role in important biological processes and signaling pathways linked to tumor progression. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação Mon, 05 Jan 2026 00:00:00 GMT https://tedebc.ufma.br/jspui/handle/tede/6790 2026-01-05T00:00:00Z