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- ItemSomente MetadadadosAgreement in the scoring of respiratory events among international sleep centers for home sleep testing(Amer acad sleep medicine, 2016) Magalang, Ulysses J.; Arnardottir, Erna S.; Chen, Ning-Hung; Cistulli, Peter A.; Gislason, Thorarinn; Lim, Diane; Penzel, Thomas; Schwab, Richard; Tufik, Sergio [UNIFESP]; Pack, Allan I.Study Objectives: Home sleep testing (HST) is used worldwide to confirm the presence of obstructive sleep apnea (OSA). We sought to determine the agreement of HST scoring among international sleep centers. Methods: Fifteen HSTs, previously recorded using a type 3 monitor, were deidentified and saved in European Data Format. The studies were scored by nine technologists from the sleep centers of the Sleep Apnea Global Interdisciplinary Consortium (SAGIC) using the locally available software. Each study was scored separately using one of three different airflow signals: nasal pressure (NP), transformed (square root) nasal pressure signal (transformed NP), and uncalibrated respiratory inductive plethysmography (RIP) flow. Only one of the three airflow signals was visible to the scorer at each scoring session. The scoring procedure was repeated to determine the intrarater reliability. Results: The intraclass correlation coefficients (ICCs) using the NP were: apnea-hypopnea index (AHI) = 0.96 (95% confidence interval [CI]: 0.93-0.99)
- ItemSomente MetadadadosAnalysis of polymorphisms in codons 11, 72 and 248 of tp53 in brazilian women with breast cancer(Funpec-editora, 2016) Almeida, B. C. [UNIFESP]; Kleine, J. P. F. O. [UNIFESP]; Camargo-Kosugi, C. M. [UNIFESP]; Lisboa, M. R. [UNIFESP]; Franca, C. N. [UNIFESP]; Franca, J. P.; Silva, I. D. C. G. [UNIFESP]The association between TP53 gene polymorphisms and breast cancer (BC) in Brazilian women is a controversial topic. In this cross-sectional study, we evaluated the association between clinical pathological variables and three polymorphisms (TP53(star)11, TP53(star)72, and TP53(star)248) in BC patients and controls. Genomic DNA was extracted from the blood cells of 393 participants
- ItemAcesso aberto (Open Access)Anemia in inflammatory bowel disease: prevalence, differential diagnosis and association with clinical and laboratory variables(Associação Paulista de Medicina - APM, 2014-04-14) Alves, Rodrigo Andrade; Miszputen, Sender Jankiel; Figueiredo, Maria Stella [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)CONTEXT AND OBJECTIVES:Anemia is the most frequent extraintestinal complication of inflammatory bowel disease. This study aimed to: 1) determine the prevalence of anemia among patients with inflammatory bowel disease; 2) investigate whether routine laboratory markers are useful for diagnosing anemia; and 3) evaluate whether any association exists between anemia and clinical/laboratory variables.DESIGN AND SETTING:Cross-sectional at a federal university.METHODS:44 outpatients with Crohn's disease and 55 with ulcerative colitis were evaluated. Clinical variables (disease activity index, location of disease and pharmacological treatment) and laboratory variables (blood count, iron laboratory, vitamin B12 and folic acid) were investigated.RESULTS:Anemia and/or iron laboratory disorders were present in 75% of the patients with Crohn's disease and in 78.2% with ulcerative colitis. Anemia was observed in 20.5% of the patients with Crohn's disease and in 23.6% with ulcerative colitis. Iron-deficiency anemia was highly prevalent in patients with Crohn's disease (69.6%) and ulcerative colitis (76.7%). Anemia of chronic disease in combination with iron deficiency anemia was present in 3% of the patients with Crohn's disease and in 7% of the patients with ulcerative colitis. There was no association between anemia and disease location. In ulcerative colitis, anemia was associated with the disease activity index.CONCLUSIONS:Most patients present iron laboratory disorders, with or without anemia, mainly due to iron deficiency. The differential diagnosis between the two most prevalent types of anemia was made based on clinical data and routine laboratory tests. In ulcerative colitis, anemia was associated with the disease activity index.
- ItemSomente MetadadadosAssociation between halitosis and mouth breathing in children(Hospital Clinicas, Univ São Paulo, 2011-01-01) Motta, Lara Jansiski; Bachiega, Joanna Carolina; Guedes, Carolina Cardoso [UNIFESP]; Laranja, Lorena Tristao; Bussadori, Sandra Kalil; Univ Nove de Julho; Assoc Brasileira Cirurgioes Dent; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)OBJECTIVE: To determine whether there is a correlation between halitosis and mouth breathing in children.STUDY DESIGN: Fifty-five children between 3 and 14 years of age were divided into two groups (nasal and mouth breathing) for the assessment of halitosis. A descriptive analysis was conducted on the degree of halitosis in each group. the chi-square test was used for comparison between groups, with a 5% level of significance.RESULTS: There was a significantly greater number of boys with the mouth-breathing pattern than girls. A total of 23.6% of the participants had no mouth odor, 12.7% had mild odor, 12.7% had moderate odor and 50.9% had strong odor. There was a statistically significant association between halitosis and mouth breathing.CONCLUSIONS: the occurrence of halitosis was high among the children evaluated, and there was a statistically significant association between halitosis and mouth breathing.
- ItemSomente MetadadadosDetection of ectatic corneal diseases based on pentacam(Elsevier gmbh, urban & fischer verlag, 2016) Lopes, Bernardo T. [UNIFESP]; Ramos, Isaac C.; Dawson, Daniel G.; Belin, Michael W.; Ambrosio, Renato, Jr. [UNIFESP]Pentacam is a rotating Scheimpflug-based corneal and anterior segment tomographer that gives as comprehensive analysis of corneal 3D geometry. With this device the detection of mild keratoconus or ectasia susceptibility is possible. This is fundamental for screening ectasia risk prior to laser vision correction. The identification of susceptible cases at risk for developing progressive iatrogenic ectasia should go beyond (but not over) corneal front surface topography.
- ItemSomente MetadadadosDifferential clinicopathological risk and prognosis of major papillary thyroid cancer variants(Oxford univ press inc, 2016) Shi, Xiaoguang; Liu, Rengyun; Basolo, Fulvio; Giannini, Riccardo; Shen, Xiaopei; Teng, Di; Guan, Haixia; Shan, Zhongyan; Teng, Weiping; Musholt, Thomas J.; Al-Kuraya, Khawla; Fugazzola, Laura; Colombo, Carla; Kebebew, Electron; Jarzab, Barbara; Czarniecka, Agnieszka; Bendlova, Bela; Sykorova, Vlasta; Sobrinho-Simoes, Manuel; Soares, Paula; Shong, Young Kee; Kim, Tae Yong; Cheng, Sonia; Asa, Sylvia L.; Viola, David; Elisei, Rossella; Yip, Linwah; Mian, Caterina; Vianello, Federica; Wang, Yangang; Zhao, Shihua; Oler, Gisele [UNIFESP]; Cerutti, Janete Maria [UNIFESP]; Puxeddu, Efisio; Qu, Shen; Wei, Qing; Xu, Huixiong; O'Neill, Christine J.; Sywak, Mark S.; Clifton-Bligh, Roderick; Lam, Alfred K.; Riesco-Eizaguirre, Garcilaso; Santisteban, Pilar; Yu, Hongyu; Tallini, Giovanni; Holt, Elizabeth H.; Vasko, Vasily; Xing, MingzhaoContext: Individualized management, incorporating papillary thyroid cancer (PTC) variant-specific risk, is conceivably a useful treatment strategy for PTC, which awaits comprehensive data demonstrating differential risks of PTC variants to support. Objective: This study sought to establish the differential clinicopathological risk of major PTC variants: conventional PTC (CPTC), follicular-variant PTC (FVPTC), and tall-cell PTC (TCPTC). Methods: This was a retrospective study of clinicopathological outcomes of 6282 PTC patients (4799 females and 1483 males) from 26 centers and The Cancer Genome Atlas in 14 countries with a median age of 44 years (interquartile range, 33-56 y) and median follow-up time of 37 months (interquartile range, 15-82 mo). Results: The cohort consisted of 4702 (74.8%) patients with CPTC, 1126 (17.9%) with FVPTC, and 239 (3.8%) with TCPTC. The prevalence of high-risk parameters was significantly different among the three variants, including extrathyroidal invasion, lymph node metastasis, stages III/IV, disease recurrence, mortality, and the use (need) of radioiodine treatment (all P < .001), being highest in TCPTC, lowest in FVPTC, and intermediate in CPTC, following an order of TCPTC > CPTC >> FVPTC. Recurrence and mortality in TCPTC, CPTC, and FVPTC were 27.3 and 6.7%, 16.1 and 2.5%, and 9.1 and 0.6%, corresponding to events per 1000 person-years (95% confidence interval [CI]) of 92.47 (64.66-132.26) and 24.61 (12.31-49.21), 34.46 (30.71-38.66), and 5.87 (4.37-7.88), and 24.73 (18.34-33.35) and 1.68 (0.54-5.21), respectively. Mortality hazard ratios of CPTC and TCPTC over FVPTC were 3.44 (95% CI, 1.07-11.11) and 14.96 (95% CI, 3.93-56.89), respectively. Kaplan-Meier survival analyses showed the best prognosis in FVPTC, worst in TCPTC, and intermediate in CPTC in disease recurrence-free probability and disease-specific patient survival. This was particularly the case in patients at least 45 years old. Conclusion: This large multicenter study demonstrates differential prognostic risks of the three major PTC variants and establishes a unique risk order of TCPTC > CPTC >> FVPTC, providing important clinical implications for specific variant-based management of PTC.
- ItemAcesso aberto (Open Access)Estudos de associação genética no transtorno obsessivo-compulsivo(Faculdade de Medicina da Universidade de São Paulo, 2013-01-01) Sampaio, Aline Santos; Lins, Rita Márcia Pacheco; Daltro-Oliveira, Renato; Quarantini, Lucas de Castro [UNIFESP]; Rosario-Campos, Maria Conceicao do [UNIFESP]; Miguel, Euripedes Constantino; Hounie, Ana Gabriela; Universidade de São Paulo (USP); Universidade Federal da Bahia Serviço Médico Universitário Dr. Rubens Brasil; UFBA Faculdade de Medicina Departamento de Neurociências e Saúde Mental; Universidade Federal de São Paulo (UNIFESP)BACKGROUND: Obsessive-compulsive disorder (OCD) segregates in families. It follows a complex model of genetic transmission, which involves the influence of several small effect genes interacting with the environment. METHODS: A systematic review of genetic association studies in OCD was performed. Articles published until 2012 were searched in the databases PubMed, Embase and SciELO using the terms of MeSH and its associates or synonyms for obsessive-compulsive disorder, gene and genetic association studies. RESULTS: We selected 105 papers and described their main results grouped as genes related to: serotonin, dopamine, glutamate, GABA, white matter, immune system, hormones and other genes. CONCLUSION: There is high variability between findings of association studies among the several candidate genes studied in OCD. Glutamate-related genes are promising candidates for OCD, but there is no conclusive association between any of the candidate genes studied and OCD. Association studies with large sample size, evaluation of more homogeneous subgroups of phenotype and meta-analyses are still needed.
- ItemSomente MetadadadosThe imbalance of sex-hormones related to depressive symptoms in obese men(Univ Fed Rio De Janeiro, Fac Letras, 2016) Monteagudo, Patrícia Teófilo [UNIFESP]; Falcão, Adriana Andrade [UNIFESP]; Verreschi, Ieda Therezinha do Nascimento [UNIFESP]; Zanella, Maria-Teresa [UNIFESP]Obese men may present hypogonadothrofic hypogonadism, mainly related to higher insulinemia and aromatase activity. Our objectives were to evaluate the relationship of sex-hormones profiles and frequency of depressive symptoms in 43 obese men, in a cross-sectional study. They had 19-60 years, and body mass index 30-50kg/m(2). LH, total and free testosterone (TT and FT), estradiol (E-2), sex hormone binding globulin, estradiol/total testosterone ratio (E-2/T) were analyzed. Depressive symptoms were evaluated by beck depression inventory (BDI), and significant depression was considered if BDI16.Thirty-four (80%) presented low TT levels, but only 4 (14%) had low free testosterone and hypogonadism symptoms
- ItemSomente MetadadadosIs neck circumference a marker for cardiovascular risk in obese adolescents?(Cuba Editora, 2016) Faria, Bruno [UNIFESP]; Schimith Escrivão, Maria Arlete Meil [UNIFESP]; Nogueira, Paulo Cesar Koch [UNIFESP]Background: Weight excess has become a public health problem worldwide, reaching about 200 million children, of whom 40 to 50 million are obese. Obesity in childhood is associated with increased blood pressure (BP), high triglycerides, low HDL-cholesterol and abnormal glucose metabolism. Visceral fat is a stronger predictor of metabolic dysfunction and cardiovascular risk than total body adiposity. Assessment of neck circumference (NC) is an easy method, which can serve as screening to identify individuals with weight excess. Our study aim was to examine associations between NC with BP values, lipid profile, blood glucose and fasting insulin in obese adolescents and verify the reproducibility of measurements of NC. Methods: 82 adolescents aged 10 to 17 years were included in the study, being 43 (22 boys and 21 girls) with obesity and 39 with normal weight (20 boys and 19 girls). Results: Significant associations were observed between NC and BMI, BP, HDL cholesterol, insulin and HOMA-IR. Disagreement between both observers for NC was observed in 5.2% of the sample, only concerning obese individuals. Conclusion: Our findings strengthen the knowledge about the potential value of NC as a tool for identifying patients at risk for hypertension, insulin resistance, and obesity. However as with the waist circumference it may be flawed in obese individuals.
- ItemSomente MetadadadosA prospective study showing an excellent response of patients with low-risk differentiated thyroid cancer who did not undergo radioiodine remnant ablation after total thyroidectomy(Future Sci Ltd, 2016) Janovsky, Carolina Castro Porto Silva [UNIFESP]; Maciel, Rui M. B. [UNIFESP]; Camacho, Cleber P. [UNIFESP]; Padovani, Rosalia P. [UNIFESP]; Nakabashi, Claudia C. [UNIFESP]; Yang, Ji H. [UNIFESP]; Malouf, Eduardo Z. [UNIFESP]; Ikejiri, Elza S. [UNIFESP]; Mamone, M. Conceicao O. C. [UNIFESP]; Wagner, Jairo; Andreoni, Danielle M. [UNIFESP]; Biscolla, Rosa Paula M. [UNIFESP]Objectives: To prospectively evaluate the outcome of patients with low-risk papillary thyroid carcinoma treated with total thyroidectomy (TT) who did not undergo radioiodine remnant ablation (RRA). Study Design: We prospectively followed up 57 patients
- ItemAcesso aberto (Open Access)Saúde é política… Há uma grande desordem sob o céu: a experiência “comunal” do 15ºº Congresso Paulista de Saúde Pública(Univ Sao Paulo, Fac Saude Publica, 2018) Botazzo, Carlos; Prado Louvison, Marilia Cristina; Akerman, Marco; Pereira, Ana Lucia [UNIFESP]; Buso Weiller, Jose Alexandre; Teixeira, Ricardo RodriguesThis text aims to present a hrief account of the preparatory activities of the 15' Con9resso Paulista de Saude Publica, held in the second half of 2017. Within the material that was used, there are not taken during the preparatory meetings, excerpts from the exchanged messages and, fundamentally, the living record contained in the memory of the authors, as participants in the organization process. We present then the contours of the necessary health politicization and the trends that were mainly ohserved in the activities carried out in all the regional centers of the Associacao Paulista de Saude Publica It was also highlighted the particularity of the congress, which presented a very innovative program proposal it was a forward-looking propulsive congress, composed by nine events hosted in the regions in which are located the association centers. The10th event (a closing activity) took place in Sao Paulo as a theoretical-political celehration. At last, we highlight the strengthening of associative ties and the consolidation of the organization into nuclei.
- ItemSomente MetadadadosSystemic expression of inflammatory mediators in patients with chronic rhinosinusitis and nasal polyps with and without Aspirin Exacerbated Respiratory Disease(Academic Press Ltd- Elsevier Science Ltd, 2016) Pezato, Rogerio [UNIFESP]; Swierczynska-Krepa, Monika; Niankowska-Mogilnicka, Ewa; Holtappels, Gabriele; De Ruyck, Natalie; Sanak, Marek; Derycke, Lara; Van Crombruggen, Koen; Bachert, Claus; Perez-Novo, Claudina Angela; Universidade Federal de São Paulo (UNIFESP)Background: Systemic reactions are related to the pathogenesis of Aspirin Exacerbated Respiratory Disease (AERD). With this work we wanted to study the changes in the systemic levels of inflammatory mediators in both baseline and after oral aspirin challenge in patients with and without AERD. Methods: Patients with nasal polyposis and asthma with AERD (n = 20) and without (n = 18) were orally challenged with aspirin in a single-blind placebo controlled study. Serum samples and urine were collected before and 6 h after placebo and aspirin oral challenges. Serum levels of inflammatory mediators were assayed by using the Luminex technology and ELISA. The concentrations of 9-alpha, 11-beta prostaglandin F-2, and leukotriene E-4 (uLTE(4)) were measured in urine samples by ELISA. The expression of T-cell surface markers was analyzed in peripheral blood mononuclear cells isolated before and after the challenges. Results: AERD patients showed significantly higher baseline levels of s-IL-5R-alpha, uLTE(4) and percentage of CD4(+)CD25(+)CD127(pos) and CD4(+)CD45RA(-)CD45RO(+) but decreased levels of TGF-beta(1) and number of CD4(+)CD25(+)CD127(neg) cells. Aspirin challenge induced the release of uLTE4, IL-6 and increased the number of CD4(+)CD45RA(-)CD45RO(+) memory T-cells only in AERD patients but failed to reduce the levels of sCD40L as observed in non-AERD subjects. Further, IL-8 and sIL-5R-alpha levels directly correlated with the PD(20)ASA and the effects of aspirin on IL-6 and number of memory T-cells was more pronounced in subjects showing more strong reaction (bronchial and nasal). Conclusions: AERD patients have a differential baseline inflammatory pattern that supports the role inflammation as underlying mechanism of the disease. Systemic response to oral aspirin challenge was related to an increase in serum IL-6 and the number of circulating memory T-cells in AERD patients. (C) 2015 Elsevier Ltd. All rights reserved.
- ItemSomente MetadadadosSystemic expression of inflammatory mediators in patients with chronic rhinosinusitis and nasal polyps with and without Aspirin Exacerbated Respiratory Disease(Academic Press Ltd- Elsevier Science Ltd, 2016) Pezato, Rogerio [UNIFESP]; Swierczynska-Krepa, Monika; Niankowska-Mogilnicka, Ewa; Holtappels, Gabriele; De Ruyck, Natalie; Sanak, Marek; Derycke, Lara; Van Crombruggen, Koen; Bachert, Claus; Perez-Novo, Claudina A.Background: Systemic reactions are related to the pathogenesis of Aspirin Exacerbated Respiratory Disease (AERD). With this work we wanted to study the changes in the systemic levels of inflammatory mediators in both baseline and after oral aspirin challenge in patients with and without AERD. Methods: Patients with nasal polyposis and asthma with AERD (n = 20) and without (n = 18) were orally challenged with aspirin in a single-blind placebo controlled study. Serum samples and urine were collected before and 6 h after placebo and aspirin oral challenges. Serum levels of inflammatory mediators were assayed by using the Luminex technology and ELISA. The concentrations of 9-alpha, 11-beta prostaglandin F-2, and leukotriene E-4 (uLTE(4)) were measured in urine samples by ELISA. The expression of T-cell surface markers was analyzed in peripheral blood mononuclear cells isolated before and after the challenges. Results: AERD patients showed significantly higher baseline levels of s-IL-5R-alpha, uLTE(4) and percentage of CD4(+)CD25(+)CD127(pos) and CD4(+)CD45RA(-)CD45RO(+) but decreased levels of TGF-beta(1) and number of CD4(+)CD25(+)CD127(neg) cells. Aspirin challenge induced the release of uLTE4, IL-6 and increased the number of CD4(+)CD45RA(-)CD45RO(+) memory T-cells only in AERD patients but failed to reduce the levels of sCD40L as observed in non-AERD subjects. Further, IL-8 and sIL-5R-alpha levels directly correlated with the PD(20)ASA and the effects of aspirin on IL-6 and number of memory T-cells was more pronounced in subjects showing more strong reaction (bronchial and nasal). Conclusions: AERD patients have a differential baseline inflammatory pattern that supports the role inflammation as underlying mechanism of the disease. Systemic response to oral aspirin challenge was related to an increase in serum IL-6 and the number of circulating memory T-cells in AERD patients. (C) 2015 Elsevier Ltd. All rights reserved.