Navegando por Palavras-chave "review"

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    Advances in the treatment of multiple myeloma: the role of thalidomide
    (Taylor & Francis Ltd, 2003-01-01) Ribas, Christian [UNIFESP]; Colleoni, Gisele Wally Braga [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Multiple myeloma (MM) accounts for 1% of all malignancies and 10% of malignant hematological neoplasms. in spite of high-dose therapy with stem cell rescue, relapse and disease resistance are common events in the course of the disease. Thalidomide (Thal) has been successfully used in such situations and it's use has also been expanded to the up-front therapy and as adjuvant to stem cell transplantation. Here, we review the underlying concepts and current clinical data regarding Thal in the treatment of MM.
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    Angiotensin II antagonists for hypertension: Are there differences in efficacy?
    (Elsevier B.V., 2000-04-01) Conlin, P. R.; Spence, J. D.; Williams, B.; Ribeiro, A. B.; Saito, I; Benedict, C.; Bunt, AMG; Brigham & Womens Hosp; Harvard Univ; Univ Western Ontario; Univ Leicester; Universidade Federal de São Paulo (UNIFESP); Keio Univ; Univ Texas; Merck & Co Inc
    We compared the antihypertensive efficacy of available drugs in the new angiotensin-II-antagonist (AIIA) class. the antihypertensive efficacy of losartan, valsartan, irbesartan, and candesartan was evaluated from randomized controlled trials (RCT) by performing a metaanalysis of 43 published RCT. These trials involved AIIA compared with placebo, other antihypertensive classes, and direct comparisons between AIIA. A weighted-average for diastolic and systolic blood pressure reduction with AIIA monotherapy, dose titration, and with addition of low-dose hydrochlorothiazide (HCTZ) were calculated. Weighted-average responder rates were also determined. the metaanalysis assessed a total of 11,281 patients. the absolute weighted-average reductions in diastolic (8.2 to 8.9 mm Hg) and systolic (10.4 to 11.8 mm Hg) blood pressure reductions (not placebo-corrected) for AIIA monotherapy were comparable for all AIIA. Responder rates for AIIA monotherapy were 48% to 55%. Dose titration resulted in slightly greater blood pressure reduction and an increase in responder rates to 53% to 63%. AIIA/hydrochlorothiazide combinations produced substantially greater reduction in systolic (16.1 to 20.6 mm Hg) and diastolic (9.9 to 13.6 mm Hg) blood pressure reductions than AIIA monotherapy and responder rates for AIIA/HCTZ combinations were 56% to 70%. This comprehensive analysis shows comparable antihypertensive efficacy within the AIIA class, a near-flat AIIA-dose response when titrating from starting to maximum recommended dose, and substantial potentiation of the antihypertensive effect with addition of HCTZ. (C) 2000 American Journal of Hypertension, Ltd.
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    Biogenic synthesis of nanostructured iron compounds: applications and perspectives
    (Inst Engineering Technology-iet, 2013-09-01) Seabra, Amedea Barozzi [UNIFESP]; Haddad, Paula [UNIFESP]; Duran, Nelson; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Campinas (UNICAMP); Universidade Federal do ABC (UFABC)
    'Green nanotechnology' has attracted increasing attention in recent years because of the possibility to reduce and/or eliminate toxic substances. Indeed, biogenic syntheses of nanomaterials, such as nanoparticles (NPs), are considered economic and valuable alternatives for the production of metallic NPs for diverse applications. Recent studies have revealed that the development of eco-friendly technologies in material science is under extensive investigation in the field of nanobiotechnology. Considering this scenario, this review highlights the recent advances in the biogenic syntheses of metallic iron, iron sulphides and iron oxide NPs for a wide range of applications. Moreover, this review also discusses the medical, environmental and technological applications of biogenically synthesised NPs, and the challenges to be faced to optimise the eco-friendly production of these important nanomaterials.
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    Bioinformatics Approach to BDNF and BDNF-Related Disorders
    (Bentham Science Publ Ltd, 2011-06-01) Dias, Alvaro Machado [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    Context: Currently, the keyword 'BDNF' retrieves 7388 publications in Pubmed, which point to many directions.Objective: This paper aims to uncover patterns that are hidden under this huge mass of studies and then to review the most prominent sub-topics in 'BDNF and mental health'.Method: Several semi-automatic tools employed, in order to present: 1. A visual representation of BDNF's main molecular pathways; 2. A table with all the components of this pathway that are known to be associated with human diseases; 3. A conceptual map of the whole literature; 4. A histogram of the mental disorders that are known to be associated with BDNF, as well as a review of the literature on each one of these topics.Results: The conceptual map suggests that the field is divided in two major sections: BDNF molecular pathways, receptors, other neurotrophins and neurotransmitters; and BDNF-related disorders. Among the latter, the mental disorders that are mostly related to BDNF are: depression, schizophrenia, Parkinson disease, Alzheimer disease, and bipolar disorder.
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    Comparison of carbamazepine and lithium in treatment of birolar disorder: a systematic review of randomized controlled trials
    (Wiley-Blackwell, 2009-01-01) Ceron-Litvoc, Daniela [UNIFESP]; Soares, Bernardo Garcia [UNIFESP]; Geddes, John; Litvoc, Julio; Lima, Mauricio Silva de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ Oxford; Universidade de São Paulo (USP)
    Objectives To review data from randomized controlled trials (RCTs) assessing the comparative efficacy of carbamazepine and lithium in treatment of acute manic and maintenance phase of bipolar disorder (BD).Design RCTs were identified through a search strategy that included: electronic databases, reference cross-checking, hand search of non-indexed publications. and book chapters on the treatment of BD comparing carbamazepine with lithium. Outcomes investigated were antimanic effect. trial withdrawal, relapse, hospitalization, need for rescue medication, and presence of adverse effects. Selection of studies and data analysis were performed independently by authors. Whenever possible, data from trials were combined through meta-analyses. Relative risks (RR) were estimated for dichotomous data.Results in acute mania. carbamazepine was similar to lithium oil the following Outcomes: trial withdrawal due to adverse effects, number of participants with at least one adverse effect. improvement in the Clinical Global Impression (CGI). in acute mania, carbamazepine was associated with fewer trial withdrawals. in maintenance treatment. carbamazepine was similar to lithium in relapses and hospitalization. but there were fewer trial withdrawals due to adverse effects on lithium.Conclusion This review suggests that carbamazepine might be comparable to lithium in terms of efficacy and safety. and therefore it valuable option in the treatment of both manic and maintenance phases. Copyright (c) 2008 John Wiley & Sons, Ltd.
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    Diagnosis, antiretroviral therapy, and emergence of resistance to antiretroviral agents in HIV-2 infection: a review
    (Brazilian Society of Infectious Diseases, 2003-02-01) Hightower, Maia [UNIFESP]; Kallas, Esper Georges [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Human immunodeficiency virus type 1 (HIV-1) and type 2 (HIV-2) are the causative agents of AIDS. HIV-2 is prevalent at moderate to high rates in West African countries, such as Senegal, Guinea, Gambia, and Cape Verde. Diagnosis of HIV-2 is made with a positive HIV-1/HIV-2 ELISA or simple/rapid assay, followed by one or two confirmatory tests specific for HIV-2. Following CD4+ T cell counts, HIV-2 viral burden and clinical signs and symptoms of immunodeficiency are beneficial in monitoring HIV-2 disease progression. Although non-nucleoside reverse transcriptase inhibitors are ineffective in treating HIV-2, nucleoside reverse transcriptase inhibitors and protease inhibitors can be effective in dual and triple antiretroviral regimens. Their use can decrease HIV-2 viral load, increase CD4+ T cell counts and improve AIDS-related symptoms. HIV-2 resistance to various nucleoside reverse transcriptase inhibitors and protease inhibitors, including zidovudine, lamivudine, ritonavir and indinavir, has been identified in some HIV-2 infected patients on antiretroviral therapy. The knowledge of HIV-2 peculiarities, when compared to HIV-1, is crucial to helping diagnose and guide the clinician in the choice of the initial antiretroviral regimen and for monitoring therapy success.
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    Dietary calcium supplementation for prevention of pre-eclampsia and related problems: a systematic review and commentary
    (Blackwell Publishing, 2007-08-01) Hofmeyr, G. J.; Duley, L.; Atallah, Álvaro [UNIFESP]; Univ Witwatersrand; Univ Leeds; Universidade Federal de São Paulo (UNIFESP)
    Background Calcium supplementation during pregnancy may reduce the risk of hypertensive disorders of pregnancy.Search strategy We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Central Register of Controlled Trials (March 2006).Selection criteria Randomised trials comparing at least 1 g of calcium daily during pregnancy with placebo. Eligibility and trial quality were assessed.Data collection and analysis Data were extracted and analysed using Review Manager software.Main results Twelve studies (15 528 women) were included, all of good quality. Most women were at low risk and had low dietary calcium. High blood pressure was reduced with calcium supplementation rather than placebo (11 trials, 14 946 women: relative risk [RR] random effects model 0.70; 95% CI 0.57-0.86), as was pre-eclampsia (12 trials, 15 206 women: RR 0.48; 95% CI 0.33-0.69). the effect was greatest for women at high risk (five trials, 587 women: RR 0.22; 95% CI 0.12-0.42) and for those with low baseline calcium intake (seven trials, 10 154 women: RR 0.36; 95% CI 0.18-0.70). There was heterogeneity, with less effect in the larger trials. the composite outcome maternal death or serious morbidity was reduced (four trials, 9732 women: RR 0.80; 95% CI 0.65-0.97). the syndrome of haemolysis, elevated liver enzymes and low platelets was increased (two trials, 12 901 women: RR 2.67; 95% CI 1.05-6.82). There was no overall effect on the risk of preterm birth or stillbirth or death before discharge from hospital.Conclusions Calcium supplementation appears to reduce the risk of pre-eclampsia and to reduce the rare occurrence of the composite outcome 'maternal death or serious morbidity'. There were no other clear benefits or harms.Commentary We present the hypothesis that adequate dietary calcium before and in early pregnancy may be needed to prevent the underlying pathology responsible for pre-eclampsia. We suggest that the research agenda be redirected towards calcium supplementation at a community level.
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    EARLY-ONSET NEONATAL PNEUMOCOCCAL SEPSIS: A FATAL CASE REPORT AND BRIEF LITERATURE REVIEW
    (Lippincott Williams & Wilkins, 2018) Jarovsky, Daniel; Marchetti, Ivan Cese; Mori, Mariana Alves da Silva; Souza, Ricardo Magalhaes de; Almeida, Flavia Jacqueline; Safadi, Marco Aurelio Palazzi [UNIFESP]; Berezin, Eitan Naaman [UNIFESP]
    Sepsis caused by Streptococcus pneumoniae is rare in neonates although associated with high morbidity and mortality. We report a fatal case of invasive pneumococcal disease in a term neonate whose mother was healthy and did not receive any pneumococcal vaccine. Investigation of the infection source yielded negative results. Acquisition of infection through the birth canal was considered unlikely.
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    Efetividade e segurança dos diferentes tipos de enxertia para o levantamento do seio maxilar com finalidade implantodológica: revisão sistemática
    (Universidade Federal de São Paulo (UNIFESP), 2013-03-27) Martins Junior, Joao de Paula [UNIFESP]; Atallah, Alvaro Nagib Atallah [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Context: Edentulous patients under use of removable dentures have important limitations, which include the socio-cultural ones and, for this reason, the insertion of implants has been frequently used in clinical practice. However, the success of this method depends on the type of material used for grafting, the donor area quality and the quantity of bone present on the installation site. Objective: to evaluate the effectiveness and safety of various types of grafting used in surgeries of maxillary sinus lifting with implantodontic purpose. Methods: a systematic review of randomized or quasi-randomized clinical trials. Were used the Cochrane Collaboration manual of systematic reviews guidelines and built a sensitive search strategy in three electronic databases. Results: were included six randomized clinical trials of different regions of the world with 135 participants. The bone volume was 3% higher in the site grafted with pure autogenic bone, but without a statistically significant difference: DM 3 (-8.48 -14.48), the average percentage between the vital and non-vital bone was 0.82% in the site grafted with FDBA+PRP. Already the vital tissue average percentage was also 15.8% bigger on the side where PRP was used. Conclusion: the available evidences are insufficient to recommend a specific type of bone graft in the sinus lifting during the insertion of dental implantation. There was no statistically significant difference for the bone volume, sensory loss, local inflammatory reaction and implant loss, among others. The combination of dry and frozen allogenic bone with platelet rich plasma proved to be favorable to vital bone formation in the maxillary sinus lifting, when compared to grafting with dry and frozen allogenic bone combined with absorbable membrane. So, new randomized and controlled trials that evaluate the effectiveness and safety of different types of bone graft for lifting of the maxillary sinus are needed.
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    Effective Targeting of the Epidermal Growth Factor Receptor (EGFR) for Treating Oral Cancer: A Promising Approach
    (Int Inst Anticancer Research, 2014-04-01) Ribeiro, Flavia Andressa Pidone [UNIFESP]; Noguti, Juliana [UNIFESP]; Oshima, Celina Tizuko Fujiyama [UNIFESP]; Ribeiro, Daniel Araki [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Oral cancer is a serious problem growing in incidence in many parts of the world; it is considered the sixth most common cancer and despite sophisticated surgical and radiotherapeutic modalities, oral squamous cell carcinoma, which represents 90% of oral cancers, is characterized by poor prognosis and a low survival rate. The Epidermal growth factor receptor family of receptor tyrosine kinases (RTK) comprises of four distinct receptors: the EGFR (also known as ErbB-1/HER1), ErbB-2 (neu, HER2), ErbB-3 (HER3) and ErbB-4 (HER4). Several studies have been published on the role of EGFR in the pathogenesis of oral carcinoma. The aim of the present review is to describe the role of EGFR pathway in oral cancer with special focus on its role during the carcinogenesis process as a result of therapeutic approaches of EGFR in oral cancer. The EGFR is a 170-kDa cell-surface protein involved in many biological processes, such as proliferation, migration, DNA synthesis and adhesion. Overexpression of EGFR results in a poor prognosis in oral cancer and its activation is associated with the malignant phenotype, inhibition of apoptosis and increased metastatic potential. EGFR variations and mutations have been correlated with tumor formation, and possibly alter the therapeutic efficacy of EGFR inhibitors.
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    Efficacy of sublingual immunotherapy in asthma: systematic review of randomized-clinical trials using the Cochrane Collaboration method
    (Blackwell Publishing, 2006-10-01) Calamita, Z.; Saconato, Humberto [UNIFESP]; Pela, A. B.; Atallah, Álvaro Nagib [UNIFESP]; Med Sch Marilia; Universidade Federal de São Paulo (UNIFESP)
    Background: Sublingual immunotherapy (SLIT) is effective and safe in the treatment of allergic rhinitis. However, there is no meta-analysis in asthma treatment.Methods: the clinical efficacy of SLIT for asthma was evaluated through a systematic review with meta-analysis. MEDLINE (1966-2005), EMBASE (1974-2005), LILACS (1982-2005), and the Cochrane Library were searched for related literature in any language. Randomized-controlled clinical trials (RCT) on SLIT in asthma treatment for adults and children were selected. From 119 citations, 25 studies with 1706 patients were included in this meta-analysis. for each report, quality scores were assigned and data were extracted in relation to the outcomes analyzed: asthmatic symptoms, use of asthma medications, lung function, and bronchial provocation.Results: According to the Jadad quality method, 64% of the studies were assigned scores of 4 or 5. Immunotherapy was seen to significantly reduce asthma severity when parameter compositions were all analyzed by categorical outcomes. There was a nonsignificant reduction in asthma symptoms when analyzed using standardized mean differences. No severe reactions were observed.Conclusions: This meta-analysis found that SLIT is beneficial for asthma treatment albeit the magnitude of the effect is not very large. Moreover, it is a safe alternative to the subcutaneous route. More RCT with standardization of symptom scores and medications are needed in order to contribute further to this subject.
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    Efficiency indicators to assess the organ donation and transplantation process: systematic review of the literature
    (Pan Amer Health Organization, 2016) Siqueira, Marina Martins; Araujo, Claudia Affonso; Roza, Bartira de Aguiar [UNIFESP]; Schirmer, Janine [UNIFESP]
    Objective. To search the literature and identify indicators used to monitor and control the organ donation and transplantation process and to group these indicators into categories. Method. In November 2014, a systematic review of the literature was carried out in the following databases: Biblioteca Virtual em SaLde (BVS), EBSCO, Emerald, Proquest, Science Direct, and Web of Science. The following search terms (and the corresponding terms in Brazilian Portuguese) were employed: "efficiency," "indicators," "organ donation," "tissue and organ procurement," and "organ transplantation." Of the 344 articles retrieved, 23 original articles published between 1992 and 2013 were selected and reviewed for analysis of efficiency indicators. Results. The review revealed 117 efficiency indicators, which were grouped according to similarity of content and divided into three categories: 1) 71 indicators related to organ donation, covering mortality statistics, communication of brain death, clinical status of donors and exclusion of donors for medical reasons, attitude of families, confirmation of donations, and extraction of organs and tissues
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    Estatinas para estenose da valva aórtica: revisão sistemática de ensaios clínicos randomizados
    (Universidade Federal de São Paulo (UNIFESP), 2014-11-30) Thiago, Luciana [UNIFESP]; Atallah, Alvaro Nagib Atallah [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To evaluate the effectiveness and safety of statins for aortic valve stenosis. Methods: Systematic review of randomized controlled trials. The following electronic databases: The Cochrane Library, MEDLINE, EMBASE, LILACS, ISI Web of Science and CINAHL Plus were used until December 2013 and June 2014. There was no language restriction. Only randomized controlled trials that compared statins alone or in combination with other lipid lowering drug for aortic valve stenosis were included. We measured outcomes as severity of aortic valve stenosis (mean pressure gradient, valve area and aortic jet velocity), valve replacement, death from cardiovascular causes, hospitalization for any cause, overall mortality, adverse events and quality of life. For dichotomous outcomes, we calculated the relative risk (RR) and for continuous outcomes we calculated the standardized mean difference (SMD). The confidence interval (95% CI) was measured to estimate the effect of outcomes. Results: Four randomized controlled trials were included (2363 participants). There were no statistically significant differences between the statin and placebo for the following outcomes: mean pressure gradient (DMP - fixed effect, 95% CI: -0.04 [-0.13, 0:05], P = 0:42, two studies, 1935 participants and moderate quality of evidence); valve area (DMP fixed effect, 95% CI: -0.16 [-0.51, 0:19], P = 0:37, two studies and 127 participants); valve replacement (relative risk - fixed effect 95% CI: 0.93 [0.81, 1.06] I, P = 0.25, four trials, 2360 participants and moderate quality of evidence) and death from cardiovascular causes (relative risk - fixed effect 95% CI: 0.80 [0:56, 1:14], P = 0:22, three studies, 2297 participants and low quality of evidence). No meta-analysis was performed for hospitalization for any cause and the aortic jet velocity, due to the lack of included studies (n = 155 participants). None of the four studies evaluated the quality of life and overall mortality. Cancer incidence was higher in the statin group (relative risk - fixed effect 95% CI: 1.44 [1:09, 1.92], P = 0.01, two studies, 2141 participants), as well as elevated liver enzymes (relative risk - effect fixed 95% CI: 2.66 [1.24 5.67], P = 0.01, two studies, 2109 participants). There were no statistically significant differences between the statin and placebo for muscle pain (relative risk - fixed effect 95% CI: 91 [0.75, 1:09], P = 0.31, three studies, 2204 participants and low quality of evidence); hepatitis (relative risk - fixed effect 95% CI: 1:14 [0:40, 3:25], P = 0.80, 2 studies and included 2141 participants); gastrointestinal symptoms (relative risk - fixed effect 95% CI: 1.10 [0.96, 1.25], P = 0:18, 3 studies and 2296 participants) and creatine kinase (relative risk - fixed effect 95% CI: 0.75 [0:17, 3:33], P = 0:40, 3 studies and 2109 participants). Conclusion: Although this systematic review demonstrated no benefit of statins for aortic valve stenosis, this conclusion should be viewed with caution, because the quality of evidence was low to moderate. Further studies need to be published to confirm this result.
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    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.
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    Eyelid Entropion
    (Informa Healthcare, 2010-05-01) Bomfim Pereira, Mario Genilhu [UNIFESP]; Rodrigues, Murilo Alves [UNIFESP]; Carvalho Rodrigues, Silvia Andrade [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Entropion is a common eyelid malposition in which the margin turns inward against the globe. If untreated, this condition can cause irritative symptoms like ocular discomfort, corneal abrasion, microbial keratitis, corneal vascularization, and visual loss. It may be classified as cicatricial, congenital, acute spastic and involutional. Involutional entropion is the most common type seen in general ophthalmic practice and its prevalence is increasing as the population ages. There are several treatment strategies including nonsurgical and surgical procedures. This paper describes the surgical techniques most commonly used to treat entropion: everting sutures (Quickert), transverse blepharotomy and marginal rotation (Weis procedure), orbicularis transfer technique, tarsal strip, and advancement of the lower lid retractors.
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    Fenômeno de Raynaud
    (Sociedade Brasileira de Reumatologia, 2009-02-01) Kayser, Cristiane [UNIFESP]; Corrêa, Marcelo José Uchôa [UNIFESP]; Andrade, Luiz Eduardo Coelho [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Fleury Medicina Diagnóstica
    Raynaud's phenomenon (RP) is an episodic vasospasm of the peripheral arterioles, causing pallor followed by cyanosis and redness of the fingers and toes, usually in response to stress or cold exposure. Primary Raynaud's phenomenon is a benign event and occurs without an underlying disease. In contrast, secondary Raynaud's phenomenon can occur in association with several underlying diseases or conditions, mostly autoimmune rheumatic diseases. In systemic sclerosis (SSc), RP is the most frequent initial manifestation. In RP secondary to SSc-related diseases, digital ischemic lesions are a frequent problem. In recent years, advances in the understanding of the physiopathology of RP have favored the development of novel promising therapeutic alternatives for this clinical condition. This article presents a review of the pathogenesis, clinical investigation and treatment of RP, with special emphasis in novel therapeutic modalities.
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    Fibromyalgia: clinical and occupational aspects
    (Assoc Medica Brasileira, 2012-05-01) Helfenstein Junior, Milton [UNIFESP]; Goldenfum, Marco Aurelio; Siena, César Augusto Fávaro; Universidade Federal de São Paulo (UNIFESP); Univ Tecnol Nacl Buenos Aires; Escola Super Gestao & Ciencias Saude Porto Alegre
    Fibromyalgia: clinical and occupational aspectsFibromyalgia (FM) is a clinical syndrome commonly observed in daily medical practice and its etiopathogenesis is still unclear. As it is characterized by chronic musculoskeletal pain associated with several symptoms, FM may be confused with several other rheumatic and nonrheumatic diseases when they course with pictures of diffuse pain and chronic fatigue. FM treatment should be multidisciplinary, individualized, count on active participation of the patient, and based on combined pharmacological and non-pharmacological modalities. It is found both in work and non-work settings, and there is no scientific evidence in the literature showing that FM might be caused by occupation. FM seldom leads to incapacity to work. In cases where pain or fatigue do not respond to appropriate treatment, reaching significant levels, a short period away from work can be considered. As FM is a relevant subject, this review article was based on exploratory, qualitative, and bibliographic investigation, aiming to study the main clinical and occupational aspects of FM, emphasizing the theoretical-conceptual background and the experience of specialists.
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    GBV-C/HGV and HIV-1 coinfection
    (Brazilian Society of Infectious Diseases, 2005-04-01) Maidana, Maria Teresa [UNIFESP]; Sabino, Ester Cerdeira [UNIFESP]; Kallas, Esper Georges [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Pró-Sangue Foundation
    An interesting interaction pattern has been found between HIV-1 and GBV-C/HGV, resulting in protection against progression to AIDS. The mechanisms involved in this interaction remain to be clarified. We examined the current knowledge concerning this coinfection and developed hypotheses to explain its effects. A better understanding of this interaction could result in new concepts, which may lead to new strategies to control HIV-1 replication and progression to AIDS.
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    In Vivo Models for Measuring Placental Glutatione-S-transferase (GST-P 7-7) Levels: A Suitable Biomarker for Understanding Cancer Pathogenesis
    (Int Inst Anticancer Research, 2012-07-01) Noguti, Juliana [UNIFESP]; Barbisan, Luis Fernando; Cesar, Augusto [UNIFESP]; Pereira, Camilo Dias Seabra [UNIFESP]; Choueri, Rodrigo Brasil [UNIFESP]; Ribeiro, Daniel Araki [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    The Glutatione-S-transferases (GSTs) comprise a family of enzymes closely associated with the cell detoxification of xenobiotics. GSTs exist as homo- or heterodimers and have been grouped into at least seven distinct classes. The main function of GSTs is to catalyze the conjugation of reduced glutathione (GSH) to an electrophilic site of a broad range of potentially toxic and carcinogenic compounds, thereby making such compounds less dangerous and enabling their ready-excretion. Placental GST, known as GST-P 7-7, is the main isoform found in normal placental tissue and comprises 67% of the total GST concentration in this tissue. During development, GST-P 7-7 decreases in concentration and is absent in adult tissues. Interestingly, GST-P 7-7 expression has been detected in adult tissues after exposure to carcinogenic agents in several experimental test systems, being considered a reliable biomarker of exposure and susceptibility in early phases of carcinogenesis. In this article, we review a series of studies involving GST-P 7-7 expression as a suitable tool for understanding cancer pathogenesis, especially cancer risk.
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    Methods to increase muscle tonus of upper airway to treat snoring: systematic review
    (Academia Brasileira de Neurologia - ABNEURO, 2008-01-01) Valbuza, Juliana Spelta [UNIFESP]; Oliveira, Márcio Moysés de [UNIFESP]; Conti, Cristiane Fiquene [UNIFESP]; Prado, Lucila Bizari Fernandes do [UNIFESP]; Carvalho, Luciane Bizari Coin de [UNIFESP]; Prado, Gilmar Fernandes do [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND: Snoring is the noise caused by vibration during the in-breath; and which structure actually vibrates depends on many factors. OBJECTIVE: The treatment of snoring with methods to increase muscle tonus of upper airway has been controversial, and poorly reported, thus a review of evidence is necessary to evaluate the effectiveness of these methods. METHOD: A review of randomized or quasi-randomized, double blind trials on snoring treatment that have employed any method to increase muscle tonus of upper airway like phonotherapy or physical therapy among others. Outcomes: decrease or completely stop of snoring, sleep quality, quality of life, and adverse events. RESULTS: Three eligible trials were potentially analyzed, but none of them could provide good scientific evidence favoring the intervention. The objective analyses of one study showed improvement of snoring, although the objective sub-analyses and subjective analyses showed controversial results. The adverse events were not reported. CONCLUSION: There is no enough evidence to support the recommendation of methods to increase muscle tonus of upper airways in treatment of snoring. Well designed randomized clinical trials are needed to asses the efficacy of such methods, and a standard and worldwide accepted method for snoring assessment would be useful for future researches.