WANDERLEY MARQUES BERNARDO
Projetos de Pesquisa
Unidades Organizacionais
FMUSP, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/47 - Laboratório de Hepatologia por Vírus, Hospital das Clínicas, Faculdade de Medicina
LIM/47 - Laboratório de Hepatologia por Vírus, Hospital das Clínicas, Faculdade de Medicina
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- Guidelines on the diagnosis of primary immune thrombocytopenia in children and adolescents: Associacao Brasileira de Hematologia, Hemoterapia e Terapia Celular Guidelines Project: Associacao Medica Brasileira - 2012(2013) BRAGA, Josefina Aparecida Pellegrini; LOGGETTO, Sandra Regina; HOEPERS, Andrea Thives de Carvalho; BERNARDO, Wanderley Marques; MEDEIROS, Leticia; VERISSIMO, Monica Pinheiro de Almeida
- Part 5: Myelodysplastic syndromes—Treatment of high-risk disease(2018) MAGALHÃES, Silvia Maria Meira; CHAUFFAILLE, Maria de Lourdes Lopes Ferrari; VELLOSO, Elvira Deolinda Rodrigues Pereira; BUZZINI, Renata; BERNARDO, Wanderley Marques
- Use of cannabidiol in the treatment of epilepsy: Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex(2022) SILVINATO, Antonio; FLORIANO, Idevaldo; BERNARDO, Wanderley MarquesOBJECTIVE: The objective of this systematic review with meta-analysis was to evaluate the efficacy, safety, and short-and long-term tolerability of cannabidiol (CBD), as an adjunct treatment, in children and adults with Dravet syndrome (SD), Lennox-Gataut syndrome (LGS), or tuberous sclerosis complex (TSC), with inadequate control of seizures.METHODS: This systematic review was conducted through a search for scientific evidence in the Mediline/PubMed, Central Cochrane, and ClinicalTrials. gov databases until April 2022. Selected randomized clinical trials (RCTs) that presented the outcomes: reduction in the frequency of seizures and total seizures (all types), number of patients with a response greater than or equal to 50%, change in caregiver global impression of change (CGIC) (improvement >= 1 category on the initial scale), adverse events (AEs), and tolerability to treatment. This review followed Preferred Reporting Items for Systematic reviews and Meta-Analyses.RESULTS: Notably, six RCTs were included, with a total of 1,034 patients with SD, LGS, and TSC, of which 3 were open-label extension RCTs. The meta-analysis of the studies showed that the use of CBD as compared with placebo, in patients with convulsive seizures refractory to the use of medications, reduces the frequency of seizures by 33%; increases the number of patients with a reduction >= 50% in the frequency of seizures by 20%; increases the number of patients with absence of seizures by 3%; improves the clinical impression evaluated by the caregiver or patient (S/CGIC) in 21%; increases total AEs by 12%; increases serious AE by 16%; increases the risk of treatment abandonment by 12%; and increases the number of patients with transaminase elevation (>= 3 times the referral) by 15%.CONCLUSIONS: This systematic review, with meta-analysis, supports the use of CBD in the treatment of patients with seizures, originated in DS, LGS, and TSC, who are resistant to the common medications, presenting satisfactory benefits in reducing seizures and tolerable toxicity.
- EFFICACY OF ENDOSCOPIC TOPICAL MITOMYCIN C APPLICATION IN CAUSTIC ESOPHAGEAL STRICTURES IN THE PEDIATRIC POPULATION: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS(2021) FLOR, Marcelo Mochate; RIBEIRO, Igor Braga; DE MOURA, Diogo Turiani Hourneaux; MARQUES, Sérgio Barbosa; BERNARDO, Wanderley Marques; DE MOURA, Eduardo Guimarães HourneauxABSTRACT BACKGROUND: Caustic ingestion and development of esophageal strictures are recognized major public health problems in childhood. Different therapeutic methods have been proposed in the management of such strictures. OBJECTIVE: To evaluate efficacy and risk of endoscopic topical application of mitomycin C in the treatment of caustic esophageal strictures. METHODS: We searched MEDLINE, EMBASE, Central Cochrane, and LILACS databases. The outcomes evaluated were dysphagia resolution rate, number of dilations performed in resolved cases, and the number of dilations performed in all patients. RESULTS: Three randomized clinical trials were included for final analysis with a total of 190 patients. Topical mitomycin C application group showed a significant increase in dysphagia resolution rate, corresponding to a 42% higher dysphagia resolution as compared to endoscopic dilation alone, with statistical significance between the two groups (RD: 0.42 - [CI: 0.29-0.56]; P-value <0.00001). The mean number of dilations performed in resolved cases were significantly less in the topical mitomycin C application group, compared to endoscopic dilations alone, with statistical significance between the two groups (MD: 2.84 [CI: 1.98-3.69]; P-value <0.00001). When comparing the number of dilations in all patients, there was no statistical difference between the two groups (MD: 1.46 [CI: -1.53-4.44]; P-value =0.34). CONCLUSION: Application of topical mitomycin C with endoscopic dilations in caustic esophageal strictures was more effective in dysphagia resolution than endoscopic therapy alone in the pediatric population. Moreover, topical mitomycin C application also reduced the number of dilation sessions needed to alleviate dysphagia without rising morbidity.
- Hepatitis C Among People Who Inject Drugs (PWID) in Latin America and the Caribbean: A Meta-Analysis of Prevalence Over Three Decades(2023) MAGRI, Mariana Cavalheiro; MANCHIERO, Caroline; DANTAS, Bianca Peixoto; NUNES, Arielle Karen Da Silva; PRATA, Thamiris Vaz Gago; DOMINGOS, Dayse Evelly Alexandre; NASCIMENTO, Gabrielly Dos Santos; ALVAREZ, Maria Stella Montanha; BERNARDO, Wanderley Marques; TENGAN, Fatima MitikoObjective: People who inject drugs (PWID) are known to be more susceptible to infections such as hepatitis C virus (HCV). This systematic review and meta-analysis aimed to estimate the prevalence of hepatitis C among PWID in Latin America and the Caribbean (LAC). Method: The MEDLINE, Embase, and LILACS databases were searched without language restriction from inception to 2021. Articles were screened based on titles and abstracts. After reading the full texts, the articles were selected based on eligibility criteria. Results: Of the 486 identified publications, 123 full texts were assessed, and 23 studies with a mean quality score of 7.2 were included. A total of 11,419 PWID were included in the meta-analysis, and the estimated overall prevalence of hepatitis C among PWID in LAC was 57.0%, which was higher than the United Nations Office on Drugs and Crime global prevalence of 50.2%. In meta-analyses of subgroups divided according to the risk of exposure to HCV infection (in addition to the imminent risk of injected drugs), the estimated prevalence of hepatitis C in PWID in the lower-risk population (general) was 57.0%. The prevalence of hepatitis C in PWID who were infected with HIV was 61.0%. The estimated hepatitis C prevalence was also assessed for three periods: in 1991-2000, it was 59.0%; in 2001-2010, it was 63.0%; and in 2011-2020, it was 48.0%. Conclusions: The high estimated prevalence of hepatitis C in LAC reinforces the need for increased diagnostic efforts, strategies for treating drug addiction and hepatitis C, and harm reduction policies that target PWID.
- The correlation of research diagnostic criteria for temporomandibular disorders and magnetic resonance imaging: a study of diagnostic accuracy(2013) GALHARDO, Alessandra Pucci Mantelli; LEITE, Claudia da Costa; GEBRIM, Eloisa Maria Mello Santiago; GOMES, Regina Lucia Elia; MUKAI, Marcio Katsuyoshi; YAMAGUCHI, Claudio Akira; BERNARDO, Wanderley Marques; SOARES JR., Jose Maria; BARACAT, Edmund Chada; GIL, CarlosObjective. The aim of this study was to evaluate the performance of research diagnostic criteria for temporomandibular disorders (RDC/TMD) as a diagnostic test for temporomandibular joint problems using magnetic resonance imaging (MRI) as the gold standard. Study Design. Sixty-seven women were assessed with RDC/TMD (2 examiners) and underwent MRI examination (3.0 T). Images were evaluated by 2 independent radiologists blinded to the clinical diagnoses. Results were analyzed by the Catmaker system. Results. Of the 67 patients, 44 were diagnosed with temporomandibular disorders (TMD) according to RDC/TMD, but 21 (32%) of the diagnoses were not confirmed by MRI. The RDC/TMD sensitivity was 83.0%, specificity was 53.0%, and the positive likelihood ratio was 1.77, whereas the negative likelihood ratio was 0.32 (P = 0.16). Conclusions. Our data suggest that RDC/TMD is a good research tool, but the high rate of false-positive results limits its use in clinical practice. (Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115:277-284)
- EUS-FNA versus ERCP for tissue diagnosis of suspect malignant biliary strictures: a prospective comparative study(2018) MOURA, Diogo Turiani Hourneaux; GUIDAMARAES, Eduardo; MOURA, Hourneaux de; MATUGUMA, Sergio Eiji; SANTOS, Marcos Eduardo dos; MOURA, Eduardo Turiani Hourneaux; BARACAT, Felipe Iankelevich; ARTIFON, Everson L. A.; CHENG, Spencer; BERNARDO, Wanderley Marque; CHACON, Danielle; TANIGAWA, Ryan; JUKEMURA, JoseBackground and study aims Biliary strictures are frequently a challenging clinical scenario and the anatomopathological diagnosis is essential in the therapeutic management, whether for curative or palliative purposes. The acquisition of specimens is necessary since many benign diseases mimic biliopancreatic neoplasms. Endscopic retrograde cholangiopancreatography (ERCP) is the traditionally used method despite the low sensitivity of biliary brush cytology and forceps biopsy. On the other hand, several studies reported good accuracy rates using endoscopic ultrasound- guided fine-needle aspiration (EUS-FNA). The aim of this prospective study was to compare, the accuracy of EUS-FNA and ERCP for tissue sampling of biliary strictures. Patients and methods After performing the sample size calculation, 50 consecutive patients with indeterminate biliary strictures were included to undergo ERCP and EUS on the same sedation. The gold-standard was surgery or 6 months' follow-up. Evaluation of the diagnostic indices (sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio), concordance and adverse events among the methods were performed. Also, subtype analyses of the techniques, anatomical localization and size of the lesion were included. Results The final diagnoses reported in 50 patients were 47 malignant, 1 suspicious and 2 benign lesions. 31 lesions were extraductal and 19 intraductal, 35 were distal and 15 proximal strictures. In the intention-to-treat analysis, the sensitivity and accuracy of EUS-FNA were superior than ERCP tissue sampling (93,8%, 94% vs. 60,4%, 62%, respectively) (P = 0.034), with similar adverse events. There was no concordance between the methods and combining both methods improved the sensitivity and accuracy for 97.9% and 98%, respectively. In the subtype analyses, the EUS-FNA was superior, with a higher accuracy than ERCP tissue sampling in evaluating extraductal lesions (100% vs. 54.8 %, P = 0.019) and in those larger than 1.5 cm (95.8% vs. 61.9%, P = 0.031), but were similar in evaluating intraductal lesions and lesions smaller than 1.5 cm. There was no significant difference between the methods in the analyzes of proximal, distal and pancreatic lesions. Conclusion EUS-FNA is better than ERCP with brush cytology and intraductal forceps biopsy in diagnosing malignant biliary strictures, mainly in the assessment of extraductal lesions and in those larger than 1.5 cm. Combining ERCP with tissue sampling and EUS-FNA is feasible, the techniques have similar complication rates, and the combination greatly improves diagnostic accuracy.
- The Brazilian Society of Rheumatology guidelines for axial spondyloarthritis-2019(2020) RESENDE, Gustavo Gomes; MEIRELLES, Eduardo de Souza; MARQUES, Claudia Diniz Lopes; CHIEREGHIN, Adriano; LYRIO, Andre Marun; XIMENES, Antonio Carlos; SAAD, Carla Goncalves; GONCALVES, Celio Roberto; KOHEM, Charles Lubianca; SCHAINBERG, Claudia Goldenstein; CAMPANHOLO, Cristiano Barbosa; BUENO FILHO, Julio Silvio de Sousa; PIERUCCETTI, Lenise Brandao; KEISERMAN, Mauro Waldemar; YAZBEK, Michel Alexandre; PALOMINOS, Penelope Esther; GONCALVES, Rafaela Silva Guimaraes; LAGE, Ricardo da Cruz; ASSAD, Rodrigo Luppino; BONFIGLIOLI, Rubens; ANTI, Sonia Maria Alvarenga; CARNEIRO, Sueli; OLIVEIRA, Thauana Luiza; AZEVEDO, Valderilio Feijo; BIANCHI, Washington Alves; BERNARDO, Wanderley Marques; PINHEIRO, Marcelo de Medeiros; SAMPAIO-BARROS, Percival DegravaSpondyloarthritis is a group of chronic inflammatory systemic diseases characterized by axial and/or peripheral joints inflammation, as well as extra-articular manifestations. The classification axial spondyloarthritis is adopted when the spine and/or the sacroiliac joints are predominantly involved. This version of recommendations replaces the previous guidelines published in May 2013. A systematic literature review was performed, and two hundred thirty-seven studies were selected and used to formulate 29 recommendations answering 15 clinical questions, which were divided into four sections: diagnosis, non-pharmacological therapy, conventional drug therapy and biological therapy. For each recommendation the level of evidence supporting (highest available), the strength grade according to Oxford, and the degree of expert agreement (inter-rater reliability) is informed. These guidelines bring evidence-based information on clinical management of axial SpA patients, including, diagnosis, treatment, and prognosis.
- Desmoid tumors of the chest wall: surgical challenges and possible risk factors(2011) ABRAO, Fernando Conrado; WAISBERG, Daniel Reis; FERNANDEZ, Angelo; BERNARDO, Wanderley Marques; PEGO-FERNANDES, Paulo Manuel; JATENE, Fabio Biscegli
- Chronic myeloid leukemia treatment guidelines: Brazilian Association of Hematology, Hemotherapy and Cell Therapy. Brazilian Medical Association Guidelines Project - 2012(2012) SOUZA, Carmino Antonio de; PAGNANO, Katia Borgia Barbosa; BENDIT, Israel; CONCHON, Monika; FREITAS, Carla Maria Boquimpani de Moura; COELHO, Arthur Moellmann; FUNKE, Vaneuza Araújo Moreira; BERNARDO, Wanderley Marques