Artigos e Materiais de Revistas Científicas - LIM/58

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  • article 1 Citação(ões) na Scopus
    Factors influencing the work of researchers in Scientific Initiation: A systematic review protocol
    (2024) COSTA, Woska Pires da; FERNANDES, Michele da Silva Valadao; MEMON, Aamir Raoof; NOLL, Priscilla Rayanne E. Silva; SOUSA, Marcos de Moraes; NOLL, Matias
    Introduction Scientific Initiation (SI) is an educational activity that allows students to begin their scientific training and research under the guidance of an experienced researcher. While several studies have examined students' perceptions of SI, research on the perspective of researchers working in this field is currently lacking. Thus, this study's aim is to describe the protocol design for conducting a systematic review. At the same time, the review aims also to identify factors influencing the work of researchers in SI and explore the motivations leading researchers to engage in research projects within institutions and their respective impacts.Method and analyses Literature search will be done using the bibliographic databases, including Academic Search Premier, APA PsycNet, CINAHL Plus, ERIC, SocINDEX, Scopus, and Web of Science. The search strategy was guided by the PICo framework (Population, phenomenon of Interest, and Context). The preparation and development of this protocol following guidelines were employed: Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015), Peer Review of Electronic Search Strategies 2015 (PRESS 2015), and PRISMA-Search (PRISMA-S). Original, peer-reviewed articles that examine the factors related to the work of researchers in SI will be included without any language or publication date restrictions. Qualitative, quantitative, and mixed-methods studies will be screened by two independent researchers. The included studies will be analyzed to identify factors, policies, and their impacts obtained analytically. Findings will be objectively categorized and synthetically represented through figures, diagrams, and graphic models. The risk of bias will be assessed using the Critical Appraisal Skills Program (CASP) and the Downs and Black checklists. A third senior reviewer will resolve any discrepancies.Discussion We aim to understand the factors that drive researchers to engage in SI research through the dissemination of the findings of this systematic review. This may aid the development of institutional strategies and actions that can support the enhancement of SI programs and encourage greater researcher participation.
  • article 0 Citação(ões) na Scopus
    Immune checkpoint inhibitors: here to stay
    (2023) CARVALHO, Filomena Marino; DIZ, Maria Del Pilar Estevez; CARVALHO, Jesus Paula
  • article 1 Citação(ões) na Scopus
    A closer look at heterotopic sites of pleomorphic adenoma, particularly in women: fide, sed cui vide?
    (2024) SENGUL, Ilker; SENGUL, Demet; JUNIOR, Jose Maria Soares
  • article 0 Citação(ões) na Scopus
    Autologous heterotopic fresh ovarian graft: technique description
    (2023) BERTOLAZZI, Marilia Albanezi; FERNANDES, Rodrigo Pinto; GENTA, Maria Luiza Nogueira Dias; BARACAT, Edmund Chada; CARVALHO, Jesus Paula
  • article 0 Citação(ões) na Scopus
    Visual Analogue Scale Cut-off Point of Seven Represents Poor Quality of Life in Patients with Endometriosis
    (2024) ANDRES, Marina Paula; RICCIO, Luiza Gama Coelho; ABRAO, Henrique Mendonca; MANZINI, Mariana Simionato; BRAGA, Lais; ABRAO, Mauricio Simoes
    Establishing objective criteria to assess endometriosis symptoms is crucial in defining therapeutic strategies. The visual analogue scale (VAS) is the most used system to enhance the accuracy and reduce the subjectivity of pain assessment, and symptoms of endometriosis are considered severe when the VAS score is >= 7 cm. Pain symptoms can significantly impact patients' quality of life, resulting in psychological and social distress. The aim of this study is to evaluate whether a VAS cut-off point of 7 cm for each pain symptom correlates with a diminished quality of life in women with endometriosis. This retrospective study included 1129 patients who underwent surgical treatment for endometriosis. Dysmenorrhea, acyclic pelvic pain, deep dyspareunia, dyschezia, and dysuria were assessed using a 0-10 cm VAS. The Short Form-36 (SF-36) questionnaire was employed to evaluate the quality of life 6 months prior to surgery. Dysmenorrhea was the most prevalent symptom reported in 93.6% of cases, with a mean VAS of 7.6 cm. The quality of life reported was reduced in most patients, with domain scores ranging from 49.4 to 80.1. The mean SF-36 scores in all domains were significantly lower in patients with severe pain (VAS score >= 7 cm) compared to those with mild to moderate pain (VAS < 7 cm). This trend was observed across all evaluated pain symptoms. Our research demonstrates that the prevalent VAS cut-off point for establishing severe pain symptoms in endometriosis (VAS >= 7 cm) accurately represents the negative impact of the disease on women's quality of life, as assessed via the SF-36 questionnaire.
  • article 0 Citação(ões) na Scopus
    Granulosa cells and follicular development: a brief review (vol 69, e20230175, 2023)
    (2023) CAVALCANTI, Giovanna Santos; CARVALHO, Katia Candido; FERREIRA, Cecilia da Silva; CHEDRAUI, Peter; MONTELEONE, Pedro Augusto Araujo; BARACAT, Edmund Chada; SOARES JUNIOR, Jose Maria
  • article 1 Citação(ões) na Scopus
    A randomized trial comparing vaginal laser therapy and pelvic floor physical therapy for treating women with stress urinary incontinence
    (2023) FONSECA, Lucilia C. da; GIARRETA, Fernanda Bacchi Ambrosano; PETERSON, Thais V.; LOCALI, Priscila Katsumi Matsuoka; BARACAT, Edmund C.; FERREIRA, Elizabeth A. Goncalves; HADDAD, Jorge Milhem
    IntroductionFemale stress urinary incontinence (SUI) is considered a major public health issue. Physical therapy is an important conservative treatment; however, it is primarily limited by poor long-term compliance. Furthermore, surgical treatment entails significant risks. Therefore, new treatment techniques must be identified. ObjectiveTo compare the use of laser therapy and pelvic floor (PF) physical therapy for treating postmenopausal women with SUI. MethodsThis pilot study enrolled 40 women with a clinical and urodynamic diagnosis of SUI who were randomized into two groups: those who received erbium-doped yttrium-aluminum-garnet (Er:YAG) laser therapy implemented over three sessions with a 1-month interval (n = 20) and those who received physical therapy with supervision twice a week for 3 months (n = 20). In total, 16 women completed the treatment in each group. The patients were assessed for PF function using the modified Oxford scale and for pelvic organ prolapse using the Pelvic Organ Prolapse Quantification System. The 1-h pad test and quality of life questionnaires, King's Health Questionnaire (KHQ), and Incontinence Quality of Life (IQOL) were also administered. Patients were re-evaluated at 1, 3, 6, and 12 months after treatment. ResultsThe mean patient age was 62.7 & PLUSMN; 9.1 and 57.9 & PLUSMN; 6.1 years, median Oxford score at baseline was 3 (2-4.5) and 4 (3-4), mean IQOL score was 79.8 & PLUSMN; 17 and 74.6 & PLUSMN; 18 for physical therapy group (PTG) and laser group (LG), respectively. For the amount of urine leak in the 1-h pad test evaluation, we found significance for the interaction of group and time points only for the Laser intragroup. The cure rate, that is, the rate of reaching an insignificant score in the pad test, at 6 and 12 months was 43.75% and 50% in PTG and 62.5% and 56.25% in the LG, respectively (p > 0.05). IQOL scores demonstrated considerable improvement in both groups (p > 0.05). Upon comparing the initial and follow-up results, the LG showed an improvement at all consultations, whereas the PTG showed improvements at 1, 3, and 6 months but not at 12 months after treatment. KHQ analysis revealed a considerable improvement in the quality of life (QOL) of patients over time, with no substantial difference between the groups. QOL comparison before and after treatment revealed that the vaginal LG improved more consistently in some domains. Only the PTG showed a significant increase in the mean Oxford score from pretreatment to 1 and 3 months after treatment (p < 0.001 and p = 0.002, respectively). However, no statistically significant difference was observed between the groups. ConclusionBoth treatments are safe and have a positive influence on the impact of UI on patients' QOL. The laser caused a greater reduction in the urinary loss, as measured using the weight of pad test, at 6-month and 12-month after treatment without difference with PTG at the end of the follow-up.
  • article 0 Citação(ões) na Scopus
    Soluble MICA in endometriosis pathophysiology: Impairs NK cell degranulation and effector functions
    (2024) MARIN, Maria Lucia Carnevale; RACHED, Marici Rached; MONTEIRO, Sandra Maria; KALIL, Jorge; ABRAO, Mauricio Simoes; COELHO, Veronica
    Problem: Endometriosis exhibits several immune dysfunctions, including deficient natural killer (NK) cell cytotoxicity. MICA (MHC class I chain-related molecule A) is induced by biological stress and soluble MICA (sMICA) negatively modulates the expression of the activating receptor, NKG2D, reducing NK cells activities. We investigated the involvement of soluble MICA in NK cell-deficient activity in endometriosis. Methods of study: sMICA levels (serum and peritoneal fluid-PF) were evaluated by ELISA. Circulating NK cell subsets quantification and its NKG2D receptor expression, NK cell cytotoxicity and CD107a, IFN-gamma and IL-10 expressions by NK cells stimulated with K562 cells were determined by flow cytometry. Results: We found higher sMICA levels (serum and PF) in endometriosis, especially in advanced and deep endometriosis. Endometriosis presented lower percentages of CD56(dim)CD16+ cytotoxic cells and impaired NK cell responses upon stimulation, resulting in lower CD107a and IFN-gamma expressions, and deficient NK cell cytotoxicity. NK cell stimulation in the MICA-blocked condition (mimicking the effect of sMICA) showed decreased cytotoxicity in initial endometriosis stages and the emergence of a negative correlation between CD107a expression and sMICA levels. Conclusions: We suggest that soluble MICA is a potential player in endometriosis pathophysiology with involvement in disease progression and severity, contributing to NK cell impaired IFN-gamma response and degranulation. NK cell compartment exhibits multiple perturbations, including quantitative deficiency and impaired cytotoxicity, contributing to inadequate elimination of ectopic endometrial tissue.
  • article 0 Citação(ões) na Scopus
    Skin-sparing mastectomy for the treatment of breast cancer
    (2023) MOTA, B. S.; BEVILACQUA, J. L. B.; BARRETT, J.; RICCI, M. D.; MUNHOZ, A. M.; FILASSI, J. R.; BARACAT, E. C.; RIERA, R.
    Background: Skin-sparing mastectomy (SSM) is a surgical technique that aims to maximize skin preservation, facilitate breast reconstruction, and improve cosmetic outcomes. Despite its use in clinical practice, the benefits and harms related to SSM are not well established. Objectives: To assess the effectiveness and safety of skin-sparing mastectomy for the treatment of breast cancer. Search methods: We searched Cochrane Breast Cancer's Specialized Register, CENTRAL, MEDLINE, Embase, LILACS, the World Health Organization's International Clinical Trials Registry Platform (WHO ICTRP), and ClinicalTrials.gov on 9 August 2019. Selection criteria: Randomized controlled trials (RCTs), quasi-randomized or non-randomized studies (cohort and case-control) comparing SSM to conventional mastectomy for treating ductal carcinoma in situ (DCIS) or invasive breast cancer. Data collection and analysis: We used standard methodological procedures expected by Cochrane. The primary outcome was overall survival. Secondary outcomes were local recurrence free-survival, adverse events (including overall complications, breast reconstruction loss, skin necrosis, infection and hemorrhage), cosmetic results, and quality of life. We performed a descriptive analysis and meta-analysis of the data. Main results: We found no RCTs or quasi-RCTs. We included two prospective cohort studies and twelve retrospective cohort studies. These studies included 12,211 participants involving 12,283 surgeries (3183 SSM and 9100 conventional mastectomies). It was not possible to perform a meta-analysis for overall survival and local recurrence free-survival due to clinical heterogeneity across studies and a lack of data to calculate hazard ratios (HR). Based on one study, the evidence suggests that SSM may not reduce overall survival for participants with DCIS tumors (HR 0.41, 95% CI 0.17 to 1.02; P = 0.06; 399 participants; very low-certainty evidence) or for participants with invasive carcinoma (HR 0.81, 95% CI 0.48 to 1.38; P = 0.44; 907 participants; very low-certainty evidence). For local recurrence-free survival, meta-analysis was not possible, due to high risk of bias in nine of the ten studies that measured this outcome. Informal visual examination of effect sizes from nine studies suggested the size of the HR may be similar between groups. Based on one study that adjusted for confounders, SSM may not reduce local recurrence-free survival (HR 0.82, 95% CI 0.47 to 1.42; P = 0.48; 5690 participants; very low-certainty evidence). The effect of SSM on overall complications is unclear (RR 1.55, 95% CI 0.97 to 2.46; P = 0.07, I2 = 88%; 4 studies, 677 participants; very low-certainty evidence). Skin-sparing mastectomy may not reduce the risk of breast reconstruction loss (RR 1.79, 95% CI 0.31 to 10.35; P = 0.52; 3 studies, 475 participants; very low-certainty evidence), skin necrosis (RR 1.15, 95% CI 0.62 to 2.12; P = 0.22, I2 = 33%; 4 studies, 677 participants; very low-certainty evidence), local infection (RR 2.04, 95% CI 0.03 to 142.71; P = 0.74, I2 = 88%; 2 studies, 371 participants; very low-certainty evidence), nor hemorrhage (RR 1.23, 95% CI 0.47 to 3.27; P = 0.67, I2 = 0%; 4 studies, 677 participants; very low-certainty evidence). We downgraded the certainty of the evidence due to the risk of bias, imprecision, and inconsistency among the studies. There were no data available on the following outcomes: systemic surgical complications, local complications, explantation of implant/expander, hematoma, seroma, rehospitalization, skin necrosis with revisional surgery, and capsular contracture of the implant. It was not possible to perform a meta-analysis for cosmetic and quality of life outcomes due to a lack of data. One study performed an evaluation of aesthetic outcome after SSM: 77.7% of participants with immediate breast reconstruction had an overall aesthetic result of excellent or good versus 87% of participants with delayed breast reconstruction. Authors' conclusions: Based on very low-certainty evidence from observational studies, it was not possible to draw definitive conclusions on the effectiveness and safety of SSM for breast cancer treatment. The decision for this technique of breast surgery for treatment of DCIS or invasive breast cancer must be individualized and shared between the physician and the patient while considering the potential risks and benefits of available surgical options.
  • article 0 Citação(ões) na Scopus
    AUGS-IUGA Joint Clinical Consensus Statement on Enhanced Recovery After Urogynecologic Surgery
    (2023) LATTHE, Pallavi; MARQUINI, Gisele Vissoci; ACHTARI, Chahin; HADDAD, Jorge; PANZA, Joseph; JANKOWSKI, Christopher. J.; HEISLER, Christine. A.; REAGAN, Krista; HICKMAN, Lisa. C.
  • article 1 Citação(ões) na Scopus
    Follitropin delta combined with menotropin in patients at risk for poor ovarian response during in vitro fertilization cycles: a prospective controlled clinical study
    (2024) DUARTE-FILHO, Oscar Barbosa; MIYADAHIRA, Eduardo Hideki; MATSUMOTO, Larissa; YAMAKAMI, Lucas Yugo Shiguehara; TOMIOKA, Renato Bussadori; PODGAEC, Sergio
    Background The maximum daily dose of follitropin delta for ovarian stimulation in the first in vitro fertilization cycle is 12 mu g (180 IU), according to the algorithm developed by the manufacturer, and based on patient's ovarian reserve and weight. This study aimed to assess whether 150 IU of menotropin combined with follitropin delta improves the response to stimulation in women with serum antimullerian hormone levels less than 2.1 ng/mL.Methods This study involved a prospective intervention group of 44 women who received 12 mu g of follitropin delta combined with 150 IU of menotropin from the beginning of stimulation and a retrospective control group of 297 women who received 12 mu g of follitropin delta alone during the phase 3 study of this drug. The inclusion and exclusion criteria and other treatment and follow-up protocols in the two groups were similar. The pituitary suppression was achieved by administering a gonadotropin-releasing hormone (GnRH) antagonist. Ovulation triggering with human chorionic gonadotropin or GnRH agonist and the option of transferring fresh embryos or using freeze-all strategy were made according to the risk of developing ovarian hyperstimulation syndrome.Results Women who received follitropin delta combined with menotropin had higher estradiol levels on trigger day (2150 pg/mL vs. 1373 pg/mL, p < 0.001), more blastocysts (3.1 vs. 2.4, p = 0.003) and more top-quality blastocysts (1.8 vs. 1.3, p = 0.017). No difference was observed in pregnancy, implantation, miscarriage, and live birth rates after the first embryo transfer. The incidence of ovarian hyperstimulation syndrome did not differ between the groups. However, preventive measures for the syndrome were more frequent in the group using both drugs than in the control group (13.6% vs. 0.6%, p < 0.001).Conclusions In women with serum antimullerian hormone levels less than 2.1 ng/mL, the administration of 150 IU of menotropin combined with 12 mu g of follitropin delta improved the ovarian response, making it a valid therapeutic option in situations where ovulation triggering with a GnRH agonist and freeze-all embryos strategy can be used routinely.
  • article 0 Citação(ões) na Scopus
    Association of early cleavage, morula compaction and blastocysts ploidy of IVF embryos cultured in a time-lapse system and biopsied for genetic test for aneuploidy
    (2024) MARTIN, H. De; BONETTI, T. C. S.; NISSEL, C. A. Z.; GOMES, A. P.; FUJII, M. G.; MONTELEONE, P. A. A.
    IVF embryos have historically been evaluated by morphological characteristics. The time-lapse system (TLS) has become a promising tool, providing an uninterrupted evaluation of morphological and dynamic parameters of embryo development. Furthermore, TLS sheds light on unknown phenomena such as direct cleavage and incomplete morula compaction. We retrospectively analyzed the morphology (Gardner Score) and morphokinetics (KIDScore) of 835 blastocysts grown in a TLS incubator (Embryoscope+), which were biopsied for preimplantation genetic testing for aneuploidy (PGT-A). Only the embryos that reached the blastocyst stage were included in this study and time-lapse videos were retrospectively reanalysed. According to the pattern of initial cleavages and morula compaction, the embryos were classified as: normal (NC) or abnormal (AC) cleavage, and fully (FCM) or partially compacted (PCM) morulae. No difference was found in early cleavage types or morula compaction patterns between female age groups (< 38, 38-40 and > 40 yo). Most of NC embryos resulted in FCM (congruent to 60%), while no embryos with AC resulted in FCM. Aneuploidy rate of AC-PCM group did not differ from that of NC-FCM group in women < 38 yo, but aneuploidy was significantly higher in AC-PCM compared to NC-FCM of women > 40 yo. However, the quality of embryos was lower in AC-PCM blastocysts in women of all age ranges. Morphological and morphokinetic scores declined with increasing age, in the NC-PCM and AC-PCM groups, compared to the NC-FCM. Similar aneuploidy rates among NC-FCM and AC-PCM groups support the hypothesis that PCM in anomalous-cleaved embryos can represent a potential correction mechanism, even though lower morphological/morphokinetic scores are seen on AC-PCM. Therefore, both morphological and morphokinetic assessment should consider these embryonic development phenomena.
  • article 0 Citação(ões) na Scopus
    Oral probiotics and vaginal microbiome in post-menopause women: an opinion for the improvement of natural therapies in gynecology
    (2024) SILVA, Virginia Franco; REFINETTI, Paulo; VICARIOTTO, Franco; BARACAT, Edmund Chada; SOARES JUNIOR, Jose Maria
  • article 0 Citação(ões) na Scopus
    Association of intrauterine synechiae with pituitary gonadotrophin pulse patterns: A pilot study
    (2023) GIANFALDONI, Arlete; ROA, Cristiane; SIMOES, Ricardo dos Santos; BARACAT, Maria Candida P.; FONSECA, Angela Maggio da; BAGNOLI, Vicente Renato; SOPRESO, Isabel Cristina Esposito; RIVAS, Fernando Wladimir Silva; MONTELEONE, Pedro; BARACAT, Edmund C.; JR, Jose Maria Soares
    BackgroundIntrauterine synechiae (IS) is an acquired uterine condition that occurs when scar tissues (adhesions) form within the uterus and/or cervix, causing menstrual disturbance. However, approximately 50% of patients with IS are refractory to treatment. Therefore, other endocrine disturbances, such as gonadotropin disturbance, may affect treatment success.Study aimTo analyze gonadotropin levels in women with and without IS.MethodsTen women with refractory IS experiencing amenorrhea since at least 6 months and nine with normal menstrual cycles (control group) were included in this study. Blood sample were collected every 10 minutes during a 4-h period. The serial ultrasound was performed in both groups for evaluating the cycle phase. Blood was collected when the follicles size was between 5-10 mm. Serum LH, FSH, progesterone and estradiol concentrations were measured. To detect LH and FSH pulses, the technique proposed by Santen and Bardin was adopted; therefore, one pulse was defined as a 20% increase in the concentrations as to the preceding point, followed by an important decrease.ResultsNo differences were observed between the study groups at baseline. Estradiol levels were lower in the IS group than in the control group, but the difference was not statistically significant. During the first hour of monitoring, cumulative FSH pulsatile frequency of IS group was lower than one of control.ConclusionOur data suggest that the estradiol levels of IS participants are lower than those of women with normal menstrual cycle. The role of this finding in the physiology of uterine synechiae requires further investigation.
  • article 1 Citação(ões) na Scopus
    Effects of estrogen and raloxifene on synaptic density in the hippocampal CA1 region of ovariectomized rats
    (2023) MENEZESDASILVA, Glaucia Mara; VEIGA, Eduardo Carvalho de Arruda; SIMOES, Manuel Jesus; SIMOES, Ricardo Santos; SHIROMA, Marcos Eiji; BARACAT, Maria Candida Pinheiro; CAVALCANTI, Givanna Santos; SOARES JUNIOR, Jose Maria; BARACAT, Edmund Chada
    Introduction: The CA1 region of the hippocampus has an important role in learning and memory. It has been shown that estrogen deficiency may reduce the synaptic density in the region and that hormone replacement ther-apy may attenuate the reduction. Objectives: This study aimed to evaluate the effects of estrogen and raloxifene on the synaptic density profile in the CA1 region of the hippocampus in ovariectomized rats.Methods: Sixty ovariectomized three-month-old virgin rats were randomized into six groups (n = 10). Treatments started either three days (early treatment) or sixty days (late treatment) after ovariectomy. The groups received propylene glycol vehicle (0.5 mL/animal/day), equine conjugated estrogens (50 mu g/animal/day), or raloxifene (3 mg/kg/day) either early or late after ovariectomy. The drugs were administered orally by gavage for 30 days. At the end of the treatments, the animals were anesthetized and transcardially perfused with ether and saline solu-tion. The brains were removed and prepared for analysis under transmission electron microscopy and later fixed. Results: Results showed a significant increase in the synaptic density profile of the hippocampal CA1 region in both the early estrogen (0.534 +/- 0.026 mu/m2) and the early raloxifene (0.437 +/- 0.012 mu/m2) treatment groups compared to the early or late vehicle-treated control groups (0.338 +/- 0.038 mu/m2 and 0.277 +/- 0.015 mu/m2 respectively).Conclusions: The present data suggest that the raloxifene effect may be lower than that of estrogen, even early or late treatment, on synaptic density in the hippocampus.
  • article 0 Citação(ões) na Scopus
    Locally advanced breast cancer: breast-conserving surgery and other factors linked to overall survival after neoadjuvant treatment
    (2023) NOBREGA, Gabriela Bezerra; MOTA, Bruna Salani; FREITAS, Gabriela Boufelli de; MAESAKA, Jonathan Yugo; MOTA, Rosa Maria Salani; GONCALVES, Rodrigo; TRINCONI, Angela Francisca; RICCI, Marcos Desiderio; PIATO, Jose Roberto; SOARES-JR, Jose Maria; BARACAT, Edmund Chada; FILASSI, Jose Roberto
    Background Recent data suggest that breast-conserving surgery (BCS) may positively impact overall survival (OS) in early breast cancer. However, the role of BCS in locally advanced breast cancer (LABC) following neoadjuvant therapy (NAT) remains uncertain.Methods We conducted a retrospective cohort study involving 530 LABC patients who underwent surgery after NAT between 2010 and 2015. Outcomes examined included OS, distant recurrence rates (DRR), and loco-regional recurrence rates (LRRs).Results Among the 927 breast cancer patients who received NAT, 530 were eligible for our study. Of these, 24.6% underwent BCS, while 75.4% underwent mastectomy (MS). The median follow-up duration was 79 months. BCS patients exhibited a higher pathological complete response (PCR) rate compared to those who underwent MS (22.3% vs. 10%, p < 0.001). The 6-year OS rates for BCS and MS were 81.5% and 62%, respectively (p < 0.000). In multivariate OS analysis, MS was associated with worse outcomes (OR 1.678; 95% CI 1.069-2.635; p = 0.024), as was body mass index (BMI) (OR 1.031; 95% CI 1.006-1.058; p = 0.017), and stage IIIB or IIIC (OR 2.450; 95% CI 1.561-3.846; p < 0.000). Conversely, PCR (OR 0.42; 95% CI 0.220-0.801; p = 0.008) was associated with improved survival. DRR was significantly lower in BCS (15.4%) compared to MS (36.8%) (OR 0.298; 95% CI 0.177-0.504). LRRs were comparable between BCS (9.2%) and MS (9.5%) (OR 0.693; 95% CI 0.347-1.383).Conclusion Our findings suggest that BCS is oncologically safe, even for patients with large lesions, and is associated with superior OS rates compared to MS. Additionally, lower BMI, lower pretreatment stage, and achieving PCR were associated with improved survival outcomes.
  • article 2 Citação(ões) na Scopus
    Does bisphenol A (BPA) participates in the pathogenesis of Polycystic Ovary Syndrome (PCOS)?
    (2023) URBANETZ, Lorena Ana Mercedes Lara; JR, Jose Maria Soares; MACIEL, Gustavo Arantes Rosa; SIMOES, Ricardo dos Santos; BARACAT, Maria Candida Pinheiro; BARACAT, Edmund Chada
    PCOS is an endocrine disorder characterized by chronic anovulation, hyperandrogenism, and polycystic ovaries. Its etiology is uncertain. It is debated whether BPA would be a component of the environmental factor in the etiology of PCOS. Contamination by BPA can occur from food packaging (exposure during the diet) and through skin absorption and/or inhalation. It can be transferred to the fetus via the placenta or to the infant via breast milk, and it can be found in follicular fluid, fetal serum, and amniotic fluid. The phenolic structure of BPA allows it to interact with Estrogen Receptors (ERs) through genomic signaling, in which BPA binds to nuclear ER alpha or Er beta, or through nongenomic signaling by binding to membrane ERs, prompting a rapid and intense response. With daily and constant exposure, BPA's tendency to bioaccumulate and its ability to activate nongenomic signaling pathways can alter women's metabolic and reproductive function, leading to hyperandrogenism, insulin resistance, obesity, atherogenic dyslipidemia, chronic inflammatory state, and anovulation and favoring PCOS. The harmful changes caused by BPA can be passed on to future generations without the need for additional exposure because of epigenetic modifications. Not only high BPA levels can produce harmful effects, but at low levels, BPA may be harmful when exposure occurs during the most vulnerable periods, such as the fetal and neonatal periods, as well as during the prepubertal age causing an early accumulation of BPA in the body. Learning how BPA participates in the pathogenesis of PCOS poses a challenge and further studies should be conducted.
  • article 2 Citação(ões) na Scopus
    Influence of Phenotypes on the Metabolic Syndrome of Women with Polycystic Ovary Syndrome over a Six-Year Follow-Up in Brazil
    (2023) JR, Jose Maria Soares; HAYASHIDA, Sylvia Asaka Yamashita; MARCONDES, Jose Antonio Miguel; MACIEL, Gustavo Arantes Rosa; BARCELLOS, Cristiano Roberto Grimaldi; MAFFAZIOLI, Giovana De Nardo; MONTEIRO, Karla Krislaine Alves Costa; TURRI, Jose Antonio Orellana; AZZIZ, Ricardo; BARACAT, Edmund Chada
    Background: We followed polycystic ovary syndrome (PCOS) women with metabolic syndrome (MS) over a six-year treatment period and evaluated the influence of PCOS phenotypes on MS and on the risk for type 2 diabetes mellitus (T2DM). Methods: This was an observational study of 457 PCOS women, whose demographic, clinical, hormonal, and metabolic data underwent analysis. The PCOS women were divided into four groups per NIH recommendations. Results: After a follow-up of a mean of six years (1-20 years), 310 patients were selected to assess the development of T2DM and MS. The clinical and biochemical parameters, along with the Rotterdam phenotypes, were evaluated. Data were analyzed using Student's t- and the Pearson chi-square tests for data variation and group proportions, respectively. Additionally, multivariate analysis was applied to evaluate the effect of PCOS phenotypes on the risk for MS and T2DM. Patients of the four PCOS phenotypes did not differ in age, body mass index, total testosterone, insulin resistance, and dyslipidemia, but phenotype A patients showed the highest risk for T2DM. A decrease in androgen levels was not followed by an improved metabolic profile; instead, there was a significant increase in the number of T2DM cases. Conclusion: Phenotype A women are at the highest risk for type 2 diabetes mellitus.
  • article 1 Citação(ões) na Scopus
    Assessing the safety and use of medicinal herbs during pregnancy: a cross-sectional study in São Paulo, Brazil
    (2023) IM, Hyea Bin; GHELMAN, Ricardo; PORTELLA, Caio Fabio Schlechta; HWANG, Jung Hye; CHOI, Dain; KUNWOR, Sangita Karki; MORAES, Sandra Dircinha Teixeira de Araujo; HAN, Dongwoon
    Background: Despite the lack of evidence supporting the safety and clinical efficacy of herbal medicine (HM), its use among pregnant women continues to increase. Given the high prevalence of contraindicated herbs among the pregnant population in Brazil, it is crucial to examine the use of HM and evaluate its safety based on the current scientific literature to ensure that women are using HM appropriately.Methods: A cross-sectional study was conducted from October 2022 to January 2023 at a public teaching hospital in Sao Paulo, Brazil. A total of 333 postpartum women in the postnatal wards and postnatal clinic were interviewed using a semi-structured questionnaire. The survey instrument consisted of 51 items covering the use of HM during pregnancy, sociodemographic and health-related characteristics, COVID-19 experiences, and pregnancy outcomes. For data analysis, chi-square and multivariate logistic regression were conducted using SPSS ver. 26.0.Results: Approximately 20% of respondents reported using HM during their most recent pregnancy, with a higher use observed among women from ethnic minority groups and those with prior HM experience. Among the 20 medicinal herbs identified, 40% were found to be contraindicated or recommended for use with caution during pregnancy. However, only half of the women discussed their HM use with obstetric care providers.Conclusion: This study emphasizes the continued public health concern regarding the use of contraindicated or potentially harmful HM among pregnant women in Brazil, highlighting the need for sustained efforts to reduce the risk of inappropriate HM use. By updating antenatal care guidelines based on the latest scientific evidence, healthcare providers can make informed clinical decisions and effectively monitor pregnant women's HM use, ultimately promoting safer and more effective healthcare practices.
  • article 3 Citação(ões) na Scopus
    Exercise training and experimental myocardial ischemia and reperfusion: A systematic review and meta-analysis
    (2023) VEIGA, Eduardo Carvalho de Arruda; LEVY, Rozeli Ferreira; BOCALINI, Danilo Sales; JR, Jose Maria Soares; BARACAT, Edmund Chada; CAVALLI, Ricardo Carvalho; SANTOS, Leonardo dos
    Background: Despite the success of interventional coronary reperfusion strategies, morbidity and mortality from acute myocardial infarction are still substantial. Physical exercise is a well-recognized effective nonpharmacological therapy for cardiovascular diseases. Therefore, the objective of this systematic review was to analyze studies in animal models of ischemia-reperfusion in association with physical exercise protocols.Search strategy: Articles published on the topic over a 13-year period (2010-2022) were searched in two databases (PubMed and Google Scholar) using the keywords exercise training, ischemia/reperfusion or ischemia reperfusion injury. Meta-analysis and quality assessment of the studies were performed using the Review Manager 5.3 program.Results: From the 238 articles retrieved from PubMed and 200 from Google Scholar, after screening and eligibility assessment, 26 articles were included in the systematic review and meta-analysis. For meta-analysis comparing the group of previously exercised animals with the non-exercised animals and then submitted to ischemia-reperfusion, the infarct size was significantly decreased by exercise (p < 0.00001). In addition, the group exercised had increased heart-to-body weight ratio (p < 0.00001) and improved ejection fraction as measured by echocardiography (p < 0.0004) in comparison to non-exercised animals.Conclusion: We concluded that the animal models of ischemia-reperfusion indicates that exercise reduce infarct size and preserve ejection fraction, associated with beneficial myocardial remodeling.