Artigos e Materiais de Revistas Científicas - ODS/03

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A coleção de Artigos e Materiais de Revistas Científicas engloba artigos originais, artigos de revisão, artigos de atualização, artigos técnicos, relatos de experiências, resenhas, ensaios, editoriais, cartas ao editor, debates, notas científicas e técnicas, depoimentos, entrevistas e pontos de vista. Consideram-se como artigos científicos originais os trabalhos redigidos para divulgação de informações e resultados sobre determinada pesquisa científica, publicados em periódico científico após avaliação por outros pesquisadores.

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  • article 0 Citação(ões) na Scopus
    Myocardial Injury Progression after Radiofrequency Ablation in School-Age Children
    (2024) MELO, Sissy Lara de; FERRAZ, Alberto Pereira; LEMOUCHE, Stephanie Ondracek; DEVIDO, Marcela Santana; SOUSA, Gabriela Liberato de; ROCHITTE, Carlos E.; PISANI, Cristiano Faria; HACHUL, Denise Tessariol; SCANAVACCA, Mauricio
    Background: The past decades have seen the rapid development of the invasive treatment of arrhythmias by catheter ablation procedures. Despite its safety and efficacy being well-established in adults, to date there has been little data in pediatric scenarios. One of the main concerns is the possible expansion of the ablation procedure scar in this population and its consequences over the years. Objectives: This study aimed to analyze the risk of myocardial injury progression after radiofrequency catheter ablation in pediatric patients. Methods: This is a retrospective study of 20 pediatric patients with previous ablation for treatment of supraventricular arrhythmia that underwent cardiac magnetic resonance and coronary angiography for evaluation of myocardial fibrosis and the integrity of the coronary arteries during follow-up. Results: The median age at ablation procedure was 15.1 years (Q1 12.9, Q3 16.6) and 21 years (Q1 20, Q3 23) when the cardiac magnetic resonance was performed. Fourteen of them were women. Nodal reentry tachycardia and WolfParkinson-White Syndrome were the main diagnosis (19 patients), with one patient with atrial tachycardia. Three patients had ventricular myocardial fibrosis, but with a volume < 0.6 cm(3) . None of them developed ventricular dysfunction and no patient had coronary lesions on angiography. Conclusion: Radiofrequency catheter ablation did not show to increase the risk of myocardial injury progression or coronary artery lesions.
  • article 0 Citação(ões) na Scopus
    Primary results of the brazilian registry of atherothrombotic disease (NEAT)
    (2024) SILVA, Pedro G. M.; NASCIMENTO, Charlene Troiani do; PEDROSA, Rodrigo Pinto; NAKAZONE, Marcelo Arruda; NASCIMENTO, Michel Ulloffo do; MELO, Leiliandry de Araujo; JUNIOR, Osvaldo Lourenco Silva; ZIMMERMANN, Sergio Luiz; MELO, Rodrigo Morel Vieira de; BERGO, Ricardo Reinaldo; PRECOMA, Dalton Bertolim; TRAMUJAS, Lucas; LIMA, Eduardo Gomes; DANTAS, Joao Miguel Malta; BARUZZI, Antonio Claudio do Amaral; FLUMIGNAN, Ronald Luiz Gomes; PAIVA, Maria Sanali Moura de Oliveira; GOWDAK, Luis Henrique Wolff; CARVALHO, Priscila Nasser de; FIGUEIREDO NETO, Jose Albuquerque de; SILVESTRE, Odilson Marcos; FIORANELLI, Alexandre; VIEIRA, Ricardo D. 'Oliveira; HORAK, Ana Clara Peneluppi; MIYADA, Debora Harumi Kodama; KOJIMA, Flavia Cristina Soares; OLIVEIRA, Julia Souza de; SILVA, Leila de Oliveira; PAVANELLO, Ricardo; RAMACCIOTTI, Eduardo; LOPES, Renato D.; NASCIMENTO, Charlene Troiani do; PEDROSA, Rodrigo Pinto; NAKAZONE, Marcelo Arruda; NASCIMENTO, Michel Ulloffo do; MELO, Leiliandry de Araujo; JUNIOR, Osvaldo Lourenco Silva; ZIMMERMANN, Sergio Luiz; MELO, Rodrigo Morel Vieira de; BERGO, Ricardo Reinaldo; PRECOMA, Dalton Bertolim; TRAMUJAS, Lucas; DANTAS, Joao Miguel Malta; BARUZZI, Antonio Claudio do Amaral; FLUMIGNAN, Ronald Luiz Gomes; PAIVA, Maria Sanali Moura de Oliveira; CARVALHO, Priscila Nasser de; FIGUEIREDO NETO, Jose Albuquerque de; SILVESTRE, Odilson Marcos; FIORANELLI, Alexandre; VIEIRA, Ricardo D. 'Oliveira; FORTES, Jose Augusto Ribas; RITT, Luiz Eduardo Fonteles; REQUIAO-MOURA, Lucio R.; BORGES, Fabricio Assami; BERNOCHE, Claudia; POMPILIO, Mauricio Antonio
    There is limited contemporary prospective real-world evidence of patients with chronic arterial disease in Latin America. The Network to control atherothrombosis (NEAT) registry is a national prospective observational study of patients with known coronary (CAD) and/or peripheral arterial disease (PAD) in Brazil. A total of 2,005 patients were enrolled among 25 sites from September 2020 to March 2022. Patient characteristics, medications and laboratorial data were collected. Primary objective was to assess the proportion of patients who, at the initial visit, were in accordance with good medical practices (domains) for reducing cardiovascular risk in atherothrombotic disease. From the total of patients enrolled, 2 were excluded since they did not meet eligibility criteria. Among the 2,003 subjects included in the analysis, 55.6% had isolated CAD, 28.7% exclusive PAD and 15.7% had both diagnoses. Overall mean age was 66.3 (+/- 10.5) years and 65.7% were male patients. Regarding evidence-based therapies (EBTs), 4% were not using any antithrombotic drug and only 1.5% were using vascular dose of rivaroxaban (2.5 mg bid). Only 0.3% of the patients satisfied all the domains of secondary prevention, including prescription of EBTs and targets of body-mass index, blood pressure, LDL-cholesterol, and adherence of lifestyle recommendations. The main barrier for prescription of EBTs was medical judgement. Our findings highlight that the contemporary practice does not reflect a comprehensive approach for secondary prevention and had very low incorporation of new therapies in Brazil. Large-scale populational interventions addressing these gaps are warranted to improve the use of evidence-based therapies and reduce the burden of atherothrombotic disease.ClinicalTrials.gov NCT04677725
  • article 4 Citação(ões) na Scopus
    Effect of Tafamidis on Cardiac Function in Patients With Transthyretin Amyloid Cardiomyopathy A Post Hoc Analysis of the ATTR-ACT Randomized Clinical Trial
    (2024) SHAH, Sanjiv J.; FINE, Nowell; GARCIA-PAVIA, Pablo; KLEIN, Allan L.; FERNANDES, Fabio; WEISSMAN, Neil J.; MAURER, Mathew S.; BOMAN, Kurt; GUNDAPANENI, Balarama; SULTAN, Marla B.; ELLIOTT, Perry
    Importance Tafamidis has been shown to improve survival in patients with transthyretin amyloid cardiomyopathy (ATTR-CM) compared with placebo. However, its effect on cardiac function has not been fully characterized.Objective To examine the effect of tafamidis on cardiac function in patients with ATTR-CM.Design, Setting, and Participants This was an exploratory, post hoc analysis of the Tafamidis in Transthyretin Cardiomyopathy Clinical Trial (ATTR-ACT), a multicenter, international, double-blind, placebo-controlled phase 3 randomized clinical trial conducted from December 2013 to February 2018. The ATTR-ACT included 48 sites in 13 counties and enrolled patients aged 18 to 90 years with ATTR-CM. Data were analyzed from July 2018 to September 2023.Intervention Patients were randomized to tafamidis meglumine, 80 mg or 20 mg, or placebo for 30 months.Main Outcomes and Measures Patients were categorized based on left ventricular (LV) ejection fraction at enrollment as having heart failure with preserved ejection fraction (>= 50%), mildly reduced ejection fraction (41% to 49%), or reduced ejection fraction (<= 40%). Changes from baseline to month 30 in LV ejection fraction, LV stroke volume, LV global longitudinal strain, and the ratio of early mitral inflow velocity to septal and lateral early diastolic mitral annular velocity (E/e ') were compared in patients receiving tafamidis, 80 mg, vs placebo.Results A total of 441 patients were randomized in ATTR-ACT, and 436 patients had available echocardiographic data. Of 436 included patients, 393 (90.1%) were male, and the mean (SD) age was 74 (7) years. A total of 220 (50.5%), 119 (27.3%), and 97 (22.2%) had heart failure with preserved, mildly reduced, and reduced LV ejection fraction, respectively. Over 30 months, there was less pronounced worsening in 4 of the echocardiographic measures in patients receiving tafamidis, 80 mg (n = 176), vs placebo (n = 177) (least squares mean difference: LV stroke volume, 7.02 mL; 95% CI, 2.55-11.49; P = .002; LV global longitudinal strain, -1.02%; 95% CI, -1.73 to -0.31; P = .005; septal E/e ', -3.11; 95% CI, -5.50 to -0.72; P = .01; lateral E/e ', -2.35; 95% CI, -4.01 to -0.69; P = .006).Conclusions and Relevance Compared with placebo, tafamidis, 80 mg, attenuated the decline of LV systolic and diastolic function over 30 months in patients with ATTR-CM. Approximately half of patients had mildly reduced or reduced LV ejection fraction at enrollment, suggesting that ATTR-CM should be considered as a possible diagnosis in patients with heart failure regardless of underlying LV ejection fraction.Trial Registration ClinicalTrials.gov Identifier: NCT01994889
  • article 1 Citação(ões) na Scopus
    The Use of the Oxygenation Stretch Index to Predict Outcomes in Mechanically Ventilated PatientsWith COVID-19 ARDS
    (2023) ROLDAN, Rollin; BARRIGA, Fernando; VILLAMONTE, Renan; ROMANI, Franco; TUCCI, Mauro; GONZALES, Arturo; WONG, Paolo; ZAGACETA, Jorge; BROCHARD, Laurent
    BACKGROUND: In ARDS caused by COVID-19 pneumonia, appropriate adjustment of physiologic parameters based on lung stretch or oxygenation may optimize the ventilatory strategy. This study aims to describe the prognostic performance on 60-d mortality of single and composite respiratory variables in subjects with COVID- 19 ARDS who are on mechanical ventilation with a lung-protective strategy, including the oxygenation stretch index combining oxygenation and driving pressure (Delta P). METHODS: This single-center observational cohort study enrolled 166 subjects on mechanical ventilation and diagnosed with COVID-19 ARDS. We evaluated their clinical and physiologic characteristics. The primary study outcome was 60-d mortality. Prognostic factors were evaluated through receiver operating characteristic analysis, Cox proportional hazards regression model, and Kaplan-Meier survival curves. RESULTS: Mortality at day 60 was 18.1%, and hospital mortality was 22.9%. Oxygenation, DP, and composite variables were tested: oxygenation stretch index (P-aO2 /F-IO2 divided by Delta P) and Delta P 3 4 + breathing frequency (f) (Delta P 3 4 + f). At both day 1 and day 2 after inclusion, the oxygenation stretch index had the best area under the receiver operating characteristic curve (oxygenation stretch index on day 1 0.76 (95% CI 0.67-0.84) and on day 2 0.83 (95% CI 0.76-0.91) to predict 60-d mortality, although without significant difference from other indexes. In multivariable Cox regression, Delta P, PaO2 /FIO2, Delta P 3 4 + f, and oxygenation stretch index were all associated with 60-d mortality. When dichotomizing the variables, Delta P >= 14, P-aO2 / F-IO2 >= 152 mm Hg, Delta P x 4 + f >= 80, and oxygenation stretch index < 7.7 showed lower 60-d survival probability. At day 2, after optimization of ventilatory settings, the subjects who persisted with the worse cutoff values for the oxygenation stretch index showed a lower probability of survival at 60 d compared with day 1; this was not the case for other parameters. CONCLUSIONS: The oxygenation stretch index, which combines P-aO2 /F-IO2 and DP, is associated with mortality and may be useful to predict clinical outcomes in COVID-19 ARDS.
  • article 0 Citação(ões) na Scopus
    Spirited discussion: lymph node count versus nodal station count
    (2024) D'AMBROSIO, Paula Duarte; VIEIRA, Arthur; FIGUEROA, Paula Ugalde
  • article 0 Citação(ões) na Scopus
    Implementation of a High-Risk Outpatient Clinic for Children with Complex Congenital Heart Disease in a Reference Service in Brazil
    (2023) FORONDA, Gustavo; MELO, Vanessa Ferreira Amorim de; GRAU, Claudia Regina Pinheiro de Castro; PIVA, Ingrid Magatti; TAVARES, Glaucia Maria Penha; TANAKA, Ana Cristina Sayuri; MIURA, Nana
    Background: Children with congenital heart disease (CHD), even after surgical approaches, and especially those who undergo staged procedures in the first months of life, remain vulnerable to readmissions and complications, requiring very close monitoring and differentiated intervention strategies. Methods: Descriptive and exploratory study, of the experience report type, which presents the process of building the high -risk outpatient clinic for complex congenital heart diseases (AAR) at the Instituto do Coracao (InCor). Results: Report of the path taken to structure the AAR, demonstrating the organization, interface with the multidisciplinary team, admission and discharge criteria, training, and patient profile. In these five years of care, 275 patients were treated, 59.65% with biventricular interstage physiology, followed by univentricular interstage physiology (34.55%), residual defects after surgical procedures (3.63%), tumors with risk of mechanical obstruction ( 1.45%) and patients with an intrauterine approach (0.72%). The significant number of critical patients who were successfully discharged from hospital (44.72%), the low mortality rate due to sudden deaths at home and the high adherence to follow-up corroborate the impact of this specialized assistance. Conclusions: Despite the limitations of the study, this experience report showed that with few resources, there is the possibility of organizing an AAR with differentiated care, with the objective of early detection and treatment of residual injuries, identification of early interventions, education of parents for follow-up of their children, resulting in individualized treatment, promoting a better quality of life for this population.
  • article 1 Citação(ões) na Scopus
    Position Statement on the Use of Myocardial Strain in Cardiology Routines by the Brazilian Society of Cardiology's Department Of Cardiovascular Imaging-2023
    (2023) ALMEIDA, Andre Luiz Cerqueira; MELO, Marcelo Dantas Tavares de; BIHAN, David Costa de Souza Le; VIEIRA, Marcelo Luiz Campos; PENA, Jose Luiz Barros; CASTILLO, Jose Maria Del; ABENSUR, Henry; HORTEGAL, Renato de Aguiar; OTTO, Maria Estefania Bosco; PIVETA, Rafael Bonafim; DANTAS, Maria Rosa; ASSEF, Jorge Eduardo; BECK, Adenalva Lima de Souza; SANTO, Thais Harada Campos Espirito; SILVA, Tonnison de Oliveira; SALEMI, Vera Maria Cury; ROCON, Camila; LIMA, Marcio Silva Miguel; BARBERATO, Silvio Henrique; RODRIGUES, Ana Clara; RABSCHKOWISKY, Arnaldo; FROTA, Daniela do Carmo Rassi; GRIPP, Eliza de Almeida; BARRETTO, Rodrigo Bellio de Mattos; SILVA, Sandra Marques e; CAUDURO, Sanderson Antonio; PINHEIRO, Aurelio Carvalho; ARAUJO, Salustiano Pereira de; TRESSINO, Cintia Galhardo; SILVA, Carlos Eduardo Suaide; MONACO, Claudia Gianini; PAIVA, Marcelo Goulart; FISHER, Claudio Henrique; ALVES, Marco Stephan Lofrano; GRAU, Claudia R. Pinheiro de Castro; SANTOS, Maria Veronica Camara dos; GUIMARAES, Isabel Cristina Britto; MORHY, Samira Saady; LEAL, Gabriela Nunes; SOARES, Andressa Mussi; CRUZ, Cecilia Beatriz Bittencourt Viana; GUIMARAES FILHO, Fabio Villaca; ASSUNCAO, Bruna Morhy Borges Leal; FERNANDES, Rafael Modesto; SARAIVA, Roberto Magalhaes; TSUTSUI, Jeane Mike; SOARES, Fabio Luis de Jesus; FALCAO, Sandra Nivea dos Reis Saraiva; HOTTA, Viviane Tiemi; ARMSTRONG, Anderson da Costa; HYGIDIO, Daniel de Andrade; MIGLIORANZA, Marcelo Haertel; CAMAROZANO, Ana Cristina; LOPES, Marly Maria Uellendahl; CERCI, Rodrigo Julio; SIQUEIRA, Maria Eduarda Menezes de; TORREAO, Jorge Andion; ROCHITTE, Carlos Eduardo; FELIX, Alex
  • article 1 Citação(ões) na Scopus
    Siamese pyramidal deep learning network for strain estimation in 3D cardiac cine-MR
    (2023) GRAVES, Catharine V.; REBELO, Marina F. S.; MORENO, Ramon A.; DANTAS-JR, Roberto N.; JR, Antonildes N. Assuncao; NOMURA, Cesar H.; GUTIERREZ, Marco A.
    Strain represents the quantification of regional tissue deformation within a given area. Myocardial strain has demonstrated considerable utility as an indicator for the assessment of cardiac function. Notably, it exhibits greater sensitivity in detecting subtle myocardial abnormalities compared to conventional cardiac function indices, like left ventricle ejection fraction (LVEF). Nonetheless, the estimation of strain poses considerable challenges due to the necessity for precise tracking of myocardial motion throughout the complete cardiac cycle. This study introduces a novel deep learning-based pipeline, designed to automatically and accurately estimate myocardial strain from three-dimensional (3D) cine-MR images. Consequently, our investigation presents a comprehensive pipeline for the precise quantification of local and global myocardial strain. This pipeline incorporates a supervised Convolutional Neural Network (CNN) for accurate segmentation of the cardiac muscle and an unsupervised CNN for robust left ventricle motion tracking, enabling the estimation of strain in both artificial phantoms and real cine-MR images. Our investigation involved a comprehensive comparison of our findings with those obtained from two commonly utilized commercial software in this field. This analysis encompassed the examination of both intra- and inter-user variability. The proposed pipeline exhibited demonstrable reliability and reduced divergence levels when compared to alternative systems. Additionally, our approach is entirely independent of previous user data, effectively eliminating any potential user bias that could influence the strain analyses.
  • article 0 Citação(ões) na Scopus
    TIGIT is Frequently Expressed in the Tumor Microenvironment of Select Lymphomas
    (2024) LIBERT, Diane; ZHAO, Shuchun; YOUNES, Sheren; MOSQUERA, Alicia P.; BHARADWAJ, Sushma; FERREIRA, Cristiane; NATKUNAM, Yasodha
    Immune checkpoint inhibitors against Programmed Cell Death Protein 1/Programmed Cell (PD-1/PD-L1) and CTLA-4/B7 axes have had limited success in hematologic malignancies, requiring the need to explore alternative targets such as T-cell immunoreceptor with Ig and ITIM domains (TIGIT)/CD155 to improve durable clinical responses. We undertook this study to investigate the expression profile of TIGIT such that the potential efficacy of TIGIT blockade could be mapped among lymphoma subtypes. We validated an immunohistochemical assay for TIGIT and evaluated its expression in lymphoma and tumor microenvironment (TME) cells in 661 lymphoma/leukemia biopsies. Multiplex immunofluorescence was used for correlation with normal TME cell subsets. Tumor or TME TIGIT-positivity was defined as moderate to strong membrane staining in at least 10% of tumor or TME cells, respectively. TME TIGIT expression was correlated with overall survival and progression-free survival and comparison with PD-L1 expression. In most cases, lymphoma cells were TIGIT-negative except for angioimmunoblastic and peripheral T-cell lymphomas, which showed 91% and 47% positivity, respectively. A high proportion of small B-cell lymphoma and anaplastic large cell lymphoma cases had TIGIT-positive TME cells. Chronic lymphocytic leukemia/small lymphocytic lymphoma patients with TIGIT-negative TME cells showed significantly shorter overall survival (P=0.04). No other statistically significant differences were found. When TIGIT was expressed in TME cells, there were a comparable number of TIGIT-positive only and dual TIGIT/PD-L1 positive cases except for more TIGIT-positive only cases in CLL/SLL. TIGIT expression shows distinctive profiles among lymphoma subtypes. Chronic lymphocytic leukemia/small lymphocytic lymphoma and anaplastic large cell lymphoma demonstrated high TME TIGIT expression compared with PD-L1, with a high proportion of dual TIGIT and PD-L1-positivity. Our results are likely to contribute to the design and correlative study of therapeutic response in clinical trials targeting TIGIT alone or in combination with PD1/PDL1.
  • article 0 Citação(ões) na Scopus
    Influence of polymorphisms in IRS1, IRS2, MC3R, and MC4R on metabolic and inflammatory status and food intake in Brazilian adults: An exploratory pilot study
    (2023) FAJARDO, Cristina Moreno; CERDA, Alvaro; BORTOLIN, Raul Hernandes; OLIVEIRA, Raquel de; STEFANI, Tamires Invencioni Moraes; SANTOS, Marina Aparecida dos; BRAGA, Aecio Assuncao; DOREA, Egidio Lima; BERNIK, Marcia Martins Silveira; BASTOS, Gisele Medeiros; SAMPAIO, Marcelo Ferraz; DAMASCENO, Nagila Raquel Teixeira; VERLENGIA, Rozangela; OLIVEIRA, Maria Rita Marques de; HIRATA, Mario Hiroyuki; HIRATA, Rosario Dominguez Crespo
    Polymorphisms in genes of leptin-melanocortin and insulin pathways have been associated with obesity and type 2 diabetes. We hypothesized that polymorphisms in IRS1, IRS2, MC3R, and MC4R influence metabolic and inflammatory markers and food intake composi tion in Brazilian subjects. This exploratory pilot study included 358 adult subjects. Clinical, anthropometric, and laboratory data were obtained through interview and access to medical records. The variants IRS1 rs2943634 A >C, IRS2 rs1865434 C > T, MC3R rs3746619 C > A, and MC4R rs17782313 T > C were analyzed by real-time polymerase chain reaction. Food intake composition was assessed in a group of subjects with obesity ( n = 84) before and after a short-term nutritional counseling program (9 weeks). MC4R rs17782313 was associated with increased risk of obesity ( P = .034). Multivariate linear regression analysis adjusted by covariates indicated associations of IRS2 rs1865434 with reduced low-density lipoprotein cholesterol and resistin, MC3R rs3746619 with high glycated hemoglobin, and IRS1 rs2943634 and MC4R rs17782313 with increased high-sensitivity C-reactive protein ( P < .05). Energy intake and carbohydrate and total fat intakes were reduced after the diet-oriented program ( P < .05). Multivariate linear regression analysis showed associations of IRS2 rs1865434 with high basal fiber intake, IRS1 rs2943634 with low postprogram carbohydrate intake, and MC4R rs17782313 with low postprogram total fat and saturated fatty acid intakes ( P < .05). Although significant associations did not survive correction for multiple comparisons using the Benjamini-Hochberg method in this exploratory study, polymorphisms in IRS1, IRS2, MC3R, and MC4R influence metabolic and inflammatory status in Brazilian adults. IRS1 and MC4R variants may influence carbohydrate, total fat, and saturated fatty acid intakes in response to a diet-oriented program in subjects with obesity.
  • article 1 Citação(ões) na Scopus
    EZH2 Expression Correlates With T-Cell Infiltration in Oral Leukoplakia and Predicts Cancer Transformation
    (2023) GANESH, Divya; DAFAR, Amal; NIKLASSON, Julia; SANDBERG, Ingrid; BRAZ-SILVA, Paulo; SAPKOTA, Dipak; OHMAN, Jenny; GIGLIO, Daniel; HASSEUS, Bengt
    Background/Aim: The EZH2 complex is involved in cellular proliferation and modulates the immune response in cancer. Less is known about the importance of EZH2 in precancerous lesions such as oral leukoplakia (OL). The aim of the study was to explore the association between EZH2 expression, immune activation, and cancer transformation in OL. Patients and Methods: Analyses were retrospectively performed on nine OL cases that had undergone transformation to oral squamous cell carcinoma (OSCC; OL-ca) and nine that had not undergone transformation (OL-non). EZH2-expressing cells, CD3+ and CD8+ T cells, and CD1a+ Langerhans cells were visualized with immunohistofluorescence and counted. Results: A moderate positive correlation between CD3-and EZH2-expressing and CD8-and EZH2-expressing cells in the epithelium was found (r=0.57, p=0.01; r=0.59, p=0.01). The number of EZH2-expressing cells in the epithelium of OL-ca was significantly higher compared to OL-non (p=0.0002). Cancer - free survival rates differed significantly between patients with EZH2high compared to EZH2low expression (p=0.001). EZH2high expression in OL epithelium was associated with a 13-fold higher risk for developing OSCC (HR=12.8). Conclusion: EZH2 expression in oral epithelium predicts OSCC transformation of OL and correlates with the level of T-cell infiltration.
  • article 0 Citação(ões) na Scopus
    Vitamin C Inhibits Lipopolysaccharide-Induced Hyperinflammatory State of Chronic Myeloid Leukemia Cells through Purinergic Signaling and Autophagy
    (2024) PIRES, Daniela A.; BRANDAO-RANGEL, Maysa A. R.; SILVA-REIS, Anamei; OLIMPIO, Fabiana R. S.; AIMBIRE, Flavio; OLIVEIRA, Carlos R.; MATEUS-SILVA, Jose R.; ZAMARIOLI, Lucas S.; BACHI, Andre L. L.; BELLA, Yanesko F.; SANTOS, Juliana M. B.; BINCOLETTO, Claudia; JR, Antonio Herbert Lancha; VIEIRA, Rodolfo P.
    Background: Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by the overproduction of white blood cells, leading to symptoms such as fatigue, infections, and other complications. CML patients must take measures to prevent infections to mitigate the exacerbation of cancer cell proliferation and comorbidities. Methods: This study investigated whether vitamin C can suppress the hyperinflammatory activation of K-562 cells induced by lipopolysaccharide (LPS) and whether purinergic signaling (ATP and P2X7 receptor) and autophagy play a role in it. Two different doses of vitamin C (5 mu g/mL and 10 mu g/mL) were employed, along with the lysosome inhibitor chloroquine (CQ; 100 mu M), administered 2 h prior to LPS stimulation (10 ng/mL) for a duration of 22 h in K-562 cells (3 x 10(5) cells/mL/well). Results: Both doses of vitamin C reduced the release of interleukin-6 (IL-6) (5 mu g/mL, p < 0.01 and 10 g/mL, p < 0.01) and tumor necrosis factor (TNF) (5 g/mL, p < 0.01 and 10 g/mL, p < 0.01) induced by LPS. Furthermore, in LPS + CQ-stimulated cells, vitamin C at a concentration of 10 g/mL inhibited the expression of LC3-II (p < 0.05). Conversely, both doses of vitamin C led to the release of the anti-inflammatory cytokine interleukin-10 (IL-10) (5 g/mL, p < 0.01 and 10 g/mL, p < 0.01), while only the 10 g/mL dose of vitamin C induced the release of Klotho (10 mu g/mL, p < 0.01). In addition, both doses of vitamin C reduced the accumulation of ATP (5 g/mL, p < 0.01 and 10 g/mL, p < 0.01) and decreased the expression of the P2X7 receptor at the mRNA level. Conclusions: Vitamin C inhibits the hyperinflammatory state induced by LPS in K-562 cells, primarily by inhibiting the ATP accumulation, P2X7 receptor expression, and autophagy signaling.
  • article 0 Citação(ões) na Scopus
    Dynamic associations between glucose and ecological momentary cognition in Type 1 Diabetes
    (2024) HAWKS, Z. W.; BECK, E. D.; JUNG, L.; FONSECA, L. M.; SLIWINSKI, M. J.; WEINSTOCK, R. S.; GRINSPOON, E.; XU, I.; STRONG, R. W.; SINGH, S.; DONGEN, H. P. A. Van; FRUMKIN, M. R.; BULGER, J.; CLEVELAND, M. J.; JANESS, K.; KUDVA, Y. C.; PRATLEY, R.; RICKELS, M. R.; RIZVI, S. R.; CHAYTOR, N. S.; GERMINE, L. T.
    Type 1 diabetes (T1D) is a chronic condition characterized by glucose fluctuations. Laboratory studies suggest that cognition is reduced when glucose is very low (hypoglycemia) and very high (hyperglycemia). Until recently, technological limitations prevented researchers from understanding how naturally-occurring glucose fluctuations impact cognitive fluctuations. This study leveraged advances in continuous glucose monitoring (CGM) and cognitive ecological momentary assessment (EMA) to characterize dynamic, within-person associations between glucose and cognition in naturalistic environments. Using CGM and EMA, we obtained intensive longitudinal measurements of glucose and cognition (processing speed, sustained attention) in 200 adults with T1D. First, we used hierarchical Bayesian modeling to estimate dynamic, within-person associations between glucose and cognition. Consistent with laboratory studies, we hypothesized that cognitive performance would be reduced at low and high glucose, reflecting cognitive vulnerability to glucose fluctuations. Second, we used data-driven lasso regression to identify clinical characteristics that predicted individual differences in cognitive vulnerability to glucose fluctuations. Large glucose fluctuations were associated with slower and less accurate processing speed, although slight glucose elevations (relative to person-level means) were associated with faster processing speed. Glucose fluctuations were not related to sustained attention. Seven clinical characteristics predicted individual differences in cognitive vulnerability to glucose fluctuations: age, time in hypoglycemia, lifetime severe hypoglycemic events, microvascular complications, glucose variability, fatigue, and neck circumference. Results establish the impact of glucose on processing speed in naturalistic environments, suggest that minimizing glucose fluctuations is important for optimizing processing speed, and identify several clinical characteristics that may exacerbate cognitive vulnerability to glucose fluctuations.
  • article 1 Citação(ões) na Scopus
  • article 0 Citação(ões) na Scopus
    Epidemiological and Clinical Characteristics of Young Patients With Breast Cancer in Brazil: A Retrospective Study
    (2023) CORREA, Daniela B.; ARAUJO, Guilhermino C.; ALVARENGA, Bruno H.; RODRIGUES, Angelica N.
    PURPOSE Understanding the epidemiological profile of young patients with breast cancer (BC) is crucial for devising effective control strategies. However, data on Brazilian patients with BC, particularly concerning the association with pathogenic germline mutations, are limited. This retrospective cross-sectional study seeks to shed light on the epidemiological and genetic profiles of young patients with BC in Brazil, with a specific focus on the correlation between germline mutations and clinical outcomes. METHODS We analyzed medical records from two institutions in Minas Gerais, Brazil, focusing on young patients with BC diagnosed from January 2012 to December 2020. The collected variables included sociodemographic profile, tumor characteristics, mutational status, follow-up duration, and time from diagnosis to death. RESULTS The findings highlight high rates of genetic mutations, more aggressive tumor characteristics, and the necessity for more radical surgical interventions in patients with mutations. CONCLUSION In general, young patients with BC in Brazil present an unfavorable prognosis, emphasizing the need for early diagnosis and personalized treatment strategies.
  • article 0 Citação(ões) na Scopus
    Comparing the Addiction Severity Index (ASI) and Measurements in the Addictions for Triage and Evaluation (MATE)
    (2023) MARTINS-DA-SILVA, Anderson Sousa; MOURA, Welissa da Silva; MARCO, Ciro; GALVAO, Lucas; BALLIARI, Eric; CAVALLO, Isabela; BECKER, Ruth; SILVA, Lucina; OLIVEIRA, Eclesiaster; GIL, Felipe; NATHALIE, Moschetta Monteiro-Gil; CAMPOS, Marcela Waisman; TORALES, Julio; VENTRIGLIO, Antonio; PERICO, Cintia de Azevedo-Marques; CASTALDELLI-MAIA, Joao Mauricio
    Substance use disorder (SUD) assessment and measurement in Brazil, as well as in many other countries, face significant shortcomings. The Measurement in the Addictions for Triage and Evaluation (MATE) was developed as a public domain tool, drawing from validated scales and incorporating World Health Organization International Classification of Functioning, Disability, and Health (ICF) framework. The Brazilian version of the MATE (MATE-pt-BR) was evaluated for its reliability and validity, with a total of 239 subjects participating in the study, and data collected between 11/01/2021 and 09/01/2022. The majority were male (79.2%), with diverse racial backgrounds. The substances most prevalently used in the last 30 days were. Alcohol (73.2%), nicotine (63.6%), and cocaine (44.2%). The mean scores for MATE modules showed variations, with Module Q2 assessing psychological well-being having high internal consistency (Cronbach's alpha = 0.92). MATE-pt-BR demonstrated robust internal consistency, with Module 6 (personality) and Module 2 (medical and psychiatric consultation indicators) being exceptions. MATE-pt-BR exhibited significant correlations among its sections and strong discriminant validity. Moreover, the paper compares MATE-pt-BR with the Addiction Severity Index (ASI-6), which is considered the gold-standard measure for SUD assessments. MATE-pt-BR offers a valuable tool for assessing substance use and related functional impairments in the Brazilian context.
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    Exploring correlates of involuntary treatment in substance use disorders: a global systematic review and meta-analysis
    (2023) FOGO, Rodrigo Casa; MARTINS-DA-SILVA, Anderson Sousa; BLAAS, Israel Kanaan; GALVAO, Lucas Pequeno; HASEGAWA, Ellen Hiroe; CASTALDELLI, Fernando Ikeda; GIMENES, Gislaine Koch; PERICO, Cintia de Azevedo-Marques; PAIVA, Henrique; CASTALDELLI-MAIA, Joao Mauricio
    Given the legislative heterogeneity about involuntary treatment and psychoactive substance users, we opted to perform a systematic review and meta-analysis of the correlates of involuntary substance use disorders (SUD) treatment across different countries. We conducted research on the Pubmed database, searching for involuntary SUD treatment data worldwide. The systematic review analysed a total of 36 articles and included a sample of 47,739 patients. Our review highlights the elevated risk of involuntary treatment among male, unmarried individuals with alcohol and/or opioid use disorders. Targeted preventive and therapeutic interventions should focus on addressing the underlying factors contributing to involuntary treatment, such as psychosis, aggressiveness, suicidal ideation, legal problems, and severe social exposure. By targeting these factors and providing comprehensive care, we can strive to improve outcomes and reduce the burden of substance use disorders in this vulnerable population. It is essential to critically examine and understand the factors contributing to the selection of patients for compulsory treatment. By doing so, we can identify potential gaps or inconsistencies in the current processes and work towards ensuring that decisions regarding compulsory treatment are based on sound clinical and ethical principles.
  • article 0 Citação(ões) na Scopus
    Good Psychiatric Management for Borderline Personality Disorder During the Perinatal Period: GPM-P
    (2024) UCHOA, Caroline L. Mesquita; NADEL, Isabella L.; CHOI-KAIN, Lois W.
    Purpose of ReviewWomen with borderline personality disorder (BPD) are especially at risk for experiencing adverse physiological, psychological, and social effects of pregnancy and postpartum. Those with BPD are vulnerable to these developmental transitions because of the interpersonal hypersensitivity that underpins the confusing oscillations of their symptoms.Recent FindingsGood Psychiatric Management (GPM) is a structured generalist intervention for patients with BPD found to be comparable in effectiveness to more intensive specialized psychotherapies such as DBT. GPM is adaptable to address the known vulnerabilities of patients in the perinatal period, during this critical time when mothers encountered critical transitions in identity and role transformation.SummaryThese brief, pragmatic clinical interventions can be adjunct to usual obstetric care to improve outcomes, both psychiatrically and medically. Expectant mothers with BPD and the clinical teams caring for them will benefit from the inherent flexibility of GPM, which incorporates (extra)conservative pharmacotherapy, increased family and social support network involvement, and increased attention to the social-emotional demands.
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    Mood disorders among adolescents in conflict with the law and in custody
    (2024) GUILHERME, Eduardo Alves; MORENO, Ricardo Alberto
    The high prevalence of psychiatric symptoms among juvenile delinquents is a well-replicated international finding. This study aimed to find the prevalence of mood disorders and their relationship with serious criminal acts in a population of adolescents in conflict with the law and in custody. A total of 123 male inmates aged 14 to 17 years were interviewed and assessed. Mood disorders were diagnosed in 15% of the sample for current episode and 31% for lifetime, making them third most prevalent after dependence disorders and disruptive disorders. The psychopathological profile of the adolescents who had committed violent crimes corroborates other studies reporting a high prevalence of mood disorders in this population. Several factors have been found to influence the formation of juvenile delinquency, including absence of family structure, social inequality, lack of quality school education, alcohol and drug abuse/addiction and disruptive disorders. The present results confirm mood disorders as another such factor.