Faculdade de Medicina - FM

URI Permanente desta comunidade

A Faculdade de Medicina da Universidade de São Paulo (FMUSP) foi fundada oficialmente em 24 de novembro de 1891, de acordo com a Lei nº 19, como 'Academia de Medicina, Cirurgia e Pharmácia'; a aula inaugural foi realizada anos mais tarde, em 1913, quando foi rebatizada como Faculdade de Medicina e Cirurgia de São Paulo, sendo designada como Faculdade de Medicina de São Paulo em 1925 e incorporada à Universidade de São Paulo em 1934.

A FMUSP está vincula ao Sistema FMUSP-HC, que é o maior do país e também o maior centro assistencial da América Latina, compreendendo, além da Faculdade de Medicina, institutos especializados no atendimento de alta complexidade (atenção terciária), hospital de média complexidade (atenção secundária), hospitais auxiliares, unidades especializadas no atendimento integral de pacientes portadores de HIV/AIDS, Centro de Saúde Escola (atenção primária), Unidades Básicas de Saúde (atenção primária), Laboratórios de Investigação Médica (LIMs) e Fundação de Apoio.

Atualmente a FMUSP atua na graduação e pós-graduação de médicos, fisioterapeutas, fonoaudiólogos e terapeutas ocupacionais com sólida formação geral e básica, além de promover o treinamento nos três níveis de atenção à saúde.

Entre as atividades realizadas na FMUSP estão pesquisa e desenvolvimento na área da saúde, além de pesquisa básica e clínica e o oferecimento de ensino, pesquisa e atividades de cultura e extensão, tendo como prioridade o investimento em pesquisa científica e sua reversão para projetos de assistência social.

Site oficial: http://www.fm.usp.br

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article 0 Citação(ões) na Scopus
In vitro and in vivo evaluation of novel chromeno[2,3-d]pyrimidinones as therapeutic agents for triple negative breast cancer
(2024) CARVALHO, Luisa; LIMA, Fabio Pedroso de; CERQUEIRA, Monica; SILVA, Ana; PONTES, Olivia; OLIVEIRA-PINTO, Sofia; GUERREIRO, Sara; COSTA, Marta D.; GRANJA, Sara; MACIEL, Patricia; LONGATTO-FILHO, Adhemar; BALTAZAR, Fatima; PROENCA, Fernanda; COSTA, Marta
Triple-negative breast cancer (TNBC) is the most aggressive subtype of breast cancer, and the limited therapeutic options show poor efficacy in patients, associated to severe side effects and development of resistance. Considering that chromene-based scaffolds proved to be attractive candidates for cancer therapy, herein we prepared new chromeno[2,3-d]pyrimidinone derivatives by a simple two step procedure, starting from the reaction of cyanoacetamide and a salicylaldehyde. A cell viability screening in several breast cancer cell lines allowed to identify two promising compounds with IC50 values in the low micromolar range for TNBC cells. These chromenes inhibited cell proliferation, induced cell cycle arrest and triggered cell death through apoptosis. In vivo studies revealed a safe profile in invertebrate and vertebrate animal models and confirmed their capacity to inhibit tumor growth in the CAM model, inducing significant tumor regression after 4 days of treatment. The two compounds identified in this study are promising drug candidates for TNBC treatment and valuable hits for future optimization, using the versatile synthetic platform that was developed.
article 0 Citação(ões) na Scopus
Strong OLIG2 expression in supratentorial ependymoma, ZFTA fusion-positive: A potential diagnostic pitfall
(2024) CASTRO, Joao Victor Alves de; KULIKOWSKI, Leslie Domenicki; WOLFF, Beatriz Martins; NATALINO, Renato; CARRARO, Dirce Maria; TORREZAN, Giovana Tardin; NETO, Cristovam Scapulatempo; AMANCIO, Camila Trolez; CANEDO, Felipe Sales Nogueira Amorim; FEHER, Olavo; COSTA, Felipe D'Almeida
Ependymomas (EPN) are central nervous system neoplasms that exhibit an ependymal phenotype. In particular, supratentorial EPN (ST-EPN) must be differentiated from more aggressive entities such as glioblastoma, IDH-wildtype. This task is frequently addressed with the use of immunohistochemistry coupled with clinical presentation and morphological features. Here we describe the case of a young adult presenting with migraine-like symptoms and a temporoinsular-based expansile mass that was first diagnosed as a GBM, mostly based on strong and diffuse oligodendrocyte transcription factor 2 (OLIG2) expression. Molecular characterization revealed a ZFTA::RELA fusion, supporting the diagnosis of ST-EPN, ZFTA fusion-positive. OLIG2 expression is rarely reported in tumors other than GBM and oligodendrocyte-lineage committed neoplasms. The patient was treated with radiotherapy and temozolomide after surgery and was alive and well at follow-up. This report illustrates the need to assess immunostains within a broader clinical, morphological and molecular context to avoid premature exclusion of important differential diagnoses.
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Evidence of a pan-tissue decline in stemness during human aging
(2024) SANTOS, Gabriel Arantes dos; MAGDALENO, Gustavo Daniel Vega; MAGALHAES, Joao Pedro de
Despite their biological importance, the role of stem cells in human aging remains to be elucidated. In this work, we applied a machine learning methodology to GTEx transcriptome data and assigned stemness scores to 17,382 healthy samples from 30 human tissues aged between 20 and 79 years. We found that (similar to)60% of the studied tissues exhibit a significant negative correlation between the subject's age and stemness score. The only significant exception was the uterus, where we observed an increased stemness with age. Moreover, we observed that stemness is positively correlated with cell proliferation and negatively correlated with cellular senescence. Finally, we also observed a trend that hematopoietic stem cells derived from older individuals might have higher stemness scores. In conclusion, we assigned stemness scores to human samples and show evidence of a pan-tissue loss of stemness during human aging, which adds weight to the idea that stem cell deterioration may contribute to human aging.
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Dentistry medicalization at SUS: a qualitative practice-based perspective
(2023) SINKOC, Celia Regina; BULGARELI, Jaqueline Vilela; GONDINHO, Brunna Verna Castro; LEME, Pedro Augusto Thiene; SPADACIO, Cristiane; OCTAVIANI, Julia Vitorio; CORTELLAZZI, Karine Laura; POSSOBON, Rosana de Fatima; GUERRA, Luciane Miranda
This study explores the senses and meanings attributed to dental work in the Brazilian National Health System (SUS) focusing on dentist-patient relations. A qualitative research was conducted with 20 dentists working in a medium-sized municipality in Sao Paulo, divided into three focus groups and asked the guiding question ""What sense or meaning do you attribute to your work here in the city?"" Data were audio-recorded, fully transcribed, and analyzed using thematic content analysis. Floating reading, categorization, and peer discussion of the findings were performed for the final validation, resulting in two categories: 1) Strangeness to patients' needs and the subsequent medicalization of life, and 2) Power and consumption as meanings of practice. In this context, the dental practices showed the differences between patients' needs and those considered relevant by dentists. It also showed the power imbalance between patients and professionals as a hindrance to patients' autonomy. Such meanings seem to cause suffering to these professionals. In conclusion, reflections on health work are paramount to avoid suffering and understand that the practice of these dentists bears many senses and meanings.
article 5 Citação(ões) na Scopus
Effect of Different Extraction Methods on Anthocyanin Content in Hibiscus sabdariffa L. and their Antiplatelet and Vasorelaxant Properties
(2023) MARTINS, Denise Rubinho dos Santos; LESCANO, Caroline Honaiser; JUSTO, Alberto Fernando Oliveira; VICENTE, Julia Modesto; SANTOS, Sergio Henrique Sousa; AGUILAR, Charles Martins; BORGES, Alexandre; OLIVEIRA, Ivan Pires de; SANJINEZ-ARGANDONA, Eliana Janet
Hibiscus sabdariffa L. is a worldwide component for tea and beverages, being a natural source of anthocyanins, which are associated with cardiovascular activities. To investigate this relationship, we explored different methods of aqueous extraction on the anthocyanin content and antioxidant activity of H. sabdariffa L. calyx extract (HSCE). Pharmacological effects via platelet aggregation, calcium mobilization, cyclic nucleotide levels, vasodilator-stimulated phosphoprotein Ser157 and Ser239, and on the vasomotor response of aortic rings isolated from mice are studied herewith. We found that the application of ultrasonic turbolization, 20 min, combined with acidified water was significantly more effective in the extraction process, providing extracts with the highest levels of anthocyanins (8.73 and 9.63 mg/100 g) and higher antioxidant activity (6.66 and 6.78 mu M trolox/g of sample). HSCE significantly inhibited (100-1000 mu g/mL) arachidonic acid-induced platelet aggregation, reduced calcium mobilization, and increased cAMP and cGMP levels with VASPSer157 and VASPSer239 phosphorylation. Vasorelaxation reduction was confirmed by the aortic rings and endothelium assays treated with nitric oxide synthase inhibitors, soluble guanylyl cyclase (sGC) oxidizing agent, or Ca2+-activated K+ channel inhibitor. The increasing of cGMP levels could be understood considering the sGC stimulation by HSCE compounds in the specific stimulus domain, which allows an understanding of the observed antiplatelet and vasorelaxant properties of H. sabdariffa L. calyx extract.
article 0 Citação(ões) na Scopus
A primary oral mucosal melanoma of the hard palate with no recurrence: Report of a 10 years follow-up
(2024) CORREIA-NETO, Ivan Jose; CORREA, Marcelo Brum; ARAUJO, Anna Luiza Damaceno; PENAFORT, Paulo Victor Mendes; COLAFEMINA, Ana Carolina Evangelista; ELIAS, Rogerio de Andrade; SANTOS-SILVA, Alan Roger; VARGAS, Pablo Agustin; LOPES, Marcio Ajudarte
BackgroundPrimary oral mucosal melanoma (OMM) represents an extremely rare and aggressive tumor that arises from malignant transformation and clonal expansion of melanocytes in the oral cavity. The prognosis of patients affected by OMM is quite unfavorable, with survival rates lower than those described for patients with cutaneous melanoma.Case reportHere, we report a case of OMM in a 59-year-old Caucasian woman, who was referred for evaluation of a large asymptomatic pigmented lesion on the left side of the hard palate under the removable total denture. Incisional biopsy was performed, and histopathological analysis revealed the proliferation of spindle-shaped and pigmented epithelioid cells, with cellular pleomorphism. These cells were positive for Melan A, S-100, HMB-45, SOX-10, and Ki-67 confirming the diagnosis of OMM. The patient underwent partial maxillectomy and adjuvant radiotherapy. After treatment, she was rehabilitated with a palatal obturator prosthesis and has been in follow-up for 10 years with no evidence of disease. Due to the rarity in the oral cavity and the nonspecific signs and symptoms, the diagnosis of OMM is difficult and often overlooked.ConclusionTherefore, multidisciplinary management from diagnosis, treatment, and rehabilitation is important to increase the expectation of cure.
article 0 Citação(ões) na Scopus
Investigating Dyslexia through Diffusion Tensor Imaging across Ages: A Systematic Review
(2024) MARTINS, Bruce; BABA, Mariana Yumi; DIMATEO, Elisa Monteiro; COSTA, Leticia Fruchi; CAMARA, Aila Silveira; LUKASOVA, Katerina; NUCCI, Mariana Penteado
Dyslexia is a neurodevelopmental disorder that presents a deficit in accuracy and/or fluency while reading or spelling that is not expected given the level of cognitive functioning. Research indicates brain structural changes mainly in the left hemisphere, comprising arcuate fasciculus (AF) and corona radiata (CR). The purpose of this systematic review is to better understand the possible methods for analyzing Diffusion Tensor Imaging (DTI) data while accounting for the characteristics of dyslexia in the last decade of the literature. Among 124 articles screened from PubMed and Scopus, 49 met inclusion criteria, focusing on dyslexia without neurological or psychiatric comorbidities. Article selection involved paired evaluation, with a third reviewer resolving discrepancies. The selected articles were analyzed using two topics: (1) a demographic and cognitive assessment of the sample and (2) DTI acquisition and analysis. Predominantly, studies centered on English-speaking children with reading difficulties, with preserved non-verbal intelligence, attention, and memory, and deficits in reading tests, rapid automatic naming, and phonological awareness. Structural differences were found mainly in the left AF in all ages and in the bilateral superior longitudinal fasciculus for readers-children and adults. A better understanding of structural brain changes of dyslexia and neuroadaptations can be a guide for future interventions.
article 0 Citação(ões) na Scopus
Know-how of holding a Bioinformatics competition: Structure, model, overview, and perspectives
(2023) HORACIO, Elvira C. A.; CARVALHO, Lucas M. de; PEREIRA, Gustavo G.; ABRAHIM, Mayla C.; COELHO, Monica P.; JESUS, Deivid A. De; GARCIA, Glen J. Y.; MELO-MINARDI, Raquel C. de; NAGAMATSU, Sheila T.
The article presents a framework for a Bioinformatics competition that focuses on 4 key aspects: structure, model, overview, and perspectives. Structure represents the organizational framework employed to coordinate the main tasks involved in the competition. Model showcases the competition design, which encompasses 3 phases. Overview presents our case study, the League of Brazilian Bioinformatics (LBB) 2nd Edition. Finally, the section on perspectives provides a brief discussion of the LBB 2nd Edition, along with insights and feedback from participants. LBB is a biannual team competition launched in 2019 to promote the ongoing training of human resources in Bioinformatics and Computational Biology in Brazil. LBB aims to stimulate ongoing training in Bioinformatics by encouraging participation in competitions, promoting the organization of future Bioinformatics competitions, and fostering the integration of the Bioinformatics and Computational Biology community in the country, as well as collaboration among participants. The LBB 2nd Edition was launched in 2021 and featured 251 competitors forming 91 teams. Knowledge competitions promote learning, collaboration, and innovation, which are crucial for advancing scientific knowledge and solving real-world problems. In summary, this article serves as a valuable resource for individuals and organizations interested in developing knowledge competitions, offering a model based on our experience with LBB to benefit all levels of Bioinformatics trainees. There are various methods of learning, and one such approach involves a commonly used in the computing field, fostering competition, where communication, teamwork, group learning, and problem-solving play crucial roles. Similarly, in bioinformatics and computational biology, certain institutions or platforms promote learning through challenges. However, national-level competitions in these domains are relatively scarce. Here, we would like to present a framework for a Bioinformatics competition by showing structure, model, overview, and perspectives, using the League of Brazilian Bioinformatics (LBB) 2nd Edition as case study. LBB is the first bioinformatics competition in Latin America and aims to encompass the diverse multidisciplinary aspects of Bioinformatics and promote networking. In LBB, individuals not only have the opportunity to learn but also get to know one another. Further, to stimulate undergraduate training, we promoted teams with a mixture of different academic backgrounds. This approach promotes integration among participants and facilitates the exchange of information. To ensure that all participants have the opportunity to connect and form teams regardless of their background, we have created the MATCH, a script that allows individuals to be randomly paired with others, enabling them to get to know each other and create teams effectively.This approach fosters collaboration and creates a conducive environment for learning and problem-solving.
article 0 Citação(ões) na Scopus
Pathways and identity: toward qualitative research careers in child and adolescent psychiatry
(2024) MARTIN, Andres; DIGIOVANNI, Madeline; ACQUAYE, Amber; PONTICIELLO, Matthew; CHOU, Debora Tseng; NETO, Emilio Abelama; MICHEL, Alexandre; SIBEONI, Jordan; PIOT, Marie-Aude; SPODENKIEWICZ, Michel; BENOIT, Laelia
Objective Qualitative research methods are based on the analysis of words rather than numbers; they encourage self-reflection on the investigator's part; they are attuned to social interaction and nuance; and they incorporate their subjects' thoughts and feelings as primary sources. Despite appearing well suited for research in child and adolescent psychiatry (CAP), qualitative methods have had relatively minor uptake in the discipline. We conducted a qualitative study of CAPs involved in qualitative research to learn about these investigators' lived experiences, and to identify modifiable factors to promote qualitative methods within the field of youth mental health.Methods We conducted individual, semi-structured 1-h long interviews through Zoom. Using purposive sample, we selected 23 participants drawn from the US (n = 12) and from France (n = 11), and equally divided in each country across seniority level. All participants were current or aspiring CAPs and had published at least one peer-reviewed qualitative article. Ten participants were women (44%). We recorded all interviews digitally and transcribed them for analysis. We coded the transcripts according to the principles of thematic analysis and approached data analysis, interpretation, and conceptualization informed by an interpersonal phenomenological analysis (IPA) framework.Results Through iterative thematic analysis we developed a conceptual model consisting of three domains: (1) Becoming a qualitativist: embracing a different way of knowing (in turn divided into the three themes of priming factors/personal fit; discovering qualitative research; and transitioning in); (2) Being a qualitativist: immersing oneself in a different kind of research (in turn divided into quality: doing qualitative research well; and community: mentors, mentees, and teams); and (3) Nurturing: toward a higher quality future in CAP (in turn divided into current state of qualitative methods in CAP; and advocating for qualitative methods in CAP). For each domain, we go on to propose specific strategies to enhance entry into qualitative careers and research in CAP: (1) Becoming: personalizing the investigator's research focus; balancing inward and outward views; and leveraging practical advantages; (2) Being: seeking epistemological flexibility; moving beyond bibliometrics; and the potential and risks of mixing methods; and (3) Nurturing: invigorating a quality pipeline; and building communities.Conclusions We have identified factors that can support or impede entry into qualitative research among CAPs. Based on these modifiable findings, we propose possible solutions to enhance entry into qualitative methods in CAP (pathways), and to foster longer-term commitment to this type of research (identity).
article 3 Citação(ões) na Scopus
MRI with DWI improves detection of liver metastasis and selection of surgical candidates with pancreatic cancer: a systematic review and meta-analysis
(2024) ALTMAYER, Stephan; ARMELIN, Larissa Maria; PEREIRA, Jussara Soares; CARVALHO, Lis Vitoria; TSE, Justin; BALTHAZAR, Patricia; FRANCISCO, Martina Zaguini; WATTE, Guilherme; HOCHHEGGER, Bruno
ObjectiveTo perform a systematic review and meta-analysis to evaluate if magnetic resonance imaging (MRI) with diffusion weighted imaging (DWI) adds value compared to contrast-enhanced computed tomography (CECT) alone in the preoperative evaluation of pancreatic cancer.MethodsMEDLINE, EMBASE, and Cochrane databases were searched for relevant published studies through October 2022. Studies met eligibility criteria if they evaluated the per-patient diagnostic performance of MRI with DWI in the preoperative evaluation of newly diagnosed pancreatic cancer compared to CECT. Our primary outcome was the number needed to treat (NNT) to prevent one futile surgery using MRI with DWI, defined as those in which CECT was negative and MRI with DWI was positive for liver metastasis (i.e., surgical intervention in metastatic disease missed by CECT). The secondary outcomes were to determine the diagnostic performance and the NNT of MRI with DWI to change management in pancreatic cancer.ResultsNine studies met the inclusion criteria with a total of 1121 patients, of whom 172 had liver metastasis (15.3%). The proportion of futile surgeries reduced by MRI with DWI was 6.0% (95% CI, 3.0-11.6%), yielding an NNT of 16.6. The proportion of cases that MRI with DWI changed management was 18.1% (95% CI, 9.9-30.7), corresponding to an NNT of 5.5. The per-patient sensitivity and specificity of MRI were 92.4% (95% CI, 87.4-95.6%) and 97.3% (95% CI, 96.0-98.1).ConclusionMRI with DWI may prevent futile surgeries in pancreatic cancer by improving the detection of occult liver metastasis on preoperative CECT with an NNT of 16.6.