RICARDO GHELMAN
Índice h a partir de 2011
4
Projetos de Pesquisa
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LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina
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bookPart Pediatria integrativa(2021) GHELMAN, Ricardo; PEREIRA, Priscilla Araújo Duprat de Britto; MEIRA, Lara Vieira da Silva- A twelve-week, four-arm, randomized, double-blind, placebo-controlled, phase 2 prospective clinical trial to evaluate the efficacy and safety of an anthroposophic multimodal treatment on chronic pain in outpatients with postpolio syndrome(2020) GHELMAN, Ricardo; AKIYAMA, Ivete Y.; SOUZA, Valeria T. de; FALCAO, Jussara; ORGOLINI, Vera; HOSOMI, Jorge K.; QUADROS, Abrahao A. J.; OLIVEIRA, Acary S. B.Introduction Chronic pain and fatigue are the main symptoms of postpoliomyelitis syndrome (PPS). This study aimed to evaluate the efficacy and safety of an anthroposophic multimodal treatment for chronic pain in PPS outpatients. Methods A twelve-week, four-arm, randomized, double-blind, placebo-controlled, phase 2 prospective clinical trial was designed to compare four groups (n = 48): groups A and B received daily active experimental transdermal gel (ETG) or placebo gel (PTG), respectively; groups C and D received weekly external therapies, art therapies, and neurofunctional reorganization, plus either daily ETG or PTG, respectively. The pain symptoms were evaluated through a visual analogue scale (VAS), the McGill questionnaire, and thermography. Quality of life and resilience were evaluated by the WHOQOL-BREF and Antonovsky sense of coherence questionnaires applied at baseline and after the interventions. Results No related adverse events occurred, and 10% of the patients reports dysphagia improvement. In the groups C and D, pain reduction was statistically significant in both the placebo group (p = .02, d = 1.315) and in the ETG (p = .005, d = 2.035). However, following the week-to-week evolution of pain with the concomitant use of the ETG, this significant pain reduction occurred earlier from the 4th week and continued to decrease (p = .016, d = 1.369). In the group that received the complete multimodal treatment, the greatest significant benefit in increasing quality of life occurred in the physical domain and elevation in resilience with an emphasis on meaning and comprehension domains. Conclusions The anthroposophic multimodal treatment group presented both safety and efficacy as an analgesic in the groups that received the nonpharmacological therapies, much earlier when associated with the ETG. The multimodal approach corresponded to the pattern of better efficacy for both pain reduction and improvement in quality of life and resilience.
bookPart Medicamentos dinamizados(2021) QUARESMA, Carla Holandino; BATISTA, João Vitor da Costa; OLIVEIRA, Adriana Passos; VIRIATO, Ezequiel Paulo; MORERA, Marcelo Camilo; GHELMAN, Ricardo; ROCHA, Leandro MachadobookPart Panorama global da pesquisa em medicina e saúde integrativa(2021) GHELMAN, Ricardo; SCHVEITZER, Mariana Cabral; ABDALA, Carmen Verônica Mendes; NUNES, Gelza Matos; PORTELLA, Caio Fábio Schlechta- The Sao Paulo agreement on integrative pediatrics: A consensus-based document fostering integrative health of children and adolescents globally(2021) GHELMAN, Ricardo; SIBINGA, Erica Maria Smit; SCHOEN-ANGERER, Tido von; VAGEDES, Jan; SEIFERT, Georg
- 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, DongwoonBackground: 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.
- Beyond the Standard of Care: An Exploratory Qualitative Study of an Implemented Integrative Therapeutic Care Program in a Brazilian Pediatric Oncology Unit(2021) TROENDLE, Marc; STRITTER, Wiebke; ODONE, Vicente; PERON, Karina; GHELMAN, Ricardo; SEIFERT, GeorgIntroduction: This article examines the feedback of health care providers within the implementation of an integrative care project in a clinic for pediatric oncology in Sao Paulo, Brazil. Since 2017, the project has implemented external anthroposophic therapies in the activities of daily nursing. The objective is to evaluate how the project evolved and what impact it had on the daily operation of the hospital. A special focus emphasizes the perspective of study nurses. Materials and Methods: Twelve qualitative semistructured interviews were conducted. Audio files were transcribed, translated to German, and underwent a MAXQDA software-assisted analysis. Using a thematic approach, coherent cross-case topics were defined. Results: Three main topics emerged from analysis of the data. (1) The implementation and its effects on daily patient care demonstrated positive outcomes in patients and were well accepted with minimal changes in daily activities. (2) The perspective of study nurses showed a large motivation due to beneficial and stress-relieving effects of the application and a growing patient-health care provider relationship. (3) Problems and aspirations for improvement were the lack of time and the urge to make the project grow in the future. Conclusion: Not only patients but also health care providers seem to benefit from integrative methods. They have the potential to improve the working atmosphere and to strengthen relations between patients, caregivers, and family members. General feedback was positive and acceptance in the team arose over time when beneficial effects became visible.
conferenceObject Discovering Resources Beyond the Standard of Care - Impact of an integrative care program for children with cancer in Brazil(2021) MARC, Troendle; WIEBKE, Stritter; VICENTE, Odone; KARINA, Peron; RICARDO, Ghelman; GEORG, Seifert- Integrative oncology: Addressing the global challenges of cancer prevention and treatment(2022) MAO, Jun J.; PILLAI, Geetha Gopalakrishna; ANDRADE, Carlos Jose; LIGIBEL, Jennifer A.; BASU, Partha; COHEN, Lorenzo; KHAN, Ikhlas A.; MUSTIAN, Karen M.; PUTHIYEDATH, Rammanohar; DHIMAN, Kartar Singh; LAO, Lixing; GHELMAN, Ricardo; GUIDO, Paulo Caceres; LOPEZ, Gabriel; GALLEGO-PEREZ, Daniel F.; SALICRUP, Luis AlejandroThe increase in cancer incidence and mortality is challenging current cancer care delivery globally, disproportionally affecting low- and middle-income countries (LMICs) when it comes to receiving evidence-based cancer prevention, treatment, and palliative and survivorship care. Patients in LMICs often rely on traditional, complementary, and integrative medicine (TCIM) that is more familiar, less costly, and widely available. However, spheres of influence and tensions between conventional medicine and TCIM can further disrupt efforts in evidence-based cancer care. Integrative oncology provides a framework to research and integrate safe, effective TCIM alongside conventional cancer treatment and can help bridge health care gaps in delivering evidence-informed, patient-centered care. This growing field uses lifestyle modifications, mind and body therapies (eg, acupuncture, massage, meditation, and yoga), and natural products to improve symptom management and quality of life among patients with cancer. On the basis of this review of the global challenges of cancer control and the current status of integrative oncology, the authors recommend: 1) educating and integrating TCIM providers into the cancer control workforce to promote risk reduction and culturally salient healthy life styles; 2) developing and testing TCIM interventions to address cancer symptoms or treatment-related adverse effects (eg, pain, insomnia, fatigue); and 3) disseminating and implementing evidence-based TCIM interventions as part of comprehensive palliative and survivorship care so patients from all cultures can live with or beyond cancer with respect, dignity, and vitality. With conventional medicine and TCIM united under a cohesive framework, integrative oncology may provide citizens of the world with access to safe, effective, evidence-informed, and culturally sensitive cancer care.
bookPart Medicina antroposófica(2021) GHELMAN, Ricardo; BENEVIDES, Iracema de Almeida; HOSOMI, Jorge Kioshi