PEDRO MACUL FERREIRA DE BARROS
Projetos de Pesquisa
Unidades Organizacionais
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina
13 resultados
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conferenceObject Pharmacological Interventions for the Treatment of Tourette's Syndrome in Youth: A Systematic Review and Network Meta-Analysis(2022) FARHAT, Luis; BEHLING, Emily; LANDEROS-WEISENBERGER, Angeli; LEVINE, Jessica; BARROS, Pedro Macul Ferreira de; WANG, Ziyu; BLOCH, Michael- Parental Age and the Risk for Alzheimer's Disease in Offspring: Systematic Review and Meta-Analysis(2021) SZEJKO, Natalia; BARROS, Pedro Macul Ferreira de; AVILA-QUINTERO, Victor J.; LOMBROSO, Adam; BLOCH, Michael HowardBackground: Alzheimer's disease (AD) is the most common cause of dementia worldwide, accounting for 50-75% of all cases. While older maternal and paternal age at childbirth are established risk factors for Down syndrome which is associated with later AD, it is still not entirely clear whether parental age is a risk factor for AD. Previous studies have suggested contradictory findings. Objectives: We conducted a systematic review and meta-analysis to examine whether parental (maternal and paternal) age at birth was associated with AD and whether individuals born to younger or older parents were at an increased risk for AD. Methods: Two reviewers searched the electronic database of PubMed for relevant studies. Eligibility for the meta-analysis was based on the following criteria: (1) studies involving patients with AD and an adequate control group, (2) case control or cohort studies, (3) studies investigating parental age. All statistical analyses were completed in STATA/IC version 16. Results:Eleven studies involving 4,371 participants were included in the systematic review and meta-analysis. Meta-analysis demonstrated no significant association between maternal (weighted mean difference [WMD] 0.49, 95% CI -0.52 to 1.49, p = 0.34) and paternal age and AD (WMD 1.00, 95% CI -0.55 to 2.56, p = 0.21). Similarly, individuals born to younger (<25 years) or older parents (>35 years) did not demonstrate a differential risk for AD. Conclusions: Overall, this meta-analysis did not demonstrate an association between parental age and the risk of AD in offspring. These findings should be interpreted with caution given the limited power of the overall meta-analysis and the methodological limitations of the underlying studies as in many cases no adjustment for potential confounders was included. (c) 2021 The Author(s) Published by S. Karger AG, Basel
- Parental age and the risk of bipolar disorder in the offspring: A systematic review and meta-analysis(2022) POLGA, Natalia; BARROS, Pedro Macul Ferreira de; FARHAT, Luis C.; ALMEIDA, Karla Mathias de; BLOCH, Michael H.; LAFER, BenyObjectives Whether parental age, i.e., paternal or maternal, at childbirth is associated with the risk of bipolar disorder (BD) in offspring remains unclear. We conducted a meta-analysis of observational studies to address this gap. Methods PubMed, PsycINFO, Embase, and Web of Science were searched up to June 2021. Studies investigating the associations between parental age at childbirth (exposure) and the risk of BD in offspring (outcome) were eligible for inclusion in our study. Paternal and maternal age were examined separately. Odds ratio (OR) was used as the effect size index. Data were pooled through random-effects meta-analyses. Results Seven studies involving 3,183,539 participants and 23,253 individuals with BD were included in our meta-analyses. Meta-analyses indicated an increased risk of BD in the offspring of the older paternal age groups (35-44 years old [k = 5; OR = 1.09; 95% CI 1.05, 1.14; p < 0.0001] and >= 45 years old [k = 5; OR = 1.44; 95% CI 1.19, 1.14; p = 0.0001]) in comparison with the reference category (25-34 years old). Meta-analysis also indicated an increased risk of BD in the offspring of the older maternal age group (>= 40 years old [k = 3; OR = 1.20; 95% CI 1.10, 1.31; p < 0.0001]) in comparison with the reference category (20-29 years old). Conclusions Advanced paternal and maternal age were both associated with an increased risk of BD in offspring. Further studies are needed to investigate the mechanisms behind this association.
- Comparative efficacy, tolerability, and acceptability of pharmacological interventions for the treatment of children, adolescents, and young adults with Tourette?s syndrome: a systematic review and network meta-analysis(2023) FARHAT, Luis C.; BEHLING, Emily; LANDEROS-WEISENBERGER, Angeli; LEVINE, Jessica L. S.; BARROS, Pedro Macul Ferreira de; WANG, Ziyu; BLOCH, Michael H.Background In clinical practice guidelines there is no consensus about the medications that should be initially offered to children and young people with Tourette's syndrome. To provide a rigorous evidence base that could help guide decision making and guideline development, we aimed to compare the efficacy, tolerability, and acceptability of pharmacological interventions for Tourette's syndrome. Methods For this systematic review and network meta-analysis, we searched the Cochrane Central Register of Controlled Trials, Embase, PsycINFO, PubMed, Web of Science, the WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov, for published and unpublished studies from database inception to Nov 19, 2021. We included double-blind randomised controlled trials of any medication administered as a monotherapy for at least 1 week against another medication or placebo in children and adolescents (aged =4 years and =18 years), adults (>18 years), or both, diagnosed with Tourette's syndrome according to standardised criteria. We excluded studies that exclusively recruited participants with comorbid attention-deficit hyperactivity disorder or obsessive-compulsive disorder. The primary outcome was change in severity of tic symptoms (efficacy). Secondary outcomes were treatment discontinuations due to adverse events (tolerability) and for any reason (acceptability). Pharmacological interventions were examined considering medication categories and medications individually in separate analyses. Summary data were extracted and pooled with a random-effects network meta-analysis to calculate standardised mean differences for efficacy and odds ratios for tolerability and acceptability, with 95% CIs. The Confidence in Network Meta-Analysis (CINeMA) framework was used to assess the certainty of evidence. The protocol was pre-registered in PROSPERO (CRD42022296975). Findings Of the 12 088 records identified through the database search, 88 records representing 39 randomised controlled trials were included in the network meta-analysis; these 39 randomised controlled trials comprised 4578 partici-pants (mean age 11 center dot 8 [SD 4 center dot 5] years; 3676 [80 center dot 8%] male participants) and evaluated 23 individual medications distributed across six medication categories. When considering medication categories, first-generation (standardised mean difference [SMD] -0 center dot 65 [95% CI -0 center dot 79 to -0 center dot 51]; low certainty of evidence) and second-generation (-0 center dot 71 [-0 center dot 88 to -0 center dot 54]; moderate certainty of evidence) antipsychotic drugs, as well as a-2 agonists (-0 center dot 21 [-0 center dot 39 to -0 center dot 03]; moderate certainty of evidence), were more efficacious than placebo. First-generation and second-generation antipsychotic drugs did not differ from each other (SMD 0 center dot 06 [95% CI -0 center dot 14 to 0 center dot 25]; low certainty of evidence). However, both first-generation (SMD 0 center dot 44 [95% CI 0 center dot 21 to 0 center dot 66]) and second-generation (0 center dot 49 [0 center dot 25 to 0 center dot 74]) antipsychotic drugs outperformed a-2 agonists, with moderate certainty of evidence. Similar findings were observed when individual medications were considered: aripiprazole (SMD -0 center dot 60 [95% CI -0 center dot 83 to -0 center dot 38]), haloperidol (-0 center dot 51 [-0 center dot 88 to -0 center dot 14]), olanzapine (-0 center dot 83 [-1 center dot 49 to -0 center dot 18]), pimozide (-0 center dot 48 [-0 center dot 84 to -0 center dot 12]), risperidone (-0 center dot 66 [-0 center dot 98 to -0 center dot 34]), and clonidine (-0 center dot 20 [-0 center dot 37 to -0 center dot 02]) all outperformed placebo, with moderate certainty of evidence. Antipsychotic medications did not differ from each other, but there was low to very low certainty of evidence for these comparisons. However, aripiprazole (SMD -0 center dot 40 [95% CI -0 center dot 69 to -0 center dot 12]) and risperidone (-0 center dot 46 [-0 center dot 82 to -0 center dot 11]) outperformed clonidine, with moderate certainty of evidence. Heterogeneity or inconsistency only emerged for a few comparisons. In terms of tolerability and acceptability, there were no relevant findings for any of the efficacious medication categories or individual medications against each other or placebo, but there was low to very low certainty of evidence associated with these comparisons. Interpretation Our analyses show that antipsychotic drugs are the most efficacious intervention for Tourette's syndrome, while a-2 agonists are also more efficacious than placebo and could be chosen by those who elect not to take antipsychotic drugs. Shared decision making about the degree of tic-related severity and distress or impairment, the trade-offs of efficacy and safety between antipsychotic drugs and a-2 agonists, and other highly relevant individual factors that could not be addressed in the present analysis, should guide the choice of medication for children and young people with Tourette's syndrome.
conferenceObject Inhibitors of vesicular monoamine transporter type 2 (VMAT2) and the risk of anxiety and depression: meta-analysis(2022) SZEJKO, N.; CUENOD, M.; BARROS, P. Macul Ferreira de; ARTUKOGLU, B.; FLORES, J.; NASIR, M.; BLOCH, M.conferenceObject CHARACTERISTICS OF TICS IN FOLLOW-UP STUDY OF COMMUNITY-BASED HIGH RISK COHORT OF 2511 CHILDREN(2023) SZEJKO, N.; BARROS, P. Macul Ferreira de; PANCZYK, M.; PAN, P. M.; ALVARENGA, P. Gomez de; HOEXTRA, M.; TIMPANO, K.; LECKMAN, J.; MIGUEL, E.- Assessing the impact of engineered nanoparticles on wound healing using a novel in vitro bioassay(2014) ZHOU, Enhua H.; WATSON, Christa; PIZZO, Richard; COHEN, Joel; Quynh Dang; BARROS, Pedro Macul Ferreira de; PARK, Chan Young; CHEN, Cheng; BRAIN, Joseph D.; BUTLER, James P.; RUBERTI, Jeffrey W.; FREDBERG, Jeffrey J.; DEMOKRITOU, PhilipAim: As engineered nanoparticles (ENPs) increasingly enter consumer products, humans become increasingly exposed. The first line of defense against ENPs is the epithelium, the integrity of which can be compromised by wounds induced by trauma, infection, or surgery, but the implications of ENPs on wound healing are poorly understood. Materials & methods: Herein, we developed an in vitro assay to assess the impact of ENPs on the wound healing of cells from human cornea. Results & discussion: We show that industrially relevant ENPs impeded wound healing and cellular migration in a manner dependent on the composition, dose and size of the ENPs as well as cell type. CuO and ZnO ENPs impeded both viability and wound healing for both fibroblasts and epithelial cells. Carboxylated polystyrene ENPs retarded wound healing of corneal fibroblasts without affecting viability. Conclusion: Our results highlight the impact of ENPs on cellular wound healing and provide useful tools for studying the physiological impact of ENPs.
- Obsessive-Compulsive Symptoms, Polygenic Risk Score, and Thalamic Development in Children From the Brazilian High-Risk Cohort for Mental Conditions (BHRCS)(2021) SALTO, Ana Beatriz Ravagnani; SANTORO, Marcos L.; HOEXTER, Marcelo Q.; JACKOWSKI, Andrea Parolin; PAN, Pedro M.; ROSARIO, Maria Conceicao; I, Sintia Belangero; ALVARENGA, Pedro Gomes; DORETTO, Victoria Fogaca; FUMO, Afonso Mazine Tiago; BATISTUZZO, Marcelo C.; BARROS, Pedro Macul Ferreira de; TIMPANO, Kiara R.; OTA, Vanessa K.; ROHDE, Luis Augusto; MIGUEL, Euripedes Constantino; LECKMAN, James F.; ZUGMAN, AndreBackground: Thalamic volume measures have been linked to obsessive-compulsive disorder (OCD) in children and adolescents. However, it is unclear if alterations in thalamic volumes occur before or after symptom onset and if there is a relation to the presence of sub-clinical obsessive-compulsive symptoms (OCS). Here, we explore the relationship between OCS and the rate of thalamic volume change in a cohort of children and youth at high risk to develop a mental disorder. A secondary aim was to determine if there is a relationship between OCS and the individual's OCD polygenic risk score (OCD-PRS) and between the rate of thalamic volume change and the OCD-PRS. Methods: The sample included 378 children enrolled in the longitudinal Brazilian High-Risk Cohort for Mental Conditions. Participants were assessed for OCS and the symmetrized percent change (SPC) of thalamic volume across two time-points separated by 3 years, along with the OCD-PRS. Zero-altered negative binomial models were used to analyze the relationship between OCS and thalamic SPC. Multiple linear regressions were used to examine the relationship between thalamic SPC and OCD-PRS. Results: A significant relationship between OCS and the right thalamus SPC (p = 0.042) was found. There was no significant relationship between changes in thalamic volume SPC and OCD-PRS. Conclusions: The findings suggest that changes in the right thalamic volume over the course of 3 years in children may be associated to OCS. Future studies are needed to confirm these results and further characterize the specific nature of OCS symptoms associated with thalamic volumes.
conferenceObject Pharmacological Interventions for the Treatment of Tourette's Syndrome in Youth: A Systematic Review and Network Meta-Analysis(2022) FARHAT, Luis; BEHLING, Emily; LANDEROS-WEISENBERGER, Angeli; LEVINE, Jessica; BARROS, Pedro Macul Ferreira de; WANG, Ziyu; BLOCH, Michael- Family accommodation mediates the impact of childhood anxiety on functional impairment(2020) BARROS, Pedro Macul Ferreira de; POLGA, Natalia; SZEJKO, Natalia; MIGUEL, Euripedes Constantino; LECKMAN, James Frederick; SILVERMAN, Wendy K.; LEBOWITZ, Eli R.Background: Anxiety disorders are the most common childhood-onset psychiatric disorders and are extensively associated with child functional impairment. Data suggest that family accommodation plays a role in the association between anxiety severity and functional impairment in children, but more empirical evidence is needed. Methods: Participants were 425 clinically anxious children (ages 6-17 years), and their mothers. We first examined associations between child anxiety symptom severity, family accommodation, and child functional impairment. Next, we investigated the hypothesized mediation pathway linking anxiety severity to child impairment through increased family accommodation using structural equation modeling. We tested two models: one using parent ratings of their child's anxiety and the other using the child's self-ratings. Finally, we estimated the effect sizes of the mediation pathway in both models. Results: Family accommodation was significantly correlated with all the study variables. Child functional impairment was significantly correlated with parent-rated and self-rated child anxiety severity. Both structural equation models provided excellent fit for the data and supported the theoretical model by which family accommodation significantly explains part of the association between anxiety symptoms and functional impairment. The indirect effect sizes indicate that family accommodation accounts for between a fifth and a half of the impairment associated with symptom severity. Conclusions: The data provide important empirical evidence that family accommodation mediates the association between child anxiety and functional impairment and accounts for up to 50 % of this association. These findings contribute to the growing understanding of the critical role of family accommodation and underscore the importance of assessing accommodation when evaluating and treating anxious children.