WANDERLEY MARQUES BERNARDO

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FMUSP, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/47 - Laboratório de Hepatologia por Vírus, Hospital das Clínicas, Faculdade de Medicina

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  • article 4 Citação(ões) na Scopus
    Accuracy of MRI-guided Versus Systematic Prostate Biopsy in Patients Under Active Surveillance: A Systematic Review and Meta-analysis
    (2021) BACCAGLINI, Willy; GLINA, Felipe A.; PAZETO, Cristiano Linck; MEDINA, Luis G.; KORKES, Fernando; BERNARDO, Wanderley M.; SOTELO, Rene; GLINA, Sidney; MARRA, Giancarlo; MOSCHINI, Marco; CATHELINEAU, Xavier; SANCHEZ-SALAS, Rafael
    This meta-analysis focuses on the accuracy of upgrading to clinically significant prostate cancer (PCa) by multi parametric magnetic resonance imaging-targeted biopsy (MRI-TB) versus systematic biopsy (SB). We searched the Medline, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, and Literatura Latino Americana em Ciencias da Saude databases through January 2020 for comparative, retrospective/prospective, paired-cohort, and randomized clinical trials with paired comparisons. The population consisted of patients with low risk PCa in active surveillance with at least 1 index lesion on imaging. We evaluated the quality of evidence by using the Quality Assessment of Diagnostic Accuracy Studies-2 score. Group comparisons considered the differences between the area under the curve summary receiver operating characteristic curve in a 2-tailed method. We also compared the positive predictive value of the best single method (MRI-TB or SB) and the referral study test (combined biopsy, a combination of MRI-TB and SB). The meta-analysis included 6 studies enrolling 741 patients. The pooled sensitivity for the 2 groups was 0.79 (95% confidence interval, 0.74-0.83; I-2 = 75%) and 0.67 (95% confidence interval, 0.63-0.74; I-2 = 55.4%), respectively. The area under the curve for the MRI-TB and SB groups were 0.99 and 0.92 (P < .001), respectively. The positive predictive value for the MRI-TB and combined biopsy groups were similar. The accumulated evidence suggests better results for MRI-TB compared with SB. Therefore, use of MRI-TB alone may be preferable in patients in active surveillance harboring low-risk PCa.
  • article 4 Citação(ões) na Scopus
    Sulfonylurea for improving neurological features in neonatal diabetes: A systematic review and meta-analyses
    (2022) PASSONE, Caroline de Gouveia Buff; GIANI, Elisa; VAIVRE-DOURET, Laurence; KARIYAWASAM, Dulanjalee; BERDUGO, Marianne; GARCIN, Laure; BELTRAND, Jacques; BERNARDO, Wanderley Marques; POLAK, Michel
    Objective In monogenic diabetes due to KCNJ11 and ABCC8 mutations that impair KATP- channel function, sulfonylureas improve long-term glycemic control. Although KATP channels are extensively expressed in the brain, the effect of sulfonylureas on neurological function has varied widely. We evaluated published evidence about potential effects of sulfonylureas on neurological features, especially epilepsy, cognition, motor function and muscular tone, visuo-motor integration, and attention deficits in children and adults with KCNJ11 and ABCC8-related neonatal-onset diabetes mellitus. Research Design and Methods We conducted a systematic review and meta-analyses of the literature (PROSPERO, CRD42021254782), including individual-patient data, according to PRISMA, using RevMan software. We also graded the level of evidence. Results We selected 34 of 776 publications. The evaluation of global neurological function before and after sulfonylurea (glibenclamide) treatment in 114 patients yielded a risk difference (RD) of 58% (95%CI, 43%-74%; I-2 = 54%) overall and 73% (95%CI, 32%-113%; I-2 = 0%) in the subgroup younger than 4 years; the level of evidence was moderate and high, respectively. EEG studies of epilepsy showed a RD of 56% (95%CI, 23%-89%; I-2 = 34%) in patients with KCNJ11 mutations, with a high quality of evidence. For hypotonia and motor function, the RDs were 90% (95%CI, 69%-111%; I-2 = 0%) and 73% (95%CI, 35%-111%; I-2 = 0%), respectively, with a high level of evidence. Conclusions Glibenclamide significantly improved neurological abnormalities in patients with neonatal-onset diabetes due to KCNJ11 or ABCC8 mutations. Hypotonia was the symptom that responded best. Earlier treatment initiation was associated with greater benefits.
  • article 4 Citação(ões) na Scopus
    mpMRI-targeted biopsy versus systematic biopsy for clinically significant prostate cancer diagnosis: a systematic review and metaanalysis
    (2020) BACCAGLINI, Willy; GLINA, Felipe P. A.; PAZETO, Cristiano L.; BERNARDO, Wanderley M.; SANCHEZ-SALAS, Rafael
    Purpose of review We aimed to compare the accuracy of clinically significant prostate cancer (csPCa) diagnosis by magnetic resonance imaging-targeted biopsy (MRI-TB) versus systematic biopsy (SB) in men suspected of having prostate cancer (PCa). Recent findings In biopsy-naive patients, MRI-TB was more accurate to identify csPCa than SB. However, when comparing specifically MRI-TB versus transperineal (SB), we did not find any difference. Furthermore, in a repeat biopsy scenario, MRI-TB found more csPCa than SB as well. Finally, postanalysis comparing combined biopsy (SB plus MRI-TB) suggests that the later alone may play a role in both scenarios for identifying csPCa. MRI-TB found more csPCa than SB in patients with suspected PCa in both scenarios, naive and repeat biopsies, but more studies comparing those methods are warranted before any recommendation on this topic.
  • article 37 Citação(ões) na Scopus
    Growth hormone treatment in Prader-Willi syndrome patients: systematic review and meta-analysis
    (2020) PASSONE, Caroline de Gouveia Buff; FRANCO, Ruth Rocha; ITO, Simone Sakura; TRINDADE, Evelinda; POLAK, Michel; DAMIANI, Durval; BERNARDO, Wanderley Marques
    Background Growth hormone (GH) treatment is currently recommended in Prader-Willi syndrome (PWS) patients. Objectives To evaluate the impact (efficacy and safety) of the use of recombinant human GH (rhGH) as a treatment for PWS. Method We performed a systematic review and, where possible, meta-analysis for the following outcomes: growth, body mass index, body composition, cognitive function, quality of life, head circumference, motor development/strength, behaviour and adverse effects. We included all PWS patients, with all types of genetic defects and with or without GH deficiency, who participated in rhGH studies performed in infancy, childhood and adolescence, that were either randomised controlled trials (RCTs) (double-blinded or not) or non-randomised controlled trials (NRCTs) (cohort and before and after studies). The databases used were MEDLINE, Embase and Cochrane Central. Results In 16 RCTs and 20 NRCTs selected, the treated group had an improvement in height (1.67 SD scores (SDS); 1.54 to 1.81); body mass index z-scores (-0.67 SDS; -0.87 to -0.47) and fat mass proportion (-6.5% SDS; -8.46 to -4.54) compared with the control group. Data about cognition could not be aggregated. Conclusion Based on high quality evidence, rhGH treatment favoured an improvement of stature, body composition and body mass index, modifying the disease's natural history; rhGH treatment may also be implicated in improved cognition and motor development in PWS patients at a young age. Ethics and dissemination The current review was approved by the ethical committee of our institution. The results will be disseminated through conference presentations and publications in peer-reviewed journals. PROSPERO registration number CRD42019140295