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Bruno Hochhegger, Edson Marchiori, Matheus Zanon, Adalberto Sperb Rubin, Renata Fragomeni, Stephan Altmayer, Carlos Roberto Ribeiro Carvalho, Bruno Guedes Baldi
Idiopathic pulmonary fibrosis is a chronic disease of unknown etiology that usually has a progressive course and is commonly associated with a poor prognosis. The main symptoms of idiopathic pulmonary fibrosis, including progressive dyspnea and dry cough, are often nonspecific. Chest high-resolution computed tomography is the primary modality used in the initial assessment of patients with suspected idiopathic pulmonary fibrosis and may have considerable influence on subsequent management decisions. The main role of computed tomography is to distinguish chronic fibrosing lung diseases with a usual interstitial pneumonia pattern from those presenting with a non-usual interstitial pneumonia pattern, suggesting an alternative diagnosis when possible...
February 4, 2019: Clinics
Roger Chammas, Joyce Chacon Fernandes, Paulo Marcelo Gehm Hoff
No abstract text is available yet for this article.
February 4, 2019: Clinics
Fernanda Antunes, Adolfo Garcia Erustes, Angélica Jardim Costa, Ana Carolina Nascimento, Claudia Bincoletto, Rodrigo Portes Ureshino, Gustavo José Silva Pereira, Soraya Soubhi Smaili
Cancer is a leading cause of death worldwide, and its incidence is continually increasing. Although anticancer therapy has improved significantly, it still has limited efficacy for tumor eradication and is highly toxic to healthy cells. Thus, novel therapeutic strategies to improve chemotherapy, radiotherapy and targeted therapy are an important goal in cancer research. Macroautophagy (herein referred to as autophagy) is a conserved lysosomal degradation pathway for the intracellular recycling of macromolecules and clearance of damaged organelles and misfolded proteins to ensure cellular homeostasis...
December 10, 2018: Clinics
Carlos Roberto Koscky Paier, Sarah Sant'Anna Maranhão, Teiliane Rodrigues Carneiro, Lídia Moreira Lima, Danilo Damasceno Rocha, Renan da Silva Santos, Kaio Moraes de Farias, Manoel Odorico de Moraes-Filho, Claudia Pessoa
Cell cycle control genes are frequently mutated in cancer cells, which usually display higher rates of proliferation than normal cells. Dysregulated mitosis leads to genomic instability, which contributes to tumor progression and aggressiveness. Many drugs that disrupt mitosis have been studied because they induce cell cycle arrest and tumor cell death. These antitumor compounds are referred to as antimitotics. Vinca alkaloids and taxanes are natural products that target microtubules and inhibit mitosis, and their derivatives are among the most commonly used drugs in cancer therapy worldwide...
December 10, 2018: Clinics
Madson Q Almeida, Joao Evangelista Bezerra-Neto, Berenice B Mendonça, Ana Claudia Latronico, Maria Candida B V Fragoso
Malignancy must be considered in the management of adrenal lesions, including those incidentally identified on imaging studies. Adrenocortical carcinomas (ACCs) are rare tumors with an estimated annual incidence of 0.7-2 cases per year and a worldwide prevalence of 4-12 cases per million/year. However, a much higher incidence of these tumors (>15 times) has been demonstrated in south and southeastern Brazil. Most ACCs cause hypersecretion of steroids including glucocorticoids and androgens. ACC patients have a very poor prognosis with a 5-year overall survival (OS) below 30% in most series...
December 10, 2018: Clinics
Heloisa de Andrade Carvalho, Rosangela Correa Villar
Technological developments have allowed improvements in radiotherapy delivery, with higher precision and better sparing of normal tissue. For many years, it has been well known that ionizing radiation has not only local action but also systemic effects by triggering many molecular signaling pathways. There is still a lack of knowledge of this issue. This review focuses on the current literature about the effects of ionizing radiation on the immune system, either suppressing or stimulating the host reactions against the tumor, and the factors that interact with these responses, such as the radiation dose and dose / fraction effects in the tumor microenvironment and vasculature...
December 10, 2018: Clinics
Marco Aurélio V Kulcsar, Natasha Sobreira Canovas, Vergilius Jose Furtado de Araujo-Neto, Jorge Du Ub Kim, Claudio Roberto Cernea
No abstract text is available yet for this article.
December 10, 2018: Clinics
Gabriela Ávila Fernandes Silva, Rafaella Almeida Lima Nunes, Mirian Galliote Morale, Enrique Boccardo, Francisco Aguayo, Lara Termini
Oxidative stress results from an imbalance between the generation and elimination of oxidant species. This condition may result in DNA, RNA and protein damage, leading to the accumulation of genetic alterations that can favor malignant transformation. Persistent infection with high-risk human papillomavirus types is associated with inflammatory responses and reactive oxygen species production. In this context, oxidative stress, chronic inflammation and high-risk human papillomavirus can act in a synergistic manner...
December 10, 2018: Clinics
Marcus Fernando Kodama Pertille Ramos, Marina Alessandra Pereira, Osmar Kenji Yagi, Andre Roncon Dias, Amir Zeide Charruf, Rodrigo Jose de Oliveira, Evelise Pelegrinelli Zaidan, Bruno Zilberstein, Ulysses Ribeiro-Júnior, Ivan Cecconello
OBJECTIVES: Surgery remains the cornerstone treatment modality for gastric cancer, the fifth most common type of tumor in Brazil. The aim of this study was to analyze the surgical treatment outcomes of patients with gastric cancer who were referred to a high-volume university hospital. METHODS: We reviewed all consecutive patients who underwent any surgical procedure due to gastric cancer from a prospectively collected database. Clinicopathological characteristics, surgical and survival outcomes were evaluated, with emphasis on patients treated with curative intent...
December 10, 2018: Clinics
Alessandro Gonçalves Campolina
Recently, professional and healthcare-related entities have launched frameworks designed to assess the value of cancer innovations in multistakeholder decision processes. Among the most visible entities that propose and implement value frameworks in oncology are the European Society of Medical Oncology (ESMO), the American Society of Clinical Oncology (ASCO), the Memorial Sloan Kettering Cancer Center (MSKCC) and the National Comprehensive Cancer Network (NCCN). However, these value frameworks have been criticized for conceptual inconsistencies, inability to include a greater variety of value criteria, and inadequate explanation of the uncertainty approach used in the modeling process...
December 10, 2018: Clinics
Alexandre Cavalcante, Públio Cesar C Viana, Giuliano B Guglielmetti, José Pontes Junior, Henrique Nonemacher, Mauricio D Cordeiro, Regis Otaviano F Bezerra, Rafael F Coelho, William Carlos Nahas
No abstract text is available yet for this article.
December 10, 2018: Clinics
Gustavo Rosa Gameiro, Viktor Sinkunas, Gabriel Romero Liguori, José Otavio Costa Auler-Júnior
Health care has changed since the decline in mortality caused by infectious diseases as well as chronic and non-contagious diseases, with a direct impact on the cost of public health and individual health care. We must now transition from traditional reactive medicine based on symptoms, diagnosis and treatment to a system that targets the disease before it occurs and, if it cannot be avoided, treats the disease in a personalized manner. Precision Medicine is that new way of thinking about medicine. In this paper, we performed a thorough review of the literature to present an updated review on the subject, discussing the impact of the use of genetics and genomics in the care process as well as medical education, clinical research and ethical issues...
December 3, 2018: Clinics
Alexandre Viana Frascino, Marcelo Fava, Louise Cominato, Vicente Odone-Filho
The aim of this study was to provide an updated review of dental procedures undertaken at the dental unit of the Onco-hematology service of the Instituto da Criança at the Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (ICr/HC-FMUSP). We retrospectively reviewed 565 of 1902 medical and dental records of patients diagnosed with onco-hematological diseases who were seen in a 3-year study (January 2015 to December 2017). We assessed data regarding population characteristics, onco-hematological diagnosis and dental procedures performed...
December 3, 2018: Clinics
Beibei Wang, Haoyu Wang, Peiquan Li, Liangliang Wang, Hongli Liu, Jingbo Liu, Lihua Wang
OBJECTIVE: This study investigated serum interleukin-10 (IL-10) levels, changes in peripheral blood CD4+CD25+ regulatory T cell (PBCDT) ratios, and the prognosis of cervical cancer (CC) patients. METHODS: Seventy patients with CC composed the observation group, and 70 healthy subjects composed the control group. The PBCDT ratios in the CC patients and healthy subjects were calculated. Serum IL-10 levels were detected with a double antibody sandwich enzyme-linked immunosorbent assay (ELISA)...
December 3, 2018: Clinics
Raphael R Pratali, Mohamed A Nasreddine, Bassel Diebo, Carlos Eduardo A S Oliveira, Virginie Lafage
OBJECTIVES: The purpose of this study is to investigate the normal values of and chain of correlations between spinopelvic parameters in a Brazilian population. METHODS: This is a prospective observational study including asymptomatic adult subjects who had full spinal radiographs performed. The subjects were stratified by age into 3 groups (18-39 years old, 40-59 years old, and >60 years old), and radiographic parameters were compared across age groups and gender using ANOVA and Student's t-test, respectively...
December 3, 2018: Clinics
Marcela Rosana Maia da Silveira, Ana Karina Lima Buriti, Ana Maria Martins, Daniela Gil, Marisa Frasson de Azevedo
OBJECTIVES: To characterize the audiometric evaluation and acoustic immittance measures in different types of mucopolysaccharidosis. METHOD: Fifty-three mucopolysaccharidosis patients were evaluated. The classification consisted of type I (Hurler syndrome, Hurler-Scheie and Scheie syndrome), type II (Hunter syndrome), type III (Sanfilippo syndrome), type IV (Morquio syndrome), and type VI (Maroteaux-Lamy syndrome). Immittance audiometry and play or conventional threshold tone audiometry were used to obtain auditory thresholds and were chosen according to the patient's chronological age and ability to understand/respond to the procedure...
December 3, 2018: Clinics
Jiangying Kong, Zhuo Liu, Feng Cai, Xiaocheng Xu, Jun LiuI
OBJECTIVES: To study the relationship between the Asp1104His polymorphism of the nucleotide excision repair gene ERCC5 and treatment sensitivity to oxaliplatin in patients with advanced colorectal cancer (CRC) in China. METHODS: A group of 226 patients in the Department of Gastrointestinal Oncology at Zhejiang Xiaoshan Hospital from July 2011∼December 2016 and a control group of 226 normal healthy individuals were involved in this study. All patients were first diagnosed with advanced CRC and were treated with oxaliplatin-based chemotherapy...
December 3, 2018: Clinics
Maria Clara Ponce, Alessandro Rozim Zorzi, João Batista de Miranda, Eliane Maria Ingrid Amstalden
OBJECTIVE: This study aimed to develop a new histological scoring system for use in a partial-thickness cartilage repair animal model. Although previous papers have investigated the regeneration of articular cartilage, the good results achieved in small animals have not been replicated in large animal models or humans, possibly because of the frequent use of models with perforation of the subchondral bone plates. Partial-thickness lesions spare the subchondral bone, and this pattern is the most frequent in humans; therefore, new therapies should be tested using this model...
November 29, 2018: Clinics
Zhengming Yang, Huimin Tao, Zhaoming Ye, Xin Huang, Nong Lin, Minfei Yang
OBJECTIVES: To investigate the diagnosis and treatment of tibial intercondylar chondroblastoma. METHODS: We retrospectively analyzed the diagnosis and treatment of 12 patients with tibial intercondylar chondroblastoma admitted to the orthopedics department from May 2011 to February 2016; among them were 4 males and 3 females aged 10-19 years, with an average age of 15.7 years. Tibial intercondylar chondroblastoma was on the left and right side in 7 and 5 cases, respectively...
November 29, 2018: Clinics
Jennifer Yohanna Ferreira de Lima Antão, Acary Souza Bulle Oliveira, Renata Thaís de Almeida Barbosa, Tânia Brusque Crocetta, Regiani Guarnieri, Claudia Arab, Thaís Massetti, Thaiany Pedrozo Campos Antunes, Alan Patrício da Silva, Ĺtalla Maria Pinheiro Bezerra, Carlos Bandeira de Mello Monteiro, Luiz Carlos de Abreu
New technologies designed to improve the communication of autistic children can also help to promote interaction processes and cognitive and social development. The aim of this study was to analyze the instruments used to improve the communication skills of children with autism spectrum disorder. We searched the PubMed and Web of Science databases using the descriptors "autism", "Asperger", "education", "children" and "assistive technology" and selected articles that met the following inclusion criteria: (i) original research; (ii) written in English; (iii) based on participants with a primary diagnosis of autism spectrum disorder; and (iv) tested an instrument designed to promote communication in children with autism spectrum disorder...
November 29, 2018: Clinics
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