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Risk factors for the prognosis of pediatric medulloblastoma: a retrospective analysis of 40 cases
OBJECTIVES: To evaluate the influence of secondhand cigarette smoke exposure on longitudinal growth of the tibia of growing rats and some parameters of bone quality. METHODS: Forty female rats were randomly divided into four groups: control: rats were sham exposed; 30 days: rats were exposed to tobacco smoke for 30 days; 45 days: rats were exposed to tobacco smoke for 45 days; and 60 days: rats were exposed to tobacco smoke for 60 days. Blood samples were collected to evaluate the levels of cotinine and alkaline phosphatase. Both tibias were dissected and weighed; the lengths were measured, and the bones were then stored i...
Source: Clinics - January 9, 2018 Category: General Medicine Source Type: research

Second hand tobacco smoke adversely affects the bone of immature rats
OBJECTIVES: To evaluate the influence of secondhand cigarette smoke exposure on longitudinal growth of the tibia of growing rats and some parameters of bone quality. METHODS: Forty female rats were randomly divided into four groups: control: rats were sham exposed; 30 days: rats were exposed to tobacco smoke for 30 days; 45 days: rats were exposed to tobacco smoke for 45 days; and 60 days: rats were exposed to tobacco smoke for 60 days. Blood samples were collected to evaluate the levels of cotinine and alkaline phosphatase. Both tibias were dissected and weighed; the lengths were measured, and the bones were then stored i...
Source: Clinics - January 9, 2018 Category: General Medicine Source Type: research

Experimental implantation of an arterial substitute made of silicone reinforced with polyester fabric in rabbits
CONCLUSIONS: We concluded that polydimethylsiloxane has limited potential as an alternative material for small vascular prostheses. (Source: Clinics)
Source: Clinics - January 9, 2018 Category: General Medicine Source Type: research

Evaluation of the efficacy and safety of endovascular management for transplant renal artery stenosis
CONCLUSION: Angioplasty with stent placement for the treatment of transplant renal artery stenosis is a safe and effective technique with good results in both the short and long term. (Source: Clinics)
Source: Clinics - January 9, 2018 Category: General Medicine Source Type: research

Characteristics and Outcomes of Intensive Care Unit Survivors: Experience of a Multidisciplinary Outpatient Clinic in a Teaching Hospital
CONCLUSIONS: A significant number of intensive care unit survivors evaluated 3 months after discharge had psychological, respiratory, motor, and socioeconomic problems; these findings highlight that strategies aimed to assist critically ill patients should be extended to the post-hospitalization period and that this problem is particularly important in low-income populations. (Source: Clinics)
Source: Clinics - January 9, 2018 Category: General Medicine Source Type: research

Pain and quality of life in breast cancer patients
OBJECTIVE: To evaluate the influence of pain on quality of life in breast cancer patients. METHODS: A cross-sectional study of 400 patients, including 118 without metastasis, 160 with loco-regional metastasis and 122 with distant metastasis. The instruments used were the European Organization for Research and Treatment for Cancer Quality of Life Questionnaire-Core 30 and the Breast Cancer-specific 23 and short McGill Pain Questionnaire. RESULTS: In total, 71.7% of patients reported pain. The most frequent sensory descriptor used by patients was ‘ jumping. ’ In the evaluative dimension, the main descriptor chose...
Source: Clinics - January 9, 2018 Category: General Medicine Source Type: research

Microcirculation improvement after short-term infusion of vasopressin in septic shock is dependent on noradrenaline
CONCLUSIONS: In patients with septic shock for no longer than 48 h, administration of vasopressin is likely to result in an improvement in microcirculation when the baseline noradrenaline dose is higher than 0.38 mcg/kg/min. (Source: Clinics)
Source: Clinics - January 9, 2018 Category: General Medicine Source Type: research

Depression and adherence to antiretroviral treatment in HIV-positive men in São Paulo, the largest city in South America: Social and psychological implications
CONCLUSION S: Individuals with low adherence rates have proportionally higher depression rates. Depressed men tend to show less adherence to treatment. Black but not mixed race or white men show less adherence to Highly Active Antiretroviral Therapy and have a greater chance of developing depression, which dir ectly interferes with adherence. The chances of developing depression are four times greater for a patient with non-adherent behavior than for a patient with adherent behavior. (Source: Clinics)
Source: Clinics - January 9, 2018 Category: General Medicine Source Type: research

A new low-cost negative-pressure wound therapy versus a commercially available therapy device widely used to treat complex traumatic injuries: a prospective, randomized, non-inferiority trial
CONCLUSIONS: For treating complex traumatic injuries, USP was non-inferior to and less expensive than VAC. (Source: Clinics)
Source: Clinics - January 9, 2018 Category: General Medicine Source Type: research

Effects of periarticular injection on analgesic effects and NSAID use in total knee arthroplasty and total hip arthroplasty
CONCLUSION: Intraoperative periarticular multimodal drug injection significantly relieved pain after surgery and reduced nonsteroidal anti-inflammatory drug consumption. These patient had a better postoperative experience, including satisfaction and rehabilitation. (Source: Clinics)
Source: Clinics - January 9, 2018 Category: General Medicine Source Type: research

Serum 25-hydroxyvitamin D levels in patients with Granulomatosis with Polyangiitis: association with respiratory infection
OBJECTIVES: To determine the possible association of serum 25-hydroxyvitamin D (25OHD) levels with disease activity and respiratory infection in granulomatosis with polyangiitis patients during two different periods: winter/spring and summer/autumn. METHODS: Thirty-two granulomatosis with polyangiitis patients were evaluated in the winter/spring, and the same patients (except 5) were evaluated in summer/autumn (n=27). The 25OHD levels were measured by radioimmunoassay. Disease activity was assessed by the Birmingham Vasculitis Activity Score Modified for Wegener ’ s Granulomatosis (BVAS/WG) and antineutrophil cytopla...
Source: Clinics - January 9, 2018 Category: General Medicine Source Type: research

Screening protocol for dysphagia in adults: comparison with videofluoroscopic findings
CONCLUSION: The clinical protocol used in the present study is a simple, rapid and reliable clinical assessment. Despite the absence of a completely satisfactory result, especially in terms of the sensitivity and positive predictive values, we suggest that lower rates of pneumonia can be achieved using a formal dysphagia screening method. (Source: Clinics)
Source: Clinics - January 9, 2018 Category: General Medicine Source Type: research

Evidence of progenitor cells in the adult human cochlea: sphere formation and identification of ABCG2
CONCLUSIONS: Evidence suggests that there may be progenitor cells in the adult human cochlea, although further studies are required. (Source: Clinics)
Source: Clinics - December 12, 2017 Category: General Medicine Source Type: research

Peri-implant assessment via cone beam computed tomography and digital periapical radiography: an ex vivo study
CONCLUSIONS: The registration of peri-implant details was influenced by the image acquisition protocol, although metal artifacts were produced in all situations. The evaluators preferred the Kodak 9000 3D cone beam computer tomography in most cases. The evaluators identified buccal bone defects better with cone beam computer tomography and identified peri-implant bone defects better with digital periapical radiography. (Source: Clinics)
Source: Clinics - December 12, 2017 Category: General Medicine Source Type: research

A novel body mass index reference range - an observational study
CONCLUSIONS: The new proposed curve for body mass index during pregnancy showed weak agreement with the currently used curve. The new curve provided more information regarding body mass index increase using percentiles for general and specific groups of body mass index. Overweight pregnant women showed an upward body mass index trend throughout pregnancy that increased more dramatically than those of other groups of pregnant women, and they also presented a major mean difference between weight gain and the Institute of Medicine recommendation. (Source: Clinics)
Source: Clinics - December 12, 2017 Category: General Medicine Source Type: research

Videofluoroscopic analysis of different volumes of liquid bolus swallowing in healthy individuals: comparison between height and sex
CONCLUSION: An increase in the swallowed liquid bolus volume from 5 mL to 10 mL causes a faster pharyngeal bolus transit and a longer bolus transit through the upper esophageal sphincter, with similar alterations in men and women and in shorter and taller individuals. (Source: Clinics)
Source: Clinics - December 12, 2017 Category: General Medicine Source Type: research

Prognostic factors of the short-term outcomes of patients with hepatitis B virus-associated acute-on-chronic liver failure
CONCLUSION: The neutrophil count/lymphocyte count ratio and serum levels of gamma-glutamyl transferase, albumin and sodium were independ ent risk factors predicting short-term outcomes of hepatitis B virus-associated acute-on-chronic liver failure, and the administration of multiple treatments with artificial liver support therapy during the early stage is conducive to improved short-term outcomes. (Source: Clinics)
Source: Clinics - December 12, 2017 Category: General Medicine Source Type: research

Dental status, oral prosthesis and chewing ability in an adult and elderly population in southern Brazil
CONCLUSION: Age, oral health status through dental prosthesis, preference for foods of soft consistency and difficulty breathing through the nose were factors associated with chewing inability in adults and the elderly. (Source: Clinics)
Source: Clinics - December 12, 2017 Category: General Medicine Source Type: research

Impact of the delay to start treatment in patients with lung cancer treated in a densely populated area of Brazil
CONCLUSION: In our highly populated region with preferential access to the public health system, patients are required to wait a relatively long time to effectively begin treatment for lung cancer. This type of study is important to alert medical societies and government health agencies. (Source: Clinics)
Source: Clinics - December 12, 2017 Category: General Medicine Source Type: research

Cardiorespiratory performance of coronary artery disease patients on land versus underwater treadmill tests: a comparative study
OBJECTIVE: To compare responses to a cardiopulmonary exercise test on land versus on an underwater treadmill, to assess the cardiorespiratory performance of coronary artery disease patients while immersed in warm water and to compare with the performance of healthy individuals. METHODS: The sample population consisted of 40 subjects, which included 20 coronary artery disease patients aged 63.7 ±8.89 years old, functional class I and II, according to the New York Hearth Association, and 20 healthy subjects aged 64.7±7.09 years old. The statistical significances were calculated through an ANOVA test with a (1 -...
Source: Clinics - December 12, 2017 Category: General Medicine Source Type: research

Assessment of the quality of life, muscle strength, and dynamic balance of elderly Kendo players
CONCLUSION: The results suggest that Kendo is a health-promoting activity that improves the quality of life, functional aspects (muscle strength and postural balance) and body composition of players. (Source: Clinics)
Source: Clinics - December 12, 2017 Category: General Medicine Source Type: research

Role of T. cruzi exposure in the pattern of T cell cytokines among chronically infected HIV and Chagas disease patients
CONCLUSIONS: Taken together, our data suggest the presence of an immunoregulatory response in chronic Chagas disease, which seems to be driven by T. cruzi antigens. Our findings provide new insights into immunotherapeutic strategies for people living with HIV/AIDS and Chagas disease. (Source: Clinics)
Source: Clinics - December 12, 2017 Category: General Medicine Source Type: research

Sudden unexpected death in Parkinson’s disease (SUDPAR): a review of publications since the decade of the brain
(Source: Clinics)
Source: Clinics - December 12, 2017 Category: General Medicine Source Type: research

Reduction of venous pressure during the resection of liver metastases compromises enteric blood flow: IGFBP-1 as a novel biomarker of intestinal barrier injury
CONCLUSION: We propose the use of insulin-like growth factor binding protein-1 as a novel biomarker of intestinal damage in such situations. (Source: Clinics)
Source: Clinics - November 13, 2017 Category: General Medicine Source Type: research

Plasmid-mediated mcr-1 in carbapenem-susceptible Escherichia coli ST156 causing a blood infection: an unnoticeable spread of colistin resistance in Brazil?
CONCLUSION: Our findings warn of the possible silent dissemination of colistin resistance by carbapenem-susceptible mcr-1 producers, as colistin susceptibility is commonly tested only among carbapenem-resistant isolates. (Source: Clinics)
Source: Clinics - November 13, 2017 Category: General Medicine Source Type: research

Review of magnetic resonance-guided focused ultrasound in the treatment of uterine fibroids
Uterine leiomyoma is the most frequently occurring solid pelvic tumor in women during the reproductive period. Magnetic resonance-guided high-intensity focused ultrasound is a promising technique for decreasing menorrhagia and dysmenorrhea in symptomatic women. The aim of this study is to review the role of Magnetic resonance-guided high-intensity focused ultrasound in the treatment of uterine fibroids in symptomatic patients. We performed a review of the MEDLINE and Cochrane databases up to April 2016. The analysis and data collection were performed using the following keywords: Leiomyoma, High-Intensity Focused Ultrasoun...
Source: Clinics - November 13, 2017 Category: General Medicine Source Type: research

Impact assessment of an automated drug-dispensing system in a tertiary hospital
CONCLUSIONS: Evidence of the positive impact of this technology on personnel time and costs and on other outcomes of interest is important for decision making by health managers. (Source: Clinics)
Source: Clinics - November 13, 2017 Category: General Medicine Source Type: research

Local and systemic effects of fibrin and cyanoacrylate adhesives on lung lesions in rabbits
The objective of this study is to evaluate local and systemic effects of fibrin and cyanoacrylate tissue adhesives on lung lesions in rabbits. METHODS: Eighteen rabbits were submitted to videothoracoscopy + lung incision alone (control) or videothoracoscopy + lung incision + local application of fibrin or cyanoacrylate adhesive. Blood samples were collected and assessed for leukocyte, neutrophil and lymphocyte counts and interleukin-8 levels preoperatively and at 48 hours and 28 days post-operatively. After 28 days, the animals were euthanized for gross examination of the lung surface, and lung fragments were excised for h...
Source: Clinics - November 13, 2017 Category: General Medicine Source Type: research

Effect of prophylactic non-invasive mechanical ventilation on functional capacity after heart valve replacement: a clinical trial
CONCLUSION: Non-invasive ventilation as a therapeutic resource was effective toward improving functionality; however , non-invasive ventilation did not influence the intensive care unit or hospitalization times of the studied cardiac patients. (Source: Clinics)
Source: Clinics - November 13, 2017 Category: General Medicine Source Type: research

Comparison of short-segment monoaxial and polyaxial pedicle screw fixation combined with intermediate screws in traumatic thoracolumbar fractures: a finite element study and clinical radiographic review
CONCLUSION: Smaller von Mises stress in the pedicle screws and lower intradiscal pressure in the adjacent segment were observed in the polyaxial screw model than in the monoaxial pedicle screw fixation spine models. Fracture-level fixation could significantly correct kyphosis and reduce correction loss, and adjacent segment degeneration was less likely to be observed in the intermediate polyaxial pedicle screw fixation group. (Source: Clinics)
Source: Clinics - November 13, 2017 Category: General Medicine Source Type: research

Identification of the difference in the pathogenesis in heart failure arising from different etiologies using a microarray dataset
CONCLUSION: These results indicate that the pathogenesis of heart failure arising from different etiologies varies, which may provide molecular evidence supporting etiology-based treatment for heart failure patients. (Source: Clinics)
Source: Clinics - November 13, 2017 Category: General Medicine Source Type: research

Longitudinal study of lung function in pregnant women: Influence of parity and smoking
OBJECTIVES: To evaluate pulmonary function in the first and third trimesters of pregnancy and analyze the influence of parity and smoking on spirometry parameters. METHODS: This longitudinal prospective study included a cohort of 120 pregnant women. The inclusion criteria were as follows: singleton pregnancy, gestational age less than 13.86 weeks, and no preexisting maternal diseases. The exclusion criteria were as follows: change of address, abortion, and inadequate spirometry testing. ClinicalTrials.gov: NCT02807038. RESULTS: A decrease in values of forced vital capacity and forced expiratory volume were noted in the fir...
Source: Clinics - November 13, 2017 Category: General Medicine Source Type: research

Next-generation Sequencing-based genomic profiling: Fostering innovation in cancer care?
CONCLUSION: We identified a high prevalence of gene alterations using an next-generation sequencing test. Although some benefit was associated with the matched therapy, most of the patients had disease progression as the best response, indicating the limited biological potential and unclear clinical relevance of this practice. (Source: Clinics)
Source: Clinics - November 13, 2017 Category: General Medicine Source Type: research

A Biomechanical Analysis of the Interlock Suture and a Modified Kessler-Loop Lock Flexor Tendon Suture
CONCLUSIONS: The interlock and modified Kessler-loop lock techniques for flexor tendon sutures produce similar mechanical characteristics in vitro. (Source: Clinics)
Source: Clinics - October 23, 2017 Category: General Medicine Source Type: research

An activating mutation in the CRHR1 gene is rarely associated with pituitary-dependent hyperadrenocorticism in poodles
CONCLUSION: These results suggest that germline activating mutations in CRHR1 may be a rare cause of pituitary hyperadrenocorticism in poodles. (Source: Clinics)
Source: Clinics - October 23, 2017 Category: General Medicine Source Type: research

Caring for critically ill patients outside intensive care units due to full units: a cohort study
CONCLUSIONS: Patients presented a high severity in terms of disease scores, had multiple organ dysfunction and needed multiple invasive therapeutic interventions. The study patients received intensive care with specialized consultation during their stay in the hospital wards and presented high costs of treatment. (Source: Clinics)
Source: Clinics - October 23, 2017 Category: General Medicine Source Type: research

The value of high-flow nasal cannula oxygen therapy after extubation in patients with acute respiratory failure
CONCLUSIONS: At a fixed inspired oxygen fraction, the application of a high-flow nasal cannula after extubation achieves a higher success rate of oxygen therapy and less discomfort at 24h than an air entrainment mask in patients with acute respiratory failure. (Source: Clinics)
Source: Clinics - October 23, 2017 Category: General Medicine Source Type: research

Endoscopic endonasal approach for mass resection of the pterygopalatine fossa
CONCLUSION: The low frequency of complications together with the high efficacy of resection support the use of the endoscopic endonasal approach as a feasible, safe, and beneficial technique for the management of masses in the pterygopalatine fossa. (Source: Clinics)
Source: Clinics - October 23, 2017 Category: General Medicine Source Type: research

Early menarche and teenager pregnancy as risk factors for morbid obesity among reproductive-age women: A case-control study
CONCLUSIONS: Early menarche, teenage pregnancy and low education level are risk factors for the occurrence of morbid obesity in women of reproductive age. Some non-communicable diseases were already more prevalent in women with morbid obesity even before 50 years of age. (Source: Clinics)
Source: Clinics - October 23, 2017 Category: General Medicine Source Type: research

Long-term efficiency of cataract surgery with hydrophilic acrylic Ioflex intraocular lens
CONCLUSIONS: The efficiency of cataract surgery with low-cost Ioflex intraocular lens implantation was significantly reduced in a long-term follow-up study because postoperative complications related to intraocular lens es emerged at higher rates than when the gold-standard treatment was used. (Source: Clinics)
Source: Clinics - October 23, 2017 Category: General Medicine Source Type: research

Experimental study of histological changes in vascular loops according to the duration of the postoperative period: Application in reconstructive microsurgery
CONCLUSION: Intimal proliferation was the most significant change noted in venous grafts as a function of the duration of the postoperative period and was directly correlated with graft occlusion. In cases in which vascular loops are required during free flap reconstruction, both procedures should preferably be performed during the same surgery. (Source: Clinics)
Source: Clinics - October 23, 2017 Category: General Medicine Source Type: research

Cytogenomic assessment of the diagnosis of 93 patients with developmental delay and multiple congenital abnormalities: The Brazilian experience
CONCLUSION: The obtained results corroborated data reported in the literature, but the overall detection rate was higher than the rates previously reported, due in part to the criteria used to select patients. Although arrays are the most efficient tool for diagnosis, they are not always suitable as a first-line diagnostic approach because of their high cost for large-scale use in developing countries. Thus, clinical and laboratory interactions with skilled technicians are required to target patients for the most effective and beneficial molecular diagnosis. (Source: Clinics)
Source: Clinics - October 23, 2017 Category: General Medicine Source Type: research

Accuracy of transient elastography-FibroScan®, acoustic radiation force impulse (ARFI) imaging, the enhanced liver fibrosis (ELF) test, APRI, and the FIB-4 index compared with liver biopsy in patients with chronic hepatitis C
CONCLUSION: Transient elastography remained the most effective method for evaluating all degrees of fibrosis. The accuracy of all methodologies was best at F4. (Source: Clinics)
Source: Clinics - October 23, 2017 Category: General Medicine Source Type: research

Errata
CONCLUSIONS: Testosterone- and estradiol-exposed rats with different endocrine phenotypes showed differential transcriptional expression of members of the kisspeptin system and sex steroid receptors in the hypothalamus. These differences might account for the different endocrine phenotypes found in testosterone- and estradiol-induced polycystic ovary syndrome rats. (Source: Clinics)
Source: Clinics - September 22, 2017 Category: General Medicine Source Type: research

Hypothalamic transcriptional expression of the kisspeptin system and sex steroid receptors differs among polycystic ovary syndrome rat models with different endocrine phenotypes
CONCLUSIONS: Testosterone- and estradiol-exposed rats with different endocrine phenotypes showed differential transcriptional expression of members of the kisspeptin system and sex steroid receptors in the hypothalamus. These differences might account for the different endocrine phenotypes found in testosterone- and estradiol-induced polycystic ovary syndrome rats. (Source: Clinics)
Source: Clinics - September 22, 2017 Category: General Medicine Source Type: research

Systematic Review of Health Economic Evaluations of Diagnostic Tests in Brazil: How accurate are the results?
The aim of this study is to identify and characterize the health economic evaluations (HEEs) of diagnostic tests conducted in Brazil, in terms of their adherence to international guidelines for reporting economic studies and specific questions in test accuracy reports. We systematically searched multiple databases, selecting partial and full HEEs of diagnostic tests, published between 1980 and 2013. Two independent reviewers screened articles for relevance and extracted the data. We performed a qualitative narrative synthesis. Forty-three articles were reviewed. The most frequently studied diagnostic tests were laboratory ...
Source: Clinics - September 22, 2017 Category: General Medicine Source Type: research

Selenocysteine modulates resistance to environmental stress and confers anti-aging effects in C. elegans
CONCLUSION: These findings suggest that dietary supplementation of selenocysteine can modulate response to stressors and lead to lifespan extension, thus supporting the free radical theory of aging. (Source: Clinics)
Source: Clinics - September 22, 2017 Category: General Medicine Source Type: research

Community Care Administration of Spinal Deformities in the Brazilian Public Health System
CONCLUSION: The current management of patients with spinal deformities in the public healthcare system does not provide adequate treatment for these patients in our region. They experience long waiting periods for referral and prolonged waiting times to receive surgical treatment; additionally, many of the necessary proce dures are not reimbursed by the public healthcare system. (Source: Clinics)
Source: Clinics - September 22, 2017 Category: General Medicine Source Type: research

A Comparative Study of Sagittal Balance in Patients with Neuromuscular Scoliosis
CONCLUSIONS: Despite correction of coronal scoliotic deformity in patients with neuromuscular deformiti es, there were no changes in spinopelvic alignment parameters in the group studied. (Source: Clinics)
Source: Clinics - September 22, 2017 Category: General Medicine Source Type: research

High frequency of silent brain infarcts associated with cognitive deficits in an economically disadvantaged population
OBJECTIVE: Using magnetic resonance imaging, we aimed to assess the presence of silent brain vascular lesions in a sample of apparently healthy elderly individuals who were recruited from an economically disadvantaged urban region (S ão Paulo, Brazil). We also wished to investigate whether the findings were associated with worse cognitive performance. METHODS: A sample of 250 elderly subjects (66-75 years) without dementia or neuropsychiatric disorders were recruited from predefined census sectors of an economically disadvanta ged area of Sao Paulo and received structural magnetic resonance imaging scans and cogniti...
Source: Clinics - September 22, 2017 Category: General Medicine Source Type: research