Is local resection sufficient for parathyroid carcinoma?
CONCLUSION: Parathyroid carcinoma has a slow-growing natural progression, and regional lymph node metastases are uncommon. Although our study comprised few patients, it nevertheless showed that in selected cases, parathyroid carcinoma could be solely treated with parathyroidectomy. (Source: Clinics)
Source: Clinics - May 27, 2015 Category: Journals (General) Source Type: research

Computed tomography imaging of early coronary artery lesions in stable individuals with multiple cardiovascular risk factors
OBJECTIVES: To investigate the prevalence, extent, severity, and features of coronary artery lesions in stable patients with multiple cardiovascular risk factors. METHODS: Seventy-seven patients with more than 3 cardiovascular risk factors were suspected of having coronary artery disease. Patients with high-risk factors and 39 controls with no risk factors were enrolled in the study. The related risk factors included hypertension, impaired glucose tolerance, dyslipidemia, smoking history, and overweight. The characteristics of coronary lesions were identified and evaluated by 64-slice coronary computed tomography angiograp...
Source: Clinics - May 27, 2015 Category: Journals (General) Source Type: research

Expenditures in the health care system in Brazil: the participation of states and the Federal District in financing the health care system from 2002 to 2013
CONCLUSIONS: By analyzing the results, there is clearly a disparity regarding the investment expended by the entities of the Federation. Although municipalities and states have gradually increased their application of resources to health care, the federal state has maintained the same budget. These results reveal a bit of concern about public health funding. (Source: Clinics)
Source: Clinics - May 27, 2015 Category: Journals (General) Source Type: research

Developing strategies to be added to the protocol for antenatal care: An exercise and birth preparation program
CONCLUSIONS: The detailed description of the protocol used may serve as a basis for further studies and also for the implementation of birth preparation programs within the healthcare system in different settings. (Source: Clinics)
Source: Clinics - May 27, 2015 Category: Journals (General) Source Type: research

Medical education at the University of São Paulo Medical School
(Source: Clinics)
Source: Clinics - May 27, 2015 Category: Journals (General) Source Type: research

Psychosocial factors and T lymphocyte counts in Brazilian peacekeepers
OBJECTIVE: To investigate the associations between psychosocial factors and peripheral blood CD4 and CD8 T lymphocyte numbers in Brazilian peacekeepers. METHODS: Venous blood was collected from 759 peacekeepers who had just returned from a peace mission in Haiti. Among the 759 soldiers, 642 individuals completed the psychosocial measures. CD4 and CD8 T lymphocyte counts were measured by flow cytometry using a commercially available kit. Psychosocial factors, including military peace force stressors, clinical stress, anxiety and depression, were recorded. As a reference for T lymphocyte numbers, we measured T lymphocyte cou...
Source: Clinics - March 17, 2015 Category: Journals (General) Source Type: research

Steroidogenesis-related gene expression in the rat ovary exposed to melatonin supplementation
CONCLUSION: Our data suggest that melatonin supplementation decreases gene expression of cyclic adenosine monophosphate, which changes ovarian steroidogenesis. (Source: Clinics)
Source: Clinics - March 17, 2015 Category: Journals (General) Source Type: research

Trypsin inhibitor from tamarindus indica L. seeds reduces weight gain and food consumption and increases plasmatic cholecystokinin levels
CONCLUSION: The results indicate that the isolated trypsin inhibitor from Tamarindus reduces weight gain by reducing food consumption, an effect that may be mediated by increased cholecystokinin. Thus, the potential use of this trypsin inhibitor in obesity prevention and/or treatment should be evaluated. (Source: Clinics)
Source: Clinics - March 17, 2015 Category: Journals (General) Source Type: research

Effects of ischemic preconditioning in a pig model of large-for-size liver transplantation
CONCLUSION: Ischemia-reperfusion injury in this model of large-for-size liver transplantation could be partially attenuated by ischemic preconditioning. (Source: Clinics)
Source: Clinics - March 17, 2015 Category: Journals (General) Source Type: research

Repeated microendoscopic discectomy for recurrent lumbar disk herniation
CONCLUSION: In these cases, microendoscopic discectomy was able to achieve satisfactory clinical results. Furthermore, it has advantages over other methods because of its smaller incision, reduced bleeding and more efficient recovery. (Source: Clinics)
Source: Clinics - March 17, 2015 Category: Journals (General) Source Type: research

Surgical treatment of the osteoporotic spine with bone cement-injectable cannulated pedicle screw fixation: technical description and preliminary application in 43 patients
OBJECTIVES: To describe a new approach for the application of polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws. METHODS: Between June 2010 and February 2013, 43 patients with degenerative spinal disease and osteoporosis (T-score
Source: Clinics - March 17, 2015 Category: Journals (General) Source Type: research

What is the influence of hormone therapy on homocysteine and crp levels in postmenopausal women?
CONCLUSION: Our data suggested that hormone therapy (unopposed estrogen or estrogen associated with progestin) may have a positive influence on decreasing cardiovascular risk due to a significant reduction in homocysteine levels. (Source: Clinics)
Source: Clinics - March 17, 2015 Category: Journals (General) Source Type: research

Improvement in medication adherence and self-management of diabetes with a clinical pharmacy program: a randomized controlled trial in patients with type 2 diabetes undergoing insulin therapy at a teaching hospital
CONCLUSION: The program improved health outcomes and resulted in better glycemic control in patients with type 2 diabetes undergoing insulin therapy. (Source: Clinics)
Source: Clinics - March 17, 2015 Category: Journals (General) Source Type: research

Comparison of pre- and post-levothyroxine high-sensitivity c-reactive protein and fetuin-a levels in subclinical hypothyroidism
CONCLUSION: The decrease in fetuin-A levels in subclinical hypothyroidism cases indicates that levothyroxine treatment exerts anti-inflammatory and anti-apoptotic effects. Although the decrease in high-sensitivity C-reactive protein levels was statistically non-significant, it is predicted to reach significance with sustained treatment. (Source: Clinics)
Source: Clinics - March 17, 2015 Category: Journals (General) Source Type: research

Increased risk of depression in patients with rheumatoid arthritis: a seven-year population-based cohort study
This study aimed to investigate the incidence and risk factors of depression among RA patients in Taiwan. METHODS: Using Taiwan's National Health Insurance Research Database, we identified 3,698 newly diagnosed RA patients aged 18 years or older, together with 7,396 subjects without RA matched by sex, age and index date, between 2000 and 2004. The incidence of depression and the risk factors among RA cases were evaluated using Cox proportional-hazard regression. RESULTS: The incidence of depression was 1.74-fold greater in the RA cohort than in the non-RA cohort (11.80 versus 6.89 per 1,000 person-years; p
Source: Clinics - March 17, 2015 Category: Journals (General) Source Type: research

Excess body weight in children may increase the length of hospital stay
CONCLUSIONS: The length of stay and loss of weight at the hospital may be greater among children with excess weight than among children with normal weight. (Source: Clinics)
Source: Clinics - March 17, 2015 Category: Journals (General) Source Type: research

Immunohistochemical analysis of the neural structures of the posterior cruciate ligament in osteoarthritis patients submitted to total knee arthroplasty: an analysis of thirty-four cases
CONCLUSIONS: Severe posterior cruciate ligament degeneration was related to neurovascular bundle compromise. Neural structures were more commonly detected in varus knees. Intrinsic neural structures were detected in the majority of the posterior cruciate ligaments of patients submitted to knee arthroplasty for osteoarthritis. (Source: Clinics)
Source: Clinics - March 17, 2015 Category: Journals (General) Source Type: research

Relationship of the total atrial conduction time to subclinical atherosclerosis, inflammation and echocardiographic parameters in patients with type 2 diabetes mellitus
OBJECTIVES: The aim of our study was to evaluate the total atrial conduction time and its relationship to subclinical atherosclerosis, inflammation and echocardiographic parameters in patients with type 2 diabetes mellitus. METHODS: A total of 132 patients with type 2 diabetes mellitus (mean age 54.5±9.6 years; 57.6% male) and 80 age- and gender-matched controls were evaluated. The total atrial conduction time was measured by tissue-Doppler imaging and the carotid intima-media thickness was measured by B-mode ultrasonography. RESULTS: The total atrial conduction time was significantly longer in the patients with typ...
Source: Clinics - March 17, 2015 Category: Journals (General) Source Type: research

The prevalence of helicobacter pylori among dyspeptic patients in an earthquake-stricken area
OBJECTIVES: Helicobacter pylori is a gram-negative, spiral-shaped, urease-producing bacterium with multiple unipolar flagella. Humans are a major reservoir for H. pylori; however, there are no data on the prevalence of H. pylori among dyspeptic patients who have experienced natural disasters. Therefore, the aim of this study was to examine the prevalence of H. pylori in dyspeptic patients who survived a recent natural disaster and to compare the data between the pre-disaster and post-disaster periods. METHODS: Between December 2011 and February 2012 (∼ one month following an earthquake), 209 dyspeptic patients who unde...
Source: Clinics - February 14, 2015 Category: Journals (General) Source Type: research

Evaluation of the effects of ischemic preconditioning on the hematological parameters of rats subjected to intestinal ischemia and reperfusion
CONCLUSION: The most remarkable parameters were those related to leukocytes and platelets. Some of the data, including the lymphocyte and granulocytes counts, suggest that ischemic preconditioning attenuates the effect of intestinal ischemia/reperfusion on circulating blood cells. Our work contributes to a better understanding of the hematological responses after intestinal ischemia/reperfusion and IPC, and the present findings may also be used as predictive values. (Source: Clinics)
Source: Clinics - February 14, 2015 Category: Journals (General) Source Type: research

Neuroprotective effect of atorvastatin in spinal cord ischemia-reperfusion injury
CONCLUSION: This study demonstrates the considerable neuroprotective effect of atorvastatin on the neurological, biochemical and histopathological status of rabbits with ischemia-induced spinal cord injury. Moreover, the acute withdrawal of atorvastatin therapy following the induction of spinal cord ischemia did not increase the neuronal damage in this rabbit model. (Source: Clinics)
Source: Clinics - February 14, 2015 Category: Journals (General) Source Type: research

The influence of aerobic fitness status on ventilatory efficiency in patients with coronary artery disease
OBJECTIVE: To test the hypotheses that 1) coronary artery disease patients with lower aerobic fitness exhibit a lower ventilatory efficiency and 2) coronary artery disease patients with lower initial aerobic fitness exhibit greater improvements in ventilatory efficiency with aerobic exercise training. METHOD: A total of 123 patients (61.0±0.7 years) with coronary artery disease were divided according to aerobic fitness status into 3 groups: group 1 (n = 34, peak VO217.5 and 24.5 ml/kg/min). All patients performed a cardiorespiratory exercise test on a treadmill. Ventilatory efficiency was determined by the lowes...
Source: Clinics - February 14, 2015 Category: Journals (General) Source Type: research

Tongue forces and handgrip strength in normal individuals: association with swallowing
CONCLUSION: There were differences in the measures of tongue force in young, adult and elderly individuals. Greater variations within these differences were observed when repeated movements were performed; in addition, a decrease in strength was associated with an increase in age. The decrease in tongue force among the elderly was offset by the increase in time needed to swallow the liquid. There was an association between the measures of tongue force and grip strength in the different age groups. The results of this study can be applied clinically and may act as a basis for guidelines in healthy or vulnerable elderly popu...
Source: Clinics - February 14, 2015 Category: Journals (General) Source Type: research

Increased neutrophil-to-lymphocyte ratio predicts persistent coronary no-flow after wire insertion in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention
CONCLUSIONS: An increased neutrophil-to-lymphocyte ratio on admission is significantly associated with persistent coronary no-flow after wire insertion in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. (Source: Clinics)
Source: Clinics - February 14, 2015 Category: Journals (General) Source Type: research

Clinical and epidemiological differences between septic arthritis of the knee and hip caused by oxacillin-sensitive and -resistant s. aureus
CONCLUSION: Provenance from a health service-related environment was associated with a higher incidence of MRSA-related septic arthritis, suggesting that this agent should be considered in the initial choice of antibiotic treatment. Previous surgeries of the knee or affected limb and the absence of leukocytes might also be related to infection with this agent. (Source: Clinics)
Source: Clinics - February 14, 2015 Category: Journals (General) Source Type: research

Tetrodotoxin poisoning caused by Goby fish consumption in southeast China: a retrospective case series analysis
CONCLUSION: This outbreak demonstrates an underestimation of the risk of Goby fish poisoning. Furthermore, the relationships among the toxic species, climates and marine algae present should be clarified in the future. (Source: Clinics)
Source: Clinics - February 14, 2015 Category: Journals (General) Source Type: research

Red blood cell distribution width is associated with myocardial injury in non-ST-elevation acute coronary syndrome
CONCLUSION: A greater baseline red cell distribution width value was associated with myocardial injury and elevated cardiac troponin I levels in non-ST-elevation acute coronary syndrome. Therefore, the red cell distribution width could be considered for risk stratification of acute coronary syndrome patients admitted to emergency departments. (Source: Clinics)
Source: Clinics - February 14, 2015 Category: Journals (General) Source Type: research

Relationship between retinal sensitivity and disease activity in patients with psoriasis vulgaris
CONCLUSIONS: Retinal sensitivity appears to be affected by the severity of psoriasis vulgaris. (Source: Clinics)
Source: Clinics - February 14, 2015 Category: Journals (General) Source Type: research

Effects of resistance training in older women with knee osteoarthritis and total knee arthroplasty
This study sought to analyze the effects of resistance training on functional performance, lower-limb loading distribution and balance in older women with total knee arthroplasty (TKA) and osteoarthritis (OA) in the contralateral knee. In addition, this older knee OA and TKA group (OKG) was compared to older (OG) and young women (YG) without musculoskeletal diseases who underwent the same resistance training program. METHODS: Twenty-three women divided into OKG (N = 7), OG (N = 8) and YG (N = 8) had their functional performance, lower-limb loading distribution and balance compared before and after 13 weeks of a...
Source: Clinics - February 14, 2015 Category: Journals (General) Source Type: research

Can contrast-enhanced ultrasound with second-generation contrast agents replace computed tomography angiography for distinguishing between occlusion and pseudo-occlusion of the internal carotid artery?
OBJECTIVE: The purpose of this study was to evaluate the effectiveness of contrast-enhanced ultrasound with a second-generation contrast agent in distinguishing between occlusion and pseudo-occlusion of the cervical internal carotid artery, comparing it with that of conventional Doppler ultrasound and the gold standard, computed tomography angiography. METHOD: Between June 2006 and June 2012, we screened 72 symptomatic vascular surgery outpatients at a public hospital. Among those patients, 78 cervical internal carotid arteries were previously classified as occluded by Doppler ultrasound (without contrast). The patients we...
Source: Clinics - February 14, 2015 Category: Journals (General) Source Type: research

The prevalence of helicobacter pylori among dyspeptic patients in an earthquake-stricken area
OBJECTIVES: Helicobacter pylori is a gram-negative, spiral-shaped, urease-producing bacterium with multiple unipolar flagella. Humans are a major reservoir for H. pylori; however, there are no data on the prevalence of H. pylori among dyspeptic patients who have experienced natural disasters. Therefore, the aim of this study was to examine the prevalence of H. pylori in dyspeptic patients who survived a recent natural disaster and to compare the data between the pre-disaster and post-disaster periods. ME...
Source: Clinics - February 8, 2015 Category: Journals (General) Source Type: research

Evaluation of the effects of ischemic preconditioning on the hematological parameters of rats subjected to intestinal ischemia and reperfusion
CONCLUSION: The most remarkable parameters were those related to leukocytes and platelets. Some of the data, including the lymphocyte and granulocytes counts, suggest that ischemic preconditioning attenuates the effect of intestinal ischemia/reperfusion on circulating blood cells. Our work contributes to a better understanding of the hematological responses after intestinal ischemia/reperfusion and IPC, and the present findings may also be used as predictive values. (Source: Clinics)
Source: Clinics - February 8, 2015 Category: Journals (General) Source Type: research

Neuroprotective effect of atorvastatin in spinal cord ischemia-reperfusion injury
CONCLUSION: This study demonstrates the considerable neuroprotective effect of atorvastatin on the neurological, biochemical and histopathological status of rabbits with ischemia-induced spinal cord injury. Moreover, the acute withdrawal of atorvastatin therapy following the induction of spinal cord ischemia did not increase the neuronal damage in this rabbit model. (Source: Clinics)
Source: Clinics - February 8, 2015 Category: Journals (General) Source Type: research

The influence of aerobic fitness status on ventilatory efficiency in patients with coronary artery disease
OBJECTIVE: To test the hypotheses that 1) coronary artery disease patients with lower aerobic fitness exhibit a lower ventilatory efficiency and 2) coronary artery disease patients with lower initial aerobic fitness exhibit greater improvements in ventilatory efficiency with aerobic exercise training. METHOD: A total of 123 patients (61.0±0.7 years) with coronary artery disease were divided according to aerobic fitness status into 3 groups: group 1 (n = 34, peak VO217.5 and 24.5 ml/kg/min). All ...
Source: Clinics - February 8, 2015 Category: Journals (General) Source Type: research

Tongue forces and handgrip strength in normal individuals: association with swallowing
CONCLUSION: There were differences in the measures of tongue force in young, adult and elderly individuals. Greater variations within these differences were observed when repeated movements were performed; in addition, a decrease in strength was associated with an increase in age. The decrease in tongue force among the elderly was offset by the increase in time needed to swallow the liquid. There was an association between the measures of tongue force and grip strength in the different age groups. The results of this study can be ...
Source: Clinics - February 8, 2015 Category: Journals (General) Source Type: research

Increased neutrophil-to-lymphocyte ratio predicts persistent coronary no-flow after wire insertion in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention
CONCLUSIONS: An increased neutrophil-to-lymphocyte ratio on admission is significantly associated with persistent coronary no-flow after wire insertion in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. (Source: Clinics)
Source: Clinics - February 8, 2015 Category: Journals (General) Source Type: research

Clinical and epidemiological differences between septic arthritis of the knee and hip caused by oxacillin-sensitive and -resistant s. aureus
CONCLUSION: Provenance from a health service-related environment was associated with a higher incidence of MRSA-related septic arthritis, suggesting that this agent should be considered in the initial choice of antibiotic treatment. Previous surgeries of the knee or affected limb and the absence of leukocytes might also be related to infection with this agent. (Source: Clinics)
Source: Clinics - February 8, 2015 Category: Journals (General) Source Type: research

Tetrodotoxin poisoning caused by Goby fish consumption in southeast China: a retrospective case series analysis
CONCLUSION: This outbreak demonstrates an underestimation of the risk of Goby fish poisoning. Furthermore, the relationships among the toxic species, climates and marine algae present should be clarified in the future. (Source: Clinics)
Source: Clinics - February 8, 2015 Category: Journals (General) Source Type: research

Red blood cell distribution width is associated with myocardial injury in non-ST-elevation acute coronary syndrome
CONCLUSION: A greater baseline red cell distribution width value was associated with myocardial injury and elevated cardiac troponin I levels in non-ST-elevation acute coronary syndrome. Therefore, the red cell distribution width could be considered for risk stratification of acute coronary syndrome patients admitted to emergency departments. (Source: Clinics)
Source: Clinics - February 8, 2015 Category: Journals (General) Source Type: research

Relationship between retinal sensitivity and disease activity in patients with psoriasis vulgaris
CONCLUSIONS: Retinal sensitivity appears to be affected by the severity of psoriasis vulgaris. (Source: Clinics)
Source: Clinics - February 8, 2015 Category: Journals (General) Source Type: research

Effects of resistance training in older women with knee osteoarthritis and total knee arthroplasty
This study sought to analyze the effects of resistance training on functional performance, lower-limb loading distribution and balance in older women with total knee arthroplasty (TKA) and osteoarthritis (OA) in the contralateral knee. In addition, this older knee OA and TKA group (OKG) was compared to older (OG) and young women (YG) without musculoskeletal diseases who underwent the same resistance training program. METHODS: Twenty-three women divided into OKG (N = 7), OG (N = 8) and YG (N = 8) had thei...
Source: Clinics - February 8, 2015 Category: Journals (General) Source Type: research

Can contrast-enhanced ultrasound with second-generation contrast agents replace computed tomography angiography for distinguishing between occlusion and pseudo-occlusion of the internal carotid artery?
OBJECTIVE: The purpose of this study was to evaluate the effectiveness of contrast-enhanced ultrasound with a second-generation contrast agent in distinguishing between occlusion and pseudo-occlusion of the cervical internal carotid artery, comparing it with that of conventional Doppler ultrasound and the gold standard, computed tomography angiography. METHOD: Between June 2006 and June 2012, we screened 72 symptomatic vascular surgery outpatients at a public hospital. Among those patients, 78 cervical internal ...
Source: Clinics - February 8, 2015 Category: Journals (General) Source Type: research

Clinical research in pediatric organ transplantation
In conclusion, the lack of robust data related to pediatric transplantation remains problematic, and further clinical trials are needed to develop more efficacious and safer treatments. (Source: Clinics)
Source: Clinics - January 20, 2015 Category: Journals (General) Source Type: research

Issues in solid-organ transplantation in children: translational research from bench to bedside
In this review, we identify important challenges facing physicians responsible for renal and cardiac transplantation in children based on a review of the contemporary medical literature. Regarding pediatric renal transplantation, we discuss the challenge of antibody-mediated rejection, focusing on both acute and chronic antibody-mediated rejection. We review new diagnostic approaches to antibody-mediated rejection, such as panel-reactive antibodies, donor-specific cross-matching, antibody assays, risk assessment and diagnosis of antibody-mediated rejection, the pathology of antibody-mediated rejection, the issue of ABO inc...
Source: Clinics - January 20, 2015 Category: Journals (General) Source Type: research

Pediatric lung transplantation: 10 years of experience
The objective of this study was to demonstrate our experience with pediatric lung transplants over a 10-year period in a program initially designed for adults. (Source: Clinics)
Source: Clinics - January 20, 2015 Category: Journals (General) Source Type: research

Clinical recommendations for postoperative care after heart transplantation in children: 21 years of a single-center experience
Heart transplantation is an option for children with complex congenital heart disease and cardiomyopathies. A patient's quality of life and long-term survival depend on successful management of the surgical complications and adverse side effects of immunosuppression. The purpose of this review was to summarize the practical management of postoperative care in this patient population and to make recommendations for the future. (Source: Clinics)
Source: Clinics - January 20, 2015 Category: Journals (General) Source Type: research

Postoperative care in pediatric liver transplantation
In the last 25 years, liver transplantation in children has become an effective, definitive, and universally accepted treatment for terminal liver diseases. Long-term survival exceeds 80% and improves each year as the result of constant technical advancements and improvements in immediate postoperative intensive care and clinical control. (Source: Clinics)
Source: Clinics - January 20, 2015 Category: Journals (General) Source Type: research

Current management issues of immediate postoperative care in pediatric kidney transplantation
The number of pediatric kidney transplants has been increasing in many centers worldwide, as the procedure provides long-lasting and favorable outcomes; however, few papers have addressed the immediate postoperative care of this unique population. Herein, we describe the management of these patients in the early postoperative phase. After the surgical procedure, children should ideally be managed in a pediatric intensive care unit, and special attention should be given to fluid balance, electrolyte disturbances and blood pressure control. Antibiotic and antiviral prophylaxes are usually performed and are based on the recip...
Source: Clinics - January 20, 2015 Category: Journals (General) Source Type: research

Long-term outcomes of children after solid organ transplantation
Solid organ transplantation has transformed the lives of many children and adults by providing treatment for patients with organ failure who would have otherwise succumbed to their disease. The first successful transplant in 1954 was a kidney transplant between identical twins, which circumvented the problem of rejection from MHC incompatibility. Further progress in solid organ transplantation was enabled by the discovery of immunosuppressive agents such as corticosteroids and azathioprine in the 1950s and ciclosporin in 1970. Today, solid organ transplantation is a conventional treatment with improved patient and allograf...
Source: Clinics - January 20, 2015 Category: Journals (General) Source Type: research

ABO-incompatible living-donor pediatric kidney transplantation in Japan
The Japanese ABO-Incompatible Transplantation Committee officially collected and analyzed data on pediatric ABO-incompatible living-donor kidney transplantation in July 2012. The age of a child was defined as
Source: Clinics - January 20, 2015 Category: Journals (General) Source Type: research