CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in medical and biomedical sciences.
Edited by: Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP)
CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in medical and biomedical sciences.
Edited by: Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP)
16/Aug/2021
Daniele Moraes Losada , André Luiz da Cruz Ribeiro , Francisco Fontes Cintra , Guilherme Rossi Assis de Mendonça , Maurício Etchebehere , Eliane Maria Ingrid Amstalden
DOI: 10.6061/clinics/2021/e2914
OBJECTIVES: The aim of this study was to evaluate the role of amphiregulin protein, an epidermal growth factor receptor ligand, in cartilaginous tumors. METHODS: Amphiregulin expression was examined in 31 enchondromas and 67 chondrosarcomas using immunohistochemistry analysis. RESULTS: Overall, 15 enchondromas (48.40%) and 24 chondrosarcomas (35.82%) were positive for amphiregulin. According to the receiver operating characteristic curve test, no difference in amphiregulin expression was observed between enchondromas and low-grade chondrosarcomas (p=0.0880). Additionally, 39 lesions Enchondromas or chondrosarcomas? Please clarify. This […]
Keywords: Amphiregulin; Bone Tumors; Chondrosarcoma; Enchondroma; Immunohistochemistry
16/Aug/2021
Tatiana Carvalho de Souza Bonetti , Flavia Roche Moreira Latini , Adriana Lukow Invitti , Marcelo Cunio Machado Fonseca , Fulvio Alexandre Scorza , Maira Garcia Saldanha , [...]
DOI: 10.6061/clinics/2021/e2818
OBJECTIVE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is characterized by high contagiousness, as well as variable clinical manifestations and immune responses. The antibody response to SARS-CoV-2 is directly related to viral clearance and the antibodies’ ability to neutralize the virus and confer long-term immunity. Nevertheless, the response can also be associated with disease severity and evolution. This study correlated the clinical characteristics of convalescent COVID-19 patients with immunoglobulin A (IgA) and IgG anti-SARS-CoV-2 antibodies. METHODS: This study included […]
Keywords: Antibodies; COVID-19; Disease Severity; SARS-CoV-2
16/Aug/2021
Allison A. Gockley , Lawrence H. Lin , Michelle Davis , Alexander Melamed , Anthony Rizzo , Sue Yazaki Sun , [...]
DOI: 10.6061/clinics/2021/e2830
OBJECTIVES: This study aimed to determine the effects of age, race/ethnicity, body mass index, and contraception on human chorionic gonadotropin (hCG) regression following the evacuation of a molar pregnancy. METHODS: This was a retrospective cohort study of 277 patients with molar pregnancies between January 1, 1994 and December 31, 2015. The rate of hCG regression was estimated using mixed-effects linear regression models on daily log-transformed serum hCG levels after evacuation. RESULTS: There were no differences in hCG half-lives among age […]
Keywords: Chorionic Gonadotropin; Gestational Trophoblastic Disease; Molar Pregnancy
05/Aug/2021
Ana Luiza Santos Marques , Marina Paula Andres , Leandro A. Mattos , Manoel O. Gonçalves , Edmund Chada Baracat , Mauricio Simões Abrão
DOI: 10.6061/clinics/2021/e2981
OBJECTIVE: To evaluate the association of two-dimensional (2D) and three-dimensional (3D) transvaginal ultrasound (TVUS) findings with adenomyosis symptoms. METHODS: This prospective study conducted between January and December 2018 enrolled 78 women aged 18 to 40 years with abnormal uterine bleeding (AUB), infertility, and/or pelvic pain. All patients underwent 2D and 3D TVUS. Signs of adenomyosis on TVUS were identified according to the consensus of the Morphological Uterus Sonographic Assessment group. RESULTS: The prevalence of adenomyosis on TVUS was 55.12%. Patients […]
Keywords: Abnormal Uterine Bleeding; Adenomyosis; Dysmenorrhea; Pelvic Pain; Transvaginal Ultrasound
Cínthia Minatel Riguetto , Icléia Siqueira Barreto , Frederico Fernandes Ribeiro Maia , Lígia Vera Montali da Assumpção , Denise Engelbrecht Zantut-Wittmann
05/Aug/2021
Cínthia Minatel Riguetto , Icléia Siqueira Barreto , Frederico Fernandes Ribeiro Maia , Lígia Vera Montali da Assumpção , Denise Engelbrecht Zantut-Wittmann
DOI: 10.6061/clinics/2021/e3022
OBJECTIVE: This study aimed to analyze the relationship of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR) with clinicopathological characteristics of patients with differentiated thyroid cancer (DTC). METHODS: This retrospective study included 390 patients with DTC who had complete blood cell counts available at the time of surgery. NLR, PLR, and MLR were calculated, and the risk of cancer-related death, structural recurrence, and response to therapy were assessed using the eighth edition of the tumor-node-metastasis classification, American Thyroid […]
Keywords: Differentiated Thyroid Cancer; Distant Metastasis; Monocyte-Lymphocyte Ratio; Neutrophil-Lymphocyte Ratio; Platelet-Lymphocyte Ratio
Munick Linhares Pierre, Beatriz Friso, Raquel Aparecida Casarotto , Jorge Milhem Haddad , Edmund Chada Baracat , Elizabeth Alves Gonçalves Ferreira
05/Aug/2021
Munick Linhares Pierre, Beatriz Friso, Raquel Aparecida Casarotto , Jorge Milhem Haddad , Edmund Chada Baracat , Elizabeth Alves Gonçalves Ferreira
DOI: 10.6061/clinics/2021/e3039
OBJECTIVE: To compare the effectiveness of tibial nerve transcutaneous electrical nerve stimulation (TENS) for an overactive bladder, considering the sites of application and frequency of attendance. METHODS: This multi-arm randomized controlled trial enrolled 137 adult women (61.0±9.0 years) with overactive bladder from a university hospital. They underwent 12 sessions of 30-min TENS application and were assigned to five groups: one leg, once a week (n=26); one leg, twice a week (n=27); two legs, once a week (n=26); two legs, twice […]
Keywords: Overactive Bladder; Physical Therapy Specialty; Tibial Nerve; Transcutaneous Electrical Nerve Stimulation; Women's Health
05/Aug/2021
Fernanda Yamamoto Ricardo-da-Silva , Roberto Armstrong-Jr , Marina Vidal-dos-Santos , Cristiano de Jesus Correia , Raphael dos Santos Coutinho e Silva , Lucas Ferreira da Anunciação , [...]
DOI: 10.6061/clinics/2021/e3042
OBJECTIVES: Lung transplantation is limited by the systemic repercussions of brain death (BD). Studies have shown the potential protective role of 17β-estradiol on the lungs. Here, we aimed to investigate the effect of estradiol on the long-lasting lung inflammatory state to understand a possible therapeutic application in lung donors with BD. METHODS: Female Wistar rats were separated into 3 groups: BD, subjected to brain death (6h); E2-T0, treated with 17β-estradiol (50 μg/mL, 2 mL/h) immediately after brain death; and E2-T3, […]
Keywords: Brain death; Estradiol; Female rats; Lung inflammation; Organ Donor
26/Jul/2021
Jianlong Sheng , Nina Liu , Fei He , Cheng Cheng , Shichun Shen , Yuting Sun
DOI: 10.6061/clinics/2021/e2580
OBJECTIVES: This study aimed to prospectively observe the changes in the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) before and after percutaneous coronary intervention (PCI) and their impact on the prognosis of patients with acute coronary syndrome (ACS). METHODS: Blood samples from 205 patients with ACS were collected at admission and at 24h and 30 days post-PCI to observe changes in the complete blood count. The Cox multivariate regression model was used to analyze the factors influencing major adverse cardiac […]
Keywords: Acute Coronary Syndrome; Neutrophil-to-Lymphocyte Ratio; Percutaneous Coronary Intervention; Platelet-to-Lymphocyte Ratio
26/Jul/2021
Giovana Biasia de Sousa , Rodrigo Strehl Machado , Frank Shigueo Nakao , Ermelindo Della Libera
DOI: 10.6061/clinics/2021/e2701
OBJECTIVES: Pancreatic pseudocysts (PPC) are fluid collections with a well-defined wall that persist for more than 4 weeks inside or around the pancreas as a result of pancreatic inflammation and/or a ductal lesion. PPC have been successfully treated with endoscopic ultrasound (EUS)-guided drainage using different stents. This study aimed to evaluate the safety and efficacy of EUS-guided drainage of PPC using double-pigtail plastic stents in a tertiary hospital. METHODS: Patients with PPC referred for EUS-guided drainage between May 2015 and […]
Keywords: Drainage; Endoscopy; Endosonography; Pancreatic Pseudocyst
26/Jul/2021
Roberto de Cleva , Flavio Kawamoto , Georgia Borges , Priscila Caproni , Alex Jones Flores Cassenote , Marco Aurelio Santo
DOI: 10.6061/clinics/2021/e2906
OBJECTIVES: Several predictors of type 2 diabetes mellitus (T2DM) remission after metabolic surgery have been proposed and used to develop predictive scores. These scores may not be reproducible in diverse geographic regions with different baseline characteristics. This study aimed to identify predictive factors associated with T2DM remission after Roux-en-Y gastric bypass (RYGB) in patients with severe obesity. We hypothesized that the body composition alterations induced by bariatric surgery could also contribute to diabetes remission. METHODS: We retrospectively evaluated 100 patients […]
Keywords: Bariatric Surgery; C-Peptide; Diabetes Remission; Type 2 diabetes mellitus
08/Jul/2021
Nilton Salles Rosa Neto , Judith Campos de Barros Bento , Valéria de Falco Caparbo , Rosa Maria Rodrigues Pereira
DOI: 10.6061/clinics/2021/e2643
OBJECTIVES: Fabry disease (FD) is an X-linked lysosomal disease caused by variants of the GLA gene; the formation of defective alpha-galactosidase A contributes to the accumulation of substrates in several organs. Chronic inflammation is thought to contribute to organ damage in FD patients. METHODS: In total, 36 classic FD patients (15 men/21 women) and 25 healthy controls (20 men/8 women) were assessed. The Mainz Severity Score Index (MSSI) was established after conducting interviews with the patients and chart review. Serum […]
Keywords: Cytokine; Fabry Disease; GLA Gene; Inflammation; Mainz Severity Score Index
08/Jul/2021
Camila Nascimento Monteiro , Felipe Tadeu Carvalho Santos , Karen Sarmento Costa , Marilisa Berti de Azevedo Barros , Chester Luiz Galvão Cesar , Moisés Goldbaum
DOI: 10.6061/clinics/2021/e2781
OBJECTIVES: To analyze the use and acquisition of medicines in São Paulo, Brazil, in 2003 and 2015, according to sociodemographic factors, socioeconomic status, and health conditions of the population. METHODS: Data were obtained from population health surveys “ISA-Capital”. Descriptive analysis, bivariate analysis, and logistic regression models were used to evaluate the use of medicines and coverage by the Brazilian Unified Health System (SUS) according to socioeconomic status and health conditions in two periods: 2003 and 2015. RESULTS: From 2003 to […]
Keywords: Pharmaceutical Policies; Population Health Survey; State Health Care Coverage; Use of Medicines
08/Jul/2021
Tauana Rodrigues Nagy , Simone Maistro , Giselly Encinas , Maria Lucia Hirata Katayama , Glaucia Fernanda de Lima Pereira , Nelson Gaburo-Júnior , [...]
DOI: 10.6061/clinics/2021/e2837
OBJECTIVES: In breast cancer (BC) patients, the frequency of germline BRCA mutations (gBRCA) may vary according to the ethnic background, age, and family history of cancer. Phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) is the second most common somatic mutated gene in BC; however, the association of mutations in both genes with cancer has not been thoroughly investigated. Thus, our aims were to investigate gBRCA mutation frequency in a cohort of postmenopausal Brazilian BC patients and the association of gBRCA1/BRCA2 and […]
Keywords: BRCA1; BRCA2; Breast Cancer; Germline Mutation; PIK3CA; Somatic Mutation
Natally Horvat , Jose de Arimateia B. Araujo-Filho , Antonildes N. Assuncao-Jr , Felipe Augusto de M. Machado , John A. Sims , Camila Carlos Tavares Rocha , [...]
08/Jul/2021
Natally Horvat , Jose de Arimateia B. Araujo-Filho , Antonildes N. Assuncao-Jr , Felipe Augusto de M. Machado , John A. Sims , Camila Carlos Tavares Rocha , [...]
DOI: 10.6061/clinics/2021/e2888
OBJECTIVES: To investigate whether quantitative textural features, extracted from pretreatment MRI, can predict sustained complete response to radiofrequency ablation (RFA) in patients with hepatocellular carcinoma (HCC). METHODS: In this IRB-approved study, patients were selected from a maintained six-year database of consecutive patients who underwent both pretreatment MRI imaging with a probable or definitive imaging diagnosis of HCC (LI-RADS 4 or 5) and loco-regional treatment with RFA. An experienced radiologist manually segmented the hepatic nodules in MRI arterial and equilibrium phases […]
Keywords: Carcinoma Hepatocellular; Magnetic Resonance Imaging; Radiofrequency Ablation; Radiomics
Maria Fernanda Cassino Portugal , Marcelo Passos Teivelis , Marcelo Fiorelli Alexandrino da Silva , Alexandre Fioranelli , Claudia Szlejf , Edson Amaro-Júnior , [...]
08/Jul/2021
Maria Fernanda Cassino Portugal , Marcelo Passos Teivelis , Marcelo Fiorelli Alexandrino da Silva , Alexandre Fioranelli , Claudia Szlejf , Edson Amaro-Júnior , [...]
DOI: 10.6061/clinics/2021/e2890
OBJECTIVES: In Brazil, descending thoracic aorta disease, including aneurysms and dissections, is managed preferentially by endovascular treatment, owing to its feasibility and good results. In this study, we analyzed endovascular treatment of isolated descending thoracic aortic disease cases in the Brazilian public health system over a 12-year period. METHODS: Public data from procedures performed from 2008 to 2019 were extracted using web scraping techniques to assess procedure type frequency (elective or urgency), mortality, and governmental costs. RESULTS: A total of […]
Keywords: Aneurysm Surgery; Aorta Thoracic; Aortic Aneurysm