Search Articles
08/Jul/2021
Use of medicines in São Paulo, Brazil, and State Health Care Coverage, 2003 and 2015
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
29/Jun/2021
Combination of Dendrobium Mixture and Metformin Curbs the Development and Progression of Diabetic Cardiomyopathy by Targeting the lncRNA NEAT1
Wenmin Qin , Xing Zhao , Jie Tai , Guoyun Qin , Shanshan Yu
DOI: 10.6061/clinics/2021/e2669
OBJECTIVES: This study aimed to explore the efficacy of combination treatment with dendrobium mixture and metformin (Met) in diabetic cardiomyopathy (DCM) and its effects on NEAT1 and the Nrf2 signaling pathway. METHODS: H9c2 cells were maintained in medium supplemented with either low (5.5 mmol/L) or high (50 mmol/L) glucose. Male Sprague-Dawley rats were fed a high-glucose diet and administered a single, low dose of streptozotocin (35 mg/kg) via intraperitoneal injection to induce the development of DM. After induction of DM, […]
Keywords: Dendrobium Mixture; Diabetic Cardiomyopathy; Metformin; miR-23a-3p; NEAT1; Nrf2
29/Jun/2021
Effect of tumor and normal lung volumes on the lung volume–dose parameters of IMRT in non–small-cell lung cancer
Xi Zou , Linzhen Lan , Lijing Zheng , Jinmei Chen , Feibao Guo , Chuanshu Cai , [...]
DOI: 10.6061/clinics/2021/e2769
OBJECTIVES: To explore the effect of tumor and normal lung volumes on lung volume-dose parameters in patients with non-small-cell lung cancer (NSCLC) who had undergone intensity-modulated radiation therapy (IMRT). METHODS: The clinical data of 208 patients with NSCLC who underwent radical IMRT between June 2014 and June 2018 were retrospectively analyzed. A regression model curve was used to evaluate the effect of tumor and normal lung volumes on normal lung relative volumes receiving greater than 5 and 20 Gy (V5, […]
Keywords: Intensity-Modulated Radiotherapy; Lung Volume; Non-small Cell Lung Cancer; Primary Tumor Volume; Volume-Dose Parameter
29/Jun/2021
Mental health in medical students during COVID-19 quarantine: a comprehensive analysis across year-classes
Thais Perissotto , Thamires Clair Rodrigues Pereira da Silva , Fabricio Petermann Choueiri Miskulin , Mariana Berwerth Pereira , Beatriz Astolfi Neves , Beatriz Cantieri Almeida , [...]
DOI: 10.6061/clinics/2021/e3007
OBJECTIVES: The COVID-19 pandemic brought abrupt changes when quarantine measures were implemented. Most medical students had distance learning as their main content delivery mode, but in clerkship (fifth and sixth years), in-person activities were maintained under new protocols. These different modes may have affected student mental health. This study examines mental burden and empathy in medical students during the beginning of the COVID-19 pandemic according to the year of attendance. METHODS: All students attending first to the sixth year in […]
Keywords: Anxiety; COVID-19; Depression; Empathy; Medical students
23/Jun/2021
Pulmonary function evaluation after hospital discharge of patients with severe COVID-19
Jessica Polese , Larissa Sant’Ana , Isac Ribeiro Moulaz , Izabella Cardoso Lara , Julia Muniz Bernardi , Marina Deorce de Lima , [...]
DOI: 10.6061/clinics/2021/e2848
OBJECTIVES: Coronavirus disease 2019 (COVID-19) may be associated with prolonged symptoms and post-recovery health impairment. This study aimed to evaluate the persistence of symptoms, lung function, and pulmonary diffusion for carbon monoxide (DLCO) in patients between 15 and 30 days after hospital discharge after admission for severe COVID-19. METHODS: The evaluation consisted of 1) comparative analysis between the initial symptoms and symptoms still present at the post-discharge evaluation 2) analysis of the chest images obtained during hospitalization, and 3) conducting […]
Keywords: COVID-19; Pulmonary function test; SARS-CoV-2; Symptoms
23/Jun/2021
Current Status of Antimicrobial Stewardship Programs in São Paulo Hospitals
Silvia Akemi Sato , Denise Assis Brandão , Geraldine Madalosso , Anna S. Levin , Lauro Vieira Perdigão Neto , Maura Salaroli Oliveira
DOI: 10.6061/clinics/2021/e2882
OBJECTIVES: Antimicrobial stewardship programs (ASPs) comprise coordinated interventions designed to improve antimicrobial use. Understanding the current structure of ASP hospitals will support interventions for the improvement of these programs. This study aimed to describe the status of ASPs in hospitals in São Paulo, Brazil. METHODS: A cross-sectional survey was conducted on the ASPs of hospitals in the state of São Paulo from March to July 2018. Through interviews by telephone or e-mail, we queried which components of the Infectious Diseases […]
Keywords: Antibiotics; Antimicrobial resistance; Antimicrobial Stewardship; Statewide Survey
23/Jun/2021
Symptoms of anxiety and depression in patients with primary hyperhidrosis and its association with the result of clinical treatment with oxybutynin
Débora Yumi Ferreira Kamikava , Nelson Wolosker , Marcelo Fiorelli Alexandrino da Silva , José Ribas Milanez de Campos , Pedro Puech-Leão
DOI: 10.6061/clinics/2021/e2892
OBJECTIVES: Studies have identified correlations between the psychological characteristics of individuals with primary hyperhidrosis (HH), the degree of sweating, and the quality of life (QoL). This study aimed to evaluate the prevalence of anxiety and depression symptoms in patients with HH before and after oxybutynin treatment. METHODS: Data were collected from 81 patients. Palmar or axillary HH was the most frequent complaint (84.0%). All patients were evaluated before the medication was prescribed and after five weeks of treatment. The Beck […]
Keywords: Anxiety; Depression; Hyperhidrosis; Oxybutynin
23/Jun/2021
Mental health and the COVID-19 pandemic: a study of medical residency training over the years
Vitor S. Mendonça , Amanda Steil , Aécio F.T. Góis
DOI: 10.6061/clinics/2021/e2907
OBJECTIVES: This study aims to assess the symptoms of burnout, depression, and anxiety in Brazilian medical residents during the COVID-19 pandemic and to compare residents’ beliefs and clinical practices related to COVID-19 patients among all six years of medical residency training in Brazil. METHODS: A quantitative study was conducted in April 2020 with a convenience sample of medical resident volunteers from an anonymous online survey. This investigation collected sociodemographic information and used the Oldenburg Burnout Inventory (OLBI) to measure burnout, […]
Keywords: COVID-19; Medical Residency; Mental Health
23/Jun/2021
Risk stratification in acute variceal bleeding: Far from an ideal score
Carla Luiza de Souza Aluizio , Ciro Garcia Montes , Glaucia Fernanda Soares Ruppert Reis , Cristiane Kibune Nagasako
DOI: 10.6061/clinics/2021/e2921
OBJECTIVES: Acute variceal bleeding (AVB) results from rupture of esophageal or gastric varices. It is a life-threatening complication of portal hypertension. Nevertheless, it remains unclear how to predict adverse outcomes and identify high-risk patients. In variceal hemorrhage, high Child-Turcotte-Pugh (Child) and Model for End-stage Liver Disease (MELD) scores are associated with a worse prognosis. The Rockall system (Rockall), Glasgow-Blatchford (Blatchford), and AIMS65 scores have been validated for risk stratification for nonvariceal upper gastrointestinal bleeding; however, their use is controversial in […]
Keywords: Cirrhosis; Risk Stratification; Upper Gastrointestinal Bleeding; Variceal Bleeding
07/Jun/2021
Brazilian version of Calgary-Cambridge Observation Guide 28-item version: cross-cultural adaptation and psychometric properties
Marcela C. Dohms , Carlos Fernando Collares , Iolanda Calvo Tiberio
DOI: 10.6061/clinics/2021/e1706
OBJECTIVES: The search for appropriate tools to assess communicational skills remains an ongoing challenge. The Calgary-Cambridge Observation Guide (CCOG) 28-item version can measure and compare performance in communication skills training. Our goal was to adapt this version of the CCOG for the Brazilian cultural context and perform a psychometric quality analysis of the instrument. METHODS: Experienced preceptors (35) assessed videos of five medical residents with a simulated patient using the translated guide. For the cultural adaptation, we followed the methodological […]
Keywords: Assessment; Communication Skills; Medical Education; Primary Care; Psychometrics; Reliability
07/Jun/2021
Statistical analysis for efficacy of tirofiban combined with ozagrel in the treatment of progressive cerebral infarction patients out of thrombolytic therapy time window
DOI: 10.6061/clinics/2021/e2728
OBJECTIVES: To investigate the safety and efficacy of combined tirofiban-ozagrel therapy for treating progressive stroke patients out of thrombolytic therapy time window. METHODS: This prospective, double-blind, randomized controlled study included 337 patients who had experienced an acute ischemic stroke between November 2017 and December 2018. All patients were randomized into three groups: 1) the tirofiban/ozagrel group (n=113), 2) the tirofiban group (n=110), and 3) the ozagrel group (n=114). The platelet aggregation (PAG), thrombin time (TT), prothrombin time (PT), activated partial […]
Keywords: Out of Thrombolytic Therapy Time Window; Ozagrel; Progressive Cerebral Infarction; Tirofiban
07/Jun/2021
Building an outpatient telemedicine care pilot using Scrum-like framework within a medical residency program
Kaio Jia Bin , Natalia Higa , Jéssica Helena da Silva , Daniele Abud Quagliano , Rosemeire Keiko Hangai , Vilson Cobello-Júnior , [...]
DOI: 10.6061/clinics/2021/e2795
OBJECTIVES: A good health care does not only depend on good medical practice, but also needs great management of its resources, which are generally short. In this sense, PROAHSA has been training new health managers since 1972. With the arrival of the COVID-19 pandemic, it was clear that medicine will go through a new phase, where telehealth will be present in this “Improved Normal”. This report is about how a pilot teleconsultation study was carried out for HCFMUSP patients through […]
Keywords: Agile Methodology; COVID-19; Scrum; Telehealth; Telemedicine
Rehabilitation of patients after COVID-19 recovery: An experience at the Physical and Rehabilitation Medicine Institute and Lucy Montoro Rehabilitation Institute
Marta Imamura , Aline Rossetti Mirisola , Fernando de Quadros Ribeiro , Lucas Ramos De Pretto , Fábio Marcon Alfieri , Vinicius Ramos Delgado , [...]
07/Jun/2021
Rehabilitation of patients after COVID-19 recovery: An experience at the Physical and Rehabilitation Medicine Institute and Lucy Montoro Rehabilitation Institute
Marta Imamura , Aline Rossetti Mirisola , Fernando de Quadros Ribeiro , Lucas Ramos De Pretto , Fábio Marcon Alfieri , Vinicius Ramos Delgado , [...]
DOI: 10.6061/clinics/2021/e2804
OBJECTIVES: As patients recovering from the novel coronavirus disease 2019 (COVID-19) present with physical, respiratory, cognitive, nutritional, and swallowing-related impairments and mental health complications, their rehabilitation needs are complex. This study aimed to describe the demographic, clinical, and functional status after the discharge of COVID-19 survivors who underwent intensive multidisciplinary inpatient rehabilitation at the Physical and Rehabilitation Medicine Institute of the University of Sao Paulo Medical School General Hospital and Lucy Montoro Rehabilitation Institute. We determined the most important factors […]
Keywords: Coronavirus Infection; COVID-19; Inpatient Rehabilitation; Rehabilitation; Rehabilitation Center; Rehabilitation Services; Treatment Outcome
Clinical and echocardiographic predictors of left ventricular remodeling following anterior acute myocardial infarction
Caroline Ferreira da Silva Mazeto Pupo da Silveira , Karina Nogueira Dias Secco Malagutte , Bruna Franco Nogueira , Fabrício Moreira Reis , Cássia da Silva Antico Rodrigues , Daniele Andreza Antonelli Rossi , [...]
27/May/2021
Clinical and echocardiographic predictors of left ventricular remodeling following anterior acute myocardial infarction
Caroline Ferreira da Silva Mazeto Pupo da Silveira , Karina Nogueira Dias Secco Malagutte , Bruna Franco Nogueira , Fabrício Moreira Reis , Cássia da Silva Antico Rodrigues , Daniele Andreza Antonelli Rossi , [...]
DOI: 10.6061/clinics/2021/e2732
OBJECTIVES: Coronary artery disease is the primary cause of death and is responsible for a high number of hospitalizations worldwide. Ventricular remodeling is associated with worse prognosis following ST-segment elevation myocardial infarction (STEMI) and is a risk factor for ventricular dysfunction and heart failure. This study aimed to identify the predictors of ventricular remodeling following STEMI. Additionally, we evaluated the clinical, laboratory, and echocardiographic characteristics of patients with anterior wall STEMI who underwent primary percutaneous intervention in the acute phase […]
Keywords: Acute Myocardial Infarction; Echocardiography; Predictors; Ventricular Remodeling
27/May/2021
Biomechanical evaluation in runners with Achilles tendinopathy
Nathalie Ferrari Bechara Andere , Alexandre Leme Godoy , Luis Mochizuki , Marcelo Bordalo Rodrigues , Túlio Diniz Fernandes , José Maria Soares-Júnior , [...]
DOI: 10.6061/clinics/2021/e2803
OBJECTIVES: To evaluate the clinical characteristics, ground reaction force (GRF), and function of the plantar muscles and dorsiflexors of the ankle in runners with and without Achilles tendinopathy (AT) and in non-runners. METHODS: Seventy-two participants (42 men, 30 women; mean age: 37.3±9.9 years) were enrolled in this cross-sectional study and divided into three groups: AT group (ATG, n=24), healthy runners’ group (HRG, n=24), and non-runners’ group (NRG, n=24). Both ankles were evaluated in each group. The American Orthopedic Foot and […]
Keywords: Achilles Tendon; Biomechanical Phenomena; Ground Reaction Force; Muscle Strength; Running; Tendinopathy