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)
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Melatonin improves fertilization rate in assisted reproduction: Systematic review and meta-analysis
Eduardo Carvalho de Arruda Veiga, Marise Samama, Fabio Ikeda, Giovanna Santos Cavalcanti, Amanda Sartor, Suelen Fernanda Parames, Edmund C. Baracat, Joji Ueno, Jose Maria Soares Junior

  • Melatonin had beneficial effects on outcomes in assisted reproductive technologies, but it had no influence on pregnancy.

  • Melatonin had beneficial effects such as the improvement in the fertilization rate.

  • Melatonin has a beneficial effect on the formation of mature oocytes (MII).

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Systematic evaluation and meta-analysis of Flunarizine Hydrochloride combined with traditional Chinese medicine decoction in the treatment of migraine headaches
Dan Fan, Wei Leng, Liqin Zhang

  • Flunarizine Hydrochloride combined with TCM notably enhances migraine management.

  • Flunarizine Hydrochloride and TCM improve TCM scores, endothelin, NRS and VAS scores.

  • Flunarizine Hydrochloride combined with TCM reduces headache frequency and duration.

  • Standardized protocols are crucial to understand TCM's role in migraine management better.

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The effects of art therapy interventions on anxiety in children and adolescents: A meta-analysis
Bo Zhang, Jiahua Wang, Azizah binti Abdullah

  • This meta-analysis aimed to evaluate the impact of art therapy on reducing anxiety symptoms among children and adolescents. A comprehensive search was conducted across several databases, including PubMed, Web of Science, Embase, PsychINFO, The Cochrane Library, CNKI, and Wan Fang Data, resulting in the inclusion of six studies with a total of 422 participants. The findings demonstrated a significant decrease in anxiety symptoms through art therapy interventions, with a Standardized Mean Difference (SMD) of -1.42, 95% Confidence Interval (-2.33, -0.51), p < 0.002. This indicates that art therapy is an effective method for treating anxiety in this demographic. Moreover, the analysis revealed that art therapy had a more pronounced effect on state anxiety than on trait anxiety, suggesting that art therapy may be particularly beneficial in helping children and adolescents manage anxiety in specific situations. These insights underscore the importance of integrating art therapy into mental health care, especially for managing anxiety among young individuals, and have significant implications for clinical practice and policy making.

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Real-world setting comparison of bridging therapy versus direct mechanical thrombectomy for acute ischemic stroke: A meta-analysis
Bin Qin, Tao Wei, Wen Gao, Hui-xun Qin, Yu-Ming Liang, Cheng Qin, Hong Chen, Ming-Xiu Yang

  • Acute ischaemic stroke is becoming a major public health concern.

  • The nationwide or health organization registry databases were included.

  • Bridging therapy remains the standard treatment until more data are available.

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Is religiosity/spirituality in patients with Crohn's disease important to their quality of life?
José Luiz Amuratti Gonçalves, José Jukemura, Carolina Bortolozzo Graciolli Facanali, Carlos Frederico Sparapan Marques, Rodrigo Ambar Filho, Carlos Walter Sobrado, Sergio Carlos Nahas
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Visceral crisis in metastatic breast cancer: an old concept with new perspectives
Matheus de Oliveira Andrade, Renata Rodrigues da Cunha Colombo Bonadio, Maria Del Pilar Estevez Diz, Laura Testa

  • Visceral crisis in metastatic breast cancer is associated with a dismal prognosis.

  • There is a lack of objective clinical criteria in the definition of visceral crisis.

  • Visceral crisis management is currently based on limited retrospective evidence and expert opinions.

  • The role of chemotherapy as the treatment of choice for visceral crisis has been recently questioned.

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Low-level red-light therapy for myopia control in children: A systematic review and meta-analysis
Dillan Cunha Amaral, Sávio Batista, Edson dos Santos-Neto, José Eduardo Ferreira Manso, Márcio Penha Morterá Rodrigues, Mário Luiz Ribeiro Monteiro, Milton Ruiz Alves, Ricardo Noguera Louzada

  • There is a global increase in childhood myopia and current treatments are limited.

  • LLRL non-invasive therapy shows promise in myopia control.

  • LLRL is promising and requires further studies for standardization and safety.

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Screening and diagnostic tools for autism spectrum disorder: Systematic review and meta-analysis
Clara Lucato dos Santos, Indyanara Inacio Barreto, Idevaldo Floriano, Luca Schiliró Tristão, Antonio Silvinato, Wanderley Marques Bernardo

  • Autism Spectrum Disorder (ASD) is a heterogeneous neurodevelopmental disorder.

  • Autism spectrum disorder has a significant impact on the patient and their family.

  • To provide adequate advice is to carry out screening and diagnosis correctly and accurately.

  • Screening test must be applied, M-CHAT-R/F is recommended.

  • For diagnosis CARS and ADOS are the most recommended tools.

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Impulse oscillometry in patients with pulmonary arterial hypertension: an exploratory study
Helena Jannuzzi Villas Bôas, Ilma Aparecida Paschoal, Mônica Corso Pereira

  • Impulse Oscillometry (IOS) can be used to analyze lung resistance and reactance in patients with PAH.

  • Patients with PAH show increased resistance and pulmonary reactance compared to healthy individuals.

  • The IOS findings showed a good correlation with the spirometric variables.

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Effect of photobiomodulation therapy on pain perception during anesthetic puncture of dental local anesthesia: A systematic review
Caio Melo Mesquita, Millena Barroso Oliveira, Marcelo Dias Moreira de Assis Costa, Walbert Andrade Vieira, Rafael Rodrigues Lima, Sigmar de Mello Rode, Luiz Renato Paranhos

  • Photobiomodulation therapy seems to have little or no effect on pain perception during the anesthetic puncture in patients undergoing dental local anesthesia.

  • Clinical trials found in the literature used different study samples, pain assessment tools, and photobiomodulation therapy protocols.

  • Further randomized studies should be performed with a standardized methodology to strengthen the current evidence.

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