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Santos CLD, Barreto II, Floriano I, Tristão LS, Silvinato A, Bernardo WM. Screening and diagnostic tools for autism spectrum disorder: Systematic review and meta-analysis. Clinics (Sao Paulo) 2024; 79:100323. [PMID: 38484581 PMCID: PMC10951453 DOI: 10.1016/j.clinsp.2023.100323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/18/2023] [Indexed: 03/23/2024] Open
Abstract
INTRODUCTION Autism Spectrum Disorder (ASD) is a heterogeneous neurodevelopmental disorder, with main manifestations related to communication, social interaction, and behavioral patterns. The slight dynamics of change in the child over time require that the onset of clinical manifestations presented by the child be more valued, with the aim of stabilizing the condition. Faced with a variety of methods for diagnosing ASD, the question arises as to which method should be used. This systematic review aims to recommend the best tools to perform screening and diagnosis. METHODOLOGY This systematic review followed the PRISMA guidelines. The databases MEDLINE, Embase, CENTRAL (Cochrane), and Lilacs were accessed, and gray and manual searches were performed. The search strategy was created with terms referring to autism and the diagnosis/broad filter. The studies were qualitatively evaluated and quantitatively. Statistical analysis was performed using Meta-diSc-2.0 software, the confidence interval was 95 %. RESULTS The M-CHAT-R/F tool demonstrated a sensitivity of 78 % (95 % CI 0.57‒0.91) and specificity of 0.98 (95 % CI 0.88-1.00). The diagnostic tools demonstrated sensitivity and specificity respectively of: ADOS, sensitivity of 87 % (95 % CI 0.79‒0.92) and specificity 75 % (95 % CI 0.73‒0.78); ADI-R demonstrated test sensitivity of 77 % (95 % CI 0.56‒0.90) and specificity 68 % (95 % CI 0.52‒0.81), CARS test sensitivity was 89 % (95 % CI 0.78‒0.95) and specificity 79 % (95 % CI 0.65‒0.88). CONCLUSION It is mandatory to apply a screening test, the most recommended being the M-CHAT-R/F. For diagnosis CARS and ADOS are the most recommended tools.
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Affiliation(s)
- Clara Lucato Dos Santos
- Departamento de Medicina Baseada em Evidências, Faculdade de Ciências Médicas de Santos (UNILUS), Santos, SP, Brazil.
| | | | - Idevaldo Floriano
- Medicina Baseada em Evidências, Cooperativa Baixa Mogiana, Mogi-Guaçu, SP, Brazil
| | - Luca Schiliró Tristão
- Departamento de Medicina Baseada em Evidências, Faculdade de Ciências Médicas de Santos (UNILUS), Santos, SP, Brazil
| | - Antonio Silvinato
- Medicina Baseada em Evidências, Associação Médica Brasileira, São Paulo, SP, Brazil
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2
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Floriano I, Silvinato A, Bacha HA, Barbosa AN, Tanni S, Bernardo WM. Effectiveness of wearing masks during the COVID-19 outbreak in cohort and case-control studies: a systematic review and meta-analysis. J Bras Pneumol 2024; 49:e20230003. [PMID: 38198343 PMCID: PMC10760436 DOI: 10.36416/1806-3756/e20230003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 09/06/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVE To evaluate the efficacy of wearing a mask to prevent COVID-19 infection. METHODS This was a systematic review and meta-analysis of cohort and case-control studies, considering the best level of evidence available. Electronic databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Clinical Trials.gov) were searched to identify studies that evaluated the effectiveness of wearing masks compared with that of not wearing them during the COVID-19 pandemic. Risk of bias and quality of evidence were assessed using the Cochrane risk of bias tool and the Grading of Recommendations Assessment, Development, and Evaluation. RESULTS Of the 1,028 studies identified, 9 met the inclusion criteria (2 cohort studies and 7 case-control studies) and were included in the analysis. The meta-analysis using cohort studies alone showed statistically significant differences, wearing a cloth mask decreased by 21% [RD = -0.21 (95% CI, -0.34 to -0.07); I2 = 0%; p = 0,002] the risk of COVID-19 infection, but the quality of evidence was low. Regarding case-control studies, wearing a surgical mask reduced the chance of COVID-19 infection [OR = 0.51 (95% CI, 0.37-0.70); I2 = 47%; p = 0.0001], as did wearing an N95 respirator mask [OR = 0.31 (95% CI, 0.20-0.49); I2 = 0%; p = 0.00001], both with low quality of evidence. CONCLUSIONS In this systematic review with meta-analysis, we showed the effectiveness of wearing masks in the prevention of SARS-CoV-2 infection regardless of the type of mask (disposable surgical mask, common masks, including cloth masks, or N95 respirators), although the studies evaluated presented with low quality of evidence and important biases.
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Affiliation(s)
- Idevaldo Floriano
- . Cooperativa Baixa Mogiana, Medicina Baseada em Evidências, Mogi-Guaçu (SP) Brasil
| | - Antônio Silvinato
- . Cooperativa Baixa Mogiana, Medicina Baseada em Evidências, Mogi-Guaçu (SP) Brasil
- . Associação Médica Brasileira, Medicina Baseada em Evidências, São Paulo (SP) Brasil
| | | | - Alexandre Naime Barbosa
- . Disciplina de Moléstias Infecciosas e Parasitárias, Departamento de Infectologia, Dermatologia, Diagnóstico por Imagem e Radioterapia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
| | - Suzana Tanni
- . Disciplina de Pneumologia, Departamento de Clínica Médica, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
| | - Wanderley Marques Bernardo
- . Associação Médica Brasileira, Medicina Baseada em Evidências, São Paulo (SP) Brasil
- . Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
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Floriano I, Silvinato A, Bernardo WM. The use of esketamine in the treatment of patients with oral antidepressant-resistant depression: systematic review and meta-analysis. Rev Assoc Med Bras (1992) 2023; 69:e2023D696. [PMID: 37377288 DOI: 10.1590/1806-9282.2023d696] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/19/2023] [Indexed: 06/29/2023]
Abstract
The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field to standardize how to conduct, and to assist in the reasoning and decision-making of doctors. The information provided by this project must be critically evaluated by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical condition of each patient. Guideline conclusion: April 2023. Societies: Brazilian Medical Association.
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Affiliation(s)
- Idevaldo Floriano
- Cooperativa Baixa Mogiana, Evidence-Based Medicine - Mogi-Guaçu (SP), Brazil
| | - Antônio Silvinato
- Brazilian Medical Association, Evidence-Based Medicine - São Paulo (SP), Brazil
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Batista DR, Floriano I, Silvinato A, Bacha HA, Barbosa AN, Tanni SE, Bernardo WM. Use of anticoagulants in patients with COVID-19: an update of a living systematic review and meta-analysis. J Bras Pneumol 2023; 49:e20230095. [PMID: 37283403 PMCID: PMC10578923 DOI: 10.36416/1806-3756/e20230095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Affiliation(s)
- Diane R Batista
- . Disciplina de Pneumologia, Departamento de Clínica Médica, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
| | - Idevaldo Floriano
- . Medicina Baseada em Evidências, Associação Médica Brasileira, São Paulo (SP) Brasil
| | - Antonio Silvinato
- . Medicina Baseada em Evidências, Cooperativa Baixa Mogiana, Mogi-Guaçu (SP) Brasil
| | - Hélio A Bacha
- . Hospital Israelita Albert Einstein, São Paulo (SP) Brasil
| | | | - Suzana E Tanni
- . Disciplina de Pneumologia, Departamento de Clínica Médica, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
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Floriano I, Silvinato A, Bernardo WM. The use of esketamine in the treatment of patients with severe depression and suicidal ideation: systematic review and meta-analysis. Rev Assoc Med Bras (1992) 2023; 69:e2023D694. [PMID: 37194806 DOI: 10.1590/1806-9282.2023d694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/28/2023] [Indexed: 05/18/2023]
Affiliation(s)
- Idevaldo Floriano
- Cooperativa Baixa Mogiana, Evidence-Based Medicine - Mogi-Guaçu (SP), Brazil
| | - Antônio Silvinato
- Cooperativa Baixa Mogiana, Evidence-Based Medicine - Mogi-Guaçu (SP), Brazil
- Brazilian Medical Association, Evidence-Based Medicine - São Paulo (SP), Brazil
| | - Wanderley Marques Bernardo
- Brazilian Medical Association, Evidence-Based Medicine - São Paulo (SP), Brazil
- Universidade de São Paulo, Faculty of Medicine - São Paulo (SP), Brazil
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Silvinato A, Floriano I, Bernardo W. Nitinol double-layer stent versus closed single-layer stent: a systematic review. Rev Assoc Med Bras (1992) 2022; 68:1490-1495. [DOI: 10.1590/1806-9282.222d6811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/01/2022] [Indexed: 11/29/2022] Open
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Silvinato A, Floriano I, Bernardo WM. Use of cannabidiol in the treatment of epilepsy: Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex. Rev Assoc Med Bras (1992) 2022; 68:1345-1357. [PMID: 36417631 PMCID: PMC9683917 DOI: 10.1590/1806-9282.2022d689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 07/07/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The objective of this systematic review with meta-analysis was to evaluate the efficacy, safety, and short- and long-term tolerability of cannabidiol (CBD), as an adjunct treatment, in children and adults with Dravet syndrome (SD), Lennox-Gataut syndrome (LGS), or tuberous sclerosis complex (TSC), with inadequate control of seizures. METHODS This systematic review was conducted through a search for scientific evidence in the Mediline/PubMed, Central Cochrane, and ClinicalTrials.gov databases until April 2022. Selected randomized clinical trials (RCTs) that presented the outcomes: reduction in the frequency of seizures and total seizures (all types), number of patients with a response greater than or equal to 50%, change in caregiver global impression of change (CGIC) (improvement ≥1 category on the initial scale), adverse events (AEs), and tolerability to treatment. This review followed Preferred Reporting Items for Systematic reviews and Meta-Analyses. RESULTS Notably, six RCTs were included, with a total of 1,034 patients with SD, LGS, and TSC, of which 3 were open-label extension RCTs. The meta-analysis of the studies showed that the use of CBD as compared with placebo, in patients with convulsive seizures refractory to the use of medications, reduces the frequency of seizures by 33%; increases the number of patients with a reduction ≥50% in the frequency of seizures by 20%; increases the number of patients with absence of seizures by 3%; improves the clinical impression evaluated by the caregiver or patient (S/CGIC) in 21%; increases total AEs by 12%; increases serious AE by 16%; increases the risk of treatment abandonment by 12%; and increases the number of patients with transaminase elevation (≥3 times the referral) by 15%. CONCLUSIONS This systematic review, with meta-analysis, supports the use of CBD in the treatment of patients with seizures, originated in DS, LGS, and TSC, who are resistant to the common medications, presenting satisfactory benefits in reducing seizures and tolerable toxicity.
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Batista DR, Floriano I, Silvinato A, Bacha HA, Barbosa AN, Tanni SE, Bernardo WM. Use of anticoagulants in patients with COVID-19: a living systematic review and meta-analysis. J Bras Pneumol 2022; 48:e20220041. [PMID: 35674523 PMCID: PMC9262438 DOI: 10.36416/1806-3756/e20220041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/07/2022] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To answer questions related to the use of anticoagulants in the treatment of COVID-19 patients. METHODS This was a systematic review and meta-analysis of phase 3 randomized controlled trials comparing the use of anticoagulants in non-hospitalized and hospitalized COVID-19 patients. We searched the following databases: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov from their inception to January 22, 2022. The risk of bias was assessed by the Cochrane risk-of-bias tool, and the quality of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation system. RESULTS A total of 401 studies were initially selected. Of those, 9 met the inclusion criteria and were therefore analyzed (a total of 6,004 patients being analyzed). In non-hospitalized COVID-19 patients, no significant difference was found between post-discharge prophylactic anticoagulation and no intervention regarding venous thromboembolism or bleeding at 30 days. In hospitalized COVID-19 patients, full anticoagulation resulted in a slight reduction in thrombotic events at 30 days (risk difference, -0.03; 95% CI, -0.06 to -0.00; p = 0.04; I2 = 78%), the quality of evidence being moderate. However, no significant difference was found between full anticoagulation and no intervention regarding the risk of major bleeding, the quality of evidence being very low. No significant difference was found between intermediate- and standard-dose prophylactic anticoagulation (risk difference, -0.01; 95% CI, -0.07 to 0.06; p = 0.81; I2 = 0%), the quality of evidence being very low. CONCLUSIONS Therapeutic anticoagulation appears to have no effect on mortality in COVID-19 patients, resulting in a slight reduction in venous thromboembolism in hospitalized patients.
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Affiliation(s)
- Diane R Batista
- . Divisão de Pneumologia, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu (SP) Brasil
| | - Idevaldo Floriano
- . Medicina Baseada em Evidências, Associação Médica Brasileira, São Paulo (SP) Brasil
| | - Antonio Silvinato
- . Medicina Baseada em Evidências, Cooperativa Baixa Mogiana, Mogi-Guaçu (SP) Brasil
| | - Hélio A Bacha
- . Hospital Israelita Albert Einstein, São Paulo (SP) Brasil
| | - Alexandre N Barbosa
- . Departamento de Infectologia, Universidade Estadual Paulista, Botucatu (SP) Brasil
| | - Suzana E Tanni
- . Divisão de Pneumologia, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu (SP) Brasil
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Barbosa AN, Silvinato A, Bacha H, Floriano I, Tanni S, Bernardo W. Antibiotics in the prophylaxis of COVID or in the treatment of mild COVID. Rev Assoc Med Bras 2022; 68:553-556. [DOI: 10.1590/1806-9282.2022d685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 11/21/2022]
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Tanni SE, Silvinato A, Floriano I, Bacha HA, Barbosa AN, Bernardo WM. Use of remdesivir in patients with COVID-19: a systematic review and meta-analysis. J Bras Pneumol 2022; 48:e20210393. [PMID: 35137874 PMCID: PMC8836613 DOI: 10.36416/1806-3756/e20210393] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/02/2021] [Indexed: 02/06/2023] Open
Abstract
Objective: Studies in the literature regarding the use of remdesivir to treat COVID-19 patients have shown conflicting results. This study sought to answer questions related to the use of remdesivir for the treatment of patients hospitalized with moderate to severe COVID-19. Methods: This was a systematic review and meta-analysis including phase 3 randomized clinical trials (RCTs) and observational cohort studies selected from various databases, comparing patients hospitalized with moderate to severe COVID-19 receiving remdesivir and controls. Results: A total of 207 studies were retrieved, 9 of which met the eligibility criteria and were included in the study. The meta-analysis using RCTs alone showed no statistically significant differences regarding mortality or use of mechanical ventilation/extracorporeal membrane oxygenation between remdesivir and control groups, and the quality of evidence was moderate and low, respectively. The use of remdesivir increased the recovery rate by 6% (95% CI, 3-9); p = 0.004) and the clinical improvement rate by 7% (95% CI, 1-14); p = 0.02). Additionally, no significant differences in mortality were found between remdesivir and control groups when the meta-analysis used observational cohort studies alone (risk difference = −0.01 (95% CI, −0.02 to 0.01; p = 0.32), the quality of evidence being moderate, and the risk of adverse events was 4% ([95% CI, −0.08 to 0.01]; p = 0.09). Conclusions: The use of remdesivir for the treatment of patients with moderate to severe COVID-19 had no significant impact on clinically important outcomes.
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Affiliation(s)
- Suzana E Tanni
- . Disciplina de Pneumologia, Departamento de Clínica Médica, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
| | - Antonio Silvinato
- . Medicina Baseada em Evidências, Associação Médica Brasileira, São Paulo (SP) Brasil
| | - Idevaldo Floriano
- . Medicina Baseada em Evidências, Cooperativa Baixa Mogiana, Mogi-Guaçu (SP) Brasil
| | - Hélio A Bacha
- . Hospital Israelita Albert Einstein, São Paulo (SP) Brasil
| | - Alexandre Naime Barbosa
- . Departamento de Infectologia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
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Barbosa AN, Silvinato A, Bacha H, Floriano I, Tanni S, Bernardo W. Use of disease-modifying drugs (tocilizumab, tofacitinib, and baricitinib—a biological or synthetic target specific) in patients hospitalized with COVID-19. Rev Assoc Med Bras (1992) 2022; 68:3-8. [DOI: 10.1590/1806-9282.2022d681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 11/22/2022] Open
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Floriano I, Silvinato A, Reis JC, Cafalli C, Bernardo WM. Efficacy and safety in the use of intraperitoneal hyperthermia chemotherapy and peritoneal cytoreductive surgery for pseudomyxoma peritonei from appendiceal neoplasm: A systematic review. Clinics (Sao Paulo) 2022; 77:100039. [PMID: 35576869 PMCID: PMC9118488 DOI: 10.1016/j.clinsp.2022.100039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 01/10/2022] [Indexed: 11/25/2022] Open
Abstract
The objective of this systematic review is to provide efficacy and safety data in the application of Intra-Abdominal Hyperthermia Chemotherapy (HIPEC) and Cytoreductive Surgery (CRS) in patients with Peritoneal Pseudomyxoma (PMP) of origin in the cecal appendix. The databases Medline and Central Cochrane were consulted. Patients with PMP of origin in the cecal appendix, classified as low grade, high or indeterminate, submitted to HIPEC and CRS. The results were meta-analyzed using the Comprehensive Metanalysis software. Twenty-six studies were selected to support this review. For low-grade PMP outcome, 60-month risk of mortality, Disease-Free Survival (DFS), and adverse events was 28.8% (95% CI 25.9 to 32), 43% (95% CI 36.4 and 49.8), and 46.7% (95% CI 40.7 to 52.8); for high-grade PMP, 60-month risk of mortality, Disease-Free Survival (DFS) and adverse events was 55.9% (95% CI 51.9 to 59.6), 20.1% (95% CI 15.5 to 25.7) and 30% (95% CI 25.2 to 35.3); PMP indeterminate degree, 60-month risk of mortality, Disease-Free Survival (DFS) and adverse events was 32.6% (95% CI 30.5 to 34.7), 61.8% (95% CI 58.8 to 64.7) and 32.9% (95% CI 30.5 to 35.4). The authors conclude that the HIPEC technique and cytoreductive surgery can be applied to selected cases of patients with PMP of peritoneal origin with satisfactory results.
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Affiliation(s)
- Idevaldo Floriano
- Evidence Based Medicine Center, UNIMED Cooperative, Baixa Mogiana regional, Mogi-Guaçu, SP, Brazil; Evidence Based Medicine Center, UNIMED Fesp, São Paulo, SP, Brazil.
| | - Antônio Silvinato
- Evidence Based Medicine Center, UNIMED Cooperative, Baixa Mogiana regional, Mogi-Guaçu, SP, Brazil; Evidence Based Medicine Center, UNIMED Fesp, São Paulo, SP, Brazil
| | - João C Reis
- Guidelines Program of the Brazilian Medical Association, São Paulo, SP, Brazil
| | - Claudia Cafalli
- Evidence Based Medicine Center, UNIMED Fesp, São Paulo, SP, Brazil
| | - Wanderley Marques Bernardo
- Guidelines Program of the Brazilian Medical Association, São Paulo, SP, Brazil; Evidence Based Medicine Center, UNIMED Fesp, São Paulo, SP, Brazil
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Affiliation(s)
| | | | - Wanderley Marques Bernardo
- Associação Médica Brasileira. Coordenador do Programa Diretrizes da Associação Médica Brasileira, São Paulo, SP, Brasil
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Floriano I, Silvinato A, Bernardo WM, Reis JC, Soledade G. Accuracy of the Polymerase Chain Reaction (PCR) test in the diagnosis of acute respiratory syndrome due to coronavirus: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2020; 66:880-888. [PMID: 32844930 DOI: 10.1590/1806-9282.66.7.880] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
| | | | | | - João C Reis
- Programa Diretrizes da AMB, São Paulo, SP, Brasil
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Silvinato A, Floriano I, Bernardo WM. Multiple lidocaine infusions for relief of neuropathic pain: systematic review and meta-analysis. Rev Assoc Med Bras (1992) 2020; 66:889. [DOI: 10.1590/1806-9282.66.7.889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Silvinato A, Bernardo WM, Floriano I, Soledade GNB. Neonatal sepsis with neutropenia: granulocytecolony stimulating factor (G-CSF). Rev Assoc Med Bras (1992) 2020; 66:400. [PMID: 32578768 DOI: 10.1590/1806-9282.66.4.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Antonio Silvinato
- . Programa Diretrizes da Associação Médica Brasileira, São Paulo, SP, Brasil
| | | | - Idevaldo Floriano
- . Programa Diretrizes da Associação Médica Brasileira, São Paulo, SP, Brasil
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Silvinato A, Floriano I, Bernardo WM. Multiple lidocaine infusions for relief of neuropathic pain: systematic review and meta-analysis. Rev Assoc Med Bras (1992) 2020; 66:583-588. [DOI: 10.1590/1806-9282.66.5.583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Indexed: 11/21/2022] Open
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Silvinato A, Bernardo WM, Floriano I, Soledade GNB. Neonatal sepsis with neutropenia: granulocyte-colony stimulating factor (G-CSF). Rev Assoc Med Bras (1992) 2020; 66:3-10. [PMID: 32130373 DOI: 10.1590/1806-9282.66.1.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2019] [Indexed: 01/22/2023] Open
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Silvinato A, Floriano I, Bernardo WM. Advanced non-small cell lung cancer - Treatment with Pembrolizumab. ACTA ACUST UNITED AC 2020; 65:1423-1432. [PMID: 31994619 DOI: 10.1590/1806-9282.65.12.1423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2019] [Indexed: 11/22/2022]
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Silvinato A, Bernardo WM, Floriano I. Advanced melanoma in adults: Pembrolizumab as a treatment option. Rev Assoc Med Bras (1992) 2020; 66:100-107. [DOI: 10.1590/1806-9282.66.2.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 07/28/2019] [Indexed: 11/22/2022] Open
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Buzzini RF, Silvinato A, Floriano I, Bernardo WM, Almeida GRD. Decompensated congestive heart failure - treatment with levosimendan. Rev Assoc Med Bras (1992) 2019; 65:524-529. [DOI: 10.1590/1806-9282.65.4.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2019] [Indexed: 11/22/2022] Open
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Floriano I, Bonini GC, Matos R, Novaes TF, Ekstrand KR, Mendes FM, Braga MM. How different do visuo-tactile criteria assess caries lesions activity status on occlusal surfaces? Oral Dis 2014; 21:299-307. [PMID: 24912618 DOI: 10.1111/odi.12265] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Revised: 05/05/2014] [Accepted: 05/26/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We tested the association between active caries lesions assessed by two different criteria and clinical features of these caries lesions. MATERIALS AND METHODS Three examiners examined forty-nine 3- to 12-year-old children: one examiner used the Nyvad criteria, another examiner used the International Caries Detection and Assessment System with an additional criteria--Lesion Activity Assessment (ICDAS + LAA), and a reference examiner classified lesions regarding plaque stagnation, colour, lustre, cavities, depth and texture. Logistic regressions were used to test associations. For analyses, we grouped sound sites and inactive lesions vs active caries lesions, but also considering only inactive vs active lesions. RESULTS Active lesions scored by both criteria were similarly associated with different clinical parameters tested, except when the sound sites were excluded from the analysis. In these cases, active lesions according to ICDAS + LAA were associated only with cavitation and texture. Texture was associated with divergences between criteria when differentiating sound or inactive lesions from active ones. Fewer divergences in differentiating active from inactive lesions were observed when lesions present lustre. CONCLUSION Most clinical signs associated with active caries lesions were similar, but texture and severity tend to have a greater importance when using ICDAS + LAA for distinguishing caries activity status. Attention should be given to differences due to texture and lustre when using different indices.
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Affiliation(s)
- I Floriano
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Cavaliere H, Floriano I, Medeiros-Neto G. Gastrointestinal side effects of orlistat may be prevented by concomitant prescription of natural fibers (psyllium mucilloid). Int J Obes (Lond) 2001; 25:1095-9. [PMID: 11443512 DOI: 10.1038/sj.ijo.0801645] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2000] [Revised: 11/29/2000] [Accepted: 01/23/2001] [Indexed: 11/10/2022]
Abstract
OBJECTIVES This placebo-controlled open study was designed to test the hypothesis that most of the gastrointestinal (GI) side events induced by treatment of obese patients with orlistat (a gastrointestinal lipase inhibitor) could be prevented or ameliorated by concomitant use of natural fibers (psyllium mucilloid). DESIGN Two groups of obese women (BMI>27 kg/m(2)) were treated with orlistat 120 mg three times a day. One group (A, n=30) was randomized to receive orlistat and, approximately 6.0 g of orange-flavored psyllium mucilloid dissolved in water and the other group (B, n=30) received orlistat and orange-flavored placebo. At the end of 30 days and 2 weeks of washout, group A switched to placebo and group B received psyllium while continuing orlistat three times a day. SUBJECTS Sixty professional women, more than 21-y-old with a body mass index (BMI) between 27.3 and 48.0 kg/m(2), who were not receiving any other medication. MEASUREMENTS Assessments included weekly visits to attending physician, filling a form in which GI events were recorded, monthly measurements of body weight, blood pressure and serum lipids. The frequency and severity of GI events were evaluated by a score system, based on information provided by the patients. RESULTS Both groups A and B significantly lost (P<0.01) weight after 60 days of orlistat (A=96.8 to 94.9 kg and B=98.7 to 96.5 kg). Similarly, BMI values declined significantly in both groups. While in the psyllium plus orlistat group (group A) the mean +/-s.e.m. of the scores reflecting GI events was 13.0+/-1.8, the placebo plus orlistat group (B) had a value of 35.9+/-2.7 (P<0.01). When the reverse situation was instituted the placebo and orlistat group presented a mean score of 36.1+/-3.6 and the psyllium plus orlistat a mean score of 8.9+/-1.5 (P<0.01). CONCLUSIONS Psyllium hydrophilic mucilloid concomitantly prescribed to obese patients receiving 120 mg of orlistat three times a day is an effective and safe adjunct therapy that is helpful in controlling the GI side effects of this pancreatic lipase inhibitor.
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Affiliation(s)
- H Cavaliere
- Department of Clinical Medicine, University of São Paulo Medical School, São Paulo, Brazil
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