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Institution

Federal University of São Paulo

EducationSão Paulo, Brazil
About: Federal University of São Paulo is a education organization based out in São Paulo, Brazil. It is known for research contribution in the topics: Population & Transplantation. The organization has 27971 authors who have published 49365 publications receiving 935536 citations. The organization is also known as: Universidade Federal de São Paulo & Universidade Federal de Sao Paulo.


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Journal ArticleDOI
TL;DR: O polen do estado do Parana extraido com etanol a 60%, apresentou o maior indice de atividade antioxidante e tambem a maior concentracao de compostos fenolicos.
Abstract: Objetivou-se, neste estudo determinar compostos fenolicos, a atividade antioxidante a antibacteriana dos extratos etanolicos de polen, obtidos com diferentes concentracoes de etanol. As diferentes condicoes de extracao (etanol de 40 a 90%) apresentaram diferentes efeitos no conteudo dos compostos fenolicos extraidos. Os extratos de polen obtidos com etanol a 60, 70 e 80% apresentaram maiores niveis de compostos fenolicos (>10 mg/g) e nao apresentaram diferencas estatisticas entre essas condicoes de extracao. A quantidade de compostos fenolicos nos extratos de polen variou de 3.6 a 8.1 e 6.6 a 11 mg de equivalente em acido galico por g de polen (GAE), para os estados de Alagoas e Parana, respectivamente. Os maiores indices de atividade antioxidante para o polen do estado de Alagoas foi de 83.30% e 81.15 % para o polen do estado do Parana. O polen do estado do Parana extraido com etanol a 60%, apresentou o maior indice de atividade antioxidante e tambem a maior concentracao de compostos fenolicos. A bacteria Staphylococcus aureus foi inibida pelo extrato etanolico do polen de Alagoas, em todas as concentracoes, exceto no extrato etanolico a 90%. O extrato etanolico a 60%, no polen do Parana, inibiu Bacillus subtilis, Pseudomonas aeruginosa e Klebsiella sp.

159 citations

Journal ArticleDOI
TL;DR: Low-quality evidence from six trials indicates that diacerein has a small beneficial effect on overall pain, and this updated review now includes 10 trials, totalling 2,210 participants.
Abstract: Background Osteoarthritis (OA) is one of the most prevalent musculoskeletal diseases. There is currently no consensus on what is the best treatment to improve OA symptoms and slow disease progression. Diacerein is an anthraquinone synthesised in 1980 that interferes with interleukin-1, an inflammatory mediator. It has been proposed that diacerein acts as a slow-acting, symptom-modifying and perhaps disease-structure-modifying drug for OA. This is an update of a Cochrane review first published in 2006. Objectives To assess the benefits and harms of diacerein for the treatment of adults with OA when compared with placebo and other pharmacologically active interventions (nonsteroidal anti-inflammatory drugs (NSAIDs) and other symptom-modifying, slow-acting drugs) for OA. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) - The Cochrane Library, Issue 10, 2013, MEDLINE (1966 to 2013), EMBASE (1980 to 2013), LILACS (1982 to 2013), and ACP Journal Club, and we handsearched reference lists of published articles. We also searched the World Health Organization International Clinical Trials Platform ( http://www.who.int/trialsearch/Default.aspx) to identify ongoing trials and screened reference lists of retrieved review articles and trials to identify potentially relevant studies. All searches were up to date as of March 2013. Pharmaceutical companies and authors of published articles were contacted. We searched the websites of the regulatory agencies using the keyword ‘diacerein’ in November 2013. No language restrictions were applied. Selection criteria Studies were included if they were randomised or quasi-randomised controlled trials that compared diacerein with placebo or another active pharmacological intervention in participants with OA. Data collection and analysis Data abstraction and quality assessment were performed by two independent investigators, and their results were compared. The Cochrane risk of bias tool was used. The quality of evidence obtained was assessed using the GRADE approach. Main results We identified three new trials (141 participants), and this updated review now includes 10 trials, totalling 2,210 participants. The most frequent risk of bias was incomplete outcome data, identified in approximately 80% of the studies. Allocation concealment and random sequence generation were unclear in 90% and 40% of the studies, respectively, because of poor reporting. Low-quality evidence from six trials (1,283 participants) indicates that diacerein has a small beneficial effect on overall pain (measured on a 100 mm visual analogue scale) at three to 36 months (mean difference (MD) -8.65, 95% confidence interval (CI) -15.62 to -1.68), which is equivalent to a 9% pain reduction in the diacerein group (95% CI -16% to -2%) compared with the placebo group. This benefit may not be clinically significant. No statistically significant differences in physical function (4 studies, 1006 participants) were noted between the diacerein and placebo groups (Lequesne impairment index, 0 to 24 points) (MD -0.29, 95% CI -0.87 to 0.28). Low-quality evidence from two trials (616 participants) on slowing of joint space narrowing (a decrease greater than 0.50 mm) in the knee or hip favoured diacerein over placebo (risk ratio (RR) 0.85, 95% CI 0.72 to 0.99), with an absolute risk difference of -6% (95% CI -15% to 2%) and a number needed to treat for an additional beneficial outcome (NNTB) of 14 (95% CI 8 to 203). Analysis of the knee joint alone (1 study, 170 participants) did not reach statistical significance (RR 0.94, 95% CI 0.51 to 1.74). None of the trials of diacerein versus placebo measured quality of life. According to one trial (161 participants), which compared diacerein versus non-steroidal anti-inflammatory drugs (NSAIDs), the quality of life of participants in the two groups (as assessed by the Short Form (SF)-36 health survey questionnaire (0 to 800 sum score)) did not differ significantly (MD -40.70, 95% CI -85.20 to 3.80). Low-quality evidence from seven trials showed significantly more adverse events in the diacerein group compared with the placebo group after two to 36 months, mainly diarrhoea (RR 3.52, 95% CI 2.42 to 5.11), with an absolute risk increase of 24% (95% CI 12% to 35%), and a number needed to treat for an additional harmful outcome (NNTH) of 4 (95% CI 3 to 7). No statistically significant differences in participant withdrawal due to adverse events were seen at two to 36 months for diacerein compared with placebo (RR 1.29, 95% CI 0.83 to 2.01). A search of regulatory websites found a recommendation from the European Medicines Agency (EMA) Pharmacovigilance Risk Assessment Committee (PRAC) that the marketing authorization of diacerein should be suspended across Europe because of harms (particularly the risk of severe diarrhoea and potentially harmful effects on the liver) outweighing benefits. However, this guidance is not final as the PRAC recommendation will be re-examined. Authors' conclusions In this update, the strength of evidence for effectiveness outcomes was low to moderate. We confirmed that symptomatic benefit provided by diacerein in terms of pain reduction is minimal. The small benefit derived in terms of joint space narrowing is of questionable clinical relevance and was observed only for OA of the hip. With respect to adverse effects of diacerein, diarrhoea was most frequent. Given the recent guidance issued by the EMA recommending suspension of diacerein in Europe, the EMA website should be consulted for further recommendations regarding the use of diacerein.

159 citations

Journal ArticleDOI
TL;DR: The results in terms of occurrence of postoperative stoma prolapse support the choice of loop ileostomy as a technique for fecal diversion for colorectal anastomosis, but large scale RCT's is needed to verify this.
Abstract: Background The use of loop ileostomy or loop transverse colostomy represents an important issue in colorectal surgery. Despite a slight preference for a loop ileostomy as a temporary stoma, the best form for temporary decompression of colorectal anastomosis still remains controversial. Objectives To assess the evidence in the use of loop ileostomy compared with loop transverse colostomy for temporary decompression of colorectal anastomosis, comparing the safety and effectiveness. Search methods We identified randomised controlled trials from MEDLINE, EMBASE, Lilacs, and the Cochrane Central Register of Controlled Trials. Further, by hand-searching relevant medical journals and proceedings from major gastroenterological congresses. We did not limit the seaches regarding date and language. Selection criteria We assessed all randomised clinical trials, that met the objectives and reported major outcomes: 1. Mortality; 2. Wound infection; 3. Time of formation of stoma; 4. Time of closure of stoma; 5. Time interval between formation and closure of stoma; 6. Stoma prolapse; 7. Stoma retraction; 8. Parastomal hernia; 9. Parastomal fistula; 10. Stenosis; 11. Necrosis; 12. Skin irritation; 13. Ileus; 14. Bowel leakage; 15. Reoperation; 16. Patient adaptation; 17. Length of hospital stay; 18. Colorectal anastomotic dehiscence; 19. Incisional hernia; 20. Postoperative bowel obstruction. Data collection and analysis Details of the randomisation, blinding, whether an intention-to-treat analysis was done, and the number of patients lost to follow-up was recorded. For data analysis the relative risk and risk difference were used with corresponding 95% confidence interval; fixed effect was used for all outcomes unless incisional hernia (random effect model). Statistical heterogeneity in the results of the meta-analysis was assessed by inspection of graphical presentation (funnel plot) and by calculating a test of heterogeneity. Main results Five trials were included with 334 patients: 168 to loop ileostomy group and 166 to loop transverse colostomy group. The continuous outcomes could not be measured because of the lack of the data. The outcomes stoma prolapse had statistical significant difference: p=0.00001, but with statistical heterogeneity, p=0,001. When the sensitive analysis was applied excluding the trials that included emergencies surgeries, the result had a discreet difference: p = 0.02 and Test for heterogeneity: chi-square = 0.78, df = 2, p = 0.68, I2=0%. Authors' conclusions The best available evidence for decompression of colorectal anastomosis, either use of loop ileostomy or loop colostomy, could not be clarified from this review. So far, the results in terms of occurrence of postoperative stoma prolapse support the choice of loop ileostomy as a technique for fecal diversion for colorectal anastomosis, but large scale RCT's is needed to verify this.

159 citations

Journal ArticleDOI
TL;DR: Ocular involvement in infants with presumed ZIKV congenital infection were more often seen in infantsWith smaller cephalic diameter at birth and in infants whose mothers reported symptoms during the first trimester.
Abstract: Importance The Zika virus (ZIKV) might cause microcephaly and ophthalmoscopic findings in infants of mothers infected during pregnancy. Objective To assess and identify possible risk factors for ophthalmoscopic findings in infants born with microcephaly and a presumed clinical diagnosis of ZIKV intrauterine infection. Design, Setting, and Participants We conducted a cross-sectional study at the Altino Ventura Foundation in Recife, Brazil, that included 40 infants with microcephaly born in Pernambuco state, Brazil, between May and December 2015. Toxoplasmosis, rubella, cytomegalovirus, syphilis, and human immunodeficiency virus were ruled out in all of them. Testing of cerebrospinal fluid for ZIKV using IgM antibody-capture enzyme-linked immunosorbent assay was performed in 24 of 40 infants (60.0%). The infants and mothers underwent ocular examinations. The infants were divided into 2 groups, those with and without ophthalmoscopic alterations, for comparison. Main Outcomes and Measures Identification of risk factors for ophthalmoscopic findings in infants born with microcephaly and ZIKV intrauterine infection. Results Among the 40 infants, the mean (SD) age was 2.2 (1.2) months (range, 0.1-7.3 months). Of the 24 infants tested, 100% had positive results for ZIKV infection: 14 of 22 infants (63.6%) from the group with ophthalmoscopic findings and 10 of 18 infants (55.6%) from the group without ophthalmoscopic findings. The major symptoms reported in both groups were rash by 26 mothers (65.0%), fever by 9 mothers (22.5%), headache by 9 mothers (22.5%), and arthralgia by 8 mothers (20.0%). No mothers reported conjunctivitis or other ocular symptoms during pregnancy or presented signs of uveitis at the time of examination. Thirty-seven eyes (46.3%) of 22 infants (55.0%) had ophthalmoscopic alterations. Ten mothers (71.4%) of infants with ocular findings reported symptoms during the first trimester (frequency, 0.48; 95% CI, 0.02-0.67; P = .04). A difference was also observed between the groups of infants with and without ocular findings regarding the cephalic perimeter: mean (SD) of 28.8 (1.7) and 30.3 (1.5), respectively (frequency, −1.50; 95% CI, −2.56 to −0.51; P = .004). Conclusions and Relevance Ocular involvement in infants with presumed ZIKV congenital infection were more often seen in infants with smaller cephalic diameter at birth and in infants whose mothers reported symptoms during the first trimester.

159 citations

Journal ArticleDOI
TL;DR: It is demonstrated that cycloheximide, a protein synthesis inhibitor, blocked pilocarpine- and kainate-induced mossy fiber sprouting in rats, but did not prevent the subsequent development of spontaneous seizures or affect their frequency.

159 citations


Authors

Showing all 28240 results

NameH-indexPapersCitations
Majid Ezzati133443137171
Christian Guilleminault13389768844
Jean Rivier13376973919
Myron M. Levine12378960865
Werner Seeger114111357464
Katherine L. Tucker10668339404
Michael Bader10373537525
Paulo A. Lotufo89622100527
Fernando Q. Cunha8868231501
Paul R. Sanberg8763529745
Harold A. Chapman8719126617
Ricardo T. Gazzinelli8634028233
Carlito B. Lebrilla8649525415
Roger S. McIntyre8580732040
Sergio Tufik85142435174
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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
202372
2022409
20213,981
20203,843
20193,234
20182,898