São José do Rio Preto, Brazil
São José do Rio Preto, Brazil

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Spessoto L.C.F.,FAMERP | Cordeiro J.A.,FAMERP | De Godoy J.M.P.,FAMERP
BJU International | Year: 2010

OBJECTIVE To report the effect of systemic arterial pressure on erectile dysfunction (ED) in patients in the initial stages of peripheral arterial disease. PATIENTS AND METHODS All patients with a diagnosis of ED in the urology outpatient clinic of the Medicine School in São José do Rio Preto, Brazil were evaluated in a cross-sectional, quantitative study. The patients were assessed using the International Index of Erectile Function, the ankle-brachial index, and measurement of arterial blood pressure. Binary logistic regression, log-likelihood, Pearson chi-square and likelihood ratio chi-square and Kruskal-Wallis Test were used for statistical analysis with P < 0.05 being considered acceptable. Fifty-two patients (mean age 56.63 years) were enrolled in the study. RESULTS Differences were detected between the median grades of ED of patients with differing degrees of chronic arterial insufficiency. Hypertensive patients in the initial stages of peripheral arterial disease had less severe grades of ED than normotensive patients. CONCLUSIONS The progression of ED parallels the development of chronic arterial insufficiency. Systemic arterial hypertension in the initial stages of peripheral arterial disease might protect against ED, but peripheral arterial disease constitutes an aggravating factor for ED, and thus hypertension might exert a paradoxical effect in this stage of the disease. © 2009 BJU International.


Bastos A.S.,Hospital Of Base | Beccaria L.M.,FAMERP | Contrin L.M.,FAMERP | Cesarino C.B.,FAMERP
Brazilian Journal of Cardiovascular Surgery | Year: 2012

Objectives: To characterize the profile of patients with acute myocardial infarction (AMI) treated at the emergency department and to verify the time of arrival of each patient (ΔT). Identify how the patient was transported and to correlate Delta-T (ΔT) with the treatment and the prognosis of each patient. Methods: Cross-sectional survey involving 52 patients with AMI admitted to the Emergency Department of a Teaching Hospital took part in the study from July to December 2010. Data collection was performed using medical records and interviews. Results: The majority of the patients were male with a mean age of 62.35 ± 14.66 years. The participants were married, with low education levels, family history of heart diseases, arterial hypertension, dyslipidemia, and a sedentary lifestyle. The symptoms presented were pains in the chest, epigastric region, or a chest discomfort associated to dyspnea and/or sudden sweating. The majority of the patients were transported by ambulance. They were submitted to cardiac catheterization followed by angioplasty. Delta-T found was 9h45min ± 18h9min. In this study, the overall lethality was 3.85%. Conclusions: The perception of signs and symptoms of AMI by the patient was a decisive factor when seeking out specialized treatment. Those with the lowest Delta-T presented better prognosis.


Bellini M.F.,São Paulo State University | Cury P.M.,FAMERP | Silva A.E.,São Paulo State University
Anticancer Research | Year: 2010

Background: The present study aimed to evaluate apoptosis and cell proliferation alterations in esophageal benign lesions in comparison to esophageal carcinomas. Materials and Methods: Immunohistochemistry was performed for caspase-3 protein (CPP32) and Ki-67 antigen expression in the esophageal mucosa from patients with Chagas disease (CD) with and without megaesophagus (CM), chronic esophagitis (CE), esophageal carcinoma (ESCC) and in normal mucosa (NM). Results: The Ki-67 labeling index (LI) was similar in all groups (range: 30%-48%), having no statistically significant difference among the groups. Positive CPP32 immunostaining was observed with similar frequency in the CD (30.8%), CM (30.4%) and CE (34.8%) groups, but it was increased in the ESCC group (555%); however, it was not statistically different from the other groups. No associations among the levels of CPP32 and Ki-67 expression were observed in the various groups, neither among parameters such as age, gender or alcohol and tobacco consumption. Conclusion: There were no evident changes in cell proliferation and apoptosis in benign lesions studied.


Fornitano L.D.,FAMERP | Godoy M.F.,FAMERP
Obesity Surgery | Year: 2010

Background Obesity is an independent risk factor for cardiovascular disease, especially in its morbid form. Bariatric surgery is an effective therapeutic option for sustained weight loss. However, there is no consensus in these cases regarding the performance of functional tests for preoperative evaluations. The aim of the present study was to analyze clinical, electrocardiographic, and hemodynamic response variables using a conventional exercise test on individuals with morbid obesity in comparison to overweight individuals. Methods Six hundred seventeen cases were included. Group I had 290 patients with morbid obesity and group II had 327 overweight patients. All were submitted to a conventional treadmill exercise test. Classic positivity criteria were used. Results Both groups tolerated the test well. There was no statistically significant difference in terms of positivity of the test [ST segment abnormality or angor (P=0.3863) or ST segment abnormality alone (P=0.1000)]. The significantly higher values in the obese individuals were basal heart rate, basal systolic arterial pressure (SAP), maximum SAP, basal diastolic arterial pressure (DAP), maximum DAP, chronotropic deficit (P<0.0001), and maximum ratepressure product (P<0.0421). The significantly lower values in the obese individuals were exercise time, maximum heart rate, and metabolic equivalents values (P<0.0001). Conclusion Hemodynamic parameters were significantly different between the two groups. However, there were no differences in terms of ST segment abnormalities or effortinduced angina. The very low functional capacity and complex arrhythmia found in some obese individuals draws attention to the need for complementary investigation, with the aim of diminishing the risk of postoperative heart complications. © 2008 Springer Science + Business Media, LLC.


Morais D.F.,Base Hospital | De Melo Neto J.S.,Health and Aging | Meguins L.C.,Base Hospital | Filho J.R.L.F.,FAMERP | Tognola W.A.,FAMERP
European Spine Journal | Year: 2014

Purpose: To assess the clinical application of magnetic resonance imaging (MRI) in patients with acute spinal cord trauma (SCT) according to the type, extension, and severity of injury and the clinical-radiological correlation. Methods: Diagnostic imaging [computed tomography (CT) and MRI] tests of 98 patients with acute SCT were analyzed to assess their clinical diagnostic value. The following radiological findings of SCT were investigated: vertebral compression fractures, bursts and dislocations, posterior element fractures, C1 and C2 lesions, vertebral listhesis, bone swelling, spinal canal compression, disk herniation, extradural hematoma, spinal cord contusions, spinal cord swelling, and posterior ligamentous complex (PLC) injuries. Results: The radiological findings were better visualized using MRI, except for the posterior elements (p = 0.001), which were better identified with CT. A total of 271 lesions were diagnosed as follows: 217 using MRI, 154 using CT, and 100 (36.9 %) using both MRI and CT. MRI detected 117 more lesions than CT. Conclusion: MRI was significantly superior to CT in the diagnosis of bone swelling, PLC injury, disk herniation, spinal canal compression, spinal cord contusion and swelling present in SCT. MRI detected a larger number of lesions than CT and is highly useful for the diagnosis of soft tissue and intrathecal injuries. © 2013 Springer-Verlag.


Godoy M.F.G.,Medicine School in Sao Jose do Rio Preto | Pereira M.R.,FAMERP
International Journal of Medical Sciences | Year: 2012

Trial design: A randomized controlled trial was performed to evaluate the effect of the combination of compression therapy with active exercising using a facilitating apparatus on arm lymphedema. Method: Twenty women with a mean age of 63.3 years were evaluated; all had lymphedema resulting from breast cancer treatment. The inclusion criterion was a dif-ference of 200 mL in size between arms. The apparatus used, called 'pulley system', is a ver-tical iron wheel fixed on a support at a distance of 10 cm from the patient's body. Participants were submitted to two series of active exercises using this facilitating device, one series using a compression sleeve and the other without. Each series consisted of four 12-minute sessions of exercises separated by 3-minute rest intervals. Volumetry was performed before and after each series of exercises. The paired t-test was utilized for statistical analysis (p-value < 0.05). Results: A significant mean reduction (p-value < 0.007) and non-significant mean increase (p-value < 0.2) in volumes were observed during exercising with and without compression, respectively. Conclusion: Controlled active exercising utilizing a facilitating apparatus while wearing a compression sleeve reduces the size of lymphedematous arms. © Ivyspring International Publisher.


Gaillard A.L.,FAMERP | Anastacio V.M.,FAMERP | Piatto V.B.,FAMERP | Maniglia J.V.,FAMERP | Molina F.D.,Outpatient Unit
Brazilian Journal of Otorhinolaryngology | Year: 2010

Juvenile nasopharyngeal angiofibroma QNA) is a rare tumor in adolescent males. It originates in the nasopharynx. Aim: to present the experience of JNA management at an Otorhinolaryngology Service between 2001 and 2008. Materials and Methods: Demographical data, clinical presentation, investigations as well as the treatment of sixteen JNA patients were reviewed and collected from medical records from the ORL Service. Design: Cross-sectional, retrospective and descriptive study. Results: All JNA patients were male. The average age at diagnosis was 16.8 years (range 9-23 years). More than 56% of the patients were classified as Fisch II. Preoperative embolization was carried out in ten (62.5%) patients. All 16 patients were submitted to primary surgical resection. Two patients (66.7%) who didn't receive preoperative embolization required intraoperative blood transfusion. The overall recurrence rate was 43.75% and the cure rate was 93.75%. Conclusion: Preoperative embolization minimizes intraoperative blood loss. The recurrence rate was related to advanced tumoral stage at diagnostic and the lack of preoperative embolization. Surgery combined with preoperative embolization is the major treatment for JNA. All the patients should undergo preoperative imaging studies, especially CT, to assist in surgical planning and follow-up.


Luna D.M.N.,Federal University of Pernambuco | Oliveira M.D.L.,Federal University of Pernambuco | Nogueira M.L.,FAMERP | Andrade C.A.S.,Federal University of Pernambuco
Chemistry and Physics of Lipids | Year: 2014

In this work, we developed a biosystem based on Concanavalin A (ConA) and lipid membranes to recognize glycoproteins from the serum of patients contaminated with dengue serotypes 1, 2 and 3 (DENV1, DENV2 and DENV3). The modified gold electrode was characterized using cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS) and atomic force microscopy. Morphological analyses of 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC), DPPC-ConA, DPPC-ConA-DENV1, DPPC-ConA-DENV2 and DPPC-ConA-DENV3 revealed the existence of a non-uniform covering and large globules. EIS and CV measurements have shown that redox probe reactions on the modified gold electrodes were partially blocked due to the adsorption of lipid-ConA system and reveal the interaction response of the immobilized ConA to the presence of glycoproteins of dengue serum. The biosystem exhibited a wide linear response to different concentrations of sera of dengue serotypes 1, 2 and 3. A higher impedimetric response to glycoproteins present in dengue serotype 3 was observed. Our results demonstrate the applicability of lectin and lipid membranes to the development of biosensors for dengue infections. © 2014 Elsevier Ireland Ltd.


de Godoy M.F.G.,FAMERP
International Journal of Medical Sciences | Year: 2010

The aim of this paper is to report new options in the treatment of lymphedema for under-privileged populations. Several articles and books have been published reporting recent advances and contributions. A new technique of manual lymph drainage, mechanisms of compression, development of active and passive exercising apparatuses and the adaptation of myolymphokinetic activities have been developed for the treatment of lymphedema. This novel approach can be adapted for the treatment of lymphedema in mass. © Ivyspring International Publisher.


News Article | December 15, 2016
Site: www.eurekalert.org

A specific group of variants in the human leukocyte antigen genomic region is associated with enhanced protection against HPV-positive oropharyngeal cancer A number of genetic variants associated with susceptibility to oral cavity and pharyngeal cancer have been described in an international study published in the journal Nature Genetics. The most noteworthy finding was an association between cancer of the oropharynx and certain polymorphisms (alternative versions of a given DNA sequence) found in the human leukocyte antigen (HLA) genomic region. HLAs, proteins found on the surface of most cells in the body, play an important role in recognizing potential threats and triggering the immune response to foreign substances. According to Eloiza Helena Tajara, a professor at the São José do Rio Preto Medical School (FAMERP) in São Paulo State, Brazil, and co-author of the article, a specific group of variants in this region, located on chromosome 6, is associated with enhanced protection against oropharyngeal cancer caused by human papilloma virus (HPV). "Previous research showed that these same variants confer protection against cancer of the uterine cervix, which is known to be associated with HPV," Tajara said. "Our findings suggest that the genes that control the immune system play a key role in predisposition to HPV-related tumors. This discovery points to the possibility of clarifying the mechanisms whereby such tumors develop and of designing methods for monitoring risk groups." The study was coordinated by the International Agency for Research on Cancer (IARC) and involved 40 research groups in Europe, the United States, and South America. The Brazilian participants are members of the Head & Neck Genome Project (GENCAPO), a consortium of scientists affiliated with several institutions. In a recent study, GENCAPO evaluated more than 7 million genetic variants in samples from 6,034 patients with head and neck cancer. The cases comprised 2,990 oral cavity tumors, 2,641 oropharyngeal tumors, 305 tumors in the hypopharynx (the bottom part of the pharynx near the esophagus), and 168 tumors in other regions or more than one region concurrently. The study population also included samples from 6,585 people without cancer as controls. The researchers detected eight loci (genomic sites) associated with susceptibility to these types of tumor. Seven had not previously been linked to mouth or throat cancer. According to Tajara, the IARC set out to focus on analyzing oral cavity and oropharynx tumors because there are no genome-wide association studies of these two tumor types. Although these cancers are predominantly caused by tobacco and alcohol use, the importance of HPV, particularly HPV16, as a cause of oropharyngeal cancer has become more evident in recent years. "The throat is the most affected area among head and neck cancer subsites, likely because its tissue is more receptive to the virus," Tajara said. In the article, the researchers note that the proportion of HPV-related oropharyngeal cancer cases is estimated to be approximately 60% in the US and 30% in Europe but lower in South America. "One finding that was expected to some extent was the absence of HLA associations with oropharyngeal cancer, which may be due to the fact that the frequency of HPV-positive oropharyngeal cancer is less than 10% in South America," Tajara said. "The same factor appears to account for the weak association between the variants identified and HPV-positive oral cavity cancer, which is also far less frequent than HPV-negative oral cavity cancer." In her view, the strong rise in cases linked to HPV in the US could be partly due to a change in sexual habits, especially regarding the practice of oral sex. "It's possible that Brazil is still in a transition stage and that the habits that favor infection are only starting to become more common. If so, the effects will appear in a few years' time," she said. Previous studies have already shown that HPV-associated head and neck cancers affect younger people and develop rapidly. By contrast, cases associated with tobacco and alcohol use as well as poor oral hygiene are more prevalent in those over fifty years old and progress more slowly but are harder to treat. In addition to DNA in tissue samples taken from participants of the study, data were also collected on environmental and clinical factors possibly associated with the development of this type of cancer, such as smoking, alcohol consumption, and age. According to Tajara, thanks to the joint efforts of 40 research groups it was possible to obtain data on a significant number of patients, thus enhancing the impact and reliability of the results. The GENCAPO team contributed some 1,000 samples from tumors for analysis. "Based on these results, we can try to understand from the molecular standpoint how the observed polymorphisms interfere with the response to HPV infection," Tajara said. "This may give us clues as to how to protect people and how to reduce the incidence of this type of tumor."

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