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ISSN: 1807-5932
e-ISSN: 1980-5322

Clinics is a gold open access electronic international journal that publishes peer-reviewed research in continuous flow of interest to clinicians and researchers in medical and biomedical sciences based on its originality, importance, conclusions and interest to readers. CLINICS also publishes Comments and Editorials. The journal is committed to the principles of ethics, respect for the individual, humanization, honesty, pioneering spirit and excellence.Clinics is the Official Scientific journal of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP).

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Clarivate/ISI: Web of Sciences, SCOPUS, PubMed Central (PMC), SciELO Brasil, SciELO Public Health, Redalyc, EMBASE, Nutrition Abstracts & Reviews, POPLINE, Tropical Diseases Bulletin, LILACS

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The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years.

© Clarivate Analytics, Journal Citation Reports 2022

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Vol. 78.
(January - December 2023)
Will there be a critical review on the malignant transformation of oral lichen planus?
Dante Migliari
Clinics. 2023;78C:100146
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COVID-19 in children and adolescents with neuroimmunological disorders
Ingrid Lacerda Pessoa, Renata Barbosa Paolilo, José Albino da Paz
Clinics. 2023;78C:100142
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Do anti-VEGFs used in the ophthalmic clinic cause Müller glial cell stress?
Rafael André da Silva, Luiz Philipe de Souza Ferreira, Vinicius Moraes de Paiva Roda, José Maria Soares Junior, Manuel de Jesus Simões, Caio Vinicius Saito Regatieri
Clinics. 2023;78C:100161
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Humanization: Improving patient and family experience in a public pediatric hospital
Jussara de Oliveira Zimmermann, Anna-Dulce S.C. Sampaio, Aide Mitie Kudo, Magda Carneiro-Sampaio
Clinics. 2023;78C:100187
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The double-edged sword: COVID-19 pandemic-related delay in immune maturation in young children
Braian Lucas Aguiar Sousa, Magda Maria Sales Carneiro-Sampaio
Clinics. 2023;78C:100239
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Pesticide exposure and human health: Toxic legacy
Fulvio A. Scorza, Larissa Beltramim, Larissa M. Bombardi
Clinics. 2023;78C:100249
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Original articles
LIM-domain binding protein 2 was down-regulated by miRNA-96-5p inhibited the proliferation, invasion and metastasis of lung cancer H1299 cells
Fuying Chu, Xinxin Xu, Yan Zhang, Hua Cai, Jingjing Peng, Yanan Li, Han Zhang, Hongli Liu, Xiang Chen
Clinics. 2023;78C:100145

  • This is the first time to verify the targeting regulation of miR-96-5p on LDB2.

  • MiR-96-5p/LDB2 regulates cellular behaviors through ERK1/2 signaling pathway in lung cancer H1299 cell.

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LncRNA ZFAS1 contributes to osteosarcoma progression via miR-520b and miR-520e-mediated inhibition of RHOC signaling
Xiaofeng Liu, Mingyang Wang, Liwen Zhang, Lei Huang
Clinics. 2023;78C:100143

  • Lnc-ZFAS1 is highly expressed in osteosarcoma.

  • Lnc-ZFAS1 could promote cell proliferation, migration, invasion and EMT in vitro.

  • Lnc-ZFAS1 acted sponger of miR-520b and miR-520e to promote RHOC.

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Mesenchymal stem cells-derived exosomal miR-653-5p suppresses laryngeal papilloma progression by inhibiting BZW2
Binya Hu, Min Huang, Lihua Tao, Yun Li, Yuting Kuang, Guangliang Liu, Sijun Zhao
Clinics. 2023;78C:100129

  • The downregulation of miR-653-5p is involved in the progression of LP.

  • MSCs-derived exosomal miR-653-5p suppressed the malignant behaviors of LP cells.

  • The role of MSCs-derived exosomal miR-653-5p in LP relied on BZW2.

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Dysarthria in hereditary spastic paraplegia type 4
Lais Alves Jacinto-Scudeiro, Rui Rothe-Neves, Vanessa Brzoskowski dos Santos, Gustavo Dariva Machado, Daniela Burguêz, Marina Martins Pereira Padovani, Annelise Ayres, Rafaela Soares Rech, ... Maira Rozenfeld Olchik
Clinics. 2023;78C:100128

  • • Prevalence of dysarthria in SPG4 is greater than previously considered.

  • • The dysarthria in SPG4 is mild or moderate.

  • • The subsystems of speech more affected are articulatory and phonation.

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Intra-abdominal desmoid tumors in familial adenomatous polyposis: How much do clinical and surgical variables interfere with their development?
Fábio Guilherme Campos, Carlos Augusto Real Martinez, Leonardo Alfonso Bustamante-Lopez, Roberta Laís da Silva Mendonça, Danillo Toshio Kanno
Clinics. 2023;78C:100144

  • Desmoid Tumors in Familial Adenomatous Polyposis are a huge problem in these patients, the ability to prevent desmoid development is limited.

  • Some clinical and surgical variables were identified as unfavorable and associated with a greater risk.

  • This variable may be useful during the decision-making process.

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Complete blood count and C-reactive protein to predict positive blood culture among neonates using machine learning algorithms
Felipe Yu Matsushita, Vera Lúcia Jornada Krebs, Werther Brunow de Carvalho
Clinics. 2023;78C:100148

  • It can take days to get the result of blood culture.

  • CBC and CRP are readily available exams and could be used to predict blood culture.

  • ML algorithms based on CBC and CRP couldn't predict neonatal blood culture positivity.

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Anti-SARS-CoV-2 inactivated vaccine in patients with ANCA-associated vasculitis: Immunogenicity, safety, antibody decay and the booster dose
Rosa M.R. Pereira, Marilia A. Dagostin, Valeria F. Caparbo, Lucas P. Sales, Sandra G. Pasoto, Clovis A. Silva, Emily F.N. Yuki, Carla G.S. Saad, ... Eloisa Bonfa
Clinics. 2023;78C:100150

  • This study provides evidence that CoronaVac, an inactivated virus vaccine against SARS-CoV-2, is safe and has a moderate immunogenicity in AAV.

  • The authors identified that immunogenicity is negatively influenced by glucocorticoids.

  • A mild antibody decay occurs in 6-months with a good response with a booster dose, although lower than health controls.

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Transforming the invisible into the visible: disparities in the access to health in LGBT+ older people
Milton Roberto Furst Crenitte, Leonardo Rabelo de Melo, Wilson Jacob-Filho, Thiago Junqueira Avelino-Silva
Clinics. 2023;78C:100149

  • LGBT+ people can face several inequalities in access to healthcare.

  • LGBT+ people performed fewer preventive exams than their non-LGBT+ peers.

  • The worst access score was found in black LGBT+ over 50 years old.

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Changes in clinical and CT manifestations related to liver abscesses in patients with vs. without basic diabetes mellitus before and after CT-guided interventional therapy: An observational study
Yuxiang Chen, Xunfu Lai, Yuping Zhu, Mengting Wang, Yulin He
Clinics. 2023;78C:100164

  • Liver abscess patients with diabetes mellitus have featured presentations.

  • Liver abscess patients with diabetes mellitus have featured changes after therapy.

  • Liver abscess patients with diabetes mellitus cannot have a better therapeutic effect.

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Results of endoscopic biliary drainage in patients with malignant hilar stricture
Bruno Costa Martins, Caio A. Perez, Jennifer N. Ruas, Luiza H. Bento, Ernesto Q. Mendonça, Gustavo A. de Paulo, Ricardo S. Uemura, Sebastian N. Geiger, ... Fauze Maluf-Filho
Clinics. 2023;78C:100153

  • Malignant hilar biliary stricture had a high technical success rate but suboptimal clinical success rate.

  • At multivariable logistic-regression analyses, Bismuth IV strictures were related to higher clinical failure rates when compared to other strictures levels.

  • There was a trend towards higher failure rates with increased levels of pre-drainage bilirubin level, although not statistically significant.

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Could be FOXO3a, miR-96-5p and miR-182-5p useful for Brazilian women with luminal A and triple negative breast cancers prognosis and target therapy?
Daniele Carvalho Calvano Mendes, Carlos Marino Cabral Calvano Filho, Natália Garcia, Marcos Desidério Ricci, José Maria Soares, Katia Candido Carvalho, Edmund Chada Baracat
Clinics. 2023;78C:100155

  • miR-96-5p and 182-5p are associated with FOXO3a dysregulation and cancer.

  • FOXO3a and miRNAs represent molecular markers in Brazilian breast cancer patients.

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The association of diabetes, subclinical hypothyroidism and carotid intima-media thickness: results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brazil)
Aída de Melo Spilack, Alessandra C. Goulart, Bianca de Almeida-Pititto, Carolina Castro Porto Silva Janovsky, Paulo A. Lotufo, Itamar de Souza Santos, Isabela M. Benseñor
Clinics. 2023;78C:100154

  • cIMT is associated with diabetes.

  • Subclinical hypothyroidism was not associated with cIMT.

  • No additive effect over cIMT was detected in patients with both diseases.

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Social inequalities in access to cancer screening and early detection: A population-based study in the city of São Paulo, Brazil
Edige Felipe de Sousa Santos, Camila Nascimento Monteiro, Diama Bhadra Vale, Marília Louvison, Moisés Goldbaum, Chester Luiz Galvão Cesar, Marilisa Berti de Azevedo Barros
Clinics. 2023;78C:100160

  • The proportion of Pap smears remained at a high level (>89%) from 2003 to 2015 in São Paulo.

  • The offer of exams was expanded, more significantly for mammography and PSA, especially among the less educated group.

  • Were identified inequalities in access to cancer screening due to education, being more expressive for mammography and PSA tests.

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Safety and efficacy of short-term dual antiplatelet therapy combined with intensive rosuvastatin in acute ischemic stroke
Ting Deng, Wei He, Xiaohua Yao, Jingmian Chen, Xiaomeng Liu, Lushan Liu, Tong Zhang, Haitao Lu
Clinics. 2023;78C:100171

  • What Is New?

  • Short-term (7-day) DAPT with intensive rosuvastatin can quickly and effectively relieve the clinical symptoms for patients with mild-to-moderate AIS within 21-day.

  • Short-term (7-day) DAPT with intensive rosuvastatin significantly can reduce recurrent ischemic stroke for patients with mild-to-moderate AIS within 90-day.

  • Short-term (7-day) DAPT with intensive rosuvastatin rarely increased bleeding events, statin-induced liver injury, or statin-associated myopathy in patients with mild-to-moderate AIS.

  • What are the clinical implications?

  • Short-term (7-day) DAPT with intensive rosuvastatin might be a good alternative therapy regimen for mild-to-moderate AIS.

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Emotional, hyperactivity and inattention problems in adolescents with immunocompromising chronic diseases during the COVID-19 pandemic
Reinan T. Campos, Livia Lindoso, Renan A. de Sousa, Alberto C. Helito, Bianca P. Ihara, Claudia A.A. Strabelli, Levi M.V. Paradelas, Beatriz O.L. Carneiro, ... Clovis A. Silva
Clinics. 2023;78C:100167

  • The frequencies of abnormal emotional SDQ scores from adolescents with chronic diseases were significantly lower than those of healthy controls during the COVID-19 pandemic.

  • The frequencies of abnormal hyperactivity and inattention SDQ scores from adolescents with chronic diseases were significantly lower than those of healthy controls.

  • Abnormal emotional scores from adolescents with chronic diseases were as independently associated with female sex, poor sleep quality, and intrafamilial violence during the pandemic.

  • Abnormal hyperactivity and inattention SDQ scores from patients were inversely associated with total PedsQL score, changes in medical appointments during the pandemic, and reliable COVID-19 information remained.

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Adaptation to the driving simulator and prediction of the braking time performance, with and without distraction, in older adults and middle-aged adults
Alexandra Carolina Canonica, Angelica Castilho Alonso, Guilherme Carlos Brech, Mark Peterson, Natália Mariana Silva Luna, Alexandre Leopold Busse, Wilson Jacob-Filho, Juliana Leme Rosa, ... Júlia Maria D'Andrea Greve
Clinics. 2023;78C:100168

  • What does interfere with the virtual task of driving?

  • Older adults require a longer adaptation time to the driving simulator.

  • Main predictors of braking time are age e muscle strength.

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How to incorporate telemedicine in medical residency: A Brazilian experience in pediatric emergency
Rafael da Silva Giannasi Severini, Michelle Marcovici, Sylvia Costa Lima Farhat, Danielle Bivanco-Lima, Thomaz Bittencourt Couto, Ana Carolina Amarante, Katharina Reichmann Rodrigues, Danielle Saad Nemer Bou Ghosn, Cláudio Schvartsman
Clinics. 2023;78C:100162

  • The exponential growth of telehealth services during the COVID-19 pandemic led to the implementation of a telemedicine care service in a tertiary university pediatric hospital. It brought the need to develop a training aimed at remote care within the pediatric emergency.

  • This descriptive prospective study with 40 pediatric resident physicians describes an innovative proposal for training in telemedicine.

  • The preliminary results were encouraging, demonstrating the program's potential in training future pediatricians.

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The amygdala lesioning due to status epilepticus – Changes in mechanisms controlling chloride homeostasis
Luiz E.C. Santos, Antônio-Carlos G. Almeida, Sílvia C.B. Silva, Antônio M. Rodrigues, Samyra G. Cecílio, Carla A. Scorza, Josef Finsterer, Marcelo Moret, Fulvio A. Scorza
Clinics. 2023;78C:100159

  • Amygdala is involved in the control of cardiorespiratory functioning.

  • KCC2, α1-Na+/K+-ATPase and GFAP changes were observed in the amygdala after SE.

  • The changes in chloride regulation may contribute to SUDEP.

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Current morbimortality and one-year survival after pneumonectomy for infectious diseases
Paula Duarte D'Ambrosio, Alessandro Wasum Mariani, Eserval Rocha Júnior, Israel Lopes de Medeiros, Leonardo César Silva Oliveira, Antero Gomes Neto, Ricardo Mingarini Terra, Paulo Manuel Pêgo-Fernandes
Clinics. 2023;78C:100169

  • Pneumonectomy for benign disease is a high-risk procedure performed for a variety of indications.

  • Patients with benign conditions would be expected to have superior long-term survival in comparison with those with malignancy.

  • Morbidity is often significant, with a meticulous operative technique and detailed patient management, which can be similar to a pneumonectomy performed for malignancy.

  • Pneumonectomy for a benign disease should continue to be considered a treatment option for carefully selected patients.

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Pregnancy in women living with perinatally acquired HIV: Perinatal outcomes and drug resistance profile
Gilmar de Souza Osmundo, Rafaela Alkmin da Costa, Rosa Maria Aveiro Ruocco, Rossana Pulcineli Vieira Francisco
Clinics. 2023;78C:100174

  • HIV viral resistance in pregnancy.

  • Adverse perinatal outcomes in pregnant women living with HIV.

  • Perinatally acquired HIV can increase the risk of viral suppression failure.

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The Hertel classification can't predict the risk of humeral head osteonecrosis after osteosynthesis using an anterolateral approach
Márcio Alves Cruz, Guilherme Grisi Mouraria, Fernando Kenji Kikuta, Daniel Romano Zogbi, Sérgio de Paula Coelho, Maurício Etchebehere
Clinics. 2023;78C:100173

  • Proximal humeral fractures can progress to humeral head osteonecrosis

  • It's controversial if the Hertel classification can predict humeral head osteonecrosis.

  • Proximal Humeral Fractures can be fixed through the anterolateral approach.

  • Objective: to correlate the Hertel's predictors with the humeral head osteonecrosis.

  • Hertel's criteria were not able to predict the risk for humeral head osteonecrosis.

  • The overall prevalence humeral head osteonecrosis was 17.9%.

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Expression changes and clinical significance of serum neuron-specific enolase and squamous cell carcinoma antigen in lung cancer patients after radiotherapy
Lulu Sun, Qing Shao
Clinics. 2023;78C:100135

  • The aim is to explore NSE and SCC in patients with lung cancer before and after radiotherapy.

  • Total of 82 patients with lung cancer were selected as the study group.

  • NSE and SCC levels can preliminarily evaluate the effect of radiotherapy.

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KCNK9 mediates the inhibitory effects of genistein on hepatic metastasis from colon cancer
Yuan Cheng, Yi Tang, Yiming Tan, Juan Li, Xuping Zhang
Clinics. 2023;78C:100141

  • High KCNK9 expression level is correlated with colon cancer patients' poor survival.

  • KCNK9 promotes proliferation, migration, invasion, EMT, and Wnt signaling pathway.

  • KCNK9 mediates the inhibitory effects of genistein on colon cancer liver metastasis.

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Bone marrow-derived mesenchymal stem cell-conditioned medium ameliorates diabetic foot ulcers in rats
Yi-Feng Xu, Yan-Xiang Wu, Hong-Mei Wang, Cui-Hua Gao, Yang-Yang Xu, Yang Yan
Clinics. 2023;78C:100181

  • BMMSC-CM therapy on rats with DFUs enhanced the wound healing process.

  • It accelerated wound closure and promoted cell proliferation and angiogenesis.

  • It enhancd cell autophagy and reduced cell pyroptosis in ulcers.

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Prognostic significance of circulating tumor cell measurement in the peripheral blood of patients with nasopharyngeal carcinoma
Tinghua Gao, Jinxing Mao, Jindu Huang, Fengling Luo, Lixiang Lin, Yingni Lian, Sanmei Bin, Lianghua Zhao, Shuping Li
Clinics. 2023;78C:100179

  • The number of total CTCs and MCTCs had a strong correlation with Tumor-Node-Metastasis (TNM) stages (p < 0.05), Progression-Free Survival (PFS), and Overall Survival (OS).

  • The patients with > 7 CTCs or > 5 MCTCs per 5 mL blood had poorer PFS.

  • The PFS of the patients with chemotherapy combined targeted therapy had shorter PFS than that of the patients with chemoradiotherapy.

  • The patients with > 4 CTC counts change between pre-treatment and post-treatment had shorter PFS survival rates and overall rates (p < 0.05).

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Sexuality and fertility desire in a large cohort of individuals with 46, XY differences in sex development
Rafael Loch Batista, Marlene Inácio, Vinicius Nahime Brito, Maria Helena Palma Sircili, Min Jeong Bag, Nathália Lisboa Gomes, Elaine Maria Frade Costa, Sorahia Domenice, Berenice Bilharinho Mendonca
Clinics. 2023;78C:100185

  • Prenatal androgen exposure reduced the desire for motherhood in 46, XY women.

  • 46, XY DSD people who changed from female to male gender presented similar sexual parameters as those assigned as males.

  • Among females, virilized genitalia at birth did not affect sexuality once the surgical treatment is completed.

  • Fertility desire is shared among 46, XY DSD people, regardless of gender.

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Major discrepancy between clinical diagnosis of death and anatomopathological findings in adolescents with chronic diseases during 18-years
Maira P. Ribeiro, Amaro N. Duarte-Neto, Marisa Dolhnikoff, Livia Lindoso, Benito Lourenço, Heloisa H. Marques, Maria F.B. Pereira, Lilian M. Cristofani, ... Clovis A. Silva
Clinics. 2023;78C:100184

  • • Evaluation of disagreement between clinical diagnosis of death and autopsy findings in adolescents with chronic diseases.

  • • 30% of the adolescents with chronic diseases had major discrepancies between clinical diagnosis of death and autopsy findings, mainly caused by infections.

  • • Pneumonia, pulmonary abscess, as well as isolation of yeast and virus were identified at autopsy findings in the groups with major discrepancies.

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The relationship of major depressive disorder with Crohn's disease activity
Carolina Bortolozzo Graciolli Facanali, Carlos Walter Sobrado Junior, Renério Fraguas Junior, Marcio Roberto Facanali Junior, Lucas Rodrigues Boarini, Lucas Faraco Sobrado, Ivan Cecconello
Clinics. 2023;78C:100188

  • There is a high prevalence of depressive symptoms in patients with Crohn's disease.

  • Depressive symptoms are related to the active disease.

  • According to the Montreal classification, the penetraing behavior of Crohn's disease, was less related a rates of depression than inflammatory behavior disease.

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Aging-related predictive factors for oxygenation improvement and mortality in COVID-19 and acute respiratory distress syndrome (ARDS) patients exposed to prone position: A multicenter cohort study
Marieta C.A. Cunha, Jociane Schardong, Natiele C. Righi, Adriana C. Lunardi, Guadalupe N. Sant'Anna, Larissa P. Isensee, Rafaela F. Xavier, Jose E. Pompeu, ... Celso R.F. Carvalho
Clinics. 2023;78C:100180

  • Prone position in intubated patients with COVID-19 improves gas exchange.

  • Elderly and severe comorbidities increase mortality risk after prone sessions for ARDS-COVID-19.

  • ARDS-COVID-19 better respond when prone is applied early in patients with good health status.

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Prediction of intensive care admission and hospital mortality in COVID-19 patients using demographics and baseline laboratory data
Vivian I. Avelino-Silva, Thiago J. Avelino-Silva, Marlon J.R. Aliberti, Juliana C. Ferreira, Vilson Cobello Junior, Katia R. Silva, Jose E. Pompeu, Leila Antonangelo, ... Study Group
Clinics. 2023;78C:100183

  • Prediction scores can be used to support clinical decisions and resource allocation.

  • The authors used data from 3,022 hospitalized patients with COVID-19, of whom 1054 died.

  • The final scores included age, comorbidities, and baseline laboratory data.

  • Accuracy was 75% for ICU admission and 77% for death in the validation sample.

  • Our scores were more accurate than the previous NEWS-2 and 4C Mortality Scores.

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Immunothrombosis and COVID-19 ‒ a nested post-hoc analysis from a 3186 patient cohort in a Latin American public reference hospital
Clarice Antunes de Lima, Fabio Augusto Rodrigues Gonçalves, Bruno Adler Maccagnan Pinheiro Besen, Antônio José Rodrigues Pereira, Sandro Félix Perazzio, Evelinda Marramon Trindade, Luiz Augusto Marcondes Fonseca, Nairo Massakazu Sumita, ... Arnaldo Lichtenstein
Clinics. 2023;78C:100178

  • VTE COVID-19 patients were sicker, their hospital stay was longer, and they were more likely to die.

  • VTE incidence is still considerable in COVID-19 patients even under pharmacological prophylaxis.

  • Prophylaxis and treatment compliance are essential to achieve a low VTE incidence.

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OLIG2 expression level could be used as an independent prognostic factor for patients with cerebellar Glioblastoma (cGBM)
Jia Zhou, Ling-Fei Shi, Zheng Wang, Min Li, Jin-Seng Zhang, Ying Mao, Wei Hua
Clinics. 2023;78C:100120

  • The retrospective study included 73 cGBM patients, which was the largest patient cohort in east Asia to date.

  • OLIG2 expression level was high in more than half cGBM patients (42/73, 57.5%).

  • OLIG2 expression level could be used as an independent prognostic factor for cGBM patients.

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β-catenin ameliorates myocardial infarction by preventing YAP-associated apoptosis
Haofei Kang, Weiwei Jiang
Clinics. 2023;78C:100189

  • β-catenin protects cardiomyocytes against H2O2-induced apoptosis.

  • CIL56 restored apoptotic cell death in H2O2-treated cardiomyocytes, reversing the effects of β-catenin.

  • The β-catenin/YAP axis may be a target for the treatment of acute MI.

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Effect of concurrent training in unilateral transtibial amputees using Paralympic athletes as a control group
Marcus Vinicius Grecco, Guilherme Carlos Brech, Jose Maria Soares-Junior, Edmund Chada Baracat, Júlia Maria D'Andrea Greve, Paulo Roberto Santos Silva
Clinics. 2023;78C:100165

  • Unilateral transtibial amputees and functional deficits.

  • Concurrent training proved to be effective.

  • Paralympic athletes should review their physical training.

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A new systematization of histological analysis for the diagnosis of Hirschsprung's disease
Suellen Serafini, Maria Mercês Santos, Ana Cristina Aoun Tannuri, Celso Di Loreto, Josiane de Oliveira Gonçalves, Uenis Tannuri
Clinics. 2023;78C:100198

  • Hirschsprung's disease is a congenital disorder characterized by intestinal sub-occlusion and the absence of neurons in the enteric nervous system, with involvement of varying segments of the large intestine.

  • The treatment is only surgical, for this reason the diagnosis must have a good accuracy.

  • This research demonstrates a simplified method to perform the diagnosis with 93% of accuracy.

  • The use of this method brings benefits to the patient, the pathologist, and the service.

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Reduction of vascular reactivity in rat aortas following pilocarpine-induced status epilepticus
Karolini Zuqui Nunes, Fulvio Alexandre Scorza, Esper Abrão Cavalheiro, Dalton Valentim Vassallo
Clinics. 2023;78C:100195

  • Decreased phenylephrine-induced vascular reactivity.

  • Increased production of NO.

  • Increased in H2O2 production.

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Maternal and fetal/neonatal outcomes of pregnancies complicated by pulmonary hypertension: a retrospective study of 154 patients
Chengtian Lv, Lichan Wu, Guangyuan Liao, Yuwen Huang, Jingyi Chen, Shuyi Jiang, Dunjin Chen, Yuanmei Gao
Clinics. 2023;78C:100194

  • Pregnant women with severe pulmonary hypertension have a higher risk of mortality.

  • Pulmonary artery systolic pressure is associated with maternal mortality.

  • Screening before pregnancy and multidisciplinary monitoring are crucial.

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Braided stent-assisted coil embolization versus laser engraved stent-assisted coil embolization in patients with unruptured complex intracranial aneurysms
Jie Zhang, Ling He, Xun Xia, Lie Zhang, Kai Yu
Clinics. 2023;78C:100202

  • Laser engraved stent has easy deployment & has better follow-up outcomes.

  • Success of coil embolism would be higher for braided stent-assisted embolization.

  • Braided stent should be preferred for the posterior circulation aneurysm.

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Neobaicalein prevents isoflurane anesthesia-induced cognitive impairment in neonatal mice via regulating CREB1
Niming Wu, Hua Liu, Xiang Lv, Yu Sun, Hong Jiang
Clinics. 2023;78C:100201

  • Neobaicalein ameliorates isoflurane-induced cognitive impairment in neonatal mice.

  • Neobaicalein reduces isoflurane treatment-induced inflammation.

  • Neobaicalein reduces isoflurane-induced apoptosis of hippocampal neurons through the p-CREB1 pathway.

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Extended criteria donor organ use for heart-lung transplantation in the modern era
Noah Weingarten, Amit Iyengar, David Alan Herbst, Mark Helmers, Danika Meldrum, Sara Guevara-Plunkett, Jessica Dominic, Pavan Atluri
Clinics. 2023;78C:100205

  • Extended criteria donor organs in heart-lung transplant do not worsen mortality.

  • Advanced donor age and P/F ratio remain predictive of mortality.

  • Extended criteria donor organ use is safe in appropriately chosen patients.

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Abnormal expression of miRNA-122 in cerebral infarction and related mechanism of regulating vascular endothelial cell proliferation and apoptosis by targeting CCNG1
Xiao-Juan Yu, Tian Zhang, Zeng-Zhen Wei, Bin Gu, Ting Guo, Wen-Juan Jiang, Yue-Qin Shen, Dong Wang, ... Jun Wang
Clinics. 2023;78C:100199

  • miRNA-122 in cerebral infarction.

  • miRNA-122 may be involved in the pathological process of ACI.

  • miRNA-122 related to the degree of neurological impairment and short-term prognosis in patients with ACI.

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Deep learning for diagnosis of malign pleural effusion on computed tomography images
Neslihan Ozcelik, Ali Erdem Ozcelik, Nese Merve Guner Zirih, Inci Selimoglu, Aziz Gumus
Clinics. 2023;78C:100210

  • Decision support systems that can predict the diagnosis of malignancy for pleural effusion will help physicians in patient management.

  • Advances in computer-aided diagnostic analysis of CT images and obtaining a pre-diagnosis of pleural fluid may reduce the need for interventional procedures by guiding physicians about which patients may have malignancy.

  • Image-based decision support systems enable early diagnosis and treatment by saving cost and time in patient management.

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Soluble epoxide hydrolase inhibitor promotes the healing of oral ulcers
Juanjuan Li, Zihan Wen, Yue Lou, Jili Chen, Lu Gao, Xiaojie Li, Fu Wang
Clinics. 2023;78C:100208

  • The present results support the potential of TPPU to be a multi-functional therapeutic approach for oral ulcers by targeting soluble epoxide hydrolase.

  • To provide a new idea for the treatment and prevention of clinical oral ulcers.

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Preliminary outcomes of five-year survival for ovarian malignancies in profiled Serbian Oncology Centre
Bojana Gutic, Tatjana Bozanovic, Aljosa Mandic, Stefan Dugalic, Jovana Todorovic, Miroslava Gojnic Dugalic, Demet Sengul, Dzenana A. Detanac, ... José Maria Soares Junior
Clinics. 2023;78C:100204

  • Analyzing predictors of survival in patients with ovarian carcinoma is crucial.

  • Independent estimators of mortality in ovarian carcinoma, are more precise by identifying histopathologic tumor grade, FIGO, and NACT.

  • The aforementioned predictors also involve the number of therapeutic cycles, type of surgery, and chemotherapy response.

  • Poor chemotherapy response increases the hazard ratio for mortality.

  • Significant predictors of survival in ovarian carcinoma are the absence of recurrent disease and lymphovascular space invasion.

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Identification of FKBP10 prognostic value in lung adenocarcinoma patients with surgical resection of brain metastases: A retrospective single-institution cohort study
Zhi-Dan Liu, Song-Quan Wang, Sai Li, Jie He, Shao-Hua Wang, Hong-Qing Cai, Jing-Hai Wan
Clinics. 2023;78C:100212

  • FKBP10 proteins are highly expressed in lung adenocarcinoma, including brain metastasis tissue.

  • FKBP10 is a valuable prognostic indicator for lung adenocarcinoma.

  • FKBP10 is a potential clinical biomarker for lung adenocarcinoma.

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Measurement of extracapsular extension in sentinel lymph node as a possible predictor of residual axillary disease in breast cancer
Gabriela Boufelli de Freitas, Bruna Salani Mota, Jonathan Yugo Maesaka, Cintia Cardoso Pinheiro, Luiz Guilherme Cernaglia Aureliano de Lima, José Maria Soares, Edmund Chada Baracat, José Roberto Filassi
Clinics. 2023;78C:100216

  • This study aimed to find the clinical significance of the extracapsular extension in sentinel lymph nodes on the number of additional involved axillary lymph nodes, overall survival, and disease-free survival.

  • One hundred twenty-eight patients with positive sentinel lymph nodes were separated into two groups according to the presence or absence of ECE and following during 10 years.

  • There was found a positive correlation between the presence of ECE and the number of additional positive lymph nodes. Therefore, this does not impact overall survival, and disease-free survival in a follow-up of 10 years.

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Early prediction of acute respiratory distress syndrome complicated by acute pancreatitis based on four machine learning models
Mengran Zhang, Mingge Pang
Clinics. 2023;78C:100215

  • ML can be a practical and effective early prediction method of AP complicated by ARDS.

  • PaO2, CRP, PCT, LA, Ca2+, NLR, WBC, and AMY were used as the optimal subset of features to early identify AP patients with a high risk for developing ARDS in ML.

  • BC was the superior predictive model and EDTs could be promising for predicting large samples.

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Post-natal prognostic factors in CDH: experience of 11 years in a referral center in Brazil
Camila Pinho Brasileiro Martins Nam, Carolina Vieira Campos, Gabriela Nunes Leal, Uenis Tannuri, Maria Esther Jurfest Rivero Ceccon, Werther Brunow de Carvalho
Clinics. 2023;78C:100217

  • Clinical features, prognostic indexes and echocardiographic parameters may contribute together to better define survival chances in CDH.

  • When antenatal factors are not available, postnatal factors can be good predicting tools and may suffice to assess the prognosis of CDH patients.

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The safety and efficacy of hypothermia combining mechanical thrombectomy or thrombolysis in the treatment of ischemic stroke: A systematic meta-analysis
Jiankang Huang, Peng Wang, Hongbo Wen
Clinics. 2023;78C:100218

  • To comprehensively assess the safety and efficacy of hypothermia in ischemic stroke.

  • Articles published were searched from Google scholar, Baidu scholar and PubMed.

  • The results showed that hypothermia treatment was correlated with mRS≤2 at 3 month.

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Perianal fistulizing Crohn's disease is associated with a higher prevalence of HPV in the anorectal fistula tract. A comparative study
Lucas Rodrigues Boarini, Carlos Walter Sobrado, Giana Rabello Mota, Luisa Lina Villa, Idblan Carvalho de Albuquerque, Natalia Sousa Freitas Queiroz, Carolina Bortolozzo Graciolli Facanali, Sidney Roberto Nadal, Ivan Cecconello
Clinics. 2023;78C:100219

  • Perianal Crohn's disease is the main risk factor for anal cancer in IBD patients.

  • Perianal Crohn's disease patient has a chance of HPV 3.29 time higher than control.

  • High risk HPV is numerically twice as prevalent in perianal Crohn's disease patient.

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Comparison of acute kidney injury following brain death between male and female rats
Roberto Armstrong-Jr, Fernanda Yamamoto Ricardo-da-Silva, Marina Vidal-dos-Santos, Lucas Ferreira da Anunciação, Petra J. Ottens, Cristiano Jesus Correia, Luiz Felipe Pinho Moreira, Hendrik Gerrit Derk Leuvenink, Ana Cristina Breithaupt-Faloppa
Clinics. 2023;78C:100222

  • Experimental evidence suggested that hypoperfusion could impact organ viability.

  • High eNOS-expression in female rats favored the maintenance of renal perfusion.

  • BD-female rats showed progressive inflammatory responses.

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A-80426 suppresses CFA-induced inflammatory pain by suppressing TRPV1 activity via NFκB and PI3K pathways in mice
Xiaomei Ling, Wei Wang
Clinics. 2023;78C:100213

  • A8 treatment inhibits CFA-triggered inflammatory pain.

  • A8 treatment exerts a significant inhibitory effect on the production of pain-associated pro-inflammatory cytokines.

  • A8 increased the signal transduction of the TRPV1 and CGRP.

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Venous thromboembolism incidence in postoperative breast cancer patients
Jonathan Yugo Maesaka, Yedda Nunes Reis, Livia Menezes Elias, Denise Akerman, Edmund Chada Baracat, José Roberto Filassi
Clinics. 2023;78C:100229

  • This is a pioneer study investigating VTE in breast surgery patients in Brazil.

  • Patients undergoing SSM or NSM, immediate breast reconstruction – especially abdominal flap – and procedures longer than four hours had a higher incidence of VTE events.

  • Neoadjuvant chemotherapy and LMWH were associated with a lower incidence of thrombotic events.

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Venous thromboembolism risk score during hospitalization in pregnancy: results of 10694 prospective evaluations in a clinical trial
Venina Isabel Poço Viana Leme de Barros, Ana Maria Kondo Igai, Fernanda Spadotto Baptista, Maria Rita de Figueiredo Lemos Bortolotto, Stela Verzinhasse Peres, Rossana Pulcinelli Vieira Francisco
Clinics. 2023;78C:100230
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Investigating the efficacy of ultrasound-guided ethanol retention technique for endometrioma sclerotherapy and its effect on pro-inflammatory cytokine levels: A single-arm clinical trial
Roghayeh Anvari Aliabad, Aliyeh Ghasemzadeh, Kobra Hamdi, Nazli Navali, Parvin Hakimi, Laya Farzadi
Clinics. 2023;78C:100224

  • IL-1β and AMH were lower, and IL-6 was higher in the endometriosis group.

  • The treatment significantly decreased dysmenorrhea, dyspareunia, and cyst diameter.

  • The treatment had no significant effect on the IL-1β, IL-6, and AMH levels.

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COVID-19 outcomes in people living with HIV: Peering through the waves
Thaís Lorenna Souza Sales, Maíra Viana Rego Souza-Silva, Polianna Delfino-Pereira, João Victor Baroni Neves, Manuela Furtado Sacioto, Vivian Costa Morais de Assis, Helena Duani, Neimy Ramos de Oliveira, ... Milena Soriano Marcolino
Clinics. 2023;78C:100223

  • Signs and symptoms of COVID-19 at hospital admission are similar between patients infected with HIV and controls.

  • Mortality from COVID-19 in patients infected with HIV was higher compared to the controls in 2020, but no difference in 2021.

  • Similar rates of ICU and invasive mechanical ventilation were observed in the different waves.

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Seroprevalence of SARS-CoV-2 in Brazil: A systematic review and meta-analysis
Gerusa Maria Figueiredo, Fátima Mitiko Tengan, Sergio Roberto Campos, Expedito José Luna
Clinics. 2023;78C:100233

  • The seroprevalence of SARS-CoV-2 antibodies in Brazil in 2020 was 11%.

  • Seroprevalence increased with time, 1% in the first and 83% in the last quarter of the year.

  • Seroprevalence was higher in the Northern region, decreasing as one moves south.

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Impact of COVID-19 on healthcare-associated infections: Antimicrobial consumption does not follow antimicrobial resistance
Maristela Pinheiro Freire, Denise Brandão de Assis, Bruno de Melo Tavares, Valquiria O.C. Brito, Igor Marinho, Milton Lapchik, Ana Rubia Guedes, Geraldine Madalosso, ... Anna S. Levin
Clinics. 2023;78C:100231

  • COVID-19 pandemic was associated with an increase in healthcare-associated infection.

  • For the majority of microorganisms, the proportion of resistance did not increase.

  • The large spectrum antibiotic consumption increased disproportionately during the pandemic.

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Prediction of IDH1 gene mutation by a nomogram based on multiparametric and multiregional MR images
Jinjing Zheng, Haibo Dong, Ming Li, Xueyao Lin, Chaochao Wang
Clinics. 2023;78C:100238

  • Combination of clinical factors and radiomic features to construct models for predicting IDH1 gene mutations in glioma.

  • Multiparametric and multiregional MR images were used to achieve more accurate prediction performance.

  • The model performance with different regions of interest for different sequences was compared.

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A longitudinal study of the peripheral and central auditory pathways in individuals with acute lymphoid leukemia
Jéssica Sales Vosgrau, Liliane Aparecida Fagundes Silva, Vicente Odone Filho, Carla Gentile Matas
Clinics. 2023;78C:100234

  • Acute lymphoid leukemia changes the central auditory pathway.

  • Changes in the central auditory pathway in individuals with acute lymphoid leukemia are due to neurotoxicity.

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Association between monocyte lymphocyte ratio and abdominal aortic calcification in US adults: A cross-sectional study
Peiyuan Zuo, Ranran Xu, Liya Hu, Wei Hu, Song Tong
Clinics. 2023;78C:100232

  • Elevated level of MLR associated with higher AAC score.

  • Each 0.1 unit of increased MLR was associated with a 14% increased risk of severe AAC.

  • This positive relationship between MLR and AAC score was stronger in the elderly and with diabetes.

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Respiratory gas kinetics in patients with congestive heart failure during recovery from peak exercise
Alessandro Patti, Yair Blumberg, Kristofer Hedman, Daniel Neunhäuserer, Francois Haddad, Matthew Wheeler, Euan Ashley, Kegan J. Moneghetti, ... Jeffrey W. Christle
Clinics. 2023;78C:100225

  • Analysis of recovery from cardiopulmonary exercise testing reveals pathophysiology.

  • Recovery of respiratory gases from peak exercise is hindered in heart failure.

  • Recovery from peak exercise in heart failure is negatively correlated with peak VO2 but not baseline LVEF.

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Overexpression of lncRNA-MEG3 inhibits endometrial cell proliferation and invasion via miR-21–5p/DNMT3B/Twist
Shaoyan Yang, Limei Feng, Qin Zhang, Lu Wu, Qinghua Zhao, Youfang Hou, Bo Yan, Suxian Zhang
Clinics. 2023;78C:100235

  • MEG3 expressed exceptionally low in the ectopic endometrial.

  • Overexpression of MEG3 inhibits hESCs proliferation and invasion.

  • MEG3 is a ceRNA that has regulatory effects on miR-21–5p/DNMT3B axis.

  • DNMT3B inhibits Twist expression after upregulation of MEG3 action.

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Fructosamine and glycated hemoglobin as biomarkers of glycemic control in people with type 2 diabetes mellitus and cancer (GlicoOnco study)
Marcos Tadashi Kakitani Toyoshima, Priscilla Cukier, Aline Santos Damascena, Rafael Loch Batista, Fernanda de Azevedo Correa, Eduardo Zanatta Kawahara, Carlos André Minanni, Ana O. Hoff, Marcia Nery
Clinics. 2023;78C:100240

  • Fructosamine and HbA1c are associated in individuals with diabetes and cancer, even on chemotherapy.

  • HbA1c and fructosamine are associated with self-monitoring of blood glucose in cancer.

  • The association between fructosamine and HbA1c occurs even in anemia and hypoproteinemia.

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Mechanism underlying Müller cell pyroptosis and its role in the development of proliferative vitreoretinopathy
Yue Bai, Maosong Xie, Yihua Zhu
Clinics. 2023;78C:100241

  • MCP enhanced ARPE-19 CA, proliferation, migration, invasion, and cytokine expression.

  • MCP can promote the further development of PVR.

  • The inhibition of MCP may be the key to the treatment of PVR.

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Serum 25-hydroxyvitamin D levels and the risk of idiopathic central precocious puberty in girls
Dong-Mei Gan, Jie Fang, Ping-Ping Zhang, Yu-Dan Zhao, Ya-Nan Xu
Clinics. 2023;78C:100244

  • Insufficient vitamin D levels and sufficient vitamin D levels had a lower risk of ICPP.

  • The vitamin D levels in ICPP girls could affect by height, weight, breast stage, mother's height, and luteinizing hormone/follicle-stimulating hormone ratio.

  • The results could affect by the imbalance of girls in vitamin D deficiency, insufficiency, and sufficiency groups.

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Plasma exosomal microRNAs are non-invasive biomarkers of moyamoya disease: A pilot study
Da Huang, Hui Qi, Hongchun Yang, Meng Chen
Clinics. 2023;78C:100247

  • miRNA-seq analysis obtained 1,002 differentially expressed miRNAs.

  • Differentially expressed miRNAs were mainly enriched in axon guidance, regulation of the actin cytoskeleton and the MAPK signaling pathway.

  • 10 miRNAs (miR-1306-5p, miR-196b-5p, miR-19a-3p, miR-22-3p, miR-320b, miR-34a-5p, miR-485-3p, miR-489-3p, miR-501-3p, and miR-487-3p) were found to be associated with the most sensitive and specific pathways for MMD prediction.

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Evaluation of the effect of intrathecal GM1 in 24, 48, and 72 hours after acute spinal cord injury in rats
Daniel de Moraes Ferreira Jorge, Raphael Martus Marcon, Alexandre Fogaça Cristante, Tarcísio Eloy Pessoa Barros Filho, Gustavo Bispo dos Santos
Clinics. 2023;78C:100228

  • GM1 has neuroprotective effects, but it may face difficulty with the blood-brain barrier.

  • Intrathecal application in models of spinal cord injury induced in rats.

  • Determination of optimal timing of GM1 application for best functional results.

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The weight-adjusted-waist index predicts all-cause and cardiovascular mortality in general US adults
Ying Han, Jieli Shi, Pengfei Gao, Lin Zhang, Xuejiao Niu, Na Fu
Clinics. 2023;78C:100248

  • WWI was a potential predictor for cardiovascular mortality with a cut-off of 11.33.

  • Higher WWI associated with an increased 95% risk for cardiovascular mortality.

  • Higher WWI associated with an increased 68% risk for all-cause mortality.

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Effects of atorvastatin in suppressing pulmonary vascular remodeling in rats with chronic obstructive pulmonary disease
YongHong He, SongPing Wang, Yuying Li, Jun Deng, Lan Huang
Clinics. 2023;78C:100252

  • HMG-CoA reductase inhibitor statins can inhibit vascular remodeling.

  • The regulation of HDAC2/NF-κB signaling pathway can improve pulmonary vascular remodeling.

  • Atorvastatin can be used in the early intervention of pulmonary vascular remodeling.

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Role of cardiac β1-adrenergic and A1-adenosine receptors in severe arrhythmias related to Parkinson's disease
Francisco Sandro Menezes-Rodrigues, Marcelo Pires de Oliveira, Erisvaldo Amarante Araújo, Henrique Ballalai Ferraz, Josef Finsterer, Efrain Olszewer, Murched Omar Taha, Carla Alessandra Scorza, ... Fúlvio Alexandre Scorza
Clinics. 2023;78C:100243

  • Pharmacological modulation of cardiac receptors can be an efficient therapeutic strategy to increase life expectancy in Parkinson's disease.

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Association of opioid use disorder with outcomes of hospitalizations for acute myocardial infarction in the United States
Nameer Ascandar, Amulya Vadlakonda, Arjun Verma, Nikhil Chervu, Jacob S. Roberts, Sara Sakowitz, Catherine Williamson, Peyman Benharash
Clinics. 2023;78C:100251

  • Patients with opioid use disorder experience greater in-hospital mortality and readmissions following MI.

  • Paradoxically, these patients experience superior cardiovascular outcomes compared to their counterparts.

  • Opioid use disorder remains associated with high resource utilization and healthcare expenditures.

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Study of aged central auditory function using the auditory middle latency response
Anna Caroline Silva De Oliveira, Yara Bagali Alcântara, Viviane Borim De Góes, Pedro de Lemos Menezes, Eduardo Federighi Baisi Chagas, Milena Sonsini Machado, Ana Claudia Figueiredo Frizzo
Clinics. 2023;78C:100245

  • Aging impairs binaural interaction in cortical and subcortical regions, elderly people with hearing loss show differences in responses between the ears/electrodes.

  • Elderly people without hearing loss show differences in responses between the hemispheres.

  • Binaural interaction is more impaired in older adults with high-frequency hearing loss.

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METTL3 promotes hyperoxia-induced pyroptosis in neonatal bronchopulmonary dysplasia by inhibiting ATG8-mediated autophagy
Lili Xu, Zhan Shi, Zhaojun Pan, Rong Wu
Clinics. 2023;78C:100253

  • m6A modification participates in the development of BPD.

  • METTL3 promotes the pyroptosis of BEAS-2B cells.

  • ETTL3-mediated m6A modification of ATG8 disrupts the interaction between ATG8 and GSDMD.

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MicroRNA-15a/β1,4-GalT-I axis contributes to cartilage degeneration via NF-κB signaling in osteoarthritis
Hairong Wang, Weilin Wang, Jian Wang, Linsheng Zhang, Yujie Luo, Xiaobo Tang
Clinics. 2023;78C:100254

  • MiR-15a/β1,4-GalT-I axis inhibits ECM degradation and senescence in chondrocytes.

  • MiR-15a inhibits β1,4-GalT-I expression with post-transcriptional modifications.

  • β1,4-GalT-I promotes NF-κB phosphorylation to exacerbate osteoarthritis.

  • Intra-articular injection of miR-15a attenuates cartilage degeneration in vivo.

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The nonsynaptic plasticity in Parkinson's disease: Insights from an animal model
Mônica P.C. Viegas, Luiz E.C. Santos, Mayra C. Aarão, Samyra G. Cecilio, Joana M. Medrado, Arthur C. Pires, Antônio M. Rodrigues, Carla A. Scorza, ... Antônio-Carlos G. Almeida
Clinics. 2023;78C:100242

  • 6-OHDA lesioned striatum without changes in CCC cotransporters and Na+/K+-atpase.

  • However, was observed astrocytic reactivity.

  • Dopaminergic degeneration was followed by changes in connexin-36.

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Gene mutation profiling and clinical significances in patients with renal cell carcinoma
Yongquan Wang, Peng He, Xiaozhou Zhou, Cong Wang, Jian Fu, Dawei Zhang, Deyang Liao, Zhansong Zhou, ... Wei Gong
Clinics. 2023;78C:100259

  • EGFR, POLE, and PB1 genes had high mutated frequency in the patients with relapse and metastatic cancer.

  • PBRM1, BAP1, KDM5C, and BAP1 genes were critical for the overall survival.

  • Wild-type PBRM1 and mutated BAP1 were key indications for the predication of OS.

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Effects of exercise training on neurological recovery, TGF-β1, HIF-1α, and Nogo-NgR signaling pathways after spinal cord injury in rats
Xubin Ji, Zhaowan Xu, Dayong Liu, Yangwang Chen
Clinics. 2023;78C:100236

  • Exercise training can enhance motor function and improve the spinal cord.

  • Exercise training can improve gastrocnemius muscle morphology.

  • Exercise training can promote neurological recovery after spinal cord injury in rats.

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The effect of sperm DNA fragmentation on in vitro fertilization outcomes of unexplained infertility
Qingxin Wang, Xiaoling Gu, Yannan Chen, Minyan Yu, Lingna Peng, Shuping Zhong, Xia Wang, Jinxing Lv
Clinics. 2023;78C:100261

  • Infertility is caused by heterogeneous risks, but most of them are unexplained.

  • Sperm DFI diagnostic value was controversial as not rule out male sperm parameters.

  • Whether DFI was a useful indicator for embryologists and clinicians in UEI couples.

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Immunotherapy in the treatment of chemoresistant gestational trophoblastic neoplasia - systematic review with a presentation of the first 4 Brazilian cases
Antonio Braga, Elaine Balthar, Laís Cristhine Santos Souza, Michelle Samora, Matheus Rech, José Mauro Madi, Joffre Amim Junior, Jorge Rezende Filho, ... Ross S. Berkowitz
Clinics. 2023;78C:100260

  • Gestational trophoblastic neoplasia responds to anti-PD-1 or anti-PD-L1 immunotherapy.

  • Multi-drug resistant gestational trophoblastic neoplasia may achieve remission with pembrolizumab.

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Efficacy of ultrasound-guided percutaneous transhepatic biliary drainage for acute obstructive suppurative cholangitis combined with septic shock
Miao Meng, Hui Feng, Shuan Tang, Xiaobin Peng
Clinics. 2023;78C:100258

  • Ultrasound-guided PTCD improves treatment effect for AOSC combined with septic shock.

  • Ultrasound-guided PTCD reduces stress response for AOSC combined with septic shock.

  • Ultrasound-guided PTCD assists patients smoothly to pass preoperative critical period.

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Leptin plays a role in the multiplication of and inflammation in ovarian granulosa cells in polycystic ovary syndrome through the JAK1/STAT3 pathway
Xuan Zhao, Yaming Xiong, Ya Shen
Clinics. 2023;78C:100265

  • LEP may be associated with the development of PCOS.

  • LEP may be a protective factor against apoptosis in GCs treated with insulin.

  • LEP knockdown induced JAK1/STAT3 activation could be reversed by administration of curcumin.

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A nationwide analysis of the outcomes in hospitalized patients with atrial fibrillation and temperature-related illnesses
Daniel Antwi-Amoabeng, Sunil Sathappan, Tarek R. Firzli, Bryce D. Beutler, Mark B. Ulanja, T. David Gbadebo
Clinics. 2023;78C:100269

  • Temperature-Related Illness (TRI) describes physiologic aberrations that occur secondary to exposure to extreme cold or heat.

  • Individuals with Atrial Fibrillation (AF) who present with TRI may be at increased risk of poor outcomes relative to patients without TRI.

  • Our analysis shows that individuals with AF who develop a cold-related TRI face an increased risk of mortality as compared to those without TRI.

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Trastuzumab-induced human cardiomyocyte damage through the Notch2/JAK2/STAT3 pathway
Zhenbo Su, Siyao Liu, Yinggang Zou, Liang Shan, Miao Yu, Shishun Xie, Xiangjun Li, Ying Jin
Clinics. 2023;78C:100268

  • Notch2 is important in trastuzumab-induced cardiomyocytes apoptosis through JAK2/STAT3 pathway.

  • Trastuzumab promotes cell apoptosis and causes cardiomyocyte injury.

  • Notch2 may be a potential target of trastuzumab-induced myocardial injury.

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Maternal consumption of caffeine and second-hand tobacco smoke as risk factors for the development of oral clefts
Rodrigo Soares de Andrade, Fabrício Emanuel Soares de Oliveira, Daniella Reis Barbosa Martelli, Letízia Monteiro de Barros, Hercílio Martelli Júnior
Clinics. 2023;78C:100266

  • Several environmental and genetic factors may cause oral clefts.

  • Iron supplementation use of folic acid are protective factors for oral fissures.

  • Passive smoking during pregnancy can be a risk factor for oral clefts.

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Risk factors independently associated with the maintenance of severe restriction of oral intake and alternative feeding method indication at hospital outcome in patients after acute ischemic stroke
Karoline Kussik de Almeida Leite, Fernanda Chiarion Sassi, Iago Navas Perissinotti, Luiz Roberto Comerlatti, Claudia Regina Furquim de Andrade
Clinics. 2023;78C:100275

  • Dysphagia has a high incidence in post-stroke patients.

  • Alternative long-term feeding method indication in post-stroke patients.

  • Dysartrhia associated dysphagia in post-stroke patients.

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The role of Vav3 expression for inflammation and cell death during experimental myocardial infarction
Yan Zhang, Yonglei Zhang, Qin Song, Yuanxin Wang, Jiming Pan
Clinics. 2023;78C:100273

  • Activation of the NFκB signaling pathway aggravates myocardial injury.

  • Vav3 might exert an effect in MI model by repressing the NFκB signaling pathway.

  • Vav3 exerted its cardio-protective function in a NFκB-dependent manner.

  • CLINICS-D-23-00277_Original Article

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Muscle function, Lysholm score and hop performance in individuals with clinical indications for the combined reconstruction of the anterior cruciate and the anterolateral ligaments of the knee: A cross-sectional study
Adriana Carvalho, Marilia Novaes, Juliana Sauer, Marco Kawamura Demange, Camilo Partezani Helito, Silvia Maria Amado João
Clinics. 2023;78C:100267

  • Studies have shown worse rotational stability in the presence of a supposed ALL injury combined with an ACL injury. However, there is no evidence, so far, on how individuals behave regarding muscle strength and functionality.

  • Knee and hip muscular functions are impaired after an ACL injury and do not seem to be influenced or worsened in individuals with greater rotational instability with clinical indications for combined reconstruction of the anterior cruciate and the anterolateral ligaments of the knee.

  • The ACL+ALL group showed a significantly shorter distance achieved in the Crossover Hop Test than the other groups, as well as the reports of more pain during the tests.

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The prevalence of vascular and metabolic complications after lung transplant in people with cystic fibrosis in a Dutch cohort
Lisa M. Oppelaar, Bart Luijk, Harry G.M. Heijerman, Harold W. De Valk, Gerdien Belle- van Meerkerk
Clinics. 2023;78C:100274

  • Cystic fibrosis related vascular complications.

  • Survival of people with cystic fibrosis.

  • Cystic fibrosis related vascular complications and metabolic complications.

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Screening tool development for hand surgery referrals in systemic sclerosis
Marcos Felipe Marcatto de Abreu, Síbila Landim, Fernanda Yuri Yuamoto, Carolina Lins, Eduardo Paiva Magalhães, Maurício Etchebehere
Clinics. 2023;78C:100270

  • Identification of potential candidates for hand surgery in Systemic Sclerosis.

  • Presence of digital ulcers increases the likelihood of surgical indication.

  • Development of a predictive tool to identify candidates for surgical treatment.

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The role of TMEM26 in disrupting tight junctions and activating NF-κB signaling to promote epithelial-mesenchymal transition in esophageal squamous cell carcinoma
Guohu Han, Shuangshuang Zhou, Junjun Shen, Yuanyuan Yang, Xuyu Bian, Yahu Li, Rui Ling, Rongrui Liang, Min Tao
Clinics. 2023;78C:100276

  • The involvement of TMEM26, a novel plasma membrane protein, in cancer EMT was examined for the first time.

  • The discovery of TMEM26 and its regulation on the tight junction activates NF-κB signaling as a novel therapeutic target of metastatic ESCC.

  • A mechanism that directly controls the assembly of tight junctions at the plasma membrane, which affects a plethora of signaling pathways, was discovered.

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Characteristics of the oral glucose tolerance test in women with different pre-pregnancy body mass index and the effect of gestational diabetes mellitus on twin pregnancy outcomes
Jinying Luo, Xiaoyan Geng, Jinfu Zhou, Shengnan Liang, Wei Zheng, Guanghui Li
Clinics. 2023;78C:100272

  • The oral glucose tolerance characteristics were analyzed.

  • Effect of gestational diabetes on the pregnancy outcome of twins was analyzed.

  • The influence of preconception BMI on twin pregnancy outcome was explored.

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Implementation of an organized colorectal cancer screening program through quantitative fecal immunochemical test followed by colonoscopy in an urban low-income community: Guidance and strategies
Ulysses Ribeiro, Adriana Vaz Safatle-Ribeiro, Maurício Sorbello, Poliana Helena Rosolem Kishi, Diane Dede Cohend, Rejane Mattar, Vera Lucia Pagliusi Castilho, Elenice Messias Do Nascimento Goncalves, ... José Eluf-Neto
Clinics. 2023;78C:100278

  • This study describes the implementation of an organized colorectal cancer (CRC) screening in an urban low-income community.

  • Quantitative fecal immunochemical test (FIT) followed by colonoscopy is an efficacious strategy to improve the adenoma detection rate and CRC.

  • FIT followed by colonoscopy ensued a high participation rate, and high predictive positive value for adenoma and CRC.

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Contact aspiration and stent retriever versus stent retriever alone following mechanical thrombectomy for patients of acute ischemic stroke: A recanalization success analysis
Xiaowei Xu, Xiangzhong Shao, Jian Cao, Xiaoyong Huang, Lin Li
Clinics. 2023;78C:100262

  • A stent-assisted thrombectomy can use in symptomatic intracranial hemorrhage.

  • Contact aspiration plus stent retriever catheters have high chances of reperfusion.

  • Contact aspiration + stent retriever has fewer disease-related adverse effects.

  • The reperfusion parameter should be used to evaluate mechanical thrombectomy.

  • Failure attempts increased procedural time and procedural-adverse effects.

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Effect of the MiR-99b and MiR-135b on peritoneal carcinomatosis and liver metastasis in colorectal cancer
Mehmet Aziret, Gamze Güney Eskiler, Gözde Çakırsoy Çakar, Asuman Deveci Özkan, Metin Ercan, Cemil Bilir, Erdal Polat, Havva Belma Koçer, ... Mustafa Duman
Clinics. 2023;78C:100271
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The financial impact of neonatal sepsis on the Brazilian Unified Health System
Mariana Ferreira Carvalho Westerstahl de Abreu, Joice Fabíola Meneguel Ogata, Marcelo Cunio Machado Fonseca, Dayan Sansone, Ruth Guinsburg
Clinics. 2023;78C:100277

  • Understanding the costs of neonatal sepsis helps to provide the problem's dimension.

  • Mean hospital cost for neonatal sepsis was US$ 3345.59 per patient in 2008‒2018.

  • Improvement in quality of care may decrease neonatal sepsis’ economic impact.

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A clinical model to predict successful renal replacement therapy (RRT) discontinuation in patients with Acute Kidney Injury (AKI)
Eduardo de Oliveira Valle, Igor Smolentzov, João Lucas Martins Gorzoni, Isabela Cavalcante Salgado, Lorena Catelan Mainardes, Vanessa Oliveira Gomes, Charles Hamilton Mélo Júnior, Camila Eleuterio Rodrigues, José Mauro Vieira Júnior
Clinics. 2023;78C:100280

  • Score to predict successful RRT discontinuation in AKI.

  • Timely catheter removal.

  • Comparison among different strategies to assess.

  • Creatinine variation.

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Differences in long-term continence rates between prostate cancer patients with extraprostatic vs. organ-confined disease undergoing robotic-assisted radical prostatectomy: An observational studys
Cristina Cano Garcia, Mike Wenzel, Florestan Koll, Agnes Zatik, Jens Köllermann, Markus Graefen, Derya Tilki, Pierre I. Karakiewicz, ... Benedikt Hoeh
Clinics. 2023;78C:100284

  • No difference in long-term continence in extraprostatic vs. organ-confined prostate cancer.

  • Even after multivariable adjustment, no difference between these two groups was identified.

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KCNH2 mutation c.3099_3112del causes congenital long QT syndrome type 2 with gender differences
ZunPing Ke, Chao Li, Gang Bai, Li Tan, JunFeng Wang, Ming Zhou, JianHua Zhou, Shi-You Chen, Xiao Dong
Clinics. 2023;78C:100285

  • A mutation reported in this article appeared to be a definite pathogenic mutation of LQT2.

  • This mutation exhibit gender differences in clinical symptoms and T-wave morphology.

  • The female proband with this mutation showed a positive reaction to lidocaine attenuation test.

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Highlighting early detection of thyroid pathology and gestational diabetes effects on oxidative stress that provokes preterm delivery in thyroidology: Does that ring a bell?
Stefan Dugalic, Jovana Todorovic, Demet Sengul, Ilker Sengul, Eduardo Carvalho de Arruda Veiga, Jovana Plesinac, Milica Petronijevic, Maja Macura, ... Miroslava Gojnic
Clinics. 2023;78C:100279

  • The status of the thyroid gland and metabolic disturbance leads to the alteration of oxygenation.

  • The cases undergoing cesarean section had significantly higher values of the pulsatility index.

  • The cases with cesarean section had significantly higher values of the cerebroplacental ratio.

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Exercise and associated features with low-level exercise among doctors
Siriwan Tangjitgamol, Paisan Bunsiricomchai, Watcharagan Kaewwanna, Natapon Ativanichayapong, Sumonmal Manusirivithaya
Clinics. 2023;78C:100282

  • Exercise, one of the most crucial and beneficial health habits, is not a common practice among the general population.

  • Data on exercise were mainly from trainees, with few from professional doctors.

  • Nearly half of the 1187 doctors in the study had low-level exercise with young age, female, hard work, poor diet, and irregular health surveillance as risk factors.

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Muscle strength and psychometric properties of the health-related quality of life in patients with soft tissue sarcoma resection in the thigh
Liza Furlan Ranzani Vitti, Carlos Eduardo Hideo Hanasilo, Cleide Moreira Silva, Mauricio Etchebehere
Clinics. 2023;78C:100283

  • Supportive therapies are essential for maintenance of the muscle strength and quality of life.

  • Some quality of life parameters are hampered after soft tissue sarcoma treatment.

  • Soft tissue sarcoma treatment does not interfere with the functionality of the operated limb.

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Prevalence and interference of neuropathic pain in the quality of life in patients with knee osteoarthritis
Camilo Partezani Helito, Fernando Sant'Anna Moreira, Matheus Augusto Maciel Santiago, Lucas de Faria Barros Medeiros, Pedro Nogueira Giglio, Andre Giardino Moreira da Silva, Riccardo Gomes Gobbi, José Ricardo Pécora
Clinics. 2023;78C:100287

  • Total Knee Arthrosplasty (TKA) candidates often have associated neuropathic pain.

  • Patients with gonarthrosis and neuropathic pain have worse functional scores.

  • TKA candidates should be assessed for the presence of associated neuropathic pain.

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Stroke in children and adolescents: Analysis of electrophysiological and behavioral assessment findings of auditory processing
Andréia Rodrigues Parnoff Stadulni, Pricila Sleifer, Amanda Zanatta Berticelli, Rudimar Riesgo, Carolina Nunes Rocha-Muniz, Eliane Schochat
Clinics. 2023;78C:100286

  • Auditory processing behavior of children diagnosed with stroke was analyzed.

  • Children and adolescents with stroke performed worse in auditory processing tests.

  • Stroke-related lesions compromise the auditory neural mechanisms.

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An increase in a long noncoding RNA ANRIL in peripheral plasma is an indicator of stable angina
Yunjuan Jiao, Fanming Meng, Gaoen Ma, Hetian Lei, Junwen Liu
Clinics. 2023;78C:100289

  • ANRIL is a better diagnostic indicator than cardiac troponin I in patients with stable angina.

  • The levels of ANRIL are higher in patients with stable angina than those with myocardial infraction.

  • The levels of ANRIL in peripheral plasma could be used as a good biomarker for stable angina.

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Microablative fractional radiofrequency for sexual dysfunction and vaginal Trophism: A randomized clinical trial
Ayane Cristine Alves Sarmento, Fabíola Sephora Fernandes, Rafaella Rêgo Maia, Juliana Dantas de Araújo Santos Camargo, Janaina Cristiana de Oliveira Crispim, José Eleutério Júnior, Ana Katherine Gonçalves
Clinics. 2023;78C:100293

  • No significative adverse effects were reported following the Radiofrequency protocol.

  • Radiofrequency was comparable in efficacy to estrogen for vulvovaginal atrophy.

  • Radiofrequency could be a viable option in vulvovaginal atrophy management.

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Predictive value of serum inflammatory markers for histological chorioamnionitis among women with preterm premature rupture of membranes after undergoing cervical cerclage
Li Li, Xinxin Huang, Jianying Yan, Jun Zhang, Danlin Yang, Mian Pan
Clinics. 2023;78C:100292

  • Study on predictive value for HCA among women with PPROM after undergoing cervical cerclage.

  • WBC and neutrophil can predict HCA among women with PPROM after surgery of cervical cerclage.

  • The study provides a valuable prediction tool for early detection of HCA.

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Study on the correlation between gene polymorphisms of adiponectin and resistin levels and abdominal aortic aneurysm
Zhongyin Wu, Shuangqing Liu, Zhi Yang, Xiangxi Meng, Yang An, Hong Zhang
Clinics. 2023;78C:100298

  • Examined resistin gene polymorphisms' link with AAA.

  • -420C>G (especially CC/CG) tied to AAA risk & progression.

  • +276G/T polymorphism showed no AAA association.

  • Resistin gene's potential role in AAA highlighted.

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Associations between insomnia and large vessel occlusion acute ischemic stroke: An observational study
Huali Xu, Weili Li, Jiahao Chen, Piao Zhang, Siming Rong, Jinping Tian, Yuqian Zhang, Yanke Li, ... Yuhu Zhang
Clinics. 2023;78C:100297

  • The incidence of insomnia is higher in the acute ischemic stroke population.

  • Insomnia is closely related to the clinical outcome of acute ischemic stroke with large vessel occlusion.

  • The effects of Insomnia on acute ischemic stroke may involve inflammation and oxidative stress mechanisms.

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Value-based health care in heart failure: Quality of life and cost analysis
Eduarda Chiesa Ghisleni, Vitória Rech Astolfi, Larissa Zimmermann, Camila Nogueira Leandro Lira, Eduarda Faria do Nascimento, Ana Paula Beck da Silva Etges, Fabiana G. Marcondes-Braga, Fernando Bacal, ... Andreia Biolo
Clinics. 2023;78C:100294

  • Value-based models might improve care for heart failure.

  • The authors observed poor QoL and high treatment costs in HF outpatients in Brazil.

  • Women seem to have worse quality of life, more anxiety and depression symptoms.

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MicroRNA-218-5p accelerates malignant behaviors of breast cancer through LRIG1
Juhang Chu, Luyao Huang, Yaru Wang, Lin Fang, Mingping Qian
Clinics. 2023;78C:100302

  • MiRNA-218-5p up-regulates ErbB2 and EGFR expression by suppressing LRIG1 expression.

  • MiRNA-218-5p promotes the malignant behaviors of BC.

  • MiRNA-218-5p may exert a pro-tumor effect on BC and serve as a therapeutic target for BC treatment.

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Comparative efficacy & safety of buparlisib plus fulvestrant, fulvestrant plus dalpiciclib, and ribociclib plus letrozole for postmenopausal, hormone receptor-positive, and HER2-negative breast cancer
Qi Liu, Lingli Hou, Ying Zhao, Hongwei Yang, Zhengying Mo, Fei Yu
Clinics. 2023;78C:100291

  • Dalpiciclib + fulvestrant is effective in hormone (+) and HER2 (−) breast cancers.

  • Dalpiciclib and buparlisib cause neutropenia.

  • Gastrointestinal tract-related adverse effects while treatment with fulvestrant.

  • Liver function monitoring is recommended for ribociclib + letrozole treatment.

  • Women should be under the supervision of a consultant while 100 mg/day of buparlisib.

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Clinical study of modified photodynamic therapy combined with Taohong Siwu Decoction in treating hypertrophic scar after severe burn
Zhenguo Zhang, Shidong He, Qiaoxia Yu, Jiayue Ding
Clinics. 2023;78C:100295

  • MPT combined with THSD shows remarkable efficacy in hyperplastic scar patients.

  • MPT combined with THSD can reduce the level of cytokines related to tissue repair.

  • The study provides a new comprehensive therapy for hyperplastic scar patients.

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Early-stage non-alcoholic fatty liver disease in relation to atherosclerosis and inflammation
Si-hua Tan, Xiao-li Zhou
Clinics. 2023;78C:100301
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Butyrate facilitates immune clearance of colorectal cancer cells by suppressing STAT1-mediated PD-L1 expression
Yan Zhang, Yuan Tao, Yuqing Gu, Qiujie Ma
Clinics. 2023;78C:100303

  • Butyrate could suppress IFN-γ-induced PD-L1 up-regulation in Colorectal Cancer (CRC) cells.

  • Butyrate promoted the lysine acetylation of STAT1 to reduce STAT1 expression.

  • Butyrate attenuated the IFN-γ-induced impairment of CD8+ T-cell cytotoxicity against CRC cells.

  • Butyrate suppressed CRC tumor growth by enhancing CD8+ T-cell infiltration.

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Effect of restrictive fluid resuscitation on the coagulation function and hemodynamic parameters in patients with hemorrhagic traumatic shock
Junfen Zheng, Jinqiang Zhu, Liexiang Cao, Meiping Dong, Yi Mao, Zhiwei Zhao, Yao Liu
Clinics. 2023;78C:100300

  • It is able to as the balance point between the blood pressure and bleeding event.

  • It can reduce the bleeding amount and infusion volume and increase the cure rate of patients.

  • Restrictive fluid resuscitation has a promising value in the treatment of HTS, which is worthy of promotion in clinical practice.

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KIF22 promotes the proliferation and glycolysis of melanoma by activating EGFR/STAT3 signaling
Zhi Zhong, Hua Zhong
Clinics. 2023;78C:100307

  • KIF22 expression is upregulated in melanoma tissues and cells.

  • KIF22 knockdown suppresses proliferation and facilitates apoptosis of melanoma cells.

  • KIF22 knockdown inhibits tumor glycolysis in melanoma cells.

  • KIF22 depletion suppresses proliferation, glycolysis and facilitates apoptosis of melanoma cells by inactivating EGFR/STAT3 signaling.

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Evaluation of oxidative stress in an experimental model of Crohn's disease treated with hyperbaric oxygen therapy
Fernanda Serafim Nakutis, Iêda Nishitokukado, Fabiana Maria dos Santos, Carmen Lucia Ortiz-Agostinho, Daniel Teixeira de Alencar, Cassiana Ganem Achtschin, Valeria Sutti Nunes, André Zonetti Arruda Leite, Aytan Miranda Sipahi
Clinics. 2023;78C:100305

  • HBO promoted a significant improvement in the clinical and histological statuses of the animals of this study experimental.

  • HBO is effective for the treatment of colitis by increasing the activity of antioxidant enzymes.

  • This study demonstrated a modulation of the immune response by reducing the expression of inflammatory cytokines and increasing the anti-inflammatory cytokines.

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miRNA-143 expression is associated with inflammation and time of exposure to amniotic fluid in experimental gastroschisis
Ana Maria Bicudo Diniz, Igor José Nogueira Gualberto, Luiza Almeida Lima, Mucio Luiz de Assis Cirino, Rodrigo Kendi Murakami, Bella Luna Colombini Ishikiriama, Rodrigo Ruano, Luiz Fernando Ferraz da Silva, ... Lourenço Sbragia
Clinics. 2023;78C:100311

  • miR-143 is related with more inflammation and edema of intestinal loops of gastroschisis rat model.

  • Time of exposure of the amniotic fluid increases the intestinal damage.

  • miR-143 is a possible marker of gut inflammation.

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Effects of estrogen and raloxifene on synaptic density in the hippocampal CA1 region of ovariectomized rats
Glaucia Mara MenezesdaSilva, Eduardo Carvalho de Arruda Veiga, Manuel Jesus Simões, Ricardo Santos Simões, Marcos Eiji Shiroma, Maria Cândida Pinheiro Baracat, Giovanna Santos Cavalcanti, Jose Maria Soares Junior, Edmund Chada Baracat
Clinics. 2023;78C:100312

  • Raloxifene effect on the CA1 hippocampus synaptic density.

  • Differences between early and late hormonal treatment on CA1 hippocampus synaptic density.

  • Estrogen action on the rat synaptic density is higher than one of raloxifene.

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Influence of blood hemodynamics on the treatment outcomes of limited fluid resuscitation in emergency patients with traumatic hemorrhagic shock
Wen Ke, Linghong Zhang
Clinics. 2023;78C:100308

  • LFR can improve blood hemodynamics parameters after traumatic hemorrhagic shock.

  • LFR would influence serum inflammatory levels after traumatic hemorrhagic shock.

  • Medium MAP can be employed as the optimal administrating strategy for LFR.

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Dietary pattern in women with polycystic ovary syndrome with and without associated non-alcoholic fatty liver disease: A cross-sectional study
Thais Cristine Moura Guimarães, Daniela Oliveira de Lima Taranto, Claudia Alves Couto, Mateus Jorge Nardelli, Ana Lucia Cândido, Cristina de Almeida Hott, Lucilene Rezende Anastácio, Fernando M. Reis, ... Luciana Costa Faria
Clinics. 2023;78C:100288

  • • The role of diet in NAFLD development is still uncertain in PCOS women.

  • • Anthropometry and sedentarism were different between PCOS women with and without NAFLD.

  • • Food intake and dietary patterns were similar between PCOS women with and without NAFLD.

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Review articles
Comparison of gefitinib plus chemotherapy versus gefitinib alone for advanced non‑small‑cell lung cancer: A meta analysis
Min Yi, Ting He, Kaijin Wang, Yonggang Wei
Clinics. 2023;78C:100152

  • This meta-analysis shows that gefitinib plus chemotherapy showed significantly better efficacy in improving objective response rate, disease control rate, progression-free survival, and OS as compared with gefitinib alone.

  • Similar efficacy of gefitinib plus chemotherapy is found in the sub-population with positive EGFR mutation.

  • The toxicity of gefitinib plus chemotherapy is also increased but within clinical management.

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Endoscopic Biliary Darinage (EBD) versus Percutaneous Transhepatic Biliary Drainage (PTBD) for biliary drainage in patients with Perihilar Cholangiocarcinoma (PCCA): A systematic review and meta-analysis
Caroline Flaksbaum Moll, Diogo Turiani Hourneaux de Moura, Igor Braga Ribeiro, Igor Mendoça Proença, Epifanio Silvino do Monte Junior, Sergio A. Sánchez-Luna, Maria Fernanda Shinin Merchán, Josselyn Mariana Vera Intriago, ... Eduardo Guimarães Hourneaux de Moura
Clinics. 2023;78C:100163

  • There is no consensus about which method is preferred for biliary drainage for Perihilar Cholangiocarcinoma (PCCA).

  • Endoscopic retrograde cholangiopancreatography (EBD) or Percutaneous Transhepatic Biliary Drainage (PTBD) are options of choice.

  • PTBD is superior to EBD regarding crossover rate, overall post-drainage complications, and post-drainage pancreatitis.

  • EBD is superior to PTBD when it comes to hospital length of stay.

  • For the palliation of PCCA, PTBD is superior to EBD in terms of clinical success and post-drainage cholangitis.

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Programmed cell death-1 and its ligands: Current knowledge and possibilities in immunotherapy
Bojana Gutic, Tatjana Bozanovic, Aljosa Mandic, Stefan Dugalic, Jovana Todorovic, Dejana Stanisavljevic, Miroslava Gojnic Dugalic, Demet Sengul, ... José Maria Soares
Clinics. 2023;78C:100177

  • Recently, cancer immunotherapy targeting PD-1 or PD-L1 has proven effective in causing durable antitumor immune responses with less toxicity in many types of tumors.

  • PD-1/PD-L1 blockade therapy will be the major cancer immunotherapy modality.

  • A deeper understanding of personal genomic information, and personalized markers in guiding anti-PD therapy.

  • Similar to the tip of an iceberg, PD-1/PD-L1 blockade antitumor immunotherapy opens a new era of cancer treatment, and further work on safety and efficiency will be required.

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Health-related quality of life following lung transplantation for cystic fibrosis: A systematic review
Aarohanan Raguragavan, Dujinthan Jayabalan, Akshat Saxena
Clinics. 2023;78C:100182

  • 10 studies (1494 patients) were included in this systematic review.

  • LTx confers improved HRQoL in CF patients relative to their baseline state.

  • Up to 5-years post-LTx, CF patients’ HRQoL remains at the general population level.

  • Several factors modulate HRQoL outcomes in CF post-LTx.

  • HRQoL post-LTx in CF patients is either equal to or greater than other indications.

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Polyethylene glycol combined with lactulose has better efficacy than polyethylene glycol alone in bowel preparation before colonoscopy: A meta-analysis
Xiaofen Zhang, Yishu Chen, Ye Chen, Wei Zhu, Chenxi Tang, Shelby Lamm, Lan Li
Clinics. 2023;78C:100172

  • High quality of bowel cleansing is important to the accuracy of diagnosis and the safety of treatment in colonoscopy.

  • PEG combined with lactulose has a better efficacy in bowel preparation than PEG alone.

  • PEG combined with lactulose has fewer adverse reactions than PEG alone in bowel preparation.

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Understanding the journey of patients with depression in Brazil: A systematic review
Alexandrina Meleiro, Chei Tung Teng, Frederico Navas Demetrio, Vivian Cardoso Batista, Luiz Fernando Vieira, Paola Marina Elorza
Clinics. 2023;78C:100192

  • Depression in Brazil.

  • Patient journey stages.

  • Awareness.

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Economic evaluations of colorectal cancer screening: A systematic review and quality assessment
Marcela Castro Ramos, Julio Augusto de Lima Passone, Ana Carolina de Freitas Lopes, Adriana Vaz Safatle-Ribeiro, Ulysses Ribeiro Júnior, Patrícia Coelho de Soárez
Clinics. 2023;78C:100203

  • Colorectal Cancer (CRC) screening programs reduced the incidence and mortality of CRC.

  • CRC screening strategies were cost-effective or cost-saving, mainly in high-income countries.

  • There is a need to develop economic evaluation studies for CRC screening in low- and middle-income countries.

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Acute kidney injury in COVID-19 patients receiving remdesivir: A systematic review and meta-analysis of randomized clinical trials
Golnaz Shams, Asma Kazemi, Khatereh Jafaryan, Mohammad Hossein Morowvat, Payam Peymani, Iman Karimzadeh
Clinics. 2023;78C:100200
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The effectiveness of ultrasound-guided core needle biopsy in detecting lymph node metastases in the axilla in patients with breast cancer: systematic review and meta-analysis
Qi Xu, Jiale Wang, Jing Wang, Runzhao Guo, Yao Qian, Feng Liu
Clinics. 2023;78C:100207

  • US-CNB is a reliable preoperative test for detecting axillary metastasis in breast cancer patients, with high accuracy and safety.

  • Compared to US-FNA, US-CNB shows even higher accuracy for detecting axillary metastasis in breast cancer patients.

  • The use of US-CNB as a preoperative test can reduce the need for a second operation and improve patient outcomes.

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Prevalence of chronic pain in Brazil: A systematic review and meta-analysis
Bruno Vitor Martins Santiago, Ana Beatriz Garcez de Oliveira, Gabriel Machado Romão da Silva, Maxuel de Freitas da Silva, Pedro Ernandes Bergamo, Maud Parise, Nivaldo Ribeiro Villela
Clinics. 2023;78C:100209

  • The prevalence of chronic pain in the adult population (35.70%) and older adults (47.32%).

  • Differs from region to region and is associated with heterogeneous risk factors.

  • Manifested mainly with moderate or severe intensity and with an elevated rate of disability.

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Mesenchymal stem cells in lung diseases and their potential use in COVID-19 ARDS: A systematized review
Bruna Benigna Sales Armstrong, Juan Carlos Montano Pedroso, José da Conceição Carvalho, Lydia Masako Ferreira
Clinics. 2023;78C:100237

  • None of the analized studies related serious adverse effects or toxicity to IV ASCs administration.

  • This review suggests optimism in IV ASCs for lung damage in severe COVID-19 ARDS.

  • Further studies on IV ASCs in COVID-19 are needed for standard dosage.

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Driving force of deteriorated cellular environment in heart failure: Metabolic remodeling
Lu Fan, Chenchen Meng, Xiaoming Wang, Yunjiao Wang, Yanyang Li, Shichao Lv, Junping Zhang
Clinics. 2023;78C:100263

  • Improving the cellular environment is expected to further optimize the management of HF.

  • Metabolic remodeling is the driving force of deteriorated cellular environment in HF.

  • Targeting impaired energy provision is of great potential in the treatment of HF.

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CT radiomics for prediction of microvascular invasion in hepatocellular carcinoma: A systematic review and meta-analysis
Hai-ying Zhou, Jin-mei Cheng, Tian-wu Chen, Xiao-ming Zhang, Jing Ou, Jin-ming Cao, Hong-jun Li
Clinics. 2023;78C:100264

  • CT radiomics could preoperatively predict MVI in HCC with an AUC of 0.87.

  • Radiomics model based on 3D tumor segmentation, and deep learning model can be superior to predict MVI.

  • Reproducibility of current radiomics models for clinical application may be uncertain.

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Efficacy, safety, and potential industry bias in using deoxycholic acid for submental fat reduction ‒ A systematic review and meta-analysis of randomized clinical trials
Gabriel Santiago Giuglio Inocêncio, Daniela Meneses-Santos, Marcelo Dias Moreira de Assis Costa, Walbert A. Vieira, Vinicius Lima de Almeida, Renata Prata Cunha Bernardes Rodrigues, Sigmar de Mello Rode, Luiz Renato Paranhos
Clinics. 2023;78C:100220

  • Deoxycholic acid is effective in submental fat reduction for both clinician and patient-related outcomes.

  • Well-tolerated side-effects were observed in Deoxycholic acid groups.

  • All eligible randomized trials showed a potential industry bias.

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Diagnostic performance of microRNA-29a in active pulmonary tuberculosis: a systematic review and meta-analysis
Xiaoying Li, Yuehong Xu, Pu Liao
Clinics. 2023;78C:100290

  • A meta-analysis was applied to analyze the performance of miRNA-29a in diagnosing active pulmonary tuberculosis.

  • miRNA-29a can be used as a biomarker for the diagnosis of active tuberculosis.

  • Tuberculosis burden and sample type of miRNA-29a may influence its diagnostic performance.

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Does bisphenol A (BPA) participates in the pathogenesis of Polycystic Ovary Syndrome (PCOS)?
Lorena Ana Mercedes Lara Urbanetz, José Maria Soares Junior, Gustavo Arantes Rosa Maciel, Ricardo dos Santos Simões, Maria Cândida Pinheiro Baracat, Edmund Chada Baracat
Clinics. 2023;78C:100310

  • Bisphenola A (BPA) is an endocrine disruptor widely investigated as a possible environmental contributor to the pathogenesis of Polycystic Ovary Syndrome (PCOS).

  • Due to its structural similarity with the Estrogen molecule (E2), it acts as a xenoestrogen, binding to genomic and non-genomic estrogen receptors, causing metabolic and hormonal changes that lead to PCOS (hyperandrogenism, insulin resistance, hyperinsulinemia, obesity, atherogenic dyslipidemia, anovulation, and ovarian cysts).

  • The aim and of this review were to present the mechanisms of bisphenol A participation in the pathogenesis of Polycystic Ovary Syndrome.

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Epigenetics, hypersensibility and asthma: what do we know so far?
Douglas da Silva Lima, Rahuany Velleda de Morais, Ciliana Rechenmacher, Mariana Bohns Michalowski, Marcelo Zubaran Goldani
Clinics. 2023;78C:100296

  • Epigenetics, hypersensibility and asthma: what do we know so far?

  • Asthma can be triggered from epigenetic changes.

  • Early life exposures can contribute to the development and exacerbation of asthma.

  • DNA methylation profile of certain genes is related to asthma and allergy.

  • Nasal epithelium samples have shown promise as a tissue for studying DNA methylation changes related to asthma.

  • To find biomarkers and standardized assays to advance the field of epigenetics in respiratory disorders are still a challenge.

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If you can't kill the beast, tame it: Tips for surviving WhatsApp® in medical practice
Max S. Mano
Clinics. 2023;78C:100156
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Bioethics and xenotransplantation from pig to human
Flavio Henrique Ferreira Galvao, Max Grinberg
Clinics. 2023;78C:100170
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SARS-CoV-2 infection and COVID-19 and human reproduction – A changing perspective – A 2022 update
Luciana C. Delamuta, Pedro A.A. Monteleone, Edson S. Ferreira-Filho, Vanessa Heinrich-Oliveira, José Maria Soares-Júnior, Edmund C. Baracat, Gustavo Arantes Rosa Maciel
Clinics. 2023;78C:100166

  • SARS-CoV-2 can temporarily reduce male fertility and alter sperm parameters.

  • Reversible menstrual disturbances happened after infection and vaccination.

  • IVF outcomes and laboratory parameters were not affected by SARS-CoV-2.

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CYP2C19 metabolic estrogen phenotypes and endometriosis risk in Brazilian women
Jamila Alessandra Perini, Daniel Escorsim Machado, Jéssica Vilarinho Cardoso, Vanessa Camara Fernandes, Claudio José Struchiner, Guilherme Suarez-Kurtz
Clinics. 2023;78C:100176
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Long post-COVID-vaccination syndrome manifesting as temperature-sensitive myalgia and hyper-CKemia
Josef Finsterer, Carla A. Scorza, Fulvio A. Scorza
Clinics. 2023;78C:100175
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Medical research: Are e-Sports really sports?
Fulvio A. Scorza, Ana C. Fiorini, Camila C. de Lima, Nilton Camilo, Eliana P. Magro, Liliane Guimarães, Claudio Pavanelli, Josef Finsterer, ... Ricardo M. Arida
Clinics. 2023;78C:100190
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Stroke seven hours after SARS-CoV-2 vaccination
Ana Claudia Fiorini, Carla Alexandra Scorza, Antonio-Carlos G. de Almeida, Fulvio Alexandre Scorza, Josef Finsterer
Clinics. 2023;78C:100193
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Role of sulfonylurea administration in sepsis and septic shock patients: A systematic review
Taline Lazzarin, Raquel Simões Ballarin, Filipe Welson Leal Pereira, Paula Schmidt Azevedo, Suzana Erico Tanni, Marcos Ferreira Minicucci
Clinics. 2023;78C:100197
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Parkinson's disease in LGBT+ older adults: The unexplored connection
Fulvio A. Scorza, Antonio-Carlos G. de Almeida, Ana C. Fiorini, Carla A. Scorza, Josef Finsterer
Clinics. 2023;78C:100196
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Pharmacogenetic testing for thiopurine drugs in Brazilian acute lymphoblastic leukemia patients
Guilherme Suarez-Kurtz, Cristina Wiggers Almeida, Eduardo Chapchap, Márcia Trindade Schramm, Maura Rosane Valério Ikoma-Coltutato, Mecneide Mendes Lins, Teresa Cristina Cardoso Fonseca, Thais Ferraz Aguiar, Mariana Emerenciano
Clinics. 2023;78C:100214
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Mitochondrial small fiber neuropathy as a novel phenotypic trait of Leigh-like syndrome due to the variant m.10191T>C in MT-ND3
Shaundra M. Newstead, Carla A. Scorza, Ana C. Fiorini, Fulvio A. Scorza, Josef Finsterer
Clinics. 2023;78C:100206
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The rise of intelligent research: how should artificial intelligence be assisting researchers in conducting medical literature searches?
Shankargouda Patil, Marcos Roberto Tovani-Palone
Clinics. 2023;78C:100226
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Severe thrombocytopenia due to idiopathic myelodysplastic syndrome complicated by spontaneous, fatal intracerebral hemorrhage
Carla Alexandra Scorza, Antonio-Carlos G. de Almeida, Fulvio Alexandre Scorza, Josef Finsterer
Clinics. 2023;78C:100227
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Changes in neutrophil-lymphocyte and platelet-lymphocyte ratios before and after percutaneous coronary intervention and their impact on the prognosis of patients with acute coronary syndrome
Edenilson de Souza Teixeira, João Gabriel Ferreira de Oliveira, Rodrigo Mendes, Cristian Rodrigues do Nascimento, Johnnatas Mikael Lopes, Pedro Pereira Tenório
Clinics. 2023;78C:100221
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Stroke after SARS-CoV-2 vaccination: Comment
Amnuay Kleebayoon, Rujittika Mungmunpuntipantip, Viroj Wiwanitkit
Clinics. 2023;78C:100246
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Pseudomonas aeruginosa ventriculitis following pancytopenia due to myelodysplastic syndrome with an excess of blasts type 2
Carla Alexandra Scorza, Fulvio Alexandre Scorza, Josef Finsterer
Clinics. 2023;78C:100250
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“Scientific Evidence for Homeopathy”
Marcus Zulian Teixeira
Clinics. 2023;78C:100255

  • Homeopathy is based on heterodox and complementary four scientific assumptions.

  • Pseudosceptics deny these assumptions and any scientific evidence that proves them.

  • The dossier describes hundreds of clinical and experimental studies in homeopathy.

  • The dossier demystifies the fallacy that “there isn't scientific evidence for homeopathy”.

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Does SARS-CoV-2vaccination induce acquired autoimmune discords and inflammatory manifestations?
Khadija Bahrini, Emna Hannachi
Clinics. 2023;78C:100257
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos