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A randomized clinical trial on inhaled ciclesonide for managing acute asthma in the emergency room
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Martins, Demétrius Tierno

; Carlos, Karla

; Carvalho, Luciane Bizari

; Prado, Lucila Bizari

; Fransolin, Carolina

; Atallah, Alvaro Nagib

; Prado, Gilmar Fernandes do

Sao Paulo Medical Journal

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jun 2022, Volume 140 N. 3 Pages 430 - 438

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Use of inhaled corticosteroids for managing acute asthma exacerbations has been tested since the 1990s. OBJECTIVE: To compare high doses of inhaled ciclesonide with systemic hydrocortisone for managing acute asthma exacerbations in the emergency department. DESIGN AND SETTING: Double-blind, randomized clinical trial in the public healthcare system of the city of São Paulo. METHODS: Fifty-eight patients with moderate or severe asthma with peak flow < 50% of predicted were randomized into two groups. Over the course of four hours, one group received 1440 mcg of inhaled ciclesonide plus hydrocortisone-identical placebo (ciclesonide + placebo), while the other received 500 mg of intravenous hydrocortisone plus ciclesonide-identical placebo (hydrocortisone + placebo). Both groups received short-acting bronchodilators (fenoterol hydrobromide and ipratropium bromide). The research protocol included spirometry, clinical evaluation, vital signs and electrocardiogram monitoring. Data were obtained at 30 (baseline), 60, 90, 120, 180, and 240 minutes. We compared data from baseline to hour 4, between and within groups. RESULTS: Overall, 31 patients received ciclesonide + placebo and 27 received hydrocortisone + placebo. Inhaled ciclesonide was as effective as intravenous hydrocortisone for improving clinical parameters (Borg-scored dyspnea, P = 0.95; sternocleidomastoid muscle use, P = 0.55; wheezing, P = 0.55; respiratory effort, P = 0.95); and spirometric parameters (forced vital capacity, P = 0.50; forced expiratory volume in the first second, P = 0.83; peak expiratory flow, P = 0.51). CONCLUSIONS: Inhaled ciclesonide was not inferior to systemic hydrocortisone for managing acute asthma exacerbations, and it improved both clinical and spirometric parameters. TRIAL REGISTRATION: RBR-6XWC26 - Registro Brasileiro de Ensaios Clínicos (http://www.ensaiosclinicos.gov.br/rg/RBR-6xwc26/).

https://doi.org/10.1590/1516-3180.2021.0542.r1.15092021

Analysis on mental-insanity and cessation-of-dangerousness examinations in three Brazilian custodial institutions: a retrospective cross-sectional study
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Marchewka, Tania Maria Nava

; Atallah, Alvaro Nagib

; Valente, Nathalia Marchewka

; Melnik, Tamara

Sao Paulo Medical Journal

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dec 2021, Volume 139 N. 6 Pages 624 - 634

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: In Brazil, the right to healthcare and the incorporation of best scientific evidence in public health are universally guaranteed by law. However, the treatment offered to patients with mental disorders in custodial hospitals in this country has not been rigorously evaluated. OBJECTIVES: To analyze the psychiatric diagnoses and treatments implemented in three Brazilian custodial institutions. DESIGN AND SETTING: This was a retrospective, cross-sectional and descriptive study on patients held in custody in three Brazilian institutions, as judicially-determined safety measures due to their mental disorders, and the tools used in diagnoses and treatments. These institutions are in Rio de Janeiro and the Federal District. METHODS: The data from medical and judicial records that were made available were assessed regarding the diagnoses that were made and the instruments that were used. RESULTS: None of these inpatients were evaluated using validated tools, and only a few medical records presented clear descriptions of the cases. No patient with substance involvement had undergone laboratory toxicological assays. It was not possible to verify the adequacy of treatments because the procedures were inadequately described in the records. CONCLUSIONS: No standardized protocols or instruments for diagnosing mental health disorders or assessing use of psychoactive substances had been applied among the inpatients at these custodial institutions in Rio de Janeiro and the Federal District. The treatments that were prescribed to these inpatients consisted mainly of drugs.

https://doi.org/10.1590/1516-3180.2020.0450.r1.22042021

[SciELO Preprints] - Intervention with ivermectin for of COVID-19: synopsis of evidence
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Person, Osmar Clayton Puga, Maria Eduarda dos Santos Atallah, Alvaro Nagib Amaral, José Luiz Gomes do

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Publication date: 2021-03-01

Abstract: En Pt

Context: COVID-19 is a viral disease that has recently emerged and is associated with severe respiratory distress syndrome (SARS). Its potential for severity and impact on the health of the population and the global economy is a prime object in the search for effective therapy and ivermectin has been recommended for prevention and treatment. Objective: To evaluate the evidence in the literature regarding the use of ivermectin for the prevention and treatment of cases of COVID-19. Study design: This is a synopsis of evidence. Methods: We searched the electronic databases PubMed (1966-2021), EMBASE (1974-2021) and Clinical Trials (2021) and two evidence megabusers: Turning Research Into Practice (TRIP) database (2021) and Epstemonikos (2021). There was no geographic or language restriction, using DeCS descriptors and terms (Health Sciences Descriptors). The synthesis method involved the combination of similar studies in a narrative review. Results: 527 citations were identified and 5 studies were included. There are few completed clinical trials, all of which have a small sample size. Discussion: Most of the studies available in the literature are based on in vitro therapeutic responses and the recommendation for use in humans has been based on the findings of these studies. The question cannot be answered with current studies, and quality clinical trials are recommended. Conclusions: There is currently no support in the literature for the use of ivermectin in the prevention or treatment of COVID-19.

Contexto: A COVID-19 é uma doença viral que surgiu recentemente e associada à síndrome da angústia respiratória severa (SARS). Seu potencial de gravidade e impacto na saúde da população e economia global é objeto primordial na busca por uma terapêutica eficaz ea ivermectina tem sido recomendada para prevenção e tratamento da COVID-19. Objetivo: avaliar como evidências na literatura relativa ao uso de ivermectina para prevenção e tratamento de casos de COVID-19. Desenho de estudo: Trata-se de sinopse de evidências. Métodos:Procedeu-se à busca de bases eletrônicas de dados PubMed (1966-2021), EMBASE (1974-2021) e Clinical Trials (2021) e em dois megabuscadores de evidências: Turning Research Into Practice (TRIP) database (2021) e Epstemonikos ( 2021). Não houve restrição geográfica e de idioma, sendo utilizados descritores e termos do DeCS (Descritores em Ciências da Saúde). O método de síntese envolveu uma combinação de estudos semelhantes em uma revisão narrativa. Resultados: Foram identificados 527 citações e 5 estudos foram incluídos. Há poucos ensaios clínicos concluídos todos apresentam pequena. Discussão: A maioria dos estudos disponíveis na literatura respalda-se em respostas terapêuticas in vitroea recomendação para uso em humanos tem-se baseado nos achados desses estudos. A questão não pode ser respondida com os estudos atuais, sendo recomendada a realização de ensaios de qualidade. Conclusões: Não há suporte atualmente na literatura para uso da ivermectina na prevenção ou tratamento COVID-19.

https://doi.org/10.1590/SciELOPreprints.1871

SARS-CoV-2 and arbovirus infection: a rapid systematic review
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Milby, Keilla Martins

; Atallah, Alvaro Nagib

; Rocha-Filho, César Ramos

; Pinto, Ana Carolina Pereira Nunes

; Rocha, Aline Pereira da

; Reis, Felipe Sebastião de Assis

; Carvas Junior, Nelson

; Civile, Vinicius Tassoni

; Santos, Rodolfo Rodrigo Pereira

; Ferla, Laura Jantsch

; Trevisani, Giulia Fernandes Moça

; Ramalho, Gabriel Sodré

; Puga, Maria Eduarda dos Santos

; Trevisani, Virgínia Fernandes Moça

Sao Paulo Medical Journal

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dec 2020, Volume 138 N. 6 Pages 498 - 504

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: The numbers of cases of arboviral diseases have increased in tropical and subtropical regions while the coronavirus disease (COVID-19) pandemic overwhelms healthcare systems worldwide. The clinical manifestations of arboviral diseases, especially dengue fever, can be very similar to COVID-19, and misdiagnoses are still a reality. In the meantime, outcomes for patients and healthcare systems in situations of possible syndemic have not yet been clarified. OBJECTIVE: We set out to conduct a systematic review to understand and summarize the evidence relating to clinical manifestations, disease severity and prognoses among patients coinfected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and arboviruses. METHODS: We conducted a rapid systematic review with meta-analysis, on prospective and retrospective cohorts, case-control studies and case series of patients with confirmed diagnoses of SARS-CoV-2 and arboviral infection. We followed the Cochrane Handbook recommendations. We searched EMBASE, MEDLINE, Cochrane Library, LILACS, Scopus and Web of Science to identify published, ongoing and unpublished studies. We planned to extract data and assess the risk of bias and the certainty of evidence of the studies included, using the Quality in Prognosis Studies tool and the Grading of Recommendations Assessment. RESULTS: We were able to retrieve 2,407 citations using the search strategy, but none of the studies fulfilled the inclusion criteria. CONCLUSION: The clinical presentations, disease severity and prognoses of patients coinfected with SARS-CoV-2 and arboviruses remain unclear. Further prospective studies are necessary in order to provide useful information for clinical decision-making processes. Protocol registration number in the PROSPERO database: CRD42020183460

https://doi.org/10.1590/1516-3180.2020.0422.08092020 1325 downloads

[SciELO Preprints] - SARS-COV-2 AND ARBOVIRUS INFECTIONS: PROTOCOL FOR A RAPID LIVING SYSTEMATIC REVIEW
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Milby, Keilla Martins Atallah, Alvaro Nagib Rocha-Filho, César Ramos Pinto, Ana Carolina Pereira Nunes Rocha, Aline Pereira da Reis, Felipe Sebastião de Assis Carvas Junior, Nelson Civile, Vinicius Tassoni Santos, Rodolfo Rodrigo Pereira Ferla, Laura Jantsch Trevisani, Giulia Fernandes Moça Ramalho, Gabriel Sodré Trevisani, Virgínia Fernandes Moça

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Publication date: 2020-05-09

Abstract: En

Context and objective: While cases of COVID-19 disease increase daily worldwide, outbreaks of arboviral infections have affected health systems of countries in tropical regions. The outcomes for patients and health systems of a possible syndemic are not clarified yet. Thus, we aim to systematically review the literature searching for evidence that describes the clinical presentation, severity and prognostic of SARS-CoV-2 and Arboviral coinfection. Design and setting: Protocol for a rapid living systematic review, that will follow the Cochrane Handbook for Systematic Reviews recommendations. We will include prospective and retrospective cohort, case-control studies and case series of patients with confirmed diagnosis of SARS-CoV-2 and Arboviral infection. We will perform the search strategy with no language restrictions on Medline via PubMed, Embase via Elsevier, Cochrane Library - Cochrane Central Register of Controlled Trials (CENTRAL), Portal Regional BVS - LILACS, Scopus and WebOfScience to identify published, ongoing, and unpublished studies. The selection and extraction will be performed by two authors. We will perform the critical appraisal of included studies with the Newcastle-Ottawa Scale and the certainty of evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).    

https://doi.org/10.1590/SciELOPreprints.346

[SciELO Preprints] - Telehealth interventions in the context of the COVID-19 pandemic: Protocol for a scoping review
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Puga, Maria Eduarda dos Santos Reis, Felipe Sebastião de Assis Milby, Keilla Martins Pinto, Ana Carolina Pereira Nunes Rocha-Filho, César Ramos Rocha, Aline Pereira da Carvas Junior, Nelson Civile, Vinicius Tassoni Santos, Rodolfo Rodrigo Pereira Ramalho, Gabriel Sodré Trevisani, Giulia Fernandes Moça Ferla, Laura Jantsch Puga, Maria Eduarda dos Santos Atallah, Alvaro Nagib Trevisani, Virgínia Fernandes Moça

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Publication date: 2020-05-06

Abstract: En

CONTEXT AND OBJECTIVE: The current health crisis due to COVID-19 is forcing us to profoundly rethink our social organizations and practices in health. While there is no effective treatment for the virus, staying home and social isolation are the control measures recommended by health authorities. The aim of this study is to perform a scoping review in order to summarize the current evidence in telehealth for COVID-19. METHODS: This study is a protocol to describe the rationale, hypothesis and planned methods of our scoping review. We will include randomized controlled trials (RCTs), observational cohort studies, case-control studies, cross-sectional studies, qualitative studies, and/or case series that describe telehealth interventions applied or developed to respond to COVID-19. We will search Medline via PubMed, Embase via Elsevier, Cochrane Library - Cochrane Central Register of Controlled Trials (CENTRAL), Portal Regional BVS - LILACS, and Scopus. We will include studies performed since December 2019 with no language restrictions. We will use the Risk of Bias tool and the Newcastle-Ottawa Scale to perform the critical appraisal of included studies. We will assess the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).

https://doi.org/10.1590/SciELOPreprints.353

[SciELO Preprints] - Pharmacological interventions for COVID-19: Protocol for a Rapid Living Systematic Review with network meta-analysis
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Puga, Maria Eduarda dos Santos Pinto, Ana Carolina Pereira Nunes Rocha, Aline Pereira da Milby, Keilla Martins Rocha-Filho, César Ramos Reis, Felipe Sebastião de Assis Carvas Junior, Nelson Civile, Vinicius Tassoni Santos, Rodolfo Rodrigo Pereira Trevisani, Giulia Fernandes Moça Ferla, Laura Jantsch Ramalho, Gabriel Sodré Puga, Maria Eduarda dos Santos Trevisani, Virgínia Fernandes Moça Atallah, Alvaro Nagib

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Publication date: 2020-05-06

Abstract: En

CONTEXT AND OBJECTIVE: Coronavirus disease 2019 (COVID-19) has emerged in China in December 2019 and rapidly spread. Although extraordinary efforts have been made on research regarding pharmacological interventions, none have proven effective. This is the protocol for a rapid living systematic review that aims to compare the effectiveness and safety of different pharmacological interventions for the treatment of COVID-19. METHODS: rapid living systematic review methodology with Network Meta-Analysis following the recommendations of Cochrane Handbook. We will include randomized controlled trials (RCT) and quasi-RCTs that evaluate single and/or combined pharmacological interventions at any dose for the treatment of COVID-19. We will search Medline via PubMed, Embase via Elsevier, Cochrane Library - Cochrane Central Register of Controlled Trials (CENTRAL), Portal Regional BVS - LILACS, Scopus and WebofScience to identify potentially eligible studies. No language restrictions will be used in the selection. We will perform the critical appraisal of included studies with the Risk of Bias tool and the certainty of evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).

https://doi.org/10.1590/SciELOPreprints.348

[SciELO Preprints] - PROGNOSTIC FACTORS FOR CLINICAL COURSE OF PATIENTS WITH COVID-19: PROTOCOL FOR A RAPID LIVING SYSTEMATIC REVIEW
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Puga, Maria Eduarda dos Santos Rocha-Filho, César Ramos Pinto, Ana Carolina Pereira Nunes Rocha, Aline Pereira da Milby, Keilla Martins Reis, Felipe Sebastião de Assis Civile, Vinicius Tassoni Carvas Junior, Nelson Santos, Rodolfo Rodrigo Pereira Ramalho, Gabriel Sodré Trevisani, Giulia Fernandes Moça Ferla, Laura Jantsch Puga, Maria Eduarda dos Santos Trevisani, Virgínia Fernandes Moça Atallah, Alvaro Nagib

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Publication date: 2020-05-06

Abstract: En

CONTEXT AND OBJECTIVE: Determining prognostic factors in a context of health crises such as the COVID-19 scenario may provide the best possible care for patients and optimize the management and the resource utilization of the health system. Thus, we aim to systematically review the prognostic factors for different outcomes of patients with COVID-19. DESIGN AND SETTING: Protocol for a rapid living systematic review methodology following the recommendations proposed by the Cochrane Handbook. METHODS: We will include cohorts and case‐control studies. We will search Medline via PubMed, Embase via Elsevier, Cochrane Library - Cochrane Central Register of Controlled Trials (CENTRAL), Portal Regional BVS- LILACS, Scopus and WebofScience to identify studies. No language restrictions will be applied. We will perform the critical appraisal of included studies with the Quality in Prognosis Studies (QUIPS) tool and the certainty of evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).

https://doi.org/10.1590/SciELOPreprints.351

[SciELO Preprints] - COVID-19 AND PATIENTS UNDERGOING PHARMACOLOGICAL TREATMENTS FOR IMMUNE-MEDIATED INFLAMMATORY DISEASES: PROTOCOL FOR A RAPID LIVING SYSTEMATIC REVIEW
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Puga, Maria Eduarda dos Santos Rocha, Aline Pereira da Atallah, Alvaro Nagib Pinto, Ana Carolina Pereira Nunes Rocha-Filho, César Ramos Reis, Felipe Sebastião de Assis Milby, Keilla Martins Civile, Vinicius Tassoni Carvas Junior, Nelson Santos, Rodolfo Rodrigo Pereira Ferla, Laura Jantsch Trevisani, Giulia Fernandes Moça Ramalho, Gabriel Sodré Puga, Maria Eduarda dos Santos Trevisani, Virgínia Fernandes Moça

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Publication date: 2020-05-06

Abstract: En

CONTEXT AND OBJECTIVE: We propose to systematically review the available evidence to evaluate if patients with immune mediated or inflammatory diseases under pharmacological treatment with immunosuppressants, immunobiologics, DMARDs or targeted synthetic DMARDs have better or worse outcomes when infected by SARS-CoV-2. This study is a protocol for our rapid living systematic review. METHODS: Protocol for a rapid living systematic review methodology following the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) guidance. To conduct the rapid systematic review, we will employ abbreviated systematic review methods, including: not performing independent screens of abstracts and not searching grey literature. As this will be a living review, it will be continuously updated.

https://doi.org/10.1590/SciELOPreprints.349

10.

What do Cochrane systematic reviews say about new practices on integrative medicine?
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Riera, Rachel

; Braga, Vinícius Lopes

; Rocha, Luana Pompeu dos Santos

; Bernardo, Daniel Damasceno

; Andrade, Luísa Avelar Fernandes de

; Hsu, Jessica Chiu

; Silva, Luciana Di Giovanni Marques da

; Suetsugu, Rodrigo Cesar de Sá

; Dittrich, Nicole Hosni

; Lima, Lucas Riguete Pereira de

; Silveira, Vicente Penido da

; Kruglensky, Barbara Caon

; Leonel, Letícia de Freitas

; Barros, Edivando de Moura

; Costa, Anderson Adriano Leal Freitas da

; Quintella, Miguel Lins

; Pacheco, Rafael Leite

; Cruz, Carolina de Oliveira

; Martimbianco, Ana Luiza Cabrera

; Pachito, Daniela Vianna

; Mozetic, Vania

; Teixeira, Tatiana de Bruyn Ferraz

; Torloni, Maria Regina

; Atallah, Alvaro Nagib

Sao Paulo Medical Journal

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may 2018, Volume 136 N. 3 Pages 251 - 261

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: This study identified and summarized all Cochrane systematic reviews (SRs) on the effects of ten integrative practices that were recently added to the Brazilian public healthcare system (SUS). DESIGN AND SETTING: Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp). METHODS: Review of Cochrane SRs on the following interventions were identified, summarized and critically assessed: apitherapy, aromatherapy, bioenergetics, family constellation, flower therapy, chromotherapy, geotherapy, hypnotherapy, hand imposition or ozone therapy. RESULTS: We included a total of 16 SRs: 4 on apitherapy, 4 on aromatherapy, 6 on hypnotherapy and 2 on ozone therapy. No Cochrane SR was found regarding bioenergetics, family constellation, chromotherapy, clay therapy, flower therapy or hand imposition. The only high-quality evidence was in relation to the potential benefit of apitherapy, specifically regarding some benefits from honey dressings for partial healing of burn wounds, for reduction of coughing among children with acute coughs and for preventing allergic reactions to insect stings. CONCLUSION: Except for some specific uses of apitherapy (honey for burn wounds and for acute coughs and bee venom for allergic reactions to insect stings), the use of ten integrative practices that have recently been incorporated into SUS does not seem to be supported by evidence from Cochrane SRs.

https://doi.org/10.1590/1516-3180.2018.0172170418 2326 downloads

11.

Risk of drug interaction: combination of antidepressants and other drugs
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Miyasaka, Lincoln Sakiara

; Atallah, Alvaro Nagib

Revista de Saúde Pública

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apr 2003, Volume 37 N. 2 Pages 212 - 215

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: Verificar a freqüência de combinações de antidepressivos com outros medicamentos e o risco de interações medicamentosas em um hospital público no Brasil. MÉTODOS: Prescrições de todos os pacientes internados em um hospital público, em São Paulo, SP, de novembro de 1996 a fevereiro de 1997 foram analisadas pelo centro de processamento de dados do hospital. Foi realizada busca manual de todos os prontuários de pacientes internados na enfermaria de psiquiatria do hospital de janeiro de 1993 a dezembro de 1995, assim como de todos os pacientes registrados no ambulatório de doenças afetivas em dezembro de 1996. Foram identificados os pacientes que usaram algum antidepressivo e as drogas utilizadas concomitantemente. Foram identificadas pelo programa Micromedex® as interações medicamentosas. RESULTADOS: Dentre os 6.844 pacientes internados nas enfermarias gerais (não psiquiátricas) do hospital, 63 usaram antidepressivos (0,9%) e 16 (25,3%) usavam medicações com risco de interação. Dentre os 311 pacientes da enfermaria de psiquiatria, 63 (20,2%) usavam antidepressivos e 13 (20,6%) apresentavam risco de interação. Dos 87 pacientes do ambulatório de doenças afetivas, 43 (49,4%) usavam antidepressivos e 7 (16,2%) apresentavam risco. Em geral, o uso de antidepressivos foi encontrado em 169 pacientes e 36 (21,3%) estavam em risco de interação medicamentosa. Vinte diferentes tipos de interações foram identificados, sendo 4 leves, 15 moderados e um grave. CONCLUSÕES: Nas enfermarias gerais o número de interações medicamentosas foi superior em relação à enfermaria de psiquiatria; e o número de prescrições de antidepressivos foi menor do que o esperado.

OBJECTIVE: To assess the frequency of combination of antidepressants with other drugs and risk of drug interactions in the setting public hospital units in Brazil. METHODS: Prescriptions of all patients admitted to a public hospital from November 1996 to February 1997 were surveyed from the hospital's data processing center in São Paulo, Brazil. A manual search of case notes of all patients admitted to the psychiatric unit from January 1993 to December 1995 and all patients registered in the affective disorders outpatient clinic in December 1996 was carried out. Patients taking any antidepressant were identified and concomitant use of drugs was checked. By means of a software program (Micromedex®) drug interactions were identified. RESULTS: Out of 6,844 patients admitted to the hospital, 63 (0.9%) used antidepressants and 16 (25.3%) were at risk of drug interaction. Out of 311 patients in the psychiatric unit, 63 (20.2%) used antidepressants and 13 of them (20.6%) were at risk. Out of 87 patients in the affective disorders outpatient clinic, 43 (49.4%) took antidepressants and 7 (16.2%) were at risk. In general, the use of antidepressants was recorded in 169 patients and 36 (21.3%) were at risk of drug interactions. Twenty different forms of combinations at risk of drug interactions were identified: four were classified as mild, 15 moderate and one severe interaction. CONCLUSION: In the hospital general units the number of drug interactions per patient was higher than in the psychiatric unit; and prescription for depression was lower than expected.

4628 downloads Cited 4 times in SciELO

12.

Risk of drug interaction: combination of antidepressants and other drugs
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Miyasaka, Lincoln Sakiara

; Atallah, Alvaro Nagib

Revista de Saúde Pública

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apr 2003, Volume 37 N. 2 Pages 212 - 215

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

1573 downloads Cited 4 times in SciELO

13.

Physical Diagnosis in the Contemporary Era
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Atallah, Alvaro Nagib

Sao Paulo Medical Journal

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sep 1998, Volume 116 N. 5 Pages 1789 - 1789

Abstract: En | Text: En | PDF: En

821 downloads

14.

Relapsing polychondritis
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Miyasaka, Lincoln Sakiara

; Andrade Junior, Ary de

; Bueno, Carlos Eduardo

; Atallah, Alvaro Nagib

Sao Paulo Medical Journal

Journal Metrics
- Sobre o periódico
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feb 1998, Volume 116 N. 1 Pages 1637 - 1642

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: O propósito deste artigo e a descrição de um caso com diagnostico clinico de Policondrite Recorrente atendido no Hospital São Paulo e realizar uma revisão da literatura sobre o tema. FONTE DE DADOS: A pesquisa foi feita através do Medline(1990-96) e Lilacs (1980-96) buscando os temas Policondrite Recorrente, e Policondrite Recidivante, alem de livros textos de reumatologia e artigos mais antigos sobre a historia da moléstia. SELEÇÃO DOS ESTUDOS: No Medline foram encontra-dos 113 artigos publicados em inglês, espanhol, e português entre 1990 e 1996. No Lilacs foram encontrados 23 artigos entre 1980 e 1996. COLETA DOS DADOS: Foram analisados os artigos disponíveis na BIREME cujo enfoque primário era a moléstia em questão. SÍNTESE DOS DADOS: Policondrite recorrente é uma doença rara de etiologia desconhecida descrita inicialmente por Jacksch-Wartenhorst em 1923 e caracterizada por um processo inflamatório agudo e recorrente de cartilagens que provoca o desabamento das estruturas cartilaginosas e sua substituição por tecido conjuntivo fibroso. As cartilagens mais comumente acometidas são do pavilhão auricular e septo nasal, embora as cartilagens da traquéia, laringe, epiglote, arcos costais e articulações também possam estar envolvidas. lnflamações oculares e reações sistêmicas como febre também são descritas. Em 1976, Mc Adam apresentou um estudo prospectivo completo de 23 pacientes e revisou os 136 casos descritos até aquela época, propondo critérios diagnósticos que foram logo ampliados por Damani e Levine. Atualmente já foram descritos mais de 500 casos. CONCLUSÃO: Mesmo sendo uma doença rara, há necessidade de maior divulgação na classe médica desta afecção, pois a policondrite recorrente pode se tornar letal por colapso traqueal e obstrução das vias respiratórias, sendo que um diagnóstico preciso e uma intervenção terapêutica adequada se fazem necessários.

PURPOSE: This article describes a clinically-diagnosed case of relapsing polychondritis (RP), attended at the Hospital São Paulo, and presents a literature review of the subject. SOURCE OF RESEARCH: The literature review was made via Medline (1990-96), Lilacs (1980-96), textbooks of rheumatology, and some articles about the history of the disease. In Medline, 113 articles from 1990 to 1996 were found, and there were 23 articles from 1980 to 1996 in Lilacs. RESEARCH PROCEDURE: We reviewed the articles available at BIREME (Biblioteca Regional de Medicina) with the primary focus being on the disease in question. SUMMARY: RP is a rare disease of unknown etiology described initially by Jackson-Wartenhorst in 1923 and characterized by a recurrent and acute inflammatory process that causes the collapse of the cartilaginous structures and their subsequent replacement by fibrous connective tissue. The cartilage most commonly attacked is that of the auricle of the ear and nasal septum, while the cartilage of the trachea, larynx, epiglottis, ribs, and articulations may also be involved. Ocular inflammations and systemic reactions with fever are also described. In 1976, McAdam presented a complete prospective study of 23 patients, reviewed the 136 cases described up until that time, and then proposed diagnostic criteria which were later expanded by Damiani and Levine. Currently, more than 500 cases have been described. CONCLUSION: Although a rare disease, better knowledge of it is needed, as RP may be lethal with tracheal collapse and obstruction of respiratory pathways, making precise diagnosis and adequate therapeutic intervention necessary.

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15.

Medical controversies and systematic reviews: the heat and the light
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Atallah, Alvaro Nagib

Sao Paulo Medical Journal

Journal Metrics
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- SciELO Analytics

dec 1997, Volume 115 N. 6 Pages 1599 - 1599

Abstract: En | Text: En | PDF: En

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