308 results on '"Antonio Carlos Pires"'
Search Results
2. Brazilian guidelines on prevention of cardiovascular disease in patients with diabetes: a position statement from the Brazilian Diabetes Society (SBD), the Brazilian Cardiology Society (SBC) and the Brazilian Endocrinology and Metabolism Society (SBEM)
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Marcello Casaccia Bertoluci, Rodrigo Oliveira Moreira, André Faludi, Maria Cristina Izar, Beatriz D. Schaan, Cynthia Melissa Valerio, Marcelo Chiara Bertolami, Ana Paula Chacra, Marcus Vinicius Bolivar Malachias, Sérgio Vencio, José Francisco Kerr Saraiva, Roberto Betti, Luiz Turatti, Francisco Antonio Helfenstein Fonseca, Henrique Tria Bianco, Marta Sulzbach, Adriana Bertolami, João Eduardo Nunes Salles, Alexandre Hohl, Fábio Trujilho, Eduardo Gomes Lima, Marcio Hiroshi Miname, Maria Teresa Zanella, Rodrigo Lamounier, João Roberto Sá, Celso Amodeo, Antonio Carlos Pires, and Raul D. Santos
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Diabetes mellitus ,Cardiovascular prevention ,Cardiovascular screening ,Blood glucose ,Risk factors ,Coronary artery disease ,Nutritional diseases. Deficiency diseases ,RC620-627 - Abstract
Abstract Background Since the first position statement on diabetes and cardiovascular prevention published in 2014 by the Brazilian Diabetes Society, the current view on primary and secondary prevention in diabetes has evolved as a result of new approaches on cardiovascular risk stratification, new cholesterol lowering drugs, and new anti-hyperglycemic drugs. Importantly, a pattern of risk heterogeneity has emerged, showing that not all diabetic patients are at high or very high risk. In fact, most younger patients who have no overt cardiovascular risk factors may be more adequately classified as being at intermediate or even low cardiovascular risk. Thus, there is a need for cardiovascular risk stratification in patients with diabetes. The present panel reviews the best current evidence and proposes a practical risk-based approach on treatment for patients with diabetes. Main body The Brazilian Diabetes Society, the Brazilian Society of Cardiology, and the Brazilian Endocrinology and Metabolism Society gathered to form an expert panel including 28 cardiologists and endocrinologists to review the best available evidence and to draft up-to-date an evidence-based guideline with practical recommendations for risk stratification and prevention of cardiovascular disease in diabetes. The guideline includes 59 recommendations covering: (1) the impact of new anti-hyperglycemic drugs and new lipid lowering drugs on cardiovascular risk; (2) a guide to statin use, including new definitions of LDL-cholesterol and in non-HDL-cholesterol targets; (3) evaluation of silent myocardial ischemia and subclinical atherosclerosis in patients with diabetes; (4) hypertension treatment; and (5) the use of antiplatelet therapy. Conclusions Diabetes is a heterogeneous disease. Although cardiovascular risk is increased in most patients, those without risk factors or evidence of sub-clinical atherosclerosis are at a lower risk. Optimal management must rely on an approach that will cover both cardiovascular disease prevention in individuals in the highest risk as well as protection from overtreatment in those at lower risk. Thus, cardiovascular prevention strategies should be individualized according to cardiovascular risk while intensification of treatment should focus on those at higher risk.
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- 2017
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3. Impaired flow-mediated dilation response and carotid intima-media thickness in patients with type 1 diabetes mellitus with a mean disease duration of 4.1 years
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Lúcia Helena Bonalume Tacito, Antonio Carlos Pires, and Juan Carlos Yugar-Toledo
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Nitric oxide ,carotid intima-media thickness ,diabetes mellitus, type 1 ,cardiovascular diseases ,diabetes complications ,Medicine ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
ABSTRACT Objective This study aimed at assessing the endothelial function in patients with Type 1 diabetes (T1DM) using flow-mediated dilation (FMD) response and carotid artery intima-media thickness (CIMT). Materials and methods This study enrolled 32 T1DM patients (mean disease duration 4.1 years) and 28 age-matched controls (CTL Group). Endothelial function and CIMT were assessed with high-resolution ultrasound using standardized offline measurements. Results FMD was significantly lower in patients in the T1DM Group (8.9 ± 3.2%) compared with those in the CTL Group (13.3 ± 4.3%; P-value < 0.0001). Similarly, CIMT differed significantly between T1DM patients (0.525 ± 0.03 mm) and controls (0.508 ± 0.03 mm; P-value = 0.041). Even though, the values are within the normal range for age. Conclusions Patients with T1DM have impaired endothelial function characterized by reduced FMD when compared to controls. However, vascular remodeling as seen by increases in CIMT was not found in this study.
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- 2017
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4. High frequency ultrasound with color Doppler in dermatology
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Elisa de Oliveira Barcaui, Antonio Carlos Pires Carvalho, Flavia Paiva Proença Lobo Lopes, Juan Piñeiro-Maceira, and Carlos Baptista Barcaui
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Dermatology ,Skin ,Skin Neoplasms ,Ultrasonography ,RL1-803 - Abstract
Abstract: Ultrasonography is a method of imaging that classically is used in dermatology to study changes in the hypoderma, as nodules and infectious and inflammatory processes. The introduction of high frequency and resolution equipments enabled the observation of superficial structures, allowing differentiation between skin layers and providing details for the analysis of the skin and its appendages. This paper aims to review the basic principles of high frequency ultrasound and its applications in different areas of dermatology.
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- 2016
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5. Ultrassonografia de alta frequência (22MHz) na identificação e remoção de ferrão de arraia
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Elisa de Oliveira Barcaui, Antonio Carlos Pires Carvalho, and Carlos Baptista Barcaui
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ultrassom ,ultrassonografia ,corpo estranho ,cirurgia ,Dermatology ,RL1-803 - Abstract
A presença de corpos estranhos localizados na pele, sua dimensão, constituição e exata localização muitas vezes não são perceptíveis ao exame clínico dermatológico. Apesar de seu caráter benigno, a existência de corpos estranhos à pele provocam alta morbidade. A ultrassonografia de alta frequência tem sido amplamente utilizada nas diferentes áreas da Dermatologia. O avanço tecnológico com a introdução de aparelhos de alta frequência e resolução torna esse método útil na identificação e orientação da remoção de corpos estranhos localizados na pele. Apresentamos caso em que a ultrassonografia de alta frequência foi utilizada na identificação e retirada de um ferrão de arraia.
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- 2017
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6. Effectiveness of Sequential Viscosupplementation in Temporomandibular Joint Internal Derangements and Symptomatology: A Case Series
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Roberta Maria Drumond Furtado Bossi Fonseca, Eduardo Januzzi, Luciano Ambrosio Ferreira, Eduardo Grossmann, Antonio Carlos Pires Carvalho, Pedro Gonçalves de Oliveira, Érica Leandro Marciano Vieira, Antônio Lúcio Teixeira, and Camila Megale Almeida-Leite
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Medicine (General) ,R5-920 - Abstract
Viscosupplementation is a minimally invasive technique that replaces synovial fluid by intra-articular injection of hyaluronic acid (HA). Although effective in some joints, there is not conclusive evidence regarding temporomandibular disorders. This case series described the efficacy of a viscosupplementation protocol in intra-articular temporomandibular disorders. Ten patients with a diagnosis of disc displacement and/or osteoarthritis by Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were submitted to four monthly injections of low or medium molecular weight HA. Pain, mandibular function, image analysis by tomography and magnetic resonance, and quality of life were assessed at baseline and follow-ups (1 and 6 months). Pain, jaw range-of-motion, mandibular function, and quality of life improved at follow-up evaluations. Osteoarthritis changes decreased, and 20% of patients improved mandibular head excursion after treatment. Resolution of effusion and improvement in disc morphology were observed for most patients. This viscosupplementation protocol reduced pain and symptoms associated with internal derangement of temporomandibular joint, improved quality of life, and showed benefits from both low and medium molecular weight HA in alternate cycles.
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- 2018
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7. High-frequency ultrasound associated with dermoscopy in pre-operative evaluation of basal cell carcinoma
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Elisa de Oliveira Barcaui, Antonio Carlos Pires Carvalho, Paulo Marcos N. Valiante, and Carlos Baptista Barcaui
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Carcinoma, basal cell ,Dermoscopy ,Ultrasound ,Dermatology ,RL1-803 - Abstract
The recent development of high-frequency ultrasound, associated with the improved sensitivity in color Doppler, enabled the identification of various skin structures and layers. In basal cell carcinoma, the 22 MHz frequency ultrasound permits the delimitation of tumor margins, while color Doppler, determines its vascularization. We present two cases in which the association of both exams allowed an in vivo analysis of the tumor's morphology, size, thickness and vascularization, thus contributing to a better pre-operative evaluation.
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- 2014
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8. Physical properties of soil cultivated with Jatropha curcas and associated green vegetation covers
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Willian José Ferreira, Getulio Teixeira Batista, Marcelo dos Santos Targa, Cristina Maria de Castro, and Antonio Carlos Pires Devide
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Physic nut ,biodiesel ,green manure ,soil conservation ,sustainability ,Environmental sciences ,GE1-350 - Abstract
The cultivation of physic nut (Jatropha curcas L.) is a sustainable option for biodiesel production due to its adaptation to different agro-ecological conditions and its high content of non-edible oil grains. The possibility of its cultivation in degraded low fertility soils makes the physic nut attractive to the Paraíba do Sul Valley region. This study evaluated physical attributes and water processes of an Oxisol which had been previously used for livestock and later converted to experimental farming. The soil was intercropped with perennial herbaceous legumes (Arachis pintoi and Calopogonio muconoides) in place of the original cover of Brachiaria brizantha, largely cultivated in the region. We determined the soil texture, the levels of saturation and water retention, soil resistance to root penetration and the basic infiltration rate of water into the soil (VIB). The soil resistance to root penetration in B. brizantha ranged from high to moderate at 30 cm depth, while the addition of perennial herbaceous legumes as cover crops intercropped with Jatropha reduced this resistance and increased the average soil VIB from 4 mm h-1 (B. brizantha) to 33 mm h-1. We conclude that the association of herbaceous legumes with Jatropha contributed to the improvement of the soil’s physical properties.
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- 2013
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9. Ressonância magnética cardíaca e seus planos anatômicos: como eu faço?
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Marcelo Souto Nacif, Amarino Carvalho de Oliveira Junior, Antonio Carlos Pires Carvalho, and Carlos Eduardo Rochitte
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Imagen por resonancia magnética ,corazón ,educación médica ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Devido à crescente utilização do método de ressonância magnética cardíaca (RMC) e sua frequente implantação em novos serviços, apresentaremos neste trabalho, em um formato passo a passo, as técnicas de aquisição, necessárias para uma completa abordagem cardíaca, dos principais planos anatômicos do coração utilizados pela RMC.
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- 2010
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10. Hemorragia intraparenquimatosa encefálica espontânea: achados à tomografia computadorizada
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Celso Monteiro Soares, Antonio Carlos Pires Carvalho, and Andréa de Jesus Rodrigues
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hematoma intraparenquimatoso ,tomografia computadorizada ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Foram analisados os exames de tomografia computadorizada de crânio de 250 pacientes com hematoma intraparenquimatoso encefálico espontâneo em três diferentes hospitais na cidade do Rio de Janeiro, com o objetivo de se levantar os aspectos mais freqüentes desta doença. O hematoma intraparenquimatoso cerebral profundo foi o de maior incidência, seguido do lobar. Mais raramente foi observado sangramento cerebelar e do tronco cerebral. A faixa etária de acometimento mais freqüente foi entre 61 e 70 anos de idade. Não houve diferença expressiva quanto ao sexo predominante ou ao lado mais acometido, porém verificou-se que os homens são mais acometidos em uma faixa etária mais precoce do que as mulheres. A cefaléia foi o sintoma de maior freqüência e a hipertensão arterial esteve presente na maioria dos casos. A drenagem da hemorragia para o sistema ventricular ocorreu mais comumente nos hematomas profundos.
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- 2004
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11. Ruptura bilateral e simultânea do mecanismo extensor do joelho em um pré-adolescente: relato de caso Simultaneous bilateral tear of the knee extensor mechanism in a pre-adolescent: case report
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Rodrigo Pires e Albuquerque, Vincenzo Giordano, Maria Isabel Pires e Albuquerque, Antonio Carlos Pires Carvalho, Ney Pecegueiro do Amaral, and João Maurício Barretto
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Ligamento Patelar ,Joelho ,Ruptura Espontânea ,Adolescente ,Patellar Ligament ,Knee ,Rupture, Spontaneous ,Adolescence ,Medicine ,Orthopedic surgery ,RD701-811 - Abstract
A ruptura do tendão patelar de um lado e um sleeve fracture contralateral em um pré-adolescente são uma lesão rara. Nós relatamos um caso em um pré-adolescente que caiu enquanto saltava durante uma partida de futebol. Não foram diagnosticados fatores predisponentes. As lesões foram tratadas com os reparos cirúrgicos e suturas transósseas. O objetivo desta pesquisa foi apresentar um caso de ruptura concorrente e espontânea do mecanismo extensor do joelho em um pré-adolescente.Unilateral tearing of a patellar tendon and a contralateral sleeve fracture in a pre-adolescent are rare lesions. We report a case in which a pre-adolescent sustained a fall while jumping during a soccer match. No predisposing risk factors were identified. The injuries were treated with surgical repairs and transosseous suturing. The aim of this study was to present a case of spontaneous concurrent tearing of the extensor mechanism of the knee in a pre-adolescent.
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- 2012
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12. Diagnosis of temporomandibular joint disorders: indication of imaging exams
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Luciano Ambrosio Ferreira, Eduardo Grossmann, Eduardo Januzzi, Marcos Vinicius Queiroz de Paula, and Antonio Carlos Pires Carvalho
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Temporomandibular joint disorders ,Diagnostic imaging ,Temporomandibular joint ,Magnetic resonance imaging ,X-ray computed tomography ,Radiography ,Otorhinolaryngology ,RF1-547 - Abstract
ABSTRACT INTRODUCTION: Knowledge of the different imaging tests and their appropriate indications is crucial to establish the diagnosis of temporomandibular disorders, especially in patients with overlapping signs and symptoms. OBJECTIVE: To present and assess the main diagnostic imaging tests for temporomandibular disorders and rationally discuss their indication criteria, advantages, and disadvantages. METHODS: Literature review in the Web of Knowledge, PubMed and SciELO databases, as well as manual search for relevant publications in reference lists of the selected articles. RESULTS: Computed tomography and magnetic resonance imaging were considered the gold standard assessments for the temporomandibular joint to evaluate hard and soft tissues, respectively. Each diagnostic method exhibited distinct sensitivity and specificity for the different subtypes of joint dysfunction. CONCLUSION: Selecting an evaluation examination based on its accuracy, safety, and clinical relevance is a rational decision that can help lead to an accurate diagnosis and an optimum treatment plan.
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13. Diretriz brasileira baseada em evidências sobre prevenção de doenças cardiovasculares em pacientes com diabetes: posicionamento da Sociedade Brasileira de Diabetes (SBD), da Sociedade Brasileira de Cardiologia (SBC) e da Sociedade Brasileira de Endocrinologia e Metabologia (SBEM)
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André Arpad Faludi, Maria Cristina de Oliveira Izar, José Francisco Kerr Saraiva, Henrique Tria Bianco, Ana Paula Marte Chacra, Marcello Casaccia Bertoluci, Rodrigo Oliveira Moreira, Luiz Alberto Andreotti Turatti, Adriana Bertolami, Martha L. Sulzbach, Beatriz D. Schaan, Cynthia Melissa Valerio, Marcelo Chiara Bertolami, Marcus Vinícius Bolívar Malachias, Sérgio Vencio, Roberto Tadeu Barcellos Betti, Francisco Antonio Helfenstein Fonseca, João Eduardo Nunes Salles, Alexandre Hohl, Fábio Rogério Trujilho, Eduardo Gomes Lima, Marcio Hiroshi Miname, Maria Teresa Zanella, Rodrigo Lamounier, João Roberto Sá, Celso Amodeo, Antonio Carlos Pires, Raul Dias dos Santos Filho, Rui Manuel dos Santos Póvoa, Otávio Berwanger da Silva, and Aloisio Marchi da Rocha
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Diabetes mellitus ,Prevenção cardiovascular ,Triagem cardiovascular ,Glicemia ,Fatores de risco ,Doença arterial coronária ,Dislipidemias ,Hipertensão ,Agentes Antiplaquetários ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Resumo Fundamentação: desde o primeiro posicionamento da Sociedade Brasileira de Diabetes (SBD) sobre diabetes e prevenção cardiovascular, em 2014,1 importantes estudos têm sido publicados na área de prevenção cardiovascular e tratamento do diabetes,2 os quais contribuíram para a evolução na prevenção primária e secundária nos pacientes com diabetes. Ferramentas de estratificação de risco mais precisas, novos fármacos hipolipemiantes e novos antidiabéticos com efeitos cardiovasculares e redução da mortalidade, são parte desta nova abordagem para os pacientes com diabetes. O reconhecimento de que o diabetes é uma doença heterogênea foi fundamental, sendo claramente demonstrado que nem todos os pacientes diabéticos pertencem a categorias de risco alto ou muito alto. Um porcentual elevado é composto por pacientes jovens, sem os fatores de risco clássicos, os quais podem ser classificados adequadamente em categorias de risco intermediário ou mesmo em baixo risco cardiovascular. O presente posicionamento revisa as melhores evidências atualmente disponíveis e propõe uma abordagem prática, baseada em risco, para o tratamento de pacientes com diabetes. Estruturação: perante este desafio e reconhecendo a natureza multifacetada da doença, a SBD uniu-se à Sociedade Brasileira de Cardiologia (SBC) e à Sociedade Brasileira de Endocrinologia e Metabolismo (SBEM), e formou um painel de especialistas, constituído por 28 cardiologistas e endocrinologistas, para revisar as melhores evidências disponíveis e elaborar uma diretriz contendo recomendações práticas para a estratificação de risco e prevenção da Doença Cardiovascular (DVC) no Diabetes Melito (DM). As principais inovações incluem: (1) considerações do impacto de novos hipolipemiantes e das novas medicações antidiabéticas no risco cardiovascular; (2) uma abordagem prática, baseada em fator de risco, para orientar o uso das estatinas, incluindo novas definições das metas da Lipoproteína de Baixa Densidade-colesterol (LDL-colesterol) e colesterol não Lipoproteína de Alta Densidade HDL; (3) uma abordagem baseada em evidências, para avaliar a isquemia miocárdica silenciosa (IMS) e a aterosclerose subclínica em pacientes com diabetes; (4) as abordagens mais atuais para o tratamento da hipertensão; e (5) recomendação de atualizações para o uso de terapia antiplaquetária. Esperamos que esta diretriz auxilie os médicos no cuidado dedicado aos pacientes com diabetes. Métodos: inicialmente, os membros do painel foram divididos em sete subcomitês para definirem os tópicos principais que necessitavam de uma posição atualizada das sociedades. Os membros do painel pesquisaram e buscaram no PubMed estudos clínicos randomizados e metanálises de estudos clínicos e estudos observacionais de boa qualidade, publicados entre 1997 e 2017, usando termos MeSH: [diabetes], [diabetes tipo 2], [doença cardiovascular], [estratificação de risco cardiovascular] [doença arterial coronária], [rastreamento], [isquemia silenciosa], [estatinas], [hipertensão], [ácido acetilsalicílico]. Estudos observacionais de baixa qualidade, metanálises com alta heterogeneidade e estudos transversais não foram incluídos, embora talvez tenham impactado no Nível de Evidência indicado. A opinião de especialistas foi usada quando os resultados das buscas não eram satisfatórios para um item específico. É importante salientar que este posicionamento não teve a intenção de incluir uma revisão sistemática rigorosa. Um manuscrito preliminar, destacando recomendações de graus e níveis de evidência (Quadro 1), foi esboçado. Este passo levou a várias discussões entre os membros dos subcomitês, que revisaram os achados e fizeram novas sugestões. O manuscrito foi, então, revisto pelo autor líder, encarregado da padronização do texto e da inclusão de pequenas alterações, sendo submetido à apreciação mais detalhada pelos membros dos comitês, buscando uma posição de consenso. Depois desta fase, o manuscrito foi enviado para a banca editorial e edição final, sendo encaminhado para publicação. Quadro 1 Graus de recomendações e níveis de evidências adotados nesta revisão Grau de recomendação Classe I A evidência é conclusiva ou, se não, existe consenso de que o procedimento ou tratamento é seguro e eficaz Classe II Há evidências contraditórias ou opiniões divergentes sobre segurança, eficácia, ou utilidade do tratamento ou procedimento Classe IIa As opiniões são favoráveis ao tratamento ou procedimento. A maioria dos especialistas aprova Classe IIb A eficácia é bem menos estabelecida, e as opiniões são divergentes Classe III Há evidências ou consenso de que o tratamento ou procedimento não é útil, eficaz, ou pode ser prejudicial Níveis de Evidência A Múltiplos estudos clínicos randomizados concordantes e bem elaborados ou metanálises robustas de estudos clínicos randomizados B Dados de metanálises menos robustas, um único estudo clínico randomizado ou estudos observacionais C Opinião dos especialistas
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14. Periapical and Endodontic Status Scale for Endodontically Treated Teeth and Their Association with Maxillary Sinus Abnormalities: A Cone-beam Computed Tomographic Study
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Souza-Nunes, Lílian Azevedo de, Verner, Francielle Silvestre, Rosado, Lucas de Paula Lopes, Aquino, Sibele Nascimento de, Carvalho, Antônio Carlos Pires, and Junqueira, Rafael Binato
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- 2019
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15. MRI changes and clinical characteristics in temporomandibular joints with displacement of the articular disk without reduction – a cross-sectional observational study
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Glaucia Marques Dias, Eduardo Grossmann, Antonio Carlos Pires Carvalho, Karina Lopes Devito, Marcos Fabio dos Santos, and Luciano Ambrosio Ferreira
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Otorhinolaryngology ,General Dentistry - Published
- 2023
16. Back pain and sagittal spine alignment in obese patients eligible for bariatric surgery
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de Mello, Alexandre Peixoto, Martins, Glaucus Cajaty dos Santos, Heringer, André Raposo, Gamallo, Raphael Barbosa, Martins Filho, Luiz Felippe dos Santos, de Abreu, Antônio Vítor, Carvalho, Antonio Carlos Pires, and Gama, Maurício de Pinho
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- 2019
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17. MRI changes and clinical characteristics in temporomandibular joints with displacement of the articular disk without reduction – a cross-sectional observational study
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Dias, Glaucia Marques, primary, Grossmann, Eduardo, additional, Carvalho, Antonio Carlos Pires, additional, Devito, Karina Lopes, additional, dos Santos, Marcos Fabio, additional, and Ferreira, Luciano Ambrosio, additional
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- 2023
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18. Diagnosis of temporomandibular joint disorders: indication of imaging exams
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Ferreira, Luciano Ambrosio, Grossmann, Eduardo, Januzzi, Eduardo, de Paula, Marcos Vinicius Queiroz, and Carvalho, Antonio Carlos Pires
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- 2016
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19. Ultrasonography of Hands and Wrists in the Diagnosis of Complications of Chikungunya Fever
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Mogami, Roberto, Pereira Vaz, João Luiz, de Fátima Barcelos Chagas, Yêdda, de Abreu, Mirhelen Mendes, Torezani, Rodrigo Sperling, de Almeida Vieira, André, Junqueira Filho, Eduardo Alvarenga, Barbosa, Yasmin Baptista, Carvalho, Antonio Carlos Pires, and Lopes, Agnaldo José
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- 2018
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20. Periapical and Endodontic Status Scale for Endodontically Treated Teeth and Their Association with Maxillary Sinus Abnormalities: A Cone-beam Computed Tomographic Study
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Sibele Nascimento de Aquino, Lílian Azevedo de Souza-Nunes, Rafael Binato Junqueira, Francielle Silvestre Verner, Antonio Carlos Pires Carvalho, and Lucas de Paula Lopes Rosado
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0301 basic medicine ,Cone beam computed tomography ,Maxillary sinus ,Dentistry ,Computed tomographic ,Mucosal thickening ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,General Dentistry ,Retrospective Studies ,Dental Implants ,Tooth, Nonvital ,business.industry ,030206 dentistry ,Cone-Beam Computed Tomography ,Maxillary Sinus ,Periostitis ,medicine.disease ,Cross-Sectional Studies ,030104 developmental biology ,medicine.anatomical_structure ,Coronal plane ,business ,Sinus polyp ,Periapical Periodontitis ,Calcification - Abstract
This retrospective cross-sectional study investigated the applicability of the periapical and endodontic status scale (PESS) to determine the association of endodontically treated teeth with maxillary sinus (MS) abnormalities through cone-beam computed tomographic imaging.A total of 631 endodontically treated teeth were analyzed. MS abnormalities were classified as mucosal thickening, sinus polyp, antral pseudocyst, nonspecific opacification, periostitis, and antral calcification. The PESS was used to evaluate the quality of endodontic treatment as well as periapical tissue conditions. The data were analyzed by chi-square tests (P.05).MS abnormalities were detected in 70.52% of the sample, with a greater prevalence of mucosal thickening (38.19%), whereas periapical lesions were observed in 55.94% of the cases. Treated root canals with unsatisfactory filling, homogeneity, and coronal sealing had an odds Ratio (OR) of 2.21, 2.88, and 2.99, respectively (P.001). Periapical lesions larger than 5 mm (OR = 314.95), in more than 1 root (OR = 3.72), involving the furcation region (OR = 5.21), in contact with important structures (OR = 7.37), and with cortical bone destruction (OR = 4.09) were significantly related to the presence of MS abnormalities (P.001). An OR of 99,668 was observed in periostitis lesions greater than 5 mm (P.001).The PESS proved to be an important tool for the analysis of endodontic and periapical conditions and was applicable to determine potential associations with MS abnormalities.
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- 2019
21. ANALYSIS ON THE MODIFIED LYSHOLM FUNCTIONAL PROTOCOL AMONG PATIENTS WITH NORMAL KNEES
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e Albuquerque, Rodrigo Pires, Giordano, Vincenzo, Calixto, Alexandre, Malzac, Felipe, Aguiar, Carlomã, do Amaral, Ney Pecegueiro, and Carvalho, Antônio Carlos Pires
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- 2011
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22. TOTAL KNEE ARTHROPLASTY IN A PATIENT WITH HOFFA FRACTURE PSEUDARTHROSIS: CASE REPORT
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Albuquerque, Rodrigo Pires e, Giordano, Vincenzo, Amaral, Ney Pecegueiro do, Carvalho, Antônio Carlos Pires, and Barretto, João Maurício
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- 2011
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23. Laser acupuncture in patients with temporomandibular dysfunction: a randomized controlled trial
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Ferreira, Luciano Ambrosio, de Oliveira, Rodrigo Guerra, Guimarães, Josemar Parreira, Carvalho, Antonio Carlos Pires, and De Paula, Marcos Vinicius Queiroz
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- 2013
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24. Back pain and sagittal spine alignment in obese patients eligible for bariatric surgery
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Glaucus Cajaty Martins, Raphael Barbosa Gamallo, Luiz Felippe Martins Filho, Antonio Carlos Pires Carvalho, Alexandre Peixoto de Mello, Maurício de Pinho Gama, André Raposo Heringer, and Antonio Vitor de Abreu
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Male ,medicine.medical_specialty ,Visual Analog Scale ,Visual analogue scale ,Bariatric Surgery ,Body Mass Index ,Disability Evaluation ,03 medical and health sciences ,0302 clinical medicine ,Lumbar ,Back pain ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Kyphosis ,Obesity ,030222 orthopedics ,Neck pain ,business.industry ,Middle Aged ,Low back pain ,Spine ,Sagittal plane ,Surgery ,Oswestry Disability Index ,Radiography ,Cross-Sectional Studies ,medicine.anatomical_structure ,Back Pain ,Case-Control Studies ,Lordosis ,Female ,medicine.symptom ,business ,Body mass index ,030217 neurology & neurosurgery - Abstract
The objective of this research was to evaluate the prevalence of cervical and lumbar pain in obese patients eligible for bariatric surgery and to investigate possible changes in sagittal spine alignment in these patients. The following parameters were compared in 30 obese patients and a control group of 25 non-obese volunteers: body mass index, prevalence of cervical and lumbar pain assessed by visual analog scale (VAS), Neck Disability Index [NDI] and Oswestry Disability Index [ODI], as well as radiographic parameters of the spine and pelvis measured with Surgimap software. The cervical and lumbar VAS and the NDI and ODI were significantly worse in obese patients. Compared with the control group, the cervical sagittal vertical axis (cSVA) of the obese group had higher variance (p value = 0.0025) and the cervical lordosis was diminished (p value = 0.0023). Thoracic kyphosis, lumbar lordosis, and the pelvic parameters were not significantly different between the groups. Obese patients demonstrated lower functional performance compared with their non-obese counterparts, while cervical lordosis was diminished and the cSVA was increased in obese patients. These slides can be retrieved under Electronic Supplementary Material.
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- 2019
25. A rare case of facial nerve schwannoma masked by a concomitant temporomandibular disorder pain
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Natália R. Ferreira, Marcos F. DosSantos, Aleli T. Oliveira, Valéria Battistella, Paulo Roberto Valle Bahia, Antonio Carlos Pires Carvalho, and André Antonio Monteiro
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Orofacial pain ,medicine.medical_specialty ,lcsh:Surgery ,Schwannoma ,lcsh:RC346-429 ,Benign tumor ,03 medical and health sciences ,0302 clinical medicine ,medicine ,lcsh:Neurology. Diseases of the nervous system ,Paresis ,business.industry ,030206 dentistry ,lcsh:RD1-811 ,medicine.disease ,Dermatology ,Facial nerve ,stomatognathic diseases ,030211 gastroenterology & hepatology ,Surgery ,Neurology (clinical) ,Geniculate ganglion ,Differential diagnosis ,medicine.symptom ,business ,Tinnitus - Abstract
Facial nerve schwannoma (FNS) is an uncommon benign tumor that arises from the Schwann cells of the facial nerve (FN). Although rare, this is the most frequent type of FN tumor, potentially affecting any segment of the nerve. Nevertheless, a higher incidence of intracranial lesions and a predilection for the geniculate ganglion has been reported. Hearing loss, facial paresis and tinnitus are the most frequent symptoms. Conversely, pain, is not among the most prominent complaints and when present, it can be misdiagnosed as an orofacial pain of other source, including pain due to a temporomandibular disorder (TMD). In this paper, we describe a rare case of a patient presenting a FNS located in the intratemporal part and geniculate ganglion of the FN, which was initially masked by the symptoms of a coexistent TMD. It highlights the importance of considering intracranial tumors in the differential diagnosis of orofacial pains. Keywords: Facial nerve schwannoma, Intracranial tumors, Facial paralysis, Orofacial pain, Temporomandibular disorder
- Published
- 2018
26. Efficacy of viscosupplementation with hyaluronic acid in temporomandibular disorders: A systematic review
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Eduardo Grossmann, Tatiana Kelly da Silva Fidalgo, Brenda De Souza Moura, Marcos F. DosSantos, Danielle Masterson, Antonio Carlos Pires Carvalho, Natália Ferreira, Aleli T. Oliveira, and Rodrigo Lopes de Lima
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,MEDLINE ,Osteoarthritis ,Cochrane Library ,Injections, Intra-Articular ,law.invention ,Viscosupplementation ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Humans ,Medicine ,Hyaluronic Acid ,030222 orthopedics ,Viscosupplements ,business.industry ,Arthrocentesis ,030206 dentistry ,Temporomandibular Joint Disorders ,medicine.disease ,Temporomandibular joint ,Clinical trial ,Treatment Outcome ,medicine.anatomical_structure ,Otorhinolaryngology ,Physical therapy ,Surgery ,Oral Surgery ,business - Abstract
Objective To perform a systematic review of the viscosupplementation effectiveness with hyaluronic acid (HA) in the articular Temporomandibular Dysfunctions (TMDs) clinical management. Method Electronic searches were performed in the following databases: MEDLINE (via PubMed), Scopus, Web of Science, Cochrane Library, EMBASE, LILACS, BBO, SIGLE (System for Information on Grey Literature in Europe), ClinicalTrials.gov, and the Brazilian Clinical Trials Registry (ReBec). Only randomized clinical trials that evaluated the intra-articular administration of HA or its derivatives in osteoarthritis and/or anterior displacement of the temporomandibular joint (TMJ) disc were included. The primary outcomes evaluated were patients' self-report of pain and/or discomfort in the TMJ. Each study was assessed for the risk of bias, using the Cochrane collaboration's risk of bias tool. Results A total of 640 studies were obtained in the electronic search. After the application of the eligibility criteria, manual search, and duplicate removal, 21 articles were included. Five articles classified their volunteers with internal derangements of the TMJ, in 4 articles the treatment was directed to participants with disc displacement with reduction and the other articles evaluated HA therapy in osteoarthritis. The protocols presented heterogeneity, varying in the form of application, associated or not with arthrocentesis, number of applications, molecular weight, dose and concentration. Nine studies presented high risk of bias. Conclusion Due to the heterogeneity and methodological inconsistencies of the studies evaluated, it was not possible to establish the efficacy of HA in articular TMDs.
- Published
- 2018
27. Reversed Halo Sign on Computed Tomography: State-of-the-Art Review
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Marchiori, Edson, Zanetti, Gláucia, Hochhegger, Bruno, Irion, Klaus L, Carvalho, Antonio Carlos Pires, and Godoy, Myrna C. B.
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- 2012
- Full Text
- View/download PDF
28. High-frequency (22-MHz) ultrasound for assessing the depth of basal cell carcinoma invasion
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Paulo Marcos Valiante, Elisa de Oliveira Barcaui, Antonio Carlos Pires Carvalho, Carlos Baptista Barcaui, and Juan Piñeiro-Maceira
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medicine.medical_specialty ,Skin Neoplasms ,Dermatology ,01 natural sciences ,Micrographic surgery ,010309 optics ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Fibrosis ,0103 physical sciences ,Surgical site ,medicine ,Medical imaging ,Humans ,Basal cell carcinoma ,Basophilic degeneration ,Ultrasonography ,business.industry ,Ultrasound ,medicine.disease ,Mohs Surgery ,Carcinoma, Basal Cell ,Histopathology ,Radiology ,business ,Hair Follicle - Abstract
BACKGROUND High-frequency ultrasound (HFUS) has been studied in the diagnosis and therapeutic management of basal cell carcinoma (BCC). The accuracy of this method for location of deep margins remains unknown. This study evaluates HFUS for localization of deep surgical margins in BCC. MATERIALS AND METHODS Ultrasound images of 83 lesions from 67 patients with clinical and dermoscopic diagnosis of BCC were compared with histopathological findings. Pearson's correlation coefficient was used to assess the relationship between thickness as measured by HFUS and histopathology. RESULTS A strong correlation between HFUS and histopathological measurements was identified (r = 0.9744, P
- Published
- 2020
29. Effectiveness of Sequential Viscosupplementation in Temporomandibular Joint Internal Derangements and Symptomatology: A Case Series
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Antônio Lúcio Teixeira, Luciano Ambrosio Ferreira, Eduardo Grossmann, Roberta Maria Drumond Furtado Bossi Fonseca, Érica Leandro Marciano Vieira, Eduardo Januzzi, Pedro Gonçalves de Oliveira, Antonio Carlos Pires Carvalho, and Camila Megale Almeida-Leite
- Subjects
Adult ,Male ,Article Subject ,Research Diagnostic Criteria ,Osteoarthritis ,Severity of Illness Index ,Magnetic resonance angiography ,Injections, Intra-Articular ,Viscosupplementation ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,stomatognathic system ,Severity of illness ,Humans ,Pain Management ,Medicine ,Synovial fluid ,Disco da articulação temporomandibular ,Hyaluronic Acid ,Osteoartrite ,Aged ,030203 arthritis & rheumatology ,Orthodontics ,lcsh:R5-920 ,Viscosupplements ,medicine.diagnostic_test ,business.industry ,Viscossuplementação ,Magnetic resonance imaging ,030206 dentistry ,Middle Aged ,Temporomandibular Joint Disorders ,medicine.disease ,Magnetic Resonance Imaging ,Temporomandibular joint ,stomatognathic diseases ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Neurology ,Clinical Study ,Female ,lcsh:Medicine (General) ,business ,Ácido hialurônico ,Magnetic Resonance Angiography ,Follow-Up Studies - Abstract
Viscosupplementation is a minimally invasive technique that replaces synovial fluid by intra-articular injection of hyaluronic acid (HA). Although effective in some joints, there is not conclusive evidence regarding temporomandibular disorders. This case series described the efficacy of a viscosupplementation protocol in intra-articular temporomandibular disorders. Ten patients with a diagnosis of disc displacement and/or osteoarthritis by Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were submitted to four monthly injections of low or medium molecular weight HA. Pain, mandibular function, image analysis by tomography and magnetic resonance, and quality of life were assessed at baseline and follow-ups (1 and 6 months). Pain, jaw range-of-motion, mandibular function, and quality of life improved at follow-up evaluations. Osteoarthritis changes decreased, and 20% of patients improved mandibular head excursion after treatment. Resolution of effusion and improvement in disc morphology were observed for most patients. This viscosupplementation protocol reduced pain and symptoms associated with internal derangement of temporomandibular joint, improved quality of life, and showed benefits from both low and medium molecular weight HA in alternate cycles.
- Published
- 2018
30. Combined high-frequency and Doppler ultrasound in early diagnosis of atrophoderma of Pasini and Pierini
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Barcaui, Elisa de Oliveira, Carvalho, Antonio Carlos Pires, Piñeiro-Maceira, Juan, and Barcaui, Carlos Baptista
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Adult ,Pathology ,medicine.medical_specialty ,Ultrasonography, doppler ,Biopsy ,Pierini ,Dermatology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Ultrasonography, Doppler, Color ,Ultrasonography ,Dermal collagen ,integumentary system ,biology ,business.industry ,Atrophic skin ,Ultrasound ,Dermis ,General Medicine ,biology.organism_classification ,Skin diseases ,Early Diagnosis ,RL1-803 ,030220 oncology & carcinogenesis ,Images in Dermatology ,Female ,Atrophoderma ,Doppler ultrasound ,Atrophy ,business ,Scleroderma, localized ,High frequency ultrasound - Abstract
Atrophoderma of Pasini and Pierini is a skin disorder affecting dermal collagen and is clinically characterized by well-defined plaques of depressed skin. Histopathological changes are subtle, and in most cases, the diagnosis requires a comparative study with healthy skin from the same anatomical site. High frequency ultrasound is a useful imaging method for diagnosis of atrophic skin changes. A case is presented in which ultrasound can support the clinical and the histopathological diagnosis of atrophoderma of Pasini and Pierini.
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- 2019
31. High‐frequency (22‐MHz) ultrasound for assessing the depth of basal cell carcinoma invasion
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Barcaui, Elisa de Oliveira, primary, Carvalho, Antonio Carlos Pires, additional, Valiante, Paulo Marcos, additional, Piñeiro‐Maceira, Juan, additional, and Barcaui, Carlos Baptista, additional
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- 2021
- Full Text
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32. Ultrasonography of Hands and Wrists in the Diagnosis of Complications of Chikungunya Fever
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Mirhelen Mendes de Abreu, Eduardo Alvarenga Junqueira Filho, Rodrigo Sperling Torezani, Yêdda de Fátima Barcelos Chagas, André de Almeida Vieira, Yasmin Baptista Barbosa, Agnaldo José Lopes, Roberto Mogami, João Luiz Pereira Vaz, and Antonio Carlos Pires Carvalho
- Subjects
030203 arthritis & rheumatology ,medicine.medical_specialty ,Tenosynovitis ,Radiological and Ultrasound Technology ,business.industry ,Radiography ,Ultrasound ,virus diseases ,Wrist ,medicine.disease ,Chikungunya fever ,Median nerve ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Cellulitis ,Synovitis ,medicine ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Radiology ,business - Abstract
The purpose of this series was to describe the ultrasonographic and radiographic manifestations of changes to the hands and wrists in 50 patients with chronic musculoskeletal symptoms secondary to Chikungunya fever during the 2016 outbreak that occurred in Rio de Janeiro, Brazil. Most of the plain radiographs were normal (62%). The most common ultrasonographic findings were small joint synovitis (84%), wrist synovitis (74%), finger tenosynovitis (70%), and cellulitis (50%). In most cases, power Doppler did not show an increase in synovial vascular flow. The plain radiographs showed no specific findings, whereas the ultrasound images revealed synovial compromise and neural thickening.
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- 2017
33. Brazilian guidelines on prevention of cardiovascular disease in patients with diabetes: a position statement from the Brazilian Diabetes Society (SBD), the Brazilian Cardiology Society (SBC) and the Brazilian Endocrinology and Metabolism Society (SBEM)
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Marcus Vinícius Bolívar Malachias, Eduardo Gomes Lima, Fábio Rogério Trujilho, João Eduardo Nunes Salles, Francisco Antonio Helfenstein Fonseca, Rodrigo Nunes Lamounier, Marta Sulzbach, Cynthia Melissa Valerio, Henrique Tria Bianco, Luiz Alberto Turatti, Raul D. Santos, Antonio Carlos Pires, Alexandre Hohl, Sergio Vencio, Maria Teresa Zanella, Rodrigo O. Moreira, Ana Paula Marte Chacra, Marcio H. Miname, Maria Cristina de Oliveira Izar, José Francisco Kerr Saraiva, Adriana Bertolami, André Arpad Faludi, Celso Amodeo, Roberto T. B. Betti, Beatriz D'Agord Schaan, Marcelo Chiara Bertolami, João Roberto Sá, and Marcello Casaccia Bertoluci
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Position statement ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Cardiovascular screening ,Review ,Disease ,030204 cardiovascular system & hematology ,Lower risk ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Cardiovascular prevention ,Internal medicine ,Internal Medicine ,Medicine ,Blood glucose ,In patient ,030212 general & internal medicine ,lcsh:RC620-627 ,Dyslipidemias ,business.industry ,Antiplatelet agents ,Guideline ,medicine.disease ,lcsh:Nutritional diseases. Deficiency diseases ,Endocrinology ,Risk factors ,Hypertension ,BRASIL ,Cardiology ,business - Abstract
Background Since the first position statement on diabetes and cardiovascular prevention published in 2014 by the Brazilian Diabetes Society, the current view on primary and secondary prevention in diabetes has evolved as a result of new approaches on cardiovascular risk stratification, new cholesterol lowering drugs, and new anti-hyperglycemic drugs. Importantly, a pattern of risk heterogeneity has emerged, showing that not all diabetic patients are at high or very high risk. In fact, most younger patients who have no overt cardiovascular risk factors may be more adequately classified as being at intermediate or even low cardiovascular risk. Thus, there is a need for cardiovascular risk stratification in patients with diabetes. The present panel reviews the best current evidence and proposes a practical risk-based approach on treatment for patients with diabetes. Main body The Brazilian Diabetes Society, the Brazilian Society of Cardiology, and the Brazilian Endocrinology and Metabolism Society gathered to form an expert panel including 28 cardiologists and endocrinologists to review the best available evidence and to draft up-to-date an evidence-based guideline with practical recommendations for risk stratification and prevention of cardiovascular disease in diabetes. The guideline includes 59 recommendations covering: (1) the impact of new anti-hyperglycemic drugs and new lipid lowering drugs on cardiovascular risk; (2) a guide to statin use, including new definitions of LDL-cholesterol and in non-HDL-cholesterol targets; (3) evaluation of silent myocardial ischemia and subclinical atherosclerosis in patients with diabetes; (4) hypertension treatment; and (5) the use of antiplatelet therapy. Conclusions Diabetes is a heterogeneous disease. Although cardiovascular risk is increased in most patients, those without risk factors or evidence of sub-clinical atherosclerosis are at a lower risk. Optimal management must rely on an approach that will cover both cardiovascular disease prevention in individuals in the highest risk as well as protection from overtreatment in those at lower risk. Thus, cardiovascular prevention strategies should be individualized according to cardiovascular risk while intensification of treatment should focus on those at higher risk.
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- 2017
34. Influence of lip retraction on the cone beam computed tomography assessment of bone and gingival tissues of the anterior maxilla
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Karina Lopes Devito, Jesca Neftali Nogueira Silva, Bruno Salles Sotto-Maior, Priscila Ferreira de Andrade, Neuza Maria Souza Picorelli Assis, and Antonio Carlos Pires Carvalho
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Orthodontics ,Cone beam computed tomography ,business.industry ,Gingival tissue ,Anterior maxilla ,Mean value ,Dentistry ,030206 dentistry ,Pathology and Forensic Medicine ,Retractor ,stomatognathic diseases ,03 medical and health sciences ,0302 clinical medicine ,stomatognathic system ,030220 oncology & carcinogenesis ,Medicine ,Radiology, Nuclear Medicine and imaging ,Dentistry (miscellaneous) ,Surgery ,Implant ,Oral Surgery ,business - Abstract
Objective To evaluate the influence of lip retraction on cone beam computed tomography (CBCT) assessment of bone and gingival tissues on the labial surface of the anterior maxilla. Study Design A retrospective study was conducted using measurements of bone and gingival tissues collected from 120 maxillary incisors. The thicknesses of the bone and gingival tissues of different regions were measured on CBCT images, with and without a lip retractor. The thicknesses of the gingival tissues obtained from CBCT were correlated with measurements performed by clinical probing. Results The thickness of bone in the more cervical region presented a higher mean value for exams performed with a lip retractor ( P = .021). The thickness of bone found a significant correlation with the thickness of the gingiva ( P ≤ .020) with a lip retractor in CBCT exams. The thickness of the gingival tissue obtained from CBCT scans with lip retraction found significant correlations with those obtained clinically ( P ≤ .001). Conclusions The use of lip retractors is a simple and reliable practice that allows the measurement of gingival tissues on CBCT images. This practice can exempt a patient from an invasive clinical procedure for measuring the thickness of the gingival tissue for implant cases of the anterior segment.
- Published
- 2017
35. The Impact of a Nutritional Intervention on Glycemic Control and Cardiovascular Risk Markers in Type 2 Diabetes
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Tatiana Palotta Minari, Carolina Freitas Manzano, Lúcia Helena Bonalume Tácito, Louise Buonalumi Tácito Yugar, Luis Gustavo Sedenho-Prado, Tatiane de Azevedo Rubio, Antônio Carlos Pires, José Fernando Vilela-Martin, Luciana Neves Cosenso-Martin, Heitor Moreno, and Juan Carlos Yugar-Toledo
- Subjects
Type 2 diabetes mellitus ,nutritional intervention ,personalized nutrition ,mediterranean diet ,DASH diet ,cardiovascular risk markers ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Introduction: Nutritional management plays a crucial role in treating patients with type 2 diabetes (T2D), working to prevent and control the progression of chronic non-communicable diseases. Objectives: To evaluate the effects of individualized nutritional interventions on weight, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), fasting blood glucose (FBG), hemoglobin A1c (HbA1c), total cholesterol (TC), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), triglycerides (TGs), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR)} over 12 months and subsequently at follow-up (15 months). Methods: This longitudinal experimental study (without randomization and blinding) enrolled 84 sedentary participants with T2D (both sexes, aged 18–80 years). They were divided into a control group of 40 participants who received only medical consultations, and an intervention group of 44 participants who received the same medical care along with a nutritional assessment. Consultations occurred quarterly from August 2020 to November 2022 (first–twelfth month), with six to nine patients per session. Subsequently, a follow-up was conducted from December 2022 to November 2023, during which the intervention group had only medical care (during the 12th–15th months). Personalized dietary planning was inspired by the Mediterranean/DASH diets adapted to Brazilian foods and socioeconomic cultures. Statistical Analysis: Normal variables were compared between groups for each time point and also within each group across different time points using a two-way ANOVA (repeated measures for intragroup) followed by the Šídák post hoc test. Non-normal variables were compared between groups for each time point using Kruskal–Wallis followed by the Dunn post hoc test, and within each group across different time points using Friedman followed by the Dunn post hoc test. Data with a Gaussian distribution were presented as mean ± standard deviation (SD), and data with a non-Gaussian distribution were presented as median ± interquartile range (IQR). For all cases, α < 0.05 and p < 0.05 were adopted. Results: In the intervention group, significant reductions were observed between the first and twelfth month for all parameters (p < 0.05), (except for TC), along with an increase in HDL-C (p = 0.0105). Conversely, in the control group, there was a significant increase in HbA1c, weight, BMI, FBG, and WHR (p < 0.05) between the first and twelfth months. Regarding the comparison between groups, there was a significant difference for all analyzed parameters (p < 0.05) from the first to the twelfth month. In the follow-up, differences were also observed (p < 0.05), except for BMI (p > 0.05). Conclusion: The individualized nutritional intervention improved eating habits, anthropometric, biochemical, and cardiovascular markers in T2D over 12 months, with sustained results during follow-up. The dietary plan inspired by the Mediterranean and DASH diets demonstrated good adaptation to the Brazilian food culture and the patients’ socioeconomic contexts. Consistent monitoring and personalized nutritional management are essential for optimizing long-term outcomes. However, more clinical trials are necessary in order to optimize the level of evidence for longitudinal interventions.
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- 2024
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36. High frequency ultrasound with color Doppler in dermatology
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Juan Piñeiro-Maceira, Carlos Baptista Barcaui, Flávia Paiva Proença Lobo Lopes, Antonio Carlos Pires Carvalho, and Elisa de Oliveira Barcaui
- Subjects
Inflammation ,medicine.medical_specialty ,Continuing Medical Education ,Skin Neoplasms ,business.industry ,Transducers ,Ultrasonography, Doppler ,Color doppler ,Dermatology ,Ultrasonography doppler ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,RL1-803 ,Humans ,Medicine ,Skin Diseases, Infectious ,Ultrasonography ,business ,High frequency ultrasound ,Skin - Abstract
Ultrasonography is a method of imaging that classically is used in dermatology to study changes in the hypoderma, as nodules and infectious and inflammatory processes. The introduction of high frequency and resolution equipments enabled the observation of superficial structures, allowing differentiation between skin layers and providing details for the analysis of the skin and its appendages. This paper aims to review the basic principles of high frequency ultrasound and its applications in different areas of dermatology.
- Published
- 2016
37. Magnetic Resonance Image Evaluation of Temporomandibular Joint Osteophytes
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Luciano Ambrosio Ferreira, Eduardo Grossmann, Antonio Carlos Pires Carvalho, and Marcelo Pereira Remedi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Mandible ,Osteoarthritis ,Condyle ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Temporomandibular Joint Disc ,Humans ,Medicine ,Aged ,Aged, 80 and over ,Orthodontics ,Temporomandibular Joint ,medicine.diagnostic_test ,business.industry ,Osteophyte ,Magnetic resonance imaging ,030206 dentistry ,General Medicine ,Middle Aged ,Temporomandibular Joint Disorders ,medicine.disease ,Sagittal plane ,Temporomandibular joint ,Surgery ,Cross-Sectional Studies ,medicine.anatomical_structure ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Coronal plane ,Female ,business - Abstract
This research aims to examine the presence of osteophyte in patients with arthrogenic temporomandibular disorders through magnetic resonance imaging (MRI); to investigate the influence of sex and clinical symptoms in its prevalence; and the position of the osteophytes in the condyle. The study was based on 100 MRI and on reports of patients, which corresponded to the evaluation of 200 joints. Patients of both sexes were aged from 18 to 82 years (average = 49.48) and were subjected to the aforementioned examination from January 2006 to March 2009. The assessment considered the type of disc displacement, the presence of effusion, bone marrow edema, condyle changes, joint noise and pain. The MRI machine used was the GE Signa HDX (General Electric, Milwaukee, WI), with T1 and T2-weighted, 1.5 T magnetic field, sagittal oblique (mouth closed, mouth open) and coronal (mouth closed) imaging, with spherical surface coil and an asymmetric matrix. All images were interpreted by an experienced radiologist. A total of 28% (n = 56) of the temporomandibular joints showed osteophytes on the anterior surface of the mandible. No relationship was found between sex and osteophytes. The authors found a statistically significant difference between osteophytes and disc displacement without reduction (P < 0.001). The presence of osteophytes suggested a possible cause and effect relationship between osteoarthritis and disc displacement without reduction; the osteophyte was always located in the anterior surface of condyle, regardless of the sex variable; no significant difference was found between osteophytes and the main complaints of the patient.
- Published
- 2016
38. Agenda Ambiental na UNICENTRO: um estudo da qualidade de vida no trabalho a partir do método Kruger
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Antonio Carlos Pires de Lima and Carlos Golembiewski
- Subjects
General Medicine - Abstract
Este artigo apresenta um diagnóstico das ações ambientais realizadas pela Unicentro, visando à implantação de uma Agenda Ambiental. O estudo faz parte da Dissertação de Mestrado apresentada no Programa de Pós-Graduação em Gestão de Políticas Públicas da UNIVALI. Por questões de espaço, apresenta-se aqui apenas a análise referente à qualidade de vida no ambiente de trabalho. O referencial teórico é formado pelos conceitos de Sustentabilidade e Agenda Ambiental na Administração Pública. Em relação aos resultados, conclui-se que a universidade ainda precisa melhorar muito as suas ações, para que possa ter efetivamente uma Agenda Ambiental implantada.
- Published
- 2015
39. The Contribution of Endogenous Modulatory Systems to TMS- and tDCS-Induced Analgesia: Evidence from PET Studies
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Paulo Castro, Antonio Carlos Pires Carvalho, Marcos F. DosSantos, Natália R. Ferreira, and Aleli T. Oliveira
- Subjects
0301 basic medicine ,medicine.medical_treatment ,Dopamine ,Review Article ,Transcranial Direct Current Stimulation ,03 medical and health sciences ,0302 clinical medicine ,Neuroimaging ,medicine ,Humans ,Endogenous opioid ,lcsh:R5-920 ,Transcranial direct-current stimulation ,business.industry ,Chronic pain ,medicine.disease ,Transcranial Magnetic Stimulation ,Transcranial magnetic stimulation ,Analgesics, Opioid ,030104 developmental biology ,Anesthesiology and Pain Medicine ,Nociception ,Neurology ,Brain stimulation ,Positron-Emission Tomography ,Chronic Pain ,business ,lcsh:Medicine (General) ,Neuroscience ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Chronic pain is an important public health issue. Moreover, its adequate management is still considered a major clinical problem, mainly due to its incredible complexity and still poorly understood pathophysiology. Recent scientific evidence coming from neuroimaging research, particularly functional magnetic resonance (fMRI) and positron emission tomography (PET) studies, indicates that chronic pain is associated with structural and functional changes in several brain structures that integrate antinociceptive pathways and endogenous modulatory systems. Furthermore, the last two decades have witnessed a huge increase in the number of studies evaluating the clinical effects of noninvasive neuromodulatory methods, especially transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), which have been proved to effectively modulate the cortical excitability, resulting in satisfactory analgesic effects with minimal adverse events. Nevertheless, the precise neuromechanisms whereby such methods provide pain control are still largely unexplored. Recent studies have brought valuable information regarding the recruitment of different modulatory systems and related neurotransmitters, including glutamate, dopamine, and endogenous opioids. However, the specific neurocircuits involved in the analgesia produced by those therapies have not been fully elucidated. This review focuses on the current literature correlating the clinical effects of noninvasive methods of brain stimulation to the changes in the activity of endogenous modulatory systems.
- Published
- 2018
40. Diretriz brasileira baseada em evidências sobre prevenção de doenças cardiovasculares em pacientes com diabetes: posicionamento da Sociedade Brasileira de Diabetes (SBD), da Sociedade Brasileira de Cardiologia (SBC) e da Sociedade Brasileira de Endocrinologia e Metabologia (SBEM)
- Author
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Sergio Vencio, Rodrigo O. Moreira, Celso Amodeo, Otávio Berwanger da Silva, Roberto Tadeu Barcellos Betti, Marcio H. Miname, José Francisco Kerr Saraiva, Marcello Casaccia Bertoluci, Martha L. Sulzbach, Francisco Antonio Helfenstein Fonseca, Alexandre Hohl, André Arpad Faludi, Raul Dias dos Santos Filho, Eduardo Gomes Lima, Cynthia Melissa Valerio, Fábio Rogério Trujilho, Henrique Tria Bianco, Rodrigo Nunes Lamounier, Ana Paula Marte Chacra, Beatriz D'Agord Schaan, Marcelo Chiara Bertolami, Adriana Bertolami, Antonio Carlos Pires, Aloisio Marchi da Rocha, Maria Cristina de Oliveira Izar, Maria Tereza Zanella, Luiz Alberto Turatti, João Roberto de Sá, Rui Manuel dos Santos Póvoa, Marcus Vinícius Bolívar Malachias, and João Eduardo Nunes Salles
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Doenças cardiovasculares ,Gynecology ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Dislipidemias ,Fatores de risco ,business.industry ,Prevenção cardiovascular ,Doença arterial coronária ,030209 endocrinology & metabolism ,030204 cardiovascular system & hematology ,Triagem cardiovascular ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,lcsh:RC666-701 ,medicine ,Cardiology and Cardiovascular Medicine ,business ,Agentes Antiplaquetários ,Glicemia ,Hipertensão - Abstract
Resumo Fundamentação: desde o primeiro posicionamento da Sociedade Brasileira de Diabetes (SBD) sobre diabetes e prevenção cardiovascular, em 2014,1 importantes estudos têm sido publicados na área de prevenção cardiovascular e tratamento do diabetes,2 os quais contribuíram para a evolução na prevenção primária e secundária nos pacientes com diabetes. Ferramentas de estratificação de risco mais precisas, novos fármacos hipolipemiantes e novos antidiabéticos com efeitos cardiovasculares e redução da mortalidade, são parte desta nova abordagem para os pacientes com diabetes. O reconhecimento de que o diabetes é uma doença heterogênea foi fundamental, sendo claramente demonstrado que nem todos os pacientes diabéticos pertencem a categorias de risco alto ou muito alto. Um porcentual elevado é composto por pacientes jovens, sem os fatores de risco clássicos, os quais podem ser classificados adequadamente em categorias de risco intermediário ou mesmo em baixo risco cardiovascular. O presente posicionamento revisa as melhores evidências atualmente disponíveis e propõe uma abordagem prática, baseada em risco, para o tratamento de pacientes com diabetes. Estruturação: perante este desafio e reconhecendo a natureza multifacetada da doença, a SBD uniu-se à Sociedade Brasileira de Cardiologia (SBC) e à Sociedade Brasileira de Endocrinologia e Metabolismo (SBEM), e formou um painel de especialistas, constituído por 28 cardiologistas e endocrinologistas, para revisar as melhores evidências disponíveis e elaborar uma diretriz contendo recomendações práticas para a estratificação de risco e prevenção da Doença Cardiovascular (DVC) no Diabetes Melito (DM). As principais inovações incluem: (1) considerações do impacto de novos hipolipemiantes e das novas medicações antidiabéticas no risco cardiovascular; (2) uma abordagem prática, baseada em fator de risco, para orientar o uso das estatinas, incluindo novas definições das metas da Lipoproteína de Baixa Densidade-colesterol (LDL-colesterol) e colesterol não Lipoproteína de Alta Densidade HDL; (3) uma abordagem baseada em evidências, para avaliar a isquemia miocárdica silenciosa (IMS) e a aterosclerose subclínica em pacientes com diabetes; (4) as abordagens mais atuais para o tratamento da hipertensão; e (5) recomendação de atualizações para o uso de terapia antiplaquetária. Esperamos que esta diretriz auxilie os médicos no cuidado dedicado aos pacientes com diabetes. Métodos: inicialmente, os membros do painel foram divididos em sete subcomitês para definirem os tópicos principais que necessitavam de uma posição atualizada das sociedades. Os membros do painel pesquisaram e buscaram no PubMed estudos clínicos randomizados e metanálises de estudos clínicos e estudos observacionais de boa qualidade, publicados entre 1997 e 2017, usando termos MeSH: [diabetes], [diabetes tipo 2], [doença cardiovascular], [estratificação de risco cardiovascular] [doença arterial coronária], [rastreamento], [isquemia silenciosa], [estatinas], [hipertensão], [ácido acetilsalicílico]. Estudos observacionais de baixa qualidade, metanálises com alta heterogeneidade e estudos transversais não foram incluídos, embora talvez tenham impactado no Nível de Evidência indicado. A opinião de especialistas foi usada quando os resultados das buscas não eram satisfatórios para um item específico. É importante salientar que este posicionamento não teve a intenção de incluir uma revisão sistemática rigorosa. Um manuscrito preliminar, destacando recomendações de graus e níveis de evidência (Quadro 1), foi esboçado. Este passo levou a várias discussões entre os membros dos subcomitês, que revisaram os achados e fizeram novas sugestões. O manuscrito foi, então, revisto pelo autor líder, encarregado da padronização do texto e da inclusão de pequenas alterações, sendo submetido à apreciação mais detalhada pelos membros dos comitês, buscando uma posição de consenso. Depois desta fase, o manuscrito foi enviado para a banca editorial e edição final, sendo encaminhado para publicação. Quadro 1 Graus de recomendações e níveis de evidências adotados nesta revisão Grau de recomendação Classe I A evidência é conclusiva ou, se não, existe consenso de que o procedimento ou tratamento é seguro e eficaz Classe II Há evidências contraditórias ou opiniões divergentes sobre segurança, eficácia, ou utilidade do tratamento ou procedimento Classe IIa As opiniões são favoráveis ao tratamento ou procedimento. A maioria dos especialistas aprova Classe IIb A eficácia é bem menos estabelecida, e as opiniões são divergentes Classe III Há evidências ou consenso de que o tratamento ou procedimento não é útil, eficaz, ou pode ser prejudicial Níveis de Evidência A Múltiplos estudos clínicos randomizados concordantes e bem elaborados ou metanálises robustas de estudos clínicos randomizados B Dados de metanálises menos robustas, um único estudo clínico randomizado ou estudos observacionais C Opinião dos especialistas
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- 2017
41. Study of the skin anatomy with high-frequency (22 MHz) ultrasonography and histological correlation
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Juan Piñeiro-Maceira, Elisa de Oliveira Barcaui, Carlos Baptista Barcaui, Heleno Pinto de Moraes, and Antonio Carlos Pires Carvalho
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lcsh:Medical physics. Medical radiology. Nuclear medicine ,medicine.medical_specialty ,Pathology ,Histology ,lcsh:R895-920 ,Dermatology ,Cutaneous tissue ,medicine ,Radiology, Nuclear Medicine and imaging ,Iconographic Essay ,Fixation (histology) ,Ultrasonography ,Skin ,Pele ,integumentary system ,business.industry ,Histologia ,Dermatologia ,Ultrassom ,Skin structure ,Radiology ,business ,Normal skin ,Histological correlation - Abstract
The present essay is aimed at getting the radiologist familiar with the basic histological skin structure, allowing for a better correlation with sonographic findings. A high-frequency (22 MHz) ultrasonography apparatus was utilized in the present study. The histological analysis was performed after the skin specimens fixation with formalin, inclusion in paraffin blocks and subsequent staining with hematoxylin-eosin. The authors present a literature review showing the relationship between sonographic and histological findings in normal cutaneous tissue, and discuss the technique for a better performance of the sonographic scan. High-frequency ultrasonography is an excellent tool for the diagnosis of different skin conditions. However, as this method is operator-dependent, it is crucial to understand the normal skin structure as well as the correlation between histological and sonographic findings. ResumoO objetivo deste trabalho é familiarizar o radiologista com a estrutura histológica cutânea, o que torna possível uma melhor correlação dos achados ultrassonográficos da pele. Para o exame radiológico foi utilizado aparelho de ultrassom de alta frequência (22 MHz). O exame histológico foi realizado após fixação do material em formol, inclusão em parafina e coloração com hematoxilina-eosina. Os autores fazem uma revisão da literatura, demonstram a relação dos achados ultrassonográficos e histológicos do tecido cutâneo normal e discutem a técnica para o melhor aproveitamento do exame ultrassonográfico da pele. O ultrassom de alta frequência representa uma excelente ferramenta no diagnóstico das diferentes alterações cutâneas. Como o método é operador-dependente, é crucial o perfeito entendimento da pele normal e sua equivalência histológica/ultrassonográfica.
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- 2015
42. Intraobserver and interobserver agreement of Goutallier classification applied to magnetic resonance images
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Márcio Schiefer, César Rubens da Costa Fontenelle, Antonio Carlos Pires Carvalho, Gabriel A.M. Ferreira, Ana Cláudia Chu, Mariana M. Almeida, Renato Mendonça, José Sergio Franco, Monica Maria Ferreira Magnanini, Filipe Visconti, and Sérgio Maurício Silva
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medicine.medical_specialty ,Prognostic factor ,Supraspinatus muscle ,Computed tomography ,Supraspinatus tendon ,Rotator Cuff Injuries ,Rotator Cuff ,Shoulder Pain ,Tendon Injuries ,medicine ,Humans ,Orthopedics and Sports Medicine ,Rotator cuff ,Rupture ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,General Medicine ,Magnetic Resonance Imaging ,Mr imaging ,medicine.anatomical_structure ,ROC Curve ,Surgery ,Radiology ,Fatty infiltration ,business - Abstract
Fatty infiltration of the muscle bellies is an important prognostic factor in rotator cuff tears. It was described initially in computed tomography examinations, and there is an ongoing debate about whether magnetic resonance (MR) is a reliable method for staging fatty infiltration. This study sought to determine intraobserver and interobserver agreement for Goutallier's classification of fatty infiltration of the rotator cuff as evaluated through MR imaging.Twenty MR examinations of the shoulder showing full-thickness tear of the supraspinatus tendon, with or without associated lesions, were evaluated by 3 radiologists with experience in musculoskeletal system imaging and 3 fellowship-trained shoulder surgeons. The evaluators classified the fatty infiltration of the supraspinatus muscle according to the guidelines proposed by Goutallier et al. After 8 weeks, they re-evaluated the examinations, without access to their previous reports. Weighted κ index values were determined for intraobserver and interobserver agreement analyses, and intraobserver agreement κ values are reported with 95% confidence intervals (CIs).The mean intraobserver agreement was 0.832 among the orthopedists (CI95%) and 0.741 among the radiologists (CI95%). Interobserver agreement was 0.8214 (evaluation 1) and 0.7231 (evaluation 2) among the orthopedists (P.0001) and 0.6627 (evaluation 1) and 0.6067 (evaluation 2) among the radiologists (P.0001). Intraobserver agreement was not associated with length of experience or frequency of routine evaluations.When it is applied to MR images of rotator cuff musculature, Goutallier's fatty infiltration staging rubric yielded highly significant intraobserver and interobserver agreement.
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- 2015
43. Effects of Mindful Eating in Patients with Obesity and Binge Eating Disorder
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Tatiana Palotta Minari, Gerardo Maria de Araújo-Filho, Lúcia Helena Bonalume Tácito, Louise Buonalumi Tácito Yugar, Tatiane de Azevedo Rubio, Antônio Carlos Pires, José Fernando Vilela-Martin, Luciana Neves Cosenso-Martin, André Fattori, Juan Carlos Yugar-Toledo, and Heitor Moreno
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eating disorders ,binge eating disorder ,obesity ,nutritional intervention ,mindful eating ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Introduction: Binge eating disorder (BED) is a psychiatric illness related to a high frequency of episodes of binge eating, loss of control, body image dissatisfaction, and suffering caused by overeating. It is estimated that 30% of patients with BED are affected by obesity. “Mindful eating” (ME) is a promising new eating technique that can improve self-control and good food choices, helping to increase awareness about the triggers of binge eating episodes and intuitive eating training. Objectives: To analyze the impact of ME on episodes of binge eating, body image dissatisfaction, quality of life, eating habits, and anthropometric data [weight, Body Mass Index (BMI), and waist circumference] in patients with obesity and BED. Method: This quantitative, prospective, longitudinal, and experimental study recruited 82 patients diagnosed with obesity and BED. The intervention was divided into eight individual weekly meetings, guided by ME sessions, nutritional educational dynamics, cooking workshops, food sensory analyses, and applications of questionnaires [Body Shape Questionnaire (BSQ); Binge Eating Scale (BES); Quality of Life Scale (WHOQOL-BREF)]. There was no dietary prescription for calories, carbohydrates, proteins, fats, and fiber. Patients were only encouraged to consume fewer ultra-processed foods and more natural and minimally processed foods. The meetings occurred from October to November 2023. Statistical analysis: To carry out inferential statistics, the Shapiro–Wilk test was used to verify the normality of variable distribution. All variables were identified as non-normal distribution and were compared between the first and the eighth week using a two-tailed Wilcoxon test. Non-Gaussian data were represented by median ± interquartile range (IQR). Additionally, α < 0.05 and p < 0.05 were adopted. Results: Significant reductions were found from the first to the eighth week for weight, BMI, waist circumference, episodes of binge eating, BSQ scale score, BES score, and total energy value (all p < 0.0001). In contrast, there was a significant increase in the WHOQOL-BREF score and daily water intake (p < 0.0001). Conclusions: ME improved anthropometric data, episodes of binge eating, body image dissatisfaction, eating habits, and quality of life in participants with obesity and BED in the short-term. However, an extension of the project will be necessary to analyze the impact of the intervention in the long-term.
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- 2024
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44. Barriers to insulin initiation in elderly patients with type 2 diabetes mellitus in Brazil
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Mauricio A. de Paula, Antonio Carlos Pires, Hermelinda Cordeiro Pedrosa, Luiz Alberto Turatti, Marcos Antonio Tambascia, João Eduardo Nunes Salles, and Freddy Goldberg Eliaschewitz
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Blood Glucose ,medicine.medical_specialty ,Health Knowledge, Attitudes, Practice ,Attitude of Health Personnel ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Health Personnel ,030209 endocrinology & metabolism ,Public healthcare ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Humans ,Hypoglycemic Agents ,Insulin ,030212 general & internal medicine ,Negative perception ,Practice Patterns, Physicians' ,Glycemic ,Glycated Hemoglobin ,Health professionals ,business.industry ,Type 2 Diabetes Mellitus ,General Medicine ,Middle Aged ,Patient Acceptance of Health Care ,medicine.disease ,Prognosis ,Endocrinology ,Diabetes Mellitus, Type 2 ,Family medicine ,Private healthcare ,business ,Biomarkers ,Follow-Up Studies - Abstract
Aims We aimed to explore insulin initiation barriers in the Brazilian Type 2 Diabetes Mellitus (T2DM) elderly population, according to the physician’s perspective, and suggest strategies to overcome them. Methods A 45-questions survey addressing issues as clinical characteristics, barriers to insulinization, and treatment strategies in elderly patients with T2DM, was sent to six endocrinologists from different Brazilian locations. Thereafter, all the respondents participated in a panel discussion to validate their responses and collect additional relevant data. Results Endocrinologists had at least 15 years of experience, with a mean of 63 elderly patients per month. Nearly 25% of the elderly patients were treated in the Brazilian public healthcare system (SUS, Unified Health System); only a quarter presented proper glycemic control. In contrast, 55% of the patients from private healthcare system presented adequate glycemic control. The main barriers for insulin initiation for patients, according to physicians’ perspective, are side effects and negative perception over treatment (100%). For endocrinologists, main barriers were lack of time to guide patients and concern over side effects (83%). Therefore, specialists considered education for both healthcare professionals and patients as one of the most important strategies to circumvent the current scenario related insulin therapy among elderly patients in the country. Conclusion Insulin therapy remains underused due to several barriers, such as concern over side effects and negative perception. Educational measures for patients and HCPs could improve the current scenario.
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- 2017
45. Diagnosis of Mesiodistal Vertical Root Fractures in Teeth with Metal Posts: Influence of Applying Filters in Cone-beam Computed Tomography Images at Different Resolutions
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Karina Lopes Devito, Antonio Carlos Pires Carvalho, Débora De Martin e Silva, and Celso Neiva Campos
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Cone beam computed tomography ,Materials science ,Dentistry ,computer.software_genre ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Metal Artifact ,Tooth Fractures ,0302 clinical medicine ,Vertical root fracture ,stomatognathic system ,Voxel ,medicine ,Humans ,Tooth Root ,General Dentistry ,Digital radiography ,Artifact (error) ,Receiver operating characteristic ,Crowns ,business.industry ,Periapical radiography ,030206 dentistry ,Cone-Beam Computed Tomography ,medicine.disease ,Metals ,business ,Artifacts ,computer ,Post and Core Technique - Abstract
The aim of this article was to evaluate the influence of applying filters in cone-beam computed tomography (CBCT) images at different resolutions. These CBCT images were obtained for diagnosing mesiodistal vertical root fractures (VRFs) in teeth with metal posts.Forty teeth were treated endodontically, and 20 received metal posts. Ten teeth without posts and 10 teeth with posts were subjected to VRF in the mesiodistal direction. The sample was submitted to periapical radiographs and CBCT exams with a voxel of 0.25 and 0.30 mm. To reduce the influence of the metal artifact in the CT images, the teeth were evaluated with and without the application of filters ("Sharpen" and "Hard"). The images were evaluated by 2 radiologists who identified the presence of VRF. Accuracy values (receiver operating characteristic curves) for the different variables were compared by using analysis of variance and t test.No difference was observed between images with and without filter application (P .05). Images obtained with a 0.25-mm voxel were more accurate (P .05). The presence of the metal post reduced the accuracy of the diagnosis of VRF (P .05), and the CBCT images showed superior results compared with periapical radiographs (P .05).The presence of a metal post and the voxel size significantly interfere with the diagnosis of VRF. Despite the formation of metal artifacts associated with metallic cores, applying filters did not improve the diagnosis. For mesiodistal VRF, the CBCT images are superior to the periapical radiographs.
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- 2017
46. Semitendinosus and patellar tendons shear modulus evaluation by supersonic shearwave imaging elastography
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F. B. D. O. Ribeiro, L. L. Menegaldo, César Rubens da Costa Fontenelle, L. F. Oliveira, Antonio Carlos Pires Carvalho, M. A. Milito, and Pietro Mannarino
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Anterior cruciate ligament reconstruction ,medicine.diagnostic_test ,Physiology ,business.industry ,medicine.medical_treatment ,Young's modulus ,030229 sport sciences ,General Medicine ,Patellar tendon ,030218 nuclear medicine & medical imaging ,Tendon ,Shear modulus ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,medicine.anatomical_structure ,Physiology (medical) ,medicine ,symbols ,Supersonic speed ,Semitendinosus tendon ,Elastography ,business ,Biomedical engineering - Abstract
PURPOSE Shear modulus (μ) is directly correlated to the tissue stiffness and can predict the tendon ultimate force to failure. With the knee extended 0° (K0), semitendinosus tendon (ST) is tensioned while patellar tendon (PT) is relaxed. At 80o , knee flexion (K80) tendons present an opposite stress pattern; however, the relation between ST and PT μ in both situations was not studied yet. METHOD We accessed the μ of the ST and PT at 0o and 80o knee flexion by supersonic shear wave imaging (SSI) elastography from 18 healthy males. Relative μ indexes were calculated for relaxed and tensioned conditions. RESULT The average μ for ST was μST-K0 = 197·62 ± 31·93 kPa and μST-K80 = 77·76 ± 30·08. For TP, values were μTP-K0 = 23·45 ± 5·89 and μTP-K80 = 113·92 ± 57·23 kPa. Relative μ indexes were calculated for relaxed (IR = μST-K80 /μTP-K0 ) and tensioned conditions (IT = μST-K0 /μPT-K80 ). The relative μ indexes were IR = 3·63 ± 1·50 and IT = 2·00 ± 0·96 (P
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- 2017
47. miRNAs: Important Targets for Oral Cancer Pain Research
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Estevão Oliveira da Fonseca, Vivaldo Moura-Neto, Alexandre F. DaSilva, Marcos F. DosSantos, Cláudia Pereira, Heráclito Fernando Gurgel Barboza, Antonio Carlos Pires Carvalho, and Dayany Sehnem
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0301 basic medicine ,Central nervous system ,lcsh:Medicine ,Disease ,Review Article ,Bioinformatics ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Mice ,0302 clinical medicine ,microRNA ,medicine ,Carcinoma ,Animals ,Humans ,Epigenetics ,General Immunology and Microbiology ,business.industry ,Squamous Cell Carcinoma of Head and Neck ,lcsh:R ,Chronic pain ,General Medicine ,Cancer Pain ,medicine.disease ,Head and neck squamous-cell carcinoma ,MicroRNAs ,030104 developmental biology ,medicine.anatomical_structure ,Head and Neck Neoplasms ,030220 oncology & carcinogenesis ,Immunology ,Carcinoma, Squamous Cell ,Mouth Neoplasms ,Cancer pain ,business ,Signal Transduction - Abstract
Pain is a symptom shared by an incredible number of diseases. It is also one of the primary conditions that prompt individuals to seek medical treatment. Head and neck squamous cell carcinoma (HNSCC) corresponds to a heterogeneous disease that may arise from many distinct structures of a large, highly complex, and intricate region. HNSCC affects a great number of patients worldwide and is directly associated with chronic pain, which is especially prominent during the advanced stages of oral squamous cell carcinoma (OSCC), an anatomical and clinical subtype that corresponds to the great majority oral cancers. Although the cellular and molecular bases of oral cancer pain have not been fully established yet, the results of recent studies suggest that different epigenetic mechanisms may contribute to this process. For instance, there is strong scientific evidence that microRNAs (miRNAs), small RNA molecules that do not encode proteins, might act by regulating the mechanisms underlying cancer-related pain. Among the miRNAs that could possibly interfere in pain-signaling pathways, miR-125b, miR-181, and miR-339 emerge as some of the most promising candidates. In fact, such molecules apparently contribute to inflammatory pain. Moreover, these molecules possibly influence the activity of endogenous pain control systems (e.g., opioidergic and serotonergic systems), which could ultimately result in peripheral and central sensitization, central nervous system (CNS) phenomena innately associated with chronic pain. This review paper focuses on the current scientific knowledge regarding the involvement of miRNAs in cancer pain, with special attention dedicated to OSCC-related pain.
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- 2017
48. High-frequency ultrasonography (22MHz) for identification and removal of a rayfish stinger
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Elisa de Oliveira Barcaui, Antonio Carlos Pires Carvalho, and Carlos Baptista Barcaui
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medicine.medical_specialty ,business.industry ,Stinger ,medicine ,High frequency ultrasonography ,Surgery ,Identification (biology) ,Dermatology ,Radiology ,business - Published
- 2017
49. Mialgia crônica mediada centralmente
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Antonio Carlos Pires Carvalho, Luciano Ambrosio Ferreira, Josemar Parreira Guimarães, Antônio Márcio Lima Ferraz Júnior, and Felipe Lara Francischetti
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Temporomandibular joint disorders ,myalgia ,medicine.medical_specialty ,business.industry ,Temporomandibular disorder ,Chronic pain ,Interdisciplinary research ,medicine.disease ,Pesquisa interdisciplinar ,Occlusal Splints ,stomatognathic diseases ,Mouth opening ,Facial muscles ,medicine.anatomical_structure ,stomatognathic system ,Transtornos da articulação temporomandibular ,medicine ,Physical therapy ,Clinical case ,medicine.symptom ,Malocclusion ,Dor crônica ,business ,General Dentistry - Abstract
The clinical case report of a 50-year-old patient who presented to the Diagnostic and Guidance Service for Patients with Temporomandibular Disorders, at the School of Dentistry, Federal University of Juiz de Fora, with complaint of pain in the facial muscles in a continuous, throbbing manner that was paroxysmal at times, with severe intensity and of a chronic nature. After semiological interdisciplinary examination (dental, speech and physical therapy), the diagnosis suggestive of temporomandibular disorder was reached, characterized by centrally mediated chronic myalgia, associated with articular structures, parafunctional habits, malocclusion and emotional factors. Supportive dental treatment consisted of guidance throughout treatment and use of occlusal splints. After a three-and-a-half-month period of interdisciplinary therapy the patient was discharged with an 80% improvement in pain and increase in mouth opening amplitude. Episodes of pain were related only to moments of stress. The patient was instructed about the need for orthodontic treatment and psycho therapy. O caso clínico reporta uma paciente de 50 anos que se apresentou ao Serviço de Diagnóstico e Orientação a Pacientes com Desordens Temporomandibulares da Faculdade de Odontologia da Universidade Federal de Juiz de Fora com queixa de dores nos músculos da face de modo contínuo, do tipo latejante, às vezes paroxístico, de intensidade severa e caráter crônico. Após exame semiológico interdisciplinar (odontológico, fonoaudiológico e fisioterapêutico), chegou-se ao diagnóstico sugestivo de desordem temporomandibular caracterizado por mialgia crônica mediada centralmente, associada às alterações articulares, hábitos parafuncionais, má oclusão e fatores emocionais. O tratamento odontológico de suporte constituiu-se de orientações ao longo do tratamento e uso da placa neuromiorrelaxante. Após um período de 3 meses e meio de terapia interdisciplinar a paciente recebeu alta com melhora de 80% das dores e aumento da amplitude de abertura bucal. Relacionou episódios de dor somente em momentos de estresse. Foi orientada sobre a necessidade de tratamento ortodôntico e psicoterapia.
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- 2014
50. The efficacy of transcranial direct current stimulation and transcranial magnetic stimulation for chronic orofacial pain: A systematic review
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Nathália B. M. Brito, Ygor N. Junqueira, Daniele Masterson Tavares Pereira Ferreira, Thayná A. Menezes, Marcos F. DosSantos, Marcio Magini, Tatiana Kelly da Silva Fidalgo, Natália R. Ferreira, Rodrigo Lopes de Lima, Estevão Oliveira da Fonseca, Nathália B. Corrêa, and Antonio Carlos Pires Carvalho
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Physiology ,Myofascial Pain ,medicine.medical_treatment ,Transcranial Direct Current Stimulation ,Pathology and Laboratory Medicine ,law.invention ,0302 clinical medicine ,Transcranial Direct-Current Stimulation ,Randomized controlled trial ,law ,Medicine and Health Sciences ,030212 general & internal medicine ,Brain Mapping ,Multidisciplinary ,Transcranial direct-current stimulation ,Research Assessment ,Transcranial Magnetic Stimulation ,Electrophysiology ,Bioassays and Physiological Analysis ,Systematic review ,medicine.anatomical_structure ,Brain Electrophysiology ,Neuropathic pain ,Medicine ,Chronic Pain ,Anatomy ,medicine.symptom ,Research Article ,medicine.medical_specialty ,Orofacial pain ,Systematic Reviews ,Science ,Neurophysiology ,Pain ,Surgical and Invasive Medical Procedures ,Research and Analysis Methods ,Placebo ,03 medical and health sciences ,Signs and Symptoms ,Physical medicine and rehabilitation ,Facial Pain ,Diagnostic Medicine ,medicine ,Humans ,Pain Management ,Transcranial Stimulation ,Neuropathic Pain ,Functional Electrical Stimulation ,business.industry ,Electrophysiological Techniques ,Biology and Life Sciences ,Dorsolateral prefrontal cortex ,Transcranial magnetic stimulation ,Jaw ,Face ,Quality of Life ,business ,Head ,030217 neurology & neurosurgery ,Neuroscience - Abstract
BackgroundTranscranial Direct Current Stimulation (tDCS) and Transcranial Magnetic Stimulation (TMS) have been described as promising alternatives to treat different pain syndromes. This study evaluated the effects of TMS and tDCS in the treatment of chronic orofacial pain, through a systematic review.MethodsAn electronic search was performed in major databases: MEDLINE, Scopus, Web of Science, Cochrane, Embase, LILACS, BBO, Open Gray and CINAHL. The eligibility criteria comprised randomized clinical trials (RCTs) that applied TMS or tDCS to treat chronic orofacial pain. The variables analyzed were pain, functional limitation, quality of life, tolerance to treatment, somatosensory changes, and adverse effects. The risk of bias was assessed through the Cochrane Collaboration tool, and the certainty of evidence was evaluated through GRADE. The protocol was registered in the PROSPERO database (CRD42018090774).ResultsThe electronic search resulted in 636 studies. Thereafter, the eligibility criteria were applied and the duplicates removed, resulting in eight RCTs (four TMS and four tDCS). The findings of these studies suggest that rTMS applied to the Motor cortex (M1), the dorsolateral prefrontal cortex (DLPFC) and the secondary somatosensory cortex (S2) provide adequate orofacial pain relief. Two studies reported significant pain improvement with tDCS applied over M1 while the other two failed to demonstrate significant effects compared to placebo.ConclusionsrTMS, applied to M1, DLPFC or S2, is a promising approach for the treatment of chronic orofacial pain. Moreover, tDCS targeting M1 seems to be also effective in chronic orofacial pain treatment. The included studies used a wide variety of therapeutic protocols. In addition, most of them used small sample sizes, with a high risk of biases in their methodologies, thus producing a low quality of evidence. The results indicate that further research should be carried out with caution and with better-standardized therapeutic protocols.
- Published
- 2019
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