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Bau M, Zacharias P, Ribeiro DA, Boaron L, Steckert Filho A, Kotze PG. SAFETY PROFILE OF ANTI-TNF THERAPY IN CROHN'S DISEASE MANAGEMENT: A BRAZILIAN SINGLE-CENTER DIRECT RETROSPECTIVE COMPARISON BETWEEN INFLIXIMAB AND ADALIMUMAB. Arq Gastroenterol 2017; 54:328-332. [PMID: 28954043 DOI: 10.1590/s0004-2803.201700000-43] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 07/27/2017] [Indexed: 02/13/2023]
Abstract
BACKGROUND Infliximab and adalimumab are considered effective drugs in the management of Crohn's disease. However, due to significant immunossupression, they can cause important adverse events, mostly infections. OBJECTIVE The aim of this study was to quantify and describe adverse events derived from adalimumab and infliximab use in Crohn's disease patients, and to compare the safety profile between these two agents. METHODS This was an observational, single-center, longitudinal, retrospective study with Crohn's disease patients under infliximab or adalimumab therapy. Variables analyzed: demographic characteristics (including the Montreal classification), type of agent used, concomitant immunomodulators, presence and types of adverse events observed. Patients were allocated in two groups (infliximab and adalimumab) and had their adverse events accessed and subsequently compared. RESULTS A total of 130 patients were included (68 in infliximab and 62 in adalimumab groups, respectively). The groups were fully homogeneous in all baseline characteristics, with a median follow-up of 47.21±36.52 months in the infliximab group and 47.79±35.09 in the adalimumab group (P=0.512). Adverse events were found in 43/68 (63.2%) and 40/62 (64.5%) in each group, respectively (P=0.879). There were no differences between the groups regarding infections (P=0.094) or treatment interruption (P=0.091). There were higher rates of infusion reactions in the infliximab group (P=0.016). Cephalea and injection site reactions were more prevalent in adalimumab patients. CONCLUSION Adverse events were found in approximately two thirds of Crohn's disease patients under anti-TNF therapy, and there were no significant differences between infliximab or adalimumab.
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Affiliation(s)
- Mariella Bau
- Unidade de Cirurgia Colorretal, Hospital Universitário Cajuru, Universidade Católica do Paraná, Curitiba, PR, Brasil
| | - Patricia Zacharias
- Unidade de Cirurgia Colorretal, Hospital Universitário Cajuru, Universidade Católica do Paraná, Curitiba, PR, Brasil
| | - Diogo Araújo Ribeiro
- Unidade de Cirurgia Colorretal, Hospital Universitário Cajuru, Universidade Católica do Paraná, Curitiba, PR, Brasil
| | - Larissa Boaron
- Unidade de Cirurgia Colorretal, Hospital Universitário Cajuru, Universidade Católica do Paraná, Curitiba, PR, Brasil
| | | | - Paulo Gustavo Kotze
- Unidade de Cirurgia Colorretal, Hospital Universitário Cajuru, Universidade Católica do Paraná, Curitiba, PR, Brasil
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Barichello T, Simões LR, Generoso JS, Carradore MM, Moreira AP, Panatto AP, Costa CS, Filho AS, Jeremias IC, Bez GD, Streck E. Evaluation of energetic metabolism in the rat brain after meningitis induction by Klebsiella pneumoniae. Acta Neuropsychiatr 2013; 25:95-100. [PMID: 25287310 DOI: 10.1111/j.1601-5215.2012.00671.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Bacterial meningitis is an infection of the central nervous system characterised by strong inflammatory response. The brain is highly dependent on ATP, and the cell energy is obtained through oxidative phosphorylation, a process which requires the action of various respiratory enzyme complexes and creatine kinase (CK) as an effective buffering system of cellular ATP levels in tissues that consume high energy. OBJECTIVES Evaluate the activities of mitochondrial respiratory chain complexes I, II, III, IV and CK activity in hippocampus and cortex of the Wistar rat submitted to meningitis by Klebsiella pneumoniae. METHODS Adult Wistar rats received either 10 µl of sterile saline as a placebo or an equivalent volume of K. pneumoniae suspension. The animals were killed in different times at 6, 12, 24 and 48 h after meningitis induction. Another group was treated with antibiotic, starting at 16 h and continuing daily until their decapitation at 24 and 48 h after induction. RESULTS In the hippocampus, the meningitis group without antibiotic treatment, the complex I was increased at 24 and 48 h, complex II was increased at 48 h, complex III was inhibited at 6, 12, 24 and 48 h and in complex IV all groups with or without antibiotic treatment were inhibited after meningitis induction, in the cortex there was no alteration. Discussion Although descriptive, our results show that antibiotic prevented in part the changes of the mitochondrial respiratory chain. The meningitis model could be a good research tool to study the biological mechanisms involved in the pathophysiology of the K. pneumoniae meningitis.
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Affiliation(s)
- Tatiana Barichello
- 1 Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Lutiana Roque Simões
- 1 Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Jaqueline S Generoso
- 1 Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Mirelle M Carradore
- 1 Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Ana Paula Moreira
- 1 Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Ana Paula Panatto
- 1 Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Caroline S Costa
- 1 Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Alvaro Steckert Filho
- 1 Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Isabela C Jeremias
- 2 Laboratório de Fisiopatologia and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Gisele D Bez
- 2 Laboratório de Fisiopatologia and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Emilio Streck
- 2 Laboratório de Fisiopatologia and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
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Steckert JS, Sartor MC, Miranda EF, Rocha JG, Martins JF, Wollmann MCFDAS, Freitas CD, Steckert Filho A, Kotze PG. Análise das complicações tardias em operações anorretais: experiência de um serviço de referência em coloproctologia. ACTA ACUST UNITED AC 2010. [DOI: 10.1590/s0101-98802010000300006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUÇÃO: as operações anorretais correspondem a 80% do movimento do coloproctologista. O índice de complicações tardias após estas operações é indefinido, e varia de acordo com o tipo de operação e serviço onde estas são realizadas. OBJETIVO: estabelecer a taxa de complicações tardias decorrentes das operações anorretais e fatores de risco que pudessem estar associados a estas complicações. MÉTODO: estudo retrospectivo (série de casos) dos pacientes submetidos a operações anorretais entre janeiro de 2007 e julho de 2009. Variáveis estudadas: sexo, idade, operação, sistema de saúde, técnica de anestesia, complicações tardias, além da taxa de reoperações realizadas. RESULTADOS: foram avaliados 430 pacientes (234 mulheres - 54,4%), submetidos a 453 operações anorretais. A hemorroidectomia foi o mais freqüente procedimento realizado: 50,3% das operações. Encontrou-se 102 complicações tardias pós-operatórias, representando 22,52% dos casos. A fissura anal residual foi a complicação mais freqüente (54%/ n=55). Somente 38 pacientes necessitaram de reintervenção cirúrgica (8,83%). Não houve diferença significativa em relação ao sexo, idade, sistema de saúde e ao tipo de operação realizada com as complicações encontradas. CONCLUSÕES: a taxa de complicações tardias foi de 22,52%, com reintervenções cirúrgicas em 8,83% dos pacientes. Não houve fator de risco para complicações identificado nesta série de casos.
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Filho AS, Hetem LAB, Ferrari MCF, Trzesniak C, Martín-Santos R, Borduqui T, de Lima Osório F, Loureiro SR, Busatto Filho G, Zuardi AW, Crippa JAS. Social anxiety disorder: what are we losing with the current diagnostic criteria? Acta Psychiatr Scand 2010; 121:216-26. [PMID: 19694635 DOI: 10.1111/j.1600-0447.2009.01459.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To assess the rate of comorbidities and the functional impairment associated with the social anxiety disorder (SAD), with an emphasis on the so-called subthreshold clinical signs and symptoms. METHOD Psychiatric comorbidities and psychosocial functioning were evaluated in 355 volunteers (college students) who had been diagnosed as SAD (n = 141), Subthreshold SAD (n = 92) or Controls (n = 122). RESULTS The rate of comorbidities was 71.6% in the SAD group and 50% in subjects with Subthreshold SAD, both significantly greater than Controls (28.7%). Concerning psychosocial functioning, the SAD group had higher impairment than the other two groups in all domains evaluated, and subjects with Subthreshold SAD presented intermediate values. CONCLUSION The rates of psychiatric comorbidities and the impairment of psychosocial functioning increase progressively along the spectrum of social anxiety. The fact that Subthreshold SAD causes considerable disability and suffering in comparison with control subjects justifies a review of the validity of the diagnostic criteria.
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Affiliation(s)
- A S Filho
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
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Sarinho ES, Sarinho S, Ferreira OS, Brito WP, Filho AS, Cartaxo CG. [Risk factors for childhood asthma in Fernando de Noronha: a case control study]. J Pediatr (Rio J) 1995; 71:270-2. [PMID: 14688994 DOI: 10.2223/jped.791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Fernando de Noronha Island, because of its ecological characteristics,has virtually no atmospheric pollution that could cause asthma. Nevertheless, asthma prevalence in children younger than 6 years old is 11.22%. 17 asthmatic children and 68 healthy ones were included in this case control study (1:4 case/controls) conducted in a closed community free from atmosphere pollution. Maternal asthma and exposure to smoking were more frequently associated with asthmatic children than with controls, the risk of asthmatic syndrome being respectively 6.9 and 4.6 times bigger. As for breastfeeding no protective effect was found in both cases and controls.
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Affiliation(s)
- E S Sarinho
- Departamento Materno Infantil, Universidade Federal de Pernambuco, Recife, PE
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Guimarães AC, Filho AS, Esteves JP, Abreu WN, Vinhaes LA, de Almeida Souza JA, Machado A. Annular subvalvular left ventricular aneurysm in Bahia, Brazil. Heart 1976; 38:1080-5. [PMID: 973882 PMCID: PMC483135 DOI: 10.1136/hrt.38.10.1080] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Two cases of left ventricular aneurysm, a 16-year-old black boy and a 23-year-old white girl, from Bahia, Brazil, are presented. In both patients there was enlargement of the cardiac silhouette and a prominent bulge of the left inferior border. On the right oblique view a ring of calcium at the ventricular opening of the aneurysms was visualized. A left ventriculogram showed a huge aneurysm in the first case and a bulge on the lateral wall of the left ventricle in the other. Cardiac catheterization showed a rise in left and right ventricular end-diastolic pressures and in the mean pulmonary artery pressure. In the first case the contour of the right ventricular pressure curve showed a restrictive pattern. The similarities of these aneurysms with the annular submitral type described in young black Africans are stressed.
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