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Tsunoda AT, Ribeiro R, Reis RJ, da Cunha Andrade C, Moretti Marques R, Baiocchi G, Fin F, Zanvettor PH, Falcao D, Batista TP, Azevedo B, Guitmann G, Pessini SA, Nunes JS, Campbell LM, Linhares JC, Carneiro V, Coimbra F. Surgery in ovarian cancer - Brazilian Society of Surgical Oncology consensus. BJOG 2018; 125:1243-1252. [PMID: 29900651 DOI: 10.1111/1471-0528.15328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2018] [Indexed: 12/22/2022]
Abstract
Surgical management in epithelial ovarian cancer (EOC) has a significant impact in overall survival and progression-free survival. The Brazilian Society of Surgical Oncology (BSSO) supported a taskforce of experts to reach a consensus: experienced and specialised trained surgeons, in cancer centres, provide the best EOC surgery. Laparoscopic and/or radiological staging prognosticates the possibility of complete cytoreduction (CC0) and helps to reduce unnecessary laparotomies. Surgical techniques were reviewed. Multidisciplinary input is essential for treatment planning. Quality assurance criteria are proposed and require national consensus. Genetic testing is mandatory. This consensus states the final recommendations from BSSO for management of EOC. TWEETABLE ABSTRACT Brazilian Society of Surgical Oncology consensus for surgery in epithelial ovarian cancer patients.
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Affiliation(s)
- A T Tsunoda
- Gynaecological Oncology Department, Hospital Erasto Gaertner, Curitiba, Brazil.,Albert Einstein Hospital, São Paulo, Brazil.,Positivo University, Curitiba, Brazil
| | - R Ribeiro
- Gynaecological Oncology Department, Hospital Erasto Gaertner, Curitiba, Brazil
| | - R J Reis
- Hospital Erasto Dorneles e Hospital Mãe de Deus, Porto Alegre, Brazil.,Brazilian Lutheran University, Porto Alegre, Brazil
| | - Cem da Cunha Andrade
- Gynaecological Oncology Department, Barretos Cancer Hospital, Barretos, Brazil.,Paulo Prata Medical University, Barretos, Brazil
| | | | - G Baiocchi
- Gynaecological Oncology Department, AC Camargo Cancer Centre, Sao Paulo, Brazil
| | - F Fin
- Gynaecological Oncology Department, Hospital São Vicente, Curitiba, Brazil.,Faculdade Evangélica de Curitiba, Curitiba, Brazil
| | - P H Zanvettor
- Gynaecological Oncology Department, Aristides Maltez Hospital, Salvador, Brazil.,AMO Clinic, Salvador, Brazil
| | - D Falcao
- Gynaecological Oncology Department, Aristides Maltez Hospital, Salvador, Brazil
| | - T P Batista
- Surgery Department, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil
| | - Brb Azevedo
- Hospital São Vicente, Curitiba, Brazil.,Instituto de Hemato Oncologia do Paraná, Curitiba, Brazil
| | - G Guitmann
- Brazilian National Cancer Institute, Rio de Janeiro, Brazil.,Americas Hospital, Rio de Janeiro, Brazil
| | - S A Pessini
- Gynaecological Oncology Department, Fundação Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - J S Nunes
- Hospital Erasto Gaertner, Curitiba, Brazil.,Instituto de Oncologia do Paraná, Curitiba, Brazil
| | | | - J C Linhares
- Gynaecological Oncology Department, Hospital Erasto Gaertner, Curitiba, Brazil.,Instituto de Oncologia do Paraná, Curitiba, Brazil
| | - V Carneiro
- Hospital de Câncer de Pernambuco, Recife, Brazil Instituto de Medicina Integral Professor Fernando Figueira NeoH - Núcleo Especializado em Oncologia e Hematologia D'OR, Recife, Brazil
| | - Fjf Coimbra
- AC Camargo Cancer Centre, Sao Paulo, Brazil.,Brazilian Society of Surgical Oncology 2016/2017, Sao Paulo, Brazil
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de Lima CRM, de Souza PRS, Stopilha RT, de Morais WA, Silva GTM, Nunes JS, Wanderley Neto AO, Pereira MR, Fonseca JLC. Formation and structure of chitosan–poly(sodium methacrylate) complex nanoparticles. J DISPER SCI TECHNOL 2017. [DOI: 10.1080/01932691.2017.1296772] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- C. R. M. de Lima
- Instituto de Química, Universidade Federal do Rio Grande do Norte, Campus Universitário, Lagoa Nova, Natal, RN, Brazil
| | - P. R. S. de Souza
- Instituto de Química, Universidade Federal do Rio Grande do Norte, Campus Universitário, Lagoa Nova, Natal, RN, Brazil
| | - R. T. Stopilha
- Instituto de Química, Universidade Federal do Rio Grande do Norte, Campus Universitário, Lagoa Nova, Natal, RN, Brazil
| | - W. A. de Morais
- Instituto de Química, Universidade Federal do Rio Grande do Norte, Campus Universitário, Lagoa Nova, Natal, RN, Brazil
| | - G. T. M. Silva
- Instituto de Química, Universidade Federal do Rio Grande do Norte, Campus Universitário, Lagoa Nova, Natal, RN, Brazil
| | - J. S. Nunes
- Instituto de Química, Universidade Federal do Rio Grande do Norte, Campus Universitário, Lagoa Nova, Natal, RN, Brazil
| | - A. O. Wanderley Neto
- Instituto de Química, Universidade Federal do Rio Grande do Norte, Campus Universitário, Lagoa Nova, Natal, RN, Brazil
| | - M. R. Pereira
- Instituto de Química, Universidade Federal do Rio Grande do Norte, Campus Universitário, Lagoa Nova, Natal, RN, Brazil
| | - J. L. C. Fonseca
- Instituto de Química, Universidade Federal do Rio Grande do Norte, Campus Universitário, Lagoa Nova, Natal, RN, Brazil
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Andrade DA, Carcano FM, Teixeira MR, Gomes JC, Schroeter D, Nunes JS, Souza FH. Prospective evaluation of factors associated with delayed chemotherapy-induced nausea and emesis (CINE) in patients (pts) with breast cancer (BC) receiving adjuvant anthracycline-based chemotherapy (ABCT). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e19677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Nunes JS, Lawhon SD, Rossetti CA, Khare S, Figueiredo JF, Gull T, Burghardt RC, Bäumler AJ, Tsolis RM, Andrews-Polymenis HL, Adams LG. Morphologic and cytokine profile characterization of Salmonella enterica serovar typhimurium infection in calves with bovine leukocyte adhesion deficiency. Vet Pathol 2009; 47:322-33. [PMID: 20118318 DOI: 10.1177/0300985809358037] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The role of neutrophils in the pathogenesis of Salmonella enterica Typhimurium-induced ruminant and human enteritis and diarrhea has yet to be characterized with in vivo models. To address this question, the in vivo bovine ligated ileal loop model of nontyphoidal salmonellosis was used in calves with the naturally occurring bovine leukocyte adhesion deficiency (BLAD) mutation whose neutrophils are unable to extravasate and infiltrate the extravascular matrix. Data obtained from 4 BLAD Holstein calves homozygous for BLAD (CD18-), 1 to 5 weeks of age, were compared with 4 controls, age-matched Holstein calves negative for BLAD (CD18+). Morphologic studies revealed that infection of CD18- calves with S Typhimurium resulted in no significant tissue infiltration by neutrophils, less tissue damage, reduced luminal fluid accumulation, and increased bacterial invasion, when compared with CD18+ calves. Ultrastructurally, lesions in enterocytes induced by S Typhimurium infection in CD18- calves--including attachment and disruption of the brush border, apical membrane ruffling formation, and cellular degeneration--were similar to the ones reported in the literature for CD18- calves. Study of cytokine gene expression by quantitative real-time polymerase chain reaction revealed that early stages of acute infection (4-8 hours postinfection) were associated with increased interleukin 8 gene expression in the absence of tissue influx of neutrophils in CD18- calves, whereas later stages of infection (12 hours postinfection) were associated with increased expression of growth-related oncogene alpha in the presence of neutrophil influx in CD18+ calves. In contrast, the proinflammatory cytokines interleukin 1beta and tumor necrosis factor alpha were poorly correlated with the presence or absence of tissue neutrophils.
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Affiliation(s)
- J S Nunes
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A&M University, College Station, Texas, USA.
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Khare S, Nunes JS, Figueiredo JF, Lawhon SD, Rossetti CA, Gull T, Rice-Ficht AC, Adams LG. Early phase morphological lesions and transcriptional responses of bovine ileum infected with Mycobacterium avium subsp. paratuberculosis. Vet Pathol 2009; 46:717-28. [PMID: 19276052 DOI: 10.1354/vp.08-vp-0187-g-fl] [Citation(s) in RCA: 53] [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] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Mycobacterium avium subsp. paratuberculosis (MAP) is the causative agent of chronic enteritis in ruminants (Johne's disease) and a possible etiopathologic agent in human Crohn's disease. The host-pathogen interaction in this chronic disease has largely depended on the randomly collected static lesions studied in subclinically or clinically infected animals. We have established and utilized the neonatal calf ligated ileal loop model to study the early temporal host changes during MAP infection. After inoculation of ligated ileal loop with MAP, samples were analyzed for bacterial invasion, histologic and ultrastructural morphologic changes, and gene expression at several times (0.5-12 hours) postinfection. Our results indicate that MAP invades the intestinal mucosa as early as 0.5 hour postinoculation. Distribution and migration of neutrophils, monocytes/macrophages, and goblet cells were confirmed by histopathology, scanning and transmission electron microscopy. Coincident with the morphologic analysis, we measured by real-time polymerase chain reaction gene expression of various cytokines/chemokines that are involved in the recruitment of mononuclear and polymorphonuclear leukocytes to the site of infection. We also detected expression of several other genes, including intestinal-trefoil factor, profilin, lactoferrin, and enteric ss-defensin, which may play significant roles in the early MAP infection. Thus, the calf ligated intestinal loop model may be used as a human disease model to understand the role of MAP in the pathogenesis of Crohn's disease.
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Affiliation(s)
- S Khare
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Veterinary Research Building, Bldg. 1197, Room 141, Texas A&M University, College Station, TX 77843-4467, USA
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Nunes JS, Tsunoda AT, Viana LS, Souza FH, Castro N, Hohmann J, Serrano SV. Analysis of response to neoadjuvant chemotherapy (NCT) with doxorubicin plus cyclophosphamide followed by paclitaxel (AC- T) in triple negative locally advanced breast cancer (LABC) in Brazil. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.11551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Viana LS, Souza FH, Nunes JS, Correia NC, Hohmann JV, Serrano SV. Does the receptor expression pattern in ductal carcinoma in situ predict recurrence? J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.22189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Nunes JS, Vasconcelos CLD, Dantas TNC, Pereira MR, Fonseca JLC. Preparation of Acrylic Latexes with Dispersed Magnetite Nanoparticles. J DISPER SCI TECHNOL 2008. [DOI: 10.1080/01932690701753260] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Martins JM, Trinca A, Afonso A, Carreiras F, Falcão J, Nunes JS, do Vale S, da Costa JC. Psychoneuroendocrine characteristics of common obesity clinical subtypes. Int J Obes (Lond) 2001; 25:24-32. [PMID: 11244454 DOI: 10.1038/sj.ijo.0801500] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To relate psychological profiles, cerebral asymmetry and the hypothalamus-pituitary-adrenal axis (HPA) reactivity to clinical characteristics of common obesity. METHODS Sixty consecutive adult female overweight and obese patients attending the outpatient endocrine department were included in this study. Clinical evaluation specifically selected a priori the following indexes: obesity age of onset, parenthood obesity, carbohydrate craving, binge eating with purging, obesity degree (defined by the body mass index (BMI)--weight (kg)/height (m(2))), body fat distribution (defined by the abdominal--thigh ratio (A/T)) and initial weight loss after medical treatment. Psychological evaluation was performed with the Minnesota Multiphasic Personality Inventory (MMPI). In the last 30 patients, the Edinburgh Inventory of Manual Preference (EIMP) and the corticotrophin-releasing hormone (CRH) test were also performed. RESULTS Clinical characteristics defined a priori were independent variables as evaluated by contingency table analysis. Factorial analysis of variance (ANOVA) revealed a significantly different MMPI profile, according to parental obesity, with post-hoc significantly higher scores on the hypochondriasis (Hs), paranoia (Pa), psychasthenia (Pt) and schizophrenia (Sc) scales in patients with obese parents. Obese patients presented significantly higher dichotomized manual preference indexes in relation to overweight patients. Parental obesity, binge eating behaviour with purging, body fat distribution and the dichotomized manual preference index were independent significant factors for the ACTH response in the CRH test, together explaining 41% of the response variability. Age of onset of obesity and the dichotomized manual preference index were independent and significant factors for the cortisol response, together explaining 37% of its variability. A non-normal distribution was found for the ACTH response: high- and low-responders presented significantly different MMPI profiles, with high-responders presenting higher scores on all clinical scales except masculinity/femininity (Mf). CONCLUSION Overweight/obese subjects with parental obesity present a distinctive personality profile and a higher ACTH response in the CRH test. Cerebral asymmetry may be a relevant factor for obesity development and is associated with the HPA reactivity. HPA reactivity is a sensitive index integrating clinical, psychological and neural asymmetric factors. International Journal of Obesity (2001) 25, 24-32
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Affiliation(s)
- J M Martins
- Endocrine Unit, Curry Cabral Hospital, Lisbon, Portugal.
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Nunes JS, Correia LG, Corrêa JN. [Insulin resistance and atherosclerosis]. ACTA MEDICA PORT 2000; 13:203-10. [PMID: 11155488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
The western way of life favours the development of a state of insulin resistance, in genetically predisposed subjects. In this state, greater levels of insulin are necessary so that an answer can be obtained and, consequently, hyperinsulinism occurs. Insulin has several target tissues, thus insulin resistance is associated with the dysfunction of a multiplicity of tissues, organs and systems in the body (Syndrome X). All of those dysfunctions together with hyperinsulinism can greatly enhance the risk of atherosclerotic vascular disease. In this article we review the dysfunction at several levels, including blood pressure, endothelium, lipid metabolism and fibrinolytic system and the way they can, together with hyperinsulinism, induce atherogenesis. We review some of the therapeutic options that can reduce this state of insulin resistance as well as the morbidity and mortality associated with atherosclerosis.
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Affiliation(s)
- J S Nunes
- Unidade de Endocrinologia, Hospital Curry Cabral, Lisboa
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Nunes JS. Psychiatric training in Portugal. Eur Arch Psychiatry Clin Neurosci 1998; 247:S24-5. [PMID: 9476018 DOI: 10.1007/bf02913551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- J S Nunes
- Portuguese College of Psychiatrists, Hospital Santa Maria, Servico de Psiquiatria, P-Lisbon, Portugal
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Ferreira PP, Fonseca C, Pereira I, Carvalho A, Morais H, Sá Nogueira J, Santos AL, Aleixo A, Nunes JS, Rodrigues C. [Infectious endocarditis. The current diagnostic problems]. Rev Port Cardiol 1995; 14:745-50. [PMID: 7492410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Affiliation(s)
- P P Ferreira
- Serviço de Medicina, UCIM Hospital S. Francisco Xavier
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Paiva T, Nunes JS, Moreira A, Santos J, Teixeira J, Barbosa A. Effects of frontalis EMG biofeedback and diazepam in the treatment of tension headache. Headache 1982; 22:216-20. [PMID: 7141868 DOI: 10.1111/j.1526-4610.1982.hed2205216.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Araújo JM, Nunes JS, Laginba F, Sarmento JL. [Occlusive thrombosis of the left atrium. Apropos of a case]. ACTA MEDICA PORT 1980; 2:137-47. [PMID: 7435231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Nunes JS, Marks IM. Feedback of true heart rate during exposure in vivo. Partial replication with methodological improvement. Arch Gen Psychiatry 1976; 33:1346-50. [PMID: 10874 DOI: 10.1001/archpsyc.1976.01770110074007] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Ten specific phobics improved during a mean of two sessions of experimental treatment by exposure in vivo in a balanced design. Short-term results replicated those of a previous study that self-control of heart rate with the aid of biofeedback significantly reduced heart rate during treatment, but this did not hasten reduction of subjective anxiety, nor of respiratory rate or skin conductance responses. An hour's pretreatment training in self-control of heart rate with the aid of feedback did not enhance the effect. Mere instructions to lower heart rate without feedback had a significant effect during treatment, but the addition of heart rate feedback to instructions significantly augmented the decline in heart rate.
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Abstract
Ten women with specific chronic animal phobias were treated by graded exposure in vivo in two to four two-hour treatment sessions. Sessions were divided into four balanced half-hour epochs, half with visual feedback of true heart rate plus instructions to lower heart rate during approach to phobic stimulus. All patients improved significantly from the start to end of sessions on heart rate and on subjective anxiety. Feedback of heart rate plus instructions to lower it substantially reduced heart rate during epochs of feedback, compared to non-feedback epochs without instructions, but this effect did not generalize to skin conductance or to subjective anxiety in our short-term experiment.
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