1
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Nunes CP, Rodrigues C, Suchmacher M, Esteves CR, Gonçalves K, Rzetelna H, Rodrigues RV, de Vasconcelos LR, Mezitis SG, Rabelo H, Kaufmann R, Schwarz F, Goldberg H, Sintoveter A, Geller M. A Combination of Gamma-Aminobutyric Acid, Glutamic Acid, Calcium, Thiamine, Pyridoxine, and Cyanocobalamin vs Ginger Extract in the Management of Chronic Motion Sickness: A Clinical Evaluation. Curr Ther Res Clin Exp 2023; 99:100719. [PMID: 38021267 PMCID: PMC10630771 DOI: 10.1016/j.curtheres.2023.100719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/02/2023] [Indexed: 12/01/2023]
Abstract
Background Motion sickness (kinetosis) is a common and temporarily incapacitant ailment, manageable with behavioral as well as pharmacological measures. Objective To assess the effectiveness and safety of a combination of gamma-aminobutyric acid, glutamic acid, calcium, thiamine, pyridoxine, and cyanocobalamin (Group A) (n = 170) and extract of Zingiber officinale (ginger) (Group B) (n = 165) in the management of chronic complaints consistent with motion sickness. Methods Both groups were tested according to the following end points, under self-paired as well as comparative study designs: reduction of ≥20 score points in the total motion sickness assessment questionnaire (MSAQ) score, percentage of patients presenting a reduction of the total MSAQ score, absolute MSAQ score reduction, physician's assessment scores, final overall assessment of study medication, and willingness to continue treatment. Safety was also evaluated. Results There was a statistically significant better performance under both study designs for Group A (P = 0.05 using different statistical tests) in all end points. Both regimens were safe, with different neurological and gastrointestinal tolerability outcomes. Conclusions Group A and Group B regimens were effective and safe in the management of chronic complaints consistent with motion sickness and the Group A regimen was more effective than Group B.
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Affiliation(s)
- Carlos P. Nunes
- Centro Universitário Serra Dos Órgãos, Rio de Janeiro, Brazil
| | | | - Mendel Suchmacher
- Instituto de Pós-graduação Médica Carlos Chagas, Rio de Janeiro, Brazil
| | | | | | - Hélio Rzetelna
- Universidade Estácio de Sá. Faculdade de Medicina, RJ, Rio de Janeiro, Brazil
| | | | | | | | - Heros Rabelo
- Instituto Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Renato Kaufmann
- Instituto Estadual de Cardiologia Aloysio de Carvalho, Rio de Janeiro, Brazil
| | | | | | | | - Mauro Geller
- Centro Universitário Serra Dos Órgãos, Rio de Janeiro, Brazil
- Instituto de Pós-graduação Médica Carlos Chagas, Rio de Janeiro, Brazil
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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2
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Darrigo Junior LG, Ferraz VEDF, Cormedi MCV, Araujo LHH, Magalhães MPS, Carneiro RC, Sales LHN, Suchmacher M, Cunha KS, Filho AB, Azulay DR, Geller M. Epidemiological profile and clinical characteristics of 491 Brazilian patients with neurofibromatosis type 1. Brain Behav 2022; 12:e2599. [PMID: 35506373 PMCID: PMC9226847 DOI: 10.1002/brb3.2599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 03/08/2022] [Accepted: 03/23/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Neurofibromatosis type 1 (NF1) is a chronic and progressive autosomal dominant genetic and sporadic disease characterized by cutaneous and neurological abnormalities. Plexiform neurofibroma (PN), a significant cause of clinical complications in NF-1, is a benign tumor of the peripheral nerve sheath that involves multiple nerve fascicles. Although there is an important number of patients who are affected by NF1 in Brazil, there is little data on the behavior of the disease in the national literature as well as in other low- and middle-income countries. METHODS We performed a retrospective analysis of 491 patients with NF1 followed at two reference centers in Brazil. RESULTS Approximately 38% of patients had PNs, resulting in reduced life quality. The median patient age with PNs was 30 years (range: 6 to 83 years). Head and neck, and extremity were the main affected locations with 35.8 and 30.6%, respectively. PNs were classified as asymptomatic in 25.1% of patients, while 52.5% presented symptomatic and inoperable tumors. The most common manifestations related to PNs were disfigurement and orthopedic involvement. Twenty patients developed neoplasms and ten (50%) presented with malignant peripheral nerve sheath tumors (MPNST). The prevalence of MPNST in our study was 2.9%. CONCLUSIONS Patients with NF1 experience clinically significant morbidity, especially when it is associated with PN. Though there are many patients affected by NF1 in Brazil and other low- and middle-income countries, there is little data available in the corresponding literature. Our results are comparable to the previous results reported from higher-income countries and international registries.
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Affiliation(s)
| | | | | | | | | | - Rafaella Curis Carneiro
- Immunology Department, Fundação Educacional Serra dos Órgãos (UNIFESO), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luis Henrique Nunes Sales
- Immunology Department, Fundação Educacional Serra dos Órgãos (UNIFESO), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mendel Suchmacher
- Immunology Department, Fundação Educacional Serra dos Órgãos (UNIFESO), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Karin Soares Cunha
- Department of Pathology and Post-graduation Program in Pathology, School of Medicine, Fluminense Federal University, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - David Rubem Azulay
- Dermatology Service, Prof. Rubem David Azulay Dermatology Institute, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mauro Geller
- Immunology Department, Fundação Educacional Serra dos Órgãos (UNIFESO), Rio de Janeiro, Rio de Janeiro, Brazil.,Clinical Immunology, Instituto de Pós-Graduação Médica Carlos Chagas (IPGMCC), Rio de Janeiro, Rio de Janeiro, Brazil
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3
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Kleinherbers E, Stegmann P, Kurzmann A, Geller M, Lorke A, König J. Pushing the Limits in Real-Time Measurements of Quantum Dynamics. Phys Rev Lett 2022; 128:087701. [PMID: 35275653 DOI: 10.1103/physrevlett.128.087701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
Time-resolved studies of quantum systems are the key to understanding quantum dynamics at its core. The real-time measurement of individual quantum numbers as they switch between certain discrete values, well known as a "random telegraph signal," is expected to yield maximal physical insight. However, the signal suffers from both systematic errors, such as a limited time resolution and noise from the measurement apparatus, as well as statistical errors due to a limited amount of data. Here we demonstrate that an evaluation scheme based on factorial cumulants can reduce the influence of such errors by orders of magnitude. The error resilience is supported by a general theory for the detection errors as well as experimental data of single-electron tunneling through a self-assembled quantum dot. Thus, factorial cumulants push the limits in the analysis of random telegraph data, which represent a wide class of experiments in physics, chemistry, engineering, and life sciences.
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Affiliation(s)
- E Kleinherbers
- Faculty of Physics and CENIDE, University of Duisburg-Essen, 47057 Duisburg, Germany
| | - P Stegmann
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Kurzmann
- 2nd Institute of Physics, RWTH Aachen University, 52074 Aachen, Germany
| | - M Geller
- Faculty of Physics and CENIDE, University of Duisburg-Essen, 47057 Duisburg, Germany
| | - A Lorke
- Faculty of Physics and CENIDE, University of Duisburg-Essen, 47057 Duisburg, Germany
| | - J König
- Faculty of Physics and CENIDE, University of Duisburg-Essen, 47057 Duisburg, Germany
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4
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Geller M, Slater R, Graham‐Williams E, Wolf T, Spriet M, Berryhill E, Skipper L, Aleman M. Imaging of equine septic discospondylitis using MRI, CT and post‐mortem radiographs. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M. Geller
- University of California Davis California USA
- The William R. Pritchard Veterinary Medical Teaching Hospital Davis California USA
| | - R. Slater
- University of California Davis California USA
- The William R. Pritchard Veterinary Medical Teaching Hospital Davis California USA
| | - E. Graham‐Williams
- University of California Davis California USA
- The William R. Pritchard Veterinary Medical Teaching Hospital Davis California USA
| | - T. Wolf
- University of California Davis California USA
- The William R. Pritchard Veterinary Medical Teaching Hospital Davis California USA
| | - M. Spriet
- University of California Davis California USA
- The William R. Pritchard Veterinary Medical Teaching Hospital Davis California USA
| | - E. Berryhill
- University of California Davis California USA
- The William R. Pritchard Veterinary Medical Teaching Hospital Davis California USA
| | - L. Skipper
- University of California Davis California USA
- The William R. Pritchard Veterinary Medical Teaching Hospital Davis California USA
| | - M. Aleman
- University of California Davis California USA
- The William R. Pritchard Veterinary Medical Teaching Hospital Davis California USA
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5
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Oliveira LB, Geller M, Cunha KS, Santos A, Bernacchi A, Rubenstein AE, Takirambudde S, Mezitis S, de Almeida Ito Brum C, Darrigo LG, Ribeiro MG. Clinical assessment of the use of topical liquid diclofenac following laser microporation of cutaneous neurofibromas in individuals with neurofibromatosis type 1. Heliyon 2021; 7:e06518. [PMID: 33817379 PMCID: PMC8010391 DOI: 10.1016/j.heliyon.2021.e06518] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 10/16/2020] [Accepted: 03/11/2021] [Indexed: 11/03/2022] Open
Abstract
Background Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder with a prevalence of 1:3000 births and a wide variety of clinical manifestations. Cutaneous neurofibromas (cNF) are among the most common visible manifestations of NF1 and present a major clinical burden for patients. NF1 patients with cNF often report decreased quality of life, emotional well-being and physical comfort. Developing effective medical therapies for cNF has been identified as a priority for the majority of adults with NF1. Methods The study was an open, controlled and prospective proof-of-concept clinical trial. The topical treatment consisted of two steps: cNF microporation using a laser device followed by topical application of one drop of diclofenac 25 mg/mL on the surface of the cNF (T neurofibroma = treatment) or physiological saline (C neurofibroma = control) and reapplied twice daily for 3 days. Neurofibroma assessments included visual and dermatoscopy observations noting color and presence of necrosis, presence of flaccidity, measurements in two dimensions, photographs, and histopathology after excision. The primary efficacy variable was the presence of tissue necrosis. The primary safety variable was the occurrence of treatment-related adverse events. Results Six patients were included in the study. The treatment resulted in transitory topical changes (healing of the microporation grid with formation of scintillating tissue layer, hyperemia and desquamation), with no statistically significant variation in the dimensions of the T and C neurofibromas in relation to pretreatment measurements. There was no necrosis in the T or C neurofibromas. In the histopathological analysis, there was no significant difference in the distribution of chronic (lymphocytic) inflammatory infiltrate in the papillary reticular dermis (subepithelial), type of infiltrate (diffuse, perivascular, or both), presence of fibrosis, and presence of atrophy among the T and C neurofibromas. No adverse events attributable to the use of diclofenac were reported during the treatment period. Conclusions Treatment did not result in significant alterations in terms of presence of tissue necrosis, size, or histopathological features in the T neurofibromas or in comparison to the C neurofibromas. Topical diclofenac with laser microporation was well-tolerated, with no adverse events attributable to diclofenac reported. Whether these observations are due to minimal systemic and neurofibroma exposure remain to be explored in dosage studies with larger patient groups. Trial registration ClinicalTrials.gov (NCT03090971) retrospectively registered March 27, 2017.
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Affiliation(s)
- Lisa Brauer Oliveira
- Postgraduate Program in Clinical Medicine, Universidade Federal do Rio de Janeiro (UFRJ) - Rio de Janeiro, Brazil
| | - Mauro Geller
- Medical Genetics Service, Instituto de Puericultura e Pediatria Martagão Gesteira Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Department of Immunology and Microbiology, Centro Universitário Serra dos Órgãos (UNIFESO), Teresópolis, Brazil.,Hospital Israelita Albert Einstein, São Paulo, Brazil.,Department of Clinical Immunology, Instituto de Pós-Graduação Médica Carlos Chagas - Rio de Janeiro, Brazil
| | - Karin Soares Cunha
- Postgraduate Program in Pathology, Universidade Federal Fluminense (UFF) Medical School, Niterói, Brazil.,Pathology Department, Faculdade de Medicina - Universidade Federal Fluminense (UFF), Niterói, Brazil
| | - Alessandra Santos
- Postgraduate Program in Clinical Medicine, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Allan Bernacchi
- Department of Plastic Surgery, Serviço Prof. Pitanguy, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Allan E Rubenstein
- Department of Neurology and Pediatrics, NYU Langone Medical Center, New York, NY, USA
| | - Sanyu Takirambudde
- Department of Pediatrics, New York University Langone Medical Center, New York, NY, USA
| | - Spyros Mezitis
- Department of Endocrinology/Clinical Medicine, Weill Medical College of Cornell University, New York, NY, USA.,New York Presbyterian Hospital/Cornell Medicine, Lenox Hill Hospital/Northwell Health, New York, NY, USA
| | | | - Luiz Guilherme Darrigo
- Bone Marrow Transplant Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Marcia Gonçalves Ribeiro
- Department of Pediatrics, Federal University of Rio de Janeiro Medical School (UFRJ), Rio de Janeiro, Brazil.,Medical Genetics Service, Instituto de Puericultura e Pediatria Martagão Gesteira, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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6
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Gama CRB, Pombo MAG, Nunes CP, Gama GF, Mezitis SGE, Suchmacher Neto M, Guimarães OR, Geller M, Oliveira L, de Souza da Fonseca A, Sitnoveter A, Goldwasser G, Cunha KS, Darrigo Junior LG. Treatment of Recurrent Urinary Tract Infection Symptoms with Urinary Antiseptics Containing Methenamine and Methylene Blue: Analysis of Etiology and Treatment Outcomes. Res Rep Urol 2020; 12:639-649. [PMID: 33365282 PMCID: PMC7751791 DOI: 10.2147/rru.s279060] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/22/2020] [Indexed: 01/28/2023] Open
Abstract
Purpose Urinary antiseptics including methenamine and methylene blue are used in the symptomatic treatment of urinary tract infections (UTIs). Patients and Methods This was a prospective, double-blind, randomized, double-dummy safety and efficacy study of 2 urinary antiseptic combinations in the symptomatic treatment of recurrent cystitis: methenamine 120mg + methylene blue 20mg (Group A) versus acriflavine 15mg + methenamine 250mg + methylene blue 20mg + Atropa belladonna L. 15mg (Group B). All subjects underwent pretreatment urine culture and antibiotic sensitivity tests prior to 3-day oral treatment with study drug, followed by 3 days of antibiotic therapy (based on urine culture) + study drug treatment. Efficacy was evaluated using the Urinary Tract Infection Symptoms Assessment Questionnaire (UTISA). The primary endpoint was the percentage of patients presenting improvement in cystitis manifestations on the UTISA domain "Urination Regularity" at Visit 2. The primary safety variable was the incidence of treatment-related adverse events. Results A total of 144 subjects were randomized per group and 272 completed the study. Primary endpoint analysis demonstrates homogeneity between treatment groups, with 69.4% and 72.2% subjects, respectively, showing improvement in the score of the urinary regularity UTISA domain after 3 days of treatment (p= 0.87). At Visit 2, incidence of treatment-related adverse events was higher in Group B (Group A: n= 11, Group B: n= 31, p= 0.0057). Conclusion Both treatments were effective in reducing UTI symptoms assessed by UTISA questionnaire after 3 days of treatment. The two regimens were comparable in incidence of adverse events, but the combination of methenamine + methylene blue resulted in fewer treatment-related adverse effects.
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Affiliation(s)
| | | | | | | | - Spyros G E Mezitis
- New York-Presbyterian Hospital/Weill-Cornell Medical Center, New York, NY, USA
| | | | | | - Mauro Geller
- UNIFESO Medical School, Rio de Janeiro, Brazil.,Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Lisa Oliveira
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | | | - Gerson Goldwasser
- Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Karin Soares Cunha
- Pathology Department, Faculdade de Medicina - Universidade Federal Fluminense (UFF), Niterói, Brazil
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7
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Theresa Holanda-Freitas I, Do Carmo Cupertino M, C. dos Santos E, Oliveira L, Geller M, Siqueira-Batista R. Human african trypanosomiasis: current standing and challenges. Rev Patol Trop 2020. [DOI: 10.5216/rpt.v49i3.62857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Human African trypanosomiasis (HAT) caused by the protozoan Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense, and transmitted by the tsetse fly (genus Glossina), affects 36 Sub-Saharan African countries with considerable public health impact. Despite approximately 15,000 infected individuals and 70 million at risk, in recent years the World Health Organization has mentioned removal of HAT from the list of Neglected Tropical Diseases by 2020, due to the decrease in cases over the last two decades. When untreated, the disease presents high lethality rates and the available treatments are complicated to administer, highly toxic, and do not guarantee cure, especially in the advanced stages of the disease. Further, there is no prospect for vaccine development in the near future. The present review compiles information on the history of the clinical aspects of HAT, as well as its epidemiology, diagnosis, therapy, and prophylaxis, as well as updating information on the current panorama and perspectives regarding the disease.KEY WORDS: African Trypanosomiasis; neglected diseases; Trypanosoma brucei.
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8
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Mibielli MAN, Nunes CP, Goldberg H, Buchman L, Oliveira L, Mezitis SGE, Wajnzstajn F, Kaufman R, Nigri R, Cytrynbaum N, Cunha KS, Santos A, Goldberg SW, Platenik NC, Rzetelna H, Futuro DB, Da Fonseca ADS, Geller M. Nucleotides Cytidine and Uridine Associated with Vitamin B12 vs B-Complex Vitamins in the Treatment of Low Back Pain: The NUBES Study. J Pain Res 2020; 13:2531-2541. [PMID: 33116795 PMCID: PMC7568635 DOI: 10.2147/jpr.s277024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 09/08/2020] [Indexed: 11/28/2022] Open
Abstract
Purpose We report the results of low back pain treatment using a combination of nucleotides, uridine (UTP), cytidine (CMP) and vitamin B12, vs a combination of vitamins B1, B6, and B12. Patients and Methods Randomized, double-blind, controlled trial, of a 60-day oral treatment: Group A (n=317) receiving nucleotides+B12 and Group B (n=317) receiving B vitamins. The primary endpoint was the percentage of subjects in each group presenting adverse events (AEs). Secondary endpoints were visual analog scale (VAS) pain scores at Visit 2 (day 30) and Visit 3 (day 60) in relation to pretreatment values, Roland–Morris Questionnaire (RMQ) scores and finger-to-floor distance (FFD) (percentage of subjects per group presenting improvement ≥5 points and ≥3cm, respectively). Results Seventy-five (24%) and 105 (33%) subjects (P=0.21) presented 133 and 241 AEs, with 3159% of subjects presenting ≥2 AEs (P=0.0019) in Group A and Group B, respectively. Twenty-four subjects in Group B were discontinued due to AEs, while no AE-related discontinuations occurred in Group A (P<0.0001). VAS score reduction after 30 and 60 days of treatment was statistically significant (P<0.0001) in both groups, with Group A showing greater reduction at Visit 2 (P<0.0001). RMQ score improvement ≥5 points occurred in 99% of subjects from each group, and FFD improvement ≥3 cm occurred in all subjects. Conclusion Treatment with nucleotides+B12 was associated with a lower number of total AEs, fewer AEs per subject, and no AE-related treatment discontinuation. Pain intensity (VAS) reduction was superior at 30 days of treatment in the nucleotides+B12 group and equivalent between groups at 60 days of treatment. Improvements in efficacy measures RMQ and FFD were observed in both groups at treatment days 30 and 60.
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Affiliation(s)
| | - Carlos Pereira Nunes
- UNIFESO Medical School, Teresópolis, Brazil.,UERJ Medical School, Rio De Janeiro, Brazil
| | - Henrique Goldberg
- Instituto De Pós-Graduação Médica Carlos Chagas (ICC), Rio De Janeiro, Brazil
| | | | - Lisa Oliveira
- Federal University of Rio De Janeiro (UFRJ), Rio De Janeiro, Brazil
| | - Spyros G E Mezitis
- New York-Presbyterian Hospital/Weill-Cornell Medical Center, New York, NY, USA
| | | | - Renato Kaufman
- Instituto De Pós-Graduação Médica Carlos Chagas (ICC), Rio De Janeiro, Brazil
| | - Rafael Nigri
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Natasha Cytrynbaum
- Instituto De Pós-Graduação Médica Carlos Chagas (ICC), Rio De Janeiro, Brazil
| | - Karin Soares Cunha
- Pathology Department, Universidade Federal Fluminense (UFF) Medical School, Niterói, Brazil
| | | | | | | | - Helio Rzetelna
- Santa Casa Da Misericórdia Do Rio De Janeiro, Rio De Janeiro, Brazil
| | | | | | - Mauro Geller
- UNIFESO Medical School, Teresópolis, Brazil.,Instituto De Pós-Graduação Médica Carlos Chagas (ICC), Rio De Janeiro, Brazil.,Federal University of Rio De Janeiro (UFRJ), Rio De Janeiro, Brazil
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9
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Aapro M, Bossi P, Dasari A, Fallowfield L, Gascón P, Geller M, Jordan K, Kim J, Martin K, Porzig S. Digital health for optimal supportive care in oncology: benefits, limits, and future perspectives. Support Care Cancer 2020; 28:4589-4612. [PMID: 32533435 PMCID: PMC7447627 DOI: 10.1007/s00520-020-05539-1] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 05/18/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Digital health provides solutions that capture patient-reported outcomes (PROs) and allows symptom monitoring and patient management. Digital therapeutics is the provision to patients of evidence-based therapeutic interventions through software applications aimed at prevention, monitoring, management, and treatment of symptoms and diseases or for treatment optimization. The digital health solutions collecting PROs address many unmet needs, including access to care and reassurance, increase in adherence and treatment efficacy, and decrease in hospitalizations. With current developments in oncology including increased availability of oral drugs and reduced availability of healthcare professionals, these solutions offer an innovative approach to optimize healthcare resource utilization. DESIGN This scoping review clarifies the role and impact of the digital health solutions in oncology supportive care, with a view of the current segmentation according to their technical features (connection to sensors, PRO collection, remote monitoring, self-management in real time…), and identifies evidence from clinical studies published about their benefits and limitations and drivers and barriers to adoption. A qualitative summary is presented. RESULTS Sixty-six studies were identified and included in the qualitative synthesis. Studies supported the use of 38 digital health solutions collecting ePROs and allowing remote monitoring, with benefits to patients regarding symptom reporting and management, reduction in symptom distress, decrease in unplanned hospitalizations and related costs and improved quality of life and survival. Among those 38 solutions 21 provided patient self-management with impactful symptom support, improvement of QoL, usefulness and reassurance. Principal challenges are in developing and implementing digital solutions to suit most patients, while ensuring patient compliance and adaptability for use in different healthcare systems and living environments. CONCLUSIONS There is growing evidence that digital health collecting ePROs provide benefits to patients related to clinical and health economic endpoints. These digital solutions can be integrated into routine supportive care in oncology practice to provide improved patient-centered care.
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Affiliation(s)
- M Aapro
- Medical Oncology, Genolier Cancer Center, Clinique de Genolier, Genolier, Switzerland.
- Institut Multidisciplinaire d'Oncologie (IMO), Clinique de Genolier, Case Postale (PO Box) 100, 1 Route de Muids, CH-1272, Genolier, Switzerland.
| | - P Bossi
- Department of Medical Oncology, University of Brescia, Brescia, Italy
| | - A Dasari
- Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, MD Anderson Cancer Center, Houston, TX, USA
| | - L Fallowfield
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Brighton, UK
| | - P Gascón
- Department of Hematology-Oncology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - M Geller
- Gynecologic Oncology, Department of Obstetrics, Gynecology and Women's Health (OBGYN), University of Minnesota, Minneapolis, MN, USA
| | - K Jordan
- Department of Medicine, Haematology, Oncology and Rheumatology, Heidelberg University Hospital, Heidelberg, Germany
| | - J Kim
- Medical Oncology, Yale University School of Medicine, New Haven, CT, USA
| | - K Martin
- Gyneco-oncology, Barnes-Jewish Hospital, St. Louis, MO, USA
| | - S Porzig
- Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
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10
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Nunes CP, Rodrigues CDC, Cardoso CAF, Cytrynbaum N, Kaufman R, Rzetelna H, Goldwasser G, Santos A, Oliveira L, Geller M. Clinical Evaluation of the Use of Ginger Extract in the Preventive Management of Motion Sickness. Curr Ther Res Clin Exp 2020; 92:100591. [PMID: 32714473 PMCID: PMC7378854 DOI: 10.1016/j.curtheres.2020.100591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 06/05/2020] [Accepted: 06/10/2020] [Indexed: 12/30/2022] Open
Abstract
Background Motion sickness can be triggered in a variety of situations and is characterized primarily by nausea and vomiting. Ginger is widely used in treating conditions including chemotherapy-associated gastrointestinal symptoms, morning sickness, postoperative nausea, and motion sickness. Objectives The primary study objective was to evaluate Zingiber officinale extract in the treatment of motion sickness. Secondary objectives were to evaluate treatment effect on Motion Sickness Assessment Questionnaire (MSAQ) score and subscores before and after treatment, and to evaluate treatment tolerability. Methods Open-label, single-arm study assessing motion sickness outcomes with and without pre-travel oral treatment with Zingiber officinale 160 mg extract (containing 8 mg gingerols). All patients answered the MSAQ on 4 separate occasions following a trip of at least 15 minutes in duration: Trip 1 (pretreatment) and Trips 2, 3, and 4 (after oral treatment with study medication). The primary end point was percentage of patients presenting improvement ≥20 score points on the MSAQ during Trip 2, Trip 3, and Trip 4 in comparison to pretreatment score (Trip 1). Secondary end points included percentage of patients presenting improvement in MSAQ subscores during Trips 2, 3, and 4; percentage of patients presenting treatment-related adverse events; and pre- and posttreatment physician assessment scores. Results One hundred eighty-four patients were included and 174 completed treatment. A reduction of ≥20 points in total MSAQ score points occurred in 26.52%, 29.89%, and 29.31% of patients from Trips 2, 3, and 4, respectively. There was no significant difference at Trips 2, 3, and 4 in number of patients presenting improvement ≥20 score points (P = 0.9579). There was a significant reduction in total MSAQ scores from Trips 2, 3, and 4 (P < 0.0001) compared with Trip 1. Total MSAQ scores did not vary at each trip taken under treatment (P = 0.28). There were significant (P < .001) improvements in all domain subscores from Trips 2, 3, and 4 in relation to scores from Trip 1. There was a significant improvement in physician assessment scores at Visit 2 (P < .0001). Adverse events were reported among 31 patients, mainly affecting the gastrointestinal system. Twenty-four patients (13.04%) reported 39 adverse events considered related to treatment. No significant change in physical exam was noted at Visit 2 in relation to Visit 1. Conclusions These open label, historically controlled study results suggest the need for randomized, blinded, placebo and active substance controlled clinical trials. (Curr Ther Res Clin Exp. 2020; 81:XXX–XXX)
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Affiliation(s)
| | | | | | - Natasha Cytrynbaum
- Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Renato Kaufman
- Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Helio Rzetelna
- Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gerson Goldwasser
- Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alessandra Santos
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lisa Oliveira
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mauro Geller
- Centro Universitário Serra dos Órgãos, Teresópolis, Rio de Janeiro, Brazil
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
- Address correspondence to: Centro Universitário Serra dos Órgãos, Teresópolis, Rio de Janeiro, Brazil.
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Santos A, Geller M, Mezitis S, Rubenstein AE, Oliveira L, Medeiros Lima DJM, Suchmacher Neto M, Nigri R, Cunha KGS, Takirambudde S, Gonçalves Ribeiro M. Determination of Vitamin D Levels in Patients With Neurofibromatosis Type 1 in the Pediatric Age Group. Clin Med Insights Pathol 2020; 13:2632010X20928930. [PMID: 35156025 PMCID: PMC8826272 DOI: 10.1177/2632010x20928930] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/18/2020] [Indexed: 11/16/2022] Open
Abstract
Introduction: Neurofibromatosis type 1 (NF1) is one of the most common autosomal dominant genetic disorders. Some clinical manifestations are present at birth, while some develop during childhood, and others can occur at any age. Given the early age at which patients develop clinical features, diagnosis is often made during childhood. The most prevalent features of NF1 are café au lait spots, dermal and plexiform neurofibromas, and learning disability. A variety of skeletal problems may be seen in NF1, including scoliosis, short stature, and pseudoarthrosis. Reduced skeletal bone mass has been documented to be a common phenomenon in children and adults with NF1. Decreased serum 25-hydroxyvitamin D (vitamin D) levels have been noted in adults and children with NF1 and have been reported to be inversely correlated with the number of dermal neurofibromas in adults. However, the actual correlation of vitamin D level to bone density and dermal neurofibroma number in children with NF1 remains unclear. Objectives: The primary objective of this study was to evaluate vitamin D levels among children and adolescents with NF1. The secondary objective was to describe the levels of vitamin D among children and adolescents with NF1, to verify in which age group there is a higher frequency of vitamin D alterations, and to explore vitamin D level correlations between age, gender, sun exposure, number of neurofibromas, and number of plexiform neurofibromas. Methods: This was an observational, cross-sectional, hospital-based study. We obtained a convenience sample of individuals with confirmed diagnosis of NF1 from patients attending the Medical Genetics Service of the IPPMG-UFRJ and Santa Casa de Misericórdia of Rio de Janeiro over a 24-month period. We evaluated vitamin D levels in blood samples of patients with NF1 by a chemiluminescent immunoassay method, and we correlated the results with gender, age, number of neurofibromas, number of plexiform neurofibromas, and satisfactory sun exposure. Results: Of the 55 patients, 28 (50.9%) were female and 27 (49.1%) were male. Patient ages ranged from a minimum of 1.2 to a maximum of 19.6 years (mean age 10.95 years) and the median was 11.11 years. Median and mean body mass index (BMI; z score) were -0.09 (minimum value -1.63 and maximum of 4.62) and 0.16, respectively. The mean value of vitamin D was 30.82 ng/mL (±12.31) and the median was 29 ng/mL (minimum value of 10.40 ng/mL and maximum of 79.19 ng/mL). Conclusions: The levels of vitamin D did not differ according to gender, age group, or the presence or number of cutaneous neurofibromas. Among patients with adequate sun exposure, there was a higher incidence of sufficient serum vitamin D levels. Patients with cutaneous neurofibromas in the 0 to 11 age group had a greater tendency to vitamin D sufficiency in relation to patients aged 11 to 19 years.
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Affiliation(s)
- Alessandra Santos
- Department of Medical Genetics, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Mauro Geller
- Department of Medical Genetics, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Department of Microbiology and Immunology, Centro Universitário Serra dos Órgãos (UNIFESO), Teresópolis, Brazil
- Department of Climical Immunology, Instituto de Pós-Graduação Médica Carlos Chagas, Rio de Janeiro, Brazil
| | - Spyros Mezitis
- Department of Endocrinology, New York-Presbyterian Hospital/Weill-Cornell Medical Center, New York, NY, USA
| | - Allan E Rubenstein
- Department of Neurology, New York University Langone Medical Center, New York, NY, USA
| | - Lisa Oliveira
- Department of Medical Genetics, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Department of Microbiology and Immunology, Centro Universitário Serra dos Órgãos (UNIFESO), Teresópolis, Brazil
| | - Daniel JM Medeiros Lima
- Faculdade de Medicina de Campos (FMC), Department of Pharmacology and Physiology, Campos dos Goytacazes, Brazil
| | - Mendel Suchmacher Neto
- Department of Medical Genetics, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Department of Medical Genetics, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Nigri
- Department of Medical Genetics, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | - Sanyu Takirambudde
- Department of Pediatrics, New York University Langone Medical Center, New York, NY, USA
| | - Marcia Gonçalves Ribeiro
- Department of Medical Genetics, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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12
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Kurzmann A, Stegmann P, Kerski J, Schott R, Ludwig A, Wieck AD, König J, Lorke A, Geller M. Optical Detection of Single-Electron Tunneling into a Semiconductor Quantum Dot. Phys Rev Lett 2019; 122:247403. [PMID: 31322370 DOI: 10.1103/physrevlett.122.247403] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Indexed: 06/10/2023]
Abstract
The maximum information of a dynamic quantum system is given by real-time detection of every quantum event, where the ultimate challenge is a stable, sensitive detector with high bandwidth. All physical information can then be drawn from a statistical analysis of the time traces. We demonstrate here an optical detection scheme based on the time-resolved resonance fluorescence on a single quantum dot. Single-electron resolution with high signal-to-noise ratio (4σ confidence) and high bandwidth of 10 kHz make it possible to record the individual quantum events of the transport dynamics. Full counting statistics with factorial cumulants gives access to the nonequilibrium dynamics of spin relaxation of a singly charged dot (γ_{↑↓}=3 ms^{-1}), even in an equilibrium transport measurement.
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Affiliation(s)
- A Kurzmann
- Faculty of Physics and CENIDE, University of Duisburg-Essen, Lotharstrasse 1, 47057 Duisburg, Germany
- Solid State Physics Laboratory, ETH Zurich, 8093 Zurich, Switzerland
| | - P Stegmann
- Faculty of Physics and CENIDE, University of Duisburg-Essen, Lotharstrasse 1, 47057 Duisburg, Germany
| | - J Kerski
- Faculty of Physics and CENIDE, University of Duisburg-Essen, Lotharstrasse 1, 47057 Duisburg, Germany
| | - R Schott
- Chair for Applied Solid State Physics, Ruhr-Universität Bochum, Universitätsstrasse 150, 44780 Bochum, Germany
| | - A Ludwig
- Chair for Applied Solid State Physics, Ruhr-Universität Bochum, Universitätsstrasse 150, 44780 Bochum, Germany
| | - A D Wieck
- Chair for Applied Solid State Physics, Ruhr-Universität Bochum, Universitätsstrasse 150, 44780 Bochum, Germany
| | - J König
- Faculty of Physics and CENIDE, University of Duisburg-Essen, Lotharstrasse 1, 47057 Duisburg, Germany
| | - A Lorke
- Faculty of Physics and CENIDE, University of Duisburg-Essen, Lotharstrasse 1, 47057 Duisburg, Germany
| | - M Geller
- Faculty of Physics and CENIDE, University of Duisburg-Essen, Lotharstrasse 1, 47057 Duisburg, Germany
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Moore K, Secord A, Geller M, Miller D, Cloven N, Fleming G, Wahner Hendrickson A, Azodi M, DiSilvestro P, Oza A, Cristea M, Berek J, Chan J, Rimel B, Li Y, Luptakova K, Clark R, Matulonis U, Monk B. QUADRA: A phase II, open-label, single-arm study to evaluate niraparib in patients (pts) with relapsed ovarian cancer (ROC) in 4th or later line of therapy: Results from the tBRCAmut subset. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy285.152] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Geller M, Nunes CP, Oliveira L, Nigri R. S. maltophilia pneumonia: A case report. Respir Med Case Rep 2018; 24:44-45. [PMID: 29977756 PMCID: PMC6010609 DOI: 10.1016/j.rmcr.2018.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/05/2018] [Accepted: 04/06/2018] [Indexed: 11/16/2022] Open
Abstract
Case report of Community-acquired pneumonia in a male patient without co-morbidities. Empiric antibiotic treatment did not resolve the clinical picture of productive cough, and a chest computerized tomography and sputum culture with antibiogram were performed, identifying S. maltophilia infection with sensitivity to levofloxacin and sulfamethoxazole/trimethoprim. Treatment with levofloxacin (500 mg/day for 15 days) resulted in resolution of the clinical picture.
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Affiliation(s)
- Mauro Geller
- Centro Universitário Serra dos Órgãos (UNIFESO), Av. Alberto Torres 111, Teresópolis, RJ, Brazil.,Universidade Federal do Rio de Janeiro (UFRJ), Av. Brigadeiro Trompovsky, s/n, Rio de Janeiro, Brazil.,Instituto de Pós-Graduação Médica Carlos Chagas, Av. Beira-Mar 406, gr 503/506, Rio de Janeiro, Brazil
| | - Carlos Pereira Nunes
- Centro Universitário Serra dos Órgãos (UNIFESO), Av. Alberto Torres 111, Teresópolis, RJ, Brazil.,Instituto de Pós-Graduação Médica Carlos Chagas, Av. Beira-Mar 406, gr 503/506, Rio de Janeiro, Brazil
| | - Lisa Oliveira
- Universidade Federal do Rio de Janeiro (UFRJ), Av. Brigadeiro Trompovsky, s/n, Rio de Janeiro, Brazil
| | - Rafael Nigri
- Instituto de Pós-Graduação Médica Carlos Chagas, Av. Beira-Mar 406, gr 503/506, Rio de Janeiro, Brazil
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15
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Luna EB, Janini MER, Lima F, Pontes RRA, Guedes FR, Geller M, da Silva LE, Motta AT, Cunha KS. Craniomaxillofacial morphology alterations in children, adolescents and adults with neurofibromatosis 1: A cone beam computed tomography analysis of a Brazilian sample. Med Oral Patol Oral Cir Bucal 2018; 23:e168-e179. [PMID: 29476678 PMCID: PMC5911357 DOI: 10.4317/medoral.22155] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 09/05/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Oral manifestations are common in neurofibromatosis 1 (NF1), and include jaws and teeth alterations. Our aim was to investigate the craniomaxillofacial morphology of Brazilian children, adolescents and adults with NF1 using cone beam computed tomography. MATERIAL AND METHODS This study was conducted with 36 Brazilian individuals with NF1 with ages ranging from 4 to 75. The participants were submitted to anamnesis, extra and intraoral exam and cephalometric analysis using cone beam computed tomography. Height of the NF1 individuals was compared to the length of jaws and skull base. The results of the cephalometric measurements of the NF1 group were compared with a control group paired by age, gender and skin color. RESULTS Individuals with NF1 had lower maxillary length (p<0.0001), lower mandibular length (p<0.0001), lower skull base length (p<0.0001). In children and adolescents, the mandible was more posteriorly positioned (p=0.01), when compared with the control group. There was no association between jaws and skull base length with the height of the individuals with NF1. CONCLUSIONS Brazilian children, adolescents and adults with NF1 have short mandible, maxilla and skull base. Moreover, children and adolescents present mandibular retrusion.
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Affiliation(s)
- E-B Luna
- School of Medicine, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Av. Marquês do Paraná, 303, 4o andar, sala 01, Centro, Niterói, RJ, Brazil, Zip code: 24033-900,
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Kaufman R, Azevedo VMP, Sá RMGD, Geller M, Xavier RMDA, Chaves RBM, Castier MB. Epidemiological Characteristics and Mortality Predictors in Patients Over 70 Years
Submitted to Coronary Artery Bypass Grafting. International Journal of Cardiovascular Sciences 2018. [DOI: 10.5935/2359-4802.20180020] [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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17
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Bongert M, Gehron J, Geller M, Böning A, Grieshaber P. Bernoulli Effect Aggravates Leg Malperfusion during Extracorporeal Life Support with Femoral Arterial Cannulation: An in Silico Simulation Study. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M. Bongert
- Fachhochschule Dortmund, FB Maschinenbau, Forschungsschwerpunkt Biomedizintechnik, Dortmund, Germany
| | - J. Gehron
- Klinik für Herz-, Kinderherz- und Gefäßchirurgie, Universitätsklinikum Giessen, Giessen, Germany
| | - M. Geller
- Fachhochschule Dortmund, FB Maschinenbau, Forschungsschwerpunkt Biomedizintechnik, Dortmund, Germany
| | - A. Böning
- Klinik für Herz-, Kinderherz- und Gefäßchirurgie, Universitätsklinikum Giessen, Giessen, Germany
| | - P. Grieshaber
- Klinik für Herz-, Kinderherz- und Gefäßchirurgie, Universitätsklinikum Giessen, Giessen, Germany
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18
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Rozza-de-Menezes RE, Gaglionone NC, Andrade-Losso RM, Siqueira OHK, Almeida LM, Peruzini KDS, Guimarães-Filho MAC, Brum CI, Geller M, Cunha KS. Receptor of ghrelin is expressed in cutaneous neurofibromas of individuals with neurofibromatosis 1. Orphanet J Rare Dis 2017; 12:186. [PMID: 29262839 PMCID: PMC5738781 DOI: 10.1186/s13023-017-0734-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 12/05/2017] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Multiple cutaneous neurofibromas are a hallmark of neurofibromatosis 1 (NF1). They begin to appear during puberty and increase in number and volume during pregnancy, suggesting a hormonal influence. Ghrelin is a hormone that acts via growth hormone secretagogue receptor (GHS-R), which is overexpressed in many neoplasms and is involved in tumorigenesis. We aimed to investigate GHS-R expression in NF1 cutaneous neurofibromas and its relationship with tumors volume, and patient's age and gender. RESULTS Sample comprised 108 cutaneous neurofibromas (55 large and 53 small tumors) from 55 NF1 individuals. GHS-R expression was investigated by immunohistochemistry in tissue micro and macroarrays and quantified using a digital computer-assisted method. All neurofibromas expressed GHS-R, with a percentage of positive cells ranging from 4.9% to 76.1%. Large neurofibromas expressed more GHS-R than the small ones. The percentage of GHS-R-positive cells and intensity of GHS-R expression were positively correlated with neurofibromas volume. GHS-R expression was more common in female gender. CONCLUSIONS GHS-R is expressed in cutaneous neurofibromas. Larger neurofibromas have a higher percentage of positive cells and higher GHS-R intensity. Based on our results we speculate that ghrelin may have an action on the tumorigenesis of cutaneous neurofibromas. Future studies are required to understand the role of ghrelin in the pathogenesis of NF1-associated cutaneous neurofibroma.
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Affiliation(s)
- Rafaela E. Rozza-de-Menezes
- Graduate Program in Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Av. Marquês do Paraná, 303, 4o andar, sala 01 – Centro, Niterói, RJ 24033-900 Brazil
- Neurofibromatosis National Center (Centro Nacional de Neurofibromatose), Rio de Janeiro, RJ Brazil
- School of Dentistry, Health Institute of Nova Friburgo, Universidade Federal Fluminense, Nova Friburgo, RJ Brazil
| | - Nicolle C. Gaglionone
- Graduate Program in Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Av. Marquês do Paraná, 303, 4o andar, sala 01 – Centro, Niterói, RJ 24033-900 Brazil
| | - Raquel M. Andrade-Losso
- Graduate Program in Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Av. Marquês do Paraná, 303, 4o andar, sala 01 – Centro, Niterói, RJ 24033-900 Brazil
- Neurofibromatosis National Center (Centro Nacional de Neurofibromatose), Rio de Janeiro, RJ Brazil
| | - Orlando H. K. Siqueira
- Department of General and Specialized Surgery, School of Medicine, Universidade Federal Fluminense, Niterói, RJ Brazil
| | - Lilian M. Almeida
- Graduate Program in Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Av. Marquês do Paraná, 303, 4o andar, sala 01 – Centro, Niterói, RJ 24033-900 Brazil
- Neurofibromatosis National Center (Centro Nacional de Neurofibromatose), Rio de Janeiro, RJ Brazil
| | | | - Marco A. C. Guimarães-Filho
- Department of General and Specialized Surgery, School of Medicine, Universidade Federal Fluminense, Niterói, RJ Brazil
| | - Carolina I. Brum
- Department of Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ Brazil
| | - Mauro Geller
- Department of Immunology and Microbiology, School of Medicine, Centro Universitário Serra dos Órgãos (UNIFESO), Teresópolis, RJ Brazil
- Instituto de Puericultura e Pediatria Martagão Gesteira, School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ Brazil
| | - Karin S. Cunha
- Graduate Program in Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Av. Marquês do Paraná, 303, 4o andar, sala 01 – Centro, Niterói, RJ 24033-900 Brazil
- Neurofibromatosis National Center (Centro Nacional de Neurofibromatose), Rio de Janeiro, RJ Brazil
- Department of Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ Brazil
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Batista RS, Gomes AP, Dutra Gazineo JL, Balbino Miguel PS, Santana LA, Oliveira L, Geller M. Meningococcal disease, a clinical and epidemiological review. ASIAN PAC J TROP MED 2017; 10:1019-1029. [PMID: 29203096 DOI: 10.1016/j.apjtm.2017.10.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 08/29/2017] [Accepted: 09/28/2017] [Indexed: 11/29/2022] Open
Abstract
Meningococcal disease is the acute infection caused by Neisseria meningitidis, which has humans as the only natural host. The disease is widespread around the globe and is known for its epidemical potential and high rates of lethality and morbidity. The highest number of cases of the disease is registered in the semi-arid regions of sub-Saharan Africa. In Brazil, it is endemic with occasional outbreaks, epidemics and sporadic cases occurring throughout the year, especially in the winter. The major epidemics of the disease occurred in Brazil in the 70's caused by serogroups A and C. Serogroups B, C and Y represent the majority of cases in Europe, the Americas and Australia. However, there has been a growing increase in serogroup W in some areas. The pathogen transmission happens for respiratory route (droplets) and clinically can lead to meningitis and sepsis (meningococcemia). The treatment is made with antimicrobial and supportive care. For successful prevention, we have some measures like vaccination, chemoprophylaxis and droplets' precautions. In this review, we have described and clarify clinical features of the disease caused by N. meningitidis regarding its relevance for healthcare professionals.
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Affiliation(s)
- Rodrigo Siqueira Batista
- Laboratório de Agentes Patogênicos, Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa, MG, Brazil; Curso de Medicina, Faculdade Dinâmica do Vale do Piranga, Ponte Nova, MG, Brazil.
| | - Andréia Patrícia Gomes
- Laboratório de Agentes Patogênicos, Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa, MG, Brazil
| | - Jorge Luiz Dutra Gazineo
- Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paulo Sérgio Balbino Miguel
- Laboratório de Agentes Patogênicos, Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa, MG, Brazil
| | - Luiz Alberto Santana
- Laboratório de Agentes Patogênicos, Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa, MG, Brazil
| | - Lisa Oliveira
- Curso de Medicina, Centro Universitário Serra dos Órgãos (UNIFESO), Teresópolis, RJ, Brazil
| | - Mauro Geller
- School of Medicine, New York University - NYU, New York, USA; Departamento de Genética Médica, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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Motta M, Geller M, Motta C. Cutaneous Neurofibroma of the Lacrimal Caruncule: A Case Report. Case Rep Ophthalmol 2017; 8:358-361. [PMID: 28690538 PMCID: PMC5498952 DOI: 10.1159/000477577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 05/15/2017] [Indexed: 11/29/2022] Open
Abstract
We describe the case of a neurofibroma on the lacrimal caruncle of a female patient with neurofibromatosis type 1 (NF1). NF1 is an autosomal dominant genetic disease with a wide variety of clinical manifestations, one of the most common of which is neurofibroma. The lesion was removed surgically under general anesthesia and sent to histopathological analysis, which confirmed the clinical diagnosis of a neurofibroma.
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Affiliation(s)
- Mario Motta
- Ophthalmology Department, Hospital Universitário Gaffrée e Guinle (UNIRIO), Rio de Janeiro, Brazil.,Ophthalmology Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil
| | - Mauro Geller
- Clinical Genetics, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Microbiology and Immunology, Faculdade de Medicina de Teresópolis (UNIFESO), Teresópolis, Brazil.,Internal Medicine, Hospital Albert Einstein, São Paulo, Brazil
| | - Cesar Motta
- Ophthalmology Department, Hospital Universitário Gaffrée e Guinle (UNIRIO), Rio de Janeiro, Brazil
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Goldberg H, Mibielli MA, Nunes CP, Goldberg SW, Buchman L, Mezitis SGE, Rzetelna H, Oliveira L, Geller M, Wajnsztajn F. A double-blind, randomized, comparative study of the use of a combination of uridine triphosphate trisodium, cytidine monophosphate disodium, and hydroxocobalamin, versus isolated treatment with hydroxocobalamin, in patients presenting with compressive neuralgias. J Pain Res 2017; 10:397-404. [PMID: 28243144 PMCID: PMC5317309 DOI: 10.2147/jpr.s123045] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
CONTEXT This paper reports on the results of treatment of compressive neuralgia using a combination of nucleotides (uridine triphosphate trisodium [UTP] and cytidine monophosphate disodium [CMP]) and vitamin B12. OBJECTIVES To assess the safety and efficacy of the combination of nucleotides (UTP and CMP) and vitamin B12 in patients presenting with neuralgia arising from neural compression associated with degenerative orthopedic alterations and trauma, and to compare these effects with isolated administration of vitamin B12. METHODS A randomized, double-blind, controlled trial, consisting of a 30-day oral treatment period: Group A (n=200) receiving nucleotides + vitamin B12, and Group B (n=200) receiving vitamin B12 alone. The primary study endpoint was the percentage of subjects presenting pain visual analog scale (VAS) scores ≤20 at end of study treatment period. Secondary study endpoints included the percentage of subjects presenting improvement ≥5 points on the patient functionality questionnaire (PFQ); percentage of subjects presenting pain reduction (reduction in VAS scores at study end in relation to pretreatment); and number of subjects presenting adverse events. RESULTS The results of this study showed a more expressive improvement in efficacy evaluations among subjects treated with the combination of nucleotides + vitamin B12, with a statistically significant superiority of the combination in pain reduction (evidenced by VAS scores). There were adverse events in both treatment groups, but these were transitory and no severe adverse event was recorded during the study period. Safety parameters were maintained throughout the study in both treatment groups. CONCLUSION The combination of uridine, cytidine, and vitamin B12 was safe and effective in the treatment of neuralgias arising from neural compression associated with degenerative orthopedic alterations and trauma.
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Affiliation(s)
| | | | | | | | - Luiz Buchman
- Instituto de Pós-Graduação Médica Carlos Chagas (ICC), Rio de Janeiro, Brazil
| | - Spyros GE Mezitis
- New York-Presbyterian Hospital/Weill-Cornell Medical Center, New York, NY, USA
| | - Helio Rzetelna
- Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Fernanda Wajnsztajn
- New York-Presbyterian Hospital/Columbia University Medical Center, Neurology, New York, NY, USA
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Cunha KS, Oliveira NS, Fausto AK, de Souza CC, Gros A, Bandres T, Idrissi Y, Merlio JP, de Moura Neto RS, Silva R, Geller M, Cappellen D. Hybridization Capture-Based Next-Generation Sequencing to Evaluate Coding Sequence and Deep Intronic Mutations in the NF1 Gene. Genes (Basel) 2016; 7:genes7120133. [PMID: 27999334 PMCID: PMC5192509 DOI: 10.3390/genes7120133] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 11/29/2016] [Accepted: 12/07/2016] [Indexed: 12/25/2022] Open
Abstract
Neurofibromatosis 1 (NF1) is one of the most common genetic disorders and is caused by mutations in the NF1 gene. NF1 gene mutational analysis presents a considerable challenge because of its large size, existence of highly homologous pseudogenes located throughout the human genome, absence of mutational hotspots, and diversity of mutations types, including deep intronic splicing mutations. We aimed to evaluate the use of hybridization capture-based next-generation sequencing to screen coding and noncoding NF1 regions. Hybridization capture-based next-generation sequencing, with genomic DNA as starting material, was used to sequence the whole NF1 gene (exons and introns) from 11 unrelated individuals and 1 relative, who all had NF1. All of them met the NF1 clinical diagnostic criteria. We showed a mutation detection rate of 91% (10 out of 11). We identified eight recurrent and two novel mutations, which were all confirmed by Sanger methodology. In the Sanger sequencing confirmation, we also included another three relatives with NF1. Splicing alterations accounted for 50% of the mutations. One of them was caused by a deep intronic mutation (c.1260 + 1604A > G). Frameshift truncation and missense mutations corresponded to 30% and 20% of the pathogenic variants, respectively. In conclusion, we show the use of a simple and fast approach to screen, at once, the entire NF1 gene (exons and introns) for different types of pathogenic variations, including the deep intronic splicing mutations.
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Affiliation(s)
- Karin Soares Cunha
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói 24033-900, Brazil.
- Department of Pathology, School of Medicine, Universidade Federal Fluminense, Niterói 24033-900, Brazil.
- Neurofibromatosis National Center (Centro Nacional de Neurofibromatose), Rio de Janeiro 20011-330, Brazil.
| | - Nathalia Silva Oliveira
- Anatomy Pathology Service, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói 24033-900, Brazil.
| | - Anna Karoline Fausto
- Anatomy Pathology Service, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói 24033-900, Brazil.
| | | | - Audrey Gros
- Service de Biologie des Tumeurs, Centre Hospitalier Universitaire de Bordeaux, Hôpital du Haut Lévêque, Pessac F-33604, France.
- Inserm (Institut National de la Santé et de la Recherche Médicale) U1053, Bordeaux Research in Translational Oncology (BaRITON) and University of Bordeaux, Bordeaux F-33076, France.
| | - Thomas Bandres
- Service de Biologie des Tumeurs, Centre Hospitalier Universitaire de Bordeaux, Hôpital du Haut Lévêque, Pessac F-33604, France.
| | - Yamina Idrissi
- Inserm (Institut National de la Santé et de la Recherche Médicale) U1053, Bordeaux Research in Translational Oncology (BaRITON) and University of Bordeaux, Bordeaux F-33076, France.
| | - Jean-Philippe Merlio
- Service de Biologie des Tumeurs, Centre Hospitalier Universitaire de Bordeaux, Hôpital du Haut Lévêque, Pessac F-33604, France.
- Inserm (Institut National de la Santé et de la Recherche Médicale) U1053, Bordeaux Research in Translational Oncology (BaRITON) and University of Bordeaux, Bordeaux F-33076, France.
| | | | - Rosane Silva
- Carlos Chagas Filho Biophysics Institute, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-599, Brazil.
| | - Mauro Geller
- Department of Immunology and Microbiology, School of Medicine, Centro Universitário Serra dos Órgãos, Teresópolis 25964-004, Brazil.
- Martagão Gesteira Child Care and Pediatrics Institute, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-912, Brazil.
| | - David Cappellen
- Service de Biologie des Tumeurs, Centre Hospitalier Universitaire de Bordeaux, Hôpital du Haut Lévêque, Pessac F-33604, France.
- Inserm (Institut National de la Santé et de la Recherche Médicale) U1053, Bordeaux Research in Translational Oncology (BaRITON) and University of Bordeaux, Bordeaux F-33076, France.
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Kurzmann A, Merkel B, Labud PA, Ludwig A, Wieck AD, Lorke A, Geller M. Optical Blocking of Electron Tunneling into a Single Self-Assembled Quantum Dot. Phys Rev Lett 2016; 117:017401. [PMID: 27419589 DOI: 10.1103/physrevlett.117.017401] [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] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Indexed: 06/06/2023]
Abstract
Time-resolved resonance fluorescence (RF) is used to analyze electron tunneling between a single self-assembled quantum dot (QD) and an electron reservoir. In equilibrium, the RF intensity reflects the average electron occupation of the QD and exhibits a gate voltage dependence that is given by the Fermi distribution in the reservoir. In the time-resolved signal, however, we find that the relaxation rate for electron tunneling is, surprisingly, independent of the occupation in the charge reservoir-in contrast to results from all-electrical transport measurements. Using a master equation approach, which includes both the electron tunneling and the optical excitation or recombination, we are able to explain the experimental data by optical blocking, which also reduces the electron tunneling rate when the QD is occupied by an exciton.
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Affiliation(s)
- A Kurzmann
- Fakultät für Physik and CENIDE, Universität Duisburg-Essen, Lotharstraße 1, Duisburg 47048, Germany
| | - B Merkel
- Fakultät für Physik and CENIDE, Universität Duisburg-Essen, Lotharstraße 1, Duisburg 47048, Germany
| | - P A Labud
- Chair of Applied Solid State Physics, Ruhr-Universität Bochum, Universitätsstraße 150, 44780 Bochum, Germany
| | - A Ludwig
- Chair of Applied Solid State Physics, Ruhr-Universität Bochum, Universitätsstraße 150, 44780 Bochum, Germany
| | - A D Wieck
- Chair of Applied Solid State Physics, Ruhr-Universität Bochum, Universitätsstraße 150, 44780 Bochum, Germany
| | - A Lorke
- Fakultät für Physik and CENIDE, Universität Duisburg-Essen, Lotharstraße 1, Duisburg 47048, Germany
| | - M Geller
- Fakultät für Physik and CENIDE, Universität Duisburg-Essen, Lotharstraße 1, Duisburg 47048, Germany
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Geller M, Mibielli MA, Nunes CP, da Fonseca ADS, Goldberg SW, Oliveira L. Comparison of the action of diclofenac alone versus diclofenac plus B vitamins on mobility in patients with low back pain. J Drug Assess 2016; 5:1-3. [PMID: 27785373 PMCID: PMC5039993 DOI: 10.3109/21556660.2016.1163263] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 02/25/2016] [Indexed: 11/13/2022] Open
Abstract
Objective: To assess results of the finger-to-floor distance (FFD) and the Schober test performed during the DOLOR study, and to verify correlation between Visual Analog Pain Scale scores (VAS) with these measures. Research design and methods: Previously tabulated data from the Clinical Research Forms of the DOLOR study were analyzed (statistical significance defined with a two-tailed p value < 0.05 and confidence interval of 95%). For continuous variables, the Student’s T- test or analysis of variance (ANOVA) was used, and differences between pre-treatment and Visits 2, 3, and 4 in the absolute number and percentage of patients with no change, improvement, or worsening of the Schober test and the FFD test scores were calculated, and the results were analyzed with the Chi-squared test. Spearman non-parametric correlation was used for correlating VAS scores with FFD and Schober test scores at each study visit. Main outcome measures: FFD, measured in centimeters; Schober test scores. Results: Throughout the treatment period, there was a statistically significant correlation between the VAS scores and the FFD in the total patient population and within treatment groups. This was not observed for the correlation between the Schober’s test scores and the VAS scores. FFD scores within treatment groups improved progressively at each study visit, as did the Schober Test scores. Conclusions: The results of this post-hoc analysis show that combination therapy with diclofenac plus vitamins B1, B6, and B12 had additional positive effects on mobility restoration among the patients of the DOLOR study and serve to highlight the correlation between mobility and pain intensity among patients presenting with low back pain. The two fundamental goals of low back pain therapy are to provide improvements in pain and function. In this sense, the combination of diclofenac with the B vitamins was particularly effective in achieving both of these goals.
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Affiliation(s)
- Mauro Geller
- Teresópolis Medical School, UNIFESO , Rio de Janeiro , Brazil
| | | | | | | | | | - Lisa Oliveira
- Teresópolis Medical School, UNIFESO , Rio de Janeiro , Brazil
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25
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Silverman SL, Wang A, Cheng L, Yang Y, Libanati C, Geller M, Grauer A, Nevitt M, Revicki D, Viswanathan HN. Comorbidity indices for clinical trials: adaptation of two existing indices for use with the FREEDOM trial in women with postmenopausal osteoporosis. Osteoporos Int 2016; 27:75-80. [PMID: 26174879 PMCID: PMC4715856 DOI: 10.1007/s00198-015-3215-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 06/15/2015] [Indexed: 12/15/2022]
Abstract
UNLABELLED Two comorbidity indices were adapted for use in the FREEDOM trial and significantly correlated with the number of medications and impaired health status at baseline. The indices have applications for the analysis of clinical trial data and would allow for the appropriate adjustment of comorbidities when evaluating clinical trial outcomes. INTRODUCTION The purpose of this study is to adapt two published comorbidity indices for use with the FREEDOM clinical trial evaluating postmenopausal women with osteoporosis. METHODS FREEDOM enrolled women aged 60-90 years with a bone mineral density T-score <-2.5 at the lumbar spine or total hip and ≥-4.0 at both sites. Comorbidity indices were calculated using methods described by Sangha (Arthritis Rheum 49:156-163, 2003) and Wolfe (J Rheumatol 37:305-315, 2010) following modification. The adapted Sangha index included 12 conditions with a summary score of 0-12; the adapted Wolfe index included 7 conditions with a weighted summary score of 0-8. Higher scores indicated greater comorbidity. A panel of clinicians independently reviewed subjects' medical histories using a systematic process based on Medical Dictionary for Regulatory Activities (MedDRA) preferred terms to map specified comorbid conditions. Spearman correlations between the adapted indices and baseline subject characteristics expected to be associated with comorbidities were examined. RESULTS Of the 7808 subjects in this study, 74 % had ≥1 comorbidities based on the adapted Sangha or Wolfe comorbidity indices. The mean (SD) adapted Sangha and Wolfe comorbidity indices were 1.4 (1.2) and 1.4 (1.3), respectively. Both indices correlated positively with age, body mass index, and the number of medications (r = 0.54 to 0.55) at baseline and inversely correlated with health-related quality of life (r = -0.22 to -0.30) (all P < 0.0001). Further, when either the adapted Sangha or Wolfe index was included as a covariate for assessing mortality over 36 months in the FREEDOM population, the hazard ratio of the comorbidity index indicated that the mortality risk increased by 27 or 28 %, respectively, for each unit increase in the adapted index (both P < 0.0001). CONCLUSIONS Our work suggests these comorbidity indices may be adapted for use with clinical trial data, thereby allowing for the appropriate adjustment and reporting of covariates in the evaluation of clinical trial outcomes in an osteoporotic population.
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Affiliation(s)
- S L Silverman
- UCLA School of Medicine, and OMC Clinical Research Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
- , 8641 Wilshire Blvd, Suite 301, Beverly Hills, CA, 90211, USA.
| | - A Wang
- Amgen Inc., Thousand Oaks, CA, USA
| | - L Cheng
- Amgen Inc., Thousand Oaks, CA, USA
| | - Y Yang
- Amgen Inc., Thousand Oaks, CA, USA
| | | | - M Geller
- Amgen Inc., Thousand Oaks, CA, USA
| | - A Grauer
- Amgen Inc., Thousand Oaks, CA, USA
| | - M Nevitt
- University of California San Francisco, San Francisco, CA, USA
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Geller M, Oliveira L, Cunha KS. Mini Review: Potential Role of Hormones in the Tumors of Neurofibromatosis Type-1. J Mol Genet Med 2016. [DOI: 10.4172/1747-0862.1000226] [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: 11/09/2022] Open
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Abstract
This paper aims to provide an update on the main aspects of sepsis, a very relevant health care issue. A number of hypotheses have been proposed to explain its origin, involving interactions between microorganisms and the innate immune system, inflammation/immune mediation and the coagulation system. The clinical features of sepsis are variable and depend on the primary site of infection. The identification of early signs and symptoms is crucial for starting therapeutic measures fundamentally based on volume resuscitation, antibiotic therapy, use of steroids, anticoagulant therapy, biologic viability maintenance interventions and nutritional support.
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Affiliation(s)
| | | | | | | | | | | | | | - Mauro Geller
- Universidade Federal de Viçosa, Viçosa, MG, Brasil
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Canuto KS, Sergio LPS, Guimarães OR, Geller M, Paoli F, Fonseca AS. Low-level red laser therapy alters effects of ultraviolet C radiation on Escherichia coli cells. ACTA ACUST UNITED AC 2015; 48:939-44. [PMID: 26445338 PMCID: PMC4617121 DOI: 10.1590/1414-431x20154459] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 04/23/2015] [Indexed: 11/29/2022]
Abstract
Low-level lasers are used at low power densities and doses according to clinical
protocols supplied with laser devices or based on professional practice. Although use
of these lasers is increasing in many countries, the molecular mechanisms involved in
effects of low-level lasers, mainly on DNA, are controversial. In this study, we
evaluated the effects of low-level red lasers on survival, filamentation, and
morphology of Escherichia colicells that were exposed to ultraviolet
C (UVC) radiation. Exponential and stationary wild-type and
uvrA-deficientE. coli cells were exposed to a
low-level red laser and in sequence to UVC radiation. Bacterial survival was
evaluated to determine the laser protection factor (ratio between the number of
viable cells after exposure to the red laser and UVC and the number of viable cells
after exposure to UVC). Bacterial filaments were counted to obtain the percentage of
filamentation. Area-perimeter ratios were calculated for evaluation of cellular
morphology. Experiments were carried out in duplicate and the results are reported as
the means of three independent assays. Pre-exposure to a red laser protected
wild-type and uvrA-deficient E. coli cells against
the lethal effect of UVC radiation, and increased the percentage of filamentation and
the area-perimeter ratio, depending on UVC fluence and physiological conditions in
the cells. Therapeutic, low-level red laser radiation can induce DNA lesions at a
sub-lethal level. Consequences to cells and tissues should be considered when
clinical protocols based on this laser are carried out.
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Affiliation(s)
- K S Canuto
- Centro de Ciências da Saúde, Centro Universitário Serra dos =rgãos, Teresópolis, RJ, BR
| | - L P S Sergio
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Rio de Janeiro, RJ, BR
| | - O R Guimarães
- Centro de Ciências da Saúde, Centro Universitário Serra dos =rgãos, Teresópolis, RJ, BR
| | - M Geller
- Centro de Ciências da Saúde, Centro Universitário Serra dos =rgãos, Teresópolis, RJ, BR
| | - F Paoli
- Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, BR
| | - A S Fonseca
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Rio de Janeiro, RJ, BR
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Batista PB, Bertollo EMG, Costa DDS, Eliam L, Cunha KSG, Cunha-Melo JR, Darrigo Junior LG, Geller M, Gianordoli-Nascimento IF, Madeira LG, Mendes HM, Miranda DMD, Mata-Machado NA, Morato EG, Pavarino ÉC, Pereira LB, Rezende NAD, Rodrigues LDO, Sette JBC, Silva CMD, Souza JFD, Souza MLRD, Martins AS, Valadares ER, Vidigal PVT, Waisberg V, Waisberg Y, Rodrigues LOC. Neurofibromatosis: part 2 – clinical management. Arq Neuro-Psiquiatr 2015; 73:531-43. [DOI: 10.1590/0004-282x20150042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 02/20/2015] [Indexed: 11/21/2022]
Abstract
Part 1 of this guideline addressed the differential diagnosis of the neurofibromatoses (NF): neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and schwannomatosis (SCH). NF shares some features such as the genetic origin of the neural tumors and cutaneous manifestations, and affects nearly 80 thousand Brazilians. Increasing scientific knowledge on NF has allowed better clinical management and reduced rate of complications and morbidity, resulting in higher quality of life for NF patients. Most medical doctors are able to perform NF diagnosis, but the wide range of clinical manifestations and the inability to predict the onset or severity of new features, consequences, or complications make NF management a real clinical challenge, requiring the support of different specialists for proper treatment and genetic counseling, especially in NF2 and SCH. The present text suggests guidelines for the clinical management of NF, with emphasis on NF1.
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Fernandes PV, Castro MMD, Fuchs A, Machado MCDR, Oliveira FDD, Silva LB, Rosa LF, Azevedo VMP, Geller M, Kaufman R. Predictive Value of the Framingham Risk Score in Identifying High Cardiovascular Risk. International Journal of Cardiovascular Sciences 2015. [DOI: 10.5935/2359-4802.20150002] [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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Kaufman R, Azevedo VMP, Xavier RMDA, Geller M, Chaves RBM, Castier MB. Evolution of Heart Failure-related Hospital Admissions and Mortality Rates: a 12-Year Analysis. International Journal of Cardiovascular Sciences 2015. [DOI: 10.5935/2359-4802.20150040] [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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Gama CR, Lasmar R, Gama GF, Abreu CS, Nunes CP, Geller M, Oliveira L, Santos A. Clinical Assessment of Tribulus terrestris Extract in the Treatment of Female Sexual Dysfunction. Clin Med Insights Womens Health 2014; 7:45-50. [PMID: 25574150 PMCID: PMC4275110 DOI: 10.4137/cmwh.s17853] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 08/21/2014] [Accepted: 11/19/2014] [Indexed: 01/04/2023]
Abstract
This is a qualitative–quantitative study based on hospital records of female patients of reproductive age, presenting sexual dysfunction, and treated with 250 mg Tribulus terrestris extract (1 tablet thrice daily for 90 days). Safety monitoring included vital signs, physical examination, laboratory tests, and occurrence of adverse events. Efficacy analysis included results of the Female Sexual Function Index (FSFI), dehydroepiandrosterone (DHEA) levels together with total and free testosterone, and the patient and physician assessments. There was a statistically significant improvement in total FSFI scores (P < 0.0001) post-treatment, with improvement among 106 (88.33%) subjects. There was a statistically significant (P < 0.0001) increase in the level of DHEA, while the levels of both serum testosterone (P = 0.284) and free testosterone decreased (P < 0.0001). Most adverse events recorded were related to the gastrointestinal tract. Physical examination showed no significant changes post-treatment. Based on the results, it is concluded that the T. terrestris extract is safe and effective in the treatment of female sexual dysfunction.
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Affiliation(s)
- Carlos Rb Gama
- Department of Gynecology-Universidade Estadual Paulista (UNESP) São Paulo-SP, Brazil. ; Department of Gynecology-Fundação Educacional Serra dos Órgãos (UNIFESO) Teresópolis-RJ, Brazil. ; Colégio Brasileiro de Cirurgiões-Rio de Janeiro-RJ, Brazil. ; Department of Gynecologic Endoscopy-UNIFESO Teresópolis-RJ, Brazil
| | - Ricardo Lasmar
- Department of Gynecology-Universidade Estadual Paulista (UNESP) São Paulo-SP, Brazil. ; Department of Gynecology-Universidade Federal Fluminense (UFF) Rio de Janeiro, RJ, Brazil
| | - Gustavo F Gama
- Department of Gynecologic Endoscopy-UNIFESO Teresópolis-RJ, Brazil. ; Department of Gynecology & Obstetrics Service-Hospital das Clínicas-UNIFESO Teresópolis-RJ, Brazil
| | - Camila S Abreu
- Department of Pharmaceutics-Universidade Federal do Rio de Janeiro (UFRJ) Rio de Janeiro-RJ, Brazil
| | - Carlos P Nunes
- Department of Internal Medicine-UNIFESO Teresópolis-RJ, Brazil. ; Department of Clinical Immunology-Instituto de Pós-Graduação Médica Carlos Chagas (IPGMCC) Rio de Janeiro-RJ, Brazil
| | - Mauro Geller
- Department of Clinical Immunology-Instituto de Pós-Graduação Médica Carlos Chagas (IPGMCC) Rio de Janeiro-RJ, Brazil. ; Department of Immunology-UNIFESO Teresópolis-RJ, Brazil
| | - Lisa Oliveira
- Researcher in Immunology and Microbiology-UNIFESO Teresópolis-RJ, Brazil
| | - Alessandra Santos
- Department of Clinical Immunology-Instituto de Pós-Graduação Médica Carlos Chagas (IPGMCC) Rio de Janeiro-RJ, Brazil. ; Department of Clinical Genetics-UFRJ Rio de Janeiro-RJ, Brazil
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Cunha KSG, Rozza-de-Menezes RE, Andrade RM, Theos A, Luiz RR, Korf B, Geller M. Validity and interexaminer reliability of a new method to quantify skin neurofibromas of neurofibromatosis 1 using paper frames. Orphanet J Rare Dis 2014; 9:202. [PMID: 25475340 PMCID: PMC4267434 DOI: 10.1186/s13023-014-0202-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 11/25/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Skin neurofibromas represent one of the main clinical manifestations of neurofibromatosis 1, and their number varies greatly between individuals. Quantifying their number is an important step in the methodology of many clinical studies, but counting neurofibromas one by one in individuals with thousands of tumors is arduous, time-consuming, and subject to intra and interexaminer variability. We aimed to evaluate the efficacy of a new methodology for skin neurofibromas quantification using paper frames. METHODS The sample comprised 92 individuals with NF1. Paper frames, with a central square measuring 100 cm2, were placed on the back, abdomen and thigh. Images were taken, transferred to a computer and two independent examiners counted the neurofibromas. The average number of neurofibromas/100 cm2 of skin was obtained from the mean of the three values. The differences in the quantity of neurofibromas counted by two examiners were evaluated with Intraclass correlation coefficient (ICC), paired t-test, Bland-Altman and survival-agreement plots. To evaluate the predictive value of the method in obtaining the total number of neurofibromas, 49 participants also had their tumors counted one by one. Reproducibility was assessed with Pearson's correlation coefficients and simple linear regression model. RESULTS There was excellent agreement between examiners (ICC range 0.992-0.997) and the total number of skin neurofibromas could be predicted by the adhesive frames technique using a specific formula (P < 0.0001). CONCLUSIONS In this article we describe a reliable, easy and rapid technique using paper frames to quantify skin neurofibromas that accurately predicts the total number of these tumors in patients with NF1. This method may be a useful tool in clinical practice and clinical research to help achieve an accurate quantitative phenotype of NF1.
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Affiliation(s)
- Karin SG Cunha
- />Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Rio de Janeiro, Brazil
- />Neurofibromatosis National Center (Centro Nacional de Neurofibromatose), Rio de Janeiro, Brazil
| | - Rafaela E Rozza-de-Menezes
- />Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Rio de Janeiro, Brazil
- />Neurofibromatosis National Center (Centro Nacional de Neurofibromatose), Rio de Janeiro, Brazil
| | - Raquel M Andrade
- />Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Rio de Janeiro, Brazil
- />Neurofibromatosis National Center (Centro Nacional de Neurofibromatose), Rio de Janeiro, Brazil
| | - Amy Theos
- />Children’s South Specialty Clinic, University of Alabama at Birmingham, Alabama, USA
| | - Ronir R Luiz
- />Instituto de Estudos de Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bruce Korf
- />Department of Genetics, School of Medicine, University of Alabama at Birmingham, Alabama, USA
| | - Mauro Geller
- />Neurofibromatosis National Center (Centro Nacional de Neurofibromatose), Rio de Janeiro, Brazil
- />Department of Immunology and Microbiology, School of Medicine, Centro Universitário Serra dos Órgãos, Rio de Janeiro, Brazil
- />Instituto de Puericultura e Pediatria Martagão Gesteira, School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Rivard C, Geller M, Isaksson Vogel R, Schnettler E, Saluja M, Saluja A, Ramakrishnan S. Minnelide: A promising new therapy for ovarian cancer. Gynecol Oncol 2014. [DOI: 10.1016/j.ygyno.2014.07.021] [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: 11/27/2022]
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Slaibi ÉB, Daher JGL, Fonseca GGGD, Daher CM, Geller M, Ribeiro MG. Repercussões clínicas e radiológicas do neurofibroma plexiforme na região pélvica. Radiol Bras 2014; 47:326-8. [PMID: 25741110 PMCID: PMC4341387 DOI: 10.1590/0100-3984.2012.1648] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 11/19/2013] [Accepted: 11/19/2013] [Indexed: 11/22/2022] Open
Abstract
The authors report the case of a plexiform neurofibroma located in the pelvis,
affecting the bladder, prostate and spine (lumbar/sacral), followed-up for three
years and six months. Surgical removal was contraindicated and the patient underwent
biannual clinical and radiological follow-up that did not demonstrate any tumor
increase. The clinical manifestations of neurofibromatosis type 1 are variable, and
the medical team should be attentive to further investigations, considering possible
unexpected rare findings. Large pelvic masses may correspond to plexiform
neurofibromas, so the diagnostic hypothesis of neurofibromatosis should be taken into
consideration.
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Affiliation(s)
| | | | | | | | - Mauro Geller
- Instituto de Pós-Graduação Médica Carlos Chagas, Brasil
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Geller M, Wagman R, Ho P, Siddhanti S, Stehman-Breen C, Watts N, Papapoulos S. SAT0479 Early Findings from Prolia® Post-Marketing Safety Surveillance for Atypical Femoral Fracture, Osteonecrosis of the Jaw, Severe Symptomatic Hypocalcemia, and Anaphylaxis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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37
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Rodrigues LOC, Batista PB, Goloni-Bertollo EM, Souza-Costa DD, Eliam L, Eliam M, Cunha KSG, Darrigo Junior LG, Ferraz Filho JRL, Geller M, Gianordoli-Nascimento IF, Madeira LG, Malloy-Diniz LF, Mendes HM, Miranda DMD, Pavarino EC, Baptista-Pereira L, Rezende NA, Rodrigues LDO, Silva CMD, Souza JFD, Souza MLRD, Stangherlin A, Valadares ER, Vidigal PVT. Neurofibromatoses: part 1 ? diagnosis and differential diagnosis. Arq Neuro-Psiquiatr 2014; 72:241-50. [DOI: 10.1590/0004-282x20130241] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 11/25/2013] [Indexed: 11/22/2022]
Abstract
Neurofibromatoses (NF) are a group of genetic multiple tumor growing predisposition diseases: neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and schwannomatosis (SCH), which have in common the neural origin of tumors and cutaneous signs. They affect nearly 80 thousand of Brazilians. In recent years, the increased scientific knowledge on NF has allowed better clinical management and reduced complication morbidity, resulting in higher quality of life for NF patients. In most cases, neurology, psychiatry, dermatology, clinical geneticists, oncology and internal medicine specialists are able to make the differential diagnosis between NF and other diseases and to identify major NF complications. Nevertheless, due to its great variability in phenotype expression, progressive course, multiple organs involvement and unpredictable natural evolution, NF often requires the support of neurofibromatoses specialists for proper treatment and genetic counseling. This Part 1 offers step-by-step guidelines for NF differential diagnosis. Part 2 will present the NF clinical management.
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Antonio Mibielli M, Pereira Nunes C, Scussel Jr. AB, Suchmacher Neto M, Oliveira L, Geller M. Symptomatic improvement in an acute, non-traumatic spine pain model with a combination of uridine triphosphate, cytidine monophosphate, and hydroxocobalamin. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/pst.2014.21002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Sueblinvong T, Argenta P, Geller M, Downs L, Jonson A, Carson L, Ivy J, Judson Lancaster P. Hyperthermic intraperitoneal chemotherapy with carboplatin for recurrent epithelial ovarian cancer: A pilot study. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.356] [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: 10/26/2022]
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40
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Geller M, Petzel S, Vogel R, Chan D, McClellan M, Gerber M, Cragg J, Jacko J, Sainfort F. A novel approach to palliative care and end-of-life decision-making: A patient-centered website to promote health care decision-making. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.396] [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: 10/26/2022]
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41
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Hunt CR, Geller M, Evans C, Vogel R, Ramakrishnan S, Saluja A. A water-soluble analog of triptolide induces ovarian cancer cell death in vitro and in vivo. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.372] [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: 10/26/2022]
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42
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Geller M, Petzel S, Vogel R, McClellan M, Jacko J, Cragg J, Gerber M, Chan D, Sainfort F. An interactive website for patients with ovarian cancer and their care givers - can we improve quality of life? Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.411] [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: 10/26/2022]
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43
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Geller M, Knorr D, Pribyl L, Bendzick L, McCullar V, Miller J, Kaufman D. Intraperitoneal delivery of human natural killer cells for treatment of ovarian cancer. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.145] [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: 10/26/2022]
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44
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da Silva Sergio LP, da Silva Marciano R, Teixeira GR, da Silva Canuto K, Polignano GAC, Guimarães OR, Geller M, de Paoli F, de Souza da Fonseca A. Therapeutic low-intensity red laser for herpes labialis on plasmid survival and bacterial transformation. Photochem Photobiol Sci 2013; 12:930-5. [DOI: 10.1039/c3pp25394e] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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45
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Lima Estefan J, Queiroz M, Costa FF, Coutinho MP, Higino K, Clinton Llerena J, Vargas FR, Santos S, Geller M, Ribeiro MG. Clinical characteristics of alopecia areata in Down syndrome. Acta Dermatovenerol Croat 2013; 21:253-258. [PMID: 24476614] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study was undertaken to better understand clinical characteristics, environmental and physical events in Down syndrome (DS) and alopecia areata (AA). This cross-sectional study included 18 DS patients who were currently presenting or had presented AA. We evaluated gender, age, location and type of AA, presence of autoimmune disease or atopy, AA in first-degree relatives, and environmental, physical, and clinical intercurrences. The mean age of study subjects was 11.6 (SD ± 5.5) years and mean age at AA onset 7.2 (2.5 to 15.2) years. The duration of alopecia episodes varied, with a mean of 2.7 (0.1 to 18.7) years. Recurrence of AA was reported in 27.7% (5/18) of subjects, with a mean number of recurrences of 3.6. Localized type AA was seen in 83.4% of individuals, with the most frequent location on the scalp (100%). Seven of the individuals presented atopy. Fourteen individuals had undergone environmental and/or clinical intercurrences. In conclusion, the most frequent presentation of AA in DS is the non-recurrent, localized form on the scalp, with a varied period of duration. Changes in the individuals' routine occurred in more than half of the study group. We suggest further studies of the psychology and immunogenetics in the etiopathology of AA in DS.
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Affiliation(s)
- Juliany Lima Estefan
- Juliany Lima Estefan, MD, MSc, Brigadeiro Trompowsky , Ave s/n - Ilha do Fundão, Rio Janeiro, RJ - Brasil - 21.941-590;
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de Souza da Fonseca A, Mencalha AL, Araújo de Campos VM, Ferreira Machado SC, de Freitas Peregrino AA, Geller M, de Paoli F. DNA repair gene expression in biological tissues exposed to low-intensity infrared laser. Lasers Med Sci 2012; 28:1077-84. [PMID: 22941447 DOI: 10.1007/s10103-012-1191-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 08/20/2012] [Indexed: 12/21/2022]
Abstract
Special properties of laser light have led to its usefulness in many applications in therapy. Excitation of endogenous chromophores in biotissues and generation of free radicals could be involved in its biological effects. DNA lesions induced by free radicals are repaired by base excision repair pathway. In this work, we evaluated the expression of APE1 and OGG1 genes related to repair of DNA lesions induced by free radicals. Skin and muscle tissues of Wistar rats were exposed to low-intensity infrared laser at different fluences and frequencies. After laser exposition of 1 and 24 h, tissue samples were withdrawn for total RNA extraction, cDNA synthesis, and evaluation of APE1 and OGG1 gene expression by quantitative polymerase chain reaction. Data obtained show that laser radiation alters the expression of APE1 and OGG1 mRNA differently in skin and muscle tissues of Wistar rats depending of the fluence, frequency, and time after exposure. Our study suggests that low-intensity infrared laser affects expression of genes involved in repair of DNA lesions by base excision repair pathway.
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Affiliation(s)
- Adenilson de Souza da Fonseca
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier, 524, Maracanã, Rio de Janeiro 20550900, Brazil.
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Calixto-Lima L, Martins de Andrade E, Gomes AP, Geller M, Siqueira-Batista R. Dietetic management in gastrointestinal complications from antimalignant chemotherapy. NUTR HOSP 2012; 27:65-75. [PMID: 22566305 DOI: 10.1590/s0212-16112012000100008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Accepted: 07/23/2011] [Indexed: 11/22/2022] Open
Abstract
Antineoplastic chemotherapy (CT) represents the systemic treatment of malignant tumors. It can be used alone or combined with surgery and / or radiotherapy. The cytotoxic agents used in chemotherapy work on both cancerous cells and noncancerous cells of the body, generally resulting in high toxicity. The biological aggressiveness of chemotherapy particularly affects rapidly replicating cells, such as those of the digestive tract, resulting in adverse effects that impair food intake, leading to compromised nutritional status and which may lead to cachexia. The main toxic effects of chemotherapy in the gastrointestinal tract include nausea, vomiting -these are the most frequent- constipation, diarrhea, xerostomia, mucositis, dysphagia and anorexia. Given the high frequency of such effects, nutritional intervention should be an integral part of cancer treatment, to maintain and/or improve the patient's nutritional status and reduce or minimize the side effects caused by treatment. Accordingly, the goal of this study is to review dietetic conduct in the process of caring for patients undergoing cancer chemotherapy.
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Cunha KSG, Caruso AC, Faria PASD, Silva LED, Pires ARC, Geller M, Lopes VS, Moura-Neto RSD. Malignant peripheral nerve sheath tumors: clinicopathological aspects, expression of p53 and survival. Clinics (Sao Paulo) 2012; 67:963-8. [PMID: 22948467 PMCID: PMC3416905 DOI: 10.6061/clinics/2012(08)18] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Karin S G Cunha
- Post-graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niteroi, RJ, Brazil.
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Papadopoulos NG, Arakawa H, Carlsen KH, Custovic A, Gern J, Lemanske R, Le Souef P, Mäkelä M, Roberts G, Wong G, Zar H, Akdis CA, Bacharier LB, Baraldi E, van Bever HP, de Blic J, Boner A, Burks W, Casale TB, Castro-Rodriguez JA, Chen YZ, El-Gamal YM, Everard ML, Frischer T, Geller M, Gereda J, Goh DY, Guilbert TW, Hedlin G, Heymann PW, Hong SJ, Hossny EM, Huang JL, Jackson DJ, de Jongste JC, Kalayci O, Aït-Khaled N, Kling S, Kuna P, Lau S, Ledford DK, Lee SI, Liu AH, Lockey RF, Lødrup-Carlsen K, Lötvall J, Morikawa A, Nieto A, Paramesh H, Pawankar R, Pohunek P, Pongracic J, Price D, Robertson C, Rosario N, Rossenwasser LJ, Sly PD, Stein R, Stick S, Szefler S, Taussig LM, Valovirta E, Vichyanond P, Wallace D, Weinberg E, Wennergren G, Wildhaber J, Zeiger RS. International consensus on (ICON) pediatric asthma. Allergy 2012; 67:976-97. [PMID: 22702533 PMCID: PMC4442800 DOI: 10.1111/j.1398-9995.2012.02865.x] [Citation(s) in RCA: 259] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2012] [Indexed: 01/08/2023]
Abstract
Asthma is the most common chronic lower respiratory disease in childhood throughout the world. Several guidelines and/or consensus documents are available to support medical decisions on pediatric asthma. Although there is no doubt that the use of common systematic approaches for management can considerably improve outcomes, dissemination and implementation of these are still major challenges. Consequently, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), recently formed by the EAACI, AAAAI, ACAAI, and WAO, has decided to propose an International Consensus on (ICON) Pediatric Asthma. The purpose of this document is to highlight the key messages that are common to many of the existing guidelines, while critically reviewing and commenting on any differences, thus providing a concise reference. The principles of pediatric asthma management are generally accepted. Overall, the treatment goal is disease control. To achieve this, patients and their parents should be educated to optimally manage the disease, in collaboration with healthcare professionals. Identification and avoidance of triggers is also of significant importance. Assessment and monitoring should be performed regularly to re-evaluate and fine-tune treatment. Pharmacotherapy is the cornerstone of treatment. The optimal use of medication can, in most cases, help patients control symptoms and reduce the risk for future morbidity. The management of exacerbations is a major consideration, independent of chronic treatment. There is a trend toward considering phenotype-specific treatment choices; however, this goal has not yet been achieved.
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Affiliation(s)
- N G Papadopoulos
- Department of Allergy, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
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da Silva Marciano R, da Silva Sergio LP, Polignano GAC, Presta GA, Guimarães OR, Geller M, de Paoli S, de Paoli F, da Fonseca ADS. Laser for treatment of aphthous ulcers on bacteria cultures and DNA. Photochem Photobiol Sci 2012; 11:1476-83. [PMID: 22766761 DOI: 10.1039/c2pp25027f] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Low-intensity red lasers are proposed for treatment of oral aphthous ulcers based on biostimulative effects. However, effects of low-intensity lasers at fluences used in clinical protocols on DNA are controversial. The aim of this work was to evaluate the effects of low-intensity red laser on survival and induction of filamentation of Escherichia coli cells, and induction of DNA lesions in bacterial plasmids. Escherichia coli cultures were exposed to laser (660 nm, 100 mW, 25 and 45 J cm(-2)) to study bacterial survival and filamentation. Also, bacterial plasmids were exposed to laser to study DNA lesions by electrophoretic profile and action of DNA repair enzymes. Data indicate that low-intensity red laser: (i) had no effect on survival of E. coli wild type, exonuclease III and formamidopyrimidine DNA glycosylase/MutM protein but decreased the survival of endonuclease III deficient cultures; (ii) induced bacterial filamentation, (iii) there was no alteration in the electrophoretic profile of plasmids in agarose gels, (iv) there was no alteration in the electrophoretic profile of plasmids incubated with formamidopyrimidine DNA glycosylase/MutM protein and endonuclease III enzymes, but it altered the electrophoretic profile of plasmids incubated with exonuclease III. Low-intensity red laser at therapeutic fluences has an effect on the survival of E. coli endonuclease III deficient cells, induces bacterial filamentation in E. coli cultures and DNA lesions targeted by exonuclease III.
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Affiliation(s)
- Roberta da Silva Marciano
- Centro de Ciências da Saúde, Centro Universitário Serra dos Órgãos, Avenida Alberto Torres, 111, Alto, Teresópolis, Rio de Janeiro, 25964004, Brazil
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