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Publisher: SciELO   (Total: 713 journals)

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Showing 1 - 200 of 713 Journals sorted alphabetically
ABCD. Arquivos Brasileiros de Cirurgia Digestiva     Open Access   (Followers: 2, SJR: 0.277, h-index: 5)
ACIMED     Open Access   (Followers: 1)
Acta Agronómica     Open Access   (SJR: 0.11, h-index: 2)
Acta Amazonica     Open Access   (Followers: 5, SJR: 0.32, h-index: 18)
Acta Bioethica     Open Access   (SJR: 0.131, h-index: 4)
Acta Botanica Brasilica     Open Access   (Followers: 3, SJR: 0.364, h-index: 23)
Acta botánica mexicana     Open Access   (Followers: 1, SJR: 0.251, h-index: 6)
Acta Cirurgica Brasileira     Open Access   (SJR: 0.319, h-index: 19)
Acta Limnologica Brasiliensia     Open Access   (Followers: 3, SJR: 0.29, h-index: 6)
Acta Literaria     Open Access   (Followers: 3, SJR: 0.1, h-index: 2)
Acta Medica Colombiana     Open Access   (Followers: 1)
Acta Médica Costarricense     Open Access   (Followers: 2)
Acta Neurológica Colombiana     Open Access   (Followers: 2)
Acta Ortopédica Brasileira     Open Access   (Followers: 1, SJR: 0.288, h-index: 10)
Acta Paulista de Enfermagem     Open Access   (Followers: 2, SJR: 0.242, h-index: 15)
Acta Pediátrica Costarricense     Open Access   (Followers: 1)
Acta Scientiarum. Agronomy     Open Access   (Followers: 5, SJR: 0.961, h-index: 15)
Acta zoológica mexicana     Open Access  
Actualidades Biológicas     Open Access   (Followers: 1)
African Human Rights Law J.     Open Access   (Followers: 18)
African Natural History     Open Access   (Followers: 2, SJR: 0.106, h-index: 4)
Afro-Asia     Open Access  
Ágora - studies in psychoanalytic theory     Open Access   (Followers: 3, SJR: 0.101, h-index: 2)
Agricultura Tecnica     Open Access   (Followers: 5)
Agrociencia     Open Access   (Followers: 1, SJR: 0.213, h-index: 15)
Agrociencia Uruguay     Open Access  
Agronomía Mesoamericana     Open Access  
Aisthesis     Open Access   (Followers: 6, SJR: 0.1, h-index: 1)
Alea : Estudos Neolatinos     Open Access   (Followers: 2, SJR: 0.1, h-index: 3)
Alfa : Revista de Linguística     Open Access  
Alpha (Osorno)     Open Access   (SJR: 0.114, h-index: 3)
Ambiente & sociedade     Open Access   (Followers: 3, SJR: 0.142, h-index: 8)
Ambiente & Agua : An Interdisciplinary J. of Applied Science     Open Access   (Followers: 1, SJR: 0.221, h-index: 4)
Ambiente Construído     Open Access   (Followers: 1)
América Latina en la historia económica     Open Access   (Followers: 2, SJR: 0.148, h-index: 1)
Anais Brasileiros de Dermatologia     Open Access   (Followers: 3, SJR: 0.498, h-index: 23)
Anais da Academia Brasileira de Ciências     Open Access   (Followers: 2, SJR: 0.322, h-index: 42)
Anais do Museu Paulista : História e Cultura Material     Open Access  
Anales de Medicina Interna     Open Access   (Followers: 1)
Anales del Instituto de la Patagonia     Open Access  
Anales del Sistema Sanitario de Navarra     Open Access   (Followers: 1, SJR: 0.196, h-index: 18)
Análise Psicológica     Open Access   (Followers: 1, SJR: 0.129, h-index: 3)
Análise Social     Open Access   (Followers: 1, SJR: 0.109, h-index: 8)
Andean geology     Open Access   (Followers: 11, SJR: 0.997, h-index: 25)
Antipoda. Revista de Antropología y Arqueología     Open Access   (Followers: 5, SJR: 0.1, h-index: 0)
Anuario Colombiano de Historia Social y de la Cultura     Open Access   (SJR: 0.101, h-index: 1)
Anuario de Historia Regional y de las Fronteras     Open Access  
Apuntes : Revista de Estudios sobre Patrimonio Cultural - J. of Cultural Heritage Studies     Open Access   (Followers: 6)
Archivos de Medicina Veterinaria     Open Access   (Followers: 1, SJR: 0.199, h-index: 16)
Archivos de Neurociencias     Open Access   (Followers: 3, SJR: 0.1, h-index: 4)
Archivos de Pediatria del Uruguay     Open Access   (Followers: 3)
Archivos de Zootecnia     Open Access   (Followers: 1, SJR: 0.248, h-index: 9)
Archivos Españoles de Urología     Open Access   (SJR: 0.188, h-index: 19)
ARQ     Open Access   (Followers: 4, SJR: 0.1, h-index: 2)
Arquitectura y Urbanismo     Open Access   (Followers: 3)
Arquivo Brasileiro de Medicina Veterinária e Zootecnia     Open Access   (SJR: 0.307, h-index: 22)
Arquivos Brasileiros de Cardiologia     Open Access   (Followers: 1, SJR: 0.334, h-index: 32)
Arquivos Brasileiros de Endocrinologia e Metabologia     Open Access  
Arquivos Brasileiros de Oftalmologia     Open Access   (SJR: 0.308, h-index: 19)
Arquivos de Gastroenterologia     Open Access   (Followers: 1, SJR: 0.424, h-index: 22)
Arquivos de Medicina     Open Access   (SJR: 0.1, h-index: 5)
Arquivos de Neuro-Psiquiatria     Open Access   (SJR: 0.374, h-index: 38)
Arquivos do Instituto Biológico     Open Access   (Followers: 1)
Arquivos Internacionais de Otorrinolaringologia     Open Access  
ARS     Open Access   (Followers: 3)
Atenea (Concepción)     Open Access   (SJR: 0.111, h-index: 3)
Atmósfera     Open Access   (Followers: 2, SJR: 0.377, h-index: 18)
Audiology - Communication Research     Open Access   (Followers: 8)
Avaliação : Revista da Avaliação da Educação Superior (Campinas)     Open Access  
Avances en Odontoestomatologia     Open Access   (Followers: 1, SJR: 0.109, h-index: 4)
Avances en Periodoncia e Implantología Oral     Open Access   (Followers: 1)
Bakhtiniana : Revista de Estudos do Discurso     Open Access  
BAR. Brazilian Administration Review     Open Access   (Followers: 1, SJR: 0.188, h-index: 6)
Biota Neotropica     Open Access   (SJR: 0.373, h-index: 18)
Biotecnología Aplicada     Open Access   (SJR: 0.122, h-index: 10)
Biotecnología en el Sector Agropecuario y Agroindustrial     Open Access  
Boletim de Ciências Geodésicas     Open Access   (SJR: 0.227, h-index: 5)
Boletim do Museu Paraense Emílio Goeldi. Ciências Humanas     Open Access   (Followers: 1, SJR: 0.139, h-index: 4)
Boletin Chileno de Parasitologia     Open Access  
Boletín de Filología     Open Access  
Boletín de la Sociedad Botánica de México     Open Access  
Boletin de la Sociedad Chilena de Quimica     Open Access  
Boletín de la Sociedad Geológica Mexicana     Open Access   (SJR: 0.231, h-index: 8)
Boletín del Museo Chileno de Arte Precolombino     Open Access   (Followers: 1, SJR: 0.149, h-index: 1)
Bosque     Open Access   (Followers: 2, SJR: 0.256, h-index: 10)
Bragantia     Open Access   (Followers: 2, SJR: 0.522, h-index: 20)
Brazilian Archives of Biology and Technology     Open Access   (Followers: 3, SJR: 0.242, h-index: 31)
Brazilian Dental J.     Open Access   (Followers: 2, SJR: 0.47, h-index: 34)
Brazilian J. of Biology     Open Access   (Followers: 3, SJR: 0.358, h-index: 35)
Brazilian J. of Chemical Engineering     Open Access   (Followers: 4, SJR: 0.424, h-index: 32)
Brazilian J. of Food Technology     Open Access   (Followers: 3)
Brazilian J. of Medical and Biological Research     Open Access   (SJR: 0.541, h-index: 70)
Brazilian J. of Microbiology     Open Access   (Followers: 3, SJR: 0.39, h-index: 38)
Brazilian J. of Oceanography     Open Access   (SJR: 0.285, h-index: 13)
Brazilian J. of Oral Sciences     Open Access   (Followers: 1, SJR: 0.145, h-index: 6)
Brazilian J. of Physical Therapy     Open Access   (SJR: 0.466, h-index: 16)
Brazilian J. of Plant Physiology     Open Access   (Followers: 3, SJR: 0.452, h-index: 32)
Brazilian J. of Veterinary Research and Animal Science     Open Access   (Followers: 7, SJR: 0.184, h-index: 10)
Brazilian Oral Research     Open Access  
Brazilian Political Science Review     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 16, SJR: 2.819, h-index: 123)
Caderno CRH     Open Access   (Followers: 2, SJR: 0.102, h-index: 4)
Caderno de Estudos     Open Access  
Cadernos CEDES     Open Access   (Followers: 1, SJR: 0.111, h-index: 5)
Cadernos de Pesquisa     Open Access   (Followers: 2, SJR: 0.26, h-index: 8)
Cadernos de Saúde Pública     Open Access   (Followers: 1, SJR: 0.593, h-index: 55)
Cadernos de Tradução     Open Access  
Cadernos Metrópole     Open Access   (Followers: 1)
Cadernos Nietzsche     Open Access  
Cadernos Pagu     Open Access   (SJR: 0.179, h-index: 4)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Calidad en la educación     Open Access   (Followers: 1)
Cerâmica     Open Access   (Followers: 4, SJR: 0.19, h-index: 11)
CES Medicina     Open Access  
Chilean J. of Agricultural Research     Open Access   (Followers: 1, SJR: 0.366, h-index: 15)
Chungara (Arica) - Revista de Antropologia Chilena     Open Access   (Followers: 1, SJR: 0.49, h-index: 13)
Ciência & Educação (Bauru)     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2, SJR: 0.588, h-index: 30)
Ciência Animal Brasileira     Open Access   (Followers: 1, SJR: 0.322, h-index: 4)
Ciência da Informação     Open Access   (Followers: 1, SJR: 0.117, h-index: 7)
Ciencia del suelo     Open Access   (Followers: 2, SJR: 0.206, h-index: 13)
Ciência e Agrotecnologia     Open Access   (SJR: 0.444, h-index: 19)
Ciencia e Cultura     Open Access   (Followers: 1)
Ciencia e investigación agraria     Open Access   (Followers: 1, SJR: 0.21, h-index: 10)
Ciencia forestal en México     Open Access  
Ciência Rural     Open Access   (Followers: 2, SJR: 0.389, h-index: 24)
Ciencia y Enfermeria - Revista Iberoamericana de Investigacion     Open Access   (Followers: 3, SJR: 0.165, h-index: 7)
Ciencias Marinas     Open Access   (Followers: 2, SJR: 0.348, h-index: 21)
Ciencias Psicológicas     Open Access  
Cirugia Plastica Ibero-Latinoamericana     Open Access   (SJR: 0.175, h-index: 8)
CLEI Electronic J.     Open Access  
Clínica y Salud     Open Access   (SJR: 0.15, h-index: 3)
Clinics     Open Access   (SJR: 0.525, h-index: 36)
CoDAS     Open Access   (SJR: 0.177, h-index: 12)
Computación y Sistemas     Open Access   (SJR: 0.253, h-index: 4)
Comuni@cción     Open Access  
Comunicación y sociedad     Open Access   (Followers: 2, SJR: 0.104, h-index: 1)
Contaduría y Administración     Open Access   (SJR: 0.103, h-index: 1)
Contexto Internacional     Open Access  
Convergencia     Open Access   (Followers: 2, SJR: 0.112, h-index: 4)
Correo Científico Médico     Open Access  
Corrosão e Protecção de Materiais     Open Access  
Crop Breeding and Applied Biotechnology     Open Access   (Followers: 3, SJR: 0.604, h-index: 13)
Cuadernos de Economía     Open Access   (Followers: 2)
Cuadernos de Economia - Latin American J. of Economics     Open Access   (Followers: 2)
Cuadernos de Historia     Open Access   (Followers: 1)
Cuadernos de Historia de la Salud Publica     Open Access  
Cuadernos de Medicina Forense     Open Access   (Followers: 2, SJR: 0.106, h-index: 4)
Cuadernos.info     Open Access   (SJR: 0.117, h-index: 2)
Cubo. A Mathematical J.     Open Access  
Cuicuilco     Open Access   (Followers: 1)
Cultivos Tropicales     Open Access   (Followers: 1)
Culturales     Open Access   (Followers: 2)
Dados - Revista de Ciências Sociais     Open Access   (SJR: 0.429, h-index: 15)
De Jure     Open Access   (Followers: 1)
DELTA : Documentação de Estudos em Lingüística Teórica e Aplicada     Open Access   (SJR: 0.142, h-index: 5)
Dementia & Neuropsychologia     Open Access   (Followers: 8, SJR: 0.232, h-index: 10)
Dental Press J. of Orthodontics     Open Access   (Followers: 2, SJR: 0.214, h-index: 7)
Desacatos     Open Access   (Followers: 1)
Desarrollo y Sociedad     Open Access   (Followers: 3, SJR: 0.106, h-index: 2)
Diálogo Andino - Revista de Historia, Geografía y Cultura Andina     Open Access  
Diánoia     Open Access   (Followers: 1)
Dimensión Empresarial     Open Access  
Dynamis : Acta Hispanica ad Medicinae Scientiarumque Historiam Illustrandam     Open Access   (Followers: 2, SJR: 0.134, h-index: 7)
e-J. of Portuguese History     Open Access   (Followers: 2, SJR: 0.125, h-index: 2)
Eclética Química     Open Access   (Followers: 1)
Ecología en Bolivia     Open Access  
Economia Aplicada     Open Access   (SJR: 0.168, h-index: 6)
Economia e Sociedade     Open Access  
EconoQuantum     Open Access  
Educação & Sociedade     Open Access   (Followers: 3, SJR: 0.244, h-index: 12)
Educação e Pesquisa     Open Access   (Followers: 1, SJR: 0.171, h-index: 8)
Educação em Revista     Open Access  
Educación Matemática     Open Access  
Educación Médica     Open Access   (Followers: 1, SJR: 0.11, h-index: 7)
Educación Médica Superior     Open Access   (Followers: 1, SJR: 0.188, h-index: 7)
Educación y Educadores     Open Access  
Educar em Revista     Open Access  
EDUMECENTRO     Open Access  
En-Claves del pensamiento     Open Access   (Followers: 1)
Encuentros     Open Access  
Ene : Revista de Enfermería     Open Access  
Enfermería Global     Open Access   (Followers: 3, SJR: 0.14, h-index: 2)
Enfermería Nefrológica     Open Access   (Followers: 1)
Engenharia Agrícola     Open Access   (SJR: 0.396, h-index: 18)
Engenharia Sanitaria e Ambiental     Open Access   (SJR: 0.15, h-index: 10)
Ensaio Avaliação e Políticas Públicas em Educação     Open Access   (Followers: 1, SJR: 0.19, h-index: 6)
Entomologia y Vectores     Open Access   (Followers: 2)
Escritos de Psicología : Psychological Writings     Open Access   (Followers: 2)
Estudios Atacameños     Open Access   (Followers: 2, SJR: 0.418, h-index: 8)
Estudios Constitucionales     Open Access   (Followers: 5, SJR: 0.383, h-index: 5)
Estudios de Cultura Maya     Open Access   (Followers: 2, SJR: 0.167, h-index: 1)
Estudios de Economía     Open Access   (SJR: 0.144, h-index: 7)
Estudios de historia moderna y contemporánea de México     Open Access   (SJR: 0.101, h-index: 3)
Estudios Filologicos     Open Access   (SJR: 0.105, h-index: 3)
Estudios Fronterizos     Open Access   (Followers: 1)
Estudios internacionales     Open Access   (Followers: 5)
Estudios Pedagogicos (Valdivia)     Open Access   (Followers: 1, SJR: 0.209, h-index: 7)
Estudios Políticos     Open Access  
Estudios Sociales     Open Access   (Followers: 2)

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Journal Cover Clinics
  [SJR: 0.525]   [H-I: 36]   [0 followers]  Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Print) 1807-5932 - ISSN (Online) 1980-5322
   Published by SciELO Homepage  [713 journals]
  • Difficulties in the diagnosis and treatment of rare diseases according to
           the perceptions of patients, relatives and health care professionals

    • Abstract: OBJECTIVES: The aim of this study is to present a survey of vulnerabilities and to suggest approaches for the treatment of rare diseases according to the perceptions of a group of affected individuals, patient association representatives and health care professionals. METHODS: The focus group technique was used in interviews with patients and primary caregivers, patient support groups/non-governmental organizations, primary health care professionals and physician specialists. RESULTS: The transcript analysis focused on thematic units, which were tailored to each group and allowed comparisons in search of concordant views. Unanimity was observed in relation to the physical, emotional and social damage to the life standards of the affected individuals and their families as a result of illness. The Brazilian health system was unanimously classified as inadequate to respond to the needs of patients with rare diseases, and this inadequacy led to unpleasant experiences, such as the seemingly endless referrals among health services to reach a final diagnosis and develop a treatment plan. CONCLUSIONS: The complex set of health system requirements necessary to support the care of patients with rare diseases represents an obstacle to successfully meeting the needs of patients and their families. Therefore, it is important to develop specific public policies to create referral services, guarantee access to appropriate therapeutic modalities and incorporate technologies that promote research for developing new, affordable therapies.
       
  • Micromass cultures are effective for differentiation of human amniotic
           fluid stem cells into chondrocytes

    • Abstract: OBJECTIVES: Articular cartilage is vulnerable to injuries and undergoes an irreversible degenerative process. The use of amniotic fluid mesenchymal stromal stem cells for the reconstruction of articular cartilage is a promising therapeutic alternative. The aim of this study was to investigate the chondrogenic potential of amniotic fluid mesenchymal stromal stem cells from human amniotic fluid from second trimester pregnant women in a micromass system (high-density cell culture) with TGF-β3 for 21 days. METHODS: Micromass was performed using amniotic fluid mesenchymal stromal stem cells previously cultured in a monolayer. Chondrocytes from adult human normal cartilage were used as controls. After 21 days, chondrogenic potential was determined by measuring the expression of genes, such as SOX-9, type II collagen and aggrecan, in newly differentiated cells by real-time PCR (qRT-PCR). The production of type II collagen protein was observed by western blotting. Immunohistochemistry analysis was also performed to detect collagen type II and aggrecan. This study was approved by the local ethics committee. RESULTS: SOX-9, aggrecan and type II collagen were expressed in newly differentiated chondrocytes. The expression of SOX-9 was significantly higher in newly differentiated chondrocytes than in adult cartilage. Collagen type II protein was also detected. CONCLUSION: We demonstrate that stem cells from human amniotic fluid are a suitable source for chondrogenesis when cultured in a micromass system. amniotic fluid mesenchymal stromal stem cells are an extremely viable source for clinical applications, and our results suggest the possibility of using human amniotic fluid as a source of mesenchymal stem cells.
       
  • Improvement in lung function and functional capacity in morbidly obese
           women subjected to bariatric surgery

    • Abstract: OBJECTIVE: To determine whether weight loss in women with morbid obesity subjected to bariatric surgery alters lung function, respiratory muscle strength, functional capacity and the level of habitual physical activity and to investigate the relationship between these variables and changes in both body composition and anthropometrics. METHODS: Twenty-four women with morbid obesity were evaluated with regard to lung function, respiratory muscle strength, functional capacity, body composition, anthropometrics and the level of habitual physical activity two weeks prior to and six months after bariatric surgery. RESULTS: Regarding lung function, mean increases of 160 mL in slow vital capacity, 550 mL in expiratory reserve volume, 290 mL in forced vital capacity and 250 mL in forced expiratory volume in the first second as well as a mean reduction of 490 mL in inspiratory capacity were found. Respiratory muscle strength increased by a mean of 10 cmH2O of maximum inspiratory pressure, and a 72-meter longer distance on the Incremental Shuttle Walk Test demonstrated that functional capacity also improved. Significant changes also occurred in anthropometric variables and body composition but not in the level of physical activity detected using the Baecke questionnaire, indicating that the participants remained sedentary. Moreover, correlations were found between the percentages of lean and fat mass and both inspiratory and expiratory reserve volumes. CONCLUSION: The present data suggest that changes in body composition and anthropometric variables exerted a direct influence on functional capacity and lung function in the women analyzed but exerted no influence on sedentarism, even after accentuated weight loss following bariatric surgery.
       
  • Standardization of a spinal cord lesion model and neurologic evaluation
           using mice

    • Abstract: OBJECTIVE: To standardize a spinal cord lesion mouse model. METHODS: Thirty BALB/c mice were divided into five groups: four experimental groups and one control group (sham). The experimental groups were subjected to spinal cord lesion by a weight drop from different heights after laminectomy whereas the sham group only underwent laminectomy. Mice were observed for six weeks, and functional behavior scales were applied. The mice were then euthanized, and histological investigations were performed to confirm and score spinal cord lesion. The findings were evaluated to prove whether the method of administering spinal cord lesion was effective and different among the groups. Additionally, we correlated the results of the functional scales with the results from the histology evaluations to identify which scale is more reliable. RESULTS: One mouse presented autophagia, and six mice died during the experiment. Because four of the mice that died were in Group 5, Group 5 was excluded from the study. All the functional scales assessed proved to be significantly different from each other, and mice presented functional evolution during the experiment. Spinal cord lesion was confirmed by histology, and the results showed a high correlation between the Basso, Beattie, Bresnahan Locomotor Rating Scale and the Basso Mouse Scale. The mouse function scale showed a moderate to high correlation with the histological findings, and the horizontal ladder test had a high correlation with neurologic degeneration but no correlation with the other histological parameters evaluated. CONCLUSION: This spinal cord lesion mouse model proved to be effective and reliable with exception of lesions caused by a 10-g drop from 50 mm, which resulted in unacceptable mortality. The Basso, Beattie, Bresnahan Locomotor Rating Scale and Basso Mouse Scale are the most reliable functional assessments, and but the horizontal ladder test is not recommended.
       
  • Burkholderia cepacia, cystic fibrosis and outcomes following lung
           transplantation: experiences from a single center in Brazil

    • Abstract: OBJECTIVES: To evaluate the impact of Burkholderia cepacia complex colonization in cystic fibrosis patients undergoing lung transplantation. METHODS: We prospectively analyzed clinical data and respiratory tract samples (sputum and bronchoalveolar lavage) collected from suppurative lung disease patients between January 2008 and November 2013. We also subtyped different Burkholderia cepacia complex genotypes via DNA sequencing using primers against the recA gene in samples collected between January 2012 and November 2013. RESULTS: From 2008 to 2013, 34 lung transplants were performed on cystic fibrosis patients at our center. Burkholderia cepacia complex was detected in 13 of the 34 (38.2%) patients. Seven of the 13 (53%) strains were subjected to genotype analysis, from which three strains of B. metallica and four strains of B. cenocepacia were identified. The mortality rate was 1/13 (7.6%), and this death was not related to B. cepacia infection. CONCLUSION: The results of our study suggest that colonization by B. cepacia complex and even B. cenocepacia in patients with cystic fibrosis should not be considered an absolute contraindication to lung transplantation in Brazilian centers.
       
  • Voice deviation, dysphonia risk screening and quality of life in
           individuals with various laryngeal diagnoses

    • Abstract: OBJECTIVES: To characterize the voice quality of individuals with dysphonia and to investigate possible correlations between the degree of voice deviation (D) and scores on the Dysphonia Risk Screening Protocol-General (DRSP), the Voice-Related Quality of Life (V-RQOL) measure and the Voice Handicap Index, short version (VHI-10). METHODS: The sample included 200 individuals with dysphonia. Following laryngoscopy, the participants completed the DRSP, the V-RQOL measure, and the VHI-10; subsequently, voice samples were recorded for auditory-perceptual and acoustic analyses. The correlation between the score for each questionnaire and the overall degree of vocal deviation was analyzed, as was the correlation among the scores for the three questionnaires. RESULTS: Most of the participants (62%) were female, and the mean age of the sample was 49 years. The most common laryngeal diagnosis was organic dysphonia (79.5%). The mean D was 59.54, and the predominance of roughness had a mean of 54.74. All the participants exhibited at least one abnormal acoustic aspect. The mean questionnaire scores were DRSP, 44.7; V-RQOL, 57.1; and VHI-10, 16. An inverse correlation was found between the V-RQOL score and D; however, a positive correlation was found between both the VHI-10 and DRSP scores and D. CONCLUSION: A predominance of adult women, organic dysphonia, moderate voice deviation, high dysphonia risk, and low to moderate quality of life impact characterized our sample. There were correlations between the scores of each of the three questionnaires and the degree of voice deviation. It should be noted that the DRSP monitored the degree of dysphonia severity, which reinforces its applicability for patients with different laryngeal diagnoses.
       
  • Preoperative treatment with 5α-reductase inhibitors and the risk of
           hemorrhagic events in patients undergoing transurethral resection of the
           prostate – A population-based cohort study

    • Abstract: OBJECTIVES: To assess the associations between preoperative treatment with 5-alpha reductase inhibitors and the risks of blood transfusion during transurethral resection of the prostate and blood clot evacuation or emergency department visits for hematuria within 1 month after surgery. METHODS: We used data from the Taiwan National Health Insurance Research Database in this population-based cohort study. A total of 3,126 patients who underwent first-time transurethral resection of the prostate from 2004 to 2013 were identified. Adjusted odds ratios estimated by multiple logistic regression models were used to assess the independent effects of the preoperative use of 5-alpha reductase inhibitors on the risks of perioperative hemorrhagic events after adjustment for potential confounders. RESULTS: Two hundred and ninety-seven (9.4%) patients were treated with 5-alpha reductase inhibitors for <3 months, and 65 (2.1%) patients were treated for ≥3 months prior to undergoing transurethral resection of the prostate. The blood transfusion rates for patients who were not treated with 5-alpha reductase inhibitors (controls), patients who were treated with 5-alpha reductase inhibitors for <3 months, and patients who were treated with 5-alpha reductase inhibitors ≥3 months were 9.5%, 8.8%, and 3.1%, respectively. 5-alpha reductase inhibitors tended to decrease the risk of blood transfusion; however, this association was not statistically significant (adjusted odds ratio=0.14, 95% confidence interval: 0.02-1.01). Age ≥80 years, coagulopathy, and a resected prostate tissue weight >50 g were associated with significantly higher risks of blood transfusion than other parameters. CONCLUSIONS: This nationwide study did not show that significant associations exist between 5-alpha reductase inhibitor use before transurethral resection of the prostate and the risks of blood transfusion and blood clot evacuation or emergency visits for hematuria.
       
  • ERRATUM: Systematic review and meta-analysis of the efficacy and safety of
           amfepramone and mazindol as a monotherapy for the treatment of obese or
           overweight patients

    • Abstract: Our aim in this study was to compare the efficiency of 25G versus 22G needles in diagnosing solid pancreatic lesions by EUS-FNA. We performed a systematic review and meta-analysis. Studies were identified in five databases using an extensive search strategy. Only randomized trials comparing 22G and 25G needles were included. The results were analyzed by fixed and random effects. A total of 504 studies were found in the search, among which 4 randomized studies were selected for inclusion in the analysis. A total of 462 patients were evaluated (233: 25G needle/229: 22G needle). The diagnostic sensitivity was 93% for the 25G needle and 91% for the 22G needle. The specificity of the 25G needle was 87%, and that of the 22G needle was 83%. The positive likelihood ratio was 4.57 for the 25G needle and 4.26 for the 22G needle. The area under the sROC curve for the 25G needle was 0.9705, and it was 0.9795 for the 22G needle, with no statistically significant difference between them (p=0.497). Based on randomized studies, this meta-analysis did not demonstrate a significant difference between the 22G and 25G needles used during EUS-FNA in the diagnosis of solid pancreatic lesions.
       
  • The Association of Vitamin D Levels and the Frailty Phenotype Among
           Non-geriatric Dialysis Patients: A Cross-sectional Study

    • Abstract: OBJECTIVES: The aim of this study was to investigate the frequency of frailty and the association of vitamin D levels and the frailty phenotype among non-geriatric dialysis patients. METHOD: Seventy-four stable, chronic hemodialysis patients from the hemodialysis unit of the hospital were enrolled in the study. The patients’ medical histories and laboratory findings were obtained from the medical records of the dialysis unit. Serum parathyroid hormone and 25-hydroxy vitamin D levels were determined using chemiluminometric immunoassays. Frailty was defined by Fried et al. as a phenotype; shrinking, weakness, self-reported exhaustion, decreased activity and slowed walking speed were evaluated. RESULTS: Forty-one (55%) of the patients were males. The patients were divided into 3 groups according to frailty scores: 39 (53%) patients were frail, 6 (8%) patients were intermediately frail, and 28 (39%) patients were normal. Significant differences were found for 25-hydroxy vitamin D and hemoglobin levels among the groups; however, no differences were observed in body mass index, comorbidities, sex, marital status, education, disease and dialysis durations, or parathyroid hormone, creatinine, serum calcium, phosphorus, and potassium levels. CONCLUSIONS: Weakness and slowness are serious outcomes of both vitamin D deficiency and frailty, and vitamin D deficiency has been associated with increased risks of decreased physical activity, falls, fractures and death in postmenopausal women and older men. Although studies on frailty have focused on older adults, growing evidence indicates that the frailty phenotype is becoming a factor associated with poor health outcomes in non-geriatric populations with chronic disease.
       
  • Application of a pharmacokinetics-pharmacodynamics approach to the free
           propofol plasma levels during coronary artery bypass grafting surgery with
           hypothermic cardiopulmonary bypass

    • Abstract: OBJECTIVES: The objective of this study was to apply a pharmacokinetics-pharmacodynamics approach to investigate the free propofol plasma levels in patients undergoing coronary artery bypass grafting under hypothermic conditions compared with the off-pump procedure. METHODS: Nineteen patients scheduled for on-pump coronary artery bypass grafting under hypothermic conditions (n=10) or the equivalent off-pump surgery (n=9) were anesthetized with sufentanil and propofol target-controlled infusion (2 μg/mL) during surgery. The propofol concentration was then reduced to 1 μg/mL, and a pharmacokinetics-pharmacodynamics analysis using the maximum-effect-sigmoid model obtained by plotting the bispectral index values against the free propofol plasma levels was performed. RESULTS: Significant increases (two- to five-fold) in the free propofol plasma levels were observed in the patients subjected to coronary artery bypass grafting under hypothermic conditions. The pharmacokinetics of propofol varied according to the free drug levels in the hypothermic on-pump group versus the off-pump group. After hypothermic coronary artery bypass was initiated, the distribution volume increased, and the distribution half-life was prolonged. Propofol target-controlled infusion was discontinued when orotracheal extubation was indicated, and the time to patient extubation was significantly higher in the hypothermic on-pump group than in the off-pump group (459 versus 273 min, p=0.0048). CONCLUSIONS: The orotracheal intubation time was significantly longer in the hypothermic on-pump group than in the off-pump group. Additionally, residual hypnosis was identified through the pharmacokinetics-pharmacodynamics approach based on decreases in drug plasma protein binding in the hypothermic on-pump group, which could explain the increased hypnosis observed with this drug in this group of patients.
       
  • Monitoring auditory cortical plasticity in hearing aid users with long
           latency auditory evoked potentials: a longitudinal study

    • Abstract: OBJECTIVE: The objective of this study was to compare long-latency auditory evoked potentials before and after hearing aid fittings in children with sensorineural hearing loss compared with age-matched children with normal hearing. METHODS: Thirty-two subjects of both genders aged 7 to 12 years participated in this study and were divided into two groups as follows: 14 children with normal hearing were assigned to the control group (mean age 9 years and 8 months), and 18 children with mild to moderate symmetrical bilateral sensorineural hearing loss were assigned to the study group (mean age 9 years and 2 months). The children underwent tympanometry, pure tone and speech audiometry and long-latency auditory evoked potential testing with speech and tone burst stimuli. The groups were assessed at three time points. RESULTS: The study group had a lower percentage of positive responses, lower P1-N1 and P2-N2 amplitudes (speech and tone burst), and increased latencies for the P1 and P300 components following the tone burst stimuli. They also showed improvements in long-latency auditory evoked potentials (with regard to both the amplitude and presence of responses) after hearing aid use. CONCLUSIONS: Alterations in the central auditory pathways can be identified using P1-N1 and P2-N2 amplitude components, and the presence of these components increases after a short period of auditory stimulation (hearing aid use). These findings emphasize the importance of using these amplitude components to monitor the neuroplasticity of the central auditory nervous system in hearing aid users.
       
  • Preventable adverse drug events in critically ill HIV patients: Is the
           detection of potential drug-drug interactions a useful tool'

    • Abstract: OBJECTIVES: The aim of this study was to develop a strategy to identify adverse drug events associated with drug-drug interactions by analyzing the prescriptions of critically ill patients. METHODS: This retrospective study included HIV/AIDS patients who were admitted to an intensive care unit between November 2006 and September 2008. Data were collected in two stages. In the first stage, three prescriptions administered throughout the entire duration of these patients’ hospitalization were reviewed, with the Micromedex database used to search for potential drug-drug interactions. In the second stage, a search for adverse drug events in all available medical, nursing and laboratory records was performed. The probability that a drug-drug interaction caused each adverse drug events was assessed using the Naranjo algorithm. RESULTS: A total of 186 drug prescriptions of 62 HIV/AIDS patients were analyzed. There were 331 potential drug-drug interactions, and 9% of these potential interactions resulted in adverse drug events in 16 patients; these adverse drug events included treatment failure (16.7%) and adverse reactions (83.3%). Most of the adverse drug reactions were classified as possible based on the Naranjo algorithm. CONCLUSIONS: The approach used in this study allowed for the detection of adverse drug events related to 9% of the potential drug-drug interactions that were identified; these adverse drug events affected 26% of the study population. With the monitoring of adverse drug events based on prescriptions, a combination of the evaluation of potential drug-drug interactions by clinical pharmacy services and the monitoring of critically ill patients is an effective strategy that can be used as a complementary tool for safety assessments and the prevention of adverse drug events.
       
  • Granulocyte Colony-Stimulating Factor Combined with Methylprednisolone
           Improves Functional Outcomes in Rats with Experimental Acute Spinal Cord
           Injury

    • Abstract: OBJECTIVES: To evaluate the effects of combined treatment with granulocyte colony-stimulating factor (G-CSF) and methylprednisolone in rats subjected to experimental spinal cord injury. METHODS: Forty Wistar rats received a moderate spinal cord injury and were divided into four groups: control (no treatment); G-CSF (G-CSF at the time of injury and daily over the next five days); methylprednisolone (methylprednisolone for 24 h); and G-CSF/Methylprednisolone (methylprednisolone for 24 h and G-CSF at the time of injury and daily over the next five days). Functional evaluation was performed using the Basso, Beattie and Bresnahan score on days 2, 7, 14, 21, 28, 35 and 42 following injury. Motor-evoked potentials were evaluated. Histological examination of the spinal cord lesion was performed immediately after euthanasia on day 42. RESULTS: Eight animals were excluded (2 from each group) due to infection, a normal Basso, Beattie and Bresnahan score at their first evaluation, or autophagy, and 32 were evaluated. The combination of methylprednisolone and G-CSF promoted greater functional improvement than methylprednisolone or G-CSF alone (p<0.001). This combination also exhibited a synergistic effect, with improvements in hyperemia and cellular infiltration at the injury site (p<0.001). The groups displayed no neurophysiological differences (latency p=0.85; amplitude p=0.75). CONCLUSION: Methylprednisolone plus G-CSF promotes functional and histological improvements superior to those achieved by either of these drugs alone when treating spinal cord contusion injuries in rats. Combining the two drugs did have a synergistic effect.
       
  • A comparison of the efficiency of 22G versus 25G needles in EUS-FNA for
           solid pancreatic mass assessment: A systematic review and meta-analysis

    • Abstract: Our aim in this study was to compare the efficiency of 25G versus 22G needles in diagnosing solid pancreatic lesions by EUS-FNA. We performed a systematic review and meta-analysis. Studies were identified in five databases using an extensive search strategy. Only randomized trials comparing 22G and 25G needles were included. The results were analyzed by fixed and random effects. A total of 504 studies were found in the search, among which 4 randomized studies were selected for inclusion in the analysis. A total of 462 patients were evaluated (233: 25G needle/229: 22G needle). The diagnostic sensitivity was 93% for the 25G needle and 91% for the 22G needle. The specificity of the 25G needle was 87%, and that of the 22G needle was 83%. The positive likelihood ratio was 4.57 for the 25G needle and 4.26 for the 22G needle. The area under the sROC curve for the 25G needle was 0.9705, and it was 0.9795 for the 22G needle, with no statistically significant difference between them (p=0.497). Based on randomized studies, this meta-analysis did not demonstrate a significant difference between the 22G and 25G needles used during EUS-FNA in the diagnosis of solid pancreatic lesions.
       
  • Increase of 10% in the Rate of Adverse Drug Reactions for Each Drug
           Administered in Hospitalized Patients

    • Abstract: OBJECTIVE: To assess the risk factors, incidence and severity of adverse drug reactions in in-patients. METHODS: This prospective study evaluated 472 patients treated at a teaching hospital in Brazil between 2010 and 2013 by five medical specialties: Internal Medicine, General Surgery, Geriatrics, Neurology, and Clinical Immunology and Allergy. The following variables were assessed: patient age, gender, comorbidities, family history of hypersensitivity, personal and family history of atopy, number of prescribed drugs before and during hospitalization, hospital diagnoses, days of hospitalization. The patients were visited every other day, and medical records were reviewed by the investigators to detect adverse drug reactions. RESULTS: There were a total of 94 adverse drug reactions in 75 patients. Most reactions were predictable and of moderate severity. The incidence of adverse drug reactions was 16.2%, and the incidence varied, according to the medical specialty; it was higher in Internal Medicine (30%). Antibiotics were the most commonly involved medication. Chronic renal failure, longer hospital stay, greater number of diagnoses and greater number of medications upon admission were risk factors. For each medication introduced during hospitalization, there was a 10% increase in the rate of adverse drug reaction. In the present study, the probability of observing an adverse drug reaction was 1 in 104 patients per day. CONCLUSIONS: Adverse drug reactions are frequent and potentially serious and should be better monitored in patients with chronic renal failure or prolonged hospitalization and especially in those on ‘polypharmacy’ regimens. The rational use of medications plays an important role in preventing adverse drug reactions.
       
 
 
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