Efficacy of Early Optimization of Infliximab Guided by Therapeutic Drug Monitoring during Induction-A Prospective Trial.

Therapeutic drug monitoring (TDM) during induction therapy with anti-tumor necrosis factor drugs has emerged as a strategy to optimize response to these biologics and avoid undesired outcomes related to inadequate drug exposure. This study aimed to describe clinical, biological, and endoscopic remission rates at six months in Brazilian inflammatory bowel disease (IBD) patients following a proactive TDM algorithm guided by IFX trough levels (ITL) and antibodies to IFX (ATI) levels during induction, at week six. A total of 111 IBD patients were prospectively enrolled, excluding those previously exposed to the drug.

SECOND BRAZILIAN CONSENSUS ON THE MANAGEMENT OF ULCERATIVE COLITIS IN ADULTS: A CONSENSUS OF THE BRAZILIAN ORGANIZATION FOR CROHN'S DISEASE AND COLITIS (GEDIIB).

Background: Inflammatory bowel diseases are immune-mediated disorders that include Crohn's disease (CD) and ulcerative colitis (UC). UC is a progressive disease that affects the colorectal mucosa causing debilitating symptoms leading to high morbidity and work disability. As a consequence of chronic colonic inflammation, UC is also associated with an increased risk of colorectal cancer.

SECOND BRAZILIAN CONSENSUS ON THE MANAGEMENT OF CROHN'S DISEASE IN ADULTS: A CONSENSUS OF THE BRAZILIAN ORGANIZATION FOR CROHN'S DISEASE AND COLITIS (GEDIIB).

Background: Inflammatory bowel disease (IBD) is an immune-mediated disorder that includes Crohn's disease (CD) and ulcerative colitis. CD is characterized by a transmural intestinal involvement from the mouth to the anus with recurrent and remitting symptoms that can lead to progressive bowel damage and disability over time.

Objective: To guide the safest and effective medical treatments of adults with CD.

Pioglitazone Attenuates the Effects of Peripheral Inflammation in a Human In Vitro Blood-Brain Barrier Model.

Biological mediators secreted during peripheral chronic inflammation reach the bloodstream and may damage the blood-brain barrier (BBB), triggering central nervous system (CNS) disorders. Full-fledged human BBB models are efficient tools to investigate pharmacological pathways and mechanisms of injury at the BBB. We here employed a human in vitro BBB model to investigate the effects of either plasma from inflammatory bowel disease (IBD) patients or tumor necrosis factor α (TNFα), a cytokine commonly released in periphery during IBD, and the anti-inflammatory role of pioglitazone, a peroxisome proliferator-activated receptor γ agonist (PPARγ).

Acoustic radiation force impulse elastography and liver fibrosis risk scores in severe obesity.

Objective: Identifying significant fibrosis is crucial to evaluate the prognosis and therapeutic interventions in patients with nonalcoholic fatty liver disease (NAFLD). We assessed the performance of acoustic radiation force impulse (ARFI) elastography, APRI, FIB-4, Forns, NFS and BARD scores in determining liver fibrosis in severe obesity.

Methods: A prospective study included 108 patients undergoing bariatric surgery.

Formyl Peptide Receptors and Annexin A1: Complementary Mechanisms to Infliximab in Murine Experimental Colitis and Crohn's Disease.

Non-responsiveness to anti-TNF-α therapies presents relevant rates in inflammatory bowel disease patients, presenting the need to find biomarkers involved in therapeutic efficacy. Herein, we demonstrate that higher levels of colonic formyl peptide receptor 1 and annexin A1 correlate with histological recovery in Crohn's disease patients under remission. Using the dextran sulfate sodium colitis model in mice, we suggest that infliximab induces annexin A1 expression and secretion in activated intestinal leukocytes.

Risk factors associated with inflammatory bowel disease: A multicenter case-control study in Brazil.

Background: The etiology of inflammatory bowel disease (IBD) is unknown, but it is believed to be multifactorial. The hygiene hypothesis proposes that better hygiene conditions would lead to less infectious disease during childhood and favor the development of immune-mediated diseases.

Aim: To test the hygiene hypothesis in IBD by assessing the environmental risk factors associated with IBD development in different regions of Brazil with diverse socioeconomic development indices.

Milk Fermented by Lactobacillus paracasei NCC 2461 (ST11) Modulates the Immune Response and Microbiota to Exert its Protective Effects Against Salmonella typhimurium Infection in Mice.

Probiotics form a promising strategy to maintain intestinal health. Milks fermented with probiotic strains, such as the Lactobacillus paracasei ST11, are largely commercialized in Brazil and form a low-cost alternative to probiotic pharmaceutical formulations. In this study, we assessed the probiotic effects of milk fermented by L.

Age and sex estimation based on pulp cavity volume using cone beam computed tomography: development and validation of formulas in a Brazilian sample.

Objectives: To develop and validate formulas for age and sex estimation based on the pulp cavity volume of teeth using cone beam CT.

Methods: The sample was composed of 116 cone beam CT scans from Brazilian individuals of both sexes, ranging in age from 13 to 70 years. A total of 232 teeth (upper central incisors and canines) were evaluated.

Ulcerative colitis - treatment with biologicals.

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.

Identification of a Carbonized Body Using Implanted Surgical Plates: The Importance of Computed Tomography.

In addition to clinical examination, forensic odontologists can use diagnostic imaging as an auxiliary method for identification. This paper reports a case where forensic odontologists from the Afrânio Peixoto Legal Medicine Institute in Rio de Janeiro (Brazil) positively identified a carbonized and partially calcined body using oral and maxillofacial imaging. The cadaver showed several metallic plates fixed with metallic screws on bones of the neurocranium and viscerocranium.

Association of nonalcoholic fatty liver disease and liver cancer.

Aim: To investigate the association between nonalcoholic fatty liver disease (NAFLD) and liver cancer, and NAFLD prevalence in different liver tumors.

Methods: This is a retrospective study of the clinical, laboratory and histological data of 120 patients diagnosed with primary or secondary hepatic neoplasms and treated at a tertiary center where they underwent hepatic resection and/or liver transplantation, with subsequent evaluation of the explant or liver biopsy. The following criteria were used to exclude patients from the study: a history of alcohol abuse, hepatitis B or C infection, no tumor detected in the liver tissue examined by histological analysis, and the presence of chronic autoimmune hepatitis, hemochromatosis, Wilson's disease, or hepatoblastoma.

Endometriosis in a patient with mayer-rokitansky-küster-hauser syndrome.

Objective. To report a case of Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) in which there were two nonfunctional rudimentary uteruses with the presence of ovarian endometrioma, corroborating that there are valid alternative theories to the existence of endometriosis, rather than Sampson's theory alone, such as the coelomic metaplasia theory. Design.

Acoustic radiation force impulse elastography and serum fibrosis markers in chronic hepatitis C.

Objective: Liver biopsy (LB) remains the gold standard for the assessment of liver fibrosis, although it is invasive and can have complications. The present study compares several noninvasive methods of fibrosis assessment in chronic hepatitis C (CHC), including acoustic radiation force impulse (ARFI) elastography, aspartate aminotransferase:platelet ratio index (APRI), Forns, FIB-4, and King scores versus percutaneous LB.

Material And Methods: This prospective study enrolled 51 untreated CHC patients.

FSH replaced by low-dose hCG in the late follicular phase versus continued FSH for assisted reproductive techniques.

Background: During controlled ovarian hyperstimulation (COH) follicle-stimulating hormone (FSH) is frequently used for several days to achieve follicular development. FSH is a relatively expensive drug, substantially contributing to the total expenses of assisted reproductive techniques (ART). When follicles achieve a diameter greater than 10 mm they start expressing luteinising hormone (LH) receptors.

Ovarian reserve assessment for infertility investigation.

The current trends to postpone motherhood and the increase in demand for assistance in reproductive medicine highlight the need for seeking guidelines for the establishment of individualized treatment protocols. Currently available ovarian reserve tests do not provide sufficient evidence to be solely considered ideal, but they may occupy important place in initial counseling, predicting unsatisfactory results that could be improved by individualized induction schemes and reducing excessive psychological and financial burdens, and adverse effects. In this paper, we revise the role of hormonal basal and dynamic tests, as well as ultrasonographic markers, as ovarian reserve markers, in order to provide embasement for propaedeutic strategies and their interpretation in order to have reproductive success.

Inflammatory bowel disease activity assessed by fecal calprotectin and lactoferrin: correlation with laboratory parameters, clinical, endoscopic and histological indexes.

Background: Research has shown that fecal biomarkers are useful to assess the activity of inflammatory bowel disease (IBD). The aim of the study is: to evaluate the efficacy of the fecal lactoferrin and calprotectin as indicators of inflammatory activity.

Findings: A total of 78 patients presenting inflammatory bowel disease were evaluated.

[Relapse of alcohol consumption in liver transplant candidates. Risk factor analysis].

Background: Alcohol relapse after transplantation is a serious concern in transplant centers and is a subject of controversy and debate.

Aim: To evaluate the relapse of alcohol ingestion and the eventual associated factors in cirrhotic patients referred for liver transplantation.

Methods: A retrospective study comprised of 90 adult patients with liver cirrhosis, listed for transplant.

Effect of metronidazole analogues on Giardia lamblia cultures.

We comparatively evaluate the effect of metronidazole (MTZ) and its five analogues on trophozoites of Giardia lamblia axenically growing. The compounds MTZ-Ms, MTZ-I, MTZ-Br, MTZ-N(3), and MTZ-NH(3)Cl were obtained by molecular modification of the side chain of MTZ. Four of them presented higher giardicidal activity when compared with MTZ.

Pro-epileptic effect of alfentanil in rats subjected to pilocarpine-induced chronic epilepsy.

Pharmacological induction of epileptiform activity is a complementary method to study the epileptogenic area in drug-resistant epileptic patients. Among the different activation methods, fentanyl derivatives (e.g.

Effect of ejaculatory abstinence period on the pregnancy rate after intrauterine insemination.

Objective: To determine the optimal interval of ejaculatory abstinence for couples undergoing IUI.

Design: Retrospective analysis.

Setting: Reproductive endocrinology and infertility center.

Treatment of obese adolescents with sibutramine: a randomized, double-blind, controlled study.

Adolescent obesity is becoming a health problem in both developed and developing countries. Antiobesity drug therapy is not currently indicated for the treatment of adolescent obesity and remains investigational at this time. The aim of this study was to determine the efficacy and safety of sibutramine in obese adolescents.

An open-label trial of sibutramine in obese patients with binge-eating disorder.

Background: Binge-eating disorder was recently included in Appendix B of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Binge-eating disorder is a common diagnosis among patients who seek treatment for obesity. There are scant data about the efficacy of the novel antiobesity agents for binge-eating disorder.