Publications by authors named "Francisco Cezar Aquino De Moraes"

Introduction: Telemedicine, propelled by recent technological advancements, has transformed healthcare delivery, notably benefiting patients with chronic non-communicable diseases (NCDs) such as systemic arterial hypertension and diabetes mellitus. This meta-analysis of randomized clinical trials aimed to assess the efficacy of telehealth-based interventions on disease control rates and clinical parameters among NCD patients, including systolic and diastolic blood pressure (SBP and DBP), fasting blood glucose (FBG), and glycated hemoglobin (HbA1c) levels.

Methods: We conducted searches in PubMed, Scopus, Web of Science, and the Cochrane Database for interventional studies that compared tele-monitoring with usual care in patients with hypertension and type 2 diabetes mellitus.

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Introduction: Colorectal cancer is the second leading cause of cancer-related deaths worldwide. The impact of proton pump inhibitors (PPIs) on patients taking capecitabine, an oral fluoropyrimidine, remains uncertain, despite their use by 20 to 55% of cancer patients. We investigated how PPIs affect the effectiveness of capecitabine in treating colorectal cancer.

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Background: Colorectal cancer (CRC) and polypoid syndromes are significant public health concerns, with somatic mosaicism playing a crucial role in their genetic diversity. This study aimed to investigate the prevalence and impact of somatic mosaicism in these conditions.

Methods: A search was conducted using PubMed, Scopus, and Web of Sciences to identify studies evaluating mosaicism in patients with CRC or polyposis syndromes.

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  • Schizophrenia is a severe mental illness with high mortality rates, and Xanomeline combined with Trospium has shown promise in clinical trials as a treatment option.
  • A meta-analysis of 3 randomized controlled trials involving 674 patients revealed that XTC significantly improved schizophrenia symptoms measured by the PANSS total score, although it also led to nausea and other cholinergic side effects.
  • While XTC effectively reduces symptoms of schizophrenia, the associated adverse effects may affect patient compliance and overall treatment tolerability.
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Background/aim: Lung cancer accounts for the largest percentage of cancer deaths worldwide, with non-small cell lung cancer (NSCLC) being the predominant type. Gefitinib, an EGFR tyrosine kinase inhibitor (EGFR-TKI), has shown marked efficacy in NSCLC patients with an EGFR mutation. However, gefitinib resistance because of ABCG2 polymorphisms such as rs2231142(421C > A) might limit its clinical use.

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  • Sacituzumab Govitecan (SG) has shown significant clinical benefits for breast cancer patients but is associated with considerable toxicity.
  • A meta-analysis of seven studies included 928 patients on SG and highlighted high rates of adverse events, particularly neutropenia (70%) and grade ≥3 neutropenia (46%).
  • The findings suggest a need for careful monitoring and management of side effects when using SG, as it poses a higher risk of neutropenia, diarrhea, and anemia compared to standard treatment options.
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  • A systematic review and meta-analysis were conducted to evaluate the safety and efficacy of osimertinib in non-small-cell lung cancer (NSCLC) patients with uncommon epidermal growth factor receptor mutations.
  • The analysis included 15 studies with 594 patients, revealing common mutations such as G719X and L861Q, and determining key metrics like a 51.30% objective response rate (ORR) and a median progression-free survival of 9.71 months.
  • Osimertinib was found to be generally safe, with only 21.77% of patients experiencing serious adverse events, showing promise for treating NSCLC with these uncommon mutations.
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Background: Atherosclerotic cardiovascular disease (ASCVD), affects approximately 18.6 million individuals worldwide and poses a significant healthcare related challenge. Despite the established efficacy of both high-intensity statin monotherapy (HIS) and moderate-intensity statin plus ezetimibe (MIS+EZT) in ASCVD management, the optimal treatment strategy remains unclear.

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Background: Patients with Down syndrome (DS) have a unique genetic and clinical profile that may increase the risk of cancer.

Methods: A literature search on PubMed, Scopus, Web of Science, and the Cochrane databases was conducted, focusing on studies to investigate the prevalence of solid and hematologic tumors in DS.

Results: Fifteen studies were included, encompassing 62,121 individuals with Down syndrome (DS).

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  • Risk reduction salpingo-oophorectomy (RRSO) is a surgery often performed on women with hereditary breast and ovarian cancer (HBOC) syndrome caused by BRCA1 and BRCA2 mutations, which leads to surgical menopause and potential health risks.
  • A meta-analysis of six studies involving 1,320 patients examined the rates of cardiovascular and metabolic conditions post-surgery, including myocardial infarction, hypertension, hypercholesterolemia, and type 2 diabetes.
  • The results showed that while there were increased prevalence rates for conditions like hypertension (28%) and hypercholesterolemia (27.2%), the overall cardiovascular risk did not significantly increase for women undergoing RRSO.
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Background: The optimal treatment for resectable Non-Small Cell Lung Cancer (NSCLC) remains under investigation, particularly about its effectiveness across different ethnicities. This meta-analysis aims to investigate the potential benefits of adding PD1/PD-L1 inhibitors for treatment, stratified by ethnicity.

Methods: We searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCTs) that investigated the use of PD1/PD-L1 inhibitors to treat patients with resectable NSCLC.

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Immunotherapy treatments that target programmed cell death receptor-1 (PD-1) or its ligand (PD-L1) have revolutionized the treatment of metastatic melanoma and currently represent the standard first-line treatment for this type of cancer. However, it is still not entirely clear which biomarkers are cost-effective, simple, and highly reliable. This systematic review and meta-analysis aims to analyze the predictive value of the baseline neutrophil-lymphocyte ratio (NLR) regarding disease progression and overall survival of patients with metastatic melanoma undergoing treatment with PD-1/PD-L1 blockade.

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Background: Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine skin cancer characterized by high rates of metastasis. Emerging evidence suggests that PD-L1/PD1 blockade holds promise as a therapeutic option for MCC. However, the efficacy and safety of this approach in treating MCC remain incompletely understood.

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Background: Degarelix is a third-generation GnRH receptor antagonist approved for the treatment of prostate cancer, however, the decision to use a GnRH agonist or an antagonist depends on several factors. We aimed to perform a meta-analysis comparing the cardiovascular disease risk between degarelix and gonadotropin-releasing hormone agonists in patients with all stages of prostate cancer.

Methods: Databases were searched for randomized control trials (RCTs) and observational studies that compared the risk of cardiovascular disease between degarelix and GnRH agonists in patients with prostate cancer.

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  • Resistant arterial hypertension (RAH) is a significant global health issue linked to increased cardiovascular risk, and the effectiveness of ultrasound renal denervation (uRDN) as a treatment is not fully understood.
  • This study analyzed data from five trials involving 709 patients to evaluate the impact of uRDN on reducing both systolic and diastolic blood pressure in those with RAH.
  • Results indicated that uRDN significantly lowered office blood pressure levels compared to sham treatments, though more research is necessary to fully assess its efficacy in managing RAH.
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Background: Gastric cancer (GC) is a major global cause of cancer mortality, with a median overall survival of just 12 months. CLDN18.2, a specific isoform of Claudin18 normally expressed in the gastric mucosa, has emerged as a potential therapeutic target and prognostic biomarker due to its exposure on the surface of tumor cells following malignant transformation.

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  • * This study conducted a systematic review of 14 studies involving 520 patients to evaluate the safety and efficacy of re-administering anti-EGFR treatments (like cetuximab and panitumumab) to those who previously progressed after treatment.
  • * Results indicated a low objective response rate (17.70%) and a moderate disease control rate (61.72%), with notable differences in effectiveness between the types of anti-EGFR therapy used, highlighting the complexities of managing metastatic CRC
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Introduction:  The question of whether assisted reproductive technologies (ART) and ovulation induction are related to a higher incidence of ovarian tumors (OTs) is still controversial in the literature.

Methods: We performed a comprehensive search of PubMed, Embase, and Web of Science databases for case-control and cohort studies that investigated ART and ovulation induction exposure as risk factors for OT in infertile women. Odds ratios (OR) with 95% confidence intervals (CI) were employed for all endpoints.

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  • Renal denervation (RDN) is a potential treatment for resistant hypertension, but initial trials showed no significant difference in blood pressure reduction compared to a SHAM procedure.
  • A meta-analysis of nine studies with 1622 patients evaluated the effectiveness of RDN, focusing on different blood pressure measurements.
  • Results indicated significant reductions in 24-hour ambulatory and daytime systolic blood pressure with RDN, while office and night-time systolic pressures showed mixed results.
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Importance: Seasonal humor disorders are prone to have a link with daylight exposure. However, the effect of external light on nonseasonal disorders remains unclear. Evidence is lacking for the validity of bright light therapy (BLT) as an adjunctive treatment for these patients.

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  • Fluoropyrimidines are chemotherapy drugs that rely on the DPD enzyme for metabolism, and genetic mutations in the DPYD gene can lead to DPD deficiency, increasing toxicity risk in patients.
  • A meta-analysis of 36 studies with over 16,000 patients focused on identifying significant DPYD gene variants linked to severe toxicity from fluoropyrimidine treatment, particularly in patients with colorectal cancer.
  • The study highlighted four DPYD variants—DPYD*2A, DPYD p.D949V, DPYD*13, and DPYD Hap23—as predictors of severe toxicity, indicating a need for genetic screening to improve patient safety.
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  • Metformin is the primary medication for treating insulin resistance in PCOS and has been extensively researched, while inositols have recently gained attention but lack strong evidence.
  • A study analyzed 6 randomized control trials involving 388 women with PCOS to compare the effects of combined metformin and inositols against metformin alone.
  • Results showed that the combination therapy improved menstrual cycle regularity and reduced certain hormone ratios, but no significant differences were found in acne, body weight, blood sugar, or insulin resistance measures; more research is needed on inositol's effectiveness.
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Background: Breast cancer (BC) is a significant global health issue, accounting for 1 in 8 cancer diagnoses worldwide. HLA class I molecules are typically expressed on the cell surface, but cancer cells can develop mechanisms to evade recognition by CTLs, including the downregulation of HLA class I expression. In this context, we aimed to conduct a systematic review and meta-analysis to clarify the role of HLA class I expression in clinical outcomes for patients with BC.

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Aim: To assess the effects of once-weekly subcutaneous retatrutide on weight and metabolic markers and the occurrence of side effects in patients with overweight, obesity and/or type 2 diabetes (T2D).

Methods: PubMed, Embase, Cochrane Library, and ClinicalTrials.gov databases were systematically searched for placebo-controlled, randomized clinical trials (RCTs) published up until February 23, 2024.

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