483 results match your criteria: "Hospital de Clínicas de Curitiba[Affiliation]"

Noninvasive Ultra Low Intensity Light Photodynamic Treatment of Glioblastoma with Drug Augmentation: LoGlo PDT Regimen.

Brain Sci

November 2024

Neurosurgery Department-Neuro-Oncology, Instituto de Neurologia de Curitiba, Rua Jeremias Maciel Perretto, 300-Campo Comprido, Curitiba 81210-310, Brazil.

This paper presents the basis for LoGlo PDT, a new treatment for glioblastoma. Glioblastoma is currently treated with maximal safe resection, temozolomide, and ionizing irradiation. Mortality in 2024 remains over 80% within several years from diagnosis.

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Since the description of autoimmune encephalitis (AE) associated with N-methyl-D-aspartate receptor antibodies (anti-NMDARE) in 2007, more than 12 other clinical syndromes and antibodies have been reported. In this article, we review recent advances in pathophysiology, genetics, diagnosis pitfalls, and clinical phenotypes of AE associated with cell surface antibodies and anti-GAD associated neurological syndromes. Genetic studies reported human leukocyte antigen (HLA) associations for anti-LGI1, anti-Caspr2, anti-IgLON5, and anti-GAD.

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Resting ECG findings in male Brazilian soccer players of different ethnicities: Results from the B-Pro Foot ECG study.

J Sci Med Sport

December 2024

Graduate Program in Cardiology and Cardiovascular Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Exercise Cardiology Research Group (CardioEx), Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Internal Medicine Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.

Objectives: To compare the prevalence of training-related ECG findings in white, mixed-race, and black male Brazilian soccer players.

Design: Multicenter observational study.

Methods: This study involved athletes aged 15 to 35 years from 82 professional clubs across Brazil's five regions.

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Background: Psoriasis, a chronic, inflammatory skin disease, requires long-term therapy. Risankizumab is a humanized immunoglobulin G1 monoclonal antibody that specifically inhibits interleukin 23 by binding to its p19 subunit.

Objective: The authors assessed the efficacy and safety of risankizumab compared with methotrexate in adults with moderate-to-severe plaque psoriasis.

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THE GROWING EVIDENCE OF THE RELATIONSHIP BETWEEN OBESITY AND CANCER AND THE ROLE OF BARIATRIC SURGERY.

Arq Bras Cir Dig

December 2024

Universidade Federal do Paranê, Faculdade de Medicina de Curitiba, Department of Surgery - Curitiba (PR), Brazil.

Obesity is recognized as a significant risk factor for various types of cancer. Although the incidence of some types of cancer across various primary sites is decreasing due to specific prevention measures (screening programs, smoking cessation), the incidence of neoplasms in the young population shows a significant increase associated with obesity. There is sufficient evidence to say that bariatric surgery has been shown to significantly lower the risk of developing obesity-associated cancers, which are linked to metabolic dysregulation, chronic low-grade systemic inflammation, and hormonal alterations such as elevated levels of insulin and sex hormones.

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Cluster headache and galcanezumab: the first real-world Brazilian study and an expert consensus on its use among other treatments.

J Headache Pain

December 2024

Universidade Federal do Delta do Parnaíba, Avenida São Sebastião, 2819, Fátima, Parnaíba, PI, 64001-020, Brazil.

Objective: To present the first Brazilian real-world results with galcanezumab and provide a consensus expert opinion on the prophylactic treatment of cluster headache (CH) in Brazil.

Methods: The first part of the study (real-world results) was observational, prospective, uncontrolled, and descriptive. A sample of 44 consecutive patients with episodic or chronic CH were evaluated and treated in a traditional tertiary clinic from March 2020 to June 2024.

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Background: Cardiovascular diseases (CVD) remain the leading cause of mortality worldwide. Medication adherence is an important issue in managing chronic CVD, directly influencing outcomes and healthcare costs.

Objectives: This systematic review, supported by the Brazilian Society of Cardiology, evaluates the impact of poor adherence to cardiovascular medications on critical clinical outcomes such as death and cardiovascular events.

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Article Synopsis
  • MOGAD encephalitis and ADEM present similar symptoms to autoimmune encephalitis (AE) linked with anti-neuronal antibodies, but their treatment and outcomes vary, and testing for anti-MOG antibodies is not routine.
  • In a study of 481 patients with suspected AE, only 3.5% had anti-MOG antibodies, with a higher prevalence in children compared to adults.
  • Patients with MOGAD exhibited fewer behavioral and movement disorders compared to those with AE, but had more symptoms related to demyelination, highlighting the need to consider MOGAD as a differential diagnosis in cases of possible AE.
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Left atrial appendage occlusion devices vs direct oral anticoagulants for atrial fibrillation: An updated systematic review and meta-analysis.

Curr Probl Cardiol

January 2025

INC Hospital, Department of Interventional Cardiology, Universidade Federal do Paraná, Faculdades Pequeno Príncipe, Hospital Santa Casa de Misericórdia de Curitiba, Rua Jeremias Maciel Perretto, 300, Curitiba, Paraná, 81210-310, Brazil. Electronic address:

Article Synopsis
  • Direct Oral Anticoagulants (DOACs) are commonly used for treating non-valvular atrial fibrillation (NVAF), but Percutaneous Left Atrial Appendage Occlusion (LAAO) is a new treatment method with uncertain safety and effectiveness compared to DOACs.
  • A systematic review of ten studies involving over 18,500 patients found that LAAO is linked to lower all-cause and cardiovascular mortality rates, as well as a reduction in the composite outcomes of death, bleeding, and thromboembolic events.
  • While LAAO showed trends toward reduced stroke or TIA events and lower bleeding rates compared to DOACs, no significant differences in thromboembolic events were observed.
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The association between high-density lipoprotein (HDL) cholesterol and breast cancer (BC) remains controversial due to the high complexity of the HDL particle and its functionality. The HDL proteome was determined in newly diagnosed BC classified according to the molecular type [luminal A or B (LA or LB), HER2, and triple-negative (TN)] and clinical stage of the disease. Women (n = 141) aged between 18 and 80 years with BC, treatment-naïve, and healthy women [n = 103; control group (CT)], matched by age and body mass index, were included.

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Backgound: During the SARS-CoV-2 pandemic, a significant number of critical patients required ventilatory assistance in health institutions. In this context, Ventilator-Associated Pneumonia (VAP) was the most prevalent nosocomial infection among critically ill patients. We aimed to analyze the occurrence of VAP in critically ill patients with SARS-CoV-2 and the risk factors associated with the outcome.

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Background:  Atrial fibrillation (AF) is a risk factor for cerebral ischemia. Identifying the presence of AF, especially in paroxysmal cases, may take time and lacks clear support in the literature regarding the optimal investigative approach; in resource-limited settings, identifying a higher-risk group for AF can assist in planning further investigation.

Objective:  To develop a scoring tool to predict the risk of incident AF in the poststroke follow-up.

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Article Synopsis
  • - The phase 3 NEURO-TTRansform trial demonstrated that eplontersen significantly reduced transthyretin (TTR) levels and halted the progression of neuropathy impairment in patients with hereditary TTR-mediated amyloidosis after 65 weeks of treatment.
  • - The study involved patients initially receiving inotersen, who then switched to eplontersen, resulting in a greater reduction of TTR levels and stabilized quality of life and nutritional status during the eplontersen treatment.
  • - Patients who switched to eplontersen experienced fewer treatment-emergent adverse events, restored platelet counts, and overall better tolerability, indicating a favorable benefit-risk profile for this treatment strategy. *
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The diagnosis of pigmented nail lesions is a concern for both general practitioners and dermatologists, due to the possibility of indicating nail melanoma. The origin of the dark pigmentation can be either melanocytic or non-melanocytic (fungi, bacteria, or blood), and clinical evaluation alone may not be sufficient for differentiation, requiring additional exams. Onychoscopy provides valuable information prior to biopsy.

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Background:  Autoimmune encephalitis (AIE) is a group of inflammatory diseases characterized by the presence of antibodies against neuronal and glial antigens, leading to subacute psychiatric symptoms, memory complaints, and movement disorders. The patients are predominantly young, and delays in treatment are associated with worse prognosis.

Objective:  With the support of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, ABN) and the Brazilian Society of Child Neurology (Sociedade Brasileira de Neurologia Infantil, SBNI), a consensus on the diagnosis and treatment of AIE in Brazil was developed using the Delphi method.

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Objectives: to comprehend men's perception of paternal parenthood while caring for infants to promote child development.

Methods: this qualitative study adopts an exploratory approach and was conducted with undergraduate and graduate students, faculty, and staff who are fathers of infants up to 6 months old from a higher education institution, excluding fathers from mononuclear families. Data collection occurred through semi-structured interviews and was analyzed using thematic categorical analysis.

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Limb-girdle muscular dystrophy type 2G/R7 (LGMD2G/R7) is an ultra-rare condition initially identified within the Brazilian population. We aimed to expand clinical and genetic information about this disease, including its worldwide distribution. A multicenter historical cohort study was performed at 13 centers in Brazil in which data from index cases and their affected relatives from consecutive families with LGMD2G/R7 were reviewed from July 2017 to August 2023.

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Background: Leprosy is a chronic infection with high morbidity in Brazil. Primary care physicians' lack of knowledge about the disease may play a significant role in underdiagnosis. This study aimed to assess primary care physicians' ability to identify typical leprosy skin lesions and their knowledge of the subject.

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Article Synopsis
  • Ingrown toenails are a common issue, and the most effective treatment is partial matricectomy using phenol, although the optimal contact time for phenol remains uncertain.
  • A study evaluated 1,460 surgeries and recorded 802 cases over 6 months, tracking recurrences based on nail spicules or signs of ingrowth.
  • The findings showed low recurrence rates of 0.75% at 3 months and 1.87% at 6 months with 45 seconds of phenol contact, particularly noting higher recurrence in the medial nail fold compared to the lateral fold.
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Article Synopsis
  • Deep Brain Stimulation (DBS) has been FDA-approved since 2003 and is recommended for treating dystonia after other treatments, like botulinum toxin, fail.
  • A study analyzed the impact of DBS on botulinum toxin dosages in 23 dystonic patients, showing a significant reduction in medication use after surgery.
  • Pre-surgery, patients received a median of 800 units of botulinum toxin, which decreased to 700 units post-surgery, indicating a 12.5% reduction in dosage after DBS treatment.
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 To evaluate whether three-dimensional (3D) printing increases agreement in the classification of tibial pilon fractures.  Orthopedists and traumatologists reviewed radiographs, computed tomography scans with 3D reconstruction, and prototyping 3D printing, and classified the fractures based on the Rüedi-Allgöwer and Arbeitsgemeinschaft für Osteosynthesefragen (AO, Association for the Study of Internal Fixation) Foundation/Orthopedic Trauma Association (AO/OTA) classification systems. Next, data evaluation used Kappa agreement coefficients.

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Background: Malignant gliomas are the most prevalent primary malignant cerebral tumors. Preoperative imaging plays an important role, and the prognosis is closely related to surgical resection and histomolecular aspects. Our goal was to correlate Ki67 indexes with tumoral volumetry in semiautomatic segmentation on preoperative magnetic resonance images and residual fluorescence in a 5-ALA-assisted resection cohort.

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Pharmaceutical equivalent 5-aminolevulinic acid fluorescence guided resection of central nervous system tumors: feasibility, safeness and cost-benefit considerations.

J Neurooncol

July 2024

Division of Neurooncology, Department of Neurosurgery, Instituto de Neurologia de Curitiba, Rua Jeremias Maciel Perretto, 300 - Campo Comprido, 81210-310, Curitiba, PR, Brazil.

Purpose: 5-aminolevulinic acid (5-ALA) fluorescence-guided resection (FGR) has been an essential tool in the 'standard of care' of malignant gliomas. Over the last two decades, its indications have been extended to other neoplasms, such as metastases and meningiomas. However, its availability and cost-benefit still pose a challenge for widespread use.

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