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  1. Article ; Online: End-of-life use of antibiotics: a survey on how doctors decide.

    Crispim, Douglas H / da Silva, Ivaldo Olímpio / de Carvalho, Ricardo Tavares / Levin, Anna S

    International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

    2021  Volume 114, Page(s) 219–225

    Abstract: Objectives: Infections are the main complications in terminal diseases. Many patients die using antibiotics, which raises questions about their real usefulness and role in unnecessary prolongation of suffering. This survey evaluated how doctors use ... ...

    Abstract Objectives: Infections are the main complications in terminal diseases. Many patients die using antibiotics, which raises questions about their real usefulness and role in unnecessary prolongation of suffering. This survey evaluated how doctors use antibiotics in palliative care.
    Methods: From June to August of 2016, an online survey was conducted with 224 doctors who provide palliative care. They had to decide whether to initiate antibiotics in fictitious scenarios involving patients with suspected infections (urinary tract infection, pneumonia, sepsis) in end-of-life (from cancer, dementia, malignant stroke with sequelae, advanced COPD, multiple organ failure). Then, they had to decide whether to stop, maintain, or extend antibiotics after non-response in 72 hours.
    Results: 88-100% of doctors decided to initiate antibiotics in all situations, except in advanced dementia (45%), and most of them decided to maintain/extend antibiotics inadequately. Factors associated with maintaining/extending antibiotics inadequately were: longer time since graduation (over 13 years; significant in all 7 clinical situations; OR range: 2.45-10.11), and not having formal specialization in palliative care (statistically significant in 3 of 7 situations).
    Conclusions: Most palliative care physicians in this study decided to initiate and maintain/extend antibiotics at the end-of-life.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Death ; Humans ; Palliative Care ; Physicians ; Terminal Care
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2021-10-17
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 1331197-9
    ISSN 1878-3511 ; 1201-9712
    ISSN (online) 1878-3511
    ISSN 1201-9712
    DOI 10.1016/j.ijid.2021.10.026
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Efficacy of Fractional Laser on Steroid Receptors in GSM Patients.

    Pinho, Stella Catunda / Heinke, Thais / Dutra, Paula Fernanda Santos Pallone / Carmo, Andreia / Salmeron, Camilla / Karoleski, Luciana / Focchi, Gustavo / Speck, Neila Maria Góis / Pennati, Beatrice Marina / Silva, Ivaldo

    Bioengineering (Basel, Switzerland)

    2023  Volume 10, Issue 9

    Abstract: Background: To compare the efficacy of CO: Methods: Twenty-five menopausal women were randomized to receive either laser or estrogen treatment. Vaginal biopsies before and after treatment were compared to assess the amount and distribution of ... ...

    Abstract Background: To compare the efficacy of CO
    Methods: Twenty-five menopausal women were randomized to receive either laser or estrogen treatment. Vaginal biopsies before and after treatment were compared to assess the amount and distribution of estrogen and progesterone receptors.
    Results: Estrogen receptor levels were statistically similar between groups before and after treatment. Although there was no change over time in the estrogen group, an increase in receptor levels was confirmed in the laser group. Changes in estrogen receptor levels showed no association with treatment. Progesterone receptor levels were statistically similar between groups throughout treatment. There was no change over time in both groups. These changes displayed no association with the type of treatment. There was no significant correlation between epithelium thickness and estrogen or progesterone receptor levels.
    Conclusions: Estrogen and progesterone receptor levels increased and were maintained, respectively, in the vaginal epithelium in both groups. There was no significant relationship between epithelium thickness and receptor density. Laser therapy had similar outcomes to the gold standard without involving the disadvantages of hormone therapy.
    Language English
    Publishing date 2023-09-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2746191-9
    ISSN 2306-5354
    ISSN 2306-5354
    DOI 10.3390/bioengineering10091087
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Association between asthma and female sex hormones.

    Baldaçara, Raquel Prudente de Carvalho / Silva, Ivaldo

    Sao Paulo medical journal = Revista paulista de medicina

    2017  Volume 135, Issue 1, Page(s) 4–14

    Abstract: Context and objective:: The relationship between sex hormones and asthma has been evaluated in several studies. The aim of this review article was to investigate the association between asthma and female sex hormones, under different conditions ( ... ...

    Abstract Context and objective:: The relationship between sex hormones and asthma has been evaluated in several studies. The aim of this review article was to investigate the association between asthma and female sex hormones, under different conditions (premenstrual asthma, use of oral contraceptives, menopause, hormone replacement therapy and pregnancy).
    Design and setting:: Narrative review of the medical literature, Universidade Federal do Tocantins (UFT) and Universidade Federal de São Paulo (Unifesp).
    Methods:: We searched the CAPES journal portal, a Brazilian platform that provides access to articles in the MEDLINE, PubMed, SciELO, and LILACS databases. The following keywords were used based on Medical Subject Headings: asthma, sex hormones, women and use of oral contraceptives.
    Results:: The associations between sex hormones and asthma remain obscure. In adults, asthma is more common in women than in men. In addition, mortality due to asthma is significantly higher among females. The immune system is influenced by sex hormones: either because progesterone stimulates progesterone-induced blocking factor and Th2 cytokines or because contraceptives derived from progesterone and estrogen stimulate the transcription factor GATA-3.
    Conclusions:: The associations between asthma and female sex hormones remain obscure. We speculate that estrogen fluctuations are responsible for asthma exacerbations that occur in women. Because of the anti-inflammatory action of estrogen, it decreases TNF-α production, interferon-γ expression and NK cell activity. We suggest that further studies that highlight the underlying physiopathological mechanisms contributing towards these interactions should be conducted.
    MeSH term(s) Asthma/etiology ; Asthma/physiopathology ; Brazil ; Contraceptives, Oral/adverse effects ; Female ; Gonadal Steroid Hormones/adverse effects ; Hormone Replacement Therapy/adverse effects ; Humans ; Menopause ; Pregnancy ; Pregnancy Complications ; Progesterone/adverse effects ; Risk Factors
    Chemical Substances Contraceptives, Oral ; Gonadal Steroid Hormones ; Progesterone (4G7DS2Q64Y)
    Language English
    Publishing date 2017-01-05
    Publishing country Brazil
    Document type Journal Article ; Review
    ZDB-ID 1203171-9
    ISSN 1806-9460 ; 1516-3180 ; 0035-0362
    ISSN (online) 1806-9460
    ISSN 1516-3180 ; 0035-0362
    DOI 10.1590/1516-3180.2016.011827016
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Brain health and cognitive and mood disorders in ageing women.

    Silva, Ivaldo / Naftolin, Frederick

    Best practice & research. Clinical obstetrics & gynaecology

    2013  Volume 27, Issue 5, Page(s) 661–672

    Abstract: Improved medical, economic and socio-cultural conditions have increased life expectancy, especially for women. The incidence of hypertension, diabetes mellitus, psychiatric and degenerative brain diseases, especially stroke and dementia, are more ... ...

    Abstract Improved medical, economic and socio-cultural conditions have increased life expectancy, especially for women. The incidence of hypertension, diabetes mellitus, psychiatric and degenerative brain diseases, especially stroke and dementia, are more frequently seen in older people. Each of these conditions can separately, or in combination, result in similar signs and symptoms of cognition, memory, mood and motor function disorders. Therefore, it is important to understand the effects of normal ovarian ageing and the menopause on the nervous system, as well as the hallmarks of disease entities; many of these are described here. Also, the complexity of these issues is increased by the similarity of their effects to those of the polypharmacy and metabolic imbalances that are common in this population. These are complex issues, and it may be difficult and time-consuming to discern between normal brain functional changes and specific pathology in practice. Early evaluation of correctable possibilities, including imaging studies, may be key to management. Referral to specialists for diagnosis before starting clinical treatment is useful to address these issues.
    MeSH term(s) Aging/metabolism ; Aging/psychology ; Brain/metabolism ; Brain/physiology ; Cognition Disorders/metabolism ; Cognition Disorders/physiopathology ; Dementia/etiology ; Dementia/metabolism ; Dementia/physiopathology ; Depressive Disorder/metabolism ; Depressive Disorder/psychology ; Estrogens/metabolism ; Estrogens/physiology ; Estrogens/therapeutic use ; Female ; Humans ; Menopause/metabolism ; Menopause/psychology ; Mood Disorders/metabolism ; Sleep/physiology
    Chemical Substances Estrogens
    Language English
    Publishing date 2013-10
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2050090-7
    ISSN 1532-1932 ; 1521-6934
    ISSN (online) 1532-1932
    ISSN 1521-6934
    DOI 10.1016/j.bpobgyn.2013.06.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Effects of gradual weight loss on strength levels and body composition in wrestlers athletes.

    Miranda, Kessketlen A / Gheller, Rodrigo G / DA Silva, Ivaldo M / PicanÇo, Luhan A / Dos Santos, João O

    The Journal of sports medicine and physical fitness

    2020  Volume 61, Issue 3, Page(s) 401–406

    Abstract: Background: Few investigations have evaluated isokinetic torque after a period of weight loss in wrestlers. Thus, the current study sought to investigate the effects of gradual weight loss in the precompetitive period on isokinetic peak torque in the ... ...

    Abstract Background: Few investigations have evaluated isokinetic torque after a period of weight loss in wrestlers. Thus, the current study sought to investigate the effects of gradual weight loss in the precompetitive period on isokinetic peak torque in the upper and lower limbs and body composition in wrestling athletes.
    Methods: Eight elite athletes participated in the study (mean age 20.8±3.1 years). The athletes visited the laboratory on 2 occasions: during the period of weight maintenance (baseline) and during weight loss, in the precompetitive period (post). The variables analyzed were body composition through air displacement plethysmography (BOD POD) and peak torque (PT) of knee flexion and extension movements, and internal and external shoulder rotation in concentric action, at speeds of 60°/s and 180°/s, determined using an isokinetic dynamometer (Biodex Medical Systems; Shirley, NY, USA).
    Results: A significant decrease was observed in body composition values, except lean mass. No significant differences were observed in the PT of the movements analyzed: Shoulder internal rotation (60°/s P=0.825; 180°/s P=0.245) and external rotation (60°/s P=0.149; 180°/s P=0.163) and knee extension (60°/s P=0.086; 180°/s P=0.630) and flexion (60°/s P=0.310; 180°/s P=0.239).
    Conclusions: Gradual weight loss did not affect the production of torque in the wrestlers before a competition. In addition, gradual weight loss contributed to a reduction in body fat, associated with an increase in percentage lean body mass.
    MeSH term(s) Adipose Tissue ; Adolescent ; Adult ; Athletes ; Body Composition ; Body Weight ; Female ; Humans ; Male ; Muscle Strength ; Rotation ; Shoulder ; Torque ; Weight Loss ; Wrestling/physiology ; Young Adult
    Language English
    Publishing date 2020-10-22
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 410823-1
    ISSN 1827-1928 ; 0022-4707
    ISSN (online) 1827-1928
    ISSN 0022-4707
    DOI 10.23736/S0022-4707.20.11254-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Comparison of topical fractional CO2 laser and vaginal estrogen for the treatment of genitourinary syndrome in postmenopausal women: a randomized controlled trial.

    Dutra, Paula Fernanda Santos Pallone / Heinke, Thais / Pinho, Stella Catunda / Focchi, Gustavo Rubino Azevedo / Tso, Fernanda Kesselring / de Almeida, Bruna Cristine / Silva, Ivaldo / Speck, Neila Maria Góis

    Menopause (New York, N.Y.)

    2021  Volume 28, Issue 7, Page(s) 756–763

    Abstract: Objective: To compare the efficacy of fractional CO2 laser therapy with topical estrogen therapy for the treatment of postmenopausal genitourinary syndrome of menopause.: Methods: We conducted a randomized controlled clinical trial involving 25 ... ...

    Abstract Objective: To compare the efficacy of fractional CO2 laser therapy with topical estrogen therapy for the treatment of postmenopausal genitourinary syndrome of menopause.
    Methods: We conducted a randomized controlled clinical trial involving 25 postmenopausal women. Participants were aged between 50 and 65 years with at least 1 year of amenorrhea and follicle-stimulating hormone levels of >40 IU/L. The women were randomized into two groups: the laser therapy group (n = 13) and the vaginal topical estrogen therapy group (n = 12). Changes in the vaginal epithelium thickness, Frost index, and cell maturation were analyzed in both the groups. The female sexual quotient of each woman was also evaluated. Subjective evaluation was performed through a physical examination.
    Results: Histological analysis showed a significant increase in the vaginal epithelium thickness at the end of treatment in females in both the laser therapy (P < 0.001) and topical estrogen therapy (P = 0.001) groups. The topical estrogen therapy group tended to present a higher maturation index at the end of treatment when compared with that of the other group. Sexual function increased significantly over time in both the topical estrogen therapy (P < 0.001) and laser therapy (P < 0.001) groups. Subjective evaluation through physical examination showed a significant improvement in atrophy in both the groups.
    Conclusion: Despite the nonequivalence with topical estrogen therapy, our data suggest that laser therapy is an effective method for the treatment of vulvovaginal atrophy.
    MeSH term(s) Aged ; Atrophy/pathology ; Estrogens ; Female ; Humans ; Lasers, Gas/therapeutic use ; Menopause ; Middle Aged ; Postmenopause ; Vagina/pathology
    Chemical Substances Estrogens
    Language English
    Publishing date 2021-05-17
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 1205262-0
    ISSN 1530-0374 ; 1072-3714
    ISSN (online) 1530-0374
    ISSN 1072-3714
    DOI 10.1097/GME.0000000000001797
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Maternal childhood maltreatment: associations to offspring brain volume and white matter connectivity.

    Lugo-Candelas, Claudia / Chang, Le / Dworkin, Jordan D / Aw, Natalie / Fields, Andrea / Reed, Hannah / Spann, Marisa / Gilchrist, Michelle A / Hinds, Walter / Marsh, Rachel / Fifer, William P / Weissman, Myrna / Foerster, Bernd Uwe / Manin, Marina Giorgi / Silva, Ivaldo / Peterson, Bradley / Coelho Milani, Ana Carolina / Gingrich, Jay / Monk, Catherine /
    Duarte, Cristiane S / Jackowski, Andrea / Posner, Jonathan

    Journal of developmental origins of health and disease

    2023  Volume 14, Issue 5, Page(s) 591–601

    Abstract: The deleterious effects of adversity are likely intergenerational, such that one generation's adverse experiences can affect the next. Epidemiological studies link maternal adversity to offspring depression and anxiety, possibly via transmission ... ...

    Abstract The deleterious effects of adversity are likely intergenerational, such that one generation's adverse experiences can affect the next. Epidemiological studies link maternal adversity to offspring depression and anxiety, possibly via transmission mechanisms that influence offspring fronto-limbic connectivity. However, studies have not thoroughly disassociated postnatal exposure effects nor considered the role of offspring sex. We utilized infant neuroimaging to test the hypothesis that maternal childhood maltreatment (CM) would be associated with increased fronto-limbic connectivity in infancy and tested brain-behavior associations in childhood. Ninety-two dyads participated (32 mothers with CM, 60 without; 52 infant females, 40 infant males). Women reported on their experiences of CM and non-sedated sleeping infants underwent MRIs at 2.44 ± 2.74 weeks. Brain volumes were estimated via structural MRI and white matter structural connectivity (fiber counts) via diffusion MRI with probabilistic tractography. A subset of parents (
    MeSH term(s) Male ; Infant ; Child ; Humans ; Female ; Child, Preschool ; White Matter/diagnostic imaging ; Mothers ; Brain/diagnostic imaging ; Magnetic Resonance Imaging ; Anxiety
    Language English
    Publishing date 2023-09-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 2554780-X
    ISSN 2040-1752 ; 2040-1744
    ISSN (online) 2040-1752
    ISSN 2040-1744
    DOI 10.1017/S2040174423000247
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Distance Education Course about Sexuality for Obstetrics and Gynecology Residents.

    Vieira, Teresa Cristina Souza Barroso / Nakamura, Mary Uchiyama / Silva, Ivaldo da / Torloni, Maria Regina / Ribeiro, Meireluci Costa / Souza, Eduardo de

    Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia

    2017  Volume 39, Issue 12, Page(s) 670–675

    Abstract: ... ...

    Title translation Curso de educação a distância sobre sexualidade para residentes em Obstetrícia e Ginecologia.
    Abstract Purpose
    MeSH term(s) Adult ; Education, Distance ; Female ; Gynecology/education ; Humans ; Internship and Residency/methods ; Male ; Obstetrics/education ; Prospective Studies ; Sexology/education
    Language English
    Publishing date 2017-11-27
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 2105176-8
    ISSN 1806-9339 ; 0100-7203
    ISSN (online) 1806-9339
    ISSN 0100-7203
    DOI 10.1055/s-0037-1606273
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: IGF-1R and Leptin Expression Profile and the Effects of Metformin Treatment on Metabolic and Endocrine Parameters in PCOS Mice.

    Prado Correia, Luis Eduardo / de Almeida, Bruna Cristine / de Jesus Simões, Manuel / Abi Haidar, Mauro / Berguio Vidotti, Daniela / Silva, Ivaldo

    BioMed research international

    2017  Volume 2017, Page(s) 9058307

    Abstract: We aim to assess the effects of metformin treatment on metabolic and endocrine parameters and genes expression related to the insulin-responsive pathway in polycystic ovary syndrome (PCOS). This study comprises twenty-eight obese mice divided into three ... ...

    Abstract We aim to assess the effects of metformin treatment on metabolic and endocrine parameters and genes expression related to the insulin-responsive pathway in polycystic ovary syndrome (PCOS). This study comprises twenty-eight obese mice divided into three metformin-treated groups for seven and twenty days and eight nonobese and nontreated ones. We found a significant decrease in glycemia after metformin treatment at days seven and twenty. However, we did not observe differences in body weight measurement. Histologically, after twenty days we observed follicular development with regression of androgenic effects. Levels of IGF-1R protein expression were low after twenty days of treatment, but LEP proteins showed an overexpression in the ovarian stroma. We assessed the IGF-1R and LEP mRNAs levels; data showed a significant overexpression of LEP after seven days of treatment, while the IGF-1R was downregulated. Metformin therapy seems to exert a beneficial effect on histological and anovulatory features, reducing follicular number and pyknosis formation, possibly involved in the reversion of androgenic stimulus. Expression of IGF-1 and LEPR indicates a relevant role in androgenic features reversion present in PCOS, hormonal equilibrium, body weight regulation, and glucose metabolism, therefore, under phenotype obesity and infertility regulation in this model.
    MeSH term(s) Animals ; Blood Glucose/drug effects ; Body Weight/drug effects ; Female ; Gene Expression Regulation/drug effects ; Humans ; Hypoglycemic Agents/administration & dosage ; Insulin/metabolism ; Insulin Resistance/genetics ; Leptin/genetics ; Metformin/administration & dosage ; Mice ; Mice, Obese ; Polycystic Ovary Syndrome/drug therapy ; Polycystic Ovary Syndrome/genetics ; Polycystic Ovary Syndrome/pathology ; Receptor, IGF Type 1/genetics ; Receptors, Leptin/genetics
    Chemical Substances Blood Glucose ; Hypoglycemic Agents ; Insulin ; Leptin ; Receptors, Leptin ; leptin receptor, mouse ; Metformin (9100L32L2N) ; Receptor, IGF Type 1 (EC 2.7.10.1)
    Language English
    Publishing date 2017-12-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2698540-8
    ISSN 2314-6141 ; 2314-6133
    ISSN (online) 2314-6141
    ISSN 2314-6133
    DOI 10.1155/2017/9058307
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Experience of an online course on sexuality during pregnancy for residents.

    Vieira, Teresa Cristina Souza Barroso / Nakamura, Mary Uchiyama / da Silva, Ivaldo / Torloni, Maria Regina / Ribeiro, Meireluci Costa / Scanavino, Marco de Tubino / de Souza, Eduardo

    Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives

    2017  Volume 12, Page(s) 76–81

    Abstract: Objective: Many obstetrics and gynecology (Ob/Gyn) residents report insufficient knowledge about female sexuality and this has a negative impact on their capacity to manage their patients. The aim of this study was to describe an online course about ... ...

    Abstract Objective: Many obstetrics and gynecology (Ob/Gyn) residents report insufficient knowledge about female sexuality and this has a negative impact on their capacity to manage their patients. The aim of this study was to describe an online course about sexuality during pregnancy for Brazilian Ob/Gyn residents and evaluate their knowledge acquisition.
    Methods: This longitudinal educational intervention study involved 219 Brazilian Ob/Gyn residents. The online course lasted 24h (10 video lectures and discussion chats). Upon enrollment, the participants answered a questionnaire in regard to their training, attitudes and practices about sexuality during pregnancy. Participants' knowledge acquisition was assessed using a pre- and post-course test about sexuality during pregnancy. At the end of the course, participants were asked to evaluate their educational experience. Student's t and chi-square tests were used to analyze the pre- and post-course test scores. P values<0.05 were considered statistically significant.
    Results: A total of 143 Ob/Gyns (65.3% of those enrolled) completed the course. At baseline, most participants reported that they did not have any sexology classes as undergraduates (62.5%) or in their residency (52.1%), and that they lacked specific knowledge in this area to manage their patients. Mean test scores increased significantly at the end of the course: 4.4 (±1.6) versus 6.0 (±1.3) (out of a maximum score of 10), before and after the course, respectively (p<0.0001). Most of the residents rated the overall quality of the course as "higher than expected".
    Conclusion: An online course for Ob/Gyn residents was associated with a significant increase in knowledge about sexuality during pregnancy.
    Language English
    Publishing date 2017-06
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2541869-5
    ISSN 1877-5764 ; 1877-5756
    ISSN (online) 1877-5764
    ISSN 1877-5756
    DOI 10.1016/j.srhc.2017.03.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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