Revisão sistemática e meta-análise do uso de antidepressivos no transtorno de ansiedade generalizada

Revisão da Literatura: O Transtorno de Ansiedade Generalizada (TAG) é caracterizado por preocupação excessiva, persistente e incontrolável sobre diversos aspectos da vida do paciente. Tem prevalência entre 1,6% e 5,1% e índice de comorbidades de até 90,4%. As principais comorbidades são depressão maior (64%) e distimia (37%). Os antidepressivos podem ser eficazes no tratamento do TAG. A Medicina Baseada em Evidências (MBE) busca reunir a melhor evidência disponível com experiência clínica e conhecimentos de fisiopatologia. A melhor maneira disponível de síntese das evidências é a revisão sistemática e a meta-análise. Objetivos: Investigar a eficácia e tolerabilidade dos antidepressivos no tratamento do TAG através de uma revisão sistemática da literatura e meta-análise. Sumário do artigo científico: A revisão sistemática incluiu ensaios clínicos randomizados e controlados e excluiu estudos não-randomizados, estudos com pacientes com TAG e outro transtorno de eixo I. Os dados foram extraídos por dois revisores independentes e risco relativo, diferença da média ponderada e número necessário para tratamento (NNT) foram calculados. Antidepressivos (imipramina, paroxetina e venlafaxina) foram superiores ao placebo. O NNT calculado foi de 5,5. A evidência disponível sugere que os antidepressivos são superiores ao placebo no tratamento do TAG e bem tolerados pelos pacientes.

Psicologia social, ideológica e meta-ideológica: (psicogênese e sociogênese no modelo dialético)

O presente estudo propõe uma interpretação da Psicologia Social como expressão da relação homem/meio, baseada no modelo dialético genético-estrutural Piagetano. É conceituada uma interdependência entre diferentes níveis de análise teórica e uma continuidade do mais simples ao complexo, mantendo-se a autonomia relativa, em cada nível que, com suas próprias leis, obedecerá ao sistema global da organização vital: níveis biológicos, psicológicos e sociológicos encadeiam-se, sem que se possa definir um limite estrito entre eles. Supera-se assim o problema metodológico de abstração de níveis que leva a consideráveis distorções, especialmente quando se abstrai o nível político-social. Psicologia Social será o estudo da ação que uma estrutura social provoca no indivíduo e a ação recíproca que o indivíduo exerce sobre a estrutura social: o sujeito participa ativamente, em grupo, da construção da estrutura que sobre ele atua. Frente à abordagem psicossocial dominante, empírico-analítica e à abordagem alternativa, histórico-social, e introduzida uma visão interacionista que integra como complementares posições conflitantes, sendo criticadas teorias que pretendem reduzir o comportamento humano ao meio ou ao sujeito. É proposta uma teoria psicobiológica da relação homem/meio que definira o grau de desenvolvimento atingido pelo indivíduo e grupo como função da interação permitida: se o contexto for repressor, ocorrera uma atualização empobrecida de fenótipos culturais. O psicólogo social deverá ter um enfoque do desenvolvimento do indivíduo e sociedade, para poder atuar de forma politicamente relevante. A ideologia ê interpretada como expressa0 de uma função humana mais geral, a função simbólica e será sempre dependente da autorregularão atingida pelo grupo em um contexto sócio-político específico. Como uma ação concreta sempre é ideológica por sua práxis, um nível meta-ideológico só será atingido através da atuação num nível ideológico; apenas através da pesquisa psico e sociogenética se atingirá um dado não-ideológico.

WAMM: wiki aided meta modelling

All over the world, organizations are becoming more and more complex, and there’s a need to capture its complexity, so this is when the DEMO methodology (Design and Engineering Methodology for Organizations), created and developed by Jan L. G. Dietz, reaches its potential, which is to capture the structure of business processes in a coherent and consistent form of diagrams with their respective grammatical rules. The creation of WAMM (Wiki Aided Meta Modeling) platform was the main focus of this thesis, and had like principal precursor the idea to create a Meta-Editor that supports semantic data and uses MediaWiki. This prototype Meta-Editor uses MediaWiki as a receptor of data, and uses the ideas created in the Universal Enterprise Adaptive Object Model and the concept of Semantic Web, to create a platform that suits our needs, through Semantic MediaWiki, which helps the computer interconnect information and people in a more comprehensive, giving meaning to the content of the pages. The proposed Meta-Modeling platform allows the specification of the abstract syntax i.e., the grammar, and concrete syntax, e.g., symbols and connectors, of any language, as well as their model types and diagram types. We use the DEMO language as a proofof-concept and example. All such specifications are done in a coherent and formal way by the creation of semantic wiki pages and semantic properties connecting them.

Cabergoline versus bromocriptine in the treatment of hyperprolactinemia: a systematic review of randomized controlled trials and meta-analysis

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

TNF-308G > A Single Nucleotide Polymorphism Is Associated With Leprosy Among Brazilians: A Genetic Epidemiology Assessment, Meta-Analysis, and Functional Study

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Single-embryo transfer reduces clinical pregnancy rates and live births in fresh IVF and Intracytoplasmic Sperm Injection (ICSI) cycles: a meta-analysis

Background: It has become an accepted procedure to transfer more than one embryo to the patient to achieve acceptable ongoing pregnancy rates. However, transfers of more than a single embryo increase the probability of establishing a multiple gestation. Single-embryo transfer can minimize twin pregnancies but may also lower live birth rates. This meta-analysis aimed to compare current data on single-embryo versus double-embryo transfer in fresh IVF/ICSI cycles with respect to implantation, ongoing pregnancy and live birth rates.Methods: Search strategies included on-line surveys of databases from 1995 to 2008. Data management and analysis were conducted using the Stats Direct statistical software. The fixed-effect model was used for odds ratio (OR). Fixed-effect effectiveness was evaluated by the Mantel Haenszel method. Seven trials fulfilled the inclusion criteria.Results: When pooling results under the fixed-effect model, the implantation rate was not significantly different between double-embryo transfer (34.5%) and single-embryo transfer group (34.7%) (P = 0.96; OR = 0.99, 95% CI 0.78, 1.25). on the other hand, double-embryo transfer produced a statistically significantly higher ongoing clinical pregnancy rate (44.5%) than single-embryo transfer (28.3%) (P < 0.0001; OR: 2.06, 95% CI = 1.64,2.60). At the same time, pooling results presented a significantly higher live birth rate when double-embryo transfer (42.5%) (P < 0.001; OR: 1.87, 95% CI = 1.44,2.42) was compared with single-embryo transfer (28.4%).Conclusion: Meta-analysis with 95% confidence showed that, despite similar implantation rates, fresh double-embryo transfer had a 1.64 to 2.60 times greater ongoing pregnancy rate and 1.44 to 2.42 times greater live birth rate than single-embryo transfer in a population suitable for ART treatment.

A machine learning approach for genome-wide prediction of morbid and druggable human genes based on systems-level data

Background: The genome-wide identification of both morbid genes, i.e., those genes whose mutations cause hereditary human diseases, and druggable genes, i.e., genes coding for proteins whose modulation by small molecules elicits phenotypic effects, requires experimental approaches that are time-consuming and laborious. Thus, a computational approach which could accurately predict such genes on a genome-wide scale would be invaluable for accelerating the pace of discovery of causal relationships between genes and diseases as well as the determination of druggability of gene products.Results: In this paper we propose a machine learning-based computational approach to predict morbid and druggable genes on a genome-wide scale. For this purpose, we constructed a decision tree-based meta-classifier and trained it on datasets containing, for each morbid and druggable gene, network topological features, tissue expression profile and subcellular localization data as learning attributes. This meta-classifier correctly recovered 65% of known morbid genes with a precision of 66% and correctly recovered 78% of known druggable genes with a precision of 75%. It was than used to assign morbidity and druggability scores to genes not known to be morbid and druggable and we showed a good match between these scores and literature data. Finally, we generated decision trees by training the J48 algorithm on the morbidity and druggability datasets to discover cellular rules for morbidity and druggability and, among the rules, we found that the number of regulating transcription factors and plasma membrane localization are the most important factors to morbidity and druggability, respectively.Conclusions: We were able to demonstrate that network topological features along with tissue expression profile and subcellular localization can reliably predict human morbid and druggable genes on a genome-wide scale. Moreover, by constructing decision trees based on these data, we could discover cellular rules governing morbidity and druggability.

Probiotics for broiler chickens in Brazil: systematic review and meta-analysis

This study evaluated the efficacy of probiotic utilization as growth promoters in broiler chicken feeding using systematic literature review and meta-analysis. Thirty-five studies were recovered by the systematic review, 27 of which met the following criteria to be included in the meta-analysis: (1) Brazilian studies published between 1995 and 2005; (2) probiotics administered in the diet without growth promoter; (3) results included performance data with the respective coefficient of variation. Meta-analysis have shown that the probiotics promoted better weight gain and feed conversion than the negative control (no antimicrobial) in the initial phase (1 to 20-28 days); nevertheless, results were similar in the total period (1 to 35-48 days). Weight gain and feed conversion were similar between probiotics and the positive control (with antimicrobial) both in the initial and in the total periods. Viability in the total period improved with the use of probiotics in comparison to the negative or positive controls. Sensitivity analysis showed that the results of meta-analysis were coherent. The funnel plots and the Egger regression method evidenced that the studies published in Brazil do not present biased results. It is possible to conclude that the probiotics are a technically viable alternative to antimicrobial growth promoters in broiler feeding. Nevertheless, further studies are necessary to identify eventual differences among the probiotics commercially available in Brazil.

Cryoablation vs radiofrequency ablation for the treatment of renal cell carcinoma: a meta-analysis of case series studies

OBJECTIVETo determine the current status of the literature regarding the clinical efficacy and complication rates of cryoablation vs radiofrequency ablation in the treatment of small renal tumours.METHODSA review of the literature was conducted. There was no language restriction. Studies were obtained from the following sources: MEDLINE, EMBASE and LILACS.Inclusion criteria were (i) case series design with more than one case reported, (ii) use of cryoablation or radiofrequency ablation, (iii) patients with renal cell carcinoma and, (iv) outcome reported as clinical efficacy.When available, we also quantified the complication rates from each included study.Proportional meta-analysis was performed on both outcomes with a random-effects model. The 95% confidential intervals were also calculated.RESULTSThirty-one case series (20 cryoablation, 11 radiofrequency ablation) met all inclusion criteria.The pooled proportion of clinical efficacy was 89% in cryoablation therapy from a total of 457 cases. There was a statistically significant heterogeneity between these studies showing the inconsistency of clinical and methodological aspects.The pooled proportion of clinical efficacy was 90% in radiofrequency ablation therapy from a total of 426 cases. There was no statistically significant heterogeneity between these studies.There was no statistically significant difference regarding complications rate between cryoablation and radiofrequency ablation.CONCLUSIONSThis review shows that both ablation therapies have similar efficacy and complication rates.There is urgency for performing clinical trials with long-term data to establish which intervention is most suitable for the treatment of small renal masses.

A Meta-Analysis of Predation Risk Effects on Pollinator Behaviour

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Identifying multiple interacting bad data in power system state estimation

This paper presents an intelligent search strategy for the conforming bad data errors identification in the generalized power system state estimation, by using the tabu search meta heuristic. The main objective is to detect critical errors involving both analog and topology errors. These errors are represented by conforming errors, whose nature affects measurements that actually do not present bad data and also the conventional bad data identification strategies based on the normalized residual methods. ©2005 IEEE.

GnRH agonist versus GnRH antagonist in poor ovarian responders: A meta-analysis

The aim of this meta-analysis was to compare the efficacy of gonadotrophin antagonist (GnRH-ant) versus GnRH agonist (GnRHa) as coadjuvant therapy for ovarian stimulation in poor ovarian responders in IVF/intracytoplasmic sperm injection cycles. Search strategies included on-line surveys of databases such as MEDLINE, EMBASE and others. A fixed effects model was used for odds ratio (OR) and effect size (weighted mean difference, WMD). Six trials fulfilled the inclusion criteria (randomized controlled trials). There was no difference between GnRH-ant and GnRHa (long and flare-up protocols) with respect to cycle cancellation rate, number of mature oocytes and clinical pregnancy rate per cycle initiated, per oocyte retrieval and per embryo transfer. When the mete-analysis was applied to the two trials that had used GnRH-ant versus long protocols of GnRHa, a significantly higher number of retrieved oocytes was observed in the GnRH-ant protocols [P = 0.018; WMD: 1.12 (0.18, 2.05)]. However, when the meta-analysis was applied to the four trials that had used GnRH-ant versus flare-up protocols, a significantly higher number of retrieved oocytes (P = 0.032; WMD: -0.51, 95% CI -0.99, -0.04) was observed in the GnRHa protocols. Nevertheless, additional randomized controlled trials with better planning are needed to confirm these results.

Recombinant LH supplementation to recombinant FSH during induced ovarian stimulation in the GnRH-antagonist protocol: A meta-analysis

This study aims to compare the efficacy of recombinant LH (rLH) supplementation for ovarian stimulation in gonadotrophin-releasing hormone-antagonist protocol for IVF/intracytoplasmic sperm injection cycles. Search strategies included online surveys of databases. The fixed effects model was used for odds ratio (OR) and effect size (weighted mean difference, WMD). Five trials fulfilled the inclusion criteria. When the meta-analysis was carried out, advantages were observed for the LH supplementation protocol with respect to higher serum oestradiol concentrations on the day of human chorionic gonadotrophin administration (P < 0.0001; WMD: 514, 95% CI 368, 660) and higher number of mature oocytes (P = 0.0098; WMD: 0.88, 95% CI 0.21, 1.54). However, these differences were not observed in the total amount of recombinant FSH (rFSH) administered, days of stimulation, number of oocytes retrieved, the clinical pregnancy rate per oocyte retrieval, the implantation rate and miscarriage rate. This result demonstrates that the association of rLH with rFSH may prevent any decrease in oestradiol after antagonist administration and that a significantly higher number of mature oocytes was available for laboratory work. Nevertheless, it failed to show any statistically significant difference in clinically significant end-points in IVF (implantation and pregnancy rates). Additional randomized controlled trials are needed to confirm these results further. © 2007 Published by Reproductive Healthcare Ltd.

Correlação entre a taxa de fertilização e o fuso meiótico em oócitos humanos: Uma meta-análise

Objective: To investigate the relationship between the presence of meiotic spindle in human oocytes and fertilization rates in ICSI cycles. Methods: Search strategies included online surveys of databases from 1990 to 2008. Nine trials fulfilled the inclusion criteria Results: According to the meta-analysis, the results showed statistically significant higher fertilization rate (p<0.0001) when the meiotic spindle was viewed than when it was not. There was heterogeneity in this comparison. Conclusion: The presence of a birefringent meiotic spindle in human oocytes can predict a higher fertilization rate. This observation has clinical relevance mainly in countries where there is a legal limit on the number of oocytes to be fertilized. Copyright - SBRA - Sociedade Brasileira de Reprodução Assistida.

A meta-analytical study about the relation of blood plasma addition in diets for piglets in the post-weaning and productive performance variables

The meta-analysis was used to evaluate the performance of piglets in post-weaning period, without imposition of sanitary challenge and fed diets containing blood plasma, obtained by spray-dried process (SDBP). Piglets are faced with normal challenges in post-weaning period such as environmental stress and the substitution of the liquid diet to a solid one. References regarding sanitary challenges were disregarded in this study. Only data regarding normal and expected challenges were considered. Data were obtained from indexed journals with information extracted from the material, methods and results sections of pre-selected scientific articles. First, the database was analyzed graphically to observe the distribution of data and presence of outliers. Afterwards correlation analysis and variance-covariance analyses were carried out. The database contained a total of 23 articles. The average initial weight of the piglets was 8.02. kg (4.00-9.28. kg) and the average initial age was 27 days (14-32 days). The average duration of feeding diets containing spray-dried blood plasma (SDBP) was 9 days (6-28 days). SDBP increased the feed conversion by 20.2% (P<0.05) during the initial period. Feed conversion during the total period was 10.2% higher (P<0.05) for animals fed with SDBP. Average daily weight gain and daily feed intake were not affected (P>0.05) during the entire period, but average daily gain was higher (P<0.05) for animals fed with SDBP during the initial period. The initial age of supplementation influenced the average daily weight gain and average daily feed intake of animals fed with SDBP. Better results were obtained than those obtained for animals up to 35 days of age fed diets without added SDBP supplementation. In early post-weaning period for piglets weaned up to 35 days of age, the SDBP supplementation positively influenced the average daily weight gain and feed conversion. © 2013 Elsevier B.V.