Efetividade da finasterida no tratamento da síndrome da dor pélvica crônica: revisão sistemática e metanálise

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Plínio Marcos e a perspectiva utópica de superação

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Apontamentos sobre a história constitutiva dos saberes crimino-penais

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A ciência na imprensa paraense em 130 anos: um estudo de três grandes jornais diários

Esta dissertação se constitui em um estudo exploratório para reconhecimento de cenário sobre a cobertura de temas científicos em jornais do Pará, por isso, nossa atenção se voltou para a análise de três importantes jornais diários paraenses ao longo de 130 anos: A Província do Pará (1876-2002), Folha do Norte (1896-1974) e O Liberal (1946-atual). Para selecionar os textos sobre ciência desses periódicos, investigamos as edições de janeiro e julho de dez em dez anos de cada jornal, desde 1876 até 2006. Foram feitas adaptações no protocolo da Rede Ibero-Americana de Monitoramento e Capacitação em Jornalismo Científico – voltado para materiais televisivos – para tornar possível a pesquisa em jornais impressos. O protocolo se baseia no método de análise de conteúdo e possibilitou a caracterização e sistematização de informações dos 496 textos encontrados com questões científicas a partir da metodologia escolhida. Identificamos dados como a data de publicação do material, a presença de manchetes e chamadas na primeira página do jornal, o gênero jornalístico dos textos, a área do conhecimento predominante, os recursos visuais utilizados, os enquadramentos, a contextualização das questões científicas, as explicações de termos científicos, os benefícios e malefícios e as promessas e riscos da ciência, as controvérsias científicas e não científicas, fontes e vozes, e os locais das pesquisas e dos pesquisadores presentes nos textos selecionados. Os dados evidenciaram que a ciência já era pauta dos jornais paraenses no fim do século XIX, mas ganharam mais espaço a partir da segunda metade do século XX. Houve um grande destaque para as questões científicas relacionadas à saúde, apesar das pesquisas espaciais também terem tido forte presença. Observamos ainda expressiva contextualização e explicações de termos científicos. De forma geral, a ciência foi divulgada a partir do seu lado “positivo”, mostrando os seus benefícios, e com ênfase nas descobertas científicas. Por outro lado, foi dado pouco espaço para a discussão de suas controvérsias. Os recursos visuais também foram raros. As principais fontes e vozes identificadas no corpus foram dos cientistas e instituições de pesquisa e a maioria dos pesquisadores foi constituída por homens. Houve ainda um equilíbrio entre as pesquisas e pesquisadores do Brasil e aqueles de fora do país. A Província do Pará destacou temas da saúde, de forma predominante, mas também das ciências exatas e engenharias e deu espaço diferenciado a fontes e vozes não científicas. A Folha do Norte publicou textos mais longos e com bastante contextualização. Já O Liberal enfatizou questões de medicina e ciências humanas e foi o único periódico que deu mais destaque à pesquisa e aos pesquisadores brasileiros e, em especial, aos paraenses.

Sexagem molecular em aves: contribuições à conservação biológica e á divulgação científica

Pós-graduação em Ciências Biológicas (Genética) - IBB

Surgical interventions for treating pectus excavatum

Background: Pectus excavatum is characterized by a depression of the anterior chest wall (sternum and lower costal cartilages) and is the most frequently occurring chest wall deformity. The prevalence ranges from 6.28 to 12 cases per 1000 around the world. Generally pectus excavatum is present at birth or is identified after a few weeks or months; however, sometimes it becomes evident only at puberty. The consequence of the condition on a individual's life is variable, some live a normal life and others have physical and psychological symptoms such as: precordial pain after exercises; impairments of pulmonary and cardiac function; shyness and social isolation. For many years, sub-perichondrial resection of the costal cartilages, with or without transverse cuneiform osteotomy of the sternum and placement of a substernal support, called conventional surgery, was the most accepted option for surgical repair of these patients. From 1997 a new surgical repair called, minimally invasive surgery, became available. This less invasive surgical option consists of the retrosternal placement of a curved metal bar, without resections of the costal cartilages or sternum osteotomy, and is performed by videothoracoscopy. However, many aspects that relate to the benefits and harms of both techniques have not been defined. Objectives: To evaluate the effectiveness and safety of the conventional surgery compared with minimally invasive surgery for treating people with pectus excavatum. Search methods: With the aim of increasing the sensitivity of the search strategy we used only terms related to the individual's condition (pectus excavatum); terms related to the interventions, outcomes and types of studies were not included. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, LILACS, and ICTPR. Additionally we searched yet reference lists of articles and conference proceedings. All searches were done without language restriction. Date of the most recent searches: 14 January 2014. Selection criteria: We considered randomized or quasi-randomized controlled trials that compared traditional surgery with minimally invasive surgery for treating pectus excavatum. Data collection and analysis: Two review authors independently assessed the eligibility of the trials identified and agreed trial eligibility after a consensus meeting. The authors also assessed the risk of bias of the eligible trials. Main results: Initially we located 4111 trials from the electronic searches and two further trials from other resources. All trials were added into reference management software and the duplicates were excluded, leaving 2517 studies. The titles and abstracts of these 2517 studies were independently analyzed by two authors and finally eight trials were selected for full text analysis, after which they were all excluded, as they did not fulfil the inclusion criteria. Authors' conclusions: There is no evidence from randomized controlled trials to conclude what is the best surgical option to treat people with pectus excavatum.

Surgical interventions for treating pectus excavatum

Pectus excavatum is characterized by a depression of the anterior chest wall (sternum and lower costal cartilages) and is the most frequently occurring chest wall deformity. The prevalence ranges from 6.28 to 12 cases per 1000 around the world. Generally pectus excavatum is present at birth or is identified after a few weeks or months; however, sometimes it becomes evident only at puberty. The consequence of the condition on a individual’s life is variable, some live a normal life and others have physical and psychological symptoms such as: precordial pain after exercises; impairments of pulmonary and cardiac function; shyness and social isolation. For many years, sub-perichondrial resection of the costal cartilages, with or without transverse cuneiform osteotomy of the sternum and placement of a substernal support, called conventional surgery, was the most accepted option for surgical repair of these patients. From 1997 a new surgical repair called, minimally invasive surgery, became available. This less invasive surgical option consists of the retrosternal placement of a curved metal bar, without resections of the costal cartilages or sternum osteotomy, and is performed by videothoracoscopy. However, many aspects that relate to the benefits and harms of both techniques have not been defined. Objectives To evaluate the effectiveness and safety of the conventional surgery compared with minimally invasive surgery for treating people with pectus excavatum. Search methods With the aim of increasing the sensitivity of the search strategy we used only terms related to the individual’s condition (pectus excavatum); terms related to the interventions, outcomes and types of studies were not included. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, LILACS, and ICTPR. Additionally we searched yet reference lists of articles and conference proceedings. All searches were done without language restriction.

Intervenções cirúrgicas para o tratamento do pectus excavatum: revisão sistemática

Pós-graduação em Bases Gerais da Cirurgia - FMB

Intervenções cirúrgicas para o tratamento do pectus excavatum: revisão sistemática

Pós-graduação em Bases Gerais da Cirurgia - FMB

Forensische Psychophysiologie

Dieses Experiment untersuchte die Effekte der unterschiedlichen Fragen- bzw. Itemtypen (Stimuli), des Wahrheitsgehalts der Antworten und der elektrodermalen Labilität auf die Hautleitfähigkeitsreaktionen (SCR) und die phasische Herzschlagfrequenz (HR) für zwei relativ neue Befragungstechniken der forensischen Psychophysiologie ('Lügendetektion'): Directed Lie Test (DLT) und Guilty Actions Test (GAT).Achtzig Männer begingen einen simulierten Schmuckdiebstahl. Jeweils die Hälfte entwendete entweder einen Ring oder eine Kette. Während dieser Tat wurden jedoch alle Probanden mit den kritischen Details beider Scheinverbrechen konfrontiert. Anschließend absolvierten sie entweder einen DLT oder einen GAT. Die relevanten Stimuli der Tests bezogen sich auf beide Scheinverbrechen und wurden - intraindividuell variiert - wahrheitswidrig und wahrheitsgemäß verneint. Darüber hinaus umfaßte der DLT inhaltlich parallelisierte Paare von Kontrollfragen. Die Probanden wurden instruiert, die jeweiligen Kontrollfragen eines Paars wahrheitswidrig versus wahrheitsgemäß zu verneinen. Die Testverfahren beinhalteten außerdem nicht tatbezogene, irrelevante Stimuli, die wahrheitsgemäß beantwortet wurden. Für beide Befragungstechniken fand man Reaktionsunterschiede zwischen den Stimulustypen, insbesondere stärkere SCR-Magnituden und eine niedrigere HR auf die wahrheitswidrig verneinten relevanten Stimuli. Bei den Kontrollfragen des DLT zeigten sich jedoch keine signifikanten Effekte des Wahrheitsgehalts. Die elektrodermale Labilität hatte keinen bedeutsamen Einfluß auf die Reaktionsunterschiede. Die Ergebnisse wurden vor allem anhand psychophysiologischer Theorien der Aufmerksamkeit, Konflikte und Informationsverarbeitung interpretiert.

Applicability of DNA Analysis on Adhesive Tape in Forensic Casework

Adhesive tape is commonly used in crimes and is often the subject of forensic evaluation. DNA analysis of adhesive tape can provide DNA profiles of suspects. The object of this study was to evaluate the applicability of DNA analysis on adhesive tape samples in forensic casework. We retrospectively reviewed all cases involving adhesive tape or similar items received by our institute for DNA analysis during the past 11 years. From 100 forensic cases reviewed, 150 adhesive tape samples were examined. A total of 98 DNA profiles were obtained from these samples. Sixty-two of the profiles provided feasible case-relevant information. In conclusion, DNA profiling of adhesive tape samples can be useful in a variety of forensic cases.

Effectiveness of chlamydia screening: systematic review

BACKGROUND: Screening programmes are promoted to control transmission of and prevent female reproductive tract morbidity caused by genital chlamydia. The objective of this study was to examine the effectiveness of register-based and opportunistic chlamydia screening interventions. METHODS: We searched seven electronic databases (Cinahl, Cochrane Controlled Trials Register, DARE, Embase, Medline, PsycINFO and SIGLE) without language restrictions from January 1990 to October 2007 and reference lists of retrieved articles to identify studies published before 1990. We included studies examining primary outcomes (pelvic inflammatory disease, ectopic pregnancy, infertility, adverse pregnancy outcomes, neonatal infection, chlamydia prevalence) and harms of chlamydia screening in men and non-pregnant and pregnant women. We extracted data in duplicate and synthesized the data narratively or used random effects meta-analysis, where appropriate. RESULTS: We included six systematic reviews, five randomized trials, one non-randomized comparative study and one time trend study. Five reviews recommended screening of women at high risk of chlamydia. Two randomized trials found that register-based screening of women at high risk of chlamydia and of female and male high school students reduced the incidence of pelvic inflammatory disease in women at 1 year. Methodological inadequacies could have overestimated the observed benefits. One randomized trial showed that opportunistic screening in women undergoing surgical termination of pregnancy reduced post-abortal rates of pelvic inflammatory disease compared with no screening. We found no randomized trials showing a benefit of opportunistic screening in other populations, no trial examining the effects of more than one screening round and no trials examining the harms of chlamydia screening. CONCLUSION: There is an absence of evidence supporting opportunistic chlamydia screening in the general population younger than 25 years, the most commonly recommended approach. Equipoise remains, so high-quality randomized trials of multiple rounds of screening with biological outcome measures are still needed to determine the balance of benefits and harms of chlamydia screening.

Systemic prokinetic pharmacologic treatment for postoperative adynamic ileus following abdominal surgery in adults

BACKGROUND: Postoperative adynamic bowel atony interferes with recovery following abdominal surgery. Prokinetic pharmacologic drugs are widely used to accelerate postoperative recovery. OBJECTIVES: To evaluate the benefits and harms of systemic acting prokinetic drugs to treat postoperative adynamic ileus in patients undergoing abdominal surgery. SEARCH STRATEGY: Trials were identified by computerised searches of the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and the Cochrane Colorectal Cancer Group specialised register. The reference lists of included trials and review articles were tracked and authors contacted. SELECTION CRITERIA: Randomised controlled parallel-group trials (RCT) comparing the effect of systemically acting prokinetic drugs against placebo or no intervention. DATA COLLECTION AND ANALYSIS: Four reviewers independently extracted the data and assessed trial quality. Trial authors were contacted for additional information if needed. MAIN RESULTS: Thirty-nine RCTs met the inclusion criteria contributing a total of 4615 participants. Most trials enrolled a small number of patients and showed moderate to poor (reporting of) methodological quality, in particular regarding allocation concealment and intention-to-treat analysis. Fifteen systemic acting prokinetic drugs were investigated and ten comparisons could be summarized. Six RCTs support the effect of Alvimopan, a novel peripheral mu receptor antagonist. However, the trials do not meet reporting guidelines and the drug is still in an investigational stage. Erythromycin showed homogenous and consistent absence of effect across all included trials and outcomes. The evidence is insufficient to recommend the use of cholecystokinin-like drugs, cisapride, dopamine-antagonists, propranolol or vasopressin. Effects are either inconsistent across outcomes, or trials are too small and often of poor methodological quality. Cisapride has been withdrawn from the market due to adverse cardiac events in many countries. Intravenous lidocaine and neostigmine might show a potential effect, but more evidence on clinically relevant outcomes is needed. Heterogeneity among included trials was seen in 10 comparisons. No major adverse drug effects were evident. AUTHORS' CONCLUSIONS: Alvimopan may prove to be beneficial but proper judgement needs adherence to reporting standards. Further trials are needed on intravenous lidocaine and neostigmine. The remaining drugs can not be recommended due to lack of evidence or absence of effect.

[Primary ciliary dyskinesia (Pcd) in Austria]

INTRODUCTION: Primary ciliary dyskinesia (PCD) is a rare hereditary recessive disease with symptoms of recurrent pneumonia, chronic bronchitis, bronchiectasis, and chronic sinusitis. Chronic rhinitis is often the presenting symptom in newborns and infants. Approximately half of the patients show visceral mirror image arrangements (situs inversus). In this study, we aimed 1) to determine the number of paediatric PCD patients in Austria, 2) to show the diagnostic and therapeutic modalities used in the clinical centres and 3) to describe symptoms of children with PCD. PATIENTS, MATERIAL AND METHODS: For the first two aims, we analysed data from a questionnaire survey of the European Respiratory Society (ERS) task force on Primary Ciliary Dyskinesia in children. All paediatric respiratory units in Austria received a questionnaire. Symptoms of PCD patients from Vienna Children's University Hospital (aim 3) were extracted from case histories. RESULTS: In 13 Austrian clinics 48 patients with PCD (36 aged from 0-19 years) were identified. The prevalence of reported cases (aged 0-19 yrs) in Austria was 1:48000. Median age at diagnosis was 4.8 years (IQR 0.3-8.2), lower in children with situs inversus compared to those without (3.1 vs. 8.1 yrs, p = 0.067). In 2005-2006, the saccharine test was still the most commonly used screening test for PCD in Austria (45%). Confirmation of the diagnosis was usually by electron microscopy (73%). All clinics treated exacerbations immediately with antibiotics, 73% prescribed airway clearance therapy routinely to all patients. Other therapies and diagnostic tests were applied very inconsistently across Austrian hospitals. All PCD patients from Vienna (n = 13) had increased upper and lower respiratory secretions, most had recurring airway infections (n = 12), bronchiectasis (n = 7) and bronchitis (n = 7). CONCLUSION: Diagnosis and therapy of PCD in Austria are inhomogeneous. Prospective studies are needed to learn more about the course of the disease and to evaluate benefits and harms of different treatment strategies.

Mammografie-Screening

Nur wenige Vorsorgeuntersuchungen sind so umfassend in randomisiert-kon- trollierten Studien (RCTs) untersucht worden wie das Screening auf Brustkrebs mit Hilfe der Mammografie. Es liegen derzeit acht große randomisiert-kontrol- lierte Studien und mehrere Meta-Analysen vor. Letztere kommen mehrheitlich zum Schluss, dass sich die Brustkrebssterblichkeit durch Mammografie-Screening um etwa 20 % senken lässt. Dies bedeutet im Schweizer Kontext, dass etwa 1 von 1'000 Frauen weniger an Brustkrebs stirbt, wenn Frauen ab dem 50. Lebensjahr zehn Jahre lang gescreent werden. Andererseits führt das Screening auch zu Überdiagnosen und Übertherapien. So nimmt die Zahl der Brustkrebsdiagnosen um etwa 20 % zu, was zu einer entsprechenden Zunahme an chirurgischen Ein- griffen, Strahlen- und Chemotherapien führt. Über zehn Jahre gerechnet, erhal- ten etwa 4 von 1'000 Frauen eine Brustkrebsdiagnose, die sie ohne Screening nicht erhalten hätten. Etwa 200 von 1'000 Frauen sind im Verlaufe von zehn Jahren (fünf Screening-Runden) mit abklärungsbedürftigen Befunden konfron- tiert, wobei es sich dabei mehrheitlich um falsch positive Befunde handelt. Gleichzeitig werden auch mit einem Screening-Programm 20 bis 30 % der Brust- krebse nicht im Screening erfasst. Die Information der Bevölkerung bezüglich des Mammografie-Screenings ist derzeit noch mangelhaft. Dies führt dazu, dass der mögliche Nutzen von den betroffenen Frauen überschätzt und der Schaden unterschätzt wird. Die Aufklärung der Bevölkerung im Hinblick auf Nutzen und Risiken des Mammografie-Screenings muss daher verbessert werden, denn Frau- en haben einen Anspruch auf evidenzbasierte Informationen und eine „infor- mierte Entscheidung“.