Publications by authors named "J Paulo Sousa"

1,817 Publications

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Is Isotretinoin in Acne Patients a Psychological Boon or a Bane: A Systematic Review.

Cureus 2021 Aug 2;13(8):e16834. Epub 2021 Aug 2.

Pediatrics, Wyckoff Heights Medical Center, Brooklyn, USA.

Acne vulgaris is a frequently encountered dermatological condition in clinical practice. Isotretinoin is one of the drugs prescribed for this condition. However, it is unclear whether the use of this drug worsens or improves the psychological effects in an acne patient and whether it is advisable to use this drug commonly. This systematic review aims to assess the relationship between Isotretinoin and psychiatric side effects in acne patients. A literature search was conducted using PubMed, Cochrane, and Google Scholar databases in accordance with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Articles published within the last 10 years were taken into account and a review was conducted on the relevant articles after critical appraisal. Nine studies were finalized for discussion and out of the nine studies, two studies concluded that Isotretinoin could cause psychiatric effects. Five studies showed no association between them. Two studies unexpectedly found that psychiatric symptoms improved because of Isotretinoin use. Lack of adequate sample size and absence of randomized controlled trials are the limitations of this study. To conclude, Isotretinoin can be prescribed as a treatment option for severe acne despite some evidence of link with psychiatric effects. However, bearing the side effects in mind, a detailed evaluation before initiating the drug and a thorough monitoring while using the drug should be done as a standard practice in order to be on the safer side.
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http://dx.doi.org/10.7759/cureus.16834DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8407467PMC
August 2021

The addition of neoadjuvant pertuzumab for the treatment of HER2+ breast cancer: a cost estimate with real-world data.

Health Econ Rev 2021 Sep 10;11(1):33. Epub 2021 Sep 10.

Outcomes Research Lab, Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal.

Background: Breast cancer (BC) is largely prevalent worldwide. HER2-positive BC account for roughly 20-25% of all BC cases and has an overall survival lower than other BC. Innovation on BC therapeutics is a constant, but novel therapies have higher costs. Therefore, cost-effectiveness research is essential to provide healthcare decision-makers with solid foundations for a resource allocation. This study aims to estimate the average direct medical costs/patient and cost-effectiveness of adding pertuzumab in neoadjuvant treatment (NeoT) for HER2-positive breast cancer (BC).

Methods: Two retrospective real-world consecutive cohorts of ≥18yo female patients diagnosed with HER2-positive BC treated with NeoT at the Breast Clinic of IPO-Porto were studied. The AC-DH regimen (2012-2015) comprised 8 cycles of neoadjuvant therapy (4 cycles of doxorubicin + cyclosphosphamide followed by 4 cycles ofdocetaxel + trastuzumab), while the AC-DHP regimen (2015-2017) included also pertuzumab as NeoT. NeoT was followed by surgery and adjuvant trastuzumab. Micro-costing technique and a bottom-up approach was used comprising all medical direct costs from the hospital perspective. Unit costs were obtained from government official prices or from IPO-Porto costing system. Costs were adjusted to 2017 and are expressed in euros. Multivariable logistic regression models were used for effectiveness assessment, while generalized linear models with gamma distribution were used for costs. ICER was calculated using the pathological complete response (pCR) as the preferential measure of effectiveness. Sensitivity analysis was also performed.

Results: AC-DHP (n = 40) and AC-DH (n = 54) cohorts had heterogenous patient profiles (median age 43y/53y; 67.5%/59.3% positive HR; 60.0%/27.8% operable; 25.0%/24.1% inflammatory, respectively). The AC-DHP average total cost/patient was 56,375€, with pertuzumab accounting for 13,978€ (24.79%) and increasing in 15,982€ the average cost/patient (p < 0.001). Clinical staging and hormone receptors (HR) were significantly associated with pCR. ICER was 1.370€ per percentage point of pCR.

Conclusions: ICER was more favourable in stage III HR negative BC patients compared to other patient profiles. Innovative treatments access is critical to deliver high-quality healthcare, but sustainability must be considered. These results suggest the importance of establishing a cost-effectiveness profile of Pertuzumab in NeoT for HER2-positive BC.
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http://dx.doi.org/10.1186/s13561-021-00332-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8431932PMC
September 2021

Evaluation of homeothermy, acid-base and electrolytic balance of black goats and ewes in an equatorial semi-arid environment.

J Therm Biol 2021 Aug 8;100:103027. Epub 2021 Jun 8.

Department of Animal Science, Federal University of the Semi-arid Region (UFERSA), 59625-900, Mossoró, Rio Grande do Norte, Brazil.

The aim of this study was to investigate the influence of environmental conditions and species on thermoregulatory responses, acid-base and electrolyte balance of black goats and ewes in an equatorial semi-arid environment. Ten Canindé goats and seven Morada Nova ewes with black coat color, all multiparous, aged between 2 and 3 years, non-lactating, non-pregnant, and body weight (B) of 22.84 ± 4.17 kg for goats and 22.60 ± 3.18 kg for ewes were used in this study. Air temperature (A) and relative humidity (R) were measured. Respiratory rate (R), Rectal temperature (R), sweating rate (S), hydrogen potential (pH), partial pressure of carbon dioxide (PCO), venous oxygen pressure (PO), bicarbonate (HCO), base excess (BE), total carbon dioxide concentration (TCO), venous oxygen saturation (SO), sodium (Na) and potassium (K) were recorded. Animal species (caprine and ovine) and environmental conditions (Thermoneutral condition, T and Heat condition, H) were considered as fixed effects. Univariate and multivariate analysis techniques were used. Differences were observed between the two environmental conditions. Significant changes in all thermoregulatory responses for goats and ewes were observed according to the environmental condition effect. The general means of the species showed that only S was high in ewes (P < 0.05), following a reverse change when compared to goat S. For the environmental condition effect, only the blood pH of goats did not change under H (P < 0.05), while the B and TCO did not change for ewes. The general means of PCO, HCO, BE, TCO and SO were higher in ewes compared to goats. For electrolytic balance, Na  demonstrated elevations in H. Brazilian black goats and ewes raised in an equatorial semi-arid environment tend to have particular homeothermy, acid-base and electrolytic balance which mostly depend on the environmental conditions they are raised. The results support the changes in physiological mechanisms between black goats and ewes; however, both are locally adapted.
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http://dx.doi.org/10.1016/j.jtherbio.2021.103027DOI Listing
August 2021

Curzerene antileishmania activity: Effects on Leishmania amazonensis and possible action mechanisms.

Int Immunopharmacol 2021 Sep 6;100:108130. Epub 2021 Sep 6.

Laboratório de Doenças Infecciosas, Campus Ministro Reis Velloso, Universidade Federal do Delta do Parnaíba, 64202-020 Parnaíba, PI, Brazil. Electronic address:

Leishmaniasis is a set of infectious diseases with high rates of morbidity and mortality, it affects millions of people around the world. Treatment, mainly with pentavalent antimonials, presents significant toxicity and many cases of resistance. In previous works we have demonstrated the effective and selective antileishmanial activity of Eugenia uniflora L. essential oil, being constituted (47.3%) by the sesquiterpene curzerene. Considering the high rate of parasite inhibition demonstrated for E. uniflora essential oil, and the significant presence of curzerene in the oil, this study aimed to evaluate its antileishmania activity and possible mechanisms of action. Curzerene was effective in inhibiting the growth of promastigotes (IC 3.09 ± 0.14 µM) and axenic amastigotes (EC 2.56 ± 0.12 µM), with low cytotoxicity to RAW 264.7 macrophages (CC 83.87 ± 4.63 µM). It was observed that curzerene has direct effects on the parasite, inducing cell death by apoptosis with secondary necrotic effects (producing pores in the plasma membrane). Curzerene proved to be even more effective against intra-macrophage amastigote forms, with an EC of 0.46 ± 0.02 µM. The selectivity index demonstrated by curzerene on these parasite forms was 182.32, being respectively 44.15 and 8.47 times more selective than meglumine antimoniate and amphotericin B. The antiamastigote activity of curzerene was associated with immunomodulatory activity, as it increased TNF-α, IL-12, and NO levels, and lysosomal activity, and decreased IL-10 and IL-6 cytokine levels detected in macrophages infected and treated. In conclusion, our results demonstrate that curzerene is an effective and selective antileishmanial agent, a candidate for in vivo investigation in models of antileishmanial activity.
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http://dx.doi.org/10.1016/j.intimp.2021.108130DOI Listing
September 2021

Bacillus velezensis H2O-1 surfactin efficiently maintains its interfacial properties in extreme conditions found in post-salt and pre-salt oil reservoirs.

Colloids Surf B Biointerfaces 2021 Aug 27;208:112072. Epub 2021 Aug 27.

Universidade Federal do Rio de Janeiro, Instituto de Química, Rio de Janeiro, RJ, Brazil. Electronic address:

Biosurfactants are molecules with surfactant properties produced by microorganisms, and can be used in various industrial sectors, e.g., the oil industry. These molecules can be used in enhanced oil recovery (EOR) in the pre-salt and post-salt reservoirs, where conditions of temperature, pressure, and salinity are quite varied, requiring a study of the stability of these molecules under these conditions. Bacillus velezensis H2O-1 produces five different surfactin homologs with a fatty-acid chain ranging from C11 to C16 and with a high capacity to reduce surface (24.8 mN.m) and interfacial tensions (1.5 and 0.8 8 mN.m using light, medium oil and n-hexadecane, respectively). The critical micellar concentration (CMC) was 38.7 mg.L. Inversion wettability tests were carried out under the salinity conditions found in the post-salt (35 g.L) and pre-salt (70 g.L) reservoirs, in which it was observed that the surfactin reversed 100 % of the wettability of the calcite impregnated with light and medium oil. Using a central composite rotatable design, we demonstrated that surfactin maintained its interfacial properties when subjected simultaneously to extreme conditions of pressure, temperature and salinity commonly found in the post-salt (70 °C, 70 g.L and 27.58 MPa) and pre-salt (100 °C, 150 g.L and 48.2 MPa) layers. The results presented here highlight the efficiency and stability of H2O-1 surfactin in environmental conditions found in pre-salt and post-salt oil reservoirs.
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http://dx.doi.org/10.1016/j.colsurfb.2021.112072DOI Listing
August 2021
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