CCS - DTG - Artigos publicados em periódicos
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Artigo Associations of the consumption of unprocessed red meat and processed meat with the incidence of cardiovascular disease and mortality, and the dose-response relationship: a systematic review and meta-analysis of cohort studies(Taylor and Francis, 2022) Piuvezam, Grasiela; Medeiros, Gidyenne Christine Bandeira Silva de; Mesquita, Gabriela Xavier Barbalho; Lima, Severina Carla Vieira Cunha; Silva, David Franciole de Oliveira; Azevedo, Kesley Pablo Morais de; Pimenta, isac Davidson Santiago Fernandes; Oliveira, Ana Katherine da Silveira Gonçalves de; Lyra, Clélia de Oliveira; Martínez, Daniel Guillén; https://orcid.org/0000-0002-2343-7251Objectives: The aim of this study was to examine the associations of unprocessed red meat and processed meat consumption with cardiovascular disease (CvD) incidence and mortality, and the dose-response relationship.Methods: Published literature was retrieved through a structured search of 10 electronic databases: MeDLiNe/PubMed, Scopus, ScieLO, LiLACS, ScienceDirect, web of Science, Cochrane (CeNTRAL), wHOLiS, PAHO and embase, without language or year of publication restrictions. in addition, we searched the references of published studies. This systematic review was performed in accordance with the Preferred Reporting items for Systematic Reviews and Meta-Analyzes: The PRiSMA Statement.Results: Twenty-one prospective cohort studies were included in the systematic review. The CvDs evaluated in the inserted studies were stroke, heart failure (HF) and coronary heart disease (CHD). Considering the heterogeneity found in the studies, for the meta-analysis, 9 articles were included. The results presented in the meta-analysis of the association of consumption of unprocessed red meat and CvD indicated that there was a significant association with total stroke incidence (RR 1.10; 95%; Ci 1.01 to 1.19; p = 0.02). There was no association with ischemic stroke incidence, nor CHD Mortality with consumption of unprocessed red meat. However, for Hemorrhagic Stroke Mortality the assessment in the consumption of unprocessed red meat showed an association of protection for women (RR 0.64; 95%; Ci 0.45 to 0.91; p = 0.01). As for the results of the meta-analysis of the association between consumption of processed meat and CvD, they indicated that there was a significant association with total stroke incidence (RR 1.17; 95%; Ci 1.08 to 1.26; p < 0.0001). There was no association with ischemic stroke, nor with CHD Mortality with consumption of processed meat. Some studies that showed no association of risk, presented a significant linear trend dose response for the association of the consumption of unprocessed red meat (Bernstein et al. 2010; Nagao et al. 2012) or processed meat (Bernstein et al. 2012) and CvD.Conclusion: According to the results found in the meta-analysis, the consumption of unprocessed red meat and processed meat are associated with the incidence of stroke, however, no positive association was observed in relation to mortality from CvD. This systematic review and meta-analysis protocol was registered on the PROSPeRO (number: CRD42019100914)Artigo Is rituximab effective for systemic sclerosis? A systematic review and meta-analysis(Springer, 2021) Piuvezam, Grasiela; Caldas, Marina Maria Vieira de Figueiredo; Azevedo, Kesley Pablo Morais de; Nunes, Ana Clara de França; Oliveira, Victor Hugo de; Pimenta, Isac Davidson Santiago Fernandes; Araújo, Isabela Dantas Torres de; Bezerra Neto, Francisco Alves; Oliveira, Ana Katherine da Silveira Gonçalves de; https://orcid.org/0000-0002-2343-7251Background: Systemic sclerosis (SSc) is a clinically complex and challenging disease, that leads to skin fibrosis. Its most frequent complication is interstitial lung disease (ILD), which leads to a worse prognosis. In this situation, cyclophosphamide is considered the gold standard for its treatment, despite the controversies regarding its efficacy and toxicity. However, studies using rituximab (RTX) have shown that this drug may be a promising therapeutic option. Objectives: This paper objective was to analyze the scientific evidence on the RTX effects on SSc. Methods: A systematic review (SR) was performed including clinical trials (CTs) on the use of RTX in SSc, published up to May 2020. The studies were identified through systematic searches in bibliographic databases using a predefined search strategy. The following databases were used: PUBMED, SCOPUS, SCIELO, LILACS, SCIENCE DIRECT, WEB OF SCIENCE, COCHRANE, WHOLIS, PAHO and EMBASE. Also, a manual search was performed. The methodological quality of the studies was determined using Jadad scale, Risk of Bias Tool (RoB 2.0) and Risk of Bias in Non-Randomized Studies - of Interventions tool (ROBINS-I). A meta-analysis of the randomized CTs was performed, using Review Manager. Results: Ten CTs were included in this SR. Of these, three were randomized and seven were non-randomized. Five showed a statistically significant improvement in forced vital capacity (FVC) at some time during follow-up. Regarding the skin, eight studies showed statistically significant improvements according toa the modified Rodnan skin score. The meta-analysis found positive effects of RTX in SSc, with a statistical significance for lung disease. Conclusion: Rituximab is a promising strategy for the SSc-associated ILD and cutaneous fibrosis treatment. PROSPERO registration number: CRD42019132018