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Indicadores (Outcomes) Primários e Secundários em Ensaios Clínicos Oncológicos:...
Vaz-Carneiro, António; Centro de Estudos de Medicina Baseada na Evidência. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.Introdução: A prova de eficácia de uma intervenção terapêutica em oncologia consegue-se através de ensaios clínicos rigorosamente conduzidos. Um dos factores metodológicos mais importantes é a selecção de indicadores clínicos de eficácia (outcomes), necessários ao cálculo das chamadas medidas de associação que permitem a definição de eficácia terapêutica.Material e Métodos: Foi feita uma revisão narrativa basea...
Off-Label Prescribing: Scientific Analysis Taking the Use of Bevacizumab in Oph...
Off-label prescribing poses specific technical/scientific, professional and ethical problems. In this study we carry out a technical and scientific analysis of the off-label prescribing using a current, clinical and economically relevant example: the paradigmatic case of the use of bevacizumab in ophthalmologic pathologies for which it has no formal indication. We conducted a systematic review of the literature...
Ensaios Clínicos em Medicamentos
Randomized controlled trial, despite some disadvantages, is usually considered the gold standard for determining the efficacy of an intervention (drugs, clinical devices, surgery, etc.). In this article, we discuss some aspects of the trial design needed for its critical appraisal of quality. ; Os ensaios clínicos aleatorizados e controlados, são considerados o gold-standard para a determinação da eficácia de...
Antidiabéticos Orais e Internamentos Atribuíveis à Diabetes em Portugal
Gouveia, Miguel; Laires, Pedro; Borges, Margarida; Augusto, Margarida; Martins, Ana PaulaIntrodução: O crescimento da despesa com antidiabéticos orais tem levado a preocupações questionando os ganhos de saúde e vantagens para o sistema de saúde gerados por esses medicamentos. Este estudo contribui para responder a estas questões. Material e Métodos: Numa primeira fase apresentam-se estimativas das três variáveis centrais a utilizar na análise: 1) a prevalência tratada da diabetes por ano e por regi...
Molecular and cellular mechanisms of Mycobacterium avium-induced thymic atrophy
Borges, Margarida; Silva, Palmira Barreira; Flórido, Manuela; Jordan, Michael B.; Neves, Margarida Correia; Appelberg, RuiThymic atrophy has been described as a consequence of infection by several pathogens and shown to be induced through diverse mechanisms. Using the mouse model of Mycobacterium avium infection, we show in this study that the production of NO from IFN-γ–activated macrophages plays a major role in mycobacterial infection-induced thymic atrophy. Our results show that disseminated infection with a highly virulent st...
Clinical effectiveness and economical evaluation of preventive vaccination.
Vaz Carneiro, António; Belo, Ana Isabel; Gouveia, Miguel; Costa, João; Borges, MargaridaThe value of mass vaccination as a preventive measure for infectious diseases is one of the most important advances of modern Medicine. The impact on incidence of several infectious diseases, until recently responsible for significant morbidity and mortality at world level, is well proved in a series of high quality epidemiological studies. In this scientific review we aimed firstly to briefly resume the histor...
Cytotoxicity and genotoxicity of chitooligosaccharides upon lymphocytes
Fernandes, João C.; Borges, Margarida; Nascimento, Henrique; Bronze-da-Rocha, Elsa; Ramos, Oscar S.; Pintado, Manuela E.; Malcata, F. XavierTwo COS mixtures and a low molecular weight chitosan (LMWC) were tested for potential cytotoxicity and genotoxicity upon human lymphocytes. Genotoxicity was evaluated in vitro by cytokinesis-blocked micronucleus and alkaline comet assays, while cytotoxicity was assessed by flow cytometry analysis. Our results suggest that COS do not exhibit any genotoxicity upon human lymphocytes, independently of MW or concent...
Efficacy of lipid lowering drug treatment for diabetic and non-diabetic patient...
Costa, João; Borges, Margarida; David, Cláudio; Carneiro, António VazObjective: To evaluate the clinical benefit of lipid lowering drug treatment in patients with and without diabetes mellitus, for primary and secondary prevention. Design: Systematic review and meta-analysis. Data sources: Cochrane, Medline, Embase, and reference lists up to April 2004. Study selection: Randomised, placebo controlled, double blind trials with a follow-up of at least three years that evaluated li...
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