Fernando Luiz Affonso Fonseca

Universidade Federal de São Paulo, San Paulo, São Paulo, Brazil

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Publications (102)108.18 Total impact

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    ABSTRACT: Breast cancer (BC) is the second most common cancer worldwide and the first among women. If early diagnosed and treated, this disease has a good prognosis. However, it is believed that 90 % of all patients who have had cancer died due to metastatic disease, which highlights the need for a marker which allows the detection of latent cancer cells spread from the primary tumor. The objective of this study was to investigate the expression of survinin in peripheral blood of patients with breast cancer at diagnosis and during chemotherapy aiming correlation with minimal residual disease, clinical and pathological findings. The study included 40 patients with breast cancer and 12 healthy donors as a comparison group. Survinin expression was verified by real-time PCR. For diagnosis, survinin expression cutoff point was 1.05; considering this cutoff point, we obtained a test sensitivity of 85.3 %, specificity of 75.0 %, positive predictive value of 90.6 %, negative predictive value of 64.3 %, and accuracy of 82.6 %. There was statistical significance between groups (patients × control group), presenting to patients a significantly higher value than the control group (p < 0.001). Patients that presented at the diagnosis a survinin gene expression ≥1.05 are 17 times more likely to develop metastatic disease.
    Tumor Biology 12/2014; · 2.84 Impact Factor
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    ABSTRACT: Vancomycin (VCM) is indicated in combat against Gram-positive infections, but it is not considered a first-choice drug because of its adverse effects. It is believed that oxidative stress is the primary mechanism of endothelial injury and the consequent VCM toxicity, which varies from phlebitis to nephrotoxicity. Moreover, dose recommendations, dilution, rates and types of infusion are still controversial. The aim of this study was to determine the effect of different VCM dilutions in endothelial, liver and kidney injuries by biochemical parameters and histopathological analysis. Wistar rats were randomly divided into six groups and subjected to femoral vein cannulation for drug administration. Control groups received 0.9 ml of saline and the others received VCM (10mg/Kg/day) at dilutions of 5.0 and 10.0 mg/mL for 3 and 7 days. Homocysteine, hs-CRP, AST, ALT, GGT, urea, creatinine, lycopene, alpha-tocopherol, beta-carotene and retinol were analyzed. Kidney, liver and cannulated femoral vein fragments were collected.This study showed alterations in ALT which featured hepatotoxicity. However, drug dilutions were not able to show changes in other biochemical parameters. In contrast, kidney and endothelium pathological changes were observed. More studies are needed to characterize VCM induced kidney and endothelium toxicity and biochemical markers able to show such morphological modifications.
    Anais da Academia Brasileira de Ciências 12/2014; 86(864):1963. · 0.85 Impact Factor
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    ABSTRACT: ABSTRACT The drugs used in chemotherapy treatments have little specificity, attack tumor cells, and also injure proliferative tissues. Knowledge of the functions of micronutrients has greatly increased, especially of Selenium (Se) that presents immunomodulatory and antitumor functions. The present study evaluated the health-related quality of life of patients undergoing chemotherapy for the treatment of leukemias and lymphomas (LL) and solid tumors (ST) while receiving Selenium (Se) supplementation. This is a randomized, double-blind, crossover study that evaluated the quality of life (EORTC-QLQ-C30 questionnaire), renal and liver functions of patients supplemented with Se. There was no statistically significant alteration in LL patients. However, the fatigue and nausea scores after 30 days did decrease in this group as well as in the ST group. After 1 year supplementation with Selenium, a more noticeable decrease in the scores concerning fatigue and nausea could be observed in the ST group, when compared with the beginning of the study. The LL patients also presented a decrease in the fatigue scores and physical functions. The kidney function as well as liver function has improved after Selenium supplementation when compared with the placebo intake in LL and ST patients, more remarkably in the LL group. Supplementation with Selenium promotes the reduction of chemotherapy side effects in cancer patients, especially by improving the conditions of patients with fatigue, nausea, and impaired physical function. Renal and liver functions have also improved.
    Journal of medicinal food. 11/2014;
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    ABSTRACT: Erythropoietin (EPO) has been well characterized as a renal glycoprotein hormone regulating red blood cell production by inhibiting apoptosis of erythrocyte progenitors in hematopoietic tissues. EPO exerts regulatory effects in cardiac and skeletal muscles. Duchenne muscular dystrophy is a lethal degenerative disorder of skeletal and cardiac muscle. In this study, we tested the possible therapeutic beneficial effect of recombinant EPO (rhEPO) in dystrophic muscles in mdx mice. Total strength was measured using a force transducer coupled to a computer. Gene expression for myostatin, transforming growth factor-β1 (TGF-β1), and tumor necrosis factor-α (TNF-α) was determined by quantitative real time polymerase chain reaction. Myostatin expression was significantly decreased in quadriceps from mdx mice treated with rhEPO (rhEPO=0.60±0.11, control=1.07±0.11). On the other hand, rhEPO had no significant effect on the expression of TGF-β1 (rhEPO=0.95±0.14, control=1.05±0.16) and TNF-α (rhEPO=0.73±0.20, control=1.01±0.09). These results may help to clarify some of the direct actions of EPO on skeletal muscle.
    Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas / Sociedade Brasileira de Biofisica ... [et al.] 09/2014; · 1.08 Impact Factor
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    ABSTRACT: No clear evidence is available in the literature regarding the acute effect of different styles of music on cardiac autonomic control.
    International cardiovascular research journal. 09/2014; 8(3):105-10.
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    ABSTRACT: Factors such as temperature, light exposure, drug concentration, ionic strength, time of infusion, and duration of drug association can influence the effectiveness of pharmacological solutions, which can compromise the solutions' quality, resulting in unstable solutions and drug incompatibility. The aim of this study was to determine the pH of solutions of dobutamine hydrochloride, fentanyl citrate, and their combination in 5% dextrose in water (D5W) under various light exposures and temperature conditions over time. The analysis was performed by measuring the pH of the substances in both pharmacological (commercial) preparations and in D5W under dark fluorescent light in the presence or absence of sunlight exposures, intravenous apparatus packaging (clear and amber burettes), and temperature (22°C and 37°C). Samples were collected immediately after preparation and after 0.5, 1, 2, 3, 4, and 24 hours of exposure to the various conditions; data were analyzed using mean standard deviations. Of the 260 pH values obtained, 50 (19.2%) were from commercial preparations and 210 (80.8%) from solutions exposed to various experimental conditions. Significant pH differences were found among the vials of the commercial preparation drugs. The largest pH value difference (0.88) was observed for fentanyl citrate, in which a pH increase of 0.88 (4.23 ± 0.62) was observed. The combination of drugs in D5W resulted in more acidic values than those of fentanyl citrate and of D5W and fentanyl citrate in D5W, but they were closer to what was observed for the solution of dobutamine hydrochloride in D5W. This solution was more acidic than fentanyl citrate diluted in D5W. The lower acidity of fentanyl citrate had a minor influence on the final pH of the combined drug solution in D5W. Under most conditions, the drug solutions kept at 22°C had pH values that were more acidic and less variable. Temperature was a major factor controlling the chemical behavior of the solutions analyzed. Analysis of chemical behavior in response to light exposure indicated that the solutions were more stable over time when kept in the dark.
    Journal of infusion nursing: the official publication of the Infusion Nurses Society 09/2014; 37(5):362-368.
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    ABSTRACT: Diabetes mellitus is a chronicle illness in which there is a high blood glucose level defined as hyperglycemia, resulted by a deficiency in insulin secretion and/or in its action. Nowadays, it is being seen as a public health problem and is reaching increasing proportions with regard to the appearance of new cases. For diagnosis, sensible and accurate methods should be used to avoid complications of the sickness. The measure of glycated hemoglobin may not be used for diagnosis, but is the reference method to evaluate the grade of glycemic control in the long term, reflecting the blood glucose level in the latest 2-3 months. The aim of this study was to evaluate the grade of concordance between turbidimetry and liquid chromatography methods in the glycated hemoglobin determination and to estimate the sensibility and specificity values of turbidimetry.
    Journal of Clinical Laboratory Analysis 08/2014; · 1.14 Impact Factor
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    ABSTRACT: Ovarian reserve tests provide knowledge of a possible response to controlled ovarian hyperstimulation in patients undergoing assisted reproduction treatment, allowing management and alteration of treatment protocol with the appropriate dose of gonadotrophin. Several parameters have been used as predictors of ovarian response. The basal FSH serum level on the third day of the menstrual cycle seemed to be the best predictor, but with significant intraindividual variability from one cycle to another. Thus, the anti-Müllerian hormone (AMH) emerges as a new ovarian test marker. AMH is produced exclusively in the gonads, by the granulosa cells, and plays an important role in folliculogenesis, acting on the modulation of follicular recruitment in the granulosa cells in order to limit the number of recruited oocytes and to regulate the number of growing follicles and their selection for ovulation. It has been suggested that AMH is strongly associated with oocyte yield after ovarian stimulation and could therefore be capable of predicting the ovarian response and the quality of oocytes and embryos. In this review, we discuss the role of AMH in assisted reproduction outcomes.
    Clinica Chimica Acta 07/2014; 437. · 2.76 Impact Factor
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    ABSTRACT: Aim: We have hypothesized a possible relationship between disc degeneration (DD) and VDR FokI/T2C polymorphism. Methods: A case-control study was performed comprising 121 Brazilian patients with confirmed DD by nuclear magnetic resonance and a control group consisting of 131 healthy patients without a history of disc cysts of the lumbar spine. Detection of VDR FokI/T2C polymorphism was performed using restriction fragment length polymorphism-polymerase chain reaction. The chi-square test was used to compare allele and genotype frequencies between groups, and a p-value of <0.05 was considered statistically significant. Results: The results disclosed statistical difference between allele distribution among cases and controls (p=0.025, odds ratio=1.58, confidence interval=1.07-2.32) considering VDR FokI/T2C polymorphism. Conclusion: The results showed a positive association between VDR FokI/T2C polymorphism and DD in Brazilian patients tested.
    Genetic Testing and Molecular Biomarkers 07/2014; · 1.44 Impact Factor
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    ABSTRACT: Substance A has better fungicidal activity than substance B, which represents a potential microbicide effect of these compounds.
    Materials Science and Engineering C 07/2014; 40:260–266. · 2.74 Impact Factor
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    ABSTRACT: INTRODUCTION: The Ehrlich tumor is an adenocarcinoma in the mammary glands of female mice. The immune response stimulates angiogenesis and tumor growth factors. Physical activity has been associated with a lower incidence of chemically induced tumors and tumor metastasis. We have hypothesized up to what extent the effect of physical activity may serve as a protection factor in the evolution of Ehrlich tumor and in the migration of peritoneal macrophages in mice. MATERIALS AND METHODS: This is a randomized clinical trial study with mice. The study was divided into two arms. The first aimed to evaluate the evolution of Ehrlich tumor and physical activity; the second, the phagocytic activity of peritoneal macrophages in mice subjected to physical exercises. RESULTS: Statistical differences in the macrophagic activity between groups were not observed. Physical activity promoted a tumor size reduction in the sequential evaluation performed on weeks 4 and 5, with statistical significance. DISCUSSION: Our results suggest that physical activity may reduce the tumor size. However, this reduction is not associated with the increase in the macrophagic activity. Moreover, it is important to point out that the performed mediation analysis of physical activity be not only via inflammatory response but also via hypothalamic-hypophyseal tract.
    La Pensée 04/2014; 76(4). · 0.06 Impact Factor
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    ABSTRACT: Objective: To evaluate obese children and adolescents' retinol plasma levels and to correlate them with metabolic syndrome components. Methods: Cross-sectional study with 61 obese children and adolescents (body mass index Z score - ZBMI>+2). Pubertal development, arterial blood pressure, body weight and height for nutritional classification and waist circumference were obtained. A 15mL blood sample was collected (after a 12-hour fasting in a low luminosity room) for retinol determination (cut-off inadequate if <30µg/dL), lipid profile (HDL-c, LDL-c, and triglycerides), oral glucose tolerance test (fasting and 120 minutes) and for high sensitivity C-reactive protein. Spearman correlation and multiple linear regression were used in the statistical analysis. Results: Mean age was 10.7±2.7 years. There was a predominance of male gender 38/61 (62%) and pre-pubertal 35/61 (57%) subjects. The average plasmatic retinol was 48.5±18.6ug/dL. Retinol deficiency and severe obesity were observed in 6/61 (10%) and 36/61 (59%), respectively. Glucose level at 120 minutes was the independent and predictive variable of plasma retinol levels [β=-0.286 (95%CI -0.013 - -0.001)]. Conclusions: An independent and inverse association between plasma retinol levels and glucose tolerance was observed, suggesting an important contribution of this vitamin in the morbidities associated to obesity in children and adolescents.
    Revista paulista de pediatria : orgão oficial da Sociedade de Pediatria de São Paulo. 03/2014; 32(1):50-4.
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    ABSTRACT: The use of metal devices in medical application is increasing but it remains incompletely understood the physiological effects of component degradation. Niobium (Nb) alloys have already been investigated in the 1980's and recent studies demonstrated the potential of Nb as an implant material. The purpose of this study was to determine cytotoxic, hematologic and histologic effects of niobium in Swiss mice. Animals were treated with a single dose of 3 % niobium oxide (Nb2O5) diluted in PBS, i.p. Cytotoxic assay, hematologic and histologic evaluation were done 3, 7 and 12 days after niobium treatment. Data have shown increased number of cells after niobium treatment, but there was no difference in cell viability. Furthermore, it was not observed hematological modification 3, 7 or 12 days after niobium treatment. Despite the fact that animals treated with niobium for 3 and 7 days showed mild degeneration in hepatocytes, mice kept alive for 12 days showed liver cells regeneration. Our results suggested that niobium cytotoxicity was not progressive because 12 days after treatment there was an evident liver regeneration. Data obtained indicated that niobium may be promising alternatives to biomedical applications.
    Journal of Materials Science Materials in Medicine 01/2014; · 2.14 Impact Factor
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    ABSTRACT: Hyperhomocysteinemia in breast cancer (BC) patients can be a risk factor for thromboembolic events. This study aimed to evaluate homocysteine and its cofators (folic acid and vitamin B12) concentrations and platelet count at diagnosis of BC, 3 and 6 months after the beginning of chemotherapy treatment and to correlate them with clinical data. Thirty-five BC patients were included; blood samples were obtained by venipuncture. Plasmatic Hcy and cofactors concentrations were measured by competitive chemiluminescent enzyme immunoassay method. Platelet count was done using an automated analyzer. Statistical analysis was performed using the software SPSS. During chemotherapy, homocysteine (P = 0.032) and vitamin B12 (P < 0.001) concentrations increased, while folate and platelets decreased (P < 0.001). Among the clinical data, the menopausal status showed significant positive correlation (P = 0.022) with homocysteine concentration increase. Evaluation of homocysteine concentrations during chemotherapy is extremely important because their levels increase during chemotherapy treatment, thus increasing the risk of thromboembolism development.
    Journal of Clinical Laboratory Analysis 01/2014; · 1.14 Impact Factor
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    ABSTRACT: Tuberculosis is a contagious infectious disease mainly caused by the bacteria Mycobacterium tuberculosis that still meets the priority criteria - high magnitude, transcendence and vulnerability - due to the threat it poses to public health. When taking into consideration the vulnerability conditions that favor the onset of the disease, this article aimed to investigate the implications originated from individual and social vulnerability conditions in which tuberculosis patients are inserted. Databases like MEDLINE, LILACS and SciELO were searched in Portuguese, Spanish and English using the descriptors tuberculosis and vulnerability, and 183 articles were found. After the selection criterion was applied, there were 22 publications left to be discussed. Some of the aspects that characterize the vulnerability to tuberculosis are: low-income and low-education families, age, poor living conditions, chemical dependency, pre-existing conditions/aggravations like diabetes mellitus and malnutrition, indigenous communities, variables related to health professionals, intense border crossings and migration, difficulty in accessing information and health services and lack of knowledge on tuberculosis. Much as such aspects are present and favor the onset of the disease, several reports show high incidence rates of tuberculosis in low vulnerability places, suggesting that some factors related to the disease are still unclear. In conclusion, health promotion is important in order to disfavor such conditions or factors of vulnerability to tuberculosis, making them a primary target in the public health planning process and disease control.
    International Archives of Medicine 01/2014; 7:35. · 1.08 Impact Factor
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    ABSTRACT: Hepatitis B is responsible for the development of half of hepatocellular carcinoma cases and is a major cause of hepatic insufficiency. The vaccine against hepatitis B virus does not exhibit the same high efficacy in patients on hemodialysis as it does in immunocompetent individuals. The medical literature recommends vaccination with four doses (40 mg each) of the hepatitis B virus vaccine before beginning hemodialysis; however, approximately one-third of hemodialysis patients do not respond to this vaccination schedule. A new serologic test should be performed each year for individuals who respond adequately, whereas a booster dose should be offered to those with antibody titers below 10 mIU/mL. In this study, we followed 83 hemodialysis patients and collected quantitative serologic measurements every 2 months over a 1-year period. We made the measurements 1 month after the vaccination period. We found that 41% of the patients had antibody titers below 10 mIU/mL (nonresponders), 21.7% had antibody titers between 10 mIU/mL and 100 mIU/mL (poor responders), and 37.3% had antibody titers higher than 100 mIU/mL (good responders). Patients with diabetes and/or hypertension exhibited worse response to vaccination. All subjects displayed decreasing antibody titers during the observation period. The group of poorly responsive patients had antibody titers below 10 mIU/mL at the 6-month follow-up period.
    International Journal of General Medicine 01/2014; 7:109-14.
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    ABSTRACT: It is poor in the literature the behavior of the geometric indices of heart rate variability (HRV) during the musical auditory stimulation. The objective is to investigate the acute effects of classic musical auditory stimulation on the geometric indexes of HRV in women in response to the postural change maneuver (PCM). We evaluated 11 healthy women between 18 and 25 years old. We analyzed the following indices: Triangular index, Triangular interpolation of RR intervals and Poincarι plot (standard deviation of the instantaneous variability of the beat-to beat heart rate [SD1], standard deviation of long-term continuous RR interval variability and Ratio between the short - and long-term variations of RR intervals [SD1/SD2] ratio). HRV was recorded at seated rest for 10 min. The women quickly stood up from a seated position in up to 3 s and remained standing still for 15 min. HRV was recorded at the following periods: Rest, 0-5 min, 5-10 min and 10-15 min during standing. In the second protocol, the subject was exposed to auditory musical stimulation (Pachelbel-Canon in D) for 10 min at seated position before standing position. Shapiro-Wilk to verify normality of data and ANOVA for repeated measures followed by the Bonferroni test for parametric variables and Friedman's followed by the Dunn's posttest for non-parametric distributions. In the first protocol, all indices were reduced at 10-15 min after the volunteers stood up. In the protocol musical auditory stimulation, the SD1 index was reduced at 5-10 min after the volunteers stood up compared with the music period. The SD1/SD2 ratio was decreased at control and music period compared with 5-10 min after the volunteers stood up. Musical auditory stimulation attenuates the cardiac autonomic responses to the PCM.
    Noise and Health 01/2014; 16(68):57-62. · 1.43 Impact Factor
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    ABSTRACT: Introduction: Thyroid dysfunctions are highly prevalent diseases. Despite of its high prevalence the presentation is unusual nowadays because of oral hormone therapy widely used in insufficiency of the gland however hyperfunction states are common also. About 12% of the US population will develop some alteration of thryroid function in their lifetime. Among these diseases we highlight the presence of myxedema coma in a female patient. Case presentation: A 58-year-old female patient with symptoms of drowsiness and loss of motor coordination. At admission in the emergency department, ventilatory assistance was required, and the patient presented progressive improvement after oral levothyroxine reposition. Differential diagnosis of the reduction of consciousness highlighted the presence of infection and stroke. They were not detected. The ultrasonographic analysis showed a diffuse and heterogeneous enlargement of thyroid. Conclusion: Despite the possibility of adrenal insufficiency, pan hypopituitarism, infection and even a tumour, the thyroid stimulating hormone and free thyroxin levels were determinant to make the diagnosis of myxedematous coma according the signs and symptoms of the patient´s entrance presentation. Myxedema coma is a syndrome that results from the intense reduction of the thyroid hormone synthesis.
    JSM Clinical Case Reports. 12/2013; 1(1):1008.
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    Pediatric Allergy and Immunology 12/2013; · 3.38 Impact Factor
  • Clinica chimica acta; international journal of clinical chemistry 11/2013; · 2.54 Impact Factor

Publication Stats

194 Citations
108.18 Total Impact Points

Institutions

  • 2011–2014
    • Universidade Federal de São Paulo
      • Departamento de Medicina
      San Paulo, São Paulo, Brazil
  • 2008–2014
    • Faculdade de Medicina do ABC
      Santo André, São Paulo, Brazil
  • 2005–2012
    • University of São Paulo
      San Paulo, São Paulo, Brazil