BNP Paribas (France)

OBJECTIVE: To investigate the effectiveness of intervention strategies for primary and secondary prevention of knee osteoarthritis (OA). DESIGN: Intervention systematic review of randomized controlled trials (RCTs). DATA SOURCES: The Medline, EMBASE, CINAHL, PEDro, and The Cochrane Library databases were searched from inception to June 10, 2025. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: RCTs evaluating interventions for primary/secondary knee OA prevention. Eligible trials targeted populations at-risk of developing knee OA or population with knee OA, and the outcome of interest must not have been present at study entry. Primary outcomes were self-reported knee pain and associated disability. Secondary outcomes included imaging features of knee joint structure and the incidence of knee arthroplasty. Data were synthesized narratively and reported as relative risks (RRs) with 95% Confidence Intervals (CIs). RESULTS: Five published reports from three RCTs (1481 participants) were included. We found evidence that a self-management lifestyle program for community-based women with BMI ≥ 25 kg/m 2 may reduce the risk of developing pain associated with knee OA at 12-months, when compared to a single education session (RR: 0.27, 95%CI: 0.16-0.46). There was uncertain evidence from four reports to draw conclusions about the effects of diet & exercise, glucosamine supplements, diet & exercise plus glucosamine supplements, and intra-articular sprifermin interventions for preventing or reducing Knee OA progression or arthroplasty. CONCLUSION: A self-management lifestyle program may be effective for reducing the risk of developing pain associated with knee OA in women with a BMI ≥ 25 kg/m 2 . Evidence for other preventive interventions remains uncertain.

O Diabetes Mellitus Gestacional (DMG) é uma condição metabólica de alta prevalência, associada a importantes repercussões para a saúde materna e fetal. Estima-se que essa condição afete até 25% das gestações globalmente, tornando-se um tópico de significativa relevância clínica e de saúde pública. Objetivo: O presente estudo tem como objetivo analisar as principais complicações gestacionais e fetais relacionadas ao DMG, a partir de uma revisão sistemática de literatura. Metodologia: Trata-se de uma revisão sistemática, baseada em artigos científicos publicados entre 2019 e 2025, nas bases de dados SciELO, PubMed e Google Acadêmico. Foram utilizados os descritores “diabetes gestacional”, “complicações maternas” e “complicações fetais”, em português e inglês. Resultados e Discussão: Os resultados apontam que o DMG está relacionado a desfechos adversos para a gestante, como pré-eclâmpsia, parto prematuro e maior necessidade de cesarianas. Observou-se também uma associação entre o DMG e o desenvolvimento posterior de diabetes tipo 2 no feto, além de macrossomia, hipoglicemia neonatal e icterícia neonatal. Conclusão: Conclui-se que diversas são as morbidades associadas à DMG, e que a detecção precoce e o controle glicêmico rigoroso durante a gestação são fundamentais para reduzir os riscos de morbimortalidade materno-fetal.

Endometriosis is a highly prevalent disease that has several clinical repercussions, such as pain and infertility. In the management of the disease, combined oral contraceptives, intrauterine systems, anti-inflammatories, surgeries, and also GnRH analogues can be used. However, the current recommendation is that the use of GnRH analogues be for a period of up to six months. Objective: Analyze the risks and benefits of using GnRH analogues associated with add-back therapy (hormonal therapy with estrogens and progestins) for a period of more than six months in patients with endometriosis. Methods: A systematic review was carried out searching for articles in the PUBMED, Scopus, and Web of Science databases, using the descriptors “Gonadotropin-Releasing Hormone”, “GnRH”, “Endometriosis” and “Hormone Replacement Therapy”. Results: Eight studies were selected, which used GnRH analogues (leuprolide or goserelin or triptorelin) for at least 12 months, associated with add-back therapy (tibolone or norethindrone and estrogens or promegestone and estradiol). The average age of the participants ranged from 17.9 to 37.2 years. Pain control was observed in most studies (six), and no significant bone loss was demonstrated with the therapy. Conclusion: The studies suggest the safety of prolonged use of GnRH analogues, despite the bone mass loss.

Aim: The research examined the relationship between SLC6A3 3′-UTR and intron 8 VNTR polymorphisms and their influence on supra-second time estimation performance and EEG alpha band activity. Material and methods: A total of 178 male participants (aged 18 to 32 years) underwent genotyping for the SLC6A3 3′-UTR and intron 8 VNTR polymorphisms. An electroencephalographic assessment was conducted targeting the dorsolateral prefrontal cortex (DLPFC), simultaneously with the time estimation task. The 3′-UTR and intron 8 VNTRs polymorphisms were linked to absolute error and ratio in a time estimation task (target duration: 1 s, 4 s, 7 s, and 9 s) neurophysiological variable. Results: Regarding the absolute error and ratio, the combinatory effect of SLC6A3 3′-UTR and intron 8 VNTRs showed a difference in the interpretation of time only for 1 s (p = 0.0002). In the EEG alpha power, the analysis revealed a difference only for the left DLPFC (p = 0.0002). Conclusions: Electrophysiological and behavioral investigation in the time perception associated with the SLC6A3 gene suggests an alternative evaluation of neurobiological aspects inbuilt in timing. The 3′-UTR and intron 8 VNTR polymorphisms modulate dopaminergic neurotransmission during short-temporal scale judgment in the domain of supra seconds and indicate a role in its inputs to the left dorsolateral prefrontal cortex during the voluntary attention processes for visual stimulus. Our findings demonstrate that cognitive resources to capture and store time intervals can be measured based on the EEG power activity pattern.