Asthma-related deaths in Brazil: data from an ecological study.

Objective: The aim of this study was to present epidemiological data on hospitalizations and deaths related to asthma in Brazil over the past 11 years.

Methods: An ecological study was conducted on asthma-related hospitalizations and mortality in Brazil from 2013 to 2023, using data extracted from the Department of Informatics of the Brazilian Unified Health System and the Mortality Information System.

Results: Asthma-related deaths showed an increasing trend during the analyzed period.

New spirometry recommendations from the Brazilian Thoracic Association - 2024 update.

The latest pulmonary function guideline from the Brazilian Thoracic Association was published in 2002, since which there have been updates to international guidelines (mainly those from the European Respiratory Society and the American Thoracic Society), as well as new national and international publications on various aspects of the performance, interpretation, and clinical implications of spirometry. Despite those updates, a careful analysis of what applies to the reality in Brazil is essential, because there have been studies that evaluated individuals who are representative of our population and who could show responses different from those of individuals in other regions of the world. This document is the result of the work of a group of specialists in pulmonary function who evaluated relevant scientific articles that could be applicable to the population of Brazil.

Topical application of the ethanol extract and the hydroethanolic fraction of ripe Solanum lycocarpum A. St. Hil. fruit improves the healing of excisional wounds.

Purpose: To evaluate the effect of the topical application of the ethanol extract (EESL) and the hydroethanolic fraction (HFSL) of ripe Solanum lycocarpum fruit on the healing of experimentally-induced wounds in mice.

Methods: The EESL and HFSL obtained from ripe fruit of the species S. lycocarpum were obtained by percolation with ethanol.

SURGICAL TECHNIQUES TO INCREASE RESECTABILITY IN LIVER METASTASIS.

The development of surgical techniques, chemotherapy, biological agents, and multidisciplinary approaches have made patients with unresectable colorectal liver metastases eligible for surgery. Many strategies have been developed to allow patients for surgical resection (percutaneous portal vein embolization, liver venous deprivation, parenchyma-sparing liver surgery, reverse strategy, associating liver partition and portal vein ligation for staged hepatectomy, and liver transplantation), the only form of disease control and curative treatment.

MANAGEMENT OF SYNCHRONIC LARGE LIVER METASTASIS IN A NON-OCCLUSIVE COLON TUMOR.

In patients with synchronic liver colorectal metastasis, resection of the primary tumor and liver metastases is the only potentially curative strategy. In such cases, there is no consensus on whether resection of the primary tumor and metastases should be performed simultaneously or whether a staged approach should be performed (resection of the primary tumor and after, hepatectomy, or hepatectomy first). Patients with no bowel occlusion and with extensive liver disease are advised neoadjuvant oncological therapy.

NON-FUNCTIONING SPORADIC PANCREATIC NEUROENDOCRINE TUMOR IS AN INDEPENDENT RISK FACTOR FOR RECURRENCE AFTER SURGICAL TREATMENT.

Background: Pancreatic neuroendocrine tumors (PNETs) are uncommon and heterogeneous neoplasms, often exhibiting indolent biological behavior. Their incidence is rising, largely due to the widespread use of high-resolution imaging techniques, particularly influencing the diagnosis of sporadic non-functioning tumors, which account for up to 80% of cases. While surgical resection remains the only curative option, the impact of factors such as tumor grade, size, and type on prognosis and recurrence is still unclear.

COMPLICATIONS AFTER HEPATECTOMY.

Complete removal of metastatic disease and maintenance of an adequate liver remnant remains the only treatment option with curative intent concerning colorectal liver metastases. Surgery impacts on the long-term prognosis and complications adversely affect oncological results. The actual morbidity involving this scenario is debatable and estimated to be ranging from 15% to 50%.

EARLY REFEEDING AFTER COLORECTAL CANCER SURGERY REDUCES COMPLICATIONS AND LENGTH OF HOSPITAL STAY.

Background: Multimodal protocols such as Acceleration of Total Postoperative Recovery and Enhanced Recovery After Surgery propose a set of pre- and post-operative care to accelerate the recovery of surgical patients. However, in clinical practice, simple care such as early refeeding and use of drains are often neglected by multidisciplinary teams.

Aims: Investigate whether early postoperative refeeding determines benefits in colorectal oncological surgery; whether the patients' clinical conditions preoperatively and the use of a nasogastric tube and abdominal drain delay their recovery.

PREOPERATIVE HOSPITALIZATION AS A BRIDGING STRATEGY FOR WEIGHT LOSS IN PATIENTS WITH BODY MASS INDEX = 50 KG/M2 WHO ARE CANDIDATES FOR BARIATRIC SURGERY.

Background: Preoperative hospitalization with the purpose to obtain more effective weight loss provides intensive care for patients who have a higher body mass index (BMI) and associated diseases that involve a greater risk of peri- and postoperative complications. It is a therapeutic strategy that can make it possible to overcome obstacles related to the difficulty of adhering to obesity treatment.

Aims: To analyze the implementation of a preoperative hospitalization strategy for weight loss in patients eligible for bariatric surgery.

Neonatal mortality of live births with congenital diaphragmatic hernia in São Paulo State, Brazil: Failure of care?

Objective: The aim of this study was to analyze if the healthcare organization of perinatal care and availability of referral neonatal intensive care units (NICU) impacted congenital diaphragmatic hernia (CDH) neonatal mortality in the period 2004-2020. This study analyzed the spatial distribution of neonatal deaths of live births with CDH in São Paulo State, Brazil, and its association with NICU beds' availability.

Methods: Population-based study of all live births in São Paulo State from mothers residing in the same State, from 2004 to 2020.

First report of hypoplastic left heart syndrome in 3p- syndrome and review of candidate genes.

Objective: 3p deletion syndrome is a rare monosomal disease that encompasses deletions throughout the short arm of chromosome 3. It is often in the distal region (3p25-pter), but variations in breakpoints and a complex clinical manifestation exist, with congenital heart defects being considered rare. We present the first case of hypoplastic left heart syndrome and minor dysmorphic features associated with 3p- syndrome.

Physical development and sociocultural context influences on children's physical activity.

Objective: To examine the predictive strength of cardiorespiratory fitness (CRF), motor competence (MC), maternal educational status, and parental perception of their children's favorite leisure activities for meeting physical activity (PA) guidelines of each gender among children aged 3-6 years.

Methods: This is a cross-sectional study with 367 preschoolers (53% girls), assessing CRF (PREFIT 20m shuttle run), MC (battery of motor skills), PA (accelerometry), maternal education and parental perception of children's preferred leisure (questionnaires). Factorial analysis of covariance, multiple logistic regression, and chi-square tests were conducted.

Effect of application of the thoracoabdominal rebalancing (TAR) method in moderate premature children: randomized and controlled clinical trial.

Objective: To analyze the effect of the thoracoabdominal rebalancing (TAR) method on respiratory biomechanics, respiratory discomfort, pain sensation, and physiological parameters in moderate preterm newborns, compared to a control group.

Methods: This randomized clinical trial was conducted in a neonatal intensive care unit. The evaluation included: Neonatal Infant Pain Scale, physiological parameters, Silverman-Andersen score, and biomechanics (thoracic cirtometry and Charpy angle).

Montreal Cognitive Assessment Hearing Impairment (MoCA-H): cross-cultural adaptation to Brazilian Portuguese.

Purpose: This study aimed to adapt the Montreal Cognitive Assessment Hearing Impaired (MoCA-H) into Brazilian Portuguese (BP).

Methods: This was a descriptive, cross-sectional, quantitative, and qualitative study involving participants selected by convenience. The instrument was adapted from its original version, in a six-stage process consisting of the following: Stage 1 - Translation and back translation of the MoCA-H; Stage 2 - Stimulus analysis and selection; Stage 3 - Semantic analysis of stimuli; Stage 4 - Analysis by non-expert judges, part 1; Stage 5 - Analysis by non-expert judges, part 2; Stage 6 - Pilot study.

Self-perception of stuttering: association with self-perception of hearing, fluency profile, and contextual aspects.

Purpose: This study investigated the association between self-perception of stuttering and self-perception of hearing, speech fluency profile, and contextual aspects in Brazilian adults who stutter.

Methods: Fifty-five adults who stutter (ages 18 to 58 years), speakers of Brazilian Portuguese speakers, participated in an observational study that included: (a) a clinical history survey to collect identification, sociodemographic, clinical, and assistance data; (b) the Brazil Economic Classification Criteria (CCEB); (c) a hearing self-perception questionnaire (Speech, Spatial and Qualities of Hearing Scale - SSQ, version 5.6); (d) self-perception of the impact of stuttering (Brazilian Portuguese version of the Overall Assessment of the Speaker's Experience of Stuttering - Adults - OASES-A); and (e) an assessment of speech fluency (Fluency Profile Assessment Protocol -- PAPF).

Current context and the experience of Brazilian Medical Societies with Specialist Title Exams.

The editorial discusses the need for the Specialist Title to be valued by Medical Societies, as a stage after the conclusion of medical residency and a mandatory prerequisite for taking the tests. Finally, it shows the experience of seven Medical Societies with their specialist title exams.

50 Years of the Journal of the Brazilian College of Surgeons: History, Evolution and Future Prospects.

This article celebrates the 50th anniversary of the continuous publication of the Journal of the Brazilian College of Surgeons (RCBC), revisiting its trajectory from the beginning to the present day. RCBC has evolved from a nationally relevant publication to a journal with international impact, constantly adapting to changes in editorial and scientific practices. This article presents an analysis of the major milestones, editorial changes, and innovations that have cemented RCBC as a prominent scientific vehicle.

Current context and evaluation of medical residency programs: experience of six Brazilian Medical Societies.

This article shows the most recent data on the evolution of the number of resident physicians and vacancies from R1 to R5, as well as the number of programs and institutions accredited by the National Commission for Medical Residency (CNRM). It also discusses the types and modalities of evaluation of medical residency, with a focus on the assessment of competencies throughout in-service training, which were incorporated into the most recent CNRM resolution, at the end of 2023, which amended and updated the 2006 directives. Finally, it shows the experience of six Medical Societies that conduct periodic evaluation of resident physicians, presented at a Brazilian Medical Association event.

Comments on "Reflections on the current context and evaluation of undergraduate medical education".

The authors debate the arguments presented in the editorial "Reflections on the current context and evaluation of undergraduate medical education", bringing the context that culminated in the recent application of the National Proficiency Exam in Dentistry.

Reflections on the current context and assessment of undergraduate medical education in Brazil.

This reflection article can be divided into two complementary parts. The first shows the current context of medical education in Brazil, bringing the most recent data on the number of undergraduate students and its growing gap in relation to the reduced number of vacancies in medical residency, which, despite being the most appropriate modality to train specialists, has been overlooked by the excessive number of lato sensu graduate courses. The second part discusses the possibilities of evaluating medical training, which is terminal in Brazil, enabling the newly graduated physician to claim the professional registration and to practice medicine, being evaluated only by their own medical course.

Effects of stimuli and contralateral noise levels on auditory cortical potentials recorded in school-age children.

Background And Objective: One of the functions attributed to the auditory efferent system is related to the processing of acoustic stimuli in noise backgrounds. However, clinical implications and the neurophysiological mechanisms of this system are not yet understood, especially on higher regions of the central nervous system. Only a few researchers studied the effects of noise on cortical auditory evoked potentials (CAEP), but the lack of studies in this area and the contradictory results, especially in children, point to the need to investigate different protocols and parameters that could allow the study of top-down activity in humans.

Hypopigmented mycosis fungoides: an important differential diagnosis of hypochromias in childhood.

Objective: To highlight the importance of early recognition of hypopigmented mycosis fungoides (HMF) in cases of cutaneous hypochromia in children, with a view to an effective diagnostic and therapeutic approach.

Case Description: Two cases of HMF in children are reported. The first case involves an eight-year-old boy with hypochromic macules on the trunk and root of the upper and lower limbs, while the second case is a six-year-old boy with widespread hypochromic patches.

Jacobsen syndrome associated with Shone's complex: a case report.

Objective: The aim of this study was to report the case of a child with Jacobsen syndrome in order to provide phenotypic information about this rare genetic disorder.

Case Description: A 5-year-old female preschooler was diagnosed with Jacobsen syndrome by karyotype testing. She presented with a variety of craniofacial anomalies and malformations, including cardiac impairment, characterized by a cluster of malformations in the left ventricle in line with the diagnosis of Shone's complex.