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.

Situational Analysis of the Medication Practices in Brazilian Hospitals: A Multicenter Study.

Objective: To carry out a situational analysis of the medication practices in Brazilian hospitals through the Medication Safety Self-Assessment for Hospitals and the factors associated with better performance in the evaluation.

Methods: This is a multicenter cross-sectional study in which the results of the application of the Medication Safety Self-Assessment for Hospitals, between 2015 and 2020, in 30 Brazilian hospitals were described. In addition, whether the institutional profile was associated with higher self-assessment scores (better performance in the evaluation) was also evaluated.

Validation of the Brazilian Portuguese Version of the Western Ontario Shoulder Instability Index (WOSI) Questionnaire.

 To evaluate the validity of the Brazilian Portuguese version of the Western Ontario Shoulder Instability Index (WOSI).  We assessed 51 patients aged 18 to 40 years who were divided into 3 groups: 17 patients with shoulder instability undergoing conservative treatment, 17 with shoulder instability treated surgically, and 17 without shoulder instability. The patients underwent functional and health assessments using the following scores: WOSI, Rowe, Visual Analog Scale (VAS), Subjective Shoulder Value (SSV), Disabilities of the Arm, Shoulder and Hand (DASH), and University of California-Los Angeles (UCLA) Shoulder Scale.

Treatment of penetrating injuries of the retrohepatic vena cava: systematic review protocol.

Injuries to the retrohepatic segment of the inferior vena cava require complex procedures, as exposure without prior vascular control can lead to uncontrollable and fatal bleeding. To achieve such control, the classic techniques of hepatic vascular exclusion and the implantation of an atriocaval shunt have been described, and more recently, endovascular strategies have been reported. However, there is no consensus in the literature regarding which of these strategies is associated with lower mortality.

Functional autoantibodies against G protein-coupled receptors in hepatic and pulmonary hypertensions in human schistosomiasis.

Introduction: Schistosomiasis (SM) is a parasitic disease caused by . SM causes chronic inflammation induced by parasitic eggs, with collagen/fibrosis deposition in the granuloma process in the liver, spleen, central nervous system, kidneys, and lungs. Pulmonary arterial hypertension (PAH) is a clinical manifestation characterized by high pressure in the pulmonary circulation and right ventricular overload.

Feasibility of performing the 3-minute step test with remote supervision in children and adolescents with cystic fibrosis: A comparative study.

Importance: The 3-min step test is a simple option to monitor submaximal exercise capacity, although its use via remote video monitoring has not been investigated in children with cystic fibrosis (CF).

Objective: This study aimed to assess the feasibility and reproducibility of performing the 3-min step test with remote supervision.

Methods: A cross-sectional study including CF patients (6-18 years) from two CF services were performed.

ABCO risk score for in-hospital mortality of COVID-19 patients admitted to intensive care units.

Purpose: To develop a mortality risk score for COVID-19 patients admitted to intensive care units (ICU), and to compare it with other existing scores.

Materials And Methods: This retrospective observational study included consecutive adult patients with laboratory-confirmed COVID-19 admitted to ICUs of 18 hospitals from nine Brazilian cities, from September 2021 to July 2022. Potential predictors were selected based on the literature review.

Evaluation of humoral immune response after yellow fever infection: an observational study on patients from the 2017-2018 sylvatic outbreak in Brazil.

Between 2016 and 2018, Brazil experienced major sylvatic yellow fever (YF) outbreaks that caused hundreds of casualties, with Minas Gerais (MG) being the most affected state. These outbreaks provided a unique opportunity to assess the immune response triggered by the wild-type (WT) yellow fever virus (YFV) in humans. The plaque reduction neutralization test (PRNT) is currently the standard method to assess the humoral immune response to YFV by measuring neutralizing antibodies (nAbs).

New Cardiovascular Biomarkers in Breast Cancer Patients Undergoing Doxorubicin-Based Chemotherapy.

Background: Central Illustration : New Cardiovascular Biomarkers in Breast Cancer Patients Undergoing Doxorubicin-Based Chemotherapy. Cardiovascular diseases (CVDs) are relevant to the management of breast cancer treatment since a substantial number of patients develop these complications after chemotherapy.

Objective: This study aims to evaluate new cardiovascular biomarkers, namely CXCL-16 (C-X-C motif ligand 16), FABP3 (fatty acid binding protein 3), FABP4 (fatty acid binding protein 4), LIGHT (tumor necrosis factor superfamily member 14/TNFS14), GDF-15 (Growth/differentiation factor 15), sCD4 (soluble form of CD14), and ucMGP (uncarboxylated Matrix Gla-Protein) in breast cancer patients treated with doxorubicin (DOXO).

Effect of the COVID-19 Pandemic on the Epidemiology of Pediatric Traumatic Brain Injury in Brazil.

Aim In response to the coronavirus 2019 disease (COVID-19) pandemic, governments worldwide implemented measures to prevent infection, resulting in restricted school activities, restricted children's freedom of movement, and increased risk of violence and injuries at home, including traumatic brain injury (TBI), among children. In Brazil, the consequences of the COVID-19 pandemic on the causes, severity, and mortality of pediatric TBI have not yet been investigated. Thus, our study aimed to determine whether the COVID-19 pandemic has affected the epidemiology of pediatric TBI among Brazilian children.

Brazilian guidelines on diagnosis and management of traumatic vascular injuries.

Trauma is a leading cause of death, permanent disability, and health care cost worldwide. The young and economically active are the most affected population. Exsanguination due to noncompressible torso hemorrhage is one of the most frequent causes of early death, posing a significant challenge to trauma and vascular surgeons.

Real-Life Data on Hydroxychloroquine or Chloroquine with or Without Azithromycin in COVID-19 Patients: A Retrospective Analysis in Brazil.

Background: Despite no evidence showing benefits of hydroxychloroquine and chloroquine with or without azithromycin for COVID-19 treatment, these medications have been largely prescribed in Brazil.

Objectives: To assess outcomes, including in-hospital mortality, electrocardiographic abnormalities, hospital length-of-stay, admission to the intensive care unit, and need for dialysis and mechanical ventilation, in hospitalized COVID-19 patients who received chloroquine or hydroxychloroquine, and to compare outcomes between those patients and their matched controls.

Methods: A retrospective multicenter cohort study that included consecutive laboratory-confirmed COVID-19 patients from 37 Brazilian hospitals from March to September 2020.

Microparticles and cardiotoxicity secondary to doxorubicin-based chemotherapy in breast cancer patients.

Doxorubicin (DOXO)-cardiotoxicity is a limiting factor for breast cancer chemotherapy. The relationship between microparticles (MPs) and cardiotoxicity remains unclear. MPs can be released under varying pathophysiological conditions.

Association of the three-minute step test with the occurrence of pulmonary exacerbations in children with cystic fibrosis: a cross-sectional study.

Background: Cystic fibrosis (CF) patients experience pulmonary exacerbations and the three-minute step test (3-min step test) may be a simple and easy-to-perform functional test to help identify such episodes. The present study aimed to evaluate the association of the 3-min step test with the occurrence of pulmonary exacerbations in children with CF.

Methods: Cross-sectional study of CF patients aged 6 years and older.

Clinical factors associated with systemic sporotrichosis in Brazil.

Background: Systemic sporotrichosis occurs when organs, other than subcutaneous tissues and lymph nodes, are infected. Interestingly, systemic sporotrichosis in apparently immunocompetent individuals is increasing in Brazil, but data on clinical manifestations and risk factors are scarce. Most of the existing data on such condition relate to people living with HIV.

COVID-19 and candiduria: an investigation of the risk factors and immunological aspects.

Secondary fungal infections are frequently observed in COVID-19 patients. However, the occurrence of candiduria in these patients and its risk factors are underexplored. We evaluated the risk factors of candiduria in COVID-19 patients, including inflammatory mediators that could be used as prognostic markers.

Brazilian guidelines for the pharmacological treatment of the pulmonary symptoms of cystic fibrosis. Official document of the Sociedade Brasileira de Pneumologia e Tisiologia (SBPT, Brazilian Thoracic Association).

Cystic fibrosis (CF) is a genetic disease that results in dysfunction of the CF transmembrane conductance regulator (CFTR) protein, which is a chloride and bicarbonate channel expressed in the apical portion of epithelial cells of various organs. Dysfunction of that protein results in diverse clinical manifestations, primarily involving the respiratory and gastrointestinal systems, impairing quality of life and reducing life expectancy. Although CF is still an incurable pathology, the therapeutic and prognostic perspectives are now totally different and much more favorable.

Potential Biomarkers of impulsivity in mild traumatic brain injury: A pilot study.

Very few studies have investigated cognition and impulsivity following mild traumatic brain injury (mTBI) in the general population. Furthermore, the neurobiological mechanisms underlying post-TBI neurobehavioral syndromes are complex and remain to be fully clarified. Herein, we took advantage of machine learning based-modeling to investigate potential biomarkers of mTBI-associated impulsivity.

Serum soluble mediators as prognostic biomarkers for morbidity, disease outcome, and late-relapsing hepatitis in yellow fever patients.

This study described a soluble mediator storm in acute Yellow Fever/YF infection along the kinetics timeline towards convalescent disease. The analyses of the YF Viral RNAnemia, chemokines, cytokines, and growth factors were performed in YF patients at acute/(D1-15) and convalescent/(D16-315) phases. Patients with acute YF infection displayed a trimodal viremia profile spreading along D3, D6, and D8-14.

Potential and limitations of machine meta-learning (ensemble) methods for predicting COVID-19 mortality in a large inhospital Brazilian dataset.

The majority of early prediction scores and methods to predict COVID-19 mortality are bound by methodological flaws and technological limitations (e.g., the use of a single prediction model).

Clinical characteristics and outcomes of hospital-manifested COVID-19 among Brazilians.

Objectives: To analyze the clinical characteristics and outcomes of admitted patients with the hospital- versus community-manifested COVID-19 and to evaluate the risk factors related to mortality in the first population.

Methods: This retrospective cohort included consecutive adult patients with COVID-19, hospitalized between March and September 2020. The demographic data, clinical characteristics, and outcomes were extracted from medical records.

Late Diagnosis of Disseminated Infection with Bone Marrow Involvement in an HIV-Negative Patient.

Sporotrichosis is a fungal disease that causes symptoms similar to those of other infectious and non-infectious diseases, making diagnosis difficult and challenging. Here, we report a case of an HIV-negative patient presenting disseminated sporotrichosis with widespread cutaneous lesions mimicking pyoderma gangrenosum, with bone marrow infection, pancytopenia, and hemophagocytic syndrome. However, all the clinical manifestations and a bacterial coinfection delayed the request for a fungal diagnosis.

Custody and Psychiatric Treatment Hospitals in the prison system: A social death decreed?

This text discusses people with mental disorders in conflict with the law in Brazil and the Custody and Psychiatric Treatment Hospitals, institutions included in the prison system and considered a hybrid between health and justice. When we present the reality in the national context, we show that the Psychiatric Reform did not reach these institutions, and these individuals continue to be stigmatized, and their human rights are violated. We substantiate the need to advance the debate and raise some questions to establish new solutions to tackle the issue and ensure well-structured, scientific evidence-based health care.

Prognostic factors in treatment of traumatic femoropopliteal arterial injuries at a Brazilian trauma center.

Background: Despite significant improvements in outcomes, traumatic arterial limb injuries remain a significant cause of limb loss and mortality.

Objectives: This study sought to identify predictors of mortality and major amputation in patients undergoing revascularization after femoropopliteal arterial trauma.

Methods: This was a retrospective review of a trauma registry from an urban trauma center in Brazil.