Epidemiologic Characteristics, Time Trend, and Seasonality of Orofacial Clefts in São Paulo State, Brazil. 2008-2019.

Objective: To characterize the epidemiology, identify trends in prevalence, seasonality, and risk factors for orofacial clefts (OFC), selecting the São Paulo state (SPS) population database.

Design: A population-based study to estimate the OFC prevalence trends in recent years, stratified by maternal age and SPS geographical clusters.

Setting: All live births (LB) with OFC in SPS from 2008-2019.

Evaluation of the characteristics of infection prevention and control programs and infection control committees in Brazilian hospitals: A countrywide cross-sectional study.

Objective: Data are scarce regarding hospital infection control committees and compliance with infection prevention and control (IPC) recommendations in Brazil, a country of continental dimensions. We assessed the main characteristics of infection control committees (ICCs) on healthcare-associated infections (HAIs) in Brazilian hospitals.

Methods: This cross-sectional study was conducted in ICCs of public and private hospitals distributed across all Brazilian regions.

The Role of Radiomics in Rectal Cancer.

Purpose: Radiomics is a promising method for advancing imaging assessment in rectal cancer. This review aims to describe the emerging role of radiomics in the imaging assessment of rectal cancer, including various applications of radiomics based on CT, MRI, or PET/CT.

Methods: We conducted a literature review to highlight the progress of radiomic research to date and the challenges that need to be addressed before radiomics can be implemented clinically.

Ixazomib Versus Placebo as Postinduction Maintenance Therapy in Newly Diagnosed Multiple Myeloma Patients: An Analysis by Age and Frailty Status of the TOURMALINE-MM4 Study.

Background: The TOURMALINE-MM4 trial demonstrated a significant and clinically meaningful progression-free survival (PFS) benefit with ixazomib versus placebo as postinduction maintenance in nontransplant, newly-diagnosed multiple myeloma patients, with a manageable and well-tolerated toxicity profile.

Materials And Methods: In this subgroup analysis, efficacy and safety were assessed by age (< 65, 65-74, and ≥ 75 years) and frailty status (fit, intermediate-fit, and frail).

Results: In this analysis, PFS benefit with ixazomib versus placebo was seen across age subgroups, including patients aged < 65 years (hazard ratio [HR], 0.

Case Report: Evolutionary Clinical-Radiological Features of a Diffuse Hemispheric Glioma, H3 G34 Mutant with Over 5 Years of Survival.

Diffuse hemispheric glioma (DHG), H3 G34 mutant was included in the 5th edition of the World Health Organization Classification of Tumors of the Central Nervous System recently published. Given the recent inclusion in the current classification and its rarity in adult patients, there are scarce data on clinical-radiological characteristics, survival, and outcome. The authors report the case of a 35-year-old female with DHG, H3 G34-mutant characteristics and outcomes with an unusual presentation, recurrence, and prolonged survival.

Watch and Wait Approach for Rectal Cancer.

The administration of neoadjuvant chemoradiotherapy (nCRT) followed by total mesorrectal excision (TME) and selective use of adjuvant chemotherapy can still be considered the standard of care in locally advanced rectal cancer (LARC). However, avoiding sequelae of TME and entering a narrow follow-up program of watch and wait (W&W), in select cases that achieve a comparable clinical complete response (cCR) to nCRT, is now very attractive to both patients and clinicians. Many advances based on well-designed studies and long-term data coming from big multicenter cohorts have drawn some important conclusions and warnings regarding this strategy.

Fibroblastic reticular cell tumour of the internal iliac lymph node presenting as a hypervascular lesion and mimicking a pseudoaneurysm: an extremely rare diagnosis.

A woman in her 50s presented with a rounded and hypervascular lesion in the right internal iliac lymph node chain, contacting with small branches of the anterior division of the internal iliac artery. Since the lesion matched the blood arterial pool in CT and the patient exhibited multiple vascular abnormalities that suggested segmental arterial mediolysis, a pseudoaneurysm hypothesis was initially made. Arteriography was realised due to the intention for embolisation of the pseudoaneurysm, but the dynamic behaviour during the exam suggested a hypervascular tumour more.

Microsurgical Resection of Tonsillar Arteriovenous Malformation: Operative Video.

Cerebellar arteriovenous malformation (AVM) comprises 10%-15% of intracranial AVMs. Rupture often leads to devastating brainstem compression, with mortality reported as high as 67%. AVM can be a challenging disease, especially when large in size.

Posterior-Transcallosal Approach to a Choroidal Fissure Arteriovenous Malformation: Video of Adapting a "Bridging Vein Free" Corridor to This Complex Region.

Choroidal fissure arteriovenous malformations (ChFis-AVMs) are uncommon and challenging to treat due to their deep location and pattern of supply. The choroidal fissure lies between the thalamus and fornix, from the foramen of Monroe to the inferior choroidal point. AVMs in this location receive their supply from the anterior, lateral posterior choroidal artery and medial posterior choroidal arteries and drain to the deep venous system.

Immediate Results after Multiple Arterial Grafts in Coronary Artery Bypass Graft Surgery in the São Paulo State: Cross Cohort Study.

Background: The short-term results after using arterial grafts still raise questions and doubts for medical society.

Objective: To compare the immediate outcomes of patients undergoing single arterial graft versus multiple arterial grafts coronary artery bypass grafting surgery.

Methods: Cross-sectional cohort study in the São Paulo Registry of Cardiovascular Surgery II (REPLICCAR II).

High-dose chemotherapy with autologous stem cell transplantation for patients with extracranial germ cell tumors - experience of two Brazilian pediatric centers.

Malignant extracranial germ cell tumors (GCTs) are rare in pediatric patients and are usually extremely sensitive to chemotherapy. Relapsed or refractory tumors, although rare, established the need for second-line therapies, including high-dose chemotherapy with autologous stem cell transplantation (HDCT/ASCT). However, there are few data on its use in children with GCTs.

Exploring the Brazilian pediatric palliative care network: a quantitative analysis of a survey data.

Objective: The aim of this study was to identify the characteristics of services in Brazil that compound the Brazilian Pediatric Palliative Care (PPC) Network.

Methods: An online survey was conducted among representatives from PPC services. A total of 90 services from Brazil completed the online survey and answered a questionnaire about the service's characterization, health professionals working in PPC, access to opioid prescription and education, and research in PPC.

Plasticity of the adult circle of Willis in response to flow diversion stents.

Background: We present five patients with remodeling of the adult circle of Willis in response to flow diverter stents (FDSs) at the anterior communicating artery (AComA) and the posterior communicating artery (PComA). The observed changes provide a paradigm of how flow change can institute anatomic changes in the adult circle of Willis vasculature.

Case Description: In the first two cases, after placement of the FDS covering the AComA, there was an increase in size and flow of the contralateral A1-anterior cerebral artery which had previously been hypoplastic.

Importance of Arachnoid Dissection in Arteriovenous Malformation Microsurgery: A Technical Note.

Intracranial arteriovenous malformations (AVMs) are congenital anomalies where arteries and veins connect without a capillary bed. AVMs are the leading cause of nontraumatic intracerebral hemorrhages in people younger than 35 years old. The leptomeninges (arachnoid and pia) form from the meninx primitiva.

Effect of Total Hip Arthroplasty with Ceramic Acetabular Component on Clinical, Radiographic and Functional Parameters in Older Patients with Hip Osteoarthritis: Two-Year Follow-Up.

Background: Total hip arthroplasty (THA) is a widely used surgical procedure to reduce pain and improve function and quality of life in patients with hip disorders. The most common condition that leads to THA is osteoarthritis, with most surgeries being performed to treat severe osteoarthritis with pain and functional limitations. Despite the evident success of THA, the search for its improvement and better results, especially in the long term, continues, especially in older patients, for which there is still little scientific evidence.

Cost-effectiveness analysis of Oncotype DX from a Brazilian private medicine perspective: a GBECAM multicenter retrospective study.

Background: Oncotype DX (ODX) is a validated assay for the prediction of risk of recurrence and benefit of chemotherapy (CT) in both node negative (N0) and 1-3 positive nodes (N1), hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) early breast cancer (eBC). Due to limited access to genomic assays in Brazil, treatment decisions remain largely driven by traditional clinicopathologic risk factors. ODX has been reported to be cost-effective in different health system, but limited data are available considering the reality of middle-income countries such as Brazil.