Persisting Gaps in Cytomegalovirus Prevention and Management After Solid Organ Transplantation in a Resource-Limited Setting.

Background: Cytomegalovirus (CMV) infection remains among the leading complications after solid organ transplantation (SOT). Large international surveys mainly focused on high-income countries, detected considerable variability in the management of this infection after SOT. Limited data are available from resource-limited settings.

Deloyers Technique for Restoration of Bowel Continuity Following Extended Left Hemicolectomy: A Comprehensive Analysis of 97 Cases and Literature Review.

Background: Deloyers technique addresses challenges in restoring bowel continuity following extended left hemicolectomies. Despite being first described in 1958, the technique remains underutilized, with limited data on long-term outcomes.

Objective: To evaluate the indications, surgical and functional outcomes of Deloyers technique and review existing literature.

Large language models for the mental health community: framework for translating code to care.

Large language models (LLMs) offer promising applications in mental health care to address gaps in treatment and research. By leveraging clinical notes and transcripts as data, LLMs could improve diagnostics, monitoring, prevention, and treatment of mental health conditions. However, several challenges persist, including technical costs, literacy gaps, risk of biases, and inequalities in data representation.

Intensity-modulated radiation therapy for early-stage breast cancer: a systematic review and meta-analysis.

Background: Radiation therapy (RT) is a standard treatment for non-metastatic breast cancer and is associated with acute and late toxicities. Intensity-modulated RT (IMRT) may decrease toxicity and is convenient for patients.

Objectives: To assess the efficacy and safety of IMRT in women with early stage breast cancer.

Tissue Engineering Construct for Articular Cartilage Restoration with Stromal Cells from Synovium vs. Dental Pulp-A Pre-Clinical Study.

Background/objectives: Cartilage injuries and osteoarthritis are prevalent public health problems, due to their disabling nature and economic impact. Mesenchymal stromal cells (MSCs) isolated from different tissues have the immunomodulatory capacity to regulate local joint environment. This translational study aims to compare cartilage restoration from MSCs from the synovial membrane (SM) and dental pulp (DP) by a tissue-engineered construct with Good Manufacturing Practices.

EEG Oscillations as Neuroplastic Markers of Neural Compensation in Spinal Cord Injury Rehabilitation: The Role of Slow-Frequency Bands.

Background: Spinal cord injury (SCI) affects approximately 250,000 to 500,000 individuals annually. Current therapeutic interventions predominantly focus on mitigating the impact of physical and neurological impairments, with limited functional recovery observed in many patients. Electroencephalogram (EEG) oscillations have been investigated in this context of rehabilitation to identify effective markers for optimizing rehabilitation treatments.

Systematic review and meta-analysis of the treatment of hypernatremia in adult hospitalized patients: impact on mortality, morbidity, and treatment-related side effects.

Background: Hypernatremia is relatively common in acutely ill patients and associated with mortality. Guidelines recommend a slow rate of correction (≤ 0.5 mmol/L per hour).

Oncolytic alphavirus-induced extracellular vesicles counteract the immunosuppressive effect of melanoma-derived extracellular vesicles.

Extracellular vesicles (EVs)-mediated communication by cancer cells contributes towards the pro-tumoral reprogramming of the tumor microenvironment. Viral infection has been observed to alter the biogenesis and cargo of EVs secreted from host cells in the context of infectious biology. However, the impact of oncolytic viruses on the cargo and function of EVs released by cancer cells remains unknown.

Clinical impact of healthcare-associated infections in Brazilian ICUs: a multicenter prospective cohort.

Background: Limited data is available to evaluate the burden of device associated healthcare infections (HAI) [central line associated bloodstream infection (CLABSI), catheter associated urinary tract infection (CAUTI), and ventilator associated pneumonia (VAP)] in low and-middle-income countries. Our aim is to investigate the population attributable mortality fraction and the absolute mortality difference of HAI in a broad population of critically ill patients from Brazil.

Methods: Multicenter cohort study from September 2019 to December 2023 with prospective individual patient data collection.

Case report: Additional grounds for tighter regulation? A case series of five women with zolpidem dependence from a Brazilian women-specific substance use disorder outpatient service.

Objective: This study presents a case series of five women with zolpidem dependence treated at the Drug Dependent Women Treatment Center (PROMUD), one of the first women-specific substance use disorder outpatient services in Latin America.

Methods: This was an retrospective review of medical records of patients with a diagnosis of zolpidem dependence at the Institute of Psychiatry of Clinics Hospital of University of São Paulo between December 2021 and December 2023. Description of the cases followed the Case Report Statement, Checklist and Guidelines (CARE).

Immunogenicity and safety of the fourth dose of quadrivalent human papillomavirus (HPV) vaccine in immunosuppressed women who did not seroconvert after three doses.

Introduction: Immunocompromised persons have high risk of persistent human papillomavirus (HPV) infection and HPV-related diseases, and lower immune response to vaccines. This study evaluated the immunogenicity and safety of administering a fourth dose of quadrivalent (4v)HPV vaccine in immunosuppressed women who did not seroconvert after three doses.

Methods: An open-label, not-controlled trial included immunosuppressed women (solid organ transplant patients and women receiving treatment for SLE) who did not seroconvert to at least one of the four HPV vaccine types after three 4vHPV vaccine doses.

Automatic segmentation of cardiac structures can change the way we evaluate dose limits for radiotherapy in the left breast.

Purpose: Radiotherapy is a crucial part of breast cancer treatment. Precision in dose assessment is essential to minimize side effects. Traditionally, anatomical structures are delineated manually, a time-consuming process subject to variability.

Effects of paclitaxel and methotrexate associated with cholesterol-rich nanoemulsions on ischemia-reperfusion injury after unilateral lung transplantation in rats.

Currently, the barrier to successful lung transplantation is ischemia and reperfusion injury, which can lead to the development of bronchiolitis obliterans. Paclitaxel and methotrexate are drugs known to inhibit cell proliferation and have anti-inflammatory effects, and the association of these drugs with cholesterol-rich nanoparticles has been shown to be beneficial in the treatment of other transplanted organs. Thirty-three male Sprague Dawley rats were divided into 3 groups: Basal group, no intervention; Control group, received only nanoparticles; Drug group, paclitaxel and methotrexate treatment.

Intra- and Inter-Rater Reliability, Measurement Error and Criteria and Convergent Validities of the Dualpex Plus for the Vaginal Manometry of Pelvic Floor Muscles in Women With Urinary Incontinence.

Objective: To test the Intra- and inter-rater reliability, measurement error and criteria and convergent validities of the Dualpex Plus (DP) for vaginal manometry in women with urinary incontinence (UI).

Design: This is a clinimetric properties study.

Setting: University Hospital in Brazil.

Effect of melatonin on postoperative cognitive function in elderly patients submitted to transurethral resection of the prostate under spinal anesthesia.

Background: Hospitalization for Transurethral Prostate Resection (TURP) involves circadian rhythm disturbance - a possible cause of Postoperative Neurocognitive Disorder (POCD) in elderly patients. This study investigated whether melatonin ameliorated this effect.

Methods: A double-blind, randomized clinical trial used a battery of neuropsychological tests to evaluate cognitive performance of 118 patients aged ≥ 60, before TURP with spinal anesthesia, and at 21- and 180-days PO.

Left ventricle remodeling by CMR in treated patients with primary aldosteronism and primary systemic arterial hypertension.

Background: Increased cardiac after load and multiple non-hemodynamic stimuli implicate in adverse left ventricular remodeling (LVR). This is particularly identifiable in treatment-resistant and secondary hypertension contexts, like primary hyperaldosteronism (PA), however little data exists on post-treatment residual LVR in these individuals.

Methods: Cardiac magnetic resonance (CMR) with T1 mapping were performed in 14 patients with treated PA matched with 15 treated patients with primary hypertension (PH) and 15 healthy individuals.

Blood-Based Biomarkers for Identifying Disease Activity in AQP4-IgG-Positive Neuromyelitis Optica Spectrum Disorder.

Importance: The temporal dynamics of serum glial fibrillary acidic protein (sGFAP) and serum neurofilament light chain (sNfL) as biomarkers of disease activity for neuromyelitis optica spectrum disorder (NMOSD) remain underexplored.

Objective: To determine optimal timing for assessing sGFAP and sNfL, establish cutoff values differentiating between attacks and remissions in NMOSD, and evaluate these findings across independent cohorts.

Design, Setting, And Participants: This retrospective, longitudinal, multicenter cohort study was conducted among patients with aquaporin-4 antibody (AQP4-IgG)-positive NMOSD.

Neurofilament Light Chain as a Discriminator of Disease Activity Status in MOG Antibody-Associated Disease.

Background And Objectives: In patients with myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD), acute disease activity is generally identified through medical history, neurologic examination, and imaging. However, these may be insufficient for detecting disease activity in specific conditions. This study aimed to investigate the dynamics of serum neurofilament light chain (sNfL) and serum glial fibrillary acidic protein (sGFAP) after clinical attacks and to assess their utility in discriminating attacks from remission in patients with MOGAD.

Win Ratio approach for the composite outcome of postoperative pulmonary complications: Secondary analysis of a harmonised and pooled database of three randomised clinical trials.

Background: The win ratio analysis method might provide new insight on the impact of positive end-expiratory pressure (PEEP) on clinical outcomes.

Objective: The aim is to re-analyse the results of the 'Re-evaluation of the effects of high PEEP with recruitment manoeuvres vs. low PEEP without recruitment manoeuvres during general anaesthesia for surgery' (REPEAT) study using the win ratio analysis.

Lack of association between revision ACL reconstruction and preoperative, intraoperative and post-operative factors at primary ACL reconstruction in children and adolescents.

Purpose: To evaluate factors associated with revision anterior cruciate ligament reconstruction (ACLR) within 5 years of primary ACLR in children and adolescents.

Methods: Children and adolescents (age <20 years at surgery) who underwent primary hamstring tendon ACLR at the Capio Artro Clinic, Stockholm, Sweden, between January 2005 and December 2018 were identified. Revision ACLR within 5 years of primary ACLR was captured in the Swedish National Knee Ligament Registry.

2024 Standardization of Polysomnography Reports - A Consensus of the Brazilian Sleep Association.

 The absence of standardized reporting for sleep medicine exams across different laboratories can lead to misinterpretation, diagnostic inconsistencies, and suboptimal treatment strategies. This document seeks to establish guidelines for the development of sleep study reports, covering recordings from studies of types 1 to 4, and represents the official position of Associação Brasileira do Sono (ABS; Brazilian Sleep Association) on the standardization of polysomnography (PSG) and cardiorespiratory polygraphies.  The recommendations for the items to be reported in PSG records were developed by means of a Delphi study, comprised of two voting rounds.

Allogeneic Hematopoietic Cell Transplantation in Elderly Patients in a Latin American Country: Analysis of 11 Year of Data from the Brazilian Registry SBTMO/CIBMTR.

This study analyzed recent changes in the utilization of allogeneic hematopoietic cell transplantation (HCT) for treatment of acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), and myeloproliferative diseases (MPDs) and the survival of HCT recipients ≥60 years of age in Brazil. This retrospective registry study included patients who received a first allogeneic HCT from any donor between 2012 and 2023. Of the 6657 patients, 444 (7%) were 60 years of age or older who received grafts from human leukocyte antigen (HLA)-matched related (42%) or unrelated (20%) donors or HLA-haploidentical donors (32%).

HBV, HCV and HIV among inmates in Latin America and the Caribbean: A systematic review and meta-analysis.

Objectives: Hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) affect 340 million people worldwide and have a high impact on vulnerable populations. The aim of this systematic review and meta-analysis was to estimate the prevalence of these infections among inmates in Latin America and the Caribbean.

Methods: Searches were conducted in Medline, Embase, LILACS and Web of Science databases on 17 May 2024, without time or language restriction, according to PRISMA guidelines.