Dengue Mimickers: Which Clinical Conditions Can Resemble Dengue Fever?

Epidemics and outbreaks caused by the dengue virus pose risks to populations and have high mortality rates, causing burdens and economic costs worldwide. Brazil recently experienced an explosive increase in the number of dengue cases and fatalities. Dengue is an acute febrile illness that can progress to severe forms.

Fungal Necrotizing Fasciitis Due to Mucormycosis Following Contaminated Substance Inoculation: A Report of Two Cases.

Unlabelled: Mucormycosis is a life-threatening fungal infection caused by Mucorales fungi, characterized by angioinvasion and tissue necrosis. While it predominantly affects immunocompromised individuals, it can also occur in immunocompetent patients through traumatic inoculations, such as contaminated surgical dressings or injections. We report two cases of cutaneous mucormycosis following the shared use of contaminated intramuscular corticosteroid injections (dexamethasone).

III BRAZILIAN CONSENSUS STATEMENT ON ENDOSCOPIC ULTRASOUND.

Background: In the past decades, endoscopic ultrasound has developed from a diagnostic tool to a platform for many therapeutic interventions. Various technological advancements have emerged since the last Brazilian Consensus, demanding a review and update of the recommendations based on the best scientific evidence.

Methods: A group of 32 renowned echoendoscopists selected eight relevant topics to be discussed to generate clinical questions.

COVID-19 IN INFLAMMATORY BOWEL DISEASE: SHOULD WE BE MORE CAREFUL WITH THE USE OF SALICYLATES?

Backgrounds: Fortunately, much has been studied about COVID-19 in patients with inflammatory bowel diseases (IBD). Evidence suggests that these patients do not appear to be at increased risk of severe COVID-19. However, there are still some uncertainties regarding the clinical manifestations of COVID-19 in patients with immune-mediated diseases.

Accuracy of the Verbal Autopsy questionnaire in the diagnosis of COVID-19 deaths in a Brazilian capital.

The Verbal Autopsy (VA) is a questionnaire about the circumstances surrounding a death. It was widely used in Brazil to assist in postmortem diagnoses and investigate excess mortality during the Coronavirus Disease 2019 (COVID-19) pandemic. This study aimed to determine the accuracy of investigating acute respiratory distress syndrome (ARDS) using VA.

PERORAL ENDOSCOPIC MYOTOMY FOR ACHALASIA: SAFETY PROFILE, COMPLICATIONS AND RESULTS OF 94 PATIENTS.

Background: Achalasia is an esophageal motility disorder, with clinical presentation of dysphagia and regurgitation. This is a chronic condition with no cure. Current treatment options aim to reduce lower esophageal sphincter tone by pharmacological, endoscopic or surgical means, with the aim of improving patients' symptoms.

Investigation of the impact of AXL, TLR3, and STAT2 in congenital Zika syndrome through genetic polymorphisms and protein-protein interaction network analyses.

Introduction: Zika virus (ZIKV) is a human teratogen that causes congenital Zika syndrome (CZS). AXL, TLR3, and STAT2 are proteins involved in the ZIKV's entry into cells (AXL) and host's immune response (TLR3 and STAT2). In this study, we evaluated the role of genetic polymorphisms in these three genes as risk factors to CZS, and highlighted which proteins that interact with them could be important for ZIKV infection and teratogenesis.

TECHNIQUE OF EXPOSURE OF THE ESOPHAGOGASTRIC JUNCTION OBTAINED BY THE FLEXIBLE LIVER RETRACTOR IN BARIATRIC SURGERY: A RANDOMIZED CONTROLLED TRIAL.

Aim: In the Roux-en-Y gastric bypass technique, classic laparoscopic surgical retractors are usually rigid, require an additional incision for its installation, or must be handled by an assistant during the surgical procedure, involving a risk of liver injury. The aim of this study was to evaluate and validate a technique of the esophagogastric junction exposure obtained by the flexible liver retractor in bariatric surgery, comparing its efficacy with the retractor classically used for this purpose.

Methods: This study was performed as a randomized, open, prospective, controlled, and comparative design in patients with medical indications of bariatric surgery.

A prospective controlled randomized multicenter study to evaluate the severity of compensatory sweating after one-stage bilateral thoracic sympathectomy versus unilateral thoracic sympathectomy in the dominant side.

Objective: To evaluate the contribution that unilateral thoracic sympathectomy in dominant side or two-stage bilateral thoracic sympathectomy can have as strategies to reduce the incidence of compensatory sweating after sympathectomy for palmar hyperhidrosis.

Methods: This is a prospective, controlled, randomized multicenter trial of 200 participants with palmar hyperhidrosis, which will be randomized into two arms: (a) one-stage bilateral thoracic sympathectomy (control arm); or (b) unilateral thoracic sympathectomy in dominant side (intervention arm). At six months the participants submitted to unilateral procedure can make the contralateral surgery if they wanted it, creating a third group called two-stage bilateral sympathectomy.

COVID-19 in a Patient with Chronic Lymphocytic Leukaemia with Pseudohypoxemia.

Unlabelled: Infection with SARS-CoV-2 causes critical disease in approximately 5% of affected patients, particularly the elderly, hypertensive, obese and immunocompromised. Patients with haematological cancer, including chronic lymphocytic leukaemia (CLL), are particularly at risk of complications. Very rarely, patients with extreme leukocytosis may develop spurious hypoxemia, or pseudohypoxemia, which confuses the diagnosis of complications and can lead to intervention errors.

Functional capacity as a predictor of postoperative delirium in transurethral resection of prostate patients in Northeast Brazil.

Introduction: Postoperative delirium (POD) is a common disorder and its frequency varies from 15% to 25% after major elective surgery. There are few data on the incidence of POD in Brazil. Here, we sought to assess the incidence of POD following transurethral resection of the prostate (TURP) and to examine precipitating and predisposing factors associated.

Plasmic score applicability for the diagnosis of thrombotic microangiopathy associated with ADAMTS13-acquired deficiency in a developing country.

Background: Thrombotic thrombocytopenic purpura (TTP) is a potentially fatal disease that requires early diagnosis and treatment that can be made possible by applying the PLASMIC score. This study aims to evaluate this score applicability for patients with suspected TTP in a developing country.

Methods: This was a retrospective study performed at a tertiary hospital in the northeastern region of Brazil.

Evaluation tool for a gastroenterostomy simulated training1.

Purpose: To create a checklist to evaluate the performance and systematize the gastroenterostomy simulated training.

Methods: Experimental longitudinal study of a quantitative character. The sample consisted of twelve general surgery residents.

Ursodeoxycholic acid in the prevention of gallstones in patients subjected to Roux-en-Y gastric bypass1.

Purpose: To evaluate the contribution of ursodeoxycholic acid (UDCA) in the first 12 months after Roux-en-Y gastric bypass in the prevention of gallstone formation.

Methods: A community-based clinical trial was conducted. A total of 137 patients were included in the study; 69 were treated with UDCA, starting 30 days after the surgery, at a dose of 150 mg twice daily (300 mg/day) over a period of 5 consecutive months (GROUP A), and 68 were control patients (GROUP B).

A pioneering RET genetic screening study in the State of Ceará, Brazil, evaluating patients with medullary thyroid cancer and at-risk relatives: experience with 247 individuals.

Objective: Initial diagnosis of medullary thyroid carcinoma (MTC) is frequently associated with advanced stages and a poor prognosis. Thus, the need for earlier diagnoses and detection in relatives at risk for the disease has led to increased use of RET genetic screening.

Subjects And Methods: We performed RET screening in 247 subjects who were referred to the Brazilian Research Consortium for Multiple Endocrine Neoplasia (BRASMEN) Center in the State of Ceará.

Sexual function of undergraduate women: a comparative study between Brazil and Italy.

Objective: to evaluate the sexual function of Italian and Brazilian nursing students using the Female Sexual Function Index (FSFI), to estimate the prevalence of sexual dysfunctions and related factors.

Method: this is a cross-sectional study involving 84 Brazilian and 128 Italian undergraduate. For the evaluation of sexual function, the Female Sexual Function Index (FSFI) questionnaire was used.

Figurate erythematous lesion by Microsporum canis in immunosuppressed patient.

Dermatophytes are fungi capable of invading keratinized tissues. Isolation of the fungus with the culture is essential to guide the treatment, because there are more resistant species like Microsporum canis. The chronic use of corticosteroids leads to the deregulation of immunity, promoting atypical manifestations of infections.

Analysis of cases of gestational and congenital syphilis between 2008 and 2010 in Fortaleza, State of Ceará, Brazil.

This study analyzes the reported cases of syphilis in pregnant women and the possible outcomes for fetuses and the newborn in Fortaleza, Ceará. It is a cross-sectional study that analyzed 175 reported cases of syphilis in pregnant women matched with the corresponding reports of congenital syphilis during the years 2008-2010. Descriptive statistics with absolute and relative frequencies, central tendency and dispersion measures, and the Pearson's chi-square test were used to analyze the statistical significance using the p-value <0.

Effects of bariatric surgery on night eating and depressive symptoms: a prospective study.

Background: Night eating syndrome (NES) is characterized by a delayed pattern of food intake and is clinically defined by the presence of evening hyperphagia, nocturnal ingestion, morning anorexia, and sleep problems. Although most studies report an association of obesity, depressive mood, and NES, very little is known about the impact of bariatric surgery in the course of this syndrome, particularly in patients with depressive symptoms.

Objectives: To assess the effects of bariatric surgery on night eating and depressive symptoms.

Model for simulated training of laparoscopic gastroenterostomy.

Purpose:: To develop a model of gastroenterostomy and to analyze the acquisition of skills after training by simulation.

Methods:: Experimental longitudinal study and of a quantitative character. The sample consisted of twelve general surgery residents from four hospitals.

Obesity, Hypersomnolence, and Quality of Sleep: the Impact of Bariatric Surgery.

Purpose: Obesity is commonly associated with poor sleep, excessive daytime sleepiness (EDS) and depressive mood but the impact of bariatric surgery on these conditions is incompletely understood. This study aimed to investigate the course of EDS and sleep quality in bariatric surgery patients in relation with changes in body weight and depressive symptoms.

Methods: In patients consecutively submitted to bariatric surgery, baseline and postoperative sleep quality were evaluated by the Pittsburgh Sleep Quality Index (PSQI), excessive daytime sleepiness by the Epworth Sleepiness Scale (ESS), risk for OSA by the Berlin Questionnaire (BQ), and depressive symptoms by the Beck Depression Inventory-Short Form (BDI).

[Access of pregnant women to technologies for the prevention and control of congenital syphilis in Fortaleza-Ceará, Brazil].

Objective: To evaluate access to technologies for prevention and control of Congenital Syphilis (CS) by pregnant women.

Methodology: Multi-case study that analyzed prenatal care to pregnant women with syphilis, which aimed at identifying the aspects that hinder their access to soft, soft-hard and hard health technologies that may contribute to the prevention of SC. The field research was done from April to September 2011 at four Health Units of two Regional Executive Divisions in Fortaleza City.

Update on the 2012 Brazilian Society of Rheumatology Guidelines for the treatment of rheumatoid arthritis: position on the use of tofacitinib.

In 2014, tofacitinib, a target-specific, synthetic disease modifying anti rheumatic drug (DMARD) and a selective inhibitor of Janus kinase (JAK) was approved for use in Brazil. This position paper aims to update the recommendations of the Brazilian Society of Rheumatology (SBR) on the treatment of rheumatoid arthritis (RA) in Brazil, specifically regarding the use of target-specific synthetic DMARDs. The method of this recommendation consisted of a literature review of scientific papers held on the Medline database.