Seven versus 14 days of antimicrobial therapy for severe multidrug-resistant Gram-negative bacterial infections in intensive care unit patients (OPTIMISE): a randomised, open-label, non-inferiority clinical trial.

Background: Shorter courses of antimicrobial therapy have been shown to be non-inferior to longer durations for the management of several infections. However, data on critically ill patients with severe infections by multidrug-resistant Gram-negative bacteria (MDR-GNB) are scarce. In the duratiOn of theraPy in severe infecTIons by MultIdrug-reSistant gram-nEgative bacteria (OPTIMISE) trial, we assessed the non-inferiority of 7-day versus 14-day antimicrobial therapy for patients with intensive care unit (ICU)-acquired severe infections by MDR-GNB.

The role of the radiologist in the dengue endemic: a pictorial essay.

The dengue virus, a member of the family Flaviviridae, is transmitted by mosquitoes and causes a viral disease known as dengue fever that is prevalent in tropical and subtropical regions. It is estimated that there are 100-400 million new infections every year, with underreporting due to limited surveillance systems. The presentation ranges from asymptomatic to dengue shock syndrome.

Disentangling the effects of intermittent faecal shedding and imperfect test sensitivity on the microscopy-based detection of gut parasites in stool samples.

Background: Gut-parasite transmission often involves faecal shedding, and detecting parasites in stool samples remains the cornerstone of diagnosis. However, not all samples drawn from infected hosts contain parasites (because of intermittent shedding), and no test can detect the target parasites in 100% of parasite-bearing samples (because of imperfect sensitivity). Disentangling the effects of intermittent shedding and imperfect sensitivity on pathogen detection would help us better understand transmission dynamics, disease epidemiology, and diagnostic-test performance.

Robotic colorectal surgery in Latin America: a systematic review on surgical outcomes.

Background And Objectives: Robotic approach in colorectal surgery is rapidly gaining interest, particularly in the context of rectal cancer resection. Despite economic barriers, substantial proliferation of robotic colorectal procedures has been observed throughout Latin America. However, there is a lack of data regarding intraoperative and early postoperative outcomes, as well as oncological and long-term results.

Effectiveness of hypertonic saline irrigation following functional endoscopic sinus surgery: a systematic review and meta-analysis.

Objectives: This study aimed to clarify the impact of hypertonic solutions on various outcomes, including persistence or reduction of nasal crusts, polypoid edema, and postoperative inflammatory symptoms.

Methods: We searched PubMed, Embase, and Cochrane Central Register of Controlled Trials for studies comparing hypertonic with isotonic saline irrigation after FESS in adult patients with Chronic Rhinosinusitis (CRS). Outcomes were polypoid mucosa, nasal crusts, and variation from the baseline of Sino-Nasal Outcome Test (SNOT) 20/22 and Visual Analog Scale (VAS).

Usefulness of prolactin levels in predicting the etiology of hyperprolactinemia in a cohort of 770 patients.

Objective: Determining the etiology of hyperprolactinemia is fundamental for selecting the most appropriate treatment strategy. The aim of this study was to evaluate the usefulness and accuracy of prolactin levels in predicting the etiology of nonphysiological hyperprolactinemia.

Subjects And Methods: In this retrospective study, we reviewed medical records of patients with nonphysiological hyperprolactinemia seen at two neuroendocrine reference centers located in Recife, Brazil, from January 2000 to December 2019.

Effects of two immunosuppression regimens on T-lymphocyte subsets in elderly kidney transplant recipients.

Background: Despite the growing number of elderly kidney transplant (Ktx) recipients, few studies have examined the effects of immunosuppression on their lymphocyte profiles.

Methods: We evaluated the early conversion from mycophenolate sodium (MPS) to everolimus (EVL) after rabbit antithymocyte globulin (rATG) 2 mg/kg induction in elderly kidney recipients. Three groups of KTx patients were compared: (a) Young (n=20, 36 ± 7 y) receiving standard immunosuppression (Group A1) (prednisone, tacrolimus, and MPS), (b) Elderly (n=35, 65 ± 3 y) receiving standard immunosuppression (Group B1), and (c) Elderly (n=16, 65 ± 3 y) with early (mean 30 d) conversion from MPS to EVL (Group B2).

Pulmonary Rehabilitation Program Is an Effective Treatment Approach for Post-COVID-19 Syndrome Patients.

Patients with post-COVID-2019 syndrome may have reduced functional capacity and physical activity levels. The pulmonary rehabilitation program (PRP)-an exercise training program-is designed to restore these functions and has been shown to improve dyspnea, exercise capacity, and other measures in these patients. This study aimed to analyze the effects of the RP on post-COVID-19 syndrome patients with respect to objective and subjective functional capacity, balance, and musculoskeletal strength.

Association of Body Image and Genital Self-Image with Female Sexual Function: A Systematic Review.

The aim of this study was to identify, through a systematic review, how perceptions of genital and body self-image can influence the sexual function of young adult women. A systematic review was performed in which 704 studies were selected. After analyzing the articles, only 10 articles were included, from which the data for this research were extracted.

Hydroxychloroquine is associated with lower seroconversion upon 17DD-Yellow fever primovaccination in patients with primary Sjögren's syndrome.

The present study aimed at investigating whether the hydroxychloroquine (HCQ) treatment would impact the neutralizing antibody production, viremia levels and the kinetics of serum soluble mediators upon planned 17DD-Yellow Fever (YF) primovaccination (Bio-Manguinhos-FIOCRUZ) of primary Sjögren's syndrome (pSS). A total of 34 pSS patients and 23 healthy controls (HC) were enrolled. The pSS group was further categorized according to the use of HCQ (HCQ and Non-HCQ).

To be or not to B27 positive: implications for the phenotypes of axial spondyloarthritis outcomes. Data from a large multiracial cohort from the Brazilian Registry of Spondyloarthritis.

Background: There is a remarkable variability in the frequency of HLA-B27 positivity in patients with spondyloarthritis (SpA), which may be associated with different clinical presentations worldwide. However, there is a lack of data considering ethnicity and sex on the evaluation of the main clinical and prognostic outcomes in mixed-race populations. The aim of this study was to evaluate the frequency of HLA-B27 and its correlation with disease parameters in a large population of patients from the Brazilian Registry of Spondyloarthritis (RBE).

Creation of an institutional preoperative checklist to support clinical risk assessment in patients with ulcerative colitis (UC) considering ileoanal pouch surgery.

Background: Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the most established restorative operative approach for patients with ulcerative colitis. It has associated morbidity and the potential for major repercussions on quality of life. As such, patient selection is crucial to its success.

Comparison of arterial hypotension incidence during general anesthesia induction - target-controlled infusion vs. bolus injection of propofol: a randomized clinical trial.

Background: The incidence of arterial hypotension during induction of general anesthesia is influenced by the method of propofol administration, but there is a dearth of randomized clinical trials comparing bolus injection and target-controlled infusion in relation to arterial hypotension. This study seeks to compare the incidence of arterial hypotension between these two methods of propofol administration.

Methods: This prospective, randomized, single-center, non-blinded study included 60 patients (aged 35 to 55 years), classified as ASA physical status I or II, who were undergoing non-cardiac surgeries.

Autosomal Recessive IL-12p40 Deficiency due to a Mutation in the Gene: Report of a Brazilian Patient with Lymph Node Mycobacterial Infection.

Autosomal recessive interleukin (IL)-12p40 deficiency is a genetic etiology of Mendelian susceptibility to mycobacterial disease (MSMD). It has been described in ∼50 patients, usually with onset at childhood with Bacille Calmette-Guérin (BCG) and infections. A male patient born to consanguineous parents was diagnosed with presumed lymph node MSMD at the age of 13 years after ocular symptoms.

Health-related quality of life and clinical severity in people with epidermolysis bullosa - A proposal for assessing nutritional compromise by body mass index (Birmingham Epidermolysis Bullosa Severity Score).

Introduction and objectives: epidermolysis bullosa (EB) is a rare genetic disease characterised by skin fragility with blisters and erosions on the skin and/or mucous membranes. People with EB often experience several extracutaneous manifestations, including clinical and health-related quality of life (HRQoL) complications. Herein, we evaluate their HRQoL and clinical severity and propose an objective criterion for estimating nutritional compromise using the Birmingham Epidermolysis Bullosa Severity Score (BEBS) tool.

Current perspectives on the management of refractory or relapsed classic hodgkin lymphoma in brazil: Balancing efficacy, safety, and tolerability.

Classic Hodgkin lymphoma (CHL), which accounts for 90-95% of all cases of Hodgkin lymphoma, is the most frequent cancer in adolescents and the most frequent lymphoma in adolescents and young adults. Despite progressive improvements over past decades and the general sensitivity of CHL to frontline chemotherapy, approximately 10-15% of patients have refractory disease that either does not respond to such therapy or progresses after an initial partial response. In patients with refractory or relapsed disease, standard treatment until recently consisted mainly of salvage chemotherapy, in many cases followed by high-dose chemotherapy and autologous stem-cell transplantation.

Telehealth strategies in the care of people with chronic kidney disease: integrative review.

Objective: to evaluate the evidence about telehealth strategies in caring for people with chronic kidney disease.

Method: integrative literature review. The search for primary studies was carried out in six databases: PubMed/MEDLINE, Web of Science, EMBASE, CINAHL, LILACS, and Scopus.

Factors Associated With Mortality in Patients With Immune-Mediated Rheumatic Diseases and COVID-19 From Latin America: Data From Argentina, Mexico, and Brazil.

Objective: To describe characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with rheumatic immune-mediated inflammatory diseases (IMIDs) from Argentina, Mexico and Brazil, and to assess factors associated with mortality in this population.

Methods: Data from 3 national registries, SAR-COVID (Argentina), CMR-COVID (Mexico), and ReumaCoV-Brasil (Brazil), were combined. Adult patients with IMIDs and SARS-CoV-2 infection were recruited.