Massive Splenomegaly in Felty's Syndrome: A Case Report.

Felty's syndrome (FS) is a rare and complex condition most commonly seen as a complication of longstanding rheumatoid arthritis (RA), characterized by a triad of RA, splenomegaly, and neutropenia. Diagnosing FS can be challenging due to its diverse clinical presentations and overlap with other hematologic and autoimmune conditions. We report a 47-year-old male with a history of severe anemia, recurrent blood transfusions, and a chronic leg ulcer.

Brain tissue integrity in neuromyelitis optica spectrum disorder through T1-w/T2-w ratio, MTR and DTI.

Background: The presence of diffuse brain damage in normal-appearing white matter (NAWM) and gray matter (NAGM) in neuromyelitis optica spectrum disorder (NMOSD) remains controversial. We aimed to address this controversy by applying a multiparametric MRI approach. Additionally, the association between MRI metrics and clinical variables was explored.

Comprehensive molecular epidemiology of influenza viruses in Brazil: insights from a nationwide analysis.

Influenza A and B viruses represent significant global health threats, contributing substantially to morbidity and mortality rates. However, a comprehensive understanding of the molecular epidemiology of these viruses in Brazil, a continental-size country and a crucial hub for the entry, circulation, and dissemination of influenza viruses within South America, still needs to be improved. This study addresses this gap by consolidating data and samples across all Brazilian macroregions, as part of the Center for Viral Surveillance and Serological Assessment project, together with an extensive number of other Brazilian sequences provided by a public database during the epidemic seasons spanning 2021-23.

Newborn screening in Brazil: realities and challenges.

Neonatal screening is a critical public health initiative introduced worldwide to detect severe congenital disorders early in life. This study provides an updated overview of public neonatal screening in Brazil, highlighting the transition from initial pilot projects to a robust national program. Through the analysis of recent data up to 2023, we discuss the coverage and regional efficiencies of the program.

Pterional vs. mini-pterional craniotomy for intracranial aneurysms: a systematic review and meta-analysis.

The mini-pterional craniotomy (mPT) was designed to be a minimally invasive alternative to the standard pterional (PT) approach. However, it remains unclear which technique produces better results. Thus, we aimed to perform a meta-analysis comparing functional, surgical, and aesthetic outcomes between mPT and PT in intracranial aneurysms.

The Patterns of P53, E-Cadherin, β-Catenin, CXCR4 and Podoplanin Expression in Oral Squamous Cell Carcinoma Suggests a Hybrid Invasion Model: an Immunohistochemical Study on Tissue Microarrays.

Purpose: Oral squamous cell carcinoma (OSCC) is a significant public health challenge associated with high mortality rates primarily due to its invasive and metastatic behavior. This study aimed to evaluate the expression patterns of five critical biomarkers: β-catenin, E-cadherin, podoplanin (PDPN), CXCR4, and p53 in OSCC tissues and to investigate their correlations with clinicopathologic features and patient outcomes.

Methods: We conducted an immunohistochemical analysis utilizing tissue microarrays (TMAs) from 95 patients diagnosed with primary OSCC.

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.

Case Report: Filamin C gene mutation associated with restrictive cardiomyopathy leading to heart transplantation.

Background: Cardiomyopathy is a disease that affects the myocardium and can be classified as dilated, restrictive, or hypertrophic cardiomyopathy. Among the subtypes, restrictive cardiomyopathy is characterized by restriction of ventricular filling and its uncommon cause is a disease due to mutation on Filamin C (FLNC) gene. Filamin C is an actin-binding protein encoded by FLNC gene and participates in sarcomere stability maintenance, which is expressed on the striated muscle.

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.

Prevalence and factors associated with sensitivity to methylisothiazolinone in individuals with suspected allergic contact dermatitis: A cross-sectional study.

Objectives: To evaluate the prevalence of methylisothiazolinone sensitivity and associated factors in individuals with suspected allergic contact dermatitis.

Methods: Cross-sectional study based on patch tests, including methylisothiazolinone 0.2%, in 286 participants with suspected allergic contact dermatitis, in Brasília/DF, Brazil, between March/2020 and March/2022.

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.

Prediction of good neurological outcome after return of circulation following paediatric cardiac arrest: A systematic review and meta-analysis.

Aim: To evaluate the ability of blood-biomarkers, clinical examination, electrophysiology, or neuroimaging, assessed within 14 days from return of circulation to predict good neurological outcome in children following out- or in-hospital cardiac arrest.

Methods: Medline, EMBASE and Cochrane Trials databases were searched (2010-2023). Sensitivity and false positive rates (FPR) for good neurological outcome (defined as either 'no, mild, moderate disability or minimal change from baseline') in paediatric survivors were calculated for each predictor.

Enhancing recovery and reducing inflammation: the impact of enhanced recovery after surgery recommendations on inflammatory markers in laparoscopic surgery-a scoping review.

Introduction: The relationship between the Enhanced Recovery After Surgery (ERAS) guidelines and inflammatory markers in laparoscopic surgery has garnered increasing attention. These recommendations are designed to minimize surgical stress and potentially improve recovery outcomes by modifying perioperative care.

Objective: This scoping review aims to evaluate the impact of ERAS recommendations on inflammatory markers in patients undergoing laparoscopic surgeries, identifying current research gaps and consolidating findings from existing studies.

Ultrasound measurements and normal findings in the thyroid gland.

The present work describes the process of the sonographic examination, normal findings and measurements in the B-mode ultrasound evaluation. Reference is made to anatomical variants in shape, the pyramidal lobe, tubercle of Zuckerkandl, ectopic thyroid tissue, and their significance. Particular attention is paid to the reference values, the very miscellaneous reference values in different geographic regions of the world and influencing factors.

Inflammatory pathways and anti-inflammatory therapies in sickle cell disease.

Sickle cell disease (SCD) is a monogenic disease, resulting from a single-point mutation, that presents a complex pathophysiology and high clinical heterogeneity. Inflammation stands as a prominent characteristic of SCD. Over the past few decades, the role of different cells and molecules in the regulation of the inflammatory process has been elucidated.

Outpatient subcutaneous alemtuzumab is feasible and safe for aplastic anemia and associated with high response rates.

Immunosuppressive therapy (IST) using horse antithymocyte globulin (h-ATG) combined with cyclosporine (CsA) and eltrombopag is the standard care for aplastic anemia (AA) in patients without a suitable matched donor. However, in many countries, h-ATG use has been discontinued, leaving rabbit ATG (r-ATG), which has a lower response rates and poorer survival, as the only alternative. In previous studies, alemtuzumab (ALZ), a humanized monoclonal antibody targeting CD52, combined with CsA resulted in an adequate ORR in AA patients.

WFUMB Commentary Paper on Artificial intelligence in Medical Ultrasound Imaging.

Artificial intelligence (AI) is defined as the theory and development of computer systems able to perform tasks normally associated with human intelligence. At present, AI has been widely used in a variety of ultrasound tasks, including in point-of-care ultrasound, echocardiography, and various diseases of different organs. However, the characteristics of ultrasound, compared to other imaging modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), poses significant additional challenges to AI.

Lifetime Impact Study for Achondroplasia (LISA): Findings from an observational and multinational study focused on health-related quality of life in individuals with achondroplasia in Latin America.

Purpose: The multisystem clinical manifestations and complications of achondroplasia, the most common form of disproportionate short stature, can cause functional impairment and psychosocial burden. The Lifetime Impact Study for Achondroplasia (LISA), aimed to assess health-related quality of life and medical resource utilization among Latin America patients with achondroplasia.

Methods: Data were collected from individuals aged 3 years and above in Argentina, Brazil, and Colombia between 2018 and 2021.

A Two-Year cohort study examining the impact of cytokines and chemokines on cognitive and psychiatric outcomes in Long-COVID-19 patients.

This study investigates the relationship between clinical, sociodemographic, and neuropsychological symptoms and serum cytokine concentrations with long-term cognitive and psychiatric outcomes in long-COVID-19 patients. We reassessed 108 adults who survived moderate to severe COVID-19 at two intervals post-discharge (T1, mean 6.9 months; T2, mean 23.