New spirometry recommendations from the Brazilian Thoracic Association - 2024 update.

The latest pulmonary function guideline from the Brazilian Thoracic Association was published in 2002, since which there have been updates to international guidelines (mainly those from the European Respiratory Society and the American Thoracic Society), as well as new national and international publications on various aspects of the performance, interpretation, and clinical implications of spirometry. Despite those updates, a careful analysis of what applies to the reality in Brazil is essential, because there have been studies that evaluated individuals who are representative of our population and who could show responses different from those of individuals in other regions of the world. This document is the result of the work of a group of specialists in pulmonary function who evaluated relevant scientific articles that could be applicable to the population of Brazil.

External Validation of the Walter Index for Posthospitalization Mortality Prediction in Older Adults.

Importance: The Walter Index is a widely used prognostic tool for assessing 12-month mortality risk among hospitalized older adults. Developed in the US in 2001, its accuracy in contemporary non-US contexts is unclear.

Objective: To evaluate the external validity of the Walter Index in predicting posthospitalization mortality risk in Brazilian older adult inpatients.

The Renal Effect of 20% Human Albumin Solution Fluid Bolus Therapy in Patients After Cardiac Surgery. A Secondary Analysis of the HAS FLAIR II Randomized Clinical Trial.

Objective: To compare the effects of fluid bolus therapy (FBT) with 20% albumin to crystalloid FBT on the incidence of cardiac surgery-associated acute kidney injury (CSA-AKI) and its severity and duration.

Design: Secondary analysis of the multicenter, parallel-group, open-label, randomized HAS FLAIR-II trial.

Setting: Six intensive care units.

Beyond sleep: Rest and activity rhythm as a marker of preclinical and mild dementia in older adults with less education.

Background: Although sleep duration and sleep-related breathing disorders were associated with dementia previously, few studies examined the association between circadian rhythm association and cognitive status.

Objective: We aimed to investigate the association of rest and activity rhythm with cognitive performance in older people with cognitive complaints and less education.

Methods: Activity rhythm was evaluated with wrist actigraphy in 109 community-dwelling older people with cognitive complaints without diagnosed dementia.

Palovarotene in fibrodysplasia ossificans progressiva: review and perspective.

Introduction: Palovarotene is a retinoic acid receptor gamma agonist that was studied in phase-2 and phase-3 clinical trials for the inhibition of new heterotopic ossification (HO) in fibrodysplasia ossificans progressiva (FOP). Despite numerous setbacks and regulatory delays, palovarotene is now the first approved FOP treatment in the U.S.

Empowering Health: Innovative Strategies to Successfully Increase Physical Activity Promotion in Brazilian Primary Health Care Settings.

Background: Implementation of physical activity (PA) initiatives within the scope of Primary Health Care (PHC) is still a challenge for the field of public health. It is necessary to consolidate operational processes to promote PA in the daily lives of patients in PHC. The use of implementation science has significant potential for advancing PA initiatives.

Sacubitril-Valsartan in Cancer Therapy-Induced Heart Failure: A Systematic Review and Meta-Analysis of Functional and Hemodynamic Parameters.

Background: Cancer therapy-induced cardiotoxicity (CTRCD), in the form of heart failure with reduced ejection fraction (HFrEF), is being increasingly recognized. However, the potential benefits of sacubitril/valsartan (S/V) in managing HFrEF secondary to CTRCD remain unclear.

Objective: We performed a systematic review and meta-analysis to assess the effectiveness of S/V in preventing cardiotoxicity.

Artificial intelligence applied in identifying left ventricular walls in myocardial perfusion scintigraphy images: Pilot study.

This paper proposes the use of artificial intelligence techniques, specifically the nnU-Net convolutional neural network, to improve the identification of left ventricular walls in images of myocardial perfusion scintigraphy, with the objective of improving the diagnosis and treatment of coronary artery disease. The methodology included data collection in a clinical environment, followed by data preparation and analysis using the 3D Slicer Platform for manual segmentation, and subsequently, the application of artificial intelligence models for automated segmentation, focusing on the efficiency of identifying the walls of the left ventricular. A total of 83 clinical routine exams were collected, each exam containing 50 slices, which is 4,150 images.

Assessment of Rare Cancers and Sarcoma Policy and Sarcoma Drug Approvals in Latin America: A Report From the LACOG Sarcoma Group.

Purpose: The availability of drugs and national public policies for patients with rare cancers, including sarcomas, varies in different parts of the world.

Methods: In this manuscript, we have conducted a comprehensive analysis to evaluate rare cancer policies in Latin American countries' national policy documents. Additionally, we have reviewed the approvals for sarcoma drugs in selected Latin American countries and compared them with US Food and Drug Administration (FDA) and European Medicines Agency (EMA) approvals.

Long-term outcomes of patients who received extracorporeal cardiopulmonary resuscitation (ECPR) following in-hospital cardiac arrest: Analysis of EXCEL registry data.

Objective: To describe the six-month functional outcomes of patients who received extracorporeal cardiopulmonary resuscitation (ECPR) following in-hospital cardiac arrest (IHCA) in Australia.

Design: Secondary analysis of EXCEL registry data.

Setting: EXCEL is a high-quality, prospective, binational registry including adult patients who receive extracorporeal membrane oxygenation (ECMO) in Australia and New Zealand.

Social representations of oncologic surgery for patients with cancer.

Objectives: to analyze the social representations of patients with cancer regarding oncologic surgery.

Methods: a qualitative study based on Social Representation Theory was conducted with 126 participants between October 2021 and May 2022 in a public hospital in Rio de Janeiro. A characterization questionnaire, free evocations of the inducing term "surgery", and semi-structured interviews with 60 participants were applied.

Fractional exhaled nitric oxide and respiratory symptoms in central sterile supply department workers exposed to different ventilation systems.

Objective: To verify the association between different types of ambient ventilation in Central Sterile Supply Department (CSSD), fractional exhaled nitric oxide (FeNO) values, and respiratory symptoms of workers .

Methods: CSSD workers from five hospitals were evaluated in three different ventilation systems: negative air pressure, air conditioning, and natural ventilation. The prevalence of respiratory symptoms was evaluated by The European Community Respiratory Health Survey.

Nurse worry as a trigger for rapid response team activation improving outcomes: a retrospective cohort study in non-critical units.

Background: Patients hospitalized outside of monitored environments may experience sudden clinical worsening requiring transfer to the Intensive Care Unit. Early detection based on the clinical nurse's identification of the risk of clinical deterioration represents an opportunity to prevent serious adverse events. Nurse worry is defined as the use of clinical reasoning combined with intuition that precedes the patient's clinical deterioration.

Dysregulated autoantibodies targeting AGTR1 are associated with the accumulation of COVID-19 symptoms.

Coronavirus disease 2019 (COVID-19) presents a wide spectrum of symptoms, the causes of which remain poorly understood. This study explored the associations between autoantibodies (AABs), particularly those targeting G protein-coupled receptors (GPCRs) and renin‒angiotensin system (RAS) molecules, and the clinical manifestations of COVID-19. Using a cross-sectional analysis of 244 individuals, we applied multivariate analysis of variance, principal component analysis, and multinomial regression to examine the relationships between AAB levels and key symptoms.

Androgen Receptor Pathway Inhibitor Therapy for Advanced Prostate Cancer: Secondary Analysis of a Randomized Clinical Trial.

Importance: The open-label randomized phase 2 LACOG0415 trial evaluated 3 treatment strategies for patients with advanced castration-sensitive prostate cancer (CSPC): androgen deprivation therapy (ADT) plus abiraterone acetate and prednisone (AAP), apalutamide (APA) alone, or APA plus AAP.

Objective: To investigate the association of ADT plus AAP, APA alone, or APA plus AAP with health-related quality of life (HRQOL) in patients with advanced CSPC in the LACOG0415 trial.

Design, Setting, And Participants: The LACOG0415 randomized clinical trial comprised 128 patients with advanced CSPC who were randomized (1:1:1) to 1 of 3 treatment arms from October 16, 2017, to April 23, 2019.

Ultra-early versus early surgery for hip fracture.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects (benefits and harms) of ultra-early versus early surgery for hip fracture in adults.

Overweight, obesity, and cardiovascular disease in heterozygous familial hypercholesterolaemia: the EAS FH Studies Collaboration registry.

Background And Aims: Overweight and obesity are modifiable risk factors for atherosclerotic cardiovascular disease (ASCVD) in the general population, but their prevalence in individuals with heterozygous familial hypercholesterolaemia (HeFH) and whether they confer additional risk of ASCVD independent of LDL cholesterol (LDL-C) remains unclear.

Methods: Cross-sectional analysis was conducted in 35 540 patients with HeFH across 50 countries, in the EAS FH Studies Collaboration registry. Prevalence of World Health Organization-defined body mass index categories was investigated in adults (n = 29 265) and children/adolescents (n = 6275); and their association with prevalent ASCVD.

Incorporating Percutaneous Laser Ablation for Early Breast Cancer Treatment: A Systematic Review.

We conducted a systematic review to compile the findings of all published studies on the use of percutaneous laser ablation (PLA) in the treatment of early-stage breast cancer. We aimed to identify appropriate methodology as well as parameters for the selection of suitable patients to optimize outcomes with the use of PLA. Additionally, we aimed to analyze whether this method is a viable alternative to current surgical treatments employed.

Ultrasound-guided Transperineal Prostate Thermal Ablation (TPTA) for Benign Prostatic Hyperplasia: Feasibility of an Outpatient Procedure using Radiofrequency Ablation.

Purpose: To evaluate the feasibility, safety, and short-term (3-month) results of transperineal prostate thermal ablation (TPTA) as a minimally invasive outpatient treatment for benign prostatic hyperplasia (BPH).

Materials And Methods: A prospective nonrandomized study of 25 patients with lower urinary tract symptoms secondary to BPH seeking care at 2 interventional radiology centers between March and July 2024. TPTA was performed using a 17G radiofrequency needle with a 10-mm active tip under unconscious sedation combined with bilateral perineal and periprostatic nerve blocks.

Hospital-level volume in extracorporeal membrane oxygenation cases and death or disability at 6 months.

Objective: Extracorporeal membrane oxygenation (ECMO) is a high-risk procedure with significant morbidity and mortality and there is an uncertain volume-outcome relationship, especially regarding long-term functional outcomes. The aim of this study was to examine the association between ECMO centre volume and long-term death and disability outcomes.

Design Setting And Participants: This is a registry-embedded observational cohort study.

Computational modeling of fear and stress responses: validation using consolidated fear and stress protocols.

Dysfunction in fear and stress responses is intrinsically linked to various neurological diseases, including anxiety disorders, depression, and Post-Traumatic Stress Disorder. Previous studies using in vivo models with Immediate-Extinction Deficit (IED) and Stress Enhanced Fear Learning (SEFL) protocols have provided valuable insights into these mechanisms and aided the development of new therapeutic approaches. However, assessing these dysfunctions in animal subjects using IED and SEFL protocols can cause significant pain and suffering.