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.

Current context and evaluation of medical residency programs: experience of six Brazilian Medical Societies.

This article shows the most recent data on the evolution of the number of resident physicians and vacancies from R1 to R5, as well as the number of programs and institutions accredited by the National Commission for Medical Residency (CNRM). It also discusses the types and modalities of evaluation of medical residency, with a focus on the assessment of competencies throughout in-service training, which were incorporated into the most recent CNRM resolution, at the end of 2023, which amended and updated the 2006 directives. Finally, it shows the experience of six Medical Societies that conduct periodic evaluation of resident physicians, presented at a Brazilian Medical Association event.

Reflections on the current context and assessment of undergraduate medical education in Brazil.

This reflection article can be divided into two complementary parts. The first shows the current context of medical education in Brazil, bringing the most recent data on the number of undergraduate students and its growing gap in relation to the reduced number of vacancies in medical residency, which, despite being the most appropriate modality to train specialists, has been overlooked by the excessive number of lato sensu graduate courses. The second part discusses the possibilities of evaluating medical training, which is terminal in Brazil, enabling the newly graduated physician to claim the professional registration and to practice medicine, being evaluated only by their own medical course.

A Modified Method for DNA Extraction From Buccal Cells for Genetic Epidemiological Studies Among Children.

Background:  In large-scale molecular studies, a protocol that generates high yields and quality DNA for future polymerase chain reaction (PCR) assays is needed. The collection of buccal cells by cytobrush may represent an efficient, noninvasive, and inexpensive method for obtaining genetic material from school populations. The aim of this study was to develop a method to obtain genomic DNA from buccal cells of schoolchildren, and the DNA was extracted immediately after collecting the buccal cell samples and after storing the samples for 8 months at -20 °C to establish the feasibility of the method for epidemiological studies.

Nationwide economic analysis of pulmonary tuberculosis in the Brazilian healthcare system over seven years (2015-2022): a population-based study.

Background: Tuberculosis (TB) remains a global challenge and disproportionately affecting vulnerable populations. This study analyses the economic burden of pulmonary TB in Brazil, focusing on direct healthcare costs. It also evaluates the cost-effectiveness of the Directly Observed Treatment (DOT) strategy and the economic effort required to achieve a 90% probability of cure.

Age-dependent phenotypes of cognitive impairment as sequelae of SARS-CoV-2 infection.

Cognitive changes associated with PASC may not be uniform across populations. We conducted individual-level pooled analyses and meta-analyses of cognitive assessments from eight prospective cohorts, comprising 2,105 patients and 1,432 controls from Argentina, Canada, Chile, Greece, India, Italy, Russia, and the UK. The meta-analysis found no differences by country of origin.

Fishers and First Responders: Oil Spill Safety Workshop Design and Evaluation.

Objectives: This paper describes the design and evaluation of a workshop created to develop safer disaster response strategies for fishing communities, using the 2019 Northeast Brazil Oil Spill as a starting point for community-engaged education.

Methods: The 3-day pilot workshop included presentations, structured discussions, and interactive activities with small-scale fishers (SSFs), university researchers, and representatives of local government agencies. The workshop was evaluated through a mixed-method approach that considered qualitative data from discussion groups, collectively built products, and content retention.

Interocular astigmatic symmetry: A systematic review.

Purpose: The objective of this investigation was to consolidate the extant data pertaining to interocular astigmatic symmetry, with a view to discerning any patterns that may emerge from the research.

Methods: A systematic literature review was conducted in accordance with the PICO framework. The search, conducted through September 2024, included three databases (PubMed, Web of Science, and Scopus) and the reference list of the selected articles, which were identified from inception.

Standardization of the use of opsonized zymosan as stimulus in the 1,2,3-dihydrorhodamine technique for the assessment of neutrophil respiratory burst.

Introduction: Chronic granulomatous disease is a defect in phagocytosis due to deficiency of gp91phox, p22phox, p47phox, p40phox, and p67phox (classic form of the disease). Recently, EROS and p40phox deficiency were described as responsible for the non-classical form of the disease. The 1,2,3-dihydrorhodamine oxidation technique, with phorbol-12-myristate-13-acetate as a stimulus, is performed to diagnose the classic chronic granulomatous disease.

Evidence-Based Umbrella Review of Non-Invasive Neuromodulation in Chronic Neuropathic Pain.

Background And Objective: Non-invasive neuromodulation techniques (NIN), such as transcranial Direct Current Stimulation (tDCS) and repetitive Transcranial Magnetic Stimulation (rTMS), have been extensively researched for their potential to alleviate pain by reversing neuroplastic changes associated with neuropathic pain (NP), a prevalent and complex condition. However, treating NP remains challenging due to the numerous variables involved, such as different techniques, dosages and aetiologies. It is necessary to provide insights for clinicians and public healthcare managers to support clinical decision-making.

Physical fitness assessment tools for children with developmental coordination disorder and their feasibility for low-income settings: A systematic review.

Background: This study systematically reviewed the literature on physical fitness assessment tools for children with developmental coordination disorder compared with typically developing children aged 7 to 10 and analyzed the feasibility of these tools for use in low-income settings.

Methods: Searches were conducted in the PubMed, Scopus, Web of Science, and EBSCO/RIC databases. The Newcastle - Ottawa Quality Assessment Scale assessed the methodological quality of the studies, and a checklist adapted from COSMIN assessed the feasibility of the instruments.

Bayesian spatio-temporal modeling of severe acute respiratory syndrome in Brazil: A comparative analysis across pre-, during, and post-COVID-19 eras.

This paper presents an investigation into the spatio-temporal dynamics of Severe Acute Respiratory Syndrome (SARS) across the diverse health regions of Brazil from 2016 to 2024. Leveraging extensive datasets that include SARS cases, climate data, hospitalization records, and COVID-19 vaccination information, our study employs a Bayesian spatio-temporal generalized linear model to capture the intricate dependencies inherent in the dataset. The analysis reveals significant variations in the incidence of SARS cases over time, particularly during and between the distinct eras of pre-COVID-19, during, and post-COVID-19.

Insights into host-pathogen interaction based on the comparison of genomes of isolated from dogs, humans, and a rodent in the same epidemiological context: A one health approach.

Leptospirosis is a zoonotic infectious disease that significantly impacts animal and public health. Comparative genomics can aid in understanding poorly understood aspects of leptospirosis pathogenesis, including infection mechanisms, antimicrobial resistance, and host interactions across different epidemiological scenarios. This study aimed to compare the genomes of serogroup Icterohaemorrhagiae strains isolated from three host species in a single epidemiological scenario.

A Bayesian Interpretation of CABANA and Other Randomized Controlled Trials for Catheter Ablation in Patients With Atrial Fibrillation.

Background: Catheter ablation improves symptoms and quality of life in atrial fibrillation patients, but its effect on adverse cardiovascular outcomes and mortality remains uncertain. Bayesian analysis of randomized controlled trials offers a deeper understanding of treatment effects beyond conventional p-value thresholds.

Methods: We conducted a post hoc Bayesian reanalysis of CABANA and four similar trials to estimate catheter ablation's effect on cardiovascular and survival outcomes.

Arbovirus exposure and subclinical myocardial dysfunction in an Indigenous population in Northeast Brazil: a cross-sectional study.

Background: Human activities, such as urbanization and climate change, have facilitated the spread of arbovirus-carrying vectors, disproportionately affecting vulnerable traditional Indigenous communities.

Objective: To explore the relationships between subclinical myocardial dysfunction, assessed by global longitudinal strain (GLS), and comprehensive arbovirus serology in an Indigenous population, while also describing the serological and epidemiological profile of dengue, chikungunya, and Zika viruses.

Methods: This ancillary study is part of the first phase (2016-2017) of the Project of Atherosclerosis among Indigenous Populations (PAI), a cross-sectional study involving participants from two Indigenous communities with different degrees of urbanization and a highly urbanized city in Northeast Brazil.

Machine learning validation of the AVAS classification compared to ultrasound mapping in a multicentre study.

The Arteriovenous Access Stage (AVAS) classification simplifies information about suitability of vessels for vascular access (VA). It's been previously validated in a clinical study. Here, AVAS performance was tested against multiple ultrasound mapping measurements using machine learning.

PrEP15-19 Choices: an implementation study protocol of HIV prevention with oral and long-acting injectable cabotegravir PrEP in real-word settings among sexual and gender minority adolescents in Brazil.

Introduction: Long-acting injectable (LAI) cabotegravir is a promising new method for preventing HIV. Safe and effective long-acting agents for pre-exposure prophylaxis (PrEP) for HIV infection are needed to increase preventive options among sexual and gender minority adolescents.

Methods And Analysis: This is a multisite, prospective implementation study of three PrEP modalities (LAI-PrEP, event-driven (ED) and daily oral), using a mixed-method design with quantitative and qualitative approaches.

Determinants of adherence to obesity medication: A narrative review.

The increasing prevalence of obesity, complex nature of this chronic disease, and risks of developing obesity-related comorbidities outline the need for sustainable and effective management for people living with obesity. In addition to behavioral interventions, obesity medications (OMs) are increasingly considered an integral part of management of people living with obesity. OM adherence is essential to achieve the health benefits of these medications.

Knowledge and use of pericranial nerve blocks in headache treatment in Mexico.

Background: In developed countries, most of the neurologists use pericranial nerve blocks to treat headache patients, nevertheless, the knowledge and use patterns of this technique in developing countries are unknown.

Objective: Evaluate the knowledge and use patterns of pericranial nerve blocks in headache treatment by Mexican neurologists.

Material And Methods: We did a cross-sectional study, 90 Mexican neurologists completed a 26-question survey including data about sociodemographics, knowledge and patterns of use of pericranial nerve blocks.

Dyslipidemia: recommendations for diagnosis and treatment at the first level of medical contact.

Cardiovascular disease is the main cause of mortality in Mexico as well as the rest of the world, with dyslipidemia being one of the main risk factors. Despite the importance of its epidemiological impact, there is still -among primary care physicians- a lack of knowledge ranging from the basic concepts for diagnosis to the most recent recommendations for treatment. This document consisting of 10 questions is done by experts in this field.

The clinical assessment of lung involvement in patients with Still's disease, results from the multicentre international AIDA Network Still's Disease Registry.

Objectives: To assess the lung involvement in patients with Still's disease, an inflammatory disease assessing both children and adults. To exploit possible associated factors for parenchymal lung involvement in these patients.

Methods: A multicentre observational study was arranged assessing consecutive patients with Still's disease characterized by the lung involvement among those included in the AIDA (AutoInflammatory Disease Alliance) Network Still's Disease Registry.

Long-term outcomes of second-generation drug-eluting stents versus coronary artery bypass graft: a systematic review and meta-analysis of randomized trials and multivariable adjusted data.

Long-term data are limited comparing percutaneous coronary intervention (PCI) with second-generation drug-eluting stents (S-DES) vs coronary artery bypass grafting (CABG) in patients with complex coronary artery disease (CAD). We aimed to conduct a systematic review and meta-analysis comparing these interventions in patients with left main or multivessel CAD. We systematically reviewed PubMed, Embase, and Cochrane for studies that compared PCI with S-DES and CABG in patients with left main or multivessel CAD with a minimum mean follow-up period of 3 years.