Hepatic vein Doppler ultrasound to estimate central venous pressure in mechanically ventilated children.

Monitoring central venous pressure (CVP) is crucial for managing critically ill patients yet poses challenges in pediatric cases. This study aimed to correlate CVP with hepatic vein Doppler and IVC ultrasound variables in children. Mechanically ventilated children underwent simultaneous ultrasound and CVP measurements.

The impact of PEEP on mechanical power and driving pressure in children with pediatric acute respiratory distress syndrome.

Background: Positive end-expiratory pressure (PEEP) is widely used to improve oxygenation and avoid alveolar collapse in mechanically ventilated patients with pediatric acute respiratory distress syndrome (PARDS). However, its improper use can be harmful, impacting variables associated with ventilation-induced lung injury, such as mechanical power (MP) and driving pressure (∆P). Our main objective was to assess the impact of increasing PEEP on MP and ∆P in children with PARDS.

The Impact of Increased PEEP on Hemodynamics, Respiratory Mechanics, and Oxygenation in Pediatric ARDS.

Background: PEEP is a cornerstone treatment for children with pediatric ARDS. Unfortunately, its titration is often performed solely by evaluating oxygen saturation, which can lead to inadequate PEEP level settings and consequent adverse effects. This study aimed to assess the impact of increasing PEEP on hemodynamics, respiratory system mechanics, and oxygenation in children with ARDS.

Acute kidney injury in children undergoing cardiac surgery: predictive value of kidney arterial Doppler-based variables.

Background: Acute kidney injury (AKI) is a common condition in critically ill children and is associated with increased morbidity and mortality. This study aimed to assess the performance of point-of-care ultrasonography to predict AKI in children undergoing cardiac surgery.

Methods: In this prospective study, consecutive children underwent kidney Doppler ultrasound examination within 24 h following cardiac surgery, and an experienced operator obtained both renal resistive index (RRI) and renal pulsatility index (RPI).

Bladder training compared to bladder training associated with pelvic floor muscle training for overactive bladder symptoms in women: A randomized clinical trial.

Aims: To compare the effects of bladder training (BT) versus BT with pelvic floor muscle training (PFMT) in women with overactive bladder (OAB) symptoms.

Methods: Randomized controlled clinical trial including women with OAB symptoms, randomized into two groups: BT versus BT + PFMT. For 12 consecutive weeks, the women received home BT.

Point-of-care ultrasonography to predict fluid responsiveness in children: A systematic review and meta-analysis.

Background: Point-of-care ultrasonography (POCUS) is proposed as a valuable method for hemodynamic monitoring and several ultrasound-based predictors of fluid responsiveness have been studied. The main objective of this study was to assess the accuracy of these predictors in children.

Methods: PubMed, Embase, Scopus, ClinicalTrials.

Acute kidney injury in critically ill children: predictive value of renal arterial Doppler assessment.

Background: Renal resistive index (RRI) and renal pulsatility index (RPI) are Doppler-based variables proposed to assess renal perfusion at the bedside in critically ill patients. This study aimed to assess the accuracy of such variables to predict acute kidney injury (AKI) in mechanically ventilated children.

Methods: Consecutive children aged <14 years underwent kidney Doppler ultrasound examination within 24 h of invasive mechanical ventilation.

Carotid doppler ultrasonography as a method to predict fluid responsiveness in mechanically ventilated children.

Aims: The aim of this study was to investigate whether respiratory variations in carotid and aortic blood flows measured by Doppler ultrasonography could accurately predict fluid responsiveness in critically ill children.

Methods: This was a prospective single-center study including mechanically ventilated children who underwent fluid replacement at the discretion of the attending physician. Response to fluid load was defined by a stroke volume increase of more than 15%.

Sarcopenia in critically ill children: A bedside assessment using point-of-care ultrasound and anthropometry.

Background & Aims: Due to the lack of validated methods of muscle assessment, sarcopenia is not well described in critically ill children. The main objectives of this study were to assess muscle wasting using point-of-care ultrasound (POCUS) and anthropometry, as well as its association with nutrition delivery in PICU.

Methods: This was a single-center, prospective cohort study, including consecutive children admitted to the PICU.

High-frequency oscillatory ventilation in children: A systematic review and meta-analysis.

Background: High-frequency oscillatory ventilation (HFOV) is an alternative mechanical ventilation mode proposed to reduce ventilator-induced lung injuries and improve clinical outcomes. The aim of this study was to determine the effects of HFOV compared to conventional mechanical ventilation (CMV) when used in children with hypoxemic respiratory failure.

Methods: The literature search was conducted to identify all studies published before December 2020.

Underexpression of miR-126-3p in Patients with Cholangiocarcinoma.

Objectives: To evaluate the expression of miR-126-3p and its potential as a biomarker for cholangiocarcinoma (CCA) and to better understand the prognosis, comorbidities, and lifestyle habits associated with the disease.

Methods: Fifty-nine individuals were distributed into either the study group (38 CCA patients) or the control group (21 individuals without liver diseases). Total RNA was extracted, cDNA synthesis was performed, and miR-126-3p expression was assessed using real-time PCR.

Enhancing Community Safety through Interagency Collaboration: Lessons from Connecticut's Project Longevity.

Group Violence Interventions (GVIs) combine a focused deterrence law enforcement approach with community mobilization and social services. The current study qualitatively examines Project Longevity, Connecticut's largest GVI initiative, to contribute to the limited literature on implementation of gun violence reduction strategies. Relying on interviews with 24 of Project Longevity law enforcement and non-law enforcement partners, we explore the establishment of interagency collaboration, which was viewed by study participants as the most pressing implementation challenge of Project Longevity.

Dilatation of Aortic Neck and Common Iliac Arteries after Open Repair of Abdominal Aortic Aneurysms: Long-Term Follow-Up According to Aortic Reconstruction Configuration.

Background: Several studies in the literature report continued proximal aorta and distal iliac artery dilatation after surgical correction of an abdominal aortic aneurysm (AAA). The purpose of this study is to evaluate these findings, in a South American population, and relate them to the type of configuration of the open procedure aortic reconstruction.

Methods: This is a retrospective review of ultrasonographic follow-up of patients submitted to open repair of AAA from 1989 to 2013, reporting proximal aorta dilatation (≥3 cm) and distal iliac artery dilatation (≥1.

Enzalutamide and Survival in Nonmetastatic, Castration-Resistant Prostate Cancer.

Background: Preliminary trial results showed that enzalutamide significantly improved metastasis-free survival among men who had nonmetastatic, castration-resistant prostate cancer and rapidly increasing prostate-specific antigen (PSA) levels while taking androgen-deprivation therapy. Results from the final analysis of overall survival have not yet been reported.

Methods: In this double-blind, phase 3 trial, men with nonmetastatic, castration-resistant prostate cancer (defined on the basis of conventional imaging and a PSA doubling time of ≤10 months) who were continuing to receive androgen-deprivation therapy were randomly assigned (in a 2:1 ratio) to receive enzalutamide at a dose of 160 mg or placebo once daily.

Acute-subacute paracoccidioidomycosis: A paediatric cohort of 141 patients, exploring clinical characteristics, laboratorial analysis and developing a non-survival predictor.

The acute-subacute form of paracoccidioidomycosis (PCM) is a severe systemic mycosis that affects children and adolescents from endemic regions, leading to generalised lymphadenopathy, fever, weight loss, anaemia, eosinophilia, hypoalbuminemia and hypergammaglobulinemia. The objective of this study is to describe the clinical and laboratorial characteristics of acute-subacute PCM, to determine a mortality risk factor and to propose a test for non-survival hazard related to the disease. Children and adolescents diagnosed with PCM, under 15 years were included in the study.

The evaluation of a home-based program for hands in patients with systemic sclerosis.

Study Design: This study used a quasi-experimental design where patients were evaluated before and after participation in the self-management program.

Introduction: Hands are commonly affected in systemic sclerosis (SSc). Strategies to maintain or improve hand function are indicated upon diagnosis and throughout the course of the disease.

Periungual tegumentary leishmaniasis: a diagnostic challenge.

Periungual and paronychia-like skin lesions can mimic various diseases, setting up a diagnostic challenge that invariably requires correlation with complementary tests. We report a case of an ulcerated tumor of the nailfold diagnosed as leishmaniasis. Although paronychia-like cutaneous leishmaniasis is a rare variant, its epidemiological relevance in Brazil should prompt dermatologists to include it as a plausible diagnosis thus leading to correct work up and treatment.

Predictive Factors for Fatal Tick-Borne Spotted Fever in Brazil.

In Brazil, two pathogenic Rickettsia species have been identified causing tick-borne spotted fever (SF). The aetiological agent Rickettsia rickettsii causes serious illness, particularly in the south-eastern region of the country. Moreover, the Rickettsia sp.

A pelvic floor muscle training program in postmenopausal women: A randomized controlled trial.

Objectives: The purpose of this study was to investigate if a specific pelvic floor muscle training (PFMT) program effectively increases pelvic floor muscle (PFM) contractility and decreases anterior pelvic organ prolapse (POP) as well as urogynecological symptoms, in postmenopausal women. The mean outcome measure of this study was the pelvic floor surface electromyography (sEMG) activity.

Study Design: A clinical, randomized, blinded-assessor and controlled study was conducted with 46 postmenopausal women.

Electromyographic pelvic floor activity: Is there impact during the female life cycle?

Aim: To evaluate the pelvic floor muscle (PFM) electromyographic activity in different phases of the female life cycle, correlating electromyographic activity with age, Body Mass Index (BMI), parity as well as the presence and severity of urinary symptoms.

Methods: A clinical, observational, transversal and controlled study was conducted in 384 women: 49 nulliparous, 103 primigravid pregnant, 92 primiparous postpartum (vaginal delivery: n = 43; cesarean section delivery: n = 49), 22 climacteric, 65 postmenopausal, and 53 women identified as being unable to perform voluntary maximum contraction. All subjects were evaluated with digital palpation and PFM surface electromyography (sEMG) and completed the questionnaires: International Consultation on Incontinence Urinary Incontinence Short Form (ICIQ IU-SF) and International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB).

Pelvic floor muscle training program increases muscular contractility during first pregnancy and postpartum: electromyographic study.

Aims: The aim of this study was to evaluate the effect of a training program over both pelvic floor muscles contractility and urinary symptoms in primigravid pregnant and postpartum primiparous women.

Patients And Methods: A clinical, prospective and blinded trial was conducted with 33 women divided into three groups: (G1) 13 primigravid pregnant women; (G2) 10 postpartum primiparous women (49.3 ± 5.

Are transversus abdominis/oblique internal and pelvic floor muscles coactivated during pregnancy and postpartum?

Aim: The aim of this study was to simultaneously evaluate both transversus abdominis/internal oblique (Tra/IO) and pelvic floor muscles (PFM) during isometric exercises in nulliparous, pregnant, and postpartum women.

Methods: The study included 81 women divided into four groups: (G1) nulliparous women without urinary symptoms (n = 20); (G2) primigravid pregnant women with gestational age ≥24 weeks (n = 25); (G3) primiparous postpartum women after vaginal delivery with right mediolateral episiotomy (n = 19); (G4) primiparous postpartum women after cesarean section delivery, with 40 to 60 days of postpartum (n = 17). The assessment consisted of simultaneous surface electromyography (EMGs) of the PFM and Tra/IO, during three isometric maximum voluntary contractions.