Artigos e Materiais de Revistas Científicas - HC/ICHC

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A coleção de Artigos e Materiais de Revistas Científicas engloba artigos originais, artigos de revisão, artigos de atualização, artigos técnicos, relatos de experiências, resenhas, ensaios, editoriais, cartas ao editor, debates, notas científicas e técnicas, depoimentos, entrevistas e pontos de vista. Consideram-se como artigos científicos originais os trabalhos redigidos para divulgação de informações e resultados sobre determinada pesquisa científica, publicados em periódico científico após avaliação por outros pesquisadores.

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Lidocaine 5% patch in the treatment of localized neuropathic pain due to nerve compression. Case reports
(2023) LIGGIERI, André; PALLADINI, Mariana
ABSTRACT BACKGROUND AND OBJECTIVES: Neuropathic pain is a chronic condition with a significant burden for patients, society, and healthcare systems. Due to neuropathic complexity, its management must be different than the one for nociceptive pain. First-line systemic treatments may be associated with dose-dependent adverse events and drug-drug interactions. On the other hand, topical treatments have less systemic adverse events, with the 5% lidocaine transdermal patch being recommended for firstor second line of treatment for neuropathic pain according to various international guidelines. The aim of this study is to present three cases of localized neuropathic pain due to nerve compression managed with 5% lidocaine transdermal patch. CASE REPORTS: The cases of three adult patients (>40 years old) with pain or tingling for a long period of time and their outcomes with treatment with 5% lidocaine transdermal patch for a prolonged duration were investigated. All three cases report a significant improvement in pain. CONCLUSION: The results of the reported cases revealed that a 5% lidocaine transdermal patch represents an effective, safe and tolerable and noninvasive option for the management of localized neuropathic pain due to peripheric nerve compression.
Use of 5% lidocaine patch in the management of post-traumatic localized neuropathic pain. Case reports
(2023) LIGGIERI, André; MINSON, Fabíola
ABSTRACT BACKGROUND AND OBJECTIVES: Neuropathic pain is defined as a pain caused by a lesion or condition that affects the somatosensory nervous system. Taking its prevalence into account, in particular post-traumatic localized neuropathic pain, and to discuss ways to manage patients with this condition, considering efficacy and tolerability of proposed treatments, this report presents three clinical cases of patients with post-traumatic localized neuropathic pain treated with 5% lidocaine transdermal patch in both monotherapy and polytherapy. CASE REPORTS: This study reports the cases of three female patients aged between 29 and 81 years with complaints of pain due to trauma, who were managed with 5% lidocaine transdermal patch in prolonged treatment, with a significant improvement in pain. CONCLUSION: According to scientific evidence, the use of 5% lidocaine transdermal patch in post-traumatic localized neuropathic pain as shown efficacy with favorable safety and tolerance. Moreover, it was possible to demonstrate that a 5% lidocaine transdermal patch in a polytherapy format has contributed to improved outcomes with no effect in treatment tolerability.
Dermatofibrossarcoma na glabela: Uma localização incomum
(2023) BALDINI, CARLOS EDUARDO; CASTRO, MARIO AUGUSTO FERRARI DE; DEDIVITIS, ROGéRIO APARECIDO
ABSTRACT Dermatofibrosarcoma is a rare cancer with a slow growth pattern and aggressive tissue invasion. The treatment for this condition involves surgical intervention to achieve clear margins. In this particular case, we have a 60-year-old man who had a mass in the glabella area that was excised twice under local anesthesia at a different facility. The results of both biopsies indicated dermatofibroma. However, the patient experienced a new recurrence, and during the immunohistochemistry analysis of the initial excision, it was revealed to be dermatofibrosarcoma. As a result, a broad excision was performed until negative margins were obtained based on frozen sections. Additionally, a frontal flap was employed to reconstruct the surgical defect. The outcome of the treatment was deemed successful, without complications.
“Star of Bethlehem sign” in the analysis of the evolution of brain lesions during and after treatment for neuroparacoccidioidomycosis
(2023) SANTANA, Larissa M.; PEÇANHA, Paulo Mendes; FALQUETO, Aloísio; KRUSCHEWSKY, Wdson L. M.; GRÃO-VELLOSO, Tânia Regina; GONÇALVES, Sarah Santos; ROSA-JÚNIOR, Marcos
Abstract Objective: To describe the clinical and radiological evolution of lesions during and after treatment in patients diagnosed with neuroparacoccidioidomycosis (NPCM). Materials and Methods: This was a retrospective study of the medical records, computed tomography scans, and magnetic resonance imaging (MRI) scans of patients with NPCM treated between September 2013 and January 2022. Results: Of 36 cases of NPCM, eight were included in the study. One patient presented only with pachymeningeal and skull involvement, and seven presented with pseudotumors in the brain. Collectively, the eight patients presented with 52 lesions, of which 46 (88.5%) were supratentorial. There were 32 lesions with a diameter ≤ 1.2 cm, of which 27 (84.4%) disappeared during the treatment. In three cases, there were lesions > 1.2 cm that showed a characteristic pattern of evolution on MRI: an eccentric gadolinium contrast-enhanced nodule, with a subsequent decreased in the size and degree of contrast enhancement of the lesions. Conclusion: In NPCM, supratentorial lesions seem to predominate. Lesions ≤ 1.2 cm tend to disappear completely during treatment. Lesions > 1.2 cm tend to present with a similar pattern, designated the “Star of Bethlehem sign”, throughout treatment.
Tapentadol extended-release as a therapeutic strategy for pain control in cases of osteoarthritis. Case reports
(2023) MORAES, Frederico Barra de; LIGGIERI, André Cicone; SADIGURSKY, David
ABSTRACT BACKGROUND AND OBJECTIVES: Osteoarthritis affects many individuals worldwide and is caused by multiple factors that lead to joint wear and tear, inflammation and, consequently, chronic pain that is difficult to treat. It is predominant in seniors, but not restricted to older age groups. Pain reduction is prioritized when facing crises, so that rehabilitation work and postural corrections can be applied later. The present study aimed to evaluate the analgesic potential of tapentadol extended-release (ER) in three patients with osteoarthritis who had undergone numerous previous treatments and had a history of moderate to severe chronic pain. CASE REPORTS: Three women, aged 49, 75 and 86 years old, diagnosed with osteoarthritis, with complaints of severe pain and who had undergone numerous therapies including drug use, without significant pain control were included in the study. The use of tapentadol ER was recommended and adjusted to each patient according to the intensity of pain. All of them responded satisfactorily and returned to their daily activities. One of them presented nausea after two days of tapentadol use, which was controlled with an antiemetic drug only during the two days of nausea CONCLUSION: Tapentadol ER was effective in controlling pain from osteoarthritis in the three cases evaluated, without serious adverse effects. The period and dosage of tapentadol ER must be in accordance with the clinical evolution of each patient.
Pedagogical concerns of physical therapist professors and their perceptions of the COVID-19 pandemic
(2023) ARAUJO, Cintia Pereira de; OLIVO, Clarice Rosa
ABSTRACT In health professions education, professors usually face some difficulties and concerns. The COVID-19 pandemic has further amplified these challenges, leading to changes in teaching methods and new concerns. This study aimed to identify undergraduate physical therapy professors’ concerns (PC) about the learning environment during the COVID-19 pandemic. Physical therapists who served as undergraduate physical therapy professors in Brazil answered a questionnaire on PC (Teacher Concerns Questionnaire - TCQ), a sociodemographic profile questionnaire, and an open-ended question on the perception of changes in PC during the pandemic. A total of 187 physical therapist professors completed the questionary and had moderate PC (TCQ 49.6±10.5), with no association with the stage of their teaching career, age, and length of professional training. Participants in continuing education activities had higher PC. Of the participants, 94.1% reported changes in PC resulting from the pandemic. Therefore, professors who participate in continuing education activities are more concerned about the impact of their practice than those who do not participate. At the same time, these concerns seem to have changed during the pandemic.
The generation of innovative ophthalmologists
(2023) KARA-JÚNIOR, Newton
Cognitive profile of patients with and without speech impairment in Parkinson's disease
(2023) SOUSA, Nariana Mattos Figueiredo; DINIZ, Juliana de Fátima Garcia; GALVÃO, Ana Paula; BRUCKI, Sonia Maria Dozzi
ABSTRACT. Cognitive functions have been the subject of studies evaluating the pathophysiological mechanism of speech control. Objective: To compare the groups of patients with and without speech disorders with cognitive assessment, demographic, and clinical data (disease duration, functionality, and motor symptoms). Methods: Retrospective, cross-sectional study. Patients were evaluated using the Addenbrooke's Cognitive Examination III and neuropsychological tests. The following speech subsystems were analyzed: articulation, phonation, resonance, and prosody, through auditory-perceptual evaluation (based on the Protocol for the Evaluation of Acquired Speech Disorders in Individuals with Parkinson's Disease — PADAF Protocol tests), observing aspects of speech programming and execution. The patients were distributed into three subgroups (normal cognition, mild cognitive impairment, and dementia). After speech evaluation, they were divided into two subgroups (with and without speech disorders). Results: A total of 150 patients participated in this study, 104 men and 46 women, 63.58 (8.81) years of age, 11.03 (4.00) years of schooling, 6.61 (4.69) years of disease progression, and with the highest proportion of individuals in stage I–II of the Hoehn & Yarh (H&Y) scale (86, or 57.33%). Statistically significant differences were observed between subgroups with and without speech alteration. Worse performance was verified in the Trail Making Test (TMT) TMT-Δ and a tendency of difference in the TMT-B of the subgroup with speech disorders, in addition to worse severity of motor symptoms (H&Y) and cognitive complaints. Conclusion: Individuals with speech disorders brought more frequent cognitive complaints and impairment below expected in tests assessing executive functions. Future studies, with stratification by type of speech disorder, are necessary to contribute to and validate these results.
Difração e o olho humano
(2023) HELENE, Otaviano; FERNANDES, Ícaro Salerno; MARTINS, Thiago Gonçalves dos Santos
This work presents some aspects of diffraction in the human eye, which occurs in the pupil, in the cells of the lens, and in structures within it. An Appendix presents the calculations necessary to understand the phenomenon of diffraction. To complement the understanding of optical phenomena, some physiological aspects of the eye, especially the retina, are examined. The purpose of the paper is to provide teachers and students with examples that can help in the study of optics and motivate students to take a closer look at diffraction, including numerical calculations. Examples include the visibility of structures like the Great Wall of China when viewed from long distances, the dots of the letters i and j from the drug information leaflet the shape of floaters, and why we see stars as pointy objects. This article targets physicists, physics students, and professionals from other areas related to human vision, such as ophthalmologists, opticians, and optometrists.
The presence of depressive symptoms and cognitive performance among older individuals with and without self-reported chronic diseases
(2023) SILVA, Thaís Bento Lima da; ORDONEZ, Tiago Nascimento; SILVA, Guilherme Alves da; SOUZA, Maria Antônia Antunes de; SILVA, Sabrina Aparecida da; SANTOS, Gabriela dos; GUTIERREZ, Beatriz Aparecida Ozello; MOREIRA, Ana Paula Bagli; COSTA, Laydiane Alves; MORAES, Luiz Carlos de; LESSA, Patrícia Prata; CARDOSO, Neide Pereira; SAKAGUCHI, Mitsuru; SILVA, Henrique Salmazo da; BRUCKI, Sonia Maria Dozzi
ABSTRACT. Dementias secondary to cardiovascular diseases are the second cause of neurogenerative diseases. These conditions can be prevented by controlling risk factors, and it is necessary to observe the relationship between chronic diseases. Objective: to know the influence of chronic non-communicable diseases on cognition and depressive symptoms in the elderly, amid the COVID-19 pandemic. Methods: 578 older adults were evaluated using a sociodemographic questionnaire, the Brazilian Telephone version of the Mini Mental State Examination (Braztel-MMSE), the Geriatric Depression Scale (GDS-15) and an open questionnaire related to NCDs. Results: the association of Non-Communicable Diseases (NCD) with age, depressive symptoms and schooling was confirmed. Conclusion: no association with cognitive decline was evident due to the relationship of high schooling of participants and control of NCDs.
Comment on: Short-term outcomes of bariatric surgery in patients with inflammatory bowel disease: a national analysis
(2024) DANTAS, Anna Carolina Batista
Validation of a low-cost continuous renal replacement therapy dialysate fluid controller for experimental purposes
(2024) SANTOS, Yuri de Albuquerque Pessoa dos; PARK, Viviane Flor; CARDOZO JUNIOR, Luis Carlos Maia; BESEN, Bruno Adler Maccagnan Pinheiro; MENDES, Pedro Vitale; PARK, Marcelo
BackgroundContinuous renal replacement therapy (CRRT) support is crucial for critically ill patients and it is underexplored in specific situations. Experimental CRRT offers a means to gain insights into these scenarios, but the prohibitive cost of CRRT machines limits their accessibility. This study aimed to develop and validate a low-cost and precise dialysate controller for experimental CRRT.ResultsOur results demonstrate a commendable level of precision in affluent flow control, with a robust correlation (R2 = 0.99) for continuous flow and a strong correlation (R2 = 0.95) for intermittent flow. Additionally, we observed acceptable agreement with a bias = 3.4 mL (upper limit 95% = 43.9 mL and lower limit 95% = - 37 mL) for continuous flow and bias = - 20.9 mL (upper limit 95% = 54 mL and lower limit 95% = - 95.7 mL) for intermittent flow, in this way, offering a precise CRRT dose for the subjects. Furthermore, we achieved excellent precision in the cumulative ultrafiltration net (UFnet), with a bias = - 2.8 mL (upper limit 95% = 6.5 mL and lower limit 95% = - 12 mL). These results remained consistent even at low affluent flow rates of 8, 12, and 20 mL/min, which are compatible with CRRT doses of 25-30 mL/kg for medium-sized animals. Moreover, the acceptable precision of our findings persisted when the dialysate controller was subjected to high filter dialysate chamber pressure for an extended duration, up to 797 min.ConclusionsThe low-cost dialysate controller developed and tested in this study offers a precise means of regulating CRRT in experimental settings. Its affordability and accuracy render it a valuable instrument for studying CRRT support in unconventional clinical scenarios, particularly in middle-income countries' experimental ICU laboratories.
Construct Validity of Inherited Retinal Disease-Specific Patient-Reported Outcome Measures
(2023) JAYASUNDERA, K. Thiran; ABUZAITOUN, Rebhi O.; POPOVA, Lilia; ABALEM, Maria Fernanda; ANDREWS, Chris A.; LACY, Gabrielle D.; FRESCO, David M.; MUSCH, David C.
PURPOSE: To evaluate aspects of construct validity of the Michigan Retinal Degeneration Questionnaire (MRDQ) and the Michigan Vision-related Anxiety Ques-tionnaire (MVAQ). center dot METHODS: Subjects with a clinical diagnosis of an inherited retinal disease (IRD) were recruited prospec-tively and 3 tests were used to assess construct valid-ity: the ability to distinguish different IRD phenotypes; test a priori hypothesis of an association between vision-related anxiety and vision-related disabilities; and corre-late MRDQ and MVAQ with the National Eye Insti-tute Visual Functioning Questionnaire 25 (NEI VFQ-25) and the Impact of Vision Impairment (IVI). One-way analysis of variance (ANOVA) was used to com-pare different phenotypes for mean domain scores for MRDQ/MVAQ. Pearson correlations were performed be-tween; Cone-Function Anxiety and Central Vision con-trolling for better eye visual acuity, Rod-Function Anxi-ety and Scotopic Function controlling for visual field area (III4e and IV4e), and scores of MRDQ/MVAQ, NEI VFQ-25, and IVI. center dot RESULTS: The study sample consisted of 146 pa-tients evenly divided between males and females, and mean age was 50 years. The 1-way ANOVA test was significant for distinguishing IRD phenotypes in 6 do-mains of MRDQ/MVAQ. Cone-Function Anxiety corre-lated with Central Vision controlling for visual acuity, Rod-Function Anxiety correlated with Scotopic Func-tion controlling for visual field area, and all domains in MRDQ/MVAQ had significant correlations with NEI VFQ-25 and IVI composite scores. center dot CONCLUSION: MRDQ and MVAQ domenstrate aspects of construct-validity set forth by the US Food and Drug Administration. The study futher supports the use of both patient-reported outcome measures in IRD clinical trials and natural history studies. (Am J Ophthalmol 2023;248: 116-126. (c) 2022 Elsevier Inc. All rights re-served.)
Anti-Neutrophil Extracellular Trap Antibodies in Antiphospholipid Antibody-Positive Patients: Results From the Antiphospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking Clinical Database and Repository
(2023) ZUO, Yu; NAVAZ, Sherwin; TSODIKOV, Alex; KMETOVA, Katarina; KLUGE, Lyndsay; AMBATI, Amala; HOY, Claire K.; YALAVARTHI, Srilakshmi; ANDRADE, Danieli de; TEKTONIDOU, Maria G.; SCIASCIA, Savino; PENGO, Vittorio; RUIZ-IRASTORZA, Guillermo; BELMONT, H. Michael; GEROSA, Maria; FORTIN, Paul R.; JESUS, Guilherme Ramires de; BRANCH, D. Ware; ANDREOLI, Laura; RODRIGUEZ-ALMARAZ, Esther; PETRI, Michelle; CERVERA, Ricard; WILLIS, Rohan; KARP, David R.; LI, Quan-Zhen; COHEN, Hannah; BERTOLACCINI, Maria Laura; ERKAN, Doruk; KNIGHT, Jason S.
ObjectiveThis study aimed to elucidate the presence, antigen specificities, and potential clinical associations of anti-neutrophil extracellular trap (anti-NET) antibodies in a multinational cohort of antiphospholipid (aPL) antibody-positive patients who did not have lupus. MethodsAnti-NET IgG/IgM levels were measured in serum samples from 389 aPL-positive patients; 308 patients met the classification criteria for antiphospholipid syndrome. Multivariate logistic regression with best variable model selection was used to determine clinical associations. For a subset of the patients (n = 214), we profiled autoantibodies using an autoantigen microarray platform. ResultsWe found elevated levels of anti-NET IgG and/or IgM in 45% of the aPL-positive patients. High anti-NET antibody levels are associated with more circulating myeloperoxidase (MPO)-DNA complexes, which are a biomarker of NETs. When considering clinical manifestations, positive anti-NET IgG was associated with lesions affecting the white matter of the brain, even after adjusting for demographic variables and aPL profiles. Anti-NET IgM tracked with complement consumption after controlling for aPL profiles; furthermore, patient serum samples containing high levels of anti-NET IgM efficiently deposited complement C3d on NETs. As determined by autoantigen microarray, positive testing for anti-NET IgG was significantly associated with several autoantibodies, including those recognizing citrullinated histones, heparan sulfate proteoglycan, laminin, MPO-DNA complexes, and nucleosomes. Anti-NET IgM positivity was associated with autoantibodies targeting single-stranded DNA, double-stranded DNA, and proliferating cell nuclear antigen. ConclusionThese data reveal high levels of anti-NET antibodies in 45% of aPL-positive patients, where they potentially activate the complement cascade. While anti-NET IgM may especially recognize DNA in NETs, anti-NET IgG species appear to be more likely to target NET-associated protein antigens.
Physical activity for obstructive sleep apnea after stroke? A pilot study assessing the contribution of body fluids
(2023) FRANGE, Cristina; ELIAS, Rosilene Motta; SIENGSUKON, Catherine; COELHO, Fernando Morgadinho Santos
Purpose Obstructive sleep apnea (OSA) and physical inactivity are common after stroke. Physical inactivity can lead to/or exacerbate edema following stroke, and the resultant overnight fluid shift may increase the risk of OSA. We aimed to investigate the effect of physical activity on nocturnal rostral fluid shift, sleep pattern, and edematous state of hemiparetic patients. Methods Neck circumference (tape measured) and arms, legs, and trunk fluid volume (bioelectrical impedance spectrum analyzer) were measured before and after 2 polysomnography (PSG) examinations. In the lab, a whole night PSG was performed after the intervention. The intervention consisted of inactivity (lying down and sitting) or activity (standing, performing calf muscle contractions while standing, walking, and climbing stairs) between 13 and 21 h, after the randomization of the participants. With a 7-day interval, participants crossed over to the other group. Results From 126 eligible participants, 8 with hemiparetic post-first-ever ischemic stroke at the subacute phase were recruited (age: 53.2 +/- 16.2; 6 women). Physical activity reduced AHI from 19 to 13 n degrees/h and wake after sleep onset from 76.5 to 60.3 min and increased fluid volume of paretic and non-paretic arms and trunk before sleep compared to inactivity. Conclusion An acute bout of physical activity reduced OSA classification based on AHI (from moderate to mild) and sleep fragmentation. Our results provide preliminary evidence of a possible link between physical activity in patients after stroke as an intervention to counteract OSA severity and improve sleep.
A novel insight on SARS-CoV-2 S-derived fragments in the control of the host immunity (vol 13, 8060, 2023)
(2023) BASTOS, Thais Sibioni Berti; PAULA, Andre Guilherme Portela de; LUZ, Rebeca Bosso dos Santos; GARNIQUE, Anali M. B.; BELO, Marco A. A.; ETO, Silas Fernandes; FERNANDES, Dayanne Carla; FERRARIS, Fausto Klabund; PONTES, Leticia Gomes de; FRANCA, Tabata Takahashi; BARCELLOS, Leonardo Jose Gil; VERAS, Flavio P. P.; BERMEJO, Pamela; GUIDELLI, Giovanna; MANEIRA, Carla; MELLO, Fellipe da Silveira Bezerra de; TEIXEIRA, Gleidson; PEREIRA, Goncalo Amarante Guimaraes; FERNANDES, Bianca H. Ventura; SANCHES, Paulo R. S.; BRAZ, Helyson Lucas Bezerra; JORGE, Roberta Jeane Bezerra; MALAFAIA, Guilherme; CILLI, Eduardo M. M.; OLIVIER, Danilo da Silva; AMARAL, Marcos Serrou do; MEDEIROS, Renata J. J.; CONDINO-NETO, Antonio; CARVALHO, Luciani R. R.; MACHADO-SANTELLI, Glaucia M. M.; CHARLIE-SILVA, Ives; GALINDO-VILLEGAS, Jorge; BRAGA, Tarcio Teodoro
Cerebrospinal fluid proteomics define the natural history of autosomal dominant Alzheimer's disease
(2023) JOHNSON, Erik C. B.; BIAN, Shijia; HAQUE, Rafi U.; CARTER, E. Kathleen; WATSON, Caroline M.; GORDON, Brian A.; PING, Lingyan; DUONG, Duc M.; EPSTEIN, Michael P.; MCDADE, Eric; BARTHELEMY, Nicolas R.; KARCH, Celeste M.; XIONG, Chengjie; CRUCHAGA, Carlos; PERRIN, Richard J.; WINGO, Aliza P.; WINGO, Thomas S.; CHHATWAL, Jasmeer P.; DAY, Gregory S.; NOBLE, James M.; BERMAN, Sarah B.; MARTINS, Ralph; GRAFF-RADFORD, Neill R.; SCHOFIELD, Peter R.; IKEUCHI, Takeshi; MORI, Hiroshi; LEVIN, Johannes; FARLOW, Martin; LAH, James J.; HAASS, Christian; JUCKER, Mathias; MORRIS, John C.; BENZINGER, Tammie L. S.; ROBERTS, Blaine R.; BATEMAN, Randall J.; FAGAN, Anne M.; SEYFRIED, Nicholas T.; I, Allan Levey
Alzheimer's disease (AD) pathology develops many years before the onset of cognitive symptoms. Two pathological processes-aggregation of the amyloid-& beta; (A & beta;) peptide into plaques and the microtubule protein tau into neurofibrillary tangles (NFTs)-are hallmarks of the disease. However, other pathological brain processes are thought to be key disease mediators of A & beta; plaque and NFT pathology. How these additional pathologies evolve over the course of the disease is currently unknown. Here we show that proteomic measurements in autosomal dominant AD cerebrospinal fluid (CSF) linked to brain protein coexpression can be used to characterize the evolution of AD pathology over a timescale spanning six decades. SMOC1 and SPON1 proteins associated with A & beta; plaques were elevated in AD CSF nearly 30 years before the onset of symptoms, followed by changes in synaptic proteins, metabolic proteins, axonal proteins, inflammatory proteins and finally decreases in neurosecretory proteins. The proteome discriminated mutation carriers from noncarriers before symptom onset as well or better than A & beta; and tau measures. Our results highlight the multifaceted landscape of AD pathophysiology and its temporal evolution. Such knowledge will be critical for developing precision therapeutic interventions and biomarkers for AD beyond those associated with A & beta; and tau. Proteomic analysis of cerebrospinal fluid from individuals with autosomal dominant Alzheimer's disease reveals how this complex and chronic disease evolves over many decades.
Adverse events leading to intensive care unit admission in a low-and-middle-income-country: A prospective cohort study and a systematic review
(2024) PEDRO, Rodolpho Augusto de Moura; BESEN, Bruno Adler Maccagnan Pinheiro; MENDES, Pedro Vitale; GOMES, Augusto Cezar Marins; CARVALHO, Marcelo Ticianelli de; MALBOUISSON, Luiz Marcelo Sa; PARK, Marcelo; TANIGUCHI, Leandro Utino
Introduction: Adverse events (AE) are frequent in critical care and could be even more prevalent in LMIC due to a shortage of ICU beds and Human resources. There is limited data on how relevant AE are among the reasons for ICU admission, being all of which published by High-Income-Countries services. Our main goal is to describe the rate of adverse events-related ICU admissions and their preventability in a LMIC scenario, comparing our results with previous data.Methods: This was a prospective cohort study, during a one-year period, in two general ICUs from a tertiary public academic hospital. Our exposure of interest was ICU admission related to an AE in adult patients, we further characterized their preventability and clinical outcomes. We also performed a systematic review to identify and compare previous published data on ICU admissions due to AE.Results: Among all ICU admissions, 12.1% were related to an AE (9.8% caused by an AE, 2.3% related but not directly caused by an AE). These ICU admissions were not associated with a higher risk of death, but most of them were potentially preventable (70.9% of preventability rate, representing 8.6% of all ICU admissions). The meta-analysis resulted in a proportion of ICU admissions due to AE of 11% (95% CI 6%-16%), with a pre-ventability rate of 54% (95% CI 42%-66%).Conclusions: In this prospective cohort, adverse events were a relevant reason for ICU admission. This result is consistent with data retrieved from non-LMIC as shown in our meta-analysis. The high preventability rate described reinforces that quality and safety programs could work as a tool to optimize scarce resources.
Isatuximab, carfilzomib, and dexamethasone in patients with relapsed multiple myeloma: updated results from IKEMA, a randomized Phase 3 study (vol 13, 152, 2023)
(2023) MARTIN, Thomas; DIMOPOULOS, Meletios-Athanasios; MIKHAEL, Joseph; YONG, Kwee; CAPRA, Marcelo; FACON, Thierry; HAJEK, Roman; SPICKA, Ivan; BAKER, Ross; KIM, Kihyun; MARTINEZ, Gracia; MIN, Chang-Ki; POUR, Ludek; LELEU, Xavier; ORIOL, Albert; KOH, Youngil; SUZUKI, Kenshi; CASCA, France; MACE, Sandrine; RISSE, Marie-Laure; MOREAU, Philippe
Type 1 diabetes prevention and treatment: Time to think outside the box
(2023) PINHEIRO, Marcelo Maia; PINHEIRO, Felipe Moura Maia

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