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Clinics
ISSN: 1807-5932
e-ISSN: 1980-5322

Clinics is a gold open access electronic international journal that publishes peer-reviewed research in continuous flow of interest to clinicians and researchers in medical and biomedical sciences based on its originality, importance, conclusions and interest to readers. CLINICS also publishes Comments and Editorials. The journal is committed to the principles of ethics, respect for the individual, humanization, honesty, pioneering spirit and excellence.Clinics is the Official Scientific journal of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP).

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Medline, Directory of Open Access Journals (DOAJ), PubMed Central (PMC), Science Citation Index Expanded (SCIE)

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Impact factor

The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years.

© Clarivate Analytics, Journal Citation Reports 2022

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Impact factor 2023
2.2
Citescore

CiteScore measures average citations received per document published.

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Citescore 2023
4.1
SJR

SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact.

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SJR 2023
0.535
SNIP

SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.

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SNIP 2023
0.668
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Issue
portada-S1807593224X00022Vol. 80. (In progress)
(January - December 2025)
This issue is in progress but contains articles that are final and fully citable.
Original articles
Lactylated histone H3K18 as a potential biomarker for the diagnosis and prediction of the severity of pancreatic cancer
Jinping Hou, Mingsong Guo, Yongqiong Li, Yijin Liao
Highlights

  • High level of Pan Lysine Lactylation (Pan-Kla) is found in pancreatic cancer tissues.

  • H3K18la levels are increased in pancreatic cancer tissues.

  • H3K18la is related to the severity and prognosis of pancreatic cancer.

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The role of hormone dosages in the assessment of cervical lesions by FNA: A descriptive analysis of 762 cases
Arthur Henrique Cunha-Volpato, Carlos Izaias Sartorão Neto, Luiz Fernando Ferraz da Silva, Paulo Campos Carneiro
Highlights

  • Hormone measurement in FNA washout fluid is an accessible method for improving accuracy.

  • Thyroglobulin (TG) dosage can enhance the accuracy of detecting well-differentiated thyroid carcinomas.

  • Calcitonin dosage complements cytology in detecting medullary thyroid carcinoma cervical metastasis.

  • Post-thyroidectoby bed dosages help to determine non-thyroid/parathyroid lesions.

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Correlation between liver volume drainage and clinical success after endoscopic biliary drainage of hilar malignant obstruction
Jennifer Nakamura Ruas, Ernesto Quaresma Mendonça, Luciano Lenz, Gustavo Andrade de Paulo, Ricardo Uemura Sato, José Jukemura, Ulysses Ribeiro Junior, Fauze Maluf-Filho, Bruno Costa Martins
Highlights

  • The main cause of hilar obstruction was cholangiocarcinoma (32.9 %) followed by lymph node metastasis (23.2 %).

  • Technical success was achieved in 91.5 %, clinical success in 60 %.

  • A significant correlation between clinical success rate was found when at least 50 % of viable parenchyma was drained (p = 0.016; OR = 4.15, 95 % CI 1.4–12.5).

  • Considering liver sectors, higher clinical success rates were found when at least 2 sectors were drained (p < 0.001; OR = 8.50, 95 % CI 2.7–26.7).

  • Correlation between unilateral versus bilateral drainage and clinical success was not statistically significant.

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Descriptive study of claims in primary care during the year 2022 in a health area of Spain
María F. Velázquez-López, María García-Pérez, Montserrat Souto-Pereira, Juan M. Vazquez-Lago
Highlights

  • Analyzing complaints is essential for identifying areas for improvement.

  • 79 % of the complaints were related to communication issues with the patient.

  • Improving communication with the patient will help reduce the number of complaints filed.

  • Using a web application simplifies the management of complaints in primary care.

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Anatomical variations of the marginal mandibular nerve
Arthur Paredes Gatti, Matheus Trovão Ribeiro, Flávio Hojaij
Highlights

  • Most surgeons underestimate the positional and numerical variations of the Facial Nerve.

  • About 50% of the Marginal Nerves of the Mandible have more than one subdivision.

  • Just over half of the branches of the Mandibular Marginal Nerve are found below the lower border of the mandible.

  • The great anatomical variation of the Mandibular Marginal Nerve is responsible for the majority of postoperative motor sequelae.

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Infiltration of micro-fragmented adipose tissue under local anesthesia for knee osteoarthritis treatment is a safe procedure: A case series
Bruno Butturi Varone, Daniel Peixoto Leal, Daniel Duarte Perini, Vitor Penteado Figueiredo Pagotto, Riccardo Gomes Gobbi, Marco Kawwamura Demange
Highlights

  • Harvesting abdominal fat for mFAt knee injection is a safe procedure.

  • Minor events, such as ecchymosis, mild abdominal discomfort, and mild discomfort at the infiltrated knee are common.

  • The procedure can be done under local anesthesia, without sedation after single-time preparation.

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Clinical and swallowing characteristics of tracheostomized patients with post-intubation acquired tracheal or laryngotracheal stenosis
Carina Escudero, Fernanda Chiarion Sassi, Ana Paula Ritto, Paulo Francisco Guerreiro Cardoso, Claudia Regina Furquim de Andrade
Highlights

  • Despite the efficacy of reconstructive surgeries and Montgomery T-tube, clinical and neurological instability significantly impact outcomes and prolong tracheostomy use.

  • Treatment for post-intubation tracheal or laryngotracheal stenosis requires a multidisciplinary and personalized approach.

  • Dysphagia is a significant factor linked to poorer clinical outcomes and extended tracheostomy use.

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The impact of photodynamic therapy on cellular immune function in patients with cervical HPV infection
Yan Ju, Qunyan Zhou
Highlights

  • Photodynamic Therapy (PDT) significantly increased HPV clearance rates in cervical HPV-infected patients.

  • PDT treatment augmented CD3+ and CD4+ T-cell levels, with sustained elevation observed up to 6 months post-treatment.

  • A higher CD4+/CD8+ ratio was noted in the PDT group, indicating an enhanced cellular immune response.

  • Pro-inflammatory cytokines IL-6, IL-8, and TNF-α levels decreased post-PDT, suggesting reduced inflammation.

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Clinical study of the effect of mometasone furoate nasal spray treatment on hearing and in secretory otitis media in children
Xiaoyan Yu, Lang Xu, Youqi Xie, Mengjie Huang
Highlights

  • The total effective rate of treatment in the observation group was higher than that in the control group.

  • The middle ear resonance frequency of the children in the observation group was higher than that of the control group at weeks 4, 8 and 12 of treatment, and the air-conduction hearing threshold was lower than that of the control group.

  • The total effective rate of the observation group after 12 weeks of treatment was 92.11 %, which was significantly higher than that of the control group (73.68 %).

  • The T-ETDQ score of the observation group was lower than that of the control group after treatment.

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Diagnostic value of contrast-enhanced ultrasound combined with serum procalcitonin in tuberculous lymph nodes and metastatic lymph nodes
Lin Li, Lan He, Minchao Xiong, Xiaoyan Wang
Highlights

  • According to imaging findings of CEUS, TLN was associated with enhanced concentric performance in the arterial phase and heterogeneous enhancement pattern in lymph nodes.

  • Peak Intensity (PI) of lesions was higher in MLN patients.

  • Increased age-enhanced concentric performance in the arterial phase, increased PI, and serum PCT above 5.39 ng/mL were independent risk factors for MLN.

  • The prediction model of serum PCT combined with CEUS had a higher diagnostic value for MLN.

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The effect of Licochalcone A on proliferation, invasion, and drug resistance of glioma cells by regulating TLR4/NF-κB signaling pathway
Baigui Zhou, Kun Mu, Xuzhou Yu, Xu Chen, Xiaoying Shi
Highlights

  • LCA has the ability to suppress the growth, movement, and invasion of glioma cells.

  • It can also counteract resistance to TMZ drugs.

  • This opens up new possibilities for identifying clinical drugs to treat glioma patients who are resistant to TMZ.

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A study on the intervention of eight-section brocade exercises in combination with comprehensive measures on the physical function status of patients with chronic obstructive pulmonary disease
Jiezhen Li, Yan Lei, Meini Li
Highlights

  • Eight-section brocade exercises enhance exercise endurance and lung function of COPD patients.

  • Eight-section brocade exercises improve the physical function of COPD patients.

  • Eight-section brocade exercises improve patient emotions, nursing efficiency, and satisfaction.

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CST1 promoted gastric cancer development by activating the AKT pathway
Lei Zhang, Dongmei Wang, Liqun Zhang, Lini Zhu
Highlights

  • Comparison of the invasive capabilities.

  • Comparison of the metastatic capabilities.

  • Effect of CST1 and AKT mRNA in gastric cancer.

  • Effect of CST1 and AKT protein in gastric cancer.

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Gyosaponin ameliorates sevoflurane anesthesia-induced cognitive dysfunction and neuronal apoptosis in rats through modulation of the PI3K/AKT/mTOR pathway
Lijuan Lin, Chenhui Zhu, Bing Yan, Pinxian Yu, Liu Yang, Wei Huang, Junren Chen
Highlights

  • GpS ameliorates Sev-induced cognitive deficits in rats.

  • GpS ameliorates Sev-induced neuronal cell damage in rats.

  • GpS promotes activation of the PI3K/AKT/mTOR pathway.

  • PI3K/AKT/mTOR pathway inhibitor reduces the amelioration of cognitive deficits in Sev-anesthetized rats by high-dose GpS.

  • PI3K/AKT/mTOR pathway inhibitor impairs the ameliorative effect of high-dose GpS on neuronal cell damage in Sev-anesthetized rats.

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Effect of melatonin on postoperative cognitive function in elderly patients submitted to transurethral resection of the prostate under spinal anesthesia
Cristiane Tavares, Cláudia Maia Memória, Luiz Guilherme Villares da Costa, Vinícius Caldeira Quintão, Alberto Azoubel Antunes, Deborah Teodoro, Maria José Carvalho Carmona
HIGHLIGHTS

  • Perioperative Neurocognitive Disorders (PND) can occur in patients submitted to elective surgical procedures under general or regional anesthesia, especially the elderly.

  • Circadian rhythm disruptions have harmful effects on cognition and may also play a role in the development of PND.

  • Melatonin 10 mg administered in the perioperative period of TURP surgery for elderly patients hasn't shown any protective effect against postoperative cognitive decline, mainly because the patients have shown a significant improvement in cognitive functions after the surgery.

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Agreement analysis and associated factors of SARC-F and SARC-CALF in screening of risk sarcopenia in people living with human immunodeficiency virus
Lara Cristina Vieira, Jaine Alves Ximenez, Maria Claudia Bernardes Spexoto
Highlights

  • SARCCalf is better than SARC-F in screening the risk of sarcopenia in PLHIV.

  • Low CD4+ count, the presence of opportunistic infections, and AIDS status are associated with the risk of sarcopenia in PLHIV, regardless of the tool used.

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Incidence of mycobacteria in pulmonary granulomatous lesions
Sibele Inácio Meireles, Mariana Vargas Cruz, Gustavo Palmer Irffi, Leonardo Abreu Testagrossa
Highlights

  • Lung granulomas have been associated with mycobacteria and fungal infections.

  • The largest cohort of pulmonary granulomatous lesions in Brazil was studied.

  • FFPE specimens are a valuable source of material for molecular methods.

  • Molecular methods contribute to the fast diagnosis of all mycobacteria species.

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Role of centchroman in regression of fibroadenoma: A 2-arm randomized control trial
Priyanka Rai, Soniya Nityanand, Amarjot Singh, Sunil Kumar Singh, Neha Singh, Arvind Kumar Singh, Dhananjay Singh
Highlights

  • The findings of the study indicate that Centchroman led to a notable reduction in fibroadenoma size, with a significant proportion of patients experiencing more than 50 % regression in their fibroadenomas.

  • Patients experienced significant relief from breast pain (mastalgia), showcasing the efficacy of Centchroman in alleviating associated physical discomfort.

  • Centchroman led to a significant improvement in anxiety and depression scores, highlighting its positive impact on the psychological health and overall well-being of patients.

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The impact of clinical seizures and adverse brain MRI patterns in neonates with hypoxic-ischemic encephalopathy and abnormal neurodevelopment
Sae Yun Kim, Hyun-Mi Kang, Soo-Ah Im, Young-Ah Youn
Highlights

  • Electrographic seizures did not have predictive value for adverse neurodevelopmental outcomes at 12‒24 months of age.

  • The incidence of neurodevelopmental impairment or death was significantly higher in the clinical seizure group.

  • Only cord blood pH and abnormal brain MRI findings were consistently associated with long-term neurodevelopmental outcomes in a multivariate analysis.

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Bleeding in patients hospitalized with acute pulmonary embolism in Brazil
Leonardo Jordan Hansen Vizzotto, Corina dos Reis Sepeda, Carlos Henrique Miranda
Highlights

  • Antithrombotics are the cornerstone for acute Pulmonary Embolism (APE) treatment.

  • Patients hospitalized with APE in Brazil had a high prevalence of bleeding.

  • The major bleeding increased the one-year mortality rate.

  • The bleeding predictive scores assessed showed limited accuracy in identifying high bleeding-risk patients.

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Relationship between sleep disorders and information processing speed in multiple sclerosis
Fereshteh Ashtari, Arshia Ghalamkari, Saba Naghavi, Ahmad Pourmohammadi, Iman Adibi, Zahra Karimi, Aryan Kavosh
Highlights

  • Restless legs syndrome is associated with lower information processing speed.

  • Obstructive sleep apnea is not associated with lower information processing speed.

  • Managing sleep disorders is critical for improving cognition in multiple sclerosis.

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Variations of renal Doppler indices during the initial 24-hour predict acute kidney injury in patients with sepsis: A single-center observational case-control clinical study
Xing Chen, Wen Wu, Chao Lei, Chong Li, Zhaohui Zhang, Xingguang Qu
Highlights

  • Renal Doppler marker variations within the initial 24 h in sepsis patients.

  • RRI reduction after 24h of ICU treatment can be used for early detection of SA-AKI.

  • Critical ultrasound for dynamic monitoring of renal perfusion.

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Efficacy and safety of a modified DVD regimen followed by lenalidomide for the treatment of Newly Diagnosed Multiple Myeloma
Zhichao Li, Wenhao Zhang, Fang Huang, Siguo Hao
Highlights

  • Adverse effects of lenalidomide for Newly Diagnosed Multiple Myeloma (NDMM) cannot be ignored.

  • Lower-dose PLD administered with dexamethasone and subcutaneous bortezomib is associated with a good durable response.

  • Lenalidomide is retained as maintenance or salvage therapy if the DVD regimen fails.

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Evaluation of corneal incision in femtosecond laser-assisted phacoemulsification
Guilherme Horta, Newton Kara-Junior, Rogério Horta
Highlights

  • After cataract surgery, the prevalence rate of Descemet membrane Detachment was significantly higher in the group with keratome incisions (63.2 %) compared to that with femtolaser incisions (22.2 %).

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OSVE or multiple-choice test: Is that a relevant question?
Francine Jomara Lopes, Renato Fraga Righetti, Matheus Belloni Torsani, Gustavo Silva Azevedo, Fernando Mauad Sacramento, Iolanda de Fátima Lopes Calvo Tibério
Highlights

  • OSVE and multiple-choice tests can be used interchangeably in the context of formative assessment.

  • OSVE and multiple-choice tests as effective tools to enhance intern training and monitoring.

  • OSVE holds promise as a transformative tool, capable of ensuring the continuity and integrity of clinical skills assessment in medical education.

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Evaluation of l-cell activity in the small intestine according to the extension of the biliopancreatic loop in patients undergoing Roux-en-Y gastric by-pass
Priscila Costa Estabile, Márcia Saldanha Kubrusly, Robson Kiyoshi Ishida, André Bubna Hirayama, Roberto de Cleva, Marco Aurelio Santo
Highlights

  • Question – Extension of the biliopancreatic loop increases l-cell activity after surgery bariatric?

  • Findings – l-cell activity increased independent of extension of the biliopancreatic limb.

  • Meaning – The additional beneficial effects of long BPL may be due to more rapid delivery of food and bile salts to more distal portions of the intestine.

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Metabolomics in juvenile idiopathic arthritis: A distinct profile in patients under methotrexate
Renato B. Tomioka, Gabriela R.V. Ferreira, Nadia E. Aikawa, Gustavo A.R. Maciel, José M. Soares Junior, Edmund C. Baracat, Eloisa Bonfá, Ismael Dale Cotrim Guerreiro da Silva, Clovis Almeida da Silva
Highlights

  • We identified a distinctive pattern of serum metabolic signatures in juvenile idiopathic arthritis patients under methotrexate therapy.

  • Methotrexate use is associated with a more efficient mitochondrial function.

  • A decreased mitochondrial metabolism was observed in polyarticular and systemic JIA subtypes, with a decrease of several acylcarnitines’ concentrations.

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Difference among frailty assessment tools in predicating postoperative prognosis of elderly patients with mild traumatic brain injury
Chunhua Ni, Chen Gu, Hua Liu, Feng Cheng, Chao Cheng, Xiaohua Xia
Highlights

  • Incidence of frailty in elderly patients varies widely among different tools.

  • FP and FS could be employed as tools for predicting frail conditions.

  • Different tools had low consistency in predicting frail conditions.

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Pulmonary rehabilitation under supervision of health-professional at institute versus conventional exercise-based pulmonary rehabilitation at home in COPD patients: A longitudinal cohort study
Guxiang Zhang, Jiajing Yu, Zhiqiang Pei, Fei Xie, Ruiyang Ding, Lili Bao, Anyang Li
Highlights

  • Guidelines recommended pulmonary rehabilitation in COPD.

  • Self-driven pulmonary rehabilitation is an undertreatment for COPD patients in China.

  • Chinese patients with COPD have worse clinical conditions.

  • Treatment with pulmonary rehabilitation at institutes improves clinical outcomes.

  • Chinese COPD patients are required to be treated as per proper guidelines.

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Prolonged high Myl9 levels are associated with the pathogenesis and respiratory symptom of post-acute COVID-19 syndrome: A 6-month follow-up study
Jun Sugihara, Chiaki Iwamura, Tomoya Tateishi, Tadashi Hosoya, Sho Shimada, Kiyoshi Hirahara, Shinsuke Yasuda, Yasunari Miyazaki
Highlights

  • Respiratory symptoms of PACS are associated with high serum Myl9 levels.

  • Patients who have had COVID-19 can be divided into two groups according to their serum Myl9 levels.

  • The neutrophil count is correlated with the Myl9 level at 6 months after infection.

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circLOC375190 promotes autophagy through modulation of the mTORC1/TFEB axis in acute ischemic stroke-induced neurological injury
Qie Liu, Lu Zhang, Xin Xu
Highlights

  • circLOC375190 reduction ameliorates neuronal autophagy and apoptosis in tMCAO mice.

  • circLOC375190 knockdown improves OGD/R-mediated neuronal autophagy and apoptosis.

  • circLOC375190 affects OGD/R-mediated neuronal apoptosis and autophagy by adsorbing miR-93-5p.

  • circLOC375190 affects OGD/R-mediated neuronal apoptosis and autophagy by regulating the miR-93-5p/MKNK2 axis.

  • circLOC375190 affects AIS autophagy by regulating the mTORC1/TFEB axis.

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Hsa_circ_0000105 promotes nasopharyngeal carcinoma malignancy by miR-541-3p/S100A11 axis
LuXing Peng, Jian Qin, DeFeng Qing, XinJun Huang, XiuRong Huang
Highlights

  • hsa_circ_0000105 modulates malignancy of NPC cells.

  • hsa_circ_0000105 influences the malignant behavior of NPC via downstream miR-541-3p.

  • hsa_circ_0000105 positively regulates S100A11 to accelerate the malignant behavior of NPC.

  • hsa_circ_0000105 inhibits NPC tumor growth in vivo.

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Prevalence of dry eye in Brazil: Home survey reveals differences in urban and rural regions
Leidiane Adriano Pereira, Laura Braga Arantes, Etiene Lorriane de Souza Persona, Denny Marcos Garcia, Isvander Gustavo de Souza Persona, Regina Celia Nucci Pontelli, Eduardo M. Rocha
Highlights

  • Dry eye is more frequent in the urban than in the rural population.

  • Dry eye is associated with dyslipidemia, visual display terminal, and ocular surface problems.

  • Dry eye is more frequent in women and the associated factors are associated with antiallergics, chronic pelvic pain, and fibromyalgia.

  • Dry eye in the elderly has distinct clinical associated factors.

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Evaluation of single-dose umbilical cord blood-derived mononuclear cell injection immediately and 7 days after spinal cord trauma in mice
Alex Oliveira de Araujo, Gustavo Bispo dos Santos, Raphael Martus Marcon, Maria Helena Alves Nicola, Marcela Saldanha Pereira, Fernando Barbosa Sanchez, Thiego Pedro Freitas Araujo, Alexandre Fogaça Cristante
Highlights

  • Stem cell therapy is a promising alternative in the spinal cord injury arsenal.

  • Challenges in stem cell treatment in SCI: phase uncertainty and cell type controversy.

  • Umbilical cord mononuclear cells may enhance recovery via multiple mechanisms.

  • Umbilical cord mononuclear cells can promote histological improvement after SCI.

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Construction and validation of a personalized risk prediction model for in-hospital mortality in patients with acute myocardial infarction undergoing percutaneous coronary intervention
Bing-Zheng Xu, Bin Wang, Jian-Ping Chen, Jin-Gang Xu, Xiao-Ya Wu
Highlights

  • Construction of a personalized risk prediction model for in-hospital mortality in patients with acute myocardial infarction undergoing Percutaneous Coronary Intervention (PCI).

  • Identification of risk factors associated with in-hospital mortality in AMI patients who underwent PCI.

  • Development of a nomogram prediction model for in-hospital mortality in AMI patients after emergency PCI.

  • Evaluation of the nomogram model's effectiveness through c-index, internal validation, Hosmer-Lemeshow test, and calibration curve analysis.

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Association between serum C-reactive protein and low muscle mass among US adults: Results from NHANES 1999 to 2006
Ruzheng Lin, Ying Chen, Kai Liu
Highlights

  • NHANES data from 1999 to 2006 show a positive link between serum CRP levels and low muscle mass risk in US adults.

  • An inverse J-shaped pattern emerges, indicating a non-linear association between CRP levels and low muscle mass risk, with critical points at 0.273 mg/dL for the overall population, 0.172 mg/dL for males, and 0.296 mg/dL for females.

  • This nationally representative study underscores the crucial role of inflammation in muscle function and advocates for future research and clinical strategies to address inflammation's impact on muscle mass and function.

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Do not expect an endoluminal complete response to identify a pathologic complete response in rectal cancer!
Alexandre Gheller, Guilherme Inácio Bertoldo de Melo e Patriarca da Silva Neiva, Mario Nóbrega de Araújo Neto, Fernando Gonçalves Lyrio, Dunya Bachour Basílio, Marília Cristina Roda da Costa, Douglas Vieira Mourão, Paulo Gonçalves de Oliveira, João Batista de Sousa
Highlights

  • Correlation between pathologic complete response and endoluminal complete response.

  • Half of pathologic complete responses do not achieve an endoluminal complete response.

  • Gross findings do not perfectly reflect microscopic findings.

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Effect of adipose-derived mesenchymal stem cells on the viability of the transverse rectus abdominis myocutaneous flap in rats
André Luiz Pires de Freitas, Sang Won Han, Priscila Keiko Matsumoto Martin, Lydia Masako Ferreira
Highlights

  • ADSCs increased the viability (significantly less necrosis) of a TRAM flap in rats.

  • Vessel formation in the ischemic segment of the flap was also enhanced by the ADSCs.

  • Fluorescence microscopy indicated no differentiation of ADSCs into endothelial cells.

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The educational impact of medical students’ participation in a short-term health expedition: The Iguape one health experience
Marcelo Arruda Candido, Vinicius Venturini, Matheus Polly, Matheus Belloni Torsani, Alexandre Sizilio, João Mitsuji Sakô, Wen-Jan Tuan, Robert Patrick Lennon, ... Iolanda de Fátima Lopes Calvo Tibério
Highlights

  • Educational value of health expeditions assessed via surveys.

  • No significant clinical or empathy gains observed.

  • 80 % reported positive career influence from participation.

  • 60 % intend to work within the public health system.

  • Practical experiences deemed crucial for shaping careers.

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Analysis of risk factors for depression in peritoneal dialysis patients and establishment of a risk nomogram model
Ming Yang, Xinhai Tang, Yehua Fang
Highlights

  • Risk factors for depression in peritoneal dialysis patients identified.

  • Nomogram predicts depression risk in peritoneal dialysis patients.

  • Gender, income, and comorbidities influence depression risk in dialysis.

  • Low hemoglobin and uric acid levels are linked to higher depression risk.

  • Developed nomogram shows strong clinical applicability and accuracy.

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Circular RNA pappalysin-1 enhances glycolysis via microRNA-656-3p targeting G-protein subunit gamma-5 to promote colon cancer progression
AiYuan Cai, HuiShi Ye, YuanHong Lin, JinYun Li, DongSheng Fang, ZhongBin Pan, ZhiWei Li, GuangLiang Luo, ... CiAi Lai
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The economic impact of Long-Acting Contraceptives (LARCs) on public health
Ana Claudia Marcelino, Paula da Cunha Pereira, Luis Bahamondes
Highlights

  • The use of LARCs reduces unplanned pregnancies.

  • Single-visit placements of LARCs increase access and uptake.

  • Train and allowed nurses on the placement of LARCs is important to women access and uptake.

  • Expand the knowledge of non-contraceptive benefits of LARCs is important among providers and users.

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Coronavirus disease 2019 infection severity among different variants in children under 2-years old in Brazil
Beatriz Martinelli Menezes Gonçalves, Rossana P.V. Francisco, Ágatha S. Rodrigues, José Carlos Soares Junior
Highlights

  • The original variant was responsible for most of the cases that evolved with death, omicron seems to be responsible for milder symptoms when compared to delta.

  • Children between 1‒6-months of age account for most of the cases, which concerns since there is no vaccination coverage.

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The phenotype of monocyte subtypes and expression of chemokine receptors in the Chronic Venous Insufficiency
Danielle Borges Germano, Larissa Namie Chiba, Ana Paula Augusto da Cruz Ballerini, Jônatas Bussador do Amaral, Marina Tiemi Shio, Jhefferson Miranda Alves, Daniela Alves de Abreu, Luiz Henrique da Silva Nali, ... Carolina Nunes França
Highlights

  • Receptors have chemotactic property cells and are characterized as inflammatory markers.

  • Monocyte subtypes can play an important role in the Chronic Venous Disease scenario.

  • Receptors that act by recruiting monocytes include CCR2, CCR5, and CX3CR1.

  • Chronic Venous Insufficiency changes the monocyte phenotype.

  • The chemokine receptors might be changed by the Chronic Venous Insufficiency.

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Multi-omics model is an effective means to diagnose benign and malignant pulmonary nodules
Yunzeng Zhang, Fan Zhang, Changming Shen, Gaofeng Qiao, Cheng Wang, Feng Jin, Xiaogang Zhao
Highlights

  • Multi-omics study is promising to improve the sensitivity and specificity of screening for NSCLC.

  • The risk score of Metabonomics, radiomics and multi-omics had different levels of performance in different risk groups.

  • Multi-omics model is more effective in the non-invasive diagnosis of pulmonary malignant nodules.

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Investigating the role of MicroRNA-519d-3p in enhancing chemosensitivity of colorectal cancer cells to 5-Fluorouracil through PFKFB3 targeting
Yangyang Zhang, Yiqing Zhang, Yanan Xiao, Shufen Xu, Jie Li, Juan Li, Lisha Chang, Jie Ding, ... Keming Wang
Highlights

  • miR-519d-3p affects the antitumor effect of 5-FU on CRC cells.

  • miR-519d-3p could regulate PFKFB3 and could have a significant effect on CRC.

  • PFKFB3 attenuated 5-FU sensitivity in CRC cells and enhanced glycolysis.

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Thrombin generation indices and Wells score predict pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease
Linjie Luo, Dan Zheng, Li Da, Jian Cheng, Yirui Cao, Na Wang
Highlights

  • History of venous thromboembolism, d-Dimer as well as ETP, APTT coagulation indices, and Wells score were significantly higher in the AECOPD with PE group, and ttpeak, ALB and TP were lower.

  • Wells score had a positive correlation with ETP and APTT and a negative correlation with ttpeak, which were all independent risk factors for PE in AECOPD.

  • Wells score, ETP, APTT and ttpeak had the efficacy of predicting PE by ROC curve analysis.

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Power Doppler in hand joints predicts therapeutic failure in treatment-naive women with early rheumatoid arthritis: A prospective study
Karine Rodrigues da Luz, Jamil Natour, Marcelo de Medeiros Pinheiro, Giovanna S. Petterle, Marla Francisca dos Santos, Artur da Rocha Correa Fernandes, Rita Nely Vilar Furtado
Highlights

  • Power Doppler as a Predictor: In hand ultrasound of women with early rheumatoid arthritis, Power Doppler was a significant predictor of therapeutic failures.

  • Important Power Doppler Scores: The total Power Doppler score, wrist Power Doppler score, and metacarpophalangeal Power Doppler score were the most critical predictors of therapeutic failures.

  • Clinical Implications of Power Doppler: The use of Power Doppler can help clinicians identify the risk of therapeutic failures in women with early rheumatoid arthritis, allowing for early intervention and treatment adjustments to improve patient outcomes.

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Pembrolizumab in gestational trophoblastic neoplasia: Systematic review and meta-analysis with sub-group analysis of potential prognostic factors
Marcio Barcellos, Antonio Braga, Matheus Machado Rech, Solange Artimos de Oliveira, Jose Mauro Madi, Sue Yazaki Sun, Jorge de Rezende-Filho, Kevin M. Elias, ... Ross S. Berkowitz
Highlights

  • Pembrolizumab is effective for GTN multi-drug resistant treatment.

  • Pembrolizumab seems also effective for PSTT/ETT treatment.

  • Pembrolizumab efficacy is similar in cases of resistance or GTN relapse.

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Magnetic resonance-guided focused ultrasound for uterine fibroids
Pedro Felipe Magalhães Peregrino, Marcos de Lorenzo Messina, José Maria Soares Júnior, Edmund Chada Baracat
Highlights

  • Fibroids are tumors that can cause important symptoms that reduce women's quality of life.

  • The gold standard treatment for symptomatic fibroids is hysterectomy.

  • Myomectomy is the treatment of choice for women with reproductive desire.

  • Magnetic resonance-guided focused ultrasound for uterine fibroids is a minimally invasive treatment alternative for symptomatic women.

  • Magnetic resonance-guided focused ultrasound for uterine fibroids proves to be a good alternative to improve the symptoms and quality of life of symptomatic women.

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Routinely available inflammation biomarkers to predict stroke and mortality in atrial fibrillation
Long Wu, Zhiquan Yuan, Yuhong Zeng, Lanqing Yang, Qin Hu, Huan Zhang, Chengying Li, Yanxiu Chen, ... Na Wu
Highlights

  • Adding Lymphocyte to Monocyte Ratio (LMR) to CHA2DS2-VASc score improves its reclassification ability and is comparable with the ABC score in predicting stroke.

  • Adding a systemic inflammation score (using LMR, albumin and fibrinogen) to CHA2DS2-VASc score improves its predictive and reclassification ability and is comparable with the ABC score in predicting death.

  • Because traditional inflammatory biomarkers are more readily available and less expensive, they may be used to improve decision support for AF.

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Biliary HMGB1 levels and biochemical indices in the assessment of acute obstructive septic cholangitis combined with septic shock
DanYang Gu, YuHao Wu, ZhengHua Ding, Yang Dai
Highlights

  • High levels of HMGB1 in AOSC bile are associated with the risk of septic shock.

  • AOSC bile HMGB1 is significantly correlated with blood CRP.

  • Elevated HMGB1 in AOSC bile increases the risk of postoperative complications.

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Diagnosis and management of acute abnormal uterine bleeding during menacme
Gabriela Pravatta-Rezende, Cristina Laguna Benetti-Pinto, Daniela Angerame Yela Gomes, Ana Carolina Japur de Sá Rosa e Silva, José Maria Soares
Highlights

  • Abnormal Uterine Bleeding (AUB) is the leading cause of seeking gynecological care, with data showing that 3 in 10 Brazilian women have this condition, with intermenstrual bleeding standing out.

  • According to the International Federation of Gynecology and Obstetrics (FIGO), cycles lasting less than 24 days or more than 38 days, with menstrual flow lasting eight days or more and blood loss reported by the woman as intense, are considered abnormal.

  • The main causes of AUB are summarized in the mnemonic PALM-COEIN, dividing them into structural and non-structural causes.

  • Diagnosing the etiology of AUB is essential to establish specific treatments, directed at the cause, which can be clinical or surgical, aiming not only to control the amount of blood loss, but also to improve the quality of life of women with AUB.

  • In general, the first line of treatment for AUB is medication, with surgical treatment being intended for failure or contraindication to clinical treatment or in cases of significant hemodynamic instability.

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Uterine artery doppler and pregnancy-associated plasma protein-A in pregnancies with fibroids
Lida Anwari
Highlights

  • Uterine fibroids adversely impact maternal and neonatal outcomes.

  • UAD parameters and PAPP-A levels do not markedly associate with the fibroid size.

  • UAD and PAPP-A play functional roles in determining the outcomes of pregnancies carrying fibroids.

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Normal ranges of the fetal weight determined by ultrasound in the population of the Hospital das Clínicas of the Faculdade de Medicina da Universidade de São Paulo
Eliane Azeka Hase, Amanda Amaral, Stela Verzinhasse Peres, Rossana Pulcineli Vieira Francisco
Highlights

  • Normal ranges of fetal weight as a function of gestational age was created.

  • New parameter, days before birth, was incorporated for normal ranges of fetal weight.

  • Parameter days before birth is useful for estimating fetal weight at scheduled birth.

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Review articles
Towards optimal management of lower eyelid malpositions: A systematic review of treatment effectiveness and safety
Lana Sbitan, Haneen Tanous, Mira Nawfal Jardak, Cristina Pires Camargo
Highlights

  • A comprehensive systematic review was conducted, to provide healthcare workers with a vital resource in the treatment of eyelid malposition, our search spanned electronic databases, clinical trials registries, and relevant journals.

  • The study includes 15 selected trials evaluating 709 patients (855 eyelids), with an assessment of trial quality using the Cochrane Risk-of-Bias tool (RoB V2).

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Personalized nutrition and precision medicine in perimenopausal women: A minireview of genetic polymorphisms COMT, FUT2, and MTHFR
Pedro Andrade, Aline Boveto Santamarina, Jéssica Alves de Freitas, Annete Bressan Rente Ferreira Marum, Ana Flávia Marçal Pessoa
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Behavioral therapies for the treatment of autism spectrum disorder: A systematic review
Clara Lucato dos Santos, Indyanara Inacio Barreto, Ana Carolina Furian da Silva, Juliana Firmino Batista Soriano, Jeferson de Lima Silva Castro, Luca Schiliró Tristão, Wanderley Marques Bernardo
Highlights

  • Autism Spectrum Disorder (ASD) is a heterogeneous neurodevelopmental disorder.

  • With correct screening and diagnosis, treatment must be offered to improve prognosis.

  • Adequate treatment in a healthcare setting must be known.

  • The Early Start Denver Model (ESDM) showed improvements in the cognitive, verbal, and social aspects.

  • Time occasionally can improve some scores independently of the group.

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Plants used by Brazilian communities of African descent for women's health
Letícia Francine Silva Ramos, Ananda Gomes de Sousa, Rebeca de Siqueira Amorim, Alan de Araújo Roque, Israel Luís Diniz Carvalho, Ana Laura Vilela de Carvalho, Maiara Bernardes Marques, Milena Evangelista dos Santos, ... Pedro Henrique Sette-de-Souza
Highlights

  • Ethnopharmacological knowledge is passed down through generations by women in the community, who use plants especially for sexual and postpartum care.

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Knowledge and attitude of deaf women in relation to contraceptive methods: A systematic review
Gabriela Fuster Barbosa, Edson Santos Ferreira-Filho, Lais Abdo Quintão, Laura Fernandes Berto, Patrícia Gonçalves de Almeida, Edmund Chada Baracat, Luis Bahamondes, José Maria Soares-Junior, Isabel Cristina Esposito Sorpreso
Highlights

  • Knowledge was low mainly about contraceptive methods of high effectiveness.

  • The acceptance of the chosen contraceptive method by deaf women was satisfactory.

  • There are no intervention studies to improve contraceptive use among deaf women.

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Mitochondrial DNA alterations in precision oncology: Emerging roles in diagnostics and therapeutics
Alexis Germán Murillo Carrasco, Roger Chammas, Tatiane Katsue Furuya
Highlights

  • Mitochondria regulate cellular functions, and mtDNA mutations can affect metabolism.

  • mtDNA mutations are promising biomarkers for cancer detection and tumor progression.

  • These mutations might influence therapy response, drug resistance, and patient outcomes.

  • Tools and models advance precision oncology and mitochondrial-targeted treatments.

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Impact of the association of strength training with neuromuscular electrostimulation on the functionality of individuals with functional decline during senescence: A systematic review and meta-analysis
Dhianey de Almeida Neves, Leonardo Costa Pereira, Kerolyn Ramos Garcia, Frederico Santos de Santana, Rhenan Yoshio de Caldas Fujita, Beatriz dos Santos Faria, José Antônio Alves de Oliveira, Carlos James Zeidan Silva Filho, Margô Gomes de Oliveira Karnikowski
Highlights

  • • NMES+ can improve the aerobic capacity of individuals in functional decline.

  • • NMES+ appears to improve physical functional capacity in general.

  • • More RCTs are needed to better evaluate the evidence found.

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Pharmacological treatment of antidepressant-induced sexual dysfunction in women: A systematic review and meta-analysis of randomized clinical trials
Antonio Carlos Queiroz de Aquino, Ayane Cristine Alves Sarmento, Raphaell Lucas de Araújo Teixeira, Tâmilly Nascimento Batista, Cijara Leonice de Freitas, José Manuel Pérez Mármol, Lucia Alves Silva Lara, Ana Katherine Gonçalves
Highlights

  • Sexual dysfunction is a common side effect of antidepressants, especially in women.

  • Identifying effective pharmacological treatments for Antidepressant-Induced Sexual Dysfunction (AISD) is crucial for enhancing patient quality of life.

  • Bupropion at a dose of 150 mg has shown greater effectiveness in treating AISD in women.

  • The meta-analysis found no direct correlation between improvements in sexual function and reductions in depressive symptoms.

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Comparison of endoscopic submucosal dissection and transanal endoscopic surgery for the treatment of rectal neoplasia: A systematic review and meta-analysis
Igor Valdeir Gomes de Sousa, Alexandre Moraes Bestetti, Diego Paul Cadena-Aguirre, Angelo So Taa Kum, Paulo Ferreira Mega, Pedro Henrique Veras Ayres da Silva, Nelson Tomio Miyajima, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura
Highlights

  • Colorectal cancer is one of the most common neoplasms and a leading cause of cancer-related mortality worldwide.

  • The treatment of colorectal neoplasia has evolved significantly over the past few decades due to advances in minimally invasive techniques.

  • Although conventional surgery remains the gold standard for rectal tumors, ESD, TEM, and TAMIS emerged as effective and less invasive therapies for benign tumors and early cancers without nodal metastases, allowing lower morbidity.

  • ESD and TES are safe and effective treatment options for early-stage rectal tumors.

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Phyllodes tumors of the breast: A comprehensive review of diagnosis, treatment, and follow-up
Aline Rocha Donato, Rodrigo Goncalves, Jonathan Yugo Maesaka, Fernando Nalesso Aguiar, José Maria Soares, Carlos Alberto Ruiz, José Roberto Filassi, Edmund Chada Baracat
Highlights

  • Molecular and IHC markers aid in objective classification and outcome prediction of PT.

  • Surgery is the gold standard for PT, but margin extent lacks consensus.

  • Local recurrence is key in PT prognosis, with margin status as the main risk factor.

  • Adjuvant radiotherapy lowers recurrence in borderline/malignant PTs with close margins.

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Recognition of medical error: It is not too late for an open disclosure – a narrative review
Ivan Dieb Miziara, Carmen Silvia Molleis Galego Miziara
Highlights

  • Errors during patient care are a huge source of ethical, financial, and even mental problems affecting patients, physicians, and healthcare organizations.

  • Open disclosure is a process for ensuring that open, honest, empathic and timely discussions occur between patients and/or their support person(s) and healthcare staff following a patient safety incident.

  • Physicians may avoid or hide errors or blame other health professionals.

  • Adopting an effective disclosure system, increases the possibility of an agreement between the parties involved, meaning significant savings in financial resources.

  • Patients want some attitudes from their doctors: an explicit statement that an error occurred and an apology.

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Comments
Updated report of Blastocystis spp. in a teaching hospital of Brazil: A 6-year retrospective experience
Gessica Baptista de Melo, Marcelo Alves Ferreira, Vera Lucia Pagliusi Castilho, Elenice Messias do Nascimento Gonçalves, Ronaldo Cesar Borges Gryschek, Fabiana Martins de Paula
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Correspondence
Role of tomography in the screening at the emergency room during pandemics
Marcel Lima Albuquerque, Ricardo D'Oliveira Vieira, Luiz Eduardo Fonteles Ritt
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Aseptic thoracic spondylodiscitis (pseudo discitis) in a septuagenarian without predisposing factors
Ana C. Fiorini, Carla Alexandra Scorza, Fulvio Alexandre Scorza, Josef Finsterer
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Small fiber neuropathy with dysautonomia and positive GPCR and FGFR-3 antibodies after the first BNT162b2 dose
Josef Finsterer, Carla Alexandra Scorza, Fulvio Alexandre Scorza, Ana C. Fiorini
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Fatal long-term complications due to bendamustine for Waldenstrom's macroglobulinemia
Fulvio Alexandre Scorza, Carla Alexndra Scorza, Josef Finsterer
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Erratums
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