RATIONAL USE OF TRANEXAMIC ACID There is strong evidence supporting the use of tranexamic acid (TXA) to reduce bleeding and transfusion needs in cardiac surgery, even among patients receiving dual antiplatelet therapy.(,) The OPTIMAL trial (2022), involving over 3,000 patients, demonstrated that high- and low-dose regimens had comparable efficacy, although high-dose TXA was associated with a higher risk of postoperative seizures.() In practice, we favor a low-dose regimen of 10-15mg/kg as a bolus, followed by a continuous infusion of 1mg/kg/h. […]

Dear Editor, Monitoring patient effort or muscle pressure (Pmus) during mechanical ventilation is essential to prevent diaphragm injury.(-) Excessive inspiratory effort may cause patient self-inflicted lung injury and diaphragm overuse, whereas insufficient effort may result in rapid diaphragm atrophy.() […]

Dear Editor, Physicians often encounter clinical questions during patient care.() They often spend more than half an hour trying to find answers to these point-of-care questions, yet inquiries are not always resolved.() For family physicians, electronic medical databases have shown promise in answering most clinical questions. However, point-of-care searches are not fast enough;() slow internet connections and poor navigability limit the practical use of these resources during patient visits.() […]

Dear Editor, The coronavirus disease 2019 (COVID-19) pandemic has unprecedentedly affected the global society, healthcare systems, and economies.() Analyzing the place of death of patients with COVID-19 over the first five years of the pandemic offers valuable insights into shifting healthcare dynamics. Therefore, this study aimed to assess trends in COVID-19-caused patient deaths to better understand how healthcare and social infrastructure adapted to the evolving crisis. […]

Dear Editor, A recent study by Costa et al.() investigated the association between facemask usage and SARS-CoV-2 viral load in individuals with mild COVID-19 symptoms. This cross-sectional study, conducted at a public emergency care facility in Belo Horizonte, Brazil, aimed to explore whether the regular use of facemasks is correlated with lower viral loads in infected individuals. The principal findings revealed a significantly lower probability of high SARS-CoV-2 viral load in individuals who regularly wore masks than those who did […]

Dear Editor, The Brazilian Society of Medical Genetics and Genomics recently issued a statement against using polygenic risk scores for breast cancer risk stratification in Brazilian women. In fact, an ongoing surge could be observed in genomic signatures and prognostic models, with over 200 LASSO-based TCGA signatures appearing in Scientific Reports last year, based on a focused keyword-based search, several of questionable quality. Discerning reliable models from unreliable ones is crucial for clinicians in order to avoid poorly validated tools. […]

Dear Editor, Biocomputer literature has speculated on ChatGPT application in post mortem interactions, i.e., the interlocution between living people and supervening “memories” of already deceased persons., Within the generative artificial intelligence (AI) research spectrum, such speculations raise a bioethical dilemma related to the violation of the dignity of dead people, who did not consent or authorize such invasive appropriation and exploitation of their memories and ethos in their lives. In a sense, our perspective presupposes and proposes a new question: […]

Dear Editor, For several decades, the dengue epidemic has been a concern for public health authorities. The dengue virus (DENV) is endemic to tropical and subtropical regions, and its annual incidence has increased significantly over the years.() Since it is transmitted by an arthropod vector (the Aedes aegypti mosquito), it is classified as an arbovirus, along with the yellow fever, chikungunya, and Zika viruses. There are four serotypes of the virus (DENV-1 to DENV-4), all of which can infect humans.() […]

Dear Editor: We thank Dr. Hinpetch Daungsupawong and Dr. Viroj Wiwanitkit for their detailed review of our work: Lessons from the pandemic and the value of a structured system of ultrasonographic findings in the diagnosis of COVID-19 pulmonary manifestations() published in einstein. We appreciate your interest in our work, and the time dedicated to sharing your concerns. […]

Dear Editor, Acute respiratory failure (ARF) is a leading cause of pediatric hospitalizations, and invasive mechanical ventilation (IMV) is an essential support in severe cases.() Data obtained through expiratory and inspiratory pause maneuvers on mechanical ventilators during spontaneous breathing in adult IMV patients have been shown to aid prevention of patient self-inflicted lung injury (P-SILI).(,) […]