This is not a new phenomenon. Scientific medical information has always competed with people promoting both new and old theories and remedies lacking a solid evidence base. In the past, this was part of the social milieu, and did not raise many concerns. However, social networks have changed this dynamic, allowing unscientific information to spread wildly.()Medicine is not easy to understand: complicated biological information is used, and evidence-based medicine requires physicians to read and understand complex statistics and evaluate clinical […]

Our institution, Hospital Israelita Albert Einstein, has been using Artificial Intelligence (AI) long before the advent of large language models. For example, our emergency department has used Isabel, an AI-based diagnostic program, for several years. Artificial Intelligence holds significant promise, particularly in freeing healthcare professionals from routine and repetitive tasks. A systematic review evaluated the use of large language models in healthcare applications,() while a scoping review() and an umbrella review on the impact of ChatGPT in healthcare() further explored […]

Highlights ■ Ultrasound improves success rates and reducescomplications during vascular puncture. ■ Simulation-based training enables safe and effectiveacquisition of procedural skills. ■ A low-cost, reproducible simulation model was developed. ■ Specialists validated the model as effective for teaching and training. ABSTRACT Objective: To develop a low-fidelity, low-cost simulation model for ultrasound-guided vascular puncture that is easily reproducible and validated by an expert panel. Methods: Sequential tests using different materials were conducted based on phantom models described in the literature. The […]

Highlights ■ Family identified with recurrent colorectal cancer, suggestive of Lynch syndrome. ■ A new variant was detected, NM_000251.3(MSH2):c.1894_1898del (p.Ile633Lysfs*9). ■ The variant causes a frameshift mutation leading to a premature stop codon, suggesting pathogenicity. ■ Using bioinformatics tools, we investigated possible escape mechanisms, such as the presence of isoforms without the mutated exon. ■ Location of the variant suggests that it causes non-sense mediated decay, which is reinforced by immunohistochemistry findings showing absence of MSH2 protein expression. ■ Detailed […]

Highlights ■ This large real-world study analyzed blood cholesterol trends over a 15-year period in São Paulo, Brazil. ■ Mean total and LDL-C decreased significantly across all groups. ■ A higher proportion of patients achieved recommended  LDL-C target levels. ■ The observed trends may reflect improvements in cardiovascular prevention strategies and treatment efficacy. ABSTRACT Objective: This study aimed to evaluate monthly trends in low-density lipoprotein cholesterol (LDL-C) levels in the examined population. Methods: Monthly trends in LDL-C levels from 2009 […]

Highlights ■ This study describes a series of cases in which SARS-CoV-2  infection is associated with profound sensorineural hearing loss. ■ COVID-19 infections can indeed cause sensorineural hearing loss. ■ Seven patients with profound sensorineural hearing loss due to COVID-19 were clinically evaluated and underwent audiological testing. ■ This study highlights that the consequences of COVID-19 extend beyond respiratory symptoms and affect other systems, such as the inner ear. ABSTRACT Objective: To describe a series of cases in which severe […]

Highlights ■ In Peru, 5.2% of the population has a disability, and among them, 59.2% have physical limitations. ■ People with disabilities face physical/communication healthcare access barriers. ■ Barriers can affect satisfaction with care received and facility infrastructure. ABSTRACT Objective: To analyze the association of physical disability with medical care and health center infrastructure satisfaction among users of medical offices in Peru in 2016. Methods: We conducted a cross-sectional analysis of secondary data from the 2016 National Health User Satisfaction […]

Highlights ■ EDAcw objectively quantifies sweating in patients with hyperhidrosis. ■ Sympathectomy significantly reduced EDAcw and  improved the quality of life. ■ The hands showed a 97% reduction in electrodermal activity postoperatively. ■ EDAcw is a reliable non-invasive tool for clinical evaluation and follow-up. ABSTRACT Objective: To analyze continuous exosomatic electrodermal activity (EDA) without external stimuli (EDAcw) in patients with primary hyperhidrosis before and after sympathectomy. Methods: This prospective study included 28 participants, categorized into two groups. The first group […]

Highlights ■ The role of adenomatous and serrated polyps in ulcerative colitis-related colorectal cancer remains unclear. ■ Data regarding adenomatous and serrated polyps in ulcerative colitis remain scarce. ■ Preneoplastic polyps were identified in 16.2% of patients with ulcerative colitis. ■ Age >41 years and higher body mass index were associated with an increased risk of polyps. ABSTRACT Objective: To Describe the prevalence of adenomatous and serrated polyps in ulcerative colitis and investigate risk factors associated with the development and […]

Highlights ■ ChatGPT and Gemini are showing increased ability to accurately answer multiple-choice questions on medical exams. ■ There was no statistical significance in the rate of correct  answers by ChatGPT 3.5 and Gemini 1.5. However, we observed that ChatGPT 4.0 performed significantly better,  and so did Gemini 2.5 Flash, when comparing to the  literature. ■ The question taxonomy did not appear to be a relevant  factor regarding the success rate of the models. ABSTRACT Objective: Given the rapid advancement […]

Highlights ■ Peripheral muscle strength outperformed the Rapid Shallow Breathing Index in predicting extubation success. ■ Extubation was successful in 83% patients within a 48-hour monitoring period. ■ Peripheral muscle strength showed strong predictive accuracy. ■ Rapid Shallow Breathing Index demonstrated limited value as a predictor of extubation success. ABSTRACT Objective: To evaluate the effects of peripheral muscle strength on extubation success after cardiac surgery. Methods: In this prospective cohort study, peripheral muscle strength and Rapid Shallow Breathing Index were […]

Highlights ■ The institutional nutritional program in tertiary care was effective in promoting moderate weight loss. ■ Obese patients with high cardiovascular risk undergoing multi-drug therapy showed significant improvement in anthropometric, biochemical, and heart rate variability components. ■ Heart rate variability analysis revealed enhanced autonomic balance, increased parasympathetic activity, and reduced sympathetic activity after weight loss. ■ Moderate weight loss presents a promising adjunctive  strategy for managing cardiovascular risk in obese patients undergoing multi-drug therapy. Abstract Objective: Cardiovascular diseases remain […]

Highlights ■ ACE2 rs2285666 GG genotype increased the risk ofintensive care unit risk in women. ■ TNF rs1800629 A allele was associated with severe COVID-19 and invasive mechanical ventilation. ■ IL1A rs1800587 influenced disease severity and respiratory symptoms. ■ TNF polymorphism was associated with post-COVID, cough and fatigue. ABSTRACT Objective: We evaluated the influence of single-nucleotide polymorphisms in cytokine, renin-angiotensin-aldosterone system, and uromodulin genes on COVID-19 severity and the persistence of symptoms in the post-COVID phase. Methods: Two cross-sectional cohort […]

Highlights ■ Pre-sarcopenic women showed increased cortical excitation during motor tasks. ■ Sarcopenia was associated with slower motor reaction time. ■ EEG revealed central nervous system changes across sarcopenia stages. ■ Pre-sarcopenia may represent a window for early  neuromotor intervention. ABSTRACT Objective: This study aimed to analyze cortical activity during simple motor reaction time tasks in older women with different degrees of sarcopenia. Methods: This cross-sectional, observational, analytical study included 59 women classified into control, pre-sarcopenia, and sarcopenia groups according […]

Highlights ■ The rs2814778 C allele is linked to severe/critical COVID-19. ■ The association is independent of major clinical risk factors. ■ The Duffy “null” phenotype may promote lung inflammation. ■ rs12075 and rs4073 showed no association with COVID-19 severity. ABSTRACT Objective: This study aimed to analyze the possible association between rs2814778, rs12075 (ACKR1 gene), and rs4073 (CXCL8 gene) single nucleotide variants and COVID-19 severity. Methods: This cross-sectional study included 319 COVID-19 diagnosed patients at two hospitals in Paraná, Brazil […]

Highlights ■ This randomized controlled trial in elective neurosurgery adds important evidence to the growing body of literature comparing Plasma-Lyte 148 with 0.9% saline in specialized surgical populations. ■ Plasma-Lyte 148 demonstrated superior acid-base homeostasis with significantly higher bicarbonate levels and base excess at surgical completion, whereas 0.9% saline induced hyperchloremia in the saline group. ■ The biochemical advantages of Plasma-Lyte 148 align with current evidence supporting balanced crystalloids as the preferred choice in perioperative fluid management. ■ These findings […]

Highlights ■ Immunohistochemistry distinguishes Warthin-like mucoepidermoid carcinoma from metaplastic Warthin tumor. ■ CK7, mitochondrial patterns, and double-layer epithelium suggest metaplastic Warthin tumor. ■ Basal CK14, CK5/6, and p63 distinguish metaplastic Warthin tumor from Warthin-like mucoepidermoid carcinoma. ABSTRACT Objective: This study aimed to analyze the clinicopathological and immunohistochemical profiles of unconventional Warthin tumors and mucoepidermoid carcinomas. Methods: Eleven low-grade salivary gland tumors with Warthin-like features were analyzed. Group A (n=6) showed a double-layered oncocytic epithelium in less than 50% of the […]

Highlights ■ This study aimed to evaluate the association between  damage-associated molecular patterns and peripheral hypoperfusion in sepsis. ■ Surviving patients showed better peripheral perfusion than  non-survivors. ■ No significant association was observed between mortality  and serum levels of the evaluated damage-associated  molecular patterns. ■ Damage-associated molecular patterns levels did not differ between patients with reduced or normal peripheral perfusion. ABSTRACT Objective: The causal mechanisms of peripheral hypoperfusion in sepsis have not yet been fully elucidated. Therefore, this study aimed […]

Highlights ■ Carbapenem resistance rose sharply during the COVID-2019 pandemic, doubling from 2019 to 2020, while infection control practices prevented proportional increases in  healthcare-associated infections. ■ Genomic analyses revealed high diversity among blaKPC-positive isolates, with an expansion of sequence types and a predominance of sporadic non-outbreak clones throughout the pandemic period. ■ Shifts in mobile genetic elements and virulence markers occurred during the pandemic, including the emergence of the integrative and conjugative element of Klebsiella pneumoniae ICEKp4, changes in O-antigen […]

Highlights ■ Transoral robotic surgery applied in patients with T1–T2 oropharyngeal and laryngeal tumors. ■ Mean hospital stay: 2.1 days. ■ Minimal postoperative complications. ■ 5-year survival: 77%, with comparable cost-effectiveness. ABSTRACT Objective: To assess the feasibility and benefits of transoral robotic surgery in the public healthcare system and to conduct a cost analysis of its implementation. Methods: This prospective, nonrandomized, observational cohort study was conducted over 24 months and included patients with T1-T2 oropharyngeal and supraglottic laryngeal tumors. Results: […]