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: […]

Highlights ■ All standard echocardiographic views were obtained in the prone position. ■ In the prone position, 16 of 17 key variables were consistently acquired. ■ Image quality was slightly reduced only in the parasternal view. ■ Quantitative measurements were comparable between the prone and supine positions. ABSTRACT Objective: Transthoracic echocardiography is essential for hemodynamic assessment in critically ill patients; however, its use in the prone position remains challenging. This study aimed to assess the feasibility of performing transthoracic echocardiography […]

Highlights ■ Mammary hypertrophy was not associated with postoperative totally implantable venous access device catheter tip displacement. ■ Upright and supine chest radiography with a radiopaque ruler allowed precise quantification of catheter tip displacement. ■ Non-deforming chest wall surgery and a history of peripherally inserted central catheters history were significantly associated with catheter tip migration. ABSTRACT Objective: This study aimed to evaluate the change in the position of totally implantable venous access devices in patients with mammary hypertrophy compared to […]

Highlights ■ High vaccine coverage correlated with sharp declines in the incidence of pediatric meningitis C. ■ The incidence fell by 98% by 2021 following national introduction of the MenC vaccine. ■ Vaccine coverage dropped after 2015, aligned with the rising cases observed in 2022. ■ MenC vaccination significantly reduced morbidity and mortality nationwide. ABSTRACT Objective: To analyze the correlation between vaccination coverage against meningitis C and epidemiological indicators of morbidity and mortality associated with the disease in Brazilian pediatric […]

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 ■ 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 ■ The Brazilian Portuguese version of the Sexual Risk Behaviors Scale has strong measurement properties, including content validity, structural validity, and internal consistency. ■ The Sexual Risk Behaviors Scale showed measurement invariance between females and males and sufficient test-retest reliability, supporting its stability and applicability across sexes. ■ The Sexual Risk Behaviors Scale is a valid and reliable instrument for assessing sexual risk behaviors among university students in Brazil. Abstract Objective: This study aimed to translate and evaluate the […]

Highlights ■ Smartphone-based training improved functional capacity in older adults. ■ Remote and in-person supervision led to similar gains in functional capacity. ■ Postural balance improved comparably in both groups. ■ Lower limb strength improved only in-person supervision with exercise App. ABSTRACT Introduction: Population aging is a significant global challenge, demanding strategies that promote healthy aging. Regular physical activity is crucial for maintaining functional capacity, quality of life, and preventing chronic diseases in older adults. However, sedentary behavior remains high, […]

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 ■ Accessibility to novel drugs for multiple myeloma render excellent outcomes. ■ Hemoglobin at diagnosis is a significant risk factor. ■ Age also impacts outcomes. ■ Hemoglobin and age-based model fared better than the International Staging System. ABSTRACT Objective: To report the outcomes of patients with multiple myeloma who had access to novel drugs in Brazil, and to establish a local benchmark. Methods: This prospective observational study was conducted at Hospital Israelita Albert Einstein in São Paulo, Brazil. We […]