Highlights ■ Only 34.4% of patients with primary Antiphospholipid Syndrome achieved adequate anticoagulation  (time in therapeutic range ≥60%). ■ More than half had insufficient INR monitoring, precluding  time in therapeutic range calculation. ■ No clinical or demographic factors were associated with  poor anticoagulation control. ■ Gaps in follow-up and adherence issues appear to be key contributors to suboptimal anticoagulation. ABSTRACT Objective: This study aimed to evaluate the quality of anticoagulation control in patients with primary antiphospholipid syndrome, using time in […]

Highlights ■ Remaining obese over time was independently associated with higher odds of depression. ABSTRACT Objective: To evaluate the association between longitudinal self-initiated changes in body mass index patterns and depression in a large sample of adults and older individuals. Methods: Participants included 1,944 adults and older individuals with depressive symptoms at baseline who underwent routine health screening examinations. Depression was defined as Beck Depression Inventory-II scores ≥14. Body mass index, blood pressure, blood samples, alcohol consumption, smoking status, physical […]

Highlights ■ Telecardiology enabled perioperative cardiovascular risk assessment for non-cardiac surgery. ■ Most patients were safely classified as low cardiovascular risk at first consultation. ■ Additional testing and urgent referrals were rarely required. ■ Remote assessment expanded access to cardiology care in underserved regions. ABSTRACT Objective: This study aimed to investigate the clinical characteristics and management strategies of patients referred for telecardiology consultations, specifically for preoperative cardiovascular risk assessment. Methods: A retrospective observational study at a Telemedicine Center in São […]

Highlights ■ A total of 441 rapid response team activations among  adult oncology outpatients in 2023. ■ Most activations occurred during clinic visits or imaging exams; few in chemotherapy. ■ Key triggers included staff concern and arterial  hypertension. ■ Outcomes: 8.8% of patients required intensive care unit transfer and 2.3% died in the hospital. ABSTRACT Objective: To describe the characteristics, timing, documentation completeness, and outcomes of Rapid Response Team activations among adult oncology outpatients. Methods: This retrospective study analyzed all […]

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 ■ One-third of patients older than 65 years exhibit a hyperinflammatory state typical of inflammatory anemia. ■ The pathophysiology of anemia of inflammation is multifactorial. ■ Higher inflammation is associated with high prevalence of anemia and age-associated disorders. ■ The inflammatory state stimulates hepatocytes to produce hepcidin. ■ Understanding the immunomodulatory parameters in  anemia of inflammation may be effective for differential diagnosis and therapeutic approaches. ABSTRACT Objective: This study aimed to assess the relationship between hepcidin, IFN-γ, iron biomarkers, […]

Highlights ■ SARS-CoV-2 patients had 83.7% ischemic stroke and 39% in-hospital mortality rates. ■ D-dimer levels independently predict mortality in patients with COVID-19 and stroke. ■ Patients with COVID-19 and stroke have high complication rates: pneumonia 61%, renal failure 35%, sepsis 30.3% sepsis. ■ Time from symptom onset to admission was shorter than the pre-pandemic average. ABSTRACT Objective: This study aimed to characterize the clinical, laboratory, and neuroimaging profiles of hospitalized Brazilian patients with confirmed SARS-CoV-2 and acute cerebrovascular events. […]

Highlights ■ This is the largest cohort of individuals with NF1 investigated through whole-genome sequencing. ■ Molecular data contributed to the representation of the  Brazilian population in genomic research. ■ Novel variants in the NF1 gene have been described, including c.3372del, c.7299del, and c.7457_7457+2del. ■ The first report of spinocerebellar ataxia type 19 in Brazil is also presented. ABSTRACT Objective: To describe clinical and molecular aspects of a cohort of Brazilian individuals with neurofibromatosis type 1, a neurocutaneous disorder associated […]

ABSTRACT Myelomeningocele is a severe neural tube defect that significantly affects neurological development. Studies have demonstrated that intrauterine repair leads to better neurological outcomes than postnatal correction, likely due to reduced exposure of the neural tissue to amniotic fluid. Despite its benefits, prenatal surgery is performed in only a limited number of centers worldwide and is associated with both maternal and fetal risks. This case report aims to describe a complication rarely reported in the literature: umbilical cord presentation at […]

ABSTRACT Non-B DNA structures represent alternative conformations to the canonical double helix, characterized by unconventional base pairing that diverge from the Watson-Crick model. Among these, the i-motifs, formed in cytosine-rich regions, has attracted considerable attention due to its potential regulatory roles. This review examines the molecular mechanisms underlying the formation and stability of i-motifs, which rely on hydrogen bonding between protonated cytosines. These structures can form under slightly acidic and even neutral pH conditions, depending on the DNA sequence context. […]