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OBJECTIVE: To map scientific evidence on educational technologies developed for family members and children with type 1 diabetes. METHOD: Scoping review, according to JBI recommendations, and described in accordance with the checklist PRISMA-ScR. Searches were carried out in the LILACS, BDENF, PUBMED, COCHRANE, CINAHL, EBSCO, Scopus and Embase/Elsevier, Web of Science/Clarivate Analytics, Scielo, VHL Regional Portal and gray literature databases. RESULTS: Fifty-three studies published between 1980 and 2023 were included. The evidence was categorized into digital educational technologies, which provide innovative resources to educate and support children and families, and non-digital educational technologies, which provide practical and interactive opportunities for learning about diabetes. CONCLUSION: The results highlight the relevance of educational technologies in the care of children with type 1 diabetes. However, they reveal a gap in the assessment of the effectiveness of these interventions in the long term, with regard to adherence to treatment and improvement in quality of life. Research is required to evaluate the effectiveness of these technologies and the impact of educational interventions.

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This randomized clinical trial aimed to evaluate the effect of selective caries removal in deep Class I cavities in posterior teeth followed or not by photobiomodulation (PBM) therapy at two different wavelengths on postoperative sensitivity. Baseline spontaneous and stimulated sensitivity scores of 33 vital permanent molars were determined by the participants using a numeric rating scale. The teeth had their affected dentine preserved and were randomly allocated into three groups (n = 11): selective removal of infected dentine (control), selective removal of infected dentine followed by infrared (IR; 810 nm) or red (R; 660 nm) laser irradiation. The teeth were restored with a two-step self-etch adhesive and nanoparticle composite layers, and followed by laser irradiation only for IR and R groups. Both spontaneous and stimulated sensitivity were recorded after 12 h, 7 days, and 14 days. Data were statistically analyzed by Kruskal-Wallis, Friedman, and Wilcoxon tests (p < 0.05). The pulp of all teeth positively responded to cold a stimulus. The control group presented a significant increase in spontaneous sensitivity at 12 h (p < 0.05), which decreased to the preoperative level after 14 days. In both IR and R groups, the sensitivity levels remained stable over time (p > 0.05). At both 7- and 14-day follow-ups, the spontaneous sensitivity for the IR group was significantly lower than the other groups (p < 0.05). In addition to preserving tooth sensitivity, selective deep caries removal can be associated with R or IR to respectively attenuate or completely resolve postoperative sensitivity within one week.

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INTRODUCTION: Parkinson's disease (PD) is becoming more prevalent, highlighting the urgency of developing treatments to minimize its effects on muscular strength and physical function. Power training (PT) is a potential approach that may improve endurance and muscular power, essential for maintaining functional ability in PD. OBJECTIVE: To compare the effect of PT versus control or other physical activity (PA) interventions on physical functional performance (PFP) in PD patients. METHODS: We searched PubMed, MEDLINE, Embase, LILACS, PEDro, Cochrane Library, and Scopus. Inclusion criteria were randomized controlled trials comparing PT to a control group or another PA intervention in PD patients. PFP was the primary outcome. Pooled effect estimates were calculated from baseline to endpoint scores. RESULTS: From 21,558 results, four studies were included in the meta-analysis due to their moderate to high methodological quality. PT showed no significant effect on PFP outcomes compared to control groups (TUG: ES, -0.281; 95% CI, -0.693 to 0.130; P = 0.180; I2:0%; PWS: ES, 0.748; 95% CI, -0.768 to 2.265; P = 0.333; I2:88%; FWS: ES, 0.420; 95% CI, -0.950 to 1.791; P = 0.548; I2:83%; SLS: ES, 0.161; 95% CI, -0.332 to 0.655; P = 0.521; I2:0%). No differences were found between PT and alternative interventions (TUG: ES, 0.132; 95% CI, -0.394 to 0.657; P = 0.623; I2:0%; BBA: ES, 0.057; 95% CI, -0.430 to 0.544; P = 0.820; I2:0%). CONCLUSION: PT did not improve PFP compared to control or alternative interventions. More studies are needed to explore PT effects (e.g., higher volume, intensity, and combined types) in PD patients.

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Respiratory viruses, including SARS-CoV-2, influenza, parainfluenza, rhinovirus, and respiratory syncytial virus (RSV), are pathogens responsible for lower respiratory tract infections, particularly in vulnerable populations such as children and the elderly. Upon infection, these viruses are recognized by pattern recognition receptors, leading to the activation of inflammasomes, which are essential for mediating inflammatory responses. This review discusses the mechanisms by which these RNA respiratory viruses activate inflammasomes, emphasizing the roles of various signaling pathways and components involved in this process. Additionally, we highlight the specific interactions between viral proteins and inflammasome sensors, elucidating how these viruses manipulate the host immune response to facilitate infection. Understanding the dynamics of inflammasome activation in response to respiratory viruses provides critical insights for developing immunomodulatory therapeutic strategies aimed at mitigating inflammation and improving outcomes in respiratory tract infections.

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BACKGROUND: The ethanolamine oleate (EO) in different concentrations has been used in sclerotherapy of oral benign vascular lesions (OBVLs). The aim of the present study was to define demographic and clinical characteristics of patients with OBVLs treated with 5% EO. MATERIAL AND METHODS: A retrospective study was conducted of cases treated by sclerotherapy from 1992 to 2022, and medical records of 52 patients with OBVLs were analysed. Thus, 44 cases with complete data were selected and described. Categorical data were analyzed using the chi-square test, with the significance level set at 5% (p < 0.05). RESULTS: Mean age was 52.89 years (range seven to 82 years). The female sex was predominant (77%) and brown was the most common skin color (54%). Most lesions occurred on the lower lip (65.9%), tongue (11.4%), buccal mucosa (9.1%), upper lip (6.8%) and palate (25%.3%). Approximately 73% of the lesions were ≤ 1 cm, > 1 ≤ 2 cm (18.2%,) and > 2 cm (9.1%). Complete regression of the lesions occurred in 97.7% of the cases, with no case of recurrence and no need for complementary surgery. All patients were satisfied with the treatment. CONCLUSIONS: Sclerotherapy with 5% EO is a safe and effective method for the treatment of OBVLs.

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INTRODUCTION: The dissemination of information to caregivers of pediatric cancer patients in Chilean hospitals is now sporadic and contingent upon available time, underscoring the need for a systematic education program. This study assesses caregivers' perceptions of the information provided by healthcare teams to support the development of a national education program tailored to their needs. METHODS: A descriptive, prospective, multicenter study was conducted from June 2021 to March 2022 across six public hospitals in Chile. The study included caregivers of children undergoing cancer treatment. Caregivers completed a survey assessing the education received and their preferred educational methods. Data were analyzed using STATA 18 and Graph Pad 6.0, with qualitative responses analyzed through an iterative coding process. RESULTS: Of 173 respondents, 94% rated the education received as very good or good. While 51% felt well-informed at hospital discharge, 28% desired more information. Caregivers preferred information from healthcare teams (88%), websites (55%), and written materials (51%). Significant differences were found in preferred educational content based on cancer type and the time elapses since diagnosis. CONCLUSION: Caregivers generally rated the education provided positively but expressed a need for more structured and targeted information. The findings inform the design of a national education program, emphasizing the need for tailored content and improved communication strategies to enhance caregiver support.

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The complex relationship between chronic kidney disease (CKD) and neuroinflammation shows how important immunological processes are in mediating cognitive dysfunction and psychiatric symptoms in this disease. Proinflammatory cytokines and chemokines, such as IL-1ß and IL-6, are capable of crossing the blood-brain barrier, and, consequently, may contribute to neuropsychiatric symptoms including anxiety, depression, and cognitive impairment in CKD patients. The peptides of the renin-angiotensin system (RAS), with their dual functions in inflammation and neuroprotection, also highlight the intricate immunological mechanisms operating within the kidney-brain axis. Understanding these immunological pathways is essential for developing targeted interventions to modulate neuroinflammation and improve cognitive outcomes in individuals with CKD. Further research in renal immunology and neuroinflammation holds promise for advancing our understanding of the intricate connections between kidney health, brain function, and immune responses in the context of CKD. This review summarizes the critical role of immunological factors in the pathophysiology of CKD-related cognitive impairment and psychiatric disorders.

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INTRODUCTION: The CheckMate 816 study, a global phase III randomized trial, demonstrated that neoadjuvant treatment with nivolumab plus chemotherapy significantly improves event-free survival in patients with resectable non-small cell lung cancer (NSCLC). Additionally, the treatment significantly increases the rate of complete pathological response. We present the results of CheckMate 816 in an Argentine subpopulation to evaluate the efficacy and safety of the neoadjuvant treatment. MATERIALS AND METHODS: A retrospective observational and descriptive study was conducted at a high-volume single center in Argentina from January 2023 to March 2024. Patients received 360 mg of nivolumab plus chemotherapy and a platinum doublet every three weeks for three cycles before undergoing definitive surgery. The results were compared with the international trial and the Japanese population subgroup. RESULTS: Nine patients received neoadjuvant therapy, of whom eight underwent definitive surgery. All patients achieved complete (R0) resection, and in three cases, a complete pathological response was observed. Currently, all are alive and disease-free. DISCUSSION: The results obtained in the Argentine subpopulation were consistent with those observed in the global population and the Japanese subgroup. A high proportion of patients achieved a complete pathological response, an early indicator of therapeutic efficacy. Neoadjuvant therapy with nivolumab plus chemotherapy could be considered an effective treatment option for Argentine patients with resectable NSCLC.

Introducción: El estudio CheckMate 816, un ensayo global de fase III y aleatorizado, mostróque el tratamiento neoadyuvante con nivolumab más quimioterapia mejora significativamente la supervivencia libre de eventos y la tasa de respuesta patológica completa (RPC) en pacientes con cáncer de pulmón de células no pequeñas (CPCNP) resecable. Presentamos los resultados del CheckMate 816 en una subpoblación argentina para evaluar la eficacia y seguridad del tratamiento neoadyuvante. Materiales y métodos: Se realizóun estudio retrospectivo observacional y descriptivo en un único centro de alto volumen en Argentina en el periodo de enero 2023 hasta marzo 2024. Los pacientes recibieron 360 mg de nivolumab más quimioterapia con doblete de platino cada tres semanas durante tres ciclos, antes de someterse a cirugía definitiva. Se compararon los resultados con el ensayo internacional y el subgrupo de población japonesa. Resultados: Se reportóun total de nueve pacientes que recibieron neoadyuvancia de los cuales ocho fueron sometieron a cirugía definitiva. Todos alcanzaron una resección completa (R0) y en tres casos se logróuna RPC. Actualmente todos se encuentran vivos y libres de enfermedad. Discusión: Los resultados obtenidos en la subpoblación argentina fueron consistentes con los observados en la población global y en el subgrupo japonés. Una alta proporción de pacientes alcanzaron una RPC, indicador temprano de la eficacia terapéutica. El uso de neoadyuvancia con nivolumab más quimioterapia podría considerarse como una opción de tratamiento efectiva para pacientes argentinos con CPCNP resecable.

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• Although advances in the treatment of gynecological cancer have improved survival rates, they may also increase the effects of induced menopause, especially in young women. • Cancer treatments such as oophorectomy, gonadotoxic chemotherapy, and pelvic radiotherapy can induce menopause. • Gonadotoxic chemotherapy, especially alkylating-containing regimens, often damages ovarian function and may result in permanent menopause. • Pelvic radiotherapy usually results in permanent loss of ovarian function unless ovarian transposition is performed. • Diagnosing menopause after cancer is challenging, and common diagnostic criteria such as 12 months or more of amenorrhea and elevated follicle-stimulating hormone (FSH) levels are not entirely reliable, since ovarian function may return years after treatment. • A multidisciplinary approach to post-cancer menopause is essential and should include an appropriate line of care, since hormone replacement therapy after treatment of gynecologic malignancy is controversial.

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Immune checkpoint inhibitors (ICIs) have improved clinical outcomes in patients with non-small cell lung cancer (NSCLC) lacking targetable oncogenic alterations. However, their efficacy in individuals with such genomic alterations remains heterogeneous and poorly understood. In detail, certain oncogenic alterations in TP53, EGFR (uncommon mutations), KRAS (G12C), BRAF (non-V600E), MET (amplifications), FGFR1 and FGFR4, actively modify MAPK, PI3K, and STING signaling, thus remodeling tumoral immune phenotype and are associated with high TMB counts, enriched T lymphocyte tumor infiltration, and high expression of antigen-presenting molecules, supporting their consideration as part of the eligibility criteria for ICIs treatment. Nonetheless, other oncogenic alterations are associated with an immunosuppressive TME, low TMB counts, and downregulation of targetable immune checkpoints, in which novel therapeutic approaches are currently being tested to overcome their intrinsic resistance. In this context, this review discusses the fundamental mechanisms by which frequent driver alterations affect ICIs efficacy in patients with NSCLC, and outlines their prognostic relevance in the era of immunotherapy.

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INTRODUCTION: Children who suffer from severe caries in childhood may have negative impacts on the growth, development, nutritional problems and quality-of-life problems related to the oral health of the child and their family. There are no studies that have compared rehabilitative techniques of primary anterior teeth regarding patient-centred outcomes and even longevity of the restoration. Thus, this project aims to evaluate the effectiveness of restorative treatment of anterior primary teeth with monochromatic composite resin in single insertion through polyvinyl crowns, after selective removal of carious tissue compared with the effectiveness of conventional restoration. METHODS AND ANALYSIS: This study proposes to conduct a randomised clinical trial, composed of a sample of 194 deciduous central and lateral incisors with active cavitated lesions, simplified International Caries Detection and Assessment System (ICDAS) C+ score (active and extensive stage caries: ICDAS 5 and 6), with involvement of more than two surfaces. This sample will be divided into two experimental groups, both with selective removal of carious tissue: a group in which conventional restoration will be performed using opaque resins, and another group with monochrome resin with chameleon effect and polyvinyl crowns. The explanatory variables-gender, age, toothbrushing, use of fluoridated toothpaste and dental floss, and socioeconomic status-will be collected through a questionnaire with open questions. The progression of caries lesions after 24 months of follow-up will be considered as the primary outcome. Secondary outcomes will include tooth survival, longevity of restoration, quality of life, perception and satisfaction of the participants' parents/guardians. ETHICS AND DISSEMINATION: This protocol has been approved by the Human Research Ethics Committee of Universidade Metropolitana de Santos (protocol number: 6.019.297. Approved 24 April 2023). Results will be submitted to international peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER: NCT05875064.

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INTRODUCTION: Headache is common among patients diagnosed with pituitary adenoma (PA). There are still controversies regarding the headache presentation, pathophysiology and outcome after treatment in these patients. OBJECTIVES: To determine the prevalence of headache among patients with PA, describe their phenotypes and identify precipitating factors. Also, to evaluate prospectively if PA treatment leads to headache improvement. METHODS: Treatment-naïve adult patients with PA were included. A questionnaire based on the beta version of the International Classification of Headache Disorders 3rd edition was created to classify the headaches. Patients submitted to surgery or medical treatment were reevaluated at least three to six months after treatment. RESULTS: Headache during the previous 3 months was present in 62% of the 104 patients. The most prevalent phenotypes were migraine and tension-type headache. Trigeminal autonomic cephalalgias (TACs) were observed only in prolactinoma patients. Both genders presented headache at similar rates (64% in females and 58% in males) but patients with headache were younger (41.5 ± 13.8 vs. 56.8 ± 13.6 years). Tumor characteristics were not determinant of headache. Patients with acromegaly that presented headache had higher GH levels. Headache was more frequent in prolactinomas (83%) than in NFPA (52%). After disease remission or control, resolution of headache was observed in 83%, 50% and 33% of the NFPA, somatotropinomas and prolactinomas, respectively. CONCLUSIONS: Migraine and tension-type are the most common headache phenotypes in PA patients, and TACs were only observed in prolactinomas. Also, headache was more common in prolactinomas than in NFPA. GH levels were higher in patients with acromegaly that presented headache. Surgical and medical treatments completely resolve the headaches in 50% of the patients.

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BACKGROUND: Type 2 diabetes is the fastest-growing global health concern, and its global prevalence is projected to affect 643 million individuals by 2030. Social media platforms, like Facebook, have become crucial channels for healthcare organisations to engage with the public to promote prevention and disease management, especially in low-resource settings like Honduras. This study aims to perform a retrospective analysis of Honduran healthcare organisations' Facebook posts to understand how effectively they engage diabetes-related content with their followers. METHODS: The top 10 followed healthcare organisations' Facebook pages were taken as a sample. Data were retrieved from October 2023 to March 2024. Diabetic-related posts were identified using keywords and categorised based on their contents and features. RESULTS: Findings reveal significant disparities in the frequencies of posts and public engagement among different types of organisations. The majority of posts were classified under the miscellaneous category and text+image feature. Recipes and food-related posts were liked and shared the most among the followers. CONCLUSION: The results of the study found that patients' engagement with diabetes-related content was low in social media. The gap between patients' participation and engagement highlights the need for reassessment and refinement of social media communication strategies for healthcare organisations to empower patients with diabetes through social media and increase public engagement.

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BACKGROUND: The COVID-19 pandemic has resulted in a critical shortage of respiratory ventilators, highlighting the urgent need to explore alternative treatment options for patients with acute respiratory distress syndrome (ARDS) caused by respiratory viruses, as an alternative to invasive mechanical ventilation (IMV) in future pandemics. OBJECTIVES: The objective of this study was to assess the effectiveness of alternative noninvasive oxygenation and ventilation strategies in comparison to invasive mechanical ventilation (IMV) in patients with virus-induced acute respiratory failure (ARF). The primary outcome was the all-cause ICU mortality rate. METHODS: A systematic review was conducted following the Cochrane guidelines and PRISMA reporting guidelines. The search encompassed databases such as Medline, Cochrane CENTRAL, and Embase to identify relevant indexed literature. Additionally, gray literature was included by consulting regulatory agencies. The included studies compared various oxygenation and ventilatory alternatives, such as high-flow nasal cannula (HFNC), continuous positive airway pressure (CPAP), or noninvasive mechanical ventilation (NIMV) with IMV. An exploratory meta-analysis was performed by calculating the risk ratio (RR) by random effects and meta-regression to explore possible sources of heterogeneity and to compare ventilatory alternatives against IMV to reduce mortality, length of stay (LOS) days in ICU, nosocomial infection, and barotrauma. RESULTS: A total of forty-seven studies were included in this systematic review. NIMV had an RR of 0.70 (0.58-0.85), HFNC had an RR of 0.54 (0.42-0.71), and CPAP had an RR of 0.80 (0.71-0.90), with meta-regression models that reduced heterogeneity to 0%. For LOS days in ICU, NIMV had 0.38 (- 0.69: - 0.08) lower days and HFNC 0.29 (- 0.64: 0.06) lower days with meta-regression models that reduction heterogeneity to 0% for HFNC and 50% for NIMV. Not enough studies reported nosocomial infection or barotrauma to evaluate them in a meta-analysis. The overall quality of evidence, as assessed by GRADE evaluation, was determined to be from very low to medium certainty depending on the ventilatory strategy and outcome. CONCLUSIONS: The findings of this systematic review support the use of alternative noninvasive oxygenation and ventilation strategies as viable alternatives to conventional respiratory ventilation for managing viral-induced ARF. Although it is essential to interpret these findings with caution given the overall low to medium certainty of the evidence, the integration of these modalities as part of the management strategies of these patients could help reduce the utilization of ICU beds, invasive ventilators, and costs in both developed and developing countries.

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to analyze the vaccination status of individuals with type 1 and type 2 diabetes in Primary Healthcare.cross-sectional, analytical study conducted in 25 Family Health teams with 274 individuals with diabetes. Sociodemographic and clinical variables were evaluated, as well as the full vaccination schedule for each vaccine recommended by the National Immunization Program, through bivariate analysis and logistic regression.among individuals with diabetes mellitus, the following incomplete vaccination rates were found: 69.1% for hepatitis B; 64.6% for diphtheria and tetanus; 74.3% for yellow fever; 87.9% for pneumococcus; 87.9% for varicella; 24.5% for influenza; and 0.7% for COVID-19. The reported reasons for low vaccination rates included not knowing the importance of vaccination and not being informed by healthcare providers. A statistically significant association was found between sociodemographic and clinical profile regarding the full vaccination schedule between the influenza vaccine and age and income; COVID-19 and age, type of diabetes and duration of diabetes.individuals with type 1 and type 2 diabetes treated in Primary Healthcare showed low vaccination rates, which is concerning due to increased vulnerability to vaccine-preventable infections and mortality within this group. BACKGROUND: (1) Individuals with diabetes have low vaccination rates. (2) It is essential to provide vaccination opportunities in health services for individuals with diabetes. (3) Education for vaccine-prescribing professionals is necessary. (4) Young people are less likely to get vaccinated than older adults. (5) It is essential to understand the predisposing factors related to vaccination status.

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BACKGROUND: Previous studies have shown that women with coronary artery disease (CAD) are less likely to undergo angiography and have less favorable outcomes after percutaneous coronary intervention (PCI). OBJECTIVES: Assess the outcomes of women with acute coronary syndrome (ACS) and stable CAD (lesion>50%) treated with contemporary PCI using DES. METHODS: Observational, longitudinal cohort study with prospective follow-up included all female patients ≥ 18 years admitted at a tertiary public cardiovascular center in Brazil from January 2019 to December 2020. The level of significance adopted in the statistical analysis was 5%. RESULTS: 1146 women (average age 65 years) underwent guideline-recommended PCI. Risk factors were frequent (hypertension: 88%, dyslipidemia: 85%, diabetes: 47.5%), and 69% were admitted due to ACS. Radial access was used in 59% of patients; 1516 vessels were treated with 1725 stents implanted (1.5 stents/patient). PCI was successful in 97.7%, in-hospital death occurred in 1.2%, peri-procedural MI in 3.6%, and TIA in 0.4%. Predictors of in-hospital major adverse cardiac and cerebrovascular events (MACCE): previous stroke (OR: 2.97; CI: 1.06-7.15; p= 0.023), CKD (OR: 3.11; CI: 1.49-6.20; p= 0.002), and at least one procedural failure during PCI (OR: 10.2; CI: 1.17-5.9; p<0.001). The average follow-up was 576.2 days in 1047 patients. All-cause mortality occurred in 5.3%, cardiac death in 3.5%, recurrent ACS in 8%, and additional revascularization procedures in 5.5%. The predictors for MACCE during FU were hospital admission for ACS for the index PCI (OR: 1.58; HR: 1.06-2.35; p=0.023) and the presence of MACCE during hospitalization (OR: 6.66; HR: 2.42- 18.3; p< 0.001). CONCLUSION: In this pioneering study involving 1146 patients treated by contemporary PCI and followed for almost 2 years, we obtained very encouraging in-hospital and mid-term results.

FUNDAMENTO: Estudos prévios demonstram que mulheres com doença arterial coronariana (DAC) são menos submetidas a angiografia e apresentam resultados menos favoráveis após intervenção coronariana percutânea (ICP). OBJETIVOS: Avaliar os resultados de mulheres com síndrome coronariana aguda (SCA) e DAC estável (lesão>50%) tratadas com ICP contemporânea usando stents liberadores de drogas. MÉTODOS: Estudo de coorte observacional, longitudinal, com acompanhamento prospectivo, que incluiu todas as pacientes do sexo feminino > 18 anos admitidas em centro cardiológico público terciário no Brasil, no período de janeiro de 2019 a dezembro de 2020. RESULTADOS: 1146 mulheres (idade média de 65 anos) foram submetidas à ICP recomendada pela diretriz. Os fatores de risco foram frequentes (hipertensão: 88%, dislipidemia: 85%, diabetes: 47,5%) e 69% foram internadas devido à SCA. O acesso radial foi usado em 59% das pacientes; 1516 vasos foram tratados com 1725 stents implantados (1,5 stents/paciente). A ICP foi bem-sucedida em 97,7%, a morte intra-hospitalar ocorreu em 1,2%, IM periprocedimento em 3,6% e ataque isquêmico transitório em 0,4%. Preditores de eventos adversos cardíacos e cerebrovasculares maiores (ECCAM) intra-hospitalares: acidente vascular cerebral prévio (OR: 2,97; IC: 1,06-7,15; p = 0,023), DRC (OR: 3,11; IC: 1,49-6,20; p = 0,002) e pelo menos uma falha de procedimento durante ICP (OR: 10,2; IC: 1,17-5,9; p < 0,001). O acompanhamento médio foi de 576,2 dias em 1.047 pacientes. Mortalidade por todas as causas ocorreu em 5,3%, morte cardíaca em 3,5%, nova SCA em 8% e necessidade de nova revascularização em 5,5%. Os preditores de ECCM durante o seguimento foram admissão por SCA (retirar índice ICP) e a presença de ECCM durante a hospitalização (OR: 6,66; HR: 2,42-18,3; p< 0,001). CONCLUSÃO: Neste estudo pioneiro envolvendo 1146 pacientes tratados por ICP contemporânea e acompanhados por quase 2 anos, obtivemos resultados hospitalares e de médio prazo muito encorajadores.

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BACKGROUND: Rapid progression of symptoms and development of Acute Respiratory Distress Syndrome (ARDS) frequently occurred during COVID-19 pandemic, while CT-Scan was useful to assess severity of lung damage, with classic patterns like early Ground Glass Opacity and/or late consolidation. Likewise, lung injury has been related to activation of the coagulation-fibrinolysis systems and pro-inflammatory mediators; where D-Dimer acquires prognostic relevance. The present study aimed to evaluate whether the extent of lung involvement and pattern of lung injury, as determined by chest CT-scan, are related with D-Dimer; and further impact clinical prognosis in patients with ARDS due to COVID-19. METHODS: Longitudinal, prospective, observational, multi-center study. Patients diagnosed with ARDS due to COVID-19, without previous lung damage, clotting disorder and/or anticoagulants use, who were attended at the Intensive Care Unit and Internal Medicine Department from March to June 2020. Tomographic extent of lung involvement was analyzed by image software, as well as damage patterns, assessed by experienced radiologists. Endpoints included relation of lung injury with coagulopathy markers like D-Dimer, and prognostic outcome including mortality, mechanical ventilation and hospitalization time. RESULTS: One-hundred and four patients mean aged 55 years old, 66% males, main comorbidities obesity, hypertension and diabetes mellitus. Larger lung damage was associated with older age, male gender and higher pro-inflammatory mediators like leukocytes and ferritin; whilst consolidation pattern was related to higher Body Mass Index. Higher values of D-Dimer were related either to a larger extent of lung involvement or late consolidation pattern. In addition, the extent of lung involvement was related with longer hospital stay, higher requirement of mechanical ventilation (HR 0.12, p < 0.01) and mortality rate (HR 0.13, p < 0.01); whereas late consolidation was mainly associated with requirement of mechanical ventilation (HR 0.23, p < 0.01). CONCLUSION: Tomographic extent of lung involvement and the pattern of lung injury are related with coagulopathy severity markers like D-Dimer, and own prognostic clinical ability in ARDS.

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Atypical hemolytic uremic syndrome (aHUS) is a rare cause of thrombotic microangiopathy (TMA) caused by the dysregulation of the alternative complement pathway. The diagnosis of TMA is made clinically by the triad: microangiopathic hemolytic anemia, thrombocytopenia, and organ damage (mainly acute kidney injury). The heterogeneity of clinical manifestation and the lack of a gold standard diagnostic test makes the precise diagnosis of aHUS a challenging process that may impact patient management. Until one decade ago, there was no specific treatment for aHUS and patients were submitted to plasma therapy (plasma exchange and/or plasma infusion) and/or liver transplantation, procedures that are not free of serious complications and that do not address the underlying pathophysiology of the disease. Since 2011, an anti-C5 complement monoclonal antibody has been approved by the Food and Drug Administration (FDA) for aHUS patients beginning a new era in treatment. Clinical trials on new complement inhibitors may also add to the treatment portfolio in the future. The Brazilian population is a mixed race with a unique genetic and clinical profile. This consensus aims to offer recommendations for the diagnosis and treatment of patients with aHUS in this population based on expert experience, data from the aHUS Brazilian Registry and literature review. The GRADE system was used to classify the quality of the evidence.

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INTRODUCTION: Pain is one of the primary symptoms affecting individuals with rotator cuff tendinopathy. Physical exercise serves as the main approach for managing this condition, aiming to restore movement patterns, optimise scapular kinematics and improve strength and local muscular endurance. Pain neuromodulation techniques, such as transcranial direct current stimulation (tDCS), may offer complementary non-pharmacological options for pain relief by promoting central modulation and altering cortical excitability. METHODS AND ANALYSIS: This protocol outlines a randomised, blinded clinical trial. Participants will be randomly allocated to two groups: G1 (active tDCS combined with progressive exercise) and G2 (sham tDCS combined with progressive exercise). The protocol will span 4 weeks, with two sessions per week. Pain intensity, measured using the numerical pain scale, will serve as the primary outcome. Secondary outcomes will include physical function, range of motion, global perception of change and treatment adherence. ETHICS AND DISSEMINATION: This protocol was approved by the Ethics Committee Health Sciences College of Trairi, Federal University of Rio Grande do Norte (number: 6.821.408). Followed the Declaration of Helsinki recommendations for research with human beings. The results will be published later in peer-reviewed journals and scientific events. TRIAL REGISTRATION NUMBER: The Brazilian Registry of Clinical Trials (RBR-59xmv6s); Results.

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BACKGROUND: Multimodal rehabilitation has shown good results in adults with temporomandibular disorder (TMD), but there is still doubt regarding the protocol's ideal format (face-to-face or online), and its effectiveness among adolescents. The purpose of this study is to describe a randomized clinical trial protocol of face-to-face and online multimodal rehabilitation, in adolescents with TMD, and to determine its effects on pain, peripheral oxygenation of the masseter muscle, and mandibular range of motion, kinesiophobia and parafunction. METHODS: A randomized, controlled clinical trial, blinded to statistical analyses, will be carried out, involving 26 adolescents, diagnosed with TMD. After randomization, the participants will be allocated into two groups: (1) telerehabilitation and (2) face-to-face treatment groups. Each group will undergo an initial assessment, followed by three treatment sessions, reassessment, and follow-up. Appointments and reassessments will be face-to-face, with instruments validated and adapted for adolescent age groups. The intervention protocol also aims at practicality, ease of execution, and strategies for the patient to easily self-manage and perform independently, adapted for face-to-face or online formats. The Diagnostic Criteria for Temporomandibular Disorders, physical and psychosocial aspects, algometry, near-infrared spectroscopy, and the Tampa scale for kinesiophobia will be used to assess the outcomes. DISCUSSION: It is expected that this study will contribute to online and face-to-face assessments and demonstrate the differences in the practice of rehabilitation of adolescents with TMD. Data will be published after the study is completed, and if the benefits are proven, care modalities may be implemented. TRIAL REGISTRATION: REBEC-RBR-5scd5tm, UTN code: U1111-1288-4495 . Registered on 19 May 2023.