Prognostic immunotherapy score (PIS) in patients with advanced urothelial carcinoma treated with pembrolizumab: real-world data and validation from ARON-2 dataset.

Recent years have seen the development and advent of novel combinatorial strategies based on immunotherapy, and immune checkpoint inhibitor (ICI) - based treatment has established itself as a mainstay in the treatment of metastatic urothelial carcinoma (UC). Herein, we aimed to validate the prognostic value of a previously developed score, the Prognostic Immunotherapy Score (PIS), including female sex, Eastern Cooperative Oncology Group Performance Status (ECOG-PS) and liver metastases, in patients treated with pembrolizumab for advanced UC from the ARON-2 dataset. We retrospectively analyzed clinical data from Metastatic UC patients diagnosed at age ≥ 18 years.

Insights from the first 820 patients from the Brazilian Multicenter Registry of Hereditary Angioedema: the key role of genetic testing and targeted therapies.

Background: Hereditary angioedema (HAE) is a rare autosomal dominant disorder with a prevalence of 1:50,000 individuals. Delayed diagnosis and deaths from asphyxia still occur.

Objective: To identify knowledge and management gaps regarding clinical, genetic, and therapeutic aspects of HAE in Brazil, aiming to improve patient care and outcomes.

Quality of Hand Hygiene Performance: A Systematic Literature Review.

Background: Hand hygiene (HH) is essential for infection prevention in healthcare, but the quality of its performance, meaning how well it is done, receives much less attention than compliance. This review examines how HH technique is assessed and can be improved among healthcare providers.

Methods: Following PRISMA guidelines, six databases were searched through May 15, 2025.

Digital Health in Low-Resource Settings: Comprehensive Challenges and Opportunities With a Focus on Stroke Care.

The global transition to digital health offers a critical opportunity to transform health care delivery, particularly in low- and middle-income countries. Stroke care exemplifies the need for timely, coordinated, and longitudinal management across health systems. Although substantial progress has been achieved, low- and middle-income countries continue to encounter persistent challenges, including infrastructural deficiencies, digital inequity, fragmented governance structures, and limitations within the health care workforce.

Short-term effects of remote ischemic conditioning on vascular function in patients with cardiovascular diseases: a systematic review with meta-analysis.

Objective: The purpose of this systematic review with meta-analysis was to compare the short-term (≤1 month) effects of remote ischemic conditioning versus sham remote ischemic conditioning on vascular function in patients with cardiovascular diseases.

Methods: A systematic review was conducted to identify relevant studies through six healthcare science databases up to March 2025. Arterial stiffness and endothelial function were defined as the primary outcome.

Characteristic competencies for effective teachers in healthcare education.

Teachers have the significant potential to facilitate alterations in the teaching-learning process that can positively affect student outcomes. In the healthcare field, exposure to effective teachers is associated with enhanced clinical performance and student knowledge. The literature explores several characteristics that increase the possibility of obtaining better outcomes when developed by teachers.

Cost-benefit analysis of implementing Vendor Neutral Archive (VNA) technology in the Brazilian Public Health System.

Objective: To conduct an ex-ante cost-benefit analysis of implementing Vendor Neutral Archive technology in the Brazilian Public Health System.

Methods: The cost-benefit analysis involves monetizing the potential costs and benefits of implementing Vendor Neutral Archive in the Brazilian Public Health System, focusing on comparing these values using the return on investment measure.

Results: The aggregate analysis at the Brazilian Public Health System level reveals that the estimated return on investment for the first year after Vendor Neutral Archive implementation is 5.

Transrectal prostate biopsy complications: a prospective single center study in a mid-income country.

Objective: To identify complications following transrectal posterior biopsies in a public Brazilian reference center, and to identify the risk factors associated with complications.

Methods: This is a prospective cohort study that employed a form designed by the Global Prevalence Infections in Urology study. Data from 1,043 consecutive patients who underwent transrectal prostate biopsy at a single Brazilian center were analyzed, including patient characteristics, procedural characteristics, and self-assessed complications at 28 days.

Efficacy and Safety of a Novel Triple Single-Pill For Uncontrolled Hypertension: the OPTION TREAT Trial.

Background: Novel single-pill combinations with blood pressure (BP)-lowering agents are needed to increase treatment options for hypertension.

Objectives: To assess the efficacy and safety of a novel single-pill (candesartan cilexetil, amlodipine, and chlorthalidone) compared with an active control (valsartan, amlodipine, and hydrochlorothiazide) for uncontrolled hypertension.

Methods: OPTION TREAT was a randomized, double-blind, double-dummy, noninferiority trial conducted across 19 sites in Brazil.

Early Withdrawal of Aspirin after PCI in Acute Coronary Syndromes.

Background: Whether potent P2Y12 inhibitor monotherapy without aspirin initiated shortly after successful percutaneous coronary intervention (PCI) is effective and safe for patients with acute coronary syndromes is unclear.

Methods: We conducted a multicenter, open-label, randomized trial in Brazil involving patients with acute coronary syndromes who had undergone successful PCI. Patients were assigned in a 1:1 ratio within the first 4 days of hospitalization to stop treatment with aspirin and receive potent P2Y12 inhibitor monotherapy (ticagrelor or prasugrel) or to receive dual antiplatelet therapy (aspirin and a potent P2Y12 inhibitor) for 12 months.

National trends in laryngectomy and the influence of hospital volume on short-term outcomes in Brazil: A 16-year cross-sectional analysis.

Objective: Analyze the trends and outcomes of total laryngectomy in Brazil, focusing on the influence of surgical volume on mortality.

Methods: A retrospective, population-based study was conducted using data from the Brazilian Unified Health System (SUS) between 2008 and 2023. Total laryngectomies were identified through specific procedure codes, and hospitals were categorized into quartiles based on surgical volume.

Stress-inducible phosphoprotein 1 (STIP1) is a critical stemness regulator in mouse embryonic stem cells and early mammalian development.

Proteostasis, maintained by a network of molecular chaperones, plays a central role in cell biology, and has emerged as a critical mechanism underlying pluripotency and development. The stress-inducible phosphoprotein 1 (STIP1) is a co-chaperone essential for proteostasis. STIP1 knockout causes embryonic lethality in mice, but its precise function during embryogenesis remains poorly understood.

Polymorphism in IFNλ Can Impact the Immune/Inflammatory Response to COVID-19 Vaccination in Older CMV-Seropositive Adults.

Background: Chronic cytomegalovirus (CMV) infection may favor the development of immunosenescence and inflammation that impair vaccine responses, including COVID-19. In addition, the polymorphism of the interferon-lambda gene (IFNλ) affects COVID-19 immune responses in older adults.

Objective: We aimed to investigate the impact of IFNλ polymorphism ( gene-rs12979860) on the immune/inflammatory response to vaccination with CoronaVac for COVID-19 in older adults who were CMV-seropositive.

Angiotensin-Converting Enzyme Inhibition and/or Angiotensin Receptor Blockade Modulate Cytokine Profiles and Improve Clinical Outcomes in Experimental COVID-19 Infection.

The regulation of angiotensin-converting enzyme 2 (ACE2) expression by medications such as ACE inhibitors (ACEis) and angiotensin receptor blockers (ARBs) has raised critical questions regarding their potential benefits and risks during COVID-19. ACE2, a regulator of blood pressure through the renin-angiotensin system (RAS), is the primary receptor for SARS-CoV-2. ACEis and ARBs can modulate ACE2 expression, potentially exacerbating viral load.

Preserving medical confidentiality in Brazilian criminal investigation cases: a narrative review of the principles of bioethics.

Medical confidentiality is a fundamental element of the doctor-patient relationship, ensuring a secure environment for sharing sensitive information. This narrative review examines the ethical and legal challenges faced by physicians in Brazil when balancing professional secrecy with the legal duty to report, particularly in the context of criminal investigations. Grounded in the core bioethical principles of autonomy, beneficence, non-maleficence, and justice, the study analyzes Brazilian constitutional and infra-constitutional norms, including the Penal Code, the Code of Criminal Procedure, and the Code of Medical Ethics.

Intracellular and Extracellular Vesicle miRNA Signatures in Human iPSC-Derived Neural Stem Cells and Floor Plate Progenitors.

Refined control of intrinsic and extrinsic signals is critical for specific neuronal differentiation. Here, we differentiated human induced pluripotent stem cells (hiPSCs) from three different healthy donors into neural stem cells (NSCs) and floor plate progenitors (FPPs; progenitors of dopaminergic neurons) and further performed intracellular and extracellular vesicles' (EVs) miRNA profiling. While NSC and FPP cells differed significantly in levels of only 8 intracellular miRNAs, their differences were more evident in the EV miRNAs with 27 differentially expressed miRNAs.

Feasibility, efficacy, and safety of sheathless transradial mechanical thrombectomy in acute ischemic stroke: A meta-analysis.

Introduction: Mechanical thrombectomy (MT) is the standard of care for large vessel occlusions (LVO) in acute ischemic stroke (AIS), traditionally performed using transfemoral access (TFA). However, the sheathless transradial approach (sTRA) has emerged as a viable alternative, particularly for patients with complex vascular anatomies.

Objectives: This systematic review and meta-analysis aim to evaluate the feasibility, efficacy, and safety of sTRA in MT for AIS.

Real-Life Clinical Validation of AI-Assisted Detection and Differentiation of Pleomorphic Lesions in Capsule Endoscopy.

Background And Aims: Capsule endoscopy (CE) is a minimally invasive procedure designed for small bowels' evaluation. However, prolonged reading times and a risk of missing clinically significant findings limit its potential. Prospective clinical validation studies of artificial intelligence (AI) for CE remain scarce.