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.

Entangled cellular and molecular relationships at the sensory neuron-cancer interface.

Peripheral sensory neurons, once regarded merely as a passive route for nociceptive signals, are now acknowledged as active participants in solid tumor progression. This review explores how sensory neurons influence and are influenced by the tumor microenvironment (TME) through both chemical and electrical signaling, underscoring their pivotal role in the emerging field of cancer neuroscience. We summarize recent findings indicating that cancer-neuron interactions vary among different organs and experimental models, highlighting the ways in which various tumors recruit and reprogram sensory neurons to establish mutual communication loops that foster malignancy.

Preoperative knee laxity is not associated with subjective knee function or revision surgery after primary anterior cruciate ligament reconstruction: An analysis of 5425 patients.

Purpose: To determine whether preoperative knee laxity, as measured by the KT-1000 arthrometer, was associated with subjective knee function preoperatively and at 1, 2 and 5 years, or with revision anterior cruciate ligament (ACL) reconstruction (ACLR) within 5 years of the primary surgery.

Methods: Patients who underwent primary ACLR using a hamstring tendon autograft at the Capio Artro Clinic, Stockholm, Sweden, between January 1, 2005, and December 31, 2018, and had no associated ligament injuries, were identified. The KT-1000 arthrometer (134-N) was used to assess knee laxity preoperatively.

Cleaning and disinfection in neonatal intensive care units: correlation of evaluation methods.

Objectives: to correlate surface cleaning and disinfection monitoring methods in two neonatal intensive care units and compare threshold values for adenosine triphosphate.

Methods: a correlational study with 864 assessments was conducted using adenosine triphosphate quantification, visual inspection, aerobic colony count, Staphylococcus aureus detection, and resistance testing before and after hygiene procedures.

Results: in Unit A, correlations were found between colony count and Staphylococcus aureus on the counter (phase I; P=0.

Interconnected study of molecular pathways: miR-137 as a central element at the intersection of lipid metabolism and prostate carcinogenesis.

Objective: To evaluate the roles of miR-137 and its target genes in lipid metabolism and prostate tumorigenesis.

Methods: We used a series of bioinformatic approaches to establish the relationship between miR-137 and its target genes. We mapped the metabolic pathways of interest in the Reactome database and identified the central target genes of miR-137 in this pathway using four platforms: Reactome, miRDB, miRmap, and TargetScan.

Brain health: a new concept to the neurologist - an initiative of the Lifestyle Medicine Commission of the Brazilian Academy of Neurology.

Brain health is an emerging concept that is gaining international attention. It encompasses cognitive, sensory, social-emotional, behavioral, and motor functions that enable people to reach their maximum potential throughout all stages of life. With substantial preventable components, neurological diseases-including stroke and dementia-are the second largest cause of death worldwide and of disability-adjusted life years (DALYs).

Comparable Outcomes Across 4 Hamstring Tendon Graft Configurations in ACL Reconstruction, Despite Increased Knee Laxity With Gracilis Tendon Harvesting.

Background: There is a lack of studies that have thoroughly compared subjective and objective outcomes in patients undergoing anterior cruciate ligament reconstruction (ACLR) using different hamstring tendon (HT) graft configurations.

Purpose/hypothesis: The purpose of this study was to compare anterior knee laxity, isokinetic knee extension and flexion strength, single-leg hop (SLH) test performance, subjective knee function, and the 5-year revision surgery rates between patients who underwent ACLR using 4 HT graft configurations. It was hypothesized that there would be no significant differences in the outcomes examined between the groups.

Pre-Exposure Prophylaxis Use Among Cisgender and Transgender Adult Entertainment Workers in Brazil.

Adult entertainment work may be associated with increased vulnerability to sexually transmitted infections, particularly HIV. In Brazil, pre-exposure prophylaxis (PrEP) for HIV infection has been available through the Brazilian Unified Health System (SUS) since November 2017, representing a significant advancement in public sexual health policy. The objective of this study was to understand the individual and social determinants that promote PrEP use among adult entertainment workers.

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.

Minimizing and Managing Hepatic Vein and Portal Vein Complications in Pediatric Liver Transplantation.

Pediatric liver transplantation (PLT) is challenged by anatomical variability and small vessel size, especially in partial grafts. This review outlines strategies to minimize and manage complications of hepatic vein (HV) and portal vein (PV) reconstruction. HV reconstruction employs vein unification, direct caval implantation, or interposition grafts to prevent outflow obstruction, with diagnosis and management guided by imaging and interventional radiology.

Oral Manifestations, Dental Interventions, and Clinical Outcomes in Hospitalized COVID-19 Patients: A Two-Year Cohort Study in São Paulo, Brazil.

To investigate the demographic, epidemiological, and medical profiles of hospitalized COVID-19 patients who received dental care, and to identify their main oral health needs. This retrospective, descriptive cohort study analyzed medical and dental records of patients hospitalized with COVID-19 at a private tertiary hospital in São Paulo, Brazil, from January 2020 to March 2022. The data collected included demographic variables, comorbidities, length of hospitalization, need for respiratory support, clinical outcomes, dental diagnoses, and procedures performed.

Person-centered clinical method: application in the occupational context.

Health promotion, which is important for health policies in Brazil and worldwide, enhances patient self-awareness and autonomy, strengthening the relationship between health care professionals and patients by negotiating care priorities and goals, resulting in the efficient use of health resources. These principles align with the person-centered clinical method, a theoretical framework that offers techniques to assist health care professionals in clinical practice, especially physicians. This method positions the patients as the protagonists of their own health, actively participating in setting priorities and making decisions.

Impact of syndromic molecular diagnostics on antimicrobial adequacy and time to therapy in critically ill patients with pneumonia: a systematic review and meta-analysis of randomized trials.

Background: Pneumonia is a leading cause of ICU admission and mortality, requiring prompt and adequate antimicrobial therapy to improve outcomes. Conventional cultures are slow and often insensitive, delaying targeted treatment. Syndromic PCR panels offer rapid identification of pathogens and resistance genes directly from respiratory samples, potentially improving early antibiotic optimization.

PCSK9 targeting therapies for familial hypercholesterolaemia: a meta-analysis of efficacy on lipid biomarkers and safety in adults and children across 23 RCTs.

Background: Familial hypercholesterolaemia (FH) is a hereditary disorder characterised by elevated low-density lipoprotein cholesterol (LDL-C) levels, substantially increasing the risk of atherosclerotic cardiovascular disease. Proprotein convertase subtilisin/kexin type 9 (PCSK9) targeting therapies, including monoclonal antibodies and small interfering RNA (siRNA) agents, have emerged as effective lipid lowering therapies.

Objective: To assess the efficacy and safety of PCSK9-targeting therapy on lipid biomarkers and adverse events in patients with FH, compared with placebo on the background of standard lipid-lowering therapy.

Maximizing the Conspicuity of CSF-Venous Fistulas on CT Myelography: Assessment of Contrast Density and Timing Effects.

Background And Purpose: Advancements in CT myelography (CTM) have improved visualization of CSF-venous fistulas (CVFs), a frequent cause of spontaneous intracranial hypotension (SIH). However, the relative impact of the timing of image acquisition and the contrast density in the subarachnoid space remains unclear. This study compared the effects of timing and contrast density in the ipsilateral subarachnoid space and assessed the impact of other technical factors on CVF conspicuity, using a validated instrument to stratify diagnostic confidence.

Clinical and Epidemiological Profile of Heart Failure Patients With Chagas Disease: Insights From the SEPE-HF Registry.

Chagas cardiomyopathy (Ch-CMP) represents a unique and understudied phenotype of heart failure (HF) in endemic regions, with distinct clinical, electrocardiographic, and therapeutic characteristics compared to non-Chagas HF. In this retrospective cohort of 417 patients hospitalized for decompensated HF at a tertiary center in Brazil, 155 (37.1%) had confirmed Ch-CMP.

Evidence-based practice knowledge, attitude and skills among healthcare professionals: a quasi-experimental study.

Objective: To analyze health professionals' knowledge, attitude, and skills before and after implementing the evidence-based practice (EBP) methodology of the Joanna Briggs Institute (JBI).

Method: A quasi-experimental study was conducted in a private hospital between June and December 2021 after implementing an institutional evidence-based practice program. Best practice projects in care units were developed according to the JBI framework.

mRNA expression, tumor heterogeneity, and response to therapy in patients with advanced renal cell carcinoma treated with immune-based combinations (ARON-1α).

Background: Renal Cell Carcinoma (RCC) represents a spectrum of tumors, characterized by heterogeneous growth patterns, histology and response to immune-based combinations.

Objectives: The aim of the present retrospective analysis was to investigate the mRNA expression of 32 genes associated with RCC carcinogenesis and their potential involvement in patients treated with first-line immune-based combination therapies. Additionally, we examined the role of tumor heterogeneity by comparing mRNA expression levels between primary renal tumors and metastatic sites in a group of patients included in the ARON-1 study.

Efficacy and Safety of Landiolol in the Treatment of Tachycardia in Patients With Sepsis and Septic Shock: A Systematic Review and Meta-Analysis.

Landiolol is being investigated for its potential to manage septic shock (SS) and sepsis-related tachyarrhythmias (TA). We performed a systematic review and meta-analysis of three randomized controlled trials (RCTs) involving 473 patients with sepsis or SS, including those with TA, comparing landiolol to standard therapy-controlled (STC) groups. Standard therapy consisted of usual sepsis care ± placebo but excluded β-blockers in the control arms.

Informative statements to communicate the findings of systematic reviews of interventions: Cross-cultural translation of GRADE plain language into Portuguese language.

Objective: Transparent and easy-to-understand communication can enhance the dissemination of systematic reviews (SR) results to interest-holders. The GRADE Working Group developed an approach to improve the communication of results from SR of interventions in the English language. Here, we present the cross-cultural translation into Brazil Portuguese language of this approach.