Clinics最新文献

{"title":"Cost-effectiveness of selective laser trabeculoplasty as a replacement for hypotensive eye drops in the Brazilian public health system","authors":"Leopoldo Ernesto Oiticica Barbosa ,&nbsp;Wilma Lelis Barboza ,&nbsp;Ricardo Agusto Paletta Guedes ,&nbsp;Alfredo Chaoubah ,&nbsp;Marcelo Hatanaka","doi":"10.1016/j.clinsp.2025.100650","DOIUrl":"10.1016/j.clinsp.2025.100650","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to determine the cost-effectiveness of selective laser trabeculoplasty (SLT) as a replacement for hypotensive eye drops in the Brazilian Unified Health System (SUS).</div></div><div><h3>Methods</h3><div>The authors conducted a cost-effectiveness economic assessment using data from a previously published prospective, non-randomized, single-arm interventional study. The costs were estimated from the perspective of the SUS, using data from the SIGTAP. The authors proposed a value of R$ 588.00 for bilateral SLT, based on the observed cost reduction with medications in the SLT group. Effectiveness was assessed as a reduction in intraocular pressure (IOP).</div></div><div><h3>Results</h3><div>The average annual cost of medications per patient was R$ 669.53 in the reference group (continuous use of eye drops) and R$ 80.62 in the intervention group (SLT). The average IOP reduction was 9.3 mmHg in the reference group and 9.8 mmHg in the intervention group. SLT proved to be a dominant strategy compared to the continuous use of eye drops, presenting a greater reduction in IOP and a lower total annual cost. The incremental cost-effectiveness ratio (ICER) was negative (-R$ 1.82), indicating that SLT is more effective and less costly.</div></div><div><h3>Conclusions</h3><div>SLT is a cost-effective alternative to hypotensive eye drops in the treatment of glaucoma in the SUS. The adoption of SLT can optimize resource allocation and improve clinical outcomes for patients with glaucoma. Implementing SLT at the proposed procedural cost optimizes spending by substantially reducing long-term medication costs and offering a sustainable alternative within the healthcare system.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100650"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of human serum albumin infusion in heart failure patients with hypoproteinemia: a propensity score-matched analysis","authors":"Tongqing Yao ,&nbsp;Yinhua Xi ,&nbsp;Fei Chen ,&nbsp;Hao Lin ,&nbsp;Jun Qian ,&nbsp;Xuebo Liu","doi":"10.1016/j.clinsp.2025.100659","DOIUrl":"10.1016/j.clinsp.2025.100659","url":null,"abstract":"<div><h3>Objectives</h3><div>Heart failure, especially in the elderly, is a growing global issue. This research explores the safety of human albumin infusion in treating heart failure patients with hypoalbuminemia, despite limited clinical data on its use with diuretic therapy.</div></div><div><h3>Methods</h3><div>Data were collected from the Medical Information Mart for Intensive Care III (MIMIC-III) database, which included a cohort of 6094 patients diagnosed with heart failure. Propensity score matching, logistic regression, Kaplan-Meier curves, and Locally Weighted Scatterplot Smoothing (LOWESS) curves were used to examine how albumin administration correlates with different clinical results. The evaluated results comprised in-hospital mortality, cumulative fluid output over 24 hours, Length of Stay in the Intensive Care Unit (ICU LOS), and overall hospitalization duration (hospital LOS).</div></div><div><h3>Results</h3><div>Infusing albumin was found to be markedly linked with higher in-hospital mortality among heart failure patients whose serum albumin levels were ≤ 2.9 g/dL (<em>p</em> &lt; 0.001). However, no statistically significant correlation was found between the patients with levels &gt; 2.9 g/dL (<em>p</em> = 0.62). Following propensity score matching in the ≤ 2.9 g/dL serum albumin group, albumin infusion was linked to prolonged hospital and ICU stays (<em>p</em> = 0.002, <em>p</em> &lt; 0.001), but showed no significant association with total 24 hour fluid output and 90-day survival (<em>p</em> = 0.173, <em>p</em> = 0.656).</div></div><div><h3>Conclusion</h3><div>The use of albumin has been linked to increased risk-adjusted mortality during hospitalization, as well as prolonged stays in both hospital and ICU settings for patients with heart failure and low levels of serum albumin. Physicians should exercise caution when considering the administration of albumin in these cases.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100659"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding prognostic factors in SARS-CoV-2 complications among patients with hematological disorders","authors":"Fengbo Jin ,&nbsp;Wei Qian ,&nbsp;Yingying Chen ,&nbsp;Wanlu Tian ,&nbsp;Ling Ge ,&nbsp;Mingzhen Yang ,&nbsp;Leiming Xia","doi":"10.1016/j.clinsp.2025.100625","DOIUrl":"10.1016/j.clinsp.2025.100625","url":null,"abstract":"<div><div>Within the intricate tapestry of the global SARS-CoV-2 pandemic, this study delves into the intricate interplay of clinical data to elucidate prognostic factors associated with complications in patients concomitantly afflicted with hematological disorders and SARS-CoV-2. An exhaustive analysis of 71 individuals, spanning the period from November 2022 to March 2023, aims to unveil distinctive clinical characteristics and explicate the nuanced determinants steering the trajectory of the disease. The updated findings reveal a multi-faceted correlation, underscoring the complex interplay of clinical parameters. Among individuals with hematological disorders, anomalously elevated ferritin levels are closely associated with the development of SARS-CoV-2 pneumonia, while interferon-γ is intricately linked to the severity of SARS-CoV-2. Conversely, elevated ferritin levels, increased <span>D</span>-dimer and fibrin degradation products, along with significantly elevated iron levels, manifest a significant association with patient mortality. Intriguingly, those in patients in complete hematologic remission confront an augmented risk of developing SARS-CoV-2 pneumonia, while those abstaining from anti-tumor treatments exhibit mitigated case severity. This study unveils the intricate interplay of clinical factors impacting the prognosis of SARS-CoV-2 complications in individuals with hematological disorders. The cognizance of aberrant interferon-γ activation and nuanced associations with ferritin, iron levels, and coagulation markers contributes to a more holistic comprehension of the prognostic landscape.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100625"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pembrolizumab in gestational trophoblastic neoplasia: Systematic review and meta-analysis with sub-group analysis of potential prognostic factors","authors":"Marcio Barcellos ,&nbsp;Antonio Braga ,&nbsp;Matheus Machado Rech ,&nbsp;Solange Artimos de Oliveira ,&nbsp;Jose Mauro Madi ,&nbsp;Sue Yazaki Sun ,&nbsp;Jorge de Rezende-Filho ,&nbsp;Kevin M. Elias ,&nbsp;Neil S. Horowitz ,&nbsp;Ross S. Berkowitz","doi":"10.1016/j.clinsp.2025.100583","DOIUrl":"10.1016/j.clinsp.2025.100583","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the performance of pembrolizumab for the treatment of Gestational Trophoblastic Neoplasia (GTN).</div></div><div><h3>Methods</h3><div>The Medical Subject Headings related to immunotherapy/pembrolizumab and GTN were used alone or in combination to retrieve relevant articles. The authors searched in EMBASE, MEDLINE/PubMed, Elsevier's Scopus, and Web of Science until November/2024. The authors included any randomized controlled trials, cohort studies, case series, and case reports focusing on pembrolizumab treatment in GTN. Meta-analysis of proportions was carried out employing a random-effects model. The meta-analysis employed the inverse variance method, with the arcsine link function for the analysis of proportional data. All analyses were performed using Stata 18. For all analyses, a p-value &lt; 0.05 indicated statistical significance. This study was registered on PROSPERO (CRD42023493329).</div></div><div><h3>Results</h3><div>A total of 550 studies were identified after a literature search among which 15 original studies were included in the systematic review and in the meta-analysis. Pembrolizumab induced complete sustained remission in 71.59% (95% CI 53.27‒84.78%; I² = 0.00%, H² = 1.00, p = 0.90) of cases. The subgroups meta-analysis showed pembrolizumab had similar performance, regardless of age (&lt; 40 vs. ≥ 40-years-old, p = 0.38), GTN histopathology (Placental Site Trophoblastic Tumor [PSTT], Epithelioid Trophoblastic Tumor [ETT]/noninvasive mole/others versus invasive mole/choriocarcinoma, p = 0.48), time from diagnosis to the beginning of immunotherapy (&lt; 4 vs. ≥ 4-years, p = 0.84), pembrolizumab combined with chemotherapy (yes vs. no, p = 0.66).</div></div><div><h3>Conclusions</h3><div>Pembrolizumab seems an effective treatment for patients with high-risk GTN with chemoresistant or relapsed disease, including cases of PSTT/ETT, notwithstanding patient age, time to initiate immunotherapy and whether or not it was associated with chemotherapy.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100583"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143526870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing loss and small and large fibre neuropathy associated with the heterozygous variants c.20A>T in HBB and del-3.7 in HBA","authors":"Josef Finsterer ,&nbsp;Fulvio A. Scorza ,&nbsp;Carla A. Scorza ,&nbsp;Ana C. Fiorini","doi":"10.1016/j.clinsp.2025.100597","DOIUrl":"10.1016/j.clinsp.2025.100597","url":null,"abstract":"","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100597"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of contrast-enhanced ultrasound combined with serum procalcitonin in tuberculous lymph nodes and metastatic lymph nodes","authors":"Lin Li ,&nbsp;Lan He ,&nbsp;Minchao Xiong ,&nbsp;Xiaoyan Wang","doi":"10.1016/j.clinsp.2024.100541","DOIUrl":"10.1016/j.clinsp.2024.100541","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the value of Contrast-Enhanced Ultrasound (CEUS) combined with Procalcitonin (PCT) in differentiating Tuberculous Lymph Nodes (TLN) from Metastatic Lymph Nodes (MLN).</div></div><div><h3>Methods</h3><div>This prospective cohort study included 207 consecutive patients diagnosed with CTL. Before confirming through pathology or laboratory tests, every patient received standard ultrasound, CEUS, and MRI examinations, with the imaging results analyzed afterward. Serum indicators were measured by Enzyme-Linked Immunosorbent Assay (ELISA). Predictive modeling was performed by multifactorial logistic regression. Evaluate the diagnostic and calibration performance of the predictive model by drawing Receiver Operating Characteristic (ROC) curves and calibration curves, and using Area Under the Curve (AUC) and Hosmer-Lemeshow (H-L) tests.</div></div><div><h3>Results</h3><div>The presence of lymph node lesions was confirmed by routine ultrasound and MRI in 207 patients, of which 102 (49.27 %) had a pathological or laboratory diagnosis of metastatic lymph nodes (MLN), and 50.8 % were tuberculous lymph nodes (TLN). According to imaging findings of CEUS, TLN was more commonly associated with enhanced concentric performance in the arterial phase (67.65 % vs. 40.95 %) and heterogeneous enhancement pattern in lymph nodes (70.59 % vs. 52.38 %). Peak Intensity (PI) of lesions was higher in patients with MLN. Increased age-enhanced concentric performance in the arterial phase, increased PI, and serum PCT greater than 5.39 ng/mL were independent risk factors for MLN. The prediction model of serum PCT combined with CEUS had a higher diagnostic value for MLN. The H-L test indicated a satisfactory model fit (all p &gt; 0.05), and the calibration curve closely approximates the ideal diagonal.</div></div><div><h3>Conclusion</h3><div>CEUS combined with serum PCT has better clinical application value in the differential diagnosis of TLN and MLN.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100541"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic superior capsule reconstruction with dermal allograft and autologous long head of the biceps tendon for irreparable posterosuperior rotator cuff tears, a two-year clinical and radiological results","authors":"Joe Chih-Hao Chiu,&nbsp;Yu-Cheng Chen,&nbsp;Poyu Chen,&nbsp;Yi Lu,&nbsp;Cheng-Pang Yang,&nbsp;You-Hung Cheng,&nbsp;Alvin Chao-Yu Chen","doi":"10.1016/j.clinsp.2025.100628","DOIUrl":"10.1016/j.clinsp.2025.100628","url":null,"abstract":"<div><h3>Background</h3><div>A 2 mm-thick dermal allograft and autologous Long Head of the Biceps Tendon (LHBT) Superior Capsule Reconstruction (SCR) could provide improved clinical and radiographic outcomes for posterosuperior Massive Irreparable Rotator Cuff Tears (MIRCTs).</div></div><div><h3>Methods</h3><div>A retrospective study was conducted between April 2019 and October 2021. The LHBT was rerouted 5 mm posteriorly to the bicipital groove, and a 2 mm-thcick dermal allograft was used to cover the rerouted LHBT. Clinical assessment included Constant-Murley Shoulder score (CMS), American Shoulder and Elbow Surgeons (ASES) score, Subjective Shoulder Value (SSV), Visual Analog Scale (VAS) pain scores, and active ROM measurements. The radiological assessment included Acromiohumeral Distance (AHD), Superior Capsular Distance (SCD), muscle Fatty Infiltration (FI), and follow-up SCR integrity using ultrasound two years after surgery.</div></div><div><h3>Results</h3><div>25 patients (7 male, 18 female) were included with a mean age of 64.2 ± 6.9 years. Active ROM, AHD, and SCD did not change significantly after the surgery. Patients' VAS (8.3 ± 0.7 to 1.3 ± 0.6, <em>p</em> &lt; 0.001), SSV (22.4 ± 8.6 to 77.6 ± 12.7, <em>p</em> &lt; 0.001), CMS (36.2 ± 6.8 to 79.9 ± 8.4, <em>p</em> &lt; 0.001), and ASES (37.2 ± 10.0 to 80.5 ± 5.7, <em>p</em> &lt; 0.001) improved significantly at final follow-up. The ultrasound examination of all patients demonstrated a healed dermal allograft on the supraspinatus footprint. One patient (4 %) had a postoperative trauma causing irreparable subscapularis tear, leading to reverse total shoulder arthroplasty during revision surgery.</div></div><div><h3>Conclusions</h3><div>The combined SCR technique using a 2 mm dermal allograft and autologous LHBT for posterosuperior MIRCTs significantly improved the patient-reported outcomes.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100628"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of endoscopic submucosal dissection and transanal endoscopic surgery for the treatment of rectal neoplasia: A systematic review and meta-analysis","authors":"Igor Valdeir Gomes de Sousa,&nbsp;Alexandre Moraes Bestetti,&nbsp;Diego Paul Cadena-Aguirre,&nbsp;Angelo So Taa Kum,&nbsp;Paulo Ferreira Mega,&nbsp;Pedro Henrique Veras Ayres da Silva,&nbsp;Nelson Tomio Miyajima,&nbsp;Wanderley Marques Bernardo,&nbsp;Eduardo Guimarães Hourneaux de Moura","doi":"10.1016/j.clinsp.2025.100613","DOIUrl":"10.1016/j.clinsp.2025.100613","url":null,"abstract":"<div><h3>Background and aim</h3><div>Minimally invasive techniques offer alternatives to conventional surgery in the treatment of early-stage colorectal cancer, reducing morbidity. Transanal Endoscopic Microsurgery (TEM) and Transanal Minimally Invasive Surgery (TAMIS) are widely used, while Endoscopic Submucosal Dissection (ESD) is gaining attention for its ability to achieve complete resection with low recurrence rates. This study compares the efficacy and safety of ESD with Transanal Endoscopic Surgery (TES).</div></div><div><h3>Methods</h3><div>The authors performed a systematic review and meta-analysis of comparative studies involving patients with endoscopically resectable rectal lesions. Electronic searches were conducted in MEDLINE, EMBASE, Cochrane, and LILACS. Outcomes included recurrence rate, complete resection, en bloc resection, hospital stay, procedure time, and complication rate.</div></div><div><h3>Results</h3><div>The analysis included ten observational studies and one Randomized Controlled Trial (RCT) involving 1,094 patients. No significant differences were found in terms of recurrence rate, en bloc resection, R0 resection, and complications between techniques. The RCT showed a shorter procedure time in the TES (RD = 16.6; 95 % CI 8.88 to 24.32; p &lt; 0.0001), whereas observational studies found no significant difference. In addition, observational studies found a shorter hospital stay duration in the ESD (MD = -1.22; 95 % CI -2.11 to -0.33; I² = 82 %; p &lt; 0.007), while the RCT found no difference.</div></div><div><h3>Conclusion</h3><div>ESD and TES are safe and effective for the treatment of early-stage rectal tumors. Rates of local recurrence, block resection, R0 resection, complications, and procedure time were similar. However, the RCT showed a shorter procedure time with TES, while observational studies showed a shorter hospital stay with ESD.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100613"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An evidence-based care program in a local healthcare setting in Brazil: Experience and impact","authors":"César Ramos Rocha-Filho ,&nbsp;Felipe Sebastião de Assis Reis ,&nbsp;Aline Rocha ,&nbsp;Ana Carolina Pereira Nunes Pinto ,&nbsp;Rozana Mesquita Ciconelli","doi":"10.1016/j.clinsp.2025.100640","DOIUrl":"10.1016/j.clinsp.2025.100640","url":null,"abstract":"<div><h3>Objective</h3><div>To provide an overview of the activities and impact of an Evidence-Based Care Program (EBCP) on professionals’ decision-making in a large hospital located in São Paulo, Brazil.</div></div><div><h3>Methods</h3><div>Retrospective descriptive analysis of a hospital EBCP's database (covering a 40-month period), involving data from the studies conducted and an online feedback survey.</div></div><div><h3>Results</h3><div>Since its inception, the EBCP performed 95 scientific technical reports, including 55 Rapid Systematic Reviews (RSR) and 40 Literature Reviews (LR). The authors identified 21 review topics, with the 3 most common being inpatients (<em>n</em> = 20), oncology (<em>n</em> = 11), and surgical procedure (<em>n</em> = 9). The 3 most common technologies assessed were medical devices (<em>n</em> = 28), drugs (<em>n</em> = 27), and scale/questionnaire (<em>n</em> = 16). Studies were mainly used to update policy or procedure (<em>n</em> = 59), support scientific research (<em>n</em> = 10), support clinical program development (<em>n</em> = 8), provide clinical guidance (<em>n</em> = 7), or as a communication tool (<em>n</em> = 5). Among the requestors who responded to the feedback survey (76/95), 97 % agreed or strongly agreed that they were satisfied with the review delivered, and 100 % indicated that they likely would request a review in the future and would indicate the EBCP to a coworker. Among the RSR responders (51/55), 94 % agreed or strongly agreed that the EBCP work informed their project or final decision, and 32 % reported that the result presented changed their perspective about the technology assessed.</div></div><div><h3>Conclusion</h3><div>Employing evidence-based methodology, the program provided timely and pertinent evidence for local decision-making. Health professionals who utilized the EBPC expressed high satisfaction with the process and reported a positive shift in their decision-making.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100640"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical conduct and knowledge about physical activity counseling in the largest hospital complex in Latin America","authors":"Débora Borowiak Reiss ,&nbsp;Ítalo Ribeiro Lemes ,&nbsp;Hamilton Roschel ,&nbsp;Bruno Gualano","doi":"10.1016/j.clinsp.2025.100666","DOIUrl":"10.1016/j.clinsp.2025.100666","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize practices and knowledge regarding PA counseling at a large tertiary hospital.</div></div><div><h3>Design</h3><div>Cross-sectional observational study.</div></div><div><h3>Participants and setting</h3><div>Physicians with an active medical practice within the university hospital were invited to respond to an online survey.</div></div><div><h3>Interventions</h3><div>A questionnaire designed to capture information on medical training, life habits and knowledge about PA.</div></div><div><h3>Main outcomes measures</h3><div>Sedentary behavior, clinical practice and self-efficacy were assessed by Likert-type questions, whereas regular practice, previous training, and knowledge of PA were evaluated through dichotomous questions (answers: “yes or no” or “true or false”).</div></div><div><h3>Results</h3><div>Response rate was 11.5 % (50.6 % female, 44.9 ± 12.8 years), 67.7 % were physically active, and 63.3 % had 4 to 8 h/day of sedentary behavior. Only 40.7 % had previous training on PA, 99.7 % recognized the importance of recommending PA, but only a small part (48.4 %) recommended PA in all consultations (the main barrier was lack of specific training). In addition, 69.2 %, 58.7 % and 65.5 % rated their abilities to collect PA history, assess contraindications, and engage the patient as good/excellent, respectively. Knowledge of PA was rated as low to very low, with correct answers ranging from 49 % to 17 % and as low as ∼10 % (when considering the pediatric population).</div></div><div><h3>Conclusion</h3><div>Although physicians recognize the importance of PA counseling and have high perceived self-efficacy in relation to counseling skills, few put them into practice. This may be due to insufficient training on PA and/or the complexity of services provided at the tertiary hospital. The present results corroborate the need for improvements in medical training on PA.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100666"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}