Clinics最新文献

{"title":"A gamified approach to burn education among Brazilian youth: The “Burn Game” pilot study","authors":"Felipe Giraldo Alvarez Gonçalves ,&nbsp;Vinicius Oberdan Souza Reis ,&nbsp;Vinicius Freire Costa Alves ,&nbsp;Bruno Damico Terada ,&nbsp;José Maria Soares Junior ,&nbsp;Patricia Zen Tempski ,&nbsp;Sérgio Henrique Bastos Damous ,&nbsp;Edivaldo Massazo Utiyama ,&nbsp;Rolf Gemperli ,&nbsp;Cristina Pires Camargo","doi":"10.1016/j.clinsp.2026.100899","DOIUrl":"10.1016/j.clinsp.2026.100899","url":null,"abstract":"<div><h3>Introduction</h3><div>Burn injuries are a significant global health concern, with an estimated 8.4 million cases annually. Although specific cost data from Brazil are limited, international reports estimate an average burn-related hospitalization cost of USD 88,218. Educational tools for populations are desirable to prevent burn injury. Thus, the authors designed a gamified model to promote burn education and prevention among Brazilian students.</div></div><div><h3>Methods</h3><div>The intervention was conducted in four public schools, three High Schools (HS) and one Vocational School (VS). Students first completed a 21-question online pre-test assessing their baseline knowledge. A 20-minute lecture followed, covering burn classification and prevention. Students then participated in an interactive online trivia game (Burn Game) designed to reinforce learning. Finally, they completed the same test as a post-intervention assessment.</div></div><div><h3>Results</h3><div>A total of 134 students participated (73 from VS, 61 from HS), with a mean age of 18.6 ± 4.9 years; 73.13% were female. Post-test scores improved significantly across the participants, with 132 students showing higher scores. The overall mean score difference was 7.16-points (95% CI: 6.47–7.86; p &lt; 0.001). Subgroup analysis revealed gains in both VS (MD = 6.08; 95% CI: 5.33–6.83) and HS students (MD = 8.46; 95% CI: 7.41–9.51), with HS students showing the greatest improvement.</div></div><div><h3>Conclusion</h3><div>The present study suggests that gamified teaching indeed contributed to significantly increasing students' knowledge about burn prevention and classification.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100899"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147396186","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":"Intraventricular hemorrhage profile in very low birth weight preterm infants (< 1000 g and ≥ 1000 g) at a tertiary center in São Paulo State over a decade","authors":"Juliana Fattori Hamamoto,&nbsp;Saskia Maria Wiegerinck Fekete,&nbsp;José Eduardo Corrente,&nbsp;Pedro Tadao Hamamoto Filho,&nbsp;Lígia Maria Suppo de Souza Rugolo","doi":"10.1016/j.clinsp.2026.100914","DOIUrl":"10.1016/j.clinsp.2026.100914","url":null,"abstract":"<div><h3>Objective</h3><div>The better survival of preterm infants in recent years raises concerns about the risk of Intraventricular Hemorrhage (IVH). The authors investigated the incidence, risk factors, severity, and mortality of IVH in Very Low Birth Weight (VLBW) infants, comparing those &lt; 1000 g with those weighing 1000 g ‒ 1499 g.</div></div><div><h3>Methods</h3><div>This is a cohort of VLBW infants admitted from 2009‒2018. All neonates with gestational age between 24‒36 weeks, weighing from 400 g to 1499 g, and who underwent cranial ultrasound in the first 72-hours of life were included. Independent variables were maternal, gestational, birth, and neonatal data. Outcomes were IVH (all grades) and severe IVH (grades 3 and 4) in preterm infants &lt; 1000 g and in those ≥ 1000 g.</div></div><div><h3>Results</h3><div>A total of 724 VLBW infants were studied, 37% of these weighing &lt; 1000 g. The incidence of IVH was 32% and was more frequent in those &lt; 1000 g (50.5%) compared with those ≥ 1000 g (21.5%). In preterm infants &lt; 1000 g, gestational age and patent ductus arteriosus were associated with IVH, and severe IVH. In the group ≥ 1000 g, IVH was associated with preeclampsia, first-minute Apgar, use of vasoactive drugs and surfactant. The mortality of preterm infants with IVH was 35%; in severe cases, it reached 64.5% in those &lt; 1000 g and 41% in those ≥ 1000 g.</div></div><div><h3>Conclusions</h3><div>IVH is frequent and severe, with a high mortality rate in VLBW infants, especially in those &lt; 1000 g. Several risk factors for IVH are potentially preventable and most of them reflect the role of hemodynamic instability in the occurrence of IVH. These results can guide obstetricians and neonatologists in the implementation of good care practices.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100914"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518223","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":"Genetic predisposition to smoking and the risk of Carpal Tunnel Syndrome: a mendelian randomization study","authors":"Qi Zeng ,&nbsp;Xuepeng Rao ,&nbsp;Weiwen Hu ,&nbsp;Haichao Chao ,&nbsp;Yu Cheng ,&nbsp;Guanghao Zheng","doi":"10.1016/j.clinsp.2026.100950","DOIUrl":"10.1016/j.clinsp.2026.100950","url":null,"abstract":"<div><h3>Background</h3><div>Carpal Tunnel Syndrome (CTS) is a common entrapment neuropathy leading to pain and functional impairment. While smoking has been proposed as a modifiable risk factor, evidence from observational studies remains inconsistent due to potential confounding and reverse causality.</div></div><div><h3>Method</h3><div>The authors performed a two-sample Mendelian Randomization (MR) analysis to assess the causal relationship. Genetic instruments for five smoking phenotypes were derived from large-scale Genome-Wide Association Studies (GWAS). Summary-level data for CTS were obtained from the FinnGen Consortium (n = 480,201). The Inverse Variance Weighted (IVW) method was the primary analysis, supplemented by four other MR methods and a suite of sensitivity analyses to assess robustness and pleiotropy.</div></div><div><h3>Results</h3><div>Genetically predicted smoking propensity was associated with a higher risk of CTS. Specifically, genetic predisposition to smoking initiation (ORMR-IVW = 1.53; 95% CI 1.33–1.76; p &lt; 0.001) and heavier cigarette consumption (ORMR-IVW = 1.52; 95% CI: 1.31–1.77; p &lt; 0.001) significantly increased CTS risk. The estimate for current smoking was particularly strong (ORMR-IVW=3.96; 95% CI 2.20–7.12; p &lt; 0.001). Sensitivity analyses were largely consistent, though some heterogeneity and potential pleiotropy were detected for specific phenotypes.</div></div><div><h3>Conclusions</h3><div>This MR study supports a causal role of smoking in the development of CTS. These findings underscore the importance of smoking cessation as a potential preventive measure against CTS and should be integrated into patient counseling and public health strategies.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100950"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679950","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":"Juvenile stroke during long-term therapy with adalimumab","authors":"Ana C. Fiorini ,&nbsp;Fulvio A. Scorza ,&nbsp;Josef Finsterer ,&nbsp;Carla A. Scorza","doi":"10.1016/j.clinsp.2026.100873","DOIUrl":"10.1016/j.clinsp.2026.100873","url":null,"abstract":"","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100873"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260628","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":"Risk factors associated with mortality among patients with COVID-19 in the intensive care unit: prospective cohort study from the early pandemic phase in Brazil","authors":"Brena Ramos Athaydes ,&nbsp;Mariane Vedovatti Monfardini ,&nbsp;Priscila Marinho Abreu ,&nbsp;Frederico Firme Figueira ,&nbsp;Juliana Couto-Vieira ,&nbsp;Roberta Ferreira Ventura Mendes ,&nbsp;Rahyza Inacio Freire de Assis ,&nbsp;Luiz Felipe Camporez ,&nbsp;Priscilla de Aquino Martins ,&nbsp;Liliana Cruz Spano ,&nbsp;Sandra Ventorin von Zeidler","doi":"10.1016/j.clinsp.2026.100894","DOIUrl":"10.1016/j.clinsp.2026.100894","url":null,"abstract":"<div><h3>Objective</h3><div>This prospective cohort study describes clinical, laboratory factors and virological factors associated with in-hospital mortality among 227 Intensive Care Unit (ICU) patients with SARS-CoV-2 infection admitted in Brazil during the pre-vaccination, pre-Omicron phase of the pandemic (September 2020 to March 2021).</div></div><div><h3>Methods</h3><div>Clinical and laboratory data were extracted from medical records, and viral load was quantified by RT-qPCR Cycle threshold (Ct) values. Independent predictors of mortality were evaluated using multivariable Cox proportional hazards regression, and survival was analyzed with Kaplan-Meier curves.</div></div><div><h3>Results</h3><div>Non-survivors were significantly older (<em>p</em> &lt; 0.001) and more likely to have hypertension (<em>p</em> = 0.014) and chronic respiratory disease (<em>p</em> = 0.042). At admission, they exhibited higher leukocyte counts (<em>p</em> = 0.001), D-dimer (<em>p</em> = 0.028), and creatinine levels (<em>p</em> = 0.001), as well as more frequent tracheal intubation (<em>p</em> &lt; 0.001). During hospitalization, non-survivors showed persistently elevated leukocyte counts and developed more complications, including acute kidney injury, septic shock, and cardiac arrest (<em>p</em> &lt; 0.001). Viral load was higher in non-survivors (<em>p</em> = 0.026) and among those requiring intubation (<em>p</em> = 0.042) or with cardiovascular disease (<em>p</em> = 0.016). In the multivariable Cox model, only creatinine at admission remained independently associated with mortality (HR = 1.18; 95% CI: 1.00–1.39; <em>p</em> = 0.049). Survival analysis showed reduced survival among patients aged ≥ 65-years (<em>p</em> = 0.004) and those with chronic respiratory disease (<em>p</em> = 0.029).</div></div><div><h3>Conclusions</h3><div>This study integrates clinical, laboratory, and viral load data to detail the early COVID-19 severity and mortality patterns in a Brazilian ICU.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100894"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147329101","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":"The influence of sex steroids on cognition in elderly men","authors":"Carolina C.B. Caetano ,&nbsp;Sami Liberman ,&nbsp;Jéssica M.L. Ie ,&nbsp;Valmari C.A. Toscano ,&nbsp;Wilson Jacob ,&nbsp;Tânia A.S.S. Bachega","doi":"10.1016/j.clinsp.2026.100892","DOIUrl":"10.1016/j.clinsp.2026.100892","url":null,"abstract":"<div><h3>Background</h3><div>Testosterone plays a crucial role in cognitive development and behavioral differences between sexes. However, it remains unclear whether age-related testosterone decline affects cognitive function in elderly men.</div></div><div><h3>Objective</h3><div>To determine whether serum steroid levels influence cognitive function in elderly males.</div></div><div><h3>Methods</h3><div>Sixty men with a mean age of 73.5 ± 5.9 years were evaluated. Global cognitive function was assessed using the Mini-Mental State Examination (MMSE), administered by a single trained examiner. To rule out the influence of depression on MMSE, the Geriatric Depression Scale (GDS) was applied. Age, BMI, education level, serum Total Testosterone (TT), Free Testosterone (FT), Estradiol (E2), and sex hormone-binding globulin levels were measured and correlated with total and subdomain MMSE scores and GDS scores. Nonparametric tests and multivariable regression analyses were performed.</div></div><div><h3>Results</h3><div>Age was negatively correlated with TT (<em>r</em> = -0.36; <em>p</em> = 0.003), and TT was inversely associated with BMI (<em>r</em> = -0.45; <em>p</em> &lt; 0.001). BMI was negatively correlated with total MMSE scores (<em>r</em> = -0.30; <em>p</em> = 0.010). TT and E2 levels showed no significant associations with overall MMSE, except for a positive correlation between TT and the Spatial Orientation subdomain (<em>r</em> = 0.26; <em>p</em> = 0.040). TT and FT were both negatively correlated with GDS scores (<em>r</em> = -0.32; <em>p</em> = 0.010; and <em>r</em> = -0.27; <em>p</em> = 0.030, respectively). After adjustment, only education years remained independently associated with MMSE (β = 0.374, <em>p</em> = 0.013).</div></div><div><h3>Conclusions</h3><div>Although lower serum testosterone levels were associated with depressive symptoms, no significant correlation was found with global cognitive performance; an interesting finding was the impact of years of education on MMSE score.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100892"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147329100","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":"Fat harvesting protocol for enhanced stem cell viability – pilot study","authors":"Ruan Pimenta ,&nbsp;Vanessa Ribeiro Guimarães ,&nbsp;Samirah Abreu Gomes ,&nbsp;Silvana Cereijido Altran ,&nbsp;Emily Caroline da Fonseca Sampaio ,&nbsp;Elaine Rufo Tavares ,&nbsp;Rolf Gemperli ,&nbsp;Cristina Pires Camargo","doi":"10.1016/j.clinsp.2026.100945","DOIUrl":"10.1016/j.clinsp.2026.100945","url":null,"abstract":"<div><h3>Objective</h3><div>Adipose tissue is used in several specialties to obtain Adipose-derived Stem Cells (ASC) and fat derivatives. Several studies analyze protocols for harvesting fat tissues. However, these studies showed inconclusive data regarding cell viability and function. Thus, the objective of this study was to analyze protocols regarding cell viability, identify the best method, and test cell differentiation and proliferation when using the chosen methods.</div></div><div><h3>Methods</h3><div>This study harvested lipoaspirate products from three healthy women undergoing aesthetic procedures. The first analysis corresponds to the viability of fat tissue liposuction products for the washing process. The second analyzes the effect of anesthetic drugs, and the third analyzes the cytotoxicity of the fraction process. After testing all these steps, the authors prepared the fat tissue using the best method chosen after the first analysis to test cell differentiation (adipogenesis, osteogenesis, and chondrogenesis) and proliferation.</div></div><div><h3>Results</h3><div>The analysis showed that saline solution 0.9% was the washing solution that induced less cell death. Regarding anesthetic and vasoconstrictor drugs, lidocaine, ropivacaine, and epinephrine caused similar levels of cell death, but sodium bicarbonate increased cell proliferation. The number of passages through a 2.4 mm Luer-to-Luer transfer device did not influence cell viability. The proliferation and differentiation of ASC in adipocytes, osteoblasts, and chondrocytes were preserved using saline solution 0.9% and 20 × passages for fat fractioning.</div></div><div><h3>Conclusions</h3><div>The findings of this study provide preliminary in vitro evidence that may improve future investigations on the fat harvesting process.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100945"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147747529","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":"Feasibility of telephone-based telemedicine for gynecologic oncology follow-up in Brazil’s public health system: a descriptive pilot study","authors":"Raphael Federicci Haddad ,&nbsp;Fernanda Mazziero Pires ,&nbsp;Luiza Perez ,&nbsp;Gustavo Yano Callado ,&nbsp;Juliana Lomanto ,&nbsp;Flavia Paiva Proenca Lobo Lopes ,&nbsp;Eduardo Cordioli ,&nbsp;Vanessa Alvarenga-Bezerra ,&nbsp;Renato Moretti-Marques","doi":"10.1016/j.clinsp.2026.100968","DOIUrl":"10.1016/j.clinsp.2026.100968","url":null,"abstract":"<div><h3>Background</h3><div>Telemedicine expanded rapidly during COVID-19 and may reduce logistical burdens for oncology patients. Evidence on patient satisfaction within Brazil’s public health system (SUS) remains limited. Here, the authors evaluated the feasibility of telephone-based telemedicine for gynecologic oncology follow-up.</div></div><div><h3>Methods</h3><div>The authors conducted a cross-sectional mixed-methods pilot study at a public gynecologic oncology clinic in São Paulo (March 2023 – February 2024). Established patients attending follow-up visits that did not require a physical exam were included; new patients were excluded. Telemedicine visits were conducted by phone. The PSQ-18 was translated and adapted to the SUS context (two cost items removed: 16-items total). Item-level satisfaction is presented for in-person and telemedicine visits. Semi-structured interviews explored experiences and barriers.</div></div><div><h3>Results</h3><div>From 54 eligible patients, 18 were enrolled (in-person = 10; telemedicine = 8). Item-level PSQ-18 responses indicated high satisfaction in both groups, though direct comparison is limited by baseline differences and limited statistical power. Regarding logistics, the telemedicine group reported low rates of out-of-pocket expenses (1/7, 14.3%) and missed work (0/8), whereas these burdens were frequently reported in the in-person group (77.8% and 33.3%, respectively). Physicians reported full goal achievement (100%) and patient understanding (100%) for telemedicine encounters. Interviews highlighted convenience, reduced travel/time costs, and ease of use; barriers included technology access, digital literacy, and lack of visual cues in audio-only calls.</div></div><div><h3>Conclusions</h3><div>In this SUS setting, telephone-based telemedicine for appropriately selected follow-up visits was feasible. Implementation should address digital inclusion and clarify indications that require in-person assessment. Larger studies should validate telemedicine-specific satisfaction measures and assess downstream outcomes.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100968"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147747530","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":"Effects of vitamin D supplementation combined with resistance exercise on body composition and metabolic variables in older women: a randomized clinical trial","authors":"Illana Patricia da Silva Queiroz ,&nbsp;Angélica Castilho Alonso ,&nbsp;Vanderlei Carneiro da Silva ,&nbsp;Adriana Machado-Lima ,&nbsp;Priscila Long Amorim Bichara Pipa ,&nbsp;José Maria Soares-Junior ,&nbsp;Edmund Chada Baracat ,&nbsp;Júlia Maria D’Andréa Greve ,&nbsp;Marta Ferreira Bastos ,&nbsp;Guilherme Carlos Brech","doi":"10.1016/j.clinsp.2026.100942","DOIUrl":"10.1016/j.clinsp.2026.100942","url":null,"abstract":"<div><h3>Introduction</h3><div>Aging has a significant impact on health, leading to changes in body composition and physical functionality in older adults.</div></div><div><h3>Objective</h3><div>Given the relevance of this topic, the aim of this study was to analyze the effects of vitamin D supplementation combined with physical exercise over a 12-week period on body composition and metabolic profile in elderly women.</div></div><div><h3>Methods</h3><div>The study followed a clinical approach, employing a randomized, double-blind, placebo-controlled trial, in accordance with the guidelines established by the Consolidated Standards of Reporting Trials (CONSORT), conducted at the Movement Studies Laboratory in São Paulo, Brazil. Analyses were performed using an intention-to-treat approach with random effects regression models. The study sample consisted of 46 elderly individuals, divided into two groups with 23 participants each. The experimental group received vitamin D3 supplementation at a dose of 49,000 IU/week, while the placebo group received seven capsules of the same size, volume, and color, containing lactose but no vitamin D3.</div></div><div><h3>Results</h3><div>After analyzing the results, it was observed that the groups were homogeneous in terms of age (p = 0.7658) and BMI (p = 0.5904). The results showed differences in 25-OH vitamin D levels (p &lt; 0.001) between the groups over time.</div></div><div><h3>Conclusion</h3><div>In conclusion, vitamin D supplementation successfully increased serum levels but failed to provide additional benefits for muscle mass or metabolic markers compared to resistance training alone.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100942"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725387","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":"Patient characteristics and palliative care eligibility in public vs. private emergency care: A cross-sectional observational study","authors":"Carla Bertelli ,&nbsp;Cristina Terzi ,&nbsp;Marileise Roberta Fonseca ,&nbsp;Felipe Cecílio ,&nbsp;Luciana Nucci ,&nbsp;Luana Aranha ,&nbsp;Paulo de Campos ,&nbsp;Fernanda Engelbrecht ,&nbsp;Renan Oliveira ,&nbsp;Elisa Teixeira Mendes","doi":"10.1016/j.clinsp.2025.100859","DOIUrl":"10.1016/j.clinsp.2025.100859","url":null,"abstract":"<div><h3>Context</h3><div>The rapid aging of the Brazilian population in recent decades has strained the healthcare system. A lack of chronic patient absorption in primary care has led to overloaded emergency departments, which handle preventable decompensation and care that could be managed at home.</div></div><div><h3>Objectives</h3><div>To identify the demand for patients eligible for Palliative Care (PC), among patients in four Emergency Departments (ED) in a metropolitan region in Brazil.</div></div><div><h3>Methods</h3><div>This observational, cross-sectional study involved four emergency departments: two public university hospitals and two private hospitals. Patient data on gender, age, visit reasons, and comorbidities were collected, along with the Supportive and Palliative Care Indicators Tool (SPCIT-BR™), Palliative Performance Scale (PPS) assessments, and opioid use information.</div></div><div><h3>Results</h3><div>Of the 270 patients, 101 (37.4 %) were eligible for PC. Of these eligible patients, the median age was 70-years, 54.5 % were male and public EDs had 9-fold higher odds of palliative care eligibility. Age, dyspnea, and fever predicted palliative care eligibility.</div></div><div><h3>Conclusions</h3><div>The present findings demonstrate the necessity of further implementation of palliative care programs, particularly in the public health system. Such integration could lead to a decrease in unnecessary ED visits and home-based care that reflects patient wishes.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100859"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137662","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}