Clinics最新文献

{"title":"Assessing pediatric visual acuity with a computerized optokinetic nystagmus analyzer","authors":"Boyang Zhu ,&nbsp;Min Yang ,&nbsp;Xiaonan Liu ,&nbsp;Bin Yuan ,&nbsp;Yuqian Yin ,&nbsp;Che Cheng ,&nbsp;Faisal UL Rehman","doi":"10.1016/j.clinsp.2025.100671","DOIUrl":"10.1016/j.clinsp.2025.100671","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the practicality, accuracy, and consistency of a computer-based Optokinetic Nystagmus (OKN) analyzer for vision diagnosis in preschoolers.</div></div><div><h3>Design</h3><div>A comparative study evaluating the performance of a computerized OKN analyzer against the traditional E-word visual acuity chart in assessing visual acuity in preschool children.</div></div><div><h3>Participants</h3><div>A total of 138 children aged 2 to 6 years were enrolled in the study, divided into five age groups: 2 years (29 children), 3 years (27 children), 4 years (28 children), 5 years (28 children), and 6 years (26 children).</div></div><div><h3>Methods</h3><div>Visual acuity was tested using both the nystagmus meter and the E-word visual acuity chart. Statistical analyses, including correlation coefficient calculation and chi-square tests, were conducted to evaluate the testability and consistency of the methods.</div></div><div><h3>Results</h3><div>Out of 138 participants, 125 (90.6 %) successfully completed the test using the computerized OKN analyzer. There was no significant difference in the measurability across different age groups. The testability of the E-word visual acuity chart was significantly lower at 71.0 %. A strong correlation (R = 0.872) was found between the results from the nystagmus meter and the E-word visual acuity chart, indicating high consistency between the two methods.</div></div><div><h3>Conclusion</h3><div>The computerized OKN analyzer is a reliable, accurate, and practical tool for assessing visual acuity in preschoolers. It offers a non-invasive alternative to traditional methods, with high testability and strong correlation with standard visual acuity tests, making it a valuable tool for early detection of vision impairments in young children.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100671"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891421","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":"NAT10-mediated N4-acetylcytosine modification promotes the progression of retinoblastoma by improving the HK1 mRNA stability to enhance glycolysis","authors":"Shan Xu,&nbsp;Xuming Lin,&nbsp;Fengling Jia","doi":"10.1016/j.clinsp.2025.100678","DOIUrl":"10.1016/j.clinsp.2025.100678","url":null,"abstract":"<div><h3>Objective</h3><div>Retinoblastoma (RB) is a type of intraocular tumor in childhood with a high lethality rate. N4-acetylcytosine (ac⁴C) modification is known to regulate multiple cancers, which is mediated by the only known ac⁴C writer N-Acetyltransferase 10 (NAT10). In this study, the authors aimed to reveal the mechanism of RB progression regulated by ac⁴C modification.</div></div><div><h3>Method</h3><div>Phenotypically, dot blot assay and quantitative real-time PCR were used to detect the ac⁴C levels and NAT10 expression in clinical samples and RB cell lines. Then, NAT10 was knocked down to assess its effect on glycolysis. Mechanically, RNA immunoprecipitation assay, immunofluorescence assay, and dual luciferase report were used to explore the mRNA modified by NAT10-mediated ac⁴C modification. Mice xenograft model was used to determine the effect of NAT10 on tumor growth <em>in vivo</em>.</div></div><div><h3>Results</h3><div>The present results demonstrated that the levels of ac⁴C and NAT10 were increased in cancer tissues and RB cell lines. Furthermore, NAT10 knockdown inhibited the glycolysis in RB cell lines. Moreover, the authors revealed that NAT10 knockdown decreased the ac⁴C modification and mRNA stability of HK1, while the inhibition of glycolysis by NAT10 knockdown was reversed by HK1 overexpression. Finally, NAT10 knockdown relieved the growth of tumors in mice models.</div></div><div><h3>Conclusion</h3><div>The authors illustrated that NAT10 plays an important role in the progression of RB by regulating the ac⁴C modification on HK1 mRNA and affects its stability, which may provide a novel theoretical basis for the treatment of RB.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100678"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143922469","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":"Clinical study of the effect of mometasone furoate nasal spray treatment on hearing and in secretory otitis media in children","authors":"Xiaoyan Yu,&nbsp;Lang Xu,&nbsp;Youqi Xie,&nbsp;Mengjie Huang","doi":"10.1016/j.clinsp.2024.100551","DOIUrl":"10.1016/j.clinsp.2024.100551","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the effect of Mometasone furoate (Elocon Cream) Nasal Spray (MFNS) treatment on hearing secretory Otitis Media (SOM) in younger children.</div></div><div><h3>Methods</h3><div>Seventy-six children with SOM (ages 5 to 10 years-old) were selected as study subjects and divided into two groups of 38 cases each using a randomized numerical table. The control group was given conventional treatment, and the observation group was treated with MFNS based on the control group. Both groups were treated for 12 weeks. The improvements in clinical symptoms and hearing were compared between the two groups at weeks 4, 8 and 12 of treatment, respectively.</div></div><div><h3>Results</h3><div>The total effective rate of treatment in the observation group was higher than that in the control group. The middle ear resonance frequency of the children in the observation group was higher than that of the control group at weeks 4, 8 and 12 of treatment, and the air-conduction hearing threshold was lower than that of the control group. The total effective rate of the observation group after 12-weeks of treatment was 92.11 %, which was significantly higher than that of the control group (73.68 %). In addition, the T-ETDQ score of the observation group was lower than that of the control group after treatment.</div></div><div><h3>Conclusion</h3><div>MFNS has clinical efficacy in the treatment of SOM in young children, which can improve clinical symptoms, promote the recovery of hearing and eustachian tube function, reduce the local inflammatory response, and improve immune function.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100551"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821861","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":"CST1 promoted gastric cancer development by activating the AKT pathway","authors":"Lei Zhang ,&nbsp;Dongmei Wang ,&nbsp;Liqun Zhang ,&nbsp;Lini Zhu","doi":"10.1016/j.clinsp.2024.100561","DOIUrl":"10.1016/j.clinsp.2024.100561","url":null,"abstract":"<div><h3>Background</h3><div>Gastric Cancer (GC) was the third highest mortality rate among malignant tumors. Currently, no specific treatment is utilized to prevent the progression of GC. The detailed mechanism of GC was still elusive and this study aimed to clarify the mechanism of GC occurrence and development.</div></div><div><h3>Method</h3><div>This study was performed to clarify the molecular mechanisms of CST1 promoting GC development through activating AKT. The normal gastric tissue cells and GC cell was obtained, followed by transfection with oe-CST1 or sh-CST1, and their apoptosis and viability were evaluated. Finally, Western blot, Flow cytometry assay, Transwell assay, and Scratch assay were used to elucidate the molecular mechanisms of CST1 promoting GC development through activating the AKT pathway.</div></div><div><h3>Results</h3><div>Research outcomes show a significant elevation in CST1 and AKT protein as well as mRNA quantities in both the model and CST1-activator cohorts in relation to the control. Conversely, these proteins and mRNA concentrations were notably decreased in the presence of the CST1 inhibitor when compared to the model group, a difference that was statistically significant as evidenced by the <em>p</em>-value.</div></div><div><h3>Conclusion</h3><div>CST1 can promote the gastric cancer process by targeting the AKT pathway.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100561"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892632","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":"Coronavirus disease 2019 infection severity among different variants in children under 2-years old in Brazil","authors":"Beatriz Martinelli Menezes Gonçalves ,&nbsp;Rossana P.V. Francisco ,&nbsp;Ágatha S. Rodrigues ,&nbsp;José Carlos Soares Junior","doi":"10.1016/j.clinsp.2025.100592","DOIUrl":"10.1016/j.clinsp.2025.100592","url":null,"abstract":"<div><div>To analyze whether there is a significant difference in the virulence, symptoms, and outcomes of different Coronavirus Disease 2019 (COVID-19) variants in children under 2-years of age. We collected data from the <em>Sistema de Informação de Vigilância Epidemiológica</em> da <em>Gripe</em>, a nationwide Brazilian database on severe acute respiratory syndrome. The patients were classified according to four variants of concern: wild-type, gamma, delta, and omicron. The wild-type variant was defined as the baseline. A total of 11,153 patients were analyzed. The risk of presenting dyspnea (adjusted Odds Ratio[Aor = 1.20], 95 % Confidence Interval [95 % CI 1.07–1.34]) was higher in patients with gamma infection. Respiratory discomfort was more likely to be present for the omicron (Aor = 1.29, 95 % CI 1.15–1.43) and gamma (aOR = 1.26, 95 % CI 1.13–1.41) infections. Desaturation was more likely to be present for the omicron (aOR = 1.67, 95 % CI 1.50–1.86), gamma (aOR = 1.16, 95 % CI 1.43–1.79), and delta (aOR 1.41, CI 95 % 1.18–1.68) infections. Infection by the omicron variant was a protective factor for intubation (aOR = 0.78, 95 % CI 0.67–0.91) and death (aOR = 0.43, 95 % CI 0.35–0.53). Additionally, delta infection was a protective factor against death (aOR = 0.60, 95 % CI 0.43–0.85). The wild-type variant was responsible for most of the cases that evolved with death. Omicron appears to be responsible for milder symptoms than delta. Children between 1 and 6 months of age account for most cases, which is a concern because there is no vaccination coverage.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100592"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455137","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":"Pharmacological treatment of antidepressant-induced sexual dysfunction in women: A systematic review and meta-analysis of randomized clinical trials","authors":"Antonio Carlos Queiroz de Aquino ,&nbsp;Ayane Cristine Alves Sarmento ,&nbsp;Raphaell Lucas de Araújo Teixeira ,&nbsp;Tâmilly Nascimento Batista ,&nbsp;Cijara Leonice de Freitas ,&nbsp;José Manuel Pérez Mármol ,&nbsp;Lucia Alves Silva Lara ,&nbsp;Ana Katherine Gonçalves","doi":"10.1016/j.clinsp.2025.100602","DOIUrl":"10.1016/j.clinsp.2025.100602","url":null,"abstract":"<div><h3>Background</h3><div>Antidepressant-Induced Sexual Dysfunction (AISD) is a significant public health concern, and pharmacological treatments may offer potential solutions for managing this side effect. This study aims to assess the efficacy of these therapies in treating AISD in women, as well as their impact on improving depressive symptoms.</div></div><div><h3>Methods</h3><div>The authors conducted a search of PubMed, Cochrane, Scopus, Web of Science, Embase, and ClinicalTrials.gov databases up to July 3, 2024, including Randomized Controlled Trials (RCTs) comparing pharmacological treatments with placebo. The risk of bias was assessed using the Cochrane Risk of Bias tool (RoB 2.0). Data synthesis was performed with RevMan 5.4, and the certainty of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.</div></div><div><h3>Results</h3><div>Eleven studies, with 859 women, were included in the review. Two studies were used in the meta-analysis. The participants' ages ranged from 28 to 48 years. The interventions studied included <em>Aphrodite</em>, bupropion SR, ephedrine, <em>maca root, rosa damascena, saffron</em>, sildenafil, testosterone, and the compound VML-670. Bupropion SR 150 mg/b.i.d. showed improvements in three sexual function domains: desire (1.74 [1.03, 2.44], p = 0.00001), arousal (1.30 [1.16, 1.43], p = 0.00001), and orgasm (1.90 [1.78, 2.02], p = 0.00001) compared to placebo. However, it did not improve depressive symptoms (0.46 [-0.71, 1.63], p = 0.44). The GRADE rating for the evidence quality was low.</div></div><div><h3>Conclusions</h3><div>Bupropion SR 150 mg/b.i.d. is the most effective pharmacological treatment for AISD in women, though the evidence quality is low. Further clinical trials focusing on women with rigorous methodologies are needed to strengthen these findings.</div></div><div><h3>PROSPERO registration number</h3><div>CRD42024496931.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100602"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455139","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":"Normal ranges of the fetal weight determined by ultrasound in the population of the Hospital das Clínicas of the Faculdade de Medicina da Universidade de São Paulo","authors":"Eliane Azeka Hase,&nbsp;Amanda Amaral,&nbsp;Stela Verzinhasse Peres,&nbsp;Rossana Pulcineli Vieira Francisco","doi":"10.1016/j.clinsp.2025.100616","DOIUrl":"10.1016/j.clinsp.2025.100616","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to determine the normal range of fetal weight by ultrasound in pregnant women followed at the Obstetric Clinic of the Hospital das Clínicas of the Faculty of Medicine, University of São Paulo.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included singleton pregnant women without associated maternal diseases, at 15–41 weeks of gestation, who underwent their last ultrasound up to 7 days before birth. Fetal parameters analyzed for the normal range were biparietal diameter, femur length, head and abdominal circumference. 3rd, 10th, 50th, 90th, and 97th weight percentiles were determined for each gestational age. Newborns were classified by birth weight as Small (SGA), Appropriate (AGA), or Large (LGA) for gestational age.</div></div><div><h3>Results</h3><div>Among 837 women admitted without maternal diseases, 136 were included and 379 examinations performed at 15–41 weeks of gestation. Multiple linear regression models were generated to develop the normal range of fetal weight. Three equations were selected, and six normal ranges were created considering the total population and stratified by fetal sex. Weight estimates were calculated for the 3rd, 10th, 50th, 90th, and 97th percentiles for each gestational age. Among the 136 newborns, 107 (78.7 %) were classified as AGA, 23 (16.9 %) as SGA, and 6 (4.4 %) as LGA.</div></div><div><h3>Conclusion</h3><div>The normal range of the fetal weight determined by ultrasound in this population showed a good correlation with gestational age, enabling the fetal weight gain pattern evaluation. The equation based on four parameters, including days before birth, presented the lowest percentage error variation to estimate the normal range.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100616"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629376","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":"A systematic review and meta-analysis of the efficacy and safety of glucocorticoids in the treatment of severe pneumonia","authors":"Jingye Liu ,&nbsp;Zhiqiang Yang","doi":"10.1016/j.clinsp.2025.100630","DOIUrl":"10.1016/j.clinsp.2025.100630","url":null,"abstract":"<div><h3>Objectives</h3><div>To systematically evaluate the efficacy and superiority of glucocorticoids in the treatment of severe pneumonia.</div></div><div><h3>Method</h3><div>Randomized Controlled Trials (RCTs) on glucocorticoids in the treatment of severe pneumonia were retrieved from CNKI, CBM, China Science and Technology Journal Database (VIP), Wanfang Database, and PubMed as of January 1, 2017. The literature was independently and objectively screened, extracted, and evaluated by two researchers, and a meta-analysis of the extracted data was performed using Revman 5.3 software.</div></div><div><h3>Results</h3><div>Ten studies that met the inclusion criteria were included, with a cumulative total of 1120 cases. The meta-analysis results confirmed that the observation group was superior to the control group in terms of efficacy rate, temperature recovery time, cough relief time, rale disappearance time, and serum CRP level. There was no statistically significant difference in terms of the incidence of adverse reactions, mortality rate, and reinfection rate between the two groups.</div></div><div><h3>Conclusions</h3><div>Glucocorticoids showed an obvious clinical efficacy in patients with severe pneumonia. However, due to the small number of included studies and the ambiguity of numerous bias risk assessments, high-quality and large-sample RCTs are still needed to provide corroborating evidence.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100630"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864604","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":"Effect of combined training on the cardiorespiratory, muscle system and body composition in employees at a tertiary hospital after mild to moderate intensity COVID 19","authors":"Marcus Vinicius Grecco ,&nbsp;Alexandre Moura dos Santos ,&nbsp;JúliaMaria D'Andrea Greve ,&nbsp;Angélica Castilho Alonso ,&nbsp;Mara Silvia Afonso ,&nbsp;Juliana Cristina de Sousa ,&nbsp;Marília Simões Lopes Quintana ,&nbsp;José Maria Soares-Junior ,&nbsp;Edmund Chada Baracat ,&nbsp;Guilherme Carlos Brech ,&nbsp;Paulo Roberto Santos Silva","doi":"10.1016/j.clinsp.2025.100614","DOIUrl":"10.1016/j.clinsp.2025.100614","url":null,"abstract":"<div><h3>Objective</h3><div>To verify the effect of 12 weeks of Combined Training (CT) in patients suffering from COVID-19 of mild to moderate intensity.</div></div><div><h3>Methods</h3><div>69 participants diagnosed with mild to moderate COVID-19 were evaluated, with shortness of breath as the main symptom. All of them were sent by the Centro de Atendimento ao Funcionário do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (CEAC-HCFMUSP). The sample was divided into three groups: Group 1 (G1) – 26 patients diagnosed with COVID-19 evaluated before and after combined training together with nutritional guidance. Group 2 (G2) – 21 patients diagnosed with COVID-19 were evaluated before and after 12 weeks. Patients in G2 (control) did not participate in the protocol but were instructed to train outside the hospital and did not receive nutritional guidance. Group 3 (G3) – 22 patients diagnosed with COVID-19 were evaluated before and after combined training along with nutritional monitoring and post-workout whey protein supplementation throughout the duration of the protocol.</div></div><div><h3>Results</h3><div>The three groups did not have significant statistical differences when compared to each other, but there was significant intragroup improvement in the analyzed variables. There was an improvement in cardiorespiratory, metabolic, and muscular fitness. Furthermore, late symptoms of the disease were reduced at the end of the program.</div></div><div><h3>Conclusion</h3><div>The results of the dependent variables analyzed were significant within groups, CT was an efficient training model in improving the patient's general condition (fatigue and dyspnea) when training was controlled with supervision.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100614"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869816","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":"Brugada pattern changes during tilt table test with high precordial leads. An exploratory data to better understand the dynamic profile","authors":"Eduardo Nolla Silva Pereira,&nbsp;Luciana Sacilotto,&nbsp;Tan Chen Wu,&nbsp;Gabriele D'Arezzo Pessente,&nbsp;Denise Tessariol Hachul,&nbsp;Mauricio Ibrahim Scanavacca,&nbsp;Francisco Carlos da Costa Darrieux","doi":"10.1016/j.clinsp.2025.100647","DOIUrl":"10.1016/j.clinsp.2025.100647","url":null,"abstract":"<div><h3>Introduction</h3><div>Brugada Syndrome (BrS) typically manifests with a dynamic type 1 Brugada pattern (Br1ECGp) that depends on the dominance of the sympathetic or parasympathetic nervous system. This pattern is more prominent during activities that stimulate the vagus nerve, such as sleeping and after meals. By conducting the tilt table test and adding high precordial leads to the standard protocol, it is possible to provoke sympathetic or parasympathetic responses, providing valuable information.</div></div><div><h3>Materials and methods</h3><div>This was an observational, cross-sectional and hypothesis-generating pilot study. The tilt table test was performed with high precordial leads on three Brugada patients to assess the Br1ECGp during the test. The ECG features were continuously recorded to analyze variations during all phases of the test.</div></div><div><h3>Results</h3><div>The first patient exhibited a significant Br1ECGp that disappeared during the upward phase of the tilt table test and reappeared during the recovery phase. The second patient had a Br1ECGp in three leads that persisted during both the upward and recovery phases of the tilt table test. The third patient displayed a Br1ECGp in three leads, which was maintained during the upward phase in two leads and recovered during the recovery phase. The third patient was the only one to experience cardioinhibitory syncope.</div></div><div><h3>Conclusion</h3><div>This study provided insights into the dynamics of the Br1ECGp during the tilt table test when enhanced by high precordial leads. It reaffirmed that the Brugada ECG pattern is influenced by sympathetic or parasympathetic dominance.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100647"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768264","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}