Einstein-Sao Paulo最新文献

{"title":"Concerns about the dengue epidemic.","authors":"Mariana Hayashi Garcia, Paulo Bandiera-Paiva, Luciano Rodrigo Lopes","doi":"10.31744/einstein_journal/2025CE1632","DOIUrl":"10.31744/einstein_journal/2025CE1632","url":null,"abstract":"","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eCE1632"},"PeriodicalIF":1.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Alert Score: evaluation of measurement properties.","authors":"Vitória Yukari Chaves Aoki, Giselli Cristina Villela Bueno, Flávia Carvalho Pena Dias, Renata Cristina Gasparino, Daniela Fernanda Dos Santos Alves","doi":"10.31744/einstein_journal/2025AO1214","DOIUrl":"10.31744/einstein_journal/2025AO1214","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the construct validity and reliability of the Pediatric Alert Score in hospitalized children and adolescents.</p><p><strong>Methods: </strong>This methodological study included 84 children aged 0-14 years. Data were collected using three instruments: a sociodemographic and clinical characterization form, the Brazilian version Brighton Pediatric Early Warning Score, and the Pediatric Alert Score. The reliability of the Pediatric Alert Score was assessed using interobserver equivalence expressed by the intraclass correlation coefficient, and the construct validity was evaluated using Spearman's correlation analysis of the Pediatric Alert Score and the Brighton Pediatric Early Warning Score.</p><p><strong>Results: </strong>The reliability analysis of the Pediatric Alert Score revealed an intraclass correlation coefficient of 0.95 (95% confidence interval from 0.93-0.97), and the Spearman's correlation coefficient was 0.53 (p<0.0001), indicating a strong positive correlation between the instruments.</p><p><strong>Conclusion: </strong>The Pediatric Alert Score demonstrated construct validity and internal consistency in the studied sample and can be used to enhance patient safety.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eAO1214"},"PeriodicalIF":1.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidentally detected breast lesions: a pictorial essay of malignant and benign findings.","authors":"Bruna Mayumi Takaki Tachibana, Rodrigo Marques Carneiro, Iviny Yonekura, Renato Leme de Moura Ribeiro, Ana Cláudia Silveira Racy, Érica Elisângela Francolin Federicci","doi":"10.31744/einstein_journal/2025RW0681","DOIUrl":"10.31744/einstein_journal/2025RW0681","url":null,"abstract":"<p><p>Incidentalomas are lesions incidentally identified in patients undergoing imaging for unrelated reasons. Breast incidentalomas have a high correlation with malignancy, occurring in over 40% of cases. Consequently, their interpretation poses significant challenges for radiologists who must discern the findings that may present a potential risk to the patient. This pictorial review presents different incidental breast lesions revealed through cross-sectional imaging. We further review key concepts related to such incidentalomas.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eRW0681"},"PeriodicalIF":1.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uretero-fallopian fistula after gynecological surgery for endometriosis: a case report.","authors":"Flavia Mansur Starling, Marcela Caetano Vilela Lauar, Gabriela Caetano Vilela Lauar, Maria Helena Pedroso, Cinthia Callegari Barbisan","doi":"10.31744/einstein_journal/2025RC1294","DOIUrl":"10.31744/einstein_journal/2025RC1294","url":null,"abstract":"<p><p>The increasing use of videolaparoscopy for the complete excision of endometriotic lesions and restoration of pelvic anatomy has helped improve long-term outcomes. However, risks remain, including rare but significant complications such as salpingoureteral fistulas. Early diagnosis using imaging methods enables adequate treatment and reduces the risk of new complications. In this report, we present a case of uretero-fallopian fistula following gynecological surgery for the resection of endometriotic lesions, with intraoperative inadvertent ureteral injury. This case report aimed to highlight the importance of diagnostic imaging in postoperative complications of gynecological surgeries for endometriosis, especially if inadvertent injuries occur during the procedure, and to guide the medical community in suspecting and addressing this condition.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eRC1294"},"PeriodicalIF":1.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stiff-person syndrome manifesting as unilateral extrinsic ocular musculature paresis.","authors":"Iago Resende Carvalho, Diogo Fernandes Dos Santos","doi":"10.31744/einstein_journal/2025AI0881","DOIUrl":"10.31744/einstein_journal/2025AI0881","url":null,"abstract":"","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eAI0881"},"PeriodicalIF":1.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception of the multidisciplinary team and the patient's family companion regarding their presence during emergency room care.","authors":"Juanna Elisa Oliveira, Rafael da Silva Giannasi Severini, Gabriella Trevisan Padilha, Amélia Gorete Afonso da Costa Reis, Sylvia Costa Lima Farhat, Cláudio Schvartsman","doi":"10.31744/einstein_journal/2025AO0871","DOIUrl":"10.31744/einstein_journal/2025AO0871","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the perceptions of family companions and the professional team regarding the presence of a family member during emergency and urgent care at a tertiary pediatric hospital.</p><p><strong>Methods: </strong>This exploratory, descriptive cross-sectional study was conducted at a tertiary pediatric hospital that mandated the presence of companions in the emergency room during emergency care and/or procedures. The researcher conducted interviews after emergency care and administered questionnaires to the participants.</p><p><strong>Results: </strong>Ninety-five emergency room visits were selected, resulting in 92 interviews with companions and 148 interviews with multidisciplinary team members. Of the companions, 71% were unaware of the legislation regarding their presence. Despite their lack of knowledge, 90.2% insisted on accompanying the patient. Of the multidisciplinary team members, 37% were unaware that the patient could be accompanied to the emergency room, and 2% reported not allowing a companion in the emergency room. Nevertheless, 87% of the team agreed that the companion comforted the patient during care in the emergency room.</p><p><strong>Conclusion: </strong>Results from both companions and health professionals perceive the companion's presence during emergency room care as positive, making it necessary to implement care protocols that supports a companion's presence during pediatric care.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eAO0871"},"PeriodicalIF":1.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to \"comment on: Lessons from the pandemic and the value of a structured system of ultrasonographic findings in the diagnosis of COVID-19 pulmonary manifestations\".","authors":"Vítor Carminatti Romano, Natália Tavares de Melo Barros Lima, Victor Arantes Jabour, Guilherme Ciconelli Del Guerra, Paulo Rogério Barboza Silvério, Rodrigo Gobbo Garcia, Yoshino Tamaki Sameshima, Miguel José Francisco Neto, Marcos Roberto Gomes de Queiroz","doi":"10.31744/einstein_journal/2025CE1697","DOIUrl":"10.31744/einstein_journal/2025CE1697","url":null,"abstract":"","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eCE1697"},"PeriodicalIF":1.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of hypercalcemia related to polymethylmethacrylate injection: report of three cases.","authors":"Lívia Reis de Miranda, Eduardo de Paiva Luciano, Eduarda Andrea Silva Rizzo, Marissol Fernandes Oliveira, Sheila Cavalca Cortelli, Walnei Fernandes Barbosa","doi":"10.31744/einstein_journal/2025RC1377","DOIUrl":"10.31744/einstein_journal/2025RC1377","url":null,"abstract":"<p><p>Polymethylmethacrylate is a microsphere-based plastic used in aesthetic procedures. However, it can cause granuloma formation and severe hypercalcemia, often accompanied by renal impairment, which is a significant concern. Despite increasing reports, there is no standardized treatment approach for polymethylmethacrylate-induced hypercalcemia, and its incidence remains underreported. In this study, we present three cases of polymethylmethacrylate users who developed severe hypercalcemia that was resistant to conventional treatments, resulting in deteriorating renal function. These patients achieved symptom control with cinacalcet, a medication primarily used to treat secondary hyperparathyroidism, severe primary hyperparathyroidism, and parathyroid cancer.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eRC1377"},"PeriodicalIF":1.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of tonsillar human papillomavirus infection in low-risk individuals without cancer.","authors":"Jéssica Boscariol da Silva, Aline Oliveira Silva, Luciana Reis Rosa Sacoman, Leandro Luongo Matos, Ronaldo Frizzarini, Raquel Ajub Moyses, José Eduardo Levi","doi":"10.31744/einstein_journal/2025AO1715","DOIUrl":"10.31744/einstein_journal/2025AO1715","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the prevalence of human papillomavirus (HPV) 16 infection in the tonsils of patients without cancer and to analyze the associated risk factors in a low-risk population in Brazil.</p><p><strong>Methods: </strong>The study included 113 adult patients who underwent surgery for non-neoplastic conditions. The participants completed an interview-based questionnaire on lifestyle habits, including the use of tobacco and alcohol, and a questionnaire on sexual behavior. Overall, 226 freshly frozen tonsil samples were subjected to DNA extraction, conventional polymerase chain reaction using the PGMY09/11 primer for β-globin, and quantitative polymerase chain reaction for HPV16 detection.</p><p><strong>Results: </strong>In this cohort, 47 patients (41.6%) were women between 18 and 58 years of age (mean age, 28.5 years), and 66 (58.4%) were men between 18 and 68 years of age (mean age, 34 years). A total of 81 (71.7%) and 46 (40.7%) patients answered questionnaires on lifestyle habits and sexual behavior, respectively. All samples successfully amplified the β-globin gene fragment but tested negative for HPV DNA. This outcome precluded an investigation of the association between risk factors such as sexual behavior and HPV infection. External validation using oropharyngeal squamous cell carcinoma specimens confirmed the reliability of the laboratory procedures to detect HPV DNA, showing a 10% prevalence of HPV infection in the comparator population.</p><p><strong>Conclusion: </strong>The findings of this study suggest that the actual prevalence of HPV16 tonsillar infection in the general population without cancer may be lower than that previously reported in Brazil.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eAO1715"},"PeriodicalIF":1.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact evaluation of technical notes issued by NATJUS on healthcare judicialization.","authors":"Lucas Reis Correia, Luís Gustavo Nascimento de Paula, Julio Trecenti, Bruno Daleffi da Silva","doi":"10.31744/einstein_journal/2025GS0766","DOIUrl":"10.31744/einstein_journal/2025GS0766","url":null,"abstract":"<p><strong>Introduction: </strong>Technical Support Centers of the Judiciary (NATJUST), provide health technology assessments to judges in health-related litigations against both public and private healthcare systems. These centers provide technical notes, that can assist Brazilian Courts in making provisional rulings and determining patient access to health services during legal proceedings.</p><p><strong>Objective: </strong>This study aimed to evaluate the impact of NATJUS technical notes on preliminary injunctions in lawsuits against the Brazilian Unified Health System. Specifically, we analyzed the alignment between judicial decisions and technical notes recommendations, assessed lawsuit costs, and examined NATJUS-generated savings for Brazilian Unified Health System. Furthermore, we examined the technical notes issued by Hospital Israelita Albert Einstein, which manages the national NATJUS.</p><p><strong>Methods: </strong>We constructed a database of lawsuits with and without NATJUS technical notes. Using random forest models, we predicted the potential outcomes of preliminary injunctions where technical notes were available. Savings were estimated by examining the relationship between preliminary injunctions and case values, then compared with potential injunctions incorporating technical notes recommendations.</p><p><strong>Results: </strong>The technical notes recommendations and judges' decisions were aligned in 76% of the cases, with median savings from lawsuits amounting to BRL10,120. The estimated impact of NATJUS technical notes for Brazilian Unified Health System indicated median savings of BRL1,312.74 per case per year. Between 2020 and 2022, NATJUS resulted in total savings of BRL111.4 million. Focusing on Hospital Israelita Albert Einstein NATJUS, the cost savings for Brazilian Unified Health System amounted to BRL27 million, which indicates a return on investment of BRL1.66 per BRL1 invested in the project.</p><p><strong>Conclusion: </strong>Our findings indicate the economic importance of technical notes in shaping preliminary injunctions, not only elevating decision quality but also fostering evidence-based judicial processes.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eGS0766"},"PeriodicalIF":1.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}