Einstein-Sao Paulo最新文献

{"title":"Accuracy of oxidative stress markers for predicting delayed graft function lasting longer than a week in deceased-donor kidney transplantation.","authors":"João Paulo Ribeiro Neto, Thales Paulo Batista, Cristiano Souza Leão, Leuridan Cavalcante Torres, Danielle da Silva Dias, Kátia De Angelis","doi":"10.31744/einstein_journal/2026AO1827","DOIUrl":"10.31744/einstein_journal/2026AO1827","url":null,"abstract":"<p><strong>Objective: </strong>To assess the accuracy of oxidative stress markers in predicting delayed graft function (DGF) lasting more than one week after deceased-donor kidney transplantation (KTx).</p><p><strong>Methods: </strong>A translational pilot study was carried out and a five-step hierarchical diagnostic accuracy strategy was applied to evaluate the predictive value of oxidative stress markers for DGF >7 days in adult patients with end-stage kidney disease undergoing deceased-donor KTx. Statistics comprise multiple conventional methods, C-statistics, and diagnostic test performance measures.</p><p><strong>Results: </strong>Cohort analysis of 27 consecutive patients revealed that 33.3% (9/27) developed DGF >7 days. Assessment of the oxidative stress markers selected in the first statistical step comparing donors and controls revealed a significant correlation of the DGF duration with the recipient's protein oxidation (ρ=0.466; p=0.022) as well as donor's hydrogen peroxide (ρ=-0.489; p<0.014). The areas under the curve were 0.683 (95% confidence interval [95%CI], 0.458-0.859; p=0.224) and 0.746 (95%CI=0.534-0.897; p=0.019), respectively. A cutoff of ≤14 μM H2O2 had the highest level of discriminating power for predicting DGF >7 days. The sensitivity, specificity, positive predictive value, negative predictive value, and overall diagnostic accuracy to identify patients at risk for experiencing DGF >7 days was 85.7%, 61.1%, 46.1%, 91.7%, and 68%, respectively.</p><p><strong>Conclusion: </strong>Donor hydrogen peroxide was identified as a potential predictor of DGF >7 days in patients who underwent deceased-donor KTx. A cut-off value of ≤14 μmol/L is suggested to stratify patients at high risk of requiring dialysis beyond the first post-transplant week.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eAO1827"},"PeriodicalIF":0.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785520","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":"Preliminary diagnostic criteria for distinguishing metaplastic Warthin tumors from mucoepidermoid carcinomas rich in lymphoid stroma.","authors":"João Felipe Leite Bonfitto, João Figueira Scarini, Iara Vieira Ferreira, Reydson Alcides de Lima-Souza, Erika Said Abu Egal, Albina Altemani, Fernanda Viviane Mariano","doi":"10.31744/einstein_journal/2026AO1591","DOIUrl":"10.31744/einstein_journal/2026AO1591","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyze the clinicopathological and immunohistochemical profiles of unconventional Warthin tumors and mucoepidermoid carcinomas.</p><p><strong>Methods: </strong>Eleven low-grade salivary gland tumors with Warthin-like features were analyzed. Group A (n=6) showed a double-layered oncocytic epithelium in less than 50% of the epithelial cells, whereas Group B (n=5) lacked this feature. Additionally, five conventional Warthin tumors and ten conventional mucoepidermoid carcinomas were analyzed as reference groups. Immunohistochemical staining was performed for cytokeratins (types 5/6, 7, and 14), p63, mitochondrial antigens, and Ki-67. Expression patterns were compared between groups.</p><p><strong>Results: </strong>Group A exhibited an oncocytic epithelium arranged in a double-layered pattern, with mitochondrial antigens strongly staining the luminal oncocytic cells. Cytokeratin 7 expression in Warthin tumors was predominantly luminal. In contrast, Group B showed glandular and cystic structures with diffuse mitochondrial antigen and cytokeratin 7 positivity. Immunohistochemical analysis revealed significant differences, with Warthin tumors showing distinct double-layered epithelial structures, and mucoepidermoid carcinomas displaying diffuse staining patterns.</p><p><strong>Conclusion: </strong>Distinct immunohistochemical profiles, including mitochondrial antigen and cytokeratin 7 expression, along with morphological differences, support the classification of Group A as metaplastic Warthin tumors and Group B as Warthin-like variants of mucoepidermoid carcinoma. These findings highlight the importance of molecular and immunohistochemical analyses for accurate classification of these tumors.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eAO1591"},"PeriodicalIF":0.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785655","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":"Irreversible electroporation combined with immunotherapy versus irreversible electroporation alone for locally advanced pancreatic cancer: a systematic review and meta-analysis.","authors":"Miriana Mariussi, Laura Costa de Oliveira Lima, Mariano Gallo Ruelas, Victor Arthur Ohannesian, Bruno Murad, Guilherme Strieder de Oliveira, Luiza Giuliani Schmitt, Giovanni Brondani Torri, Stephan Altmayer, Priscila Mina Falsarella, Pedro Luiz Serrano Usón Junior, Rodrigo Gobbo Garcia","doi":"10.31744/einstein_journal/2026RW1656","DOIUrl":"10.31744/einstein_journal/2026RW1656","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this meta-analysis was to determine the efficacy and safety of percutaneous irreversible electroporation combined with immunotherapy compared with irreversible electroporation alone in patients with locally advanced pancreatic cancer.</p><p><strong>Methods: </strong>We systematically searched Embase, Cochrane Central Register of Controlled Trials, and PubMed/Medline for relevant studies. The outcomes of interest were progression-free survival, overall survival, carbohydrate antigen 19-9 (CA 19-9) levels, and adverse events. Progression-free survival and overall survival were assessed using pooled hazard ratios (HR), odds ratios (OR) were used for adverse events, and mean differences (MD) for CA 19-9.</p><p><strong>Results: </strong>Four studies involving 310 patients were included in the pooled analysis. Irreversible electroporation combined with immunotherapy significantly prolonged progression-free survival compared with irreversible electroporation alone (hazard ratio [HR], 0.56; 95%CI=0.39 - 0.80; p<0.01; I2=10%). Additionally, patients who received irreversible electroporation plus immunotherapy achieved a greater overall survival compared with irreversible electroporation alone (HR=0.52; 95%CI=0.37 - 0.73; p<0.01; I2=0%). The pooled results for CA 19-9 showed significantly lower levels in patients receiving irreversible electroporation and immunotherapy compared with those receiving irreversible electroporation alone (MD: -70.18U/L; 95%CI=-121.07 - -19.29; p<0.01; I2=98%). No significant difference in the occurrence of adverse events such as nausea and vomiting (OR=1.58; 95%CI=0.71 - 3.49; p=0.26; I2=0%) and gastroparesis (OR=0.88; 95%CI=0.23 - 3.40; p=0.85; I2=0%) was not observed between the groups.</p><p><strong>Conclusion: </strong>Combined therapy using percutaneous irreversible electroporation and systemic immunotherapy offers a safe and effective treatment approach for locally advanced pancreatic cancer, with irreversible electroporation potentially enhancing the efficacy of systemic immunotherapy in combined applications.</p><p><strong>Prospero database registration: </strong>ID CRD42024562216.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eRW1656"},"PeriodicalIF":0.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785601","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":"Factors associated with sleep quality and duration in mothers of children with autism spectrum disorder: a cross-sectional study.","authors":"Patrícia Souza de Almeida, Carlos Eduardo Lins E Silva, Alisson Henrique de Almeida, Flavia Eloize de Souza Silva, Raphael Mendes Ritti-Dias, Ozeas Lima Lins-Filho, Breno Quintella Farah","doi":"10.31744/einstein_journal/2026AO2004","DOIUrl":"10.31744/einstein_journal/2026AO2004","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the factors associated with sleep quality and duration in mothers of children with autism spectrum disorder.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 595 mothers (37±7yrs) of children and adolescents with autism spectrum disorder (8.1±3.1yrs). The assessed sleep parameters included sleep quality and duration. Mothers reporting poor sleep quality and those who did not sleep between seven and nine hours per night were considered at risk. Demographic data (age, education, income, marital status, and number of children), child-related data, comorbidities (overweight, diabetes, hypertension, dyslipidemia, heart disease, depression symptoms, and anxiety), and lifestyle factors (physical activity, sedentary behavior, and smoking) were evaluated.</p><p><strong>Results: </strong>Forty-four percent of mothers reported poor sleep quality, and 70.4% did not achieve the recommended seven to nine hours of sleep per night. Factors associated with poor sleep quality included being unmarried [Odds-ratio(OR): 2.152; 95% confidence interval (95%CI)= 1.332-3.478], heart diseases (OR=4.859; 95%CI=1.153-20.471), depression symptoms (OR=3.833; 95%CI=(2.273-6.464), sedentary behavior on weekdays (OR=2.293; 95%CI=1.335-3.938), dissatisfaction with their child's therapy (OR=1.990; 95%CI=1.214-3.262), and inadequate sleep duration (OR=9.025; 95%CI=4.661-17.473). Inadequate sleep duration was associated with depression symptoms (OR=1.965; 95%CI=1.290-2.993), age (OR=1.051; 95%CI=1.152-2.517), number of children with autism spectrum disorder (OR=3.574; 95%CI=1.152-.517), total number of children (OR=1.655; 95%CI=1.089-2.517), and poor sleep quality (OR=6.259; 95%CI=3.843-10.193).</p><p><strong>Conclusion: </strong>Most mothers of children with autism spectrum disorder experience poor sleep quality and inadequate sleep duration. Demographic data, child-related data, heart disease, depressive symptoms, and sedentary behavior were associated with inadequate sleep.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eAO2004"},"PeriodicalIF":0.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785475","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":"The use of an objective method (continuous exosomatic electrodermal activity without external stimuli) to evaluate patients with hyperhidrosis undergoing video-assisted sympathectomy.","authors":"Rafael José Silveira, Carolina Carvalho Jansen Sorbello, Nelson Wolosker, José Ribas Milanez de Campos, João José de Deus Cardoso, Alexandre Sherlley Casimiro Onofre","doi":"10.31744/einstein_journal/2026AO1266","DOIUrl":"10.31744/einstein_journal/2026AO1266","url":null,"abstract":"<p><strong>Objective: </strong>To analyze continuous exosomatic electrodermal activity (EDA) without external stimuli (EDAcw) in patients with primary hyperhidrosis before and after sympathectomy.</p><p><strong>Methods: </strong>This prospective study included 28 participants, categorized into two groups. The first group comprised 18 patients with palmoplantar hyperhidrosis who underwent bilateral thoracic sympathectomy. The second group (control) consisted of 10 patients. Two questionnaires were administered: the Control Group completed them once, whereas the Sympathectomy Group completed them preoperatively, and on the first and thirtieth postoperative days. Sweating was evaluated by measuring EDAcw using an MP36R biosensor. Measurements were obtained from the hands and feet for 5 min without external stimuli in an air-conditioned environment and were performed preoperatively, and on the first and thirtieth postoperative days. Anthropometric, clinical, and surgical data were collected, and no significant sociodemographic differences were observed between the groups.</p><p><strong>Results: </strong>In the Sympathectomy Group, quality of life improved, and sweating reduced. During preoperative assessment, EDA was higher in the hands and feet of patients with hyperhidrosis than in the Control Group. Postoperatively, EDA in the hands decreased, with 100% of the patients showing a decrease in sweating. For the feet, 67% of the patients reported reduced sweating, and 44% showed a statistically significant decline in EDA.</p><p><strong>Conclusion: </strong>Continuous exosomatic EDA measurement without external stimuli is a suitable method for assessing patients with palmoplantar hyperhidrosis and shows appropriate clinical correlation.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eAO1266"},"PeriodicalIF":0.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785706","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":"Effects of an exercise program using an smatphone App with remote or in-person supervision on the functional capacity of older adults: a randomized clinical.","authors":"André Issao Kunitake, João Carlos Ferrari Corrêa, Raphael Mendes Ritti-Dias, Fernanda Ishida Corrêa","doi":"10.31744/einstein_journal/2026AO1757","DOIUrl":"10.31744/einstein_journal/2026AO1757","url":null,"abstract":"<p><strong>Introduction: </strong>Population aging is a significant global challenge, demanding strategies that promote healthy aging. Regular physical activity is crucial for maintaining functional capacity, quality of life, and preventing chronic diseases in older adults. However, sedentary behavior remains high, and evidence on effective, supervised smartphone-based exercise strategies for older adults is limited.</p><p><strong>Objective: </strong>To evaluate the effects of smartphone-based exercises with in-person or remote therapeutic supervision on functional capacity.</p><p><strong>Methods: </strong>Thirty-four older adults were randomized into two training groups with App-based exercises: a Control Group with in-person supervision and an Experimental Group with remote supervision. The exercises were performed three times a week for 8 weeks. The Experimental Group performed exercises at homes with remote supervision, and the Control Group performed exercises in the laboratory. Functional capacity was measured using the Glittre Activities of Daily Living (Glittre ADL) test, postural balance with the Mini Balance Evaluation Systems Test, and lower limb strength with the Five Times Sit-to-Stand test.</p><p><strong>Results: </strong>Both groups demonstrated significant improvement in functional capacity. After 8 weeks, Glittre-ADL test time reduced similarly in both groups (Experimental Group: 217±63 to 188±47 s and Control Group 194±34 to 171±30 s, ES=0.09). Postural balance improved similarly in both groups (ES=0.15), and the lower limb strength improved in the Experimental Group (ES=0.32).</p><p><strong>Conclusion: </strong>A smartphone App-based exercise program, with and without in-person supervision, improved functional capacity and postural balance in older adults, whereas lower limb strength improved only with in-person supervision. Brazilian Registry of Clinical Trials: RBR-22ctkjq.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eAO1757"},"PeriodicalIF":0.9,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785470","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":"One-dimensional computational circulatory models: a scoping review.","authors":"Gabriella de Araujo Cunha Lima Nóbrega, Stefano Garzon, Pablo J Blanco, Pedro Alves Lemos Neto","doi":"10.31744/einstein_journal/2026RW1854","DOIUrl":"10.31744/einstein_journal/2026RW1854","url":null,"abstract":"<p><strong>Background: </strong>Computational modeling of human circulatory system has evolved significantly in recent decades. Among the various modeling strategies, one-dimensional (1D) models have emerged as alternatives to more complex models because of their balance between physiological accuracy and computational efficiency.</p><p><strong>Objective: </strong>This scoping review aimed to summarize and compare the studies on 1D computational models of the entire circulatory system, including those that incorporated additional 0D and 3D components.</p><p><strong>Methods: </strong>A systematic search was performed for studies on computational 1D models of the entire arterial tree. Studies were eligible if they employed 1D modeling either exclusively or in combination with 0D and/or 3D components. Article screening, data extraction, and analyses were conducted in accordance with the PRISMA-ScR guidelines.</p><p><strong>Results: </strong>Out of the 6,841 records, 19 studies were included. Eleven articles presented strictly 1D nonlinear models, two used linear 1D models, and six employed multiscale frameworks that integrated 1D, 0D, and/or 3D components. Nonlinear 1D models consistently outperformed linear models in simulating large elastic arteries and pathological conditions, whereas linear models were effective in simulating small vessels under low-pressure variations. Multiscale models improve local hemodynamic details, but impose significantly higher computational costs.</p><p><strong>Conclusion: </strong>1D models provide a robust and computationally efficient framework for simulating global cardiovascular hemodynamics. Although nonlinear and multiscale models enhance the physiological fidelity and adaptability to complex scenarios, their higher computational demands should be weighed against the available resources and specific clinical or research goals.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eRW1854"},"PeriodicalIF":0.9,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785711","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":"Childhood vaccination against meningitis C from 2010 to 2024: a descriptive study based on the Department of Informatics of the Brazilian National Health System (DATASUS).","authors":"Laura Beatriz Fonseca, Carlos Eduardo de Oliveira Pereira, Taísa Roberta Lopes Machado, Alisson Bruno Luzia","doi":"10.31744/einstein_journal/2026AO1927","DOIUrl":"10.31744/einstein_journal/2026AO1927","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the correlation between vaccination coverage against meningitis C and epidemiological indicators of morbidity and mortality associated with the disease in Brazilian pediatric populations aged 3 months to 14 years.</p><p><strong>Methods: </strong>This descriptive and exploratory epidemiological study used secondary data from the National Immunization Program Information System (SI-PNI) and Notifiable Diseases Information System (SINAN). The analysis covered the period from 2010 to 2024, and examined the relationship between vaccination coverage and the number of meningitis cases and related deaths. The data included variables such as sex, age group, vaccine dose, incidence, mortality, and geographic distribution. Descriptive statistics, including calculations of proportions and rates, were performed using Microsoft Excel® (2019).</p><p><strong>Results: </strong>Following the introduction of the meningitis C vaccine in the National Immunization Program in 2010, the incidence of the disease in Brazil decreased significantly. From 2010 to 2015, the number of confirmed cases decreased by approximately 81%, reaching the lowest recorded rate in 2021 (0.02 per 100,000 inhabitants), representing a 98% reduction. However, an increase in the incidence was observed in 2022 (0.05 per 100,000 inhabitants). Although vaccination coverage exceeded 95% in 2011, it has declined in subsequent years.</p><p><strong>Conclusion: </strong>The meningitis C vaccination program has had a positive impact on public health, contributing to a marked reduction in disease cases and related deaths since its implementation. Higher vaccination coverage was associated with lower morbidity and mortality rates.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eAO1927"},"PeriodicalIF":0.9,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785457","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":"Feasibility of transthoracic echocardiography in the prone position with a low-cost adaptation: morphological, functional, and hemodynamic analysis.","authors":"Nilson Bossle Conci, Nathalia Conci Santorio, Pandreli Testa Santorio, Juliana Cassiano Lemos, Fábio Fernandes, Viviane Tiemi Hotta","doi":"10.31744/einstein_journal/2026AO1802","DOIUrl":"10.31744/einstein_journal/2026AO1802","url":null,"abstract":"<p><strong>Objective: </strong>Transthoracic echocardiography is essential for hemodynamic assessment in critically ill patients; however, its use in the prone position remains challenging. This study aimed to assess the feasibility of performing transthoracic echocardiography using a low-cost ultrasound table adaptation in the prone position.</p><p><strong>Methods: </strong>This was a single-center, cross-sectional, comparative pilot study. Anthropometric and clinical data were collected along with echocardiographic image acquisition in the conventional and prone positions by the same operator. Feasibility was assessed by the acquisition of echocardiographic windows and the number of key variables in both positions. Comparative analyses were conducted for image quality, examination duration, and quantitative parameters such as variables related to systemic congestion, biventricular function, and cardiac output estimation. Statistical analysis was performed using the Wilcoxon signed-rank test, Fisher's exact test, binomial test, and false discovery rate correction for multiple comparisons.</p><p><strong>Results: </strong>Echocardiographic views were obtained for all patients in both positions. Imaging in the prone position allowed consistent acquisition of 16 of 17 key variables, with no significant difference. Image quality in the parasternal view was slightly reduced in the prone position but remained appropriate (p=0.015). Examinations in the prone position were on average 4.2 min longer (p=0.037). No significant differences were observed between the positions for any quantitative echocardiographic parameters, including chamber dimensions, systolic and diastolic function, cardiac output, and inferior vena cava assessment.</p><p><strong>Conclusion: </strong>Transthoracic echocardiography in the prone position was feasible, with measurements comparable to those in the conventional position in healthy individuals undergoing routine evaluations in a regular echocardiography laboratory. Further studies are required to validate the accuracy and applicability of this method, particularly for patients in intensive care and emergency settings.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eAO1802"},"PeriodicalIF":0.9,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785465","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":"Evaluation of the effects of Plasma-Lyte 148 or 0.9% saline on acid-base balance in patients undergoing neurosurgery: a randomized clinical trial.","authors":"Murilo Moreira Thom, Guilherme Antonio Moreira de Barros, Lucas Guimarães Ferreira Fonseca, Rodrigo Leal Alves, Murillo Gonçalves Santos, Vitória Mariah Giriboni, Paulo do Nascimento Junior, Norma Sueli Pinheiro Módolo","doi":"10.31744/einstein_journal/2026AO1574","DOIUrl":"10.31744/einstein_journal/2026AO1574","url":null,"abstract":"<p><strong>Objective: </strong>The choice of crystalloid solution considerably affects perioperative outcomes in neurosurgery. This study aimed to evaluate the effects of Plasma-Lyte 148 and 0.9% saline on acid-base and hydroelectrolyte balance in adults undergoing elective neurosurgical procedures.</p><p><strong>Methods: </strong>A double-blind randomized controlled trial was conducted at Botucatu Medical School from November 2019 to May 2020. Patients received either Plasma-Lyte 148 or 0.9% saline at a maintenance rate of 2mL/kg/h, with additional bolus guided by mean arterial pressure and pulse pressure variation. The primary endpoint was arterial pH at the end of surgery.</p><p><strong>Results: </strong>Sixty-eight patients (33 in the Plasma-Lyte 148 group and 35 in the saline group) completed the study. The total median volumes administered (1st-3rd quartiles) were 2,227 (1,416-3,000) and 3,000 (2,000-4,000) mL in the Plasma-Lyte 148 and saline groups, respectively (p=0.107). At procedure completion, Plasma-Lyte 148 demonstrated superior acid-base homeostasis with significantly higher pH (7.39±0.04 versus 7.35±0.05, p<0.001), bicarbonate (22.5±1.8 versus 20.6±2.2mmol/L, p<0.001), and base excess (-1.6±2.3 versus -3.9±2.6, p<0.001), while preventing hyperchloremia (109.1±6.6 versus 113.9±4.5 mmol/L, p=0.001).</p><p><strong>Conclusion: </strong>Plasma-Lyte 148 provides superior acid-base homeostasis compared to 0.9% saline in patients undergoing neurosurgery, with significantly better pH, bicarbonate, and base excess profiles while avoiding hyperchloremia. These findings support the preferential use of balanced crystalloids in neurosurgical practice, aligning with current evidence favoring Plasma-Lyte 148 for optimal perioperative fluid management. ReBEC platform registration number: RBR-2592-hd.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eAO1574"},"PeriodicalIF":0.9,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785489","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}