Einstein-Sao Paulo最新文献

{"title":"Physiological responses during walking in men and women with intermittent claudication.","authors":"Roberto Sanches Miyasato, Alex Jesus Felix, Aluísio Andrade-Lima, Natan Daniel da Silva Júnior, Raphael Mendes Ritti-Dias, Nelson Wolosker, Véronique Cornelissen, Karla Fabiana Goessler, Claúdia Lúcia de Moraes Forjaz","doi":"10.31744/einstein_journal/2023AO0120","DOIUrl":"https://doi.org/10.31744/einstein_journal/2023AO0120","url":null,"abstract":"<p><strong>Background: </strong>Miyasato et al. show that peak oxygen consumption, walking economy, anaerobic threshold, and cardiovascular responses (heart rate, blood pressure, and rate pressure product) during walking were similar between men and women with peripheral artery disease and intermittent claudication. There were no differences in the physiological responses to walking between men and women with intermittent claudication. Sex per se is not a factor that demands changes in walking prescription for patients with intermittent claudication.</p><p><strong>Objective: </strong>Peak oxygen consumption (VO2peak), anaerobic threshold, walking economy, and cardiovascular responses during walking are used to guide and monitor walking training in patients with peripheral artery disease and intermittent claudication. Women with peripheral artery disease and intermittent claudication present greater impairments than men, and evaluating training markers according to sex for decisions regarding walking prescription in this population is important. This study aimed to compare VO2peak, walking economy, anaerobic threshold, and cardiovascular responses during walking in men and women with peripheral artery disease and intermittent claudication.</p><p><strong>Methods: </strong>Forty patients (20 men and 20 women with similar baseline characteristics) underwent a cardiopulmonary treadmill test (3.2km/h and 2% increase in slope every 2 minutes until maximal leg pain). The VO2 and rate-pressure product were assessed. Data from men and women were compared using t-tests.</p><p><strong>Results: </strong>There were no significant differences between men and women (VO2peak: 15.0±4.8 versus 13.9±2.9mL∙kg-1∙min-1, p=0.38; walking economy: 9.6±2.7 versus 8.4±1.6mL∙kg-1∙min-1, p=0.09; anaerobic threshold: 10.5±3.2 versus 10.5±2.2mL∙kg-1∙min-1, p=0.98; rate pressure product at 1st stage: 13,465± 2,910 versus 14,445±4,379bpm∙mmHg, p=0.41; and rate pressure product at anaerobic threshold:13,673±3,100 versus 16,390±5,870bpm∙mmHg, p=0.08 and rate pressure product at peak exercise: 21,253±6,141 versus 21,923±7,414bpm∙mmHg, p=0.76, respectively).</p><p><strong>Conclusion: </strong>Men and women with peripheral artery disease and similar baseline characteristics presented similar responses to walking, suggesting that decisions regarding walking prescription and monitoring can be made regardless of sex in this specific population.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of pulmonary aspiration during semaglutide use and anesthesia in a fasting patient: a case report with tomographic evidence.","authors":"Veronica Neves Fialho Queiroz, Priscila Mina Falsarella, Renato Carneiro de Freitas Chaves, Flávio Takaoka, Luis Ricardo Socolowski, Rodrigo Gobbo Garcia","doi":"10.31744/einstein_journal/2023RC0628","DOIUrl":"https://doi.org/10.31744/einstein_journal/2023RC0628","url":null,"abstract":"<p><p>Pulmonary aspiration of gastric residues during anesthesia is a potentially fatal complication for which no specific treatment is available. The primary way to prevent its occurrence in the context of elective surgeries is adherence to fasting protocols. However, some clinical conditions can prolong the gastric emptying time, and the risk of aspiration may exist despite adequate fasting. Recognizing the risk factors for gastroparesis allows the adoption of preventive methods and is the primary way to reduce morbidity and mortality from pulmonary aspiration. In this scenario, the anesthesiologist can investigate the gastric content by using ultrasound, adjust the anesthetic technique, and even postpone elective surgeries. Here, we describe incidental computed tomography finding of solid contents in the stomach of a patient without prior identification of the risk factors for gastroparesis. The patient underwent elective renal nodule ablation under general anesthesia after fasting for 9 hours. During the procedure, solid contents in the stomach were noted on computed tomography. Subsequently, it was discovered that the patient had been using semaglutide for 6 days and had not disclosed this information. Semaglutide use may represent a new and significant risk factor for anesthesia-related pulmonary aspiration. Until studies provide information on the appropriate perioperative management of patients using semaglutide, anesthesiologists need to adopt preventive measures to avoid aspiration. Awareness of this potential association and open communication among patients, physicians, and anesthesia teams are essential for enhancing patient safety.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between chronic pain, depressive symptoms, and functional disability in community-dwelling older adults: mediating role of frailty.","authors":"Flávia Silva Arbex Borim, Daniela de Assumpção, Mônica Sanches Yassuda, Henrique Trajano de Moraes Costa, Samila Sathler Tavares Batistoni, Anita Liberalesso Neri, Richard C Oude Voshaar, Ivan Aprahamian","doi":"10.31744/einstein_journal/2023AO0284","DOIUrl":"https://doi.org/10.31744/einstein_journal/2023AO0284","url":null,"abstract":"<p><strong>Background: </strong>Borim et al. showed that older adults with chronic pain exhibited more depressive symptoms and frailty components. Depressive symptoms were associated with more frailty components, and those with more depressive symptoms and frailty faced greater limitations in IADL performance. Frailty appears to mediate the pathway from chronic pain to functional impairment Chronic pain is directly associated with depressive symptoms and frailty. Chronic pain is not directly associated with functional disability. Depression and frailty are both directly associated with functional disabilities. Frailty mediates the association between chronic pain and functional disability. Depression; Disability evaluation; Frailty; Frail elderly.</p><p><strong>Objective: </strong>To evaluate the direct and indirect effects of chronic pain, depressive symptoms, frailty components, and functional disability through a pathway analysis approach in a sample of community-dwelling older adults.</p><p><strong>Methods: </strong>Data of 419 participants were cross-sectionally evaluated for the presence of depressive symptoms (Geriatric Depression Scale [15 items]), physical frailty components (phenotype criteria), chronic pain, and limitations in performing instrumental activities of daily living (functional disability scale by Lawton and Brody). Structural equation modeling via path analysis was used to explore the direct and indirect effects among these four variables. Statistical significance was set at p<0.05.</p><p><strong>Results: </strong>Of the total participants, 69.8% were women and 59.3% had low education (1-4 years); the mean age was 80.3±4.6 years. Chronic pain and depressive symptoms were directly related and were associated to frailty. The number of frailty components and depressive symptoms were directly associated with functional disability. Frailty had an indirect effect on the association between chronic pain, depressive symptoms, and functional disabilities.</p><p><strong>Conclusion: </strong>The pathway from chronic pain and depressive symptoms to functional disability is potentially mediated by the number of frailty components.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial peptide for bacterial infection imaging: first case reported in Brazil.","authors":"Solange Amorim Nogueira, Marycel Rosa Felisa Figols de Barboza, Rosemeire Pereira Bezerra, Jorge Mejia Cabeza, Adriana Macedo Dell'Aquila, Durval do Carmo Barros Santos, Lilian Yuri Itaya Yamaga, Akemi Osawa","doi":"10.31744/einstein_journal/2023RC0621","DOIUrl":"10.31744/einstein_journal/2023RC0621","url":null,"abstract":"<p><p>Molecular imaging markers can be used to differentiate between infection and aseptic inflammation, determine the severity of infection, and monitor treatment responses. One of these markers is ubiquicidin(29-41) (UBI), a cationic peptide fragment that binds to the bacterial membrane wall and is labeled with gallium-68 (68Ga), a positron emitter radioisotope. The use of UBI in positron emission tomography (PET)/computed tomography (CT) for improved detection of lesions has been receiving considerable attention recently. Herein, we report the first case of 68Ga-UBI PET/CT performed in Brazil. The patient was a 39-year-old woman referred for a scan to confirm a clinical suspicion of chronic osteomyelitis of her fractured left tibia. PET images revealed radiotracer uptake near the posterior contour of the tibial fracture focus and the fixation plate, in the soft tissue around the distal half of the tibia, and in the non-consolidated fracture of the left distal fibula. Surgery for local cleaning was performed, and culture of a specimen collected from the surgical site confirmed the presence of Staphylococcus aureus. In the present case, 68Ga-UBI PET/CT, a non-invasive imaging modality, identified the infection foci in vivo, indicating its potential for clinical use.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10697694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499769","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":"Perinatal N(G)-Nitro-L-arginine methyl ester administration decreases anxiety- and depression-like behaviors in adult mice.","authors":"Raoni Conceição Dos-Santos, Cláudio da Silva-Almeida, Bruno Guimarães Marinho, Rodrigo Rodrigues da Conceição, Wellington da Silva Côrtes, Ragab Gaber Ahmed, Roberto Laureano-Melo","doi":"10.31744/einstein_journal/2023AO0302","DOIUrl":"10.31744/einstein_journal/2023AO0302","url":null,"abstract":"<p><strong>Objective: </strong>We hypothesized that perinatal manipulations of the nitrergic system would affect adult animal behaviors.</p><p><strong>Methods: </strong>We tested this hypothesis by perinatally administering N(G)-Nitro-L-arginine methyl ester (L-NAME), a non-specific antagonist of nitric oxide synthase for 15 days and assessed anxiety- and depression-like behaviors in adult mice. At 70 days of age, the mice were subjected to a battery of tests consisting of the open-field, light/dark box, forced swim, and tail-flick tests. The tests were performed at two-day intervals, and the order of the tests within the battery was determined according to the progressive invasiveness degree.</p><p><strong>Results: </strong>L-NAME-treated animals exhibited decreased anxiety-like behavior in the light/dark box and open field tests, with no change in locomotor activity. Additionally, they demonstrated decreased depression-like behavior in the forced swim test and no change in pain perception in the tail-flick test.</p><p><strong>Conclusion: </strong>The nitrergic system is possibly involved in neural circuitry development that regulates behaviors since blocking perinatal nitric oxide production decreases anxiety- and depression-like behaviors in adult mice.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10699357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499771","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":"Combined larynx large cell neuroendocrine and squamous cell carcinoma: a case report.","authors":"Juliana Hesse, Leandro Aurélio Liporoni Martins, Leonardo Haddad, Fabio Pupo Ceccon","doi":"10.31744/einstein_journal/2023RC0618","DOIUrl":"10.31744/einstein_journal/2023RC0618","url":null,"abstract":"<p><p>Laryngeal cancer ranks third among the most common head and neck neoplasms. The most common histological subtype is squamous cell carcinoma, and neuroendocrine tumors are rare. An even rarer entity is a composite tumor with both these histologies. This case reports a metastatic combined carcinoma of squamous cells and large neuroendocrine cells, presenting favorable response to treatment with a total laryngectomy followed by adjuvant therapy including chemo-, radio-, and immunotherapy.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10697695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499770","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":"Implication of FSHB rs10835638 variant in endometriosis in Brazilian women.","authors":"Bianca Bianco,&nbsp;Flávia Altheman Loureiro,&nbsp;Camila Martins Trevisan,&nbsp;Denise Maria Christofolini,&nbsp;Antonio Simone Laganà,&nbsp;Caio Parente Barbosa","doi":"10.31744/einstein_journal/2023AO0483","DOIUrl":"https://doi.org/10.31744/einstein_journal/2023AO0483","url":null,"abstract":"<p><strong>Objective: </strong>The follicle-stimulating hormone subunit beta gene rs10835638 variant (c.-211G>T) may have detrimental effects on fertility and protective effects against endometriosis. A case-control analysis was performed, aiming to investigate the possible relationship between this variant and the development and/or progression of endometriosis.</p><p><strong>Methods: </strong>This study included 326 women with endometriosis and 482 controls without endometriosis, both confirmed by inspection of the pelvic cavity during surgery. Genotyping was performed using a TaqMan real-time polymerase chain reaction assay. Genotype and allele frequencies and genetic models were compared between the groups.</p><p><strong>Results: </strong>The genotype and allele frequencies of the rs10835638 variant did not differ between women with and those without endometriosis. Subdividing the endometriosis group into fertile and infertile groups did not result in a significant difference in these frequencies. However, the subgroup with minimal/mild endometriosis had a higher frequency of the GT genotype than the Control Group, regardless of fertility. The T allele was significantly more common in women with minimal/mild endometriosis than in the Control Group in the recessive model.</p><p><strong>Conclusion: </strong>The T allele is associated with the development of minimal/mild endometriosis in Brazilian women.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10586852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427801","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":"Radiological characteristics of hepatocellular carcinoma that achieved complete response after chemoembolization with drug-eluting beads for liver transplantation planning.","authors":"Leonardo Guedes Moreira Valle,&nbsp;Marcela Juliano Silva Cunha,&nbsp;Bruno Pagnin Schmid,&nbsp;Priscila Mina Falsarella,&nbsp;Marcelo Bruno de Rezende,&nbsp;Guilherme Eduardo Gonçalves Felga,&nbsp;Renata Emy Ogawa,&nbsp;Rodrigo Gobbo Garcia,&nbsp;Breno Boueri Affonso,&nbsp;Felipe Nasser,&nbsp;Francisco Leonardo Galastri","doi":"10.31744/einstein_journal/2023AO0307","DOIUrl":"https://doi.org/10.31744/einstein_journal/2023AO0307","url":null,"abstract":"<p><strong>Objective: </strong>To describe the radiological characteristics of hepatocellular carcinoma (HCC) lesions that achieved a complete response following drug-eluting bead transarterial chemoembolization (DEB-TACE) preceding liver transplantation.</p><p><strong>Methods: </strong>This single-center case-control study enrolled patients with hepatocellular carcinoma who underwent neoadjuvant DEB-TACE therapy, were followed up with contrast-enhanced magnetic resonance imaging or computed tomography, and were successively evaluated according to the modified Response Evaluation Criteria in Solid Tumors. The HCCs were divided into two groups based on their diameter (Group A: ≤3cm; Group B: 3cm). Viability was assessed using the Kaplan-Meier method according to tumor size categories. The relationship between tumor variables was analyzed using bivariate Cox regression.</p><p><strong>Results: </strong>Three-hundred and twenty-eight patients with 667 hepatocellular carcinomas who underwent their first DEB-TACE session were enrolled. A total of 105 hepatocellular carcinomas in 59 patients exhibited complete response after the initial DEB-TACE session and were divided into Group A (92 HCCs) and Group B (13 HCCs). The diameter in Group A decreased significantly compared to the pre-procedure size until the second assessment (p<0.001), with no subsequent reduction in diameter, despite maintaining a complete response. In Group B, the reduction in diameter remained significant compared with the initial value until the sixth imaging evaluation (p=0.014). The average reduction was 45.1% for Group B and a maximum of 14.9% in Group A.</p><p><strong>Conclusion: </strong>HCCs >3cm exhibited a greater reduction in size and a longer time to recurrence. HCCs ≤3cm had a shorter relapse time. The recurrence rates were similar. These findings may aid in planning for liver transplantation.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10586851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427802","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":"Articular mobilization promotes improvement in functional and inflammatory parameters in a gouty arthritis model.","authors":"Iranilda Moha Hoss,&nbsp;Lilian de Araujo Pradal,&nbsp;Taciane Stein da Silva Leal,&nbsp;Gladson Ricardo Flor Bertolini,&nbsp;Rose Meire Costa,&nbsp;Lucinéia de Fátima Chasko Ribeiro","doi":"10.31744/einstein_journal/2023AO0465","DOIUrl":"https://doi.org/10.31744/einstein_journal/2023AO0465","url":null,"abstract":"<p><strong>Objective: </strong>Gouty arthritis is characterized by painful inflammation due to the deposition of monosodium urate crystals in joint tissues. Despite available treatments, many patients experience ineffective management and adverse effects. This study evaluated a manual therapy protocol involving passive joint mobilization at the peak of inflammation in a gouty arthritis model using functional and inflammatory parameters.</p><p><strong>Methods: </strong>Twenty male Wistar rats, 12 weeks old, were divided into two groups (n=10 each): Gouty Arthritis and Control Groups, which were further subdivided into treated and untreated groups (n=5 each). The Gouty Arthritis Group received intraarticular knee injection of 50µL of monosodium urate crystals, while the Control Group received 50µL of phosphate buffered saline. The treatment involved a 9-minutes session of grade III joint mobilization (according to Maitland). Nociception, grip strength, and edema were evaluated before induction (EV0), 7 hours after assessment (EV1), immediately after treatment (EV2), and 1 hour after treatment (EV3). The animals were euthanized, and synovial fluid was collected to analyze leukocyte migration.</p><p><strong>Results: </strong>The model mimicked the signs of the Gouty Arthritis Group, with a decrease in the threshold of nociception and strength and an increase in edema and leukocyte count. The mobilization protocol significantly increased the nociceptive threshold and grip strength and reduced edema; however, it did not reverse the increase in leukocyte count.</p><p><strong>Conclusion: </strong>Our results suggest that mobilization promotes analgesia and may modulate the inflammatory process owing to reduced edema and subtle attenuation of cell migration, which contributes to strength gain.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10586854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427800","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":"Impacts of the COVID-19 pandemic on private hospitals in Brazil.","authors":"Andrizio Alexandrino de Morais,&nbsp;Ana Maria Malik,&nbsp;Gonzalo Vecina Neto","doi":"10.31744/einstein_journal/2023AO0174","DOIUrl":"10.31744/einstein_journal/2023AO0174","url":null,"abstract":"<p><p>The COVID-19 pandemic has significantly impacted hospital performance. To assess its effects on hospital indicators, we studied a sample of over 100 facilities. These facilities are members of a private hospital association, considered quality institutions with higher-tier socioeconomic patients, and are mostly financed by private insurers. We utilized publicly available data for 2020, the year when the pandemic effect was most acute. Sanitary restriction measures had a strong impact on usual performance indicators from a selected group of private hospitals in Brazil. P۪۪regnancies and deliveries continued to constitute an important proportion of hospital admissions because they did not depend on external restrictions. H۪۪ospital costs increased due to increased utilization of more expensive Personal Protection Equipment (due to lack of availability or much higher demand). Article extracted from the master's dissertation presented to the Master´s Program in Management for Competitiveness at Fundação Getulio Vargas , São Paulo, SP, in 2022.</p><p><strong>Objective: </strong>To analyze the operational and/or financial impacts of regulatory measures implemented by the National Agency for Supplementary Health and government health departments in response to the COVID-19 pandemic on a group of 118 private hospitals affiliated with the National Association of Private Hospitals.</p><p><strong>Methods: </strong>This study used a quantitative methodological design of descriptive, cross-sectional, and retrospective studies, utilizing secondary data provided by the National Agency for Supplementary Health.</p><p><strong>Results: </strong>There was a -20.1% reduction in hospital admissions and hospital occupancy rate and a decrease of -4.4 percentage points in earnings before interest, taxes, depreciation, and amortization margins. Additionally, the average length of hospital stay increased by +0.5, while total expenses for hospital leaves and total net revenue for hospital leaves increased by +39.4% and +23.6%, respectively. Comparing the participation of the different International Classification of Diseases, according to ICD-10 in 2019 and 2020, revealed the following variations in percentage points of hospitalizations. Hospitalizations for infectious diseases (including COVID-19), treatment of neoplasms, and pregnancy increased by +2.1, +2.4, and +1.2, respectively. However, hospitalizations for respiratory diseases decreased by -4.1.</p><p><strong>Conclusion: </strong>The most critical period of the pandemic required the redirection of activities to concentrate efforts on caring for COVID-19 cases. This situation highlighted the non-prioritization of primary care, as many problems presented by patients not affected by COVID-19 had to be referred to emergency services when and if appropriate.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10567103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50163242","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}