Einstein-Sao Paulo最新文献

{"title":"Motor reaction time in older women with different degrees of sarcopenia: What do electroencephalograms show?","authors":"Raquel Brito Elmescany, Iully Ingrid Pereira da Silva Alves, Guilherme Augusto Santos Bueno, Silvana Schwerz Funghetto, Juliana de Faria Fracon E Romão, Valéria Pagotto, Anabela Correia Martins, Ruth Losada de Menezes","doi":"10.31744/einstein_journal/2026AO1541","DOIUrl":"10.31744/einstein_journal/2026AO1541","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyze cortical activity during simple motor reaction time tasks in older women with different degrees of sarcopenia.</p><p><strong>Methods: </strong>This cross-sectional, observational, analytical study included 59 women classified into control, pre-sarcopenia, and sarcopenia groups according to European Working Group on Sarcopenia in Older People criteria. Motor reaction time was assessed through standardized visual stimuli with simultaneous electroencephalography. All participants received identical instructions and completed a practice block. The trials were verified by blinded raters. Electroencephalogram alpha (8-12 Hz) and beta (12-28 Hz) power ratios were analyzed as markers of cortical excitation using a false discovery rate correction (q=0.05).</p><p><strong>Results: </strong>Pre-sarcopenic participants exhibited significantly higher cortical excitation than did the control and sarcopenic groups (p<0.001), suggesting that compensatory hyperactivation precedes cortical decline.</p><p><strong>Conclusion: </strong>Sarcopenia involves central neurophysiological changes in addition to muscle atrophy. The pre-sarcopenic stage represents an optimal window for neuromotor intervention given its increased cortical responsiveness.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eAO1541"},"PeriodicalIF":1.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370308","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":"High-mobility group box 1 protein, histone H3 and histone H4 are not associated with peripheral hypoperfusion in sepsis: a retrospective cohort study.","authors":"Bruna Cassia Dal Vesco, Ana Carolina de Miranda, Fernanda do Carmo De Stefani, Luis Gustavo Morello, Dalila Luciola Zanette, Luiz Eduardo Nunes Ferreira, Igor Alexandre Cortês de Menezes","doi":"10.31744/einstein_journal/2026AO1615","DOIUrl":"10.31744/einstein_journal/2026AO1615","url":null,"abstract":"<p><strong>Objective: </strong>The causal mechanisms of peripheral hypoperfusion in sepsis have not yet been fully elucidated. Therefore, this study aimed to investigate whether peripheral hypoperfusion in septic patients is associated with serum levels of damage-associated molecular patterns.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted to compare serum levels of damage-associated molecular patterns - histone H3, histone H4, and high-mobility group box-1 protein (HMGB1) - with markers of tissue hypoperfusion - the peripheral perfusion index and the capillary refill time, using a single measurement obtained within the first 24 hours after sepsis diagnosis in critically ill patients from two Brazilian hospitals.</p><p><strong>Results: </strong>Eighty patients were included in the study. Approximately half of the patients showed persistent peripheral hypoperfusion as determined by at least one of the techniques used. Surviving patients had better capillary refill time [2 (2-4) versus 4 (2-5), p=0.01] and perfusion index [1.9 (0.98-4.95) versus 0.54 (0.32-0.87) p<0.0001] compared with non-survivors. None of the evaluated damage-associated molecular patterns distinguished between survivors and non-survivors. In addition, damage-associated molecular patterns were not associated with perfusion index (versus HMGB1, p=0.13; versus H3, p=0.51 and versus H4, p=0.25) or capillary refill time (versus HMGB1, p=0.29; versus H3, p=0.60 and versus H4, p=0.92).</p><p><strong>Conclusion: </strong>In septic patients evaluated in this retrospective cohort study, no statistically significant association was found between the levels of histones H3, H4, and HMGB1 protein, tissue hypoperfusion, and mortality.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eAO1615"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151568","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":"Phacoemulsification in a highly myopic, single-seeing, post-vitrectomized eye with an anterior chamber phakic intraocular lens: a surgical challenge.","authors":"Raquel Byel Kim, Diego Monteiro Verginassi, Carolina Engelbrecht, Cláudio Luiz Lottenberg","doi":"10.31744/einstein_journal/2026RC2213","DOIUrl":"10.31744/einstein_journal/2026RC2213","url":null,"abstract":"<p><p>We report a case of a highly myopic patient with a single functional eye, previously vitrectomized, and implanted with an anterior chamber phakic intraocular lens (Artisan®), who underwent phacoemulsification with phakic lens explantation and posterior chamber intraocular lens implantation. The case illustrates the surgical challenges and highlights the importance of individualized planning in patients with multiple prior interventions and at high risk of complications.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eRC2213"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151587","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":"Lymphatic malformations: formerly known as lymphangiomas. A rare case of two breast masses in different locations mimicking breast carcinomas.","authors":"Laura Mulazzani Minuzzi Macedo, Fernando Camargo Fernandes, Ana Carolina Dourado Mattos Raful, Heni Debs Skaf, Marcela Caetano Vilela Lauar, Erica Elisângela Françolin Federicci","doi":"10.31744/einstein_journal/2026RC2042","DOIUrl":"10.31744/einstein_journal/2026RC2042","url":null,"abstract":"<p><p>Lymphatic malformations are benign disorders of the lymphatic system and represent a rare diagnosis in adulthood, particularly when involving the breast. This report describes the case of a 64-year-old patient referred to our service with two suspicious masses located in different areas of right breast. Imaging studies reinforced the suspicion of malignancy, and further investigation was conducted with an ultrasound-guided core needle biopsy, which confirmed the diagnosis of lymphatic malformation. As illustrated in this report, although lymphatic malformation may present with imaging findings, histopathological evaluation is often required to exclude malignancy before complete surgical excision. Therefore, lymphatic malformation should be considered as a potential differential diagnosis in the investigation of breast masses suspicious for breast cancer.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eRC2042"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151592","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: Socioeconomic inequities in prostate cancer care: private versus public treatment settings pose a significant impact on overall survival\".","authors":"Amanda Caroline de Souza Costa, Fernando Korkes, Jose Augusto Rinck Junior, Frederico Timóteo Silva Cunha, Luciana Holtz de Camargo Barros, Stênio de Cássio Zequi, Maria Nirvana da Cruz Formiga","doi":"10.31744/einstein_journal/2026CE2477","DOIUrl":"10.31744/einstein_journal/2026CE2477","url":null,"abstract":"","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eCE2477"},"PeriodicalIF":1.1,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044278","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":"Cost-effectiveness of microsurgical reconstructions in reconstructive plastic surgery within the Brazilian Public Health System: a 15-year overview (2009-2023).","authors":"Dov Charles Goldenberg, Marcos Antonio Neves Noronha, Klaus Werner Wende, Ricardo Yugi Eri, Beatriz Peral Venet Ferreira, Lucas Andrew Jikal, Vitor Pelogi Arienzo","doi":"10.31744/einstein_journal/2026AO2003","DOIUrl":"10.31744/einstein_journal/2026AO2003","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the national distribution and cost-effectiveness of oncologic microsurgical reconstructions performed within the Brazilian Public Health System over a 14-year period.</p><p><strong>Methods: </strong>A retrospective analysis of DATASUS data was conducted using three procedure codes related to oncologic microsurgical reconstruction. Surgical volume was assessed by state and geographic region. Hospital reimbursement values were compared with those of less complex reconstructive procedures, and inter-state patient referral patterns were analyzed to identify trends in service centralization.</p><p><strong>Results: </strong>Between 2009 and 2023, a total of 1,902 microsurgical reconstructions were performed nationwide. The Southeast and South regions accounted for the majority of cases, with São Paulo (n=563) and Rio Grande do Sul (n=474) representing the highest-volume states. In contrast, the North and Center-West regions exhibited substantially lower availability of microsurgical services. Reimbursement analyses demonstrated that microsurgical procedures were compensated at levels comparable to those of less complex reconstructions, despite their greater technical and infrastructural requirements. Referral flow analyses revealed a pronounced concentration of patients toward a limited number of high-volume centers.</p><p><strong>Conclusion: </strong>Microsurgical reconstruction within the Brazilian Public Health System is cost-effective; however, its availability remains unevenly distributed, restricting equitable access to complex oncologic reconstructive care. Public policies focused on workforce training, capacity-building, and regional decentralization are necessary to expand access and reduce reliance on a small number of specialized centers.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eAO2003"},"PeriodicalIF":1.1,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044188","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":"Outcomes and other characteristics of the nutritional screening and assessment tools validation processes in hospitalized adults: a systematic review.","authors":"Giovanna Guimarães Lopes Bergamasco, Bruna Rodrigues Lima, Kadine Andrade de Araújo, Nicolly Baião Martins, Silvia Maria Fraga Piovacari, Mayumi Shima, Drielle Schweiger Freitas Bottairi, Samara Cristina Mascarenhas Ferreira, Zelita Melo Fortes de Cerqueira, Adriano José Pereira","doi":"10.31744/einstein_journal/2026RW1855","DOIUrl":"10.31744/einstein_journal/2026RW1855","url":null,"abstract":"<p><strong>Background: </strong>Hospital malnutrition has been studied for decades; however, its prevalence remains high, and research in this area is still relevant. Nutritional screening and assessment tools are routinely used in hospital settings.</p><p><strong>Objective: </strong>We aimed to describe and discuss the general characteristics of studies that used nutritional screening and assessment instruments in hospitalized adult populations, with a focus on clinical outcomes.</p><p><strong>Methods: </strong>We conducted a systematic review without meta-analysis. Eligible studies were original prospective or retrospective studies published in Portuguese or English, with no inception date, conducted in hospitalized adult populations, and reporting clinical outcomes. Information sources included PubMed, LILACS, Web of Science, Embase, and Scopus. The search covered articles published up to July 2022. Risk of bias was assessed for all included studies using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Results presented in the tables were transcribed from the main findings of each evaluated study, and no new statistical analyses were performed.</p><p><strong>Results: </strong>Seventy-seven studies were included, encompassing 20 tools evaluated in hospital settings. The Mini Nutritional Assessment was the most extensively tested in relation to clinical outcomes. Among studies conducted in Brazilian populations, the nutritional assessment tool Subjective Global Assessment and the screening tool Nutritional Risk Screening 2002 were the most frequently studied. Among full-text articles assessed for tool evaluation in hospitals, 77% were excluded because clinical outcomes were not reported.</p><p><strong>Discussion: </strong>The evidence has some limitations. First, the exclusive focus on hospitalized populations may limit generalizability. Second, validation studies that did not evaluate clinical outcomes were not described in detail. Third, the use of \"clinical outcomes\" as a search term may have led to an underestimation of validation studies focusing solely on diagnostic or screening performance. Overall, nutritional screening and assessment tools commonly used in daily practice have been validated many years ago, largely based on subjective clinical assessments, with relatively few studies reporting clinical outcomes. In addition, most studies were single-center and conducted predominantly in non-Latin American populations. Future research should prioritize multicenter designs, improve population representativeness, and incorporate clinically relevant outcomes.</p><p><strong>Prospero database registration: </strong>ID CRD42022347507.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eRW1855"},"PeriodicalIF":1.1,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044157","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":"Comment to: Socioeconomic inequities in prostate cancer care: private versus public treatment settings pose a significant impact on overall survival.","authors":"Rafael Gomes de Melo D'Elia, Angélica Saiuri de Aurelio Penteado","doi":"10.31744/einstein_journal/2026CE2346","DOIUrl":"10.31744/einstein_journal/2026CE2346","url":null,"abstract":"","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eCE2346"},"PeriodicalIF":1.1,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044207","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":"Use of the OSCE in assessing performance in first aid of high school students.","authors":"Vinicyus Eduardo Melo Amorim, Renan Gatis Ayres, Mikhael Morais de Souza, Ana Cecília Araújo Cabral, Bruna Sampaio Tavares, Tiago Fernando Ferreira da Silva, Felipe César Gomes de Andrade, Luciano Calheiros de Morais Guerra, Edvaldo da Silva Souza","doi":"10.31744/einstein_journal/2026AO1865","DOIUrl":"10.31744/einstein_journal/2026AO1865","url":null,"abstract":"<p><strong>Objective: </strong>To assess the knowledge and performance of high school students in cardiopulmonary resuscitation and foreign body airway obstruction management using an objective structured clinical examination.</p><p><strong>Methods: </strong>An interventional design was implemented with high school students, who were assessed before and after the intervention. Participants completed a theoretical questionnaire and two objective structured clinical examinations-one for cardiopulmonary resuscitation and one for foreign body airway obstruction-before receiving theoretical and practical first aid training. Subsequent assessments included the same theoretical questionnaire and objective structured clinical examinations, administered immediately after training and again after six months to measure knowledge retention.</p><p><strong>Results: </strong>Comparison of pre-training, immediate post-training, and six-month follow-up data revealed significant improvements in knowledge and performance across all student groups and scenarios (p<0.001), with sustained retention over time. Implications for School Health Policy, Practice, and Equity: Utilizing handmade mannequins alongside the objective structured clinical examination methodology offers a cost-effective approach for training students and mitigating adverse outcomes in high schools.</p><p><strong>Conclusion: </strong>The objective structured clinical examination is an effective and evaluative tool for first aid training among high school students.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eAO1865"},"PeriodicalIF":1.1,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976330","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":"Translation and cross-cultural adaptation into Brazilian Portuguese of the 35 navigation metrics developed by the Academy of Oncology Nurse & Patient Navigators (AONN+).","authors":"Thamyris Pontes Cunha Maia, Mariana Lucas da Rocha Cunha","doi":"10.31744/einstein_journal/2026AO2089","DOIUrl":"10.31744/einstein_journal/2026AO2089","url":null,"abstract":"<p><strong>Objective: </strong>To perform the translation and cross-cultural adaptation into Brazilian Portuguese of the 35 navigation metrics developed by the Academy of Oncology Nurse & Patient Navigators (AONN+).</p><p><strong>Methods: </strong>This study employed a methodological approach for cross-cultural adaptation. Following authorization from the authors of the original version of the 35 metrics for evaluating navigation programs, the instrument was translated in accordance with established guidelines. A committee of ten experts was formed to review and reach consensus on the translation. The snowball sampling technique was used to recruit 35 judges, including nurse navigator and oncology nurses, with the aim of assessing the applicability of the metrics to the Brazilian context. The data were collected in the first semester of 2025.</p><p><strong>Results: </strong>The expert committee evaluated whether the metrics achieved semantic, idiomatic, experiential, and conceptual equivalence. Three rounds of evaluation were required to reach a 90% agreement rate. In the subsequent pretest, Brazilian oncology nurses and nurse navigators individually assessed each metric for cultural comprehensibility and applicability. The instrument's mean content validity index was 0.97.</p><p><strong>Conclusion: </strong>The 35 metrics were adapted and refined in accordance with the proportions of agreement and content validity index, which reached values consistent with those recommended for adequacy. Therefore, the translation enables the use of standardized navigation metrics to measure program outcomes in Brazil.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eAO2089"},"PeriodicalIF":1.1,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976119","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}