Sao Paulo Medical JournalPub Date : 2025-06-06eCollection Date: 2025-01-01DOI: 10.1590/1516-3180.2024.0175.R1.29112024
Barbara Rossana Gimenez Hidalgo, Rafael Rodrigo da Silva Pimentel, Marcelo José Dos Santos, Edvaldo Leal de Moraes
{"title":"Trends in organ- and tissue-specific donation refusals in São Paulo, Brazil, a quantitative cross-sectional study.","authors":"Barbara Rossana Gimenez Hidalgo, Rafael Rodrigo da Silva Pimentel, Marcelo José Dos Santos, Edvaldo Leal de Moraes","doi":"10.1590/1516-3180.2024.0175.R1.29112024","DOIUrl":"10.1590/1516-3180.2024.0175.R1.29112024","url":null,"abstract":"<p><strong>Background: </strong>The mismatch between the supply and demand for organs and tissues for transplantation is one of the reasons for the high rates of donation refusal. A more recent contributing factor has been the COVID-19 pandemic.</p><p><strong>Objectives: </strong>To analyze, through the Terms of Donation of Organs and Tissues, the rates and trends of specific refusals for each organ and tissue from brain-dead donors between 2001 and 2020 in an Organ Procurement Organization.</p><p><strong>Design and setting: </strong>This was a cross-sectional, exploratory, and retrospective quantitative study on specific donation refusals conducted in one of the ten Organ Procurement Organizations in São Paulo, Brazil.</p><p><strong>Methods: </strong>The variables collected included year, age, gender, cause of death, type of hospital, and organs and tissues donated and refused. The data were transferred to Stata software for descriptive and inferential analysis, using generalized linear regression to examine time trends. A significance level of P lt; 0.05 was adopted.</p><p><strong>Results: </strong>Bones and skin had the highest rates of tissue donation refusal, at 56.40% and 55.37%, respectively. Among solid organs, the pancreas (4.05%) and lungs (5.23%) had the highest refusal rates. In the first decade analyzed, there were increasing time trends in refusals of valves, heart, pancreas, and lungs. In contrast, during the second decade, refusals of valves, kidneys, and pancreas showed decreasing trends. In 2020, the number of refusals for all tissues declined.</p><p><strong>Conclusion: </strong>To reduce tissue-specific refusals, it is important to address and mitigate family beliefs, myths, and negative attitudes toward organ and tissue donation.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 3","pages":"e2024175"},"PeriodicalIF":1.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jaqueline Ribeiro Scholz, Sara Del Vecchio Ziotti, Paulo Manuel Pêgo Fernandes
{"title":"Electronic cigarette: a grand deception?","authors":"Jaqueline Ribeiro Scholz, Sara Del Vecchio Ziotti, Paulo Manuel Pêgo Fernandes","doi":"10.1590/1516-3180.2025.1433.15042025","DOIUrl":"10.1590/1516-3180.2025.1433.15042025","url":null,"abstract":"","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 3","pages":"e20251433"},"PeriodicalIF":1.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sao Paulo Medical JournalPub Date : 2025-06-06eCollection Date: 2025-01-01DOI: 10.1590/1516-3180.2024.0215.R1.27112024
Bruno Pereira de Moura, Bruna Priscila Colombo, Valter Paulo Neves Miranda, Isabella Toledo Caetano, Jeffer Eidi Sasaki, Paulo Roberto Dos Santos Amorim
{"title":"Sociodemographic factors associated with physical activity and sedentary behavior in Brazilian adults living with type 1 diabetes: a cross-sectional study.","authors":"Bruno Pereira de Moura, Bruna Priscila Colombo, Valter Paulo Neves Miranda, Isabella Toledo Caetano, Jeffer Eidi Sasaki, Paulo Roberto Dos Santos Amorim","doi":"10.1590/1516-3180.2024.0215.R1.27112024","DOIUrl":"10.1590/1516-3180.2024.0215.R1.27112024","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) and sedentary behavior (SB) are key determinants of health outcomes in individuals living with type 1 diabetes (T1D). However, the influence of sociodemographic and clinical factors on engagement in these behaviors is not yet well understood.</p><p><strong>Objective: </strong>This study aimed to analyze the associations of sociodemographic factors, body mass index, and both the duration and age at diagnosis of diabetes with SB, light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) in Brazilian adults.</p><p><strong>Design and setting: </strong>A cross-sectional study was conducted at the Diabetes and Metabolism Service of a public secondary care unit in Rio de Janeiro.</p><p><strong>Methods: </strong>One hundred adults diagnosed with T1D had their daily awake time spent in SB, LPA, and MVPA measured using triaxial accelerometers. Sociodemographic and clinical factors were assessed using questionnaires. Generalized Linear Models were used to analyze the relationships of these factors with SB, LPA, and MVPA.</p><p><strong>Results: </strong>Significant associations were found between age, education level, and employment status with SB and LPA, but not with MVPA. On average, each additional year of age was associated with decreased time in SB and increased time in LPA. Higher education levels and unemployment were linked to more SB and less time in LPA.</p><p><strong>Conclusions: </strong>Age, education level, and employment status emerged as key sociodemographic predictors of SB and LPA in Brazilian adults living with T1D. These findings contribute to a better understanding of the sociodemographic determinants associated with SB and PA in individuals diagnosed with T1D.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 3","pages":"e2024215"},"PeriodicalIF":1.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sao Paulo Medical JournalPub Date : 2025-06-02eCollection Date: 2025-01-01DOI: 10.1590/1516-3180-2024.0040.R1.13082024
Patrícia Martins Bock, Lucas Stahlhöfer Kowalewski, Layane Ramos Ayres, Mariana Kras Borges Russo, Gabriela Tomedi Leites, Andreza Francisco Martins, Álvaro Reischak de Oliveira, Mauricio Krause
{"title":"Effect of heat therapy compared with strength training on metabolic profile, heat shock response, inflammation, cardiovascular responses and microbiota in individuals with type 2 diabetes: study protocol of a randomized trial.","authors":"Patrícia Martins Bock, Lucas Stahlhöfer Kowalewski, Layane Ramos Ayres, Mariana Kras Borges Russo, Gabriela Tomedi Leites, Andreza Francisco Martins, Álvaro Reischak de Oliveira, Mauricio Krause","doi":"10.1590/1516-3180-2024.0040.R1.13082024","DOIUrl":"10.1590/1516-3180-2024.0040.R1.13082024","url":null,"abstract":"<p><strong>Background: </strong>Interventions capable of modulating the heat shock response (HSR), such as physical exercise and heat therapy (HT), are potential therapeutic strategies for the prevention and treatment of diabetes.</p><p><strong>Objective: </strong>This study aims to evaluate the effects of resistance training (RT) and HT on HbA1c levels, metabolic and inflammatory profiles, gut microbiota, and HSR in patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Design and setting: </strong>A randomized, double-blind, parallel clinical trial will be conducted for 12 weeks in southern Brazil.</p><p><strong>Methods: </strong>Participants with T2DM will be randomized into control (any intervention), RT, or HT groups. In the RT group, participants will perform supervised exercise, and the HT group will undergo whole-body heat treatment in an environmental chamber initially set at 55.0°C, both on three non-consecutive days of the week (60 min). Blood samples will be collected before and after 12 weeks of treatment. Heat shock response, body composition and physical fitness, glycemic control, lipid profile, gut microbiota composition and diversity, inflammatory markers, and flow-mediated dilation will be evaluated.</p><p><strong>Conclusion: </strong>Since the HSR response is decreased in individuals with diabetes, we believe that improving the HSR may be important in preventing chronic complications associated with T2DM. This randomized clinical trial will determine the efficacy of HT compared to RT in improving HSR when combined with conventional therapy in individuals with T2DM. Multiple HT and RT effects may contribute to a lower mortality risk in these individuals.</p><p><strong>Clinical trial registration: </strong>Unique Identifier NCT05847075. https://clinicaltrials.gov/study/NCT05847075.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 3","pages":"e2024040"},"PeriodicalIF":1.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sao Paulo Medical JournalPub Date : 2025-06-02eCollection Date: 2025-01-01DOI: 10.1590/1516-3180.2024.0280.R1.07032025
Yunus Coşkun, Halit Fidanci
{"title":"Subclinical hypothyroidism, focusing on carpal tunnel syndrome and peroneal neuropathy at the fibular head: a prospective case-control study.","authors":"Yunus Coşkun, Halit Fidanci","doi":"10.1590/1516-3180.2024.0280.R1.07032025","DOIUrl":"10.1590/1516-3180.2024.0280.R1.07032025","url":null,"abstract":"<p><strong>Background: </strong>Peripheral nerves may be affected in subclinical hypothyroidism (SH).</p><p><strong>Objectives: </strong>This study aimed to investigate the presence of common entrapment mononeuropathies in patients with SH.</p><p><strong>Design and setting: </strong>A prospective case-control study conducted between September 2022 and November 2023 at Adana City Training and Research Hospital, Adana, Türkiye.</p><p><strong>Methods: </strong>SH patients without neurological complaints and healthy individuals over the age of 18 were included. Serum levels of free T3, free T4, thyroid-stimulating hormone (TSH), thyroid peroxidase (TPO) antibody, and creatine kinase (CK) were measured. All participants underwent nerve conduction studies of the upper and lower extremities.</p><p><strong>Results: </strong>Thirty patients with SH and 40 healthy individuals were included in the study. The percentage reduction in compound muscle action potential (CMAP) amplitude across the knee segment was 2.8 ± 3.5% in healthy individuals and 6.7 ± 6.6% in SH patients (P = 0.017). Apart from this significant difference, other nerve conduction study findings did not differ between the two groups. A positive correlation was observed between CK levels and the percentage reduction in peroneal nerve CMAP amplitude across the knee segment (P = 0.021, r = 0.421). Additionally, there was a positive correlation between TPO antibody levels and F-wave latency in both the median and ulnar nerves (P = 0.028 r = 0.400/P = 0.005 r = 0.501). Electrodiagnostic evaluations revealed carpal tunnel syndrome (CTS) in four patients, peroneal neuropathy at the fibular head (PNFH) in four patients, and ulnar neuropathy at the elbow (UNE) in one patient.</p><p><strong>Conclusion: </strong>This study suggests that patients with SH may develop subclinical CTS and PNFH, but not UNE. Accordingly, it highlights the importance of avoiding risk factors that may contribute to the development of CTS and PNFH. Serum CK and TPO antibody levels may be useful in monitoring subclinical neuropathy in SH.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 4","pages":"e2024280"},"PeriodicalIF":1.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sao Paulo Medical JournalPub Date : 2025-05-30eCollection Date: 2025-01-01DOI: 10.1590/1516-3180.2024.0252.R1.14022025
Esin Sevgi Dogan, Ozden Dedeli Caydam
{"title":"Effect of planned visual education on university students' attitudes and beliefs regarding skin cancer: a cluster-randomized controlled trial.","authors":"Esin Sevgi Dogan, Ozden Dedeli Caydam","doi":"10.1590/1516-3180.2024.0252.R1.14022025","DOIUrl":"10.1590/1516-3180.2024.0252.R1.14022025","url":null,"abstract":"<p><strong>Background: </strong>The incidence of skin cancer is increasing globally. However, it is largely preventable through early detection. Therefore, raising public awareness through education is essential.</p><p><strong>Objective: </strong>This study aimed to evaluate the effect of a planned visual education program-based on the Health Belief Model-on university students' attitudes and beliefs regarding skin cancer.</p><p><strong>Design and setting: </strong>This cluster-randomized controlled trial was conducted in two departments at a university in Manisa, Türkiye.</p><p><strong>Methods: </strong>The study was conducted with 116 university students, divided equally into an intervention group (n = 58) and a control group (n = 58). Data were collected using the Student Information Form and the Health Belief Model Scale in Skin Cancer.</p><p><strong>Results: </strong>Following the visual education program based on the Health Belief Model, significant differences were observed between the intervention and control groups in perceived severity, perceived susceptibility, perceived barriers, perceived benefits, and self-efficacy scores. While the intervention group showed significant improvements across these domains, no significant difference was found in perceived severity scores.</p><p><strong>Conclusion: </strong>The findings indicate that planned visual education based on the Health Belief Model positively influenced students' attitudes and beliefs regarding skin cancer.</p><p><strong>Clinical trial registration: </strong>The research was recorded at https://clinicaltrials.gov/study/NCT05788939.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 4","pages":"e2024252"},"PeriodicalIF":1.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Selenium intake, food sources, and associated factors in Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): a cross-sectional study.","authors":"Elen Cintia Vale Pedro, Jéssica Levy, Dirce Maria Lobo Marchioni, Isabela Judith Martins Bensenor","doi":"10.1590/1516-3180.2024.0104.R1.07032025","DOIUrl":"10.1590/1516-3180.2024.0104.R1.07032025","url":null,"abstract":"<p><strong>Background: </strong>Selenium is essential to human health. There are few reports on the analysis of selenium intake in the Brazilian population; however, data have shown that Brazilian are in the deficient range of consumption.</p><p><strong>Objectives: </strong>This study aimed to identify the major foods that contribute to dietary selenium and determine the socioeconomic and lifestyle factors associated with selenium intake.</p><p><strong>Design and setting: </strong>This cross-sectional study used baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).</p><p><strong>Methods: </strong>Selenium consumption was evaluated using a food frequency questionnaire (FFQ) developed and validated for the ELSA-Brasil. To determine the contribution of selenium consumption, each food item was divided by the total selenium intake of the population. Associations between selenium intake (mg/day, dependent variable) and sociodemographic and lifestyle factors (predictors) were tested using multiple linear regression analyses.</p><p><strong>Results: </strong>The sample comprised 14,780 participants, most of whom were adults (78.5%). Individuals with income ≥ 3 minimum wages were mostly concentrated in the 5th quintile of selenium consumption; positive and significant correlations were found between selenium intake and female sex, age ≥ 60 years, income ≥ 3 minimum wages, higher or postgraduate education, alcohol consumption, and moderate physical activity level. Nuts and fish contributed the most to dietary selenium.</p><p><strong>Conclusion: </strong>Nuts, meat, and fish contributed the most to the dietary intake of selenium, and selenium intake was associated with sociodemographic and lifestyle factors among the evaluated individuals.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 4","pages":"e2024104"},"PeriodicalIF":1.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sao Paulo Medical JournalPub Date : 2025-05-26eCollection Date: 2025-01-01DOI: 10.1590/1516-3180.2023.0232.R2.21102024
Alessandra Fortes Almeida-Menezes, Maria Ester Pereira da Conceição-Machado, Maria Helena Lima Gusmão, Lílian Barbosa Ramos, Thais Vitorino Neves do Nascimento, Magali Teresópolis Reis Amaral, Jairza Maria Barreto-Medeiros
{"title":"Diabetes and smoking are associated with dynapenic abdominal obesity in patients with chronic kidney disease: a cross-sectional study.","authors":"Alessandra Fortes Almeida-Menezes, Maria Ester Pereira da Conceição-Machado, Maria Helena Lima Gusmão, Lílian Barbosa Ramos, Thais Vitorino Neves do Nascimento, Magali Teresópolis Reis Amaral, Jairza Maria Barreto-Medeiros","doi":"10.1590/1516-3180.2023.0232.R2.21102024","DOIUrl":"10.1590/1516-3180.2023.0232.R2.21102024","url":null,"abstract":"<p><strong>Background: </strong>No study has reported about the prevalence and factors associated with dynapenic abdominal obesity in patients with pre-dialysis chronic kidney disease (CKD).</p><p><strong>Objective: </strong>Evaluation of the prevalence of dynapenic abdominal obesity and its relationship with sociodemographic, lifestyle, clinical, and nutritional variables in patients with CKD not dependent on dialysis.</p><p><strong>Design and setting: </strong>A cross-sectional study was conducted at the Nutrition and Nephropathy Outpatient Clinic (public service) in Bahia, Brazil.</p><p><strong>Methods: </strong>This cross-sectional study was conducted on 102 patients of both sexes, aged ≥ 20 years. Dynapenic abdominal obesity (DAO) was defined as the simultaneous presence of dynapenia (handgrip strength less than the first tertile of the sample itself, according to sex and age) and increased waist circumference. Differences between groups with and without DAO were assessed using the Student's Mann-Whitney t-test, Pearson's chi-square test, or Fisher's exact test. Associations were tested using bivariate and multivariate models with Poisson regression to calculate the prevalence ratio and 95% confidence intervals (PR; 95% CI).</p><p><strong>Results: </strong>The mean age of the patients was 58.7 (standard deviation = 11.69); 50.5% were male, 51.6% were elderly, 41.8% had diabetes, 5.5% were smokers, 58.2% were abdominally obese, and 38.5% were dynapenic. DAO was identified in 18.7% of participants and was associated with diabetes mellitus (PR = 2.8; 95% CI = 1.12-6.99) and smoking (PR = 3.22; 95% CI = 1.16-8.96).</p><p><strong>Conclusion: </strong>Non-dialysis dependent patients with CKD showed a significant prevalence of DAO associated with smoking and diabetes mellitus.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 3","pages":"e2023232"},"PeriodicalIF":1.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sao Paulo Medical JournalPub Date : 2025-05-26eCollection Date: 2025-01-01DOI: 10.1590/1516-3180.2024.0141.R1.29012025
Raoni de Oliveira Domingues-da-Silva, Helady Sanders-Pinheiro, Emiliana Holanda Pedrosa, Camila Mendes Dos Santos, Jerônimo Junqueira Junior, Ronaldo de Matos Esmeraldo, Paula Frassinetti Castelo Branco Camurça Fernandes, Claudia Maria Costa de Oliveira, Tainá Veras de Sandes-Freitas
{"title":"Prevalence and factors associated with frailty among incident kidney transplant patients: a cross-sectional study.","authors":"Raoni de Oliveira Domingues-da-Silva, Helady Sanders-Pinheiro, Emiliana Holanda Pedrosa, Camila Mendes Dos Santos, Jerônimo Junqueira Junior, Ronaldo de Matos Esmeraldo, Paula Frassinetti Castelo Branco Camurça Fernandes, Claudia Maria Costa de Oliveira, Tainá Veras de Sandes-Freitas","doi":"10.1590/1516-3180.2024.0141.R1.29012025","DOIUrl":"10.1590/1516-3180.2024.0141.R1.29012025","url":null,"abstract":"<p><strong>Background: </strong>Evidence on frailty prevalence in Brazilian patients with kidney transplant (KT) is scarce.</p><p><strong>Objectives: </strong>To estimate frailty prevalence in pre-KT patients and its association with functional, cognitive, and laboratory anomalies.</p><p><strong>Design and setting: </strong>Cross-sectional descriptive study included adult KT candidates assessed within 24 hours before KT, at two medical centers in Northeast Brazil.</p><p><strong>Methods: </strong>Frailty was classified as non-frail (scores 0-1), intermediate frail (score 2), or frail (scores 3-5), using Fried et al. criteria. Patients were divided into: Non-frail (0-1) and Frail (≥ 2) groups. Katz and Lawton's scales assessed the dependence on basic (ADLs) and instrumental (IADLs) activities of daily living, respectively. Montreal Cognitive Assessment was used to evaluate cognition. Laboratory tests were performed during pre-KT evaluation.</p><p><strong>Results: </strong>Among 82 patients, most were male (80.5%), mixed-race (76.8%), and 48.8 ± 14.9-years-old. The Frail group (63.4%) comprised 34.1% intermediate frail, and 29.3% frail individuals. This group had a higher prevalence of hypertension (90.4% vs. 70%, P = 0.018), rheumatological diseases (15.4% vs. 0%, P = 0.024), cognitive impairment (71.0% vs. 40.7%, P = 0.020), dependence on ADLs (32% vs. 0%, P < 0.001) and IADLs (82% vs. 56.7%, P = 0.014), lower hemoglobin (11.9 ± 2.7 g/dL vs. 13.4 ± 1.8 g/d, P = 0.005), and lower creatinine levels (7.1 mg/dL, IQR 6-10 vs. 9.1 mg/dL, IQR 7-11, P = 0.044).</p><p><strong>Conclusions: </strong>Pretransplant frailty was prevalent and associated with functional disability, cognitive impairment, and biomarkers indicating sarcopenia. Early frailty assessment and identification of modifiable factors are essential.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 3","pages":"e2024141"},"PeriodicalIF":1.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sao Paulo Medical JournalPub Date : 2025-05-26eCollection Date: 2025-01-01DOI: 10.1590/1516-3180.2023.0369.11022025
Diogo Gonçalves Dos Santos Martins, Thiago Goncalves Dos Santos Martins, Paulo Schor
{"title":"The use of artificial intelligence to identify ophthalmic biomarkers in cardiovascular disease and stroke: a narrative review.","authors":"Diogo Gonçalves Dos Santos Martins, Thiago Goncalves Dos Santos Martins, Paulo Schor","doi":"10.1590/1516-3180.2023.0369.11022025","DOIUrl":"10.1590/1516-3180.2023.0369.11022025","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) and stroke are among the leading causes of death worldwide.</p><p><strong>Objective: </strong>This article presents a review of the application of artificial intelligence in identifying biomarkers for CVD and stroke.</p><p><strong>Design and setting: </strong>Narrative review conducted by a research group at the Universidade Federal de São Paulo, São Paulo, Brazil.</p><p><strong>Methods: </strong>A literature search was conducted to identify the main applications of artificial intelligence in ophthalmology, using the keywords \"artificial intelligence,\" \"prediction,\" \"biomarker,\" \"cardiovascular disease,\" \"retina,\" and \"stroke,\" covering the period from January 1, 2018, to July 3, 2023. The Medical Literature Analysis and Retrieval System Online (MEDLINE, via PubMed) and the Latin American and Caribbean Literature in Health Sciences (Literatura Latino-Americana e do Caribe em Ciências da Saúde, LILACS, via the Virtual Health Library) were used to identify relevant articles.</p><p><strong>Results: </strong>A total of 30 references were retrieved, of which 14 were considered eligible for intensive review and critical analysis.</p><p><strong>Conclusions: </strong>Artificial intelligence has proven effective in identifying non-invasive biomarkers through the analysis of patients' retinal examinations. These findings contribute to a better understanding of the pathophysiology of CVD and stroke.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 3","pages":"e2023369"},"PeriodicalIF":1.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}