Sao Paulo Medical Journal最新文献

{"title":"Awareness of stroke among patients with chronic kidney disease on hemodialysis: a cross-sectional study.","authors":"Orlando Vieira Gomes,&nbsp;Manoel Pereira Guimarães,&nbsp;Bárbara Maria Batista Barbosa,&nbsp;Christielle Lidianne Alencar Marinho,&nbsp;Jandir Mendonça Nicacio,&nbsp;Matheus Pereira Barreira,&nbsp;Mateus de Sousa Rodrigues,&nbsp;Leonardo Fernandes E Santana,&nbsp;Ubiracé Fernando Elihimas Júnior,&nbsp;Paulo Adriano Schwingel","doi":"10.1590/1516-3180.2022.0644.R1.24042023","DOIUrl":"10.1590/1516-3180.2022.0644.R1.24042023","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a major cause of mortality worldwide. Renal dysfunction is an important risk factor for stroke. Brazilian studies on stroke knowledge are generally population based. Studies stratifying stroke knowledge according to comorbidities are rare. Scientific data are essential to guide the awareness of stroke.</p><p><strong>Objective: </strong>To assess stroke knowledge in patients with chronic kidney disease (CKD) on hemodialysis.</p><p><strong>Design and setting: </strong>Cross-sectional analytical study of patients with CKD on hemodialysis in north-eastern Brazil.</p><p><strong>Methods: </strong>A self-administered questionnaire survey on stroke awareness was administered to patients with CKD on hemodialysis between April and November 2022. The chi-square test and other descriptive statistics were used. Univariate and multivariate analyses were performed using logistic regression.</p><p><strong>Results: </strong>A total of 197 patients were included in the analysis. The Brazilian acronym for stroke was used by 53.5% of the participants. Less than 10.0% of the sample showed optimal decision-making ability regarding stroke. Of the participants, 29.9% knew at least one risk factor and one symptom; however, this was considered as having below the minimum capacity because they did not know the emergency service call number. In the analysis adjusted for income and education, females (odds ratio [OR], 0.40%; 95% confidence interval [CI], 0.20-0.82), older patients (OR, 0.24%; 95% CI, 0.09-0.63) and having at most one comorbidity (OR, 0.48%; 95% CI, 0.23-0.98) were factors for lower levels of knowledge or ideal decision-making capacity against stroke.</p><p><strong>Conclusions: </strong>Patients on hemodialysis, especially women and older people, have little knowledge about stroke.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"142 1","pages":"e2022644"},"PeriodicalIF":1.4,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10393371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10307458","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":"Potentially inappropriate medications with older people in intensive care and associated factors: a historic cohort study.","authors":"Karina Sichieri,&nbsp;Danilo Donizetti Trevisan,&nbsp;Ricardo Luís Barbosa,&nbsp;Silvia Regina Secoli","doi":"10.1590/1516-3180.2022.0666.R1.190523","DOIUrl":"10.1590/1516-3180.2022.0666.R1.190523","url":null,"abstract":"<p><strong>Background: </strong>The epidemiology of potentially inappropriate medications (PIMs) in critical care units remains limited, especially in terms of the factors associated with their use.</p><p><strong>Objective: </strong>To estimate the incidence and factors associated with PIMs use in intensive care units.</p><p><strong>Design and setting: </strong>Historical cohort study was conducted in a high-complexity hospital in Brazil.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on 314 patients aged ≥ 60 years who were admitted to intensive care units (ICUs) at a high-complexity hospital in Brazil. The dates were extracted from a \"Patient Safety Project\" database. A Chi-square test, Student's t-test, and multivariable logistic regression analyses were performed to assess which factors were associated with PIMs. The statistical significance was set at 5%.</p><p><strong>Results: </strong>According to Beers' criteria, 12.8% of the identified drugs were considered inappropriate for the elderly population. The incidence rate of PIMs use was 45.8%. The most frequently used PIMs were metoclopramide, insulin, antipsychotics, non-steroidal anti-inflammatory drugs, and benzodiazepines. Factors associated with PIMs use were the number of medications (odds ratio [OR] = 1.17), length of hospital stay (OR = 1.07), and excessive potential drug interactions (OR = 2.43).</p><p><strong>Conclusions: </strong>Approximately half of the older adults in ICUs received PIM. Patients taking PIMs had a longer length of stay in the ICU, higher numbers of medications, and higher numbers of potential drug interactions. In ICUs, the use of explicit methods combined with clinical judgment can contribute to the safety and quality of medication prescriptions.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"142 1","pages":"e2022666"},"PeriodicalIF":1.4,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10393373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10307456","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":"Assessing the effect of prophylactic ankle taping on ankle and knee biomechanics during landing tasks in healthy individuals: A cross-sectional observational study.","authors":"Carlos Romero-Morales,&nbsp;Ana Matilde-Cruz,&nbsp;María García-Arrabe,&nbsp;Felix Higes-Núñez,&nbsp;Alexandre Días Lópes,&nbsp;Sergio Jiménez Saiz,&nbsp;Helios Pareja-Galeano,&nbsp;Daniel López-López","doi":"10.1590/1516-3180.2022.0548.R1.10032023","DOIUrl":"10.1590/1516-3180.2022.0548.R1.10032023","url":null,"abstract":"<p><strong>Background: </strong>Current research supports the fact that prophylactic ankle taping (AT) is effective in preventing ankle injuries in amateur and elite sports athletes.</p><p><strong>Objective: </strong>This study aimed to investigate the effect of AT on balance, knee valgus during drop jump and single-leg countermovement jump (SL-CMJ) landings, and ankle range of motion (ROM) restriction in healthy participants.</p><p><strong>Design and setting: </strong>A cross-sectional observational study was conducted at the Universidad Europea de Madrid, Madrid, Spain.</p><p><strong>Methods: </strong>Participants: Thirty-nine healthy individuals participated in this study and performed the movements under two conditions (with and without tape). Outcome measurements: ankle ROM, balance, SL-CMJ height, flight time, ground time, and knee valgus. Before any intervention, a random process was developed with a 1:1 allocation ratio, and the participants were assigned to groups A (tape-no tape) and B (no tape-tape).</p><p><strong>Results: </strong>Significant differences between tape and no-tape moments were observed for drop jump knee valgus flexion (P = 0.007), with an increase in knee valgus in participants with ankle taping. Similarly, the Y-balance testshowed a significant decrease in all variables (P = 0.001 and), ankle dorsiflexion (P = 0.001) in participants with ankle taping.</p><p><strong>Conclusions: </strong>AT is effective for immediate ankle ROM restriction. However, an increase in knee valgus during drop jump task and a decrease in lower limb balance were observed during drop jump task. Based on these results, it can be concluded that AT application in healthy individuals should not be recommended as it results in increase in injury risk factors.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"142 2","pages":"e2022548"},"PeriodicalIF":1.4,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10393372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9933224","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":"What is an \"ongoing\" clinical trial? An analysis of different sources revealed heterogeneous definitions of when a clinical trial starts and ends: a meta-research study.","authors":"Rafael Leite Pacheco, Ana Luiza Cabrera Martimbianco, Rachel Riera","doi":"10.1590/1516-3180.2022.0634.R2.100523","DOIUrl":"10.1590/1516-3180.2022.0634.R2.100523","url":null,"abstract":"<p><strong>Background: </strong>Although the concept of an \"ongoing study\" seems self-explanatory, it is difficult to determine whether a trial is underway.</p><p><strong>Objective: </strong>To analyze the definitions of \"ongoing clinical trial\" across different clinical trial registries, methodological guidelines, and other sources.</p><p><strong>Design and setting: </strong>This meta-research study was conducted at the Universidade Federal de São Paulo (UNIFESP), Brazil.</p><p><strong>Methods: </strong>We performed a cross-sectional analysis of relevant clinical trial registry databases, methodological guidelines for conducting systematic reviews, and other sources that would define or regulate clinical trials.</p><p><strong>Results: </strong>We identified various heterogeneous definitions used by eligible sources at both the start and end of a clinical trial. The starting criteria used were as follows: when the team is planning the protocol, when permission is given to conduct the study, or when the first participant is enrolled. Some sources used the time at which the last outcome data was collected as a criterion to determine the end of the trial. The International Committee of Medical Journal Editors stated that a study is still \"ongoing\" during the analysis process. Several sources use a vague definition or present no clear criteria for defining the start or end of a study.</p><p><strong>Conclusion: </strong>The concept of \"ongoing clinical trials\" lacks a transparent and homogeneous definition across relevant sources. A consensus on this concept is important to facilitate the evaluation of available evidence and conduct research synthesis. Further efforts are necessary to determine the best definition for the start and end of a clinical trial.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"142 1","pages":"e20220634"},"PeriodicalIF":1.3,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10353842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9872301","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":"Quality of life of older adults in Family Health Strategy: a cross-sectional study.","authors":"Ilaise Brilhante Batista,&nbsp;Annah Thereza Mota,&nbsp;Ana Luiza Blanco,&nbsp;Jéssica da Silva Marinho,&nbsp;Maria Sortênia Alves Guimarães,&nbsp;Andréia Queiroz Ribeiro,&nbsp;Daniella Pires Nunes","doi":"10.1590/1516-3180.2022.0445.R1.24042023","DOIUrl":"10.1590/1516-3180.2022.0445.R1.24042023","url":null,"abstract":"<p><strong>Background: </strong>With the increase in the older adult population, it is essential to identify the living and health conditions that can impact the quality of life of these individuals.</p><p><strong>Objectives: </strong>To identify the domains and factors associated with the quality of life of older adults under the Family Health Strategy program.</p><p><strong>Design and setting: </strong>This was a cross-sectional analytical study was conducted in the municipality of Palmas, Tocantins, Brazil.</p><p><strong>Methods: </strong>We assessed 449 older adults enrolled in the Family Health Strategy program. Data were collected between April and July, 2018. World Health Organization Quality of Life Assessment (WHOQOL-OLD) was used to assess the quality of life (QoL) and multiple linear regression was used to estimate the factors associated with QoL.</p><p><strong>Results: </strong>The QoL domain with the highest score was death and dying (mean = 70.4), and the lowest score was for sensory functions (mean = 61.0 points). The factors associated with QoL were single marital status (β = -4.55; P = 0.014), level of independence for daily living activities (β = 4.92; P < 0.001), self-assessment of regular health (β = 5.35; P < 0.001), and poor health (β = -8.67; P < 0.001).</p><p><strong>Conclusion: </strong>The death and dying domain of QoL presented the highest score. Marital status, impairment in daily activities, and health self-assessment were associated with QoL.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"142 1","pages":"e2022445"},"PeriodicalIF":1.4,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10353843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9834616","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":"Assessing a cut-off point for the diagnosis of abnormal uterine bleeding using the Menstrual Bleeding Questionnaire (MBQ): a validation and cultural translation study with Brazilian women.","authors":"Gabriela Pravatta Rezende,&nbsp;Luiz Gustavo Oliveira Brito,&nbsp;Daniela Angerame Yela Gomes,&nbsp;Leticia Mansano de Souza,&nbsp;Sergio Polo,&nbsp;Cristina Laguna Benetti-Pinto","doi":"10.1590/1516-3180.2022.0539.R2.100423","DOIUrl":"10.1590/1516-3180.2022.0539.R2.100423","url":null,"abstract":"<p><strong>Background: </strong>Abnormal uterine bleeding (AUB) is a common condition, and the Menstrual Bleeding Questionnaire (MBQ) is used for its assessment.</p><p><strong>Objectives: </strong>To translate, assess the cut-off point for diagnosis, and explore psychometric properties of the MBQ for use in Brazilian Portuguese.</p><p><strong>Design and setting: </strong>Prospective cohort study including 200 women (100 with and 100 without AUB) at a tertiary referral center.</p><p><strong>Methods: </strong>MBQ translation involved a pilot-testing phase, instrument adjustment, data collection, and back-translation. Cut-off point was obtained using receiver operating curve analysis. Menstrual patterns, impact on quality of life due to AUB, internal consistency, test-retest, responsiveness, and discriminant validity were assessed. For construct validity, the Pictorial Blood Assessment Chart (PBAC) and World Health Organization Quality of Life - abbreviated version (WHOQOL-BREF) were applied.</p><p><strong>Results: </strong>Women with AUB were older, had higher body mass indices, and had a worse quality of life during menstruation. Regarding the MBQ's psychometric variables, Cronbach's alpha coefficient was > 0.70 in all analyses, high intraclass correlation coefficient was found in both groups; no ceiling and floor effects were observed, and construct validity was demonstrated (correlation between MBQ score, PBAC score, and clinical menstrual cycle data). No difference between MBQ and PBAC scores were perceived after the test-retest. Significant differences were found between MBQ and PBAC scores before and after treatment. An MBQ score ≥ 24 was associated with a high probability of AUB; accuracy of 98%.</p><p><strong>Conclusion: </strong>The MBQ is a reliable questionnaire for Brazilian women. The cut-off ≥ 24 shows high accuracy to discriminate AUB.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"142 1","pages":"e2022539"},"PeriodicalIF":1.4,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10328441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9870907","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":"The 500th Lung Transplantation at the Faculdade de Medicina da Universidade de São Paulo: Reflecting on Our Journey and Looking Ahead.","authors":"Flavio Pola Dos Reis,&nbsp;Paulo Manuel Pêgo-Fernandes","doi":"10.1590/1516-3180.2023.1414030423","DOIUrl":"https://doi.org/10.1590/1516-3180.2023.1414030423","url":null,"abstract":"Lung transplantation is a widely accepted therapeutic option for the treatment of some advanced lung diseases. With current medical advances and new technologies, discussions on terminal patients and the possibility administering of a treatment option, whose objective is to increase survival or at least the quality of life of patients, are gaining more attention. 1","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"141 4","pages":"e20231414"},"PeriodicalIF":1.4,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10328440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9815536","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":"Correlation between depressive and anxious symptoms and white matter changes in relatives of people with epilepsy","authors":"Gabriel Ferri Baltazar, L. Ribeiro, M. Nogueira, Ricardo Brioschi, L. Silva, R. Joao, M. Alvim, F. Cendes, C. Yasuda","doi":"10.5327/1516-3180.616","DOIUrl":"https://doi.org/10.5327/1516-3180.616","url":null,"abstract":"Background: depression and anxiety are common symptoms observed in people with epilepsy and their relatives. Objective: Investigate associations between white matter (WM) changes and psychiatric symptoms in relatives of TLE patients. Methods: We analyzed brain MRI with DTI from 40 TLE relatives and applied the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). We extracted 6 WM tracts (fornix, cingulum, uncinate fasciculus (UF), inferior fronto-occipital fasciculus, corpus callosum, corticospinal tract) and analyzed fractional anisotropy (FA), medium diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD). We investigated correlations between scores and the DTI measures. Symptoms of depression were positive with BDI scores above 10, while symptoms of anxiety were positive with BAI scores above 11. Results: we observed a prevalence of 37.5% of depressive symptoms and 27.5% of anxious symptoms. BDI correlated with FA in the left cingulum (p=0.0003;r=-0.547); and with MD in the right cingulum (p=0.015;r=0.401) and right and left UF (p=0.023;r=0.374 and p=0.021;r=0.363). BDI correlated also with RD in the left and right cingulum (p=0.0003;r=0.583 and p=0.015;r=0.401). BAI correlated with fornix`s FA (p=0.026;r=- 0.352), and with MD in the left cingulum (p=0.01;r=0.415) and left UF (p=0.003;r=0.374) and with RD in the left cingulum (p=0.022;r=0.371) and left UF (p=0.01;r=0.440). Discussion: The regions correlated with psychiatric symptoms here overlap with those affected in patients with epilepsy, however, they differ from areas mainly affected in patients with isolated depression. We hypothesize a possible genetic substrate involved in comorbidity between epilepsy and depression, distinct from psychiatric disease in people without epilepsy.","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"1 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70976356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HANDS-ON: Training Simulation in Surgery.","authors":"Carlos Manuel de Almeida Brandão,&nbsp;Paulo Manuel Pêgo-Fernandes","doi":"10.1590/1516-3180.2022.1413230223","DOIUrl":"https://doi.org/10.1590/1516-3180.2022.1413230223","url":null,"abstract":"Methods of the teaching-learning binomial in surgery has undergone major transformations in the last decade, moving from purely informational content models of environments that stimulate theoretical “know-how” by incorporating skills and competencies. There has been a paradigm shift in the training of surgical residents from the traditional ‘‘apprenticeship’’ model to a hybrid one, involving simulation training. This shift has been in response to several current challenges in residency training, including time constraints, patient safety concerns, financial costs, and decreasing durations of training programs. 1 During the past several years, major shifts in surgical education have brought into question whether surgical residency programs could truly ensure competency and technical proficiency in these surgeons. 2 Simulation is an increasingly vital component of graduate medical education and becoming the standard of practice in many residency programs, particularly in surgical specialties, owing to the need for moving basic skill acquisition out of operating rooms into surgical skill laboratories. Deliberate practice is an educational technique that aims to improve performance through intense training and preparation. These steps include repetition, assessment, and feedback, which lead to performance improvement. 3","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"141 3","pages":"e20231413"},"PeriodicalIF":1.4,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10085531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9686281","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":"Challenges in Managing a Medical School.","authors":"Paulo Manuel Pêgo-Fernandes,&nbsp;Eloisa Bonfá","doi":"10.1590/1516-3180.2022.141216122022","DOIUrl":"https://doi.org/10.1590/1516-3180.2022.141216122022","url":null,"abstract":"We recently had the honor and enormous challenge of taking over as co-directors of the School of Medicine of the University of São Paulo (FMUSP). FMUSP has been nationally and internationally recognized for its pioneering spirit and excellence, both in terms of teaching and research and university extension. It has been training professionals for 110 years in the fields of medicine, physiotherapy, speech therapy, and occupational therapy, and the most recent Medical Physics Program establishes a partnership between the School of Medicine and the Physics Institute of the University of São Paulo. Our numbers speak for themselves: we have approximately 1,400 undergraduate students; more than 1,000 employees, including 368 professors; 2,000 graduate students; and 1,600 residents. We publish more than 2,500 scientific articles annually. Our Clinical Hospital (CH) is the largest hospital in Latin America, a state institution linked to the Secretary of Health of the State of São Paulo for administrative coordination purposes and associated with FMUSP for teaching, research, health initiatives, and community services. The CH comprises eight institutes (Central Institute, Psychiatry Institute, Heart Institute, Radiology Institute, Cancer Institute, Institute for Children and Adolescents, Orthopedics and Traumatology Institute, and Physical Medicine and Rehabilitation Institute) and two auxiliary hospitals (Suzano Auxiliary Hospital and Cotoxó Hospital Complex). Annually, we provide more than one million outpatient appointments, 180,000 urgent and emergency care appointments, and approximately 50,000 surgeries. We are one of the largest medical-scientific research centers in Brazil, with 66 medical investigation laboratories, 230 research groups, and extensive intellectual output. Our faculty and healthcare professionals represent a huge competitive advantage for obtaining resources in the areas of clinical research, innovation, education, and assistance. Many of our professors are among the most influential researchers in the world, according to an assessment by the British consultancy Clarivate Analytics.1 In the search for community-based planning that reflects the best strategies to meet the institution’s needs and define its future directions, the FMUSP 2030 strategic plan was prepared in December 2021 to outline new goals, processes, and guidelines for the new cycle that has just begun. Several CH leaders and representatives from the Zerbini Foundation (ZF) and the School of Medicine Foundation (SMF) participated in it. Planning is integrated between the FMUSP and the CH, with a focus on care, technical, and administrative teaching processes, research and innovation actions, and human resources. The actions are developed according to strategic axes, which deal with current themes of high social relevance, such as Excellence in Teaching, Culture, and Extension; Excellence in Care; Integration; Humanization-Participatory Management; Internationalizatio","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"141 2","pages":"87-88"},"PeriodicalIF":1.4,"publicationDate":"2023-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10005460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9517600","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}