Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Primary care effectiveness, multimorbidity, and hospital use in public and private health-care systems in Brazil: a cross-sectional analysis of data from the 2019–2021 Brazilian longitudinal study of aging

Background Whether patient-reported experiences in primary care modify the association between multimorbidity and emergency department (ED) visits and hospitalizations remains unclear. We examined these associations across public and private health system sectors among Brazilians...

Safety and Efficacy of Acute Normovolemic Hemodilution in Female Patients

Importance Female patients undergoing cardiac surgery have a higher transfusion burden, yet they remain underrepresented in randomized clinical trials. Although the ANH trial showed no significant reduction in the proportion of patients receiving allogeneic blood transfusions wit...

Global Incidence of All-Cause Dementia

Importance Global dementia incidence estimates are limited by underrepresentation of low- and middle-income countries and heterogeneous analytic methods. Due to these limitations, true understanding of the global dementia landscape remains incomplete. Objective To identify dement...

Globalising the access to advanced molecular diagnostics of CNS tumors: Experience of the Molecular Neuro-Pathology (MNP) Outreach Consortium

Central nervous system (CNS) tumors pose a major global health challenge, particularly in low- and middle-income countries (LMICs), where outcomes remain disproportionately poor. The global CONCORD-3 study (Lancet Oncology) highlighted stark disparities in five-year survival (201...

Severe skeletal fragility in SCN8A ‐related developmental and epileptic encephalopathy

Abstract In this child with a phenotype compatible with the SCN8A gain‐of‐function spectrum, more than 20 bone fractures were documented. Together with previously reported cases, these observations raise the possibility that skeletal fragility may represent an underrecognized fea...

Identifying Cardiac Autoantibody Biomarkers that Predict the Severity of Chagas Cardiomyopathy

Chagas cardiomyopathy (ChCM) affects up to 30% of patients with chronic Chagas disease and lacks reliable biomarkers for severity and conduction abnormalities. We profiled cardiac autoantibodies using 2-dimensional gel electrophoresis and mass spectrometry, followed by enzyme-lin...

Differential associations between treatment delay and survival across head and neck cancer subsites: a national hospital-based framework for risk-stratified prioritization

Purpose Delays in time to treatment initiation (TTI) have been associated with inferior outcomes in head and neck cancer, yet prior studies have typically evaluated tumors collectively, assuming uniform time sensitivity across diseases. This study quantified subsite- and stage-sp...

Long-term immunological impairment after early thymectomy in congenital heart disease

Abstract Early thymectomy during congenital heart disease repair may impair thymic output, but long-term effects across age groups remain incompletely defined. We evaluated T-cell receptor excision circles (TRECs) and a comprehensive panel of lymphocyte subsets in 20 adults (mean...

International Modified Delphi Consensus on Assessment and Management of Covert Brain Infarction

BackgroundCovert brain infarction (CBI) is a frequent incidental neuroradiological finding increasingly recognized as clinically relevant due to its association with stroke, cognitive decline, and other adverse outcomes. However, substantial uncertainty remains regarding its opti...

Detection of Chagas Disease from the ECG: The George B. Moody PhysioNet Challenge 2025

Abstract Objective: Chagas disease is a parasitic infection that is endemic to Latin America and primarily transmitted by insects. When untreated, Chagas disease can cause cardiomyopathy. Serological testing capacities for Chagas disease are limited, but Chagas cardiomyopathy oft...

Photothrombotic Ischemic Stroke in Rats: A Systematic Review of Experimental Parameters and Therapeutic Applications in Neuroprotection, Neuromodulation, and Post-Stroke Recovery

Background/Objectives: This systematic review analyzed the experimental parameters of the photothrombotic ischemic stroke model in rats and their relationship with neuroprotection, neuromodulation, and post-stroke recovery studies. We examined the follow-up periods and the behavi...

Chromosomal bla NDM-1 embedded within mosaic genomic islands in Pseudomonas aeruginosa ST235 co-producing VIM-2 or KPC-2

ABSTRACT Chromosomal integration of carbapenemase genes in Pseudomonas aeruginosa remains rare and poorly characterized. We report the genomic resolution of two extensively drug-resistant (XDR) Pseudomonas aeruginosa ST235 clinical isolates from Southern Brazil co-producing multi...

Dydrogesterone and inflammatory marker regulation: a systematic review and quantitative meta-analysis

Objective To evaluate the effects of dydrogesterone on systemic inflammatory biomarkers in women across different reproductive and hormonal clinical contexts compared with placebo or other pharmacological interventions.Methods This systematic review and meta-analysis followed PRI...

Circulating blood biomarkers after traumatic brain injury: A subanalysis of the biperiden phase III randomized, double‐blind clinical trial ( NCT01048138 )

OBJECTIVE: Traumatic brain injury (TBI) is a leading cause of acquired epilepsy, death, and long-term disability, yet reliable biomarkers to predict chronic sequelae such as post-traumatic epilepsy (PTE) remain limited. We evaluated the associations between circulating blood biom...

Healthcare occupancy data as an early warning indicator of infectious disease surges in São Paulo

Early detection of infectious disease surges is critical for effective public health response, yet traditional surveillance systems often suffer from delayed reporting. Here, we investigate whether passively collected occupancy data from healthcare facilities can act as an early...

Prayer and acute pain sensitivity in migraine and non-migraine cohorts: two assessor-blinded crossover experiments

Prayer is a widely used coping strategy that engages affective and cognitive processes implicated in pain regulation. Despite growing interest in the effects of religion and spirituality in health research, experimental evidence linking prayer to quantitative sensory outcomes in...

Mental health problems as mediators between childhood trauma and cardiometabolic risk behaviours in the 2004 Pelotas Birth Cohort

BACKGROUND: Childhood trauma is associated with greater engagement in health risk behaviours (HRBs) that predispose to cardiometabolic disease. However, the mechanisms underlying these associations remain poorly understood. Mental health problems are hypothesised to mediate links...

A systematic review of ultrasound to predict severe disease in patients with dengue and other viral infections associated with hemorrhagic fevers

Background Viral infections associated with hemorrhagic fevers (VaHFs) cause millions of cases each year across a broad geography with severity ranging from asymptomatic cases to clinical disease with a high case fatality rate. Commonalities in pathophysiology across VaHFs includ...

Capturing regional variation in aortic mechanics: dual-estimation method for material parameter identification and biological correlation

Abstract The aorta shows significant regional variation in geometry and composition. This complexity makes numerical modeling challenging, as it requires identifying material parameters. Typically, the Holzapfel-Gasser-Ogden model is used. However, it suffers from nonuniqueness a...

Outcomes of patients with adult T-cell leukemia/lymphoma at a university and a public cancer center in Brazil

OBJECTIVE: This study aimed to characterize adult T-cell leukemia/lymphoma (ATLL) cases in Brazil, a human T-cell lymphotropic virus type 1 (HTLV-1) endemic country, focusing on clinical presentation, diagnostic patterns, and prognostic factors, in order to address potential unde...