Over the past two decades, the concept of preoperative fasting for pediatric patients undergoing elective surgery has been reviewed by the scientific medical community. The European Society of Anesthesiology and American Society of Anesthesiology announced a minimum of 2h of preoperative fasting time for children and adolescents and the ingestion of only clear fluids within 2h prior to procedural anesthesia (,). We currently know that more than 4h of fasting may lead to unfavorable metabolic and inflammatory effects, such as […]

Congenital diaphragmatic hernia (CDH) is a severe defect with an estimated incidence of 1:3000 live births (). This anomalous condition is characterized by an absence of separation between the thoracic and abdominal cavities during fetal development. Some of the first hypotheses about this congenital defect postulated that the presence of abdominal viscera in the thoracic cavity caused pulmonary hypoplasia by pushing the abdominal contents into the developing lungs (,). After several studies in animal models, a new theory was presented […]

Protocol description First, when implementing SARS-CoV-2 vaccination for healthcare workers in health services that serve patients with COVID-19, some specific actions are required. Ideally, the real-time polymerase chain reaction test should be performed for all COVID-19 suspected cases before vaccination, as it is possible that the healthcare professional may have been previously infected with SARS-CoV-2 and appears asymptomatic. In the absence of prior testing, some professionals who receive the vaccination may be asymptomatic infected patients and may subsequently develop clinical […]

In Parkinson’s disease (PD), extensive research using experimental models has been conducted to study different aspects of the disease to understand its etiology, pathology, molecular mechanisms, and potential therapeutic targets (). Despite interesting debates in the literature, the available animal models are indispensable for the development of new concepts and ideas that can lead to novel protective or disease-modifying therapies (). However, little contribution has been made in the understanding of sudden unexpected death in PD (SUDPAR). PD, a very […]

Breast cancer is the most common cancer among the female population worldwide (). In Brazil, a developing country, breast cancer is the most common malignancy in women after non-melanoma skin cancer (). The success of breast cancer treatment depends on early diagnosis and treatment, which has an influence on the overall survival, regardless of the advancements in therapy (,). The main imaging procedures that usually lead to the early detection of breast cancer are mammography, ultrasonography, and magnetic resonance imaging […]

Dear Editor, I have read the article titled “The need to standardize use of the newly deceased in medical trainings” published in Clinics by Cabar FR et al. () with avid interest. The article provides information that would be useful for activists and researchers working in the fields of medical ethics and medical education. The implications of the brilliant issues highlighted by Dr. Cabar could be discussed further. In a similar field study, participants were asked two additional questions to […]

INTRODUCTION The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease (COVID-19), was first reported in Wuhan, Hubei Province, China, in late December 2019. In January 2020, the World Health Organization declared COVID-19 as a public health emergency of international concern (). As of March 27, 2021, which was one year after the first case was reported, COVID-19 has already affected 126,726,672 people worldwide and has caused 2,777,337 deaths (). COVID-19 affects all age groups and […]

We read with great interest the research article entitled “Effect of the location and size of thyroid nodules on the diagnostic performance of ultrasound elastography: A retrospective analysis” by Xie and Yu (). The authors claimed that the results of strain ultrasound elastography should be carefully evaluated when small thyroid nodules are close to the carotid artery. They indicated that the use of cytology to determine nodule parameters is effective in determining the diagnostic ability of strain ultrasound elastography. However, […]

Dear editor, Telomeres are the physical ends of eukaryotic chromosomes, and their structures are essential to maintain genome stability and limit cell proliferation (). Normally, the replication of telomeric DNA is done by a molecule called telomerase, which is an enzyme that is inactive in the vast majority of somatic cells. Therefore, every time our cells go into mitosis, we lose pieces of the telomeres (). When telomeres become severely short (as a natural consequence of aging or due genotoxic […]

Epilepsy is a common severe neurological disease independent of age, race, social class, geographic, or national boundaries (). Refractory epilepsy patients require the most time, attention, effort, and focus from neurologists due to the frequency and severity of their seizures. Refractory epilepsy is a major cause of disability, comorbidity, stigma, costs, and mortality ( -). Epilepsy has been associated with an increased risk of premature death, particularly among refractory epilepsy patients (,,). Sudden Unexpected Death in Epilepsy (SUDEP) is the […]

The coronavirus disease (COVID-19) pandemic has led to social distancing and isolation measures worldwide (,). Quarantine began on July 20, 2020 in São Paulo State, Brazil (). Institutional guidelines of the Hospital das Clínicas of FMUSP (HCFMUSP) released on March 18, 2020 recommended postponing medical and multidisciplinary appointments, outpatient procedures, and elective surgeries. As a result, the regular follow-up of a considerably large group of adolescents living with pre-existing chronic conditions was provisionally scheduled at longer intervals or even paused. […]

To the Editor, There is sufficient evidence to confirm that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a proinflammatory and prothrombogenic virus with a highly mutagenic profile. SARS-CoV-2 can produce active infection of variable duration in various organs and systems (lung, digestive system, central nervous system, skin) (), although the pathophysiological mechanism by which disseminated microthrombosis occurs is unclear. […]

BACKGROUND Since December 2019, with the first descriptions of cases of pneumonia caused by the new coronavirus in Wuhan, China, the virus causing this infection has spread globally (). One of the main characteristics of this new virus is its high transmissibility (). Since February 2020, when the first coronavirus disease 2019 (COVID-19) case was reported in Brazil, a series of changes have been incorporated for the treatment of cancer patients with COVID-19. In particular, for patients with esophageal cancer, […]

INTRODUCTION Although Parkinson’s disease (PD) primarily affects the central nervous system, it is a multi-organ disease which also affects the eyes and the peripheral nervous system, including the autonomic fibers (,). PD-related disturbance of the peripheral nerves may result in sensory, motor, or autonomic neuropathy. Autonomic dysfunction can manifest as sicca syndrome, hypo-/hyperhidrosis, orthostatic hypotension, reduced blood pressure variability, reduced heart rate variability, nausea, constipation, vomiting, urinary dysfunction, or erectile dysfunction (). Non-motor manifestations, such as hyposmia, rapid eye movement […]

Coronavirus disease (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (). This novel coronavirus, which was first reported in Wuhan city, China, in late December 2019 and subsequently spreaded rapidly to all provinces of China and then worldwide, has had a devastating effect on global public health (). As SARS-CoV-2 is highly contagious, the number of global infections has continuously increased since the first confirmed case a SARS-CoV-2 infection. The disease is often transmitted to the patient’s […]

Hemostasis in children and adolescents: ontogenetic characteristics and impact on pediatric thromboembolism During phylogenetic evolution, living beings develop a regulatory hemostatic system for protecting the cardiovascular system. In humans, the hemostatic system has a peculiar ontogenesis, which consists of a dynamic evolutionary process deeply influenced by age. The term “developmental hemostasis” has been used since the 1990s to describe age-dependent changes in the hemostatic system, as seen in (). Children are physiologically protected from thromboembolic events due to a decreased […]

Serological surveys, such as EPICOVID19 (), are important to monitor the evolution of COVID-19 in a population. In this letter, we discuss how to best estimate its prevalence. It is well known that the naive estimator of prevalence that consists of counting how many individuals tested positive ignores the possibility of test errors and may therefore substantially bias the conclusions. The often-used Rogan-Gladen estimator () is an alternative that provides corrected confidence intervals based on sensitivity/specificity values. However, this estimator […]

Since December 2019, when the initial cases of severe viral pneumonia caused by a new coronavirus were described, health services worldwide have sought to understand the evolution and risk factors related to the severity of coronavirus disease (COVID-19). Elderly individuals have been shown to be the highest risk group. However, other factors, such as male sex; obesity; smoking; and chronic heart, lung, kidney, and liver diseases, are also associated with a poor prognosis. We draw attention to immunosuppressed patients as […]

Dear Editor, We went through a recent article published in volume 75 of your esteemed journal, titled “Transcutaneous tibial nerve stimulation versus parasacral stimulation in the treatment of overactive bladder in elderly people: A triple-blinded randomized controlled trial” (). We found the article very resourceful and well written. The treatment intervention used by the authors can be effective in treating overactive bladder symptoms not only in patients receiving tibial nerve stimulation but also in amputees through stimulation of the parasacral […]

Dear editor: In parallel with the efforts of the global scientific community toward investigating the pathophysiology, prevention, and treatment of coronavirus disease (COVID-19), all medical specialties that deal with frontline care have readapted their care protocols to better treat patients and protect their teams when fighting against the pandemic. […]