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Clinics
Journal Information
Issue
portada-S1807593224X00022Vol. 80. (In progress)
(January - December 2025)
This issue is in progress but contains articles that are final and fully citable.
Editorials
Advances in immunomodulation for organ transplantation: The role of the Annexin A1/FPR axis
Rafael André da Silva, João Vitor Ferreira de Lima, Raquel Fink Lins e Silva de Macedo, Monielle Sant'Ana, Cristiane Damas Gil, M. Natalia Vergara
Clinics. 2025;80C:100626
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Can proton pump inhibitors increase the risk of sudden unexpected death in Parkinson's disease (SUDPAR)?
Francisco Sandro Menezes-Rodrigues, Fernando Sabia Tallo, Afonso Caricati-Neto, Josef Finsterer, Carla Alessandra Scorza, Fulvio Alexandre Scorza
Clinics. 2025;80C:100721
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Ascending to Q1: A critical analysis of clinics journal's editorial trajectory and future challenges
José Maria Soares-Júnior, Fauze Maluf-Filho
Clinics. 2025;80C:100722
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Melatonin and cancer: towards a time-sensitive oncological adjunct
Ricardo Hsieh, Silvia Vanessa Lourenço, Edmund Chada Baracat, José Cipolla-Neto, José Maria Soares Junior
Clinics. 2025;80C:100834
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Strategic acquisition of healthcare equipment in Brazil: balancing legislative amendments and research funding agencies
Everson L.A. Artifon, Marcio Roberto Facanali, José Maria Soares, Edmund Chada Baracat
Clinics. 2025;80C:100840
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Original articles
Lactylated histone H3K18 as a potential biomarker for the diagnosis and prediction of the severity of pancreatic cancer
Jinping Hou, Mingsong Guo, Yongqiong Li, Yijin Liao
Clinics. 2025;80C:100544
Highlights

  • High level of Pan Lysine Lactylation (Pan-Kla) is found in pancreatic cancer tissues.

  • H3K18la levels are increased in pancreatic cancer tissues.

  • H3K18la is related to the severity and prognosis of pancreatic cancer.

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The role of hormone dosages in the assessment of cervical lesions by FNA: A descriptive analysis of 762 cases
Arthur Henrique Cunha-Volpato, Carlos Izaias Sartorão Neto, Luiz Fernando Ferraz da Silva, Paulo Campos Carneiro
Clinics. 2025;80C:100539
Highlights

  • Hormone measurement in FNA washout fluid is an accessible method for improving accuracy.

  • Thyroglobulin (TG) dosage can enhance the accuracy of detecting well-differentiated thyroid carcinomas.

  • Calcitonin dosage complements cytology in detecting medullary thyroid carcinoma cervical metastasis.

  • Post-thyroidectoby bed dosages help to determine non-thyroid/parathyroid lesions.

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Correlation between liver volume drainage and clinical success after endoscopic biliary drainage of hilar malignant obstruction
Jennifer Nakamura Ruas, Ernesto Quaresma Mendonça, Luciano Lenz, Gustavo Andrade de Paulo, Ricardo Uemura Sato, José Jukemura, Ulysses Ribeiro Junior, Fauze Maluf-Filho, Bruno Costa Martins
Clinics. 2025;80C:100540
Highlights

  • The main cause of hilar obstruction was cholangiocarcinoma (32.9 %) followed by lymph node metastasis (23.2 %).

  • Technical success was achieved in 91.5 %, clinical success in 60 %.

  • A significant correlation between clinical success rate was found when at least 50 % of viable parenchyma was drained (p = 0.016; OR = 4.15, 95 % CI 1.4–12.5).

  • Considering liver sectors, higher clinical success rates were found when at least 2 sectors were drained (p < 0.001; OR = 8.50, 95 % CI 2.7–26.7).

  • Correlation between unilateral versus bilateral drainage and clinical success was not statistically significant.

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Descriptive study of claims in primary care during the year 2022 in a health area of Spain
María F. Velázquez-López, María García-Pérez, Montserrat Souto-Pereira, Juan M. Vazquez-Lago
Clinics. 2025;80C:100546
Highlights

  • Analyzing complaints is essential for identifying areas for improvement.

  • 79 % of the complaints were related to communication issues with the patient.

  • Improving communication with the patient will help reduce the number of complaints filed.

  • Using a web application simplifies the management of complaints in primary care.

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Anatomical variations of the marginal mandibular nerve
Arthur Paredes Gatti, Matheus Trovão Ribeiro, Flávio Hojaij
Clinics. 2025;80C:100548
Highlights

  • Most surgeons underestimate the positional and numerical variations of the Facial Nerve.

  • About 50% of the Marginal Nerves of the Mandible have more than one subdivision.

  • Just over half of the branches of the Mandibular Marginal Nerve are found below the lower border of the mandible.

  • The great anatomical variation of the Mandibular Marginal Nerve is responsible for the majority of postoperative motor sequelae.

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Infiltration of micro-fragmented adipose tissue under local anesthesia for knee osteoarthritis treatment is a safe procedure: A case series
Bruno Butturi Varone, Daniel Peixoto Leal, Daniel Duarte Perini, Vitor Penteado Figueiredo Pagotto, Riccardo Gomes Gobbi, Marco Kawamura Demange
Clinics. 2025;80C:100527
Highlights

  • Harvesting abdominal fat for mFAt knee injection is a safe procedure.

  • Minor events, such as ecchymosis, mild abdominal discomfort, and mild discomfort at the infiltrated knee are common.

  • The procedure can be done under local anesthesia, without sedation after single-time preparation.

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Clinical and swallowing characteristics of tracheostomized patients with post-intubation acquired tracheal or laryngotracheal stenosis
Carina Escudero, Fernanda Chiarion Sassi, Ana Paula Ritto, Paulo Francisco Guerreiro Cardoso, Claudia Regina Furquim de Andrade
Clinics. 2025;80C:100552
Highlights

  • Despite the efficacy of reconstructive surgeries and Montgomery T-tube, clinical and neurological instability significantly impact outcomes and prolong tracheostomy use.

  • Treatment for post-intubation tracheal or laryngotracheal stenosis requires a multidisciplinary and personalized approach.

  • Dysphagia is a significant factor linked to poorer clinical outcomes and extended tracheostomy use.

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The impact of photodynamic therapy on cellular immune function in patients with cervical HPV infection
Yan Ju, Qunyan Zhou
Clinics. 2025;80C:100537
Highlights

  • Photodynamic Therapy (PDT) significantly increased HPV clearance rates in cervical HPV-infected patients.

  • PDT treatment augmented CD3+ and CD4+ T-cell levels, with sustained elevation observed up to 6 months post-treatment.

  • A higher CD4+/CD8+ ratio was noted in the PDT group, indicating an enhanced cellular immune response.

  • Pro-inflammatory cytokines IL-6, IL-8, and TNF-α levels decreased post-PDT, suggesting reduced inflammation.

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Clinical study of the effect of mometasone furoate nasal spray treatment on hearing and in secretory otitis media in children
Xiaoyan Yu, Lang Xu, Youqi Xie, Mengjie Huang
Clinics. 2025;80C:100551
Highlights

  • The total effective rate of treatment in the observation group was higher than that in the control group.

  • The middle ear resonance frequency of the children in the observation group was higher than that of the control group at weeks 4, 8 and 12 of treatment, and the air-conduction hearing threshold was lower than that of the control group.

  • The total effective rate of the observation group after 12 weeks of treatment was 92.11 %, which was significantly higher than that of the control group (73.68 %).

  • The T-ETDQ score of the observation group was lower than that of the control group after treatment.

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Diagnostic value of contrast-enhanced ultrasound combined with serum procalcitonin in tuberculous lymph nodes and metastatic lymph nodes
Lin Li, Lan He, Minchao Xiong, Xiaoyan Wang
Clinics. 2025;80C:100541
Highlights

  • According to imaging findings of CEUS, TLN was associated with enhanced concentric performance in the arterial phase and heterogeneous enhancement pattern in lymph nodes.

  • Peak Intensity (PI) of lesions was higher in MLN patients.

  • Increased age-enhanced concentric performance in the arterial phase, increased PI, and serum PCT above 5.39 ng/mL were independent risk factors for MLN.

  • The prediction model of serum PCT combined with CEUS had a higher diagnostic value for MLN.

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The effect of Licochalcone A on proliferation, invasion, and drug resistance of glioma cells by regulating TLR4/NF-κB signaling pathway
Baigui Zhou, Kun Mu, Xuzhou Yu, Xu Chen, Xiaoying Shi
Clinics. 2025;80C:100542
Highlights

  • LCA has the ability to suppress the growth, movement, and invasion of glioma cells.

  • It can also counteract resistance to TMZ drugs.

  • This opens up new possibilities for identifying clinical drugs to treat glioma patients who are resistant to TMZ.

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A study on the intervention of eight-section brocade exercises in combination with comprehensive measures on the physical function status of patients with chronic obstructive pulmonary disease
Jiezhen Li, Yan Lei, Meini Li
Clinics. 2025;80C:100536
Highlights

  • Eight-section brocade exercises enhance exercise endurance and lung function of COPD patients.

  • Eight-section brocade exercises improve the physical function of COPD patients.

  • Eight-section brocade exercises improve patient emotions, nursing efficiency, and satisfaction.

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CST1 promoted gastric cancer development by activating the AKT pathway
Lei Zhang, Dongmei Wang, Liqun Zhang, Lini Zhu
Clinics. 2025;80C:100561
Highlights

  • Comparison of the invasive capabilities.

  • Comparison of the metastatic capabilities.

  • Effect of CST1 and AKT mRNA in gastric cancer.

  • Effect of CST1 and AKT protein in gastric cancer.

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Gyosaponin ameliorates sevoflurane anesthesia-induced cognitive dysfunction and neuronal apoptosis in rats through modulation of the PI3K/AKT/mTOR pathway
Lijuan Lin, Chenhui Zhu, Bing Yan, Pinxian Yu, Liu Yang, Wei Huang, Junren Chen
Clinics. 2025;80C:100560
Highlights

  • GpS ameliorates Sev-induced cognitive deficits in rats.

  • GpS ameliorates Sev-induced neuronal cell damage in rats.

  • GpS promotes activation of the PI3K/AKT/mTOR pathway.

  • PI3K/AKT/mTOR pathway inhibitor reduces the amelioration of cognitive deficits in Sev-anesthetized rats by high-dose GpS.

  • PI3K/AKT/mTOR pathway inhibitor impairs the ameliorative effect of high-dose GpS on neuronal cell damage in Sev-anesthetized rats.

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Effect of melatonin on postoperative cognitive function in elderly patients submitted to transurethral resection of the prostate under spinal anesthesia
Cristiane Tavares, Cláudia Maia Memória, Luiz Guilherme Villares da Costa, Vinícius Caldeira Quintão, Alberto Azoubel Antunes, Deborah Teodoro, Maria José Carvalho Carmona
Clinics. 2025;80C:100562
HIGHLIGHTS

  • Perioperative Neurocognitive Disorders (PND) can occur in patients submitted to elective surgical procedures under general or regional anesthesia, especially the elderly.

  • Circadian rhythm disruptions have harmful effects on cognition and may also play a role in the development of PND.

  • Melatonin 10 mg administered in the perioperative period of TURP surgery for elderly patients hasn&apos;t shown any protective effect against postoperative cognitive decline, mainly because the patients have shown a significant improvement in cognitive functions after the surgery.

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Agreement analysis and associated factors of SARC-F and SARC-CALF in screening of risk sarcopenia in people living with human immunodeficiency virus
Lara Cristina Vieira, Jaine Alves Ximenez, Maria Claudia Bernardes Spexoto
Clinics. 2025;80C:100565
Highlights

  • SARCCalf is better than SARC-F in screening the risk of sarcopenia in PLHIV.

  • Low CD4+ count, the presence of opportunistic infections, and AIDS status are associated with the risk of sarcopenia in PLHIV, regardless of the tool used.

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Incidence of mycobacteria in pulmonary granulomatous lesions
Sibele Inácio Meireles, Mariana Vargas Cruz, Gustavo Palmer Irffi, Leonardo Abreu Testagrossa
Clinics. 2025;80C:100564
Highlights

  • Lung granulomas have been associated with mycobacteria and fungal infections.

  • The largest cohort of pulmonary granulomatous lesions in Brazil was studied.

  • FFPE specimens are a valuable source of material for molecular methods.

  • Molecular methods contribute to the fast diagnosis of all mycobacteria species.

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Role of centchroman in regression of fibroadenoma: A 2-arm randomized control trial
Priyanka Rai, Soniya Nityanand, Amarjot Singh, Sunil Kumar Singh, Neha Singh, Arvind Kumar Singh, Dhananjay Singh
Clinics. 2025;80C:100567
Highlights

  • The findings of the study indicate that Centchroman led to a notable reduction in fibroadenoma size, with a significant proportion of patients experiencing more than 50 % regression in their fibroadenomas.

  • Patients experienced significant relief from breast pain (mastalgia), showcasing the efficacy of Centchroman in alleviating associated physical discomfort.

  • Centchroman led to a significant improvement in anxiety and depression scores, highlighting its positive impact on the psychological health and overall well-being of patients.

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The impact of clinical seizures and adverse brain MRI patterns in neonates with hypoxic-ischemic encephalopathy and abnormal neurodevelopment
Sae Yun Kim, Hyun-Mi Kang, Soo-Ah Im, Young-Ah Youn
Clinics. 2025;80C:100533
Highlights

  • Electrographic seizures did not have predictive value for adverse neurodevelopmental outcomes at 12‒24 months of age.

  • The incidence of neurodevelopmental impairment or death was significantly higher in the clinical seizure group.

  • Only cord blood pH and abnormal brain MRI findings were consistently associated with long-term neurodevelopmental outcomes in a multivariate analysis.

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Bleeding in patients hospitalized with acute pulmonary embolism in Brazil
Leonardo Jordan Hansen Vizzotto, Corina dos Reis Sepeda, Carlos Henrique Miranda
Clinics. 2025;80C:100573
Highlights

  • Antithrombotics are the cornerstone for acute Pulmonary Embolism (APE) treatment.

  • Patients hospitalized with APE in Brazil had a high prevalence of bleeding.

  • The major bleeding increased the one-year mortality rate.

  • The bleeding predictive scores assessed showed limited accuracy in identifying high bleeding-risk patients.

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Relationship between sleep disorders and information processing speed in multiple sclerosis
Fereshteh Ashtari, Arshia Ghalamkari, Saba Naghavi, Ahmad Pourmohammadi, Iman Adibi, Zahra Karimi, Aryan Kavosh
Clinics. 2025;80C:100574
Highlights

  • Restless legs syndrome is associated with lower information processing speed.

  • Obstructive sleep apnea is not associated with lower information processing speed.

  • Managing sleep disorders is critical for improving cognition in multiple sclerosis.

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Variations of renal Doppler indices during the initial 24-hour predict acute kidney injury in patients with sepsis: A single-center observational case-control clinical study
Xing Chen, Wen Wu, Chao Lei, Chong Li, Zhaohui Zhang, Xingguang Qu
Clinics. 2025;80C:100538
Highlights

  • Renal Doppler marker variations within the initial 24 h in sepsis patients.

  • RRI reduction after 24h of ICU treatment can be used for early detection of SA-AKI.

  • Critical ultrasound for dynamic monitoring of renal perfusion.

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Efficacy and safety of a modified DVD regimen followed by lenalidomide for the treatment of Newly Diagnosed Multiple Myeloma
Zhichao Li, Wenhao Zhang, Fang Huang, Siguo Hao
Clinics. 2025;80C:100575
Highlights

  • Adverse effects of lenalidomide for Newly Diagnosed Multiple Myeloma (NDMM) cannot be ignored.

  • Lower-dose PLD administered with dexamethasone and subcutaneous bortezomib is associated with a good durable response.

  • Lenalidomide is retained as maintenance or salvage therapy if the DVD regimen fails.

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Evaluation of corneal incision in femtosecond laser-assisted phacoemulsification
Guilherme Horta, Rogério Horta, Newton Kara-Junior
Clinics. 2025;80C:100572
Highlights

  • After cataract surgery, the prevalence rate of Descemet membrane Detachment was significantly higher in the group with keratome incisions (63.2 %) compared to that with femtolaser incisions (22.2 %).

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OSVE or multiple-choice test: Is that a relevant question?
Francine Jomara Lopes, Renato Fraga Righetti, Matheus Belloni Torsani, Gustavo Silva Azevedo, Fernando Mauad Sacramento, Iolanda de Fátima Lopes Calvo Tibério
Clinics. 2025;80C:100519
Highlights

  • OSVE and multiple-choice tests can be used interchangeably in the context of formative assessment.

  • OSVE and multiple-choice tests as effective tools to enhance intern training and monitoring.

  • OSVE holds promise as a transformative tool, capable of ensuring the continuity and integrity of clinical skills assessment in medical education.

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Evaluation of l-cell activity in the small intestine according to the extension of the biliopancreatic loop in patients undergoing Roux-en-Y gastric by-pass
Priscila Costa Estabile, Márcia Saldanha Kubrusly, Robson Kiyoshi Ishida, André Bubna Hirayama, Roberto de Cleva, Marco Aurelio Santo
Clinics. 2025;80C:100555
Highlights

  • Question – Extension of the biliopancreatic loop increases l-cell activity after surgery bariatric?

  • Findings – l-cell activity increased independent of extension of the biliopancreatic limb.

  • Meaning – The additional beneficial effects of long BPL may be due to more rapid delivery of food and bile salts to more distal portions of the intestine.

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Metabolomics in juvenile idiopathic arthritis: A distinct profile in patients under methotrexate
Renato B. Tomioka, Gabriela R.V. Ferreira, Nadia E. Aikawa, Gustavo A.R. Maciel, José M. Soares Junior, Edmund C. Baracat, Eloisa Bonfá, Ismael Dale Cotrim Guerreiro da Silva, Clovis Almeida da Silva
Clinics. 2025;80C:100522
Highlights

  • We identified a distinctive pattern of serum metabolic signatures in juvenile idiopathic arthritis patients under methotrexate therapy.

  • Methotrexate use is associated with a more efficient mitochondrial function.

  • A decreased mitochondrial metabolism was observed in polyarticular and systemic JIA subtypes, with a decrease of several acylcarnitines’ concentrations.

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Difference among frailty assessment tools in predicating postoperative prognosis of elderly patients with mild traumatic brain injury
Chunhua Ni, Chen Gu, Hua Liu, Feng Cheng, Chao Cheng, Xiaohua Xia
Clinics. 2025;80C:100554
Highlights

  • Incidence of frailty in elderly patients varies widely among different tools.

  • FP and FS could be employed as tools for predicting frail conditions.

  • Different tools had low consistency in predicting frail conditions.

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Pulmonary rehabilitation under supervision of health-professional at institute versus conventional exercise-based pulmonary rehabilitation at home in COPD patients: A longitudinal cohort study
Guxiang Zhang, Jiajing Yu, Zhiqiang Pei, Fei Xie, Ruiyang Ding, Lili Bao, Anyang Li
Clinics. 2025;80C:100563
Highlights

  • Guidelines recommended pulmonary rehabilitation in COPD.

  • Self-driven pulmonary rehabilitation is an undertreatment for COPD patients in China.

  • Chinese patients with COPD have worse clinical conditions.

  • Treatment with pulmonary rehabilitation at institutes improves clinical outcomes.

  • Chinese COPD patients are required to be treated as per proper guidelines.

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Prolonged high Myl9 levels are associated with the pathogenesis and respiratory symptom of post-acute COVID-19 syndrome: A 6-month follow-up study
Jun Sugihara, Chiaki Iwamura, Tomoya Tateishi, Tadashi Hosoya, Sho Shimada, Kiyoshi Hirahara, Shinsuke Yasuda, Yasunari Miyazaki
Clinics. 2025;80C:100584
Highlights

  • Respiratory symptoms of PACS are associated with high serum Myl9 levels.

  • Patients who have had COVID-19 can be divided into two groups according to their serum Myl9 levels.

  • The neutrophil count is correlated with the Myl9 level at 6 months after infection.

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circLOC375190 promotes autophagy through modulation of the mTORC1/TFEB axis in acute ischemic stroke-induced neurological injury
Qie Liu, Lu Zhang, Xin Xu
Clinics. 2025;80C:100581
Highlights

  • circLOC375190 reduction ameliorates neuronal autophagy and apoptosis in tMCAO mice.

  • circLOC375190 knockdown improves OGD/R-mediated neuronal autophagy and apoptosis.

  • circLOC375190 affects OGD/R-mediated neuronal apoptosis and autophagy by adsorbing miR-93-5p.

  • circLOC375190 affects OGD/R-mediated neuronal apoptosis and autophagy by regulating the miR-93-5p/MKNK2 axis.

  • circLOC375190 affects AIS autophagy by regulating the mTORC1/TFEB axis.

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Hsa_circ_0000105 promotes nasopharyngeal carcinoma malignancy by miR-541-3p/S100A11 axis
LuXing Peng, Jian Qin, DeFeng Qing, XinJun Huang, XiuRong Huang
Clinics. 2025;80C:100577
Highlights

  • hsa_circ_0000105 modulates malignancy of NPC cells.

  • hsa_circ_0000105 influences the malignant behavior of NPC via downstream miR-541-3p.

  • hsa_circ_0000105 positively regulates S100A11 to accelerate the malignant behavior of NPC.

  • hsa_circ_0000105 inhibits NPC tumor growth in vivo.

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Prevalence of dry eye in Brazil: Home survey reveals differences in urban and rural regions
Leidiane Adriano Pereira, Laura Braga Arantes, Etiene Lorriane de Souza Persona, Denny Marcos Garcia, Isvander Gustavo de Souza Persona, Regina Celia Nucci Pontelli, Eduardo M. Rocha
Clinics. 2025;80C:100578
Highlights

  • Dry eye is more frequent in the urban than in the rural population.

  • Dry eye is associated with dyslipidemia, visual display terminal, and ocular surface problems.

  • Dry eye is more frequent in women and the associated factors are associated with antiallergics, chronic pelvic pain, and fibromyalgia.

  • Dry eye in the elderly has distinct clinical associated factors.

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Evaluation of single-dose umbilical cord blood-derived mononuclear cell injection immediately and 7 days after spinal cord trauma in mice
Alex Oliveira de Araujo, Gustavo Bispo dos Santos, Raphael Martus Marcon, Maria Helena Alves Nicola, Marcela Saldanha Pereira, Fernando Barbosa Sanchez, Thiego Pedro Freitas Araujo, Alexandre Fogaça Cristante
Clinics. 2025;80C:100579
Highlights

  • Stem cell therapy is a promising alternative in the spinal cord injury arsenal.

  • Challenges in stem cell treatment in SCI: phase uncertainty and cell type controversy.

  • Umbilical cord mononuclear cells may enhance recovery via multiple mechanisms.

  • Umbilical cord mononuclear cells can promote histological improvement after SCI.

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Construction and validation of a personalized risk prediction model for in-hospital mortality in patients with acute myocardial infarction undergoing percutaneous coronary intervention
Bing-Zheng Xu, Bin Wang, Jian-Ping Chen, Jin-Gang Xu, Xiao-Ya Wu
Clinics. 2025;80C:100580
Highlights

  • Construction of a personalized risk prediction model for in-hospital mortality in patients with acute myocardial infarction undergoing Percutaneous Coronary Intervention (PCI).

  • Identification of risk factors associated with in-hospital mortality in AMI patients who underwent PCI.

  • Development of a nomogram prediction model for in-hospital mortality in AMI patients after emergency PCI.

  • Evaluation of the nomogram model&apos;s effectiveness through c-index, internal validation, Hosmer-Lemeshow test, and calibration curve analysis.

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Association between serum C-reactive protein and low muscle mass among US adults: Results from NHANES 1999 to 2006
Ruzheng Lin, Ying Chen, Kai Liu
Clinics. 2025;80C:100588
Highlights

  • NHANES data from 1999 to 2006 show a positive link between serum CRP levels and low muscle mass risk in US adults.

  • An inverse J-shaped pattern emerges, indicating a non-linear association between CRP levels and low muscle mass risk, with critical points at 0.273 mg/dL for the overall population, 0.172 mg/dL for males, and 0.296 mg/dL for females.

  • This nationally representative study underscores the crucial role of inflammation in muscle function and advocates for future research and clinical strategies to address inflammation&apos;s impact on muscle mass and function.

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Do not expect an endoluminal complete response to identify a pathologic complete response in rectal cancer!
Alexandre Gheller, Guilherme Inácio Bertoldo de Melo e Patriarca da Silva Neiva, Mario Nóbrega de Araújo Neto, Fernando Gonçalves Lyrio, Dunya Bachour Basílio, Marília Cristina Roda da Costa, Douglas Vieira Mourão, Paulo Gonçalves de Oliveira, João Batista de Sousa
Clinics. 2025;80C:100587
Highlights

  • Correlation between pathologic complete response and endoluminal complete response.

  • Half of pathologic complete responses do not achieve an endoluminal complete response.

  • Gross findings do not perfectly reflect microscopic findings.

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Effect of adipose-derived mesenchymal stem cells on the viability of the transverse rectus abdominis myocutaneous flap in rats
André Luiz Pires de Freitas, Sang Won Han, Priscila Keiko Matsumoto Martin, Lydia Masako Ferreira
Clinics. 2025;80C:100590
Highlights

  • ADSCs increased the viability (significantly less necrosis) of a TRAM flap in rats.

  • Vessel formation in the ischemic segment of the flap was also enhanced by the ADSCs.

  • Fluorescence microscopy indicated no differentiation of ADSCs into endothelial cells.

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The educational impact of medical students’ participation in a short-term health expedition: The Iguape one health experience
Marcelo Arruda Candido, Vinicius Venturini, Matheus Polly, Matheus Belloni Torsani, Alexandre Sizilio, João Mitsuji Sakô, Wen-Jan Tuan, Robert Patrick Lennon, ... Iolanda de Fátima Lopes Calvo Tibério
Clinics. 2025;80C:100601
Highlights

  • Educational value of health expeditions assessed via surveys.

  • No significant clinical or empathy gains observed.

  • 80 % reported positive career influence from participation.

  • 60 % intend to work within the public health system.

  • Practical experiences deemed crucial for shaping careers.

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Analysis of risk factors for depression in peritoneal dialysis patients and establishment of a risk nomogram model
Ming Yang, Xinhai Tang, Yehua Fang
Clinics. 2025;80C:100600
Highlights

  • Risk factors for depression in peritoneal dialysis patients identified.

  • Nomogram predicts depression risk in peritoneal dialysis patients.

  • Gender, income, and comorbidities influence depression risk in dialysis.

  • Low hemoglobin and uric acid levels are linked to higher depression risk.

  • Developed nomogram shows strong clinical applicability and accuracy.

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Circular RNA pappalysin-1 enhances glycolysis via microRNA-656-3p targeting G-protein subunit gamma-5 to promote colon cancer progression
AiYuan Cai, HuiShi Ye, YuanHong Lin, JinYun Li, DongSheng Fang, ZhongBin Pan, ZhiWei Li, GuangLiang Luo, ... CiAi Lai
Clinics. 2025;80C:100594
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The economic impact of Long-Acting Contraceptives (LARCs) on public health
Ana Claudia Marcelino, Paula da Cunha Pereira, Luis Bahamondes
Clinics. 2025;80C:100598
Highlights

  • The use of LARCs reduces unplanned pregnancies.

  • Single-visit placements of LARCs increase access and uptake.

  • Train and allowed nurses on the placement of LARCs is important to women access and uptake.

  • Expand the knowledge of non-contraceptive benefits of LARCs is important among providers and users.

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Coronavirus disease 2019 infection severity among different variants in children under 2-years old in Brazil
Beatriz Martinelli Menezes Gonçalves, Rossana P.V. Francisco, Ágatha S. Rodrigues, José Carlos Soares Junior
Clinics. 2025;80C:100592
Highlights

  • The original variant was responsible for most of the cases that evolved with death, omicron seems to be responsible for milder symptoms when compared to delta.

  • Children between 1‒6-months of age account for most of the cases, which concerns since there is no vaccination coverage.

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The phenotype of monocyte subtypes and expression of chemokine receptors in the Chronic Venous Insufficiency
Danielle Borges Germano, Larissa Namie Chiba, Ana Paula Augusto da Cruz Ballerini, Jônatas Bussador do Amaral, Marina Tiemi Shio, Jhefferson Miranda Alves, Daniela Alves de Abreu, Luiz Henrique da Silva Nali, ... Carolina Nunes França
Clinics. 2025;80C:100595
Highlights

  • Receptors have chemotactic property cells and are characterized as inflammatory markers.

  • Monocyte subtypes can play an important role in the Chronic Venous Disease scenario.

  • Receptors that act by recruiting monocytes include CCR2, CCR5, and CX3CR1.

  • Chronic Venous Insufficiency changes the monocyte phenotype.

  • The chemokine receptors might be changed by the Chronic Venous Insufficiency.

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Multi-omics model is an effective means to diagnose benign and malignant pulmonary nodules
Yunzeng Zhang, Fan Zhang, Changming Shen, Gaofeng Qiao, Cheng Wang, Feng Jin, Xiaogang Zhao
Clinics. 2025;80C:100599
Highlights

  • Multi-omics study is promising to improve the sensitivity and specificity of screening for NSCLC.

  • The risk score of Metabonomics, radiomics and multi-omics had different levels of performance in different risk groups.

  • Multi-omics model is more effective in the non-invasive diagnosis of pulmonary malignant nodules.

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Investigating the role of MicroRNA-519d-3p in enhancing chemosensitivity of colorectal cancer cells to 5-Fluorouracil through PFKFB3 targeting
Yangyang Zhang, Yiqing Zhang, Yanan Xiao, Shufen Xu, Jie Li, Juan Li, Lisha Chang, Jie Ding, ... Keming Wang
Clinics. 2025;80C:100606
Highlights

  • miR-519d-3p affects the antitumor effect of 5-FU on CRC cells.

  • miR-519d-3p could regulate PFKFB3 and could have a significant effect on CRC.

  • PFKFB3 attenuated 5-FU sensitivity in CRC cells and enhanced glycolysis.

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Thrombin generation indices and Wells score predict pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease
Linjie Luo, Dan Zheng, Li Da, Jian Cheng, Yirui Cao, Na Wang
Clinics. 2025;80C:100582
Highlights

  • History of venous thromboembolism, d-Dimer as well as ETP, APTT coagulation indices, and Wells score were significantly higher in the AECOPD with PE group, and ttpeak, ALB and TP were lower.

  • Wells score had a positive correlation with ETP and APTT and a negative correlation with ttpeak, which were all independent risk factors for PE in AECOPD.

  • Wells score, ETP, APTT and ttpeak had the efficacy of predicting PE by ROC curve analysis.

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Power Doppler in hand joints predicts therapeutic failure in treatment-naive women with early rheumatoid arthritis: A prospective study
Karine Rodrigues da Luz, Jamil Natour, Marcelo de Medeiros Pinheiro, Giovanna S. Petterle, Marla Francisca dos Santos, Artur da Rocha Correa Fernandes, Rita Nely Vilar Furtado
Clinics. 2025;80C:100593
Highlights

  • Power Doppler as a Predictor: In hand ultrasound of women with early rheumatoid arthritis, Power Doppler was a significant predictor of therapeutic failures.

  • Important Power Doppler Scores: The total Power Doppler score, wrist Power Doppler score, and metacarpophalangeal Power Doppler score were the most critical predictors of therapeutic failures.

  • Clinical Implications of Power Doppler: The use of Power Doppler can help clinicians identify the risk of therapeutic failures in women with early rheumatoid arthritis, allowing for early intervention and treatment adjustments to improve patient outcomes.

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Pembrolizumab in gestational trophoblastic neoplasia: Systematic review and meta-analysis with sub-group analysis of potential prognostic factors
Marcio Barcellos, Antonio Braga, Matheus Machado Rech, Solange Artimos de Oliveira, Jose Mauro Madi, Sue Yazaki Sun, Jorge de Rezende-Filho, Kevin M. Elias, ... Ross S. Berkowitz
Clinics. 2025;80C:100583
Highlights

  • Pembrolizumab is effective for GTN multi-drug resistant treatment.

  • Pembrolizumab seems also effective for PSTT/ETT treatment.

  • Pembrolizumab efficacy is similar in cases of resistance or GTN relapse.

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Magnetic resonance-guided focused ultrasound for uterine fibroids
Pedro Felipe Magalhães Peregrino, Marcos de Lorenzo Messina, Marcos Roberto de Menezes, José Maria Soares Júnior, Giovanni Guido Cerri, Edmund Chada Baracat
Clinics. 2025;80C:100603
Highlights

  • Fibroids are tumors that can cause important symptoms that reduce women&apos;s quality of life.

  • The gold standard treatment for symptomatic fibroids is hysterectomy.

  • Myomectomy is the treatment of choice for women with reproductive desire.

  • Magnetic resonance-guided focused ultrasound for uterine fibroids is a minimally invasive treatment alternative for symptomatic women.

  • Magnetic resonance-guided focused ultrasound for uterine fibroids proves to be a good alternative to improve the symptoms and quality of life of symptomatic women.

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Routinely available inflammation biomarkers to predict stroke and mortality in atrial fibrillation
Long Wu, Zhiquan Yuan, Yuhong Zeng, Lanqing Yang, Qin Hu, Huan Zhang, Chengying Li, Yanxiu Chen, ... Na Wu
Clinics. 2025;80C:100610
Highlights

  • Adding Lymphocyte to Monocyte Ratio (LMR) to CHA2DS2-VASc score improves its reclassification ability and is comparable with the ABC score in predicting stroke.

  • Adding a systemic inflammation score (using LMR, albumin and fibrinogen) to CHA2DS2-VASc score improves its predictive and reclassification ability and is comparable with the ABC score in predicting death.

  • Because traditional inflammatory biomarkers are more readily available and less expensive, they may be used to improve decision support for AF.

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Biliary HMGB1 levels and biochemical indices in the assessment of acute obstructive septic cholangitis combined with septic shock
DanYang Gu, YuHao Wu, ZhengHua Ding, Yang Dai
Clinics. 2025;80C:100611
Highlights

  • High levels of HMGB1 in AOSC bile are associated with the risk of septic shock.

  • AOSC bile HMGB1 is significantly correlated with blood CRP.

  • Elevated HMGB1 in AOSC bile increases the risk of postoperative complications.

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Diagnosis and management of acute abnormal uterine bleeding during menacme
Gabriela Pravatta-Rezende, Cristina Laguna Benetti-Pinto, Daniela Angerame Yela Gomes, Ana Carolina Japur de Sá Rosa e Silva, José Maria Soares
Clinics. 2025;80C:100608
Highlights

  • Abnormal Uterine Bleeding (AUB) is the leading cause of seeking gynecological care, with data showing that 3 in 10 Brazilian women have this condition, with intermenstrual bleeding standing out.

  • According to the International Federation of Gynecology and Obstetrics (FIGO), cycles lasting less than 24 days or more than 38 days, with menstrual flow lasting eight days or more and blood loss reported by the woman as intense, are considered abnormal.

  • The main causes of AUB are summarized in the mnemonic PALM-COEIN, dividing them into structural and non-structural causes.

  • Diagnosing the etiology of AUB is essential to establish specific treatments, directed at the cause, which can be clinical or surgical, aiming not only to control the amount of blood loss, but also to improve the quality of life of women with AUB.

  • In general, the first line of treatment for AUB is medication, with surgical treatment being intended for failure or contraindication to clinical treatment or in cases of significant hemodynamic instability.

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Uterine artery doppler and pregnancy-associated plasma protein-A in pregnancies with fibroids
Lida Anwari
Clinics. 2025;80C:100615
Highlights

  • Uterine fibroids adversely impact maternal and neonatal outcomes.

  • UAD parameters and PAPP-A levels do not markedly associate with the fibroid size.

  • UAD and PAPP-A play functional roles in determining the outcomes of pregnancies carrying fibroids.

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Normal ranges of the fetal weight determined by ultrasound in the population of the Hospital das Clínicas of the Faculdade de Medicina da Universidade de São Paulo
Eliane Azeka Hase, Amanda Amaral, Stela Verzinhasse Peres, Rossana Pulcineli Vieira Francisco
Clinics. 2025;80C:100616
Highlights

  • Normal ranges of fetal weight as a function of gestational age was created.

  • New parameter, days before birth, was incorporated for normal ranges of fetal weight.

  • Parameter days before birth is useful for estimating fetal weight at scheduled birth.

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Virtual reality and traditional training in surgical instrumentation: A non-inferiority comparative study
Cristina Pires Camargo, Sergio Henrique Bastos Damous, Jocielle Santos de Miranda, Patricia Zen Tempski, Francisco de Salles Collet e Silva, José Maria Soares, Edivaldo Massazo Utiyama, Rolf Gemperli
Clinics. 2025;80C:100609
Highlights

  • A newly developed tool, featuring a virtual reality immersion headset combined with software created in collaboration with a Brazilian company, enables students to immerse themselves in a simulated surgical theater environment.

  • The study demonstrated that virtual reality learning was equivalent to textbook training and scored higher than traditional training in satisfaction ratings.

  • The use of virtual reality offers a practical and appealing alternative to conventional instrumentation classes.

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Simultaneous 18F-labeled AlF-FAPI PET/MR images targeting the myocardial fibrosis in coronary artery disease and degenerative mitral valve regurgitant participants with left ventricular mechanical dyssynchrony
YuFeng Chen, Jia Guo, YuJi Zhang, DengShun Tao, KeYan Zhao, QingXue Shi, GuoXu Zhang, HuiShan Wang
Clinics. 2025;80C:100624
Highlights

  • Uptake of 18F-FAPI in the myocardium can detect fibrosis and predict LV dyssynchrony.

  • There are different distributions of FAPI-uptake in CAD and DMVR patients.

  • FAPI-uptake in the anterior, septal and inferior walls can detect cardiac dysfunction.

  • SUVmean of FAPI in the lateral wall can determine the progression of cardiac dysfunction.

  • FAPI-uptake in the basal inferospetal/basal inferior walls can assess the level of MR.

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Eugenol alleviates renal ischemia-reperfusion injury induced-endoplasmic reticulum stress via activating Sestrin2
Jingwei Liu, Xujie Sun, Junfeng Liang, Shiqiang Song
Clinics. 2025;80C:100627
Highlights

  • Eugenol significantly lessens renal injury and oxidative stress in ischemia-reperfusion.

  • Eugenol&apos;s protection is enhanced by increasing Sestrin2 expression, crucial for its benefits.

  • Eugenol protects kidneys by modulating oxidative and endoplasmic reticulum stress via Sestrin2.

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Sex differences in kidney and lung status in an animal model of brain death
Marina Vidal-dos-Santos, Roberto Armstrong-Jr, Maryna van Zil, Fernanda Yamamoto Ricardo-da-Silva, Lucas Ferreira da Anunciação, Mayara Munhoz de Assis Ramos, Cristiano de Jesus Correia, Petra J. Ottens, ... Ana Cristina Breithaupt-Faloppa
Clinics. 2025;80C:100623
Highlights

  • Slow induction of BD affects male and female organs differently.

  • Reduced lung function was observed in females with higher leukocyte infiltration.

  • Greater kidney injury was observed in males, with higher plasma creatinine levels.

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Risk factors and predictive model for pulmonary arterial hypertension in adult idiopathic-inflammatory-myopathy patients: A cross-sectional study
Junyu Liang, Xiaoqun Ba, Liyan Wan, Xiao Cui, Ye He, Lanlan Xiao, Yini Ke, Hanyin Zhang, ... Jin Lin
Clinics. 2025;80C:100621
Highlights

  • Systemically identify risk factors for PAH among IIM patients in southern China.

  • Anti-SRP antibody and Interleukin (IL)−17A are correlated with IIM-related PAH.

  • The BAIMS model is valuable in prediction and early-identification of PAH in IIM.

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Decoding prognostic factors in SARS-CoV-2 complications among patients with hematological disorders
Fengbo Jin, Wei Qian, Yingying Chen, Wanlu Tian, Ling Ge, Mingzhen Yang, Leiming Xia
Clinics. 2025;80C:100625
Highlights

  • This study addresses the critical prognostic factors for SARS-CoV-2 complications in hematological patients, a high-risk population with reported mortality rates up to 31 %.

  • Through a retrospective analysis of 71 hematology inpatients (November 2022–March 2023), elevated ferritin levels emerged as a robust predictor of COVID-19 pneumonia development (p = 0.016), while heightened serum interferon-γ concentrations correlated strongly with disease severity (p = 0.048).

  • Mortality risk was significantly associated with elevated neutrophil counts, ferritin, D-dimer, and fibrin degradation products (p < 0.05). Notably, patients with myeloid malignancies in complete remission exhibited increased pneumonia susceptibility (p = 0.012), suggesting post-treatment immune vulnerability.

  • Conversely, B-cell-targeted therapy or cytotoxic chemotherapy markedly reduced severe infection rates (p = 0.024).

  • These findings fill critical gaps in prognostic assessment for hematological patients with SARS-CoV-2 co-infection and establish a scientific foundation for personalized monitoring through multidimensional biomarker analysis (e.g., iron metabolism, coagulation profiles, cytokine dynamics), directly informing optimized management strategies for high-risk populations.CLINICS-D-23–00783_Original Article.

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Arthroscopic superior capsule reconstruction with dermal allograft and autologous long head of the biceps tendon for irreparable posterosuperior rotator cuff tears, a two-year clinical and radiological results
Joe Chih-Hao Chiu, Yu-Cheng Chen, Poyu Chen, Yi Lu, Cheng-Pang Yang, You-Hung Cheng, Alvin Chao-Yu Chen
Clinics. 2025;80C:100628
Highlights

  • Superior capsule reconstruction with an autologous iliotibial band, dermal allograft, and long head of biceps tendon has been proposed to treat massive irreparable posterosuperior rotator cuff tears.

  • Superior capsule reconstruction with dermal allograft combined with autologous long head of biceps tendon demonstrates significant improvements in shoulder function and pain relief over two years for patients with irreparable posterosuperior rotator cuff tears.

  • The indications for this method included painful irreparable posterosuperior massive rotator cuff tears less or equal to Hamada grade 2 rotator cuff tear arthropathy, supraspinatus tendon retraction at Patte stage III, no preoperative pseudoparesis, supraspinatus fatty infiltration equal to or more than Goutallier stage 2, and presence of long head of the biceps tendon.

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The effect of the leukoreduction filtration moment on the clinical outcome of transfused patients: A retrospective cohort study
Natasha Dejigov Monteiro da Silva, Lilia de Souza Nogueira, Youko Nukui, Cesar de Almeida-Neto
Clinics. 2025;80C:100633
Highlights

  • Leukoreduction decreases the adverse effects of blood component transfusion.

  • Leukoreduction by pre-storage filtration reduced the length of hospital stay.

  • Leukoreduction by pre-storage filtration reduced hospital deaths.

  • No effect of leukoreduction filtration moment on adverse transfusion reaction.

  • No effect of leukoreduction filtration moment on healthcare-associated infection.

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Association between decreased p53 expression, elevated serum CagA levels, and oral squamous cell carcinoma
Minxiao Lin, Jing Wang, Xiaowu Yao
Clinics. 2025;80C:100632
Highlights

  • In OSCC patients, p53 expression in oral mucosal tissues was downregulated.

  • The concentration of CagA in the serum of OSCC patients was increased.

  • A correlation was observed between p53 expression and the tumor stage in OSCC.

  • The decreased p53 expression may be related to the progression of OSCC.

  • Elevated serum CagA levels could potentially serve as a factor for OSCC diagnosis.

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RBBP4 downregulation increases the sensitivity of A549 and HeLa cells to cisplatin by inhibiting cyclin D1 expression
Zhiyu Zeng, Meiqing Mai, Dandan Wang, Jie Ouyang, Zhiru Chen, Jingjing Zhong, Jinjun Rao
Clinics. 2025;80C:100637
Highlights

  • Cisplatin induces RBBP4 in A549 cells, higher in cisplatin-resistant A549/DDP.

  • Downregulating RBBP4 with siRNA increased cisplatin sensitivity in A549 and A549/DDP.

  • Overexpressing RBBP4 reduced sensitivity, while downregulation inhibited cyclinD1.

  • CyclinD1 overexpression reversed this effect in A549, A549/DDP, and HeLa/DDP cells.

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Brugada pattern changes during tilt table test with high precordial leads. An exploratory data to better understand the dynamic profile
Eduardo Nolla Silva Pereira, Luciana Sacilotto, Tan Chen Wu, Gabriele D'Arezzo Pessente, Denise Tessariol Hachul, Mauricio Ibrahim Scanavacca, Francisco Carlos da Costa Darrieux
Clinics. 2025;80C:100647
Highlights

  • Brugada syndrome presents with a dynamic ECG pattern during autonomic stimulation.

  • Tilt table test can provide different autonomic situations during the exam.

  • High precordial leads can be used during the test to enhance ECG information.

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hsa_circ_0095812 accelerates periodontitis progression by adsorbing miR-485-3p-mediated THBS1 expression
XiaoTing Xie, RuiTing Li, FangLin Mi
Clinics. 2025;80C:100631
Highlights

  • circLRRC4C is highly expressed in periodontitis tissues.

  • circLRRC4C acts as a sponge for miR-485-3p.

  • •THBS1 is a target gene of miR-485-3p.

  • Knockdown of circLRRC4C ameliorates periodontitis in mice.

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The application of transperineal ultrasonography combined with shear wave elastography in the evaluation and monitoring of pelvic floor function in the early stage after total hysterectomy
Runyan Ji, Jing Wu, Yanqing Xu, Hanzhen Ji
Clinics. 2025;80C:100656
Highlights

  • This study explores imaging assessment of pelvic floor function after hysterectomy.

  • The TAH can cause more significant damage to the pelvic floor structure and function.

  • Transperineal ultrasound and SWE assess pelvic floor function in multiple dimensions.

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The supramolecular polymer-related signature predicts prognosis and indicates immune microenvironment infiltration in gastric cancer
Yan Liu, Hongyao Cui, Chuan Sun
Clinics. 2025;80C:100641
Highlights

  • Supramolecular Polymer-Related Genes (SPRGs) was associated with Gastric Cancer (GC).

  • A prognostic signature was constructed based on SPRGs for GC patients.

  • A nomogram was constructed for prognostic evaluation in GC patients.

  • KLC1 was confirmed to promote proliferation, metastasis, and invasion in GC cells.

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Post-isometric exercise hypotension occurs irrespective of muscle mass in adults with hypertension: A randomized clinical trial
Patrícia Caetano de Oliveira, Thiago Dipp, Gustavo Waclawovsky, Alexandre Machado Lehnen
Clinics. 2025;80C:100612
Highlights

  • SBP was lower in the SMM (−4.1 mmHg) and the LMM (−5.6 mmHg) vs. control.

  • No statistical difference between SMM and LMM was observed.

  • DBP did not change over a period of 24 h in response to SMM or LMM involved.

  • Isometric exercise caused lower SBP, but not DBP, regardless of the mass of muscle.

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An evidence-based care program in a local healthcare setting in Brazil: Experience and impact
César Ramos Rocha-Filho, Felipe Sebastião de Assis Reis, Aline Rocha, Ana Carolina Pereira Nunes Pinto, Rozana Mesquita Ciconelli
Clinics. 2025;80C:100640
Highlights

  • Evidence-Based Care Program improves decision-making in a large Brazilian hospital.

  • 95 reviews conducted, including 55 rapid and 40 scoping reviews in 40 months.

  • High satisfaction: 99 % of requestors reported a positive impact on decision-making.

  • Most frequent topics: medical devices, drugs, and scale assessments.

  • Rapid reviews were critical for updating policies and guiding clinical decisions.

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Kynurenine promotes the immune escape of colorectal cancer cells via NAT10-mediated ac4C acetylation of PD-L1
Zaibiao Wang, Manman Yin, Ruhang Zhou, Ming Li, Jie Peng, Zhengguang Wang
Clinics. 2025;80C:100658
Highlights

  • Kynurenine suppressed T-cell activation and promoted immune escape.

  • Kynurenine promoted NAT10-mediated ac4C mRNA modification.

  • NAT10 inhibition improved T-cell activation and suppressed immune escape.

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CircRNA-NOLC1 mediates Insulin-like growth factor 1 receptor via performing as a ceRNA of miRNA-140–5p to facilitate testicular germ cell tumor advancement
Feng Lin, Xianming Yao, ShuoShuo Zhang, Huajun Yang
Clinics. 2025;80C:100629
Highlights

  • CircNOLC1 and IGF1R are upregulated while miR-140–5p is downregulated in TGCT.

  • CircNOLC1 can act as a sponge of miR-140–5p to up-regulate IGF1R.

  • Silencing circNOLC1 or overexpressing miR-140–5p inhibits TGCT cell proliferation, colony formation, and invasion, and promotes cell apoptosis.

  • CircNOLC1 promotes the progression of TGCT by modulating the miR-140–5p/IGF1R axis.

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Effect of omega-3 polyunsaturated fatty acid on endometriosis
Erniao Liu, Qianting Wang, Yaoxian Bai, Xi Zhang, Jingfang Wang
Clinics. 2025;80C:100654
Highlights

  • ω−3 PUFAs had no significant effect on endometriosis symptoms, such as pain, etc.

  • ω−3 PUFAs could reduce the inflammatory response in patients with endometriosis.

  • The local environment of implants exhibits pre-inflammatory tissue characteristics.

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circPOLA2 promotes proliferation, invasion, migration, and epithelial-mesenchymal transition in breast cancer via the miR-1224–5p/HMGA2 axis
XinYan Xu, Jie Li, RuiJuan Li, YanFang Tan, ZhiBing Lu
Clinics. 2025;80C:100653
Highlights

  • Upregulated circPOLA2 in BC is associated with poor prognosis.

  • circPOLA2 triggers BC cell malignant phenotype.

  • circPOLA2 directly interacts with miR-1224–5p in cells.

  • Depleting miR-1224–5p reverses si-circPOLA2-mediated inhibition of malignant behavior in BC cells.

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Effect of combined training on the cardiorespiratory, muscle system and body composition in employees at a tertiary hospital after mild to moderate intensity COVID 19
Marcus Vinicius Grecco, Alexandre Moura dos Santos, JúliaMaria D'Andrea Greve, Angélica Castilho Alonso, Mara Silvia Afonso, Juliana Cristina de Sousa, Marília Simões Lopes Quintana, José Maria Soares-Junior, ... Paulo Roberto Santos Silva
Clinics. 2025;80C:100614
Highlights

  • COVID-19 and functional disability.

  • combined training as a treatment for COVID-19 symptoms.

  • Therapeutic approach to patients with COVID-19.

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TeleHCV: A single-visit protocol and minimal passive remote monitoring are sufficient to achieve high SVR with a sofosbuvir-velpatasvir regimen
Jerônimo De Conto Oliveira, Fernando Comunello Schacher, Marisa Boff Costa, Maurício Godinho Kolling, Raquel Boff Costa, Henrique Cabral Scherer, Paula Martins Fernandes, Natan Katz, ... Mário Reis Álvares-da-Silva
Clinics. 2025;80C:100643
Highlights

  • Direct-acting antivirals are highly efficacious for hepatitis C virus cure.

  • Access to specialized care and antivirals are difficult in some areas.

  • Simplifying delivery and follow-up of therapy can facilitate hepatitis C cure.

  • A single-day visit protocol achieved acceptable cure rates in this study.

  • This strategy.

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Cost-consequence analysis of surgical and clinical treatment modalities of laryngeal cancer
Alexandre Bezerra dos Santos, Patrícia Coelho de Soárez, Rossana Veronica Mendoza Lopez, Luciana Martins Rozman, Alessandro Gonçalves Campolina
Clinics. 2025;80C:100585
Highlights

  • Laryngeal carcinoma may be treated clinically or surgically as an initial therapeutic option.

  • Differences in terms of costs and outcomes has not been evaluated in Brazil.

  • Clinical and surgical therapeutic modalities for laryngeal carcinoma showed similar total costs.

  • Overall survival of laryngeal carcinoma patients was better in the surgical group.

  • Further studies should consider implementing cost-effectiveness analysis.

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The impact of the quarantine period due to the pandemic on the severity of Parkinson's disease and the quality of life of Parkinson's patients
Fatemeh Rafizadeh, Masoud Saadat Fakhr, Elham Esmaeili, Zahra Amini, Koosha Amiri, Delyar Mardmomen, Hadi Aqajani, Rozita Hajibagher Naeeni
Clinics. 2025;80C:100605
Highlights

  • The COVID-19 pandemic impacts global physical and mental health.

  • Parkinson&apos;s disease is the second most common age-related neurodegenerative disease.

  • COVID-19 quarantine worsened Parkinson&apos;s severity and quality of life.

  • Improved care, support, and activity plans are needed for Parkinson&apos;s patients during pandemics.

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Outcomes of Susanna UF implants in refractory congenital glaucoma
Aline Domingos Pinto Ruppert, Nara Gravina Ogata, Leopoldo Ernesto Oiticica Barbosa, Paulo Silas Neroni Stina, Marcus Vinícius Takatsu, Ernst Werner Oltrogge, Marcelo Hatanaka
Clinics. 2025;80C:100619
Highlights

  • Primary congenital glaucoma is a leading cause of childhood blindness.

  • Eyes with primary congenital glaucoma often require multiple surgeries to control pressure.

  • Pediatric glaucoma drainage device studies show declining surgical success rates by year 3 due to complications.

  • The Susanna UF Glaucoma Drainage Device has a published complication rate under 6 % in adults.

  • No published data is available on the Susanna UF Glaucoma Drainage Device in pediatrics.

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C-reactive protein to lymphocyte ratio combined with clinical features to construct a predictive model for upper gastrointestinal bleeding due to peptic ulcer
Hong Song, Juan Yang, Jiao Li, Cui Deng, SiMin Zhang, Sheng Zheng
Clinics. 2025;80C:100644
Highlights

  • CRP levels in patients with PU with UGIB were significantly higher than those without UGIB.

  • PU patients with UGIB had a higher CLR compared to those without UGIB.

  • HP infection is an independent risk factor for UGIB.

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LBP and iFABP mismatch in the evaluation of intestinal barrier dysfunction due to SARS-CoV-2 infection
Hermes Vieira Barbeiro, Denise Frediani Barbeiro, Heraldo Possolo de Souza, Francisco Garcia Soriano, Marcel Cerqueira Machado, Ludhmila Abrahão Hajjar
Clinics. 2025;80C:100642
Highlights

  • Inflammation in SARS-CoV-2 has an extrapulmonary alteration in 20 % of cases.

  • Intestinal damage is a direct action of the virus.

  • Enterocyte damage is lower to tight junction alteration.

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Clinical characteristics, SARS-CoV-2 variants, and outcomes of adults hospitalized due to COVID-19 in Latin American countries
Constantino López-Macías, Eduardo López-Medina, Maysa Bonfleur Alves, Aline da Rocha Matos, Juan V. Hernández-Villena, Zuleika Aponte-Torres, Laura E. Sarabia, Paula Manrique-Ramirez, ... Bárbara Emoingt Furtado
Clinics. 2025;80C:100648
Highlights

  • During the Omicron wave, hospitalized patients with COVID-19 were mainly older adults.

  • Disorders of the cardiovascular system were the most prevalent comorbidities.

  • More COVID-19 cases were unvaccinated individuals compared to the controls.

  • Most COVID-19 cases were moderate, but in-hospital deaths occurred in ∼20 % of cases.

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Cost-effectiveness of selective laser trabeculoplasty as a replacement for hypotensive eye drops in the Brazilian public health system
Leopoldo Ernesto Oiticica Barbosa, Wilma Lelis Barboza, Ricardo Agusto Paletta Guedes, Alfredo Chaoubah, Marcelo Hatanaka
Clinics. 2025;80C:100650
Highlights

  • SLT cost-effective for glaucoma in SUS.

  • SLT reduces costs & improves outcomes.

  • Economic analysis of SLT in Brazil.

  • SLT as alternative to eye drops.

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The impact of early morphine administration on septic patients with pre-existing chronic heart failure
Zhi-Ye Zou, Shui-Qing Gui
Clinics. 2025;80C:100655
Highlights

  • Early Morphine in Septic CHF Patients Reduces 30-Day Mortality (HR = 0.539).

  • Morphine Dose < 15 mg Lowers Mortality in Septic CHF Patients (HR = 0.233).

  • Analysis of 7424 Septic CHF Patients from MIMIC-IV Database.

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Inhibition of NSUN3 suppresses immune escape in non-small cell lung cancer through stabilizing PD-L1 in a 5-methyladenosine dependent way
Hancong Huang, Xiaohong Lv, Qianhua Chen, Lixia Dong
Clinics. 2025;80C:100662
Highlights

  • NSUN3 levels were up-regulated in NSCLC.

  • Inhibition of NSUN3 promotes CD8+ T-cell cytotoxicity against NSCLC cells.

  • NSUN3 inhibition suppresses the tumor growth.

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Safety of human serum albumin infusion in heart failure patients with hypoproteinemia: a propensity score-matched analysis
Tongqing Yao, Yinhua Xi, Fei Chen, Hao Lin, Jun Qian, Xuebo Liu
Clinics. 2025;80C:100659
Highlights

  • Heart failure cohort analysis using the MIMIC-III database of 6094 patients.

  • Impact of clinical factors on heart failure prognosis and patient outcomes.

  • Exploring biomarkers associated with heart failure progression and mortality.

  • Data-driven insights into heart failure management from ICU patient data.

  • Predictive modeling of heart failure outcomes based on the MIMIC-III dataset.

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Group interpersonal psychotherapy for generalized anxiety disorder: development process and a pilot test
Xia Sun, Lujia Zhang, Yan Pan, Kaiji Ni, Chenfeng Ji, Qian Zhou, Scott Stuart, Yanli Luo
Clinics. 2025;80C:100664
Highlights

  • A novel Group IPT was developed for Generalized Anxiety Disorder (GAD).

  • Reduction in GAD symptoms highlights the potential efficacy of Group IPT for GAD.

  • N Group IPT effectively addresses mental health care access barriers.

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Malignant risk of thyroid nodules with isolated macrocalcifications – A study based on surgery results
Xi-Yue Yang, Li-Fang Huang, Yue-Jian Han, Xiao-Xin Cen
Clinics. 2025;80C:100657
Highlights

  • Focal disruption of the anterior margin of IMC was significantly associated with malignancy.

  • Both small and large thyroid nodules with IMC had a lower intermediate risk of malignancy.

  • Interruption of IMC is more often seen in malignant nodules.

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Novel variants of the ATRX gene identified in MYCN non-amplified Neuroblastoma in Brazilian patients
Thamiris Magalhães Gimenez, Vanessa Pretes Peralta, Ricardo Rodrigues Giorgi, Karina Morikawa, Carolina Camargo Vince, Nathalia Halley, Sheila Aparecida Siqueira, Israel Bendit, ... Estela Maria Novak
Clinics. 2025;80C:100652
Highlights

  • Inactivation of the ATRX tumor suppressor in MYCN non-amplified neuroblastoma.

  • ATRX mutations have been associated with complete loss of protein expression.

  • ATRX mutations in neuroblastoma tend to have a progressive course of disease.

  • ATRX mutations are associated with age at diagnosis in patients with neuroblastoma.

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Clinical insights into circulating free-DNA in patients with bone sarcomas and ewing sarcoma
Veronica Aran, Amanda Santos Cavalcanti, Walter Meohas, Bruna Canteri, Jamila Alessandra Perini, Jesus Pino Minguez, João Antônio Matheus Guimarães, Vivaldo Moura Neto, Maria Eugênia Leite Duarte
Clinics. 2025;80C:100661
Highlights

  • Non-invasive ctDNA monitoring shows promise for sarcoma patient management.

  • ddPCR identified IDH2 and TP53 mutations in bone sarcoma plasma samples.

  • Liquid biopsy could improve bone sarcoma diagnosis.

  • Study highlights the detection of a novel IDH2 mutation in osteosarcoma.

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Analysis of factors affecting acute fatigue in patients with acute ischemic stroke: A single-center study from China
Yukun Lin, Wenjing He, Junwei He, Limei Liu
Clinics. 2025;80C:100667
Highlights

  • This study aimed to analyze factors affecting acute fatigue in acute ischemic stroke patients. A single-center convenience sample of 420 patients was used.

  • Female gender, chronic comorbidities, etc. were identified as risk factors for acute fatigue, while social support was a protective factor, guiding clinical interventions.

  • There was a positive correlation between fear of disease progression and acute fatigue. Alleviating fear may improve patients&apos; fatigue and quality of life.

  • The incidence of acute fatigue in acute ischemic stroke patients was 37.4 %, which affected rehabilitation. It&apos;s crucial to intervene for better rehabilitation outcomes.

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Assessing pediatric visual acuity with a computerized optokinetic nystagmus analyzer
Boyang Zhu, Min Yang, Xiaonan Liu, Bin Yuan, Yuqian Yin, Che Cheng, Faisal UL Rehman
Clinics. 2025;80C:100671
Highlights

  • Computerized optokinetic nystagmus testing improves pediatric vision accuracy.

  • Non-invasive OKN analyzer enables early detection of vision impairments in children.

  • Innovative OKN technology advances pediatric ophthalmology diagnostic methods.

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Can elastography predict early allograft dysfunction or loss after liver transplantation? A prospective study of diagnostic accuracy
Guilherme Marques Andrade, Luiz Marcelo Sá Malbouisson, Denise Paranaguá Vezozzo, Wellington Andraus, Paula Sepulveda Mesquita, Luiz Augusto Carneiro D'Albuquerque, Alberto Queiroz Farias, Flair José Carrilho
Clinics. 2025;80C:100634
Highlights

  • Elastography can be used to measure liver stiffness after transplantation.

  • Elastography had good accuracy in predicting allograft loss.

  • Elastography has the advantage of prediction dysfunction on the first day.

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Identification of prognostic biomarkers for endometrioid endometrial carcinoma based on the miRNA and mRNA co‐expression network regulated by estradiol
Qiu Xie, Junting Huang, Yuan Xie, Jin Hu, Li Jin
Clinics. 2025;80C:100672
Highlights

  • This study aimed to identify prognostic biomarkers for Endometrioid Endometrial Carcinoma (EEC) regulated by estradiol.

  • miR-142–5p and miR-30a-5p exhibited high sensitivity to estradiol stimulation and a strong association with EEC prognosis.

  • SACS and GPR157 were identified as potential biomarkers for EEC prognosis.

  • miR-142–5p–SACS and miR-30a-5p–GPR157 are novel therapeutic targets for EEC.

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Medical conduct and knowledge about physical activity counseling in the largest hospital complex in Latin America
Débora Borowiak Reiss, Ítalo Ribeiro Lemes, Hamilton Roschel, Bruno Gualano
Clinics. 2025;80C:100666
Highlights

  • PA training is allied to assessing, knowledge, and recognizing skills in PA counseling.

  • Training on PA is the key for physicians to be confident in their counseling abilities.

  • High self-efficacy for PA counseling is associated with willingness to prescribe PA.

  • Major gaps in physicians’ knowledge of PA recommendations were identified.

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NAT10-mediated N4-acetylcytosine modification promotes the progression of retinoblastoma by improving the HK1 mRNA stability to enhance glycolysis
Shan Xu, Xuming Lin, Fengling Jia
Clinics. 2025;80C:100678
Highlights

  • NAT10 mediated ac4C modification by interacting with HK1.

  • The levels of ac4C and NAT10 were increased in cancer tissues and RB cell lines.

  • NAT10 knockdown inhibited the glycolysis in RB cell lines.

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Associations of obesity defined comprehensively by body mass index and body fat percentage with osteopenia
Xin Liu, Yan Lou, Zhiyong Chang, Changyuan Gu, Bin Du, Guangquan Sun
Clinics. 2025;80C:100674
Highlights

  • Weighted logistic regression examined Body Fat percentage (BF%) obesity associated with osteopenia across gender and Body Mass Index (BMI) levels.

  • In females, compared to BMI obesity combined with BF% obesity, BF% obesity or non-obesity was respectively associated with higher osteopenia odds.

  • In males, BMI obesity was linked to lower osteopenia odds compared to both BMI and BF% obesity.

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Methotrexate carried in lipid core nanoparticles reduces microglial activation and induces neuroprotection after cortical stroke induced in rats
Edmundo L.R. Pereira, Raul C. Maranhão, Michelle N.C. Dias, Ijair R. dos Santos, Carolina Ramos dos Santos, Moisés Hamoy, Danielle Cristine A. Feio, Priscila O. Carvalho, ... Walace Gomes-Leal
Clinics. 2025;80C:100676
Highlights

  • MTX in lipid core nanoparticles (LDE) shows low toxicity and reduces inflammation.

  • LDE-MTX treatment reduces microglial activation and macrophage count in rats.

  • LDE-MTX boosts neuroprotection, increasing neuronal survival by 319 %.

  • LDE-MTX reduces ischemic stroke damage in rat models.

  • Potential novel treatment for ischemic stroke patients.

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The triglyceride-glucose index, metabolic biomarkers, and olive oil in diabetic patients: Real-world evidence from a propensity-score matched study
Ge Zhi-Wen, Hong Zhong-Xin
Clinics. 2025;80C:100618
Highlights

  • Olive oil has more obvious effects in improving muscle strength than soybean oil.

  • Patients with high TyG exhibit more improvements in biomarkers to interventions.

  • The TyG index is a valuable tool for clinically screening and categorizing patients.

  • TyG index can be used for personalized precision treatment of diabetes.

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Diagnostic performance of multiple ultrasonic modalities for prostate cancer
Yushan Liu, Shi Zeng, Dan Zhou, Haiqing He, Shuiqing Wu, Changkun Huang, Kai Ai, Xuan Zhu, Ran Xu
Clinics. 2025;80C:100680
Highlights

  • Real-time tissue elastography has excellent diagnostic performance in prostate cancer.

  • A blue area on elastography has significant diagnostic value for prostate cancer.

  • Multiparametric ultrasound can accurately diagnose prostate cancer.

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Sex and gender differences in cancer research and its application to clinical oncology and therapeutics
Rut Lucas-Domínguez, Cristina Rius, Yiming Liu, Andrea Sixto-Costoya, Juan Carlos Valderrama-Zurián
Clinics. 2025;80C:100670
Highlights

  • Gender gap in cancer research improved with more female authors/articles last decade.

  • Slightly Reduction in Gender Bias in cancer publications between 2021 and 2011.

  • No gender perspective differences in research studies among female/male authorship.

  • Breast cancer was studied by female majority and Lung cancer by parity or male majority.

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The effect of the art therapy interventions to alleviate depression symptoms among children and adolescents: a systematic review and meta-analysis
Bo Zhang, Lifang Yang, Wen Sun, Peng Xu, Hui Ma, Azizah binti Abdullah
Clinics. 2025;80C:100683
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A new option of reconstruction after extensive chest wall resection
João Paulo Cassiano de Macedo, Pedro Henrique Xavier Nabuco-de-Araujo, José Ribas M. de Campos, Paulo M. Pêgo-Fernandes, Ricardo M. Terra
Clinics. 2025;80C:100679
Highlights

  • Chest wall reconstruction plays an important role in the outcomes of chest wall surgery. The ideal prosthesis characteristics are already established, even though, the best choice is not well decided.

  • The authors propose a new prosthesis for chest wall reconstruction.

  • This study is the first to assess patients with chest wall disease reconstructed with Vitagraft®. It is a synthetic, biocompatible, and absorbable material, which has never been found in thoracic surgery before.

  • Finally, the use of Vitagraft® has been shown to have good prosthesis biocompatibility.

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RPS27A as a potential clock-related diagnostic biomarker for myocardial infarction: Comprehensive bioinformatics analysis and experimental validation
Rui Xu, Changshun Yan, GuiQiu Cao
Clinics. 2025;80C:100677
Highlights

  • Clock genes are linked to myocardial infarction, offering novel insights into its pathogenesis.

  • Ten differentially expressed clock genes suggest new pathways in myocardial infarction development.

  • RPS27A’s core role in myocardial infarction was validated via Lasso regression and qRT-PCR, showing elevated expression.

  • Gene enrichment analysis uncovers gap junction and circadian rhythm pathways in myocardial infarction.

  • RPS27A was identified as a potential molecular target for diagnosing myocardial infarction.

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Role of meditation on the essence of self in the psychological profile, quality of life and lifestyle – a comparative study
Paula Ricci Arantes, Tatiana Caccese Perrotti, Susan Andrews, Ernesto Sasaki Imakuma, Rosana Aparecida de Oliveira Maurelli, Emmanuel A. Burdmann
Clinics. 2025;80C:100682
Highlights

  • First research to investigate meditators’ profile for Gurusakásha meditation.

  • Meditators had higher levels of psychological well-being and quality of life.

  • Third phase meditation may impact stress, resilience, lifestyle, and quality of life.

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CircHIPK3′s dual role in promoting angiogenesis and inhibiting apoptosis through FASN mRNA stabilization in gallbladder cancer
ZhenWei Li, HaiJiu Wang, Cheng Wang, ZhiXin Wang, Zhi Xie, JinMing Liu
Clinics. 2025;80C:100697
Highlights

  • Nude mice implantation experiment.

  • RNA FISH-immunofluorescence microscopy.

  • Cycloheximide (CHX) and protease inhibitor MG132 treatment assay.

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Baihu Guizhi decoction alleviates inflammation in rats with acute gouty arthritis by targeting miR-17–5p to regulate the TLR4/Myd88/NF-κB signaling pathway
GuangYu Liu, JunKai Wu, HongJie Song
Clinics. 2025;80C:100665
Highlights

  • Serum TNF-α, IL-1β, and IL-6 contents.

  • TLR4 and MyD88 expression levels in rat synovium.

  • TLR4 and MyD88 expression levels in rat synovium.

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Clinicopathological and prognostic analysis of PIK3CA mutated invasive breast cancer in Chinese women
Juhang Chu, Luyao Huang, Yaru Wang, Mingping Qian
Clinics. 2025;80C:100702
HIGHLIGHTS

  • PIK3CA mutations involve exon 20 and 9 in breast cancer.

  • PIK3CA mutations are linked to tumor characteristics and NLR.

  • A tumor recurrence prediction model was established based tumor characteristics.

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Impact of fiberoptic bronchoscopy with bronchoalveolar lavage on infection control in patients with severe ventilator-associated pneumonia
Chunfeng Sheng, Xun Xu, Xiaobo Song, Bangfeng Zhao, Yu Zhang, Fengli Si
Clinics. 2025;80C:100699
Highlights

  • FOB with BAL enhances infection control and improves overall patient prognosis.

  • FOB with BAL provides a clear basis for pathogen diagnosis.

  • FOB with BAL aids in enhancing the effectiveness of antibiotic therapy.

  • FOB with BAL is safe for use in severe VAP patients.

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Predicting pancreatic fistulas after pancreatoduodenectomy: development and internal validation of a new preoperative nomogram
Guilherme Naccache Namur, Fernanda Lopez Mazzucato, Ricardo Jureidini, Thiago Costa Ribeiro, Manoel de Souza Rocha, José Jukemura, Ulysses Ribeiro Junior
Clinics. 2025;80C:100706
Highlights

  • A preoperative nomogram predicts Pancreatic Fistula (PF) after pancreatoduodenectomy.

  • Risk factors for PF: male gender, BMI, and pancreatic duct ≤ 3 mm.

  • Weight loss > 10 % is protective against PF development.

  • The nomogram shows strong predictive accuracy (AUC = 0.798).

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Recognition and diagnosis of Alzheimer’s Disease using T1-weighted magnetic resonance imaging via integrating CNN and Swin vision transformer
Yanlei Wang, Hui Sheng, Xueling Wang
Clinics. 2025;80C:100673
Highlights

  • This study proposes a new vision transformer to evaluate MRI from the ADNI dataset.

  • The proposed model captures global relationships between long-range pixels.

  • The suggested model achieves high accuracy in classifying AD classes.

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Optimizing malignancy prediction: A comparative analysis of transfer learning techniques on EBUS images
Ali Erdem Ozcelik, Neslihan Ozcelik, Emre Bendes, Gizem Ozcibik Isik, Omer Topaloglu
Clinics. 2025;80C:100703
Highlights

  • EBUS enhances mediastinal lymph node evaluation with less invasiveness.

  • VGG19, EfficientNet, and DenseNet achieved top malignancy prediction (AUC = 0.96).

  • Model architecture plays a key role in selecting transfer learning approaches.

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Risk factors and primary indications for cesarean section in women with gestational diabetes mellitus according to Robson classification
Ana Paula Veiga de Oliveira, Tatiana Assunção Zaccara, Marcela Del Carlo Bernardi, Cristiane de Freitas Paganoti, Fernanda Cristina Ferreira Mikami, Rossana Pulcineli Vieira Francisco, Rafaela Alkmin da Costa
Clinics. 2025;80C:100705
Highlights

  • Cesarean rates were highest in GDM women from group 5 with prior uterine scars.

  • Spontaneous labor was the strongest predictor of vaginal delivery.

  • Prior C-section, fetal distress, and multiples reduced vaginal delivery odds.

  • Promoting safe spontaneous labor may lower C-sections in GDM cases.

  • More prospective studies are needed to confirm findings and guide practice.

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Different prophylactic measures for preventing postoperative deep venous thromboembolism in adenomyosis: a retrospective study
Yan Lei, Na Chen, Yuqin Tang, Xiaojia Xie
Clinics. 2025;80C:100700
Highlights

  • High postoperative VTE incidence in women with adenomyosis after surgery.

  • Laparoscopic lesion excision shows higher VTE rates than hysterectomy.

  • Combined mechanical and pharmacological prophylaxis reduces VTE incidence.

  • Preoperative d-dimer levels significantly elevated in VTE cases.

  • The study emphasizes the need for VTE screening post-adenomyosis surgery.

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Impact of implementing a prioritization process on waiting time for non-scheduled surgeries in a tertiary emergency unit
Marcelo Cristiano Rocha, Sergio Henrique Bastos Damous, Rafaela Alkmin Costa, Edivaldo Massazo Utiyama
Clinics. 2025;80C:100712
Highlights

  • A structured prioritization model was implemented for non-elective surgeries in a tertiary academic hospital in Brazil.

  • The intervention combined urgency classification, a Kanban dashboard, and daily multidisciplinary meetings.

  • Median surgical waiting time dropped from 17h20min to 8h52min after implementation (p < 0.001).

  • Compliance with acceptable waiting time windows improved from 60.5 % to 77.1 %.

  • The model enhanced surgical efficiency and was well-accepted by multidisciplinary teams.

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A randomized controlled trial comparing the efficacy and safety of indobufen versus aspirin in reducing target vessel restenosis after drug-eluting balloon angioplasty in patients with coronary artery disease
Zhenhua Jiang, Dewen Zhu, Jiangqian Meng
Clinics. 2025;80C:100716
Highlights

  • Indobufen matches aspirin in preventing TVR for CAD patients post-DEB treatment.

  • Indobufen shows better safety with fewer adverse events in the trial.

  • Indobufen may cut GI bleeding and bruising, benefiting high-risk patients.

  • This trial fills the literature gap of indobufen post-DEB in CAD treatment.

  • New comparative evidence for post-PCI antiplatelet therapy is provided.

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Identification of plasminogen activator urokinase receptor-related non-coding RNA and immune prognostic signature for non-small cell lung cancer
Yuan Cheng, Shihao Bao, Hao Zhang, Yifan Zhang, Xianjie Li, Hanyi Li, Xuewang Jia, Qianqian Sun, Zuoqing Song
Clinics. 2025;80C:100711
Highlights

  • Significant differences in the expression of PLAUR in NSCLC tumor types.

  • PLAUR could serve as a prognostic biomarker for NSCLC patients.

  • MIRLET7BHG/hsa-miR-127–3p axis was the upstream pathway for PLAUR.

  • PLAUR-mediated carcinogenesis of NSCLC involves tumor immune escape.

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Rising trends on folic acid test requests in a middle-income large academic hospital: A low-value care target for improvement
Bruno Adler Maccagnan Pinheiro Besen, Fabio Augusto Rodrigues Gonçalves, João Vitor Ziroldo Lopes, Evelinda Marramom Trindade, Guilherme Henrique Hencklain Fonseca, Luiz Augusto Marcondes Fonseca, Nairo Massakazu Sumita, Arnaldo Lichtenstein, Leila Antonangelo
Clinics. 2025;80C:100707
Highlights

  • Folate test ordering is rising in this large academic hospital.

  • Only 0.7 % of folate tests have results in the low range (< 3 ng/mL).

  • Most patients had more than one test ordered (74.8 %), many within three months.

  • Non-clinical guided test ordering suggests low-value testing of folate.

  • Almost $600 K dollars were spent on low-value folate ordering over 5-years.

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The cognitive and motor effects of immersive virtual reality in individuals with neurocognitive disorder: randomized controlled trial protocol
Maristela Chaya, Jessica Maria Ribeiro Bacha, Paula Lagos, Vitória Terzian, Ana Claudia Souza, Luciana dos Anjos, Julia Maria D'Andrea Greve, Regina Miksian Magaldi, ... José Eduardo Pompeu
Clinics. 2025;80C:100704
Highlights

  • IVR games can enhance cognitive and motor training in mild neurocognitive disorders.

  • IVR games support cognitive and motor function non-pharmacologically.

  • Combining fun and rehab to boost motivation and tech inclusion in older adults.

  • IVR games offer an affordable and accessible option for middle-income countries.

  • IVR Games may help delay Alzheimer’s in mild neurocognitive disorder.

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Construction and validation of a predictive model for the efficacy of valproic acid monotherapy in epilepsy based on Lasso-logistic regression
Qichang Xing, Zheng Liu, Haibo Lei, Renzhu Liu, Xiang Liu, Jia Chen
Clinics. 2025;80C:100684
Highlights

  • valproic acid (Depakene) efficacy varies; a predictive model was developed.

  • 86 genes linked to VPA response: 3 genes (NELL2, SNORD3A, mir-1974) in final model.

  • AUC of 0.70 indicates good predictive ability for VPA resistance.

  • qPCR validation confirms SNORD3A as a potential biomarker for VPA efficacy.

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Postpartum indicators of stress injury and inflammatory factors in high-risk pregnancies by oxytocin combined with cervical balloon dilators
Ruihong Lan, Mengdi Xue, Yihong Yu, Xiaoqing Huang, Humin Gong
Clinics. 2025;80C:100668
Highlights

  • Oxytocin combined with cervical balloon dilators improves postpartum stress in high-risk pregnancies.

  • Oxytocin in combination with cervical balloon dilators improves postpartum inflammation in high-risk pregnancies.

  • Oxytocin in combination with cervical balloon dilators may improve hemodynamics in high-risk pregnancies.

  • Oxytocin combined with Cervical balloon dilators can shorten the duration of labor and improve the safety of delivery in high-risk pregnancies.

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Association between fibrinogen-to-albumin ratio and carotid intraplaque neovascularization on AngioPLUS in patients with asymptomatic carotid stenosis
Jun He, Jimei Xu, Shugang Cao, Yuan Feng, Jian Wang, Yan Yan, Fang Ma, Mingwu Xia, Qingsong Wang
Clinics. 2025;80C:100710
Highlights

  • AngioPLUS is an innovative microvascular Doppler ultrasound technique for the evaluation of carotid IPN.

  • The IPN score is positively correlated with the IMVF grade on AngioPLUS.

  • FAR exhibits a strong association with both carotid IPN scores and IMVF grades.

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Expression and clinical significance of MCF2L-AS1 in stomach adenocarcinoma
Chaowen Sun, Jun Guo, Bixia Chen, Xiayang Lu, Huihui Jiang
Clinics. 2025;80C:100701
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Neurological adverse events of PD-1/PD-L1 immune checkpoint inhibitors in clinical trials: A meta-analysis
Yanting Zhou, Hansong Yu, Hongyan Li
Clinics. 2025;80C:100698
Highlights

  • A meta-analysis of 141 RCTs evaluated 12 PD-1/PD-L1 inhibitors in 18 cancer types.

  • PD-1/PD-L1 therapy has a higher incidence of serious Neurological Adverse Events (NAEs) compared to the control group.

  • Six predominant NAEs showed higher incidence in the PD-1/PD-L1 group, including stroke and Guillain-Barré.

  • This analysis reveals a potential interaction between cancer immunotherapy and the nervous system.

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Relationship between Tic disorders and 41 inflammatory factors in circulating blood: a two-sample Mendelian randomization study
Ciai Lai, Guolin Huang, Xi Chen, Xionghan Lian, Xin Li, Wei He, Guangliang Luo, Aiyuan Cai
Clinics. 2025;80C:100649
Highlights

  • IL-17, MIF, and PDGF-BB are causally linked to tic disorders.

  • IL-17 and MIF increase TD risk, while PDGF-BB is protective.

  • Study results are robust with strong statistical power.

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New evidence for the effect of type 2 diabetes and glycemic traits on lung function: a Mendelian randomization and mediation analysis
Shuo Xie, Liping Yu, Lulu Song, Fei Chen, Wanlu Ma, Yifan He, Xiaoping Chen, Ying Yang, Bo Zhang
Clinics. 2025;80C:100693
Highlights

  • Type 2 diabetes linked to reduced lung function, with smoking and high BP as mediators.

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Analysis of the relationship between antidepressants and seizures based on the food and drug administration's adverse event reporting system database
Dan Zou, Qiaozhi Hu, Lei Yu, Bin Wu
Clinics. 2025;80C:100727
Highlights

  • 14 antidepressants show a significant seizure risk association in the FAERS analysis.

  • Bupropion shows the strongest seizure signal with the highest reporting odds ratio.

  • TCAs/tetracyclics elevate seizure risk, particularly clomipramine and maprotiline.

  • SSRIs/SNRIs require safety reconsideration as seizure risk persists.

  • Mirtazapine is linked to seizure risk despite low initial reports.

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Serum uric acid levels and the risk of hemorrhagic stroke: Insights from a two-sample Mendelian randomization study
Zi-Wen Wang, Fang Zhao, Jin-Chao Liu, Dan-Feng Li
Clinics. 2025;80C:100726
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Inverse relationship between serum haptoglobin and acute kidney injury in critically Ill patients with sepsis: A retrospective cohort study of the MIMIC-IV 3.0 database
Yue Liao, Qilin Yang, Daxue Li, Yulong Wang
Clinics. 2025;80C:100725
Highlights

  • Identified an inverse association between serum haptoglobin levels and sepsis-associated AKI risk.

  • First evidence of haptoglobin as a predictive biomarker for AKI in septic ICU patients.

  • Highlights haptoglobin&apos;s potential for AKI prevention and intervention in sepsis.

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The association between mechanical ventilation and in-hospital mortality in cardiac intensive care units: A propensity score-matched cohort study
XiangTing Tian, Meng Zheng, ShengQing Zhuo, BaoJuan Zheng
Clinics. 2025;80C:100728
Highlights

  • Mechanical Ventilation (MV) significantly increases in-hospital mortality in Cardiac Intensive Care Unit (CICU) patients (OR = 4.16).

  • Propensity score matching confirmed that MV is independently associated with mortality risk (p < 0.001).

  • Patients with acute respiratory failure and shock had the highest mortality risk with MV (OR > 4).

  • Large-sample analysis based on the eICU database (n = 12,480), ensuring reliable results.

  • The study supports cautious use of MV in CICU and optimization of respiratory management strategies.

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Exploratory unsupervised machine learning of angiogenesis biomarkers in a phase II advanced cervical cancer trial of radiochemotherapy with or without neoadjuvant chemotherapy
Roberto J. Arai, Thiago R. da Costa, Renata Colombo Bonadio, Silvaneide Ferreira, Laura Sichero, Hugo P. Monteiro, Arnold Stern, Maria Del Pilar Estevez-Diz
Clinics. 2025;80C:100723
Highlights

  • Baseline angiogenic biomarkers showed a weak predictive value by the ROC curve.

  • CRT changes VEGF-A, HB-EGF, angiopoietin-2, and HGF.

  • These alterations are not observed after NAC.

  • Biomarker patterns post-CRT were associated with improved outcomes by PCA.

  • ML may aid future stratification of angiogenesis profiles.

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Evaluation of functionality and quality of life in patients with lower limb fractures after traffic accidents admitted to IOT-HCFMUSP
Aline Ferreira Guimarães Gubolin, Julia Maria D'Andrea Greve, Vanderlei Carneiro da Silva
Clinics. 2025;80C:100742
Highlights

  • Complex fractures of the lower limbs, often resulting from traffic accidents, require extended periods of hospitalization and rehabilitation. These injuries are highly disabling and significantly impact the victims&apos; quality of life and work conditions.

  • Many individuals experience substantial physical limitations and a decreased quality of life. This suggests that, even after months of rehabilitation, many have not been able to return to their functional level before the accident.

  • The severity of the injuries influences the ability to return to work. Factors such as exposed fractures, multiple fractures, and long hospital stays are associated with poorer functional outcomes.

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Healthcare professionals’ knowledge of organic foods and their health impact: a survey-based analysis
Angela Cristine Bersch-Ferreira, Stela Verzinhasse Peres, Patrick Araujo Terezan, Gisele Medeiros Bastos, Rozana Mesquita Ciconelli, Fúlvio Alexandre Scorza
Clinics. 2025;80C:100720
Highlights

  • Used a hospital-based survey to assess healthcare professionals&apos; knowledge.

  • Many lacked a clear definition of organic foods and their health benefits.

  • High cost and uncertainty emerged as common consumption barriers.

  • Enhanced education could boost evidence-based dietary guidance.

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Analysis on artificial intelligence-based chest computed tomography in multidisciplinary treatment models for discriminating benign and malignant pulmonary nodules
Xian-Yan Liu, Fa-Cheng Shan, Hui Li, Jian-Bo Zhu
Clinics. 2025;80C:100734
Highlights

  • Artificial intelligence based chest Computed Tomography (CT) is a diagnosis.

  • Eighty-seven patients with pulmonary nodules who underwent chest CT scanning.

  • Analysis shows 69 malignant (79.3 %) and 18 benign-nodules (20.7 %) with 87 patients.

  • Accuracy of combined diagnostic method is 96.55 % in discriminating these nodules.

  • Compared to AI, AI-based chest CT combined with the MDT model had greater value.

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Effectiveness of airway clearance techniques versus control in non-hospitalized infants with moderate acute viral bronchiolitis: A randomized controlled clinical trial
Vanesa González-Bellido, Noelia Rama Suárez, Gustavo Adolfo Yánez Yepez, Maria del Carmen Jimeno Esteo, Rubén García Caraballo, Sagrario Mayoralas Alises, Juan Nicolás Cuenca Zaldívar, Márcio Vinícius Fagundes Donadio, ... Samuel Fernández Carnero
Clinics. 2025;80C:100735
Highlights

  • Randomized controlled trial with 4-week follow-up.

  • Supervised ACTs improve short-term outcomes in infants with AVB.

  • ACTs reduce clinical symptoms in viral bronchiolitis.

  • Respiratory rate and retractions improved with physiotherapy.

  • PSE showed greater ABSS and SpO2 improvements vs. AAD and control.

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Association of hematological malignancies with clinical and financial outcomes following transcatheter aortic valve replacement
Zeyu Liu, Esteban Aguayo, Giselle Porter, Konmal Ali, Radoslav Zinoviev, Peyman Benharash
Clinics. 2025;80C:100741
Highlights

  • Hematological Malignancies (HM) did not increase in-hospital mortality after TAVR.

  • Prior stem cell transplantation was associated with an 8-fold increase in mortality.

  • TAVR patients with HM had slightly greater resource utilization.

  • Patients with HM had higher 30- and 90-day non-elective readmission rates.

  • Infection-related rehospitalizations were more frequent in patients with HM.

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Association between systemic immune-inflammation index and all-cause and CVD mortality in non-elderly diabetic adults
Bing Hu, Tong Liu, Yanxiang Sun, Jie Sun, Li Feng, Fei Li
Clinics. 2025;80C:100739
Highlights

  • ·

    Elevated SII predicts increased CVD/all-cause mortality in US non-elderly adults with diabetes.

  • ·

    SII > 947.6 elevates CVD mortality risk 3.05-fold (95 % CI 1.85‒5.01).

  • ·

    Nonlinear SII-all-cause vs. linear SII-CVD mortality links in NHANES cohort.

  • ·

    Consistent SII-mortality associations across multi-subgroup analyses confirmed.

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High prevalence of low back pain across the lifespan in Brazilian elderly: Temporal trends and multifactorial associations in Barra Mansa
Priscila de Oliveira Januário, Ingred Merllin Batista de Souza, Ariela Torres Cruz, Mateus Dias Antunes, Mara Maria Lisboa Santana Pinheiro, Anice de Campos Pássaro, Deizyane dos Reis Galhardo, João Simão de Mello Neto, ... Amélia Pasqual Marques
Clinics. 2025;80C:100747
Highlights

  • High temporal prevalence: 52.1 % (current), 93 % (past year), 77.4 % (lifetime) LBP in elderly Brazilians.

  • Key risk factors: Female sex, hypertension, lower BMI, and functional disability drive LBP burden.

  • Protective effect: Very active elderly had 74 % lower odds of current LBP (p < 0.05).

  • Novel associations: Widowhood and diabetes significantly increased lifetime LBP risk.

  • Clinical implication: Community-based exercise programs may reduce disability and healthcare costs.

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Effects of the cardiac cycle on carotid intima-media thickness in ELSA-Brasil baseline assessment
Yasmin C.G. Silva, Isabela M. Bensenor, Danilo P. Meireles, Alessandra C. Goulart, Paulo A. Lotufo, Itamar S. Santos
Clinics. 2025;80C:100744
Highlights

  • The authors studied CIM variability across the cycle and its association with CVRFs.

  • The authors analyzed video CIMT imaging from 9546 ELSA-Brasil participants.

  • Median coefficients of variation were 2 % (far wall) to 5 %‒6 % (near wall).

  • CIMT varied ≥0.1 mm during the cycle in approximately 25 % of the exams.

  • Cardiac cycle had higher effects on CIMT in participants with CVRFs.

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hsa_circ_0002872 functions in lung cancer prognostic and tumorigenesis through regulating ZBTB46 via sponging hsa-miR-29b-1-5p
Xifan Wang, Xiaoyan Song, Hongxuan Wei, Xiaoqing Li, Huihui Li, Yan Zhu, Chuandong Zhu, Fangfang Chen
Clinics. 2025;80C:100733
Highlights

  • 411 differentially expressed circRNAs found in lung cancer and paracarcinoma tissues by high ‒ throughput sequencing.

  • hsa_circ_0002872/hsa-miR-29b-1-5p/ZBTB46 axis predicted to affect lung cancer progression.

  • ZBTB46 expression in lung cancer correlates with prognosis, immune cell infiltration, and immune checkpoints.

  • Study suggests ZBTB46 as a potential biomarker and target for lung cancer immunotherapy.

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Diagnostic and prognostic value of lactate metabolism-related genes in Sepsis
Guitao Pan, Guiming Huang, Ruiming Deng
Clinics. 2025;80C:100738
Highlights

  • Identified 4 diagnostic genes (APRT, ARG1, UMPS and LDHB) for sepsis prognosis.

  • ARG1 and age are independent prognostic factors for sepsis outcomes.

  • qRT-PCR confirmed diagnostic gene expression patterns in sepsis patients.

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Improved outcomes in Familial Adenomatous polyposis management. Results achieved in a single center over a 40-year period
Fábio Guilherme Campos, Carlos Augusto Real Martinez, Carlos Frederico Sparapan Marques, Ulysses Ribeiro Jr, Paulo Herman
Clinics. 2025;80C:100717
Highlights

  • Adenomatous polyposis must be diagnosed and treated before colorectal cancer develops.

  • Screening and prophylactic surgery may improve quality of life and survival.

  • A review of a 40-year experience demonstrated excellent results and improvement in FAP management.

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Potential function exploration of lncRNAs in idiopathic pulmonary fibrosis: insights from whole transcriptome sequencing data analysis
Xinran Ma, Dong Chen, Chenghai Li, Wenjuan Wu
Clinics. 2025;80C:100732
Highlights

  • Long Noncoding RNAs (lncRNAs) played a role in Idiopathic Pulmonary Fibrosis (IPF).

  • Their specific functions and patterns of expression are still unclear.

  • The authors conducted a diagnostic study to study lncRNA functions in IPF.

  • lncRNAs were functionally active and potentially involved in inflammatory response.

  • Specific lncRNAs might be promising diagnostic biomarkers or therapeutic targets.

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Left atrial reverse remodeling in patients with persistent atrial fibrillation and HFpEF following radiofrequency ablation: prospective evaluation with echocardiographic atrial analysis
Yan Chen, Mingxia Li, Xiaoxian Wang, Xichen Liang, Minglong Chen, Yingming Zhao, Fen Chen, Yunxian Yu, ... Jing Yao
Clinics. 2025;80C:100730
Highlights

  • LA remodeling reversed after successful RFCA in HFpEF patients with persistent AF.

  • LA strain parameters effectively assess LA function in HFpEF patients with persistent AF.

  • Echocardiographic LA contractile function quantifies reverse remodeling post-RFCA.

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hsa_circ_0004276 inhibits osteogenic differentiation of bone marrow mesenchymal stem cells and exacerbates postmenopausal osteoporosis through interaction with ELAVL1
BaiQuan Fu, YuXin Sui, Yu Liu, XiaoTian Yang, Hui Leng
Clinics. 2025;80C:100718
Highlights

  • Identification of aberrantly expressed circRNAs in PMO.

  • Increased expression of hsa_circ_0004276 during OD of BMSCs.

  • ELAVL1 inhibits the OD of BMSCs.

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Long-term pioglitazone use in MASLD patients: insights from a multicentric preliminary study
Isabel Veloso Alves Pereira, Ana Beatriz Souza de Oliveira, Patricia Momoyo Yoshimura Zitelli, Lais Arrivabene Barbieri, Ana Carolina Cardoso, Mísia Joyner de Sousa Dias Monteiro, Juliana Souza de Oliveira, José Tadeu Stefano, ... Mário G Pessoa
Clinics. 2025;80C:100737
Highlights

  • Long-term pioglitazone therapy significantly reduces hepatic fat accumulation, as evidenced by reductions in CAP and FAST™ scores.

  • Pioglitazone demonstrated dual benefits by improving both liver parameters and glycemic control in MASLD patients.

  • Non-invasive tools, such as VCTE and FAST™ score, are valuable for monitoring treatment responses and reducing the need for liver biopsies.

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Risk factors and nomogram prediction model for pneumothorax after CT-guided coaxial biopsy combined with microwave ablation in ground-glass nodules
Canxing Wu, Yangtao Zhao, Mengjun Chen, Jun Ma
Clinics. 2025;80C:100750
Highlights

  • The present work identifies modifiable risk factors (e.g., needle diameter, puncture frequency) and patient-specific predictors (BMI, lesion depth) to optimize procedural safety.

  • Methodological Rigor: The authors developed and validated a nomogram model (AUC: 0.875–0.897) using multicenter retrospective data (n = 383), incorporating Decision Curve Analysis (DCA) to confirm clinical utility.

  • Practical Impact: The model enables preoperative risk stratification, aiding surgeons in tailoring interventions to reduce pneumothorax rates (26.8 % in the studied cohort) and improve patient outcomes.

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Neutralizing activity against Omicron subvariants BA.1, BA.2, and BA.4/5 following the third SARS-CoV-2 vaccination in cancer patients undergoing chemotherapy
Jina Yun, Bora Kim, Hyuk Kim, Sung Hee Lim, Seong Hyeok Choi, Ji Youn Kim, Hyun Jung Kim, Seong Kyu Park
Clinics. 2025;80C:100757
Highlights

  • COVID-19 bivalent vaccine uptake in Korea is low at 12.95 %.

  • Cancer patients with no history of Omicron infection exhibit low antibody titers.

  • Hematologic cancer patients exhibit the lowest immune response.

  • These high-risk patients need additional vaccinations.

  • Stronger recommendations are needed for these individuals.

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Comprehensive analysis of lymphocyte subsets and transcriptome profiles in sepsis-induced acute respiratory distress syndrome: a prospective, observational study
Lei Yan, Zhimin Dong, Yumei Chen, Yi Han, Chaoyang Tong
Clinics. 2025;80C:100754
Highlights

  • Sepsis patients with and without ARDS exhibited significantly different gene expression and immune cell profiles.

  • The number and proportion of lymphocytes, especially CD8+ T-cells, were lower in patients with sepsis-induced ARDS compared to those without ARDS. The recovery of CD8+ T-cells in these patients was also slow.

  • By the seventh day of hospitalization, sepsis patients with ARDS generally had a CD8+ T-cell count of less than 162.5.

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The complex architecture of COVID-19: clinical determinants and deepening of inequities as three epidemic waves progress
Giulia Souza da Costa, Lucia Campos Pellanda, Leonardo Hercílio Florêncio Silva, Rosimar da Rosa Minho dos Santos, Luciana Tovo-Rodrigues, Bruna Pasqualini Genro, Marilu Fiegenbaum, Júlia Pasqualini Genro
Clinics. 2025;80C:100751
Highlights

  • As vaccination progressed, social risk factors emerged as increasingly important.

  • The first pandemic wave was marked by higher income and fewer comorbidities.

  • Low income, older age and black or brown ethnicity drove the last 2 epidemic waves.

  • Higher heart rate was an independent predictor of SARS-CoV-2 infection.

  • Black or brown ethnicity was an independent predictor of severe COVID-19.

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Effects of a bifid triple viable capsule on inflammatory factors and intestinal barrier function in children with abdominal infection
XiaoHui Yan, XiaoDan Zhong, XiaoXiao Zhang
Clinics. 2025;80C:100731
Highlights

  • BTV capsule alleviates the local inflammatory response of abdominal infection.

  • BTV capsule improves intestinal mucosal barrier function and immune function.

  • BTV capsules effectively corrected the dysbiosis of gut microbiota.

  • BTV capsule can reduce the IgA and IgG levels of patients.

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Oxycodone attenuates endotoxin-induced acute lung injury by regulating mitophagy via the HO-1 pathway
Cuicui Liu, Yanting Wang, Shaona Li, Jia Shi, Pei Wang, Yang Ma, Xiangkun Li, Jianbo Yu
Clinics. 2025;80C:100753
Highlights

  • Oxycodone alleviated the LPS-driven lung pathological injury both in vivo and in vitro.

  • Oxycodone pretreatment attenuated LPS-induced systemic inflammation and subsequent lung injury.

  • Oxycodone increases the expression of HO-1 while downregulating the mitophagy-related proteins.

  • HO-1 deficiency weakens the effect of oxycodone on the expression of mitophagy-related proteins.

  • Oxycodone attenuates LPS-induced cell injury by regulating mitophagy via the HO-1 pathway.

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Assessment of oxidative stress and trace element dynamics in acute myocardial infarction and heart failure: a focus on zinc, copper, and thiol dynamics
Yasin Ali Cimen, Bahadir Taslidere, Ufuk Sarikaya, Metin Demirel, Nusret Acikgoz, Sahabettin Selek
Clinics. 2025;80C:100755
HIGHLIGHTS

  • Oxidative and thiol balance is altered in AMI and HF.

  • Serum zinc levels are elevated in AMI.

  • Zinc and copper have the potential to be biomarkers in AMI and HF.

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Examining transitional care for patients and caregivers: Lessons from a Brazilian public university hospital
Mariana Taddeo Dal Medico, Larissa Vidal, Ivaldo Olimpio da Silva, Thales Chelala Toledo, Gabriela Alves de Oliveira Hidalgo, Eduardo da Silva Santocchi, Douglas Henrique Crispim
Clinics. 2025;80C:100756
Highlights

  • Examined patient and caregiver perceptions post-hospital discharge in Brazil.

  • Employed CTM-15 Brazil for data collection on transitional care quality.

  • Patients with chronic illnesses showed higher satisfaction with transitional care.

  • Hospital transitional care units play a vital role in patient reintegration.

  • Emphasized the importance of personalized care plans for enhancing outcomes

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Shifted windowing vision transformer-based skin cancer classification via transfer learning
Jian Lian, Lina Han, Xiaomei Wang, Zhenpen Ji, Lei Cheng
Clinics. 2025;80C:100724
Highlights

  • A classification method based on a vision transformer with a shifted window is proposed.

  • The proposed transformer model consists of two primary blocks and an attention unit.

  • The performance of this work outperforms state-of-the-art.

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Translation and cross-cultural adaptation of Adolescent Asthma Self-Efficacy Questionnaire to Brazilian Portuguese and analysis of its measurement properties
Nathalia Ribeiro Berdu, Fernanda Lehrbaum, Adriano Luppo, Dirceu Solé, Gustavo Falbo Wandalsen, Karina Couto Furlanetto, Simone Dal Corso
Clinics. 2025;80C:100752
Highlights

  • AASEQ is a self-efficacy tool with rigorous validation procedures.

  • AASEQ was translated and cross-culturally adapted to Brazilian Portuguese.

  • AASEQ shows good internal consistency and substantial test-retest reliability.

  • AASEQ fills a gap in assessing self-efficacy in Brazilian asthmatic adolescents.

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Chronic hepatitis C mortality in Brazil from 2000 to 2019: An analysis of multiple causes of death
Larissa Festa, Gerusa Maria Figueiredo, Fatima Mitiko Tengan
Clinics. 2025;80C:100746
Highlights

  • Underreporting of chronic hepatitis C deaths was identified in Brazil.

  • In deaths in which Hepatitis C was the underlying cause of death, it was mentioned as an associated cause of death.

  • Multiple cause analysis revealed the true extent of hepatitis C mortality.

  • Study recommends reviewing the death cause recording processes in Brazil.

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Relationship between serum ferritin and the risk of all-cause death in patients with coronary artery disease
Zhi-Hui Jiang, Ming-Ming Lyu, Yu-Juan Feng, Ting-Ting Wu, Ying Pan, Chang-Jiang Deng, Yi Yang, Xiao-Xia Guo, ... Xiang Xie
Clinics. 2025;80C:100772
Highlights

  • High ferritin levels are linked to increased all-cause mortality risk in CAD patients.

  • Elevated ferritin is associated with a 167.4 % higher risk of all-cause mortality.

  • Long follow-up ensures reliable findings, supporting ferritin as a risk stratification tool.

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Effects of diet-induced weight loss and Roux-en-Y gastric bypass on the glycemic and gut hormones profile in patients with severe obesity and diabetes
Andréa de Fátima Cristino Bastos Crespo, Leila Antoangelo, Priscila Costa Estabile, Roberto de Cleva, Marco Aurelio Santo
Clinics. 2025;80C:100736
Highlights

  • Question – Are early changes in glycemic and gut hormones similar after weight loss induced by VLCD and bariatric surgery?.

  • Findings – 50 % of patients had glycemic control after diet-induced weight loss. All patients had improved glycemic control after RYGB. There was an increase of GLP1 after weight loss by diet only in fasting and at all times after surgery.

  • Meaning – 50 % of patients had glycemic control after VLCD and 100 % after RYGB.

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Advances in exploring the association between FMR1 premutation and fibromyalgia: a pilot study with a more effective sample definition
Mara Maria Lisboa Santana Pinheiro, Mateus Dias Antunes, Laura Machado Lara Carvalho, Anice de Campos Pássaro, Ingred Merllin Batista de Souza, Priscila de Oliveira Januário, Ariela Torres Cruz, Renan Barbosa Lemes, ... Amélia Pasqual Marques
Clinics. 2025;80C:100758
Highlights

  • The preliminary data suggest an association between the FMR1 gene premutation and susceptibility to Fibromyalgia (FM), but larger studies with consistent designs are needed to confirm this hypothesis.

  • A sample definition focusing on FM prevalence among premutation carriers may offer a more effective approach to exploring this association.

  • The authors calculated the sample size needed to achieve statistical significance based on our pilot study.

  • Investigating this association could inform future clinical management and the identification of therapeutic targets.

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Impact of telomere length on autoimmune thyroid disease in Europeans: insights from Mendelian randomization
Gang Hu, Yunfeng Yu, Yuman Yin, Xinyu Yang, Rong Yu, Qin Xiang
Clinics. 2025;80C:100765
Highlights

  • Telomere length is associated with Graves&apos; disease risk in Europeans.

  • Telomere length is not associated with autoimmune thyroiditis risk in Europeans.

  • The impact of telomere length on autoimmune thyroid disease in Europeans is unequal.

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Predicting readmission rates in critically ill heart failure patients during a 90-day vulnerable phase using interpretable machine learning models
Meng-Han Jiang, Fang Yu, Hai-Ying Yang, Sun-Jun Yin, Li-Juan Yang, Yu Chen, De-Min Li, Yu Guo, ... Gong-Hao He
Clinics. 2025;80C:100775
Highlights

  • First study to develop a model using total comorbidities and medication data.

  • Fill the gap in the readmission rate of critically ill HF pts in the 90-day vulnerable phase.

  • Model results suggest psychoanaleptics may be linked to HF readmissions.

  • Construct full & compact models with good performance for diverse clinical settings.

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A machine learning approach towards endometriosis screening using infrared spectra of urine
Matthews Silva Martins, Gabriela Barros Valente, Yasmin do Nascimento Pedra, Thaís Campos Ribeiro, Neide Aparecida Tosato Boldrini, Mara Rejane Barroso Barcelos, Francis L. Martin, Karin Kneipp Costa Rossi, Valerio Garrone Barauna
Clinics. 2025;80C:100760
Highlights

  • ML-based urine test enables screening for endometriosis (93 % sensitivity).

  • 42 % reduction in unnecessary MRI referrals during endometriosis evaluation.

  • Same-day results support early triage of symptomatic gynecologic patients.

  • ATR-FTIR spectra combined with ML distinguish endometriosis biochemical profiles.

  • Decision-support tool for stratifying symptomatic patients before imaging.

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The hidden connection: systemic immune-inflammation index and its role in asthma
Cheng Peng, Dong Gao, Zanchen Zhou, Tiancheng Wang
Clinics. 2025;80C:100779
Highlights

  • The increase in SII level is associated with an increase in asthma incidence.

  • Age disparities may influence the relationship between inflammation and asthma.

  • Higher SII correlates with a 31 % increased asthma incidence.

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Multicentre randomized controlled trial of acupuncture for vascular cognitive impairment: cognitive benefits and inflammatory biomarker modulation
Xixi Han, Baoguo Wang, Lei Xu, Yabin Pi, Fei Li, Tianxin Jiang
Clinics. 2025;80C:100770
Highlights

  • Acupuncture improves cognitive and daily living abilities in VCI patients.

  • Long-term effects of acupuncture surpass those of donepezil and sham acupuncture.

  • Large-scale, multicenter trial enhances the reliability of acupuncture findings.

  • Minimal adverse reactions confirm the safety of acupuncture in VCI treatment.

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Nomogram models for predicting sarcopenia in elderly Asian patients with type 2 diabetes
Hong Zhang, Ying Jin, Shan Che, Zhen Song
Clinics. 2025;80C:100771
HIGHLIGHTS

  • Identified key sarcopenia risk factors in elderly patients with type 2 diabetes.

  • Developed a predictive nomogram using clinical and lifestyle-based variables.

  • Model showed high accuracy with AUCs of 0.891 and 0.868 in two cohorts.

  • Validated nomogram supports early sarcopenia screening in diabetic patients.

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Impaired cardiopulmonary functions in prepubertal patients with Kawasaki disease
Yen-Sen Lu, I-Ching Huang, Yen-Hsien Wu, Sheng-Hui Tuan, Yi-Ching Liu, Yi-Cheng Wang, Shih-Hsing Lo, Jong-Hau Hsu, Ko-Long Lin
Clinics. 2025;80C:100773
Highlights

  • Prepubertal children with Kawasaki disease have lower aerobic capacity and exercise tolerance.

  • Males with Kawasaki disease are more severely affected in cardiopulmonary function than females.

  • Despite reduced capacity, KD children can safely engage in vigorous physical activities.

  • Regular exercise is crucial for improving long-term cardiopulmonary health in KD patients.

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Riociguat for CTEPH: A retrospective cohort study from a single reference center in Brazil
Caio Julio Cesar dos Santos Fernandes, William Salibe-Filho, José Leônidas Alves-Jr, Carlos Vianna Poyares Jardim, Túlio Martins Vieira, Mario Terra-Filho, Rogerio de Souza
Clinics. 2025;80C:100769
Highlights

  • CTEPH treatment is challenging and multimodal; only Riociguat is approved.

  • Access to Riociguat in Brazil is difficult; limited data exist for local patients.

  • The cohort of CTEPH patients treated with Riociguat showed improved NYHA class.

  • BNP levels significantly dropped after treatment with Riociguat.

  • 6MWD increased, confirming the positive impact of Riociguat therapy.

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The impact of muscle mass, strength, and physical functioning on postural balance in older adults with sarcopenia
Cenyi Wang, Xinrong Jiao, Jiling Liang, Aming Lu
Clinics. 2025;80C:100784
Highlights

  • Revealed differential predictors of balance control in sarcopenia.

  • Identified sex- and age-specific vulnerability patterns.

  • Proposed targeted rehabilitation protocols.

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CircRNA MALAT1/miR-96-5p/FOXK2 axis regulates choroidal neovascularization
Yue YIN, Tong Zhao
Clinics. 2025;80C:100759
Highlights

  • circ-MALAT1 is upregulated and functions as a pro-angiogenic regulator in laser-induced CNV and hypoxic HRMECs.

  • circ-MALAT1 knockdown attenuates CNV lesions in a mouse model.

  • circ-MALAT1 knockdown impairs pro-angiogenic functions in HRMECs.

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Self-sampling for HPV genotyping: a study of vaginal and urine collection in Brazilian women with high-grade lesions
Cristina Paula Castanheira, Noely Paula Cristina Lorenzi, Fernanda Dahrouge Chiarot, Alex Jones Flores Cassenote, Maricy Tacla, Adhemar Longatto-Filho, José Maria Soares-Junior, Edmund C. Baracat, ... Lara Termini
Clinics. 2025;80C:100780
Highlights

  • Urine and vaginal self-sampling were highly acceptable among women with CIN2+.

  • Instructional videos were effective and well-received for self-collection guidance.

  • HPV testing showed excellent agreement, especially for HPV16 detection.

  • Findings support self-collection in national programs to expand screening coverage.

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Assessment of sarcopenia tools as predictors of falls in patients with mild to moderate Parkinson's Disease: A cohort study
Danielle Pessoa Lima, Vlademir Carneiro Gomes, João Rafael Gomes de Luna, Lucas Tadeu Rocha Santos, Samuel Brito de Almeida, Antonio Brazil Viana-Júnior, Carlos Eduardo Urbano da Silva, Thais de Menezes Dantas, ... Pedro Braga-Neto
Clinics. 2025;80C:100776
Highlights

  • Predictors of falls were assessed in patients with mild to moderate Parkinson’s disease.

  • Higher SARC-F scores and type-2 diabetes independently predicted recurrent falls.

  • Longer disease duration and dysautonomia were independent predictors of falls.

  • Confirmed sarcopenia did not predict falls in the 12-month cohort study.

  • Future studies should include specific tools for sarcopenia assessment in Parkinson’s disease.

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Human epidermal growth factor receptor 2 and proliferation Ki-67 biomarkers using a tissue microarray to refine the histopathological subtyping of hydatidiform moles: Limitations and prognostic value
Consuelo Lozoya López, Nathália Silva Carlos Oliveira, Fabiana Resende Rodrigues, Ana Luisa Figueira Gouvêa, Karin Soares Gonçalves Cunha, Ana Carolina Brito, Antonio Braga, Vânia Gloria Silami Lopes
Clinics. 2025;80C:100766
Highlights

  • Ki-67 and HER2 serve as biomarkers to differentiate CHM from PHM for better prognosis.

  • Increased Ki-67 levels in CHM suggest association with disease aggression and prognosis.

  • HER2 2+ tumors show amplification, indicating potential for targeted therapies.

  • Tissue microarray efficiently analyzes multiple samples, enhancing cost-effectiveness.

  • Notable trends in Ki-67 and HER2 suggest utility in prognosis, despite no strong stats.

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Trade-offs in airway stability vs. hemodynamic safety: a retrospective study of alfentanil-sevoflurane-propofol anesthesia for tracheal intubation
Wanquan Ming, Yunfei Cao, Xianfei Xu, Miao Ding, Cheng Sheng
Clinics. 2025;80C:100764
Highlights

  • Propofol, sevoflurane, and alfentanil facilitate airway management.

  • 6 % sevoflurane + 10 μg/kg of alfentanil can provide spontaneous breathing.

  • Propofol + sevoflurane + alfentanil showed superior airway conditions.

  • Propofol + sevoflurane + alfentanil had a hypotension risk and prolonged bradycardia.

  • 10 µg/kg alfentanil without titration led to significant respiratory depression.

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Health literacy in patients with Type 2 Diabetes Mellitus: A systematic review
Ariel Cesar de Carvalho, Matheus Tonholo Silva, Isadora Lagreca Garrafa Treptow, Carolina de Oliveira Cruz Latorraca, Rafael Leite Pacheco, Victor Alexandre dos Santos Valsecchi, Rachel Riera, Lucas Leite Cunha
Clinics. 2025;80C:100774
Highlights

  • Inadequate health literacy is prevalent (4.7 %–71.7 %) in individuals with Type 2 Diabetes Mellitus (T2DM).

  • Lower health literacy correlates with poorer glycemic control (10 studies confirmed an inverse association with HbA1c).

  • Increased risk of microvascular complications with inadequate health literacy.

  • Socioeconomic factors (e.g., HDI) significantly influence health literacy levels and diabetes outcomes.

  • Routine health literacy assessment in T2DM may improve disease control and reduce complications (e.g., retinopathy, neuropathy).

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C-reactive protein to lymphocyte ratio is a prognostic factor for unfavorable outcomes following aneurysmal subarachnoid hemorrhage
Yijun Lin, Sijia Li, Xingquan Zhao
Clinics. 2025;80C:100778
Highlights

  • Prospective study of 650 aSAH patients examining CLR levels within 24 h.

  • Exploring CLR as a biomarker for inflammation-immune imbalance in aSAH.

  • Elevated CLR levels are significantly linked to 3-month poor outcomes in aSAH.

  • CLR as a biomarker for predicting outcomes and guiding treatments in aSAH.

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Anatomy of the deltoid muscle trigger points
Leonardo Henrique Alves Rocha, Lucas Hara, Larissa Barbosa Lima, Ana Itezerote, Flávio Hojaij, Mauro Andrade, Alfredo Jacomo, Flavia Akamatsu
Clinics. 2025;80C:100795
Highlights

  • First 3D chart of deltoid muscle nerve entrance sites, matching clinical trigger points.

  • Anatomical evidence supports nerve entry sites as targets for precision therapies.

  • Anatomy provides a scaffold for in vivo validation in clinical practice.

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Worsening quality of life in asthmatics, non-obstructed smokers and ACO during the COVID-19 pandemic in patients from the ELSA-Brazil
Roselaine Maria Oliveira, Francine Maria de Almeida, Vitoria Caroline Queiroz, Anna Paula de Lima Costa, Renato Fraga Righetti, Edna Aparecida Leick, Paulo Lotufo, Isabela Bensenor, ... Iolanda de Fatima Lopes Calvo Tibério
Clinics. 2025;80C:100788
HIGHLIGHTS

  • Cytokines and lung function link to health decline worsened by COVID-19 and smoking.

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Early neonatal deaths with perinatal asphyxia of newborns ≥ 37-weeks in Brazil, 2000‒2020
Maria Fernanda B. de Almeida, Ana Sílvia S. Marinonio, Daniela T. Costa-Nobre, Mandira D. Kawakami, Adalberto O. Tardelli, Kelsy N. Areco, Paulo Bandiera-Paiva, Ruth Guinsburg
Clinics. 2025;80C:100785
Highlights

  • Most term infant deaths are preventable with improved perinatal care quality.

  • Perinatal asphyxia is a key indicator of care quality for mothers and newborns.

  • Early neonatal mortality associated with perinatal asphyxia has declined since 2000.

  • Mortality is higher in the North/Northeast than in the South/Southeast of Brazil.

  • Targeted interventions are urgently needed to reduce regional disparities.

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SESTD1 as a potential prognostic biomarker associated with tumor aggressiveness and immune infiltration in hepatocellular carcinoma
Ying Liu, Taoying Chen, Li Tang, Daqing Cheng, Ming Xu, Jiaoxiang Wu, Bingyan Liu, Hao Cheng, ... Sheng Cheng
Clinics. 2025;80C:100796
Highlights

  • SESTD1 is highly expressed in 15 cancer types and HCC patient tissues.

  • Aberrant SESTD1 overexpression predicts worse prognosis in HCC patients.

  • Silencing SESTD1 inhibits HCC cell proliferation, cell cycle and metastasis in vitro.

  • SESTD1 positively related with immune infiltration and PD-1/PD-L1 expression in HCC.

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Balancing on the edge of age: neuroendocrine, mental health and functional fitness correlates of fear of falling in older women
Rafael N. Rodrigues, Dina Maria Mamede Pereira, Sónia Brito-Costa, António Felipe Souza-Gomes, Natália Oiring de Castro Cezar, Júlia Maria D’Andréa Greve, Angelica Castilho Alonso, Felipe Santos Marques, ... Guilherme Eustáquio Furtado
Clinics. 2025;80C:100792
Highlights

  • FOF relates to low fitness and altered biomarkers (↑cortisol, ↓DHEA).

  • Depressive symptoms mediate the link between fitness and FOF.

  • DHEA may serve as a biomarker for predicting FOF in older women.

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Molecular mechanism of modified KAT2A-mediated histone succinylation in asthma through inhibition of ferroptosis
Jian Han, Hui-li Du, Shan-shan Lu, Jun-Feng Li
Clinics. 2025;80C:100786
Highlights

  • KAT2A, epigenetic enzyme has been found to be involved in iron death.

  • Asthma model shown the expression of KAT2A, GPX4 and SLC7A11.

  • Erastin significantly increased the levels of Fe2+, lipid ROS, SOD, Iron, and MDA.

  • Decreased the expression of GPX4 and SLC7A11 and reduced inflammatory response.

  • KAT2A-mediated histone succinylation by inhibiting iron death provides therapeutic.

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Striking the balance: exploring the influence of exercise quantity and intensity on quality-of-life outcomes
Ronaldo Alves da Cunha, Claudio Andre Barbosa de Lira, Rodrigo Luiz Vancini, Katja Weiss, Beat Knechtle, Marilia Santos Andrade
Clinics. 2025;80C:100782
Highlights

  • More physical activity than recommended by the WHO does not generate additional gains in quality of life (physical or mental).

  • Quality of life (physical and mental) is better among those who perform the WHO physical activity recommendation than among those who perform less physical activity.

  • There is no linear relationship between physical activity and quality of life.

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From blue November to broader diagnosis: The Youden index to evaluate the performance of any diagnostic tests
Paulo Sergio Panse Silveira, Flavio Trigo Rocha, Joaquim Edson Vieira, Jose Oliveira Siqueira
Clinics. 2025;80C:100804
Highlights

  • Many efforts to improve PSA tests have led to minimal or no significant progress.

  • Youden index is a statistical method for evaluating diagnostic tests.

  • It also provides a rule of thumb: sensitivity + specificity >1 is required for a diagnostic test.

  • Prevalence and individual probability of disease are interchangeable parameters for clinical practice.

  • This statistical method can be applied to any symptom, sign, or laboratory test, current or future.

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Impact of a urological medical student interest group on education and career development
Eduardo Zinoni Silva Pato, Luiz Carlos Neves de Oliveira, Jose de Bessa, Gabriel Kayano Freudenthal, Guilherme Pimenta Roncete, Luiza Rafih Abud, Victor Hondo Silva de Moraes, William Carlos Nahas, Cristiano Mendes Gomes
Clinics. 2025;80C:100799
Highlights

  • Urology is underrepresented in medical training worldwide.

  • The group supported early mentorship and educational growth.

  • Career choices were positively influenced by participation.

  • Most participants reported high satisfaction with the program.

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Effects of HIIT at different frequencies in an aquatic environment on mental health in multimorbid older people: A randomized clinical trial
Vitória Oliveira Silva da Silva, Anand Thirupathi, Rafael Alex dos Santos Macedo, Mauricio Fagundes Santos, Ana Claudia de Oliveira Borba, Yaodong Gu, Karin Martins Gomes, Rodrigo Sudatti Delevatti, ... Luciano Acordi da Silva
Clinics. 2025;80C:100803
Highlights

  • HIIT aqua aerobics twice a week improves sleep, anxiety, and depression in older adults.

  • Mental health benefits were observed only with a training frequency of twice per week.

  • HIIT in water was safe and well-tolerated by multimorbid elderly participants.

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The impact of the PNPLA3 rs738406 C>G polymorphism on hepatocellular carcinoma risk in Brazilian patients with chronic hepatitis C and advanced fibrosis
Claudia Maccali, Isabel Veloso Alves Pereira, Lisa Rodrigues da Cunha Saud, Regiane Saraiva de Souza Melo Alencar, Arthur Ivan Nobre Oliveira, Jose Tadeu Stefano, Michele Soares Gomes Gouvea, Joyce Matie Kinoshita da Silva Etto, ... Claudia Pinto Marques Souza de Oliveira
Clinics. 2025;80C:100797
Highlights

  • PNPLA3 rs738409 polymorphism was associated with fibrosis and steatosis in CHC patients.

  • The impact on HCC risk is not yet well defined.

  • This was the first evaluation of this association in the Brazilian population.

  • PNPLA3 rs738409 polymorphism was not associated with HCC risk in the studied population.

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β-glucan combined with PD-1/PD-L1 checkpoint blockade suppresses pancreatic tumor growth after ablation therapy
Shengbo Wu, Xixi Sun, Han Wang, Jiayuan Chai, Bin Huang
Clinics. 2025;80C:100805
Highlights

  • First proposal of “DC-trained immunity combined MWA therapy” for pancreatic cancer.

  • Trained DCs reshape post-ablation immunosuppressive tumor microenvironment.

  • High clinical potential with broad applicability to improve ablation outcomes.

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Changes in serum metal concentrations following high-intensity interval training: A 16-week pilot study
Guilherme da Silva Rodrigues, Natalia Yumi Noronha, Jhennyfer Aline Lima Rodrigues, Andressa Crystine da Silva Sobrinho, Jonas Benjamim, Luísa Maria Diani, Isabela Harumi Yonehara Noma, Fernando Barbosa Júnior, ... Carlos Roberto Bueno Júnior
Clinics. 2025;80C:100802
Highlights

  • HIIT for 16-weeks reduced both essential and toxic serum metal levels.

  • High-intensity training altered the body’s metal accumulation profile.

  • Manganese reduction was linked to lower hip circumference post-HIIT.

  • Exercise-induced metal shifts may relate to metabolic health outcomes.

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Portal hypertension and bleeding esophageal varices caused by portal vein thrombosis in children: experience of a single center with emphasis on treatments and results
Ana Cristina Aoun Tannuri, Amanda Anacleto dos Santos Barsuttini, Nelson Elias Mendes Gibelli, Giovanna Pedreira, Maria Luiza Villela Corullon, Pedro Zanetta Brenner, Manoel Ernesto Peçanha Gonçalves, Silvia Regina Cardoso, ... Uenis Tannuri
Clinics. 2025;80C:100801
Highlights

  • Portal Vein Thrombosis (PVT) is a cause of gastrointestinal bleeding in children.

  • Results of endoscopic and surgical treatment are comparable.

  • We concluded that a conservative approach should be adopted whenever possible.

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Fatal occupational accidents in Brazil: A national case-control study using 2023 data
Cristine Scattolin Andersen, Victor Alexandre Percinio Gianvecchio, João Silvestre Silva-Junior
Clinics. 2025;80C:100798
Highlights

  • Male workers showed 2.6-fold higher odds of fatal occupational accidents.

  • Informal employment raised fatality risk by 77 % versus formal contracts.

  • Night-time accidents were 65 % more lethal than daytime incidents.

  • Older age, illiteracy, and poorer regions markedly increased lethality.

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METTL3 knockdown promotes the osteogenic differentiation of hPDLSCs by regulating CARD11 levels
Bing Zhou, Cheng Wang
Clinics. 2025;80C:100787
Highlights

  • METTL3 was upregulated in periodontitis.

  • METTL3 silencing promoted the osteogenic differentiation of hPDLSCs.

  • METTL3 regulated the m6A levels of CARD11.

  • CARD11 overexpression neutralized the role of si-METTL3 in hPDLSCs.

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Metabolic dysfunction-associated steatotic liver disease and new onset diabetes mellitus after liver transplantation
Marcelo Arouca Araujo, Mateus Jorge Nardelli, Rafael Pereira Freitas Mendes, Amanda Cássia da Cruz Cardoso, Guilherme Grossi Lopes Cançado, Henrique Drumond Braga, Livia Manussakis Vaz Ferreira, Luis Henrique de Oliveira Moreira, ... Luciana Costa Faria
Clinics. 2025;80C:100806
Highlights

  • After Liver Transplantation (LT), weight gain, MASLD and NODALT were frequent.

  • MASLD was associated with diabetes and hypertriglyceridemia post-LT.

  • NODALT was associated with older age, longer follow-up, body mass index and MASLD.

  • It is crucial to prevent post-LT metabolic complications.

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METTL1-mediated m7G modification regulates osteogenic differentiation of human periodontal ligament stem cells
Chungang Zhao, Kunlun Li, Aimin Wu
Clinics. 2025;80C:100813
Highlights

  • METTL1 expression increases in PDLSCs during osteogenic differentiation.

  • METTL1 mediates RUNX2 mRNA stability in PDLSCs through m7G modification.

  • High METTL1 boosts PDLSC osteogenesis through m7G-dependent RUNX2 activation.

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Efficacy of acupuncture as an adjunctive therapy for perimenopausal insomnia: A systematic review and meta-analysis of randomized controlled trials
Meiling Dong, Yunxia Sun, Xiaoman Wang, Xue Yu, Hanbin Li
Clinics. 2025;80C:100814
Highlights

  • Acupuncture can enhance the clinical efficacy of PMI as an adjunctive therapy.

  • The GV20 acupoint is the most widely used in PMI treatment.

  • Acupuncture adjuvant treatment of PMI is safe and superior to medication.

  • Individualized scheme design is flexible and effective.

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Hemoglobin glycation index predicts reduced mortality in critically ill patients with chronic kidney disease
Yangpei Peng, Wenwen Huang, Jie Wang
Clinics. 2025;80C:100812
Highlights

  • First to evaluate the hemoglobin glycation index in critically ill CKD patients.

  • A higher HGI is an independent predictor of reduced mortality in this population.

  • The association remains significant after adjusting for relevant confounding factors.

  • HGI is readily available and can help stratify risk in critically ill CKD patients.

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Epiregulin drives keratinocyte hyperproliferation in sorafenib-induced hand-foot skin reaction: A mechanistic and therapeutic insight
Yuxin Liang, Xiao Hong, Xiaorong Zhong, Ke Chen, Jie Wang, Jingbin Zhao, Zhao Li, Jianlin Wu, ... Zhengwei Leng
Clinics. 2025;80C:100809
Highlights

  • First evidence linking EREG to sorafenib-induced HFSR via keratinocyte proliferation.

  • Mouse model recapitulates human HFSR with neutrophil-rich inflammation and hyperkeratosis.

  • EREG promotes HaCaT proliferation (p < 0.05), while sorafenib acts indirectly.

  • 100 mg/kg sorafenib in mice (≈10 mg/kg human dose) validated by FDA scaling.

  • Therapeutic potential: EREG blockade may mitigate HFSR severity.

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Machine learning predictor to investigate treatment modalities and overall survival in HER2+ patients with early-stage breast cancer
Kai Wang, Jianing Liu
Clinics. 2025;80C:100818
Highlights

  • Machine learning algorithm enhances cancer survival prediction.

  • Nomogram incorporating treatment data validated for high predictive accuracy.

  • Comprehensive therapy with multiple treatment modalities boosts survival.

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Analysis of the application value of the Roy Adaptation Model in Parkinson's disease nursing care: A non-blinded, single-center observational study
Yong-Li Xu, Yunxin Hu, Na Luo, Lu Sun, Xiaomei Xiao, Liu Tang, Yan Li
Clinics. 2025;80C:100820
Highlights

  • Parkinson’s Disease (PD) substantially impacts patients&apos; quality of life.

  • The Roy Adaptation Model (RAM) was developed on Maslow&apos;s hierarchy of needs theory.

  • In PD, diagnosis and treatment present significant challenges.

  • In PD, RAM may have clinical value.

  • RAM improves clinical symptoms, quality of life, and self-efficacy in PD patients.

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The causal role of multiple negative emotions in chronic respiratory diseases: A two-sample Mendelian randomized study
Hui Chen, Jinping Zhu, Zewen Yang, Yimin Zha, Junjie Yang
Clinics. 2025;80C:100819
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VSIG4 as a novel immune-related diagnostic biomarker and therapeutic target in renal fibrosis
Chen Gao, Fenghua Peng, Xubiao Xie, Longkai Peng
Clinics. 2025;80C:100817
Highlights

  • VSIG4 is highly expressed in renal fibrosis tissues.

  • VSIG4 may be an important mediator involved in renal fibrosis.

  • VSIG4 may be a potential biomarker for renal fibrosis.

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Longitudinal outcomes of severe post-stroke dysphagia: high mortality, partial recovery, and persistent dependence on alternative feeding
Gabriela Mourthé Félix, Fernanda Chiarion Sassi, Carina Escudero, Karoline Kussik de Almeida Leite, Ana Paula Ritto, Cirley Novais Valente Junior, Claudia Regina Furquim de Andrade
Clinics. 2025;80C:100825
Highlights

  • High Mortality Risk: Half of patients with severe dysphagia died within 3-months, linked to age, NIHSS scores, and prior neurological deficits.

  • Recovery Patterns: Partial swallowing improvement occurred in 62.5% of survivors, yet 75% had persistent dysphagia symptoms.

  • Clinical Gaps: Only 33% received guideline-recommended gastrostomy, and 25% developed aspiration pneumonia.

  • Telehealth Utility: EAT-10 via telehealth captured dysphagia symptoms but underscores the need for adjunctive instrumental assessments.

  • Prognostic Insights: Vertebrobasilar strokes had lower mortality despite severe deficits, suggesting infarct volume may modulate outcomes.

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Local anesthetic levobupivacaine promotes hip-fracture healing by targeting HIF/Ca2+signaling
Hui Zhang, Ying Zhang, Fang Wang, Yulong Wei, Dezhi Wang
Clinics. 2025;80C:100831
Highlights

  • Levobupivacaine is a common local anesthetic agent for pain management.

  • Bone fracture rat model was established and treated with levobupivacaine.

  • Levobupivacaine for bone fracture healing, promoted CD90, HIF-1α, VEGF expression.

  • Proliferation, migration, and calcium production were elevated by levobupivacaine.

  • Proliferated bone marrow-derived mesenchymal stem cells by HIF-1α/Ca2+ signaling.

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Correlation of systemic immune-inflammation index and functional status of living score with disease activity in patients with rheumatoid arthritis
Chuan Yang, Yu Shu, Jie Luo, DongSheng Wang
Clinics. 2025;80C:100815
Highlights

  • SII index and HAQ scores are significantly associated with RA disease activity.

  • SII and HAQ combination increases AUC to 85.76 for disease activity prediction.

  • Decreased hemoglobin was a relevant factor affecting DAS28-CRP and DAS-ESR.

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Pregabalin as a neuroprotective alternative to methylprednisolone in peripheral nerve regeneration: an experimental study
İrem Ateş, Esra Laloglu, Neslihan Küçün, Sevilay Ozmen, Serkan Yıldırım, Basri Pür, Duygu Köse, Maide Sena Civelek, ... İsmail Bolat
Clinics. 2025;80C:100838
Highlights

  • Peripheral nerve injuries cause significant morbidity, necessitating better treatments.

  • Low-dose pregabalin promotes nerve regeneration comparably to methylprednisolone.

  • Pregabalin reduces euroinflammation (↓NF-κB) and enhances neurotrophic factors (↑NGF).

  • Synergistic effect of combination therapy on functional (SFI, EMG) and histological recovery.

  • Findings support pregabalin as a candidate neuroprotective agent with effects comparable to steroids.

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Factors influencing adolescents' attitudes towards vaccination
Pelin Dağ
Clinics. 2025;80C:100824
Highlights

  • A young person&apos;s vaccination decision is influenced by multiple factors.

  • Parents&apos; education and occupation significantly affect children&apos;s vaccination decisions.

  • Adolescents tested for suspected COVID-19 had higher vaccination rates.

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Effects of pemafibrate (a selective PPAR-α agonist) versus weight loss through an intensive lifestyle modification on liver enzymes, serum soluble dipeptidyl peptidase-4, and hepatic steatosis and fibrosis evaluated by FibroScan transient elastography in people with type 2 diabetes and MASLD
Kanako Kato, Teruo Jojima, Dai Tanuma, Kanako Suda, Shintaro Sakurai, Toshie Iijima, Takuya Tomaru, Isao Usui, Yoshimasa Aso
Clinics. 2025;80C:100839
Highlights

  • Pemafibrate did not improve hepatic steatosis, while mild weight loss improved it.

  • Both pemafibrate and mild weight loss decreased serum ALT and GGT levels similarly.

  • Both pemafibrate and weight loss showed a similar reduction in serum sDPP-4 levels.

  • Weight loss was better than pemafibrate regarding the main pathogenesis of MASLD.

  • Pemafibrate may be another therapy for MASLD in type 2 diabetes on lifestyle changes.

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Analysis of influencing factors of pulmonary infection during chemotherapy in patients with multiple myeloma and construction of a nomogram prediction model
Tianxia Deng, Hui Zhong, Xiaohong Xie, Jinglong Lv
Clinics. 2025;80C:100822
Highlights

  • Pulmonary infection occurred in 52.05 % of MM patients during chemotherapy.

  • Six key risk factors were identified: age, ISS stage, ECOG score, anemia, neutropenia, and albumin.

  • A nomogram model was developed with high accuracy (AUC > 0.88).

  • Calibration and decision curve analysis confirmed strong predictive performance.

  • The nomogram enables individualized risk prediction for MM chemotherapy patients.

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Development and validation of a machine learning model and nomogram for predicting brain metastasis in lung cancer: a population-based study
Yukai Zeng, Fengwu Lin, Lening Zhang, Jingyuan Jiang, Chen Zhang, Dongliang Qin, Zhe Zhang
Clinics. 2025;80C:100843
Highlights

  • Brain metastasis focus: Predicts brain spread and survival in lung cancer.

  • Big-data study: 25 k SEER patients, Cox/logistic regressions.

  • Best ML: GBM wins internal/external tests.

  • Clinician web tool: One-click risk calculator online.

  • Nomogram: Simple chart forecasts prognosis.

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Persistent overhydration despite significant fluid reduction limits lung function improvement after a single haemodialysis session in CKD patients: A before and after study using BIA
Alexander M. Tungu, Elvis Msaki, Jacktan J. Ruhighira, Ashabilan Ebrahim, Davis Ngarashi, Jacqueline G. Shoo, Fredirick L. Mashili
Clinics. 2025;80C:100821
Highlights

  • Severe overhydration often follows long dialysis-free periods in CKD patients.

  • Hemodialysis removes excess fluids, potentially reducing lung congestion.

  • A single dialysis session reduces fluids but fails to restore normal hydration.

  • Persistent overhydration after dialysis limits lung function improvement.

  • BIA-guided dialysis monitoring may optimize fluid balance and patient outcomes.

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Is infracolic omentectomy necessary for presumed early-stage Borderline Ovarian Tumors (BOTs)? A retrospective cohort study and meta-analysis
Rosilene Jara Reis, Lidia Rosi Medeiros, Airton Teltebom Stein, Sophie Derchain, Igor Casotti de Pádua, Leonardo Octavio Lobo Soares, Guilherme Alves Diogo da Silva, Thais Andrade Gewehr, ... Ricardo dos Reis
Clinics. 2025;80C:100827
Highlights

  • The metastatic disease in the omentum was low in Borderline Ovarian Tumor (BOT).

  • Omentectomy does not interfere with the risk of death and PFS in BOT.

  • Omentectomy does not interfere with recurrence in BOT.

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Causal effects of gut microbiome on aortic dissection: A mendelian randomization study
Yu Tian, Furong Hao, Guangyang Xu, Yuxuan Qian, Jiahao Liu, Ning Pan, Tao Yang
Clinics. 2025;80C:100811
Highlights

  • First Mendelian Randomization analysis of gut microbiota and aortic dissection.

  • Uses large FinnGen genetic data to minimize confounding and reverse causality.

  • Ten protective and eight risk gut microbiome taxa identified for aortic dissection.

  • Suggests novel mechanistic pathways involving TMAO, bile acids, and inflammation.

  • Shows gut microbiome as a potential therapeutic target for aortic dissection.

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Effects of a moderate combined exercise program on cognitive function, quality of life, and glycemic profile in older adults with type II diabetes mellitus
Matheus Henrique dos Santos Lino, Alisson de Lima Guiotto, Vanderlei Carneiro da Silva, Marcus Vinicius Grecco, André Luiz de Seixas Soares, Catherine L. Davis, José Maria Soares-Junior, Edmund Chada Baracat, ... Angelica Castilho Alonso
Clinics. 2025;80C:100833
Highlights

  • Type 2 Diabetes Mellitus and quality of life.

  • Combined training as a treatment for cognitive decline.

  • Physical exercise as a therapeutic approach for people with Type 2 Diabetes Mellitus.

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Predictors of persistent fatigue one year after severe COVID-19: A prospective cohort study on depression and lung function
Elizabeth Mendes da Silva, Camila Machado de Campos, Caroline Gil de Godoy, Danielle Brancolini de Oliveira, Angelica Castilho Alonso, Vanderlei Carneiro da Silva, Ana Carolina Basso Schmitt, Gabriela Sayuri Ochiai, ... José Eduardo Pompeu
Clinics. 2025;80C:100846
Highlights

  • Fatigue is a persistent symptom that often resists complete recovery in many cases.

  • Patients experiencing fatigue exhibited minimal variation in functional capacity after 12 months.

  • Anxiety, depression, and pulmonary impairments are associated with long-term fatigue.

  • Comprehensive screening for post-COVID-19 fatigue is essential for effective management.

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Sinomenine ameliorates lipopolysaccharide-induced acute lung injury by stimulating M2 polarization and suppressing pyroptosis in alveolar macrophages
Xiaoli Jian, Liang Zhao, Jiawu Yang, Peilong Li, Chuxiong Gong, Qiong Li, Zhu Tian, Enli Lan, ... Feng Li
Clinics. 2025;80C:100832
Highlights

  • LPS stimulation led to systemic inflammation in mice.

  • SINO could suppress pyroptosis and induce M2 polarization in LPS-induced AMs.

  • SINO repressed the LPS-activated NF-κB pathway.

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Children with developmental coordination disorder exhibit altered cardiac autonomic control at rest and during exercise
Tatiane T.G. Draghi, Jorge L. Cavalcante Neto, Natália S. Valverde, Antonio R. Zamunér, Eloisa Tudella
Clinics. 2025;80C:100835
Highlights

  • Cardiac autonomic control in children with DCD is altered.

  • Children with DCD exhibit higher sympathetic modulation compared to controls.

  • Children with DCD exhibit reduced parasympathetic modulation compared to controls.

  • This study reinforces the evidence of impaired autonomic control in children with DCD.

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Wideband acoustic immittance in early childhood: The role of outer and middle ear in auditory development
Ana Paula Bruner, Sumitrajit Dhar, Uzma Akhtar, Alessandra Spada Durante, Renata Mota Mamede Carvallo
Clinics. 2025;80C:100841
Highlights

  • ECV, YTM, absorbance and RF of healthy ears change throughout childhood.

  • In newborns, low-frequencies absorbance and RF are attributed to EAC wall mobility.

  • ECV, absorbance and RF change notably before 6-months and stabilize after 3-years.

  • Absorbance decreases at 0.25‒0.6k Hz up to 6-months, then decreases at 2k‒6k Hz.

  • From birth to preadolescence, specific WAI patterns must be considered.

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Differentiating bacterial from viral respiratory tract infections using CRP, SAA, and blood routine parameters: A retrospective cohort study
Yu Zhou, Lei Xu, Xiaowu Zhong, Xiaolan Guo, Qiang Ma
Clinics. 2025;80C:100845
Highlights

  • Bacterial infections exhibit elevated CRP and SAA levels.

  • The combined parameter (WBC + Neu + Mon + CRP) achieved an AUC of 0.764.

  • The proposed model achieved 75.2 % sensitivity and 89.3 % specificity.

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CRISPR/Cas9–mediated MMP-9 silencing inhibits bladder cancer T24 cell invasion and migration in vitro
Fabio Pescarmona Gallucci, Juliana Alves de Camargo, Nayara Izabel Viana, Ruan Cesar Aparecido Pimenta, Vanessa Ribeiro Guimarães, Patrícia Candido, Katia Ramos Moreira Leite, William Carlos Nahas, Sabrina Thalita dos Reis
Clinics. 2025;80C:100842
Highlights

  • CRISPR/Cas9 effectively silenced MMP-9 in bladder cancer cells.

  • MMP-9 silencing reduced T24 cell proliferation and colony formation.

  • Edited cells showed increased apoptosis after MMP-9 knockdown.

  • Migration and invasion capacity were strongly inhibited by MMP-9 silencing.

  • MMP-9 is a potential therapeutic target in bladder cancer progression.

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Different treatment modalities for advanced laryngeal cancer: improvement of oncological outcomes after tumor board implementation
Mariana Gonçalves Rodrigues, Daniel Marin Ramos, Leandro Luongo de Matos, Chin Shien Lin, Jorge Tomio Takahashi, Tiago Wanderley Diniz Chamel, Luiz Paulo Kowalski
Clinics. 2025;80C:100836
Highlights

  • Laryngeal cancer can be treated with total laryngectomy or chemoradiation therapy.

  • Total laryngectomy is the main treatment for patients with T4a stage tumors.

  • A multidisciplinary discussion has a positive impact on the oncological outcomes.

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A survival analysis of T1 stage breast cancer and nomogram development: based on the SEER database
Lizhi Teng, Yuhan Dong, Juntong Du, Peng Xu, Weiyang Tao
Clinics. 2025;80C:100837
Highlights

  • The prognosis for small tumors in stage T1 breast cancer is not always favorable.

  • Identify independent prognostic risk factors for the T1 stage.

  • •Using nomograms to assist clinical treatment and predict prognosis in the T1 stage.

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One-minute stages are optimal for maximal exercise testing in endurance male and female athletes
Alice D. Campos, Claudio A.B. de Lira, Rodrigo L. Vancini, João V R de Freitas, Katja Weiss, Thomas Rosemann, Beat Knechtle, Marilia S. Andrade
Clinics. 2025;80C:100829
Highlights

  • V̇O2max is similar between 1- and 3-min stages for men and women.

  • The test protocol did not affect %V̇O2max, HR or power at Ventilatory threshold.

  • Female athletes show less MAP reduction in long tests than males.

  • Relative MAP reductions are similar between sexes in both protocols.

  • Protocols with 1-min stages are more suitable for evaluating V̇O2max and MAP.

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Surgical treatment of gastric cancer: A single center’s 15-year experience
Marcus Fernando Kodama Pertille Ramos, Marina Alessandra Pereira, Andre Roncon Dias, Osmar Kenji Yagi, Bruna de Camargo Nigro, Carolina Ribeiro Victor, Juliana Depra Panichella, Poliana Fonseca Zampieri, ... Ulysses Ribeiro-Junior
Clinics. 2025;80C:100828
Highlights

  • 1406 patients with gastric adenocarcinoma underwent surgical treatment in 15 years.

  • Minimally invasive surgery use has increased significantly.

  • Diffuse-type tumors became more frequent.

  • More lymph nodes were resected despite higher D1 lymphadenectomy rates.

  • Multimodal treatment increased, with greater use of preoperative chemotherapy.

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Integrated analysis of metastasis-related circRNA-miRNA-mRNA ceRNA regulatory network involved in breast cancer
Hongming Song, Mingkai Gong, Wenfeng Li, Chen Liu, Haiyan Hu, Zhongliang Ma, Xiangping Liu, Yuanxiang Wang, ... Haibo Wang
Clinics. 2025;80C:100826
Highlights

  • Four GEO databases overlapped DEcircRNAs hsa_circ_0001936 and hsa_circ_0089131.

  • Breast cancer-related network with 2 circRNAs, 44 miRNAs, 122 mRNAs was constructed.

  • Circ_0089131-miR-378a-3p-TP53-PI3K-Akt/MAPK pathway ceRNA network was constructed.

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Review articles
Towards optimal management of lower eyelid malpositions: A systematic review of treatment effectiveness and safety
Lana Sbitan, Haneen Tanous, Mira Nawfal Jardak, Cristina Pires Camargo
Clinics. 2025;80C:100547
Highlights

  • A comprehensive systematic review was conducted, to provide healthcare workers with a vital resource in the treatment of eyelid malposition, our search spanned electronic databases, clinical trials registries, and relevant journals.

  • The study includes 15 selected trials evaluating 709 patients (855 eyelids), with an assessment of trial quality using the Cochrane Risk-of-Bias tool (RoB V2).

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Personalized nutrition and precision medicine in perimenopausal women: A minireview of genetic polymorphisms COMT, FUT2, and MTHFR
Pedro Andrade, Aline Boveto Santamarina, Jéssica Alves de Freitas, Annete Bressan Rente Ferreira Marum, Ana Flávia Marçal Pessoa
Clinics. 2025;80C:100549
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Behavioral therapies for the treatment of autism spectrum disorder: A systematic review
Clara Lucato dos Santos, Indyanara Inacio Barreto, Ana Carolina Furian da Silva, Juliana Firmino Batista Soriano, Jeferson de Lima Silva Castro, Luca Schiliró Tristão, Wanderley Marques Bernardo
Clinics. 2025;80C:100566
Highlights

  • Autism Spectrum Disorder (ASD) is a heterogeneous neurodevelopmental disorder.

  • With correct screening and diagnosis, treatment must be offered to improve prognosis.

  • Adequate treatment in a healthcare setting must be known.

  • The Early Start Denver Model (ESDM) showed improvements in the cognitive, verbal, and social aspects.

  • Time occasionally can improve some scores independently of the group.

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Plants used by Brazilian communities of African descent for women's health
Letícia Francine Silva Ramos, Ananda Gomes de Sousa, Rebeca de Siqueira Amorim, Alan de Araújo Roque, Israel Luís Diniz Carvalho, Ana Laura Vilela de Carvalho, Maiara Bernardes Marques, Milena Evangelista dos Santos, ... Pedro Henrique Sette-de-Souza
Clinics. 2025;80C:100513
Highlights

  • Ethnopharmacological knowledge is passed down through generations by women in the community, who use plants especially for sexual and postpartum care.

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Knowledge and attitude of deaf women in relation to contraceptive methods: A systematic review
Gabriela Fuster Barbosa, Edson Santos Ferreira-Filho, Lais Abdo Quintão, Laura Fernandes Berto, Patrícia Gonçalves de Almeida, Edmund Chada Baracat, Luis Bahamondes, José Maria Soares-Junior, Isabel Cristina Esposito Sorpreso
Clinics. 2025;80C:100558
Highlights

  • Knowledge was low mainly about contraceptive methods of high effectiveness.

  • The acceptance of the chosen contraceptive method by deaf women was satisfactory.

  • There are no intervention studies to improve contraceptive use among deaf women.

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Mitochondrial DNA alterations in precision oncology: Emerging roles in diagnostics and therapeutics
Alexis Germán Murillo Carrasco, Roger Chammas, Tatiane Katsue Furuya
Clinics. 2025;80C:100570
Highlights

  • Mitochondria regulate cellular functions, and mtDNA mutations can affect metabolism.

  • mtDNA mutations are promising biomarkers for cancer detection and tumor progression.

  • These mutations might influence therapy response, drug resistance, and patient outcomes.

  • Tools and models advance precision oncology and mitochondrial-targeted treatments.

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Impact of the association of strength training with neuromuscular electrostimulation on the functionality of individuals with functional decline during senescence: A systematic review and meta-analysis
Dhianey de Almeida Neves, Leonardo Costa Pereira, Kerolyn Ramos Garcia, Frederico Santos de Santana, Rhenan Yoshio de Caldas Fujita, Beatriz dos Santos Faria, José Antônio Alves de Oliveira, Carlos James Zeidan Silva Filho, Margô Gomes de Oliveira Karnikowski
Clinics. 2025;80C:100586
Highlights

  • • NMES+ can improve the aerobic capacity of individuals in functional decline.

  • • NMES+ appears to improve physical functional capacity in general.

  • • More RCTs are needed to better evaluate the evidence found.

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Pharmacological treatment of antidepressant-induced sexual dysfunction in women: A systematic review and meta-analysis of randomized clinical trials
Antonio Carlos Queiroz de Aquino, Ayane Cristine Alves Sarmento, Raphaell Lucas de Araújo Teixeira, Tâmilly Nascimento Batista, Cijara Leonice de Freitas, José Manuel Pérez Mármol, Lucia Alves Silva Lara, Ana Katherine Gonçalves
Clinics. 2025;80C:100602
Highlights

  • Sexual dysfunction is a common side effect of antidepressants, especially in women.

  • Identifying effective pharmacological treatments for Antidepressant-Induced Sexual Dysfunction (AISD) is crucial for enhancing patient quality of life.

  • Bupropion at a dose of 150 mg has shown greater effectiveness in treating AISD in women.

  • The meta-analysis found no direct correlation between improvements in sexual function and reductions in depressive symptoms.

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Comparison of endoscopic submucosal dissection and transanal endoscopic surgery for the treatment of rectal neoplasia: A systematic review and meta-analysis
Igor Valdeir Gomes de Sousa, Alexandre Moraes Bestetti, Diego Paul Cadena-Aguirre, Angelo So Taa Kum, Paulo Ferreira Mega, Pedro Henrique Veras Ayres da Silva, Nelson Tomio Miyajima, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura
Clinics. 2025;80C:100613
Highlights

  • Colorectal cancer is one of the most common neoplasms and a leading cause of cancer-related mortality worldwide.

  • The treatment of colorectal neoplasia has evolved significantly over the past few decades due to advances in minimally invasive techniques.

  • Although conventional surgery remains the gold standard for rectal tumors, ESD, TEM, and TAMIS emerged as effective and less invasive therapies for benign tumors and early cancers without nodal metastases, allowing lower morbidity.

  • ESD and TES are safe and effective treatment options for early-stage rectal tumors.

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Phyllodes tumors of the breast: A comprehensive review of diagnosis, treatment, and follow-up
Aline Rocha Donato, Rodrigo Goncalves, Jonathan Yugo Maesaka, Fernando Nalesso Aguiar, José Maria Soares, Carlos Alberto Ruiz, José Roberto Filassi, Edmund Chada Baracat
Clinics. 2025;80C:100617
Highlights

  • Molecular and IHC markers aid in objective classification and outcome prediction of PT.

  • Surgery is the gold standard for PT, but margin extent lacks consensus.

  • Local recurrence is key in PT prognosis, with margin status as the main risk factor.

  • Adjuvant radiotherapy lowers recurrence in borderline/malignant PTs with close margins.

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Recognition of medical error: It is not too late for an open disclosure – a narrative review
Ivan Dieb Miziara, Carmen Silvia Molleis Galego Miziara
Clinics. 2025;80C:100622
Highlights

  • Errors during patient care are a huge source of ethical, financial, and even mental problems affecting patients, physicians, and healthcare organizations.

  • Open disclosure is a process for ensuring that open, honest, empathic and timely discussions occur between patients and/or their support person(s) and healthcare staff following a patient safety incident.

  • Physicians may avoid or hide errors or blame other health professionals.

  • Adopting an effective disclosure system, increases the possibility of an agreement between the parties involved, meaning significant savings in financial resources.

  • Patients want some attitudes from their doctors: an explicit statement that an error occurred and an apology.

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Benefits of melatonin on mortality in severe-to-critical COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials
Jinlv Qin, Guizuo Wang, Dong Han
Clinics. 2025;80C:100638
Highlights

  • This study was designed to assess melatonin in severe-to-critical COVID-19.

  • Melatonin significantly reduced in-hospital mortality.

  • Melatonin should be considered for severe-to-critical COVID-19 patients.

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Motivations for uterus transplantation in women with absolute uterine factor infertility: A systematic review of the literature
Luciana Leis, Francisco Tustumi, José Maria Soares-Jr, Edmund Chada Baracat, Luiz Augusto Carneiro-D'Albuquerque, Dani Ejzenberg, Wellington Andraus
Clinics. 2025;80C:100646
Highlights

  • Uterine transplantation is the preferred choice for most women with absolute uterine factor infertility.

  • The motivations for transplantation go beyond the desire to conceive one&apos;s own child.

  • Having a genetic child, controlling pregnancy, and restoring femininity are also among the reasons for seeking uterus transplantation.

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Minimally invasive radical prostatectomy versus open radical prostatectomy: A systematic review and meta-analysis of randomized control trials
Caio Felipe Araujo Matalani, Mateus Silva Santos Costa, Marcelo Ribeiro da Rocha, Roberto Iglesias Lopes, Thalita Bento Talizin, José Bessa Júnior, William Carlos Nahas, Leopoldo Alves Ribeiro-Filho, Caio Vinicius Suartz
Clinics. 2025;80C:100636
Highlights

  • Minimally invasive surgery reduces blood loss and transfusions vs. open surgery.

  • Fewer complications occur with minimally invasive than with open prostate surgery.

  • Urinary continence and erectile function are similar in both surgical approaches.

  • Cancer control outcomes are comparable between minimally invasive and open surgery.

  • More studies are needed to confirm the long-term benefits of minimally invasive surgery.

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A systematic review and meta-analysis of the efficacy and safety of glucocorticoids in the treatment of severe pneumonia
Jingye Liu, Zhiqiang Yang
Clinics. 2025;80C:100630
Highlights

  • Glucocorticoids could effectively improve the condition of patients with severe pneumonia.

  • Glucocorticoids could effectively shorten the temperature recovery time, cough relief time, and rale disappearance time.

  • Glucocorticoids could effectively reduce the length of stay, and regulate the serum CRP level.

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Extracellular vesicles as cancer biomarkers and drug delivery strategies in clinical settings: Advances, perspectives, and challenges
Raphaela Rebeca Silveira Assunção, Nathalia Leal Santos, Luciana Nogueira de Sousa Andrade
Clinics. 2025;80C:100635
Highlights

  • Extracellular Vesicles (EVs) are circulating lipid-bilayer particles delivered by almost all cells as a form of cell-to-cell communication.

  • Tumor-derived EVs carry various cargo from tumor cells, including DNA, RNA, and proteins that are mutated or dysregulated, and can be found in all biological fluids.

  • The cargo and concentration of circulating EVs could be as potential biomarkers for cancer prognosis, diagnosis and therapy evaluation using liquid biopsy strategy.

  • Engineering EVs is a promising strategy for targeted drug delivery in oncology research.

  • Engineering therapeutic EVs could increase precision, reduce off-target effects and offer a more personalized therapeutic approach.

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Risk factors for the growth of ground-glass nodules in the lungs: A systematic review and meta-analysis
Qianfang Yang, Fan Wang, Hongxin Cao
Clinics. 2025;80C:100669
Highlights

  • GGN is emerging as an important public health problem after COVID-19.

  • The system evaluates the risk factors for GGN, enabling early identification of high-risk populations.

  • Correctly identifying risk factors for GGN growth is clinically significant.

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The association between the monocyte Chemoattractant protein-1–2518A/G polymorphism and the risk of tuberculosis in the Chinese population: A meta-analysis and systematic review
Hongfang Lu, Jingang Wang, Xinyu Song, Xiaoqi Xiong
Clinics. 2025;80C:100685
Highlights

  • This meta-analysis investigated MCP-1–2518A/G polymorphism in Chinese population.

  • The MCP-1–2518A/G polymorphism increased tuberculosis susceptibility.

  • Non-Han Chinese individuals showed a higher risk of tuberculosis.

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The impact of using electromyographic biofeedback on pelvic floor rehabilitation in men with post-prostatectomy urinary incontinence: a meta-analysis
Camila Chaves dos Santos Novais, Adélia Regina Oliveira da Rosa Santana, Alisson Rodrigo Moura da Paz, Aline Tenório Lins Carnaúba, Kelly Cristina Lira de Andrade, Pedro de Lemos Menezes
Clinics. 2025;80C:100687
Highlights

  • Urinary incontinence is observed as the main post-prostatectomy complication.

  • Pelvic floor rehabilitation is the first-line treatment for urinary incontinence.

  • Electromyography biofeedback instructs the patient on the correct activation muscle.

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The association between age at menarche and depression: A systematic review and meta-analysis with meta-regression
Erfan Ghadirzadeh, Mahmood Moosazadeh, Kiarash Shakeriastani, Maryam Zarrinkamar, Mobina Gheibi, Forouzan Elyasi, Mojgan Geran
Clinics. 2025;80C:100695
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Exploring the interplay between host genetics and acute and long COVID: A narrative review
Thais Beuren, Filipe Ferrari, Leandro Tolfo Franzoni, Cássia da Luz Goulart, Fernando Val, Gerson Cipriano, Ricardo Stein
Clinics. 2025;80C:100708
Highlights

  • Genetic variants may affect individual COVID-19 severity.

  • Some polymorphisms worsen outcomes; others may offer protection.

  • Gene effects likely interact with environmental and biological factors.

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Premature ovarian insufficiency: Updated concepts in diagnosis and hormonal treatment strategies
Gabriela Pravatta-Rezende, Cristina Laguna Benetti-Pinto, Daniela Angerame Yela, Ana Carolina Japur de Sá Rosa e Silva, Andrea Prestes Nácul, Fernando Marcos dos Reis, Edmund Chada Baracat, José Maria Soares Junior
Clinics. 2025;80C:100745
Highlights

  • Diagnosis and etiology of POI.

  • Hormone therapy as an essential treatment.

  • Fertility preservation strategies.

  • Long-term monitoring and multidisciplinary care.

  • Androgen therapy for sexual dysfunction.

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Dense breasts and women's health: which screenings are essential?
Bruna Salani Mota, Carlos Shimizu, Yedda N. Reis, Rodrigo Gonçalves, Jose Maria Soares Junior, Edmund Chada Baracat, José Roberto Filassi
Clinics. 2025;80C:100743
Highlights

  • Mammographic density impacts the primary screening process, as dense tissue may mask tumors, resulting in false-negative results.

  • Mammographic density is known to be a risk factor for breast cancer, associated with a 1- to 6-fold increase in the incidence of this disease.

  • In women at average risk, going to annual screening mammography at age 40 has demonstrated a reduction in breast cancer mortality by roughly 20 %.

  • For women at intermediate and high-risk, supplementary modalities such as magnetic resonance imaging, ultrasound, tomosynthesis, and molecular breast imaging may be considered for enhanced screening to increase detection rates.

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Preserving medical confidentiality in Brazilian criminal investigation cases: a narrative review of the principles of bioethics
Henrique Martin Zarpellon, Fabiano Bianchi, Henderson Fürst, Rui Nunes
Clinics. 2025;80C:100740
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Partial prostatectomy in prostate cancer: a systematic review of current evidence
Caio Mazzonetto Teófilo de Moraes, Catharina Lyra, Alice Matos Fontes, Jose de Bessa Junior, William Carlos Nahas, Leopoldo Alves Ribeiro Filho, Caio Vinicius Suartz
Clinics. 2025;80C:100777
Highlights

  • Partial prostatectomy shows promise but lacks evidence for routine clinical use.

  • Partial prostatectomy has emerged as a novel surgical option aiming to preserve urinary and sexual function while maintaining oncologic control in carefully selected patients with localized prostate cancer.

  • Early series suggest feasibility and safety, but long-term oncological outcomes remain uncertain compared with radical prostatectomy and focal therapies.

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Effect of aerobic and resistance training on body composition, functional capacity, and quality of life in patients with liver cirrhosis: a systematic review with meta-analysis
Thiago Casali Rocha, Rafael Ribeiro Germano, Maria Clara Dias Giacomini, Fábio Heleno de Lima Pace, Mateus Camaroti Laterza, Daniel Godoy Martinez
Clinics. 2025;80C:100748
Highlights

  • First meta-analysis comparing aerobic and resistance training in liver cirrhosis.

  • Resistance training seems to improve the quality of life in liver cirrhosis.

  • Aerobic and resistance training should be part of cirrhosis treatment.

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Etiology and treatment options for refractory gastroesophageal reflux disease: A scope review
Gaofeng Wang, Changtai Zhu, Jianyun Yin
Clinics. 2025;80C:100763
Highlights

  • Some refractory gastroesophageal reflux disease patients have shown a poor response to traditional treatment options.

  • Optimization of drug therapy, endoscopic therapy, surgical procedures, and traditional Chinese medicine treatment are the main treatment strategies currently.

  • Individualized treatment plans should be explored for future research.

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Tetramethylpyrazine modulates airway inflammation and remodeling in bronchial asthma: A review
Zichao Han, Fei Yu, Zhen Ding, Qinghua Liu, Xiangyi Zheng, Lijuan Zhang, Dong Li, Chao Wang
Clinics. 2025;80C:100768
Highlights

  • Tetramethylpyrazine (TMP) can restore the balance of Th1/Th2 and Th17/Treg in asthma.

  • TMP can regulate signaling pathways such as Gαs/cAMP/PKA and AMPK/NF-κB.

  • TMP inhibits airway remodeling through TGF-β and ORMDL3.

  • TMP can reduce vascular remodeling by inhibiting factors like VEGF.

  • This review emphasizes that TMP is a promising complementary therapy for asthma.

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Brazilian guide for the diagnosis of severe community-acquired pneumonia and hospital-acquired pneumonia
Jorge Luiz Mello Sampaio, Alexandre Cunha, Daniel Wagner de Castro Lima Santos, Alvaro Pulchinelli Junior
Clinics. 2025;80C:100793
Highlights

  • No consensus on the use of molecular panels in the diagnosis of severe pneumonia.

  • Algorithm for the use of laboratory tests for the diagnosis of pneumonia.

  • Molecular panels in the diagnosis of pneumonia have reduced hospitalization time.

  • Molecular panels in pneumonia reduced the length of stay in intensive care units.

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Aprepitant and fosaprepitant as a prophylactic antiemetic for preventing postoperative nausea and vomiting after general anaesthesia: a systematic review and meta-analysis
Thiago Ramos Grigio, Hans Timmerman, Natanael Pietroski dos Santos, José Eduardo Guimarães Pereira, Angela Maria Sousa, André Paul Wolff
Clinics. 2025;80C:100783
Highlights

  • Aprepitant reduces nausea, vomiting, and rescue antiemetics post-surgery.

  • Aprepitant increases the complete response rate within 24 hours post-surgery.

  • Fosaprepitant reduces vomiting but not nausea or rescue antiemetic use.

  • The review included 35 studies with 6241 participants under general anesthesia.

  • Identical time points were analyzed to assess the efficacy and safety of both drugs.

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Pulmonary epithelioid haemangioendothelioma: A comprehensive review of clinical and molecular advances
Bo Tang, Shengliang Zhao, Jingsi Wang, Mingzhang Xiang, Jigang Dai, Quanxing Liu
Clinics. 2025;80C:100789
Highlights

  • This is a rare low-to-moderate grade malignant tumor derived from vascular tissue.

  • The tumor can present as bilateral multiple nodules or as a single cystic lesion.

  • The histological features include spindle-shaped cells with vacuolated cytoplasm.

  • The immunohistochemical markers CD31, CD34, and ERG are strongly positive.

  • Surgical resection is performed for localized lesions, while anti-angiogenic therapy and chemotherapy are used for advanced metastatic lesions.

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Functional impact for indication and access to physical therapy after hospital discharge due to COVID-19
Vivian Cintra Sousa, Fabio Cavalcanti Freitas, Erika Christina Gouveia e Silva, Nayara Oliveira Santos, Daniella de Melo, Sara Cristina Aparecida da Silva, Debora Stripari Schujmann Nogueira, Carolina Fu, ... Ana Carolina Basso Schmitt
Clinics. 2025;80C:100807
Highlights

  • Functional impacts after hospitalization for Covid-19.

  • Continuity of physical therapy care after hospitalization for Covid-19.

  • Criteria for physical therapy after Covid-19.

  • Functionality as a criterion for physical therapy indication after hospital discharge.

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A systematic review and meta-analysis of the prevalence of psoriasis in patients living with HIV
Xiaojuan Yang, Lingxu Zhou, Zhen Zhang, Yinghong Liu
Clinics. 2025;80C:100810
Highlights

  • Estimate psoriasis prevalence in HIV-positive individuals via meta-analysis.

  • Analyze trends over time (1984–1994 vs. 2000–2022) and by regional latitude.

  • Identify publication bias; confirm result stability through sensitivity analysis.

  • Guide health resource allocation and policy for HIV-associated psoriasis.

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The risk factors of anti-neutrophil cytoplasmic antibody-associated vasculitis-associated interstitial lung disease: a systematic review and meta-analysis
Ningxia Yu, Shuguang Yang, Danyang Zang, Lili Xu, Ruonan Yan, Xueqing Yu
Clinics. 2025;80C:100823
Highlights

  • Identifies key risk factors for AAV-ILD, encompassing sociodemographic, lifestyle, and clinical factors.

  • Older age, male, and smoking history are strong predictors of AAV-ILD development.

  • Clinical factors, including but not limited to KL-6, ESR, and MPO-ANCA, are risk factors for AAV-ILD.

  • Findings contribute to early warning and risk stratification for AAV-ILD patients.

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Benefits of martial arts on the functional capacity of elderly people: a systematic review and meta-analysis
Dário Lucas Costa de Mendonça, José Matos Raider Junior, Leandro Bruno Barbosa da Silva, Angelica Castilho Alonso, Júlia Maria D'Andrea Greve, Luiz Eugênio Garcez-Leme
Clinics. 2025;80C:100830
Highlights

  • Taekwondo and Muay Thai reduce the risk of falls in elderly individuals.

  • Physical exercises are more effective than martial arts for improving handgrip strength.

  • Quality of life is improved by martial arts, but meta-analysis was not possible because of study heterogeneity.

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Neurologic monitoring in children and adolescents with hepatic failure: new mechanisms and non-invasive approach
Beatriz Kelly Oliveira Silva, Maria Clara Silveira de Carvalho, Artur Figueiredo Delgado, Werther Brunow de Carvalho, Michele Luglio
Clinics. 2025;80C:100844
Highlights

  • • Non-invasive neurologic monitoring is feasible in pediatric ALF.

  • • Optic nerve sheath diameter detects intracranial hypertension in pediatric ALF.

  • • Multimodal, noninvasive tools guide better neurological pre-transplant assessment.

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Comments
Updated report of Blastocystis spp. in a teaching hospital of Brazil: A 6-year retrospective experience
Gessica Baptista de Melo, Marcelo Alves Ferreira, Vera Lucia Pagliusi Castilho, Elenice Messias do Nascimento Gonçalves, Ronaldo Cesar Borges Gryschek, Fabiana Martins de Paula
Clinics. 2025;80C:100543
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Olanzapine as a prophylactic antiemetic for preventing postoperative nausea and vomiting after general anesthesia: A systematic review and meta-analysis
Thiago Ramos Grigio, Hans Timmerman, Angela Maria Sousa, André Paul Wolff
Clinics. 2025;80C:100645
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Beyond non-inferiority: Exploring the full potential of virtual reality in surgical training
Brijesh Sathian, Hanadi Al Hamad, Javed Iqbal
Clinics. 2025;80C:100675
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First Brazilian patient undergoing nocturnal self-care home hemodialysis
Rafael C. S. Tavares, Erica Adelina Guimarães, Rodrigo Dias, Ísisde S.F. Cordeiro, Benedito Jorge Pereira, Rosilene M. Elias
Clinics. 2025;80C:100681
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Mapping delays in breast cancer care during COVID-19: Lessons from the Brazilian Public Health System (SUS)
Diego Wallace Nascimento, José Roberto Filassi, Rodrigo Gonçalves, Edmund Chada Baracat, José Maria Soares Júnior, Bruna Salani Mota
Clinics. 2025;80C:100696
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H3K18 lactylation in pancreatic cancer: promising yet unproven ‒ a call for validation
Sohaib Aftab Ahmad Chaudhry, Rida Shakeel, Javed Iqbal
Clinics. 2025;80C:100715
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Using a computerized database (REDCap) to access the clinical follow-up of patients undergoing bariatric surgery
Caroline Rossi Welendorf, Thaís Alves de Azevedo Chaves Pastore, Natália Yumi Noronha, Flávia de Campos Ferreira, Ligia Moriguchi Watanabe, Carolina Ferreira Nicoletti-Fino, Wilson Salgado Junior, Guilherme da Silva Rodrigues, ... Carla Barbosa Nonino
Clinics. 2025;80C:100714
Highlights

  • Use of REDCap database for follow-up of bariatric surgery patients.

  • Study shows the effectiveness of REDCap in managing bariatric surgery data.

  • Electronic data platforms can optimize the management of bariatric patients.

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Response to commentary on “pembrolizumab in gestational trophoblastic neoplasia: systematic review and meta-analysis with sub-group analysis of potential prognostic factors”
Marcio Barcellos, Antonio Braga, Matheus Machado Rech, Solange Artimos de Oliveira, Jose Mauro Madi, Sue Yazaki Sun, Jorge de Rezende-Filho, Kevin M. Elias, ... Ross S. Berkowitz
Clinics. 2025;80C:100713
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The divergent roles of tgf-β isoforms in thyroid cancer and goiter: from mechanistic insights to clinical biomarker potential in thyroidology
Demet Sengul, Ilker Sengul, José Maria Soares Júnior
Clinics. 2025;80C:100800
Highlights

  • TGF-β isoform levels show divergent perioperative dynamics in thyroid cancer versus goiter.

  • The pro-tumorigenic role of TGF-β1 (via EMT) is contrasted with TGF-β3′s potential anti-fibrotic function.

  • Pre-operative TGF-β1 may predict radioiodine resistance in DTC (HR=2.3), suggesting prognostic utility.

  • TGF-β2 is associated with reduced goiter recurrence, highlighting its biomarker potential.

  • Multicenter studies with standardized assays are urgently needed to validate clinical thresholds.

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Correspondence
Role of tomography in the screening at the emergency room during pandemics
Marcel Lima Albuquerque, Ricardo D'Oliveira Vieira, Luiz Eduardo Fonteles Ritt
Clinics. 2025;80C:100559
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New, late-onset relapsing-remitting multiple sclerosis in a woman in her 60s after SARS-CoV-2 vaccination
Carla Alexandra Scorza, Fulvio Alexandre Scorza, Josef Finsterer
Clinics. 2025;80C:100556
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Aseptic thoracic spondylodiscitis (pseudo discitis) in a septuagenarian without predisposing factors
Ana C. Fiorini, Carla Alexandra Scorza, Fulvio Alexandre Scorza, Josef Finsterer
Clinics. 2025;80C:100571
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Small fiber neuropathy with dysautonomia and positive GPCR and FGFR-3 antibodies after the first BNT162b2 dose
Josef Finsterer, Carla Alexandra Scorza, Fulvio Alexandre Scorza, Ana C. Fiorini
Clinics. 2025;80C:100557
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Fatal long-term complications due to bendamustine for Waldenstrom's macroglobulinemia
Fulvio Alexandre Scorza, Carla Alexndra Scorza, Josef Finsterer
Clinics. 2025;80C:100591
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Hearing loss and small and large fibre neuropathy associated with the heterozygous variants c.20A>T in HBB and del-3.7 in HBA
Josef Finsterer, Fulvio A. Scorza, Carla A. Scorza, Ana C. Fiorini
Clinics. 2025;80C:100597
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Comment on: “Gastric adenocarcinoma and periodontal disease: a systematic review and meta-analysis”
Shubham Kumar, Nosaibah Razaqi, Rachana Mehta, Ranjana Sah
Clinics. 2025;80C:100596
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The new variant c.458C>G in CHRNA1 causes late-onset post-synaptic slow-channel congenital myasthenic syndrome
Josef Finsterer, Fulvio A. Scorza, Carla A. Scorza, Ana C. Fiorini
Clinics. 2025;80C:100791
Highlights

  • Avoid pyridostigmine in slow channel syndrome due to CHRNA1 variants.

  • Congenital myasthenic syndrome due to CHRNA1 mutations may have a late onset.

  • Salbutamol can be beneficial in carriers of CHRNA1 variants.

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A call for equity: Investing in substance use research for Brazil’s LGBTQ+ population
Clarice Sandi Madruga, Katia Isicawa de Sousa Barreto, Danilo Seabra, Claudio Jerônimo da Silva, Guilherme Sabino de Godoy Filho, Carmen Silvia Molleis Galego Miziara, Martha Canfield, Quirino Cordeiro, Ronaldo Ramos Laranjeira
Clinics. 2025;80C:100790
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Erratums