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Clinics

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Clinics
Journal Information
Issue
Cover Vol. 81.  (In progress) Vol. 81. (In progress)
(January - December 2026)
This issue is in progress but contains articles that are final and fully citable.
Editorials
Planetary health: Real challenges for elderly population
Fulvio A. Scorza, Josef Finsterer, Antonio-Carlos G. de Almeida, Marcelo F. de Mello
Clinics. 2026;81C: 100911
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Comparing traditional and AI-enhanced mentorship for leadership development in medicine
Ayla Mohtat, Fabio Ynoe Moraes, Alireza Mansouri, Ruth Gotian
Clinics. 2026;81C: 100956
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Metabolic and inflammatory mechanisms in uric acid-induced tubular dysfunction: Emerging perspectives
Caixiu Yang, Shuo Xu, Hongmei Zhao, Yanwen Wang, Dongmei Meng, Qiuxia Ji
Clinics. 2026;81C: 100958
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Vaccination in immunocompetent and immunosuppressed youth with special health care needs during healthcare transition
Flavia C. Yarshell, Clara R. Doria, Ana Paula S. Ferrer, Artur F. Delgado, Claudia B. Fonseca, Darusa C. Souza, Pedro Henrique P. Sampaio, Maria Fernanda B. Pereira, ... Clovis A. Silva
Clinics. 2026;81C: 101032
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Testosterone abuse in Brazil: a growing public health challenge
Adriano Fregonesi, Bruno Chiesa Gouveia Nascimento, José Maria Soares Junior, Ana Cláudia Latronico, Carmita Helena Najjar Abdo, Lucas Vasconcelos Sanvido, Archimedes Nardozza Junior, Fernando Nestor Facio Junior, ... Cristiano Mendes Gomes
Clinics. 2026;81C: 101036
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Prometheus’ fire and Brazilian universities: A decade of the quota law
Lucas Leite Cunha, Laura Sterian Ward
Clinics. 2026;81C: 101058
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Innovation in reconstructive plastic surgery
Fábio F. Busnardo, Nivaldo Alonso, Rolf Gemperli
Clinics. 2026;81C: 101108
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Original articles
The role of SIGLEC9 in immunosuppression and prognosis in cervical cancer
Bihui Wang, Yuejie Zhu, Zhenyu Ru, Yulian Zhang, Mingkai Yu, Pingfen Li, Manli Zhang, Jianbing Ding, Zhifang Chen
Clinics. 2026;81C: 100849
Highlights

  • SIGLEC9 is highly expressed in cervical cancer and linked to poor prognosis.

  • Bioinformatics show SIGLEC9 correlates with macrophages and T-cells.

  • SIGLEC9+ TAMs and T-cells are highly enriched in the cervical cancer microenvironment.

  • High SIGLEC9+ TAM expression correlates with poor prognosis in cervical cancer.

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Electrophysiological evaluation of the auditory pathway in newborns and infants with peri-intraventricular hemorrhage and/or periventricular leukomalacia
Rosanna Giaffredo Angrisani, Natalia Olival Balzarini, Carla Regina Tragante, Valdenise Martins Laurindo Tuma Calil, Werther Brunow de Carvalho, Carla Gentile Matas
Clinics. 2026;81C: 100853
Highlights

  • Prematurity is a risk factor for lifelong hearing damage.

  • Hearing monitoring is necessary until around 3-years of age.

  • Hearing monitoring after peri-intraventricular hemorrhage is essential.

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New population-specific cephalic index standards for Malaysian subadults: prevalence, growth patterns, and clinical implications from a CT imaging study
Sharifah Nabilah Syed Mohd Hamdan, Rabi’ah Al-Adawiyah Rahmat, Selva Malar Munusamy, Norliza Ibrahim
Clinics. 2026;81C: 100855
Highlights

  • Establishes the first cephalic index standards for multi-ethnic Malaysian subadults.

  • Reports a negative correlation between age and CI, with a decline of 0.026 yearly.

  • Shows higher CI values in Malaysians than in Caucasians and other Asian groups.

  • Provides a validated tool (ICC > 0.93) to track cranial growth and deformity severity.

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Head and neck cancer patients present late cancer cachexia two years after curative chemoradiotherapy
Willian das Neves, Thomás Giollo Rivelli, Eduardo Furquim Simão, Marco Aurélio Vamondes Kulcsar, Gilberto de Castro Junior
Clinics. 2026;81C: 100851
Highlights

  • Two diagnostic criteria diagnose cancer cachexia in HNSCC patients.

  • Disease-free HNSCC patients present cancer cachexia after long-term follow-up.

  • Cachexia is not associated with dysphagia.

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Prognostic impact of sarcomatous component in patients with localized and locally advanced uterine carcinosarcoma: a retrospective study in Latin America
Daniel Santos Rocha Sobral Filho, Giulia Mazaro de Oliveira, Letícia Vecchi Leis, Mariana de Paiva Batista, Vanessa da Costa Miranda, Renata Colombo Bonadio, Maria del Pilar Estevez Diz, Samantha Cabral Severino da Costa
Clinics. 2026;81C: 100854
Highlights

  • Uterine carcinosarcoma is treated with no histology-based management.

  • Heterologous sarcomatous component has a negative impact on overall survival.

  • First study to report a negative prognostic impact in FIGO I‒IVA in Latin America.

  • There is a need to reconsider the role of sarcomatous component to tailor treatment.

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Skin layer thickness, muscle elasticity and their effects on pain level in fibromyalgia patients
Selçuk Akan, Mehtap Balaban, Ahmet Kor, Bahadir Erturk
Clinics. 2026;81C: 100858
Highlights

  • Fibromyalgia patients have thinner skin on ultrasound.

  • Trapezius muscle is thicker and stiffer in fibromyalgia.

  • Muscle stiffness is correlated with pain severity.

  • Reduced skin thickness may drive peripheral sensitization.

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Predictive value of serum chitinase 3-like 1 for dysfunctional autogenous arteriovenous fistulas in patients with chronic kidney disease stage G5
You Wen Lin, Qing Zhang, Ying Sheng Xu, Ting Qu
Clinics. 2026;81C: 100852
Highlights

  • Uterine carcinosarcoma is treated with no histology-based management.

  • Heterologous sarcomatous component has a negative impact on overall survival.

  • First study to report a negative prognostic impact in FIGO I-IVA in Latin America.

  • There is a need to reconsider the role of the sarcomatous component to tailor treatment.

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Enhancing tertiary cardiology triage with vectorcardiographic features: a machine learning approach using real-world data
Lucas José da Costa, Vinicius Ruiz Uemoto, Mariana FN de Marchi, Renato de Aguiar Hortegal, Renata Valeri de Freitas
Clinics. 2026;81C: 100856
Highlights

  • ML model uses VCG-derived GEH to predict tertiary care (AUC 68 %, Sens 94 %) for triage.

  • Interpretable XGBoost prioritizes GEH and prior PCI, matching clinical risk factors.

  • High sensitivity and low specificity highlight its use as a screening support tool.

  • SHAP confirms robustness of SVG, QTc, and age across several sensitivity scenarios.

  • VCG biomarker extraction enables low-cost, scalable support for clinical triage use.

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Painful subcutaneous edema is associated with early age at disease onset in Immunoglobulin A vasculitis patients: A multicenter study
Lia V. Steuer, Clara R. Doria, Matheus S. França, Paula S. Marra, Sebastian D. Cordoba, Luisa F.C. Forero, Ricardo N. Machado, Sylvia C.L. Farhat, ... Clovis A.A. Silva
Clinics. 2026;81C: 100857
Highlights

  • PSE occurred in approximately one-third of IgAV patients at disease onset.

  • IgAV painful subcutaneous edema was mainly located on the lower and upper limbs.

  • IgAV painful subcutaneous edema was identified predominantly at an early age.

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Six IL-8 gene polymorphisms and the entire cancer susceptibility according to a comprehensive analysis especially in prostate cancer
Xiao Zhang, Jian Sun, Xiqi Ding
Clinics. 2026;81C: 100862
Highlights

  • +2767, +781, and −251 polymorphisms were associated with cancer risk.

  • −251 variant may directly influence IL-8 expression in prostate cancer patients.

  • These polymorphisms represent promising candidate biomarkers of cancer detection.

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Sex-disparate safety profile of Obinutuzumab: a pharmacovigilance analysis using the FDA adverse event reporting system
Zhixun Bai, Jiaxi Chen, Yongping Lan, Houze Li, Rubin Zheng, Miao Deng, Wenyi Pang
Clinics. 2026;81C: 100865
Highlights

  • Obinutuzumab safety evaluated using FAERS data from 2013–2024.

  • Blood and lymphatic disorders show the highest signal strength in both sexes.

  • Women show a higher risk of severe hematologic toxicities with Obinutuzumab.

  • Novel signals for pure red cell aplasia and enteroviral meningitis in women.

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Associations of physical activity, sleep with functional disability in Chinese older adults: a five-year prospective study
Xuewei Zhao, Jiani Zeng, Lijuan Zhang, Haibo Zhang, Jingjing Huang, Lei Jiang, Jun Zhao
Clinics. 2026;81C: 100863
Highlights

  • Healthy nighttime sleep may be linked to lower odds of ADLD.

  • Healthy sleep is linked to reduced risk of ADLD in the elderly with sufficient PA.

  • Benefits of sufficient PA and healthy sleep on reducing the risk of ADLD is unclear.

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Patient characteristics and palliative care eligibility in public vs. private emergency care: A cross-sectional observational study
Carla Bertelli, Cristina Terzi, Marileise Roberta Fonseca, Felipe Cecílio, Luciana Nucci, Luana Aranha, Paulo de Campos, Fernanda Engelbrecht, ... Elisa Teixeira Mendes
Clinics. 2026;81C: 100859
Highlights

  • 37.4 % of emergency patients were eligible for palliative care.

  • Public EDs had 9-fold higher odds of palliative care eligibility.

  • Pain was the most reported symptom among eligible patients.

  • Opioid use was low despite high symptom burden in PC patients.

  • SPICT-BR™ and PPS tools revealed unmet needs in emergency care.

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Development and implementation of an interdisciplinary one-stop clinic for infant hip dysplasia: A pilot study
Patricia Moreno Grangeiro, Giovanna Braga Motta, Natasha Vogel Majewski Rodrigues, Daniel Frank Liggio, Cristiane Aun Bertoldi, Roberta Coimbra, Ina Fialho Zürcher, Yasmin Estefanía González Herrera, ... Roberto Guarniero
Clinics. 2026;81C: 100864
Highlights

  • Describes the co-design and pilot implementation of a one-stop clinic for DDH.

  • Introduces a novel grouping of Graf subtypes to guide a structured three-phase treatment.

  • Presents collaboratively designed algorithms for clinic workflow and evidence-based treatment.

  • In the pilot phase, 22 of 98 infants were treated with a Pavlik harness, showing feasibility.

  • Aims to standardize care and serve as a model for implementation in similar healthcare settings.

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Combination of serum TBL1XR1, MFAP5, and PSA as diagnostic biomarkers for prostate cancer
Xianxian Wu, Xiuping Lin, Jiejun Lin
Clinics. 2026;81C: 100868
Highlights

  • TBL1XR1 and MFAP5 are highly expressed in the serum of patients with PCa.

  • TBL1XR1 and MFAP5 expression levels are positively related to PSA concentration.

  • Combination of TBL1XR1, MFAP5 and PSA improves the accuracy of PCa diagnosis.

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Monoclonal gammopathy of renal significance in western China: A large cohort study dominated by amyloidosis with distinct clinical outcomes
Junru Wang, Kun Peng, Guisen Li, Shasha Chen
Clinics. 2026;81C: 100866
Highlights

  • Renal amyloidosis is the dominant lesion in this Chinese MGRS cohort.

  • Amyloidosis MGRS shows a distinct clinical phenotype at presentation.

  • Cardiac involvement is a key predictor of end-stage kidney disease.

  • Therapy response (hematologic/renal) is linked to better survival.

  • Early clone-directed therapy is critical for amyloidosis MGRS.

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External validation of a nomogram for predicting tubulointerstitial lesions in IgA nephropathy: a cross-regional study in China
Xinyu Wang, Litian Pu, Lu Song, Jian Xu, Hu Meng, Meng Yang, Yan Xu, Qiao Wang, ... Qinyuan Deng
Clinics. 2026;81C: 100860
Highlights

  • Cross-regional validation of IgAN tubulointerstitial lesion prediction nomogram in China.

  • eGFRcr and eGFRcr-cys perform equally, supporting use in low-resource settings.

  • High-altitude IgAN subgroup shows improved nomogram predictive performance.

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Obstructive sleep apnea in adults with Down syndrome: body composition, metabolic profile and cognitive status
Lígia Fidelis Ivanovic, Cristiana Castanho de Almeida Rocca, Rosa Hasan, Pâmella Pollyanna Braga Carra Costela, Geraldo Lorenzi-Filho, Orestes Vicente Forlenza, Milton A. Martins, Patricia Zen Tempski
Clinics. 2026;81C: 100867
Highlights

  • Sleep apnea in Down syndrome may relate to obesity and body fat distribution.

  • Abdominal fat and neck size are linked to sleep apnea in Down syndrome.

  • Sleep apnea may be related to metabolic changes in adults with Down syndrome.

  • Obstructive sleep apnea may impair memory and cognition in Down syndrome.

  • Obstructive sleep apnea in Down syndrome is linked to poor memory performance.

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From diagnosis to daily life: A comparative pilot study on healthcare access and challenges for neurofibromatosis type 1 in public systems of Brazil and Portugal
Déborah Domeneghetti de Francisco, Isabela Mayá Wayhs Silva, Jorge M. Saraiva, Carlos Eduardo Steiner, Vera Lúcia Gil-da-Silva-Lopes
Clinics. 2026;81C: 100875
Highlights

  • First study of NF1 patient experiences in the health systems of Brazil and Portugal.

  • Portuguese patients showed lower genetic and health literacy than Brazilians.

  • Access to neurologists and psychiatrists was a key barrier in both countries.

  • Despite economic differences, both nations face similar barriers in multidisciplinary care.

  • Findings highlight urgent need for national NF1 data and structured care pathways.

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Clinical significance and mechanistic role of Hsa_circ_0005075 in recurrent spontaneous abortion: Regulation of trophoblast proliferation and invasion through the Wnt/β-catenin pathway
Meng Li, Shuyuan Liu, Xuan Du
Clinics. 2026;81C: 100816
Highlights

  • Serum hsa_circ_0005075 is significantly elevated in patients with Recurrent Spontaneous Abortion (RSA).

  • Hsa_circ_0005075 exhibits high diagnostic value (AUC = 0.820) for distinguishing RSA patients from healthy controls.

  • Overexpression of hsa_circ_0005075 suppresses trophoblast cell proliferation, invasion, and cell cycle progression while promoting apoptosis.

  • Hsa_circ_0005075 exerts its functional effects by inhibiting the activation of the Wnt/β-catenin signaling pathway.

  • Targeting hsa_circ_0005075 may represent a novel diagnostic and therapeutic strategy for RSA.

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Effects of different acupuncture strategies on the prognosis and inflammatory factor levels associated with the treatment of knee osteoarthritis
Jun Li, Di Wu, Xueli Chen, Guanhua Li
Clinics. 2026;81C: 100871
Highlights

  • Acupuncture could improve the physical function and reduce pain of knee.

  • Acupuncture improving the life quality of patients.

  • Electroacupuncture showed the strongest effects.

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Personalized sepsis mortality prediction: An interpretable machine learning nomogram
Lulu Weng, Haidong Li, Yonglai Lv, Jiayi Luo, Zhenliang Wen, Jiawen Shi, Li Zhong
Clinics. 2026;81C: 100872
Highlights

  • A machine learning nomogram predicts in-hospital mortality in sepsis.

  • Seven clinical parameters were identified as independent mortality predictors.

  • The nomogram showed excellent discrimination with an AUC of 0.900.

  • SHAP analysis offers interpretability to the machine learning model.

  • The tool facilitates early risk stratification of high-risk patients.

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Limb remote ischemic preconditioning attenuates biomarkers of acute lung injury and inflammation during thoracoscopic lobectomy: a randomized controlled trial
Wenfu Zhang, Mingwang Zeng, Chao Yang, Lijun Yang, Juan Yang, Yi Wang, Haiyu Xie, Lifeng Wang, ... Weidong Liang
Clinics. 2026;81C: 100883
Highlights

  • Limb RIPC decreases plasma CC16, a key biomarker of lung epithelial injury.

  • RIPC attenuates systemic Inflammation (IL-6) and oxidative stress (MDA).

  • A simple, non-invasive intervention for molecular lung protection.

  • No short-term improvement in oxygenation indices was observed postoperatively.

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Validation of the GALAD model for diagnosing HBV-related hepatocellular carcinoma in Chinese patients
KeCheng Li, Fei Xia, XiaoYa Wu
Clinics. 2026;81C: 100882
Highlights

  • GALAD model shows high accuracy in diagnosing HBV-related HCC in Chinese patients.

  • GALAD outperforms AFP, AFP-L3 %, and DCP in diagnostic performance.

  • GALAD is a cost-effective tool for HCC screening in HBV-endemic and in resource-limited regions.

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Prevalence and related factors of irritable bowel syndrome in women with chronic pelvic pain
João Nogueira Neto, Kamilly Ieda Silva Veigas, Lyvia Maria Rodrigues de Sousa Gomes, Leonardo Carvalho Silva, Júlio Cesar Rosa e Silva, Plínio da Cunha Leal
Clinics. 2026;81C: 100884
Highlights

  • Study found 53.15% prevalence of IBS in women with Chronic Pelvic Pain (CPP).

  • No significant differences in sociodemographic factors between IBS and non-IBS patients.

  • IBS patients had higher rates of myofascial pain, neuropathic pain, and sensitization.

  • Multiple assessment tools were used, including the Rome IV criteria for IBS diagnosis.

  • Results highlight the link between IBS and chronic pelvic pain, necessitating better care.

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Resveratrol protects against isoflurane-induced testicular injury: a stereological and molecular study in mice
Zahra Mohammadi, Sanaz Alaee, Majid Kamali-Dolat Abadi, Somayyeh Karami-Mohajeri, Zahra Khodabandeh, Saeed Shokri, Sulagna Dutta, Pallav Sengupta, Hesam Kamyab
Clinics. 2026;81C: 100878
Highlights

  • Resveratrol studied for protection against isoflurane-induced testicular damage.

  • Sixty C57BL/6 mice were divided into control, isoflurane, and resveratrol groups.

  • Isoflurane reduced testicular volume, tubular structures, and altered cells.

  • Resveratrol modulated apoptotic markers and boosted antioxidant gene expression.

  • Resveratrol shows potential in preventing isoflurane-induced testicular toxicity.

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Short-term effects of a 12-week Zumba program on thyroid and cardiometabolic markers in overweight/obese postmenopausal women: A randomized pilot study
Hanen Saadouni, Okba Selmi, Nejmeddine Ouerghi, Hamza Marzouki, Soukaina Hattabi, Lamia Attig, Katja Weiss, Thomas Rosemann, ... Anissa Bouassida
Clinics. 2026;81C: 100880
Highlights

  • Zumba lowers TSH and triglycerides in postmenopausal obese women.

  • Zumba improves body composition and blood pressure after menopause.

  • Zumba is a non-drug strategy to boost postmenopausal women's health.

  • Dance-based training helps regulate thyroid and lipid levels postmenopause.

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Low prevalence of GCK gene mutations in Chinese patients with gestational diabetes mellitus
Zhixin Wang, Lili Huo, Ling Lan, Yongzeng Chen, Qingyao Zuo, Wei Deng
Clinics. 2026;81C: 100889
Highlights

  • Screened 177 Chinese GDM women (FBG ≥5.1 mmoL/L) for GCK variants.

  • Identified 8 rare GCK variants in 9 individuals (1.9 % prevalence).

  • No confirmed GCK-MODY cases found among variant carriers.

  • Limited utility of FBG-based GCK-MODY screening in Chinese GDM.

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Short-term outcome of totally laparoscopic gastrectomy for gastric cancer: a comparative study
Liu Liu, Shijie Feng, Haiyan Wang, Lin Liu
Clinics. 2026;81C: 100887
Highlights

  • Totally Laparoscopic Gastrectomy (TLG) has been used for the treatment of gastric cancer.

  • Compared with Laparoscopy-Assisted Gastrectomy (LAG), TLG has a shorter operative time and less intraoperative blood loss.

  • TLG contributes to faster recovery and shorter time of hospitalization than LAG.

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Correlation study on different types of chronic sinusitis and eustachian tube dysfunction: analysis of prevalence and risk factors
Qihang Zhang, Qianjin Zeng, Jingtao Wang, Fu Feng, Guangke Wang
Clinics. 2026;81C: 100890
Highlights

  • Eustachian tube dysfunction prevalence does not differ across chronic sinusitis subtypes.

  • Serum IgE levels correlate with eustachian tube dysfunction in CRSwNP.

  • Total IgE and age correlate with ETD in EosCRSwNP, IgE as a risk factor.

  • ET function assessment shows moderate-good consistency between ETDQ-7 and ETS results.

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A cross-sectional analysis of all vena cava filter placement over 9-years in Brazil: trends and mortality rates in a population of over 200 million
Clara Sanches Bueno, Hedra Marques Santos, Júlia Freire Castanheira, Bruno Jeronimo Ponte, Felipe Soares Oliveira Portela, Marcelo Fiorelli Alexandrino da Silva, Marcelo Passos Teivelis, Alexandre Fioranelli, Nelson Wolosker
Clinics. 2026;81C: 100874
Highlights

  • The private sector performs the majority of procedures despite serving a minority of the population.

  • National procedure volume more than doubled (140% increase) in almost a decade.

  • The Southeast region is responsible for 70% of all private procedures.

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Systematic review of the efficacy and safety of lenvatinib vs. sorafenib as first-line treatments for hepatocellular carcinoma
Wentao Bo, Zhenguo Wang, Xiuhua Dong, Jing Zou
Clinics. 2026;81C: 100869
Highlights

  • Lenvatinib was associated with a higher incidence of ascites and bilirubin elevation, highlighting the need for vigilant liver function monitoring.

  • Lenvatinib’s inhibition of VEGFR, FGFR, and PDGFR pathways contributes to its superior anti-angiogenic and anti-proliferative effects.

  • Preclinical evidence suggests lenvatinib may synergize with immunotherapy by modifying the tumor microenvironment, offering novel therapeutic avenues.

  • Economic analyses indicate lenvatinib is more cost-effective than sorafenib, supporting its adoption in resource-limited settings.

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Moderate and vigorous aerobic exercise enhances inhibitory control, but not working memory or cognitive flexibility, up to the second ventilatory threshold: a randomized crossover trial
Marcelo Hiro Akiyoshi Ichige, Paulo Roberto Santos-Silva, Julia Maria D’Andrea Greve
Clinics. 2026;81C: 100896
Highlights

  • Executive functions components behave differently during aerobic exercise.

  • Inhibitory control improves during moderate and vigorous exercise.

  • No effect of moderate or vigorous exercise on working memory or cognitive flexibility.

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Effect of Δ9-tetrahydrocannabinol and cannabidiol on myofascial pain modulation in patients with temporomandibular disorder: a prospective crossover study
Francisco Gomes Bonetto Schinko, Luiz Renato Paranhos, Lucas Gonçalves de Sousa, Gabriel Phelipe de Paula Santos, Sigmar de Mello Rode, Antonio Sergio Guimarães, Juliana Cama Ramacciato
Clinics. 2026;81C: 100885
Highlights

  • Δ9-THC/CBD reduced TMD pain from 7.35 to 3.50 on the VAS scale.

  • Functional gain: mouth opening increased from 45.9 mm to 49.9 mm.

  • Significant improvement in mandibular protrusion and laterality.

  • ∼90 % reduction in functional pain; allodynia and hyperalgesia nearly absent.

  • Superior analgesic effect vs. placebo, with large effect size (d > 0.8).

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Elective single embryo transfer in in vitro fertilization cycles with or without preimplantation genetic testing using next-generation sequencing: A randomized clinical trial
Pedro Felipe Magalhães Peregrino, Carlos Augusto Z. Nissel, Patricia Florido, Mayara Satiko Nakano, Marcos de Lorenzo Messina, José Maria Soares Júnior, Edmund Chada Baracat, Pedro Augusto Araujo Monteleone
Clinics. 2026;81C: 100870
Highlights

  • Infertility affects around 15 % of couples around the world.

  • The quality of eggs and the chances of pregnancy in IVF treatment decrease with maternal age.

  • Preimplantation genetic diagnosis can help select euploid embryos for embryo transfer.

  • The indication of preimplantation genetic diagnosis in IVF treatment does not seem to reduce treatment costs.

  • Preimplantation genetic diagnosis does not seem to ALTER miscarriage or pregnancy rates in good prognosis fertile couples.

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Risk factors associated with mortality among patients with COVID-19 in the intensive care unit: prospective cohort study from the early pandemic phase in Brazil
Brena Ramos Athaydes, Mariane Vedovatti Monfardini, Priscila Marinho Abreu, Frederico Firme Figueira, Juliana Couto-Vieira, Roberta Ferreira Ventura Mendes, Rahyza Inacio Freire de Assis, Luiz Felipe Camporez, ... Sandra Ventorin von Zeidler
Clinics. 2026;81C: 100894
Highlights

  • Elevated serum creatinine at ICU admission independently predicted in-hospital mortality.

  • Viral load correlated with disease severity but was not an independent predictor after adjustment.

  • Advanced age and chronic respiratory disease were associated with reduced survival.

  • Non-survivors showed higher D-dimer, leukocyte counts, and greater multiorgan dysfunction.

  • This study provides a historical record of early COVID-19 mortality in a Brazilian ICU.

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The influence of sex steroids on cognition in elderly men
Carolina C.B. Caetano, Sami Liberman, Jéssica M.L. Ie, Valmari C.A. Toscano, Wilson Jacob, Tânia A.S.S. Bachega
Clinics. 2026;81C: 100892
Highlights

  • Education years predicted global cognitive performance in older men.

  • Serum testosterone levels inversely correlated with depression scores.

  • Higher BMI was associated with lower MMSE scores in bivariate analysis.

  • BMI was negatively correlated with serum testosterone levels.

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High prevalence of endometriosis in women with chronic pelvic pain and confirmed pelvic varicosities: a multiparametric MRI study
Mira Zlotnik, Marcos de Lorenzo Messina, Thiago Dieb Ristum Vieira, Vinicius Bertoldi, Andrei Skromov de Albuquerque, Pedro Puech-Leão, Edmund Chada Baracat
Clinics. 2026;81C: 100895
Highlights

  • Endometriosis was found in 61.5 % of women with chronic pelvic pain and confirmed pelvic varicosities.

  • Multiparametric MRI allows non-invasive, simultaneous detection of vascular and gynecological abnormalities.

  • Integrated imaging may improve diagnostic workup in women with chronic pelvic pain.

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Inequalities in mammograms and cervical biopsies provision in the public and private sectors of the Brazilian healthcare system and the availability of gynecology and obstetrics specialists
Ivan Wilson Hossni Dias, Edmund Chada Baracat, Alicia Matijasevich, César Eduardo Fernandes, Cristiane de Jesus Almeida, Paola Soledad Mosquera, Mário César Scheffer
Clinics. 2026;81C: 100876
Highlights

  • Gynecologist and obstetrician availability in Brazil shows significant inequalities.

  • Mammography and cervical biopsy service provision shows significant inequalities.

  • These inequalities exist across regions and between the public and private sectors.

  • The inequalities create barriers to breast and cervical cancer diagnosis.

  • The inequalities lead to increased health inequities in North and Northeast Brazil.

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Body composition paradox: high muscle mass and adiposity jointly predict incident chronic kidney disease in a Korean cohort
Eun Young Lee, Choon Hee Chung, Tae Hwa Go, Sang Baek Koh, Jung Ran Choi
Clinics. 2026;81C: 100879
Highlights

  • First large cohort study to identify high muscle mass as a novel and independent risk factor for incident CKD.

  • Reveals a body composition paradox: both high adiposity and high muscle mass increase CKD risk.

  • Gender-specific adipokine roles: Leptin (women) is a stronger predictor than adiponectin.

  • Metabolic syndrome confers a 5-fold higher risk of developing CKD over 10-years.

  • Findings challenge the traditional focus solely on fat and highlight muscle mass as a key prognostic factor.

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