Hospital São Vicente de Paulo

Foot drop syndrome is defined as the inability to perform ankle dorsiflexion and is most commonly caused by compressive neuropathy of the common fibular nerve. Although several etiologies may be implicated—such as trauma, prolonged limb positioning, and neoplasms—compression by synovial cysts represents a rare and underreported cause, particularly when located at the proximal tibiofibular joint. We report the case of a young, previously healthy female patient who presented with lateral leg pain and progressive motor deficit, ultimately evolving into complete dorsiflexion paralysis. Electroneuromyography revealed a severe lesion of the common fibular nerve. Despite the absence of abnormalities on magnetic resonance imaging, surgical exploration identified a synovial cyst infiltrating the nerve. Complete excision of the lesion, including the articular pedicle, was performed and confirmed through histopathological analysis. Postoperative management included intensive motor rehabilitation, with satisfactory functional recovery observed over a five-month period. This case highlights the importance of early diagnosis and high clinical suspicion in patients presenting with acute lower limb weakness, as well as the need for prompt surgical intervention to prevent permanent neurological sequelae.

O acidente vascular cerebral (AVC) é a primeira causa de morte entre as doenças crônicas não transmissíveis no Brasil, sendo a segunda causa de incapacidade funcional no mundo. Diante disso, ações que visam mudar este cenário nas diferentes esferas de atenção à saúde e ao AVC são cruciais. Por isso, as Jornadas de Atenção ao AVC têm o objetivo de mesclar ações de educação em e para a saúde, para diferentes populações, primando o objetivo de conscientizar sobre os diferentes níveis de cuidado e atenção ao AVC. Aqui, relata-se sobre os principais eixos desenvolvidos e públicos envolvidos, assim como, os resultados obtidos durante os quatro (04) anos de ação de ensino, pesquisa e extensão vinculados a Jornada. Ações educativas durante todas as jornadas levaram a construção e desconstrução do saber, que juntas, estas duas ações ativas levam e levaram a congruência entre o saber e disseminação de informações sobre saúde e a doença AVC. Medidas e estratégias como esta visam mudar o cenário da rota de atendimento do paciente com AVC, elevando o número de pessoas recuperadas e diminuindo a carga de sequelas dos afetados. Palavras–chave: acidente vascular cerebral; educação em saúde; atenção a saúde; educação para a saúde.

Abstract Dengue fever, caused by the dengue virus (DENV), is the most important mosquito-borne disease impacting human health globally, it is particularly prevalent in tropical regions whereAedesvectors thrive. However, due to a recent expansion of the main dengue vectors to subtropical and temperate zones in the last decades there is an increasing human population at risk. Brazil is a global hotspot for dengue, accounting for 70% of all dengue cases reported worldwide in 2024. Noteworthy, dengue became endemic even in the southernmost Brazilian state of Rio Grande do Sul, which until recently had only imported cases. In this study, we integrated entomological, epidemiological, and high-resolution genomic data to investigate DENV transmission dynamics in Southern Brazil over nine years. From 2015 to 2023, we detected a partial to full invasion of the state municipalities byAedes aegypti, with dengue cases increasing substantially from 2020 onwards. The suitability index for transmission effectively predict the intensity of the outbreaks in the region, providing a two-month lead time before the surge in cases, representing an interesting proxy to forecast the outbreak size in the next few years. Invaded municipalities that surpassed a given case incidence level also increased, and by 2023, nearly half of the municipalities of the state surpassed that threshold, suggesting that dengue became endemic in the region. By analyzing 665 newly generated DENV genomes, we observed persistent overwintering lineages driving seasonal outbreaks, with the Northwest and Metropolitan regions serving as the main transmission hubs for dengue spread in the state. These regions were also the first to experience the endemic establishment of dengue lineages, making them key areas for targeted control efforts to mitigate further local outbreaks and the virus spread to other regions. These findings underscore the expansion of DENV-affected areas and increasing outbreaks into temperate zones, likely driven by the spread of the vector, associated with increased infestation level of the vector and widespread viral transmission in an immunologically naive population. In this context, enhanced control efforts are critical to mitigate the dengue burden in previously non-endemic areas.

861 Background: This study aimed to characterize and compare the profiles of inflammatory and immune responses (IFN-γ, CX3CR1, iNOS, PD-L1, CTLA-4, CD163, FOXP3), monoamine oxidases (MAO-A and MAO-B), and the expression of HABP4 (hyaluronan-binding protein 4) and SERBP1 (Serpine1 mRNA-binding protein 1) in bladder tissue samples from patients with initial non-muscle-invasive bladder cancer (NMIBC), BCG-unresponsive NMIBC, and muscle-invasive bladder cancer (MIBC). Additionally, we aimed to provide an overview of the involvement of these factors and their signaling pathways in the tumor microenvironment (TME) of bladder cancer (BC). Methods: A total of 60 formalin-fixed, paraffin-embedded bladder cancer samples were obtained from patients diagnosed with BC at the Paulínia Municipal Hospital and São Vicente de Paulo Charity Hospital, Brazil. The samples were classified into three groups (n= 20 samples per group): Group 1 – initial NMIBC, Group 2 – BCG-unresponsive NMIBC, and Group 3 – MIBC. Immunohistochemical analysis was performed to evaluate the expression of target markers. Results: MAO-A immunoreactivity was significantly elevated (p<0.05) in Groups 1 and 2 compared to Group 3. In contrast, MAO-B expression was significantly higher (p<0.05) in Groups 2 and 3 compared to Group 1. These findings suggest that MAO-A serves as a potential biomarker for superficial disease, whereas MAO-B may be associated with disease progression. Elevated levels of CTLA-4 and PD-L1 were observed in Group 1 relative to Groups 2 and 3 (p<0.05), indicating that BCG treatment reduces their immunoreactivity in both BCG-unresponsive NMIBC and MIBC phenotypes, thereby modulating the TME. Additionally, immunoreactivities of CD163 and FOXP3 were significantly increased (p<0.05) in Group 2, followed by Group 3, implying that FOXP3 + regulatory T cells and CD163 + M2 macrophages contribute to BCG treatment failure and tumor progression. Conversely, IFN-γ, CX3CR1, and iNOS expression were significantly elevated (p<0.05) in Group 1, indicating that a heightened infiltration of CX3CR1 + cells and iNOS + M1 macrophages creates a cytotoxic microenvironment more responsive to immunotherapeutic interventions. This study represents the first report of HABP4 and SERBP1 immunoreactivities in BC. SERBP1 expression was significantly higher (p<0.05) in Groups 2 and 3, linking its overexpression to tumor progression. In contrast, HABP4 expression was significantly elevated (p<0.05) in Group 1 compared to Groups 2 and 3, supporting its role in inhibiting cell proliferation. Conclusions: These findings suggest that analyzing markers such as MAO-A, MAO-B, HABP4, and SERBP1 can improve risk stratification, prognosis, and personalized therapies for BC patients, particularly in the context of immunotherapies. Identifying specific profiles in the TME can guide more effective, tailored treatments and enhance clinical outcomes.

Resumo: Este texto provém de partes dos resultados da pesquisa de doutoramento que resultou na tese Resistências malungas: agências sociopolíticas das mulheres quilombolas de Salvaterra, Arquipélago do Marajó, Pará. Assim, trazemos reflexões entretecidas com 22 mulheres malungas e coautoras da pesquisa, durante a escrevivência plurivocal e afrocentrada do estudo. Porém, a análise detém-se apenas na trajetória de vida de quatro “Marias”: Tia Conci, Zeca, Tia Noca e Páscoa, enfocando nossas ações e práticas enquanto ativistas quilombolas de Salvaterra, Pará. Concluímos o texto destacando a existência de uma agência e resistência malunga frente aos desafios impostos pela luta em defesa do território de existência do povo quilombola salvaterrense, concretizada em ações enquanto Cuidadoras e Guardiãs da Vida, atuando em áreas como educação, saúde, meio ambiente, economia, política, história social e cultura. São vozes-potências criadoras e recriadoras de mundos, engendradoras de resistências malungas cotidianas diante dos obstáculos as nossas vidas-liberdades.

BackgroundThis study aimed at describing the demographic and clinical characteristics, treatment patterns and overall survival of patients with MM in Brazil to identify gaps in the disease diagnosis and treatment. MethodsMMyBRAve (NCT03506386) was a multicenter, observational study of patients diagnosed with MM in Brazil between January 2008 and December 2016, with data collection between August 2018 and September 2019 at 17 participating centers. ResultsOf 943 patients included, 914 had complete data for overall survival (OS) analysis. The most used frontline regimens were cyclophosphamide, thalidomide and dexamethasone; bortezomib, cyclophosphamide and dexamethasone; and thalidomide and dexamethasone. After a median follow-up of 63 months, the median OS from diagnosis was 70 months. These results indicate continuous improvements in comparison with previous observational studies from Brazil. The median OS in transplantation-ineligible (N = 491) and eligible (N = 452) patients were 49 and 93 months, respectively (hazard ratio [HR] = 0.52; 95% confidence interval [CI], 0.43 to 0.63; P < .001). The median OS also differed between patients with and without known prognostic factors. ConclusionDespite the improvements, our results suggest that access to novel agents and transplantation continue to hinder further progress in patient outcomes in Brazil and countries with similar health-care constraints.