Introduction: The new corona virus (2019-nCoV OR HCOV-19 or CoV2), has emerged in China as the main cause of viral pneumonia (COVID-19, Coronavirus Disease-19). Objective: To provide evidence-based Physiotherapy and functionality in patients with adult and pediatric COVID-19. Methods: This is an integrative literature review using the MedLine / PubMed databases, library of Latin American and Caribbean Literature in Health Sciences (LILACS) and Physiotherapy Evidence Database (PEDRo). Results: Part of the patients with covid 19 show signs of respiratory deficiency with hypoxemia, with low severity in children. Impaired functionality is also expected. Conclusion: COVID-19 causes low pulmonary compliance and important changes in lung function with hypoxemia and cardiovascular repercussions. These changes lead to the need for Physiotherapy and the management of oxygen therapy and ventilatory support (invasive and non-invasive) for these patients.
OBJECTIVE:To characterize the histopathological subtypes of basal cell carcinoma (BCC) in the lip region, emphasizing common and rare morphological features and determining the proportion of high-risk tumors at this site. STUDY DESIGN:This study analyzed histopathological records of BCCs located in the lip and labial commissure regions in 3 Brazilian dental institutions. Demographic and clinical data were collected. Histopathological evaluation was independently performed by 3 oral pathologists and 1 dermatopathologist, with consensus reached when necessary. Tumors were classified according to contemporary histopathological criteria and stratified by risk based on World Health Organization guidelines. RESULTS:Among 68 lip BCCs, the upper lip was the most frequently affected site (52.9%). The nodular subtype was the most prevalent (52.9%) and predominantly classified as low risk. However, 45.6% of tumors were considered high risk, mainly due to aggressive variants, including micronodular and sclerodermiform patterns, and mixed histological subtypes. Ulcerated lesions tended to be high risk (68.4%; P = .07). Depth of invasion (mean 1.27 mm) showed a tendency toward greater infiltration in high-risk tumors (P = .05). CONCLUSION:Lip BCCs exhibit marked histopathological heterogeneity. Although low-risk nodular tumors predominate, a substantial proportion present high-risk features, reinforcing the importance of detailed histopathological assessment.
BACKGROUND:Cutaneous squamous cell carcinoma exhibits a significant disease burden due to local relapses and metastasis. Despite advances in prognosis, little evidence exists on prognostic factors of early and late relapse, which could provide more personalized management and follow-up schedules. METHODS:We conducted a multicenter retrospective cohort study including 23,166 cases of cutaneous squamous cell carcinoma. Patients were categorized into those with early recurrence (≤4 months), late recurrence (>24 months), and no recurrence. Risk factors and tumor characteristics were analyzed to identify patterns associated with early and late relapses. RESULTS:Some risk factors show a different impact depending on the type of recurrence and its timing. Lymphovascular invasion (subdistribution hazard ratios [SHR] = 3.01) and large caliber and deep perineural invasion (SHR = 2.55) show a statistically significant association with early locorregional metastasis, losing impact with time. Poor differentiation shows impact early (SHR = 3.26) and late (SHR = 4.63), with less relevance from 4 to 24 months (SHR = 1.68). Other features keep a similar impact along the whole period. LIMITATIONS:Retrospective cohort study. CONCLUSIONS:Lymphovascular invasion and large caliber and deep perineural invasion are risk factors associated with early locorregional metastasis and should encourage nodal staging at diagnosis. Poor differentiation keeps importance beyond 24 months, and longer follow-up might be recommended in patients with this feature.
Diet quality is an important component of care for patients on peritoneal dialysis (PD), who are at risk of nutritional disturbances. Thus, we aimed to evaluate the intake of food groups among patients on PD from different regions, to compare their intake with that of the general population, and to assess factors independently associated with the consumption of these selected foods. Cross-sectional study including prevalent patients on PD from four of the five Brazilian geographic regions (QUALI-DIET-PD). Participants completed a food frequency questionnaire to assess the intake of four food groups (beans, raw vegetables, cooked vegetables, and fruits), and the prevalence of consumption ≥ 5 times per week were compared between patients across participating centers and with the general population according to the Brazilian national epidemiological surveillance system (VIGITEL). A composite Healthy Foods Score based on the frequency of consumption of four selected plant-based food groups was calculated, with higher scores indicating greater consumption of selected healthy food groups. We included 360 patients (52
Objective: Advances in endovascular technology and evolving workforce dynamics have prompted reassessment of vascular surgery training models. In Brazil, this discussion is shaped by regulatory constraints, regional disparities, and the demands of a large public health system. This review examines prerequisite-based and direct-access training pathways in the Brazilian context. Methods: A reviewwas conducted integrating regulatory documents, national workforce data, and published literature on vascular surgery education, career trajectories, and competency-based training, contextualized with international experience. Results: Prerequisite-based training provides important foundations in surgical judgment and adaptability, particularly in resource-variable environments. However, prolonged training duration has been associated with recruitment challenges. Integrated direct-access models may improve training efficiency and early specialty identity when supported by structured curricula and robust assessment. Workforce data indicate that post-training practice patterns are influenced by training structure and system-level factors. Emerging educational technologies may support standardization when implemented within coordinated frameworks. Conclusions: Context-aware, evidence-informed training strategies, developed through coordinated efforts among professional societies, academic institutions, and regulatory authorities, are essential for sustainable vascular surgery education. (JVS-Vascular Insights 2026;4:100409.)
