Abstract Introduction Screening for erectile dysfunction (ED) in primary care requires simple tools, particularly where educational levels are low and multi-item instruments such as the International Index of Erectile Function (IIEF) may be impractical. Likert-type visual scales for erection hardness are widely and intuitively used, but few have been formally validated. The Erection Hardness Score (EHS; 1–4) is the most common visual scale, yet it provides only categorical, subjective grades of rigidity. The Eretometer is a 0–10 visual penile rigidity scale proposed as a continuous alternative to EHS Objective To evaluate the diagnostic accuracy, correlation, and reliability of the Eretometer as an index test, using the EHS as the reference standard. Methods We conducted a cross-sectional diagnostic accuracy study, designed and reported according to STARD recommendations, including 280 men aged 18–80 years from primary care and urology clinics. Erectile rigidity was self-assessed using the EHS (reference standard; moderate-to-severe ED = EHS ≤2) and the Eretometer (0–10 visual scale inspired by the Orgasmometer-F). Sociodemographic data and comorbidities were recorded. Spearman’s correlation and linear regression were used to evaluate the association and agreement. Receiver operating characteristic (ROC) analysis estimated area under the curve (AUC) and the optimal Eretometer cutoff for EHS ≤2. Test–retest reliability and internal consistency (Cronbach’s α) were examined in a subsample.in accordance with STARD recommendations, involving Results Median age was 54 years (interquartile range [IQR] 45–63); 62% had ≤8 years of schooling. Median EHS was 3 (IQR 2–4) and median Eretometer score 6.5 (IQR 5–8). The Eretometer correlated strongly with the EHS (ρ = 0.82; p < 0.001). For detecting EHS ≤2, the Eretometer showed an AUC of 0.94 (95% confidence interval 0.91–0.97); a cutoff of ≤5 yielded 89% sensitivity and 86% specificity. Test–retest reliability was excellent (r = 0.91), and internal consistency was high (Cronbach’s α = 0.88). Conclusions The Eretometer showed strong correlation and diagnostic agreement with the EHS and appears to be a valid, reliable visual tool for assessing penile rigidity. Its continuous 0–10 format offers finer discrimination of erectile function than categorical scales and may be particularly useful for ED screening and counseling in settings with low literacy, while remaining applicable to broader male populations. It demonstrated a strong correlation and diagnostic agreement with the EHS, indicating it to be a valid and Disclosure No
INTRODUCTION:The Brazilian Society of Surgical Oncology (SBCO) developed national guidelines for the rational use of blood concentrates in surgical procedures. METHODS:Between June and December 2024, a multidisciplinary team of 42 experts formulated 48 key questions on the rational use of blood concentrates in surgery. The guidelines were structured in three phases: preoperative, intraoperative, and postoperative. Expert groups performed literature reviews and proposed preliminary recommendations, which were later refined by the coordinators. An adapted grading system was used to assess the level of evidence, and an online voting process determined consensus among experts. CONCLUSION:Implementing a bloodless surgery protocol requires a meticulous and coordinated approach across multiple medical disciplines. Essential elements for success include patient and staff education, comprehensive preparation, and the use of advanced surgical techniques and technologies to optimize outcomes.
Antiretroviral therapy suppresses HIV replication, but 10–40
Objetivo: Analisar a presença da transgeneridade nos relatórios finais das Conferências Nacionais de Saúde realizadas entre 2003 e 2023. Metodologia: Trata-se de um estudo descritivo de cunho histórico, do tipo análise documental, com abordagem qualitativa. Resultados: Foram encontradas quarenta e sete menções à saúde da população LGBTQIAPN+, com enfoque na comunidade trans, nos relatórios finais da décima segunda, décima terceira, décima quarta, décima quinta, décima sexta e décima sétima Conferências Nacionais de Saúde. O relatório final da 17ª Conferência foi o que apresentou o maior número de citações sobre a comunidade em estudo, sendo trinta e quatro menções no total. Compreende-se que as Conferências Nacionais de Saúde que ocorreram entre os anos de 2003 e 2023 podem ser agrupadas em duas vertentes de análise: (i) aquelas que ocorreram anteriormente à postulação da Política Nacional de Saúde Integral da População LGBT e (ii) as que aconteceram após a implementação da referida política. Os relatórios das conferências que ocorreram antes da política apresentaram estigmatização, superficialidade, mas também uma luta pela legitimação da comunidade LGBTQIAPN+. Já os relatórios após a implantação da política de saúde apresentam maior atenção às especificidades da população trans, embora ainda seja uma abordagem tímida. Conclusão: Evidenciou-se a invisibilização da população trans ao aglutiná-la em uma sigla, sem considerar individualidades e particularidades, sendo possível identificar o baixo comprometimento com a educação permanente dos profissionais de saúde e a pouca representatividade dos sujeitos trans nos espaços de controle social do Sistema Único de Saúde. Recebido: 14/01/2026 | Revisado: 30/03/2026 | Aprovado: 06/04/2026
Background SARS-CoV-2 infection during pregnancy and preeclampsia has been associated with adverse maternal and neonatal outcomes. The modulation of the typical physiological immune response during pregnancy in patients with COVID-19 and the increased complexity associated with preeclampsia are not yet fully understood. We investigated the expression/levels of inflammatory/immunoregulatory molecules at the systemic level and at the maternal‒fetal interface of the placenta in pregnant women infected with COVID-19, with or without preeclampsia. Methods We evaluated 113 pregnant women, 45 of whom had COVID-19 without preeclampsia (C-NPE), 44 of whom had preeclampsia without COVID-19 (NC-PE), and 24 had COVID-19 and preeclampsia (C-PE). circulating levels of 35 immunological mediators. Placental samples were analyzed for the detection of the spike (S) protein, the ACE-2 receptor, and regulatory immune molecules.In the placenta, the type of lesion, presence of the spike (S) protein, and expression of ACE-2, HLA-G, PD-1, PDL-1, CD28, and CTLA-4 were investigated. Results The main results include the following: 1) a significant increase in the circulating levels of IL-12, HGF, IL-4, and IFN-α in groups with preeclampsia, regardless of SARS-CoV-2 infection0 2) the association between placental lesions and the presence of the S protein was greater in the PE-C group; 3) decreased PD-L1 expression on the maternal side of the placenta was associated with the severity of the lesion and the disease; 4) PD-L1 expression was more frequent on the fetal side of the placenta; 5) the risk to newborns was associated with increased CD28 expression on the fetal side of the placenta; and 6) pregnant women with preeclampsia infected with SARS-CoV-2 presented a reduced expression of CTLA-4 and PD-1, associated with increased expression of CD28, which may contribute to a more effective cellular response against the infectious agent. They also exhibited increased expression of placental HLA-G, whose inhibitory effect on different immune cells minimizes the cytotoxic effect on the placenta and fetal rejection. Conclusions Immunological homeostasis in the placenta is crucial for fighting the virus and maintaining pregnancy; the results presented here explain, at least in part, the less severe presentation of COVID-19 in pregnant women with preeclampsia than in those with COVID-19 alone.
