Purpose Parosmia is a condition associated with a significant impact on quality of life. Although its pathophysiology remains poorly understood, certain aromas and fragrances are frequently reported as triggers. This study aimed to identify the primary triggers of parosmia and analyze their molecular similarities. Methods This cross-sectional study included individuals with current complaints of parosmia. Data were prospectively collected via an online survey that assessed the most commonly reported triggers and associated perceptions. A perfumer analyzed the molecular characteristics of these substances. Results A total of 102 individuals with parosmia were included. The most frequently reported triggers were onion (68%), garlic (62.9%), coffee (49.5%), and beef (48.5%). These substances share sulfur-containing, nitrogenous, and thioester components, characterized by high olfactory potency and sensory notes described as "rotten," "sulfurous," and "roasted/burnt." The most associated perceptions were sewage (71%) and burnt (37.6%). Conclusion The primary triggers of parosmia appear to share significant molecular similarities. This knowledge may contribute to a better understanding of the pathophysiology of parosmia and serve as a preliminary step toward developing new therapeutic approaches for this disorder.
Background: Platelet-rich plasma (PRP) is frequently used in sports medicine to treat muscle injuries; however, the clinical evidence remains inconsistent and fragmented. Purpose: To assess whether PRP therapy improves clinical outcomes, particularly return to sport (RTS) and reinjury rate, compared with conventional treatments for acute muscle injuries. Study Design: Systematic review and meta-analysis; Level of evidence, 2. Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic search of PubMed, Embase, BVS, and Scopus was conducted through April 2025 for systematic reviews, with or without meta-analysis, to evaluate PRP for acute muscle injuries in athletes. A total of 1464 manuscripts were identified through the initial search. Main outcomes included RTS, reinjury rate, pain, and complications. Methodological quality was assessed using the Risk of Bias in Systematic Reviews (ROBIS) tool, and the certainty of the evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Meta-analyses were performed using random-effects models with Hartung-Knapp-Sidik-Jonkman adjustments. Results: Eight systematic reviews were included. PRP significantly reduced reinjury risk compared with controls (risk ratio, 0.84 [95% CI, 0.76 to 0.92]; I 2 = 0%), with high-certainty evidence. A reduction in RTS time favored PRP (mean difference, –4.43 days [95% CI, –9.28 to 0.42); however, it did not reach statistical significance (low-certainty evidence). Narrative synthesis suggested inconsistent short-term pain relief and low complication rates, but evidence certainty was rated very low to low due to methodological and reporting limitations. Conclusion: Our review study demonstrated that PRP may reduce muscular reinjury rates and potentially accelerate RTS, although benefits on pain and safety remain uncertain. Current evidence supports the selective use of PRP in sports settings; however, standardization in protocols and outcomes is needed. These findings may assist clinicians in individualizing treatment strategies involving PRP for acute muscle injuries, particularly in high-performance athletes at risk of recurrence. Registration: CRD42021279300.
Metabolic and bariatric surgery (MBS) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are both effective strategies for obesity management, but their comparative efficacy remains uncertain. This systematic review and meta-analysis aimed to compare weight loss outcomes between MBS and GLP-1 RA therapy in adults with obesity. A systematic search of PubMed, Scopus, and Cochrane Library was conducted from inception to September 22, 2025. Eligible studies included randomized and observational comparisons between MBS—specifically sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB)—and GLP-1 RA therapy in adults with obesity. Pooled mean differences (MDs) for total weight loss (TWL) and body mass index (BMI) change were calculated using a DerSimonian–Laird random-effects model. Risk of bias was assessed using ROBINS-I V2, and certainty of evidence was graded with GRADE. Five retrospective observational studies (n = 5,944; 3,489 MBS, 2,455 GLP-1 RA) met the inclusion criteria. Pooled analysis showed significantly greater TWL in the MBS group (MD − 18.15
Introduction: Multidrug-resistant (MDR) Staphylococcus spp. and Enterococcus spp. are pathogens frequently identified in fracture-related infections (FRI), and may be associated with unfavorable outcomes. This study aims to evaluate the prevalence, the susceptibility profile to beta-lactams, and the presence of resistance genes in these pathogens from patients included in the multicenter FRIDAY project (Fracture-Related Infection Clinical and Microbiological Data Analysis Study). Methods: Microorganisms previously isolated in conventional culture media, originating from eleven Brazilian hospitals, were identified at the Laboratório Especial de Microbiologia Clínica (LEMC-UNIFESP) by mass spectrometry (MALDI-TOF MS). Isolates with a phenotypic resistance profile to beta-lactams were submitted to DNA extraction from colony-forming units (CFU) in broth and analyzed by conventional single PCR for detection of the genes mecA, vanA and vanB, with subsequent agarose gel electrophoresis. Results: Among the 202 patients evaluated and 312 microorganisms identified, Gram-positive bacteria were found in 186 isolates (59.6%). Among the total pathogens identified, Staphylococcus spp. accounted for 152 (48.7%) and Enterococcus spp. 19 (6.1%). Of the 85 Staphylococcus spp. isolates, the mecA gene was detected in 44 (51.8%), and 36 of these also proved resistant to cefoxitin in the phenotypic test, representing a genotype–phenotype concordance rate of 81.8%. Among the 41 isolates negative for mecA, 37 were also susceptible to cefoxitin. For Enterococcus spp., 13 isolates were tested for vanA and vanB, with three (23.1%) positive for vanA and none with detection of vanB. Conclusion: There was high genotype–phenotype concordance using conventional PCR in the detection of the mecA gene in Staphylococcus spp. and the vanA gene in Enterococcus spp. The data reinforce the relevance of molecular analyses in the genotypic characterization of the resistance profile, providing support for rapid diagnosis and for earlier guidance of antimicrobial therapies in complex orthopedic infections, contributing to more assertive clinical decisions in high-complexity services.
Background: Postoperative spine infection (PSI) is a major complication of spinal arthrodesis, associated with substantial morbidity and healthcare burden. Evidence remains fragmented, with limited multivariable analyses and scarce South American data. This study evaluated PSI incidence, characteristics, management, outcomes, and factors associated with infection and treatment failure in a tertiary-care hospital. Methods: This single-centre retrospective cohort included patients undergoing spinal arthrodesis from January 2018 to December 2023. PSI was defined according to adapted European Bone and Joint Infection Society criteria. Bivariate and exploratory multivariable analyses evaluated factors associated with PSI and treatment failure. Results: Among 150 patients, 30 (20.0%) developed PSI, predominantly early infections (96.7%). Microbiological identification was achieved in 56.7% of cases. Staphylococcus aureus was the most frequently isolated pathogen (47.1%), while Gram-negative bacilli constituted the main aetiological group (58.8%). In multivariable analysis, alcohol consumption (odds ratio [OR] 3.29, 95% confidence interval [CI] 1.11–9.71) and body mass index ≥25 kg/m² (OR 3.89, 95% CI 1.42–10.69) were associated with increased odds of PSI, while non–β-lactam prophylaxis showed lower odds (OR 0.35, 95% CI 0.14–0.92). Treatment failure occurred in 36.7% and was associated with late infection, persistent pain, reinterventions, and plastic wound reconstruction. Conclusions: PSI showed high incidence and severity, with substantial Gram-negative bacilli contribution. Body mass index ≥25 kg/m², alcohol consumption and antimicrobial prophylaxis strategy were factors associated with PSI, supporting tailored prevention based on local epidemiology.
