ABSTRACT Heart neoplasms are classified as primary or secondary, with primary tumors considered rare. Cardiac papillary fibroelastoma is the second most common benign cardiac tumor. It has distinct morphological features and carries a potential risk of embolization; therefore, surgical excision is generally recommended. The use of three-dimensional transesophageal echocardiography (3D TEE) enables improved characterization of the suspected lesion, provides a detailed anatomical assessment, and assists in intraoperative planning and management. We report the case of a patient diagnosed with a cardiac papillary fibroelastoma of the mitral valve who underwentrobotic-assisted surgery guided by 3D TEE.
ABSTRACT Objective: To compare the clinical phenotype of patients with primary antiphospholipid syndrome who have isolated lupus anticoagulant positivity versus those with triple positivity. Methods: This cross-sectional study included two cohorts from two tertiary centers in Brazil comprising patients diagnosed with primary antiphospholipid syndrome. Results: Of 313 patients, 135 were selected and divided into two groups. A total of 99 had isolated lupus anticoagulant positivity and 36 had triple positivity. Most participants were female (58.5%) and White (61.5%), with a mean age of 50.1±12.0 years and a median disease duration of 16 (12-22) years. Both groups showed similar rates of thrombosis (93.9% in the lupus anticoagulant group versus 100% in the triple positivity group, p=0.131) and obstetric events (55.8% versus 60.0%, p=0.754). Microthrombotic and non-thrombotic event rates were also comparable. Hydroxychloroquine use was higher in the triple-positive group (36.1%) than in the lupus anticoagulant group (15.2%, p=0.008). Conclusion: No more severe phenotype was observed in patients with triple positivity compared with those with isolated lupus anticoagulant positivity. The mixed ancestry and demographic composition of the Brazilian population may explain differences compared with more homogeneous populations.
ABSTRACT Objective: To assess residents’ and graduates’ perceptions of the theoretical-practical teaching and training model in Orthopedics and Traumatology residency programs in Bahia, Brazil; to determine whether the program meets educational expectations; and to suggest improvements. Methods: In this multicenter, cross-sectional observational study, a structured questionnaire was administered to 106 current and former orthopedic residents. It addressed the teaching model, workload, scientific training, and interpersonal relationships. Results: Of 106 respondents, 22 were excluded for incomplete responses, leaving 84. Overall, 77 (91.7%) recognized a need to improve residency training, yet 66 (78.6%) felt adequately prepared for professional practice on completion. Proposed improvements included expanding theoretical activities and lectures (36; 42.9%), strengthening practical training (40; 47.6%), and improving journal club article discussion sessions (48; 57.1%). Conclusion: Orthopedics and Traumatology residency programs in Bahia are generally perceived to meet residents’ theoretical and practical learning needs. Enhancing scientific output and interpersonal development may further improve training outcomes.
ABSTRACT Objective: To investigate the association between TRMT9B expression and clinicopathological features in thyroid carcinoma. Methods: TRMT9B mRNA expression was analyzed using The Cancer Genome Atlas Thyroid Cancer (TCGA-THCA) and Genotype-Tissue Expression (GTEx) datasets as well as six independent Gene Expression Omnibus (GEO) datasets. Protein-level data were obtained from The Human Protein Atlas. Associations between TRMT9B expression and clinicopathological parameters were evaluated in the TCGA cohort. Results: TRMT9B mRNA was significantly downregulated in thyroid tumors compared with normal tissues across multiple cohorts. In the TCGA cohort, lower TRMT9B expression was significantly correlated with advanced T stage, lymph node involvement, and aggressive histological variants of papillary thyroid carcinoma. Immunohistochemistry data qualitatively supported these findings: protein staining was lower in tumor samples than in healthy tissue. Conclusion: TRMT9B is downregulated in thyroid carcinoma and is associated with markers of disease progression. These findings suggest that TRMT9B plays a role in thyroid tumor biology. Further functional studies are required to clarify its mechanisms and potential clinical utility as a biomarker.
