Mauro de Deus Passos

This search strategy was designed for a comprehensive review investigating the diagnostic applications and clinical utility of artificial intelligence integrated with medical infrared thermography. The strategy combines controlled vocabulary (MeSH terms) and text words covering infrared imaging, thermography, machine learning, deep learning, and diagnostic evaluation to retrieve relevant studies published from January 2010 to July 2026.

This search strategy was designed for a comprehensive review investigating the diagnostic applications and clinical utility of artificial intelligence integrated with medical infrared thermography. The strategy combines controlled vocabulary (MeSH terms) and text words covering infrared imaging, thermography, machine learning, deep learning, and diagnostic evaluation to retrieve relevant studies published from January 2010 to July 2026.

As urgências endocrinológicas, como a cetoacidose diabética, o estado hiperglicêmico hiperosmolar, a crise tireotóxica, o coma mixedematoso, a crise adrenal e a apoplexia hipofisária, são condições potencialmente fatais que exigem reconhecimento rápido e manejo hospitalar qualificado. Este estudo teve como objetivo mapear as evidências recentes sobre diagnóstico diferencial, manejo hospitalar e prevenção de complicações sistêmicas nessas condições em adultos. Trata-se de revisão de escopo conduzida segundo o método do Joanna Briggs Institute e o checklist PRISMA-ScR, com busca em outubro de 2026 na PubMed/MEDLINE e na Biblioteca Virtual em Saúde (LILACS e BDENF), abrangendo publicações de 2026. Dos 873 registros identificados, 17 estudos primários foram incluídos, de 13 países, com predomínio de coortes retrospectivas. As crises hiperglicêmicas concentraram a maior parte das evidências. Os achados indicaram que o atraso diagnóstico se associou a maior necessidade de suporte intensivo, que escores clínicos e biomarcadores simples auxiliam a estratificação de risco e que choque, sepse, lesão renal aguda, doença cardiovascular e infecções concomitantes determinaram a mortalidade. Conclui-se que protocolos individualizados, vigilância metabólica e estratégias de prevenção baseadas em educação e continuidade do cuidado são centrais para reduzir complicações.

BACKGROUND Perioperative hyperglycemia is a common metabolic response to surgical stress and has been shown to be associated with adverse outcomes after cardiac surgery. However, the optimal glycemic target in this setting remains uncertain, since both hyperglycemia and hypoglycemia can be harmful. This study aimed to evaluate the association between perioperative glucose levels and postoperative infection and in-hospital mortality in patients undergoing cardiac surgery at a tertiary cardiovascular center. MATERIAL AND METHODS This study included consecutive adult patients who underwent elective or emergency cardiac surgery between January 2021 and December 2022 at a tertiary cardiovascular center in Brazil. Perioperative glycemic exposure was defined using all glucose measurements recorded from anesthesia induction until hospital discharge or in-hospital death. Compliance with the blood glucose target (BGT) was defined as values within 70 to 180 mg/dL in ≥70% of measurements. Hypoglycemia and hyperglycemia were defined as at least 1 glucose measurement 180 mg/dL, respectively. Primary outcomes were postoperative infection and in-hospital mortality. Multivariable logistic regression was used to identify independent associations. RESULTS A total of 157 patients were included (mean age 59.7±13.0 years). Postoperative infection occurred in 59.9% (n=94), and in-hospital mortality occurred in 8.9% (n=14). BGT compliance was observed in 78.3% of patients. Hypoglycemia occurred in 31.8%, and hyperglycemia in 82.8%. BGT compliance was independently associated with lower in-hospital mortality (OR 0.10, 95% CI 0.02-0.59; P=0.011). At least one episode of hyperglycemia was independently associated with postoperative infection (OR 3.77, 95% CI 1.38-10.35; P=0.010). CONCLUSIONS Perioperative glycemic patterns were associated with clinically relevant outcomes after cardiac surgery. Compliance with a moderate blood glucose target range (70-180 mg/dL) was associated with lower in-hospital mortality, whereas hyperglycemia >180 mg/dL was associated with postoperative infection. These findings should be interpreted as hypothesis-generating and need confirmation in larger prospective studies.

BACKGROUND Subclavian steal syndrome (SSS) is typically caused by atherosclerotic occlusion of the proximal subclavian artery. While atherosclerosis is the primary etiology, clinical awareness of non-atherosclerotic triggers is essential for accurate diagnosis. Non-atherosclerotic causes, such as arterial kinking, are exceedingly rare and are frequently overlooked in the differential diagnosis of vertebrobasilar insufficiency. This report describes a case of partial SSS secondary to mechanical kinking of the brachiocephalic trunk (BCT) in an elderly patient, emphasizing the need to consider anatomical variations even without obstructive plaques. CASE REPORT A 66-year-old woman with a history of stroke and atrial fibrillation (CHA₂DS₂-VASc score of 5) was referred for color Doppler ultrasound of the carotid and vertebral arteries. Imaging revealed Stage II (intermittent) flow reversal in the right vertebral artery, characterized by a distinctive mid-systolic deceleration pattern. Subsequent computed tomography angiography (CTA) excluded atherosclerotic disease but demonstrated a severe 90-degree angulation (kinking) at the BCT origin. This anatomical variation created a pressure gradient sufficient to induce a partial steal phenomenon. Given the patient's high thromboembolic risk and clinical stability, a conservative management approach with optimized anticoagulation and strict cardiovascular risk control was prioritized. CONCLUSIONS BCT kinking should be considered a potential hemodynamic cause of SSS when atherosclerosis is absent. This case highlights the importance of multi-modal imaging (color Doppler ultrasound and CTA) in identifying rare anatomical triggers for flow inversion. A conservative strategy is safe when flow in the basilar artery remains stable.

Non-communicable chronic diseases (NCDs), such as type 2 diabetes mellitus, represent one of the greatest challenges for public health systems, especially in contexts of social vulnerability. In low-income regions, care for these patients cannot be limited to clinical disease control; it is essential to consider the social determinants that directly influence treatment adherence, access to health services, and quality of life. In this context, a humanized approach becomes an indispensable tool in general medical practice, particularly in primary health care. The concept of humanization in care goes beyond politeness: it requires active listening, respect for the patient's individuality, and the development of a therapeutic bond that fosters mutual trust and encourages autonomy in self-care. However, several obstacles still hinder the consolidation of this practice in public health services, including professional overload, high demand, lack of material and human resources, and fragmented care. This article aims to analyze the importance of a humanized approach in managing type 2 diabetes in low-income regions, highlighting the role of the general practitioner as a key figure in this process. The discussion is based on scientific literature and field experience reports, seeking to understand how empathy, welcoming attitudes, and knowledge of the patient's sociocultural context can positively influence therapeutic outcomes. From this analysis, it is argued that humanization, even in the face of structural limitations, can be applied effectively and ethically, contributing to more comprehensive, accessible, and person-centered care.

O objetivo do estudo foi identificar e sintetizar as principais barreiras, fatores facilitadores e resultados clínicos associados à atuação de equipes interdisciplinares em serviços de urgência e emergência. Realizou-se revisão integrativa, guiada por PRISMA e estruturada em PICO, com busca nas principais bases e seleção de estudos quantitativos, qualitativos e de métodos mistos. As barreiras mais frequentes foram trabalho em silos, comunicação fragmentada, papéis indefinidos, superlotação e burnout. Como facilitadores, destacaram-se liderança efetiva com comunicação em closed loop e consciência situacional, definição clara de papéis, currículos interprofissionais com simulação e debriefing, planejamento pré-chegada e mobilização multidisciplinar, políticas institucionais e segurança psicológica. Os resultados clínicos/organizacionais incluíram maior adesão a protocolos e padronização do cuidado, redução de atrasos decisórios, qualificação das transições de cuidado, melhora de indicadores de competência em segurança do paciente e, em cenários específicos, recuperação clínica mais rápida em trauma complexo. Conclui-se que “pessoas + processos + tecnologia” constituem pacote de maior probabilidade de sucesso; recomenda-se priorizar treino de liderança, simulação interprofissional, vias clínicas com papéis definidos, governança de transições e promoção ativa de segurança psicológica para ganhos sustentáveis em qualidade e segurança assistencial.