Cancer is the abnormal proliferation of physiologically inadequate cells. Studies have identified the cardiac pacemaker pocket as a site of rare neoplasms. To evaluate the clinical outcomes, treatment, prognosis, and individualized management of tumors originating in the cardiac pacemaker pocket, a systematic review was conducted using case reports and case series available in the PubMed/Medline, Science Direct, Cochrane Central, LILACS, and Scientific Electronic Library Online (Scielo) databases. Pacemaker pocket tumors affected patients with a mean age of 72.9 years, with a higher incidence in males (76.9%, n = 10). The average time for neoplasm development was 4.4 years (54.07 months). The most prevalent model was Medtronic (38.4%, n = 5), with titanium (83.3%) being the most common metal composition. Chemotherapy was the most performed procedure among patients (38.4%), followed by radiation therapy (38.4%) and surgical tumor resection (30.7%). Six analyzed cases (46.1%) resulted in death, and four patients (30.7%) achieved a cure. Patients with pacemakers should be routinely evaluated for the occurrence of malignant tumors at the site of device implantation.

Background/Objectives: Although oxytocin administration is recommended for delayed labor progress, there is no consensus over the preferred optimal dose of oxytocin. We aimed to perform a meta-analysis of pregnancy outcomes comparing high-dose versus low-dose oxytocin regimens for augmentation of delayed labor. Methods: PubMed, Embase, and Cochrane databases were systematically searched for studies comparing high-dose with low-dose oxytocin for labor augmentation from inception up to May 2023. The outcomes assessed were cesarean rate, instrumental delivery rate, postpartum hemorrhage, neonatal death, and uterine tachysystole. Subgroup analysis was performed with randomized controlled trials (RCTs) and propensity-matched studies. Statistical analysis was performed using Rstudio. Heterogeneity was assessed with I² statistics, and a random-risk effect was used if I² > 50%. Results: Twenty-one studies met inclusion criteria, and eighteen were RCTs. A total of 14.834 patients were included, of whom 7.921 (53.3%) received high-dose and 6.913 (46.6%) received low-dose oxytocin during labor augmentation. No statistical differences were found in cesarean delivery, neonatal mortality, postpartum hemorrhage and vaginal instrumentation rate. However, uterine tachysystole incidence was significantly higher with high-dose oxytocin (95% Cl, 1.30–1.94, p = 0.3; 0.6; I² = 9%). Conclusions: Labor augmentation with a low-dose oxytocin regimen is effective as with a high-dose regimen, but with significantly less uterine tachysystole events, which can lead to intrauterine and neonatal complications. Our findings suggest that a low-dose regimen may be safe and effective for labor augmentation in medical practice.

Galactosyl hydroxylysine and deoxypyridinoline are at present the most promising markers of bone resorption. Various studies have indeed shown that these two markers discriminate with high accuracy subjects with different rates of bone turnover and that their accuracies and discriminate power are very similar. The aim of this paper is to compare the practicality and the reproducibility of the HPLC galactosyl hydroxylysine and deoxypyridinoline assays. In summary, this review shows that the galactosyl hydroxylysine and deoxypyridinoline HPLC assays differ mainly in the need, in using deoxypyridinoline, for an acid hydrolysis and a preextraction of the urine samples. This implies two major problems for deoxypyridinoline: 1) more time is required due to the cumbersome preanalytical procedures; and 2) a lower reproducibility. Our data, in fact, show that both the intra-assay and inter-assay coefficient of variation of the deoxypyridinoline assay are almost 100% higher than those of the galactosyl hydroxylysine assay.

Introdução: A fisiopatologia hipertensiva e a chagásica se assemelham, ambas evoluem para a lesão endotelial. Com isso, pacientes chagásicos hipertensos são mais propensos a desenvolver cardiomiopatia. Objetivo: Investigar a relação da Hipertensão Arterial (HAS) com cardiopatias na Doença de Chagas Aguda (DCA). Metodologia: Foi realizado um estudo transversal retrospectivo, a partir da análise de prontuários de pacientes portadores de DCA atendidos no Instituto Evandro Chagas (IEC), no período entre 2014 e 2022. O Estudo faz parte do projeto aprovado sob parecer Nº 655.002, e buscou avaliar a relação da HAS com o acometimento cardíaco com base nas alterações clínicas e ecocardiográficas. Foi utilizado o teste exato de Fisher para a análise das amostras, valores de p< 0.05 foram considerados significativos. Resultados: Dos 40 pacientes com DCA, 72,5% eram portadores de HAS e 52,5% possuíam alterações no ECO, sendo a disfunção diastólica e hipertrofia do ventrículo esquerdo (52,5%) a mais frequentes. A presença de Hipertensão Arterial teve associação estatisticamente significativa em relação à presença de alterações ecocardiográficas (p <0,05), pelo teste exato de Fisher. Conclusão: A HAS atua como fator de desenvolvimento da cardiomiopatia chagásica. Com isso, reforçam a necessidade de prevenção de novos casos.