Chronic urticaria (CU) is a mast cell-driven inflammatory skin disorder characterized by recurrent wheals, angioedema, or both lasting more than six weeks, often resulting in significant impairment of quality of life. Although CU has traditionally been regarded as a predominantly histamine-mediated condition, evidence accumulated over the past decade has redefined chronic spontaneous urticaria (CSU) as a complex immune-mediated disease with marked biological heterogeneity. Distinct pathogenic mechanisms involving autoimmune pathways, dysregulated mast cell activation, and chronic inflammatory networks have been identified, providing a mechanistic basis for disease persistence, variable severity, and therapeutic refractoriness. This review synthesizes current concepts in CSU pathophysiology, with emphasis on mast cell biology, autoimmune endotypes, and inflammatory amplification mechanisms. We further discuss emerging biomarkers with potential relevance for disease stratification and treatment prediction, as well as established and novel therapeutic strategies targeting key pathogenic pathways. By integrating mechanistic insights with clinical implications, this review highlights the transition toward endotype-driven and biomarker-guided management of chronic urticaria.

Antimicrobial resistance is one of the most important global public health challenges, particularly in low and middle-income countries where antimicrobial consumption remains high. In Brazil, several regulatory measures have been implemented over the last decade to improve control over antimicrobial use, including restrictions on over-the-counter sales and strengthened monitoring of antimicrobial dispensing. This article provides an overview of antimicrobial use, regulatory measures, and resistance-related challenges in Brazil. Evidence from epidemiological studies, antimicrobial dispensing records, national monitoring initiatives coordinated by the Brazilian Health Regulatory Agency (ANVISA), the National System for Controlled Product Management (SNGPC), and antimicrobial resistance surveillance efforts, including GLASS/BR-GLASS and national reports on healthcare-associated infections and resistance, was considered to identify trends in antimicrobial consumption, regional variation, and the influence of public health policies. Available data indicate that antibiotics such as amoxicillin, azithromycin, and cephalosporins remain among the most commonly dispensed antimicrobials in community settings. Regulatory measures have strengthened prescription requirements, improved oversight of antimicrobial dispensing, and reduced unrestricted non-prescription sales, although their broader impact on inappropriate clinical use and resistance trends remains heterogeneous across settings. Hospital settings continue to show high rates of broad-spectrum antimicrobial use, especially in intensive care units. The COVID-19 pandemic also influenced antimicrobial use patterns, particularly by increasing the consumption of macrolides despite limited evidence of bacterial coinfection. Continued efforts involving prescriber education, antimicrobial stewardship programs, microbiological diagnostics, and integrated surveillance are essential to support more rational antimicrobial use and help address antimicrobial resistance in Brazil.

A prevenção de gestações indesejadas motiva o uso de métodos contraceptivos, mas ainda há deficiências na disseminação de informações e na orientação adequada sobre seu uso. A relação médico-paciente exerce papel essencial na escolha consciente e personalizada desses métodos. Este estudo teve como objetivo analisar o grau de conhecimento e satisfação em relação aos métodos contraceptivos entre acadêmicas do curso de Medicina de uma universidade do Tocantins. Foi aplicado um questionário online, entre setembro e outubro de 2024, abordando aspectos sociais, culturais e individuais relacionados ao uso de contraceptivos. Os resultados mostraram que 68% das participantes utilizam algum método contraceptivo, sendo a pílula anticoncepcional o mais prevalente. Observou -se ainda um nível satisfatório de conhecimento e adesão entre as alunas, embora persistam lacunas significativas, especialmente em relação à educação sexual precoce e ao acompanhamento profissional contínuo. Os achados reforçam a importância de ampliar o acesso à educação sexual de qualidade, capacitando futuras profissionais de saúde a tomarem decisões informadas sobre sua saúde reprodutiva e a atuarem de forma eficaz na orientação da população. Somente assim será possível garantir que as acadêmicas de Medicina estejam preparadas para enfrentar os desafios da saúde reprodutiva e contribuírem para a promoção do bem-estar sexual de suas futuras pacientes.

Chronic urticaria (CU) is a mast cell–driven inflammatory skin disorder characterized by recurrent wheals, angioedema, or both lasting more than six weeks, often resulting in significant impairment of quality of life. Although CU has traditionally been re-garded as a predominantly histamine-mediated condition, evidence accumulated over the past decade has redefined chronic spontaneous urticaria (CSU) as a complex im-mune-mediated disease with marked biological heterogeneity.. Distinct pathogenic mechanisms involving autoimmune pathways, dysregulated mast cell activation, and chronic inflammatory networks have been identified, providing a mechanistic basis for disease persistence, variable severity, and therapeutic refractoriness. This review syn-thesizes current concepts in CSU pathophysiology, with emphasis on mast cell biology, autoimmune endotypes, and inflammatory amplification mechanisms.. We further discuss emerging biomarkers with potential relevance for disease stratification and treatment prediction, as well as established and novel therapeutic strategies targeting key pathogenic pathways. By integrating mechanistic insights with clinical implica-tions, this review highlights the transition toward endotype-driven and bi-omarker-guided management of chronic urticaria.