Introduction: We aimed to evaluate whether infrared thermography (IRT) with a portable camera is a useful tool for diagnosing or screening peripheral arterial disease of the lower limbs (PAD-LL) when compared with the traditional method of color Doppler ultrasonography.Material and methods: The study enrolled 90 volunteers: 45 who were diagnosed with PAD-LL (PAD-LL group) and 45 who did not have a diagnosis of PAD-LL (control group). The diagnosis was made using color Doppler ultrasonography, and the results were compared with those of IRT.Results: The IRT-based procedure evaluated in this study had a sensitivity of 97.62% and a specificity of 91.67% for PAD-LL diagnosis compared to color Doppler ultrasonography. The method was limited for diagnosing PAD-LL manifesting above the knees (suprapopliteal PAD-LL). Our results also suggest that the ankle-brachial index is an important predictor of PAD-LL, with a sensitivity of 91.17% and a specificity of 75% at a value of ≤ 0.9. Current or previous smoking habits, higher body mass index, and the presence of diabetes mellitus were significantly elevated in the PAD-LL group.Conclusions: Our results indicate that IRT is an efficient and low-cost method for screening and diagnosing PAD-LL, particularly infrapopliteal PAD-LL manifesting below the knees. However, further studies are required to establish the validity of this technique.

Management of emergency care This article presents a case involving complications after intentional injection of crushed tablets into the arterial circulation, its diagnosis, and the treatment adopted. The diagnosis process illustrates the potential of techniques based on thermal imaging as tools to assess tissue perfusion. Inadvertent intravenous injection of crushed tablets is more common, but there are few reports on arterial circulation, and no studies were found on the self-injection of crushed morphine tablets, particularly into the radial artery. A 51-year-old man with alcoholism and a history of illegal drug usage intentionally self-injected 3 crushed morphine tablets into his right radial artery. The patient progressed with compartment syndrome, requiring decompressive fasciotomy of the right forearm and ischemia of the right fingers, which were amputated. He presented with rhabdomyolysis and required dialysis. The patient agreed to full heparinization, corticotherapy, and the use of nitroglycerin and prostaglandin E1. Due to the progression of the necrotic area, the patient underwent proximal phalanx excision and surgical reconstruction of the right-hand remnant. The injection of morphine tablets into circulation caused severe complications, which led to the excision of the proximal phalanx and the surgical reconstruction of the remnant of the right hand. In the present case, infrared thermography proved to be an effective method in assessing tissue perfusion.

Este estudo teve como objetivo analisar as evidências disponíveis na literatura científica sobre os efeitos da simulação clínica na formação multiprofissional em saúde, com ênfase na comunicação interprofissional e na segurança do paciente. Foi realizada uma revisão integrativa de artigos publicados entre 2015 e 2025, em português, inglês e espanhol, nas bases MEDLINE, non-MEDLINE e IBECS. Foram incluídos estudos que abordaram a aplicação da simulação clínica em contextos multiprofissionais relacionados à comunicação e segurança. A amostra final contemplou pesquisas de diferentes delineamentos, incluindo estudos experimentais, quase-experimentais, revisões narrativas e de escopo. Os resultados evidenciaram que a simulação clínica favorece a melhoria da comunicação verbal e não verbal, a cooperação interprofissional e o fortalecimento do trabalho em equipe, impactando diretamente na segurança do paciente. Também foram relatados avanços na tomada de decisão compartilhada, no desenvolvimento de competências colaborativas e na criação de uma cultura de segurança em saúde. Apesar dos resultados promissores, foram identificadas lacunas metodológicas, como a necessidade de padronização de indicadores de desempenho coletivo e maior número de ensaios clínicos randomizados. Conclui-se que a simulação clínica deve ser incorporada de forma sistemática à formação em saúde e à educação continuada, por seu potencial de qualificar práticas colaborativas e aprimorar a segurança do cuidado

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.

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.