São Paulo medical journal = Revista paulista de medicina
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Clinical assessment of head and neck cancers is highly challenging owing to the complexity of regional anatomy and wide range of lesions. The diagnostic evaluation includes detailed physical examination, biopsy and imaging modalities for disease extent and staging. Appropriate imaging is done to enable determination of precise tumor extent and involvement of lymph nodes, and detection of distant metastases and second primary tumors. ⋯ Our study demonstrated that 18F-FDG PET/CT had higher sensitivity and accuracy for detecting head and neck malignancy, in comparison with conventional contrast-enhanced computed tomography. 18F-FDG PET/CT improved the initial staging and substantially impacted the management strategy for head and neck malignancies.
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Brazil is facing increasing cycles of numbers of infected people and deaths resulting from coronavirus disease 2019 (COVID-19). This situation involves a series of factors, including the behavior of the population, that can be decisive for controlling the disease. ⋯ A large part of the population has general knowledge about COVID-19, but not all knowledge was applied in practice. Older people, females and university graduates stood out as the best informed and most committed to controlling the disease.
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Due to the coronavirus disease 2019 (COVID-19) pandemic, access to healthcare services may have become difficult, which may have led to an increase in chronic diseases and multimorbidity. ⋯ The incidence of multimorbidity during a six-month period during the COVID-19 pandemic was 27.1% in the state of Rio Grande do Sul, Brazil.
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Telemedicine can be a component of integrated healthcare practices and its use is not a recent phenomenon around the world. In Brazil, its more widespread use began during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, through extraordinary authorization from the Brazilian Ministry of Health. ⋯ This study demonstrates that important issues such as professional remuneration, use of electronic platforms and medical records, ensuring data protection and relationships between physicians and other stakeholders still need to be better defined, in order to achieve the desired scale and reach the outcomes defined.
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The number of nephrologists has risen slowly, compared with the prevalence of chronic kidney disease (CKD) in Brazil. Data on patients referred to nephrology outpatient clinics remains scarce. ⋯ Referrals to a nephrologist were not being made using any guidelines for CKD risk and many cases could have been managed within primary care. Late referral to a nephrologist happened in one-fifth of the cases and more frequently in the public service.