Referências em breve.

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Boletins epidemiológicos:
https://www.ial.sp.gov.br/ial/publicacoes/boletim

Referências:
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4. Patel AA, Arnold RM, Taddei TH, Woodrell CD. "Am I Going to Die?": Delivering Serious News to Patients With Liver Disease. Gastroenterology. 2023;164(2):177-181. doi:10.1053/j.gastro.2022.11.006
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1. Kittleson MM, Panjrath GS, Amancherla K, et al. 2023 ACC Expert Consensus Decision Pathway on Management of Heart Failure With Preserved Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2023;81(18):1835-1878. doi:10.1016/j.jacc.2023.03.393
2. Borlaug BA, Sharma K, Shah SJ, Ho JE. Heart Failure With Preserved Ejection Fraction: JACC Scientific Statement. J Am Coll Cardiol. 2023;81(18):1810-1834. doi:10.1016/j.jacc.2023.01.049
3. Bakalakos A, Monda E, Elliott PM. Tailored therapeutics for cardiomyopathies. Nat Rev Cardiol. 2025;22(10):814-831. doi:10.1038/s41569-025-01183-6
4. Cannata A, McDonagh TA. Heart Failure with Preserved Ejection Fraction. N Engl J Med. 2025;392(2):173-184. doi:10.1056/NEJMcp2305181
5. Rahi W, Lababidi H, Hussain I, Quinones MA, Nagueh SF. Improving the Diagnosis of HFpEF: A Comparison of the H2FPEF Score and the 2025 ASE Diastolic Function Guideline Recommendations Using Invasive Hemodynamics as the Gold Standard. JACC Cardiovasc Imaging. 2026;19(2):166-174. doi:10.1016/j.jcmg.2025.09.011
6. Ndumele CE, Rangaswami J, Chow SL, et al. Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association. Circulation. 2023;148(20):1606-1635. doi:10.1161/CIR.0000000000001184
7. FIGUEIREDO, Viviane Melo e Silva de; SANTOS, João Vitor Soares; GALVÃO, Natália Garcia; FIGUEIREDO NETO, José Albuquerque de. Fluxograma do Tratamento da Insuficiência Cardíaca com Fração de Ejeção Preservada. ABC Heart Fail Cardiomyop, v. 2, n. 3, p. 299-303, dez. 2022.

O Pipoca TdC é um podcast bônus do TdC. Um espaço pra conversar sobre séries, filmes e medicina de um jeito leve e descontraído.
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Referência:
1. Prabhakaran, Shyam et al. “2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association.” Stroke, 10.1161/STR.0000000000000513. 26 Jan. 2026, doi:10.1161/STR.0000000000000513

O Pipoca TdC é um podcast bônus do TdC. Um espaço pra conversar sobre séries, filmes e medicina de um jeito leve e descontraído.
Depois de duas temporadas falando de House, agora é a vez de The Pitt, acompanhando os lançamentos semanais.
É só dar o play e aproveitar!

Referências:
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O Pipoca TdC é um podcast bônus do TdC. Um espaço pra conversar sobre séries, filmes e medicina de um jeito leve e descontraído.
Depois de duas temporadas falando de House, agora é a vez de The Pitt, acompanhando os lançamentos semanais.
É só dar o play e aproveitar!

🚨 www.tadeclinicagem.com.br/guia - Conheça o Guia TdC com 7 dias grátis 🚨

O Pipoca TdC é um podcast bônus do TdC. Um espaço pra conversar sobre séries, filmes e medicina de um jeito leve e descontraído.
Depois de duas temporadas falando de House, agora é a vez de The Pitt, acompanhando os lançamentos semanais.
É só dar o play e aproveitar!

Referências: 
1. Writing Committee Members* et al. “2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.” Circulation, 10.1161/CIR.0000000000001415. 19 Feb. 2026, doi:10.1161/CIR.0000000000001415
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4. Zhang, Robert S et al. “Composite Pulmonary Embolism Shock Score and Risk of Adverse Outcomes in Patients With Pulmonary Embolism.” Circulation. Cardiovascular interventions vol. 17,8 (2024): e014088. doi:10.1161/CIRCINTERVENTIONS.124.014088
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O Pipoca TdC é um podcast bônus do TdC. Um espaço pra conversar sobre séries, filmes e medicina de um jeito leve e descontraído.
Depois de duas temporadas falando de House, agora é a vez de The Pitt, acompanhando os lançamentos semanais.
É só dar o play e aproveitar!

Referências em breve.

O Pipoca TdC é um podcast bônus do TdC. Um espaço pra conversar sobre séries, filmes e medicina de um jeito leve e descontraído.
Depois de duas temporadas falando de House, agora é a vez de The Pitt, acompanhando os lançamentos semanais.
É só dar o play e aproveitar!

Referências:
1. HURTTE, Edward; YOUNG, Jocelyn; GYAWALI, C. Prakash. Dysphagia. Primary Care, [S.l.], v. 50, n. 3, p. 325-338, set. 2023. DOI: https://doi.org/10.1016/j.pop.2023.03.001.
2. KIM, Jooho P.; KAHRILAS, Peter J. How I approach dysphagia. Current Gastroenterology Reports, [S.l.], v. 21, p. 49, 2019. DOI: https://doi.org/10.1007/s11894-019-0713-3.
3. Selvanderan, Shane et al. “Dysphagia: clinical evaluation and management.” Internal medicine journal vol. 51,7 (2021): 1021-1027. doi:10.1111/imj.15409

O Pipoca TdC é um podcast bônus do TdC. Um espaço pra conversar sobre séries, filmes e medicina de um jeito leve e descontraído.
Depois de duas temporadas falando de House, agora é a vez de The Pitt, acompanhando os lançamentos semanais.
É só dar o play e aproveitar!

🚨 www.tadeclinicagem.com.br/guia - Conheça o Guia TdC com 7 dias grátis 🚨

O Pipoca TdC é um podcast bônus do TdC. Um espaço pra conversar sobre séries, filmes e medicina de um jeito leve e descontraído.
Depois de duas temporadas falando de House, agora é a vez de The Pitt, acompanhando os lançamentos semanais.
É só dar o play e aproveitar!

Referências:
1. Olagunju, Amanda E, and Faraz Ghoddusi. “Attention-Deficit/Hyperactivity Disorder in Adults.” American family physician vol. 110,2 (2024): 157-166.
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13. Leffa, Douglas Teixeira et al. “ADHD in Children and Adults: Diagnosis and Prognosis.” Current topics in behavioral neurosciences vol. 57 (2022): 1-18. doi:10.1007/7854_2022_329

O Pipoca TdC é um podcast bônus do TdC. Um espaço pra conversar sobre séries, filmes e medicina de um jeito leve e descontraído.
Depois de duas temporadas falando de House, agora é a vez de The Pitt, acompanhando os lançamentos semanais.
É só dar o play e aproveitar!

Referências:
1. Pan American Health Organization. Recommendations for Laboratory Detection and Diagnosis of Arbovirus Infections in the Region of the Americas. Washington, D.C.: PAHO; 2023. Available from: https://doi.org/10.37774/9789275125878.
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O Pipoca TdC é um podcast bônus do TdC. Um espaço pra conversar sobre séries, filmes e medicina de um jeito leve e descontraído.
Depois de duas temporadas falando de House, agora é a vez de The Pitt, acompanhando os lançamentos semanais.
É só dar o play e aproveitar!

Referências:
1. https://www.tadeclinicagem.com.br/guia/239/caso-clinico-16/
2. Shelat AM, Ye S, Gottesman MH. Weakness, hemiparesis. In: Ettinger AB, Weisbrot DM, eds. Neurologic Differential Diagnosis: A Case-Based Approach. Cambridge University Press; 2014:502-513.
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5.⁠ ⁠Shahan, Brian et al. “Cerebrospinal Fluid Analysis.” American family physician vol. 103,7 (2021): 422-428.

O Pipoca TdC é um podcast bônus do TdC. Um espaço pra conversar sobre séries, filmes e medicina de um jeito leve e descontraído.
Depois de duas temporadas falando de House, agora é a vez de The Pitt, acompanhando os lançamentos semanais.
É só dar o play e aproveitar!

🚨 www.tadeclinicagem.com.br/guia - Conheça o Guia TdC com 7 dias grátis 🚨

O Pipoca TdC é um podcast bônus do TdC. Um espaço pra conversar sobre séries, filmes e medicina de um jeito leve e descontraído.
Depois de duas temporadas falando de House, agora é a vez de The Pitt, acompanhando os lançamentos semanais.
É só dar o play e aproveitar!

Referências:
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19. Aguilar-Guisado M, Espigado I, Martín-Peña A, et al. Optimisation of empirical antimicrobial therapy in patients with haematological malignancies and febrile neutropenia (How Long study): an open-label, randomised, controlled phase 4 trial. Lancet Haematol. 2017;4(12):e573-e583. doi:10.1016/S2352-3026(17)30211-9

O Pipoca TdC é um podcast bônus do TdC. Um espaço pra conversar sobre séries, filmes e medicina de um jeito leve e descontraído.
Depois de duas temporadas falando de House, agora é a vez de The Pitt, acompanhando os lançamentos semanais.
É só dar o play e aproveitar!

Veja mais sobre paracentese em https://www.tadeclinicagem.com.br/guia/528/paracentese-como-fazer/

Referências:
1. McMahon, Naoimh E et al. “Etiologic Workup in Cases of Cryptogenic Stroke: A Systematic Review of International Clinical Practice Guidelines.” Stroke vol. 51,5 (2020): 1419-1427. doi:10.1161/STROKEAHA.119.027123
2. Kleindorfer, Dawn O et al. “2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association.” Stroke vol. 52,7 (2021): e364-e467. doi:10.1161/STR.0000000000000375
3. Sposato, Luciano A et al. “Embolic Stroke of Undetermined Source: New Data and New Controversies on Cardiac Monitoring and Anticoagulation.” Neurology vol. 103,1 (2024): e209535. doi:10.1212/WNL.0000000000209535

O Pipoca TdC é um podcast bônus do TdC. Um espaço pra conversar sobre séries, filmes e medicina de um jeito leve e descontraído.
Depois de duas temporadas falando de House, agora é a vez de The Pitt, acompanhando os lançamentos semanais.
É só dar o play e aproveitar!

Referências:
1. https://www.tadeclinicagem.com.br/guia/104/caso-clinico-5/
2. Ropper, Alexander E, and Allan H Ropper.  Mahartypinal Cord Compression.” The New England journal of medicine vol. 376,14 (2017): 1358-1369. doi:10.1056/NEJMra1516539
3. Darouiche, Rabih O. “Spinal epidural abscess.” The New England journal of medicine vol. 355,19 (2006): 2012-20. doi:10.1056/NEJMra055111
4. Laur, Olga et al. “Nontraumatic Spinal Cord Compression: MRI Primer for Emergency Department Radiologists.” Radiographics : a review publication of the Radiological Society of North America, Inc vol. 39,6 (2019): 1862-1880. doi:10.1148/rg.2019190024
5. Fraser, Stuart et al. “Cauda equina syndrome: a literature review of its definition and clinical presentation.” Archives of physical medicine and rehabilitation vol. 90,11 (2009): 1964-8. doi:10.1016/j.apmr.2009.03.021
6. Maharty, Donald Clinton et al. “Chronic Low Back Pain in Adults: Evaluation and Management.” American family physician vol. 109,3 (2024): 233-244.
7. Hoeritzauer, Ingrid et al. “The clinical features and outcome of scan-negative and scan-positive cases in suspected cauda equina syndrome: a retrospective study of 276 patients.” Journal of neurology vol. 265,12 (2018): 2916-2926. doi:10.1007/s00415-018-9078-2

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• Indicações além do DM
• Risco de CAD euglicêmica
• Quando não usar?
• ⁠Cuidados com doença aguda (sick day) e hipovolemia
• ⁠Cuidados pré-operatório
• Risco de fratura e amputação

Referências:
1. Bailey CJ, et al. Dapagliflozin add-on to metformin in type 2 diabetes inadequately controlled with metformin: a randomized, double-blind, placebo-controlled 102-week trial. BMC Med. 2013;11:43. Published 2013 Feb 20. doi:10.1186/1741-7015-11-43
2. Bersoff-Matcha SJ, et al. Fournier Gangrene Associated With Sodium-Glucose Cotransporter-2 Inhibitors: A Review of Spontaneous Postmarketing Cases. Ann Intern Med. 2019;170(11):764-769. doi:10.7326/M19-0085
3. Chang HY, et al. Association Between Sodium-Glucose Cotransporter 2 Inhibitors and Lower Extremity Amputation Among Patients With Type 2 Diabetes. JAMA Intern Med. 2018;178(9):1190-1198. doi:10.1001/jamainternmed.2018.3034
4. Clar C, et al. Systematic review of SGLT2 receptor inhibitors in dual or triple therapy in type 2 diabetes. BMJ Open. 2012 Oct 18;2(5):e001007. doi: 10.1136/bmjopen-2012-001007. PMID: 23087012; PMCID: PMC3488745.
5. Das SR, et al. 2020 Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2020 Sep 1;76(9):1117-1145. doi: 10.1016/j.jacc.2020.05.037. Epub 2020 Aug 5. PMID: 32771263; PMCID: PMC7545583.
6. Fralick M, et al. Risk of amputation with canagliflozin across categories of age and cardiovascular risk in three US nationwide databases: cohort study. BMJ. 2020;370:m2812. Published 2020 Aug 25. doi:10.1136/bmj.m2812
7. Li D, et al. Urinary tract and genital infections in patients with type 2 diabetes treated with sodium-glucose co-transporter 2 inhibitors: A meta-analysis of randomized controlled trials. Diabetes Obes Metab. 2017;19(3):348-355. doi:10.1111/dom.12825
8. Neal B, et al. Rationale, design, and baseline characteristics of the Canagliflozin Cardiovascular Assessment Study (CANVAS)--a randomized placebo-controlled trial. Am Heart J. 2013;166(2):217-223.e11. doi:10.1016/j.ahj.2013.05.007
9. Nyirjesy P, et al. Evaluation of vulvovaginal symptoms and Candida colonization in women with type 2 diabetes mellitus treated with canagliflozin, a sodium glucose co-transporter 2 inhibitor. Curr Med Res Opin. 2012;28(7):1173-1178. doi:10.1185/03007995.2012.697053
10. Perkovic V, et al. Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. N Engl J Med. 2019;380(24):2295-2306. doi:10.1056/NEJMoa1811744
11. Rosenwasser RF, et al. SGLT-2 inhibitors and their potential in the treatment of diabetes. Diabetes Metab Syndr Obes. 2013 Nov 27;6:453-67. doi: 10.2147/DMSO.S34416. PMID: 24348059; PMCID: PMC3848644.
12. Sridharan K, Sivaramakrishnan G. Risk of limb amputation and bone fractures with sodium glucose cotransporter-2 inhibitors: a network meta-analysis and meta-regression. Expert Opin Drug Saf. 2025;24(7):797-804. doi:10.1080/14740338.2024.2377755
13. Ueda P,  et al. Sodium glucose cotransporter 2 inhibitors and risk of serious adverse events: nationwide register based cohort study. BMJ. 2018;363:k4365. Published 2018 Nov 14. doi:10.1136/bmj.k4365
14. Watts NB, et al. Effects of Canagliflozin on Fracture Risk in Patients With Type 2 Diabetes Mellitus. J Clin Endocrinol Metab. 2016 Jan;101(1):157-66. doi: 10.1210/jc.2015-3167. Epub 2015 Nov 18. PMID: 26580237; PMCID: PMC4701850.
15. Zhuo M, et al. Association of Sodium-Glucose Cotransporter-2 Inhibitors With Fracture Risk in Older Adults With Type 2 Diabetes. JAMA Netw Open. 2021;4(10):e2130762. Published 2021 Oct 1. doi:10.1001/jamanetworkopen.2021.30762
16. Emerson Cestari Marino, Leandra Anália Freitas Negretto, Rogério Silicani Ribeiro, Denise Momesso, Alina Coutinho Rodrigues Feitosa, Marcos Tadashi Kakitani Toyoshima, Joaquim Custódio da Silva Junior, Sérgio Vencio, Marcio Weissheimer Lauria, João Roberto de Sá, Domingos A. Malerbi, Fernando Valente, Silmara A. O. Leite, Danillo Ewerton Oliveira Amaral, Gabriel Magalhães Nunes Guimarães, Plínio da Cunha Leal, Maristela Bueno Lopes, Luiz Carlos Bastos Salles, Liana Maria Torres de Araújo Azi, Amanda Gomes Fonseca, Lorena Ibiapina M. Carvalho, Francília Faloni Coelho, Bruno Halpern, Cynthia M. Valerio, Fabio R. Trujilho,  Antonio Carlos Aguiar Brandão, Ruy Lyra e Marcello Bertoluci. Rastreamento e Controle da Hiperglicemia no Perioperatório – Posicionamento Conjunto da Sociedade Brasileira de Diabetes (SBD), Sociedade Brasileira de Anestesiologia (SBA) e Associação Brasileira para o Estudo da Obesidade e Síndrome Metabólica (ABESO). Diretriz Oficial da Sociedade Brasileira de Diabetes (2025). DOI: 10.29327/5660187.2025-10 , ISBN: 978-65-5941-367-6.
17. Singh LG, Ntelis S, Siddiqui T, Seliger SL, Sorkin JD, Spanakis EK. Association of Continued Use of SGLT2 Inhibitors From the Ambulatory to Inpatient Setting With Hospital Outcomes in Patients With Diabetes: A Nationwide Cohort Study. Diabetes Care. 2024;47(6):933-940. doi:10.2337/dc23-1129
18. Mehta PB, Robinson A, Burkhardt D, Rushakoff RJ. Inpatient Perioperative Euglycemic Diabetic Ketoacidosis Due to Sodium-Glucose Cotransporter-2 Inhibitors - Lessons From a Case Series and Strategies to Decrease Incidence. Endocr Pract. 2022;28(9):884-888. doi:10.1016/j.eprac.2022.06.006
19. Umapathysivam MM, Morgan B, Inglis JM, et al. SGLT2 Inhibitor-Associated Ketoacidosis vs Type 1 Diabetes-Associated Ketoacidosis. JAMA Netw Open. 2024;7(3):e242744. Published 2024 Mar 4. doi:10.1001/jamanetworkopen.2024.2744
20. Fleming N, Hamblin PS, Story D, Ekinci EI. Evolving Evidence of Diabetic Ketoacidosis in Patients Taking Sodium-Glucose Cotransporter 2 Inhibitors. J Clin Endocrinol Metab. 2020;105(8):dgaa200. doi:10.1210/clinem/dgaa200
21. Neuen BL, Young T, Heerspink HJL, et al. SGLT2 inhibitors for the prevention of kidney failure in patients with type 2 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2019;7(11):845-854. doi:10.1016/S2213-8587(19)30256-6
22. Braunwald E. Gliflozins in the Management of Cardiovascular Disease. N Engl J Med. 2022;386(21):2024-2034. doi:10.1056/NEJMra2115011
23. Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med. 2015;373(22):2117-2128. doi:10.1056/NEJMoa1504720
24. Neal B, Perkovic V, Mahaffey KW, et al. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med. 2017;377(7):644-657. doi:10.1056/NEJMoa1611925
25. Wiviott SD, Raz I, Bonaca MP, et al. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2019;380(4):347-357. doi:10.1056/NEJMoa1812389
26. McMurray JJV, Solomon SD, Inzucchi SE, et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med. 2019;381(21):1995-2008. doi:10.1056/NEJMoa1911303
27. Packer M, Anker SD, Butler J, et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med. 2020;383(15):1413-1424. doi:10.1056/NEJMoa2022190
28. Anker SD, Butler J, Filippatos G, et al. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. N Engl J Med. 2021;385(16):1451-1461. doi:10.1056/NEJMoa2107038
29. Heerspink HJL, Stefánsson BV, Correa-Rotter R, et al. Dapagliflozin in Patients with Chronic Kidney Disease. N Engl J Med. 2020;383(15):1436-1446. doi:10.10...

Referências:
1. Expert Panel on Neurological Imaging, Hagiwara M, Policeni B, et al. ACR Appropriateness Criteria® Sinonasal Disease: 2021 Update. J Am Coll Radiol. 2022;19(5S):S175-S193. doi:10.1016/j.jacr.2022.02.011
2. Frerichs N, Brateanu A. Rhinosinusitis and the role of imaging. Cleve Clin J Med. 2020;87(8):485-492. Published 2020 Jul 31. doi:10.3949/ccjm.87a.19092
3. Payne SC, McKenna M, Buckley J, et al. Clinical Practice Guideline: Adult Sinusitis Update. Otolaryngol Head Neck Surg. 2025;173 Suppl 1:S1-S56. doi:10.1002/ohn.1344
4. Schreiber CP, Hutchinson S, Webster CJ, Ames M, Richardson MS, Powers C. Prevalence of migraine in patients with a history of self-reported or physician-diagnosed "sinus" headache. Arch Intern Med. 2004;164(16):1769-1772. doi:10.1001/archinte.164.16.1769
5. Smith KA, Ashby S, Orlandi RR, Oakley G, Alt JA. The price of pain in chronic rhinosinusitis. Int Forum Allergy Rhinol. Published online April 12, 2018. doi:10.1002/alr.22128
6. Fokkens WJ, Lund VJ, Hopkins C, et al. Executive summary of EPOS 2020 including integrated care pathways. Rhinology. 2020;58(2):82-111. doi:10.4193/Rhin20.601
7. Fischer, J.L., Lee, J.T. Update on the Role of the Microbiome in Chronic Rhinosinusitis. Curr Treat Options Allergy 11, 17–33 (2024). https://doi.org/10.1007/s40521-024-00361-0
8. Anselmo-Lima WT, Romano FR, Tamashiro E, et al. Brazilian guideline for the use of immunobiologicals in chronic rhinosinusitis with nasal polyps ‒ 2024 update. Braz J Otorhinolaryngol. 2024;90(3):101394. doi:10.1016/j.bjorl.2024.101394
9. Orlandi RR, Kingdom TT, Smith TL, et al. International consensus statement on allergy and rhinology: rhinosinusitis 2021. Int Forum Allergy Rhinol. 2021;11(3):213-739. doi:10.1002/alr.22741
10. https://aborlccf.org.br/wp-content/uploads/2022/11/1669816618_Manual_de_lavagem_nasal-v2.pdf

Referências:
1. Jori E. May, Stephan Moll; Unexplained arterial thrombosis: approach to diagnosis and treatment. Hematology Am Soc Hematol Educ Program 2021; 2021 (1): 76–84. doi: https://doi.org/10.1182/hematology.2021000235
2. Carol Mathew, 2025. "Atypical-site thrombosis", American Society of Hematology Self-Assessment Program, Ninth Edition, Brady L. Stein, MD, Anand A. Patel, MD, Jacquelyn M. Powers, MD, MS, Catherine C. Smith, MD
3. May JE, Moll S. How I treat unexplained arterial thrombosis. Blood. 2020;136(13):1487-1498. doi:10.1182/blood.2019000820
4. O'Donnell M, Shatzel JJ, Olson SR, et al. Arterial thrombosis in unusual sites: A practical review. Eur J Haematol. 2018;101(6):728-736. doi:10.1111/ejh.13165
5. May JE, Moll S. Unexplained arterial thrombosis: approach to diagnosis and treatment. Hematology Am Soc Hematol Educ Program. 2021;2021(1):76-84. doi:10.1182/hematology.2021000235
6. Yaghi S, Johansen MC, Ghannam M, et al. Proposal for the Ischemic Stroke Phenotyping System 2025: ISPS25. Stroke. 2025;56(12):3552-3562. doi:10.1161/STROKEAHA.125.051169

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Referências:
1. 2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC, European Heart Journal, Volume 44, Issue 37, 1 October 2023, Pages 3627–3639. https://doi.org/10.1093/eurheartj/ehad195
2. Anker SD, et al. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. N Engl J Med. 2021;385(16):1451-1461. doi:10.1056/NEJMoa2107038
3. Anker SD, et al. Systematic review and meta-analysis of intravenous iron therapy for patients with heart failure and iron deficiency. Nat Med. 2025 Aug;31(8):2640-2646. doi:10.1038/s41591-025-03671-1
4. Armstrong PW, et al. Vericiguat in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med. 2020;382(20):1883-1893. doi:10.1056/NEJMoa1915928
5. Bavendiek U, et al. Digitoxin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med. 2025;393(12):1155-1165. doi:10.1056/NEJMoa2415471
6. Belfort D, et al. Carvedilol as Single Therapy for Heart Failure With Improved Ejection Fraction: A Randomized Clinical Trial (CATHEDRAL-HF). J Am Coll Cardiol HF. Published online May 14, 2025. doi:10.1016/j.jchf.2025.02.022
7. Butler J, et al. Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction: the DIAMOND trial. Eur Heart J. 2022;43(41):4362-4373. doi:10.1093/eurheartj/ehac401
8. Comitê Coordenador da Diretriz de Insuficiência Cardíaca, Rohde LEP, Montera MW, et al. Diretriz Brasileira de Insuficiência Cardíaca Crônica e Aguda. Arq Bras Cardiol. 2018;111(3):436-539. doi:10.5935/abc.20180190
9. Ferreira J, et al. Sodium-Glucose Cotransporter 2 Inhibitor With and Without an Aldosterone Antagonist for Heart Failure With Preserved Ejection Fraction: The SOGALDI-PEF Trial. JACC. 2025 Aug;86(5):320–333.
10. Halliday BP, et al. Withdrawal of pharmacological treatment for heart failure in patients with recovered dilated cardiomyopathy (TRED-HF): an open-label, pilot, randomised trial. Lancet. 2019;393(10166):61–73.
11. Heidenreich PA, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. Circulation. 2022;145(18):e895-e1032. doi:10.1161/CIR.0000000000001063
12. Kalra PR, et al. Lancet. 2022;400(10369):2199–2209. Intravenous ferric derisomaltose in patients with heart failure and iron deficiency in the UK (IRONMAN): an investigator-initiated, prospective, randomised, open-label, blinded-endpoint trial. 
13. Kosiborod MN, et al. Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity. N Engl J Med. 2023;389(12):1069-1084. doi:10.1056/NEJMoa2306963
14. Kosiborod MN, et al. Semaglutide versus placebo in patients with heart failure and mildly reduced or preserved ejection fraction: a pooled analysis of the SELECT, FLOW, STEP-HFpEF, and STEP-HFpEF DM randomised trials. Lancet. 2024;404(10456):949-961. doi:10.1016/S0140-6736(24)01643-X
15. Maddox TM, et al. 2024 ACC Expert Consensus Decision Pathway for Treatment of Heart Failure With Reduced Ejection Fraction. J Am Coll Cardiol. 2024;83(15):1444-1488. doi:10.1016/j.jacc.2023.12.024
16. Marcondes-Braga FG, et al. Atualização de Tópicos Emergentes da Diretriz Brasileira de Insuficiência Cardíaca – 2021. Arq Bras Cardiol. 2021;116(6):1174-1212.
17. Marcondes-Braga FG. Sequenciamento do Tratamento Farmacológico da Insuficiência Cardíaca com Fração de Ejeção Reduzida. ABC Heart Fail Cardiomyop. 2022;2(1):31-35.
18. McMurray JJV, Packer M. How Should We Sequence the Treatments for Heart Failure and a Reduced Ejection Fraction?: A Redefinition of Evidence-Based Medicine. Circulation. 2021;143(9):875-877. doi:10.1161/CIRCULATIONAHA.120.052926
19. Mebazaa A, et al. Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised trial. Lancet. 2022;400(10367):1938-1952. doi:10.1016/S0140-6736(22)02076-1
20. Packer M, et al. Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity. N Engl J Med. 2025;392(5):427-437. doi:10.1056/NEJMoa2410027
21. Ponikowski P, et al. Ferric carboxymaltose for iron deficiency at discharge after acute heart failure: a multicentre, double-blind, randomised, controlled trial. Lancet. 2020;396(10266):1895-1904. doi:10.1016/S0140-6736(20)32339-4
22. Solomon SD, et al. Dapagliflozin in heart failure with preserved and mildly reduced ejection fraction: rationale and design of the DELIVER trial. Eur J Heart Fail. 2021;23(7):1217-1225. doi:10.1002/ejhf.2249
23. Solomon SD, et al. Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction. N Engl J Med. 2024;391(16):1475-1485. doi:10.1056/NEJMoa2407107
24. Writing Committee, et al. 2024 ACC Expert Consensus Decision Pathway on Clinical Assessment, Management, and Trajectory of Patients Hospitalized With Heart Failure Focused Update. J Am Coll Cardiol. 2024;84(13):1241-1267. doi:10.1016/j.jacc.2024.06.002
25. Yusuf S, et al. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved Trial. Lancet. 2003;362(9386):777-781. doi:10.1016/S0140-6736(03)14285-7

Referências:

1. Monticone, Silvia et al. “Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: a systematic review and meta-analysis.” The lancet. Diabetes & endocrinology vol. 6,1 (2018): 41-50. doi:10.1016/S2213-8587(17)30319-4
2. Rossi, Gian Paolo et al. “A prospective study of the prevalence of primary aldosteronism in 1,125 hypertensive patients.” Journal of the American College of Cardiology vol. 48,11 (2006): 2293-300. doi:10.1016/j.jacc.2006.07.059
3. Xu, Zhixin et al. “Primary Aldosteronism in Patients in China With Recently Detected Hypertension.” Journal of the American College of Cardiology vol. 75,16 (2020): 1913-1922. doi:10.1016/j.jacc.2020.02.052
4. Brown, Jenifer M et al. “The Unrecognized Prevalence of Primary Aldosteronism: A Cross-sectional Study.” Annals of internal medicine vol. 173,1 (2020): 10-20. doi:10.7326/M20-0065
5. Brown, Jenifer M et al. “The Spectrum of Subclinical Primary Aldosteronism and Incident Hypertension: A Cohort Study.” Annals of internal medicine vol. 167,9 (2017): 630-641. doi:10.7326/M17-0882
6. Rossi, Gian Paolo et al. “Clinical Management of Primary Aldosteronism: An Update.” Hypertension (Dallas, Tex. : 1979) vol. 81,9 (2024): 1845-1856. doi:10.1161/HYPERTENSIONAHA.124.22642

Referências:
1. https://kdigo.org/wp-content/uploads/2017/02/KDIGO-2021-Glomerular-Diseases-Guideline_English_LN-2024-Update.pdf
2. Sabanis N, Liaveri P, Geladari V, Liapis G, Moustakas G. DNAJB9 Fibrillary Glomerulonephritis With Membranous-Like Pattern: A Case-Based Literature Review. Cureus. 2023;15(10):e47862. Published 2023 Oct 28. doi:10.7759/cureus.47862
3. Leung N, Bridoux F, Nasr SH. Monoclonal Gammopathy of Renal Significance. N Engl J Med. 2021;384(20):1931-1941. doi:10.1056/NEJMra1810907

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Minutagem:
00:10 Apresentação
01:09 Roteiro do episódio
01:37 Quando pensar em derrame pericárdico?
07:15 Como diagnosticar?
11:20 Quando drenar (indicações de pericardiocentese)
16:45 Análise do líquido pericárdico
20:37 Complicações e condutas pós-drenagem
27:26 Salves

Referências:
1. YYamani, Naser et al. “Diagnosis, treatment, and management of pericardial effusion- review.” Annals of medicine and surgery (2012) vol. 80 104142. 9 Jul. 2022, doi:10.1016/j.amsu.2022.104142
2. https://bestpractice.bmj.com/topics/en-us/458
3. Willner DA, Goyal A, Grigorova Y, et al. Pericardial Effusion. [Updated 2024 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431089/
4. Willner DA, Goyal A, Grigorova Y, et al. Pericardial Effusion. [Updated 2024 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431089/
5. Del Portillo-Navarrete, Juan Hernando et al. “Unveiling the causes of pericardial effusion in a contemporary case series of pericardiocentesis in Latin America.” Scientific reports vol. 12,1 16010. 26 Sep. 2022, doi:10.1038/s41598-022-19339-6

Minutagem:
00:10 Apresentação
03:03 Clinicagem 1 - Fluido também é remédio
15:39 Clinicagem 2 - O soro fisiológico não é tão fisiológico
21:19 Clinicagem 3 - Soro fisiológico vs Ringer lactato e outras soluções balanceadas
34:47 Clinicagem 4 - Há espaço para albumina como expansor?
44:47 Clinicagem 5 - Soro glicosado nutre?

Referências:
1. Malbrain, Manu L N G et al. “Principles of fluid management and stewardship in septic shock: it is time to consider the four D's and the four phases of fluid therapy.” Annals of intensive care vol. 8,1 66. 22 May. 2018, doi:10.1186/s13613-018-0402-x
2. https://www.gov.br/anvisa/pt-br/assuntos/medicamentos/bulas-e-rotulos/especificos/arquivos/6440json-file-1
3. Rajasekaran, Arun et al. “Lactated Ringer's solution and risk of hyperkalemia in patients with reduced kidney function.” The American journal of the medical sciences vol. 364,4 (2022): 433-443. doi:10.1016/j.amjms.2022.04.024
4. Tseng, Chien-Hua et al. “Impact of Comorbidities on Beneficial Effect of Lactated Ringers vs. Saline in Sepsis Patients.” Frontiers in medicine vol. 8 758902. 13 Dec. 2021, doi:10.3389/fmed.2021.758902
5. Figge, James J. “Integration of acid-base and electrolyte disorders.” The New England journal of medicine vol. 372,4 (2015): 390. doi:10.1056/NEJMc1414731
6. Franchini, Stefano. “Physiological approach to assessment of acid-base disturbances.” The New England journal of medicine vol. 372,2 (2015): 193-4. doi:10.1056/NEJMc1413880
7. Lehtiranta, Saara et al. “Risk of Electrolyte Disorders in Acutely Ill Children Receiving Commercially Available Plasmalike Isotonic Fluids: A Randomized Clinical Trial.” JAMA pediatrics vol. 175,1 (2021): 28-35. doi:10.1001/jamapediatrics.2020.3383
8. https://www.azivmedics.com/iv-fluids
9. https://www.nyp-cc.com/dart/iv-fluid-selection
10. Castera, Mark R. and Mahesh B. Borhade . “Fluid Management.” StatPearls, StatPearls Publishing, 29 April 2025.
11. https://link.springer.com/book/10.1007/978-3-031-42205-8#about-this-book
12. Malbrain, Manu L N G et al. “Principles of fluid management and stewardship in septic shock: it is time to consider the four D's and the four phases of fluid therapy.” Annals of intensive care vol. 8,1 66. 22 May. 2018, doi:10.1186/s13613-018-0402-x
13. Malbrain ML, Wong A, Nasa P, Ghosh S. Rational use of intravenous fluids in critically ill patients. Springer Nature; 2024.
14. Joannidis M, Wiedermann CJ, Ostermann M. Ten myths about albumin. Intensive care medicine. 2022 May;48(5):602-5.
15. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/207449Orig1s000lbl.pdf
16. Finfer S, Bellomo R, Boyce N, French J, Myburgh J, Norton R: A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med. 2004, 350:2247-56. 10.1056/NEJMoa040232
17. Finfer S, McEvoy S, Bellomo R, McArthur C, Myburgh J, Norton R: Impact of albumin compared to saline on organ function and mortality of patients with severe sepsis. Intensive Care Med. 2011, 37:86-9. 10.1007/s00134-010-2039-6
18. Caironi P, Tognoni G, Masson S, Fumagalli R, Pesenti A, Romero M, Fanizza C, Caspani L, Faenza S, Grasselli G, Iapichino G. Albumin replacement in patients with severe sepsis or septic shock. New England Journal of Medicine. 2014 Apr 10;370(15):1412-21.
19. Lewis SR, Pritchard MW, Evans DJ, Butler AR, Alderson P, Smith AF, Roberts I. Colloids versus crystalloids for fluid resuscitation in critically ill people. Cochrane Database of Systematic Reviews. 2018(8).
20. Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, Machado FR, Mcintyre L, Ostermann M, Prescott HC, Schorr C. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Critical care medicine. 2021 Nov 1;49(11):e1063-143.
21. Yu YT, Liu J, Hu B, Wang RL, Yang XH, Shang XL, et#al. Expert consensus on the use of human serum albumin in critically ill patients. Chin Med J. 2021;134(14):1639–54
22. Hryciw N, Joannidis M, Hiremath S, Callum J, Clark EG: Intravenous albumin for mitigating hypotension and augmenting ultrafiltration during kidney replacement therapy. Clin J Am Soc Nephrol. 2020, 10.2215/CJN.09670620

23. Annane D, Siami S, Jaber S, et al.: Effects of fluid resuscitation with colloids vs crystalloids on mortality in critically ill patients presenting with hypovolemic shock: the CRISTAL randomized trial. JAMA. 2013, 310:1809-17. 10.1001/jama.2013.280502
24. http://bvsms.saude.gov.br/bvs/publicacoes/dengue_ diagnostico_manejo_clinico_6ed.pdf

Referências:
1. Häussinger D, Dhiman RK, Felipo V, et al. Hepatic encephalopathy. Nat Rev Dis Primers. 2022;8(1):43. Published 2022 Jun 23. doi:10.1038/s41572-022-00366-6
2. Rose CF, Amodio P, Bajaj JS, et al. Hepatic encephalopathy: Novel insights into classification, pathophysiology and therapy. J Hepatol. 2020;73(6):1526-1547. doi:10.1016/j.jhep.2020.07.013
3. Fogerty RL, Greenwald JL, McDermott S, Lin AE, Stone JR. Case 7-2017. A 73-Year-Old Man with Confusion and Recurrent Epistaxis. N Engl J Med. 2017;376(10):972-980. doi:10.1056/NEJMcpc1613462
4. Rudler M, de Matharel M, Bouzbib C, et al. Multiple Concomitant Precipitating Factors of Hepatic Encephalopathy Are Associated With a Poor Prognosis in Patients With Cirrhosis Admitted to Intensive Care Unit. United European Gastroenterol J. 2025;13(5):738-749. doi:10.1002/ueg2.12706
5. https://www.tadeclinicagem.com.br/guia/250/encefalopatia-hepatica/#250-1004-avaliacao-inicial-e-diagnosticos-diferenciais-de-encefalopatia-hepatica

Minutagem:
00:10 Apresentação
01:45 Panorama do surto atual e contextualização
07:45 Definição de caso suspeito
9:20 Metabolismo e toxicidade
10:20 Sinais e sintomas clínicos
12:00 Alterações laboratoriais (acidose metabólica com ânion gap elevado)
13:50 Diagnóstico diferencial de cetoacidose alcoólica
14:50 Gap osmolar
18:00 Dosagem de metanol sérico
18:30 Diagnóstico empírico
19:40 Achados em exame de imagem
20:38 Tratamento de suporte
22:00 Antídoto (fomepizol e etanol)
25:00 Suplementação (ácido folínico ou ácido fólico)
25:50 Uso de bicarbonato
27:10 Indicações de hemodiálise
28:58 Recomendações finais

Referências:
1. https://methanolpoisoning.msf.org/wp-content/uploads/2023/03/MSF_International_Methanol-Poisoning_Protocol_v2_20230110_EN.pdf
2. https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/notas-tecnicas/2025/nota-tecnica-conjunta-no-360-2025-dvsat-svsa-ms.pdf
3. Roberts, Darren M et al. “Recommendations for the role of extracorporeal treatments in the management of acute methanol poisoning: a systematic review and consensus statement.” Critical care medicine vol. 43,2 (2015): 461-72. doi:10.1097/CCM.0000000000000708
4. Kraut, Jeffrey A, and Michael E Mullins. “Toxic Alcohols.” The New England journal of medicine vol. 378,3 (2018): 270-280. doi:10.1056/NEJMra1615295
5. Kraut, Jeffrey A. “Approach to the Treatment of Methanol Intoxication.” American journal of kidney diseases : the official journal of the National Kidney Foundation vol. 68,1 (2016): 161-7. doi:10.1053/j.ajkd.2016.02.058
6. Barceloux, Donald G et al. “American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning.” Journal of toxicology. Clinical toxicology vol. 40,4 (2002): 415-46. doi:10.1081/clt-120006745
7. Souza FGT e, Nogueira VVE, Maynart LI, Oliveira RL de, Mendonça TC dos S, Oliveira PD. Neuropatia óptica tóxica por inalação de metanol. Rev brasoftalmol [Internet]. 2018Jan;77(1):47–9. Available from: https://doi.org/10.5935/0034-7280.20180010
8. https://www.gov.br/mj/pt-br/assuntos/noticias/nota-oficial-2014-governo-federal-estabelece-protocolo-de-acao-diante-de-intoxicacoes-por-metanol
9. https://emcrit.org/ibcc/alcohols/
10. Anyfantakis, D et al. “Ruling in the diagnosis of methanol intoxication in a young heavy drinker: a case report.” Journal of medicine and life vol. 5,3 (2012): 332-4.

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Minutagem:
01:39 Apresentação
02:45 Diagnóstico de diabetes
04:00 Classificação de diabetes
05:30 Rastreio
06:40 Complicações microvasculares
11:53 Complicações macrovasculares
15:12 Doença hepática e diabetes
17:40 Alvo glicêmico
20:25 Escolha da primeira droga
24:00 Insulinização no DM2 

Minutagem:
00:10 Apresentação
01:30 Apresentação do caso clínico
04:00 Abordagem e investigação da anemia
14:30 Investigação laboratorial da anemia
17:00 Análise e abordagem da hipocalcemia
21:00 Investigação da hipocalcemia
23:00 Hipocalcemia e magnésio
27:30 Retomada do caso e a busca pelo diagnóstico unificador
35:00 Manifestações clínicas da deficiência de cobre
38:00 Tratamento e Resolução do Caso
40:00 Mensagens finais e salves

Referências:
1. Barcellini, Wilma et al. “Clinical heterogeneity and predictors of outcome in primary autoimmune hemolytic anemia: a GIMEMA study of 308 patients.” Blood vol. 124,19 (2014): 2930-6. doi:10.1182/blood-2014-06-583021
2. Barcellini, W, and B Fattizzo. “Clinical Applications of Hemolytic Markers in the Differential Diagnosis and Management of Hemolytic Anemia.” Disease markersvol. 2015 (2015): 635670. doi:10.1155/2015/635670
3. Halimi, Jean-Michel et al. “Diagnostic Value of Biological Parameters in Biopsy-Confirmed Thrombotic Microangiopathy-MATRIX Consortium Group.” Kidney international reports vol. 10,6 1950-1959. 17 Mar. 2025, doi:10.1016/j.ekir.2025.03.019
4. Kidney Disease: Improving Global Outcomes (KDIGO) Anemia Work Group. KDIGO 2025 Clinical Practice Guideline for Anemia in Chronic Kidney Disease. Public Review Draft. 2024 Nov 4 [cited 2025 Nov 3]

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Minutagem:
00:00 Abertura
01:18 Definição de DRC
03:20 Estimativa de taxa de filtração glomerular
06:46 Avaliação da albuminúria e proteinúria
10:12 Classificação e predição de risco da DRC
13:40 Determinação da etiologia da DRC
23:58 Como diferenciar injúria renal aguda da DRC?
29:22 Redução da progressão da DRC
36:40 Manejo de complicações da DRC
41:47 Encaminhamento para nefrologia e início de diálise

2.⁠ ⁠Valorizar somente o exame físico e não realizar o ITB 

3.⁠ ⁠Solicitar exame de imagem no diagnóstico

4.⁠ ⁠Focar apenas no tratamento farmacológico

5.⁠ ⁠Não usar os tratamentos farmacológicos disponíveis

6.⁠ Não reconhecer o momento de indicar revascularização

7.⁠ ⁠Não reconhecer isquemia de membro aguda

Minutagem:
00:00 Abertura
3:30 Primeira armadilha: Não reconhecer as manifestações clínicas iniciais da DAP
7:37 Segunda armadilha: Valorizar apenas o exame físico e não fazer o ITB
14:10 Terceira armadilha: Solicitar exame de imagem para fazer diagnóstico da DAP
17:51 Quarta armadilha: Focar apenas no tratamento farmacológico
23:44 Quinta armadilha: Não utilizar todos os tratamentos farmacológicos disponíveis
29:35 Sexta armadilha: Não reconhecer o momento de indicar revascularização
39:52 Sétima armadilha: Não reconhecer isquemia de membro aguda
47:17 Salves

Referências:
1. https://www.tadeclinicagem.com.br/guia/324/doenca-arterial-obstrutiva-periferica-diretriz-ahaacc-2024/
2. Gornik, Heather L et al. “2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.” Circulation vol. 149,24 (2024): e1313-e1410. doi:10.1161/CIR.0000000000001251
3. Khan, Nadia A et al. “Does the clinical examination predict lower extremity peripheral arterial disease?.” JAMA vol. 295,5 (2006): 536-46. doi:10.1001/jama.295.5.536
4. Londero, Louise S et al. “Pulse palpation is an effective method for population-based screening to exclude peripheral arterial disease.” Journal of vascular surgery vol. 63,5 (2016): 1305-10. doi:10.1016/j.jvs.2015.11.044

Referências:
1. Gramlich L, Guenter P. Enteral Nutrition in Hospitalized Adults. N Engl J Med. 2025;392(15):1518-1530. doi:10.1056/NEJMra2406954
2. Singer P, Blaser AR, Berger MM, et al. ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit. Clin Nutr. 2023;42(9):1671-1689. doi:10.1016/j.clnu.2023.07.011
3. Compher C, Bingham AL, McCall M, et al. Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2022;46(1):12-41. doi:10.1002/jpen.2267
4. Heyland DK, Dhaliwal R, Drover JW, Gramlich L, Dodek P; Canadian Critical Care Clinical Practice Guidelines Committee. Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients. JPEN J Parenter Enteral Nutr. 2003;27(5):355-373. doi:10.1177/0148607103027005355
5. Ramaswamy T, DeWane MP, Dashti HS, et al. Nine Myths about Enteral Feeding in Critically Ill Adults: An Expert Perspective. Adv Nutr. 2025;16(1):100345. doi:10.1016/j.advnut.2024.100345
6. Reignier J, Boisramé-Helms J, Brisard L, et al. Enteral versus parenteral early nutrition in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2). Lancet. 2018;391(10116):133-143. doi:10.1016/S0140-6736(17)32146-3
7. Lewis SJ, Andersen HK, Thomas S. Early enteral nutrition within 24 h of intestinal surgery versus later commencement of feeding: a systematic review and meta-analysis. J Gastrointest Surg. 2009;13(3):569-575. doi:10.1007/s11605-008-0592-x
8. Reignier J, Mercier E, Le Gouge A, et al. Effect of not monitoring residual gastric volume on risk of ventilator-associated pneumonia in adults receiving mechanical ventilation and early enteral feeding: a randomized controlled trial. JAMA. 2013;309(3):249-256. doi:10.1001/jama.2012.196377
9. Ho KM, Dobb GJ, Webb SA. A comparison of early gastric and post-pyloric feeding in critically ill patients: a meta-analysis. Intensive Care Med. 2006;32(5):639-649. doi:10.1007/s00134-006-0128-3
10. Montejo JC. Enteral nutrition-related gastrointestinal complications in critically ill patients: a multicenter study. The Nutritional and Metabolic Working Group of the Spanish Society of Intensive Care Medicine and Coronary Units. Crit Care Med. 1999;27(8):1447-1453. doi:10.1097/00003246-199908000-00006
11. Dionne JC, Johnstone J, Heels-Ansdell D, et al. Diarrhea in Mechanically Ventilated Patients: A Nested Multicenter Substudy. Crit Care Med. 2025;53(6):e1247-e1256. doi:10.1097/CCM.0000000000006667
12. Qu J, Xu X, Xu C, Ding X, Zhang K, Hu L. The effect of intermittent versus continuous enteral feeding for critically ill patients: a meta-analysis of randomized controlled trials. Front Nutr. 2023;10:1214774. Published 2023 Aug 21. doi:10.3389/fnut.2023.1214774

Referencias:
1. https://www.tadeclinicagem.com.br/guia/381/abordagem-a-diarreia-cronica/
2. Tome J, Kamboj AK, Sweetser S. A Practical 5-Step Approach to Nausea and Vomiting. Mayo Clin Proc. 2022;97(3):600-608. doi:10.1016/j.mayocp.2021.10.030
3. Arasaradnam RP, Brown S, Forbes A, et al. Guidelines for the investigation of chronic diarrhoea in adults: British Society of Gastroenterology, 3rd edition. Gut. 2018;67(8):1380-1399. doi:10.1136/gutjnl-2017-315909
4. Schiller LR, Pardi DS, Sellin JH. Chronic Diarrhea: Diagnosis and Management. Clin Gastroenterol Hepatol. 2017;15(2):182-193.e3. doi:10.1016/j.cgh.2016.07.028
5. BONIS, Peter AL; LAMONT, J. Thomas. Approach to the adult with chronic diarrhea in resource-abundant settings. 2022.

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O Pipoca TdC é um podcast bônus do TdC, que vem para discutir como a medicina é retratada em séries e filmes. A primeira e segunda temporadas foram sobre a série House. Nesse episódio atendemos aos pedidos e vamos falar de The Pitt. Fica tranquilo que você não precisa assistir os episódios ou a série pra curtir, a ideia é ser um papo descontraído e de repente você conseguir aprender algo também. 

Minutagem:
00:00 Apresentação 
01:55 Caso clínico
02:35 Definição a partir do caso
03:31 Incidência e frequência
04:24 Clinicagem 1: avaliação de malignidade
09:52 Exames além da tomografia
11:01 Mielolipoma
12:42 Clinicagem 2: há produção de hormônio?
19:22 Investigação de outras funções hormonais da adrenal
26:45 Retomada do caso clínico
27:29 Clinicagem 3: tem indicação de cirurgia?
33:40 Clinicagem 4: como fazer o acompanhamento?

Referências:
1. Vassiliadi DA, Delivanis DA, Papalou O, Tsagarakis S. Approach to the Patient With Bilateral Adrenal Masses. J Clin Endocrinol Metab. 2024 Jul 12;109(8):2136-2148. doi: 10.1210/clinem/dgae164. PMID: 38478374.
2. Martin Fassnacht, Stylianos Tsagarakis, Massimo Terzolo, Antoine Tabarin, Anju Sahdev, John Newell-Price, Iris Pelsma, Ljiljana Marina, Kerstin Lorenz, Irina Bancos, Wiebke Arlt, Olaf M Dekkers, European Society of Endocrinology clinical practice guidelines on the management of adrenal incidentalomas, in collaboration with the European Network for the Study of Adrenal Tumors, European Journal of Endocrinology, Volume 189, Issue 1, July 2023, Pages G1–G42, https://doi.org/10.1093/ejendo/lvad066
3. Rowe NE, Kumar R, Schieda N, Siddiqi F, McGregor T, McAlpine K, Violette P, Bathini V, Eng M, Izard J. Diagnosis, Management, and Follow-Up of the Incidentally Discovered Adrenal Mass: CUA Guideline Endorsed by the AUA. J Urol. 2023 Oct;210(4):590-599. doi: 10.1097/JU.0000000000003644. Epub 2023 Aug 9. PMID: 37556768.
4. Yip L, Duh QY, Wachtel H, Jimenez C, Sturgeon C, Lee C, Velázquez-Fernández D, Berber E, Hammer GD, Bancos I, Lee JA, Marko J, Morris-Wiseman LF, Hughes MS, Livhits MJ, Han MA, Smith PW, Wilhelm S, Asa SL, Fahey TJ 3rd, McKenzie TJ, Strong VE, Perrier ND. American Association of Endocrine Surgeons Guidelines for Adrenalectomy: Executive Summary. JAMA Surg. 2022 Oct 1;157(10):870-877. doi: 10.1001/jamasurg.2022.3544. PMID: 35976622; PMCID: PMC9386598.
5. Di Dalmazi G, Vicennati V, Garelli S, Casadio E, Rinaldi E, Giampalma E, Mosconi C, Golfieri R, Paccapelo A, Pagotto U, Pasquali R. Cardiovascular events and mortality in patients with adrenal incidentalomas that are either non-secreting or associated with intermediate phenotype or subclinical Cushing's syndrome: a 15-year retrospective study. Lancet Diabetes Endocrinol. 2014 May;2(5):396-405. doi: 10.1016/S2213-8587(13)70211-0. Epub 2014 Jan 29. PMID: 24795253.
6. Rafael B Giorgi, Marcelo V Correa, Flávia A Costa-Barbosa, Claudio E Kater, Cyclic Subclinical Hypercortisolism: A Previously Unidentified Hypersecretory Form of Adrenal Incidentalomas, Journal of the Endocrine Society, Volume 3, Issue 3, March 2019, Pages 678–686, https://doi.org/10.1210/js.2018-00385

Referências:
1. Ropper AH, Klein JP. Cerebral Venous Thrombosis. N Engl J Med. 2021 Jul 1;385(1):59-64. doi: 10.1056/NEJMra2106545. PMID: 34192432.
2. Saposnik, Gustavo et al. “Diagnosis and Management of Cerebral Venous Thrombosis: A Scientific Statement From the American Heart Association.” Stroke vol. 55,3 (2024): e77-e90. doi:10.1161/STR.0000000000000456

Referências:
1. Aldulaimi, Sommer, and Ana M Mendez. “Splenomegaly: Diagnosis and Management in Adults.” American family physician vol. 104,3 (2021): 271-276.
2. Biswas S, Sharma S. Patient with Hepatosplenomegaly: Possibilities and Evaluation. In: Clinical Medicine. Chapter 35. April 2020.
3. Curovic Rotbain E, Hansen DL, Schaffalitzky de Muckadell O, et al. Splenomegaly – Diagnostic validity, work-up, and underlying causes. PLoS ONE. 2017;12(11):e0186674.
4. Sjoberg BP, Menias CO, Lubner MG, et al. Splenomegaly: A Combined Clinical and Radiologic Approach to the Differential Diagnosis. Gastroenterol Clin N Am. 2018.
5. Brown NF, Marks DJB, Smith PJ, Bloom SL. Splenomegaly. Br J Hosp Med. 2011 Nov;72(11):M166–M167.

Referências:
1. Organização Pan-Americana da Saúde. Manual operacional de tuberculose da OMS. Módulo 4: Tratamento. Tratamento da tuberculose sensível. Brasília, D.F.; 2024. Disponível em: https://doi.org/10.37774/9789275727362.
2. Ministério da Saúde, Manual de Recomendacoes e Controle da Tuberculose no Brasil - 2ª ed (2019), disponível em https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/svsa/tuberculose/manual-de-recomendacoes-e-controle-da-tuberculose-no-brasil-2a-ed.pdf/view
3. Dorman SEet al; AIDS Clinical Trials Group; Tuberculosis Trials Consortium. Four-Month Rifapentine Regimens with or without Moxifloxacin for Tuberculosis. N Engl J Med. 2021 May 6;384(18):1705-1718

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Referências:
1. Yu JB, Wilson LD, Detterbeck FC. Superior vena cava syndrome--a proposed classification system and algorithm for management. J Thorac Oncol. 2008;3(8):811-814. doi:10.1097/JTO.0b013e3181804791
2. Wilson LD, Detterbeck FC, Yahalom J. Clinical practice. Superior vena cava syndrome with malignant causes [published correction appears in N Engl J Med. 2008 Mar 6;358(10):1083]. N Engl J Med. 2007;356(18):1862-1869. doi:10.1056/NEJMcp067190
3. Ahmann FR. A reassessment of the clinical implications of the superior vena caval syndrome. J Clin Oncol. 1984;2(8):961-969. doi:10.1200/JCO.1984.2.8.961
4. Temel JS, Dudzinski DM, Digumarthy SR, Keyes CM, Keane FK, Shepherd D. Case 35-2022: A 60-Year-Old Man with Progressive Dyspnea, Neck Swelling, and a Lung Mass. N Engl J Med. 2022;387(20):1889-1896. doi:10.1056/NEJMcpc2211354
5. Schraufnagel DE, Hill R, Leech JA, Pare JA. Superior vena caval obstruction. Is it a medical emergency?. Am J Med. 1981;70(6):1169-1174. doi:10.1016/0002-9343(81)90823-8
6. Loeffler JS, Leopold KA, Recht A, Weinstein HJ, Tarbell NJ. Emergency prebiopsy radiation for mediastinal masses: impact on subsequent pathologic diagnosis and outcome. J Clin Oncol. 1986;4(5):716-721. doi:10.1200/JCO.1986.4.5.716
7. Rowell NP, Gleeson FV. Steroids, radiotherapy, chemotherapy and stents for superior vena caval obstruction in carcinoma of the bronchus: a systematic review. Clin Oncol (R Coll Radiol). 2002;14(5):338-351. doi:10.1053/clon.2002.0095

Referências:
1. Li, Jie et al. “Noninvasive Ventilation for Preoxygenation during Emergency Intubation.” The New England journal of medicine vol. 391,11 (2024): 1068-1069. doi:10.1056/NEJMc2409126
2. Driver, Brian E et al. “Flush Rate Oxygen for Emergency Airway Preoxygenation.” Annals of emergency medicine vol. 69,1 (2017): 1-6. doi:10.1016/j.annemergmed.2016.06.018
3. Ferguson, Ian M C et al. “The effect of ketamine and fentanyl on haemodynamics during intubation in pre-hospital and retrieval medicine.” Acta anaesthesiologica Scandinavica vol. 67,3 (2023): 364-371. doi:10.1111/aas.14177
4. Takahashi, Jin et al. “Association of fentanyl use in rapid sequence intubation with post-intubation hypotension.” The American journal of emergency medicine vol. 36,11 (2018): 2044-2049. doi:10.1016/j.ajem.2018.03.026
5. Levitan, Richard M et al. “Laryngeal view during laryngoscopy: a randomized trial comparing cricoid pressure, backward-upward-rightward pressure, and bimanual laryngoscopy.” Annals of emergency medicine vol. 47,6 (2006): 548-55. doi:10.1016/j.annemergmed.2006.01.013
6. Driver, Brian E et al. “Engagement of the Median Glossoepiglottic Fold and Laryngeal View During Emergency Department Intubation.” Annals of emergency medicine vol. 78,6 (2021): 699-707. doi:10.1016/j.annemergmed.2021.04.024
7. von Hellmann, Rafael et al. “Effect of Bougie Use on First-Attempt Success in Tracheal Intubations: A Systematic Review and Meta-Analysis.” Annals of emergency medicine vol. 83,2 (2024): 132-144. doi:10.1016/j.annemergmed.2023.08.484
8. Shah, Amit P.; Nasa, Prashant1; Ahmed, Syed M.2; Divatia, Jigeeshu V.3; Doctor, Jeson R.4; Garg, Rakesh5; Kundra, Pankaj6; Ramkumar, Venkateswaran7; Shetty, Sumalatha R.8; Ali, Zulfiqar9; Bhardwaj, Neerja10; Bhat, Mala G.11; Das, Sabyasachi12; Ghosh, Sujata13; Goswami, Jyotsna14; Grewal, Anju15; Kumar, Rakesh16; Kumar, M.R Anil17; Malde, Anila D.18; Manjuldevi, M19; Mehandale, Sripada G.20; Parameswari, Aruna21; Patwa, Apeksh22; Pawar, Dilip23; Sahu, Sandeep24; Sharma, Jyoti25; Singaravelu, Ramesh26; Solanki, Sohan L.4; Swaika, Sarbari27; Tiwari, Tanmay28; Ranjan, R V29; Yaddanapudi, Sandhya10; Myatra, Sheila N.4. Expert consensus for difficult airway management in the absence of clear evidence using a Delphi method. Indian Journal of Anaesthesia 69(11):p 1106-1116, November 2025. | DOI: 10.4103/ija.ija_1333_25 

Referências:
1. Nojkov, Borko et al. “Utility of repeated abdominal CT scans after prior negative CT scans in patients presenting to ER with nontraumatic abdominal pain.” Digestive diseases and sciences vol. 58,4 (2013): 1074-83. doi:10.1007/s10620-012-2473-0
2. Cunningham, John M et al. “Things We Do for No Reason™: Ultrasonography after an initial negative CT in patients presenting with acute abdominal or pelvic pain.” Journal of hospital medicine vol. 17,2 (2022): 120-122. doi:10.12788/jhm.3704
3. Murali, Neeraja, and Sahar Morkos El Hayek. “Abdominal Pain Mimics.” Emergency medicine clinics of North America vol. 39,4 (2021): 839-850. doi:10.1016/j.emc.2021.07.003
4. Fields, J Matthew, and Anthony J Dean. “Systemic causes of abdominal pain.” Emergency medicine clinics of North America vol. 29,2 (2011): 195-210, vii. doi:10.1016/j.emc.2011.01.011
5. Wang, Bruce et al. “AGA Clinical Practice Update on Diagnosis and Management of Acute Hepatic Porphyrias: Expert Review.” Gastroenterology vol. 164,3 (2023): 484-491. doi:10.1053/j.gastro.2022.11.034
6. Shaish H, Ream J, Huang C, et al. Diagnostic Accuracy of Unenhanced Computed Tomography for Evaluation of Acute Abdominal Pain in the Emergency Department. JAMA Surg. 2023;158(7):e231112. doi:10.1001/jamasurg.2023.1112
7. Brenner, Darren M et al. “Rare, Overlooked, or Underappreciated Causes of Recurrent Abdominal Pain: A Primer for Gastroenterologists.” Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association vol. 21,2 (2023): 264-279. doi:10.1016/j.cgh.2022.09.022
8. Cates, Alexis L, and Brenna Farmer. “Chronic Drug Use and Abdominal Pain.” Emergency medicine clinics of North America vol. 39,4 (2021): 821-837. doi:10.1016/j.emc.2021.07.006

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Referências:
1. Mach, François et al. “2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk.” European heart journal vol. 41,1 (2020): 111-188. doi:10.1093/eurheartj/ehz455
2. Faludi, André Arpad et al. “Atualização da Diretriz Brasileira de Dislipidemias e Prevenção da Aterosclerose – 2017.” Arquivos brasileiros de cardiologia vol. 109,2 Supl 1 (2017): 1-76. doi:10.5935/abc.20170121
3. Grundy, Scott M et al. “2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.” Journal of the American College of Cardiology vol. 73,24 (2019): 3168-3209. doi:10.1016/j.jacc.2018.11.002
4. Pearson, Glen J et al. “2021 Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in Adults.” The Canadian journal of cardiology vol. 37,8 (2021): 1129-1150. doi:10.1016/j.cjca.2021.03.016
5. Marx, Nikolaus et al. “2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes.” European heart journal vol. 44,39 (2023): 4043-4140. doi:10.1093/eurheartj/ehad192
6. Vrints, Christiaan et al. “2024 ESC Guidelines for the management of chronic coronary syndromes.” European heart journal vol. 45,36 (2024): 3415-3537. doi:10.1093/eurheartj/ehae177
7. Hong, Sung-Jin et al. “Treat-to-Target or High-Intensity Statin in Patients With Coronary Artery Disease: A Randomized Clinical Trial.” JAMA vol. 329,13 (2023): 1078-1087. doi:10.1001/jama.2023.2487
8. Cannon, Christopher P et al. “Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes.” The New England journal of medicine vol. 372,25 (2015): 2387-97. doi:10.1056/NEJMoa1410489
9. Sabatine, Marc S et al. “Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease.” The New England journal of medicine vol. 376,18 (2017): 1713-1722. doi:10.1056/NEJMoa1615664
10. http://departamentos.cardiol.br/sbc-da/2015/calculadoraer2017/etapa1.html
11. Lipidology update: targets and timing of well-established therapies, Luigina Guasti 1, MD, PhD, FAHA, FESC; Alessandro Lupi 2, MD at https://www.escardio.org/Councils/Council-for-Cardiology-Practice-(CCP)/Cardiopractice/lipidology-update-targets-and-timing-of-well-established-therapies
12. Ray, Kausik K et al. “EU-Wide Cross-Sectional Observational Study of Lipid-Modifying Therapy Use in Secondary and Primary Care: the DA VINCI study.” European journal of preventive cardiology vol. 28,11 (2021): 1279-1289. doi:10.1093/eurjpc/zwaa047
13. Cholesterol Treatment Trialists’ (CTT) Collaboration et al. “Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials.” Lancet (London, England) vol. 376,9753 (2010): 1670-81. doi:10.1016/S0140-6736(10)61350-5

Referências: 
1. Vrints C, Andreotti F, Koskinas KC, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes [published correction appears in Eur Heart J. 2025 Feb 21:ehaf079. doi: 10.1093/eurheartj/ehaf079.]. Eur Heart J. 2024;45(36):3415-3537. doi:10.1093/eurheartj/ehae177
2. Virani, Salim S et al. “2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines.” Circulation vol. 148,9 (2023): e9-e119. doi:10.1161/CIR.0000000000001168
3. Montone RA, Rinaldi R, Niccoli G, et al. Optimizing Management of Stable Angina: A Patient-Centered Approach Integrating Revascularization, Medical Therapy, and Lifestyle Interventions. J Am Coll Cardiol. 2024;84(8):744-760. doi:10.1016/j.jacc.2024.06.015
4. Mortensen MB, Dzaye O, Steffensen FH, et al. Impact of Plaque Burden Versus Stenosis on Ischemic Events in Patients With Coronary Atherosclerosis. J Am Coll Cardiol. 2020;76(24):2803-2813. doi:10.1016/j.jacc.2020.10.021
5. Doenst T, Haverich A, Serruys P, et al. PCI and CABG for Treating Stable Coronary Artery Disease: JACC Review Topic of the Week. J Am Coll Cardiol. 2019;73(8):964-976. doi:10.1016/j.jacc.2018.11.053
6. Maron DJ, Hochman JS, Reynolds HR, et al. Initial Invasive or Conservative Strategy for Stable Coronary Disease. N Engl J Med. 2020;382(15):1395-1407. doi:10.1056/NEJMoa1915922
7. Rajkumar CA, Foley MJ, Ahmed-Jushuf F, et al. A Placebo-Controlled Trial of Percutaneous Coronary Intervention for Stable Angina. N Engl J Med. 2023;389(25):2319-2330. doi:10.1056/NEJMoa2310610
8. Eikelboom JW, Connolly SJ, Bosch J, et al. Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease. N Engl J Med. 2017;377(14):1319-1330. doi:10.1056/NEJMoa1709118
9. Howlett JG, Stebbins A, Petrie MC, et al. CABG Improves Outcomes in Patients With Ischemic Cardiomyopathy: 10-Year Follow-Up of the STICH Trial. JACC Heart Fail. 2019;7(10):878-887. doi:10.1016/j.jchf.2019.04.018
10. Nidorf SM, Fiolet ATL, Mosterd A, et al. Colchicine in Patients with Chronic Coronary Disease. N Engl J Med. 2020;383(19):1838-1847. doi:10.1056/NEJMoa2021372
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12. Ford TJ, Stanley B, Good R, et al. Stratified Medical Therapy Using Invasive Coronary Function Testing in Angina: The CorMicA Trial. J Am Coll Cardiol. 2018;72(23 Pt A):2841-2855. doi:10.1016/j.jacc.2018.09.006
13. Carvalho, Tales de et al. “Brazilian Cardiovascular Rehabilitation Guideline - 2020.” “Diretriz Brasileira de Reabilitação Cardiovascular – 2020.” Arquivos brasileiros de cardiologia vol. 114,5 (2020): 943-987. doi:10.36660/abc.20200407

O Pipoca TdC é um podcast bônus do TdC, que vem para discutir como a medicina é retratada em séries e filmes. A primeira e segunda temporadas são sobre a série House. Fica tranquilo que você não precisa assistir o episódio pra curtir, a ideia é ser um papo descontraído e de repente você conseguir aprender algo também.

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Referências:
1. ⁠Grabau CM, Crago SF, Hoff LK, Simon JA, Melton CA, Ott BJ, Kamath PS. Performance standards for therapeutic abdominal paracentesis. Hepatology. 2004 Aug;40(2):484-8. doi: 10.1002/hep.20317. PMID: 15368454.
2.⁠ ⁠Arroyo V, Moreau R, Jalan R. Acute-on-Chronic Liver Failure. N Engl J Med. 2020 May 28;382(22):2137-2145. doi: 10.1056/NEJMra1914900. PMID: 32459924.
3.⁠ ⁠Williams JW Jr, Simel DL. The rational clinical examination. Does this patient have ascites? How to divine fluid in the abdomen. JAMA. 1992 May 20;267(19):2645-8. doi: 10.1001/jama.267.19.2645. PMID: 1573754.
4.⁠ ⁠Biggins SW, Angeli P, Garcia-Tsao G, Ginès P, Ling SC, Nadim MK, Wong F, Kim WR. Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome: 2021 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology. 2021 Aug;74(2):1014-1048. doi: 10.1002/hep.31884. Erratum in: Hepatology. 2024 Nov 1;80(5):E89. doi: 10.1097/HEP.0000000000000983. PMID: 33942342.
5.⁠ ⁠Tocia C, Dumitru A, Alexandrescu L, Popescu R, Dumitru E. Timing of paracentesis and outcomes in hospitalized patients with decompensated cirrhosis. World J Hepatol. 2020 Dec 27;12(12):1267-1275. doi: 10.4254/wjh.v12.i12.1267. PMID: 33442453; PMCID: PMC7772729.
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8.⁠ ⁠Wu PS, Lee KC, Li CY, Hsieh YC, Huo TI, Lin HC, Hou MC. Paracentesis exceeding three liters increases risks of acute kidney injury even in cirrhotic patients with albumin infused refractory ascites. J Formos Med Assoc. 2025 Jan 7:S0929-6646(25)00002-6. doi: 10.1016/j.jfma.2025.01.002. Epub ahead of print. PMID: 39779410.
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O Pipoca TdC é um podcast bônus do TdC, que vem para discutir como a medicina é retratada em séries e filmes. A primeira e segunda temporadas são sobre a série House. Fica tranquilo que você não precisa assistir o episódio pra curtir, a ideia é ser um papo descontraído e de repente você conseguir aprender algo também.

Episódios novos a cada 2 semanas!

Referências:
1. Alves, A. C. (2009). Histologia da medula óssea. Revista Brasileira de Hematologia e Hemoterapia, 31, 183-188.
2. Malempati, Suman et al. “Videos in clinical medicine. Bone marrow aspiration and biopsy.” The New England journal of medicine vol. 361,15 (2009): e28. doi:10.1056/NEJMvcm0804634
3. Ryan DH, Cohen HJ. Bone marrow aspiration and morphology. In: Hematology: Basic Principles and Practice, 3rd ed, Hoffman R, Benz EJ, Shattil SJ, et al. (Eds), Churchill Livingstone, Philadelphia 2000. p.2460.

Minutagem:
00:14 Abertura

02:12 Definição de dobutamina e efeitos

07:31 Como prescrever e titular?

14:05 Quando indicar?

24:05 Como desmamar?

30:40 Desmame falhou e agora?

Referências:
1. Menon V, Slater JN, White HD, Sleeper LA, Cocke T, Hochman JS. Acute myocardial infarction complicated by systemic hypoperfusion without hypotension: report of the SHOCK trial registry. Am J Med. 2000 Apr 1;108(5):374-80. doi: 10.1016/s0002-9343(00)00310-7. PMID: 10759093.
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3. Uhlig K, Efremov L, Tongers J, Frantz S, Mikolajczyk R, Sedding D, Schumann J. Inotropic agents and vasodilator strategies for the treatment of cardiogenic shock or low cardiac output syndrome. Cochrane Database Syst Rev. 2020 Nov 5;11(11):CD009669. doi: 10.1002/14651858.CD009669.pub4. PMID: 33152122; PMCID: PMC8094388.
4. Wilkman E, Kaukonen KM, Pettilä V, Kuitunen A, Varpula M. Association between inotrope treatment and 90-day mortality in patients with septic shock. Acta Anaesthesiol Scand. 2013 Apr;57(4):431-42. doi: 10.1111/aas.12056. Epub 2013 Jan 8. PMID: 23298252.
5. Liu DH, Ning YL, Lei YY, Chen J, Liu YY, Lin XF, Yang ZQ, Xian SX, Chen WT. Levosimendan versus dobutamine for sepsis-induced cardiac dysfunction: a systematic review and meta-analysis. Sci Rep. 2021 Oct 13;11(1):20333. doi: 10.1038/s41598-021-99716-9. PMID: 34645892; PMCID: PMC8514594.
6. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A; ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 Sep 21;42(36):3599-3726. doi: 10.1093/eurheartj/ehab368. Erratum in: Eur Heart J. 2021 Dec 21;42(48):4901. doi: 10.1093/eurheartj/ehab670. PMID: 34447992.
7. Comitê Coordenador da Diretriz de Insuficiência Cardíaca; Rohde LEP, Montera MW, Bocchi EA, Clausell NO, Albuquerque DC, Rassi S, Colafranceschi AS, Freitas AF Junior, Ferraz AS, Biolo A, Barretto ACP, Ribeiro ALP, Polanczyk CA, Gualandro DM, Almeida DR, Silva ERR, Figueiredo EL, Mesquita ET, Marcondes-Braga FG, Cruz FDD, Ramires FJA, Atik FA, Bacal F, Souza GEC, Almeida GLG Junior, Ribeiro GCA, Villacorta H Junior, Vieira JL, Souza JD Neto, Rossi JM Neto, Figueiredo JA Neto, Moura LAZ, Goldraich LA, Beck-da-Silva L, Danzmann LC, Canesin MF, Bittencourt MI, Garcia MI, Bonatto MG, Simões MV, Moreira MCV, Silva MMF, Olivera MT Junior, Silvestre OM, Schwartzmann PV, Bestetti RB, Rocha RM, Simões R, Pereira SB, Mangini S, Alves SMM, Ferreira SMA, Issa VS, Barzilai VS, Martins WA. Diretriz Brasileira de Insuficiência Cardíaca Crônica e Aguda. Arq Bras Cardiol. 2018 Sep;111(3):436-539. Portuguese. doi: 10.5935/abc.20180190. Erratum in: Arq Bras Cardiol. 2019 Jan;112(1):116. doi: 10.5935/abc.20190004. PMID: 30379264.
8. Overgaard CB, Dzavík V. Inotropes and vasopressors: review of physiology and clinical use in cardiovascular disease. Circulation. 2008 Sep 2;118(10):1047-56. doi: 10.1161/CIRCULATIONAHA.107.728840. PMID: 18765387.

O Pipoca TdC é um podcast bônus do TdC, que vem para discutir como a medicina é retratada em séries e filmes. A primeira e segunda temporadas são sobre a série House. Fica tranquilo que você não precisa assistir o episódio pra curtir, a ideia é ser um papo descontraído e de repente você conseguir aprender algo também.

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Referências:
1. Stene-Larsen, Kim, and Anne Reneflot. “Contact with primary and mental health care prior to suicide: A systematic review of the literature from 2000 to 2017.” Scandinavian journal of public health vol. 47,1 (2019): 9-17. doi:10.1177/1403494817746274
2. Walby, Fredrik A et al. “Contact With Mental Health Services Prior to Suicide: A Systematic Review and Meta-Analysis.” Psychiatric services (Washington, D.C.) vol. 69,7 (2018): 751-759. doi:10.1176/appi.ps.201700475
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Referências: 

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7. Novotny, Richard W et al. “Palpable Purpura.” American family physician vol. 109,3 (2024): 265-267.
8. https://www.tadeclinicagem.com.br/guia/321/amiloidose-manifestacoes-clinicas-e-diagnostico/

O Pipoca TdC é um podcast bônus do TdC, que vem para discutir como a medicina é retratada em séries e filmes. A primeira e segunda temporadas são sobre a série House. Fica tranquilo que você não precisa assistir o episódio pra curtir, a ideia é ser um papo descontraído e de repente você conseguir aprender algo também.

Episódios novos a cada 2 semanas!

🚨 www.tadeclinicagem.com.br/guia - Conheça o Guia TdC com 7 dias grátis 🚨

Minutagem:
00:14 Abertura

02:46 Definição de asma

05:10 Diagnóstico de asma

14:50 Tratamento de asma
45:30 Salves

Quer saber mais sobre asma? Acesso o Guia TdC: https://www.tadeclinicagem.com.br/guia/368/atualizacao-de-asma-gina-2024/

Referências:
1. https://www.tadeclinicagem.com.br/guia/368/atualizacao-de-asma-gina-2024/
2. https://www.tadeclinicagem.com.br/guia/174/asma-gina-2023/
3. https://ginasthma.org/2024-report/
4. Stanojevic, Sanja et al. “ERS/ATS technical standard on interpretive strategies for routine lung function tests.” The European respiratory journal vol. 60,1 2101499. 13 Jul. 2022, doi:10.1183/13993003.01499-2021
5. Albuquerque AL, Berton DC, Campos EV, Queiroga-Júnior FJ, Santana AN, Wong BD, Batista DR, Melo FX, Didier-Neto FM, Barros JA, Salge JM. Novas recomendações de espirometria da Sociedade Brasileira de Pneumologia e Tisiologia-atualização 2024. Jornal Brasileiro de Pneumologia. 2025 Jan 20;50:e20240169. https://dx.doi.org/10.36416/1806-3756/e2021027
6. Rank, Matthew A et al. “The risk of asthma exacerbation after stopping low-dose inhaled corticosteroids: a systematic review and meta-analysis of randomized controlled trials.” The Journal of allergy and clinical immunology vol. 131,3 (2013): 724-9. doi:10.1016/j.jaci.2012.11.038
7. Grant, Torie et al. “Asthma and the social determinants of health.” Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology vol. 128,1 (2022): 5-11. doi:10.1016/j.anai.2021.10.002
8. https://www.nice.org.uk/guidance/ng80/chapter/recommendations#algorithms
9. O'Byrne, Paul M et al. “Inhaled Combined Budesonide-Formoterol as Needed in Mild Asthma.” The New England journal of medicine vol. 378,20 (2018): 1865-1876. doi:10.1056/NEJMoa1715274
9. Bateman, Eric D et al. “As-Needed Budesonide-Formoterol versus Maintenance Budesonide in Mild Asthma.” The New England journal of medicine vol. 378,20 (2018): 1877-1887. doi:10.1056/NEJMoa1715275
10. Melani, Andrea S et al. “Inhaler mishandling remains common in real life and is associated with reduced disease control.” Respiratory medicine vol. 105,6 (2011): 930-8. doi:10.1016/j.rmed.2011.01.005
11. Hekking PW, Wener RR, Amelink M, Zwinderman AH, Bouvy ML, Bel EH. The prevalence of severe refractory asthma. J Allergy Clin Immunol. 2015;135(4):896-902. doi:10.1016/j.jaci.2014.08.042

O Pipoca TdC é um podcast bônus do TdC, que vem para discutir como a medicina é retratada em séries e filmes. A primeira e segunda temporadas são sobre a série House. Fica tranquilo que você não precisa assistir o episódio pra curtir, a ideia é ser um papo descontraído e de repente você conseguir aprender algo também.

Episódios novos a cada 2 semanas!

Referências:
1. Dinkin, Marc. “Diagnostic approach to diplopia.” Continuum (Minneapolis, Minn.) vol. 20,4 Neuro-ophthalmology (2014): 942-65. doi:10.1212/01.CON.0000453310.52390.58
2. Kim, Hyun-Jae et al. “Diplopia: characteristics and etiologic distribution in a referral-based university hospital.” Journal of neurology vol. 270,2 (2023): 1067-1075. doi:10.1007/s00415-022-11471-7
3. Jacobson, D M. “Relative pupil-sparing third nerve palsy: etiology and clinical variables predictive of a mass.” Neurology vol. 56,6 (2001): 797-8. doi:10.1212/wnl.56.6.797

Quer saber mais sobre amiloidose, veja o tópico: https://www.tadeclinicagem.com.br/guia/321/amiloidose-manifestacoes-clinicas-e-diagnostico/

Minutagem:

00:10 Apresentação 

03:55 Definição

05:40 Epidemiologia

07:45 Como o paciente chega 

08:00 Mnemônicos 

09:00 Cálcio

11:50 Rim - disfunção renal

17:05 Anemia

19:50 Bone - osso

21:45 Outros sintomas além do CRAB

26: 45 Apresentação do paciente

27:00 Caso 1

27:45 Caso 2

28:30 Investigação

35:55 Retornando aos casos

38:30 Diagnóstico 

43:10 Retornando aos casos

44:00 Doenças e manifestações atípicas do mieloma

52:00 Encerramento

Referências:
1. Rajkumar, S Vincent. “Multiple myeloma: 2024 update on diagnosis, risk-stratification, and management.” American journal of hematology vol. 99,9 (2024): 1802-1824. doi:10.1002/ajh.27422
2. Kumar, Shaji K et al. “Multiple myeloma.” Nature reviews. Disease primers vol. 3 17046. 20 Jul. 2017, doi:10.1038/nrdp.2017.46
3. Rajkumar, S Vincent et al. “International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma.” The Lancet. Oncology vol. 15,12 (2014): e538-48. doi:10.1016/S1470-2045(14)70442-5
4. Dimopoulos, Meletios A et al. “Management of multiple myeloma-related renal impairment: recommendations from the International Myeloma Working Group.” The Lancet. Oncology vol. 24,7 (2023): e293-e311. doi:10.1016/S1470-2045(23)00223-1
5. Palumbo, Antonio, and Kenneth Anderson. “Multiple myeloma.” The New England journal of medicine vol. 364,11 (2011): 1046-60. doi:10.1056/NEJMra1011442
6. Nandra, Taran K et al. “Multiple myeloma: what a non-haematologist should know.” Clinical medicine (London, England) vol. 22,3 (2022): 230-233. doi:10.7861/clinmed.2022-0144
7. Sive, Jonathan et al. “Guidelines on the diagnosis, investigation and initial treatment of myeloma: a British Society for Haematology/UK Myeloma Forum Guideline.” British journal of haematology vol. 193,2 (2021): 245-268. doi:10.1111/bjh.17410
8. Mikhael, Joseph et al. “Treatment of Multiple Myeloma: ASCO and CCO Joint Clinical Practice Guideline.” Journal of clinical oncology : official journal of the American Society of Clinical Oncologyvol. 37,14 (2019): 1228-1263. doi:10.1200/JCO.18.02096
9. Marron, Thomas U et al. “Validation and Utility of the Free Light Chain Assay in Pleural Effusions of Patients With Multiple Myeloma.” Clinical lymphoma, myeloma & leukemia vol. 16,7 (2016): e113-7. doi:10.1016/j.clml.2016.04.008
10. Witzig, T E et al. “Quantitation of circulating peripheral blood plasma cells and their relationship to disease activity in patients with multiple myeloma.” Cancer vol. 72,1 (1993): 108-13. doi:10.1002/1097-0142(19930701)72:1<108::aid-cncr2820720121>3.0.co;2-t
11. Dimopoulos, M A et al. “Pathogenesis and treatment of renal failure in multiple myeloma.” Leukemia vol. 22,8 (2008): 1485-93. doi:10.1038/leu.2008.131
12. Agbuduwe, Charles et al. “Clinical presentation and outcomes of solitary plasmacytoma in a tertiary hospital in the UK.” Clinical medicine (London, England) vol. 20,5 (2020): e191-e195. doi:10.7861/clinmed.2019-0488
13. Leung, Nelson et al. “Monoclonal Gammopathy of Renal Significance.” The New England journal of medicine vol. 384,20 (2021): 1931-1941. doi:10.1056/NEJMra1810907

O Pipoca TdC é um podcast bônus do TdC, que vem para discutir como a medicina é retratada em séries e filmes. A primeira e segunda temporadas são sobre a série House. Fica tranquilo que você não precisa assistir o episódio pra curtir, a ideia é ser um papo descontraído e de repente você conseguir aprender algo também.

Episódios novos a cada 2 semanas!

🚨 www.tadeclinicagem.com.br/guia - Conheça o Guia TdC com 7 dias grátis 🚨

Minutagem:
01:14 Abertura

01:42 Como fazer o diagnóstico? 

09:15 Situações especiais (rastreio, pacientes com hepatopatia e manifestação extra-hepática)

18:56 O que fazer após o diagnóstico?

22:18 Como tratar?
29:33 Salves

Quer saber mais sobre carcinoma hepatocelular? Acesso o Guia TdC https://www.tadeclinicagem.com.br/guia/291/carcinoma-hepatocelular/

Referências:
1. BRASIL. Ministério da Saúde. Protocolo Clínico e Diretrizes Terapêuticas de Hepatite B e Coinfecções. Brasília, DF: Ministério da Saúde, 2023. Disponível em: http://bvsms.saude.gov.br/bvs/publicacoes/protocolo_clinico_diretrizes_terapeuticas_hepbdigital.pdf
2. BRASIL. Ministério da Saúde. Protocolo Clínico e Diretrizes Terapêuticas para Prevenção da Transmissão Vertical do HIV, Sífilis e Hepatites Virais. Brasília, DF: Ministério da Saúde, 2022. Disponível em: http://bvsms.saude.gov.br/bvs/publicacoes/protocolo_clinico_hiv_sifilis_hepatites.pdf

O Pipoca TdC é um podcast bônus do TdC, que vem para discutir como a medicina é retratada em séries e filmes. A primeira e segunda temporadas são sobre a série House. Fica tranquilo que você não precisa assistir o episódio pra curtir, a ideia é ser um papo descontraído e de repente você conseguir aprender algo também.

Episódios novos a cada 2 semanas!

Minutagem:
2:04 Apresentação do caso clínico

4:55 Definição de perda ponderal não intencional

5:27 Abordagem da perda de peso não intencional 

7:30 Cuidados no pronto-socorro

8:49 Exame físico do caso clínico 

12:47 Causas subagudas e crônicas de perda ponderal não intencional

19:35 Análise do quadro clínico

21:31 Diagnóstico diferencial das vasculites 

22:19 Púrpura palpável x púrpura não palpável

25:46 Exames para avaliar acometimento orgânicos na perda ponderal não intencional

28:16 Exames laboratoriais do caso clínico 

31:02 Exames para investigação de vasculites 

34:05 Outros exames do caso clínico 

36:16 Discussão e finalização do caso 

40:33 Salves

Referências:
1.⁠ ⁠Gaddey HL, Holder K. Unintentional weight loss in older adults. Am Fam Physician 2014; 89:718.
2.⁠ ⁠Moriguti JC, Moriguti EK, Ferriolli E, et al. Involuntary weight loss in elderly individuals: assessment and treatment. Sao Paulo Med J 2001; 119:72.
3.⁠ ⁠McMinn J, Steel C, Bowman A. Investigation and management of unintentional weight loss in older adults. BMJ 2011; 342:d1732.
4.⁠ ⁠Marton KI, Sox HC Jr, Krupp JR. Involuntary weight loss: diagnostic and prognostic significance. Ann Intern Med 1981; 95:568.
5.⁠ ⁠Soo MRT, Khor JH, Cheah MH, Nashi NB. Approach to weight loss in adults. Singapore Med J. 2024 May 1;65(5):291-294.
6.⁠ ⁠Bosch X, Monclús E, Escoda O, Guerra-García M, Moreno P, Guasch N, López-Soto A. Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients. PLoS One.
7.⁠ ⁠Wong CJ. Involuntary weight loss. Med Clin North Am 2014; 98:625.
8.⁠ ⁠Noblett D, Kwong A, Corwin MT, Fananapazir G. Prevalence of Malignancy on Contrast-Enhanced Computed Tomography of the Abdomen and Pelvis in Patients With Unexplained, Unintentional Weight Loss. J Comput Assist Tomogr 2021; 45:663.

Referências:
1. Provan, Drew et al. “Updated international consensus report on the investigation and management of primary immune thrombocytopenia.” Blood advancesvol. 3,22 (2019): 3780-3817. doi:10.1182/bloodadvances.2019000812
2. Neunert, Cindy et al. “American Society of Hematology 2019 guidelines for immune thrombocytopenia.” Blood advances vol. 3,23 (2019): 3829-3866. doi:10.1182/bloodadvances.2019000966
3. Gasbarrini, A et al. “Regression of autoimmune thrombocytopenia after eradication of Helicobacter pylori.” Lancet (London, England) vol. 352,9131 (1998): 878. doi:10.1016/S0140-6736(05)60004-9
4. Vrbensky, John R et al. “The sensitivity and specificity of platelet autoantibody testing in immune thrombocytopenia: a systematic review and meta-analysis of a diagnostic test.” Journal of thrombosis and haemostasis : JTH vol. 17,5 (2019): 787-794. doi:10.1111/jth.14419
5. Li, Na et al. “Platelet variability index: a measure of platelet count fluctuations in patients with immune thrombocytopenia.” Blood advances vol. 5,20 (2021): 4256-4264. doi:10.1182/bloodadvances.2020004162
6. Mazzucconi, Maria Gabriella et al. “Prednisone vs high-dose dexamethasone in newly diagnosed adult primary immune thrombocytopenia: a randomized trial.” Blood advances vol. 8,6 (2024): 1529-1540. doi:10.1182/bloodadvances.2023010975
7. Wei, Yu et al. “High-dose dexamethasone vs prednisone for treatment of adult immune thrombocytopenia: a prospective multicenter randomized trial.” Blood vol. 127,3 (2016): 296-302; quiz 370. doi:10.1182/blood-2015-07-659656
8. Stasi, Roberto. “How to approach thrombocytopenia.” Hematology. American Society of Hematology. Education Program vol. 2012 (2012): 191-7. doi:10.1182/asheducation-2012.1.191
9. AM Donald, C Adam. Immune thrombocytopenia (ITP) in adults: Clinical manifestations and diagnosis. Uptodate.com acesso em dezembro/2024.
10. AM Donald, C Adam. Initial treatment of immune thrombocytopenia (ITP) in adults. Uptodate.com acesso em dezembro/2024.

🚨 www.tadeclinicagem.com.br/guia - Conheça o Guia TdC com 7 dias grátis 🚨

Referências:
1. Smith, Andrew et al. “Cirrhosis: Diagnosis and Management.” American family physician vol. 100,12 (2019): 759-770.
2. Udell JA, Wang CS, Tinmouth J, et al. Does This Patient With Liver Disease Have Cirrhosis? JAMA.2012;307(8):832–842. doi:10.1001/jama.2012.186
3. Bonacini, M et al. “Utility of a discriminant score for diagnosing advanced fibrosis or cirrhosis in patients with chronic hepatitis C virus infection.” The American journal of gastroenterology vol. 92,8 (1997): 1302-4.
4. Lok, Anna S F et al. “Predicting cirrhosis in patients with hepatitis C based on standard laboratory tests: results of the HALT-C cohort.” Hepatology (Baltimore, Md.) vol. 42,2 (2005): 282-92. doi:10.1002/hep.20772
5. Ginès, Pere et al. “Liver cirrhosis.” Lancet (London, England) vol. 398,10308 (2021): 1359-1376. doi:10.1016/S0140-6736(21)01374-X
6. Wilson, Rachel, and Donna M Williams. “Cirrhosis.” The Medical clinics of North America vol. 106,3 (2022): 437-446. doi:10.1016/j.mcna.2021.12.001

Referências em breve.

Referências:
1. Spasovski, Goce et al. “Clinical practice guideline on diagnosis and treatment of hyponatraemia.” European journal of endocrinology vol. 170,3 G1-47. 25 Feb. 2014, doi:10.1530/EJE-13-1020
2. Hoorn, Ewout J, and Robert Zietse. “Diagnosis and Treatment of Hyponatremia: Compilation of the Guidelines.” Journal of the American Society of Nephrology : JASN vol. 28,5 (2017): 1340-1349. doi:10.1681/ASN.2016101139
3. Baek, Seon Ha et al. “Risk of Overcorrection in Rapid Intermittent Bolus vs Slow Continuous Infusion Therapies of Hypertonic Saline for Patients With Symptomatic Hyponatremia: The SALSA Randomized Clinical Trial.” JAMA internal medicine vol. 181,1 (2021): 81-92. doi:10.1001/jamainternmed.2020.5519
4. Seethapathy, Harish et al. “Severe Hyponatremia Correction, Mortality, and Central Pontine Myelinolysis.” NEJM evidence vol. 2,10 (2023): EVIDoa2300107. doi:10.1056/EVIDoa2300107

Quer saber mais?  Clique no link: https://www.tadeclinicagem.com.br/guia/edition/edicao-97/#diretriz-de-hipertensao-arterial-da-esc-2024-e-como-iniciar-tratamento-de-hipertensao

Referências:
1. Silva Júnior WS, Gabbay M, Lamounier R, Bertoluci M. Insulinoterapia no diabetes mellitus tipo 1 (DM1). Diretriz Oficial da Sociedade Brasileira de Diabetes (2023). DOI: 10.29327/557753.2022-5, ISBN: 978-85-5722-906-8.
2. American Diabetes Association, novembro/23. https://diabetesjournals.org/care/issue/47/Supplement_1
3. https://steno.shinyapps.io/T1RiskEngine/
4. Siebenhofer A, Plank J, Berghold A, Jeitler K, Horvath K, Narath M, et al. Short acting insulin analogues versus regular human insulin in patients with diabetes mellitus. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD003287
5. Siebenhofer, A et al. “Short acting insulin analogues versus regular human insulin in patients with diabetes mellitus.” The Cochrane database of systematic reviews ,2 CD003287. 19 Apr. 2006, doi:10.1002/14651858.CD003287.pub4

O Pipoca TdC é um podcast bônus do TdC, que vem para discutir como a medicina é retratada em séries e filmes. A primeira temporada fala sobre a série House. Fica tranquilo que você não precisa assistir o episódio pra curtir, aqui ideia é ser um papo descontraído e de repente você conseguir aprender algo também. 

Referências:
1. Firkin, Anna L et al. “Mind the gap: Multiple events and lengthy delays before presentation with a "first seizure".” Epilepsia vol. 56,10 (2015): 1534-41. doi:10.1111/epi.13127 

Minutagem:
00:10 Apresentação e sumarização do episódio

03:50 Indicações do exame de urina

05:45 Aspectos físicos do exame de urina

16:41 Aspectos químicos do exame de urina

39:03 Aspectos microscópicos do exame de urina

47:24 Encerramento e salves

Referências:
1. Echeverry, Germán et al. “Introduction to urinalysis: historical perspectives and clinical application.” Methods in molecular biology (Clifton, N.J.) vol. 641 (2010): 1-12. doi:10.1007/978-1-60761-711-2_1
2. Wise, Gilbert J, and Peter N Schlegel. “Sterile pyuria.” The New England journal of medicine vol. 372,11 (2015): 1048-54. doi:10.1056/NEJMra1410052
3. Muriithi, Angela K et al. “Utility of urine eosinophils in the diagnosis of acute interstitial nephritis.” Clinical journal of the American Society of Nephrology : CJASN vol. 8,11 (2013): 1857-62. doi:10.2215/CJN.01330213
4. Köhler, H et al. “Acanthocyturia--a characteristic marker for glomerular bleeding.” Kidney internationalvol. 40,1 (1991): 115-20. doi:10.1038/ki.1991.188
5. Mazouz, Benjamin, and Miriam Almagor. “False-positive microhematuria in dipsticks urinalysis caused by the presence of semen in urine.” Clinical biochemistry vol. 36,3 (2003): 229-31. doi:10.1016/s0009-9120(02)00473-3
6. Stern, Adam B et al. “Pink urine after propofol anesthesia.” Kidney international vol. 78,11 (2010): 1193. doi:10.1038/ki.2010.363

Referências:
1. Andrade, Jason G, and L Brent Mitchell. “Periprocedural Anticoagulation for Cardioversion of Acute Onset Atrial Fibrillation and Flutter: Evidence Base for Current Guidelines.” The Canadian journal of cardiology vol. 35,10 (2019): 1301-1310. doi:10.1016/j.cjca.2019.06.006
2. Palomäki, A., Mustonen, P., Hartikainen, J. E. K., Nuotio, I., Kiviniemi, T., Ylitalo, A., Hartikainen, P., Lehtola, H., Luite, R., & Airaksinen, K. E. J. (2016). Strokes after cardioversion of atrial fibrillation - The FibStroke study. International Journal of Cardiology, 203, 269–273. https://doi.org/10.1016/j.ijcard.2015.10.168
3. Joglar, José A et al. “2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.” Circulation vol. 149,1 (2024): e1-e156. doi:10.1161/CIR.0000000000001193
4. Moran JL, Gallagher J, Peake SL, et al. Parenteral magnesium sulfate versus amiodarone in the therapy of atrial tachyarrhythmias: a prospective, randomized study. Crit Care Med. 1995 Nov;23(11):1816-24. doi: 10.1097/00003246-199511000-00005
5. Slavik RS, Tisdale JE, Borzak S. Pharmacologic conversion of atrial fibrillation: a systematic review of available evidence. Prog Cardiovasc Dis. 2001 Sep-Oct;44(2):121-52. doi: 10.1053/pcad.2001.26966
6. Davey MJ, Teubner D. A randomized controlled trial of magnesium sulfate, in addition to usual care, for rate control in atrial fibrillation. Ann Emerg Med. 2005 Apr;45(4):347-53. doi: 10.1016/j.annemergmed.2004.09.013
7. Van Gelder IC, Groenveld HF, Crijns HJ, et al.; RACE II Investigators. Lenient versus strict rate control in patients with atrial fibrillation. N Engl J Med. 2010 Apr 15;362(15):1363-73. doi: 10.1056/NEJMoa1001337
8. Wetterslev M, Haase N, Hassager C, et al. New-onset atrial fibrillation in adult critically ill patients: a scoping review. Intensive Care Med. 2019 Jul;45(7):928-938. doi: 10.1007/s00134-019-05633-x
9. O'Bryan LJ, Redfern OC, Bedford J, et al. Managing new-onset atrial fibrillation in critically ill patients: a systematic narrative review. BMJ Open. 2020 Mar 24;10(3):e034774. doi: 10.1136/bmjopen-2019-034774
10. Kirchhof P, Camm AJ, Goette A, et al. EAST-AFNET 4 Trial Investigators. Early Rhythm-Control Therapy in Patients with Atrial Fibrillation. N Engl J Med. 2020 Oct 1;383(14):1305-1316. doi: 10.1056/NEJMoa2019422

O Pipoca TdC é um podcast bônus do TdC, que vem para discutir como a medicina é retratada em séries e filmes. A primeira temporada falará sobre a série House. Fica tranquilo que você não precisa assistir o episódio pra curtir, aqui ideia é ser um papo descontraído e de repente você conseguir aprender algo também. 

Episódios novos a cada 2 semanas!

Minutagem:
00:10 Apresentação
2:41 Clinicagem 1: O que é a colonoscopia e qual é a diferença da colonoscopia para a retossigmoidoscopia
flexível e para a anuscopia?
8:35 Clinicagem 2: Uso clínico da colonoscopia (diagnóstico e terapêutico)
14:45 Clinicagem 3: Preparo da colonoscopia
29:15 Clinicagem 4: Efeitos adversos/complicações da colonoscopia

Referências:
1. da Silva, José Guilherme Nogueira, et al. "Preparo de cólon para colonoscopia–Diretriz da Sociedade Brasileira de Endoscopia Digestiva (SOBED). (https://amb.org.br/wp-content/uploads/2024/09/PREPARO-DE-COLON-PARA-COLONOSCOPIA.pdf)
2. Whitlock, Evelyn P et al. “Screening for colorectal cancer: a targeted, updated systematic review for the U.S. Preventive Services Task Force.” Annals of internal medicine vol. 149,9 (2008): 638-58. doi:10.7326/0003-4819-149-9-200811040-00245
3. Reumkens, Ankie et al. “Post-Colonoscopy Complications: A Systematic Review, Time Trends, and Meta-Analysis of Population-Based Studies.” The American journal of gastroenterology vol. 111,8 (2016): 1092-101. doi:10.1038/ajg.2016.234
4. ASGE Standards of Practice Committee et al. “Complications of colonoscopy.” Gastrointestinal endoscopy vol. 74,4 (2011): 745-52. doi:10.1016/j.gie.2011.07.025
5. Warren, Joan L et al. “Adverse events after outpatient colonoscopy in the Medicare population.” Annals of internal medicine vol. 150,12 (2009): 849-57, W152. doi:10.7326/0003-4819-150-12-200906160-00008
6. Michetti, Christopher P et al. “Splenic injury due to colonoscopy: analysis of the world literature, a new case report, and recommendations for management.” The American surgeon vol. 76,11 (2010): 1198-204. doi:10.1177/000313481007601117
7. Kothari, Shivangi T et al. “ASGE review of adverse events in colonoscopy.” Gastrointestinal endoscopyvol. 90,6 (2019): 863-876.e33. doi:10.1016/j.gie.2019.07.033

Minutagem: 
00:10 Apresentação 
05:47 Introdução e Definições Operacionais do EME
10:45 Manejo Inicial na Sala de Emergência (First line)
15:27 Fármacos de Segunda Linha (Second line)
26:46 Investigação Etiológica (Pistas Clínicas e Exames)
31:47 Estado de Mal Epiléptico Refratário (RSE) e Super-Refratário (SRSE)
40:08 Complementação

Referências:
1. Trinka E, Cock H, Hesdorffer D, et al. A definition and classification of status epilepticus--Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia. 2015;56(10):1515-1523. doi:10.1111/epi.13121
2. Brophy GM, Bell R, Claassen J, et al. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care. 2012;17(1):3-23. doi:10.1007/s12028-012-9695-z
3. Vignatelli L, Tontini V, Meletti S, et al. Clinical practice guidelines on the management of status epilepticus in adults: A systematic review. Epilepsia. 2024;65(6):1512-1530. doi:10.1111/epi.17982

O Pipoca TdC é um podcast bônus do TdC, que vem para discutir como a medicina é retratada em séries e filmes. A primeira temporada falará sobre a série House. Fica tranquilo que você não precisa assistir o episódio pra curtir, aqui ideia é ser um papo descontraído e de repente você conseguir aprender algo também. 

Episódios novos a cada 2 semanas!

Referências:
1. Brasil. Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Complexo da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Protocolo Clínico e Diretrizes Terapêuticas para Profilaxia Pós-Exposição de Risco (PEP) à Infecção por HIV, ISTs e Hepatites Virais [recurso eletrônico] / Ministério da Saúde, Secretaria de Ciência, Tecnologia, Inovação e Complexo da Saúde, Secretaria de Vigilância em Saúde e Ambiente. – Brasília : Ministério da Saúde, 2024.
2. Brasil. Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Secretaria de Vigilância em Saúde. Protocolo Clínico e Diretrizes Terapêuticas para Profilaxia Pré-Exposição (PrEP) de Risco à Infecção pelo HIV [recurso eletrônico] / Ministério da Saúde, Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde, Secretaria de Vigilância em Saúde. – 1. ed. rev. – Brasília : Ministério da Saúde, 2022.
3. Centers for Disease Control and Prevention: US Public Health Service: Preexposure prophylaxis for the prevention of HIV infection in the United States—2021 Update: a clinical practice guideline. https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2021.pdf. Published 2021.
4. Molina, Jean-Michel et al. “On-Demand Preexposure Prophylaxis in Men at High Risk for HIV-1 Infection.” The New England journal of medicine vol. 373,23 (2015): 2237-46. doi:10.1056/NEJMoa1506273
5. Molina, Jean-Michel et al. “Daily and on-demand HIV pre-exposure prophylaxis with emtricitabine and tenofovir disoproxil (ANRS PREVENIR): a prospective observational cohort study.” The lancet. HIV vol. 9,8 (2022): e554-e562. doi:10.1016/S2352-3018(22)00133-3
6. Chou, Roger et al. “Preexposure Prophylaxis for the Prevention of HIV: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.” JAMA vol. 330,8 (2023): 746-763. doi:10.1001/jama.2023.9865
7. Landovitz, Raphael J et al. “Type 1 Human Immunodeficiency Virus (HIV-1) Incidence, Adherence, and Drug Resistance in Individuals Taking Daily Emtricitabine/Tenofovir Disoproxil Fumarate for HIV-1 Pre-exposure Prophylaxis: Pooled Analysis From 72 Global Studies.” Clinical infectious diseases : an official publication of the Infectious Diseases Society of America vol. 79,5 (2024): 1197-1207. doi:10.1093/cid/ciae143
8. Segal-Maurer, Sorana et al. “Capsid Inhibition with Lenacapavir in Multidrug-Resistant HIV-1 Infection.” The New England journal of medicine vol. 386,19 (2022): 1793-1803. doi:10.1056/NEJMoa2115542
9. Bekker, Linda-Gail et al. “Twice-Yearly Lenacapavir or Daily F/TAF for HIV Prevention in Cisgender Women.” The New England journal of medicine vol. 391,13 (2024): 1179-1192. doi:10.1056/NEJMoa2407001

Referências:
1. Domínguez-Rodríguez A, Suero-Mendez C, Burillo-Putze G, Gil V, Calvo-Rodriguez R, Piñera-Salmeron P, Llorens P, Martín-Sánchez FJ, Abreu-Gonzalez P, Miró Ò; MIMO (MIdazolam versus MOrphine) Trial Investigators. Midazolam versus morphine in acute cardiogenic pulmonary oedema: results of a multicentre, open-label, randomized controlled trial. Eur J Heart Fail. 2022 Oct;24(10):1953-1962. doi: 10.1002/ejhf.2602. Epub 2022 Jul 16. PMID: 35780488.
2. Stemple K, DeWitt KM, Porter BA, Sheeser M, Blohm E, Bisanzo M. High-dose nitroglycerin infusion for the management of sympathetic crashing acute pulmonary edema (SCAPE): A case series. Am J Emerg Med. 2021 Jun;44:262-266. doi: 10.1016/j.ajem.2020.03.062. Epub 2020 Apr 2. PMID: 32278569.
3. McDonagh, Theresa A et al. “2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure.” European heart journal vol. 42,36 (2021): 3599-3726. doi:10.1093/eurheartj/ehab368
4. Heidenreich, Paul A et al. “2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.” Circulation vol. 145,18 (2022): e895-e1032. doi:10.1161/CIR.0000000000001063
5. Biegus, Jan et al. “Impact of empagliflozin on decongestion in acute heart failure: the EMPULSE trial.” European heart journal vol. 44,1 (2023): 41-50. doi:10.1093/eurheartj/ehac530
6. Meekers, Evelyne et al. “Renal function and decongestion with acetazolamide in acute decompensated heart failure: the ADVOR trial.” European heart journal vol. 44,37 (2023): 3672-3682. doi:10.1093/eurheartj/ehad557
7. Felker, G Michael et al. “Diuretic strategies in patients with acute decompensated heart failure.” The New England journal of medicine vol. 364,9 (2011): 797-805. doi:10.1056/NEJMoa1005419
8. Yancy, Clyde W et al. “Quality of care and outcomes in acute decompensated heart failure: The ADHERE Registry.” Current heart failure reports vol. 1,3 (2004): 121-8. doi:10.1007/s11897-004-0021-8
9. Fonarow, Gregg C et al. “Overview of acutely decompensated congestive heart failure (ADHF): a report from the ADHERE registry.” Heart failure reviews vol. 9,3 (2004): 179-85. doi:10.1007/s10741-005-6127-6
10. Gray, A J et al. “A multicentre randomised controlled trial of the use of continuous positive airway pressure and non-invasive positive pressure ventilation in the early treatment of patients presenting to the emergency department with severe acute cardiogenic pulmonary oedema: the 3CPO trial.” Health technology assessment (Winchester, England) vol. 13,33 (2009): 1-106. doi:10.3310/hta13330
11. Domínguez-Rodríguez, Alberto et al. “Midazolam versus morphine in acute cardiogenic pulmonary oedema: results of a multicentre, open-label, randomized controlled trial.” European journal of heart failure vol. 24,10 (2022): 1953-1962. doi:10.1002/ejhf.2602

O Pipoca TdC é um podcast bônus do TdC, que vem para discutir como a medicina é retratada em séries e filmes. A primeira temporada falará sobre a série House. Fica tranquilo que você não precisa assistir o episódio pra curtir, aqui ideia é ser um papo descontraído e de repente você conseguir aprender algo também.

Episódios novos a cada 2 semanas!

Minutagem:
00:10 Apresentação
03:14  Caso clínico
08:53 Termos de leucocitose
12:44 Causas de leucocitose
22:33 Abordagem de leucocitose
26:22 Retorno ao caso
34:24 Emergências associadas com as leucemias agudas
43:33 Mielograma e biópsia
45:54 Hipótese diagnóstica e conduta para o caso
47:59 Outras situações de precursores jovens no sangue periférico

Referências em breve.

Referências:
1. HONARMAND, Kimia et al. Society of critical care medicine guidelines on glycemic control for critically ill children and adults 2024. Critical care medicine, v. 52, n. 4, p. e161-e181, 2024.
2. Hermanides, Jeroen et al. “Hypoglycemia is associated with intensive care unit mortality.” Critical care medicine vol. 38,6 (2010): 1430-4. doi:10.1097/CCM.0b013e3181de562c
3. NICE-SUGAR Study Investigators et al. “Hypoglycemia and risk of death in critically ill patients.” The New England journal of medicine vol. 367,12 (2012): 1108-18. doi:10.1056/NEJMoa1204942
4. CARE, Diabetes. 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—. Diabetes Care, v. 47, n. 1, p. S295-S306, 2024.

O Pipoca TdC é um podcast bônus do TdC, que vem para discutir como a medicina é retratada em séries e filmes. A primeira temporada falará sobre a série House. Fica tranquilo que você não precisa assistir o episódio pra curtir, aqui ideia é ser um papo descontraído e de repente você conseguir aprender algo também.

Episódios novos a cada 2 semanas!

Minutagem:
00:10 Apresentação
01:15 4 passos da Hipercalcemia
01:43 Classificação da Hipercalcemia
07:39 Manejo da Hipercalcemia
12:00 Terapia Medicamentosa
14:40 Denosumabe
24:46 Salves

Referências: 
1. Walker MD, Shane E. Hypercalcemia: A Review. JAMA. 2022;328(16):1624-1636. doi:10.1001/jama.2022.18331
2. LeGrand SB, Leskuski D, Zama I. Narrative review: furosemide for hypercalcemia: an unproven yet common practice. Ann Intern Med. 2008;149(4):259-263. doi:10.7326/0003-4819-149-4-200808190-00007
3. Hu MI, Glezerman IG, Leboulleux S, Insogna K, Gucalp R, Misiorowski W, Yu B, Zorsky P, Tosi D, Bessudo A, Jaccard A, Tonini G, Ying W, Braun A, Jain RK. Denosumab for treatment of hypercalcemia of malignancy. J Clin Endocrinol Metab. 2014 Sep;99(9):3144-52. doi: 10.1210/jc.2014-1001. Epub 2014 Jun 10. PMID: 24915117; PMCID: PMC4154084.
4. Guise TA, Wysolmerski JJ. Cancer-Associated Hypercalcemia [published correction appears in N Engl J Med. 2022 Jul 7;387(1):96. doi: 10.1056/NEJMx220006]. N Engl J Med. 2022;386(15):1443-1451. doi:10.1056/NEJMcp2113128
5. El-Hajj Fuleihan G, Clines GA, Hu MI, et al. Treatment of Hypercalcemia of Malignancy in Adults: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2023;108(3):507-528. doi:10.1210/clinem/dgac621

Minutagem:
01:51 Caso 01

02:46 Avaliação inicial 

06:26 Características das cefaleias primárias

11:15 Conduta nas cefaleias primárias

19:47 Caso 02

20:56 Neuralgias cranianas
31:33 Caso 3
32:15 Cefaleia em trovoada (Thunderclap)

Referências:
1. Diener HC, Tassorelli C, Dodick DW. Management of Trigeminal Autonomic Cephalalgias Including Chronic Cluster: A Review. JAMA Neurol. 2023;80(3):308-319. doi:10.1001/jamaneurol.2022.4804
2. Filler L, Akhter M, Nimlos P. Evaluation and Management of the Emergency Department Headache. Semin Neurol. 2019;39(1):20-26. doi:10.1055/s-0038-1677023
3. Cruccu G, Di Stefano G, Truini A. Trigeminal Neuralgia. N Engl J Med. 2020;383(8):754-762

O Pipoca TdC é o novo podcast Bônus do TdC, que vem para discutir como a medicina é retratada em séries e filmes. A primeira temporada falará sobre a série House. Mas fica tranquilo que você não precisa assistir o episódio pra curtir aqui: a ideia é ser um papo descontraído e de repente você conseguir aprender algo também.

Episódios novos a cada 2 semanas!

Referências citadas: 1. Bernoche, Claudia et al. “Atualização da Diretriz de Ressuscitação Cardiopulmonar e Cuidados Cardiovasculares de Emergência da Sociedade Brasileira de Cardiologia - 2019.” Arquivos brasileiros de cardiologia vol. 113,3 449-663. 10 Oct. 2019, doi:10.5935/abc.20190203

Minutagem:
00:00 Abertura
01:30 Apresentação do caso clínico
04:10 Discussão causas graves icterícia
07:15 Hiperbilirrubinemia direta x indireta
07:57 Exposições que podem causar icterícia
10:30 Exames solicitados
11:49 Conduta Inicial
12:20 Resultados dos exames
15:40 Razão ALT/FA
19:16 Hipótese diagnóstica
21:45 Papel da colangiorresonância
25:50 Conclusão do caso

Referências:

1. Kwo, P. Y., Cohen, S. M., & Lim, J. K. (2017). ACG Clinical Guideline: Evaluation of Abnormal Liver Chemistries. The American journal of gastroenterology, 112(1), 18–35. https://doi.org/10.1038/ajg.2016.517

2. Fargo, M. V., Grogan, S. P., & Saguil, A. (2017). Evaluation of Jaundice in Adults. American family physician, 95(3), 164–168. 3. Expert Panel on Gastrointestinal Imaging:, Hindman, N. M., Arif-Tiwari, H., Kamel, I. R., Al-Refaie, W. B., Bartel, T. B., Cash, B. D., Chernyak, V., Goldstein, A., Grajo, J. R., Horowitz, J. M., Kamaya, A., McNamara, M. M., Porter, K. K., Srivastava, P. K., Zaheer, A., & Carucci, L. R. (2019). ACR Appropriateness Criteria® Jaundice. Journal of the American College of Radiology : JACR, 16(5S), S126–S140. https://doi.org/10.1016/j.jacr.2019.02.012

4. European Association for the Study of the Liver (2009). EASL Clinical Practice Guidelines: management of cholestatic liver diseases. Journal of hepatology, 51(2), 237–267. https://doi.org/10.1016/j.jhep.2009.04.009 5. European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu, & European Association for the Study of the Liver (2017). EASL Clinical Practice Guidelines: The diagnosis and management of patients with primary biliary cholangitis. Journal of hepatology, 67(1), 145–172. https://doi.org/10.1016/j.jhep.2017.03.022

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Referências:

1. Chuang MH, Chen JY, Wang HY, Jiang ZH, Wu VC. Clinical Outcomes of Tirzepatide or GLP-1 Receptor Agonists in Individuals With Type 2 Diabetes. JAMA Netw Open. 2024;7(8):e2427258. Published 2024 Aug 1. doi:10.1001/jamanetworkopen.2024.27258

2. Coutinho W, Halpern B. Pharmacotherapy for obesity: moving towards efficacy improvement. Diabetol Metab Syndr. 2024;16(1):6. Published 2024 Jan 3. doi:10.1186/s13098-023-01233-4

3. Gudzune KA, Kushner RF. Medications for Obesity: A Review. JAMA. Published online July 22, 2024. doi:10.1001/jama.2024.10816

4. Halpern B, Mancini MC, de Melo ME, et al. Proposal of an obesity classification based on weight history: an official document by the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Society for the Study of 

5. Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022;387(3):205-216. doi:10.1056/NEJMoa2206038

6. Jastreboff AM, Kaplan LM, Frías JP, et al. Triple-Hormone-Receptor Agonist Retatrutide for Obesity - A Phase 2 Trial. N Engl J Med. 2023;389(6):514-526. doi:10.1056/NEJMoa2301972

7. Li JR, Cao J, Wei J, Geng W. Case Report: Semaglutide-associated depression: a report of two cases. Front Psychiatry. 2023;14:1238353. Published 2023 Aug 29. doi:10.3389/fpsyt.2023.1238353

8. Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. N Engl J Med. 2023;389(24):2221-2232. doi:10.1056/NEJMoa2307563

9. Obesity and Metabolic Syndrome (ABESO). Arch Endocrinol Metab. 2022;66(2):139-151. doi:10.20945/2359-3997000000465

10. Rodriguez PJ, Goodwin Cartwright BM, Gratzl S, et al. Semaglutide vs Tirzepatide for Weight Loss in Adults With Overweight or Obesity. JAMA Intern Med. Published online July 8, 2024. doi:10.1001/jamainternmed.2024.2525

11. Wang W, Volkow ND, Berger NA, Davis PB, Kaelber DC, Xu R. Associations of semaglutide with incidence and recurrence of alcohol use disorder in real-world population [published correction appears in Nat Commun. 2024 Jun 18;15(1):5177. doi: 10.1038/s41467-024-49655-6]. Nat Commun. 2024;15(1):4548. Published 2024 May 28. doi:10.1038/s41467-024-48780-6

12. Wang W, Volkow ND, Berger NA, Davis PB, Kaelber DC, Xu R. Association of semaglutide with risk of suicidal ideation in a real-world cohort. Nat Med. 2024;30(1):168-176. doi:10.1038/s41591-023-02672-2

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Minutagem:

(01:46) Contexto clínico para prescrever anticoagulantes orais

(03:15) Contraindicações dos DOACS e uso da Varfarina

(09:55) Prescrição dos DOACS na TEP

(13:57) Cuidados e orientações para casa

(20:22) Prescrição dos DOACS em outros contextos clínicos

Referência:

1. Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41(4):543-603. doi:10.1093/eurheartj/ehz405

2. Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS) [published correction appears in Eur Heart J. 2021 Feb 1;42(5):507. doi: 10.1093/eurheartj/ehaa798]

3. Siontis KC, Zhang X, Eckard A, et al. Outcomes Associated With Apixaban Use in Patients With End-Stage Kidney Disease and Atrial Fibrillation in the United States [published correction appears in Circulation. 2018 Oct 9;138(15):e425. doi: 10.1161/CIR.0000000000000620]. Circulation. 2018;138(15):1519-1529. doi:10.1161/CIRCULATIONAHA.118.035418

4. Holt A, Strange JE, Rasmussen PV, et al. Bleeding Risk Following Systemic Fluconazole or Topical Azoles in Patients with Atrial Fibrillation on Apixaban, Rivaroxaban, or Dabigatran. Am J Med. 2022;135(5):595-602.e5. doi:10.1016/j.amjmed.2021.11.008

5. Beyer-Westendorf J, Siegert G. Of men and meals. J Thromb Haemost. 2015;13(6):943-945. doi:10.1111/jth.12973

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Minutagem:

(03:42) 1ª armadilha: Lesão de órgão alvo

(08:50) 2ª armadilha: Considerar metas ambulatoriais para pacientes internados

(13:51) 3ª armadilha: Não considerar causas comuns e outros fatores para o aumento da pressão

(16:35) 4ª armadilha: Não reavaliar a pressão com técnica adequada e em um ambiente tranquilo

(18:58) 5ª armadilha: Controlar a hipertensão com anti-hipertensivo endovenoso

(22:32) 6ª armadilha: Modificar o regime anti-hipertensivo crônico do paciente

Referências:

1. Stanistreet, Bryan et al. “An Evidence-Based Review of Elevated Blood Pressure for the Inpatient.” The American journal of medicine vol. 133,2 (2020): 165-169. doi:10.1016/j.amjmed.2019.10.004

2. Axon, R Neal et al. “Prevalence and management of hypertension in the inpatient setting: a systematic review.” Journal of hospital medicine vol. 6,7 (2011): 417-22. doi:10.1002/jhm.804

3. Rastogi, Radhika et al. “Treatment and Outcomes of Inpatient Hypertension Among Adults With Noncardiac Admissions.” JAMA internal medicine vol. 181,3 (2021): 345-352. doi:10.1001/jamainternmed.2020.7501 

4. Gauer, Robert L et al. “Managing Selected Chronic Conditions in Hospitalized Patients.” American family physician vol. 109,2 (2024): 134-142.

5. Chaganti, Bhanu, and Richard A Lange. “Treatment of Hypertension Among Non-Cardiac Hospitalized Patients.” Current cardiology reports vol. 24,7 (2022): 801-805. doi:10.1007/s11886-022-01699-0

6. Wilson, Linnea M et al. “Management of Inpatient Elevated Blood Pressures : A Systematic Review of Clinical Practice Guidelines.” Annals of internal medicine vol. 177,4 (2024): 497-506. doi:10.7326/M23-3251

7. Bean-Thompson, Kelsi et al. “Impact of Intravenous Antihypertensives on Outcomes Among Hospitalized Patients.” American journal of hypertension vol. 34,8 (2021): 867-873. doi:10.1093/ajh/hpab060

8. Ghazi, Lama et al. “Effect of intravenous antihypertensives on outcomes of severe hypertension in hospitalized patients without acute target organ damage.” Journal of hypertension vol. 41,2 (2023): 288-294. doi:10.1097/HJH.0000000000003328

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Minutagem:

(00:02) Abertura

(02:10) Parte 1 do caso clínico

(05:30) Definição de lesão renal aguda, desafios e exames adicionais

(11:15) As quatro perguntas e as indicações de diálise de urgência

(15:12) Gravidade da injúria renal aguda

(19:10) Etiologia de injúria renal aguda

(22:29) Parte 2 do caso clínico

(25:55) Resultados dos exames e interpretação

(32:40) Causas de tubulopatia proximal

(34:50) Indicações de biópsia renal

(36:48) Resultados dos exames finais e conclusão do caso

(40:55) Encerramento e salves

Referências:

1. Mercado MG, Smith DK, Guard EL. Acute Kidney Injury: Diagnosis and Management. Am Fam Physician. 2019;100(11):687-694.

2. Bhatla A, Menez S, Feldman L. Things We Do For No Reason™: Routine renal ultrasound testing for patients presenting with or developing acute kidney injury in the hospital. J Hosp Med. Published online June 27, 2024. doi:10.1002/jhm.13446 3. Foreman JW. Fanconi Syndrome. Pediatr Clin North Am. 2019;66(1):159-167. doi:10.1016/j.pcl.2018.09.002

4. Douvris A, Zeid K, Hiremath S, et al. Safety Lapses Prior to Initiation of Hemodialysis for Acute Kidney Injury in Hospitalized Patients: A Patient Safety Initiative. J Clin Med. 2018;7(10):317. Published 2018 Oct 1. doi:10.3390/jcm7100317

5. Luciano RL, Moeckel GW. Update on the Native Kidney Biopsy: Core Curriculum 2019. Am J Kidney Dis. 2019;73(3):404-415. doi:10.1053/j.ajkd.2018.10.011

6. Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4):c179-c184. doi:10.1159/000339789 7. Kellum JA, Romagnani P, Ashuntantang G, Ronco C, Zarbock A, Anders HJ. Acute kidney injury. Nat Rev Dis Primers. 2021;7(1):52. Published 2021 Jul 15. doi:10.1038/s41572-021-00284-z

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🔴 Junte-se aos mais de 4.000 assinantes. Assine o Guia, ganhe tempo e atualize-se sem esforço.

🟠 Um serviço de revisão e atualização continuados em clínica médica. A informação que você precisa, do jeito que você prefere.

📚 Confira agora mesmo a edição aberta do Guia TdC sobre a nova diretriz de Insuficiência Cardíaca (IC) da American Heart Association (AHA): https://www.tadeclinicagem.com.br/guia/2/diretriz-de-insuficiencia-cardiaca-aha-2022/.

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Referências:

1. Brasil. Ministério da Saúde. Secretaria de Gestão Estratégica e Participativa. Departamento de Apoio à Gestão Participativa. Política Nacional de Saúde Integral de Lésbicas, Gays, Bissexuais, Travestis e Transexuais / Ministério da Saúde, Secretaria de Gestão Estratégica e Participativa, Departamento de Apoio à Gestão Participativa. Brasília : 1. ed., 1. reimp. Ministério da Saúde, 2013.

2. São Paulo (SP). Secretaria Municipal da Saúde. Coordenação da Atenção Primária à Saúde. “Protocolo para o atendimento de pessoas transexuais e travestis no município de São Paulo”, Secretaria Municipal da Saúde|SMS|PMSP, 2020: Julho - p. 133.

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🔴 Junte-se aos mais de 4.000 assinantes. Assine o Guia, ganhe tempo e atualize-se sem esforço.

🟠 Um serviço de revisão e atualização continuados em clínica médica. A informação que você precisa, do jeito que você prefere.

📚 Confira agora mesmo a edição aberta do Guia TdC sobre a nova diretriz de Insuficiência Cardíaca (IC) da American Heart Association (AHA): https://www.tadeclinicagem.com.br/guia/2/diretriz-de-insuficiencia-cardiaca-aha-2022/.

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Referência:

UCSF Gender Affirming Health Program, Department of Family and Community Medicine, University of California San Francisco. Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People; 2nd edition. Deutsch MB, ed. June 2016. Available at transcare.ucsf.edu/guidelines.

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Referências:

1. Site da ABRASSO - https://abrasso.org.br/

2. Frax Plus https://www.fraxplus.org/frax-plus 

3. https://www.tadeclinicagem.com.br/guia/198/tratamento-farmacologico-de-osteoporose-primaria/ 

4. Richard Eastell, Clifford J Rosen, Dennis M Black, Angela M Cheung, M Hassan Murad, Dolores Shoback, Pharmacological Management of Osteoporosis in Postmenopausal Women: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 104, Issue 5, May 2019, Pages 1595–1622, https://doi.org/10.1210/jc.2019-00221

5. Silva BC, Madeira M, d'Alva CB, et al. Definition and management of very high fracture risk in women with postmenopausal osteoporosis: a position statement from the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Association of Bone Assessment and Metabolism (ABRASSO). Arch Endocrinol Metab. 2022;66(5):591-603. doi:10.20945/2359-3997000000522

6. Radominski SC, Bernardo W, Paula AP, et al. Brazilian guidelines for the diagnosis and treatment of postmenopausal osteoporosis. Rev Bras Reumatol Engl Ed. 2017;57 Suppl 2:452-466. doi:10.1016/j.rbre.2017.07.001

7. Gregson, C.L., Armstrong, D.J., Bowden, J. et al. UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos 17, 58 (2022). https://doi.org/10.1007/s11657-022-01061-5 

8. El Miedany, Y., Toth, M., Elwakil, W. et al. Post-Fracture Care Program: Pharmacological Treatment of Osteoporosis in Older Adults with Fragility Fractures. Curr Osteoporos Rep 21, 472–484 (2023). https://doi.org/10.1007/s11914-023-00791-w

9. Wang CY, Fu SH, Yang RS, Chen LK, Shen LJ, Hsiao FY. Timing of anti-osteoporosis medications initiation after a hip fracture affects the risk of subsequent fracture: A nationwide cohort study. Bone. 2020;138:115452. doi:10.1016/j.bone.2020.115452

10. Camacho PM, Petak SM, Binkley N, et al. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS/AMERICAN COLLEGE OF ENDOCRINOLOGY CLINICAL PRACTICE GUIDELINES FOR THE DIAGNOSIS AND TREATMENT OF POSTMENOPAUSAL OSTEOPOROSIS-2020 UPDATE. Endocr Pract. 2020;26(Suppl 1):1-46. doi:10.4158/GL-2020-0524SUPPL

11. Ramchand SK, Leder BZ. Sequential Therapy for the Long-Term Treatment of Postmenopausal Osteoporosis. J Clin Endocrinol Metab. 2024;109(2):303-311. doi:10.1210/clinem/dgad496

12. Chandran M. The why and how of sequential and combination therapy in osteoporosis. A review of the current evidence. Arch Endocrinol Metab. 2022;66(5):724-738. doi:10.20945/2359-3997000000564

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Referências:

1. https://amdg.wa.gov/Files/AssessmentTools/5-Keele_STarT_Back9_item-7.pdf 

2. Chou, Roger, and Paul Shekelle. “Will this patient develop persistent disabling low back pain?.” JAMA vol. 303,13 (2010): 1295-302. doi:10.1001/jama.2010.344

3. Stevans, Joel M et al. “Risk Factors Associated With Transition From Acute to Chronic Low Back Pain in US Patients Seeking Primary Care.” JAMA network open vol. 4,2 e2037371. 1 Feb. 2021, doi:10.1001/jamanetworkopen.2020.37371

4. Suri, Pradeep et al. “Predictive Validity of the STarT Back Tool for Risk of Persistent Disabling Back Pain in a U.S. Primary Care Setting.” Archives of physical medicine and rehabilitation vol. 99,8 (2018): 1533-1539.e2. doi:10.1016/j.apmr.2018.02.016

5. Samanta, Jo et al. “10-minute consultation: chronic low back pain.” BMJ (Clinical research ed.) vol. 326,7388 (2003): 535. doi:10.1136/bmj.326.7388.535

6. Gomes, Luís Antunes et al. “A Stratified Approach for Managing Patients With Low Back Pain in Primary Care (SPLIT Program): A Before-and-After Study.” Annals of family medicine vol. 22,3 (2024): 195-202. doi:10.1370/afm.3104

7. Richmond, Helen et al. “The Effectiveness of Cognitive Behavioural Treatment for Non-Specific Low Back Pain: A Systematic Review and Meta-Analysis.” PloS one vol. 10,8 e0134192. 5 Aug. 2015, doi:10.1371/journal.pone.0134192

8. Chou, Roger et al. “Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline.” Annals of internal medicine vol. 147,7 (2007): 492-504. doi:10.7326/0003-4819-147-7-200710020-00007

9. Qaseem, Amir et al. “Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians.” Annals of internal medicine vol. 166,7 (2017): 514-530. doi:10.7326/M16-2367

10. Flynn, Diane M. “Chronic Musculoskeletal Pain: Nonpharmacologic, Noninvasive Treatments.” American family physician vol. 102,8 (2020): 465-477.

11. Chou, Roger et al. “Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society.” Annals of internal medicine vol. 147,7 (2007): 478-91. doi:10.7326/0003-4819-147-7-200710020-00006

12. Vitoula, Kristallia et al. “Behavioral Therapy Approaches for the Management of Low Back Pain: An Up-To-Date Systematic Review.” Pain and therapy vol. 7,1 (2018): 1-12. doi:10.1007/s40122-018-0099-4

13. Deyo, R A, and J N Weinstein. “Low back pain.” The New England journal of medicine vol. 344,5 (2001): 363-70. doi:10.1056/NEJM200102013440508

14. van Middelkoop, Marienke et al. “Exercise therapy for chronic nonspecific low-back pain.” Best practice & research. Clinical rheumatology vol. 24,2 (2010): 193-204. doi:10.1016/j.berh.2010.01.002

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Minutagem:

(00:09) Apresentação

(01:40) Início do caso clínico

(03:44) Comentários sobre o caso

(11:00) Causas de pseudo-hemoptise

(14:30) Quando utilizar exames de imagem?

(18:00) Avaliação do paciente com hemoptise não ameaçadora à vida

(21:59) Solicitação de dados e exames complementares)

(22:55) Parte 2 do caso clínico

(24:37) Resultado dos exames

(26:00) Comentários

(28:30) Etiologia de hemoptise

(34:25) Quadro pulmonar e renal: como direcionar o raciocínio?

(41:00) Parte final do caso clínico

(46:50) Salves

Referências:

1. Atchinson PRA, Hatton CJ, Roginski MA, Backer ED, Long B, Lentz SA. The emergency department evaluation and management of massive hemoptysis. Am J Emerg Med. 2021 Dec;50:148-155. doi: 10.1016/j.ajem.2021.07.041. Epub 2021 Jul 27. PMID: 34365064.

2. Ittrich H, Bockhorn M, Klose H, Simon M. The Diagnosis and Treatment of Hemoptysis. Dtsch Arztebl Int. 2017 Jun 5;114(21):371-381. doi: 10.3238/arztebl.2017.0371. PMID: 28625277; PMCID: PMC5478790.

3. Charya AV, Holden VK, Pickering EM. Management of life-threatening hemoptysis in the ICU. J Thorac Dis. 2021 Aug;13(8):5139-5158. doi: 10.21037/jtd-19-3991. PMID: 34527355; PMCID: PMC8411133.

4. Casey JD, Englert JA, Katz JT, Miller AL, Loscalzo J. An Unexpected Expectoration. N Engl J Med. 2018 Mar 1;378(9):853-858. doi: 10.1056/NEJMcps1711048. PMID: 29490174.

5. Charya AV, Holden VK, Pickering EM. Management of life-threatening hemoptysis in the ICU. J Thorac Dis. 2021 Aug;13(8):5139-5158. doi: 10.21037/jtd-19-3991. PMID: 34527355; PMCID: PMC8411133.

6. McGuinness G, Beacher JR, Harkin TJ, Garay SM, Rom WN, Naidich DP. Hemoptysis: prospective high-resolution CT/bronchoscopic correlation. Chest. 1994 Apr;105(4):1155-62. doi: 10.1378/chest.105.4.1155. PMID: 8162743.

7. Haponik EF, Chin R. Hemoptysis: clinicians' perspectives. Chest. 1990 Feb;97(2):469-75. doi: 10.1378/chest.97.2.469. PMID: 2298074.

8. Herth F, Ernst A, Becker HD. Long-term outcome and lung cancer incidence in patients with hemoptysis of unknown origin. Chest. 2001 Nov;120(5):1592-4. doi: 10.1378/chest.120.5.1592. PMID: 11713139.

9. Atchinson, Patricia Ruth A et al. “The emergency department evaluation and management of massive hemoptysis.” The American journal of emergency medicine vol. 50 (2021): 148-155. doi:10.1016/j.ajem.2021.07.041

10. Singhal, Rajat et al. “Society of Chest Imaging and Interventions Consensus Guidelines for the Interventional Radiology Management of Hemoptysis.” The Indian journal of radiology & imaging vol. 33,3 361-372. 10 Apr. 2023, doi:10.1055/s-0043-1762552

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Minutagem

(00:00) Apresentação e sumarização

(04:05) Hipertireoidismo x tireotoxicose

(07:10) Como escolher o melhor tratamento

(17:55) Como controlar os sintomas da doença

(21:40) Como prescrever as drogas antitireoidianas

(31:33) Como monitorar o paciente em uso de drogas antitireoidianas

(43:33) Encerramento e salves

Referências:

1. Azizi, F et al. “Effect of long-term continuous methimazole treatment of hyperthyroidism: comparison with radioiodine.” European journal of endocrinology vol. 152,5 (2005): 695-701. doi:10.1530/eje.1.01904

2. Villagelin, Danilo et al. “Outcomes in Relapsed Graves' Disease Patients Following Radioiodine or Prolonged Low Dose of Methimazole Treatment.” Thyroid : official journal of the American Thyroid Association vol. 25,12 (2015): 1282-90. doi:10.1089/thy.2015.0195

3. Kahaly, George J et al. “2018 European Thyroid Association Guideline for the Management of Graves' Hyperthyroidism.” European thyroid journal vol. 7,4 (2018): 167-186. doi:10.1159/000490384

4. Villagelin, Danilo et al. “A 2023 International Survey of Clinical Practice Patterns in the Management of Graves' Disease: A Decade of Change.” The Journal of clinical endocrinology and metabolism, dgae222. 5 Apr. 2024, doi:10.1210/clinem/dgae222

5. Ross, Douglas S et al. “2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis.” Thyroid : official journal of the American Thyroid Association vol. 26,10 (2016): 1343-1421. doi:10.1089/thy.2016.0229

6. Shalaby M, Hadedeya D, Toraih EA, et al. Predictive factors of radioiodine therapy failure in Graves' Disease: A meta-analysis. Am J Surg. 2022;223(2):287-296. doi:10.1016/j.amjsurg.2021.03.068

7. Carella, C et al. “Serum thyrotropin receptor antibodies concentrations in patients with Graves' disease before, at the end of methimazole treatment, and after drug withdrawal: evidence that the activity of thyrotropin receptor antibody and/or thyroid response modify during the observation period.” Thyroid : official journal of the American Thyroid Association vol. 16,3 (2006): 295-302. doi:10.1089/thy.2006.16.295 8. Struja T, Kaeslin M, Boesiger F, et al. External validation of the GREAT score to predict relapse risk in Graves' disease: results from a multicenter, retrospective study with 741 patients. Eur J Endocrinol. 2017;176(4):413-419. doi:10.1530/EJE-16-0986

9. Park SY, Kim BH, Kim M, et al. The longer the antithyroid drug is used, the lower the relapse rate in Graves' disease: a retrospective multicenter cohort study in Korea. Endocrine. 2021;74(1):120-127. doi:10.1007/s12020-021-02725-x

10. Azizi F, Amouzegar A, Tohidi M, et al. Increased Remission Rates After Long-Term Methimazole Therapy in Patients with Graves' Disease: Results of a Randomized Clinical Trial. Thyroid. 2019;29(9):1192-1200. doi:10.1089/thy.2019.0180

11. Chaker L, Cooper DS, Walsh JP, Peeters RP. Hyperthyroidism. Lancet. 2024;403(10428):768-780. doi:10.1016/S0140-6736(23)02016-0

12. Lee SY, Pearce EN. Hyperthyroidism: A Review. JAMA. 2023;330(15):1472-1483. doi:10.1001/jama.2023.19052

13. https://www.tadeclinicagem.com.br/guia/146/tempestade-tireotoxica/