ABSTRACT Background: The no-show of patients to their scheduled appointments has caused a large increase in healthcare costs, worsening service quality and clinical efficiency. Objectives: This case study aims to identify the factors associated with patient no-shows in cardiology and neurology clinics, and develop a prediction model to estimate the no-show probability. Methods: We developed a retrospective analysis of 32,573 appointments from January 2019 to June 2022 in a Rio de Janeiro clinic. Logistic regressions were performed to analyze and model the influence of patient and appointment variables on no-show rates. Results: The factors most related to no-shows were the patient’s sex, age, medical specialty, month of the year, and type of insurance. Female patients have an increase of approximately 17% chance of no-shows compared to males. The age group with the highest no-show rates is between 21 and 30. Clinic consultations have higher no-shows when compared to medical procedures. Appointments in December tend to have higher non-attendance than in January, and patients with insurance from the five major companies presents greater no-show than those with smaller insurance. The prediction model presented the following performance indicators: AUC = 0.65, Sensitivity = 0.64, Specificity = 0.58, PPV = 0.11, and NPV = 0.95. Conclusions: This work contributes to understanding the factors related to non-attendance, assisting optimized management of appointment schedules.

Resumo As variantes anatômicas dos arcos costais são, geralmente, achados incidentais nos exames de imagem, em razão do seu comportamento assintomático ou quadro inespecífico, podendo constituir alterações isoladas ou relacionadas a anomalias e síndromes clínicas. Essas alterações são facilmente negligenciadas na radiografia convencional e na tomografia computadorizada se não forem investigadas ativamente, principalmente quando a maioria das indicações do estudo radiológico do tórax tem como objetivo a avaliação do parênquima pulmonar e das estruturas mediastinais. O objetivo deste artigo é demonstrar, por meio da tomografia computadorizada multidetectores, os aspectos de imagem das principais variantes anatômicas e anomalias congênitas dos arcos costais.

Abstract As they are asymptomatic or have a nonspecific, anatomical variations of the ribs are usually detected as incidental findings on imaging studies. They may be isolated changes or can be related to anomalies or clinical syndromes. Such variations are easily overlooked on conventional radiography and computed tomography if they are not actively investigated, mainly because most indications for a chest X-ray studies aim to evaluate the lung parenchyma and mediastinal structures. The objective of this pictorial essay was to use multislice computed tomography images to illustrate the imaging aspects of the main anatomical variations and congenital anomalies of the ribs.

Abstract Amazon parrots are long-lived birds with highly developed cognitive skills, including vocal learning. Several parrot mitogenomes have been sequenced, but important aspects of their organization and evolution are not fully understood or have limited experimental support. The main aim of the present study was to describe the mitogenome of the blue-fronted Amazon, Amazona aestiva, and compare it to other mitogenomes from the genus Amazona and the order Psittaciformes. We observed that mitogenomes are highly conserved among Amazon parrots, and a detailed analysis of their duplicated control regions revealed conserved blocks. Population level analyses indicated that the specimen analyzed here seems to be close to A. aestiva individuals from Bahia state. Evolutionary relationships of 41 Psittaciformes species and three outgroups were inferred by BEAST. All relationships were retrieved with high support.

A avaliação da resistência à ação da proteína C ativada (rPCA), causada por mutação no fator V (fator V de Leiden), é fator de risco importante para tromboembolia venosa, cujo papel como geradora de obstruções arteriais in situ é um tema ainda controverso. O caso clínico de um jovem com história de coronariopatia, múltiplas lesões cerebrovasculares e doença arterial periférica é relatado. A investigação diagnóstica apontou a rPCA como possível etiologia.

The assessment of activated protein C resistance (APCR) caused by mutations in factor V (factor V Leiden) is an important risk factor for venous thromboembolism, of which role as the originator of arterial obstructions in situ is still a controversial subject. The clinical case of a young patient with history of coronariopathy, multiple cerebrovascular lesions and peripheral artery disease is reported. The diagnostic investigation showed APCR as the possible etiology.

The PrP C prion protein contains 250 amino acids with some variation among species and is expressed in several cell types. PrP C is converted to PrP Sc by a post-translational process in which it acquires amino acid sequences of three-dimensional conformation of beta-sheets. Variations in the prion protein gene were observed among 16 genera of New World primates (Platyrrhini), and resulted in amino acid substitutions when compared with the human sequence. Seven substitutions not yet described in the literature were found: W -> R at position 31 in Cebuella, T -> A at position 95 in Cacajao and Chiropotes, N-> S at position 100 in Brachyteles, L -> Q at position 130 in Leontopithecus (in the sequence responsible for generating the beta-sheet 1), D -> E at position 144 in Lagothrix (in the sequence responsible for the alpha-helix 1), D-> G at position 147 in Saguinus (also located in the alpha-helix 1 region), and M -> I at position 232 in Alouatta. The phylogenetic trees generated by parsimony, neighbor-joining and Bayesian analyses strongly support the monophyletic status of the platyrrhines, but did not resolve relationships among families. However, the results do corroborate previous findings, which indicate that the three platyrrhine families radiated rapidly from an ancient split.