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PURPOSE: This study explores the potential of the Chat-Generative Pre-Trained Transformer (Chat-GPT), a Large Language Model (LLM), in assisting healthcare professionals in the diagnosis of obstructive sleep apnea (OSA). It aims to assess the agreement between Chat-GPT's responses and those of expert otolaryngologists, shedding light on the role of AI-generated content in medical decision-making. METHODS: A prospective, cross-sectional study was conducted, involving 350 otolaryngologists from 25 countries who responded to a specialized OSA survey. Chat-GPT was tasked with providing answers to the same survey questions. Responses were assessed by both super-experts and statistically analyzed for agreement. RESULTS: The study revealed that Chat-GPT and expert responses shared a common answer in over 75% of cases for individual questions. However, the overall consensus was achieved in only four questions. Super-expert assessments showed a moderate agreement level, with Chat-GPT scoring slightly lower than experts. Statistically, Chat-GPT's responses differed significantly from experts' opinions (p = 0.0009). Sub-analysis revealed areas of improvement for Chat-GPT, particularly in questions where super-experts rated its responses lower than expert consensus. CONCLUSIONS: Chat-GPT demonstrates potential as a valuable resource for OSA diagnosis, especially where access to specialists is limited. The study emphasizes the importance of AI-human collaboration, with Chat-GPT serving as a complementary tool rather than a replacement for medical professionals. This research contributes to the discourse in otolaryngology and encourages further exploration of AI-driven healthcare applications. While Chat-GPT exhibits a commendable level of consensus with expert responses, ongoing refinements in AI-based healthcare tools hold significant promise for the future of medicine, addressing the underdiagnosis and undertreatment of OSA and improving patient outcomes.

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(1) Background: This narrative review aims to explore the predictors of success for pharyngeal surgery in the treatment of obstructive sleep apnea (OSA). An extensive literature search was conducted, identifying relevant studies published up to June 2023, utilizing various databases and key search terms related to OSA, surgical interventions, and predictors of success. The review encompasses both retrospective and prospective studies, case series, and cohort studies to provide a broad understanding of the topic; (2) Methods: Review of English scientific literature on phenotypes of OSA related to predictors of success of pharyngeal surgery; (3) Results: Of 75 articles, 21 were included, in these the following were determined to be factors for surgical success: body mass index (BMI) (8 articles), apnea/hypopnea index (AHI) (8 articles), cephalometry (8 articles), palatine tonsil size (7 articles), Modified Mallampati score (2 articles), genioglossus electromyography (2 articles), Friedman score or upper airway anatomy (3 articles), nasopharyngolaryngoscopy (2 articles), drug-induced sleep endoscopy (DISE) (1 article), oral cavity anatomy (1 article) and oxygen desaturation index (ODI) (1 article); (4) Conclusions: The lack of standardized protocols for the indication of pharyngeal surgery is a reality, however identifying known predictors of surgical success may facilitate homogenizing indications.

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Since the outset of body image reconstruction for diagnosis purposes, ultrasound has been used to investigate structural changes located in tendons. Ultrasound has clinical applications in the intensive care unit, but its utility for tendon imaging remains unknown. Thus, we aimed to determine intra- and inter-rater reproducibility of measures obtained by images generated through morphological tendon sonographic analysis recorded from critically ill patients. We designed a cross-sectional study to assess thickness, cross-sectional area, and echogenicity of patellar and quadriceps tendons in a convenience sample formed with 20 critically ill patients. Two independent raters (experienced and novice) recorded repeated measures, checking for agreement (Kappa statistics) and reliability (Intraclass coefficient Correlation-ICC and Bland-Altman). The quality of images acquired by the two independent raters substantially agreed (k = 0.571-1.000), regardless of the region on the patellar tendon or the studied tendon (patellar or quadriceps). Regardless of how much experience the rater had, their repeated records (intra-rater reliability) always demonstrated almost complete correlation, ICC ranging from 0.89 to 0.98 for both tendons in all outcomes. At the same way, the statistically significant inter-rater ICC ranging from 0.87 to 0.97. Both repeated measures by the raters (intra-rater) and the repeated single and double measures between the raters (inter-rater) presented a minimum measurement error constituting a predominant pattern of random variability. We conclude that ultrasound imaging acquisition performed by independent raters for tendon thickness, CSA, and echogenicity monitoring of critically ill patients are acceptable and are not influenced by rater experience.

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Objective To adapt and validate a widely used set of moral dilemmas to European Portuguese, which can be applied to assess decision-making. Moreover, the classical formulation of the dilemmas was compared with a more focused moral probe. Finally, a shorter version of the moral scenarios was tested. Methods The Portuguese version of the set of moral dilemmas was tested in 53 individuals from several regions of Portugal. In a second study, an alternative way of questioning on moral dilemmas was tested in 41 participants. Finally, the shorter version of the moral dilemmas was tested in 137 individuals. Results Results evidenced no significant differences between English and Portuguese versions. Also, asking whether actions are "morally acceptable" elicited less utilitarian responses than the original question, although without reaching statistical significance. Finally, all tested versions of moral dilemmas exhibited the same pattern of responses, suggesting that the fundamental elements to the moral decision-making were preserved. Conclusions We found evidence of cross-cultural validity for moral dilemmas. However, the moral focus might affect utilitarian/deontological judgments.

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Abstract Objective To adapt and validate a widely used set of moral dilemmas to European Portuguese, which can be applied to assess decision-making. Moreover, the classical formulation of the dilemmas was compared with a more focused moral probe. Finally, a shorter version of the moral scenarios was tested. Methods The Portuguese version of the set of moral dilemmas was tested in 53 individuals from several regions of Portugal. In a second study, an alternative way of questioning on moral dilemmas was tested in 41 participants. Finally, the shorter version of the moral dilemmas was tested in 137 individuals. Results Results evidenced no significant differences between English and Portuguese versions. Also, asking whether actions are "morally acceptable" elicited less utilitarian responses than the original question, although without reaching statistical significance. Finally, all tested versions of moral dilemmas exhibited the same pattern of responses, suggesting that the fundamental elements to the moral decision-making were preserved. Conclusions We found evidence of cross-cultural validity for moral dilemmas. However, the moral focus might affect utilitarian/deontological judgments.

Resumo Objetivos Validar e adaptar para português europeu um conjunto de dilemas morais amplamente utilizado, que poderá ser aplicado para avaliar a tomada de decisão moral. Além disso, comparou-se a formulação clássica dos dilemas com uma versão alternativa, que incluía uma questão mais focada na moralidade. Finalmente, testou-se uma versão reduzida dos cenários morais. Métodos A versão portuguesa dos dilemas morais foi testada em 53 participantes de várias regiões de Portugal, e a versão alternativa foi testada em 41 sujeitos. Finalmente, a versão reduzida dos dilemas morais foi testada numa amostra de 137 participantes. Resultados Não houve diferenças significativas entre a versão portuguesa e a inglesa. A pergunta "É moralmente aceitável...?" evocou menos respostas utilitárias que a versão original, embora não tenham sido obtidas diferenças significativas. A versão portuguesa original, a alternativa e a reduzida evidenciaram o mesmo padrão de respostas, sugerindo que os elementos fundamentais para a tomada de decisão moral estão preservados. Conclusões Encontramos evidências para a validade intercultural dos dilemas morais. No entanto, o foco moral colocado na questão final pode afetar os juízos utilitários/deontológicos.

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JUSTIFICATIVA E OBJETIVOS: O acidente vascular encefálico (AVE) é uma doença de grande importância para a saúde pública por ser uma das principais causas de mortalidade e invalidez nos países industrializados. A maioria das doenças cerebrovasculares pode ser atribuída à hipertensão e à aterosclerose, sendo essa a principal responsável pelos acidentes vasculares encefálicos isquêmicos (AVEi). O objetivo deste estudo foi avaliar a prevalência dos principais fatores de risco para AVE numa determinada população. MÉTODO: Foram incluídas nesse estudo famílias cadastradas na área 1 da Unidade Básica de Saúde do Pari, Mooca. Foram levantados os fatores de risco das pessoas com idade entre 30 e 90 anos. Foram consideradas as seguintes variáveis descritivas: idade, sexo, tabagismo, etilismo, hipertensão arterial sistêmica, dislipidemia, diabetes mellitus e insuficiência coronariana. RESULTADOS: Dentre os 300 prontuários levantados, 60,3% eram do sexo feminino com idade entre 38 e 90 anos e os do sexo masculino representaram 39,7% com idade entre 30 e 82 anos. A hipertensão arterial sistêmica foi o fator de risco mais prevalente (73,6%), seguida pelo diabetes mellitus (39,6%), dislipidemia (39,3%), insuficiência coronariana (18,6%) e etilismo (4%). Foram registrados 10 casos de AVE isquêmico em pacientes com idade entre 65 e 82 anos, todos do sexo masculino, tabagistas, hipertensos e diabéticos. CONCLUSÃO: Deve-se enfatizar a promoção de estilos de vida mais saudáveis; controles periódicos e tratamento adequado da hipertensão e demais fatores de risco, são essenciais para prevenir e diminuir a incidência de AVE.

BACKGROUND AND OJECTIVES: Stroke is a very important disease for Public Health, because it is one of the main causes of mortality and invalidity in industrialized countries.Cerebrovascular disease in their majority is referred to hypertension and atherosclerosis, this last being the principal cause of ischemic strokes. The objective of this study was to conduct an investigation of the prevalence of the main risk factors for brainvascular accidents among this population. METHOD: This study included families enrolled in Area 1 of the Basic Health Unit of Pari in the borough of Mooca, São Paulo. The main risk factors in people from 30 to 90 years of age were investigated. The following descriptive variables were considered: age, gender, smoking, drinking, systemic arterial hypertension (SAH), dyslipidemia, diabetes mellitus, and coronary insufficiency. RESULTS: Among the 300 medical charts studied, 60.3% were females between 38 and 90 years of age, and males represented 39.7%, with ages ranging from 30 to 82. Systemic arterial hypertension was the most prevalent risk factor (73.6%), followed by diabetes mellitus (39.6%), dyslipidemia (39.3%), coronary insufficiency (18.6%) and drinking (4%). There were 10 reported cases of ischemic stroke (CVA) in patients aged 65 to 82, all males, smokers, hypertensive, and diabetics. CONCLUSION: Motivating patients to adopt changes in lifestyle and providing guidelines about the importance of periodic checkups and proper treatment for hypertension and other risk factors are critical to preventing and decreasing the occurrence of CVA.

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