Revista da Associacao Medica Brasileira最新文献

{"title":"Colic and sleep outcomes of nonpharmacological intervention in infants with infantile colic: systematic review and metaanalysis.","authors":"Doğan Çağrı Tanrıverdi,&nbsp;Aysu Yıldız Karaahmet,&nbsp;Fatma Şule Bilgiç","doi":"10.1590/1806-9282.20230071","DOIUrl":"https://doi.org/10.1590/1806-9282.20230071","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to systematically review the colic and sleep outcomes of nonpharmacological intervention in infants with infantile colic and perform a meta-analysis of the available evidence.</p><p><strong>Methods: </strong>The literature review for this systematic review was conducted between December 2022 and January 2023 using five electronic databases, namely PubMed, CINAHL, Scopus, Web of Science, and ULAKBİM. Published articles were scanned using MeSH-based keywords. Only randomized controlled trials conducted in the past 5 years were included. The data were analyzed using the Review Manager computer program.</p><p><strong>Results: </strong>This meta-analysis included three studies involving a total of 386 infantile colic infants. After nonpharmacological treatment, it was found that infants with infantile colic reduced crying time (standardized mean difference: 0.61; 95%CI 0.29-0.92; Z=3.79; p=0.00002), improved sleep duration (standardized mean difference: 0.22; 95%CI -0.04 to 0.48; Z=1.64; p=0.10), and decreased crying intensity (mean difference: -17.24; 95%CI -20.11 to 14.37; Z=11.77; p<0.000001).</p><p><strong>Conclusion: </strong>According to the meta-analysis findings, it was determined that the risk of bias was low in the studies included and that nonpharmacological chiropractic, craniosacral, and acupuncture treatments applied to infantile colic infants in the three included studies reduced crying time and intensity and increased sleep duration.</p>","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/65/18/1806-9282-ramb-69-05-e20230071.PMC10204857.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9577123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal thymus in growth-restricted fetuses due to placental insufficiency.","authors":"Marisa Akemi Takeno,&nbsp;Roseli Mieko Yamamoto Nomura","doi":"10.1590/1806-9282.20220975","DOIUrl":"https://doi.org/10.1590/1806-9282.20220975","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to assess fetal thymus size by ultrasound in growth-restricted fetuses due to placental insufficiency and compare to high-risk and low-risk pregnancy fetuses with normal placental function.</p><p><strong>Methods: </strong>This is a nested case-control study of pregnant women followed up at a university hospital (July 2012 to July 2013). In all, 30 pregnant women presenting small fetuses for gestational age (estimated fetal weight <p10) due to placental insufficiency (umbilical artery Doppler >p95) were compared to 30 high-risk and 30 low-risk pregnancies presenting normal Doppler indices. The thymus transverse diameter and perimeter were converted into zeta score according to the normal values for gestational age. Head circumference and femur length were used to calculate ratios.</p><p><strong>Results: </strong>Fetal thymus were significantly lower in pregnancies with placental insufficiency when compared to high-risk and low-risk pregnancies presenting, respectively, transverse diameter zeta score (-0.69±0.83 vs. 0.49±1.13 vs. 0.83±0.85, p<0.001) and P zeta score (-0.73±0.68 vs. 0.45±0.96 vs. 0.26±0.89, p<0.001). There was also a significant difference (p<0.05) in the ratios among the groups: pregnancies with placental insufficiency (TD/HC=0.10, P/FL=1.32, and P/HC=0.26), high-risk pregnancies (TD/HC=0.11, P/FL=1.40, and P/HC=0.30), and control group (DT/HC=0.11, P/FL=1.45, and P/HC=0.31).</p><p><strong>Conclusion: </strong>Fetal thymus size is reduced in growth-restricted fetuses due to placental insufficiency, suggesting fetal response as a consequence of the adverse environment.</p>","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/17/8e/1806-9282-ramb-69-01-0136.PMC9937593.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10834924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Syndecan-1 as a marker to predict acute kidney injury after isolated coronary artery bypass graft operations.","authors":"Derih Ay,&nbsp;Mesut Engin,&nbsp;Sadık Ahmet Sünbül,&nbsp;Filiz Ata,&nbsp;Rahime Feyza Koloğlu,&nbsp;Yasemin Ustundag,&nbsp;Senol Yavuz,&nbsp;Ahmet Fatih Özyazıcıoğlu","doi":"10.1590/1806-9282.20220839","DOIUrl":"https://doi.org/10.1590/1806-9282.20220839","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative acute kidney injury is an important problem that can occur after coronary artery bypass graft operations, and it is important to identify risky patient groups preoperatively. This study aimed to investigate the importance of preoperative syndecan-1 levels in predicting acute kidney injury after elective coronary artery bypass graft operations accompanied by cardiopulmonary bypass.</p><p><strong>Methods: </strong>Patients who underwent coronary artery bypass graft operation in our clinic between March 1 and May 10, 2022, were included in this prospective study. Patients who did not develop acute kidney injury in the postoperative period were recorded as group 1 and patients who developed it were recorded as group 2.</p><p><strong>Results: </strong>A total of 79 patients undergoing coronary artery bypass graft surgery with cardiopulmonary bypass were included in the study. There were 55 patients in group 1 and 24 patients in group 2. There was no difference between the groups in terms of age, gender, diabetes mellitus, body mass index, smoking, and hyperlipidemia rates. In multivariate logistic regression analysis, increased blood product use (odds ratio 1.634; 95%CI 1.036-2.579; p=0.035), preoperative high creatinine (odds ratio 59.387; 95%CI 3.034-1162.496; p=0.007), and high syndecan-1 (odds ratio 1.015; 95%CI 1.002-1.028; p=0.025) were independent predictors of acute kidney injury.</p><p><strong>Conclusion: </strong>This study revealed that elevated preoperative syndecan-1 is associated with acute kidney injury after isolated coronary artery bypass graft accompanied by cardiopulmonary bypass and has prognostic utility independent of other recognized risk factors.</p>","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/ff/1806-9282-ramb-69-01-0107.PMC9937607.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10836371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of coronavirus disease pandemic on performance and satisfaction, physical activity, and quality of life of the elderly.","authors":"Elif Gur Kabul,&nbsp;Bilge Basakcı Calık","doi":"10.1590/1806-9282.20221018","DOIUrl":"https://doi.org/10.1590/1806-9282.20221018","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to examine the effects of the coronavirus disease pandemic in the elderly.</p><p><strong>Methods: </strong>A total of 140 elderly with a mean age of 71.30±6.00 years (69 females, 71 males) who spent the coronavirus disease pandemic period at home were included. Canadian Occupational Performance Measure, Visual Analog Scale (for pain intensity at rest and activity), International Physical Activity Questionnaire-Short Form, and EuroQol Five-Dimensional Questionnaire, Three-Level Version Health States were used in the evaluation. Two scores are obtained in Canadian Occupational Performance Measure: one for performance and one for satisfaction. EuroQol Five-Dimensional Questionnaire, Three-Level Version consists of two parts: EuroQol Five-Dimensional Questionnaire, Three-Level Version descriptive system and EuroQol Five-Dimensional Questionnaire, Three-Level Version Visual Analog Scale.</p><p><strong>Results: </strong>While female gender (p=0.006, p=0.001), using walking assistant (p=0.001, p=0.001), being single/widow (p=0.031, p=0.007), and history of falling (p=0.004, p=0.001) made difference in Visual Analog Scale (rest, activity), female gender (p=0.013) and being single/widow (p=0.020) made difference in satisfaction scores of Canadian Occupational Performance Measure. Female gender (p=0.001), using walking assistant (p=0.001), and history of falling (p=0.010) made difference in EuroQol Five-Dimensional Questionnaire, Three-Level Version descriptive system. In addition, performance scores of Canadian Occupational Performance Measure had a low correlation with Visual Analog Scale (rest r=-0.198, p=0.019; activity r=-0.188, p=0.026) and had a moderate correlation with EuroQol Five-Dimensional Questionnaire, Three-Level Version descriptive system (r=0.327, p=0.001) and EuroQol Five-Dimensional Questionnaire, Three-Level Version Visual Analog Scale (r=0.307, p=0.001). Satisfaction scores of Canadian Occupational Performance Measure had a low correlation with Visual Analog Scale (rest r=-0.247, p=0.003; activity r=-0.223, p=0.008) and had a moderate correlation with EuroQol Five-Dimensional Questionnaire, Three-Level Version descriptive system (r=0.399, p=0.001) and EuroQol Five-Dimensional Questionnaire, Three-Level Version Visual Analog Scale (r=0.306, p=0.001).</p><p><strong>Conclusion: </strong>The elderly who were women, single/widowed, using walking assistant, and having a history of falling were more affected during the coronavirus disease period.</p>","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e6/a6/1806-9282-ramb-69-06-e20221018.PMC10305824.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9729738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brazilian guidelines for allergen immunotherapy in the treatment of allergic rhinitis.","authors":"Fernando Monteiro Aarestrup,&nbsp;Geórgia Véras de Araújo Gueiros Lira,&nbsp;Ernesto Akio Taketomi,&nbsp;Elaine Gagete,&nbsp;Nelson Augusto Rosário Filho,&nbsp;Maria Cândida Rizzo,&nbsp;Dirceu Solé,&nbsp;Norma de Paula Motta Rubini,&nbsp;Emanuel Savio Cavalcanti Sarinho,&nbsp;Wanderley Marques Bernardo","doi":"10.1590/1806-9282.2023D695","DOIUrl":"https://doi.org/10.1590/1806-9282.2023D695","url":null,"abstract":"INTRODUCTION Epidemiological studies show that allergic rhinitis (AR) is observed in 10–40% of the world’s population. This disease significantly compromises the quality of life, impairing development in children and professional activities in adults. AR is also frequently associated with allergic asthma (AA)1,2. It has been observed that 15–38% of patients with AR develop concomitant AA. This relationship between AR and AA is based on robust pathophysiological mechanisms, which are consistent with the united airways theory. This model states that environmental exposure to allergenic molecules in genetically predisposed individuals directs the production of specific cytokines responsible for the development of the allergic inflammatory process in the nasal mucosa and lungs1,3. The association between AR and AA or atopic dermatitis (AD) is very common, usually developing since childhood, representing a phenomenon called the atopic march. Therefore, patients with AR should be evaluated in a broad and systemic way due to the implications and interactions of this disease that is part of a broad allergic process that can affect the upper airways, lower airways, skin, and mucous membranes. These diseases, classified as atopic diseases, are characterized by the presence of a specific, genetically directed immune response after exposure to allergens1,2,4,5. In Brazil, the components derived from the house dust mites Dermatophagoides farinae (Df ), Dermatophagoides pteronyssinus (Dp), and Blomia tropicalis (Bt) are the main allergens associated with the etiology of AR. Particularly in southern Brazil and in rural areas, pollens are also allergens associated with the etiology of AR6. Knowledge of the pathophysiology of AR is important for understanding the diagnostic strategies and therapeutic possibilities. Sensitization in the nasal mucosa starts with the presentation of allergens by antigen-presenting cells, such as dendritic cells, macrophages, and Langerhans cells, to naive CD4+ T lymphocytes, which at the level of innate immunity may present themselves as dysfunctional, and individuals with genetic predisposition in the presence of allergens have a tendency to differentiate naive CD4+ T cells into Th2 cells, which are characterized by producing interleukin (IL)-4, IL-5, and IL-13. In addition, other important cytokines in this allergen-specific response or even in nonspecific triggers (irritants, pollutants, virus infection, etc.) are IL-25, IL-33, and thymic stromal lymphopoietin produced by respiratory mucosal epithelial cells. These cytokines (alarmins) can contribute to induce immunoglobulin E (IgE) production and the recruitment of eosinophils to the site of the inflammatory allergic process by stimulating, respectively, IL-4and IL-5-producing Th2 and ILC2 cells. This entire process is currently referred to as type 2 inflammation, characterizing the pathophysiological mechanisms of AR and AA5,6.","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e8/86/1806-9282-ramb-69-05-e2023D695.PMC10240924.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9998625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brazilian Portuguese version of Eating Pathology Symptoms Inventory.","authors":"Jônatas de Oliveira","doi":"10.1590/1806-9282.20221729","DOIUrl":"https://doi.org/10.1590/1806-9282.20221729","url":null,"abstract":"Universidade de São Paulo, Faculty of Medicine, School of Medicine – São Paulo (SP), Brazil. *Corresponding author: oliveira.jonatas@usp.br Conflicts of interest: the authors declare there is no conflict of interest. Funding: none. Received on January 04, 2023. Accepted on January 21, 2023. The identification of eating disorder (ED) symptoms and their diagnosis is still a challenge in the Brazilian scenario, which requires the association of various methodologies to identify symptoms in terms of frequency, association, and an approximation to the clinical diagnosis. The commonly used methods are the Eating Attitudes Test (EAT26)1 and the Binge Eating Scale2, which are self-administered. Also, recently, the questionnaire on Eating and Weight Patterns (QEWP-5)3, with its Brazilian version, is available for use by clinical interviewers, bringing great advances to the study of binge eating disorders. On the contrary, questionnaires that assess symptoms and risk for ED, such as the EAT-26, present limited features of ED pathology. Also, with the use of the BES, binge eating can be assessed, but not with other aspects such as cognitive restraint and restraint. Fat phobia through negative attitudes toward weight and obesity is also a prominent indicator in the psychopathology of EDs. In response to this gap, Forbush et al., developed the Eating Pathology Symptoms Inventory (EPSI)4, which comprises 45 items to assess the frequency of cognitions and behaviors in the last month. An initial pool of 160 items was developed by the researchers to assess 20 dimensions of eating pathology, and after the ensuing analyses were conducted, an 8-factor structure was identified: body dissatisfaction, binge eating, cognitive restraint, excessive exercise, restricting, purging, muscle building, and negative attitudes toward obesity. Bilingual researchers translated the original scale from English to Portuguese version. Then, additional bilingual translators produced two back-translations. The cross-cultural adaptation process of the instrument was carried out, and the final version for use in the Brazilian population is presented in Table 1.","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/04/c9/1806-9282-ramb-69-06-e20221729.PMC10241078.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9998627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy for female surgeons: an eternal challenge.","authors":"Andréa Povedano,&nbsp;Luciana Ribeiro","doi":"10.1590/1806-9282.2023S107","DOIUrl":"https://doi.org/10.1590/1806-9282.2023S107","url":null,"abstract":"Medical career in Brazil has experienced the phenomenon of feminization. However, surgical specialties have not proportionally accompanied this growth. Among the factors supposedly responsible for the preference of young doctors for clinical specialties in detriment to surgical ones are the concern about having children, starting a family, and the need to reconcile the responsibilities and professional obligations imposed by the practice of surgery. This article brings an analysis of the problems involving pregnancy and the professional career of female surgeons, including their main occupational risks. Female participation in surgical practice dates back to ancient history when the art of healing was closely linked to divine powers. Archeological records suggest practices equivalent to medicine practiced by Egyptian queens and Greek deities. In the Middle Ages, under strong religious influence, the practice of medicine by women, and in particular the surgical practice, was strongly discouraged and even prohibited, being viable only in exceptional cases, for example, when the profession was inherited from a deceased spouse. Women practicing acts of “healing” were at risk of being accused of witchcraft and sentenced to death1. With the arrival of the modern era, women still had less social participation. Perhaps, the first woman to practice surgery on the European continent was Margareth Bulkley. Records suggest that Bulkley was forced to assume a male identity (Sir James Barry, British army surgeon) as a way to graduate in medicine in 1809 in Scotland and to work in surgery without discrimination. Her true identity was discovered only after her death in 18651. The title of first woman graduate in medical school in the world is credited to Elizabeth Blackwell, and it was in 1849 in the USA2. In Brazil, women were allowed only to attend regular university careers after the enactment of the Leôncio de Carvalho law in 1879. Before this date, wealthier families with avantgarde thoughts in relation to their daughters needed to send them abroad, as they did with Maria Augusta Generoso Estrela and Josefa Águeda de Oliveira. They were considered the first Brazilian female medical doctors, both having graduated from medical school in the USA in 1881 and 1882, respectively. The first doctor formally graduated as a medical doctor in Brazil was Rita Lobato Lopes in 1887. The first female surgeon to join the Brazilian College of Surgeons, the biggest and oldest association of surgeons in the country, was Mariza Garrido in 1959, only 30 years after its foundation3. Fortunately, the current scenario is very different from the past. Currently, in the United States of America, 37.1% of physicians registered at the American Medical Association are women4. In the United Kingdom, the percentage of women in medicine is even higher, which is 47.5% of the total number of registered professionals. However, when analyzing the percentage of medical specialists by gender, o","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/37/e8/1806-9282-ramb-69-suppl1-e2023S107.PMC10411699.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10036586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoporosis and fracture risk assessment: improving outcomes in postmenopausal women.","authors":"Mariana Ortega Perez,&nbsp;Pedro Paulo de Alcantara Pedro,&nbsp;André Marun Lyrio,&nbsp;Felipe Merchan Ferraz Grizzo,&nbsp;Marco Antonio A da Rocha Loures","doi":"10.1590/1806-9282.2023S130","DOIUrl":"https://doi.org/10.1590/1806-9282.2023S130","url":null,"abstract":"Osteoporosis is a skeletal disease characterized by impaired bone density, bone mineral density (BMD), and bone strength, resulting in bone fragility and an increased risk of fractures1. A fracture is the worst outcome for patients with osteoporosis, as it increases morbidity and mortality in addition to increasing the risk of new subsequent fractures. The main cause of osteoporosis in women is estrogen deficiency secondary to menopause2,3. Osteoporosis has a high prevalence and a social and financial impact. The prevalence of the diagnosis of osteopenia in postmenopausal women was present in 30–56.5% of the population, and osteoporosis enters the range of 14.7–43.4%4. Osteoporosis can lead to a major impact on public health, such as hospitalizations, surgeries with prostheses, temporary or permanent loss of mobility, and death2,3. Although BMD is a strong predictor of fracture risk, there are patients who may fracture even without presenting osteoporosis in the bone densitometry exam, making it necessary to evaluate risk factors other than bone density. In this context, the FRAX (Fracture Risk Assessment Tool) tool brings together other risk factors for fracture prediction independent of BMD, such as the presence of previous fragility fracture, hip fragility fracture in the parents, current smoking, use of glucocorticoids, rheumatoid arthritis, secondary osteoporosis, and use of three or more units of alcoholic beverage per day1-4. Interestingly, FRAX is an algorithm that analyzes all clinical risk factors together and finally calculates the absolute risk of fracture in 10 years. Patients diagnosed with osteoporosis or those at high risk of fracture by FRAX deserve drug treatment targeting bone mass gain and fracture prevention. Among the drug strategies are anti-resorptive drugs (bisphosphonates and denosumab) and anabolic agents (teriparatide and romosozumab), which must be associated with other measures, such as physical activity, calcium intake, preferably in the diet, and supplementation of vitamin D2. The prevalence of osteoporosis increases with age, with a consequent increase in the number of fractures, either due to worsening of the bone structure, with thinning of the cortical bone, reduction of the trabeculae, and alteration of the bone microarchitecture, or due to the increased risk of falls, reduced lean mass, impairment of proprioception, and decreased visual acuity, among other factors. Osteoporotic fractures are those due to fragility, that is, low impact. Fragility fractures may be asymptomatic, mostly when occurred in the vertebral bodies with wedging, leading to height loss and dorsal hyperkyphosis5. Annually, almost 9 million fractures occur worldwide due to osteoporosis, which corresponds to an osteoporosis-related fracture every 3 s, and of these fractures, 1.6 million are hip fractures. The world estimate is that there are about 500 million people with osteoporosis, predominantly women, with an estimated fracture resulting","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8e/b1/1806-9282-ramb-69-suppl1-e2023S130.PMC10411691.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10045484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory prognostic index predicts new-onset atrial fibrillation and mortality after on-pump coronary artery bypass grafting.","authors":"Serdar Badem,&nbsp;Atilla Pekcolaklar","doi":"10.1590/1806-9282.20230226","DOIUrl":"https://doi.org/10.1590/1806-9282.20230226","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyze its predictive role in incipient postoperative atrial fibrillation by constructing an inflammatory prognostic index based on hematological and biochemical parameters in patients undergoing elective isolated coronary artery surgery accompanied by cardiopulmonary bypass.</p><p><strong>Methods: </strong>The data of 343 patients who underwent coronary bypass surgery between May 2021 and July 2022 were evaluated. Multivariate logistic regression and recipient study characteristic curve analyses were studied by comparing the patients' hematological indices and basic clinical features between the two groups.</p><p><strong>Results: </strong>Logistic regression analysis showed that age (p<0.001), hypertension (p=0.01), and inflammatory prognostic index (p<0.001) were independent predictors of new-onset postoperative atrial fibrillation. To predict the development of postoperative atrial fibrillation, a cutoff value of 0.25 (77.8% sensitivity and 69.3% specificity) was determined for inflammatory prognostic index in the receiver-operating characteristic curve analysis (area under curve=0.798, 95% confidence interval 0.752-0.840).</p><p><strong>Conclusion: </strong>Inflammatory prognostic index can be a noninvasive, easily available marker for predicting new-onset atrial fibrillation after coronary artery bypass surgery.</p>","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/31/1806-9282-ramb-69-08-e20230226.PMC10427184.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10046772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between IL-17, TNF-α, IL-10, IFN-γ, and IL-18 polymorphisms with the outcome of hepatitis B virus infection in the Turkish population.","authors":"Esra Nurlu Temel,&nbsp;Fusun Zeynep Akcam,&nbsp;Vildan Caner,&nbsp;Gülseren Bagcı,&nbsp;Muhammet Yusuf Tepebası","doi":"10.1590/1806-9282.20230355","DOIUrl":"https://doi.org/10.1590/1806-9282.20230355","url":null,"abstract":"<p><strong>Objective: </strong>Hepatitis B virus is a global threat that can lead to liver cirrhosis and hepatocellular carcinoma. For the treatment of chronic hepatitis B virus, polymorphisms might be an option for gene treatments. This study aimed to investigate the effects of IL-17, TNF-α, IL-10, IFN-γ, and IL-18 gene polymorphisms on hepatitis B virus infection in the Turkish population.</p><p><strong>Methods: </strong>The genotypes and allele distribution of 75 patients exposed to hepatitis B virus and 50 healthy control individuals were analyzed. The real-time polymerase chain reaction method was used for identification.</p><p><strong>Results: </strong>A correlation was observed between susceptibility to hepatitis B virus infection and IL-17 Exon 3/3'UTR (rs1974226) C, IL-17 Exon 3 (rs763780) A, IL-18 (-607) (rs1946518) A alleles, and IL-17 Exon 3 (rs763780) AA genotype (p=0.006, p=0.009, p=0.025, and p=0.008, respectively). Furthermore, IL-18 (-137) (rs187238) TT genotype and TNF-α-308 (rs1800629) G and A alleles, were associated with protection against hepatitis B virus infection (p=0.0351 and p=0.032, respectively).</p><p><strong>Conclusion: </strong>This study demonstrated that TNF-α (-308), IL-17 (Exon 3/3' UTR), IL-17 (Exon 3), and IL-18 (-607) polymorphisms are associated with hepatitis B virus infection. Therefore, these may serve as potential therapeutic targets for chronic viral hepatitis in the Turkish population.</p>","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ab/0e/1806-9282-ramb-69-08-e20230355.PMC10427177.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10048813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}