Revista da Associacao Medica Brasileira最新文献

{"title":"The effect of functional independence levels on sleep and constipation in children with cerebral palsy","authors":"Elif Irem Gunaydin, Aysenur Tuncer","doi":"10.1590/1806-9282.20230765","DOIUrl":"https://doi.org/10.1590/1806-9282.20230765","url":null,"abstract":"SUMMARY OBJECTIVE: The study aimed to examine the effect of functional independence levels on sleep behavior and constipation in children with cerebral palsy. METHODS: This cross-sectional observational single-center study was carried out in a special rehabilitation center in Istanbul. Inclusion criteria were those aged between 4 and 18 years with Gross Motor Function Classification System III-IV-V functional independence levels. Those who had surgery concerning intestinal health, had a chronic infectious bowel disease, had congenital intestinal anomalies, had received botox treatment in the last 6 months, had uncontrolled epileptic seizures, had complained of constipation in the last 6 months, and had cardiopulmonary disease were excluded from the study. The sociodemographic characteristics of the participants and the Gross Motor Function Classification System were recorded. Pediatric Functional Independence Scale (Functional Independence Measure for Children) was used to measure the functional independence level, Pediatric Sleep Questionnaire was used to measure the level of sleep problems, and Constipation Severity Scale was used to measure constipation severity. RESULTS: A total of 60 children who were diagnosed with cerebral palsy were included. According to Gross Motor Function Classification System, 46.7% of the cases were Level III, 35% were Level IV, and 18.3% were Level V. There was a negative moderate significant correlation between Functional Independence Measure for Children and Pediatric Sleep Questionnaire (r=-0.303; p=0.019) and between Functional Independence Measure for Children and Constipation Severity Scale (r=-0.342; p=0.007). CONCLUSION: We described that lower functional independence levels were related to worse sleep and constipation symptoms. The results suggest that effective strategies for developing functional independence levels may be beneficial for both sleep and constipation symptoms in the concept of cerebral palsy management.","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135658871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty and its associates in community-dwelling older adults","authors":"Meris Esra Bozkurt, Nezahat Muge Catikkas, Tugba Erdogan, Meryem Merve Oren, Cihan Kilic, Mehmet Akif Karan, Gulistan Bahat","doi":"10.1590/1806-9282.20230681","DOIUrl":"https://doi.org/10.1590/1806-9282.20230681","url":null,"abstract":"SUMMARY OBJECTIVE: While the literature contains several studies on the frailty assessed during hospitalization and/or outpatient settings and nursing homes, few studies have assessed frailty in community-dwelling older adults. We investigated the prevalence of frailty and associated factors among older adults in a sample of community-dwelling older adults. METHODS: We included community-dwelling older adults >60 years living in the Fatih District of the Istanbul Province. We conducted the study between November 2014 and May 2015. We collected the data such as age, sex, number of diseases and drugs, functional status, frailty, the presence of geriatric syndromes, common diseases, and quality-of-life assessment. Frailty was evaluated by the FRAIL scale. RESULTS: A total of 204 adults (mean age: 75.4±7.3 years) were included, of whom 30.4% were robust, 42.6% were pre-frail, and 27% were frail. In multivariate analyses, associated factors of frailty were the number of drugs [odds ratio (OR)=1.240, p=0.036], the presence of cognitive impairment (OR=0.300, p=0.016), and falls (OR=1.984, p=0.048). CONCLUSION: The present study established the prevalence of frailty in a large district in the largest metropolis in the country through a valid screening method. Our results suggest that clinicians should consider frailty evaluation in patients with multiple drug usage, cognitive impairment, and falls.","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135658941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of erector spina plane, quadratus lumborum blocks, and intrathecal morphine for analgesia after cesarean: a randomized study","authors":"Mehmet Aksoy, Ayse Nur Aksoy, Emsal Pınar Topdagi Yilmaz, Gamze Nur Cimilli Senocak, Aysenur Dostbil, Hava Ozkan","doi":"10.1590/1806-9282.20230867","DOIUrl":"https://doi.org/10.1590/1806-9282.20230867","url":null,"abstract":"SUMMARY OBJECTIVE: This prospective randomized study was conducted at Ataturk University Medical Faculty Hospital, Department of Anesthesia and Reanimation, from June 2022 to May 2023. The aim of this study was to compare the effectiveness of ultrasound-guided erector spinae plane block, quadratus lumborum block, and intrathecal morphine to decrease postoperative pain after cesarean section. METHODS: Sixty-term pregnant women who were scheduled for elective cesarean sections with spinal anesthesia were included. Patients were randomly divided into three groups (n=20 for each group): Group 1: Patients were administered intrathecal morphine during spinal anesthesia; Group 2: Patients performed bilateral erector spinae plane block postoperatively; and Group 3: Patients performed bilateral quadratus lumborum block postoperatively. In the postpartum care unit, patients received intravenous Patient-Controlled Analgesia. The Patient-Controlled Analgesia devices were set to administer an intravenous bolus of 25 μg fentanyl, with a lockout interval of 10 min. Opioid consumption and maximum pain score in the 24 postoperative hours were recorded. RESULTS: Patients in Group 1 had a longer time to first analgesic requirement compared to Group 2 (p=0.017). Opioid consumption and resting and moving visual analog score scores in the first 24 h postoperatively were similar between groups. CONCLUSION: All three methods, including intrathecal morphine, erector spinae plane block, and quadratus lumborum block, are efficacious and comparable in providing postoperative analgesia after cesarean under spinal anesthesia.","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135659853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive assessment model for patients with spinal muscular atrophy: proposal of tools for clinical practice and real-world studies.","authors":"Renalli Manuella Rodrigues Alves, Vanessa Van Der Linden, Lívia Barbosa de Andrade","doi":"10.1590/1806-9282.20221608","DOIUrl":"https://doi.org/10.1590/1806-9282.20221608","url":null,"abstract":"Spinal muscular atrophy (SMA) is a rare genetic condition, with an incidence of 10 per 100,000 live births, in which an autosomal recessive alteration occurs in the motor neuron survival gene SMN1, leading to hypotonia, progressive weakness, developmental damage, and motor losses1. It is a condition with great variability in presentation and clinical course, classified into four types from I to IV based on the age of onset of symptoms and maximum motor function reached, with type I, with childhood onset, being the most severe and type IV, with late onset, having a better prognosis. Type I SMA affects infants before 6 months of age, impairs the acquisition of motor milestones, and reduces life expectancy1. The severity of the disease and its limitations are related to complications of the respiratory, musculoskeletal, cardiovascular, and gastrointestinal systems2,3. Advances in elucidating the molecular, cellular, and physiological processes of disease have allowed innovative studies with disease-modifying therapies, in combination with interdisciplinary care, that demonstrated promising results in clinical trials and real-world studies1-3. Among the three alternatives approved as disease-modifying therapies, Nusinersen, an antisense oligonucleotide, increases the production of the motor neuron survival protein by acting on the inclusion of exon 7 in the mRNA transcripts of the SMN2 gene. It is a medication applied via intrathecal administration with four loading doses on days 0, 14, 28, and 63 and reinforcement every 4 months1,4. Safety and efficacy research and real-world studies demonstrate positive results and suggest new phenotypes1. However, differences in study methodologies in different countries may limit of results and indicate the need for greater standardization in evaluation4. The interpretation of real gains of the patients is impaired by the heterogeneity of the studies, different periods of data collection, and duration of follow-up, as well as by the use of different outcome measures and poor description of quality of life, respiratory, and nutritional outcomes1. A recent systematic review shows an important gap in the follow-up data of the therapeutic program of children with SMA I and highlights the need for new studies with independent publication, without conflicts of interest, that reinforce the long-term stabilization of results, functional abilities acquired, and additional characteristics of patients and multidisciplinary therapies4. As it is an expensive drug, such data and information reaffirm its costeffectiveness and guarantee the treatment. In Brazil, the drug was incorporated in 2019 for patients with SMA I. The new Clinical and Therapeutic Protocol, approved in January 2022, brings recommendations for the analysis of clinical effectiveness, including the use of the Children’s Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP INTEND)5, Hammersmith Infant Neurological Exam-Part 2 (HINE-2)6, and Exp","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"69 3","pages":"377-379"},"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/c7/3b/1806-9282-ramb-69-03-0377.PMC10004283.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9154495","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":"Healthcare compliance: pioneer experience in a public hospital.","authors":"Fabio Roberto Cabar, Matheus Abelo de Oliveira, Maria Luiza Gorga","doi":"10.1590/1806-9282.20221160","DOIUrl":"https://doi.org/10.1590/1806-9282.20221160","url":null,"abstract":"INTRODUCTION The judicialization of health is an irreversible reality not only for professionals, but also for public or private institutions, with an exponential increase in actions against public entities, hospitals, and professionals. Such actions can result in indemnification for alleged malpractice, accountability for various illegal acts, in addition to requiring the right to treatments, hospitalizations, and surgeries. The Brazilian National Council of Justice published a report showing a 130% increase in cases involving health-related aspects between 2008 and 2017, compared to a 50% increase in cases in general1. A detailed analysis identified that medications, orthotics, prostheses and auxiliary means, examinations, procedures, and hospitalization beds are the main causes related to the search for judicial guardianship. On the contrary, actions with allegations of medical error represented a higher number than the demands for transplants, for example. Another very sensitive subject is hospital mortality related to the occurrence of preventable adverse events. In a survey by the Institute for Supplementary Health Studies, it was demonstrated that mortality from this cause could be prevented in almost 40% of cases. In addition, the prevention of serious adverse events could provide fence one million beds for hospitalizations for other causes every year2. In addition to the direct and indirect damages caused to patients and families, there is undeniable and enormous financial damage, with the consequent misuse of resources that could be used in the treatment of other patients. Some of the possible causes of this situation may be the lack of hierarchical definitions, tolerance for individualistic measures and practices, poverty in available information, and fear of punishment. Adjunct to these aspects, conducts known to be unethical or even illegal can be taken in professional practice, which should not be seen as mere individual inappropriate conduct, but as systemic problems in hospital institutions3. In this scenario, it is evident that measures need to be adopted to try to prevent or reduce harm, such as the establishment of a non-punitive culture of care security, so that failures are seen as real opportunities for improvement, and the training of health professionals to know and use measures to prevent these failures. It is essential to make professionals aware of the consequences of harmful attitudes, even when they are routine and apparently harmless. As a result, it is urgent to implement a compliance culture in health practices.","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"69 2","pages":"203-206"},"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/46/81/1806-9282-ramb-69-02-0203.PMC9983469.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9155014","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":"Effect of protection of enoxaparin against experimental ischemia/reperfusion injury in the rat ovary on in vitro fertilization outcomes.","authors":"Mehmet Suhha Bostancı,&nbsp;Ozcan Budak,&nbsp;Hüseyin Çakiroğlu,&nbsp;Osman Köse,&nbsp;Özkan Durmaz,&nbsp;Erdem Cokluk","doi":"10.1590/1806-9282.20220385","DOIUrl":"https://doi.org/10.1590/1806-9282.20220385","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to investigate the protection of enoxaparin (E) against experimental ischemic (I) and ischemic-reperfusion (I/R) injury in rat ovaries on in vitro fertilization outcomes.</p><p><strong>Methods: </strong>In total, 56 adult female Sprague-Dawley albino rats were randomly assigned to 6 groups of 8 animals each: Sham, Ischemia, I/R, Sham+E, I+E, and I/R+E. Ischemia groups were subjected to bilateral adnexal torsion for 3 h. In contrast, I/R and I/R+E groups received subsequent detorsion for 3 h. Enoxaparin (0.5 mg/kg s.c.) was administered 30 min prior to ischemia (I+platelet-rich plasma) or reperfusion (I/R+I+platelet-rich plasma). Ovaries were stimulated through intraperitoneal injection of 150-300 internal units IU/kg pregnant mare serum gonadotropin. Anti-Müllerian hormone levels were measured before and after surgery in all groups.</p><p><strong>Results: </strong>When the number of metaphase II oocytes was evaluated, statistically significant differences were observed between the I and I+E (p=0.001) and I/R and I/R+E (p=0.000) groups. When both I and I+E groups and I/R and I/R+E groups were compared, it was found that E application increased the number of fertilized oocytes. The number of embryos on the second day was higher in the I/R+E group than that in the I/R group. Statistically significant differences were found in the number of grade 1 embryos between the I/R and I/R+E groups (p=0.003). In comparing anti-Müllerian hormone values within the group, the highest decrease was observed in the I and I/R groups.</p><p><strong>Conclusion: </strong>Enoxaparin effectively minimizes ovarian damage and preserves ovarian reserve following ovarian torsion.</p>","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"69 3","pages":"380-385"},"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/93/06/1806-9282-ramb-69-03-0380.PMC10004281.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9192302","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":"Cardiovascular disease risk prediction in scleroderma.","authors":"Aliye Çelikkol,&nbsp;Rıdvan Mercan,&nbsp;Savaş Güzel,&nbsp;Ahsen Yılmaz","doi":"10.1590/1806-9282.20220936","DOIUrl":"https://doi.org/10.1590/1806-9282.20220936","url":null,"abstract":"<p><strong>Objective: </strong>Cardiovascular disease risk prediction in scleroderma is important. In this study of scleroderma patients, the aim was to investigate the relationship between cardiac myosin-binding protein-C, sensitive troponin T, and trimethylamine N-oxide and cardiovascular disease risk with the Systematic COronary Risk Evaluation 2 model of the European Society of Cardiology.</p><p><strong>Methods: </strong>Systematic COronary Risk Evaluation 2 risk groups of 38 healthy controls and 52 women with scleroderma were evaluated. Cardiac myosin-binding protein-C, sensitive troponin T, and trimethylamine N-oxide levels were analyzed with commercial ELISA kits.</p><p><strong>Results: </strong>In scleroderma patients, cardiac myosin-binding protein-C and trimethylamine N-oxide levels were higher than healthy controls but sensitive troponin T was not (p<0.001, p<0.001, and p=0.274, respectively). Out of 52 patients, 36 (69.2%) were at low risk, and the other 16 (30.8%) patients were at high-moderate risk with the Systematic COronary Risk Evaluation 2 model. At the optimal cutoff values, trimethylamine N-oxide could discriminate high-moderate risk with sensitivity 76%, specificity 86% and cardiac myosin-binding protein-C with sensitivity 75%, specificity 83%. Patients with high trimethylamine N-oxide levels (≥10.28 ng/mL) could predict high-moderate- Systematic COronary Risk Evaluation 2 risk 15 times higher than those with low trimethylamine N-oxide (<10.28 ng/mL) levels (odds ratio [OR]: 15.00, 95%CI 3.585-62.765, p<0.001). Similarly, high cardiac myosin-binding protein-C (≥8.29 ng/mL) levels could predict significantly higher Systematic COronary Risk Evaluation 2 risk than low cardiac myosin-binding protein-C (<8.29 ng/mL) levels (OR: 11.00, 95%CI 2.786-43.430).</p><p><strong>Conclusion: </strong>Noninvasive cardiovascular disease risk prediction indicators in scleroderma, cardiac myosin-binding protein-C, and trimethylamine N-oxide could be recommended to distinguish between high-moderate risk and low risk with the Systematic COronary Risk Evaluation 2 model.</p>","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"69 2","pages":"246-251"},"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/a5/61/1806-9282-ramb-69-02-0246.PMC9983472.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9434175","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":"Transjugular intrahepatic portosystemic shunt in decompensated cirrhotic patients in a tertiary hospital in southern Brazil.","authors":"Carolina Moro Titton,&nbsp;Marcio Torikachvili,&nbsp;Heloísa M C Rêgo,&nbsp;Eduardo F Medronha,&nbsp;Enio Ziemiecki Junior,&nbsp;Carolina Ribas,&nbsp;Carlos Germano Ceratti,&nbsp;Angelo Alves de Mattos,&nbsp;Cristiane Valle Tovo","doi":"10.1590/1806-9282.20220944","DOIUrl":"https://doi.org/10.1590/1806-9282.20220944","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the present study was to evaluate the outcomes of cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt.</p><p><strong>Methods: </strong>A retrospective longitudinal observational study was carried out evaluating 38 cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt. The outcomes were evaluated in an outpatient follow-up period of 3 months. The assumed significance level was 5%.</p><p><strong>Results: </strong>The indications for transjugular intrahepatic portosystemic shunt were refractory ascites in 21 (55.3%), variceal hemorrhage in 13 (34.2%), and hydrothorax in 4 (10.5%) patients. There was development of hepatic encephalopathy in 10 (35.7%) patients after transjugular intrahepatic portosystemic shunt. From the 21 patients with refractory ascites, resolution was observed in 1 (3.1%) patient, and in 16 (50.0%) patients, there was ascites control. Regarding transjugular intrahepatic portosystemic shunt after variceal bleeding, 10 (76.9%) patients remained without new bleeding or hospitalizations in the follow-up period. The global survival in the follow-up period in patients with and without hepatic encephalopathy was 60 vs. 82%, respectively (p=0.032).</p><p><strong>Conclusion: </strong>Transjugular intrahepatic portosystemic shunt can be considered in decompensated cirrhotic patients; however, the development of hepatic encephalopathy which can shorten survival should be focused.</p>","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"69 4","pages":"e20220944"},"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/fb/f5/1806-9282-ramb-69-04-e20220944.PMC10176653.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9450205","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":"Analysis of appendiceal neoplasms in 1,423 appendectomy specimens: a 10-year retrospective cohort study from a single institution.","authors":"Ahmet Rencuzogullari,&nbsp;Cihan Atar,&nbsp;Ugur Topal,&nbsp;İbrahim Coğal,&nbsp;Ahmet Gokhan Saritas,&nbsp;Orcun Yalav,&nbsp;Kubilay Dalci,&nbsp;İsmail Cem Eray","doi":"10.1590/1806-9282.20220714","DOIUrl":"https://doi.org/10.1590/1806-9282.20220714","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to reveal the incidence, clinicopathological, and oncological outcomes of appendiceal neoplasms.</p><p><strong>Methods: </strong>This is a retrospective cohort study from a single institution. Patients with a pathological diagnosis of malignancy who underwent appendectomy between January 2011 and 2021 were included in the study, and groups were formed according to pathological type. Clinical, pathological, and oncological results were compared in these groups.</p><p><strong>Results: </strong>The incidence of neoplasia was 2.38% (n=34) in a cohort of 1,423 appendectomy cases. Of the cases, 56% (n=19) were female. The median age in the entire cohort was 55.5 (range: 13-106) years. In the cohort, the rate of neuroendocrine tumor mucinous cystadenoma adenocarcinoma, and low-grade appendiceal mucinous neoplasm, according to the American Joint Committee on Cancer classification of appendiceal neoplasms, was 32.3% (n=11), 26.4% (n=9), 26.4% (n=9), and 14.7% (n=5), respectively. Neuroendocrine tumor patients (median age: 35 years) were younger than the other groups (p=0.021). Secondary complementary surgery was performed in 66.7% (n=6) of adenocarcinoma patients and 27.3% (n=3) of neuroendocrine tumor patients. Right hemicolectomy was performed in all neuroendocrine tumor patients requiring secondary surgery, while right hemicolectomy was performed in three adenocarcinoma patients and cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in three adenocarcinoma patients. After a median follow-up of 44.4 months (95% confidence interval: 18.6-70.1), the mean survival rate was 55% in appendiceal adenocarcinoma patients compared to 100% in neuroendocrine tumor patients.</p><p><strong>Conclusion: </strong>Appendiceal neoplasms are rare but remain an important cause of mortality. Appendiceal adenocarcinomas are associated with poorer oncological outcomes compared to other neoplasms.</p>","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"69 5","pages":"e20220714"},"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/f9/0b/1806-9282-ramb-69-05-e20220714.PMC10204856.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9524941","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":"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":"69 5","pages":"e20230071"},"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}