Revista da Associacao Medica Brasileira最新文献

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An enlarged fetal thymus may be the initial response to intrauterine inflammation in pregnant women at risk for preterm birth. 胎儿胸腺肿大可能是有早产风险的孕妇对宫内炎症的最初反应。
IF 1.4 4区 医学
Revista da Associacao Medica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.20221678
Tatiana Emy Nishimoto Kawanami Hamamoto, Alan Roberto Hatanaka, Marcelo Santucci França, Stéphanno Gomes Pereira Sarmento, Talita Micheletti Helfer, Roseli Mieko Yamamoto Nomura, Edward Araujo Júnior, Antonio Fernandes Moron
{"title":"An enlarged fetal thymus may be the initial response to intrauterine inflammation in pregnant women at risk for preterm birth.","authors":"Tatiana Emy Nishimoto Kawanami Hamamoto,&nbsp;Alan Roberto Hatanaka,&nbsp;Marcelo Santucci França,&nbsp;Stéphanno Gomes Pereira Sarmento,&nbsp;Talita Micheletti Helfer,&nbsp;Roseli Mieko Yamamoto Nomura,&nbsp;Edward Araujo Júnior,&nbsp;Antonio Fernandes Moron","doi":"10.1590/1806-9282.20221678","DOIUrl":"https://doi.org/10.1590/1806-9282.20221678","url":null,"abstract":"<p><strong>Objective: </strong>Fetal thymus involvement in prematurity has been studied, and this study aimed to evaluate its relationship with short cervix and amniotic fluid sludge in the second trimester of pregnancy.</p><p><strong>Methods: </strong>In this prospective cross-sectional study, 79 pregnant women (19+0 to 24+6 weeks) were included, and cervical length and the presence or absence of amniotic fluid sludge were evaluated. In the three-vessel view of the fetal thorax, the thymus was identified, and its perimeter and transverse diameter were measured and transformed to a zeta score based on gestational age.</p><p><strong>Results: </strong>Data from 22 women with short cervix (<25 mm) and 57 patients with normal cervix (≥25 mm) were analyzed. The transverse diameter of the fetal thymus was significantly greater in the short cervix group compared to that of the normal cervix group (z-score 2.708 vs. -0.043, p=0.003). There were no significant differences in the perimeter (z-score -0.039 vs. -0.071, p=0.890) or the transverse diameter (z-score 1.297 vs. -0.004, p=0.091) of the fetal thymus associated with the presence (n=21) or absence of sludge (n=58).</p><p><strong>Conclusion: </strong>A short cervix is associated with an increased transverse diameter of the fetal thymus during the second trimester of gestation.</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/66/e6/1806-9282-ramb-69-05-e20221678.PMC10176657.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9456588","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}
引用次数: 0
Treatment results of carotid artery stenting in a developing country. 发展中国家颈动脉支架植入术的治疗效果。
IF 1.4 4区 医学
Revista da Associacao Medica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.20220525
Isabella Sales de Macêdo, Rafaela Almeida Alquères, Lorena Souza Viana, Paulo Puglia Júnior, Adriana Bastos Conforto
{"title":"Treatment results of carotid artery stenting in a developing country.","authors":"Isabella Sales de Macêdo,&nbsp;Rafaela Almeida Alquères,&nbsp;Lorena Souza Viana,&nbsp;Paulo Puglia Júnior,&nbsp;Adriana Bastos Conforto","doi":"10.1590/1806-9282.20220525","DOIUrl":"https://doi.org/10.1590/1806-9282.20220525","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to investigate the details of minor complications of carotid artery stenting in a developing country.</p><p><strong>Methods: </strong>This was a retrospective, single-center study conducted on the target group consisting of 65 symptomatic patients who underwent carotid artery stenting. We assessed technical success rate, periprocedural complication within 30 days (hypotension, bradycardia, acute kidney injury, vasospasm, a transient ischemic attack, stroke, myocardial infarction, and death), and the differences between groups with and without complications.</p><p><strong>Results: </strong>Minor periprocedural complications occurred in 15 patients. In all, 8 (12.3%) had transient hypotension, 6 (9.2%) had bradycardia, 7 (10.7%) had acute kidney injury, 2 (3.1%) had vasospasm, and 1 (1.5%) had transient ischemic attack. A greater rate of minor complications was observed in women (p=0.051).</p><p><strong>Conclusion: </strong>The results of the carotid artery stenting procedures performed in a developing country were acceptable.</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/c5/94/1806-9282-ramb-69-04-e20220525.PMC10176659.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9456589","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}
引用次数: 0
Obstetric simulation for undergraduate medical education: how to improve students' self-confidence and expectation according to gender. 本科医学教育中的产科模拟:如何根据性别提高学生的自信心和期望值。
IF 1.4 4区 医学
Revista da Associacao Medica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.20221625
Roseli Mieko Yamamoto Nomura, Fabiana Medeiros D Reis, Amanda Menezes Gonçalves, Carolina Matos de Proença
{"title":"Obstetric simulation for undergraduate medical education: how to improve students' self-confidence and expectation according to gender.","authors":"Roseli Mieko Yamamoto Nomura,&nbsp;Fabiana Medeiros D Reis,&nbsp;Amanda Menezes Gonçalves,&nbsp;Carolina Matos de Proença","doi":"10.1590/1806-9282.20221625","DOIUrl":"https://doi.org/10.1590/1806-9282.20221625","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate the effects of obstetric simulation training on undergraduate medical students to improve their self-confidence.</p><p><strong>Methods: </strong>Fifth-year undergraduate medical students were invited to a 2-week course of simulation in obstetrics during their clerkship. The sessions included were as follows: (1) care for the second and third periods of childbirth, (2) partograph analysis and pelvimetry, (3) premature rupture of membranes at term, and (4) diagnosis and management of third-trimester bleeding. Before the first session and at the end of the training period, a questionnaire about self-confidence in obstetric procedures and skills was applied.</p><p><strong>Results: </strong>A total of 115 medical students were included, of whom 60 (52.2%) were male and 55 (47.8%) were female. Comparing initial and final scores, the median results of the subscales \"comprehension and preparation\" (18 vs. 22, p<0.001), \"knowledge of procedures\" (14 vs. 20, p<0.001), and \"expectation\" (22 vs. 23, p<0.01) were significantly higher at the end of the training period in all items of the questionnaire than in the beginning. Differences were found based on the students' gender, i.e., female students had a significantly higher sum of scores than the male students in the initial subscale for \"expectation\" (median, 24 vs. 22, p<0.001) and \"interest\" (median, 23 vs. 21, p=0.032), and a higher sum of scores in the subscale for \"expectation\" (median, 23 vs. 21, p=0.010) in the final questionnaire.</p><p><strong>Conclusion: </strong>Obstetric simulation enhances the improvement of students' self-confidence in understanding both the physiology of childbirth and the obstetric care procedures. Further studies are needed to understand the influence of gender on obstetric care.</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/6f/4c/1806-9282-ramb-69-04-e20221625.PMC10176646.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9458699","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}
引用次数: 0
Identification of novel variants in retinitis pigmentosa genes by whole-exome sequencing. 通过全外显子组测序鉴定视网膜色素变性基因的新变异。
IF 1.4 4区 医学
Revista da Associacao Medica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.20221073
Ayca Kocaaga, İrem Öztürk Aköz, Nihal Ulus Demir, Bariş Paksoy
{"title":"Identification of novel variants in retinitis pigmentosa genes by whole-exome sequencing.","authors":"Ayca Kocaaga,&nbsp;İrem Öztürk Aköz,&nbsp;Nihal Ulus Demir,&nbsp;Bariş Paksoy","doi":"10.1590/1806-9282.20221073","DOIUrl":"https://doi.org/10.1590/1806-9282.20221073","url":null,"abstract":"<p><strong>Objective: </strong>Retinitis pigmentosa is an inherited degenerative disorder causing severe retinal dystrophy and visual impairment, mainly with onset in the first or second decades. The next-generation sequencing has become an efficient tool to identify disease-causing mutations in retinitis pigmentosa. The aim of this retrospective study was to investigate novel gene variants and evaluate the utility of whole-exome sequencing in patients with retinitis pigmentosa.</p><p><strong>Methods: </strong>The medical records of 20 patients with retinitis pigmentosa at Eskişehir City Hospital between September 2019 and February 2022 were analyzed retrospectively. Peripheral venous blood was obtained, followed by the extraction of genomic DNAs. The medical and ophthalmic histories were collected, and ophthalmological examinations were performed. Whole-exome sequencing was performed to determine the genetic etiology of the patients.</p><p><strong>Results: </strong>The proportion of genetically solved cases was 75% (15/20) in the patients with retinitis pigmentosa. Molecular genetic testing identified 13 biallelic and 4 monoallelic mutations in known retinitis pigmentosa genes, including 11 novel variants. According to in silico prediction tools, nine variants were predicted as pathogenic or possibly pathogenic. We identified six previously reported mutations to be associated with retinitis pigmentosa. The age of onset of the patients ranged from 3 to 19, with a mean age of onset of 11.6. All patients had a loss of central vision.</p><p><strong>Conclusion: </strong>As the first study of the application of whole-exome sequencing among patients with retinitis pigmentosa in a Turkish cohort, our results may contribute to the characterization of the spectrum of variants related to retinitis pigmentosa in the Turkish population. Future population-based studies will enable us to reveal the detailed genetic epidemiology of retinitis pigmentosa.</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/10/07/1806-9282-ramb-69-05-e20221073.PMC10204840.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9524942","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}
引用次数: 0
The use of esketamine in the treatment of patients with severe depression and suicidal ideation: systematic review and meta-analysis. 使用艾氯胺酮治疗重度抑郁症和自杀意念患者:系统回顾和荟萃分析。
IF 1.4 4区 医学
Revista da Associacao Medica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.2023D694
Idevaldo Floriano, Antônio Silvinato, Wanderley Marques Bernardo
{"title":"The use of esketamine in the treatment of patients with severe depression and suicidal ideation: systematic review and meta-analysis.","authors":"Idevaldo Floriano,&nbsp;Antônio Silvinato,&nbsp;Wanderley Marques Bernardo","doi":"10.1590/1806-9282.2023D694","DOIUrl":"https://doi.org/10.1590/1806-9282.2023D694","url":null,"abstract":"INTRODUCTION Depression is a very common and disabling mental illness and can be assessed by applying several questionnaires, the most common being the Montgomery-Asberg rating scale1, scoring on a scale of 0–60, where 7–19 denotes mild depression, 20–34 moderate depression, and greater than 34 severe depression. Major or severe depression is commonly associated with suicidal ideation, resulting in a suicide attempt or suicide. Esketamine, the S-enantiomer of racemic ketamine, is an antidepressant with a novel mechanism of action. It is a nonselective, noncompetitive antagonist of the N-methyl-Daspartate receptor and the ionotropic glutamate receptor. It promotes increased stimulation of the α-amino-3-hydroxy5-methyl-4-isoxazole propionic acid receptor (AMPAR) and neurotrophic signaling, which restore brain synaptic function. However, the mechanism by which esketamine exerts its antidepressant effect is unknown. Unlike other antidepressant treatments, the primary antidepressant action of esketamine does not directly involve monoamine, GABA, or opioid receptors2. The aim of this systematic review was to evaluate the use of esketamine compared to placebo in patients with severe depression and suicidal ideation. CLINICAL DOUBT What is the efficacy and safety of using esketamine in the treatment of patients with severe depression and suicidal ideation?","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/db/e5/1806-9282-ramb-69-04-e20230694.PMC10185056.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9525672","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}
引用次数: 2
Evaluation of first- and third-trimester afamin levels in preeclampsia. 先兆子痫早期和晚期维生素a水平的评估。
IF 1.4 4区 医学
Revista da Associacao Medica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.20221115
Selim Gülücü, Sebahattin Çelik, Gökhan Unver
{"title":"Evaluation of first- and third-trimester afamin levels in preeclampsia.","authors":"Selim Gülücü,&nbsp;Sebahattin Çelik,&nbsp;Gökhan Unver","doi":"10.1590/1806-9282.20221115","DOIUrl":"https://doi.org/10.1590/1806-9282.20221115","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate serum afamin levels in the first and third trimesters in preeclampsia.</p><p><strong>Methods: </strong>Serum samples from 118 patients in the first and third trimesters were analyzed. Serum samples were collected from pregnant women who had enrolled in the first trimester. Blood was then collected from pregnant women who had developed preeclampsia and from healthy controls in the third trimester. The collected blood samples were resolved for analysis, and serum afamin concentrations were measured in the first and third trimesters. Preeclampsia and healthy controls were compared.</p><p><strong>Results: </strong>There was no significant difference between the control and preeclampsia groups in terms of age, body mass index, and smoking. Afamin levels in the first and third trimesters were higher in the preeclampsia group than in the control group (p<0.05). In the subgroup analysis of the preeclampsia group, afamin levels were higher in the early-onset preeclampsia group than in the late-onset preeclampsia group in the first and third trimesters (p<0.05). In the receiver operating characteristic analysis afamin levels were 96.23 ng/mL in the first trimester and 123.57 ng/mL in the third trimester as cut-off values for preeclampsia.</p><p><strong>Conclusion: </strong>Serum afamin levels are useful for predicting preeclampsia in the first trimester in pregnant women and can be used in clinical practice as a supportive biomarker for the diagnosis of preeclampsia in the third trimester. Meta-analyzes are needed to investigate the effect of afamin levels in the prediction and diagnosis of preeclampsia and to determine the cut-off value.</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/8e/cc/1806-9282-ramb-69-03-0430.PMC10004282.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9529025","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}
引用次数: 0
Criteria for selection and classification of studies in medical events. 医学事件研究的选择和分类标准。
IF 1.4 4区 医学
Revista da Associacao Medica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.20220888
René Aloisio da Costa Vieira, Regis Resende Paulinellli, Fábio Francisco Oliveira Rodrigues, Marise Amaral Rebouças Moreira, Ricardo Caponero, Eduardo Carvalho Pessoa, Rosemar Macedo Sousa Rahal, Gil Facina, Ruffo de Freitas Junior
{"title":"Criteria for selection and classification of studies in medical events.","authors":"René Aloisio da Costa Vieira,&nbsp;Regis Resende Paulinellli,&nbsp;Fábio Francisco Oliveira Rodrigues,&nbsp;Marise Amaral Rebouças Moreira,&nbsp;Ricardo Caponero,&nbsp;Eduardo Carvalho Pessoa,&nbsp;Rosemar Macedo Sousa Rahal,&nbsp;Gil Facina,&nbsp;Ruffo de Freitas Junior","doi":"10.1590/1806-9282.20220888","DOIUrl":"https://doi.org/10.1590/1806-9282.20220888","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate the impact of study methodology and evaluation type on the selection of studies during the presentation of scientific events.</p><p><strong>Methods: </strong>A prospective, observational, transversal approach was applied to a cohort of studies that were submitted for presentation at the 2021 Brazilian Breast Cancer Symposium. Three forms of criteria (CR) were presented. CR1 was based on six criteria (method, ethics, design, originality, promotion, and social contribution); CR2 graded the studies from 0 to 10 for each study, and CR3 was based on five criteria (presentation, method, originality, scientific knowledge, and social contribution). To evaluate the item correlation, Cronbach's alpha and factorial analysis were performed. For the evaluation of differences between the tests, we used the Kruskal-Wallis and post-hoc Dunn tests. To determine the differences in the study classifications, we used the Friedman test and Namenyi's all-pairs comparisons.</p><p><strong>Results: </strong>A total of 122 studies were evaluated. There was also a good correlation with the items concerning criterion 1 (α=0.730) and 3 (α=0.937). Evaluating CR1 methodology, study design and social contribution (p=0.741) represents the main factor and CR3 methodology, and the scientific contribution (p=0.994) represents the main factor. The Kruskal-Wallis test showed differences in the results (p<0.001) for all the criteria that were used [CR1-CR2 (p<0.001), CR1-CR3 (p<0.001), and CR2-CR3 (p=0.004)]. The Friedman test showed differences in the ranking of the studies (p<0.001) for all studies (p<0.01).</p><p><strong>Conclusion: </strong>Methodologies that use multiple criteria show good correlation and should be taken into account when ranking the best studies.</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/0e/be/1806-9282-ramb-69-04-e20220888.PMC10176649.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10399826","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}
引用次数: 1
Comment on "Relationship between the number of comorbidities, quality of life, and cardiac autonomic modulation in patients with coronary disease: a cross-sectional study". 对“冠心病患者合并症数量、生活质量和心脏自主神经调节之间的关系:一项横断面研究”的评论。
IF 1.4 4区 医学
Revista da Associacao Medica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.20221136
Yi-Feng Wang, Yangfen Zhang, Yi Lin, Yi Luo
{"title":"Comment on \"Relationship between the number of comorbidities, quality of life, and cardiac autonomic modulation in patients with coronary disease: a cross-sectional study\".","authors":"Yi-Feng Wang,&nbsp;Yangfen Zhang,&nbsp;Yi Lin,&nbsp;Yi Luo","doi":"10.1590/1806-9282.20221136","DOIUrl":"https://doi.org/10.1590/1806-9282.20221136","url":null,"abstract":"between the number of comorbidities, quality of life","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/42/c2/1806-9282-ramb-69-01-0007.PMC9937596.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10831660","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}
引用次数: 1
Foley catheter plus misoprostol versus misoprostol alone for labor induction. Foley导管加米索前列醇与单用米索前列醇进行引产。
IF 1.4 4区 医学
Revista da Associacao Medica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.20220897
Jhonathan Alcides Elpo, Bruna de Aguiar Araújo, Lia Karina Volpato
{"title":"Foley catheter plus misoprostol versus misoprostol alone for labor induction.","authors":"Jhonathan Alcides Elpo,&nbsp;Bruna de Aguiar Araújo,&nbsp;Lia Karina Volpato","doi":"10.1590/1806-9282.20220897","DOIUrl":"https://doi.org/10.1590/1806-9282.20220897","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyze the effects of Foley catheter combined with misoprostol in the labor induction process.</p><p><strong>Methods: </strong>This is a nonblinded, block randomized, controlled trial that compared the association between transcervical Foley catheter/vaginal misoprostol 25 μg combination and vaginal misoprostol 25 μg alone in normal-risk and healthy pregnant women undergoing labor induction in the south of Brazil.</p><p><strong>Results: </strong>A total of 230 patients with indications for labor induction were evaluated and classified into the \"combined\" group (Foley catheter plus misoprostol), consisting of 107 patients, and the \"misoprostol\" group (misoprostol only), consisting of 123 patients. The \"combined\" group was observed to have a shorter labor induction time (p=0.008). In addition, there was a lower need for misoprostol use for overall cervical ripening (p<0.001) and a lower relative risk of needing a second, third, or fourth misoprostol tablet in the \"combined\" group (risk ratio [RR] 0.80, 95% confidence interval [CI] 0.71-0.91; RR 0.41; 95%CI 0.31-0.56; and RR 0.29, 95%CI 0.17-0.52, respectively) (p<0.001). No statistically significant difference was found in induction failure rate, cesarean section rate, or perinatal outcomes.</p><p><strong>Conclusion: </strong>A combination of methods leads to shorter labor induction, lower need for misoprostol doses, and lower risk of cesarean section, with no increase in the rate of perinatal complications. REBEC number is RBR-7xcjz3z.</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/9c/bc/1806-9282-ramb-69-01-0119.PMC9937608.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10834923","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}
引用次数: 0
Clinical and electrophysiological efficacy of extracorporeal shock-wave therapy in carpal tunnel syndrome: a placebo-controlled, double-blind clinical trial. 体外冲击波治疗腕管综合征的临床和电生理疗效:一项安慰剂对照双盲临床试验。
IF 1.4 4区 医学
Revista da Associacao Medica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.20220943
Ahmet Kivanc Menekseoglu, Merve Damla Korkmaz, Hatice Segmen
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