Einstein-Sao Paulo最新文献

{"title":"Phacoviscocanalostomy versus phacotrabeculectomy to treat glaucoma associated with cataracts: a meta-analysis.","authors":"Dillan Cunha Amaral, Mário Luiz Ribeiro Monteiro, Denisse J Mora-Paez, Ana Luiza Machado Ribeiro Pimentel, Matheus Mizerani Fernandes de Almeida, Jacqueline L Chen, Raíza Jacometti, Milton Ruiz Alves, Jaime Guedes, Ricardo Noguera Louzada","doi":"10.31744/einstein_journal/2025RW1045","DOIUrl":"https://doi.org/10.31744/einstein_journal/2025RW1045","url":null,"abstract":"<p><strong>Objective: </strong>To compare the effectiveness and safety of phacoviscocanalostomy and phacotrabeculectomy in treating combined glaucoma and cataracts.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following the PRISMA guidelines. The PubMed, Web of Science, Cochrane, and Embase databases were searched for randomized controlled trials or observational studies comparing phacotrabeculectomy to phacoviscocanalostomy in patients with glaucoma and cataracts. Statistical analysis was used to compare the efficacy (intraocular pressure reduction, mean deviation of the visual field, and failure rates) and safety (general complication rate and rates of hyphema, hypotony, perforation, and intraocular pressure spikes) between the two procedures.</p><p><strong>Results: </strong>The study included 331 eyes from one randomized controlled trial and two non-randomized controlled trials, with 154 undergoing phacoviscocanalostomy and 177 undergoing phacotrabeculectomy. The results indicated no significant differences in surgical failure rates, mean deviation of the visual field, and intraocular pressure at one, three, six, and twelve months between the phacoviscocanalostomy and phacotrabeculectomy groups. Furthermore, although the overall complication rate between the two procedures showed no difference, the rate of intraocular pressure spikes was higher in patients who underwent phacoviscocanalostomy.</p><p><strong>Conclusion: </strong>Phacotrabeculectomy and phacoviscocanalostomy are effective treatments for glaucoma and cataracts.Prospero database registration: (www.crd.york.ac.uk/prospero) under ID CRD42024502391.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eRW1045"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is self-perception of cardiac symptoms related to the psychological profile of patients? A cross-sectional study of individuals undergoing 24-hour Holter monitoring.","authors":"Renata Lima Giolo, Guilherme Fenelon, Marcelo Franken, Marcelo Katz","doi":"10.31744/einstein_journal/2025AO0742","DOIUrl":"https://doi.org/10.31744/einstein_journal/2025AO0742","url":null,"abstract":"<p><strong>Background: </strong>Depression, anxiety, distress and Type D personality traits have been implicated in the pathogenesis of cardiovascular diseases. Mental health status is associated with arrhythmic events. Esler and Lampert reported that anxiety and distress contribute to the occurrence of atrial and ventricular arrhythmias. ■ Self-reported cardiac symptoms not associated with arrhythmias. ■ High prevalence of anxiety and depression symptoms. ■ Anxiety was correlated with self-reported cardiac symptoms.</p><p><strong>Objective: </strong>This study aimed to examine the presence of psychological characteristics and their association with self-reported cardiac symptoms in individuals undergoing 24-hour Holter monitoring.</p><p><strong>Methods: </strong>This observational cross-sectional study included 304 individuals who consecutively underwent 24-hour Holter monitoring. Clinical, demographic, and electrocardiographic data were collected. Psycho-behavioral characteristics were assessed using the Hospital Anxiety and Depression Scale and the Type D Scale. Logistic regression models were employed to examine associations between cardiac symptoms and anxiety, depression, distress, and Type D personality traits. Statistical significance was set at p<0.05.</p><p><strong>Results: </strong>Anxiety, depression, distress, and type D personality traits were observed in 42.7%, 15.1%, 26.3%, and 19% of the participants, respectively. Logistic regression analysis revealed a significant association between the perception of cardiac symptoms and both mild anxiety (odds ratio (OR) = 2.305, 95%CI= 1.098-4.841, p=0.027) and severe anxiety (OR = 9.245, 95%CI= 1.582-54.013, p=0.014) scores. No significant association was found between depression, distress, or Type D personality traits and an increased perception of cardiac symptoms.</p><p><strong>Conclusion: </strong>A high prevalence of anxiety was observed among individuals undergoing 24-hour Holter recording. Anxiety was significantly associated with self-reported cardiac symptoms, though not with the presence of arrhythmias. The findings could have practical implications for clinical practice. The study suggests that patients reporting anxious palpitations should receive a more thorough cardiological assessment, with 24-hour Holter monitoring serving as an effective tool for this evaluation.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eAO0742"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How the COVID-19 pandemic affected routine child vaccination: an integrative review.","authors":"Julia Stoeterau Moré, Daniel Rodrigo Serbena, Luiz Gustavo Gusson de Camargo, Pedro Augusto Clemente, Fernando Sluchensci Dos Santos, Juliana Sartori Bonini","doi":"10.31744/einstein_journal/2025RW1119","DOIUrl":"https://doi.org/10.31744/einstein_journal/2025RW1119","url":null,"abstract":"<p><strong>Background: </strong>Child immunization plays a critical role in preventing numerous diseases. However, the COVID-19) pandemic has profoundly disrupted healthcare systems globally, including routine child vaccination programs.</p><p><strong>Objective: </strong>To provide an overview of the reduction in vaccine coverage among infants and children during the pandemic and analyze the potential impacts of decreased child immunization during this period.</p><p><strong>Methods: </strong>A comprehensive search was conducted using the MeSH terms \"Child,\" \"Vaccination\", and \"COVID-19,\" along with their synonyms. Systematic reviews published between March 11, 2020, and June 1, 2023, in Portuguese or English were included. Databases searched included PubMed, BVS (Biblioteca Virtual em Saúde), Embase, and Scopus. Two blinded independent reviewers performed the selection process, with conflicts resolved by a third reviewer. The AMSTAR-II tool was used to assess the methodological quality of the included studies.</p><p><strong>Results: </strong>Of the 1,534 eligible articles, only 13 addressed the pandemic's impact on children's vaccination coverage. Most studies involved multiple countries and reported a significant decrease in children's vaccination coverage due to the COVID-19 pandemic.</p><p><strong>Conclusion: </strong>The findings were heterogeneous but consistently highlighted the substantial impact of the COVID-19 pandemic on routine vaccination coverage in most countries. Further research is needed to explore the epidemiological consequences of disruptions to vaccination schedules, potentially guiding public policies and raising awareness about the importance of adhering to health protection programs.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eRW1119"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of mortality due to severe SARS-CoV-2 infection in public and private intensive care units in Brazil: a multicenter retrospective cohort study.","authors":"Thiago Domingos Corrêa, Thais Dias Midega, Ricardo Kenji Nawa, Ricardo Luiz Cordioli, Adriano José Pereira, Moacyr Silva Júnior, Bruno de Arruda Bravim, Niklas Soderberg Campos, Amanda Pascoal Valle Felicio, Angelo Antônio Gomes de Carvalho, Andreia Pardini, Raquel Afonso Caserta Eid, Rodrigo Dias Rodrigues, Marcele Liliane Pesavento, Leonardo Van de Wiel Barros Urbano Andari, Bento Fortunato Cardoso Dos Santos, Claudia Regina Laselva, Felipe Maia de Toledo Piza, Miguel Cendoroglo Neto, Guilherme de Paula Pinto Schettino, Sidney Klajner, Leonardo José Rolim Ferraz","doi":"10.31744/einstein_journal/2025AO1060","DOIUrl":"https://doi.org/10.31744/einstein_journal/2025AO1060","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This retrospective multicenter cohort study compared characteristics and outcomes of 5,790 critically ill patients with COVID-19 in Brazil's public and private intensive care units. Patients in public intensive care units exhibited greater disease severity, more frequent use of organ support, and higher mortality rates compared to those in private intensive care units. The risk of in-hospital death was more than twice as high in public intensive care units. ■ Public intensive care unit COVID-19 patients presented with more comorbidities and higher severity at admission. ■ Public intensive care units required more invasive organ support (e.g., mechanical ventilation, vasopressors, and renal replacement therapy) but less non-invasive ventilation and high-flow nasal cannula than private intensive care units. ■ In-hospital mortality was higher in public intensive care units, with an increased risk of death even after adjusting for patient characteristics and illness severity at intensive care unit admission.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare the clinical characteristics, use of organ support, and outcomes of critically ill patients with COVID-19 admitted to public and private intensive care units.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This multicenter retrospective cohort study included patients admitted to four intensive care units from March 1, 2020, to December 31, 2021. Patients with COVID-19 admitted to public and private intensive care units were compared. The primary outcome of interest, in-hospital mortality, was assessed using a hierarchical logistic regression (multilevel) model adjusted for study site and patient characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 5,790 patients with COVID-19 were admitted to the participating intensive care units, with 3,321 (57.3%) admitted to private hospitals and 2,469 (42.6%) admitted to public hospitals. Patients in public intensive care units were less likely to be male and had higher median SAPS III scores, Charlson Comorbidity Index values, and SOFA scores. They also required mechanical ventilation (53.1% versus 40.0%, p&lt;0.001), vasopressors (43.1% versus 33.9%, p&lt;0.001), and renal replacement therapy (20.3% versus. 14.5%, p&lt;0.001) more frequently than those in private intensive care units. In contrast, patients in private intensive care units were more frequently managed with non-invasive ventilation (38.0% versus 66.8%; p&lt;0.001) and high-flow nasal cannulas (18.3% versus 48.1%; p&lt;0.001). The in-hospital mortality rate was significantly higher in public intensive care units (40.3%) compared to private intensive care units (16.4%) (adjusted OR=2.96; 95%CI=1.94-4.51; p&lt;0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;We observed significant differences in resource utilization and mortality rates between patients with COVID-19 admitted to public and private intensive care units. Patients with COVID-19 in public care units face a higher risk of in-hospital morta","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 spe1","pages":"eAO1060"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are changes in physical activity associated with depression? A follow-up study of 1,950 individuals.","authors":"Luana de Lima Queiroga, Oskar Grau Kaufmann, Raphael Mendes Ritti-Dias, Carlos André Minanni, Rafael Mathias Pitta, Nelson Wolosker","doi":"10.31744/einstein_journal/2025AO1128","DOIUrl":"https://doi.org/10.31744/einstein_journal/2025AO1128","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the association between changes in physical activity and depression among 1,950 Brazilians. Individuals who increased their physical activity and those who decreased it were not associated with reduced depression. Conversely, being consistently active was identified as an independent and significant protective factor against depression in this population. ■ Persistently active individuals have strong independent protective factors against depression. ■ BMI (kg/m) is an independent risk factor for depression. ■ Individuals with depression at follow-up were older than those without depression. ■ Perceived stress is a strong independent risk factor for depression.</p><p><strong>Objective: </strong>To evaluate the association between changes in physical activity and depression in 1,950 Brazilians.</p><p><strong>Methods: </strong>This follow-up study included 1,950 Brazilians, aged ≥18 years, of both sexes, who participated in a health screening initiative between 2008 and 2022. Physical activity levels were evaluated using the International Physical Activity Questionnaire at baseline and follow-up, and groups related to changes in physical activity were created. Depression was assessed using the Beck Depression Inventory. Clinical data and behavioral profiles were also analyzed. Comparative and logistic regression models were used.</p><p><strong>Results: </strong>The multivariate analysis demonstrated that persistently active individuals had reduced depression (odds ratio [OR], 0.70, 95%CI= 0.55-0.91, p=0.006). Individuals who became active and those who became less active were not associated with a reduction in depression (respectively, OR= 0.81, 95%CI= 0.63-1.05, p=0.109 and OR= 1.11, 95%CI= 0.82-1.51, p=0.481).</p><p><strong>Conclusion: </strong>Persistent activity was an independent, strong protective factor against depression in 1,950 Brazilians. Furthermore, becoming active or less active was not associated with depression in the same population.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eAO1128"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of 3'-sialyllactose, saliva, and colostrum on Candida albicans biofilms.","authors":"Juliana Barbosa Faria, Marcela Beraldo Santiago, Paula Hueb Menezes de Oliveira, Vinicius Rangel Geraldo-Martins, Ruchele Dias Nogueira","doi":"10.31744/einstein_journal/2025AO0663","DOIUrl":"https://doi.org/10.31744/einstein_journal/2025AO0663","url":null,"abstract":"<p><strong>Background: </strong>Faria et al. evaluated the initial adhesion and biofilm formation of Candida albicans in vitro in the presence of saliva, human colostrum, and 3'-sialyllactose. Colostrum applied either before or after inoculation with saliva did not differ from that of the control biofilms (p<0.05). In contrast, colostrum applied during C. albicans inoculation resulted in a higher biomass than the control (p<0.05). Saliva without colostrum decreased the biofilm biomass (p<0.05), and the application of 3'- sialyllactose reduced biofilm formation regardless of the timing of application (p<0.05). Candidiasis can present as localized or systemic infections. Disseminated infections in newborns and adults can be life-threatening, with high mortality and morbidity rates (40-60%), and rank as the fourth most common type of nosocomial infection. Oral candidiasis is a local condition affecting 10-15% of children in their first months of life. Saliva and 3'-sialyllactose can disrupt the initial development of Candida albicans biofilm. The effect of colostrum needs to be elucidated because it may hinder initial adhesion but promote fungal proliferation after application.</p><p><strong>Objective: </strong>The aim of this study was to investigate the effects of saliva, human colostrum, and 3'-sialyllactose on the initial adhesion and biofilm formation of Candida albicans in vitro.</p><p><strong>Methods: </strong>Colostrum and saliva samples were collected from 30 postpartum mothers and newborns, respectively. An 18h culture of C. albicans was treated with colostrum, 3'-sialyllactose, saliva, or a combination of colostrum and saliva at three different time points: before, during, and 24h after C. albicans inoculation. Biofilm assays were conducted in sterile 96-well flat-bottom microtiter plates for 24h. Biofilms were fixed, washed, stained with crystal violet, and extracted. Absorbance was measured to evaluate biofilm biomass.</p><p><strong>Results: </strong>The combined application of colostrum and saliva before and after microbial inoculation did not differ from the control biofilms (p<0.05). In contrast, the combined application of colostrum and saliva during C. albicans application resulted in a higher biomass than the control (p<0.05). Saliva alone decreased the biofilm biomass (p<0.05), and the application of 3'-sialyllactose reduced biofilm formation regardless of the timing of application (p<0.05).</p><p><strong>Conclusion: </strong>Saliva contributed to the proliferation of biofilms, while colostrum did not prevent initial adhesion but influenced biofilm accumulation and development. In contrast, 3'-sialyllactose significantly decreased biofilm formation at all application times. These findings underscore the importance of colostrum as a potent oral antimicrobial biofluid.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eAO0663"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silicone gel migration masquerading as metastatic breast cancer.","authors":"Felipe Magaldi de Carvalho, Leandro Jonata Carvalho Oliveira, Carlos Shimizu, Felipe de Galiza Barbosa, Leonardo de Abreu Testagrossa, Max Senna Mano","doi":"10.31744/einstein_journal/2025AI1493","DOIUrl":"https://doi.org/10.31744/einstein_journal/2025AI1493","url":null,"abstract":"","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eAI1493"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spiritual care in the intensive care unit. Is it already a reality?: an integrative review.","authors":"Alessandre Carvalho Junior, Adriane Maria Netto de Oliveira, Camila Daiane Silva, Diéssica Roggia Piexak","doi":"10.31744/einstein_journal/2025RW1081","DOIUrl":"https://doi.org/10.31744/einstein_journal/2025RW1081","url":null,"abstract":"<p><strong>Introduction: </strong>Spirituality has emerged as a phenomenon of interest in various global contexts. The adoption of spirituality as a fundamental aspect of healthcare remains underexplored, especially in critical environments such as intensive care units.</p><p><strong>Objective: </strong>To identify strategies for incorporating spiritual care into adult intensive care environments through an integrative literature review.</p><p><strong>Methods: </strong>An integrative review was conducted using the Embase, Web of Science, Medline/PubMed, PsycINFO, LILACS, and Cochrane Central databases. Twenty-one studies published in English, Spanish, or Portuguese over the last 10 years were selected.</p><p><strong>Results: </strong>Different approaches to spirituality were identified, including training implementation, individual interviews, meetings, educational programs, and practices involving healthcare professionals.</p><p><strong>Conclusion: </strong>Spirituality in the intensive care environment has been a growing reality in recent years through efforts aimed at helping healthcare professionals integrate spirituality into the care provided in clinical practice. Individual interviews were the primary strategy for incorporating spiritual care in intensive care unit settings. Questionnaires were used to support these interviews, and the frequency and duration typically involved a single session, ranging from 15 to 60 min.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 spe1","pages":"eRW1081"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology with real-world data: deep endometriosis in women of reproductive age.","authors":"Nilson Abrão Szylit, Luciana Cristina Pasquini Raiza, Anucha Andrade Schindler Leal, Sérgio Podgaec","doi":"10.31744/einstein_journal/2025AO1259","DOIUrl":"https://doi.org/10.31744/einstein_journal/2025AO1259","url":null,"abstract":"<p><strong>Background: </strong>Szylit et al. conducted a descriptive prevalence study combined with a cross-sectional observational study in a public primary care clinic. Using real-world data, they determined the prevalence of endometriosis in women selected without prior screening for the condition, employing pelvic and transvaginal ultrasound. This study represents the first of its kind in Latin America. This study represents the first investigation into the prevalence of deep endometriosis within outpatient services. Utilizing real-world data, this study explores the prevalence of endometriosis. The prevalence of endometriosis among women of reproductive age is 6.4% (based on real-world data). The prevalence of endometriosis in women experiencing pelvic pain is 34.2%. Infertility is 6.5 times more common in women diagnosed with endometriosis. The presence of palpable posterior cul-de-sac nodules or a retroverted uterus suggests endometriosis.</p><p><strong>Objective: </strong>Endometriosis is characterized by the presence of glandular tissue or endometrial stroma outside the uterus. This study aimed to determine the prevalence of symptomatic deep endometriosis and the clinical factors associated with this condition in women of reproductive age.</p><p><strong>Methods: </strong>A descriptive prevalence study combined with a cross-sectional observational study was conducted between 2017 and 2021 at a public primary care outpatient clinic in Brazil. Women of reproductive age with at least one of the following symptoms were included in the study: deep dyspareunia, dysmenorrhea, chronic pelvic pain, intestinal or urinary symptoms during the menstrual cycle, or infertility. A sample size calculation indicated that an estimated sample of 269 patients was required for the study. Qualitative variables are described as absolute and relative frequencies, while quantitative variables are expressed as medians and quartiles. Factors associated with endometriosis were analyzed using logistic regression and multiple models.</p><p><strong>Results: </strong>Data from 1,445 patients were considered. Among these, 92 were diagnosed with deep endometriosis, resulting in a prevalence of 6.4% (95%CI= 5.2-7.7) and 34.2% among women with pelvic pain (95%CI= 28.8-40.1). Women with palpable posterior cul-de-sac nodules (0R= 3.58, 95%CI= 1.68-7.63, p = 0.001) or a retroverted uterus (0R= 2.36, 95%CI= 1.28-4.37, p = 0.006) were more likely to have endometriosis.</p><p><strong>Conclusion: </strong>Using real-world data, the prevalence of deep endometriosis was found to be 6.4% in women of reproductive age and 34.2% in those with pelvic pain. The primary clinical variables associated with endometriosis are palpable posterior cul-de-sac nodules and a retroverted uterus.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eAO1259"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nodular vulvar lesions and its key differential diagnoses: a case report.","authors":"Juliana Jorge Romano, Fernanda Kesselring Tso, Yasmin Cristina Cesquim Noronha, Julizia Foloni May, Mariano Tamura Vieira Gomes, Sérgio Podgaec, Patricia Napoli Belfort-Mattos","doi":"10.31744/einstein_journal/2025RC0362","DOIUrl":"10.31744/einstein_journal/2025RC0362","url":null,"abstract":"<p><p>The etiologies of vulvar nodules range from infectious to neoplastic. Owing to the wide spectrum of vulvar diseases, clinical differentiation of the lesions is crucial for adequate diagnosis and management. A 46-year-old patient presented with a nodular lesion in the vulvar region that had been growing slowly for 10 years. Gynecological examination revealed the presence of a solid nodular lesion measuring approximately 3 cm in the middle third of the right labia majora without phlogistic signs or secretion discharge. The lesion was excised and an anatomopathological study revealed a nodular hidradenoma. Nodular hidradenoma is a rare benign neoplasm of the apocrine glands that mainly affects women between 30 and 60 years of age. Although generally asymptomatic, some symptoms have been described, such as itching, pain, ulceration, or secretory discharge. The diagnosis was made by an anatomopathological study, and treatment consisted of total excision of the lesion without the need to enlarge the margin. During the investigation, malignant lesions such as liposarcoma of the vulvar region and non-melanoma skin cancers were excluded. Differential diagnosis is important because it requires a more invasive approach and surgical margins. This report aimed to expand the knowledge of the diagnosis of vulvar hidradenoma to exclude the possibility of malignant neoplasia while caring for vulvar nodules, thereby allowing proper management of the case.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eRC0362"},"PeriodicalIF":1.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}