Sao Paulo Medical Journal最新文献

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Sedentary behavior, abdominal obesity and healthcare costs in Brazilian adults with cardiovascular diseases: a cross-sectional study. 巴西成人心血管疾病患者的久坐行为、腹部肥胖和医疗费用:一项横断面研究
IF 1.4 4区 医学
Sao Paulo Medical Journal Pub Date : 2023-12-04 eCollection Date: 2023-01-01 DOI: 10.1590/1516-3180.2023.0029.140823
Maria Carolina Castanho Saes Norberto, Monique Yndawe Castanho Araujo, Suelen Jane Ricardo, Charles Rodrigues Junior, Juziane Teixeira Guiça, Bruna Camilo Turi-Lynch, Jamile Sanches Codogno
{"title":"Sedentary behavior, abdominal obesity and healthcare costs in Brazilian adults with cardiovascular diseases: a cross-sectional study.","authors":"Maria Carolina Castanho Saes Norberto, Monique Yndawe Castanho Araujo, Suelen Jane Ricardo, Charles Rodrigues Junior, Juziane Teixeira Guiça, Bruna Camilo Turi-Lynch, Jamile Sanches Codogno","doi":"10.1590/1516-3180.2023.0029.140823","DOIUrl":"10.1590/1516-3180.2023.0029.140823","url":null,"abstract":"<p><strong>Background: </strong>Research on the economic burden of sedentary behavior and abdominal obesity on health expenses associated with cardiovascular diseases is scarce.</p><p><strong>Objective: </strong>The objective of this study was to verify whether sedentary behavior, isolated and combined with abdominal obesity, influences the medication expenditure among adults with cardiovascular diseases.</p><p><strong>Design and setting: </strong>This cross-sectional study was conducted in the city of President Prudente, State of São Paulo, Brazil in 2018.</p><p><strong>Methods: </strong>The study included adults with cardiovascular diseases, aged 30-65 years, who were treated by the Brazilian National Health Services. Sedentary behavior was assessed using a questionnaire. Abdominal obesity was defined by waist circumference. Medication expenditures were verified using the medical records of each patient.</p><p><strong>Results: </strong>The study included a total of 307 adults. Individuals classified in the group with risk factor obesity combined (median [IQ] USD$ 29.39 [45.77]) or isolated (median [IQ] USD$ 27.17 [59.76]) to sedentary behavior had higher medication expenditures than those belonging to the non-obese with low sedentary behavior group (median [IQ] USD$ 13.51 [31.42]) (P = 0.01). The group with combined obesity and sedentary behavior was 2.4 (95%CI = 1.00; 5.79) times more likely to be hypertensive.</p><p><strong>Conclusion: </strong>Abdominal obesity was a determining factor for medication expenses, regardless of sedentary behavior, among adults with cardiovascular diseases.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10718638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499970","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
Knowledge and attitudes of rural healthcare providers regarding domestic violence against women: a systematic review. 农村卫生保健提供者关于对妇女的家庭暴力的知识和态度:系统审查。
IF 1.4 4区 医学
Sao Paulo Medical Journal Pub Date : 2023-12-04 eCollection Date: 2023-01-01 DOI: 10.1590/1516-3180.2022.0682.R1.180723
Cláudio Tarso de Jesus Santos Nascimento, Maria Tereza Campos Vidigal, Vinícius Henrique Ferreira Pereira de Oliveira, Raquel Porto Alegre Valente Franco, Walbert Andrade Vieira, Adriana de-Jesus-Soares, Rafael Rodrigues Lima, Ademir Franco, Luiz Renato Paranhos
{"title":"Knowledge and attitudes of rural healthcare providers regarding domestic violence against women: a systematic review.","authors":"Cláudio Tarso de Jesus Santos Nascimento, Maria Tereza Campos Vidigal, Vinícius Henrique Ferreira Pereira de Oliveira, Raquel Porto Alegre Valente Franco, Walbert Andrade Vieira, Adriana de-Jesus-Soares, Rafael Rodrigues Lima, Ademir Franco, Luiz Renato Paranhos","doi":"10.1590/1516-3180.2022.0682.R1.180723","DOIUrl":"10.1590/1516-3180.2022.0682.R1.180723","url":null,"abstract":"<p><strong>Background: </strong>Specific types of violence such as intimate partner sexual violence and intimate partner homicide occur more frequently in rural areas.</p><p><strong>Objective: </strong>This study aimed to systematically review the literature on the knowledge and attitudes of rural healthcare providers regarding cases of domestic violence against women.</p><p><strong>Design and setting: </strong>Systematic review developed at Universidade Federal de Uberlândia.</p><p><strong>Methods: </strong>We conducted an electronic search of six databases, which only included observational studies, regardless of the year, language, or country of publication, except for studies that used secondary data and were exclusively qualitative. Two reviewers performed the selection, data extraction, and risk of bias assessment using a specific Joanna Briggs Institute tool.</p><p><strong>Results: </strong>Six studies met the inclusion criteria. All the studies had a low risk of bias. Approximately 38% of these professionals identified injuries caused by violence in patients. When asked about knowing the correct attitude to take in cases of confirmed violence, between 12% and 64% of rural healthcare providers answered positively; most of them would refer to specialized institutions and promote victim empowerment and counseling. The number of professionals with an educational background in the field ranged from 16% to 98%.</p><p><strong>Conclusions: </strong>The evident disparity across studies shows that some professionals have suboptimal knowledge and require training to adopt the correct attitude when identifying female victims of domestic violence in clinical practice.</p><p><strong>Systematic review registration: </strong>This systematic review was registered in the Open Science Framework Database under the registration http://doi.org/10.17605/OSF.IO/B7Q6S.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10703492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499969","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
Cut-off points of neck and waist circumference as predictors of obstructive sleep apnea in the Colombian population: a comparison with polysomnography. 颈部和腰围截断点作为哥伦比亚人群阻塞性睡眠呼吸暂停的预测指标:与多导睡眠图的比较。
IF 1.4 4区 医学
Sao Paulo Medical Journal Pub Date : 2023-12-04 eCollection Date: 2023-01-01 DOI: 10.1590/1516-3180.2022.0415.R2.310523
Sandra Brigitte Amado Garzon, Oscar Mauricio Muñoz-Velandia, Alvaro J Ruiz, Patricia Hidalgo Martínez, Liliana Otero
{"title":"Cut-off points of neck and waist circumference as predictors of obstructive sleep apnea in the Colombian population: a comparison with polysomnography.","authors":"Sandra Brigitte Amado Garzon, Oscar Mauricio Muñoz-Velandia, Alvaro J Ruiz, Patricia Hidalgo Martínez, Liliana Otero","doi":"10.1590/1516-3180.2022.0415.R2.310523","DOIUrl":"10.1590/1516-3180.2022.0415.R2.310523","url":null,"abstract":"<p><strong>Background: </strong>Neck circumference (NC) is a useful anthropometric measure for predicting obstructive sleep apnea (OSA). Ethnicity and sex also influence obesity phenotypes. NC cut-offs for defining OSA have not been established for the Latin American population.</p><p><strong>Objectives: </strong>To evaluate NC, waist circumference (WC), and body mass index (BMI) as predictors of OSA in the Colombian population and to determine optimal cut-off points.</p><p><strong>Design and setting: </strong>Diagnostic tests were conducted at the Javeriana University, Bogota.</p><p><strong>Methods: </strong>Adults from three cities in Colombia were included. NC, WC, and BMI were measured, and a polysomnogram provided the reference standard. The discrimination capacity and best cut-off points for diagnosing OSA were calculated.</p><p><strong>Results: </strong>964 patients were included (57.7% men; median age, 58 years) and 43.4% had OSA. The discrimination capacity of NC was similar for men and women (area under curve, AUC 0.63 versus 0.66, P = 0.39) but better for women under 60 years old (AUC 0.69 versus 0.57, P < 0.05). WC had better discrimination capacity for women (AUC 0.69 versus 0.57, P < 0.001). There were no significant differences in BMI. Optimal NC cut-off points were 36.5 cm for women (sensitivity [S]: 71.7%, specificity [E]: 55.3%) and 41 cm for men (S: 56%, E: 62%); and for WC, 97 cm for women (S: 65%, E: 69%) and 99 cm for men (S: 53%, E: 58%).</p><p><strong>Conclusions: </strong>NC and WC have moderate discrimination capacities for diagnosing OSA. The cut-off values suggest differences between Latin- and North American as well as Asian populations.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10703493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499968","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
When the fever will not stop, stop the pills! A case report. 发烧停不下来的时候,就停药!一份病例报告。
IF 1.4 4区 医学
Sao Paulo Medical Journal Pub Date : 2023-12-04 eCollection Date: 2023-01-01 DOI: 10.1590/1516-3180.2022.0401.R1.13032023
César Ricardo Coimbra de Matos, Eduarda Maria da Conceição Sério Pereira Beirão, Rafael Simões Neves, António José Assunção, Rui Moreira Marques
{"title":"When the fever will not stop, stop the pills! A case report.","authors":"César Ricardo Coimbra de Matos, Eduarda Maria da Conceição Sério Pereira Beirão, Rafael Simões Neves, António José Assunção, Rui Moreira Marques","doi":"10.1590/1516-3180.2022.0401.R1.13032023","DOIUrl":"10.1590/1516-3180.2022.0401.R1.13032023","url":null,"abstract":"<p><strong>Background: </strong>Neuroleptic malignant syndrome (NMS) is a neurologic emergency potentially fatal. This rare side effect is most commonly associated with first-generation antipsychotics and less frequently with atypical or second-generation antipsychotics. The diagnosis relies on both clinical and laboratory criteria, with other organic and psychiatric conditions being ruled out.</p><p><strong>Case report: </strong>A 39-year-old female patient, who is institutionalized and completely dependent, has a medical history of recurrent urinary infections and colonization by carbapenem-resistant Klebsiella pneumoniae. Her regular medication regimen included sertraline, valproic acid, quetiapine, risperidone, lorazepam, diazepam, haloperidol, baclofen, and fentanyl. The patient began experiencing dyspnea. Upon physical examination, she exhibited hypotension and a diminished vesicular murmur at the right base during pulmonary auscultation. Initially, after hospitalization, she developed high febrile peaks associated with hemodynamic instability, prompting the initiation of antibiotic treatment. Despite this, her fever persisted without an increase in blood inflammatory parameters, and she developed purulent sputum, necessitating antibiotherapy escalation. The seventh day of hospitalization showed no improvement in symptoms, suggesting NNMS as a differential diagnosis. All antipsychotic and sedative drugs, as well as antibiotherapy, were discontinued, after which the patient showed significant clinical improvement.</p><p><strong>Conclusion: </strong>Antipsychotic agents are commonly employed to manage behavioral changes linked to various disorders. However, their severe side effects necessitate a high degree of vigilance, the cessation of all medications, and the implementation of supportive care measures. A prompt and accurate diagnosis of NMS is crucial to alleviating the severe, prolonged morbidity and potential mortality associated with this syndrome.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10703491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499971","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 influence of hemodialysis on intracranial pressure waveform in patients with chronic kidney disease: an observational study. 血液透析对慢性肾病患者颅内压波形的影响:一项观察性研究
IF 1.4 4区 医学
Sao Paulo Medical Journal Pub Date : 2023-11-27 eCollection Date: 2023-01-01 DOI: 10.1590/1516-3180.2023.0068.R1.07072023
Mariana Schechtel Koch, Bianca Drewnowski, Cristiane Rickli, Fábio André Dos Santos, Gilberto Baroni, José Carlos Rebuglio Vellosa
{"title":"The influence of hemodialysis on intracranial pressure waveform in patients with chronic kidney disease: an observational study.","authors":"Mariana Schechtel Koch, Bianca Drewnowski, Cristiane Rickli, Fábio André Dos Santos, Gilberto Baroni, José Carlos Rebuglio Vellosa","doi":"10.1590/1516-3180.2023.0068.R1.07072023","DOIUrl":"10.1590/1516-3180.2023.0068.R1.07072023","url":null,"abstract":"<p><strong>Background: </strong>Among the complications related to chronic kidney disease (CKD), those of a neurological nature stand out, and for a better quality of life for patients, the diagnosis and treatment of these complications is fundamental.</p><p><strong>Objectives: </strong>This study aimed to assess the effect of hemodialysis on intracranial pressure waveform (ICPw) in patients with chronic kidney disease undergoing hemodialysis and those who are not yet undergoing substitutive therapy.</p><p><strong>Design and setting: </strong>An observational study was conducted in two stages at a kidney replacement therapy center in Brazil. The first was a longitudinal study and the second was a cross-sectional study.</p><p><strong>Methods: </strong>Forty-two patients on hemodialysis were included in the first stage of the study. In the second stage, 226 participants were included. Of these, 186 were individuals with chronic kidney disease (who were not undergoing substitutive therapy), and 40 did not have the disease (control group). The participants' intracranial compliance was assessed using the non-invasive Brain4care method, and the results were compared between the groups.</p><p><strong>Results: </strong>There was a significant difference between the hemodialysis and non-hemodialysis groups, with the former having better ICPw conditions.</p><p><strong>Conclusions: </strong>Hemodialysis influenced the improvement in ICPw, probably due to the decrease in the patients' extra-and intracellular volumes. Furthermore, ICPw monitoring can be a new parameter to consider when defining the moment to start substitutive therapy.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10681329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452942","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
Improving breastfeeding among adolescent mothers: a prospective cohort. 改善青少年母亲的母乳喂养:一个前瞻性队列。
IF 1.4 4区 医学
Sao Paulo Medical Journal Pub Date : 2023-11-20 eCollection Date: 2023-01-01 DOI: 10.1590/1516-3180.2022.0647.R1.260723
Maira Pinho-Pompeu, Renan Massao Nakamura, Erika Zambrano, Fernanda Garanhani Surita
{"title":"Improving breastfeeding among adolescent mothers: a prospective cohort.","authors":"Maira Pinho-Pompeu, Renan Massao Nakamura, Erika Zambrano, Fernanda Garanhani Surita","doi":"10.1590/1516-3180.2022.0647.R1.260723","DOIUrl":"10.1590/1516-3180.2022.0647.R1.260723","url":null,"abstract":"<p><strong>Background: </strong>Exclusive breastfeeding is recommended for the first six months, and mother's age impact early weaning. Educational support and relevant information can increase breastfeeding rates.</p><p><strong>Objective: </strong>To determine whether antenatal education enhances the maintenance, intention, and confidence in breastfeeding among adolescents.</p><p><strong>Design and setting: </strong>A prospective cohort study involving primiparous adolescents who gave birth at the Woman's Hospital (CAISM), Universidade Estadual de Campinas, Brazil.</p><p><strong>Methods: </strong>Adolescent mothers were categorized into two groups based on the location of prenatal care: those at the Woman's Hospital (WH) who received antenatal education, and at the Primary Care (PC) who did not receive antenatal education. All adolescents received breastfeeding orientation during their postpartum hospital stay. The groups were compared using the Student's t-test, Mann-Whitney U test, and chi-squared test. Log-binomial models were used to compare the groups at different time intervals.</p><p><strong>Results: </strong>The study included 132 adolescents: 59 in the WH group and 73 in the PC group. Six months postpartum, adolescents in the WH group demonstrated higher engagement in breastfeeding (P < 0.005) and exclusive breastfeeding (P = 0.04) than PC group. PC group showed greater lack of confidence in breastfeeding (P = 0.02) and felt less prepared (P = 0.01). Notably, all WH adolescents reported a stronger desire to breastfeed after antenatal education.</p><p><strong>Conclusion: </strong>Antenatal education significantly improves the maintenance, intention, and confidence of breastfeeding among adolescents. This education approach can be implemented across all healthcare levels and should be made accessible to all women throughout the pregnancy and postpartum period.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10665004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138292248","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
Cognitive abilities and medical students' practice of physical exams: A quasi-experimental study. 认知能力与医学生体检实践:一项准实验研究
IF 1.4 4区 医学
Sao Paulo Medical Journal Pub Date : 2023-11-20 eCollection Date: 2023-01-01 DOI: 10.1590/1516-3180.2022.0564.R1.10042023
Lucas Moura Yamamoto, Matheus Landi Pavin, Giordano Bruno Duarte de Souza, Julio Lamartine Hayne Bastos de Oliveira, Raphael Raniere de Oliveira Costa, Adriano Yacubian Fernandes, Alessandra Mazzo
{"title":"Cognitive abilities and medical students' practice of physical exams: A quasi-experimental study.","authors":"Lucas Moura Yamamoto, Matheus Landi Pavin, Giordano Bruno Duarte de Souza, Julio Lamartine Hayne Bastos de Oliveira, Raphael Raniere de Oliveira Costa, Adriano Yacubian Fernandes, Alessandra Mazzo","doi":"10.1590/1516-3180.2022.0564.R1.10042023","DOIUrl":"10.1590/1516-3180.2022.0564.R1.10042023","url":null,"abstract":"<p><strong>Background: </strong>To highlight the importance of clinical simulations and simulated laboratories for student training, especially in physical examination teaching.</p><p><strong>Objective: </strong>To evaluate the gains obtained by medical students in their cognitive and practical performance of physical examinations (abdominal, cardiological, and pulmonary), as well as satisfaction and self-confidence in what they have learned, after concentrated practice developed in a skills and simulation laboratory.</p><p><strong>Design and setting: </strong>A quantitative and quasi-experimental study in which 48 students were evaluated at the Faculdade de Odontologia de Bauru, São Paulo, Brazil.</p><p><strong>Methods: </strong>A quantitative and descriptive study was conducted with regularly enrolled 2nd year medical students over 18 years of age who had content prior to data collection regarding anamnesis and physical examination remotely taught in a Moodle virtual learning environment. For data collection, the participants were subjected to a concentrated period of skill training (abdominal, cardiological, and pulmonary). Every day after the skill training session, they were subjected to a practical evaluation and completed a theoretical test before and after the practical activities. At the end of all activities, they answered the instrument to assess the simulated practices (self-confidence and satisfaction).</p><p><strong>Results: </strong>Among the 49 students evaluated, positive and significant theoretical and practical gains were identified in all three components (abdominal, cardiological, and pulmonary) (P = 0.000), as well as in the general evaluation (Theoretical 1 and Theoretical 2) (P = 0.000), satisfaction, and self-confidence (P = 0.000).</p><p><strong>Conclusion: </strong>Concentrated laboratory practice resulted in positive improvements in students' physical examination skills.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10665003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138292249","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
Robotic surgery training. 机器人手术培训。
IF 1.4 4区 医学
Sao Paulo Medical Journal Pub Date : 2023-10-30 DOI: 10.1590/1516-3180.2022.1415310823
Pedro Henrique Xavier Nabuco de Araujo, Paulo Manuel Pêgo-Fernandes
{"title":"Robotic surgery training.","authors":"Pedro Henrique Xavier Nabuco de Araujo,&nbsp;Paulo Manuel Pêgo-Fernandes","doi":"10.1590/1516-3180.2022.1415310823","DOIUrl":"https://doi.org/10.1590/1516-3180.2022.1415310823","url":null,"abstract":"Robot-assisted surgery emerged in the 2000s and has grown almost exponentially in the last decade. The use of robotic-assisted surgery has increased 10–40-fold more than that of laparoscopic surgery for general routine procedures. 1 The continuous improvement of robotic platforms has allowed surgeons to overcome the limitations of conventional laparoscopy, such as 2D visualization and long instruments that do not accurately reproduce human wrist movements. Robotic systems provide high-definition 3D visualization, giving control of the camera to the surgeon. Robotic platforms have surgical instruments with intracavitary joints that reduce tremors, reproducing the movements of the surgeon on the console with great accuracy. Combined with these technical advantages, the clinical results consistently demonstrated in scientific articles seem to corroborate the great growth of robotic surgery in several specialties. 2 The increasing use of robotic systems has raised concerns about the safety of patients operated on by surgeons on a learning curve. This demand resulted in a standardized curriculum for training new surgeons. A few years ago, robotic training was controlled and certified by Intuitive, the company that manufactured the only robotic platforms then available in Brazil. The significantly increased demand for robotic surgery led the Brazilian Medical Association (AMB), the Specialty Societies, and the Federal Council of Medicine (CFM) to regulate robotic surgery in Brazil, establishing a structured training curriculum 3,4 consisting of a basic and an advanced stage. The basic or pre-clinical stage includes acquiring theoretical knowledge about robotic equipment and how the robot works, online training on the fundamentals of robotic surgery, watching videos and attending some robotic surgeries in person, training on a robotic simulator, and training on the robot console simulating real surgery movements and procedures (in-service training","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10619944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428373","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
Correlation analysis of cardiopulmonary exercise test indices and conditions of overweight patients with obstructive sleep apnea: a retrospective study. 阻塞性睡眠呼吸暂停超重患者心肺运动测试指标与病情的相关性分析:一项回顾性研究。
IF 1.4 4区 医学
Sao Paulo Medical Journal Pub Date : 2023-10-13 eCollection Date: 2023-01-01 DOI: 10.1590/1516-3180.2022.0264.R2.010623
Ying Huang, Chunyan Ruan, Peng Wu, Qian Cai, Yu Chen, Changcai Xie, Jianying Lang, Jiqiang Li, Hai Chen
{"title":"Correlation analysis of cardiopulmonary exercise test indices and conditions of overweight patients with obstructive sleep apnea: a retrospective study.","authors":"Ying Huang,&nbsp;Chunyan Ruan,&nbsp;Peng Wu,&nbsp;Qian Cai,&nbsp;Yu Chen,&nbsp;Changcai Xie,&nbsp;Jianying Lang,&nbsp;Jiqiang Li,&nbsp;Hai Chen","doi":"10.1590/1516-3180.2022.0264.R2.010623","DOIUrl":"10.1590/1516-3180.2022.0264.R2.010623","url":null,"abstract":"<p><strong>Background: </strong>The cardiopulmonary function of patients with obstructive sleep apnea (OSA) is significantly lower than that of patients with simple snoring and is significantly related to the severity of OSA. Currently, only a few studies have been conducted on cardiopulmonary exercise testing in overweight patients with OSA.</p><p><strong>Objective: </strong>To analyze the correlation between cardiopulmonary exercise test (CPET) indices and the condition of overweight patients with OSA.</p><p><strong>Design and setting: </strong>Retrospective study in Guangdong Provincial Hospital of Chinese Medicine.</p><p><strong>Methods: </strong>This study included 73 hospitalized overweight patients. The patients were divided into no, mild, moderate, and severe OSA groups. Differences in the CPET indices among the four groups were compared. The correlation between the CPET indices and conditions was analyzed.</p><p><strong>Results: </strong>No, mild, moderate, and severe OSA groups had 18 men and 5 women, 11 men and 3 women, 12 men and 2 women, and 21 men and 1 woman, respectively (P > 0.05). No significant difference was observed in resting pulmonary function among the four groups (P > 0.05). In the CPET, the anaerobic threshold, maximum oxygen uptake, and oxygen pulse were significantly lower in the severe OSA group than those in the normal OSA group (P < 0.05). Moreover, CPET indices negatively correlated with the apnea-hypopnea index.</p><p><strong>Conclusion: </strong>Changes in CPET indices occurred earlier than changes in resting pulmonary function in patients with OSA. CPET might be a potential method for evaluating the severity of OSA combined with overweight status.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684217","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
Validation and calibration of the Food Consumption Frequency Questionnaire for pregnant women. 孕妇食品消费频率问卷的验证和校准。
IF 1.4 4区 医学
Sao Paulo Medical Journal Pub Date : 2023-10-09 eCollection Date: 2023-01-01 DOI: 10.1590/1516-3180.2023.0059.R2.190523
Sheila Monteiro Brito, Jerusa da Mota Santana, Marcos Pereira, Djanilson Barbosa Santos, Ana Marlucia Oliveira
{"title":"Validation and calibration of the Food Consumption Frequency Questionnaire for pregnant women.","authors":"Sheila Monteiro Brito,&nbsp;Jerusa da Mota Santana,&nbsp;Marcos Pereira,&nbsp;Djanilson Barbosa Santos,&nbsp;Ana Marlucia Oliveira","doi":"10.1590/1516-3180.2023.0059.R2.190523","DOIUrl":"10.1590/1516-3180.2023.0059.R2.190523","url":null,"abstract":"<p><strong>Background: </strong>Few food frequency questionnaires (FFQ) have been validated for pregnant women, particularly those in small- and medium-sized cities in different regions of Brazil.</p><p><strong>Objectives: </strong>To validate and calibrate a semiquantitative FFQ for pregnant women.</p><p><strong>Design and setting: </strong>The study was validated with a sample of 50 pregnant women (≥ 18 years) enrolled in Brazilian prenatal services.</p><p><strong>Methods: </strong>An FFQ and a 24-hour recall were used to evaluate dietary intake. Dietary variables were tested for normality and log-converted when asymmetrical. Pearson's Correlation Coefficient was used to validate the questionnaire. Linear regression was applied to extract calibration factors. All variables underlying the consumption analysis were adjusted for energy.</p><p><strong>Results: </strong>The mean age of the pregnant women was 26 years ± 6.2 years; 58% were in their first trimester, and 30% were identified as overweight/obese. The Pearson correlation analysis results indicated that the FFQ overestimated energy and nutrient intake, whose coefficients ranged from -0.15 (monounsaturated fat) to 0.50 (carbohydrate). Adjusting for energy reduced the mean values of intake coefficients, which now ranged from -0.33 (sodium) to 0.96 (folate). The calibration analysis results indicated variation in the coefficients from -0.23 (sodium) to 1.00 (folate). Calibration produced satisfactory coefficients for the FFQ compared with the reference standard for energy, macronutrients, monounsaturated fat, cholesterol, vitamins B12/C, folate, sodium, iron, and calcium.</p><p><strong>Conclusions: </strong>After validating and calibrating tests, we observed that the FFQ was adequately accurate for assessing the food consumption of the pregnant women in this study.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10564392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41217836","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
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