Sao Paulo Medical Journal最新文献

{"title":"The effect of methadone and ketamine on quality of recovery in patients undergoing laparoscopic cholecystectomy: a prospective cohort study.","authors":"Leopoldo Muniz da Silva, Ana Clara Mourão Barreto, Rafael Souza Fava Nersessian, Saullo Queiroz Silveira, Helidea de Oliveira Lima, Matheus de Alencar Arraes, Gabriel Silva Dos Anjos, Sérgio Martins Pereira","doi":"10.1590/1516-3180.2024.0193.R2.18062025","DOIUrl":"10.1590/1516-3180.2024.0193.R2.18062025","url":null,"abstract":"<p><strong>Background and objectives: </strong>Acute pain following laparoscopic cholecystectomy is most intense in the first 24 h. The use of shorter-acting opioids for pain management may contribute to increased postoperative morbidity. The combination of methadone and ketamine has been associated with lower postoperative pain scores and less opioid use. We aimed to determine whether the combination of ketamine and methadone improves the quality of recovery.</p><p><strong>Methods: </strong>This prospective cohort study included patients undergoing laparoscopic cholecystectomy. Patients who received either methadone alone or a combination of methadone and ketamine (0.3 mg/kg) were followed up for 24 h after surgery. The primary outcome was the quality of recovery, measured using the quality of recovery-40 (QoR-40) questionnaire. Secondary outcomes included postoperative pain intensity, opioid consumption, and the incidence of nausea and vomiting.</p><p><strong>Results: </strong>The QoR-40 scores were higher in patients who received methadone and ketamine than in those who received methadone alone [197 (194.7-198) versus 195 (189-197), P = 0.01]. Postoperative pain scores, the incidence of postoperative nausea and vomiting, and postoperative opioid use were similar between the groups. The combination of methadone and ketamine was not associated with lower incidence of moderate-to-severe pain in propensity score analysis.</p><p><strong>Conclusions: </strong>Although the combination of methadone and ketamine showed a slight increase in QoR40 scores at 24 h postoperatively, the observed difference between the groups was not clinically significant. Moreover, the absence of a reduction in postoperative pain intensity and similar perioperative opioid consumption between the groups further support the hypothesis that small, isolated doses of ketamine may not be effective in improving recovery quality compared with methadone alone.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 6","pages":"e2024193"},"PeriodicalIF":1.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132173","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":"The systemic immune-inflammatory index in high-risk patients with hypertension: a cross sectional-study.","authors":"Francelise Susan Mihara Bettanin, Marcelo Rodrigues Bacci","doi":"10.1590/1516-3180.2024.0301.R1.14072025","DOIUrl":"10.1590/1516-3180.2024.0301.R1.14072025","url":null,"abstract":"<p><strong>Introduction: </strong>Essential hypertension is an important health condition responsible for conditions such as heart attack, stroke, and kidney disease. Traditional risk factors and their control are important for reducing mortality. Inflammation caused by organ damage plays a role in the undesirable outcomes of hypertension. Biomarkers, such as the systemic immune-inflammatory index (SII), are predictors, but their relationship with risk factors is poorly understood.</p><p><strong>Objective: </strong>To evaluate the correlation between the SII and risk factors in patients with hypertension.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in 2020 in Bahia with hypertensive patients from an outpatient clinic. We collected demographic and clinical data such as age, body mass index, and the following biomarkers: low-density lipoprotein level, glomerular filtration rate, interleukin 6 level, C-reactive protein level, neutrophil/lymphocyte ratio (NLR), hemogram, creatinine level, urea level, ferritin level, and vitamin D level.</p><p><strong>Results: </strong>A total of 61 patients, most of them black women, participated in the study. The prevalence of type 2 diabetes was 19%, and there was no prevalence of stroke or heart attacks. According to the Framingham risk index, a large part of the sample presented high and very high risks. The bivariate analysis between SII and NLR was positive. Multivariate analysis showed that age, renal function, and NLR were positively correlated with the SII. The patients' Framingham risk did not correlate with the SII.</p><p><strong>Conclusions: </strong>Inflammation is important for vascular damage in arterial hypertension caused by increased oxidative stress. We evaluated SII and NLR as indices of correlation with risk factors. The SII is a lowcost tool that can be used to screen for chronic conditions, such as hypertension. In summary, higher SII was positively associated with older age and worse renal function in patients with high-risk hypertension.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 6","pages":"e2024301"},"PeriodicalIF":1.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132231","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":"Is the atherogenic index of plasma a predictor for mortality in ischemic stroke patients?: a retrospective cross-sectional study.","authors":"Sefa Tatar, Osman Serhat Tokgöz, Ümmü Gülsüm Selvi","doi":"10.1590/1516-3180.2024.0337R1.14072025","DOIUrl":"10.1590/1516-3180.2024.0337R1.14072025","url":null,"abstract":"<p><strong>Background: </strong>The atherogenic index of plasma (AIP), derived from the logarithmic transformation of the triglyceride to high-density lipoprotein cholesterol ratio, is frequently used to predict cardiovascular events.</p><p><strong>Objective: </strong>This study aimed to investigate the association between AIP and 1-month mortality in patients with acute ischemic stroke (AIS).</p><p><strong>Design and setting: </strong>Retrospective study was conducted in Türkiye.</p><p><strong>Methods: </strong>In total, 530 AIS patients were enrolled in this study. Clinical, demographic, and laboratory characteristics were recorded within 24 hours of admission. One-month mortality outcomes were analyzed in relation to the AIP of the patients.</p><p><strong>Results: </strong>Of the 530 patients, 140 patients did not survive during the follow-up period. The mean AIP was 0.50 ± 0.33 in survivors and 0.11 ± 0.27 in the mortality group (P = 0.001). In the receiver operating characteristic analysis, the AIP value of 0.291 had a sensitivity of 74.4%, specificity of 76.4%, positive predictive value of 75.92%, and negative predictive value of 74.9% for mortality. The AIP value above 0.291 had an AUC (area under curve) of 0.829 (95% CI [confidence interval] 0.78-0.88, P = 0.0001). In Cox regression analysis, AIP values below 0.291 (HR 3.962; 95% CI 2.643-5.937) were identified as an independent predictor of mortality. Higher mortality rates were observed in patients with cryptogenic stroke and AIP below 0.291 after stratification by stroke TOAST (P = 0.003).</p><p><strong>Conclusions: </strong>Lower AIP is an independent predictor of short-term mortality in AIS patients, surpassing the sensitivity of traditional lipid parameters. This study provides a valuable prognostic tool for clinicians, offering a non-invasive and cost-effective test for a condition associated with substantial mortality and morbidity.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 6","pages":"e2024337"},"PeriodicalIF":1.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132256","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":"Premenstrual Syndrome-Impact Questionnaire: Cross-cultural adaptation, reliability, and validity of the Turkish version.","authors":"Halime Arıkan, Erkan Erol","doi":"10.1590/1516-3180.2024.0288.R1.07042025","DOIUrl":"10.1590/1516-3180.2024.0288.R1.07042025","url":null,"abstract":"<p><strong>Background: </strong>Short and practical questionnaires and tests that assess premenstrual symptoms and premenstrual syndrome (PMS) are required.</p><p><strong>Objectives: </strong>This study aimed to investigate the cross-cultural adaptation, validity, and reliability of the Premenstrual Syndrome Impact Questionnaire (PMS-IQ) in Turkish women with PMS.</p><p><strong>Design and setting: </strong>The reliability and validity of the questionnaire were evaluated in Tokat, Türkiye.</p><p><strong>Methods: </strong>A convenience sample of 146 individuals diagnosed with PMS was used to assess the reliability and validity of the Turkish version of the PMS-IQ. Test-retest analyses were performed in a subset of 96 individuals one week after the initial assessment. Construct validity was evaluated through convergent validity analysis using the Premenstrual Syndrome Scale (PMSS) and the Premenstrual Symptoms Impact Survey (PMSIS), and divergent validity analysis with the Big Five Inventory-10 (BFI-10).</p><p><strong>Results: </strong>Cronbach's α values for the total score and subscales ranged from 0.861 to 0.917, whereas the test-retest reliability values ranged from 0.755 to 0.847. Factor analysis indicated that the scale had a three-factor structure. The total PMS-IQ score was significantly correlated with both the PMSS (r = 0.718) and PMSIS (r = 0.774), but showed no significant correlation with the BFI-10 (r = 0.113). No floor or ceiling effects were observed for the total or subscale scores of the PMS-IQ.</p><p><strong>Conclusions: </strong>The Turkish version of the PMS-IQ demonstrated reliability and validity for evaluating individuals with PMS.</p><p><strong>Clinical trial registration: </strong>This study is registered at ClinicalTrials.gov (identifier: NCT05725447).</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 5","pages":"e2024288"},"PeriodicalIF":1.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076449","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":"Functional constipation in pediatric patients: an observational study in southern Brazil.","authors":"Anita Dos Santos Cardoso, Laura Bittencourt de Oliveira, Mayra Sonego","doi":"10.1590/1516-3180.2025.2853.13062025","DOIUrl":"10.1590/1516-3180.2025.2853.13062025","url":null,"abstract":"<p><strong>Background: </strong>Functional constipation is characterized by a set of symptoms including hardened stools, abdominal discomfort, a tendency to retain stools, and eventual fecal incontinence. This condition negatively affects the quality of life of the affected individuals and has potential psychosocial repercussions.</p><p><strong>Objectives: </strong>To assess the epidemiological, clinical, and therapeutic aspects of functional constipation in patients treated at a pediatric gastroenterology outpatient clinic.</p><p><strong>Design and setting: </strong>Descriptive observational study with a quantitative approach using secondary data collected from the medical records of a pediatric gastroenterology outpatient clinic in Criciúma between 2018 and 2023.</p><p><strong>Methods: </strong>This study was approved by the Human Research Ethics Committee of the Universidade do Extremo Sul Catarinense (Unesc) under number 6.788.465. Sociodemographic, clinical, and therapeutic variables were evaluated in 67 patients aged 0-18 years who were diagnosed with Functional Constipation (ICD K590) during the study period. Data were analyzed using descriptive statistics in the Statistical Package for the Social Sciences (SPSS), version 25.0.</p><p><strong>Results: </strong>There was a predominantly female profile (36; 53.7%), with an average age at diagnosis of 7.75 years (± 3.96). The main symptoms included abdominal pain (52, 77.6%) and hardened stools (42, 62.7%), with an average interval of 4 days between bowel movements. Treatment consisted of macrogol prescriptions (60, 89.6%), with most patients showing complete symptom improvement (49, 73.1%).</p><p><strong>Conclusion: </strong>Analysis of medical records highlighted the need for continuous monitoring and targeted interventions, considering the variability of symptoms and individual characteristics of patients.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 6","pages":"e20252853"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976468","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":"Effects of unsupervised walking on walk performance and functional mobility in individuals with chronic stroke: a blind randomized clinical trial.","authors":"Ronaldo Rodrigues Borges, André Pontes-Silva, Sara Andrade Rodrigues, Túlio Luiz Banja Fernandes, Claudio de Oliveira Assumpção, Almir Vieira Dibai-Filho, Cristiano Teixeira Mostarda, Augusto Ribeiro de Oliveira, Christian Emmanuel Torres Cabido","doi":"10.1590/1516-3180.2024.0190.R2.26022025","DOIUrl":"10.1590/1516-3180.2024.0190.R2.26022025","url":null,"abstract":"<p><strong>Background: </strong>What are the effects of walking training on the ground in an unsupervised manner and with different weekly durations after chronic stroke?</p><p><strong>Objective: </strong>To compare the effects of unsupervised walking for 150 and 300 minutes per week on walking performance, speed, and functional mobility in individuals with chronic stroke.</p><p><strong>Design and setting: </strong>Randomized clinical trial was conducted at Rede Sarah Rehabilitation Hospital (São Luís, Brazil).</p><p><strong>Methods: </strong>Individuals included (n = 40) were assessed using the 6-minute walk test (6MWT), functional mobility using the Timed Up and Go (TUG) test, and the Five Times Sit to Stand Test (FTSST). They were assigned to the two experimental groups and instructed to walk 150 (G150) or 300 minutes per week (G300) and to perform unsupervised gait training for the next eight weeks.</p><p><strong>Results: </strong>No significant differences were observed between the group factors and no significant interaction was found for the group × time interaction, indicating that G150 and G300 changed similarly. The comfortable walking speed increased for both G150 and G300, resulting in a large effect size. Performance on the TUG and 6MWT also improved, but the effect size was small. For maximum walking speed, despite the improvement in performance in G150 and the G300, effect size was medium for both groups. The same was true for the FTSST.</p><p><strong>Conclusion: </strong>Unsupervised walking was effective in improving gait performance and functional mobility in individuals with chronic stroke regardless of the recommended weekly duration (150 or 300 minutes).</p><p><strong>Clinical trial registration: </strong>RBR-5g4g9bq (https://ensaiosclinicos.gov.br/rg/RBR-5g4g9bq).</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 5","pages":"e2024190"},"PeriodicalIF":1.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976450","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":"Percutaneous tracheostomy in COVID-19 patients: a retrospective cohort study.","authors":"Sofia Wagemaker Viana, Brenda Feres, Gabriel Roberto, Rodrigo Sardenberg","doi":"10.1590/1516-3180.2024.0036.R2.07032025","DOIUrl":"10.1590/1516-3180.2024.0036.R2.07032025","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic has placed unprecedented strain on healthcare systems, particularly on critically ill patients requiring prolonged mechanical ventilation (MV). Percutaneous tracheostomy (PT) has emerged as a potential strategy to facilitate weaning, reduce intensive care unit (ICU) stay, and optimize resource use. However, the timing, safety, and outcomes of PT in COVID-19 patients remain debatable.</p><p><strong>Objectives: </strong>This study aimed to describe the technical aspects of the procedure and evaluate the early safety of our technique to healthcare professionals, as well as the short-term factors affecting survival in 103 consecutive patients after tracheostomy.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with COVID-19 who underwent PT between March 2020 and June 2020 at Hospital Alemão Oswaldo Cruz, São Paulo. The factors considered for analysis included age, sex, timing of tracheostomy, proportion of affected lungs, comorbidities, fraction of inspired oxygen on MV, and availability of professional private equipment. Univariate analysis was performed for screening, and variables with P < 0.20 were included in the multivariate Cox proportional hazards regression model.</p><p><strong>Results: </strong>Most patients were male, with a median age of 68 years. The most common comorbidities were hypertension (n = 55/52%), diabetes (n = 37/36%), and heart disease (n = 24/21%). Patients over 60 years old had reduced survival (hazard ratio [HR] = 3.35; P = 0.003), and those who underwent high nasal flow catheter (HR = 0.49; P = 0.02) and PT earlier (< 10 days) had better survival (HR = 0.37; P = 0.04).</p><p><strong>Conclusion: </strong>Early PT in selected patients may reduce the duration of MV and lead to shorter ICU stays. The health system is overloaded by the scarcity of ventilators and beds for critically ill patients.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 4","pages":"e2024036"},"PeriodicalIF":1.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976478","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":"Psychological distress among university students during remote learning in Brazil: a multicenter online study.","authors":"Bruna Carolina Rafael Barbosa, Waléria de Paula, Aline Dayrell Ferreira Sales, Eulilian Dias de Freitas, Carolina Martins Dos Santos Chagas, Helian Nunes de Oliveira, Lívia Garcia Ferreira, Luciana Saraiva da Silva, Fernanda de Carvalho Vidigal, Luciana Neri Nobre, Elaine Leandro Machado, Clareci Silva Cardoso, Adriana Lúcia Meireles","doi":"10.1590/1516-3180.2024.0299.R1.07032025","DOIUrl":"10.1590/1516-3180.2024.0299.R1.07032025","url":null,"abstract":"<p><strong>Background: </strong>Studies assessing the prevalence of mental disorders in the context of remote teaching in Brazil during the coronavirus disease (COVID-19) pandemic are scarce.</p><p><strong>Objective: </strong>To estimate the prevalence of symptoms of anxiety and depression and their relationship with sociodemographic characteristics among university students during the COVID-19 pandemic.</p><p><strong>Design and setting: </strong>This multicenter cross-sectional study was conducted at eight Brazilian public universities.</p><p><strong>Methods: </strong>This study was conducted on students regularly enrolled in undergraduate courses. Data were collected between October 2021 and February 2022 using an online self-administered questionnaire that addressed sociodemographic and academic characteristics, lifestyle habits, and health conditions. Anxiety and depression symptoms were assessed using the Depression, Anxiety, and Stress Scale-21. The variables were analyzed descriptively using frequency distribution, proportion, 95% confidence interval (95% CI), and Pearson's chi-squared test.</p><p><strong>Results: </strong>A total of 8,650 students participated, and most of them were women, white, heterosexual, cisgender, and unmarried, with a mean age of 23.9 (standard deviation: ± 6.34) years and living with family members. Symptoms of anxiety and depression were observed in 59.7% (95% CI: 58.7-60.7) and 63.0% (95% CI: 62.0-64.0) of the students, respectively. These symptoms were associated with sex, age, skin color, sexual orientation, gender identity, marital status, education of the head of the family, family income, decrease in income during the pandemic, and area of knowledge.</p><p><strong>Conclusion: </strong>Most university students showed symptoms of anxiety and depression during the suspension of face-to-face activities in universities, indicating the need for institutional actions and public policies aimed at promoting their health and mental well-being.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 5","pages":"e2024299"},"PeriodicalIF":1.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976483","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":"Patients with DVT and primary antiphospholipid syndrome have worse obstetric outcomes than pregnant women with DVT and negative antiphospholipid antibodies: a retrospective cohort study.","authors":"Priscila Guyt Rebelo, Marcela Ignacchiti Lacerda Ávila, Nilson Ramires de Jesús, Flávio Victor Signorelli, Evandro Mendes Klumb, Guilherme Ramires de Jesús","doi":"10.1590/1516-3180.2024.0310.R1.24032025","DOIUrl":"10.1590/1516-3180.2024.0310.R1.24032025","url":null,"abstract":"<p><strong>Background: </strong>Pregnant women are at an increased risk of thromboembolism compared with non-pregnant women. Venous thrombosis is a manifestation of antiphospholipid syndrome (APS), an autoimmune thrombophilia associated with pregnancy morbidity.</p><p><strong>Objectives: </strong>This study was designed to compare gestational outcomes of pregnant patients with deep venous thrombosis (DVT) and primary APS with outcomes of patients with DVT and negative results for antiphospholipid antibodies (aPLs).</p><p><strong>Design and setting: </strong>This was a retrospective cohort study with data collected from patients with DVT who received prenatal care for autoimmunity and thrombophilia at Hospital Universitário Pedro Ernesto, Rio de Janeiro.</p><p><strong>Methods: </strong>All patients with DVT were tested for aPLs. Those with positive results were tested again after 12 weeks and classified as having primary APS. Patients with systemic lupus erythematosus, superficial venous thrombosis without DVT, twin pregnancies, or fetuses with congenital malformations were excluded.</p><p><strong>Results: </strong>This study included 171 patients (39 with APS, 132 with DVT and negative aPL results). Patients with primary APS and DVT had higher frequencies of miscarriages (P = 0.004) and stillbirths during previous pregnancies (P < 0.001). When obstetric outcomes were analyzed prospectively, APS patients had a lower birth weight (P = 0.001) and higher rates of oligohydramnios (P = 0.04), intrauterine growth restriction (P = 0.01), preeclampsia (P = 0.04), stillbirths (P = 0.02), and small-for-gestational-age newborns (P < 0.001) than patients with DVT and negative aPL results. The latter group had gestational outcomes similar to those of the general population.</p><p><strong>Conclusions: </strong>Patients with primary APS have adverse obstetric outcomes despite appropriate treatment, whereas those with DVT and negative for aPLs have favorable results.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 5","pages":"e2024310"},"PeriodicalIF":1.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976485","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":"Validation of the Pearlin Mastery Scale for unpaid caregivers of people living with dementia in Brazil: a methodological study.","authors":"Gustavo Carrijo Barbosa, Diana Quirino Monteiro, Ana Carolina Ottaviani, Camila Rafael Ferreira Campos, Ludmyla Caroline de Souza Alves, Gabriela Martins, Larissa Corrêa, Luana Aparecida da Rocha, Sofia Cristina Iost Pavarini, Elizabeth Joan Barham, Fabiana de Souza Orlandi, Keila Cristianne Trindade da Cruz, Deborah Oliveira, Aline Cristina Martins Gratão","doi":"10.1590/1516-3180.2024.0446.R1.13062025","DOIUrl":"10.1590/1516-3180.2024.0446.R1.13062025","url":null,"abstract":"<p><strong>Background: </strong>Sense of mastery has been described in the literature as a psychological resource potentially associated with reduced caregiver burden. However, there are no validated instruments in the Brazilian context that allow the evaluation of the sense of mastery as a possible outcome of interventions aimed at supporting unpaid caregivers of people with dementia.</p><p><strong>Objective: </strong>To validate the construct of the Brazilian version of the Pearlin Mastery Scale among unpaid caregivers of people living with dementia.</p><p><strong>Design and setting: </strong>This methodological study was conducted with 100 unpaid caregivers of people living with dementia, cared for at home, and who resided in Brazil.</p><p><strong>Methods: </strong>Evidence of validity was tested based on internal structure, reliability, and correlations with theoretically related constructs. Sociodemographic data on sense of mastery, burden, depressive symptoms, anxiety, and quality of life were collected.</p><p><strong>Results: </strong>Difficulties involving burden (80%), depressive symptoms (70%), anxiety (65%), and low quality of life (62%) were reported. Satisfactory measures of adjustment were found in the factor analysis; however, by removing two inversely scored items, these measures improved, resulting in a Cronbach's alpha of 0.75. Significant correlations were found between sense of mastery and burden scores (ρ = -.56), symptoms of depression (ρ = -.57), anxiety (ρ = -.57), and quality of life (ρ = .64).</p><p><strong>Conclusion: </strong>Evidence of validity was found for the Pearlin Mastery Scale Brazilian version based on the internal structure, reliability, and correlations with theoretically related constructs, indicating that it is a suitable instrument for use in Brazil.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":"143 5","pages":"e2024446"},"PeriodicalIF":1.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976545","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}