Revista da Associacao Medica Brasileira (1992)最新文献

{"title":"The role of hyaluronan modification in the etiopathogenesis of gastric cancer.","authors":"Ahmet Turan Durak, Hızır Yakup Akyıldız, Pınar Altın Çelik, Metin Aytekin","doi":"10.1590/1806-9282.20241087","DOIUrl":"10.1590/1806-9282.20241087","url":null,"abstract":"<p><strong>Objective: </strong>Gastric cancer is the second most common cancer in the world, accounting for 650,000 deaths per year, and is observed in approximately 10% of the patients diagnosed. Extracellular matrix abnormalities have been documented in gastric cancer patients. The aim of our study was to understand the role of high levels of hyaluronan, an extracellular matrix glycosaminoglycan, and its mechanistic role in gastric cancer pathobiology.</p><p><strong>Methods: </strong>Blood samples were collected from 82 gastric cancer patients and 41 healthy volunteers. Hyaluronan measurements were performed with the help of commercially purchased enzyme-linked immunosorbent assay kits. Gastric cancer (n=27) and healthy (n=29) tissue specimens were obtained after surgery and aliquoted for Western blot, immunofluorescence, and messenger RNA expression analysis.</p><p><strong>Results: </strong>Increased hyaluronan levels were detected in the blood of cancer patients compared to controls [plasma hyaluronan levels mg/dL (mean±SD): gastric cancer (n=82) 549.80±155.68, and healthy control (n=41) 27.21±4.95 (p<0.044)]. In addition, intense hyaluronan binding protein staining was observed in gastric cancer tissues, while tumor necrosis factor-inducible gene 6 messenger RNA expression was found to be significantly increased in gastric cancer tissues compared to healthy controls [tumor necrosis factor-inducible gene 6 messenger RNA expression: gastric cancer (n=27) 7.09±1.94 and healthy control (n=29) 3.20±0.67 (p=0.048)] according to the immunofluorescence staining.</p><p><strong>Conclusion: </strong>The high hyaluronan levels in gastric cancer patients and the detection of increased messenger RNA levels of the tumor necrosis factor-inducible gene 6 enzyme in gastric cancer tissue, supporting a possible hyaluronan modification, suggest that this abnormality may have an important role in the formation of gastric cancer.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"70 12","pages":"e20241087"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857474","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}

{"title":"Serum hCG levels in the prediction of molar pregnancy below 11 weeks of gestational age.","authors":"Lucas Ribeiro Borges de Carvalho, Rafaela Tessaro de Assis, Antônio Braga, Tatiana Carvalho de Souza Bonetti, Edward Araujo Júnior, Rosiane Mattar, Sue Yazaki Sun","doi":"10.1590/1806-9282.20240659","DOIUrl":"10.1590/1806-9282.20240659","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate the serum hCG level in the differential diagnosis between non-molar miscarriage and complete hydatidiform mole in<11 weeks gestation.</p><p><strong>Methods: </strong>This was a retrospective collaborative cohort study. This study included women with gestational age<11 weeks, with ultrasound evidence of failed pregnancy and available serum hCG pre-uterine evacuation, divided into two groups: the non-molar miscarriage group and the complete hydatidiform mole group. Serum hCG levels were compared according to gestational age. Statistical analysis used a nonparametric test with a 5% significance level (p<0.05).</p><p><strong>Results: </strong>In total, 416 patients were included, out of which 79 were included in the non-molar miscarriage group and 337 in the complete hydatidiform mole group. The calculated power of the sample was more than 80%. Data analysis showed that the 75th quartile of the median in the non-molar miscarriage group was always lower than the 25th quartile of the median in the complete hydatidiform mole group [9,721 mUI/mL/16,435 mUI/mL (6-7 weeks), 20,229 mUI/mL/64,911 mUI/mL (8-9 weeks), and 29,633 mUI/mL/126,278 mUI/mL (10-11 weeks), respectively; p<0.001].</p><p><strong>Conclusion: </strong>Facing failed pregnancies, hCG>16,435 mUI/mL at 6-7 weeks, hCG>64,911 mUI/mL at 8-9 weeks, and hCG >126,278 mUI/mL at 10-11 weeks were most prevalent on complete hydatidiform mole diagnosis. On the contrary, hCG<30,000 mUI/mL at 10-11 weeks was most prevalent in non-molar miscarriage diagnosis.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"70 12","pages":"e20240659"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857462","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}

{"title":"Evaluation of the effect of BioFire FilmArray nested multiplex polymerase chain reaction method on rapid pathogen identification and antimicrobial stewardship in sepsis.","authors":"Tuba Tatlı Kış, Can Biçmen, Suleyman Yıldırım, Ozlem Ediboğlu, Fatma Sebnem Yıldız, Ayriz Tuba Gunduz, Ferhat Demirci, Cenk Kıraklı","doi":"10.1590/1806-9282.20241038","DOIUrl":"10.1590/1806-9282.20241038","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we aimed to assess the effect of the BioFire FilmArray Blood Culture Identification 2 panel on agent identification and antimicrobial stewardship in patients with a critical state of sepsis secondary to bloodstream infection.</p><p><strong>Methods: </strong>This study was designed as a prospective observational study. Patients who developed sepsis and septic shock secondary to bloodstream infection in the intensive care unit were included in the study. Concordance in both monomicrobial and polymicrobial results of Blood Culture Identification 2 panel and conventional blood culture, test result times, and antibiotherapy changes according to Blood Culture Identification 2 panel results were evaluated.</p><p><strong>Results: </strong>In monomicrobial samples, sensitivity and specificity were 97.1% (95%CI 84.6-99.3) and 100% (95%CI 66.3-100), respectively, for gram-negative pathogens and 85.7% (95%CI 42.1-99.6) and 100% (95%CI 90.2-100), respectively, for gram-positive pathogens. In polymicrobial samples, Blood Culture Identification 2 panel results were 79% in concordance with conventional blood culture results. In this study, when the final turnaround time of the Blood Culture Identification 2 panel was compared with culture results, the Blood Culture Identification 2 panel was on average 1 day, 5 h, and 35 min faster than the culture (p<0.01).</p><p><strong>Conclusion: </strong>Blood Culture Identification 2 testing is a reliable tool for rapid pathogen and antimicrobial susceptibility detection in critically ill sepsis patients. The use of the Blood Culture Identification 2 panel in patients with sepsis and/or septic shock, where the transition to targeted antibiotherapy is critical, may improve patient outcomes.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"70 12","pages":"e20241038"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857461","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}

{"title":"Effects of interpersonal psychotherapy on anxiety and alexithymia in mothers in the postpartum period: a randomized controlled trial.","authors":"Vesile Adiguzel, Ayse Okanli","doi":"10.1590/1806-9282.20241002","DOIUrl":"10.1590/1806-9282.20241002","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to determine the effects of interpersonal psychotherapy on anxiety and alexithymia in mothers in the postpartum period.</p><p><strong>Methods: </strong>This randomized controlled experimental study with a pre-test and post-test design was conducted to determine the effects of interpersonal psychotherapy on anxiety and alexithymia in mothers during the postpartum period. Data were collected from postpartum mothers who presented to the pediatric outpatient clinic in a private hospital in Istanbul at the pre- and post-tests between August 2022 and January 2023. The study was conducted between June 10, 2022, and June 23, 2023. In the study, data were obtained with the \"Personal Information Form,\" \"Beck Anxiety Inventory,\" and \"Toronto Alexithymia Scale.\" This randomized controlled experimental study with the pre- and post-test designs was conducted in a private hospital in Istanbul, a province located on both sides of the Bosporus Strait in northwest Turkey, with 14 postpartum mothers. Of them, seven were assigned to the experimental group and seven to the control group. The participants in the experimental group underwent interpersonal psychotherapy. The participants in the control group underwent no intervention. In the analysis of the data, while repeated measures analysis of variance was used to compare the scale scores, Fisher's least significant difference test was used for multiple comparisons of the group*time interaction.</p><p><strong>Results: </strong>The mean scores obtained from the \"Beck Anxiety Inventory\" and \"Toronto Alexithymia Scale\" by the participants in the experimental group before the interpersonal psychotherapy were 19.71±4.11 and 55.43±9.05, respectively, and 8.86±3.02 and 41.00±7.44, respectively, after the intervention, indicating that they decreased statistically significantly (p<0.05).</p><p><strong>Conclusion: </strong>The results of the study indicated that interpersonal psychotherapy reduced anxiety and alexithymia levels in mothers in the postpartum period. Based on this result, it is recommended that interpersonal psychotherapy be utilized in clinical practice.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"70 12","pages":"e20241002"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857436","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}

{"title":"Changes in the pathophysiology of viral variants of COVID-19 with a significant reduction in thrombotic events.","authors":"Jose Maria Pereira de Godoy, Gleison Juliano da Silva Russeff","doi":"10.1590/1806-9282.20241110","DOIUrl":"10.1590/1806-9282.20241110","url":null,"abstract":"","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"70 11","pages":"e20241110"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781374","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}

{"title":"Evaluation of the effect of delivery type on dynamic thiol-disulfide balance: a prospective randomized controlled study.","authors":"Merve Keskin Paker, Mehmet Zahit Çıracı, Hayrullah Yazar, Hilal Uslu Yuvaci","doi":"10.1590/1806-9282.20240295","DOIUrl":"10.1590/1806-9282.20240295","url":null,"abstract":"<p><strong>Objective: </strong>Thiols play an essential role in eliminating oxidative stress in cells. We aimed to evaluate the oxidative stress occurring during labor with thiol-disulfide balance.</p><p><strong>Methods: </strong>A total of 97 healthy pregnant women in the 37th-41st gestational weeks who underwent delivery between June 2021 and August 2022 were included in the study. Elective cesarean section group 1 (n=33), vaginal deliveries group 2 (n=29), and cesarean section due to cephalopelvic disproportion group 3 (n=35) were determined. Blood samples were taken before delivery, and from the umbilical artery just after the fetus and placenta were delivered. Serum native thiol (μmol/L), total thiol (μmol/L), and disulfide (μmol/L) were measured. Disulfide/native thiol (%), disulfide/total thiol (%), and native thiol/total thiol (%) ratios were calculated.</p><p><strong>Results: </strong>No significant difference was observed in thiol values in maternal blood (p>0.05). There was a significant difference between the groups in terms of native/total thiol (p=0.017), disulfide/total thiol (%) (p=0.018), and disulfide/native thiol (%) (p=0.018) in cord blood.</p><p><strong>Conclusion: </strong>In the literature, evidence concerning the impact of the mode of delivery on the level of neonatal and maternal oxidative stress is inconsistent. It is not clear whether parturition accompanied by pain, as in spontaneous vaginal delivery, poses more oxidative stress than a planned operative delivery. Prospective studies in larger cohorts are needed to better understand the impact of oxidative stress on pregnant women and neonates.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"70 11","pages":"e20240295"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782140","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}

{"title":"Influencing factors of recurrence after pelvic organ prolapse surgery and construction of a nomogram risk prediction model.","authors":"Penghui Zhang, Weijie Du, Gang Guo, Meijuan Yuan, Jun Wei","doi":"10.1590/1806-9282.20240849","DOIUrl":"10.1590/1806-9282.20240849","url":null,"abstract":"<p><strong>Objective: </strong>Pelvic organ prolapse affects women's quality of life through symptoms such as vaginal laxity, urinary incontinence, defecation and sexual dysfunction, and pelvic pain. Given the challenges in managing recurrent cases, understanding risk factors and the effect of surgical choices on recurrence is vital for guiding clinical decisions. This study explores how uterine preservation influences postoperative recurrence and develops predictive models to aid in assessing recurrence risk.</p><p><strong>Methods: </strong>A total of 87 patients diagnosed with pelvic organ prolapse who underwent laparoscopic sacral fixation were included. Patients were classified into two groups based on the occurrence of pelvic organ prolapse recurrence within 3 years post-surgery (recurrence: n=22; no recurrence: n=65). Follow-up over 3 years was recorded. Factors including age, body mass index, birth order, occupation, and uterus preservation during surgery were evaluated. The relationship between pelvic floor muscle strength and pelvic organ prolapse recurrence was also examined. Logistic regression analysis assessed the correlation between pelvic organ prolapse recurrence and levels of serum elastase inhibitor and osteopontin.</p><p><strong>Results: </strong>In a follow-up of 87 patients with pelvic organ prolapse, 22 experienced recurrences within 3 years, marking a 25.29% recurrence rate. Multivariate analysis identified older age, higher parity, and sustained contraction of type II muscle fibers as independent risk factors for recurrence (all p<0.05). Lower systolic blood pressure in type I and II muscle fibers was associated with decreased serum elastase inhibitor and osteopontin levels, increasing pelvic organ prolapse recurrence risk. Logistic regression identified age, multiple deliveries, and low systolic pressure in type II muscle fibers as independent recurrence factors. The constructed nomogram risk prediction model, incorporating these factors, showed good discrimination ability with an area under the receiver operating characteristic curve of 0.891 (95%CI 0.871, 0.921), indicating accurate predictions and high net benefit.</p><p><strong>Conclusion: </strong>Factors such as age, birth order, uterine preservation, and pelvic floor muscle strength impact postoperative pelvic organ prolapse recurrence. Older age, a higher number of deliveries, and reduced systolic pressure of class II muscle fibers are independent risk factors for pelvic organ prolapse recurrence after surgery.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"70 12","pages":"e20240849"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782165","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}

{"title":"The mediatıng role of insomnia in the effect of depression on healthy lifestyle behaviors in post-menopausal women.","authors":"Mehmet Ali Sen, Eda Yakıt Ak","doi":"10.1590/1806-9282.20240943","DOIUrl":"10.1590/1806-9282.20240943","url":null,"abstract":"","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"70 12","pages":"e20240943"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782264","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}

{"title":"Translation and validation of the Second Victim Experience and Support Tool-Revised into Brazilian Portuguese.","authors":"Ana Paula Almeida Lima, Marcos Antônio Almeida Matos, Carolina Villa Nova Aguiar","doi":"10.1590/1806-9282.20241154","DOIUrl":"10.1590/1806-9282.20241154","url":null,"abstract":"<p><strong>Introduction: </strong>The term second victim arises when a healthcare professional experiences an adverse event that has an emotional impact and/or physical suffering for the healthcare professional. The experiences of the second victim can be measured using the Second Victim Experience and Support Tool, originally developed in English, translated and validated internationally in several languages. A revised version of the tool (Second Victim Experience and Support Tool-Revised) has been published since 2020.</p><p><strong>Objective: </strong>The objective of this study was to translate and gather evidence of the validity of the Second Victim Experience and Support Tool-Revised Version into Brazilian Portuguese.</p><p><strong>Methods: </strong>This is a methodological study that involved the necessary procedures for the translation and cross-cultural adaptation of the instrument, carefully following the stages of translation, back-translation, pre-testing, evaluation by a panel of experts, and a test on a large population for validity and reliability.</p><p><strong>Results: </strong>A total of 146 health professionals took part in the study, with a greater predominance of doctors (38.4%) and physiotherapists (30.8%). Seven items were excluded, all with factor loadings of less than 0.50. The \"institutional support\" dimension had to be excluded due to its low factor loadings. The fit indices of the re-specified model were χ2/df=1.60, CFI=0.90, TLI=0.88, and RMSEA=0.07 (CI 0.06-0.08).</p><p><strong>Conclusion: </strong>The adapted version of the instrument showed satisfactory psychometric properties when composed of 28 items distributed in eight dimensions, making it a valid and reliable instrument for assessing second victim experiences in different professions, suitable for dissemination in Brazil.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"70 11","pages":"e20241154"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782247","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}

{"title":"Reinterpretation on a comparison of cytological adequacy between 23- and 25-gauge in thyroidology: smaller needle gauges \"ratio\"nale or (over)use it?","authors":"Demet Sengul, Ilker Sengul","doi":"10.1590/1806-9282.20240874","DOIUrl":"10.1590/1806-9282.20240874","url":null,"abstract":"","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"70 11","pages":"e20240874"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782234","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}