Revista da Associacao Medica Brasileira (1992)最新文献

{"title":"Comparison of high- and low-dose radial extracorporeal shock wave therapy in carpal tunnel syndrome.","authors":"İsmail Ceylan, Büşra Kürtüncüoğlu, Figen Tuncay, Mehmet Canli, Halil Alkan, Abdulhamit Tayfur","doi":"10.1590/1806-9282.20241815","DOIUrl":"10.1590/1806-9282.20241815","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to compare the efficacy of radial extracorporeal shock wave therapy administered at low vs. high pressures in patients with carpal tunnel syndrome.</p><p><strong>Methods: </strong>Patients with carpal tunnel syndrome were randomized into two groups: low-dose group and high-dose group. Each patient underwent a total of four sessions of radial extracorporeal shock wave therapy, administered once a week. The radial extracorporeal shock wave therapy was delivered at 4.0 bars for the high-dose group and 1.5 bars for the low-dose group. Both groups received conventional physical therapy program consisting of transcutaneous electrical nerve stimulation, paraffin wax, orthoses, and tendon gliding exercises, three times per week over a 4-week duration. Outcome measures included pain levels, hand grip strength, pinch strength, the Boston Carpal Tunnel Syndrome Questionnaire, and nerve conduction studies.</p><p><strong>Results: </strong>Both groups exhibited improvements across all measures, except for the nerve conduction studies parameters. In the intragroup analysis, statistically significant differences were observed with small-to-moderate effect sizes for median motor distal latency, median sensory nerve conduction velocity, median sensory distal latency, and the Boston functional status subscale, all favoring the high-dose group (p<0.05). In the low-dose group, a statistically significant difference with a moderate effect size was noted solely for hand grip strength (p<0.05).</p><p><strong>Conclusion: </strong>High-dose radial extracorporeal shock wave therapy was significantly better than low-dose radial extracorporeal shock wave therapy with small-to-moderate effect sizes in the recovery of the function and nerve conduction studies parameters of patients with carpal tunnel syndrome.</p><p><strong>Clinical trials registry: </strong>The study was registered on the Clinical Trials Registry (registration number: NCT05681663).</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 3","pages":"e20241815"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056460","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 cinitapride's efficacy and safety in treating functional dyspepsia with overlapping symptoms: a real-world study in Chinese healthcare settings.","authors":"Bing Yan, Shimin Wang, Jian Chen, Xiaolin Zhong, Bangmao Wang, Yumei Wu, Ji Wu, Nina Zhang, Jing Sun, Duowu Zou","doi":"10.1590/1806-9282.20241628","DOIUrl":"10.1590/1806-9282.20241628","url":null,"abstract":"<p><strong>Objective: </strong>Cinitapride, a gastrointestinal prokinetic, is commonly used for treating functional dyspepsia. However, large-scale, real-world data on its efficacy, especially in patients with overlapping symptoms, are limited. The aim of this study was to evaluate the clinical effectiveness and safety of cinitapride in Chinese patients with functional dyspepsia, including those with overlapping symptoms, in a real-world setting.</p><p><strong>Methods: </strong>In this single-arm, prospective, multicentric study, 1,012 Chinese outpatients with functional dyspepsia and functional dyspepsia overlapping with gastroesophageal reflux disease, irritable bowel syndrome, and/or functional constipation were treated with cinitapride (1 mg t.i.d.) from May 2019 to March 2021. Symptom improvement was assessed at weeks 2 and 4, with adverse events recorded.</p><p><strong>Results: </strong>At weeks 2 and 4, the overall symptom improvement rate was 62.4 and 90.9%, respectively. Subgroup improvement rates were as follows: functional dyspepsia-gastroesophageal reflux disease, 86.8%; functional dyspepsia-irritable bowel syndrome, 96.2%; functional dyspepsia-functional constipation, 91.7%; and functional dyspepsia-gastroesophageal reflux disease-irritable bowel syndrome, 67.6%. functional dyspepsia patients showed statistically significantly higher improvement than those with overlapping symptoms at weeks 2 (p=0.018) and 4 (p=0.009). The dyspepsia symptom score decreased by 51.0% at week 2 and 74.4% at week 4 (p<0.001). The most common adverse event was asymptomatic electrocardiogram abnormalities (n=8).</p><p><strong>Conclusion: </strong>Cinitapride is effective and well-tolerated in treating functional dyspepsia and functional dyspepsia-overlapping gastroesophageal reflux disease, irritable bowel syndrome, and functional constipation in Chinese patients.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 3","pages":"e20241628"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046100","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":"A new approach to osteoarthritis: gut microbiota.","authors":"Mustafa Aydin, Gulcin Alp Avci, Ulku Irem Yilmaz, Emre Avci","doi":"10.1590/1806-9282.20241528","DOIUrl":"https://doi.org/10.1590/1806-9282.20241528","url":null,"abstract":"<p><strong>Objective: </strong>Studies investigating the relationship between the gut microbiome and osteoarthritis have increased in recent years. However, data on the relationship between joints and the gut microbiome are limited. The aim of this study was to determine whether there is a relation between knee joint fluid and gut microbiota in patients with knee osteoarthritis.</p><p><strong>Methods: </strong>This study included 40 individuals, 20 of whom were diagnosed with knee osteoarthritis and 20 of whom were considered healthy controls. Joint-fluid and stool samples were taken from the participants. Bacteria isolated from the samples were identified using a matrix-assisted laser desorption ionization-time of flight-mass spectrometry device.</p><p><strong>Results: </strong>Twenty-nine different bacteria were isolated from the stool samples and five bacteria were isolated from the joint-fluid samples. In our study, the same types of microorganisms (Enterococcus faecium and Staphylococcus hominis) were isolated from the stool and joint-fluid samples.</p><p><strong>Conclusion: </strong>The data obtained in our study shed light on the uncertainty of how microorganisms, especially those identified in the knee and hip in the literature, reach these regions. The presence of intestinal bacteria in the knee joint fluid of osteoarthritis patients indicates that intestinal bacteria, especially in individuals with a weak immune system, malnutrition, and obesity, pass through the intestinal wall and reach other parts of the body via the bloodstream, a condition also known as \"leaky gut.\"</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 3","pages":"e20241528"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033019","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":"Independent risk factors for diversion colitis: a retrospective case-control study.","authors":"Di Wu, Bin Wang, Hao Yang","doi":"10.1590/1806-9282.20241590","DOIUrl":"https://doi.org/10.1590/1806-9282.20241590","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate independent risk factors for diversion colitis induced by the surgical interruption of fecal flow in the non-functional colon.</p><p><strong>Methods: </strong>We performed a retrospective study with 163 patients who underwent low anterior resections and created prophylactic ileostomies for rectal cancer between January 2014 and June 2023 at the Department of General Surgery, Air Force Medical University Tangdu Hospital. Colonoscopy results of the non-functional region of the distal colon and clinical variables were collected, including age, sex, body mass index, pathological tumor node metastasis staging, ileostomy method, diversion time, receiving radiotherapy or chemotherapy or not, suffering from preoperative inflammatory bowel disease or postoperative anastomotic leakage or not. Diagnosis of diversion colitis based on the results of the patients' colonoscopy results. Univariate analysis and multivariate analysis of diversion colitis-related risk factors were performed subsequently.</p><p><strong>Results: </strong>The morbidity of diversion colitis is 53.4% (87/163) in our study. Multivariate analysis showed that risk factors for diversion colitis included single-lumen prophylactic ileostomy (63.2 vs. 30.3%, OR 4.481, 95%CI 1.897-10.584, p<0.001), diversion time ≥90 days (79.3 vs. 40.8%, OR 4.474, 95%CI 1.849-10.826, p<0.001), inflammatory bowel disease (17.2 vs. 3.9%, OR 7.491, 95%CI 1.839-30.507, p=0.005), radiotherapy (58.6 vs. 42.1%, OR 0.515, 95%CI 0.196-1.352, p=0.178).</p><p><strong>Conclusion: </strong>These findings suggest that single-lumen prophylactic ileostomy, diversion time, and inflammatory bowel disease are independent risk factors for diversion colitis.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 3","pages":"e20241590"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013700","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 effect of music-supported acceptance and commitment therapy on perceived stress and pain in cancer patients.","authors":"Mehtap Tan, Sibel Asi Karakaş, Mine Ekinci, Filiz Ersöğütçü, Asude Aksoy","doi":"10.1590/1806-9282.20241027","DOIUrl":"https://doi.org/10.1590/1806-9282.20241027","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate the effect of music-supported acceptance and commitment therapy on perceived stress and pain levels in cancer patients.</p><p><strong>Methods: </strong>A total of 79 cancer patients participated in this controlled, pre-test/post-test quasi-experimental study (experimental group: n=29; control group: n=50). The intervention group received eight sessions of acceptance and commitment therapy with music, while the control group received standard care. Data were collected using the Perceived Stress Scale and the West Haven-Yale Multidimensional Pain Inventory.</p><p><strong>Results: </strong>The post-test Perceived Stress Scale scores of the experimental group were statistically significantly lower compared to the control group (26.17±3.52 vs. 28.88±5.73, p<0.05), indicating a reduction in perceived stress. Additionally, there was a statistically significant difference in pain severity scores between the groups (9.62±2.33 in the experimental group vs. 8.06±3.14 in the control group, p<0.05). The effect size for stress reduction was moderate (Cohen's d=-0.54).</p><p><strong>Conclusion: </strong>This study revealed that a music-supported acceptance and commitment therapy reduced perceived stress, pain severity, and pain interference in cancer patients. Nurses should actively involve non-pharmacological methods in pain and stress management planning in collaboration with patients and their families. They should create a therapeutic environment and take necessary measures to enable patients to benefit from non-pharmacological interventions.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 3","pages":"e20241027"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058470","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":"Response to \"The Glasgow prognostic score is unsuitable for stroke prediction in infective endocarditis\".","authors":"Cihan Aydın, Aykut Demirkıran","doi":"10.1590/1806-9282.20241531","DOIUrl":"https://doi.org/10.1590/1806-9282.20241531","url":null,"abstract":"","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 3","pages":"e20241531"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046952","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":"Before respiratory muscle weakness is attributed to a stroke, alternative causes must be considered and thoroughly ruled out.","authors":"Josef Finsterer","doi":"10.1590/1806-9282.20241422","DOIUrl":"https://doi.org/10.1590/1806-9282.20241422","url":null,"abstract":"","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 3","pages":"e20241422"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063783","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 effect of eight different gene polymorphisms on osteopenia and osteoporosis in the Turkish population.","authors":"Naim Uzun, Ahmet Kiziltunc, Adem Keskin","doi":"10.1590/1806-9282.20241624","DOIUrl":"https://doi.org/10.1590/1806-9282.20241624","url":null,"abstract":"<p><strong>Objective: </strong>Bone mineral density is affected by many gene regions. Osteoporosis is a disease that occurs due to decreased bone mineral density and has a polygenetic multifactorial pathogenesis. The aim of this study was to examine the effect of gene variants in eight gene regions related to bone mineral density in patients diagnosed with osteopenia or osteoporosis.</p><p><strong>Methods: </strong>A total of 60 patients diagnosed with osteoporosis, 50 patients diagnosed with osteopenia, and 40 healthy volunteers (control group) were included in the study. Collagen type I alpha 1 1997G/T, estrogen receptor α PvuII, estrogen receptor α XbaI, vitamin D receptor BsmI, lactase gene, osteoprotegerin G209A, osteoprotegerin T245G, and interleukin-6 G174C gene variants were analyzed.</p><p><strong>Results: </strong>No important difference was found in the distribution of collagen type I alpha 1 1997G/T, estrogen receptor α PvuII, estrogen receptor α XbaI, vitamin D receptor BsmI, lactase gene T13910C, osteoprotegerin T245G, and interleukin-6 G174C gene variants between groups. A significant difference was detected between the distribution of osteoprotegerin G209A gene variants in the patient groups and the distribution of osteoprotegerin G209A gene variants in the control group. On the other hand, no important difference was detected in the distribution of osteoprotegerin G209A gene variants between patient groups.</p><p><strong>Conclusion: </strong>The osteoprotegerin G209A gene variant may be associated with the risk of osteopenia and osteoporosis in the Turkish population. Other gene variants analyzed that affect bone mineral density were not associated with the risk of osteopenia and osteoporosis.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 3","pages":"e20241624"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061135","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":"Is cesarean scar defect becoming history? The effect of uterotomy closure.","authors":"Neset Gumusburun, Ulya Uskent","doi":"10.1590/1806-9282.20241507","DOIUrl":"10.1590/1806-9282.20241507","url":null,"abstract":"<p><strong>Objective: </strong>Isthmocele or cesarean scar defect is a pouch-like defect in the myometrium at the isthmic level that is thought that it might occur as a result of the insufficient healing process of the uterine incision after cesarean section. It is important not to underestimate isthmocele and its preventive measures since it might cause serious gynecologic and obstetric complications. However, the best suturing technique suitable for the prevention of isthmocele formation is yet to be identified. The aim of this study was to compare the effects of three different uterine closure techniques applied during cesarean section on isthmocele formation.</p><p><strong>Methods: </strong>In this prospective study, a total of 120 term (>37 weeks) pregnant women with no history of cesarean section and scheduled for primary cesarean section were randomized preoperatively to three different uterotomy closure techniques (baseball, single-locked, and single-unlocked groups).</p><p><strong>Results: </strong>In a total of 43 patients, postoperative third-month sonography revealed isthmocele as an anechoic triangular area with ≥1 mm depth at the scar site. Compared with the single-locked and single-unlocked groups, isthmocele development was significantly lower in the baseball-type closure group (47.5% in the single-locked, 46.2% in the single-unlocked, and 15.4% in the baseball-type closure group). The group with the highest residual myometrial thickness, that is, 5.7 mm, was again the patients who underwent baseball sutures.</p><p><strong>Conclusion: </strong>Uterotomy closure with baseball-type suturing seems to be an advantageous method as compared to the traditional techniques in terms of preserving the residual myometrial thickness and preventing isthmocele formation.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 3","pages":"e20241507"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058197","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 relationship between spexin and liver steatosis in polycystic ovary syndrome: a novel analysis using ultrasound-guided attenuation parameter.","authors":"İzzet Özgürlük, Rasime Pelin Kavak, Berna Turhan, Sümeyya Duran Kaymak, Rabia Şeker, Gülin Feykan Yeğin, İhsaniye Süer Doğan","doi":"10.1590/1806-9282.20241313","DOIUrl":"10.1590/1806-9282.20241313","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the relationship between spexin levels and nonalcoholic fatty liver disease in patients with polycystic ovary syndrome.</p><p><strong>Methods: </strong>The study included 90 participants, comprising 44 patients diagnosed with polycystic ovary syndrome and 46 age- and body mass index-matched controls. Participants' spexin, glucose, urea, alanine aminotransferase, aspartate aminotransferase, total cholesterol, low-density lipoprotein, high-density lipoprotein, triglycerides, progesterone, follicle-stimulating hormone, luteinizing hormone, estradiol, total testosterone, free testosterone, and dehydroepiandrosterone sulfate levels were measured. The liver steatosis grading was done using the ultrasound-guided attenuation parameter from General Electric Healthcare. The parameters were evaluated between the groups.</p><p><strong>Results: </strong>Spexin levels in polycystic ovary syndrome patients were significantly lower compared to the control group (p<0.001). Glucose, triglycerides, luteinizing hormone, total testosterone, free testosterone, and dehydroepiandrosterone sulfate levels were found to be significantly higher in polycystic ovary syndrome patients compared to the control group (p<0.001). High-density lipoprotein levels in polycystic ovary syndrome patients were significantly lower compared to the control group (p<0.001). The prevalence of liver steatosis was notably higher among the polycystic ovary syndrome patients compared to the control group (p<0.001). In patients with polycystic ovary syndrome, spexin levels demonstrated significant negative correlations with body mass index, glucose, triglycerides, luteinizing hormone, total testosterone, free testosterone, and dehydroepiandrosterone sulfate (all p<0.001). A strong negative correlation was observed between spexin levels and liver steatosis grading (p<0.001).</p><p><strong>Conclusion: </strong>Spexin is a coordinator in the metabolic relationship between polycystic ovary syndrome and liver health, suggesting its utility as a biomarker for detecting liver steatosis and related metabolic disturbances in this population.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 2","pages":"e20241313"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766321","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}