Revista da Associacao Medica Brasileira (1992)最新文献

{"title":"Comment on: \"Serologic screening for viral infections among blood donors: a study in a blood bank in southern Brazil\".","authors":"Fatma Yilmaz","doi":"10.1590/1806-9282.20250246","DOIUrl":"10.1590/1806-9282.20250246","url":null,"abstract":"","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 6","pages":"e20250246"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610733","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":"Investigation of predictors of body awareness of pregnant women.","authors":"Aslıhan Turan, Hasan Gerçek, Hafize Dağ Tüzmen, Jule Eriç Horasanli","doi":"10.1590/1806-9282.20241931","DOIUrl":"10.1590/1806-9282.20241931","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to determine the predictors of body awareness in pregnant women.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 149 women in their second and third trimesters of pregnancy in Turkey between August and November 2024. Participants completed a sociodemographic form, the Body Awareness Questionnaire, and the International Physical Activity Questionnaire-Short Form. Multiple linear regression was used to analyze the effects of age, number of pregnancies, gestational weeks, and physical activity levels on body awareness.</p><p><strong>Results: </strong>Participants had a mean age of 27.69±4.82 years, a mean body mass index of 26.59±3.49, and a mean gestational week of 31.97±6.95. The average body awareness score was 92.52±15.48, and the mean physical activity level was 1,084.56±671.93 metabolic equivalent of task-minutes/week. Regression analysis showed that gestational weeks significantly predicted body awareness (β=-0.327, p<0.001), with decreased body awareness observed as the pregnancy progressed. No significant associations were found with age, number of pregnancies, or physical activity levels (p>0.05).</p><p><strong>Conclusion: </strong>Gestational weeks negatively influence body awareness in pregnant women. These findings highlight the importance of developing interventions to enhance body awareness during advanced stages of pregnancy.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 6","pages":"e20241931"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610791","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 pregnant women's perception of traumatic birth and their mode of delivery preference.","authors":"Esra Ünal, Şükrü Can Karaman, Sevim Yildirim, Hatice Aslıhan Hacimuhittinoğullari","doi":"10.1590/1806-9282.20241835","DOIUrl":"10.1590/1806-9282.20241835","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to examine the relationship between pregnant women's perception of traumatic birth and their preference for the mode of delivery.</p><p><strong>Methods: </strong>This cross-sectional study was conducted between April 12, 2023, and June 22, 2023, in the obstetrics and gynecology clinic of a state hospital in Turkey. The study population consisted of pregnant women who applied to the clinic during the study period. The inclusion criteria were being 18 years or older, having a singleton pregnancy between the 20th and 40th gestational weeks, and having no high-risk pregnancy conditions. The exclusion criteria included pregnancy through assisted reproductive techniques and the presence of intellectual disabilities. Participants meeting the inclusion criteria were selected through a non-probability random sampling method. Data were collected using a sociodemographic questionnaire, the traumatic childbirth perception scale, and the belief scale for normal delivery.</p><p><strong>Results: </strong>Among the participants, 71.8% preferred cesarean section over vaginal delivery. A significant negative correlation was found between the perception of traumatic birth and the belief in and preference for vaginal delivery (r=-0.427, p<0.001). Pregnant women with a higher perception of traumatic birth were more likely to choose cesarean delivery.</p><p><strong>Conclusion: </strong>The findings suggest that a higher perception of traumatic birth is associated with a decreased preference for vaginal delivery. Addressing these concerns may help support informed decision-making regarding childbirth.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 6","pages":"e20241835"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610811","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":"Prospective clinical cohort study on the accuracy of magnetic resonance imaging in preoperative staging for cancer of the rectum with node-by-node analysis by pathologists.","authors":"Lucia Ihnát Rudinská, Ilker Sengul, Jozef Škarda, Demet Sengul, Anton Pelikán, Pavel Koscielnik, Peter Ihnát","doi":"10.1590/1806-9282.20250301","DOIUrl":"10.1590/1806-9282.20250301","url":null,"abstract":"<p><strong>Objective: </strong>Multidisciplinary treatment is the standard of care for patients with cancer of the rectum. Neoadjuvant therapy decisions rely on the local carcinoma stage's magnetic resonance imaging assessment. However, the reliability of magnetic resonance imaging in evaluating mesorectal lymphadenopathy remains highly questionable.</p><p><strong>Methods: </strong>A prospective clinical study was conducted to assess the accuracy of preoperative magnetic resonance imaging in assessing T-stage and N-stage rectal carcinoma. The magnetic resonance imaging findings were compared with those of a detailed histopathological examination of rectal specimens in each patient.</p><p><strong>Results: </strong>The study included 48 patients with cancer of the rectum who had undergone rectal resection with total mesorectal excision. The magnetic resonance imaging assessment of the T-stage was accurate in 26 out of the 48 cases (54.2%). Overstaging of the T-stage was recognized in 18 patients (37.5%), and 4 (8.3%) were understaged. According to preoperative magnetic resonance imaging (using Horvat's criteria), 56 suspicious/malignant lymph nodes were identified. However, only 13 (23.2%) of these lymph nodes were proved malignant on histopathology examination. The sensitivity of magnetic resonance imaging for nodal involvement assessment was 52.0% and specificity was 93.6%. Of the 646 magnetic resonance imaging-negative lymph nodes, 12 (1.9%) were false negatives (histopathology revealed metastatic lymph nodes). Of note, 20 study patients with malignant lymphadenopathy (according to magnetic resonance imaging) were detected. The magnetic resonance imaging diagnosis of malignant lymphadenopathy was correct in only 30.0% of these patients.</p><p><strong>Conclusion: </strong>The accuracy of magnetic resonance imaging in evaluating mesorectal lymph nodes for cases with cancer of the rectum is remarkably low. Therefore, neoadjuvant therapy indications should be based primarily on the magnetic resonance imaging description of the depth of carcinoma invasion.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 6","pages":"e20250301"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610804","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":"Opportunistic computed tomography-based sarcopenia screening and mortality after liver transplantation: a systematic review and meta-analysis.","authors":"Daniel Alvarenga Fernandes, Daniel Bohn, Pedro Antune da Silva Pereira, Mila Mucci, Vittor Hugo Andrade Marques, Paula Juliano Lopes de Faria, Elaine Cristina de Ataide, João Rafael Terneira Vicentini, Nelson Marcio Gomes Caserta, Ilka de Fátima Santana Ferreira Boin","doi":"10.1590/1806-9282.20241672","DOIUrl":"10.1590/1806-9282.20241672","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate the diagnosis of sarcopenia in chronic liver disease by opportunistic computed tomography screening using the Psoas Muscle Index method as a predictor of mortality after liver transplantation.</p><p><strong>Methods: </strong>We systematically searched PubMed, Scopus, and Cochrane Central Register of Controlled Trials from July 2014 to July 2024. We restricted inclusion in this meta-analysis to observational studies and clinical trials on adult patients with chronic liver disease diagnosed with sarcopenia by computed tomography undergoing liver transplantation or on a waiting list. We included the one with a larger sample size for studies with overlapping populations. We excluded studies with therapeutic interventions, animal experiments, cell-line studies, editorial pieces, commentaries, review articles, and case reports.</p><p><strong>Results: </strong>After the removal of duplicate records and ineligible studies, 163 remained and were thoroughly reviewed based on inclusion criteria. Of these, a total of 11 studies were included in qualitative synthesis and four studies were included in quantitative analysis (meta-analysis), comprising 382 patients. Patients with muscle mass loss after liver transplantation diagnosed by computed tomography scan using the Psoas Muscle Index method had a 4.1 times higher risk of death than non-sarcopenic patients (random-effects model: OR 4.1386; 95%CI 2.4215-7.0730; p<0.0001). Interpretatively, a scale with an I2 value close to 0% indicates no heterogeneity. The other criteria also did not reject the hypothesis of homogeneity among the articles.</p><p><strong>Conclusions: </strong>Patients with muscle mass loss diagnosed by computed tomography using the Psoas Muscle Index method had a fourfold increased mortality risk after transplantation. The findings reinforce the need to identify sarcopenic patients preoperatively to optimize liver transplantation outcomes. Using the Psoas Muscle Index, an opportunistic diagnosis by computed tomography scan can be helpful in this setting.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 6","pages":"e20241672"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610794","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":"Nutritional status and prognosis in metastatic colorectal cancer: a cohort study.","authors":"Tanju Kapagan, Nilufer Bulut, Beyza Arslansoy, Zozan Ozcalimli, Mehmet Turkmencalikoglu, Ece Yontan, Cagla Ecem Kılıc, Beyza Canan Ozkan Kardes, Gokmen Umut Erdem","doi":"10.1590/1806-9282.20250238","DOIUrl":"10.1590/1806-9282.20250238","url":null,"abstract":"<p><strong>Objective: </strong>Colorectal cancer is a common and often fatal malignancy, and predicting survival can help guide treatment decisions. This study aimed to investigate the impact of clinicopathological characteristics and nutritional status on survival in patients with metastatic colorectal cancer receiving first-line treatment with 5-fluorouracil in combination with monoclonal antibodies (bevacizumab, cetuximab, or panitumumab).</p><p><strong>Methods: </strong>This prospective, non-interventional, observational, single-center study included 150 adult patients with metastatic colorectal cancer undergoing first-line therapy. Demographic data, cancer-related characteristics, laboratory parameters, and nutritional status assessed via the Mini Nutritional Assessment-Short Form were recorded prior to treatment initiation. Mini Nutritional Assessment-Short Form scores of 12-14, 8-11, and 0-7 were used to define normal nutritional status, risk of malnutrition, and malnutrition, respectively.</p><p><strong>Results: </strong>The mean ages of patients without and with malnutrition were 60±11 and 62±11 years, respectively. Median progression-free survival and overall survival were 12 and 22 months, respectively. Multivariate analysis identified alcohol history (HR=2.83; 95%CI 1.27-6.34; p=0.011) and Mini Nutritional Assessment-Short Form≤7 (HR=1.93; 95%CI 1.09-3.45; p=0.025) as significant predictors of shorter progression-free survival. Mini Nutritional Assessment-Short Form ≤7 (HR=2.96; 95%CI 1.80-4.89; p<0.001) was also significantly associated with decreased overall survival.</p><p><strong>Conclusion: </strong>Among patients with metastatic colorectal cancer receiving first-line therapy, malnutrition (Mini Nutritional Assessment-Short Form≤7) and a history of alcohol use were associated with poorer survival outcomes. These findings underscore the importance of routine nutritional assessment and support the need for further prospective multicenter studies to validate these results.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 6","pages":"e20250238"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610793","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":"Fetal mortality before and during the COVID-19 pandemic: a single-center cohort study in Rio de Janeiro, Brazil.","authors":"Gustavo Yano Callado, Edward Araujo Júnior, Carolina Aquino Guedes Ramos, José Maria Andrade Lopes, Danielle Negri, Maria Elizabeth Lopes Moreira, Renato Augusto Moreira de Sá","doi":"10.1590/1806-9282.20250382","DOIUrl":"10.1590/1806-9282.20250382","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to compare the characteristics of pregnancies that resulted in fetal death before and during the COVID-19 pandemic in a private maternity hospital in Rio de Janeiro, Brazil.</p><p><strong>Methods: </strong>This retrospective cohort study considered all pregnancies that ended in fetal death in a private maternity hospital in Rio de Janeiro, Brazil, from January 2018 to December 2021. Maternal and fetal characteristics were compared between the periods before the pandemic and during the pandemic. Data were extracted from electronic medical records, and statistical analyses included Student's t-test, chi-square test, and Fisher's exact test where applicable.</p><p><strong>Results: </strong>Among 41,162 deliveries at Casa de Saúde Perinatal, 88 (0.21%) resulted in fetal death, with 38 (43.2%) occurring pre-pandemic (2018-March 2020) and 50 (56.8%) during the pandemic (March 2020-2021). Maternal demographics, comorbidities, and prepartum complications showed no statistically significant differences between groups. COVID-19 infection was identified in 12% of the pandemic-group pregnancies, but no significant disparities in fetal death causes or abnormalities were found.</p><p><strong>Conclusions: </strong>No significant differences were observed in maternal or fetal characteristics, prepartum complications, or fetal mortality rates between the pre-pandemic and pandemic periods in this private hospital setting. However, this does not reflect the broader Brazilian healthcare reality, where disparities in access and resources may have influenced outcomes differently.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 6","pages":"e20250382"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610788","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":"Role of epiregulin levels in polycystic ovary syndrome patients: new findings and clinical significance.","authors":"Senay Topsakal, Fatih Altıntas, Guzin Fidan Yaylali, Semin Melahat Fenkci, Sadettin Caliskan","doi":"10.1590/1806-9282.20242048","DOIUrl":"10.1590/1806-9282.20242048","url":null,"abstract":"<p><strong>Objective: </strong>Polycystic ovary syndrome, a prevalent endocrine disorder in reproductive-age women, is characterized by polycystic ovaries, oligoanovulation, and hyperandrogenemia. Epiregulin is a member of the epidermal growth factor (EGF) family, playing a crucial role in processes such as cell growth, differentiation, and proliferation. It is also known to be involved in reproductive system-specific mechanisms, including ovulation and oocyte maturation. This study aimed to investigate the role of epiregulin, an EGF family member implicated in ovulation and oocyte maturation, in women with polycystic ovary syndrome.</p><p><strong>Methods: </strong>Serum epiregulin levels were analyzed in 39 women with polycystic ovary syndrome and 28 healthy controls. Associations between epiregulin and clinical/metabolic parameters such as body mass index, insulin resistance, and androgen levels were assessed.</p><p><strong>Results: </strong>Women with polycystic ovary syndrome exhibited significantly lower epiregulin levels compared to controls (p<0.001). Epiregulin levels showed a negative correlation with polycystic ovary syndrome status and were inversely associated with body mass index, waist circumference, Homeostatic Model Assessment Insulin Resistance, triglycerides, fasting insulin, fasting glucose, and testosterone.</p><p><strong>Conclusion: </strong>Reduced epiregulin levels may contribute to the pathophysiology of polycystic ovary syndrome, highlighting its potential as a biomarker and therapeutic target. Further studies are needed to explore the underlying mechanisms and clinical implications.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 6","pages":"e20242048"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610807","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":"Health outcomes of umbilical cord clamping techniques in preterm neonates: meta-analysis.","authors":"Fatma Şule Bilgiç, Aysu Yıldız Karaahmet, Altan Alaybeyoğlu","doi":"10.1590/1806-9282.20241480","DOIUrl":"10.1590/1806-9282.20241480","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to determine the effect of umbilical cord clamping time and milking on blood parameters in preterm neonates.</p><p><strong>Methods: </strong>A literature search was conducted between July and September 2024 in four databases. The search was performed using MeSH-based keywords.</p><p><strong>Results: </strong>In this study, the results of 14 studies covering a total of 1,609 preterm neonates were analyzed. Follow-up after intervention showed no statistically significant difference in hemoglobin (standardized mean difference=0.22, 95%CI 0.04-0.48, Z=1.65, p=0.10) and bilirubin (standardized mean difference=0.22, 95%CI 0.30-0.74, Z=0.82, p=0.41) between the groups. There was a statistically significant difference in ferritin (standardized mean difference=0.73, 95%CI 0.30-1.15, Z=3.37, p=0.00008) and hematocrit (standardized mean difference=0.30, 95%CI 0.05-0.54, Z=2.41, p=0.02) values, and the effect size was positive. According to the subgroup analysis of the combined results of the studies, it was seen that there was no statistically significant difference in the adverse health outcomes in preterms (OR 0.92, 95%CI 0.74-1.15, Z=0.72, p=0.47).</p><p><strong>Conclusion: </strong>From the analysis, it can be observed that late cord clamping and cord milking can prevent premature anemia by increasing hematocrit and ferritin formation in preterm newborns.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 5","pages":"e20241480"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610710","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":"Sleep deprivation in third-trimester pregnancies is multi-causal and requires careful differential consideration.","authors":"Carla Alexandra Scorza, Fulvio Alexandre Scorza, Josef Finsterer","doi":"10.1590/1806-9282.20241690","DOIUrl":"10.1590/1806-9282.20241690","url":null,"abstract":"","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 5","pages":"e20241690"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12172522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328268","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}