Resumo em Inglês:

SUMMARY OBJECTIVE: The objective of this study was to investigate factors influencing intrapartum fever in parturients receiving epidural labor analgesia. METHODS: This study included 410 parturients who received epidural labor analgesia at the authors’ hospital between February 2022 and February 2024. Participants were divided into a fever group (>37.5℃) and a control group (<37.5℃) based on their body temperature post-analgesia. General data, gestational comorbidities, and intrapartum-related conditions were compared. Influencing factors were analyzed using the chi-squared test and logistic regression. RESULTS: Intrapartum fever occurred in 90 parturients (22.0%). Univariate analysis indicated that maternal age (p=0.046), parity (p=0.042), oxytocin use (p=0.041), and timing of analgesia (p<0.001) were associated with intrapartum fever. Multivariate analysis revealed that the timing of analgesia (OR 3.612, 95%CI 1.533–8.510) and amniotic fluid contamination degrees I (OR 1.072, 95%CI 1.012–3.082) and II (OR 2.874, 95%CI 1.901–9.092) were independent risk factors. No significant differences were found between the fever and control groups in body mass index, gestational age, gestational comorbidities, and artificial membrane rupture (p>0.05). Intrapartum fever increased the rate of neonatal fever within 2 h after birth (41.7 vs 18.6%, p<0.05) but did not significantly affect other neonatal health indicators. CONCLUSION: Timing of analgesia and amniotic fluid contamination are significant factors influencing intrapartum fever in parturients receiving epidural labor analgesia.

Resumo em Inglês:

SUMMARY OBJECTIVE: Newborns’ jaundice is the result of bilirubin accumulation as fetal hemoglobin is metabolized by the immature liver. This study aimed to estimate the prevalence of mother-reported newborn jaundice and associated factors. METHODS: A cross-sectional study was carried out using data from a longitudinal study involving 914 children. The data were reviewed using Poisson regression with a robust estimator in a hierarchical model in which the sociodemographic variables constituted the first level, those related to the conditions of the pregnancy constituted the second level, and those related to the report of jaundice, the third level. Prevalence ratios and their relevant confidence intervals were estimated. RESULTS: The prevalence of reported jaundice in newborns was 17.9%. The variables late pregnancy, urinary infection during pregnancy, and preterm and post-term birth were independently statistically associated with a higher prevalence of newborn jaundice reports. CONCLUSION: We can conclude that mother-reported newborn jaundice was 17.9% associated with maternal and birth aspects.

Resumo em Inglês:

SUMMARY OBJECTIVE: This study aims to compare vastus lateralis and ventrogluteal site utilizations concerning pain and fear in intramuscular injection in children between 4 and 6 years of age. METHODS: A randomized trial design was utilized in this study. Groups were randomly assigned as ventrogluteal (n=43) and vastus lateralis (n=40). Children in both groups were compared before, during, and after the procedure using the Children’s Fear Scale and the Wong-Baker Faces Pain Rating Scale. Crying time was measured using a stopwatch during the procedure. RESULTS: While the mean Children’s Fear Scale total scores of the children in the ventrogluteal group were similar before the procedure, the mean Children’s Fear Scale total scores during and after the procedure were significantly lower than the children in the vastus lateralis group. Wong-Baker Faces Pain Rating Scale mean scores were significantly lower in the ventrogluteal group. The mean crying time of the children in the ventrogluteal group was significantly lesser than those in the vastus lateralis group (p=0.000). CONCLUSION: The results of the study showed that the choice of the ventrogluteal site in intramuscular injection in children between 4 and 6 years of age was effective in reducing pain, fear, and crying time.

Resumo em Inglês:

SUMMARY OBJECTIVE: The aim of this study was to examine the utility of the albumin–bilirubin score in cases of intrahepatic cholestasis of pregnancy. METHODS: A total of 413 patients (182 intrahepatic cholestasis of pregnancy, 50 suspected intrahepatic cholestasis of pregnancy, 181 healthy controls) enrolled in this study. Patients with typical pruritus and bile acid levels >10 μmol/L are defined as the intrahepatic cholestasis of pregnancy group. Patients with pruritus have the same pattern as intrahepatic cholestasis of pregnancy, but who are ultimately diagnosed with other dermatoses of pregnancy are defined as suspected intrahepatic cholestasis of pregnancy. Demographic data, laboratory parameters, and albumin–bilirubin scores were compared between three groups. Correlation analysis was performed on the albumin–bilirubin score and bile acid levels. Also, receiver operating curve analyses were performed to evaluate the predictive performance of the albumin–bilirubin score for intrahepatic cholestasis of pregnancy diagnosis. RESULTS: The albumin–bilirubin score of the intrahepatic cholestasis of pregnancy group was significantly higher than the other groups. A positive, weak correlation was found between the albumin–bilirubin score and bile acid levels in the intrahepatic cholestasis of pregnancy group. The receiver operating curve curve analyses showed albumin–bilirubin score has significant performance for the prediction of intrahepatic cholestasis of pregnancy in all subjects (area under the curve: 0.726, 95%CI 0.679–0.774, p<0.001) (sensitivity: 69%, specificity: 64%). The detection rate for albumin–bilirubin score was calculated as 67.3%. The positive predictive value was 3.95% (CI 2.9–5.3%), and the negative predictive value was 98.9% (CI 98.6–99.2%). CONCLUSION: This study indicated higher albumin–bilirubin score levels in the intrahepatic cholestasis of pregnancy group and a positive relationship between serum bile acid levels and albumin–bilirubin score. Therefore, albumin–bilirubin score could be a cost-effective liver function test for pregnant women with intrahepatic cholestasis of pregnancy.

Resumo em Inglês:

SUMMARY OBJECTIVE: The objective of this study was to determine the prevalence of low-body cell mass by sex and age in a community-dwelling population. METHODS: In this retrospective study, 981 community-dwelling adults aged ≥35 years (648 women and 333 men) from Mexico City were recruited in a subway station between February and April 2012. Demographic data, anthropometry, and body composition were assessed, and self-reported comorbidities were recorded in the consulting room. Impedance values were obtained using mono-frequency equipment at 50 kHz. For the diagnosis of low-body cell mass by bioelectrical impedance vectorial analysis: resistance (R, Ohm) and reactance (Xc, Ohm) values were adjusted for height to obtain impedance vector (R/H and Xc/H) and then plotted in the R/Xc to perform the bioelectrical impedance vectorial analysis RXc Z-score analysis. RESULTS: The total prevalence of low body cell mass by bioelectrical impedance vectorial analysis was 29.4% (n=288) with a 95%CI 26.5–32.3%; was higher in men (39%) compared with women (24.4%) (p<0.0001). The group aged>75 years had the highest prevalence (men: 85.3%, p<0.001; women: 63.3%, p<0.001). The bioelectrical impedance vectorial analysis RXc Z-score analysis showed lower cell mass in men aged>75 years (R Z-score −0.30, Xc Z-score −2.13), and women aged 65–74 years also presented with overhydration (Z-score −2.6, Z-score −1.27). CONCLUSION: The prevalence of low body cell mass, evaluated by bioelectrical impedance vectorial analysis, increased with age. RXc Z-score analysis could be a useful tool to evaluate nutritional status and changes in hydration in community-dwelling populations.

Resumo em Inglês:

SUMMARY OBJECTIVE: The aim of this study was to assess the dietary pattern of healthy adult and adolescent women, pregnant and non-pregnant, and relate this profile to clinical and laboratory characteristics. METHODS: A prospective cohort study was carried out with 40 women who met the selection criteria: 10 non-pregnant adults, 10 pregnant adults, 10 non-pregnant adolescents, and 10 pregnant adolescents. Dietary data were collected using a registration form, a 24-h recall, and a food frequency questionnaire. Serum levels of interleukin 6 and tumor necrosis factor α were determined by capture ELISA. RESULTS: The majority of women were married (22.5%), had completed high school (57.5%), and were white (47.5%). Overall, only one (10%) pregnant adult reported smoking. Dietary supplement use was reported by eight (80%) pregnant adults, four (40%) pregnant adolescents, two (20%) non-pregnant adolescents, and no non-pregnant adults. Pregnant adolescents had a higher intake of omega-3 when compared to pregnant adults and non-pregnant adults (p=0.01 and 0.02, respectively). Pregnant adolescents consumed less minimally processed foods than pregnant adults, non-pregnant adults, and non-pregnant adolescents (p=0.008, 0.019, and 0.024, respectively). Serum levels of tumor necrosis factor α and interleukin 6 did not show statistical differences among the four groups (p=0.229 and 0.440, respectively). CONCLUSIONS: The dietary patterns of healthy adult and adolescent women, whether pregnant or not, were similar, with pregnant adolescents having a higher intake of omega-3. Pregnant adolescents ate less in natura (minimally processed) food than all the other women.

Resumo em Inglês:

SUMMARY OBJECTIVE: The objective of this study was to describe the single-surgeon experience on transvaginal natural orifice transluminal endoscopic surgery for uterosacral ligament suspension in patients with severe prolapse who had concomitant vaginal hysterectomy. METHODS: A total of 53 patients with severe uterine prolapse who underwent vaginal hysterectomy and transvaginal natural orifice transluminal endoscopic surgery for uterosacral ligament suspension between January 2021 and March 2023 were included in the study. Operation time, intraoperative and postoperative complications, de novo urinary continence, and duration of hospitalization were obtained from the patient records. Initial postoperative follow-up visits were scheduled for the first week of the month. Patients were followed up yearly, and they had the opportunity to reach the surgical team at any time. Symptomatic prolapse beyond the hymen is defined as recurrence. RESULTS: Patients had a mean age of 61.7 years ±7.7 SD. All patients received bilateral opportunistic salpingectomy and salpingo-oophorectomy. The total operation time was 162±31 min, with transvaginal natural orifice transluminal endoscopic surgery taking 32.3±5.37 min. There were no intraoperative complications. 12 patients had recurrence; 8 anterior, 3 apical, and 1 posterior prolapse. The mean recurrence time was 11.5 months (range 5–23 months). The reoperation rate was 13.2% (n:7). Three of the patients had obliterative vaginal surgery, three of the patients had anterior, and one patient had posterior repair. Overall failure of apical surgical procedure was 5.6%. Two patients had de novo incontinence postoperatively. CONCLUSIONS: Transvaginal natural orifice transluminal endoscopic surgery uterosacral ligament suspension is a feasible technique to treat severe pelvic organ prolapse with promising results for short-term efficacy and safety in patients who had concomitant vaginal hysterectomy. Longer follow-up periods are needed to evaluate the long-term efficacy profile of transvaginal natural orifice transluminal endoscopic surgery for uterosacral ligament suspension.

Resumo em Inglês:

SUMMARY OBJECTIVE: Initially diagnosed as a respiratory disease, SARS-CoV-2 revealed numerous extrapulmonary implications. The aim of this study was to investigate prolonged urinary retention in survivors post-COVID-19 infection that led to hospitalization. METHODS: A retrospective cohort analysis included male and female patients hospitalized during the COVID-19 pandemic in a reference center hospital. Exclusions were patients with a history of lower urinary tract surgeries or symptoms, including urinary incontinence, those using medication affecting detrusor contractile activity, and those with established neurological diseases. Clinical, laboratory, and radiographic data were obtained from medical records and analyzed using chi-square, Fisher's exact, Mann-Whitney, Kruskal-Wallis, and Dunn tests. RESULTS: The study included 834 patients, with 471 (56.5%) male and 363 (43.5%) female. Of these, 300 patients used a urinary catheter, and 12.6% were unable to remove it due to sustained urinary retention. Orotracheal intubation, thrombocytopenia, urinary tract infections, and higher Sequential Organ Failure Assessment scores were associated with urinary retention. Correlation analysis showed that the highest percentage of pulmonary involvement on computed tomography was related to longer catheterization time and failed attempts to remove the catheter, affecting men and women equally. CONCLUSIONS: Urinary tract involvement in COVID-19 infection is increasingly evident. The correlation between COVID-19 severity and failure to remove the urinary catheter in a similar percentage of men and women reinforces the hypothesis that sex-independent urothelial injury and bladder dysfunction might be caused by COVID-19.

Resumo em Inglês:

SUMMARY OBJECTIVE: The objective of this study was to compare the efficacy and safety between ultrasound- and computed tomography-guided pulsed radiofrequency in treating ophthalmic branch postherpetic neuralgia. METHODS: A retrospective study was conducted on data of 84 patients with ophthalmic branch postherpetic neuralgia. According to the puncture guiding method, the patients were divided into the ultrasound- and computed tomography-guided groups, which received the ultrasound- and computed tomography-guided supraorbital nerve pulsed radiofrequency treatment, respectively. The puncture time, numeric rating scale pain score before pulsed radiofrequency and after pulsed radiofrequency, effective rate of treatment, and intraoperative and postoperative adverse events were observed. RESULTS: The puncture time in the ultrasound-guided group was significantly shorter than that in the computed tomography-guided group (p<0.05). At 1, 4, and 12 weeks after pulsed radiofrequency, in two groups, the numeric rating scale pain score was significantly lower than that before pulsed radiofrequency, respectively (p<0.05). At each time, the numeric rating scale pain score showed no significant difference between the two groups (p>0.05). At 12 weeks after pulsed radiofrequency, there was no significant difference in the effective rate of treatment between the two groups (p>0.05). During the intraoperative and postoperative periods, the incidences of adverse event hematoma and oculocardiac reflex in the ultrasound-guided group were significantly lower than those in the computed tomography-guided group, respectively (p<0.05). CONCLUSIONS: Both ultrasound- and computed tomography-guided supraorbital nerve pulsed radiofrequencys have good efficacy in treating the ophthalmic branch postherpetic neuralgia. Compared with the computed tomography-guided pulsed radiofrequency, the ultrasound-guided pulsed radiofrequency has faster puncture operation and is safer. It is more worthy of clinical applications.