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Revista da Associação Médica Brasileira, Volume: 70, Número: 6, Publicado: 2024
  • The challenges of female chronic pelvic pain Editorial

  • Panel testing may not be sufficient to reveal the etiology of suspected genetic epilepsy Letter To The Editor

    Finsterer, Josef; Scorza, Fulvio Alexandre
  • There is currently no evidence that high serum leptin and low insulin-like growth factor-1 levels characterise fibromyalgia Letter To The Editor

    Finsterer, Josef; Scorza, Fulvio Alexandre
  • Digital therapeutics and its role in cancer treatment management: current development and future scope Letter To The Editor

    Singh, Akhilesh Vikram
  • Comments on "Investigations of the effects of upper extremity home exercises on grip strength, range of motion, activity performance, and functionality in individuals with systemic sclerosis: a randomized controlled trial" Letter To The Editor

    Patil, Pooja Sunil; Kumar, Amit; Sharma, Shashi Prakash; Guleria, Mahima
  • MTHFR genetic testing: is there a clinical utility? Point Of View

    Planello, Aline Cristiane; Villela, Darine; Loureiro, Thereza
  • Validity and reliability of Turkish pregnant women's preferences for mode of delivery questionnaire Original Article

    Yilmaz, Nurdan Kaya; Evcili, Funda

    Resumo em Inglês:

    SUMMARY OBJECTIVE: The aim of this study was to determine whether Pregnant Women's Preferences for Mode of Delivery Questionnaire, created by Zamani-Alavijeh et al., is a valid and reliable measurement tool for Turkish pregnant women. METHODS: This study has a methodological research design and was conducted with 139 pregnant women who were randomly selected from those aged 18–35 years, who applied to obstetric clinic,.who had no previous prenatal losses and no systemic diseases, and who had conceived naturally. The data for this study were collected with the Personal Information Form and the Pregnant Women's Preferences for Mode of Delivery Questionnaire. To test the reliability and validity of Pregnant Women's Preferences for Mode of Delivery Questionnaire, Cronbach's α, split-half method, item analysis, Kendall's coefficient of agreement (W), explanatory factor analysis, and confirmatory factor were used. RESULTS: The study found that Cronbach's α was 0.94, the Spearman–Brown reliability coefficient was 0.883, and the Guttman split-half was 0.880. Explanatory factor analysis revealed an 18-item structure with three factors having an eigenvalue exceeding 1, explaining 67.593% of the total variability, and factor loading between 0.40 and 0.64. CONCLUSION: Based on the scientific recommendations, the Turkish version of the Pregnant Women's Preferences for Mode of Delivery Questionnaire has adequate psychometric properties.
  • Analysis of long-term family dynamics in mothers who have undergone fetal myelomeningocele surgery using telemedicine: a pilot study Original Article

    Nunes, Tatiane Santos; Araujo Júnior, Edward; Rolo, Liliam Cristine; Sañudo, Adriana; Cavalheiro, Sergio; Moron, Antonio Fernandes

    Resumo em Inglês:

    SUMMARY OBJECTIVE: The aim of this study was to understand the dynamics of families with children with myelomeningocele undergoing intrauterine fetal surgery. METHODS: A retrospective cohort pilot study was carried out with 11 mothers of children who had undergone intrauterine myelomeningocele repair. Participants in this study responded to an electronic questionnaire (via Google Forms), developed by the study authors, that consisted of 22 multiple-choice questions, of which 17 were closed-ended and 5 had a standardized format. RESULTS: The mean (± standard deviation) of the mothers’ age was 37.6 (± 3.5) years. The median of gestational age at delivery and birthweight were 34.9 (range, 33 to 36.1) weeks and 2,300 (range, 1,950 to 2,763) g, respectively. The majority of mothers were white (81.8%), had university degree (81.8%), were Catholic (63.6%), and were married (100%). The majority of mothers rated their relationship with their husband, family, and friends as excellent (54.5, 72.7, and 54.5%, respectively). All 11 mothers reported that the newborn with myelomeningocele was born <37 weeks gestation and the birthweight most often<2,500 g. Approximately 64% of the mothers reported that their child required adaptations or had special needs, of which walking aids (50%) and bladder control (50%) were the most common ones. CONCLUSION: Telemedicine proved to be a useful tool in the long-term follow-up of children who underwent intrauterine surgery to correct myelomeningocele.
  • Isolated polyhydramnios in the third trimester or polyhydramnios secondary to late-onset gestational diabetes: is it worth distinguishing? Original Article

    Özkan, Sadullah; Dereli, Murat Levent; Sucu, Sadun; Varlı, Erol Nadi; Akay, Arife; Uzlu, Safiye Elif; Çağlar, Ali Turhan; Engin-Ustun, Yaprak

    Resumo em Inglês:

    SUMMARY OBJECTIVE: The aim of this study was to compare pregnancy outcomes of patients with polyhydramnios due to late-onset gestational diabetes mellitus and patients with isolated polyhydramnios. METHODS: Of the women who fully participated in prenatal examinations at Etlik Lady Zübeyde Hospital between January 1, 2018, and December 31, 2019, women with polyhydramnios of nonfetal–placental origin manifesting in the third trimester were retrospectively reviewed. Women with normal 75-g oral glucose tolerance test results between 24 and 28 weeks gestation who met the inclusion criteria were enrolled in the study and divided into two groups based on the results of rescreening with the 75-g oral glucose tolerance test for polyhydramnios in the third trimester: women with isolated polyhydramnios (group 1) and women with late-onset polyhydramnios due to gestational diabetes mellitus (group 2). RESULTS: There were a total of 295 participants, of whom 35 (11.8%) were diagnosed with polyhydramnios due to late-onset gestational diabetes mellitus. There were no differences in the main outcomes. Birthweight and gestational age at birth were identified as independent risk factors for predicting composite maternal outcome {[odds ratio (OR)=1.273, 95% confidence interval (CI) 1.063–1.524, p=0.009]} and composite neonatal outcome (OR=0.606, CI 0.494–0.744, p<0.001), respectively. CONCLUSION: Polyhydramnios in late pregnancy without evidence of pregnancy-related causes leading to polyhydramnios may be a sign of late-onset gestational diabetes mellitus in women with a normal prior oral glucose tolerance test. As pregnancy outcomes and management were indifferent, it does not seem necessary or useful to diagnose whether or not late-onset gestational diabetes mellitus is present.
  • Genetic association of the BsmI variant of vitamin D receptor gene with risk of morbid obesity Original Article

    Ozsoy, Seyma; Yigit, Serbulent; Nursal, Ayse Feyda; Ozsoy, Zeki; Dasiran, Mehmet Fatih; Daldal, Emin; Tekcan, Akin

    Resumo em Inglês:

    SUMMARY OBJECTIVE: The aim of this study was to evaluate the vitamin D receptor (VDR) BsmI variant in morbidly obese patients compared with healthy normal controls. METHODS: The study included 103 patients with morbid obesity and 120 healthy individuals serving as normal controls. The DNA samples obtained from blood were genotyped using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. The gender, age, smoking status, triglycerides, total cholesterol, insulin, mean body mass index, and frequency of allele and genotype of the BsmI variant in the VDR gene in morbidly obese patients were evaluated. RESULTS: The body mass index of the patients was 47.14 ± 7.19. The VDR B/B, B/b, and b/b genotype frequencies were 27.2% versus 28.3%; 54.4% versus 50%; and 18.4% versus 21.7% in the morbidly obese patients and the control group, respectively. There was no statistically significant difference between patients and control subjects in the genotype and allele distribution of the VDR BsmI variant (p>0.05). Both patients and control genotype frequencies are consistent with Hardy-Weinberg equilibrium. CONCLUSION: The BsmI variant in the VDR gene may not seem to predispose to morbid obesity in our study population. Further studies with a larger number of subjects are needed to make a more precise evaluation of this relationship.
  • The pregnant women's perception of risks and pregnancy stress levels: a cross-sectional study from Turkey Original Article

    Maharramova, Aytan; Gur, Elif Yagmur

    Resumo em Inglês:

    SUMMARY OBJECTIVE: The aim of this study was to compare pregnant women's perceptions of risk and pregnancy-specific stress levels. METHODS: This cross-sectional descriptive study was conducted with 410 healthy pregnant women at the city hospital located in the east of Turkey. Data were collected via Personal Information Form, Perception of Pregnancy Risk Questionnaire, and Pregnancy Stress Rating Scale. RESULTS: The pregnancy risk perception mean score was 2.43±1.82, and the pregnancy-specific stress mean score was 22.27±12.67. There is a statistically significant and strong positive correlation between the perception of pregnancy risk and pregnancy-specific stress level (p<0.01). Pregnant women's pregnancy risk perception decreased as the duration of marriage and the number of living children increased, and it increased as the gestational week increased (p<0.05). Pregnancy-specific stress decreased as the duration of marriage (p<0.001), the age of the spouse, the number of pregnancies, and the number of living children increased (p<0.01), and it increased as the gestational week increased (p<0.01). CONCLUSION: The pregnant women's perceptions of pregnancy risks and pregnancy-specific stress were low, but pregnancy-specific stresses increased as their perceptions of pregnancy risks increased.
  • Metabolic dysfunction-associated steatotic liver disease prevalence and risk factors in inflammatory bowel disease in tertiary center Original Article

    Oliveira, Lívia dos Remédios Pamplona de; Ribeiro, Tarsila Campanha da Rocha; Mourao Junior, Carlos Alberto; Barra, Maria Antônia de Lima; Silva, Mariana Hippert Gonçalves; Shafee, Luis Pordeus; Zacarias, Sarah Mendes; Campos, Lenilton da Costa; Valério, Helena Maria Giordano; Chebli, Júlio Maria Fonseca

    Resumo em Inglês:

    SUMMARY OBJECTIVE: The aim of this study was to evaluate the prevalence and risk factors related to metabolic dysfunction-associated steatotic liver disease in inflammatory bowel disease patients. METHODS: This is a cross-sectional study conducted on adults with inflammatory bowel disease from 2019 to 2021. Metabolic dysfunction-associated steatotic liver disease encompasses patients with steatosis and at least one cardiometabolic risk factor. Patients with alcohol consumption ≥20 g/day, chronic liver diseases, or methotrexate use were excluded. RESULTS: Almost 140 patients were included: 67.1% were female, with a mean age of 49.7±13.7 years, and 63.6% had Crohn's disease. The mean duration of inflammatory bowel disease was 9.7±7.9 years. Metabolic dysfunction-associated steatotic liver disease was observed in 44.3% and advanced liver fibrosis was excluded in 63.5% by Fibrosis-4. Patients with metabolic dysfunction-associated steatotic liver disease were older (p = 0.003) and had a higher number of metabolic syndrome components (2.9±1.1 versus 1.6±1.0; p<0.001), greater abdominal circumference (p<0.001), and body mass index (p<0.001). The only factor related to inflammatory bowel disease associated with metabolic dysfunction-associated steatotic liver disease was disease duration (11.6±9.5 versus 8.3±6.2; p = 0.017). A higher number of metabolic syndrome components and obesity increase by 2.2 times and an altered waist circumference by 2.6 times the occurrence of metabolic dysfunction-associated steatotic liver disease. CONCLUSION: A high prevalence of metabolic dysfunction-associated steatotic liver disease was observed in patients with inflammatory bowel disease, with the main risk factors being associated with metabolic syndrome predicting it, but not with inflammatory bowel disease features and/or its treatment.
  • Prospective monitoring of patients undergoing radiotherapy during COVID-19 Original Article

    Alves, Denise Ferreira Silva; Rosa, Daniela Dornelles; Finatto, Luciane Borelli; Rigatti, Brenda; Anna, Pedro Tofani Sant'

    Resumo em Inglês:

    SUMMARY OBJECTIVE: The objective of this study was to evaluate the quality of life of consecutive patients undergoing radiotherapy during the coronavirus disease 2019 pandemic at a private hospital in Southern Brazil from September 2020 to September 2021. METHODS: This study was approved by the Research Ethics Board under project number 112 on April 17, 2020, and it was a prospective descriptive cohort study conducted in a Brazilian radiotherapy department from September 2020 to September 2021. It involved the weekly administration of the European Organisation for Research and Treatment of Cancer Questionnaire Core 30 questionnaires via telephone to consecutively assess patients with pathology-proven cancer diagnoses. These questionnaires captured both demographic data and patients' concerns related to the pandemic, providing a comprehensive overview of their quality of life during radiotherapy treatment. RESULTS: In this study, 141 patients were analyzed, predominantly female (69.5%) with an average age of 61 years. Breast and prostate were the most treated sites, accounting for 51 and 19% of cases, respectively. The majority of treatments lasted between 3 and 5 weeks (73.77%). A small fraction (4.26%) tested positive for coronavirus disease 2019. The findings also highlighted a relatively high quality of life, with mean global scores of 77.95 and emotional functioning scores of 87.53, indicating maintained well-being during treatment. CONCLUSIONS: Oncological patients continuing radiotherapy at our center during the pandemic experienced a low coronavirus disease 2019 infection rate and maintained a high quality of life with minimal emotional distress throughout their treatment period.
  • Evaluation of maternal serum fibroblast growth factor-23 levels in fetal growth restriction and gestational hypertensive disease Original Article

    Karacan, Erdener; Turgut, Ümran Kılınçdemir; Büyükbayram, Halil İbrahim; Güney, Mehmet

    Resumo em Inglês:

    SUMMARY OBJECTIVE: The objective of this study was to determine serum fibroblast growth factor-23 levels in preeclampsia, eclampsia, gestational hypertension, and the presence of fetal growth restriction subgroups. METHODS: A total of 55 pregnant women with planned cesarean section were included in this cross-sectional study. They were divided into two groups, namely, control (25) and gestational hypertensive disease (30). The gestational hypertensive disease group was evaluated by dividing it into three subgroups (preeclampsia, eclampsia, and gestational hypertension) according to the clinical and laboratory findings of the disease and two subgroups (presence of fetal growth restriction and absence of fetal growth restriction) according to the birth weight percentile. Demographic parameters, obstetric history, physical examination findings, and laboratory values were evaluated. RESULTS: Demographic parameters and obstetric history were similar between the two groups, while gestational week of delivery was lower in the gestational hypertensive disease group (p=0.002). Laboratory parameters and serum fibroblast growth factor-23 (pg/mL) values were similar between the two groups. In the subgroup analysis for gestational hypertension, preeclampsia, and eclampsia, there was no statistically significant difference in serum fibroblast growth factor-23 levels between gestational hypertension, preeclampsia, eclampsia, and control groups. In the subgroup analysis based on the presence of fetal growth restriction, serum fibroblast growth factor-23 levels were similar to the control group in the gestational hypertensive disease absence of fetal growth restriction, while serum fibroblast growth factor-23 levels and serum calcium levels were statistically significantly lower in the gestational hypertensive disease with the presence of fetal growth restriction (p=0.044 and p<0.001, respectively). Conclusion: Serum fibroblast growth factor-23 levels are similar between pregnancies complicated with gestational hypertensive disease and normotensive pregnancies. However, serum fibroblast growth factor-23 levels were found to be lower in pregnancies complicated with gestational hypertensive disease with the presence of fetal growth restriction.
  • Preoperative promestriene for hysteroscopy: a randomized clinical trial Original Article

    Caetano, Isabela Maciel; Silva Filho, Agnaldo Lopes da; Lamaita, Rivia Mara; Maia, Bernardo Avila; Barroso, Eduardha Santos Temponi; Candido, Eduardo Batista

    Resumo em Inglês:

    SUMMARY OBJECTIVE: Intraoperative complications of hysteroscopy, such as the creation of a false passage, cervix dilatation failure, and uterine perforation, may require suspension of the procedure. Some patients refuse a new procedure, which delays the diagnosis of a possible serious uterine pathology. For this reason, it is essential to develop strategies to increase the success rate of hysteroscopy. Some authors suggest preoperative use of topical estrogen for postmenopausal patients. This strategy is common in clinical practice, but studies demonstrating its effectiveness are scarce. The aim of this study was to evaluate the effect of cervical preparation with promestriene on the incidence of complications in postmenopausal women undergoing surgical hysteroscopy. METHODS: This is a double-blind clinical trial involving 37 postmenopausal patients undergoing surgical hysteroscopy. Participants used promestriene or placebo vaginally daily for 2 weeks and then twice a week for another 2 weeks until surgery. RESULTS: There were 2 out of 14 (14.3%) participants with complications in the promestriene group and 4 out of 23 (17.4%) participants in the placebo group (p=0.593). The complications were difficult cervical dilation, cervical laceration, and vaginal laceration. CONCLUSION: Cervical preparation with promestriene did not reduce intraoperative complications in postmenopausal patients undergoing surgical hysteroscopy.
  • Menopause and metabolic syndrome: anthropometric, lipid, and dietary profiles Original Article

    Gonçalves, Virginia Barros Sgorlon; Lima, Sônia Maria Rolim Rosa

    Resumo em Inglês:

    SUMMARY OBJECTIVE: The aim of this study was to characterize the anthropometric, lipid, and dietary profiles of postmenopausal women with metabolic syndrome attending a public health service and compare them with a group of women without metabolic syndrome. METHODS: A cross-sectional study was conducted with 60 postmenopausal women who were divided into two groups: control group and metabolic syndrome group, attending the Climacteric Outpatient Clinic at Santa Casa de São Paulo Hospital, Brazil, between February 2019 and December 2021. Participants were evaluated using a validated semi-quantitative food frequency questionnaire, body mass index, waist circumference, and serum laboratory tests. RESULTS: Significant differences were observed between the groups regarding body mass index and all parameters of metabolic syndrome. The nutritional profile revealed an imbalance in the number of food portions consumed, particularly in the intake of carbohydrates in the form of flour and sweets, which was higher in the metabolic syndrome group. CONCLUSION: The analysis of the three profiles of postmenopausal women revealed significant imbalances, particularly in the metabolic syndrome group, highlighting the importance of regular adjustments and evaluations during this phase of a woman's life.
  • The role of the Chitinase 3-Like 1 (CHI3L1) genes in the preeclampsia pathophysiology Original Article

    Mammadova, Nigar; Özler, Sibel; Özdemir, Belma Gözde; Avcı, Fazıl; Koçak, Nadir; Çintesun, Ersin; Örgül, Gökçen; Çelik, Çetin

    Resumo em Inglês:

    SUMMARY OBJECTIVE: The aim of this study was to investigate the relationship between Chitinase 3-Like 1 gene polymorphisms and the occurrence of preeclampsia in a selected cohort of pregnant women. METHODS: A total of 75 pregnant women participated in the study, 35 of whom were diagnosed with preeclampsia, while 40 served as healthy controls. The preeclamptic group was subdivided based on severity. Real-time polymerase chain reaction was employed to analyze the serum samples for variations in Chitinase 3-Like 1 gene polymorphisms. RESULTS: The rs880633 polymorphism was found to be significantly more frequent in the control group (80%) compared with the overall preeclamptic group (60%) (p<0.05). In the severity-based subgroups, rs880633 appeared in 57.1% of non-severe and 61.9% of severe preeclamptics. Contrarily, the heterozygous form of rs7515776 polymorphism showed a significantly higher prevalence in the preeclamptic cohort (p<0.05), without distinctions in severity subgroups. CONCLUSION: The study suggests that the rs880633 polymorphism may serve a protective role against the development of preeclampsia, whereas the rs7515776 polymorphism may be associated with an elevated risk. Further research is warranted to elucidate the clinical implications of these findings.
  • The investigation of relationship between serum melatonin levels with Beck Depression Inventory and Beck Scale for Suicidal Ideation in suicide patients Original Article

    Yurtseven, Aynur; Kavalci, Cemil; Aydin, Yasemin Yilmaz; Aydin, Kemal; Demir, Ömer Faruk; Özdemir, Şeyda; Kavalci, Gülsüm

    Resumo em Inglês:

    OBJECTIVE: Melatonin plays a role in many biological and physiological events. There are studies in the literature relating melatonin levels to many psychiatric disorders such as schizophrenia, bipolar disorder, and major depressive disorder. We aimed to investigate the relationship between serum melatonin levels with the Beck Depression Inventory and the Beck Scale for Suicidal Ideation in suicide patients. METHODS: The study was conducted prospectively with volunteer patients aged 20–50 years who were admitted to the emergency department after a suicide attempt. The social and occupational status, educational levels, marital status, and stressor factors of patients were questioned. Beck Depression Inventory and Beck Scale for Suicidal Ideation were applied to each patient included in the study. Blood melatonin levels were evaluated using the enzyme-linked immunosorbent assay method. The data were analyzed with the SPSS 23.00 statistical program. Descriptive values were expressed by the number of cases (n), percentage (%), median (interquartile range), and mean±standard deviation. The Kolmogorov-Smirnov test was used to assess the distribution of continuous variables, and the Pearson or Spearman correlation test was used to assess the relationship between disease severity and melatonin level. A value of p<0.05 was considered statistically significant. RESULTS: No statistically significant correlation was found between melatonin level and the Beck Depression Inventory score (r=-0.098, p=0.44). However, a statistically weak, inverse, and significant correlation was discovered between melatonin levels and the Beck Scale for Suicidal Ideation score (r=-0.465, p=0.00). CONCLUSION: According to our results, it was determined that there was a significant negative relationship between melatonin level and the Beck Scale for Suicidal Ideation scoring.
  • A new insight into the pathway behind spontaneous recurrent pregnancy loss: decreased CYR61 gene expression Original Article

    Firatligil, Fahri Burcin; Yildirir, Burcu Firatligil; Yalcin-Ozuysal, Ozden

    Resumo em Inglês:

    ABSTRACT OBJECTIVE: Investigating the potential role of CYR61 in recurrent pregnancy loss is critical for developing diagnostic approaches and treatments for recurrent pregnancy loss. METHODS: In this prospective case-control study, we have investigated the expression patterns of CYR61 in blood samples from participants with recurrent pregnancy loss in their medical history and control group (n=20 vs n=10). Peripheral blood mononuclear cells from study and control groups were isolated and the expression patterns of the CYR61 gene were determined by real-time semi-quantitative reverse transcriptase PCR. RESULTS: A significant decrease in CYR61 gene expression was demonstrated in patients with two or more clinically recognized miscarriages compared with patients without miscarriages or with a history of miscarriage (p<0.01), which may make the CYR61 gene a potential candidate for predicting the risk of recurrent pregnancy loss. DISCUSSION: This study provides a basis for a detailed investigation of candidate biomarkers and molecular players involved in the development of recurrent pregnancy loss and for the development of potential treatment approaches to prevent recurrent pregnancy loss.
  • Portal thrombosis after surgical treatment of schistosomatic portal hypertension Original Article

    Vasconcellos, Leonardo de Souza; Resende, Vivian; Rodrigues, João Bernardo Sancio Rocha; Petroianu, Andy

    Resumo em Inglês:

    SUMMARY OBJECTIVE: Several studies have investigated the correlation between the effects of different surgical treatments and laboratory exams for schistosomal portal hypertension, especially concerning portal system thrombosis. The etiopathogenic factors of this thrombosis are not fully understood. In this study, the correlation between surgical treatment for schistosomal portal hypertension and the occurrence of postoperative portal system thrombosis was investigated. METHODS: A total of 61 patients who underwent surgical treatment for schistosomal portal hypertension were distributed into four groups: Patients in Group 1 (n=12) underwent portal variceal disconnection associated with splenic artery ligation and spleen preservation. Patients in Group 2 (n=20) underwent portal variceal disconnection and total splenectomy. Patients in Group 3 (n=20) underwent portal variceal disconnection with subtotal splenectomy, preserving the upper splenic pole supplied by the splenogastric vessels. Patients in Group 4 (n=9) underwent portal variceal disconnection with total splenectomy and autogenous splenic implants on the greater omentum. Late postoperative portal vein thrombosis was diagnosed using Doppler ultrasound. RESULTS: Over the 10-year follow-up, portal vein thrombosis occurred in 26 operated patients (42.6%), with no significant difference observed among the four surgical groups (p=0.217). Most of the thrombi only partially occluded the portal system veins. All the patients presented with a thrombus inside the portal vein. There was no difference in hematological and biochemical tests between groups with or without portal vein thrombosis. CONCLUSIONS: Portal vein thrombosis is often observed in the late postoperative period, irrespective of the surgical treatment employed, and is not associated with patient characteristics or any hematological and biochemical tests.
  • Knowledge and awareness level of health undergraduate students on child abuse: a cross-sectional study Original Article

    Üstündağ, Alev; Göktaş, Ayşe; Aytekin, Çiğdem

    Resumo em Inglês:

    SUMMARY OBJECTIVE: The aim of the study was to investigate the level of knowledge of symptoms and risks of child abuse among undergraduate health science students according to their socio-demographic characteristics. METHODS: This is a cross-sectional study involving 485 student volunteers. The data collection tools used in the study were the Demographic Data Collection Form and the Scale for Diagnosing Symptoms and Risks of Child Abuse and Neglect. RESULTS: It was found that health students' knowledge of the symptoms and risks of child abuse was moderate. It was also found that knowledge of diagnosing the symptoms and risks of child abuse was higher among women than among men, higher among those who had received education on child abuse, and increased with grade level. CONCLUSION: Child abuse is an important public health issue, and there is a need to raise awareness of this issue among health students.
  • Effect of Cymbopogon olivieri-based herbal vaginal product on bacterial vaginosis Original Article

    Esmaili, Mitra; Sarhadynejad, Zarrin; Salari, Zohreh; Dehesh, Tania; Lashkarizadeh, Mahdiyeh; Tajadini, Haleh; Kamali, Mohadese

    Resumo em Inglês:

    SUMMARY OBJECTIVE: Bacterial vaginosis is the most common vaginal infection in reproductive-age women. If it is not treated, the quality of life will be reduced. In this study, the herbal medicine product Cymbopogon olivieri was used for its treatment. METHODS: This study was conducted with 90 women. The patients were randomly divided into two groups of 45: Cymbopogon olivieri and metronidazole. The treatment period was 7 days for each group. Improvement status was determined by eliminating at least three out of four of Amsel's criteria. A new variable with two order levels (negative and positive) was constructed. This new variable shows the status of the treatment process. Chi-square and Fisher's exact tests were used to examine the relationship between the new variable and treatment status. RESULTS: The results demonstrate that Cymbopogon olivieri and metronidazole significantly reduced the burning, itching, malodor, abnormal vaginal discharge, pH, clue cell, and positive whiff test (p<0.05). The findings also demonstrate that neither treatment was statistically different from the other for at least three of Amsel's criteria. CONCLUSION: This study shows that the effect of Cymbopogon olivieri on bacterial vaginosis is similar to that of metronidazole. Hence, Cymbopogon olivieri is a suitable option to treat bacterial vaginosis.
  • Biochanin A restored the blood–brain barrier in cerebral ischemia-reperfusion in rats Original Article

    Karaaslanli, Abdulmutalip; Aşir, Fırat; Gürsoy, Görkem Tutal; Tuncer, Mehmet Cudi

    Resumo em Inglês:

    SUMMARY OBJECTIVE: Blood–brain barrier is a protective layer that regulates the influx and efflux of biological materials for cerebral tissue. The aim of this study was to investigate the effects of Biochanin A on cerebral histopathology and blood–brain barrier immunohistochemically. METHODS: A total of 24 rats were assigned to three groups: sham, ischemia-reperfusion, and ischemia-reperfusion+Biochanin A. Ischemia-reperfusion was performed by occluding the left carotid artery for 2/24 h. Notably, 20 mg/kg Biochanin A was administered to rats for 7 days after ischemia-reperfusion. Blood was collected for malondialdehyde and total oxidant/antioxidant status analysis. Cerebral tissues were processed for histopathology and further for immunohistochemical analysis. RESULTS: Malondialdehyde content with total oxidant status value was significantly increased and total antioxidant status values were significantly decreased in the ischemia-reperfusion group compared with the sham group. Biochanin A treatment significantly improved scores in the ischemia-reperfusion+Biochanin A group. The normal histological appearance was recorded in the cerebral sections of the sham group. Degenerated neurons and vascular structures with disrupted integrity of the cerebral cortex were observed after ischemia-reperfusion. Biochanin A alleviated the histopathology in the cerebrum in the ischemia-reperfusion+Biochanin A group. Ischemia-reperfusion injury decreased the expression of blood–brain barrier in the ischemia-reperfusion group compared to the sham group. Administration of Biochanin A upregulated the blood–brain barrier immunoreactivity in the cerebrum by restoring blood–brain barrier. CONCLUSION: Cerebral ischemia-reperfusion caused an increase in oxidative stress and pathological lesions in the cerebrum. Biochanin A treatment restored the adverse effects of ischemia-reperfusion injury by restoring blood–brain barrier.
  • Clinical and uterine cervix characteristics of women with Mycoplasma and Ureaplasma in genital discharge Original Article

    Matos, Margarida Santos; Silva, Maria Clara Andrade Teles da; Brito, Milena Bastos; Gonçalves, Ana Katherine

    Resumo em Inglês:

    SUMMARY OBJECTIVE: The objective of this study was to assess the clinical and uterine cervix characteristics of patients displaying vaginal discharge with positive results for Mycoplasma sp. and/or Ureaplasma spp. METHODS: An analytical cross-sectional study involving women aged 18–45 years was conducted. Microbiological assessments included Ureaplasma and Mycoplasma cultures, as well as human papillomavirus hybrid capture using ecto and endocervix swabs. All tests were two-tailed, and significance was set at p<0.05. RESULTS: Among 324 women, Ureaplasma prevalence was 17.9%, and Mycoplasma prevalence was 3.1%. The Ureaplasma-positive group exhibited a higher frequency of urinary tract infections (39.1 vs. 19%, p=0.002) and human papillomavirus (39.7 vs. 12.8%, p≤0.001) compared with controls. The Mycoplasma-positive group showed a higher frequency of non-contraceptive use compared with controls (66.2 vs. 30.0%, p=0.036). Abnormal colposcopic findings were more prevalent in the Mycoplasma/Ureaplasma-positive group than in controls (positive: 65% vs. control: 35%, p=0.001). Pap smear findings did not differ between the groups. CONCLUSION: Ureaplasma spp. was associated with urinary tract infections and human papillomavirus, while the presence of Mycoplasma sp. was linked to reduced contraceptive use. When analyzing both pathogens together, a higher frequency of abnormal colposcopic findings was observed, with no difference in cytological findings in the positive group.
  • Accuracy of neck circumference in the diagnosis of overweight in children Original Article

    Traebert, Guilherme de Azevedo; Albino, André Legat; Zaidan, Milcia Almeida; Bobinski, Franciane; Ribeiro, Francieli Pereira; Traebert, Eliane; Traebert, Jefferson

    Resumo em Inglês:

    SUMMARY OBJECTIVE: The objective of this study was to estimate the accuracy of measuring neck circumference as a diagnostic method for overweight in 10-year-old children. METHODS: A cross-sectional diagnostic accuracy study was performed in 2019. The population was composed of 942 school children from the municipality of Palhoça, SC, Brazil. For each measurement of the neck circumference, sensitivity, specificity, positive and negative predictive values, likelihood ratio for a positive test, and accuracy were estimated using the receiver operator characteristic curve, with body mass index as a reference. RESULTS: The estimated overall accuracy was 88.9%. For males, the accuracy was 90.1%, and for females, 88.5%. A 30.0 cm neck circumference had a sensitivity of 22.8%, a specificity of 95.4%, a positive predictive value of 76.6%, a negative predictive value of 65.3%, a likelihood ratio for a positive test of 5.0, and an accuracy of 66.7% for all students. CONCLUSION: Neck circumference showed a global accuracy of 88.9% as a method for diagnosing overweight in 10-year-old children. Predictive values showed high values, mainly starting with a neck circumference of 30 cm.
  • The effect of mandala coloring on anxiety and quality of life of women in the climacteric period: a randomized controlled study Original Article

    Kırca, Ayça Şolt; Dağlı, Elif; Derin, Efsun; Aka, Nurettin

    Resumo em Inglês:

    SUMMARY OBJECTIVE: This study was conducted to determine the effect of mandala coloring on anxiety and quality of life of women in the climacteric period. METHODS: This research was conducted as an experimental study based on a randomized controlled pre-test and post-test model (single-blind). The study was conducted with women in the climacteric period who presented to a training and research hospital in a western city of Turkey between November 1, 2022, and April 28, 2023. Participants were divided into mandala coloring (n=38) and control groups (n=38). RESULTS: According to the women's socio-demographic and descriptive characteristics, mean age, body mass index, and frequency of menopausal symptoms were similar in both groups. The mean post-test scores of the women in the mandala coloring group on the state-trait anxiety inventory and menopause-specific quality of life questionnaire vasomotor, psychosocial, physical, and sexual subscales (29.71±5.22, 0.86±0.97, 0.53±0.61, 0.79±0.84, and 0.92±1.24, respectively) were lower than the mean post-test scores of the women in the control group on the same scales (41.02±1.20, 1.79±1.76, 1.49±1.39, 1.72±1.38, and 1.95±1.82, respectively) (p=0.000). CONCLUSION: Mandala coloring reduces menopause-related anxiety levels and improves quality of life effectively.
  • Relationship between polycystic ovary syndrome and high periostin level Original Article

    Eroglu, Semra; Cakmakliogullari, Elcin Kal

    Resumo em Inglês:

    SUMMARY OBJECTIVE: There is growing evidence suggesting a relationship between periostin levels, inflammation, and ovarian dysfunction. In this prospective case-control study, we aimed to investigate serum periostin levels and their relationship with metabolic parameters in patients with polycystic ovary syndrome. METHODS: We conducted a prospective case-control study involving 45 polycystic ovary syndrome patients and 45 control subjects, matched in a 1:1 ratio. Serum samples collected from both study and control groups were analyzed using enzyme-linked immunosorbent assay. RESULTS: The demographic characteristics were similar between the polycystic ovary syndrome and control groups (p>0.05). Periostin levels were significantly higher in patients with polycystic ovary syndrome compared with the control group (4.67±2.46 vs. 2.60±1.41 ng/mL, respectively; p=0.000). CONCLUSION: Our study revealed a significant elevation in periostin levels among polycystic ovary syndrome patients compared with controls. These findings suggest that periostin could serve as a potential marker for assessing disease severity in polycystic ovary syndrome patients.
  • The impact of herbal treatments on cervicovaginal human papillomavirus infection: a systematic review and meta-analysis Original Article

    Gençtürk, Nuran; Karaahmet, Aysu Yildiz; Cömert, Dilan

    Resumo em Inglês:

    SUMMARY OBJECTIVE: This systematic review and meta-analysis aimed to investigate the effects of herbal treatments on cervicovaginal human papillomavirus infection. METHODS: A comprehensive literature search was conducted in PubMed, Scopus, Science Direct, and the Cochrane Library until December 2023, following Cochrane guidelines. Data were analyzed using the Review Manager computer program (Version 5.4.1). RESULTS: Five randomized controlled trials involving a total sample size of 662 women were included in the study. The pooled odds ratio for individuals testing negative for human papillomavirus after herbal intervention among human papillomavirus-positive patients was 1.86 (95% confidence interval (CI) 0.64–5.43), according to the fixed-effects model. Three out of the five studies indicated a significant relationship. The relationship between positive human papillomavirus infection and herbal treatments, measured by the fixed-effects model, resulted in a pooled odds ratio of 0.41 (95%CI 0.17–1.01), reporting a significant association (p=0.05). Subgroup analysis revealed a significant reduction in the relationship between herbal treatment and atypical squamous cells of undetermined significance (OR 0.16, 95%CI 0.03–0.88, p=0.04) but no significant impact on the relationship between herbal treatment and low-grade squamous intraepithelial lesion (OR 0.33, 95%CI 0.01–8.77, p=0.51). CONCLUSION: The meta-analysis suggests that herbal treatments reduce human papillomavirus infections. While herbal treatments show a significant reduction in atypical squamous cells of undetermined significance, they do not significantly impact the regression of low-grade squamous intraepithelial lesions.
  • Efficacy of probiotics, paraprobiotics, and postbiotics in colorectal cancer cell line and their role in immune response Original Article

    Avci, Gülçin Alp; Yilmaz, Ülkü İrem; Avci, Emre

    Resumo em Inglês:

    SUMMARY OBJECTIVE: The aim of this study was to reveal certain features (anti-tumor/microbial activities) of postbiotics and heat-inactivated paraprobiotics obtained from two different bacteria with determined probiotic properties, which are thought to contribute to human health. METHODS: In the study, Lactobacillus reuteri ENA31 and L. rhamnosus GAA6 strains were used. Supernatants of postbiotically active cultures were used. Paraprobiotics were obtained by exposing probiotic bacteria to high temperatures. The cytotoxic effects of probiotics, paraprobiotics, and postbiotics were evaluated by the MTT method. IL-1/-10/-12/-13, TNF-α, IFN-γ, and neopterin parameters were determined via the ELISA method in immunity studies. RESULTS: It was detected that biotics had a cytotoxic effect on cancer cells with rising concentrations (paraprobiotic<probiotic<postbiotics, respectively). Intercalarily, with these biotic applications, a decline in the values of IL-1, IFN-γ, TNF-α, and neopterin and a rise in the values of IL-10/-12/-13 were observed in cancer cells. CONCLUSION: Our study shows that biotics, which are widely used and beneficial to health, are also available for use in immunocompromised individuals. The resulting paraprobiotics and postbiotics will both increase the conscious use of probiotics and provide the opportunity for use in immunocompromised individuals.
  • The first study appraising colonic diverticulosis and Helicobacter pylori diagnosed by histopathology Original Article

    Kuloglu, Ersin; Issever, Kubilay; Muhtaroglu, Ali; Aydın, Gokhan; Aslan, Sefer; Ozturan, Aykut; Sengul, Demet; Cinar, Esma; Dulger, Ahmet Cumhur; Sengul, Ilker

    Resumo em Inglês:

    SUMMARY OBJECTIVE: Colonic diverticulosis might be caused by low-fiber dietary habits, gastrointestinal motility disorders, and colonic wall resistance changes, which might also affect the upper gastrointestinal system mucosa. Therefore, the present study aims to answer whether the gastric histopathological findings of the cases with diverge from those without. METHODS: This retrospective cross-sectional study included 184 cases who underwent both upper and lower gastrointestinal endoscopy procedures between January 2020 and December 2022. Notably, 84 cases were colonic diverticulosis, while the rest of the study group was control. Their demographic, laboratory, and histopathological findings were compared meticulously. RESULTS: The median ages for the colonic diverticulosis and control were 67.07±8.14 and 66.29±15.83 years, respectively, and no statistical difference concerning the age and gender distribution between them was recognized. The median levels of white blood cells, neutrophils, glucose, creatinine, and aspartate aminotransferase in colonic diverticulosis were significantly increased compared to control. As for pathological comparison, colonic diverticulosis had a higher prevalence of Helicobacter pylori (45.2 vs. 38%), while atrophy and intestinal metaplasia prevalence were nearly the same in the groups, without significance regarding Helicobacter pylori. CONCLUSION: Consequently, colonic diverticulosis should not be overlooked, particularly when the abovementioned laboratory parameters are augmented in a dyspeptic patient. A correlation might be raised between Helicobacter pylori and colonic diverticulosis. Eradication therapy might help attenuate the risk of colonic diverticulosis when Helicobacter pylori has emerged in a patient.
  • Polycystic ovary syndrome: emerging stem cell therapies Review Article

    Busari, Karimat Adeola; Tulay, Pinar
Associação Médica Brasileira R. São Carlos do Pinhal, 324, 01333-903 São Paulo SP - Brazil, Tel: +55 11 3178-6800, Fax: +55 11 3178-6816 - São Paulo - SP - Brazil
E-mail: ramb@amb.org.br