Clinics最新文献_第10页

An evidence-based care program in a local healthcare setting in Brazil: Experience and impact 巴西当地医疗保健机构的循证护理方案：经验和影响

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2025.100640

César Ramos Rocha-Filho , Felipe Sebastião de Assis Reis , Aline Rocha , Ana Carolina Pereira Nunes Pinto , Rozana Mesquita Ciconelli

Objective

To provide an overview of the activities and impact of an Evidence-Based Care Program (EBCP) on professionals’ decision-making in a large hospital located in São Paulo, Brazil.

Methods

Retrospective descriptive analysis of a hospital EBCP's database (covering a 40-month period), involving data from the studies conducted and an online feedback survey.

Results

Since its inception, the EBCP performed 95 scientific technical reports, including 55 Rapid Systematic Reviews (RSR) and 40 Literature Reviews (LR). The authors identified 21 review topics, with the 3 most common being inpatients (n = 20), oncology (n = 11), and surgical procedure (n = 9). The 3 most common technologies assessed were medical devices (n = 28), drugs (n = 27), and scale/questionnaire (n = 16). Studies were mainly used to update policy or procedure (n = 59), support scientific research (n = 10), support clinical program development (n = 8), provide clinical guidance (n = 7), or as a communication tool (n = 5). Among the requestors who responded to the feedback survey (76/95), 97 % agreed or strongly agreed that they were satisfied with the review delivered, and 100 % indicated that they likely would request a review in the future and would indicate the EBCP to a coworker. Among the RSR responders (51/55), 94 % agreed or strongly agreed that the EBCP work informed their project or final decision, and 32 % reported that the result presented changed their perspective about the technology assessed.

Conclusion

Employing evidence-based methodology, the program provided timely and pertinent evidence for local decision-making. Health professionals who utilized the EBPC expressed high satisfaction with the process and reported a positive shift in their decision-making.

目的概述巴西圣保罗一家大型医院的循证护理项目（EBCP）对专业人员决策的影响。方法回顾性描述性分析某医院EBCP数据库（涵盖40个月），包括所进行研究的数据和在线反馈调查。结果EBCP自成立以来共完成科学技术报告95份，其中快速系统评价（RSR） 55份，文献评价（LR） 40份。作者确定了21个综述主题，其中3个最常见的是住院患者（n = 20）、肿瘤学（n = 11）和外科手术（n = 9）。评估的3个最常见的技术是医疗器械（n = 28）、药物（n = 27）和量表/问卷（n = 16）。研究主要是用于更新政策或程序(n = 59),支持科学研究(n = 10),支持临床程序开发(n = 8),提供临床指导(n = 7),或作为一种通信工具(n = 5)。在请求者回应调查的反馈(76/95),97%同意或强烈认为他们审查交付满意,100%表示,他们将来可能会请求审查并将表明EBCP同事。在RSR应答者（51/55）中，94%的人同意或强烈同意EBCP工作为他们的项目或最终决策提供了信息，32%的人报告说，所呈现的结果改变了他们对所评估技术的看法。结论项目采用循证方法，为地方决策提供了及时、中肯的证据。使用EBPC的卫生专业人员对这一过程表示高度满意，并报告了他们在决策方面的积极转变。

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引用次数: 0

Medical conduct and knowledge about physical activity counseling in the largest hospital complex in Latin America 拉丁美洲最大的综合医院的医疗行为和身体活动咨询知识

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2025.100666

Débora Borowiak Reiss , Ítalo Ribeiro Lemes , Hamilton Roschel , Bruno Gualano

Objective

To characterize practices and knowledge regarding PA counseling at a large tertiary hospital.

Design

Cross-sectional observational study.

Participants and setting

Physicians with an active medical practice within the university hospital were invited to respond to an online survey.

Interventions

A questionnaire designed to capture information on medical training, life habits and knowledge about PA.

Main outcomes measures

Sedentary behavior, clinical practice and self-efficacy were assessed by Likert-type questions, whereas regular practice, previous training, and knowledge of PA were evaluated through dichotomous questions (answers: “yes or no” or “true or false”).

Results

Response rate was 11.5 % (50.6 % female, 44.9 ± 12.8 years), 67.7 % were physically active, and 63.3 % had 4 to 8 h/day of sedentary behavior. Only 40.7 % had previous training on PA, 99.7 % recognized the importance of recommending PA, but only a small part (48.4 %) recommended PA in all consultations (the main barrier was lack of specific training). In addition, 69.2 %, 58.7 % and 65.5 % rated their abilities to collect PA history, assess contraindications, and engage the patient as good/excellent, respectively. Knowledge of PA was rated as low to very low, with correct answers ranging from 49 % to 17 % and as low as ∼10 % (when considering the pediatric population).

Conclusion

Although physicians recognize the importance of PA counseling and have high perceived self-efficacy in relation to counseling skills, few put them into practice. This may be due to insufficient training on PA and/or the complexity of services provided at the tertiary hospital. The present results corroborate the need for improvements in medical training on PA.

目的了解某大型三级医院心理咨询的实践和知识。设计横断面观察性研究。参与者和在大学医院积极从事医疗实践的医生被邀请参与一项在线调查。干预：一份旨在获取医疗培训、生活习惯和PA知识信息的问卷。主要结果测量：久坐行为、临床实践和自我效能通过李克特问题进行评估，而常规实践、以前的培训和PA知识通过二分法进行评估（答案：“是或否”或“对或错”）。结果有效率为11.5%（50.6%为女性，44.9±12.8岁），67.7%为体力活动，63.3%为4 ~ 8小时/天的久坐行为。只有40.7%的人接受过PA培训，99.7%的人认识到推荐PA的重要性，但只有一小部分（48.4%）的人在所有咨询中推荐PA（主要障碍是缺乏专门的培训）。此外，69.2%、58.7%和65.5%的人分别认为他们收集PA病史、评估禁忌症和与患者接触的能力为良好/优秀。对PA的了解程度从低到非常低，正确率从49%到17%不等，低至10%（考虑到儿科人群）。结论虽然医师认识到心理健康咨询的重要性，并对心理健康咨询技能有较高的自我效能感，但很少有医师将心理健康咨询付诸实践。这可能是由于私人护理培训不足和/或三级医院提供的服务复杂所致。目前的结果证实，需要改进医疗培训的PA。

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引用次数: 0

Assessing pediatric visual acuity with a computerized optokinetic nystagmus analyzer 用计算机化光动力眼球震颤分析仪评估儿童视力

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2025.100671

Boyang Zhu , Min Yang , Xiaonan Liu , Bin Yuan , Yuqian Yin , Che Cheng , Faisal UL Rehman

Objectives

To investigate the practicality, accuracy, and consistency of a computer-based Optokinetic Nystagmus (OKN) analyzer for vision diagnosis in preschoolers.

Design

A comparative study evaluating the performance of a computerized OKN analyzer against the traditional E-word visual acuity chart in assessing visual acuity in preschool children.

Participants

A total of 138 children aged 2 to 6 years were enrolled in the study, divided into five age groups: 2 years (29 children), 3 years (27 children), 4 years (28 children), 5 years (28 children), and 6 years (26 children).

Methods

Visual acuity was tested using both the nystagmus meter and the E-word visual acuity chart. Statistical analyses, including correlation coefficient calculation and chi-square tests, were conducted to evaluate the testability and consistency of the methods.

Results

Out of 138 participants, 125 (90.6 %) successfully completed the test using the computerized OKN analyzer. There was no significant difference in the measurability across different age groups. The testability of the E-word visual acuity chart was significantly lower at 71.0 %. A strong correlation (R = 0.872) was found between the results from the nystagmus meter and the E-word visual acuity chart, indicating high consistency between the two methods.

Conclusion

The computerized OKN analyzer is a reliable, accurate, and practical tool for assessing visual acuity in preschoolers. It offers a non-invasive alternative to traditional methods, with high testability and strong correlation with standard visual acuity tests, making it a valuable tool for early detection of vision impairments in young children.

目的探讨基于计算机的光动力学眼球震颤（OKN）分析仪在学龄前儿童视力诊断中的实用性、准确性和一致性。设计对计算机化OKN分析仪与传统e字视力表在学龄前儿童视力评估中的性能进行比较研究。共有138名2 - 6岁的儿童入组，分为5个年龄组：2岁（29名）、3岁（27名）、4岁（28名）、5岁（28名）和6岁（26名）。方法采用眼球震颤仪和E-word视力表检测视力。统计分析包括相关系数计算和卡方检验来评价方法的可检验性和一致性。结果138名参与者中，125名（90.6%）成功完成了计算机化OKN分析仪的测试。不同年龄组的可测量性无显著差异。E-word视力表的可测性较低，为71.0%。眼球震颤仪测定结果与E-word视力表测定结果具有很强的相关性（R = 0.872），两者具有较高的一致性。结论计算机化OKN分析仪是一种可靠、准确、实用的学龄前儿童视力评估工具。它提供了传统方法的非侵入性替代方法，具有高可测试性和与标准视力测试的强相关性，使其成为早期发现幼儿视力障碍的宝贵工具。

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引用次数: 0

NAT10-mediated N4-acetylcytosine modification promotes the progression of retinoblastoma by improving the HK1 mRNA stability to enhance glycolysis nat10介导的n4 -乙酰胞嘧啶修饰通过提高HK1 mRNA的稳定性促进糖酵解，从而促进视网膜母细胞瘤的进展

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2025.100678

Shan Xu, Xuming Lin, Fengling Jia

Objective

Retinoblastoma (RB) is a type of intraocular tumor in childhood with a high lethality rate. N4-acetylcytosine (ac⁴C) modification is known to regulate multiple cancers, which is mediated by the only known ac⁴C writer N-Acetyltransferase 10 (NAT10). In this study, the authors aimed to reveal the mechanism of RB progression regulated by ac⁴C modification.

Method

Phenotypically, dot blot assay and quantitative real-time PCR were used to detect the ac⁴C levels and NAT10 expression in clinical samples and RB cell lines. Then, NAT10 was knocked down to assess its effect on glycolysis. Mechanically, RNA immunoprecipitation assay, immunofluorescence assay, and dual luciferase report were used to explore the mRNA modified by NAT10-mediated ac⁴C modification. Mice xenograft model was used to determine the effect of NAT10 on tumor growth in vivo.

Results

The present results demonstrated that the levels of ac⁴C and NAT10 were increased in cancer tissues and RB cell lines. Furthermore, NAT10 knockdown inhibited the glycolysis in RB cell lines. Moreover, the authors revealed that NAT10 knockdown decreased the ac⁴C modification and mRNA stability of HK1, while the inhibition of glycolysis by NAT10 knockdown was reversed by HK1 overexpression. Finally, NAT10 knockdown relieved the growth of tumors in mice models.

Conclusion

The authors illustrated that NAT10 plays an important role in the progression of RB by regulating the ac⁴C modification on HK1 mRNA and affects its stability, which may provide a novel theoretical basis for the treatment of RB.

目的视网膜母细胞瘤（RB）是一种致死率高的儿童眼内肿瘤。已知n4 -乙酰胞嘧啶（ac4C）修饰可调节多种癌症，这是由唯一已知的ac4C写入者n -乙酰转移酶10 （NAT10）介导的。在本研究中，作者旨在揭示ac4C修饰调控RB进展的机制。方法采用斑点斑点法和实时荧光定量PCR法检测临床标本和RB细胞株中ac4C水平和NAT10表达。然后，敲低NAT10以评估其对糖酵解的影响。机械上，采用RNA免疫沉淀法、免疫荧光法和双荧光素酶报告法对nat10介导的ac4C修饰的mRNA进行检测。采用小鼠异种移植瘤模型研究NAT10对肿瘤生长的影响。结果肿瘤组织和RB细胞株中ac4C和NAT10水平升高。此外，NAT10敲低可抑制RB细胞株的糖酵解。此外，作者发现NAT10敲低降低了HK1的ac4C修饰和mRNA稳定性，而NAT10敲低对糖酵解的抑制被HK1过表达逆转。最后，NAT10敲低可减轻小鼠模型中肿瘤的生长。结论NAT10通过调控HK1 mRNA的ac4C修饰，影响其稳定性，在RB的进展中发挥重要作用，为RB的治疗提供新的理论依据。

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引用次数: 0

Clinical study of the effect of mometasone furoate nasal spray treatment on hearing and in secretory otitis media in children 糠酸莫米松鼻喷雾剂对儿童听力和分泌性中耳炎影响的临床研究。

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2024.100551

Xiaoyan Yu, Lang Xu, Youqi Xie, Mengjie Huang

Objective

To investigate the effect of Mometasone furoate (Elocon Cream) Nasal Spray (MFNS) treatment on hearing secretory Otitis Media (SOM) in younger children.

Methods

Seventy-six children with SOM (ages 5 to 10 years-old) were selected as study subjects and divided into two groups of 38 cases each using a randomized numerical table. The control group was given conventional treatment, and the observation group was treated with MFNS based on the control group. Both groups were treated for 12 weeks. The improvements in clinical symptoms and hearing were compared between the two groups at weeks 4, 8 and 12 of treatment, respectively.

Results

The total effective rate of treatment in the observation group was higher than that in the control group. The middle ear resonance frequency of the children in the observation group was higher than that of the control group at weeks 4, 8 and 12 of treatment, and the air-conduction hearing threshold was lower than that of the control group. The total effective rate of the observation group after 12-weeks of treatment was 92.11 %, which was significantly higher than that of the control group (73.68 %). In addition, the T-ETDQ score of the observation group was lower than that of the control group after treatment.

Conclusion

MFNS has clinical efficacy in the treatment of SOM in young children, which can improve clinical symptoms, promote the recovery of hearing and eustachian tube function, reduce the local inflammatory response, and improve immune function.

目的：探讨糠酸莫米松（Elocon霜）鼻喷雾剂（MFNS）治疗幼儿听力分泌性中耳炎（SOM）的疗效。方法：选取5 ~ 10岁SOM患儿76例作为研究对象，采用随机数字表法分为两组，每组38例。对照组给予常规治疗，观察组在对照组的基础上给予MFNS治疗。两组均治疗12周。分别在治疗第4周、第8周和第12周比较两组患者临床症状和听力的改善情况。结果：观察组治疗总有效率高于对照组。观察组患儿在治疗第4、8、12周中耳共振频率高于对照组，气传导听阈低于对照组。观察组治疗12周后总有效率为92.11%，显著高于对照组（73.68%）。治疗后观察组T-ETDQ评分低于对照组。结论：MFNS治疗幼儿SOM具有临床疗效，可改善临床症状，促进听力和咽鼓管功能恢复，减轻局部炎症反应，提高免疫功能。

{"title":"Clinical study of the effect of mometasone furoate nasal spray treatment on hearing and in secretory otitis media in children","authors":"Xiaoyan Yu, Lang Xu, Youqi Xie, Mengjie Huang","doi":"10.1016/j.clinsp.2024.100551","DOIUrl":"10.1016/j.clinsp.2024.100551","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the effect of Mometasone furoate (Elocon Cream) Nasal Spray (MFNS) treatment on hearing secretory Otitis Media (SOM) in younger children.</div></div><div><h3>Methods</h3><div>Seventy-six children with SOM (ages 5 to 10 years-old) were selected as study subjects and divided into two groups of 38 cases each using a randomized numerical table. The control group was given conventional treatment, and the observation group was treated with MFNS based on the control group. Both groups were treated for 12 weeks. The improvements in clinical symptoms and hearing were compared between the two groups at weeks 4, 8 and 12 of treatment, respectively.</div></div><div><h3>Results</h3><div>The total effective rate of treatment in the observation group was higher than that in the control group. The middle ear resonance frequency of the children in the observation group was higher than that of the control group at weeks 4, 8 and 12 of treatment, and the air-conduction hearing threshold was lower than that of the control group. The total effective rate of the observation group after 12-weeks of treatment was 92.11 %, which was significantly higher than that of the control group (73.68 %). In addition, the T-ETDQ score of the observation group was lower than that of the control group after treatment.</div></div><div><h3>Conclusion</h3><div>MFNS has clinical efficacy in the treatment of SOM in young children, which can improve clinical symptoms, promote the recovery of hearing and eustachian tube function, reduce the local inflammatory response, and improve immune function.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100551"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

CST1 promoted gastric cancer development by activating the AKT pathway CST1通过激活AKT通路促进胃癌的发展。

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2024.100561

Lei Zhang , Dongmei Wang , Liqun Zhang , Lini Zhu

Background

Gastric Cancer (GC) was the third highest mortality rate among malignant tumors. Currently, no specific treatment is utilized to prevent the progression of GC. The detailed mechanism of GC was still elusive and this study aimed to clarify the mechanism of GC occurrence and development.

Method

This study was performed to clarify the molecular mechanisms of CST1 promoting GC development through activating AKT. The normal gastric tissue cells and GC cell was obtained, followed by transfection with oe-CST1 or sh-CST1, and their apoptosis and viability were evaluated. Finally, Western blot, Flow cytometry assay, Transwell assay, and Scratch assay were used to elucidate the molecular mechanisms of CST1 promoting GC development through activating the AKT pathway.

Results

Research outcomes show a significant elevation in CST1 and AKT protein as well as mRNA quantities in both the model and CST1-activator cohorts in relation to the control. Conversely, these proteins and mRNA concentrations were notably decreased in the presence of the CST1 inhibitor when compared to the model group, a difference that was statistically significant as evidenced by the p-value.

Conclusion

CST1 can promote the gastric cancer process by targeting the AKT pathway.

背景：胃癌是恶性肿瘤中死亡率第三高的肿瘤。目前，尚无专门的治疗方法来预防胃癌的进展。气相色谱的具体机理尚不清楚，本研究旨在阐明气相色谱的发生和发展机理。方法：本研究旨在阐明CST1通过激活AKT促进GC发展的分子机制。取正常胃组织细胞和胃癌细胞，分别转染e- cst1和sh-CST1，观察其凋亡和生存能力。最后，采用Western blot、Flow cytometry、Transwell、Scratch等方法分析CST1通过激活AKT通路促进GC发展的分子机制。结果：研究结果显示，与对照组相比，模型组和CST1激活剂组的CST1和AKT蛋白以及mRNA数量均显著升高。相反，与模型组相比，CST1抑制剂存在时，这些蛋白和mRNA浓度明显降低，p值证明差异具有统计学意义。结论：CST1可通过靶向AKT通路促进胃癌的发生。

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引用次数: 0

Coronavirus disease 2019 infection severity among different variants in children under 2-years old in Brazil 巴西2岁以下儿童不同变异的2019冠状病毒病感染严重程度

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2025.100592

Beatriz Martinelli Menezes Gonçalves , Rossana P.V. Francisco , Ágatha S. Rodrigues , José Carlos Soares Junior

To analyze whether there is a significant difference in the virulence, symptoms, and outcomes of different Coronavirus Disease 2019 (COVID-19) variants in children under 2-years of age. We collected data from the Sistema de Informação de Vigilância Epidemiológica da Gripe, a nationwide Brazilian database on severe acute respiratory syndrome. The patients were classified according to four variants of concern: wild-type, gamma, delta, and omicron. The wild-type variant was defined as the baseline. A total of 11,153 patients were analyzed. The risk of presenting dyspnea (adjusted Odds Ratio[Aor = 1.20], 95 % Confidence Interval [95 % CI 1.07–1.34]) was higher in patients with gamma infection. Respiratory discomfort was more likely to be present for the omicron (Aor = 1.29, 95 % CI 1.15–1.43) and gamma (aOR = 1.26, 95 % CI 1.13–1.41) infections. Desaturation was more likely to be present for the omicron (aOR = 1.67, 95 % CI 1.50–1.86), gamma (aOR = 1.16, 95 % CI 1.43–1.79), and delta (aOR 1.41, CI 95 % 1.18–1.68) infections. Infection by the omicron variant was a protective factor for intubation (aOR = 0.78, 95 % CI 0.67–0.91) and death (aOR = 0.43, 95 % CI 0.35–0.53). Additionally, delta infection was a protective factor against death (aOR = 0.60, 95 % CI 0.43–0.85). The wild-type variant was responsible for most of the cases that evolved with death. Omicron appears to be responsible for milder symptoms than delta. Children between 1 and 6 months of age account for most cases, which is a concern because there is no vaccination coverage.

分析2岁以下儿童不同冠状病毒病2019 （COVID-19）变异的毒力、症状和结局是否存在显著差异。我们从巴西全国严重急性呼吸系统综合征数据库Sistema de informa o de vigilicia Epidemiológica da Gripe收集数据。患者根据关注的四种变异进行分类：野生型、伽玛型、德尔塔型和奥米克隆型。野生型变异被定义为基线。共分析了11153例患者。gamma感染患者出现呼吸困难的风险更高（校正优势比[Aor = 1.20]， 95%可信区间[95% CI 1.07-1.34]）。呼吸不适更可能出现在组粒（Aor = 1.29, 95% CI 1.15-1.43）和γ (Aor = 1.26, 95% CI 1.13-1.41)感染中。去饱和更可能出现于组粒型（aOR = 1.67, 95% CI 1.50-1.86）、γ型（aOR = 1.16, 95% CI 1.43-1.79）和德尔塔型（aOR 1.41, 95% CI 1.18-1.68）感染。组粒变异感染是插管（aOR = 0.78, 95% CI 0.67-0.91）和死亡（aOR = 0.43, 95% CI 0.35-0.53）的保护因素。此外，三角洲病毒感染是预防死亡的保护因素（aOR = 0.60, 95% CI 0.43-0.85）。大多数随着死亡而进化的病例都是野生型变异造成的。欧米克隆引起的症状似乎比德尔塔病毒轻。1至6个月的儿童占大多数病例，这是一个令人关切的问题，因为没有疫苗接种覆盖。

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引用次数: 0

Pharmacological treatment of antidepressant-induced sexual dysfunction in women: A systematic review and meta-analysis of randomized clinical trials 抗抑郁药诱导的女性性功能障碍的药物治疗：随机临床试验的系统回顾和荟萃分析

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2025.100602

Antonio Carlos Queiroz de Aquino , Ayane Cristine Alves Sarmento , Raphaell Lucas de Araújo Teixeira , Tâmilly Nascimento Batista , Cijara Leonice de Freitas , José Manuel Pérez Mármol , Lucia Alves Silva Lara , Ana Katherine Gonçalves

Background

Antidepressant-Induced Sexual Dysfunction (AISD) is a significant public health concern, and pharmacological treatments may offer potential solutions for managing this side effect. This study aims to assess the efficacy of these therapies in treating AISD in women, as well as their impact on improving depressive symptoms.

Methods

The authors conducted a search of PubMed, Cochrane, Scopus, Web of Science, Embase, and ClinicalTrials.gov databases up to July 3, 2024, including Randomized Controlled Trials (RCTs) comparing pharmacological treatments with placebo. The risk of bias was assessed using the Cochrane Risk of Bias tool (RoB 2.0). Data synthesis was performed with RevMan 5.4, and the certainty of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.

Results

Eleven studies, with 859 women, were included in the review. Two studies were used in the meta-analysis. The participants' ages ranged from 28 to 48 years. The interventions studied included Aphrodite, bupropion SR, ephedrine, maca root, rosa damascena, saffron, sildenafil, testosterone, and the compound VML-670. Bupropion SR 150 mg/b.i.d. showed improvements in three sexual function domains: desire (1.74 [1.03, 2.44], p = 0.00001), arousal (1.30 [1.16, 1.43], p = 0.00001), and orgasm (1.90 [1.78, 2.02], p = 0.00001) compared to placebo. However, it did not improve depressive symptoms (0.46 [-0.71, 1.63], p = 0.44). The GRADE rating for the evidence quality was low.

Conclusions

Bupropion SR 150 mg/b.i.d. is the most effective pharmacological treatment for AISD in women, though the evidence quality is low. Further clinical trials focusing on women with rigorous methodologies are needed to strengthen these findings.

PROSPERO registration number

CRD42024496931.

背景：抗抑郁药引起的性功能障碍（AISD）是一个重要的公共卫生问题，药物治疗可能为控制这一副作用提供潜在的解决方案。本研究旨在评估这些疗法治疗女性AISD的疗效，以及它们对改善抑郁症状的影响。方法作者检索了截至2024年7月3日的PubMed、Cochrane、Scopus、Web of Science、Embase和ClinicalTrials.gov数据库，包括比较药物治疗与安慰剂治疗的随机对照试验（RCTs）。使用Cochrane风险偏倚工具（RoB 2.0）评估偏倚风险。使用RevMan 5.4进行数据合成，并使用分级推荐评估、发展和评价（GRADE）方法评估证据的确定性。结果：共有859名女性参与了7项研究。荟萃分析采用了两项研究。参与者的年龄从28岁到48岁不等。研究的干预措施包括阿芙罗狄忒、安非他酮SR、麻黄碱、玛卡根、大马士革玫瑰、藏红花、西地那非、睾酮和化合物VML-670。安非他酮SR 150mg /b.i d。与安慰剂相比，在三个性功能领域表现出改善：欲望（1.74 [1.03,2.44],p = 0.00001），性唤起（1.30 [1.16,1.43],p = 0.00001）和性高潮（1.90 [1.78,2.02],p = 0.00001）。然而，它并没有改善抑郁症状（0.46 [-0.71,1.63],p = 0.44）。证据质量的GRADE评分较低。结论安非他酮SR 150 mg/ bbid是女性AISD最有效的药物治疗方法，尽管证据质量较低。需要以严格的方法对妇女进行进一步的临床试验，以加强这些发现。普洛斯彼罗注册号crd42024496931。

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引用次数: 0

Normal ranges of the fetal weight determined by ultrasound in the population of the Hospital das Clínicas of the Faculdade de Medicina da Universidade de São Paulo <s:1>圣保罗大学医学院das医院人口超声测定胎儿体重的正常范围

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2025.100616

Eliane Azeka Hase, Amanda Amaral, Stela Verzinhasse Peres, Rossana Pulcineli Vieira Francisco

Objective

This study aimed to determine the normal range of fetal weight by ultrasound in pregnant women followed at the Obstetric Clinic of the Hospital das Clínicas of the Faculty of Medicine, University of São Paulo.

Methods

This retrospective cohort study included singleton pregnant women without associated maternal diseases, at 15–41 weeks of gestation, who underwent their last ultrasound up to 7 days before birth. Fetal parameters analyzed for the normal range were biparietal diameter, femur length, head and abdominal circumference. 3rd, 10th, 50th, 90th, and 97th weight percentiles were determined for each gestational age. Newborns were classified by birth weight as Small (SGA), Appropriate (AGA), or Large (LGA) for gestational age.

Results

Among 837 women admitted without maternal diseases, 136 were included and 379 examinations performed at 15–41 weeks of gestation. Multiple linear regression models were generated to develop the normal range of fetal weight. Three equations were selected, and six normal ranges were created considering the total population and stratified by fetal sex. Weight estimates were calculated for the 3rd, 10th, 50th, 90th, and 97th percentiles for each gestational age. Among the 136 newborns, 107 (78.7 %) were classified as AGA, 23 (16.9 %) as SGA, and 6 (4.4 %) as LGA.

Conclusion

The normal range of the fetal weight determined by ultrasound in this population showed a good correlation with gestational age, enabling the fetal weight gain pattern evaluation. The equation based on four parameters, including days before birth, presented the lowest percentage error variation to estimate the normal range.

目的：本研究旨在通过超声确定圣保罗大学医学院Clínicas医院产科门诊孕妇胎儿体重的正常范围。方法本回顾性队列研究纳入了妊娠15-41周无相关母体疾病的单胎孕妇，她们在出生前7天前进行了最后一次超声检查。正常范围内的胎儿参数包括双顶骨直径、股骨长、头围和腹围。测定每个胎龄的第3、第10、第50、第90和第97个体重百分位数。新生儿按出生体重分为小（SGA），适当（AGA），或大（LGA）胎龄。结果837例无孕产妇疾病的住院妇女中，136例纳入，379例在妊娠15 ~ 41周检查。采用多元线性回归模型建立胎儿体重正常范围。选取3个方程，根据总体情况建立6个正常范围，并按胎儿性别分层。计算每个胎龄的第3、第10、第50、第90和第97百分位的体重估计值。136例新生儿中，AGA 107例（78.7%），SGA 23例（16.9%），LGA 6例（4.4%）。结论超声测得的胎儿体重正常范围与胎龄有较好的相关性，可用于胎儿增重模式的评价。该方程基于四个参数，包括出生前天数，呈现出最低百分比的误差变化，以估计正常范围。

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引用次数: 0

A systematic review and meta-analysis of the efficacy and safety of glucocorticoids in the treatment of severe pneumonia 糖皮质激素治疗重症肺炎的有效性和安全性的系统回顾和荟萃分析

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2025.100630

Jingye Liu , Zhiqiang Yang

Objectives

To systematically evaluate the efficacy and superiority of glucocorticoids in the treatment of severe pneumonia.

Method

Randomized Controlled Trials (RCTs) on glucocorticoids in the treatment of severe pneumonia were retrieved from CNKI, CBM, China Science and Technology Journal Database (VIP), Wanfang Database, and PubMed as of January 1, 2017. The literature was independently and objectively screened, extracted, and evaluated by two researchers, and a meta-analysis of the extracted data was performed using Revman 5.3 software.

Results

Ten studies that met the inclusion criteria were included, with a cumulative total of 1120 cases. The meta-analysis results confirmed that the observation group was superior to the control group in terms of efficacy rate, temperature recovery time, cough relief time, rale disappearance time, and serum CRP level. There was no statistically significant difference in terms of the incidence of adverse reactions, mortality rate, and reinfection rate between the two groups.

Conclusions

Glucocorticoids showed an obvious clinical efficacy in patients with severe pneumonia. However, due to the small number of included studies and the ambiguity of numerous bias risk assessments, high-quality and large-sample RCTs are still needed to provide corroborating evidence.

目的系统评价糖皮质激素治疗重症肺炎的疗效和优越性。方法检索截至2017年1月1日的CNKI、CBM、中国科技期刊数据库（VIP）、万方数据库和PubMed中关于糖皮质激素治疗重症肺炎的随机对照试验（RCTs）。由两位研究者独立客观地筛选、提取和评价文献，并使用Revman 5.3软件对提取的资料进行meta分析。结果符合纳入标准的研究共纳入10例，累计1120例。meta分析结果证实，观察组在有效率、体温恢复时间、止咳时间、咳嗽消失时间、血清CRP水平等方面均优于对照组。两组患者不良反应发生率、死亡率、再感染率差异无统计学意义。结论糖皮质激素治疗重症肺炎临床疗效显著。然而，由于纳入的研究数量较少，且许多偏倚风险评估存在模糊性，因此仍需要高质量、大样本的随机对照试验来提供确证。

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引用次数: 0