Pub Date : 2023-07-17eCollection Date: 2023-01-01DOI: 10.1590/1806-9282.20230500
Georgeana Debs Guesine, Marina Carvalho Paschoini, Giselle Agreli Melo, Edward Araujo Júnior, Alberto Borges Peixoto
Objective: This study aimed to assess adverse maternal and perinatal outcomes in parturients undergoing labor analgesia.
Methods: This was a retrospective cohort study in parturients who underwent labor analgesia. Parturients were categorized into three groups: Group 1 (n=83)-analgesia performed with cervical dilatation ≤4.0 cm; Group 2 (n=82)-analgesia performed with cervical dilatation between 5.0 and 8.0 cm; and Group 3 (n=83)-analgesia performed with cervical dilatation ≥9.0 cm.
Results: Analgesia in parturients with cervical dilatation ≥9.0 cm showed a higher prevalence and a 3.86-fold increase (OR 3.86; 95%CI 1.50-9.87; p=0.009) in the risk of forceps delivery. Analgesia in parturients with cervical dilatation ≤4.0 cm showed a higher prevalence and a 3.31-fold increase (OR 3.31; 95%CI 1.62-6.77; p=0.0016) in the risk of cesarean section. Analgesia in parturients with cervical dilatation ≥9.0 cm was associated with a higher prevalence of fetal bradycardia (20.7%), a need for neonatal oxygen therapy (6.1%), and a need for admission to a neonatal intensive care unit (4.9%). Analgesia in parturients with cervical dilatation ≤4 cm was associated with a higher prevalence of Apgar score <7 at 1st minute (44.6%).
Conclusion: Performing labor analgesia in parturients with cervical dilatation ≤4.0 or ≥9.0 cm was associated with a higher prevalence of adverse maternal and perinatal outcomes.
{"title":"Labor analgesia and its impact on the maternal and perinatal outcomes.","authors":"Georgeana Debs Guesine, Marina Carvalho Paschoini, Giselle Agreli Melo, Edward Araujo Júnior, Alberto Borges Peixoto","doi":"10.1590/1806-9282.20230500","DOIUrl":"10.1590/1806-9282.20230500","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess adverse maternal and perinatal outcomes in parturients undergoing labor analgesia.</p><p><strong>Methods: </strong>This was a retrospective cohort study in parturients who underwent labor analgesia. Parturients were categorized into three groups: Group 1 (n=83)-analgesia performed with cervical dilatation ≤4.0 cm; Group 2 (n=82)-analgesia performed with cervical dilatation between 5.0 and 8.0 cm; and Group 3 (n=83)-analgesia performed with cervical dilatation ≥9.0 cm.</p><p><strong>Results: </strong>Analgesia in parturients with cervical dilatation ≥9.0 cm showed a higher prevalence and a 3.86-fold increase (OR 3.86; 95%CI 1.50-9.87; p=0.009) in the risk of forceps delivery. Analgesia in parturients with cervical dilatation ≤4.0 cm showed a higher prevalence and a 3.31-fold increase (OR 3.31; 95%CI 1.62-6.77; p=0.0016) in the risk of cesarean section. Analgesia in parturients with cervical dilatation ≥9.0 cm was associated with a higher prevalence of fetal bradycardia (20.7%), a need for neonatal oxygen therapy (6.1%), and a need for admission to a neonatal intensive care unit (4.9%). Analgesia in parturients with cervical dilatation ≤4 cm was associated with a higher prevalence of Apgar score <7 at 1st minute (44.6%).</p><p><strong>Conclusion: </strong>Performing labor analgesia in parturients with cervical dilatation ≤4.0 or ≥9.0 cm was associated with a higher prevalence of adverse maternal and perinatal outcomes.</p>","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"69 7","pages":"e20230500"},"PeriodicalIF":1.2,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9c/83/1806-9282-ramb-69-07-e20230500.PMC10352013.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9844458","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}
Pub Date : 2023-07-17eCollection Date: 2023-01-01DOI: 10.1590/1806-9282.20230182
Jeisiane Acsa Santos do Nascimento, Nayara Ribeiro Máximo de Almeida, Francisco Costa da Rocha, Johnnatas Mikael Lopes, Marcello Barbosa Otoni Gonçalves Guedes
Dear Editor, Atherosclerosis is an inflammatory vascular disease, caused by the deposition of cells, lipids, and tissue debris in the vascular intimal layer. Among the risk factors for this disease are sedentary lifestyle, poor diet, systemic arterial hypertension, and smoking1. Psoriasis is a common chronic inflammatory disease of the skin, with characteristic features of erythematous plaques demarcated by whitish scales. It is not only restricted to skin involvement but can also affect joints and other organs. Thus, psoriasis is not a specifically dermatological pathology but a systemic one, as demonstrated in studies that indicate a higher prevalence of diabetes and cardiovascular disease correlated with the severity of psoriasis2. Thus, when reading the article by Ozisler C, Kaplanoglu H, Sandikci SC, Ozisler Z, entitled “Evaluation of subclinical atherosclerosis by ultrasound radiofrequency data technology in patients with psoriatic arthritis,”3 one can see the importance of highlighting elements relevant to the management of psoriatic arthritis, atherosclerosis. Thus, the magnitude of the structural differences in the arteries between the group with psoriasis and the control is notorious. Hence, when comparing the variables in Table 2 of the aforementioned article, through the calculation of Cohen’s d, it is possible to show that in all of them there are effects considered to have a moderate to very large real impact. In view of this, it is possible to conclude that these probabilistic and structural measurement differences may have diagnostic or prognostic utility. However, they are still just differences. Furthermore, the identification of structural alterations still in the preclinical phase can reduce the incidence of cases with clinical manifestations and, therefore, false positives and overdiagnoses4. Therefore, the finding of greater thickening and stiffness in the structure of the carotid artery in individuals with psoriasis, as well as this identified subclinical state, need to be clarified as really pathological in view of their possible impacts on the outcomes of clinical manifestation and death. Thus, it is worth mentioning that the indiscriminate use of diagnostic/prognostic tests without estimated effectiveness on the prescription and therapeutic results causes psychological, financial, and physical loss to individuals undergoing unnecessary treatments, in addition to excessive costs to the health system. We therefore recommend that future studies should focus on the follow-up of individuals with psoriasis, assessing the difference in outcomes under and without treatment, and in the population, in which atherosclerosis and psoriasis do not coexist.
{"title":"Radiofrequency us and overdiagnosis of atherosclerosis in individuals with psoriatric arthritis.","authors":"Jeisiane Acsa Santos do Nascimento, Nayara Ribeiro Máximo de Almeida, Francisco Costa da Rocha, Johnnatas Mikael Lopes, Marcello Barbosa Otoni Gonçalves Guedes","doi":"10.1590/1806-9282.20230182","DOIUrl":"10.1590/1806-9282.20230182","url":null,"abstract":"Dear Editor, Atherosclerosis is an inflammatory vascular disease, caused by the deposition of cells, lipids, and tissue debris in the vascular intimal layer. Among the risk factors for this disease are sedentary lifestyle, poor diet, systemic arterial hypertension, and smoking1. Psoriasis is a common chronic inflammatory disease of the skin, with characteristic features of erythematous plaques demarcated by whitish scales. It is not only restricted to skin involvement but can also affect joints and other organs. Thus, psoriasis is not a specifically dermatological pathology but a systemic one, as demonstrated in studies that indicate a higher prevalence of diabetes and cardiovascular disease correlated with the severity of psoriasis2. Thus, when reading the article by Ozisler C, Kaplanoglu H, Sandikci SC, Ozisler Z, entitled “Evaluation of subclinical atherosclerosis by ultrasound radiofrequency data technology in patients with psoriatic arthritis,”3 one can see the importance of highlighting elements relevant to the management of psoriatic arthritis, atherosclerosis. Thus, the magnitude of the structural differences in the arteries between the group with psoriasis and the control is notorious. Hence, when comparing the variables in Table 2 of the aforementioned article, through the calculation of Cohen’s d, it is possible to show that in all of them there are effects considered to have a moderate to very large real impact. In view of this, it is possible to conclude that these probabilistic and structural measurement differences may have diagnostic or prognostic utility. However, they are still just differences. Furthermore, the identification of structural alterations still in the preclinical phase can reduce the incidence of cases with clinical manifestations and, therefore, false positives and overdiagnoses4. Therefore, the finding of greater thickening and stiffness in the structure of the carotid artery in individuals with psoriasis, as well as this identified subclinical state, need to be clarified as really pathological in view of their possible impacts on the outcomes of clinical manifestation and death. Thus, it is worth mentioning that the indiscriminate use of diagnostic/prognostic tests without estimated effectiveness on the prescription and therapeutic results causes psychological, financial, and physical loss to individuals undergoing unnecessary treatments, in addition to excessive costs to the health system. We therefore recommend that future studies should focus on the follow-up of individuals with psoriasis, assessing the difference in outcomes under and without treatment, and in the population, in which atherosclerosis and psoriasis do not coexist.","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"69 7","pages":"e20230182"},"PeriodicalIF":1.4,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/08/c8/1806-9282-ramb-69-07-e20230182.PMC10351989.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10042549","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}
Pub Date : 2023-07-17eCollection Date: 2023-01-01DOI: 10.1590/1806-9282.20230412
Ricardo Augusto Leoni De Sousa, Ricardo Cardoso Cassilhas
{"title":"Microglia role as the regulator of cognitive function.","authors":"Ricardo Augusto Leoni De Sousa, Ricardo Cardoso Cassilhas","doi":"10.1590/1806-9282.20230412","DOIUrl":"10.1590/1806-9282.20230412","url":null,"abstract":"","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"69 7","pages":"e20230412"},"PeriodicalIF":1.2,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/85/f1/1806-9282-ramb-69-07-e20230412.PMC10352012.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9947123","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}
Pub Date : 2023-06-26eCollection Date: 2023-01-01DOI: 10.1590/1806-9282.20230175
Giovanna Santos Cavalcanti, Kátia Cândido Carvalho, Cecília da Silva Ferreira, Peter Andre Chedraui Alvarez, Pedro Augusto Araújo Monteleone, Edmund Chada Baracat, José Maria Soares Júnior
{"title":"Granulosa cells and follicular development: a brief review.","authors":"Giovanna Santos Cavalcanti, Kátia Cândido Carvalho, Cecília da Silva Ferreira, Peter Andre Chedraui Alvarez, Pedro Augusto Araújo Monteleone, Edmund Chada Baracat, José Maria Soares Júnior","doi":"10.1590/1806-9282.20230175","DOIUrl":"10.1590/1806-9282.20230175","url":null,"abstract":"","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"69 6","pages":"e20230175"},"PeriodicalIF":1.4,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/02/b9/1806-9282-ramb-69-06-e20230175.PMC10305830.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9741308","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}
Pub Date : 2023-05-19eCollection Date: 2023-01-01DOI: 10.1590/1806-9282.20230091
André Pontes-Silva, Karolayne Dos Santos Lima, Cassius Iury Anselmo-E-Silva, André Luiz Lopes, Aldair Darlan Santos-de-Araújo
{"title":"Comments on \"Effect of coolant spray on rib fracture pain of geriatric blunt thoracic trauma patients: a randomized controlled trial\".","authors":"André Pontes-Silva, Karolayne Dos Santos Lima, Cassius Iury Anselmo-E-Silva, André Luiz Lopes, Aldair Darlan Santos-de-Araújo","doi":"10.1590/1806-9282.20230091","DOIUrl":"10.1590/1806-9282.20230091","url":null,"abstract":"","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"69 5","pages":"e20230091"},"PeriodicalIF":1.2,"publicationDate":"2023-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/00/19/1806-9282-ramb-69-05-e20230091.PMC10204835.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9878863","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}
Pub Date : 2023-05-15eCollection Date: 2023-01-01DOI: 10.1590/1806-9282.20221009
Gisele Vissoci Marquini, Letícia Maria de Oliveira, Claudia Cristina Takano, Marcia Maria Dias, Eduarda Vilela Silva, Ana Beatriz Amorim Nunes, Zsuzsanna Ilona Katalin de Jármy-Di Bella, Marair Gracio Ferreira Sartori
{"title":"Feminization of science: female pioneering in the healthcare area.","authors":"Gisele Vissoci Marquini, Letícia Maria de Oliveira, Claudia Cristina Takano, Marcia Maria Dias, Eduarda Vilela Silva, Ana Beatriz Amorim Nunes, Zsuzsanna Ilona Katalin de Jármy-Di Bella, Marair Gracio Ferreira Sartori","doi":"10.1590/1806-9282.20221009","DOIUrl":"10.1590/1806-9282.20221009","url":null,"abstract":"","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"69 6","pages":"e20221009"},"PeriodicalIF":1.2,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/40/3b/1806-9282-ramb-69-06-e20221009.PMC10185045.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9520406","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}
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