Pub Date : 2024-05-20eCollection Date: 2024-01-01DOI: 10.31744/einstein_journal/2024AO0514
José Paulo de Siqueira Guida, Tábata Zumpano Dias, Giuliane Jesus Lajos, Marcelo Luis Nomura, Rodolfo de Carvalho Pacagnella, Ricardo Porto Tedesco, Patricia Moretti Rehder, Samira Haddad, Maria Helena Sousa, Renato Passini Junior, José Guilherme Cecatti, Maria Laura Costa
Objective: This study aimed to evaluate the prevalence of hypertensive disorders during pregnancy among Brazilian women with preterm births and to compare the epidemiological characteristics and perinatal outcomes among preterm births of women with and without hypertension.
Methods: This was a secondary cross-sectional analysis of the Brazilian Multicenter Study on Preterm Birth. During the study period, all women with preterm births were included and further split into two groups according to the occurrence of any hypertensive disorder during pregnancy. Prevalence ratios were calculated for each variable. Maternal characteristics, prenatal care, and gestational and perinatal outcomes were compared between the two groups using χ2 and t-tests.
Results: A total of 4,150 women with preterm births were included, and 1,169 (28.2%) were identified as having hypertensive disorders. Advanced maternal age (prevalence ratio (PR) 2.49) and obesity (PR= 2.64) were more common in the hypertensive group. The gestational outcomes were worse in women with hypertension. Early preterm births were also more frequent in women with hypertension.
Conclusion: Hypertensive disorders of pregnancy were frequent among women with preterm births, and provider-initiated preterm births were the leading causes of premature births in this group. The factors significantly associated with hypertensive disorders among women with preterm births were obesity, excessive weight gain, and higher maternal age.
{"title":"Hypertensive disorders during pregnancy as a major cause of preterm birth and adverse perinatal outcomes: findings from a Brazilian National Survey.","authors":"José Paulo de Siqueira Guida, Tábata Zumpano Dias, Giuliane Jesus Lajos, Marcelo Luis Nomura, Rodolfo de Carvalho Pacagnella, Ricardo Porto Tedesco, Patricia Moretti Rehder, Samira Haddad, Maria Helena Sousa, Renato Passini Junior, José Guilherme Cecatti, Maria Laura Costa","doi":"10.31744/einstein_journal/2024AO0514","DOIUrl":"10.31744/einstein_journal/2024AO0514","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the prevalence of hypertensive disorders during pregnancy among Brazilian women with preterm births and to compare the epidemiological characteristics and perinatal outcomes among preterm births of women with and without hypertension.</p><p><strong>Methods: </strong>This was a secondary cross-sectional analysis of the Brazilian Multicenter Study on Preterm Birth. During the study period, all women with preterm births were included and further split into two groups according to the occurrence of any hypertensive disorder during pregnancy. Prevalence ratios were calculated for each variable. Maternal characteristics, prenatal care, and gestational and perinatal outcomes were compared between the two groups using χ2 and t-tests.</p><p><strong>Results: </strong>A total of 4,150 women with preterm births were included, and 1,169 (28.2%) were identified as having hypertensive disorders. Advanced maternal age (prevalence ratio (PR) 2.49) and obesity (PR= 2.64) were more common in the hypertensive group. The gestational outcomes were worse in women with hypertension. Early preterm births were also more frequent in women with hypertension.</p><p><strong>Conclusion: </strong>Hypertensive disorders of pregnancy were frequent among women with preterm births, and provider-initiated preterm births were the leading causes of premature births in this group. The factors significantly associated with hypertensive disorders among women with preterm births were obesity, excessive weight gain, and higher maternal age.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-20eCollection Date: 2024-01-01DOI: 10.31744/einstein_journal/2024AO0138
Clarice Elvira Saggin Sabadin, Daniel Archimedes Da Matta, Lísia Hoppe, Fernanda Aparecida Vieira Fernandes, Analy Salles de Azevedo Melo, Lilian Rigo, Dulce Aparecida Barbosa
Objective: This study aimed to verify oral candidiasis, identify the causative species, and investigate the antifungal susceptibility of yeasts isolated from liver transplant patients.
Methods: A descriptive analysis of 97 patients who underwent liver transplantation was conducted at a hospital. Two clinical examinations (Collections A and B) of the oral cavity were performed. Oral material was collected from all patients, inoculated in Sabouraud Dextrose Agar, and incubated at 35℃ for 48 hours. Samples were identified by molecular sequencing of the internal trascribed space region of rDNA.
Results: An antifungal susceptibility test with fluconazole, amphotericin B, and micafungin was performed using the Clinical and Laboratory Standards Institute yeast broth microdilution method. Among the patients, 15 presented with oral candidiasis: eight in Collection A and seven in Collection B. The primary type of candidiasis was atrophic, followed by pseudomembranous candidiasis. The most prevalent species was Candida albicans (nine), followed by Candida glabrata (three), Candida tropicalis (two), and Candida dubliniensis (one). Regarding susceptibility to fluconazole, of the 15 samples, 11 were susceptible, three were susceptible in a dose-dependent manner, and one was resistant.
Conclusion: The most commonly identified type of candidiasis was atrophic, with C. albicans and C. glabrata being the most prevalent causative species. One fluconazole-resistant isolate each of C. tropicalis and C. albicans were identified.
{"title":"Oral candidiasis in liver transplant patients: species identification and antifungal susceptibility profile.","authors":"Clarice Elvira Saggin Sabadin, Daniel Archimedes Da Matta, Lísia Hoppe, Fernanda Aparecida Vieira Fernandes, Analy Salles de Azevedo Melo, Lilian Rigo, Dulce Aparecida Barbosa","doi":"10.31744/einstein_journal/2024AO0138","DOIUrl":"10.31744/einstein_journal/2024AO0138","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to verify oral candidiasis, identify the causative species, and investigate the antifungal susceptibility of yeasts isolated from liver transplant patients.</p><p><strong>Methods: </strong>A descriptive analysis of 97 patients who underwent liver transplantation was conducted at a hospital. Two clinical examinations (Collections A and B) of the oral cavity were performed. Oral material was collected from all patients, inoculated in Sabouraud Dextrose Agar, and incubated at 35℃ for 48 hours. Samples were identified by molecular sequencing of the internal trascribed space region of rDNA.</p><p><strong>Results: </strong>An antifungal susceptibility test with fluconazole, amphotericin B, and micafungin was performed using the Clinical and Laboratory Standards Institute yeast broth microdilution method. Among the patients, 15 presented with oral candidiasis: eight in Collection A and seven in Collection B. The primary type of candidiasis was atrophic, followed by pseudomembranous candidiasis. The most prevalent species was Candida albicans (nine), followed by Candida glabrata (three), Candida tropicalis (two), and Candida dubliniensis (one). Regarding susceptibility to fluconazole, of the 15 samples, 11 were susceptible, three were susceptible in a dose-dependent manner, and one was resistant.</p><p><strong>Conclusion: </strong>The most commonly identified type of candidiasis was atrophic, with C. albicans and C. glabrata being the most prevalent causative species. One fluconazole-resistant isolate each of C. tropicalis and C. albicans were identified.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-20eCollection Date: 2024-01-01DOI: 10.31744/einstein_journal/2024AO0764
Murilo Montenegro Garrigós, Fernando Anselmo de Oliveira, Cícero Júlio Silva Costa, Lucas Renan Rodrigues, Mariana Penteado Nucci, Arielly da Hora Alves, Javier Bustamante Mamani, Gabriel Nery de Albuquerque Rego, Juan Matheus Munoz, Lionel Fernel Gamarra
Objective: To evaluate the in vitro and in vivo toxicities of polyethylene glycol-coated gold nanoparticles synthesized using a one-step process.
Methods: Gold nanoparticles were prepared via a co-precipitation method using polyethylene glycol, and the synthesis product was characterized. For the in vitro evaluation, a flow cytometry analysis with Annexin V and iodide propidium staining was used to assess cytotoxicity in MG-63 cells labeled with 10, 50, and 100µg/mL of nanoparticle concentration. For the in vivo evaluation, nanoparticles were administered intraperitoneally at a dose of 10mg/kg dose in 10-week-old mice. Toxicity was assessed 24 hours and 7 days after administration via histopathological analysis of various tissues, as well as through renal, hepatic, and hematopoietic evaluations.
Results: Synthesized nanoparticles exhibited different hydrodynamic sizes depending on the medium: 51.27±1.62nm in water and 268.12±28.45nm (0 hour) in culture medium. They demonstrated a maximum absorbance at 520nm and a zeta potential of -8.419mV. Cellular viability exceeded 90%, with less than 3% early apoptosis, 6% late apoptosis, and 1% necrosis across all labeling conditions, indicating minimal cytotoxicity differences. Histopathological analysis highlighted the accumulation of nanoparticles in the mesentery; however, no lesions or visible agglomeration was observed in the remaining tissues. Renal, hepatic, and hematopoietic analyses showed no significant differences at any time point.
Conclusion: Polyethylene glycol-coated gold nanoparticles exhibit extremely low toxicity and high biocompatibility, showing promise for future studies.
{"title":"Assessing the toxicity of one-step-synthesized PEG-coated gold nanoparticles: in vitro and in vivo studies.","authors":"Murilo Montenegro Garrigós, Fernando Anselmo de Oliveira, Cícero Júlio Silva Costa, Lucas Renan Rodrigues, Mariana Penteado Nucci, Arielly da Hora Alves, Javier Bustamante Mamani, Gabriel Nery de Albuquerque Rego, Juan Matheus Munoz, Lionel Fernel Gamarra","doi":"10.31744/einstein_journal/2024AO0764","DOIUrl":"10.31744/einstein_journal/2024AO0764","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the in vitro and in vivo toxicities of polyethylene glycol-coated gold nanoparticles synthesized using a one-step process.</p><p><strong>Methods: </strong>Gold nanoparticles were prepared via a co-precipitation method using polyethylene glycol, and the synthesis product was characterized. For the in vitro evaluation, a flow cytometry analysis with Annexin V and iodide propidium staining was used to assess cytotoxicity in MG-63 cells labeled with 10, 50, and 100µg/mL of nanoparticle concentration. For the in vivo evaluation, nanoparticles were administered intraperitoneally at a dose of 10mg/kg dose in 10-week-old mice. Toxicity was assessed 24 hours and 7 days after administration via histopathological analysis of various tissues, as well as through renal, hepatic, and hematopoietic evaluations.</p><p><strong>Results: </strong>Synthesized nanoparticles exhibited different hydrodynamic sizes depending on the medium: 51.27±1.62nm in water and 268.12±28.45nm (0 hour) in culture medium. They demonstrated a maximum absorbance at 520nm and a zeta potential of -8.419mV. Cellular viability exceeded 90%, with less than 3% early apoptosis, 6% late apoptosis, and 1% necrosis across all labeling conditions, indicating minimal cytotoxicity differences. Histopathological analysis highlighted the accumulation of nanoparticles in the mesentery; however, no lesions or visible agglomeration was observed in the remaining tissues. Renal, hepatic, and hematopoietic analyses showed no significant differences at any time point.</p><p><strong>Conclusion: </strong>Polyethylene glycol-coated gold nanoparticles exhibit extremely low toxicity and high biocompatibility, showing promise for future studies.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-13eCollection Date: 2024-01-01DOI: 10.31744/einstein_journal/2024RW0710
Vitor Pelogi Arienzo, Dov Charles Goldenberg, Marcos Antonio Neves Noronha, Phellipe Fabrini Santos Lucas, Beatriz Peral Venet Ferreira, Tatiana Scarparo de Oliveira
Objective: This work aims to review the existing use of robotics in plastic surgery.
Methods: A meticulous selection process identified 22 articles relevant to this scoping review.
Results: The literature on the use of robotics in plastic surgery is sparse. Nonetheless, this review highlights emerging benefits in microsurgery, breast reconstruction, and transoral surgery.
Conclusion: This scoping review identifies critical articles reporting the emerging use of robotics in plastic surgery. While the scientific medical community has yet to extensively document its use, the available evidence suggests a promising future for robotics in this field.
{"title":"Robotic and Plastic Surgery: actuality and prospects for the near future, a scoping review.","authors":"Vitor Pelogi Arienzo, Dov Charles Goldenberg, Marcos Antonio Neves Noronha, Phellipe Fabrini Santos Lucas, Beatriz Peral Venet Ferreira, Tatiana Scarparo de Oliveira","doi":"10.31744/einstein_journal/2024RW0710","DOIUrl":"10.31744/einstein_journal/2024RW0710","url":null,"abstract":"<p><strong>Objective: </strong>This work aims to review the existing use of robotics in plastic surgery.</p><p><strong>Methods: </strong>A meticulous selection process identified 22 articles relevant to this scoping review.</p><p><strong>Results: </strong>The literature on the use of robotics in plastic surgery is sparse. Nonetheless, this review highlights emerging benefits in microsurgery, breast reconstruction, and transoral surgery.</p><p><strong>Conclusion: </strong>This scoping review identifies critical articles reporting the emerging use of robotics in plastic surgery. While the scientific medical community has yet to extensively document its use, the available evidence suggests a promising future for robotics in this field.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-29eCollection Date: 2024-01-01DOI: 10.31744/einstein_journal/2024RW0792
Barbara Casarin Henrique-Sanches, Dario Cecilio-Fernandes, Raphael Raniere de Oliveira Costa, Rodrigo Guimarães Dos Santos Almeida, Federico Ferrero Etchegoyen, Alessandra Mazzo
Objective: To identify, synthesize, and analyze the scientific knowledge produced regarding the implications of using clinical simulation for undergraduate nursing or medical students' motivation for learning.
Methods: The search for articles was conducted between July 28 and August 3, 2022, on the PubMed/MEDLINE, Scopus, Web of Science, and SciELO databases. The following was used for the search: P - undergraduate students attending Nursing or Medicine courses; C - motivation for learning, and C - skills and clinical simulation laboratory. The following research question guided the study: "What are the implications of clinical simulation on the motivation for learning of undergraduate students of nursing and medicine?" Of the 1,783 articles found, 13 were included in the sample for analysis. All stages of the selection process were carried out by two independent evaluators. The results were presented as charts and a discursive report.
Results: The studies analyzed indicated the beneficial effects of clinical simulation on students' motivation, in addition to other gains such as competencies, technical and non-technical skills, knowledge, belonging, autonomy, clinical judgment, critical and reflective thinking, self-efficacy and decreased anxiety, self-management, and improvements in learning and learning climate.
Conclusion: Clinical simulation provides a positive learning environment favorable to the development of technical and interpersonal skills and competencies, and raising the level of motivational qualities.
{"title":"Implications of clinical simulation in motivation for learning: scoping review.","authors":"Barbara Casarin Henrique-Sanches, Dario Cecilio-Fernandes, Raphael Raniere de Oliveira Costa, Rodrigo Guimarães Dos Santos Almeida, Federico Ferrero Etchegoyen, Alessandra Mazzo","doi":"10.31744/einstein_journal/2024RW0792","DOIUrl":"10.31744/einstein_journal/2024RW0792","url":null,"abstract":"<p><strong>Objective: </strong>To identify, synthesize, and analyze the scientific knowledge produced regarding the implications of using clinical simulation for undergraduate nursing or medical students' motivation for learning.</p><p><strong>Methods: </strong>The search for articles was conducted between July 28 and August 3, 2022, on the PubMed/MEDLINE, Scopus, Web of Science, and SciELO databases. The following was used for the search: P - undergraduate students attending Nursing or Medicine courses; C - motivation for learning, and C - skills and clinical simulation laboratory. The following research question guided the study: \"What are the implications of clinical simulation on the motivation for learning of undergraduate students of nursing and medicine?\" Of the 1,783 articles found, 13 were included in the sample for analysis. All stages of the selection process were carried out by two independent evaluators. The results were presented as charts and a discursive report.</p><p><strong>Results: </strong>The studies analyzed indicated the beneficial effects of clinical simulation on students' motivation, in addition to other gains such as competencies, technical and non-technical skills, knowledge, belonging, autonomy, clinical judgment, critical and reflective thinking, self-efficacy and decreased anxiety, self-management, and improvements in learning and learning climate.</p><p><strong>Conclusion: </strong>Clinical simulation provides a positive learning environment favorable to the development of technical and interpersonal skills and competencies, and raising the level of motivational qualities.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-29eCollection Date: 2024-01-01DOI: 10.31744/einstein_journal/2024AO0546
Álvaro Silvério Avelino da Silva, Francisco Leal Carvalho, Giovanna Araújo Pinto, Laís Silva Rios Saad, Mariana Oliveira Curado, Thais Caroline Dallabona Dombroski, Hugo Dias Hoffmann-Santos, Rosa Maria Elias
Objective: The prevalent symptoms of severe dengue in pediatric patients are divided into three subgroups: severe plasma leakage, severe bleeding, and severe organ damage. In addition, the seasonal patterns of the disease and the outcomes of cure or death from dengue were evaluated.
Methods: An epidemiological, observational, analytical, cross-sectional study was conducted with data from the Notifiable Disease Information System (SINAN - Sistema de Informação de Agravos de Notificação and DATASUS - Departamento de Informática do Sistema Único de Saúde) of the Ministry of Health from 2019 to 2020.
Results: During the study period, 1,857 cases of severe dengue were observed in the pediatric age group, with the most common symptoms being respiratory failure, melena, hematemesis, and altered level of consciousness. The total proportion of patients hospitalized for severe dengue was 89.6%, and 51.2% of these patients died, corroborating the importance of early detection of the disease.
Conclusion: Severe dengue is more prevalent during the seasonal period, with hot and humid characteristics owing to the mechanism involved in the viral cycle. The most prevalent symptoms of severe dengue in pediatric patients were respiratory failure alone, gastrointestinal bleeding, and altered level of consciousness. It is important to identify signs of severity for early intervention and a better prognosis, considering that death is closely related to a delayed diagnosis.
目的:将儿童重症登革热患者的主要症状分为三个亚组:严重血浆渗漏、严重出血和严重器官损伤。此外,还评估了登革热的季节性发病规律以及治愈或死亡的结果:方法:利用2019年至2020年卫生部应报疾病信息系统(SINAN - Sistema de Informação de Agravos de Notificação 和 DATASUS - Departamento de Informática do Sistema Único de Saúde)的数据,开展了一项流行病学观察分析横断面研究:在研究期间,共观察到1857例儿科重症登革热病例,最常见的症状是呼吸衰竭、腹泻、吐血和意识改变。因重症登革热住院的患者总比例为89.6%,其中51.2%的患者死亡,这证实了早期发现疾病的重要性:结论:由于病毒循环的机制,重症登革热在炎热潮湿的季节性时期更为流行。儿科重症登革热患者最常见的症状是单纯呼吸衰竭、消化道出血和意识改变。考虑到死亡与诊断延误密切相关,因此必须识别严重登革热的征兆,以便及早干预和改善预后。
{"title":"Analysis of signs and symptoms in confirmed cases of severe dengue among children aged 0 to 10 years old.","authors":"Álvaro Silvério Avelino da Silva, Francisco Leal Carvalho, Giovanna Araújo Pinto, Laís Silva Rios Saad, Mariana Oliveira Curado, Thais Caroline Dallabona Dombroski, Hugo Dias Hoffmann-Santos, Rosa Maria Elias","doi":"10.31744/einstein_journal/2024AO0546","DOIUrl":"10.31744/einstein_journal/2024AO0546","url":null,"abstract":"<p><strong>Objective: </strong>The prevalent symptoms of severe dengue in pediatric patients are divided into three subgroups: severe plasma leakage, severe bleeding, and severe organ damage. In addition, the seasonal patterns of the disease and the outcomes of cure or death from dengue were evaluated.</p><p><strong>Methods: </strong>An epidemiological, observational, analytical, cross-sectional study was conducted with data from the Notifiable Disease Information System (SINAN - Sistema de Informação de Agravos de Notificação and DATASUS - Departamento de Informática do Sistema Único de Saúde) of the Ministry of Health from 2019 to 2020.</p><p><strong>Results: </strong>During the study period, 1,857 cases of severe dengue were observed in the pediatric age group, with the most common symptoms being respiratory failure, melena, hematemesis, and altered level of consciousness. The total proportion of patients hospitalized for severe dengue was 89.6%, and 51.2% of these patients died, corroborating the importance of early detection of the disease.</p><p><strong>Conclusion: </strong>Severe dengue is more prevalent during the seasonal period, with hot and humid characteristics owing to the mechanism involved in the viral cycle. The most prevalent symptoms of severe dengue in pediatric patients were respiratory failure alone, gastrointestinal bleeding, and altered level of consciousness. It is important to identify signs of severity for early intervention and a better prognosis, considering that death is closely related to a delayed diagnosis.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-26eCollection Date: 2024-01-01DOI: 10.31744/einstein_journal/2024AO0557
Denise Araújo Lapa, Gustavo Yano Callado, Giulia Catissi, Lucas Trigo, Fernanda Faig-Leite, Ana Paola Arthaud Berthet Sevilla
Objective: To report the need for cord untethering after prenatal repair of open spina bifida using a unique biocellulose-based technique performed at a later gestational age.
Methods: An observational cohort study was conducted to determine the incidence of tethered cord syndrome. Between May 2013 and May 2022, we performed 172 procedures using the percutaneous fetoscopic approach in fetuses at 26-28 weeks of gestation. After placode dissection, a biocellulose patch was placed to cover the placode, a myofascial flap (when possible) was dissected, and the skin was closed. Owing to death or loss to follow-up, 23 cases were excluded. Cord tethering syndrome was defined as symptoms of medullary stretching, and the infants were evaluated and operated on by local neurosurgeons after an magnetic resonance imaging examination. Infants over 30-month had ambulation and neurodevelopment evaluations (PEDI scale).
Results: Among 172 cases operated at a median gestational age of 26.7 weeks and delivered at 33.2 weeks, 149 cases were available for postnatal follow-up, and cord untethering was needed in 4.4% of cases (6/136; excluding 13 cases younger than 12 months). Cerebrospinal fluid diversion and bladder catheterization were needed in 38% and 36% of cases, respectively. Of the 78 cases evaluated at 30 months, 49% were ambulating independently, and 94% had normal social function.
Conclusion: The biocellulose-based technique was associated with a low rate of cord tethering, wich may be attributed to the lack of the duramater suture during prenatal repair, the formation of a neoduramater and/or later gestational age of surgery.
{"title":"The impact of a biocellulose-based repair of fetal open spina bifida on the need to untether the cord: is it time to unify techniques for prenatal repair?","authors":"Denise Araújo Lapa, Gustavo Yano Callado, Giulia Catissi, Lucas Trigo, Fernanda Faig-Leite, Ana Paola Arthaud Berthet Sevilla","doi":"10.31744/einstein_journal/2024AO0557","DOIUrl":"10.31744/einstein_journal/2024AO0557","url":null,"abstract":"<p><strong>Objective: </strong>To report the need for cord untethering after prenatal repair of open spina bifida using a unique biocellulose-based technique performed at a later gestational age.</p><p><strong>Methods: </strong>An observational cohort study was conducted to determine the incidence of tethered cord syndrome. Between May 2013 and May 2022, we performed 172 procedures using the percutaneous fetoscopic approach in fetuses at 26-28 weeks of gestation. After placode dissection, a biocellulose patch was placed to cover the placode, a myofascial flap (when possible) was dissected, and the skin was closed. Owing to death or loss to follow-up, 23 cases were excluded. Cord tethering syndrome was defined as symptoms of medullary stretching, and the infants were evaluated and operated on by local neurosurgeons after an magnetic resonance imaging examination. Infants over 30-month had ambulation and neurodevelopment evaluations (PEDI scale).</p><p><strong>Results: </strong>Among 172 cases operated at a median gestational age of 26.7 weeks and delivered at 33.2 weeks, 149 cases were available for postnatal follow-up, and cord untethering was needed in 4.4% of cases (6/136; excluding 13 cases younger than 12 months). Cerebrospinal fluid diversion and bladder catheterization were needed in 38% and 36% of cases, respectively. Of the 78 cases evaluated at 30 months, 49% were ambulating independently, and 94% had normal social function.</p><p><strong>Conclusion: </strong>The biocellulose-based technique was associated with a low rate of cord tethering, wich may be attributed to the lack of the duramater suture during prenatal repair, the formation of a neoduramater and/or later gestational age of surgery.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-26eCollection Date: 2024-01-01DOI: 10.31744/einstein_journal/2024RC0659
Fabio Eiti Nishibe Minamoto, Mariana Rodrigues Cremonese, Eduardo de Campos Werebe, Victor Nudelman, Helio Minamoto
A female newborn presented with respiratory distress at birth and was diagnosed with congenital tracheal stenosis. The stenosis was positioned at the distal trachea and compromised the carina and the right and left bronchi. She underwent surgical treatment using circulatory life support with veno-arterial peripheral extracorporeal membrane oxygenation, and the airway was reconstructed using the slide tracheoplasty technique to build a neocarina. The patient had an excellent postoperative course, was successfully weaned from extracorporeal membrane oxygenation and invasive ventilation, and was discharged.
{"title":"Slide tracheoplasty for congenital tracheal stenosis with involvement of the carina and bronchi: a case report.","authors":"Fabio Eiti Nishibe Minamoto, Mariana Rodrigues Cremonese, Eduardo de Campos Werebe, Victor Nudelman, Helio Minamoto","doi":"10.31744/einstein_journal/2024RC0659","DOIUrl":"10.31744/einstein_journal/2024RC0659","url":null,"abstract":"<p><p>A female newborn presented with respiratory distress at birth and was diagnosed with congenital tracheal stenosis. The stenosis was positioned at the distal trachea and compromised the carina and the right and left bronchi. She underwent surgical treatment using circulatory life support with veno-arterial peripheral extracorporeal membrane oxygenation, and the airway was reconstructed using the slide tracheoplasty technique to build a neocarina. The patient had an excellent postoperative course, was successfully weaned from extracorporeal membrane oxygenation and invasive ventilation, and was discharged.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-08eCollection Date: 2024-01-01DOI: 10.31744/einstein_journal/2024AO0447
Carolina Fernandes Giacometti, Giulia Siqueira Galfano, Denis Schapira Wajman, Eduardo Cordioli, Ana Paula Avritscher Beck, Sérgio Podgaec
Objective: The search for medical information on the internet is a part of people's daily lives. Exponential volumes of data are available through various media and platforms. There are several problems related to the ease of creating and accessing medical information on the internet, as evidenced by the quantity of false content and increasing anxiety due to the consumption of these data. In light of this accessibility, it is necessary to understand how people use internet-based medical information and its impact on specific populations. This prospective study aimed to analyze pregnant women's behavior when searching for health-related information on the internet, and how they were influenced by the information.
Methods: Questionnaires were administered to the participants during their immediate puerperium, and their answers were tabulated.
Results: Three hundred and two patients answered the questionnaires. We observed that internet use was frequent, and most patients discussed the findings with their physicians. However, this did not affect the delivery routes.
Conclusion: The search for health information by pregnant women is very prevalent but does not interfere with the delivery route.
{"title":"Internet use by pregnant women during prenatal care.","authors":"Carolina Fernandes Giacometti, Giulia Siqueira Galfano, Denis Schapira Wajman, Eduardo Cordioli, Ana Paula Avritscher Beck, Sérgio Podgaec","doi":"10.31744/einstein_journal/2024AO0447","DOIUrl":"10.31744/einstein_journal/2024AO0447","url":null,"abstract":"<p><strong>Objective: </strong>The search for medical information on the internet is a part of people's daily lives. Exponential volumes of data are available through various media and platforms. There are several problems related to the ease of creating and accessing medical information on the internet, as evidenced by the quantity of false content and increasing anxiety due to the consumption of these data. In light of this accessibility, it is necessary to understand how people use internet-based medical information and its impact on specific populations. This prospective study aimed to analyze pregnant women's behavior when searching for health-related information on the internet, and how they were influenced by the information.</p><p><strong>Methods: </strong>Questionnaires were administered to the participants during their immediate puerperium, and their answers were tabulated.</p><p><strong>Results: </strong>Three hundred and two patients answered the questionnaires. We observed that internet use was frequent, and most patients discussed the findings with their physicians. However, this did not affect the delivery routes.</p><p><strong>Conclusion: </strong>The search for health information by pregnant women is very prevalent but does not interfere with the delivery route.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-08eCollection Date: 2024-01-01DOI: 10.31744/einstein_journal/2024RC0522
Milena Ribeiro Paixão, Fernando Faglioni Ribas, Tarso Augusto Duenhas Accorsi, Karine De Amicis, José Leão de Souza
Adenosine is an antiarrhythmic drug that slows conduction through the atrioventricular node and acts as a coronary blood vessel dilator. This case report highlights two unusual life-threatening events following the use of adenosine to revert supraventricular tachycardia in a structurally normal heart: non-sustained polymorphic ventricular tachycardia and myocardial infarction. A 46-year-old woman presented to the emergency department with a two-hour history of palpitations and was diagnosed with supraventricular tachycardia. Vagal maneuvers were ineffective, and after intravenous adenosine administration, the patient presented with chest pain and hypotension. The rhythm degenerated into non-sustained polymorphic ventricular tachycardia and spontaneously reverted to sinus rhythm with ST elevation in lead aVR and ST depression in the inferior and anterolateral leads. The patient spontaneously recovered within a few minutes. Despite successful arrhythmia reversal, the patient was admitted to the intensive care unit because of an infarction without obstructive atherosclerosis. This report aims to alert emergency physicians about the potential complications associated with supraventricular tachycardia and its reversal with adenosine.
腺苷是一种抗心律失常药物,可减慢房室结的传导速度并起到扩张冠状动脉血管的作用。本病例报告强调了在使用腺苷恢复心脏结构正常的室上性心动过速后发生的两种不寻常的危及生命的事件:非持续性多形性室性心动过速和心肌梗死。一名 46 岁女性因心悸两小时后到急诊科就诊,被诊断为室上性心动过速。迷走神经刺激无效,静脉注射腺苷后,患者出现胸痛和低血压。心律退化为非持续性多形性室性心动过速,并自发恢复为窦性心律,aVR 导联 ST 段抬高,下导联和前外侧导联 ST 段压低。患者在几分钟内自发恢复。尽管成功地逆转了心律失常,但患者还是因为没有阻塞性动脉粥样硬化的心肌梗死而被送进了重症监护室。本报告旨在提醒急诊医生注意室上性心动过速以及用腺苷逆转室上性心动过速的潜在并发症。
{"title":"Torsades de pointes and myocardial infarction following reversal of supraventricular tachycardia with adenosine: a case report.","authors":"Milena Ribeiro Paixão, Fernando Faglioni Ribas, Tarso Augusto Duenhas Accorsi, Karine De Amicis, José Leão de Souza","doi":"10.31744/einstein_journal/2024RC0522","DOIUrl":"10.31744/einstein_journal/2024RC0522","url":null,"abstract":"<p><p>Adenosine is an antiarrhythmic drug that slows conduction through the atrioventricular node and acts as a coronary blood vessel dilator. This case report highlights two unusual life-threatening events following the use of adenosine to revert supraventricular tachycardia in a structurally normal heart: non-sustained polymorphic ventricular tachycardia and myocardial infarction. A 46-year-old woman presented to the emergency department with a two-hour history of palpitations and was diagnosed with supraventricular tachycardia. Vagal maneuvers were ineffective, and after intravenous adenosine administration, the patient presented with chest pain and hypotension. The rhythm degenerated into non-sustained polymorphic ventricular tachycardia and spontaneously reverted to sinus rhythm with ST elevation in lead aVR and ST depression in the inferior and anterolateral leads. The patient spontaneously recovered within a few minutes. Despite successful arrhythmia reversal, the patient was admitted to the intensive care unit because of an infarction without obstructive atherosclerosis. This report aims to alert emergency physicians about the potential complications associated with supraventricular tachycardia and its reversal with adenosine.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}