Porto biomedical journal最新文献

Introduction: Lumbar disc herniation (LDH) is a prevalent condition that can cause radiculopathy and leg pain. Full-endoscopic lumbar discectomy (FELD) has emerged as a minimally invasive alternative to microdiscectomy, offering similar clinical efficacy with potentially reduced recovery times. Degenerative disc disease (DDD) is frequently observed in patients undergoing surgery, yet its influence on surgical early outcomes of FELD remains unclear.

Methods: This prospective study included 91 patients who underwent FELD for single-level LDH between January 2022 and March 2024. Patients were classified in two groups based on Pfirrmann grade: grade inferior to 4 (Group 1) and grade 4 or 5 (Group 2). Clinical outcomes were assessed using the Numeric Rating Scale (NRS) for back and leg pain preoperatively and at 2, 14, 30, and 90 days postoperatively, and the Oswestry Disability Index (ODI) preoperatively and at 30 and 90 days postoperatively.

Results: Among the 91 patients, 89% had advanced disc degeneration (Pfirrmann grade 4 or 5). Preoperatively, Group 1 (all Pfirrmann 3) had significantly higher back pain (NRS 8.2 vs. 5.2, P < 0.01), while Group 2 had a greater difference between leg and back pain (P = 0.041). Postoperatively, both groups experienced significant pain relief, but Group 1 showed superior back pain improvement across all time points. No significant differences were observed in ODI scores or leg pain improvement.

Discussion: Patients with moderate disc degeneration (Pfirrmann grade 3) exhibited greater preoperative back pain but experienced superior back pain relief after FELD compared with those with advanced degeneration (Pfirrmann grade 4 or 5).

The Physical Activity Scale for the Elderly (PASE) assesses Physical Activity (PA) levels of older people, providing information on the frequency, duration, and intensity.

Aims: To translate, culturally adapt, and validate the PASE for the Portuguese population.

Methods: Translation and cross-cultural adaptation for the Portuguese population of the PASE, according to the Report of ISPOR Translation and Cultural Adaptation guidelines and metric validation was evaluated using the analysis of reliability and validity.

Results: The PASE-PT is a reliable and valid instrument to assess PA levels among the Portuguese population, with excellent test-retest reliability in the various domains and in total, with an ICC between 0.938 and 1.00, an acceptable internal consistency, with Cronbach's alpha of α = 0.695, and ω de McDonald was 0.63 and is significantly related to TUG (r = -0.303) and accelerometer AF levels (r = 0.416).

Conclusions: The PASE-PT is an instrument that can be used in clinical practice and in research studies involving the older population.

Background: Adenotonsillar hypertrophy is a prevalent pediatric condition that may affect children's health due to its association with obstructive sleep-disordered breathing (OSDB). This can negatively affect sleep quality, daytime behavior, neurocognitive development, and growth. This study aimed to evaluate the impact of adenotonsillectomy on children's sleep habits and behavior. A secondary objective was to explore differences in outcomes between children undergoing surgery for recurrent upper respiratory tract infections (URTIs) versus those with OSDB.

Methods: A prospective longitudinal observational study was conducted from December 2023 to December 2024, enrolling 28 children aged 2-10 years undergoing adenotonsillectomy. Sleep and behavioral changes were assessed preoperatively and postoperatively (3-6 months) using the validated Children's Sleep Habits Questionnaire-adapted Portuguese version and the Strengths and Difficulties Questionnaire-Portuguese version. Paired samples t-tests and general linear models were used for statistical analysis.

Results: Significant improvements were observed in several sleep parameters: sleep duration, parasomnias, sleep-related breathing disorders, daytime sleepiness, and the total sleep disturbance index (P < 0.001 for all). In the behavioral domain, hyperactivity was the only subscale to show statistically significant improvement (P = 0.028). Surgical indication (OSDB vs. recurrent URTIs) did not significantly influence most outcomes, except for sleep-related breathing disorders, where greater improvement was noted in the OSDB group, as expected.

Conclusion: Adenotonsillectomy positively affects multiple dimensions of sleep, particularly reducing parasomnia episodes and hyperactivity symptoms, regardless of surgical indication. These findings underscore the importance of early recognition and management of pediatric adenotonsillar disorders to promote healthy sleep, improved daytime functioning, and long-term psychosocial development.

Autoimmune thyroid disease (ATD), implicated in infertility and unfavorable outcomes in assisted reproductive technology (ART), is the most prevalent autoimmune disorder among women of reproductive age. This review summarizes the existing evidence on the impact of ATD on infertility and ART outcomes, with a particular focus on screening and therapeutic options. Subclinical hypothyroidism (SCH) frequently coexists with ATD. Thyroid-stimulating hormone (TSH) thresholds for SCH treatment in fertility range from 2.5 to 4.0 mIU/L, causing inconsistencies in clinical management. Although levothyroxine is widely recommended for TSH >4.0 mIU/L, benefits for lower thresholds remain controversial. Immunomodulatory therapies, such as glucocorticoids and intravenous immunoglobulin, have uncertain efficacy in improving ART outcomes. This review highlights the pressing need for standardized diagnostic criteria and therapeutic interventions to optimize fertility outcomes in ATD-positive women, particularly with SCH.

Introduction: Porphyrias are rare genetic disorders caused by heme biosynthesis pathway enzyme mutations, leading to porphyrin precursors build up in various tissues and diverse symptoms. This review centers on acute hepatic porphyrias (AHP).

Methods: A MEDLINE through PubMed database literature review was conducted. Systematic reviews, clinical trials, cohort studies, case-control studies, expert reviews, and guidelines were preferred for analysis.

Results: There are 4 types of AHP: acute intermittent porphyria, variegate porphyria, hereditary coproporphyria, and δ-aminolevulinic acid dehydratase deficiency porphyria. These conditions primarily present as neurovisceral attacks, characterized by severe abdominal pain, neuropsychiatric symptoms, or skin lesions, predominantly affecting women aged 15 to 50 years. The diagnostic methods include biochemical tests that assess urinary levels of aminolevulinic acid and porphobilinogen. In addition, measuring porphyrin levels in urine or feces can provide more insights into the type of AHP; however, a definitive diagnosis of the specific type is made through genetic testing. Treatment involves high-glucose diets, intravenous hemin for acute attacks, and givosiran for the prophylaxis of frequent attacks. Liver transplantation remains the only curative option. It is crucial to monitor chronic complications associated with hepatic porphyrias, particularly hepatocellular carcinoma, kidney disease, and arterial hypertension.

Conclusion: AHP continues to be an underrecognized condition, warranting consideration in individuals experiencing unexplained abdominal pain, neuropathy, psychiatric symptoms, or skin lesions. There is a need for improved diagnostic techniques and treatment options.

Background: Snakebite envenoming is a critical public health issue, recognized as the second-deadliest neglected tropical disease by the World Health Organization. In India, it accounts for an estimated 35,000 to 50,000 deaths annually, exacerbated by reliance on traditional remedies and underreporting of fatalities. This retrospective study analyzes the epidemiological and clinical profiles of snakebite cases at a secondary care hospital in Karnataka.

Methods: Snakebite cases reported from January 2020 to April 2023 were analyzed. Data on demographics, clinical manifestations, treatments, complications, and outcomes were collected using case record forms. Descriptive statistics were applied using IBM SPSS Statistics version 25.0.

Results: A total of 366 snakebite cases were reported, of which 121 (33.1%) were classified as venomous bites. The common krait (Bungarus caeruleus) was the most frequently identified species. The mean age of victims was 29.50 ± 14.62 years, and men (58.2%) were more frequently affected. Most bites occurred in the morning (51.9%), and 33.3% of victims sought traditional treatment before arriving at the hospital. Among all cases, 78.4% showed improvement, 16.7% were referred to higher centers, 3.3% left against medical advice, and 1.6% succumbed to complications.

Conclusions: Snakebite remains a major public health concern in India, particularly among young males. Neurotoxic envenoming, predominantly due to the common krait, was most common in this study area. The frequent use of traditional medicine before seeking medical care underscores the need for community education and early referral to health care facilities. Strengthening awareness, timely administration of antisnake venom, and improved documentation are essential to reduce morbidity and mortality from snakebites.