Revista da Associacao Medica Brasileira (1992)最新文献

Objective: In today's world, with the prolongation of human life span, a significant part of women's lives is spent in the menopausal period. Factors that negatively affect the health and quality of life of women experiencing this process constitute an important problem in terms of women's health. The aim of this study was to determine the relationship between spousal support and quality of life among menopausal women.

Methods: The cross-sectional study was conducted with 300 women aged 45-65 years, who were in menopausal period and volunteered to participate in the study, registered in four family health centers located in eastern Türkye. The data were collected using the "Personal Information Form," "Menopause Spousal Support Questionnaire," and "Menopause-Specific Quality of Life Questionnaire."

Results: The mean total score of the women on the spousal support questionnaire was 116.39±17.88. In the subdimensions, the highest score belonged to valuing support (41.35±7.21) and the lowest score belonged to sexual intimacy support (21.52±3.91). Quality of life questionnaire subfield mean scores were as follows: vasomotor 5.43±3.24, psychosocial 10.83±5.23, physical 17.84±13.03, and sexual 2.02±3.16. Spousal support and quality of life levels differed significantly according to demographic characteristics (p<0.05).

Conclusion: Increased support from husbands decreases menopause-related complaints and improves quality of life. On the other hand, smoking, irregular exercise, not receiving hormone therapy, and a lack of information increase complaints. The results show that spousal support and healthy living habits are determinants of quality of life during menopause.

[This corrects the article doi: 10.1590/1806-9282.20231694].

Objective: The aim of the study was to examine the effectiveness of adding indocyanine green fluorescence to the dual method, (Radioisotope+Isosulfanblue) for sentinel lymph node biopsy after neoadjuvant chemotherapy (on sentinel lymph nodes identification).

Methods: The 101 patients included in the study were randomized equally into each group. Dual method containing indocyanine green (group 1) or dual method alone (group 2) was used for sentinel lymph node mapping.

Results: The sentinel lymph node identification rate was 86.9% in the dual method group and 94.6% in the triple method group. The detection rates of two or more sentinel lymph nodes were 82.6% in the dual group and 89.2% in the triple group. There was no statistically significant difference between both the groups (p>0.05).

Conclusion: Indocyanine green-based sentinel lymph node biopsy detection will bring a significant change in the management of patients in centers where there is no access to a nuclear medicine department. Nevertheless, multicenter studies with larger patient samples are needed to confirm our results.

Objective: Lung cancer is the leading cause of cancer-related mortality, with non-small cell lung cancer accounting for most cases. Surgery remains the primary treatment for early-stage non-small cell lung cancer, while advanced disease requires multimodal strategies. Immunotherapy, particularly immune checkpoint inhibitors targeting programmed cell death protein-1, programmed death-ligand 1, and cytotoxic T-lymphocyte-associated protein 4, has significantly improved survival and is increasingly incorporated into neoadjuvant and adjuvant settings. The aim of the study was to evaluate thoracic surgeons' awareness, perceptions, and integration of immunotherapy in surgical practice.

Methods: A cross-sectional survey was conducted among 64 thoracic surgeons from 19 countries to assess their perspectives, challenges, and regional disparities in immunotherapy adoption. Statistical analyses examined associations between perceptions and variables such as specialty, experience, hospital type, and geographic region.

Results: Perceptions of immunotherapy did not differ significantly by specialty, experience, hospital type, or geographic location. However, significant associations were observed between years of experience and hospital type, as well as surgical specialty and geographic region. Key barriers included cost, lack of standardized guidelines, and challenges in multidisciplinary coordination. Surgeons in low- and middle-income countries reported greater difficulties in drug access and institutional infrastructure. The majority of participants (85%) expressed a need for further training, highlighting the importance of structured education programs and enhanced collaboration between surgical and medical oncology teams.

Conclusion: While immunotherapy is widely accepted among thoracic surgeons, challenges related to education, accessibility, and implementation persist. Addressing these barriers through global initiatives, cost-effective policies, and multidisciplinary cooperation is essential for optimizing immunotherapy integration in thoracic surgery and improving outcomes for non-small cell lung cancer patients.

Objective: The aim of the study was to examine the impact of pelvic girdle pain on quality of life and depressive symptoms during pregnancy.

Methods: This descriptive, cross-sectional study involved 433 second- and third-trimester pregnant women who volunteered at two public hospitals in Central Anatolia, Turkey, between March 2024 and March 2025, excluding those with high-risk pregnancies. Data were collected using the Demographic Form, Pelvic Girdle Questionnaire, Short-Form Health Survey (SF-36), Beck Depression Inventory, and Visual Analog Scale.

Results: The mean age of women was 27.81±5.12. The findings revealed significant negative correlations between the Pelvic Girdle Questionnaire and SF-36 subscales, including physical function, physical and emotional role limitations, social functioning, general health and pain (p<0.05). Pelvic Girdle Questionnaire was positively correlated with depression, Visual Analog Scale, and gestational weeks (p<0.05). Moreover, 32.9% of the variance in Pelvic Girdle Questionnaire scores is explained by SF-36 subdimensions (physical function, role limitations, energy/vitality, mental health, and pain), number of births, and Visual Analog Scale.

Conclusion: Pelvic girdle pain negatively affects physical and mental well-being, increases pain, and reduces quality of life in pregnancy. Its severity rises with gestational age and is linked to depressive symptoms.

Objective: Cesarean scar pregnancy is a rare form of ectopic pregnancy in which the fertilized egg implants within the scar of a previous cesarean section. With the rising global cesarean delivery rate, the incidence of cesarean scar pregnancy has increased, posing serious risks such as massive hemorrhage and uterine rupture. To evaluate and compare the diagnostic and classification accuracy of transvaginal sonography and magnetic resonance imaging in the detection of cesarean scar pregnancy.

Methods: This retrospective study included 102 patients clinically suspected of cesarean scar pregnancy between January 2023 and May 2024. All patients underwent both transvaginal sonography and magnetic resonance imaging. Using final clinical and pathological diagnoses as the reference standard, the sensitivity, overall diagnostic accuracy, and classification accuracy of transvaginal sonography and magnetic resonance imaging were compared.

Results: Magnetic resonance imaging demonstrated significantly higher sensitivity, diagnostic accuracy, and classification accuracy than transvaginal sonography (p<0.05). Compared with transvaginal sonography, magnetic resonance imaging also showed superior detection rates for intrauterine hemorrhage, villous invasion of the myometrium, and invasion of the bladder and/or cervix, with statistically significant differences (p<0.05).

Conclusion: Magnetic resonance imaging demonstrates superior diagnostic and classification accuracy compared to transvaginal sonography in evaluating cesarean scar pregnancy. As a valuable adjunct to ultrasound, magnetic resonance imaging facilitates more accurate diagnosis and individualized treatment planning, thereby reducing the risks of severe complications such as massive hemorrhage, hysterectomy, and maternal mortality in women of reproductive age.