Revista da Associacao Medica Brasileira (1992)最新文献

[This corrects the article doi: 10.1590/1806-9282.20240888].

Objective: Calorie restriction and exercise are commonly used first interventions to prevent the progression of prediabetes and alleviate the symptoms of type 2 diabetes. Our study was designed to determine the effect of the energy deficit caused by long-term (12-week) calorie restriction and exercise programs on appetite responses in obese individuals with prediabetes and type 2 diabetes.

Methods: Calorie restriction and exercise programs appropriate for age, gender, and work environment were applied to 22 individuals with prediabetes and 22 with type 2 diabetes participating in the study for a period of 12 weeks. Ghrelin, glucagon-like peptide-1, and peptide tyrosine tyrosine values of samples taken before and after treatment were determined by the enzyme-linked ιmmunosorbent assay method.

Results: Appetite hormone levels did not change after calorie restriction and exercise in the prediabetes group (p>0.05). In the diabetes group, calorie restriction and exercise significantly increased ghrelin and peptide tyrosine tyrosine concentrations (p<0.005). Additionally, when all patients were evaluated together, ghrelin, glucagon-like peptide-1 and peptide tyrosine tyrosine levels differed significantly after the intervention (p<0.005).

Conclusion: The energy deficit created by long-term calorie restriction and exercise did not modulate the appetite hormones in prediabetic and obese individuals. However, increased ghrelin and peptide tyrosine tyrosine levels in individuals with diabetes support that the same treatment program is an effective method to regulate appetite hormones.

Objective: This study aims to examine whether the presence of mutation exists in the vitamin D-connector protein gene rs7041 variant of the pancreatitis table for patients diagnosed with coronavirus disease 2019.

Methods: A total of 113 patients with normal pancreatic enzyme levels diagnosed with coronavirus disease 2019 and 120 patients with both coronavirus disease 2019 diagnosis and high pancreatic enzyme levels were included in the study. The rs7041 genotyping of the 11th single nucleotide variation in the vitamin D-connector protein gene was determined by polymerase chain reaction and restriction fragment length polymorphism methods.

Results: In the patient group with coronavirus disease 2019 diagnosis and high pancreatic enzyme levels, the vitamin D-connector protein gene rs7041 variance GG genotype ratio was determined to be higher than the normal coronavirus disease 2019 patients. As a result of comparisons between the two groups, the difference between the genotype ratios in the relationship was determined to be statistically significant (p=0.004).

Conclusion: Coronavirus disease 2019 patients were determined that the rs7041 halves in the vitamin D-connector protein gene could be prone to pancreatitis formation. Different populations and work with more patient groups are needed to verify the results of the study.

Objective: Coronary artery bypass graft surgery is one of the most frequently performed surgeries worldwide. Coronary artery bypass graft surgery induces an inflammatory response. Interleukin-8 is a pro-inflammatory cytokine that plays a role in the pathogenesis of cardiovascular diseases. C1q/TNF-related protein-12 is implicated in mitigating inflammation and cardiomyocyte damage. This study aimed to compare interleukin-8 and C1q/TNF-related protein-12 levels before and 45 days after coronary artery bypass graft surgery.

Methods: A total of 43 patients who underwent coronary artery bypass graft surgery were studied. Serum concentrations of interleukin-8 and C1q/TNF-related protein-12 were evaluated using the enzyme-linked immunosorbent assay method before and 45 days after the surgery.

Results: No significant differences were observed in interleukin-8 levels between pre- and post-coronary artery bypass graft surgery (p=0.077). However, serum levels of C1q/TNF-related protein-12 were found to be lower 45 days after coronary artery bypass graft surgery compared to pre-surgery levels (p<0.001). Moreover, changes in C1q/TNF-related protein-12 were not associated with diabetes, hypertension, and body mass index (p>0.05), but C1q/TNF-related protein-12 alterations were found to be associated with opium addiction.

Conclusion: These findings suggest that the evaluation of C1q/TNF-related protein-12 can be beneficial for the late assessment of post-coronary artery bypass graft surgery inflammation. The reduction of C1q/TNF-related protein-12 levels might indicate increased levels of inflammation after surgery at this time point, which requires the assessment of further inflammatory factors to confirm this finding.

Objective: The aim of the study was to evaluate the effects of commonly used medications for epilepsy on thyroid function tests in children.

Methods: Epileptic children treated with valproic acid, levetiracetam, carbamazepine, and oxcarbazepine were retrospectively examined along with a healthy control group. Levels of free thyroxine 4 and thyroid-stimulating hormone were compared.

Results: In patients receiving valproic acid monotherapy, thyroid-stimulating hormone levels increased compared to both the control group and pre-treatment levels, while free thyroxine 4 levels remained unchanged. In those receiving carbamazepine or oxcarbazepine monotherapy, average free thyroxine 4 levels were found to be lower compared to the control group and pre-treatment levels, with no difference in thyroid-stimulating hormone levels. For patients receiving levetiracetam monotherapy, there was no difference in free thyroxine 4 and thyroid-stimulating hormone levels compared to the control group and pre-treatment levels.

Conclusion: Despite significant changes in thyroid hormone levels with valproic acid, carbamazepine, and oxcarbazepine treatment, no significant clinical findings were observed. Additionally, no effect of levetiracetam on thyroid function tests was detected.

Objective: High serum uric acid levels are associated with metabolic syndrome and diabetes mellitus. Several observational studies have shown the association between metabolic dysfunction-associated fatty liver disease and high serum uric acid. However, this association is controversial due to reverse causality. We aimed to investigate the relationship between the serum uric acid level and "aspartate aminotransferase-platelet ratio index score," which noninvasively shows the possible changes of metabolic dysfunction-associated fatty liver disease in the liver in patients diagnosed with type II diabetes mellitus.

Methods: This retrospective study was conducted with a total of 94 patients, 36 females and 58 males, who were hospitalized in the gastroenterohepatology outpatient clinic and diagnosed with hepatosteatosis and type II diabetes mellitus between January 2023 and January 2024. Laboratory tests, height, weight, body mass index, presence of fatty liver disease on ultrasound, and aspartate aminotransferase-platelet ratio index scores of the patients were examined.

Results: The mean serum uric acid level of the patients was 5.26±1.52 mg/dL, and the mean aspartate aminotransferase-platelet ratio index score was 0.26±0.13. The serum uric acid level was found to be associated with the hemoglobin A1c value (p=0.001; p<0.01). However, the aspartate aminotransferase-platelet ratio index scores of the patients did not show a statistically significant difference according to serum uric acid levels (p>0.05).

Conclusion: No significant association was observed between serum uric acid and the noninvasive liver test aspartate aminotransferase-platelet ratio index score. Although a causal relationship between metabolic dysfunction-associated fatty liver disease and serum uric acid has been demonstrated in several studies, further research is needed to evaluate possible mechanisms in the liver.

Objective: The aim of this study was to compare the success and complication rates of retrograde intrarenal surgery for lower calyceal renal stones performed with novel tip-bendable suction ureteral access sheaths and standard ureteral access sheaths.

Methods: Between March 2023 and March 2024, a total of 88 patients underwent retrograde intrarenal surgery for lower renal calyceal stones smaller than 20 mm. Based on the access sheath used, patients were divided into two groups: Group 1 (n=43) included patients treated with novel tip-bendable suction ureteral access sheaths and Group 2 (n=45) included patients treated with standard ureteral access sheaths. The pre- and postoperative data of the two groups were compared. Complications were assessed by using the Modified Clavine Dindo system, and stone-free rate was assessed after 4 weeks by using non-contrast computed tomography.

Results: There was no significant difference between the groups regarding demographic data or preoperative laboratory results, and the median stone size was comparable in both groups. The stone-free rate did not show any significant difference between the two groups. However, the median residual stone size was substantially higher in the standard ureteral access sheaths group [4.25- (3.75-5) vs. 6- (5-7), p=0.01] and the surgical duration was less in the novel tip-bendable suction ureteral access sheaths group (p=0.032).

Conclusion: Our current findings demonstrate that the use of a new tip-bendable suction-assisted access sheath during retrograde intrarenal surgery in the management of lower calyceal stones less than 2 cm may shorten the operative duration, limit the rate of complications, and end up with smaller residual stone fragments when compared with the use of standard ureteral access sheath.