Revista da Associacao Medica Brasileira (1992)最新文献

Objective: This systematic review and meta-analysis aimed to investigate the effects of herbal treatments on cervicovaginal human papillomavirus infection.

Methods: A comprehensive literature search was conducted in PubMed, Scopus, Science Direct, and the Cochrane Library until December 2023, following Cochrane guidelines. Data were analyzed using the Review Manager computer program (Version 5.4.1).

Results: Five randomized controlled trials involving a total sample size of 662 women were included in the study. The pooled odds ratio for individuals testing negative for human papillomavirus after herbal intervention among human papillomavirus-positive patients was 1.86 (95% confidence interval (CI) 0.64-5.43), according to the fixed-effects model. Three out of the five studies indicated a significant relationship. The relationship between positive human papillomavirus infection and herbal treatments, measured by the fixed-effects model, resulted in a pooled odds ratio of 0.41 (95%CI 0.17-1.01), reporting a significant association (p=0.05). Subgroup analysis revealed a significant reduction in the relationship between herbal treatment and atypical squamous cells of undetermined significance (OR 0.16, 95%CI 0.03-0.88, p=0.04) but no significant impact on the relationship between herbal treatment and low-grade squamous intraepithelial lesion (OR 0.33, 95%CI 0.01-8.77, p=0.51).

Conclusion: The meta-analysis suggests that herbal treatments reduce human papillomavirus infections. While herbal treatments show a significant reduction in atypical squamous cells of undetermined significance, they do not significantly impact the regression of low-grade squamous intraepithelial lesions.

Objective: Melatonin plays a role in many biological and physiological events. There are studies in the literature relating melatonin levels to many psychiatric disorders such as schizophrenia, bipolar disorder, and major depressive disorder. We aimed to investigate the relationship between serum melatonin levels with the Beck Depression Inventory and the Beck Scale for Suicidal Ideation in suicide patients.

Methods: The study was conducted prospectively with volunteer patients aged 20-50 years who were admitted to the emergency department after a suicide attempt. The social and occupational status, educational levels, marital status, and stressor factors of patients were questioned. Beck Depression Inventory and Beck Scale for Suicidal Ideation were applied to each patient included in the study. Blood melatonin levels were evaluated using the enzyme-linked immunosorbent assay method. The data were analyzed with the SPSS 23.00 statistical program. Descriptive values were expressed by the number of cases (n), percentage (%), median (interquartile range), and mean±standard deviation. The Kolmogorov-Smirnov test was used to assess the distribution of continuous variables, and the Pearson or Spearman correlation test was used to assess the relationship between disease severity and melatonin level. A value of p<0.05 was considered statistically significant.

Results: No statistically significant correlation was found between melatonin level and the Beck Depression Inventory score (r=-0.098, p=0.44). However, a statistically weak, inverse, and significant correlation was discovered between melatonin levels and the Beck Scale for Suicidal Ideation score (r=-0.465, p=0.00).

Conclusion: According to our results, it was determined that there was a significant negative relationship between melatonin level and the Beck Scale for Suicidal Ideation scoring.

Objective: This study was conducted to determine the effect of mandala coloring on anxiety and quality of life of women in the climacteric period.

Methods: This research was conducted as an experimental study based on a randomized controlled pre-test and post-test model (single-blind). The study was conducted with women in the climacteric period who presented to a training and research hospital in a western city of Turkey between November 1, 2022, and April 28, 2023. Participants were divided into mandala coloring (n=38) and control groups (n=38).

Results: According to the women's socio-demographic and descriptive characteristics, mean age, body mass index, and frequency of menopausal symptoms were similar in both groups. The mean post-test scores of the women in the mandala coloring group on the state-trait anxiety inventory and menopause-specific quality of life questionnaire vasomotor, psychosocial, physical, and sexual subscales (29.71±5.22, 0.86±0.97, 0.53±0.61, 0.79±0.84, and 0.92±1.24, respectively) were lower than the mean post-test scores of the women in the control group on the same scales (41.02±1.20, 1.79±1.76, 1.49±1.39, 1.72±1.38, and 1.95±1.82, respectively) (p=0.000).

Conclusion: Mandala coloring reduces menopause-related anxiety levels and improves quality of life effectively.

Objective: The aim of this study was to evaluate the vitamin D receptor (VDR) BsmI variant in morbidly obese patients compared with healthy normal controls.

Methods: The study included 103 patients with morbid obesity and 120 healthy individuals serving as normal controls. The DNA samples obtained from blood were genotyped using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. The gender, age, smoking status, triglycerides, total cholesterol, insulin, mean body mass index, and frequency of allele and genotype of the BsmI variant in the VDR gene in morbidly obese patients were evaluated.

Results: The body mass index of the patients was 47.14 ± 7.19. The VDR B/B, B/b, and b/b genotype frequencies were 27.2% versus 28.3%; 54.4% versus 50%; and 18.4% versus 21.7% in the morbidly obese patients and the control group, respectively. There was no statistically significant difference between patients and control subjects in the genotype and allele distribution of the VDR BsmI variant (p>0.05). Both patients and control genotype frequencies are consistent with Hardy-Weinberg equilibrium.

Conclusion: The BsmI variant in the VDR gene may not seem to predispose to morbid obesity in our study population. Further studies with a larger number of subjects are needed to make a more precise evaluation of this relationship.

Objective: There is growing evidence suggesting a relationship between periostin levels, inflammation, and ovarian dysfunction. In this prospective case-control study, we aimed to investigate serum periostin levels and their relationship with metabolic parameters in patients with polycystic ovary syndrome.

Methods: We conducted a prospective case-control study involving 45 polycystic ovary syndrome patients and 45 control subjects, matched in a 1:1 ratio. Serum samples collected from both study and control groups were analyzed using enzyme-linked immunosorbent assay.

Results: The demographic characteristics were similar between the polycystic ovary syndrome and control groups (p>0.05). Periostin levels were significantly higher in patients with polycystic ovary syndrome compared with the control group (4.67±2.46 vs. 2.60±1.41 ng/mL, respectively; p=0.000).

Conclusion: Our study revealed a significant elevation in periostin levels among polycystic ovary syndrome patients compared with controls. These findings suggest that periostin could serve as a potential marker for assessing disease severity in polycystic ovary syndrome patients.

Objective: The aim of the study was to examine the relationship between social support, marital dissatisfaction, psychological factors, and health-promoting behaviors in pregnant women.

Methods: This cross-sectional study was conducted on 1,265 pregnant women who visited the outpatient clinic of a maternity hospital between May and August 2023. The Health Promotion Lifestyle-II Questionnaire was used to measure the healthy lifestyle behaviors of pregnant women. The mental health status of pregnant women was measured using the Depression Anxiety and Stress Scale-21. The Marital Disaffection Scale was used to assess the level of disaffection toward a spouse. Perceived social support was measured by the Multidimensional Perceived Social Support Scale.

Results: Pregnant women had a mean age of 26.46±5.09 years. Multivariate linear regression analysis revealed that there was a positive association between perceived social support and health-promoting behaviors. It was also found that marital disaffection was negatively associated with health-promoting behaviors (p<0.001).

Conclusion: The present study suggests that stress, anxiety, depression, and marital disaffection are negatively associated with health-promoting lifestyle behaviors, while social support is positively associated with the adoption of health practices in pregnant women. Understanding the complex interplay between psychosocial factors and healthy behaviors is crucial to improving healthy behaviors in pregnant women.

Objective: Investigating the potential role of CYR61 in recurrent pregnancy loss is critical for developing diagnostic approaches and treatments for recurrent pregnancy loss.

Methods: In this prospective case-control study, we have investigated the expression patterns of CYR61 in blood samples from participants with recurrent pregnancy loss in their medical history and control group (n=20 vs n=10). Peripheral blood mononuclear cells from study and control groups were isolated and the expression patterns of the CYR61 gene were determined by real-time semi-quantitative reverse transcriptase PCR.

Results: A significant decrease in CYR61 gene expression was demonstrated in patients with two or more clinically recognized miscarriages compared with patients without miscarriages or with a history of miscarriage (p<0.01), which may make the CYR61 gene a potential candidate for predicting the risk of recurrent pregnancy loss.

Discussion: This study provides a basis for a detailed investigation of candidate biomarkers and molecular players involved in the development of recurrent pregnancy loss and for the development of potential treatment approaches to prevent recurrent pregnancy loss.

Objective: The aim of this study was to evaluate the success rate and predictors of labor induction using vaginal misoprostol in a low-risk pregnant women population.

Methods: A prospective cohort study was carried out with 196 pregnant women. Groups 2 and 4 of the Robson Classification admitted for induction of labor with vaginal misoprostol (25 μg tablets every 6 h, up to 4 tablets, for a maximum of 24 h). The success of labor induction was considered the achievement of vaginal delivery. Binary logistic regression was used to determine the best predictors of successful induction of labor with vaginal misoprostol.

Results: Of all the pregnant women analyzed, 140 (71.4%) were successful and 56 (28.6%) were unsuccessful. Pregnant women who achieved successful induction had a higher number of pregnancies (1.69 vs. 1.36, p=0.023), a higher number of deliveries (0.57 vs. 0.19, p<0.001), a higher Bishop score (2.0 vs. 1.38, p=0.002), and lower misoprostol 25 μg tablets (2.18 vs. 2.57, p=0.031). No previous deliveries [x2(1)=3.14, odds ratio (OR): 0.24, 95% confidence interval (CI): 0.10-0.57, R2 Nagelkerke: 0.91, p=0.001] and the presence of one previous delivery [x2(1)=6.0, OR: 3.40, 95% CI: 1.13-10.16, R2 Nagelkerke: 0.043, p=0.029] were significant predictors of successful induction of labor with vaginal misoprostol.

Conclusion: A high rate of labor induction success using vaginal misoprostol in a low-risk population was observed, mainly in multiparous and with gestational age>41 weeks. No previous delivery decreased the success of labor induction, while one previous delivery increased the success of labor induction.

Objective: Nonalcoholic fatty liver disease is a chronic liver disease and a growing global epidemic. The aim of this study was to investigate the association between a visfatin gene (NAMPT) variant and nonalcoholic fatty liver disease, owing to the connection between this disease and insulin resistance, obesity, inflammation, and oxidative stress, and the role of visfatin in these metabolic disorders.

Methods: In the present case-control study, we enrolled 312 genetically unrelated individuals, including 154 patients with biopsy-proven nonalcoholic fatty liver disease and 158 controls. The rs2058539 polymorphism of NAMPT gene was genotyped using the PCR-RFLP method.

Results: Genotype and allele distributions of NAMPT gene rs2058539 polymorphism conformed to the Hardy-Weinberg equilibrium both in the case and control groups (p>0.05). The distribution of NAMPT rs2058539 genotypes and alleles differed significantly between the cases with nonalcoholic fatty liver disease and controls. The "CC" genotype of the NAMPT rs2058539 compared with "AA" genotype was associated with a 2.5-fold increased risk of nonalcoholic fatty liver disease after adjustment for confounding factors [p=0.034; odds ratio (OR)=2.52, 95% confidence interval (CI)=1.36-4.37]. Moreover, the NAMPT rs2058539 "C" allele was significantly overrepresented in the nonalcoholic fatty liver disease patients than controls (p=0.022; OR=1.77, 95%CI=1.14-2.31).

Conclusion: Our findings indicated for the first time that the NAMPT rs2058539 "CC" genotype is a marker of increased nonalcoholic fatty liver disease susceptibility; however, it needs to be supported by further investigations in other populations.