Revista da Associacao Medica Brasileira (1992)最新文献

Objective: The aim of this study was to examine the relationship between quality of life and self-confidence in women diagnosed with polycystic ovary syndrome, a chronic endocrine disorder that affects both physical and psychological well-being.

Methods: A cross-sectional study was conducted with women diagnosed with polycystic ovary syndrome. Data were collected using the Polycystic Ovary Syndrome Quality of Life-50 Scale (PCOSQ-50) and the Female Self-Confidence Scale. Descriptive statistics, correlation, and regression analyses were used to evaluate the association between quality of life and self-confidence levels.

Results: The findings indicated that sociodemographic and gynecologic characteristics did not significantly affect the quality of life or self-confidence levels of the participants. However, a significant positive correlation was observed between polycystic ovary syndrome-related quality of life and self-confidence (p>0.05). Women with lower quality of life scores reported significantly lower levels of self-confidence. Psychological distress, body image dissatisfaction, and infertility concerns were found to be key contributing factors to decreased self-confidence.

Conclusion: Polycystic ovary syndrome negatively impacts women's psychological well-being and self-confidence, in addition to its physical symptoms. Integrating psychological support into polycystic ovary syndrome treatment may help to improve quality of life and promote emotional resilience. A multidisciplinary approach is essential for comprehensive care of women with polycystic ovary syndrome.

Objective: Crimean-Congo hemorrhagic fever is a severe viral hemorrhagic disease transmitted by ticks and characterized by fever, malaise, and hemorrhages. This research was designed to measure serum neopterin concentrations in patients with Crimean-Congo hemorrhagic fever and to assess how these levels are associated with the disease's progression.

Methods: A total of 60 patients and 25 healthy controls, monitored at the Atatürk University Infectious Diseases Clinic from March 2009 to September 2010, were enrolled in the study. Serum neopterin concentrations were determined using an ELISA method, and statistical tests were conducted to explore their association with various clinical parameters.

Results: The results indicated a significant increase in serum neopterin levels in patients with Crimean-Congo hemorrhagic fever, and this rise was strongly linked to disease prognosis. Additionally, research has established that serum neopterin levels play a crucial role in determining patient outcomes, including survival and mortality.

Conclusion: This study has demonstrated that neopterin levels can be used not only to track disease progression but also as a predictor of prognosis. Future research should delve deeper into the role of this biomarker in disease management.

Objective: The aim of this study was to evaluate the kinetics of immunoglobulin G and neutralizing antibody responses following vaccination with CoronaVac in healthcare professionals.

Methods: A cohort of 35 healthcare professionals was recruited, and blood samples were collected to assess immunoglobulin G detection and neutralizing antibodies against severe acute respiratory syndrome coronavirus 2.

Results: Immunoglobulin G seroconversion peaked at D30 (68.2%, 15/22), followed by stabilization at D48 and D90. Logistic regression confirmed a significant association between time post-vaccination and seroconversion (p=0.0043). Neutralizing antibody analysis showed a stable detection rate for Nab V1 (Wuhan and B.1.1.7) between D48 and D90 (p>0.9999), while Nab V2 (B.1.351 and P.1) remained consistently lower. Among immunoglobulin G-positive individuals, 92.3% (12/13) had neutralizing antibodies at D48, decreasing to 42.8% (6/14) at D90.

Conclusion: CoronaVac effectively induces immunoglobulin G seroconversion, peaking at D30. However, neutralizing responses to emerging variants were lower, suggesting the need for booster doses to maintain immunity. These findings highlight the importance of monitoring vaccine-induced immunity over time.

Objective: The aim of this study was to compare central blood pressure, central pulse pressure, and parameters like augmentation index and pulse wave velocity, which are used to evaluate arterial stiffness using an oscillometric method called arteriography, among hypertensive patients with and without concomitant ascending aortic aneurysms.

Methods: This research was conducted as a single-center and prospective study. A total of 83 patients were included in this study, including 44 consecutive patients with hypertension diagnosed and an ascending aortic diameter of 40 mm or more detected by 2D transthoracic echocardiography, and 39 controls with hypertension diagnosed and a normal ascending aortic diameter.

Results: E/e' ratio was found to be significantly higher in the aneurysm group (9.05±2.24 vs. 7.75±1.94, p<0.05). The difference between peripheral and central systolic blood pressures was found to be significantly lower in the aneurysm group compared to the control group (9.3±4.5 vs. 11.8±4.1, p<0.05, respectively). Among the examined arterial stiffness parameters, augmentation index values were significantly higher in the aneurysm group (27±8.7 vs. 22.7±9.6, p<0.05), while pulse wave velocity did not show a statistically significant difference between the groups (8.85±1.85 vs. 8.59±1.19, p>0.05, respectively).

Conclusion: Our study suggests that a potential relationship between the development of ascending aortic aneurysm and elevated aortic stiffness in hypertensive patients.

Objective: The aim of the study was to investigate the relationship between echocardiographic parameters and clinical outcomes in acute ischemic stroke patients undergoing mechanical thrombectomy, aiming to identify predictors of poor prognosis despite successful recanalization.

Methods: This retrospective, single-center study included 320 acute ischemic stroke patients treated with mechanical thrombectomy for large vessel occlusion. Demographic, clinical, and echocardiographic data were collected. Univariable and multivariable logistic regression and receiver operating characteristic analyses were used. Futile recanalization was defined as achieving modified Thrombolysis in Cerebral Infarction 2b-3 with a poor functional outcome (mRS 3-6).

Results: Of the 320 patients, 176 (55%) were classified as favorable and 144 (45%) as futile recanalization. The futile group had a higher mean age (77.3±12.7 vs. 67.6±12.8; p<0.001), National Institutes of Health Stroke Scale score (median 17 vs. 14; p=0.007), and puncture-to-recanalization time (47.5 vs. 30 min; p=0.017), and lower Alberta Stroke Program Early Computed Tomography score (7.5 vs. 10; p<0.001). Echocardiographically, they had lower left ventricular ejection fraction (55 vs. 57.5%; p=0.036) and larger left ventricular end-diastolic diameter (4.8 vs. 4.5 cm; p=0.002). Multivariable analysis identified low Alberta Stroke Program Early Computed Tomography score (OR 0.192; p=0.002), high National Institutes of Health Stroke Scale (OR 1.212; p=0.029), and low left ventricular ejection fraction (OR 0.919; p=0.047) as independent predictors. Alberta Stroke Program Early Computed Tomography had the highest predictive value (area under the curve : 0.851), followed by left ventricular ejection fraction (area under the curve: 0.631), while National Institutes of Health Stroke Scale showed lower predictive power (area under the curve: 0.326).

Conclusion: Poor outcomes after mechanical thrombectomy are associated with low Alberta Stroke Program Early Computed Tomography scores, high National Institutes of Health Stroke Scale, and reduced left ventricular ejection fraction. Echocardiographic evaluation, particularly of left ventricular ejection fraction, may aid in prognostication and treatment planning in acute ischemic stroke.

Objective: Despite the longstanding clinical use of low-molecular-weight heparins and their well-characterized mechanisms of action, their effects on mitophagy pathways in acute myocardial ischemia remain incompletely delineated. The aim of this study was to investigate the enoxaparin effect on cardiomyocyte morphology and the immunopositivity of mitophagy-associated Parkin-LC3 proteins in a rat model of acute myocardial ischemia.

Methods: Female Wistar albino rats (median weight: 400 g, minimum: 375 g-maximum: 415 g) were divided into sham (n=7), control (n=7), and treatment (n=7) groups. The control group received subcutaneous 0.9% saline (0.2 mL/kg) twice daily for 28 days, followed by the induction of myocardial ischemia. The treatment group was administered subcutaneous enoxaparin sodium (1 mg/kg) twice daily for the same duration before undergoing myocardial ischemia. Myocardial ischemia was induced by occluding the proximal left anterior descending coronary artery using a 6-0 polypropylene suture for 10 min. Morphometric calculations of cardiomyocytes (cell length and diameter) were performed using light microscopy. Immunohistochemical analysis was performed using anti-Parkin and anti-LC3 antibodies, and immunopositive cells were counted.

Results: Statistically significant differences were found between the groups (p<0.001). Post-hoc analysis revealed significant differences between the control and treatment groups based on cell length, cell diameter, Parkin, and LC3 values (p<0.001, p=0.001, p<0.001, and p=0.001, respectively).

Conclusion: This study demonstrated that enoxaparin preserved cardiomyocyte morphology and reduced the number of Parkin-LC3 immunopositive cells in a model of induced acute ischemic injury in rat myocardium.

Objective: This research sought to examine the relationship between toilet behaviors and recurrent urinary tract infections in women.

Methods: This descriptive correlational study was conducted with female patients with recurrent urinary tract infections who applied to the urology outpatient clinic of a city hospital in Istanbul between March 2023 and April 2024. Data were collected using the Patient Information Form and Toileting Behavior-Women's Elimination Behaviors Scale.

Results: The total mean score of the Toileting Behavior-Women's Elimination Behaviors Scale was found to be 49.79±9.98 in the patients. When the total mean scores of the Toileting Behavior-Women's Elimination Behaviors Scale were examined according to the individual characteristics of the patients, it was found that there was a statistical difference in the mean score of the Toileting Behavior-Women's Elimination Behaviors Scale according to marital status, education level, incontinence status, preferred toilet position inside, and outside the home (p<0.05) and that there was a statistical relationship between age and the mean score of the Toileting Behavior-Women's Elimination Behaviors Scale (p<0.05).

Conclusion: Increasing age had a negative effect on early voiding and straining behaviors, and the presence of incontinence had a negative effect on early voiding and general toilet behavior in women with recurrent urinary tract infections.

Objective: In obesity, the fat storage in the body increases excessively and affects the whole metabolism.

Methods: Sixty-two obese patients were included in the study. The effect of weight loss, which was achieved with a 3-month diet/exercise program, on the following analytes was investigated; serum total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, triacylglycerol, triglycerides (TAG), glucose, resistin, apelin, and a transcription factor sterol regulatory element binding protein-1c, and blood hemoglobin A1c. Basal (prediet/exercise) levels of analytes were taken as control values, and they were compared to the postdiet/exercise levels.

Results: After the 3-month diet/exercise program, apelin, hemoglobin A1c, and triacylglycerol, triglycerides levels decreased compared to basal levels, and those of sterol regulatory element binding protein-1c, glucose, and low-density lipoprotein-cholesterol increased.

Conclusion: Considering the insulin-like effects of apelin, high levels of apelin in prediet/exercise phase can be interpreted as a kind of resistance to apelin, and the decreased postdiet/exercise apelin levels as a kind of normalization of it. The decrease in hemoglobin A1c and triacylglycerol, triglycerides levels following weight loss can be appreciated. High basal serum sterol regulatory element binding protein-1c levels suggest an increase in lipogenesis. The increases in glucose and low-density lipoprotein-cholesterol after diet/exercise program remain in a physiological range. However, we think that a longer diet/exercise follow-up in a larger population will further elaborate on the issue.

Objective: The aim of this study was to investigate maternal and paternal perceptions of breastfeeding self-efficacy in the postpartum period in Turkey between December 2023 and June 2024.

Methods: The present study was designed as a cross-sectional study. The sample consisted of 150 mothers and 150 fathers, making a total of 300 participants. Data were collected through face-to-face interviews using the "Descriptive Information Form for Mothers and Fathers," the "Breastfeeding Self-Efficacy Scale," and the "Paternal Breastfeeding Self-Efficacy Scale-Short Form." Data collection was carried out between December 2023 and June 2024. The obtained data were analyzed using the SPSS 25.0 statistical program, and a statistical significance level of p<0.05 was accepted.

Results: Mothers' scores were higher than fathers' scores (p<0.001). It was found that paternal breastfeeding self-efficacy significantly affected mothers' breastfeeding self-efficacy (r=0.520, p<0.001). In the multiple regression analysis, monthly income, breastfeeding education, and the time of first breastfeeding were found to affect mothers' breastfeeding self-efficacy (R2=0.099, p=0.02). Also found that employment status, breastfeeding experience, and planned pregnancy variables affected paternal breastfeeding self-efficacy (R2: 0.161, p<0.001).

Conclusion: Empowering fathers about breastfeeding with in-service training and multidisciplinary approach is very important to increase breastfeeding rates. In addition, it is recommended that fathers should be handled together with pregnant women from the prenatal period, and counseling services should be provided to support the positive development of their perspective on breastfeeding.