Revista da Associacao Medica Brasileira (1992)最新文献

Objective: The aim of this study was to evaluate the reliability and quality of information provided by artificial intelligence chatbots regarding the diagnosis, preventive methods, and treatment of contrast-associated acute kidney injury, while also discussing their benefits and drawbacks.

Methods: The most frequently asked questions regarding contrast-associated acute kidney injury on Google Trends between January 2022 and January 2024 were posed to four artificial intelligence chatbots: ChatGPT, Gemini, Copilot, and Perplexity. The responses were evaluated based on the DISCERN score, the Patient Education Materials Assessment Tool for Printable Materials score, the Web Resource Rating scale, the Coleman-Liau index, and a Likert scale.

Results: As per the DISCERN score, the quality of information provided by Perplexity received a rating of "good", while the quality of information acquired by ChatGPT, Gemini, and Copilot was scored as "average." Based on the Coleman-Liau index, the readability of the responses was greater than 11 for all artificial intelligence chatbots, suggesting a high level of complexity requiring a university-level education. Similarly, the understandability and applicability scores on the Patient Education Materials Assessment Tool for Printable Materials and the Web Resource Rating scale were low for all artificial intelligence programs. In consideration of the Likert score, all artificial intelligence chatbots received favorable ratings.

Conclusions: While patients increasingly utilize artificial intelligence chatbots to acquire information about contrast-associated acute kidney injury, the readability and understandability of the information provided may be low.

[This corrects the article doi: 10.1590/1806-9282.20240680].

Objective: This study aims to access the frequency of single-nucleotide polymorphism rs12589592 (G>A) of the fibulin-5 gene in a Brazilian population with pelvic organ prolapse.

Methods: This was a case-control study, with menopausal women divided into two groups and classified using the pelvic organ prolapse quantification system: pelvic organ prolapse group: pelvic organ prolapse quantification system stages III and IV and Control group: pelvic organ prolapse quantification system stages I and 0. We collected epidemiologic and baseline health information and performed genotyping of rs12589592 from the fibulin-5 gene using a restriction fragment length polymorphism (polymerase chain reaction-restriction fragment length polymorphism) strategy, based on the distinction of sequences from alleles G and A by the restriction enzyme DdeI. For the pelvic organ prolapse group and control, 111 and 180 women were recruited, respectively.

Results: The rs12589592 (G>A) polymorphism analysis showed 141 GG homozygotes (pelvic organ prolapse group: 53 [47.7%] and Control: 88 [49.2%] p=0.850); and 149 AA+GA: (pelvic organ prolapse group: 58 [52.3%]; Control: 91 [50.8%]; p=0.904). The distribution of genotypes did not follow the Hardy-Weinberg equilibrium conditions.

Conclusion: There was no difference between groups regarding genotypes (rs12589592 G>A) frequency; however, the population characteristics prevent the analysis of the association between the genotype and the occurrence of prolapse.

Objective: This study aims to compare liver and spleen stiffness measurements using magnetic resonance elastography with T1 and T2 relaxation times in patients with chronic liver disease.

Methods: A total of 75 chronic liver disease patients and 25 healthy volunteers underwent MR. Patients with significant liver fat and iron accumulation were excluded. Student's t-test was employed to compare magnetic resonance elastography and T1/T2 values. Pearson's correlation test was used to assess the relationship between magnetic resonance elastography and T1/T2 values.

Results: Liver magnetic resonance elastography showed a significant moderate positive correlation with liver T1 mapping (r=0.51, p<0.001) and liver T2 mapping (r=0.30, p=0.009) in patients. Spleen magnetic resonance elastography exhibited a significant moderate positive correlation with spleen T2 mapping (r=0.37, p=0.001). However, there was no significant correlation between spleen magnetic resonance elastography and spleen T1 mapping in patients. Spleen magnetic resonance elastography was moderately positively correlated with liver magnetic resonance elastography (r=0.30, p=0.01), and spleen volume showed positive correlations with spleen magnetic resonance elastography, spleen T1 mapping, and spleen T2 mapping. Cut-off values for liver magnetic resonance elastography, liver T1 mapping, and liver T2 mapping in patient and control groups were 2.6 kPa (AUC=0.97), 619 ms (AUC=0.90), and 52.5 ms (AUC=0.62), respectively.

Conclusion: Relaxation methods offer noninvasive imaging without additional equipment. Liver T1 mapping may serve as an alternative to magnetic resonance elastography for chronic liver patient follow-up, while spleen T1 mapping is not reliable.

Objective: Controlling Nutritional Status score was previously described and has been used in predicting short- and long-term outcomes in different patient populations. The aim of this study was to test the relationship between Controlling Nutritional Status score and in-hospital mortality in coronary care unit patients (MORCOR-TURK population).

Methods: In this multicenter and national study, all patients with an available Controlling Nutritional Status score were included in the analysis. The Controlling Nutritional Status score was calculated according to previously described criteria. To be able to understand the significance of the Controlling Nutritional Status score, we constructed two models. Model 1 included age, heart failure, chronic kidney disease, hypertension, diabetes mellitus, and coronary artery disease history. Model 2 included the Controlling Nutritional Status score and Model 1. We then statistically compared the performances of the two models.

Results: A total of 1,018 patients with known Controlling Nutritional Status scores were included in the analysis. Demographic characteristics are shown. In Model 1, the -2 log-likelihood ratio was 395.995, Nagelkerke R2 was 0.133, and area under the curve was 0.739 (95%CI 0.67-0.81). In the second model to which the Controlling Nutritional Status score is added (Model 2), the -2 log-likelihood ratio was 373.743, Nagelkerke R2 was 0.191, and area under the curve was 0.787 (95%CI 0.72-0.85). The area under the curve value of Model 2 was statistically higher than Model 1 (DeLong p-value: 0.01). A statistically significant correlation was found between death and Controlling Nutritional Status score in Model 2 [OR 1.347 (1.193-1.521), p<0.001].

Conclusions: Our study showed that the Controlling Nutritional Status score may be a significant predictor of in-hospital mortality in coronary care unit patients.

Introduction: The Ozaki procedure is an open-heart surgery technique used in aortic valve surgery. We investigated the effect of the Ozaki procedure on postoperative hematological and biochemical parameters as in other open-heart surgery applications.

Methods: A total of 42 patients between December 2020 and December 2022 who underwent the Ozaki procedure were analyzed retrospectively. Patients without any comorbid cardiac pathology were included in the study. Preoperative 3rd day, postoperative 6th hour, postoperative 24th hour, postoperative 7th day, and postoperative 30th day hematological and biochemical parameters of 42 patients with screening results were examined.

Results: Postoperative values were compared according to preoperative values. According to this, hematocrit and hemoglobin values were significantly lower at all times postoperatively. While white blood cells were found to be significantly higher until the postoperative 7th day, platelets were found to be significantly lower. The highest levels of creatine, blood urea, nitrogen, and aspartate aminotransferase were detected at the postoperative 24th hour, while the highest level for alanine aminotransferase was observed at the postoperative 7th day.

Conclusion: As with all open-heart surgery methods, the Ozaki procedure may cause some changes in hematological and biochemical parameters in the postoperative period. So, this situation is the same as in other open-heart surgery methods.

Objective: The aim of this study was to investigate the relationship between pelvic obliquity and trunk control, spinal deformity, upper extremity functional performance, and motor function in patients with non-ambulatory Duchenne muscular dystrophy.

Methods: This cross-sectional study included 21 patients with Duchenne muscular dystrophy aged 8-18 years. In the study, participants' upper extremity functional levels, pelvic obliquity degrees, spinal deformity, trunk control, upper extremity performance, and motor functions were evaluated using various tools such as the Brooke Upper Extremity Functional Scale, baseline scoliometer, spinal mouse, Trunk Control Measurement Scale, Upper Extremity Performance Scale, and Egen Klassifikation Scale Version 2, respectively.

Results: The study found a strong correlation between pelvic obliquity and frontal spine deformity (p<0.01), as well as moderate relationships between pelvic obliquity, motor function, wheelchair usage duration, and knee flexion contractures (p<0.05).

Conclusion: The study found that pelvic obliquity may lead to spinal health deterioration and motor function limitations in non-ambulatory patients with Duchenne muscular dystrophy, especially those with lower extremity joint contractures and long-term wheelchair use.