Revista da Associacao Medica Brasileira (1992)最新文献

Objective: Human papillomavirus, the primary etiological agent of cervical cancer, is considered to be the most common sexually transmitted infection worldwide. The aim of this study was to determine the human papillomavirus literacy levels of midwifery students.

Methods: This cross-sectional and descriptive study included midwifery students enrolled in a university in Türkiye during the 2024-2025 academic year. Out of 327 students enrolled in the midwifery program, 284 voluntarily participated in the study. Data were collected online using a Personal Information Form and the Human Papillomavirus Literacy Scale. A significance level of p<0.05 was used in the data analysis. Ethics committee and institutional approvals were obtained before the study.

Results: The mean age of the students was 21.08±2.46, and 27.8% of them were in the first year. A majority (82.7%) reported having information about human papillomavirus, primarily obtained from school (79.6%), social media/TV (48.6%), and health institutions (27.5%). Most students (97.5%) knew human papillomavirus is contagious, and 96.1% recommended human papillomavirus screening to others. The mean total Human Papillomavirus Literacy Scale score was 90.85±15.60, on a scale ranging from 24 to 120. The subdimension scores were as follows: 45.28±8.13 for knowledge, 21.75±4.56 for screening, and 23.81±4.04 for analysis.

Conclusion: The study found that midwifery students have a high level of human papillomavirus literacy. The majority reported acquiring their knowledge through school and media, highlighting the positive impact of formal education and media on human papillomavirus awareness. The findings emphasize the importance of integrating human papillomavirus education into the curriculum. Additionally, community-based education programs can be effective in reaching broader populations, increasing awareness, and promoting preventive health behaviors.

Objective: Artificial intelligence tools like Chat Generative Pretrained Transformer-4 are increasingly used in clinical decision-making, but their reliability for acute compartment syndrome remains understudied. The aim of the study was to evaluate Chat Generative Pretrained Transformer-4's accuracy, completeness, and quality in responding to acute compartment syndrome-related queries, addressing gaps in artificial intelligence-assisted medical information.

Methods: Chat Generative Pretrained Transformer-4 was given 60 questions (40 open-ended and 20 binary) that were taken from the American Academy of Orthopaedic Surgeons 2019 acute compartment syndrome guidelines. Responses were evaluated independently by two orthopedic specialists using the Quality Criteria for Consumer Health Information instrument (information quality), Flesch-Kincaid Reading Ease Score (readability), and Likert scales (accuracy and completeness). Inter-rater reliability (Cohen's kappa) was a statistical analysis.

Results: Chat Generative Pretrained Transformer-4 demonstrated high accuracy (95% for both question types) and completeness (mean scores: 5.92±0.8 [accuracy], 2.9±0.5 [completeness]). DISCERN scores were "excellent" (69-72), though source reliability was limited. Readability was "very difficult" (Flesch-Kincaid Reading Ease Score: 22.19), potentially hindering patient comprehension.

Conclusion: Although Chat Generative Pretrained Transformer-4 is excellent at providing precise, high-quality acute compartment syndrome information, its complicated language and lack of credible sources make it difficult for wider adoption. To improve clinical utility and patient education, readability and transparency must be given top priority in future artificial intelligence developments.

Objective: The effectiveness of fluidotherapy has not been investigated in patients with distal radius fracturedistal radius fracture.

Aims: The aim of this study was to investigate the effectiveness of fluidotherapy added to conventional rehabilitation programs on pain, edema, muscle strength, and functionality in conservatively followed distal radius fracture patients.

Methods: The present randomized controlled, single-blinded study was conducted with 40 distal radius fracture patients who were followed conservatively with a cast. The patients were divided into two groups: the fluidotherapy and conventional rehabilitation groups. In addition to the conventional rehabilitation programs, the patients in the fluidotherapy group received 30 sessions of fluidotherapy for 6 weeks. Rest and activity pain were measured with the Numeric Rating Scale, edema with the Figure 8 method, joint range of motion with goniometry, handgrip strength with a dynamometer, and functionality with the patient-rated wrist evaluation questionnaire. Outcome measures were assessed at baseline, at week 2, and at week 6.

Results: Statistically significant changes were found in the intragroup measurements for all parameters in both groups (p<0.05). In the measurements between the groups, there was a statistical difference in the Numeric Rating Scale rest and range of motion flexion values in the conventional rehabilitation group and in the range of motion pronation parameters in the fluidotherapy group (p<0.05). No difference was found between the groups in the other parameters (p>0.05).

Conclusion: Adding fluidotherapy to distal radius fracture rehabilitation had no effect on activity pain, edema, muscle strength, or functionality. Improvement in resting pain among distal radius fracture patients was less with the addition of fluidotherapy. Fluidotherapy was effective only on wrist pronation.

Objective: Placental insufficiency, which plays a crucial role in both preeclampsia and fetal growth restriction, can cause oxidative stress and high reactive oxygen species production that could lead to hypoxia. Carbonic anhydrase IX is induced by hypoxia-inducible factor-1α, an important transcriptional regulator of genes involved in response to hypoxia. Considering this, we aimed to determine carbonic anhydrase IX levels in early preeclampsia with and without fetal growth restriction, and also to evaluate the predictive role of carbonic anhydrase IX for the development of fetal growth restriction in early onset preeclampsia.

Methods: This prospective study included a total of 180 participants, who were divided into two groups-early onset preeclampsia (n=90) and control (n=90). Then, preeclamptic patients were followed and subgrouped as preeclampsia with fetal growth restriction (n=35) and without fetal growth restriction (n=55). Sociodemographic and obstetric characteristics and laboratory features including carbonic anhydrase IX were compared between groups.

Results: Median carbonic anhydrase IX was higher in preeclampsia than controls [2.07 (0.78-5.48) vs. 1.32 (0.63-2.12), p<0.001]. Moreover, median carbonic anhydrase IX was higher in the preeclampsia with fetal growth restriction group as compared to the preeclampsia without fetal growth restriction group [2.76 (0.78-5.48) vs. 1.77 (0.89-5.14), p=0.018]. The carbonic anhydrase IX >1.83 pg/mL predicted fetal growth restriction with 77.14% sensitivity and 52.73% specificity (p=0.015, AUC=0.649) in the early onset preeclampsia.

Conclusion: Carbonic anhydrase IX could reflect the insufficiency of the placenta in early onset preeclampsia and fetal growth restriction, and it could be used in early onset preeclampsia patients for the prediction of fetal growth restriction.

Objective: Artificial intelligence chatbots are increasingly used to disseminate health information. The aim of this study was to evaluate the accuracy, reliability, quality, and readability of responses generated by four artificial intelligence chatbots regarding human papillomavirus vaccination.

Methods: Frequently asked questions about human papillomavirus vaccination were identified using a Google search tool, and these questions were posed to the ChatGPT-3.5, Gemini, Copilot artificial intelligence, and ChatGPT-4 models. Responses were assessed for accuracy (five-point Likert scale), reliability (modified DISCERN scale), quality (Global Quality Scale), and readability (Flesch Reading Ease Score). Interobserver agreement was evaluated by the intraclass correlation coefficient. The results were evaluated at a significance level of p<0.05. SPSS 23.0 package programme was used in the analyses.

Results: There were significant differences between chatbots in terms of accuracy (p=0.001), reliability (p<0.001), and quality (p<0.001), but no significant difference in readability (p=0.497). ChatGPT-4 demonstrated the highest accuracy and quality, while Copilot artificial intelligence demonstrated superior reliability. All models produced responses that were moderately difficult to read. The intraclass correlation coefficient values for inter-rater reliability ranged from 0.034 to 0.512.

Conclusion: Artificial intelligence chatbots show promising potential for use as patient information counsellors regarding human papillomavirus vaccination. However, improvements in readability and consistent evidence-based content generation are required before widespread clinical application.