Revista da Associacao Medica Brasileira (1992)最新文献

Objective: Ascertainment of disease activation is an important component of therapeutic decisions in ulcerative colitis patients and may present certain clinical challenges. The objective of this study was to determine serum levels of the M30 fragment of cytokeratin 18 and its utility as an activation marker in patients with ulcerative colitis, who are known to have increased apoptosis.

Methods: A total of 60 ulcerative colitis (30 active and 30 remission) patients aged over 18 years and 29 healthy individuals as controls were included in the study. M30, C-reactive protein, and mean platelet volume were evaluated in all participants and compared between ulcerative colitis patients and controls, as well as between those with active disease or remission.

Results: Although ulcerative colitis patients with active disease had higher M30 levels than those in remission, the difference was not statistically significant (p=0.085). The mean M30 levels tended to increase with increasing extent of involvement, although the differences were not significant (p=0.065). The comparison of C-reactive protein and mean platelet volume according to the site of involvement, however, showed significant differences (p=0.02 and 0.004, respectively). M30 did not show significant correlations with C-reactive protein, mean platelet volume, and Mayo Score (p=0.0834, 0.768, and 0.401, respectively).

Conclusions: Our results suggest that, in contrast to C-reactive protein and mean platelet volume, M30 levels do not have a significant role as an activation marker in ulcerative colitis patients. Thus, we believe that M30 may not represent an appropriate marker to be used for this purpose.

Objective: Ghrelin is an adipokine the placenta generates to control the maternal metabolic adaptation to pregnancy. It causes different pregnancy complications like preeclampsia (PE). Therefore, the aim of this study was to assess the association between ghrelin mRNA expression and rs26311 and rs27647 polymorphisms and PE development.

Methods: In total, 156 PE women (including 97 patients with mild PE and 59 patients with severe PE) and 152 healthy controls were recruited in this case-control study during 2019-2020. All participants with other diseases have been excluded from both groups. The ghrelin expression was analyzed with real-time PCR, and ghrelin variants were examined using the RFLP-PCR method.

Results: The maternal and placental ghrelin rs27647 and rs26311 variants were unrelated to PE susceptibility. Haplotype analyses showed no significant difference between the four haplotypes and PE. No relationship was revealed between rs27647 polymorphism and severe PE. However, the results indicated a relationship between rs27647 and severe PE compared to mild PE and controls. Therefore, the rs27647 variant was associated with severe PE compared to mild PE in codominant, recessive, and log-additive models and controls in codominant, dominant, recessive, and log-additive models. The placental ghrelin mRNA expression declined in PE women compared to controls (0.67-fold), but the difference was insignificant (p=0.263). No significant difference was found between various genotypes of rs27647 and rs26311 polymorphisms concerning ghrelin mRNA expression.

Conclusion: The maternal and placental ghrelin polymorphisms, rs27647 and rs26311, showed no effect on PE. However, the rs27647 variant was associated with severe PE.

Objective: The aim of this study was to investigate the effect of watching mukbang on eating behavior and to emphasize its importance.

Methods: Students from various faculties at universities constitute the sample for this study. A total of 483 individuals participated in the study: 358 (74.1%) women and 125 (25.9%) men. The age range of the sample group varies between 18 and 50 years (Mage=21.62; SD=3.85). In our study, the Emotional Eating Disorder Scale, the Mukbang Addiction Scale, and the Problematic Internet Use Scale were used. Reliability analysis, descriptive statistics, and correlational analysis of the data were carried out using IBM SPSS Statistics 24.

Results: There appears to be a positive relationship between emotional eating, mukbang addiction, and problematic internet use. A positive relationship was also found between emotional eating and mukbang addiction. It was found that mukbang addiction had a partial mediator role in the effect of problematic internet use on emotional eating.

Conclusion: In the relationship between problematic internet use and emotional eating, mukbang addiction has played a mediating role. Therefore, when conducting a study between emotional eating and problematic internet use, it may be useful to examine the frequency of mukbang watching behavior in individuals. It can be crucial to include these people in educational programs to control problematic internet use or the habit of watching mukbang.

Objective: The aim of this study was to evaluate the role of the prognostic nutritional index in predicting in-hospital mortality among patients with acute ischemic stroke.

Methods: This retrospective, observational study included patients diagnosed with acute ischemic stroke at the emergency department of the hospital between January 1, 2022, and January 1, 2023. Demographic data, vital parameters, comorbidities, stroke interventions, and laboratory data were collected from electronic medical records. Prognostic nutritional index was calculated using serum albumin levels and a total lymphocyte count. The primary outcome was in-hospital mortality.

Results: The study included 176 patients, divided into survivor (93.2%, n=164) and deceased (6.8%, n=12) groups. No significant differences were observed in age, gender, blood pressure, heart rate, or body temperature between the groups. Atrial fibrillation was significantly more common in the deceased group (50%) compared to the survivor group (18.9%) (p=0.011). The median lymphocyte count was significantly higher in the survivor group (1,353 [interquartile range, IQR 984-1,968]/mm³) compared to the deceased group (660 [IQR 462-1,188]/mm³) (p=0.009). The median albumin level was significantly lower in the deceased group (3.31 [IQR 2.67-3.4] g/dL) compared to the survivor group (3.74 [IQR 3.39-4.21] g/dL) (p<0.001). The median prognostic nutritional index was significantly higher in the survivor group (46.05 [IQR 39.1-51.3]) compared to the deceased group (36.7 [IQR 28.7-40.5]) (p<0.001). The area under the receiver operating characteristic for prognostic nutritional index predicting mortality was 0.791 (95%CI 0.723-0.848) (p=0.0002), with a cut-off value of ≤41.92 providing the highest diagnostic accuracy.

Conclusions: Prognostic nutritional index is a valuable prognostic indicator for in-hospital mortality in acute ischemic stroke patients. Low prognostic nutritional index values are associated with increased mortality risk. Incorporating prognostic nutritional index into clinical practice may aid in the early identification of high-risk patients and the optimization of treatment strategies. Further research is needed to validate these findings and explore the broader clinical applications of prognostic nutritional index.

Objective: Coronary artery disease (CAD) is frequent, but coronary slow flow (CSF) is a less common cardiovascular disease with a significant risk of mortality and morbidity. Endocan is a proinflammatory glycopeptide that has been investigated in cardiovascular diseases as well as some inflammatory diseases in recent years. We planned to compare the levels of endocan in both CAD and CSF in a similar population and examine the relationship of endocan with additional clinical variables.

Materials and methods: In the trial, we included 169 consecutive subjects having a coronary angiography indication. According to the results of coronary angiography, 58 people were included in the CAD group, 52 were in the CSF group, and 59 people were in the control group. The control group includes those who did not have any lesions in their epicardial coronary arteries. Thrombolysis in myocardial infarction (TIMI)-frame counts (TFC) were calculated for all patients.

Results: Notably, 2.6% of the population in our study had CSF. Both the CAD (555±223 pg/mL) and CSF (559±234 pg/mL) groups had higher endocan levels than the control group (331±252 pg/mL) (p<0.001). There were similar endocan levels between the CAD and CSF groups. Endocan levels were shown to be favorably associated with mean TFC (r=0.267; p0.001). Serum endocan levels (particularly those above 450 pg/mL) and the presence of hyperlipidemia were the most important predictors of both CAD and CSF.

Conclusion: Endocan levels are higher in CAD and CSF patients than in those with normal coronary arteries.

Background: Routine screening for viral infections at blood donation is important to avoid transfusion-transmitted infections. It also offers an opportunity to detect an asymptomatic infection.

Objective: To study changes in serology positivity for viral infections (B and C hepatitis, HTLV-1/2, and HIV) at blood donation in a blood bank from Southern Brazil, comparing two periods of 5 years: the period from 2013 to 2017 with the period from 2018 to 2022. In addition, data on the donor fidelity rate during the studied period were sought.

Methods: Retrospective study using data from 2013 to 2022 from a single blood center electronic database from Curitiba, Southern Brazil.

Results: A significant drop in positive serology for all studied viruses was observed: highest in HIV (OR=0.39; 95% CI=0.27-0.57) and lowest in total anti HBc (0.56; 95 CI=0.50-0.63). Anti HBc serology became more commonly seen in women in the period of 2018-2022 when compared to men. No changes in the distribution of positive serology according to donors' ages were observed. Loyalty rates had a median of 70%, with the lowest being 60% in 2013, while the highest was 73% in 2018 and 2022.

Conclusion: A significant reduction in discarded blood bags due to viral serology was observed when the period of 2013-2017 was compared to 2018-2022 on this blood bank; the highest reduction was observed in HIV serology and the lowest in HBc serology, which became more common in women in the second period. High rates of donor fidelity were observed during the period studied.