Resumo em Inglês:

SUMMARY OBJECTIVE: Obesity is a significant risk factor for endometrial cancer. In contrast, sarcopenia describes a loss of the body’s muscle mass that is closely related to unfavorable clinical outcomes. Even endometrial cancer patients have high rates of obesity, and they should have a significantly higher risk for undiagnosed sarcopenia or fragile muscle quality. METHODS: This is a retrospective study that included an endometrial cancer database collected from a tertiary gynecologic cancer center. We investigated the relationship between preoperative psoas muscle area by magnetic resonance imaging, surgical outcomes and pathological features. RESULTS: The study included 116 patients, the mean height was 160 cm (Standart deviation 7), weight was 72 kg (Standart deviation 18), and the median duration of hospitalization was 4 days (Interquartile range 2–9) in the whole study group. Sarcopenia was diagnosed in 25 (21.6%) patients, according to the magnetic resonance imaging findings. Three (6.5%) obese patients had sarcopenia, but it was 31.4% in nonobese patients (p=0.026). The median duration of hospitalization was five days (3–9 days) in the sarcopenia group, and it was four days (2–7 days) in the non-sarcopenia group. CONCLUSION: Sarcopenic patients did not have increased surgical complication rates following uterine cancer surgery. We should be aware of hospitalization duration in those patients, and sarcopenic counterparts necessitate longer follow-up after the surgery.

Resumo em Inglês:

SUMMARY OBJECTIVE: Studies on ischemia/reperfusion injury remain the focus of interest. Ticagrelor and enoxaparin, which are antiaggregant and anticoagulant drugs developed for use in many cardiovascular pathologies, are still included in many ischemia/reperfusion studies. Remarkably, their new protective effects, especially with regard to ticagrelor, continue to be reported in the current literature. The aim of this study was to evaluate the beneficial effects of ticagrelor and enoxaparin pretreatments on the rat heart with histological and immunohistochemical markers in an ischemia/reperfusion model. METHODS: Wistar–albino rats (weighing 350–400 g) were divided into four groups as follows: Sham-Control (Group 1), Control-Saline+ischemia/reperfusion (Group 2), Ticagrelor+ischemia/reperfusion (Group 3), and Enoxaparin+ischemia/reperfusion (Group 4). The ischemia/reperfusion injury model was applied to Group 2, Group 3 and Group 4. Heart tissue sections were stained with hematoxylin and eosin for histological examinations. Caspase 3 immunostaining was evaluated to detect apoptosis in the heart tissue sections. RESULTS: Both pretreatments ameliorated the ischemic damage but especially tissue sections belonging to Group 3 were nearly similar to control levels. The results indicated that ischemia/reperfusion-induced myocardial damage was significantly increased in Group 2, whereas ticagrelor and enoxaparin pretreatments in Group 3 and Group 4 significantly decreased apoptotic scores and the histological appearance of the Group 3 close to the normal myocardium (p<0.001). CONCLUSION: As supported by histological findings in our study, ticagrelor and enoxaparin have protective properties for heart tissue in this ischemia/reperfusion injury model.

Resumo em Inglês:

SUMMARY OBJECTIVE: Crude oil extracts, components of extracts, and ethanolic extracts of Inula graveolens possess various pharmacological activities on various cancer cells including antioxidative and antiproliferative effects. Aqueous extract of this species has not been investigated on the liquid malignancies and solid tumors with a high incidence of treatment refractoriness and poor survival outcomes such as glioblastoma and leukemia. Hence, the present study aimed to evaluate the cytotoxic efficiency of I. graveolens aqueous extracts on human glioblastoma multiforme and chronic myelogenous leukemia cell lines in comparison to non-cancerous primary rat cerebral cortex and human peripheral blood mononuclear cells. METHODS: The cells were treated with the extracts of I. graveolens (125–1000 μg/mL) for 48 h, the cellular viability was identified using 3'-(4,5dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay, and lactate dehydrogenase release was measured to determine the cytotoxic potential. Total oxidant status and apurinic/apyrimidinic endodeoxyribonuclease 1 assays were used to determine the oxidative status of cells and DNA damage, respectively. RESULTS: I. graveolens showed selective cytotoxicity toward human glioblastoma multiforme and chronic myelogenous leukemia cell lines and exhibited a higher antiproliferative effect against cancer cells in comparison to non-cancerous cells. Moreover, it significantly reduced the apurinic/apyrimidinic endodeoxyribonuclease 1 levels on both cancer cell lines as compared with their control cells without changing the levels of an oxidative stress marker. CONCLUSION: The extracts of I. graveolens have anti-cancer potential on human glioblastoma multiforme and chronic myelogenous leukemia cell lines without causing oxidative stress.

Resumo em Inglês:

SUMMARY OBJECTIVE: The study aimed to investigate the use of Neutrophil/lymphocyte ratio, C-reactive protein/albumin ratio, controlling nutritional status, and prognostic nutritional index immune, inflammatory, and malnutrition markers Metabolic syndrome+ in sarcoidosis patients, as an early-stage marker. METHOD: This is a single-center and cross-sectional study that determines the association of Metabolic syndrome in patients with sarcoidosis. Patients were evaluated based on the National Cholesterol Education Program’s Adult Treatment Panel III criteria. Neutrophil/lymphocyte ratio, C-reactive protein/albumin ratio, controlling nutritional status, and prognostic nutritional index values were simultaneously determined through blood test. RESULTS: A total of 253 patients diagnosed with sarcoidosis were included in this study. Metabolic syndrome– was detected in 37.2% of patients. The prevalence was significantly higher in females (p<0.001). Any degree of malnutrition assessed by controlling nutritional status had higher Metabolic syndrome (p=0.035). The Neutrophil/lymphocyte ratio cutoff value was 2.24, sensitivity was 70.53, specificity was 60.13, and Area Under the Curve value was 0.663 for predicting Metabolic syndrome in sarcoidosis patients. CONCLUSION: Neutrophil/lymphocyte ratio and controlling nutritional status are associated with the Metabolic syndrome+ in sarcoidosis patients. Thus, close monitoring of Neutrophil/lymphocyte ratio and controlling nutritional status increase in terms of Metabolic syndrome and immune malnutrition may be important in sarcoidosis patients.

Resumo em Inglês:

SUMMARY OBJECTIVE: This study assessed obesity prejudice levels, attitudes, and perceptions of health care workers toward individuals with obesity and the relationship between health care workers’ perceptions of own and society’s weight bias, healthy lifestyle preferences, body mass index, and other factors with obesity prejudice levels. METHODS: This cross-sectional and descriptive study was conducted with 700 health care workers in Turkey via an online survey addressing characteristics, perceptions, and attitudes toward obesity including an obesity prejudice scale. Categorical variables were expressed as frequencies and percentages. The χ² test was applied to compare categorical variables. The distribution of the data was evaluated by the Kolmogorov-Smirnov test. Normally distributed data were compared by an independent sample t-test, while the Mann-Whitney U and Kruskal-Wallis tests were used for comparing non-normally distributed data. RESULTS: Participants’ mean age was 40.2±11.3 years and 67.9% were women. Notably, 57.9% worked at tertiary health care centers, 85.9% were physicians, and 64.8% were family physicians; 25% were prejudicial, while 58.1% tended to have prejudice toward individuals with obesity. Obesity prejudice scores were significantly higher among those who were in close contact with and who stated their preference for patients with obesity. CONCLUSIONS: Half of the participants tended to have prejudice, and one-fourth were prejudicial toward individuals with obesity. These results highlight the necessity of raising awareness of health care workers to reduce prejudicial attitudes that may negatively impact patients with obesity. Stigmatizing experiences might be detrimental, reducing the quality of life with long-term consequences for emotional and physical health.

Resumo em Inglês:

SUMMARY OBJECTIVE: Ureteral stents usually cause pain and lower urinary tract discomfort. This study aimed to compare the effect of mirabegron with oxybutynin in relieving ureteral stent-related symptoms over time. METHODS: A prospective, longitudinal, randomized, single-blinded study was conducted. Patients who had a ureteral stent inserted after urolithiasis treatment were classified into two groups and received either oxybutynin 5 mg/day (Group O) or mirabegron 50 mg/day (Group M). The Ureteral Stent Symptoms Questionnaire (USSQ) was applied on the 3rd, 6th, and 15th postoperative days. Group domain scores were compared, and a mixed linear model was used to better assess score differences. RESULTS: Ureteral Stent Symptoms Questionnaire scores were similar in both groups during all three postoperative days (p>0.05). A longitudinal analysis showed that global quality of life and general health improved over time, independently of the use of any of the medications (p<0.05), while urinary symptoms and body pain scores were lower over time in participants receiving oxybutynin. CONCLUSION: Both mirabegron and oxybutynin are equivalent in relieving ureteral stent symptoms. Moreover, some stent symptoms seem to decrease over time despite the use of medication.

Resumo em Inglês:

SUMMARY OBJECTIVE: The objective of the study was to correlate the thermal pain threshold (heat and cold) on myofascial trigger points with measurements of pain and skin temperature in patients with chronic neck pain. METHODS: This is a cross-sectional study. We included participants of both genders, aged between 18–45 years, with chronic neck pain (>90 days), and with active bilateral myofascial trigger point centrally located in the upper trapezius muscle. Neck Disability Index, Numerical Rating Scale, Pain-Related Catastrophizing Thoughts Scale, algometry, infrared thermography, and quantitative sensory testing were used for the evaluation. RESULTS: A significant, weak, and negative association was observed between pain intensity and heat pain threshold on the myofascial trigger point to the right (rho -0.381, p=0.022) and to the left (rho -0.334, p=0.049), and a significant, weak, and positive association was observed between pain intensity and cold pain threshold on the myofascial trigger point to the right (rho 0.471, p=0.004) and to the left (rho 0.339, p=0.043). CONCLUSION: Thermal pain threshold (heat and cold) on myofascial trigger points is associated with pain intensity in individuals with chronic neck pain.

Resumo em Inglês:

SUMMARY Objective: This study aimed to analyze the epidemiological and hospital characteristics of cases and deaths due to accidental tetanus in Brazil. Methods: A time-series study with secondary data extracted from the Department of Informatics of the Brazilian Unified Health System. The time series were evaluated by linear regression parameters, considering a significance level of 1%. Results: A total of 2,772 cases were reported between 2009–2018. Predominant cases were men and aged between 40–59 years old, with incomplete 1st–4th grade. The lethality rate was found to be predominant in women, whites, illiterates, and those who aged above 80 years. The overall lethality was 32.5%. The incidence rate reduced from 1.6 in 2009 to 0.95 per million inhabitants in 2018, but lethality increased from 30.77–40.70%. The highest rate of incidence and lethality occurred in the elderly people and in the northern region. Conclusion: The high cost and lethality of tetanus configure it as a public health problem. The demonstration of the epidemiology of patients who most evolve to death can help to contribute to a reduction in lethality, which shows an increase in the analysis period. Finally, special attention should be given to the elderly people and those living in the northern region.

Resumo em Inglês:

SUMMARY OBJECTIVE: The aim of this study was to translate, cross-culturally adapt, and validate the Canadian Diabetes Risk Questionnaire for use in Brazilian Portuguese. METHODS: This is a Questionnaire validity study conducted at a private university. The Brazilian version of the Canadian Diabetes Risk Questionnaire was developed by means of the processes of translation, back-translation, committee review, and pretesting. Test-retest reliability was measured using the intraclass correlation coefficient and kappa coefficient. Internal consistency was measured using Cronbach's alpha. For construct validity, the total score of the Canadian Diabetes Risk Questionnaire was correlated with the Diabetes Knowledge Scale and the Diabetes Mellitus Risk Questionnaire. Ceiling and floor effects were also evaluated in the present study. RESULTS: For construct validity and floor and ceiling effect measurements, a total sample of 100 participants was used. For reliability, a subsample of 34 participants out of the total sample was used. We identified adequate values for reliability (kappa between 0.46–1.00 and ICC 0.96) and internal consistency (Cronbach's alpha 0.80). There were significant correlations between the Canadian Diabetes Risk Questionnaire and the Diabetes Mellitus Risk Questionnaire (rs=0.370, p<0.001), but not the Diabetes Knowledge Scale (rs= −0.162). No ceiling or floor effects were found. CONCLUSION: We concluded that in accordance with the best international recommendations, the Brazilian version of the Canadian Diabetes Risk Questionnaire has adequate psychometric properties.

Resumo em Inglês:

SUMMARY OBJECTIVE: This study aims to determine the effect of group hope therapy on the self-efficacy of adolescents with type 1 diabetes. METHODS: This randomized clinical trial was conducted on 45 adolescent patients with type 1 diabetes in Iran. The subjects were randomly assigned into the intervention and control groups. The intervention group received eight 90-min sessions of group hope therapy using Snyder's method. RESULTS: The mean score of self-efficacies in the intervention group was significantly higher than the control group (p<0.05). CONCLUSION: The results of the study suggested that group hope therapy had a significant impact on self-efficacy of adolescents with type 1 diabetes but had no effect on academic self-efficacy and self-efficacy in blood glucose management.

Resumo em Inglês:

SUMMARY OBJECTIVE: To review data regarding the effects of hepatitis C virus eradication on glycemic control and insulin resistance. METHODS: This is an integrative literature review, carried out in the PubMed, SciELO, and Lilacs databases. Studies published in the past five years that were fully available, written in English or Portuguese, and have addressed the effects of eradication of the hepatitis C virus on glycemic control and insulin resistance were selected. RESULTS: Nine studies were selected. Among the results found, it was observed that there is no consensus on the effects of viral eradication on glycemic control and IR, as some authors show an eventual improvement in insulin resistance and glycemic control, while other studies indicate that there are no significant differences between the parameters evaluated after viral eradication. CONCLUSIONS: Although there is a relationship between hepatitis C virus infection and the development of insulin resistance and type 2 diabetes mellitus and recent advances in research, it was observed that there is no consensus on improving insulin resistance and glycemic control after antiviral treatment, probably due to methodological differences between studies. However, it emphasizes the need to guide people diagnosed with hepatitis C, regarding changes in lifestyle, encouragement of multidisciplinary monitoring, and control of other risk factors.

Resumo em Inglês:

SUMMARY OBJECTIVE: This study aims to investigate the antibody response and the side effects of the two-dose inactive SARS-CoV-2 vaccine (CoronaVac, Sinovac, China) among a health care worker population in Turkey. METHODS: This study was a prospective, cross-sectional, single-center study conducted between December 16, 2020, and March 15, 2021. We evaluated the side effects from a questionnaire, and anti-spike immunoglobulin G response to the vaccine (0- and 28-day schedule) using an enzyme-linked immunosorbent assay. RESULTS: A total of 94 of 184 health care workers completed this study. The percentages of participants who were seronegative at baseline and achieved to the seropositivity were 21.3 and 97.9%, respectively, on day 21 after vaccinations. The seropositivity was predominantly detected in 31–45 years of the age group (55.4%, p=0.636), normal body mass index (47.8%, p=0.999), nonsmokers (64.1%, p=0.999), those without any comorbidities (73.9%, p=0.463), and those without any side effects (70.2%, p=0.256). The frequencies of overall side effects within seven days after the first and second doses of CoronaVac were 37.2 and 28.7%, respectively. The most common side effects was localized pain at the injection site (15.7 and 11.6%, respectively). CONCLUSIONS: We found that vaccination by two-dose CoronaVac could elicit a specific humoral response, and it was well tolerated in health care workers. The high seropositivity developed after the second dose attracted attention. Our study will be useful in terms of showing short-term immunity and side effects.

Resumo em Inglês:

SUMMARY OBJECTIVE: Endobronchial ultrasound-guided transbronchial needle aspiration has been successfully applied in both diagnosis and staging of mediastinal and hilar lymphadenopathies and masses, especially in malignant cases. However, the optimal procedure of Endobronchial ultrasound-guided transbronchial needle aspiration to further increase diagnostic yield and minimize processing complexity remains controversial. This study aims to compare aspiration biopsy (Endobronchial ultrasound-guided transbronchial needle aspiration) and non-aspiration biopsy (Endobronchial ultrasound-guided transbronchial needle capillary sampling) in terms of sample adequacy, diagnosis, and quality in malignant cases. METHODS: Between March 2018 and June 2020, Endobronchial ultrasound-guided was performed sequentially on patients with mediastinal and/or hilar lymph nodes that were considered malignant. Each lymphadenopathy was sampled with and without aspiration. A single-blinded pathologist evaluated the samples. RESULTS: A total of 84 lymph nodes evaluations of 51 patients were included. Most samples were taken from the right lower paratracheal lymph nodes (n=27, 32.2%) and subcarinal LN (n=21, 25%). The mean size of the lymph nodes was 21.21±8.257 (8–40) mm. The agreement between the two procedures in terms of sample adequacy and diagnostic yield was 69.1% (95%CI 58–78.7, p=0.076). In addition, according to the goodness-of-fit statistics, the kappa values were 0.255 (p=0.015) and 0.302 (p=0.004) for sample adequacy and diagnostic yield, respectively. There was no difference between the two procedures in relation to complications. CONCLUSION: Although the agreement between the two procedures is weak, Endobronchial ultrasound-guided transbronchial needle capillary sampling can be performed with less personnel, without reducing diagnostic yield and tissue adequacy. These findings can assist clinicians in determining the optimal procedure for Endobronchial ultrasound-guided.

Resumo em Inglês:

SUMMARY OBJECTIVE: This study aimed to investigate and compare the ultrasonography and contrast-enhanced magnetic resonance imaging characteristics of incidentally detected hyperechoic focal liver lesions. METHODS: Seventy-four patients (29 males and 45 females) who had undergone a B-mode ultrasonography and contrast-enhanced magnetic resonance imaging examination were included in this study. A total of 91 hyperechoic lesions detected on ultrasonography were evaluated. The ultrasonography features of these hyperechoic lesions were recorded, and the results were compared with those acquired from contrast-enhanced magnetic resonance imaging. The results were compared statistically using the Shapiro-Wilk, McNemar, and Wilcoxon signed-rank tests. RESULTS: A corresponding lesion was found on contrast-enhanced magnetic resonance imaging in 72 of the 91 (79.1%) hyperechoic lesions detected on ultrasonography. Forty-one (56.9%) of the magnetic resonance imaging-defined lesions were typical hemangiomas, while 10 (13.9%) were focal steatosis areas and 4 (5.6%) were diagnosed with hepatocellular carcinoma. In contrast, 6 lesions (8.3%) were diagnosed as simple hepatic cysts, 4 (5.6%) as sclerosing hemangioma, 2 (2.8%) as thrombosed hemangioma, 1 (1.4%) as focal nodular hyperplasia, 1 (1.4%) as hamartoma, 2 (2.8%) as hydatid cysts, and 1 (1.4%) as hepatic lipoma. No statistically significant differences were found between ultrasonography and magnetic resonance imaging in terms of the segmental classification of the true positive lesions based on contour structures and lesion area measurements (p=0.558, p=0.375, and p=0.636, respectively). CONCLUSIONS: Incidentally detected hyperechoic zones may not necessarily be detected on magnetic resonance imaging. This may be secondary to focal hepatic steatosis or false interpretation of the radiologist. Lesions requiring therapy must be considered in the differential diagnosis.

Resumo em Inglês:

SUMMARY OBJECTIVE: In the recent years, the increase in death rates from nosocomial pneumonia draws attention. The aim of this study was to examine the causative agents and mortality factors of patients with pneumonia who were followed up in the chest diseases intensive care unit. METHODS: Data of 1070 patients with pneumonia were screened for this study. A total of 160 patients with hospital-acquired pneumonia included in this study. The relationship between factors such as patients’ comorbidities, length of stay in the intensive care unit, history of hospitalization or respiratory support therapy, infection markers such as C-reactive protein, white blood cell, nutritional markers such as albumin and protein, renal and liver function tests, culture growing microorganisms, and clinical pulmonary infection scores was evaluated and mortality rates were examined. RESULTS: Among 1070 patients, the rate of hospital-acquired pneumonia was 14.9%, and the mortality rate of pneumonia was 16.9%. Mortality was significantly increased in patients who stayed in the intensive care unit for more than 10 days, in patients with a clinical pulmonary infection score of ≥6 and with a history of hospitalization in the past one month, and received invasive mechanical ventilation therapy. Mortality increased in patients with hypoalbuminemia, hypoproteinemia, and high C-reactive protein values. The most commonly grown microorganism was Acinetobacter baumannii, which was also found significantly in patients who underwent invasive mechanical ventilation. CONCLUSION: In the clinical approach to hospital-acquired pneumonia, in order to prevent mortalities, it is important to reveal whether the newly emerging symptoms and signs are related to pneumonia, to identify the causative pathogen, and to determine the severity of the disease.

Resumo em Inglês:

SUMMARY OBJECTIVE: Treatment options for submassive pulmonary thromboembolism cases vary depending on the patient's hemodynamic stability, comorbidities, and bleeding risk. The long-term effect of unfractionated heparin treatment on pulmonary hypertension and mortality is unclear. The aim of this study was to investigate the long-term effect of unfractionated heparin treatment on pulmonary thromboembolism. METHODS: This is a cross-sectional study with 22 patients who were diagnosed with submassive pulmonary thromboembolism and followed up at the outpatient clinic between 2016 and 2020 and received unfractionated heparin treatment. RESULTS: Mean pulmonary artery pressure was 53±13.6 mmHg during hospital admission and 42.7±13.4 mmHg at hospital discharge. There was a statistically significant decrease in d-dimer and pulmonary artery pressure levels before and after treatment (p=0.001). At the end of one year, pulmonary artery pressure was considered high in three patients of this study. CONCLUSION: Our study suggests that unfractionated heparin is safe in the treatment of submassive pulmonary thromboembolism in terms of bleeding risk and reduces pulmonary artery pressure.