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Endometriosis is a chronic proinflammatory pathology characterized by the growth of tissue similar to the endometrium outside the uterus, affecting approximately 5 to 15% of women worldwide. Suffering from endometriosis entails a complex pathophysiological process, significantly impacting the quality of life and reproductive function of affected women; therefore, it must be addressed in a personalized and comprehensive manner, as its management requires a multidisciplinary approach. This article aims to conduct a comprehensive literature review of endometriosis, not only as a pathophysiological condition but also as a significant factor impacting the social, nutritional, and mental well-being of those who experience it. Emphasis is placed on the importance of understanding and assessing the impact of the pathology to provide a better and more comprehensive approach, integrating various alternatives and strategic treatments for the factors involved in its development. The aim is to provide a complete overview of endometriosis, from its pathophysiology to its impact on the quality of life of patients, as well as a review of current treatment options, both pharmacological and alternative, in order to broaden the perspective on the pathology to improve the care of patients with this disease.
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The aim of the present study was to advance knowledge of the secular changes in the prevalence of excess weight (overweight and obesity) and body composition of children living in different localities of La Plata district (Buenos Aires province, Argentina) over the last two decades. For this purpose, anthropometric data and information on the socioeconomic and environmental context of residence of schoolchildren aged 4.0-12.9 years collected during 2005-2009 (Cohort 1, n = 1 233) and 2016-2019 (Cohort 2, n = 1 499) were analysed and compared. From a secular perspective, the current analysis showed that the socioeconomic and environmental conditions of families living in La Plata district have deteriorated in recent decades. In this context, child excess weight increased by 13% and body composition was altered, mainly as a result of an increase in fat mass, without observing changes in the muscle component.
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AIM: Gestational diabetes (GD) is a global health concern with significant implications for maternal and neonatal outcomes. This study investigates the association between early GD (eGD) diagnosis (<24 weeks), pharmacotherapy requirements and adverse neonatal outcomes. MATERIALS AND METHODS: A cohort of 369 pregnant women underwent a 75-g oral glucose tolerance test. Maternal variables, pharmacotherapy prescriptions and neonatal outcomes were analysed employing t-tests, χ2 tests, and logistic regression. A p < .05 was considered significant. RESULTS: Early GD increased the odds of neonatal hypoglycaemia [odds ratio (OR): 18.57, p = .013] and respiratory distress syndrome (OR: 4.75, p = .034). Nutritional therapy prescription by an accredited nutritionist was the most common treatment in women diagnosed after 24 weeks, but those with eGD required more frequently specialized nutritional consulting + metformin to achieve glycaemic control (p = .027). eGD was associated with a higher requirement of nutritional therapy prescription + metformin (OR: 2.26, 95% confidence interval: 1.25-4.09, p = .007) and with maternal hyperglycaemia during the post-partum period at 2 h of the oral glucose tolerance test (OR: 1.03, 95% confidence interval: 1.02-1.13, p = .024). CONCLUSION: Timely diagnosis and personalized treatment of GD are desirable because an earlier presentation is related to a higher risk of adverse neonatal and maternal outcomes.
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Diabetes Gestacional , Diagnóstico Precoce , Teste de Tolerância a Glucose , Hipoglicemiantes , Metformina , Humanos , Feminino , Gravidez , Diabetes Gestacional/tratamento farmacológico , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/sangue , Recém-Nascido , Adulto , Hipoglicemiantes/uso terapêutico , Metformina/uso terapêutico , Hipoglicemia/induzido quimicamente , Hipoglicemia/prevenção & controle , Hipoglicemia/epidemiologia , Resultado da Gravidez/epidemiologia , Estudos de Coortes , Síndrome do Desconforto Respiratório do Recém-Nascido/prevenção & controle , Síndrome do Desconforto Respiratório do Recém-Nascido/epidemiologia , Glicemia/metabolismo , Glicemia/análiseRESUMO
OBJECTIVE: To provide information on the secular trend in age at menarche (AgM) in Argentinean girls in relation to excess weight (EW) and body adiposity. METHODS: Two cohorts (C) (C1, 2005-2007 and C2, 2015-2019) of children aged 8-14 years from La Plata district were studied using identical methodological criteria. Each participating child was asked about menarche (M) status: M presence (MP) or absence (MA). The AgM was estimated using the status quo method and logistic regression analysis. Body weight, height, and tricipital and subscapular skinfolds were collected to estimate EW (overweight + obesity) according to WHO criteria, and body adiposity (sum of skinfolds, SSK = [tricipital + subscapular]). The prevalence of EW by C was estimated and compared using the Chi-square test. The MP probability in relation to age, C, and EW was analyzed by applying logistic regression. Parents completed a questionnaire to assess family socioeconomic conditions. Data were compared using the Chi-square test. RESULTS: Differences in MP prevalence between C were significant (C1: 21.1% vs. C2: 28.7%). Median AgM was 12.81 years in C1 and 12.22 in C2. The prevalence of EW was higher in C2 (35.3%) than in C1 (24.6%). The probability of MP was higher in C2 than in C1 and children with EW. Both BMI and SSK showed inter-cohort increases. Socioeconomic conditions were substantially deteriorated between C. CONCLUSION: In an obesogenic context marked by the significant increase in body adiposity and EW, M prevalence exhibited a positive secular trend and AgM reduced by nearly seven months between the cohorts studied.
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Menarca , Humanos , Argentina/epidemiologia , Criança , Adolescente , Feminino , Fatores Etários , Sobrepeso/epidemiologia , Puberdade , Adiposidade , Estudos de Coortes , PrevalênciaRESUMO
BACKGROUND: The sphenoid bone is an irregular, unpaired, symmetrical bone located in the middle of the anterior skull and is involved in craniofacial growth and development. Since the morphology of Sella turcica (ST) is associated with different craniofacial patterns, this study aimed to investigate if there is a correlation between ST morphology on the one hand and sagittal craniofacial patterns on the other hand. METHODS: This study was conducted with a convenience sample that included Brazilian individuals undergoing orthodontic treatment. Lateral cephalograms were used to evaluate the calcification pattern and morphology of ST, as well as skeletal class by analyzing the ANB angle. Pearson's chi-square test with Bonferroni post-hoc test was performed to evaluate the association between ST calcification pattern and morphology, and anteroposterior skeletal malocclusion. The established significance level was 0.05. RESULTS: The study collective was comprised of 305 orthodontic patients (178 (58.4 %) female, 127 (41.6 %) male), who had a mean age of 23.2 (±10.6) years. 131 participants (42.9 %) presented skeletal class I, 142 (46.6%) skeletal Class II, and 32 (10.5%) had a skeletal class III. The degree of prognathism of the mandible showed a homogenous distribution within the study collective (91 (29.9 %) orthognathic, 100 (32.9 %) retrognathic, 113 (37.2 %) prognathic mandible). Concerning the maxilla, 92 (30.2%) individuals presented an orthognathic upper jaw, whereas 60 (19.7%) showed maxillary retrognathism and 153 (50.2%) maxillary prognathism. Compared to patients with skeletal class I, skeletal class III individuals presented significantly more hypertrophic posterior clinoid process (p<0.007) and pyramidal shape of the dorsum of the ST (p<0.038). CONCLUSIONS: Our results suggest that the hypertrophic posterior clinoid process and pyramidal shape of the ST dorsum are more prevalent in individuals with skeletal class III malocclusion.
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Cefalometria , Má Oclusão , Sela Túrcica , Humanos , Feminino , Masculino , Sela Túrcica/patologia , Sela Túrcica/diagnóstico por imagem , Estudos Transversais , Má Oclusão/patologia , Adolescente , Adulto Jovem , Adulto , Brasil/epidemiologia , Calcinose/patologia , Calcificação FisiológicaRESUMO
ABSTRACT BACKGROUND AND OBJECTIVES: With the necessity to assess musculoskeletal complaints caused by computer use, The Maastricht Upper Extremity Questionnaire (MUEQ) was created, which aims to assess musculoskeletal complaints of the upper limbs, shoulder complex and cervical spine in computer users. However, there is currently no comprehensive summary in the scientific literature on the psychometric properties of the MUEQ. The objective of this study was to conduct a synthesis of all available scientific evidence that has analyzed the psychometric properties of the MUEQ. CONTENTS: This study followed the PRISMA recommendations. The bibliographic search was carried out in the following databases: MEDLINE (via VHL), Embase, LILACS (via VHL), Pubmed, PsycINFO, Scielo, Academic Search Premier, CINAHL, Rehabilitation & Sports Medicine Source, MEDLINE Complete, Web of Science CENTRAL, Scopus and SPORTDiscus. Studies that addressed the psychometric properties of the MUEQ were included, as long as they were original articles of research carried out with human beings and indexed in the databases used. The studies were selected in two phases, with two independent reviewers. A total of 6 articles were included in the analysis. The evidence based on internal structure showed acceptable results. The reliability indexes ranged from α=0.52 to α=0.84, and ICC/composite reliability > 0.70 in the analyzed studies, classified as "good" and "excellent," respectively. CONCLUSION: In general, this research found a lack of detail on the process of content validity and evidence related to external variables and the description of the sample. These problems extended to the evidence based on the internal structure and reliability of the MUEQ, which did not reach levels considered acceptable to ensure its adequacy and accuracy.
RESUMO JUSTIFICATIVA E OBJETIVOS: Com a necessidade de avaliar as queixas musculoesqueléticas ocasionadas pelo uso de computadores, foi criado o The Maastricht Upper Extremity Questionnaire (MUEQ), cujo objetivo foi avaliar as queixas musculoesqueléticas relativas aos membros superiores, ao complexo do ombro e à cervical em usuários de computadores. No entanto, atualmente não existe uma sumarização abrangente, na literatura científica, sobre as propriedades psicométricas do MUEQ. O objetivo deste estudo foi realizar uma síntese de evidências científicas disponíveis que analisaram as propriedades psicométricas do MUEQ. CONTEÚDO: Este estudo seguiu as recomendações do PRISMA. A busca bibliográfica foi realizada nas bases de dados Medline (via BVS), Embase, LILACS (via BVS), Pubmed, PsycINFO, Scielo, Academic Search Premier, CINAHL, Rehabilitation & Sports Medicine Source, MEDLINE Complete, Web of Science CENTRAL, Scopus e SPORTDiscus. Foram incluídos estudos que abordaram as propriedades psicométricas do MUEQ, desde que fossem artigos originais de pesquisas desenvolvidas com seres humanos e indexados nas bases utilizadas. A seleção dos estudos ocorreu em duas fases, com dois revisores independentes. Foram incluídos 6 artigos/publicações na análise. A evidência baseada na estrutura interna apresentou resultados aceitáveis. Os índices de fidedignidade variaram de α=0,52 a α=0,84 e ICC/confiabilidade composta foram maiores que 0,70 nos estudos selecionados, classificados como "bom" e "excelente", respectivamente. CONCLUSÃO: De um modo geral, esta pesquisa constatou a falta de detalhamento sobre o processo de validade de conteúdo e de evidências relacionados a variáveis externas e à descrição da amostra. Esses problemas se estenderam à evidência baseada na estrutura interna e à confiabilidade do MUEQ, que não alcançaram níveis considerados aceitáveis para garantir sua adequação e precisão.
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INTRODUCTION: The frame index (FI), based on measurements of elbow breadth and height, is the body frame size parameter most frequently used in child and adolescent populations to assess skeletal robustness. In 2018, the first FI reference percentiles were elaborated with data of boys and girls aged 0-18 years from different European populations. In Argentina, the FI reference values were published in 2022. OBJECTIVE: The present study aims to compare the Argentine (AR) and European (EU) FI reference percentiles to evaluate possible variation in bone robustness between populations. METHODS: The values of the 3rd, 50th and 97th percentiles of the AR and EU FI references for boys and girls aged 4-14 years were compared using the Wilcoxon test (p < .05). Percentage differences between means (PDM) were calculated to analyze the magnitude of the differences between both references. The R 3.2.0 program was used to plot the percentile curves. RESULTS: The FI reference values were lower in AR than in EU in both the 3rd and the 50th percentiles, regardless of sex and age. Conversely, the AR reference values of the 97th percentile were higher than the EU values at most ages. CONCLUSIONS: The comparison of the AR and EU FI references showed similar age and sex growth patterns. However, differences in percentile values between populations were observed, highlighting the importance of having local references for the evaluation of skeletal robustness.
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Estatura , Masculino , Criança , Feminino , Adolescente , Humanos , Valores de Referência , Argentina , Índice de Massa CorporalRESUMO
Three-dimensional (3D) printing is a new method for creating human and veterinary anatomical models, which makes the education of students and professionals in the health area more complete, in addition to helping the patients themselves understand. In the area of cardiology, this technique can efficiently help the assessment of cardiac alterations for the patient during medical consultations, tying a feeling of involvement with the medical team. Likewise, it is possible to use 3D printing to understand the echocardiographic technique, where conceptual knowledge of the anatomy of the heart and the ability to translate a two-dimensional ultrasound image into a 3D idea is required. This research aimed to develop printable 3D cardiac models, to demonstrate cardiac sections used in echocardiography and use them to teach dog owners, evaluating their suitability as a tool for a better understanding of the echocardiographic exam. The 3D cardiac models were validated by dog owners through an evaluation questionnaire prepared on a Likert scale, after monitoring the echocardiographic examination with an explanation by the echocardiographer using the printed models. A total of 30 dog owners participated in the study. In all seven questions of the questionnaire, the vast majority of positive responses were observed, with partial or total agreement by the participants. These results showed that the use of 3D printed models is effective in improving the understanding of the echocardiographic examination and is feasible in the daily workflow.(AU)
A manufatura aditiva ou impressão 3D é um novo método para a criação de modelos anatômicos humanos e veterinários, que torna a educação de alunos e profissionais da área da saúde mais completa, além de auxiliar o entendimento dos próprios pacientes. Na área da cardiologia, esta técnica pode auxiliar de maneira eficiente a avaliação das alterações cardíacas para o paciente durante as consultas médicas, atrelando um sentimento de envolvimento com a equipe médica. Da mesma maneira, é possível utilizar a impressão 3D para o entendimento da técnica ecocardiográfica, onde é necessário conhecimento conceitual da anatomia do coração e a capacidade de traduzir uma imagem de ultrassonografia bidimensional em uma ideia tridimensional. Este artigo teve como objetivo desenvolver modelos cardíacos 3D imprimíveis, com o intuito de demonstrar cortes cardíacos utilizados na ecocardiografia e utilizá-los para ensinar os tutores de cães, avaliando sua adequação como ferramenta para melhor compreensão do exame ecocardiográfico. Imagens em DICOM de um exame de tomografia computadorizada de uma cadela foi adquirida para criação, edição e impressão dos diferentes modelos em 3D, que representam os cortes ecocardiográficos. Os modelos cardíacos em 3D foram validados por tutores de cães por meio de um questionário de avaliação elaborado em uma escala Likert, após acompanhamento do exame ecocardiográfico com uma explicação pelo ecocardiografista utilizando os modelos impressos. Um total de 30 tutores de cães participaram do estudo. Em todas as sete perguntas do questionário, foram observadas em sua grande maioria respostas positivas, sendo elas com concordância parcial ou total dos participantes. Até o momento não foram encontrados na literatura estudos com modelos de coração desenvolvidos para a educação clínica dos tutores de cães. Os resultados revelam que o uso dos modelos impressos em 3D é eficaz para melhorar a compreensão do exame ecocardiográfico e é viável no fluxo de trabalho diário.(AU)
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Ecocardiografia/veterinária , Cães , Educação em Veterinária , Impressão Tridimensional , Modelos CardiovascularesRESUMO
Sella turcica development involves molecular factors and genes responsible for ossification. It is possible that single nucleotide polymorphisms (SNPs) in key genes are involved in morphological variation of sella turcica. Genes belonging to the WNT signaling pathway are involved in the ossification process and are candidates of sella turcica morphology. This study aimed to evaluate if SNPs in WNT6 (rs6754599) and WNT10A (rs10177996 and rs3806557) genes are associated with the calcification and patterns of the sella turcica. Nonsyndromic individuals were included in the research. Cephalometric radiographs were examined and the sella calcification was evaluated and classified according to the calcification of the interclinoid ligament (no calcification, partial calcification, and incomplete calcification) and sella turcica pattern (normal sella turcica, bridge type A-ribbon-like fusion, bridge type B-extension of the clinoid processes, incomplete bridge, hypertrophic posterior clinoid process, hypotrophic posterior clinoid process, irregularity in the posterior part, pyramidal shape of the dorsum, double contour of the floor, oblique anterior wall, and oblique contour of the floor). DNA samples were used to evaluate SNPs in the WNT genes (rs6754599, rs10177996, and rs3806557) using real-time PCR. Chi-square test or Fisher's exact test were used to compare the allele and genotype distributions according to sella turcica phenotypes. The alpha was set as 5% for all comparisons. A total of 169 individuals were included, 133 (78.7%) present sella turcica partially or completely calcified. Sella turcica anomalies were found in 131 individuals (77.5%). Sella turcica bridge type A (27.8%), posterior hypertrophic clinoid process (17.1%), and sella turcica bridge type B (11.2%) were the most prevalent morphological patterns observed. Individuals carrying the TT genotype in rs10177996 (TT vs. CT + CC) had higher chance to present a partially calcified sella turcica (p = 0.047; Odds ratio = 2.27, Confidence Interval 95% 1.01-5.13). In conclusion, the SNP in WNT10A is associated with the calcification phenotype of the sella turcica, the pleiotropic effect of this gene should be taken into consideration in future studies.
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Polimorfismo de Nucleotídeo Único , Sela Túrcica , Sela Túrcica/anormalidades , Via de Sinalização Wnt/genética , Radiografia , Calcificação Fisiológica , CefalometriaRESUMO
Resumen INTRODUCCIÓN: La epidermólisis bulosa engloba a un grupo de enfermedades caracterizadas por una fragilidad extrema de la piel y membranas mucosas, consecuencia de la formación de ampollas posterior a un traumatismo mínimo. Hay tres tipos principales de epidermólisis. Se comunica el caso para hacer notar las implicaciones del cuidado al momento del nacimiento, y las consideraciones anestésicas. CASO CLÍNICO: Paciente de 25 años en su segundo embarazo con epidermólisis bulosa distrófica recesiva. El nacimiento fue electivo mediante cesárea, con anestesia regional. CONCLUSIONES: Debe tenerse especial cuidado durante las intervenciones terapéuticas a fin de evitar la formación de bulas o exacerbar las existentes. Las fuerzas de fricción son más dañinas que las de compresión. La planeación multidisciplinaria es necesaria para un desenlace sin complicaciones.
Abstract BACKGROUND: Epidermolysis bullosa encompasses a group of diseases characterized by extreme fragility of the skin and mucous membranes, resulting in the formation of blisters after minimal trauma; There are three main types of epidermolysis. The case is presented to highlight the implications of care both at the time of birth, as well as anesthetic considerations. CLINICAL CASE: A 25-year-old patient in her second pregnancy with recessive dystrophic epidermolysis bullosa. The birth was elective by caesarean section under regional anesthesia. CONCLUSIONS: Special care must be taken during therapeutic interventions to avoid the formation of bullae or exacerbate those already present. Friction forces are more damaging than compression forces. Multidisciplinary planning is necessary for a smooth outcome.