2020-08-09
Argın, Vural, Özduman, Ömer, Sunar, Ahmet Orhan, Okuyan, Gülten Çiçek, Duman, Mustafa, Polat, Erdal
Argın, Vural ; Özduman, Ömer ; Sunar, Ahmet Orhan ; Okuyan, Gülten Çiçek ; Duman, Mustafa ; Polat, Erdal ; SUMMARY BACKGROUND: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy are promising treatments for colorectal cancer-related peritoneal metastases. The learning curve may influence surgical outcomes. OBJECTIVE: The aim of the study was to compare outcomes of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy during the learning curve versus after surgical proficiency at a gastrointestinal cancer center. METHODS: A retrospective study of 83 patients treated between 2018 and 2023. Group 1 (n=42) included initial cases; Group 2 (n=41) represented the experienced phase. Operation time, organ resections, morbidity, transfusion needs, and survival were compared. RESULTS: Severe morbidity (Clavien-Dindo grade 3–4) was similar in both groups (G1: 21.4%, G2: 29.2%; p=0.947). No 30- or 90-day mortality occurred. Transfusions of ≥3 units were more frequent in G1 (p=0.003). Mean operative time was longer in G1 (8.5 vs. 7.2 h). More patients in G2 had multiple organ resections (p<0.001). CONCLUSION: The learning curve significantly influences perioperative outcomes in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy procedures. As surgical experience increases, intraoperative transfusion requirements and operative time decrease, while the extent of resection improves. However, these improvements do not appear to translate into a survival benefit.
2020-08-09
Oliveira, Alexandre Vizzuso de, Rocha, Júlia Ferreira, Sato, Beatrice Borges, Barnes, Rafaela Francisquetti, Bastos, Caio Oliveira, Cunha, Jonatas Lourival Zanoveli, Almeida, Vívian Cristine Lima de, Gomes, Géssika Marcelo, Sales, Gabriel Teixeira Montezuma, Rangel, Érika Bevilaqua
Oliveira, Alexandre Vizzuso De ; Rocha, Júlia Ferreira ; Sato, Beatrice Borges ; Barnes, Rafaela Francisquetti ; Bastos, Caio Oliveira ; Cunha, Jonatas Lourival Zanoveli ; Almeida, Vívian Cristine Lima De ; Gomes, Géssika Marcelo ; Sales, Gabriel Teixeira Montezuma ; Rangel, Érika Bevilaqua ; SUMMARY OBJECTIVE: The aim of this study was to analyze and compare the clinical, epidemiological, and laboratory characteristics of male and female patients with kidney disease admitted for hemodialysis. METHODS: This retrospective, observational, cross-sectional study analyzed the clinical, epidemiological, and laboratory data from electronic health records of patients admitted for hemodialysis at a university hospital between January 2022 and November 2023, comparing men’s and women’s profiles. All adult patients were consecutively included, except those with missing data. RESULTS: A total of 163 patients were included: 53.9% of whom were male and 43.4% self-identified as white. Chronic kidney disease was diagnosed at admission in 78.5% of cases, with diabetes mellitus being the leading etiology, affecting 20.4% of men and 26.6% of women. Men had significantly higher serum creatinine (7.9 vs. 6.3 mg/dL; p<0.001), potassium (4.8 vs. 4.6 mEq/L, p=0.039), and phosphorus levels (5.9 vs. 5.0 mg/dL; p=0.004), whereas women had significantly higher high-density lipoprotein cholesterol cholesterol (46 vs. 37 mg/dL; p<0.001), low-density lipoprotein cholesterol cholesterol (120.4 vs. 97.8 mg/dL; p=0.004), and total cholesterol (198 vs. 161 mg/dL; p<0.001). Among patients with diabetes mellitus, women more frequently used statins (67.7 vs. 42.4%; p=0.042) and angiotensin II type 1 receptor blockers (58.1 vs. 27.3%; p=0.013). They also had higher total cholesterol (199 vs. 156 mg/dL; p=0.005) and low-density lipoprotein cholesterol cholesterol levels (117 vs. 92 mg/dL; p=0.043), while men had higher serum phosphorous levels (6.3 vs. 5.0 mg/dL; p=0.028). CONCLUSION: Significant gender-based differences were identified in the clinical, epidemiological, and laboratory characteristics of patients admitted for hemodialysis. Men presented higher serum creatinine, phosphorus, and potassium levels, whereas women showed higher cholesterol fractions and greater use of statins and angiotensin II type 1 receptor blockers.
2020-08-09
Santos, Franciele Souza, Carvalho, Murilo Santos de, Costa, Juvenal Soares Dias da
Santos, Franciele Souza ; Carvalho, Murilo Santos De ; Costa, Juvenal Soares Dias Da ; SUMMARY OBJECTIVE: The aim of this study was to analyze trends in avoidable mortality due to circulatory system diseases and ischemic heart diseases among individuals aged 30–69 years across the health macro-regions of Rio Grande do Sul, Brazil, from 2000 to 2023. METHODS: An ecological time-series study was conducted using data from the Mortality Information System and Department of Informatics of the Unified Health System, with calculation of age- and sex-adjusted mortality coefficients. RESULTS: A reduction in mortality from circulatory system diseases and ischemic heart diseases was observed among women in almost all macroregions, except for the Central-West. Among men, decreasing trends in mortality from circulatory system diseases were identified, except in the Vales macro-region and in the state overall. Mortality was higher among men and increased with age, with the highest coefficients observed in the South, Central-West, and Metropolitan macro-regions. CONCLUSION: A downward trend in mortality was observed despite population aging, which may be attributed to health policies that strengthened the Unified Health System, including the expansion of the Family Health Strategy, the Hypertension and Diabetes Mellitus Care Reorganization Plan, and the Popular Pharmacy Program, as well as measures for chronic disease control and health promotion.
2020-08-09
Monteiro, Denise Leite Maia, Monteiro, Ida Peréa, Bruno, Zenilda Vieira, Raupp, Roberta Monteiro, Gonçalves, Fagner Ferreira, Ferreira, Gabriella de Oliveira Flor, Simões, Letícia Freitas, Oliveira, Aylana Ramos Gomes de
Monteiro, Denise Leite Maia ; Monteiro, Ida Peréa ; Bruno, Zenilda Vieira ; Raupp, Roberta Monteiro ; Gonçalves, Fagner Ferreira ; Ferreira, Gabriella De Oliveira Flor ; Simões, Letícia Freitas ; Oliveira, Aylana Ramos Gomes De ; SUMMARY OBJECTIVE: The aim of this study was to assess the changes in the sociodemographic profile and maternal healthcare associated with adolescent deliveries in Brazil in 2000, 2011, and 2022. METHOD: Cross-sectional study by search on the Live Births Data System. Analyzed variables from mothers aged 10–19 years in Brazil: age, education, ethnicity, marital status, prenatal consultations, mode of delivery, and the country’s region. RESULTS: In 2000, there were 750,537 adolescents’ live births to adolescents in Brazil, and in 2022, there were 315,606 (58% reduction). There was a decrease in the number of married adolescent mothers, from 48 to 29.7% in 2011 and 25.5% in 2022. Regarding ethnicity, 231,369 (75%) pregnant adolescents in 2022 were Black and Brown, compared with 47.4% in 2000; the Indigenous adolescent deliveries have tripled (from 0.8 to 2.4%), with 7,526 births in 2022. Education improved substantially (30.3% in 2000 to 53.0% in 2011 and 80.6% in 2022) with at least 8 years of study. Adolescents with no prenatal care decreased from 6% in 2000 to 2% in 2022. There was an increase in cesarean births from 26.4 to 41.5%. Regionally, the age-specific fertility rate from 15 to 19 years in 2000 was higher in the North (111.7/1,000) and lower in the Southeast (71.4/1,000), in 2022, there was a decrease to 61.7/1,000 and 29.1/1,000, respectively. CONCLUSION: There was a decrease in the number of married adolescent mothers and an increase in the education level of adolescent mothers. However, the rise in cesarean births and racial disparities, with Black and Brown adolescents comprising ¾ of pregnancies in 2022, highlights ongoing challenges for health policies.
2020-08-09
Agyei, Rita Okwaameh, Bilgic, Nurcan
Agyei, Rita Okwaameh ; Bilgic, Nurcan ; SUMMARY OBJECTIVE: The aim of this study was to “determine post-pandemic impact on activities of daily living and instrumental activities of daily living factors affecting daily living activities of the elderly.” No difference was identified between the post-pandemic activities of daily living and instrumental activities of daily living levels of the elderly in the two countries. METHODS: The descriptive study was conducted in Ghana and Turkish Republic of Northern Cyprus between February 16 and July 1, 2022. A total of 390 elderly volunteers aged 65 and over living at home participated in this study. The participants were administered the sociodemographic data form, Katz Activities of Daily Living Scale, and Lawton and Brody Instrumental Activities of Daily Living Form. The Slovin formula was used in selecting the study’s sample. Slovin’s formula is used to calculate the sample size necessary to achieve a certain confidence interval when sampling a population. RESULTS: According to the activities of daily livings and instrumental activities of daily livings, they can continue their lives without being dependent on others, and the scale scores of women compared to men are statistically significant, and it can be said that women are less dependent than men. CONCLUSION: The study revealed that the pandemic had a negative impact on activities of daily livings and instrumental activities of daily livings. Participants’ physical activity since the pandemic had a negative impact on activities of daily livings and instrumental activities of daily livings. It may be recommended to develop appropriate policies so that elderly individuals can live without being dependent on others. In addition, it is recommended that a variety of scales measuring activities of daily living be adopted and adapted, which, when adapted, will provide more reliable results. Since this study was conducted as a cross-sectional study in only one region in two countries, it cannot be generalized to both countries.
2020-08-09
Sen, Elzem, Aytekin, Alper
Sen, Elzem ; Aytekin, Alper ; SUMMARY OBJECTIVE: Thiol–disulfide homeostasis is a marker of oxidative stress. The aim of the study was to compare the effects of low-flow desflurane and sevoflurane anesthesia on perioperative changes in thiol–disulfide balance in patients undergoing thyroidectomy. METHODS: In this randomized controlled trial, 50 ASA I–II patients were assigned to receive low-flow desflurane (n=25) or sevoflurane (n=25). Blood samples were collected before and after surgery. The primary outcomes were between-group comparisons of perioperative changes in total and native thiol levels. Secondary outcomes included changes in disulfide concentrations and thiol–disulfide ratios. RESULTS: For the primary outcomes, the magnitude of reduction in total thiol (86.4±159.7 vs. 151.5±104.9 μmol/L; p=0.095) and native thiol (79.3±130.1 vs. 115.1±86.3 μmol/L; p=0.257) did not differ significantly between the desflurane and sevoflurane groups. For the secondary outcomes, disulfide levels significantly decreased in the sevoflurane group (67.5±19.9 vs. 48.4±18.1 μmol/L; p=0.001), whereas no significant change was observed in the desflurane group (60.2±23.2 vs. 52.5±34.5 μmol/L; p=0.300). Between-group comparisons of disulfide/total thiol, native thiol/total thiol, and disulfide/native thiol ratios revealed no significant differences. CONCLUSION: Low-flow desflurane and sevoflurane anesthesia demonstrated similar effects on perioperative thiol–disulfide homeostasis in thyroidectomy patients.