ABSTRACT BACKGROUND: Temporomandibular disorder (TMD) are among the most common causes of orofacial pain and have been associated with several systemic conditions. However, their relationship with male sexual dysfunctions (MSDs) remains largely unexplored. OBJECTIVES: To investigate the association between TMD symptoms and different subtypes of MSDs. METHODS: A cross-sectional study was conducted with 91 men aged 18 to 50, classified as having premature ejaculation (n = 33), delayed ejaculation (n = 10), or erectile dysfunction (n = 22), or being control participants (n = 26). TMD symptoms were assessed using the Mandibular Function Impairment Questionnaire (MFIQ), and sexual function was evaluated using the International Index of Erectile Function (IIEF), Premature Ejaculation Diagnostic Tool (PEDT), and intravaginal ejaculatory latency time (IELT). RESULTS: Significant group differences were found in the IELT and all IIEF subdomain (p < 0.001) values. Participants with delayed ejaculation had the longest IELTs, whereas those with erectile dysfunction had the shortest. PEDT scores were significantly higher in the premature-ejaculation and erectile-dysfunction groups than in the control group, with no significant difference observed between the delayed-ejaculation and control groups. Orofacial pain (cheek–temple–jaw) was more frequent in all MSD groups (p = 0.001), whereas temporomandibular joint pain (ear area) was particularly more prevalent in the delayed-ejaculation group. MFIQ scores indicated greater mandibular impairment primarily in the erectile-dysfunction group. Multinomial regression analysis results showed that orofacial pain independently predicted all MSD subtypes, but temporomandibular joint pain was specifically associated with delayed ejaculation. CONCLUSION: The results indicate a potential association between TMD-related symptoms and MSDs, suggesting that orofacial pain and functional jaw impairment may be related to male sexual health. These findings highlight the potential importance of using a multidisciplinary approach involving collaboration between dentists, urologists, and physical therapists to improve both jaw and sexual health outcomes.
ABSTRACT BACKGROUND: Postoperative nausea and vomiting (PONV) is a frequent complication in pediatric patients undergoing adenoidectomy. Bispectral index (BIS) monitoring, an electroencephalography-based method for assessing anesthetic depth, enables individualized sevoflurane titration and may reduce unnecessary exposure to volatile anesthetics. OBJECTIVES: To determine whether BIS-guided sevoflurane anesthesia reduces PONV in children undergoing adenoidectomy. DESIGN AND SETTING: Single-center, prospective, randomized, assessor-blinded trial conducted at University of Health Sciences, Kocaeli City Hospital, Kocaeli, Türkiye. METHODS: Fifty-eight children aged 3–8 years (American Society of Anesthesiologists score I–II) undergoing elective adenoidectomy were randomized to BIS-guided anesthesia (n = 29) or standard care (n = 29). Both groups received sevoflurane anesthesia. The primary outcome was PONV within the first 24 postoperative hours. Secondary outcomes were emergence time, total sevoflurane consumption, remifentanil dose, and rescue antiemetic use. RESULTS: PONV within 24 hours occurred less frequently in the BIS-guided group than in controls (p = 0.015), with the greatest between-group differences observed at 0–1 hour and 1–6 hours. Sevoflurane consumption and emergence time were lower in the BIS-guided group (p < 0.05). BIS-guided anesthesia was independently associated with lower odds of PONV (OR = 0.212; 95% CI: 0.067–0.675; p = 0.009). CONCLUSIONS: BIS monitoring may be a useful strategy for optimizing anesthetic depth and reducing early PONV in pediatric patients. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov (NCT07189845). Available at: https://clinicaltrials.gov/study/NCT07189845.
ABSTRACT BACKGROUND: Adverse outcomes associated with potentially inappropriate medication (PIM) use are prevalent among older adults. OBJECTIVES: This study aimed to determine the frequency of PIM use older outpatients and assess its association with chronic comorbidities and geriatric syndromes using the screening tool of older persons’ prescriptions (STOPP) and screening tool to alert to right treatment (START) version 3 criteria. DESIGN AND SETTING: This retrospective study included patients aged 65 years or older who attended geriatric outpatient clinics between January and June 2024. METHODS: PIM use was evaluated using the STOPP/START version 3 criteria. Polypharmacy was defined as the use of five or more medications. RESULTS: Among the 107 patients (median age, 77 years; range, 65-91), 71% (n = 76) used PIM, with a median of two PIMs per patient (range, 0-6). PIM use was significantly more prevalent among patients with polypharmacy (odds ratio [OR] = 3.986; 95% CI: 1.493-10.639; p = 0.006). Analyses based on the STOPP criteria also revealed significant associations of PIM use with dementia (OR = 13.240; 95% CI: 1.504-116.529; p = 0.02), polypharmacy (OR = 4.352; 95% CI: 1.476-12.827; p = 0.008), and a history of falls (OR = 3.131; 95% CI: 1.017-9.634; p = 0.047). CONCLUSION: Polypharmacy was significantly associated with greater odds of PIM use among older adults. Based on the STOPP version 3 criteria, dementia and a history of falls were also associated with increased PIM use in this population.
ABSTRACT BACKGROUND: Many scolicidal agents are used to treat hydatid cysts. However, most of these have been discontinued because of complications. Currently, no safe, effective, and useful scolicidal agent are available for the treatment of hydatid cysts in humans. Therefore, novel agents with greater efficacy, fewer side effects, and lower costs are required. In this study, we evaluated the effects of aminomix-1 solution on the liver and bile ducts of rats. MATERIALS AND METHODS: Twenty-two male Wistar-Albino rats were divided into two groups. A 0.5 mL solution of aminomix-1 was injected into the common bile duct with a 27-gauge syringe without pressure in the experimental group and normal saline (0.9% isotonic) in the control group. Blood samples for hepatic function tests and liver and bile duct tissues were examined histopathologically 4 weeks after the procedure. All statistical analyses were performed using IBM SPSS Statistics for Windows, version 21.0. Statistical significance was set at p < 0.05. RESULTS: The aminomix-1 group showed significantly higher aspartate aminotransferase and alkaline phosphatase levels than the control group. No significant differences were observed in the alanine aminotransferase and amylase levels. Total and direct bilirubin and gamma-glutamyl transferase levels were below the detection limits. No fibrosis or confluent necrosis was observed in either group. The aminomix-1 group showed moderate necrosis in the spotty (focal) necrosis analysis, which was borderline significant (p ≈ 0.08). CONCLUSION: Although aminomix-1 caused mild biochemical and histopathological changes, it did not cause advanced or irreversible liver damage or sclerosing cholangitis.
ABSTRACT BACKGROUND: Long-term metabolic complications in childhood are associated with birthweight. OBJECTIVES: This study aimed to examine trends in the prevalence of low and high birthweight over a 16-year period and to investigate the association between birthweight and overweight/obesity among schoolchildren aged 7 to 10 years. DESIGN AND SETTING: The analyses included four school-based cross-sectional surveys conducted in Florianópolis. METHODS: The probabilistic panels were conducted in 2002, 2007, 2012–2013, and 2018–2019. Multiple logistic regression models were used to assess the associations between low and high birthweight and childhood overweight/obesity. Adjusted models included biological, socioeconomic, survey-period, and dietary-intake variables. RESULTS: Over the 16-year period, low birthweight showed a progressive and statistically significant increase, rising by 58.3% from 2002 to 2018–2019. In contrast, the prevalence of high birthweight was 9.1% in 2002 and declined significantly over the ten-year period from 2002 to 2012–2013, decreasing by 40.7%. In the adjusted model, high birthweight was significantly associated with overweight/obesity across all study waves (OR = 1.63; 95% CI = 1.32–2). CONCLUSION: A statistically significant upward trend in the prevalence of low birthweight was observed among schoolchildren in Florianópolis from 2002 to 2018–2019. Despite a reduction in high birthweight over time, high birthweight remained directly associated with overweight/obesity, independently of food intake and other confounding factors.
ABSTRACT BACKGROUND: Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disorder characterized by recurrent febrile episodes and serositis. OBJECTIVES: The aim of this study was to assess the impact of FMF on sleep quality in children and adolescents and to explore the relationship between depressive symptoms and sleep disturbances in this patient population. DESIGN AND SETTING: A prospective case-control study was conducted at a secondary hospital in Istanbul between July 2024 and January 2025. METHODS: Children and adolescents diagnosed with FMF who were followed at a pediatric rheumatology clinic were included. Sleep disturbances were assessed using the Sleep Disturbance Scale for Children (SDSC), and depressive symptoms were evaluated using the Beck Depression Inventory (BDI). Correlations between these scores were analyzed. RESULTS: The mean age of the patient group (n = 97) was significantly higher than that of the control group (n = 90) (10.6 ± 2.9 years vs. 9.3 ± 2.4 years; p < 0.001). The median SDSC and BDI scores were significantly higher in the patient group than in the control group (p < 0.05). Analysis of the SDSC subscales indicated that patients with FMF experienced difficulties in sleep initiation and maintenance, sleep-related breathing problems, hyperhidrosis, arousal disturbances, sleep-wake transitions, and excessive daytime somnolence (p < 0.05). No significant differences were found between patient subgroups categorized by MEFV gene mutations in total BDI scores, total SDSC scores, all SDSC subscale scores, or depression severity classes (p > 0.05). Furthermore, no significant correlations were observed between total BDI scores and total SDSC scores or any of the SDSC subscale scores (p > 0.05).. CONCLUSION: Children and adolescents with FMF had significantly higher levels of depressive symptoms and sleep disturbances than controls.
ABSTRACT BACKGROUND: Thyroid nodules are common, and although most are benign, a proportion may be malignant. Fine-needle aspiration biopsy (FNAB), interpreted using the Bethesda System, is the standard diagnostic method. However, in euthyroid patients, the predictive value of thyroid function tests and their derived ratios in relation to Bethesda categories remains unclear. OBJECTIVES: To evaluate thyroid function parameters and their association with Bethesda classification in euthyroid patients with thyroid nodules, and to identify potential predictors of malignancy. DESIGN AND SETTING: This retrospective cross-sectional study was conducted at the University of Health Sciences Haydarpaşa Numune Training and Research Hospital and included a convenience sample of eligible euthyroid patients who underwent FNAB between January 2020 and December 2023. METHODS: A total of 828 euthyroid patients were included. Demographic data, pre-biopsy TSH, fT3, fT4, and derived ratios (TSH/T4, TSH/T3, and T3/T4) were analyzed for correlations with Bethesda categories and compared between the benign and malignant groups. RESULTS: The mean age was 52.85 ± 12.53 years, and 80.8% of participants were female. Benign cytology was found in 54.6% of cases, and malignant cytology was found in 2.8%. Cases with malignant cytology were younger (p = 0.003) and more frequently male (p = 0.021). No significant differences were observed in hormone levels or ratios between the benign and malignant groups. However, TSH and the TSH/T4 ratio showed positive correlations with Bethesda category (p = 0.034 and p = 0.033, respectively). CONCLUSION: The TSH level and TSH/T4 ratio were correlated with Bethesda categories; however, thyroid function tests and derived ratios showed no diagnostic value for predicting malignancy in euthyroid nodules.
ABSTRACT BACKGROUND: Vitamin D deficiency is common among individuals with obesity; however, the association between low 25-hydroxyvitamin D [25(OH)D] concentrations and adiposity remains unclear. Shift workers are at increased risk for both vitamin D deficiency and metabolic disorders, making this population particularly relevant for investigating this relationship. OBJECTIVES: This study aimed to evaluate the effect of cholecalciferol supplementation on central adiposity, assessed by waist circumference (WC) and waist-to-height ratio (WHtR), among male shift workers. DESIGN AND SETTING: Randomized, double-blind, placebo-controlled clinical trial involving 198 male shift workers employed by an iron ore extraction company in Minas Gerais, Brazil. METHODS: Participants with 25(OH)D concentrations <30 ng/mL and at least one metabolic abnormality, including metabolic syndrome, impaired fasting glucose, dyslipidemia, elevated blood pressure, or increased WC, were randomly assigned to receive placebo, cholecalciferol 14,000 IU/week, or cholecalciferol 28,000 IU/week for 4 months. Plasma 25(OH)D concentrations, WC, and WHtR were evaluated at baseline and post-intervention. RESULTS: After 4 months, no significant differences in WC or WHtR were observed between the vitamin D supplementation groups (14,000 IU/week and 28,000 IU/week) and the placebo group. Nevertheless, serum 25(OH)D concentrations increased significantly in the supplementation groups: +6.23 ng/mL (p25 = 0.58; p75 = 10.61) in the 14,000 IU/week group and +15.25 ng/mL (p25 = 10.57; p75 = 19.68) in the 28,000 IU/week group. In contrast, the placebo group showed a decrease of −0.50 ng/mL (p25 = −1.03; p75 = 2.71). Despite these increases, supplementation produced no significant effect on central adiposity outcomes (p > 0.05). CONCLUSION: Although vitamin D supplementation effectively increased serum 25(OH)D concentrations, it did not reduce central adiposity among male shift workers. These findings indicate that vitamin D supplementation alone is unlikely to improve obesity-related outcomes in this high-risk occupational population and underscore the need for comprehensive strategies targeting metabolic health in shift workers. CLINICAL TRIAL OR SYSTEMATIC REVIEW REGISTRATION: This study was registered in the Brazilian Registry of Clinical Trials (ReBEC) under identifier RBR-6CS352 on October 25, 2017.
ABSTRACT BACKGROUND: Brain death is the essential condition for organ procurement, yet donation rates in Brazil remain insufficient to meet national transplant needs. Understanding both the clinical determinants of brain death and the social or institutional barriers to organ donation is crucial for improving donation outcomes and informing public health strategies. OBJECTIVES: To identify the main causes of brain death and analyze the factors associated with organ non-donation at a university hospital in São Paulo State. DESIGN AND SETTING: This cross-sectional study with a quantitative approach was conducted at a university hospital in São Paulo State, using data from the Organ Procurement Organization affiliated with the Universidade de São Paulo. METHODS: The medical records of all patients diagnosed with brain death between 2001 and 2015 were reviewed. Sociodemographic variables, clinical causes of brain death, and factors related to donation outcomes were assessed using descriptive statistics and chi-square tests. RESULTS: In total, the data of 1,688 cases were analyzed, including those of 574 donors (34%) and 1,114 non-donors. Traumatic brain injury and hemorrhagic stroke were the predominant neurological causes of brain death. No significant association was observed between sex or cause of brain death and donation outcome. Public initiatives such as the 2001 consent law and the 2014 “Green September” campaign showed limited short-term impact on donation rates. CONCLUSION: Although neurological causes account for most cases of brain death, donation outcomes are strongly influenced by social and institutional factors-particularly family refusal and trust in the healthcare system.
BACKGROUND:Understanding the lingering effects of child abuse may improve healthcare pathways with preventive and supportive strategies. OBJECTIVE:To compare adverse outcomes between survivors of child abuse and non-exposed subjects. DESIGN AND SETTING:This is a cohort study conducted at the Pediatric Emergency Department of the Nuevo Hospital Civil de Guadalajara, Guadalajara, Mexico. METHODS:This cohort study of Mexicans compared adverse outcomes between survivors of child abuse and non-exposed individuals from 2011 to 2018. Additionally, we contacted survivors in 2020 to collect additional data, including sociodemographic and study variable-related information. RESULTS:This study included 300 survivors of child abuse, paired by age with 300 non-exposed subjects. Neglect and sexual abuse were the most frequent types of abuse. Among the survivors, there was a higher risk of hyperactivity with attention deficit [Relative Risk (RR) = 4.65(2.06-10.51); P = 0.0001], drug abuse [RR = 3.09(1.25-7.63); P = 0.0001], mood disorders [RR = 2.97(1.81-4.86); P = 0.0001], tobacco use [RR = 2.79(1.60-4.88); P = 0.0001], and engagement with substance abuse and sexual intercourse at a younger age. Non-exposed subjects had a higher level of education [RR = 0.65(0.49-0.87); P = 0.0001] and were more engaged in sports [RR = 0.31(0.18-0.52); P = 0.0001]. CONCLUSION:Survivors of child abuse are at risk for psychological problems and substance abuse. Increasing sports engagement and school attendance may protect against adverse outcomes.
ABSTRACT BACKGROUND: Polycystic ovary syndrome (PCOS) is a common endocrine–metabolic disorder. Irisin is an exercise-related myokine involved in energy homeostasis; however, prior studies have reported inconsistent associations between irisin and PCOS. OBJECTIVES: To compare serum irisin levels between women with PCOS and non-PCOS controls and to assess the discriminatory performance of irisin for PCOS. DESIGN AND SETTING: Cross-sectional, case–control study conducted at a tertiary referral center. METHODS: We enrolled 144 women, 72 with PCOS and 72 non-PCOS as controls. Serum irisin levels were measured using an enzyme-linked immunosorbent assay. Adjusted comparisons were performed using a general linear model, and the association between irisin and PCOS was further evaluated using multivariable binary logistic regression. Receiver operating characteristic (ROC) analysis was used to assess the diagnostic performance of irisin. RESULTS: Serum irisin levels in the PCOS group were significantly lower than those in the control group (p = 0.006). In the age and body mass index (BMI) adjusted ANCOVA model, PCOS status remained significantly associated with lower log-transformed irisin (p = 0.002). In a multivariable logistic regression analysis adjusted for age and BMI, log-transformed irisin levels remained independently associated with PCOS (p = 0.006). In ROC analysis, the area under the ROC curve for irisin was 0.632; an irisin cut-off of ≤ 16.2 ng/mL resulted in 87.5% sensitivity and 38.89% specificity. CONCLUSIONS: Women with PCOS had lower circulating irisin levels than controls, and this association persisted after adjusting for age and BMI. Discriminatory performance was modest, and specificity was low at the selected cutoff. Larger studies are warranted to validate these findings.
ABSTRACT BACKGROUND: Low birth weight (LBW) is a major public health concern associated with increased neonatal morbidity and mortality. OBJECTIVE: This study was aimed to develop a predictive learning model using machine learning techniques to identify LBW from live birth data. METHODS: A retrospective population-based study was conducted using data from the Brazilian Live Birth Information System (SINASC), which includes all live births registered in the state of São Paulo between 2019 and 2023. After data curation and exclusion of records with missing or unknown information, a total of 2,548,570 live births were analyzed. Predictors included maternal sociodemographic characteristics, obstetric history, prenatal care indicators, and newborn characteristics. Logistic regression and random forest models were trained using an 80/20 train–test split, with class imbalance addressed through class weighting. Model performance was evaluated using accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC-ROC). RESULTS: The analysis showed that the balanced logistic regression model performed best in terms of sensitivity (0.688), F1-score (0.567), and AUC-ROC (0.850). A proportional analysis of the variables between the LBW and normal-weight groups revealed a higher prevalence of LBW among mothers with low education levels, without a partner, of Black or Brown ethnicity, aged ≤ 19 years or ≥ 35 years, with multiple pregnancies, with a reduced number of prenatal consultations, and with late initiation of prenatal care. CONCLUSIONS: The findings highlight the importance of large-scale data analysis supported by machine learning techniques to inform public policies aimed at preventing LBW and promoting maternal and child health.
BACKGROUND:Melasma is one of the most common physiological hyperpigmentation disorders observed during pregnancy, and its clinical characteristics and risk factors have been extensively investigated. However, evidence regarding the relationship between pregnancy-related melasma and body perception remains limited. OBJECTIVE:This descriptive cross-sectional study aimed to determine the prevalence of melasma among pregnant women and to examine its association with body perception. METHODS:This study included 450 pregnant women in the central city center of the Central Anatolia Region of Türkiye who met the inclusion criteria. Data were collected using the Introductory Information Form, the Melasma and Skin Type Characteristics Assessment Form, and the Body Perception Scale (BPS) and analyzed using descriptive statistics, comparative analyses, and logistic regression. RESULTS:Melasma was identified in 37.8% of the participants, and the centrofacial pattern was the most common presentation (56.5%). A statistically significant association was found between pregnancy-related melasma and total BPS scores (p < 0.05). Pregnant women without melasma had significantly higher mean BPS scores than those with melasma (150.83 ± 17.18 vs. 146.15 ± 15.16; p = 0.004). Logistic regression analysis demonstrated that low educational and income levels, a personal or family history of melasma, and Fitzpatrick skin type IV were significant predictors of pregnancy-related melasma (p < 0.05), accounting for 61% of the variance. CONCLUSION:The findings indicate the need for a holistic assessment of physiological skin changes and body perception during pregnancy, as well as the integration of counseling, education, and nursing care interventions targeting risk factors into routine prenatal care.
BACKGROUND:Aphasia following stroke is primarily characterized by language impairment; however, accumulating evidence suggests that deficits in auditory and cognitive processing may also contribute to impaired language function. Auditory evoked potentials provide objective markers of neural processing across subcortical, cortical, and cognitive levels and may help clarify the neurophysiological mechanisms underlying post-stroke aphasia. OBJECTIVES:To investigate multilevel auditory processing and its relationship with language performance in individuals with post-stroke aphasia using Auditory Brainstem Responses (ABR), Late Latency Responses (LLR), and P300 potentials. DESIGN AND SETTING:Cross-sectional observational study conducted at a university hospital in Türkiye. METHODS:Twenty-nine individuals with post-stroke aphasia and 33 age-matched healthy controls were included. Language performance was assessed using the Aphasia Language Assessment Test and a standardized naming task. Auditory processing was evaluated using ABR, LLR (P1, N1, P2, N2), and P300 potentials recorded according to standard electrophysiological protocols. Group comparisons were performed for latency and amplitude measures, and correlation analyses were conducted to examine associations between electrophysiological parameters and language performance. RESULTS:Compared with healthy controls, individuals with aphasia demonstrated significantly prolonged latencies in ABR waves and interpeak intervals, as well as in all LLR and P300 components (p < 0.05). No significant group differences were observed in amplitude measures. Naming performance was significantly lower in the aphasia group. Although correlations between language performance and electrophysiological measures did not reach statistical significance, moderate negative trends were observed between naming scores and N2 and P300 latencies. CONCLUSION:Post-stroke aphasia is associated with delayed auditory processing across subcortical, cortical, and cognitive levels, reflecting generalized slowing rather than reduced neural recruitment. Latency-based auditory evoked potential measures may complement behavioral language assessments and support a multilevel auditory-cognitive framework for aphasia evaluation and rehabilitation.
BACKGROUND:Real-world data on the treatment patterns and clinical outcomes of second-line nilotinib use in chronic myeloid leukemia (CML) remain limited, particularly regarding predictors of deep molecular response (DMR). OBJECTIVES:To characterize treatment patterns and long-term clinical outcomes in patients with CML receiving second-line nilotinib and to evaluate whether early molecular milestones combined with baseline prognostic scores predict DMR. DESIGN AND SETTING:Retrospective, single-center real-world study conducted at a tertiary academic center between 2011 and 2025. METHODS:The data of 45 patients with CML receiving second-line nilotinib because of imatinib resistance or intolerance were analyzed. Treatment patterns, including duration and reasons for switching therapy, were assessed. Baseline prognostic scores (Sokal, European Treatment and Outcome Study [EUTOS], EUTOS Long-Term Survival [ELTS], Hammersmith) were calculated, and molecular responses were assessed according to the European LeukemiaNet (ELN) criteria. Predictors of DMR were examined using univariate and multivariate logistic regression, and survival outcomes were estimated using Kaplan-Meier analysis. RESULTS:The median duration of nilotinib administration was 67.3 months, with 60% of patients achieving a best response of DMR and 46.7% maintaining a sustained DMR. Univariate analysis showed that a favorable Hammersmith score (p = 0.001), low ELTS risk (p = 0.028), and attainment of ELN-defined milestones at 6 (p = 0.020) and 12 months (p = 0.006) were significantly associated with DMR. Multivariate analysis demonstrated that the 12-month ELN milestone (p = 0.008) and favorable Hammersmith score (p = 0.023) were independently associated with a DMR. Patients achieving a DMR showed a nonsignificant trend toward improved overall survival. CONCLUSION:In this real-world cohort, a DMR and favorable survival outcomes were achieved when nilotinib was administered as second-line treatment. Integrating baseline prognostic scores with molecular milestones enables individualized monitoring and supports a sustained DMR as a marker of durable disease control.
BACKGROUND:End-stage chronic kidney disease (CKD) requires hemodialysis, which carries significant biopsychosocial impact. OBJECTIVES:This study aimed to investigate the relationship between family functionality and social support among older individuals undergoing hemodialysis. DESIGN AND SETTING:This cross-sectional and correlational study was conducted at a renal replacement therapy unit located in São Paulo State. METHODS:A total of 118 participants aged ≥ 60 years undergoing hemodialysis were interviewed individually using the Family adaptability, partnership, growth, affection, and resolve (APGAR), and the Medical Outcomes Study Social Support Scale. All ethical principles were duly respected. RESULTS:Majority of participants were male (69.5%), aged between 60-69 years (50.8%), white ethnicity (63.6%), with a stable partner (54.2%), and had an income of one to three times the minimum wage (55.9%). Regarding the domains of social support, affective support (AS) had the highest mean score (93.44 ± 12.97), whereas informational support (IS) had the lowest (81.69 ± 24.60). Overall, 83.9% reported good family functioning, 9.3% moderate family dysfunction, and 6.8% severe dysfunction. A statistically significant positive correlation with a moderate magnitude was confirmed between APGAR with all support domains. Material support (MS, r = 0.327), AS (r = 0.425), emotional support (ES, r = 0.518), positive social interaction support (PSIS, r = 0.466), and IS (r = 0.421). CONCLUSION:Social support was positively associated with family functioning, indicating that patients with CKD undergoing hemodialysis who reported better family functioning also perceived higher levels of social support.
BACKGROUND:Relative energy deficiency in sport (REDs) is a syndrome that impairs physiological function because of low energy availability. Awareness and knowledge of REDs among athletes and health professionals are essential for early identification and prevention. OBJECTIVE:To translate into Brazilian Portuguese and culturally adapt a questionnaire that assesses knowledge of the signs, symptoms, and consequences of REDs, originally created by Pai et al., and to obtain evidence of content and face validity. DESIGN AND SETTING:Translation, cultural adaptation, and validation study conducted remotely using online tools and digital data collection. METHODS:The translation and cultural adaptation consisted of the following steps: two independent translations, synthesis of the translations by a committee of health professionals, two back-translations, and review by a committee of experts to determine the best version for testing. For content validity, the content validity coefficient (CVC) was calculated based on the evaluation of the experts committee on the practical pertinence, theoretical relevance, and linguistic clarity of the items of the pretest version. For face validity, the pretest version was applied to 30 individuals who assessed the items for linguistic clarity, adequacy, and comprehensibility. RESULTS:The CVC for the scale was 0.97. The CVC values for clarity, pertinence, and relevance were 0.97, 1 and 0.99, respectively. All items had a CVC > 0.8, confirming acceptable content validity. The pretest version was tested on 12 female runners, eight coaches, and 10 dietitians. Items were clear and comprehensible to 93% and adequate to 96% of respondents. No changes were needed, and the pretest version was defined as the Brazilian version of the questionnaire to assess REDs knowledge (QC-REDs). CONCLUSION:The QC-REDs obtained strong content and face validity. It provides a rigorously adapted tool for Brazil, supported by positive feedback from the target population, demonstrating its applicability and usability. This instrument fills a crucial gap and offers a valuable resource for researchers and professionals working with athletes at risk of REDs. Future research should focus on psychometric validation to further solidify its effectiveness in the Brazilian context.
BACKGROUND:Parkinson's disease (PD) is a progressive neurodegenerative disease characterized by motor and non-motor symptoms. Attention deficits are common in patients with PD, and balance can be affected by sleep quality and depression. The auditory event-related potential (ERP) P300 tool is associated with attention and discrimination processes and is a sensitive indicator of attention. OBJECTIVES:This study aimed to investigate the effects of balance, sleep quality, and depression on attention in individuals with PD using P300 latency. DESIGN AND SETTING:In this cross-sectional study, 28 individuals with PD and 27 healthy controls were assessed. METHODS:Attention was measured using the auditory ERP P300, balance with the Berg Balance Scale (BBS), sleep quality with the Pittsburgh Sleep Quality Index (PSQI), and depression with the Beck Depression Inventory (BDI). Multiple linear regression analysis was used to examine the effects of these variables on P300 latency. RESULTS:Significant differences were found between the groups in terms of attention, balance, sleep quality, and depression (all P < 0.001). Regression analysis indicated that balance (B = -4.909, P = 0.001) and sleep quality (B = 12.704, P = 0.007) were significantly associated with P300 latency, whereas depression (B = 3.472, P = 0.084) was not. CONCLUSION:PD is associated with impaired attention, balance deficits, poor sleep quality, and increased depressive symptoms. The significant association between balance performance and sleep quality with attentional processing highlights their potential relevance in clinical assessment and management. CLINICAL TRIAL REGISTRATION:The study was registered with Clinical Trials (NCT04687371 - https://clinicaltrials.gov/study/NCT04687371).
BACKGROUND:The Positive Aspects of Caregiving Scale (PAC) assesses the satisfaction and psychosocial benefits perceived by caregivers in the caregiving experience. OBJECTIVE:To analyze the psychometric properties of the PAC among unpaid caregivers of people living with dementia in the Brazilian context. DESIGN AND SETTING:Validation study of the instrument conducted online with caregivers from different regions of Brazil. METHODS:The sample comprised 100 unpaid caregivers of people living with dementia. Sociodemographic characteristics, positive aspects of caregiving, burden, depressive symptoms, anxiety symptoms, and quality of life were assessed using an online form. Evidence of validity based on internal structure was examined using confirmatory factor analysis, reliability testing, and criterion validity analysis. RESULTS:Most participants were women (95%), daughters of the care recipient (85%), with an average age of 54.5 years, a high educational level, and residence in the Southeast region of Brazil. Depressive symptoms (70%), anxiety (65%), moderate to severe burden (42%), and low quality of life (62%) were prevalent. Factor analysis indicated satisfactory fit for the PAC, and the high correlation between factors supported consideration of a one-dimensional scoring structure. The scale showed high internal consistency (α = 0.89) and significant correlations with burden, anxiety symptoms, depressive symptoms, and quality of life. CONCLUSION:The PAC showed good psychometric properties in the Brazilian context, supporting its validity and reliability for assessing positive aspects of caregiving among unpaid caregivers of people living with dementia.
