Sixth Month Research Articles

Effectiveness of multi-component modular intervention on screen-based and non-screen-based sedentary time among adolescents in an urban area of Mangalore: a school-based cluster randomised controlled trial-protocol

Background Behavioural risk factors are often present during adolescence and account for 70% of premature deaths during adulthood. Excessive sedentary behaviour and screen time have become significant concerns, especially among adolescents, due to their potential negative impact on physical and mental health. Adolescents with a high screen-based sedentary time are more likely to be physically inactive, have unhealthy body structure and poor academic performance. The objective of our study is to assess the effect of multi-component modular educational intervention on screen-based sedentary time (SST) and non-screen-based Sedentary time (NSST) among adolescents. Methods Ethical approval for the study has been obtained from the institutional Ethics Committee of Kasturba Medical College in Mangalore, India. This cluster randomized control trial will be carried out in schools located in the urban area of Mangalore. Using simple randomization, the eligible schools will be randomized into intervention and control arms, each consisting of 10 clusters. A multi-component modular educational intervention will be administered to participants in the intervention group at baseline, second and fourth month. The control group will receive the standard curriculum. Both the groups will be assessed at baseline and at second month, fourth month and sixth month of follow up for SST, NSST and level of physical activity. Anthropometric measurements like height, weight, waist circumference and hip circumference will be taken at baseline and sixth month of follow up. Results A comprehensive school-based modular educational intervention can have cumulative advantages by reducing screen- and non-screen-based sedentary time, and encouraging physical activity. Similar modular teaching can be incorporated into the curriculum, which will promote healthy life-style among the adolescents.

Outcome of cataract surgery in children with presumed trematode-induced granulomatous anterior uveitis

PurposeTo examine the 6-month visual outcomes and complications following cataract surgery in patients with persumed trematode induced granulomatous anterior uveitis.SettingAssiut university hospital, Assiut, Egypt.DesignThis is a retrospective non comparative case series study.MethodsPatients presenting with significant cataract secondary to uveitis caused by trematode induced anterior chamber granuloma were included in this study.Cases with active anterior uveitis, within the last 3 months preceding surgery, and those with a history of trauma, were excluded from this study.Data collected included demographic characteristics, history of the condition including when uveitis started, treatment received and history of other health conditions that may be relevant to uveitis.Complete opthalmologic examination including assessment of best corrected visual acuity (BCVA) and OCT macula, if possible, were done. These was repeated 1 week, 1 month, 3 months and 6 months after surgery. Specular microscopy was performed preoperatively and 3 months after surgery. Patients underwent cataract surgery with posterior chamber intra ocular lens and statistical analysis was performed to compare preoperative and postoperative BCVA and corneal endothelial cell counts. Postoperative complications were recorded.ResultsFive eyes of 5 patients were included in the study. All study eyes showed improvement in the post-operative visual acuity.A statistically significant improvement was observed in VA in the sixth postoperative month compared to the baseline measurements (p = 0.004). No statistically significant difference was observed between the preoperative and postoperative endothelial cell counts (p = 0.696). Cystoid macular edema did not occur as a postoperative complication.ConclusionVisual outcomes of cataract surgery in eyes with persumed trematode induced granulametous anterior uveitis are favorable. No sight threatening complication was observed in our series.

Breastmilk mineral composition among well-educated mothers from Central Poland – Associations with maternal dietary intake, dietary patterns and infant psychomotor development

BackgroundMaternal dietary habits could affect breastmilk mineral composition, which may influence infant development. Mineral dietary intake or supplementation slightly affects its breastmilk concentration. However, the intake of selected food groups or dietary patterns that reflect diet complexity could have a greater impact. Hence, the aim of the study was to assess breastmilk mineral composition at one, three, and six months of lactation among mothers living in urban area of Central Poland, as well as the evaluate maternal dietary determinants and associations with infant anthropometric and psychomotor development. MethodsThe study was conducted among 43 healthy and exclusively breastfeeding mothers. In the first, third, and sixth months of lactation, we collected breastmilk samples and assessed the concentration of Ca, P, Zn, Fe, Se, Ni, As, Pb, and Cd using the ICP-MS method. Maternal dietary habits were evaluated by a food frequency questionnaire in the first month of lactation, whereas in the third and sixth by the three-day food record. Based on the collected data adherence to the Polish-adapted Mediterranean (Pl-aMED; 1 month) and the DASH diet (Mellen’s Index; 3 and 6 months) was assessed. In the third and sixth months of lactation infant anthropometric parameters and the sixth month of lactation psychomotor development were evaluated. ResultsBreastmilk Se, Ni, As, Pb, and Cd levels were under the LOQ in all the breastmilk samples at all study visits. Median breastmilk mineral concentrations of Ca, P, Zn, and Fe in the first, third, and sixth months of lactation varied from 381.9 to 332.7 mg/L, 161.6 to 139.1 mg/L, 2.2 to 0.8 mg/L, and 0.26 to 0.17 mg/L, respectively. Maternal dietary intake and supplementation did not affect breastmilk Ca, P, Zn, and Fe. Pl-aMED scores were associated with breastmilk Ca (β = 0.489, 95% CI 0.180 – 0.799, p = 0.003) and Zn (β = 0.499, 95% CI 0.199 – 0.798, p = 0.002) in the first month of lactation, whereas no association with the DASH diet were observed in the third and sixth month of lactation. Breastmilk Fe in the third month was associated with infant motor development (β = 0.420, 95% CI 0.113 – 0.727, p = 0.009) in the sixth month of life, but no other associations with anthropometric or psychomotor development were observed. Moreover, we estimated that few infants meet their adequate intake (AI) requirements for P, Zn, and Fe. ConclusionOur study showed that maternal adherence to Pl-aMED is a significant predictor of breastmilk Ca and Zn in the first month of lactation, which may be especially important considering that more than 75% of infants had inadequate Zn intake. Moreover, we found that breastmilk Fe positively influenced infant motor development, despite the majority of infants having inadequate intake. On the other hand, no infant had deficiency symptoms, which emphasizes the necessity to evaluate of AI norms for infants.

Comparative evaluation of the clinical success of 3D-printed space maintainers and band-loop space maintainers.

Exploring the integration of 3D-printing technology in space maintainer (SM) manufacturing could offer innovative solutions and insights for enhancing SMs. To compare the clinical success, retention, and periodontal effect of traditional band-loop (TBL) SMs with 3D-printed SMs. Seventy children (mean age: 6.99 ± 1.18) were divided into two groups. Laser sintering (LS) group (n = 34): Patients were scanned with an intraoral scanner. SMs were produced with LS 3D-printing method from a titanium-based metal powder. T group (n = 36): Impressions were taken with alginate. SMs were produced by adjusting the bands and soldering the wires on the model. The retention and effects on oral hygiene of the SMs were evaluated at the sixth month. Preference for impression technique was assessed by a five-question survey. Thirty-eight percent of T SMs and 66% of LS SMs failed (p = .007). The mean survival time was significantly higher in the T group (p = .035). No difference was found between the initial and control full-mouth Gingival Index (GI) and Plaque Index (PI) values of the two groups. Both groups had increased GI/PI values in abutment teeth. Patients in the LS group interpreted their impression experience more positively. It is important to provide oral hygiene education before applying fixed SMs and utilize more digital workflow in paediatric dentistry.

The effect of maternal caffeine consumption during the perinatal period on lactation

Background: Caffeine is a substance found in various seeds, foods, beverages and pharmaceuticals. We sought to assess perinatal caffeine consumption rates and the impact of maternal consumption on lactation. Material and Method: This is a prospective, descriptive cohort study conducted in Greece. Women were recruited from five tertiary maternity hospitals throughout 2020. A total of 847 mothers participated and data were collected during their hospitalization in the maternity hospital using a structured questionnaire. Follow-up included a telephone interview in the first, third and sixth month after delivery. Results: A significant decrease in caffeine consumption was reported during pregnancy (84.7%) compared to the period before pregnancy (96.3%, p<0.001). On the fourth day postpartum, caffeine intake (65.8%) was reduced significantly compared to the pre-pregnancy period (p<0.001), remaining relatively unchanged over a period of three months postpartum (1st month: 71%, 3rd month: 64.7%). Moreover, there was a significant decline in caffeine intake at six months postpartum (54.2%, p<0.001) and after discontinuation of breastfeeding (42.7%, p<0.001). Our findings showed that women who ceased breastfeeding at any stage over the six-month follow-up consumed less caffeine during the first three months after delivery (p<0.001) in comparison to those who maintained breastfeeding at six months. In addition, higher pre-pregnancy caffeine consumption (β = 0.04, SE: 0.02, p = 0.032) had a positive association with longer breastfeeding duration. Conclusions: Τhis study was the first to record caffeine intake in the perinatal period in the Greek setting. The results demonstrate that perinatal maternal caffeine consumption was reduced compared to the pre-pregnancy period and that there was a positive correlation between caffeine consumption and breastfeeding duration.

Comparison of 2 Different Treatments for Conjunctivochalasis: Plasma-Based Conjunctivoplasty Versus Argon Laser Photocoagulation.

The aim of this study was to compare the clinical outcomes of plasma-based conjunctivoplasty and argon laser photocoagulation techniques used in the treatment of conjunctivochalasis. The study included 119 eyes from 67 patients who underwent plasma-based conjunctivoplasty or argon laser photocoagulation for conjunctivochalasis in our clinic between February 2021 and March 2022. Group 1 included 62 eyes from 35 patients who had plasma-based conjunctivoplasty. Group 2 included 57 eyes from 32 patients who had argon laser photocoagulation. Main outcomes were patient symptoms, the degree of conjunctivochalasis, fluorescein staining score, tear breakup time, the amount of conjunctival shrinkage, and complications. Before surgery, Group 1 had grade 1 conjunctivochalasis in 8 eyes (12.9%), grade 2 in 20 eyes (32.2%), and grade 3 in 34 eyes (54.8%). In Group 2, 9 eyes (15.7%) had grade 1, 21 eyes (36.8%) had grade 2, and 27 eyes (47.3%) had grade 3 conjunctivochalasis ( P = 0.43). At the sixth postoperative month, only 2 eyes (3.2%) in Group 1 had grade 1 conjunctivochalasis, whereas the other cases (96.7%) had no conjunctivochalasis. However, Group 2 had grade 1 conjunctivochalasis in 16 eyes (28.0%), grade 2 in 21 eyes (36.8%), and grade 3 in 2 eyes (3.5%). Conjunctival shrinkage in Group 1 (5.1 ± 1.2 mm) was significantly higher than in Group 2 (3.3 ± 0.9 mm; P < 0.001). Postoperative tear breakup time in Group 1 (10.2 ± 2.1 seconds) was significantly longer than in Group 2 (8.8 ± 2.0 seconds; P < 0.001). Plasma-based conjunctivoplasty demonstrated greater clinical improvement and efficacy than argon laser photocoagulation for the treatment of conjunctivochalasis.

A novel predictive method for risk stratification in acne patients receiving isotretinoin: an analysis of laboratory abnormalities and changes in inflammatory parameters

Introduction Isotretinoin is a widely used, effective medication for moderate to severe acne. It is typically used for several months, which necessitates regular laboratory monitoring. However, consensus on the optimal assessment frequency is lacking. Method This is a single-center retrospective study on 1182 patients who received isotretinoin for acne at the Dermatology Clinic in Jordan University Hospital over 5 years. Results Of the 1182 patients, 892 (76.57% females) met the inclusion criteria. An increase in the proportion of patients with abnormal triglycerides and total cholesterol levels from baseline to the sixth month was observed (p < 0.05). Conversely, differences in the number of patients with abnormal AST, ALT, and CBC were not found throughout treatment (p > 0.05). Moreover, there was a decrease in the neutrophil-to-lymphocyte ratio (NLR) ratio and systemic inflammatory index (SII) after the sixth month of isotretinoin treatment compared to the baseline (p = 0.012 and p = 0.021, respectively). Conclusions We found that a baseline cholesterol level of 163.9 mg/dl and a baseline triglycerides level of 85.5 mg/dL are highly specific and sensitive in detecting grade 1 abnormalities at the one-month follow-up. This novel prediction approach serves as an effective risk stratification method for isotretinoin acne patients.

Using autogenous tooth sticky bone graft repair mandibular third molar dentigerous cyst osseous defects

BackgroundDentigerous cyst are most common odontogenic cyst and they frequently occur at the mandibular third molar. Their asymptomatic long medical history always resulted in severe bone resorption at the distal aspect of the adjacent second molar. BonMaker® ATB demonstrate an excellent autogenous bone graft candidacy. The aim of this study is to share a single team’s experience of dentigerous cyst osseous defect repairing by applying autogenous tooth sticky bone graft.MethodIn total, 18 patients with dentigerous cyst, which was arised from mandibular third molar unilaterally, were enrolled in this study. Enucleation of dentigerous cyst was performed extracting with involving teeth under general anesthesia. Autogenous tooth sticky bone graft was prepared using extracted tooth and autogenous fibrin glue. Subsequently, grafting was performed above covering with concentrate growth factors. Patients were followed up at sixth months.ResultsThey were eleven male and seven female patients. Their ages ranged from 20 to 40 years, with a mean of 31 years. Primary wound healing of all sites was achieved in all the patients. Sixth months postoperative radiographic assessment show that dentigerous cysts osseous defects of seventeen patients were good bone filling and ossification. One patient occurred slight bone resorption at the distal aspect of the adjacent second molar.ConclusionWithin the limitation of sample size and retrospective nature of the present study, autogenous tooth sticky bone graft demonstrates one of the best alternative alveolar bones repairing graft.

Plasma SHBG Levels as an Early Predictor of Response to Bariatric Surgery.

Obesity is a growing global health problem, and currently, bariatric surgery (BS) is the best solution in terms of sustained total weight loss (TWL). However, a significant number of patients present weight regain (WR) in time. There is a lack of biomarkers predicting the response to BS and WR during the follow-up. Plasma SHBG levels, which are low in obesity, increase 1month after BS but there is no data of plasma SHBG levels at long term. We performed the present study aimed at exploring the SHBG role in predicting TWL and WR after BS. Prospective study including 62 patients with obesity undergoing BS. Anthropometric and biochemical variables, including SHBG were analyzed at baseline, 1, 6, 12, and 24months; TWL ≥ 25% was considered as good BS response. Weight loss nadir was achieved at 12months post-BS where maximum SHBG increase was reached. Greater than or equal to 25% TWL patients presented significantly higher SHBG increases at the first and sixth months of follow-up with respect to baseline (100% and 150% respectively, p = 0.025), than < 25% TWL patients (40% and 50% respectively, p = 0.03). Also, these presented 6.6% WR after 24months. The first month SHBG increase predicted BS response at 24months (OR = 2.71; 95%CI = [1.11-6.60]; p = 0.028) and TWL in the 12th month (r = 0.330, p = 0.012) and the WR in the 24th (r = - 0.301, p = 0.028). Our results showed for the first time that increase in plasma SHBG levels within the first month after BS is a good predictor of TWL and WR response after 2years.

Retinal phakomatosis and Von Hippel-Lindau peripheral capillary hemangioblastoma: proposal for staged surgery.

Retinal capillary hemangioblastoma (RCH) is present in about half of the carriers of the VHL (von Hippel-Lindau) gene mutation and can lead to the evolution of blindness. Herewith is a proposal for surgical intraretinal feeder vessel ligature to induce ischemia the phakoma and to resolve the exudative secondary retinal detachment, with satisfying results at the 6 months follow-up end point. The patient underwent a chandelier-assisted 23 G pars plana vitrectomy with valved trocars. A bimanual transretinal ligature of the hemangioblastoma's feeder vessel was performed, followed by localized endolaser to ablate the surrounding retina and capillaries, and a Polydimethylsiloxane 1000 (PDMS 1000) final tamponade. After 3 months, exchange PDMS/air/balanced salt solution (BSS), phacoemulsification, and in-the-bag intraocular lens (IOL) implantation were performed. At sixth month, fundus fluorescein angiography (FFA) showed a significant reduction of blood flow in the phakoma. Final best-corrected visual acuity (BCVA) was 6/6 (9 lines gain obtained compared to the baseline time). This surgical technique seems to be effective and promising for the treatment of VHL retinal capillary hemangioblastomas and their related retinal complications.

The effectiveness of educational intervention based on the Health Action Model (HAM) in improving breast cancer screening behaviors

IntroductionBreast cancer disease is known as the most common cancer among women. Lack of knowledge and awareness is a leading cause of breast cancer, and since nearly all women are increasingly susceptible to this disease, training screening behaviors for early detection is proven essential in order to reduce breast cancer mortality. Therefore, the present study was designed to determine the effect of educational intervention based on the Health Action Model in improving breast cancer screening behaviors in women aged 30 to 69 in Kashan, Iran.MethodsThis quasi-experimental study was conducted on 162 women aged 30–69 years old among the clients of Comprehensive health service centers in Kashan, Iran and they were assigned to intervention and control groups. The research instrument included a questionnaire assessed within three phases: baseline, 3-months, and 6-months, containing Health Action Model (HAM) structures and also three screening behaviors. The intervention consisted of a model-based education package and was carried out over 2 months. To evaluate the effect of the intervention, the mean of model structures and proportion screening behaviors in the third and sixth months were compared with the baseline phase. All analyses were carried out using SPSS, version 22.ResultsThe intervention and control groups were homogeneous regarding the structures of the HAM and the proportion of screening behaviors in the baseline phase (p > 0.05). In the 3-month (p < 0.05) and 6-month (p < 0.05) phases, the mean scores of the HAM constructs in the intervention group were found higher compared with the control group. Moreover, the proportion of clinical breast examinations in the intervention group was statistically higher than in the control group in the 3-month (p < 0.001) and 6-month (p < 0.001) phases. In addition, the proportion of mammography performed in the 3-month (p = 0.002) and 6-month (p < 0.001) phases were reported to be higher in the intervention group compared with the control group.ConclusionOverall, these results provide important insight into the effectiveness of the interventions based on the Health Action Model in promoting breast cancer screening behaviors and the determinants of such behaviors.

Evaluation of Laboratory Parameters as Predictors of Mortality.

Evaluation of biomarkers as risk factors for mortality may provide early intervention and treatment for fatal diseases. We aimed to determine the usability of inexpensive and easily measurable tests in the differentiation of critically ill patients by investigating their relationship with mortality. This study was executed by examining the sixth, third, and first month examinations of patients registered to the home health care services unit in 2022 before mortality due to any reason. This study was conducted by including 1,060 patients. All parameters were distributed non-parametrically. The difference between the dependent groups was evaluated with Friedman's two-way analysis of variance, and p < 0.05 was considered statistically significant. When the patients' premortem one-month, three-month, and six-month results were examined, there was an increase in mean platelet volume (MPV) values over time. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) also increased. In these two parameters, the difference between the first and third months and between the first and sixth months was statistically significant. Given the C-Reactive Protein (CRP)/Albumin Ratio (CAR) and CRP/Prealbumin results, a significant increase was observed in both ratios. A more than four-fold increase was observed in the CAR between the premortem first and sixth month results, which increased gradually over time and was statistically significant. Conclusıons: NLR, PLR, MPV, CAR and CRP/Prealbumin values were statistically associated with mortality.

Fatores relacionados ao desmame precoce em bebês nascidos a termo em uma maternidade pública

ABSTRACT Purpose to analyze how socioeconomic, pregnancy and childbirth factors relate to the feeding situation in the sixth month of life of full-term babies. Methods longitudinal observational study, with 98 mothers of full-term babies. Data collection was structured by capturing information regarding the clinical history and moment of birth in the babies' medical records, followed by the application of two questionnaires to the postpartum women, with questions regarding sociodemographic data, pre- and post-pregnancy data and the baby's nutrition. baby, the first being answered during hospital stay and the second, by telephone, in the 6th month of life. A descriptive analysis of the data was performed, using the frequency distribution of categorical variables, inferential analysis using Pearson's Chi-square test and multivariate analysis using binary logistic regression, adopting, for inclusion in the final model, the significance level of 5%. Results there was an association between exclusive breastfeeding in the 6th month and maternal education and between the period of food introduction and family income. Mothers with higher education were 4.82 times more likely to breastfeed their children exclusively until the sixth month. Families with lower income (up to one minimum wage) were 2.54 times more likely to start food introduction before the sixth month than families with higher income. Conclusion higher maternal education was a predictive factor for exclusive breastfeeding at the 6th month and higher military income was a predictive factor for introducing food after the 6th month.

Factors related to early weaning in babies born at term in a public maternity.

to analyze how socioeconomic, pregnancy and childbirth factors relate to the feeding situation in the sixth month of life of full-term babies. longitudinal observational study, with 98 mothers of full-term babies. Data collection was structured by capturing information regarding the clinical history and moment of birth in the babies' medical records, followed by the application of two questionnaires to the postpartum women, with questions regarding sociodemographic data, pre- and post-pregnancy data and the baby's nutrition. baby, the first being answered during hospital stay and the second, by telephone, in the 6th month of life. A descriptive analysis of the data was performed, using the frequency distribution of categorical variables, inferential analysis using Pearson's Chi-square test and multivariate analysis using binary logistic regression, adopting, for inclusion in the final model, the significance level of 5%. there was an association between exclusive breastfeeding in the 6th month and maternal education and between the period of food introduction and family income. Mothers with higher education were 4.82 times more likely to breastfeed their children exclusively until the sixth month. Families with lower income (up to one minimum wage) were 2.54 times more likely to start food introduction before the sixth month than families with higher income. higher maternal education was a predictive factor for exclusive breastfeeding at the 6th month and higher military income was a predictive factor for introducing food after the 6th month.

Topical Tretinoin in the Management of Thick-skinned Rhinoplasty Patients.

Despite the increasing popularity of cosmetic surgeries, some patients still experience skin problems, particularly those with thick nasal skin. Isotretinoin is a commonly used drug for severe acne, and its effects on rhinoplasty aesthetic results have recently been studied. This placebo-controlled clinical trial aimed to investigate the effects of topical tretinoin gel on the cosmetic outcomes of rhinoplasty in patients with thick nasal skin. Forty-nine individuals were randomly allocated to either the treatment group or the control group in Mashhad, Iran from 2019 to 2021. The treatment group received topical tretinoin gel (0.05%) beginning on the 31st postoperative day and continued for six months, while the control group received a usual dermatological recommendation as a placebo. Patients were assessed during the first, third, and sixth months after the intervention, and their cosmetic results were evaluated by an expert surgeon and dermatologist. There were no significant differences in baseline features between the two groups. The median score given by the surgeon was not significantly different between the groups. However, the median score given by the dermatologist was significantly higher in the treatment group during the first, third, and sixth months (P<0.001). Patient satisfaction scores were also significantly higher in the treatment group during the third and sixth months compared to the control group. (P=0.02 and 0.01, respectively). Topical tretinoin gel could effectively reduce acne in patients with thick nasal skin after rhinoplasty and increase patient satisfaction in the early months following surgery. However, it did not significantly affect final cosmetic outcomes.

Evaluation of the Effect of Radiosurgery for Target and Non-Target Lesions in Patients with Brain Metastases Using RANO-BM Criteria.

The current therapeutic indications of radiosurgery are constantly expanding. Magnetic resonance imaging (MRI) has an important role in the diagnostic and post-therapeutic period of primary and secondary brain tumor formations. A total of 66 patients with verified cancer disease and brain metastases were separated into two groups. The first group includes 34 patients with primary non-small cell lung cancer and the second one 32 patients with other types of primary cancer. All of them received high-dose radiotherapy in 1-5 fractions. The number, size, and location of the treated lesions responded to robotic stereotactic radiosurgery criteria. The Response Assessment Criteria for Brain Metastases (RANO-BM) is an international multidisciplinary group of experts who developed acceptable criteria for assessing brain metastases. Before treatment and on the first, third, sixth month after radiosurgery, a MRI and blood tests were performed. Treated lesions were separated into four groups depending on the results - complete response, partial response, progressive disease, and stable disease. In both groups of patients, the percentage of complete or partial response had increased in the third and sixth months. The results give us a reason not to recommend an MRI 1 month after treatment if the patient doesn't have any new neurological symptoms, because there may be a pseudo-progression. MRI results valued by RANO-BM criteria give us a good option to evaluate brain metastases on the third and sixth month after after stereotactic radiosurgery.

Effectiveness and Safety of Spironolactone in the Treatment of IgA Nephropathy: A Retrospective Self-Controlled Study.

It is crucial to utilize combination therapy for immunoglobulin A nephropathy (IgAN) patients to reduce proteinuria and maintain stable kidney function. We demonstrate the safety and efficacy of low-dose spironolactone in the management of IgAN patients. Adult IgAN patients treated with spironolactone were evaluated. Patients were separated into two categories according to whether 24-h proteinuria was reduced by more than 20% after 2 months of spironolactone treatment compared to baseline levels. Eighty-eight patients were analyzed and 24-h proteinuria decreased from 0.93 g to 0.70 g (p &lt; 0.001) after 2 months of treatment with spironolactone, accompanied by a slight decrease in eGFR from 75.7 to 73.9 mL/min/1.73 m2 (p = 0.033). Intriguingly, 47 patients in the effective mineralocorticoid receptor antagonist (MRA) group showed less endocapillary hypercellularity (p = 0.040). In the ineffective group, 18 patients discontinued MRA treatment because 24-h proteinuria increased from 0.83 g to 1.04 g, while the other 23 patients continued with spironolactone and proteinuria decreased to 0.57 g in the sixth month (p = 0.001). Furthermore, 12 patients with persistent high proteinuria during prednisone therapy were added with spironolactone. 24-proteinuria was dropped from 0.95 g to 0.73 g at the second month and to 0.50 g at the sixth month. In our study, we confirmed spironolactone's efficacy in reducing urine protein excretion in IgA nephropathy patients within 2 months of treatment. However, response varied among patients, with those showing endocapillary proliferation (E1) in renal biopsies having poor spironolactone responsiveness. Administering MRAs to patients with eGFR over 30 mL/min did not result in hyperkalemia, indicating the treatment's safety.

Influence of Neonatal Ankyloglossia on exclusive breastfeeding in the six first months of life: a cohort study.

To analyze the influence of ankyloglossia on the prevalence and duration of exclusive breastfeeding of full-term infants up to the sixth month of life. Prospective cohort study, carried out with 225 mother-infant dyads who were followed up in the first six months of life in a center specialized in breastfeeding in a tertiary hospital. Full-term infants with asymptomatic ankyloglossia (no need for surgery) were compared with infants without change at monthly follow-up. Ankyloglossia was diagnosed using the Bristol Tongue Assessment Tool, with a positive diagnosis being considered for those with a score less than or equal to 5 considering functional and anatomical aspects. Statistical analyzes were performed using descriptive statistics, logistic regression (weaning determinants), relative risk, and survival curves (to analyze breastfeeding duration between groups with and without ankyloglossia). Ankyloglossia was associated with weaning (considered even partial) before the sixth month of life. After adjusted analysis, a higher risk of weaning was detected in infants with this alteration, with a risk present from the second month of life. In the survival analysis, the duration of breastfeeding in infants with ankyloglossia was shorter when compared to children without alterations. Compared to infants with normal lingual frenulum, babies with ankyloglossia had shorter exclusive breastfeeding time, but well above the average observed in the general population. The risk of weaning for this group was also higher.

Influência da Anquiloglossia neonatal na amamentação exclusiva nos seis primeiros meses de vida: estudo de coorte

ABSTRACT Purpose To analyze the influence of ankyloglossia on the prevalence and duration of exclusive breastfeeding of full-term infants up to the sixth month of life. Methods Prospective cohort study, carried out with 225 mother-infant dyads who were followed up in the first six months of life in a center specialized in breastfeeding in a tertiary hospital. Full-term infants with asymptomatic ankyloglossia (no need for surgery) were compared with infants without change at monthly follow-up. Ankyloglossia was diagnosed using the Bristol Tongue Assessment Tool, with a positive diagnosis being considered for those with a score less than or equal to 5 considering functional and anatomical aspects. Statistical analyzes were performed using descriptive statistics, logistic regression (weaning determinants), relative risk, and survival curves (to analyze breastfeeding duration between groups with and without ankyloglossia). Results Ankyloglossia was associated with weaning (considered even partial) before the sixth month of life. After adjusted analysis, a higher risk of weaning was detected in infants with this alteration, with a risk present from the second month of life. In the survival analysis, the duration of breastfeeding in infants with ankyloglossia was shorter when compared to children without alterations. Conclusion Compared to infants with normal lingual frenulum, babies with ankyloglossia had shorter exclusive breastfeeding time, but well above the average observed in the general population. The risk of weaning for this group was also higher.

Evolution of the morphology of filtering blebs through anterior segment OCT, one, three and six months after Preserflo Microshunt implant and its correlation with intraocular pressure

Aims/Purpose: Study the evolution of the morphology of filtering blebs through AS‐OCT, one, three and six months after Preserflo implant and its correlation with IOP.Methods: Prospective observational study of 16 eyes with cataract and glaucoma, poorly controlled with maximum medical treatment and mean IOP of 23.6 mmHg, which underwent combined surgery with Preserflo and 0.04% MMC. The patients underwent measurement of IOP and AS‐OCT of conjunctival bleb one, three and six months after surgery. Bleb morphology is classified following the Leanzhofer classification as uniform or multiform (multilayer and/or multicystic). The presence of an episcleral aqueous lake in the distal part of the device is also studied.Results: Of the 16 patients studied, all completed the quarterly check‐up and 9 the six‐monthly check‐up. Of the total number of patients, 9 presented multiform multilayered bleb and 7 multiform multilayered with superficial cysts in the 1st and 3rd month. Of the 9 who completed the study up to the 6th month, 4 maintained their multilayered morphology, and of the remaining 5, who both in the 1st and 3rd month presented a multilayered morphology with superficial cysts, we observed a slight flattening of the bleb. The mean IOP in the 1st month was 12.5 mmHg, 12.6 in the 3rd month and 13.4 in the 6th month. Episcleral lake was observed in 9 cases, which remained present throughout the study.Conclusions: SA‐OCT is useful for monitoring conjunctival blebs after Preserflo implantation. Despite the slight thinning after the sixth month of the multiform multilayered blebs with superficial cysts, IOP remains stable. Therefore, the presence of multiform blebs and a maintained episcleral lake seem to be related to good hypotensive control.