São Paulo medical journal = Revista paulista de medicina
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Several risk factors are involved in perineal lacerations during vaginal delivery. However, little is known about the influence of perineal distensibility as a protective factor. The aim here was to determine a cutoff value for pelvic floor distensibility measured using the Epi-no balloon, which could be used as a predictive factor for perineal integrity in vaginal delivery. ⋯ Circumferences greater than 20.8 cm achieved using the Epi-no balloon are a predictive factor for perineal integrity in parturients.
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High prevalence of mistreatment among medical students has been described in the worldwide literature since the 1980s. However, studies addressing the severity and recurrence of victimization and its effects on students' perceptions of their medical course are scarce. This study had the aim of estimating the prevalence of exposure to mistreatment that was considered to be severe and recurrent and its association with medical students' perceptions about their medical course. ⋯ Occurrences of mistreatment within the academic environment are frequent in Brazil. The results suggest that mistreatment that was considered to be severe might negatively affect students' perceptions about their course.
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Catatonia can be divided into non-malignant or malignant. The latter is characterized by autonomic instability, exhibiting high fever, tachycardia and hypertension, and is regarded as a fulminant and rapidly progressive subtype. ⋯ Early intervention with lorazepam reduced the evolution of this patient to a fatal complication. Therefore, this case report sought to show that early diagnosis and intervention reduced the occurrence of serious and irreversible clinical outcomes.
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High blood pressure (hypertension) is the most frequent cause of morbidity and a major risk factor for cardiovascular complications. The aim here was to describe the prevalence of blood pressure greater than or equal to 140/90 mmHg in the adult Brazilian population and federal states, along with self-reported information about previous medical diagnoses of hypertension, use of medication and medical care for hypertension control. ⋯ These results are important for supporting measures for preventing and treating hypertension in Brazil, with the aim of achieving the World Health Organization's goal of reducing hypertension by 25% over the next decade.
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Comment
Long-term non-pharmacological weight loss interventions for adults with type 2 diabetes mellitus.
Most persons with type 2 diabetes are overweight and obesity worsens the metabolic and physiologic abnormalities associated with diabetes. ⋯ Weight loss strategies using dietary, physical activity, or behavioral interventions produced small between-group improvements in weight. These results were minimized by weight loss in the comparison group, however, and examination of individual study arms revealed that multicomponent interventions including very low calorie diets or low calorie diets may hold promise for achieving weight loss in adults with type 2 diabetes.