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Estudo da acurácia da ultra-sonografia transvaginal na avaliação da cavidade endometrial de 31 pacientes menopausadas assintomáticas em correlação com achados histeroscópicos e anatomopatológicos

Thu, 01 Jan 2009 00:00:00 GMT

Título: Estudo da acurácia da ultra-sonografia transvaginal na avaliação da cavidade endometrial de 31 pacientes menopausadas assintomáticas em correlação com achados histeroscópicos e anatomopatológicos Autor(es): Fernandes, Fernando Aguiar Abstract: This study had the objective to evaluate the performance of vaginal ultrasound and hysteroscopy as tests of endometrial evaluation, in a group of 31 pôs menopausal patients of the Gynecology Sector of Maternidade Escola Assis Chateaubriand-UFC considering the histological findings as the gold standart. The study was prospective one, in the period of abril 2005 to November 2005. Were included patients in amenorrhea of at least one year duration and FSH levels over 40 mUI/ml. Were excluded hysterectomized patients, patients with transvaginal bleeding and those that did not did vaginal ultrasound and hysteroscopy. The vaginal ultrasound data evaluate were: endometrial thickness, regularity and ecogenicity. These data were analyzed through the receiver operator characteristic curve (ROC), Kappa coefficient, t Student test for correlation of nonnal variables and Test of Mann-Whitney for abnormal distribution variables. The most frequent hysteroscopic findings was atrophic endometrium, in 61.2% of cases. Edometrial polyps were found in 19.4% of cases, and myomas in 12.9% and thickened endometrium in 6.5%. Concerning the vaginal ultrasound findings, the most common findings was atrophic endometrium in 24 patients, 77.4% of cases, thickened endometrium in two cases, 6.4%, endometrial polyp in one patient, 3.2% and myoma in 12.9%. Concerning the histological findings, the most common findings was atrophic endometrium, 64.5% of cases. Endometrial polyps m 16.1% of cases, myomas in 12.9%, proliferative endometrium in 3.2% e hyperplasic endometrium in 3.2% of patients. Taking in account the prevalence of endometrium alterations in the pos menopausal period of 30%, the sensitivity of the vaginal ultrasound to detect endometrium alterations was of 63.7%, the specificity was 100%, the positive predictive value was of 100% and the negative predictive value was of 83.3% with an accuracy of 89%. In the group of patients the possibility that a negative diagnosis can occur is 2.75 times than to have the same diagnosis in a group of patients with endometrium alterations. We conclude that vaginal ultrasound is a good screening test in pos menopausal asymptomatic patients Tipo: Dissertação

Repercussões maternas e perinatais de gestantes com cardiopatias em hospital terciário no Ceará

Fri, 01 Jan 2010 00:00:00 GMT

Título: Repercussões maternas e perinatais de gestantes com cardiopatias em hospital terciário no Ceará Autor(es): Nascimento, Zeus Peron Barbosa do Abstract: Aims. To evaluate maternal and peri-natal outcomes of pregnant women with heart disease, comparing the socio - demographic, obstetric data and peri-natal results by the type of heart disease (congenital versus acquired) and the route of delivery (vaginal versus abdominal). Methodology. This is a cross sectional, retrospective, descriptive and analytical research carried out by the records of 70 patients who delivered at Hospital Geral Cesar Cals in the years 2007 ( 26 cases) and 2008 (44 cases) by completing questionnaires. We used the Yates chi-square test, Pearson and Fisher Exact test for bi-varied analysis of data. We considered the level of significance p < 0.05. Results. The age of patients ranged from 15 to 42 (mean 25.8 + 6.5) years; on twenty five (35.7%) were first pregnancy, 22 (31.4%) second pregnancy and 23 (32.9%) were multi – pregnancy. Sixteen patients (22.9%) had congenital heart disease and 45 had acquired heart disease (64.3%). There were 15 premature births (21.7%). Twenty four (34.3%) of the women had vaginal deliveries and 46 (65.7%) cesarean section. The rate of pre term births was 21.7%. There was 27.1% of infants with low birth weight, 8.6% of fetal growth restriction, 17.1% of Apgar score < 7 in the first and 11.4% in the fifth minute of life. There was one maternal death and 5 peri-natal deaths. There was no statistical difference between congenital and acquired heart disease except for a greater presence of clinical pathologies previous to the pregnancy in the group of congenital heart disease. Patients who had vaginal deliveries presented higher parity and lower education, higher rates of prematurity in infants with low birth weight and lower Apgar scores in the first minute when compared to those who were submitted to cesarean section. The frequency of clinical discompensation during labor and / or delivery was 5.7% without statistical difference between the vaginal or abdominal. Conclusions. There was a high frequency of cesarean section, premature birth, low birth weight, Apgar score < 7 in the first minute of life and need to be admitted in the neonatal UTI. There was no clear differencebetween the types of heart disease. The worst neonatal results found for the vaginal delivery can be attributed to the very pre-term birth, that is, not necessarily the mode of delivery. Tipo: Dissertação

Efetividade da utilização de incubadoras de CO2 equipadas com filtro Hepa e filtro Hepa-Voc para cultivo de embriões em ciclos de fertilização in Vitro

Fri, 01 Jan 2010 00:00:00 GMT

Título: Efetividade da utilização de incubadoras de CO2 equipadas com filtro Hepa e filtro Hepa-Voc para cultivo de embriões em ciclos de fertilização in Vitro Autor(es): Freitas, Tulius Augusto Ferreira de Abstract: ntroduction and objectives. The air quality in sterile environment is an important aspect to cell culture. It is known the culture conditions are essential for in vitro human embryo development; however there is no standardization for incubator filters in in vitro fertilization (IVF) laboratories. Recently, the incubator air quality has been receiving attention, and effect of volatile organic compounds (VOC) has being highlighted. The aim of this study was to evaluate the laboratorial outcomes of IVF cycles with embryo culture using CO2 incubators with the HEPA filter for air particles and a high efficiency VOC filter with activated coal. Material and methods. This is an observational prospective controlled study which included 160 IVF cycles at Human Reproduction Clinic CRIAR between 2008 January and 2009 September. The cycles were matched to patient age, infertility etiology, pituitary desensitization protocol, and semen origin and quality. Thirty five cycles were compared in which the embryos were cultured in CO2 incubator with HEPA filter (HEPA group) and 35 cycles where a CO2 incubator with VOC filter was used for embryos cultures (VOC group). Results. The groups were similar for general characteristics of IVF cycles. We did not observed differences about normal fertilization and embryo cleavage rates. On the other side, the proportion of high quality embryos (grade A) was higher on VOC group (50.8%) than HEPA group (35.7%; p=0.05). Conclusions. IVF cycles using CO2 incubator with VOC filter for embryo culture results in a increased high quality embryos rate, those with high implantation potential. Tipo: Dissertação

Estudo da citologia oncótica convencional e da detecção do DNA-HPV pela captura de híbridos II no rastreamento primário de lesões pré-neoplasicas e neoplásicas cervicais

Sat, 01 Jan 2005 00:00:00 GMT

Título: Estudo da citologia oncótica convencional e da detecção do DNA-HPV pela captura de híbridos II no rastreamento primário de lesões pré-neoplasicas e neoplásicas cervicais Autor(es): Veras, Tânia Maria Cruz Werton Abstract: Objective: to compare the usual Pap smear (Papanicolaou) and the Hybrid Capture II tests in detecting cervical intraepithelial neoplasia in women of Ceara State. Subjects and Methods: 1685 women were enrolled from routine practice in five municipalities of the main Ceará State Health Regions. The whole study was explained to the volunteers, who accepted to participate by signing an informed consent form. The study procedures included filling a questionaire and a cervical sample collection, done by a physician, for cytology and HPV-DNA Hybrid Capture, followed by a complete colposcopic evaluation with directed biopsy if necessary. Data were analyzed in Statistical Package for Social Sciences - SPSS - for Windows 10.0. The accuracy of both tests – Pap smear and Hybrid Capture II - was evaluated by using the sensitivity, specificity, positive predictive value, negative predictive value and the respective 95% confidence intervals. The negative colposcopic examination or negative histological result were considered gold standard for negative results. Positive histological results were considered gold standard for positive results. Results: 56 women (3,4%) had abnormal pap smear. Hybrid Capture tests were positive in 315 women (19%). Despite 337 (20,32%) tests had positive results for one of the two tests, only 19 (1,1%) were positive in both tests. Lesions were detected in 53 women among those 150 considered positive in colposcopic examination. The prevalence for any lesion was estimated in 3,2% and for high grade lesions and cancer in 0,4%. Using the cut-off point as the finding of any cervical lesion, the sensitivity of pap smear and HC II was 30,2% and 71,7%, respectively. The specificity for pap smear and HC II was 97,5% and 82,7%, respectively. The positive and negative predictive value for pap smear was 28,6% and 97,7%, respectively. The positive and negative predictive value for HC II was 12,1% and 98,9%, respectively. By using the cut-off value as high grade cervical lesions and cancer, the sensitivity and specificity for pap smear were 28,6% and 99,9%, respectively, and the positive predictive value and negative predictive value for the same test were 54,8% and 99,7%. The sensitivity and specificity for HC II were 100% and 81,3%, respectively, as well as 2,2% and 100% for positive and negative predictive value. Conclusions: hybrid Capture II test was more sensitive than pap smear, however Hybrid Capture II test was less specific than pap smear. When both tests were used together for detecting cervical lesions the results improved significantly, mainly high grade lesion and cancer. For this group of lesions, HC II alone, presented better specificity, without loss of the sensitivity, apparently it’s a good test for primary sceening. Descrição: VERAS, Tânia Maria Cruz Werton. Tipo: Dissertação