RESUMEN
FUNDAMENTO: A Comissão Internacional de Radiologia indica rastreamento com teste de gravidez a todas pacientes do gênero feminino em período fértil que serão submetidas a exame radiológico. Sabe-se que a radiação é teratogênica e que seu efeito é cumulativo. O potencial teratogênico inicia-se com doses próximas às das utilizadas durante esses procedimentos. Não se sabe a prevalência de teste de gravidez positivo em pacientes submetidos a estudo eletrofisiológico e/ou à ablação por cateter em nosso meio. OBJETIVO: Avaliar a prevalência de teste de gravidez positivo em pacientes do gênero feminino encaminhadas para estudo eletrofisiológico e/ou ablação por radiofrequência. MÉTODOS: Estudo transversal com análise de 2.966 pacientes submetidos a estudo eletrofisiológico e/ou ablação por cateter, de junho 1997 a fevereiro 2013, no Instituto de Cardiologia do Rio Grande do Sul. Foram realizados 1.490 exames em mulheres sendo que, destas, 769 encontravam-se em idade fértil. Todas as pacientes foram rastreadas com teste de gravidez no dia anterior ao procedimento. RESULTADOS: Detectou-se positividade do teste em três pacientes, impossibilitando a realização do exame. Observou-se prevalência de 3,9 casos por 1.000 mulheres em idade fértil. CONCLUSÃO: Devido ao baixo custo e à segurança, indica-se a realização de teste de rastreamento para gravidez a todas pacientes em idade fértil, uma vez que o grau de radiação ionizante necessária nesse procedimento é muito próximo ao limiar de teratogenicidade, principalmente no primeiro trimestre, quando os sinais de gestação não são exuberantes.
BACKGROUND: The International Commission of Radiology recommends a pregnancy screening test to all female patients of childbearing age who will undergo a radiological study. Radiation is known to be teratogenic and its effect is cumulative. The teratogenic potential starts at doses close to those used during these procedures. The prevalence of positive pregnancy tests in patients undergoing electrophysiological studies and/or catheter ablation in our midst is unknown. OBJECTIVE: To evaluate the prevalence of positive pregnancy tests in female patients referred for electrophysiological study and/or radiofrequency ablation. METHODS: Cross-sectional study analyzing 2966 patients undergoing electrophysiological study and/or catheter ablation, from June 1997 to February 2013, in the Institute of Cardiology of Rio Grande do Sul. A total of 1490 procedures were performed in women, of whom 769 were of childbearing age. All patients were screened with a pregnancy test on the day before the procedure. RESULTS: Three patients tested positive, and were therefore unable to undergo the procedure. The prevalence observed was 3.9 cases per 1000 women of childbearing age. CONCLUSION: Because of their safety and low cost, pregnancy screening tests are indicated for all women of childbearing age undergoing radiological studies, since the degree of ionizing radiation needed for these procedures is very close to the threshold for teratogenicity, especially in the first trimester, when the signs of pregnancy are not evident.
Asunto(s)
Adulto , Femenino , Humanos , Embarazo , Adulto Joven , Anomalías Inducidas por Radiación/prevención & control , Ablación por Catéter/efectos adversos , Desarrollo Fetal/efectos de la radiación , Pruebas de Embarazo/estadística & datos numéricos , Factores de Edad , Estudios Transversales , Primer Trimestre del Embarazo , Prevalencia , Medición de RiesgoRESUMEN
BACKGROUND: The International Commission of Radiology recommends a pregnancy screening test to all female patients of childbearing age who will undergo a radiological study. Radiation is known to be teratogenic and its effect is cumulative. The teratogenic potential starts at doses close to those used during these procedures. The prevalence of positive pregnancy tests in patients undergoing electrophysiological studies and/or catheter ablation in our midst is unknown. OBJECTIVE: To evaluate the prevalence of positive pregnancy tests in female patients referred for electrophysiological study and/or radiofrequency ablation. METHODS: Cross-sectional study analyzing 2966 patients undergoing electrophysiological study and/or catheter ablation, from June 1997 to February 2013, in the Institute of Cardiology of Rio Grande do Sul. A total of 1490 procedures were performed in women, of whom 769 were of childbearing age. All patients were screened with a pregnancy test on the day before the procedure. RESULTS: Three patients tested positive, and were therefore unable to undergo the procedure. The prevalence observed was 3.9 cases per 1000 women of childbearing age. CONCLUSION: Because of their safety and low cost, pregnancy screening tests are indicated for all women of childbearing age undergoing radiological studies, since the degree of ionizing radiation needed for these procedures is very close to the threshold for teratogenicity, especially in the first trimester, when the signs of pregnancy are not evident.
Asunto(s)
Anomalías Inducidas por Radiación/prevención & control , Ablación por Catéter/efectos adversos , Desarrollo Fetal/efectos de la radiación , Pruebas de Embarazo/estadística & datos numéricos , Adulto , Factores de Edad , Estudios Transversales , Femenino , Humanos , Embarazo , Primer Trimestre del Embarazo , Prevalencia , Medición de Riesgo , Adulto JovenRESUMEN
OBJECTIVES: The objective was to estimate the frequency of pregnancy testing among adolescent emergency department (ED) patients and to determine factors associated with testing. METHODS: This was a retrospective cross-sectional study using the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2005 through 2009 of ED visits by females ages 14 to 21 years. The frequency of pregnancy testing among all visits was estimated for potential reproductive health complaints and for those associated with exposure to potentially teratogenic radiation. Multivariable logistic regression modeling was performed to calculate adjusted probabilities and odds ratios (ORs) with 95% confidence intervals (CIs) to evaluate factors associated with pregnancy testing by patient characteristics. RESULTS: The authors identified 11,531 visits, representing an estimated 41.0 million female adolescent ED visits. Of these, 20.9% (95% CI = 19.3% to 22.5%) included pregnancy testing. Among visits for potential reproductive health complaints and those associated with exposure to potentially teratogenic radiation, 44.5% (95% CI = 41.3% to 47.8%) and 36.7% (95% CI = 32.5% to 40.9%), respectively, included pregnancy testing. Among the entire study population, we found statistically significant differences in pregnancy testing by age, race or ethnicity, hospital admission, and geographic region (p < 0.001 for all). CONCLUSIONS: A minority of female adolescent ED visits included pregnancy testing, even if patients presented with potential reproductive health complaints or received exposure to ionizing radiation. Small but statistically significant differences in pregnancy testing rates were noted based on age, race or ethnicity, ED disposition, and geographic region. Future studies should focus on designing quality improvement interventions to increase pregnancy testing in adolescent ED patients, especially among those in whom pregnancy complications or the risk of potentially teratogenic radiation exposure is higher.
Asunto(s)
Servicio de Urgencia en Hospital/estadística & datos numéricos , Pruebas de Embarazo/estadística & datos numéricos , Adolescente , Estudios Transversales , Tratamiento de Urgencia , Femenino , Humanos , Modelos Logísticos , Embarazo , Estudios Retrospectivos , Estados Unidos , Adulto JovenRESUMEN
OBJECTIVES: The objectives of this study were to describe the experience of a novel pediatric sexual assault response team (SART) program in the first 3 years of implementation and compare patient characteristics, evaluation, and treatment among subpopulations of patients. METHODS: This was a retrospective chart review of a consecutive sample of patients evaluated at a pediatric emergency department (ED) who met institutional criteria for a SART evaluation. Associations of evaluation and treatment with sex, menarchal status, and presence of injuries were measured using logistic regression. RESULTS: One hundred eighty-four patients met criteria for SART evaluation, of whom 87.5% were female; mean age was 10.1 (SD, 4.6) years. The majority of patients underwent forensic evidence collection (89.1%), which varied by menarchal status among girls (P < 0.01), but not by sex. Evidence of acute anogenital injury on physical examination was found in 20.6% of patients. As per the Centers for Disease Control and Prevention guidelines for acute sexual assault evaluations in pediatric patients, menarchal girls were more likely to undergo testing for sexually transmitted infections and pregnancy (P < 0.01) and to be offered pregnancy, sexually transmitted infection, and HIV prophylaxis (P < 0.01). CONCLUSIONS: In an effort to improve quality and consistency of acute sexual assault examinations in a pediatric ED, development of a SART program supported the majority of eligible patients undergoing forensic evidence collection. Furthermore, a substantial number of patients had evidence of injury on examination. These findings underscore the importance of having properly trained personnel to support ED care for pediatric victims of acute sexual assault.
Asunto(s)
Abuso Sexual Infantil , Servicio de Urgencia en Hospital/organización & administración , Grupo de Atención al Paciente/organización & administración , Adolescente , Canal Anal/lesiones , Niño , Abuso Sexual Infantil/diagnóstico , Abuso Sexual Infantil/legislación & jurisprudencia , Abuso Sexual Infantil/estadística & datos numéricos , Abuso Sexual Infantil/terapia , Preescolar , Estudios Transversales , Urgencias Médicas , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Medicina Legal/métodos , Genitales/lesiones , Hospitales Pediátricos/organización & administración , Hospitales Urbanos/organización & administración , Humanos , Lactante , Masculino , Notificación Obligatoria , Philadelphia/epidemiología , Embarazo , Pruebas de Embarazo/estadística & datos numéricos , Mejoramiento de la Calidad , Estudios Retrospectivos , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/etiología , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de Transmisión Sexual/terapia , Manejo de Especímenes , Heridas y Lesiones/diagnóstico , Heridas y Lesiones/etiología , Heridas y Lesiones/terapiaRESUMEN
Condicoes ginecologicas como falencia ovariana,ovulacao e gravidez podem ser diagnosticadas por inumeros procedimentos,destacando-se os metodos porradioimunoensaio e os imunocromatograficos,de grande utilidade pela precisao e precocidade dos mesmos.Na endocrinologia feminina existem algumas condicoes que necessitam de diagnostico preciso para melhores resultados terapeuticos.Os avancos tecnologicos tem fornecido exames cada vez mais requintados quecumprem esta meta.O objetivo desta revisao e avalisr os principais metodos diagnosticos na falencia ovariana,no processo ovulatorio e na gestacao que sao algumas desta condicoes
Asunto(s)
Femenino , Embarazo , Humanos , Ovulación/fisiología , Pruebas de Embarazo , Pruebas de Embarazo/normas , Pruebas de Embarazo/estadística & datos numéricosRESUMEN
La Chlamydia trachomatis en la actualidad es la infección sexualmente transmitida más frecuente en el mundo. Las manifestaciones pueden pasar desapercibidas, producir uretritis en ambos sexos, enfermedad inflamatoria pélvica en mujeres y epididimitis en hombres. El linfogranuloma venéreo es una infección que invade vasos linfáticos causada por este microorganismo. La infección por Chlamydia puede producir infertilidad, embarazos ectópicos y durante el embarazo causar abortos, ruptura prematura de membrana y partos prematuros. Durante el periodo neonatal puede ocasionar queratoconjuntivitis y/o neumonía. El diagnóstico de esta infección previene problemas de la gestación y enfermedades neonatales. "Si no lo buscas, no lo encuentras"
Asunto(s)
Atención Prenatal/métodos , Infecciones por Chlamydia , Infecciones por Chlamydia/diagnóstico , Chlamydia trachomatis/patogenicidad , Queratoconjuntivitis/etiología , Linfogranuloma Venéreo/etiología , Pruebas de Embarazo/estadística & datos numéricos , Enfermedades de Transmisión Sexual/complicaciones , Uretritis/etiologíaRESUMEN
Se hace una revisión bibliográfica de las pruebas de embarazo disponibles en el medio para la práctica médica, haciendo énfasis en las pruebas inmunológicas. Se analizan las causas de resultados falsos positivos y falsos negativos, así como el comportamiento de la prueba en las principales situaciones anormales del embarazo, especialmente el embarazo ectópico. Se concluye que, a la luz de los conocimientos actuales, la ®mejor prueba de embarazo¼ está representada por la tecnología del radioinmunoanálisis, y que una prueba cualitativa con esta tecnología - con sensibilidad por debajo de 25 mUl/mL- es lo suficientemente sensible para detectar todos los embarazos normales a partir del momento enque se presenta la amenorrea.
Asunto(s)
Humanos , Femenino , Embarazo , Pruebas de Embarazo , Pruebas de Embarazo/normas , Pruebas de Embarazo/tendencias , Pruebas de Embarazo/estadística & datos numéricos , Gonadotropina Coriónica Humana de Subunidad betaRESUMEN
Balb/c mice were immunized with beta subunit isolated and purified from crude human chorionic gonadotropin preparations. Spleen cells from the higher titered mouse were fused with Sp 2/0 myeloma cells. Four specific secreting hybridomas were obtained. Specificity, affinity, and suitability of secreted antibodies for use in enzyme immunoassays were studied. Ascites of the selected hybridoma was raised; the antibody was purified by protein A-affinity chromatography and coupled to horseradish peroxidase. This conjugate was employed in a simultaneous sandwich enzyme immunoassay on microtiter plates sensitized with goat polyclonal antibody to measure the hormone. The test has a sensitivity of 10 mlU/ml either on urine, serum, or plasma samples when read in a microplate reader. The results can also be evaluated by the naked eye, with a sensitivity of 20 mlU/ml. No cross reactivity was detected with other human gonadotropins.