RESUMO
Background: The classification or index of heart failure severity in patients with acute myocardial infarction (AMI) was proposed by Killip and Kimball aiming at assessing the risk of in-hospital death and the potential benefit of specific management of care provided in Coronary Care Units (CCU) during the decade of 60. Objective: To validate the risk stratification of Killip classification in the long-term mortality and compare the prognostic value in patients with non-ST-segment elevation MI (NSTEMI) relative to patients with ST-segment elevation MI (STEMI), in the era of reperfusion and modern antithrombotic therapies. Methods: We evaluated 1906 patients with documented AMI and admitted to the CCU, from 1995 to 2011, with a mean follow-up of 05 years to assess total mortality. Kaplan-Meier (KM) curves were developed for comparison between survival distributions according to Killip class and NSTEMI versus STEMI. Cox proportional regression models were developed to determine the independent association between Killip class and mortality, with sensitivity analyses based on type of AMI. Results: The proportions of deaths and the KM survival distributions were significantly different across Killip class >1 (p <0.001) and with a similar pattern between patients with NSTEMI and STEMI. Cox models identified the Killip classification as a significant, sustained, consistent predictor and independent of relevant covariables (Wald χ2 16.5 [p = 0.001], NSTEMI) and (Wald χ2 11.9 [p = 0.008], STEMI). Conclusion: The Killip and Kimball classification performs relevant prognostic role in mortality at mean follow-up of 05 years post-AMI, with a similar pattern between NSTEMI and STEMI patients. .
Fundamento: A classificação ou índice de gravidade de insuficiência cardíaca em pacientes com infarto agudo do miocárdio (IAM) foi proposta por Killip e Kimball com o objetivo de avaliar o risco de mortalidade hospitalar e o potencial benefício do tratamento especializado em unidades coronárias (UCO) na década de 1960. Objetivos: Validar a classificação de Killip para mortalidade total em longo prazo e comparar o valor prognóstico em pacientes com IAM sem elevação do segmento ST (IAMSEST) em relação àqueles com elevação do segmento ST (IAMCEST), na era pós-reperfusão e de terapia antitrombótica moderna. Métodos: Foram avaliados 1906 pacientes com IAM confirmado, admitidos em UCO entre 1995 e 2011, com seguimento médio de cinco anos, para avaliação da mortalidade total. Curvas de Kaplan-Meier foram construídas para comparação da sobrevida por classe Killip e IAMSEST versus IAMCEST. Modelos de regressão de risco proporcional de Cox foram construídos para determinar a associação independente entre a classe Killip e a mortalidade, com análises de sensibilidade por tipo de IAM. Resultados: As proporções de óbitos e as distribuições das curvas de sobrevida foram diferentes conforme a classe Killip >1 (p <0,001) e similares entre IAMSEST e IAMCEST. Os modelos de risco identificaram a classificação de Killip como preditor significante, sustentado, consistente e independente de covariáveis relevantes (Wald χ2 16,5 [p = 0,001], IAMSEST) e (Wald χ2 11,9 [p = 0,008], IAMCEST). Conclusão: A classificação de Killip e Kimball desempenha papel prognóstico relevante na mortalidade em seguimento médio de cinco anos pós-IAM e, de modo similar, entre pacientes com IAMSEST e IAMCEST. .
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Infarto do Miocárdio/mortalidade , Medição de Risco/métodos , Seguimentos , Frequência Cardíaca/fisiologia , Mortalidade Hospitalar , Infarto do Miocárdio/terapia , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Reprodutibilidade dos Testes , Fatores de Risco , Índice de Gravidade de Doença , Análise de Sobrevida , Fatores de TempoRESUMO
BACKGROUND: The classification or index of heart failure severity in patients with acute myocardial infarction (AMI) was proposed by Killip and Kimball aiming at assessing the risk of in-hospital death and the potential benefit of specific management of care provided in Coronary Care Units (CCU) during the decade of 60. OBJECTIVE: To validate the risk stratification of Killip classification in the long-term mortality and compare the prognostic value in patients with non-ST-segment elevation MI (NSTEMI) relative to patients with ST-segment elevation MI (STEMI), in the era of reperfusion and modern antithrombotic therapies. METHODS: We evaluated 1906 patients with documented AMI and admitted to the CCU, from 1995 to 2011, with a mean follow-up of 05 years to assess total mortality. Kaplan-Meier (KM) curves were developed for comparison between survival distributions according to Killip class and NSTEMI versus STEMI. Cox proportional regression models were developed to determine the independent association between Killip class and mortality, with sensitivity analyses based on type of AMI. RESULTS: The proportions of deaths and the KM survival distributions were significantly different across Killip class >1 (p <0.001) and with a similar pattern between patients with NSTEMI and STEMI. Cox models identified the Killip classification as a significant, sustained, consistent predictor and independent of relevant covariables (Wald χ2 16.5 [p = 0.001], NSTEMI) and (Wald χ2 11.9 [p = 0.008], STEMI). CONCLUSION: The Killip and Kimball classification performs relevant prognostic role in mortality at mean follow-up of 05 years post-AMI, with a similar pattern between NSTEMI and STEMI patients.
Assuntos
Infarto do Miocárdio/mortalidade , Medição de Risco/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Frequência Cardíaca/fisiologia , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/terapia , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Reprodutibilidade dos Testes , Fatores de Risco , Índice de Gravidade de Doença , Análise de Sobrevida , Fatores de Tempo , Adulto JovemRESUMO
OBJECTIVE To emphasize the need of an accurate diagnosis of congenital esophageal stenosis due to tracheobronchial remnants, since its treatment differs from other types of congenital narrowing. CASE DESCRIPTION Four cases of lower congenital esophageal stenosis due to tracheobronchial remnants, whose definitive diagnosis was made by histopathology. Except for the last case, in which a concomitant anti-reflux surgery was not performed, all had a favorable outcome after resection and anastomosis of the esophagus. COMMENTS The congenital esophageal stenosis is an intrinsic narrowing of the organ's wall associated with its structural malformation. The condition can be caused by tracheobronchial remnants, fibromuscular stenosis or membranous diaphragm and the first symptom is dysphagia after the introduction of solid food in the diet. The first-choice treatment to tracheobronchial remnants cases is the surgical resection and end-to-end anastomosis of the esophagus.
Assuntos
Brônquios , Coristoma/congênito , Coristoma/complicações , Estenose Esofágica/congênito , Estenose Esofágica/etiologia , Traqueia , Pré-Escolar , Doenças do Esôfago/complicações , Doenças do Esôfago/congênito , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos RetrospectivosRESUMO
OBJECTIVE To emphasize the need of an accurate diagnosis of congenital esophageal stenosis due to tracheobronchial remnants, since its treatment differs from other types of congenital narrowing. CASE DESCRIPTION Four cases of lower congenital esophageal stenosis due to tracheobronchial remnants, whose definitive diagnosis was made by histopathology. Except for the last case, in which a concomitant anti-reflux surgery was not performed, all had a favorable outcome after resection and anastomosis of the esophagus. COMMENTS The congenital esophageal stenosis is an intrinsic narrowing of the organâ€(tm)s wall associated with its structural malformation. The condition can be caused by tracheobronchial remnants, fibromuscular stenosis or membranous diaphragm and the first symptom is dysphagia after the introduction of solid food in the diet. The first-choice treatment to tracheobronchial remnants cases is the surgical resection and end-to-end anastomosis of the esophagus. .
OBJETIVO Enfatizar la necesidad de un diagnóstico preciso de estenosis congénita del esófago por remanecientes traqueobrónquicos, una vez que su tratamiento difiere de los otros tipos de estrechamiento congénito. DESCRIPCIÓN DEL CASO Cuatro casos de estenosis congénita del esófago inferior causada por remanecientes traqueobrónquicos, cuyo diagnóstico definitivo fue obtenido por examen histopatológico. Excepto por el último caso, en el que no se utilizó cirugía antirreflujo concomitante, todos presentaron evolución satisfactoria después de resección y anastomosis del esófago. COMENTARIOS La estenosis congénita del esófago consiste en el estrechamiento intrínseco de la pared del órgano asociado a la malformación de su estructura. Puede ser causada por restos traqueobrónquicos, espesamiento fibromuscular o diafragma membranoso y tiene como primera manifestación clínica disfagia después de la introducción de alimentos sólidos en la dieta. El tratamiento de elección para los casos de remanecientes traqueobrónquicos es la resección del segmento estenosado con anastomosis término-terminal. .
OBJETIVO Enfatizar a necessidade de um diagnóstico preciso de estenose congênita do esôfago por remanescentes traqueobrônquicos, já que seu tratamento difere dos outros tipos de estreitamento congênito. DESCRIÇÃO DO CASO Quatro casos de estenose congênita do esôfago inferior causada por remanescentes traqueobrônquicos, cujo diagnóstico definitivo foi obtido por exame histopatológico. À exceção do último caso, em que não se realizou cirurgia antirrefluxo concomitante, todos apresentaram evolução satisfatória após ressecção e anastomose do esôfago. COMENTÁRIOS A estenose congênita do esôfago consiste no estreitamento intrínseco da parede do órgão associada à malformação de sua estrutura. Pode ser causada por restos traqueobrônquicos, espessamento fibromuscular ou diafragma membranoso e tem como primeira manifestação clínica disfagia após introdução de alimentos sólidos na dieta. O tratamento de escolha para os casos de remanescentes traqueobrônquicos é a ressecção do segmento estenosado com anastomose término-terminal. .
Assuntos
Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Brônquios , Coristoma/complicações , Coristoma/congênito , Estenose Esofágica/congênito , Estenose Esofágica/etiologia , Traqueia , Doenças do Esôfago/complicações , Doenças do Esôfago/congênito , Estudos RetrospectivosRESUMO
Trypanosoma caninum is a parasite of the Trypanosoma genus recently described in the natural infection of dogs in the municipality of Rio de Janeiro, Brazil. Suspecting the existence of a natural cycle and the circulation of this new species, the objective of this study was the taxonomic identification of samples of Trypanosoma spp. isolated from dogs in different Brazilian regions. Parasites were solely obtained from skin fragments culture and characterized by nested-PCR targeting the partial sequence of 18S rRNA gene and PCR products were sequenced. Thirty-three samples, obtained in São Paulo, Minas Gerais, Goiás, Mato Grosso and Rio de Janeiro states were analyzed. PCR and sequencing showed that the isolates were genetically identical or closely similar and confirmed T. caninum identity. This report broadens the geographical distribution of T. caninum in Brazil and discusses the impact of the presence of this parasite in areas of canine leishmaniasis occurrence.
Assuntos
Doença de Chagas/veterinária , Doenças do Cão/epidemiologia , Leishmania infantum/isolamento & purificação , Leishmaniose/veterinária , RNA Ribossômico 18S/isolamento & purificação , Trypanosoma/isolamento & purificação , Animais , Brasil/epidemiologia , Doença de Chagas/epidemiologia , Doença de Chagas/prevenção & controle , Controle de Doenças Transmissíveis , Doenças do Cão/prevenção & controle , Cães , Doenças Endêmicas/veterinária , Eutanásia Animal , Humanos , Leishmania infantum/genética , Leishmaniose/epidemiologia , Leishmaniose/prevenção & controle , Reação em Cadeia da Polimerase/métodos , Análise de Sequência de DNA , Trypanosoma/genéticaRESUMO
SUMMARY: The domestic dog's involvement with different members of the Trypanosomatidae family has been the focus of several studies due to this animal's close proximity to man. Recently this animal has been infected by a new Trypanosoma species (T. caninum), described in Rio de Janeiro and 19 similar isolates were later obtained. The objective of this study was to identify these isolates. All samples were isolated from intact skin cultures and analysed morphologically, by biochemical isoenzyme electrophoresis assays and by several molecular PCR assays. Additionally, anti-Leishmania sp. antibodies were assessed using the indirect Immunofluorescence Antibody Test (IFAT) in all animals. The methodologies employed to identify the isolates, including partial nucleotide sequences of 18S rRNA gene, indicated patterns identical to T. caninum and patterns different from the other species, including T. cruzi and T. rangeli samples. A phylogenetic tree constructed with the partial 18S ribosomal sequence shows that T. caninum is clustered with T. pestanai. Ten (52.6%) animals presented anti-Leishmania sp. antibodies with titres varying from 1:40 to 1:320. Thus, the hypothesis that this protozoan has disseminated among the dogs in Rio de Janeiro must be considered. The importance of a correct diagnosis in those animals and the possible consequences in the areas where visceral leishmaniasis is found are discussed here.
Assuntos
Animais Domésticos/parasitologia , Doenças do Cão/epidemiologia , Doenças do Cão/parasitologia , Trypanosoma/genética , Trypanosoma/isolamento & purificação , Tripanossomíase/veterinária , Animais , Anticorpos Antiprotozoários/sangue , Brasil/epidemiologia , Doenças do Cão/diagnóstico , Cães , Eletroforese/métodos , Isoenzimas/análise , Dados de Sequência Molecular , Filogenia , Reação em Cadeia da Polimerase/métodos , RNA Ribossômico 18S/genética , Análise de Sequência de DNA , Pele/parasitologia , Trypanosoma/classificação , Trypanosoma/enzimologia , Tripanossomíase/diagnóstico , Tripanossomíase/epidemiologia , Tripanossomíase/parasitologiaRESUMO
Analyses of MLEE, RAPD and LSSP-PCR were used to compare the panel of american tegumentary leishmaniasis (ATL) isolates obtained from lesions of patients with rare clinical manifestations of the disease and typical lesions. All of the 34 samples analyzed by MLEE demonstrated similar electromorphic profiles with Leishmania (Viannia) braziliensis reference strain. Through the RAPD analysis, nine genetic profiles (genotypes) were identified. LSSP-PCR corroborates the initial screening and phenetic analysis has grouped the isolates into two major clusters comprising the nine different genotypes. Prevalent genotype defined as LbmtDNAgen1 was detected in the largest number of isolates. There was no association between genotypes and clinical symptoms. However, two different genotypes could be identified in the initial (LbmtDNAGen9) and reactivated lesion (LbmtDNAGen3) of the same patient. Our results support the idea of a less pronounced genotypic diversity among L. (V.) braziliensis circulating in the State of Rio de Janeiro and demonstrate the useful application of these molecular markers in genetics variability studies.
Assuntos
Variação Genética , Leishmania braziliensis/classificação , Leishmaniose Cutânea/parasitologia , Animais , Brasil , Análise por Conglomerados , DNA de Protozoário/análise , Eletroforese/métodos , Enzimas/análise , Feminino , Marcadores Genéticos , Genótipo , Humanos , Leishmania braziliensis/enzimologia , Leishmania braziliensis/genética , Leishmaniose Mucocutânea/parasitologia , Masculino , Filogenia , Reação em Cadeia da Polimerase/métodos , Técnica de Amplificação ao Acaso de DNA PolimórficoRESUMO
One of the goals of gene expression experiments is the identification of differentially expressed genes among populations that could be used as markers. For this purpose, we implemented a model-free Bayesian approach in a user-friendly and freely available web-based tool called BayBoots. In spite of a common misunderstanding that Bayesian and model-free approaches are incompatible, we merged them in the BayBoots implementation using the Kernel density estimator and Rubin 's Bayesian Bootstrap. We used the Bayes error rate (BER) instead of the usual P values as an alternative statistical index to rank a class marker's discriminative potential, since it can be visualized by a simple graphical representation and has an intuitive interpretation. Subsequently, Bayesian Bootstrap was used to assess BER 's credibility. We tested BayBoots on microarray data to look for markers for Trypanosoma cruzi strains isolated from cardiac and asymptomatic patients. We found that the three most frequently used methods in microarray analysis: t-test, non-parametric Wilcoxon test and correlation methods, yielded several markers that were discarded by a time-consuming visual check. On the other hand, the BayBoots graphical output and ranking was able to automatically identify markers for which classification performance was consistent. BayBoots is available at: http://www.vision.ime.usp.br/~rvencio/BayBoots.
Assuntos
Humanos , Animais , Análise de Sequência com Séries de Oligonucleotídeos/métodos , Genes de Protozoários/genética , Modelos Genéticos , Teorema de Bayes , Trypanosoma cruzi/genética , Cardiomiopatia Chagásica/parasitologia , Marcadores GenéticosRESUMO
We report here the first case of co-infection with Leishmania (Viannia) braziliensis and Leishmania (Leishmania) chagasi in a naturally infected dog from Rio de Janeiro, Brazil. Isoenzyme characterisation identified the parasites isolated in culture from the cutaneous lesion as L. (V.) braziliensis and the isolates from blood and lymph node as L. (L.) chagasi. PCR analysis using specific primers followed by molecular hybridisation for direct Leishmania species identification in tissue fragments confirmed the presence of L. (V.) braziliensis DNA in the cutaneous lesion and of L. (L.) chagasi DNA in spleen and popliteal lymph node fragments. This report emphasises the importance of identification of Leishmania species infecting seropositive dogs in endemic areas, and the consequent re-assessment of control and epidemiological surveillance measures for the control of leishmaniasis, as is the case in Brazil.
Assuntos
Doenças do Cão/parasitologia , Leishmania/isolamento & purificação , Leishmaniose Cutânea/veterinária , Leishmaniose Visceral/veterinária , Animais , Brasil , DNA de Protozoário/análise , Reservatórios de Doenças , Cães , Eletroforese/veterinária , Leishmania/enzimologia , Leishmania/genética , Leishmania braziliensis/enzimologia , Leishmania braziliensis/genética , Leishmania braziliensis/isolamento & purificação , Leishmaniose Cutânea/complicações , Leishmaniose Visceral/complicações , Masculino , Reação em Cadeia da Polimerase/métodos , Reação em Cadeia da Polimerase/veterinária , ZoonosesRESUMO
The assessment of depressive behaviour in chronic pain patients is especially important, because depression is commonly associated with chronic pain. The aim of this pilot study was to compare depression levels between patients with head and neck cancer pain and temporomandibular disorders (TMD), and to determine whether there is an association between depression levels and chronic pain severity. This study was an observational and sectional study and the sample consisted of 40 patients, uniformly divided into those with chronic orofacial pain related to cancer and those with painful TMD classified with research diagnostic criteria for temporomandibular disorders (RDC/TMD) axis I. Depression levels, pain intensity and severity were assessed with RDC/TMD axis II. The study demonstrated statistically significant differences in depression levels present in the head and neck cancer pain group and the painful TMD group, with the occurrence of a moderate statistically significant correlation between depression levels and chronic pain severity.
Assuntos
Depressão/etiologia , Dor Facial/psicologia , Transtornos da Articulação Temporomandibular/psicologia , Adulto , Idoso , Análise de Variância , Doença Crônica , Dor Facial/etiologia , Feminino , Neoplasias de Cabeça e Pescoço/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Projetos PilotoRESUMO
Xylella fastidiosa is a fastidious, xylem-limited bacterium that causes a range of economically important plant diseases. Here we report the complete genome sequence of X. fastidiosa clone 9a5c, which causes citrus variegated chlorosis--a serious disease of orange trees. The genome comprises a 52.7% GC-rich 2,679,305-base-pair (bp) circular chromosome and two plasmids of 51,158 bp and 1,285 bp. We can assign putative functions to 47% of the 2,904 predicted coding regions. Efficient metabolic functions are predicted, with sugars as the principal energy and carbon source, supporting existence in the nutrient-poor xylem sap. The mechanisms associated with pathogenicity and virulence involve toxins, antibiotics and ion sequestration systems, as well as bacterium-bacterium and bacterium-host interactions mediated by a range of proteins. Orthologues of some of these proteins have only been identified in animal and human pathogens; their presence in X. fastidiosa indicates that the molecular basis for bacterial pathogenicity is both conserved and independent of host. At least 83 genes are bacteriophage-derived and include virulence-associated genes from other bacteria, providing direct evidence of phage-mediated horizontal gene transfer.
Assuntos
Genoma Bacteriano , Plantas/microbiologia , Pseudomonadaceae/genética , Análise de Sequência de DNA , Aderência Bacteriana , Proteínas de Bactérias/metabolismo , Transporte Biológico , Mapeamento Cromossômico , Citrus/microbiologia , Reparo do DNA , DNA Bacteriano , Metabolismo Energético , Dados de Sequência Molecular , Plantas Tóxicas , Biossíntese de Proteínas , Pseudomonadaceae/metabolismo , Pseudomonadaceae/patogenicidade , Nicotiana/microbiologia , Transcrição Gênica , Virulência/genéticaRESUMO
Two sets of markers and populations were considered in this study: (a) the variability at 17 protein loci and in the sequences of the first hypervariable segment of the mitochondrial DNA (mtDNA) were compared in 10 South American Indian tribes, in a total 3016 and 241 individuals, respectively; and (b) a triple comparison was made, in relation to 17 protein, mtDNA and six hypervariable tandem repeat loci in four Brazilian Indian tribes, involving 1567, 56 and 194 persons, respectively. Both the intrapopulational diversities and the population relationships obtained in these groups with these different sets of markers showed no significant correlation. High levels of heterogeneity were observed both at the protein and hypervariable individual loci, as well between mtDNA sites. The different positions observed for the Yanomama (but not for the other nine tribes) in the trees which summarized the protein and mtDNA data suggest some degree of asymmetric interchange related to sex between them and neighbouring tribes.
Assuntos
Núcleo Celular , DNA Mitocondrial/genética , DNA , Indígenas Sul-Americanos/genética , Proteínas/genética , Variação Genética , Genética Populacional , Humanos , Repetições de Microssatélites/genética , Repetições Minissatélites/genéticaRESUMO
O exame cardiológico do atleta tem, entre seus principais objetivos, a detecçäo de alguma cardiopatia desconhecida, que poderia levar a problemas futuros, com a manutençäo da prática esportiva. O cardiologista deve estar a par das alteraçöes que podem ser encontradas no "coraçäo do atleta", para identificar anormalidades da propedêutica potencialmente importantes, bem como conhecer como as alteraçöes habituais regridem quando o indivíduo abandona a atividade esportiva. Säo discutidos os exames mínis que deve ser realizados na avaliaçäo do atleta, tendo em vista a dificuldade de obtençäo das condiçöes tecnológicas ideais. Entretanto, säo abordados também exames mais sofisticados, que seräo realizados de acordo com a necessidade de cada caso.
Assuntos
/métodos , Cardiologia , Medicina Esportiva , CardiopatiasRESUMO
This research was carried out at the University Hospital of the University of São Paulo and deals with the experiment of papain utilization for visceral irrigation in patients with severe infection. It was observed that seventy two hours after treatment, there was a considerable reduction of purulent secretion, and that the medium time of cicatrization of all lesions was thirty days.
Assuntos
Papaína/uso terapêutico , Infecção dos Ferimentos/tratamento farmacológico , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Supuração , Irrigação Terapêutica , Fatores de Tempo , CicatrizaçãoRESUMO
Atrioventricular (AV) and ventriculoatrial (VA) branches of the coronary arteries are vessels which supply simultaneously atrial and ventricular walls by means of recurrent rami. The terminology indicates the name of the main vessel followed by the name of the recurrent vessel both combined in an adjective. These branches establish a vascular 'suture' across the coronary sulcus in front (superficially to) or behind (deeply to) the trunks of the right coronary artery and of the left coronary artery (circumflex artery). The AV and VA branches, found in 95% of 40 human hearts, should be considered a normal characteristic of the coronary circulation and an important anatomical factor for the clinical interpretation of pathological cardiac phenomena.
Assuntos
Circulação Coronária , Vasos Coronários/anatomia & histologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
40 pacientes com dismenorreia primaria foram tratadas com piroxicam durante tres periodos menstruais seguidos, na posologia de 40 mg (dois primeiros dias) seguida de 20 mg (dois dias seguintes) sempre em dose unica diaria. No primeiro periodo de tratamento, 30 pacientes (75%) ou nao sentiram mais dor ou ela foi de leve intensidade. No segundo periodo, este numero elevou-se para 36 pacientes (90%) e no terceiro periodo, para 37 (92,5%) do total de 40 pacientes tratadas. Somente uma paciente (2,5%) apresentou dor de intensidade leve antes do tratamento. Houve diminuicao da severidade com os periodos de tratamento e regressao precoce da dor (a partir da 4a. hora do primeiro dia de tratamento).Os sintomas associados e o indice de absenteismo tambem diminuiram significativamente. Reacoes adversas leves (epigastralgia, pirose etc) em 6 (15%) pacientes. Conclui-se que o piroxicam e medicamento de escolha para o tratamento da dismenorreia primaria
Assuntos
Adolescente , Adulto , Humanos , Feminino , Dismenorreia , TiazinasRESUMO
Os A.A. apresentam um caso de endometriose vesical com sintomatologia sugestiva mas cujo diagnostico so foi firmado durante o ato cirurgico. Havia comprometimento da parede vesical posterior possivelmente consequente a manobra abortiva com perfuracao de parede uterina anterior e parede vesical posterior.Tecem tambem breves consideracoes sobre a endometriose, estudando sucintamente a sintomatologia, o quadro clinico, metodos diagnosticos e terapeuticos. Realcam a importancia da associacao endometriose esterilidade
Assuntos
Adulto , Humanos , Feminino , Endometriose , Infertilidade , Neoplasias da Bexiga UrináriaRESUMO
Os autores fazem consideracoes gerais iniciais sobre o hirsutismo. Estudam a producao e o metabolismo dos androgenios circulantes na mulher. Propoem classificacao e abordam as entidades clinicas mais relacionadas ao hirsutismo, assim como o esboco diagnostico e terapeutico dessas condicoes patologicas