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Objetivo: Identificar a frequência das infecções do trato reprodutivo em mulheres atendidas em uma unidade de atenção primária à saúde, na região da Zona da Mata de Pernambuco. Método: Trata-se de um estudo retrospectivo, documental, de corte transversal, realizado com 361 registros de mulheres na faixa etária dos 14 aos 87 anos. Para a análise, procedeu-se à distribuição das frequências absolutas representados por tabelas através do programa estatístico EpiInfo versão 7.1.5.2. Pesquisa aprovada pelo Comitê de Ética em Pesquisa, com CAAE no 54417916.2.0000.5208. Resultados: A Gardnerella vaginalis (16,62%) foi o agente microbiológico mais frequente que os demais causadores de infecções do trato reprodutivo; os microrganismos foram mais prevalentes na faixa etária de 25-34 anos. Conclusão: Sob o ponto de vista dos benefícios do cuidado à saúde da mulher, na atenção primária, incentiva-se a atuação profissional no sentido de promover ações de educação em saúde visando a conscientização de mulheres das diversas faixas etárias, sobre a relevância das ITR's.

Objective: To identify the frequency of reproductive tract infections in women treated in a primary health care unit in the Pernambuco forest zone. Method: This is a retrospective, documental, cross-sectional study, conducted with 361 records of women aged 14 to 87 years. For the analysis, the absolute frequencies represented by tables were distributed through the statistical program EpiInfo version 7.1.5.2. The research was approved by the Research Ethics Committee, with CAAE No. 54417916.2.0000.5208. Results: Gardnerella vaginalis (16.62%) was the most frequent microbiological agent from all the other causes of reproductive tract infections; microorganisms were more prevalent in the 25-34 age group. Conclusion: From the point of view of the benefits of women's health care, in primary care, professional action is encouraged to promote health education actions aimed at raising awareness of women of various age groups about the relevance of ITR's.

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OBJECTIVE: Three-dimensional (3D) angular measurements between craniofacial planes pose challenges to quantify maxillary and mandibular skeletal discrepancies in surgical treatment planning. This study aims to compare the reproducibility and reliability of two modules to measure angles between planes or lines in 3D virtual surface models. METHODOLOGY: Twenty oriented 3D virtual surface models de-identified and constructed from CBCT scans were randomly selected. Three observers placed landmarks and oriented planes to determine angular measurements of pitch, roll and yaw using (1) 3D pre-existing planes, (2) 3D planes created from landmarks and (3) lines created from landmarks. Inter- and intra-observer reproducibility and repeatability were examined using the Intra-Class Correlation (ICC) test. One observer repeated the measurements with an interval of 15 days. ANOVA was applied to compare the 3 methods. RESULTS: The three methods tested provided statistically similar, reproducible and reliable angular measurements of the facial structures. A strong ICC varying from 0.92 to 1.00 was found for the intra-observer agreement. The inter-observer ICC varied from 0.84 to 1.00. CONCLUSION: Measurements of 3D angles between facial planes in a common coordinate system are reproducible and repeatable either using 3D pre-existing planes, created based on landmarks or angles between lines created from landmarks.

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Abstract Objective: Three-dimensional (3D) angular measurements between craniofacial planes pose challenges to quantify maxillary and mandibular skeletal discrepancies in surgical treatment planning. This study aims to compare the reproducibility and reliability of two modules to measure angles between planes or lines in 3D virtual surface models. Methodology: Twenty oriented 3D virtual surface models de-identified and constructed from CBCT scans were randomly selected. Three observers placed landmarks and oriented planes to determine angular measurements of pitch, roll and yaw using (1) 3D pre-existing planes, (2) 3D planes created from landmarks and (3) lines created from landmarks. Inter- and intra-observer reproducibility and repeatability were examined using the Intra-Class Correlation (ICC) test. One observer repeated the measurements with an interval of 15 days. ANOVA was applied to compare the 3 methods. Results: The three methods tested provided statistically similar, reproducible and reliable angular measurements of the facial structures. A strong ICC varying from 0.92 to 1.00 was found for the intra-observer agreement. The inter-observer ICC varied from 0.84 to 1.00. Conclusion: Measurements of 3D angles between facial planes in a common coordinate system are reproducible and repeatable either using 3D pre-existing planes, created based on landmarks or angles between lines created from landmarks.

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The cervical intraepithelial neoplasia grade I (CIN I) shows an important percentual of spontaneous regression (80%) and there is no universal consensus if these lesions should be treated or only monitored. Lesions at risk for progression are precisely those associated with high-risk HPV. Knowing which CIN I are related to these viruses may be one of the determining factors for the decision to treat or not. Objective: To determine the prevalence of high-risk HPV in women with CIN I and to evaluate if there is an association between the presence of the virus and some risk factors. Methods : Cross-sectional descriptive study. We evaluated 55 women with histological diagnosis of CIN I. All of them were previously submitted to HPV-DNA testing. Results: 25 out of 55 (45.5%) women analyzed were positive for high-risk HPV. The virus infection was related with higher level of education, smoking and history of sexually transmitted diseases. Other risk factors like age, number of sexual partners, age at first sexual intercourse, use of hormonal contraceptives, and immunosuppression condition did not show a relation to the high-risk HPV infection. Conclusions: The prevalence of high-risk HPV in women with histological diagnosis of CIN I was 45.5%. HPV-DNA detection was associated with smoking, history of sexually transmitted diseases, and higher level of education.

As neoplasias intraepiteliais cervicais grau I (NIC I) apresentam um percentual importante de regressão espontânea (cerca de 80%) e não há um consenso universal se essas lesões devam ser tratadas ou apenas acompanhadas. As lesões que apresentam risco de progressão são justamente aquelas associadas aos HPV de alto risco oncogênico. O conhecimento de quais lesões estão relacionadas a esses vírus pode ser um dos fatores determinantes para a decisão de se tratar ou não tais lesões. Objetivo: Determinar a prevalência do papilomavírus humano (HPV) de alto risco oncogênico em mulheres com resultado histológico de NIC I e verificar a existência da associação entre a presença do vírus e alguns fatores de risco. Métodos: Trata-se de um estudo transversal, de caráter descritivo, onde foram avaliadas 55 mulheres com diagnóstico histopatológico de NIC I. Todas foram submetidas ao teste de DNA-HPV previamente. Resultados: Das 55 mulheres analisadas, 25 (45,5%) apresentaram HPV de alto risco positivo. A infecção pelo vírus foi associada às mulheres com mais anos de estudo, tabagismo e à história de alguma doença sexualmente transmissível. Outros fatores de risco, como a idade, o número de parceiros sexuais, a faixa etária em que ocorreu a coitarca, o uso de anticoncepcionais hormonais e o estado de imunossupressão, não mostraram relação com a infecção pelo HPV. Conclusão: A prevalência do HPV de alto risco oncogênico nas mulheres com diagnóstico histológico de NIC I foi de 45,5%. A detecção do vírus foi associada ao tabagismo, à história de doença sexualmente transmissível e a um grau maior de escolaridade.

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Desordens temporomandibulares, distúrbios do sono por obstrução das vias aéreas e alterações na postura crânio cervical constituem alguns dos problemas que têm sido relacionados com o paciente padrão esquelético classe II hiperdivergente. Embora as telerradiografias laterais representem o padrão ouro para o diagnóstico da morfologia cranio facial na prática clínica, este exame pode não ser viável para aplicação em estudos epidemiológicos de larga escala. Objetivo: O objetivo deste estudo foi testar a validade de um novo método fotográfico no diagnóstico de pacientes classe II hiperdivergentes para fins de investigação epidemiológica. Material e Métodos: Telerradiografias laterais e fotografias de perfil foram obtidas a partir de 123 indivíduos distribuídos em dois grupos: 51 pacientes compuseram o grupo de pacientes classe II hiperdivergente, enquanto que os outros 72 pacientes formaram um segundo grupo. A análise discriminante descreveu um modelo matemático para melhor diagnosticar pacientes padrão esquelético classe II hiperdivergente através de fotografias. Resultados: Uma função canônica discriminante composta por duas variáveis fotográficas classificou corretamente 85% dos pacientes classe II hiperdivergentes durante a validação interna (p < 0,001). O método mostrou 83% de sensibilidade e 73% de especificidade no processo de validação externa. Conclusão: O método fotográfico pode ser considerado como uma alternativa viável e prática para diagnosticar o paciente classe II hiperdivergente, particularmente se existir a necessidade de um método não invasivo e de baixo custo.

Temporomandibular disorders, sleep disturbances by airway obstruction and craniocervical posture changes constitute some of the problems that have been related to hyperdivergent skeletal Class II patients. Although cephalometric radiographs represent the gold standard for diagnosing craniofacial morphology in clinical practice, it might not be feasible for large-scale epidemiological research. Objectives: The aim of this study was to test the validity of a new photographic method in diagnosing hyperdivergent skeletal Class II patients for epidemiological research purposes. Material and Methods: Lateral cephalograms and profile photographs were obtained from 123 subjects assigned into two groups. 51 patients comprised the hyperdivergent skeletal Class II group and the other 72 composed a second group. Discriminant analysis described a mathematical model to better diagnose hyperdivergent skeletal Class II patients through photographs. Results: A canonical discriminant function composed of two photographic variables correctly classified 85% of the hyperdivergent skeletal Class II patients during internal validation (p < 0.001). The method showed 83% sensitivity and 73% specificity in external validation procedure. Conclusion: The photographic method may be a feasible and practical alternative for diagnosing the hyperdivergent skeletal Class II patient, particularly if there is a need for a low-cost and noninvasive method.

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The purpose of this study was to investigate the published evidence regarding the association between head and cervical posture and craniofacial morphology. An electronic search was conducted in PubMed, Medline, Embase, Scopus, and Cochrane databases up to 23 March 2012. Abstracts that seemed to correspond with the goals of this review were selected by a consensus between two independent reviewers. The original articles were retrieved and evaluated to ensure they match the inclusion criteria. Only articles that directly compared head and/or cervical posture with craniofacial morphology were included. A total of 84 articles were found of which 12 matched all inclusion criteria. Detailed analysis of the methodology in selected articles revealed quality scores ranging from 'weak' to 'moderate'. Nine articles were cross-sectional studies, whereas only three were longitudinal studies. The findings of selected articles were linked together in order to clarify the evidence on sagittal and vertical craniofacial features as well as growth prediction regarding different postures of the head and neck. On the basis of the data obtained from the literature, significant associations were found between variables concerning head and cervical posture and craniofacial morphology. However, the results of this systematic review suggest that such associations should be carefully interpreted, considering that correlation coefficients found ranged from low to moderate. Moreover, conflicting results were observed regarding some postural variables. Further longitudinal studies are required to elucidate the relationship between the development of craniofacial morphology and functional aspects of head and cervical posture.

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OBJECTIVE: To investigate the relationship between craniofacial measurements obtained from cephalometric radiographs and analogous measurements from profile photographs. MATERIALS AND METHODS: Lateral cephalograms and standardized facial profile photographs were obtained from a sample of 123 subjects (65 girls, 58 boys; age 7-12 years). Intraclass correlation coefficients (ICCs) were calculated from repeated photographic measurements to evaluate method reliability. Analogous cephalometric and photographic measurements were compared to assess Pearson correlation coefficients. Linear regression analyses were conducted between the measurements that achieved correlation coefficients greater than r  =  0.7. RESULTS: The reliability of the photographic technique was satisfactory. Most measurements showed ICCs above 0.80 and highly significant correlations (P ≤ .001) with cephalometric variables. Among all measurements used, the A'N'B' angle was the most effective in explaining the variability of its analogous cephalometric, mainly for female subjects (r(2)  =  0.80). The FMA' angle showed the best results for vertical assessment (r(2)  =  0.65). CONCLUSIONS: The photographic method has proven to be a repeatable and reproducible tool provided that a standardized protocol is followed. Therefore, it may be considered a feasible and practical diagnostic alternative, particularly if there is a need for a low-cost and noninvasive method.

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O presente estudo teve como objetivo geral a descrição do método fotográfico, visando testar sua validade no diagnóstico do padrão esquelético facial e avaliação postural. Como objetivos específicos, buscou-se a investigação da relação existente entre medidas cefalométricas e fotográficas análogas, e a verificação da eficácia do método no diagnóstico do padrão esquelético classe II hiperdivergente e na avaliação da postura da cabeça e coluna cervical. Materiais e Métodos: Dois artigos científicos foram elaborados e utilizados para a avaliação dos propósitos apresentados. Resultados: Tanto a repetibilidade quanto a reprodutibilidade do método fotográfico foram satisfatórias. A maioria das mensurações apresentou ICC acima de 0,80. Verificaram-se correlações altamente significativas (p ≤ 0,001) comparando a maioria das variáveis fotográficas com medidas cefalométricas análogas. Não foram encontradas correlações significativas para algumas variáveis posturais. Dentre todas as mensurações utilizadas, o ângulo A'N'B' foi o mais eficaz em explicar a variabilidade da medida cefalométrica correspondente, principalmente para indivíduos do gênero feminino (r2 = 0,80). O ângulo FMA' apresentou os melhores resultados para a avaliação vertical (r2 = 0,65). Uma função canônica discriminante composta por duas variáveis fotográficas (A'N'B', FMA') classificou corretamente 85% dos pacientes classe II hiperdivergentes durante a validação interna (p < 0,001). O método demonstrou sensibilidade de 83% e especificidade de 73% no processo de validação externa. Conclusões: O método fotográfico pode ser considerado uma alternativa viável, prática e confiável para o diagnóstico de pacientes padrão esquelético classe II hiperdivergente em estudos epidemiológicos de larga escala, uma vez que um protocolo adequado de padronização da técnica seja seguido. É importante que haja cautela quando da inferência do alinhamento das vértebras cervicais a partir da análise de fotografias de perfil. Estudos adicionais são necessários a fim de testar a precisão do método no diagnóstico de outros padrões esqueléticos faciais

The general purpose of this study was to describe the photographic method, in order to test its validity for the diagnosis of skeletal facial pattern and postural evaluations. The specific goals consisted on the investigation of the relationship between analogous cephalometric and photographic measurements, and the verification of method effectiveness in diagnosing the hyperdivergent class II patient and assessing the posture of the head and cervical column. Materials and Methods: Two scientific papers were elaborated and used for assessing the purposes presented. Results: The reliability of the photographic technique was satisfactory. Most measurements showed ICC above 0.80. It was found highly significant correlations (p ≤ 0.001) for almost all analogous photographic and cephalometric variables. No significant correlations were found for some postural variables. Among all measurements used, A’N’B’ angle was the most effective in explaining the variability of its analogous cephalometric, mainly for female subjects (r2 = 0.80). FMA’ angle showed the best results for vertical assessment (r2 = 0.65). A canonical discriminant function composed of two photographic variables (A’N’B’, FMA’) correctly classified 85% of the hyperdivergent class II patients during internal validation (p < 0.001). The method showed 83% sensitivity and 73% specificity in external validation procedure. Conclusions: The photographic method has proven to be a feasible, practical and reliable alternative for diagnosing the hyperdivergent class II patient in large scale epidemiological research, since a standardized protocol is followed. Caution is needed when inferring vertebral alignment from observed surface contours. Further studies must be performed in order to establish the diagnostic accuracy of the method for other skeletal patterns

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As proliferações lobulares lactogênicas são alterações da mama específicas do ciclo gravídico-puerpural e que regridem, espontaneamente, com o término da amamentação. Neste relato, apresentamos o caso de uma pacientes que manifestou abundante saída de secreção leitosa sem pertuito periareolar da mama esquerda sem estar grávida ou no puerpério. O diagnóstico anatomopatológico foi adenoma da lactação, descartanto-se qualquer tipo de malignidade. Os autores traçam paralelo entre as características da doença no ciclo gravídico-puerpural e no caso relatado. Não foi encontrado caso semelhante na literatura, sendo esse possivelmente o único publicado. Esse resumo de caso foi aprovado pela Comissão de Ética do Hospital das Clínicas da Faculdade de Medicina de Botucatu (Unesp), com expresso consentimento da paciente.

Proliferations lactogenic lobular breast changes are specific to pregnancy and puerpural and regress spontaneously, with the end of breastfeeding. Here we present a case of a patient who expressed abundant output without milky secretion periareolar orifice of the left breast without being pregnant or postpartum. The pathological diagnosis was adenoma of lactation, descartanto to any type of malignancy. The authors draw parallels between the characteristics of the disease in pregnancy and puerpural and in our case. No similar case was found in the literature, this being possibly the only published. This case summary was approved by the Ethics Committee of the Hospital of the Medical School of Botucatu (UNESP), with the express consent of the patient.

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