RESUMO
INTRODUCTION: The COVID-19 pandemic changed the work routine of professionals at the family healthcare center (Núcleo de Atenção à Saúde da Família - NASF-AB), providing new conditions and work overload. OBJECTIVE: The purpose of this study was to explore factors associated with work overload in NASF-AB professionals during the COVID-19 pandemic. METHODS: A cross-sectional study was carried out with NASF-AB workers in the city of Salvador, Bahia, Brazil, from May to August 2021. Working conditions and overload were assessed using the National Program for Improving Access and the Quality of Primary Care questionnaire (Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica - PMAQ) and the scale measuring burden of professionals in mental health services (Escala de Avaliação da Sobrecarga de Profissionais em Serviços de Saúde Mental - IMPACTO-BR), respectively. A multivariate linear regression model was used. A total of 68 health professionals participated in the study, including 19 physiotherapists, 13 occupational therapists, 10 social workers, 10 nutritionists, 9 psychologists and 7 physical education professionals. RESULTS: There was a significant association between overall overload and being female (p=<0.005), having spaces for reflection on the work process (p=0.027), and having difficulty moving around to conduct activities in the territory (p=0.002) for increasing the chance of work overload. CONCLUSIONS: Our findings encourage workers' health policies and closer ties and negotiation with local management, as well as the return of the institutional support figure for the effectiveness and resolution of actions in primary healthcare units.
Assuntos
COVID-19 , Pessoal de Saúde , Carga de Trabalho , Humanos , COVID-19/epidemiologia , Estudos Transversais , Feminino , Masculino , Brasil/epidemiologia , Pessoal de Saúde/psicologia , Adulto , Pessoa de Meia-Idade , Pandemias , Inquéritos e Questionários , SARS-CoV-2RESUMO
Desde tempos remotos, a pelagem é valorizada no agronegócio equestre. Em animais Campolina, objetivou-se avaliar a ocorrência de pelagens e a distribuição entre sexos nos estados do Brasil, assim como verificar a frequência desse fenótipo nos acasalamentos e associá-lo com medidas lineares e qualidade da marcha. Foram selecionados 44.437 registros definitivos e utilizaram-se testes de qui-quadrado para avaliar a distribuição de pelagens entre sexos, estados e décadas. Por análise descritiva, foi obtida frequência de acasalamento dos fenótipos e proporções resultantes nos filhos. Foram contabilizados os indivíduos acasalados e os mais usados por décadas de nascimento e de registro. Pelagens baia, alazã e castanha predominaram, com 20.422; 11.941 e 5.256 animais, respectivamente. O fenótipo baio representou 45,21% em Minas Gerais; 46,98% no Rio de Janeiro e 48,98% em São Paulo. Para machos e fêmeas constatou-se maior frequência de pelagens baia, alazã e castanha. Os acasalamentos mais frequentes foram alazã x baia, baia x baia e baia x castanha. Este é o primeiro artigo a avaliar a ocorrência das pelagens em equinos da raça Campolina, sendo baia a mais prevalente em ambos os sexos. A qualidade da marcha ao registro não está associada à pelagem. Esse fenótipo deve ser usado com cautela na seleção.(AU)
Since ancient times, coat colors are valued in the equestrian business. The objective of this study was to evaluate the occurrence of coat colors and distribution among sexes in Brazil and also verify the frequency of this phenotype in reproduction to associate it with linear measurements and functionality. 44,437 definitive records were selected, and chi-square tests were used to evaluate coat colors and distribution between sexes, states and decades. By descriptive analysis the phenotypes breeding frequency and proportions in the offspring were obtained. Breeding and most used individuals were accounted by decade of birth and registration. Dun, chestnut and bay coat colors predominated, with 20,422; 11,941 and 5,256 animals, respectively. Dun represented 45.21% in Minas Gerais; 46.98% in Rio de Janeiro and 48.98% in São Paulo. For males and females there was a higher frequency of dun, chestnut and bay. The most frequent breeding colors were chestnut x dun, dun x dun and dun x bay. This is the first article to evaluate the coat colors in the Campolina population, dun being the most prevalent coat color in both sexes. The gait quality at the register is not associated with the coat color. This phenotype should be used with caution in selection.(AU)
Assuntos
Animais , Fenótipo , Pelo Animal/anatomia & histologia , Frequência do Gene , CavalosRESUMO
Desde tempos remotos, a pelagem é valorizada no agronegócio equestre. Em animais Campolina, objetivou-se avaliar a ocorrência de pelagens e a distribuição entre sexos nos estados do Brasil, assim como verificar a frequência desse fenótipo nos acasalamentos e associá-lo com medidas lineares e qualidade da marcha. Foram selecionados 44.437 registros definitivos e utilizaram-se testes de qui-quadrado para avaliar a distribuição de pelagens entre sexos, estados e décadas. Por análise descritiva, foi obtida frequência de acasalamento dos fenótipos e proporções resultantes nos filhos. Foram contabilizados os indivíduos acasalados e os mais usados por décadas de nascimento e de registro. Pelagens baia, alazã e castanha predominaram, com 20.422; 11.941 e 5.256 animais, respectivamente. O fenótipo baio representou 45,21% em Minas Gerais; 46,98% no Rio de Janeiro e 48,98% em São Paulo. Para machos e fêmeas constatou-se maior frequência de pelagens baia, alazã e castanha. Os acasalamentos mais frequentes foram alazã x baia, baia x baia e baia x castanha. Este é o primeiro artigo a avaliar a ocorrência das pelagens em equinos da raça Campolina, sendo baia a mais prevalente em ambos os sexos. A qualidade da marcha ao registro não está associada à pelagem. Esse fenótipo deve ser usado com cautela na seleção.(AU)
Since ancient times, coat colors are valued in the equestrian business. The objective of this study was to evaluate the occurrence of coat colors and distribution among sexes in Brazil and also verify the frequency of this phenotype in reproduction to associate it with linear measurements and functionality. 44,437 definitive records were selected, and chi-square tests were used to evaluate coat colors and distribution between sexes, states and decades. By descriptive analysis the phenotypes breeding frequency and proportions in the offspring were obtained. Breeding and most used individuals were accounted by decade of birth and registration. Dun, chestnut and bay coat colors predominated, with 20,422; 11,941 and 5,256 animals, respectively. Dun represented 45.21% in Minas Gerais; 46.98% in Rio de Janeiro and 48.98% in São Paulo. For males and females there was a higher frequency of dun, chestnut and bay. The most frequent breeding colors were chestnut x dun, dun x dun and dun x bay. This is the first article to evaluate the coat colors in the Campolina population, dun being the most prevalent coat color in both sexes. The gait quality at the register is not associated with the coat color. This phenotype should be used with caution in selection.(AU)
Assuntos
Animais , Fenótipo , Pelo Animal/anatomia & histologia , Frequência do Gene , CavalosRESUMO
OBJECTIVE: To describe the perceptions of patients, their caregivers, and their healthcare providers to the development of a new specific instrument for assessment of the quality of life (QoL) in patients with mucopolysaccharidoses (MPS) using a qualitative focus group (FG) design. FGs were held in two Brazilian states (Rio Grande do Sul and Rio de Janeiro). RESULTS: Three versions of the new instrument were developed, each for a different age group: children (age 8-12 years), adolescents (age 13-17), and adults (age ≥ 18). The FGs mostly confirmed the relevance of items. All FGs unanimously agreed on the facets: School, Happiness, Life Prospects, Religiosity, Pain, Continuity of Treatment, Trust in Treatment, Relationship with Family, Relationship with Healthcare Providers, Acceptance, and Meaning of Life. The overall concept of QoL (as proposed by the WHO-World Health Organization) and its facets apply to this patient population. However, other specific facets-particularly concerning clinical manifestations and the reality of the disease-were suggested, confirming the need for the development of a specific QoL instrument for MPS.
Assuntos
Mucopolissacaridoses/psicologia , Psicometria/métodos , Qualidade de Vida/psicologia , Adolescente , Adulto , Brasil , Cuidadores , Criança , Feminino , Grupos Focais , Pessoal de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Adulto JovemRESUMO
Early dietary treatment of phenylketonuria (PKU), an inborn error of phenylalanine (Phe) metabolism, results in normal cognitive development. Although health-related quality of life (HRQoL) of PKU patients has been reported as unaffected in high-income countries, there are scarce data concerning HRQoL and adherence to treatment of PKU children and adolescents from Brazil. The present study compared HRQoL scores in core dimensions of Brazilian early-treated PKU pediatric patients with those of a reference population, and explored possible relationships between adherence to treatment and HRQoL. Early-treated PKU pediatric patient HRQoL was evaluated by self- and parent-proxy reports of the Pediatric Quality of Life Inventory (PedsQL) core scales. Adherence to treatment was evaluated by median Phe levels and percentage of results within the therapeutic target range in two periods. Means for total and core scales scores of PedsQL self- and parent proxy-reports of PKU patients were significantly lower than their respective means for controls. Adequacy of median Phe concentrations and the mean percentage of values in the target range fell substantially from the first year of life to the last year of this study. There was no significant difference in mean total and core scale scores for self- and parent proxy-reports between patients with adequate and those with inadequate median Phe concentrations. The harmful consequences for intellectual capacity caused by poor adherence to dietary treatment could explain the observed decrease in all HRQoL scales, especially in school functioning. Healthcare system and financial difficulties may also have influenced negatively all HRQoL dimensions.
Assuntos
Fenilcetonúrias/dietoterapia , Qualidade de Vida , Cooperação e Adesão ao Tratamento/estatística & dados numéricos , Adolescente , Fatores Etários , Análise de Variância , Brasil , Criança , Feminino , Humanos , Testes de Inteligência , Modelos Lineares , Masculino , Pais , Fenilalanina/sangue , Fenilcetonúrias/psicologia , Procurador , Qualidade de Vida/psicologia , Prevenção Secundária , Autorrelato , Fatores Socioeconômicos , Fatores de Tempo , Cooperação e Adesão ao Tratamento/psicologia , Resultado do TratamentoRESUMO
The aim of this study was to evaluate the effect of hormone replacement therapy (HRT) on the expression of Ki-67, bcl-2 and c-erb.B2 in endometrial polyps during menopause. Sixteen patients using HRT and 24 untreated controls with endometrial polyps were enrolled in this study. Polypectomy was carried out by hysteroscopy. The presence of c-erb.B2, bcl-2 and Ki-67 expression was determined by immunohistochemistry. HRT was found to decrease Ki-67 and bcl-2 expression in endometrial polyps without affecting the c-erb.B2 staining reaction. HRT may cause endometrial polyp involution by decreasing proliferation and stimulating apoptosis.
Assuntos
Neoplasias do Endométrio/metabolismo , Terapia de Reposição de Estrogênios , Noretindrona/análogos & derivados , Pólipos/metabolismo , Administração Cutânea , Administração Oral , Idoso , Estudos de Casos e Controles , Estradiol/farmacologia , Estrogênios Conjugados (USP)/farmacologia , Feminino , Humanos , Imuno-Histoquímica , Antígeno Ki-67/metabolismo , Acetato de Medroxiprogesterona/farmacologia , Menopausa , Pessoa de Meia-Idade , Noretindrona/farmacologia , Acetato de Noretindrona , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Receptor ErbB-2/metabolismo , Estudos RetrospectivosRESUMO
Our objective was to investigate the presence of focal p53 expression in relation to proliferation rates in adenomyotic lesions during the menstrual cycle and in women on oral contraception. Fifty-nine perimenopausal patients with menorrhagia and adenomyosis were submitted to endometrial resection. The procedure was carried out during menstruation (n = 14), during the proliferative phase (n = 15), during the luteal phase (n = 20) or following the use of oral contraceptives (n = 10). The number of Ki-67-positive cells was low during menstruation, during the luteal phase and following the use of progestins. In the proliferative phase, on the other hand, there was a significant increase in the percentage of Ki-67-positive cells. Focal p53 expression was detected mainly during the proliferative phase of the menstrual cycle when proliferation rates were high. PTEN expression was detected in all cases irrespective of the phase of the menstrual cycle or use of oral contraception. We conclude that proliferation rates in adenomyotic lesions undergo marked cyclic variations and this affects the percentage of cases showing focal p53 expression in the glandular epithelium.
Assuntos
Anticoncepcionais Orais Combinados , Endometriose/patologia , Endométrio/citologia , Ciclo Menstrual , Adulto , Divisão Celular , Feminino , Humanos , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
OBJECTIVE: To determine whether or not the presence of c-erbB2 over-expression in endometrial polyps affects the percentage of cells positive for Ki-67 proliferation marker. METHODS: Thirty-five patients with endometrial polyps were submitted to polypectomy by hysteroscopy. Ki-67 and c-erbB2 over-expression were investigated in the polyps by immunohistochemistry. RESULTS: The presence of c-erbB2 over-expression by immunohistochemistry was observed in 80% of endometrial polyps and was associated with higher proliferation rates as determined by the number of positive Ki-67 cell nuclei. In c-erbB2-negative polyps, the proliferation rates were low. CONCLUSION: Ki-67 and c-erbB2 over-expression are frequent in endometrial polyps in post-menopausal women.
Assuntos
Neoplasias do Endométrio/metabolismo , Antígeno Ki-67/metabolismo , Pólipos/metabolismo , Receptor ErbB-2/metabolismo , Idoso , Idoso de 80 Anos ou mais , Divisão Celular , Neoplasias do Endométrio/patologia , Feminino , Humanos , Histeroscopia , Imuno-Histoquímica , Pessoa de Meia-Idade , Pólipos/patologia , Pós-MenopausaRESUMO
UNLABELLED: The functional and esthetic restoration of severely compromised anterior teeth is a challenge to clinicians in their daily practice. The duplication of the optical characteristics of an intact tooth, including shade, translucency, and fluorescence, is often made difficult by the use of metal infrastructures, such as post-and-cores and copings. The development of reinforced ceramics and non-metallic post systems made possible the generation of metal-free ceramic restorations in severely compromised anterior and posterior teeth. This article discusses one available technique for the generation of a single all-ceramic restoration involving the use of a zirconia- or leucite-reinforced post-and-core system and of an all-ceramic crown system. A representative clinical case is presented illustrating the potential of the technique. CLINICAL SIGNIFICANCE: Modern ceramic restorative systems offer the possibility to closely match the natural optical characteristics of lost tooth structure. Posts, cores, and copings fabricated in ceramic materials represent a promising alternative to metals in the restoration of severely compromised anterior teeth.
Assuntos
Coroas , Porcelana Dentária , Técnica para Retentor Intrarradicular , Adulto , Óxido de Alumínio , Silicatos de Alumínio , Materiais Dentários , Feminino , Humanos , Retratamento , ZircônioRESUMO
STUDY OBJECTIVE: To determine whether types I and II endometrial carcinomas have different precursor lesions recognized at hysteroscopy and immunohistochemistry. DESIGN: Single center case study (Canadian Task Force classification II-2). SETTING: A private, university affiliated hospital. PATIENTS: One hundred forty-six postmenopausal women with endometrial pathology diagnosed by hysteroscopy and biopsy. INTERVENTION: Hysteroscopy and immunohistochemical determination of p53 overexpression. MEASUREMENTS AND MAIN RESULTS: The number of cells showing p53 overexpression was low in endometrial polyps, hyperplasia, and G1 endometrioid carcinomas. A marked increase was seen only in high-grade G2-G3 endometrioid carcinomas and in cases of uterine papillary serous carcinoma. In the latter, strong p53 overexpression was detected in early forms still confined to endometrial polyps. Hysteroscopy could not differentiate between high- and low-grade endometrioid carcinomas. CONCLUSION: The p53-driven pathway plays an important role in the origin of papillary serous carcinoma but not in G1 endometrioid cancer that evolves from estrogen-stimulated endometrium. However, this pathway is important for progression of low-grade endometrioid carcinomas to higher-grade tumors.
Assuntos
Neoplasias do Endométrio/metabolismo , Histeroscopia , Proteína Supressora de Tumor p53/metabolismo , Núcleo Celular/metabolismo , Núcleo Celular/patologia , Cistadenocarcinoma Papilar/metabolismo , Cistadenocarcinoma Papilar/patologia , Hiperplasia Endometrial/metabolismo , Hiperplasia Endometrial/patologia , Neoplasias do Endométrio/patologia , Feminino , Expressão Gênica , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Pólipos/metabolismo , Pólipos/patologia , Neoplasias Uterinas/metabolismo , Neoplasias Uterinas/patologiaRESUMO
OBJECTIVE: To detect the presence of testosterone and estrogen receptors in the stroma and glandular epithelium in the malignant and non-malignant endometrium. METHODS: One hundred and forty-five consecutively-enrolled peri- or postmenopausal patients were submitted to diagnostic or operative hysteroscopy. These patients either had a history of abnormal uterine bleeding or they were asymptomatic with an endometrial echo greater than 4 mm. The presence of estrogen and testosterone receptors was determined in endometrial samples by immunohistochemistry, using monoclonal antibodies and a streptavidin-biotin peroxidase complex system with diamino benzidine as the chromogen. RESULTS: Testosterone receptors were detected mainly in the stroma in the non-malignant endometrial lesions and in the atypical glandular epithelium in cases of estrogen-positive endometrial carcinomas. CONCLUSIONS: The presence of testosterone receptors in estrogen receptor positive endometrial carcinomas may be involved in the mechanism of cell proliferation in these tumors. The strong staining reaction for testosterone receptors in the endometrial glands can be considered one of the features of invasive malignancy.
Assuntos
Carcinoma Endometrioide/metabolismo , Neoplasias do Endométrio/metabolismo , Endométrio/metabolismo , Pós-Menopausa , Receptores Androgênicos/metabolismo , Receptores de Estrogênio/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Imuno-Histoquímica , Pessoa de Meia-IdadeRESUMO
Em 10 pacientes consecutivos, realizou-se o mapeamento da parede septal do átrio direito durante taquicardia supraventricular por reentrada nodal AV, para comprovar a hipótese de que o intervalo AV mais curto identificava a área de conduçäo da via lenta. O septo atrial foi dividido em quatro zonas distintas. Em sete dos pacientes o intervalo AV anterógrado mais curto foi encontrado na zona 3; em dois, na zona 4; no último, na zona 2. A modificaçäo por radiofreqüência da via lenta foi obtida com sucesso, em todos os pacientes, na área de conduçäo AV mais curta. O intervalo AV durante ritmo sinusal permaneceu inalterado antes e após a ablaçäo. Após um seguimento de 21ñ4 meses, nenhum deles teve recorrência dos sintomas.
Assuntos
Humanos , Masculino , Feminino , Adulto , Taquicardia por Reentrada no Nó Atrioventricular/fisiopatologia , Taquicardia Paroxística , Ablação por Cateter , EndocárdioRESUMO
STUDY OBJECTIVE: To evaluate the therapeutic efficacy of polypectomy associated with endometrial resection for the treatment of polyps in postmenopausal women. DESIGN: Prospective study (Canadian Task Force classification II-2). SETTING: Private urban hospital with facilities for endoscopic surgery. PATIENTS: Sixty-six women with endometrial polyps. INTERVENTIONS: Sixty-four of the 66 patients underwent polypectomy followed by endometrial resection. One patient had hysterectomy because endometrial biopsy showed serous papillary carcinoma. MEASUREMENTS AND MAIN RESULTS: No major complications were associated with the procedure. Histopathology showed hyperplasia in most polyps. One patient had a papillary uterine carcinoma in the polyp that was not detected by preoperative endometrial biopsy. The women were followed with transvaginal sonography for 1 year after surgery. CONCLUSION: Polypectomy followed by endometrial resection is a very low-risk procedure for postmenopausal patients. There was no recurrence after the first year in women who completed follow-up.
Assuntos
Neoplasias do Endométrio/cirurgia , Procedimentos Cirúrgicos em Ginecologia/métodos , Pólipos/cirurgia , Pós-Menopausa , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha , Neoplasias do Endométrio/diagnóstico por imagem , Neoplasias do Endométrio/patologia , Endométrio/cirurgia , Endossonografia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Pólipos/diagnóstico por imagem , Pólipos/patologia , Estudos Prospectivos , Resultado do TratamentoRESUMO
STUDY OBJECTIVE: To assess the efficacy of endometrial resection for treatment of menorrhagia in women to whom no preoperative agent was given to prepare the endometrium. DESIGN: Retrospective analysis of patients' records for all endometrial resections in which medroxyprogesterone acetate was used postoperatively. SETTING: Hospital day surgery unit. PATIENTS: Seventy patients with menorrhagia. INTERVENTIONS: The women underwent transvaginal sonography, followed by hysteroscopy and endometrial biopsy. The endometrium was removed using the 27F resectoscope followed by coagulation with the rollerball. Medroxy-progesterone acetate was prescribed for 2 months after surgery. MEASUREMENTS AND MAIN RESULTS: All women achieved a reduction in menstrual flow and 50% reported amenorrhea after endometrial resection. In only two was hysterectomy necessary due to recurrence of menorrhagia. CONCLUSION: Preoperative endometrial preparation was unnecessary when endometrial resection was carried out for treatment of menorrhagia. However, the patients received medroxyprogesterone acetate postoperatively.
Assuntos
Endométrio/cirurgia , Acetato de Medroxiprogesterona/administração & dosagem , Menorragia/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Congêneres da Progesterona/administração & dosagem , Adulto , Biópsia , Feminino , Seguimentos , Humanos , Histeroscopia , Menorragia/diagnóstico , Menorragia/tratamento farmacológico , Pessoa de Meia-Idade , Cuidados Pós-Operatórios/métodos , Recidiva , Estudos RetrospectivosRESUMO
STUDY OBJECTIVE: To evaluate the endometrial cavity of menopausal women with irregular bleeding while receiving hormone replacement therapy. DESIGN: Comparative evaluation of hysteroscopic and biopsy findings. SETTING: A center for reproductive studies. PATIENTS: Forty-one patients receiving different regimens of hormone replacement therapy. INTERVENTIONS: Hysteroscopy, endometrial biopsy, and transvaginal sonography were performed in all 41 women. In 10 patients, endometrial polyps were removed with the resectoscope. MEASUREMENTS AND MAIN RESULTS: Irregular bleeding during hormone replacement therapy was associated with atrophic endometrium whenever transvaginal sonography showed endometrial thickness to be less than 4 mm. In patients who developed increased endometrial thickness after hormone replacement therapy, hysteroscopy revealed the presence of endometrial polyps in the uterine cavity. Histopathologic examination of excised polyps revealed cystic or adenomatous hyperplasia confined to these lesions. CONCLUSIONS: Endometrial polyps can appear in menopausal women receiving hormone replacement therapy despite the presence of progestins to oppose the action of estrogens.
Assuntos
Endométrio/diagnóstico por imagem , Terapia de Reposição de Estrogênios , Histeroscopia , Menopausa , Atrofia , Biópsia , Neoplasias do Endométrio/diagnóstico , Neoplasias do Endométrio/diagnóstico por imagem , Neoplasias do Endométrio/cirurgia , Endométrio/efeitos dos fármacos , Endométrio/patologia , Terapia de Reposição de Estrogênios/efeitos adversos , Feminino , Humanos , Pessoa de Meia-Idade , Pólipos/diagnóstico , Pólipos/diagnóstico por imagem , Pólipos/cirurgia , Ultrassonografia , Hemorragia Uterina/induzido quimicamente , Hemorragia Uterina/diagnóstico , Hemorragia Uterina/diagnóstico por imagemRESUMO
Transvaginal sonography made a preoperative diagnosis of ovarian endometriotic cyst in 45 women (age 20-45 yrs). The cyst was unilocular in 37 patients and multilocular in the rest. Intracystic projections were noted in seven. Doppler studies revealed benign ovarian masses. Videolaparoscopy was carried out to remove the ovarian cyst using a three-puncture technique. The cyst was aspirated before removal, which revealed chocolate material. Peritoneal or ovarian surface endometriotic lesions, with or without adhesions, associated with chocolate cysts were present in 35 women. Histopathologic examination of excised material revealed functional ovarian cysts in 12 patients, serous cystadenomas in 20, nonspecific ovarian cysts with fibrotic tissue in 4, and endometriotic cysts in 9. These results indicate that the majority of ovarian chocolate cysts are not true endometriomas but rather an association between endometriotic lesions and other neoplastic or functional ovarian cysts.
RESUMO
Seventy women (age 32-47 yrs) with a history of menorrhagia were evaluated by transvaginal sonography, hysteroscopy, and endometrial biopsy. Hysteroscopy revealed a normal uterine cavity in 60 patients, endometrial polyps in 4, and submucous myomas in 6. Endometrial biopsy revealed normal histology in 67 women and 3 cases of cystic endometrial hyperplasia. All patients underwent endometrial resection using the 27F resectoscope followed by coagulation with the rollerball. Glycine 1.5% was used as the distention medium. Endometrial resection was carried out under paracervical block plus intravenous propofol. Oral medroxyprogesterone acetate (MPA) 20 mg/day for 2 months was prescribed postoperatively for 40 women. The remaining women received a placebo. All patients were evaluated by transvaginal sonography at 1, 3, and 6 months after resection. The frequency of amenorrhea was 40% in the placebo group and 70% in the MPA group. These initial results suggest that postoperative treatment with MPA increases the frequency of amenorrhea after endometrial resection.
RESUMO
Preliminary data of a project about the ecology of the Phlebotominae (sandflies) in a tegumentary leishmaniasis area of coconut plantation in the south of the State of Bahia, Brazil are presented. There are 60 dwellings far of one another, where existed 31 dogs and 229 inhabitants. Among them 41.5% were Montenegro positive; 37.5% from these had scars of healed ulcers and 8.8% had active ulcers. 53% of the house had dogs from which 22% were seropositive; from the 7 dogs with ulcers only 3 were seropositive. 14% of the inspected house harboured sandflies inside them. During two years of observations 72 sentinels hamsters were maintened at houses of patients with leishmaniasis ulcers, but they did not get the infection. During two years of observation, monthly collectings of sandflies were made inside house, chicken pen, curral, tree trunks and open field around a house with a patient with leishmaniasis. The following results were already obtained about the vectors: 5,614 specimens were identified as belonging to fourteen different species of sandflies. Among them Lutzomyia whitmani (92%) and Lutzomyia intermedia (4.8%) were the most abundant species. They are very anthropophilic and can be found inside houses and at peridomestic sites. Probably they are the principal vectors of the disease at domestic places. The other twelve species were less frequent and more found at sylvatic places in inspite they also bite the man. Generally the biting activity of most of the species of the area begins at 5 p.m. in the dusk and reaches its peak at 0 hour a.m., when begins declining until disapear at 7 a.m. L. whitmani was similarly collected with the same density in all lunar phases while L. intermedia was more abundant during the new moon phase. Most of the hundreds sandflies collected during the second year of observations, remains preserved in liquid nitrogen, watching for the adjustment of PCR molecular techniques to be processed for determination of the vector natural infection rates with leishmanias. Final results on all the project will be published as soon as the examination of such material has been processed.
Assuntos
Ecologia , Insetos Vetores , Leishmaniose Cutânea/transmissão , Phlebotomus , Animais , Brasil , Cães , Humanos , Leishmaniose Cutânea/parasitologia , Densidade DemográficaRESUMO
OBJECTIVE: To compare transvaginal sonography (TVS), hysteroscopy and suction curettage in the evaluation of uterine bleeding during the menopause. METHODS: Forty-seven patients who presented with either postmenopausal bleeding (31 cases) or sonographic endometrial abnormalities at menopause (16 cases) were evaluated using TVS, hysteroscopy, and curettage with a Karman curette. RESULTS: When endometrial thickness measured by TVS was < 4 mm, there was no endometrial pathology. However TVS could not differentiate accurately between hyperplasia, polyps or endometrial carcinoma. In these cases, endometrial thickness was invariably greater than 5 mm. CONCLUSIONS: Hysteroscopy proved superior to curettage in the diagnosis of endometrial polyps.