Você pesquisou por y?yr=2003 - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(5):359-364
DOI 10.1590/S0100-72032003000500009
PURPOSE: to evaluate the degree of pelvic adhesions in function of time and the different substances used in its prophylaxis. MATERIAL AND METHODS: prospective study with 120 female, albino, virgin Wistar rats, 3 to 4 months of age, weighing approximately 250 g, randomly divided into 10 groups of 12 animals each: control, without lesion; lesions and without treatment; lesions + 0.9% physiologic saline, lesions + Ringer lactate; lesions + 32% dextran 70; lesions + Ringer lactate/heparin; lesions + Ringer lactate/dexamethasone; lesions + Ringer lactate/hydrocortisone/dexamethasone/ampicillin; lesions + Ringer lactate/albumin, and lesions + 1% carboxymethylcellulose. The animals were anesthetized and two types of lesions (scarification and electrocauterization) were performed in the uterine horns, followed by treatment with the solutions, intraperitoneally, to prevent pelvic adhesions. On the 7th, 14th and 28th postoperative days, moments M1, M2 and M3, respectively, the presence of adhesions was evaluated in 4 rats of each group. The methods applied to the quantification of the adhesions were based on Cohen's classification, with scores varying from 0 to 4+ according to the amount, characteristics and location of the adhesions. Statistical analysis was performed by parametric tests for analysis of variance and the Kruskal-Wallis test. RESULTS: the best treatments for prevention of pelvic adhesions in female rats were Ringer lactate/dexamethasone (score 1+ prevalence), 32% dextran 70 to (score 2+ prevalence) and Ringer lactate/hydrocortisone/dexamethasone/ampicillin (score 2+ prevalence). The postoperative period, represented by moment M3, and the surgical technique, predominantly with score 0, influenced adhesiolysis and maintenance of pelvic adhesions in female rats. CONCLUSIONS: the prevention of pelvic adhesions in female rats begins with the surgical process at a smaller extent of tissue damage. The use of prophylactic substances (solutions) had a varied effectiveness, since some were more efficient than others.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(5):359-364
DOI 10.1590/S0100-72032003000500009
PURPOSE: to evaluate the degree of pelvic adhesions in function of time and the different substances used in its prophylaxis. MATERIAL AND METHODS: prospective study with 120 female, albino, virgin Wistar rats, 3 to 4 months of age, weighing approximately 250 g, randomly divided into 10 groups of 12 animals each: control, without lesion; lesions and without treatment; lesions + 0.9% physiologic saline, lesions + Ringer lactate; lesions + 32% dextran 70; lesions + Ringer lactate/heparin; lesions + Ringer lactate/dexamethasone; lesions + Ringer lactate/hydrocortisone/dexamethasone/ampicillin; lesions + Ringer lactate/albumin, and lesions + 1% carboxymethylcellulose. The animals were anesthetized and two types of lesions (scarification and electrocauterization) were performed in the uterine horns, followed by treatment with the solutions, intraperitoneally, to prevent pelvic adhesions. On the 7th, 14th and 28th postoperative days, moments M1, M2 and M3, respectively, the presence of adhesions was evaluated in 4 rats of each group. The methods applied to the quantification of the adhesions were based on Cohen's classification, with scores varying from 0 to 4+ according to the amount, characteristics and location of the adhesions. Statistical analysis was performed by parametric tests for analysis of variance and the Kruskal-Wallis test. RESULTS: the best treatments for prevention of pelvic adhesions in female rats were Ringer lactate/dexamethasone (score 1+ prevalence), 32% dextran 70 to (score 2+ prevalence) and Ringer lactate/hydrocortisone/dexamethasone/ampicillin (score 2+ prevalence). The postoperative period, represented by moment M3, and the surgical technique, predominantly with score 0, influenced adhesiolysis and maintenance of pelvic adhesions in female rats. CONCLUSIONS: the prevention of pelvic adhesions in female rats begins with the surgical process at a smaller extent of tissue damage. The use of prophylactic substances (solutions) had a varied effectiveness, since some were more efficient than others.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(5):337-343
DOI 10.1590/S0100-72032003000500006
PURPOSE: to evaluate the effects of soy germ isoflavone on menopausal symptoms and blood lipids in postmenopausal women. METHODS: a prospective study was performed on 50 women, randomly divided into two groups: 25 women on soy germ isoflavones (60 mg/day, capsules) (G1) and 25 women on placebo (G2). Inclusion criteria: women with hot flushes and FSH >40 mIU/mL, non-vegetarian, non-smoker, non-Asiatic, not in use of hormone replacement therapy and without disease of the gastrointestinal tract. For six months, the menopausal Kupperman index (MKI) and hormonal and lipid profiles were assessed. For statistical analysis, ANOVA, t test and the non-parametric Kruskal-Wallis and Mann-Whitney tests were used. RESULTS: the median MKI values, initially similar in both groups, decreased in G1 at two and four months (MKI = 14 and 9, respectively), and in G2 at two months (MKI = 15) (p<0.01). At six months, isoflavone was significantly superior to placebo in reducing hot flushes (44 versus 12%, respectively). At the end of the study, in the isoflavone group, an increase in estradiol levels (from 16,8±7.3 to 18,0±6.7 ng/dL) (p<0.05) was observed, with no alteration in FSH, LH and vaginal cytology; there was also a reduction of 11.8% in LDL (from 151.5±39.2 for 133,6±26.4 mg/dL) and a HDL increase of 27.3% (from 44.0±11.3 to 56.0±11.9 mg/dL) (p<0.05). CONCLUSIONS: soy germ isoflavone induced favorable effects on menopausal symptoms and lipid profile, showing to be an interesting option for alternative therapy in postmenopausal women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(5):337-343
DOI 10.1590/S0100-72032003000500006
PURPOSE: to evaluate the effects of soy germ isoflavone on menopausal symptoms and blood lipids in postmenopausal women. METHODS: a prospective study was performed on 50 women, randomly divided into two groups: 25 women on soy germ isoflavones (60 mg/day, capsules) (G1) and 25 women on placebo (G2). Inclusion criteria: women with hot flushes and FSH >40 mIU/mL, non-vegetarian, non-smoker, non-Asiatic, not in use of hormone replacement therapy and without disease of the gastrointestinal tract. For six months, the menopausal Kupperman index (MKI) and hormonal and lipid profiles were assessed. For statistical analysis, ANOVA, t test and the non-parametric Kruskal-Wallis and Mann-Whitney tests were used. RESULTS: the median MKI values, initially similar in both groups, decreased in G1 at two and four months (MKI = 14 and 9, respectively), and in G2 at two months (MKI = 15) (p<0.01). At six months, isoflavone was significantly superior to placebo in reducing hot flushes (44 versus 12%, respectively). At the end of the study, in the isoflavone group, an increase in estradiol levels (from 16,8±7.3 to 18,0±6.7 ng/dL) (p<0.05) was observed, with no alteration in FSH, LH and vaginal cytology; there was also a reduction of 11.8% in LDL (from 151.5±39.2 for 133,6±26.4 mg/dL) and a HDL increase of 27.3% (from 44.0±11.3 to 56.0±11.9 mg/dL) (p<0.05). CONCLUSIONS: soy germ isoflavone induced favorable effects on menopausal symptoms and lipid profile, showing to be an interesting option for alternative therapy in postmenopausal women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(5):345-351
DOI 10.1590/S0100-72032003000500007
PURPOSE: to estimate the sensitivity, specificity and accuracy of patient age, ultrasound result and CA-125 marker variables for the differential diagnosis between malignant and benign ovarian tumors. In addition, to establish a risk of malignancy index (RMI) incorporating these three variables and to estimate its sensitivity, specificity and accuracy for the differential diagnosis. METHODS: one hundred patients with ovarian tumors with surgical indication were included. The age, ultrasonographic findings and CA-125 level variables were evaluated separately and later on together as the RMI. The study was performed based on the evaluation of the sensitivity, specificity and diagnostic accuracy and the use of the measurements: likelihood ratio, odds ratio, and the Student's t test, chi², and logistic regression with univariate and multivariate analysis. RESULTS: for the age variable, sensitivity, specificity and diagnostic accuracy were 58.8, 68.2 and 65.0%, respectively. For ultrasound, 88.2, 77.3 and 81.0%. For CA-125 dosage, the values were 64.7, 74.2 and 71.0%. When the three variables were put together, as the RMI, a sensitivity of 76.5%, a specificity of 87.9% and a diagnostic accuracy of 84.0% were observed. CONCLUSIONS: RMI, made up of the association of patient age, ultrasound results and CA-125 dosage variables is a valuable indicator to distinguish between malignant and benign ovarian tumor, especially in regard to its specificity.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(5):345-351
DOI 10.1590/S0100-72032003000500007
PURPOSE: to estimate the sensitivity, specificity and accuracy of patient age, ultrasound result and CA-125 marker variables for the differential diagnosis between malignant and benign ovarian tumors. In addition, to establish a risk of malignancy index (RMI) incorporating these three variables and to estimate its sensitivity, specificity and accuracy for the differential diagnosis. METHODS: one hundred patients with ovarian tumors with surgical indication were included. The age, ultrasonographic findings and CA-125 level variables were evaluated separately and later on together as the RMI. The study was performed based on the evaluation of the sensitivity, specificity and diagnostic accuracy and the use of the measurements: likelihood ratio, odds ratio, and the Student's t test, chi², and logistic regression with univariate and multivariate analysis. RESULTS: for the age variable, sensitivity, specificity and diagnostic accuracy were 58.8, 68.2 and 65.0%, respectively. For ultrasound, 88.2, 77.3 and 81.0%. For CA-125 dosage, the values were 64.7, 74.2 and 71.0%. When the three variables were put together, as the RMI, a sensitivity of 76.5%, a specificity of 87.9% and a diagnostic accuracy of 84.0% were observed. CONCLUSIONS: RMI, made up of the association of patient age, ultrasound results and CA-125 dosage variables is a valuable indicator to distinguish between malignant and benign ovarian tumor, especially in regard to its specificity.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(5):307-307
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(5):307-307
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(5):309-316
DOI 10.1590/S0100-72032003000500002
PURPOSE: to determine the prevalence of domestic physical violence among women who delivered at a tertiary center in the Northeast of Brazil, to study the main risk factors associated with domestic violence, and to determine perinatal outcome. METHODS: a cross-sectional study was conducted, enrolling 420 women who delivered at a tertiary center in Recife (Brazil) with fetuses weighing more than 500 g. They were submitted to interviews with open and closed questions. The prevalence of domestic physical violence was determined. Statistical analysis was performed using c² and Fisher's exact tests at a 5% level of significance. The prevalence ratio was determined as measurement of relative risk of violence. Multiple logistic regression analysis was performed and the adjusted risk was calculated. RESULTS: the prevalence of domestic physical violence was 13.1% (95% CI = 10.1-16.6) and 7.4% (95% CI = 5.2-10.2) before and during pregnancy, respectively. The pattern of violence has changed during pregnancy: stopped in 43.6%, was reduced in 27.3% and increased in 11% of the victims. After multivariate analysis the variables that persisted strongly associated with violence were low female educational level, history of violence in the women´s family, partner's use of alcohol and unemployment. Perinatal outcome was studied and a significantly higher frequency of neonatal death was observed among victims of domestic violence. CONCLUSIONS: a high prevalence of domestic physical violence was observed (about 13%) in women who delivered at a tertiary center in Northeast of Brazil. The main risk factors were low educational level and previous familiar history of violence in the women's family, alcohol use by and unemployment of their partners. Neonatal mortality was increased in victims of violence.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(5):309-316
DOI 10.1590/S0100-72032003000500002
PURPOSE: to determine the prevalence of domestic physical violence among women who delivered at a tertiary center in the Northeast of Brazil, to study the main risk factors associated with domestic violence, and to determine perinatal outcome. METHODS: a cross-sectional study was conducted, enrolling 420 women who delivered at a tertiary center in Recife (Brazil) with fetuses weighing more than 500 g. They were submitted to interviews with open and closed questions. The prevalence of domestic physical violence was determined. Statistical analysis was performed using c² and Fisher's exact tests at a 5% level of significance. The prevalence ratio was determined as measurement of relative risk of violence. Multiple logistic regression analysis was performed and the adjusted risk was calculated. RESULTS: the prevalence of domestic physical violence was 13.1% (95% CI = 10.1-16.6) and 7.4% (95% CI = 5.2-10.2) before and during pregnancy, respectively. The pattern of violence has changed during pregnancy: stopped in 43.6%, was reduced in 27.3% and increased in 11% of the victims. After multivariate analysis the variables that persisted strongly associated with violence were low female educational level, history of violence in the women´s family, partner's use of alcohol and unemployment. Perinatal outcome was studied and a significantly higher frequency of neonatal death was observed among victims of domestic violence. CONCLUSIONS: a high prevalence of domestic physical violence was observed (about 13%) in women who delivered at a tertiary center in Northeast of Brazil. The main risk factors were low educational level and previous familiar history of violence in the women's family, alcohol use by and unemployment of their partners. Neonatal mortality was increased in victims of violence.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(5):317-321
DOI 10.1590/S0100-72032003000500003
PURPOSE: to evaluate the rate of seropositivity for parvovirus B19 (PB19) among pregnant women and the rate of seroconversion against this infection during pregnancy. METHODS: prospective study carried out in the Hospital of the Medical School of Ribeirão Preto, University of São Paulo. In the first stage of the present study, we evaluated 245 pregnant women with gestational age less than 16 weeks to determine the seroprevalence of PB19 infection by ELISA. According to the serological results we determined if the PB19 infection was an acute infection (IgM positive and IgG negative or positive), or a former infection (IgM negative and IgG positive). In the second stage of this study, 73 previously seronegative pregnant women were tested again when they came to the hospital for delivery (IgM and IgG), to detect the seroconversion rate during pregnancy. RESULTS: the seroprevalence of the PB19 infection until 16 weeks of gestation was 62.9% (95% IC: 56.8-68.9), divided into acute infection (8.1%), or former infection (54.8%). Of the 73 patients, seronegative in the first stage of this investigation, seven (9.6%) showed seroconversion during pregnancy (95% IC: 2.8-16.3), two (2.7%) showed acute serological infection and five (6.9%) presented markers of past infection. The final seroprevalence of PB19 infection during pregnancy was 72.5%. CONCLUSIONS: considering that only the acute PB19 infection is associated with risk for vertical transmission, the high seroprevalence of this infection observed in this study would be protecting these fetuses against this form of infection. Despite the relatively high rate of seroconversion against PB19 infection during the pregnancy period, we did not observe any symptomatic neonate in this group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(5):317-321
DOI 10.1590/S0100-72032003000500003
PURPOSE: to evaluate the rate of seropositivity for parvovirus B19 (PB19) among pregnant women and the rate of seroconversion against this infection during pregnancy. METHODS: prospective study carried out in the Hospital of the Medical School of Ribeirão Preto, University of São Paulo. In the first stage of the present study, we evaluated 245 pregnant women with gestational age less than 16 weeks to determine the seroprevalence of PB19 infection by ELISA. According to the serological results we determined if the PB19 infection was an acute infection (IgM positive and IgG negative or positive), or a former infection (IgM negative and IgG positive). In the second stage of this study, 73 previously seronegative pregnant women were tested again when they came to the hospital for delivery (IgM and IgG), to detect the seroconversion rate during pregnancy. RESULTS: the seroprevalence of the PB19 infection until 16 weeks of gestation was 62.9% (95% IC: 56.8-68.9), divided into acute infection (8.1%), or former infection (54.8%). Of the 73 patients, seronegative in the first stage of this investigation, seven (9.6%) showed seroconversion during pregnancy (95% IC: 2.8-16.3), two (2.7%) showed acute serological infection and five (6.9%) presented markers of past infection. The final seroprevalence of PB19 infection during pregnancy was 72.5%. CONCLUSIONS: considering that only the acute PB19 infection is associated with risk for vertical transmission, the high seroprevalence of this infection observed in this study would be protecting these fetuses against this form of infection. Despite the relatively high rate of seroconversion against PB19 infection during the pregnancy period, we did not observe any symptomatic neonate in this group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(5):323-328
DOI 10.1590/S0100-72032003000500004
PURPOSE: to determine whether an elective cesarean section at the 38th week of gestation for HIV positive patients, in spite of decreasing vertical transmission, increases the risk of maternal death. METHODS: fifty-eight HIV-infected patients were studied and submitted to the complete ACTG 076 protocol (oral administration of zidovudine in the prenatal period associated with the intravenous form at delivery) followed by an elective cesarean section at the 38th week of gestation. The control group consisted of 226 noninfected women (the first four patients submitted to an elective cesarian section after each cesarian section in infected patient). The analyzed variables were: uterine atonia, puerperal fever, abdominal wall infection, urinary infection, endometritis, average blood loss, surgery time, and hospitalization time. Data were analyzed by the c² test (the Fisher test was used when there were less than 5 cases). The relative risk was calculated with the Epi-Info 6.0 program. RESULTS: results show that the elective cesarean section performed on HIV-positive patients, when compared to the control group, did not present a higher incidence of uterine atonia, puerperal fever, abdominal wall infection, urinary infection or endometritis. However, a greater average blood loss (2.26 relative risk) was recorded as well as an extended surgery time (3.32 relative risk). The HIV-infected patients remained less time in hospital than the noninfected control group (0.33 relative risk). CONCLUSION: we conclude that there was no increase in maternal morbidity after cesarean section as a means of interrupting gestation in the HIV-infected patients.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(5):323-328
DOI 10.1590/S0100-72032003000500004
PURPOSE: to determine whether an elective cesarean section at the 38th week of gestation for HIV positive patients, in spite of decreasing vertical transmission, increases the risk of maternal death. METHODS: fifty-eight HIV-infected patients were studied and submitted to the complete ACTG 076 protocol (oral administration of zidovudine in the prenatal period associated with the intravenous form at delivery) followed by an elective cesarean section at the 38th week of gestation. The control group consisted of 226 noninfected women (the first four patients submitted to an elective cesarian section after each cesarian section in infected patient). The analyzed variables were: uterine atonia, puerperal fever, abdominal wall infection, urinary infection, endometritis, average blood loss, surgery time, and hospitalization time. Data were analyzed by the c² test (the Fisher test was used when there were less than 5 cases). The relative risk was calculated with the Epi-Info 6.0 program. RESULTS: results show that the elective cesarean section performed on HIV-positive patients, when compared to the control group, did not present a higher incidence of uterine atonia, puerperal fever, abdominal wall infection, urinary infection or endometritis. However, a greater average blood loss (2.26 relative risk) was recorded as well as an extended surgery time (3.32 relative risk). The HIV-infected patients remained less time in hospital than the noninfected control group (0.33 relative risk). CONCLUSION: we conclude that there was no increase in maternal morbidity after cesarean section as a means of interrupting gestation in the HIV-infected patients.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(5):331-335
DOI 10.1590/S0100-72032003000500005
PURPOSE: to evaluate whether there is an association between recurrent spontaneous abortion and atopy. METHODS: this was a case-control study with 230 women: 71 with a history of recurrent spontaneous abortion (group A) and 159 with a history of successful pregnancy (group B). The evaluation included a questionnaire in order to investigate the personal history of atopy, considering symptoms of atopic dermatitis, urticaria, rhinitis, asthma, conjunctivitis and gastric or intestinal symptoms. The presence of specific IgE in response to a pool of inhalants, Phadiatop, detected by an enzymatic fluorescence reaction in blood was also investigated. The data were analyzed by Fisher's exact test and a p value < 0.05 was set as level of significance. RESULTS: a positive history of atopy was observed in 57.7% of group A patients and in 55.3% of group B patients. The incidence of positive IgE against Phadiatop was 38% and 33.9% in groups A and B, respectively. Association of allergy disease with positive Phadiatop (presence of specific IgE) was detected in 28.2% of group A and in 22% of group B patients. There was no significant difference between the groups. CONCLUSIONS: we did not observe any association between recurrent spontaneous abortion and atopy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(5):331-335
DOI 10.1590/S0100-72032003000500005
PURPOSE: to evaluate whether there is an association between recurrent spontaneous abortion and atopy. METHODS: this was a case-control study with 230 women: 71 with a history of recurrent spontaneous abortion (group A) and 159 with a history of successful pregnancy (group B). The evaluation included a questionnaire in order to investigate the personal history of atopy, considering symptoms of atopic dermatitis, urticaria, rhinitis, asthma, conjunctivitis and gastric or intestinal symptoms. The presence of specific IgE in response to a pool of inhalants, Phadiatop, detected by an enzymatic fluorescence reaction in blood was also investigated. The data were analyzed by Fisher's exact test and a p value < 0.05 was set as level of significance. RESULTS: a positive history of atopy was observed in 57.7% of group A patients and in 55.3% of group B patients. The incidence of positive IgE against Phadiatop was 38% and 33.9% in groups A and B, respectively. Association of allergy disease with positive Phadiatop (presence of specific IgE) was detected in 28.2% of group A and in 22% of group B patients. There was no significant difference between the groups. CONCLUSIONS: we did not observe any association between recurrent spontaneous abortion and atopy.