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Lesões cervicais intraepiteliais de alto grau: avaliação dos fatores determinantes de evolução desfavorável após conização 高级别宫颈上皮内病变:锥化后不良进展的决定因素评估
IF 1.2 Q3 Medicine Pub Date : 2011-11-01 DOI: 10.1590/S0100-72032011001100003
F. Fonseca, Flávio Daniel Saavedra Tomasich, J. Jung
PURPOSE: To evaluate the ability of various factors related to the conization process in cytological/histological cervical intraepithelial neoplasias (CIN), after therapeutic conization. METHODS: A retrospective review was conducted of patients who had undergone conization due to CIN 2 and 3, from January 1999 to January 2006. They were divided into two groups: case group (residual disease or recurrence) and control group (without residual disease or recurrence), during 18 months of follow up. Univariate and multivariate analysis were used to define the predictive factors of disease recurrence. The c2 test or Fisher exact test was used for statistical analysis, with the level of significance set at p£0.05. RESULTS: Forty-eight patients showed recurrence/progression of CIN (case group) and 65 showed no recurrence/progression of disease (control group). Age and parity were similar in the two groups, as determined by calculation of the mean and standard deviation. There was no difference in smoking habits or in the use of contraceptive methods. The recurrence rate was 14.6%. Only conization positive margins were predictors of recurrence/progression (p<0.001). The conization techinique, the surgeon, CIN grade, gland involvement, and size of the uterine volume removed were not related to the evolution of disease after surgery. CONCLUSION: The recurrence of CIN 2 and 3 was related to positive margins in the product of conization.
目的:评价治疗性宫颈上皮内瘤变(CIN)锥形化后细胞学/组织学中与锥形化过程相关的各种因素的能力。方法:回顾性分析1999年1月至2006年1月间因CIN 2型和CIN 3型行锥形切除术的患者。随访18个月,分为病例组(残余病或复发)和对照组(无残余病或复发)。采用单因素和多因素分析确定疾病复发的预测因素。采用c2检验或Fisher精确检验进行统计分析,显著性水平为p < 0.05。结果:48例CIN出现复发/进展(病例组),65例无复发/进展(对照组)。通过计算平均值和标准差确定,两组的年龄和胎次相似。在吸烟习惯和避孕方法的使用方面没有差异。复发率为14.6%。只有锥形阳性切缘是复发/进展的预测因子(p<0.001)。锥切技术、术者、CIN分级、腺体累及及切除子宫体积大小与术后疾病进展无关。结论:CIN 2、3的复发与锥化产物的阳性缘有关。
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引用次数: 10
Sobrepeso e obesidade pré-gestacionais: prevalência e desfechos associados à gestação 妊娠前超重和肥胖:与妊娠相关的患病率和结果
IF 1.2 Q3 Medicine Pub Date : 2011-11-01 DOI: 10.1590/S0100-72032011001100005
Gisele Seabra, P. Padilha, J. Queiroz, C. Saunders
OBJETIVO: Descrever o resultado obstetrico de mulheres com sobrepeso/obesidade atendidas no servico de pre-natal de uma maternidade publica no Rio de Janeiro. METODOS: Estudo do tipo descritivo transversal, tendo sido incluidas 433 puerperas (³20 anos, sem enfermidades cronicas) e seus respectivos recem-nascidos atendidos em maternidade publica do Rio de Janeiro. As informacoes foram coletadas em prontuarios e por meio de entrevistas. As caracteristicas maternas e dos recem-nascidos avaliadas foram agrupadas em maternas (habitos sociais, antropometricas, da assistencia pre-natal, clinicas e obstetricas) e dos recem-nascidos (condicoes ao nascer). A avaliacao da razao de chance entre as categorias de estado nutricional os desfechos gestacionais se deu por meio da odds ratio (OR), com intervalos de confianca (IC) de 95%. RESULTADOS: A prevalencia de sobrepeso/obesidade nesta casuistica foi de 24,5% (n=106). Observou-se uma associacao entre ganho de peso inadequado e a frequencia de sobrepeso/obesidade (OR 2,7; IC95% 1,5-4,9; p<0,05). As mulheres com sobrepeso/obesidade apresentaram maior risco para pre-eclâmpsia (OR 3,3; IC95% 1,1-9,9; p=0,03). Quanto as condicoes ao nascimento, verificou-se peso medio ao nascer de 3291,3 g (±455,2), sendo as taxas de baixo peso de 4,7% (n=5) e macrossomia de 2,8% (n=3).  CONCLUSOES: Observou-se uma prevalencia alarmante de inadequacao do estado nutricional pre e gestacional, que pode associar-se ao maior risco de morbimortalidade perinatal. Com isso, sugere-se a necessidade de monitoramento nutricional dessas gestantes.
摘要目的:描述在里约热内卢某公立妇产医院接受产前护理的超重/肥胖妇女的产科结果。方法:横断面描述性研究,包括433名产褥期妇女(20岁³,无慢性疾病)和她们各自的新生儿在里约热内卢的公共产科病房接受治疗。这些信息是从医疗记录和访谈中收集的。母亲和新生儿的特征被评估为母亲(社会习惯、人体测量、产前护理、临床和产科)和新生儿(出生条件)。营养状况和妊娠结局类别之间的机会比是通过优势比(OR)进行评估的,置信区间(ci)为95%。结果:超重/肥胖患病率为24.5% (n=106)。我们观察到体重增加不足与超重/肥胖频率(或2.7;IC95% 1、5 4、9;p < 0 . 05)。超重/肥胖妇女患子痫前期的风险更高(或3.3;IC95% 1 1 9 9;p = 0。03)。在出生条件方面,平均出生体重为3291.3 g(±455.2),低体重率为4.7% (n=5),巨体率为2.8% (n=3)。结论:孕前和孕前营养状况不足的患病率令人担忧,这可能与围产期发病率和死亡率的增加有关。因此,建议对这些孕妇进行营养监测。
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引用次数: 34
Physiotherapy assessment in the health of early and late postmenopause women 早期和晚期绝经后妇女健康的物理治疗评估
IF 1.2 Q3 Medicine Pub Date : 2011-10-01 DOI: 10.1590/S0100-72032011001000009
C. Calio
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引用次数: 0
Avaliação da qualidade da assistência ao parto normal 正常分娩护理质量评价
IF 1.2 Q3 Medicine Pub Date : 2011-10-01 DOI: 10.1590/S0100-72032011001000005
Margareth Rocha Peixoto Giglio, E. França, J. Lamounier
PURPOSE: To evaluate the quality of health care assistance during childbirth in the hospitals of Goiânia, in Brazil. METHODS: Thirteen hospitals were appraised from April to December 2007, and a random sample of 404 normal births was studied. Data were obtained from interviews with mothers after delivery and by consulting their medical records. The quality of assistance at birth was evaluated by using the Bologna score and by comparing the procedures used in those hospitals to standard recommended practices. RESULTS: The Bologna score presented an average value of 1.04 (95%CI=0.9-1.1). The elective caesarian rate was 30%, the emergency caesarian rate was 10%, and the rate of induced childbirth was 1.6% The percentage of childbirths attended by health care professionals was 100%, but pediatricians in the delivery room were present only in 30% of the time. During labor, half of the women had no evaluation of the uterine dynamics and 29% had no auscultation fetal monitoring. The partogram was used for only 28.5% of the women, whereas the use of oxytocin was 45.8%. CONCLUSIONS: The results indicate a poor quality of childbirth care with low values of the Bologna score, high elective and emergency caesarians rates, a high number of unnecessary and potentially harmful interventions, and an insufficient frequency of beneficial interventions.
目的:评价巴西goi尼亚医院分娩期间的卫生保健援助质量。方法:2007年4 - 12月对13家医院进行评价,随机抽取正常新生儿404例进行调查。数据是通过对分娩后母亲的访谈和查阅她们的医疗记录获得的。通过使用博洛尼亚评分并将这些医院使用的程序与标准推荐做法进行比较,评估了助产服务的质量。结果:Bologna评分平均值为1.04 (95%CI=0.9 ~ 1.1)。选择性剖宫产率为30%,紧急剖宫产率为10%,引产率为1.6%。由卫生保健专业人员接生的比例为100%,但产房的儿科医生只有30%的时间在场。在分娩过程中,一半的妇女没有子宫动力学评估,29%没有听诊胎儿监护。只有28.5%的女性使用了剖宫产图,而使用催产素的比例为45.8%。结论:结果表明分娩护理质量差,博洛尼亚评分值低,选择性和急诊剖腹产率高,不必要和潜在有害的干预措施数量多,有益干预措施的频率不足。
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引用次数: 31
Topography of the uretrovesical junction and proximal urethra in late pospartum continent primiparous after vaginal delivery and cesarean section intrapartum 阴道分娩和剖宫产后晚期大陆初产妇膀胱后结及近端尿道的地形特征
IF 1.2 Q3 Medicine Pub Date : 2011-09-01 DOI: 10.1590/S0100-72032011000900009
C. Santos
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引用次数: 0
Preservação da fertilidade: a importância de oferecer esta possibilidade às pacientes com doenças neoplásicas 保存生育能力:为肿瘤疾病患者提供这种可能性的重要性
IF 1.2 Q3 Medicine Pub Date : 2011-09-01 DOI: 10.1590/S0100-72032011000900001
F. P. Ferreira, J. S. Júnior, E. Motta
, as estimativas para o ano de 2010 previam a ocorrencia de 500 mil novos casos de câncer no Brasil, sendo que praticamente metade seria em mulheres, das quais 8 a 10% teriam menos de 40 anos. Dentre todos os tipos de cânceres em mulheres, o de mama responde por aproximadamente 50% e o de colo uterino por aproximadamente 20% dos casos. Nota-se a importância e a responsabilidade do especialista em Ginecologia no diagnostico e conducao destes casos. Ainda segundo o INCA, a sobrevida em 5 anos e de 61% para os tumores mamarios e de 49% para os tumores de colo uterino. Somente por esses dados epidemiologicos podemos notar quao grande e o problema e qual sua repercussao em saude publica. Mais da metade das mulheres acometidas por câncer de etiologia ginecologica estarao vivas apos cinco anos e grande parte delas em idade fertil, com provavel e possivel desejo reprodutivo.
据估计,2010年巴西将出现50万新癌症病例,其中近一半是女性,其中8 - 10%的人年龄在40岁以下。在所有类型的女性癌症中,乳腺癌约占50%,宫颈癌约占20%。我们注意到妇科专家在诊断和处理这些病例方面的重要性和责任。根据印加的数据,乳腺肿瘤的5年生存率为61%,宫颈肿瘤的5年生存率为49%。只有通过这些流行病学数据,我们才能注意到问题的严重性及其对公共健康的影响。受妇科癌症影响的妇女中,有一半以上在5岁后还活着,其中大多数是育龄妇女,有可能和可能的生育欲望。
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引用次数: 2
Fatores associados ao uso de suplemento de ácido fólico durante a gestação 与怀孕期间补充叶酸有关的因素
IF 1.2 Q3 Medicine Pub Date : 2011-09-01 DOI: 10.1590/S0100-72032011000900005
Lorena Barbosa, Davianne de Queiroz Ribeiro, F. Faria, L. N. Nobre, A. C. Lessa
OBJETIVO: Estimar a prevalencia de consumo de suplemento de acido folico durante a gestacao e identificar os fatores associados ao seu consumo. METODOS: Estudo transversal que incluiu 280 mulheres da cidade de Diamantina (MG). A variavel dependente foi o uso de suplemento de acido folico, e as independentes, a idade e escolaridade materna, paridade, numero de consultas de pre-natal, situacao marital e presenca ou nao de anemia. Utilizou-se analise de regressao de Poisson para avaliar a associacao das variaveis independentes com a variavel dependente. RESULTADOS: Mulheres com menor escolaridade, adolescentes e com numero de consultas de pre-natal inferior a sete apresentaram, respectivamente, 1,61 (IC95%=1,34-1,93), 1,18 (IC95%=1,03-1,35) e 1,18 (IC95%=1,02-1,37) mais chances de nao consumir o suplemento durante a gestacao. CONCLUSAO: A prevalencia de consumo de acido folico entre as gestantes foi baixa e associada a idade, escolaridade materna e ao numero de consultas pre-natal.
目的:评估妊娠期叶酸补充剂消费的患病率,并确定与叶酸补充剂消费相关的因素。方法:横断面研究包括280名来自Diamantina市(MG)的女性。因变量为叶酸补充剂的使用,独立变量为母亲的年龄和教育程度、胎次、产前咨询次数、婚姻状况和是否贫血。我们使用泊松回归分析来评估自变量和因变量之间的关系。结果:受教育程度较低、青少年和产前咨询次数少于7次的女性在怀孕期间不服用补充剂的可能性分别为1.61 (95% ci = 1.34 - 1.93)、1.18 (95% ci = 1.03 - 1.35)和1.18 (95% ci = 1.02 - 1.37)。结论:孕妇叶酸摄入量较低,与年龄、母亲教育程度和产前咨询次数有关。
{"title":"Fatores associados ao uso de suplemento de ácido fólico durante a gestação","authors":"Lorena Barbosa, Davianne de Queiroz Ribeiro, F. Faria, L. N. Nobre, A. C. Lessa","doi":"10.1590/S0100-72032011000900005","DOIUrl":"https://doi.org/10.1590/S0100-72032011000900005","url":null,"abstract":"OBJETIVO: Estimar a prevalencia de consumo de suplemento de acido folico durante a gestacao e identificar os fatores associados ao seu consumo. METODOS: Estudo transversal que incluiu 280 mulheres da cidade de Diamantina (MG). A variavel dependente foi o uso de suplemento de acido folico, e as independentes, a idade e escolaridade materna, paridade, numero de consultas de pre-natal, situacao marital e presenca ou nao de anemia. Utilizou-se analise de regressao de Poisson para avaliar a associacao das variaveis independentes com a variavel dependente. RESULTADOS: Mulheres com menor escolaridade, adolescentes e com numero de consultas de pre-natal inferior a sete apresentaram, respectivamente, 1,61 (IC95%=1,34-1,93), 1,18 (IC95%=1,03-1,35) e 1,18 (IC95%=1,02-1,37) mais chances de nao consumir o suplemento durante a gestacao. CONCLUSAO: A prevalencia de consumo de acido folico entre as gestantes foi baixa e associada a idade, escolaridade materna e ao numero de consultas pre-natal.","PeriodicalId":47257,"journal":{"name":"Revista Brasileira de Ginecologia e Obstetricia","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67234868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
Titrated oral suspension compared with vaginal misoprostol for labor induction: a randomized controlled trial 滴定口服混悬液与阴道米索前列醇用于引产的比较:一项随机对照试验
IF 1.2 Q3 Medicine Pub Date : 2011-09-01 DOI: 10.1590/S0100-72032011000900010
A. Souza
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引用次数: 1
Características epidemiológicas e nutricionais de gestantes vivendo com o HIV 艾滋病毒感染孕妇的流行病学和营养特征
IF 1.2 Q3 Medicine Pub Date : 2011-08-01 DOI: 10.1590/S0100-72032011000800004
T. Brandão, Kátia Silveira da Silva, Enilce Fonseca de Oliveira Sally, Marcos Augusto Bastos Dias, Claudia Silva, Vânia Matos Fonseca
PURPOSE:To describe the epidemiological profile and nutritional status of pregnant women infected with human immunodeficiency virus (HIV) and its effect on the nutritional status of these women during pregnancy. METHODS:A retrospective cohort study was conducted on 121 pregnant women with HIV infection, single fetus pregnancies, who received prenatal care and delivered at a referral unit for HIV-infected pregnant women during the period from 1997 to 2007. Outcomes of the study were the initial and final nutritional status as measured by body mass index, weight gain, anemia (hemoglobin <11 g/dL) and low birth weight. Bivariate analysis investigated the association of these outcomes with socio-demographic, clinical-care and dietary characteristics. We estimated the relative risks (RR) with 95% confidence intervals (CI).RESULTS:At the beginning of pregnancy, 11.0% of the women were underweight, and in late pregnancy, the prevalence was 29.3%. Low educational level, urinary infection and worm infestation were associated with low gestational weight in late pregnancy. The percentage of insufficient weight gain was 47.5%, with well-nourished pregnant women (RR=3.3 95%CI 1.3–8.1) and women with no companion (RR=1.5 95%CI 1.1–2.2) having a higher risk for this outcome. The prevalences of overweight at the beginning and at the end of pregnancy were 26.8 and 29.4, respectively. There was a significant prevalence of anemia (61.0%). CONCLUSIONS: The high percentage of negative nutritional outcomes identified at this referral service with multidisciplinary care for pregnant women living with HIV reveals the need to establish more effective strategies to deal with the complex context of HIV.
目的:描述感染人类免疫缺陷病毒(HIV)的孕妇的流行病学概况和营养状况及其对这些妇女孕期营养状况的影响。方法:对1997年至2007年期间在HIV感染孕妇转诊单位接受产前护理并分娩的121例HIV感染单胎孕妇进行回顾性队列研究。该研究的结果是通过体重指数、体重增加、贫血(血红蛋白<11 g/dL)和低出生体重来衡量的初始和最终营养状况。双变量分析调查了这些结果与社会人口统计学、临床护理和饮食特征的关系。我们以95%的置信区间(CI)估计相对风险(RR)。结果:妊娠初期体重过轻者占11.0%,妊娠后期体重过轻者占29.3%。低文化程度、尿路感染和寄生虫感染与妊娠后期低体重有关。体重增加不足的比例为47.5%,营养良好的孕妇(RR=3.3 95%CI 1.3-8.1)和无伴孕的孕妇(RR=1.5 95%CI 1.1-2.2)出现这一结果的风险更高。妊娠初期和妊娠末期的超重患病率分别为26.8和29.4。有明显的贫血患病率(61.0%)。结论:在多学科护理的HIV感染孕妇转诊服务中发现的高比例的不良营养结果表明,需要建立更有效的策略来处理复杂的HIV环境。
{"title":"Características epidemiológicas e nutricionais de gestantes vivendo com o HIV","authors":"T. Brandão, Kátia Silveira da Silva, Enilce Fonseca de Oliveira Sally, Marcos Augusto Bastos Dias, Claudia Silva, Vânia Matos Fonseca","doi":"10.1590/S0100-72032011000800004","DOIUrl":"https://doi.org/10.1590/S0100-72032011000800004","url":null,"abstract":"PURPOSE:To describe the epidemiological profile and nutritional status of pregnant women infected with human \u0000immunodeficiency virus (HIV) and its effect on the nutritional status of these women during pregnancy. METHODS:A \u0000retrospective cohort study was conducted on 121 pregnant women with HIV infection, single fetus pregnancies, who \u0000received prenatal care and delivered at a referral unit for HIV-infected pregnant women during the period from 1997 \u0000to 2007. Outcomes of the study were the initial and final nutritional status as measured by body mass index, weight \u0000gain, anemia (hemoglobin <11 g/dL) and low birth weight. Bivariate analysis investigated the association of these \u0000outcomes with socio-demographic, clinical-care and dietary characteristics. We estimated the relative risks (RR) with \u000095% confidence intervals (CI).RESULTS:At the beginning of pregnancy, 11.0% of the women were underweight, \u0000and in late pregnancy, the prevalence was 29.3%. Low educational level, urinary infection and worm infestation were \u0000associated with low gestational weight in late pregnancy. The percentage of insufficient weight gain was 47.5%, with \u0000well-nourished pregnant women (RR=3.3 95%CI 1.3–8.1) and women with no companion (RR=1.5 95%CI 1.1–2.2) \u0000having a higher risk for this outcome. The prevalences of overweight at the beginning and at the end of pregnancy \u0000were 26.8 and 29.4, respectively. There was a significant prevalence of anemia (61.0%). CONCLUSIONS: The high \u0000percentage of negative nutritional outcomes identified at this referral service with multidisciplinary care for pregnant \u0000women living with HIV reveals the need to establish more effective strategies to deal with the complex context of HIV.","PeriodicalId":47257,"journal":{"name":"Revista Brasileira de Ginecologia e Obstetricia","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67234819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Importância da experimentação animal em ginecologia e obstetrícia 动物实验在妇产科中的重要性
IF 1.2 Q3 Medicine Pub Date : 2011-07-01 DOI: 10.1590/S0100-72032011000700001
R. Simões, Luiz Kulay Júnior, E. Baracat
{"title":"Importância da experimentação animal em ginecologia e obstetrícia","authors":"R. Simões, Luiz Kulay Júnior, E. Baracat","doi":"10.1590/S0100-72032011000700001","DOIUrl":"https://doi.org/10.1590/S0100-72032011000700001","url":null,"abstract":"","PeriodicalId":47257,"journal":{"name":"Revista Brasileira de Ginecologia e Obstetricia","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67234780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
期刊
Revista Brasileira de Ginecologia e Obstetricia
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