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A questão do aborto no Brasil 巴西的堕胎问题
IF 1.2 Q3 Medicine Pub Date : 2010-03-01 DOI: 10.1590/S0100-72032010000300001
Elizabeth Meloni Vieira
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引用次数: 8
Perfil epidemiológico e resultados perinatais em pacientes com síndromes hipertensivas na gravidez 妊娠高血压综合征患者的流行病学概况和围产期结果
IF 1.2 Q3 Medicine Pub Date : 2010-02-01 DOI: 10.1590/S0100-72032010000200011
Eugenia Carla Sousa Batista
obter o perfil epidemiologico e resultados perinatais de pacientes com diagnostico de hipertensao na gravidez. Analisar a hipertensao grave, presente nas patologias pre-eclâmpsia grave, pre-eclâmpsia superposta a hipertensao cronica, sindrome HELLP e eclâmpsia, como fator de risco para complicacoes maternas e neonatais em relacao a sindromes hipertensivas menos graves como pre-eclâmpsia leve, hipertensao cronica e hipertensao gestacional. Sujeitos e metodos: realizou-se estudo transversal na Maternidade-Escola Assis Chateaubriand entre junho de 2007 e agosto de 2008 com 201 pacientes com sindromes hipertensivas na gravidez. Agruparam-se pacientes com sindromes hipertensivas mais graves e seus desfechos perinatais usando o teste do qui-quadrado e seguiu-se analise comparativa de suas caracteristicas socio-demograficas e obstetricas e resultados perinatais com mulheres com sindromes hipertensivas menos graves. Para mensurar a magnitude do risco foi calculado o odds ratio. Resultados: observaram-se 81,6% de pacientes pertencentes ao grupo da hipertensao mais grave, sendo 52,7% de pre-eclâmpsia grave. As pacientes nuliparas representaram 47%, sobrepeso 41% e obesidade 38%. Encontrou-se 44,2% de prematuridade, 37% recem-nascidos com peso abaixo de 2.500g e taxa de 65 obitos por mil nascidos vivos. A analise comparativa das caracteristicas das mulheres e resultados perinatais em sindromes hipertensivas graves em relacao as menos graves nao mostrou associacao significativa pelo odds ratio. Conclusao: o perfil das mulheres com sindromes hipertensivas graves foi similar ao de pacientes com quadros menos graves. Destacaram-se alta incidencia de pre-eclâmpsia grave, sobrepeso e obesidade e altas taxas de prematuridade e de obito neonatal. Nao foi observada diferenca entre o comprometimento neonatal conforme os grupos de sindromes.
获得妊娠期高血压患者的流行病学概况和围产期结果。分析重度高血压,存在于重度子痫前期、重度子痫前期与慢性高血压、help综合征和子痫,作为母婴并发症的危险因素,与轻度子痫前期、慢性高血压和妊娠高血压等较轻高血压综合征相关。研究对象和方法:2007年6月至2008年8月在阿西斯夏多布里昂妇产学校进行了一项横断面研究,研究对象为201名妊娠期高血压综合征患者。采用卡方检验对严重高血压综合征患者及其围产期结局进行分组,并对其社会人口学特征、产科特征和围产期结局与不严重高血压综合征女性进行比较分析。为了测量风险的大小,计算优势比。结果:81.6%的患者属于最严重的高血压组,52.7%的患者属于严重的子痫前期。未产患者占47%,超重41%,肥胖38%。我们发现44.2%的早产儿,37%的新生儿体重低于2500克,每千名活产婴儿中有65人死亡。对妇女特征和围产期结果的比较分析显示,严重高血压综合征与不严重高血压综合征的比值比没有显著相关性。结论:患有严重高血压综合征的女性与病情较轻的患者相似。他们强调了严重子痫前期、超重和肥胖的高发生率以及早产和新生儿死亡率的高发生率。在不同的综合征组中,没有观察到新生儿受累的差异。
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引用次数: 0
Gestação monoamniótica e entrelaçamento de cordão umbilical: relato de caso e revisão de literatura 单羊膜妊娠与脐带交错:病例报告及文献综述
IF 1.2 Q3 Medicine Pub Date : 2010-02-01 DOI: 10.1590/S0100-72032010000200008
Marcelo Luís Nomura, Cleide Mara Mazotti Franzin, Helaine Milanez, E. F. Marussi, João Luiz Pinto e Silva
Monoamniotic twin pregnancies are very rare, but they are associated with high fetal morbidity and mortality. There is much controversy regarding the follow-up and obstetric procedures towards prenatal diagnosis of intertwined umbilical cords. In this article, we describe a case of monoamniotic pregnancy with diagnosis of intertwined umbilical cords, and we discuss aspects related to the follow-up and obstetric procedures through a brief literature review.
单羊膜双胎妊娠是非常罕见的,但它们与高胎儿发病率和死亡率有关。关于缠绕脐带的产前诊断的随访和产科程序有很多争议。在这篇文章中,我们描述了一例单羊膜妊娠与交织脐带的诊断,并通过简要的文献回顾,我们讨论了与随访和产科程序有关的方面。
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引用次数: 0
Quality of life, satisfaction with surgery and shoulder-arm morbidity in breast cancer survivors submitted to quadrantectomy or mastectomy with immediate breast reconstruction 生活质量,手术满意度和肩臂发病率的乳腺癌幸存者提交的象限切除术或乳房切除术立即乳房重建
IF 1.2 Q3 Medicine Pub Date : 2010-02-01 DOI: 10.1590/S0100-72032010000200009
Renata Freitas-Silva
ObjetivOs: comparar a prevalência de morbidade no ombro e braço, satisfação com a cirurgia e a qualidade de vida (QV) de mulheres submetidas à quadrantectomia às daquelas submetidas à mastectomia radical modificada (MRM) com reconstrução imediata (RI) da mama. MétOdOs: conduziu-se estudo de corte transversal incluindo mulheres com câncer de mama, que haviam se submetido à quadrantectomia ou à MRM+RI com retalho miocutâneo transverso do músculo reto abdominal e que apresentavam pelo menos seis meses de término do tratamento. Foram investigados os movimentos de abdução, flexão, extensão, rotação interna e rotação externa do ombro. A QV foi avaliada através do questionário Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Foram incluídas 44 mulheres submetidas à quadrantectomia e 26 à MRM+RI. Resultados: a prevalência de linfedema foi de 12% no grupo de MRM+RI e 18% na quadrantectomia (OR:0,51; p=0,66). As mulheres submetidas à quadrantectomia apresentaram maior prevalência de restrição do movimento de rotação interna do ombro (OR:7,23; p=0,03). Não houve diferença nos escores de QV e da satisfação com a cirurgia. Quando as participantes foram questionadas se optariam por outra técnica cirúrgica, 25% no grupo de MRM+RI e 12% no grupo de quadrantectomia referiram que fariam uma escolha diferente (OR:7,4; p=0,09). COnClusões: nossos dados sugerem que o tipo de cirurgia não influenciou a ocorrência de linfedema. A quadrantectomia aumentou a chance de restrição do movimento do ombro. Observou-se ainda que a técnica cirúrgica apresentou impacto semelhante na QV e na satisfação da mulher com a cirurgia.
目的:比较接受四分位切除术的女性与接受改良根治性乳房切除术(MRM)和立即乳房重建(ir)的女性肩部和手臂的发病率、手术满意度和生活质量(qol)。方法:我们进行了一项横断面研究,包括接受过腹直肌横皮皮瓣四分位切除术或MRM+RI的乳腺癌女性,并且治疗结束至少6个月。研究肩外展、屈伸、内旋和外旋的运动。采用医疗结果研究36项简表健康调查(SF-36)对生活质量进行评估。44名女性接受了四分位切除术,26名接受了MRM+ ir。结果:MRM+RI组淋巴水肿发生率为12%,四分位切除术组淋巴水肿发生率为18%(或:0.51;p < 0.05)p = 66)。女人受到quadrantectomia患病率的肩内旋运动的限制(或者:7,23;p = 0。03)。生活质量评分和手术满意度无差异。当参与者被问及optariam手术技术,25%在rmn +组群quadrantectomia笑、12%表示,他们选择不同的(或:7、4;p = 0 - 9)。结论:我们的数据表明手术类型不影响淋巴水肿的发生。四分位切除术增加了限制肩部活动的机会。我们还观察到,手术技术对生活质量和女性对手术的满意度有相似的影响。
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引用次数: 2
O estudo Doppler da função cardíaca fetal e da artéria umbilical na rotura prematura das membranas amnióticas pré-termo 早产羊膜过早破裂对胎儿心功能和脐动脉的多普勒研究
IF 1.2 Q3 Medicine Pub Date : 2009-12-01 DOI: 10.1590/S0100-72032009001200011
Ana Lúcia Letti Müller
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引用次数: 1
Avaliação da proporção de colágeno no tecido uterino antes e após tratamento do leiomioma uterino pela embolização arterial 动脉栓塞治疗子宫平滑肌瘤前后子宫组织胶原蛋白比例的评价
IF 1.2 Q3 Medicine Pub Date : 2009-12-01 DOI: 10.1590/S0100-72032009001200004
C. Bonduki, Gilmar Jorge de Oliveira Júnior, Andresa Bernardo, M. Simões, R. Castro, Mariano Tamura Vieira Gomes, M. J. B. C. Girão
PURPOSE: to analyze histomorphometric consequences of the uterine arteries embolization (UAE) in the uterine tissue, especially by collagen tissue quantification through uterine biopsy, before and after treatment of uterine leiomyoma. METHODS: 15 patients with symptomatic leyomioma and/or infertility, submitted to UAE, participated in the study according to the study exclusion criteria, after having signed an informed consent. Uterine biopsy was performed in the secretory phase of the menstrual cycle, before and three months after the procedure, to evaluate the collagen. After the histological processing of the material, 3 µ slices were prepared, some of them dyed with hematoxiline-eosin (HE) and others with the specific dye for collagen fibers (Picrosirius red). Then, the slides were examined and interpreted, and the collagen quantified. The amount was calculated as the percent of the area composed by collagen, and the result expressed in mean±standard deviation (SD). Data has then been submitted to statistical analysis by Student's paired t test (p<0.05). RESULTS: the presence of smooth muscle cells was observed in the biopsies performed before the treatment, surrounded by a rich network of collagen fibers, which are part of the tumor, blood vessels and fibroblast nuclei. On the slides of biopsies performed after the treatment, it was observed the presence of widespread coagulation necrosis, vascular thrombosis, calcification and lymphoplasmocitary infiltration areas and clear reduction of the collagen component. The percentage of collagen fibers was higher in the pre-UAE group (84.07±1.41), than in the post-UAE (81.05±1.50) group, with p<0.0001, and 95% confidence interval (CI95%) from 2.080 to 3.827. CONCLUSION: the quantitative and qualitative collagen reduction clearly shows that the proposed treatment is efficient in reducing the tumoral mass, composed mainly by collagen fibers intermingled with neoplasic smooth muscle cells. Nevertheless, complementary studies are needed to investigate the functional and biological consequences of these histological changes.
目的:分析子宫肌瘤治疗前后子宫动脉栓塞(UAE)对子宫组织的组织形态学影响,特别是通过子宫活检进行胶原组织定量分析。方法:提交给UAE的15例有症状性leyomioma和/或不孕症患者,在签署知情同意书后,按照研究排除标准参加研究。在月经周期的分泌期,手术前和手术后三个月进行子宫活检,以评估胶原蛋白。对材料进行组织学处理后,制备3µ片,部分用苏木希林-伊红(HE)染色,部分用胶原纤维特异性染料(Picrosirius红)染色。然后,检查和解释载玻片,并定量胶原蛋白。量以胶原占面积的百分比计算,结果以均数±标准差(SD)表示。然后将数据提交学生配对t检验进行统计分析(p<0.05)。结果:在治疗前进行的活检中观察到平滑肌细胞的存在,被丰富的胶原纤维网络包围,胶原纤维是肿瘤、血管和成纤维细胞核的一部分。在治疗后进行的活检切片上,观察到广泛存在凝血坏死、血管血栓、钙化和淋巴浆细胞浸润区,胶原成分明显减少。uae前组胶原纤维百分比(84.07±1.41)高于uae后组(81.05±1.50),p<0.0001, 95%可信区间(CI95%)为2.080 ~ 3.827。结论:定量和定性的胶原蛋白减少清楚地表明,所提出的治疗方法有效地减少了肿瘤肿块,主要由胶原纤维与肿瘤平滑肌细胞混合组成。然而,需要补充研究来调查这些组织学变化的功能和生物学后果。
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引用次数: 2
Perceived quality of life of postpartum teenagers 产后青少年感知生活质量
IF 1.2 Q3 Medicine Pub Date : 2009-12-01 DOI: 10.1590/S0100-72032009001200012
A. M. Abeche
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引用次数: 0
Clinical usefulness of inhibin assays in Gynecology and Obstetrics 抑制素检测在妇产科的临床应用
IF 1.2 Q3 Medicine Pub Date : 2009-12-01 DOI: 10.1590/S0100-72032009001200008
F. Reis, C. P. Rezende
The main source of inhibin B in women is the growing follicle granulosa cells, while inhibin A is mainly produced by the corpus luteum and the placenta. In infertile women submitted to therapies of assisted reproduction, inhibin B has shown to be useful to predict a poor ovulatory response, though it has not yet overcome the performance of other markers. In the pre-natal screening of the Down syndrome, inhibin A has been repeatedly confirmed as useful in the second trimester and has also started to be considered in the first trimester test battery. Besides the two applications above, the dosage of total inhibin may contribute to the identification of cases of autoimmune ovarian insufficiency. Total inhibin may also be an auxiliary marker in the diagnosis of ovarian epithelial tumors, while the amount of inhibin B helps in the diagnosis of granulosa cells tumors. The use of inhibin A may be extended to the evaluation of pregnant women with risk of abortion, with a history of repeated abortion, with increased risk of pre-eclampsia, or even in the first days of follow-up of hydatiform mole post-emptying. All those applications are still under study, but with a real possibility of helping to extend the diagnostic spectrum of inhibin dosage in Gynecology and Obstetrics.
抑制素B在女性体内的主要来源是生长中的卵泡颗粒细胞,而抑制素A主要由黄体和胎盘产生。在接受辅助生殖治疗的不孕妇女中,抑制素B已被证明对预测排卵不良反应有用,尽管它尚未克服其他标记物的表现。在唐氏综合症的产前筛查中,抑制素A已被反复证实在妊娠中期有用,并且在妊娠早期测试中也开始考虑使用抑制素A。除了上述两种应用外,总抑制素的剂量可能有助于自身免疫性卵巢功能不全的鉴定。总抑制素也可作为卵巢上皮性肿瘤诊断的辅助指标,而抑制素B的量有助于颗粒细胞肿瘤的诊断。抑制素A的应用可扩展到有流产风险的孕妇、有反复流产史的孕妇、先兆子痫风险增高的孕妇,甚至在胎体胎腔排空后随访第一天的孕妇。所有这些应用仍在研究中,但确实有可能帮助扩大抑制素在妇产科剂量的诊断范围。
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引用次数: 1
Hormonal therapy with estradiol and testosterone implants: bone protection 雌激素和睾酮植入激素治疗:骨骼保护
IF 1.2 Q3 Medicine Pub Date : 2009-12-01 DOI: 10.1590/S0100-72032009001200009
R. Britto
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引用次数: 0
Avaliação do glicocódigo do carcinoma ductal invasivo mamário e sua correlação com dados clínicos e histopatológicos 乳腺浸润性导管癌糖编码的评价及其与临床和组织病理学资料的相关性
IF 1.2 Q3 Medicine Pub Date : 2009-12-01 DOI: 10.1590/S0100-72032009001200010
M. Rêgo
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引用次数: 0
期刊
Revista Brasileira de Ginecologia e Obstetricia
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