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Acurácia diagnóstica da histerossalpingografia e da ultra-sonografia para avaliação de doenças da cavidade uterina em pacientes com abortamento recorrente Diagnostic accuracy of hysterosalpingography and transvaginal sonography to evaluate uterine cavity diseases in patients with recurrent miscarriage

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Évelyn Traina

2004-01-01

Full Text Available OBJETIVO: avaliar a acurácia da histerossalpingografia e da ultra-sonografia transvaginal bidimensional para o diagnóstico de defeitos uterinos em pacientes com aborto recorrente. MÉTODOS: oitenta pacientes com história de dois ou mais abortos espontâneos consecutivos foram submetidas a histerossalpingografia, ultra-sonografia bidimensional pélvica e transvaginal e histeroscopia ambulatorial. Os achados foram divididos em três grupos: alterações da forma, sinéquias e lesões polipóides. A histeroscopia foi considerada padrão-ouro. A concordância entre os diferentes métodos foi avaliada pelo coeficiente kappa e sua significância foi testada. O nível de significância adotado foi de 0,05 (alfa=5%. Sensibilidade, especificidade, valores preditivos positivo e negativo, com intervalos de confiança de 95%, foram calculados. RESULTADOS: defeitos cavitários foram diagnosticados em 29 (36,3% pacientes, sendo 11 (13,7% alterações da forma, 17 (21,3% sinéquias e uma (1,3% lesão polipóide. A concordância global da histerossalpingografia com a histeroscopia foi de 85,0%, ao passo que da ultra-sonografia foi de apenas 78,7%. Os melhores resultados da histerossalpingografia foram obtidos para os diagnósticos de alterações da forma e sinéquias (acurácia de, respectivamente, 97,5 e 95%. Para lesões polipóides, a histerossalpingografia teve acurácia de apenas 92,5%, devido ao baixo valor preditivo positivo (14,3%. A ultra-sonografia teve acurácia inferior para todos os diagnósticos, 93,7% para alterações da forma e 85% para detecção de sinéquias, às custas principalmente de baixa sensibilidade. CONCLUSÕES: a histerossalpingografia revelou boa acurácia diagnóstica para a pesquisa da cavidade uterina em pacientes com aborto recorrente. A ultra-sonografia mostrou especificidade alta, porém com baixa sensibilidade.PURPOSE: to evaluate the diagnostic accuracy of hysterosalpingography (HSG and transvaginal sonography (TVS in
Evolução do comprimento cervical uterino na gestação, avaliado pela ultra-sonografia transvaginal Changes in cervical length during pregnancy measured by transvaginal ultrasound

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Reginaldo Antônio de Oliveira Freitas-Júnior

2003-03-01

Full Text Available OBJETIVO: analisar a evolução do comprimento cervical uterino, ao longo da gestação, avaliado por meio da ultra-sonografia transvaginal. MÉTODOS: foi realizado estudo prospectivo, longitudinal, no qual 82 gestantes hígidas foram acompanhadas desde o início da gestação, das quais 49 mantiveram o seguimento até o parto sem complicações da gravidez, sendo examinadas a cada quatro semanas, e agrupadas, conforme a paridade, em nulíparas ou com um ou mais partos anteriores. O comprimento do colo uterino foi avaliado em vista sagital pela ultra-sonografia transvaginal, com a medida linear da distância entre os orifícios cervicais interno e externo. RESULTADOS: as médias de comprimento do colo uterino, bem como os percentis 5, 25, 50, 75 e 95, em função da idade gestacional, não diferiram significativamente entre os grupos estudados (p>0.05. No intervalo entre a 20ª e a 24ª semana gestacional o comprimento cervical variou entre 28, 35 e 47,2 mm, com os percentis 5, 50 e 95, respectivamente. O comprimento cervical uterino diminuiu progressivamente ao longo da gestação normal, sendo esse encurtamento significativo após a 20ª semana de gravidez e mais expressivo após a 28ª semana (pPURPOSE: to establish a normality curve of cervical length during pregnancy measured by transvaginal ultrasonography. METHODS: we conducted a prospective, longitudinal study on 82 healthy pregnant women who were followed up from the beginning of pregnancy to delivery at four-week intervals, of whom 49 concluded the study. Patients were divided according to parity into nulliparous women and women with one or more previous deliveries. Cervical length was measured in a sagittal view by transvaginal ultrasonography, as the linear distance between internal and external cervical os. RESULTS: no significant difference was observed in mean cervical length or the 5th, 25, 50th, 75th, or 95th percentile according to gestational age between groups (p>0
Prevenção do parto prematuro: emprego do toque vaginal e da ultra-sononografia transvaginal Prevention of preterm birth: use of digital examination and transvaginal ultrasonography

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Arlete Ayako Yamasaki

1998-07-01

Full Text Available Objetivo: avaliar o colo uterino por meio do toque vaginal e da ultra-sonografia transvaginal em gestantes de risco elevado para o parto prematuro. Métodos: durante o período compreendido entre fevereiro de 1995 e setembro de 1997 foram acompanhadas 38 gestantes com elevado risco para o parto prematuro entre a 20ª e 36ª semana de gestação. Estas pacientes foram submetidas semanalmente ao toque vaginal e ao exame ultra-sonográfico transvaginal. O toque vaginal avaliou o colo uterino quanto a dois parâmetros: comprimento e dilatação. A ultra-sonografia transvaginal estudou o comprimento e o diâmetro anteroposterior do colo uterino. Foram analisados os comportamentos destas medidas cervicais ao longo da gestação. Os dois métodos foram comparados quanto à avaliação cervical e à acurácia no diagnóstico do parto prematuro. Resultados: a incidência de partos prematuros foi de 18,4% (7/38. As medidas do comprimento cervical obtidas pela ultra-sonografia foram sempre maiores em relação às medidas obtidas pelo toque vaginal. Mediante análise pelo teste de hipóteses foram observadas uma relação indireta entre o comprimento cervical e a idade gestacional por meio do toque e do estudo ultra-sonográfico (pObjective: to evaluate the uterine cervix by digital and transvaginal ultrasound examinations in pregnant women at high risk of having premature delivery. Methods: during the period between February 1995 and September 1997, 38 pregnant women at high risk of having premature delivery between the 20th and 36th week of gestation were examined. These patients were submitted weekly to both digital and transvaginal ultrasound examinations. The digital examination evaluated the uterine cervix using two parameters: length and dilation. The transvaginal ultrasound studied the length and the anteroposterior diameter of the uterine cervix. The behavior of these cervical measurements was analyzed throughout the pregnancies. The two methods
Valor da ultra-sonografia na avaliação das alterações endometriais em pacientes tratadas com tamoxifeno Value of sonographic endometrial findings in patients under tamoxifen therapy

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Arildo Corrêa Teixeira

2007-12-01

Full Text Available OBJETIVO: Avaliar as alterações endometriais por meio da ultra-sonografia transvaginal e correlacioná-las com os achados da histeroscopia e histologia, em pacientes submetidas a tratamento com tamoxifeno. MATERIAIS E MÉTODOS: No período de janeiro de 2003 a dezembro de 2005, foram incluídas pacientes com câncer de mama usuárias de tamoxifeno que apresentaram espessamento endometrial acima de 5 mm. Os achados foram correlacionados com os dados de histeroscopia e anatomopatologia. RESULTADOS: Foram selecionadas 25 pacientes com idade média de 62,6 anos. O tempo médio do diagnóstico do câncer foi de 4,3 anos e do uso de tamoxifeno, três anos. Vinte pacientes eram assintomáticas (80% e as demais apresentaram sangramento (20%. À ultra-sonografia, 16% apresentaram espessamento endometrial entre 5 mm e 8 mm, 40% entre 9 mm e 15 mm, e 44% acima de 15 mm. Ao estudo com a histeroscopia, 40% apresentaram atrofia, 16% atrofia cística, 28% pólipos, e 16% lesão hiperplásica. O estudo anatomopatológico apresentou-se normal em 35,2% dos casos e mostrou atrofia em 5,8%, pólipo em 29,4% e hiperplasia em 11,7%. Foi observado um caso de adenocarcinoma (5,8%. CONCLUSÃO: A ultra-sonografia associada à histeroscopia apresentam-se como importantes aliados na avaliação de pacientes usuárias de tamoxifeno. A detecção de espessamento endometrial à ultra-sonografia apresenta baixa especificidade, enquanto a histeroscopia é mais acurada na detecção de pólipos, hiperplasia e alterações neoplásicas.OBJECTIVE: To evaluate endometrial alterations by means of transvaginal ultrasound and to correlate them with hysteroscopic and histological findings in patients under tamoxifen therapy. MATERIALS AND METHODS: The present study was developed in the period between January 2003 and December 2005, including patients under tamoxifen therapy for breast cancer, and presenting with endometrial thickening > 5 mm. The sonographic findings were correlated
Achados histeroscópicos em mulheres na pós-menopausa com diagnóstico de espessamento endometrial por ultra-sonografia transvaginal Hysteroscopic findings in postmenopausal women with endometrial thickening diagnosed by transvaginal ultrasound

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Adriana Bittencourt Campaner

2004-02-01

Full Text Available OBJETIVO: correlacionar espessamento endometrial diagnosticado por ultra-sonografia com os achados histeroscópicos, em mulheres na pós-menopausa. MÉTODOS: foi realizado estudo transversal com avaliação histeroscópica em 121 mulheres na pós-menopausa, com diagnóstico de espessamento do endométrio por ultra-sonografia transvaginal. Das pacientes incluídas, 23 (19% recebiam diferentes esquemas de hormonioterapia e 98 não referiam uso de reposição hormnonal.; 55 pacientes queixavam-se de sangramento por via vaginal e as restantes apresentavam-se sem esta condição. Os exames endoscópicos foram realizados ambulatorialmente, utilizando-se histeroscópio rígido de 4 mm. Para a distensão da cavidade uterina empregou-se gás carbônico (CO2. Biópsia foi praticada em todas as pacientes, com auxílio de cureta tipo Novak, de 3 mm, e o material obtido submetido a estudo histopatológico. RESULTADOS: a espessura do endométrio variou entre 6 e 38 mm, com média de 10,7 ± 5,3 mm. Os achados histeroscópicos foram: lesão polipóide, em 51 pacientes (42,1%; endométrio atrófico, em 15 (12,4%; sinéquia senil, em 15 (12,4%; espessamento focal, em 13 (10,7%; lesão cerebróide, em 6 (5,0%; endométrio proliferativo, em 5 (4,1%; muco, em 5 (4,1%; mioma, em 4 (3,3%; endométrio secretor, em 3 (2,5%; hiperplasia endometrial, em 3 (2,5% e atrofia cística, em 1 (0,8%. Observou-se correlação entre os achados histeroscópicos e os resultados da histopatologia em 30 dos 51 casos de pólipo, em 12 dos 15 de endométrio atrófico e na totalidade dos casos sugestivos de hiperplasia endometrial e de adenocarcinoma. CONCLUSÃO: na maioria das pacientes, o exame histeroscópico revelou que não se tratava de real espessamento endometrial, mas sim de outras variedades de lesão da cavidade uterina.PURPOSE: to correlate endometrial thickening diagnosed by ultrasonography with hysteroscopic findings in postmenopausal women. METHODS: a transversal study
Validação da curva normal de peso fetal estimado pela ultra-sonografia para o diagnóstico do peso neonatal

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Cecatti José Guilherme; Machado Maria Regina Marrocos; Krupa Fabiana da Graça; Figueiredo Priscila Garcia; Pires Helaine Maria Besteti

2003-01-01

OBJETIVO: avaliar a concordância entre o peso fetal estimado (PFE) por ultra-sonografia e o neonatal, o desempenho da curva normal de PFE por idade gestacional no diagnóstico de desvios do peso fetal/neonatal e fatores associados. MÉTODOS: participaram do estudo 186 grávidas atendidas de novembro de 1998 a janeiro de 2000, com avaliação ultra-sonográfica até 3 dias antes do parto, determinação do PFE e do índice de líquido amniótico e parto na instituição. O PFE foi calculado e classificado d...
Acurácia diagnóstica do espessamento ecogênico periportal à ultra-sonografia e da histopatologia no diagnóstico diferencial da atresia biliar

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Roquete,Mariza L. V.; Ferreira,Alexandre R.; Fagundes,Eleonora D. T.; Castro,Lúcia P. F.; Silva,Rogério A. P.; Penna,Francisco J.

2008-01-01

OBJETIVOS: Definir a sensibilidade, especificidade e a acurácia do espessamento ecogênico periportal à ultra-sonografia e da histopatologia hepática, isolados ou em conjunto, na distinção diagnóstica entre atresia biliar e as colestases intra-hepáticas. MÉTODOS: Trata-se de estudo retrospectivo realizado entre janeiro de 1990 e dezembro de 2004. Foram analisados 51 casos de atresia biliar e 45 com colestase intra-hepática. A histopatologia foi realizada por uma patologista de forma cega. O es...
Papel da ultra-sonografia na avaliação da efusão pleural The role of ultrasound in the assessment of pleural effusion

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Adilson Cunha Ferreira

2006-04-01

Full Text Available A efusão pleural, antigamente denominada derrame pleural, é caracterizada pelo acúmulo de líquido no espaço pleural, em decorrência do desequilíbrio entre formação e reabsorção de fluido ou por alteração na drenagem linfática. O propósito desta revisão foi estabelecer a importância da aplicação da ultra-sonografia no diagnóstico de efusão pleural. Os autores discutem a aplicação da ultra-sonografia no diagnóstico e abordagem terapêutica dessa entidade, e ressaltam sua importância nas doenças do tórax, vantagens, limitações e desvantagens em relação a radiografia simples, tomografia computadorizada e exame físico. Discutem, ainda, o conceito de efusão pleural, sua fisiopatologia, morbidade, mortalidade, principais causas e apresentação clínica. A técnica de realização do exame é sistematicamente abordada, tanto pela via torácica quanto abdominal.The pleural effusion, formerly called pleural spill, is an accumulation of fluid in the pleural space, as a consequence of an imbalance between the formation and reabsorption of such fluid, or due to an alteration in the drainage to lymph nodes. The purpose of this bibliographic review is to establish the importance of the use of ultrasound in pleural diffusion diagnosis. The authors discuss the use of ultrasonography in the diagnosis and therapeutic approach of this disease, and stress the importance of ultrasonography in chest diseases diagnosis, its advantages, limitations and disadvantages when compared to the common x-ray, computed tomography and physical examination. The authors also discuss the definition of pleural effusion, its physiopathology, morbidity, mortality, main causes and clinical presentation. The examination technique is systematically approached both by thoracic and abdominal pathways.
Uso da ultra-sonografia na triagem de disrafismos espinhais ocultos Screening of occult spinal dysraphism by ultrasonography

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José Gilberto de Brito Henriques

2004-09-01

Full Text Available O uso da ultra-sonografia para diagnóstico de lesões da coluna vertebral é difundido desde a década de oitenta. Suas aplicações envolvem: diagnóstico de lesões medulares traumáticas; uso intra-operatório em cirurgias do trauma e tumores medulares; uso pré-operatório e evolutivo em pacientes com disrafismos espinhais; diagnóstico pré-natal dos disrafismos; diagnóstico dos disrafismos espinhais ocultos ao nascimento. Pacientes com suspeita de disrafismo espinhal oculto (estigmas cutâneos em linha média ou história familiar de disrafismos representaram a principal indicação do exame que foi realizado em 292 pacientes do Hospital das Clínicas da Universidade Federal de Minas Gerais. Alterações como lipomas do cone medular, medula baixa, filo terminal espesso, cistos da ponta do cone medular e seios dérmicos foram identificados com fidelidade à ultra-sonografia. A interpretação do exame não apresentou dificuldades técnicas. Sua realização é rápida, não é necessária sedação, apresenta baixo custo e idealmente deve ser realizado pelo próprio neurocirurgião devido ao grande número de informações possíveis durante o exame. O exame entretanto não substitui a ressonância magnética mas pode ser um bom método de triagem para os pacientes.Ultrasonography for diagnosis of spinal cord diseases has been used since the eighties. There are different fields for its use: traumatic spine lesions, intra-operative use in trauma and spine tumors surgery, pre-operative and follow up study for spinal dysraphism, occult spinal dysraphism of the newborn. Patients with suspected occult spinal dysraphism are the most important indication for the method. Utrasonography was performed in 292 patients of Hospital das Clínicas, Universidade Federal de Minas Gerais. Lesions such as conus medullaris lipomas, low level of conus medullaris, filum terminale tethering, cauda equina cysts and dermal sinuses can be well demonstrated. There
Ultrasonography as a predicting tool for carcass traits of young bulls Ultra-sonografia para predição das características da carcaça de bovinos jovens em confinamento

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Liliane Suguisawa

2003-12-01

Full Text Available Considerable resources have been allocated to support research in the development of non-invasive and non-destructive techniques for carcass composition and quality evaluation. Ultrasonography is a reliable and relatively low-cost technique that can be used. In the present study, real-time ultrasonography was used to predict ribeye area (REA and subcutaneous fat thickness (FT in live animals as compared to carcass measurements. Animals used were 115 yearling bull calves (initial body weight, 329 kg, kept under feedlot conditions, of four genetic groups (30, ½ Angus x Nellore; 30, ½ Canchim x Nellore; 30, ½ Simmental x Nellore, and 25 Nellore, and two finishing frame sizes (small and large. Four ultrasonographic measurements were taken every 28 days until slaughter. Predictive precision of ultrasonographic measurements increased as animals approached slaughter, reaching maximum values at the last measurement (R²=0.68 and 0.82 for REA and FT, respectively. FT carcass measurements was influenced by genetic group and live measurements (P O desenvolvimento de técnicas não invasivas e não destrutivas para a avaliação da composição e qualidade de carcaça em animais tem mobilizado consideráveis recursos em pesquisa. A ultra-sonografia aparece neste contexto como uma técnica viável, confiável e de custo aceitável para esta função. No presente trabalho foi avaliada a técnica de ultra-sonografia em tempo real como ferramenta para predição da área de olho-de-lombo (AOL e espessura da camada de gordura subcutânea (ECG a partir de imagens tomadas em animais vivos, quando comparadas com as medições na carcaça. Foram utilizados 115 bovinos jovens (30, ½ Angus x Nellore; 30, ½ Canchim x Nellore; 30, ½ Simental x Nellore, e 25 Nellores, com peso inicial médio de 329 kg e de dois tamanhos à maturidade (pequeno e grande, no sistema de produção do novilho superprecoce. As medidas de ultra-sonografia foram realizadas a cada 28 dias
Ultra-sonografia tridimensional em ginecologia: malformações uterinas Three-dimensional ultrasound in gynecology: uterine malformations

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Adilson Cunha Ferreira

2007-04-01

Full Text Available As malformações uterinas são achados pouco comuns na clínica ginecológica. As estatísticas nesta área são muito falhas. Corrobora, ainda, a falta de uniformização na terminologia empregada e as dificuldades diagnósticas. A partir da década de oitenta, a ultra-sonografia tornou-se um procedimento indispensável à prática toco-ginecológica, contribuindo e modificando conceitos e procedimentos dentro dessa especialidade. O advento dos transdutores endocavitários, a análise com Doppler colorido de amplitude e espectral, assim como a melhoria crescente da qualidade de imagem contribuíram para isso. Nos últimos dez anos muito se tem pesquisado, publicado e discutido sobre o papel da ultra-sonografia tridimensional. Os autores fazem uma revisão do tema e ressaltam a importância dessa metodologia como modalidade diagnóstica.Uterine malformations are unusual findings in the clinical practice of gynecology. Statistics regarding this abnormality are flawed, and there is a lack of standardization of the pertinent terminology, besides difficulty in the diagnosis. Starting in the 1980's, ultrasound became a procedure indispensable to the clinical practice in the field of tocogynecology, modifying concepts and procedures, and bringing an important contribution to this specialty. The advent of endocavitary transducers, amplitude and spectral color Doppler, as well as the increasing improvement in the imaging quality, has contributed to this progress. Over the last ten years, much has been studied, published and discussed about the role of the three-dimensional ultrasonography. The authors review the topic and emphasize the importance of this method as a diagnostic modality.
ASPECTOS ULTRA-SONOGRÁFICOS DA ESQUISTOSSOMOSE HEPATOESPLÊNICA Ultrasound findings in hepatosplenic schistosomiasis

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Márcio Martins Machado

2002-01-01

Full Text Available A ultra-sonografia representa uma importante contribuição no diagnóstico da forma hepatoesplênica da esquistossomose. A ultra-sonografia permite a identificação das principais alterações, como espessamento periportal, perivesicular, aumento do lobo hepático esquerdo, redução do lobo hepático direito e esplenomegalia. Adicionalmente, os padrões hemodinâmicos podem ser avaliados com o Doppler, sendo possível a análise das veias porta, mesentérica superior e esplênica, além de facilitar o estudo dos vasos venosos colaterais. Em áreas endêmicas, a ultra-sonografia assume papel de destaque, sendo superior à avaliação clínica na identificação da hepatoesplenomegalia e possibilitando o acompanhamento dos pacientes submetidos a tratamento clínico. Neste trabalho, os autores apresentam uma revisão dos principais achados sonográficos e ao Doppler da esquistossomose hepatoesplênica, sendo demonstrada, também, a relação destes achados com os aspectos clínico-patológicos desta doença.Ultrasound represents an important contribution to the diagnosis of hepatosplenic mansonic schistosomiasis. Abnormalities such as hyperechoic fibrotic bands along the portal vessels, volumetric reduction of the right hepatic lobe, enlargement of the left lobe, perivesicular fibrotic thickening and splenomegaly can be recognized. Moreover, the hemodynamic status of the portal venous system may also be evaluated by Doppler analysis, including the identification of collateral veins and portosystemic venous shunts. In endemic areas, ultrasound is of great value in the identification of hepatosplenomegaly, allowing follow-up of patients under clinical treatment. This review presents the ultrasonographic and Doppler features of hepatosplenic schistosomiasis. The relationship between these findings and the clinical and pathological characteristics of this disease are also discussed.
Curva dos valores normais de peso fetal estimado por ultra-sonografia segundo a idade gestacional

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José Guilherme Cecatti

Full Text Available Este trabalho teve por objetivo avaliar a evolução do peso fetal estimado em gestações normais de 20 a 42 semanas. Quanto ao desenho e métodos empregados na pesquisa, realizou-se estudo descritivo de um universo constituído por 2.874 gestantes normais da cidade de Campinas, efetuando-se exame ultra-sonográfico obstétrico de rotina com medida da biometria fetal e utilizando-se, para o cálculo do peso fetal, a fórmula de Hadlock et al. (1991. Calcularam-se os valores dos percentis 10, 50 e 90 do peso fetal, por idade gestacional, com construção de curva posteriormente alisada mediante ajuste polinomial de 2º grau. Como resultado, obteve-se que o valor do percentil 50 foi de 368 gramas na 20ª semana, 1.512 gramas na 30ª semana, atingindo 3.417 gramas na 42ª semana. Constatou-se ter havido ganho médio de 200 gramas de peso por semana, de 27 a 38 semanas, a partir de quando o incremento diminuiu. Concluiu-se que a disponibilidade de curva brasileira do peso fetal estimado normal permitirá o diagnóstico pré-natal de seus desvios pela ultra-sonografia.
Rastreamento Pré-natal de Anormalidades Cardíacas: Papel da Ultra–sonografia Obstétrica de Rotina renatal Screening of Cardiac Abnormalities: The Role of Routine Obstetrical Ultrasound

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Tzvi Bacaltchuk

2001-10-01

Full Text Available Objetivo: avaliar o papel da ultra-sonografia obstétrica de rotina no rastreamento pré-natal de cardiopatias congênitas ou arritmias graves e os fatores envolvidos na sua acurácia. Métodos: a amostra foi constituída de 77 neonatos ou lactentes internados no Instituto de Cardiologia do Rio Grande do Sul no período de maio a outubro de 2000, com diagnóstico pós-natal confirmado de cardiopatia estrutural ou arritmia grave, que tinham sido submetidos, durante a vida fetal, a pelo menos uma ultra-sonografia obstétrica após a 18ª semana de gestação. Após consentimento informado, um questionário padronizado foi aplicado. As variáveis categóricas (tipo de cardiopatia e a acessibilidade ecográfica para o diagnóstico, alteração do ritmo cardíaco, número de gestações, paridade, abortamentos prévios, estado civil das gestantes, tipo de parto, área de internação hospitalar, sexo, tipo de serviço onde foi realizado o pré-natal, indicação da ultra-sonografia obstétrica, número de ultra-sonografias realizadas, tipo de serviço onde foi realizada a ultra-sonografia obstétrica, local onde foi realizada a ultra-sonografia obstétrica, renda familiar, escolaridade materna e escolaridade paterna foram comparadas pelo teste do chi² ou pelo teste exato de Fisher e um modelo de regressão logística foi utilizado para determinar variáveis independentes eventualmente envolvidas na suspeita pré-natal de cardiopatia. Resultados: em 19 pacientes (24,7%, a ultra-sonografia obstétrica foi capaz de levantar suspeita de anormalidades estruturais ou de arritmias. Ao serem consideradas apenas as cardiopatias congênitas, esta taxa foi de 19,2% (14/73. Em 73,7% dos pacientes com suspeita de anormalidades cardíacas durante a ultra-sonografia obstétrica, as cardiopatias suspeitadas eram acessíveis ao corte de 4 câmaras isolado. Observou-se que 26,3% das crianças com suspeita pré-natal de cardiopatia apresentaram arritmias durante o
Importância da ultra-sonografia anorretal tridimensional na decisão terapêutica da endometriose profunda Importance of the three-dimensional anorectal ultrasonography in deep endometriosis

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Univaldo Etsuo Sagae

2009-12-01

Full Text Available OBJETIVO: Este estudo visa demonstrar a importância da ultra-sonografia anorretal tridimensional (US 3D no diagnóstico da endometriose profunda e o grau de acometimento do trato intestinal na decisão terapêutica da endometriose do septo retovaginal. MÉTODOS: Estudo prospectivo realizado entre março de 2007 e julho de 2009. Sessenta e cinco mulheres com endometriose pélvica e com queixas gastrointestinais foram avaliadas e submetidas a US 3D. Vinte pacientes, média de idade 33,7anos, com suspeita de foco endometriótico intestinal foram submetidas ao procedimento laparoscópico para a realização de inventário da cavidade abdominal e tratamento cirúrgico. RESULTADOS: Em dezenove mulheres (95%, os achados laparoscópicos confirmaram a presença do foco endometriótico retal. O procedimento realizado à laparoscopia foi: exérese de foco peritoneais (n= 1; ressecção parcial do retossigmóide (n= 9; exérese de nódulo de reto (n= 10. O tempo operatório médio por procedimento foi de 120 minutos. O tempo médio de alta foi 1,7 dias. Duas pacientes apresentaram como complicação o aparecimento de fistula retovaginal. CONCLUSÃO: Conclui-se que a ultra-sonografia anorretal tridimensional é exame específico na avaliação do segmento anorretal, decisivo na detecção de focos endometrióticos do septo retovaginal e avalia eventuais doenças associadas nesse segmento, determinando a estratégica terapêutico-cirúrgica adequada.OBJECTIVE: This study aims to demonstrate the importance of three-dimensional anorectal ultrasonography (US 3D in the diagnosis of deep endometriosis and level of intestinal involvement in the decision of the therapy of endometriosis of rectovaginal septum. METHODS: A prospective study between March 2007 and July 2009. Sixty-five women with pelvic endometriosis and gastrointestinal complaints were evaluated and submitted to 3D U.S.. Twenty patients, mean age 33.7 years, with suspected of intestinal endometriosis
Diagnóstico de cistos ovarianos pela palpação de ultra-sonografia transretal em fêmeas suínas: relato de dois casos clínicos

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VIANA, Carlos Henrique Cabral; ARRUDA, Rubens Paes de; MORETTI, Anibal Saint'Anna; VISINTIN, José Antonio

1998-01-01

Foram abordados alguns conceitos sobre a fisiopatologia e a semiologia de cistos ovarianos em fêmeas suínas, descrevendo-se dois casos clínicos, um sintomático e outro assintomático. No caso sintomático, observou-se infertilidade, cios irregulares, edema de vulva e clitóris aumentado de volume. À palpação retal, constataram-se cistos em ambos os ovários da fêmea com sintomas e um cisto no ovário esquerdo da assintomática. A ultra-sonografia possibilitou visualizar, assim como avaliar com prec...
Pancreatite aguda leve: avaliação pela ultra-sonografia. estudo prospectivo Mild acute pancreatitis: ultrasound evaluation: a prospective study

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Márcio Martins Machado

2002-07-01

Full Text Available Resumo Neste estudo foram avaliados, por meio da ultra-sonografia, 21 pacientes com pancreatite aguda leve. Foram analisadas a presença ou ausência de hipoecogenicidade do pâncreas e a presença ou ausência de líquido peripancreático. Em 19 pacientes (90,5% foi identificada hipoecogenicidade pancreática, e em três (15,8% destes pacientes foi identificada a presença de pequena quantidade de líquido na pequena cavidade dos epíploons. Em dois pacientes (9,5% não se identificou qualquer alteração pancreática. Com relação à possível etiologia da pancreatite aguda, em 15 pacientes (71,5% pôde-se demonstrar a presença de colecistopatia calculosa, em quatro pacientes (19,0% havia história de alcoolismo crônico e não foram identificados cálculos na vesícula biliar, e em dois pacientes (9,5% não foi identificada qualquer causa aparente. Os autores concluem que a ultra-sonografia pode identificar alteração na maioria dos pacientes com pancreatite aguda leve e permite, ainda, o acompanhamento daqueles com pequenas coleções líquidas peripancreáticas.We analyzed the ultrasonographic findings of 21 patients with mild acute pancreatitis. The presence or absence of pancreatic hypoechogenicity and peripancreatic fluid collection was assessed. Pancreatic hypoechogenicity was identified in 19 patients (90.5% whereas small sac fluid collection was identified in 3 (15.8% of these patients. No abnormality was seen in 2 patients (9.5%. Regarding the etiology of acute pancreatitis, cholelithiasis was identified in 15 patients (71.5%, alcohol abuse was identified in 4 patients (19.0%, and in 2 patients (9.5% no probable etiology could be found. The authors conclude that ultrasonography may identify abnormalities in the majority of patients with mild acute pancreatitis and can be used to assess patients with peripancreatic fluid collections.
Importância da ultra-sonografia ocular na avaliação pré-operatória de pacientes com catarata total The importance of ocular ultrasonography in the preoperative evaluation of patients with mature cataract

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Álvaro Pedroso de Carvalho Lupinacci

2004-02-01

Full Text Available Com os avanços da cirurgia para catarata, o prognóstico da recuperação da visão aumentou drasticamente, tornando-se necessário prever resultados indesejados para a acuidade visual no pós-operatório. OBJETIVOS: Verificar a importância da ultra-sonografia ocular na avaliação pré-operatória do segmento posterior em pacientes com catarata madura, e relacionar possíveis doenças que possam comprometer os resultados cirúrgicos, sua prevalência e seus principais fatores de risco. MÉTODOS: Foi realizado estudo retrospectivo do prontuário de 262 pacientes em que houve a necessidade de ultra-sonografia ocular devido à presença de catarata madura, impedindo assim a avaliação fundoscópica do segmento posterior. Também foi avaliada a relação entre a presença dessas alterações e o sexo, idade, raça, história de trauma ocular, doenças sistêmicas e oculares e presença de catarata no olho contralateral. RESULTADOS: Encontraram-se alterações ecográficas em 24,8% dos exames realizados entre 1996 e 2001, dos quais o descolamento de retina (9,9% e as condensações vítreas (9,9% foram as mais comuns. CONCLUSÕES: Dentre os fatores de risco levantados como predisponentes para achados de ultra-sonografia ocular, a uveíte foi o único elemento estatisticamente significante. Não foi possível, pelos dados obtidos, correlacionar positivamente o trauma ocu-lar às patologias de segmento posterior descritas.With the new techniques of cataract surgery visual success has increased and it became necessary to foresee undesirable postoperative results regarding visual acuity. PURPOSE: To verify the role of ocular ultrasonography in the preoperative evaluation of patients with mature cataract searching for pos terior segment pathologies that may affect surgical results, their prevalence and the main associated risk factors. METHODS: A retrospective study was performed analyzing records of 262 patients indicated for ocular ultrasonography
Papel da Histerossonografia no Estudo da Cavidade Uterina em Pacientes com Sangramento Uterino Anormal Role of Sonohysterography in the Evaluation of the Uterine Cavity in Patients with Abnormal Uterine Bleeding

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Angélica Lemos Debs Diniz

2000-06-01

Full Text Available Objetivo: determinar o papel da histerossonografia na avaliação das anormalidades da cavidade uterina, em pacientes com sangramento uterino anormal, selecionadas previamente pela ultra-sonografia transvaginal. Métodos: foram selecionadas 48 pacientes na menacme e pós-menopausa, portadoras de sangramento uterino anormal e anormalidades da cavidade uterina, diagnosticadas inicialmente pela ultra-sonografia transvaginal. Todas as pacientes se submeteram à histerossonografia e, posteriormente, aos métodos "padrão ouro", a histeroscopia e/ou histerectomia. As histerossonografias foram avaliadas por dois diferentes médicos e os diagnósticos confrontados. Resultados: a histerossonografia mostrou ter alta sensibilidade e especificidade no diagnóstico das patologias benignas da cavidade uterina. Na presença de pólipo a sensibilidade e a especificidade do método foram, respectivamente, de 100 e 97%, seguido do mioma submucoso cuja sensibilidade e especificidade foram, respectivamente, de 83 e 100%. Já na hiperplasia endometrial e no endométrio normal a sensibilidade e especificidade foram de 100%. Diagnosticamos 33 casos de pólipos, 13 casos de miomas submucosos, quatro casos de hiperplasia endometrial e três casos normais na análise dos métodos "padrão ouro". Houve alta correlação entre os diagnósticos dados pelos dois examinadores. Conclusões: a histerossonografia mostrou ser um exame reprodutível, com alta sensibilidade e especificidade no diagnóstico das patologias benignas da cavidade uterina em pacientes com sangramento uterino anormal.Purpose: to determine the role of sonohysterography in the evaluation of abnormalities in the uterine cavity in patients presenting abnormal uterine bleeding, who had previously been selected by transvaginal ultrasonography. Methods: forty-eight patients presenting abnormal uterine bleeding and changes in the uterine cavity seen by transvaginal ultrasonography were selected, and they were in
Acurácia diagnóstica do espessamento ecogênico periportal à ultra-sonografia e da histopatologia no diagnóstico diferencial da atresia biliar Accuracy of echogenic periportal enlargement image in ultrasonographic exams and histopathology in differential diagnosis of biliary atresia

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Mariza L. V. Roquete

2008-08-01

Full Text Available OBJETIVOS: Definir a sensibilidade, especificidade e a acurácia do espessamento ecogênico periportal à ultra-sonografia e da histopatologia hepática, isolados ou em conjunto, na distinção diagnóstica entre atresia biliar e as colestases intra-hepáticas. MÉTODOS: Trata-se de estudo retrospectivo realizado entre janeiro de 1990 e dezembro de 2004. Foram analisados 51 casos de atresia biliar e 45 com colestase intra-hepática. A histopatologia foi realizada por uma patologista de forma cega. O espessamento ecogênico periportal foi pesquisado na ultra-sonografia como único sinal diagnóstico de atresia biliar. Foram calculados os índices de sensibilidade, especificidade e acurácia do espessamento ecogênico periportal e da histologia isoladamente ou associados. O padrão-ouro utilizado para o diagnóstico de atresia biliar foi o aspecto da via biliar extra-hepática à laparotomia. RESULTADOS: O espessamento ecogênico periportal revelou sensibilidade de 49%, especificidade de 100% e acurácia de 72,5%. A histopatologia compatível com obstrução biliar extra-hepática conferiu sensibilidade de 90,2%, especificidade de 84,6% e acurácia de 87,8%. O espessamento ecogênico periportal e a histopatologia isolados ou associados proporcionaram sensibilidade de 93,2%, especificidade de 85,7% e acurácia de 90,3%. CONCLUSÕES: A evidência do espessamento ecogênico periportal na ultra-sonografia é indicação de laparotomia. Se o espessamento ecogênico periportal é negativo, está indicada a biopsia hepática; se a histopatologia revelar sinais de atresia biliar, impõe-se a laparotomia exploradora. Nos casos de espessamento ecogênico periportal negativo com histopatologia de hepatite neonatal ou de outras colestases intra-hepáticas, recomenda-se o acompanhamento ou o tratamento clínico conforme o diagnóstico.OBJECTIVES: To define the sensitivity, specificity and accuracy of the ultrasound triangular cord sign and hepatic

Relevância da ultra-sonografia dos tendões flexores em cavalos Puro Sangue de corrida na adaptação ao treinamento Significance of flexor tendon ultrasonography in training thoroughbred horses

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Carolina Roxana Greig

2005-08-01

Full Text Available Vinte e quatro potros Puro Sangue de Corrida (PSC, com dois anos de idade foram avaliados ultra-sonograficamente, durante o período final da doma e início de treinamento, através da imagem transversal dos tendões flexor digital superficial (TFDS e profundo (TFDP. As avaliações foram realizadas com intervalos de 15 dias. A área transversal (AT, a textura dos ecos e a ecogenicidade dos tendões foram avaliadas nas sete zonas da região metacarpiana através de um programa de mensuração de imagens do próprio aparelho de ultra-sonografia. Durante a doma e treinamento, houve diminuição da AT na zona IA e IIIA (PThe cross-sectional area (CSA of the superficial digital flexor tendon (SDFT and deep digital flexor tendon (DDFT of twenty four thoroughbreds was ultrasonographically evaluated before and during their initial training to determine the effect of exercise on the tendon CSA, texture and echogenicity to characterize the response to training. Ultrasonographic transverse images of the left forelimb were obtained every fifteen days. The SDFT CSA of zones IA and IIIA showed a decrease (P<0.05, f=0.010 e f=0.023 res. during the breaking and training period and an increase (P< 0.05 of zone IIIC (f=0.039. Evaluating just the training period, SDFT CSA results of zones IA, IIIA and IIIC were similar. The DDFT showed no variation during the breaking phase but when the training phase was evaluated there was a decrease (P<0.05 in zones IA (f=0.006 and IIIA (f=0.006. Evaluating both breaking and training periods the DDFT showed a decrease (P<0.05 in zones IA (f=0.027, IIIA (f=0.0001 and IIIB (f=0.0031. Fiber texture and tendon echogenicity showed no significant difference between breaking and last reading during training. This study provides evidence of variation of adaptation among the ultrasonographic zones of both SDFT and DDFT to exercise during training of thoroughbred horses. Ultra-sonography is not the most indicated method to evaluate the
Efeitos da Histerectomia Total Abdominal sobre o Fluxo Sangüíneo Ovariano Effect of Total Abdominal Hysterectomy on Ovarian Blood Supply

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Eliana Aguiar Petri Nahás

2002-06-01

Full Text Available Objetivo: avaliar os efeitos da histerectomia total abdominal (HTA sobre o fluxo sangüíneo ovariano, em mulheres no menacme, por meio da dopplervelocimetria e ultra-sonografia transvaginal. Métodos: estudo prospectivo no qual foram incluídas 61 mulheres, com idade igual ou inferior a 40 anos. As pacientes foram divididas em dois grupos: G1, com 31 pacientes submetidas à HTA, e G2, com 30 mulheres normais não submetidas à cirurgia. Somente foram incluídas pacientes eumenorréicas, ovulatórias, não-obesas ou fumantes, sem cirurgias ou doenças ovarianas prévias. Avaliou-se o fluxo sangüíneo das artérias ovarianas, inicialmente e aos 6 e 12 meses, pelo índice de pulsatilidade (IP na dopplervelocimetria, e o volume ovariano pela ultra-sonografia transvaginal (US. Para análise estatística empregou-se teste t pareado, análise de perfil, teste de Friedman e teste de Mann-Whitney. Resultados: na comparação estatística inicial os grupos foram homogêneos quanto às características epidemiológicas e quanto aos demais parâmetros avaliados neste estudo. Nas pacientes submetidas à histerectomia, observaram-se aos 6 e 12 meses aumento do volume ovariano ao US e diminuição do IP avaliado pela dopplervelocimetria (pPurpose: to evaluate the effect of total abdominal hysterectomy on ovarian blood supply in women in reproductive age, using transvaginal color Doppler. Methods: a prospective study was carried out on 61 40-year-old or younger women. They were divided into two groups: G1, 31 patients submitted to hysterectomy, and G2, 30 normal women. Criteria of inclusion: normal ovarian function at baseline, normal body weight, without expasure to tobacco, no history of laparotomy or ovarian pathology. The pulsatility index (PI of ovarian arteries determined by Doppler and the transvaginal ultrasonographic measurement of the ovarian volume were performed at three moments: baseline, 6 and 12 months. Results: at baseline the groups were
Ultra-sonografia do fígado, aparelho renal e reprodutivo da jibóia (Boa constrictor Ultrasonography of the liver, renal and reproductive apparatus of Boa constrictor Snake

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Francisco C. P. Neto

2009-04-01

Full Text Available Atualmente os animais silvestres têm despertado o interesse particular na criação domestica. Na medicina de animais selvagens, os exames ultra-sonográficos podem ser considerados como ferramenta para diagnosticar e prevenir doenças. Deste modo, realizou-se um estudo em 20 jibóias (Boa constrictor, a fim de caracterizar a morfologia e aparência ultra-sonográfica das estruturas presentes da cavidade celomática desses animais. Ultra-sonograficamente, o fígado apresentou-se variando de hipoecóica a levemente hiperecogênica, com margens ecogênicas e ecotextura homogênea em toda sua extensão. Os rins mostraram formato elipsóide, com cápsula fina, regular e hiperecóica. Os folículos ovarianos apresentaram formato ovóide, margens finas, regulares e discretamente hiperecóicas. As estruturas do sistema reprodutor do macho não foram evidenciadas com precisão, devido a sua ecogenicidade similar em relação às estruturas adjacentes e pela presença do "corpo gorduroso" localizado nessa região. A ultra-sonografia da cavidade celomática em jibóias demonstrou ser uma técnica rápida e de fácil acesso, permitindo identificar a morfologia, sintopia e aparência ultra-sonográfica de estruturas como o fígado, rins e de folículos vitelogênicos nas fêmeas.Currently, wild animals have been received special attention for domestic breeding. In Wild Animal Medicine, ultrasonographic exams could be considered as a tool to diagnose and prevent disease. Ultrasonographic examination of twenty snakes (Boa constrictor was performed in order to describe the morphological and ultrasonography appearance of their coelomic structures. Examination by ultrasonography revealed the parechymal liver ranging from slightly hypoechogenic to hyperechogenic, with echogenic margins and homogeneous echotexture in total scanning of this organ. The kidney was accessible for examination by sagittal ultrasound, showing an ellipsoid shape, a hyperechogenic capsule
Avaliação ultra-sonográfica e ao Doppler dos TIPS (anastomose portossistêmica intra-hepática transjugular

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Machado Márcio Martins

2004-01-01

Full Text Available A anastomose portossistêmica intra-hepática transjugular (TIPS compreende a técnica mais recente e mais popular para o alívio da hipertensão portal sintomática, especialmente para os casos com varizes e hemorragia digestiva alta, e menos comumente para o tratamento da ascite refratária. Os TIPS podem apresentar complicações após sua colocação, como as estenoses e oclusões. A ultra-sonografia e o Doppler permitem o estudo dos TIPS de uma forma não invasiva. Neste artigo os autores relatam os achados recentes à ultra-sonografia e ao Doppler nos casos de funcionamento normal e anormal (estenoses/oclusões dos TIPS.
Avaliação do volume de fluxo venoso da bomba sural por ultra-sonografia Doppler durante cinesioterapia ativa e passiva: um estudo piloto Evaluation of venous flow volume of the calf muscle pump by Doppler ultrasound during active and passive kinesiotherapy: a pilot study

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Carmindo Carlos Cardoso Campos

2008-12-01

Full Text Available CONTEXTO: O fisioterapeuta na unidade hospitalar atua sobre os efeitos da hipoatividade ou inatividade do paciente acamado. Na prática diária, a contração do músculo da panturrilha é difundida entre os profissionais de saúde no ambiente hospitalar, principalmente nos períodos de pré e pós-operatório, como forma de diminuir a estase venosa e os riscos de trombose venosa profunda nos membros inferiores. OBJETIVO: Avaliar o volume de fluxo venoso na bomba sural, através de ultra-sonografia doppler, durante cinesioterapia ativa e passiva (flexão plantar do tornozelo. MÉTODOS: A amostra foi constituída por 30 indivíduos escolhidos aleatoriamente e submetidos a ultra-sonografia doppler da veia poplítea direita, visando mensurar o volume de fluxo sanguíneo em quatro momentos: repouso, compressão manual da panturrilha, movimentação passiva e ativa do tornozelo em flexão plantar. Na análise dos resultados, utilizou-se o teste t, sendo utilizado um valor de p BACKGROUND: In-hospital physical therapists work on the effects of hypoactivity or inactivity of bedridden patients. In daily practice, contraction of the calf muscle is commonly performed by health professionals in hospitals, especially in pre- and post-operative periods as a form of reducing venous stasis and risk of deep venous thrombosis in the lower limbs. OBJECTIVE: To assess venous flow volume at the calf muscle pump using color Doppler ultrasound during active and passive kinesiotherapy (ankle plantar flexion. METHODS: The sample consisted of 30 individuals randomly selected and submitted to color Doppler ultrasound of the right popliteal vein, aiming to measure blood flow volume in four periods: rest, manual calf compression, active and passive ankle movement in plantar flexion. The t test was used for statistical analysis, and p < 0.05 was used as an index of statistical significance. RESULTS: The sample consisted of 16 females and 14 males. Means were as follows: age
Classificação ultra-sonográfica do derrame pleural e do empiema parapneumônico Ultrasound classification of pleural effusion and parapneumonic empyema

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Luís Marcelo Inaco Cirino; Miguel José Francisco Neto; Erasmo Magalhães Castro de Tolosa

2002-01-01

Os autores correlacionam as alterações anatomopatológicas da cavidade pleural com os achados ultra-sonográficos no derrame pleural e no empiema parapneumônico e apresentam uma classificação baseada nestes dados. Concluem que a ultra-sonografia é método diagnóstico fidedigno para inferir a fase anatomopatológica da doença pleural, bem como auxiliar na escolha da alternativa de tratamento.We correlated the anatomopathological abnormalities of the pleural space with the ultrasound findings in pa...
Aspectos morfológicos da ultra-sonografia hepática de ovinos Morphologic aspects of hepatic ultrasonography in sheep

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Pedro B. Néspoli

2009-04-01

Full Text Available A ultra-sonografia (US é uma das técnicas de exame complementar eletivas para o diagnóstico de enfermidades hepáticas de diversas espécies domésticas. Em ovinos, no entanto, existem poucos relatos sobre o aspecto ultra-sonográfico de enfermidades hepáticas e não há definição precisa dos padrões anatômicos da US normal do fígado. Neste estudo foram utilizados 58 ovinos da raça Santa Inês: n1=8 machos, n2=10 fêmeas não gestantes e n3=40 fêmeas gestantes. Os animais foram escaneados do 12º ao 8º espaços intercostais (EI para se observar a localização da veia cava caudal (VC, veia porta (VP e vesícula biliar (VB e para se aferir a espessura do fígado sobre a VC e VP no 11º e 10º EI. O fígado foi examinado de forma satisfatória do 12º até o 8º EI. Nesta área, tanto a VC como a VP, foram observadas do 12º ao 9º EI, porém a VC não foi examinada de forma adequada em 11 animais, 10 com peso acima de 50kg. Entre os dois grupos de fêmeas, a VC e a VP foram observadas com maior freqüência no 11º e 10º EI e em todos os machos examinados do 12º ao 10º EI. A localização da vesícula biliar oscilou entre o 10º e o 8º EI, com maior incidência a nível do 9º e 8º EI nas fêmeas gestantes e não gestantes, e sobre o 9º EI nos machos. Comparativamente, a ecogenicidade do parênquima hepático foi mais intensa do que a do córtex renal. Houve correlação significativa entre o peso do fígado e a espessura hepática sobre a veia porta no 11º e o 10º EI no grupo de fêmeas gestantes. A US forneceu informações importantes quanto a topografia e ecogenicidade do fígado e mostrou ser uma ferramenta útil para estimar o peso do órgão.The ultrasonography (US is a complementary technique of choice for the diagnostic of hepatic diseases in many domestics' species. In sheep however there are few reports about ultrasonography in hepatic diseases and there is not precise definition about the anatomic standards of
Medida da espessura do segmento uterino inferior em gestantes com cesárea prévia: análise da reprodutibilidade intra- e interobservador por ultra-sonografia bi- e tridimensional Lower uterine segment thickness measurement in pregnant women with previous caesarean section: intra- and interobserver reliability analysis using bi- and tridimensional ultrasonography

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Daniela de Abreu Barra

2008-03-01

Full Text Available OBJETIVO: comparar a reprodutibilidade intra- e interobservador da medida da espessura total do segmento uterino inferior (SUI, por via abdominal, e da medida da camada muscular, por via vaginal, usando ultra-sonografia bi- e tridimensional. MÉTODOS: foi estudada a medida da espessura do SUI de 30 gestantes com cesárea anterior, entre a 36ª e a 39ª semanas, por dois observadores. Foi efetuada abordagem ultra-sonográfica abdominal com a paciente em posição supina e vaginal em posição de litotomia. No corte sagital, foi identificado SUI e foram coletadas quatro imagens bidimensionais e dois blocos tridimensionais da espessura total por via abdominal e o mesmo da camada muscular por via vaginal. As aquisições tridimensionais foram manipuladas no modo multiplanar. O tempo foi cronometrado. A reprodutibilidade foi avaliada pelo cálculo da diferença absoluta entre todas as medidas, proporção de diferenças menores que 1 mm, coeficiente de correlação intraclasse (ICC e limites de concordância de Bland e Altman. RESULTADOS: a medida da espessura média do SUI por via abdominal bidimensional foi de 7,4 mm e, por via vaginal, de 2,7 mm; a tridimensional foi 6,9 mm abdominal e 5,1 mm vaginal. Reprodutibilidade intra- e interobservador da via vaginal versus abdominal: menor diferença absoluta (0,2-0,4 versus 0,8-1,5 mm, maior proporção de diferenças (85,8-97,8 versus 48,7-72,8% com p0,05 e menores limites de concordância (-3,8 a 3,4 versus -3,6 a 4 mm para ultra-sonografia tridimensional e ICC semelhantes (0,6-0,9 versus 0,7-0,9. CONCLUSÕES: do exposto, concluímos que a medida da espessura da camada muscular do SUI por via vaginal utilizando a ultra-sonogafia tridimensional é mais reprodutível. Nossos resultados, porém, não indicam que essa medida tenha implicação clínica para predição de rotura uterina, que não foi objeto deste estudo. O único trabalho que correlacionou a espessura do SUI com risco de rotura uterina, sem
Punção Aspirativa por Agulha Fina Orientada por Ultra-Sonografia em Lesões Não-palpáveis Fine Needle Aspiration Cytology Guided by Ultrasound in Nonpalpable Lesions

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Cláudio Kemp

2001-06-01

Full Text Available Objetivo: correlacionar os achados citológicos obtidos por punção com agulha fina dirigida pela ultra-sonografia de lesões não-palpáveis da mama, císticas ou sólidas, os aspectos ultra-sonográficos e os respectivos resultados histopatológicos das lesões que foram submetidas a cirurgia. Métodos: foram analisadas 617 lesões não-palpáveis visualizadas ao ultra-som. Realizou-se a punção aspirativa por agulha fina (PAAF orientada pela ultra-sonografia, com análise citológica do material, diferenciando-as em cistos ou nódulos sólidos. Estes tiveram seu resultado citológico confrontado com o resultado histopatológico, nos casos em que foi realizada a biópsia cirúrgica. Resultados: das 617 lesões não-palpáveis, 471 eram cistos, sendo 451 cistos simples que apresentaram citologia negativa em todos os casos e 20 casos foram considerados cistos complexos. Destes, 3 (15% tiveram resultado citológico positivo ou suspeito e em 2 casos confirmou-se malignidade. Dos 105 nódulos sólidos, 63 apresentaram citologia negativa, sendo 59 concordantes com a biópsia e houve 4 casos (0,3% de resultado falso-negativo pela citologia. Todos, porém, apresentavam discordância entre imagem e citologia. Em 14 nódulos sólidos (13%, a citologia foi suspeita e, destes, 5 foram diagnosticados como carcinoma. Em outros 14 (13%, o material foi insatisfatório e 1 era carcinoma. Em 51 casos, o tríplice diagnóstico foi concordante e optou-se por seguimento clínico. Conclusão: a análise citológica do material dos cistos mamários simples é desnecessária, porém quando são complexos, a citologia é imperativa. Nas lesões sólidas não-palpáveis, é fundamental a correlação da citologia com o aspecto ultra-sonográfico e mamográfico; caso sejam discordantes, deve-se sempre prosseguir a investigação da lesão.Purpose: to determine the relationship between fine needle aspiration cytology guided by ultrasound of nonpalpable breast lesions
Concentração de progesterona e de estradiol 17-b e características ultra-sonográficas da vesícula embrionária no início da gestação em éguas Puro Sangue Inglês

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Ferraz L.E.S.

2001-01-01

Full Text Available Associaram-se dosagens séricas de progesterona e estradiol 17-beta, realizadas durante os primeiros 36 dias de prenhez em 30 éguas PSI, com exames ultra-sonográficos, para verificar fenômenos que ocorrem com a vesícula embrionária. As éguas foram divididas em dois grupos de 15 animais, o primeiro constituído por éguas paridas e o segundo por éguas virgens ou vazias na estação anterior. Por meio da ultra-sonografia foram verificados fenômenos de mobilidade, fixação e orientação da vesícula embrionária. As concentrações séricas de progesterona e estradiol 17-B variaram (P<0,01 durante o período estudado porém não foi possível estabelecer uma correlação entre concentrações desses hormônios com desenvolvimento da vesícula embrionária. A concentração de estradiol 17-betacirculante foi maior (P<0,01 nas éguas paridas.
Amadurecimento precoce da placenta avaliada pela ultra-sonografia e prognóstico perinatal Early placental maturation evaluated by ultrasound and perinatal prognosis

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Ana Patrícia Santos de Queiroz

2006-03-01

Full Text Available OBJETIVO: descrever os resultados maternos e perinatais das gestações com amadurecimento precoce da placenta detectado pela ultra-sonografia. MÉTODOS: realizou-se estudo retrospectivo, descritivo, tipo série de casos, com comparação de grupos. Foram incluídas 146 gestantes, internadas entre janeiro de 2000 e dezembro de 2002 e em cujo prontuário constavam diagnóstico de amadurecimento precoce da placenta (presença de placenta grau II antes da 32ª semana de gestação ou grau III, antes da 35ª semana de gestação e descrição das condições materno-fetais. Foram excluídas gestantes com diagnóstico de: amniorrexe prematura, gravidez múltipla, forma aguda de descolamento prematuro de placenta normoinserida e malformação fetal. As complicações clínico-obstétricas foram: doenças hipertensivas, redução do crescimento intra-uterino, alterações do volume de líquido amniótico, infecções, diabete materno, anemia falciforme, soropositividade para HIV, drogadição, litíase renal, epilepsia e asma brônquica. Pelos prontuários, foram identificadas 106 gestantes com complicações clínico-obstétricas (Gcom e 40, sem essas complicações (Gsem. Para comparação entre os grupos, empregaram-se os testes de chi2 e exato de Fisher, ao nível de significância de 0,05. RESULTADOS: o grupo Gcom apresentou maior freqüência de oligoâmnio (27,3%, restrição de crescimento intra-uterino (44,3% e cesárea antecedente ao trabalho de parto (36,8%. Comparado ao grupo Gsem, o Gcom caracterizou-se por maior incidência de óbitos fetais, prematuros (58,8 versus 40%, menor índice de Apgar de 5º minuto, peso ao nascer PURPOSE: to describe perinatal and obstetric characteristics of pregnant women with ultrasonographic early placental aging. METHODS: using a retrospective, descriptive, series of cases, with group comparison, the authors analyzed the data of 146 pregnant women, whose diagnosis of placental early aging (presence of grade
Tratamento de gestação cervical viável com aplicação intra-amniótica de metotrexato: relato de um caso Treatment of a viable cervical pregnancy with a single-intraamniotic methotrexate injection: a case report

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José Juvenal Linhares

2006-10-01

Full Text Available Gestação cervical é uma condição rara, em que ocorre implantação do ovo no canal cervical distendendo-o à medida que cresce. Corresponde a menos de 1% de todas as gestações ectópicas. A hemorragia indolor é sua característica clínica habitual e ao exame físico visualiza-se um colo hipertrófico e vascularizado, com tecido saindo pelo orifício externo do colo. Ultra-sonografia pode ser usada para complementar o diagnóstico, mostrando a presença do saco gestacional. Relatamos um caso de tratamento bem sucedido de gestação cervical viável de sete semanas. Morte fetal foi conseguida com uma injeção intra-amniótica única de metotrexato (25 mg guiada por ultra-sonografia transvaginal. Metotrexato sistêmico em dose única intramuscular (50 mg/m² foi associado. O tratamento conservador da gestação cervical com metotrexato foi efetivo e seguro.Cervical pregnancy is a rare condition in which the egg is implanted in the cervical canal causing it to distend as the egg grows. Cervical pregnancy constitutes less than 1% of all ectopic pregnancies. Painless hemorrhage is a habitual clinical characteristic and on physical examination a very vascularized hypertrophic cervix is observed with a tissue surpassing the external orifice. Ultrasonography may be used as a complementary diagnostic tool to show directly the presence of a gestational sac. A successful management of a viable seven-week gestation cervical pregnancy is reported herein. Feticide was performed with a single intraamniotic methotrexate injection (25 mg guided by transvaginal ultrasonography. Systemic methotrexate in a single dose intramuscular (50 mg/m² was associated. The conservative management of cervical ectopic pregnancy with methotrexate was effective and safe.
Calcinose peritendínea do tendão calcâneo associada a dermatomiosite: correlação entre radiografia convencional, ultra-sonografia, ressonância magnética e macroscopia cirúrgica

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Rosa,Ana Cláudia Ferreira; Costa,Edegmar Nunes; Machado,Márcio Martins; Rocha,Válney Luiz da; Sernik,Renato Antônio; Nunes,Rodrigo Alvarenga; Lemes,Marcella Stival; Gomide,Lidyane Marques de Paula; Albieri,Alexandre Daher; Santos Júnior,Rubens Carneiro dos; Barros,Nestor de; Cerri,Giovanni Guido

2006-01-01

A calcinose intersticial é uma afecção incomum, na qual existe deposição de cálcio localizada ou disseminada na pele, tecido celular subcutâneo, músculos e tendões. Freqüentemente a calcinose está associada com doenças do tecido conjuntivo, como esclerodermia e dermatomiosite. Os autores relatam um caso de calcinose intersticial associada a dermatomiosite, estudada com radiografia convencional, ultra-sonografia, ressonância magnética, e com correlação com a macroscopia cirúrgica....
Calcinose peritendínea do tendão calcâneo associada a dermatomiosite: correlação entre radiografia convencional, ultra-sonografia, ressonância magnética e macroscopia cirúrgica

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Rosa Ana Cláudia Ferreira

2006-01-01

Full Text Available A calcinose intersticial é uma afecção incomum, na qual existe deposição de cálcio localizada ou disseminada na pele, tecido celular subcutâneo, músculos e tendões. Freqüentemente a calcinose está associada com doenças do tecido conjuntivo, como esclerodermia e dermatomiosite. Os autores relatam um caso de calcinose intersticial associada a dermatomiosite, estudada com radiografia convencional, ultra-sonografia, ressonância magnética, e com correlação com a macroscopia cirúrgica.
Classificação ultra-sonográfica do derrame pleural e do empiema parapneumônico Ultrasound classification of pleural effusion and parapneumonic empyema

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Luís Marcelo Inaco Cirino

2002-03-01

Full Text Available Os autores correlacionam as alterações anatomopatológicas da cavidade pleural com os achados ultra-sonográficos no derrame pleural e no empiema parapneumônico e apresentam uma classificação baseada nestes dados. Concluem que a ultra-sonografia é método diagnóstico fidedigno para inferir a fase anatomopatológica da doença pleural, bem como auxiliar na escolha da alternativa de tratamento.We correlated the anatomopathological abnormalities of the pleural space with the ultrasound findings in patients with pleural effusion and/or parapneumonic empyema and proposed a classification based on these results. Ultrasonography is a reliable method to infer the anatomopathological phase of pleural disease and consequently may be of help in the choice of the most suitable treatment.
Fatores de risco clínicos e ultra-sonográficos relacionados à litíase vesicular assintomática em mulheres

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Ferreira Adilson Cunha

2004-01-01

Full Text Available OBJETIVO: Analisar variáveis clínicas e ultra-sonográficas, como presença ou ausência de barro biliar, espessura da parede e medida transversal da vesícula biliar, idade, paridade, presença ou ausência de diabetes mellitus associadas a litíase vesicular assintomática, bem como determinar a sua prevalência em pacientes submetidas ao exame ultra-sonográfico. MATERAIS E MÉTODOS: Foram analisadas, em estudo prospectivo, 265 pacientes do sexo feminino, atendidas na Escola de Ultra-sonografia e Reciclagem Médica de Ribeirão Preto, durante o período de janeiro a setembro de 2001. RESULTADOS: Evidenciou-se diferença estatisticamente significativa relacionada à litíase da vesícula biliar e espessura da parede da vesícula biliar, barro biliar, diâmetro transverso da vesícula biliar, faixa etária, paridade, passando de 4,1% nas nulíparas para 39,1% nas multíparas e diabéticas. A prevalência de litíase na vesícula biliar em pacientes assintomáticas foi de 14,7%. CONCLUSÃO: A litíase vesicular assintomática em mulheres ocorre principalmente com o decorrer da idade e da paridade. Os achados ultra-sonográficos mais freqüentemente encontrados foram presença de barro biliar e de espessamento da parede da vesícula biliar.
Curva dos valores normais de peso fetal estimado por ultra-sonografia segundo a idade gestacional

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Cecatti,José Guilherme; Machado,Maria Regina Marrocos; Santos,Fernanda Fioravanti Azank dos; Marussi,Emílio Francisco

2000-01-01

Este trabalho teve por objetivo avaliar a evolução do peso fetal estimado em gestações normais de 20 a 42 semanas. Quanto ao desenho e métodos empregados na pesquisa, realizou-se estudo descritivo de um universo constituído por 2.874 gestantes normais da cidade de Campinas, efetuando-se exame ultra-sonográfico obstétrico de rotina com medida da biometria fetal e utilizando-se, para o cálculo do peso fetal, a fórmula de Hadlock et al. (1991). Calcularam-se os valores dos percentis 10, 50 e 90 ...
Emprego do ultra-som modo B e com efeito Doppler, termômetro infravermelho e medidas antropométricas na avaliação de uma formulação cosmética anticelulítica contendo extrato hidroglicólico de Trichilia catigua e Ptychopetalum olacoides Bentham

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Idalina Maria Nunes Salgado Reis dos Santos

2005-01-01

Hidrolipodistrofia ginóide (H.L.D.G.), a celulite, é comumente tratada com cosméticos contendo extratos vegetais. O estudo realizado foi: ultra-sonografia na avaliação da espessura da hipoderme e a microcirculação cutânea; uso de termômetro infravermelho na medida da temperatura e análise das medidas antropométricas da uma formulação cosmética anticelulítica contendo extrato hidroglicólico de Trichilia catigua e Ptychopetalum olacoides Bentham (catuaba e marapuama). Foram realizadas medidas i...
Biomecânica ultra-sonográfica da deglutição: estudo preliminar Sonographic evaluation of swallowing biomechanics: a preliminary study

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Cinthya da Silva Lynch

2008-08-01

Full Text Available OBJETIVO: Verificar, por meio da ultra-sonografia, os parâmetros espaciais do complexo hiolaríngeo na dinâmica da deglutição e a associação entre idade e efeitos. MATERIAIS E MÉTODOS: Neste estudo quantitativo e prospectivo foram incluídos 39 indivíduos sadios, de ambos os gêneros, na faixa etária de 20 a 70 anos (média, 45,56; desvio-padrão, 14,53. Avaliou-se a biomecânica da deglutição correspondente à medida da distância entre a porção superior do osso hióide e a borda superior da cartilagem tireóide, no momento de máxima elevação laríngea. As medidas foram realizadas com a ingestão de alimentos de consistências líquida e pastosa. RESULTADOS: A variação da distância da laringe ao hióide apresentou associação positiva com a idade, somente na deglutição de alimento pastoso, consistência na qual é solicitada maior atividade de propulsão lingual do que nos líquidos. CONCLUSÃO: É possível que o aumento da distância entre o hióide e a laringe, que representa menor elevação laríngea, na deglutição de pastosos, ocorra por efeito do envelhecimento, processo no qual se verifica diminuição de reservas funcionais, mesmo em indivíduos sadios. A ultra-sonografia pode detectar comportamentos relacionados a consistências alimentares, o que mostra sua possível potencialidade diagnóstica na avaliação da deglutição.OBJECTIVE: To evaluate, by means of ultrasonography, the spatial parameters of the hyolaryngeal complex in the deglutition dynamics as well the correlation between age and effects. MATERIALS AND METHODS: The present prospective and quantitative study included 39 healthy men and women in the age range between 20 and 70 years (mean, 45.56; standard deviation, 14.53. The swallowing biomechanics corresponding to the measurement of the distance between the upper portion of the hyoid bone and the upper rim of the thyroid cartilage at the moment of maximum laryngeal elevation was evaluated
Correlações simples entre as medidas de ultra-som e a composição da carcaça de bovinos jovens Correlations between ultrasound measurements and carcass composition of young bulls

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Liliane Suguisawa

2006-02-01

Full Text Available Neste estudo avaliaram-se as correlações entre as medidas ultra-sonográficas e as características de carcaça de 115 bovinos jovens (Nelore, ½ Angus Nelore, ½ Simental Nelore e Canchim, com peso inicial médio de 329 kg e dois tamanhos à maturidade (pequeno e grande, em um sistema de produção do novilho superprecoce. Aos 120 dias de confinamento, foram realizadas a pesagem e medida da área de olho-de-lombo (AOL e da gordura subcutânea (ECG, via ultra-sonografia. Após o abate, foram coletadas as medidas de AOL e ECG na carcaça e os pesos de traseiro, dianteiro e cortes cárneos comerciais, determinando-se também a composição corporal dos animais. Foram calculados os rendimentos de carcaça, cortes cárneos, traseiro, da AOL ultra-som por 100 kg de PV e da AOL carcaça por 100 kg de peso de carcaça. Dados da composição da carcaça indicaram alta deposição muscular nos animais ½ Simental Nelore e Canchim e expressiva deposição de tecido adiposo nos animais Nelore. No entanto, os animais ½ Angus Nelore mostraram-se mais apropriados para confinamento no sistema de produção do superprecoce, pois equilibraram musculosidade e gordura de acabamento. Os resultados demonstraram que a AOL tem relação com a musculosidade da carcaça e que, à medida que há seleção para o incremento desta característica, ocorre diminuição da ECG, como resultado da correlação negativa da ECG com a porcentagem de traseiro e AOL. Não foi observada diferença na composição entre os dois grupos de tamanho à maturidade, provavelmente em razão da pequena variação entre eles. Como as correlações envolvendo a AOL e a ECG por ultra-som e as mesmas medidas na carcaça apresentam resultados similares, validou-se a utilização da técnica da ultra-sonografia como alternativa para predição das características da carcaça de bovinos.The objective of this study was to evaluate correlations between ultrasonography measurements and carcass

Ultra-sonografia da aorta abdominal e de seus ramos em cães Ultrasonography of abdominal aorta and its branches in dogs

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Lilian Kamikawa

2007-04-01

Full Text Available O ultra-som bidimensional e o ultra-som Doppler foram utilizados para avaliar a biometria e a hemodinâmica da aorta abdominal e artérias ilíacas externas de 131cães clinicamente normais. Os resultados da avaliação biométrica da aorta abdominal indicaram um diâmetro médio de 0,80cm para o seu segmento diafragmático (AOD; 0,74cm para o seu segmento caudal às artérias renais (AOR e 0,69cm para o segmento cranial à sua bifurcação (AOT. A artéria ilíaca externa direita (AIED apresentou o diâmetro médio de 0,42cm e a artéria ilíaca externa esquerda (AIEE o diâmetro médio de 0,39. O estudo hemodinâmico da aorta abdominal apresentou velocidade de pico sistólico médio de 104,00cm/s para AOR; 99,61cm/s para AOT; 85,47cm/s para AIED e 99,51cm/s para AIEE. Verificaram-se correlações de diferentes intensidades entre os diâmetros vasculares em diferentes pontos de tomadas e os fatores biométricos corpóreos (CRL. Correlações baixas foram observadas quando esses diâmetros foram confrontados com a idade.A duplex ultrasound system incorporating a pulsed wave Doppler ultrasound probe with conventional B-mode real-time imaging was used to evaluate the biometric and the hemodynamic of abdominal aorta and external iliac arteries of a hundred and thirty one normal dogs. Results of biometrics of abdominal aorta, presented a mean diameter of 0.80cm in its diaphragmatic segment (AOD; 0.74cm in its segment caudal to the renal arteries (AOR and 0.69cm in the segment cranial to its termination (AOT. The right-external-iliac artery (AIED presented a mean diameter of 0.42cm and the left-external iliac artery (AIEE a mean diameter of 0.39cm. The hemodynamic study of the abdominal aorta presented a medium systolic peak velocity to AOR of 104cm per sec.; to AOT of 99.61cm per sec.; to AIED of 85.47cm per sec. and to AIEE of 99.51cm per sec. Correlations of different intensities between the vascular diameters have been verified between the
Validação da curva normal de peso fetal estimado pela ultra-sonografia para o diagnóstico do peso neonatal Validity of the normal fetal weight curve estimated by ultrasound for diagnosis of neonatal weight

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José Guilherme Cecatti

2003-02-01

Full Text Available OBJETIVO: avaliar a concordância entre o peso fetal estimado (PFE por ultra-sonografia e o neonatal, o desempenho da curva normal de PFE por idade gestacional no diagnóstico de desvios do peso fetal/neonatal e fatores associados. MÉTODOS: participaram do estudo 186 grávidas atendidas de novembro de 1998 a janeiro de 2000, com avaliação ultra-sonográfica até 3 dias antes do parto, determinação do PFE e do índice de líquido amniótico e parto na instituição. O PFE foi calculado e classificado de acordo com a curva de valores normais de PFE em: pequeno para a idade gestacional (PIG, adequado para a idade gestacional (AIG e grande para a idade gestacional (GIG. A mesma classificação foi feita para o peso neonatal. A variabilidade das medidas e o grau de correlação linear entre o PFE e o peso neonatal foram calculados, bem como a sensibilidade, especificidade e valores preditivos para o uso da curva de valores normais de PFE para o diagnóstico dos desvios do peso neonatal. RESULTADOS: diferença entre o PFE e o peso neonatal variou entre -540 e +594 g, com média de +47,1 g, e as duas medidas apresentaram um coeficiente de correlação linear de 0,94. A curva normal de PFE teve sensibilidade de 100% e especificidade de 90,5% em detectar PIG ao nascimento, e de 94,4 e 92,8%, respectivamente, em detectar GIG, porém os valores preditivos positivos foram baixos para ambos. CONCLUSÕES: a estimativa ultra-sonográfica do peso fetal foi concordante com o peso neonatal, superestimando-o em apenas cerca de 47 g e a curva do PFE teve bom desempenho no rastreamento diagnóstico de recém-nascidos PIG e GIG.PURPOSE: tocompare the ultrasound estimation of fetal weight (EFW with neonatal weight and to evaluate the performance of the normal EFW curve according to gestational age for the diagnosis of fetal/neonatal weight deviation and associated factors. METHODS: one hundred and eighty-six pregnant women who delivered at the institution from
Estudo Prospectivo das Características Sonográficas no Diagnóstico de Nódulos Sólidos da Mama

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Paulinelli Régis Resende

2002-01-01

Full Text Available Objetivo: avaliar, por meio de estudo prospectivo, o valor de diferentes características ultra-sonográficas dos nódulos sólidos, na diferenciação de lesões malignas e benignas da mama. Métodos: foram incluídas 142 pacientes do Programa de Mastologia do Departamento de Ginecologia e Obstetrícia da Universidade Federal de Goiás com nódulos sólidos da mama. A ultra-sonografia mamária foi realizada pelo médico estagiário de mastologia, acompanhado do preceptor. As seis características estudadas foram: contornos, ecos internos, ecos posteriores, diferença dos diâmetros, ligamentos de Cooper e halo ecogênico. Cada descrição característica ultra-sonográfica foi analisada estatisticamente e comparada, após a exérese da lesão, com o resultado do exame anatomopatológico. Resultados: dentre as 142 pacientes incluídas no estudo, 90 (63% tiveram suas lesões ressecadas, com diagnóstico de 77 tumores benignos (86% e 13 de malignos (14%. Foram significantes no diagnóstico de malignidade as seguintes características ultra-sonográficas: presença de sombra acústica posterior (p=0,0001, contornos irregulares (p=0,0007, ecos internos heterogêneos (p=0,0015 e diâmetro ântero-posterior (AP maior que o látero-lateral (LL (p<0,0001. A presença de halo ecogênico no tumor e a visibilização dos ligamentos de Cooper espessados não influenciaram o diagnóstico de malignidade nesse estudo. Conclusão: a ultra-sonografia é um método diagnóstico que pode ajudar na diferenciação de tumores sólidos benignos e malignos. Os contornos irregulares, os ecos internos heterogêneos, a sombra posterior e o diâmetro AP maior que o LL, quando presentes, apresentaram alta correlação com o exame anatomopatológico de câncer.
Uso do ultra-som para punção venosa central em paciente obeso com adenomegalia cervical

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Jaderson Wollmeister

2008-08-01

Full Text Available JUSTIFICATICA E OBJETIVOS: As técnicas clássicas para punção venosa central são realizadas com base em referências anatômicas de superfície e conhecimento da anatomia vascular da região em que se realizará a punção. O uso do ultra-som permite a realização da punção sob visão direta das estruturas vasculares, peri-vasculares e da agulha de punção. O objetivo deste relato foi descrever o uso do ultra-som no auxílio de acesso venoso central em paciente obeso e com adenomegalias. RELATO DO CASO: Paciente do sexo masculino, branco, 28 anos, 1,70 m, 120 kg, com diagnóstico de linfoma de Hodgkin esclerose nodular. Solicitado ao Serviço de Anestesiologia do Hospital Governador Celso Ramos, punção de veia jugular interna direita guiada por ultra-som devido à presença de gânglio supraclavicular que prejudicava a referência anatômica de punção e à obesidade do paciente. Após a obtenção da melhor imagem a veia jugular interna esquerda foi puncionada e colocado um cateter venoso de triplo lúmen. A punção foi única, com progressão fácil do cateter e realizada sem complicações. CONCLUSÕES: O uso da ultra-sonografia para punção venosa central pode evitar complicações tornando o procedimento mais seguro para o paciente.
Effect of intertrochanteric osteotomy on the proximal femur of rabbits: assessment with power Doppler sonography and scintigraphy Efeito da osteotomia intertrocantérica no femur proximal de coelhos: avaliação com utra-sonografia power Doppler e cintilografia

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Andrea S. Doria

2007-01-01

area unit.OBJETIVO: Regeneração em casos de lesão óssea resulta em aumento da vascularização local e remodelamento da medula óssea adjacente. A caracterização imagenológica de padrões vasculares e metabólicos no fêmur proximal após uma osteotomia intertrocantérica pode auxiliar ortopedistas a decidirem qual a terapêutica mais apropriada. O objetivo deste estudo foi avaliar as alterações temporais observadas por ultra-sonografia Doppler e cintilografia no fêmur proximal após a realização de uma osteotomia intertrocantérica; e comparar achados imagenológicos e histomorfométricos no estágio pós-operatório tardio (6 semanas após a cirurgia num modelo animal de lesão óssea. MATERIAIS AND MÉTODOS: Ambos os quadris de 12 coelhos adultos foram examinados por ultra-sonografia power Doppler e cintilografia antes e após (7 dias e 6 semanas uma osteotomia unilateral. A acurácia dos métodos de imagem foi avaliada usando-se o status operatório dos quadris and os resultados histomorfométricos (área vascular fracional e número de vasos/unidade de área como medidas de referência. RESULTADOS: Uma diferença significativa foi observada entre o número médio de pixels presentes no fêmur proximal operado e não-operado ao exame de power Doppler obtido no estágio pós-operatório tardio (P=0.049. Embora ser atingir significância estatística, a área abaixo da curva ("area-under-the-curve" dos exames de power Doppler (AUC=0.99 for numericamente superior à área abaixo da curva dos exames de cintilografia (AUC= 0.857±0.099 (P=0.15 para diferenciar fêmures proximais com relação a suas áreas vasculares fracionais no estágio pós-operatório tardio. Ao contrário, a cintilografia tendeu a apresentar uma "performance" diagnóstica superior (AUC=0.984±0.022 em relação ao Doppler (AUC=0.746±0.131 para demonstrar a quantidade de vasos por unidade de área (P=0.07 no estágio tardio. CONCLUSÃO: Nossos resultados despertam a importância de
Achados Ultra-Sonográficos em Pacientes com Ameaça de Abortamento no Primeiro Trimestre da Gestação Ultrasound Findings in First-trimester Threatened Abortion

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Luiz Carlos Watanabe

2000-06-01

Full Text Available Objetivo: avaliar os achados ultra-sonográficos nas gestantes com ameaça de abortamento no primeiro trimestre da gestação. Métodos: exames de ultra-som obstétrico transabdominal e transvaginal foram realizados nas pacientes com sangramento vaginal e teste de gravidez positivo. Foram incluídas as gestantes entre 6 a 14 semanas de gestação pela data da última menstruação ou pelo exame ultra-sonográfico, que apresentavam colo do útero impérvio ao exame clínico. Foram excluídas as gestações múltiplas ou aquelas que realizaram tentativa de abortamento por meio de drogas ou manipulação. Resultados: em 132 dos 247 casos (53.4% foi diagnosticada gestação viável e em 46.6% (115/247, gestação inviável. Abortamento incompleto foi identificado em 19% (47/247, abortamento completo em 8,5% (21/247, abortamento retido em 7,7% (19/247, gestação anembrionada em 6,1% (15/247, gestação ectópica em 4,5% (11/247 e mola hidatiforme em 0,8% (2/247. Conclusão: aproximadamente metade (46,6% das gestações com ameaça de abortamento no primeiro trimestre apresentaram diagnóstico de inviabilidade da gestação. O exame ultra-sonográfico pode ajudar a definir esta condição e a conduta obstétrica.Objective: to evaluate ultrasound findings in pregnant women with threatened abortion in the first trimester of pregnancy. Methods: transabdominal and transvaginal ultrasound scans were performed in patients with vaginal bleeding with previous positive pregnancy test. Patients with 6-14-week gestation (by the last menstrual period or ultrasound scan, with closed cervix on clinical evaluation were included. Multiple pregnancies and those patients who have tried abortion by using abortive drugs or manipulation were excluded. Results: in 132 of 247 (53.4% the pregnancy was viable and in 46.6% (115/247 the pregnancy was nonviable. Incomplete miscarriage was found in 19% (47/247, complete miscarriage in 8.5% (21/247, missed abortion in 7.7% (19
Avaliação da concordância diagnóstica entre métodos não invasivos e endoscopia na investigação de infertilidade Evaluation of the diagnostic agreement between non invasive methods and endoscopy in infertility investigation

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Luciana de Souza Borges

2005-07-01

Full Text Available OBJETIVO: avaliar a concordância entre os métodos não invasivos - queixa de dor pélvica, ultra-sonografia transvaginal (US-TV e histerossalpingografia (HSG e a endoscopia ginecológica no diagnóstico de fatores tubo-peritoneais responsáveis por infertilidade conjugal. MÉTODOS: foi realizado estudo do tipo corte transversal incluindo 149 pacientes inférteis submetidas à avaliação clínica, ultra-sonografia transvaginal, histerossonografia, histeroscopia e laparoscopia. Na avaliação de dor pélvica foram consideradas anormais a queixa de dor pélvica tipo dispareunia, dismenorréia ou dor acíclica e dor à mobilização do colo uterino e palpação de anexos. O exame ultra-sonográfico foi considerado alterado com os achados de alterações morfológicas anexiais ou uterinas (hidrossalpinge, miomas ou malformações uterinas. A histerossalpingografia foi considerada anormal na presença de alteração anatômica tubária e obstrução unilateral ou bilateral. Avaliou-se a concordância diagnóstica individual entre os diversos métodos não invasivos e a endoscopia por meio da análise kappa. RESULTADOS: a concordância entre dor pélvica, US-TV e HSG e avaliação endoscópica foi, respectivamente, de 46,3% (kapa=0,092; IC 95%: -0,043 a 0,228, 24% (kapa=-0,052; IC 95%: -0,148 a 0,043 e 46% (kapa=0,092; IC 95%: -0,043 a 0,228. Quando se considerou pelo menos um método não invasivo positivo, a concordância com a avaliação endoscópica foi de 63% (kapa=-0,014; IC 95%: -0,227 a 0,199. A sensibilidade e especificidade em predizer achados na endoscopia foram de 39,5 e 80% na presença de dor pélvica, de 14,5 e 72% na presença de alteração na US-TV, de 39,5 e 80% na presença de alteração na HSG e de 70,2 e 28% na presença de ao menos uma alteração na avaliação não invasiva. CONCLUSÃO: há fraca concordância diagnóstica entre os diversos métodos não invasivos e a endoscopia na investigação de infertilidade conjugal
Prolapse Recurrence after Transvaginal Mesh Removal.

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Rawlings, Tanner; Lavelle, Rebecca S; Coskun, Burhan; Alhalabi, Feras; Zimmern, Philippe E

2015-11-01

We determined the rate of pelvic organ prolapse recurrence after transvaginal mesh removal. Following institutional review board approval a longitudinally collected database of women undergoing transvaginal mesh removal for complications after transvaginal mesh placement with at least 1 year minimum followup was queried for pelvic organ prolapse recurrence. Recurrent prolapse was defined as greater than stage 1 on examination or the need for reoperation at the site of transvaginal mesh removal. Outcome measures were based on POP-Q (Pelvic Organ Prolapse Quantification System) at the last visit. Patients were grouped into 3 groups, including group 1--recurrent prolapse in the same compartment as transvaginal mesh removal, 2--persistent prolapse and 3--prolapse in a compartment different than transvaginal mesh removal. Of 73 women 52 met study inclusion criteria from 2007 to 2013, including 73% who presented with multiple indications for transvaginal mesh removal. The mean interval between insertion and removal was 45 months (range 10 to 165). Overall mean followup after transvaginal mesh removal was 30 months (range 12 to 84). In group 1 (recurrent prolapse) the rate was 15% (6 of 40 patients). Four women underwent surgery for recurrent prolapse at a mean 7 of months (range 5 to 10). Two patients elected observation. The rate of persistent prolapse (group 2) was 23% (12 of 52 patients). Three women underwent prolapse reoperation at a mean of 10 months (range 8 to 12). In group 3 (de novo/different compartment prolapse) the rate was 6% (3 of 52 patients). One woman underwent surgical repair at 52 months. At a mean 2.5-year followup 62% of patients (32 of 52) did not have recurrent or persistent prolapse after transvaginal mesh removal and 85% (44 of 52) did not undergo any further procedure for prolapse. Specifically for pelvic organ prolapse in the same compartment as transvaginal mesh removal 12% of patients had recurrence, of whom 8% underwent prolapse repair
Colecistectomía transvaginal (NOTES combinada con minilaparoscopia Transvaginal cholecystectomy (NOTES combined with minilaparoscopy

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C. Dolz

2007-12-01

Full Text Available Objetivo: comunicar la primera colecistectomía transvaginal realizada en humanos en nuestro país. Pacientes y métodos: mujer de 35 años de edad con historia de cólicos hepáticos de repetición de etiología litiásica. La intervención la realizó un equipo multidisciplinar constituido por cirujanos, gastroenterólogos y ginecólogos. Consistió en crear un neumoperitoneo mediante una aguja de Veres colocada en el fondo umbilical con posterior colocación de un trócar de 5 mm. Se colocó un segundo trócar de 3 mm en el hipocondrio derecho. Se realizó una colpotomía y colocación de un trócar vaginal de 12 mm que permitió el paso de un videogastroscopio que alcanzó el hilio hepático. Resultados: se realizó la colecistectomía mediante la acción conjunta de instrumentos de trabajo que pasaron por las puertas de entrada de la minilaparoscopia y por el videogastroscopio. La extracción de la vesícula se realizó por vía transvaginal mediante el videogastroscopio. No aparecieron complicaciones postoperatorias siendo la paciente dada de alta al cabo de 24 horas. Conclusiones: la colecistectomía transvaginal mediante la acción conjunta de un equipo multidiscliplinar es posible y segura. La cirugía endoscópica transluminal a través de orificios naturales (NOTES, es una modalidad emergente que intenta ser menos invasiva, mejor tolerada y más respetuosa con el daño estético que la cirugía laparoscópica y probablemente será la puerta de entrada de innovaciones médicas y tecnológicas de gran trascendencia durante los próximos años.Objective: to report on the first transvaginal cholecystectomy performed on a human being in Spain. Patients and methods: a 35-year-old female with a history of recurrent bouts of biliary pain resulting from gallstones. A surgical procedure was performed by a multidisciplinary team composed of surgeons, gastroenterologists, and gynecologists. It involved creating a pneumoperitoneum by placing a
Valor da mamotomia no diagnóstico e na terapia de lesões não palpáveis Usefulness of mammoty in diagnosis and therapy of nonpalpable lesions

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Aline Cristina Camacho Ambrosio

2004-02-01

Full Text Available OBJETIVOS: avaliar a acurácia diagnóstica da biópsia direcional assistida à vácuo (mamotomia, guiada por ultra-sonografia, no diagnóstico das lesões mamárias não palpáveis, comparando-a com a biópsia excisional, e estimar o valor terapêutico da mamotomia em lesões benignas não palpáveis. MÉTODOS: foram incluídas 114 pacientes, as quais apresentavam lesões mamárias não palpáveis, visíveis à ultra-sonografia. As pacientes foram encaminhadas devido mastalgia ou alteração mamográfica detectada previamente, com solicitação de avaliação ultra-sonográfica complementar. Todas foram submetidas à mamotomia guiada por ultra-sonografia com Mammotome® (Biopsys, Irvine, Califórnia, com sonda gauge 11. A biópsia excisional foi realizada com agulhamento prévio daquelas pacientes que apresentaram lesão residual após a mamotomia, ou seja, em 88 pacientes. Para comparar os resultados do material obtido por mamotomia com os da biópsia excisional foram calculados os índices de sensibilidade e especificidade, valores preditivos positivo e negativo, e a proporção de concordância. As sensibilidades, assim como as especificidades e as proporções de concordância dos dois exames, foram comparadas por meio da estatística de Wald, utilizando um modelo para dados categorizados. RESULTADOS: das 114 pacientes, 88 submeteram-se a biópsia excisional. As 26 restantes não apresentaram lesões pós-mamotomia, visíveis à ultra-sonografia, sendo seguidas por um ano sem alterações nos exames semestrais, tanto mamográficos quanto ultra-sonográficos. Tratava-se de lesões menores do que 1,5 cm de diâmetro. Dentre as 88 pacientes submetidas à biópsia excisional 69 apresentaram lesões benignas (78,4% e, 19 (21,6%, malignas. A mamotomia diagnosticou 16 das lesões malignas, com três resultados falso-negativos e nenhum falso-positivo. Os resultados falsos ocorreram: nos primeiros casos realizados, mostrando a existência de curva
O uso da ressonância magnética na investigação do câncer mamário Magnetic resonance imaging in the evaluation of breast cancer

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Beatriz Regina Alvares

2003-12-01

Full Text Available Os métodos diagnósticos de imagem mamografia, ultra-sonografia e cintilografia são exames imprescindíveis no diagnóstico do câncer de mama e no acompanhamento após o procedimento cirúrgico, porém, todos apresentam limitações específicas. Atualmente, a ressonância magnética tem-se revelado um método diagnóstico promissor para avaliar mais detalhadamente lesões tumorais do parênquima mamário. Neste trabalho os autores descrevem as principais indicações e os achados da ressonância magnética no câncer de mama, bem como comparam o seu desempenho com o dos outros métodos de imagem - mamografia, ultra-sonografia e cintilografia -, incluindo as vantagens e limitações de cada modalidade.Mammography, ultrasonography and scintimammography are essential examinations for the diagnosis and post-surgical follow-up of patients with breast cancer, although all these modalities may present specific limitations. In recent years magnetic resonance imaging has demonstrated good performance in detecting breast tumors in the mammary gland. In this study the authors describe the magnetic resonance imaging main indications and findings in patients with breast cancer, and compare the performance of mammography, ultrasonography and scintimammography, including the advantages and limitations of each modality.
Gravidez ectópica cervical com embrião vivo: relato de quatro casos Cervical pregnancy with live embryo: a report of four cases

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Julio Elito Junior

1999-07-01

Full Text Available Objetivo: avaliar a eficácia e segurança do tratamento da gravidez ectópica cervical com embrião vivo com a injeção intra-amniótica de metotrexato (MTX. Métodos: quatro pacientes fizeram parte do estudo. O diagnóstico foi efetuado pelo exame clínico e confirmado pela ultra-sonografia, na qual foi visualizado saco gestacional com embrião vivo em topografia do colo uterino. As pacientes foram submetidas a punção do saco gestacional guiada pela ultra-sonografia, tendo sido aspirado o seu conteúdo e injetado metotrexato (1 mg/kg. O controle foi realizado com dosagens seriadas de beta-hCG nos dias 1, 4 e 7 após a injeção e semanalmente até negativação dos títulos. Resultados: os quatro casos foram tratados com sucesso. O tempo necessário para regressão dos níveis de beta-hCG a valores pré-gravídicos foi de: 60 dias (caso 1, 74 dias (caso 2, 28 dias (caso 3 e 10 dias (caso 4. Conclusão: a injeção intra-amniótica de MTX é uma alternativa do tratamento da gravidez ectópica cervical com embrião vivo, pois evita a cirurgia e preserva a fertilidade.Purpose: to evaluate safety and efficacy of intra-amniotic injection of methotrexate (MTX for treatment of viable cervical pregnancy. Methods: four women with viable cervical pregnancy confirmed by ultrasound (US were treated with transvaginal injection of MTX (1 mg/kg under sonographic control. The follow-up was made with serial dosages of beta-hCG on days 1, 4 and 7 after injection and weekly until the titers were negative. Results: the patients were treated with success. The time for the titers of beta-hCG to become negative after the treatment was: 62 days (case 1, 84 days (case 2, 28 days (case 3 and 10 days (case 4. Conclusion: intra-amniotic injection of MTX can be used to avoid surgery in cases of viable cervical pregnancy.
Pure transvaginal excision of mesh erosion involving the bladder.

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Firoozi, Farzeen; Goldman, Howard B

2013-06-01

We present a pure transvaginal approach to the removal of eroded mesh involving the bladder secondary to placement of transvaginal mesh for management of pelvic organ prolapse (POP) using a mesh kit. Although technically challenging, we demonstrate the feasibility of a purely transvaginal approach, avoiding a potentially more morbid transabdominal approach. The video presents the surgical technique of pure transvaginal excision of mesh erosion involving the bladder after mesh placement using a prolapse kit was performed. This video shows that purely transvaginal removal of mesh erosion involving the bladder can be done safely and is feasible.
Estimativa do Peso Fetal: Comparação Entre um Método Clínico e a Ultra-Sonografia Estimation of Fetal Weight: Comparison Between a Clinical Method and Ultrasonography

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Alexandre Faisal Cury

1998-12-01

Full Text Available Objetivo: avaliar a validade da estimativa do peso fetal por método baseado na altura uterina - regra de Johnson. Métodos: foram estudadas 101 gestantes e seus recém-nascidos (RN, estimando-se o peso fetal pela utilização da regra de Johnson adaptada, que consiste em aplicação clínica de modelo matemático para cálculo do peso fetal baseado na altura uterina e na altura da apresentação fetal. O peso estimado foi obtido no dia do parto e foi comparado com o peso observado ao nascer, que constituiu o controle da análise da validade do método empregado. Na mesma data foi realizada ultra-sonografia obstétrica (US detalhada, que inclui cálculo do peso fetal pela aplicação das tabelas de Sheppard, e este peso, estimado pela US, foi comparado ao peso observado ao nascer. Resultados: os resultados destas comparações mostraram que a estimativa clínica empregada nesta casuística tem valor semelhante à US para avaliação do peso ao nascer: a margem de acerto do método clínico com variações de 5%, 10% e 15% entre peso estimado e peso observado foi de 55,3%, 73% e 86,7% respectivamente, e, para o US, de 60,7%, 75,4% e 91,1%, respectivamente. Conclusões:quando comparados, estes valores não se mostraram diferentes do ponto de vista estatístico, permitindo concluir-se que a avaliação clínica mostra acurácia semelhante à da US para o cálculo do peso ao nascer.Purpose: to assess the validity of fetal weight estimation by a method based on uterine height -- Johnson's rule. Methods: one hundred and one pregnant women and their newborn children were studied. The fetal weight was estimated using an adaptation of Johnson's rule, which consists of the clinical application of a mathematical model to calculate the fetal weight based on the uterine height and the height of fetal presentation. The estimated weight was obtained on the day of delivery and was compared to the weight observed after birth. This, in turn, was the control of
O Projeto Queixadinha: a morbidade e o controle da esquistossomose em área endêmica no nordeste de Minas Gerais, Brasil

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José Roberto Lambertucci

1996-04-01

Full Text Available Nos últimos cinco anos, em uma área endêmica para esquistossomose no nordeste de Minas Gerais, 561 indivíduos submeteram-se a exames clínico, laboratoriais, ultra-sonografia abdominal e dopplerecocardtografia visando definir a morbidade da doença antes e após o tratamento. Revelaram-se altas a prevalência de esquistossomose (66,3% e de formas graves (9,5% com baço palpável. A prevalência de indivíduos sem fibrose hepática e com fibrose teve, moderada e intensa ao ultra-som foi de 46,0%, 19,6%, 27,6% e 6,8%, respectivamente. Vinte um (39,6%: de 53 indivíduos com baço palpável não apresentavam fibrose periportal ao ultrasom. Linfonodos periportais foram identificados em 33,8% dos indivíduos examinados e anticorpos anti-KLH no soro de 40,7%,. Observaram-se alterações urinárias compatíveis com glomerulopatia esquistossamótica em 4,5% da população e 11,7% apresentavam achados dopplerecocardiográficos de hipertensão pulmonar. Doze meses após o tratamento da esquistossomose, a prevalência da doença reduziu-se de 66,3% para 25,0%. Em Queixadinha, um perfil da morbidade da doença e de sua evolução após o tratamento começa a ser delineado.
Transvaginal ultrasonography of rectal endometriosis

DEFF Research Database (Denmark)

Egekvist, Anne Gisselmann; Seyer-Hansen, Mikkel; Forman, Axel

Objectives: The aim of this present study was to evaluate the interobserver variation of transvaginal ultrasonographic measurements of endometriosis infiltrating the rectosigmoid wall. Methods: Transvaginal ultrasonography was performed independently by two observers. Observer 1 had several years...... of experience in ultrasonography while observer 2 was a medical student with no prior experience in ultrasonography or endometriosis. In 24 patient length, width and depth of endometriosis infiltrating the rectosigmoid bowel was measured. The differences between the observers were analysed by Bland and Altman...... for a relatively short period gives comparable scanning results between the two observers. It seems that transvaginal ultrasound could be used as a diagnostic tool for rectal endometriosis in most departments. However, the irregular morphology of the lesions makes the measurements very complex, and a strict...
Carcass traits of surubim (“Pseudoplatystoma” spp. evaluated by ultrasound Rendimento de carcaça em surubim ("Pseudoplatystoma" spp. avaliado por ultra-som

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Daniela Chemim Melo

2008-12-01

Full Text Available The parameters of carcass trait of alive surubim (Pseudoplatystoma spp. evaluated by ultrasound were estimated in this trial. A total of 34 fish was divided into two groups according to average body weight: group 1 = 2.7 kg e group 2 = 1.5 kg. The fish were measured for total, head and standard lengths. Ultrasound images of four defined points were obtained: 1 - anterior insertion of dorsal fin; 2 - posterior insertion of dorsal fin; 3 - anterior insertion of fat fin and 4 - insertion of caudal fin. After, weights of carcass, head, shank fillet and belly fillet were obtained. Correlations of measures obtained by the ultrasound images with carcass yield traits were determined. The point 3 showed the best correlations for yield of group 1 with: carcass (0.91, head (0.86, shank fillet (0.87 and belly fillet (0.91. Carcass yield of group 1 was higher (70.9% than group 2 (66.9%, probably due to the highest head weight of these animals. The best equations for carcass yield and fillet weight were the ones that considered the measures of point 3 and total length, respectively. Ultrasound for evaluation of carcass traits in alive surubim is a reliable technique, once it can maintains reproducers with great performance inside stock.Objetivou-se com este trabalho definir parâmetros de avaliação do rendimento de carcaça em surubins Pseudoplatystoma spp. vivos por intermédio da ultra-sonografia. Foram utilizados 34 peixes divididos em dois grupos conforme peso médio: grupo 1 = 2,7 kg e grupo 2 = 1,5 kg. De cada exemplar obtiveram-se as medidas de comprimento total, comprimento de cabeça e comprimento padrão. Foram realizadas imagens dorso ventrais em quatro pontos: 1 - base anterior da nadadeira dorsal; 2 - base posterior da nadadeira dorsal; 3 - base anterior da nadadeira adiposa e 4 - base do pedúnculo caudal, onde foram mensuradas altura, largura e área da musculatura epi-axial. Posteriormente, foram obtidos pesos da carcaça, da cabeça, do fil
Histeroscopia na menopausa: análise das técnicas e acurácia do método Histeroscopy in menopause: analysis of the techniques and accuracy of the method

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Hélio de Lima Ferreira Fernandes Costa

2008-10-01

Full Text Available O rastreamento do câncer do endométrio em mulheres assintomáticas não tem se mostrado custo-efetivo. Os estudos sobre o tema mostram que a ultra-sonografia como método de rastreio apresenta alta taxa de resultados falsos-positivos e efeito desprezível sobre a mortalidade. Desta forma, a estratégia para assistência deve se basear no diagnóstico precoce e tratamento oportuno em mulheres que apresentam sangramento pós-menopausa. A ultra-sonografia transvaginal, por ser método não-invasivo, amplamente disponível e com elevada sensibilidade, deve ser o método propedêutico inicial. Embora não haja consenso acerca do ponto de corte da espessura endometrial ecográfica acima da qual se deva prosseguir a investigação, a histeroscopia diagnóstica com biópsia deve ser o próximo passo. O risco de neoplasia em endométrios com espessura menor ou igual a 3 mm é reduzido o suficiente para limitar a histeroscopia, nesses casos, à situações excepcionais. A biópsia deve ser parte obrigatória da histeroscopia, porque o diagnóstico em bases puramente visuais pode fornecer falsos resultados. A histeroscopia pode ser realizada em regime ambulatorial em mais de 95% dos casos, mesmo em mulheres menopausadas, com raras complicações graves. A adoção de técnicas de exame "sem contato" e a redução progressiva do diâmetro dos histeroscópios tem reduzido o desconforto associado à histeroscopia, enquanto que a utilização de novos instrumentais tem permitido a realização de pequenos procedimentos em nível ambulatorial.Detection of endometrial cancer in asymptomatic women has not proved to be a cost-effective procedure. Studies on this matter have shown that ultrasonography as a detecting method presents a high ratio of false-positive results and a negligible effect on the mortality rate. This way, the assistance strategy should be based on earlier diagnosis and appropriate treatment in women who present postmenopause bleeding. Being a
Ultra-sonografia na artrite reumatóide: aplicabilidade e perspectivas Ultrasonography in rheumatoid arthritis: applicability and expectations

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Eloy de Ávila Fernandes

2008-02-01

Full Text Available Este trabalho realiza uma revisão bibliográfica sobre o papel do ultra-som (US no diagnóstico precoce da artrite reumatóide (AR, sua utilização no tratamento destes pacientes e sua utilidade na avaliação da resposta ao tratamento. A AR é uma doença inflamatória crônica que, quando não diagnosticada e tratada adequadamente, pode levar à deformidade física e à incapacidade para o trabalho. A introdução precoce das drogas modificadoras da doença (DMCD, sejam elas tradicionais ou mais novas (agentes biológicos, pode modificar a evolução da doença. Para tanto, o diagnóstico da AR precisa ser feito o mais rápido possível. O US é um método que possibilita o estudo das articulações e pode mostrar sinais de atividade inflamatória, especialmente a sinovite. Técnicas como o estudo com Doppler colorido e o Doppler de amplitude podem ajudar na avaliação de atividade da doença, diferenciando tecido inflamatório ativo (pannus de inativo. Outros achados como erosões, alterações tendíneas, bursites, cistos sinoviais e derrames articulares também podem ser encontrados. Esta revisão, no entanto, demonstra que métodos de quantificação da atividade inflamatória ainda precisam ser estabelecidos no US.This review discusses the usefulness of ultrasound in the early diagnosis of reumathoid arthritis, its utilization in these patients treatment and its utility in evaluation of the response to treatment. Reumathoid arthritis is a chronic disease that when it is not promptly diagnosed it can cause physical deformity and disability to work. The early introduction of disease modifying antirheumatic drugs (DMARDs, no matter traditional or newer (biologic agents, may modify the disease outcome. In order that , the diagnosis of RA must be made as soon as possible. Ultrasound makes possible to study the joints and can show signs of inflammatory activity, especially synovitis. Color Doppler and power Doppler can help differentiate
Transvaginal ultrasound ovarian diathermy: sheep as an experimental model

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Pimentel Anita M

2012-01-01

Full Text Available Abstract Background Some techniques of transvaginal ovarian drilling have been previously described. Nevertheless a monopolar transvaginal ovarian cauterization, that use the expertise and safety of transvaginal puncture for oocyte captation seems to be an easier and feasible approach. The aim of this study was to develop a minimally invasive ovarian cauterization technique under transvaginal ultrasound control, and to evaluate the safety of the transvaginal ovarian monopolar cauterization, female sheep at reproductive age were used as an experimental model. Findings An experimental study was performed in a university research center. Seventeen female sheep (15 Corriedale e 2 Suffolk in reproductive age were submitted to transvaginal ovarian cauterization with a monopolar Valleylab Force 2 electrocautery. Macroscopic and microscopic lesions were assessed. Ovarian size were 1.31 cm2 ± 0,43 (Corriedale and 3.41 cm2 ± 0,64 (Suffolk. From 30 ovaries from Corriedale sheep punctured, only 3 were cauterized, presenting macroscopic and typical microscopic lesion. In the Suffolk sheep group, only one ovary was cauterized. No lesion could be found in the needle path. Conclusions This is the first experimental animal model described for ovarian cauterization needle guided by transvaginal ultrasound. The sheep does not seem to be the ideal animal model to study this technique. Another animal model, whose ovaries are better identified by transvaginal ultrasound should be sought for this technique, theoretically less invasive, before it could be offered safely to women with polycystic ovary syndrome.

Fatores maternos associados ao peso fetal estimado pela ultra-sonografia

OpenAIRE

Melo,Adriana Suely de Oliveira; Amorim,Melania Maria Ramos de; Assunção,Paula Lisiane; Melo,Fabiana de Oliveira; Gondim,Sheila Sherezaide Rocha; Carvalho,Danielle Franklin de; Cardoso,Maria Aparecida Alves

2008-01-01

OBJETIVO: avaliar o efeito de variáveis maternas, socioeconômicas e obstétricas, assim como a presença de incisuras na 20ª e na 24ª semana, sobre o peso fetal estimado no final da gravidez (36ª semana) em gestantes atendidas pelo Programa Saúde da Família em uma cidade do interior do Nordeste do Brasil. MÉTODOS: estudo longitudinal incluindo 137 gestantes. As gestantes foram acompanhadas a cada quatro semanas para aferição das condições clínicas, socioeconômicas e obstétricas, incluindo o pes...
Ovários policísticos: critérios hemodinâmicos

OpenAIRE

Ávila,Márcio Augusto Pinto de; Murta,Carlos Geraldo Viana

2001-01-01

O advento da ultra-sonografia endovaginal de alta resolução abriu novas áreas de pesquisa nos ovários policísticos. O conhecimento da hemodinâmica ovariana é fundamental para o entendimento do comportamento fisiopatológico dos ovários policísticos. Os autores tecem considerações sobre a possibilidade da utilização do Doppler colorido na melhor definição dos ovários policísticos. Os dados sugerem que o aumento da vascularidade e a diminuição da resistência dos vasos do estroma ovariano, assim ...
Transvaginal Appendectomy: A Systematic Review

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Mehmet Ali Yagci

2014-01-01

Full Text Available Background. Natural orifice transluminal endoscopic surgery (NOTES is a new approach that allows minimal invasive surgery through the mouth, anus, or vagina. Objective. To summarize the recent clinical appraisal, feasibility, complications, and limitations of transvaginal appendectomy for humans and outline the techniques. Data Sources. PubMed/MEDLINE, Cochrane, Google-Scholar, EBSCO, clinicaltrials.gov and congress abstracts, were searched. Study Selection. All related reports were included, irrespective of age, region, race, obesity, comorbidities or history of previous surgery. No restrictions were made in terms of language, country or journal. Main Outcome Measures. Patient selection criteria, surgical techniques, and results. Results. There were total 112 transvaginal appendectomies. All the selected patients had uncomplicated appendicitis and there were no morbidly obese patients. There was no standard surgical technique for transvaginal appendectomy. Mean operating time was 53.3 minutes (25–130 minutes. Conversion and complication rates were 3.6% and 8.2%, respectively. Mean length of hospital stay was 1.9 days. Limitations. There are a limited number of comparative studies and an absence of randomized studies. Conclusions. For now, nonmorbidly obese females with noncomplicated appendicitis can be a candidate for transvaginal appendectomy. It may decrease postoperative pain and enable the return to normal life and work off time. More comparative studies including subgroups are necessary.
Gravidez ectópica na cicatriz uterina de cesárea: relato de caso Cesarean scar ectopic pregnancy: a case report

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Maurício de Souza Arruda

2008-10-01

Full Text Available Gravidez ectópica na cicatriz de cesárea é a forma mais rara de gravidez ectópica e provavelmente uma das mais perigosas em função dos riscos de ruptura e hemorragia volumosa. Essa situação deve ser diferenciada da gravidez cervical e de abortamento em curso, para que o tratamento apropriado seja imediatamente oferecido. Desde o advento da ultra-sonografia transvaginal, a gravidez ectópica na cicatriz de cesárea pode ser diagnosticada precocemente na gestação e, para isso o ultra-sonografista deve estar familiarizado com e atento aos critérios diagnósticos, especialmente em mulheres com cicatriz de cesárea prévia. Descrevemos aqui um caso de gravidez ectópica em cicatriz de cesárea, cujo diagnóstico foi tardio, havendo apresentação de involução espontânea.Ectopic pregnancy in a cesarean scar is the rarest form of ectopic pregnancy and probably the most dangerous one because of the risk of uterine rupture and massive hemorrhage. This condition must be distinguished from cervical pregnancy and spontaneous abortion in progress, so that the appropriate treatment can be immediately offered. Since the advent of endovaginal ultrasonography, ectopic pregnancy in a cesarean scar can be diagnosed early in pregnancy if the sonographer is familiarized with the diagnostic criteria of this situation, especially in women with previous cesarean scar. Here we describe a case of ectopic pregnancy in a cesarean scar in which the diagnosis was considerably late, with presentation of spontaneous regression.
Malformação arteriovenosa uterina após doença trofoblástica gestacional Uterine arteriovenous malformation after gestational trophoblastic disease

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Paulo Belfort

2006-02-01

Full Text Available OBJETIVO: investigar a presença e resultados de malformações vasculares uterinas (MAVU após doença trofoblástica gestacional (DTG. MÉTODOS: estudo retrospectivo com inclusão de casos diagnosticados entre 1987 e 2004; 2764 pacientes após DTG foram acompanhadas anualmente com ultra-sonografia transvaginal e Doppler colorido no Centro de Neoplasia Trofoblástica Gestacional da Santa Casa da Misericórdia (Rio de Janeiro, RJ, Brasil. Sete pacientes tiveram diagnóstico final de MAVU baseado em análise ultra-sonográfica - índice de pulsatilidade (IP, índice de resistência (IR e velocidade sistólica máxima (VSM - e achados de imagens de ressonância nuclear magnética (RNM. Dosagens negativas de beta-hCG foram decisivas para estabelecer o diagnóstico diferencial com DTG recidivante. RESULTADOS: a incidência de MAVU após DTG foi 0,2% (7/2764. Achados ultra-sonográficos de MAVU: IP médio de 0,44±0,058 (extremos: 0,38-0,52; IR médio de 0,36±0,072 (extremos: 0,29-0,50; VSM média de 64,6±23,99 cm/s (extremos: 37-96. A imagem de RNM revelou útero aumentado, miométrio heterogêneo, espaços vasculares tortuosos e vasos parametriais com ectasia. A apresentação clínica mais comum foi hemorragia transvaginal, presente em 52,7% (4/7 dos casos. Tratamento farmacológico com 150 mg de acetato de medroxiprogesterona foi empregado para controlar a hemorragia, após a estabilização hemodinâmica. Permanecem as pacientes em seguimento, assintomáticas até hoje. Duas pacientes engravidaram com MAVU, com gestações e partos exitosos. CONCLUSÃO: presente sangramento transvaginal em pacientes com beta-hCG negativo e história de DTG, deve-se considerar a possibilidade de MAVU e solicitar avaliação ultra-sonográfica com dopplervelocimetria. O tratamento conservador é a melhor opção na maioria dos casos de MAVU pós-DTG.PURPOSE: to investigate the presence and outcome of uterinevascular malformations (UVAM after gestational
Transvaginal mesh procedures for pelvic organ prolapse.

Science.gov (United States)

Walter, Jens-Erik

2011-02-01

To provide an update on transvaginal mesh procedures, newly available minimally invasive surgical techniques for pelvic floor repair. The discussion is limited to minimally invasive transvaginal mesh procedures. PubMed and Medline were searched for articles published in English, using the key words "pelvic organ prolapse," transvaginal mesh," and "minimally invasive surgery." Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Searches were updated on a regular basis, and articles were incorporated in the guideline to May 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on the Preventive Health Care. Recommendations for practice were ranked according to the method described in that report (Table 1). Counselling for the surgical treatment of pelvic organ prolapse should consider all benefits, harms, and costs of the surgical procedure, with particular emphasis on the use of mesh. 1. Patients should be counselled that transvaginal mesh procedures are considered novel techniques for pelvic floor repair that demonstrate high rates of anatomical cure in uncontrolled short-term case series. (II-2B) 2. Patients should be informed of the range of success rates until stronger evidence of superiority is published. (II-2B) 3. Training specific to transvaginal mesh procedures should be undertaken before procedures are performed. (III-C) 4. Patients should undergo thorough preoperative counselling regarding (a) the potential serious adverse sequelae of transvaginal mesh repairs, including mesh exposure, pain, and dyspareunia; and (b) the limited data available
Correlação entre a graduação histológica de biópsias e do espécimen cirúrgico em câncer da prostata

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José Cury

Full Text Available Foram estudados, retrospectivamente, os prontuários de 120 pacientes com câncer localizado da próstata nos estádios clínicos T1, T2 e T3a e que foram submetidos a 1infadenectomia ilíaca e a cirurgia radical da próstata. Todos haviam sido graduados pela escala de Gleason através de biópsias da próstata guiadas pela ultra-sonografia transretal. Correlacionamos a graduação histo1ógica destas biópsias da próstata com a graduação final obtida no exame da peça cirúrgica correspondente e obtivemos exata concordância em 39 pacientes (32,50%. Ao considerarmos a concordância de ± 1unidade, observamos concordância de resultado em 81 pacientes (67,50%. A subgraduação histológica das biópsias prostáticas foi encontrada em 75 pacientes (62,50% dos casos.
Ultra-sonografia transcraniana em cães com distúrbios neurológicos de origem central Transcranial ultrasonography in dogs with central neurologycal disorders

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C.F. Carvalho

2007-12-01

Full Text Available Avaliaram-se 55 cães com distúrbios neurológicos e verificou-se a ocorrência de afecções neurológicas de origem central, detectadas pela ultra-sonografia transcraniana (USTC. Vinte e nove (52,9% animais apresentaram diagnóstico compatível com hidrocefalia, e destes, 16 (55,1% eram fêmeas e 15 (51,7% tinham menos de dois anos. Quinze (27,3% cães apresentaram lesões focais, quatro (7,2%, alterações difusas e quatro (7,2% apresentavam imagens sugestivas de lissencefalia; em três (5,4% não foram detectadas alterações pela USTC. A hidrocefalia foi o distúrbio neurológico de origem central mais freqüente e a USTC é uma alternativa viável para auxiliar na rotina clínica veterinária como ferramenta diagnóstica na detecção de alterações morfológicas e estruturais do cérebro no cão.In this work, 55 dogs with neurologycal disorder were examined and central neurological affections were detected by transcranial ultrasonography (TCUS. They were classifyed in hydrocephaly, lissencephaly, focal and difuse parenchimal disorders, and none changes. From the examinated dogs, 52.9% presented diagnosis compatible with hydrocephaly, being 55.1% female and 51.7% younger than 2 year-old. Fifteen dogs (27.3% presented focal lesions, 7.2% diffuse lesions, 7.2% images that suggested lissencephaly, and in 5.4% no changes were detected by TCUS. It was concluded that hydrocephaly was the most frequent central neurologycal disorder and TCUS is a valuable alternative to be used in clinical routine as a tool of diagnostic to detect morphological and structural cerebral disorders in dogs.
Ultra-sonografia de características lineares e estimativas do volume de rins de cães Ultrasonographic measurement of linear characteristics and renal volumetry in dogs

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K.M.O.R. Sampaio

2002-06-01

Full Text Available Obtiveram-se as medidas lineares de rins de cães adultos, clinicamente normais, por meio da ultra-sonografia, e estimou-se o volume dos rins de 35 cães (18 fêmeas e 17 machos sem raça definida e com idade entre dois e seis anos. Os animais foram divididos em três grupos de acordo com o peso corporal (3,1 a 10,0 kg; 10,1 a 20,0 kg e 20,1 a 45,0 kg. Os planos de secção sagital, dorsal e transversal foram utilizados para obtenção das medidas lineares de comprimento (C, largura (L e espessura (E. O volume renal foi calculado a partir das medidas lineares utilizando-se a fórmula para o volume de um elipsóide. Os valores médios encontrados para os três grupos foram, respectivamente: comprimento (4,73; 6,09 e 7,13cm, largura (2,81; 3,44 e 3,95cm, espessura (2,43; 3,00 e 3,58cm e volume (17,98; 33,36 e 53,81cm³. As dimensões dos rins esquerdo e direito e de machos e fêmeas foram equivalentes. Observaram-se correlações positivas entre todas as medidas renais e peso corporal.This work aimed to measure by ultrasonography the length, width and depth and to estimate the volume of kidneys of normal adult dogs. Thirty five dogs (18 females and 17 males of mixed breeds, aging from two to six years, were used. The animals were separated in three groups according to their body weights (3.1 to 10.0 kg; 10.1 to 20.0 kg and 20.1 to 45 kg. Sagittal, dorsal and transverse plans of section were used to obtain measures of length, width and depth. The kidney volume was estimated from these measures. Mean values according to the groups were, respectively: 4.73; 6.09 and 7.13cm for length; 2.81; 3.44 and 3.95cm for width; 2.43; 3.00 and 3.58cm for depth; and the estimated volumes were 17.98; 33.36 and 53.81cm³. The length, width, depth and volume of the left and right kidneys were similar, and no difference between male and female was found for these traits. Body weight of animals was positively correlated with all the kidney traits.
PARÂMETROS REPRODUTIVOS DE MATRIZES SUÍNAS INSEMINADAS COM SÊMEN DILUÍDO EM ÁGUA DE COCO APÓS MONITORAMENTO ULTRA-SONOGRÁFICO TRANSCUTÂNEO

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Pierre Castro Soares

2006-10-01

Full Text Available Com o objetivo de avaliar o efeito de diluidores de sêmen (MERK III, BTS e água de coco acrescida de citrato de sódio a 5% sobre parâmetros reprodutivos de matrizes suínas, utilizou-se sêmen diluído nas concentrações de 4x109 e 8x109 espermatozóides/100ml na inseminação artificial de 173 fêmeas púberes e 184 adultas, com prévio monitoramento ultra-sonográfico do estro e ovulação. O diagnóstico de gestação também foi realizado por ultra-sonografia transcutânea. Os dados revelaram altas percentagens (89,5% a 95,6% de prenhes das matrizes suínas púberes e adultas, sem variação significativa entre os tipos de diluidores utilizados. Sugere-se, portanto, que a água de coco in natura pode ser utilizada na diluição de sêmen suíno, significando uma alternativa de baixo custo, e que monitoramento ultra-sonográfico transcutâneo constitui um método auxiliar no diagnóstico de estro, ovulação e prenhez. PALAVRAS-CHAVE: Suíno, sêmen, água de coco, MERK III, BTS, ultra-sonografia.
The accuracy of transvaginal sonography to detect endometriosis cyst

Science.gov (United States)

Diantika, M.; Gunardi, E. R.

2017-08-01

Endometriosis is common in women of reproductive age. Late diagnosis is still the main concern. Currently, noninvasive diagnostic testing, such as transvaginal sonography, is recommended. The aim of the current study was to evaluate the accuracy of transvaginal sonography in diagnosing endometrial cysts in patients in Cipto Mangunkusumo Hospital, Jakarta, Indonesia. This diagnostic study was carried out at Cipto Mangunkusumo Hospital between January 2014 and June 2015. Outpatients suspected have an endometrial cyst based on the patient history and a clinical examination was recruited. The patients were then evaluated using transvaginal sonography by an experienced sonologist, according to the research protocol. The gold standard test was a histological finding in the removed surgical mass. Ninety-eight patients were analyzed. An endometrial cyst was confirmed by histology in 85 patients (87%). The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of transvaginal sonography was established to be 85% (a range of 71-99%), 93%, 77%, 96%, and 63%, respectively. A significantly higher area under the curve was identified using transvaginal sonogpraphy compared to that achieved with a clinical examination alone (85% versus 79%). Transvaginal sonography was useful in diagnosing endometrial cysts in outpatients and is recommended in daily clinical practice.
Confirmation of Essure placement using transvaginal ultrasound.

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Veersema, Sebastiaan; Vleugels, Michel; Koks, Caroline; Thurkow, Andreas; van der Vaart, Huub; Brölmann, Hans

2011-01-01

To evaluate the protocol for confirmation of satisfactory Essure placement using transvaginal ultrasound. Prospective multicenter cohort study (Canadian Task Force classification II-2). Outpatient departments of 4 teaching hospitals in the Netherlands. Eleven hundred forty-five women who underwent hysteroscopic sterilization using the Essure device between March 2005 and December 2007. Transvaginal ultrasound examination 12 weeks after uncomplicated successful bilateral placement or as indicated according to the transvaginal ultrasound protocol after 4 weeks, and hysterosalpingography (HSG) at 12 weeks to confirm correct placement of the device after 3 months. The rate of successful placement was 88.4% initially. In 164 women (15%), successful placement was confirmed at HSG according the protocol. In 9 patients (0.84%), incorrect position of the device was observed at HSG. The cumulative pregnancy rate after 18 months was 3.85 per thousand women. Transvaginal ultrasound should be the first diagnostic test used to confirm the adequacy of hysteroscopic Essure sterilization because it is minimally invasive, averts ionizing radiation, and does not decrease the effectiveness of the Essure procedure. Copyright © 2011 AAGL. Published by Elsevier Inc. All rights reserved.
Qualitative and quantitative analysis of women's perceptions of transvaginal surgery.

Science.gov (United States)

Bingener, Juliane; Sloan, Jeff A; Ghosh, Karthik; McConico, Andrea; Mariani, Andrea

2012-04-01

Prior surveys evaluating women's perceptions of transvaginal surgery both support and refute the acceptability of transvaginal access. Most surveys employed mainly quantitative analysis, limiting the insight into the women's perspective. In this mixed-methods study, we include qualitative and quantitative methodology to assess women's perceptions of transvaginal procedures. Women seen at the outpatient clinics of a tertiary-care center were asked to complete a survey. Demographics and preferences for appendectomy, cholecystectomy, and tubal ligation were elicited, along with open-ended questions about concerns or benefits of transvaginal access. Multivariate logistic regression models were constructed to examine the impact of age, education, parity, and prior transvaginal procedures on preferences. For the qualitative evaluation, content analysis by independent investigators identified themes, issues, and concerns raised in the comments. The completed survey tool was returned by 409 women (grouped mean age 53 years, mean number of 2 children, 82% ≥ some college education, and 56% with previous transvaginal procedure). The transvaginal approach was acceptable for tubal ligation to 59%, for appendectomy to 43%, and for cholecystectomy to 41% of the women. The most frequently mentioned factors that would make women prefer a vaginal approach were decreased invasiveness (14.4%), recovery time (13.9%), scarring (13.7%), pain (6%), and surgical entry location relative to organ removed (4.4%). The most frequently mentioned concerns about the vaginal approach were the possibility of complications/safety (14.7%), pain (9%), infection (5.6%), and recovery time (4.9%). A number of women voiced technical concerns about the vaginal approach. As in prior studies, scarring and pain were important issues to be considered, but recovery time and increased invasiveness were also in the "top five" list. The surveyed women appeared to actively participate in evaluating the technical
Avaliação crítica dos benefícios e limitações da ressonância magnética como método complementar no diagnóstico das malformações fetais A critical review of benefits and limitations of magnetic resonance imaging as a complementary method in the diagnosis of fetal malformations

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Renato Luis da Silveira Ximenes

2008-10-01

Full Text Available OBJETIVO: Avaliar, por meio da ressonância magnética, uma série de fetos com diagnóstico ultra-sonográfico de malformação, a fim de estabelecer os benefícios e limites diagnósticos proporcionados pela técnica de ressonância magnética fetal, em comparação com a ultra-sonografia. MATERIAIS E MÉTODOS: Foram estudadas 40 mulheres entre 15-35 semanas de gestação com diagnóstico de anomalia fetal durante o exame de ultra-sonografia. As pacientes foram encaminhadas para o estudo complementar com ressonância magnética. As indicações para o estudo da ressonância magnética fetal foram: anomalias do sistema nervoso central, do tórax, do abdome, renais, esqueléticas e tumores. A avaliação pós-natal incluiu a revisão das imagens de ultra-sonografia e ressonância magnética, o acompanhamento do nascimento, exames laboratoriais, radiológicos e necropsia. RESULTADOS: Os resultados mostraram que os estudos complementares com ressonância magnética fetal trouxeram informações adicionais em 60% dos casos estudados. Os benefícios da ressonância magnética fetal foram: ampliação da avaliação global, aumento do campo de avaliação, maior resolução tecidual pelo uso de seqüências, e avaliação em pacientes obesas e com oligoidrâmnio. Os limites da ressonância magnética fetal foram: evitar exame no primeiro trimestre, avaliação do fluxo sanguíneo, movimentação fetal, claustrofobia materna, estudo do coração fetal e esqueleto. CONCLUSÃO: A ressonância magnética fetal pode ser utilizada como método complementar para a avaliação das malformações fetais.OBJECTIVE: The present study was aimed at evaluating by means of magnetic resonance imaging a series of fetuses with sonographic diagnosis of malformation, establishing the diagnostic benefits and limitations of fetal magnetic resonance imaging as compared with ultrasonography. MATERIALS AND METHODS: Forty women between 15-35 gestational weeks and previously
Emergency Department Patient Perceptions of Transvaginal Ultrasound for Complications of First-Trimester Pregnancy.

Science.gov (United States)

Panebianco, Nova; Shofer, Frances; O'Conor, Katie; Wihbey, Tristan; Mulugeta, Lakeisha; Baston, Cameron M; Suzuki, Evan; Alghamdi, Adel; Dean, Anthony

2018-01-30

Emergency department (ED) transvaginal ultrasound (US) is underused in clinical practice. This study assessed pregnant women's perceptions of ED transvaginal US in terms of pain, embarrassment, anxiety, and willingness to receive the procedure. Secondary variables include physicians' perceptions of patients' experiences. Women undergoing US examinations for complications of first-trimester pregnancy were prospectively surveyed before any US and after ED and/or radiology transvaginal US. Patients' and physicians' assessments of pain, embarrassment, and anxiety were measured with visual analog scales (0-100). A total of 398 women were enrolled. In the pre-US survey, the median anxiety score was 14 (interquartile range, 3-51), and 96% of patients were willing to have an ED transvaginal US if necessary. Of those who had ED transvaginal US, 96% would agree to have another examination. Patients reported minimal pain/embarrassment, and there was no difference if performed in the ED versus radiology (median pain, 11.5 versus 13; P = .433; median embarrassment, 7 versus 4; P = .345). Of the 48 who had both ED and radiology transvaginal US, 85% thought the ED transvaginal US was worthwhile. Physicians accurately assessed patient's embarrassment and pain (mean differences, 3.5 and -1.9, respectively; P > .25 for both); however, they overestimated them relative to the pelvic examination (mean difference for embarrassment, 12.8; P < .0001; pain, 8.0; P = .01). Pregnant ED patients report low levels of anxiety, pain, and embarrassment, and after ED transvaginal US, 96% would agree to have the examination again. There is no difference in pain/embarrassment between ED and radiology transvaginal US. Emergency department physicians accurately assessed patients' pain and embarrassment with ED transvaginal US but overestimated them compared to the pelvic examination. © 2018 by the American Institute of Ultrasound in Medicine.
Sacral colpopexy versus transvaginal mesh colpopexy in obese patients.

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McDermott, Colleen D; Park, Jean; Terry, Colin L; Woodman, Patrick J; Hale, Douglass S

2013-05-01

Obesity can predispose women to pelvic organ prolapse and can also affect the success of pelvic organ prolapse surgery. The purpose of this study was to compare the postoperative anatomical outcomes following sacral colpopexy (SC) and transvaginal mesh colpopexy in a group of obese women with pelvic organ prolapse. We conducted a retrospective cohort study of obese women who underwent SC (n = 56) or transvaginal mesh colpopexy (n = 35). Follow-up ranged from 6 to 12 months. Preoperative, perioperative, and postoperative variables were compared using Student t, Mann-Whitney U, and Fisher exact tests, and by analysis of covariance. The women in the SC group had significantly higher mean apical vaginal measurements (P transvaginal mesh colpopexy group. There were no significant differences between the groups for other postoperative outcomes, including mesh erosion, recurrent prolapse symptoms, dyspareunia, and surgical satisfaction (P > 0.05). In these 91 obese patients with pelvic organ prolapse, SC resulted in better anatomical outcomes than transvaginal mesh colpopexy. However, the two procedures had similar outcomes with regard to recurrent symptoms and surgical satisfaction.
Sexual function after transvaginal cholecystectomy

DEFF Research Database (Denmark)

Donatsky, Anders M; Jørgensen, Lars N; Meisner, Søren

2014-01-01

INTRODUCTION: Despite several benefits, patients are concerned that transvaginal cholecystectomy has a negative impact on sexual health. The objective of this systematic review was to assess the impact of transvaginal cholecystectomy on postoperative dyspareunia and sexual function. METHOD......: A literature search was performed in the PubMed and EMBASE databases. Papers reporting on postoperative dyspareunia, vaginal pain or discomfort, and sexual function were included. RESULTS: Seventeen papers reported on dyspareunia and vaginal pain or discomfort. Two papers reported a rate of de novo dyspareunia...... of 3.8% and 12.5%, respectively. One study reported a nonsignificant reduction in painful sexual intercourse and the remaining 14 reported no incidents of dyspareunia. Eight papers reported on sexual function. One paper using a nonvalidated questionnaire found impaired sexual function. The papers...
Sinais ultra-sonográficos em fetos portadores de toxoplasmose congênita Ultrasonographic markers for fetal congenital toxoplasmosis

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Júlio César de Faria Couto

2004-06-01

Full Text Available OBJETIVO: descrever as alterações ultra-sonográficas em fetos com toxoplasmose congênita, correlacionando-as com o prognóstico neonatal. MÉTODOS: entre junho de 1997 e maio de 2003 foram examinadas 150 gestantes com suspeita de toxoplasmose. A infecção aguda foi confirmada em 72 (48% gestantes e a toxoplasmose congênita foi diagnosticada em 12 (16% fetos. O diagnóstico pré-natal foi realizado pela reação em cadeia da polimerase no líquido amniótico. Todas as pacientes receberam terapia antiparasitária. O acompanhamento ultra-sonográfico foi quinzenal e todos os recém-nascidos foram acompanhados no primeiro ano de vida. RESULTADOS: as alterações ultra-sonográficas foram observadas em oito fetos. Todos apresentavam dilatação ventricular bilateral, associada a calcificações periventriculares em cinco casos. Outras alterações como calcificação hepática, hepatomegalia, poliidrâmnio e derrame pericárdico foram menos freqüentes. Dentre esses fetos, quatro foram neomortos e três apresentaram seqüelas (coriorretinite e retardo neuropsicomotor. Os quatro fetos com ultra-sonografia normal evoluíram satisfatoriamente. CONCLUSÃO: observou-se elevada incidência de alterações ultra-sonográficas nos fetos com toxoplasmose congênita, principalmente cerebrais. Outras alterações como hepatomegalia e derrame pericárdio são menos freqüentes e traduzem infecção sistêmica. O prognóstico dos fetos parece correlacionar-se com a presença de lesões ultra-sonográficas, uma vez que nesse grupo de fetos observou-se alta mortalidade e entre os sobreviventes a incidência de seqüelas foi importante. Os fetos sem alterações ultra-sonográficas evoluíram de forma favorável, sem seqüelas de desenvolvimento. Esses resultados destacam a importância da ultra-sonografia no acompanhamento desses fetos, a fim de se estabelecer um prognóstico e permitir a elaboração de conduta pós-natal adequada.OBJECTIVE: to describe
Transvaginal uterosacral ligament hysteropexy: a retrospective feasibility study.

Science.gov (United States)

Milani, Rodolfo; Frigerio, Matteo; Manodoro, Stefano; Cola, Alice; Spelzini, Federico

2017-01-01

Uterine-sparing procedures could be attractive in patients concerned about preservation of fertility and change in corporeal image and sexuality. Transvaginal uterosacral hysteropexy can provide an alternative mesh-free technique for uterine suspension. This study aimed to evaluate the feasibility of transvaginal uterine suspension to uterosacral ligaments in terms of operative data, complications, midterm efficacy, and patient satisfaction. This retrospective study analyzed the first 20 cases of transvaginal hysteropexy through bilateral high uterosacral ligaments (modified Shull technique) performed in our Institution. Mean follow-up was 33.2 months. The procedure was performed in 84 ± 19 min ,and blood loss was 228 ± 139 ml. Three mild complications (15 %) were observed. Recurrence [Pelvic Organ Prolapse Quantification system (POP-Q) stage ≥ II was observed in five patients (25 %), and three of them (15 %) required reintervention. Mean Patient Global Impression of Improvement score was "much improved." Two woman (40 %) who had not fulfilled their childbearing desire obtained a pregnancy. Both underwent elective caesarean section at term. Transvaginal uterosacral hysteropexy appears a feasible mesh-free technique for apical support. This procedure can be indicated in women with the desire of preserving fertility or who prefer a uterine-sparing surgical option.
Ultrasonography findings of musculotendinous lesions of the shoulder

OpenAIRE

Zorzetto, Arquimedes Artur; Urban, Linei Augusta Brolini Dellê; Liu, Christian Bark; Prevedello, Luciano; Zapparoli, Mauricio; Vitola, Maria Luiza Amalfi; Awamura, Yumi; Pedro, Mônica Simeão; Nascimento, Alessandra Bettega

2003-01-01

Este estudo propôs-se a revisar os aspectos relevantes da anatomia, técnica de exame e achados de imagens, com o objetivo de auxiliar o radiologista no diagnóstico diferencial frente às afecções músculo-tendinosas do ombro. Foram realizadas 34 ultra-sonografias da região do ombro, no período de janeiro a dezembro de 2001. A avaliação foi realizada com transdutores de alta freqüência (7,5-10 MHz). O exame foi normal em 23% dos pacientes (oito casos). Dos 26 casos alterados, observaram-se oito ...

Estimativa da gordura de cobertura ao abate, por ultra-som, em tourinhos Brangus e Nelore Prediction of backfat at slaughter, by ultrasound, in Nellore and Brangus young bulls

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Saulo da Luz e Silva

2004-04-01

Full Text Available O objetivo deste trabalho foi verificar a viabilidade da utilização da ultra-sonografia para estimar a espessura de gordura na carcaça (EGSC no momento do abate. Foram confinados 24 machos inteiros Brangus e 24 Nelore com dietas contendo 20, 40, 60 ou 80% de concentrado. A área de olho de lombo (AOLU e a espessura de gordura (EGSU entre a 12ª e a 13ª costelas e a espessura de gordura sobre o músculo Biceps femoris (EGPU, foram obtidas com equipamento de ultra-som PieMedical Scanner 200 Vet com transdutor linear de 178 mm e guia acústica, a cada intervalo de aproximadamente 28 dias. Após 142 dias de confinamento, os animais foram abatidos e 24 h após foi obtida a EGSC. As correlações entre EGSU e EGSC foram de 0,19, 0,64, 0,74, 0,78, 0,82, 080 e 0,86, quando obtidas aos 0, 26, 53, 84, 109, 125 e 142 dias de confinamento. Equações de regressão múltipla entre raças para estimar a EGSC apresentaram R² = 0,10 e Sy,x = 2,04 quando realizadas 142 dias antes do abate e R² = 0,78 e Sy,x = 0,10 imediatamente antes do abate. Medidas de ultra-som podem ser úteis para classificar grupos de animais para abate em igual acabamento.The objective of this work was to verify the usefullness of ultrasound to estimate the carcass backfat thickness (EGSC at slaughter. Twenty four Brangus and 24 Nelore, intact males, were fed with diets containing 20, 40, 60 or 80% of concentrate. Ribeye area (AOLU and backfat thickness (EGSU between 12ª and 13ª ribs and the fat thickness over Biceps femoris muscle (EGPU were collected with a PieMedical Scanner 200 Vet equipment, with linear array transducer of 178 mm coupled with standoff guide, on intervals of approximately 28 days. After 142 days on fed, animals were slaughtered and the carcass backfat thickness (EGSC was taken, 24 hours after. The correlations between EGSU and EGSC were 0.19, 0.64, 0.74, 0.78, 0.82, 0.80 and 0.86 when taken at 0, 26, 53, 84, 109, 125 and 142 days on fed. Multiple regression
Transvaginal ultrasound in threatened abortions with empty gestational sacs.

Science.gov (United States)

Tongsong, T; Wanapirak, C; Srisomboon, J; Sirichotiyakul, S; Polsrisuthikul, T; Pongsatha, S

1994-09-01

To determine whether transvaginal ultrasound criteria alone can distinguish viable from non-viable gestational sacs at a single examination. A prospective descriptive study was undertaken and analysis performed on 211 pregnancies complicated by threatened abortion and empty gestation sacs diagnosed by transvaginal ultrasound. The main outcome measure was the final diagnosis of viable or non-viable gestation on subsequent transvaginal sonography. The study shows that a single transvaginal ultrasound examination is useful in differentiating viable from non-viable gestation sacs. The mean sac diameter (MSD) was found to be the most useful criterion for determining non-viability. An MSD of > or = 17 mm that lacked an embryo and an MSD of > or = 13 mm without visible yolk sac were reliable predictors of non-viable gestation sacs at a single examination with 100% specificity and 100% positive predictive value. An MSD > or = 13 mm without visible yolk sac was the most sensitive criterion. Using MSD criteria, 73% of non-viable gestations could be reliably identified without any false-positive diagnoses. Deformed shape, low position and thin decidual reaction are strong indicators of non-viable gestations but are not 100% accurate. There is still a significant proportion of empty sacs, where no accurate distinction between viable and non-viable can be made according to one criterion at a single examination and in these cases serial examinations should be carried out before any active management is advocated. In most cases, transvaginal sonographic criteria alone can distinguish viable from non-viable empty gestational sacs at a single examination.
Transvaginal organ extraction: potential for broad clinical application.

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Jacobsen, Garth R; Barajas-Gamboa, Juan S; Coker, Alisa M; Cheverie, Joslin; Macias, C Aitor; Sandler, Bryan J; Talamini, Mark A; Horgan, Santiago

2014-02-01

Natural orifice transluminal endoscopic surgery procedures have evolved over the past few years. A transvaginal approach is a promising alternative for intraperitoneal procedures. Our objective was to evaluate the safety and feasibility of transvaginal organ extraction. This institutional review board-approved protocol involved retrospective review of an ongoing prospective study. Female subjects who presented to our hospital for elective cholecystectomy, appendectomy, or sleeve gastrectomy were offered participation in the study. Eligible patients met the following criteria: age between 18 and 75, diagnosis of gallbladder disease, acute appendicitis, or morbid obesity who desired surgical treatment. A hybrid transvaginal natural orifice approach was used in this series. Thirty-four women underwent transvaginal organ extraction between September 2007 and January 2012. The mean age was 40 ± 12.1 years (range 23-63 years). The mean body mass index was 27 ± 6.4 kg/m(2) (range 16-43 kg/m(2)). All patients had an American Society of Anesthesiologists classification of two or below. The mean operative time for cholecystectomy, appendectomy, and sleeve gastrectomy was 90, 71, and 135 min, respectively. There were no conversions to open operation and no intraoperative complications. The mean hospital stay was 2 days for all cases. Patients were followed for a mean of 24 months (range 1-61 months). There were two pregnancies and two successful vaginal deliveries. Six patients (18 %) had minor complaints of spotting or heavy menses in the immediate postoperative period that resolved with conservative measures. There were no abdominal wall complications. There were no long-term complications and no mortalities. This initial experience suggests that this surgical approach is safe, does not increase length of stay, and has no long-term vaginal complications. Given this attractive profile, a transvaginal approach may prove to be a superior mode of organ extraction
Rambam Hospital is the Birthplace of the Modern Version of Transvaginal Ultrasound

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Ilan E. Timor-Tritsch

2017-04-01

Full Text Available The worldwide use of the transvaginal scanning route has revolutionized obstetrical and gynecologic imaging. The long, slow, and at times challenging aspects of its acceptance by the obstetrical and gynecologic community are the subject of this article. From its inception to its recent use, the dedicated doctors in the Department of Obstetrics and Gynecology at Rambam Medical Center, Haifa, Israel, were instrumental in conceiving and then collaborating with an Israeli manufacturer in the construction and worldwide use of the transvaginal ultrasound probe, resulting in the now well-known field of transvaginal sonography.
Perfil epidemiológico e genotípico da infecção pelo vírus da hepatite B no Norte de Portugal

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Ana Mota

2010-12-01

Full Text Available OBJECTIVO: Descrever o perfil epidemiológico e genotípico da infecção crônica pelo vírus da hepatite B na Região Norte de Portugal. MÉTODOS: Foram incluídos 358 indivíduos oriundos das consultas de especialidade que apresentavam resultados positivos para o antígeno da hepatite B durante pelo menos seis meses em dois hospitais do Norte de Portugal em 2008 e 2009. Os dados foram obtidos a partir dos processos clínicos, determinações laboratoriais feitas quando da genotipagem do vírus, ecografia e/ou ultra-sonografia e biópsia hepática. As características demográficas, marcadores víricos, carga viral e genótipos, e severidade da doença hepática foram avaliadas e comparadas entre sexos. RESULTADOS: Os genótipos A e D predominaram. A transmissão intrafamiliar ocorreu predominantemente nas mulheres. Um terço das mulheres apresentava ingestão alcoólica superior a 20 g/dia, aumentando para 58,9% nos homens. A ausência do AgHBe foi semelhante nos dois sexos (p = 0,662. Os parâmetros bioquímicos em geral apresentaram-se com valores mais altos nos homens, assim como nos estágios necro-inflamatório e de esteatose hepática (p = 0,003. CONCLUSÕES: As diferenças relativas às vias de transmissão da infecção pelo vírus da hepatite B entre homens e mulheres podem ser conseqüência de comportamentos de risco associadas ao género. A ingestão excessiva de álcool é predominante nos indivíduos do sexo masculino, assim como maior severidade da doença hepática em relação às mulheres.
Transvaginal sonography of acute pelvic inflammatory disease

International Nuclear Information System (INIS)

Choi, Jin Soo; Kim, Young Hwa; Shin, Hyung Chul; Han, Gun Soo; Kim, Il Young

1999-01-01

To determine the value of transvaginal sonography in evaluating women with acute pelvic inflammatory disease (PID). Transvaginal sonography was performed in 25 patients with clinically suggested PID during recent 36 months. The sonographic findings of fallopian tubes and ovaries were analyzed and correlated with pathological findings of 2 fallopian tubes and 19 ovaries in 16 patients who had operations. The correct diagnosis of acute PID was made in 20/25 (80%) by transvaginal sonography. the abnormal sonographic findings of the fallopian tube include tubal thickening or dilatation with internal echo. The sensitivity, specificity, and accuracy for tubal abnormality were 88%, 96%, and 86% , respectively. Ovarian changes were seen on TVS in 14/19 (73%), which include multiple follicular enlargement in 5, tubo-ovarian complex in 9 (tubo-ovarian adhesion in 3, tubo-ovarian abscess in 6). At surgery, the ovay was not involved in all three women who showed tubo-ovarian adhesion on TVS. Among 6 women who showed tubo-ovarian abscess on TVS, tubo-ovarian abscess was confirmed in 3 and the remaining 3 had ovarian cysts. Trandvaginal sonography, a facilitative and accurate modality, is highly sensitive in detecting the abnormality of the tube and useful in differentiating the tubo-ovarian complex in patients with acute PID.
Sphincter-saving extrasphincteric rectal dissection and proximal segmental sphincteric excision techniques by using combined abdominal and transvaginal anterior perineal access in female patients who have lower rectal cancer (Transvaginal low anterior rectal resection

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Ali Naki Yücesoy

2017-10-01

Full Text Available Background: Combined abdominal and transvaginal anterior perineal approaches have been used as an alternative surgical method for the surgical treatment of the lower rectal cancer. The main aim of this paper is to describe the surgical stages of the combined abdominal and transvaginal approaches performed for lower rectal cancer, especially in transvaginal anterior perineal stage. Method: We have performed sphincter-saving surgical operations by using transvaginal anterior perineal access by combining with the abdominal access in four female patients who had lower rectal cancer. Results: Sphincter-saving extrasphincteric dissection and proximal segmental sphincteric excision techniques were performed in four female patients operated with combined abdominal and transvaginal anterior perineal approach. All patients were found to have continence. Postoperatively, one patient was converted to abdominoperineal rectal amputation due to the detected distal resection margin positivity. Conclusion: Transvaginal anterior perineal access provides the extrasphincteric rectal dissection possibility in the ischioanal fossa. Therefore, the combined abdominal and transvaginal anterior perineal approaches have been based on the different anatomical and surgical features when compared to intersphincteric dissection technique which is the most common used surgical procedure in lower rectal cancer surgery. Resumo: Introdução: Uma combinação de abordagens abdominal e perineal anterior transvaginal tem sido empregada como método cirúrgico alternativo para o tratamento cirúrgico do câncer de reto baixo. O principal objetivo do presente artigo é a descrição dos estágios cirúrgicos das abordagens abdominal e transvaginal combinadas realizadas para câncer de reto baixo, especialmente no estágio perineal anterior transvaginal. Método: Realizamos operações cirúrgicas com preservação de esfíncter com o uso do acesso perineal anterior transvaginal, em
Aspectos ultra-estruturais da forma epimastigota do Trypanosoma cruzi em meio LIT

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Wanderley de Souza

1975-06-01

Full Text Available E feito um estudo da ultra-estrutura da forma epismastigota do Trypanosoma cruzi mantida em meio de cultivo acelular. O núcleo das formas em divisão apresenta um aspecto homogêneo. Microtúbulos intranucleares são observados durante a divisão. No entanto, a membrana nuclear permanece íntegra. O citoplasma apresenta-se com vacúolos de dimensões e aspectos variados. Com o método do ácido periódico-tiosemicarbazida-proteinato de prata, polissacaríáeos e/ou glicoproteínas foram localizados na membrana celular e na membrana que delimita certos vacúolos citoplasmáticos.
Transvaginal Ultrasound for the Diagnosis of Abnormal Uterine Bleeding.

Science.gov (United States)

Wheeler, Karen C; Goldstein, Steven R

2017-03-01

Transvaginal ultrasound is the first-line imaging test for the evaluation of abnormal uterine bleeding in both premenopausal and postmenopausal women. Transvaginal ultrasound can be used to diagnose structural causes of abnormal bleeding such as polyps, adenomyosis, leiomyomas, hyperplasia, and malignancy, and can also be beneficial in making the diagnosis of ovulatory dysfunction. Traditional 2-dimensional imaging is often enhanced by the addition of 3-dimension imaging with coronal reconstruction and saline infusion sonohysterography. In this article we discuss specific ultrasound findings and technical considerations useful in the diagnosis of abnormal uterine bleeding.
Women's perception of transvaginal sonography in a tertiary hospital in nigeria

International Nuclear Information System (INIS)

Eze, C.U.; Okaro, A.O.; Nwobi, I.C.

2008-01-01

Available studies suggest that pregnant women's views on the desirability of routine ultrasound are Influenced by their perceptions of its potential benefits and concern about possible adverse effects. To assess women's views of transvaginal sonography and to determine any correlation between their perception of the procedure and their prior knowledge and experience of it. We surveyed women presenting with various gynecologic problems or complications of the first trimester. Data collection was by self-administered questionnaires using conveniences sampling technique on women attending the clinic over a period of one year. Only women who had transvaginal sonography were included. A total of 250 women were recruited and interviewed. Transvaginal sonography was considered not embarrassing by 76%, acceptable by 86%, not painful by 87.2% and not stressful by 82% of the women. There were no statistically significant differences in the women's perception of the procedure whether they had prior knowledge and previous experience of the procedure or not (P>0.05). The majority of the women perceived transvaginal sonography favourably. Their perception of the Procedure was favourable whether they had prior knowledge and previous experience of it or not. (author)
Aspectos ultra-sonográficos da trombose da veia porta Ultrasonographic features of portal vein thrombosis

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Márcio Martins Machado

2006-04-01

Full Text Available A trombose da veia porta pode estar associada a várias alterações, como a presença de tumores (por exemplo: hepatocarcinoma, doença metastática hepática e carcinoma do pâncreas, pancreatite, hepatite, septicemia, trauma, esplenectomia, derivações porto-cava, estados de hipercoagulabilidade (por exemplo: gravidez, em neonatos (por exemplo: onfalite e cateterização da veia umbilical e desidratação aguda. Os autores discutem, neste artigo, os aspectos ultra-sonográficos da trombose de veia porta e alguns aspectos de relevância clínica.Portal vein thrombosis may be associated with many alterations, such as the presence of tumors (for example, hepatocellular carcinoma, metastatic liver disease and carcinoma of the pancreas as well as pancreatitis, hepatitis, septicemia, trauma, splenectomy, portacaval shunts, hypercoagulable conditions (for example, pregnancy, in neonates (for example, omphalitis and umbilical vein catheterization and in acute dehydration. The authors discuss herein the sonographic features of portal vein thrombosis as well as some aspects of clinical relevance.
Complications of transvaginal silicone-coated polyester synthetic mesh sling.

Science.gov (United States)

Govier, F E; Kobashi, K C; Kuznetsov, D D; Comiter, C; Jones, P; Dakil, S E; James, R

2005-10-01

To report a premarket multicenter trial to test the feasibility of a transvaginal silicone-coated polyester synthetic mesh sling in women with anatomic incontinence. Fifty-one patients in four centers underwent transvaginal placement of a silicone-coated polyester synthetic mesh sling (American Medical Systems) during an 8-month period. Of the 51 patients, 31 were part of a prospective institutional review board-approved feasibility trial in three centers funded by American Medical Systems (group 1) and 20 underwent implantation by a single surgeon and their data were retrospectively reviewed (group 2). The studies were done concomitantly, and all slings were fixed transvaginally with bone anchors. All patients in group 1 were followed up at 4 weeks, 6 months, and 1 year (as applicable) with repeat questionnaires, physical examinations, and pad tests. In group 1, 20 patients completed 6 months of follow-up. Ten patients (32%) required a second surgical procedure at an average of 183 days (range 68 to 343) postoperatively. Eight patients (26%) had vaginal extrusion of the mesh, one (3%) required sling lysis, and one (3%) required sling removal because of infection. In group 2, 8 patients (40%) underwent sling removal for vaginal extrusion at a mean of 160 days (range 83 to 214). Transvaginally placed silicone-coated mesh slings used for the treatment of urinary incontinence demonstrated an unacceptably high vaginal extrusion rate in this study. Once identified, this study was immediately terminated, and this product was not marketed for this application in the United States.
Transvaginal ultrasound during pregnancy: Perception and ...

African Journals Online (AJOL)

With the use of high‑resolution transducers, the transvaginal probe has proved to be particularly useful for finding the location and dating of early pregnancies when compared with transabdominal sonography ... Majority (410; 96.7%) had heard about ultrasound scanning, and 395 (93.2%) had undergone at least one type.
Laparoscopic sacrocolpopexy for recurrent pelvic organ prolapse after failed transvaginal polypropylene mesh surgery.

Science.gov (United States)

Schmid, Corina; O'Rourke, Peter; Maher, Christopher

2013-05-01

A prospective case series to assess the safety and efficacy of laparoscopic sacrocolpopexy for the surgical management of recurrent pelvic organ prolapse (POP) after transvaginal polypropylene mesh prolapse surgery. Between January and December 2010, women with post-hysterectomy recurrent prolapse (≥ stage 2 POP-Q) after transvaginal polypropylene mesh prolapse surgery were included. Perioperative morbidity and short-term complications were recorded and evaluated. Surgical outcomes were objectively assessed utilising the Pelvic Organ Prolapse Quantification system (POP-Q), the validated, condition-specific Australian Pelvic Floor Questionnaire (APFQ) and the Patient Global Impression of Improvement (PGI-I) at 12 months. All 16 women in this study had undergone surgery with trocar-guided transvaginal polypropylene mesh kits. In 75% the recurrent prolapse affected the compartment of prior mesh surgery with the anterior (81%) and apical (75%) compartment prolapse predominating. At a mean follow-up of 12 months, all women had resolution of awareness of prolapse, had transvaginal mesh surgery is feasible and safe. Further widespread evaluation is required.
Ovários policísticos em meninas e adolescentes normais: uma avaliação ultra-sonográfica

OpenAIRE

Teixeira Rosimere J.; Silva Valéria C.G.; Freitas Josele R.; Henriques Jodélia L.M.; Guimarães Marília M.

2001-01-01

Realizamos ultra-sonografia pélvica em tempo real e de alta resolução em 140 meninas com idade entre dois e 18 anos, para descrever a prevalência de ovários policísticos durante o desenvolvimento puberal normal. O volume dos ovários foi calculado e sua estrutura classificada como homogênea, microcística, multicística, policística e folicular. O volume aumentou e a freqüência das classes ovarianas variou de acordo com o status puberal. Os ovários eram de aspecto policístico em 8% (duas meninas...
Transvaginal Ultrasound-Guided Aspiration of Pelvic Abscesses

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P. J. Corsi

1999-01-01

Full Text Available Objective: To assess the utility of a less invasive approach to the care of women with a pelvic abscess, we retrospectively reviewed the outcome of women with pelvic abscesses managed by transvaginal ultrasound-guided aspiration.
[Current state of transvaginal meshes by resolution of pelvic organ prolapse].

Science.gov (United States)

Jírová, J; Pán, M

Treatment of pelvic organs prolapse with transvaginal mesh kits represents nowadays a widespread surgical method, which partially replaced classic operations due to high success rate and low count of recurrences. Just like any other surgical method, the placement of transvaginal mesh is linked with occurrence of complications. In this article we attempt to review the more and less known facts about trans-vaginal meshes, their efficacy, count of recurrence and the spectrum of complications and we try to compare this technique with traditional surgical methods used to treat pelvic organs prolapse (without graft materials). Review. Department of Obstetrics and Gynecology, Regional hospital Mladá Boleslav a.s., Mladá Boleslav. Overview of the results of recent studies published in the Czech and English language in recent years. Pelvic organ prolapse repair with vaginal mesh has generally lower count of relapse especially in patients with wide genital hiatal area and with major levator ani avulsion. The spectrum of complications differs from classical techniques because of the presence of synthetic nonabsorbable material. Some of the specific complications we did not encounter during classical operations include vaginal mesh erosion, infection of mesh associated with chronic pelvic pain, dyspareunia, protrusion of the mesh into the closest organs or the rejection and progressive extrusion of the mesh. Primary enthusiasm has now been replaced with worries of major complications. Future tasks should therefore be aimed at minimizing the rate of complications associated with transvaginal meshes. Except using well-known and safe materials and providing specialized training of physicians for each mesh implantation technique, other precautions outlined in this article should help, such as a closer specification of indication for the application of transvaginal mesh.
Confirmation of Essure placement using transvaginal ultrasound

NARCIS (Netherlands)

Veersema, Sebastiaan; Vleugels, Michel; Koks, Caroline; Thurkow, Andreas; van der Vaart, Huub; Brölmann, Hans

2011-01-01

To evaluate the protocol for confirmation of satisfactory Essure placement using transvaginal ultrasound. Prospective multicenter cohort study (Canadian Task Force classification II-2). Outpatient departments of 4 teaching hospitals in the Netherlands. Eleven hundred forty-five women who underwent
Síndrome dos Ovários Policísticos: Avaliação Dopplerfluxométrica

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Bruno Ricardo Vasconcellos

2001-01-01

Full Text Available Objetivo: avaliar a eficácia do Doppler colorido como método diagnóstico na síndrome dos ovários policísticos (SOP, mediante as variações do fluxo sangüíneo no estroma ovariano, nas artérias uterinas e no tecido subendometrial. Métodos: foram selecionadas trinta pacientes distribuídas em dois grupos: quinze com amenorréia ou oligomenorréia, hirsutismo (índice de Ferriman e Gallwey >8, índice de massa corporal IMC maior que 25 kg/m² e exame ecográfico que identificou estroma aumentado, hiperecogênico e policistose ovariana (grupo de estudo, e número idêntico de pacientes com ciclos menstruais normais, sem sinais de hirsutismo e ultra-sonografia normal (grupo controle. Com o uso da dopplerfluxometria transvaginal foram medidas a velocidade de pico sistólico ou velocidade máxima (Vmáx, índice de pulsatilidade (IP e resistência dos vasos do estroma ovariano, da artéria uterina e do subendométrio. Resultados: a dopplervelocimetria mostrou Vmáx significativamente maior no estroma ovariano das pacientes com SOP (12,2 cm/s (p<=0,0004 em relação ao grupo controle (8,5 cm/s. O IP da artéria uterina também se revelou muito superior no grupo com SOP (3,3 cm/s em relação ao controle (2,7 cm/s. Outros parâmetros da dopplervelocimetria não evidenciaram diferença significativa. Ao estabelecermos um cutoff (ponto de corte = 9 cm/s na amostragem para a Vmáx obtivemos os percentuais de 95,2 para sensibilidade, 80,0 para especificidade e de 83,3 para o valor preditivo positivo e 94,1 para o negativo. Com referência ao IP para um cutoff = 2.35 os testes revelaram: sensibilidade de 81,0%, especificidade de 50,0%, valor preditivo positivo de 63,0% e negativo de 71,4%. Conclusão: a dopplervelocimetria pode constituir subsídio a ser incorporado à investigação clínica e ultra-sonográfica no tocante ao diagnóstico da síndrome dos ovários policísticos.
Mapeamento da safena interna com ecocolor Doppler no pré-operatório de cirurgia de revascularização mioc��rdica

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BARROS Fanilda Souto

1999-01-01

Full Text Available INTRODUÇÃO: O advento do ecocolor Doppler vascular tornou possível informar o estado anatômico e funcional da safena interna ao cirurgião cardiovascular, no pré-operatório da cirurgia de revascularização miocárdica, sem riscos para o paciente ou para o conduto venoso. O objetivo do estudo foi, juntamente com o cirurgião, avaliar a utilidade do mapeamento da safena interna no pré-operatório. CASUÍSTICA E MÉTODOS: Foram estudados, entre março de 1995 e maio de 1998, 208 extremidades inferiores de 104 pacientes selecionados para cirurgia de revascularização miocárdica. O critério utilizado para a seleção da safena foi a safena patente e o diâmetro maior ou igual a 3,0 mm, utilizando os aparelhos de ultra-sonografia ATL - HDI 3000 e Acuson-Sequóia 512. RESULTADOS: Dentre as 208 extremidades estudadas, 186 (89,4% das safenas preenchiam os critérios e a análise do cirurgião estava de acordo com a descrição do ecocolor Doppler. Dezessete (8,2% não preenchiam os critérios e, em 5 (2,4% ,o exame foi compatível com safenectomia radical. Das 17 safenas consideradas não apropriadas, 2 foram exploradas cirurgicamente, sendo a análise do cirurgião concordante com o ultra-som. CONCLUSÃO: Os autores concluem que o ecocolor Doppler, sendo um método diagnóstico não invasivo, pode ser útil no mapeamento da safena interna no pré-operatório de revascularização miocárdica devido à sua capacidade de identificar e selecionar com segurança o vaso a ser utilizado como conduto vascular, o que permite ao cirurgião cardíaco o planejamento cirúrgico.

Controle ultra-sonográfico de gestações, de mortalidades embrionárias e fetais e do sexo de fetos bovinos zebuínos

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Breno José Pelozo de Barros

2001-01-01

Full Text Available Este trabalho avaliou a eficácia do ultra-som no diagnóstico precoce de prenhez e nas avaliações das mortalidades embrionárias e fetais e dos sexos de fetos em dois grupos de vacas zebuínas. Os animais que não retornaram ao estro aos 21 dias da Inseminação Artificial (G1 ou aos 14 dias da Transferência de Embriões (G2B foram examinados aos 25 dias de gestação para o diagnóstico precoce de prenhez, aos 45 dias para avaliação das perdas embrionárias entre 26 e 45 dias e aos 60 dias para avaliações das perdas fetais entre 45 e 60 dias e dos sexos de fetos. O Grupo G2A foi examinado por palpação retal aos 45 dias para diagnóstico de prenhez e aos 60 dias para avaliações das perdas fetais e dos sexos de fetos. As taxas de prenhez foram, respectivamente, 94,6%, 88,1% e 83,4% aos 25, 45 e 60 dias de gestação. As taxas de perdas embrionárias e fetais e de abortos foram, respectivamente, 4,6%, 4,7% e 1,2%. As taxas de acertos do diagnóstico precoce de gestação e dos sexos de fetos foram 88,5% e 90,7%, respectivamente. A ultra-sonografia mostrou-se eficaz no diagnóstico precoce de prenhez aos 25 dias, nas avaliações das perdas embrionárias aos 45 dias e fetais aos 60 dias e no diagnóstico do sexo de fetos a partir dos 60 dias de gestação. Os exames ultra-sonográficos não causaram perdas gestacionais nos animais Bos indicus ou Bos indicus X Bos taurus.
Da Vinci-assisted abdominal cerclage.

Science.gov (United States)

Barmat, Larry; Glaser, Gretchen; Davis, George; Craparo, Frank

2007-11-01

To report the first placement of an abdominal cervicoisthmic cerclage using the da Vinci robot. Case report. Tertiary-care hospital. A 39-year-old female with a history of cervical insufficiency who required a cerclage and was not a candidate for transvaginal cerclage placement. Abdominal cervicoisthmic cerclage placement using the da Vinci robot. Ability to safely and successfully place an abdominal cerclage using the da Vinci robot. Abdominal cerclage was successfully placed using the da Vinci robot. The patient had minimal blood loss and was discharged to home on the same day as surgery. Da Vinci robot-assisted abdominal cerclage placement is an innovative application of robotic surgery and may alter the standard of care for women who require this surgery.
Avaliação do Tratamento Clínico da Endometriose Clinical Treatment Evaluation of Endometriosis

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Marcos Dias de Moura

1999-03-01

Full Text Available Objetivo: o objetivo do presente trabalho é apresentar um perfil das pacientes com endometriose, estadio e resultados do tratamento entre as pacientes atendidas no nosso Serviço. Métodos: foram revistos 155 prontuários médicos de pacientes portadoras de endometriose atendidas no período de 1991 a 1996 segundo um protocolo preestabelecido. Resultados: a média de idade das pacientes foi de 31 anos, sendo que a maioria era branca e com ciclos menstruais regulares. Os sintomas mais observados foram a dismenorréia, dor pélvica e infertilidade, sendo esses sinais e sintomas de grau leve na maioria dos casos. Os métodos diagnósticos utilizados foram a laparoscopia ou ultra-sonografia. Houve concordância entre a ultra-sonografia e a laparoscopia em 96% das vezes. Em 28% dos casos houve necessidade de realização de laparotomia para elucidação diagnóstica e/ou tratamento. O achado de endometrioma ocorreu em 37% das vezes e em apenas 74% das biópsias das lesões houve a confirmação de endometriose pelo estudo anatomopatológico. Houve melhora significativa com o tratamento clínico independente da droga utilizada, com melhora dos sintomas em cerca de 50% delas. Foram realizadas técnicas de fertilização assistida em 34 pacientes, das quais 80% foram fertilização in vitro (FIV, com taxa de 27% de gravidez/paciente. Conclusões: o método diagnóstico de escolha deve ser a laparoscopia, embora a ultra-sonografia apresente um alto índice de concordância. O estudo anatomopatológico das lesões deve ser utilizado como método auxiliar no diagnóstico, pois ele não é positivo em todos os casos. O tratamento clínico com reprodução assistida é uma boa opção terapêutica, principalmente com o uso de FIV.Purpose: to present a profile of endometriosis, stages and results of treatment among the patients seen in our Service. Methods: the medical records of 155 patients with endometriosis treated during the period from 1991 to 1996
Transvaginal Ultrasound-Guided Biopsy of Deep Pelvic Masses: How We Do It.

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Plett, Sara K; Poder, Liina; Brooks, Rebecca A; Morgan, Tara A

2016-06-01

The purpose of this review is to discuss the rationale and indications for transvaginal ultrasound-guided biopsy. Transvaginal ultrasound-guided biopsy can be a helpful tool for diagnosis and treatment planning in the evaluation of pelvic masses, particularly when the anatomy precludes a transabdominal or posterior transgluteal percutaneous biopsy approach. A step-by-step summary of the technique with preprocedure and postprocedure considerations is included. © 2016 by the American Institute of Ultrasound in Medicine.
Forma atípica de tireoidite supurativa aguda em paciente pediátrico: relato de caso

OpenAIRE

Torres, Maria Rosineide dos S.; Medeiros, Carla C. M.; Nóbrega Neto, Sebastião Horácio; Souza, Lincoln S.; Rodrigues, Mônica L. C.; Silva, Maria Nelice M.; Maior, Lyzandra de H. C. S.; Avelino, Márcia C.; Mourão, Germana T. F.

2008-01-01

A tireoidite aguda é uma doença rara. Na infância associa-se principalmente a anormalidades congênitas com acometimento do lobo esquerdo. Na ausência de tireoidopatia preexistente, a função tireoidiana geralmente está normal. Relatamos um caso de uma menina, 6 anos de idade, com tumoração associada a sinais flogísticos na região cervical anterior há 15 dias acompanhada de leucocitose com desvio à esquerda, VSH e TSH elevados. Não havia história prévia de tireoidopatia. A ultra-sonografia da r...
Associação da Vaginose Bacteriana com o Parto Prematuro Espontâneo Association of Bacterial Vaginosis with Spontaneous Preterm Delivery

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Mário Henrique Burlacchini de Carvalho

2001-09-01

Full Text Available Objetivo: relacionar a presença de vaginose bacteriana em gestantes com a ocorrência de parto prematuro espontâneo. Método: foram estudadas 611 gestantes do serviço pré-natal da Clínica Obstétrica do HCFMUSP. Foram incluídas gestantes com idade gestacional confirmada por ultra-sonografia no primeiro trimestre de gestação ou duas ultra-sonografias até a 20ª semana quando havia discordância da idade gestacional no primeiro exame. Os partos prematuros eletivos foram excluídos. A pesquisa da vaginose foi realizada na 23ª ou 24ª semana de gestação por meio da técnica de coloração de Gram. O pH vaginal foi pesquisado utilizando-se fita de pH Universal 0-14 produzida pela Merck. O conteúdo vaginal foi coletado com a paciente em posição ginecológica, utilizando-se espéculo não-lubrificado. O pH foi medido na parede lateral da vagina e o conteúdo para Gram foi coletado do fundo de saco vaginal utilizando-se de cotonete estéril. Resultado: das 611 gestantes envolvidas inicialmente no estudo, foram obtidos os resultados do parto em 541. A vaginose bacteriana foi diagnosticada por bacterioscopia em 19% dos casos. No grupo de gestantes com vaginose, 9,7% (10/103 evoluíram com parto prematuro, contra apenas 3,2% (14/438 no grupo negativo (p=0,008. A sensibilidade da bacterioscopia positiva para vaginose bacteriana para predição do parto prematuro foi de 41,7%, a especificidade de 82%, a acurácia de 80,2%, com taxa de falso-positivos de 18% e risco relativo de 1,8. Conclusão: a vaginose bacteriana diagnosticada pelo Gram do conteúdo vaginal representa fator de risco para o parto prematuro, com risco relativo de 1,8.Purpose: to evaluate the relationship between bacterial vaginosis (BV and spontaneous preterm delivery. Method: a total of 611 pregnant women from the general antenatal clinic of the "Clínica Obstétrica do Hospital das Clínicas da Universidade de São Paulo" were enrolled in this study. All pregnancies were
Challenging the Myth: Transvaginal Mesh is Not Associated with Carcinogenesis.

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Chughtai, Bilal; Sedrakyan, Art; Mao, Jialin; Thomas, Dominique; Eilber, Karyn S; Clemens, J Quentin; Anger, Jennifer T

2017-10-01

We sought to determine if there was a potential link between synthetic polypropylene mesh implantation for transvaginal pelvic organ prolapse and stress urinary incontinence, and carcinogenesis using statewide administrative data. Women who underwent transvaginal surgery for pelvic organ prolapse or stress urinary incontinence with mesh between January 2008 and December 2009 in New York State were identified using ICD-9-CM procedure codes and CPT-4 codes. Patients in the mesh cohort were individually matched to 2 control cohorts based on comorbidities and procedure date. Carcinogenesis was determined before and after matching at 1, 2 and 3 years, and during the entire followup time. A total of 2,229 patients who underwent mesh based pelvic organ prolapse surgery and 10,401 who underwent sling surgery for stress urinary incontinence between January 2008 and December 2009 were included in the study. Mean followup was 6 years (range 5 to 7). Exact matching between the mesh and control cohorts resulted in 1,870 pairs for pelvic organ prolapse mesh and cholecystectomy (1:2), 1,278 pairs for pelvic organ prolapse mesh and hysterectomy (1:1), 7,986 pairs for sling and cholecystectomy (1:1) and 3,810 pairs for sling and hysterectomy (1:1). Transvaginal mesh implantation was not associated with an increased risk of a cancer diagnosis (pelvic/local cancers or any cancer) at 1 year and during the entire followup of up to 7 years. Transvaginal surgery with implantation of mesh was not associated with the development of malignancy at a mean followup of 6 years. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Transvaginal expulsion of intramural leiomyoma after uterine artery embolization: case report

Energy Technology Data Exchange (ETDEWEB)

Lee, Seung Woo; Cho, Jae Ho; Park, Won Kyu; Lee, Doo Jin [College of Medicine, Yeungnam Univ., Daegu (Korea, Republic of)

2004-03-01

We report a case in which an intramural uterine Ieiomyoma was transvaginally expelled after uterine arterial embolization (UAE). A 29-year-old unmarried female presented with vaginal bleeding, and at pre-treatment MRI an intramural leiomyoma was diagnosed. UAE was performed and after 13 days the tumor was transvaginally expelled. Follow-up MRI performed seven days later depicted a large myometrial defect in the anterior uterine wall; subsequent follow-up MRI showed that the defect became gradually smaller, and the size and configuration of the uterus progressively normalized.
Transvaginal sling excision: tips and tricks.

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Clifton, Marisa M; Goldman, Howard B

2017-01-01

Complications of synthetic midurethral sling surgery include bladder outlet obstruction, mesh extrusion, and vaginal pain. A treatment of these complications is transvaginal mesh removal. The objectives of this video are to present cases of complications after sling placement and describe techniques to help with successful sling removal. Three patients are presented in this video. One experienced urinary hesitancy and was found to have bladder outlet obstruction on urodynamic study. The second patient presented to the clinic with diminished force of stream and significant dyspareunia. The last patient presented with mesh extrusion. After discussion of management options, all three patients wished to pursue transvaginal sling excision. All patients had successful removal of a portion of their synthetic midurethral sling. This video presents techniques to aide with dissection, mesh excision and prevention of further mesh complications. These include using an individualized surgical technique based on patient presentation and surgeon expertise, planning surgical incisions based on where mesh can be identified or palpated, using a cystoscope sheath or urethral dilator to identify any bladder outlet obstruction, and using a knife blade to identify mesh from surrounding tissue. Sling excision can be successfully performed with careful surgical technique and dissection.
Hipertensão portal por esquistossomose mansônica hepatoesplênica: efeito da desconexão ázigo-portal com esplenectomia no diâmetro e na velocidade média de fluxo do sistema portal (estudo ultra-sonográfico com Doppler Hepatosplenic schistosomotic portal hypertension: effect of esophagogastric devascularization with splenectomy on the diameter and mean flow velocity in the portal system (ultra-sonographic Doppler study

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Azzo WIDMAN

2001-01-01

Full Text Available Racional - A esplenectomia com desconexão ázigo-portal tem sido indicada para o tratamento da hemorragia digestiva pelas varizes esofágicas na hipertensão portal da esquistossomose mansônica hepatoesplênica. Todavia, esta técnica terapêutica apresenta índices variáveis de complicações trombóticas precoces do sistema portal (13,3% a 53,2%. Supondo que as alterações circulatórias devidas ao tratamento cirúrgico tenham papel preponderante neste acontecimento, procurou-se identificar elementos hemodinâmicos que, dentre os múltiplos fatores causais, tenham facilitado a ocorrência desta complicação. Com este intuito estudou-se comparativamente, mediante ultra-sonografia com Doppler, o sistema portal de dois grupos de pacientes em condições clínicas semelhantes: não-operados e com desconexão ázigo-portal em fase pós-operatória tardia (período superior a 6 meses. Casuística/Método - Foram estudados 58 pacientes com esquistossomose mansônica hepatoesplênica e com antecedentes de hemorragia digestiva alta, divididos em dois grupos: A (29 sob controle ambulatorial: clínico e endoscópico; B (29 submetidos previamente a desconexão ázigo-portal. Em todos foi feita a medida do diâmetro e da velocidade média de fluxo do sangue na veia porta e seus ramos direito e esquerdo, mediante ultra-sonografia com Doppler. Os resultados foram submetidos a análise univariada inter e intragrupo. Resultados - No grupo A (não-operados: a veia porta apresentou diâmetro maior do que o dos ramos direito e esquerdo e nestes esta medida foi semelhante (10,6 ± 2,9, 8,0 ± 1,8, 9,1 ± 2,6 cm; a velocidade média de fluxo na veia porta e nos ramos portais foi semelhante (15,62 ± 6,17, 14,92 ± 5,33, 16,12 ± 4,18 cm/seg. No grupo B (operados: houve diminuição de ambos os parâmetros na veia porta e seus ramos (8,8 ± 1,7, 5,2 ± 1,2, 7,5 ± 2,2 cm/12,53 ± 2,60, 8,86 ± 1,75, 9,60 ± 3,75 cm/seg. Conclusões - Houve redu
Comparative study of transvaginal hysterosonography and biopsy for theevaluation of post-menopausal bleeding

International Nuclear Information System (INIS)

Abu-Ghazzeh, Y.; Sahkoury, Waheed A.; Barqawi, R.

1999-01-01

The aim of this prospective study was to evaluate transvaginalhysterosonography (TVHS) in post-menopausal bleeding (PMB) as an alternativeto endometrial biopsy. The study was conducted at the Zarka MilitaryHospital, Amman, Jordan, over a one year period from 1996 to 1997. The studycomprised 98 women presenting with post-menopausal bleeding who had beenlisted for diagnostic dilatation and curettage. Transvaginal sonography (TVS)and transvaginal hysterosonography were performed one week before operation.The mean age of the women was 75 years, and all of them had their menopausefor at least six months. Sixty-one women (62%) demonstrated endometrialthickness of more than 5mm by transvaginal sonography. All the women hadtransvaginal hysterosonography, except seven on whom hysterosonography couldnot be performed for technical reasons and who had to be excluded from thestudy, leaving a total 54 women. TVS confirmed the presence of endoluminalmass in 30 of 54 women (60%). Twenty-two of the 30 endoluminal mass caseswere pedunculated while eight were sessile. Sixteen of the pedunculated caseswere endometrial polyps while the remaining six were fibroid polyps. Five ofthe sessile cases were fibroid, two were endometrial hyperplasia, and thelast one endometrial carcinoma. The other 44 out of the 98 patients alsounderwent transvaginal hysterosonography. No pathology could be detected inthese patients, but they were noted to have atrophic endometrium afterdilatation and curettage. The combination of transvaginal sonography andtransvaginal hysterosonography is both sensitive and specific with regard todetecting and excluding endoluminal masses as the cause of post-menopausalbleeding. Diagnostic dilatation and curettage fails to detect a largepercentage of some lesions, so TVS in combination with TVHS should beconsidered as the initial examination in the evaluation of all women withpost-menopausal bleeding. (author)
Desempenho da ultra-sonografia na detecção das metástases em linfonodos axilares em mulheres com câncer de mama Performance of ultrasound in the detection of axillary lymph node metastases in breast cancer patients

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Rodrigo Menezes Jales

2005-09-01

Full Text Available OBJETIVOS: avaliar o desempenho de diversas características ultra-sonográficas morfológicas (12 e doplervelocimétricas (7, para detecção de metástases linfonodais em mulheres com câncer de mama. MÉTODOS: foram incluídas 179 mulheres (181 axilas, entre janeiro e dezembro de 2004. Os exames ultra-sonográficos foram realizados com transdutor linear em tempo real (Toshiba-Power Vision-6000 (modelo SSA-370A. Para o estudo de parâmetros morfológicos foram utilizadas freqüências entre 7,5 e 12 MHz. Para os parâmetros Doppler foi utilizada freqüência de 5 MHz. Subsequentemente, as pacientes foram submetidas a axilectomia dos níveis I, II e III (158 ou à técnica do linfonodo sentinela (23. Foram calculadas a sensibilidade, a especificidade e os valores preditivos positivo e negativo para cada parâmetro. Para a associação de parâmetros foi utilizada a árvore de decisão. Foram estabelecidos os valores de corte para as variáveis contínuas por meio da curva ROC. RESULTADOS: ao exame ultra-sonográfico foi identificado pelo menos um linfonodo axilar em 173 (96% exames. O exame histológico detectou metástase linfonodal em 87 mulheres (48%. As melhores sensibilidades dos critérios morfológicos foram encontradas com o volume (62%, diâmetro ântero-posterior (62% e local do centro ecogênico (56%. Embora a especificidade da invasão da gordura adjacente (100%, regularidade das margens (92% e da ecotextura do parênquima (99% tenham sido elevadas, a sensibilidade destes parâmetros foi muito baixa. Nenhum critério dopplervelocimétrico alcançou 50% de sensibilidade. A árvore de decisão selecionou a localização do centro ecogênico, a ecotextura do parênquima e a regularidade das margens como melhor associação de parâmetros. CONCLUSÃO: o estadiamento dos linfonodos axilares por método não invasivo ainda é um objetivo não alcançado no tratamento das pacientes com câncer de mama.PURPOSE: to evaluate the role of
Laparoscopic sacrocolpopexy versus transvaginal mesh for recurrent pelvic organ prolapse.

Science.gov (United States)

Iglesia, Cheryl B; Hale, Douglass S; Lucente, Vincent R

2013-03-01

Both expert surgeons agree with the following: (1) Surgical mesh, whether placed laparoscopically or transvaginally, is indicated for pelvic floor reconstruction in cases involving recurrent advanced pelvic organ prolapse. (2) Procedural expertise and experience gained from performing a high volume of cases is fundamentally necessary. Knowledge of outcomes and complications from an individual surgeon's audit of cases is also needed when discussing the risks and benefits of procedures and alternatives. Yet controversy still exists on how best to teach new surgical techniques and optimal ways to efficiently track outcomes, including subjective and objective cure of prolapse as well as perioperative complications. A mesh registry will be useful in providing data needed for surgeons. Cost factors are also a consideration since laparoscopic and especially robotic surgical mesh procedures are generally more costly than transvaginal mesh kits when operative time, extra instrumentation and length of stay are included. Long-term outcomes, particularly for transvaginal mesh procedures, are lacking. In conclusion, all surgery poses risks; however, patients should be made aware of the pros and cons of various routes of surgery as well as the potential risks and benefits of using mesh. Surgeons should provide patients with honest information about their own experience implanting mesh and also their experience dealing with mesh-related complications.
Análise da fórmula SRK/T no cálculo de lente intra-ocular em cães portadores de catarata Analysis of the SRK/T formula for calculation of intra-ocular lens in dogs carrying cataract

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T.P. Peixoto

2008-12-01

Full Text Available Foram utilizados 20 cães de raças e idades variadas, machos e fêmeas, portadores de catarata e não diabéticos, os quais foram submetidos ao exame oftálmico. Posteriormente, realizaram-se mensurações oculares empregando-se um ecobiômetro ultra-sônico (ultra-sonografia modo-A para o cálculo do poder dióptrico da lente intra-ocular por meio da fórmula SRK/T. O comprimento axial médio foi de 19,94±1,12mm. Todos os animais foram submetidos à facoemulsificação extracapsular. A lente calculada foi implantada no transoperatório da cirurgia de catarata, obtendo-se média de 37,33±3,05D. A avaliação pós-cirúrgica do erro refracional aos 60 dias de pós-operatório, pela retinoscopia, com a utilização da esquiascopia, foi de 5,57±1,59D. A fórmula SRK/T não ofereceu bons resultados.Twenty males and females non-diabetic dogs of different breeds and ages underwent ophthalmic examination because they presented catarats. Ocular measurements were performed by echobiometry (A-scan ultrasound for intraocular lens power calculation using the SRK/T formula. The obtained mean axial length was 19.94±1.12mm. All animals were submitted to extracapsular phacoemulsification; the mean intraocular lens power implanted was 37.33±3.05. At 60 days postoperative, the refractional error assessed via retinoscopy was 5.57±1.59 D. The SRK/T formula did not offer good results.
Hybrid NOTES transvaginal cholecystectomy: operative and long-term results after 18 cases.

Science.gov (United States)

Pugliese, Raffaele; Forgione, Antonello; Sansonna, Fabio; Ferrari, Giovanni Carlo; Di Lernia, Stefano; Magistro, Carmelo

2010-03-01

Natural orifice transluminal endoscopic surgery (NOTES) is a novel technique that aims at reducing or abolishing skin incisions and potentially also postoperative pain. The purpose of this study was to analyse operative and long-term results of a series of hybrid transvaginal cholecystectomy. Between July 2007 and May 2009, transvaginal NOTES cholecystectomy for symptomatic cholelithiasis was performed by a hybrid technique in 18 women (mean age 54 years), including four women with a body mass index >30 kg/m(2). Dissection was conducted in the first four cases by a round-tip unipolar electrode (UE) introduced through the operative channel of the endoscope coming from the vagina and in the last 14 cases by a ultrasonic scalpel (US) introduced through a 5-mm abdominal port. The short-term outcomes and the long-term results of the two methods were compared. The transvaginal approach entailed no intraoperative complication and no conversion. The overall mean duration of procedures was 75 min (range 40-190). In the first four cases (UE), the operating time was 148 min (range 140-190), whilst in the last 14 (US), it was considerably shorter, 53 min (range 40-60, p < 0.01). We experienced one biliary leak in the UE group, whilst morbidity with US was nil (p < 0.005). The biliary leak healed in 7 days with nasobiliary drainage. No other complications were encountered in either group. The mean follow-up was 12 months (range 1-22), and none of the patients has complained of dyspareunia or other colpotomy-related complications so far. Until specifically designed endoscopic tools are available for NOTES, the hybrid technique with US dissection conducted through a 5-mm port should be preferred in transvaginal cholecystectomy in order to shorten the duration of surgery and make this approach effective, safe and reproducible. After a mean follow-up of 1 year, none of our patients has complained of any problem related to transvaginal approach.
Hiperecogenicidade dos vasos talâmicos no recém-nascido prematuro Hyperechogenicity of thalamic vessels in preterm newborn infants

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Natália Paczko

2002-09-01

Full Text Available Objetivo: o presente estudo procura avaliar as possíveis patologias que se manifestam associadas à hiperecogenicidade dos vasos talâmicos na ultra-sonografia cerebral, e observar a freqüência com que ocorrem. Métodos: a amostra foi constituída de 206 recém-nascidos prematuros, nascidos no Hospital de Clínicas de Porto Alegre, no período de julho de 1998 a maio de 1999. Todos realizaram a ultra-sonografia cerebral na primeira semana de vida. Foram incluídos no estudo aqueles prematuros que necessitaram de internação hospitalar, e que tiveram o termo de consentimento informado assinado por um dos responsáveis. Foram excluídos aqueles cuja ultra-sonografia cerebral evidenciava sangramento cerebral e/ou malformações congênitas associadas, e os que evoluíram para óbito antes da realização do exame. Resultados: a ultra-sonografia cerebral levou à identificação de 65 recém-nascidos prematuros com hiperecogenicidade dos vasos talâmicos e de 141 recém-nascidos prematuros sem. Conclusão: a forma de apresentação do tipo pélvica ao nascimento, a maior idade gestacional, o maior peso do recém-nascido ao nascimento e a classificação grande para a idade gestacional foram fatores de risco para a ocorrência de hiperecogenicidade dos vasos talâmicos, enquanto a presença de hipertensão materna durante o período de gestação tendeu a ser fator de proteção. Os recém-nascidos que apresentaram crises convulsivas durante o período de internação hospitalar tiveram risco 3,2 vezes maior de ter hiperecogenicidade dos vasos talâmicos, quando comparados aos que não apresentaram crises convulsivas.Objective: the aim of this study is to evaluate possible pathologies associated with hyperechogenicity of thalamic vessels (HETV, which are found on brain ultrasounds (BUS, as well as to observe the frequency of their occurrence. Methods: the sample was composed of 206 preterm newborn infants at Hospital de Clíncas de Porto Alegre
Transvaginal mesh kits--how "serious" are the complications and are they reversible?

Science.gov (United States)

Lee, Dominic; Dillon, Benjamin; Lemack, Gary; Gomelsky, Alex; Zimmern, Philippe

2013-01-01

To review the merit of the U.S. Food and Drug Administration-issued warnings on the use of transvaginal mesh in women with pelvic organ prolapse because of escalating complications. On institutional review board approval, we reviewed the data from 2 tertiary institutions managing complications of transvaginal mesh. The data recorded included mesh type, details of surgical removal, and patient-reported clinical outcomes. From 2006 to March 2011, 58 women were evaluated. Their mean age was 54.6 years (range 32-80), with a mean follow-up of 13 months (range 6-67). The mean interval to mesh excision surgery from the original prolapse surgery was 21 months (range 2-60). Of the 58 women, 35 (60%) had undergone concurrent midurethral sling surgery with the transvaginal mesh surgery. Also, 21 of the 58 patients (36%) had undergone initial mesh removal attempts before their referral to either tertiary institution. Most women presented with multiple complaints, with mesh extrusion the most frequently reported (n=43 [74%]). Of the 58 women, 17 (29%) required re-excision of residual mesh, 13 once and 4 twice. Five women developed recurrent symptomatic pelvic organ prolapse (7%). The residual rate of dyspareunia and pelvic pain was 14% and 22%, respectively. Fourteen women (24%) were treated successfully, with complete resolution of all presenting symptoms. As outlined in the Food and Drug Administration notifications, patients should be forewarned that some transvaginal mesh complications are life altering and might not always be surgically correctable. Copyright © 2013 Elsevier Inc. All rights reserved.
Transvaginal sonography in abnormal uterine bleeding and correlation to hysteroscopy

International Nuclear Information System (INIS)

Saeed, S.; Shah, S.; Ali, H.; Khan, S.; Ehsan, N.; Ahmed, S.Z.

2017-01-01

To correlate results of Transvaginal sonography with those of hysteroscopy and biopsy in abnormal uterine bleeding to estimate the accuracy and analytical values of non-invasive transvaginal sonography in abnormal uterine bleeding. Methodology: This cross-sectional Study was carried out at BMCH, Quetta, Balochistan, Pakistan from March 2013 to February 2014 and included 200 patients of abnormal uterine bleeding. Exclusion criteria were pregnancy, virginity, local bleeding of perineal or vaginal origin. Hysteroscopy and biopsy and Transvaginal Ultrasound (TVS) were performed in all. Result: The most common type of bleeding was found to be menorrhagia in 39% while the least common type was postmenopausal bleeding in 9%. Mean endometrial thickness was 11.64 mm and it was noted that at less than 14mm thickness no serious pathology was found. Sensitivity of TVS for endometrial hyperplasia was found to be 66.66% while specificity was 100%. Positive analytical value was 100% while negative value was 100%. Overall sensitivity calculated for TVS was 94.44%, specificity 98.55%, PPV was 81.93% and NPV 98.55%. Conclusion: Sensitivity and specificity of TVS were lower than hysteroscopy and biopsy but the difference was not significant. TVS can be used as first line investigation while hysteroscopy and biopsy may be left for cases of high risk or in those cases where some positive findings could be found on TVS. (author)
Hybrid NOTES transvaginal intraperitoneal onlay mesh in abdominal wall hernias: an alternative to traditional laparoscopic procedures.

Science.gov (United States)

Descloux, Alexandre; Pohle, Sebastian; Nocito, Antonio; Keerl, Andreas

2015-12-01

Abdominal wall hernias are increasingly treated by laparoscopic placement of an intraperitoneal onlay mesh (IPOM). We present an alternative technique for women: the laparoscopic-assisted transvaginal IPOM. Before surgery, all patients underwent a gynecological examination. The patients agreed to IPOM repair via a transvaginal approach, and written informed consent for surgery was obtained. Pneumoperitoneum was established with a Veress needle at the umbilicus. This access was subsequently dilated to 5 mm (VersaStep), and a 5-mm laparoscope was inserted. Under laparoscopic view, the transvaginal trocars (12-mm VersaStep and 5-mm flexible accesses) were safely inserted after lifting the uterus with a uterus manipulator. After preparation of the falciform ligament, the ligamentum teres and the preperitoneal fat, a lightweight composite mesh was introduced through the transvaginal access and fixed with absorbable tacks using the double-crown technique. From September 2011 to December 2012, we performed six laparoscopic-assisted transvaginal IPOM procedures (one epigastric, three umbilical, two combined epigastric and umbilical hernias; all were primary hernias). In the initial phase, only patients with small or medium primary abdominal wall hernia were selected (max. 3 cm diameter). Median hospital stay was 3 days (range 2-6 days). One minor complication occurred perioperatively (second-degree skin burn to the labia majora). At 1-year follow-up, we identified one recurrence in a high-risk patient with a body mass index higher than 35 kg/m(2). No infection and no mortality were observed. Although no final conclusion can be made regarding the presumed non-inferiority of this technique in terms of recurrence and mesh infection compared with traditional laparoscopic IPOM, laparoscopic-assisted transvaginal IPOM is a feasible alternative to treat abdominal wall hernias.
Heterotopic pregnancy after in vitro fertilization and embryo transfer: the role of routine transvaginal ultrasonography

International Nuclear Information System (INIS)

Lee, Eun Ju

1994-01-01

Spontaneous heterotopic pregnancy (HP) is a rare condition, however, the rising incidence after in-vitro fertilization and embryo transfer (IVF-ET) may present serious problems as the diagnosis of this potentially fatal condition is often missed. The purposes of this study were to investigate the frequency of HP after IVF-ET, to analyze the clinical presentation and the outcome of coincidental intrauterine pregnancy, and to evaluate the value of routine transvaginal ultrasonography in early diagnosis and treatment of HP. There were 11 cases of HP among 484 pregnancies after IVF-ET (The incidence was 2.3%) in recent 2 years. We evaluated the clinical findings and the findings of transvaginal sonography in those 11 patients. The combined extrauterine pregnancies were tubal (n = 9), cornual (n = 1), and both the tubal and cornual (n = 1). Vaginal bleeding was absent in 4 cases and one of them was asymptomatic. HP may be suspected if there was an elevated serum hCG in the absence of intrauterine multiple gestations. In all cases, the condition was diagnosed by transvaginal sonography performed prior to surgical intervention. The coincidental intrauterine pregnancies were ended in successful full-term delivery in 7 cases, while one pregnancy was ongoing at that time. The incidence of HP was evidently higher in IVF-ET than in spontaneous pregnancies. Transvaginal sonography was useful in accurate diagnosis in clinically suspected cases and even in asymptomatic cases. Routine transvaginal sonography played an important role in early diagnosis and prompt management of HP

Transvaginal ultrasound examination of women with and without pelvic venous congestion

International Nuclear Information System (INIS)

Halligan, Steve; Campbell, Deidre; Bartram, Clive I.; Rogers, Vera; El-Haddad, Cadria; Patel, Sujata; Beard, Richard W.

2000-01-01

AIM: To determine if transvaginal ultrasound, including power Doppler examination, can distinguish between women with and without pelvic congestion. MATERIALS AND METHODS: Thirty-six women with pelvic congestion were prospectively examined using transvaginal ultrasonography and standard uterine and ovarian measurements made. Additionally, planimetric measurements of each ovary were taken using an image analysis program to determine the cross-sectional area of ovarian stroma and follicles, if any. Power Doppler images of adnexal vessels were obtained and planimetric estimates of surface area calculated. A congestion score was assigned to each patient, based on vein number, diameter and morphology on grey-scale scanning. Identical measurements were obtained from 19 asymptomatic women and results compared. RESULTS: There was no significant difference between women with pelvic congestion and controls with respect to power Doppler or grey-scale images of adnexal vessels, or congestion score. However, women with pelvic congestion had significantly larger and multicystic ovaries when compared to controls. CONCLUSIONS: Transvaginal ultrasound measurements of adnexal vasculature, including power Doppler measurements, cannot reliably distinguish women with pelvic congestion from controls. However, ultrasound may remain useful for diagnosis of pelvic congestion, predominantly because it is able to visualize multi-cystic ovaries in these patients. Halligan, S. (2000).Clinical Radiology 55 , 954-958
Transvaginal Drainage of Pelvic Abscesses and Collections Using Transabdominal Ultrasound Guidance.

Science.gov (United States)

Ching, Kevin C; Sumkin, Jules H

2015-01-01

Objectives. To evaluate clinical outcomes following transvaginal catheter placement using transabdominal ultrasound guidance for management of pelvic fluid collections. Methods. A retrospective review was performed for all patients who underwent transvaginal catheter drainage of pelvic fluid collections utilizing transabdominal ultrasound guidance between July 2008 and July 2013. 24 consecutive patients were identified and 24 catheters were placed. Results. The mean age of patients was 48.1 years (range = 27-76 y). 88% of collections were postoperative (n = 21), 8% were from pelvic inflammatory disease (n = 2), and 4% were idiopathic (n = 1). Of the 24 patients, 83% of patients (n = 20) had previously undergone a hysterectomy and 1 patient (4%) was pregnant at the time of drainage. The mean volume of initial drainage was 108 mL (range = 5 to 570). Catheters were left in place for an average of 4.3 days (range = 1-17 d). Microbial sampling was performed in all patients with 71% (n = 17) returning a positive culture. All collections were successfully managed percutaneously. There were no technical complications. Conclusions. Transvaginal catheter drainage of pelvic fluid collections using transabdominal ultrasound guidance is a safe and clinically effective procedure. Appropriate percutaneous management can avoid the need for surgery.
Descolamento Crônico da Placenta: Relato de Caso Chronic Placental Abruption: A Case Report

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Júlio César Faria Couto

2002-01-01

Full Text Available O descolamento crônico da placenta é um evento raro cujo diagnóstico pode ser feito precocemente utilizando-se a ultra-sonografia. Sangramento vaginal e hipertonia uterina são sinais clínicos encontrados de forma infreqüente. A fisiopatologia do descolamento crônico é pouco conhecida e a importância dos fatores de risco na sua gênese é controversa. O resultado perinatal é insatisfatório, com alta incidência de prematuridade e mortalidade fetal e neonatal. A conduta obstétrica baseia-se na idade gestacional, condições do feto e evolução do hematoma. Nós apresentamos o caso de uma gestação, complicada por descolamento crônico da placenta identificado na 14ª semana de gestação, que evoluiu com crescimento intra-uterino restrito, oligoidrâmnio e óbito neonatal.Chronic placental abruption is a rare condition that can be early detected by ultrasound. Vaginal bleeding and uterine excitability can be present in an infrequent way. Chronic placental abruption physiopathology is unknown and there are no consistent medical risks that predispose to this condition. The perinatal outcome is poor and is often associated with prematurity and fetal or perinatal death. The obstetric treatment depends on the gestational age, fetal conditions and the size of the clot. We present a case of a chronic placental abruption diagnosed in a 14-week gestation complicated by intrauterine growth retardation, oligohydramnios and perinatal death.
Outcomes of trocar-guided Gynemesh PS™ versus single-incision trocarless Polyform™ transvaginal mesh procedures.

Science.gov (United States)

Larouche, Maryse; Merovitz, Lisa; Correa, José A; Walter, Jens-Erik

2015-01-01

The aim of the study was to compare rates of success, mesh exposure, and surgical re-intervention after trocar-guided Gynemesh PS™ and trocarless Polyform™ transvaginal mesh procedures. We conducted a retrospective cohort study of all transvaginal mesh procedures performed at our centers between January 2008 and May 2012. Multiple logistic regression models were used to explore the binary outcomes of objective and subjective success rates, as well as mesh exposure and re-intervention rates, between the two procedures after adjustment for patient's age, parity, body mass index, smoking status, previous hysterectomy, previous prolapse surgery, and follow-up time. We included 103 transvaginal mesh procedures (47 trocar-guided Gynemesh PS™ and 56 trocarless Polyform™). In both groups, Pelvic Organ Prolapse Quantification (POP-Q) scores were significantly improved after the procedure. Median follow-up was 340 days and interquartile range (IQR) 152-644. Objective success rates were 55.3 % (26/47) in the trocar group and 60.7 % (34/56) in the trocarless group (p = 0.9), whereas subjective success was 83.0 % (39/47) and 94.6 % (53/56), respectively (p = 0.1). The adjusted odds of developing mesh exposure were significantly less after trocarless transvaginal mesh procedures compared to trocar-guided ones [odds ratio (OR) 0.16, 95 % confidence interval (CI) 0.03-0.97]. Surgical re-interventions, aimed mostly at treating recurrent prolapse, mesh exposure, and latent stress urinary incontinence, were also significantly less frequent after trocarless procedures [5 patients (8.9 %) requiring re-intervention versus 15 (31.9 %), respectively, adjusted OR 0.15, 95 % CI 0.04-0.60]. Trocar-guided Gynemesh PS™ and trocarless Polyform™ transvaginal mesh systems result in similar objective and subjective success rates. The newer Polyform™ mesh results in significantly fewer mesh exposures and surgical re-interventions.
Transvaginal Repair of a Large Chronic Porcine Ventral Hernia with Synthetic Mesh Using NOTES

OpenAIRE

Powell, Ben; Whang, Susan H.; Bachman, Sharon L.; Andres Astudillo, J.; Sporn, Emanuel; Miedema, Brent W.; Thaler, Klaus

2010-01-01

Background: Ventral incisional hernias still remain a common surgical problem. We tested the feasibility of transvaginal placement of a large synthetic mesh to repair a porcine hernia. Methods: Seven pigs were used in this survival model. Each animal had creation of a 5-cm hernia defect and underwent a transvaginal repair of the defect with synthetic mesh. A single colpotomy was made using a 12-cm trocar for an overtube. The mesh was cut to size and placed through the trocar. A single-channel...
Digital examination and transvaginal scan - competing or complementary for predicting preterm birth?

DEFF Research Database (Denmark)

Reiter, Eva; Nielsen, Kurt Aagaard; Fedder, Jens

2012-01-01

The transvaginal ultrasonographic cervix scan has partly replaced digital examination for diagnosing preterm birth; conflicting results are reported about their respective contribution to birth prediction....
The clinical value of trans-vaginal ultrasound-guided puncture in the treatment of pelvic abscess

International Nuclear Information System (INIS)

Wang Ping; Gong Wei

2008-01-01

Objective: To investigate the clinical value of trans-vaginal ultrasound-guided (TVS) puncture in the treatment of pelvic abscess. Methods 30 cases with pelvic abscess were treated by transvaginal ultrasound-guided puncture. The long-dated effects were followed-up. Results: 29 cases were cured by TVS puncture. Operation was performed in 1 patient because of invalid effect. The cure rate was 97%. Conclusion: Ultrasound-guided puncture is a safe and convenient method in the treatment of pelvic abscess. (authors)
Transvaginal Resection of an Infected Sacrocolpopexy Mesh by Single-Port Trocar.

Science.gov (United States)

Schaub, Marie; Lecointre, Lise; Faller, Emilie; Boisramé, Thomas; Baldauf, Jean-Jacques; Akladios, Cherif Youssef

Laparoscopy using a single port improves morbidity while keeping the same level of requirement. This technique has been evaluated in gynecology for salpingectomy, ovarian surgery, and hysterectomy. Here, the authors illustrate a new use of a single port using the transvaginal approach. Case report (Canadian Task Force classification III). Tertiary referral center in Strasbourg, France. Woman age 59 years. Single-port platform used in the transvaginal approach for resection of sacrocolpopexy mesh. The local institutional review board approved the video. A 59-year-old woman suffering from insulin-dependent diabetes and a tobacco user had 2 laparoscopic sacrocolpopexies for recurrent rectocele, the first in 2007 and the second in 2012. The sequences were marked by mesh erosion and granuloma in the vagina, requiring its surgical excision in 2016. The patient was then symptomatic, with an increasingly foul-smelling vaginal discharge with recurrent mesh erosion. Magnetic resonance imaging showed an abscess formation along the length of the mesh to the promontory. The patient then underwent surgery, realized under probabilistic antibiotic therapy, consisting of complete excision of the sacrocolpopexy mesh by the transvaginal approach. After putting the single-port trocar (GelPoint; Applied Medical, Rancho Santa Margarita, CA) into the vagina and obtaining distension with the insufflator (AirSeal; Conmed, Utica, NY), classic laparoscopic instruments were introduced by the single-port trocar. The mesh was entirely resected in the retroperitoneal space. Mesh was again used because the exposed space is almost always surrounded by loose granulation tissue that facilitates dissection and also prevents injury to adjacent structures such as bladder, rectum, and peritoneum. Moreover, the opening of adjacent structures will manifest gas leaks and, consequently, loss of the pneumovagina. At the end of procedure, the vagina is not closed to permit optimal drainage with a multitubular
Comparative analysis of early adverse events of pelvic organ prolapse repair with or without transvaginal mesh using Clavien-Dindo classification.

Science.gov (United States)

Besser, Limor; Schwarzman, Polina; Mastrolia, Salvatore A; Rotem, Reut; Leron, Elad; Yohay, David; Weintraub, Adi Y

2018-04-10

To assess adverse events following surgical repair of pelvic organ prolapse (POP) with or without the use of transvaginal mesh. The present retrospective study was conducted among women who underwent surgical POP repair at Soroka University Medical Center, Beer Sheva, Israel, between January 1, 2013, and December 31, 2015. Patients underwent anterior and posterior colporrhaphy either with transvaginal mesh (Elevate Prolapse Repair System; American Medical Systems, Minnetonka, MN, USA) or without transvaginal mesh (native tissue repair). Perioperative adverse events were assessed using the Clavien-Dindo classification; multivariate regression models were constructed to predict minor and major adverse events. There were 111 women included; 35 were treated with transvaginal mesh, and 76 underwent native tissue repair. Women undergoing native tissue repair had a lower mean grade of cystocele (P=0.023) and a higher rate of urinary stress incontinence (P=0.017) than patients treated with transvaginal mesh. The duration of surgery (P=0.002), duration of hospitalization (Ptransvaginal mesh was not associated with increased odds of major or minor adverse events (P>0.05 for all models examined). Perioperative and postoperative adverse events were comparable regardless of the operative approach. © 2018 International Federation of Gynecology and Obstetrics.
A prospective study of transobturator tape as treatment for stress urinary incontinence after transvaginal mesh repair.

Science.gov (United States)

Lau, Hui-Hsuan; Su, Tsung-Hsien; Huang, Wen-Chu; Hsieh, Ching-Hung; Su, Chin-Hui; Chang, Rhu-Chu

2013-10-01

The transobturator suburethral sling is a common surgical treatment for stress urinary incontinence (SUI). In patients with incontinence after trocar-guided transvaginal mesh repair (Prolift), data on outcome remain limited. In the present study, we hypothesized that transobturator tape in such cases is assumed to be as effective as surgery alone. This was a prospective analysis of outcomes of transobturator slings in women who had undergone transvaginal mesh repair and in those who underwent sling surgery alone (controls). Objective cure was defined as the absence of urinary leakage during the stress test at filling cystometry and a negative cough test during pelvic examination. The success rates were evaluated 3-6 months postoperatively. One hundred women were recruited for the study. Compared to the control group, women after transvaginal mesh repair had a significantly lower objective success rate (62 vs 86%, p = 0.005) and poorer bladder neck mobility (0.5 ± 0.8 vs 1.1 ± 0.5 cm, p = 0.001). The transobturator sling has lower objective success rate in women after transvaginal mesh that may be due to decreased bladder neck mobility. Patients with post-mesh repair SUI who opt for sling surgery should be informed of these less satisfactory outcomes during preoperative counseling.
A prospective comparison of transvaginal ultrasonography and diagnostic hysteroscopy in the evaluation of patients with abnormal uterine bleeding: clinical implications

NARCIS (Netherlands)

Emanuel, M. H.; Verdel, M. J.; Wamsteker, K.; Lammes, F. B.

1995-01-01

We determined the diagnostic value of transvaginal ultrasonography for endometrial and intrauterine abnormalities in patients with abnormal uterine bleeding. Between June 1, 1992, and June 1, 1993, 279 consecutive patients underwent transvaginal ultrasonography. Findings were compared with the final
Desenvolvimento e validação de equação preditiva da gordura visceral em mulheres

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Marina de Moraes Vasconcelos Petribu

2012-04-01

Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2012v14n3p333 Os métodos atualmente disponíveis para avaliação da obesidade visceral apresentam limitações, tornando-os inviáveis para avaliação em grandes grupos de indivíduos. Esse estudo teve por objetivo desenvolver e validar equação preditiva para estimar a área de tecido adiposo visceral em mulheres jovens. Foram estudadas 64 mulheres entre 19 e 36 anos. As seguintes variáveis foram avaliadas: volume de gordura visceral (VGV (medido pela ultra-sonografia, Índice de Massa Corporal (IMC, Circunferência da Cintura, Razão Cintura-Estatura (RCE, Razão Cintura-Quadril, Índice de Conicidade, Perfil Lipídico e Glicemia de Jejum (GJ. As mulheres foram divididas em dois grupos: desenvolvimento (n=48 e validação (n=16 da equação. Foram propostas e validadas três equações para estimativa do VGV: Equação 1: VGV=-31,888+(4,044xIMC; Equação 2: VGV= -51,891+(248,018xRCE; Equação 3: VGV= -130,941 +(198,673 * RCE + (1,185xGJ, com poder preditivo de 34%, 24% e 45%, respectivamente. Não foi observada diferença estatisticamente significante entre os valores de VGV avaliados pela ultrassonografia e estimados pelas equações preditivas no grupo de validação. As equações propostas podem ser utilizadas para calculo do VGV de mulheres jovens, quando os exames de imagem não estiverem disponíveis, sendo uma ferramenta valiosa para estudos epidemiológicos e serviços de saúde.
Transvaginal echography in the diagnose of the ectopic pregnancy

International Nuclear Information System (INIS)

Betancourt, Claudia; Rivera, Humberto

1993-01-01

The ultrasound findings in 21 patients with confirmed ectopic pregnancy were reviewed. The inclusion criteria were those of anatomopathologic confirmation of this diagnosis. All patients were examined with trans-vaginal ultrasound. The most important echographic finding was and an adnexial mass, of mix nature, associated with fluid at the posterior cul-de-sac, in 86% of our patients
Aspectos clínicos, ultra-sonográficos e venográficos da tromboflebite jugular experimental em equinos

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Carlos Alberto Hussni

2012-07-01

Full Text Available A tromboflebite jugular ocorre frequentemente em equinos, decorrendo geralmente de processos mórbidos associados à iatrogenia, podendo levar a perda de função, edema cefálico, diminuição do desempenho atlético e ainda causar o óbito. Esta enfermidade nos equinos apesar de frequente é pouco conhecida quanto à sua evolução e tratamentos. O objetivo deste trabalho foi avaliar a evolução da tromboflebite jugular experimental em equinos, quanto às alterações clínicas e estruturais envolvidas na enfermidade, observando-se os aspectos clínicos, ultra-sonográficos e venográficos no contexto do trombo e do vaso, quanto à possibilidade de recanalização do trombo produzido e da vascularização compensatória. A tromboflebite da veia jugular foi induzida, unilateralmente, em 05 equinos nos quais previamente à indução da tromboflebite e diariamente após foram observadas manifestações clínicas e realizados exames ultra-sonográficos. Venografias foram feitas nos momentos pré-indução, na indução e a cada seis dias após a indução da tromboflebite, verificando-se a recanalização do trombo oclusivo e a presença de vasos na drenagem sanguínea compensatória. Observou-se a ocorrência de edema moderado das regiões parotídea, massetérica e supra-orbitária e discreto edema submandibular que reduziram até o 6º dia, permanecendo apenas discreto aumento parotídeo. O ingurgitamento da jugular cranial a região da indução permaneceu durante todo o período de avaliação. A porção caudal à tromboflebite mostrou ingurgitamento frente ao garrote na entrada do tórax desde o primeiro dia após a indução. Os exames ultra-sonográficos mostraram formação de trombo oclusivo total durante todo o período de observação em 3 animais e o restabelecimento parcial do fluxo na jugular em 2 animais e a presença de vasos colaterais conduzindo o sangue da porção cranial para a porção caudal à obstrução. As venografias
Aneurisma da artéria carótida interna extracraniana: relato de caso Aneurysm of the extracranial internal carotid artery: a case report

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Marcio Ricardo Taveira Garcia

2004-08-01

Full Text Available Os aneurismas verdadeiros da artéria carótida interna extracraniana são raros, ao contrário dos supraclinóideos, somando menos de 4% dos aneurismas periféricos. Eles se apresentam clinicamente como massas palpáveis cervicais, junto à margem inferior do ângulo da mandíbula, causando rouquidão, disfagia e dor por compressão nervosa. Há freqüente associação desta doença com outros aneurismas periféricos devido à sua etiologia principal (aterosclerose. Os aneurismas periféricos são comumente identificados à ultra-sonografia Doppler, quando na vigência de janela acústica adequada. Nesta situação, os aneurismas podem ser avaliados tanto morfológica como hemodinamicamente. Sua identificação e estudo são importantes para prevenir graves complicações, como tromboses, infartos maciços ou embólicos da área correspondente no sistema nervoso central, ruptura e dissecção, além de auxiliar na indicação da melhor conduta terapêutica.Unlike supraclinoid aneurysms, true aneurysms of the extracranial internal carotid artery are extremely rare (less than 4% of the peripheral aneurysms. The commonest presentation is a pulsatile neck swelling below the angle of the jaw associated with hoarseness, dysphagia and pain (neural compression. Concomitance with other peripherical aneurysms is frequent and caused by atherosclerosis. The morphological and hemodynamic features are very well evaluated by Doppler ultrasound, when the acoustic window is satisfactory. Identification and evaluation of these aneurysms are very important to prevent thrombosis, rupture, dissections, massive strokes and embolic brain infarcts, besides helping in the decision of the best treatment.
Estimativa do Peso Fetal: Comparação Entre um Método Clínico e a Ultra-Sonografia

OpenAIRE

Cury,Alexandre Faisal; Garcia,Sidney A. L.

1998-01-01

Objetivo: avaliar a validade da estimativa do peso fetal por método baseado na altura uterina - regra de Johnson. Métodos: foram estudadas 101 gestantes e seus recém-nascidos (RN), estimando-se o peso fetal pela utilização da regra de Johnson adaptada, que consiste em aplicação clínica de modelo matemático para cálculo do peso fetal baseado na altura uterina e na altura da apresentação fetal. O peso estimado foi obtido no dia do parto e foi comparado com o peso observado ao nascer, que consti...
No. 351-Transvaginal Mesh Procedures for Pelvic Organ Prolapse.

Science.gov (United States)

Larouche, Maryse; Geoffrion, Roxana; Walter, Jens-Erik

2017-11-01

This guideline reviews the evidence related to the risks and benefits of using transvaginal mesh in pelvic organ prolapse repairs in order to update recommendations initially made in 2011. Gynaecologists, residents, urologists, urogynaecologists, and other health care providers who assess, counsel, and care for women with pelvic organ prolapse. Adult women with symptomatic pelvic organ prolapse considering surgery and those who have previously undergone transvaginal mesh procedures for the treatment of pelvic organ prolapse. The discussion relates to transvaginal mesh procedures compared with other surgical options for pelvic organ prolapse (mainly about vaginal native tissue repairs and minimally about other alternatives such as biological and absorbable vaginal mesh and abdominally placed surgical mesh). The outcomes of interest are objective and subjective success rates and intraoperative and postoperative complications, such as adjacent organ injury (urinary, gastrointestinal), infection, hematoma/bleeding, vaginal mesh exposure, persistent pain, dyspareunia, de novo stress urinary incontinence, and reoperation. PubMed, Medline, the Cochrane Database, and EMBASE were searched using the key words pelvic organ prolapse/surgery*, prolapse/surgery*, surgical mesh, surgical mesh*/adverse effects, transvaginal mesh, and pelvic organ prolapse. were restricted to English or French language and human research. Articles obtained through this search strategy were included until the end of June 2016. Pertinent new studies were added up to September 2016. Grey literature was not searched. Clinical practice guidelines and guidelines of specialty societies were reviewed. Systematic reviews were included when available. Randomized controlled trials and observational studies were included when evidence for the outcome of interest or in the target population was not available from systematic reviews. New studies not yet included in systematic reviews were also included. Only
Transvaginal mesh in the media following the 2011 US food and drug administration public health notification update.

Science.gov (United States)

Koo, Kevin; Gormley, E Ann

2017-02-01

Prompted by patients' changing perceptions of transvaginal mesh, this study examines how mesh has been reported in the news following the 2011 US Food and Drug Administration (FDA) updated notification about the use of mesh in the treatment of pelvic organ prolapse. Two national newspaper databases were queried for articles discussing transvaginal mesh published within 3 years of the FDA announcement. Content analysis included headline subjects, mesh-related complications, quoted sources, and the FDA recommendations. To determine whether more widely read sources publish higher quality reporting, a subgroup analysis was conducted based on newspaper circulation. Ninety-five articles met inclusion criteria. Mesh-related litigation was the most common headline subject (36 articles, 38%), and 54% of all articles referenced legal action. Fifty-seven articles (60%) cited at least one mesh-related complication. Only 18 articles (19%) quoted surgeons who use transvaginal mesh. For the FDA update, 40% of articles that first reported the announcement accurately specified that it applies to mesh for prolapse, not incontinence. This ambiguity persisted: half of all articles cited the warning, but only 23% distinguished between prolapse and incontinence. Higher newspaper circulation did not significantly improve the quality of reporting about the content or context of the FDA's recommendations. Despite frequent media coverage of transvaginal mesh and its complications since 2011, very few news sources that cited the FDA warning distinguished between prolapse and incontinence. Given prevalent reporting of mesh-related litigation, the findings raise concern about how patients perceive the safety and efficacy of transvaginal mesh, regardless of indication. Neurourol. Urodynam. 36:329-332, 2017. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.
Analysis of Surgical Outcomes and Determinants of Litigation Among Women With Transvaginal Mesh Complications.

Science.gov (United States)

Zoorob, Dani; Karram, Mickey; Stecher, Anna; Maxwell, Rose; Whiteside, James

To identify litigation predictors among women with complications of transvaginal mesh. Chart review and patient survey were conducted among women who had undergone a complication-related explant of a transvaginal prolapse or incontinence sling mesh. Trained study personnel administered a 57-question survey addressing subjective complaints related to bowel, bladder, sexual dysfunction, and development of pain or recurrent prolapse. These data were analyzed with respect to the subject's reported pursuit of litigation related to the mesh complication. Categorical and continuous variables were analyzed using the χ test and the t test as indicated. Ninety-five (68%) of 139 women completed the surveys with 60% of the patients pursuing litigation at the time of the survey. Individual risk factors for pursuing litigation included development of vaginal pain after mesh placement (P = 0.01); dyspareunia after mesh placement (P = 0.01); persistence of dyspareunia, suprapubic pain, and groin pain after mesh excision (P = 0.04, P = 0.02, and P = 0.001, respectively); unsuccessful attempts at conservative management of pelvic pain using pelvic floor rehabilitation (P = 0.002). There is an association between a higher likelihood of pursuing litigation and new-onset or persistent pain symptoms attributable to transvaginal mesh.
Transvaginal Repair of a Large Chronic Porcine Ventral Hernia with Synthetic Mesh Using NOTES

Science.gov (United States)

Powell, Ben; Whang, Susan H.; Bachman, Sharon L.; Andres Astudillo, J.; Sporn, Emanuel; Miedema, Brent W.

2010-01-01

Background: Ventral incisional hernias still remain a common surgical problem. We tested the feasibility of transvaginal placement of a large synthetic mesh to repair a porcine hernia. Methods: Seven pigs were used in this survival model. Each animal had creation of a 5-cm hernia defect and underwent a transvaginal repair of the defect with synthetic mesh. A single colpotomy was made using a 12-cm trocar for an overtube. The mesh was cut to size and placed through the trocar. A single-channel gastroscope with an endoscopic atraumatic grasper was used for grasping sutures. Further fascial sutures were placed every 5cm. Results: Mesh repair was feasible in all 7 animals. Mean operative time was 133 minutes. Technical difficulties were encountered. No gross contamination was seen at the time of necropsy. However, 5 animals had positive mesh cultures; 7 had positive cultures in the rectouterine space in enrichment broth or on direct culture. Conclusion: Transvaginal placement of synthetic mesh to repair a large porcine hernia using NOTES is challenging but feasible. Future studies need to be conducted to develop better techniques and determine the significance of mesh contamination. PMID:20932375

Evidence to justify retention of transvaginal mesh: comparison between laparoscopic sacral colpopexy and transvaginal Elevate™ mesh.

Science.gov (United States)

To, Valérie; Hengrasmee, Pattaya; Lam, Alan; Luscombe, Georgina; Lawless, Anna; Lam, Justin

2017-12-01

To determine if laparoscopic sacral colpopexy (LSC) offers better apical support with a lower exposure rate than transvaginal mesh surgery with Elevate™. This was a retrospective cohort study comparing patients with apical prolapse (POP-Q point C ≥ -1) who underwent Elevate™ mesh repair (n = 146) with patients who underwent laparoscopic sacral colpopexy (n = 267). The sacral colpopexy group had a mean age of 59 years and a BMI of 25.7. Patients in the Elevate™ group were older, with a mean age of 63 and a BMI of 26.3. Most of the patients of both groups presented with pelvic organ prolapse stage III (LSC 73.8% and Elevate™ 87.0%) and their mean POP-Q point C were not significantly different (LSC 1.4 vs Elevate™ 1.2 cm). Operative time was longer in the LSC group (113 vs 91 min, p < 0.001), but estimated blood loss was lower (75 cm 3 vs 137 cm 3 , p < 0.001). No difference in mesh exposure rate could be found between the two groups at one year (Elevate™ 0.7% vs LSC 2.6%, OR 0.26, 95% CI 0.03 to 2.10, p = 0.21). One-year objective cure rate, defined as no descent beyond the hymen, was 97.0% in the LSC group and 96.6% in the Elevate™ group (p = .81). The overall recurrence (objective, subjective recurrence or reoperation) was also not different between the groups (LSC 4.5% vs Elevate 4.8%, p = 0.89). Transvaginal Elevate™ mesh delivers comparable apical support with a low exposure rate similar to that of laparoscopic sacral colpopexy.
Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse.

Science.gov (United States)

Altman, Daniel; Väyrynen, Tapio; Engh, Marie Ellström; Axelsen, Susanne; Falconer, Christian

2011-05-12

The use of standardized mesh kits for repair of pelvic-organ prolapse has spread rapidly in recent years, but it is unclear whether this approach results in better outcomes than traditional colporrhaphy. In this multicenter, parallel-group, randomized, controlled trial, we compared the use of a trocar-guided, transvaginal polypropylene-mesh repair kit with traditional colporrhaphy in women with prolapse of the anterior vaginal wall (cystocele). The primary outcome was a composite of the objective anatomical designation of stage 0 (no prolapse) or 1 (position of the anterior vaginal wall more than 1 cm above the hymen), according to the Pelvic Organ Prolapse Quantification system, and the subjective absence of symptoms of vaginal bulging 12 months after the surgery. Of 389 women who were randomly assigned to a study treatment, 200 underwent prolapse repair with the transvaginal mesh kit and 189 underwent traditional colporrhaphy. At 1 year, the primary outcome was significantly more common in the women treated with transvaginal mesh repair (60.8%) than in those who underwent colporrhaphy (34.5%) (absolute difference, 26.3 percentage points; 95% confidence interval, 15.6 to 37.0). The surgery lasted longer and the rates of intraoperative hemorrhage were higher in the mesh-repair group than in the colporrhaphy group (Pmesh-repair group and 0.5% in the colporrhaphy group (P=0.07), and the respective rates of new stress urinary incontinence after surgery were 12.3% and 6.3% (P=0.05). Surgical reintervention to correct mesh exposure during follow-up occurred in 3.2% of 186 patients in the mesh-repair group. As compared with anterior colporrhaphy, use of a standardized, trocar-guided mesh kit for cystocele repair resulted in higher short-term rates of successful treatment but also in higher rates of surgical complications and postoperative adverse events. (Funded by the Karolinska Institutet and Ethicon; ClinicalTrials.gov number, NCT00566917.).
Estudo ultra-sonográfico da involução uterina pós-parto em cadelas Ultrasonography study of the post-partum uterine involution in bitches

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S.T.S. Ferri

2002-02-01

Full Text Available Utilizando-se 15 cadelas no pós-parto, são descritas as características da involução uterina e determinado o diâmetro do útero, por meio de exames seriados de ultra-som em modo B (tempo real, no período de zero a 28 dias pós-parto. O diâmetro uterino declina progressivamente, sem influência da ordem de parto ou tamanho da ninhada. As características ultra-sonográficas do útero são melhor visualizadas na primeira semana pós-parto e a qualidade da imagem diminui com o progresso da involução. Pela técnica usada são visualizadas apenas três camadas constituintes da parede uterina.The ultrasonographic characteristics and the involution of the uterus were described in 15 pregnant bitches by serial B-mode (real time technique at period of 0 to 28 days postpartum. The uterine diameter decreased progressively, without influence of parity or litter size. The ultrasonographic image of the uterus is better view in the first week and the image quality is poor at subsequent weeks. The uterus was composed of only three ecographic layers.
Obstetrical and Gynecological Devices; Reclassification of Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair; Final order.

Science.gov (United States)

2016-01-05

The Food and Drug Administration (FDA or the Agency) is issuing a final order to reclassify surgical mesh for transvaginal pelvic organ prolapse (POP) repair from class II to class III. FDA is reclassifying these devices based on the determination that general controls and special controls together are not sufficient to provide reasonable assurance of safety and effectiveness for this device, and these devices present a potential unreasonable risk of illness or injury. The Agency is reclassifying surgical mesh for transvaginal POP repair on its own initiative based on new information.
Ultra-low-dose continuous combined estradiol and norethisterone acetate: improved bleeding profile in postmenopausal women

DEFF Research Database (Denmark)

Sturdee, D.W.; Archer, D.F.; Rakov, V.

2008-01-01

OBJECTIVE: To evaluate the effect of two ultra-low-dose hormone treatments containing estradiol (E2) 0.5 mg and norethisterone acetate (NETA) 0.1 or 0.25 mg on the endometrium and bleeding. METHODS: A prospective, randomized, placebo-controlled trial of 6 months. Local Ethics Committee approval...... and informed consent were obtained prior to initiation and enrollment. Out of 577 postmenopausal women randomized, 575 took E2/NETA 0.1 (n = 194), or E2/NETA 0.25 (n = 181) or placebo (n = 200). Endometrial bleeding was monitored by daily diary cards and endometrial thickness by transvaginal ultrasound......: The ultra-low-dose combination of E2/NETA 0.1 or E2/NETA 0.25 resulted in a high incidence of amenorrhea and no bleeding in postmenopausal women, and a corresponding high level of compliance. Overall, there was no significant change in mean endometrial thickness during 6 months of active treatment...
Clinical importance of appearance of cesarean hysterotomy scar at transvaginal ultrasonography in nonpregnant women.

Science.gov (United States)

Vikhareva Osser, Olga; Valentin, Lil

2011-03-01

To estimate the association between the appearance of cesarean hysterotomy scars at transvaginal ultrasound examination of nonpregnant women and the outcome of subsequent pregnancies and deliveries. A total of 162 women who had ever given birth by cesarean underwent transvaginal ultrasound examination of the hysterotomy scar 6 to 9 months after the latest cesarean delivery. Published ultrasound definitions of large scar defects were used. The appearance of the hysterotomy scar at ultrasound examination was compared with the outcome of subsequent pregnancies and deliveries. Clinical information on subsequent pregnancies was obtained from medical records. Six women were lost to follow-up, leaving 156 for analysis. Of these 156 women, 69 became pregnant after the ultrasound examination (99 pregnancies, 65 deliveries). There were no placental complications or scar pregnancies. At the first repeat cesarean delivery after the ultrasound examination, 5.3% (1/19) of the women with an intact scar or a small scar defect had uterine dehiscence or rupture compared with 42.9% (3/7) of those with a large defect (P=.047), odds ratio 11.8 (95% confidence interval 0.7-746). Our results point toward a likely association between large defects in the hysterotomy scar after cesarean delivery detected by transvaginal ultrasonography in nonpregnant women and uterine rupture or dehiscence in subsequent pregnancy.
Avaliação do risco para parto prematuro espontâneo pelo comprimento do colo uterino no primeiro e segundo trimestres da gravidez Risk assessment for spontaneous preterm delivery according to cervical length in the first and second trimesters of pregnancy

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Mário Henrique Burlacchini de Carvalho

2002-08-01

Full Text Available Objetivos:avaliar, no primeiro e segundo trimestres da gravidez, a correlação entre o comprimento do colo uterino e a ocorrência de parto prematuro espontâneo. Métodos:em 641 grávidas do pré-natal geral, a medida do comprimento do colo uterino foi realizada em dois momentos: entre a 11ª e a 16ª e entre a 23ª e a 24ª semana da gravidez. A avaliação do colo uterino foi feita pela ultra-sonografia transvaginal, com a grávida em posição ginecológica e tendo realizado previamente esvaziamento da bexiga. O comprimento do colo uterino foi medido linearmente do seu orifício interno ao externo. A medida do comprimento do colo uterino foi correlacionada com a idade gestacional no momento do parto. Para comparação das médias do grupo de grávidas que tiveram parto prematuro e a termo utilizamos o teste t de Student. A sensibilidade, especificidade, taxa de falso-positivos, falso-negativos e acurácia para o parto prematuro foram calculadas para os comprimentos de colo menores ou iguais a 30 mm, 25 mm e 20 mm. Resultados:a medida do comprimento do colo uterino entre a 11ª e a 16ª semana de gestação não apresentou diferença significativa entre o grupo de parto prematuro e o grupo a termo (40,6 mm e 42,7 mm, respectivamente, p=0,2459. A diferença entre os grupos, no entanto, foi significativa quando o colo foi medido entre a 23ª e a 24ª semana de gravidez (37,3 mm para o grupo que evoluiu com parto prematuro e 26,7 mm para o grupo a termo, p=0,0001, teste t de Student. Conclusões:o comprimento do colo uterino entre a 11ª e a 16ª semana de gravidez não foi significativamente diferente entre as gestantes com parto prematuro ou a termo. No entanto, na 23ª e 24ª semana esta diferença foi significativa, podendo ser um método de predição da prematuridade.Purpose: to evaluate, in the first and second trimesters of pregnancy, the correlation between cervical length and spontaneous preterm delivery. Methods: cervical length was
Mobilidade do Colo Vesical e Avaliação Funcional do Assoalho Pélvico em Mulheres Continentes e com Incontinência Urinária de Esforço, Consoante o Estado Hormonal Bladder Neck Mobility and Functional Pelvic Floor Evaluation in Women with and without Stress Urinary Incontinence, According to Hormonal Status

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Sonia Fátima da Silva Moreira

2002-07-01

Full Text Available Objetivo: estudar a mobilidade do colo vesical e a força da musculatura perineal em mulheres com e sem incontinência urinária de esforço, no menacme e na pós-menopausa. Métodos: foram avaliadas 61 pacientes, das quais 31 estavam no menacme, sendo 17 com incontinência urinária de esforço (IUE e 14 continentes, e 30 estavam na pós-menopausa, das quais 15 com e 15 sem IUE. Todas as incontinentes foram submetidas ao teste da coluna d'água e ao teste de esforço com bexiga vazia. A mobilidade do colo vesical foi avaliada pelo teste do cotonete e por ultra-sonografia e, para estudo da função da musculatura perineal, foram utilizados a palpação digital e cones vaginais. Resultados: a posição do colo vesical nas mulheres com incontinência urinária de esforço (grupos A e C, tanto pela ultra-sonografia quanto pelo teste do cotonete, foi mais baixa, sendo --11,8 cm no grupo A e --12,5 cm no grupo C, do que as mulheres continentes, nas quais o colo encontrava-se, em média, a +4,4 cm no grupo B e +2,3 cm no grupo D. Quanto à mobilidade do colo vesical, avaliada pela ultra-sonografia e pelo teste do cotonete, não houve diferença significativa entre os grupos continentes no menacme (9,1 cm e na pós-menopausa (9,5 cm. Também não houve diferença significativa entre os dois grupos incontinentes entre si (17,1 cm para o grupo A e 16,6 cm para o C. No entanto, a mobilidade foi significativamente maior nos grupos com incontinência urinária de esforço (A e C do que nos grupos continentes (B e D Verificamos que, quanto à avaliação da musculatura do assoalho pélvico, o teste realizado com cones vaginais e a avaliação funcional do assoalho pélvico mostraram índice 4 no grupo B e 3,4 no grupo D, indicando maior força muscular nas mulheres continentes, quando comparadas às incontinentes (2,9 e 2,3, respectivamente no menacme e na pós-menopausa. Conclusão: a mobilidade do colo vesical, avaliada por meio do teste do cotonete e da
Transvaginal Resection of a Bladder Leiomyoma Misdiagnosed with a Vaginal Mass: A Case Report and Literature Review

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Fu-Fen Yin

2015-01-01

Full Text Available Bladder leiomyoma is a rare benign tumor and it could be easily misdiagnosed with many other pelvic diseases, especially obstetrical and gynecological diseases; abdominal, laparoscopic, and transurethral resection of bladder leiomyoma have been reported. Herein, we present a case of bladder leiomyoma misdiagnosed with a vaginal mass preoperatively; the mass was isolated, enucleated from the bladder neck, and removed transvaginally; to the best of our knowledge, this is the first case of intramural leiomyoma of bladder neck that has been enucleated transvaginally only without cystotomy.
Diagnosis of Pentalogy of Cantrell in the First Trimester Using Transvaginal Sonography and Color Doppler

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Ayşe Figen Türkçapar

2015-01-01

Full Text Available We report the prenatal diagnosis of Cantrell syndrome in the first trimester. During a routine transabdominal ultrasonographic examination, a midline supraumbilical abdominal wall defect including herniated liver and ectopia cordis with a large omphalocele containing the intestines and cystic hygroma was incidentally identified at the 12th week of gestation. A transvaginal sonography examination revealed a severe lumbosacral scoliosis in addition to the inability to visualize the abdominal aorta which was indicative of a severe intracardiac defect. The parents opted for pregnancy to be terminated. In this case report, we discuss the complementary role of transvaginal sonography and Doppler imaging in the diagnosis of Cantrell syndrome in early pregnancy.
To Compare the Diagnostic Effectiveness of Transvaginal Ultrasonography, Sonohisterography and Endometrial Biopsy in Woman with Abnormal Uterine Bleeding

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Ahmet Kökden

2005-12-01

Full Text Available OBJECTIVE: To compare the effectiveness of saline sonohysterography in abnormal uterine bleeding with endometrial biopsy and transvaginal ultrasound. Design: Controlled clinical study. Settings: Bakirkoy Dr.Sadi Konuk Research and Training Hospital Patients: Total 51 pre and postmenopausal women age between 35 and 73 Interventions: Sonohysterography, endometrial biopsy, transvaginal ultrasound RESULTS: When we compared SIS with endometrail biopsy at the diagnosis of intracavitery lesions like myomas and polyps, endometrial biopsy diagnosed 7 on the other hand SIS diagnosed 12 of pathologies (p
Analysis of abnormally thickened endometrial patterns on transvaginal sonography

International Nuclear Information System (INIS)

Lee, Myung Sook; Cho, Hyeun Cha

1999-01-01

To determine whether the transvaginal sonographic appearance of the thickened endometrium can help to predict the underlying endometrial pathologic process. The sonogram reports of fall 41 pre- and 21 postmenopausal women who underwent transvaginal sonogram were retrospectively analyzed. The women undergoing estrogen replacement therapy, tamoxifen therapy or having abnormal cervical cytology were excluded from this study. The analysis of sonographic and histologic results was performed in all patients. Three distinct sonographic patterns were encountered. Type I consisted of heterogeneous endometrial thickening with internal hypoechoic areas (normal [n=4], polyp [n=1] and cancer [n=4] in premenopausal women and cancer [n=4] in postmenopausal women). Type II consisted of echogenic endometrial thickening with or without tiny cysts (normal[n=5], and hyperplasia [n=7] in premenopausal women and normal [n=4], polyp [n=2], and hyperplasia [n=1] in postmenopausal women). Type III consisted of localized well defined endoluminal lesion (normal [n=1], polyp [n=14], hyperplasia [n=1], cancer [n=1], and submucosal mass [n=3] in premenopausal women and normal [n=4], polyp [n=2],submucosal mass [n=3], and hematoma [n=1] in postmenopausal women). The measurement of the endometrial thickness combined with analysis of sonographic echo patterns may be helpful in prediction and differentiation of endometrial disease in pre- and postmenopausal women. Also it can contribute to avoiding unnecessary D and C.
OPPORTUNITIES OF TRANSVAGINAL ECHOCARDIOGRAPHY FOR EARLY PRENATAL DIAGNOSIS OF INBORN HEART DISEASES IN FETUS

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E.A. Shevchenko

2008-01-01

Full Text Available According to the literature data, transvaginal echocardiography (Echocg is the method, used for the doppler diagnostics in early terms of pregnancy (if principles of safety are observed. This method allows detecting about 70–97% of all prognostic cally significant inborn heart diseases in fetus, beginning at 12 week of pregnancy. a scheme of research includes estimation of four chamber cut of fetus heart, and study of state of its main arteries. This is an expert investigation, because it needs special grounding of specialist, high resolution ultrasonic equipment, and considerable expense of time. Wile parameters are estimated, it is necessary to use normative rates of sizes of ventricles and main arteries of fetus, developed by Russian experts, taking into account individual variations.Key words: transvaginal echocardiography, diagnosis, inborn heart disease.
Three-dimensional transvaginal ultrasound: clinical implementation in assessing uterine cavity

OpenAIRE

Abdelaziz E. Tammam; Mostafa M. Khodry; Shymaa M. A. Elnagar; Ahmed H. Abdella; Sayed A. M. Taha

2015-01-01

Background: Three-dimensional transvaginal ultrasonography (3D TVS) represents a new technique of imaging and provides a unique diagnostic tool for non-invasive examination of the uterine morphology and diagnosis of congenital uterine anomalies. In this study the clinical value of 3D TVS in diagnosis of uterine cavity abnormalities were evaluated. Methods: A prospective of diagnostic accuracy study included 226 patients with various clinical presentations; infertility, recurrent pregnancy ...
Minilaparoscopic-assisted transvaginal approach in benign liver lesions Abordaje transvaginal asistido por minilaparoscopia en lesiones benignas del hígado

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R. Castro-Pérez

2010-06-01

Full Text Available Objective: to report two benign liver lesions treatment under minilaparoscopic-assisted transvaginal approach. Patients and methods: females, 44 and 45 years old, respectively, were treated. Patient 1 showed a 1,2 cm Ø tumor located in the left liver lobe. In preoperative studies was not possible to discern the etiology, for what was decided surgical treatment. The patient 2 showed a symptomatic liver simple cyst, 8 cm Ø, located in the subsegment VI. She refused percutaneous treatment, it was recommended surgical treatment under general anesthesia. The surgical intervention offered was either the laparoscopic or the transvaginal approach, but this latter was accepted. Pneumoperitoneum with 15 mmHg was used. Two small trocars were inserted into the abdomen. The first one (5 mm Ø at the umbilical region, the second one (3 mm Ø near the lesion. One trocar 11 mm Ø, was placed in the posterior cul-de-sac. In patient 1 a large dissector was introduced adjacent to the trocar. In the patient 2, one second trocar 5 mm Ø was introduced in vagina for operative instruments. Both specimens were extracted through the vagina, protected in extractor bags. Variables studied: operating room time; analgesia required and post-operative complications. Results: the operating room times were 51 and 73 min, respectively. Only the patient with hepatic liver cyst required post-operative analgesia for pain at the right upper quadrant. Both patients were discharged before 24 hours. No postsurgical complications were found in the 6 months follow up. Conclusions: using transvaginal approach assisted with minilaparoscopy was possible to carry out surgical treatment in benign and non complex liver lesions located in outlying subsegments. It is a safe method with better aesthetic result than laparoscopic surgery. Nevertheless, will be necessary future studies that demonstrate the advantages of this approach in the hepatic lesions.Objetivo: reportar dos casos de lesiones
Considerações sobre eficiência administrativa relacionado aos exames de ultra-sonografia, tomografia computadorizada e ressonância magnética nas afecções orbitárias Reasons for the administrative efficiency related to ultrassonography, computed tomography and magnetic resonance imaging tests in orbital diseases

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Magno Watanabe

2007-12-01

Full Text Available OBJETIVOS: Enfocar os exames de ultra-sonografia (US, tomografia computadorizada (TC e ressonância magnética (RM, levantando, revisando e discutindo as seguintes medidas na melhoria da eficiência destes procedimentos na órbita: 1- Defasagem dos honorários médicos; 2- Vantagens e desvantagens dos exames; 3- Diretrizes clínicas. MÉTODOS: No período de julho de 2002 a março de 2003, realizou-se um levantamento dos valores dos exames orbitários de US, TC e RM pagos pelo Sistema Único de Saúde - SUS, operadoras de planos e seguros de saúde e particulares cobrados em três clínicas oftalmológicas e três clínicas radiológicas referenciadas. Pesquisa bibliográfica e revisão na literatura dos referidos exames e suas diretrizes clínicas nas afecções orbitárias. RESULTADOS: 1- Valores dos exames em reais (R$: US: 9,05 - SUS / 81,77 - AMB 90 / 57,01 - AMB/CIEFAS 93 / 102,00 - AMB/LPM 99 / 158,33 - particular. TC: 86,76 - SUS / 193,70 - AMB 90 / 196,30 - AMB/CIEFAS 93 / 204,12 - AMB/LPM 99 / 255,33 - particular. RM: 268,75 - SUS / 475,80 - AMB 90 e AMB/CIEFAS 93 / 472,50 - AMB/LPM 99 / 563,33 - particular; 2- Vantagens e desvantagens dos exames descritos de acordo com a revisão da literatura; 3- As doenças da órbita não têm ainda listadas suas diretrizes. CONCLUSÃO: Estes exames são os mais utilizados e consagrados pela sua eficácia no estudo da órbita. Para uma maior eficiência, devemos considerar as seguintes recomendações administrativas: 1- Modernização e atualização das tabelas de honorários com índices mínimos e mais justos na remuneração dos exames com reembolso dos insumos utilizados como filmes radiológicos e contrastes: 2- Promover e estimular a educação médica continuada, evitando o excesso de exames desnecessários ou inapropriados: 3- Elaboração e implementação de diretrizes e protocolos clínicos baseados em evidências nas principais doenças orbitárias que possam ser utilizados como refer
Symptom resolution after operative management of complications from transvaginal mesh.

Science.gov (United States)

Crosby, Erin C; Abernethy, Melinda; Berger, Mitchell B; DeLancey, John O; Fenner, Dee E; Morgan, Daniel M

2014-01-01

Complications from transvaginal mesh placed for prolapse often require operative management. The aim of this study is to describe the outcomes of vaginal mesh removal. A retrospective review of all patients having surgery by the urogynecology group in the department of obstetrics and gynecology at our institution for a complication of transvaginal mesh placed for prolapse was performed. Demographics, presenting symptoms, surgical procedures, and postoperative symptoms were abstracted. Comparative statistics were performed using the χ or Fisher's exact test with significance at Pmesh and 84 had follow-up data. The most common presenting signs and symptoms were: mesh exposure, 62% (n=56); pain, 64% (n=58); and dyspareunia, 48% (n=43). During operative management, mesh erosion was encountered unexpectedly in a second area of the vagina in 5% (n=4), in the bladder in 1% (n=1), and in the bowel in 2% (n=2). After vaginal mesh removal, 51% (n=43) had resolution of all presenting symptoms. Mesh exposure was treated successfully in 95% of patients, whereas pain was only successfully treated in 51% of patients. Removal of vaginal mesh is helpful in relieving symptoms of presentation. Patients can be reassured that exposed mesh can almost always be successfully managed surgically, but pain and dyspareunia are only resolved completely in half of patients. III.
Transvaginal versus transabdominal sonography in the evaluation of pelvic pathology

International Nuclear Information System (INIS)

Qureshi, I.H.; Ullah, H.; Akram, M.H.; Ashfaq, S.; Nayyar, S.

2004-01-01

Objective: To find the accuracy of sonographic information provided by transvaginal sonography (TVS) in pelvic pathology as compared to transabdominal sonography (TAS). Materials and Methods: Hundred patients were included in the study from a total of 212 referred for pelvic sonography. Two radiologists independently performed transabdominal and transvaginal sonography of these patients. An independent observer compared the findings. TVS was graded as superior, equal or inferior to TAS depending on the score assigned by them. Results: TVS was considered superior in 63%, equal in 27% and inferior in 10% of the cases as compared to transabdominal sonography. It was graded inferior to TAS in cases with large pelvic masses and superior in majority of cases of ovarian follicle monitoring, polycystic ovaries, endometrial carcinoma and suspected ectopic pregnancy. Cases in which both techniques were considered equal included patients with no abnormal finding, some pelvic masses and advanced pelvic inflammatory disease. Conclusion: Transvagival sonography is superior to transabdominal sonography in most cases of pelvic pathology. However, TAS should still be the initial sonographic technique for routine evaluation of the female pelvis followed by TVS if indicated. In cases of ovarian follicle monitoring, suspected polycystic ovaries, endometrial pathology and suspected ectopic pregnancy, TVS may be used as the initial sonographic technique and can even replace TAS. (author)
Índice de congestão portal e a ocorrência de trombose portal pós-dape Portal congestion and thrombosis after EDS

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Fabio Gonçalves Ferreira

2005-08-01

Full Text Available OBJETIVO: Comparar os dados obtidos pela ultra-sonografia com doppler no pré-operatório de esquistossomóticos submetidos à desconexão ázigo-portal com esplenectomia (DAPE, calculando o índice de congestão portal, e sua correlação com a trombose portal no pós-operatório. MÉTODOS: Foram estudados 65 pacientes submetidos à DAPE por hipertensão portal esquistossomótica com antecedente de hemorragia digestiva, divididos em dois grupos: Grupo A (28 pacientes que não desenvolveram trombose portal pós-operatória e Grupo B (37 pacientes com trombose portal no pós-operatório. Analisaram-se através de ultra-sonografia com doppler no pré-operatório os seguintes parâmetros da veia porta: diâmetro, área, velocidade média de fluxo do sangue, fluxo de sangue, e estabeleceu-se o índice de congestão portal. RESULTADOS: O diâmetro, área e o fluxo da veia porta foram maiores no grupo B (média de 1,52 cm; 1,77 cm² e 2533,12 ml/min em relação ao grupo A (média de 1,33 cm; 1,44 cm² e 1609,03 ml/min com p = 0,03; 0,03 e 0,04 respectivamente. O índice de congestão portal não foi estatisticamente significativo na comparação dos dois grupos (p = 0,07. CONCLUSÃO: O índice de congestão portal obtido no pré-operatório através da ultra-sonografia com doppler não se mostrou preditivo de trombose portal no pós-operatório dos doentes estudados.BACKGROUND: The study compared the preoperative portal vein congestion index estimated by Doppler ultrasound and the postoperative portal vein thrombosis of patients submitted to esophagogastric devascularization and splenectomy (EDS. METHODS: 65 patients with portal hypertension due to schistosomiasis and previous gastrointestinal bleeding submitted to EDS were divided into two groups: GROUP A (28 patients without postoperative portal vein thrombosis and GROUP B (37 patients with postoperative portal vein thrombosis. The following parameters of preoperative Doppler ultrasound of the
Robotic repair of vesicovaginal fistulae with the transperitoneal-transvaginal approach: A case series

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Luciano A. Nunez Bragayrac

2014-12-01

Full Text Available Objective To describe a novel technique of repairing the VVF using the transperitoneal-transvaginal approach. Materials and Methods From June 2011 to October 2013, four patients with symptoms of urine leakage in the vagina underwent robotic repair of VVF with the transperitoneal-transvaginal approach. Cystoscopy revealed the fistula opening on the bladder. A ureteral stent was placed through the fistulous tract. After trocar placement, the omental flap was prepared and mobilized robotically. The vagina was identified and incised. The fistulous tract was excised. Cystorrhaphy was performed in two layers in an interrupted fashion. The vaginal opening was closed with running stitches. The omentum was interposed and anchored between the bladder and vagina. Finally, the ureteral catheters were removed in case they have been placed, and an 18 Fr urethral catheter was removed on the 14th postoperative day. Results The mean age was 46 years (range: 41 to 52 years. The mean fistula diameter was 1.5 cm (range 0.3 to 2 cm. The mean operative time was 117.5 min (range: 100 to 150 min. The estimated blood loss was 100 mL (range: 50 to 150 mL. The mean hospital stay was 1.75 days (range: 1 to 3 days. The mean Foley catheter duration was 15.75 days (range: 10 to 25 days. There was no evidence of recurrence in any of the cases. Conclusions The robot-assisted laparoscopic transperitoneal transvaginal approach for VVF is a feasible procedure when the fistula tract is identified by first intentionally opening the vagina, thereby minimizing the bladder incision and with low morbidity.

Management of complications arising from transvaginal mesh kit procedures: a tertiary referral center's experience.

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Hurtado, Eric A; Appell, Rodney A

2009-01-01

This case series' purpose is to review a referral center's experience with complications from mesh kits. A chart review of 12 patients who presented with complications associated with transvaginal mesh kit procedures was performed. All patients underwent complete surgical removal of the mesh to treat mesh exposure, pain, or vaginal bleeding/discharge followed by an anterior or posterior repair. The mean follow-up time after surgery was 3.4 months. Eight of 12 patients had mesh that had formed a fibrotic band. Six of 12 patients had complete resolution of pain. Of the nine patients with mesh exposure, all required significant resection of the vaginal wall. No further mesh exposure occurred. The use of transvaginal mesh kits may cause previously undescribed complications such as pelvic/vaginal pain or large extrusions requiring complete removal. Removal of all mesh except the arms may cure or significantly improve these problems.
A new technique of laparoscopic intracorporeal anastomosis for transrectal bowel resection with transvaginal specimen extraction.

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Faller, Emilie; Albornoz, Jaime; Messori, Pietro; Leroy, Joël; Wattiez, Arnaud

2013-01-01

To show a new technique of laparoscopic intracorporeal anastomosis for transrectal bowel resection with transvaginal specimen extraction, a technique particularly suited for treatment of bowel endometriosis. Step-by-step explanation of the technique using videos and pictures (educative video). Endometriosis may affect the bowel in 3% to 37% of all endometriosis cases. Bowel endometriosis affects young women, without any co-morbidities and in particular without any vascular disorders. In addition, affected patients often express a desire for childbearing. Radical excision is sometimes required because of the impossibility of conservative treatment such as shaving, mucosal skinning, or discoid resection. Bowel endometriosis should not be considered a cancer, and consequently maximal resection is not the objective. Rather, the goal would be to achieve functional benefit. As a result, resection must be as economic and cosmetic as possible. The laparoscopic approach has proved its superiority over the open technique, although mini-laparotomy is generally performed to prepare for the anastomosis. Total laparoscopic approach in patients with partial bowel stenosis, using the vagina for specimen extraction. This technique of intracorporeal anastomosis with transvaginal specimen extraction enables a smaller resection and avoidance of abdominal incision enlargement that may cause hernia, infection, or pain. When stenosis is partial, this technique seems particularly suited for treatment of bowel endometriosis requiring resection. If stenosis is complete, the anvil can be inserted above the lesion transvaginally. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.
Update on Instrumentations for Cholecystectomies Performed via Transvaginal Route: State of the Art and Future Prospectives

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Elia Pulvirenti

2010-01-01

Full Text Available Natural Orifice Transluminal Endoscopic Surgery (NOTES is an innovative approach in which a flexible endoscope enters the abdominal cavity via the transesophageal, transgastric, transcolonic, transvaginal or transvescical route, combining the technique of minimally invasive surgery with flexible endoscopy. Several groups have described different modifications by using flexible endoscopes with different levels of laparoscopic assistance. Transvaginal cholecystectomy (TVC consists in accessing the abdominal cavity through a posterior colpotomy and using the vaginal incision as a visual or operative port. An increasing interest has arisen around the TVC; nevertheless, the most common and highlighted concern is about the lack of specific instruments dedicated to the vaginal access route. TVC should be distinguished between “pure”, in which the entire operation is performed through the transvaginal route, and “hybrid”, in which the colpotomy represents only a support to introduce instruments and the operation is performed mainly by the classic transabdominal-introduced instruments. Although this new technique seems very appealing for patients, on the other hand it is very challenging for the surgeon because of the difficulties related to the mode of access, the limited technology currently available and the risk of complications related to the organ utilized for access. In this brief review all the most recent advancements in the field of TVC's techniques and instrumentations are listed and discussed.
Measuring leading placental edge to internal cervical os: Transabdominal versus transvaginal approach

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Westerway, Susan Campbell; Hyett, Jon; Henning Pedersen, Lars

2017-01-01

We aimed to compare the value of transabdominal (TA) and transvaginal (TV) approaches for assessing the risk of a low-lying placenta. This involved a comparison of TA and TV measurements between the leading placental edge and the internal cervical os. We also assessed the intra-/interobserver var......We aimed to compare the value of transabdominal (TA) and transvaginal (TV) approaches for assessing the risk of a low-lying placenta. This involved a comparison of TA and TV measurements between the leading placental edge and the internal cervical os. We also assessed the intra......-/interobserver variation for these measurements and the efficacy of TA measures in screening for a low placenta. Methodology Transabdominal and TV measurements of the leading placental edge to the internal cervical os were performed on 369 consecutive pregnancies of 16–41 weeks' gestation. The difference (TA-TV) from...... the area under the receiver operator characteristics (ROC) curve. Intra-/interobserver variations were also calculated. Results Of the pregnancies, 278 had a leading placental edge that was visible with the TV approach. Differences (TA-TV) ranged from −50 mm to +57 mm. Bland-Altman plot shows that TA...
Ecodefecografia tridimensional dinâmica: nova técnica para avaliação da Síndrome da Defecação Obstruída (SDO

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Sthela Maria Murad-Regadas

2006-06-01

Full Text Available O objetivo deste estudo é apresentar novas técnicas para avaliação da SDO, utilizando a ultra-sonografia endorretal tridimensional dinâmica e comparando os resultados com a defecografia. Foram incluídas neste estudo 25 mulheres adultas, distribuídas em dois grupos. Grupo I: 15 mulheres normais, idade média de 52,4 anos (23-76 e todas se submeteram ao exame proctológico completo e à ultra-sonografia anorretal tri-dimensional dinâmica para se estabelecer os padrões de normalidade do canal anal e reto. Grupo II: 10 pacientes mulheres com evacuação obstruída, idade média de 47,8 anos (33 a 65 anos, apresentando como principais sintomas a sensação de evacuação incompleta, disquezia e digitação vaginal ou perineal. Submeteram-se a exame proctológico completo, seguindo-se defecografia e posteriormente ecodefecografia por dois examinadores que desconheciam o resultado do exame anterior. A ecodefecografia dinâmica foi realizada com um equipamento B-K Medical®, sonda 360º, tipo 2050, com escaneamento automático durante 50 segundos com 6 cm de extensão. O tamanho médio do ângulo formado pelo músculo PR no repouso foi 87,13º (variação 78,9 - 90,8° (± 1,01 e no esforço evacuatório 99,22º (variação 84,9 - 114,5° (± 1,84 nas mulheres normais (grupo I. Houve elevação do ângulo em todas as pacientes normais, significando relaxamento normal do PR durante o esforço evacuatório. Com relação à avaliação da anoretocele, a parede posterior da vagina se manteve na posição horizontal durante todo o esforço evacuatório, exceto nas portadoras de anoretocele. Foram diagnosticadas anoretocele (grau I = 1, grau II = 5, grau III = 4 em todas as pacientes do grupo II pelo exame clínico e defecografia. Todos os casos foram confirmados pela ecodefecografia. A partir destes resultados, foram estabelecidos os valores para classificar a anorectocele de acordo com a ecodefecografia (grau I - distância entre as posições da
The transvaginal hybrid NOTES versus conventionally assisted laparoscopic sigmoid resection for diverticular disease (TRANSVERSAL) trial: study protocol for a randomized controlled trial.

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Senft, Jonas D; Warschkow, Rene; Diener, Markus K; Tarantino, Ignazio; Steinemann, Daniel C; Lamm, Sebastian; Simon, Thomas; Zerz, Andreas; Müller-Stich, Beat P; Linke, Georg R

2014-11-20

Natural orifice transluminal endoscopic surgery (NOTES) is the consequence of further development of minimally invasive surgery to reduce abdominal incisions and surgical trauma. The potential benefits are expected to be less postoperative pain, faster convalescence, and reduced risk for incisional hernias and wound infections compared to conventional methods. Recent clinical studies have demonstrated the feasibility and safety of transvaginal NOTES, and transvaginal access is currently the most frequent clinically applied route for NOTES procedures. However, despite increasing clinical application, no firm clinical evidence is available for objective assessment of the potential benefits and risks of transvaginal NOTES compared to the current surgical standard. The TRANSVERSAL trial is designed as a randomized controlled trial to compare transvaginal hybrid NOTES and laparoscopic-assisted sigmoid resection. Female patients referred to elective sigmoid resection due to complicated or reoccurring diverticulitis of the sigmoid colon are considered eligible. The primary endpoint will be pain intensity during mobilization 24 hours postoperatively as measured by the blinded patient and blinded assessor on a visual analogue scale (VAS). Secondary outcomes include daily pain intensity and analgesic use, patient mobility, intraoperative complications, morbidity, length of stay, quality of life, and sexual function. Follow-up visits are scheduled 3, 12, and 36 months after surgery. A total sample size of 58 patients was determined for the analysis of the primary endpoint. The confirmatory analysis will be performed based on the intention-to-treat (ITT) principle. The TRANSVERSAL trial is the first study to compare transvaginal hybrid NOTES and conventionally assisted laparoscopic surgery for colonic resection in a randomized controlled setting. The results of the TRANSVERSAL trial will allow objective assessment of the potential benefits and risks of NOTES compared to the
Purely transvaginal/perineal management of complications from commercial prolapse kits using a new prostheses/grafts complication classification system.

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Firoozi, Farzeen; Ingber, Michael S; Moore, Courtenay K; Vasavada, Sandip P; Rackley, Raymond R; Goldman, Howard B

2012-05-01

Commercial prolapse mesh kits are increasingly used in the management of pelvic organ prolapse. We present our experience with the transvaginal/perineal management of synthetic mesh related complications from prolapse kits. In addition, we used the new ICS/IUGA (International Continence Society/International Urogynecological Association) prostheses/grafts complication classification system to report on our contemporary series. A retrospective chart review of all patients who underwent surgical removal of transvaginal mesh for mesh related complications after prolapse kit use from November 2006 to April 2010 at 1 institution was performed. We report our contemporary series of mesh complications using the new ICS/IUGA prostheses/grafts complication classification system. Postoperative pain, degree of improvement and presence of continued symptoms were reported by patients at last followup. A total of 23 patients underwent transvaginal removal of mesh during the study period. Mean patient age was 61 years. Median period of latency to mesh related complication was 10 months (range 1 to 27). Indications for mesh removal included vaginal/pelvic pain (39%), dyspareunia (39%), vaginal mesh extrusion/exposure (26%), urinary incontinence (35%), recurrent pelvic organ prolapse (22%), bladder mesh perforation with recurrent urinary tract infection (22%), rectal mesh perforation (4%), ureteral perforation injury (4%), retained foreign body (surgical sponge) in the bladder (4%) and vesicovaginal fistula (9%), with most patients citing more than 1 reason. Although technically difficult in some cases, purely transvaginal mesh excision appears to be safe with resolution of almost all presenting symptoms. Although slightly cumbersome, the new ICS/IUGA prostheses/graft complication classification system can be used to report and more accurately characterize mesh complications. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc
Sexual function in women following transvaginal mesh procedures for the treatment of pelvic organ prolapse.

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Liang, Ching-Chung; Lo, Tsia-Shu; Tseng, Ling-Hong; Lin, Yi-Hao; Lin, Yu-Jr; Chang, Shuenn-Dhy

2012-10-01

Synthetic mesh kits recently adopted in pelvic reconstructive surgeries have achieved great surgical efficacy, but the effects of transvaginal synthetic mesh procedures on women's sexual function are still controversial. This study was conducted to demonstrate sexual function in women before and after surgery with transvaginal mesh (TVM) repair for pelvic organ prolapse (POP). A total of 93 sexually active women scheduled for correcting POP with synthetic mesh kits were recruited. In addition to urogynecological history, pelvic examination by the Pelvic Organ Prolapse Quantification system, and urodynamic testing, consenting participants were asked to complete the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) to evaluate sexual function before and after surgery. At the 3-month urodynamic studies, among the 25 patients with coexistent urodynamic stress incontinence (USI) who had undergone a concomitant transobturator suburethral tape procedure (TOT), 1 (4 %) had persistent USI; 8 of 68 (11.8 %) patients with a negative pessary test developed postoperative USI. Six-month prolapse recurrence rates following TVM alone and TVM with concomitant TOT were 9 and 12 %, respectively. The total PISQ-12 score after surgery showed worse results in the TVM alone group but not in the TVM with concomitant TOT group. The individual scores of PISQ-12 after surgery demonstrated prolapse-related items improved in both TVM groups; sexual function worsened in dyspareunia and behavior domains. Our data revealed that transvaginal synthetic mesh procedures for the treatment of POP generated favorable clinical outcomes, but situations might worsen in dyspareunia and behavior domains, thereby invoking a negative emotional reaction during intercourse after surgery.
Evaluation of pelvic varicose veins using color Doppler ultrasound: comparison of results obtained with ultrasound of the lower limbs, transvaginal ultrasound, and phlebography Avaliação de varizes pélvicas por Doppler colorido: comparação dos resultados obtidos com ultrassom dos membros inferiores, ultrassom transvaginal e flebografia

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Fanilda Souto Barros

2010-06-01

Full Text Available Introduction: Pelvic varicose veins, one of the main causes of chronic pelvic pain and dyspareunia, are an important source of reflux for lower limb varicose veins, especially in recurrent cases. Color Doppler ultrasound of the lower limbs and transvaginal ultrasound are the noninvasive diagnostic methods most commonly used to assess pelvic venous insufficiency, whereas phlebography is still considered as the gold standard. Objectives: To determine the prevalence of lower limb varicose veins originating from the pelvis in a group of female patients and to determine the agreement between results obtained via color Doppler ultrasound of the lower limbs, transvaginal ultrasound, and phlebography. Methods: The sample comprised female patients referred to a vascular laboratory for lower limb screening. Patients diagnosed with deep venous thrombosis were excluded. Data analysis included kappa coefficient of agreement, McNemar's test, sensitivity and specificity values. Results: Of a total of 1,020 patients, 124 (12.2% had findings compatible with reflux of pelvic origin. Among these patients, 51 (41.2% were recurrent cases. A total of 249 were submitted to transvaginal ultrasound. There was significant agreement between lower limb ultrasonographic findings and transvaginal findings. Phlebography was performed in 54 patients. The comparison between transvaginal ultrasound and phlebography was associated with a 96.2% sensitivity and 100% specificity. Conclusions: The authors draw attention to the relatively high prevalence of lower limb varicose veins originating from the pelvis, suggesting an important but underdiagnosed cause of recurrent varicose veins.Introdução: AS VARIZES Pélvicas, uma das principais causas de dor pélvica crônica e dispareunia, são uma importante fonte de refluxo para as varizes dos membros inferiores, especialmente em casos recorrentes. O Doppler colorido dos membros inferiores e o ultrassom transvaginal são os m
Acrania/encephalocele sequence (exencephaly) associated with 92,XXXX karyotype: early prenatal diagnosis at 9(+5) weeks by 3D transvaginal ultrasound and coelocentesis.

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Tonni, Gabriele; Ventura, Alessandro; Bonasoni, Maria Paola

2009-09-01

A 27-year-old pregnant woman was diagnosed by 3D transvaginal ultrasound as carrying a fetus of 9(+5) weeks gestation affected by acrania/encephalocele (exencephaly) sequence. A 2D transvaginal ultrasound-guided aspiration of 5 mL of extra-coelomic fluid was performed under cervical block before uterine suction. Conventional cytogenetic analysis demonstrated a 92,XXXX karyotype. Transvaginal 2D ultrasound-guided coelocentesis for rapid karyotyping can be proposed to women who are near to miscarriage or in cases where a prenatal ultrasound diagnosis of congenital anomaly is performed at an early stage of development. Genetic analysis can be performed using traditional cytogenetic analysis or can be aided by fluorescence in situ hybridization (FISH). Coelocentesis may become an integral part of first trimester armamentarium and may be clinically useful in the understanding of the pathogenesis of early prenatally diagnosed congenital anomalies.
Age-stratified analysis of long-term outcomes of transvaginal mesh repair for treatment of pelvic organ prolapse.

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Dong, Shengnan; Zhong, Yanbo; Chu, Lei; Li, Huaifang; Tong, Xiaowen; Wang, Jianjun

2016-10-01

To investigate long-term outcomes after transvaginal mesh repair among patients with pelvic organ prolapse in different age groups. A retrospective cohort study was conducted among women who underwent transvaginal mesh repair with polypropylene mesh for pelvic organ prolapse of stage II or higher between January 2007 and November 2011 at a center in Shanghai, China. Patients were invited to attend a follow-up appointment between July 2014 and May 2015. Surgical outcomes were compared among three age groups (≤59, 60-74, and ≥75 years), and quality-of-life questionnaires were evaluated. Multivariate logistic regression was used to identify risk factors associated with recurrent prolapse and mesh exposure. Among 158 patients, 143 (90.5%) were objectively cured and 149 (94.3%) were subjectively cured at follow-up. Surgical outcomes were similar across all age groups. Significant improvements were observed on the Pelvic Floor Distress Inventory across all applicable subscales in all age groups (Pmesh exposure (odds ratio 11.89, 95% confidence interval 1.08-131.48; P=0.043). Transvaginal mesh repair was found to be a safe and effective technique for treating pelvic organ prolapse among women of all ages. An active postoperative sex life increased the odds of mesh exposure. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Sangrado transvaginal durante el embarazo, como factor de riesgo para isoinmunización al antígeno Rhesus-D Transvaginal bleeding during pregnancy associated with Rhesus-D isoimmunization

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Edgar Hernández-Andrade

2003-12-01

Full Text Available OBJETIVO: Evaluar el sangrado transvaginal en cualquier etapa del embarazo como factor de riesgo para la sensibilización al antígeno eritrocitario Rhesus-D en mujeres previamente no isoinmunizadas (Rh(-NI, como una alternativa para la aplicación rutinaria de gama-globulina anti-D a la semana 28 de gestación. MATERIAL Y MÉTODOS: Estudio de casos y controles consecutivos, efectuado en el Instituto Nacional de Perinatología de la Ciudad de México, en el periodo de 1995 a 2001.Casos (n=24, pacientes Rh(-NI que mostraron seroconversión positiva de anticuerpos contra el componente D del antígeno Rh durante el embarazo o en el puerperio inmediato. Controles (n=24, mujeres Rh(-NI, captadas consecutivamente y que no presentaron seroconversión positiva de anticuerpos Anti-D. En todos los casos los recién nacidos fueron Rh positivos. Ninguna de las pacientes recibió inmunoprofilaxis Anti-D a la semana 28 de gestación. Se evaluaron periodos de sangrado transvaginal en cualquier etapa del embarazo y antes del inicio del trabajo de parto. Se estimaron razones de probabilidad e intervalos de confianza de 95%. RESULTADOS: La presencia de sangrado transvaginal se observó en 18/24 (75% de los casos y en 5/24 de los controles (20%. La actividad uterina pretérmino y la amenaza de aborto fueron las causas más frecuentes identificadas como causa de este sangrado. La presencia de uno solo de estos eventos durante cualquier etapa del embarazo aumentó 11.4 veces (IC 95% 2.9-44.0 el riesgo de sensibilización al antígeno eritrocitario Rh-D, y si el sangrado se presentó después de la semana 20 el riesgo se incrementó 5.0 veces (IC 95% 1.3-19.1. La presencia de sangrado antes de la semana 20 no se asoció con un incremento significativo en el riesgo de sensibilización (OR=7.6, IC 95% 0.8-69.5. CONCLUSIONES: En presencia de cualquier sangrado transvaginal durante el embarazo en una paciente Rh-NI se recomienda la aplicación profiláctica de gama
Immobilization of Lecitase® Ultra onto a novel polystyrene DA-201 resin: characterization and biochemical properties.

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Liu, Ning; Fu, Min; Wang, Yong; Zhao, Qiangzhong; Sun, Weizheng; Zhao, Mouming

2012-11-01

A simple, rapid, and economic method of enzyme immobilization was developed for phospholipase Lecitase® ultra (LU) via interfacial adsorption. The effect of nature of the polystyrene supports and the kinetic behavior and stability of immobilized lecitase® ultra (IM-LU) were evaluated. Six macroporous resins (AB-8, X-5, DA-201, NKA-9, D101, D4006) and two anion resins (D318 and D201) were studied as the supports. DA-201 resin was selected because of its best immobilization effect for LU. Immobilization conditions were investigated, including immobilization time, pH, and enzyme concentration. IM-LU with a lipase activity of 1,652.4 ± 8.6 U/g was obtained. The adsorption process was modeled by Langmuir and Freundlich equations, and the experimental data were better fit for the former one. The kinetic constant (K (m)) values were found to be 192.7 ± 2.2 mM for the free LU and 249.3 ± 5.4 mM for the IM-LU, respectively. The V (max) value of free LU (169.5 ± 4.3 mM/min) was higher than that of the IM-LU (53.8 ± 1.5 mM/min). Combined strategies of scanning electron micrograph, thermogravimetric analysis, and Fourier transform infrared (FTIR) spectroscopy were employed to characterize the IM-LU. FTIR spectroscopy showed that the secondary conformation of the enzyme had changed after immobilization, through which a decrease of α-helix content and an increase of β-sheet content were observed. The IM-LU possessed an improved thermal stability as well as metal ionic tolerance when compared with its free form. The reusability of IM-LU was also evaluated through catalyzing esterification reaction between oleic acid and glycerol. It exhibited approximately 70 % of relative esterification efficiency after six successive cycles. This immobilized enzyme on hydrophobic support may well be used for the synthesis of structural lipids in lipid area.
Flurbiprofen Axetil Provides Effective Analgesia Without Changing the Pregnancy Rate in Ultrasound-Guided Transvaginal Oocyte Retrieval: A Double-Blind Randomized Controlled Trial.

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Zhao, Hong; Feng, Yi; Jiang, Yan; Lu, Qun

2017-10-01

In this prospective double-blind randomized study, we evaluated the analgesic effect and potential effect on pregnancy rate of the nonsteroidal anti-inflammatory drug flurbiprofen axetil in patients undergoing ultrasound-guided transvaginal oocyte retrieval under propofol-remifentanil anesthesia. A total of 200 patients scheduled to undergo ultrasound-guided transvaginal oocyte retrieval were randomly allocated to receive 1.5 mg/kg of flurbiprofen axetil (FA group) or placebo (control group) 30 minutes before the procedure. Postoperative pain scores, embryo implantation rate, and pregnancy rate were recorded. Neuroendocrine biomarkers and prostaglandin E2 levels in follicular fluid were tested after oocyte retrieval. Patients in the FA group awakened earlier after surgery than patients in the control group (3.3 ± 2.6 vs 5.3 ± 3.4 minutes, P Flurbiprofen axetil given before ultrasound-guided transvaginal oocyte retrieval for patients under propofol-remifentanil general anesthesia relieves pain without any detrimental effect on clinical pregnancy rate.
Transvaginal duplex ultrasonography appears to be the gold standard investigation for the haemodynamic evaluation of pelvic venous reflux in the ovarian and internal iliac veins in women.

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Whiteley, M S; Dos Santos, S J; Harrison, C C; Holdstock, J M; Lopez, A J

2015-12-01

To assess the suitability of transvaginal duplex ultrasonography to identify pathological reflux in the ovarian and internal iliac veins in women. A retrospective study of patients treated in 2011 and 2012 was performed in a specialised vein clinic. Diagnostic transvaginal duplex ultrasonography in women presenting with symptoms or signs of pelvic vein reflux were compared with the outcomes of treatment from pelvic vein embolisation. A repeat transvaginal duplex ultrasonography was performed 6 weeks later by a blinded observer and any residual reflux was identified. Results from 100 sequential patients were analysed. Mean age 44.2 years (32-69) with mode average parity of 3 (0-5 deliveries). Pre-treatment, 289/400 veins were refluxing (ovarian - 29 right, 81 left; internal iliac - 93 right, 86 left). Coil embolisation was successful in 86/100 patients and failed partially in 14/100 - 5 due to failure to cannulate the target vein. One false-positive diagnosis was made. Currently there is no accepted gold standard for pelvic vein incompetence. Comparing transvaginal duplex ultrasonography with the outcome from selectively treating the veins identified as having pathological reflux with coil embolisation, there were no false-negative diagnoses and only one false-positive. This study suggests that transvaginal duplex ultrasonography could be the gold standard in assessing pelvic vein reflux. © The Author(s) 2014.
Use of dynamic 3-dimensional transvaginal and transrectal ultrasonography to assess posterior pelvic floor dysfunction related to obstructed defecation.

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Murad-Regadas, Sthela M; Regadas Filho, Francisco Sergio Pinheiro; Regadas, Francisco Sergio Pinheiro; Rodrigues, Lusmar Veras; de J R Pereira, Jacyara; da S Fernandes, Graziela Olivia; Dealcanfreitas, Iris Daiana; Mendonca Filho, Jose Jader

2014-02-01

New ultrasound techniques may complement current diagnostic tools, and combined techniques may help to overcome the limitations of individual techniques for the diagnosis of anorectal dysfunction. A high degree of agreement has been demonstrated between echodefecography (dynamic 3-dimensional anorectal ultrasonography) and conventional defecography. Our aim was to evaluate the ability of a combined approach consisting of dynamic 3-dimensional transvaginal and transrectal ultrasonography by using a 3-dimensional biplane endoprobe to assess posterior pelvic floor dysfunctions related to obstructed defecation syndrome in comparison with echodefecography. This was a prospective, observational cohort study conducted at a tertiary-care hospital. Consecutive female patients with symptoms of obstructed defecation were eligible. Each patient underwent assessment of posterior pelvic floor dysfunctions with a combination of dynamic 3-dimensional transvaginal and transrectal ultrasonography by using a biplane transducer and with echodefecography. Kappa (κ) was calculated as an index of agreement between the techniques. Diagnostic accuracy (sensitivity, specificity, and positive and negative predictive values) of the combined technique in detection of posterior dysfunctions was assessed with echodefecography as the standard for comparison. A total of 33 women were evaluated. Substantial agreement was observed regarding normal relaxation and anismus. In detecting the absence or presence of rectocele, the 2 methods agreed in all cases. Near-perfect agreement was found for rectocele grade I, grade II, and grade III. Perfect agreement was found for entero/sigmoidocele, with near-perfect agreement for rectal intussusception. Using echodefecography as the standard for comparison, we found high diagnostic accuracy of transvaginal and transrectal ultrasonography in the detection of posterior dysfunctions. This combined technique should be compared with other dynamic techniques and
Nódulos benignos da mama: uma revisão dos diagnósticos diferenciais e conduta Benign breast masses: a review on diagnosis and management

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Afonso Celso Pinto Nazário

2007-04-01

Full Text Available Os nódulos mamários benignos são responsáveis por até 80% das massas palpáveis. Seu diagnóstico diferencial é amplo, envolvendo os cistos mamários, os fibroadenomas, os tumores filóides, os papilomas, os lipomas, os hamartomas e os adenomas, entre outros. O fibroadenoma é a neoplasia mamária mais comum em pacientes menores de 35 anos e os cistos são mais freqüentes na perimenopausa. O diagnóstico diferencial entre nódulos sólidos ou císticos poderá ser feito por meio da punção aspirativa com agulha fina ou pela ultra-sonografia, sendo terapêutica para os últimos. Neste artigo serão revisados os aspectos diagnósticos diferenciais entre estes tumores e as novas abordagens terapêuticas.The benign mammary tumors are responsible for up to 80% of the clinical masses. Its differential diagnosis is wide, involving mammary cysts, fibroadenomas, phyllodes tumors, papillomas, hamartomas, and adenomas, among others. The fibroadenoma is the most common mammary neoplasia in patients under 35 years old, while the cysts are more frequent in the perimenopause. The differential diagnosis among solid or cystic nodules can be made through the fine-needle aspiration or by ultrasound, being therapeutic for the last ones. In this article, the differential diagnostic aspects will be revised between these tumors, as well as the new therapeutic approaches.
Transobturator tapes are preferable over transvaginal tapes for the management of female stress urinary incontinence: Against

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Arun Chawla

2009-01-01

Full Text Available Midurethral placement of tension-free vaginal tapes with a transvaginal route for stress urinary incontinence achieves higher and better long-term success rates than the transobturator route. Bladder perforations are reported more in transvaginal tape (TVT but incidences of vaginal erosions, extrusion, and groin pain are exceedingly more in TOT groups. There is no clear evidence that transobturator tape (TOT is associated with less post-operative voiding problems than TVT. Major complications such as bowel injuries and significant vascular injuries with TVT are rare. TVT has been found to be superior to TOT and preferable in technically demanding conditions such as prior anti-incontinence operation failures, obese women, and very elevated and scarred lateral cul-de sac. TVT is always preferred in severe grades of stress urinary incontinence and with patients of intrinsic sphincter deficiency (ISD with little or no urethral mobility.
O efeito da infusão das flores de Hibiscus pernambucensis Arruda sobre ratas gestantes e lactantes expostas ao campo eletromagnético de ultra-alta-frequência

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Juliana Becker Borba

2010-01-01

O Hibiscus pernambucensis Arruda (HpA) é uma planta da família Malvaceae, típica de clima tropical de ecossistemas de mangues. A infusão das flores do HpA apresenta propriedades antioxidantes, decorrentes da vitamina E, flavonóides, quercetina e taninos. Há estudos mostrando que os campos eletromagnéticos de ultra-alta-freqüência (CEMUAF) podem provocar danos à saúde. Estes danos acontecem por indução de estresse oxidativo às células. O presente estudo visa verificar o efeito antioxidante das...
Ultra-sonografia mamária: avaliação dos critérios ecográficos na diferenciação das lesões mamárias Breast ultrasound: evaluation of echographic criteria for differentiation of breast lesions

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Maria Julia Gregorio Calas

2007-02-01

Full Text Available OBJETIVO: O câncer de mama é uma das causas mais importantes de mortalidade feminina. Na busca do diagnóstico cada vez mais precoce, a associação de métodos diagnósticos tem sido utilizada com êxito, tendo grande participação a ultra-sonografia mamária diagnóstica e intervencionista. Este trabalho tem como objetivos: identificar os critérios ecográficos mais relacionados com benignidade e malignidade e avaliar as propriedades das características ecográficas, verificando o seu poder de predição de malignidade. MATERIAIS E MÉTODOS: Os critérios morfológicos ecográficos utilizados nas descrições das imagens foram: forma, limites, contorno, ecogenicidade, ecotextura, ecotransmissão, orientação e sinais secundários. A validação foi buscada em 450 imagens ecográficas, comparadas aos resultados de seguimento ou de histopatologia de peça cirúrgica. RESULTADOS: Os principais critérios de benignidade foram: forma definida, contorno regular, limites precisos, lesões isoecóicas ao tecido adiposo, ecotextura homogênea e orientação horizontal. Os critérios mais característicos de malignidade foram: forma indefinida, contorno irregular, limites parcialmente precisos e lesões hipoecóicas. O contorno irregular apresentou a maior sensibilidade (92,7% e o maior valor preditivo negativo (98,2% para malignidade, a orientação vertical apresentou a maior especificidade (99,3%, e a forma indefinida, o maior valor preditivo positivo (91,0%. CONCLUSÃO: O método padronizado para a caracterização e descrição das imagens ultra-sonográficas mamárias apresentado resultou em uniformidade e otimização dos laudos, viabilizando as condutas mais adequadas.OBJECTIVE: Breast cancer is one of the most important causes of death in women. The association of different diagnostic methods has been successfully employed as a means to enhance early diagnosis. In this scenario, the interventional and diagnostic breast ultrasound has

Transvaginal ultrasonography in first trimester of pregnancy and its comparison with transabdominal ultrasonography

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Aneet Kaur

2011-01-01

Full Text Available Objectives : Examination of pregnant women in the first trimester with transvaginal ultrasonography with the aim to study various fetal development markers, e.g., gestation sac, yolk sac, fetal heart motion, CRL length, and fetal anatomy in both normal and abnormal pregnancies. Comparative evaluation of transvaginal ultrasonography vis-ΰ-vis transabdominal scanning in the study of first trimester of pregnancy and its complications. To assess the relative merits and demerits of transvaginal ultrasonography in comparison with the transabdominal technique. Materials and Methods : The study will be conducted on 50 females patients during the first trimester of pregnancy. The study population will consist of both normal and abnormal pregnancies. These patients will be included on the basis of suspicion of or proven pregnancy of duration up to 12 weeks from LMP. The evaluation of the patients will include the following: Record of patients obstetrical history and clinical examination, record of pregnancy test and relevant investigations, ultrasonic examination of pregnancy. (a Transabdominal ultrasound scanning will be done with moderately distended bladder by using real time scanners with low frequency probe (3/3.5 MHz; (b transvaginal sonography will be done with the real-time sector scanner using high-frequency endovaginal probe (5/7.5 MHz, after the patient voids urine. Relevant images will be taken by using the multiformat automatic camera. Results and Conclusions : In the study of 46 normal intrauterine pregnancies, TVS showed additional information in 36 patients (78.3% as compared to TAS, in detection of gestation sac, yolk sac, double bleb sign, or better visualization of embryonic anatomy. In the abnormal pregnancy (n=17, TVS provided more information in 11 cases (64.9%, which included detection of embryonic demise, yolk sac, double bleb sign, or subchorionic hemorrhage. Regarding ectopic gestations (n=7, TVS gave additional information in 5
Correlation between transvaginal ultrasound measured endometrial thickness and histopathological findings in Turkish women with abnormal uterine bleeding.

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Ozer, Alev; Ozer, Serdar; Kanat-Pektas, Mine

2016-05-01

The present study aims to determine how transvaginal ultrasonography and histopathological examination findings are correlated in a cohort of premenopausal and postmenopausal Turkish women with abnormal uterine bleeding. This is a retrospective review of 350 Turkish women who underwent transvaginal ultrasonography and suction curettage as a result of abnormal uterine bleeding. Sonographic appearance of the endometrium was normal in 244 patients (69.7%), while homogeneous thickening was detected in 47 patients (13.4%) and cystic thickening in 21 patients (6.0%). A sonographic diagnosis of endometrial polyp was made in 38 patients (10.9%). Histopathological analysis of endometrial samplings revealed proliferative endometrium (36%), secretory endometrium (24.6%), decidualization (10.9%), endometrial polyp (8.3%), endometritis (6.8%), endometrial hyperplasia (4.6%), irregular shedding (3.7%), atrophic endometrium (3.1%), endometrial cancer (1.1%) and placental retention (0.9%). The sonographic and histopathological findings correlated significantly (χ(2) = 122 768, P = 0.001; r = 0.215, P = 0.001). Approximately 51% of the women with homogeneous endometrial thickening had proliferative endometrium. Only 44.7% of the women with ultrasonographically visualized endometrial polyps had histopathologically diagnosed endometrial polyps. Nearly 57% of the women with cystic endometrial thickening had proliferative endometrium. If there is no facility for hysteroscopy or hysteroscopy-guided endometrial biopsy for women with abnormal uterine bleeding, transvaginal ultrasonography findings can be efficiently used to make a preliminary diagnosis and, thus, notify the pathologists. © 2016 Japan Society of Obstetrics and Gynecology.
Long-term outcome after transvaginal mesh repair of pelvic organ prolapse.

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Heinonen, Pia; Aaltonen, Riikka; Joronen, Kirsi; Ala-Nissilä, Seija

2016-07-01

The aim of this study was to report long-term subjective and objective outcomes after the transvaginal mesh (TVM) procedure in long-term. Possible late-onset complications were of particular interest. This was a retrospective analysis of TVM performed using Prolift™ transvaginal mesh measuring subjective outcome using validated questionnaires. Objective outcome was assessed using the Pelvic Organ Prolapse Quantification (POP-Q) system using two definitions: POP-Q stage ≤ 1, and vaginal wall prolapse at or above the hymen or vaginal apex not descending below the upper third of the vagina. Complications were reported with the Prosthesis/Graft Complication Classification Code designed by the International Continence Society/International Urogynecological Association (ICS/IUGA). Of 195 patients, 161 (82.6 %) participated this study after a median of 7 years. The scores in questionnaires evaluating urinary (UI) or anal incontinence and constipation or pelvic floor symptoms were low, indicating favorable surgical outcomes. Altogether, 80.1 % of patients were satisfied with the procedure. Anatomical cure was 56.4 % and 69.3 % depending on the definition used. Reoperation due to POP in any compartment was performed in 16.2 % of patients. Mesh exposure rate was 23 %, most of these being asymptomatic and of late onset. Outcome of the TVM procedure was satisfactory. Anatomical cure was inferior to subjective cure. Mesh exposure rate was high; most exposures observed in the long-term were of late onset and were asymptomatic.
Transvaginal Mesh and Transanal Resection to Treat Outlet Obstruction Constipation Caused by Rectocele

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Shi, Yang; Yu, Yongjun; Zhang, Xipeng; Li, Yuwei

2017-01-01

Background The aim of this study was to evaluate the curative effect of transvaginal mesh repair (TVMR) and stapled transanal rectal resection (STARR) in treating outlet obstruction constipation caused by rectocele. Material/Methods Patients who had outlet obstruction constipation caused by rectocele were retrospectively analyzed and 39 patients were enrolled the study. Patients were assigned to either the TVMR or STARR group. Postoperative factors such as complications, pain, recurrence rate...
Metaplasia óssea e esterilidade primária

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Reggiani Celeste P. Demeterco

2001-01-01

Full Text Available A metaplasia óssea do endométrio é uma condição rara e pode ser explicada por uma neoformação no endométrio, com deposição de sais de cálcio. Entretanto, a situação mais comum é a história prévia de abortamento com permanência de ossículos na cavidade uterina. Foi relatado um caso de ossificação endometrial em uma mulher de 31 anos, sem gravidez prévia ou história de aborto, apresentando dismenorréia e infertilidade. A ultra-sonografia pélvica mostrou área hiperecóica no fundo da cavidade uterina. A histeroscopia foi realizada e uma imagem sugestiva de tecido ósseo foi encontrada. Este tecido foi retirado e a histopatologia confirmou a ossificação endometrial.
Necrotising fasciitis after hysterectomy and concomitant transvaginal mesh repair in a patient with pelvic organ prolapse.

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Pushkar, Dmitry Y; Vasilchenko, Mikhail I; Kasyan, George R

2013-10-01

Necrotising fasciitis is a severe form of soft tissue infection. Herein, we present an unreported complication of the transvaginal repair of a pelvic organ prolapse (POP) with trocar-guided polypropylene mesh and a concomitant hysterectomy. A 61-year-old Caucasian female who had been using an intrauterine device (IUD) for 30 years presented with a stage 3 pelvic organ prolapse. A genital ultrasound examination confirmed the presence of an IUD, but found no endometrial abnormalities. The surgical management was limited to a transvaginal hysterectomy and simultaneous anterior vaginal wall repair augmented with trocar-guided mesh. A morphological examination of the removed uterus confirmed the presence of the intrauterine device and additionally found endometrial cancer (T1N0M0), which was not revealed during the preoperative ultrasound. Within 6 days of the surgery, she developed anaerobic bilateral necrotising fasciitis on both thighs. Non-clostridial streptococci were identified in the wound. After 18 days of intensive care, the patient died of fatal coagulopathy.
Volume do embrião estimado pela ultra-sonografia tridimensional entre a sétima e a décima semana de gestação Embryo volume estimated by three-dimensional ultrasonography at seven to ten weeks of pregnancy

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João Bortoletti Filho

2008-10-01

Full Text Available OBJETIVO: avaliar a evolução do volume do embrião (VE entre a sétima e a décima semana de gestação por meio da ultra-sonografia tridimensional. MÉTODOS: realizou-se um estudo de corte transversal com 63 gestantes normais entre a sétima e a décima semana. Os exames ultra-sonográficos foram realizados por meio de um transdutor endocavitário volumétrico. Para o cálculo do VE, utilizou-se o método VOCAL (Virtual Organ Computer-aided Analysis com ângulo de rotação de 12º, com delimitação de 15 planos seqüenciais. Para o VE foram calculadas médias, medianas, desvios padrão e valores máximo e mínimo em todas as idades gestacionais. Para se avaliar a correlação entre o VE e o comprimento cabeça-nádega (CCN foi criado gráfico de dispersão, sendo o ajuste realizado pelo coeficiente de determinação (R². Para se determinarem intervalos de referência do VE em função do CCN, utilizou-se a seguinte fórmula: percentil =VE+K versus dp, com K=1,96. RESULTADOS: o CCN variou de 9,0 a 39,7 mm, com média de 23,9 mm (±7,9 mm, enquanto o VE variou de 0,1 a 7,6 cm³, com média de 2,7 cm³ (±3,2 cm³. O VE foi altamente correlacionado com o CCN, sendo que o melhor ajuste foi obtido com regressão quadrática (VE=0,165 - 0,055 x CCN + 0,005 x CCN²; R²=0,853. O VE médio variou de 0,1 (-0,3 a 0,5 cm³ a 6,7 cm³ (3,8 a 9,7 cm³ no intervalo de 9 a 40 mm do CCN. Neste intervalo o VE aumentou 67 vezes, enquanto o CCN aumentou apenas 4,4 vezes. CONCLUSÕES: o VE é um parâmetro mais sensível que o CCN para avaliar o crescimento embrionário entre a sétima e a décima semana de gestação.PURPOSE: to evaluate the embryo's volume (EV between the seventh and the tenth gestational week, through tridimensional ultrasonography. METHODS: a transversal study with 63 normal pregnant women between the seventh and the tenth gestational week. The ultrasonographical exams have been performed with a volumetric abdominal transducer. Virtual
A proposal to reduce the risk of transmission of human papilloma virus via transvaginal ultrasound.

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Combs, C Andrew; Fishman, Alan

2016-07-01

Three steps must be followed to prevent the transmission of infection via a contaminated transvaginal ultrasound probe: cleaning the probe after every use, high-level disinfection, and covering the probe with a single-use barrier during the examination. There may be critical flaws in at least 2 of these steps as they are currently practiced. First, 2 widely used disinfectants, glutaraldehyde and orthophthalaldehyde, have recently been found to be ineffective at neutralizing human papilloma virus type 16 and type 18. Second, commercial ultrasound probe covers have an unacceptable rate of leakage (8-81%) compared to condoms (0.9-2%). We recommend the use of a sonicated hydrogen peroxide disinfectant system rather than aldehyde-type disinfectants. We recommend that the probe be covered with a condom rather than a commercial probe cover during transvaginal ultrasound examination. Combined with probe cleaning, these 2 steps are estimated to result in an 800 million- to 250 billion-fold reduction in human papilloma virus viral load, which should translate to greatly enhanced patient safety. Copyright © 2016 Elsevier Inc. All rights reserved.
Medida da velocidade de fluxo nas artérias cerebrais utilizando ultra-som Doppler transfontanela antes e após o tratamento cirúrgico da hidrocefalia

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ASSIS MARCELO CARDOSO DE

1999-01-01

Full Text Available Vinte e sete crianças portadoras de hidrocefalia de diversas etiologias, diagnosticadas pelo exame clínico, neurosonografia e tomografia cerebral computadorizada, foram submetidas a avaliação por ultra-som Doppler (US-Doppler transfontanela para medida da velocidade de fluxo sanguíneo e cálculo do índice de resistência (IR nas artérias cerebrais anteriores, médias e carótidas internas. Todas as crianças foram submetidas a avaliações no pré-operatório e no 1º, 7º, 30º e 60º dias do pós-operatório. Concluímos ser a técnica de neurosonografia e US-Doppler útil no diagnóstico da hidrocefalia, na indicação e controle das derivações liquóricas e no acompanhamento das modificações dos valores do IR comparando-os no pré e pós-operatório imediato e tardio do tratamento cirúrgico da hidrocefalia. Os resultados obtidos permitiram-nos ainda, pela comparação dos valores do IR entre as diversas artérias avaliadas nos diferentes estágios do estudo, concluir serem as artérias cerebrais anteriores representativas das alterações máximas que ocorrem na resistência vascular cerebral em pacientes pediátricos portadores de hidrocefalia.
Prediction of endometriosis by transvaginal ultrasound in reproductive-age women with normal ovarian size

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Tamer H. Said; Amal Z. Azzam

2014-01-01

Objective: To predict endometriosis by transvaginal ultrasound (TVS) in reproductive-age women with normal ovarian size. Design: Prospective study. Setting: El-Shatby Maternity Hospital, Alexandria University. Patients: 125 Women with symptoms suggestive of endometriosis and with normal ovarian size during TVS. Interventions: Patients were subjected to high frequency ultrasound and evaluated for the presence of ultrasound signs of endometriosis (TVS-based soft markers). All patien...
Importância da ecogenicidade da tireóide no diagnóstico da tireoidite crônica auto-imune Value of thyroid echogenicity in the diagnosis of chronic autoimmune thyroiditis

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Danilo Bianchini Höfling

2008-12-01

Full Text Available A tireoidite crônica auto-imune é, atualmente, a principal causa de hipotireoidismo e seu diagnóstico baseia-se nas manifestações clínico-laboratoriais. O marcador laboratorial mais importante é a presença de anticorpos antitireoglobulina e antiperoxidase, sendo este último o teste mais sensível. A biópsia aspirativa apresenta alta sensibilidade e especificidade, porém, é um método invasivo e, por isso, reservado para quando há presença de nódulo ou bócio de crescimento rápido. A cintilografia é desnecessária para o diagnóstico, já que apresenta baixa sensibilidade e especificidade. A ultra-sonografia, tanto ao modo B como ao dúplex-Doppler colorido, evoluiu de forma muito rápida e tornou-se um método simples, não-invasivo, reprodutível e com alta sensibilidade para o diagnóstico da tireoidite crônica auto-imune. Ao modo B, a ecogenicidade é um parâmetro de extrema importância, já que, além de apresentar alta correlação com o quadro citopatológico, também apresenta alta sensibilidade para o diagnóstico da tireoidite crônica auto-imune. Embora este parâmetro não seja específico da tireoidite crônica auto-imune, pois também pode estar presente na doença de Graves, na tireoidite pós-parto e na tireoidite subaguda, tais desordens podem ser facilmente diferenciadas tanto pelo quadro clínico-laboratorial quanto pelo dúplex-Doppler colorido. Assim, este artigo tem o objetivo de revisar a importância do estudo da ecogenicidade no diagnóstico da tireoidite crônica auto-imune.Chronic autoimmune thyroiditis is currently considered as the main cause for hypothyroidism and its diagnosis is based on clinical manifestations and laboratory tests results. The most significant laboratory marker for this disease is the presence of anti-thyroperoxidase and anti-thyroglobulin antibodies, the latter being the most sensitive one. Aspiration biopsy shows high sensitivity and specificity but, considering the
Fatores maternos associados ao peso fetal estimado pela ultra-sonografia Maternal factors associated with fetal weight estimated by ultrasonography

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Adriana Suely de Oliveira Melo

2008-09-01

Full Text Available OBJETIVO: avaliar o efeito de variáveis maternas, socioeconômicas e obstétricas, assim como a presença de incisuras na 20ª e na 24ª semana, sobre o peso fetal estimado no final da gravidez (36ª semana em gestantes atendidas pelo Programa Saúde da Família em uma cidade do interior do Nordeste do Brasil. MÉTODOS: estudo longitudinal incluindo 137 gestantes. As gestantes foram acompanhadas a cada quatro semanas para aferição das condições clínicas, socioeconômicas e obstétricas, incluindo o peso materno. As artérias uterinas foram avaliadas pelo Doppler na 20ª e 24ª semana, o peso fetal e o índice de líquido amniótico (ILA foram determinados na 36ª semana. O estado nutricional materno inicial foi determinado pelo índice de massa corpórea (IMC, classificando-se as gestantes como com baixo peso, eutróficas, com sobrepeso e obesas. O ganho ponderal durante a gestação foi avaliado de acordo com o estado nutricional inicial, sendo ao final do segundo e terceiro trimestre classificado em ganho ponderal insuficiente, adequado e excessivo. Foi realizada análise de variância para avaliar a associação do peso fetal estimado na 36ª semana com as variáveis preditoras, ajustada por regressão linear múltipla. RESULTADOS: observou-se associação entre peso fetal estimado na 36ª semana e idade da mãe (p=0,02, trabalho materno (p=0,02, estado nutricional inicial (p=0,04, ganho ponderal no segundo trimestre (p=0,01, presença de incisuras nas artérias uterinas (p=0,02 e ILA (p=0,007. Os principais fatores associados ao peso fetal estimado na 36ª semana, após a análise de regressão múltipla, foram: IMC no início da gravidez, ganho ponderal no segundo trimestre, ILA e tabagismo. CONCLUSÕES: o peso fetal no presente estudo associou-se positivamente ao estado nutricional materno inicial, ao ganho ponderal no segundo trimestre, ao volume do líquido amniótico e negativamente ao hábito de tabagismo.PURPOSE: to evaluate the
Modificações da junção uretrovesical e uretra proximal após a cirurgia de alça sem tensão em mulheres de 45 a 72 anos Urethrovesical junction and proximal urethra changes following tension-free vaginal tape surgery in women aged 45 to 72 years old

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Frederico Teixeira Brandt

2005-06-01

Full Text Available OBJETIVOS: descrever as modificações da junção uretrovesical e uretra proximal decorrentes do uso do Tension-Free Vaginal Tape (TVT, empregado no tratamento da incontinência urinária de esforço (IUE. MÉTODOS: trabalho realizado na Unidade de Pesquisa em Incontinência Urinária da Universidade Federal de Pernambuco. Foram estudadas 22 mulheres com incontinência urinária de esforço foram submetidas à cirurgia do tipo TVT e avaliadas por ultra-sonografia antes e depois da cirurgia. RESULTADOS: os deslocamentos verticais médios da distância vertical da junção uretrovesical no pré e pós-operatório foram respectivamente de 16,7 mm e de 10,7 mm; e os deslocamentos médios da uretra proximal no pré e pós-operatório foram de 13,1 mm e de 6,7 mm (p=0,02. CONCLUSÕES: a cirurgia do tipo TVT, usada no tratamento de mulheres com incontinência urinária de esforço, reduz significativamente a mobilidade vertical da junção uretrovesical (p=0,005 e da uretra proximal (p=0,02.OBJECTIVES: to describe the urethrovesical junction and proximal urethra changes following Tension-free Vaginal Tape (TVT procedure for stress urinary incontinence treatment (SUI. METHODS: this study was performed at the Urinary Incontinence Research Unit of the Universidade Federal de Pernambuco. Twenty two stress urinary incontinence female patients were submitted to TVT. They were evaluated through ultrasound before and following surgery. RESULTS: ultrasound results at rest, before and following TVT surgery, were: mean displacement of urethrovesical junction vertical length, before and after TVT procedure respectively 16,7mm and 10,7 mm; and mean displacement of proximal urethra length, before and following TVT surgery, respectively 13,1 mm and 6,7 mm. CONCLUSIONS: TVT surgery used for treating women with stress urinary incontinence significantly reduces the vertical mobility of the urethrovesical junction (p=0,005 and proximal urethra (p=0,02.
Fertilização in vitro com ciclos programados de baixo custo - avaliação de resultados iniciais de um centro de reprodução humana de hospital de ensino In vitro fertilization with low-cost programmed cycles - first outcome in a teaching hospital

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Nelson Antunes Júnior

2003-01-01

Full Text Available OBJETIVOS: avaliação dos resultados iniciais de fertilização in vitro (FIV em instituição universitária, empregando ciclos programados de baixo custo. MÉTODOS: entre maio e dezembro de 2002, foram iniciados 66 ciclos programados de FIV, utilizando acetato de noretisterona, citrato de clomifeno e gonadotrofina coriônica humana (hCG. A punção folicular guiada por ultra-sonografia foi realizada 34 a 36 horas após a administração de hCG e a transferência, 48 horas após a punção. A gestação foi considerada clínica após visualização de batimentos cardíacos à ultra-sonografia transvaginal. RESULTADOS: a taxa de cancelamento foi de 21,2%. Em média, 2,8 folículos e 1,7 oócitos foram obtidos por punção. Em 79,6% dos ciclos puncionados recuperaram-se oócitos, que foram fertilizados em 69% dos casos. O número de embriões por transferência foi de 1,5. Houve algum grau de dificuldade em 10,2% das punções e 32,4% das transferências realizadas. A taxa de gestação obtida foi de 10,8% por transferência, entretanto, o custo com medicação por embrião transferido foi de apenas R$ 96,00. CONCLUSÃO: evidenciam-se as dificuldades de iniciar um programa de FIV em instituição de ensino, sem fins lucrativos e voltada à população carente. Com a prática, a taxa cumulativa de gravidez tende a ser semelhante às dos centros de referência, porém com custo e incidência de complicações significativamente inferiores.PURPOSE: to evaluate the first in vitro fertilization results at a medical university using low-cost programmed cycles. METHODS: from May to December 2002, 66 programmed cycles of in vitro fertilization were carried out using norethisterone acetate, clomiphene citrate and human chorionic gonadotrophin (hCG. The ovarian follicle aspiration was guided by ultrasonography, 34 to 36 h after the administration of hCG, and the embryo transfer, 48 h after puncturing. The diagnosis of clinical pregnancy was defined when a
Short-term outcomes of the transvaginal minimal mesh procedure for pelvic organ prolapse

OpenAIRE

Naoko Takazawa; Akiko Fujisaki; Yasukuni Yoshimura; Akira Tsujimura; Shigeo Horie

2018-01-01

Purpose: This study aimed to evaluate the clinical outcomes and complications of transvaginal minimal mesh repair without using commercially available kits for treatment of pelvic organ prolapse (POP). Materials and Methods: This retrospective cohort study involved 91 women who underwent surgical management of POP with originally designed small mesh between July 2014 and August 2015. This mesh is 56% smaller than the mesh widely used in Japan, and it has only two arms delivered into each righ...
Outcomes of Autologous Fascia Pubovaginal Sling for Patients with Transvaginal Mesh Related Complications Requiring Mesh Removal.

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McCoy, Olugbemisola; Vaughan, Taylor; Nickles, S Walker; Ashley, Matt; MacLachlan, Lara S; Ginsberg, David; Rovner, Eric

2016-08-01

We reviewed the outcomes of the autologous fascial pubovaginal sling as a salvage procedure for recurrent stress incontinence after intervention for polypropylene mesh erosion/exposure and/or bladder outlet obstruction in patients treated with prior transvaginal synthetic mesh for stress urinary incontinence. In a review of surgical databases at 2 institutions between January 2007 and June 2013 we identified 46 patients who underwent autologous fascial pubovaginal sling following removal of transvaginal synthetic mesh in simultaneous or staged fashion. This cohort of patients was evaluated for outcomes, including subjective and objective success, change in quality of life and complications between those who underwent staged vs concomitant synthetic mesh removal with autologous fascial pubovaginal sling placement. All 46 patients had received at least 1 prior mesh sling for incontinence and 8 (17%) had received prior transvaginal polypropylene mesh for pelvic organ prolapse repair. A total of 30 patients underwent concomitant mesh incision with or without partial excision and autologous sling placement while 16 underwent staged autologous sling placement. Mean followup was 16 months. Of the patients 22% required a mean of 1.8 subsequent interventions an average of 6.5 months after autologous sling placement with no difference in median quality of life at final followup. At last followup 42 of 46 patients (91%) and 35 of 46 (76%) had achieved objective and subjective success, respectively. There was no difference in subjective success between patients treated with a staged vs a concomitant approach (69% vs 80%, p = 0.48). Autologous fascial pubovaginal sling placement after synthetic mesh removal can be performed successfully in patients with stress urinary incontinence as a single or staged procedure. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Recidiva hemorrágica em pacientes esquistossomóticos operados

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José Cesar Assef

Full Text Available Foram estudados, no período de 1987 a 1991, trinta doentes esquistossomóticos submetidos anteriormente a operações não descompressivas para tratamento da hemorragia digestiva alta, e que apresentaram recidiva hemorrágica. Através de endoscopia digestiva alta, ultra-sonografia abdominal e estudo angiográfico, procurou-se determinar o local do novo sangramento e quais os possíveis fatores de recidiva hemorrágica presentes. Procurou-se também determinar a influência da cirurgia anterior no intervalo de tempo decorrido entre esta e o primeiro episódio de recidiva hemorrágica. Os autores concluem que as varizes esofágicas foram significativamente o local mais freqüente do sangramento nas recidivas hemorrágicas (86,7%; que a úlcera péptica gástrica (13,3%, a não desvascularização gastroesofágica (30%, a desvascularização incompleta (16,7% ou a trombose da veia porta (26,7% estão presentes na maioria dos casos de recidiva hemorrágica; e que a associação da desvascularização gastroesofágica à esplenectomia não alterou o intervalo médio de tempo decorrido entre a cirurgia anterior e o primeiro episódio de recidiva do sangramento.
Benefit of the UltraZoom beamforming technology in noise in cochlear implant users.

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Mosnier, Isabelle; Mathias, Nathalie; Flament, Jonathan; Amar, Dorith; Liagre-Callies, Amelie; Borel, Stephanie; Ambert-Dahan, Emmanuèle; Sterkers, Olivier; Bernardeschi, Daniele

2017-09-01

The objectives of the study were to demonstrate the audiological and subjective benefits of the adaptive UltraZoom beamforming technology available in the Naída CI Q70 sound processor, in cochlear-implanted adults upgraded from a previous generation sound processor. Thirty-four adults aged between 21 and 89 years (mean 53 ± 19) were prospectively included. Nine subjects were unilaterally implanted, 11 bilaterally and 14 were bimodal users. The mean duration of cochlear implant use was 7 years (range 5-15 years). Subjects were tested in quiet with monosyllabic words and in noise with the adaptive French Matrix test in the best-aided conditions. The test setup contained a signal source in front of the subject and three noise sources at +/-90° and 180°. The noise was presented at a fixed level of 65 dB SPL and the level of speech signal was varied to obtain the speech reception threshold (SRT). During the upgrade visit, subjects were tested with the Harmony and with the Naída CI sound processors in omnidirectional microphone configuration. After a take-home phase of 2 months, tests were repeated with the Naída CI processor with and without UltraZoom. Subjective assessment of the sound quality in daily environments was recorded using the APHAB questionnaire. No difference in performance was observed in quiet between the two processors. The Matrix test in noise was possible in the 21 subjects with the better performance. No difference was observed between the two processors for performance in noise when using the omnidirectional microphone. At the follow-up session, the median SRT with the Naída CI processor with UltraZoom was -4 dB compared to -0.45 dB without UltraZoom. The use of UltraZoom improved the median SRT by 3.6 dB (p noise and for speech understanding in noise (p noise. The use of UltraZoom beamforming technology, available on the new sound processor Naída CI, improves speech performance in difficult and realistic noisy conditions when the
Efeitos da ingestão de glicose sobre a circulação materno-fetal Materno-fetal hemodynamic repercussion of glucose ingestion

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Rose Mary de Castro Ranciaro

2006-12-01

Full Text Available OBJETIVOS: analisar o efeito da glicose na hemodinâmica materno-fetal pela avaliação doplervelocimétrica da circulação materno-fetal e fetoplacentária. MÉTODOS: trata-se de estudo realizado por único observador, no qual foram incluídas 31 gestantes clinicamente sadias entre a 28ª e a 36ª semana. Os parâmetros foram avaliados imediatamente antes e 60 minutos após a ingestão de 50 g de glicose. Foram utilizados como critérios de inclusão a avaliação clínica e laboratorial normal, a presença de feto único, a idade gestacional entre a 28ª e a 36ª semana de gestação confirmada por exame de ultra-sonografia e/ou a data da última menstruação, a glicemia de jejum menor ou igual a 110 mg/dL e o teste de sobrecarga após 50 g de glicose menor de 140 mg/dL. Como critérios de exclusão, adotaram-se a presença de malformação ou alterações de desenvolvimento fetal, o trabalho de parto, os antecedentes familiares de diabetes, as patologias próprias ou intercorrentes à gestação e o uso de fumo, álcool ou outras drogas. Foram avaliados os vasos maternos da artéria carótida comum e artérias uterinas, os vasos placentários da artéria umbilical e os vasos fetais da artéria cerebral média e aorta abdominal. Foram analisados os seguintes parâmetros em cada vaso: índice de resistência, índice de pulsatilidade, velocidade sistólica máxima, velocidade diastólica final e tempo de aceleração. A freqüência cardíaca fetal foi avaliada pelo modo M da ultra-sonografia. Para análise estatística foi utilizado o teste t de Student quando a variável diferença de antes e depois da ingestão de glicose apresentou distribuição normal no teste de Kolmogorov-Smirnov. Quando a normalidade foi rejeitada, utilizamos o teste não-paramétrico de Wilcoxon, com o nível de significância sempre estabelecido de pPURPOSE: to analyze the effect of glucose in the materno-fetal hemodynamics through dopplervelocimetric assessment of
Effective Date of Requirement for Premarket Approval for Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair. Final order.

Science.gov (United States)

2016-01-05

The Food and Drug Administration (FDA or the Agency) is issuing a final order to require the filing of a premarket approval application (PMA) or notice of completion of a product development protocol (PDP) for surgical mesh for transvaginal pelvic organ prolapse (POP) repair.

Anomalias branquiais: revisão de 23 casos

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Rogério Aparecido Dedivitis

Full Text Available A anomalia branquial é a doença congênita mais comum vista pelo cirurgião de cabeça e pescoço. Vinte e três pacientes portadores de anomalias branquiais tratados no período de 1994 a 1997 foram revisados. O diagnóstico clínico foi documentado por ultra-sonografia e comprovado pelo exame histopatológico. Encontramos seis anomalias de primeiro arco (26%; 16 do segundo arco (69,5%; e uma do terceiro (4,5%. Não houve anomalia do quarto arco. Após um seguimento que variou de três a 43 meses, não houve caso de recidiva. A prevalência de anomalias do segundo arco é compatível com a literatura, porém, foi alta a incidência do primeiro arco. O emprego da técnica cirúrgica adequada, com a ressecção de todo o trajeto fistuloso, mostrou-se eficaz.
Acute pulmonary edema caused by takotsubo cardiomyopathy in a pregnant woman undergoing transvaginal cervical cerclage

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Lee, Jae-Young; Kwon, Hyun-Jung; Park, Sang-Wook; Lee, Yu-Mi

2017-01-01

Abstract Background: The physiological changes associated with pregnancy may predispose pregnant women to pulmonary edema. Other known causes of pulmonary edema during pregnancy include tocolytic drugs, preeclampsia, eclampsia, and peripartum cardiomyopathy. Methods: We describe a rare case of pulmonary edema caused by takotsubo cardiomyopathy in a pregnant woman at 14 weeks of gestation who was undergoing emergency transvaginal cervical cerclage. Results: Intraoperative chest radiography rev...
Transvaginal mesh in repair of pelvic organs prolapse as a minimally invasive surgical procedure

OpenAIRE

Argirović Rajka; Berisavac Milica; Likić-Lađević Ivana; Kadija Saša; Bošković Vladimir; Žižić Vojislav

2011-01-01

Background/Aim. Prolapse of genital organs with or without urinary stress incontinention is the most often health problem in the elderly female population tending to increase with ageing. The aim of this study was to assess the perioperative complications and short-term outcomes of prolaps repair using transvaginal polypropylene mesh (Prolift system, Gynecare, Ethicon, USA). Methods. A retrospective study was conducted evaluating 96 women from September 2006 to January 2010 who undewent...
Tratamento cirúrgico dos insulinomas -- estudo de 59 casos Surgical treatment of insulinoma. Study of 59 cases

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M.C.C. Machado

1998-06-01

Full Text Available Após a confirmação clínica e laboratorial de hiperinsulinismo, o principal problema consiste na localização precisa da lesão no parênquima pancreático, propiciando tratamento cirúrgico adequado. OBJETIVO: Analisar os métodos utilizados para o diagnóstico e localização pré e intra-operatório dos insulinomas, bem como as técnicas e os resultados do tratamento cirúrgico. MÉTODOS: Foram estudados 59 casos consecutivos de insulinoma submetidos a intervenção cirúrgica. Cada um dos métodos utilizados para a localização pré-operatória dessas lesões foi avaliado quanto à sua eficiência em confronto com os achados intra-operatórios. A palpação do pâncreas, isoladamente ou associada à ultra-sonografia intra-operatória, como métodos de localização dos insulinomas, foi também estudada. Os tipos de intervenção cirúrgica foram analisados quanto aos seus resultados imediatos e tardios. RESULTADOS: Dos 59 insulinomas, 55 eram benignos e quatro, malignos. Dos métodos utilizados para a localização pré-operatória, a ultra-sonografia foi eficiente em 28,1% dos casos, a tomografia computadorizada em 25%, a ultra-sonografia endoscópica em 27,2%, a arteriografia seletiva em 54,1% e a colheita de amostras de sangue portal para dosagem de insulina em 94,4% dos casos. A palpação bidigital, durante a intervenção cirúrgica, localizou as lesões em 54/55 casos (98,2%. A ultra-sonografia intra-operatória foi decisiva em apenas um caso. Cinco doentes apresentavam neoplasia endócrina múltipla tipo I e em todos as lesões pancreáticas eram múltiplas. Foram efetuadas 29 enucleações e 32 ressecções pancreáticas nos doentes com lesões benignas. Os doentes com lesões malignas foram submetidos a ressecções pancreáticas e quimioterapia. Não houve mortalidade, porém observaram-se complicações (fístulas em 29/59 casos. Os resultados foram bons em 98,1% dos doentes com lesões benignas. Apenas um dos doentes com
Open-access transvaginal sonography in women of reproductive age with abnormal vaginal bleeding: a descriptive study in general practice

NARCIS (Netherlands)

de Vries, Corlien J. H.; Wieringa-de Waard, Margreet; Bindels, Patrick J. E.; Ankum, Willem M.

2011-01-01

Diagnostic ultrasonography is used by GPs in approximately 10% of patients of reproductive age with abnormal vaginal bleeding. Transvaginal sonography is recommended as a first-line diagnostic instrument for assessing uterine pathology. To assess if findings resulting from open-access sonography
Intra- and inter-observer reproducibility and generalizability of first trimester uterine artery pulsatility index by transabdominal and transvaginal ultrasound

NARCIS (Netherlands)

Marchi, Laura; Zwertbroek, Eva; Snelder, Judith; Kloosterman, Maaike; Bilardo, Caterina Maddalena

2016-01-01

Objectives The primary aim of the study was to assess intra-observer and inter-observer reproducibility and generalizability (general reliability) of first trimester Doppler measurements of uterine arteries (UtA) performed both transabdominally (TA) and transvaginally (TV). Secondary aims were to
Validação do escore ultra-sonográfico de Williams para o diagnóstico da hepatopatia da fibrose cística Validation of the Williams ultrasound scoring system for the diagnosis of liver disease in cystic fibrosis

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Eleonora D. T. Fagundes

2004-01-01

Full Text Available OBJETIVOS: Descrever as alterações hepáticas observadas ao exame ultra-sonográfico de fibrocísticos do Ambulatório de Fibrose Cística do Hospital das Clínicas da UFMG, comparar os achados ultra-sonográficos com critérios clínicos e bioquímicos e validar o escore de Williams para o diagnóstico de hepatopatia associada à fibrose cística. MÉTODOS: Setenta fibrocísticos foram acompanhados prospectivamente e submetidos a exame clínico, bioquímico e ultra-sonográfico. Os achados ultra-sonográficos foram comparados com os resultados do exame clínico e bioquímico. Para a validação do escore ultra-sonográfico de Williams, os critérios clínicos e bioquímicos foram utilizados como padrão-ouro. Foram calculados sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo do escore de Williams. Para os cálculos, os pacientes foram divididos em dois grupos: normal ao exame ultra-sonográfico (escore = 3 ou alterado (escore > 3. RESULTADOS: Dez pacientes preencheram os critérios clínicos e/ou bioquímicos para hepatopatia (14,3%. Todos os pacientes hepatopatas segundo os critérios clínicos e/ou bioquímicos apresentavam alguma alteração ao exame ultra-sonográfico. As alterações do parênquima hepático, borda hepática e fibrose periportal foram encontradas mais freqüentemente entre os hepatopatas, com diferença estatisticamente significativa. O escore de Williams apresentou alta especificidade (91,7%; IC 80,9-96,9, mas baixa sensibilidade (s = 50%; IC 20,1-79,9 para o diagnóstico da hepatopatia. CONCLUSÕES: O escore de Williams não constituiu um bom exame de triagem quando comparado ao exame clínico e bioquímico. Uma vez que ainda não há nenhum teste que, utilizado isoladamente, apresente sensibilidade adequada, é recomendável a utilização conjunta dos exames clínico, bioquímico e ultra-sonográfico no diagnóstico da hepatopatia associada à fibrose cística, sempre em avalia
Application of single-incision transvaginal mesh in a woman undergoing peritoneal dialysis and suffering from refractory advanced stage pelvic organ prolapse

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Yi-Hung Sun

2017-05-01

Conclusion: Patients with POP at an advanced stage during peritoneal dialysis who failed to be treated conservatively may require a surgical intervention. Uterus-sparing transvaginal mesh was a feasible minimal invasive option.
Contribution of spiral artery blood flow changes assessed by transvaginal color Doppler sonography for predicting endometrial pathologies

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Suna Kabil Kucur

2013-01-01

Full Text Available ive: To investigate the diagnostic value of blood flow measurements in spiral artery by transvaginal color Doppler sonography (CDS in predicting endometrial pathologies.Methods: Ninety-seven patients presenting with abnormal uterine bleeding and requiring endometrial assessment were included in this prospective observational study. Endometrial thickness, structure and echogenicity were recorded. Pulsatility index (PI and resistive index (RI of the spiral artery were measured by transvaginal CDS. Endometrial sampling was performed for all subjects. Sonographic and hystopathologic findings were compared.Results: The histopathological diagnoses were as follows; 39 cases (40.2% endometrial polyp, 9 cases (9.3% endometrial hyperplasia, 10 cases (10.3 submucous myoma, 7 cases (7.2% endometrium cancer, and 32 cases (33% nonspecific findings. The spiral artery PI in endometrium cancer group was highly significantly lower than other groups (p<0.01. The spiral artery RI was also significantly lower in the patients with malignant histology (p<0.05. Conclusion: Endometrial pathologies are associated significantly with endometrial spiral artery Doppler changes.Key words: Spiral artery, Doppler ultrasonography, endometrium
Transvaginal sonographic evaluation at different menstrual cycle phases in diagnosis of uterine lesions

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Hajishaiha M

2011-10-01

Full Text Available Masomeh Hajishaiha1, Mohammad Ghasemi-rad2, Nazila Karimpour1, Nikol Mladkova3, Farzaneh Boromand11Department of Gynecology, 2Student Research Committee (SRC, Urmia University of Medical Sciences, Urmia, Islamic Republic of Iran; 3Institute of Cell and Molecular Science, London, UKPurpose: Intrauterine lesions (IULs are a common finding in women of reproductive age, particularly infertile women. Transvaginal sonography (TVS is a popular tool for IUL detection, but there are conflicting data with respect to its accuracy.Methods: Five hundred and six women were enrolled into the study. Of these, 496 underwent hysterosalpingography and subsequent TVS six different times during the course of their menstrual cycle. If a lesion was detected, it was further evaluated by sonohysterography (SHG and hysteroscopy.Results: Of 496 women, 41 were shown to have IULs by TVS and those lesions were confirmed in 39 by SHG and hysteroscopy. All 39 lesions were detectable during the ovulatory and early luteal phase (days 16–19 of the menstrual cycle. Accuracy of TVS during different phases was largely dependent on the size of the lesion. TVS falsely detected two lesions and missed fine adhesions in two patients.Conclusion: Accuracy of TVS in detection of IULs is highly dependent on the menstrual cycle phase, with the ovulatory and early luteal phase being the optimal time for this examination.Keywords: menstrual cycle phase, space occupying lesions, transvaginal sonography
Randomized Clinical Trial of Virtual Reality Simulation Training for Transvaginal Gynecologic Ultrasound Skills.

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Chao, Coline; Chalouhi, Gihad E; Bouhanna, Philippe; Ville, Yves; Dommergues, Marc

2015-09-01

To compare the impact of virtual reality simulation training and theoretical teaching on the ability of inexperienced trainees to produce adequate virtual transvaginal ultrasound images. We conducted a randomized controlled trial with parallel groups. Participants included inexperienced residents starting a training program in Paris. The intervention consisted of 40 minutes of virtual reality simulation training using a haptic transvaginal simulator versus 40 minutes of conventional teaching including a conference with slides and videos and answers to the students' questions. The outcome was a 19-point image quality score calculated from a set of 4 images (sagittal and coronal views of the uterus and left and right ovaries) produced by trainees immediately after the intervention, using the same simulator on which a new virtual patient had been uploaded. Experts assessed the outcome on stored images, presented in a random order, 2 months after the trial was completed. They were blinded to group assignment. The hypothesis was an improved outcome in the intervention group. Randomization was 1 to 1. The mean score was significantly greater in the simulation group (n = 16; mean score, 12; SEM, 0.8) than the control group (n = 18; mean score, 9; SEM, 1.0; P= .0302). The quality of virtual vaginal images produced by inexperienced trainees was greater immediately after a single virtual reality simulation training session than after a single theoretical teaching session. © 2015 by the American Institute of Ultrasound in Medicine.
Transvaginal Cystocele Repair by Purse-String Technique Reinforced with Three Simple Sutures: Surgical Technique and Results

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Ho-Sook Song

2012-09-01

Full Text Available Purpose Different techniques for cystocele repair including the conventional anterior colporrhaphy and mesh technique are known. Our goal was to evaluate the anatomical success and safety of our method of transvaginal anterior vaginal wall repair by the purse-string technique reinforced with three simple additional sutures in the repair of cystocele over a 4-year follow-up period. Methods This was a retrospective review of 69 consecutive patients (grades 2 to 4 who underwent the above operations between 2001 and 2011, including their success rates as assessed by use of the Baden-Walker halfway classification system. Results Of the patients, 62 patients (98% were completely cured of cystocele and 1 patient showed grade 2 cystocele recurrence that required no further treatment. Two patients with grade 4 cystocele were completely cured. There was no vaginal erosion related to the cystocele repair. Conclusions Transvaginal anterior colporrhaphy by a purse-string technique reinforced with simple additive sutures appears to be a simple, safe, and easily performed approach in cystocele repair. There is no need for other material for reinforcement, even in high-grade cystocele, which is an advantage of our technique.
Transvaginal mesh in repair of pelvic organs prolapse as a minimally invasive surgical procedure

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Argirović Rajka

2011-01-01

Full Text Available Background/Aim. Prolapse of genital organs with or without urinary stress incontinention is the most often health problem in the elderly female population tending to increase with ageing. The aim of this study was to assess the perioperative complications and short-term outcomes of prolaps repair using transvaginal polypropylene mesh (Prolift system, Gynecare, Ethicon, USA. Methods. A retrospective study was conducted evaluating 96 women from September 2006 to January 2010 who undewent vaginal repair with implatation of a soft mesh manufactured by Gynecare, Ethicon, USA. Results. All the patients had a stage 3 or stage 4 prolapse according to the POP-Q system of ICS. Total mesh was used in 12 (13% patients isolated anterior mesh in 52 (54% patients and isolated posterior mesh in 32 (33% patients. We reported one intra-operative bladder injury and no other serious complications. At 3 months, all 96 patients were available for follow-up. Vaginal erosion occured in 9 (9.3% patients, shrinkage of mesh in 6 (6.2% patients and de novo urinary incontinence in 5 (5.2% patients. Failure rate was 6.25% (recurrent prolapse stage 3 or 4 even asymptomatic. Conclusion. Our study suggests that transvaginal polypropylene mesh applied with a tensionfree technique is a safe and effective method with low intraoperative complications and low morbidity rates. However, some complications are serious and require highly specialised management.
[Transvaginal mesh in repair of pelvic organs prolapse as a minimally invasive surgical procedure].

Science.gov (United States)

Argirović, Rajka; Berisavac, Milica; Likić-Ladević, Ivana; Kadija, Sasa; Bosković, Vladimir; Zizić, Vojislav

2011-07-01

Prolapse of genital organs with or without urinary stress incontinention is the most often health problem in the elderly female population tending to increase with ageing. The aim of this study was to assess the perioperative complications and short-term outcomes of prolaps repair using transvaginal polypropylene mesh (Prolift system, Gynecare, Ethicon, USA). A retrospective study was conducted evaluating 96 women from September 2006 to January 2010 who underwent vaginal repair with implatation of a soft mesh manufactured by Gynecare, Ethicon, USA. All the patients had a stage 3 or stage 4 prolapse according to the POP-Q system of ICS. Total mesh was used in 12 (13%) patients isolated anterior mesh in 52 (54%) patients and isolated posterior mesh in 32 (33%) patients. We reported one intra-operative bladder injury and no other serious complications. At 3 months, all 96 patients were available for follow-up. Vaginal erosion occured in 9 (9.3%) patients, shrinkage of mesh in 6 (6.2%) patients and de novo urinary incontinence in 5 (5.2%) patients. Failure rate was 6.25% (recurrent prolapse stage 3 or 4 even asymptomatic). Our study suggests that transvaginal polypropylene mesh applied with a tension-free technique is a safe and effective method with low intraoperative complications and low morbidity rates. However, some complications are serious and require highly specialised management.
Role of transvaginal ultrasonography in diagnosing endometrial hyperplasia in pre- and post-menopause women

OpenAIRE

Shokouhi, Behrooz

2015-01-01

Background: Abnormal uterine bleeding (AUB) is the most common presenting symptom of endometrial hyperplasia (EH). Transvaginal ultrasonography (TVS) is a diagnostic tool in the evaluation of AUB and EH with various sensitivity and specificity. However, the exact accuracy of TVS in diagnosing EH had not been evaluated. In this study, we aim to evaluate the accuracy of TVS in detecting EH. Materials and Methods: In this retrospective study, 120 women (mean age of 48.64 ± 6.74 years) with AUB w...
Ultrasonic and radiographic study of laxity in hip joints of young dogs Estudo ultra-sonográfico e radiográfico da frouxidão articular em cães jovens

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B.D. Rocha

2007-02-01

Full Text Available In the present study, 22 hip joints of Whippet (four, Rottweiler (five and Labrador Retriever (two young dogs were evaluated with the aim of comparing the ultrasonic examination of coxofemoral joints with the radiographic evaluations, both distraction and conventional procedures, for the early diagnosis of passive laxity. The study was based on static ultrasonography, conventional radiography (CR and distraction radiography (DR methods. In order to quantify the relationship between the femur head and the acetabulum, the alpha (alpha and gamma (gamma angles were measured by ultrasonographic examination, the Norberg angle (NA was measured by CR, and the distraction index (DI was measured by DR. It was observed a negative correlation between angles alpha and gamma (r= -0,756; PAvaliaram-se 22 articulações coxofemorais de cães das raças Whippet (quatro cães, Rottweiler (cinco cães e Labrador Retriever (dois cães, com o objetivo de comparar o exame ultra-sonográfico da articulação coxofemoral de cães jovens com as avaliações radiográficas em distração e convencional, para a determinação precoce da frouxidão articular passiva. Utilizaram-se os métodos ultra-sonográfico estático, radiográfico convencional (MRC e radiográfico em distração (MRD. Para quantificar a relação entre a cabeça do fêmur e o acetábulo, foram medidos os ângulos alfa (alfa e gama (gama no exame ultra-sonográfico, o ângulo de Norberg (AN no MRC e o índice de distração (ID no MRD. Observou-se correlação negativa entre os ângulos alfa e gama (r= -0,756; P<0,001 e entre ID e AN (r= -0,474; P<0,026. Não se observou correlação entre os ângulos alfa e gama em relação ao ID e o AN (alfa e ID: r= -0,380; P<0,081; alfa e NA: r= 0,013; P<0,954; gama e ID: r= 0, 338; P<0,124; ângulo gama e AN: r= -0,192; P<0,391. O método ultra-sonográfico estático não se mostrou sensível para a detecção precoce da frouxidão passiva da articula
Tumor maligno indiferenciado disseminado. Diagnóstico ao exame oftalmológico: relato de um caso Metastatic undifferentiated malignant tumor: report of a case

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Henrique Shiguekiyo Kikuta

2001-08-01

Full Text Available Objetivo: Demonstrar a importância da anamnese e do exame físico geral nas afecções orbitárias, como orientadores do diagnóstico e do tratamento adequados. Métodos: Anamnese, exame físico geral e oftalmológico e exames complementares: radiografia de tórax, ultra-sonografia abdominal e pélvica, tomografia computadorizada de órbita; e procedimentos de biópsia punção aspirativa de massa orbitária, biópsia excisional de nódulo esternal e respectivos exames de citologia, histologia e imuno-histoquímico. Resultados: A ultra-sonografia pélvica demonstrou a presença de grande massa em anexo, provavelmente o foco primário. A radiografia de tórax revelou massas provavelmente metastáticas. O resultado do exame histopatológico das biópsias de massa retrobulbar e nódulo esternal foi compatível com neoplasia maligna indiferenciada. Conclusões: Este relato ressalta a importância da anamnese e do exame físico geral nas afecções orbitarias, orientando o diagnóstico e o tratamento adequado, pois embora a paciente apresentasse múltiplas metástases, foram os sinais oftalmológicos que a conduziram ao médico.Purpose: To demonstrate the importance of clinical history and general physical examination in orbital affections as guides for correction of and early diagnosis allowing adequate treatment. Methods: Clinical history, ophthalmologic and general physical examination and complementary examinations: Chest X-ray, pelvic and abdominal ultrasonography, orbital computerized tomography; fine needle aspiration biopsy of tumor, orbitary procedures, excisional biopsy of sternal nodule and retrospective cytologic, histologic and imunohistochenical examinations. Results: Pelvic ultrasonography demonstrated the presence of a large tumor in anexus, probably the primary focus. In the chest X-ray there is evidence of metastatic mass. The histopathological findings of both retrobulbar mass and sternal nodule were compatible with
Resultados de Técnicas de Reprodução Assistida em Pacientes Previamente Submetidas a Cirurgia Ovariana para o Tratamento da Endometriose

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Geber Selmo

2002-01-01

Full Text Available Objetivo: avaliar os efeitos da cirurgia ovariana prévia para o tratamento da endometriose na resposta ovariana durante ciclos de reprodução assistida e na taxa de gravidez subseqüente. Métodos: foram avaliadas 61 mulheres inférteis, com cirurgia ovariana prévia para endometriose, submetidas a 74 ciclos de fertilização in vitro/injeção intracitoplasmática de espermatozóides (FIV/ICSI (Grupo caso, e comparadas a 74 pacientes inférteis, submetidas a 77 ciclos de FIV/ICSI no mesmo período e na mesma clínica, sem cirurgia ovariana prévia ou endometriose (Grupo controle. As pacientes foram pareadas por idade e tratamento realizado. A FIV foi realizada utilizando-se o protocolo longo para dessensibilização hipofisária seguida de indução da foliculogênese, monitorizada por ultra-sonografia e dosagem de estradiol. Após punção folicular os oócitos eram inseminados ou injetados e os embriões obtidos foram transferidos entre o dia 2 e dia 5 pós-inseminação. Resultados: pacientes com menos de 35 anos previamente submetidas a cirurgia ovariana recrutaram número menor de oócitos quando comparadas às pacientes do grupo controle (p=0,049. O número de ampolas utilizadas, a duração da foliculogênese, o número de folículos, a taxa de fertilização e de gravidez (53 e 56,2%, respectivamente, para os grupos caso e controle foram semelhantes. Mulheres com idade superior a 35 anos com cirurgia ovariana prévia necessitaram de maior número de ampolas para superovulação (p=0,0017 e apresentaram um número menor de folículos e oócitos (p=0,001. Um total de 10 pacientes ficaram grávidas no grupo caso (34,5% e 14 no grupo controle (48,3% (p=0,424. Conclusão: a cirurgia ovariana para tratamento da endometriose reduz a resposta ovariana durante ciclos de FIV/ICSI em mulheres >35 anos e apresenta tendência a diminuir as taxas de gravidez. Assim, acreditamos que, para as pacientes inférteis com endometriose ovariana, o
Índice orientador do tratamento sistêmico da gravidez ectópica íntegra com dose única de metotrexato Index for the systemic treatment of unruptured ectopic pregnancy with a single dose of methotrexate

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Julio Elito Junior

1998-04-01

Full Text Available Foi realizado estudo longitudinal em 42 pacientes com diagnóstico de gravidez ectópica íntegra, com o intuito de se elaborar um índice orientador do uso sistêmico de metotrexato em dose única (50 mg/m² por via intramuscular. O acompanhamento se fez através de dosagens de beta-hCG (fração beta do hormônio gonadotrópico coriônico realizadas no 1º, 4º e 7º dias após o emprego do quimioterápico. Quando ocorreu queda de 15% ou mais nos títulos de beta-hCG, apurados no 4º e no 7º dia, as pacientes receberam alta hospitalar e seguimento ambulatorial com dosagens semanais de beta-hCG até que se atingissem níveis inferiores a 5 mUI/ml. Foi elaborado um índice orientador do tratamento sistêmico com metotrexato baseado nos seguintes parâmetros: (1 valores iniciais de beta-hCG; (2 aspecto da imagem à ultra-sonografia (hematossalpinge, anel tubário, embrião vivo; (3 maior diâmetro da massa anexial; (4 quantidade de líquido livre; (5 fluxo vascular medido por meio do doppler colorido. Cada parâmetro recebeu pontuação de 0 a 2. A nota zero significa elemento de mau prognóstico, a nota dois indica parâmetros favoráveis e a nota um, situações intermediárias. O índice de sucesso com dose única foi de 69,0% (29/42 pacientes. A ultra-sonografia transvaginal com doppler colorido foi realizada em 20 das 42 pacientes do estudo. Neste grupo de 20 pacientes o sucesso do tratamento ocorreu em 75,0% dos casos (15/20. Entre as 22 pacientes que não foram avaliadas com doppler colorido a média das notas do índice nos casos de sucesso foi de 6,6, nas de insucesso 3,1. No grupo de pacientes avaliadas por doppler (20 pacientes as médias foram de 7,9 (sucesso e 4,2 (fracasso. No presente estudo a nota de corte foi estabelecida levando-se em conta o valor abaixo do qual o tratamento não foi efetivo e correspondeu a cinco, pois 93,75% das pacientes com nota superior a 5 evoluíram com sucesso (15/16, ao passo que notas inferiores ou
[TVT (transvaginal mesh) surgical method for complex resolution of pelvic floor defects].

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Adamík, Z

2006-01-01

Assessment of the effects of a new surgical method for complex resolution of pelvic floor defects. Case study. Department of Obstetrics and Gynaecology, Bata Hospital, Zlín. We evaluated the procedures and results of the new TVM (transvaginal mesh) surgical method which we used in a group of 12 patients. Ten patients had vaginal prolapse following vaginal hysterectomy and in two cases there was uterine prolapse and vaginal prolapse. Only in one case there was a small protrusion in the range of 0.5 cm which we resolved by removal of the penetrated section. The resulting anatomic effect was very good in all the cases.

Short-term outcomes of the transvaginal minimal mesh procedure for pelvic organ prolapse

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Naoko Takazawa

2018-03-01

Full Text Available Purpose: This study aimed to evaluate the clinical outcomes and complications of transvaginal minimal mesh repair without using commercially available kits for treatment of pelvic organ prolapse (POP. Materials and Methods: This retrospective cohort study involved 91 women who underwent surgical management of POP with originally designed small mesh between July 2014 and August 2015. This mesh is 56% smaller than the mesh widely used in Japan, and it has only two arms delivered into each right and left sacrospinous ligament. The main study outcome was the anatomic cure rate defined as recurrence of POP quantification (POP-Q stage II or more. We also assessed changes in the overactive bladder symptom score (OABSS and prolapse quality of life questionnaire (P-QOL and evaluated adverse events. Finally, we compared patient backgrounds between the patients with and without recurrence. Results: Prolapse recurred in 10 of 91 patients (11.0%, and all patients with recurrence were diagnosed as POP-Q stage II. As adverse events, only mesh erosion occurred in two (2.2% and pelvic pain in one (1.1% of the 91 patients. The OABSS and P-QOL were significantly improved by the operation. When we compared patient backgrounds between the patients with and without recurrence, body mass index was the only factor influencing affecting recurrence. Conclusions: Transvaginal minimal mesh repair resulted in successful outcomes with low mesh-related complications and anatomic recurrence at one year. Furthermore, significant improvement in QOL was offered by this procedure. Our minimal mesh technique should be considered as one treatment option for the management of POP.
Short-term outcomes of the transvaginal minimal mesh procedure for pelvic organ prolapse.

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Takazawa, Naoko; Fujisaki, Akiko; Yoshimura, Yasukuni; Tsujimura, Akira; Horie, Shigeo

2018-03-01

This study aimed to evaluate the clinical outcomes and complications of transvaginal minimal mesh repair without using commercially available kits for treatment of pelvic organ prolapse (POP). This retrospective cohort study involved 91 women who underwent surgical management of POP with originally designed small mesh between July 2014 and August 2015. This mesh is 56% smaller than the mesh widely used in Japan, and it has only two arms delivered into each right and left sacrospinous ligament. The main study outcome was the anatomic cure rate defined as recurrence of POP quantification (POP-Q) stage II or more. We also assessed changes in the overactive bladder symptom score (OABSS) and prolapse quality of life questionnaire (P-QOL) and evaluated adverse events. Finally, we compared patient backgrounds between the patients with and without recurrence. Prolapse recurred in 10 of 91 patients (11.0%), and all patients with recurrence were diagnosed as POP-Q stage II. As adverse events, only mesh erosion occurred in two (2.2%) and pelvic pain in one (1.1%) of the 91 patients. The OABSS and P-QOL were significantly improved by the operation. When we compared patient backgrounds between the patients with and without recurrence, body mass index was the only factor influencing affecting recurrence. Transvaginal minimal mesh repair resulted in successful outcomes with low mesh-related complications and anatomic recurrence at one year. Furthermore, significant improvement in QOL was offered by this procedure. Our minimal mesh technique should be considered as one treatment option for the management of POP.
Off ice Hysteroscopy in Patients with Abnormal Uterine Bleeding and Normal Transvaginal Sonography

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Mojgan Barati

2008-01-01

Full Text Available Background: Abnormal uterine bleeding (AUB is one of the most common clinical problemsin gynecology. Transvaginal sonography (TVS and hysteroscopy are two diagnostic methods forpatients with AUB. For most of the patients with AUB, diagnostic hysteroscopy can be done inclinic with minimal discomfort and much lower expense than operative room.Materials and Methods: In our clinical trial study, from March 21, 2005 to March 20, 2007,patients with AUB in Ahwaz Imam Khomayni hospital, after history and physical examinationsunderwent TVS. Of those, 147 patients with normal TVS entered the study and were considered foroutpatient hysteroscopy. Patients with endometrial cavity lesion were scheduled for operation room,and those with empty endometrial cavity aspiration biopsy were done outpatiently. Specimens weresent to pathologist for examination.Results: All the patients were divided into three groups: group 1 or minority was under 30 yearsold (7 women, group 2 was 30-40 years, and group 3 or majority was over 40 years old (96women. 115 patients (78.2% had normal and 32 patients (21.8% had abnormal hysteroscopicresults. 116 patients (78.8% had normal and 31 patients (21.2% had abnormal pathologic results;moreover, cervical canal polyp was the most common lesion hysteroscopically and pathologicallyin all groups.Conclusion: Of 147 patients (100% with AUB and normal TVS, 32 patients (21.8% wereabnormal hysteroscopically. Cervical canal polyps may be missed by transvaginal sonography, butcan be diagnosed by hysteroscopy. In patients with AUB and normal TVS, hysteroscopy can beused as the second step.
Avaliação estatística da variação da velocidade de propagação de ondas de ultra-som na madeira em presença de defeitos Statistical evaluation of the ultrasonic wave velocity variation in defective wood

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Carlos T. Puccini

2002-12-01

Full Text Available Os métodos visuais para a detecção de defeitos na madeira, ainda que de grande utilidade, podem ser falhos e exigem a utilização de mão-de-obra relativamente bem treinada. Muitas vezes, a presença de nós, rachaduras ou, ainda, regiões com medula no interior de uma peça serrada, podem ser imperceptíveis na avaliação visual. Um dos grandes avanços obtidos nos últimos anos na caracterização de materiais, tanto do ponto de vista mecânico quanto da qualidade, é a aplicação de técnicas que utilizam a propagação de ondas, destacando-se, dentre elas, o ultra-som. O objetivo deste trabalho é avaliar, estatisticamente, a possibilidade de se utilizar o método do ultra-som na detecção de defeitos em peças de madeira serrada. Para isto, foram utilizadas 180 peças de dimensões nominais: 0,027 m de espessura; 0,10 m de largura e 0,25 m de comprimento, retiradas de vigas de Pinus sp obtidas em serraria da cidade de Campinas. As peças foram ensaiadas na umidade de equilíbrio ao ar. Para a realização dos ensaios utilizou-se o equipamento de emissão de ondas de ultra-som marca Steinkamp BP-7 com transdutores de 45 kHz. Inicialmente foi realizada uma análise visual das peças e, posteriormente, a determinação da velocidade de propagação das ondas nas mesmas peças. Com os resultados, realizou-se uma análise exploratória das variáveis e obteve-se um modelo de regressão logística visando verificar a relação entre a presença ou não de defeitos e a velocidade de propagação da onda do ultra-som na madeira. Os resultados demonstram uma forte relação entre a velocidade de propagação da onda de ultra-som e os defeitos detectados pela análise visualVisual methods to detect wood defects, although of great utility, can lead to inaccurate results and demand a specialist to carry it out. The presence of knots, cracks or pith regions inside a sawed piece can be imperceptible in the visual evaluation. One of the greatest
Surgical intervention after transvaginal Prolift mesh repair: retrospective single-center study including 524 patients with 3 years' median follow-up.

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de Landsheere, Laurent; Ismail, Sharif; Lucot, Jean-Philippe; Deken, Valérie; Foidart, Jean-Michel; Cosson, Michel

2012-01-01

The aim of this study was to explore the nature and rate of surgical intervention after transvaginal Prolift mesh repair for pelvic organ prolapse. This was a retrospective study of all patients who underwent Prolift mesh repair between January 2005 and January 2009. Patient data were obtained from medical records, and patients were telephoned to check if they had surgery in other hospitals. A total of 600 consecutive patients were identified. Of these, 524 patients (87.3%) were included in the study, with a median follow-up duration of 38 months (range, 15-63). Global reoperation rate was 11.6%. Indications of intervention were surgery for urinary incontinence (6.9%), mesh-related complications (3.6%), or prolapse recurrence (3%). The global reoperation rate after transvaginal Prolift mesh repair was 11.6%, with urinary incontinence surgery being the most common indication. Rates of mesh complications and prolapse recurrence are relatively low in an experienced team. Copyright © 2012 Mosby, Inc. All rights reserved.
Rectal water contrast transvaginal ultrasound versus double-contrast barium enema in the diagnosis of bowel endometriosis

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Jiang, Jipeng; Liu, Ying; Wang, Kun; Wu, Xixiang; Tang, Ying

2017-01-01

Objectives The aim of study was to compare the accuracy between rectal water contrast transvaginal ultrasound (RWC-TVS) and double-contrast barium enema (DCBE) in evaluating the bowel endometriosis presence as well as its extent. Design and setting 198 patients at reproductive age with suspicious bowel endometriosis were included. Physicians in two groups specialised at endometriosis performed RWC-TVS as well as DCBE before laparoscopy and both groups were blinded to other groups’ results. Fi...
Office hysteroscopy, transvaginal ultrasound and endometrial histology: a comparison in infertile patients

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Devleta Balić

2011-05-01

Full Text Available Objective. To evaluate accuracy of transvaginal sonography (TVS and hysteroscopy in detection of intrauterine pathology in infertile women. Subjects and methods. This retrospective study was conducted in 56 infertile women with abnormal transvaginal ultrasound findings of the uterine cavity which was performed during the midfollicular phase as a part of routine infertility workup. Hysteroscopy was performed between 6th and 10th day of cycle. Results. The mean age of the subjects was 31.9±4.0. The most frequent ultrasound finding was endometrial polyp in 34 (60.7% patients, septate uterus in 8 (14.3% patients, submucosal myoma in 7 (12.5% patients, endometrial hyperplasia in 5 (8.9% patients and Syndroma Ascherman in 2 (3.6% patients. Hysteroscopy confirmed 20 (35.7% polyps, the same number of myomas, septate uterus and Syndroma Ascherman as detected by ultrasound, (7 (12.5%, 8 (14.3% and 2 (3.6%, respectively and 19 (33.9% endometrial hyperplasia. In 46 women with histological excamination, the sensitivity of TVS and hysteroscopy in the diagnosis of endometrial polyps were identical - 100%, while the specificity was higher in hysteroscopy than in TVS (92.3% versus 56.4%, p<0.001. The sensitivity of TVS in the diagnosis of endometrial hyperplasia was higher than that of hysteroscopy (86.4% versus 22.7%, p<0.001, while specificity was identical, of 100%. Accordance between hysteroscopy and histology was good (k=0.79, between ultrasound and histology was moderete (k=0.59. Conclusion. Hysteroscopy appeared to be more reliable in diagnosis than TVS. The use of a high frequency ultrasound probe leads us to a lack of diagnostic clarity between endometrial polyps and hyperplasia.
Cesarean Delivery Changes the Natural Position of the Uterus on Transvaginal Ultrasonography.

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Kaelin Agten, Andrea; Honart, Anne; Monteagudo, Ana; McClelland, Spencer; Basher, Basmy; Timor-Tritsch, Ilan E

2018-05-01

To assess whether cesarean delivery changes the natural position of the uterus. In this retrospective Institutional Review Board-approved cohort study, we conducted a search of our university gynecologic ultrasonography (US) database. Patients with transvaginal US images before and after either vaginal or cesarean delivery between 2012 and 2015 were included. Women with prior cesarean delivery were excluded. Two readers independently measured antepartum and postpartum flexion angles between the longitudinal axis of the uterine body and the cervix. We calculated intraclass correlation coefficients to measure inter-reader agreement. Antepartum and postpartum uterine flexion angles were compared between patients with vaginal and cesarean delivery. We included 173 patients (107 vaginal and 66 cesarean delivery). The mean interval between scans ± SD was 18 ± 10 months. Inter-reader agreement for flexion angles was almost perfect (intraclass correlation coefficients: antepartum, 0.939; postpartum, 0.969; both P cesarean delivery (154.8° ± 45.7°) versus vaginal delivery (145.8° ± 43.7°; P = .216). Mean postpartum flexion angles were higher after cesarean delivery (180.4° ± 51.2°) versus vaginal delivery (152.8° ± 47.7°; P = .001. Differences in antepartum and postpartum flexion angles between cesarean and vaginal delivery were statistically significant (25.6° versus 7.0°; P = .027). Cesarean delivery can change the uterine flexion angle to a more retroflexed position. Therefore, all women with a history of cesarean delivery should undergo a transvaginal US examination before any gynecologic surgery or intrauterine device placement to reduce the possibility of surgical complications. © 2017 by the American Institute of Ultrasound in Medicine.
Avaliação do comportamento auditivo e neuropsicomotor em lactentes de baixo peso ao nascimento Assessment of auditory behaviour and neuropsychomotor development of low weight infants

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I. Lichtig

2001-03-01

Full Text Available OBJETIVOS E MÉTODOS: Este estudo teve como objetivos detectar a presença de deficiência auditiva (DA de moderada a profunda em 60 lactentes de baixo peso ao nascimento, e na ausência desta, acompanhar o desenvolvimento da função auditiva (localização da fonte sonora, e acompanhar o desenvolvimento neuropsicomotor destas crianças durante os dois primeiros anos de vida, através da avaliação comportamental da audição (Hear Kit, Downs - 1984, avaliação clínica do desenvolvimento neuropsicomotor e ultra-sonografia de crânio. RESULTADOS: Os resultados obtidos mostraram que dos 60 lactentes, em um caso foi levantada a hipótese de DA e em nove crianças foi verificado atraso no desenvolvimento neuropsicomotor. Na análise transversal dos dados obtidos da avaliação auditiva, verificou-se que o comportamento auditivo dos lactentes apresentou respostas diferentes do que aquelas citadas na literatura americana. CONCLUSÃO: Concluiu-se que 5% dos lactentes apresentaram atraso na localização auditiva da fonte sonora e que os atendimentos médico e fonoaudiológico precoces, no berçário e ambulatório, nos dois primeiros anos de vida destas crianças de alto - risco são necessários.PURPOSES AND METHODS: The aims of this study were: to detect moderate to profound hearing loss in high risk infants for deafness, to follow up their auditory development (localization of the sound source- Hear Kit - Downs, 1984; and their neuropsychomotor development during the two first years of life. All subjects were submitted to cerebral ultra sound assessment. RESULTS: An infant with a suspected hearing loss was identified and nine infants presented neuropsychomotor development delay. In a transversal analysis of the hearing assessment data it was verified that infants in this study presented different response than the referred in the American literature. CONCLUSIONS: It was concluded that 5% of the infants were delayed in localizing the sound source
Achados ultra-sonográficos abdominais em pacientes com dengue Abdominal ultrasound findings in patients with dengue fever

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Karen Amaral do Vabo

2004-06-01

Full Text Available OBJETIVO: Apresentar os achados ultra-sonográficos abdominais em pacientes com dengue e compará-los aos descritos na literatura. MATERIAIS E MÉTODOS: Foram realizados exames ultra-sonográficos abdominais de 38 pacientes, 25 do sexo feminino e 13 do sexo masculino, com idade média de 35 anos, com diagnóstico de dengue sorologicamente confirmado. Os achados foram comparados com os descritos na literatura. RESULTADOS: Os achados ultra-sonográficos mais relevantes foram espessamento difuso da parede da vesícula biliar em 18 casos (47,4%, líquido livre na cavidade abdominal e/ou pélvica em 12 (31,6%, esplenomegalia em 11 (28,9%, hepatomegalia em 10 (26,3% e líquido pericolecístico em 10 (26,3%. Vinte e seis por cento dos pacientes apresentaram exames ultra-sonográficos normais. CONCLUSÃO: Os achados ultra-sonográficos abdominais são uma ferramenta adicional útil na confirmação de casos suspeitos de dengue hemorrágica e na detecção precoce da gravidade e da progressão da doença, sendo de extrema importância para o radiologista o conhecimento destes possíveis achados.OBJECTIVE: To review the abdominal ultrasound findings in patients with serologically proven dengue fever and to compare the results with data from the literature. MATERIALS AND METHODS: Thirty-eight patients with serologically proven dengue fever, 25 female and 13 male, mean age of 35 years, were submitted to abdominal ultrasound. The ultrasound findings were compared with data from the literature. RESULTS: The most relevant ultrasound findings were diffuse gallbladder wall thickening in 18 cases (47.4%, abdominal and/or pelvic free fluid in 12 (31.6%, splenomegaly in 11 (28.9%, hepatomegaly in 10 (26.3% and perivesicular fluid in 10 (26.3%. Twenty-six percent of the patients had normal abdominal ultrasound. CONCLUSION: Abdominal sonography is a useful additional diagnostic tool for the confirmation of suspected cases of dengue hemorrhagic fever and for the
Persistência hiperplástica do vítreo primitivo: avaliação por métodos de imagem

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Jacob Beatriz Mahmud

2003-01-01

Full Text Available Persistência hiperplásica do vítreo primitivo (PHVP é um desenvolvimento anormal, afetando crianças, resultante da falha de regressão do vítreo primitivo e dos vasos hialóides, com proliferação de tecido conectivo. A PHVP pode ter três variações: uma anterior, outra posterior e uma terceira com a combinação das duas. Clinicamente manifesta-se como leucocoria (reflexo branco pupilar em um olho de dimensões reduzidas. Esta anomalia é usualmente unilateral e não associada com outros achados sistêmicos. Leucocoria, descolamento de retina, pregas retinianas e catarata podem confundir PHVP com outras afecções oculares que têm achados semelhantes. Retinoblastoma, catarata congênita, retinopatia da prematuridade e pseudogliomas são doenças com achados semelhantes aos da PHVP. A visualização direta dos remanescentes do sistema vascular hialóide fetal é a melhor evidência da lesão presente, se não fosse, muitas vezes impossivel, à fundoscopia, devido à opacidade do tecido. Nestes casos, a visualização indireta, por meio de ultra-sonografia, tomografia computadorizada e ressonância magnética, fornece o diagnóstico. As imagens obtidas por estes métodos proporcionam, ainda, informações e diagnóstico diferencial com outras doenças, particularmente com o retinoblastoma. Os autores fazem uma revisão na literatura e apresentam um estudo iconográfico das imagens e achados da PHVP.
Quem são as mulheres e porque vão procurar o serviço de assistência pré-natal das unidades de saúde de Ribeirão Preto

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Maria das Dores do Vale Oba

1999-12-01

Full Text Available Este estudo foi realizado em duas Unidades Básicas Distritais de Saúde de Ribeirão Preto-S.P., localizadas na região central e oeste do município e que realizam atendimento às gestantes. Objetivo do trabalho foi conhecer e identificar os motivos e o perfil das mulheres que utilizam estes serviços. Utiliza-se a abordagem qualitativa. Observa-se que os motivos da procura ao atendimento pré-natal foram: proximidade da Unidade de Saúde às residências, necessidade de acompanhamento médico, oportunidade de utilizar as tecnologias disponíveis (ultra-sonografia, exames de análise clínicas, odontologia, medicamentos e etc. e a preocupação em ter um encaminhamento médico ao hospital para realizar o parto. O perfil das mulheres que utilizam estas Unidades Básicas Distritais de Saúde foram de: baixa escolaridade e renda familiar e sem nenhum tipo de convênio médico e, portanto, elas dependem única e exclusivamente do Sistema Único de Saúde, para o acompanhamento no pré-natal, resolução do parto e seguimento no puerpério.
Teste triplo biofísico: um novo parâmetro ultra-sonográfico para prognóstico em gestações iniciais Biophysical triple test: a new ultrasonographic parameter for prognostic evaluation in early pregnancies

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Joaquim R. M. Coelho

1999-01-01

Full Text Available Objetivos: atrasos no desenvolvimento do saco gestacional (SG, no tamanho do botão embrionário (CCN, assim como freqüências cardíacas embrionárias (FCE baixas podem ser considerados fatores de mau prognóstico na evolução da gestação. O objetivo deste trabalho foi avaliar a utilização destes 3 parâmetros em conjunto, o que denominamos Teste Triplo Biofísico (TTB. Metodo: foram avaliadas 35 gestações únicas provenientes de fertilização assistida por injeção intracitoplasmática de espermatozóide (ICSI. Todos os exames de ultra-som foram realizados por um único examinador, após 4-5 semanas da transferência de embriões (6-7 semanas de gestação, com equipamento modelo Synergy da Diasonics, sonda transvaginal de 7,0 MHz. O SG foi medido em seu maior diâmetro transverso, o CCN foi medido no sentido sagital e a FCE pelo modo B-M e Doppler. Na análise estatística foi utilizado o teste de Fisher. Resultados: considerou-se como parâmetros alterados : SG Purpose: it has been demonstrated that delays in gestational sac development, in crown-rump length and low embryonic heart rate could be indicators of poor pregnancy outcome. The purpose was to evaluate the use of these three parameters together, which we named Biophysical Triple Test (BTT. Method: thirty-five singleton pregnancies following IVF treatment with intracytoplasmatic sperm injection (ICSI were studied. All ultrasonographic scans were performed by the same examiner, 4-5 weeks after embryo transference (6-7 week gestation, using a Diasonics equipment, model Synergy, with a 7.0-MHz transvaginal transducer. The gestational sac (GS was measured at the longest transverse diameter; the crown-rump length (CRL was measured at the sagittal plan and the embryonic heart rate (EHR was calculated from frozen B and M-mode and Doppler. The statistical test used was Fisher's test. Results: the following parameters were considered abnormal: GS < 15.4 mm, CRL < 3.9 mm, EHR < 100
Road to recovery after transvaginal surgery for urethral mesh perforation: evaluation of outcomes and subsequent procedures.

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Kowalik, Casey G; Cohn, Joshua A; Kakos, Andrea; Lang, Patrick; Reynolds, W Stuart; Kaufman, Melissa R; Karram, Mickey M; Dmochowski, Roger R

2018-01-29

Urethral injury resulting from transvaginal mesh slings is a rare complication with an estimated incidence of surgical management and functional outcomes of women presenting with urethral mesh perforation following midurethral sling (MUS) placement. This was a retrospective multicenter review of women who from January 2011 to March 2016 at two institutions underwent mesh sling excision for urethral perforation with Female Pelvic Medicine and Reconstructive Surgery fellowship-trained surgeons. Data comprising preoperative symptoms, operative details, and postoperative outcomes were collected by telephone (n 13) or based on their last follow-up appointment. Nineteen women underwent transvaginal sling excision for urethral mesh perforation. Eight (42%) patients had undergone previous sling revision surgery. Sixty percent of women had resolution of their pelvic pain postoperatively. At follow-up, 92% reported urinary incontinence (UI), and three had undergone five additional procedures for vaginal prolapse mesh exposure (n 1), incontinence (onabotulinum toxin injection n 1, rectus fascia autologous sling n 1), prolapse (colpopexy n 1), and pain (trigger-point injection n 1). Patient global impression of improvement data was available for 13 patients, of whom seven (54%) rated their postoperative condition as Very much better or Much better. The management of urethral mesh perforation is complex. Most women reported resolution of their pelvic pain and a high rate of satisfaction with their postoperative condition despite high rates of incontinence.
Avaliação dos tumores hepáticos ao Doppler Doppler evaluation of liver tumors

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Márcio Martins Machado

2004-10-01

Full Text Available Os avanços recentes na ultra-sonografia têm ampliado a possibilidade de detecção de tumores hepáticos. Isto tem auxiliado na perspectiva de melhora do prognóstico destes pacientes, à medida que novas técnicas terapêuticas têm surgido. Neste artigo os autores relatam achados ao Doppler que podem auxiliar na identificação e caracterização dos tumores hepáticos, avaliando dados do Doppler colorido, pulsado e do Doppler de amplitude ("power Doppler". Fazem, também, referência a novas modalidades de imagem, como o uso da harmônica.Recent advances in ultrasound have optimized the detection of liver tumors and helped to improve the prognosis of patients with this condition as newly developed and improved therapeutic modalities have been established. The authors review important Doppler findings which may help in the identification and characterization of some hepatic tumors through the evaluation of color Doppler, pulsed Doppler and power Doppler features. New imaging methods such as the use of harmonics imaging are also reviewed.
Degeneração cística maciça de leiomioma uterino em gestante simulando neoplasia ovariana: relato de caso Degenerating cystic uterine fibroid mimics an ovarian cyst in a pregnant patient: a case report

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Arildo Corrêa Teixeira

2008-08-01

Full Text Available Os autores descrevem o caso de uma gestante encaminhada por apresentar massa anexial. A ultra-sonografia demonstrou volumosa lesão sólido-cística sugestiva de neoplasia ovariana. A ressonância magnética mostrou que a lesão era recoberta pela serosa uterina, sugerindo mioma degenerado. O correto diagnóstico das massas pélvicas na gestação é fundamental para o estabelecimento da terapêutica. A ressonância magnética traz importantes contribuições no diagnóstico dessas entidades.The authors describe the case of a pregnant woman referred to the institution to be evaluated for an adnexal mass. Ultrasonography showed a voluminous solid-cystic lesion suggestive of ovarian neoplasm. Magnetic resonance imaging demonstrated that the lesion was located within the uterine serosa, suggesting the presence of a degenerated leiomyoma. A correct diagnosis of pelvic masses in pregnancy is essential for the definition of a therapeutic approach. Magnetic resonance imaging represents a relevant tool in the diagnosis of these abnormalities.
Tratamento de linfocele inguinal pós-operatória com injeção de cola de fibrina: relato de caso Treatment of postoperative inguinal lymphocele with fibrin glue injection: case report

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Priscila Nunes Boaventura

2007-06-01

Full Text Available O paciente desenvolveu linforragia na região inguinal direita, depois de ponte aorto-bifemoral com enxerto de dácron®. Não respondeu ao tratamento conservador com cuidados locais e compressão. Foi realizado exame de ultra-sonografia Doppler, que evidenciou grande linfocele (6,4 x 3,36 x 6,1 cm, tratada pelo esvaziamento da loja por aspiração e injeção de cola de fibrina (1,6 mL em seu interior. O paciente se recuperou sem intercorrências e sem recidiva, após 3 meses de seguimento.The patient developed lymphatic drainage in the right groin after an aortobifemoral bypass with Dacron® graft. Conservative treatment with local wound care and compression was unsuccessful. Duplex scan showed a 6.4 x 3.36 x 6.1 cm lymphocele, which was treated by aspiration and injection of fibrin glue (1.6 mL. The patient recovered uneventfully and without recurrence after a 3-month follow-up.
Impact of transvaginal modified sacrospinous ligament fixation with mesh for the treatment of pelvic organ prolapse-before and after studies.

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Zhu, Qinyi; Shu, Huimin; Du, Guiqiang; Dai, Zhiyuan

2018-04-01

Pelvic organ prolapse (POP) is a common disease in women. The aim of this research was to evaluate the safety, efficacy and complication of transvaginal modified sacrospinous ligament fixation with mesh using for the treatment of vaginal vault prolapse. This was a prospective study including information from 60 symptomatic women with anterior-apical pelvic floor prolapse. The patients underwent transvaginal modified sacrospinous ligament fixation combined with anterior vaginal wall mesh between May 2014 and Sep 2015. The perioperative data including clinical characteristic, operation time, blood loss, and surgical complications were collected at 1 year and 2 years. During a 2-year follow-up, the primary outcome evaluation included Pelvic organ prolapse Quantification system (POP-Q), Incontinence Quality of Life scale (I-QoL), the Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and the Pelvic Floor Distress Inventory, short form 20 (PFDI-20). The mean follow-up time was 2 years (range 24-37 months). The patients' mean age was 66.75 ± 6.44. Of 60 patients who were enrolled in this research, 26 patients had severe stress urinary incontinence (SUI). The mean operation time was 99.14 ± 19.60 min and the mean estimated blood loss was 73.83 ± 41.05 ml. The rate of anatomical success was 98.3% and one patient had a recurrence. The POP-Q point measurements were evaluated preoperatively and postoperatively (P transvaginal modified sacrospinous ligament fixation with mesh might be performed easily and might be a safe surgery for elderly patients whose requirements for sexual life were relatively low. Further researches were required to investigate its long-term efficacy. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.
Hematuria and clot retention after transvaginal oocyte aspiration: a case report.

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Modder, Joshua; Kettel, L Michael; Sakamoto, Kyoko

2006-09-01

To report a case of bladder injury with hematuria and urinary retention after transvaginal oocyte aspiration. Case report. Emergency room in a university medical center. A 28-year-old woman presented with urinary retention and suprapubic pain 8 hours after oocyte aspiration. Foley catheter, intravenous fluid bolus, bladder irrigation, and computed tomography with postvoid films that showed a blood clot in the bladder. Patient was discharged home with antibiotics and catheter in place. Clinical follow-up. Patient passed voiding trial 4 days later and was artificially inseminated. No further hematuria or voiding problems were reported, and she had a successful pregnancy. Patients who elect to undergo oocyte aspiration should be warned about the possibility of bladder injury because of the close proximity of the ovaries to the bladder, and physicians should have an appropriate treatment plan.
Transvaginal sonographic findings of the ectopic pregnancy

Energy Technology Data Exchange (ETDEWEB)

Jun, Soon Ae; Youn, Chang Seon; Han, Sei Yul; Cho, Joo Youn; Chang, Sang Sik; Cha, Kwang Yul; Cha, Kyung Sub [Cha Women' s Hospital, Sungnam (Korea, Republic of)

1989-08-15

Transvaginal(TV) sonography uses high-frequency transducer and allows access to the uterus and adnexa, provides better resolution and more accurate diagnosis of ectopic pregnancy. To determine the value and the utility of TV sonography for a suspected ectopic pregnancy, we studied 56 women during 4 months from January to April 1989. Of 56 patients 46 had an surgically confirmed ectopic pregnancy, 5 had not an ectopic pregnancy and 5 had not follow up. TV sonography provides definite sonographic diagnosis of ectopic pregnancy including an extrauterine gestational sac 34 cases(74%), extrauterine embryo 9 caes(19.7%), hematosalpinx 10 cases(21.7%). Overall adnexal mass was detected in 38 cases(82.6%) at initial TV sonography and in 44 cases(95.6%) at follow up TV sonography. Additional findings were uterine decidual reaction 19 cases(41.3%), pseudo G-sac 4 cases(8.7%), cul-de-sac fluid 42 cases(91.2%). Follow-up TV sonography showed newly developed or growing adnexal mass in 8 among 9 cases. False positive 5 cases were two ovarian cysts, one incomplete abortion, two parametrial thickening due to previous ectopic pregnancy and salpingectomy. TV sonography may improve the govality of patient management by early diagnosis and early surgical treatment, so may preserve fertility. In conclusion, we may suggest that TV sonography is an integral part of diagnostic modality in suspected ectopic pregnancy.

Transvaginal sonographic findings of the ectopic pregnancy

International Nuclear Information System (INIS)

Jun, Soon Ae; Youn, Chang Seon; Han, Sei Yul; Cho, Joo Youn; Chang, Sang Sik; Cha, Kwang Yul; Cha, Kyung Sub

1989-01-01

Transvaginal(TV) sonography uses high-frequency transducer and allows access to the uterus and adnexa, provides better resolution and more accurate diagnosis of ectopic pregnancy. To determine the value and the utility of TV sonography for a suspected ectopic pregnancy, we studied 56 women during 4 months from January to April 1989. Of 56 patients 46 had an surgically confirmed ectopic pregnancy, 5 had not an ectopic pregnancy and 5 had not follow up. TV sonography provides definite sonographic diagnosis of ectopic pregnancy including an extrauterine gestational sac 34 cases(74%), extrauterine embryo 9 caes(19.7%), hematosalpinx 10 cases(21.7%). Overall adnexal mass was detected in 38 cases(82.6%) at initial TV sonography and in 44 cases(95.6%) at follow up TV sonography. Additional findings were uterine decidual reaction 19 cases(41.3%), pseudo G-sac 4 cases(8.7%), cul-de-sac fluid 42 cases(91.2%). Follow-up TV sonography showed newly developed or growing adnexal mass in 8 among 9 cases. False positive 5 cases were two ovarian cysts, one incomplete abortion, two parametrial thickening due to previous ectopic pregnancy and salpingectomy. TV sonography may improve the govality of patient management by early diagnosis and early surgical treatment, so may preserve fertility. In conclusion, we may suggest that TV sonography is an integral part of diagnostic modality in suspected ectopic pregnancy
A 52-month follow-up on the transvaginal mesh surgery in vaginal cuff eversion.

Science.gov (United States)

Lo, Tsia-Shu; Yusoff, Faridah Mohd; Kao, Chuan-Chi; Jaili, Sukanda; Uy Patrimonio, Ma Clarissa

2017-06-01

Transvaginal mesh anterior-posterior (TVM-AP) provides better cure rates in the surgical treatment of vaginal cuff eversion than anterior transvaginal mesh combined with sacrospinous ligament fixation (TVM-A). We determine the outcomes after TVM-A and TVM-AP surgeries in advanced vaginal cuff prolapse. The charts of 796 women who underwent pelvic organ prolapse (POP) surgery from July 2006 to January 2012 in Chang Gung Memorial Hospitals were reviewed. We included women who presented with advanced cuff eversion and treated with TVM surgery. Data were analysed after three years post-surgery. Descriptive statistics were used for demographic and perioperative data. The paired-samples t test was used for comparison of preoperative and postoperative continuous data. The outcomes measured were objective cure (POP-Q stage ≤ 1) and subjective cure (negative response to question 2 and 3 on POPDI-6). A total of 97 patients was analysed. 61 patients had TVM-A and 36 patients had TVM-AP insertion. Mean follow-up was 52 months. The objective cure rate for TVM-AP was significantly higher than TVM-A, 94.4% versus 80.3%. TVM-AP also showed a higher subjective cure rate (91.7%) though there was no significant difference from TVM-A (p = 0.260). The mesh extrusion rate was low at 3.1% with no major complications seen. In TVM-A the blood loss was lesser and the operation time was shorter. TVM-AP showed better objective cure rate than TVM-A at 52 months. However, TVM-A is less invasive in comparison with an acceptably good cure rates. Copyright © 2017. Published by Elsevier B.V.
Transvaginal prolapse repair with or without the addition of a midurethral sling in women with genital prolapse and stress urinary incontinence : a randomised trial

NARCIS (Netherlands)

van der Ploeg, J M; Oude Rengerink, K; van der Steen, A; van Leeuwen, J H S; Stekelenburg, J; Bongers, M Y; Weemhoff, M; Mol, B W; van der Vaart, C H; Roovers, J-P W R

OBJECTIVE: To compare transvaginal prolapse repair combined with midurethral sling (MUS) versus prolapse repair only. DESIGN: Multi-centre randomised trial. SETTING: Fourteen teaching hospitals in the Netherlands. POPULATION: Women with symptomatic stage two or greater pelvic organ prolapse (POP),
Efeito do comprimento do corpo-de-prova na velocidade ultra-sônica em madeiras Effect of the size of the specimen on ultrasonic velocity

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Fabiana Goia Rosa de Oliveira

2006-02-01

Full Text Available O presente artigo apresenta um estudo sobre a variação da velocidade ultra-sônica longitudinal em função do comprimento da peça de madeira. As espécies utilizadas foram: pinus caribaea (Pinus caribaea var. caribaea eucalipto citriodora (Eucalyptus citriodora, eucalipto grandis (Eucalyptus grandis e jatobá (Hymenaea sp. Utilizou-se equipamento de ultra-som com transdutores exponenciais de 22 kHz. Foram feitas medições do tempo de propagação das ondas ultra-sônicas, com o comprimento variando de 300 cm a 10 cm e mantendo-se a seção transversal constante de 12 cm x 5 cm. Os resultados apontaram que ocorre variação da velocidade em função da distância percorrida e do comprimento de onda (lambda utilizado. Conclui-se que adequar a freqüência do transdutor com o comprimento da peça é essencial para a determinação correta da velocidade ultra-sônica em madeiras.This paper reports on a study of the variation of ultrasonic velocity with the length of the specimen of pinus caribaea (Pinus caribaea var. caribaea eucalipto citriodora (Eucalyptus citriodora, eucalipto grandis (Eucalyptus grandis and jatobá (Hymenaea sp. Ultrasonic measurements were taken with an experimental apparatus having 22 kHz transducers. Tests were carried out with length from 300 cm to 10 cm and constant cross-section (12 cm x 5 cm. The results showed that velocity of ultrasonic waves is sensitive to changes in the distance between transducers and wavelength (lambda. The adjustment between the frequency of transducer and the length of the specimen is essential in order to obtain correct measurements of ultrasonic velocity in wood.
Transvaginal prolapse repair with or without the addition of a midurethral sling in women with genital prolapse and stress urinary incontinence: a randomised trial

NARCIS (Netherlands)

van der Ploeg, J. M.; Oude Rengerink, K.; van der Steen, A.; van Leeuwen, J. H. S.; Stekelenburg, J.; Bongers, M. Y.; Weemhoff, M.; Mol, B. W.; van der Vaart, C. H.; Roovers, J.-P. W. R.; Bergmans, Martin G.; Bongers, Marlies Y.; Dekker, Karin S.; van Gestel, Iris; Kluivers, Kirsten B.; Milani, A. L. Fred; van der Ploeg, J. Marinus; Oude Rengerink, Katrien; Schagen van Leeuwen, Jules H.; Schram, Aaltje J.; van der Steen, Annemarie; Stekelenburg, Jelle; van der Vaart, C. Huub; Weemhoff, Mirjam; Weis-Potters, Annemarie E.; Wijma, Jac

2015-01-01

To compare transvaginal prolapse repair combined with midurethral sling (MUS) versus prolapse repair only. Multi-centre randomised trial. Fourteen teaching hospitals in the Netherlands. Women with symptomatic stage two or greater pelvic organ prolapse (POP), and subjective or objective stress
Transvaginal prolapse repair with or without the addition of a midurethral sling in women with genital prolapse and stress urinary incontinence : a randomised trial

NARCIS (Netherlands)

van der Ploeg, J. M.; Rengerink, K. Oude; van der Steen, A.; van Leeuwen, J. H. S.; Stekelenburg, J.; Bongers, M. Y.; Weemhoff, M.; Mol, B. W.; van der Vaart, C. H.; Roovers, J-P W. R.

ObjectiveTo compare transvaginal prolapse repair combined with midurethral sling (MUS) versus prolapse repair only. DesignMulti-centre randomised trial. SettingFourteen teaching hospitals in the Netherlands. PopulationWomen with symptomatic stage two or greater pelvic organ prolapse (POP), and
Determinação do módulo de elasticidade da madeira juvenil e adulta de Pinus taeda por ultra-som Determination of the modulus of elasticity of juvenile and mature wood of Pinus taeda L.with ultrasonic method

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Adriano W. Ballarin

2005-04-01

Full Text Available A madeira de Pinus sp. tem utilização crescente na indústria madeireira brasileira. O decréscimo constante do suprimento de árvores adultas com grandes diâmetros, provenientes de florestas naturais, tornou comum a produção de madeira em ciclos curtos, com grande proporção de madeira juvenil. Resultados de diversas pesquisas têm reportado que o módulo de elasticidade e a resistência a diferentes solicitações mecânicas são seriamente afetados pela presença de madeira juvenil. Este trabalho teve por objetivo determinar o módulo de elasticidade da madeira juvenil e adulta de Pinus taeda L. a partir da constante dinâmica C LL, obtida em ensaios não-destrutivos de ultra-som. A madeira de P. taeda era originária de plantios da Estação Experimental de Itapeva - SP, sendo amostrados seis indivíduos arbóreos com 34 anos de idade. Os corpos-de-prova (4 cm x 4 cm x 45 cm foram obtidos separadamente das regiões de madeira juvenil e adulta da prancha central, previamente submetida à secagem industrial (umidade final de 12%, para a determinação da constante dinâmica por meio de ensaios de ultra-som. Para avaliar a sensibilidade do método do ultra-som, os corpos-de-prova foram ensaiados destrutivamente à compressão paralela. Os resultados mostraram boa sensibilidade do método do ultra-som (R² » 0,90 na avaliação desse parâmetro mecânico da madeira juvenil e adulta.Pinus sp. wood has an increasing importance on supplying brazilian wood industry. The diminution of adult and large diameter trees supply deriving from natural tropical forests, became usual the production of wood on short rotation plantation, with considerable proportion of juvenil wood. Results from several researches have been demonstrated that MOE and mechanical strength are strongly affected by juvenile wood occurrence. This research was developed with the main objective of correlating dynamic modulus of elasticity (non-destructive ultrasound tests and MOE
Corpus luteum blood flow in normal and abnormal early pregnancy: evaluation and analysis with transvaginal color and pulsed doppler sonography

International Nuclear Information System (INIS)

Tang Xiaoyi; Lin Meifang; Zheng Meirong; Liang Xiaoxian; Liu Jianfeng

2005-01-01

Objective: Detecting and assessment the corpus luteum blood flow in normal and abnormal early pregnancy. Methods: Using transvaginal color and pulse Doppler sonography, we detected 215 pregnant women including 150 normal intrauterine pregnancies, 25 abortion, 29 ectopic pregnancies, and then recorded corpus luteum blood flow feature and the blood flow indexes (Vmax, RI and PI). Results: 1) Corpus luteum was successfully identified in 148 cases out of 150 of normal early pregnancies, 25 cases out of 26 of threatened abortion; 22 cases out of 29 of ectopic pregnancy. 2) Three groups shared the same feature of Color Doppler imaging: a circumferential rim around the entire corpus luteum. 3) The flow index revealed mean PVS, RI and PI had no statistical difference in normal and abnormal early pregnancy; The mean PVS was lower in ectopic pregnancy than in normal pregnancy (P<0.05), while PI and PR had no characteristic in ectopic pregnancy group compared with the indexes obtained in normal pregnancy group. Conclusion: The corpus luteum can be precisely identified in most pregnancy using transvaginal color Doppler and manifests a characterized rim Doppler imaging. PVS may help in differentiating the ectopic pregnancy from normal early pregnancy. (authors)
Diagnóstico pré-natal de gêmeos unidos com uso da ressonância nuclear magnética: relato de dois casos Prenatal diagnosis of conjoined twins by magnetic resonance imaging: report of two cases

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Alex Sandro Rolland de Souza

2006-07-01

Full Text Available A gemelaridade imperfeita é entidade bastante rara e de grande interesse para fetólogos e obstetras em geral. Sua incidência estimada varia de 1:50.000 a 1:200.000 nascimentos. Seu diagnóstico precoce se faz necessário, tendo em vista sua importância para o prognóstico da gestação, correta determinação da via de parto e o planejamento pós-natal. Os dois casos relatados são de gêmeos unidos diagnosticados no pré-natal através da ultra-sonografia e ressonância nuclear magnética, para estudo do compartilhamento dos órgãos e melhor definição das relações anatômicas. O primeiro par gemelar foi cefalópago, ou seja, unidos pela cabeça, tórax e abdome, com duas pelves e oito membros. O segundo foi toracópago, ou seja, unidos pelo tórax e abdome superior. A ressonância magnética pouco contribuiu para o diagnóstico de gêmeos unidos. Entretanto, se mostrou de grande auxílio na descrição dos órgãos compartilhados entre os fetos, contribuindo na definição do prognóstico fetal.Conjoined twins have a rare prevalence and special curiosity among physicians and the general population. The reported frequency varies from 1:50,000 to 1:200,000 pregnancies. Its early diagnosis becomes very important when we think about pregnancy management, method of delivery and neonatal care. We describe two cases of conjoined twins diagnosed by ultrasound and magnetic resonance during prenatal care with the aim to better studying the fetus anatomy. The first conjoined twins were cephalopagus sharing head, thorax and abdominal wall and with two pelvis and four arms and four legs. The second were thoracopagus, united by thorax and part of abdomen. Magnetic resonance imaging contribution was not important to diagnose conjoined twins. However, it was useful to describe the shared organs, contributing to define fetal outcome.
EFFECT OF TIMING OF ARTIFICIAL INSEMINATION ON THE FERTILITY AND SEX RATIO IN NELORE HEIFERS INFLUÊNCIA DO MOMENTO DA INSEMINAÇÃO ARTIFICIAL SOBRE A FERTILIDADE E O SEXO DA CRIA DE NOVILHAS DA RAÇA NELORE

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José Ricardo Almeida de Andrade

2008-12-01

concepção dos cinco tratamentos. A proporção de machos foi 38,2% (GC, 48,5% (GT6, 45,2% (GT12, 55,9% (GT18 e de 58,6% (GT24. A relação macho/fêmea foi de 0,62 (GC, 0,94 (GT6, 0,82 (GT12, 1,27 (GT18 e de 1,42 (GT24. Houve diferença significativa (p<0,05 na relação macho/fêmea entre os cinco tratamentos. O momento da inseminação artificial exerce influência sobre a relação macho/fêmea, aumentando a proporção de machos na medida em que as inseminações são realizadas mais tardiamente. Dentro do intervalo de tempo avaliado (0 a 24h após GnRH, a fertilidade das novilhas da raça Nelore não é influenciada pelo momento da inseminação artificial.

PALAVRAS-CHAVES: Diagnóstico de gestação, gado de corte, manejo, ultra-sonografia, sexagem.
ULTRA-LIGHTWEIGHT CEMENT

International Nuclear Information System (INIS)

Fred Sabins

2001-01-01

The objective of this project is to develop an improved ultra-lightweight cement using ultra-lightweight hollow glass spheres (ULHS). Work reported herein addresses Task 1: Assess Ultra-Lightweight Cementing Issues, Task 2: Review Russian Ultra-Lightweight Cement Literature, Task 3: Test Ultra-Lightweight Cements, and Task 8: Develop Field ULHS Cement Blending and Mixing Techniques. Results reported this quarter include: preliminary findings from a literature review focusing on problems associated with ultra-lightweight cements; summary of pertinent information from Russian ultra-lightweight cement literature review; laboratory tests comparing ULHS slurries to foamed slurries and sodium silicate slurries for two different applications; and initial laboratory studies with ULHS in preparation for a field job
The usefulness of transvaginal ultrasonography and MRI in endometrial carcinoma

International Nuclear Information System (INIS)

Yoshihara, Eisuke

1992-01-01

Between October 1988 and March 1991, 29 patients with endometrial carcinoma had both transvaginal ultrasonography (TVUS) and magnetic resonance imaging (MRI) performed following hysterectomy at the Department of Gynecology and Obstetrics, Okayama University Medical School. The findings were compared with the pathological findings to determine the usefulness of each method. The sensitivity of detecting myometrial invasion was 100% by TVUS and 96% by MRI. The accuracy was 86% by each method. The depth of myometrial invasion was classified into 3 degrees [no myometrial invasion, superficial invasion (≤1/2), deep invasion (>1/2)]. The correct diagnostic rate was 86% by TVUS and MRI. The minimum width and the minimum/maximum width ratio of the intact myometrium obtained by each method in the pathological deep invasion group were significantly lower than those obtained in the other two groups (p<0.01). The sensitivity, the accuracy and the specificity for detecting cervical invasion were 89%, 93% and 95% by both methods. There was no difference between TVUS and MRI for diagnosing myometrial and cervical invasion of endometrial carcinoma. (author)
Importância da avaliação dos movimentos generalizados espontâneos no prognóstico neurológico de recém-nascidos pré-termo The role of spontaneous general movement assessment in the neurological outcome of cerebral lesions in preterm infants

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Juliana M. Garcia

2004-08-01

Full Text Available OBJETIVO: Estudar a relação entre a qualidade, tipos e trajetória dos movimentos generalizados espontâneos em recém-nascidos pré-termo com os achados da ultra-sonografia de crânio neonatal e com a evolução neurológica. MÉTODO: 40 recém-nascidos pré-termo, com idade gestacional OBJECTIVE: To study the relationship among the quality, type, and trajectory of general movements in preterm infants and neonatal cranial ultrasonography findings and neurological outcome. METHOD: Forty preterm newborn infants, with gestational ages under 35 weeks, had their general movements recorded through video-tape during the preterm, term (37th - 42nd postconceptional weeks of age and post-term (49th - 56th postconceptional weeks of age periods, and were prospectively followed up to one-year conceptional age. RESULTS: Our results showed that the quality of general movements, particularly in the post-term period (p = 0.009, were related with the presence of severe cerebral lesions in the neonatal cranial ultrasonography and the neurological outcome. While the presence of severe ultrasonography lesions was associated with an adverse neurological outcome (p = 0.01, the finding of normal general movements patterns was associated with a normal neurological outcome, with negative predictive values of 100%, for the preterm, and 80%, for both term and post-term periods. CONCLUSIONS: When concurrently used, these evaluation methods may increase the specificity and sensitivity in detecting the group of preterm infants at high-risk for neurological disturbances in long-term follow-up.
Boron affects the growth and ultrastructure of castor bean plants Boro afeta o crescimento e a ultra-estrutura da mamoneira

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Denis Herisson da Silva

2008-12-01

micronutriente pode causar toxicidade. Este estudo avalia o desenvolvimento e os efeitos ultra-estruturais de deficiência e toxicidade de boro em mamoneira. O experimento foi realizado em condições de casa de vegetação, com vasos de 10 L de solução nutritiva. Foram utilizados três tratamentos: testemunha (sem B; 0,27 e 5,40 mg L-1 B, uma planta por vaso, em delineamento experimental inteiramente ao acaso com três repetições. A produção de matéria seca de cada parte da planta foi avaliada e o teor de boro determinado. Foram observados os efeitos morfológicos e as alterações na ultra-estrutura celular nas folhas e pecíolos, através da técnica de microscopia eletrônica de transmissão e varredura. A produção de matéria seca da mamoneira foi afetada em condições de deficiência de boro, mas não em condições de toxicidade (5,4 mg L-1 B. Neste último tratamento foram constatadas cloroses nos bordos de folhas velhas e ausência de grânulos de amido. Na omissão de boro, as plantas apresentaram deformação de folhas novas, morte do meristema apical, engrossamento da lamela média, ausência de grânulos de amido nos cloroplastos e desorganização dos vasos condutores do pecíolo. O desenvolvimento e a produção da mamoneira são afetados em condições de deficiência de boro mas não na condição de toxicidade.
Do ultra-orphan medicinal products warrant ultra-high prices? A review

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Picavet E

2013-06-01

Full Text Available Eline Picavet,1 David Cassiman,2 Steven Simoens1 1Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium; 2Department of Hepatology, University Hospital Leuven, Leuven, Belgium Abstract: Ultra-orphan medicinal products (ultra-OMPs are intended for the treatment, prevention, or diagnosis of ultra-rare diseases, ie, life-threatening or chronically debilitating diseases that affect less than one per 50,000 individuals. Recently, high prices for ultra-OMPs have given rise to debate on the sustainability and justification of these prices. The aim of this article is to review the international scientific literature on the pricing of ultra-OMPs and to provide an overview of the current knowledge on the drivers of ultra-OMP pricing. The pricing process of ultra-OMPs is a complex and nontransparent issue. Evidence in the literature seems to indicate that ultra-OMPs are priced according to rarity and what the manufacturer believes the market will bear. Additionally, there appears to be a trend between the price of an ultra-OMP and the number of available alternatives. Patients, third-party payers, and pharmaceutical companies could benefit from more transparent pricing strategies. With a view to containing health care costs, it is likely that cost-sharing strategies, such as performance-based risk sharing arrangements, will become increasingly more important. However, it is vital that any measures for price control are consistent with the intended goals of the incentives to promote the development of new OMPs. Ideally, a balance must be struck between attaining affordable prices for ultra-OMPs and securing a realistic return on investment for the pharmaceutical industry. Keywords: ultra-orphan medicinal product, ultra-rare disease, pricing
Relationship of endometrial thickness detected by transvaginal sonography with the results of endometrial biopsy & hysteroscopic directed biopsy in post menopausal bleeding

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Vahid Dastjerdi M

2008-05-01

Full Text Available Background: Post-menopausal hemorrhage is one of the most common complains in gynecologic clinics. More than 60% of these cases have abnormal findings in diagnostic work ups. There is contraversy about the best diagnostic method for evaluating post-menopausal hemorrhage. The aim of this study was to evaluate the results of Trans-Vaginal Ultrasonography and compare its result to ones derived from direct endometrial biopsy and Hysteroscopy findings.Methods: In a cross-sectional study, menopausal women who attended the outpatient clinic of Arash Hospital, Tehran University of medical Sciences, from April 2005 to March 2006 with the complain of hemorrhage were evaluated. In all of these patients, after getting informed consent, Trans-Vaginal Ultrasonography, Dilatation and Curettage and Hysteroscopy were performed.Results: The total number of 90 women was recruited to the study with the age range of 41-80 years. The mean age of participants was 53.84 ± 6 years and 4.3 ± 5.1 years had passed from their menopause. The mean thickness of endometrium, measured by Trans Vaginal ultrasonography was 6.25 ± 3.7 millimeter. In the biopsy derived specimens, the most finding pathological presentation was atrophy (48.9% and the Proliferative endometrium had the second prevalence (36.7%. Atrophy (44.4% and Proliferative endometrium (33.3% were the most prevalent finding in Hysteroscopy. There was a significant difference in endometrial thickness between groups of different pathological findings. A significant difference in endometrial thickness was also seen between groups with different Hysteroscopic finding. By grouping the data according to endometrial thickness, it became evident that endometrial thickness can predict the outcome of endometrial biopsy and Hysteroscopic finding efficiently. We used ROC curves to find the best grouping threshold for endometrial thickness to achieve the best sensitivity and specificity.Conclusion: Measuring the endometrial
Does the addition of saline infusion sonohysterography to transvaginal ultrasonography prevent unnecessary hysteroscopy in premenopausal women with abnormal uterine bleeding?

Science.gov (United States)

Short, John; Sharp, Benjamin; Elliot, Nikki; McEwing, Rachael; McGeoch, Graham; Shand, Brett; Holland, Kieran

2016-08-01

This observational case series in 65 premenopausal women with abnormal uterine bleeding evaluated whether transvaginal ultrasound followed by saline infusion sonohysterography (SIS) prevented unnecessary hysteroscopy. Although SIS indicated that hysteroscopy was unnecessary in eight women, this benefit was offset by the invasive nature of the scan, the number of endometrial abnormalities falsely detected by SIS and the cost of the additional investigation. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Avaliação ultra-sonográfica do segmento posterior de olhos de cães diabéticos e não diabéticos portadores de catarata Ultrasonographic evaluation of the eyes' posterior segment of diabetic and non-diabetic dogs with cataracts

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Renata Squarzoni

2007-11-01

Full Text Available A catarata impossibilita a passagem de luz dentro do olho, dificultando o exame físico direto das estruturas oculares. É necessária a identificação prévia de quaisquer alterações oculares que contra-indiquem a cirurgia de catarata. A ultra-sonografia, ou ecografia ocular, é um exame seguro, de baixo custo, não invasivo, de fácil realização, que completa o exame oftálmico. Foi realizada avaliação ultra-sonográfica, com transdutor linear, freqüência de 10 MHz, de 225 olhos de 123 cães, sendo cães controle (Grupo 1, 52 cães não diabéticos portadores de catarata (Grupo 2 e 35 cães diabéticos portadores de catarata (Grupo 3, todos eles atendidos no Hospital Veterinário da Universidade de São Paulo. Foram encontradas as seguintes alterações ultra-sonográficas no Grupo 1: degeneração vítrea em 43%, descolamento de vítreo posterior em 7,7%, hialose asteróide em 4,6% dos olhos; no Grupo 2: degeneração vítrea em 58,9%, descolamento de vítreo posterior em 8,4%, hialose asteróide em 2,1%, processo inflamatório e/ou hemorrágico em 2,1% e descolamento de retina em 4,3% dos olhos; e no Grupo 3: degeneração vítrea em 50,7%, descolamento de vítreo posterior em 13,8%, hialose asteróide em 12,3%, processo inflamatório e/ou hemorrágico em 3,1% e descolamento de retina em 3,1% dos olhos. Concluiu-se, que (1 cães diabéticos, principalmente os que apresentam a doença há mais de 2 anos, tem maior predisposição para o desenvolvimento de hialose asteróide; (2 não houve diferença entre a freqüencia de descolamento de retina encontrada em cães diabéticos e não diabéticos; e (3 a ultra-sonografia ocular é em exame seguro, eficaz e importante na avaliação pré-operatória de cães portadores de catarata.Cataracts jeopardize the light penetration into the eye and may restrain direct exam of eye structures. It is necessary to identify very early any eye disease that could cause the failure of cataract surgery
Modelo cirúrgico de insuficiência renal crônica: estudo em coelhos

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Andrei Ferreira Nicolau da Costa

Full Text Available OBJETIVO: Estabelecer um modelo de insuficiência renal crônica (IRC em coelhos, com perspectivas de seu uso para ações terapêuticas e reparadoras. MÉTODO: Foram utilizados 19 coelhos da linhagem Nova Zelândia, machos, adultos, aleatoriamente distribuídos em três Grupos: Grupo 1 - Controle (n =5, Grupo 2- Simulação (n =7, Grupo 3 - Experimental (n =7. Os animais foram anestesiados com Cetamina e Diazepam e Fentanil por via intramuscular e Sevorane, através de vaporizador. No Grupo 3 realizou-se uma nefrectomia bipolar esquerda e após quatro semanas, uma nefrectomia direita. Todas as amostras do parênquima renal foram pesadas. O Grupo 2 foi submetido a duas laparotomias, sem nefrectomia.. Em todos os grupos foram realizadas avaliações: bioquímicas com dosagens de uréia, creatinina, sódio e potássio; ultra-sonográficas abdominais; cintigráficas e histológicas. RESULTADOS: No Grupo 3 houve aumento progressivo da uréia (p=0.0001, creatinina (p=0,0001, sódio (p= 0,0002 e potássio (p=0,0003. A comparação destes resultados com os dos Grupos 1 e 2, nos diversos intervalos, também revelou elevação sérica, com significância estatística (p < 0,05. A ultra-sonografia identificou aumento do rim esquerdo no grupo 3, após 16 semanas. A cintigrafia comprovou, na 4ª semana, perda de 75%da massa renal esquerda. No Grupo 3, a avaliação histológica evidenciou fibrose subcapsular e intersticial e regeneração tubular. CONCLUSÃO: O modelo experimental de IRC é exeqüível, com sobrevida dos animais, em médio prazo, o que permite o uso deste intervalo como janela terapêutica para testar diferentes ações reparadoras ao parênquima renal comprometido.
Mesh removal following transvaginal mesh placement: a case series of 104 operations.

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Marcus-Braun, Naama; von Theobald, Peter

2010-04-01

The objective of the study was to reveal the way we treat vaginal mesh complications in a trained referral center. This is a retrospective review of all patients who underwent surgical removal of transvaginal mesh for mesh-related complications during a 5-year period. Eighty-three patients underwent 104 operations including 61 complete mesh removal, 14 partial excision, 15 section of sub-urethral sling, and five laparoscopies. Main indications were erosion, infection, granuloma, incomplete voiding, and pain. Fifty-eight removals occurred more than 2 years after the primary mesh placement. Mean operation time was 21 min, and there were two intraoperative and ten minor postoperative complications. Stress urinary incontinence (SUI) recurred in 38% and cystocele in 19% of patients. In a trained center, mesh removal was found to be a quick and safe procedure. Mesh-related complications may frequently occur more than 2 years after the primary operation. Recurrence was mostly associated with SUI and less with genital prolapse.

The Effects of Simulation-based Transvaginal Ultrasound Training on Quality and Efficiency of Care

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Tolsgaard, Martin Grønnebæk; Ringsted, Charlotte; Rosthøj, Susanne

2017-01-01

, but no studies have examined its effects on quality and efficiency of care. METHODS: Trainees from 4 University Hospitals in East Denmark were included (N = 54). Participants were randomized to either simulation-based ultrasound training and clinical training (intervention group, n = 28), or to clinical training......, 33.5-55.1) and 19.8% (95% CI, 4.1-32.9) in the intervention and control group, respectively (P = 0.005). CONCLUSIONS: Simulation-based ultrasound training improved quality of care and reduced the need for repeated patient examination and trainee supervision.......OBJECTIVE: To explore the effect of adding simulation-based transvaginal ultrasound training to trainees' clinical training compared with only clinical training on quality of and efficiency of care. BACKGROUND: Simulation-based ultrasound training may be an effective adjunct to clinical training...
Preoperative Diagnosis of Fallopian Tube Malignancy with Transvaginal Color Doppler Ultrasonography and Magnetic Resonance Imaging after Negative Hysteroscopy for Postmenopausal Bleedin

OpenAIRE

Arko, Darja; Žegura, Branka; Virag, Mirjana; Fokter Dovnik, Nina; Takač, Iztok

2014-01-01

Primary Fallopian tube carcinoma is a rare malignancy and is not often diagnosed preoperatively. We present a case of a 67-year old woman who complained of postmenopausal vaginal bleeding. After a negative hysteroscopy, transvaginal ultrasound showed a well vascularized solid-cystic tumor in the adnexal region separate from the ovary. The presence of an adnexal mass was confirmed by MR imaging. Total abdominal hysterectomy with bilateral salpingoophorectomy, omentectomy and appendectomy, as w...
Measurement of soil aggregate stability using low intensity ultrasonic vibration Medición de la estabilidad de agregados de suelo utilizando vibración ultrasónica de baja intensidad Medição da estabilidade dos agregados do solo por vibração ultrasónica de baixa intensidade

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Herwig Mayer

2011-11-01

ía aplicada por el equipo de ultrasonidos para el análisis de variaciones en la estabilidad de los agregados del suelo con respecto a diferentes tratamientos de laboreo. La combinación de los métodos de análisis de estabilidad de agregados, por tamizado en condiciones de humedad (SAS y por dispersión ultrasónica a niveles bajos de energía, permite un análisis más preciso de la estabilidad de los agregados del suelo.
Determinou-se a influência da lavoura na estabilidade dos agregados do solo (soil aggregate stability SAS com recurso à dispersão ultrasónica. Os ensaios realizados foram executados com um equipamento de dispersão electrónica desenvolvido na nossa Universidade. Este equipamento permite a aplicação amplitudes de baixa intensidade, de 0,5 µm, 2 µm e 5 µm. A potência ultrasónica determinada por um método de balanço de energia foi de 0,7 W, 8,9 W e 22,3 W para cada amplitude ensaiada. Colheram-se amostras de agregados de 2 000 a 250 µm, num solo do tipo Chernozem franco limoso degradado, num Cambisol franco argiloso e num Cambisol franco arenoso a Este da Áustria, submetidos a diferentes tipos de lavoura: lavoura convencional (CT conventional tillage, lavoura com eliminação mecânica de infestantes e sem lavoura (NT no tillage, com sementeira intercalada no Inverno. A medição da estabilidade dos agregados do solo de acordo com a norma DIN (Deutsches Institut für Normung permitiu concluir que a estabilidade diminuiu pela seguinte ordem: Cambisol franco argiloso> Cambisol franco arenoso> Chernozem franco limoso. A influência do tipo de lavoura observou-se para o segundo e terceiro tipo de solos mencionados. A dispersão ultrasónica por amplitudes de baixa vibração apresentou uma estabilidade mais alta para os solos do tipo Cambisol. Observou-se uma influência significativa do tipo de lavoura na estabilidade dos agregados do solo (entre 1 e 1,7 J ml^-1 no Cambisol franco argiloso e
Sun Ultra 5

CERN Multimedia

1998-01-01

The Sun Ultra 5 is a 64-bit personal computer based on the UltraSPARC microprocessor line at a low price. The Ultra 5 has been declined in several variants: thus, some models have a processor with less cache memory to further decrease the price of the computer.
Transvaginal coloanal anastomosis after rectal resection for the treatment of a rectovaginal fistula induced by radiation.

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Brezean, I

2014-01-01

Although decreasing in number, radiation induced rectovaginal fistulas are caused by some radiation injuries and chronic ischemic lesions. Most of the experienced authors recommend anterior rectal resection with coloanal anastomosis accessed through the abdominal-perineum area for high fistula. We present a patient with a fistula that developed 23 years after hysterectomy and radiotherapy. In this case we performed an abdominal-transvaginal rectal resection with transverse coloplastypouch, coloanal anastomosis and protection ileostomy three months after a terminal sigmoidostomy. The dissection of the distal rectum by posteriour colpotomy and coloanal transvaginalan astomosis is a technical variant that may prove advantage ous compared to the procedures featured in the literature as solutions by rectal resection for rectovaginal fistula. Celsius.
Assessment of performance measures and learning curves for use of a virtual-reality ultrasound simulator in transvaginal ultrasound examination

DEFF Research Database (Denmark)

Madsen, M E; Konge, L; Nørgaard, L N

2014-01-01

OBJECTIVE: To assess the validity and reliability of performance measures, develop credible performance standards and explore learning curves for a virtual-reality simulator designed for transvaginal gynecological ultrasound examination. METHODS: A group of 16 ultrasound novices, along with a group......-6), corresponding to an average of 219 min (range, 150-251 min) of training. The test/retest reliability was high, with an intraclass correlation coefficient of 0.93. CONCLUSIONS: Competence in the performance of gynecological ultrasound examination can be assessed in a valid and reliable way using virtual-reality...
Transvaginal closure of urethra and correction of uterovaginal prolapse in neurologically impaired patient with chronic indwelling catheter.

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Kubal, U; Arunkalaivanan, A S; Baptiste, M

2009-08-01

We report the case of a 38-year-old neurologically impaired woman with continuous urinary incontinence as a result of a chronic indwelling catheter for neurogenic bladder. Long-term catheter resulted in dilatation of urethra and pressure necrosis of urethra, with subsequent incontinence despite the catheter. She also had a stage 3 uterovaginal prolapse. She underwent cystoscopy, closure of urethra and bladder neck by transvaginal route (Feneley procedure), insertion of a suprapubic catheter, sacrospinous fixation and posterior colporrhaphy with prolene mesh (Apogee). Vaginal hysterectomy was declined by the patient and her family. She remained dry at follow-up visit and is happy with the outcome.
Laparoscopic mesh explantation and drainage of sacral abscess remote from transvaginal excision of exposed sacral colpopexy mesh.

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Roth, Ted M; Reight, Ian

2012-07-01

Sacral colpopexy may be complicated by mesh exposure, and the surgical treatment of mesh exposure typically results in minor postoperative morbidity and few delayed complications. A 75-year-old woman presented 7 years after a laparoscopic sacral colpopexy, with Mersilene mesh, with an apical mesh exposure. She underwent an uncomplicated transvaginal excision and was asymptomatic until 8 months later when she presented with vaginal drainage and a sacral abscess. This was successfully treated with laparoscopic enterolysis, drainage of the abscess, and explantation of the remaining mesh. Incomplete excision of exposed colpopexy mesh can lead to ascending infection and sacral abscess. Laparoscopic drainage and mesh removal may be considered in these patients.
Anatomia foliar de microtomateiros fitocromo-mutantes e ultra-estrutura de cloroplastos Leaf anatomy of micro-tomato phytochrome-mutants and chloroplast ultra-structure

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Hyrandir Cabral de Melo

2011-02-01

Full Text Available Plantas fitocromo-mutantes têm sido utilizadas com o intuito de caracterizar isoladamente, dentre os demais fotorreceptores, a ação dos fitocromos sobre eventos ligados à fotomorfogênese. Raros são os estudos que relatam a ação dos fitocromos sobre aspectos estruturais, embora sejam fundamentais à compreensão do desenvolvimento das plantas. Neste trabalho, objetivou-se analisar características ultraestruturais de cloroplastos e aspectos anatômicos foliares dos microtomateiros (Solanum lycopersicum L. cv. Micro-Tom fitocromo-mutantes aurea (subexpressa fitocromos, hp1 e atroviolacea (ambos supra-responsivos a eventos mediados por fitocromo em plantas em estágio de floração. Observou-se que os fitocromos são responsáveis pela expressão de muitas características anatômicas da epiderme foliar, assim como do mesofilo e da ultraestrutura dos cloroplastos.Phytochrome-mutant plants have been used for phytochrome action characterization among all photoreceptors, in events of photomorphogenesis. Studies relating the phytochrome action on structural aspects, which are fundamental to the comprehension of plant development, are rare. The objective of this work was to analyze chloroplast ultra structure and leaf anatomical characteristics of micro-tomatos (Solanum lycopersicum L. cv. Micro-Tom phytochrome-mutants aurea (sub express phytochrome, hp1 and atroviolacea (both super express phytochrome events-mediated in plants in the flowering stage. The results show that phytochromes are responsible for the expression of many characteristics of leaf epidermis, mesophyll and chloroplast ultra-structure.
Transvaginal Ultrasound in Fertile Patients with Suspected Appendicitis: An Experience Report of Current Practice

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Malek Tabbara

2012-01-01

Full Text Available Background. Transvaginal ultrasound (TVU in female patients with acute right lower quadrant (RLQ abdominal pain is time and infrastructure intensive and not always available. This study aims to evaluate the role of TVU in these patients. Methods. Retrospective analysis identified 224 female patients with RLQ pain and TVU. Results. TVU revealed an underlying pathology in 34 (15% patients, necessitating a diagnostic laparoscopy in 12 patients. Six patients (2% had a true gynaecological emergency. The remaining 23 patients did not require surgery. The other 190 patients with RLQ pain had a bland TVU; 127 (67% were discharged, while 63 patients (33% received a diagnostic laparoscopy. Conclusion. The incidence of true gynaecological emergencies requiring urgent surgical intervention is very low in our patient cohort. TVU is a helpful tool if performed by a physician who is well trained in TVU.
Transvaginal ultrasound in fertile patients with suspected appendicitis: an experience report of current practice.

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Tabbara, Malek; Evangelopoulos, Nikolaos; Raio, Luigi; Banz, Vanessa; Zimmermann, Heinz; Kim-Fuchs, Corinne; Exadaktylos, Aristomenis K

2012-01-01

Background. Transvaginal ultrasound (TVU) in female patients with acute right lower quadrant (RLQ) abdominal pain is time and infrastructure intensive and not always available. This study aims to evaluate the role of TVU in these patients. Methods. Retrospective analysis identified 224 female patients with RLQ pain and TVU. Results. TVU revealed an underlying pathology in 34 (15%) patients, necessitating a diagnostic laparoscopy in 12 patients. Six patients (2%) had a true gynaecological emergency. The remaining 23 patients did not require surgery. The other 190 patients with RLQ pain had a bland TVU; 127 (67%) were discharged, while 63 patients (33%) received a diagnostic laparoscopy. Conclusion. The incidence of true gynaecological emergencies requiring urgent surgical intervention is very low in our patient cohort. TVU is a helpful tool if performed by a physician who is well trained in TVU.
Effects of the ultra-high pressure on structure and α-glucosidase inhibition of polysaccharide from Astragalus.

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Zhu, Zhen-Yuan; Luo, You; Dong, Guo-Ling; Ren, Yuan-Yuan; Chen, Li-Jing; Guo, Ming-Zhu; Wang, Xiao-Ting; Yang, Xue-Ying; Zhang, Yongmin

2016-06-01

A novel homogeneous polysaccharide fraction (APS) was extracted from Astragalus by hot water and purified by Sephadex G-100 and G-75 column. Its molecular weight was 693kDa. APS and APS with ultra-high pressure treatment exhibited significant inhibitory abilities on a-glucosidase, inhibition rate from high to low in order was 400MPa-APS, 300MPa-APS, 500MPa-APS and APS. The inhibition percentage of 400MPa-APS (1.5mg/mL) was 49% (max.). This suggested that the inhibitory activity of APS on a-glucosidase was improved by ultra-high pressure treatment. FT-IR, SEM, CD spectra, atomic force microscope and Congo red test analysis of APS and 400MPa-APS showed ultra-high pressure treatment didn't change the preliminary structure but had an effect on its advanced structure. Copyright © 2016 Elsevier B.V. All rights reserved.
Avaliação ultra-sonográfica da hidrocefalia fetal: associação com mortalidade perinatal Ultrasonographic evaluation of fetal hydrocephalus: association with perinatal mortality

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Ana Paula Brito Hortêncio

2001-07-01

Full Text Available Objetivo: avaliar os parâmetros ultra-sonográficos associados ao incremento da mortalidade perinatal em casos de hidrocefalia fetal. Métodos: foram avaliados 45 casos de hidrocefalia acompanhados entre janeiro/1996 e dezembro/1999. A hidrocefalia foi diagnosticada quando a relação entre a mensuração dos ventrículos laterais e os hemisférios cerebrais correspondentes foi superior a 0,35 ou quando a medida do átrio dos ventrículos laterais foi superior a 10 mm. Em todos os exames definiu-se o tipo, gravidade, simetria, evolução e época do diagnóstico da hidrocefalia. As pacientes foram submetidas a ultra-som morfológico na busca de outras alterações anatômicas. O índice de líquido amniótico e os óbitos fetais foram registrados. Os principais achados ultra-sonográficos foram correlacionados à mortalidade perinatal. Utilizaram-se, para análise estatística, o teste do chi² e o teste exato de Fisher. O valor de pPurpose: to evaluate the ultrasonographic parameters associated with perinatal mortality increase in cases of fetal hydrocephalus. Method: 45 cases of fetal hydrocephalus were followed-up between January 1996 and December 1999. Fetal hydrocephalus was diagnosed when the ratio of lateral ventricles and the corresponding cerebral hemispheres was above 0.35 or when the measurement of the atrium of the lateral ventricles was above 10 mm. In all examinations the type of hydrocephalus, severity, symmetry, evolution and time of diagnosis were defined. The patients were submitted to morphologic ultrasound in the search of other anatomical abnormalities. The amniotic fluid index and fetal deaths were registered. The main ultrasonographic findings were correlated with perinatal mortality. For statistical analysis, chi² test and exact Fisher test were used. The value of p<0,05 was considered to be significant. Results: a total of 20 deaths were observed (44.4%, 6 occurred intra-uterus and 14 in the neonatal period. The
Avaliação do ombro em pacientes portadores de espondilite anquilosante por meio de ultra-som Evaluation of the shoulder in patients with ankylosing spondylitis with ultrasound

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Ciro Yoshida Junior

2008-04-01

Full Text Available OBJETIVO: Descrever as principais alterações nos ombros de pacientes portadores de espondilite anquilosante (EA por meio de ultra-som (US e correlacionar os achados de imagem com a idade e o tempo de doença. MÉTODOS: Foram selecionados 35 pacientes com diagnóstico clínico de EA. Os pacientes foram submetidos a exame de ultra-sonografia dos ombros, sendo avaliados os tendões do manguito rotador quanto à sua ecotextura e espessura, o tendão do bíceps, a articulação acromioclavicular, os tubérculos umerais, a bursa subacromial-subdeltóidea, e a face posterior da articulação glenoumeral. Foram colhidos dados de tempo de doença, presença de dor nos ombros e freqüência das alterações das estruturas avaliadas. Os dados foram comparados com a idade e o tempo de doença, utilizando-se teste qui-quadrado e teste t de Student. RESULTADOS: Foi observada prevalência de 20% de alterações no manguito rotador, sendo 10% de tendinose/calcificação tendínea e 10% de rupturas tendíneas. A espessura média dos tendões do manguito rotador foi de 5,8 mm. As alterações ósseas nos tubérculos do úmero ocorreram em 84,3% dos ombros e as alterações acromioclaviculares em 54,3% dos ombros. CONCLUSÃO: Não há modificação da espessura dos tendões do manguito rotador relacionadas com o tempo de doença. Os principais achados de US, que se correlacionam com o tempo de doença na EA, são alterações ósseas nos tubérculos umerais e na articulação acromioclavicular. Não houve relação entre tempo de doença e presença de lesão tendínea.PURPOSE: To describe shoulder involvement and its prevalence with ultrasound in patients with ankylosing spondylitis and correlate the findings with age and duration of disease. METHODS: Ultrasound scans of both shoulders were performed in thirty five selected patients with clinical diagnosis of ankylosing spondylitis. Rotator cuff texture and thickness were evaluated as well as the biceps tendon
Patient perception of transvaginal mesh and the media.

Science.gov (United States)

Koski, Michelle Elaine; Chamberlain, Jennifer; Rosoff, James; Vaughan, Taylor; Kaufman, Melissa R; Winters, Jack C; Rovner, Eric S

2014-09-01

To assess the penetration of media-based information on transvaginal mesh (TVM) in our patient population and to determine whether exposure affects patient opinion. Since the 2011 Federal Drug Administration communication on TVM, many advertisements from legal practices have been directed toward patients. An 18-item survey was administered to female patients at 2 sites from August 2012 to April 2013. Patients presenting with new diagnoses of pelvic organ prolapse or stress urinary incontinence or patients who reported prior mesh surgery were excluded. Ninety-nine questionnaires were completed. Sixty-six of the patients (67%) were aware of TVM; and of these, 38 (58%) cited advertisements as the initial source of information. Only 12% were aware of the Food and Drug Administration's communication. Regarding opinion of TVM, 9% chose "it is a safe product," 9% "safety depends on factors related to patient," 4.5% "not a safe product," 1.5% "safety depends on the doctor," 68% "I don't know," and 4.5% marked 2 selections. Only 12% indicated knowing the difference in the use of TVM for pelvic organ prolapse vs stress urinary incontinence. When asked what influenced their opinion of TVM the most; responses were as follows: advertisement (33.3%), medical professional (22.7%), friends or family who underwent TVM procedure (12.1%), media article (6.1%), and "not sure" (25.8%). Advertisements of TVM lawsuits had a high penetration into our patient population but did not produce an overtly negative response in our sample. Clinicians should be aware of the impact of these advertisements on patient opinion and counsel patients accordingly with unbiased and scientifically accurate information. Copyright © 2014 Elsevier Inc. All rights reserved.
Surgeon Experience and Complications of Transvaginal Prolapse Mesh.

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Kelly, Erin C; Winick-Ng, Jennifer; Welk, Blayne

2016-07-01

To measure the proportion of women with transvaginal prolapse mesh complications and their association with surgeon volume. We conducted a retrospective, population-based cohort study of all women who underwent a mesh-based prolapse procedure using administrative data (hospital procedure and physician billing records) between 2002 and 2013 in Ontario, Canada. The primary outcome was surgical revision of the mesh. Primary exposure was surgeon volume: high (greater than the 75th percentile, requiring a median of five [interquartile range 5-6] procedures per year) and very high (greater than the 90th percentile, requiring a median of 13 [interquartile range 11-14] procedures per year) volume mesh implanters were identified each year. Primary analysis was an adjusted Cox proportional hazards model. A total of 5,488 women underwent mesh implantation by 1 of 368 unique surgeons. Median follow-up time was 5.4 (interquartile range 3.0-8.0) years. We found that 218 women (4.0%) underwent mesh reoperation a median of 1.17 (interquartile range 0.58-2.90) years after implantation. The hazard of reoperation for complications was only lower for patients of very high-volume surgeons (3.0% [145/3,001] compared with 4.8% [73/2,447], adjusted hazards ratio 0.59, 95% confidence interval 0.40-0.86). In multivariable modeling, younger age, concomitant hysterectomy, blood transfusion, and increased medical comorbidity were all associated with vaginal mesh reoperation. Approximately 5% of women who underwent mesh-based prolapse surgery required reoperation for a mesh complication within 10 years. The risk of reoperation was lowest for surgeons performing 14 or more procedures per year.
The impact of in situ methotrexate injection after transvaginal ultrasound-guided aspiration of ovarian endometriomas on ovarian response and reproductive outcomes during IVF-cycles

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H.E. Shawki

2012-06-01

Conclusion(s: In situ methotrexate injection after transvaginal ultrasound-guided aspiration was a simple, safe and successful method for treating ovarian endometriomas with minimal effects on ovarian response. Short term effects on reproductive outcomes, risk of fetal loss or anomaly were minimal. Six months was enough as washout period of the drug prior to conception and was advisable to prevent the small chance of chromosomal abnormalities in the offspring.
Topical estradiol does not interfere with the expression of the metalloproteinase-1 enzyme in photo exposed skin cells Estradiol tópico não interfere na expressão da enzima metaloproteinase-1 em células da pele fotoexposta

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Luciana Neder

2012-02-01

Full Text Available BACKGROUND: In postmenopausal women there is a rapid destruction of dermal collagen, resulting in accelerated skin ageing, which is manifested by cutaneous atrophy, increased number and depth of wrinkles and sagging. This accelerated catabolism of the collagen is due to estrogen deficiency and increased synthesis of the metalloproteinase-1 enzyme, which degrades the dermal collagen. OBJECTIVES: To assess whether the use of topical estradiol 0.05% cream on photo exposed skin can inhibit the expression of the metalloproteinase-1 enzyme on the dermis and subsequently the rapid loss of collagen in women after menopause. METHODS: We included 40 postmenopausal women without hormone replacement therapy. Information about lifestyle, lipid profile, blood glucose level, thyroid hormones, mammography, Pap smear and transvaginal ultrasound were obtained to rule out associated diseases. Skin biopsy of the right preauricular region was performed before and after treatment with topical estradiol 0.05% for 30 days. The biopsy specimens were subjected to immunohistochemistry to identify the expression of the metalloproteinase-1 enzyme. RESULTS: There was no statistically significant difference on the expression of the metalloproteinase-1 enzyme in keratinocytes, fibroblasts and endothelial cells before and after treatment with topical estradiol for 30 days. CONCLUSION: Treatment with estradiol 0.05% cream, in photo exposed skin for 30 days, does not inhibit the production of metalloproteinase-1.FUNDAMENTOS: Na pós-menopausa, ocorre rápida destruição do colágeno dérmico, com consequente envelhecimento acelerado da pele, que se expressa com atrofia cutânea, aumento do número e da profundidade das rugas e flacidez. Esse catabolismo acelerado do colágeno ocorre por deficiência estrogênica e aumento na síntese da enzima metaloproteinase-1, que degrada o colágeno dérmico. OBJETIVOS: Avaliar se o uso de estradiol tópico a 0,05% em creme na pele
Teratoma congênito de orofaringe: relato de caso Oropharyngeal congenital teratoma: a case report

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Yuri Seguchi Chaves

2005-02-01

Full Text Available O teratoma congênito de orofaringe é o tipo mais raro de teratoma, compreendendo apenas 2% desses tumores fetais. O diagnóstico deve ser realizado o mais precocemente possível, preferencialmente durante o pré-natal. O prognóstico irá depender do tamanho e localização da lesão, da velocidade de crescimento desta, do envolvimento de estruturas intracranianas e da ressecção adequada do tumor com equipe multidisciplinar. Relatamos o caso de uma paciente que teve diagnosticado durante a gestação feto com teratoma congênito de orofaringe (epignathus por meio de ultra-sonografia. O feto evoluiu para óbito intra-uterino na 29ª semana de gestação, sendo então induzido o parto por via vaginal. O exame anatomopatológico revelou feto do sexo feminino, compatível com 27-28 semanas, teratoma orofaríngeo e outras malformações congênitas.Oropharyngeal teratoma is the most rare type of teratoma, with only 2% of fetal teratomas. The diagnosis must be established as early as possible, preferably during the prenatal period. The prognosis will depend on the size and location of the lesion, growth rate of the lesion, degree of intracranial spread, its resectability, and immediate care at birth by a multisciplinary team. We report aparticular case of congenital oropharyngeal teratoma (epignathus. The diagnosis was made during the prenatal period by ultrasound, and the fetus evolved to intrauterine death at the 29th week. The anatomopathological examination revealed a female fetus, compatible with 27-28 weeks, oropharyngeal teratoma and congenital malformations.
Transvaginal six-arm mesh OPUR in women with apical pelvic organ prolapse - analysis of short-term results, pelvic floor ultrasound evaluation.

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Kluz, Tomasz; Wlaźlak, Edyta; Surkont, Grzegorz

2017-01-01

Analysis of feasibility, efficacy and short-term results after six-arm transvaginal mesh OPUR implantation in women with apical prolapse. The same surgeon operated all of 39 women using mesh OPUR. Preoperatively patients had a standardized interview and clinical examination. Intraoperative and postoperative complications were analyzed. Postoperative evaluation included standardized interview, clinical examination and standardized pelvic floor ultrasound performed with 2D transvaginal probe and 4D abdominal probe. There was no complication that needed operative intervention. Hematomas in 3 patients resolved spontaneously. Transient voiding difficulties which lasted less than 7 days were observed in 5 patients. No erosion was observed. Comparison of pre- and postoperative results in 34 women revealed that in all 3 compartments improvement in POP-Q scale was statistically significant (p mesh needed re-operation. During PFS-TV in 94.1% of patients urethra was normobile or hypermobile. In all of the patients urethral end of the mesh was positioned far enough from the middle part of the urethra (ultrasound) to implant suburethral sling without risk of collision. Sexually active women did not inform of any important discomfort or pain during intercourse. It seems that six-arm OPUR mesh, if implanted under strict surgical rules, gives low risk of complications and high chance to successfully reduce POP symptoms in short term after the operation. It seems that OPUR mesh should not have negative influence on the results after anti-incontinence suburethral sling.

Evaluation of a transvaginal mesh delivery system for the correction of pelvic organ prolapse: subjective and objective findings at least 1 year after surgery.

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Culligan, Patrick J; Littman, Paul M; Salamon, Charbel G; Priestley, Jennifer L; Shariati, Amir

2010-11-01

We sought to track objective and subjective outcomes ≥1 year after transvaginal mesh system to correct prolapse. This was a retrospective cohort study of 120 women who received a transvaginal mesh procedure (Avaulta Solo, CR Bard Inc, Covington, GA). Outcomes were pelvic organ prolapse quantification values; Pelvic Floor Distress Inventory, Short Form 20/Pelvic Floor Impact Questionnaire, Short Form 7 scores; and a surgical satisfaction survey. "Surgical failure" was defined as pelvic organ prolapse quantification point >0, and/or any reports of vaginal bulge. Of 120 patients, 116 (97%) were followed up for a mean of 14.4 months (range, 12-30). In all, 74 patients had only anterior mesh, 21 only posterior mesh, and 21 both meshes. Surgical cure rate was 81%. Surgical failure was more common if preoperative point C ≥+2 (35% vs 16%; P = .04). Mesh erosion and de novo pain occurred in 11.7% and 3.3%, respectively. Pelvic Floor Distress Inventory, Short Form 20/Pelvic Floor Impact Questionnaire, Short Form 7 scores improved (P < .01). Objective and subjective improvements occurred at ≥1 year, yet failure rates were high when preoperative point C was ≥+2. Copyright © 2010 Mosby, Inc. All rights reserved.
Ectopic and extranumerary parathyroid glands location in patients with hyperparathyroidism secondary to end stage renal disease Localização de paratireóides ectópicas e extranumerárias em pacientes com hiperparatireoidismo secundário à insuficiência renal crônica

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Elaine Maria Santos Gomes

2007-04-01

óides encontradas. RESULTADOS: Foram avaliados 35 pacientes: em cinco (14,3% foi encontrada uma quinta glândula, supranumerária; dezesseis (45,7% possuíam glândulas ectópicas; as localizações mais comuns foram parênquima intratireoidiano (33,3%, trajeto conduto tireotímico (18,5% e timo (14,8%. As principais glândulas ausentes na presença de ectopia foram as inferiores esquerdas (29,6% e direitas (25,9%. A sensibilidade da ultra-sonografia e da cintigrafia com sestamibi na detecção dos nódulos foi baixa (48,3% e 35,3%, respectivamente. Além disso, 51,4% das ultra-sonografias mostraram incidentalomas tireoidianos. CONCLUSÃO: A presença de paratireóides supranumerárias e ectópicas no HPT2 é suficientemente relevante para justificar sua procura exaustiva. Como os exames de imagem pré-operatórios contribuem muito pouco para localizá-los, é necessário que se desenvolva uma rotina de exploração abrangendo as localizações mais comuns.
Zur Konstruktion von ''Männlichkeit'' bei ''Ultras'' : eine empirische Untersuchung zur Fanszene in Bremen

OpenAIRE

Guth, Oliver

2014-01-01

''Männliche'' Herrschaftsstrukturen sind innerhalb der gesamten Gesellschaft stark verbreitet. Dies spiegelt sich dementsprechend auch in Fußballfanszenen wider. Diese Arbeit untersucht daher die Konstruktion von Männlichkeit bei ''Ultras'', da diese mit ihrer starken Präsens und ihren aufwendigen Choreographien in Stadien großen Einfluss vor allem auf Jugendliche haben. Ziel der Untersuchung ist es, Mechanismen innerhalb der Fanszene aufzuzeigen um somit pädagogisch zu intervenieren, damit g...
Predictive accuracy of changes in transvaginal sonographic cervical length over time for preterm birth: a systematic review and metaanalysis.

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Conde-Agudelo, Agustin; Romero, Roberto

2015-12-01

To determine the accuracy of changes in transvaginal sonographic cervical length over time in predicting preterm birth in women with singleton and twin gestations. PubMed, Embase, Cinahl, Lilacs, and Medion (all from inception to June 30, 2015), bibliographies, Google scholar, and conference proceedings. Cohort or cross-sectional studies reporting on the predictive accuracy for preterm birth of changes in cervical length over time. Two reviewers independently selected studies, assessed the risk of bias, and extracted the data. Summary receiver-operating characteristic curves, pooled sensitivities and specificities, and summary likelihood ratios were generated. Fourteen studies met the inclusion criteria, of which 7 provided data on singleton gestations (3374 women) and 8 on twin gestations (1024 women). Among women with singleton gestations, the shortening of cervical length over time had a low predictive accuracy for preterm birth at predictive accuracy for preterm birth at predictive accuracies for preterm birth of cervical length shortening over time and the single initial and/or final cervical length measurement in 8 of 11 studies that provided data for making these comparisons. In the largest and highest-quality study, a single measurement of cervical length obtained at 24 or 28 weeks of gestation was significantly more predictive of preterm birth than any decrease in cervical length between these gestational ages. Change in transvaginal sonographic cervical length over time is not a clinically useful test to predict preterm birth in women with singleton or twin gestations. A single cervical length measurement obtained between 18 and 24 weeks of gestation appears to be a better test to predict preterm birth than changes in cervical length over time. Published by Elsevier Inc.
[Usefulness of transvaginal Doppler color in ovarian neoplasms diagnosis].

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Muñoz, H; Martínez, L; Parra, M; Cunill, E; Polanco, M; Leible, S; Romero, C

1993-01-01

The vascular resistant evaluation by Doppler waveform is a method used in clinic and research. The neoplastic malignant has an increased growth with an increased amount of neomalignant vessels. The presence of these vessels produce an increase of the transversal section area from the tumoral vascular system, therefore there is a decrease in the vascular resistance. The main objective of this work is to show the usefulness of Doppler waveform as predictor factor of malignity in ovary tumors. Eighteen patients with tumoral mass in the ovary were studied. They were between 21 and 67 years old (mean = 43). The tumoral volume and the flow resistance of blood vessels which irrigated those tumoral mass were evaluated by transvaginal ultrasound with color and pulsed Doppler. The pulsatility index (SD/media) was used. The Chi cuadrado test was used to evaluate the results. The results show the presence of six malignant tumors, three of them with low malignicity and the presence of twelve benign tumors. The age of the patients between both groups (malignant and benign tumors) were significant different (40.7 versus 52 years old, p < 0.001). The mean tumoral volume was 65 ml, with a range of 17 to 225 ml in the group of patients with benign tumors and the mean tumoral volume from patients with malignant tumors was 951 ml with a range of 141 to 3142 ml. The difference in the tumoral in both groups was significative with p < 0.001.(ABSTRACT TRUNCATED AT 250 WORDS)
Designable ultra-smooth ultra-thin solid-electrolyte interphases of three alkali metal anodes.

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Gu, Yu; Wang, Wei-Wei; Li, Yi-Juan; Wu, Qi-Hui; Tang, Shuai; Yan, Jia-Wei; Zheng, Ming-Sen; Wu, De-Yin; Fan, Chun-Hai; Hu, Wei-Qiang; Chen, Zhao-Bin; Fang, Yuan; Zhang, Qing-Hong; Dong, Quan-Feng; Mao, Bing-Wei

2018-04-09

Dendrite growth of alkali metal anodes limited their lifetime for charge/discharge cycling. Here, we report near-perfect anodes of lithium, sodium, and potassium metals achieved by electrochemical polishing, which removes microscopic defects and creates ultra-smooth ultra-thin solid-electrolyte interphase layers at metal surfaces for providing a homogeneous environment. Precise characterizations by AFM force probing with corroborative in-depth XPS profile analysis reveal that the ultra-smooth ultra-thin solid-electrolyte interphase can be designed to have alternating inorganic-rich and organic-rich/mixed multi-layered structure, which offers mechanical property of coupled rigidity and elasticity. The polished metal anodes exhibit significantly enhanced cycling stability, specifically the lithium anodes can cycle for over 200 times at a real current density of 2 mA cm -2 with 100% depth of discharge. Our work illustrates that an ultra-smooth ultra-thin solid-electrolyte interphase may be robust enough to suppress dendrite growth and thus serve as an initial layer for further improved protection of alkali metal anodes.
Comparison of the clinical and quality-of-life outcomes after the inside-out TVT-O procedure with or without concomitant transvaginal gynaecological surgery.

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Cho, M K; Kim, C H; Kang, W D; Kim, J W; Kim, S M; Kim, Y H

2012-04-01

The study was undertaken to compare the clinical and quality-of-life (QoL) outcomes of the inside-out transobturator vaginal tape (TVT-O)-only procedures and TVT-O procedures with concomitant transvaginal gynaecological surgery for the treatment of stress urinary incontinence (SUI). A review of charts from January 2006 to March 2010 identified 305 patients with urodynamic stress incontinence for whom we performed the TVT-O. Of the initial 305 patients, 272 (89.2%) were re-examined for complications 1 month, 4 months, 1 year and 2-4 years postoperatively (122 TVT-O only; 150 TVT-O + other transvaginal gynaecological surgery). They were also evaluated with the Urogenital Distress Inventory Questionnaire (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7) 1-4 years after the procedure. The median follow-up was 37.3 months. The success rate was 89.3% in the TVT-O-only group vs 93.3% in the TVT-O with concomitant gynaecological surgery group (p =0.729). The QoL score was quite good for 91.8% of the TVT-O-only patients and for 96.7% of the TVT-O with concomitant gynaecologic surgery patients (p =0.405). In conclusion, gynaecological operations performed concomitantly with the TVT-O procedure do not affect the clinical and QoL outcomes of the TVT-O procedure.
Mineral and rock chemistry of Mata da Corda Kamafugitic Rocks (Minas Gerais State, Brazil)

International Nuclear Information System (INIS)

Albuquerque Sgarbi, Patricia B. de; Valenca, Joel G.

1995-01-01

The volcanic rocks of the Mata da Corda Formation (Upper Cretaceous) in Minas Gerais, Brazil, are mafic potassic to ultra potassic rocks of kamafugitic affinity containing essentially clinopyroxenes, perovskite, magnetite and occasionally olivine, phlogopite, melilite pseudomorphs and apatite. The felsic phases are kalsilite and/or leucite pseudomorphs. The rocks are classified as mafitites, leucitites and kalsilitites. The analysis of the available data of the rocks studied, based on the relevant aspects of the main proposals for the classification of alkaline mafic to ultramafic potassic rocks leads to the conclusion that Sahama's (1974) proposal to divide potassium rich alkaline rocks in two large families is the one to which the Mata da Corda rocks adapt best. According to this and the data in the literature on the mineralogy and mineral and rock chemistries of the other similar occurrences, these rocks may be interpreted as alkaline potassic to ultra potassic rocks of hamafugitic affinity. 11 figs., 5 tabs
Occurrence, morphology and ultrastructure of the Dufour gland in Melipona bicolor Lepeletier (Hymenoptera, Meliponini Ocorrência, morfologia e ultra-estrutura da glândula de Dufour em Melipona bicolor Lepeletier (Hymenoptera, Meliponini

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Fábio Camargo Abdalla

2004-03-01

Full Text Available The occurrence, morphology and ultrastructure of the Dufour gland in Melipona bicolor Lepeletier, 1836 are presented. The Dufour gland is not present in workers. In virgin queens the gland cells show characteristics of low activity, which are described in the text. In physogastric queens the gland epithelium is higher and the cells more active than in virgin queens, showing numerous basal plasmic membrane invaginations impregnated by an electrondense material, increased apical invaginations and accumulation of substances that will be released to the gland lumen in the subcuticular space. Therefore, the data show that the Dufour gland is more developed in physogastric than in virgin queens, indicating a possible involvement of the Dufour gland in the reproduction of this species.A ocorrência, morfologia e ultra-estrutura da glândula de Dufour em Melipona bicolor Lepeletier, 1836 são apresentados. A glândula de Dufour não está presente nas operárias. Nas rainhas virgens, as células glandulares mostram características de baixa atividade, as quais são descritas no texto. Nas rainhas fisogástricas, o epitélio glandular é mais alto e as células mais ativas do que nas rainhas virgens, mostrando numerosas invaginações da membrana plasmática basal impregnadas por material eletrondenso, além do aumento da freqüência de invaginações apicais e acúmulo de substâncias no espaço subcuticular, as quais serão posteriormente liberadas ao lúmen da glândula. Portanto, os dados mostram que a glândula de Dufour é mais desenvolvida nas rainhas fisogástricas do que nas virgens, indicando um possível envolvimento da glândula de Dufour na reprodução desta espécie.
Estimativa da erodibilidade pela desagregação por ultra-som e atributos de solos com horizonte B textural Estimating soil erodibility from sonication indexes and other attributes of textural B horizon soils

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Marcos Aurélio Carolino de Sá

2004-07-01

Full Text Available A erodibilidade de solos é um fator importante na estimativa das perdas por erosão. Este fator é uma expressão da combinação de atributos do solo, os quais possibilitam sua estimativa por meio de equações. O objetivo deste trabalho foi medir atributos químicos e mineralógicos que, combinados com índices de estabilidade de agregados determinados por ultra-som, pudessem ser utilizados como variáveis em modelos na estimativa da erodibilidade de solos com horizonte B textural do Brasil. Estes atributos foram determinados em 22 solos de erodibilidade conhecida, medida diretamente em parcelas no campo. Atributos de 21 dos solos foram utilizados no ajuste dos modelos. Um dos solos (Argissolo Vermelho-Amarelo foi escolhido ao acaso para teste. De 96 variáveis, 15 foram incluídas nos modelos de estimativa da erodibilidade. A maioria delas é representada por índices de desagregação por sonificação de amostras do horizonte A. Foram obtidos quatro modelos para estimar a erodibilidade, com R² variando entre 0,83** e 0,91**. A erodibilidade pode ser estimada com base na estabilidade de agregados por ultra-som.Soil erodibility is an important factor for estimating soil erosion losses. This factor is an expression of combined soil attributes, which make possible its estimation by equations. The objective of this study was to measure some chemical and mineralogical attributes, and to combine them with aggregate stability indexes from sonication analysis, in equations in order to estimate soil erodibility of textural B horizon soils from Brazil. These attributes were measured for 22 soils that had their erodibility measured from field plots. Attributes of 21 soils were used to adjust the equations. One of the soils (Red-Yellow Argisol was used to test the equations. From 96 variables, 15 were significantly correlated to soil erodibility. Most of them are represented by the disruption indexes from sonication analysis of A horizon samples. This
Hísterossonografia tridimensional em infertilidade: estudo preliminar Three-dimensional hysterosonography in infertility: preliminary study

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Nilka F. Donadio

2004-12-01

Full Text Available OBJETIVO: comparar as informações obtidas pela ultra-sonografia pélvica e transvaginal (USG, histerossalpingografia (HSG, histeroscopia diagnóstica (HSC, ressonância nuclear magnética pélvica (RNMP e hísterossonografia tridimensional (HSSNG 3D para melhorar a acurácia e simplificar a investigação do fator uterino cervical e corporal em infertilidade conjugal. MÉTODOS: no período de janeiro a julho de 2003, cinquenta mulheres com queixa de infertilidade de, no mínimo, dois anos foram submetidas a USG, HSG, HSC, RNMP e HSSNG 3D como exames de rastreamento para o diagnóstico do fator uterino. Foram analisados o canal endocervical, endométrio, miométrio e presença de malformações uterinas. Os resultados de cada exame foram analisados e comparados. RESULTADOS: das 50 mulheres incluídas, 12 (24% apresentaram alteração em pelo menos um dos exames realizados. Quando se comparou a HSSNG 3D com a USG, a HSSNG 3D forneceu informações adicionais em 7 casos (58,3%; comparada com a HSG, forneceu informações adicionais em 7 casos (58,3%; com a HSC, em 4 casos (32,1%, e comparada à RNPM, em 6 casos (50%. Somente em dois casos a HSG detectou alterações do canal endocervical que não foram visualizadas na HSSNG 3D; em todos os outros casos a HSSNG 3D forneceu o mesmo diagnóstico ou deu informações adicionais em relação aos outros exames. A análise pelo teste kappa mostrou que existe concordância entre os diagnósticos obtidos com o uso da HSSNG 3D e a USG, HSG e RNMP. No entanto, quando se associaram os resultados da HSG e da HSSNG 3D observamos que todas as condições clínicas poderiam ter sido diagnosticadas, de forma precisa, somente com esses exames. CONCLUSÃO: a associação da HSG com a HSSNG 3D pode ser suficiente para o diagnóstico do fator uterino cervical e corporal em infertilidade, reduzindo o número de exames realizados por cada paciente, os custos totais finais, a ansiedade e o retardo para o início do
Transvaginal sonographic appearance of cystic adnexal masses in postmenopausal women

International Nuclear Information System (INIS)

Cho, Hyeun Cha; Lee, Myung Sook

2000-01-01

To Analyze the transvaginal ultrasonographic(TVUS)findings of the cystic adnexal masses in postmenopausal women for differentiation of benign and malignant masses. We retrospectively reviewed the TVUS images of surgically proven 142 cystic adnexal masses in 125 patients. The masses were classified according to the pathologic findings. The size, the internal echogenicity, the internal septation, the external wall of the masses on US were analyzed and scored using Multicenter scoring system. Serum CA-125 concentration was also recorded. At surgery of 142 masses, 125 benign (88%), and 17 borderline/malignant masses (12%) were found. Among 125 benign masses, 88 masses were larger than 5 cm, 125 had smooth external wall, 109 had absence or thin internal septation, and 107 had anechoic or homogenous low internal echogenicity. Of the 17 borderline/malignant masses, there were 17 masses larger than 5 cm, 2 with smooth external wall, 12 without or with thin internal septation, and 7 with anechoic or homogenous low internal echogenicity. Multicenter score was below 8 in all benign masses, and in 4 borderline/malignant masses. Serum CA-125 concentration with normal range was in 90 patients with benign masses, and in 2 patients with borderline/malignant masses. Cystic adnexal masses with smooth external wall and internal septation, internal echogenic portion less than 10%, score below 8 on TVUS would be diagnosed as benign masses in postmenopausal women with normal serum CA-125 concentration.
Current situation of transvaginal mesh repair for pelvic organ prolapse.

Science.gov (United States)

Zhu, Lan; Zhang, Lei

2014-09-01

Surgical mesh is a metallic or polymeric screen intended to be implanted to reinforce soft tissue or bone where weakness exists. Surgical mesh has been used since the 1950s to repair abdominal hernias. In the 1970s, gynecologists began using surgical mesh products to indicate the repair of pelvic organ prolapse (POP), and in the 1990s, gynecologists began using surgical mesh for POP. Then the U.S. Food and Drug Administration (FDA) approved the first surgical mesh product specifically for use in POP. Surgical mesh materials can be divided into several categories. Most surgical mesh devices cleared for POP procedures are composed of non-absorbable synthetic polypropylene. Mesh can be placed in the anterior vaginal wall to aid in the correction of cystocele (anterior repair), in the posterior vaginal wall to aid in correction of rectocele (posterior repair), or attached to the top of the vagina to correct uterine prolapse or vaginal apical prolapse (apical repair). Over the past decades, surgical mesh products for transvaginal POP repair became incorporated into "kits" that included tools to aid in the delivery and insertion of the mesh. Surgical mesh kits continue to evolve, adding new insertion tools, tissue fixation anchors, surgical techniques, and ab- sorbable and biological materials. This procedure has been performed popularly. It was also performed increased in China. But this new technique met some trouble recently and let shake in urogynecology.
Prostatic abscess in dogs: case reportsAbscesso prostático em cães

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Sabrina dos Santos Costa

2012-06-01

Full Text Available Fifteen cases of dogs with prostatic abscesses are reported. The animals were underwent to physical examination prioritizing the digital rectal exam associated with transabdominal palpation of the prostate gland, followed by blood cell count, measurement of serum urea, creatinine, alanine aminotransferase and alkaline phosphatase levels, abdominal’s radiographic and ultrasound exam, ultrasound and prostate’s culture. The animals were underwent to different treatments, being related to the animal’s general state, location, size and quantity of prostatic abscess. The description of the cases in question reiterates the importance of prostatic disease in canine medicine, once the detailed physical examination associated with specific complementary tests, particularly the x-ray and ultrasound, are valuable for the accurate diagnosis of dog’s prostatic diseases. Surgical procedures were effective to the treatment of prostatic abscess, with a low mortality rate. Relatam-se 15 casos de cães com abscessos prostáticos. Os animais foram submetidos a exame físico destacando-se o toque retal associado à palpação transabdominal da glândula prostática, seguidos de hemograma, dosagem das concentrações séricas de uréia, creatinina e enzimas alanino-aminotransferase e fosfatase alcalina, avaliação radiográfica e ultrassonográfica da cavidade abdominal, ultra-som e cultura da próstata. Os animais foram submetidos a tratamentos diferentes, sendo estes, relacionados ao estado geral do animal, localização, tamanho e quantidade de abscessos prostáticos. A descrição dos casos em questão reitera a importância das afecções prostáticas na clínica médica canina, sendo que o exame físico detalhado associado a exames complementares específicos, particularmente o raio-x e a ultra-sonografia, são de grande valia ao diagnóstico preciso das afecções prostáticas dos cães. As técnicas cirúrgicas empregadas mostraram-se eficazes para o
Correlação clínica e ultra-sonográfica na esclerodermia localizada cutânea Clinical and ultrasonographic correlation in localized cutaneous scleroderma

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Marcio Bouer

2008-04-01

Full Text Available OBJETIVO: Apresentar os aspectos ultra-sonográficos da esclerodermia localizada e relacioná-los com os aspectos clínicos. MATERIAIS E MÉTODOS: Foram analisadas 23 lesões de esclerodermia localizada em 21 pacientes. Foi utilizado equipamento Logiq 700 com transdutor linear de 6-14 MHz. Foram avaliados, pelo dermatologista, o estágio da doença (inflamatório ou atrófico, e pelo radiologista, a espessura e a ecogenicidade da derme nas regiões afetadas e sãs adjacentes. Foi feito acompanhamento de sete casos após tratamento. RESULTADOS: Todas as lesões apresentaram perda do padrão ultra-sonográfico normal da derme. Os casos de lesão clinicamente atrófica (52,2%; 12/23 corresponderam a redução da espessura e aumento da ecogenicidade da derme e os casos de lesão clinicamente inflamatória (47,8%; 11/23 corresponderam a aumento da espessura e redução da ecogenicidade da derme. Controles pós-tratamento mostraram alterações na espessura da derme. CONCLUSÃO: Os achados ultra-sonográficos nos permitem associar o aumento da espessura e a redução da ecogenicidade da derme com a fase inflamatória da doença, e a redução da espessura e o aumento da ecogenicidade da derme com a fase atrófica da doença. Notamos também que é possível quantificar a espessura da derme e usar essa informação no controle pós-tratamento associada à avaliação clínica.OBJECTIVE: To describe ultrasonographic findings of localized cutaneous scleroderma and correlating them with clinical findings. MATERIALS AND METHODS: Twenty-three lesions of localized cutaneous scleroderma in 21 patients were evaluated with a Logiq 700 equipment coupled with a 6-14 MHz linear transducer. The disease stage (athrophic or inflammatory was evaluated by a dermatologist, and the ultrasonographic findings (skin thickness and echogenicity for both the affected and adjacent healthy regions were evaluated by a radiologist. Seven of the cases underwent post
Influência do tratamento enzimatico sobre as características reológicas e microscópicas da polpa de acerola

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Luciana Balischi

2002-04-01

Full Text Available O consumo de sucos e bebidas à base de frutas tem aumentado consideravelmente nos últimos anos. No Brasil, destaca-se a produção da acerola (alto teor de vitamina C e de seus derivados. Objetivando melhoramentos na fabricação de sucos e derivados de frutas tropicais, surgiram pesquisas visando a encontrar o melhor tratamento enzimático. Neste trabalho, estudou-se a variação que ocorre na reologia da polpa integral de acerola submetida ao tratamento enzimático, bem como a variação no diâmetro médio das partículas, para as melhores condições de tratamento obtidas. Duas enzimas comerciais foram testadas: Citrozym Ultra L e Pectinex Ultra SP-L, variou-se as temperaturas, as concentrações das enzimas e os tempos de tratamento As características reológicas e microscópicas da polpa sofreram alterações com o tratamento enzimático.
Quality of life in women of non-reproductive age with transvaginal mesh repair for pelvic organ prolapse: A cohort study.

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Hüsch, Tanja; Mager, René; Ober, Erika; Bentler, Ralf; Ulm, Kurt; Haferkamp, Axel

2016-09-01

Transvaginal mesh repair has been discredited due to high complications rates in the past years. Therefore, we evaluated the quality of life (QoL) and complication rates after transvaginal mesh (TVM) repair for pelvic organ prolapse (POP). A total of 148 women who underwent TVM repair for symptomatic POP were retrospectively enrolled. Complication rates and functional outcomes were retrospectively assessed and validated, standardised questionnaires were used prospectively for evaluation of QoL. Univariate analysis by the chi(2)-test as well as a multivariate Cox regression analysis was conducted to predict mesh exposure using various variables as predictors. Intraoperative complications with bowel or bladder injury appeared in 3.4%. Mesh exposure occurred in 2.7% whereas surgical revision was necessary only in 1.4%. No predictor for mesh exposure could be identified. Postoperative complications according to Clavien-Dindo classification ≥ III occurred in only 2.8%. An improvement of POP-symptoms was reported by 84.6% according the "patients' global impression of improvement" (PGI-I) and 88.2% women would repeat the surgery. The results of the "prolapse-quality of life"-questionnaire were comparable to asymptomatic women. Only 33% reported vaginal pain with a mean vaginal pain score of 0.6 according the international index of pain. Of sexually active women, 29% reported sexual impairments and mean score of sexual impairment was 1.52. Low complication rates and a quality of life comparable to asymptomatic women following TVM repair could be achieved in our cohort. However, a high number of sexual impairments was identified although the impact of impairment was marginal. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.
An evaluation of the Manufacturer And User Facility Device Experience database that inspired the United States Food and Drug Administration's Reclassification of transvaginal mesh.

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Sandberg, Jason M; Gray, Ian; Pearlman, Amy; Terlecki, Ryan P

2018-03-01

To assess the utility of the Manufacturer And User Facility Device Experience (MAUDE) database in objectively capturing adverse events for transvaginal mesh in the United States. We reviewed 1,103 individual medical device reports submitted to the MAUDE database that inspired the United States (US) Food and Drug Administration's 2008 Public Health Notification. Entries were compiled into a categorical database that reported manufacturer, brand, reporter type, report source, and type of adverse event. There were numerous examples of missing, duplicated, and non-standardized entries. Analysis revealed 64 reports with duplicated information, and six reports representing multiple patients. Forty-seven percent of medical device reports did not identify a reporter source. At least 28% of reported devices are no longer on the US market. There was wide variability in the quality and completeness of submitted reports and true adverse event rates could not be accurately calculated because the number of total cases was unknown. The MAUDE database was limited in its ability to collect, quantify, and standardize real-life adverse events related to transvaginal mesh. While it functions to collect information related to isolated adverse events, systematic limitations of the MAUDE database, that no doubt extend to other medical devices, necessitate the development of new reporting systems. Alternatives are under development, which may allow regulators to more accurately scrutinize the safety profiles of specific medical devices.
A ecografia no diagnóstico das lesões músculo-tendinosas do ombro Ultrasonography findings of musculotendinous lesions of the shoulder

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Arquimedes Artur Zorzetto

2003-08-01

Full Text Available Este estudo propôs-se a revisar os aspectos relevantes da anatomia, técnica de exame e achados de imagens, com o objetivo de auxiliar o radiologista no diagnóstico diferencial frente às afecções músculo-tendinosas do ombro. Foram realizadas 34 ultra-sonografias da região do ombro, no período de janeiro a dezembro de 2001. A avaliação foi realizada com transdutores de alta freqüência (7,5-10 MHz. O exame foi normal em 23% dos pacientes (oito casos. Dos 26 casos alterados, observaram-se oito com ruptura total (30%, cinco com ruptura parcial (19%, dez com tendinopatia (38%, um com tendinopatia calcificada (3%, um com tenossinovite bicipital (3% e um com tendinopatia associada a artrite gotosa (3%. A falta de experiência e de conhecimento das principais alterações que acometem o ombro é um dos principais pontos limitantes do diagnóstico ultra-sonográfico das lesões do ombro. Portanto, o estudo dessas alterações deve ser realizado amplamente.The purpose of this study is to review the anatomical structures, ultrasonography examination technique and imaging findings in patients with musculotendinous lesions of the shoulder with the aim of helping the radiologist in the differential diagnosis of these lesions. We performed ultrasonography examinations of the shoulder using high-resolution probes (7.5-10 MHz in 34 patients from January to December, 2001. The examination was normal in eight patients (23% whereas 26 patients presented abnormalities: eight patients had total rotator cuff tears (30%, five had partial rotator cuff (19%, ten had tendinopathy (38%, one had calcified tendinopathy (3%, one had biceps tendinitis, one had biceps tendon luxation (3% and one had tendinopathy associated to crystal arthropathy (3%. The lack of experience and the insufficient knowledge about the main diseases of the shoulder are limiting factors for the diagnosis of these lesions. Therefore, a comprehensive study of the abnormalities of the
Acute pulmonary edema caused by takotsubo cardiomyopathy in a pregnant woman undergoing transvaginal cervical cerclage: A case report.

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Lee, Jae-Young; Kwon, Hyun-Jung; Park, Sang-Wook; Lee, Yu-Mi

2017-01-01

The physiological changes associated with pregnancy may predispose pregnant women to pulmonary edema. Other known causes of pulmonary edema during pregnancy include tocolytic drugs, preeclampsia, eclampsia, and peripartum cardiomyopathy. We describe a rare case of pulmonary edema caused by takotsubo cardiomyopathy in a pregnant woman at 14 weeks of gestation who was undergoing emergency transvaginal cervical cerclage. Intraoperative chest radiography revealed severe pulmonary edema and echocardiography indicated moderate left ventricular dysfunction with akinesia of the mid to apical left ventricular wall segment, which is reflective of takotsubo cardiomyopathy. With early detection and appropriate management, the patient was stabilized in a relatively short period of time. Based on her clinical signs and symptoms, we suspect that the pulmonary edema was caused by takotsubo cardiomyopathy.

Early experience with mesh excision for adverse outcomes after transvaginal mesh placement using prolapse kits.

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Ridgeway, Beri; Walters, Mark D; Paraiso, Marie Fidela R; Barber, Matthew D; McAchran, Sarah E; Goldman, Howard B; Jelovsek, J Eric

2008-12-01

The purpose of this study was to determine the complications, treatments, and outcomes in patients choosing to undergo removal of mesh previously placed with a mesh procedural kit. This was a retrospective review of all patients who underwent surgical removal of transvaginal mesh for mesh-related complications during a 3-year period at Cleveland Clinic. At last follow-up, patients reported degree of pain, level of improvement, sexual activity, and continued symptoms. Nineteen patients underwent removal of mesh during the study period. Indications for removal included chronic pain (6/19), dyspareunia (6/19), recurrent pelvic organ prolapse (8/19), mesh erosion (12/19), and vesicovaginal fistula (3/19), with most patients (16/19) citing more than 1 reason. There were few complications related to the mesh removal. Most patients reported significant relief of symptoms. Mesh removal can be technically difficult but appears to be safe with few complications and high relief of symptoms, although some symptoms can persist.
Válvula de uretra anterior Anterior urethral valves

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Silvio Tucci Jr.

2003-02-01

Full Text Available Objetivo: apresentar os aspectos clínicos, diagnósticos e terapêuticos de pacientes portadores de válvula da uretra anterior. Descrição: em dois neonatos, o diagnóstico presuntivo de patologia obstrutiva do trato urinário foi sugerido pela ultra-sonografia realizada no período pré-natal, confirmando-se o diagnóstico de válvula de uretra anterior pela avaliação pós-natal. Os pacientes foram submetidos a tratamento cirúrgico paliativo, com vesicostomia temporária e, posteriormente, definitivo, pela fulguração endoscópica das válvulas. Ambos evoluíram com função renal normal. Comentários: a válvula da uretra anterior é anomalia rara que deve ser considerada em meninos com quadro radiológico pré-natal sugestivo de obstrução infravesical, secundariamente à hipótese mais comum de válvula da uretra posterior. Ressaltamos a utilização da vesicostomia como derivação urinária temporária nestes casos, prevenindo potenciais complicações pela manipulação da uretra do recém-nascido.Objective: to discuss clinical signs, diagnostic tools and therapeutics of anterior urethral valves, an obstructive anomaly of the urinary system in males. Description: signs of urinary tract obstruction were identified on pre-natal ultrasound in two male fetuses and the diagnosis of anterior urethral valves was made through post-natal evaluation. As an initial treatment, vesicostomy was performed in both patients. Later, the valves were fulgurated using an endoscopic procedure. During the follow-up period both patients presented normal renal function. Comments: anterior urethral valves are a rare form of urethral anomaly that must be ruled out in boys with pre-natal ultrasound indicating infravesical obstruction. Vesicostomy used as an initial treatment rather than transurethral fulguration may prevent potential complications that can occur due to the small size of the neonatal urethra.
Alterações na gasometria de fetos aloimunizados após procedimento de transfusão intra-uterina

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Nomura Roseli Mieko Yamamoto

2003-01-01

Full Text Available OBJETIVO: este estudo, realizado em gestações com aloimunização pelo fator Rh, tem como objetivo descrever as alterações gasométricas e do equilíbrio ácido-básico fetal antes e após transfusões intra-uterinas (TIU. MÉTODO: no período de junho de 2001 a outubro de 2001, antes e após a TIU em fetos de gestantes aloimunizadas, foram avaliados prospectivamente a gasometria e o equilíbrio ácido-básico no sangue da veia umbilical. As medidas foram realizadas em 8 amostras de sangue de 5 fetos. O sangue fetal foi obtido por cordocentese da veia umbilical antes e após TIU. Os resultados obtidos foram comparados com a expansão volêmica na TIU, a idade gestacional no procedimento, o peso fetal estimado pela ultra-sonografia e as variações da hemoglobina fetal (g/dL. RESULTADOS: em todos os casos foi observada queda nos valores do pH, com redução média de 0,09 (DP=0,02. A hemoglobina fetal apresentou aumento médio de 8,4 g/dL (DP=2,9 g/dL. Foi constatada também variação negativa da pO2 (média = -1,28 mmHg na concentração de HCO3_ (média = _2,25 mEq/l. Houve aumento da pCO2 (média = 3,2 mmHg e redução nos valores do excesso de bases (média = -3,75. CONCLUSÃO: a análise das gasometrias permite concluir que o procedimento de TIU acompanha-se de queda nos valores do pH de sangue de veia umbilical, demonstrando haver acidemia fetal relativa após o procedimento.
Ultra-som terapêutico contínuo térmico em modelo experimental de ciatalgia Continuous thermic therapeutic ultrasound in sciatica experimental model

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Adriano Polican Ciena

2009-06-01

Full Text Available O ultra-som é um recurso fisioterapêutico que pode atuar na redução dos sintomas da ciatalgia. O objetivo deste estudo foi verificar a eficácia do ultra-som terapêutico, no modo contínuo, em duas diferentes densidades de potência (0,5 W/cm² e 1 W/cm², na redução do quadro álgico em ratos submetidos a modelo experimental de ciatalgia. Foram utilizados 20 ratos, divididos em 3 grupos: G1 (n=6 submetido à ciatalgia e a tratamento placebo; G2 (n=7 submetido à ciatalgia e tratado com ultra-som com 0,5 W/cm²; e G3 (n=7 submetido à ciatalgia e tratado com ultra-som com 1 W/cm². A ciatalgia foi provocada por lesão cirúrgica de compressão do nervo no membro posterior direito de todos os animais. O tratamento na região do procedimento cirúrgico, iniciado no 3º dia pós-operatório, consistiu em 10 sessões diárias de 5 minutos. Verificou-se a dor pelo do tempo de elevação da pata (TEP durante a marcha, medido pré-cirurgia e em mais cinco momentos. Os resultados mostram aumentos no TEP em todos os grupos após a lesão; e, naqueles tratados com ultra-som terapêutico, houve diminuição significativa da TEP, restaurando-se os valores iniciais, sendo mais precoce e intensa em G2. Conclui-se que a entrega na forma continua do ultra-som terapêutico foi eficaz na redução da dor ciática.Therapeutic ultrasound is a physical therapy resource for relieving sciatic pain. The aim of this study was to assess the effectiveness of continuous therapeutic ultrasound in two different power densities (0,5 W/cm² and 1 W/cm², on reducing pain in rats submitted to a sciatica experimental model. Twenty rats were used, divided into 3 groups: G1 (n=6 submitted to sciatica and placebo treatment; G2 (n=7 submitted to sciatica and treated with 0.5 W/cm² ultrasound; and G3 (n=7, submitted to sciatica and treated with 1 W/cm² ultrasound. Sciatica was provoked by surgical nerve compression on the right posterior limb of all animals. Treatment on the
Physiology and Pathophysiology in Ultra-Marathon Running

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Beat Knechtle

2018-06-01

Full Text Available In this overview, we summarize the findings of the literature with regards to physiology and pathophysiology of ultra-marathon running. The number of ultra-marathon races and the number of official finishers considerably increased in the last decades especially due to the increased number of female and age-group runners. A typical ultra-marathoner is male, married, well-educated, and ~45 years old. Female ultra-marathoners account for ~20% of the total number of finishers. Ultra-marathoners are older and have a larger weekly training volume, but run more slowly during training compared to marathoners. Previous experience (e.g., number of finishes in ultra-marathon races and personal best marathon time is the most important predictor variable for a successful ultra-marathon performance followed by specific anthropometric (e.g., low body mass index, BMI, and low body fat and training (e.g., high volume and running speed during training characteristics. Women are slower than men, but the sex difference in performance decreased in recent years to ~10–20% depending upon the length of the ultra-marathon. The fastest ultra-marathon race times are generally achieved at the age of 35–45 years or older for both women and men, and the age of peak performance increases with increasing race distance or duration. An ultra-marathon leads to an energy deficit resulting in a reduction of both body fat and skeletal muscle mass. An ultra-marathon in combination with other risk factors, such as extreme weather conditions (either heat or cold or the country where the race is held, can lead to exercise-associated hyponatremia. An ultra-marathon can also lead to changes in biomarkers indicating a pathological process in specific organs or organ systems such as skeletal muscles, heart, liver, kidney, immune and endocrine system. These changes are usually temporary, depending on intensity and duration of the performance, and usually normalize after the race. In
Cisto de colédoco: experiência de cinco anos com o tratamento cirúrgico no hospital municipal JESUS-RJ

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Lisieux Eyer de Jesus

Full Text Available OBJETIVO: Relatar a experiência no diagnóstico e tratamento do cisto de colédoco no Hospital Municipal Jesus em cinco anos (1996-2001 e a experiência brasileira publicada para o tratamento do cisto de colédoco em crianças. MÉTODO: Avaliação prospectiva dos pacientes operados com o diagnóstico de cisto de colédoco em cinco anos no Hospital Municipal Jesus. RESULTADOS: Houve predomínio de casos diagnosticados pela presença de dor abdominal recorrente, icterícia e/ou massa abdominal palpável. Apenas dois pacientes apresentavam a tríade completa. Todos os pacientes foram submetidos à ultra-sonografia e houve dúvida no diagnóstico ultra-sonográfico em apenas dois. Todos eram cistos do tipo 1 de Todani tratados através de ressecção completa e anastomose biliodigestiva em Y Roux. Houve complicações pós-operatórias imediatas em três pacientes: um caso de hemorragia digestiva alta e dois casos de fístula biliar, um deles relacionado a problemas técnicos na anastomose que necessitou de reoperação. O seguimento variou de quatro meses a cinco anos, sem detecção de complicação tardia em nenhum caso. CONCLUSÕES: O tratamento do cisto de colédoco através da ressecção completa na criança é seguro, relacionado a poucas complicações e capaz de resolver por completo a sintomatologia pré-operatória dos pacientes.
Use of transvaginal ultrasound in females with primary bladder neck obstruction. A preliminary study

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Vikiela Galica

2015-07-01

Full Text Available Introduction and aim: The video-urodynamics study is the principal exam to establish a possible primary bladder neck obstruction (PBNO condition. While trans-rectal ultrasonography plays an important role in the evaluation of the low urinary tract symptoms (LUTS and the severity of bladder outlet obstruction (BOO in men, the use of the transvaginal ultrasound (TVUS in women with symptoms suggesting BOO remains unclear. We tried to check the utility of the TVUS in women with PBNO condition. Material and methods: We selected female patients which presented BOO without pelvic organ prolapse (POP. According to the data of the video-urodynamic exam we selected the patients with the suspicion of PBNO. A TVUS in basal and during micturition was performed before and after surgery. Results: TVUS showed a closed bladder neck bladder in basal condition and during micturition similarly to the fluoroscopic image during video-urodynamics. The mean distance from bladder neck to the vaginal mucosa resulted 1.3 cm in this patients. Conclusions: TVUS results worthy in the evaluation of patients with PBNO before and after surgery.
Racial and ethnic disparities in universal cervical length screening with transvaginal ultrasound

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Haviland, Miriam J; Shainker, Scott A; Hacker, Michele R; Burris, Heather H

2016-01-01

Objective Determine if race or ethnicity is associated with missed or late transvaginal cervical length screening in a universal screening program. Methods Retrospective cohort study of nulliparous women with singleton gestations and a fetal anatomical ultrasound from 16-24 weeks' gestation from January, 2012 through November, 2013. We classified women into mutually exclusive racial and ethnic groups: non-Hispanic black (black), Hispanic, Asian, non-Hispanic white (white), and other or unknown race. We used log-binomial regression to calculate the risk ratio (RR) and 95% confidence interval (CI) of missed or late (≥ 20 weeks' gestation) screening vs. optimally-timed screening between the different racial and ethnic groups. Results Among the 2 967 women in our study population, 971 (32.7%) had either missed or late cervical length screening. Compared to white women, black (RR: 1.3; 95% CI:1.1-1.5) and Hispanic (RR:1.2; 95% CI:1.01-1.5) women were more likely to have missed or late screening. Among women screened, black (vs. white) women were more likely to be screened late (RR: 2.2; 95% CI: 1.6-3.1). Conclusions Black and Hispanic women may be more likely to have missed or late cervical length screenings. PMID:26987873
Transvaginal Mesh and Transanal Resection to Treat Outlet Obstruction Constipation Caused by Rectocele.

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Shi, Yang; Yu, Yongjun; Zhang, Xipeng; Li, Yuwei

2017-02-01

BACKGROUND The aim of this study was to evaluate the curative effect of transvaginal mesh repair (TVMR) and stapled transanal rectal resection (STARR) in treating outlet obstruction constipation caused by rectocele. MATERIAL AND METHODS Patients who had outlet obstruction constipation caused by rectocele were retrospectively analyzed and 39 patients were enrolled the study. Patients were assigned to either the TVMR or STARR group. Postoperative factors such as complications, pain, recurrence rate, and operative time were compared between the 2 groups. RESULTS Total effective rate was 100% in both groups. No long-term chronic pain occurred and discomfort rate of tenesmus was higher in the STARR group than in the TVMR group. Postoperative defecography showed that the rectocele depth was significantly reduced, and the prolapse of the rectal mucosa and the lower rectal capacity was also decreased. Four cases had mesh exposure in the TVMR group and 2 cases in the STARR group had anastomotic bleeding after the surgery. CONCLUSIONS For outlet obstruction constipation caused by rectocele, TVMR and STARR both obtained satisfactory results. Although TVMR is complex with longer operative time and hospitalization period, its long-term effect is better than that of STARR.
Transvaginal Mesh and Transanal Resection to Treat Outlet Obstruction Constipation Caused by Rectocele

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Shi, Yang; Yu, Yongjun; Zhang, Xipeng; Li, Yuwei

2017-01-01

Background The aim of this study was to evaluate the curative effect of transvaginal mesh repair (TVMR) and stapled transanal rectal resection (STARR) in treating outlet obstruction constipation caused by rectocele. Material/Methods Patients who had outlet obstruction constipation caused by rectocele were retrospectively analyzed and 39 patients were enrolled the study. Patients were assigned to either the TVMR or STARR group. Postoperative factors such as complications, pain, recurrence rate, and operative time were compared between the 2 groups. Results Total effective rate was 100% in both groups. No long-term chronic pain occurred and discomfort rate of tenesmus was higher in the STARR group than in the TVMR group. Postoperative defecography showed that the rectocele depth was significantly reduced, and the prolapse of the rectal mucosa and the lower rectal capacity was also decreased. Four cases had mesh exposure in the TVMR group and 2 cases in the STARR group had anastomotic bleeding after the surgery. Conclusions For outlet obstruction constipation caused by rectocele, TVMR and STARR both obtained satisfactory results. Although TVMR is complex with longer operative time and hospitalization period, its long-term effect is better than that of STARR. PMID:28146137
Laminite experimental: aspectos morfológicos, morfométricos e ultra-estruturais das lâminas dérmicas e epidérmicas do casco de eqüinos tratados com a trinitroglicerina

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Sampaio, Rita de Cássia de Lima [UNESP

2007-01-01

As alterações ultra-estruturais ocorridas nas lâminas epidérmicas e dérmicas de eqüinos com laminite são responsáveis pela rotação ou afundamento da falange distal dentro do casco. Com o objetivo de prevenir esta ocorrência foram estudados os efeitos da sobrecarga de carboidratos (SCHO), assim como da utilização de trinitroglicerina na fase prodrômica da laminite, nas lâminas epidérmicas do casco de quinze eqüinos. A indução da laminite por meio da sobrecarga de carboidratos alterou siginific...
Apendicite aguda: achados na tomografia computadorizada - ensaio iconográfico Acute appendicitis: computed tomography findings - an iconographic essay

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Marcelo Eustáquio Montandon Júnior

2007-06-01

Full Text Available A apendicite aguda é a causa mais comum de dor abdominal aguda que requer intervenção cirúrgica no mundo ocidental. O diagnóstico precoce é essencial para minimizar a morbidade da doença. O uso dos métodos de imagem significou grande avanço no diagnóstico desta entidade, até então avaliada apenas com base na história clínica, exame físico e dados laboratoriais, haja vista que 20% a 33% dos pacientes apresentam sintomas atípicos. O diagnóstico é mais difícil nas crianças, nos idosos e nas mulheres em idade fértil. Os principais métodos de imagem para sua avaliação são a ultra-sonografia e a tomografia computadorizada. Os objetivos deste trabalho são: descrever a fisiopatologia da doença, comentar os principais aspectos técnicos da tomografia computadorizada, demonstrar e ilustrar os achados tomográficos e citar os principais diagnósticos diferenciais.Acute appendicitis is the most important cause of abdominal pain requiring surgical intervention in the Western world. The early diagnosis of this disease is of paramount relevance for minimizing its morbidity. Imaging methods have represented a huge progress in the diagnosis of this entity, which used to be based essentially on clinical history, physical examination and laboratory tests results, considering that 20% to 33% of patients present with atypical symptoms. Diagnostic difficulty is higher in children, the elderly, and women in childbearing age. The main imaging methods for evaluation of acute appendicitis are ultrasound and computed tomography. The present study is aimed at describing the disease physiopathology, commenting main computed tomography technical aspects, demonstrating and illustrating tomographic findings, and describing main differential diagnoses.
[Three years results of transvaginal cystocele repair with polypropylene mesh using a tension-free technique].

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El Harrech, Y; Ameur, A; Janane, A; Moufide, K; Ghadouane, M; Abbar, M

2010-01-01

To evaluate the long term efficacy and safety of transvaginal implantation of a non-resorbable synthetic prosthesis (Gynemesh) for the treatment of cystocele using transvaginal free tension technique. Prospective study of patients that have been submitted to correction of cystocele between April 2004 and July 2007. A prolene mesh was cut to an appropriate size to cover the whole cystocele leaving two tabs on each side. The two tabs of the mesh were then placed in paravaginal spaces, tension free, without stitches. Mesh was used in 31 patients. All patients had a symptomatic cystocele >or= 2 according to Baden-Walker halfway classification. Patients were reviewed initially at 1 and 3 month and then every 6 months. The mean age of the patients was 58 years (range: 47-70 years). Mean parity was 5.8 (range 1-11), and mean weight was 75 kg (range 60-82Kg). All women were postmenopausal. The operation was combined with vaginal hysterectomy in 2 patients, Posterior colporraphy in 2 patients, Perineorrhaphy in 1 patient, Sacrospinous fixation in 2 patients, transobturator tape for stress urinary incontinence in 7 women. Average time of surgery was 23 minutes for cystocele. There were no major complications, such as trauma to the bladder, urethra, bowels, or large vessels in the patient group treated. There was no immediate postoperative complications (up to 7 days) recorded. No hematoma or infection was observed in the operative area. Mesh erosion was detected in one patient. It was treated by excision of the eroded part of the mesh. Mean follow-up was 36.4 months (18 to 52 months). Using our definition of success based on both anatomic and functional outcomes, the overall cure rate was 74.19% (asymptomatic with no or grade 1 cystocele). The improvement rate (asymptomatic with a grade 2 cystocele) was 19.35% and the overall failure rate (symptomatic or with a grade 3 or 4 cystocele) was only 6.4% (2 women). The interposition of a sub-vesical transversal tension
Complications of Transvaginal Mesh for Pelvic Organ Prolapse and Stress Urinary Incontinence: Tips for Prevention, Recognition, and Management.

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MacDonald, Susan; Terlecki, Ryan; Costantini, Elisabetta; Badlani, Gopal

2016-08-01

Mesh-related complications following transvaginal management of pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI) have received significant attention in the last decade. We sought to identify patient, product, and technical factors associated with an increased risk of complications after mesh-based transvaginal repair of anterior POP and SUI. In this review we clarify the different pattern of complications after POP and SUI repairs. Our aim is to provide a practical evidence-based guide for physicians to prevent and, if necessary, manage product-associated complications in a stepwise manner. We conducted a comprehensive PubMed search of all English-language articles published from 2010 to June 2016, using these search terms: mesh, pelvic organ prolapse, and stress urinary incontinence. Expert opinion is also provided. Mesh-related complications are much lower after repair of SUI compared with POP, despite its more frequent use. Vaginal exposure is the most common mesh-specific complication. Patients may present with vaginal discharge, dyspareunia, pain, recurrent urinary tract infection, and/or hematuria. Conversely, patients may be asymptomatic. Small asymptomatic mesh exposures (mesh encountered within the urinary tract must be fully excised. Following excision, pain may persist in up to 50% of patients. Vaginal extrusion, persistent pain, and urethral and/or bladder erosion are the three most common product-specific complications following mesh-based repair for SUI or POP. Conservative therapies may be attempted, but most patients ultimately require partial or complete mesh excision. We reviewed the recent literature on mesh-related complications after repair of pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Vaginal exposure, persistent pain, and erosion into the urinary tract are the most common. These often require surgical management, best suited to a urologist with training and experience in this area. Evidence supports
Graphic and haptic simulation for transvaginal cholecystectomy training in NOTES.

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Pan, Jun J; Ahn, Woojin; Dargar, Saurabh; Halic, Tansel; Li, Bai C; Sankaranarayanan, Ganesh; Roberts, Kurt; Schwaitzberg, Steven; De, Suvranu

2016-04-01

Natural Orifice Transluminal Endoscopic Surgery (NOTES) provides an emerging surgical technique which usually needs a long learning curve for surgeons. Virtual reality (VR) medical simulators with vision and haptic feedback can usually offer an efficient and cost-effective alternative without risk to the traditional training approaches. Under this motivation, we developed the first virtual reality simulator for transvaginal cholecystectomy in NOTES (VTEST™). This VR-based surgical simulator aims to simulate the hybrid NOTES of cholecystectomy. We use a 6DOF haptic device and a tracking sensor to construct the core hardware component of simulator. For software, an innovative approach based on the inner-spheres is presented to deform the organs in real time. To handle the frequent collision between soft tissue and surgical instruments, an adaptive collision detection method based on GPU is designed and implemented. To give a realistic visual performance of gallbladder fat tissue removal by cautery hook, a multi-layer hexahedral model is presented to simulate the electric dissection of fat tissue. From the experimental results, trainees can operate in real time with high degree of stability and fidelity. A preliminary study was also performed to evaluate the realism and the usefulness of this hybrid NOTES simulator. This prototyped simulation system has been verified by surgeons through a pilot study. Some items of its visual performance and the utility were rated fairly high by the participants during testing. It exhibits the potential to improve the surgical skills of trainee and effectively shorten their learning curve. Copyright © 2016 Elsevier Inc. All rights reserved.
Cistos primários do epitélio pigmentar da íris e corpo ciliar: aspectos de biomicroscopia ultra-sônica Primary cysts of the iris and ciliary body pigment epithelium: ultrasound biomicroscopy features

Directory of Open Access Journals (Sweden)

Bernadete Ayres

2000-10-01

Full Text Available Objetivo: Descrever as características, incidência e distribuição dos cistos primários de epitélio pigmentar de íris e corpo ciliar ao exame de biomicroscopia ultra-sônica, que devem ser diferenciados de lesões sólidas. Métodos: Foram estudados de modo retrospectivo os prontuários de 73 pacientes, 82 olhos, com diagnóstico ecográfico de cisto primário de íris ou corpo ciliar durante o período de janeiro/97 a dezembro/99. Utilizou-se o biomicroscópio ultra-sônico, aplicando técnicas padronizadas de imersão. Resultados: À biomicroscopia ultra-sônica os cistos caracterizaram-se por apresentarem paredes finas e regulares, e conteúdo anecóico. Quarenta e oito pacientes (65,7% eram do sexo feminino. A maior incidência (28,8% ocorreu para o grupo incluído no intervalo de 20 a 29 anos de idade. Observou-se uma característica distribuição, predominantemente nos quadrantes temporais inferiores. Conclusões: A biomicroscopia ultra-sônica mostrou-se útil no diagnóstico de cistos primários do epitélio pigmentar da íris e do corpo ciliar, auxiliando na diferenciação de patologias tumorais e avaliando possíveis complicações. O conhecimento dos critérios ecográficos e da distribuição epidemiológica facilitam o diagnóstico destas lesões.Purpose: To describe the ultrasound biomicroscopic characteristics, incidence, distribution and location of primary cysts of the iris and ciliary body pigment epithelium, and to differentiate them from solid lesions. Methods: A retrospective study was performed through a review of charts of 73 patients, 82 eyes, with echographic diagnosis of primary cysts of the iris and ciliary body pigment epithelium during a 36-month period (January/97 through December/99. All examinations were performed using an ultrasound biomicroscope applying standard immersion techniques. Results: Ultrasound biomicroscopy revealed typical findings of the primary cysts of the pigment epithelium such as thin
Avaliação "in vivo" da composição corporal e da carcaça de caprinos: uso de ultrasonografia

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Alfredo Teixeira

2008-07-01

Full Text Available Atendendo ao crescente interesse na produção e consumo de carne de caprinos e à cada vez maior necessidade de recorrer a metodologias rápidas que proporcionem a predição da composição corporal e qualidade da carcaça, realizamos uma revisão dos últimos trabalhos realizados com recurso à técnica dos ultra-sons. Após uma breve resenha histórica sobre a evolução do uso do método na caprinicultura, são referidos os princípios da técnica e a sua aplicação aos caprinos (operador, identificação de pontos anatómicos de medida, diferentes medidas corporais e na carcaça, tipos de aparelhos e sondas e acondicionamento animal. São posteriormente analisados os resultados das principais pesquisas recentemente efectuadas. Finalmente são discutidas as expectativas futuras para o uso da técnica de ultra-sons na avaliação in vivo de caprinos, com referência a diferentes procedimentos para a obtenção de modelos de predição.Considering the increasing interest in the production and meat goat consumption and the necessity to appeal the rapid methodologies that provide to predict the body composition and quality of the carcass, we carry through a revision of the last works using ultrasound technology. After a brief history description about the evolution of the use of ultrasound methods in goats, the main important principles of the technique and its application in goats are refereed (operator, anatomical point's identification for measurements, different body and carcass measures, types of probes and equipment and animal handling. The most recent results of works in goats to predict carcass composition were mentioned. Finally the future expectations for the use of ultrasound technology to evaluate in vivo goats are discussed with a reference of different procedures to obtain the prediction models.
Determinação ultra-sonográfica do sexo fetal pela medida dos ângulos do apêndice genital Sonographic determination of fetal gender by measurement of the angles of the genital tubercle

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Victor Bunduki

2005-06-01

Full Text Available OBJETIVO: avaliar a acurácia da ultra-sonografia para predição do sexo fetal entre a 11ª e a 13ª semana e 6 dias por meio da medida dos ângulos anterior e posterior do apêndice genital. MÉTODOS: os ângulos anterior e posterior do apêndice genital foram medidos em corte sagital de 455 fetos entre a 11ª e a 13ª semana e 6 dias. A probabilidade de predição correta do sexo fetal (confirmado após o nascimento foi categorizada de acordo com a medida dos ângulos, idade gestacional e comprimento crânio-caudal. Os pontos de corte de melhor acurácia para predizer o sexo fetal foram obtidos por meio de curva ROC. A variação interobservador foi avaliada pelo método de Bland-Altman. RESULTADOS: a taxa de predição correta do sexo fetal se elevou com a idade gestacional e comprimento crânio-nádegas. Utilizando o ponto de corte de 42 graus para o ângulo anterior (curva ROC, a predição correta do sexo fetal ocorreu em 72% dos fetos da 11ª à 11ª semana e 6 dias, 86% da 12ª à 12ª semana e 6 dias e 88% da 13ª à 13ª semana e 6 dias. As taxas de predição obtidas com o ângulo posterior (ponto de corte de 24 graus foram, respectivamente: 70, 87 e 87%. A avaliação da variação interobservador revelou diferença média entre medidas pareadas de 15,7 e 9 graus para as medidas dos ângulos posterior e anterior, respectivamente. CONCLUSÃO: a acurácia da medida dos ângulos do apêndice genital na predição do sexo fetal foi elevada a partir da 12ª semana de gestação mas ainda insuficiente para sua aplicação em gestações com risco de doenças graves ligadas ao cromossomo X.PURPOSE: to evaluate the accuracy of fetal gender prediction at 11 to 13 weeks and 6 days by measuring the anterior and posterior genital tubercle angles. MESTHODS: the anterior and posterior genital tubercle angles were measured in a midsagittal plane in 455 fetuses from 11 to 13 weeks and 6 days. The probability of a correct fetal sex prediction
Estudo da eficiência das ondas de ultra-som em relação ao hipoclorito de sódio e à filtração adsorção na eliminação de microrganismos em estação de tratamento de água

OpenAIRE

Bello, Antonio Roberto Crystal [UNESP

2003-01-01

Este estudo realizado em mini Estação de Tratamento de Água (ETA-CB) relata a comparação entre diferentes processos como ondas ultra-sônicas, cloração e filtração-adsorção na eliminação de microrganismos e adequação de outros parâmetros exigidos para água de abastecimento público. Para avaliar a influência de cada processo de desinfecção e também dos processos de coagulação - floculação, decantação e filtração foi projetada e construída uma ETA em escala piloto, constituída de caixa de entrad...
Guidelines for providing privileges and credentials to physicians for transvaginal placement of surgical mesh for pelvic organ prolapse.

Science.gov (United States)

2012-01-01

The adoption of new technology or procedures into a clinician's surgical armamentarium is driven by multiple factors. Patient safety and anticipated long-term improvement in outcomes should be the primary objective that guides a surgeon's decision to deliver care involving new procedures. Surgically complex procedures require a balance of knowledge, surgical skill, and experience, with appropriate ongoing surgical volume and monitoring of outcomes and adverse events. Transvaginal placement of surgical mesh for pelvic organ prolapse has the potential to improve quality of life and anatomic outcomes (especially in the anterior compartment), but also has potential serious adverse events as outlined by the FDA's July 2011 Safety Communication. This document provides Guidelines for privileging and credentialing of physicians planning to implement or continue using this new technology in clinical practice.

Preoperative diagnosis of fallopian tube malignancy with transvaginal color doppler ultrasonography and magnetic resonance imaging after negative hysteroscopy for postmenopausal bleeding.

Science.gov (United States)

Arko, Darja; Žegura, Branka; Virag, Mirjana; Fokter Dovnik, Nina; Takač, Iztok

2014-09-01

Primary fallopian tube carcinoma is a rare malignancy and is not often diagnosed preoperatively. We present a case of a 67-year-old woman who complained of postmenopausal vaginal bleeding. After a negative hysteroscopy, transvaginal ultrasound showed a well vascularized solid-cystic tumor in the adnexal region separate from the ovary. The presence of an adnexal mass was confirmed by MR imaging. Total abdominal hysterectomy with bilateral salpingoophorectomy, omentectomy and appendectomy, as well as pelvic and paraaortic lymphadenectomy was performed. The pathohistological diagnosis was poorly differentiated serous adenocarcinoma of the fallopian tube, FIGO stage IA. The patient was subsequently treated with platinum based adjuvant chemotherapy.
Efeitos do ultra-som terapêutico sobre o crescimento longitudinal do fêmur e da tíbia em ratos Effects of therapeutic ultrasound on longitudinal growth of the femur and tibia in rats

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Alfredo Alcantara Barreto

2011-01-01

Full Text Available OBJETIVO: Estudar efeitos do ultra-som terapêutico sobre o crescimento do fêmur e da tíbia, em ratos jovens. MÉTODO: Ratus norvegicus com quatro semanas de vida, machos, totalizando 115 animais, divididos em quatro grupos, foram submetidos ao ultra-som terapêutico (0,8 MHz, cabeçote fixo, pulso contínuo, por dez minutos, durante dez dias, na face medial do joelho direito, nas potências de 0,0 W/cm2 (grupo controle, 0,5 W/cm2 (grupo G2, 1,0 W/cm2 (grupo G3, e 1,5 W/cm2 (grupo G4. Lâminas histológicas da epífise, placa de crescimento e metáfise e as medidas dos comprimentos do fêmur e da tíbia foram estudadas na sexta, décima terceira e vigésima sexta semanas de vida. Os dados foram submetidos à análise de variância - fatorial inteiramente aleatorizado. RESULTADO: Nenhuma alteração estatística do crescimento ósseo foi estabelecida entre quaisquer dos três grupos tratados e o grupo controle. Entretanto, alterações sugestivas de diminuição do crescimento do fêmur e da tíbia de G4 em relação a G2 e G3, foram evidenciadas. No grupo G4 alterações histopatológicas como necroses celulares e neoformação óssea, pós-necrose, foram encontradas. CONCLUSÃO: Quando comparados os grupos tratados com o grupo controle, não há evidência estatística de estímulo ou inibição ao crescimento ósseo pela aplicação do ultra-som terapêutico. Nível de Evidência: Nível II, estudo coorte transversal.OBJECTIVES: To determine the effects of ultrasound therapy on the femur and tibia growth in young rats. METHOD: Four-week-old male Ratus Norvegicus totaling 115 animals, divided into four groups, were submitted to ultrasound therapy (0.8 MHz, fixed tube head, continuous pulse, for 10 minutes, once a day, ten times on the medial face of the right knee, with powers of 0.0 W/cm2 (group G1, 0.5 W/cm2 (group G2, 1.0 W/cm2 (group G3, and 1.5 W/cm2 (group G4. Histological slides of the epiphysis, growth plate and metaphysis and the
Ultra-high temperature direct propulsion

International Nuclear Information System (INIS)

Araj, K.J.; Slovik, G.; Powell, J.R.; Ludewig, H.

1987-01-01

Potential advantages of ultra-high exhaust temperature (3000 K - 4000 K) direct propulsion nuclear rockets are explored. Modifications to the Particle Bed Reactor (PBR) to achieve these temperatures are described. Benefits of ultra-high temperature propulsion are discussed for two missions - orbit transfer (ΔV = 5546 m/s) and interplanetary exploration (ΔV = 20000 m/s). For such missions ultra-high temperatures appear to be worth the additional complexity. Thrust levels are reduced substantially for a given power level, due to the higher enthalpy caused by partial disassociation of the hydrogen propellant. Though technically challenging, it appears potentially feasible to achieve such ultra high temperatures using the PBR
An evaluation of the Manufacturer And User Facility Device Experience database that inspired the United States Food and Drug Administration's Reclassification of transvaginal mesh

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Jason M. Sandberg

2018-03-01

Full Text Available Purpose: To assess the utility of the Manufacturer And User Facility Device Experience (MAUDE database in objectively capturing adverse events for transvaginal mesh in the United States. Materials and Methods: We reviewed 1,103 individual medical device reports submitted to the MAUDE database that inspired the United States (US Food and Drug Administration's 2008 Public Health Notification. Entries were compiled into a categorical database that reported manufacturer, brand, reporter type, report source, and type of adverse event. Results: There were numerous examples of missing, duplicated, and non-standardized entries. Analysis revealed 64 reports with duplicated information, and six reports representing multiple patients. Forty-seven percent of medical device reports did not identify a reporter source. At least 28% of reported devices are no longer on the US market. There was wide variability in the quality and completeness of submitted reports and true adverse event rates could not be accurately calculated because the number of total cases was unknown. Conclusions: The MAUDE database was limited in its ability to collect, quantify, and standardize real-life adverse events related to transvaginal mesh. While it functions to collect information related to isolated adverse events, systematic limitations of the MAUDE database, that no doubt extend to other medical devices, necessitate the development of new reporting systems. Alternatives are under development, which may allow regulators to more accurately scrutinize the safety profiles of specific medical devices.
ULTRA-LIGHTWEIGHT CEMENT

Energy Technology Data Exchange (ETDEWEB)

Fred Sabins

2001-10-23

The objective of this project is to develop an improved ultra-lightweight cement using ultra-lightweight hollow glass spheres (ULHS). Work reported herein addresses tasks performed in the fourth quarter as well as the other three quarters of the past year. The subjects that were covered in previous reports and that are also discussed in this report include: Analysis of field laboratory data of active cement applications from three oil-well service companies; Preliminary findings from a literature review focusing on problems associated with ultra-lightweight cements; Summary of pertinent information from Russian ultra-lightweight cement literature review; and Comparison of compressive strengths of ULHS systems using ultrasonic and crush methods Results reported from the fourth quarter include laboratory testing of ULHS systems along with other lightweight cement systems--foamed and sodium silicate slurries. These comparison studies were completed for two different densities (10.0 and 11.5 lb/gal) and three different field application scenarios. Additional testing included the mechanical properties of ULHS systems and other lightweight systems. Studies were also performed to examine the effect that circulation by centrifugal pump during mixing has on breakage of ULHS.
Consumers' conceptualization of ultra-processed foods.

Science.gov (United States)

Ares, Gastón; Vidal, Leticia; Allegue, Gimena; Giménez, Ana; Bandeira, Elisa; Moratorio, Ximena; Molina, Verónika; Curutchet, María Rosa

2016-10-01

Consumption of ultra-processed foods has been associated with low diet quality, obesity and other non-communicable diseases. This situation makes it necessary to develop educational campaigns to discourage consumers from substituting meals based on unprocessed or minimally processed foods by ultra-processed foods. In this context, the aim of the present work was to investigate how consumers conceptualize the term ultra-processed foods and to evaluate if the foods they perceive as ultra-processed are in concordance with the products included in the NOVA classification system. An online study was carried out with 2381 participants. They were asked to explain what they understood by ultra-processed foods and to list foods that can be considered ultra-processed. Responses were analysed using inductive coding. The great majority of the participants was able to provide an explanation of what ultra-processed foods are, which was similar to the definition described in the literature. Most of the participants described ultra-processed foods as highly processed products that usually contain additives and other artificial ingredients, stressing that they have low nutritional quality and are unhealthful. The most relevant products for consumers' conceptualization of the term were in agreement with the NOVA classification system and included processed meats, soft drinks, snacks, burgers, powdered and packaged soups and noodles. However, some of the participants perceived processed foods, culinary ingredients and even some minimally processed foods as ultra-processed. This suggests that in order to accurately convey their message, educational campaigns aimed at discouraging consumers from consuming ultra-processed foods should include a clear definition of the term and describe some of their specific characteristics, such as the type of ingredients included in their formulation and their nutritional composition. Copyright © 2016 Elsevier Ltd. All rights reserved.
RETRATAMENTO ENDODÔNTICO: ESTUDO COMPARATIVO ENTRE TÉCNICA MANUAL, ULTRA-SOM E CANAL FINDER ENDODONTIC RETREATMENT: COMPARATIVE STUDY BETWEEN MANUAL TECHNIQUE, ULTRASONIC SCALER, AND CANAL FINDER

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Clovis Monteiro BRAMANTE

1998-01-01

Full Text Available Instrumentações manual, ultra-sônica e com Canal Finder foram utilizadas para retratamento de 30 dentes com canais obturados com guta-percha e óxido de zinco e eugenol. Avaliaram-se: 1. tempo gasto para a penetração inicial até o ápice; 2. tempo para completar a limpeza; 3. extrusão de material e 4. limpeza dos canais. O Canal Finder foi a técnica que propiciou melhor limpeza, seguida da manual e da ultra-sônica. A parede palatina do canal foi constantemente mais limpa do que a vestibular. Quanto à extrusão, a técnica de ultra-som foi a que propiciou mais extravasamento de material obturador.Endodontic retreatment of 30 teeth filled with guta percha and zinc oxide-eugenol was carried out using manual instrumentation, ultrasonic scaler, and the Canal Finder System. The following variables were evaluated: time spent to reach the apex; time spent to complete cleaning of the canal; apical extrusion of material; and cleanliness of the canals. Results showed the Canal Finder System as providing the highest level of cleanliness of the canal system; lingual walls were constantly cleaner than buccal walls; ultrasonic technique presented a greater degree of apical extrusion of filling material.
Sex Difference in Draft-Legal Ultra-Distance Events - A Comparison between Ultra-Swimming and Ultra-Cycling.

Science.gov (United States)

Salihu, Lejla; Rüst, Christoph Alexander; Rosemann, Thomas; Knechtle, Beat

2016-04-30

Recent studies reported that the sex difference in performance in ultra-endurance sports such as swimming and cycling changed over the years. However, the aspect of drafting in draft-legal ultra-endurance races has not yet been investigated. This study investigates the sex difference in ultra-swimming and ultra-cycling draft-legal races where drafting - swimming or cycling behind other participants to save energy and have more power at the end of the race to overtake them, is allowed. The change in performance of the annual best and the annual three best in an ultra-endurance swimming race (16-km 'Faros Swim Marathon') over 38 years and in a 24-h ultra-cycling race ('World Cycling Race') over 13 years were compared and analysed with respect to sex difference. Furthermore, performances of the fastest female and male finishers ever were compared. In the swimming event, the sex difference of the annual best male and female decreased non-significantly (P = 0.262) from 5.3% (1976) to 1.0% (2013). The sex gap of speed in the annual three fastest swimmers decreased significantly (P = 0.043) from 5.9 ± 1.6% (1979) to 4.7 ± 3.1% (2013). In the cycling event, the difference in cycling speed between the annual best male and female decreased significantly (P = 0.026) from 33.31% (1999) to 10.89% (2011). The sex gap of speed in the annual three fastest decreased significantly (P = 0.001) from 32.9 ± 0.6% (1999) to 16.4 ± 5.9% (2011). The fastest male swimmer ever (swimming speed 5.3 km/h, race time: 03:01:55 h:min:s) was 1.5% faster than the fastest female swimmer (swimming speed 5.2 km/h, race time: 03:04:09 h:min:s). The three fastest male swimmers ever (mean 5.27 ± 0.13 km/h) were 4.4% faster than the three fastest female swimmers (mean 5.05 ± 0.20 km/h) (P swimming and cycling, the sex difference in the annual top and annual top three swimmers and cyclists decreased (i.e. non-linearly in swimmers and linearly in cyclists) over the years. The sex difference of the
Padronização do método para cálculo da captação renal absoluta do99mTc-DMSA em cria Standardization of a method to calculate absolute renal uptake of 99mTc-DMSA in children

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Carla Rachel Ono

2006-02-01

Full Text Available OBJETIVO: O trabalho teve por objetivo padronizar o método e estabelecer valores normais da captação renal absoluta do99mTc-DMSA em crianças. MATERIAIS E MÉTODOS: Vinte e duas crianças (idade de 7 meses a 10 anos; média de 4,5 anos sem doença renal prévia foram submetidas a cintilografia renal estática com 99mTc-DMSA. Dezoito apresentavam ultra-sonografia, uretrocistografia miccional, "clearance" de creatinina e padrão visual da cintilografia renal estática normais. Quatro crianças foram excluídas por não terem completado ou por apresentarem redução do "clearance" de creatinina. A captação absoluta de DMSA (DMSA-Abs foi calculada como a porcentagem da atividade administrada retida em cada rim após seis horas da administração do radiofármaco. RESULTADOS: Os valores de DMSA-Abs foram de 21,8% ± 3,2% para o rim direito e de 23,1% ± 3,3% para o rim esquerdo. Os valores da captação absoluta não mostraram correlação com a idade dos pacientes estudados, apesar da tendência de aumento do "clearance" de creatinina com a idade. CONCLUSÃO: A definição de valores normais da DMSA-Abs permite o emprego deste parâmetro na avaliação inicial e acompanhamento de doenças renais, principalmente em pacientes com acometimento bilateral ou com rim único (nos quais a função diferencial direita X esquerda tem valor limitado.OBJECTIVE: To standardize a method and determine normal values for absolute renal uptake of 99mTc-DMSA in children with normal creatinine clearance. MATERIALS AND METHODS: Twenty-two children (between 7 months and 10 years of age; mean 4.5 years without clinical evidence of renal disease were studied using 99mTc-DMSA scintigraphy. Eighteen had normal renal ultrasonography, micturating urethrocystography, creatinine clearance and visual interpretation of the scintigraphy with 99mTc-DMSA. Four children were excluded, one with incomplete creatinine clearance and three due to reduction in the creatinine clearance
The chemistry of ultra-low concentrations

International Nuclear Information System (INIS)

Vertes, Attila; Kiss, Istvan

1987-01-01

Methods for the separation and enrichment of radionuclides in the ultra-low concentration range (coprecipitation, adsorption of radioactive substances on crystals) are disscussed in this chapter of the textbook. The properties and behaviour of ultra-dilute solutions, radiocolloids and the electrochemistry of ultra-dilute solution are also overviewed
Assessment of the fetomaternal circulation in threatened abortion by transvaginal color Doppler.

Science.gov (United States)

Kurjak, A; Zudenigo, D; Predanic, M; Kupesic, S; Funduk, B

1994-01-01

Transvaginal color Doppler was used to investigate blood flow in the fetomaternal circulation of 60 women with threatened abortion and 90 women with normal intrauterine pregnancy. The obtained Doppler sonograms were analyzed and the resistance index (RI) was calculated in the maternal circulation, while in the fetal circulation the pulsatility index (PI) was used. There was no significant difference in the RI values of the maternal circulation between women with normal pregnancies and pregnancies complicated by bleeding, but with normal pregnancy outcome (p > 0.05). No differences in RI values of the uterine, arcuate and radial arteries were found between pregnancies with threatened abortion and normal pregnancy outcome and women with abnormal outcome (p > 0.05). In 9 of 21 women with visible retrochorionic hematoma, the RI of the spiral arteries was higher on the hematoma side in comparison to the opposite side (p abortion, the RI of the spiral arteries was lower in comparison to the control group. Such findings could be caused by the vasodilatating products of inflammation which probably exist in such areas. There was no significant difference in terms of the PI of fetal blood vessels between normal pregnancy and threatened abortions with normal outcome, as well as between threatened abortions with normal outcome and subsequent abortions of live fetuses (p > 0.05).
Noninvasive detection of coronary artery disease: challenges for prevention of disease and clinical events Métodos não invasivos para identificação da doença aterosclerótica: desafios para prevenção da doença e eventos clínicos

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Protásio Lemos da Luz

2005-10-01

alternativa melhor seria prevenir o desenvolvimento da aterosclerose, ou pelo menos identificar os pacientes que tenham risco de eventos agudos e intervir antes de sua ocorrência. O objetivo desta revisão é discutir o valor prognóstico dos fatores de riscos tradicionais e emergentes, e o papel dos métodos diagnósticos não invasivos para a doença coronária - teste de esforço, eco estresse, ultra-sonografia dúplex, tomografia computadorizada e a ressonância magnética. A combinação de marcadores biológicos e de métodos não invasivos, é de grande utilidade na identificação precoce da doença aterosclerótica. Futuros desenvolvimentos logo aperfeiçoarão nossa capacidade de identificar o paciente vulnerável e nos permitir um manejo mais individualizado.
Relação entre índice de resistência obtido pela ultra-sonografia Doppler transfortanela e o neurodesenvolvimento até o primeiro ano de vida em recém-nascidos a termo com encefalopatia hipóxico-isquêmica leve e moderada Relation between the resistance index obtained by the transfontanellar Doppler ultrasonography and the neurological development until the first year of life in term infants with mild or moderate hypoxic-ischaemic encephalopathy

Directory of Open Access Journals (Sweden)

Maria Helena Martins Garcia

2007-12-01

Full Text Available OBJETIVO: Avaliar a relação do índice de resistência (IR obtido pela ultra-sonografia Doppler transfontanela com o neurodesenvolvimento até um ano de idade, em recém-nascidos (RN a termo com encefalopatia hipóxica-isquêmica (EHI leve a moderada, secundária à asfixia intra-parto. MÉTODO: Estudo prospectivo em 20 RN com EHI leve a moderada, IR elevado no primeiro exame de Doppler, e sem doenças associadas ou anormalidades morfológicas cerebrais. Foram realizados exames seriados bimensais de Doppler transfontanela a partir do sétimo dia de vida, e avaliações clínicas mensais do neurodesenvolvimento no primeiro ano de vida. RESULTADOS: Houve normalização progressiva dos valores de IR até o último exame realizado. Cinco pacientes apresentaram normalização clínico-neurológica no período neonatal, após o primeiro exame de Doppler. Quinze lactentes apresentaram alterações neurológicas com resolução a partir do segundo trimestre de vida. CONCLUSÃO: Houve relação entre os períodos em que ocorreu a normalização dos valores de IR e a melhora clínica-neurológica.OBJECTIVE: To evaluate the relation between the resistance index (RI obtained by transfontanellar Doppler ultrasonography, and the neurodevelopment until one year of life, at term newborns with mild or moderate hypoxic-ischaemic encephalopathy due to intrapartum asphyxia. METHOD: 20 term newborns, with mild or moderate hypoxic-ischemic encephalopathy, high values of resistance index in the first exam, and without cerebral morfologic abnormalities or other diseases. They were submitted to serial bimonthly transfontanellar Doppler ultrasonography, from the seventh day of life on, and monthly clinical neurodevelopment assessment until one year of life. RESULTS: There was a progressive normalization of RI values until the last examination. In five cases there were clinical neurologic normalization in the neonatal period after the first Doppler exam. Fifteen infants
Can anyone screen for deep infiltrating endometriosis with transvaginal ultrasound?

Science.gov (United States)

Piessens, Sofie; Healey, Martin; Maher, Peter; Tsaltas, Jim; Rombauts, Luk

2014-10-01

Surgical treatment of deep infiltrating endometriosis (DIE) is complex, and preoperative diagnosis benefits both surgeon and patient. Studies in expert centres have reported high accuracy for transvaginal ultrasound (TVUS) diagnosis of DIE. External validation of these findings has been limited, and no information is available on how quickly these skills can be acquired. The aim of this study was to measure the learning curve of DIE-TVUS and to identify the causes for inaccuracies in the diagnosis of bowel lesions and Pouch of Douglas (POD) obliteration. Following one week of training at the University of São Paulo (Brazil), 205 consecutive women with a history of endometriosis symptoms were prospectively assessed by TVUS after minimal bowel preparation. TVUS findings were correlated with laparoscopic findings in eighty-five cases to assess the accuracy. The LC-CUSUM and CUSUM were used to assess the learning curve and maintenance of competency, respectively. The sensitivity and specificity for DIE of the bladder, vagina and bowel were 33% and 100%, 80% and 100%, and 88% and 93%, respectively. The sensitivity and specificity for the presence of POD obliteration were 88% and 90%, respectively. LC-CUSUM analysis confirmed that competency for DIE-TVUS was achieved within 38 scans for the detection of POD obliteration and within 36 scans for the detection of bowel nodules. Competency was maintained for the remainder of the scans as assessed by the CUSUM. After one week of DIE-TVUS training, competency can be achieved within forty procedures, allowing diagnosis of DIE with similar diagnostic accuracy as reported by centres of excellence. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Influence of the development phase of the dominant follicle on the superovulatory response in Nelore heifers

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Mayra Elena Ortiz D'Avila Assumpção

1999-01-01

Full Text Available O objetivo deste trabalho foi avaliar a influência do folículo dominante nas fases de crescimento, estática e de regressão sobre a resposta superovulatória em 18 ciclos estrais de 9 novilhas da raça Nelore. Avaliaram-se os ovários entre o dia 6 e o dia 10 do ciclo estral pela técnica de ultra-sonografia, medindo-se o diâmetro do maior folículo e contando-se o número de folículos subordinados. Os animais foram superovulados com 400 ou 500 UI de FSH/LH, iniciando-se no dia 10 do ciclo estral, em subdoses decrescentes, por 4 dias consecutivos. Aplicou-se PGF2alfa concomitante com a quinta subdose de FSH/LH e realizaram-se inseminações artificiais às l2 horas e às 24 horas após o início dos sintomas de estro. Os embriões foram colhidos no dia 6,5 após a primeira inseminação artificial, obtendo-se 3,00; 3,83 e 10,17 embriões, respectivamente, nas fases de crescimento, estática e regressão. Observaram-se melhores resultados quanto ao número de embriões quando o folículo dominante se encontrava em fase de regressão.
Transvaginal ultrasound appearances of the ovary in normal women and hirsute women with oligomenorrhoea.

Science.gov (United States)

Fox, R

1999-02-01

The transvaginal ultrasound appearances of the ovary were determined in women with clinical and endocrine features of polycystic ovarian disease (PCOD) and apparently normal women. At scan the number of small follicles were counted and ovarian volume was calculated. The maximum width of the ovarian cortex was also measured. Blood was sent for measurement of LH, FSH and testosterone. The women with oligomenorrhoea were scanned at random and the normal women were seen within the first 5 days of the start of menstruation. There were significant differences between median values for the 2 groups in terms of number of small follicles, ovarian volume and stromal width; the ovaries of the hirsute women had more follicles, were of larger volume, and had greater stromal width. The 2 ranges for number of follicles did overlap, however. Four hirsute oligomenorrhoeic women had a normal number of follicles; all 4 had the several clinical and endocrine features indicative of PCOD. These data suggest that the classical ultrasound features of PCOD are not consistently present and that the absence of increased follicularity at scan should not necessarily deter clinicians from making the functional diagnosis of PCOD.
Decontamination of transvaginal ultrasound probes: Review of national practice and need for national guidelines

International Nuclear Information System (INIS)

Gray, R.A.; Williams, P.L.; Dubbins, P.A.; Jenks, P.J.

2012-01-01

Aim: To determine the national practice of transvaginal ultrasound (TVUS) probe decontamination in English hospitals and to develop recommendations for guidance. Materials and methods: A literature review was undertaken to clarify best practice and evaluate methods of decontamination of TVUS probes. A questionnaire was developed to ascertain TVUS probe decontamination programmes in current use within English hospitals. This was sent to ultrasound leads of 100 English hospitals; 68 hospitals responded. Results: There is a wide variation in TVUS probe decontamination across English hospitals. Although the majority of respondents (87%, 59/68) reported having clear and practical written guidelines for TVUS decontamination, the frequency, methods, and types of decontamination solutions utilized were widely variable and none meet the standards required to achieve high-level disinfection. Conclusion: While the decontamination of other endoluminal medical devices (e.g., flexible endoscopes) is well defined and regulated, the decontamination of TVUS probes has no such guidance. There appears to be incomplete understanding of the level of risk posed by TVUS probes, and in some cases, this has resulted in highly questionable practices regarding TVUS hygiene. There is an urgent need to develop evidence-based national guidance for TVUS probe decontamination.
PAQUIMETRIA ULTRA-SÔNICA DE CÓRNEAS DE CANINOS E SUÍNOS

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Duvaldo Eurides

2006-10-01

Full Text Available Estudaram-se trinta olhos de caninos, adultos, machos e fêmeas, mestiços, submetidos a eutanásia e cedidos pela Faculdade de Medicina da Universidade Federal de Goiás (UFG e trinta de suínos, seis meses, machos e fêmeas, mestiços, abatidos no frigorífico Boa Sorte, no município de Goiânia. Os olhos enucleados pela técnica de exenteração foram acondicionados individualmente em câmaras úmidas (Filatov com solução fisiológica 0,9% e mantidos em caixa de isopor por um período máximo de seis horas. Dividiu-se a córnea de cada olho, para efeito das leituras, em cinco áreas (central, nasal superior, nasal inferior, temporal superior e temporal inferior. Procedeu-se às leituras digitais com o paquímetro ultra-sônico de Storz em três pontos para cada área, totalizando quinze vezes em cada olho. Os resultados obtidos das médias gerais foram, para caninos, de 704,21 ± 67,11 m. Os valores médios diferenciaram-se para cada ponto, sendo que a média obtida nas áreas centrais (670,70 ± 75,29 m foi a menos espessa e nas nasais inferiores (715,50 ± 79,52 m a mais espessa. Para os suínos, os resultados apontaram 700,31 ± 30,08 m. Os valores médios diferenciaram-se para cada ponto, sendo que a média obtida nas áreas nasais inferiores (669,63 ±85,79 m foi a menos espessa e nas temporais superiores(731,47m ± 64,06m a mais espessa. O método foi eficiente, seguro e simples. Os valores obtidos nas condições deste trabalho são inéditos, mas só servem como valores de referência para estas amostras, pois são dependentes da idade,do peso, do sexo, da raça, da dieta e até do horário do exame,variáveis estas que não se consideraram neste trabalho. PALAVRAS-CHAVES: Cão, paquimetria ultra-sônica, paquímetro de Störz, suíno.
Transvaginal sonography combined with saline contrast sonohysterography in evaluating the uterine cavity in premenopausal patients with abnormal uterine bleeding

DEFF Research Database (Denmark)

Dueholm, M; Forman, A; Jensen, ML

2001-01-01

OBJECTIVES: To evaluate whether saline contrast sonohysterography (SCSH) adds additional information to that obtained by transvaginal sonography (TVS) for predicting endometrial abnormality in premenopausal patients with abnormal uterine bleeding. PATIENTS AND METHODS: This was a two......-center prospective study at a university clinic and a central hospital in Denmark. The uterine cavity was evaluated with TVS and SCSH in 470 premenopausal patients with abnormal uterine bleeding. One hundred and eighty-nine of the patients had operative hysteroscopy or hysterectomy within 4 months which provided...... uterine bleeding. All abnormalities except one were found at SCSH, while TVS alone missed polyps and had almost one in four equivocal findings. The use of TVS, without saline contrast, left one in five of the polyps undiagnosed in referred patients with abnormal bleeding....
Acidente vascular cerebral e outras complicações do sistema nervoso central nas doenças falciformes Stroke and other vascular complications of the central nervous system in sickle cell disease

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Ivan L. Angulo

2007-09-01

Full Text Available A principal complicação da doença falciforme na infância é a das artérias cerebrais, mas após os 20 anos também pode se manifestar, como seqüela de lesões anteriores ou neoformadas. A vasculopatia tem a maior importância no desenvolvimento da criança e na qualidade de vida. Além do acidente vascular cerebral completo ou incompleto ("silencioso", existem outras complicações do sistema nervoso central, porém não exclusivas. O diagnóstico da vasculopatia cerebral falciforme necessita auxílio neurorradiológico. O tratamento se faz basicamente com transfusões de eritrócitos contendo hemoglobina A. O objetivo deste trabalho é rever a literatura médica, procurando selecionar a melhor conduta em diagnóstico e tratamento que seja possível empregar de imediato, para reduzir a morbidade e mortalidade da vasculopatia cerebral e elevar a qualidade de vida dos pacientes, principalmente na infância. Os fatores de risco clínicos e laboratoriais, incluindo a triagem por ultra-sonografia Doppler das artérias cerebrais e imagens de ressonância magnética, devem influenciar a decisão de instituir transfusões crônicas e a quelação do ferro transfusional deve acompanhar este tratamento.In children with sickle cell disease, cerebral arteries are prone to lesions that may cause deficiencies and poor quality of life. After the age of 20, new lesions may also occur. Besides stroke and silent cerebral ischemia, other lesions may occur. Radiologic images are necessary to diagnose and blood transfusions to treat. We reviewed the literature to choose best practices and guidelines to reduce morbidity and mortality and improve the quality of life of children with sickle cell disease. Risk factors identified from clinical and laboratory data and screening by Doppler ultrasonography and magnetic resonance must be used in order to make decisions about transfusion and iron chelation therapy.

Ultra-orthodox Jewish Women Go to Work

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Foscarini, Giorgia

2014-12-01

Full Text Available In the last three decades the ultra-orthodox community in Israel has experienced great changes in its internal social functioning. More specifically, these developments were linked to the education of ultra-orthodox women. Through an accurate review of the existing literature and a series of in-depth interviews with Israeli scholars, rabbis, educators and women of the ultra-orthodox community in Jerusalem, it was found that the introduction of new vocational and academic training tracks in women's education, is gradually changing the internal social structure of the ultra-orthodox family and community. The main consequence is expressed in a renegotiation of gender roles within the ultra-orthodox community and in a subversion of the traditional patriarchal framework. As a result of their participation in the labor market and in higher education institutions, women are more and more exposed to the Israeli secular culture, introducing in the traditional and segregated ultra-orthodox community customs typically modern, narrowing the gap between the ultra-orthodox community and the mainstream Israeli society.
Ultra-short laser pulses. Petawatt and femtosecond

International Nuclear Information System (INIS)

Lemoine, P.

1999-01-01

This book deals with a series of new results obtained thanks to the use of ultra-short laser pulses. This branch of physics has made incredible progresses during the last 25 years. Ultra-short laser pulses offer the opportunity to explore the domain of ultra-high energies and of ultra-short duration events. Applications are various, from controlled nuclear fusion to eye surgery and to more familiar industrial applications such as electronics. (J.S.)
A influência da mobilização articular nas tendinopatias dos músculos bíceps braquial e supra-espinal

OpenAIRE

Barbosa,RI; Goes,R; Mazzer,N; Fonseca,MCR

2008-01-01

As causas mais comuns de dor no ombro estão relacionadas às degenerações dos tendões da musculatura do manguito rotador. OBJETIVO: Verificar a influência da mobilização articular por meio dos movimentos acessórios do ombro na recuperação inicial de 14 pacientes com tendinopatia crônica dos mm. supra-espinal e/ou bíceps braquial. MÉTODOS: Foram comparados dois protocolos de tratamento, compostos da aplicação de ultra-som terapêutico na área do tendão afetado e de treinamento excêntrico na musc...
Efeito das dimensões da seção transversal e da frequência do transdutor na velocidade de propagação de ondas de ultra-som na madeira Effect of the transversal section dimensions and transducer frequency on ultrasound wave propagation velocity in wood

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Alex Julio Trinca

2009-02-01

Full Text Available Diversas pesquisas vêm sendo realizadas com o uso da velocidade de propagação de ondas de ultra-som como parâmetro para estimar propriedades mecânicas da madeira. Tendo em vista que essa velocidade pode ser influenciada pela forma da peça ensaiada, bem como pela frequência do transdutor utilizado no ensaio, conhecer essas fontes de influência é fator importante para a obtenção de resultados confiáveis. Durante estudo mais amplo sobre a influência da dimensão do corpo-de-prova em ensaios destrutivos de compressão paralela às fibras, os corpos-de-prova de 0,03 x 0,03 x 0,09 m e de 0,05 x 0,05 x 0,15 m foram também utilizados para avaliar a variação da velocidade de propagação de ondas de ultrassom em razão da dimensão da peça ensaiada. Para a avaliação da influência da frequência, os ensaios foram realizados com transdutores de onda longitudinal (compressão de 25 kHz, 45 kHz, 80 kHz, 100 kHz, 500 kHz e 1 MHz, em 119 corpos-de-prova de Pinus elliottii e 244 de Eucalyptus grandis. Os resultados indicaram que, em ambas as espécies, a seção transversal exerceu influência na propagação da onda de ultrassom e que a velocidade longitudinal foi fortemente afetada pela frequência do transdutor para frequências abaixo de 500 kHz, corroborando a importância de sempre se adotarem, nos ensaios, relações de comprimento de percurso/comprimento de onda superiores a 3,0.Several works use the ultrasound wave propagation velocity as the main parameter to determine the mechanical properties of wood. Since this velocity can be influenced by the specimen's dimension or by the transducer's frequency, this influence must be known to obtain reliable results. During research on the influence of specimen dimension on destructive testing of the compression parallel to the grain, 0.03 x 0.03 x 0.09 m and 0.05 x 0.05 x 0.15 m specimens were tested to evaluate the variation in wave propagation velocity as a function of specimen dimension
Varicocele e volume testicular em adolescentes e adultos jovens portadores de esquistossomose hepatoesplênica cirúrgica

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Brandt Frederico Teixeira

2003-01-01

Full Text Available OBJETIVO: Avaliar o volume testicular e a prevalência de varicocele em adolescentes e adultos jovens portadores de esquistossomose na forma hepatoesplênica associada a varizes sangrentas de esôfago. MÉTODOS: O estudo envolveu 22 adolescentes masculinos com esquistossomose na forma descrita, submetidos à esplenectomia, ligadura da veia gástrica esquerda e auto-implante de tecido esplênico no grande omento quando crianças. O tempo médio de seguimento foi de 4 anos após a intervenção. O grupo de voluntários sadios foi de adolescentes de uma escola na mesma região onde os casos operados viviam. Eles foram selecionados de forma randomizada, considerando a faixa de idade, características epidemiológicas e não serem infestados por equistossomose. Todos os participantes possuíam história clínica completa e foram submetidos a exame físico e ultra-sonográfico. Foi dado atenção especial as características sexuais, ultra-sonografia testicular e dopplerfluxometria das veias espermáticas. RESULTADOS: Dos pacientes classificados como adultos pela idade cronológica, 53,8% tinham genitais com características infantis. A incidência de varicocele foi igual a 61,5% no grupo afetado e 40% no grupo controle, sem diferença estatística entre os grupos (x 2 =1,77; g.1.=1; p=0,18 3 p Fisher=0,16, acometendo predominantemente o testículo esquerdo, em ambos os grupos. CONCLUSÃO: Pacientes com doença esquistossomótica cirúrgica tinham significante déficit no desenvolvimento puberal e genital, no volume testicular, especialmente do lado esquerdo, e alta prevalência de varicocele (61.5% sem uma associação direta com atrofia testicular.
Risk factors of surgical failure following transvaginal mesh repair for the treatment of pelvic organ prolapse.

Science.gov (United States)

Long, Cheng-Yu; Lo, Tsia-Shu; Wang, Chiu-Lin; Wu, Chin-Hu; Liu, Cheng-Min; Su, Juin-Huang

2012-04-01

To identify the factors associated with pelvic organ prolapse (POP) recurrence after transvaginal mesh (TVM) repair. One hundred and thirteen women with symptomatic POP stage II to IV were scheduled for TVM procedures. All subjects underwent urinalyses and pelvic examination using the POP quantification (POP-Q) staging system before and after surgery. Seven (6.2%) of 113 women reported POP recurrence after a mean follow-up time of 30 months. We performed a univariate analysis of patients' characteristics to identify the predictors of surgical failure after TVM. There was no difference between two groups as to body mass index, POP stage, mesh type, and preoperative urinary symptoms and urodynamic parameters (P>0.05). However, we found that uterine prolapse (P=0.016) and surgical experience (P=0.043) were two significant predictors of surgical failure. Multivariate logistic regression showed similar results. Advanced uterine prolapse and lack of surgical experience were two significant predictors of failure following TVM. POP recurrence after mesh repair appears to be unlikely beyond the learning curve. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.
Transvaginal ultrasound assessment of myometrial and cervical stroma invasion in women with endometrial cancer -interobserver reproducibility among ultrasound experts and gynaecologists

DEFF Research Database (Denmark)

Eriksson, LS; Lindqvist, PG; Flöter Rådestad, A

2014-01-01

OBJECTIVES: To assess interobserver reproducibility among ultrasound experts and gynaecologists in the prediction of deep myometrial- and cervical stroma invasion by transvaginal ultrasound in women with endometrial cancer. METHODS: Video-clips of the corpus- and cervix uteri of 53 women...... with endometrial cancer, examined preoperatively by the same ultrasound expert, were integrated in a digitalized survey. Nine ultrasound experts and 9 gynaecologists evaluated presence or absence of deep myometrial- and cervical stroma invasion. Histopathology from hysterectomy specimen was used as gold standard.......001). CONCLUSION: Preoperative ultrasound assessment of deep myometrial- and cervical stroma invasion in endometrial cancer is best performed by ultrasound experts, as they show a higher degree of agreement to histopathology and higher interobserver reproducibility in the assessment of cervical stromal invasion....
Influence of the power level of an ultra-sonic system on dental cavity preparation Influência do nível de potência de um sistema de ultra-som em preparos cavitários

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Érika Botelho Josgrilberg

2007-12-01

Full Text Available The aim of this study was to evaluate the shape of dental cavities made with the CVDentus® system using different ultrasound power levels. One standard cavity was made on the buccal aspect of 15 bovine incisors with a CVDentus® cylindrical bur (82142. The sample was divided into three groups: G1 - ultrasound with power II; G2 - ultrasound with power III; and G3 - ultrasound with power IV. A standardizing device was used to obtain standardized preparations and ultrasound was applied during one minute in each dental preparation. The cavities were sectioned in the middle, allowing observation of the cavity’s profile with a magnifying glass, and width and depth measurement using the Leica Qwin program. The Kruskal-Wallis (p O objetivo deste estudo foi avaliar o formato dos preparos cavitários realizados com o sistema CVDentus® utilizando potências variadas do ultra-som. Uma cavidade padronizada foi realizada na face vestibular de 15 incisivos bovinos utilizando as pontas cilíndricas CVDentus® (82142. A amostra foi dividida em 3 grupos: G1 - ultra-som com potência II; G2 - ultra-som com potência III; e G3 - ultra-som com potência IV. Foi utilizada uma máquina padronizadora de preparos cavitários e o ultra-som foi aplicado durante 1 minuto em cada preparo. As cavidades foram seccionadas no centro, permitindo a visualização do perfil cavitário em uma lupa estereoscópica, e esse foi medido em largura e profundidade por meio do programa Leica Qwin. O teste estatístico Kruskal-Wallis (p < 0,05 e o método de Dunn demonstraram diferenças entre os formatos das cavidades produzidas com as potências III e IV. Entretanto, as cavidades realizadas com a potência III apresentaram dimensões semelhantes às da ponta utilizada. Concluiu-se que a potência indicada pelo fabricante (III é a mais adequada para uso do sistema CVDentus®.
Fatores prognósticos para o parto transvaginal em pacientes com cesárea anterior Prognostic factors for vaginal delivery after cesarian section

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Luiz Carlos Santos

1998-07-01

Full Text Available O objetivo deste estudo foi determinar os fatores prognósticos para a ultimação do parto por via transpélvica em gestantes com cesárea anterior admitidas em trabalho de parto no CAM-IMIP. Foi realizado um estudo tipo caso-controle, analisando os partos de pacientes com cesárea prévia assistidos no CAM-IMIP no período de janeiro/1991 a dezembro/1994. Foram considerados casos as pacientes com cesárea anterior (n=156 e controles as que tiveram parto transvaginal (n=338. Os critérios de inclusão foram: idade gestacional > 36 semanas, cesárea anterior há pelo menos 1 ano, concepto vivo, trabalho de parto espontâneo e apresentação cefálica fletida. Foram excluídas as gestações de alto risco, os casos de sofrimento fetal anteparto e pacientes com história de parto transpélvico anterior depois da cesárea. A análise estatística foi realizada em Epi-Info 6.0 e Epi-Soft, utilizando-se os testes chi² de associação, teste exato de Fisher e "t" de Student, bem como a odds ratio e seu intervalo de confiança a 95%. Análise de regressão logística múltipla foi efetuada para controle das variáveis confundidoras. O percentual de cesáreas no grupo estudado foi de 31,6%. Os fatores maternos que apresentaram associação significativa com o parto transvaginal foram a idade materna 35 anos (OR = 0,54, IC a 95% = 0,36-0,82, a história de parto vaginal anterior (OR = 1,6, IC a 95% = 1,01-2,55 e a indicação da cesárea anterior por doenças da gestação (OR = 3,67, IC a 95% = 1,19-12,02. Fatores como intervalo entre a cesárea anterior e o parto atual, outras indicações de cesárea e o tipo de histerorrafia não apresentaram associação significativa com o parto transpélvico. No modelo de regressão logística múltipla, persistiram como variáveis associadas significativamente ao parto vaginal a idade materna e a história de parto vaginal anterior. Os autores concluíram que sendo a idade materna Objectives: to determine
Tratamento da síndrome de Budd-Chiari por meio da colocação de tips e de "stent" venoso supra-hepático Transjugular intrahepatic portosystemic shunt (TIPS and suprahepatic venous stenting in the management of Budd-Chiari syndrome

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Jurandi A. Bettio

2002-11-01

Full Text Available OBJETIVOS: Descrever o uso do "shunt" intra-hepático portossistêmico (TIPS e do "stent" venoso supra-hepático no manejo da síndrome de Budd-Chiari, enfocando suas indicações, aspectos técnicos e benefícios do procedimento. MATERIAIS E MÉTODOS: De janeiro de 1999 a março de 2002, nove casos de síndrome de Budd-Chiari foram encaminhados ao Serviço de Hemodinâmica do Hospital São Lucas, Porto Alegre, RS. A obstrução venosa supra-hepática foi constatada em todos os casos por meio de ultra-sonografia com Doppler em cores. A criação de TIPS foi realizada entre o sistema venoso supra-hepático ou a veia cava inferior e a veia porta, posicionando-se a endoprótese entre as duas abordagens. Doppler em cores pós-procedimento foi efetuado em todos os pacientes em períodos seriados. RESULTADOS: Três casos foram tratados inicialmente com inserção de "stent" venoso por apresentarem estenose preponderante em veias supra-hepáticas. Em dois desses casos ocorreu trombose do "stent", sendo necessária colocação de TIPS. Os demais seis casos foram tratados primariamente com TIPS. Dos oito "shunts" criados, trombose da endoprótese foi constatada em três casos, resolvidas com limpeza dos trombos e dilatação com balão em um caso e inserção de novas próteses nos demais. Embolização com molas de colaterais venosas ectasiadas foi efetuada em um paciente. CONCLUSÕES: A colocação de TIPS constitui-se numa estratégia terapêutica segura e efetiva na síndrome de Budd-Chiari, promovendo uma significativa melhora clínica e hemodinâmica dos pacientes, evitando procedimentos mais invasivos e podendo, em casos sem cirrose estabelecida, servir de tratamento definitivo da hipertensão portal.OBJECTIVE: To evaluate the use of transjugular intrahepatic portosystemic shunt (TIPS and suprahepatic venous stenting in the management of Budd-Chiari syndrome, emphasizing the indications, technical aspects and the advantages of the procedure
The UltraLightweight Technology for Research in Astronomy (ULTRA) Project

Science.gov (United States)

Twarog, B. A.; Anthony-Twarog, B. J.; Shawl, S. J.; Hale, R.; Taghavi, R.; Fesen, R.; Etzel, P. B.; Martin, R.; Romeo, R.

2004-12-01

The collaborative focus of four academic departments (Univ. of Kansas Aerospace Engineering, Univ. of Kansas Physics & Astronomy, San Diego State University Astronomy and Dartmouth College Astronomy) and a private industry partner (Composite Mirror Applications, Inc.-CMA, Inc.) is a three-year plan to develop and test UltraLightweight Technology for Research in Astronomy (ULTRA). The ULTRA technology, using graphite fiber composites to fabricate mirrors and telescope structures, offers a versatile and cost-effective tool for optical astronomy, including the economical fabrication and operation of telescopes ranging from small (1m or smaller) aperture for education and research to extremely large (30m+) segmented telescopes (ELTs). The specific goal of this NSF-funded three-year Major Research Instrumentation project is to design, build, and test a 1m-class optical tube assembly (OTA) and mirrors constructed entirely from composites. In the first year of the project, the team has built and is field-testing two 0.4m prototypes to validate the optical surfaces and figures of the mirrors and to test and refine the structural dynamics of the OTA. Preparation for design and construction of the 1m telescope is underway. When completed in late 2005, the ULTRA telescope will be operated remotely from Mt. Laguna Observatory east of San Diego, where it will undergo a period of intensive optical and imaging tests. A 0.4m prototype OTA with mirrors (12 kg total weight) will be on display at the meeting. Support of this work by NSF through grants AST-0320784 and AST-0321247, NASA grant NCC5-600, the University of Kansas, and San Diego State University is gratefully acknowledged.
Correlação entre o exame clínico, a mamografia e a ultra-sonografia com o exame anatomopatológico na determinação do tamanho tumoral no câncer de mama Correlation between clinical examination, mammography and ultrasonography with histopathological exam in the determination of tumor size in breast cancer

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Fernanda Monteiro de Paula Siqueira

2008-03-01

Full Text Available OBJETIVO: avaliar qual o melhor método entre o exame clínico (EC, a mamografia (MMG e a ultra-sonografia (US na determinação pré-operatória do tamanho tumoral no câncer de mama, tendo como referência o exame anatomopatológico. MÉTODOS: foram incluídas neste estudo 184 pacientes com lesões mamárias detectadas por MMG e US, palpáveis ou não, e que foram submetidas a ressecção cirúrgica do tumor, com diagnóstico histopatológico de câncer de mama. O maior diâmetro tumoral foi avaliado por EC, MMG e US por um mesmo examinador, e a medida obtida por cada método foi correlacionada com o diâmetro máximo obtido pelo exame anatomopatológico. A análise comparativa foi feita por meio do coeficiente de correlação de Pearson (r. RESULTADOS: o coeficiente de correlação de Pearson encontrado entre o exame anatomopatológico e o EC foi 0,8; entre o exame anatomopatológico e a MMG foi 0,7 e entre o exame anatomopatológico e a US foi 0,7 (pPURPOSE: to evaluate which method is the best to determine pre-surgically the size of breast cancer: clinical examination, mammography or ultrasonography, using as a reference the anatomopathological exam. METHODS: this study has included 184 patients with palpable-or-not breast lesions, detected by mammography and ultrasonography, that were submitted to surgical resection of the tumor, with histopathological diagnosis of breast cancer. The same examiner evaluated clinically the largest tumoral diameter, through clinical examination, mammography and ultrasonography, and the measurements obtained by each method were correlated with the maximum diameter obtained by the anatomopathological exam. The comparative analysis has been done by Pearson's correlation coefficient (r. RESULTS: Pearson's correlation coefficient between the anatomopathological and the clinical exams was 0.8; between the anatomopathological exam and the mammography, 0.7; and between anatomopathological exam and ultrasonography 0
21 CFR 177.2910 - Ultra-filtration membranes.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 3 2010-04-01 2009-04-01 true Ultra-filtration membranes. 177.2910 Section 177... Components of Articles Intended for Repeated Use § 177.2910 Ultra-filtration membranes. Ultra-filtration membranes identified in paragraphs (a)(1), (a)(2), (a)(3), and (a)(4) of this section may be safely used in...
Moldagem por compressão a frio do polietileno de ultra alto peso molecular. Parte 1: influência do tamanho, distribuição e morfologia da partícula na densidade a verde Cold compression molding of ultra high molecular weight polyethylene. Part 1: influence of the size, distribution and morphology of particles on the green density

Directory of Open Access Journals (Sweden)

Bernadete A. Bittencourt

2009-01-01

Full Text Available Neste trabalho foram investigadas as características de amostras de pó de polietileno de ultra alto peso molecular (PEUAPM, tais como porosidade, morfologia, tamanho médio e distribuição de partícula, que são importantes na moldagem por compressão a frio. Também foi avaliada a influência dessas características na densidade a verde de pré-formas. As amostras dos pós foram caracterizadas por calorimetria diferencial de varredura (DSC, análise granulométrica, absorção de óleo, área superficial, porosimetria de mercúrio, fluidez do pó, densidade de compactação, densidade aparente e microscopia eletrônica de varredura (MEV. Através das técnicas de caracterização estudadas ficou evidenciado que as características da partícula citadas anteriormente, assim como o parâmetro de densificação (DP, que é função direta da porosidade interparticular, favorecem a densidade a verde relativa (DVR e consequentemente a tensão de resistência à flexão (TRF.In this paper an investigation was made of the characteristics of Ultra High Molecular Weight Polyethylene (UHMWPE powder samples, including porosity, particles average size, size distribution and morphology, which are important in cold compression molding. The influence of these characteristics on the green density of molded pre-shapes was also investigated. The UHMWPE powder samples were characterized by Differential Scanning Calorimetry (DSC, granulometric analysis, oil absorption, surface area, mercury porosity, density compaction, apparent density and Scanning Electron Microscopy (SEM. The characterization techniques used demonstrate that the UHMWPE particles characteristics cited above as well as the densification parameter (DP, which is a direct function of the interparticles porosity, affect the relative green density (RGD and hence, the flexural tensile strength (FTS.
Transvaginal bladder neck closure with posterior urethral flap for devastated urethra.

Science.gov (United States)

Rovner, Eric S; Goudelocke, Colin M; Gilchrist, Alienor; Lebed, Brett

2011-07-01

To present a modified transvaginal bladder neck closure (TV BNC) technique using a posterior urethral flap to minimize the potential risk of ureteral injury and fistula formation. Urethral and bladder neck destruction owing to chronic indwelling urethral catheters in female neurogenic patients is a devastating complication. A retrospective review was performed of all patients undergoing TV BNC at a single institution during a 3-year period. All patients had had a nonfunctional or destroyed urethra because of a long-term indwelling urethral catheter. In brief, the devastated outlet was closed using the dorsally bivalved urethra as a flap that was rotated cephalad onto the incised anterior bladder wall for closure, thereby rotating the suture line high into the retropubic space. A postoperative cystogram was obtained at 2-3 weeks. A total of 11 consecutive female patients with a devastated outlet underwent TV BNC, as described, with placement of a suprapubic tube. One patient experienced failure at 6 weeks postoperatively. The mean follow-up for the entire cohort was 9.6 months (range 1-36). Serial upper tract imaging at the last follow-up visit revealed no new hydroureteronephrosis. The results of our study have shown that TV BNC with a posterior urethral flap provides satisfactory early results. This technique creates a suture line far removed from the ureteral orifices, minimizing the risk of upper tract injury during closure. Also, the rotation of the posterior urethra onto the anterior bladder wall secures the suture line high into the retropubic space, minimizing the risk of failure and postoperative fistula formation. Copyright © 2011 Elsevier Inc. All rights reserved.
One-year outcome of concurrent anterior and posterior transvaginal mesh surgery for treatment of advanced urogenital prolapse: case series.

Science.gov (United States)

Lo, Tsia-Shu

2010-01-01

To estimate the safety and efficacy of performing concurrent anterior and posterior transvaginal mesh surgery using a commercially available kit (Gynecare PROLIFT Pelvic Floor Repair System; Ethicon, Inc., Somerville, NJ) for treatment of advanced urogenital prolapse (stage III or higher, Pelvic Organ Prolapse Quantification [POP-Q] system staging). Case control series study (Canadian Task Force classification II-2). Medical school-affiliated hospital. Forty-three patients with severe prolapse, POP-Q stage III (n=23) or IV (n=20), underwent surgery and were followed up for more than 1 year. In patients with any prolapse greater than stage I, surgery were considered to have functional failure. The Surgical Satisfaction Questionnaire was used for subjective evaluation at 1 year postoperatively. Extensive pelvic reconstructive procedures were primarily performed using a combination of the PROLIFT anterior and posterior pelvic systems (i.e., similar to sparing the intermediate section of the PROLIFT total pelvic system). The concurrent pelvic surgery included sequential vaginal total hysterectomy, perineorrhaphy, and suburethra sling, if indicated. Additional subjective and objective evaluations included POP-Q staging, urodynamic assessment, and preoperative and 12-month postoperative questionnaires. Objective and subjective data were available for 42 patients. The subjective cure rate and objective success rate for prolapse at 12-month follow-up was 95.2% and 97.6%, respectively. Mean follow-up was 15.7 months, operation time was 79.2 minutes, operative blood loss was 109.1 mL, and postoperative hospital stay was 4.1 days. Intraoperative and postoperative complications were minor. All patients voided spontaneously before discharge. One mesh extrusion, no wound defective healing, and no rejection were observed. Two patients developed asymptomatic recurrent rectocele (stage II, POP-Q staging) that required no surgical intervention. Urodynamic parameters related to
The Disability Impact and Associated Cost per Disability in Women Who Underwent Surgical Revision of Transvaginal Mesh Kits for Prolapse Repair.

Science.gov (United States)

Javadian, Pouya; Shobeiri, S Abbas

2017-09-13

The aim of this study was to investigate disability impact in patients and cost to the families of patients who have had complications of transvaginal prolapse mesh kits and underwent surgical revision. Patients who developed complications of transvaginal mesh kits for prolapse and who had undergone vaginal prolapse mesh surgical revision/removal in 2009 to 2014 at a single institution were identified by Current Procedural Terminology codes. The group was invited to complete a phone survey pertaining to the initial vaginal mesh used for prolapse surgery utilizing Sheehan Disability Scale (scale 0-10) and Years of life Lived with Disability (YLDs) questionnaires. The data collected were used to estimate the disability and cost analysis. We used our data to estimate the economic and quality-of-life impact of vaginal mesh complications on patients in the United States RESULTS: Sixty-two patients (62/198 [31.2%]) were consented to participate and completed the questionnaires by phone. Extremely disabled patients were 18 (29%) of 62 of whole cases, and 5 (8%) of 62 reported that they had no disability after vaginal mesh surgery. The median for overall disability score after vaginal mesh procedure was 8 (which reflects marked disability on a scale of 0-10). The majority of patients missed a median of 12 months of their school or work because of their mesh complications. Thirty-seven (59.6%) of 62 did not improve after mesh removal. Twenty-one (33.9%) of 62 stated that their family income dropped because of productivity loss related to mesh complications. The mean time between vaginal mesh surgery and mesh removal procedure was 4.7 years. Sheehan Disability Scale scores are significantly correlated with YLDs outcomes. Patients' overall disability score showed a significant correlation with YLDs scores (P mesh for prolapse reduction complications had a sustained disability impact that continued despite mesh removal. Likewise, the complications were associated with
Ultrassonografia do colo uterino versus índice de Bishop como preditor do parto vaginal Cervical ultrasonography versus Bishop score as a predictor of vaginal delivery

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José Richelmy Brazil Frota Aragão

2011-11-01

Full Text Available OBJETIVO: comparar a acurácia da mensuração ultrassonográfica transvaginal do colo uterino com o escore de Bishop para predição do parto vaginal após indução do trabalho de parto com misoprostol a 25 mcg. MÉTODOS: realizou-se estudo de validação de técnica diagnóstica com 126 gestantes com indicação para indução do trabalho de parto, as quais foram avaliadas pelo escore de Bishop e por ultrassonografia transvaginal para mensuração cervical. As pacientes foram submetidas, também, à ultrassonografia obstétrica transabdominal para avaliação da estática, pesos fetais e índice de líquido amniótico, e à cardiotocografia basal para avaliação da vitalidade fetal. Procedeu-se à indução do trabalho de parto com misoprostol vaginal e sublingual, um dos comprimidos contendo 25 mcg da droga e o outro apenas placebo. Os comprimidos foram administrados a cada seis horas, em um número máximo de oito. Construíram-se tabelas de distribuição de frequência e calcularam-se medidas de tendência central e de dispersão. Curvas ROC foram construídas para avaliação do escore de Bishop e da medida ultrassonográfica do colo uterino para predição de parto vaginal. RESULTADOS: obteve-se uma área sob a curva ROC de 0,5 (p=0,8 para medição do colo uterino pela ultrassonografia transvaginal, enquanto a curva ROC do escore de Bishop (ponto de corte ³4 apresentou área de 0,6 (p=0,02. O escore de Bishop ³4 apresentou sensibilidade de 56,2% e especificidade de 67,9% para predição de parto vaginal, com razão de verossimilhança positiva de 1,75 e negativa de 0,65. CONCLUSÕES: a medida ultrassonográfica transvaginal do colo uterino não foi boa preditora da evolução para parto vaginal em pacientes com trabalho de parto induzido com misoprostol. O escore de Bishop foi melhor preditor para parto vaginal nestas circunstâncias.PURPOSE: to compare the accuracy of transvaginal ultrasonographic measurement of the uterine cervix
Annual surveillance by CA125 and transvaginal ultrasound for ovarian cancer in both high-risk and population risk women is ineffective

DEFF Research Database (Denmark)

Woodward, E R; Sleightholme, H V; Considine, A M

2007-01-01

OBJECTIVE: To assess the efficacy of annual CA125 and transvaginal ultrasound (TVU) scan as surveillance for ovarian cancer. DESIGN: Retrospective audit. SETTING: NHS Trust. POPULATION: Three hundred and forty-one asymptomatic women enrolled for ovarian cancer screening: 179 were in a high...... and local cancer registry data. MAIN OUTCOME MEASURES: Ovarian cancers occurring in study population. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of TVU, and CA125 as a screening tool for ovarian cancer. RESULTS: Four ovarian cancers and one endometrial...... cancer occurred. One ovarian cancer was detected at surveillance, three occurred in women who presented symptomatically between screenings. Thirty women underwent exploratory surgery because of abnormal findings at surveillance. Two women had cancer (PPV = 6.7%); one had ovarian cancer and the other...
Efeitos do ultra-som de baixa intensidade na veia auricular de coelhos Effects of low intensity ultrasound in the auricular vein of rabbits

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Marcelo Araújo

2003-01-01

Full Text Available OBJETIVO: Estudar a ação do ultra-som na veia auricular de coelhos. MÉTODOS: Vinte coelhos foram divididos em dois grupos de dez animais diferindo com relação ao local da aplicação, do ultra-som, o modo e o intervalo de tempo para a análise histopatológica (3 e 7 dias. Os animais foram submetidos à aplicação de ultra-som contínuo e pulsado em dois segmentos venosos da orelha previamente determinados. Cada animal foi o seu próprio controle. Empregou-se a freqüência de 3MHz, intensidade de 3W/cm² nos ciclos pulsado e contínuo por 10 minutos, de forma estacionária. O grupo I foi submetido a eutanásia após 3 dias e o grupo II em 7 dias contemplando a fase aguda do processo inflamatório. Empregou-se o teste exato de Fisher e o teste de Mc Nemar para análise estatística. RESULTADOS: Obteve-se trombose venosa e aumento de linfócitos de forma significativa (p= 0,032 nos grupos tratados com o modo contínuo. O modo pulsado não provocou efeitos deletérios. Outros achados foram congestão, edema, hemorragia e lesão da parede vascular. CONCLUSÕES: O ultra-som pulsado não provoca qualquer alteração na parede vascular nas condições do experimento.O ultra-som contínuo induz a trombose venosa e aumento dos linfócitos de forma significativa.PURPOSE: The purpose of this experimental work was evaluate the effects of low intensity in the auricular vein of rabbits. METHODS: Twenty rabbits were divided in two groups of ten animals. The groups differed about the place where the continuous and pulsed ultrasound were applied and the period that the material was collected for the morphologic examination (3 and 7 days. Acoustic coupling gel was used on marginal ear vein, each animal underwent continuous and pulsed ultrasound treatment, in segments previously marked with indelible ink. Each animal provided its own control. Ultrasound was used in the frequency of 3MHz, intensity of 3W/cm² in the pulsed and continuous modes during 10min

ULTRA-LIGHTWEIGHT CEMENT

International Nuclear Information System (INIS)

Fred Sabins

2001-01-01

The objective of this project is to develop an improved ultra-lightweight cement using ultralight hollow glass spheres (ULHS). Work reported herein addresses Task 1: Assess Ultra-Lightweight Cementing Problems and Task 3: Test Ultra-Lightweight Cements. Results reported this quarter include a review and summary of Halliburton Energy Services (HES) and BJ Services historical performance data for lightweight cement applications. These data are analyzed and compared to ULHS cement and foamed cement performances. Similar data is expected from Schlumberger, and an analysis of this data will be completed in the following phases of the project. Quality control testing of materials used to formulate ULHS cements in the laboratory was completed to establish baseline material performance standards. A testing protocol was developed employing standard procedures as well as procedures tailored to evaluate ULHS and foamed cement. This protocol is presented and discussed. Results of further testing of ULHS cements are presented along with an analysis to establish cement performance design criteria to be used during the remainder of the project. Finally, a list of relevant literature on lightweight cement performance is compiled for review during the next quarter
Anatomical and functional characteristics of the pelvic floor in nulliparous women submitted to three-dimensional endovaginal ultrasonography: case control study and evaluation of interobserver agreement Características anatômicas e funcionais do assoalho pélvico em nulíparas avaliadas por ultrassonografia tridimensional endovaginal: estudo caso-controle e avaliação da confiabilidade interobservador

Directory of Open Access Journals (Sweden)

Sthela Maria Murad-Regadas

2013-03-01

with the 3-D endovaginal ultrasonography. The method was found to be reliable to measure pelvic floor structures at rest and during Valsalva, and might therefore be suitable for identifying dysfunctions in symptomatic patients.OBJETIVO: Avaliar as medidas anatômicas e funcionais do assoalho pélvico utilizando a ultrassonografia tridimensional transvaginal em nulíparas assintomáticas sem disfunções do compartimento posterior evidenciado pela ecodefecografia. Demonstrar o grau de concordância entre observadores do método utilizado para medir as estruturas anatômicas. MÉTODOS: Voluntárias nulíparas assintomáticas foram submetidas à ecodefecografia para identificar alterações dinâmicas no compartimento posterior, incluindo aquelas anatômicas (retocele, intussuscepção, entero/sigmoidocele e descenso perineal e funcionais (ausência de relaxamento ou contração paradoxal do puborretal e avaliadas com ultrassonografia tridimensional transvaginal para determinar índices biométricos do hiato dos elevadores do ânus, espessura do músculo pubovisceral, comprimento da uretra, ângulo anorretal, posição da junção anorretal e posição do colo vesical. Todas as medidas foram comparadas em repouso e durante Valsalva; e determinado descenso perineal e do colo da bexiga. A variabilidade interobservador foi avaliada utilizando o coeficiente de correlação intraclasse. RESULTADOS: Foram avaliadas 34 voluntárias com a ecodefecografia e a ultrassonografia tridimensional transvaginal. Dessas, 20 foram incluídas no estudo. As 14 excluídas apresentavam alterações dinâmicas no compartimento posterior. Durante a manobra de Valsalva, a área hiatal foi significativamente maior. A uretra foi significantemente mais curta e o ângulo anorretal foi maior. Medidas em repouso e durante a Valsalva diferiram significativamente em relação à posição da junção anorretal e do colo vesical. A média de valor do descenso perineal e do descenso da bexiga foram de 0
Characterisation of baroreflex sensitivity of recreational ultra-endurance athletes.

Science.gov (United States)

Foulds, Heather J A; Cote, Anita T; Phillips, Aaron A; Charlesworth, Sarah A; Bredin, Shannon S D; Burr, Jamie F; Drury, Chipman Taylor; Ngai, Shirley; Fougere, Renee J; Ivey, Adam C; Warburton, Darren E R

2014-01-01

Altered autonomic function has been identified following ultra-endurance event participation among elite world-class athletes. Despite dramatic increases in recreational athlete participation in these ultra-endurance events, the physiological effects on these athletes are less known. This investigation sought to characterise changes in surrogate measures of autonomic function: heart rate variability (HRV), blood pressure variability (BPV) and baroreceptor sensitivity (BRS) following ultra-endurance race participation. Further, we sought to compare baseline measures among ultra-endurance athletes and recreationally active controls not participating in the ultra-endurance race. Recreational ultra-endurance athletes (n = 25, 44.6 ± 8.2 years, 8 females) and recreationally active age, sex and body mass index matched controls (n = 25) were evaluated. Measurements of HRV, BPV and BRS were collected pre- and post-race for recreational ultra-endurance athletes and at baseline, for recreationally active controls. Post-race, ultra-endurance athletes demonstrated significantly greater sympathetic modulation [low frequency (LF) power HRV: 50.3 ± 21.6 normalised units (n.u.) to 65.9 ± 20.4 n.u., p = 0.01] and significantly lower parasympathetic modulation [high frequency (HF) power HRV: 45.0 ± 22.4 n.u. to 23.9 ± 13.1 n.u., p HRV and BPV measures. Recreational ultra-endurance athletes experienced increased sympathetic tone and declines in BRS post-race, similar to previously reported elite world-class ultra-endurance athletes, though still within normal population ranges.
Valor preditivo do resultado fetal da dopplervelocimetria de ducto venoso entre a 11ª e a 14ª semanas de gestação Predictive value for fetal outcome of Doppler velocimetry of the ductus venosus between the 11th and the 14th gestation week

Directory of Open Access Journals (Sweden)

Carlos Alberto Gollo

2008-01-01

Full Text Available OBJETIVO: estudar o valor da dopplervelocimetria do ducto venoso (DV entre a 11º e a 14º semanas de gestação, associado à medida da translucência nucal (TN, na detecção de resultado fetal adverso. MÉTODOS: foram estudados 1.268 fetos consecutivamente. Em 56 casos, realizou-se estudo citogenético no material obtido, por meio de biópsia de vilosidade coriônica e, em 1.181 casos, o resultado teve como base o fenótipo do recém-nascido. Todos os fetos foram submetidos, além da ultra-sonografia de rotina, à medida da TN e à dopplervelocimetria do DV. Trata-se de um estudo transversal e prospectivo. Foram calculados e analisados, para fins de prevalência e índices de acurácia: sensibilidade, especificidade, valor preditivo positivo (VPP, valor preditivo negativo (VPN, probabilidade de falso-positivo (PFP, probabilidade de falso-negativo (PFN, razão de probabilidade positiva e razão de probabilidade negativa. RESULTADOS: do total de 1.268 fetos, foram selecionados para análise 1.183 casos. Deste total, 1.170 fetos eram normais (98,9% e 13 fetos tiveram resultado fetal adverso ao nascimento (1,1% - incluindo morte fetal (trissomia 21 e 22 em dois casos, síndrome genética (Nooman em um caso, fetos polimalformados em dois casos, cardiopatia em três casos e outros defeitos estruturais em cinco casos. A prevalência do DV alterado (onda A zero/reversa na população estudada foi de 14 casos (1,2%, com taxa de falso-positivo de 0,7%. CONCLUSÕES: há correlação significativa entre alteração da dopplervelocimetria do DV e a medida da TN, como marcadores ultra-sonográficos de primeiro trimestre, na detecção de resultado fetal adverso, especialmente para malformações graves. O Doppler do DV foi capaz de diminuir o resultado falso-positivo, comparativamente ao uso isolado da TN, melhorando consideravelmente o VPP do teste.PURPOSE: to study the value of Doppler velocimetry of the ductus venosus, between the 11th and 14th weeks of
Three-dimensional transvaginal sonographic assessment of uterine volume as preoperative predictor of need to morcellate in women undergoing laparoscopic hysterectomy.

Science.gov (United States)

Gerges, B; Mongelli, M; Casikar, I; Bignardi, T; Condous, G

2017-08-01

In light of recent statements from the United States Food and Drug Administration warning against the use of power morcellation of uterine leiomyomas during laparoscopy, we sought to evaluate the use of preoperative two- (2D) and three- (3D) dimensional transvaginal ultrasound (US) assessment of uterine volume to predict the need for morcellation in women undergoing laparoscopic hysterectomy (LH). This was a prospective observational study performed between October 2008 and November 2011 in a tertiary referral laparoscopic unit. All women scheduled to undergo LH were included and underwent detailed preoperative transvaginal US. Uterine volumes were calculated using 2D-US measurements (ellipsoid formula), and using Virtual Organ Computer-aided AnaLysis (VOCAL™) having acquired 3D-US volumes of the uterus. Age, parity, need to morcellate and final uterine dry weight at histology were recorded. The estimated uterine volumes were then incorporated into a previously published logistic regression model to predict the need to morcellate for both nulliparous and parous women. The probability threshold cut-off of 0.14 (95% sensitivity) was evaluated in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratios (LRs). The performance of the models incorporating 2D- and 3D-US calculations were compared with 2D- and 3D-US-generated volumes alone, using receiver-operating characteristics (ROC) curves. Of 76 women who underwent LH during the study period, 79% (n = 60) had complete background and 3D-US data. Their mean age was 43.7 years, 91.7% were parous and 35% underwent morcellation. The greatest uterine volume that did not require morcellation was 404 mL estimated using 3D-US, which corresponded to a uterine volume of 688.8 mL using 2D-US. The smallest uterine volume that required morcellation was 118.9 mL using 3D-US, which corresponded to a uterine volume of 123.4 mL using 2D-US. The 3D-US uterine volume for
Avaliação da função renal do idoso em duas horas

OpenAIRE

Benarab,Maria do Carmo B. Sammartino; Castiglia,Yara Marcondes Machado; Vianna,Pedro Thadeu Galvão; Braz,José Reinaldo Cerqueira

2005-01-01

JUSTIFICATIVA E OBJETIVOS: Os idosos têm diminuição progressiva da função renal e os hipertensos, maior risco de lesão renal adicional no intra-operatório. Avalia-se a função renal pela depuração da creatinina, com débito urinário de 24 horas, para diluir o erro de possível volume vesical residual (VVR). O objetivo deste trabalho foi avaliar a função renal pré-operatória de idosos hipertensos e não-hipertensos, com débito urinário de duas horas, utilizando aparelho de ultra-som portátil para ...
7 CFR 58.144 - Pasteurization or ultra-pasteurization.

Science.gov (United States)

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Pasteurization or ultra-pasteurization. 58.144 Section... Service 1 Operations and Operating Procedures § 58.144 Pasteurization or ultra-pasteurization. When pasteurization or ultra-pasteurization is intended or required, or when a product is designated “pasteurized” or...
Transvaginal prolapse repair with or without the addition of a midurethral sling in women with genital prolapse and stress urinary incontinence: a randomised trial.

Science.gov (United States)

van der Ploeg, J M; Oude Rengerink, K; van der Steen, A; van Leeuwen, J H S; Stekelenburg, J; Bongers, M Y; Weemhoff, M; Mol, B W; van der Vaart, C H; Roovers, J-P W R

2015-06-01

To compare transvaginal prolapse repair combined with midurethral sling (MUS) versus prolapse repair only. Multi-centre randomised trial. Fourteen teaching hospitals in the Netherlands. Women with symptomatic stage two or greater pelvic organ prolapse (POP), and subjective or objective stress urinary incontinence (SUI) without prolapse reduction. Women were randomly assigned to undergo vaginal prolapse repair with or without MUS. Analysis was according to intention to treat. The primary outcome at 12 months' follow-up was the absence of urinary incontinence (UI) assessed with the Urogenital Distress Inventory and treatment for SUI or overactive bladder. Secondary outcomes included complications. One hundred and thirty-four women were analysed at 12 months' follow-up (63 in MUS and 71 in control group). More women in the MUS group reported the absence of UI and SUI; respectively 62% versus 30% UI (relative risk [RR] 2.09; 95% confidence interval [CI] 1.39-3.15) and 78% versus 39% SUI (RR 1.97; 95% CI 1.44-2.71). Fewer women underwent treatment for postoperative SUI in the MUS group (10% versus 37%; RR 0.26; 95% CI 0.11-0.59). In the control group, 12 women (17%) underwent MUS after prolapse surgery versus none in the MUS group. Severe complications were more common in the MUS group, but the difference was not statistically significant (16% versus 6%; RR 2.82; 95% CI 0.93-8.54). Women with prolapse and co-existing SUI are less likely to have SUI after transvaginal prolapse repair with MUS compared with prolapse repair only. However, only 17% of the women undergoing POP surgery needed additional MUS. A well-informed decision balancing risks and benefits of both strategies should be tailored to individual women. © 2015 Royal College of Obstetricians and Gynaecologists.
Mesh complications and failure rates after transvaginal mesh repair compared with abdominal or laparoscopic sacrocolpopexy and to native tissue repair in treating apical prolapse.

Science.gov (United States)

Dandolu, Vani; Akiyama, Megumi; Allenback, Gayle; Pathak, Prathamesh

2017-02-01

Our objective was to quantitate the extent of complications and failure rate for apical prolapse repair with transvaginal mesh (TVM) use versus sacrocolpopexy over a minimum of 2 years of follow-up. Truven CCAE and Medicare Supplemental databases 2008-2013 were used for analysis. Patients with apical prolapse repair via transvaginal mesh (TVMR), abdominal sacrocolpopexy (ASCP), laparoscopic sacrocolpopexy (LSCP), or native tissue repair (NTR) and continuously enrolled for years were in the study cohort. Surgical failures were identified by reoperation for any prolapse or subsequent use of pessary. SAS® 9.3 was used for analysis. Mesh removal/revision was reported highest in TVMR (5.1 %), followed by LSCP (1.7 %) and ASCP (1.2 %). In those with concomitant sling, combined rates for mesh/sling revision were high, at 9.0 % in TVMR + sling, 5.6 % in ASCP + sling, and 4.5 % LSCP + sling. Sling-alone cases reported a 3.5 % revision rate. Pelvic pain (16.4-22.7 %) and dyspareunia (5.6-7.5 %) were high in all three approaches for apical prolapse repairs. Reoperation for apical prolapse was more common for TVMR (2.9 %) compared with NTR (2.3 %) [odds ratio (OR) 1.27; confidence interval (CI) 1.1-1.47; p 0.002]. Both ASCP and LSCP were superior to NTR (ASCP 1.5 %, OR 0.63, CI 0.46-0.86; p 0.003) and LSCP 1.8 % (OR 0.79, CI 0.62-1.01; p 0.07). Overall prolapse recurrence, as indicated by any compartment surgery for prolapse and/or pessary use, was also noted highest in TVMR (5.9 % OR 1.23, CI 1.11-1.36; p mesh is used for repair, mesh revision is highest with TVMR and lowest with ASCP.
Estudo comparativo da biocompatibilidade da submucosa intestinal porcina e pericárdio bovino usados como enxertos na veia cava de cães Comparative study of the biocompatibility of the porcine intestinal submucosa and bovine pericardium used as grafts in the inferior cava vein of dogs

Directory of Open Access Journals (Sweden)

Fernando Hintz Greca

2005-08-01

Full Text Available OBJETIVO: Comparar a biocompatibilidade entre submucosa de intestino delgado (SID porcino e o pericárdio bovino como enxerto no reparo de lesões criadas na veia cava inferior de cães. MÉTODOS: Dezesseis cães foram submetidos a laparotomia. Após a abertura da cavidade abdominal a veia cava foi identificada e em seguida procedeu-se com a retirada de um segmento elíptico de 1,5X3cm de sua parede anterior. Em 8 animais o defeito foi reparado com SID porcino (grupo A e nos 8 animais restantes o defeito foi reparado com pericárdio bovino (grupo B.No 30° dia de P.O. realizou-se uma ultra-sonografia e a eutanásia foi realizada no 40°dia de pós-operatório. RESULTADOS: Observou-se estenose da veia cava em 1 cão do grupo do grupo A e em 2 animais do grupo B além de trombose em 1 cão desse mesmo grupo. A análise microscópica revelou um processo inflamatório crônico moderado em ambos os grupos. A endotelização do enxerto, regeneração de fibras musculares lisas e depósito de colágeno também foi similar nos 2 grupos estudados. CONCLUSÃO: A SID provou ser um excelente substrato para a regeneração vascular quando implantado em veia cava superior, contudo os resultados encontrados não diferem daqueles observados com o uso de pericárdio bovino.PURPOSE: To compare the biocompatibility of the bovine pericardium and the small intestine submucosa (SIS when used to repair a created defect in the inferior vena cava of dogs. METHODS: Sixteen male mongrel dogs were submitted to a midline laparotomy incision. An elliptical segment (1,5 X 3,0 cm of the inferior vena cava, below the renal veins, was excised. In 8 dogs, the A group, a patch of porcine small bowel submucosa was used to repair the defect. In the 8 remaining dogs, the B group, a bovine pericardium was implanted in the vena cava. On the 30th post-operative day an ultrasound was performed in order to identify stenosis. The euthanasia was accomplished in the 40th post-operative day
Understanding Patient Preference in Female Pelvic Imaging: Transvaginal Ultrasound and MRI.

Science.gov (United States)

Sakala, Michelle D; Carlos, Ruth C; Mendiratta-Lala, Mishal; Quint, Elisabeth H; Maturen, Katherine E

2018-04-01

Women with pelvic pain or abnormal uterine bleeding may undergo diagnostic imaging. This study evaluates patient experience in transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) and explores correlations between preference and symptom severity. Institutional review board approval was obtained for this Health Insurance Portability and Accountability Act-compliant prospective study. Fifty premenopausal women with pelvic symptoms evaluated by recent TVUS and MRI and without history of gynecologic cancer or hysterectomy were included. A phone questionnaire used validated survey instruments including Uterine Fibroid Symptoms Quality of Life index, Testing Morbidities Index, and Wait Trade Off for TVUS and MRI examinations. Using Wait Trade Off, patients preferred TVUS over MRI (3.58 vs 2.80 weeks, 95% confidence interval [CI] -1.63, 0.12; P = .08). Summary test utility of Testing Morbidities Index for MRI was worse than for TVUS (81.64 vs 87.42, 95%CI 0.41, 11.15; P = .03). Patients reported greater embarrassment during TVUS than during MRI (P MRI, and greater mental (P = .02) and physical (P = .02) problems after MRI versus TVUS. Subscale correlations showed physically inactive women rated TVUS more negatively (R = -0.32, P = .03), whereas women with more severe symptoms of loss of control of health (R = -0.28, P = .04) and sexual dysfunction (R = -0.30, P = .03) rated MRI more negatively. Women with pelvic symptoms had a slight but significant preference for TVUS over MRI. Identifying specific distressing aspects of each test and patient factors contributing to negative perceptions can direct improvement in both test environment and patient preparation. Improved patient experience may increase imaging value. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
Seeking new surgical predictors of mesh exposure after transvaginal mesh repair.

Science.gov (United States)

Wu, Pei-Ying; Chang, Chih-Hung; Shen, Meng-Ru; Chou, Cheng-Yang; Yang, Yi-Ching; Huang, Yu-Fang

2016-10-01

The purpose of this study was to explore new preventable risk factors for mesh exposure. A retrospective review of 92 consecutive patients treated with transvaginal mesh (TVM) in the urogynecological unit of our university hospital. An analysis of perioperative predictors was conducted in patients after vaginal repairs using a type 1 mesh. Mesh complications were recorded according to International Urogynecological Association (IUGA) definitions. Mesh-exposure-free durations were calculated by using the Kaplan-Meier method and compared between different closure techniques using log-rank test. Hazard ratios (HR) of predictors for mesh exposure were estimated by univariate and multivariate analyses using Cox proportional hazards regression models. The median surveillance interval was 24.1 months. Two late occurrences were found beyond 1 year post operation. No statistically significant correlation was observed between mesh exposure and concomitant hysterectomy. Exposure risks were significantly higher in patients with interrupted whole-layer closure in univariate analysis. In the multivariate analysis, hematoma [HR 5.42, 95 % confidence interval (CI) 1.26-23.35, P = 0.024), Prolift mesh (HR 5.52, 95 % CI 1.15-26.53, P = 0.033), and interrupted whole-layer closure (HR 7.02, 95 % CI 1.62-30.53, P = 0.009) were the strongest predictors of mesh exposure. Findings indicate the risks of mesh exposure and reoperation may be prevented by avoiding hematoma, large amount of mesh, or interrupted whole-layer closure in TVM surgeries. If these risk factors are prevented, hysterectomy may not be a relative contraindication for TVM use. We also provide evidence regarding mesh exposure and the necessity for more than 1 year of follow-up and preoperative counselling.
Comparison of immediate postoperative pain after transvaginal versus traditional laparoscopic cholecystectomy.

Science.gov (United States)

Wood, Stephanie G; Dabu-Bondoc, Susan; Dai, Feng; Mikhael, Hosni; Vadivelu, Nalini; Roberts, Kurt E

2014-04-01

Transvaginal cholecystectomy (TVC) is the most common natural orifice transluminal surgery (NOTES) performed in women, yet there is a paucity of data on intraoperative and immediate postoperative pain management. Previous studies have demonstrated that NOTES procedures are associated with less postoperative pain and faster recovery times. This study analyzes intraoperative and postoperative opioid use for TVC compared with traditional four-port laparoscopic cholecystectomies (LCs). This is a retrospective analysis of consecutive TVC and LC female patients between August 2009 and August 2012 in an academic institution. We compared demographics, intraoperative and postoperative opioid use and times in the operating room (OR) and in the post anesthesia care unit (PACU). A total of 68 TVC and 67 LC patients were included in this study. The TVC and LC groups were similar in terms of age (both 41 years) and body mass index (29 and 31 kg/m2, respectively). The intraoperative preparation, surgical, and emergence times were significantly longer for the TVC than for the LC (p ≤ 0.01). Compared with the LC group, the intraoperative opioid requirement was significantly greater (TVC 27 mg vs. LC 25 mg; p = 0.003), but after adjusting for anesthesia time, the difference in OR opioid consumption became non-significant (p = 0.08). The PACU opioid requirement (TVC 2.5 vs. LC 5 mg; p = 0.04) was significantly lower for the TVC group, and a greater proportion of patients did not need any pain medications (TVC 38 % vs. LC 21 %; p = 0.04), compared with the LC group. The average PACU pain scores were not significantly different between the groups (p = 0.45). TVC patients did not experience more pain than LC patients. Although the average pain scores of TVC patients did not differ from those of the LC patients, TVC patients did require less pain medication in the PACU.
Avaliação Ultra-sonográfica Longitudinal do Colo Uterino em Gestações Gemelares

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Fujita Mariza Marie

2002-01-01

Full Text Available Objetivo: analisar a evolução do comprimento do colo uterino ao longo da gestação gemelar e descrever a sua relação com a idade gestacional na época do parto. Métodos: estudo retrospectivo com análise de dados obtidos prospectivamente entre 1994 e 2000, no qual foram incluídas 149 grávidas com gestações gemelares. Estas foram submetidas a avaliações ultra-sonográficas para medida do comprimento do colo uterino no período de 1994 a 2000. A medida do colo uterino foi realizada na primeira avaliação ultra-sonográfica e, a partir desta, repetida em intervalos de quatro semanas. O exame foi realizado pela via endovaginal com a bexiga vazia. Resultados: em 127 gestações (85,2%, o parto ocorreu após a 34ª semana; em 20 (13,4%, entre a 24ª e a 33ª semanas, e 2 casos (1,3% resultaram em abortamento espontâneo antes da 24a semana. A idade gestacional média na época dos partos foi 36,3 semanas. Um total de 497 avaliações do colo foram realizadas nas 127 gestações gemelares que resultaram em parto após 34 semanas (média de 4 avaliações por paciente. As avaliações foram realizadas entre a 91ª e a 39ª semana (idade gestacional média = 29,4 semanas. O teste de regressão polinomial demonstrou correlação inversa entre a medida do colo uterino e a idade gestacional (r=-0,44; p<0,0001. O valor médio foi de 44 mm na 10ª semana e 28 mm na 36ª semana. Os valores correspondentes para o 5º percentil foram de 28 mm e 12 mm, respectivamente. A mudança na medida do comprimento do colo do útero foi mais pronunciada na segunda metade da gestação (teste de Kruskal-Wallis, p=0,0006. A medida média do colo uterino e o 5ª percentil nos diferentes períodos da gestação foram determinados. Do total de 26 casos em que o parto ocorreu antes da 34ª semana, nove (34,6% apresentavam pelo menos uma medida do colo abaixo do 5º percentil. Conclusão: o comprimento do colo do útero diminui gradualmente durante a gesta
Cicatriz radial/lesão esclerosante complexa: aspectos radiológicos com correlação clínica, ultra-sonográfica e anatomopatológica Radial scar/complex sclerosing lesion: radiologic features with clinical, ultrasonographic and pathologic correlation

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Cristina Caetano Stefenon

2003-03-01

Full Text Available OBJETIVO: Estudar, retrospectivamente, as várias formas de apresentação da cicatriz radial/lesão esclerosante complexa (CR/LEC na mamografia, correlacionando-as com o exame clínico e os achados ultra-sonográficos. Os achados histopatológicos e a associação da CR/LEC com hiperplasia atípica e carcinoma são discutidos. MATERIAIS E MÉTODOS: Foi realizado estudo retrospectivo de 926 lesões impalpáveis em 901 pacientes submetidas a biópsia excisional após localização pré-cirúrgica, do arquivo do Centro de Diagnóstico por Imagem e do Hospital Santa Rita, Vitória, ES, no período de outubro de 1993 a dezembro de 2001, nas quais 57 pacientes tiveram diagnóstico histopatológico de CR/LEC. RESULTADOS: A idade variou de 31 a 84 anos (média de 49 anos. As lesões foram palpáveis em dez casos. Na mamografia, 48 casos se apresentaram como distorção arquitetural, e com a mesma freqüência o nódulo espiculado e a densidade assimétrica, quatro casos cada. As microcalcificações foram detectadas na mamografia em 14 casos e em 20 quando o espécime cirúrgico foi avaliado. A ultra-sonografia foi realizada em 51 casos, tendo expressão em 17 como área hipoecóica irregular com atenuação acústica posterior. Houve 42 casos de CR/LEC sem ou com proliferação típica, nove casos com proliferação epitelial atípica e seis casos com carcinoma infiltrativo associado. CONCLUSÃO: Não é possível fazer diagnóstico diferencial de CR/LEC com câncer pelos métodos de imagem e a biópsia excisional deve ser realizada.OBJECTIVE: To review the different types of radial scar/complex sclerosing lesion (RS/CSL seen on clinical, mammography, and ultrasound examinations. The histopathology findings and the association of RS/CSL with atypical hyperplasia and malignancy are discussed. MATERIALS AND METHODS: We performed a retrospective study of patients from the files of the "Centro de Diagnóstico por Imagem and Hospital Santa Rita" - Vit
Introduction to Ultra Wideband for Wireless Communications

DEFF Research Database (Denmark)

Nikookar, Homayoun; Prasad, Ramjee

wireless channels, interference, signal processing as well as applications and standardization activities are addressed. Introduction to Ultra Wideband for Wireless Communications provides easy-to-understand material to (graduate) students and researchers working in the field of commercial UWB wireless......Ultra Wideband (UWB) Technology is the cutting edge technology for wireless communications with a wide range of applications. In Introduction to Ultra Wideband for Wireless Communications UWB principles and technologies for wireless communications are explained clearly. Key issues such as UWB...... communications. Due to tutorial nature of the book it can also be adopted as a textbook on the subject in the Telecommunications Engineering curriculum. Problems at the end of each chapter extend the reader's understanding of the subject. Introduction to Ultra Wideband for Wireless Communications will aslo...
Innovation: study of 'ultra-short' time reactions

International Nuclear Information System (INIS)

Anon.

2001-01-01

This short article presents the new Elyse facility of Orsay-Paris 11 university for the study of ultra-short chemical and biochemical phenomena. Elyse uses the 'pump-probe' technique which consists in two perfectly synchronized electron and photon pulses. It comprises a 3 to 9 MeV electron accelerator with a HF gun photo-triggered with a laser. Elyse can initiate reactions using ultra-short electron pulses (radiolysis) or ultra-short photon pulses (photolysis). (J.S.)
Ultra wide band antennas

CERN Document Server

Begaud, Xavier

2013-01-01

Ultra Wide Band Technology (UWB) has reached a level of maturity that allows us to offer wireless links with either high or low data rates. These wireless links are frequently associated with a location capability for which ultimate accuracy varies with the inverse of the frequency bandwidth. Using time or frequency domain waveforms, they are currently the subject of international standards facilitating their commercial implementation. Drawing up a complete state of the art, Ultra Wide Band Antennas is aimed at students, engineers and researchers and presents a summary of internationally recog
Ultra-high-speed Optical Signal Processing using Silicon Photonics

DEFF Research Database (Denmark)

Oxenløwe, Leif Katsuo; Ji, Hua; Jensen, Asger Sellerup

with a photonic layer on top to interconnect them. For such systems, silicon is an attractive candidate enabling both electronic and photonic control. For some network scenarios, it may be beneficial to use optical on-chip packet switching, and for high data-density environments one may take advantage...... of the ultra-fast nonlinear response of silicon photonic waveguides. These chips offer ultra-broadband wavelength operation, ultra-high timing resolution and ultra-fast response, and when used appropriately offer energy-efficient switching. In this presentation we review some all-optical functionalities based...... on silicon photonics. In particular we use nano-engineered silicon waveguides (nanowires) [1] enabling efficient phasematched four-wave mixing (FWM), cross-phase modulation (XPM) or self-phase modulation (SPM) for ultra-high-speed optical signal processing of ultra-high bit rate serial data signals. We show...
Conhecimento sobre o diagnóstico e rastreamento do câncer de mama entre os ginecologistas do estado de Goiás (Brasil

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Freitas Júnior Ruffo de

2003-01-01

Full Text Available OBJETIVOS: Avaliar o nível de conhecimento sobre o rastreamento e diagnóstico do câncer de mama entre os ginecologistas do Estado de Goiás, Brasil. MÉTODOS: Foi enviado um questionário contendo perguntas sobre a formação profissional e sobre o diagnóstico do câncer de mama, para os 427 sócios da Sociedade Goiana de Ginecologia e Obstetrícia, entre maio e julho de 1999. RESULTADOS: Dos 427 questionários enviados, 26 (6% foram devolvidos por endereçamento incorreto. Dos 401 médicos que receberam o questionário, 85 (21% responderam e retornaram. Destes, 28% eram do sexo feminino, a média do tempo de profissão foi de 17 anos e 70% possuía a residência médica como maior titularidade. A média de idade foi de 44 anos. As taxas de respostas corretas foram: 94% sabiam o sinal mais freqüente do câncer de mama, 75% o melhor método para rastreamento, 88% o período de quando iniciar a mamografia, 93% a periodicidade da mamografia após os 50 anos e 83% sobre a indicação da ultra-sonografia complementar. O fato de o profissional ter cursado um programa de Residência Médica foi o único fator que influenciou na taxa de respostas corretas, se comparado àqueles que não cursaram. O sexo do profissional, portadores de Título de Especialista em ginecologia e obstetrícia (TEGO e a cidade de atuação não influenciaram nas taxas de respostas corretas. CONCLUSÕES: Os ginecologistas do Estado de Goiás que responderam ao questionário têm um bom conhecimento sobre o rastreamento e diagnóstico do câncer de mama, sendo que apenas a Residência Médica influenciou na taxa de respostas corretas.

Validade dos Métodos Clínico e Ecográfico para o Diagnóstico de Adenomiose

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Cabral Júnior Sérgio Fernandes

2002-01-01

Full Text Available Objetivos: determinar a sensibilidade, especificidade, valores preditivos positivo e negativo de um método clínico e da ultra-sonografia no diagnóstico da adenomiose. Métodos: foi realizado estudo transversal do tipo validação de método diagnóstico incluindo 95 mulheres no menacme submetidas a histerectomia por diversas indicações. O diagnóstico clínico foi estabelecido em mulheres acima de 40 anos, dois ou mais filhos, com desvio menstrual para mais associado a dismenorréia. O diagnóstico ecográfico foi firmado pelo achado de, no mínimo, uma área mal delimitada de textura miometrial anormal hiper ou hipoecoíca, heterogênea ou cística. O critério histopatológico, considerado padrão-ouro, consistiu de achado de glândulas e estroma endometrial a 2,5 cm ou mais da junção endomiometrial. Resultados: o método clínico apresentou sensibilidade de 68,2%, especificidade de 78,1%, valor preditivo positivo de 48,4% e valor preditivo negativo de 89,1%. Para o método ecográfico esses valores foram de, respectivamente, 45,5%, 84,9%, 47,6% e 83,8%. A razão de verosimilhança foi de 3,11 para o método clínico e 3,03 para o método ecográfico. Considerando apenas os casos positivos para ambos os métodos concomitantemente, a sensibilidade não ultrapassou 30%, mas a especificidade aproximou-se de 100%. Considerando-se os casos positivos em um dos dois métodos ou em ambos, a sensibilidade atingiu 86% e a especificidade a 60%. Conclusões: o método ecográfico não foi superior ao método clínico no diagnóstico de adenomiose.
Ultra high energy gamma-ray astronomy

International Nuclear Information System (INIS)

Wdowczyk, J.

1986-01-01

The experimental data on ultra high energy γ-rays are reviewed and a comparison of the properties of photon and proton initiated shower is made. The consequences of the existence of the strong ultra high energy γ-ray sources for other observations is analysed and possible mechanisms for the production of ultra high energy γ-rays in the sources are discussed. It is demonstrated that if the γ-rays are produced via cosmic ray interactions the sources have to produce very high fluxes of cosmic ray particles. In fact it is possible that a small number of such sources can supply the whole Galactic cosmic ray flux
Tratamento de nódulos autônomos e císticos da tireóide com injeção intranodular de etanol Treatment of autonomous and cystic thyroid nodules with intranodular ethanol injection

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MILENA BRAGA-BASARIA

2002-12-01

Full Text Available O tratamento com injeção intranodular de etanol vem sendo utilizado há uma década como modalidade terapêutica eficaz no manejo de pacientes com nódulos da tireóide. Diversos estudos validaram o papel desta forma de tratamento em nódulos autônomos, císticos e, mais recentemente, nódulos frios benignos. OBJETIVO: Avaliar a efetividade da injeção intranodular de etanol no tratamento de nódulos císticos e autônomos da tireóide. MÉTODOS: 42 pacientes (26 pacientes com nódulos císticos e 16 com nódulos autônomos da tireóide foram submetidos a tratamento com aplicação intranodular de etanol a 99%, guiada por ultra-sonografia e acompanhados por um período mínimo de seis meses. RESULTADOS: Não observamos a ocorrência de complicações maiores durante ou após o tratamento, porém, na maioria dos casos, houve queixa de dor de leve a moderada intensidade e/ou desconforto após a aplicação do etanol. A maioria dos nódulos apresentou redução volumétrica significativa. A média de redução obtida para os nódulos autônomos foi de 50,3% e para os nódulos císticos, 69,3%. Não houve diferença significativa entre os valores basais de T3 total, T4 total e TSH em comparação aos valores obtidos seis meses após o tratamento para o grupo de pacientes com nódulos císticos. O grupo de pacientes com nódulos autônomos apresentou redução nos valores séricos de T3 total e T4 total, assim como elevação dos níveis de TSH, confirmando a efetividade do tratamento. CONCLUSÃO: A injeção intranodular de etanol é uma alternativa segura e eficaz no tratamento de nódulos autônomos e císticos da tireóide.Intranodular ethanol injection has been used for the past 10 years as an efficient modality for treating patients with thyroid nodules. Several studies have reported the success of this therapy in autonomous and cystic nodules and, more recently, in cold benign nodules. PURPOSE: To evaluate the efficacy of this therapeutic
Radiobiological response to ultra-short pulsed megavoltage electron beams of ultra-high pulse dose rate.

Science.gov (United States)

Beyreuther, Elke; Karsch, Leonhard; Laschinsky, Lydia; Leßmann, Elisabeth; Naumburger, Doreen; Oppelt, Melanie; Richter, Christian; Schürer, Michael; Woithe, Julia; Pawelke, Jörg

2015-08-01

In line with the long-term aim of establishing the laser-based particle acceleration for future medical application, the radiobiological consequences of the typical ultra-short pulses and ultra-high pulse dose rate can be investigated with electron delivery. The radiation source ELBE (Electron Linac for beams with high Brilliance and low Emittance) was used to mimic the quasi-continuous electron beam of a clinical linear accelerator (LINAC) for comparison with electron pulses at the ultra-high pulse dose rate of 10(10) Gy min(-1) either at the low frequency of a laser accelerator or at 13 MHz avoiding effects of prolonged dose delivery. The impact of pulse structure was analyzed by clonogenic survival assay and by the number of residual DNA double-strand breaks remaining 24 h after irradiation of two human squamous cell carcinoma lines of differing radiosensitivity. The radiation response of both cell lines was found to be independent from electron pulse structure for the two endpoints under investigation. The results reveal, that ultra-high pulse dose rates of 10(10) Gy min(-1) and the low repetition rate of laser accelerated electrons have no statistically significant influence (within the 95% confidence intervals) on the radiobiological effectiveness of megavoltage electrons.
Ultra Deep Wave Equation Imaging and Illumination

Energy Technology Data Exchange (ETDEWEB)

Alexander M. Popovici; Sergey Fomel; Paul Sava; Sean Crawley; Yining Li; Cristian Lupascu

2006-09-30

In this project we developed and tested a novel technology, designed to enhance seismic resolution and imaging of ultra-deep complex geologic structures by using state-of-the-art wave-equation depth migration and wave-equation velocity model building technology for deeper data penetration and recovery, steeper dip and ultra-deep structure imaging, accurate velocity estimation for imaging and pore pressure prediction and accurate illumination and amplitude processing for extending the AVO prediction window. Ultra-deep wave-equation imaging provides greater resolution and accuracy under complex geologic structures where energy multipathing occurs, than what can be accomplished today with standard imaging technology. The objective of the research effort was to examine the feasibility of imaging ultra-deep structures onshore and offshore, by using (1) wave-equation migration, (2) angle-gathers velocity model building, and (3) wave-equation illumination and amplitude compensation. The effort consisted of answering critical technical questions that determine the feasibility of the proposed methodology, testing the theory on synthetic data, and finally applying the technology for imaging ultra-deep real data. Some of the questions answered by this research addressed: (1) the handling of true amplitudes in the downward continuation and imaging algorithm and the preservation of the amplitude with offset or amplitude with angle information required for AVO studies, (2) the effect of several imaging conditions on amplitudes, (3) non-elastic attenuation and approaches for recovering the amplitude and frequency, (4) the effect of aperture and illumination on imaging steep dips and on discriminating the velocities in the ultra-deep structures. All these effects were incorporated in the final imaging step of a real data set acquired specifically to address ultra-deep imaging issues, with large offsets (12,500 m) and long recording time (20 s).
A low-cost, ultra-fast and ultra-low noise preamplifier for silicon avalanche photodiodes

Science.gov (United States)

Gasmi, Khaled

2018-02-01

An ultra-fast and ultra-low noise preamplifier for amplifying the fast and weak electrical signals generated by silicon avalanche photodiodes has been designed and developed. It is characterized by its simplicity, compactness, reliability and low cost of construction. A very wide bandwidth of 300 MHz, a very good linearity from 1 kHz to 280 MHz, an ultra-low noise level at the input of only 1.7 nV Hz-1/2 and a very good stability are its key features. The compact size (70 mm × 90 mm) and light weight (45 g), as well as its excellent characteristics, make this preamplifier very competitive compared to any commercial preamplifier. The preamplifier, which is a main part of the detection system of a homemade laser remote sensing system, has been successfully tested. In addition, it is versatile and can be used in any optical detection system requiring high speed and very low noise electronics.
Complications of transvaginal natural orifice transluminal endoscopic surgery: a series of 102 patients.

Science.gov (United States)

Wood, Stephanie G; Panait, Lucian; Duffy, Andrew J; Bell, Robert L; Roberts, Kurt E

2014-04-01

To review the complications encountered in our facility and in previously published studies of transvaginal (TV) natural orifice transluminal endoscopic surgery (NOTES) to date. TV NOTES is currently observed with critical eyes from the surgical community, despite encouraging data to suggest improved short-term recovery and pain. All TV NOTES procedures performed in female patients between 18 and 65 years of age were included. The median follow-up was 90 days. The TV appendectomies and ventral hernia repairs were pure NOTES, through a SILS port in the vagina, whereas TV cholecystectomies were hybrid procedures with the addition of a 5-mm port in the umbilicus. A total of 102 TV NOTES procedures, including 72 TV cholecystectomies, 24 TV appendectomies, and 6 TV ventral hernia repairs, were performed. The average age was 37 years old and body mass index was 29 kg/m. Three major and 7 minor complications occurred. The first major complication was a rectal injury during a TV access port insertion. The second major complication was an omental vessel bleed after a TV cholecystectomy. The third complication was an intra-abdominal abscess after a TV appendectomy. Seven minor complications were urinary retention (4), transient brachial plexus injury, dislodgement of an intrauterine device, and vaginal granulation tissue. As techniques in TV surgery are adopted, inevitably, complications may occur due to the inherent learning curve. Laparoscopic instruments, although adaptable to TV approaches, have yet to be optimized. A high index of suspicion is necessary to identify complications and optimize outcomes for patients.
Ultras in Trnava: History, Activities and Ideology

Directory of Open Access Journals (Sweden)

Kušnierová Daniela

2014-12-01

Full Text Available The environment of football fans is unknown phenomenon for the rest of the public. This article offers basic view on formation and functioning of the most numerous and the most active ultras group in Slovakia, Trnava fans. First part of the text encompasses a history overview of ultras movement, as well as an overview of basic activities of ultras fans during a football match and also outside of it. The second part of this text deals with the most debated activity of football fans, which is violence during a football match.
Ultra-thin chip technology and applications

CERN Document Server

2010-01-01

Ultra-thin chips are the "smart skin" of a conventional silicon chip. This book shows how very thin and flexible chips can be fabricated and used in many new applications in microelectronics, microsystems, biomedical and other fields. It provides a comprehensive reference to the fabrication technology, post processing, characterization and the applications of ultra-thin chips.
Stretchers and compressors for ultra-high power laser systems

Energy Technology Data Exchange (ETDEWEB)

Yakovlev, I V [Institute of Applied Physics, Russian Academy of Sciences, Nizhnii Novgorod (Russian Federation)

2014-05-30

This review is concerned with pulse stretchers and compressors as key components of ultra-high power laser facilities that take advantage of chirped-pulse amplification. The potentialities, characteristics, configurations and methods for the matching and alignment of these devices are examined, with particular attention to the history of the optics of ultra-short, ultra-intense pulses before and after 1985, when the chirped-pulse amplification method was proposed, which drastically changed the view of the feasibility of creating ultra-high power laser sources. The review is intended primarily for young scientists and experts who begin to address the amplification and compression of chirped pulses, experts in laser optics and all who are interested in scientific achievements in the field of ultra-high power laser systems. (review)
A prospective study on transvaginal ultrasound of cervical length (CL) in the first and second trimester in a low-risk population

DEFF Research Database (Denmark)

Wulff, C B; Rode, Line; Rosthøj, S

2018-01-01

OBJECTIVES: To assess cervical length (CL) longitudinally in the first and second trimester and to determine the proportion of women with a short CL. Further, to assess if women with a short CL at 19-24 weeks could be identified at the combined first-trimester screening (cFTS) at 11-14 weeks...... in relation to a potential implementation of CL screening in the Danish population. METHODS: We recruited singleton pregnant women attending the combined first-trimester screening from 1 November 2013 to 1 December 2014 to a longitudinal prospective study at three University Hospitals in Denmark. We excluded...... women with multiple pregnancies, uterine anomalies, cerclage, or progesterone treatment at inclusion. CL was measured by transvaginal sonography at 11-14 weeks (Cx1), 19-21 weeks (Cx2) and 23-24 weeks (Cx3). CL was measured as a straight line from the external to internal os by trained operators. Women...
Consumption of ultra-processed foods predicts diet quality in Canada.

Science.gov (United States)

Moubarac, Jean-Claude; Batal, M; Louzada, M L; Martinez Steele, E; Monteiro, C A

2017-01-01

This study describes food consumption patterns in Canada according to the types of food processing using the Nova classification and investigates the association between consumption of ultra-processed foods and the nutrient profile of the diet. Dietary intakes of 33,694 individuals from the 2004 Canadian Community Health Survey aged 2 years and above were analyzed. Food and drinks were classified using Nova into unprocessed or minimally processed foods, processed culinary ingredients, processed foods and ultra-processed foods. Average consumption (total daily energy intake) and relative consumption (% of total energy intake) provided by each of the food groups were calculated. Consumption of ultra-processed foods according to sex, age, education, residential location and relative family revenue was assessed. Mean nutrient content of ultra-processed foods and non-ultra-processed foods were compared, and the average nutrient content of the overall diet across quintiles of dietary share of ultra-processed foods was measured. In 2004, 48% of calories consumed by Canadians came from ultra-processed foods. Consumption of such foods was high amongst all socioeconomic groups, and particularly in children and adolescents. As a group, ultra-processed foods were grossly nutritionally inferior to non-ultra-processed foods. After adjusting for covariates, a significant and positive relationship was found between the dietary share of ultra-processed foods and the content in carbohydrates, free sugars, total and saturated fats and energy density, while an inverse relationship was observed with the dietary content in protein, fiber, vitamins A, C, D, B6 and B12, niacin, thiamine, riboflavin, as well as zinc, iron, magnesium, calcium, phosphorus and potassium. Lowering the dietary share of ultra-processed foods and raising consumption of hand-made meals from unprocessed or minimally processed foods would substantially improve the diet quality of Canadian. Copyright Â© 2016
Trombose da artéria renal e síndrome do anticorpo antifosfolípide: um relato de caso Renal arterial thrombosis and the antiphospholipid antibody syndrome: a case report

Directory of Open Access Journals (Sweden)

Célia S. Macedo

2001-12-01

Full Text Available OBJETIVO: descrever um caso clínico raro na infância, com achados clínicos da síndrome do anticorpo antifosfolípide. DESCRIÇÃO: criança, sexo masculino, com 2 anos e 6 meses de idade, com insuficiência renal, trombose da artéria renal e diagnóstico de síndrome do anticorpo antifosfolípide, foi internada com dor abdominal, palidez, letargia e anúria há 36 horas. Ao exame físico, apresentava-se desnutrida, com hipertensão arterial severa, edema moderado e dor em hipocôndrio. Os achados laboratoriais incluíram: uréia=112mg/dl; creatinina plasmática=4,5 mg/dl; pH sangüíneo=7,47; bicarbonato sangüíneo=12,8 mmol/L; K=7,2 mEq/L. A diálise peritoneal foi iniciada e mantida por 11 dias. Após 7 semanas de evolução, o paciente ainda necessitava de droga anti-hipertensiva e a função renal estava anormal. A biópsia renal revelou infarto renal anêmico; ultra-sonografia renal com doppler, fluxo sangüíneo renal ausente no lado direito, e a arteriografia mostrou oclusão total da artéria renal direita. A pesquisa de doenças do colágeno foi negativa. Foi realizada nefrectomia à direita obtendo-se normalização da pressão arterial. Aos 5 anos e 8 meses, foi novamente hospitalizada com quadro de crises de ausência e dores abdominais e precordiais. A dosagem do anticorpo anticardiolipina foi positiva. Atualmente aos 7 anos, está em seguimento ambulatorial, assintomática e com dosagens negativas do anticorpo anticardiolipina. COMENTÁRIOS: as observações deste caso mostram que crianças com quadro de trombose arterial, mesmo na ausência de doenças do colágeno, devem ser investigadas para uma possível associação com a síndrome do anticorpo antifosfolípide.OBJECTIVE: to describe an unusual case with clinical features of the antiphospholipid syndrome. DESCRIPTION: white child, two years and six months old, with renal failure, renal arterial thrombosis, and diagnosis of antiphospholipid syndrome was hospitalized with
Comparison of ultra high performance supercritical fluid chromatography, ultra high performance liquid chromatography, and gas chromatography for the separation of synthetic cathinones.

Science.gov (United States)

Carnes, Stephanie; O'Brien, Stacey; Szewczak, Angelica; Tremeau-Cayel, Lauriane; Rowe, Walter F; McCord, Bruce; Lurie, Ira S

2017-09-01

A comparison of ultra high performance supercritical fluid chromatography, ultra high performance liquid chromatography, and gas chromatography for the separation of synthetic cathinones has been conducted. Nine different mixtures of bath salts were analyzed in this study. The three different chromatographic techniques were examined using a general set of controlled synthetic cathinones as well as a variety of other synthetic cathinones that exist as positional isomers. Overall 35 different synthetic cathinones were analyzed. A variety of column types and chromatographic modes were examined for developing each separation. For the ultra high performance supercritical fluid chromatography separations, analyses were performed using a series of Torus and Trefoil columns with either ammonium formate or ammonium hydroxide as additives, and methanol, ethanol or isopropanol organic solvents as modifiers. Ultra high performance liquid chromatographic separations were performed in both reversed phase and hydrophilic interaction chromatographic modes using SPP C18 and SPP HILIC columns. Gas chromatography separations were performed using an Elite-5MS capillary column. The orthogonality of ultra high performance supercritical fluid chromatography, ultra high performance liquid chromatography, and gas chromatography was examined using principal component analysis. For the best overall separation of synthetic cathinones, the use of ultra high performance supercritical fluid chromatography in combination with gas chromatography is recommended. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Avaliação da medida do comprimento do colo e da ausência do eco glandular endocervical para predição do parto pré-termo Evaluation of risk for preterm delivery by measurement of uterine cervix and cervical gland area

Directory of Open Access Journals (Sweden)

Claudio Rodrigues Pires

2004-04-01

Full Text Available OBJETIVO: verificar a prevalência do sinal eco glandular endocervical (EGE e o comprimento cervical menor ou igual a 20 mm em gestantes entre a 21ª e a 24ª semana e comparar estes sinais ecográficos como fatores indicadores de parto pré-termo espontâneo. MÉTODOS: estudo prospectivo transversal no qual foram incluídas 361 gestantes da população geral, para realização de exame ultra-sonografico em idade gestacional entre a 21ª a 24ª semana. Os critérios de exclusão do estudo foram malformações müllerianas, gestações múltiplas, malformações fetais, óbito fetal, alterações da quantidade de líquido amniótico, placenta com inserção segmentar, antecedentes de cirurgia no colo uterino (conização, amputação, cerclagem e procedimentos cirúrgicos durante a gestação. Após a realização do exame ultra-sonográfico obstétrico morfológico efetuado por via abdominal, seguiu-se o exame ecográfico por via vaginal para observação de uma faixa hipoecóica ou hiperecóica adjacente ao canal endocervical correpondente às glândulas do epitélio endocervical (EGE e mensuração do comprimento cervical. As variáveis qualitativas são representadas por freqüência absoluta e relativa, ao passo que as variáveis quantitativas, por média, desvio-padrão, mediana e valores mínimo e máximo. A associação entre as variáveis qualitativas foi avaliada pelo teste c² ou teste exato de Fisher. Para cada variável estudada, foi calculado o risco relativo seguido do intervalo com 95% de confiança. A técnica de análise de regressão logística univariada foi utilizada para verificar, entre as variáveis estudadas, quais foram indicativas de parto pré-termo espontâneo. O nível de significância adotado foi de 95% (alfa = 5% e descritivos (p iguais ou inferiores a 0,05 foram considerados significantes. RESULTADOS: a incidência do parto pré-termo espontâneo foi de 5,0%. O comprimento do colo uterino revelou-se igual ou
Apparatus And Method For Wireless Monitoring Using Ultra-wideband Frequencies

KAUST Repository

Sana, Furrukh

2015-04-23

A system for and a method of wirelessly monitoring one or more patients can include transmitting ultra-wideband pulses toward the one or more patients, receiving ultra-wideband signals, and sampling the ultra-wideband signals. Sampling the ultra-wideband pulses can be performed with a sample rate that is less than the Nyquist rate. Impulse response can be estimated and/or recovered by exploiting sparsity of the impulse response.
Development of Transvaginal Uterus Amputation Device for Laparoscopic Hysterectomies in Gynecologic Surgeries

Directory of Open Access Journals (Sweden)

Serkan DİKİCİ

2015-01-01

Full Text Available Hysterectomy, that is removal of uterus, is one of the most common major operations in gynecologic surgeries. Laparoscopy technique is preferred in hysterectomy because of its advantages such as lower intra-operative blood loss, decreased surrounding tissue/organ damage, less operating time, lower postoperative infection and frequency of fever, shorter duration of hospitalization and post-operative returning time to normal activity. During total laparoscopic hysterectomy, first uterine vessels and ligaments are cauterized respectively, and then cervicovaginal connections are cauterized and coagulated to remove uterus completely. Uterine manipulators are used during laparoscopy to maximize the endoscopic vision of surgeons by moving related organs. However, conventional uterine manipulators have important drawbacks particularly to move uterus in three dimensions and to show cervicovaginal landmark during laparoscopic circular cauterization and amputation of the uterine cervix. A new transvaginal uterine manipulator may overcome these two important drawbacks of these currently available devices. For this reason, a3D scanned technique was used to get uterus sizes and computer aided design software is used in designing of the new manipulator and then 3D printer was used in prototyping. Special light emitting diodes (LEDs were mounted on the cervical cap of the manipulator to guide light beams from inside of cervicovaginal tissue to abdominal cavity to facilitate the visualization of tissue landmarks. Moreover, performances of different caps and LED systems will be evaluated. Furthermore, after integration of self-cutting and self-suturing mechanisms into our system, final prototype will be produced by using titanium which is biologically and mechanically appropriate. Therefore, aim of this study was to design and produce a new uterine manipulator with three dimensional movements, LED illumination, self-cutting and self-suturing systems to facilitate
Li-Ion, Ultra-capacitor Based Hybrid Energy Module

National Research Council Canada - National Science Library

Daboussi, Zaher; Paryani, Anil; Khalil, Gus; Catherino, Henry; Gargies, Sonya

2007-01-01

.... To determine the optimum utilization of ultra-capacitors in applications where high power density and high energy density are required, an optimized Li-Ion/Ultra-capacitor Hybrid Energy Module (HEM...
Avaliação da qualidade de vida e da perda urinária de mulheres com bexiga hiperativa tratadas com eletroestimulação transvaginal ou do nervo tibial Evaluation of quality of life and loss urine of women with overactive bladder treated with intravaginal or tibial nerve electro stimulation

Directory of Open Access Journals (Sweden)

Maíra de Menezes Franco

2011-06-01

Full Text Available Trata-se de um ensaio clínico prospectivo comparativo que objetivou comparar os efeitos do tratamento com eletroestimulação transvaginal (ET e do nervo tibial (ENT sobre a qualidade de vida (QV e queixas de perda urinária em mulheres com bexiga hiperativa. Participaram 42 pacientes com bexiga hiperativa ou incontinência urinária (IU mista e foram divididas para tratamento com ET ou ENT. A QV foi avaliada pelo questionário de QV genérico, o Medical Outcomes Study Short Form 36 (SF-36 e um questionário específico para IU, o Incontinence Quality of Life Instrument (I-QOL. Os relatos de perdas urinárias e incômodos ocasionados foram avaliados, respectivamente, por meio do diário miccional de 24 horas e Escala Visual Analógica (EVA. O tratamento foi realizado uma vez por semana, totalizando doze semanas. O grupo da ENT teve melhora significativa em três domínios do I-QOL, na EVA, que avaliou o grau de incômodo causado pela IU e em quatro aspectos do diário miccional. No grupo de ET houve melhora significativa de dois domínios do SF-36, três domínios do I-QOL, na EVA e em quatro aspectos do diário. Houve melhora da QV em ambos os grupos, assim como uma diminuição das queixas de perda urinária, entretanto, o grupo que recebeu ET obteve melhora nos escores em dois domínios do questionário de QV genérico após o tratamento, que teve limitação por aspectos físicos e limitação por aspectos emocionais. O que não ocorreu com o grupo de ENT.This is a prospective comparative clinical study. This study aimed to compare the effects of intravaginal electrical stimulation therapy (IS and the tibial nerve (TNS on quality of life (QOL and complaints of urinary incontinence in women with overactive bladder. Participants 42 patients with overactive bladder or urinary incontinence (UI mix and were divided for treatment with IS or TNS. To assess QOL we used a generic QOL questionnaire, the Medical Outcomes Study Short Form 36 (SF-36 and
Estudo comparativo da flarefotometria em pacientes com melanoma maligno e nevo de coróide Comparative study of flare photometry in patients with choroidal malignant melanoma and choroidal nevus

Directory of Open Access Journals (Sweden)

Priscilla Luppi Ballalai

2002-01-01

Full Text Available Introdução: Os tumores malignos intra-oculares estão associados com um aumento do "flare" na câmara anterior, causado por uma quebra na barreira hemato-aquosa, que pode ocorrer por vários mecanismos. Estudos utilizando a flarefotometria confirmam o aumento do "flare" em olhos com tumores intra-oculares malignos e benignos. Objetivo: Avaliar a flarefotometria como auxiliar no diagnóstico diferencial de melanoma maligno e nevo de coróide, comparando-se com olhos contralaterais normais. Métodos: Foram avaliados olhos com melanoma maligno e olhos com nevo de coróide diagnosticados por meio de oftalmoscopia indireta e/ou ultra-sonografia. Os olhos normais contralaterais foram utilizados como controles. A flarefotometria foi realizada em todos os pacientes, sob midríase bilateral, utilizando equipamento Laser Flare Meter (FC 500, Kowa. Foram aplicados os testes de Wilcoxon, Mann-Whitney, e Spearman para análise estatística. Resultados: A média da flarefotometria nos olhos com melanoma maligno de coróide foi 17,1 ph/ms e nos olhos normais contralaterais foi 4,06 ph/ms. Nos olhos com nevo de coróide o valor da flarefotometria foi 6,12 ph/ms e nos olhos contralaterais normais foi 4,47 ph/ms. O valor da flarefotometria foi maior nos olhos com melanoma maligno e nevo quando comparado com os olhos contralaterais normais (pIntroduction: Malignant intraocular tumors are associated with an increase in the aqueous flare, caused by alterations of the blood-ocular barriers through various mechanisms. Several studies have demonstrated an ocular flare increase using flare photometry in eyes with benign and malignant tumors. Purpose: To evaluate flare photometry as an adjunct method in the differential diagnosis of choroidal malignant melanoma and choroidal nevus comparing to normal control eyes. Methods: Eyes with melanoma and nevus were diagnosed by indirect binocular ophthalmoscopy and/or ultrasound were evaluated. The fellow normal eyes were used

New solid laser: Ceramic laser. From ultra stable laser to ultra high output laser

International Nuclear Information System (INIS)

Ueda, Kenichi

2006-01-01

An epoch-making solid laser is developed. It is ceramic laser, polycrystal, which is produced as same as glass and shows ultra high output. Ti 3+ :Al 2 O 3 laser crystal and the CPA (chirped pulse amplification) technique realized new ultra high output lasers. Japan has developed various kinds of ceramic lasers, from 10 -2 to 67 x 10 3 w average output, since 1995. These ceramic lasers were studied by gravitational radiation astronomy. The scattering coefficient of ceramic laser is smaller than single crystals. The new fast ignition method is proposed by Institute of Laser Engineering of Osaka University, Japan. Ultra-intense short pulse laser can inject the required energy to the high-density imploded core plasma within the core disassembling time. Ti 3+ :Al 2 O 3 crystal for laser, ceramic YAG of large caliber for 100 kW, transparent laser ceramic from nano-crystals, crystal grain and boundary layer between grains, the scattering coefficient of single crystal and ceramic, and the derived release cross section of Yb:YAG ceramic are described. (S.Y.)
Ultra-low-power and ultra-low-cost short-range wireless receivers in nanoscale CMOS

CERN Document Server

Lin, Zhicheng; Martins, Rui Paulo

2016-01-01

This book provides readers with a description of state-of-the-art techniques to be used for ultra-low-power (ULP) and ultra-low-cost (ULC), short-range wireless receivers. Readers will learn what is required to deploy these receivers in short-range wireless sensor networks, which are proliferating widely to serve the internet of things (IoT) for “smart cities.” The authors address key challenges involved with the technology and the typical tradeoffs between ULP and ULC. Three design examples with advanced circuit techniques are described in order to address these trade-offs, which specially focus on cost minimization. These three techniques enable respectively, cascading of radio frequency (RF) and baseband (BB) circuits under an ultra-low-voltage (ULV) supply, cascoding of RF and BB circuits in current domain for current reuse, and a novel function-reuse receiver architecture, suitable for ULV and multi-band ULP applications such as the sub-GHz ZigBee. · Summarizes the state-of-the-art i...
Ultra-high wear resistance of ultra-nanocrystalline diamond film: Correlation with microstructure and morphology

Science.gov (United States)

Rani, R.; Kumar, N.; Lin, I.-Nan

2016-05-01

Nanostructured diamond films are having numerous unique properties including superior tribological behavior which is promising for enhancing energy efficiency and life time of the sliding devices. High wear resistance is the principal criterion for the smooth functioning of any sliding device. Such properties are achievable by tailoring the grain size and grain boundary volume fraction in nanodiamond film. Ultra-nanocrystalline diamond (UNCD) film was attainable using optimized gas plasma condition in a microwave plasma enhanced chemical vapor deposition (MPECVD) system. Crystalline phase of ultra-nanodiamond grains with matrix phase of amorphous carbon and short range ordered graphite are encapsulated in nanowire shaped morphology. Film showed ultra-high wear resistance and frictional stability in micro-tribological contact conditions. The negligible wear of film at the beginning of the tribological contact was later transformed into the wearless regime for prolonged sliding cycles. Both surface roughness and high contact stress were the main reasons of wear at the beginning of sliding cycles. However, the interface gets smoothened due to continuous sliding, finally leaded to the wearless regime.
Diatermia ovariana guiada por ecografia transvaginal utilizando animais como modelo experimental

OpenAIRE

Anita Mylius Pimentel

2012-01-01

Introdução: A Síndrome dos Ovários Policísticos (SOP) afeta 5 a 10% de mulheres em idade reprodutiva. O tratamento da infertilidade de causa anovulatória em pacientes com SOP envolve a indução da ovulação, sendo o citrato de clomifeno (CC) a medicação de primeira escolha. Nos casos resistentes ao CC, a segunda linha de tratamento pode ser medicamentosa (gonadotrofinas) ou cirúrgica (cauterização ou diatermia ovariana), realizada por videolaparoscopia (VLPC). A indução com gonadotrofinas aumen...
Further demonstration of the VRLA-type UltraBattery under medium-HEV duty and development of the flooded-type UltraBattery for micro-HEV applications

Energy Technology Data Exchange (ETDEWEB)

Furukawa, J.; Takada, T.; Monma, D. [The Furukawa Battery Co., Ltd., R and D Division, 23-6 Kuidesaku, Shimofunao-machi, Joban, Iwaki-city, 972-8501 (Japan); Lam, L.T. [CSIRO Energy Technology, Bayview Avenue, Clayton South, Vic. 3169 (Australia)

2010-02-15

The UltraBattery has been invented by the CSIRO Energy Technology in Australia and has been developed and produced by the Furukawa Battery Co., Ltd., Japan. This battery is a hybrid energy storage device which combines a super capacitor and a lead-acid battery in single unit cells, taking the best from both technologies without the need of extra, expensive electronic controls. The capacitor enhances the power and lifespan of the lead-acid battery as it acts as a buffer during high-rate discharging and charging, thus enabling it to provide and absorb charge rapidly during vehicle acceleration and braking. The laboratory results of the prototype valve-regulated UltraBatteries show that the capacity, power, available energy, cold cranking and self-discharge of these batteries have met, or exceeded, all the respective performance targets set for both minimum and maximum power-assist HEVs. The cycling performance of the UltraBatteries under micro-, mild- and full-HEV duties is at least four times longer than that of the state-of-the-art lead-acid batteries. Importantly, the cycling performance of UltraBatteries is proven to be comparable or even better than that of the Ni-MH cells. On the other hand, the field trial of UltraBatteries in the Honda Insight HEV shows that the vehicle has surpassed 170,000 km and the batteries are still in a healthy condition. Furthermore, the UltraBatteries demonstrate very good acceptance of the charge from regenerative braking even at high state-of-charge, e.g., 70% during driving. Therefore, no equalization charge is required for the UltraBatteries during field trial. The HEV powered by UltraBatteries gives slightly higher fuel consumption (cf., 4.16 with 4.05 L/100 km) and CO{sub 2} emissions (cf., 98.8 with 96 g km{sup -1}) compared with that by Ni-MH cells. There are no differences in driving experience between the Honda Insight powered by UltraBatteries and by Ni-MH cells. Given such comparable performance, the UltraBattery pack
Comparação dos métodos de imagem no diagnóstico dos tumores renais e calcificações nestas neoplasias Comparison of imaging methods for diagnosis of renal tumors and their calcifications

Directory of Open Access Journals (Sweden)

Sergio Marrone Ribeiro

2004-12-01

Full Text Available OBJETIVO: Tentar estabelecer uma metodologia no diagnóstico e conduta dos pacientes com massas renais sólidas e complexas, comparando os custos e benefícios dos diferentes métodos de diagnóstico por imagem. Procuramos avançar no diagnóstico diferencial entre lesões benignas e malignas, particularmente através da investigação das calcificações tumorais. MÉTODOS: Realizamos um estudo prospectivo em 31 pacientes portadores de massas renais sólidas ou complexas, todos eles submetidos à ultra-sonografia abdominal (US, ultra-sonografia doppler da massa renal (US Dop, tomografia computadorizada (TC e ressonância magnética (RM. RESULTADOS: Encontramos 28 pacientes com massas malignas e três com massas benignas. Entre os 28 pacientes com lesões malignas, 17 mostraram calcificações pela TC; 16 deles calcificações do tipo central e um calcificação do tipo curvilinear periférica pura (casca de ovo. A urografia excretora (UGE mostrou uma taxa de detecção para calcificações significantemente menor que a US e a TC. Massas benignas e malignas apareceram como descrito na literatura, com o US, TC e RM mostrando alta sensibilidade e especificidade no diagnóstico dos tumores renais. A exceção foi na US Dop, onde nós obtivemos menor sensibilidade para a caracterização de fluxo tumoral maligno. CONCLUSÕES: Foi surpreendente verificar que a TC revelou calcificações centrais em 51,6% dos pacientes desta série, todas elas em lesões malignas, quando a literatura refere uma freqüência de calcificações entre 8% e 22% dos carcinomas de células renais, em estudos utilizando radiografias simples do abdômen e UGE. Este achado é de grande importância quando consideramos que estas calcificações ocorrem particularmente em neoplasias malignas. Como resultado da comparação dos diferentes métodos de diagnóstico por imagem, nós propomos uma metodologia para adequada investigação dos tumores renais.BACKGROUND: To establish the
Imaging of foreign bodies in the face and ultrasound guided surgical removal; Diagnostico por imagem de corpos estranhos da face e retirada cirurgica guiada por ultra-sonografia

Energy Technology Data Exchange (ETDEWEB)

Lima, Claudio Marcio Amaral de Oliveira; Gambin, Moises; Ribeiro, Erica Barreiros; Amarante Junior, Jose Luiz de Medeiros [Hospital Naval Marcilio Dias, Rio de Janeiro, RJ (Brazil)]. E-mail: cmaol@br.inter.net; cmaolima@hotmail.com; Monteiro, Alexandra Maria Vieira [Pontificia Univ. Catolica do Rio de Janeiro (PUC/Rio), RJ (Brazil). Curso de Pos-Graduacao em Radiologia

2006-10-15

The identification and surgical removal of foreign bodies is a complex procedure in medical practice, principally when the involved material is radiolucent. The technological advent of the ultrasonography equipment comes enlarging the field of application of this method more and more, in medical practice. The authors describe a case of an ultrasound guided surgical removal of glass fragments from the face of a patient. The foreign bodies were previously diagnosed by ultrasound and computed tomography. The guided technic showed secure, less invasive and efficient, allowing the retreat of all the fragments. (author)
Via de parto em gestações sucessivas em adolescentes: estudo de 714 casos Route of delivery in successive gestations in adolescents: study of 714 cases

Directory of Open Access Journals (Sweden)

Vamberto Oliveira de Azevedo Maia

2004-10-01

Full Text Available OBJETIVO: analisar a associação da via de partos consecutivos de 714 gestantes adolescentes, que pariram na Maternidade do Hospital das Clínicas da Universidade Federal de Pernambuco, no período de janeiro a dezembro de 2001. PACIENTES E MÉTODOS: em estudo prospectivo, analítico, transversal, tipo incidência, foi analisada a sucessão das vias de parto da primeira até a quarta gestação de 714 parturientes adolescentes, com idade variando entre 13 e 19 anos (média 17,2±1,5 anos. Identificando-se, no livro da sala de parto, a cada dia, as adolescentes que pariram, após ter obtido o consentimento livre e esclarecido, cada uma respondeu a um questionário estruturado, com 65 perguntas diretas e respostas fechadas, pré-codificadas, entre as quais estavam vias de parto e o número de gestações. RESULTADOS: observou-se que 527 (73,8% adolescentes tiveram uma única parturição, 149 (20,9% duas parturições, 35 (4,9% três partos e 3 (0,4% quatro partos. Dentre os 273 partos cesáreos, 207 (75,8% ocorreram em primíparas, 65 (23,8% em paucíparas e 1 (0,4% em multípara. Houve associação estatisticamente significante entre via de parto da primeira e da segunda parturições; em 83 (55,7% gestantes adolescentes quanto à via transvaginal e em 41 (27,5%, para a via cesárea. Coincidiram também as vias de parto de segunda e terceira parturições, em 23 (65,7% gestantes adolescentes no parto transvaginal e em outras 10 (28,6% na cesárea. CONCLUSÃO: identificou-se tendência da coincidência das vias de parto em gestações sucessivas em parturientes adolescentes, até a terceira parturiçãoPURPOSE: to analyze the association between modes of consecutive deliveries of 714 adolescents attended at the Maternity sector of the Hospital das Clínicas da Universidade Federal de Pernambuco (Federal University of Pernambuco, from January to December 2001. PATIENTS AND METHODS: according to a prospective, analytic, transversal, and incidence
Microscopic tomography with ultra-HVEM and applications

International Nuclear Information System (INIS)

Takaoka, Akio; Hasegawa, Toshiaki; Yoshida, Kiyokazu; Mori, Hirotaro

2008-01-01

The ultra-HVEM with an accelerating voltage of 3 MV at Osaka University is capable of achieving excellent penetration and resolution for thick specimens. We obtained images of 5-μm-thick slices tilted at angles of up to 70 o for biological samples and observed stick-shaped samples of Si devices free from missing zone. These features make the ultra-HVEM an invaluable extension of 3D observation by electron tomography. In this paper, we introduce aspects of ultra-HVEM tomography; specifically, the magnification, the amount of image blurring for thick samples and the electron staining method. Finally, we give some typical applications in the fields of cell biology, pathology and electrical engineering
The reliability of transabdominal cervical length measurement in a low-risk obstetric population: Comparison with transvaginal measurement.

Science.gov (United States)

Peng, Cheng-Ran; Chen, Chie-Pein; Wang, Kuo-Gon; Wang, Liang-Kai; Chen, Chen-Yu; Chen, Yi-Yung

2015-04-01

To determine the correlation between transabdominal (TA) and transvaginal (TV) cervical length measurement in a low-risk obstetric population in Taiwan. Women with a singleton pregnancy between 20 weeks and 24 weeks of gestation underwent postvoid TA and TV cervical length measurements. Differences between the measurements obtained using the two methods were evaluated. Two hundred and five women agreed to participate in the study. Paired TA and TV measurements were obtained in 174 women. The mean TA cervical length was 36.0 ± 4.9 mm and the mean TV cervical length was 37.6 ± 5.4 mm. The mean TA cervical length was shorter than the mean TV cervical length by 1.6 mm. The 5(th) percentile of TA and TV cervical length was 29 mm and 29.1 mm, respectively. The discrepancies between the two methods were not significantly correlated with maternal body mass index (BMI). All women with TV cervical length women in the present study, and the TA cervical length was closely correlated with the TV cervical length. The use of TA ultrasound could be an effective initial tool for cervical length screening in low-risk pregnant women. TA cervical length TV ultrasound. Copyright © 2015. Published by Elsevier B.V.
Transvaginal color Doppler ultrasound in the diagnosis of endometrial lesions%经阴道彩色多普勒超声在子宫内膜病变诊断的应用价值

Institute of Scientific and Technical Information of China (English)

高鸣

2015-01-01

目的探讨经阴道彩色多普勒超声在子宫内膜病变诊断中的应用价值,总结其应用经验.方法对90例不规则阴道流血患者行经阴道彩色多普勒超声检查,分析其超声影像学资料,并将超声检查结果与诊刮以及患者术后病理诊断结果相对照.结果本研究90例患者经阴道彩色多普勒超声检查确诊86例,其中子宫内膜增生36例、子宫内膜息肉42例,子宫内膜癌8例,确诊率为95.64％;漏诊4例,漏诊率为4.36％,其中1例子宫内膜癌病变,3例子宫内膜增生病变.结论经阴道彩色多普勒超声检查子宫内膜病变操作简便、准确性高,超声检查时应注意测量子宫内膜厚度,观察内膜形态、内膜与肌层的关系、内膜回声特点以及子宫内膜内血流情况及阻力指数,作为诊断子宫内膜病变的重要检查方法,还需要结合患者的临床表现及其他影像学检查手段,以提高其确诊率.%Objective To investigate the application value of transvaginal color Doppler ultrasound in the diagnosis of endometrial lesions,and summarize the application experience.Methods Ninety patients with irregular vaginal bleeding underwent transvaginal color Doppler ultrasound examination,the ultrasound image data were analyzed,and the ultrasonic inspection results and curettage and postoperative pathological diagnosis results were compared.Results Among the 90 cases,86 cases were diagnosed by transvaginal color Doppler ultrasound,of which 36 cases of endometrial hyperplasia,42 cases of endometrial polyps,endometrial carcinoma in 8 cases,the diagnosis rate was 95.64％ ; 4 cases of missed diagnosis,the missed diagnosis rate was 4.36％,in which l case of endometrial carcinoma lesions,3 cases of uterus hyperplasia lesions.Conclusions Transvaginal color Doppler ultrasonography for endometrial lesions has simple operation,high accuracy,we should pay attention to measure the thickness of endometrium,endometrial morphology
Ecografia na patologia torácica

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António Bugalho

2010-07-01

Full Text Available Resumo: Nos últimos anos a ecografia torácica tem vindo a ser reconhecida como um instrumento de extrema importância para os pneumologistas. Actualmente, os equipamentos são práticos, portáteis, de fácil utilização e fidedignos, o que os torna apropriados para utilização no diagnóstico e orientação de procedimentos terapêuticos.Na avaliação de derrame pleural e condução de toracentese são necessárias competências técnicas básicas em ultra-sonografia. Procedimentos mais complexos devem ser realizados perante treino específico e incluem a colocação de dreno torácico e identificação com eventual biopsia de lesões torácicas.Os autores procuram abordar, de um ponto de vista prático, a técnica e os recentes avanços alcançados neste campo. São apresentados alguns casos clínicos no sentido de ilustrar e guiar aqueles que desejam iniciar a realização de ecografia do tórax.Rev Port Pneumol 2010; XVI (4: 589-606 Abstract: In the past few years transthoracic ultrasound has been recognized as an important tool for chest physicians. At present, ultrasound devices are practical, portable, easy to use and reliable, which makes them suited for diagnostic investigations as well as for therapeutic procedures guidance.Basic ultrasound technical expertise is required to assess pleural effusions and perform ultrasound-guided thoracentesis. More complex procedures can be done with specific training and include assistance to chest drain insertion and identification with potential biopsy of thoracic lesions.The authors aim to review, in a practical approach, the technique and recent developments in this field. Clinical cases are presented in order to illustrate and guide the beginner in chest ultrasound.Rev Port Pneumol 2010; XVI (4: 589-606 Palavras-chave: Ecografia, ultra-sonografia, tórax, pleura, doenças pulmonares, derrame pleural, cancro do pulmão, Key-words: Ultrasound, sonography, chest, thorax, pleura, lung diseases
Ecografia na patologia torácica

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António Bugalho

2010-07-01

Full Text Available Resumo: Nos últimos anos a ecografia torácica tem vindo a ser reconhecida como um instrumento de extrema importância para os pneumologistas. Actualmente, os equipamentos são práticos, portáteis, de fácil utilização e fidedignos, o que os torna apropriados para utilização no diagnóstico e orientação de procedimentos terapêuticos.Na avaliação de derrame pleural e condução de toracentese são necessárias competências técnicas básicas em ultra-sonografia. Procedimentos mais complexos devem ser realizados perante treino específico e incluem a colocação de dreno torácico e identificação com eventual biopsia de lesões torácicas.Os autores procuram abordar, de um ponto de vista prático, a técnica e os recentes avanços alcançados neste campo. São apresentados alguns casos clínicos no sentido de ilustrar e guiar aqueles que desejam iniciar a realização de ecografia do tórax. Abstract: In the past few years transthoracic ultrasound has been recognized as an important tool for chest physicians. At present, ultrasound devices are practical, portable, easy to use and reliable, which makes them suited for diagnostic investigations as well as for therapeutic procedures guidance.Basic ultrasound technical expertise is required to assess pleural effusions and perform ultrasound-guided thoracentesis. More complex procedures can be done with specific training and include assistance to chest drain insertion and identification with potential biopsy of thoracic lesions.The authors aim to review, in a practical approach, the technique and recent developments in this field. Clinical cases are presented in order to illustrate and guide the beginner in chest ultrasound. Palavras-chave: Ecografia, ultra-sonografia, tórax, pleura, doenças pulmonares, derrame pleural, cancro do pulmão, Key-words: Ultrasound, sonography, chest, thorax, pleura, lung diseases, pleural effusion, lung cancer
Giant retroperitoneal lipoma: a case report Lipoma gigante do retroperitônio: relato de caso

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Carlos Augusto Real Martinez

2003-12-01

Full Text Available BACKGROUND: Retroperitoneal lipoma is an extremely rare neoplasm. AIMS: The authors report a case of giant retroperitoneal lipoma in a 32-year-old white female, with a history of pain and an abdominal mass over a 2-year period. Total abdominal ultrasonography and barium enema showed a large mass located in the retroperitoneal space behind the ascending colon. Laparotomy showed a large encapsulated tumor measuring 20 x 13 x 10 cm and weighing 3.400 g. The histological study revealed a benign neoplasm of fatty cells. CONCLUSION: The patient remains well 17 years after surgery, without recurrentce of the disease.RACIONAL: O lipoma é a neoplasia mesenquimal mais freqüente, raramente localizada no retroperitônio. Na maioria das vezes, o diagnóstico diferencial pré-operatório com os lipossarcomas de baixo grau de malignidade é difícil de ser estabelecido. OBJETIVO: Apresentar um caso de lipoma gigante retroperitoneal em mulher de 32 anos que há 2 anos apresentava história de dor e tumor abdominal palpável. A ultra-sonografia abdominal e o enema opaco mostraram grande massa localizada no retroperitônio, que deslocava o ceco e o cólon ascendente. A laparotomia mostrou tumor encapsulado com 20 x 13 x 10 cm e 3.400 g de peso. O estudo histopatológico mostrou presença de lipoma retroperitonial. A paciente encontra-se bem, sem recidiva da doença, 17 anos após a cirurgia.
Production ultra propre

CERN Document Server

Morvan, Gilles

2011-01-01

L'ultra propreté se caractérise par l'absence de particules et la maîtrise de la contamination dans un environnement défini. Largement appliquée dans diverses industries (pharmacie, cosmétiques, dispositifs médicaux, chimie fine, biotechnologies, électronique et secteurs de pointe, agroalimentaire, plasturgie…), la technicité dans ce domaine est élevée, car principalement liée à la maîtrise des différentes sources de contaminations (eau, air ambiant, fluides, etc.). Véritable guide pratique, cet ouvrage détaille les points techniques essentiels pour permettre à l’ingénieur de trouver des solutions adéquates à chaque type de projet. La démarche passe par la rédaction de spécifications rigoureuses pour : - l’eau, essentielle à toutes productions, - les équipements de production ultra propre, - la démarche qualité et environnementale, - la démarche de suivi du projet.
Invasão do nervo óptico por melanoma peripapilar: relato de caso Optic nerve invasion by juxtapapillary melanoma: case report

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Eduardo Ferrari Marback

2003-06-01

Full Text Available Tumores pigmentados localizados sobre o disco óptico são raros e representam desafio diagnóstico. Paciente masculino, 60 anos, apresenta baixa da acuidade visual no olho esquerdo devido à lesão pigmentada que cobre o disco óptico. Foi indicada a enucleação com recusa pelo paciente. O quadro evoluiu com descolamento de retina. Examinado em outro serviço teve indicação de vitrectomia também recusada. Retorna aos nossos cuidados; feita a enucleação o diagnóstico anatomopatológico revelou melanoma maligno da coróide com invasão pós-laminar do nervo óptico. A importância prognóstica da invasão do nervo óptico por melanoma da coróide ainda não está totalmente esclarecida. Embora raro, tumor pigmentado cobrindo o nervo óptico pode representar melanoma maligno. O diagnóstico diferencial destes casos é geralmente difícil, porém seu reconhecimento à ultra-sonografia ocular é patente e descolamento de retina associado é sinal de atividade tumoral. Os riscos de disseminação da doença exigem atenção na suspeita diagnóstica e conduta precisa.Small-pigmented lesions over the optic disc are very rare and may represent a diagnostic challenge. To report a case of a small malignant choroidal melanoma invading the optic nerve. A 60-year-old male presents with low vision in the left eye due to a small, pigmented lesion over the optic disc. At first the patient refused enucleation. One month later, after further drop in visual acuity, the patient was seen at another service, diagnosed as having a retinal detachment, and pars plana vitrectomy was proposed but also refused by the patient. Returning to our service, the eye was enucleated and a final diagnosis of choroidal melanoma with post-laminar optic nerve invasion was made. Although rare, pigmented lesions over the optic disc may represent a malignant melanoma. The prognostic significance of optic nerve invasion by choroidal melanoma is not clear yet. The differential
Diagnóstico pré-natal de um gêmeo hemiacárdico: relato de caso Prenatal diagnosis of hemiacardiac twin: a case report

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Júlio A. G. Alves

1998-03-01

Full Text Available A síndrome de acardia fetal é uma rara complicação de gestações gemelares monozigóticas, ocorrendo uma vez em cada 35.000 partos. O prognóstico é fatal para todos gêmeos acárdicos e para 50-75% dos gêmeos normais. Neste trabalho é apresentado um caso de hemiacardia fetal (acardia parcial em gravidez gemelar. O diagnóstico foi feito utilizando-se ultra-sonografia, ecocardiografia fetal e foi confirmado após o parto.The acardius syndrome is a rare complication of monozygotic twin pregnancies, occurring once in 35.000 births. The outcome is invariably fatal for the acardiac twin and for 50-75% of the normal twins. We report a case of partial (pseudoacardia in twin pregnancy. The diagnosis was made using ultrasonography, fetal echocardiography and confirmed after delivery.
Ultra-low power integrated circuit design circuits, systems, and applications

CERN Document Server

Li, Dongmei; Wang, Zhihua

2014-01-01

This book describes the design of CMOS circuits for ultra-low power consumption including analog, radio frequency (RF), and digital signal processing circuits (DSP). The book addresses issues from circuit and system design to production design, and applies the ultra-low power circuits described to systems for digital hearing aids and capsule endoscope devices. Provides a valuable introduction to ultra-low power circuit design, aimed at practicing design engineers; Describes all key building blocks of ultra-low power circuits, from a systems perspective; Applies circuits and systems described to real product examples such as hearing aids and capsule endoscopes.
Imagens ultra-sonográficas do plexo braquial na região axilar Imágenes ultra-sonográficas del plexo braquial en la región axilar Ultrasound images of the brachial plexus in the axillary region

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Diogo Brüggemann da Conceição

2007-12-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: A artéria axilar é referência anatômica de superfície para o bloqueio do plexo braquial por via axilar. Estudos anatômicos sugerem variabilidade das posições das estruturas nervosas do plexo braquial em relação à artéria. Essas variações podem dificultar bloqueios por neuroestimulação. A ultra-sonografia permite a identificação das estruturas do plexo braquial ¹. Este estudo visou a descrever o posicionamento dos nervos do plexo braquial em relação à artéria axilar. MÉTODO: Foram estudados 30 voluntários de ambos os sexos, em posição supina com abdução a 90º e rotação externa do ombro e flexão do cotovelo a 90º. Utilizando transdutor digital de 5 cm e 5-10 MHz, foram identificados os nervos mediano, ulnar e radial e as respectivas posições em relação à artéria foram marcadas em uma carta gráfica seccional de oito setores, numerados em ordem crescente a partir da hora 12 (medial, cujo centro representava a artéria axilar. RESULTADOS: O nervo mediano localizou-se predominante no setor 8 (55% e no setor 1 (28% (mediais; o nervo radial localizou-se predominantemente nos setores 4 (59% e 5 (34% (laterais e o nervo ulnar nos setores 2 e 3 (inferiores em 69% e 24% dos casos, respectivamente. Houve considerável variação da localização dos nervos em relação aos aspectos superior e inferior da artéria. CONCLUSÕES: A inspeção em tempo real, por ultra-som, das estruturas neurovasculares do plexo braquial na axila mostrou que os nervos mediano, ulnar e radial podem apresentar diferentes relações com a artéria axilar.JUSTIFICATIVA Y OBJETIVOS: La arteria axilar es una referencia anatómica de superficie para el bloqueo del plexo braquial por vía axilar. Estudios anatómicos sugieren variabilidad de las posiciones de las estructuras nerviosas del plexo braquial con relación a la arteria. Esas variaciones pueden dificultar bloqueos por neuro estimulación. El ultrasonido
Persistence of microbial contamination on transvaginal ultrasound probes despite low-level disinfection procedure.

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Fatima M'Zali

Full Text Available AIM OF THE STUDY: In many countries, Low Level Disinfection (LLD of covered transvaginal ultrasound probes is recommended between patients' examinations. The aim of this study was to evaluate the antimicrobial efficacy of LLD under routine conditions on a range of microorganisms. MATERIALS AND METHODS: Samples were taken over a six month period in a private French Radiology Center. 300 specimens derived from endovaginal ultrasound probes were analyzed after disinfection of the probe with wipes impregnated with a quaternary ammonium compound and chlorhexidine. Human papillomavirus (HPV was sought in the first set of s100 samples, Chlamydia trachomatis and mycoplasmas were searched in the second set of 100 samples, bacteria and fungi in the third 100 set samples. HPV, C. trachomatis and mycoplasmas were detected by PCR amplification. PCR positive samples were subjected to a nuclease treatment before an additional PCR assay to assess the likely viable microorganisms. Bacteria and fungi were investigated by conventional methods. RESULTS: A substantial persistence of microorganisms was observed on the disinfected probes: HPV DNA was found on 13% of the samples and 7% in nuclease-resistant form. C. trachomatis DNA was detected on 20% of the probes by primary PCR but only 2% after nuclease treatment, while mycoplasma DNA was amplified in 8% and 4%, respectively. Commensal and/or environmental bacterial flora was present on 86% of the probes, occasionally in mixed culture, and at various levels (10->3000 CFU/probe; Staphylococcus aureus was cultured from 4% of the probes (10-560 CFU/probe. No fungi were isolated. CONCLUSION: Our findings raise concerns about the efficacy of impregnated towels as a sole mean for disinfection of ultrasound probes. Although the ultrasound probes are used with disposable covers, our results highlight the potential risk of cross contamination between patients during ultrasound examination and emphasize the need for reviewing

ARE ULTRA-LONG GAMMA-RAY BURSTS DIFFERENT?

Energy Technology Data Exchange (ETDEWEB)

Boër, M.; Gendre, B. [CNRS-ARTEMIS, Boulevard de l' Observatoire, CS 34229, 06304 Nice Cedex 4 (France); Stratta, G., E-mail: michel.boer@unice.fr [Università degli Studi di Urbino Carlo Bo, I-61029 Urbino (Italy)

2015-02-10

The discovery of a number of gamma-ray bursts (GRBs) with duration exceeding 1000 s has opened the debate on whether these bursts form a new class of sources, the so-called ultra-long GRBs, or if they are rather the tail of the distribution of the standard long GRB duration. Using the long GRB sample detected by Swift, we investigate the statistical properties of long GRBs and compare them with the ultra-long burst properties. We compute the burst duration of long GRBs using the start epoch of the so-called ''steep decay'' phase detected with Swift/XRT. We discuss also the differences observed in their spectral properties. We find that ultra-long GRBs are statistically different from the standard long GRBs with typical burst duration less than 100-500 s, for which a Wolf-Rayet star progenitor is usually invoked. Together with the presence of a thermal emission component we interpret this result as indication that the usual long GRB progenitor scenario cannot explain the extreme duration of ultra-long GRBs, their energetics, as well as the mass reservoir and size that can feed the central engine for such a long time.
Ultra-thin zirconia films on Zr-alloys

Energy Technology Data Exchange (ETDEWEB)

Choi, Joong Il Jake; Mayr-Schmoelzer, Wernfried; Mittendorfer, Florian; Redinger, Josef; Diebold, Ulrike; Schmid, Michael [Institute of Applied Physics, Vienna University of Technology (Austria); Li, Hao; Rupprechter, Guenther [Institute of Materials Chemistry, Vienna University of Technology (Austria)

2014-07-01

Zirconia ultra-thin films have been prepared by oxidation of Pt{sub 3}Zr(0001) and showed a structure equivalent to (111) of cubic zirconia. Following previous work, we have prepared ultra-thin zirconia by oxidation of a different alloy, Pd{sub 3}Zr(0001), which resulted in a similar structure with a slightly different lattice parameter, 351.2 ±0.4 pm. Unlike the oxide on Pt{sub 3}Zr, where Zr of the oxide binds to Pt in the substrate, here the oxide binds to substrate Zr via oxygen. This causes stronger distortion of the oxide structure, i.e. a stronger buckling of Zr in the oxide. After additional oxidation of ZrO{sub 2}/Pt{sub 3}Zr, a different ultra-thin zirconia phase is observed. A preliminary structure model for this film is based on (113)-oriented cubic zirconia. 3D oxide clusters are also present after growing ultra-thin zirconia films. They occur at the step edges, and the density is higher on Pd{sub 3}Zr. These clusters also appear on terraces after additional oxidation. XPS reveals different core level shifts of the oxide films, bulk, and oxide clusters.
Synthesis of Cu Doped ZnO Nanostructures for Ultra Violet Sensing

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Nazar Abbas SHAH

2015-03-01

Full Text Available This paper mainly focused on the synthesis of zinc oxide nanostructures, their characterization and their ultra violet light sensing response at room temperature. Nanowires, nanobelts and nanosheets were synthesized by varying doping material copper by using vapor transport technique governed by the vapor-liquid-solid or vapor-solid mechanisms. The structural, morphological and optical characterization was carried out using X-ray diffraction, scanning electron microscopy, energy dispersive X-Ray and ultra violet visible spectroscopy techniques. Finally the ultra violet light sensing response of these nanostructures was observed by using Keithley meter. The high ultra violet photosensitivity and fast response time justifies the effective utilization of these ZnO nanostructures as ultra violet sensors in different areas.
Efeito do ultra-som terapêutico em tendinite experimental de eqüinos: estudo clínico, ultra-sonográfico e histopatológico de dois protocolos Clinic, ultrasonographic and histopatological studies of two protocols of ultrasonic therapy on experimental tendonitis in horses

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M.A.L. Fernandes

2003-02-01

Full Text Available Avaliaram-se dois protocolos de ultra-som no tratamento de lesões do tendão flexor digital superficial (TFDS. Foram estudados 18 eqüinos, nos quais foi injetada uma solução de colagenase a 0,25% no TFDS esquerdo, à altura do terço médio da região metacarpiana. Os eqüinos foram divididos em: grupo A - tratado por ultra-som (UST na freqüência de 3 MHz e intensidade de 1W/cm², no modo contínuo, por seis minutos; grupo B - tratado na mesma freqüência, intensidade e tempo, no modo pulsado; e grupo C - controle. Os tratamentos foram iniciados 48h após a indução da lesão, totalizando oito sessões. Os eqüinos foram estudados por 40 dias, avaliando-se o quadro clínico e a regressão dos sintomas. Por meio de exames ultra-sonográficos semanais avaliaram-se a área transversal e a ecogenicidade da lesão para estabelecimento do índice de severidade (IS. A lesão resultou em aumento médio de 1,5cm na circunferência da região metacarpiana, resposta à pressão digital de leve a moderada e grau de claudicação de 1 a 3. A regressão dos sintomas ocorreu, em média, nove dias no grupo A, 12 dias no grupo B e 21 dias no grupo C. O percentual de regressão no IS aos 40 dias foi de 42,5, 57,7 e 34,1, respectivamente. A avaliação histológica mostrou neovascularização pronunciada e maior atividade fibroblástica nos grupos tratados (A e B comparados ao grupo-controle. Estes resultados sugerem que o UST é efetivo na redução dos sintomas clínicos da tendinite.In order to evaluate two therapeutic ultrasound protocols for treatment of injuries of the superficial digital flexor tendon (SDFT a study was performed in 18 horses. In each horse, a 0.25% solution of collagenase was injected in the middle of the left SDFT. The horses were randomly and equally divided into three groups. Horses from Group A were treated with therapeutic ultrasound of 3 MHz frequency and 1 W/cm² intensity on continuous mode for six minutes; horses from Group
High-throughput LC-MS method for the rapid characterization of multiple chemical constituents and metabolites of Da-Bu-Yin-Wan.

Science.gov (United States)

Li, Xianna; Sun, Hui; Zhang, Aihua; Liu, Zhidong; Zou, Di; Song, Yanhua; Liu, Liang; Wang, Xijun

2017-11-01

Traditional Chinese medicine is the clinical experience accumulated by Chinese people against diseases. Da-Bu-Yin-Wan is a famous traditional Chinese medicine formula consisting of Phellodendri amurensis Rupr., Anemarrhenae asphodeloides Bge., Radix Rehmanniae Preparata and Chinemys reevesii. In this study, ultra high performance liquid chromatography with electrospray ionization quadrupole time-of-flight high-definition mass spectrometry with the control software of Masslynx (V4.1) was established for comprehensive screening and identification of the chemical constituents and serum metabolites of Da-Bu-Yin-Wan in vivo and in vitro. Consequently, 70 peaks in the methanol extract from Da-Bu-Yin-Wan and 38 peaks absorbed into rat blood were characterized. The 70 constituents in vitro included alkaloids, flavonoids, polysaccharide, limonoids, flavonoid, etc. And the 38 constituents consist of 22 absorbed prototypes and 16 metabolites of Da-Bu-Yin-Wan absorbed in vivo. We fully clarified the chemical constituents of Da-Bu-Yin-Wan and provided a scientific strategy for the screening and characterization of the chemical constituents and metabolites of traditional Chinese medicine in vitro and in vivo. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
TRANSVAGINAL SONOGRAPHY COMBINED WITH SALINE CONTRAST SONOHYSTEROGRAPHY IN EVALUATING THE UTERINE CAVITY IN PREMENOPAUSAL PATIENTS WITH ABNORMAL UTERINE BLEEDING

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K. G. M. Premleel

2016-06-01

Full Text Available OBJECTIVES To evaluate whether saline contrast sonohysterography (SCSH improved the diagnostic accuracy of transvaginal sonography (TVS for predicting endometrial abnormality in premenopausal patients with abnormal uterine bleeding. PATIENTS AND METHODS The uterine cavity was evaluated with TVS and SCSH in 60 premenopausal patients with abnormal uterine bleeding. All 58 patients underwent operative hysteroscopy or hysterectomy within 4 months which provided a detailed description of the uterine cavity and was used as the true value for exclusion of polyps and submucous myomas. RESULT Out of 60 patients, 45 had uterine abnormalities on TVS and SCSH and rest of the patients who appeared normal but had other abnormalities such as ovarian haemorrhagic cyst. Out of the 45 patients, 9 patients had submucous myomas and 9 were diagnosed as endometrial polyp. The findings were confirmed using hysterectomy/hysteroscopy/endometrial sampling. CONCLUSION The use of TVS without saline contrast left nine submucosal fibroids and five in nine of the polyps undiagnosed in referred patients with complaints of abnormal bleeding. It also helps in reducing the rate of more invasive procedures such as hysteroscopy. However, studies carried out for longer duration and large study population are required to validate our findings
DOKTRIN ULTRA VIRES DAN KONSEKUENSI PENERAPANNYA TERHADAP BADAN HUKUM PRIVAT

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Johnny Ibrahim

2011-05-01

Full Text Available An acts is ultra vires when corporation is without authority to perform it under any circumstance or for any purpose beyond the scope of the powers of corporation, as defined by its charter or by law of incorporation. Some countries restrict the application of the doctrine of ultra vires but do not abolish it. Indonesia adopt doctrine of ultra vires in some of its law such as Law No. 40 of 2007 concerning Limited Liability Company and Law No. 25 of 2003 concerning Anti Money Laundering. The provisions of ultra vires doctrine has impact to other legal person than Limited Liability Company.
Dopamine in high-risk populations: A comparison of subjects with 22q11.2 deletion syndrome and subjects at ultra high-risk for psychosis.

Science.gov (United States)

Vingerhoets, Claudia; Bloemen, Oswald J N; Boot, Erik; Bakker, Geor; de Koning, Mariken B; da Silva Alves, Fabiana; Booij, Jan; van Amelsvoort, Thérèse A M J

2018-02-28

Striatal dopamine (DA) dysfunction has been consistently reported in psychotic disorders. Differences and similarities in the pathogenesis between populations at clinical and genetic risk for developing psychosis are yet to be established. Here we explored markers of dopamine (DA) function in subjects meeting clinically ultra-high risk criteria for psychosis (UHR) and in subjects with 22q11.2 deletion syndrome (22q11DS), a genetic condition associated with significant risk for developing psychotic disorders. Single Photon Emission Computed Tomography (SPECT) with 123 I-labelled iodobenzamide ([ 123 I]IBZM) was used to measure striatal DA D 2/3 receptor binding potential (D 2 R BP ND ). Also, peripheral DAergic markers were assessed in serum and urine (plasma prolactin (pPRL), plasma homovanillic acid (pHVA) and urine DA(uDA)). No significant difference in striatal D 2 R BP ND was found between UHR and 22q11DS subjects. Compared to UHR subjects, pPRL and pHVA were lower and uDA levels were higher in the 22q11DS subjects. However, after correcting for age and gender, only pPRL as significantly lower in the 22q11DS patients. These results may suggest that there are differences in DAergic markers between subjects with UHR and with 22q11DS that may reflect differences in the pathways to psychosis. However, bigger samples are needed to replicate these findings. Copyright © 2017 Elsevier B.V. All rights reserved.
An Analog Correlator for Ultra-Wideband Receivers

Directory of Open Access Journals (Sweden)

Tu Chunjiang

2005-01-01

Full Text Available We present a new analog circuit exhibiting high bandwidth and low distortion, specially designed for signal correlation in an ultra-wideband receiver front end. The ultra-wideband short impulse signals are correlated with a local pulse template by the correlator. A comparator then samples the output for signal detection. A typical Gilbert mixer core is adopted for multiplication of broadband signals up to . As a result of synchronization of the received signal and the local template, the output voltage level after integration and sampling can reach up to , which is sufficient for detection by the comparator. The circuit dissipates about from double voltage supplies of and using SiGe BiCMOS technology. Simulation results are presented to show the feasibility of this circuit design for use in ultra-wideband receivers.
On the time delay between ultra-relativistic particles

Energy Technology Data Exchange (ETDEWEB)

Fleury, Pierre, E-mail: pierre.fleury@uct.ac.za [Department of Mathematics and Applied Mathematics, University of Cape Town, Rondebosch 7701, Cape Town (South Africa); Department of Physics, University of the Western Cape, Robert Sobukwe Road, Bellville 7535 (South Africa)

2016-09-10

The time delay between the receptions of ultra-relativistic particles emitted simultaneously is a useful observable for both fundamental physics and cosmology. The expression of the delay when the particles travel through an arbitrary spacetime has been derived recently by Fanizza et al., using a particular coordinate system and self-consistent assumptions. The present article shows that this formula enjoys a simple physical interpretation: the relative velocity between two ultra-relativistic particles is constant. This result reveals an interesting kinematical property of general relativity, namely that the tidal forces experienced by ultra-relativistic particles in the direction of their motion are much smaller than those experienced orthogonally to their motion.
On the time delay between ultra-relativistic particles

International Nuclear Information System (INIS)

Fleury, Pierre

2016-01-01

The time delay between the receptions of ultra-relativistic particles emitted simultaneously is a useful observable for both fundamental physics and cosmology. The expression of the delay when the particles travel through an arbitrary spacetime has been derived recently by Fanizza et al., using a particular coordinate system and self-consistent assumptions. The present article shows that this formula enjoys a simple physical interpretation: the relative velocity between two ultra-relativistic particles is constant. This result reveals an interesting kinematical property of general relativity, namely that the tidal forces experienced by ultra-relativistic particles in the direction of their motion are much smaller than those experienced orthogonally to their motion.
UltraVISTA : a new ultra-deep near-infrared survey in COSMOS

NARCIS (Netherlands)

McCracken, H. J.; Milvang-Jensen, B.; Dunlop, J.; Franx, M.; Fynbo, J. P. U.; Le Fevre, O.; Holt, J.; Caputi, K. I.; Goranova, Y.; Buitrago, F.; Emerson, J. P.; Freudling, W.; Hudelot, P.; Lopez-Sanjuan, C.; Magnard, F.; Mellier, Y.; Moller, P.; Nilsson, K. K.; Sutherland, W.; Tasca, L.; Zabl, J.

In this paper we describe the first data release of the UltraVISTA near-infrared imaging survey of the COSMOS field. We summarise the key goals and design of the survey and provide a detailed description of our data reduction techniques. We provide stacked, sky-subtracted images in YJHK(s) and
Ultra-processed foods and the nutritional dietary profile in Brazil

Science.gov (United States)

Louzada, Maria Laura da Costa; Martins, Ana Paula Bortoletto; Canella, Daniela Silva; Baraldi, Larissa Galastri; Levy, Renata Bertazzi; Claro, Rafael Moreira; Moubarac, Jean-Claude; Cannon, Geoffrey; Monteiro, Carlos Augusto

2015-01-01

OBJECTIVE To assess the impact of consuming ultra-processed foods on the nutritional dietary profile in Brazil. METHODS Cross-sectional study conducted with data from the module on individual food consumption from the 2008-2009 Pesquisa de Orçamentos Familiares (POF – Brazilian Family Budgets Survey). The sample, which represented the section of the Brazilian population aged 10 years or over, involved 32,898 individuals. Food consumption was evaluated by two 24-hour food records. The consumed food items were classified into three groups: natural or minimally processed, including culinary preparations with these foods used as a base; processed; and ultra-processed. RESULTS The average daily energy consumption per capita was 1,866 kcal, with 69.5% being provided by natural or minimally processed foods, 9.0% by processed foods and 21.5% by ultra-processed food. The nutritional profile of the fraction of ultra-processed food consumption showed higher energy density, higher overall fat content, higher saturated and trans fat, higher levels of free sugar and less fiber, protein, sodium and potassium, when compared to the fraction of consumption related to natural or minimally processed foods. Ultra-processed foods presented generally unfavorable characteristics when compared to processed foods. Greater inclusion of ultra-processed foods in the diet resulted in a general deterioration in the dietary nutritional profile. The indicators of the nutritional dietary profile of Brazilians who consumed less ultra-processed foods, with the exception of sodium, are the stratum of the population closer to international recommendations for a healthy diet. CONCLUSIONS The results from this study highlight the damage to health that is arising based on the observed trend in Brazil of replacing traditional meals, based on natural or minimally processed foods, with ultra-processed foods. These results also support the recommendation of avoiding the consumption of these kinds of foods
Ultra-processed foods and the nutritional dietary profile in Brazil.

Science.gov (United States)

Costa Louzada, Maria Laura da; Martins, Ana Paula Bortoletto; Canella, Daniela Silva; Baraldi, Larissa Galastri; Levy, Renata Bertazzi; Claro, Rafael Moreira; Moubarac, Jean-Claude; Cannon, Geoffrey; Monteiro, Carlos Augusto

2015-01-01

OBJECTIVE To assess the impact of consuming ultra-processed foods on the nutritional dietary profile in Brazil. METHODS Cross-sectional study conducted with data from the module on individual food consumption from the 2008-2009 Pesquisa de Orçamentos Familiares (POF - Brazilian Family Budgets Survey). The sample, which represented the section of the Brazilian population aged 10 years or over, involved 32,898 individuals. Food consumption was evaluated by two 24-hour food records. The consumed food items were classified into three groups: natural or minimally processed, including culinary preparations with these foods used as a base; processed; and ultra-processed. RESULTS The average daily energy consumption per capita was 1,866 kcal, with 69.5% being provided by natural or minimally processed foods, 9.0% by processed foods and 21.5% by ultra-processed food. The nutritional profile of the fraction of ultra-processed food consumption showed higher energy density, higher overall fat content, higher saturated and trans fat, higher levels of free sugar and less fiber, protein, sodium and potassium, when compared to the fraction of consumption related to natural or minimally processed foods. Ultra-processed foods presented generally unfavorable characteristics when compared to processed foods. Greater inclusion of ultra-processed foods in the diet resulted in a general deterioration in the dietary nutritional profile. The indicators of the nutritional dietary profile of Brazilians who consumed less ultra-processed foods, with the exception of sodium, are the stratum of the population closer to international recommendations for a healthy diet. CONCLUSIONS The results from this study highlight the damage to health that is arising based on the observed trend in Brazil of replacing traditional meals, based on natural or minimally processed foods, with ultra-processed foods. These results also support the recommendation of avoiding the consumption of these kinds of foods.
UltraSail CubeSat Solar Sail Flight Experiment

Science.gov (United States)

Carroll, David; Burton, Rodney; Coverstone, Victoria; Swenson, Gary

2013-01-01

UltraSail is a next-generation, highrisk, high-payoff sail system for the launch, deployment, stabilization, and control of very large (km2 class) solar sails enabling high payload mass fractions for interplanetary and deep space spacecraft. UltraSail is a non-traditional approach to propulsion technology achieved by combining propulsion and control systems developed for formation- flying microsatellites with an innovative solar sail architecture to achieve controllable sail areas approaching 1 km2, sail subsystem area densities approaching 1 g/m2, and thrust levels many times those of ion thrusters used for comparable deep space missions. UltraSail can achieve outer planetary rendezvous, a deep-space capability now reserved for high-mass nuclear and chemical systems. There is a twofold rationale behind the UltraSail concept for advanced solar sail systems. The first is that sail-andboom systems are inherently size-limited. The boom mass must be kept small, and column buckling limits the boom length to a few hundred meters. By eliminating the boom, UltraSail not only offers larger sail area, but also lower areal density, allowing larger payloads and shorter mission transit times. The second rationale for UltraSail is that sail films present deployment handling difficulties as the film thickness approaches one micrometer. The square sail requires that the film be folded in two directions for launch, and similarly unfolded for deployment. The film is stressed at the intersection of two folds, and this stress varies inversely with the film thickness. This stress can cause the film to yield, forming a permanent crease, or worse, to perforate. By rolling the film as UltraSail does, creases are prevented. Because the film is so thin, the roll thickness is small. Dynamic structural analysis of UltraSail coupled with dynamic control analysis shows that the system can be designed to eliminate longitudinal torsional waves created while controlling the pitch of the blades
Ovarian volume and antral follicle count assessed by MRI and transvaginal ultrasonography: a methodological study.

Science.gov (United States)

Leonhardt, Henrik; Gull, Berit; Stener-Victorin, Elisabet; Hellström, Mikael

2014-03-01

Ultrasonographic measurements of ovarian volume and antral follicle count are of clinical importance as diagnostic features of polycystic ovarian syndrome (PCOS), and as a parameter in estimation of ovarian follicular reserve in infertility care. To compare two-dimensional (2D)/three-dimensional (3D) transvaginal ultrasonography (TVUS) and magnetic resonance imaging (MRI) for estimation of ovarian volume and antral follicle count, and to assess reproducibility and inter-observer agreement of MRI measurements. Volumes of 172 ovaries in 99 women aged 21-37 years were calculated (length x width x height x 0.523) with conventional 2D TVUS and 2D MRI. Semi-automatic estimates of ovarian volumes were obtained by 3D MRI. Antral follicles were counted manually on 2D MRI and automatically by 3D TVUS (SonoAVC), and stratified according to follicle size. Mean ovarian volume assessed by 2D TVUS (13.1 ± 6.4 mL) was larger than assessed by 2D MRI (9.6 ± 4.1) and 3D MRI (11.4 ± 4.5) (P 0.77. 2D MRI reveals more antral follicles, especially of small size, than 3D TVUS. Ovarian volume estimation by MRI provides smaller volumes than by the reference standard 2D TVUS. Ovarian volume estimation by 3D MRI, allowing independence of non-ellipsoid ovarian shape measurement errors, provides volumes closer to 2D TVUS values than does 2D MRI. Reproducibility and inter-observer agreement of 2D MRI measurements of ovarian volume and total follicle count are good.
Challenges in the transvaginal management of abnormal uterine bleeding secondary to cesarean section scar defect.

Science.gov (United States)

Wang, Chin-Jung; Huang, Huei-Jean; Chao, Angel; Lin, Yu-Pin; Pan, Yi-Jung; Horng, Shang-Gwo

2011-02-01

Research suggests that the resectoscopic management of abnormal uterine bleeding (AUB) following cesarean section (CS) is safe and effective. There is, however, a lack of complementary data from routine clinical practice. We aimed to evaluate the efficacy of resectoscopic remodeling of the CS scar in the management of post CS AUB (pCSAUB). The case notes of 57 women with pCSAUB who had undergone a resectoscopic remodeling procedure were reviewed retrospectively. Primary outcome measures were the duration of preoperative and postoperative menstruation, and postoperative menstrual change. Secondary outcome measures were the impact of patient-dependent variables on the success of the resectoscopic remodeling procedure. The CS scar was located using transvaginal ultrasonography and hysteroscopy. The remodeling procedure was performed with a hysteroscopic resectoscope, and commenced with resection of the fibromuscular scar. This started at the roof of the scar pouch and progressed towards the external os. It then continued along a line parallel to the axis of the cervical canal. The exposed dilated blood vessels and endometrial-like tissue in the roof of the remaining pouch were electrocauterized with a roller-ball electrode. The mean operating time was 30.2 ± 6.6 min. There was a significant difference in the mean duration of preoperative and postoperative menstruation (12.9 ± 2.9 days and 9.4 ± 4.1 days, respectively; p uterine remodeling is an appropriate therapy in patients with pCSAUB and an anteflexed uterus. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Dispersão e comportamento reológico de concretos refratários ultra-baixo teor de cimento no sistema Al2O3-SiC-SiO2-C

Directory of Open Access Journals (Sweden)

Oliveira I. R. de

2003-01-01

Full Text Available Concretos refratários no sistema Al2O3-SiC-SiO2-C vêm sendo amplamente utilizados em indústrias siderúrgicas como revestimento de canais de corrida de altos-fornos, em virtude principalmente da sua elevada refratariedade aliada a altas resistências ao choque térmico e ao ataque por escória e metal fundido. Neste trabalho, investigou-se a influência de diferentes tipos de aditivos na trabalhabilidade e dispersão de concretos refratários de ultra-baixo teor de cimento nesse sistema. Apesar da sua alta capacidade de complexar íons de cálcio, moléculas de citrato não foram capazes de controlar adequadamente o tempo de pega do concreto estudado, contradizendo a idéia geral de que os íons de citrato devem ser utilizados para controlar a sua trabalhabilidade. Por outro lado, o aditivo polimetacrilato de sódio mostrou-se eficiente na otimização simultânea da dispersão e da trabalhabilidade do concreto devido provavelmente ao retardamento da dissolução dos íons advindos do cimento.
Transvaginal repair of genital prolapse: preliminary results of a new tension-free vaginal mesh (Prolift technique)--a case series multicentric study.

Science.gov (United States)

Fatton, B; Amblard, J; Debodinance, P; Cosson, M; Jacquetin, B

2007-07-01

Our goal was to report the preliminary results of a transvaginal mesh repair of genital prolapse using the Prolift system. This retrospective multicentric study includes 110 patients. All patients had a stage 3 (at the hymen) or stage 4 (beyond the hymen) prolapse. Total mesh was used in 59 patients (53.6%), an isolated anterior mesh in 22 patients (20%) and an isolated posterior mesh in 29 patients (26.4%). We report one bladder injury sutured at surgery and two haematomas requiring secondary surgical management. At 3 months, 106 patients were available for follow-up. Mesh exposure occurred in five patients (4.7%), two of them requiring a surgical management. Granuloma without exposure occurred in three patients (2.8%). Failure rate (recurrent prolapse even asymptomatic or low grade symptomatic prolapse) was 4.7%. According to the perioperative and immediate post-operative results, Prolift repair seems to be a safe technique to correct pelvic organ prolapse. Anatomical and functional results must be assessed with a long-term follow-up to confirm the effectiveness and safety of the procedure.
Ultra-wide-field imaging in diabetic retinopathy.

Science.gov (United States)

Ghasemi Falavarjani, Khalil; Tsui, Irena; Sadda, Srinivas R

2017-10-01

Since 1991, 7-field images captured with 30-50 degree cameras in the Early Treatment Diabetic Retinopathy Study were the gold standard for fundus imaging to study diabetic retinopathy. Ultra-wide-field images cover significantly more area (up to 82%) of the fundus and with ocular steering can in many cases image 100% of the fundus ("panretinal"). Recent advances in image analysis of ultra-wide-field imaging allow for precise measurements of the peripheral retinal lesions. There is a growing consensus in the literature that ultra-wide-field imaging improves detection of peripheral lesions in diabetic retinopathy and leads to more accurate classification of the disease. There is discordance among studies, however, on the correlation between peripheral diabetic lesions and diabetic macular edema and optimal management strategies to treat diabetic retinopathy. Copyright © 2017 Elsevier Ltd. All rights reserved.

Solutions for ultra-high speed optical wavelength conversion and clock recovery

DEFF Research Database (Denmark)

Oxenløwe, Leif Katsuo; Galili, Michael; Mulvad, Hans Christian Hansen

2006-01-01

This paper reports on our recent advances in ultra-fast optical communications relying on ultra-short pulses densely stacked in ultra-high bit rate serial data signals at a single wavelength. The paper describes details in solutions for the network functionalities of wavelength conversion and clock...... recovery at bit rates up to 320 Gb/s...
Doença da arranhadura do gato por Bartonella quintana em lactente: uma apresentação incomum

Directory of Open Access Journals (Sweden)

Azevedo Zina Maria Almeida de

2000-01-01

Full Text Available Relato de caso de doença da arranhadura do gato (DAG, em um paciente lactente, com história epidemiológica negativa, descrevendo o rastreamento diagnóstico, a imagem ao ultra-som, a evolução clínica e o prognóstico. B. quintana foi identificada em aspirado de secreção ganglionar pelo método de PCR. B. henselae, embora seja o agente causal habitualmente responsável pela DAG, não foi isolada. Os autores concluem que a pesquisa de B. quintana e B. henselae deve ser incluída na investigação de adenites, principalmente quando a evolução é subaguda, mesmo em lactentes e, ainda que a história epidemiológica seja negativa.
Native tissue repair or transvaginal mesh for recurrent vaginal prolapse: what are the long-term outcomes?

Science.gov (United States)

Ow, Lin Li; Lim, Yik N; Dwyer, Peter L; Karmakar, Debjyoti; Murray, Christine; Thomas, Elizabeth; Rosamilia, Anna

2016-09-01

The objective of this study was to assess outcomes in native tissue (NT) and transvaginal mesh (TVM) repair in women with recurrent prolapse. A retrospective two-group observational study of 237 women who underwent prolapse repair after failed NT repair in two tertiary hospitals. A primary outcome of "success" was defined using a composite outcome of no vaginal bulge symptoms, no anatomical recurrence in the same compartment beyond the hymen (0 cm on POPQ) and no surgical re-treatment for prolapse in the same compartment. Secondary outcomes assessed included re-operation for prolapse in the same compartment, dyspareunia and mesh-related complications. Of a total of 336 repairs, 196 were performed in the anterior compartment and 140 in the posterior compartment. Compared with the TVM groups, women undergoing repeat NT repair were more likely to experience anatomical recurrence (anterior 40.9 % vs 25 %, p = 0.02, posterior 25.3 % vs 7.5 %, p = 0.01), report vaginal bulge (anterior 34.1 % vs 12 %, p mesh exposure were 9.3 % anteriorly and 15.1 % posteriorly. Although the number of women requiring a prolapse re-operation is lower in the TVM group, the overall re-operation rate was not significantly different when procedures to correct mesh complications were included. Although the success rate is better with the use of TVM for recurrent prolapse, the total re-operation rates are similar when mesh complication-related surgeries are included.
Rectal water contrast transvaginal ultrasound versus double-contrast barium enema in the diagnosis of bowel endometriosis.

Science.gov (United States)

Jiang, Jipeng; Liu, Ying; Wang, Kun; Wu, Xixiang; Tang, Ying

2017-09-07

The aim of study was to compare the accuracy between rectal water contrast transvaginal ultrasound (RWC-TVS) and double-contrast barium enema (DCBE) in evaluating the bowel endometriosis presence as well as its extent. 198 patients at reproductive age with suspicious bowel endometriosis were included. Physicians in two groups specialised at endometriosis performed RWC-TVS as well as DCBE before laparoscopy and both groups were blinded to other groups' results. Findings from RWC-TVS or DCBE were compared with histological results. The severity of experienced pain severity through RWC-TVS or DCBE was assessed by an analogue scale of 10 cm. In total, 110 in 198 women were confirmed to have endometriosis nodules in the bowel by laparoscopy as well as histopathology. For bowel endometriosis diagnosis, DCBE and RWC-TVS demonstrated sensitivities of 96.4% and 88.2%, specificities of 100% and 97.3%, positive prediction values of 100% and 98.0%, negative prediction values of 98.0% and 88.0%, accuracies of 98.0% and 92.4%, respectively. DCBE was related to more tolerance than RWC-TVS. RWC-TVS and DCBE demonstrated similar accuracies in the bowel endometriosis diagnosis; however, patients showed more tolerance for RWC-TVS than those with DCBE. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Ultra-low noise supercontinuum source for ultra-high resolution optical coherence tomography at 1300 nm

Science.gov (United States)

Gonzalo, I. B.; Maria, M.; Engelsholm, R. D.; Feuchter, T.; Leick, L.; Moselund, P. M.; Podoleanu, A.; Bang, O.

2018-02-01

Supercontinuum (SC) sources are of great interest for many applications due to their ultra-broad optical bandwidth, good beam quality and high power spectral density [1]. In particular, the high average power over large bandwidths makes SC light sources excellent candidates for ultra-high resolution optical coherence tomography (UHR-OCT) [2-5]. However, conventional SC sources suffer from high pulse-to-pulse intensity fluctuations as a result of the noise-sensitive nonlinear effects involved in the SC generation process [6-9]. This intensity noise from the SC source can limit the performance of OCT, resulting in a reduced signal-to-noise ratio (SNR) [10-12]. Much work has been done to reduce the noise of the SC sources for instance with fiber tapers [7,8] or increasing the repetition rate of the pump laser for averaging in the spectrometer [10,12]. An alternative approach is to use all-normal dispersion (ANDi) fibers [13,14] to generate SC light from well-known coherent nonlinear processes [15-17]. In fact, reduction of SC noise using ANDi fibers compared to anomalous dispersion SC pumped by sub-picosecond pulses has been recently demonstrated [18], but a cladding mode was used to stabilize the ANDi SC. In this work, we characterize the noise performance of a femtosecond pumped ANDi based SC and a commercial SC source in an UHR-OCT system at 1300 nm. We show that the ANDi based SC presents exceptional noise properties compared to a commercial source. An improvement of 5 dB in SNR is measured in the UHR-OCT system, and the noise behavior resembles that of a superluminiscent diode. This preliminary study is a step forward towards development of an ultra-low noise SC source at 1300 nm for ultra-high resolution OCT.
Added sugars and ultra-processed foods in Spanish households (1990-2010).

Science.gov (United States)

Latasa, P; Louzada, M L D C; Martinez Steele, E; Monteiro, C A

2017-12-26

To study the association between ultra-processed foods acquisitions and added sugar content of total food purchases in Spanish households in 2010. Changes over time (1990-2000-2010) in ultra-processed food purchases and added sugars content of total food purchases are also compared. We used data from three nationally representative Household Budget Surveys (HBS) conducted in 1990, 2000 and 2010. Number of studied households was 21,012, 33,730 and 22,116, respectively. Purchased foods and drinks were classified according to NOVA food groups as ultra-processed foods, processed foods, unprocessed or minimally processed foods, or processed culinary ingredients. Linear and Poisson regressions were used to estimate the association between quintiles of energy contribution of ultra-processed foods and added sugars contents of total food purchases in 2010. Changes over time were assessed using tests of linear trend and Student's t test. In 2010, ultra-processed foods represented 31.7% of daily energy acquisitions and 80.4% of all added sugars. Added sugars content of food purchases raised from 7.3% in the lowest to 18.2% in the highest quintiles of energy contribution of ultra-processed foods. The risk of exceeding 10% energy from added sugars quadrupled between the lowest and highest quintiles. The percentage of ultra-processed foods on all food purchases almost tripled between 1990 and 2010 (from 11.0 to 31.7%), paralleling the increase of added sugars content (from 8.4 to 13.0%). Cutting down exceeding added sugars availability in Spain may require a reduction in ultra-processed food purchasing.
Danish Ultras

DEFF Research Database (Denmark)

Havelund, Jonas; Joern, Lise; Rasmussen, Kristian

2012-01-01

It is well documented that knowledge of supporter culture is crucial when assessing the risk of disorder at football matches and thereby ensuring a balanced approach by police and stewards (Stott & Pearson 2007). Both within Denmark and internationally, there is a weak understanding of risk suppo....... The article aims to create knowledge concerning ultra supporter culture with the purpose of gaining the information necessary for building differentiated and balanced action on the part of the police and security services....
Tratamento da recidiva hemorrágica por varizes do esôfago em doentes esquistossomóticos operados Treatment of recurrent hemorrhage esophageal varices in schistosomotic patients after surgery

Directory of Open Access Journals (Sweden)

José Cesar Assef

2003-01-01

Full Text Available OBJETIVO: Padronizar o tratamento da recidiva hemorrágica por varizes do esôfago em esquistossomóticos, após operações não-derivativas. MÉTODOS: Tratamos 45 doentes esquistossomóticos que apresentaram recidiva hemorrágica por varizes do esôfago. Realizamos ultra-sonografia abdominal, e, estudos angiográficos constituindo-se dois grupos: Grupo A - Dezenove doentes (42,2% com ausência do baço, artéria esplênica ocluída e artéria e veia gástricas esquerdas pérvias, caracterizando a esplenectomia na operação anterior. Grupo B - Vinte e seis doentes (57,8% com imagem esplênica ausente, artérias esplênica e gástrica esquerda ocluídas e veia gástrica esquerda não-opacificada, evidenciando esplenectomia e alguma forma de desvascularização gastroesofágica praticadas anteriormente. Os doentes do Grupo A foram reoperados para executar a desvascularização gastroesofágica e os do Grupo B, submetidos a programa de escleroterapia endoscópica. RESULTADOS: No Grupo A, um paciente (5,3% apresentou recidiva hemorrágica no pós-operatório tardio. Na avaliação endoscópica final, as varizes esofágicas diminuíram, em número ou calibre, em 14 doentes (73,7%, desapareceram em três (15,8% e em dois (10,5%, permaneceram inalteradas. No Grupo B, seis pacientes (23,1% apresentaram recidiva do sangramento, controlada em quatro deles e em dois, que persistiram com sangramento praticou-se a derivação mesentérico-cava e ambos morreram. Na última avaliação endoscópica, as varizes esofágicas desapareceram em 17 doentes (65,4%, reduziram o número ou calibre em sete (26,9% e, em dois (7,7%, permaneceram inalteradas. CONCLUSÕES: 1 A desvacularização gastroesofágica é adequada para os doentes esplenectomizados, com a artéria e a veia gástricas esquerdas pérvias. 2 Um programa de longa duração de escleroterapia endoscópica das varizes do esôfago pode ser uma opção para os doentes esplenectomizados, com a artéria g
Troublesome Thugs or Respectable Rebels? Class, Martyrdom and Cairo’s Revolutionary Ultras

Directory of Open Access Journals (Sweden)

Carl Rommel

2016-05-01

Full Text Available This ethnographic article explores the politics of Egypt’s Ultras football supporters. The Ultras have frequently been heralded as some of the Egyptian Revolution’s most prominent rebels, in particular, after the Port Said stadium massacre in February 2012, when 72 Ultras members were killed. However, this essay focuses on the earlier phase of violent clashes in central Cairo when the Ultras were highly ambivalent about the ongoing protests. As the article shows, the fan groups were hesitant to join the demonstrations, which at the time were heavily associated with “thuggery” (balṭaga. Only after the death of one of its members did the Ultras whole-heartedly take on their rebellious subjectivity.
Ultra Low Concentration Adsorption Equilibria

National Research Council Canada - National Science Library

Mahle, John J; Buettner, Leonard C; LeVan, M. D; Schindler, Bryan J

2006-01-01

.... Specifically this work focuses on novel experimental and modeling methods to characterize and predict at ultra-low chemical vapor concentrations the protection afforded by adsorption-based vapor filtration systems...
Ultra wideband antennas design, methodologies, and performance

CERN Document Server

Galvan-Tejada, Giselle M; Jardón Aguilar, Hildeberto

2015-01-01

Ultra Wideband Antennas: Design, Methodologies, and Performance presents the current state of the art of ultra wideband (UWB) antennas, from theory specific for these radiators to guidelines for the design of omnidirectional and directional UWB antennas. Offering a comprehensive overview of the latest UWB antenna research and development, this book:Discusses the developed theory for UWB antennas in frequency and time domainsDelivers a brief exposition of numerical methods for electromagnetics oriented to antennasDescribes solid-planar equivalen
Interventional prevention of ovarian hyperstimulation syndrome in infertility patients with polycystic ovaries syndrome

International Nuclear Information System (INIS)

Liang Weixiang; Chen Zhiyi; Yuan Wenlin; Chen Xia; Cai Kuan; Wang Weiqun; Zhu Junlin

2008-01-01

Objective: To assess the efficacy of aspiration of small follicles(ASF) guided by trans-vaginal ultra- sound (TVS) in preventing moderate and severe ovarian hyperstimulation syndrome (OHSS) in women with polycystic ovaries syndrome (PCOS). Methods: ASF was undertaken by trans-vaginally during artificial cycles in 25 women with PCOS who had early signs of OHSS during the early period of the cycle according to the ovaries and follicles detected by TVS. Small follicles(≤ 12 mm in diameter) were aspirated at the early period of gonadotropin therapy according to the follicle testing, three or less excellent follicles were reserve. All the patients were followed up for symptoms and signs of OHSS. Results: None of the patients developed moderate or severe OHSS. Successful intrauterine pregnancy were found in 7 cases (28%). Conclusion: ASF after gonadotropin injections is of significance to prevent moderate and severe OHSS and obtain a higher pregnancy rate in susceptible patients with PCOS during the early period of the cycles. Time of ASF is the main factor to prevent OHSS. TVS may be an important tool in the detection of early period of follicles development. (authors)
Lax pairs for ultra-discrete Painleve cellular automata

International Nuclear Information System (INIS)

Joshi, N; Nijhoff, F W; Ormerod, C

2004-01-01

Ultra-discrete versions of the discrete Painleve equations are well known. However, evidence for their integrability has so far been restricted. In this letter, we show that their Lax pairs can be constructed and, furthermore, that compatibility conditions of the result yield the ultra-discrete Painleve equation. For conciseness, we restrict our attention to a new d-P III . (letter to the editor)
Bloqueios nervosos guiados por ultra-som Bloqueos nerviosos guiados por ultrasonido Ultrasound-guided nerve blocks

Directory of Open Access Journals (Sweden)

Pablo Escovedo Helayel

2007-02-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: As técnicas de bloqueios nervosos guiados por ultra-som são baseadas na visualização direta das estruturas nervosas, da agulha de bloqueio e das estruturas anatômicas adjacentes. Desta maneira, é possível depositar a solução de anestésico local precisamente em torno dos nervos e acompanhar a sua dispersão em tempo real, obtendo-se, assim, um bloqueio mais eficaz, de menor latência, menor dependência de referências anatômicas, menor volume de solução anestésica e maior segurança. CONTEÚDO: O artigo revisa os aspectos relativos aos mecanismos físicos para formação de imagens, a anatomia ultra-sonográfica do neuroeixo e dos plexos braquial e lombossacral, os equipamentos e materiais empregados nos bloqueios, os ajustes do aparelho de ultra-som para melhorar as imagens, os planos de visualização das agulhas de bloqueio e as técnicas e o treinamento em bloqueios guiados por ultra-som. CONCLUSÕES: Os passos para se obter sucesso em anestesia regional incluem a identificação exata da posição dos nervos, a localização precisa da agulha, sem lesões nas estruturas adjacentes e, finalmente, a injeção cuidadosa de anestésico local junto aos nervos. Embora a neuroestimulação forneça grande auxílio na identificação dos nervos, esta não consegue, isoladamente, preencher todas essas exigências. Por isso, acredita-se que os bloqueios guiados por ultra-som serão a técnica de eleição para anestesia regional num futuro não muito distante.JUSTIFICATIVA Y OBJETIVOS: Las técnicas de bloqueos nerviosos guiados por ultrasonido se basan en la visualización directa de las estructuras nerviosas, de la aguja de bloqueo y de las estructuras anatómicas adyacentes. De esa manera, se puede depositar la solución de anestésico local precisamente en torno de los nervios y acompañar su dispersión en tiempo real, obteniéndose así, un bloqueo más eficaz, de menor latencia, menor dependencia de
Super Boiler: First Generation, Ultra-High Efficiency Firetube Boiler

Energy Technology Data Exchange (ETDEWEB)

None

2006-06-01

This factsheet describes a research project whose goal is to develop and demonstrate a first-generation ultra-high-efficiency, ultra-low emissions, compact gas-fired package boiler (Super Boiler), and formulate a long-range RD&D plan for advanced boiler technology out to the year 2020.
Fisioterapia na incontinência urinária de esforço: revisão de literatura

Directory of Open Access Journals (Sweden)

Josiane Teresinha Bertoldi

2014-12-01

Full Text Available A incontinência urinária de esforço (IUE é definida como qualquer perda involuntária de urina no esforço físico, espirro ou tosse, causada por disfunção das estruturas de sustentação da musculatura do assoalho pélvico (MAP. Essa desordem atinge cerca de 80% de mulheres entre 25 e 60 anos e ocasiona isolamento social, incapacidade funcional e afeta a qualidade de vida. Objetivo: comparar os tratamentos fisioterapêuticos para IUE: a cinesioterapia, o biofeedback perineal e a eletroestimulação transvaginal. Método: o levantamento bibliográfico foi realizado nas bases: PubMed, Scielo e Lilacs nos dados publicados no período de 2003 à 2014. Foram selecionados nove artigos contendo estudos clínicos, randomizados e experimentais, que envolveram 263 pacientes na faixa etária entre 22 e 74 anos. Resultados: os estudos apontam que a cinesioterapia do assoalho pélvico promove o fortalecimento dos elementos de sustentação e a elevação da pressão intra-uretral, reduzindo as perdas urinárias. O biofeedback é um importante aliado, desenvolve o controle e a consciência perineal e a eletroestimulação transvaginal, através da contração passiva, melhora a propriocepção e ativação da MAP, porém apresenta efeitos adversos. Considerações finais: os equipamentos são coadjuvantes no tratamento da IUE para promover a consciência e ativação muscular; nos demais casos, a cinesioterapia perineal de forma supervisionada, torna-se o método mais eficaz.
Benchmark ultra-cool dwarfs in widely separated binary systems

Directory of Open Access Journals (Sweden)

Jones H.R.A.

2011-07-01

Full Text Available Ultra-cool dwarfs as wide companions to subgiants, giants, white dwarfs and main sequence stars can be very good benchmark objects, for which we can infer physical properties with minimal reference to theoretical models, through association with the primary stars. We have searched for benchmark ultra-cool dwarfs in widely separated binary systems using SDSS, UKIDSS, and 2MASS. We then estimate spectral types using SDSS spectroscopy and multi-band colors, place constraints on distance, and perform proper motions calculations for all candidates which have sufficient epoch baseline coverage. Analysis of the proper motion and distance constraints show that eight of our ultra-cool dwarfs are members of widely separated binary systems. Another L3.5 dwarf, SDSS 0832, is shown to be a companion to the bright K3 giant η Cancri. Such primaries can provide age and metallicity constraints for any companion objects, yielding excellent benchmark objects. This is the first wide ultra-cool dwarf + giant binary system identified.
Leucemia linfoblástica aguda (LLA durante a gravidez: um relato de caso

Directory of Open Access Journals (Sweden)

Marcelo Gil Cliquet

2015-10-01

Full Text Available A incidência de Leucemia Linfoblástica Aguda (LLA associada à gestação é pequena, entretanto, devido à gravidade da doença, é fundamental que o obstetra esteja capacitado a orientar a conduta médica. O tratamento deve ser iniciado logo após o diagnóstico para que não haja prejuízo do prognóstico materno. Quando diagnosticada, sabe-se que haverá prejuízos fetais frente à quimioterapia a ser empregada. O dilema ético criado pela concomitância de neoplasias com a gestação é de difícil manejo. Objetivo: relatar o caso de uma gestante no primeiro trimestre com diagnóstico de LLA. Metodologia: as informações foram obtidas por meio de revisão do prontuário e da literatura. Relato: Relatamos o caso de uma gestante, 30 anos, com dores articulares no joelho e hemograma com pancitopenia. O mielograma e a imunofenotipagem foram compatíveis com Leucemia Linfoblástica B comum, quando a paciente estava com 12 semanas de gestação (ultrassom. A paciente foi informada sobre todos os riscos do tratamento quimioterápico para o feto, bem como os riscos maternos em postergar o tratamento. A partir da discussão entre a paciente, seus familiares e equipe médica, ela decidiu por iniciar o tratamento com protocolo BFM 86 modificado, assinando um termo de consentimento. Durante a Indução 2, foi diagnosticado óbito fetal por ultra-sonografia (21 semanas de gestação. A paciente continuou o tratamento com suporte psicológico e no momento encontra-se em remissão completa, iniciando a fase de consolidação do referido protocolo. Conclusão: Pretendemos alertar sobre a difícil decisão feita por uma paciente grávida com a LLA. Tal escolha deve ser feita com o amparo de toda a equipe médica e familiares dos pacientes, além de ser firmada por meio de um termo de consentimento.
Low velocity impact behaviour of ultra high strength concrete panels

Indian Academy of Sciences (India)

Ultra high strength concrete; panel; drop weight test; impact analysis;. ABAQUS. 1. Introduction. Ultra high strength concrete ... Knight (2012) investigated the dynamic behaviour of steel fibre reinforced concrete plates under impact loading with ...
Feasibility of Ultra-Thin Fiber-Optic Dosimeters for Radiotherapy Dosimetry.

Science.gov (United States)

Lee, Bongsoo; Kwon, Guwon; Shin, Sang Hun; Kim, Jaeseok; Yoo, Wook Jae; Ji, Young Hoon; Jang, Kyoung Won

2015-11-17

In this study, prototype ultra-thin fiber-optic dosimeters were fabricated using organic scintillators, wavelength shifting fibers, and plastic optical fibers. The sensor probes of the ultra-thin fiber-optic dosimeters consisted of very thin organic scintillators with thicknesses of 100, 150 and 200 μm. These types of sensors cannot only be used to measure skin or surface doses but also provide depth dose measurements with high spatial resolution. With the ultra-thin fiber-optic dosimeters, surface doses for gamma rays generated from a Co-60 therapy machine were measured. Additionally, percentage depth doses in the build-up regions were obtained by using the ultra-thin fiber-optic dosimeters, and the results were compared with those of external beam therapy films and a conventional fiber-optic dosimeter.

Analysis of ultra-narrow ferromagnetic domain walls

Energy Technology Data Exchange (ETDEWEB)

Jenkins, Catherine; Paul, David

2012-01-10

New materials with high magnetic anisotropy will have domains separated by ultra-narrow ferromagnetic walls with widths on the order of a few unit cells, approaching the limit where the elastic continuum approximation often used in micromagnetic simulations is accurate. The limits of this approximation are explored, and the static and dynamic interactions with intrinsic crystalline defects and external driving elds are modeled. The results developed here will be important when considering the stability of ultra-high-density storage media.
Ruptura da barreira hematoencefálica após injeção de droga gliotóxica no tronco encefálico de ratos wistar

Directory of Open Access Journals (Sweden)

Bondan Eduardo Fernandes

2002-01-01

Full Text Available O brometo de etídio (BE determina desaparecimento astrocitário local, com ruptura da glia limitans e suposto dano na barreira hematoencefálica (BBB. Este estudo visou avaliar a integridade da BBB após injeção de solução de BE a 0,1% (grupo E ou de salina a 0,9% (grupo C na cisterna pontis de ratos Wistar. Fragmentos do tronco encefálico foram coletados das 24 horas aos 31 dias pós-injeção para estudo ultra-estrutural e marcação imuno-histoquímica para a GFAP. Alguns animais receberam carvão coloidal por via intravenosa nos mesmos períodos. Nos ratos do grupo C, não houve sinal de perda astrocitária, nem extravasamento vascular de carvão no sítio da injeção. No grupo E, o desaparecimento astrocitário começou às 48 horas e algumas áreas estavam ainda destituídas de processos astrocíticos 31 dias após. Extravasamento de partículas de carvão nas lesões foi visto de 48 horas até 7 dias, não sendo detectada qualquer alteração ultra-estrutural das junções oclusivas pela falta de astrócitos perivasculares.
Evaluation of Ultra Clean Fuels from Natural Gas

Energy Technology Data Exchange (ETDEWEB)

Robert Abbott; Edward Casey; Etop Esen; Douglas Smith; Bruce Burke; Binh Nguyen; Samuel Tam; Paul Worhach; Mahabubul Alam; Juhun Song; James Szybist; Ragini Acharya; Vince Zello; David Morris; Patrick Flynn; Stephen Kirby; Krishan Bhatia; Jeff Gonder; Yun Wang; Wenpeng Liu; Hua Meng; Subramani Velu; Jian-Ping Shen, Weidong Gu; Elise Bickford; Chunshan Song; Chao-Yang Wang; Andre' Boehman

2006-02-28

ConocoPhillips, in conjunction with Nexant Inc., Penn State University, and Cummins Engine Co., joined with the U.S. Department of Energy (DOE) National Energy Technology Laboratory (NETL) in a cooperative agreement to perform a comprehensive study of new ultra clean fuels (UCFs) produced from remote sources of natural gas. The project study consists of three primary tasks: an environmental Life Cycle Assessment (LCA), a Market Study, and a series of Engine Tests to evaluate the potential markets for Ultra Clean Fuels. The overall objective of DOE's Ultra Clean Transportation Fuels Initiative is to develop and deploy technologies that will produce ultra-clean burning transportation fuels for the 21st century from both petroleum and non-petroleum resources. These fuels will: (1) Enable vehicles to comply with future emission requirements; (2) Be compatible with the existing liquid fuels infrastructure; (3) Enable vehicle efficiencies to be significantly increased, with concomitantly reduced CO{sub 2} emissions; (4) Be obtainable from a fossil resource, alone or in combination with other hydrocarbon materials such as refinery wastes, municipal wastes, biomass, and coal; and (5) Be competitive with current petroleum fuels. The objectives of the ConocoPhillips Ultra Clean Fuels Project are to perform a comprehensive life cycle analysis and to conduct a market study on ultra clean fuels of commercial interest produced from natural gas, and, in addition, perform engine tests for Fisher-Tropsch diesel and methanol in neat, blended or special formulations to obtain data on emissions. This resulting data will be used to optimize fuel compositions and engine operation in order to minimize the release of atmospheric pollutants resulting from the fuel combustion. Development and testing of both direct and indirect methanol fuel cells was to be conducted and the optimum properties of a suitable fuel-grade methanol was to be defined. The results of the study are also
8th conference on Ultra-Wideband Short-Pulse Electromagnetics

CERN Document Server

Tyo, J. Scott; Baum, Carl E; Ultra-Wideband Short-Pulse Electromagnetics 8; UWBSP8

2007-01-01

The purpose of the Ultra-Wideband Short-Pulse Electromagnetics Conference series is to focus on advanced technologies for the generation, radiation and detection of ultra-wideband short pulse signals, taking into account their propagation and scattering from and coupling to targets of interest. This Conference series reports on developments in supporting mathematical and numerical methods and presents current and potential future applications of the technology. Ultra-Wideband Short-Pulse Electromagnetics 8 is based on the American Electromagnetics 2006 conference held from June 3-7 in Albuquerque, New Mexico. Topical areas covered in this volume include pulse radiation and measurement, scattering theory, target detection and identification, antennas, signal processing, and communications.
Ultra thin continuously reinforced concrete pavement research in south Africa

CSIR Research Space (South Africa)

Perrie, BD

2007-08-01

Full Text Available Ultra thin continuously reinforced concrete pavements (UTCRCP), in literature also referred to as Ultra Thin Reinforced High Performance Concrete (UTHRHPC), have been used in Europe successfully as a rehabilitation measure on steel bridge decks...
Feasibility study of ultra-long life fast reactor core concept - 028

International Nuclear Information System (INIS)

Kim, T.K.; Taiwo, T.A.

2010-01-01

An ultra-long life core concept is proposed targeting capital and operational cost reductions and ultra-high discharge burnup in a fast reactor system. The core concept is achieved by de-rating the power density and adopting annular core geometry to maintain criticality for more than 40 years without refueling. The ultra-long life core has a specific power of ∼10 MW/t and an average driver fuel discharge burnup of ∼300 GWd/t. It is assumed such ultra-high burnup fuel can be developed within an advanced fuel cycle program. Several benefits are expected from the ultra-long life core concept such as capital and operational cost reductions, low proliferation risk, and effectively holding LWR spent fuel without disposal until technologies for a closed nuclear fuel cycle are developed and deployed. As future work, safety analysis, development of the advanced core cooling methods, and comparative cost analysis are expected. (authors)
Ultra-processed food products and obesity in Brazilian households (2008-2009).

Science.gov (United States)

Canella, Daniela Silva; Levy, Renata Bertazzi; Martins, Ana Paula Bortoletto; Claro, Rafael Moreira; Moubarac, Jean-Claude; Baraldi, Larissa Galastri; Cannon, Geoffrey; Monteiro, Carlos Augusto

2014-01-01

Production and consumption of industrially processed food and drink products have risen in parallel with the global increase in overweight and obesity and related chronic non-communicable diseases. The objective of this study was to analyze the relationship between household availability of processed and ultra-processed products and the prevalence of excess weight (overweight plus obesity) and obesity in Brazil. The study was based on data from the 2008-2009 Household Budget Survey involving a probabilistic sample of 55,970 Brazilian households. The units of study were household aggregates (strata), geographically and socioeconomically homogeneous. Multiple linear regression models were used to assess the relationship between the availability of processed and ultra-processed products and the average of Body Mass Index (BMI) and the percentage of individuals with excess weight and obesity in the strata, controlling for potential confounders (socio-demographic characteristics, percentage of expenditure on eating out of home, and dietary energy other than that provided by processed and ultra-processed products). Predictive values for prevalence of excess weight and obesity were estimated according to quartiles of the household availability of dietary energy from processed and ultra-processed products. The mean contribution of processed and ultra-processed products to total dietary energy availability ranged from 15.4% (lower quartile) to 39.4% (upper quartile). Adjusted linear regression coefficients indicated that household availability of ultra-processed products was positively associated with both the average BMI and the prevalence of excess weight and obesity, whereas processed products were not associated with these outcomes. In addition, people in the upper quartile of household consumption of ultra-processed products, compared with those in the lower quartile, were 37% more likely to be obese. Greater household availability of ultra-processed food products in
Ultra-thin ZnSe: Anisotropic and flexible crystal structure

Energy Technology Data Exchange (ETDEWEB)

Bacaksiz, C., E-mail: cihanbacaksiz@iyte.edu.tr [Department of Physics, Izmir Institute of Technology, 35430 Izmir (Turkey); Senger, R.T. [Department of Physics, Izmir Institute of Technology, 35430 Izmir (Turkey); Sahin, H. [Department of Photonics, Izmir Institute of Technology, 35430 Izmir (Turkey)

2017-07-01

Highlights: • Ultra-thin ZnSe is dynamically stable. • Ultra-thin ZnSe is electronically direct-gap semiconductor. • Ultra-thin ZnSe is ultra-flexible. • Ultra-thin ZnSe is mechanically in-plane anisotropic. - Abstract: By performing density functional theory-based calculations, we investigate the structural, electronic, and mechanical properties of the thinnest ever ZnSe crystal . The vibrational spectrum analysis reveals that the monolayer ZnSe is dynamically stable and has flexible nature with its soft phonon modes. In addition, a direct electronic band gap is found at the gamma point for the monolayer structure of ZnSe. We also elucidate that the monolayer ZnSe has angle dependent in-plane elastic parameters. In particular, the in-plane stiffness values are found to be 2.07 and 6.89 N/m for the arm-chair and zig-zag directions, respectively. The angle dependency is also valid for the Poisson ratio of the monolayer ZnSe. More significantly, the in-plane stiffness of the monolayer ZnSe is the one-tenth of Young modulus of bulk zb-ZnSe which indicates that the monolayer ZnSe is a quite flexible single layer crystal. With its flexible nature and in-plane anisotropic mechanical properties, the monolayer ZnSe is a good candidate for nanoscale mechanical applications.
Ultra-thin ZnSe: Anisotropic and flexible crystal structure

International Nuclear Information System (INIS)

Bacaksiz, C.; Senger, R.T.; Sahin, H.

2017-01-01

Highlights: • Ultra-thin ZnSe is dynamically stable. • Ultra-thin ZnSe is electronically direct-gap semiconductor. • Ultra-thin ZnSe is ultra-flexible. • Ultra-thin ZnSe is mechanically in-plane anisotropic. - Abstract: By performing density functional theory-based calculations, we investigate the structural, electronic, and mechanical properties of the thinnest ever ZnSe crystal . The vibrational spectrum analysis reveals that the monolayer ZnSe is dynamically stable and has flexible nature with its soft phonon modes. In addition, a direct electronic band gap is found at the gamma point for the monolayer structure of ZnSe. We also elucidate that the monolayer ZnSe has angle dependent in-plane elastic parameters. In particular, the in-plane stiffness values are found to be 2.07 and 6.89 N/m for the arm-chair and zig-zag directions, respectively. The angle dependency is also valid for the Poisson ratio of the monolayer ZnSe. More significantly, the in-plane stiffness of the monolayer ZnSe is the one-tenth of Young modulus of bulk zb-ZnSe which indicates that the monolayer ZnSe is a quite flexible single layer crystal. With its flexible nature and in-plane anisotropic mechanical properties, the monolayer ZnSe is a good candidate for nanoscale mechanical applications.
Estudo da produção do suco clarificado de cajá (Spondias lutea L.

Directory of Open Access Journals (Sweden)

SILVA Antonio de Pádua Valença da

1999-01-01

Full Text Available Cajás ( Spondias lutea L., oriundos do município de Maranguape, Ceará, Brasil, foram processados em nível de escala-piloto para obtenção de suco clarificado através do emprego de enzimas pectinolíticas e agentes clarificantes. Aplicaram-se 120ppm de enzima pectinolítica (Pectinex Ultra SP-L na polpa para obtenção do suco polposo e, em seguida, 500ppm de enzima pectinolítica (Pectinex-AR no suco extraído, utilizando-se a "Prova do álcool" como indicador da presença de pectina. Para o processo de clarificação do suco foram utilizados, como agentes clarificantes, 400ppm de gelatina e 500ppm de sílica sol. A "Prova do excesso e/ou da insuficiência de clarificação", bem como a "Prova de estabilidade" mostraram resultados negativos, indicando a eficiência do processo de clarificação.
Ultra high field magnetic resonance imaging

International Nuclear Information System (INIS)

Lethimonnier, F.; Vedrine, P.

2007-01-01

Understanding human brain function, brain development and brain dysfunction is one of the great challenges of the twenty first century. Biomedical imaging has now run up against a number of technical constraints that are exposing limits to its potential. In order to overcome the current limits to high-field magnetic resonance cerebral imaging (MRI) and unleash its fullest potential, the Cea has built NeuroSpin, an ultra-high-field neuroimaging facility at its Saclay centre (in the Essonne). NeuroSpin already boasts three fully operational MRI systems. The first is a 3-tesla high-field system and the second is a very-high-field 7-tesla system, both of which are dedicated to clinical studies and investigations in humans, while the third is an ultra-high-field 17.65-tesla system designed for studies on small animals. In 2011, NeuroSpin will be commissioning an 11.7-tesla ultra-high-field system of unprecedented power that is designed for research on human subjects. The level of the magnetic field and the scale required will make this joint French-German project to build the magnet a breakthrough in the international arena. (authors)
Leiomiossarcoma do intestino grosso: relato de um caso Large bowel leiomyosarcoma: a case report

Directory of Open Access Journals (Sweden)

Simone Gonçalves Lopes

2001-04-01

Full Text Available Os autores relatam um caso de leiomiossarcoma de cólon ascendente acometendo um paciente do sexo masculino, de 49 anos de idade. O paciente iniciou o quadro com anemia e massa abdominal, e a evolução dos sintomas até o diagnóstico final foi de nove meses. Na radiografia simples do abdome havia presença de coleção aérea localizada no hipocôndrio direito, fora da topografia de alças; no clister opaco com duplo contraste foi demonstrado deslocamento inferior da flexura hepática e divertículos. A ultra-sonografia abdominal mostrou lesão expansiva heterogênea, com gás no seu interior, de localização sub-hepática. A tomografia computadorizada do abdome revelou massa escavada com nível líquido, sub-hepática, que não se impregnou pelo meio de contraste. Foi realizada hemicolectomia direita com ileocoloanastomose, e o diagnóstico histopatológico foi de leiomiossarcoma de cólon ascendente.The authors report a case of a 49-year-old male patient with leiomyosarcoma of the ascending colon. The patient presented with anemia and an abdominal mass, and the symptoms progressed until a final diagnosis was made nine months later. A plain abdominal x-ray showed the presence of gas outside the bowel, in the right hypochondrium. The double contrast barium enema showed a sublevel displacement of the hepatic flexure and diverticula. An abdominal ultrasound revealed a heterogeneous expansive lesion below the liver containing gas, and a computed tomography of the abdomen revealed an excavated mass below the liver containing liquid, that was not filled in by contrast medium. The patient was submitted to a right hemicolectomy with ileocoloanastomosis and the histopathological analysis of the excised material revealed a leiomyosarcoma of the ascending colon.
Risk factors for surgical site infection after transvaginal mesh placement in a nationwide Japanese cohort.

Science.gov (United States)

Kamei, Jun; Yazawa, Satoshi; Yamamoto, Shingo; Kaburaki, Naoto; Takahashi, Satoru; Takeyama, Masami; Koyama, Masayasu; Homma, Yukio; Arakawa, Soichi; Kiyota, Hiroshi

2018-03-01

We conducted a nationwide survey on perioperative management and antimicrobial prophylaxis of transvaginal mesh surgeries for pelvic organ prolapse in Japan to understand the practice and risk factors for surgical site infection (SSI). Health records of women undergoing tension-free vaginal mesh (TVM) surgeries from 2010 to 2012 were obtained from 135 medical centers belonging to the Japanese Society of Pelvic Organ Prolapse Surgery. The questionnaire addressed hospital volume, perioperative management, and SSI. Risk factors for SSI were investigated by comparing cases with and without SSI. The hospital volume among institutions varied from 0 to 248 per year (median 16.7). Preoperative hair removal, bowel preparation, and urine culture were routinely performed at 74 (55%), 66 (49%), and 24 (18%) hospitals, respectively. Prophylactic antimicrobials used were mostly first-generation (43%) or second-generation (42%) cephalosporin. SSI was reported in 86 of 9323 patients (0.92%). A multivariate analysis indicated lower hospital volume (odds ratio [OR], 0.995 [by 1-point increase]; P < 0.001), preoperative bowel preparation (OR, 2.08; P = 0.013), non-routine urine culture (OR, 3.00; P = 0.0006), and the use of antibiotics other than first-generation cephalosporin (OR, 5.29; P = 0.0011) as significant risk factors for SSI. In contrast, the cut-off points of hospital volume for preventing SSI was 116.7 cases (area under curve: 0.61). The prevalence of SSI in TVM surgeries was 0.92% in Japan. Lower hospital volume, bowel preparation, non-routine preoperative urine culture, and prophylactic antibiotics other than first-generation cephalosporin significantly elevated the incidence of SSI. © 2018 Wiley Periodicals, Inc.
Ultra low bit-rate speech coding

CERN Document Server

Ramasubramanian, V

2015-01-01

"Ultra Low Bit-Rate Speech Coding" focuses on the specialized topic of speech coding at very low bit-rates of 1 Kbits/sec and less, particularly at the lower ends of this range, down to 100 bps. The authors set forth the fundamental results and trends that form the basis for such ultra low bit-rates to be viable and provide a comprehensive overview of various techniques and systems in literature to date, with particular attention to their work in the paradigm of unit-selection based segment quantization. The book is for research students, academic faculty and researchers, and industry practitioners in the areas of speech processing and speech coding.
Consumption of ultra-processed foods : an assessment of the literature on determinants of ultra-processed food consumption and an investigation of the potential effect of time scarcity

OpenAIRE

Djupegot, Ingrid Laukeland; Nenseth, Camilla Bengtson

2016-01-01

Masteroppgave folkehelsevitenskap - Universitetet i Agder 2016 Background Highly processed foods have been classified as ultra-processed, and consumption of such foodstuffs have expanded rapidly over the last decades. Ultra-processed foods are characterized as being accessible, attractive, palatable and often time-saving. An excess intake of ultra-processed foods has been associated with increased risk of e.g. overweight/obesity and diabetes type II. The aim of this master’s pr...
Biomicroscopia ultra-sônica (UBM no planejamento cirúrgico e acompanhamento pós-operatório de melanomas malignos de íris e corpo ciliar Ultrasound biomicroscopy (UBM in the surgical planning and postoperative follow-up of iris and ciliary body melanomas

Directory of Open Access Journals (Sweden)

Zélia Maria da Silva Corrêa

2003-08-01

Full Text Available OBJETIVO: Estudar os achados da biomicroscopia ultra-sônica (UBM em melanomas malignos primários da íris e corpo ciliar antes e depois da resecção cirúrgica e correlacionar a extensão do tumor (revelado pela biomicroscopia ultra-sônica aos achados histopatológicos. MÉTODOS: Estudo prospectivo de 5 pacientes com diagnóstico clínico de tumor de íris e/ou corpo ciliar. Estes pacientes foram avaliados pela biomicroscopia ultra-sônica antes e após iridociclectomia ou iridectomia. Os espécimens foram enviados para estudo histopatológico. Os pacientes foram acompanhados por período mínimo de 6 meses quando foi realizada nova biomicroscopia ultra-sônica. RESULTADOS: Neste grupo de 5 pacientes, 3 eram do sexo feminino e 2, do masculino, variação de idade de 32 e 64 anos. Todos os casos eram unilaterais. Quatro pacientes apresentaram massa iridociliar e um apresentou lesão limitada à íris. Em todos os casos a biomicroscopia ultra-sônica auxiliou o planejamento cirúrgico para a ressecção tumoral com margens livres. A biomicroscopia ultra-sônica no pós-operatório revelou ausência de crescimento tumoral em todos os casos, sendo que 2 pacientes apresentaram vítreo na incisão cirúrgica, 1 deles com tração vítrea leve, mas sem sinais de descolamento de retina. CONCLUSÃO: A biomicroscopia ultra-sônica pareceu ser método auxiliar confiável para diagnosticar tumores de íris e corpo ciliar, planejar o tratamento cirúrgico e o acompanhamento pós-operatório.PURPOSE: To study pre-operatively and post-operatively ultrasound biomicroscopy (UBM findings of iris and ciliary body melanomas and correlate tumor extension (revealed by ultrasound biomicroscopy with histopathology findings. METHODS: Prospective study of 5 patients with a clinical diagnosis of iris and ciliary body tumors. These patients were evaluated by ultrasound biomicroscopy before and after treatment with iridectomy or iridociclectomy. All specimens were sent
Ultra-relativistic heavy-ion physics with AFTER@LHC

DEFF Research Database (Denmark)

Rakotozafindrabe, A.; Arnaldi, R.; Brodsky, Stanley

2013-01-01

We outline the opportunities for ultra-relativistic heavy–ion physics which are offered by a next generation and multi-purpose fixed-target experiment exploiting the proton and ion LHC beams extracted by a bent crystal.......We outline the opportunities for ultra-relativistic heavy–ion physics which are offered by a next generation and multi-purpose fixed-target experiment exploiting the proton and ion LHC beams extracted by a bent crystal....
Ultra low-power integrated circuit design for wireless neural interfaces

CERN Document Server

Holleman, Jeremy; Otis, Brian

2014-01-01

Presenting results from real prototype systems, this volume provides an overview of ultra low-power integrated circuits and systems for neural signal processing and wireless communication. Topics include analog, radio, and signal processing theory and design for ultra low-power circuits.
Filosofia da análise da estabilidade da liquidez

Directory of Open Access Journals (Sweden)

Rodrigo Antônio Chaves da Silva

2005-07-01

Full Text Available A informação foi considerada finalidade de nosso conhecimento, até o período em os pensadores e pesquisadores da contabilidade passaram a raciocinar sobre o conteúdo e o significado dos informes. Nesta busca da razão sobre os estados patrimoniais, surgiu a análise contábil que procura por meio de relações e identidades, o significado da dinâmica expressa da estaticamente na informação. O primeiro aspecto que surgiu no objeto de análise foi o estudo da liquidez, que é um dos principais exercícios do patrimônio. A estabilidade também é outro exercício básico e imprescindível, pois este é que promove o equilíbrio do organismo administrativo. A ciência contábil após a sua dignidade científica passou a trilhar caminhos esplendorosos, amparados em doutrina que permite alcançar os píncaros filosóficos. Os estudos concernentes aos aspectos de interação da estabilidade na liquidez são, complexos e somente com os recursos filosóficos da contabilidade se pode estudá-los com o panorama holístico e sublime. A filosofia da contabilidade não é alheia às suas práticas tecnológicas, podendo buscar pontos sublimes de panoramas abrangentes, para o estudo analítico da liquidez e estabilidade, observando todas as dimensionalidades e essencialidades de acontecimentos, na comprovação e orientação dos estados de ineficácia e eficácia patrimonial.
Experimental intoxication of pregnant goats with Tetrapterys multiglandulosa A. Juss. (Malpighiaceae Intoxicação experimental por Tetrapterys multiglandulosa A. Juss. (Malpighiaceae em cabras gestantes

Directory of Open Access Journals (Sweden)

M.M. Melo

2001-02-01

Full Text Available Green leaves of Tetrapterys multiglandulosa A. Juss were fed to pregnant goats from day 35 of pregnancy. Five goats received 10g/kgBW (group I, five received 20g/kgBW (group II and five were used as control (group III, and received only hay, fresh grass and commercial ration. All animals were clinically examined daily and submitted to ultrasonography every three days. Fetal death and vulvar catarrhal discharge with subsequent abortion were observed at the end of the second month of pregnancy in group II and at the third month of pregnancy in group I. Animals from groups I and II were slaughtered after abortion and necropsied. Goats from the control group were necropsied at the same time. The main lesions in the aborted goats were focal placentitis with early involution (apoptosis and placentary coagulation necrosis, acute focal endometritis and vulvo-vaginal petechiae. All aborted fetuses were underdeveloped when compared to control fetuses, probably due to fetal malnutrition, since no congenital malformations could be noted. The majority of aborted fetuses showed some degree of autolysis, as fetal death occurred five and three days before abortion, in groups I and II, respectively. The most remarkable fetal lesions were focal or diffuse hemorrhages in the skin, meninges and visceral serosae.Com o objetivo de investigar a toxicidade da Tetrapterys multiglandulosa A. Juss. foram utilizadas 15 cabras gestantes, divididas aleatoriamente em três grupos (GI, GII e GIII com cinco animais cada. Após estabelecer o diagnóstico de gestação no tempo médio de 35 dias, eram oferecidas diariamente doses de 10 e 20g/kg PV das folhas (jovens e maduras de Tetrapterys multiglandulosa para os grupos I e II, respectivamente, junto ao capim picado, feno e concentrado. Para o grupo III, usado como controle, foram fornecidos somente capim picado, feno e concentrado. Todos os animais foram submetidos a exames clínicos diários e a ultra-sonografia a cada tr

Ultra-short time sciences. From the atto-second to the peta-watts

International Nuclear Information System (INIS)

2000-01-01

This book presents the recent advances in the scientific and technical domains linked with ultra-short time physics. It deals first with the conceptual and technological aspects of ultra-intense and ultra-brief lasers. Then, it describes the different domains of research (atoms, molecules and aggregates; gaseous phase dynamics using the pump-probe technique; femto-chemistry in dense phase; condensed matter; plasma physics; consistent control; aerosols; functional femto-biology) and the different domains of application (medical diagnosis; ophthalmology; telecommunications; technological and industrial developments). A last part is devoted to the teaching of ultra-short time sciences. (J.S.)
Ultra-peripheral collisions of relativistic heavy ions

International Nuclear Information System (INIS)

Klein, S.; STAR Collaboration

2001-01-01

We report the first observation of exclusive ρ production in ultra-peripheral collisions at RHIC. The ρ are produced electromagnetically at large impact parameters where no hadronic interactions occur. The produced ρ have a small perpendicular momentum, consistent with production that is coherent on both the photon emitting and scattering nuclei. We observe both exclusive ρ production, and ρ production accompanied by electromagnetic dissociation of both nuclei. We discuss models of vector meson production and the correlation with nuclear breakup. We also observe e + e - pair production in these ultra-peripheral collisions
Silicon nanowires for ultra-fast and ultrabroadband optical signal processing

DEFF Research Database (Denmark)

Ji, Hua; Hu, Hao; Pu, Minhao

2015-01-01

In this paper, we present recent research on silicon nanowires for ultra-fast and ultra-broadband optical signal processing at DTU Fotonik. The advantages and limitations of using silicon nanowires for optical signal processing are revealed through experimental demonstrations of various optical...
Endometrial safety of ultra-low-dose estradiol vaginal tablets

DEFF Research Database (Denmark)

Simon, James; Nachtigall, Lila; Ulrich, Lian G

2010-01-01

To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17ß-estradiol vaginal tablets in postmenopausal women with vaginal atrophy.......To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17ß-estradiol vaginal tablets in postmenopausal women with vaginal atrophy....
Endometrial safety of ultra-low-dose estradiol vaginal tablets

DEFF Research Database (Denmark)

Simon, James; Nachtigall, Lila; Ulrich, Lian G

2010-01-01

To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17β-estradiol vaginal tablets in postmenopausal women with vaginal atrophy.......To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17β-estradiol vaginal tablets in postmenopausal women with vaginal atrophy....
Multicentre evaluation of the Naída CI Q70 sound processor: feedback from cochlear implant users and professionals

Directory of Open Access Journals (Sweden)

Jeanette Martin

2016-12-01

Full Text Available The aim of this survey was to gather data from both implant recipients and professionals on the ease of use of the Naída CI Q70 (Naída CI sound processor from Advanced Bionics and on the usefulness of the new functions and features available. A secondary objective was to investigate fitting practices with the new processor. A comprehensive user satisfaction survey was conducted in a total of 186 subjects from 24 centres. In parallel, 23 professional questionnaires were collected from 11 centres. Overall, there was high satisfaction with the Naída CI processor from adults, children, experienced and new CI users as well as from professionals. The Naída CI processor was shown as being easy to use by all ages of recipients and by professionals. The majority of experienced CI users rated the Naída CI processor as being similar or better than their previous processor in all areas surveyed. The Naída CI was recommended by the professionals for fitting in all populations. Features like UltraZoom, ZoomControl and DuoPhone would not be fitted to very young children in contrast to adults. Positive ratings were obtained for ease of use, comfort and usefulness of the new functions and features of the Naída CI sound processor. Seventy-seven percent of the experienced CI users rated the new processor as being better than their previous sound processor from a general point of view. The survey also showed that fitting practices were influenced by the age of the user.
Conjecturas da Epistemológia Jurídica e Aspectos da Teoria da Linguagem

OpenAIRE

Oliveira, Rita de Cássia Cartelli de; Cesumar; Motta, Ivan Dias; Cesumar

2008-01-01

Apresentar-se-ão reflexões em torno da epistemologia jurídica e alguns aspectos da teoria da linguagem; a necessidade de acompanhamento e aprimoramento da linguagem jurídica, para que o direito não se distancie da realidade, mantendo-se apenas como um sistema do status quo; uma breve análise de algumas teorias da ciência do direito e da linguagem; as especificidades dos termos lingüísticos para a análise da ciência do direito, pautada na contemporaneidade sob a perspectiva humanista, buscando...
Ultra-thin lithium micro-batteries. Performances and applications; Microaccumulateurs ultra minces au lithium. Performances et applications

Energy Technology Data Exchange (ETDEWEB)

Martin, M.; Terrat, J.P. [Hydromecanique et frottement (HEF), 42 - Andrezieux Boutheon (France); Levasseur, A.; Vinatier, P.; Meunier, G. [Centre National de la Recherche Scientifique (CNRS), 33 - Talence (France). Institut de Chimie de la Matiere Condensee et Physique de Bordeaux

1996-12-31

This short paper (abstract) describes the characteristics and performances of prototypes of ultra-thin lithium micro-batteries (thickness < 0.2 mm) which can be incorporated into microelectronic circuits. (J.S.)
Ultra-thin lithium micro-batteries. Performances and applications; Microaccumulateurs ultra minces au lithium. Performances et applications

Energy Technology Data Exchange (ETDEWEB)

Martin, M; Terrat, J P [Hydromecanique et frottement (HEF), 42 - Andrezieux Boutheon (France); Levasseur, A; Vinatier, P; Meunier, G [Centre National de la Recherche Scientifique (CNRS), 33 - Talence (France). Institut de Chimie de la Matiere Condensee et Physique de Bordeaux

1997-12-31

This short paper (abstract) describes the characteristics and performances of prototypes of ultra-thin lithium micro-batteries (thickness < 0.2 mm) which can be incorporated into microelectronic circuits. (J.S.)
Household availability of ultra-processed foods and obesity in nineteen European countries.

Science.gov (United States)

Monteiro, Carlos Augusto; Moubarac, Jean-Claude; Levy, Renata Bertazzi; Canella, Daniela Silva; Louzada, Maria Laura da Costa; Cannon, Geoffrey

2018-01-01

To assess household availability of NOVA food groups in nineteen European countries and to analyse the association between availability of ultra-processed foods and prevalence of obesity. Ecological, cross-sectional study. Europe. Estimates of ultra-processed foods calculated from national household budget surveys conducted between 1991 and 2008. Estimates of obesity prevalence obtained from national surveys undertaken near the budget survey time. Across the nineteen countries, median average household availability amounted to 33·9 % of total purchased dietary energy for unprocessed or minimally processed foods, 20·3 % for processed culinary ingredients, 19·6 % for processed foods and 26·4 % for ultra-processed foods. The average household availability of ultra-processed foods ranged from 10·2 % in Portugal and 13·4 % in Italy to 46·2 % in Germany and 50·4 % in the UK. A significant positive association was found between national household availability of ultra-processed foods and national prevalence of obesity among adults. After adjustment for national income, prevalence of physical inactivity, prevalence of smoking, measured or self-reported prevalence of obesity, and time lag between estimates on household food availability and obesity, each percentage point increase in the household availability of ultra-processed foods resulted in an increase of 0·25 percentage points in obesity prevalence. The study contributes to a growing literature showing that the consumption of ultra-processed foods is associated with an increased risk of diet-related non-communicable diseases. Its findings reinforce the need for public policies and actions that promote consumption of unprocessed or minimally processed foods and make ultra-processed foods less available and affordable.
Ultra-Wideband Transceivers for Cochlear Implants

Directory of Open Access Journals (Sweden)

Reisenzahn Alexander

2005-01-01

Full Text Available Ultra-wideband (UWB radio offers low power consumption, low power spectral density, high immunity against interference, and other benefits, not only for consumer electronics, but also for medical devices. A cochlear implant (CI is an electronic hearing apparatus, requiring a wireless link through human tissue. In this paper we propose an UWB link for a data rate of Mbps and a propagation distance up to 500 mm. Transmitters with step recovery diode and transistor pulse generators are proposed. Two types of antennas and their filter characteristics in the UWB spectrum will be discussed. An ultra-low-power back tunnel diode receiver prototype is described and compared with conventional detector receivers.
Armazenamento da maçã cv. golden delicious em atmosfera controlada com altas concentrações de CO2 e ultra-baixas de O2 Controlled atmosphere storage of golden delicious apples with high CO2 and ulo concentrations

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Auri Brackmann

1998-06-01

Full Text Available O trabalho foi desenvolvido com o objetivo de avaliar os efeitos de altas concentrações de CO2, e ultra-baixas de O2, sobre as qualidades fisico-químicas, distúrbios fisiológicos e podridões durante o armazenamento em atmosfera controlada (AC de maçãs da cv. 'Golden Delicious'. Os frutos foram armazenados nas temperaturas de -0,5°C e +0,5°C e umidade relativa do ar de 97%. As condições de AC foram 1.0% de O2, e 6.0% de CO2; 1,5% de O2, e 6,0% de CO2; 1,0% de O2, e 4,0% de CO2, 2.0% de O2, e 4.0% de CO2; 3,0% de O2, e 4,0% de CO2, Os parâmetros avaliados foram: firmeza da polpa, sólidos solúveis totais, acidez titulável, escaldadura, degenerescência interna e podridões. As avaliações foram realizadas em dois momentos: na abertura das câmaras (8,5 meses de armazenamento e após 14 dias (7 dias em armazenamento refrigerado e 7 dias em temperatura ambiente a 23°C. Em concentrações ultra-baixa de O2, (1% combinado com 4% de CO2, a maçã 'Golden Delicious' apresentou uma melhor manutenção das qualidades fisico-químicas após longo período de armazenamento sem apresentar sintomas de fermentação. Concentrações de 6% de CO2, com baixas de O2 na temperatura de +0,5°C, não causou danos aos frutos, porém na temperatura de -0,5"C houve degenerescência interna e escaldadura superficial, sendo a temperatura de +0,5°C mais indicada para a cv. Golden Delicious'.The experiment was conducted with the aim to evaluate the effects of the high CO2, and ultra-low O2, (ULO concentrations on the fruit quality and incidence of physiological disorders and rots during controlled atmosphere (CA storage of 'Golden Delicious'. Fruits were stored at-0.5°C and +0.5°C, with 97% relative humidity. The CA conditions were: 1.0% of O2, and 6.0% of CO2,.1.5% of O2, and 6.0% of CO2; 1.0% of O2, and 4.0% of CO2,; 2.0% of O2, and 4.0% of CO2,; 3.0% of O2, and 4.0% of CO2,. After 8.5 months of storage and 14 days after chamber opening (seven days of
Ultra-processed food products and obesity in Brazilian households (2008-2009.

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Daniela Silva Canella

Full Text Available BACKGROUND: Production and consumption of industrially processed food and drink products have risen in parallel with the global increase in overweight and obesity and related chronic non-communicable diseases. The objective of this study was to analyze the relationship between household availability of processed and ultra-processed products and the prevalence of excess weight (overweight plus obesity and obesity in Brazil. METHODS: The study was based on data from the 2008-2009 Household Budget Survey involving a probabilistic sample of 55,970 Brazilian households. The units of study were household aggregates (strata, geographically and socioeconomically homogeneous. Multiple linear regression models were used to assess the relationship between the availability of processed and ultra-processed products and the average of Body Mass Index (BMI and the percentage of individuals with excess weight and obesity in the strata, controlling for potential confounders (socio-demographic characteristics, percentage of expenditure on eating out of home, and dietary energy other than that provided by processed and ultra-processed products. Predictive values for prevalence of excess weight and obesity were estimated according to quartiles of the household availability of dietary energy from processed and ultra-processed products. RESULTS: The mean contribution of processed and ultra-processed products to total dietary energy availability ranged from 15.4% (lower quartile to 39.4% (upper quartile. Adjusted linear regression coefficients indicated that household availability of ultra-processed products was positively associated with both the average BMI and the prevalence of excess weight and obesity, whereas processed products were not associated with these outcomes. In addition, people in the upper quartile of household consumption of ultra-processed products, compared with those in the lower quartile, were 37% more likely to be obese. CONCLUSION: Greater
Inertial fusion with ultra-powerful lasers

International Nuclear Information System (INIS)

Tabak, M.; Hammer, J.; Glinsky, M.; Kruer, W.; Wilks, S.; Woodworth, J.; Campbell, E.M.; Perry, M.D.; Mason, R.

1993-10-01

Ultra-high intensity lasers can be used to ignite ICF capsules with a few tens of kilojoules of light and can lead to high gain with as little as 100 kilojoules of incident laser light. We propose a scheme with three phases. First, a capsule is imploded as in the conventional approach to inertial fusion to assemble a high density fuel configuration. Second, a hole is bored through capsule corona composed of ablated material, pushing critical density close to the high density core of the capsule, by employing the ponderomotive force associated with high intensity laser light. Finally, the fuel is ignited by suprathermal electrons, produced in the high intensity laser plasma interactions, which propagate from critical density to this high density core. This paper reviews two models of energy gain in ICF capsules and explains why ultra-high intensity lasers allow access to the model producing the higher gains. This new scheme also drastically reduces the difficulty of the implosion and thereby allows lower quality fabrication and less stringent beam quality and symmetry requirements from the implosion driver. The difficulty of the fusion scheme is transferred to the technological difficulty of producing the ultra-high-intensity laser and of transporting this energy to the fuel
Radio frequency acceleration and manipulation of ultra-cold electron bunches

NARCIS (Netherlands)

Franssen, J.G.H.; Vredenbregt, E.J.D.; Luiten, O.J.

2016-01-01

We are developing an ultra-fast and ultra-cold electron source based on a grating magneto optical trap, RF acceleration and RF (de-) compression techniques. The electrons will be created by near-threshold, femtosecond photoionization of a laser-cooled and trapped gas. The electron cloud is extracted
Endometriose umbilical sem cirurgia pélvica prévia Umbilical endometriosis without previous pelvic surgery

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Bruno Ramalho de Carvalho

2008-04-01

Full Text Available OBJETIVO: apresentar série de casos de endometriose na cicatriz umbilical, em pacientes no menacme, sem cirurgias pélvicas prévias. MÉTODOS: foram incluídas no estudo quatro pacientes com idade entre 33 e 43 anos, com queixa de sangramento umbilical associado ou não a dor pélvica, com evolução de dois meses a quatro anos. A ultra-sonografia da parede abdominal foi utilizada para o diagnóstico, procedendo-se à exérese cirúrgica das lesões sugestivas de endometriose umbilical e confirmação anatomopatológica. RESULTADOS: as avaliações ultra-sonográficas das quatro pacientes evidenciaram imagens umbilicais hipoecogênicas compatíveis com a hipótese diagnóstica de endometriose e, assim, todas elas foram encaminhadas para exérese cirúrgica da lesão. A dosagem do marcador sérico CA-125 foi realizada em três das quatro pacientes, com níveis dentro da normalidade, variando de 6,8 a 10,1 U/mL. A concomitância de endometriose pélvica apenas foi confirmada em uma paciente. Durante o seguimento de um ano, as pacientes não apresentaram recidiva dos sintomas nem das lesões. CONCLUSÕES: a endometriose umbilical é uma entidade nosológica rara, mas que deve ser sempre lembrada quando da presença de nodulações ou sangramento umbilicais, ainda que não exista relato de cirurgia pélvica prévia com manipulação endometrial. Seu tratamento cirúrgico é, em geral, suficiente para a remissão total da lesão e dos sintomas.PURPOSE: to present a series of cases of umbilical endometriosis in patients in reproductive age, with no previous pelvic surgery. METHODS: four patients aged between 33 and 43 years were included in the study. They all presented umbilical bleeding associated or not with pelvic pain, and medical history varied from two months to four years. Abdominal wall ultrasound was performed for diagnosis support before surgical excision of the umbilical lesions, and histological examination was also performed. RESULTS
Laparoscopic resection versus myolysis in the management of symptomatic uterine adenomyosis: alternatives to conventional treatment

Directory of Open Access Journals (Sweden)

Wachyu Hadisaputra

2006-03-01

Full Text Available Effective therapy preserving reproductive function in adenomyosis is warranted. From June 2003 to June 2004, patients diagnosed as having adenomyosis by transvaginal ultrasound and had symptoms of menorrhagia, dysmenorrhea, and pelvic pain were randomly allocated to either receive laparoscopic resection or myolysis. GnRH analog was given for 3 cycles after surgery. Within 6 months, symptoms were evaluated using questionnaires and at the end of follow up, adenomyosis volume was assessed by transvaginal ultra-sound. There were 20 patients included, 10 patients had resection and the rest underwent myolysis. Both procedures did not yield sig-nificant complications. Subjective evaluation by questionnaires was done in all patients. Three patients could not be evaluated objec-tively by transvaginal ultrasound, 2 patients resigned and 1 was pregnant. There was no significant difference in menorrhagia and dysmenorrhea reduction score between the 2 groups (p=0.399 and 0.213, respectively. In both groups, dysmenorrhea was reduced significantly after treatment. No significant statistical difference was found in median adenomyosis volume increment (p=0.630 be-tween the resection (median=+15.35% (-100-159} and myolysis groups (median=+48.43% (-100-553. Five patients were pregnant, 3 from the resection group and 2 from the myolysis group. Uterine rupture was found in 1 patient (from the myolysis group at the age of 8 months of pregnancy. The effectiveness of laparoscopic adenomyosis resection was not significantly different compared with lapa-rascopic myolysis as an alternative conservative surgery in treating symptomatic adenomyosis. Myolysis was not recommended for women who wish to be pregnant. (Med J Indones 2006; 15:9-17Keywords: laparascopy, resection, myolysis, conservative surgery, symptomatic adenomyosis
Detection of multiple tumor markers using ultra-long carbon nanotube devices

Science.gov (United States)

So, Hye-Mi; Park, Dong-Won; Kim, Beom Soo; Kong, Ki-Jeong; Buh, Gyoung-Ho; Chang, Hyunju; Lee, Jeong-O.; Kong, Jing

2008-03-01

For the simultaneous detection of multiple tumor markers, we have fabricated ultra-long carbon nanotube sensors that can detect carcinoembryonic antigen (CEA) and prostate specific antigen (PSA), simultaneously. Ultra-long carbon nanotubes, several millimeters long, were grown by ethanol CVD, and fabricated as FET sensors by using conventional photolithography. To functionalize each segment of a single ultra-long nanotube device with multiple-tumor markers, we first functionalize the entire device with CDI-Tween 20 linking molecules, and then immobilized CEA and PSA antibodies using the microfluidic channel. The electrical conductance from CEA-antibody functionalized and PSA-antibody functionalized segment of a ultra-long carbon nanotube device was monitored simultaneously with Ag/AgCl reference electrode as a liquid gate. We will discuss the advantages of long-nanotube device in detail.
Nanocoatings and ultra-thin films technologies and applications

CERN Document Server

Tiginyanu, Ion

2011-01-01

Gives a comprehensive account of the developments of nanocoatings and ultra-thin films. This book covers the fundamentals, processes of deposition and characterisation of nanocoatings, as well as the applications. It is suitable for the glass and glazing, automotive, electronics, aerospace, construction and biomedical industries in particular.$bCoatings are used for a wide range of applications, from anti-fogging coatings for glass through to corrosion control in the aerospace and automotive industries. Nanocoatings and ultra-thin films provides an up-to-date review of the fundamentals, processes of deposition, characterisation and applications of nanocoatings. Part one covers technologies used in the creation and analysis of thin films, including chapters on current and advanced coating technologies in industry, nanostructured thin films from amphiphilic molecules, chemical and physical vapour deposition methods and methods for analysing nanocoatings and ultra-thin films. Part two focuses on the applications...
Mudanças na ultra-estrutura da parede celular de mangas 'Tommy Atkins' tratadas com cloreto de cálcio na pré-colheita

Directory of Open Access Journals (Sweden)

EVANGELISTA REGINA MARTA

2002-01-01

Full Text Available Mangas 'Tommy Atkins' produzidas na região de Ibirá, São Paulo, foram pulverizadas na pré-colheita com cloreto de cálcio, nas concentrações de 0,0%, 2,5% e 5,0%, em três épocas de seu desenvolvimento (40; 60 e 90 dias após a floração a fim de verificar a influência do cálcio na estrutura da parede celular destes frutos através de microscopia eletrônica de transmissão, imediatamente após a colheita e depois de 35 dias de armazenamento. Para fixar o material da polpa, utilizou-se metodologia descrita por Jacob e Gowanlock (1995. Nas condições experimentais, verificou-se que os frutos do tratamento-controle (sem cloreto de cálcio, no dia da colheita, já apresentavam desestruturação da parede celular e dissolução da lamela média (LM. A degradação da parede celular ocorre inicialmente na LM, levando à formação de espaços vazios bastante distintos, apresentando uma dissolução ainda maior, com o armazenamento prolongado (35 dias. Os frutos tratados com cloreto de cálcio a 5,0% apresentaram uma LM bem definida e ausência de espaços vazios, mesmo após o armazenamento, mostrando ser uma concentração efetiva na preservação da lamela média.

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