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  1. Indicação da anuscopia de alta resolução e citologia anal na prevenção de HPV e câncer colorretal em pacientes portadores de HIV Indication of high resolution anoscopy and anal cytology for prevention of HPV and colorectal cancer in HIV patients

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    Hugo Leonardo Madeiro Arcanjo Silva

    2010-12-01

    Full Text Available OBJETIVO: Rastreamento do papilomavírus humano (HPV assim como sua correlação com a neoplasia anorretal nos pacientes portadores do vírus da imunodeficiência humana (HIV por meio da anuscopia de alta resolução (AAR e da citologia anal. MÉTODOS: Desenvolvemos um estudo observacional, transversal e duplo-cego em que participaram 31 pacientes portadores do HIV independente de queixas proctológicas. Os pacientes foram submetidos à AAR e citologia anal cujas lâminas foram enviadas ao setor de anatomia patológica para coloração e posterior análise. RESULTADOS: Verificamos 22 pacientes do sexo masculino e 9 do sexo feminino entre 20 e 67 anos. Dos 31 analisados, quatro encontravam-se em estágio de imunodepressão, 23 utilizavam terapia antirretroviral, 16 com passado de sexo anal receptivo e 12 com passado de condiloma acuminado. À AAR 11 pacientes tinham alterações e 7 foram confirmados pela citologia. Verificamos ainda oito pacientes com alterações à citologia os quais possuíam ausência de alterações à AAR. À citologia apresentaram três células escamosas atípicas de significância (Ascus, do inglês atypical squamous cells of undetermined significance, cinco com paraceratose e/ou hiperceratose, seis lesões intraepiteliais de baixo grau e uma lesão intraepitelial de alto grau. CONCLUSÃO: Sugerimos a utilização da AAR aliada à citologia anal para rastreamento nos pacientes portadores do HIV, visto que esses exames complementam-se para a detecção de lesões que estejam relacionadas ao câncer anorretal.OBJECTIVE: Screening for HPV as well as its correlation with anorectal cancer in patients carrying the human immuno deficiency virus (HIV through high-resolution anoscopy (HRA and anal cytology. METHODS: We developed an observational study, double-blind attended by 31 patients with HIV independent proctologic complaints. Patients underwent HRA and anal cytology slides were sent to which sector pathology staining and

  2. Utilidade da citologia anal no rastreamento dos homens heterossexuais portadores do HPV genital Anal cytology for screening heterosexual men harboring genital HPV infection

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    Raphael Marianelli

    2010-09-01

    Full Text Available Os papilomavírus humanos (HPV de alto risco estão fortemente relacionados à etiologia do carcinoma espinocelular (CEC anogenital e suas lesões precursoras. O HPV-16 é o tipo mais freqüente, estando presente em até 87% dos CEC do canal anal HPV-positivo. Apesar de ser relativamente raro, vem sendo cada vez mais diagnosticado, nas últimas décadas, sobretudo em indivíduos do sexo masculino. A incidência é ainda mais elevada nos grupos considerados de risco, particularmente, os homens e as mulheres HIV-positivo e os homens que fazem sexo com homens (HSH. Grande parte das pesquisas direcionadas à infecção anal pelo HPV e sua relação com neoplasia intraepitelial-anal (NIA e com o carcinoma esteve focada nos grupos de risco. Pouco interesse vem sendo destinado à investigação dos homens heterossexuais. Estudos epidemiológicos da prevalência da infecção pelo HPV em homens, mostraram que os heterossexuais masculinos apresentavam infecção anal pelo HPV em até 12%. As Sociedades médicas e os especialistas recomendam o rastreamento dos portadores de imunodepressão e dos HSH com citologia do raspado do canal anal. Entretanto, até o momento, não há recomendação de rastreamento para homens que fazem sexo com mulheres.The oncogenic human papillomaviruses (HPV are straightly associated with anogenital cancer and dysplasia. The HPV-16 is the most common type, isolated in 87% of the HPV-positive anal squamous cell carcinoma (SCC. Despite being a rare tumor, the incidence of SCC has increased in the last decades, especially in males. Incidence is particularly high amongst men who have sex with men (MSM and among HIV infected men and women. For decades anogenital HPV researches have largely focused risk groups. Poor interest was intended to men who have sex with women (MSW. Prevalence studies of HPV infection in MSW have demonstrated that anal infection was identified in as far as 12%. Medical societies and specialists recommend anal

  3. Rastreamento e seguimento dos portadores das lesões anais induzidas pelo papilomavírus humano como prevenção do carcinoma anal Screening and follow-up of patients with anal HPV induced lesions for anal carcinoma prevention

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    Sidney Roberto Nadal

    2009-06-01

    Full Text Available O Papilomavírus humano (HPV é o agente sexualmente transmissível mais comum na região perianal. O vírus provoca lesões clínicas e subclínicas que podem evoluir para carcinoma anal. É descrito o aumento da incidência desse tipo de tumor naqueles que praticam sexo anal; nos portadores, de ambos os sexos, de lesões genitais HPV induzidas; nas pessoas com neoplasias intraepiteliais anais de alto grau, o precursor do carcinoma, com maior incidência nos infectados pelo vírus da imunodeficiência humana (HIV, e com outras causas de supressão imunológica. Outra característica das lesões HPV induzidas é a elevada incidência de recidivas. Daí, a importância do seguimento por longo prazo e da pesquisa de meios terapêuticos para reduzir essa ocorrência. A possibilidade da detecção das lesões precursoras indica que programas padronizados de rastreamento para a prevenção do câncer anal deveriam ser instituídos. Os esfregaços anais para citologia vêm sendo realizados, com eficácia semelhante a das coletas cervicais e a colposcopia anal tem sido indicada para biópsias dirigidas quando a citologia mostrou-se alterada, embora muitos recomendam-na, também, como método de rastreamento. Nesse artigo, descrevemos a padronização da coleta de material para citologia anal e o método de realização da colposcopia anal, bem como a periodicidade com que devem ser repetidos.The human papillomavirus is the most frequent sexually transmitted agent in anorectal area. This virus provokes clinical and sub-clinical lesions that can evolve to anal carcinoma. Its incidence is increasing among those who practice anal receptive sex; in both gender patients with genital HPV induced lesions; in those with high grade anal intra-epithelial neoplasia, anal carcinoma precursor, mainly among HIV infected persons or with other causes of immunodeficiency. Another HPV induced lesions characteristic is their elevated incidence of recurrences. Therefore

  4. Value of conventional cytology in the presence of macroscopic lesions of the anal canal

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    Lêda Pereira de Barcellos

    2014-01-01

    Full Text Available Objectives: To verify the value of conventional cytology for the diagnosis of macroscopic le- sions of the anal canal and to describe the limitations of the samples. Method: We evaluated 395 conventional cytology samples obtained by brushing the anal canal of patients (predominantly male, HIV-positive and compared them to the presence of macroscopic lesions of the anal canal observed under anorectal examination. Results: Of the total, 91.6% of samples were classified as adequate. Cellular elements repre- sentative of the anal transformation zone were observed in 63.5% of samples. Sensitivity in the presence or absence of cellularity was 80% and 31%, respectively. Conclusion: The study demonstrates the feasibility of using conventional anal cytology in outpatients. Resumo: Objetivo: verificar o valor da citologia convencional no diagnóstico de lesões macroscópicas do canal anal e descrever as limitações das amostras obtidas. Método: avaliamos 395 exames citológicos convencionais obtidos por escovado do canal anal de pacientes predominantemente do sexo masculino, soropositivos para HIV, e com- paramos com a presença de lesões macroscópicas do canal anal constatadas ao exame proctológico. Resultado: o percentual de amostras adequadas foi de 91,6%, e os elementos celulares re- presentativos da zona de transformação anal foram observados em 63,5% das amostras. Encontramos sensibilidade de 80% e 31% na presença ou ausência desta celularidade, res- pectivamente. Conclusão: O estudo demonstra a possibilidade de utilização da citologia anal convencional no rastreio de lesões macroscópicas do canal anal em pacientes ambulatoriais. Keywords: HPV Prevention of anal neoplasia Conventional cytology, Palavras-chave: HPV Prevenção de neoplasia anal Citologia convencional

  5. Utilização da albumina na citologia esfoliativa em pacientes com conjuntivite alérgica

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    Bezerra Haroldo de Lucena; Rizzo Luiz Vicente; Yu Maria Cecília Zorat; Freitas Denise de

    2003-01-01

    OBJETIVO: Avaliar a albumina como fixador de material obtido de raspado conjuntival para citologia esfoliativa. MÉTODOS: Foi realizada citologia esfoliativa conjuntival por meio de estudo prospectivo em quarenta e seis olhos de vinte e três pacientes com conjuntivite alérgica. Foram realizadas três colheitas: (1) na fase aguda, (2) após uso de corticosteróides (tratamento A) e (3) após uso de estabilizador de membrana de mastócitos (tratamento B); em dois tipos de lâminas, com e sem albumina,...

  6. Concordância entre citologia, colposcopia e histopatologia cervical Agreement between cytology, colposcopy and cervical histopathology

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    Letícia Maria Correia Katz

    2010-08-01

    Full Text Available OBJETIVO: avaliar a concordância da citologia convencional por Papanicolaou repetida no momento da colposcopia com os achados colposcópicos e a histopatologia. MÉTODOS: o estudo foi realizado no Laboratório Central de Saúde Pública do Estado de Pernambuco (LACEN, de janeiro a julho de 2008, em 397 mulheres com exame citopatológico alterado encaminhadas para avaliação colposcópica. No momento da colposcopia, repetiu-se a citologia em meio convencional, pesquisando-se os achados colposcópicos anormais. A nomenclatura citológica utilizada foi a de Bethesda e a histopatológica, da Organização Mundial de Saúde. A citologia no momento da colposcopia e a colposcopia foram comparadas entre si e com o resultado do histopatológico obtido por biópsia dirigida. A concordância entre os métodos foi avaliada pelo coeficiente Kappa (K, além do teste χ2 a um nível de significância de 5%. RESULTADOS: foi encontrada uma concordância fraca entre a citologia realizada no momento da colposcopia e a colposcopia, K=0,33 (IC95%=0,21-0,45 e entre a colposcopia e a histopatologia, K=0,35 (IC95%=0,39-0,51. Para a concordância entre citologia no momento da colposcopia e histopatologia, o Kappa foi de 0,41 (IC95%=0,29-0,530, considerado moderado. CONCLUSÕES: houve melhor concordância entre citologia e histopatologia do que entre colposcopia e citologia ou colposcopia e histopatologia.PURPOSE: to evaluate the agreement between conventional cytology using the Papanicolaou test, repeated at the time of colposcopy, with colposcopic and histopathological findings. METHODS: the study was carried out at the central public health laboratory of the state of Pernambuco between January and July, 2008, involving 397 women referred for colposcopic evaluation following an abnormal cervical smear test. Cytology was repeated at the time of colposcopy using conventional method, with particular attention being paid to the presence of abnormal colposcopic findings

  7. Papilomavírus Humano (HPV e sua associação entre lesões cervical e anal em mulheresHuman papillomavirus (HPV and its association between cervical and anal injuries in womendoi:10.12662/2317-3076jhbs.v4i3.860.p174-180.2016

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    Luciane Maria Oliveira Brito

    2016-09-01

    Full Text Available Introdução: Entre as doenças virais sexualmente transmissíveis, a infecção pelo Papilomavírus Humano (HPV configura-se como a mais comum, e sua incidência vem aumentando acentuadamente nos últimos trinta anos. A infecção anal por subtipos específicos do HPV predispõe o indivíduo à neoplasia intraepitelial anal, que pode evoluir para o câncer de forma similar ao colo uterino. Portanto, o objetivo deste estudo foi avaliar a associação tipo-específica entre infecções anais e cervicais, assim como os aspectos citopatológicos das lesões anais pelo vírus HPV em mulheres de São Luís, Maranhão. Métodos: Estudo analítico transversal com 27 mulheres atendidas no Centro de Pesquisa Clínica da UFMA, entre agosto de 2012 e julho de 2015, mediante entrevista e realização de exames complementares. Resultados: As mulheres tinham, em média, 32 anos. Em relação ao resultado do PCR, 77,7% das pacientes apresentaram resultado positivo para HPV anal, sendo o subtipo 16 o mais frequente (47,6%. Na região cervical, 88,8% apresentaram PCR positivo, sendo o mais comum o subtipo 16 (47,8%. A coinfecção anal e cervical pelo HPV foi observada em 74% das mulheres. 93,3% dos resultados de citologia anal não apresentaram alteração, assim como 72,2% das anuscopias realizadas. Conclusões: A infecção cervical por HPV é um fator sugestivo de risco para o desenvolvimento da infecção na região anal.

  8. Monitoramento do ciclo estral de cutias (Dasyprocta leporina Lichtenstein, 1823 através de citologia esfoliativa vaginal e ultrassonografia

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    Lívia B. Campos

    2015-02-01

    Full Text Available O objetivo deste estudo foi monitorar o ciclo estral em cutias (Dasyprocta leporina criadas em cativeiro no semiárido brasileiro. Durante 70 dias, cinco cutias foram diariamente submetidas a citologia esfoliativa vaginal, e o monitoramento ultrassonográfico ovariano foi realizado a cada três dias. Um total de 8 ciclos estrais foi completamente monitorado, com duração de 28,2±0,7 dias, variando de 24 a 31 dias. Pela citologia esfoliativa vaginal, houve uma predominância de células superficiais nas fases de proestro e estro (P0,05. Os folículos foram identificados durante as fases estrogênicas (proestro e estro, com diâmetro médio de 1±0,5mm. Em apenas 12,5% das fases luteais, corpos lúteos medindo 1,4±0,9mm foram identificados. Conclui-se que a associação da citologia vaginal e da ultrassonografia ovariana constitui uma alternativa viável para o monitoramento de ciclos estrais e identificação das fases estrogênicas em cutias da espécie Dasyprocta leporina

  9. Manejo dos portadores das neoplasias intraepiteliais anais Managment of anal intra-epithelial neoplasia patients

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    Sidney Roberto Nadal

    2008-12-01

    Full Text Available Acredita-se que a neoplasia intraepitelial anal (NIA, provocada pelo HPV, seja a lesão precursora do carcinoma anal. Segundo a literatura, são encontradas entre 11% e 52% dos homens infectados pelo HIV, entre 6% a 20% dos homens e 1% a 2,8% das mulheres sem essa infecção. Entre 8,5% e 13% das NIA de alto grau evoluirão para carcinoma invasivo, indicando a necessidade do rastreamento e do seguimento desses doentes para prevenção. Não há tratamento satisfatório com baixos índices de morbidez e a recidiva é comum. Em geral, as formas de tratamento podem de ser divididas em tópicas, entre elas, ácido tricloroacético, podofilina, podofilotoxina, imiquimod, terapia fotodinâmica, e ablativas, ou seja, excisão cirúrgica, ablação pelo LASER, coagulação pelo infravermelho e eletrofulguração. Há, ainda, os que consideram aceitável a conduta expectante. O tratamento tópico se justifica pelo caráter multifocal da lesão e os ablativos têm taxas de complicação e recidiva muito semelhantes. De qualquer forma, doentes com qualquer anormalidade histológica necessitam de seguimento adequado, principalmente com colposcopia e citologia anal.Anal intra-epithelial neoplasia (AIN, provoked by HPV, is considered as an anal cancer precursor. Some articles noticed that it occurred among 11% and 52% of men who have sex with men (MSM infected with HIV and, among seronegatives, from 6% to 20% of men and from 1% to 2.8% of women. From 8.5% to 13% of high grade AIN will evolve to invasive carcinoma, needing follow-up and screening for prevention. There is no satisfactory treatment with low morbidity and recurrence is frequent. There are two main forms of treatment: topics (trichloroacetic acid, podophylin, podophylotoxin, imiquimod, photodynamic therapy and ablatives (chirurgical excision, LASER, infrared, eletrocautery. Others consider acceptable an expectant management. Topical therapy is justified because of multifocal presentation of HPV

  10. Citologia de impressão no diagnóstico de infecção corneana por Acanthamoeba: relato de caso Diagnosis of Acanthamoeba corneal infection by impression cytology: case report

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    Jeison de Nadai Barros

    2007-03-01

    Full Text Available Relatamos três casos de infecção corneana por Acanthamoeba sp em que foi possível detectar cistos do microorganismo com a técnica de citologia de impressão. Três pacientes encaminhados ao Laboratório de Doenças Externas Oculares em 2004 com alterações superficiais da córnea foram submetidos ao exame de citologia de impressão para investigação da presença de cistos de Acanthamoeba sp. Duas amostras foram obtidas da córnea de cada paciente e coradas com PAS, hematoxilina e Papanicolaou. Investigação microbiológica de rotina e cultura também foram realizadas após raspado da córnea. O cultivo das amostras e a citologia de impressão foram positivas para Acanthamoeba sp em todos os pacientes, ao passo que os raspados corados com Giemsa foram positivos em dois casos. A citologia de impressão revelou cistos de Acanthamoeba sp entre feixe de células epiteliais corneanas e como células isoladas. Foram observados cistos no epitélio de um dos pacientes com a citologia de impressão após três meses de tratamento, enquanto o raspado foi negativo. No exame anatomopatológico observaram-se cistos no epitélio e estroma de uma córnea receptora de um dos pacientes após transplante. Neste estudo, a citologia de impressão detectou com sucesso cistos de Acanthamoeba sp em pacientes com acometimento epitelial. Por tratar-se de método não invasivo, a técnica pode ser usada para facilitar o diagnóstico mais precoce da infecção por Acanthamoeba, sendo útil também no acompanhamento do tratamento da doença.To describe three cases of corneal infection due to Acanthamoeba sp in which was possible to detect Acanthamoeba sp cysts by the corneal impression cytology technique. Three patients referred to the External Eye Disease Laboratory in 2004 with superficial corneal alterations were submitted to corneal specimen collection by impression cytology filter paper to investigate the presence of Acanthamoeba sp cysts. Two impression

  11. Avaliação da resposta terapêutica nas alergias oculares por meio da citologia esfoliativa Evaluation of the therapeutic response in ocular allergies through exfoliative cytology

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    Haroldo de Lucena Bezerra

    2003-10-01

    Full Text Available OBJETIVO: Avaliar a resposta terapêutica das alergias oculares por meio da citologia esfoliativa de material obtido de raspado conjuntival. MÉTODO: Foi realizada citologia esfoliativa conjuntival mediante estudo prospectivo em quarenta e seis olhos de vinte e três pacientes com conjuntivite alérgica. Foram realizadas três colheitas: (1 na fase aguda (pré-tratamento, (2 após uso de corticosteróides (tratamento A e (3 após uso de estabilizador de membrana de mastócitos (tratamento B, e que foram submetidas à coloração pelo método de Giemsa. RESULTADOS: Dos vinte e três pacientes, cinco (21,7% eram do sexo feminino e dezoito (78,3% do sexo masculino, com média de 10,8 anos. Dezoito (78,3% apresentaram conjuntivite primaveril e cinco (21,7% ceratoconjuntivite atópica. Após análise estatística da citologia conjuntival, o número de células epiteliais degeneradas foi maior para os dois grupos de tratamento em relação à citologia pré-tratamento. A contagem de neutrófilos foi estatisticamente menor no grupo de tratamento A em relação ao tratamento B e pré-tratamento. Quanto aos eosinófilos, os dois tratamentos apresentaram distribuição percentual estatisticamente menor do que o pré-tratamento. O número de monócitos foi estatisticamente menor após o tratamento A do que o grupo B e o pré-tratamento. CONCLUSÃO: A citologia esfoliativa conjuntival mostrou-se um teste apropriado para avaliar a resposta terapêutica nas alergias oculares.PURPOSE: To evaluate the therapeutic response of ocular allergies through exfoliative cytology of conjunctival scrappings. METHOD: Conjunctival exfoliative cytology was performed through a prospective study in forty six eyes of twenty-three patients with clinical diagnosis of allergic conjunctivitis. Three scrappings were performed: (1 in the pre-treatment period, (2 after use of corticosteroids (treatment A and (3 after use of mast cell stabilizer (treatment B; in two types of smears

  12. Monitorização seqüencial do transplante renal com citologia aspirativa Aspiration citology in the sequential monitorization of kidney allografts

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    R.C. Manfro

    1998-06-01

    Full Text Available OBJETIVO: Avaliar a utilidade da citologia aspirativa renal convencional na monitorização seqüencial da rejeição aguda de transplantes renais. MATERIAL E MÉTODO: 376 punções aspirativas renais em 30 pacientes transplantados. Os diagnósticos das situações clínicas em que as aspirações foram feitas foram estabelecidos de maneira independente. RESULTADOS: Na avaliação seqüencial "cega" obteve-se 82,7% de representatividade das amostras. Encontraram-se aumentos significativos do incremento corrigido total (ICT e dos números de células imunoativadas por lâmina nos episódios de rejeição aguda quando comparados aos valores obtidos durante os períodos de função estável do enxerto, necrose tubular aguda e nefrotoxicidade por ciclosporina. Os parâmetros diagnósticos para rejeição aguda foram: sensibilidade: 71,8%; especificidade: 87,3%; valor preditivo positivo: 50,9%; valor preditivo negativo: 94,4%; e acurácia: 84,9%. Os resultados falsos-positivos para rejeição foram devidos, principalmente, a infecção citomegálica ou subseqüentes ao uso de OKT3 para tratamento de episódios de rejeição aguda celular. Em 10 dos 11 resultados falsos-negativos, encontrou-se o diagnóstico de imunoativação incipiente, que deve ser considerado como um alerta para a possibilidade de rejeição aguda. CONCLUSÕES: A citologia aspirativa renal é um método útil na monitorização seqüencial da rejeição aguda no paciente transplantado renal. Os melhores resultados são obtidos quando os dados da citologia aspirativa são interpretados juntamente com o quadro clínico.OBJECTIVE: To evaluate the utility of kidney aspiration cytology in the sequential monitorization of acute rejection in renal transplant patients. PATIENTS AND METHODS: Thirty patients were submitted to 376 aspirations. The clinical diagnoses were independently established. RESULTS: The representativity of the samples reached 82.7%. The total corrected increment index

  13. Diagnóstico Broncoscópico do Tumor do Pulmão Radiograficamente Oculto e com Citologias da Expectoração Negativas

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    Tomoya Kawaguchi

    1999-07-01

    Full Text Available RESUMO: Os Tumores Ocultos do Pulmão têm sido estudados de forma exaustiva, contudo não têm havido estudos de Tumores Ocultos do Pulmão com Citologias da Expectoração Negativas. Os autores resolveram fazer uma análise retrospectiva de todos os Tumores Ocultos do Pulmão diagnosticados em 10 anos (n=100 de 1975 a 1994.Destes 100 Tumores Ocultos do Pulmão diagnosticados, 15 tinham Citologias da Expectoração Negativas. Neste grupo foram analisadas as caracteristicas clinicas, os aspectos broncosópicos e os aspectos anatamo-patológicos. Também foram analisados o tamanho do tumor e a localização que em conjunto com os aspectos broncoscópicos foram comparados com os doentes que tinham citologias da expectoração positivas apesar de Tumores Ocultos do Pulmão. Foram diagnosticados endoscopicamente 17 lesões, em 15 doentes com Tumores Ocultos do Pulmão com Citologias de Expectoração Negativas.Nesta série todos os casos de Tumores Ocultos do Pulmão foram diagnosticados por Broncofibroscopia, todos os doentes eram homens e todos grandes fumadores.O exame endoscópico revelou espaçamento da mucosa em 10 doentes, lesão nodular em 5 doentes lesão polipoide em 2 doentes. A extensão das lesões não ultrapassou 0,52 cm o que é significativamente mais pequena do que a extensão das lesões do grupo com citologias positivas.Nos doentes de alto risco de cancro do pulmão deve ser preconizada a Broncofibroscopia e a árvore brônquica deve ser examinada com rigor mesmo nos doentes com Citologias da Expectoração Negativas COMENTARIO: Os autores diagnosticaram 100 casos de Tumores Ocultos do Pulmão sem manifestações radiológicas, sendo o diagnóstico feito na maior parte dos casos por citologias da expectoração. As lesões detectadas só por Broncofibroscopia foram em 15% dos casosEste grupo de doentes tin ham como caracteritica comum serem todos homens, grandes fumadores e com idades superiores ou iguais a 55 anos. Nos doentes

  14. Impression cytology features of conjunctival nevi reported as more noticeable Características da citologia de impressão de nevos conjuntivais referidos como mais perceptíveis

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    Jeison de Nadai Barros

    2009-04-01

    Full Text Available PURPOSE: To report the impression cytology features of conjunctival nevi reported as more noticeable. METHODS: 35 patients who reported that a conjunctival lesion had become more noticeable after color or size change were enrolled. On slit-lamp examination, a clinical diagnosis of nevus was made and lesions underwent impression cytology using acetate cellulose strips and a combined staining with PAS, H&E and Papanicolaou. At patient's or parents' request, excision of the lesion was performed and the tissue was submitted to histopathological study. RESULTS: Impression cytology examination revealed nests or cluster of nevus cells within the epithelium layer containing or not mucous-secreting goblet cells in 32 cases (91.4%. Ten patients (28.5% had the tumor removed and histopathological diagnosis was compound nevus in 8 eyes (1 from caruncle, 1 from plica semilunaris and 6 from bulbar conjunctiva and subepithelial nevus from bulbar conjunctiva (2 eyes. CONCLUSION: Optical microscopy analysis of the impression cytology specimens confirmed the clinical diagnosis by demonstrating typical histopathological features of the superficial layers from conjunctival nevi in 91.4% of the cases. For amelanotic nevi IC can also allow a differential diagnosis from other nonpigmented lesions. The technique does not replace histopathological examination, but additionally, may assist in evaluating nevus cells in children and adults.OBJETIVO: Relatar as características da citologia de impressão de nevos conjuntivais referidos como mais perceptíveis. MÉTODOS: Trinta e cinco pacientes que notaram uma lesão conjuntival que se tornou mais perceptível, por mudança de cor ou de tamanho, foram avaliados. Ao exame biomicroscópico foi feito o diagnóstico clínico de nevo, sendo obtidas amostras de citologia de impressão das lesões com auxílio do papel filtro de acetato de celulose, coradas com PAS, H&E e Papanicolaou. Para os indivíduos que optaram também pela

  15. Citologia de impressão da superfície ocular: técnica de exame e de coloração Impression cytology of the ocular surface: examination technique and staining procedure

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    Jeison de Nadai Barros

    2001-04-01

    Full Text Available Objetivo: Apresentar uma técnica de exame e de coloração de amostras de citologia de impressão da superfície ocular desenvolvida em serviço de referência. Método: Obtiveram-se 28 amostras de citologia de impressão de pacientes com alterações da superfície ocular no Setor de Doenças Externas Oculares no período de julho a novembro de 1999. Coraram-se e avaliaram-se as amostras microscopicamente no Laboratório de Microbiologia Ocular, do Departamento de Oftalmologia da Universidade Federal de São Paulo - Escola Paulista Medicina. Resultados: Desenvolveu-se um modelo de papel de filtro com ápice, base e abertura lateral, que forneceu seu posicionamento correto no olho no momento da colheita e na lâmina para a fixação e coloração. A técnica de coloração descrita, que usa ácido periódico-Schiff, hematoxilina e Papanicolaou, é um procedimento econômico e fácil, cora as células caliciformes de róseo e as epiteliais de roxo. Conclusões: A técnica de exame mostrou-se ideal na avaliação celular das amostras de citologia de impressão. A citologia de impressão é um método bastante confiável para o estudo da superfície ocular, no acompanhamento da evolução de patologias externas, e provou ser um procedimento realmente simples, mais barato e mais confortável para o paciente que as biópsias invasivas.Purpose: To present an examination technique and to standardize the staining procedure of samples of impression cytology of the ocular surface in a reference service. Methods: 28 samples of impression cytology were obtained from patients with ocular surfaces alterations of the External Eye Diseases Sector in the period of July to November 1999. They were stained and microscopically evaluated in the Ocular Microbiology Laboratory of the Federal University of São Paulo. Results: We developed a design of a filter paper with apex, base and lateral opening that promoted its adequate position both in the eye at collection

  16. Oral tumors in dogs: clinical aspects, exfoliative cytology and histopathology Neoplasias orais em cães: avaliação dos aspectos clínicos, histopatologia e citologia esfoliativa

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    Cláudia Ronca Felizzola

    1999-09-01

    Full Text Available In order to establish the diagnosis and prognosis of tumors of the oral cavity, a comparative study was carried out in 130 dogs considering age, sex, breed, clinical aspects, exfoliative cytology as well as histopathology. Exfoliative cytology revealed: 100% negative for benign non-odontogenic tumors, 97.91% negative benign odontogenic tumors and 77.92% positive for malignant tumors. Histopathology showed: 59.23% malignant tumors (33.08% malignant melanoma, 9.23% squamous cell carcinoma, 5.38% osteosarcoma, 2.31% fibrosarcoma, 2.31% angiosarcoma, 1.54% malignant mesenchymal tumors, 1.54% malignant fibrohistiocytoma, 1.54% lymphoma, 0.77% leyomyosarcoma, 0.77%% epithelioid sarcoma and 0.77% angiofibrosarcoma; 36.92% benign odontogenic tumors (25.38% peripheral odontogenic fibroma, 10.0% ossifyng fibroma and 1.54% odontoma in addition to 3.85% benign non-odontogenic tumors (1.54% fibroma, 0.77% plasmocytoma, 0.77% pilomatrixoma and 0.77% giant tumor cells. These results permit us to conclude that exfoliative cytology was an efficient, safe, quick and noninvasive method and could be used for early evaluation of oral cancer.Objetivou-se o estudo comparativo em tumores de cavidade bucal de animais de espécie canina de acordo com sexo, faixa etária, raça, aspectos clínicos, citologia esfoliativa e histopatologia, para estabelecer diagnóstico dessas neoplasias, tendo sido utilizados 130 cães, encaminhados ao Hospital Veterinário (HOVET da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo. Os resultados obtidos na citologia esfoliativa foram: 100% de negativos para neoplasias benignas não odontogênicas; 97,91% de negativos para neoplasias benignas odontôgenicas e 77,92% de positivos para neoplasias malignas. Obtiveram-se os seguintes resultados no exame histopatológico: neoplasias malignas - 59,23% (melanoma 33,08%, carcinoma epidermóide 9,23%, osteossarcoma 5,38%, fibrossarcoma 2,31%, angiossarcoma 2

  17. Verificación analítica para las determinaciones de cromo hexavalente en aguas por espectrofotometría

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    Carlos Alberto Severiche Sierra

    2013-06-01

    Full Text Available En la actualidad la prestación de servicios analíticos de laboratorios, toma de forma ascendente más auge y utilidad. El efecto de un análisis de aguas es forjar resultados correctos y confiables, siendo la verificación de ensayos uno de los aspectos más importantes y factor clave para conseguir este propósito. La determinación de cromo hexavalente en aguas por colorimetría con la difenilcarbazida es la metodología analítica más usada y útil que se conoce en el ámbito científico técnico, principalmente, por su alta selectividad y también debatida por su reacción a las interferencias. En el presente estudio se hizo la valoración analítica del método espectrofotométrico para la determinación de cromo hexavalente en aguas; el objetivo de este trabajo fue confirmar correctamente la aplicación del método para el análisis de aguas. Se trabajaron muestras de diferentes tipos de agua: potable, residual y superficial, siguiéndose estrictamente los protocolos de verificación. Se encontraron resultados satisfactorios en precisión y exactitud con el fin de emitir resultados confiables y reales de la muestra analizada.

  18. Citologia vaginal a fresco na gravidez: correlação com a citologia corada pela técnica de Papanicolaou Fresh wet mount in pregnancy: correlation with Pap smears

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    Amadeu Ramos da Silva Filho

    2004-01-01

    Full Text Available OBJETIVO: analisar o conteúdo vaginal utilizando o exame citológico a fresco na primeira consulta pré-natal em mulheres com ou sem queixas genitais e correlacionar os resultados com os encontrados na citologia corada pela técnica de Papanicolaou. A microscopia direta durante a gravidez deve ser valorizada e reconhecida como método propedêutico capaz de diagnosticar, de forma imediata, 90% dos casos de vaginose bacteriana, candidose e tricomonose. MÉTODOS: estudo prospectivo em 216 gestantes, selecionadas em ambulatório de pré-natal no período de 30 de outubro de 2001 a 12 de novembro de 2002. Foram colhidas duas amostras do conteúdo existente no fundo de saco vaginal posterior e depositadas em lâminas de vidro para microscopia. Sobre a primeira e a segunda amostra eram colocadas uma gota de NaCl a 0,9% e uma de KOH a 10%, respectivamente. Adicionalmente, em todas as grávidas determinou-se o pH vaginal e realizaram-se os testes de produção das aminas com odores de pescado. O material era examinado ao microscópio em aumentos de 100 vezes, 400 vezes e excepcionalmente 1000 vezes. Foram realizados esfregaços cervicovaginais para citologia corada pelo método de Papanicolaou. A correlação entre os resultados dos métodos citológicos empregados foi realizada pelo cálculo do coeficiente kappa, que avalia a concordância para variáveis qualitativas. RESULTADOS: o encontro nos esfregaços a fresco de flora bacteriana normal foi de 51,8, representando o aspecto citológico mais observado e sem correspondência com os 3,7% apurados na microscopia corada. No exame citológico direto foram observados 30,9% de vaginose bacteriana e 7,9% de candidose. Todavia, no Papanicolaou não foi encontrada tal equivalência, sendo as porcentagens de 0,7 e 24,3%, respectivamente. A ausência de correlação no diagnóstico de colpite bacteriana inespecífica na microscopia direta (17,5% e corada (51,3% talvez deva-se ao subdiagnóstico de vaginose

  19. Fatores de risco para câncer de colo do útero segundo resultados de IVA, citologia e cervicografia Factores de riesgo para cáncer de cuello uterino según resultados de IVA, citología y cervicografía Risk factors for uterine cervical cancer according to results of VIA, cytology and cervicography

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    Saiwori de Jesus Silva Bezerra dos Anjos

    2010-12-01

    Full Text Available Este estudo objetivou avaliar a associação entre fatores de risco para câncer de colo do útero e lesões cervicais por HPV comparando-se os resultados da inspeção visual com o ácido acético (IVA, a citologia e a cervicografia. Realizou-se pesquisa de prevalência com 157 mulheres de um centro de saúde de Fortaleza, no período de junho a setembro de 2006. Utilizou-se o SPSS para codificar os dados. Realizaram-se inferências por meio de testes estatísticos (χ2= quiquadrado e RV= razão de verossimilhança. IVA, cervicografia e citologia obtiveram 43,3%, 10,19% e 3,2% de resultados alterados, respectivamente. As variáveis com importante associação às lesões cervicais na IVA foram: idade menor de 20 anos (p= 0,0001; um ou mais parceiros nos últimos três meses (p= 0,015; uso de contraceptivos (p= 0,0008; presença de corrimento vaginal (p= 0,0001; e processo inflamatório moderado ou acentuado (p= 0,0001. Na citologia: baixa escolaridade (p= 0,0001 e elevado pH (p= 0,001. Não se encontrou associação significante na cervicografia.Este estudio objetivó evaluar la asociación entre factores de riesgo para cáncer de cuello de útero y lesiones cervicales por HPV, según comparación entre los resultados de la inspección visual con ácido acético (IVA, citología y cervicografía. Se realizó investigación de prevalencia, con 157 mujeres en un centro de salud de Fortaleza-CE-Brasil, en el período de junio a setiembre de 2006. Se utilizó el SPSS para codificar los datos. Se realizaron inferencias a través de tests estadísticos (χ2 = Qui-cuadrado y RV= razón de verosimilitud. La IVA, cervicografía y citología obtuvieron 43,3%, 10,19% y 3,2% de resultados alterados. Las variables con importante asociación a lesiones cervicales en la IVA fueron: edad menor a 20 años (p=0,0001, uno o más parejas en los últimos tres meses (p=0,015, uso de anti-conceptivos (p=0,0008, presencia de vaginitis (p=0,0001 y pH elevado (p=0

  20. Efeitos do estresse da orquiectomia na citologia broncoalveolar de bezerros da raça Holandesa

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    Jessyca Beraldi Bellinazzi

    2013-12-01

    Full Text Available A identificação do impacto que certas formas de estresse causam ao bem estar animal e equilíbrio orgânico, representa um desafio á adoção de boas práticas de criação. Assim, a presente pesquisa verificou o impacto de um desafio doloroso rotineiro dos bovinos na imunidade pulmonar e sistêmica. Avaliou-se hemograma e cortisol, em quatro momentos, sendo M1, M6, M7 e M8 (respectivamente sete dias antes e um, três e oito dias depois do desafio doloroso e citologia broncolaveolar, obtida por broncoscopia, nos momentos M1, M6 e M8. Houve uma redução dos valores do eritrograma no primeiro dia após o desafio, compatível com anaplasmose e agravada pela perda de sangue durante a cirurgia e um influxo de leucócitos para a região pulmonar. Oito dias após o desafio, evidenciou-se aumento de cortisol, gerando uma leucocitose por neutrofilia e monocitose no sangue com provável redução de quimiotaxia para o pulmão, tornando o trato respiratório potencialmente mais susceptível a infecções, sugerindo que esta prática de manejo, mesmo acompanhado de protocolo analgésico, pode ser considerada um fator de risco a penumonias afetando o bem estar animal.

  1. Validación del método analítico para tabletas de dicloroisocianurato de sodio para desinfección de agua potable

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    Luis Octavio Martínez Álvarez

    Full Text Available Introducción: en Cuba se han desarrollado las primeras tabletas efervescentes de 3,5 mg dicloroisocianurato de sodio, como ingrediente activo no terapéutico, el cual libera una determinada cantidad de cloro al disolverse en un litro de agua, capaz de inducir a una adecuada desinfección del agua potable y lista para ingerir después de transcurrido 30 min. Objetivo: desarrollar y validar un método analítico yodométrico, aplicable al control de la calidad de las tabletas efervescentes de 3,5 mg de dicloroisocianurato de sodio. Métodos: para la cuantificación del contenido de cloro activo libre en las tabletas efervescentes, se empleó como técnica un método potenciométrico, utilizando electrodos de platino y solución valorada de tiosulfato de sodio 0,1 N. El método desarrollado fue validado según los parámetros exigidos para la categoría I, que incluye las técnicas destinadas a cuantificar principios activos en las formas terminadas. Adicionalmente se realizaron otras pruebas para evaluar la influencia del analista y el día en los resultados analíticos. Resultados: los parámetros evaluados en la validación del método se encontraron dentro de los límites establecidos. El método resultó ser específico, lineal, exacto y preciso en el rango de concentraciones estudiadas. Conclusiones: los resultados permiten que el método pueda emplearse de manera confiable y segura.

  2. Modelos esquemáticos para avaliação da qualidade analítica dos dados nacionais de fibra alimentar

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    CARUSO Lúcia

    1999-01-01

    Full Text Available O controle de qualidade de uma análise laboratorial é essencial para garantir a confiabilidade da informação. Os resultados analíticos serão considerados restritos se não houver um programa definido de controle de qualidade analítico. O presente trabalho propõe modelos esquemáticos para a avaliação da qualidade dos dados nacionais de fibra alimentar. A fibra alimentar foi escolhida, como um modelo, com o propósito de se aplicar os critérios do USDA (U.S. Department of Agriculture empregados na avaliação do selênio, cobre e de carotenóides. Esta escolha foi baseada na escassez de informações desse nutriente e pela importância da fibra alimentar na prevenção de doenças crônico-degenerativas. Para a avaliação da qualidade dos dados foram consideradas cinco categorias: número de amostras, plano de amostragem, tomada de amostra, método analítico e controle de qualidade analítica. Estes modelos foram utilizados na avaliação da qualidade das determinações de fibra alimentar de 180 alimentos. O resultado obtido foi de 29% com código A e B (considerável e razoável confiança e 68% com código C (reduzida confiança. Com a determinação da qualidade dos dados, foi possível estabelecer quais os alimentos que constituem prioridades de análise, que são aqueles nos quais ainda não foi determinada a fração fibra alimentar, e aqueles com código de confiança C.

  3. Incertidumbre en métodos analíticos de rutina.

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    Maroto Sánchez, Maria Alicia

    2002-01-01

    Para que los laboratorios de análisis puedan acreditarse según la norma ISO 17025, es necesario que los resultados analíticos vayan acompañados de dos parámetros de calidadbásicos: su trazabilidad y su incertidumbre. Esto ha hecho que, hoy en día, la verificaciónde la trazabilidad y el cálculo de la incertidumbre de los resultados analíticos sea cada vezmás importante. En esta tesis doctoral hemos propuesto diversas metodologías para calcularla incertidumbre en métodos analíticos que se utili...

  4. Proceso de Explotación de Información para Analítica Académica en FaCENA-UNNE

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    Mariano E.A. Lopez

    2017-01-01

    Full Text Available Se presenta un proceso de explotación de información adaptado del modelo propuesto por Vanrell, el cual combina las etapas de la metodología CRISP-DM con actividades de la metodología COMPETISOFT, con el objetivo de aplicar un abordaje ingenieril para el desarrollo de una propuesta tecnológica como soporte para la implementación de Analítica Académica en la FaCENA-UNNE.

  5. Chaves analíticas para determinação de cultivares de aboboreiras, morangueiras e mogangueiras

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    Rochelle, Luiz Antonio

    1980-01-01

    De sete cultivares de aboboreiras rasteiras, pertencentes à espécie Cucurbita moschata Duch., duas morangueiras e duas mogangueiras, da espécie Cucurbita maxima Duch., uma aboboreira nao rasteira e uma morangueira pertencente a Cucurbita pepo L., elaborou-se chaves analíticas para determina-los, fundamentando-se nos caracteres morfológicos do caule e das folhas. Keys determining cultivars of squashes and pumpkins (Cucurbita mosohata Duch., Cueurbita maxima Duch., and Cucurbita pepo L.) bas...

  6. Técnica analítica para el estudio de estabilidad del Cromoglicato de Sodio (Cápsulas para inhalación

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    Liana Liz Pérez Suárez

    2001-04-01

    Full Text Available Se desarrolló un método analítico por cromatografía líquida de alta eficiencia para la determinación del contenido de cromoglicato de sodio en las cápsulas. La técnica desarrollada resultó ser lineal, precisa, exacta y específica, la cual fue aplicada para realizar el estudio de estabilidad acelerada y el de vida de estante. Se comprobó la estabilidad química del medicamento por un período de 2 años.An analytical method was developed by high pressure liquid chromatography to determine the content of sodium cromoglicate in capsules. The technique developed proved to be linear, precise, accurate and specific and it was used to conduct the study of accelerated stability and that of shelf life. The chemical stability of the drug was verified for a period of 2 years.

  7. Diagnóstico de HPV anal em mulheres com NIC: prevenção de câncer do ânus? Anal HPV diagnosis in women with NIC: anal cancer prevention?

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    Alice Capobiango

    2009-12-01

    Full Text Available Os objetivos deste estudo foram avaliar a frequência de HPV anal em pacientes com neoplasia intraepitelial cervical (NIC, verificar a concordância entre os subtipos encontrados nos dois locais e investigar os fatores que influenciaram a ocorrência de HPV anal em mulheres com NIC sem evidências clínicas de imunodepressão. Foram avaliadas 52 mulheres com idades entre 16 e 72 anos e diagnóstico de neoplasia intraepitelial cervical graus I, II e III. A identificação do DNA (ácido desoxirribonucleico do HPV e de sete subtipos dos vírus foi realizada por meio da reação em cadeia da polimerase (PCR em material colhido no ânus e colo uterino. Foram pesquisados fatores que poderiam contribuir para a infecção anal, como paridade, número de parceiros, tabagismo, manipulação e coito anal e o tipo de doença ginecológica. Das 52 mulheres, foi diagnosticado HPV na região anal em 25 (48%, das quais 23 (44% também apresentavam HPV no colo uterino - resultado significativo para existência do HPV em portadoras de NIC. Em 16 (31% o HPV foi diagnosticado somente no colo uterino e em 11 (21% não foi identificado em colo ou ânus. Houve associação significativa nas variáveis paridade (p=0,02 e número de parceiros (p=0,04. Concluiu-se que: as mulheres com HPV genital têm mais probabilidade de serem acometidas por HPV anal; não há concordância unânime entre os subtipos do HPV do colo do útero e do ânus e a paridade e o número de parceiros contribuem para aumentar a incidência de HPV anal nas mulheres sem imunodeficiência e com HPV cervical.This study aims were to assess the frequency of HPV anal infection in patients with cervical intra-epithelial neoplasia (CIN, to find out the relation between the found subtypes, when present in both regions, and investigate factors that influenced the occurrence of anal HPV in women with CIN. Fifty two women with age between 16 and 72 years and cervical intra-epithelial neoplasia (CIN diagnosis

  8. Assertividade e autocontrole: interpretação analítico-comportamental

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    Vívian Marchezini-Cunha

    Full Text Available Questões relacionadas à assertividade têm recebido atenção por parte de terapeutas comportamentais há mais de três décadas. É mais recente, porém, o esforço de terapeutas analítico-comportamentais para examinar problemas dessa ordem com os mesmos recursos conceituais e metodológicos empregados por seus pares da pesquisa básica e conceitual. O presente trabalho tem como objetivo oferecer uma interpretação analítico-comportamental para padrões de comportamento assertivos, agressivos e passivos. Recuperamos algumas definições de assertividade/agressividade/passividade e examinamos os fenômenos correspondentes enquanto relações comportamentais; discutimos alguns aspectos da abordagem analítico-comportamental para o autocontrole; e sugerimos que as relações comportamentais definidas como assertividade/agressividade/passividade podem ser interpretadas enquanto instâncias de autocontrole ou impulsividade. A abordagem pode abrir novas perspectivas de investigação clínica de habilidades sociais sob um enfoque analítico-comportamental.

  9. Análisis comparativo de algunos modelos analíticos para estrellas de quarks

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    Manuel Malaver de la Fuente

    2009-12-01

    Full Text Available En la presente investigación se ha encontrado una nueva clase de soluciones que resuelven el sistema de ecuaciones de Maxwell-Einstein que satisface una ecuación lineal de estado para estrellas de quarks. Se propone una nueva forma particular de potencial gravitacional que depende de un parámetro ajustable, se resuelve el sistema de ecuaciones de MaxwellEinstein y se obtiene una ecuación diferencial de primer orden cuya solución es una familia de modelos analíticos singulares y no singulares para estrellas de quarks cargadas. Variables como la densidad de energía, la presión y la intensidad de campo eléctrico se escriben en términos de funciones racionales polinómicas. Una modificación del parámetro ajustable permite obtener una solución no singular propuesta por Komathiraj y Maharaj. A diferencia de otros modelos propuestos, la forma del potencial gravitacional escogido permite resolver la ecuación diferencial para cualquier valor del parámetro y obtener soluciones físicamente aceptables.

  10. Análisis comparativo de algunos modelos analíticos para estrellas de quarks

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    Manuel Malaver de la Fuente

    2009-01-01

    Full Text Available En la presente investigación se ha encontrado una nueva clase de soluciones que resuelven el sistema de ecuaciones de Maxwell-Einstein que satisface una ecuación lineal de estado para estrellas de quarks. Se propone una nueva forma particular de potencial gravitacional que depende de un parámetro ajustable, se resuelve el sistema de ecuaciones de Maxwell-Einstein y se obtiene una ecuación diferencial de primer orden cuya solución es una familia de modelos analíticos singulares y no singulares para estrellas de quarks cargadas. Variables como la densidad de energía, la presión y la intensidad de campo eléctrico se escriben en términos de funciones racionales polinómicas. Una modificación del parámetro ajustable permite obtener una solución no singular propuesta por Komathiraj y Maharaj. A diferencia de otros modelos propuestos, la forma del potencial gravitacional escogido permite resolver la ecuación diferencial para cualquier valor del parámetro y obtener soluciones físicamente aceptables.

  11. Avaliação manométrica anal de crianças com encoprese Anal manometric evaluation of children with encopresis

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    Maria Auxiliadora Prolungatti Cesar

    2010-12-01

    Full Text Available INTRODUÇÃO: A constipação crônica é doença comum na infância, ocorrendo em 5 a 10% dos pacientes pediátricos, considerada a segunda maior causa de procura nos consultórios de pediatria, sendo a encoprese decorrente de constipação grave associada à impactação fecal no reto. Dentre os exames diagnósticos, a manometria anal é utilizada para a avaliação de pacientes com distúrbios funcionais, como a constipação intestinal e a incontinência fecal, em alguns serviços para a avaliação de pacientes com encoprese, pois pode trazer informações sobre o mecanismo evacuatório e possíveis lesões esfincterianas anais. OBJETIVO: Verificar alterações manométricas em pacientes com encoprese. MÉTODOS: Foi realizado estudo de 40 manometrias anais de crianças constipadas com encoprese (G1 e 12 crianças constipados sem encoprese (G2. Foram obtidos os seguintes dados: pressões de repouso, contração e evacuação do canal anal e ampola retal, ponto de maior pressão, reflexo inibitório anal e sensibilidade retal. As manometrias foram realizadas com o aparelho Alacer de perfusão com 8 canais. RESULTADOS: Não foram encontradas diferenças nas pressões de repouso, contração e evacuação do canal anal entre os grupos. Chamou-nos a atenção a ausência de necessidade de maior volume retal para desencadear o reflexo inibitório anal. Não houve diferença da incidência de anismus entre os dois grupos, demonstrando que não se trata de fator importante na manutenção da encoprese, mas sim da constipação. CONCLUSÃO: Não houve necessidade de maior volume para desencadear o reflexo inibitório anal. O anismus não foi diferente entre os dois grupos, não sendo importante na manutenção da encoprese.INTRODUCTION: Chronic constipation is a common childhood disorder that affects 5 to 10% of pediatric patients, being the second most common cause for seeking medical help, with the encopresis arising out of severe constipation

  12. Candidíase vulvovaginal: sintomatologia, fatores de risco e colonização anal concomitante Vulvovaginal candidiasis: symptomatology, risk factors and concomitant anal colonization

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    Antônio Arildo Reginaldo de Holanda

    2007-01-01

    Full Text Available OBJETIVO: analisar pacientes com candidíase vulvovaginal quanto a sintomatologia, fatores de risco e resultados da cultura anal, identificar a freqüência de Candida albicans e não C. albicans e correlacionar as colonizações anal e vaginal. MÉTODOS: foram incluídas 99 pacientes com suspeita clínica de candidiase vulvovaginal, procedentes de Natal, RN, atendidas entre maio de 2003 e maio de 2005, perfazendo-se o total de 294 coletas. O material clínico, colhido por zaragatoas, foi semeado em CHROMagar Candida®. As leveduras foram identificadas pelo método clássico, além da prova de crescimento a 42 e 45ºC e da prova do caldo Sabouraud hipertônico. A sintomatologia, fatores de risco e colonização anal foram analisados de acordo com a positividade ou negatividade para Candida spp. As culturas positivas para C. albicans nos dois sítios foram comparadas com outros resultados encontrados. Para análise estatística utilizou-se o teste do chi2, com correção de Yates e o teste exato de Fisher. RESULTADOS: a espécie mais frequente foi C. albicans em 69% dos casos. Uso de roupas íntimas justas e/ou sintéticas, presença de doenças alérgicas, ocorrência de prurido, leucorréia e hiperemia apresentaram associação com a positividade vaginal para Candida spp. A chance de uma paciente com colonização anal positiva de apresentar positividade vaginal concomitante foi 2,8 e 4,9 vezes maior, respectivamente, para Candida spp e C. albicans. A chance de uma paciente com cultura anal positiva para C. albicans de apresentar resultado vaginal positivo foi 3,7 vezes maior quando comparada a espécies não C. albicans. CONCLUSÕES: C. albicans foi a espécie mais comum, tendo sido observada associação da positividade vaginal para Candida spp com uso de roupas justas e/ou sintéticas, doenças alérgicas, prurido, leucorréia e eritema (pPURPOSE: to analyze patients with vulvovaginal candidiasis with respect to risk factors, symptomatology

  13. Estudo do raspado de conjuntiva de pacientes tratados de retinoblastoma: Etapa II -- citologia Study of conjunctival scrape smears in patients treated for retinoblastoma: Phase II - cytology

    Directory of Open Access Journals (Sweden)

    Maria Carmen Menezes Santos

    2002-06-01

    Full Text Available Objetivo: A citologia da conjuntiva humana tem sido amplamente estu-dada. A falta de dados sobre as características do raspado ocular em pacientes tratados de retinoblastoma submetidos à enucleação e radioterapia foi o que motivou este estudo. Métodos: Foram examinadas 114 órbitas de 58 pacientes. Este trabalho apresenta os resultados da citologia conjuntival, em 4 condições, com e sem enucleação, com e sem radioterapia. Resultados: No infiltrado leucocitário das órbitas com bulbo ocular predominaram os linfócitos e nas demais, os polimorfonucleares neutrófilos. De maneira geral, as alterações das células epiteliais mais encontradas nas lâminas dos esfregaços conjuntivais de órbitas irradiadas foram: células com núcleo aumentado e nucléolo proeminente e com hialinização do citoplasma. Conclusão: Os achados citológicos do raspado conjuntival não indicaram perfil característico e distinto para cada grupo.Purpose: Human conjunctival cytology has been extensively studied. Lack of data about the characteristics of conjunctival smears in patients treated for retinoblastoma who underwent enucleation and radiotherapy motivated this study. Methods: A previously studied group of 114 orbits of 58 patients was examined. The authors present the results of conjunctival cytology in 4 different situations, with and without enucleation, with and without radiotherapy. Results: In the leukocytic infiltrate in orbits with ocular bulbi predominated the lymphocyte, while in the others predominated the polymorphonuclear neutrophil. In general, the majority of epithelial cell alterations seen in the conjunctival smears of irradiated orbits were: cell with large nuclei, prominent nucleoli, and cytoplasmatic hyalinization. Conclusion: The cytological findings of the conjunctival smears do not indicate a characteristic and distinct pattern for each group.

  14. Zombi: una arquitectura para el análisis de información que integra procesamiento analítico en línea con minería de datos

    OpenAIRE

    González Rosas, Leopoldo

    2005-01-01

    Cada año se generan grandes volúmenes de datos en diferentes medio magnéticos, convertir esos datos en información para la toma de decisiones es un reto que muchas organizaciones están enfrentando. Se construyen almacenes de datos y se utilizan herramientas de procesamiento analítico en línea ("OLAP") y minería de datos para obtener resultados de valor para los negocios, el trabajo para lograrlo ha tomado años en muchos casos. Una arquitectura que integre esas tecnologías para análisis de ...

  15. Validación del método analítico para el control de la calidad y estudio de estabilidad de ketotifeno colirio 0,025 %

    Directory of Open Access Journals (Sweden)

    Yenilen Troche Concepción

    Full Text Available El colirio de ketotifeno se indica para aliviar los signos y síntomas de las conjuntivitis alérgicas, por ser este un potente antihistamínico H1 que muestra cierta capacidad para inhibir la liberación de histamina y otros mediadores en mastocitos. En este trabajo se desarrolló y validó un método analítico por cromatografía líquida de alta resolución, para el control de la calidad y los estudios de estabilidad del ketotifeno colirio 0,025 %. El método se basó en la separación del principio activo a través una columna cromatográfica Lichrosorb RP-18 (5 µm (250 x 4 mm, con detección ultravioleta a 296 nm, para lo cual se empleó una fase móvil compuesta por una mezcla desgasificada de metanol:buffer fosfato (75:25; pH 8,5 y se le añadió 1 mL de isopropanol por cada 1 000 mL de la mezcla anterior, con una velocidad de flujo de 1,2 mL/min. El método analítico resultó lineal, preciso, específico y exacto en el intervalo de concentraciones estudiadas.

  16. Analítica da ambiguidade: estratégia metódica para a pesquisa fenomenológica em saúde Analítica de ambiguedad: estrategia metodica para la investigación fenomenológica en salud Analytic of ambiguity: metodic strategy to the phenomenological research in health

    Directory of Open Access Journals (Sweden)

    Edite Lago da Silva Sena

    2010-12-01

    Full Text Available A estratégia aqui apresentada, denominada Analítica da ambiguidade, vincula-se à necessidade de compreensão dos achados em pesquisas fundamentadas na fenomenologia merleau-pontyana. Ela articulou-se a partir de estudo das descrições vivenciais de dez familiares, integrantes de um Grupo de Ajuda Mútua para cuidadores de portadores de doença de Alzheimer, realizado em uma universidade de Florianópolis, Santa Catarina. Tais descrições se mostraram por meio de entrevista baseada na experiência intercorporal, durante a construção de uma tese de doutorado em Enfermagem. A aplicação da analítica da ambiguidade ao referido estudo coaduna-se com outros estudos de natureza semelhante e abre possibilidades para a compreensão dos achados em pesquisas fenomenológicas, mais especificamente naquelas fundamentadas na ontologia da experiência de Merleau-Ponty, por reconhecer a consciência como algo inapreensível e a percepção, sempre, como um processo ambíguo.La estrategia presentada aquí, llamada Analítica de la ambigüedad, está vinculada a la necesidad de comprensión de los hallazgos en investigaciones basadas en la fenomenología Merleau-pontyana. Ella se articuló a partir del estudio de las descripciones vivenciales de diez familiares, componentes de un Grupo de Ayuda Mutua para cuidadores de pacientes con enfermedad de Alzheimer, realizado en una universidad en Florianópolis, Santa Catarina, Brasil. Estas descripciones se han mostrado a través de entrevistas basadas en la experiencia intercorporal, durante la construcción de una Tesis de Doctorado en Enfermería. La aplicación de la analítica de la ambigüedad al estudio citado es consistente con otros estudios similares y abre posibilidades para la comprensión de los hallazgos en investigaciones fenomenológicas, en particular las basados en la experiencia de la ontología de Merleau-Ponty, por reconocer la conciencia como algo inaprensible y la percepción, siempre

  17. Validación de un método analítico alternativo para la cuantificación de hidralazina en un inyectable de 20 mg/mL

    Directory of Open Access Journals (Sweden)

    Lisette Martínez Miranda

    2004-04-01

    Full Text Available Se desarrolló un método analítico por espectrofotometría ultravioleta para la cuantificación de hidralazina en un inyectable de 20 mg/mL. En la validación se evaluaron los parámetros de especificidad para estos fines, linealidad del sistema, exactitud y precisión expresada en sus 2 formas, repetibilidad y reproducibilidad. El método analítico resultó ser sencillo y rápido, además de específico, lineal, preciso, exacto en el rango de concentraciones estudiadas.An analytical method was developed by ultraviolet spectrophotometry to quantify hydralazine in an injection of 20 mg/mL. In the validation, the parameters of specificity to these ends, lineality of the system, accuracy and precision expressed in its 2 forms, repeatablity and reproducibility, were evaluated. The analytical method proved to be simple, fast, linear, accurate and exact in the range of the studied concentrations.

  18. Diseño, fabricación y aplicaciones analíticas de nanocelulosa y sus híbridos

    OpenAIRE

    Ruiz-Palomero, Celia

    2017-01-01

    El gran avance nanotecnológico que ha experimentado la Química Analítica en los últimos años ha sido un indicador del grado de bienestar de la sociedad. La multidisciplinaridad de la Nanociencia y Nanotecnología ha sido esencial para el avance de los métodos y herramientas analíticas, así como para llevar a cabo la automatización, simplificación y miniaturización de los procesos analíticos integrados en los laboratorios [1]. En este campo, son muchos los nanomateriales explorados por sus ...

  19. Estudio de la fisiología del esfínter anal interno porcino y de la rata, y de la fisiopatología de las alteraciones de la motilidad del esfínter anal interno en pacientes con fisura anal

    OpenAIRE

    Opazo Valdés, Álvaro Javier

    2011-01-01

    Descripció del recurs: el 01 setembre 2012 Las patologías anorectales benignas (fisura anal, incontinencia fecal, hemorroides) presentan una elevada prevalencia. De forma general, se desconoce la fisiopatología de estas enfermedades en las que se producen diversas alteraciones del esfínter anal interno (EAI). Los objetivos para esta tesis fueron: 1º Caracterizar los mecanismos y neurotransmisores implicados en el control del tono, la relajación y la contracción del EAI en dos modelos anima...

  20. Anal acoustic reflectometry

    DEFF Research Database (Denmark)

    Mitchell, Peter J; Klarskov, Niels; Telford, Karen J

    2011-01-01

    Anal acoustic reflectometry is a new technique of assessing anal sphincter function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, the opening and closing elastance, and hysteresis.......Anal acoustic reflectometry is a new technique of assessing anal sphincter function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, the opening and closing elastance, and hysteresis....

  1. Validação de método analítico para doseamento de flavonoides totais em cápsulas contendo extrato seco de Passiflora incarnata L.

    Directory of Open Access Journals (Sweden)

    Juliana Ziliotto

    2012-08-01

    Full Text Available Este trabalho teve como objetivo desenvolver e validar metodologia analítica por espectrofotometria no UV para a quantificação de flavonóides totais, expressos em vitexina, em cápsulas contendo extrato seco de Passiflora incarnata L. O método foi desenvolvido a partir da metodologia de doseamento de flavonóides totais descrita na monografia do extrato seco de P. incarnata L, disponível na Farmacopeia Britânica (2010. A validação da metodologia analítica de doseamento foi realizada de acordo com a Anvisa RE N° 899/2003 e diretrizes da International Conference on Harmonization. O método mostrou-se seletivo, pois não houve interferência dos adjuvantes na leitura das absorbâncias nas soluções analisadas. Apresentou coeficiente de correlação linear (r de 0,9999, confirmando a linearidade do método. Os valores de desvio padrão relativo, obtidos tanto para precisão, nos níveis de repetibilidade e precisão intermediária, quanto para exatidão não excederam o máximo de 15% determinado nos critérios de aceitação para métodos bioanalíticos, considerando a complexidade da matéria-prima vegetal.

  2. Proceso analítico jerárquico para evaluar tres laboratorios virtuales en la educación superior

    Directory of Open Access Journals (Sweden)

    Campo Elías Riaño-Luna

    2015-01-01

    Full Text Available El objetivo de este trabajo fue estandarizar un protocolo bajo un proceso analítico jerárquico (AHP, para evaluar el uso y la pertinencia de los laboratorios virtuales o prácticas académicas simuladas en un ambiente virtual de aprendizaje de la educación superior a distancia. Para el efecto se siguió un enfoque cuantitativo, tipo descriptivo, para evaluar y categorizar jerárquicamente tres laboratorios virtuales comerciales de química. En el proceso participaron diez estudiantes y siete profesores expertos en cursos teóricos prácticos, ofertados en aula virtual bajo la plataforma Moodle. Los criterios analizados fueron: funcionalidad (FUN, fiabilidad (FIA, usabilidad (USAB, eficiencia (EFI, mantenibilidad (MAB, portabilidad (POR, aspectos técnicos (ASPT, aspectos psicopedagógicos (ASPS, aspectos comunicacionales (ASPC y los aspectos administrativos (ASPA de los laboratorios virtuales. El análisis y la jerarquización de los criterios y los laboratorios virtuales (LVs con estas variables se realizaron matrices de comparación pareadas. La razón de consistencia entre las decisiones pareadas que realizaron los evaluadores fue de 0.05885, y al ser esta menor a 0.10, se concluye que es una metodología pertinente para analizar y evaluar objetivamente laboratorios virtuales y además los clasifica jerárquicamente, acorde con sus atributos.

  3. Validación de un método analítico para la determinación del contenido de sodio en los alimentos

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    Ericka Valverde Montero

    2012-08-01

    Full Text Available Se validó la metodología analítica para la determinación de sodio en alimentos mediante espectroscopía de absorción atómica de llama. Las muestras de 0,5 g se digirieron en un horno de microondas con 5,0 mL de HNO3 al 65 % en masa. El ámbito de linealidad óptimo que se obtuvo fue de 0,043 mg/L a 0,70 mg/L con un coeficiente de correlación de 0,998. Los límites de detección y cuantificación reportados fueron de 0,025 mg/L y 0,043 mg/L, respectivamente; con una sensibilidad de calibración de 0,805 Lmg-1, una sensibilidad analítica de 44 Lmg-1.La precisión se evaluó en condiciones de repetibilidad y se obtuvo un valor para RDSr igual a 2,9%. La veracidad se determinó utilizando tres patrones certificados del NIST®, SRM 1846 Infant Formula con un valor reportado para sodio de (2310 ± 130 mg/kg, SRM 8414 Bovine Muscle Powder con (0,210 ± 0,008 % en masa, y SRM 8415 Whole Egg Powder con (0,377 ± 0,034 % en masa. Se obtuvieron sesgos de entre (-0,010 a 0,009 mg/L. De la lista de alimentos seleccionados para el estudio, se encontró que la leche entera en polvo, el pan blanco de trigo, el queso fresco y el queso mozzarella presentan el contenido más elevado en sodio, con concentraciones que oscilan entre (106 a 452 mg Na/100g

  4. Palacios, Analía (comp.) Claves para incluir: aprender, enseñar y comprender : Noveduc, Buenos Aires, 2015

    OpenAIRE

    Gandini, Fiorella

    2016-01-01

    Claves para incluir: aprender, enseñar y comprender es una compilación que presenta las complejidades y desafíos en Educación de la mano de autoras de prestigiosas universidades argentinas y españolas con trayectoria en docencia e investigación en los campos de la Psicología Educacional, Pedagogía Social, Sociología Educativa y Didáctica. Su compiladora, Analía Palacios, es Doctora en Educación (UDESA), actualmente es profesora Adjunta de la cátedra Psicología Educacional de la FaHCE (UNLP) e...

  5. Clinicopathological aspects and prevalence of human papillomavirus in anal cancer

    Directory of Open Access Journals (Sweden)

    Marina Tayla Mesquita Aguiar

    2014-04-01

    desenvolvimento do câncer anal, incluindo idade maior que 50 anos, dieta pobre em fibras, fístulas anais crônicas, tabagismo, múltiplos parceiros, prática de intercurso anal, infecção pelo HIV e imunossupressão. Entretanto, a presença do Papilomavírus Humano (HPV representa o principal fator de risco para o desenvolvimento do câncer anal. O objetivo deste estudo consistiu em avaliar os aspectos clínico-patológicos de uma série de pacientes com carcinomas anais diagnosticados no Hospital Araújo Jorge, Goiânia/GO, bem como a prevalência do genoma do HPV nesses tumores. Dados clínico-patológicos e sóciodemográficos foram colhidos a partir dos respectivos prontuários e blocos de parafina contendo espécimes de carcinomas anais foram usados para extração de DNA e detecção de HPV, por meio da reação em cadeia da polimerase, usando oligonucleotídeos iniciadores SPF. Quarenta e três casos foram selecionados e tiveram os dados clinico-patológicos analisados, enquanto 38 casos foram testados para a detecção do genoma do HPV. Dentre os pacientes avaliados, 62,8% eram mulheres; 53,4% dos tumores eram carcinomas de células escamosas e 46,5% dos pacientes estavam na faixa etária entre os 60 e 75 anos. Fatores de risco, como tabagismo (39,5% e etilismo (20,9% foram registrados no grupo estudado. Metástases linfonodais foram detectadas em 30,2% dos casos e 7,0% apresentaram metástase à distância. A detecção de HPV foi positiva em 76,0% dos casos analisados e este significativamente associado aos carcinomas de células escamosas. O comportamento agressivo e o estágio avançado dos carcinomas anais descritos no presente estudo destacam a necessidade de medidas de prevenção que contemplem esses tumores, incluindo a vacinação contra o HPV. Keywords: Anal cancer, Characteristics, Human papillomavirus, HPV, HPV16, HPV18, Palavras-chave: Câncer anal, Características, Papilomavirus humano, HPV, HPV16, HPV18

  6. The importance of ultrasound findings in the study of anal pain Importancia de los hallazgos ecográficos en el dolor anal

    Directory of Open Access Journals (Sweden)

    A. M. Vieira

    2010-05-01

    15 de junio de 2008, en todos los pacientes referenciados para hacerse la ecografía endoanal, debido a dolor anal con exploración física normal o sin alteraciones que justifiquen el dolor anal. Resultados: analizamos 90 pacientes con edad media de 50,5 años, 58% mujeres. Veintitrés pacientes presentaban criterios de dolor anal funcional. La ecografía endoanal reveló alteraciones en el 49% de los casos. Las alteraciones más frecuentes fueron las alteraciones esfinterianas, en 14 pacientes, seguido de sepsis anal, en 12 pacientes, de fisura anal, en 10 pacientes, de las lesiones perirrectales, en 6 pacientes y de úlcera del canal anal, en 2 pacientes. De los pacientes con alteraciones esfinterianas, 5 pacientes tenían criterios de dolor crónico. En este grupo de pacientes, no se encuentran diferencias en los hallazgos manométricos y defecográficos entre las diferentes alteraciones ecográficas. Conclusiones: la ecografía endoanal detectó lesiones estructurales no sospechadas en el examen físico en la mitad de los enfermos con dolor anal. Se han encontrado alteraciones ecográficas en el 22% de los pacientes con dolor anal funcional. Sin embargo, no se encontró correlación entre los hallazgos ecográficos y los estudios fisiológicos, así que no fue posible encontrar factores etiológicos o patogénicos del dolor anal funcional.

  7. O terapêutico e o analítico em Freud

    Directory of Open Access Journals (Sweden)

    Vinicius Anciães Darriba

    2013-06-01

    Full Text Available Este artigo tem como objetivo investigar, na obra de Freud, a demarcação que se institui entre o terapêutico e o analítico. Tal investigação enfoca, primeiramente, a passagem da hipnose à associação livre e o direcionamento do autor à questão da causa, o que estabelece uma visada para a cura analítica em confluência com o que se desdobra da exploração do campo do inconsciente e da consideração de um domínio pulsional. Delimitados por esta via os objetivos terapêuticos e analíticos, interroga-se, em seguida, como a dimensão do terapêutico se veria reintroduzida nos termos da nova direção de cura proposta por Freud.

  8. Keratosis reduces sensitivity of anal cytology in detecting anal intraepithelial neoplasia.

    Science.gov (United States)

    ElNaggar, Adam C; Santoso, Joseph T; Xie, Huiwen Bill

    2012-02-01

    To identify factors that may contribute to poor sensitivity of anal cytology in contrast to the sensitivity of anoscopy in heterosexual women. We analyzed 324 patients with biopsy confirmed diagnosis of genital intraepithelial neoplasia (either vulva, vaginal, or cervical) from 2006 to 2011 who underwent both anal cytology and anoscopy. Cytology, anoscopy, and biopsy results were recorded. Biopsy specimens underwent independent analysis for quality of specimen. Also, biopsy specimens were analyzed for characteristics that may contribute to correlation, or lack thereof, between anal cytology and anoscopic directed biopsy. 133 (41%) patients had abnormal anoscopy and underwent directed biopsy. 120 patients with normal anal cytology had anoscopy directed biopsies, resulting in 58 cases of AIN (sensitivity 9.4%; 0.039-0.199). This cohort was noted to have extensive keratosis covering the entire dysplastic anal lesion. 18 patients yielded abnormal anal cytology. Of these patients, 13 had anoscopic directed biopsies revealing 6 with AIN and absent keratosis (specificity 88.6%; 0.78-0.95). The κ statistic for anal cytology and anoscopy was -0.0213 (95% CI=-0.128-0.086). Keratosis reduces the sensitivity of anal cytology. Furthermore, anal cytology poorly correlates with anoscopy in the detection of AIN (κ statistic=-0.0213). Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Validade da citologia e da biópsia orientada pela colposcopia no diagnóstico do carcinoma cervical pré-clínico Validity of cytology and colposcopy - guided biopsy for the diagnosis of preclinical cervical carcinoma

    Directory of Open Access Journals (Sweden)

    Aldo Franklin Ferreira Reis

    1999-05-01

    Full Text Available Objetivo: avaliar a eficácia da citologia e da biópsia orientada pela colposcopia na discriminação entre o carcinoma invasor pré-clínico e as lesões intra-epiteliais. Pacientes e Métodos: 441 pacientes submetidas a conização, histerectomia e operação de Wertheim-Meigs, no período de 1978 a 1995, no Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Setor de Patologia Cervical. Foram efetuados os cálculos da sensibilidade, especificidade, valores preditivos, razão de verossimilhança e intervalos de confiança de cada exame, divididos em quatro categorias: normal e inflamatório; displasia leve e displasia moderada; displasia acentuada e carcinoma in situ, e carcinoma microinvasor e invasor. As biópsias foram analisadas como um todo e separadas pelo tipo de colposcopia (satisfatória e insatisfatória. Resultados: a citologia mostrou sensibilidade de 50%, especificidade de 89%, valor preditivo positivo de 63% e valor preditivo negativo de 82%. As razões de verossimilhança foram 4,4 para o diagnóstico de invasão, 0,7 para displasia acentuada e carcinoma in situ, 0,1 para displasia leve e moderada, 2,2 para normal e inflamatório e 0,6 para o conjunto de resultados negativos para invasão. A biópsia orientada pela colposcopia apresentou sensibilidade de 50%, especificidade de 100%, valor preditivo positivo de 100% e valor preditivo negativo de 83%. As razões de verossimilhança foram: tendendo ao ¥ para o resultado de invasão, 0,5 para displasia acentuada e carcinoma in situ, 0,2 para displasia leve e moderada, 0,3 para normal e inflamatório e 0,5 para o conjunto de resultados negativos para invasão. A biópsia orientada pela colposcopia satisfatória com lesão visível mostrou sensibilidade de 59%, especificidade de 100%, valor preditivo positivo de 100% e valor preditivo negativo de 83%. As razões de verossimilhança foram: tendendo ao ¥ para o resultado positivo de invasão, 0

  10. Solución analítica del problema directo de la tomografía de capacitancia eléctrica para un fluido bifásico con una inclusión circular

    Directory of Open Access Journals (Sweden)

    Silvia Reyes

    2012-01-01

    Full Text Available En este artículo se expone un modelo matemático al problema de la Tomografía de Capacitancia Eléctrica (TCE, para el caso de un fluido bifásico dieléctrico con una inclusión circular. Se resuelve el problema directo, que consiste en obtener una expresión analítica para las capacitancias mutuas. La solución del problema directo servirá para validar cualquier método de solución al problema inverso, para calibrar los equipos de medición actualmente existentes y además para construir un método de discretización adaptiva para resolver el problema inverso de la TCE.

  11. Anal manometric evaluation of children with encopresis

    OpenAIRE

    CESAR, Maria Auxiliadora Prolungatti; MOURA, Brenda C de; SILVA, Fernanda Perez Adorno da; BARBIERI, Dorina; BRUNO, Rodrigo Ciotolla; BERTOLI, Ciro João; ORTIZ, Jorge Alberto

    2010-01-01

    INTRODUÇÃO: A constipação crônica é doença comum na infância, ocorrendo em 5 a 10% dos pacientes pediátricos, considerada a segunda maior causa de procura nos consultórios de pediatria, sendo a encoprese decorrente de constipação grave associada à impactação fecal no reto. Dentre os exames diagnósticos, a manometria anal é utilizada para a avaliação de pacientes com distúrbios funcionais, como a constipação intestinal e a incontinência fecal, em alguns serviços para a avaliação de pacientes c...

  12. A presença de retocele interfere nos resultados de exames de fisiologia anal? Rectocele influences results of anal physiological examinations?

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Prolungatti Cesar

    2008-09-01

    Full Text Available INTRODUÇÃO: A retocele é causa comum de constipação por defecação obstruída. Freqüentemente está relacionada com outras causas de defecação obstruída, e os exames de fisiologia anal são importantes para o diagnóstico preciso da causa de constipação intestinal. OBJETIVO: observar a influência da retocele nos exames de fisiologia anal, e a necessidade da realização desses após o diagnóstico da retocele. MÉTODO: Para este trabalho foram estudados 40 pacientes com diagnóstico de defecação obstruída. Todos os pacientes foram submetidos aos exames de manometria, sensibilidade retal, eletromiografia, latência do nervo pudendo e proctografia, e foram separados em 2 grupos: portadores e não portadores de retocele . Foram encontrados 18 pacientes com retocele, e o diagnóstico mais freqüentemente associado foi o anismus . Em relação aos exames foi encontrada diferença significante apenas na proctografia no ângulo ano retal, demonstrando que a presença de retocele não interferiu nos resultados de exames de fisiologia anal quando comparados com outros constipados, mas esteve associada a outras causas de constipação, como anismus que necessita de outro tipo de tratamento. CONCLUSÃO: A retocele não interferiu nos valores dos exames de fisiologia anal, mas esteve associada a outros diagnósticos, sendo importante a realização dos mesmos.INTRODUCTION: Rectocele is a common cause of constipation for obstructed defecation. It often is related with other causes of outlet obstruction and the examinations of anal physiology tests are important for necessary diagnosis of the constipation cause. OBJECTIVE: To observe the influence of rectocele in the anal physiology tests and the necessity of its accomplishment to the diagnosis of rectocele. METHOD: In this study, 40 patients with diagnosis of outlet obstruction had been analyzed. All the patients had been submitted to manometry, rectal sensitivity, electromyography, pudendal

  13. Uma contribuição para a construção de instrumentos analítico-sintéticos de representação do conhecimento

    Directory of Open Access Journals (Sweden)

    Lígia Café

    Full Text Available Foram investigados critérios lingüísticos adotados em modelos de representação do conhecimento para a recuperação da informação. Para isso, a validação do modelo de predicação sintático-semântico proposto por Café (1999 foi testada, para a construção de sistemas analítico-sintéticos de representação do conhecimento. Aplicou-se, de forma experimental, esse modelo de predicação na construção de esquemas de representação do conhecimento, usando-se, para isso, do corpus recolhido da terminologia específica da Biotecnologia de Plantas, com o intuito de identificar as relações conceituais nele existentes e a determinação de suas facetas. Observou-se, na pesquisa, que algumas regras se firmaram como constantes no decorrer das análises, revelando a constituição de padrões científicos precisos de classificação. Além disso, percebeu-se tanto a ocorrência de resultados qualitativos, quanto a de resultados quantitativos a respeito da interpretação referente ao corpus. Tratou-se dos mesmos aspectos em ambos, proporcionando, assim, uma análise densa dos dados. Dessa forma, pela adoção do modelo é possível identificar as relações conceituais, e determinar as categorias fundamentais, as facetas e os seus indicadores, indispensáveis na construção de classificações analítico-sintéticas. Concluiu-se que a interpretação do corpus analisado resulta na validação da proposta de Café (1999 como um modelo de predicação para a aplicação em instrumentos de representação do conhecimento voltados para a recuperação da informação.

  14. Protocolo estandarizado para el seguimiento poblacional del pavón, Oreophasis derbianus: propuesta de métodos de campo y analíticos

    Directory of Open Access Journals (Sweden)

    Fernando González-García

    2017-04-01

    Full Text Available La estimación robusta del tamaño poblacional de especies de fauna silvestre es un requisito fundamental en estudios ecológicos y en el diseño e implementación de estrategias de conservación. Sin embargo, en varios casos, estas estimaciones carecen de exactitud, precisión, representatividad y comparabilidad. Esto ha ocasionado que la información generada para las poblaciones de una determinada especie sea difícilmente generalizable y que su aplicación sea limitada. Éste es el caso del pavón, Oreophasis derbianus, un ave endémica de Mesoamérica y en peligro de extinción. En este trabajo presentamos una propuesta de protocolo de muestreo en campo y métodos analíticos estandarizados para el estudio poblacional de esta especie. La propuesta está basada en nuestra experiencia en el estudio de la especie y en la aplicación de la teoría del muestreo de distancias. El propósito de este protocolo estandarizado es generar datos de campo de calidad para obtener estimaciones robustas de la abundancia poblacional de O. derbianus. Este protocolo lo desarrollamos y evaluamos principalmente en la Reserva de la Biosfera El Triunfo, en Chia­pas, México, pero también fue replicado en otras tres localidades en México y Guatemala. Su desarrollo y evaluación incluyó muestreos mensuales en campo durante casi diez años y la impartición de talleres de capacitación teórico-prácticos a personal de campo para la adecuada implementación de este protocolo. Como resultado de esta experiencia, definimos una serie de li­neamientos básicos y factibles que proponemos sea un estándar como métodos de muestreo y analíticos de las poblaciones de O. derbianus para asegurar la calidad y comparabilidad de los datos generados en campo. Finalmente, presentamos estimaciones de la densidad poblacional de O. derbianus en las cuatro localidades estudiadas y discutimos el significado de su variación espacial y temporal en el contexto de esta propuesta.

  15. Anal fissure - series (image)

    Science.gov (United States)

    Anal fissures are tears in the skin overlying the anal sphincter, usually due to increased tone of the anal sphincter muscles, and a failure of these muscle to relax. Anal fissures cause pain during defecation and bleeding from the anus.

  16. HIV-associated anal cancer

    OpenAIRE

    Newsom-Davis, T; Bower, M

    2010-01-01

    HIV-associated anal carcinoma, a non-AIDS-defining cancer, is a human papillomavirus-associated malignancy with a spectrum of preinvasive changes. The standardized incidence ratio for anal cancer in patients with HIV/AIDS is 20-50. Algorithms for anal cancer screening include anal cytology followed by high-resolution anoscopy for those with abnormal findings. Outpatient topical treatments for anal intraepithelial neoplasia include infrared coagulation therapy, trichloroacetic acid, and imiqui...

  17. La Contabilidad Analítica en los Hospitales Públicos

    OpenAIRE

    Ma Silvia Fresneda Fuentes

    1998-01-01

    La confección de presupuestos públicos austeros para la consecución de los criterios de convergencia impuestos por el Tratado de Maastricht ha originado una preocupación en todo el Sector Público en general, y en el hospitalario en particular, por la contención de los costes. Esta situación ha puesto de manifiesto la necesidad de introducir sistemas de Contabilidad para la Gestión interna de las organizaciones hospitalarias públicas. Así, la Contabilidad Analítica o de Costes se constituye co...

  18. IMPORTANCE OF THE ANAL MANOMETRY IN THE JUDICIALMEDICAL EXPERTISE OF THE ANAL PENETRATION

    Directory of Open Access Journals (Sweden)

    Jelica Miljkovic

    2001-11-01

    Full Text Available The forceful anal penetration can leave as a consequence a lasting damage ofthe anal sphincter function. The anal manometry is one of the methods that, in anindirect way, by measuring the pressure in the anal channel, may determine theexistence of the anus-closing muscles' function damage. The importance of the analmanometry application as an objective indicator of a possible damage of the analsphincter function is presented in the cases of the judicial-medical expertise of theanal penetration. Three cases of criminal acts of sexual abuse and rape in which thejudicial-medical expertise by the anal manometry method was applied are analyzed.The anal manometry method is reliable in determining the functional stote of theexternal and the internal anal sphincter and it should be accepted as obligatory indiagnostics and verification of the anal penetration.

  19. Redes socio-técnicas y participación ciudadana : propuestas conceptuales y analíticas para el uso de las TICs

    OpenAIRE

    Kauchakje, Samira; Penna, Manoel Camillo; Frey, Klaus; Duarte, Fábio

    2006-01-01

    La sociedad contemporánea tiene en los flujos de la información una de sus características más destacadas, siendo las nuevas tecnologías de la información y comunicación uno de sus pilares. En este contexto, el paradigma de las redes adquiere fuerza, sea cualitativamente (sociedad en red), o sea como instrumento analítico. Este último es el punto que desarrollaremos en el artículo desde un punto de vista conceptual y metodológico, para acercanos a estudios de caso desarrollados sobre los prin...

  20. Anal cancer precursor lesions in HIV-positive and HIV-negative patients seen at a tertiary health institution in Brazil Lesões precursoras do câncer anal em pacientes HIV-positivos e HIV-negativos atendidos numa instituição de saúde terciária no Brasil

    Directory of Open Access Journals (Sweden)

    Ivan Tramujas da Costa e Silva

    2011-02-01

    Full Text Available Purpose: To investigate the prevalence of anal squamous intraepithelial lesions (ASIL or anal cancer in patients attended at the Tropical Medicine Foundation of Amazonas. Methods: 344 patients consecutively attended at the institution, in 2007/2008, were distributed in the following strata according to presence/abscense of at risk conditions for anal cancer: Group 1 _ HIV-positive men-who-have-sex-with-men (101; Group 2 _ HIV-positive females (49; Group 3 _ patients without any at risk condition for anal cancer (53; Group 4 _ HIV-positive heterosexual men (38; Group 5 _ HIV-negative patients, without anoreceptive sexual habits, but with other at risk conditions for anal cancer (45; Group 6 _ HIV-negative men-who-have-sex-with-men (26; and Group 7 _ HIV-negative anoreceptive females (32. The histopathological results of biopsies guided by high-resolution anoscopy were analyzed by frequentist and bayesian statistics in order to calculate the point-prevalence of ASIL/cancer and observe any eventual preponderance of one group over the other. Results: The point-prevalence of ASIL for all the patients studied was 93/344 (27%, the difference between HIV-positive and negative patients being statistically significant (38.3% versus 13.5%; p Objetivo: Investigar a prevalência de lesões intraepiteliais escamosas anais (ASIL ou câncer anal em pacientes atendidos na Fundação de Medicina Tropical do Amazonas. Métodos: 344 pacientes consecutivamente atendidos na instituição, em 2007/2008, foram distribuídos nos seguintes estratos conforme a presença/ausência de fatores de risco para o câncer anal: Grupo 1 _ homens-que-fazem-sexo-com-homens HIV-positivos (101; Grupo 2 _ mulheres HIV-positivas (49; Grupo 3 _ pacientes sem condição de risco para o câncer anal (53; Grupo 4 _ homens heterossexuais HIV-positivos (38; Grupo 5 _ pacientes HIV-negativos, sem hábitos sexuais anorreceptivos, mas com outras condições de risco para o câncer anal (45

  1. Construcción y caracterización de un nuevo nebulizador múltiple para técnicas analíticas basadas en plasma (ICP-OES, ICP-MS y MP-AES).

    OpenAIRE

    Lúñez Fernández, Claudia

    2016-01-01

    En la siguiente memoria, se presenta la metodología para la construcción de un nuevo nebulizador múltiple, resultado de una serie de nebulizadores anteriores, los cuales se han ido mejorando para optimizar las características del aerosol generado y con ello los parámetros analíticos de calidad en la espectrometría de emisión atómica con plasma de microondas (MP-AES) y espectrometría de emisión óptica con plasma de acoplamiento inductivo (ICP-OES). Este nuevo nebulizador multiconducto presenta...

  2. Resultados do tratamento do carcinoma espinocelular anal e do seu precursor em doentes HIV-positivos Outcome of treatment of anal squamous cell carcinoma and its precursor in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    Sidney Roberto Nadal

    2007-08-01

    Full Text Available OBJETIVO: A incidência de carcinomas espinocelulares anais vem aumentando nos doentes HIV-positivos. O tratamento consiste de radio e/ou quimioterapia, eventualmente seguidos pela ressecção do tumor. O objetivo é avaliar o seguimento desses doentes para verificar as recidivas e a evolução do NIAA para câncer. Apresentação da casuística da Equipe Técnica de Proctologia do Instituto de Infectologia Emílio Ribas, de São Paulo. MÉTODOS: Acompanhamos 45 doentes HIV-positivos portadores de carcinoma espinocelular anal e seu precursor no período de 1996 a 2006. Eram 30 neoplasias intra-epiteliais anais de alto grau (NIAA, tratadas com ressecção local e 15 carcinomas invasores do canal anal. Nove das 15 lesões invasivas foram submetidas ao esquema de Nigro isolado ou associado à ressecção local, amputação abdominoperineal ou colostomia para derivação. RESULTADOS: No seguimento ambulatorial das NIAA tivemos recidiva em 16,7% e não observamos evolução para carcinoma, num período mínimo de três anos. Entre os nove tumores submetidos ao esquema de Nigro, com ou sem operação complementar, cinco estão livres de tumor. Nenhum tratamento foi feito em cinco doentes. Em três, devido às péssimas condições clínicas, e em dois, pois recusaram tratamento. Outro teve diagnóstico na vigência de oclusão intestinal sendo submetido à colostomia de derivação. CONCLUSÃO: Concluímos que a NIAA pode reincidir após excisão local em doentes HIV-positivos, mas não evolui para carcinoma invasor e que os doentes de câncer anal invasor podem ser tratados da mesma maneira que a população soronegativa para o HIV desde que as condições clínicas o permitam.OBJECTIVE: Incidence of anal squamous cell carcinoma is increasing mainly among HIV-positive patients. Treatment consists of radiotherapy and chemotherapy, sometimes followed by tumor resection. The objective was to evaluate the follow-up of such patients to verify recurrences

  3. Differences in the pressures of canal anal and rectal sensitivity in patients with fecal incontinence, chronic constipation and healthy subjects Diferencias en las presiones del canal anal y la sensibilidad rectal en pacientes con incontinencia anal, estreñimiento crónico y sujetos sanos

    Directory of Open Access Journals (Sweden)

    C. Ciriza de los Ríos

    2010-12-01

    Full Text Available Introduction: There exist a great variability in the manometric findings between patients with anal incontinence (AI and healthy subjects. The correlation between the pressures of the anal canal and the AI is not exact by the wide rank of normal values. Objectives: Prospective study to evaluate differences in the pressures of the anal canal and in rectal sensitivity in patients with AI, chronic constipation (CC and healthy subjects. Material and methods: Ninety four patients with AI, 36 patients with CC and 15 healthy subjects were included. The following data were obtained: age, sex, resting pressure, anal canal length (ACL, squeeze maximum pressure (SMP, squeeze pressure duration (SPD, first sensation, urge and maximum tolerated volume (MTV. Statistical study: test of Kruskal-Wallis, test of Mann-Whitney, and multinomial logistic regression test. Results: There were significant differences in the resting pressure (p Introducción: Existe gran variabilidad en los hallazgos manométricos entre pacientes con incontinencia anal (IA y sujetos sanos. La correlación entre las presiones del canal anal y la IA no es exacta por el amplio rango de valores normales. Objetivos: Estudio prospectivo para evaluar diferencias en las presiones del canal anal y en la sensibilidad rectal en pacientes con IA, estreñimiento crónico (EC y sujetos sanos. Material y métodos: Noventa y cuatro pacientes con IA, 36 pacientes con EC y 15 sujetos sanos. Se obtuvieron: edad, sexo, presión de reposo, longitud del canal anal (LCA, presión de máxima contracción voluntaria (PMCV, duración de la contracción voluntaria, primera sensación, sensación de urgencia y máximo volumen tolerado (MVT. Estudio estadístico: test de Kruskal-Wallis, test de Mann-Whitney, regresión logística multinomial. Resultados: Se encontraron diferencias significativas en la edad (p < 0,001, la presión de reposo (p < 0,001, la LCA (p < 0,001 y la PMCV (p < 0,01 en el grupo de IA con

  4. Anal incontinence after two vaginal deliveries without obstetric anal sphincter rupture

    DEFF Research Database (Denmark)

    Persson, Lisa K G; Sakse, Abelone; Langhoff-Roos, Jens

    2017-01-01

    PURPOSE: To evaluate prevalence and risk factors for long-term anal incontinence in women with two prior vaginal deliveries without obstetric anal sphincter injury (OASIS) and to assess the impact of anal incontinence-related symptoms on quality of life. METHODS: This is a nation-wide cross......-sectional survey study. One thousand women who had a first vaginal delivery and a subsequent delivery, both without OASIS, between 1997 and 2008 in Denmark were identified in the Danish Medical Birth Registry. Women with more than two deliveries in total till 2012 were excluded at this stage. Of the 1000 women...... affected their quality of life. No maternal or obstetric factors including episiotomy and vacuum extraction were consistently associated with altered risk of anal incontinence in the multivariable analyses. CONCLUSIONS: Anal incontinence and fecal urgency is reported by one fifth of women with two vaginal...

  5. Psicoterapia Analítica Funcional feminista: possibilidades de um encontro

    OpenAIRE

    fideles, marcela nayara duarte; Vandenberghe, Luc

    2015-01-01

    O presente estudo reflete sobre o encontro dos posicionamentos da Terapia Feminista (TF) e da Psicoterapia Analítica Funcional (Functional Analytic Psychotherapy – FAP) na clínica. Um estudo de literatura foi feito para comparar seus estilos clínicos. Sua compatibilidade destacou-se quanto ao manejo da relação terapêutica, à inclusão de elementos sociais e culturais, à ênfase sobre a aquisição de habilidades para modificar o ambiente, ao fato de o terapeuta e o cliente assumirem seus valores ...

  6. HPV infection, anal intra-epithelial neoplasia (AIN and anal cancer: current issues

    Directory of Open Access Journals (Sweden)

    Stanley Margaret A

    2012-09-01

    Full Text Available Abstract Background Human papillomavirus (HPV is well known as the major etiological agent for ano-genital cancer. In contrast to cervical cancer, anal cancer is uncommon, but is increasing steadily in the community over the last few decades. However, it has undergone an exponential rise in the men who have sex with men (MSM and HIV + groups. HIV + MSM in particular, have anal cancer incidences about three times that of the highest worldwide reported cervical cancer incidences. Discussion There has therefore traditionally been a lack of data from studies focused on heterosexual men and non-HIV + women. There is also less evidence reporting on the putative precursor lesion to anal cancer (AIN – anal intraepithelial neoplasia, when compared to cervical cancer and CIN (cervical intraepithelial neoplasia. This review summarises the available biological and epidemiological evidence for HPV in the anal site and the pathogenesis of AIN and anal cancer amongst traditionally non-high risk groups. Summary There is strong evidence to conclude that high-grade AIN is a precursor to anal cancer, and some data on the progression of AIN to invasive cancer.

  7. Nuevas estrategias analíticas para el control de aldehídos como subproductos de desinfección de aguas por cromatrografía de líquidos y electroforesis capilar

    OpenAIRE

    Fernández Molina, José María

    2015-01-01

    El desarrollo de metodologías analíticas para la identificación y determinación de compuestos químicos que se originan tras la desinfección del agua (subproductos de desinfección, DBPs) es el principal objetivo de nuestro Grupo de Investigación [1,2,3]. En esta Tesis Doctoral se aborda, dentro de estos DBPs, el estudio de compuestos carbonílicos, fundamentalmente aldehídos aromáticos derivados del benzaldehído, dado que constituyen un grupo de contaminantes emergentes no regulados para los cu...

  8. Desarrollo de las nuevas metodologías analíticas que incorporan la nanotecnología en procesos (Bio)Químicos de medida.

    OpenAIRE

    Bouri, Mohamed

    2014-01-01

    El desarrollo de la Nanociencia y Nanotecnología (N&N) ha provocado un nuevo marco dentro de la ciencia y la tecnología. La Química Analítica ha experimentado, al igual que otras áreas de la ciencia, un gran cambio gracias a las necesidades y oportunidades que proporciona la Nanociencia y Nanotecnología Analíticas. La Nanotecnología se está demostrando cada vez más como un aliado poderoso de la Química Analítica para que alcance sus objetivos, así como para la simplificación de los procesos a...

  9. Anal Cancer—Patient Version

    Science.gov (United States)

    Anal cancer cases have been increasing over several decades. Infection with human papillomavirus (HPV) is the major risk factor for anal cancer. Start here to find information on anal cancer treatment, causes and prevention, research, and statistics.

  10. Validación del método analítico para la determinación de 3 vitaminas hidrosolubles en un suplemento vitamínico

    Directory of Open Access Journals (Sweden)

    Iverlis Díaz Polanco

    2000-08-01

    Full Text Available Se presentan los resultados obtenidos en la validación de un método analítico por cromatografía líquida de alta resolución, para la determinación de tiamina mononitrato, piridoxina clorhidrato y nicotinamida en el suplemento nutricional neovitamin II, el cual se diseñó para separar las vitaminas entre sí, con la utilización de una columna RP-18 de 25 cm y un detector UV-Visible. Dicho método se empleó para el control de la calidad y la estabilidad de este producto. El método fue validado siguiendo una metodología de trabajo elaborada previamente en un Protocolo de Validación, donde se analizaron diferentes parámetros como son: linealidad, exactitud, precisión, selectividad, límites de detección y cuantificación, adecuación del sistema y estabilidad de las soluciones. Se obtuvieron resultados satisfactorios y se comprobó de esta forma la validez del método analítico.The results obtained in the validation of an anlytical method by high resolution liquid chromatography for the determination of thiamine mononitrate, pyridoxine hydrochloride and nicotinamide in the Neovitamin dietary supplement are presented. It was designed to separate vitamins among themselves, using a RP-18 column of 25 cm and a UV Visible detector. This method was used for controlling the quality and stability of the product. This method was validated according to a working methodology that was previously prepared in a Validation Protocol where paramaters such as lineality, accuracy, precision, selectivity, limits of detection and quantitation, system adequacy and the solution stability were analyzed. The results were satisfactory and the validity of the analytical method was proved.

  11. Nanopartículas como herramientas analíticas y estudios toxicológicos asociados

    OpenAIRE

    Caballero-Díaz, E.

    2014-01-01

    Las nanopartículas (NPs) exhiben unas magníficas propiedades fisicoquímicas que las hacen ser excelentes candidatas para su uso en numerosos campos de aplicación incluyendo el ámbito de la Química Analítica. Con este fin, las NPs pueden emplearse como materiales sorbentes en los métodos de tratamiento de muestra que constituyen la primera etapa de la mayoría de los procedimientos analíticos [1]. La enorme habilidad de adsorción superficial que muestran hacia numerosos compuestos tanto orgánic...

  12. Anal Cancer—Health Professional Version

    Science.gov (United States)

    Anal cancer is a rare malignancy and accounts for a small percentage of cancers of the lower alimentary tract. The most common type of anal cancer is squamous cell carcinoma in the anal canal. Find evidence-based information on anal cancer treatment, causes and prevention, research, and statistics.

  13. Um sistema de processamento escalável de consultas analíticas sobre data warehouses criptografados e armazenados na nuvem

    Directory of Open Access Journals (Sweden)

    Claudivan Cruz Lopes

    2017-06-01

    Full Text Available Sistemas de processamento de consultas para bancos de dados criptografados têm sido propostos como uma solução para proteger a confidencialidade de dados armazenados em servidores não confiáveis, tais como provedores de computação em nuvem, e para reduzir o impacto da criptografia no desempenho de consultas sobre dados criptografados. Pouca atenção, no entanto, tem sido dedicada em determinar como a escalabilidade provida pela computação em nuvem pode ser usada para melhorar o desempenho de consultas analíticas sobre Data Warehouses (DW criptografados. Nesse sentido, este artigo descreve um sistema de processamento escalável de consultas analíticas sobre DW criptografados armazenados na nuvem, em que são especificados os componentes arquiteturais que dão suporte a esta escalabilidade.

  14. Comentarios sobre dibujo analítico

    OpenAIRE

    Mata Botella, Elena

    2004-01-01

    Cuaderno de apoyo a la docencia del DIBUJO DE ARQUITECTURA que pretende hacer reflexionar al alumno (de primero o segundo de carrera) sobre un tipo de dibujo que aquí se ha llamado “dibujo analítico”. Un dibujo que a través de operaciones gráficas y conceptuales como la esquematización y la selección de información, tiende a alejarse de la descripción del objeto arquitectónico para adentrarse en determinados aspectos o dimensiones que subyacen en el proyecto arquitectónico. Unas notas intr...

  15. Anal incontinence in women with recurrent obstetric anal sphincter rupture

    DEFF Research Database (Denmark)

    Bøgeskov, Reneé; Nickelsen, Carsten Nahne Amtoft; Secher, Niels Jørgen

    2015-01-01

    UNLABELLED: Abstract Objectives: To determine the risk of recurrent anal sphincter rupture (ASR), and compare the risk of anal incontinence (AI) after recurrent ASR, with that seen in women with previous ASR who deliver by caesarean section or vaginally without sustaining a recurrent ASR. METHODS...

  16. [Acute anal pain].

    Science.gov (United States)

    Pittet, Olivier; Demartines, Nicolas; Hahnloser, Dieter

    2013-07-01

    Acute anal pain is a common proctological problem. A detailed history together with the clinical examination are crucial for the diagnosis. An acute perianal vein thrombosis can be successfully excised within the first 72 hours. Acute anal fissures are best treated conservatively using stool regulation and topical medications reducing the sphincter spasm. A chronic anal fissure needs surgery. Perianal abscesses can very often be incised and drained in local anesthesia. Proctalgia fugax and the levator ani syndrome are exclusion diagnoses and are treated symptomatically.

  17. Alcance y disyuntivas de la ética analógica de M. Beuchot

    Directory of Open Access Journals (Sweden)

    Miquel Seguró

    2016-01-01

    Full Text Available En el presente artículo se discute críticamente el alcance axiológico de la "hermenéutica analógica" de Mauricio Beuchot. Para ello se expone en primer lugar el fundamento ontológico sobre el que se sustenta su propuesta hermenéutica, para luego proceder a una clarificación de su traslación al campo axiológico y de sus problemas. Una vez ponderado y discutido críticamente su planteamiento, en un tercer momento se deducen los principios aporéticos que se vislumbran en los intentos de resolución analógica de los dilemas éticos. El telón de fondo de toda la problemática no es otro que el de la insoslayable finitud primera que constituye la realidad ontológica humana y su capital influencia en el planteamiento fundamental de la cuestión ética.

  18. Método analítico para la determinación de protirelina por cromatografía líquida de alta resolución

    Directory of Open Access Journals (Sweden)

    Alejandro S Padrón Yaquis

    1998-08-01

    Full Text Available Se desarrolló un método analítico para el control de la calidad y estudio de estabilidad de protirelina inyectable. Se realizó el análisis por cromatografía líquida de alta resolución, con la utilización de un sistema isocrático de buffer fosfato-metanol (85:15 como fase móvil y una columna Lichrosorb RP-18 de 250 x 4 mm de 5 mm y detección ultravioleta, a una longitud de onda de 210 nm. El método analítico resultó ser lineal, preciso, exacto y específico en el rango de concentraciones estudiadas.An analytical for the quality control and stability study of injectable protirelin was developed. The analysis was made by high pressure liquid chromatography with the utilization of an isocratic system of phosphate-methanol buffer (85:15 as a mobile phase and a Lichrosorb RP-18 column of 250 x 4 mm of 5 mm and ultraviolet detection at a wave length of 210 nm. The analytical method proved to be lineal, precise, accurate and specific in the range of studied concentrations.

  19. Endosonographic and manometric assessment of the anal sphincters after ileal pouch-anal anastomosis

    International Nuclear Information System (INIS)

    Sudol-Szopinska, I.; Jakubowski, W.; Ciesielski, A.; Bielecki, K.; Baczuk, L.; Tarnowski, W.

    2003-01-01

    Background. The aim of this study was to compare endosonography and manometry of the anal sphincters in patients after ileal pouch-anal anastomosis (IPAA). Patients and methods. Ten patients aged between 23 and 50 years with IPAA performed for ulcerative colitis were examined with anal endosonography (AES) and manometry. Results. AES visualised abnormal image of the internal anal sphincter (IAS) in 9 patients (90%). Defects of the external anal sphincter (EAS) and puborectalis muscle (PR) were shown in 4 patients (40%). In 5 patients (50%) correlation between endosonographic and manometric assessment for the all analysed muscles: IAS, EAS and PR was found. In 4 cases (40%) both methods correlated with the evaluation of the EAS only and in 1 patient (10%) no correlation was found. Correlation between both methods for the IAS was found in half of the patients (50%) while in the evaluation of the EAS and PR dynamic activity, it was found in 9 cases (90%). Conclusions. Anal endosonography and manometry allow us to assess the morphology as well as the function of the anal sphincters in patients with IPAA. The methods mentioned above show high correlation in the assessment of the EAS function (9 cases; 90%) whereas in the case of IAS, manometry frequently (5 patients; 50%) does not confirm endosonografically detected defects. (author)

  20. Chronic anal fissure: morphometric analysis of the anal canal at 3.0 Tesla MR imaging.

    Science.gov (United States)

    Erden, Ayşe; Peker, Elif; Gençtürk, Zeynep Bıyıklı

    2017-02-01

    OBJECTıVE: To compare the morphometric data relating to the muscular structures of the anal canal, in patients with chronic anal fissure and in control group, examined at a 3.0 Tesla MR system. Forty-seven consecutive patients with chronic anal fissure and randomly selected 40 patients who had no claims for perianal disease during their life time were included in the study. T2-weighted sagittal, high-resolution (HR) T2-weighted, and contrast-enhanced fat-suppressed T1-weighted oblique axial and oblique coronal images were retrospectively analyzed by two observers in consensus. Thickness of sphincteric muscles, anal canal length, anorectal angle, thickness of anococcygeal ligament, depth of Minor triangle, width between subcutaneous sphincters, vascularity of posterior commissure, visibility of posterosuperior projection of external sphincter, and angle between the distal anal canal and posterosuperior projection of external sphincter (H angle) in patients and in controls were compared and analyzed using t test, Mann-Whitney U test, and Spearman correlation. The patients with chronic anal fissure had longer anal canal (51.50 mm ± 0.91 vs. 44.11 mm ± 0.71; p = 0.000), thicker internal anal sphincter muscle at mid-anal level (4.18 ± 0.15 vs. 3.39 ± 0.07; p = 0.007), and wider space between subcutaneous external sphincters (11.39 ± 0.50 vs. 6.89 ± 0.22; p = 0.000). In patients, there was a positive correlation between H angle and external sphincter thickness at proximal (r = 0.347; p = 0.021), middle (r = 0427; p = 0.000), and distal (r = 0.518; p = 0.000)) levels of the anal canal. CONCLUSıON: 3.0 Tesla MR imaging provides detailed information about the morphometric changes in the anal sphincter muscles in patients with chronic anal fissure.

  1. El pensamiento crítico-analítico en estudiantes del área de Biología de la Universidad de Guayaquil, Ecuador

    OpenAIRE

    López Silva, Byron Orlando; García Rodríguez, Idalmys Yelivi; Hernández Navarro, Marlene Isabel; López Córdova, Byron Alfredo; López Córdova, Marcel Orlando; Barbies Rubiera, Amarilis

    2016-01-01

    Fundamento: el pensamiento crítico-analítico es un proceso intelectual necesario en los estudiantes universitarios para su desarrollo profesional. Objetivo: indagar sobre las necesidades sentidas de estudiantes y profesores para desarrollar el pensamiento crítico-analítico en el primer año de la carrera de Medicina en el área de Biología en la Universidad de Guayaquil. Métodos: se desarrolló un estudio descriptivo en el período comprendido entre mayo y diciembre de 2015 en la Facultad de Medi...

  2. Aplicaciones analíticas de métodos basados en luminiscencia molecular en combinación con metodologías dinámicas

    OpenAIRE

    Jiménez Girón, Ana María

    2013-01-01

    El objetivo de esta tesis es establecer nuevos métodos de determinación analítica, utilizando como técnica de detección la luminiscencia molecular (flourescencia y quimoluminiscencia), en combinación con metodologías dinámicas. Para ello, se utilizará el tiempo como parámetro analítico, con objeto de aprovechar el comportamiento cinético, para proporcionar información relevante adicional de la especie de interés. Se pretende explorar la utilización de quimioluminiscencia resuelta en el tiempo...

  3. [Surgical treatment of anal fistula].

    Science.gov (United States)

    Zeng, Xiandong; Zhang, Yong

    2014-12-01

    Anal fistula is a common disease. It is also quite difficult to be solved without recurrence or damage to the anal sphincter. Several techniques have been described for the management of anal fistula, but there is no final conclusion of their application in the treatment. This article summarizes the history of anal fistula management, the current techniques available, and describes new technologies. Internet online searches were performed from the CNKI and Wanfang databases to identify articles about anal fistula management including seton, fistulotomy, fistulectomy, LIFT operation, biomaterial treatment and new technology application. Every fistula surgery technique has its own place, so it is reasonable to give comprehensive individualized treatment to different patients, which may lead to reduced recurrence and avoidance of damage to the anal sphincter. New technologies provide promising alternatives to traditional methods of management. Surgeons still need to focus on the invention and improvement of the minimally invasive techniques. Besides, a new therapeutic idea is worth to explore that the focus of surgical treatment should be transferred to prevention of the formation of anal fistula after perianal abscess.

  4. Galerías mineras: la modelización analítica como una ayuda geomecánica para el diseño minero

    Directory of Open Access Journals (Sweden)

    Alvaro Correa Arroyave

    1991-09-01

    Full Text Available Después de una introducción en la que se esbozan los métodos analíticos utilizados en la Geotecnica Aplicada y se analizan las dificultades inherentes a cada método, se cuestiona por qué la Geomecánica no ha llegado a las minas tan rápido como se hubiera querido. En efecto estas obras, sui generis por su actividad, se encuentran en nuestro país más al abrigo de la experiencia adquirida in situ que a las aplicaciones de los desarrollos geomecánicos logrados en otros países. Posiblemente el desconocimiento o quizás la falta de credibilidad en estos logros, es la explicación de la ausencia casi total en la utilización de aquellos métodos en nuestro medio. Siendo la determinación de los datos de entrada el mayor problema práctico para llevar a buen término cualquiera de los métodos analíticos. el texto recomienda una metodología que permite cuantificar aquellos parámetros, y en especial las características geomecánicas de esfuerzo, deformación y resistencia de las masas rocosas.

  5. Aprendizaje de los conceptos de masa, peso y gravedad. Investigación de la efectividad de un modelo analógico

    Directory of Open Access Journals (Sweden)

    Lucrecia E. Moro

    2007-01-01

    Full Text Available La línea de investigación sobre los procesos de enseñanza y aprendizaje científico basada en modelos analógicos ha adquirido relevancia, pero notamos que son pocas las aplicaciones en el aula, sobre todo en el nivel medio de enseñanza. Los modelos didácticos analógicos son una herramienta importante para la instrucción pero a condición de que el profesor y los alumnos adquieran una visión en común sobre el análogo y se describan sus limitaciones comparado con el modelo teorético. Se espera del alumno una toma de conciencia sobre sus procesos y eventos cognitivos para que pueda evaluar los progresos y resultados, comprendiendo su propia versión acerca de la naturaleza de su conocimiento y sobre el proceso de aprendizaje, es decir sobre sus esencias epistemológicas. En este trabajo se evalúa la eficiencia de un modelo didáctico analógico para la enseñanza de los conceptos de masa, peso y gravedad mediante un estudio correlacional, cuasiexperimental con posprueba y grupo control.

  6. Modelo analítico de resistência ao rolamento de pneus de carga

    OpenAIRE

    Marcos Rodolfo Gali

    2015-01-01

    Resumo: Em 2012, Rhyne & Cron desenvolveram um modelo analítico para estimar a mínima Resistência ao Rolamento (RR) para pneus destinados aos veículos de passageiro. Os parâmetros estudados pelos autores foram a área de contato, a espessura e a largura da rodagem, o raio da cintura metálica, o módulo elástico do composto da banda de rodagem, a carga vertical imposta, a pressão de inflação do pneu e a área efetiva de contato do pneu com o solo. Para o fator área de contato, os autores simplifi...

  7. De mundejarismo de los Anales Toledanos Segundos

    Directory of Open Access Journals (Sweden)

    Felipe MAÍLLO SALGADO

    2009-12-01

    Full Text Available Como es sabido los Anales Toledanos (Primeros, Segundos y Terceros, compuestos en su mayor parte durante el siglo XIII en distintos momentos y por diferentes manos, son piezas importantes de la historiografía medieval hispánica, tanto por recoger gran cantidad de noticias —por más que éstas sean escuetas— cuanto por estar todas ellas rigurosamente fechadas; de ahí que sean de gran utilidad para el historiador.De estos tres anales, los Segundos (A.T.II tienen unas peculiaridades que los distinguen fuertemente de los otros; sin embargo, en una primera hojeada el lector poco avisado vería que, por su aspecto formal, nada difieren de otros escritos del mismo género, un género éste cuya condición esencial radica en la consignación del evento fechado, esto es, se presenta en párrafos que comienzan o terminan —como es aquí el caso— con una fecha determinada. Nuestro imaginario lector, por otra parte, se encontraría con las peladas noticias típicas del género analístico, a saber: una serie de referencias que dan cuenta de fenómenos naturales (como son las sequías prolongadas o las excesivas lluvias, las heladas intempestivas, los terremotos, los eclipses..., que informan de las épocas de hambre o carestía, de los precios de los artículos, de prodigios, de acontecimientos locales, etc.; el todo amalgamado con noticias de carácter político-militar.

  8. Avaliação hormonal indireta e estudo da preservação folicular em tecido ovariano autólogo transplantado para região inguinal em ratos

    Directory of Open Access Journals (Sweden)

    Ceschin Álvaro Pigatto

    2004-01-01

    Full Text Available OBJETIVO: O transplante autólogo de tecido ovariano tem sido objeto de estudo de diversos pesquisadores pela perspectiva de manter a funcionalidade deste órgão, mesmo não localizado em seu sítio habitual, sendo daí removido, a fim de minimizar os efeitos causados, por exemplo, pela radioterapia. Este trabalho visa a analisar a efetividade da técnica de autotransplante subcutâneo de tecido ovariano bisseccionado em região inguinal de ratas albinas, próximo aos vasos femorais, através do estudo indireto da produção hormonal, feita pela avaliação da citologia de esfregaços vaginais e do estudo direto da viabilidade tecidual, realizado por meio da análise histológica. MÉTODOS: Analisaram-se 30 ratas, que sofreram ooforectomia bilateral, sendo 15 delas destinadas ao controle e 15 submetidas ao transplante ovariano. Decorridos 28 dias, recuperaram-se e avaliaram-se os enxertos. As análises da citologia dos esfregaços vaginais efetuaram-se no momento 0, ou seja, pré-transplante, e no momento 1, pós-transplante, para os animais de ambos os grupos e a avaliação histológica realizou-se no momento 0 para os dois grupos e no momento 1 para os animais transplantados. RESULTADOS: Os resultados do experimento demonstraram a viabilidade e funcionalidade dos enxertos em 100% das lâminas analisadas, isso verificado através da obtenção de esfregaços em fase de estro para todas as ratas do grupo experimento e da presença de folículos em vários estágios de desenvolvimento, observados nos enxertos recuperados, indicando diretamente a viabilidade do tecido ovariano. CONCLUSÃO: o transplante de tecido ovariano é uma alternativa viável, nas condições do experimento, para a preservação hormonal e folicular, em ratas.

  9. Métodos analíticos necesarios para el desarrollo de tabletas de metformina 500 mg Analytical methods needed for Metformin 500mg tablets development

    Directory of Open Access Journals (Sweden)

    Caridad M. García Peña

    2009-12-01

    Full Text Available El clorhidrato de metformina es un derivado de la biguanida usado en la diabetes mellitus no insulina dependiente, reduce la concentración de glucosa sanguínea sin incrementar la secreción de insulina, se considera un agente antihiperglucemiante y no un fármaco hipoglucemiante. El desarrollo tecnológico requiere de métodos analíticos confiables que permitan la cuantificación del fármaco en diferentes etapas de la investigación. El objetivo de este trabajo fue la validación del método analítico, reportado en la Farmacopea de los Estados Unidos (USP 31, 2008, por espectrofotometría ultravioleta y la adaptación del método analítico, reportado en la misma farmacopea, para el análisis de los compuestos relacionados en la determinación del principio activo en el producto terminado, por cromatografía líquida de alta resolución, validados para el control de la calidad y estudio de estabilidad de las tabletas de metformina 500 mg. A las técnicas validadas, por métodos cromatográficos y espectrofotométricos se le determinaron los parámetros de desempeño, especificidad, linealidad, exactitud y precisión. Las curvas de calibración para cada método, se realizaron en el intervalo de 60 al 140 %, donde fueron lineales con coeficientes de correlación igual a 0,9994 y 0,99903, respectivamente; la prueba estadística para el intercepto y la pendiente se consideró no significativa. Se obtuvieron recobrados de 100,01 y 99,1 %, respectivamente, en el intervalo de concentraciones estudiados y las pruebas de Cochran´(G y Student´s (t resultaron no significativas. Los coeficientes de variación en los estudios de la repetibilidad fueron iguales a 1,4 y 0,8 %, respectivamente, para las 6 réplicas ensayadas, mientras que en los análisis de la precisión intermedia las pruebas de Fischer y Student fueron no significativas. Los resultados permiten concluir que ambos métodos cumplen con los requisitos establecidos como aceptables para

  10. Anal Sphincter Augmentation Using Biological Material.

    Science.gov (United States)

    Alam, Nasra N; Narang, Sunil K; Köckerling, Ferdinand; Daniels, Ian R; Smart, Neil J

    2015-01-01

    The aim of this review is to provide an overview of the use of biological materials in the augmentation of the anal sphincter either as part of an overlapping sphincter repair (OSR) or anal bulking procedure. A systematic search of PubMed was conducted using the search terms "anal bulking agents," "anal sphincter repair," or "overlapping sphincter repair." Five studies using biological material as part of an overlapping sphincter repair (OSR) or as an anal bulking agent were identified. 122 patients underwent anal bulking with a biological material. Anorectal physiology was conducted in 27 patients and demonstrated deterioration in maximum resting pressure, and no significant change in maximum squeeze increment. Quality of life scores (QoLs) demonstrated improvements at 6 weeks and 6 months, but this had deteriorated at 12 months of follow up. Biological material was used in 23 patients to carry out an anal encirclement procedure. Improvements in QoLs were observed in patients undergoing OSR as well as anal encirclement using biological material. Incontinence episodes decreased to an average of one per week from 8 to 10 preoperatively. Sphincter encirclement with biological material has demonstrated improvements in continence and QoLs in the short term compared to traditional repair alone. Long-term studies are necessary to determine if this effect is sustained. As an anal bulking agent the benefits are short-term.

  11. Evaluación de un modelo didáctico analógico para el aprendizaje de energía interna y temperatura

    Directory of Open Access Journals (Sweden)

    Zamorano, R.O.

    2006-09-01

    Full Text Available Las dificultades de los estudiantes para conceptualizar correctamente las leyes de la termodinámica han sido estudiadas por diferentes autores, asimismo se han detectado los errores en nociones relativas a las magnitudes involucradas. Esas dificultades parecen residir en la falta de correspondencia entre el modelo macroscópico de las leyes de la termodinámica y el modelo cinético molecular de la materia. Ambos modelos teoréticos, uno macroscópico y otro microscópico se plantean habitualmente en la clase, de modo que esta falta de conexión sería en parte proveniente de la instrucción. Consideramos que existe una continuidad entre los modelos conceptuales de los alumnos y el modelo teorético objeto del aprendizaje. En este trabajo se propone un modelo didáctico analógico para la enseñanza de los conceptos de temperatura y energía interna y se evalúa su eficiencia. Los resultados obtenidos fueron positivos mostrando una mejor utilización del modelo cinético molecular por parte de los alumnos.

  12. Trends in incidence of anal cancer and high-grade anal intraepithelial neoplasia in Denmark, 1978-2008

    DEFF Research Database (Denmark)

    Nielsen, Ann; Plum, Christian Edinger Munk; Kjaer, Susanne K

    2012-01-01

    The aim of the study was to determine the incidences of anal cancer and high-grade anal intraepithelial neoplasia (AIN2/3) over time in Danish women and men. Describing the burden of anal cancer and AIN may be valuable in future evaluations of the human papillomavirus (HPV) vaccine. We included all...... anal cancers in the Danish Cancer Register in the period 1978-2008 and all cases of AIN2/3 in the Danish Registry of Pathology. Overall and age-, period- and histology-specific incidence rates were estimated. During the 30-year period, 2187 anal cancers were identified, two thirds of which were...... in women. Between 1978-1982 and 2003-2008, the age-standardized incidence rate of anal cancer increased from 0.68 to 1.48 per 100 000 person-years in women and from 0.45 to 0.80 per 100 000 person-years in men. Although there is no systematic screening for AIN in Denmark, we nevertheless identified 608...

  13. HIV/AIDS, HPV and Anal Cancer

    Science.gov (United States)

    Wang, Chia-ching J.; Sparano, Joseph; Palefsky, Joel M.

    2016-01-01

    SYNOPSIS Anal cancer is an increasingly common non-AIDS-defining cancer among HIV-infected individuals. It is associated with human papillomavirus (HPV), the most common sexually transmitted infectious agent. The 14 oncogenic types of HPV are causally associated with 5–10% of all cancers, notably anogenital cancers. HPV16 is the most common genotype detected in about 70% of anal cancers. The HPV types detected in anal cancer are included in the 9-valent vaccine. HPV vaccines have demonstrated efficacy in reducing anal precancerous lesions in HIV-infected individuals. The standard treatment for anal cancer has been fluorouracil (5-FU) and mitomycin (or cisplatin) as chemotherapy agents plus radiation, which can also be effectively used for the HIV-infected patients. Continued studies will be needed to test new treatment strategies in HIV-infected patients with anal cancer to determine which treatment protocols provide the best therapeutic index. PMID:27889034

  14. Prevalência das lesões intra-epiteliais de alto grau em pacientes com citologia com diagnóstico persistente de ASCUS Prevalence of high-grade squamous intraepithelial lesions in patients with persistent cytological diagnosis of ASCUS

    Directory of Open Access Journals (Sweden)

    Fernanda Rangel da Veiga

    2006-02-01

    Full Text Available OBJETIVO: verificar a prevalência de lesões intra-epiteliais de alto grau (LIAG e câncer invasor em mulheres com citologia com diagnóstico de ASCUS (atipias em células escamosas de significado indeterminado persistente após 6 meses e verificar se a idade é fator indicador para a existência destas lesões neste grupo de mulheres. MÉTODOS: foram incluídos 215 casos de mulheres não-gestantes e HIV-negativas com diagnóstico de ASCUS (sem especificação persistente em duas citologias com intervalo mínimo de 6 meses. Tais resultados foram confrontados com o resultado histológico de biópsias, exéreses da zona de transformação (large loop excision of the transformation zone ou cones. Foram considerados negativos para LIAG ou câncer quando a colposcopia foi satisfatória e sem alterações ou quando, apesar de insatisfatória, não foi detectada lesão em pelo menos um seguimento citológico e colposcópico. Para estabelecer a prevalência de lesões, calculamos a freqüência de diagnósticos com seus respectivos intervalos de confiança a 95% (IC 95%. Para análise estatística da diferença de proporções de LIAG ou câncer em cada faixa de idade, foi utilizado teste do chi2, e ainda estimamos o risco destas lesões entre mulheres com mais de 35 anos pela razão de prevalências com seu IC 95%. RESULTADOS: encontramos um total de negativos de 49,3% dos casos (IC 95%: 42,6-55,9. A prevalência de lesões intra-epiteliais de baixo grau foi de 38,6% (IC 95%: 32,1-45,1 e de LIAG de 10,7% (IC 95%: 6,5-14,8. Casos de câncer foram encontrados em 1,4% das pacientes (IC 95%: 0-2,9. Não foi possível estabelecer, de forma significativa, maior risco de LIAG/câncer considerando o corte de idade em 35 anos. CONCLUSÃO: a prevalência de LIAG/câncer encontrada em nosso estudo mostra que o risco de encontrarmos este tipo de lesão em mulheres atendidas no Sistema Único de Saúde em nosso município com duas citologias com diagnóstico de

  15. Uma contribuição para a discussão sobre as imagens psíquicas no contexto da Psicologia Analítica

    Directory of Open Access Journals (Sweden)

    Paulo Afrânio Sant'Anna

    2005-09-01

    Full Text Available A discussão sobre a natureza das imagens psíquicas ocorre desde os primórdios da Psicologia. Nas últimas décadas, o tema vem ganhando destaque em todas as abordagens, notadamente em modalidades clínicas que se apóiam predominantemente no discurso imagético. Para a Psicologia Analítica, a questão da imagem tem sido tema de diversas discussões, destacando-se três direcionamentos teórico-práticos - clássico, desenvolvimentista e arquetípico -, que vão determinar diferentes perspectivas sobre a questão. Observa-se uma tendência em abordar a imagem a partir de sua própria fenomenologia, em detrimento de sua interpretação e, apesar da importância das imagens para o contexto clínico, o tema está praticamente ausente dos programas de graduação em Psicologia e da própria estruturação das teorias psicológicas. Nesse sentido, algumas propostas são discutidas a título de possibilidades de aprendizado e de teorização no campo da imagem. Como a relação dialética entre teoria e prática é necessária para que a teoria permaneça atualizada e vitalmente ligada à realidade sociocultural contemporânea, por meio de dados obtidos em entrevistas com psicoterapeutas brasileiros, buscou-se identificar contribuições para a discussão sobre as imagens no contexto clínico.

  16. ANAL SPHINCTER INJURIES (OASIS AT DELIVERY

    Directory of Open Access Journals (Sweden)

    Katja Jakopič

    2018-02-01

    Full Text Available Background: Anal incontinence severely impairs quality of life. It affects 4 to 19 % of women and is statistically related to number of vaginal deliveries. It is grossly underreported and most patients that do seek help are referred to gastroenterologists or colorectal surgeons. Incidence of recognized sphincter injuries at time of delivery is 1 to 2 %. However studies with anal ultrasound showed incidence of anal sphincter injuries at 28 to 41 %. Depending on the degree of injury symptoms range from partial to complete inability to control passing of winds, liquid or solid stools. About three thirds of patients are asymp- tomatic in puerperium, however half of them are at risk of developing anal incontinence in later life. Hypoestrogenisem, additional perineal trauma during consequent deliveries and sphincter atrophy can unmask anal sphincter damage years later. Timely recognition and treatment are vital for good long term results and quality of life, if possible immediately after delivery. Good knowledge of perineal anatomy, recognition of risk factors, intense search and appropriate treatment and follow-up are essential to management of anal sphincter injuries. All secondary sphincter repair is less effective. Content: Updated overview of current opinion and guidelines on anal sphincter injuries are pre- sented. Anal sphincter is composed of external anal sphincter (EAS and internal anal sphincter (IAS. Striated EAS is divided into three parts – subcutaneous, superficial, deep, and con- nected to puborectalis muscle posteriorly. Smooth-muscled IAS is a continuation of a cir- cular smooth-muscle layer of rectum. In between there is a thin longitudinal muscle layer. IAS constitutes 70 % of resting tone and is under constant contraction. EAS contributes to 30 % of resting tone and almost all pressure during active contraction. EAS injury leads to insufficient contraction after rectal sampling and filling which causes urgency – patient can

  17. Formulação analítica de um elemento de barra para o cálculo elastoplástico de estruturas de aço porticadas planas

    OpenAIRE

    Baptista, A. M.; Muzeau, J. P.

    2007-01-01

    O presente trabalho apresenta as bases do desenvolvimento de um modelo analítico para o cálculo dos deslocamentos (rotação, flecha e deslocamento axial) numa secção transversal qualquer de uma viga de aço submetida a uma força axial constante e a um momento flector em cada uma das suas extremidades. Entre outras aplicações, este modelo permite efectuar o cálculo directo dos deslocamentos nodais no referencial local de um elemento de viga inserido numa estrutura, em regime elástico ou elastopl...

  18. As possibilidades analíticas da noção de campo social

    Directory of Open Access Journals (Sweden)

    Afrânio Mendes Catani

    2011-03-01

    Full Text Available O texto procura, num primeiro momento, discutir a noção de campo social, desenvolvida pelo sociólogo francês Pierre Bourdieu (1930-2002 para, em seguida, pensar o campo universitário em suas especificidades, esboçando possibilidades analíticas para o caso brasileiro a partir de seu clássico livro La noblesse d´État. Grandes Écoles et esprit de corps (1989. Embora desenvolvido por Bourdieu com a finalidade de estudar mecanismos de dominação vigentes na sociedade francesa, pretende-se indicar como esse aparato epistêmico prático pode, através do estabelecimento de relações de homologia, ser trabalhado para o estudo do campo universitário brasileiro.

  19. Encopresis and anal masturbation.

    Science.gov (United States)

    Aruffo, R N; Ibarra, S; Strupp, K R

    2000-01-01

    Current pediatric and psychiatric studies on encopresis and its treatment are heavily influenced by mechanical, physiological, and behavioral considerations. Although psychodynamic treatment has generally been considered to be of little benefit, and its findings suspect, the authors suggest that a psychodynamic approach adds substantially to the understanding of some cases of encopresis; that the anal sensations and anal erotic feelings reported by a number of encopretic children are intense, and that the encopretic symptom, soiling, in these children is the result of a conscious form of anal masturbation in which the fecal mass is used for stimulation; and that any study of encopresis is incomplete that does not include what encopretic children, engaged in a sound therapeutic relationship, know and say about their soiling. The authors further suggest that physical treatments of those children whose encopresis is psychologically driven may be contraindicated. The presence of a large stool does not in itself substantiate a physical illness. Further research is needed to elucidate the prevalence of anal masturbation in encopretic children.

  20. Clinical and manometric evaluation of women with chronic anal fissure before and after internal subcutaneous lateral sphincterotomy

    Directory of Open Access Journals (Sweden)

    Silvana Marques e Silva

    2012-06-01

    Full Text Available OBJECTIVE: To evaluate clinical and manometric parameters of chronic anal fissure females undergoing lateral internal sphincterotomy (LIS. METHODS: A total of eight women with chronic anal fissure who underwent LIS were included in this study. The preoperative assessment was performed one week before surgery and included general and anorectal examination, anorectal manometry, and Jorge Wexner questionnaire. The post operative follow up was made every 15 days until complete healing. Jorge Wexner questionnaires and anorectal manometry were repeated at 1 month and 3 months after the surgery. Time to healing, manometric changes and complications were assessed. RESULTS: All patients had preoperative increased anal resting pressure. The resting pressures and anal canal length were significantly decreased 3 months after surgery. Patients' complaints of itching and bleeding were also reduced. Fissures healed in 7 patients and median healing time was 45 days. No complications were observed due to the procedure. One patient had transient incontinence to flatus. CONCLUSION: Lateral internal sphincterotomy provided clinical improvement and reduced resting pressure of the internal anal sphincter in women with chronic anal fissure.OBJETIVO: Avaliar a evolução clínica e manométrica de mulheres com fissura anal crônica submetidas à esfincterotomia lateral interna subcutânea. MÉTODOS: Estudo prospectivo com oito pacientes. A avaliação inicial foi realizada por meio de questionários, exame físico e manometria anorretal na semana anterior ao procedimento cirúrgico. Durante o período pós-operatório, as pacientes foram avaliadas clinicamente a cada 15 dias, até a cicatrização completa. Os questionários e a manometria anorretal foram repetidos 1 mês e 3 meses após a operação. Foi avaliado o tempo para cicatrização da fissura, as alterações manométricas e as complicações decorrentes do procedimento. RESULTADOS: Todas as pacientes

  1. Protocolo de validación de métodos analíticos para la cuantificación de fármacos

    Directory of Open Access Journals (Sweden)

    Beatriz Castillo Aguilar

    1996-04-01

    Full Text Available Se presenta un resumen de las consideraciones generales para la confección del protocolo de validación de métodos analíticos utilizados en la determinación cuantitativa de fármacos en forma de materia prima o en formulaciones y en estudios de estabilidad. Se describe detalladamente el proceso de validación que incluye los requisitos exigidos para la utilización de las materias primas, materiales de referencia, equipamiento, personal y determinación de los parámetros de linealidad, precisión, exactitud y selectividad (con el procesamiento estadístico de los resultados experimentales y criterios de aceptación, así como la presentación de los resultados en el informe final de la validación.A summary of the general considerations fot the formulation of a validation protocol of the analytical methods used in drug quantitative determination in a raw material form, or in formulations and firmness studies. The validation process is fully described; it includes the necessary requirements for the usage of raw materials, reference materials, supplying, personnel, and determination of linearity, preciseness, exactness, and selectiveness (with the statistical processing of experimental results, and acceptance criteria, as well as the presentation of outcomes in the validation final report.

  2. Internal anal sphincter: Clinical perspective.

    Science.gov (United States)

    Kumar, Lalit; Emmanuel, Anton

    2017-08-01

    To summarise current knowledge of Internal anal sphincter. The internal anal sphincter (IAS) is the involuntary ring of smooth muscle in the anal canal and is the major contributor to the resting pressure in the anus. Structural injury or functional weakness of the muscle results in passive incontinence of faeces and flatus. With advent of new assessment and treatment modalities IAS has become an important topic for surgeons. This review was undertaken to summarise our current knowledge of internal anal sphincter and highlight the areas that need further research. The PubMed database was used to identify relevant studies relating to internal anal sphincter. The available evidence has been summarised and advantages and limitations highlighted for the different diagnostic and therapeutic techniques. Our understanding of the physiology and pharmacology of IAS has increased greatly in the last three decades. Additionally, there has been a rise in diagnostic and therapeutic techniques specifically targeting the IAS. Although these are promising, future research is required before these can be incorporated into the management algorithm. Copyright © 2016 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  3. Litiasis renal oxalocálcica. Avances en la comprensión de su etiología y mejoras en la metodología analítica para su estudio

    OpenAIRE

    Muñoz Martínez, José Antonio

    2004-01-01

    Consultable des del TDX A la portada: Unitat de Química Analítica, Centre Grup de Tècniques de Separació en Química Títol obtingut de la portada digitalitzada La urolitiasis es una enfermedad común, que afectará al 12% de la población de la Unión Europea a lo largo de su vida, caracterizada por una alta prevalencia e incidencia, alta morbilidad y altas tasas de recurrencia. Hoy en día, se acepta un origen multifactorial para el proceso litógeno: el fenómeno central corresponde a la s...

  4. Aplicação da técnica de Estrutura Analítica de projeto para o sub-projeto do Catálogo de Sites da Biblioteca Virtual em Saúde: Enfermagem Aplicación de la técnica de Estructura Analítica de proyecto para el subproyecto de lo Catalogo de Sitios de la Biblioteca Virtual en Salud: Enfermería Application of the technique of Analytical Structure of project for the sub-project of Websites Catalog of the Virtual Health Library: Nursing

    Directory of Open Access Journals (Sweden)

    Luís Augusto dos Santos

    2007-12-01

    Full Text Available Este trabalho procura, de forma didática, explicar os benefícios de uso de uma técnica de gerenciamento de projetos, chamada de Estrutura Analítica do Projeto - uma ferramenta gráfica para identificar os resultados principais a serem desenvolvidos por um projeto. Os exemplos são reais, aplicados a um sub-projeto da Biblioteca Virtual em Saúde em Enfermagem (BVS-Enfermagem para o desenvolvimento de Catálogo de Sites. Destacam-se os benefícios de visualização gráfica para um maior entendimento entre profissionais de diferentes áreas.Este artículo presenta, de una forma didáctica, algunas explicaciones sobre los beneficios de lo uso de la técnica de gestión de proyectos, llamada de Estructura Analítica del Proyecto una herramienta grafica para la identificación de los principales resultados que han de ser desarrollados en un proyecto. Los ejemplos son reales, aplicados a un subproyecto de la Biblioteca Virtual en Salud Enfermería (BVS-Enfermagem para el desarrollo del catalogo de sitios. Son destacados los beneficios de visualización grafica para un mejor entendimiento entre profesionales de diferentes áreas.This work search of didactic form to explain the benefits of use of one technique of management project, called Work Breakdown Structure: a graphical tool to identify the main results to be developed for a project. The real examples are applied to a sub-project of the Virtual Library in Health in Nursing (BVSEnfermagem to development of the Sites Catalogs. It is distinguished the benefits of graphical visualization for a major agreement between professionals of different expertise

  5. [Effectiveness of human papillomavirus genotyping for detection of high-grade anal intraepithelial neoplasia compared to anal cytology].

    Science.gov (United States)

    Padilla-España, Laura; Repiso-Jiménez, Juan Bosco; Fernández-Sánchez, Fernando; Pereda, Teresa; Rivas-Ruiz, Francisco; Fernández-Morano, Teresa; de la Torre-Lima, Javier; Palma, Fermín; Redondo, Maximino; de Troya-Martín, Magdalena

    2016-01-01

    The incidence of high-grade anal intraepithelial neoplasia (HGAIN) -with an aetiological based on high-risk types of human papillomavirus- is increasing in some high-risk groups. Screening for HGAIN includes routine anal cytology and, more recently, HPV genotyping. The main objective of this study was to determine the sensitivity and specificity of anal cytology and HPV genotyping for the detection of HGAIN. This is a study to determine the correlation of cytological and microbiological findings with anal biopsy findings in a cohort of patients at high risk of developing AIN referred to the department of sexually transmitted infections of the Hospital Costa del Sol, Spain, between January 2008 and December 2014. Of the 151 patients subjected to screening, a total of 92 patients, all of them with the result of three screening test (anal cytology, genotyping and biopsy) were included in the study. Just under two-thirds (62%) of them were HIV-positive. The sensitivity and specificity of anal cytology to detect HGAIN were 52.8 and 85.7%, respectively (k: 0.328), and 78 and 62.8% to detect two or more HPV oncogenic genotypes (k: 0.417). The detection of oncogenic HPV genotypes allowed the identification of 23 new cases of HGAIN that had been underdiagnosed with anal cytology, with 14 cases containing at least three high-risk genotypes. Anal cytology did not show enough sensitivity in HGAIN screening. HPV genotyping has shown to be a useful tool to detect HGAIN cases, although it could lead to an over-diagnosis as a solitary screening procedure. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  6. Anal squamous intraepithelial lesions in HIV+ MSM

    NARCIS (Netherlands)

    Siegenbeek van Heukelom, M.L.

    2018-01-01

    In this thesis we report on several aspects of high-grade anal squamous intraepithelial lesions (HSIL) in HIV+ men who have sex with men (MSM). It is estimated that 10% of HIV+ MSM with anal HSIL will develop anal squamous cell carcinoma (ASCC) over 30 years time. Screening programs similar to

  7. Closure of leak at the tip of the “J” after ileal pouch-anal anastomosis using a novel over-the-scope clipping system

    Directory of Open Access Journals (Sweden)

    Lei Lian

    2014-04-01

    vazamento foi realizada com uma escova de citologia endoscópica. Então o sistema endoscópico “over-the-scope” clip foi usado e o vazamento foi completamente fechado. Não houve sangramento ou perfuração. O processo todo levou 25 minutos. O paciente evoluiu bem e relatou a resolução do sintoma de dor lombar. Conclusão: relatamos o primeiro caso na literatura de vazamento na extremidade de bolsa ileal em J que foi fechado através de procedimento endoscópico usando um novo sistema “over-the-scope” clip (OTSC. Keywords: Ileal pouch anal anastomosis, Leak, Clipping, Endoscopy, Palavras-chave: Anastomose Bolsa ileal-anal, Vazamento, Clip, Endoscopia

  8. A Mouse Model for Human Anal Cancer

    Science.gov (United States)

    Stelzer, Marie K.; Pitot, Henry C.; Liem, Amy; Schweizer, Johannes; Mahoney, Charles; Lambert, Paul F.

    2010-01-01

    Human anal cancers are associated with high-risk human papillomaviruses (HPVs) that cause other anogenital cancers and head and neck cancers. As with other cancers, HPV16 is the most common high-risk HPV in anal cancers. We describe the generation and characterization of a mouse model for human anal cancer. This model makes use of K14E6 and K14E7 transgenic mice in which the HPV16 E6 and E7 genes are directed in their expression to stratified squamous epithelia. HPV16 E6 and E7 possess oncogenic properties including but not limited to their capacity to inactivate the cellular tumor suppressors p53 and pRb, respectively. Both E6 and E7 were found to be functionally expressed in the anal epithelia of K14E6/K14E7 transgenic mice. To assess the susceptibility of these mice to anal cancer, mice were treated topically with dimethylbenz[a]anthracene (DMBA), a chemical carcinogen that is known to induce squamous cell carcinomas in other sites. Nearly 50% of DMBA-treated HPV16 E6/E7 transgenic mice showed overt signs of tumors; whereas, none of the like treated non-transgenic mice showed tumors. Histopathological analyses confirmed that the HPV16 transgenic mice were increased in their susceptibility to anal cancers and precancerous lesions. Biomarker analyses demonstrated that these mouse anal cancers exhibit properties that are similar to those observed in HPV-positive precursors to human anal cancer. This is the first mouse model for investigating the contributions of viral and cellular factors in anal carcinogenesis, and should provide a platform for assessing new therapeutic modalities for treating and/or preventing this type of cancer. PMID:20947489

  9. A psicologia analítica de Carl Gustav Jung: apontamentos de aulaThe analytical psychology of Carl Gustav Jung: notes of lesson

    OpenAIRE

    Ramos, Luís Marcelo Alves

    2008-01-01

    O texto traz o conteúdo de uma aula sobre Teorias da Personalidade com foco nos fundamentos da Psicologia Analítica do psicólogo e psiquiatra suíço Carl Gustav Jung (1875-1961), cuja obra vem apresentando significativas contribuições para a Psicologia Educacional, Organizacional e Clínica. Palavras-chave Psicologia analítica; Teorias da personalidade Abstract The text brings the content of a lesson on Theories of Personality focused in the fundamentals of the Analytical Psychology of...

  10. Movimento analítico-hermenêutico heideggeriano: possibilidade metodológica para a pesquisa em enfermagem Movimiento analítico-hermenéutico heideggeriano: posibilidad metodológica para la investigación en enfermería Analytical movement - Heideggerian hermeneutics: methodological possibility for nursing research

    Directory of Open Access Journals (Sweden)

    Cristiane Cardoso de Paula

    2012-01-01

    Full Text Available Objetivou-se descrever o movimento analítico-hermenêutico aplicado em investigações com a criança que tem a Síndrome da Imunodeficiência Adquirida por transmissão vertical e que está em transição da infância para a adolescência, sustentada no referencial teórico-filosófico-metodológico heideggeriano. Os modos de condução da etapa de análise são descritos, desde o questionamento de pesquisa até a análise interpretativa dos significados, culminando na proposição das possibilidades assistenciais no cuidado à população do estudo. Este referencial mostra-se coerente com os princípios humanísticos da Enfermagem e com seu objeto de estudo e contribui para aproximação entre a teoria e a prática do cuidado, por meio da compreensão dos fenômenos que permeiam o vivido de saúde das pessoas, das famílias e da sociedade.Este estudio tuvo como objetivos describir el movimiento analítico-hermenéutico aplicado en investigaciones con un niño que tiene el Síndrome de la Inmunodeficiencia Adquirida por transmisión vertical y que está en transición de la infancia hacia la adolescencia, sustentada en el referencial teórico-filosófico-metodológico heideggeriano. Los modos de conducción de la etapa de análisis son descritos, desde el cuestionamiento de investigación hasta el análisis interpretativo de los significados, culminando en la proposición de las posibilidades asistenciales en el cuidado a la población del estudio. Este referencial se mostró coherente con los principios humanísticos de la Enfermería y con su objeto de estudio y contribuye para la aproximación entre la teoría y la práctica del cuidado, por medio de la comprensión de los fenómenos que permean lo vivido de salud de las personas, las familias y la sociedad.The objective was to describe the analytic-hermeneutic movement applied in investigations with the child who had Acquired Immunodeficiency Syndrome by vertical transmission, and who is

  11. Anal high-risk human papillomavirus infection and high-grade anal intraepithelial neoplasia detected in women and heterosexual men infected with human immunodeficiency virus

    Directory of Open Access Journals (Sweden)

    Gandra S

    2015-01-01

    Full Text Available Sumanth Gandra, Aline Azar, Mireya WessolosskyDivision of Infectious Disease and Immunology, University of Massachusetts Medical School, Worcester, MA, USABackground: Although anal high-risk human papillomavirus (HR-HPV infection and anal cytological abnormalities are highly prevalent among human immunodeficiency virus (HIV-infected men who have sex with men (MSM, there are insufficient data on these abnormalities among HIV-infected heterosexual men (HSM and women. In this study, we evaluated the prevalence of anal HR-HPV, cytological abnormalities, and performance of these screening tests in detecting high-grade anal intraepithelial neoplasia (AIN2+ among our cohort of HIV-infected MSM and non-MSM (HSM and women.Methods: A single-center, retrospective cohort study was conducted with HIV-infected individuals who underwent anal cancer screening with anal cytology and HR-HPV testing from January 2011 to January 31, 2013.Results: Screening of 221 HIV-infected individuals for both HR-HPV and anal cytology showed the presence of HR-HPV in 54% (abnormal anal cytology 48% of MSM, 28% (abnormal anal cytology 28% of HSM, and 27% (abnormal anal cytology 34% of women. Among 117 (53% individuals with abnormal results (HR-HPV-positive and/or cytology was atypical squamous cells of undetermined significance or above, 67 underwent high resolution anoscopy. Of these 67 individuals, 22 individuals had AIN2+ (17 MSM, four women, and one HSM. HR-HPV correlated better with AIN2+ than with anal cytology on biopsy in both MSM (r=0.29 versus r=0.10; P=0.05 versus P=0.49 and non-MSM (r=0.36 versus r=-0.34; P=0.08 versus P=0.09.Conclusion: Given the presence of AIN2+ in screened HIV-infected HSM and women, routine anal cancer screening in all HIV-infected individuals should be considered. HR-HPV merits further evaluation for anal cancer screening among non-MSM.Keywords: human immunodeficiency virus, anal human papillomavirus, heterosexual men, women, anal cancer

  12. Anal Itching

    Science.gov (United States)

    ... has many possible causes, such as skin problems, hemorrhoids, and washing too much or not enough. If ... dermatitis. Other medical conditions. These include chronic diarrhea, hemorrhoids, anal tumors and diseases that affect the whole ...

  13. Importância da aplicação de critérios morfológicos não-clássicos para o diagnóstico citológico de papilomavírus humano

    Directory of Open Access Journals (Sweden)

    Jordão Andréa Valderrama

    2003-01-01

    Full Text Available Existe atualmente grande preocupação com a melhoria no diagnóstico citológico de HPV através da introdução de critérios não-clássicos para o seu diagnóstico, tendo em vista a elevada freqüência da infecção viral, bem como o seu potencial carcinogênico. O presente trabalho objetivou uma releitura de 65 casos positivos para HPV por captura híbrida (cujos critérios inicialmente utilizados foram apenas os clássicos, e a introdução dos critérios não-clássicos. Os critérios citológicos mais observados foram os não-clássicos, sendo bi ou multinucleação o mais freqüente, com n = 39 (60%, seguido de halo perinuclear, com n = 37 (56,9% e disceratose leve e núcleo hipercromático, ambos com n = 32 (49,2%. Para NIC I predominou a disceratose, com n = 20 (100%; para inflamação, disceratose leve, com n = 35 (87,5% e para Ascus e Agus, halo perinuclear, núcleo hipercromático, células gigantes e bi ou multinucleação, todos com n = 4 (100%. Todos os 20 casos de NIC I, dez dos 40 casos de inflamação e todos os casos de Ascus (n = 1 e Agus (n = 3 foram considerados positivos para HPV com a utilização de critérios não-clássicos, passando a 52,3% dos casos positivos pela captura híbrida a apresentarem a infecção viral pela citologia, em detrimento de 23,1% só com os critérios clássicos. Um número razoável de amostras diagnosticadas inicialmente como inflamatórias passaram a apresentar a infecção viral, podendo representar a variedade subclínica do vírus, para a qual o diagnóstico molecular apresentou-se como melhor metodologia. A utilização de critérios não-clássicos de HPV pela citologia parece muito importante para maximizar a eficiência diagnóstica.

  14. Early discharge after external anal sphincter repair

    DEFF Research Database (Denmark)

    Rosenberg, J; Kehlet, H

    1999-01-01

    PURPOSE: The aim of this study was to describe an accelerated-stay program for repair of the external anal sphincter. METHODS: Twenty consecutive patients undergoing overlapping repair of the external anal sphincter were included in the study. Effect parameters were length of hospitalization....... CONCLUSION: We have described a safe accelerated-stay program (24 to 48 hours) for overlapping repair of external anal sphincter....

  15. Should anorectal ultrasonography be included as a diagnostic tool for chronic anal pain? ¿Se debe incluir la ecografía rectoanal como prueba diagnóstica del dolor anal crónico?

    Directory of Open Access Journals (Sweden)

    M. J. García-Montes

    2010-01-01

    excluyeron del estudio pacientes con fisura anal y con hemorroides internas de cualquier grado, enfermedad supurativa perianal y cirugía pélvica. Se utilizó un ecógrafo ALOKA ProSound SSD-4000 al que se conectó un transductor radial multifrecuencia ASU-67 (7,5 y 10 MHz. Resultados: un paciente no toleró la exploración. En 8 pacientes (20% de los casos estudiados se detectaron alteraciones en el estudio ecográfico: en 4 pacientes, 10% de los casos (1 hombre y 3 mujeres, hipertrofia del esfínter anal interno (EAI y en 5 pacientes (4 mujeres y 1 hombre rotura del complejo esfinteriano. En una mujer se observó rotura de EAI en canal alto e hipertrofia del mismo en el canal medio. Conclusiones: la ecografía rectoanal es una prueba sencilla, económica y útil para el estudio de la patología rectoanal. Si bien, en la mayoría de los casos estudiados no se han detectado lesiones en el canal anal ni en la pared rectal, en un porcentaje no desdeñable de pacientes hemos observado engrosamiento del EAI, que podría considerarse posible causa del dolor anal. Por tanto, consideramos que la ecografía rectoanal debe ser incluida en el estudio del dolor anal crónico idiopático.

  16. Mode of delivery after obstetric anal sphincter injury.

    Science.gov (United States)

    Karmarkar, Roopali; Bhide, Alka; Digesu, Alex; Khullar, Vik; Fernando, Ruwan

    2015-11-01

    To assess the effect of vaginal delivery and caesarean section on faecal symptoms and structure and function of anal sphincter in women who sustained obstetric anal sphincter injuries (OASIS) in their previous pregnancy and were advised about the mode of delivery based on faecal incontinence symptoms, anal manometry and endoanal ultrasound. It is a descriptive study on a cohort of women who had OASIS from 2006 to 2013. They were assessed after OASIS and during subsequent pregnancy with a questionnaire, endoanal ultrasound and anal manometry. Vaginal delivery was recommended to asymptomatic women with normal investigations. Elective caesarean section was recommended to women with faecal symptoms, anal sphincter defects of more than 30° or low resting or incremental anal pressures. All women were reassessed after subsequent delivery. Fifty women who had pregnancies after OASIS, were seen after OASIS, during subsequent pregnancy and after the second delivery. 15 women had faecal symptoms after OASIS. The external, internal and combined anal sphincter defects were seen in 13, 11 and 9 women respectively. Low resting and incremental pressure were seen in 15 and 11 women respectively. Caesarean section was done in 22 women and 28 women delivered vaginally. Worsening of faecal symptoms and reduction in anal pressures were not observed in planned vaginal delivery or elective caesarean section groups. Faecal symptoms were worse with reduced anal pressures in three women from the planned caesarean section group. One of the women had a vaginal delivery and two women had emergency caesarean section at 7cm and 10cm dilatation. There were no new sphincter defects or recurrent OASIS in any of the women in the study group. Decision about the mode of delivery of pregnancy after OASIS based on symptoms, anal manometry and endoanal ultrasound helps in preserving the anal sphincter function and avoiding unnecessary caesarean sections. Further follow-up of these patients is essential

  17. La introducción de la actividad dirigida en la enseñanza de la electrónica analógica para estudiantes del grado de Electrónica Industrial y Automática

    OpenAIRE

    Martínez García, Herminio; Domingo Peña, Joan; Grau Saldes, Antoni

    2012-01-01

    A pesar del indiscutible avance y desarrollo de la electrónica y los sistemas digitales, es bien cierto que la electrónica analógica, y especial aquélla que incide directamente en el amplificador operacional realimentado en tensión y sus aplicaciones, es uno de los pilares fundamentales sobre los que se asientan los modernos planes de estudio para estudiantes de electrónica en diferentes ámbitos de la ingeniería (industrial, telecomunicaciones, etc.). Dentro de la oferta de ...

  18. Comparación analítica de los métodos ultravioleta selectivo y test spectroquant 1.14773.0001 en la determinación del ión nitrato en aguas tratadas

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Severiche Sierra

    2014-01-01

    Full Text Available La meta de un análisis químico de aguas es generar resultados correctos y confiables, siendo la comparación de métodos uno de los aspectos más importantes para conseguir este propósito; además, constituye un factor clave para la prestación de servicios analíticos. La determinación de ion nitrato en aguas es una de las metodologías analíticas más discutidas que se conoce en el ámbito científico técnico del análisis de aguas, dado los procedimientos complejos con los que se cuentan, la gran posibilidad de encontrar sustancias interferentes y los rangos de concentración limitados que presentan las diferentes técnicas. En la presente investigación, se hizo el cotejo de dos métodos analíticos, el UV selectivo y el test spectroquant 1.14773.0001, para la determinación del ión nitrato en aguas tratadas. El objetivo fue confirmar correctamente la aplicación de los métodos para el análisis de aguas; las muestras analizadas se tomaron de la red de agua potable de la ciudad de Cartagena de Indias, donde para ambos métodos se encontraron resultados satisfactorios en precisión y exactitud.

  19. Desarrollo de metodología analítica para la determinación de contaminantes basada en el cálculo por deconvolución de perfiles isotópicos

    OpenAIRE

    Fabregat Cabello, Neus

    2015-01-01

    El análisis por dilución isotópica y espectrometría de masas (IDMS) es reconocido como una de las técnicas más potentes para obtener resultados altamente fiables y de gran calidad metrológica en el campo de la química analítica. IDMS destaca como la forma de cuantificación más adecuada ante determinaciones realizadas en matrices de alta complejidad, siendo por ello ampliamente utilizado durante el acoplamiento de las técnicas de cromatografía a la espectrometría de masas. Además IDMS también ...

  20. Botulinum toxin A injection for chronic anal fissures and anal sphincter spasm improves quality of life in recessive dystrophic epidermolysis bullosa

    Directory of Open Access Journals (Sweden)

    Cassandra Chaptini, MBBS

    2015-12-01

    Full Text Available We report a 20-year-old female with generalized, severe, recessive dystrophic epidermolysis bullosa who developed secondary chronic anal fissures. This resulted in anal sphincter spasm and severe, disabling pain. She was treated with five botulinum toxin A injections into the internal anal sphincter over a period of 2 years and gained marked improvement in her symptoms. This case demonstrates the successful use of botulinum toxin A injections to relieve anal sphincter spasm and fissuring, with long-term improvement.

  1. Analítica o evocadora: el debate olvidado de la autoetnografía

    Directory of Open Access Journals (Sweden)

    Xavier Montagud Mayor

    2016-07-01

    Full Text Available Existe la necesidad de una estrategia metodológica eficaz para sostener la investigación sobre la práctica profesional de los servicios sociales. La oposición entre el trabajo autoetnográfico de Carolyn ELLIS y Arthur BOCHNER (2000, 2006 y la propuesta analítica de Leon ANDERSON sirven como una lente a través de la cual explorar los aspectos clave de esta discusión. Mientras ELLIS y BOCHNER rechazan cualquier intento de abstracción o sistematización teórica, ANDERSON pretende tender puentes entre la tradición etnográfica y las formas emergentes de narrativa personal. Después de revisar la literatura autoetnográfica, concluyo que si bien la autoetnografía evocadora parece gozar del apoyo mayoritario en este campo, podría ser enriquecida por el enfoque analítico. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1603124

  2. Anal intraepithelial neoplasia in HIV+ men

    NARCIS (Netherlands)

    Richel, O.

    2014-01-01

    In this thesis we investigated several aspects of anal intraepithelial neoplasia (AIN) in HIV+ men who have sex with men (MSM). This condition has gained clinical interest because of the impressive increase of the anal cancer incidence in HIV+ MSM since the introduction of combination antiretroviral

  3. Electrocautery Superior to Topical Treatments for Precancerous Anal Lesions

    Science.gov (United States)

    ... Professional Anal Cancer Treatment Anal Cancer Prevention Research Electrocautery Superior to Topical Treatments for Precancerous Anal Lesions ... randomized clinical trial conducted in Amsterdam suggest that electrocautery is better than topical imiquimod or fluorouracil at ...

  4. La neuromodulación en el tratamiento de la incontinencia anal

    OpenAIRE

    Ortega López, Mario

    2016-01-01

    El manejo terapéutico de la incontinencia anal es uno de los problemas más complejos de la coloproctología y siempre debe ser individualizado en función de las peculiaridades de cada paciente. La variedad de los factores implicados exige un análisis meticuloso. A diferencia de lo que ocurre en otras patologías, el objetivo no siempre es la curación, sino mejorar la calidad de vida lo máximo posible. La esfinteroplastia hasta hace poco era la opción quirúrgica principal para pacientes con lesi...

  5. Neuronal hyperplasia in the anal canal

    DEFF Research Database (Denmark)

    Fenger, C; Schrøder, H D

    1990-01-01

    In a consecutive series of minor surgical specimens from the anal canal, neuronal hyperplasia was found in nine of 56 haemorrhoidectomy specimens and in four of 23 fibrous polyps. In an additional series of 14 resections of the anal canal, neuronal hyperplasia was present in six cases, of which f...

  6. Pressões retais e anais em primigestas ao defecar Rectal and anal straining pressures in primigravidae

    Directory of Open Access Journals (Sweden)

    Wilmar Artur Klug

    2008-04-01

    Full Text Available OBJETIVO: O estudo teve o objetivo de avaliar as mudanças nas pressões do reto e ânus de primigestas ao simular defecação. MÉTODOS: Selecionamos 60 mulheres no Ambulatório de Pré-natal e no de Cirurgia da Santa Casa de São Paulo. Estas formaram quatro grupos de 15: a grupo-controle: nuligestas; b primigestas no 1º trimestre; c primigestas no 2º trimestre; d primigestas no 3º trimestre. Em todas realizamos manometria retal e anal e as seguintes medidas: a pressão retal em repouso; b pressão retal ao esforço de defecação; c pressão anal à defecação. RESULTADOS: Observamos que as pressões retais ao esforço de defecar aumentam em grávidas em menor proporção que nas nuligestas; estas pressões caíram de 53,9 ± 17,9 em nuligestas para 36,3± 19,6, 38,1 ± 16,2 e 30,5 ± 17,0 nos três trimestres. As pressões anais de defecação foram maiores nas nuligestas (46,9± 17,6 que nas gestantes, respectivamente 37,5 ± 15,5, 32,1 ± 6,2 e 32,9 ± 8,7. Houve maior queda das pressões anais na gestação mais avançada, que compensa a dificuldade para elevar a pressão intra-retal de esforço. CONCLUSÃO: A gravidez altera as pressões retais e anais ao simular defecação, diminuindo- as, mas de forma a compensarem-se mutuamente.OBJECTIVE: This study intended to evaluate rectal and anal straining pressures in primigravidae, at simulated defecation. METHODS: The present study is based on 60 women from de Antenatal Care of Santa Casa de Misericórdia - São Paulo. Patients were divided into four groups of 15: a Control group: nuligravidae; b 1st trimester primigravidae; c 2nd trimester primigravidae; d 3rd trimester primigravidae. All patients underwent rectal and anal measurements to obtain: a Resting rectal pressure; b Straining rectal pressure; c Minimal straining anal pressure. RESULTS: Data was analyzed using statistical methods and reached, the same results: it was observed that the straining rectal pressure decreased from 53

  7. Actualización, adaptación y evolución del sistema de automedidas de receptores analógicos de TV

    OpenAIRE

    Domínguez González, Raúl

    2016-01-01

    Actualización, adaptación y evolución de un sistema automático de medidas para receptores analógicos de TV. Aumentando la calidad de las medidas, así como reduciendo el tiempo de medida y el coste de diseño. El proyecto consiste en la elaboración de un programa en entorno LabView para realizar medidas automáticas de sintonizadores de TV para la empresa Sony. Partimos de un programa básico de medidas semi-automáticas con la idea de desarrollar los siguientes objetivos: Control remoto de la ...

  8. Anal Cancer Treatment (PDQ®)—Patient Version

    Science.gov (United States)

    Anal cancer is uncommon, but often curable with treatment. Treatments include radiation therapy, chemotherapy, and surgery. Get detailed information about anal cancer including risk factors, symptoms, diagnosis, prognosis, and treatment in this expert-reviewed summary.

  9. Diagnostic methods for prevention of anal cancer and characteristics of anal lesions caused by HPV in men with HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Araiz Cajueiro Carneiro Pereira

    Full Text Available Abnormalities found with anuscopy under colposcopic vision, anal cytology and anal biopsy were evaluated in 21 men with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS at the Federal University of Pernambuco Hospital in Brazil. Mean age was 38.4 ± 6.0 years, and mean time of HIV infection was 8.3 ± 5.1 years; 95.2% of the patients had been on highly active antiretroviral therapy (HAART for an average of 6.6 ± 4.5 years. Mean CD4+ cell count was 482.2 ± 173.75 cells/mm³, and 80.9% presented a HIV viral load of < 5,000 copies/mL. Reported sexual preference was 52.4% homosexuals, 28.6% bisexuals, and 19.0%heterosexuals; 81% reported having had receptive anal intercourse and 61.9% reported more than 10 sexual partners of the same sex. Results of anuscopy under colposcopic vision revealed 17 (81.0% low-grade lesions and/or condylomata or micropapillae and four (19.0% high-grade lesions with or without condylomata. Among the 21 anal cytology examinations, seven (33.3% revealed low-grade squamous intraepithelial lesions (LSIL; three (14.3% presented atypical squamous cells of undetermined significance (ASCUS and 11 (52.4% were normal. Seventeen patients were submitted to anal biopsy with the following findings: three patients (17.6% with normal epithelium, one (5.9% with infection by HPV, three (17.6% with condylomatas, two (11.8% with AIN 1, four (23.6% with AIN 2, three (17.6% with AIN 3, and one (5.9% with PAIN 2. Anuscopy under colposcopic vision was found to be useful for detecting anal lesions and for guiding anal biopsies. Anal cytology was less useful, as it underestimated the frequency of lesions.

  10. Rastreamento anterior para câncer de colo uterino em mulheres com alterações citológicas ou histológicas Previous screening for cervical cancer among women with cytological and histological abnormalities

    Directory of Open Access Journals (Sweden)

    C Rama

    2008-06-01

    Full Text Available OBJETIVO: Analisar a história de rastreamento citológico anterior em mulheres que apresentaram alterações citológicas e confirmação histológica para câncer cervical. MÉTODOS: Estudo transversal com 5.485 mulheres (15-65 anos que se submeteram a rastreamento para o câncer cervical entre fevereiro de 2002 a março de 2003, em São Paulo e Campinas, SP. Aplicou-se questionário comportamental e foi feita a coleta da citologia oncológica convencional ou em base líquida. Para as participantes com alterações citológicas indicou-se colposcopia e, nos casos anormais, procedeu-se à biópsia cervical. Para investigar a associação entre as variáveis qualitativas e o resultado da citologia, utilizou-se o teste de qui-quadrado de Pearson com nível de significância de 5%. RESULTADOS: Dentre os resultados citológicos, 354 (6,4% foram anormais, detectando-se 41 lesões intra-epitelial escamosa de alto grau e três carcinomas; em 92,6% revelaram-se normais. De 289 colposcopias realizadas, 145 (50,2% apresentaram alterações. Dentre as biópsias cervicais foram encontrados 14 casos de neoplasia intra-epitelial cervical grau 3 e quatro carcinomas. Referiram ter realizado exame citológico prévio: 100% das mulheres com citologia compatível com carcinoma, 97,6% das que apresentaram lesões intra-epiteliais de alto grau, 100% daquelas com confirmação histológica de carcinoma cervical, e 92,9% das mulheres com neoplasia intra-epitelial cervical grau 3. A realização de citologia anterior em período inferior a três anos foi referida, respectivamente, por 86,5% e 92,8% dessas participantes com alterações citológicas e histológicas. CONCLUSÕES: Entre as mulheres que apresentaram confirmação histológica de neoplasia intra-epitelial cervical grau 3 ou carcinoma e aquelas que não apresentaram alterações histológicas não houve diferença estatisticamente significante do número de exames citológicos realizados, bem como o tempo

  11. Nodo sensor para la medida ambiental de CO2, temperatura y humedad

    OpenAIRE

    Jara Burgos, Marcos

    2007-01-01

    En este documento se describe el diseño y la implementación de un nodo sen-sor para la medida ambiental del nivel de CO2, la temperatura y la humedad relativa. El sistema se basa en un interfaz directo sensor a microcontrolador para las medidas de temperatura y humedad relativa, mientras que para el sensor de CO2 se basa en una conversión analógica digital. El sistema utiliza un sensor resistivo para medir la temperatura, un sensor capacitivo para medir la humedad relativa y un sensor...

  12. Carcinoma epidermoide del margen anal contra calidad de vida

    Directory of Open Access Journals (Sweden)

    Miguel A Reyes Argudín

    Full Text Available La calidad de vida de los pacientes debe tenerse en cuenta. Esta representa el resultado final de la actuación médica desde la perspectiva del paciente. En ocasiones solo nos basamos en este criterio para tomar decisiones terapéuticas ante determinadas enfermedades, como el carcinoma epidermoide de margen anal en estadío terminal. El tratamiento y conducta con fines paliativos tiene como objetivo mejorar la calidad de vida de estas personas. Presentamos el caso de paciente varón de 48 años de edad que acude a consulta por presentar lesión en el ano que no le permitía sentarse y después de realizársele todo el estudio necesario para determinar su diagnóstico definitivo (carcinoma epidermoide de ano evaluarlo y determinar el tratamiento requerido para el grado de la enfermedad, nos percatamos que el tratamiento radical no cambiaba la evolución de su estado y se decide tratamiento paliativo para mejorar la calidad de vida. En ocasiones acuden a consulta pacientes que al culminar su estudio, obtienen el diagnóstico de una enfermedad avanzada y es, a partir de este momento, que nuestro pensamiento médico debe cambiar y encaminar nuestros esfuerzos a mejorar la calidad de vida y no llevarlos a un final tormentoso con el objetivo de revertir la evolución de una enfermedad que no tiene regresión.

  13. Determinação analítica da performance da irrigação por sulcos abertos e em declive

    Directory of Open Access Journals (Sweden)

    Aristides Fraga Lima Filho

    2015-06-01

    Full Text Available Uma solução analítica foi desenvolvida, para avaliar sulcos abertos e em declive, com base na teoria de Balanço de Volume de Walker e Skogerboe (1987. Essa metodologia é capaz de obter, matematicamente, a performance de um sistema, dispensando a construção de gráficos que definem os parâmetros de avaliação. A solução matemática é baseada no ajuste de equações ao modelo potencial, no cálculo das áreas sob as curvas definidas no ajuste e na intercessão de curvas, obtendo-se, assim, a performance de sistemas de irrigação por sulcos abertos e em declive. Para validação da metodologia, foi realizado um experimento de campo, na Fazenda Experimental da Universidade Federal do Ceará, situada no município de Pentecoste, pertencente ao Centro de Ciências Agrárias. Os dados de campo foram submetidos à análise pelas duas metodologias. Os resultados mostraram que a metodologia analítica pode ser usada para avaliar a irrigação por sulcos abertos e em declive.

  14. Hallazgos ecográficos en la proctalgia espontánea y postoperatoria Ultrasound findings in spontaneous and postoperative anal pain

    Directory of Open Access Journals (Sweden)

    I. Pascual

    2008-12-01

    Full Text Available Objetivo: valorar la utilidad de la ecografía endoanal como prueba de imagen para identificar la causa del dolor anal en los pacientes que presentan proctalgia idiopática o dolor postoperatorio y analizar cuáles son sus causas más frecuentes. Métodos: se realiza un estudio descriptivo de los hallazgos encontrados en las ecografías endoanales de pacientes con dolor anal en los últimos seis años. Todas las ecografías se llevaron a cabo con un ecógrafo B&K (Cheetah 2003, B&K Medical, Gentofte, Denmark con sonda endoanal de 7 MHz. Resultados: se estudiaron noventa y cinco casos de proctalgia mediante ecografía endoanal. Sesenta y siete correspondieron a pacientes con una cirugía previa perineal o pélvica tras la cual comenzó el dolor anal: 48 habían sido intervenidos de fisura anal, 12 de hemorroidectomía, 4 de episiotomía, 2 de fístula y 1 de prostatectomía. El hallazgo más frecuente tras la cirugía de fisura anal fue la presencia de una esfinterotomía incompleta. Entre los veintiocho pacientes sin cirugía previa, el 57,14% presentaba hipertrofia del esfínter anal interno como única alteración ecográfica. Conclusiones: los pacientes con proctalgia espontánea y postoperatoria pueden ser estudiados mediante ecografía endoanal ya que el uso de la sonda no impide completar la exploración. Con esta prueba se encontró una causa del dolor en el 81,93% de los casos. La hipertrofia del esfínter anal interno aislada es el hallazgo ecográfico más frecuente asociado a proctalgia espontánea.Objective: to assess the use of endoanal ultrasounds to identify anal pain etiology in patients with either spontaneous or postoperative pain, and to review the most frequent causes. Methods: a descriptive study of ultrasound findings in patients with anal pain during the last six years was performed. All ultrasound scans were performed using a B&K Diagnostic Ultrasound System (Cheetah 2003, B&K Medical, Gentofte, Denmark with a 7-MHz

  15. Ettevõtte konkurentsieelis inimeste analüüsi abil / Mait Raava

    Index Scriptorium Estoniae

    Raava, Mait

    2015-01-01

    Ettevõtte töötajate analüüsimisest, analüütika tulemuste rakendamisest juhtivates ettevõttes. Viiest sambast, millel põhineb inimeste analüüsi edukas rakendamine, analüütika rakendamise etapid

  16. Correlação entre digestibilidade in vitro da parede celular e três métodos analíticos para a avaliação quantitativa da lignina

    Directory of Open Access Journals (Sweden)

    Fukushima Romualdo Shigueo

    2001-01-01

    Full Text Available Três métodos analíticos para a estimativa do conteúdo de lignina na parede celular, em diferentes frações vegetais, de sete espécies forrageiras, foram comparados. Os métodos empregados foram: lignina em detergente ácido (LDA, lignina permanganato de potássio e lignina solúvel em brometo de acetila (LSBA. Para o método espectrofotométrico (LSBA, foi utilizado como padrão de referência a lignina extraída da planta através do próprio reagente brometo de acetila. Não houve concordância entre os três métodos, sendo que, no geral, o método da LSBA mostrou valores mais elevados que os outros dois métodos e o método da LDA, menores valores. Na maioria das amostras, a concentração de lignina foi superior para a parede celular oriunda de planta madura em relação àquela proveniente de planta jovem, assim como o teor de lignina foi maior para a fração colmo em relação à fração folha. As leguminosas tenderam a apresentar teores mais elevados de lignina pelos métodos gravimétricos que as gramíneas, independentemente do estádio de maturidade. Entretanto, essa tendência não foi observada para o método LSBA, particularmente no estádio maduro. Preparações de parede celular foram fermentadas in vitro e os dados correlacionados com os teores de lignina obtidos por intermédio dos três métodos. O método LSBA exibiu os menores coeficientes de correlação, para a maioria das amostras, sugerindo que este método deve ser melhor avaliado.

  17. Validación del método analítico para la cuantificación de bacitracina Validation of the analytical method to quantify the bacitracine

    Directory of Open Access Journals (Sweden)

    Carolina Velandia-Castellanos

    2011-06-01

    Full Text Available Se desarrolló y validó un método analítico para la determinación cuantitativa de bacitracina zinc al 15 % y bacitracina metilen disalicilato al 11 %, por el método de cilindro en placa (difusión en agar, con el fin de ser usado en el control de calidad de las materias primas y productos farmacéuticos. Se evaluaron los parámetros de especificidad, selectividad, linealidad del sistema, y del método, exactitud, límite de cuantificación y precisión. Mediante el diseño experimental y la evaluación estadística de los resultados, se demostró que el método analítico es específico, selectivo, lineal, preciso (CVAn analytical method was developed and validated for quantitative determination of 15 % zinc bacitracine and 11 % disalicylate methylene-bacitracine by the plate-cylinder method (agar diffusion to be used in quality control of raw products and pharmaceutical products. Specificity, selectivity, system and method linearity, accuracy, quantification and precision parameters were assessed. By the experimental design and the statistic evaluation of results, it was demonstrated that the analytical method is specific, selective, linear, precise (CV< 5 % and exact (bias < 3 %, Gexp< Gtab< t exp< t tab during the study concentrations. The quantification and detection limit was of 0.02 and 0.005 Ul/mL, respectively. The analytical performance characteristics fulfill the requirement for the proposal analytical implementation.

  18. Diagnóstico do anismus através dos exames de fisiologia anal Diagnosis of the anismus through the anorectal physiology tests

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Prolungatti Cesar

    2009-06-01

    Full Text Available Dentre as causas de defecação obstruída, a disfunção do pubo-retal ou anismus é a mais frequente e o seu diagnóstico é feito com maior frequência através de eletromiografia , considerado como o melhor exame para o diagnóstico desta afecção. O objetivo deste trabalho é verificar a influência do anismus ou contração paradoxal do pubo-retal nos exames de fisiologia anal. Para este trabalho foram estudados 40 pacientes com diagnóstico de defecação obstruída e separados em dois grupos: com e sem anismus. Todos os pacientes foram submetidos aos exames de manometria, sensibilidade retal, eletromiografia, latência do nervo pudendo e proctografia com a finalidade de observar a influência da presença de anismus nos resultados de exames de fisiologia anal. Não observamos diferenças entre os dois grupos em relação aos exames realizados, exceto na eletromiografia que é considerada padrão ouro e no ângulo ano retal na proctografia em que nos pacientes com anismus foi significantemente menor. CONCLUSÃO: a presença de anismus interferiu nos resultados dos exames de fisiologia anal apenas na eletromiografia, considerado padrão ouro para esse diagnóstico.Amongst the causes of outlet obstruction, the anismus is most frequent and its diagnosis is made more frequently through electromyografy, considered as optimum examination for this diagnosis. The objective of this work is to verify the influence of anismus in the examinations of anal physiology. For this work 40 patients with diagnosis of outlet obstruction were separate in two groups had been studied: with and without anismus. All of the patients were submitted to manometric exams, rectal sensibility, electromyography, pudendal latency and defecography with the purpose of serving which ones exams would be important in the presence or not of the anismus. We didn´t observe differences between the two groups in relation to the carried through examinations, except in the

  19. Estratégia analítica para determinação de nitrito e amônia empregando spot test e análise de imagem digital

    Directory of Open Access Journals (Sweden)

    J. L. O. Santos

    2014-11-01

    Full Text Available Neste trabalho é proposta uma estratégia simples para determinação simultânea de nitrito e amônia empregando spot test e imagem digital. O método é baseado na reação do nitrito com a sulfanilamida, formando um cátion de diazônio que posteriormente é acoplado ao dicloreto de N-(1-nafitil etilenodiamina formando uma diazo composto de coloração rósea. A determinação da amônia foi realizada empregando a reação de berthelot modificada, onde o íon amônio em presença de salicilato, nitroprussiato e hipoclorito reage formando um composto de coloração verde. Os sinais analíticos foram obtidos a partir das intensidades de coloração por imagem digital no spot test do produto da reação. Após otimizações do sistema de análise e detecção, as seguintes figuras de mérito foram obtidas: concentração linear entre 0,2 a 10,0 mg L-1 para nitrito e 1,0 a 10,0 mg L-1 para a amônia. Os limites de detecção para o nitrito e amônia foram 0,05 mg L-1 e 0,27 mg L-1, respectivamente. A estratégia proposta foi aplicada com sucesso na determinação de nitrito e amônia em amostras de água subterrânea da zona urbana da cidade de Barreiras-Ba.

  20. Nocturnal faecal soiling and anal masturbation.

    Science.gov (United States)

    Clark, A F; Tayler, P J; Bhate, S R

    1990-01-01

    Two cases of late onset faecal soiling as a result of anal masturbation in children who were neither mentally handicapped nor psychotic were studied. The role of soiling in aiding the young person and his family to avoid separating and maturing is highlighted. We suggest that the association of anal masturbation and resistant nocturnal soiling may be unrecognised. PMID:2270946

  1. Vulnerabilidad y riesgo como conceptos indisociables para el estudio del impacto del cambio climático en la salud

    Directory of Open Access Journals (Sweden)

    Rolando Enrique Díaz Caravantes

    2018-09-01

    Full Text Available En diversas investigaciones, los conceptos de vulnerabilidad y riesgo se han estudiado por separado, como si no existiera una relación entre ellos. De aquí emerge nuestro objetivo de examinar las ventajas analíticas de estudiar ambos dentro de un mismo marco conceptual. Para ello, se revisaron definiciones de vulnerabilidad y riesgo utilizadas en distintos campos como el social, la salud pública y el impacto del clima y desastres. Las implicaciones analíticas se ilustran mediante el caso de las altas temperaturas en el noroeste de México. En los resultados se hace patente que la disociación entre vulnerabilidad y riesgo conduce a que se minusvaloren las capacidades analíticas de ambos conceptos. En tanto su integración proporciona herramientas metodológicas para desarrollar acciones precautorias ante las altas temperaturas, como la identificación de los grupos vulnerables en un entorno geográfico específico y, a su vez, posibles caminos para reducir la exposición y la vulnerabilidad ante el cambio climático.

  2. Complex anal fistulas: plug or flap?

    Science.gov (United States)

    Muhlmann, Mark D; Hayes, Julian L; Merrie, Arend E H; Parry, Bryan R; Bissett, Ian P

    2011-10-01

    Rectal mucosal advancement flaps (RMAF) and fistula plugs (FP) are techniques used to manage complex anal fistulas. The purpose of this study was to review and compare the results of these methods of repair. A retrospective review of all complex anal fistulas treated by either a RMAF or a FP at Auckland City Hospital from 2004 to 2008. Comparisons were made in terms of successful healing rates, time to failure and the use of magnetic resonance imaging. Overall, 70 operations were performed on 55 patients (55.7% male). The mean age was 44.9 years. Twenty-one patients (30%) had had at least one previous unsuccessful repair. Indications for repair included 57 high cryptoglandular anal (81%), 4 Crohn's anal (6%), 7 rectovaginal (10%), 1 rectourethral (1%) and 1 pouch-vaginal fistula (1%). All patients were followed up with a mean of 4.5 months. Forty-eight RMAFs (69% of total) were performed with 16 successful repairs (33%). Twenty-two FPs (31% of total) were performed with 7 successful repairs (32%, P = 0.9). In failed repairs, there was no difference in terms of mean time to failure (RMAF 4.8 months versus FP 4.1 months, P = 0.62). Magnetic resonance imaging was performed in 21 patients (37%) before the repair. The success rate in these patients was 20%. The results of treatment of complex anal fistulas are disappointing. The choice of operation of either a RMAF or a FP did not alter the poor healing rates of about one third of patients in each group.

  3. Environmental scan of anal cancer screening practices: worldwide survey results

    International Nuclear Information System (INIS)

    Patel, Jigisha; Salit, Irving E; Berry, Michael J; Pokomandy, Alexandra de; Nathan, Mayura; Fishman, Fred; Palefsky, Joel; Tinmouth, Jill

    2014-01-01

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty-three percent of clinics require abnormal anal cytology prior to performing high-resolution anoscopy (HRA) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA. Internal high-grade anal intraepithelial neoplasia (AIN) is most often treated with infrared coagulation (61%), whereas external high-grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening

  4. Vascularized anal autotransplantation model in rats: preliminary report.

    Science.gov (United States)

    Araki, J; Mihara, M; Narushima, M; Iida, T; Sato, T; Koshima, I

    2011-11-01

    Ostomy has served as an effective surgery for various anorectal disfunctions. However, it must also be noted that those patients suffered greatly from stresses caused by their stoma. Many alternative therapies have been developed, but none have solved this critical issue. Meanwhile, due to the improvements in operative methods and immunosuppressive therapy, allotranplantation has gained great popularity in recent years. Therefore, we began development of an anal transplantation model. The operation was performed in six adult Wistar rats that were divided into two groups. Group 1 underwent vascular anastomoses, while group 2 did not Group 1 grafts survived, fully recovering anal function. However, many of the group 2 grafts did not survive; those that did survive showed major defects in their anus, never recovering anal function. We succeeded in establishing the rat anal transplantation model utilizing super-microsurgery. While research in anal transplantation was behind compared to that in other fields, we hope that this model will bring significant possibilities for the future. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Prevalence of anal cytological abnormalities in women with positive cervical cytology.

    Science.gov (United States)

    Calore, Edenilson E; Giaccio, Claudia Maria Serafim; Nadal, Sidney R

    2011-05-01

    The objective of this study was to estimate the prevalence of cytological abnormalities of the anal mucosa in women with positive cervical cytology, but without macroscopic anal lesion. Ultimately we postulated if the anal mucosa may be a reservoir of HPV, which would allow the reinfection of cervix. Forty-nine patients with abnormal cervical cytology were selected for this work. In a period not exceeding one week of collecting cervix cytology, two swab specimens of the anal canal were also collected. Women diagnosed with cervical HSIL by Pap smear were referred for colposcopy with biopsy of the lesions, to confirm the cytologic diagnosis and ablation of the lesion. We demonstrated a high prevalence of anal squamous intraepithelial lesions in patients with cervical squamous intraepithelial lesions (29 of the total of 49 patients = 59.2%). Of the 20 cases of cervical LSIL, 11 (55%) had abnormal anal cytology. Of the 26 cases with cervical HSIL, 16 (61.5%) had abnormal anal cytology. So, there was a discrete higher prevalence of abnormal anal cytology in cases of high-grade cervical squamous lesions (cervical HSIL). These results help to support the hypothesis that the anal mucosa is a reservoir of HPV, which can be a source of re-infection for the cervix. However, there was no significant association between the practice of anal sex and the prevalence of anal cytological abnormalities. These facts are epidemiologically important for future programs for population eradication of cervical lesions related to HPV. Diagn. Cytopathol. 2011;39:323-327. © 2010 Wiley-Liss, Inc. Copyright © 2010 Wiley-Liss, Inc.

  6. Early effect of external beam radiation therapy on the anal sphincter: A study using anal manometry and transrectal ultrasound

    International Nuclear Information System (INIS)

    Birnbaum, E.H.; Dreznik, Z.; Myerson, R.J.; Lacey, D.L.; Fry, R.D.; Kodner, I.J.; Fleshman, J.W.

    1992-01-01

    The early of pelvic irradiation on the anal sphincter has not been previously investigated. This study prospectively evaluated the acute effect of preoperative radiation on anal function. Twenty patients with rectal carcinoma received 4,500 cGy of preoperative external beam radiation. The field of radiation included the sphincter in 10 patients and was delivered above the anorectal ring in 10 patients. Anal manometry and transrectal ultrasound were performed before and four weeks after radiotherapy. No significant difference in mean maximal squeeze or resting pressure was found after radiation therapy. An increase in mean minimal sensory threshold was significant. Histologic examination revealed minimal radiation changes at the distal margin in 8 of 10 patients who underwent low anterior resection and in 1 of 3 patients who underwent abdominoperineal resection. The authors conclude that preoperative radiation therapy has minimal immediate effect on the anal sphincter and is not a major contributing factor to postoperative incontinence in patients after sphincter-saving operations for rectal cancer

  7. Diagnostic imaging features of normal anal sacs in dogs and cats.

    Science.gov (United States)

    Jung, Yechan; Jeong, Eunseok; Park, Sangjun; Jeong, Jimo; Choi, Ul Soo; Kim, Min-Su; Kim, Namsoo; Lee, Kichang

    2016-09-30

    This study was conducted to provide normal reference features for canine and feline anal sacs using ultrasound, low-field magnetic resonance imaging (MRI) and radiograph contrast as diagnostic imaging tools. A total of ten clinically normal beagle dogs and eight clinically normally cats were included. General radiography with contrast, ultrasonography and low-field MRI scans were performed. The visualization of anal sacs, which are located at distinct sites in dogs and cats, is possible with a contrast study on radiography. Most surfaces of the anal sacs tissue, occasionally appearing as a hyperechoic thin line, were surrounded by the hypoechoic external sphincter muscle on ultrasonography. The normal anal sac contents of dogs and cats had variable echogenicity. Signals of anal sac contents on low-field MRI varied in cats and dogs, and contrast medium using T1-weighted images enhanced the anal sac walls more obviously than that on ultrasonography. In conclusion, this study provides the normal features of anal sacs from dogs and cats on diagnostic imaging. Further studies including anal sac evaluation are expected to investigate disease conditions.

  8. HAART slows progression to anal cancer in HIV-infected MSM.

    Science.gov (United States)

    Duncan, Katrina C; Chan, Keith J; Chiu, Connie G; Montaner, Julio S G; Coldman, Andy J; Cescon, Angela; Au-Yeung, Christopher G; Wiseman, Sam M; Hogg, Robert S; Press, Natasha M

    2015-01-28

    Antiretrovirals do not prevent anal intraepithelial neoplasia. However, the influence of antiretrovirals in the natural history of invasive anal cancer is less clear. The objective is to investigate the impact of antiretrovirals in the time to the development of anal cancer in HIV-positive MSM. A retrospective analysis of cases of anal cancer in a cohort of HIV-positive MSM receiving antiretrovirals between 1988 and 2008. Time from first CD4 cell count or HIV RNA viral load test to anal cancer diagnosis was analysed using Cox regression and Kaplan-Meier curves. Anal cancer cases treated in the era prior to HAART (cancer cases (n = 37) were compared with a cohort of 1654 HIV-positive MSM on antiretrovirals. Antiretrovirals were started in the pre-HAART era by 70% of cancer cases, and median CD4 cell count nadir was 70 cells/μl (10-130). Time to development of anal cancer was shorter for cases treated during the pre-HAART era [adjusted hazard ratio (AHR) 3.04, 95% confidence interval (95% CI) 1.48-6.24, P = 0.002], with a CD4 cell count nadir less than 100 cells/μl (AHR 2.21, 95% CI 1.06-4.62, P = 0.035) and longer duration of CD4 cell count less than 100 cells/μl (AHR 1.33, 95% CI 1.11-1.58, P = 0.002). Results show that severe immunosuppression and starting therapy pre-HAART are associated with an increased risk of anal cancer. HIV-positive MSM initiating antiretrovirals during the HAART era (1996-2008) had a longer time to the development of anal cancer than those treated pre-HAART. Our results suggest that early use of HAART may delay progression to anal cancer.

  9. Anal metastasis originating from colorectal cancer: Report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Min; Lim, Joon Seok; Choi, Jin Young; Park, Mi Suk; Kim, Myeong Jin [Dept. of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of); Chung, Taek; Kim, Ho Guen [Dept. of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-12-15

    Anal metastasis from colorectal cancer rarely occurs, but it severely impairs the patient's quality of life, often requiring wide resection including the anal sphincter with permanent colostomy. This lesion can be misdiagnosed as a perianal fistula or an abscess, and it can be overlooked at the time of surgery because it is not included in the routine surgical extent of low anterior resection. We report two rare cases of anal metastasis from colorectal cancer. In both cases, perianal nodules with an internal solid portion were detected on preoperative rectal magnetic resonance imaging and additional local excisions of the anal lesions were performed during the process of treatment. Anal metastasis was pathologically confirmed by histology and immunohistochemical staining.

  10. Assessment of fistulectomy combined with sphincteroplasty in the treatment of complicated anal fistula

    Directory of Open Access Journals (Sweden)

    Fakhrolsadat Anaraki

    2017-07-01

    Full Text Available Introduction: The ideal method of treating the complex anal fistula is to eradicate the sepsis and preserve the anal sphincter; since there is no definite consensus on the surgical method of treating it. Recent studies show that fistulectomy and immediate sphincteroplasy are a safe and appropriate way to treat the fistula-in-ano. The aim of this study was to evaluate the long term outcomes of fistulectmy and sphincteroplasty in the treatment of complex perianal fistula. Methods: In this prospective study, we have analyzed the data of 80 patients who underwent fistulectomy and sphincteroplasty from May 2013 to May 2016. Preoperative information included physical examination, preoperative fecal incontinence evaluation and taking a complete history about underlying diseases and past related surgeries were collected. Results: Of all 80 patients with complex fistula, 57.5% (46 patients were male. 70-Patients were presented with high transsphincteric fistula (87.5% and anterior fistula was diagnosed in 10 of them (12.5%. 9 patients (11.3% suffered from hypertension and 43 patients (53.75% had recurrent fistula after previous surgeries. During the follow-up period, the overall success rate was 98.8% (98.8% and fistulectomy and sphincteroplasty failed in only one patient (failure rate: 1.3%. preoperative and post-operative scoring showed mild fecal incontinence in 8 patients (10%. We have found no significant relation between the age, gender, hypertension, previous surgery and post-operative recurrence. Conclusion: Fistulectomy and sphincteroplasty is a safe surgical procedure in the treatment of anterior anal fistula in females and high transsphincteric fistulas. Resumo: Introdução: o método ideal para tratar a fístula anal complexa consiste em erradicar a sepse e preservar o esfíncter anal, uma vez que não existe consenso definitivo com relação ao método cirúrgico para tratamento desse problema. Estudos recentes demonstram que a

  11. El método analítico como método natural

    OpenAIRE

    Lopera Echavarría, Juan Diego; Ramírez Gómez, Carlos Arturo; Zuluaga Aristizábal, Marda Ucaris; Ortiz Vanegas, Jennifer

    2010-01-01

    Retomando la definición de análisis como la descomposición de un todo en sus elementos constitutivos para proceder a su comprensión y rearticulación, el presente artículo expone al método analítico como el método natural de los seres humanos, muestra sus relaciones con el método científico y explicita su vinculación íntima con la ética, en tanto hábito resultante de la incorporación de dicho método. Based on the definition of analysis like the decomposition of a whole in its constituent el...

  12. Avaliação da qualidade de vida na incontinência anal: validação do questionário FIQL (Fecal Incontinence Quality of Life Evaluation of quality of life in anal incontinence: validation of the questionnaire FIQL (Fecal Incontinence Quality of Life

    Directory of Open Access Journals (Sweden)

    Sonia Ahlaim Ibrahim Yusuf

    2004-09-01

    Full Text Available RACIONAL: A incontinência anal acarreta incapacitação física e psicológica, determinando impacto na qualidade de vida. Para quantificar esse impacto em nosso meio, não existem instrumentos específicos validados. OBJETIVOS: Avaliar a qualidade de vida na incontinência anal, através da validação do questionário "Fecal Incontinence Quality of Life" (FIQL, que é composto por 29 questões distribuídas em 4 domínios: estilo de vida, comportamento, depressão e constrangimento, sua escala de pontuação varia de 1 a 4 com exceção das questões 1 e 4 que variam de 1 a 5 e 1 a 6, respectivamente. MATERIAL E MÉTODO: Após tradução e adaptação cultural, estudou-se a validação do instrumento através das propriedades de medida de reprodutibilidade e validade. Para a avaliação da reprodutibilidade aplicou-se o questionário em 50 pacientes com incontinência anal por dois examinadores, sendo reaplicado por um dos examinadores após período de 7 a 10 dias. A validade construtiva foi testada através da comparação do FIQL e o SF-36, questionário genérico de qualidade de vida e entre o FIQL e um índice de incontinência anal. O índice de incontinência anal utilizado foi o de Jorge-Wexner, que varia de 0 (continência perfeita a 20 (incontinência total. A validade discriminativa foi avaliada através da aplicação do FIQL em dois grupos controle: indivíduos voluntários hígidos e portadores de constipação intestinal. RESULTADOS: Verificou-se que o FIQL apresentou correlação significativa com outros instrumentos (SF-36 e índice de incontinência e que a qualidade de vida no portador de incontinência anal está comprometida em todos os domínios: estilo de vida: 2,4 comportamento: 2,0, depressão: 2,5 e constrangimento: 1,9, quando comparado com os indivíduos voluntários hígidos (3,9, 3,9, 4,1 e 4,0, e pacientes com constipação intestinal (3,7, 3,8, 3,6 e 3,8, respectivamente. CONCLUSÃO: O FIQL é útil para a

  13. Sotsiaalvõrgustike analüüs / Innar Liiv

    Index Scriptorium Estoniae

    Liiv, Innar, 1982-

    2005-01-01

    Sotsiaalvõrgustike analüüs (social network analys - SNA) on tehnikate, meetodite ning vahendite kogum, mis aitab avastada mustreid sotsiaalsetes struktuurides. Analüüsi kasutamisest energeetikaettevõtte Enron ja kohalike ettevõtete võrgustike näitel. Skeemid

  14. Anal Cancer Treatment (PDQ®)—Health Professional Version

    Science.gov (United States)

    Anal cancer is often curable with treatment. Major prognostic factors are site, size, and nodal status. Treatments include radiation therapy, chemotherapy, and surgery. Get detailed information for anal cancer risk factors, classification, staging, prognosis, and treatment in this summary for clinicians.

  15. KRAS and BRAF mutations in anal carcinoma

    DEFF Research Database (Denmark)

    Serup-Hansen, Eva; Linnemann, Dorte; Høgdall, Estrid

    2015-01-01

    the frequency and the prognostic value of KRAS and BRAF mutations in a large cohort of patients with anal cancer. One hundred and ninety-three patients with T1-4N0-3M0-1 anal carcinoma were included in the study. Patients were treated with curative (92%) or palliative intent (8%) between January 2000...

  16. Citometria de fluxo no cancro do pulmão. Eficácia da citologia como técnica de selecção dos espécimes a processar

    Directory of Open Access Journals (Sweden)

    V. Hespanhol

    1995-11-01

    Full Text Available RESUMO: O cancro do pulmão é a neoplasia mais frequente no sexo masculino nos países da U.E., mostrando actualmente tendência crescente em todos os países. O cancro do pulmão é a maior causa de morte por neoplasia, tanto na E.U. como nos E.U.A. A sobrevida é geralmente curta, sendo a maioria dos doentes diagnosticados em fases avançadas da doença, dificultando a decisão terapêutica. Para estabelecer a opção terapêutica há necessidade de conhecimento mais aprofundado dos factores que podem influenciar a sobrevida, não só relativos ao doente, mas também em relação ao próprio tumor.O presente estudo insere-se numa avaliação prognóstica global, incluindo características do doente e do tumor. Na avaliação das características do tumor utilizamos citometria de fluxo (FCM que permite avaliar o conteúdo e o índice do ADN e a fracção de cálulas em Fase-S. As amostras a processar são colhidas por técnicas diagnósticas (biopsia, escovagem e lavagem brônquicas, biopsia aspirativa transtorácica - BAT e aspirado ganglionar, sendo utilizado no processamento o material restante, após ter sido obtido o diagnóstico. Pretendemos nesta investigação preliminar definir um controlo de qualidade dos espécimes a processar por FCM em relação à presença ou não de células neoplásicas, atravás de um rastreio citológico. Por outro lado, verificar se é exequível utilizando amostras tão exíguas obter resultados de FCM fláveis. Estudámos 78 doentes suspeitos de terem neoplasia maligna do pulmão. Só nos 43 em que se provou existir neoplasia maligna se procedeu á realização de FCM. Obtivemos resultados avaliáveis de FCM em 62% (27/43. As técnicas de colheita mais reotáveis, após rastreio citológico, foram a biopsia brônquica (76% e a escovagem brônquica (100%. Encontramos uma deficiente rentabilidade utilizando a BAT (31%. A citologia é um bom método de selecção para espécimes colhidos por biopsia br

  17. ASPECTOS AMBIENTALES EN LA EXPERIMENTACIÓN QUÍMICA PARA PREVENIR RIESGOS A LA SALUD Y AL AMBIENTE

    Directory of Open Access Journals (Sweden)

    María O. Peña O.

    2011-01-01

    Full Text Available Un aspecto ambiental se considera como cualquier material o elemento físico o químico que el hombre arroja al agua, al aire y al suelo o que interactúe con el ambiente y propicie un riesgo para la salud y para el medio ambiente. Los residuos originados durante el desarrollo de actividades relacionadas con la experimentación química, aunque en una proporción menor que en un proceso industrial, ellos pueden ser residuos peligrosos al medio ambiente. Los aspectos ambientales se asocian con las actividades de generación de residuos, derrames, emisión a la atmósfera, el consumo de recursos naturales y ruido. Este estudio tuvo como objetivo proponer directrices para identificar y clasificar a los residuos que son generados en una experimentación química e introducir aspectos de seguridad para la salud y para el medio ambiente dentro de los procedimientos analíticos. Se inició con una evaluación diagnóstica sobre el conocimiento de la normativa en materia de gestión de los residuos o desechos, dirigida a técnicos y profesores que realizan actividades en ocho laboratorios para la enseñanza de la Química. Se siguió con la selección de un procedimiento analítico, como caso estudio, para revisar y aplicar estrategias de reusar, reciclar y reducir la generación de los residuos. Se encontró un desconocimiento de la normativa ambiental, representada por el 73% de los encuestados y un escaso tratamiento de residuos. Se concluye que la extensión de aspectos ambientales en los procedimientos analíticos puede ayudar a prevenir la contaminación ambiental, a fortalecer aspectos toxicológicos, de seguridad y de prevención de riesgos laborales.

  18. El efecto del entorno en la emisión de fluorescencia . Modelos teóricos y aplicaciones analíticas

    OpenAIRE

    Delgado Camón, Mª Arantzazu

    2012-01-01

    En esta Tesis Doctoral se abordan aspectos teóricos y prácticos de la fluorescencia molecular, en medio líquido y sólido, que pueden resumirse en: 1.- Estudio y utilización del efecto del entorno molecular en la intensidad de fluorescencia, que se refiere a cómo las interacciones no covalentes que sufre un fluoróforo en presencia de un analito y un disolvente afectan a su emisión y a la utilización de esos cambios para obtener información analítica del entorno. Para ello se ha desarrollad...

  19. Recent Advances in the Pharmacotherapy of Chronic Anal Fissure: An Update

    Directory of Open Access Journals (Sweden)

    Bikash Medhi

    2008-07-01

    Full Text Available Surgical sphincterotomy reduces anal tone and sphincter spasm and promotes ulcer healing. Because the surgery is associated with the side effect of faecal incontinence, pharmacological agents to treat chronic anal fissure have been explored recently. Glyceryl trinitrate (GTN ointment (0.2% has an efficacy of up to 68% in healing chronic anal fissure, but it is associated with headache as the major and most common side effect. Though botulinum toxin injected into the anal sphincter healed over 80% of chronic anal fis-sures, it is more invasive and expensive than GTN therapy. Diltiazem ointment achieved healing of chronic anal fissure comparable to 0.2% GTN ointment but was associated with fewer side effects. Other drugs that have been tried are lidocaine, the alpha-adrenergic antagonist indoramin, and the potassium channel opener minoxidil.

  20. Algoritmo de Compresión de Datos para la Arquitectura MOLAP

    OpenAIRE

    María Trinidad Serna Encinas; Guillermo Gómez Almeida; César Enrique Rose Gómez

    2012-01-01

    La tecnología para el procesamiento analítico en línea (OLAP) se mueve cada vez más hacia el uso de manejadores de bases de datos multidimensionales. Debido a su naturaleza física, la forma en que estos sistemas funcionan y al crecimiento en el volumen de datos, llevan a las empresas a incrementar la capacidad de almacenamiento de sus sistemas, además del poder de procesamiento de éstos. La compresión de los cubos de datos generados por los sistemas de procesamiento analítico multidimensional...

  1. Abnormal anal cytology risk in women with known genital squamous intraepithelial lesion

    Directory of Open Access Journals (Sweden)

    Maria do Socorro Nobre

    2016-05-01

    Full Text Available The purpose of this study was to assess the risk of abnormal anal cytology in women with known genital squamous intraepithelial lesion. This study evaluated 200 women with and without genital squamous intraepithelial lesion who were recruited for anal Pap smears. Women who had abnormal results on equally or over atypical squamous cells of undetermined significance were classified as having abnormal anal cytology. A multiple logistic regression analysis (stepwise was performed to identify the risk for developing abnormal anal cytology. Data were analyzed using the SPSS 20.0 program. The average age was 41.09 (±12.64. Of the total participants, 75.5% did not practice anal sex, 91% did not have HPV-infected partners, 92% did not have any anal pathology, and 68.5% did not have anal bleeding. More than half (57.5% had genital SIL and a significant number developed abnormal anal cytology: 13% in the total sample and 17.4% in women with genital SIL. A significant association was observed between genital squamous intraepithelial lesion and anal squamous intraepithelial lesion (PR = 2.46; p = 0.03. In the logistic regression model, women having genital intraepithelial lesion were more likely to have abnormal anal Pap smear (aPR = 2.81; p = 0.02. This report shows that women with genital squamous intraepithelial lesion must be more closely screened for anal cancer.

  2. Using of thermoradiotherapy on treatment of cancerous growths of anal canal

    International Nuclear Information System (INIS)

    Timofeev, Yu.M.; Zikiryakhodjaev, D.Z.

    1997-01-01

    In this chapter of book authors investigated using of thermoradiotherapy on treatment of cancerous growths of anal canal, methods of using of thermoradiotherapy at morbid with anal cancer, methods of irradiation, the characteristic of clinical observations, using of thermoradiotherapy at treatment of epidermoid cancer of anal zone, using of thermoradiotherapy at treatment of non epithelial cancer of anal zone and using thermoradiotherapy at others types of cancerous growths

  3. The impact of anaemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin

    Directory of Open Access Journals (Sweden)

    Oblak Irena

    2016-03-01

    Full Text Available Radiochemotherapy is the main treatment for patients with squamous cell carcinoma of the anal canal. Anaemia is reported to have adverse effect on survival in cancer patients. The aim of the study was to evaluate the influence of anaemia on radiochemotherapy treatment outcome in patients with squamous cell carcinoma of the anal canal.

  4. Extracción automática de definiciones analíticas y relaciones semánticas de hiponimia-hiperonimia con un sistema basado en patrones lingüísticos

    Directory of Open Access Journals (Sweden)

    Miguel Alejandro Dorantes

    2017-12-01

    Full Text Available En el presente trabajo se muestra parte de un proyecto en curso centrada en el diseño de un autómata lexicográfico. El objetivo principal de la investigación es la extracción de definiciones analíticas y relaciones semánticas de términos con datos tomados directamente de internet. Presentamos dos de las capacidades del sistema: la extracción de definiciones analíticas y de hiperónimos. La metodología consiste principalmente en la búsqueda automática de esta información con patrones construidos manualmente basados en la estructura léxica de definiciones analíticas en lenguaje natural. Con este desarrollo, ha sido posible mejorar la precisión reportada en el estado del arte. Se ha conseguido una precisión de 92.5% para la tarea de extracción de definiciones analíticas y de las relaciones de hiperonimia.

  5. Mulheres submetidas à conização de colo uterino: análise dos resultados citológico e histopatológico

    Directory of Open Access Journals (Sweden)

    Cláudia Priscilla de Souza Amorim

    2015-06-01

    Full Text Available Objetivo: Relacionar os achados cito-histológicos em pacientes submetidas a procedimento excisional no colo uterino, avaliando as discrepâncias diagnósticas encontradas. Metodologia: Foram avaliadas 52 pacientes submetidas à conização cervical no ambulatório do Setor de Patologia do Trato Genital Inferior da Maternidade-Escola Assis Chateaubriand, atendidas entre janeiro de 2012 a dezembro 2013, retrospectivamente, por revisão de prontuário. Os diagnósticos citopatológicos foram confrontados com os achados colposcópicos e com os laudos histopatológicos para que se observe o nível de concordância. Resultados: A média de idade das pacientes avaliadas foi de 36,5 anos. A média de paridade foi de 3. Das 21 pacientes com anatomopatológico (AP de Cirurgia de Alta Frequência (CAF NIC 3, 3 tinham citologia com Atipias de Células Escamosas de Significado Indeterminado (ASC-US, 3 Lesão intraepitelial de baixo grau (LIEBG e 15 Lesão intraepitelial de alto grau (LIEAG em citologia previamente ao procedimento. As 11 pacientes com NIC 2 no AP do CAF, 1 tinha citologia prévia evidenciando ASC-US. Conclusão: Houve boa concordância entre os resultados citológicos e histológicos. Cerca de 20% das pacientes com NIC 2 ou 3 após tratamento excisional por CAF tinham citologia prévia indicando lesão cervical menor.

  6. Desarrollo y validación de los métodos analíticos para el control de calidad del micocilén polvo

    Directory of Open Access Journals (Sweden)

    Yania Suárez Pérez

    2011-06-01

    Full Text Available El micocilén es un medicamento que se presenta en forma de polvo. Contiene 2 ingredientes farmacéuticos activos: el ácido undecilénico y el undecilinato de zinc. Por su acción fungistática, se ha convertido en un producto de alta demanda en Cuba, ya que las micosis se favorecen en climas cálidos y húmedos. Se realizó el desarrollo y la validación de 2 métodos analíticos para el control de calidad sobre la base de la cuantificación de cada analito presente en la formulación. Se seleccionaron técnicas volumétricas por neutralización acuosa y complejometría. Los resultados fueron satisfactorios, ya que en ambos casos se obtuvo adecuada especificidad, linealidad, exactitud, precisión y robustez. Los métodos propuestos se compararon con los aplicados anteriormente y se obtuvieron resultados mucho más confiables, según resultados del análisis estadístico aplicado, sin diferencias significativas entre las réplicas de un mismo lote.

  7. Seoseid loov kunstiteose analüüs / Anneli Porri

    Index Scriptorium Estoniae

    Porri, Anneli, 1980-

    2013-01-01

    Kunstiteose analüüsi seosest riikliku õppekavaga, ülevaade kunstiteose analüüsimeetoditest kunstiteaduses ning metoodilistest tähelepanekutest kunsti ja visuaalkultuuri kujutiste vaatamise kohta gümnaasiumi kunstitunnis

  8. Patients with newly diagnosed cervical cancer should be screened for anal human papilloma virus and anal dysplasia: Results of a pilot study using a STELLA computer simulation and economic model

    OpenAIRE

    Eli D. Ehrenpreis; Dylan G. Smith

    2018-01-01

    Background: Women with cervical cancer often have anal human papillomavirus (HPV) infection and anal dysplasia. However, effectiveness of anal HPV screening is unknown. Methods: A dynamic model was constructed using STELLA. Populations are represented as ''stocks'' that change according to model rates. Initial anal cytology in new cervical cancer patients, dysplasia progression and regression, cost of treating high-grade squamous intraepithelial lesions (HSIL), and lifetime costs for anal can...

  9. La contabilidad analítica del sector público en España: Un panorama

    OpenAIRE

    Carmen Norverto Laborda; Clara Isabel Muñoz Colomina; Eloy Veuthey Martínez; Javier Zornoza Boy

    1988-01-01

    El objetivo de este trabajo es presentar un panorama del estado de elaboración teórica en que se encuentra en España la contabilidad analítica para el sector público, tanto en lo que se refiere a las propuestas emanadas de la propia Administración (particularmente el Grupo 9 del Plan General de Contabilidad Pública), como en lo relativo a las de los profesionales e investigadores independientes. Dado que el proceso de reforma de la contabilidad pública española se inició hace relativament...

  10. Anal squamous carcinoma: a new AIDS-defining cancer? Case report and literature review

    Directory of Open Access Journals (Sweden)

    Marcelo Corti

    2012-12-01

    Full Text Available Squamous anal cell carcinoma is a rare malignancy that represents the 1.5% to 2% of all the lower digestive tract cancers. However, an increased incidence of invasive anal carcinoma is observed in HIV-seropositive population since the widespread of highly active antiretroviral therapy. Human papillomavirus is strongly associated with the pathogenesis of anal cancer. Anal intercourse and a high number of sexual partners appear to be risk factors to develop anal cancer in both sexes. Anal pain, bleeding and a palpable lesion in the anal canal are the most common clinical features. Endo-anal ultrasound is the best diagnosis method to evaluate the tumor size, the tumor extension and the infiltration of the sphincter muscle complex. Chemoradiotherapy plus antiretroviral therapy are the recommended treatments for all stages of localized squamous cell carcinoma of the anal canal in HIV-seropositive patients because of its high rate of cure. Here we present an HIV patient who developed a carcinoma of the anal canal after a long time of HIV infection under highly active antiretroviral therapy with a good virological and immunological response.

  11. Diversidade de modelos narrativos para documentários transmídia

    Directory of Open Access Journals (Sweden)

    Denis Renó

    2013-08-01

    Full Text Available Este artigo apresenta uma definição de modelos para a produção dedocumentários transmídia a partir de um estudo de caso múltiplo de caráter analítico. Paratanto, foram analisadas três obras documentais de formatos distintos, mas relacionadosàs especificidades definidas pela narrativa transmídia. Com os resultados apresentados,espera-se orientar produtores e investigadores para o desenvolvimento de novos olhares.

  12. Dysregulation of Autophagy Contributes to Anal Carcinogenesis.

    Directory of Open Access Journals (Sweden)

    Evie H Carchman

    Full Text Available Autophagy is an intracellular catabolic process that removes and recycles unnecessary/dysfunctional cellular components, contributing to cellular health and survival. Autophagy is a highly regulated cellular process that responds to several intracellular signals, many of which are deregulated by human papillomavirus (HPV infection through the expression of HPV-encoded oncoproteins. This adaptive inhibitory response helps prevent viral clearance. A strong correlation remains between HPV infection and the development of squamous cell carcinoma (SCC of the anus, particularly in HIV positive and other immunosuppressed patients. We hypothesize that autophagy is inhibited by HPV-encoded oncoproteins thereby promoting anal carcinogenesis (Fig 1.HPV16 transgenic mice (K14E6/E7 and non-transgenic mice (FVB/N, both of which do not spontaneously develop anal tumors, were treated topically with the chemical carcinogen, 7,12-Dimethylbenz[a]anthracene (DMBA, to induce anal cancer. The anuses at different time points of treatment (5, 10, 15 and 20 weeks were analyzed using immunofluorescence (IF for two key autophagy marker proteins (LC3β and p62 in addition to histological grading. The anuses from the K14E6/E7 mice were also analyzed for visual evidence of autophagic activity by electron microscopy (EM. To see if there was a correlation to humans, archival anal specimens were assessed histologically for grade of dysplasia and then analyzed for LC3β and p62 protein content. To more directly examine the effect of autophagic inhibition on anal carcinogenesis, nontransgenic mice that do not develop anal cancer with DMBA treatment were treated with a known pharmacologic inhibitor of autophagy, chloroquine, and examined for tumor development and analyzed by IF for autophagic proteins.Histologically, we observed the progression of normal anoderm to invasive SCC with DMBA treatment in K14E6/E7 mice but not in nontransgenic, syngeneic FVB/N background control mice

  13. Anal Human Papillomavirus Infection among HIV-Infected Men in Korea.

    Directory of Open Access Journals (Sweden)

    Chang Hun Lee

    Full Text Available Little is known about the epidemiology on human papillomavirus (HPV infection among HIV-infected men in Korea. The objective of this study was to determine the prevalence, genotype distribution and risk factors associated with anal HPV infection among HIV-infected men in Korea.A single-center cross-sectional study was conducted with HIV-infected men in Korea. Participants completed a detailed sexual behavior risk factor questionnaire. Anal samples were collected for cytology and HPV genotyping. Factors associated with anal HPV infection were assessed using multivariable logistic regression, stratifying by sexual behaviour.A total of 201 HIV-infected men were included in the study: 133 were from men who have sex with men (MSM and 68 from men who have sex with women (MSW. Any anal HPV infection was detected in 82.7% of HIV-infected MSM and in 51.5% of HIV- infected MSW (P < 0.001. High-risk HPV (HR-HPV prevalence was higher among MSM (47.4% than MSW (25.0%; P = 0.002. The HR-HPV types identified most frequently were HPV 16 (11%, HPV 18 (9.9%, and HPV 58 (5% in MSM, and HPV 58(11% and HPV 16 (8.9% in MSW. Prevalence of any HPV types in 9-valent vaccine types was higher among MSM than MSW (47.4% vs 22.1%. P = 0.001. Abnormal anal cytology was more commonly detected in MSM than MSW (42.9% vs.19.1%, P < 0.001. In HIV-infected MSM, higher number of lifetime male sex partners was significantly associated with any anal HPV infection, but age was a significant risk factor associated with anal HR-HPV infection.Anal HPV infection was highly prevalent in HIV-infected MSM in Korea, and also commonly found in HIV-infected MSW. In HIV-infected MSM, the significant risk factor for being infected with any HPV infection was lifetime number of male sexual partners, and with anal oncogenic HPV infection was age.

  14. Anal endosonography and manometry: comparison in patients with defecation problems.

    Science.gov (United States)

    Schäfer, R; Heyer, T; Gantke, B; Schäfer, A; Frieling, T; Häussinger, D; Enck, P

    1997-03-01

    Correlations between anal sphincter function as assessed by anorectal manometry and anal sphincter anatomy measured by endoluminal ultrasound have been reported in the literature both for patients and for healthy individuals but have not been confirmed by other authors. For a larger series of patients (152 consecutive patients, mean age 54.1 +/- 15.5 years; female:male ratio, 111:41) with anorectal dysfunctions such as incontinence (n = 92), constipation (n = 37), and other symptoms (n = 23), diagnostic work-up included conventional multilumen anorectal manometry to evaluate internal sphincter pressure at rest, maximum external sphincter squeeze pressure during contraction, and endoanal sonography to determine anal sphincter integrity and to measure dorsal, left lateral, and right lateral diameter of the internal anal sphincter (IAS) and external anal sphincter (EAS) muscles. Maximum squeeze pressure was significantly correlated to muscle thickness of the EAS (P = 0.001). No association was found between resting pressure and IAS diameter. Women had significantly lower resting and squeeze pressures than men (P = 0.008 and P = 0.003, respectively), but age-related changes of function were only found for resting pressure. Endosonographic values of IAS and EAS did not differ between genders but were significantly correlated with age (P = 0.008 and P = 0.02, respectively). Because all correlations were rather weak, they only can explain a small portion of data variance. Anal manometry and anal ultrasound, therefore, are of complementary value and are both indicated in adequate clinical problems.

  15. MULTILOCALIZACIÓN: UNA ESTRATEGIA PARA COMPETIR GLOBALMENTE

    Directory of Open Access Journals (Sweden)

    MÓNICA MARÍA SINISTERRA RODRÍGUEZ

    2009-01-01

    Full Text Available Este artículo busca mostrar, a través de una revisión bibliográfica analítica, la pertinencia de la hipótesis que plantea la multilocalización como una de las mejores estrategias empresariales para competir globalmente, específicamente, cuando las empresas tienen ventajas competitivas y son capaces de identificar y aprovechar las ventajas comparativas de las regiones. La principal implicación de esta hipótesis es que reclama una mayor atención sobre las nuevas necesidades de habilidades empresariales para ligar la ruptura de la cadena de valor que la integración comercial produce.

  16. Predição analítica do movimento rotacional de satélites estabilizados por rotação

    OpenAIRE

    Borderes Motta, Gabriel [UNESP

    2014-01-01

    Uma abordagem analítica para o movimento rotacional de satélites arti ciais estabilizados por rotação é apresentada, considerando os satélites em órbita elíptica de baixa excentricidade e a in uência conjunta do torque aerodinâmico, o torque de gradiente de gravidade, o torque magnético residual, o torque magnético devido às correntes de Foucault e o torque de pressão de radiação solar. Modelos matemáticos são apresentados para todos os torques e os componentes médios de cada torque são deter...

  17. Vaccine-preventable anal human papillomavirus in Australian gay and bisexual men

    Directory of Open Access Journals (Sweden)

    I. Mary Poynten

    2017-06-01

    Full Text Available Objective: HPV causes ~90% of anal cancer and HPV16 is the type most commonly associated with anal cancer. Gay and bisexual men (GBM are at greatly increased risk. We investigated patterns of vaccine-preventable anal HPV in older GBM. Methods: The Study of the Prevention of Anal Cancer (SPANC is an ongoing, prospective cohort study of HIV-positive and HIV-negative Australian GBM. Participants completed questionnaires and underwent an anal swab for HPV genotyping using Roche Linear Array. We analysed baseline data from SPANC by HPV type, mean number of types, stratified by age and HIV status. Results: Anal HPV results from 606 (98.2% of 617 participants (median age 49 years, 35.7% HIV-positive showed 525 (86.7% had ≥1 HPV type and 178 (29.4% had HPV16. Over one third of participants (214, 35.3% had no nonavalent vaccine-preventable types detected. Two (0.3% participants had all quadrivalent types and none had all nonavalent vaccine types. HIV-positive participants (p<0.001 and younger participants (p=0.059 were more likely to have more vaccine-preventable HPV types detected. Conclusion: Anal HPV was highly prevalent in this largely community-based GBM cohort. Vaccine-preventable HPV16 was detected in approximately one third of participants. These findings suggest that the potential efficacy of HPV vaccination of older GBM should be explored. Keywords: Human papillomavirus, HPV, Anal, Vaccine, Prevalence, Gay and bisexual men, MSM, HIV

  18. La Contabilidad Analítica en los Hospitales Públicos

    Directory of Open Access Journals (Sweden)

    Ma Silvia Fresneda Fuentes

    1998-06-01

    Full Text Available La confección de presupuestos públicos austeros para la consecución de los criterios de convergencia impuestos por el Tratado de Maastricht ha originado una preocupación en todo el Sector Público en general, y en el hospitalario en particular, por la contención de los costes. Esta situación ha puesto de manifiesto la necesidad de introducir sistemas de Contabilidad para la Gestión interna de las organizaciones hospitalarias públicas. Así, la Contabilidad Analítica o de Costes se constituye como un componente más de dichos sistemas y está llamada a alcanzar dos objetivos muy claros, por un lado, la determinación del coste del producto hospitalario para en base a él realizar una presupuestación prospectiva, y por otro, suministrar información interna que permita llevar a cabo un verdadero Control de Gestión. Con este trabajo se pretenden describir los modelos de costes alternativos propuestos por la literatura especializada, señalando su idoneidad en base a la consecución de los objetivos que la Contabilidad Analítica debe satisfacer. Se pondrá de manifiesto la tendencia actual a establecer modelos basados en la nueva definición de producto hospitalario, los cuales tienen como finalidad la determinación de los costes totales de dicho producto, dejando a un lado el objetivo del control de la eficacia y eficiencia de la gestión.The development of strict Public Budgets in order to reach the goals settled by Maastricht agreements have caused a deep concern in the Public Sector and mostly in hospitals in order to brake the growth of costs. Such a situation has stated clearly the necessity of implementing Management Accounting Systems in Public Hospitals organizations. Therefore, costs accounting cames to be a part of such systems, which is to reach two very clear objetives. In one hand, the definition of the hospital product cost using it as the base to develop the hospital budget. On the other hand, to supply internal

  19. [Caesarean section and anal incontinence].

    Science.gov (United States)

    Kalis, V; Stipán, J; Chaloupka, P; Karbanová, J; Rokyta, Z

    2008-04-01

    Summary of the impact of Caesarean section on anal incontinence. Review. Department of Gynaecology and Obstetrics, Charles University and University Hospital Plzen. Review of the current international literature. Currently, Caesarean section is not considered to reduce symptoms of anal incontinence. If there is any reduction of symptoms, that remains only for a short term (40% in 3 months after the delivery in the largest trial). In a long term, virtually in no trial has been observed any difference, and others, non-obstetrical factors (particularly aging) prevail. Current knowledge does not allow to assess sufficiently pros and cons of Caesarean compared to vaginal delivery. High risk groups, that would profit from elective Ceasarean, have not been clearly identified yet.

  20. Carcinoma of the anal canal: radiation or radiation plus chemotherapy

    International Nuclear Information System (INIS)

    Cummings, B.J.

    1983-01-01

    An editorial is presented which discusses the treatment of carcinoma of the anal canal. Following the initial report of the successful preoperative use of combined chemotherapy and radiation by Nigro in 1974, several centers have confirmed the effectiveness of such combinations either as preoperative or as definitive treatment of anal carcinomas, and many patients are now being referred for radiation therapy. The article by Cantril in this issue describe the successful treatment of anal carcinomas by radiation alone, and raises the important issue of whether radiation plus chemotherapy is more effective treatment than radiation alone for squamous or cloacogenic carcinomas arising in the anal canal or perianal area. Several studies are cited

  1. Efeito do tempo de espera para radioterapia na sobrevida geral em cinco anos de mulheres com câncer do colo do útero, 1995-2010

    Directory of Open Access Journals (Sweden)

    Maria Isabel do Nascimento

    2015-11-01

    Full Text Available Resumo A sobrevida geral em cinco anos e os fatores associados ao óbito foram avaliados em uma coorte de 342 mulheres com câncer do colo uterino indicadas para radioterapia na Baixada Fluminense, Rio de Janeiro, Brasil. A sobrevida geral foi de 25,3%, alcançando 60,8% para os casos até IIA. O ajustamento com uso do modelo de riscos proporcionais de Cox estendido mostrou risco de óbito aumentado para tumores IIB-IIIB (HR = 1,89; IC95%: 1,214; 2,957 e IVA-IVB (HR = 5,78; IC95%: 2,973; 11,265. A captação por citologia (HR = 0,58; IC95%: 0,362; 0,961 e o encaminhamento direto para o serviço de radioterapia na Baixada Fluminese (HR = 0,60; IC95%: 0,418; 0,875 foram os principais fatores protetores encontrados. O tempo de espera pela radioterapia (> 60 dias versus ≤ 60 dias foi não estatisticamente significativo, porém o retardo de quatro dias piorou os resultados (HR = 1,70; IC95%: 1,153; 2,513. O limite de 60 dias para iniciar a radioterapia deve ser respeitado com rigor, pois, a partir de 64 dias, o retardo mostrou associação significativa entre todos os pontos de corte de tempo de espera analisados e o risco de morte em cinco anos.

  2. Regenerative medicine provides alternative strategies for the treatment of anal incontinence

    DEFF Research Database (Denmark)

    Gräs, Søren; Tolstrup, Cæcilie Krogsgaard; Lose, Gunnar

    2017-01-01

    of culture-expanded skeletal myogenic cells stimulates repair of both acute and 2 - 4-week-old anal sphincter injuries. The results from a small clinical trial with ten patients and a case report support the preclinical findings. Animal studies have also demonstrated that local injections of mesenchymal stem...... cells stimulate repair of sphincter injuries, and a complex bioengineering strategy for creation and implantation of an intrinsically innervated internal anal sphincter construct has been successfully developed in a series of animal studies. CONCLUSION: Cellular therapies with myogenic cells...... and mesenchymal stem cells and the use of bioengineering technology to create an anal sphincter are new potential strategies to treat anal incontinence caused by anal sphincter defects, but the clinical evidence is extremely limited. The use of culture-expanded autologous skeletal myogenic cells has been most...

  3. Exploring dynamics of anal sex among female sex workers in Andhra Pradesh.

    Science.gov (United States)

    Tucker, Saroj; Krishna, Rama; Prabhakar, Parimi; Panyam, Swarup; Anand, Pankaj

    2012-01-01

    The anal sex among heterosexual couples is on the rise as reported in many scientific studies. Considering that unprotected anal sex has higher risk of human immunodeficiency virus (HIV) transmission than the vaginal sex, we undertook a study to understand the anal sex practices among Female Sex Workers (FSW). The study was conducted among FSW attending 11 randomly selected sexually transmitted infection (STI) clinics in Bill and Melinda Gates supported targeted interventions in Andhra Pradesh. A structured questionnaire was administered to the 555 FSW attending these clinics by project clinic counselors. Informed consent was obtained from all the study participants. Engaging in anal sex was self reported by 22% of sex workers, though demand from clients was reported to be much higher (40%). The reasons for anal sex practices included more money (61%), clout/influence of the client (45%), risk of losing client (27%), and forced sex (1.2%). Factors associated with anal sex were higher number of clients, higher duration of sex work, higher income, and older age group. Associated risks perceived by FSW were bleeding and injury to anal canal (98%) while only 28% associated it with higher HIV transmission risk. Reported Condom and lubricant use was about 88% and 39% respectively. The study shows that there is frequent anal sex, inconsistent condom and infrequent lubricant usage, economic and physical coercion, and low awareness of STI/HIV transmission risk among FSW, which have serious implications for HIV prevention programmes. There is a need to focus on anal sex education and use of lubricants along with condoms during anal sex in FSW-targeted interventions in AP.

  4. Revisión analítica de los procesos de Internacionalización de las PYMES

    OpenAIRE

    Tabares Arroyave, Sabrina

    2012-01-01

    Con la aceleración de la globalización y la interdependencia económica entre países, las empresas se han enfrentado a procesos de internacionalización en el mercado internacional, lo cual ha generado incertidumbre con respecto a las estrategias que deben utilizar estas, especialmente las pequeñas y medianas, para operar en el escenario internacional. Buscando resolver esta inquietud, este artículo realiza una revisión analítica de los principales planteamientos en la internacionalización de p...

  5. Anal intraepitelial neoplasia: a narrative review

    Directory of Open Access Journals (Sweden)

    Garazi Elorza

    2016-01-01

    Full Text Available Anal intraepitelial neoplasia (AIN constitutes a major health problem in certain risk groups, such as patients with immunosuppression of varied origin, males who have sexual relations with other males, and females with a previous history of vaginal or cervical abnormalities in cytology. Its relationship with the human papillomavirus (HPV infection has been well documented; however, many of the factors involved in the progression and regression of the viral infection to dysplasia and anal carcinoma are unknown. AIN can be diagnosed through cytology of the anal canal or biopsy guided by high-resolution anoscopy. However, the need for these techniques in high-risk groups remains controversial. Treatment depends on the risk factors and given the high morbidity and high recurrence rates the utility of the different local treatments is still a subject of debate. Surgical biopsy is justified only in the case of progression suggesting lesions. The role of the vaccination in high-risk patients as primary prevention has been debated by different groups. However, there is no general consensus on its use or on the need for screening this population.

  6. HPV infection and intraepithelial lesions from the anal region: how to diagnose?

    Directory of Open Access Journals (Sweden)

    Newton Sérgio de Carvalho

    Full Text Available In the last years, the prevalence of HPV infection in the anal region has increased, especially in some groups like homosexual and HIV-positive people. Since this infection can be associated with the development of squamous anal cancer due to its progression from HPV infection to anal intraepithelial neoplasia (AIN and finally to cancer, the screening and evaluation of these conditions are important. Anal cytology and high resolution anoscopy are good methods that are available and can be used. Although useful, these methods should be performed correctly and not indiscriminately in all patients. Patients for whom anal cytology screening is recommended are: HIV-infected patients, homosexuals, women who present with high-grade vulvar squamous intraepithelial neoplasia, vulvar cancer or cervical cancer. An abnormal anal cytology should be further evaluated with high resolution anoscopy.

  7. Magnetic resonance imaging anatomy of the anal canal

    International Nuclear Information System (INIS)

    Kashyap, P.; Bates, N.

    2004-01-01

    The anatomy of the anal canal is complex but well demonstrated by MRI. Understanding the anatomy is a prerequisite for determining the true site and the extent of pathology, especially for surgical workup. In this article, the MRI anatomy of the anal canal has been displayed using highlighted MRI images and line diagrams. Copyright (2004) Blackwell Science Pty Ltd

  8. Fiber types in the striated urethral and anal sphincters

    DEFF Research Database (Denmark)

    Schrøder, H D; Reske-Nielsen, E

    1983-01-01

    Seven normal human striated urethral and anal sphincters obtained by autopsy were examined using histochemical techniques. In both the urethral sphincter and the subcutaneous (s.c.) and superficial part of the anal sphincter a characteristic pattern with two populations of muscle fibers, abundant...

  9. Regenerative medicine provides alternative strategies for the treatment of anal incontinence.

    Science.gov (United States)

    Gräs, Søren; Tolstrup, Cæcilie Krogsgaard; Lose, Gunnar

    2017-03-01

    Anal incontinence is a common disorder but current treatment modalities are not ideal and the development of new treatments is needed. The aim of this review was to identify the existing knowledge of regenerative medicine strategies in the form of cellular therapies or bioengineering as a treatment for anal incontinence caused by anal sphincter defects. PubMed was searched for preclinical and clinical studies in English published from January 2005 to January 2016. Animal studies have demonstrated that cellular therapy in the form of local injections of culture-expanded skeletal myogenic cells stimulates repair of both acute and 2 - 4-week-old anal sphincter injuries. The results from a small clinical trial with ten patients and a case report support the preclinical findings. Animal studies have also demonstrated that local injections of mesenchymal stem cells stimulate repair of sphincter injuries, and a complex bioengineering strategy for creation and implantation of an intrinsically innervated internal anal sphincter construct has been successfully developed in a series of animal studies. Cellular therapies with myogenic cells and mesenchymal stem cells and the use of bioengineering technology to create an anal sphincter are new potential strategies to treat anal incontinence caused by anal sphincter defects, but the clinical evidence is extremely limited. The use of culture-expanded autologous skeletal myogenic cells has been most intensively investigated and several clinical trials were ongoing at the time of this report. The cost-effectiveness of such a therapy is an issue and muscle fragmentation is suggested as a simple alternative.

  10. Detecção sorológica de anti-HPV 16 e 18 e sua associação com os achados do papanicolaou em adolescentes e mulheres jovens Serological detection of anti HPV 16/18 and its association with pap smear in adolescents and young women

    Directory of Open Access Journals (Sweden)

    Cristina Helena Rama

    2006-02-01

    Full Text Available OBJETIVO: Verificar a taxa de anticorpos neutralizantes anti-HPV 16 e/ou 18, e a sua associação com os achados da citologia oncológica do colo uterino em adolescentes e mulheres jovens. MÉTODOS: Foram incluídas, neste estudo transversal, 541 mulheres de 15 a 25 anos de idade, saudáveis, sexualmente ativas, que apresentaram exame ginecológico normal, no período de setembro a novembro de 2000. Foi obtida uma amostra cervical para citologia em meio líquido e uma amostra de sangue para identificação dos anticorpos anti-HPV 16 e/ou 18, por meio do método ELISA. As amostras foram encaminhadas para um laboratório de referência na Bélgica. Para análise estatística, foram estimadas a prevalência e a razão de prevalência (RP, com intervalo de confiança de 95%. RESULTADOS: Entre as mulheres incluídas, 150 (27,7% apresentaram resultados positivos da sorologia sendo: 79 (14,6% por anticorpos anti-HPV 16, 35 (6,4% anti-HPV 18 e 36 (6,6% anti-HPV 16 e 18. Foram detectadas anormalidades citológicas em 107 casos (20,5%, sendo 63 classificadas como atipias celulares de significado indeteminado (ASCUS, 41 casos sugestivos de lesões de baixo (LSIL e três casos sugestivos de lesões de alto grau (HSIL. A prevalência de citologias anormais quando a sorologia foi positiva foi apenas 1,75 vez a prevalência de citologias positivas observadas com sorologia negativa. Nesta amostra não houve evidência de associação entre os resultados anormais da citologia e a positividade da sorologia. CONCLUSÃO: O resultado deste estudo indica uma alta prevalência de sorologia positiva para o HPV 16 e 18 em mulheres jovens sadias sem relação com os achados anormais da colpocitologia.OBJECTIVE: Verify the relation between HPV 16/18 antibodies and the association with cervical cytology findings in adolescents and young women. METHODS: A cross sectional study with 541 healthy and sexually active women from 15 to 25 years of age was carried on from

  11. Retalhos de avanço no tratamento da fissura anal crônica: experiência inicial Advancement flap in the treatment of chronic anal fissure: inicial experience

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Prolungatti Cesar

    2009-12-01

    Full Text Available A fissura anal é uma laceração do canal anal relacionada ao trauma, hipertonia esfincteriana e isquemia. A maioria cicatriza espontaneamente ou com tratamento conservador, e poucas requerem tratamento cirúrgico. O objetivo deste trabalho é verificar os resultados clínicos e alterações manométricas de pacientes submetidos ao tratamento cirúrgico da fissura anal com avançamento de retalhos em v-y. Métodos: Estudo prospectivo, realizado nos anos de 2007, 2008 e 2009, que abrangeu nove pacientes portadores de fissura anal crônica submetidos ao avançamento de retalho anal. Foram avaliadas as pressões do canal anal ao repouso, contração e esforço evacuatório; no pré e pós-operatório. Resultados: Na amostra, todos os pacientes apresentaram hipertonia esfincteriana prévia. seis (66,6% obtiveram resolução total dos sintomas e das lesões. Um (11,11% sofreu deiscência parcial do retalho, sem sintomas clínicos; e outros dois (22,22%, infecção com perda dos mesmos e persistência da fissura. A análise manométrica das pressões de repouso, contração e evacuação nos grupos não mostrou alteração estatisticamente significativa (p>0,05, o que comprova que a cirurgia não incluiu manipulação dos esfíncteres. Conclusão: Os retalhos anais mostraram-se efetivos no tratamento da fissura anal, com cicatrização da lesão, sem que ocorram alterações nas pressões anais desses pacientes.The anal fissure is a laceration of the anal canal related to trauma, hypertonic sphincter and ischemia. The majority heals spontaneously or with conservative treatment and only a few requires surgical treatment. The objective of this study is to verify the clinical results and manometric alterations of patients submitted to the surgical treatment of the anal fissure with advance of v-y skin flaps. Methods: Prospective study, accomplished in 2007,2008 and 2009, in witch nine patients with chronic anal fissure were submitted to v-y advance. The

  12. Análisis de metales en filtros de aire para monitoreo ambiental

    OpenAIRE

    Ballena Salvador, Luis Humberto; Ballena Salvador, Luis Humberto

    2012-01-01

    La mayoría de laboratorios de servicios de análisis para medio ambiente, realizan implementación y/o validación de métodos analíticos normalizados y no normalizados para matrices de aguas, suelos y aire. Al no existir métodos normalizados se hace la validación de un método nuevo, se realizan pruebas a nivel de laboratorio de límites de detección e incertidumbre de los analitos; y finalmente se hace una incertidumbre con parámetros de calidad interlaboratorios. Para el estudio de calidad de...

  13. The Danish anal sphincter rupture questionnaire: Validity and reliability

    DEFF Research Database (Denmark)

    Due, Ulla; Ottesen, Marianne

    2008-01-01

    Objective. To revise, validate and test for reliability an anal sphincter rupture questionnaire in relation to construct, content and face validity. Setting and background. Since 1996 women with anal sphincter rupture (ASR) at one of the public university hospitals in Copenhagen, Denmark have bee...

  14. Métodos analíticos para el estudio de Legionella

    Directory of Open Access Journals (Sweden)

    Carmen Pelaz Antolín

    2006-12-01

    Full Text Available Los ensayos para la determinación de Legionella en muestras de agua son uno de los aspectos contemplados en la legislación española sobre prevención de legionelosis. La periodicidad de estos ensayos en función del tipo de instalación, los laboratorios que los realizan, y las acciones correctoras que derivan de ellos en función de los recuentos bacterianos son acciones incluidas en los planes de mantenimiento preventivo de las instalaciones consideradas de riesgo (Real Decreto 865/2003. La comparación de nuestra legislación con otras legislaciones o recomendaciones adoptadas en otros paises (Reino Unido, Francia, Australia, América permite conocer nuestro grado de exigencia en relación a algunos de los parámetros contemplados. El cultivo de la bacteria es el método de referencia para la detección de Legionella en muestras de agua y existen varios ensayos normalizados, como los estándares ISO 11731/98 y 2004 y NF T 90- 431/2003 (AFNOR. Para ayudar a la interpretación de los resultados, los ensayos deben reflejar el estándar en el que se basan y el límite de detección del método, que no debe ser superior a 100 ufc/L. Además, los laboratorios que realizan estos ensayos deben estar acreditados por nuestra entidad de acreditación ENAC. En los últimos años se han desarrollado métodos rápidos de detección de la bacteria basados en la amplificación de ADN cromosómico en muestras de agua mediante reacciones de PCR. El desarrollo científico de estos métodos va por delante del desarrollo reglamentario, y los ensayos de PCR no deben desplazar a los ensayos de cultivo en cumplimiento de las normativas vigentes, sino que deben complementarlo.

  15. Dominant Role of HPV16 E7 in Anal Carcinogenesis

    Science.gov (United States)

    Thomas, Marie K.; Pitot, Henry C.; Liem, Amy; Lambert, Paul F.

    2011-01-01

    Ninety percent of anal cancer is associated with human papilloma viruses (HPVs). Using our previously established HPV transgenic mouse model for anal cancer, we tested the role of the individual oncogenes E6 and E7. K14E6 and K14E7 transgenic mice were treated with dimethylbenz[a]anthracene (DMBA) to the anal canal and compared to matched nontransgenic and doubly transgenic K14E6/E7 mice. K14E7 and K14E6/E7 transgenic mice developed anal tumors (papillomas, atypias and carcinomas combined) at significantly higher rates (88% and 100%, respectively) than either K14E6 or NTG mice (18% and 19%, respectively). Likewise, K14E7 and K14E6/E7 transgenic mice developed frank cancer (carcinomas) at significantly higher rates (85% and 85%, respectively) than either K14E6 or NTG mice (18% and 10%, respectively). These findings indicate that E7 is the more potent oncogene in anal cancer caused by HPVs. PMID:21999991

  16. Cancer of the anal canal: Diagnosis, staging and follow-up with MRI

    Energy Technology Data Exchange (ETDEWEB)

    Durot, Carole; Hoeffel, Christine [Dept. of Radiology, Centre Hospitalo-Universitaire de Reims, Reims (France); Dohan, Anthony; Boudiaf, Mourad; Soyer, Philippe [Dept. of Abdominal Imaging, Hopital Lariboisiere-APHP, Paris(France); Servois, Vincent [Dept. of Radiology and Nuclear Medicine, Institut Curie, Paris (France)

    2017-11-15

    Although a rare disease, anal cancer is increasingly being diagnosed in patients with risk factors, mainly anal infection with the human papilloma virus. Magnetic resonance imaging (MRI) with external phased-array coils is recommended as the imaging modality of choice to grade anal cancers and to evaluate the response assessment after chemoradiotherapy, with a high contrast and good anatomic resolution of the anal canal. MRI provides a performance evaluation of size, extent and signal characteristics of the anal tumor before and after treatment, as well as lymph node involvement and extension to the adjacent organs. MRI is also particularly helpful in the assessment of complications after treatment, and in the diagnosis for relapse of the diseases.

  17. Cancer of the anal canal: Diagnosis, staging and follow-up with MRI

    International Nuclear Information System (INIS)

    Durot, Carole; Hoeffel, Christine; Dohan, Anthony; Boudiaf, Mourad; Soyer, Philippe; Servois, Vincent

    2017-01-01

    Although a rare disease, anal cancer is increasingly being diagnosed in patients with risk factors, mainly anal infection with the human papilloma virus. Magnetic resonance imaging (MRI) with external phased-array coils is recommended as the imaging modality of choice to grade anal cancers and to evaluate the response assessment after chemoradiotherapy, with a high contrast and good anatomic resolution of the anal canal. MRI provides a performance evaluation of size, extent and signal characteristics of the anal tumor before and after treatment, as well as lymph node involvement and extension to the adjacent organs. MRI is also particularly helpful in the assessment of complications after treatment, and in the diagnosis for relapse of the diseases

  18. Use of Anal Acoustic Reflectometry in the Evaluation of Men With Passive Fecal Leakage

    DEFF Research Database (Denmark)

    Hornung, Benjamin R; Telford, Karen J; Carlson, Gordon L

    2017-01-01

    with greater sensitivity and discriminatory ability than conventional anal manometry. OBJECTIVE: The aim of this study was to determine whether men with fecal leakage have an abnormality in anal sphincter function that is detectable by anal acoustic reflectometry. DESIGN: This was an age-matched study......BACKGROUND: Men with passive fecal leakage represent a distinct clinical entity in which the pathophysiology remains unclear. Standard anorectal investigations fail to demonstrate consistent abnormalities in this group. Anal acoustic reflectometry is a new test of anal sphincter function...... of continent and incontinent men. SETTINGS: The study was conducted at a university teaching hospital. PATIENTS: Male patients with isolated symptoms of fecal leakage were recruited. Anal acoustic reflectometry, followed by conventional anal manometry, was performed. Results were then compared with those from...

  19. The anal verge: localization with multi-slice spiral CT

    International Nuclear Information System (INIS)

    Wang Wei; Tang Guangjian

    2010-01-01

    Objective: To determine and evaluate the method of localization of anal verge by multislice spiral CT. To provide an imaging reference for operative guidance of low-rectal cancer. Methods Forty eight consecutive adult patients suspected of abnormalities other than rectal disease were evaluated with abdominal and pelvic CT scans since August, 2009. They were divided into two groups based on sex and age. There were 23 men and 25 women. The ages of young group were 28 to 50 years and the average age was 41 years. The ages of elderly group were 52 to 81 years and the average age was 64 years. A small cotton ball dipped with contrast media was put at the anal verge as a marker and CT scans were performed with 64-slice spiral CT scanner. The distances between the cotton balls and the lower margin of the pubis combination (La), the lower margin of the Sth sacral vertebra (Lb), the inferior aperture of minor pelvis (Lc) and the lower margin of the basement of external anal sphincter (Ld) were measured on the mid- sagittal images obtained by MPR. The averages, the standard deviations (s), the 95% and 80% confidence intervals of La, Lb, Lc and Ld were calculated. We took the intervals of ±1.96 s or ±1.28 s 0.05) between two different sex groups [male group, (10.0±1.2) mm], female group, (9.6±1.2) mm and between two age groups [young group, (9.6±1.2) mm, elderly group, (9.9±1.3) mm]. Conclusions: The lower margin of the basement of external anal sphincter was a useful anatomic landmark for localizing the anal verge, and could be definitely identified on the middle sagittal pelvic CT image. The distance between the structure and anal verge is constant enough and can be used in measuring distance from low rectal lesion to the anal verge. (authors)

  20. Anal sphincter complex: endoanal MR imaging of normal anatomy

    NARCIS (Netherlands)

    Hussain, S. M.; Stoker, J.; Laméris, J. S.

    1995-01-01

    To determine the normal anatomy of the anal sphincter complex on magnetic resonance (MR) images. Ten healthy volunteers (four men, six women; age range, 21-26 years) underwent MR imaging with an endoanal coil. The lower part of the anal canal contained the internal sphincter, the longitudinal muscle

  1. Multilocalización: Una Estrategia Para Competir Globalmente

    Directory of Open Access Journals (Sweden)

    Mónica María Sinisterra Rodríguez

    2009-01-01

    Full Text Available Este artículo busca mostrar, a través de una revisión bibliográfica analítica, la pertinencia de la hipótesis que plantea la multilocalización como una de las mejores estrategias empresariales para competir globalmente, específicamente, cuando las empresas tienen ventajas competitivas y son capaces de identificar y aprovechar las ventajas comparativas de las regiones. La principal implicación de esta hipótesis es que reclama una mayor atención sobre las nuevas necesidades de habilidades empresariales para ligar la ruptura de la cadena de valor que la integración comercial produce.

  2. Estudo da associação entre hipertonia do complexo esfincteriano anal e dispareunia em mulheres adultas

    OpenAIRE

    Fernandes, Samantha Figueiredo Frota

    2012-01-01

    Existem várias associações entre causas orgânicas e dispareunia, no entanto há poucos estudos que examinam sua relação com a hipertonia da musculatura do assoalho pélvico. Portanto, mulheres com hipertonia neste grupo muscular caracterizam uma amostra relevante para investigar a ocorrência de dispareunia. Objetivo: Estudar a possível associação entre hipertonia do complexo esfincteriano anal e dispareunia em mulheres adultas. Método: Participaram do estudo 57 mulheres, com idade de 18 a 51 an...

  3. Development of a pulse height analizer

    International Nuclear Information System (INIS)

    Moreira, E.S.

    1984-01-01

    The development of a Pulse Height Analizer is described. This equipment is essential to analize data coming from detectors producing information codified in pulse amplitudes. The system developed consist of a Signal Input Module connected to a Controller Module based on a 8085A microprocessor capable to memorize pulses up to 1 uS in 256 channels with a resolution better than 20 mV. A Communication Module with a serial interface is used for data transfer to a host computer using RS232c protocol. The Monitoring and Operation Module consist of a hexadecimal Keybord, a 6 digit 7-segment display and a XY analog output enabling real time visualization of data on a XY monitor. The hardware and the software designed for this low cost system were optimized to obtain a typical dead time of approximately 100 uS. As application, this device was used to adquire curves at the Small Angle X-ray Scattering Laboratory in this Department. The apparatus performance was tested by comparing its data with a Northern Pulse Height Analizer model NS633 output, with favorable results. (Author) [pt

  4. Validación de método analítico para el control de la calidad de vitamina B12 10 000 inyección Validation of analytical method for quality control of B12 Vitamin-10 000 injection

    Directory of Open Access Journals (Sweden)

    Martha Botet García

    2009-12-01

    Full Text Available Se validó el método analítico reportado en la Farmacopea de los Estados Unidos, para el control de la calidad de vitamina B12 10 000 U (cianocobalamina inyectable, por espectrofotometría ultravioleta, por ser este un método más sencillo, económico y que permite controlar la calidad del producto terminado. La curva de calibración se realizó en el intervalo de 60 al 140 %, donde fue lineal con un coeficiente de correlación igual a 0,9999; la prueba estadística para el intercepto y la pendiente se consideró no significativa. Se obtuvo un recobrado del 99,97 % en el intervalo de concentraciones estudiado, y las pruebas de Cochran (G y Student (t resultaron no significativas. El coeficiente de variación en el estudio de la repetibilidad fue igual a 0,59 % para las 6 réplicas ensayadas, mientras que en los análisis de la precisión intermedia las pruebas de Fischer y Student no significativas. El método analítico resultó lineal, preciso, específico y exacto en el intervalo de concentraciones estudiadas.Analytical method reported by USA Pharmacopeia was validated for quality control of injectable B12 Vitamin (10 000 U by UV spectrophotometry because this is a simpler and low-cost method allowing quality control of finished product. Calibration curve was graphed at 60 to 140 % interval, where it was linear with a correlation coefficient similar to 0, 9999; statistical test for interception and slope was considered non-significant. There was a recovery of 99.7 % in study concentrations interval where the Cochran (G and Student(t test were not significant too. Variation coefficient in repetition study was similar to 0.59 % for the 6 assayed replies, whereas in intermediate precision analysis, the Fisher and Student tests were not significant. Analytical method was linear, precise, specific and exact in study concentrations interval.

  5. Evaluación externa de la calidad analítica en hematología: una necesidad en América Latina

    Directory of Open Access Journals (Sweden)

    Fink Nilda E.

    1997-01-01

    Full Text Available La garantía de calidad analítica de un laboratorio clínico se logra mediante un sistema de control de calidad interno complementado por un programa de evaluación externa. Esa garantía es la base que fundamenta la confiabilidad de los resultados obtenidos por los laboratorios y su uso en el diagnóstico y tratamiento de las enfermedades. En los países de América Latina hay muchos laboratorios que no cuentan con sistemas apropiados de evaluación y control de la calidad. Dada la importancia de los diagnósticos basados en datos hematológicos, durante el XI Congreso Latinoamericano de Bioquímica Clínica (México, 1993 la Organización Panamericana de la Salud patrocinó un curso de control de la calidad en hematología en el que participaron Argentina, Chile, Cuba, México, Paraguay, República Dominicana y Uruguay. Como parte del curso se produjeron materiales de control: solución estándar secundario de cianmetahemoglobina (HICN, solución concentrada estabilizada de hemoglobina (Hb y sangre entera humana preservada con seudoleucocitos. Estos materiales fueron enviados a laboratorios de los siete países participantes para su uso en procedimientos analíticos, con objeto de llevar a cabo posteriormente una evaluación externa del desempeño individual y de la comparabilidad de los resultados en conjunto. Las tareas asignadas fueron: 1 determinación de hemoglobina, hematocrito, y glóbulos rojos y blancos con los métodos en uso en cada laboratorio; 2 registro de los datos obtenidos en formularios especiales para la notificación de datos y 3 envío de dichos formularios al coordinador de cada país. Los resultados fueron analizados en función de los procedimientos analíticos y de los países participantes. Los valores de referencia se establecieron por consenso general de todos los participantes después de someterse al método estadístico de truncamiento. El análisis comparado de los resultados mostró coeficientes de variaci

  6. Validación del método analítico para el control de la calidad y estudio de estabilidad de ketotifeno colirio 0,025 % Validation of analytical method to quality control and the stability study of 0.025 % eyedrops Ketotiphen

    Directory of Open Access Journals (Sweden)

    Yenilen Troche Concepción

    2010-09-01

    Full Text Available El colirio de ketotifeno se indica para aliviar los signos y síntomas de las conjuntivitis alérgicas, por ser este un potente antihistamínico H1 que muestra cierta capacidad para inhibir la liberación de histamina y otros mediadores en mastocitos. En este trabajo se desarrolló y validó un método analítico por cromatografía líquida de alta resolución, para el control de la calidad y los estudios de estabilidad del ketotifeno colirio 0,025 %. El método se basó en la separación del principio activo a través una columna cromatográfica Lichrosorb RP-18 (5 µm (250 x 4 mm, con detección ultravioleta a 296 nm, para lo cual se empleó una fase móvil compuesta por una mezcla desgasificada de metanol:buffer fosfato (75:25; pH 8,5 y se le añadió 1 mL de isopropanol por cada 1 000 mL de la mezcla anterior, con una velocidad de flujo de 1,2 mL/min. El método analítico resultó lineal, preciso, específico y exacto en el intervalo de concentraciones estudiadas.The Ketotiphen eyedrop is prescribed to relief the signs and symptoms of allergic conjunctivitis due to its potent H1 antihistaminic effect showing some ability to inhibit the histamine release and other mediators in cases of mastocytosis. The aim of present paper was to develop and validate an analytical method for the high-performance liquid chromatography, to quality control and the stability studies of 0.025 % eyedrop Ketotiphen. Method was based on active principle separation by means of a Lichrosorb RP-18 (5 µm (250 x 4 mm, with UV detection to 296 nm using a mobile phase including a non-gasified mixture of methanol:buffer-phosphate (75:25; pH 8.5 adding 1 mL of Isopropanol by each 1 000 mL of the previous mixture at a 1.2 mL/min flow velocity. The analytical method was linear, accurate, specific and exact during the study concentrations.

  7. Nuevo método para medir un inductor de proteínas recombinantes

    OpenAIRE

    Fernández Castañé, Alfred

    2012-01-01

    El IPTG es un azúcar sintético análogo de la lactosa que se utiliza para la inducción de la producción de proteínas en la bacteria Escherichia coli. En la presente tesis doctoral se ha desarrollado por primera vez un método analítico para medir el IPTG en el medio de cultivo y dentro de las células que ha permitido estudiar el comportamiento de inducción en cultivos de alta densidad celular así como optimizar su dosis para obtener la máxima cantidad de producto.

  8. Validación de métodos analíticos para los estudios de estabilidad del naproxeno en supositorios para uso infantil y adulto Validation of analytical methods for the stability studies of naproxen suppositories for infant and adult use

    Directory of Open Access Journals (Sweden)

    Yaslenis Rodríguez Hernández

    2011-12-01

    Full Text Available En el presente trabajo se realizaron los estudios analíticos y de validación para su aplicación en los estudios de estabilidad de las futuras formulaciones de supositorios de naproxeno para uso infantil y adulto. Se determinaron los factores que más influyeron en la estabilidad del naproxeno; la mayor degradación ocurrió en el medio ácido, oxidante y por acción de la luz. Se evaluó un método por cromatografía líquida de alta resolución, el cual mostró adecuado desempeño para cuantificar naproxeno en supositorios y fue selectivo frente a los productos de degradación. Se obtuvo un límite de cuantificación de 3,480 µg, por lo que fue válido para la realización de dichos estudios. Adicionalmente, se evaluaron los parámetros especificidad para estabilidad, límites de detección y de cuantificación para el método por volumetría ácido-base semiacuosa directa validado anteriormente para control de calidad, lo cual mostró resultados satisfactorios. No obstante, los métodos volumétricos no se consideran indicadores de estabilidad, por lo que este método será utilizado conjuntamente con los métodos cromatográficos de elección para determinar productos de degradación: cromatografía de capa delgada y cromatografía líquida de alta resolución.Analytical and validating studies were performed in this paper, with a view to using them in the stability studies of the future formulations of naproxen suppositories for children and adults. The most influential factors in the naproxen stability were determined, that is, the major degradation occurred in acid medium, oxidative medium and by light action. One high-performance liquid chromatography-based method was evaluated, which proved to be adequate to quantify naproxen in suppositories and was selective against degradation products. The quantification limit was 3,480 µg, so it was valid for these studies. Additionally, the parameters specificity for stability, detection and

  9. Leiomyoma of the anal canal: report of two cases.

    Science.gov (United States)

    Witz, M; Bernheim, J; Griffel, B; Dinbar, A

    1986-10-01

    Leiomyoma of the rectum and anal canal is an unusual clinical entity. Generally, it does not produce any clinical signs and in most cases it is discovered incidentally in the course of routine rectal examination. The clinical presentation, diagnosis, and surgical treatment are described in two presented cases of anal canal leiomyoma.

  10. Squamous intraepithelial lesions of the anal squamocolumnar junction: Histopathological classification and HPV genotyping

    Directory of Open Access Journals (Sweden)

    Omar Clavero

    2017-06-01

    Full Text Available Background: Human papillomavirus (HPV-related anal cancer lesions are often found adjacent to the squamocolumnar junction (SCJ. We have assessed the histopathology and associated HPV genotypes in anal SCJ lesions in surgically excised anal warts in HIV-negative and –positive patients. Methods: Histopathology identified 47 squamous intraepithelial lesions (SILs adjacent to the SCJ amongst a total of 145 cases of clinically diagnosed anal condylomata. The anal SCJ lesions were further analyzed with p16, CK7 and p63 immunohistochemistry and HPV genotyping. Results: Sixteen (16/47 of the excised anal wart lesions contained HSIL; Three were HSIL and exclusively associated with oncogenic HPVs. A further thirteen (13/47 were mixed lesions. Of these eight were HSILs with LSIL and six were HSILs with papillary immature metaplasia (PIM; Ten of the mixed lesions were associated with one or more oncogenic HPVs, while three cases were exclusively associated with HPV6. Conclusions: Clinically diagnosed anal warts cannot be assumed to be limited to low-grade lesions as anal warts of the SCJ often show heterogeneous lesions, with coexistence of LSIL, PIM, and HSIL. Lesions showing PIM, however, may mimic HSIL, because they are hypercellular, but lack the nuclear atypia and conspicuous mitotic activity of HSIL; and are p16 negative. Keywords: Anal squamocolumnar junction, Low-grade squamous intraepithelial lesion (LSIL, High-grade squamous intraepithelial lesion (HSIL, Papillary immature metaplasia (PIM, HPV, HIV

  11. An integrative review of guidelines for anal cancer screening in HIV-infected persons.

    Science.gov (United States)

    Wells, Jessica S; Holstad, Marcia M; Thomas, Tami; Bruner, Deborah Watkins

    2014-07-01

    HIV-infected individuals are 28 times more likely than the general population to be diagnosed with anal cancer. An integrative review of recommendations and guidelines for anal cancer screening was performed to provide a succinct guide to inform healthcare clinicians. The review excluded studies that were of non-HIV populations, redundant articles or publications, non-English manuscripts, or nonclinical trials. The review found no formal national or international guidelines exist for routine screening of anal cancer for HIV-infected individuals. To date, no randomized control trial provides strong evidence supporting efficaciousness and effectiveness of an anal cancer screening program. The screening recommendations from seven international-, national-, and state-based reports were reviewed and synthesized in this review. These guidelines suggest anal cancer screening, albeit unproven, may be beneficial at decreasing the incidence of anal cancer. This review highlights the paucity of screening-related research and is an area of need to provide clear direction and to define standard of care for anal cancer screening in HIV-infected persons.

  12. Changes in the proportions of types I and III collagen in hemorrhoids: the sliding anal lining theory

    Directory of Open Access Journals (Sweden)

    Carlos Sardiñas

    2016-07-01

    foram reunidas em 2014. Todos os pacientes passaram por uma hemorroidectomia aberta; para tanto, foi empregada a técnica descrita por Milligan e Morgan, publicada no periódico Lancet em 1937. As amostras de hemorroida foram coradas com hematoxilina-eosina com vistas ao estudo histológico para confirmação do diagnóstico de tecido hemorroidal. Após a análise histológica, o material foi corado com o protocolo de picrosirius red. O método empregado para o processamento das imagens está descrito no texto. As imagens foram importadas pelo software Image Tool for Windows. O mesmo processo foi empregado no tecido embrionário. Os dados resultantes da análise das imagens fora processados com o programa STATISTICA, um software para análise estatística. Resultados: Por comparação, constatamos que os dois tecidos apresentavam valores muito diferentes, e as hemorroidas continham os mais altos valores de colágeno do tipo III. Conclusão: Nossos resultados parecem implicar que hemorroidas possuem um percentual mais elevado de colágeno do tipo III versus tecido fetal. Os resultados também sugerem uma possível deterioração do tecido, relacionada à idade. Keywords: Hemorrhoids, Anal, Canal, Collagen, Type I, Type III, Fetus, Deterioration, Palavras-chave: Hemorroidas, Anal, Canal, Colágeno, Tipo I, Tipo III, Feto, Deterioração

  13. Surgical Treatment of Anal Stenosis with Diamond Flap Anoplasty Performed in a Calibrated Fashion.

    Science.gov (United States)

    Gülen, Merter; Leventoğlu, Sezai; Ege, Bahadir; Menteş, B Bülent

    2016-03-01

    Regarding anoplasty for anal stenosis, it is not clear to what extent the final anal caliber should be targeted. The aim of this study was to investigate the results of diamond-flap anoplasty performed in a calibrated manner for the treatment of severe anal stenosis due to a previous hemorrhoidectomy. Prospectively prepared standard forms were evaluated retrospectively. Anoplasty with unilateral or bilateral diamond flaps was performed for moderate or severe anal stenosis, targeting a final anal caliber of 25 to 26 mm. The demographic characteristics, causes of anal stenosis, number of previous surgeries, anal stenosis staging (Milsom and Mazier), anal calibers (millimeter), the Cleveland Clinic Incontinence Score, and the modified obstructed defecation syndrome Longo score were recorded on pre-prepared standard forms, as well as postoperative complications and the time of return to work. From January 2011 to July 2013, 18 patients (12 males, 67%) with a median age of 39 years (range, 27-70) were treated. All of the patients had a history of previous hemorrhoidectomy. The number of previous corrective interventions was 2.1 ± 1.8 (range, 0-4), and 2 patients had a history of failed anoplasty. Five patients (28%) had moderate anal stenosis and 13 (72%) had severe anal stenosis. Preoperative, intraoperative, and 12-month postoperative anal calibration values were 9 ± 3 mm (range, 5-15), 25 ± 0.75 mm (range, 24-26), and 25 ± 1 mm (range, 23-27) (p < 0.0001, for immediate postoperative and 12-month postoperative anal calibers compared with the intraoperative). Preoperative and 12-month postoperative Cleveland Clinic Incontinence Scores were 0.83 ± 1.15 (range, 0-4) and 0.39 ± 0.70 (range, 0-2) (p = 1.0). The clinical success rate was 88.9%. No severe postoperative complications were observed. This study was limited because it was a single-armed, retrospective analysis of prospectively designed data. Diamond-flap anoplasty performed in a standardized and calibrated

  14. Validación del método analítico para el control de la calidad y estudio de estabilidad de propiltiouracilo 50 mg Analytical method validation for quality control and the study of the 50 mg Propylthiouracil stability

    Directory of Open Access Journals (Sweden)

    María Olga Valdés Bendoyro

    2010-03-01

    Full Text Available Se desarrolló y validó un método analítico por cromatografía líquida de alta resolución, para el control de la calidad y los estudios de estabilidad del propiltiouracilo 50 mg, tabletas. El método se basó en la separación del principio activo a través una columna cromatográfica Lichrospher 100 RP-18 RP-18 (5 µm (250 x 4 mm, con detección ultravioleta a 272 nm, para lo cual se empleó una fase móvil compuesta por una mezcla desgasificada de solución amortiguadora fosfato de potasio monobásico 0,025 M a pH= 4,6, y acetonitrilo en una proporción de 80:20, con una velocidad de flujo de 0,5 mL/min. El método analítico resultó lineal, preciso, específico y exacto en el intervalo de concentraciones estudiadas.A high-performance liquid chromatography analytical method was developed and validated for the quality control and stability studies of 50 mg Propylthiouracil tablets. Method is based in active principle separation through a 100 RP-18 RP-18 (5 µm (250 x 4 mm Lichrospher chromatography with UV detection to 272 nm, using a mobile phase composed by a ungaseous mixture of a 0.025 M buffer solution-monobasic potassium phosphate to pH= 4,6 ad acetonitrile in a 80:20 ratio with a flux speed of 0,5 mL/min. Analytical method was linear, precise, specific and exact in the study concentrations interval.

  15. A trial of radiofrequency ablation for anal intraepithelial neoplasia.

    Science.gov (United States)

    Goldstone, Robert N; Hasan, Shirin R; Drury, Steven; Darragh, Teresa M; van Zante, Annemieke; Goldstone, Stephen E

    2017-03-01

    Radiofrequency ablation (RFA) effectively treats esophageal high-grade dysplasia, but its efficacy in treating anal canal high-grade squamous intraepithelial lesions (HSILs) is unsubstantiated. This prospective study assessed the safety and efficacy of applying hemi-circumferential RFA to anal canal HSIL. Twenty-one HIV-negative participants with HSIL occupying ≤ half the anal canal circumference were treated with hemi-circumferential anal canal RFA. Participants were assessed every 3 months for 12 months with high-resolution anoscopy; recurrence in the treatment zone was re-treated with focal RFA. Twenty-one participants with a mean of 1.7 lesions (range 1-4) enrolled and completed the trial. Six (29 %) participants had recurrent HSIL within the treated hemi-circumference within 1 year. Four participants (19 %) had persistence of an index lesion at 3 months. One (2.9 %) index HSIL persisted again at 12 months. No participants had more than two RFA treatments. KM curve-predicted HSIL-free survival within the treatment zone at 1 year was 76 % (95 % CI 52-89 %). Comparing the first 7 and last 14 participants, the predicted 1-year HSIL-free survivals are 43 % (95 % CI 10-73 %) and 93 % (95 % CI 59-99 %), respectively (p = 0.008), suggesting a learning curve with the treating physician. Multivariable analysis showed decreased recurrence in the last 14 participants (HR 0.02; 95 % CI 0.001-0.63) while increasing BMI increased recurrence (HR 1.43, 95 % CI 1.01-2.01). No participants had device or procedure-related serious adverse events, anal stricture, or heavy bleeding. Hemi-circumferential RFA yielded a high rate of anal HSIL eradication in HIV-negative patients at 1 year with minimal adverse events. Lesion persistence was probably related to incomplete initial ablation.

  16. Overdiagnosis and rising rate of obstetric anal sphincter injuries (OASIS): time for reappraisal.

    Science.gov (United States)

    Sioutis, D; Thakar, R; Sultan, A H

    2017-11-01

    To determine the accuracy of clinical diagnosis of obstetric anal sphincter injuries (OASIS) using three-dimensional (3D) endoanal ultrasound (EA-US) and to compare symptoms and anal manometry measurements between women with anal sphincters adequately repaired and those with persistent anal sphincter defects. The EA-US images of women with clinically diagnosed and repaired OASIS, defined as third- or fourth-degree perineal tear, who attended the perineal clinic at Croydon University Hospital over a 10-year period (2003-2013) were reanalyzed by a single expert blind to symptoms and the results of clinical examination. St Mark's Incontinence Scores (SMIS) and anal manometry measurements were obtained and compared between women with an intact anal sphincter and those with an anal sphincter scar and between those with an intact anal sphincter and those with a defect. Anal manometry measurements were compared between women with an external anal sphincter (EAS) defect and those with an internal anal sphincter (IAS) defect. The images of 908 women were reanalyzed. No evidence of OASIS was found in 64 (7.0%) women, an EAS scar alone was detected in 520 (57.3%) and an anal sphincter defect in 324 (35.7%). Of the 324 women with a defect, 112 had an EAS defect, 90 had an IAS defect and 122 had a combined IAS and EAS defect. SMIS results were significantly higher in women with an anal sphincter defect compared with those with no evidence of OASIS (P = 0.018), but there was no significant difference in scores between women with an intact sphincter and those with an EAS scar only. Women with a defect had a significantly lower maximum resting pressure (median (range), 44 (8-106) vs 55 (29-86) mmHg; P 40) vs 25 (10-40) mm; P = 0.003). Seven percent of women with a clinical diagnosis of OASIS were wrongly diagnosed. We believe that this rate may differ from that of other units but training methods and competency assessment tools for the diagnosis and repair of OASIS need

  17. Viscoelastic assessment of anal canal function using acoustic reflectometry: a clinically useful technique.

    Science.gov (United States)

    Mitchell, Peter J; Klarskov, Niels; Telford, Karen J; Hosker, Gordon L; Lose, Gunnar; Kiff, Edward S

    2012-02-01

    Anal acoustic reflectometry is a new reproducible technique that allows a viscoelastic assessment of anal canal function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, opening and closing elastance, and hysteresis. The aim of this study was to assess whether the parameters measured in anal acoustic reflectometry are clinically valid between continent and fecally incontinent subjects. This was an age- and sex-matched study of continent and incontinent women. The study was conducted at a university teaching hospital. One hundred women (50 with fecal incontinence and 50 with normal bowel control) were included in the study. Subjects were age matched to within 5 years. Parameters measured with anal acoustic reflectometry and manometry were compared between incontinent and continent groups using a paired t test. Diagnostic accuracy was assessed by the use of receiver operator characteristic curves. Four of the 5 anal acoustic reflectometry parameters at rest were significantly different between continent and incontinent women (eg, opening pressure in fecally incontinent subjects was 31.6 vs 51.5 cm H2O in continent subjects, p = 0.0001). Both anal acoustic reflectometry parameters of squeeze opening pressure and squeeze opening elastance were significantly reduced in the incontinent women compared with continent women (50 vs 99.1 cm H2O, p = 0.0001 and 1.48 vs 1.83 cm H2O/mm, p = 0.012). In terms of diagnostic accuracy, opening pressure at rest measured by reflectometry was significantly superior in discriminating between continent and incontinent women in comparison with resting pressure measured with manometry (p = 0.009). Anal acoustic reflectometry is a new, clinically valid technique in the assessment of continent and incontinent subjects. This technique, which assesses the response of the anal canal to distension and relaxation, provides a detailed viscoelastic assessment of anal canal function. This technique

  18. Cytological Anal Squamous Intraepithelial Lesions Associated with Anal High-Risk Human Papillomavirus Infections among Men Who Have Sex with Men in Northern Thailand.

    Directory of Open Access Journals (Sweden)

    Darin Ruanpeng

    Full Text Available Anal cancer, one of human papillomavirus (HPV related malignancies, has increased in recent decades, particularly among men who have sex with men (MSM and HIV-infected (HIV+ persons. We aimed to explore the prevalence of anal squamous intraepithelial lesions (ASIL using Papanicolau (Pap screening among MSM in northern Thailand and its associated factors.Two hundreds MSM aged ≥18 years reporting receptive anal intercourse in the prior 6 months were recruited from July 2012 through January 2013. Medical history and behavioral data were collected by staff interview and computer-assisted self interview. Anal Pap smear, HPV genotyping, and HIV testing were performed. Two pathologists blinded to HPV and HIV status reported cytologic results by Bethesda classification.Mean age was 27.2 years (range 18-54. Overall, 86 (43.0% had ASIL: 28 (14.2% with atypical cells of undetermined significance (ASCUS, 1 (0.5% with atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H, 56 (28.4% with low-grade squamous intraepithelial lesion (LSIL, and 1 (0.5% with high-grade squamous intraepithelial lesion (HSIL. ASIL was associated by univariate analysis (p ≤0.05 with older age, gender identity other than bisexual (i.e., gay men and transgender women, rectal douching, anal symptoms, genital warts, HIV positivity, and high-risk-HPV infection. However, on multiple logistic regression ASIL was associated only with high-risk HPV type (p = 0.002 and HIV infection (p = 0.01.ASIL is quite common in high-risk MSM in northern Thailand and is associated with high-risk HPV types and HIV infection. Routine anal Pap screening should be considered, given the high frequency of ASIL, particularly in the HIV+. High resolution anoscopy (HRA, not done here, should be to confirm PAP smears whose sensitivity and specificity are quite variable. Timely HPV vaccination should be considered for this population.

  19. Cytological Anal Squamous Intraepithelial Lesions Associated with Anal High-Risk Human Papillomavirus Infections among Men Who Have Sex with Men in Northern Thailand.

    Science.gov (United States)

    Ruanpeng, Darin; Chariyalertsak, Suwat; Kaewpoowat, Quanhathai; Supindham, Taweewat; Settakorn, Jongkolnee; Sukpan, Kornkanok; Utaipat, Utaiwan; Miura, Toshiyuki; Kosashunhanan, Natthapol; Saokhieo, Pongpun; Songsupa, Radchanok; Wongthanee, Antika

    2016-01-01

    Anal cancer, one of human papillomavirus (HPV) related malignancies, has increased in recent decades, particularly among men who have sex with men (MSM) and HIV-infected (HIV+) persons. We aimed to explore the prevalence of anal squamous intraepithelial lesions (ASIL) using Papanicolau (Pap) screening among MSM in northern Thailand and its associated factors. Two hundreds MSM aged ≥18 years reporting receptive anal intercourse in the prior 6 months were recruited from July 2012 through January 2013. Medical history and behavioral data were collected by staff interview and computer-assisted self interview. Anal Pap smear, HPV genotyping, and HIV testing were performed. Two pathologists blinded to HPV and HIV status reported cytologic results by Bethesda classification. Mean age was 27.2 years (range 18-54). Overall, 86 (43.0%) had ASIL: 28 (14.2%) with atypical cells of undetermined significance (ASCUS), 1 (0.5%) with atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H), 56 (28.4%) with low-grade squamous intraepithelial lesion (LSIL), and 1 (0.5%) with high-grade squamous intraepithelial lesion (HSIL). ASIL was associated by univariate analysis (p ≤0.05) with older age, gender identity other than bisexual (i.e., gay men and transgender women), rectal douching, anal symptoms, genital warts, HIV positivity, and high-risk-HPV infection. However, on multiple logistic regression ASIL was associated only with high-risk HPV type (p = 0.002) and HIV infection (p = 0.01). ASIL is quite common in high-risk MSM in northern Thailand and is associated with high-risk HPV types and HIV infection. Routine anal Pap screening should be considered, given the high frequency of ASIL, particularly in the HIV+. High resolution anoscopy (HRA), not done here, should be to confirm PAP smears whose sensitivity and specificity are quite variable. Timely HPV vaccination should be considered for this population.

  20. Radiation therapy of recurrent anal squamous cell carcinoma in-situ: a case report

    Directory of Open Access Journals (Sweden)

    Noone Robert

    2010-02-01

    Full Text Available Abstract Introduction High-grade anal intraepithelial neoplasia, also referred to as anal squamous carcinoma in-situ, or Bowen's disease of the anus, make up less than 1% of all digestive system cancers in the United States. The treatment of choice is surgical resection with anal mapping. However, this disease often recurs or persists, requiring additional surgery for these patients. This can compromise the anal sphincter leading to leakage. In this case report, we discuss the efficacy of radiation therapy as a modality to treat post-excisional recurrent Bowen's disease, which may prevent sphincter compromise, leading to improved quality of life. Case presentation An 84-year-old Caucasian woman presented with post-excisional persistent/recurrent squamous cell carcinoma in-situ. The initial lesion measured 3 cm in diameter on the right lateral side of the anal margin. A standard surgery consisting of wide local excision with anal mapping was performed. The margins were clear and our patient was followed up. Our patient recurred with a 1.2 × 0.8 cm lesion on the left anal verge extending to the anal canal. A biopsy along with mapping was done, and 2 of the 17 mapping specimens were positive for carcinoma in-situ, one in the anal canal. Due to the location of the positive anal mapping, and in order to prevent sphincter compromise on re-excision, our patient was offered definitive radiation therapy. Two years after radiation therapy, our patient showed no signs of recurrent disease and had good sphincter control. Conclusion Although the main treatment modality for treating persistent/recurrent Bowen's disease is surgery, an alternative approach using external beam radiation for CIS may be enough to provide a cure for some patients with recurrent disease.

  1. Critérios de positividade para cervicografia digital: melhorando a sensibilidade do diagnóstico do câncer cervical Digital cervicography criteria: improving sensitivity in uterine cervical cancer diagnosis

    Directory of Open Access Journals (Sweden)

    Eugênio Santana Franco

    2008-11-01

    Full Text Available O objetivo deste trabalho foi validar critérios de positividade para cervicografia digital. Estudo realizado com 300 mulheres submetidas a protocolo clínico composto por exame citológico, uma avaliação por meio de cervicografia digital sem ampliação de imagem (Avaliação 1, e outra avaliação também usando cervicografia digital mas com ampliação adicional de imagem e os critérios de positividade propostos neste estudo (Avaliação 2. A idade média das mulheres foi de 27,6 anos. Os critérios de positividade para cervicografia digital foram identificados em 111 casos (100% dos testes positivos para lesões precursoras do câncer do colo uterino e em 8 casos (2,6% considerados falso-positivos. As avaliações 1 e 2 classificaram os exames como positivos (163; 54,3% e suspeitos (146; 48,6%, respectivamente. Os resultados revelam que a cervicografia digital foi mais sensível (99,1% e a citologia mais específica (100%. O desempenho alcançado pela cervicografia digital, quando aplicado os critérios de positividade, alcançou sensibilidade 4,5 vezes superior ao desempenho da citologia oncológica, além do baixo custo, sugerindo ser uma técnica factível.This study aimed to validate the scoring criteria for digital cervicography. The study enrolled 300 women submitted to a clinical protocol using cytological examination alone, digital cervicography without image magnification (Evaluation 1, and digital cervicography plus additional image magnification and considering the positive criteria (Evaluation 2. Women's mean age was 27.6 years. Positive criteria for digital cervicography were identified in 111 positive cases with pre-cancerous cervical lesions (100% and in 8 cases classified as false positives (2.6%. Evaluations 1 and 2 classified the tests as positive (163; 54.3% and suspected (146; 48.6%, respectively. According to the findings, digital cervicography was more sensitive (99.1% and cytology more specific (100%. Digital

  2. Relation between anal electrosensitivity and rectal filling sensation and the influence of age

    NARCIS (Netherlands)

    Broens, PMA; Penninckx, FM

    PURPOSE: The aim of this study was to assess the effect of age and sex on the rectal filling sensation and anal electrosensitivity and to explore the relation between anal electrosensitivity and the parameters of the rectal filling sensation. METHODS: Anal mucosal electrosensitivity and anorectal

  3. The identification of specialized pacemaking cells in the anal sphincters.

    Science.gov (United States)

    Shafik, Ahmed; El Sibai, Olfat; Ahmed, Ismail

    2006-07-01

    Interstitial cells of Cajal (ICC) are claimed to generate the electrical activity in the colon and stomach. As the external (EAS) and internal (IAS) anal sphincters exhibit resting electrical activity, we hypothesized the presence of ICC in these sphincters. This hypothesis was investigated in the current study. Specimens from the EAS and IAS were taken from normal areas of the anorectum which had been surgically excised by abdominoperineal operation for rectal cancer of 28 patients (16 men, 12 women, mean age 42.2+/-4.8 years). The specimens were subjected to c-kit immunohistochemistry. Controls for the specificity of the antisera consisted of tissue incubation with normal rabbit serum substituted for the primary antiserum. Fusiform, c-kit positive, ICC-like cells were detected in the anal sphincters; they had dendritic processes. They were clearly distinguishable from the non-branching, c-kit negative smooth and striated muscle cells of the anal sphincters. The specimens contained also c-kit positive mast cells, but they had a rounded body with no dendritic processes. Immunoreactivity was absent in negative controls in which the primary antibody was omitted. We have identified, for the first time, cells in EAS and IAS with morphological and immunological phenotypes similar to ICCs of the gut. These cells appear to be responsible for initiating the slow waves recorded from the anal sphincters and for controlling their activity. A deficiency or absence of these cells may affect the anal motile activity. Studies are needed to explore the role of these cells in anal motility disorders.

  4. Explicacions basades en raons i sociologia analítica. Una rèplica a Boudon

    OpenAIRE

    Manzo, Gianluca

    2014-01-01

    El trabajo discute la teoría de la racionalidad ordinaria de Raymond Boudon, así como su valoración de la denominada «sociología analítica». Respecto a la primera cuestión, el artículo argumenta que, para combinar el realismo de una concepción de la racionalidad sin constreñimientos con el poder predictivo ex-ante facto de la versión estándar de la teoría de la elección racional, debemos comprender mejor la relación entre eventos potencialmente desencadenantes y las «razones» del actor. Heurí...

  5. The impact of anaemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin.

    Science.gov (United States)

    Oblak, Irena; Cesnjevar, Monika; Anzic, Mitja; Hadzic, Jasna But; Ermenc, Ajra Secerov; Anderluh, Franc; Velenik, Vaneja; Jeromen, Ana; Korosec, Peter

    2016-03-01

    Radiochemotherapy is the main treatment for patients with squamous cell carcinoma of the anal canal. Anaemia is reported to have adverse effect on survival in cancer patients. The aim of the study was to evaluate the influence of anaemia on radiochemotherapy treatment outcome in patients with squamous cell carcinoma of the anal canal. One hundred consecutive patients with histologically confirmed squamous cell carcinoma of the anal canal were treated radically with 3-dimensional conformal or intensity-modulated radiation therapy followed by brachytherapy or external beam radiotherapy boost and with concurrent mitomycin C and 5-fluorouracil. The influence on survival of pre-treatment, mean on-treatment and end-of-treatment haemoglobin (Hb) concentrations was studied. The 5-year locoregional control, disease free survival, disease specific survival and overall survival rates for all patients were 72%, 71%, 77% and 62%, respectively. In univariate analysis, patients with pre-treatment and end-of-treatment Hb > 120 g/L survived statistically significantly better compared to patients with Hb ≤ 120 g/L. Patients with mean on-treatment Hb > 120 g/L only had statistically significant better locoregional control and overall survival than patients with Hb ≤ 120 g/L. In multivariate analysis, independent prognostic factors were pre-treatment Hb (> 120 g/L vs. ≤ 120 g/L) for overall survival (hazard ratio [HR] = 0.419, 95% confidence interval [CI] = 0.190-0.927, p = 0.032) and stage (I & II vs. III) for disease specific (HR = 3.523, 95% CI = 1.375-9.026, p = 0.009) and overall survival (HR = 2.230, 95% CI = 1.167-4.264, p = 0.015). The pre-treatment, mean on-treatment and end-of-treatment Hb concentration > 120 g/L carried better prognosis for patients for with squamous cell carcinoma of the anal canal treated with radiochemotherapy. The pre-treatment Hb > 120 g/L was an independent prognostic factor for overall survival of patients with anal canal cancer.

  6. The impact of anaemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin

    International Nuclear Information System (INIS)

    Oblak, Irena; Cesnjevar, Monika; Anzic, Mitja; Hadzic, Jasna But; Ermenc, Ajra Secerov; Anderluh, Franc; Velenik, Vaneja; Jeromen, Ana; Korosec, Peter

    2016-01-01

    Radiochemotherapy is the main treatment for patients with squamous cell carcinoma of the anal canal. Anaemia is reported to have adverse effect on survival in cancer patients. The aim of the study was to evaluate the influence of anaemia on radiochemotherapy treatment outcome in patients with squamous cell carcinoma of the anal canal. One hundred consecutive patients with histologically confirmed squamous cell carcinoma of the anal canal were treated radically with 3-dimensional conformal or intensity-modulated radiation therapy followed by brachytherapy or external beam radiotherapy boost and with concurrent mitomycin C and 5-fluorouracil. The influence on survival of pre-treatment, mean on-treatment and end-of-treatment haemoglobin (Hb) concentrations was studied. The 5-year locoregional control, disease free survival, disease specific survival and overall survival rates for all patients were 72%, 71%, 77% and 62%, respectively. In univariate analysis, patients with pre-treatment and end-of-treatment Hb > 120 g/L survived statistically significantly better compared to patients with Hb ≤ 120 g/L. Patients with mean on-treatment Hb > 120 g/L only had statistically significant better locoregional control and overall survival than patients with Hb ≤ 120 g/L. In multivariate analysis, independent prognostic factors were pre-treatment Hb (> 120 g/L vs. ≤ 120 g/L) for overall survival (hazard ratio [HR] = 0.419, 95% confidence interval [CI] = 0.190–0.927, p = 0.032) and stage (I & II vs. III) for disease specific (HR = 3.523, 95% CI = 1.375–9.026, p = 0.009) and overall survival (HR = 2.230, 95% CI = 1.167–4.264, p = 0.015). The pre-treatment, mean on-treatment and end-of-treatment Hb concentration > 120 g/L carried better prognosis for patients for with squamous cell carcinoma of the anal canal treated with radiochemotherapy. The pre-treatment Hb > 120 g/L was an independent prognostic factor for overall survival of patients with anal canal cancer

  7. Early Squamous Cell Carcinoma of the Anal Canal Resected by Endoscopic Submucosal Dissection

    Directory of Open Access Journals (Sweden)

    Yuzuru Tamaru

    2015-04-01

    Full Text Available The standard treatment approach for squamous cell carcinoma (SCC of the anal canal includes abdominoperineal resection and chemoradiotherapy. However, there are currently very few reports of early SCC of the anal canal resected by endoscopic submucosal dissection (ESD. We report 2 rare cases of SCC of the anal canal resected by ESD. In case 1, a 66-year-old woman underwent a colonoscopy due to blood in her stool, and an elevated lesion, 15 mm in size, was identified from the rectum to the dentate line of the anal canal on internal hemorrhoids. The lesion was diagnosed as an early SCC of the anal canal, and ESD was successfully performed. The histopathological diagnosis was SCC in situ. In case 2, a 71-year-old woman underwent a colonoscopy due to constipation, and an elevated lesion, 25 mm in size, was identified from the dentate line to the anal canal. The lesion was diagnosed as early-stage SCC of the anal canal, and ESD was successfully performed. The histopathological diagnosis was SCC in situ. No complications or recurrence after ESD occurred in either case.

  8. Endosonographic and manometric evaluation of internal anal sphincter in patients with chronic anal fissure and its correlation with clinical outcome after topical glyceryl trinitrate therapy.

    Science.gov (United States)

    Pascual, Marta; Pera, Miguel; Courtier, Ricard; Gil, Mariá José; Parés, David; Puig, Sonia; Andreu, Montserrat; Grande, Luis

    2007-08-01

    Anorectal pressure studies have demonstrated internal anal sphincter (IAS) hypertonia in patients with chronic anal fissure. It is unknown however, if these changes in IAS function are associated with any abnormality in sphincter morphology. The first aim was to investigate the clinical characteristics and the manometric and endosonographic findings of the IAS in a cohort of patients with chronic anal fissure. The second aim was to investigate the association between these findings and the outcome with topical Glyceryl trinitrate (GTN) therapy. All patients who presented with chronic anal fissure from November 1999 to May 2004 were included after failure of conservative therapy. Anorectal manometry and anal endosonography were performed before treatment with 0.2% GTN ointment twice daily was initiated. Patients were evaluated after 8 weeks. One hundred and twenty-four patients (66 women, mean age, 45.2 +/- 14.8 years) were included. Hypertonia of the IAS was found in 84 (68%) patients. The mean maximum IAS thickness was 3.6 +/- 0.76 mm (1.6-5.5). An abnormally thick IAS, adjusted by age, was observed in 113 (91.1%) patients. We found no correlation between resting pressure and IAS thickness (r = 0.074; p = 0.41). At 8 weeks, 52 patients (42%) had healed with complete symptoms resolution. No statistically significant differences were observed when clinical features and manometric and endosonographic findings were compared between healing and no-healing fissures. The majority of patients with chronic anal fissure present an abnormally thick IAS. Clinical, manometric and endosonographic features had no association with outcome after GTN treatment.

  9. Desenvolvimento e validação de metodologia analítica, ensaio de dissolução e estudo de estabilidade do carbonato de lodenafila

    OpenAIRE

    Cristiane Franco Codevilla

    2012-01-01

    O carbonato de lodenafila é um inibidor da fosfodiesterase tipo 5, desenvolvido no Brasil, o qual é um dímero formado por duas moléculas de lodenafila ligadas por uma ponte carbonato. Encontra-se disponível sob a forma de comprimidos. Não existe monografia disponível para este fármaco em nenhum código oficial. Assim, o objetivo do presente estudo foi desenvolver métodos analíticos para análise qualitativa e quantitativa do carbonato de lodenafila em comprimidos, avaliação da estabilidade fren...

  10. Anal canal plasmacytoma - An uncommon presentation site

    International Nuclear Information System (INIS)

    Antunes, M. I.; Bujor, L.; Grillo, I. M.

    2011-01-01

    Background: Extramedullary plasmacytomas (EMP) are rare plasma cell tumors that arise outside the bone marrow. They are most often located in the head and neck region, but may also occur in the other locations. The lower gastrointestinal EMP represents less than 5% of all cases, and location in the anal canal is exceedingly rare. Aim: We present an exceedingly rare case of anal canal plasmacytoma, aiming to achieve a better understanding of this rare entity. Methods: We report a case of a 61-year-old man with a bulky mass in the anal canal. The lesion measured about 6 cm and invaded in all layers of the anal canal wall. The biopsy was performed and revealed a round and plasmocitoid cell population with a solid growth pattern and necrosis. The tumoral cells have express CD79a and CD138 with lambda chains. There was no evidence of disease in other locations and these features were consistent with the diagnosis of an extra-osseous plasmacytoma. The patient was submitted to conformal radiotherapy 50.4 Gy total dose, 1.8 Gy per fraction. After 24 months, the patient is asymptomatic and the lesion has completely disappeared. Conclusions: EMP accounts for approximately 3% of plasma cell malignancies. The median age is about 60 years, and the majority of patients are male. The treatment of choice for extramedullary plasmacytoma is radiation therapy in a dosage of about 50 Gy. Patients should be followed-up for life with repeated bone marrow aspiration and protein studies to detect the development of multiple myeloma. (authors)

  11. Treinamento esfincteriano anal: estudo transversal em crianças de 3 a 6 anos de idade Bowel toilet training: a cross-sectional study in children between 3 and 6 years old

    Directory of Open Access Journals (Sweden)

    José Eduardo G. B. de Miranda

    2011-09-01

    Full Text Available OBJETIVO: Avaliar o treinamento do controle esfincteriano anal em crianças, por meio de entrevista aplicada aos pais ou cuidadores. MÉTODOS: Estudo de corte transversal em crianças sadias, aplicando-se um questionário estruturado para 100 responsáveis por crianças entre três e seis anos de idade. RESULTADOS: 97% das crianças foram treinadas em casa pelas mães e 92% delas utilizaram a intuição, a experiência com o filho anterior e o aprendizado com as avós. O treinamento do controle esfincteriano anal e vesical foi iniciado simultaneamente em 84% dos casos, sendo o controle anal adquirido primeiramente em 41% das crianças. As mães com escolaridade menor e das classes C-D-E iniciaram o treinamento mais precocemente, sendo um dos fatores relatados o custo das fraldas. Não houve diferença entre meninos e meninas para idade de início e duração do treinamento. As crianças apresentavam a maioria dos "sinais de prontidão" para o início do treinamento e, das crianças que foram treinadas no vaso sanitário, uma pequena parcela utilizou redutor e apoio para os pés. Não houve aumento significativo de constipação intestinal após o treinamento e não foram observados casos de encoprese. CONCLUSÕES: As mães foram as responsáveis pelo treinamento esfincteriano anal e o iniciaram sem auxílio especializado. Nas classes sociais C-D-E, o custo das fraldas foi determinante para o início do treinamento esfincteriano anal.OBJECTIVE: To assess the practice of children's toilet training through interviews with parents and caretakers. METHODS: A cross-sectional study of healthy children using a questionnaire applied to parents or caretakers of 100 consecutive children aged 3 to 6 years old. RESULTS: 97% of the children were home-trained by their mothers and 92% of them used their intuition, previous experience with an older child and grandmothers' experience. Bowel and bladder toilet training started simultaneously in 84% of the cases

  12. Initial prevalence of anal human papilloma virus infection in liver transplant recipients.

    Science.gov (United States)

    Grąt, Michał; Grąt, Karolina; Hołówko, Wacław; Malejczyk, Magdalena; Walter de Walthoffen, Szymon; Lewandowski, Zbigniew; Kobryń, Konrad; Patkowski, Waldemar; Majewski, Sławomir; Młynarczyk, Grażyna; Krawczyk, Marek

    2014-08-01

    Although liver transplant recipients are at increased risk of human papilloma virus (HPV)-related anal cancer, limited data are available regarding the initial prevalence of anal HPV infection in this population. Anal swabs collected from 50 liver transplant recipients within the first three postoperative weeks were subjected to real-time polymerase chain reaction for detection of the four HPV genotypes: 6, 11, 16, and 18. Predictors of any, low-risk, and high-risk anal HPV infection were evaluated. Overall, the prevalence of any anal HPV infection was 18.0%, with the corresponding rates for high- and low-risk HPV genotypes being 8.0% and 10.0%, respectively. Infection with any type of anal HPV was higher in patients with hepatitis B virus (HBV) infection (P = 0.027), ≥3 sexual partners (P = 0.031), and alcoholic liver disease (P = 0.063). HBV infection was the only factor significantly associated with high-risk HPV infection (P = 0.038). Male sex (P = 0.050), age ≥52 years (P = 0.016), ≥30 sexual partners (P = 0.003), age at first intercourse ≤18 years (P = 0.045), and time since first intercourse ≥38 years (P = 0.012) were identified as predictors of low-risk HPV infection. These results indicate that HPV vaccination of liver transplant candidates and screening for anal HPV infection in high-risk groups should be considered. © 2014 Steunstichting ESOT.

  13. Anal endosonographic findings in women after vaginal delivery

    Energy Technology Data Exchange (ETDEWEB)

    Kolodziejczak, Malgorzata [Department of Proctology, Hospital at Solec, Warsaw (Poland); Sudol-Szopinska, Iwona, E-mail: iwsud@ciop.pl [Department of Proctology, Hospital at Solec, Warsaw (Poland); Department of Diagnostic Imaging, Second Faculty of Warsaw Medical University, Warsaw (Poland); Stefanski, Robert [Department of Proctology, Hospital at Solec, Warsaw (Poland); Department of Diagnostic Imaging, Second Faculty of Warsaw Medical University, Warsaw (Poland); Panorska, Anna K. [Department of Mathematics and Statistics, University of Nevada, Reno (United States); Gardyszewska, Agnieszka [Second Clinic of Obstetrics and Gynecology, Warsaw (Poland); Krasnodebski, Ireneusz [Department of General and Gastroenterological Surgery and Nutrition, Medical University, Warsaw (Poland)

    2011-04-15

    Objective: To estimate a frequency of obstetric anal sphincters defects in women after vaginal delivery. Methods: The study included 102 women, aged from 16 to 40 years (mean age 28.6 years). 28 women had perineal lacerations of 3rd and 4th degree. 22 women had instrumental delivery. Anal endosonography was performed on all participants using BK Medical scanner Pro focus with a 3D endoprobe during the first week after delivery. Starck's classification was used to score sphincters defects. Results: The endosonographic images were abnormal in 8 out of 102 women (7.8%). Follow-up examinations after 6 weeks confirmed defects in 6 out of 102 women (5.8%). Five women had external anal sphincter torn, and 1 woman had both sphincters, internal and external, defected. Discordance between endosonographic diagnosis of defect and clinical assessment of sphincters continuity was demonstrated in 6 (5.9%) out of 8 initially found, including 2 (1.9%) false endosonographic results and 4 (3.9%) false clinical diagnosis (occult sphincter defects). The endosonography sensitivity and accuracy in sphincter defect diagnostic amounted to 100% and 98%, respectively. Conclusions: (1) Anal sphincters' tears in symptomatic women are not as frequent as it was believed. (2) The defect diagnosis in the first week after delivery should be verified by a follow-up endosonography in 6 weeks, after regression of the edema and hematoma.

  14. Anal sexual experience and HIV risk awareness among female sex workers in Dire Dawa, eastern Ethiopia.

    Science.gov (United States)

    Mazeingia, Yohannes Teka; Olijjira, Lemessa; Dessie, Yadeta

    2017-01-01

    Female sex workers have been disproportionately affected with HIV and anal sexual experience elevate their vulnerability. Anal intercourse has more risk of HIV transmission than vaginal intercourse for receptors that coupled with low condom and proper lubricant use behavior during anal sex. Besides majority of them did not understand HIV transmission risk of anal intercourse. In Ethiopia, studies on anal sexual experience is almost none existent, so the purpose of this study is to explored anal sexual experience and HIV transmission risk awareness among female sex worker in Dire Dawa, Eastern Ethiopia. Qualitative study with thematic analysis approach was conducted among 18 female sex workers and recruitment of study participants performed until saturation of information. The principal investigator conducted in-depth interviews using local language (Amharic) and it was recorded on audio recorder. Tape recorded data was transcribed and translated to English and entered into open code version 3.4 for coding and theme identification. Data collection conducted simultaneously with data analysis. Female sex workers practiced anal sex for different themes like financial influence, coercion, intentionally, peer pressure and as a sign of intimacy and love. Coercion, negative attitudes, poor awareness about HIV transmission risks of anal sex and protection capacity of condom and proper lubricants are the identified themes for not using condom and proper lubricants during anal sex by female sex workers. Inaccessibility and unavailability of health services for issues related to anal sex was the core reason for female sex workers' misperception and risk anal sexual experience. Female sex workers practiced anal sex without risk reduction approaches and they did not understand exacerbated risk of anal sex to HIV transmission. Stakeholders including ministry of health need to incorporate potential awareness raising tasks and programs about risk of anal sex and methods of risk

  15. Oral and anal sex practices among high school youth in Addis Ababa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Cherie Amsale

    2012-01-01

    Full Text Available Abstract Background Understanding the full range of sexual behaviors of young people is crucial in developing appropriate interventions to prevent and control sexually transmitted infections including HIV. However, such information is meager in developing countries. The objective of this study was to describe oral and anal sex practices and identify associated factors among high school youth. Methods A cross-sectional study was conducted among high school youth in Addis Ababa, Ethiopia. A multi-stage sampling procedure was followed to select a representative sample of school youth. The total sample size for this study was 3840. Data were collected using a self-administered questionnaire. Data analysis was guided by the ecological framework. Results The overall proportion of people who reported ever having oral sex was 5.4% (190 and that of anal sex was 4.3% (154. Of these 51.6% (98 had oral sex and 57.1% (87 had anal sex in the past 12 months. Multiple partnerships were reported by 61.2% of the respondents who had oral sex and 51.1% of students practicing anal sex. Consistent condom use was reported by 12.2% of those practicing oral sex and 26.1% of anal sex. Reasons for oral and anal sex included prevention of pregnancy, preserving virginity, and reduction of HIV and STIs transmission. Oral sex practice was strongly and significantly associated with perception of best friends engagement in oral sex (AOR = 5.7; 95% CI 3.6-11.2 and having illiterate mothers (AOR = 11.5; 95%CI 6.4-18.5. Similarly, anal sex practice was strongly and significantly associated with favorable attitude towards anal sex (AOR = 6.2; 95%CI 3.8-12.4, and perceived best friends engagement in anal sex (AOR = 9.7; 95%CI 5.4-17.7. Conclusion Considerable proportion of adolescents had engaged in oral and anal sex practices. Multiple sexual partnerships were common while consistent condom use was low. Sexual health education and behavior change communication strategies need to

  16. Caracterização clínica, citopatológica e bioquímica do câncer mamário de cadelas sem raça definida

    OpenAIRE

    Burini, Caio Henrique Paganini [UNESP

    2002-01-01

    Com o objetivo de caracterizar clínica, bioquímica e citologicamente o câncer de mama de cadelas sem raça definida (SRD) foram estudados 30 animais com distribuição uniforme nos portes pequeno, médio e grande. Todos os animais foram submetidos à anamnese e exame físico para a classificação clínica do câncer (TNMc), amostra citológica da lesão por citologia aspirativa por agulha fina (CAAF) para caracterização do tipo de tumor e coleta de sangue para determinações de glicose, albumina, coleste...

  17. Correlates of unprotected anal intercourse: the influence of anal sex position among men who have sex with men in Beijing, china.

    Science.gov (United States)

    Zhang, Heng; Lu, Hongyan; Pan, Stephen W; Xia, Dongyan; Zhao, Yuejuan; Xiao, Yan; He, Xiong; Yue, Hai; Sun, Zheya; Xu, Yunan; Ruan, Yuhua; Shao, Yiming

    2015-02-01

    Understanding barriers to consistent condom use among men who have sex with men (MSM) requires consideration of the context in which risk behaviors occur. Anal sex position is one such context. This pooled cross-sectional study used survey data from 1,230 MSM and their 2,618 reported male sexual partnerships. Overall, nearly half of the participants engaged in unprotected anal intercourse (UAI) with at least one of upto three partners in the past 6 months. "Insertive" men engaged in less UAI (39 %) than "receptive" (53 %) or "versatile" (51 %) men. Regardless of sexual position, UAI was associated with cohabiting with a male or female partner and perceiving great or moderate risk of HIV from male contact at the individual level, and steady (vs. casual) partnership at the dyad level. However, early MSM anal sex debut, high number of male partners, alcohol use, receiving and buying condoms, HIV testing, and MSM sex-seeking venues were found to be only statistically significantly correlated with UAI among some but not all sexual positions, implying that interventions to increase condom use should take into account how anal sex position may influence willingness and ability to engage in safer sex. Dyad level data appear to provide additional insight into the influence of sexual positions, and should be used to complement individual data for future intervention designs.

  18. Modelo analítico rizomático para el estudio de los efectos de las políticas educativas regionales en la experiencia escolar cotidiana: las perspectivas de Rockwell, Bourdieu y Ball

    Directory of Open Access Journals (Sweden)

    Silvana Lorena Lagoria

    Full Text Available Resumen: La escuela cotidiana se comprende en parte por un particular trasfondo que tiñe toda la experiencia que allí se desarrolla. Ese trasfondo lo constituye la cultura escolar. En su construcción intervienen tanto prácticas internas como externas a la escuela, entre ellas, las políticas educativas. La influencia de las políticas educativas regionales sobre la conformación de la cultura institucional en el devenir del cotidiano escolar se plantea como un interesante y complejo objeto a desentrañar. Para emprender ese camino es importante construir una base teórica consistente a partir de la conjunción de diferentes fuentes. En términos de Tello (2015, esto implica concebir un sustento teórico rizomático como base para analizar la cultura escolar en el marco de la “escuela cotidiana” (Rockwell, 2000. En definitiva, lo que planteamos aquí es la necesidad de construir un eje epistemológico potente para hacer inteligibles los efectos de las políticas educativas en el cotidiano escolar. En ese sentido, el presente trabajo se propone interrelacionar un conjunto de perspectivas teóricas a modo de red, para comprender un aspecto intrínseco de la escuela: los efectos de las políticas educativas en la cultura institucional. En primer lugar, definimos qué entendemos por cultura y cultura institucional. A continuación proponemos nuestro modelo analítico rizomático, integrando los aportes teóricos de Rockwell, Bourdieu y Ball. Finalmente, en las conclusiones, realizamos una breve integración de las ideas expuestas en el cuerpo de este trabajo.

  19. Samatähenduslike sünteetiliste ja analüütiliste verbide kasutamine

    Directory of Open Access Journals (Sweden)

    Pille Eslon

    2015-10-01

    Full Text Available Huvi samatähenduslike sünteetiliste ja analüütiliste verbide vastu tekkis artikli esimesel autoril vene-eesti-vene tõlkesõnastikke toimetades, kui silma hakkasid regulaarsed valikud vene verbi grammatilise aspekti ning eesti keele sünteetiliste ja analüütiliste verbide vahel. Kuigi tegu on raskesti märgatava ja sugugi mitte sagedase nähtusega, tekitab see küsimusi: millal eelistab emakeelekõneleja kasutada sünteetilist, millal analüütilist verbi; kas lisaks samatähenduslikkusele ja vormilisele lihtsusele (sünteetiline verb koosneb ühest komponendist või keerukusele (analüütiline verb vähemalt kahest komponendist on veel tunnuseid, mis sünteetilise ja analüütilise verbi valikuid piiravad. Käesoleva uurimuse eesmärk on leida nendele küsimustele vastuseid. Analüüsitakse viit samatähendusliku sünteetilise ja analüütilise verbi paari (igatsema – igatsust tundma, lahkuma – ära minema, nõustuma – nõus olema, muretsema – muret tundma, töötama – tööd tegema, otsitakse mõlema verbi kasutusele omaseid keelestruktuure, analüüsitakse nende leksikaalsemantilise ja morfosüntaktilise varieerumise piire, võrreldakse verbide tähendusi. Nende tunnuste põhjal saab teha mõningaid järeldusi selle kohta, kas tegu võiks olla ühe verbi kahe vormiga või kahe erineva verbiga. Uurimuse empiiriline aspekt on seotud hüpoteesiga semantiliselt lähedaste sünteetiliste ja analüütiliste verbide tõmbumisest, millega kaasnevad ühelt poolt struktuursed, morfoloogilised, morfosüntaktilised ja leksikaalsemantilised kasutuspiirangud ning teisalt vaba varieerumine. Sisuliselt vastandlikud tendentsid – kinnistumine ja varieerumine – toimivad keele leksikaalgrammatilises perifeerias sama eesmärgi nimel, tagades keele pideva uuenemise ja säilimise.

  20. Cause-Specific Colostomy Rates After Radiotherapy for Anal Cancer: A Danish Multicentre Cohort Study

    DEFF Research Database (Denmark)

    Sunesen, Kåre G; Nørgaard, Mette; Lundby, Lilli

    2011-01-01

    In anal cancer, colostomy-free survival is a measure of anal sphincter preservation after treatment with radiotherapy or chemoradiotherapy. Failure to control anal cancer and complications of treatment are alternative indications for colostomy. However, no data exist on cause-specific colostomy...

  1. Introducción e integración de extranjeros en el Egipto del Reino Nuevo: una aproximación cuantitativa a los Anales de Tuthmosis III

    Directory of Open Access Journals (Sweden)

    Gerván, Héctor Horacio

    2014-06-01

    Full Text Available Resumen En el Antiguo Egipto, como en todas las sociedades del discurso mítico, el orden y la interpretación del mundo se vinculaba con el plano cósmico. Los diversos mitos cosmogónicos sirvieron de sustrato ideológico al aparato estatal para fundamentar y legitimar su acción sobre los pueblos extranjeros circundantes. Pero, ¿este discurso mítico se correlacionaba directamente con la realidad histórica? En este trabajo nos proponemos responder esta pregunta a partir de un caso particular, los Anales de Tuthmosis III. Adoptaremos para este propósito una metodología esencialmente cuantitativa, haciendo uso de las herramientas que nos brinda la estadística descriptiva. El análisis estadístico será, entonces, un medio para un fin, que estará dado por la identificación de ciertos valores numéricos significativos de los Anales. A partir de esto, las categorías analíticas subyacentes a ellos serán analizadas históricamente para describir las lógicas de inclusión/exclusión de los extranjeros traídos a Egipto por las campañas del monarca. Abstract In Ancient Egypt, as in all societies of mythic discourse, order and interpretation of the world was linked to the cosmic plane. The various creation myths were used as ideological substrate from state apparatus to support and legitimize their actions on the surrounding foreign peoples. But, this mythic discourse was directly correlated with historical reality? In this paper we propose to answer this question from a particular case, the Annals of Thutmose III. We will adopt for this purpose an essentially quantitative methodology, using the tools provided to us by descriptive statistics. Statistical analysis will then be a means to an end, which is given by the identification of certain significant numerical values of the Annals. From this, the underlying analytical categories to be analyzed them historically to describe the logics of inclusion/exclusion of foreigners brought to Egypt

  2. The Danish anal sphincter rupture questionnaire: Validity and reliability

    DEFF Research Database (Denmark)

    Due, Ulla; Ottesen, Marianne

    2008-01-01

    Objective. To revise, validate and test for reliability an anal sphincter rupture questionnaire in relation to construct, content and face validity. Setting and background. Since 1996 women with anal sphincter rupture (ASR) at one of the public university hospitals in Copenhagen, Denmark have been...... main questions but one. Two questions needed further explanation. Seven women made minor errors. Conclusion. The validated Danish questionnaire has a good construct, content and face validity. It is a well accepted, reliable, simple and clinically relevant screening tool. It reveals physical problems...... offered pelvic floor muscle examination and instruction by a specialist physiotherapist. In relation to that, a non-validated questionnaire about anal and urinary incontinence was to be answered six months after childbirth. Method. The original questionnaire was revised and a pilot test was performed...

  3. Los grupos de discusión como metodología adecuada para estudiar las cogniciones sociales

    Directory of Open Access Journals (Sweden)

    David Víquez-Calderón

    2009-01-01

    Full Text Available El presente artículo tiene por objetivo ofrecer propuestas metodológicas alternativas para el estudio de las cogniciones sociales, presentando los grupos de discusión como una estrategia válida para su estudio. Para ello se hace una revisión del concepto de cognición social, problematizando los enfoques tradicionales para dirigir la investigación a los enfoques que abogan por el estudio de las cogniciones socialmente distribuidas y situadas. Después se describe la estrategia de grupos de discusión, identificando especificaciones operativas y valorando las estrategias analíticas a emplear.

  4. Avaliação da sensibilidade dolorosa e fatores envolvidos na qualidade da amostra citológica do fluxo papilar: resultados preliminares da utilização de sistema automatizado de coleta Assessment of pain sensitivity and factors involved in the quality of the sample fluid cytologic papillary: preliminary results from the use of automated collection

    Directory of Open Access Journals (Sweden)

    José Roberto Filassi

    2010-10-01

    Full Text Available OBJETIVO: avaliar a sensibilidade dolorosa e os fatores envolvidos na produção de fluido papilar adequado para análise de citologia oncótica, por meio de sistema automatizado de coleta. MÉTODOS: foram selecionadas 50 mulheres assintomáticas, sem antecedente pessoal ou familiar de câncer de mama, fora do ciclo gravídico-puerperal para coleta de fluido papilar por meio de sistema automatizado. Foram registradas e relacionadas com a produção de fluido papilar a idade da paciente, tabagismo, antecedente de cirurgia mamária, paridade, amamentação, estado menopausal e idade da menarca. Todo o material coletado foi fixado em meio apropriado, e encaminhado separadamente para análise de citologia oncótica. A sensibilidade dolorosa do procedimento de coleta foi avaliada por meio da Escala Category-Ratio Scale (CR10 de Borg. RESULTADOS: a idade variou de 22 a 59 anos, média de 41,6±8,6 anos. Das 50 pacientes, 20 (40% não apresentaram fluido papilar adequado para análise em nenhuma das mamas. Naquelas pacientes que se obteve fluido papilar adequado para análise de citologia oncótica, a paridade esteve inversamente relacionada com a capacidade de obter amostra celular adequada, nível de significância estatística (p=0,035, OR=0,0032 (IC 95%=0,0001-0,1388. Em relação à sensibilidade dolorosa, o exame foi bem tolerado. CONCLUSÕES: o método automatizado de coleta de fluido papilar para análise de citologia oncótica foi bem tolerado pelas mulheres tendo produzido material analisável em 60% dos casos, esteve inversamente relacionado com a paridade.PURPOSE: to evaluate painful sensitivity and factors involved in producing papillary fluid suitable for cytological analysis by means of automated collection. METHODS: we selected 50 asymptomatic women without a personal or family history of breast cancer, outside the pregnancy and childbirth cycle in order to collect papillary fluid by the automated system. We recorded and related to the

  5. Comparison between tympanic and anal temperature with a clinical infrared ray thermometer in dogs Comparação entre a temperatura timpânica e a temperatura anal usando um termômetro clínico de raio infravermelho em cães

    Directory of Open Access Journals (Sweden)

    G.G.S. Wiedemann

    2006-08-01

    Full Text Available A clinical thermometer of infrared rays was used twice to record consecutively the temperature of the tympanic membrane in each ear and in the anus of 53 dogs. Temperatures did not differ significantly between organs, and were strongly correlated. The anal temperature measurement with an infrared thermometer in dogs is feasible and trustworthy, as well as the thermal checking of tympanic temperature.Utilizou-se um termômetro clínico de emissão de raios infravermelhos para medir, duas vezes consecutivas, a temperatura da membrana timpânica de cada ouvido e duas vezes a temperatura no ânus de 53 cães. Não houve diferença entre as temperaturas quanto ao órgão estudado e a correlação entre as temperaturas foi alta. Em cães, a medida da temperatura anal com o termômetro clínico de emissão de raios infravermelhos é rápida e confiável tanto quanto a da temperatura timpânica.

  6. Analítica del aprendizaje en un entorno virtual mediante un sistema de computación cognitiva: estudio preliminar

    OpenAIRE

    Larry Lugo Urribarrí

    2016-01-01

    En esta investigación se aplicaron métodos de la Analítica del Aprendizaje en el estudio de los datos masivos provenientes de la plataforma virtual de Fruticultura, mediante el sistema de computación cognitiva IBM Watson, basado en inteligencia artificial y aprendizaje automático. Se analizaron los registros de las evaluaciones en línea, así como las interacciones sociales en los foros para determinar su influencia sobre el desempeño estudiantil, durante los períodos lectivos desde el2006 has...

  7. ¿Pueden las escuelas - empresa de turismo, construir capital social para mejorar la calidad de vida de las personas?

    Directory of Open Access Journals (Sweden)

    N. Constanza Olaya Cantor

    2008-11-01

    Full Text Available Este artículo presenta los resultados del proyecto de investigación “¿Pueden las Escuelas-empresa de Turismo, construir Capital Social para mejorar la calidad de vida de las personas?” presentado en cumplimiento de los requerimientos para el MSc. In Development Administration and Planning de la Development Planning Unit de University College London. El proyecto de investigación analiza la construcción del capital social a través de la educación superior vocacional y de entrenamiento, específicamente en las escuelas-empresa de turismo. El objetivo de la investigación fue el entender cómo las escuelas-empresa de turismo pueden ayudar a las comunidades para relacionarse con otros actores en las esferas del Estado, el mercado y la sociedad civil para acceder, defender y transformar recursos para el beneficio individual y colectivo. Para este propósito, la investigación elabora en el capital social como herramienta analítica, desarrollando un marco específico para evaluar la construcción de capital social en las escuelas-empresa de turismo. Basado en este marco analítico, se presentan dos casos de estudio, uno en Ecuador y otro en Guatemala. En estos casos, las escuelas-empresa de turismo han sido establecidas y trabajan con comunidades locales en áreas selváticas de Latinoamérica.

  8. Evaluación analítica de óvulos de quitina Analytical evaluation of chitin pessaries

    Directory of Open Access Journals (Sweden)

    Yania Suárez Pérez

    2008-12-01

    Full Text Available Los óvulos de quitina constituyen nuevos productos en fase de investigación. Para la evaluación analítica de estos, se desarrolló un método gravimétrico directo para supositorios vaginales de diferente dosificación. La técnica se basa en la separación de la quitina de los demás componentes de la formulación según sus diferencias de solubilidad, con el empleo de la filtración al vacío. El método se validó para control de calidad, y se obtuvieron resultados satisfactorios en los parámetros evaluados: linealidad, precisión, exactitud y selectividad.Chitin pessaries are new products under research. For their analytical evaluation, a direct gravimetric method for vaginal suppositories of various dosing was designed. This technique was based on separation of chitin from the rest of the formulation components according to their solubility characteristics, by using vacuum filtering. The method was validated for quality control and the results were satisfactory in terms of the evaluated parameters such as linearity, precision, accuracy and selectivity.

  9. [Detection and analysis of the characteristic expression of microRNAs of anal fistula patients].

    Science.gov (United States)

    Qiu, Jianming; Yu, Jiping; Yang, Guangen; Xu, Kan; Tao, Yong; Lin, Ali; Wang, Dong

    2016-07-01

    To detect and analyze the characteristic miRNAs profile of anal fistula and explore their possible target genes and potential clinical significance. The anal mucosa close to the hemorrhoids were collected from three patients undergoing fistulectomy and hemorrhoidectomy (fistula group) as well as three patients receiving only hemorroidectomy(hemorrhoids group), matching with fistula group in age, gender and body weight. miRNA microarray was used to compare the expression of 1 285 human miRNAs of the anal mucosa between two groups. Cluster analysis was adopted to analyze the accumulation of the differentially expressed miRNAs(Pcharacteristic miRNAs profile in anal fistula patients, which may play a role in the occurrence and development of anal fistula.

  10. Tunni analüüs - mis see on? / Peep Leppik

    Index Scriptorium Estoniae

    Leppik, Peep

    2001-01-01

    Tunni analüüs, õppe-kasvatustöö eesmärgid. Tunni analüüs on hinnangu andmine protsessidele, mille kutsub esile õpetaja tegevus (või tegevusetus) tunnis. Tunni läbiviimise protsessi mõjutavad õpilaste koosseis klassis, erinevate õppevormide ja õppemeetodite kasutamine, kasutatud õppevõtete otstarbekus, erinevad metoodikad ja õppesüsteemid

  11. HPV and anal cancer in HIV-infected individuals: a review

    NARCIS (Netherlands)

    Schim van der Loeff, Maarten F.; Mooij, Sofie H.; Richel, Oliver; de Vries, Henry J. C.; Prins, Jan M.

    2014-01-01

    HIV infection is one of the strongest risk factors for anal squamous cell cancer (ASCC). Most ASCC are caused by HPV, and most HPV-associated ASCC are caused by HPV-16. Anal HPV infections are very common in men who have sex with men (MSM), and nearly universal among HIV-infected MSM. High-grade

  12. Informatización del conocimiento para la conservación de la biodiversidad

    OpenAIRE

    Mata Montero, Erick

    2006-01-01

    El proceso de informatizar el conocimiento necesario para conservar la biodiversidad de un país o región requiere de varias etapas de desarrollo de sistemas de información. Típicamente se inicia con el manejo de datos en formatos analógicos y se continúa con una secuencia de seis etapas más que culminan con el desarrollo de sistemas digitales interinstitucionales descentralizados que permiten generar y acceder a conocimiento para la toma de decisiones, la definición de políticas y la...

  13. Informatización del conocimiento para la conservación de la biodiversidad

    OpenAIRE

    E. Mata; E. Mata Montero

    2006-01-01

    El proceso de informatizar el conocimiento necesario para conservar la biodiversidad de un país o región requiere de varias etapas de desarrollo de sistemas de información. Típicamente se inicia con el manejo de datos en formatos analógicos y se continúa con una secuencia de seis etapas más que culminan con el desarrollo de sistemas digitales interinstitucionales descentralizados que permiten generar y acceder a conocimiento para la toma de decisiones, la definición de políticas y la educació...

  14. Activos y estructuras de oportunidades de movilidad: Una propuesta analítica para el estudio de la accesibilidad por transporte público, el bienestar y la equidad

    Directory of Open Access Journals (Sweden)

    Diego Hernández

    2012-09-01

    Full Text Available Uno de los desafíos actuales para los estudios sobre movilidad y transporte en América Latina es adoptar un enfoque multidimensional de la movilidad que trascienda la noción más estrecha de desplazamiento o viaje y que, a la vez, permita integrar este tema a la discusión más general acerca del efecto de la movilidad sobre la pobreza y la exclusión social. Este artículo aborda el desafío y propone un marco analítico que recoja la -aún incipiente en nuestra región- experiencia teórico-empírica sobre estos fenómenos. Luego de revisar la literatura y argumentar a favor de la adopción de diversos postulados, se propone el enfoque de activos y estructuras de oportunidades para el estudio de la accesibilidad. Esta es concebida como el grado de ajuste entre las estructuras de oportunidades de movilidad, y los recursos y activos con que cuentan los hogares para aprovecharlas. El esquema propuesto permite maximizar la comprensión del efecto de la movilidad sobre el bienestar y el rol del transporte público.One of the major current challenges for mobility and transport studies in Latin America is the adoption of a multidimensional approach that goes beyond the narrower notion of trip and that does not neglect a broader discussion about mobility's effect on po verty and social exclusion. This article seeks to tackle this challenge and posits an analyticalframework that takes into account the theoretical and empirical regional background on these phenomena. After reviewing existing literature and affiliating to some necessary assumptions, it proposes the assets and opportunities structures approach as a useful device to study accessibility. This concept is defined as the level of adjustment between the structures of opportunity for mobility and household's resource and assets to take advantagefrom them. I argue that thisframework is adequate in order to maximize understanding of mobility's effect on welfare and the role of public transport.

  15. The anal canal as a risk organ in cervical cancer patients with hemorrhoids undergoing whole pelvic radiotherapy.

    Science.gov (United States)

    Jang, Hyunsoo; Baek, Jong Geun; Jo, Sunmi

    2015-01-01

    Tolerance of the anal canal tends to be ignored in patients with cervical cancer undergoing whole pelvic radiotherapy. However, patients with hemorrhoids may be troubled with low radiation dose. We tried to analyze the dose-volume statistics of the anal canal in patients undergoing whole pelvic radiotherapy. The records of 31 patients with cervical cancer who received definite or postoperative radiotherapy at one institution were reviewed. Acute anal symptoms, such as anal pain and bleeding, were evaluated from radiotherapy start to 1 month after radiotherapy completion. Various clinical and dosimetric factors were analyzed to characterize relations with acute anal complications. The anal verge was located an average of 1.2 cm (range -0.6~3.9) below the lower border of the ischial tuberosity and an average of 2.7 cm (range -0.6~5.7) behind the sacral promontory level. The presence of hemorrhoids before radiotherapy was found to be significantly associated with acute radiation-induced anal symptoms (p = 0.001), and the mean induction dose for anal symptoms was 36.9 Gy. No patient without hemorrhoids developed an anal symptom during radiotherapy. Dosimetric analyses of V30 and V40 showed marginal correlations with anal symptoms (p = 0.07). The present study suggests a relation between acute anal symptoms following radiotherapy and acute hemorrhoid aggravation. Furthermore, the location of the anal verge was found to be variable, and consequently doses administered to the anal canal also varied substantially. Our results caution careful radiation treatment planning for whole pelvic radiotherapy, and that proper clinical management be afforded patients with hemorrhoids during radiotherapy.

  16. Uso do grau de preferência alimentar para a caracterização da alimentação de peixes na APA de São Pedro e Analândia - DOI: 10.4025/actascibiolsci.v27i3.1337 The use of feeding preference degree to characterize feeding habits of fishes at APA in São Pedro and Analândia - DOI: 10.4025/actascibiolsci.v27i3.1337

    Directory of Open Access Journals (Sweden)

    Leandro Muller Gomiero

    2005-03-01

    Full Text Available O trabalho caracterizou a alimentação de quatro espécies de peixes em duas bacias da Área de Proteção Ambiental de São Pedro e Analândia, área central do Estado de São Paulo. O Grau de Preferência Alimentar (GPA foi utilizado para mostrar a importância de cada item alimentar para as espécies de peixes em cada bacia. A alimentação das duas espécies de lambaris foi muito variada, sendo que os itens insetos alóctones, autóctones e material vegetal foram muito importantes, caracterizando-a como onivoria. O bagre (Rhamdia quelen alimentou-se principalmente de insetos na bacia do Jacaré-pepira e também de peixes na bacia do Corumbataí. O cascudo, Hypostomus strigaticeps, ingeriu material vegetal autóctone e sedimentos em ambas baciasWe studied feeding habits of four fish species in two watershed at APA - Área de Proteção Ambiental (Area of Environmental Protection in São Pedro and Analândia, State of São Paulo, southeastern Brazil. Feeding Preference Degree (FPD was used to demonstrate the importance of each food item for the species of both basins. Feeding habits of both species of “lambari” was variable. The allochtonous items such as insects, autochtonous items, and vegetal material were very important, characterizing omnivory. The “bagre” (Rhamdia quelen fed mainly on insects at the Jacaré-pepira Basin and also on fishes at the Corumbataí basin. The “cascudo” Hypostomus strigaticeps ingested autochtonous vegetal material and sediments at both basins

  17. Anal HPV infection in HIV-positive men who have sex with men from China.

    Directory of Open Access Journals (Sweden)

    Lei Gao

    Full Text Available BACKGROUND: Anal HPV infection, which contributes to the development of anal warts and anal cancer, is well known to be common among men who have sex with men (MSM, especially among those HIV positives. However, HIV and anal HPV co-infection among MSM has not been addressed in China. METHODS: A cross-sectional study was conducted in Beijing and Tianjin, China. Study participants were recruited using multiple methods with the collaboration of local volunteer organizations. Blood and anal swabs were collected for HIV-1 serological test and HPV genotyping. RESULTS: A total of 602 MSM were recruited and laboratory data were available for 578 of them (96.0%. HIV and anal HPV prevalence were 8.5% and 62.1%, respectively. And 48 MSM (8.3% were found to be co-infected. The HPV genotypes identified most frequently were HPV06 (19.6%, HPV16 (13.0%, HPV52 (8.5% and HPV11 (7.6%. Different modes of HPV genotypes distribution were observed with respect to HIV status. A strong dose-response relationship was found between HIV seropositivity and multiplicity of HPV genotypes (p<0.001, which is consistent with the observation that anal HPV infection was an independent predictor for HIV infection. CONCLUSIONS: A high prevalence of HIV and anal HPV co-infection was observed in the MSM community in Beijing and Tianjin, China. Anal HPV infection was found to be independently associated with increased HIV seropositivity, which suggests the application of HPV vaccine might be a potential strategy to reduce the acquisition of HIV infection though controlling the prevalence of HPV.

  18. Psicoterapia cognitivo analítica y trastornos de la personalidad: revisión

    Directory of Open Access Journals (Sweden)

    Laura Rodríguez Moya

    2013-06-01

    Full Text Available En los años 80 y 90, A. Ryle desarrolló un modelo de tratamiento denominado Psicoterapia Cognitivo Analítica (PCA. Con un enfoque integrador, breve y focal, la PCA se ha aplicado a diversas patologías, siendo su uso más frecuente con pacientes con trastorno de personalidad, sobre todo con trastorno límite. Estos pacientes poseen un número de disfunciones metacognitivas que dificultan el proceso de darse cuenta de sus diferentes estados mentales y de sus componentes. A través del modelo de Múltiples Estados del self, el objetivo es ayudar al paciente a identificar los procesos disfuncionales o restrictivos del self que está experimentando y dotarle de recursos para que pueda sustituirlos por otros más adaptativos.

  19. Nuevas metodologías para la determinación de nonilfenol, sus derivados etoxilados y parabenos en muestras medioambientales

    OpenAIRE

    Núñez García-Cuerva, Laura

    2011-01-01

    El estudio de nuevos compuestos químicos, denominados contaminantes emergentes, se ha convertido en objetivo prioritario para la Organización Mundial de la Salud (OMS) y para las agencias de protección medioambiental (EPA). Es por ello que resulta necesario el desarrollo de métodos analíticos de elevada sensibilidad y selectividad para la determinación de estos compuestos, ya que lamentablemente son pocos los existentes actualmente. Lo ideal sería disponer de métodos respetuoso...

  20. Análisis del comercio electrónico en Ecuador : limitaciones para su implementación

    OpenAIRE

    Cabrera Sánchez, Diana Elizabeth

    2006-01-01

    Mantener un nivel alto de competitividad en un mundo globalizado es indispensable para el desarrollo económico de un país; el Comercio Electrónico es una herramienta muy poderosa para mejorar las actividades comerciales en Ecuador. La Tesina titulada "Análisis del Comercio Electrónico en el Ecuador: Limitaciones para su Implementación" es un estudio teórico-analítico de la situación actual en la que se encuentra nuestro país en cuanto al desarrollo del comercio electrónico. El Capítulo ...

  1. HIV-positive MSM's knowledge of HPV and anal cancer self-sampling: A scoping review.

    Science.gov (United States)

    Poon, M K L; Wong, J P H; Li, A T W; Manuba, M; Bisignano, A; Owino, M; Vahabi, M

    2018-02-01

    Human papillomavirus (hpv) infection is the cause of anal squamous cell cancer (ascc) in 80% of cases. Available research has also shown high prevalence of anal hpv infection among men who have sex with men (msm). However, hpv vaccination is low among msm in Canada. In light of this information, we conducted a scoping review with the aim of exploring (1) the knowledge of hpv and anal cancer among hiv-positive msm and (2) the acceptability of hpv and anal cancer self-sampling in this population. In conducting the review, we searched five electronic databases for peer-reviewed articles and abstracts published in English, between 2007 and 2017. A total of 803 articles were retrieved; after accounting for duplicates ( n= 40) and unmet criteria ( n= 754), a total of 794 articles were excluded. A final total of nine articles were used in this review. Results of this review show that hiv-positive msm have limited knowledge regarding the risks of anal cancer associated with hiv and hpv coinfection. Furthermore, there is limited research on hpv and anal cancer self-sampling in this population. However, the review of available studies suggested that hiv-positive msm were open to anal cancer self-sampling. It also identified potential barriers to self-sampling. In conclusion, we provide suggestions and future directions for policy-makers and educators to develop inclusive and accessible strategies to reach hiv-positive msm regarding anal cancer education and self-screening.

  2. Hereditary internal anal sphincter myopathy causing proctalgia fugax and constipation. A newly identified condition.

    Science.gov (United States)

    Kamm, M A; Hoyle, C H; Burleigh, D E; Law, P J; Swash, M; Martin, J E; Nicholls, R J; Northover, J M

    1991-03-01

    A newly identified myopathy of the internal anal sphincter is described. In the affected family, at least one member from each of five generations had severe proctalgia fugax; onset was usually in the third to fifth decades of life. Three members of the family have been studied in detail. Each had severe pain intermittently during the day and hourly during the night. Constipation was an associated symptom, in particular difficulty with rectal evacuation. Clinically the internal anal sphincter was thickened and of decreased compliance. The maximum anal canal pressure was usually increased with marked ultraslow wave activity. Anal endosonography confirmed a grossly thickened internal anal sphincter. Two patients were treated by internal anal sphincter strip myectomy; one showed marked improvement and one was relieved of the constipation but had only slight improvement of the pain. The hypertrophied muscle in two of the patients showed unique myopathic changes, consisting of vacuolar changes with periodic acid-Schiff-positive polyglycosan bodies in the smooth muscle fibers and increased endomysial fibrosis. In vitro organ-bath studies showed insensitivity of the muscle to noradrenaline, isoprenaline, carbachol, dimethylpiperazinium, and electrical-field stimulation. Immunohistochemical studies for substance P, calcitonin gene-related peptide, galanin, neuropeptide Y, and vasoactive intestinal peptide showed staining in a similar distribution to that in control tissue. A specific autosomal-dominant inherited myopathy of the internal anal sphincter that causes anal pain and constipation has been identified and characterized.

  3. Determinación de restricciones y posibilidades ambientales para la expansion del transporte de gas natural en Colombia

    Directory of Open Access Journals (Sweden)

    Ángel Sanint Enrique

    2011-11-01

    Full Text Available En la línea de la Evaluación Ambiental Estratégica, EAE, se desarrolló un método para la determinación de restricciones y posibilidades ambientales en proyectos de transporte de gas natural por ductos, basado en el uso de herramientas de análisis territorial aplicadas sobre la plataforma SIG (Sistema de Información Geográfica, incorporando criterios ambientales que a escala 1:500.000 apoyarán la toma de decisiones en el nivel de planeación y propiciarán la elaboración del plan de expansión para el transporte de gas natural en Colombia. Para esto, se definió el concepto de ambiente a partir de un Modelo Analítico preexistente; se delimitó un área con posibilidades para la expansión de la red de transporte de gas natural incorporando nuevos trazados; se seleccionaron las variables y factores que complementaban el Modelo Analítico; se definió la estructura de preferencias a partir de una encuesta a expertos; se determinaron las restricciones nacionales y se construyeron superficies numéricas síntesis de critici dad ambiental para cada dimensión. Como resultado, se obtuvieron 5 superficies síntesis, una por cada dimensión, y una superficie final para Colombia, con restricciones y posibilidades ambientales. Además se propusieron análisis complementarios para establecer prioridades en la gestión ambiental.

  4. Modelo analítico del efecto de PRS sobre satélites GPS

    Science.gov (United States)

    Meza, A.; Brunini, C.; Usandivaras, J. C.

    El sistema GPS (Global Position System) es, hoy en día, la herramienta de navegación y posicionamiento más potente y lo será sin duda en la próxima década. Gran parte de su valiosa utilidad se debe a la alta precisión que permite lograr y ésta, a su vez, depende, entre otras causas, de la precisión con que se conocen las órbitas de los satélites. La presión de radiación solar (PRS) fija el límite de la precisión con que pueden calcularse en la actualidad las efemérides satelitarias. El objetivo de este trabajo es proponer una mejor resolución de este fenómeno. El modelo analítico aquí presentado, se basa en el análisis del comportamiento de los residuos de un ajuste por mínimos cuadrados en el que se utiliza el modelo de PRS propuesto por Beutler. El mismo consiste en un modelo determinista del fenómeno con dos parámetros libres. Los resultados obtenidos ponen de manifiesto que, aún después de aplicar dichos parámetros, prevalecen en los residuos efectos semidiurnos en las componentes radial,tangencial y normal. Estos resultados obtenidos se comparan con los de un trabajo desarrollado por el Instituto de Berne (Beutler et al., 1994), en el que se utilizaron como pseudo-observaciones las órbitas precisas del IGS (CODE). El intervalo de integración escogido por este centro fueron las semanas 680 y 681. En resumen se tienen arcos de 14 días para todos los satélites, donde las efemérides precisas de los mismos para los 14 días fueron utilizados como pseudo-observaciones. El modelo de fuerza que empleó dicho centro fue básicamente el tradicional en lo que respecta al modelo de las fuerzas gravitacionales, y para la PRS utilizo el modelo standard de Beutler. Los parámetros de este modelo junto con las 6 condiciones iniciales (posición y velocidad) fueron ajustados por el método general de mínimos cuadrados. Los residuos en la componente radial, tangencial y normal, para los satélites con un buen comportamiento, presentan una

  5. Anal carcinoma in HIV-infected patients in the period 1995-2009

    DEFF Research Database (Denmark)

    Legarth, Rebecca; Helleberg, Marie; Kronborg, Gitte

    2013-01-01

    Abstract Background: Several studies have demonstrated an increased risk of non-AIDS cancers in HIV patients and, for some cancers, also in relatives of HIV patients. We aimed to estimate (1) the risk of anal carcinoma among HIV patients and their parents, and (2) the mortality after a diagnosis...... 1995-2009, and (2) parents of HIV patients compared with parents of controls for the period 1978-2009. Cancer diagnoses were identified from The Danish Cancer Registry. We further estimated the mortality rate ratios (MRR) of HIV patients compared with controls after the diagnosis of anal carcinoma....... Results: Thirty-six HIV patients versus 8 population controls were diagnosed with anal carcinoma. HIV patients had an increased risk of anal carcinoma (IRR 77.9, 95% CI 36.2-167.7), especially among men who have sex with men (MSM) (IRR 101.4, 95% CI 39.3-261.5). Fathers of HIV patients had an increased...

  6. Should anorectal ultrasonography be included as a diagnostic tool for chronic anal pain?

    Science.gov (United States)

    García-Montes, M J; Argüelles-Arias, Federico; Jiménez-Contreras, S; Sánchez-Gey, S; Pellicer-Bautista, F; Herrerías-Gutiérrez, J M

    2010-01-01

    To assess the efficiency of endorectal ultrasound (ERUS) in the study of chronic idiopathic anal pain (CIAP). This is a prospective and descriptive study in which 40 patients, 18 men and 22 women with an average of 47 years, were included. They had chronic anal pain of at least 3 months duration. A complete colonoscopy was performed in all patients, which found no abnormalities to explain clinical symptoms. Patients with anal fissure and internal hemorrhoids of any degree, perianal suppurative processes, and pelvic surgery were excluded from the study. An ALOKA ProSound SSD-4000 ultrasound console attached to a multifrequency radial transductor ASU-67 (7.5 and 10 MHz) was used. One patient could not tolerate the examination. In 8 patients (20% of cases) alterations were detected during ultrasonography: in 4 patients (10% of the cases; 1 man and 3 women) internal anal sphincter (IAS) hypertrophy, and in 5 patients (4 women and 1 man) a torn sphincter complex. A tear in the upper IAS canal and hypertrophy of the middle anal canal were observed in one patient (1 woman). ERUS is a simple, economic and useful test to study anorectal pathologies. Although in most studied cases no damage to the anal canal or rectal wall was detected, in a considerable number of patients we observed a thickening of the IAS, a probable cause of anal pain. Therefore, we understand that ERUS should be included in the study of CIAP.

  7. Método espectroscópico para determinação de cumarina em xarope de Mikania glomerata Sprengel

    Directory of Open Access Journals (Sweden)

    Cleinils R. da Silva

    Full Text Available Este trabalho teve como objetivo desenvolver uma metodologia analítica por espectroscopia UV, para doseamento de cumarina em xaropes de Mikania glomerata. A técnica foi baseada na extração da cumarina utilizando solventes como o clorofórmio e hexano. Após a seleção do solvente, o comprimento de onda foi definido através da sobreposição dos espectros da cumarina, metil parabeno, diluição do xarope e solução extrativa do xarope. Foram preparadas curvas analíticas de cinco soluções de cumarina com concentração variando de 0,002 a 0,03 mg/mL. Para análise da exatidão do método, foram preparados três lotes de xarope de Mikania glomerata Sprengel e o teor de cumarina determinado pela técnica espectrofotométrica foi comparado a técnica por cromatografia líquida de alta eficiência. O solvente selecionado para extração foi o clorofórmio, o comprimento de onda 320 nm. A curva analítica apresentou R² de 0,99978, demonstrando linearidade. A comparação estatística do doseamento da cumarina pela técnica espectrofotométrica estudada com a técnica cromatográfica desenvolvida por Celeghini et al. (2001 demonstrou não existir diferenças significativas, indicativo de exatidão da técnica.

  8. Aportaciones de la Hermenéutica analógica a la Enfermería: entrevista al prof. Mauricio Beuchot Puente

    Directory of Open Access Journals (Sweden)

    Anabel Paramá

    Full Text Available Entrevista realizada al Prof. Dr. D. Mauricio Beuchot, fundador de la propuesta teórica llamada Hermenéutica Analógica. Este tipo de hermenéutica es, hoy en día, reconocida como una propuesta original y novedosa en el campo de la hermenéutica filosófica. Ya el propio Jean Grondin, uno de los mayores conocedores de la hermenéutica actual, llegó a afirmar que los investigadores en hermenéutica deberían comenzar a conocer el español para leer de primera mano la propuesta de hermenéutica analógica de Beuchot; mostrando con ello la importancia de este autor mexicano. El profesor Mauricio Hardie Beuchot Puente (Torreón, Coahuila, México, 1950, está reconocido como uno de los principales filósofos de Iberoamérica. Sacerdote y fraile dominico, es autor de más de 50 libros sobre temas relacionados con la Filosofía medieval, Filosofía del lenguaje, Filosofía analítica, Estructuralismo y sobre todo, Hermenéutica. Además es Director de la revista Analogía Filosófica, Director de Honor de la revista Hermes Analógica, subdirector de la revista Anamnesis, así como miembro de una cantidad importante de publicaciones académicas. En su larga trayectoria ha conseguido ser desde 1985 investigado titular "C" a tiempo completo del Centro de Estudios Clásicos del Instituto de Investigación Filológicas (IIFL de la UNAM (Universidad Nacional de México. Desde 1997 es miembro de número en la Academia Mexicana de la Lengua, desde 1999 es miembro de la Academia Pontificia de Santo Tomás de Aquino. Así mismo el Doctor Honoris Causa por la Universidad Anáhuac del Sur.

  9. Sentimentos e expectativas das mulheres acerca da Citologia Oncótica Sensaciones y expectativas de las mujeres referente a la Citología Oncótica Feelings and expectations of the women concerning Oncotic Citology

    Directory of Open Access Journals (Sweden)

    Cleidiane Maria Sales de Brito

    2007-08-01

    Full Text Available Trata-se de um estudo qualitativo cujo objetivo foi discutir e descrever os sentimentos e as expectativas vivenciadas por 28 mulheres quanto à citologia oncótica em uma unidade do Programa de Saúde da Família em Parnaíba-PI, através de uma entrevista com roteiro de questões abertas. Os resultados foram apresentados em categorias e constatou-se que a maioria das mulheres não realiza o exame, embora todas afirmem a importância deste, principalmente para detecção de doenças. Observou-se ainda que durante o procedimento, os sentimentos mais recorrentes entre as mulheres foram: timidez, insegurança, medo, vergonha e dor. Quanto às expectativas, elas anseiam um melhor atendimento dos profissionais, e um resultado que não apresente alterações, em especial o câncer.Estudio cualitativo cuyo objetivo fue discutir y describir las sensaciones y las expectativas vivenciadas por 28 mujeres cuánto a la citología del oncótica en una unidad del Programa de Salud de la Familia en Parnaíba-PI, con una entrevista con la estrutura de preguntas abiertas. Los resultados fueran presentados en categorías y evidenciados que la mayoría de las mujeres no hacen la examinación, sin embargo todas afirmen la importancia de esto, principalmente para la detención de enfermedades. Fueran observados aun que durante el procedimiento, las sensaciones más recurrentes entre las mujeres había sido: timidez, inseguridad, miedo, vergüenza y dolor. Cuánto a las expectativas, ellas anhelan para una atención mejor de los profesionales, y un resultado que no presente alteraciones, en especial el cáncer.Qualitative study whose objective was to argue and to describe the feelings and the expectations lived deeply for 28 women about oncotic citology in a unit of the Family Health Program in Parnaíba-PI, through an interview with script of opened questions. The results were presented in categories and evidenced that the majority of the women does not carry through

  10. Método espectroscópico para determinação de cumarina em xarope de Mikania glomerata Sprengel

    OpenAIRE

    Silva, Cleinils R. da; Gomes, Víctor S.; Kulkamp, Irene C.; Kanis, Luiz A.

    2008-01-01

    Este trabalho teve como objetivo desenvolver uma metodologia analítica por espectroscopia UV, para doseamento de cumarina em xaropes de Mikania glomerata. A técnica foi baseada na extração da cumarina utilizando solventes como o clorofórmio e hexano. Após a seleção do solvente, o comprimento de onda foi definido através da sobreposição dos espectros da cumarina, metil parabeno, diluição do xarope e solução extrativa do xarope. Foram preparadas curvas analíticas de cinco soluções de cumarina c...

  11. Lineamientos para la intervención del Programa de Voluntariado Rosarista para la Gestión Social Instituto Rosarista para la Acción Social “Rafael Arenas Ángel” - SERES

    OpenAIRE

    Cruz Daza, Edwin Gerardo

    2017-01-01

    Frente a la importante labor para la Gestión Social de la Universidad del Rosario, surgió la necesidad de realizar un acercamiento analítico al Programa de Voluntariado con el fin de identificar sus actores, los procesos de intervención, la organización interna, las dificultades en la ejecución, y a partir de los resultados obtenidos plantear unos lineamientos que permitan mejorar los procesos de intervención que se propuso la Universidad con la creación de dicho Programa. Se encontró entre m...

  12. ESTUDIOS MACRO Y MICROSCOPICO DEL SACO ANAL DEL COIPO (Myocastor coypus)

    OpenAIRE

    Rafasquino, Marta E.; Ramos, Pablo A.; Alonso, Cristina R.; Idiart, Julio R.

    1998-01-01

    RESUMEN:Fue realizada la disección del saco anal de 44 coipos, de ambos sexos, de distintas edades y procedencias, observándose algunas características similares a los sacos anales del perro y gato, aunque es impar y está ubicado en ventral del ano. Es ovoídeo o piriforme, siendo más grande en los adultos y, entre éstos, más aún en los machos que en las hembras; posee un conducto que desemboca en el canal anal a un centímetro del ano y que se exterioriza en el momento de secretar el producto ...

  13. Primary radiation therapy in the treatment of anal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Cantril, S.T. (Children' s Hospital of San Francisco, CA); Green, J.P.; Schall, G.L.; Schaupp, W.C.

    1983-09-01

    From 1966 to 1981, 47 patients with a diagnosis of anal carcinoma were irradiated. This group was composed of 23 males and 24 females, with age ranging from 38 to 84 years (average 64.4 years). Five patients were treated preoperatively and 34 were treated definitively with cancericidal doses of irradiation. Acute radiation reactions requiring a rest-break were noted in 28% of patients, but all were managed as outpatients without untoward chronic sequelae. Chronic complications were noted in 13 patients, including two patients who required colostomy for severe anal stenosis and two who required A-P resection for large painful ulcers. Twenty-eight of 35 patients (80%) treated with irradiation alone have remained locally controlled without further treatment. An additional four have been salvaged by surgery. Only three patients had interstitial implants as part of their treatment course. Actuarial survival at five years for the N/sub 0/ patients and the group as a whole are 95.6 and 79.3%, respectively. It is concluded that external beam irradiation alone, properly fractionated to cancericidal doses, can control anal carcinoma with acceptable morbidity rates and without the use of either chemotherapy or interstitial implants in most cases. There is also a strong correlation suggesting that anal intercourse and male homosexuality play a significant role in the etiology of this disease.

  14. Primary radiation therapy in the treatment of anal carcinoma

    International Nuclear Information System (INIS)

    Cantril, S.T.; Green, J.P.; Schall, G.L.; Schaupp, W.C.

    1983-01-01

    From 1966 to 1981, 47 patients with a diagnosis of anal carcinoma were irradiated. This group was composed of 23 males and 24 females, with age ranging from 38 to 84 years (average 64.4 years). Five patients were treated preoperatively and 34 were treated definitively with cancericidal doses of irradiation. Acute radiation reactions requiring a rest-break were noted in 28% of patients, but all were managed as outpatients without untoward chronic sequelae. Chronic complications were noted in 13 patients, including two patients who required colostomy for severe anal stenosis and two who required A-P resection for large painful ulcers. Twenty-eight of 35 patients (80%) treated with irradiation alone have remained locally controlled without further treatment. An additional four have been salvaged by surgery. Only three patients had interstitial implants as part of their treatment course. Actuarial survival at five years for the N 0 patients and the group as a whole are 95.6 and 79.3%, respectively. It is concluded that external beam irradiation alone, properly fractionated to cancericidal doses, can control anal carcinoma with acceptable morbidity rates and without the use of either chemotherapy or interstitial implants in most cases. There is also a strong correlation suggesting that anal intercourse and male homosexuality play a significant role in the etiology of this disease

  15. APLICACIÓN DE LA FOTOCATÁLISIS OXIDATIVA CON ZnO Y LUZ SOLAR PARA EL TRATAMIENTO DE AGUA CONTAMINADA CON COLORANTES INDUSTRIALES

    OpenAIRE

    ORTIZ ROMERO, DERLY DAVID

    2016-01-01

    RESUMEN El presente estudio tuvo como objetivo aplicar la fotocatálisis oxidativa con ZnO como fotocatalizador y luz solar para el tratamiento de agua contaminada con colorantes industriales. Para este fin; se validaron las técnicas analíticas necesarias para efectuar la investigación en los colorantes Amarillo Oro K–2R, Ácido Carmínico y Rodamina B; los métodos mostraron respuesta lineal, sensible y precisa para los tres colorantes; asimismo se realizó monitorización de la intensidad de...

  16. Presence of skin metastasis related to an epidermoid carcinoma of anal canal

    International Nuclear Information System (INIS)

    Danta Fundora, Debora; Collado Otero, Juan Carlos; Vazquez Gonzalez, Jose Manuel; Paredes Lopez, Dagmar

    2009-01-01

    Appearance of spreading skin metastases in colorectal cancer and of anal canal is infrequent. The aim of present paper was to show an interesting case of skin metastasis related to an advanced carcinoma of anal canal infiltrating rectum

  17. Caracterização do arenito piramboia da Fazenda São João em Analândia, SP, e sua utilização industrial

    OpenAIRE

    Roque Yuri Tandel

    1994-01-01

    A mina de areia da Sibelco Mineração Ltda., localizada no Município de Analândia, Estado de São Paulo, foi estudada visando a definição dos principais parâmetros utilizados para caracterizar areias para uso em indústrias de fundição e de vidro. Os trabalhos de campo na área de estudo permitiram o reconhecimento de quatro unidades operacionais: Formação Pirambóia unidade inferior, Formação Pirambóia unidade superior, Formação Botucatu intemperizada e solo de alteração. Ênfase especial foi dada...

  18. Testing for and the role of anal and rectal sensation.

    Science.gov (United States)

    Rogers, J

    1992-03-01

    The rectum is insensitive to stimuli capable of causing pain and other sensations when applied to a somatic cutaneous surface. It is, however, sensitive to distension by an experimental balloon introduced through the anus, though it is not known whether it is the stretching or reflex contraction of the gut wall, or the distortion of the mesentery and adjacent structures which induces the sensation. No specific sensory receptors are seen on careful histological examination of the rectum in humans. However, myelinated and non-myelinated nerve fibres are seen adjacent to the rectal mucosa, but no intraepithelial fibres arise from these. The sensation of rectal distension travels with the parasympathetic system to S2, S3 and S4. The two main methods for quantifying rectal sensation are rectal balloon distension and mucosal electrosensitivity. The balloon is progressively distended until particular sensations are perceived by the patient. The volumes at which these sensations are perceived are recorded. Three sensory thresholds are usually defined: constant sensation of fullness, urge to defecate, and maximum tolerated volume. The modalities of anal sensation can be precisely defined. Touch, pain and temperature sensation exist in normal subjects. There is profuse innervation of the anal canal with a variety of specialized sensory nerve endings: Meissner's corpuscles which record touch sensation, Krause end-bulbs which respond to thermal stimuli, Golgi-Mazzoni bodies and pacinian corpuscles which respond to changes in tension and pressure, and genital corpuscles which respond to friction. In addition, there are large diameter free nerve endings within the epithelium. The nerve pathway for anal canal sensation is via the inferior haemorrhoidal branches of the pudendal nerve to the sacral roots of S2, S3 and S4. Anal sensation may be quantitatively measured in response to electrical stimulation. The technique involves the use of a specialized constant current generator

  19. Should anorectal ultrasonography be included as a diagnostic tool for chronic anal pain?

    Directory of Open Access Journals (Sweden)

    M. J. García-Montes

    Full Text Available Objective: to assess the efficiency of endorectal ultrasound (ERUS in the study of chronic idiopathic anal pain (CIAP. Material and method: this is a prospective and descriptive study in which 40 patients, 18 men and 22 women with an average of 47 years, were included. They had chronic anal pain of at least 3 months' duration. A complete colonoscopy was performed in all patients, which found no abnormalities to explain clinical symptoms. Patients with anal fissure and internal hemorrhoids of any degree, perianal suppurative processes, and pelvic surgery were excluded from the study. An ALOKA ProSound SSD-4000 ultrasound console attached to a multifrequency radial transductor ASU-67 (7.5 and 10 MHz was used. Results: one patient could not tolerate the examination. In 8 patients (20% of cases alterations were detected during ultrasonography: in 4 patients (10% of the cases; 1 man and 3 women internal anal sphincter (IAS hypertrophy, and in 5 patients (4 women and 1 man a torn sphincter complex. A tear in the upper IAS canal and hypertrophy of the middle anal canal were observed in one patient (1 woman. Conclusions: ERUS is a simple, economic and useful test to study anorectal pathologies. Although in most studied cases no damage to the anal canal or rectal wall was detected, in a considerable number of patients we observed a thickening of the IAS, a probable cause of anal pain. Therefore, we understand that ERUS should be included in the study of CIAP.

  20. Estudio analítico de MTA-Angelus® y Biodentine® con técnicas SPME-GCMS y AFM

    OpenAIRE

    Díaz-Flores García, Víctor; Martínez Pérez, Lucía; Escribano Otero, Amparo; Kayali Sayadi, Nour

    2016-01-01

    Introducción: El objetivo del estudio fue obtener información analítica sobre la pureza química y homogeneidad de los materiales de uso endodóntico MTA-Angelus® y Biodentine®. Material y métodos: Se analizaron ambos materiales mediante la técnica de microextracción en fase sólida (SPME), combinada con cromatografía de gases acoplada a espectrómetro de masas (GC-MS) para separar e identificar los compuestos orgánicos volátiles (COVs) contenidos. Por otro lado, utilizando microscopía de f...

  1. Squamous cell carcinoma of the anal canal.

    LENUS (Irish Health Repository)

    Martin, F T

    2012-01-31

    Squamous cell carcinoma ofthe anal canal represents 1.5% of all malignancies affectingthe gastrointestinal tract. Over the past 20 years dramatic changes have been seen in both the epidemiological distribution of the disease and in the therapeutic modalities utilised to manage it. CLINICAL MANAGEMENT: Historically abdominoperineal resection had been the treatment of choice with local resection reserved for early stage disease. Work by Nigro et al. has revolutionised how we currently manage carcinoma of the anal canal, demonstrating combined modality chemoradiotherapy as an appropriate alternative to surgical resection with the benefit of preserving sphincter function. Surgery is then reserved for recurrent disease with salvage abdominoperineal resection. This article reviews current literature and highlights the changing therapeutic modalities with selected clinical cases

  2. Expresiones analíticas del coeficiente de pérdidas de energía en dispositivos de reducción del diámetro bajo régimen forzado

    Directory of Open Access Journals (Sweden)

    José Villegas-León

    2016-06-01

    Full Text Available En este artículo se obtienen expresiones analíticas del coeficiente de pérdidas de energía para dispositivos de reducción brusca y reducción gradual del diámetro, que operan en conductos bajo régimen forzado. Se observó que los métodos tradicionales para evaluar las pérdidas por dispositivos requieren el empleo de fórmulas, tablas y gráficos al estimar el coeficiente de pérdida K. Se obtuvieron curvas de valores promedio para K y se ajustaron con métodos de regresiones lineales múltiples hasta obtener una ecuación representativa para cada caso estudiado. Se concluyó que las ecuaciones pueden ser utilizadas confiablemente para determinar el coeficiente de pérdida K, sin necesidad de manipular tablas y gráficos.

  3. [Proctalgia fugax. Differential diagnosis and therapy of fleeting anal cramp].

    Science.gov (United States)

    Staude, G

    1992-05-30

    Proctalgia fugax--short-lived anal spasm--is a common, extremely unpleasant, painful condition that occurs completely unexpectedly, often waking the victim at night. Scientific assessment is difficult on account of the functional nature of the condition and its multifactorial genesis. Before the patient is labeled "anal neurotic", however, he/she should be investigated by a specialist. The results of treating the rarely absent pathological organic findings give rise to optimism.

  4. Método analítico para a determinação de meloxicam em plasma humano por cromatografia líquida de alta eficiência (CLAE Determination of meloxicam in human plasma by HPLC

    Directory of Open Access Journals (Sweden)

    Valentina Porta

    2005-06-01

    Full Text Available Desenvolveu-se e validou-se método analítico simples, rápido e específico para quantificação de meloxicam (inibidor da COX-2 em plasma humano através da cromatografia líquida de alta eficiência, para aplicação em estudos de bioequivalência. Piroxicam foi utilizado como padrão interno. Empregou-se cromatografia em fase reversa com coluna modelo Synergi RP-MAX (150 x 4,6 mm, à temperatura de 30 ºC e fase móvel constituída por mistura de acetonitrila e tampão fosfato 0,025 mol/L pH 4,5 (40:60, v/v, a um fluxo de 1,0 mL/min. Os analitos foram detectados por UV a 364 nm. As amostras de plasma foram acidificadas com ácido clorídrico 1 mol/L, extraídas utilizando-se éter terc-butil metílico e, após filtração e secagem, o resíduo foi reconstituído em 250 mL de fase móvel para injeção em CLAE. Os tempos de retenção para meloxicam (padrão e piroxicam (padrão interno foram 3,35 e 4,19 minutos, respectivamente. Este método apresentou linearidade na faixa de concentração entre 50-4000 ng/mL (R² = 0,9995, com limite de quantificação inferior de 50 ng/mL e exatidão de 114%. O método analítico desenvolvido neste trabalho demonstrou especificidade, linearidade, precisão e exatidão adequadas, permitindo sua aplicação em ensaios de bioequivalência.A simple, rapid and specific high-performance liquid cromatographic (HPLC method was developed and validated to estimate meloxicam (COX-2 inhibitor levels in human plasma. Piroxicam was used as internal standard. Reversed phase chromatography was conducted using a Synergi RP-MAX (150 x 4.6 mm column at 30 ºC and a mobile phase of acetonitrile and 0.025 mol/L pH 4,5 phosphate buffer (40:60, v/v, at a flow rate of 1mL/min. Analytes were detected at 364 nm. Plasma samples were acidified with 1 mol/L hydrochloric acid and extracted with tert-butyl methyl ether, evaporated to dryness, reconstituted in 250 mL of mobile phase and injected in the column. The retention time of

  5. Correlates of anal sex roles among Malay and Chinese MSM in Kuala Lumpur, Malaysia.

    Science.gov (United States)

    Dangerfield, Derek T; Gravitt, Patti; Rompalo, Anne M; Tai, Raymond; Lim, Sin How

    2016-03-01

    Identifying roles for anal sex is an important issue for populations of MSM. We describe the prevalence of identifying as being 'top', 'bottom', 'versatile', or 'don't know/not applicable' among Malay and Chinese MSM in Kuala Lumpur, Malaysia, and behavioural outcomes according to these labels for sexual role identity. Data analysis was conducted on a survey administered during weekly outreach throughout Kuala Lumpur in 2012. Pearson's Chi square tests were used to compare demographic and behavioural characteristics of MSM who reported roles for anal sex. Binary logistic regression was used to explore the odds of behavioural outcomes among MSM who identified as 'bottom', 'versatile,' and 'don't know' compared to MSM who reported that 'top' was their sexual role. Labels for anal sex roles were significantly associated with condom use for last anal sex. Among MSM who used labels for anal sex roles, MSM who identified as 'bottom' had highest level of not using condoms for last anal sex (24.1%, p = .045). In binary logistic regression model, identifying as 'top' was significantly associated with reporting using a condom during last anal sex and reported consistent condom use for anal sex in the past six months (p = .039 and .017, respectively). With regard to sexual role identity, some MSM may be a part of a special subgroup of at-risk men to be targeted. Future research should evaluate the origins, meanings, and perceptions of these labels, and the developmental process of how these MSM identify with any of these categories. Research should also uncover condom use decision making with regard to these labels for sexual positioning. © The Author(s) 2016.

  6. Anal canal duplication and triplication: a rare entity with different presentations.

    Science.gov (United States)

    Palazon, P; Julia, V; Saura, L; de Haro, I; Bejarano, M; Rovira, C; Tarrado, X

    2017-05-01

    Anal canal duplication (ACD) is the rarest of gastrointestinal duplications. Few cases have been reported. Most cases present as an opening in the midline, posterior to the normal anus. The aim of our revision is to contribute with eight new cases, some of them with unusual presentations: five presented as the typical form, one with a perianal nodule, and two presented as two separate orifices (anal canal triplication). Complete excision was performed in all patients with no complications. ACD is the most distal and the least frequent digestive duplication. Its treatment should be surgical excision, to avoid complications such as abscess, fistulization, or malignization. Anal canal triplication has never been described before.

  7. Uma ferramenta para automação da geração do leiaute de circuitos analógicos sobre uma matriz de transistores MOS pré-difundidos

    OpenAIRE

    Alessandro Gonçalves Girardi

    2003-01-01

    Este trabalho apresenta o LIT, uma ferramenta de auxílio ao projeto de circuitos integrados analógicos que utiliza a técnica da associação trapezoidal de transistores (TAT) sobre uma matriz digital pré-difundida. A principal característica é a conversão de cada transistor simples de um circuito analógico em uma associação TAT equivalente, seguido da síntese automática do leiaute da associação séria-paralela de transistores. A ferramenta é baseada na matriz SOT (sea-of-transistors), cuja arqui...

  8. [Usefulness of human papillomavirus testing in anal intraepithelial neoplasia screening in a risk behaviour population].

    Science.gov (United States)

    Padilla-España, Laura; Repiso-Jiménez, Bosco; Fernández-Sánchez, Fernando; Frieyro-Elicegui, Marta; Fernández-Morano, Teresa; Pereda, Teresa; Rivas-Ruiz, Francisco; Redondo, Maximino; de-Troya Martín, Magdalena

    2014-11-01

    The incidence of intraepithelial anal neoplasia is increasing in certain risk behaviour groups, and human papillomavirus (HPV) infection is involved in its pathogenesis. The systematic use of anal cytology, and more recently HPV detection by hybrid capture and genotyping, have been introduced into screening programs in recent decades. A retrospective cohort study was carried out on individuals with risk behaviours of developing intraepithelial anal neoplasia and who attended Sexually Transmitted Infections clinics in the Dermatology area of the Hospital Costa del Sol from January 2010 to December 2012. The intraepithelial anal neoplasia screening was performed using anal cytology and HPV genotyping. Half (50%) of the study population were HIV positive. A high frequency of anal dysplasia and presence of HPV in cytology (82.1%) and genotype (79%) was found. A statistically significant association (P<.005) was obtained between the presence of high-risk HPV genotypes and the presence of high-grade dysplasia in the second directed cytology. HPV genotyping enabled 17 cases (22%) of severe dysplasia to be identified that were under-diagnosed in the first cytology. Cases of high-grade dysplasia can be under-diagnosed by a first anal cytology. Detection of HPV can supplement this procedure, leading to the identification of those patients most at risk of developing high-grade anal dysplasia. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  9. Addressing Risk and Reluctance at the Nexus of HIV and Anal Cancer Screening

    Science.gov (United States)

    Ka‘opua, Lana Sue I.; Cassel, Kevin; Shiramizu, Bruce; Stotzer, Rebecca L.; Robles, Andrew; Kapua, Cathy; Orton, Malulani; Milne, Cris; Sesepasara, Maddalynn

    2015-01-01

    Anal cancer disproportionately burdens persons living with human immunodeficiency virus (PLHIV) regardless of natal sex, sexual orientation, gender expression, and ethnic identity. Culturally competent communications are recommended to address health disparities, with sociocultural relevance ensured through constituent dialogic processes. Results are presented from six provider focus groups conducted to inform the promotion/education component of a Hawai‘i-based project on anal cancer screening tools. Krueger’s focus group methodology guided discussion queries. Verbatim transcripts of digitally recorded discussions were analyzed using grounded theory and PEN-3 procedures. Adherence to an audit trail ensured analytic rigor. Grounded theory analysis detected the overall theme of risk and reluctance to anal cancer screening, characterized by anal cancer not being “on the radar” of PLHIV, conflicting attributions of the anus and anal sex, fear of sex-shaming/-blaming, and other interrelated conceptual categories. PEN-3 analysis revealed strategies for destigmatizing anal cancer, through “real talk” (proactive, candid, nonjudgmental discussion) nested in a framework of sexual health and overall well-being, with additional tailoring for relevance to Native Hawaiians/Pacific Islanders, transgender persons, and other marginalized groups. Application of strategies for health practice are specific to the Hawai‘i context, yet may offer considerations for developing strengths-based, culturally relevant screening promotion/education with diverse PLHIV in other locales. PMID:26630979

  10. Addressing Risk and Reluctance at the Nexus of HIV and Anal Cancer Screening.

    Science.gov (United States)

    Ka'opua, Lana Sue I; Cassel, Kevin; Shiramizu, Bruce; Stotzer, Rebecca L; Robles, Andrew; Kapua, Cathy; Orton, Malulani; Milne, Cris; Sesepasara, Maddalynn

    2016-01-01

    Anal cancer disproportionately burdens persons living with human immunodeficiency virus (PLHIV) regardless of natal sex, sexual orientation, gender expression, and ethnic identity. Culturally competent communications are recommended to address health disparities, with sociocultural relevance ensured through constituent dialogic processes. Results are presented from six provider focus groups conducted to inform the promotion/education component of a Hawai'i-based project on anal cancer screening tools. Krueger's focus group methodology guided discussion queries. Verbatim transcripts of digitally recorded discussions were analyzed using grounded theory and PEN-3 procedures. Adherence to an audit trail ensured analytic rigor. Grounded theory analysis detected the overall theme of risk and reluctance to anal cancer screening, characterized by anal cancer not being "on the radar" of PLHIV, conflicting attributions of the anus and anal sex, fear of sex-shaming/-blaming, and other interrelated conceptual categories. PEN-3 analysis revealed strategies for destigmatizing anal cancer, through "real talk" (proactive, candid, nonjudgmental discussion) nested in a framework of sexual health and overall well-being, with additional tailoring for relevance to Native Hawaiians/Pacific Islanders, transgender persons, and other marginalized groups. Application of strategies for health practice are specific to the Hawai'i context, yet may offer considerations for developing strengths-based, culturally relevant screening promotion/education with diverse PLHIV in other locales. © 2015 Society for Public Health Education.

  11. Prevalence of Anal HPV Infection Among HIV-Positive Men Who Have Sex With Men in India.

    Science.gov (United States)

    Hernandez, Alexandra L; Karthik, Rajiv; Sivasubramanian, Murugesan; Raghavendran, Anantharam; Gnanamony, Manu; Lensing, Shelly; Lee, Jeannette Y; Kannangai, Rajesh; Abraham, Priya; Mathai, Dilip; Palefsky, Joel M

    2016-04-01

    India has a large population of HIV-positive individuals, including men who have sex with men (MSM), and the incidence of human papillomavirus (HPV)-related cancers is high. In developed countries, HIV-positive MSM exhibit the highest prevalence of anal HPV infection and incidence of anal cancer. Little is known about anal HPV infection in HIV-positive Indian MSM. We evaluated 300 HIV-positive MSM from 2 cities in India. Men were tested for anal HPV infection using L1-HPV DNA polymerase chain reaction with probes specific for 29 types and a mixture of 10 additional types. CD4 level and plasma HIV viral load were measured. Participants completed an interviewer-administered questionnaire including a sexual history. The prevalence of anal HPV was 95% (95% confidence interval: 91% to 97%). The 3 most common types were HPV 35 (20%), HPV 16 (13%), and HPV 6/11 (13%). History of taking antiretroviral medications decreased risk of anal HPV 16 infection [relative risk (RR): 0.6 (0.4-1.0)]. Having an increased number of vaginal sex partners lowered risk of any anal HPV infection. Ever having receptive sex increased risk of any anal HPV [RR: 1.2 (1.1-1.4)] and anal HPV 16 [RR: 6.5 (1.8-107)]. Almost all Indian HIV-positive MSM had anal HPV infection. The prevalence of HPV 16 was lower and the prevalence of other oncogenic HPV types was higher than in similar populations in North America and Europe. Vaccine-based prevention strategies for HPV infection in India should consider potential differences in HPV type distribution among HIV-infected MSM when designing interventions.

  12. Resisting the "Condom Every Time for Anal Sex" Health Education Message

    Science.gov (United States)

    Adams, Jeffery; Neville, Stephen

    2012-01-01

    Objective: Ensuring men who have sex with men (MSM) adopt and maintain condom use for anal sex is a challenging health education goal. In order to inform the development of social marketing practices to encourage safe-sex practices, the views of MSM about a key HIV health education message ("using a condom every time for anal sex") were…

  13. Anal sphincter electromyography in patients with Anorectal Dysfunctions

    International Nuclear Information System (INIS)

    Trinchet Soler, Rafael; Hidalgo Marrero, Yanet; Espichicoque Megret, Arianne; Manzano Suarez, Jianeya; Perez Gonzales, Ruth Maite

    2009-01-01

    The purpose of this work is to evaluate the electromyography value of anal sphincter in patients with anorectal dysfunctions. Anorectal dysfunctions are frequent reason of pediatric consultation in children, especially with anal incontinence. A study of series of cases in patient with anorectal dysfunctions was carried out from January 2002 to January of 2006. 65 patients were studied. Anorectal malformations (ARM) represented the predominant affection with 38 patients (58.5%), prevailing the male sex in 25 patients (65.8%). Encopresis and intestinal agagliosis dicrease was observed. Sphincter was found before surgical treatment through electromyography in patients with anorectal malformations and colostomy; in those with definitive operation and open colostomy, it avoided the operation in a patient that did not have muscular activity of the external sphincter. In children already operated and with closed colostomy several electromyography changes were observed in correspondence with different incontinence grades. In encopresis cases the study was useful to rule out sphincter functional alterations. Electromyography was pathological in all the operated patients of intestinal aganglionosis. This procedure was very useful for anal incontinence study that helped to determine and establish the prognosis. (author)

  14. Associação de agenesia sacrococcígea e atresia anal em gato sem raça definida Sacrococcygeal agenesis association and anal atresia in mixed breed cats

    Directory of Open Access Journals (Sweden)

    Felipe Purcell de Araújo

    2009-09-01

    Full Text Available O presente trabalho teve como objetivo descrever o caso de um felino, que desde o nascimento apresentou atresia anal, ausência de cauda e malformação dos membros pélvicos. Ao exame radiográfico, pôde-se observar presença de agenesia da sétima vértebra lombar, sacro e vértebras coccígeas, espinha bífida, meningocele, hiperflexão dos joelhos e desvio valgo dos tarsos, diagnosticando-se agenesia sacrococcígea associada à atresia anal.This paper has the objective to report a case of a cat that since birth had anal atresia, absence of tail and malformation of the pelvic member. The radiographic examination revealed agenesis of the seventh lumbar vertebra, sacral and coccygeal vertebrae, spina bifida, meningocele, hyperflexion of the knees and tarsal valgus deviation, diagnosing sacrococcygeal agenesis associated with anal atresia.

  15. Empaatia kogemus kunstiteoses kujutatud subjekti suhtes: fenomenoloogiline analüüs / Marge Paas

    Index Scriptorium Estoniae

    Paas, Marge, 1976-

    2015-01-01

    Analüüsitakse vaataja esteetilist kogemust kunstiteose suhtes. Autor tugineb Edith Steini empaatia kogemuse uurimusele ja fenomenoloogilisele uurimismeetodile. Vaataja empaatia kogemuse analüüs Maarit Murka maalisarjas "Hairpower" kujutatud subjekti suhtes

  16. Comportamiento de aceites poliinsaturados en la preparación de patatas fritas para consumo inmediato: Formación de nuevos compuestos y comparación de métodos analíticos

    Directory of Open Access Journals (Sweden)

    Masson, L.

    1997-10-01

    de hidrólisis cuya presencia es difícil de explicar. A partir de las correlaciones existentes entre métodos analíticos se puede deducir que, en este sector, la acidez libre y el porcentaje de dienos conjugados (o viscosidad, son útiles para predecir las cantidades de los principales grupos de nuevos compuestos presentes en los aceites de fritura poliinsaturados.

  17. Urinary and anal incontinence during pregnancy and postpartum: incidence, severity, and risk factors.

    Science.gov (United States)

    Solans-Domènech, Maite; Sánchez, Emília; Espuña-Pons, Montserrat

    2010-03-01

    To estimate frequency and severity and to identify risk factors of urinary incontinence (UI) and anal incontinence during pregnancy and after delivery in previously continent nulliparous women. We designed a cohort study of healthy, continent, nulliparous pregnant women attending public health care services. The field work was conducted during the control visits of the three trimesters of pregnancy, at the time of delivery, and postpartum. A self-administered questionnaire was used to assess UI (validated and adapted) and anal incontinence. Frequency of UI and anal incontinence and their confidence intervals (95% CIs) were calculated. The correlations between the severity of UI and the degree of effect on daily life were also estimated. Multivariable Cox models were applied to estimate hazard ratios for both incontinences (urinary/anal) during pregnancy and postpartum. The cumulative incidence rate during pregnancy was 39.1% (95% CI 36.3-41.9) for UI and 10.3% (95% CI 8.3-12.3) for anal incontinence. The correlation between severity of UI and effect on daily life was moderate. Age, baseline body mass index, and family history of UI were significantly associated with the occurrence of UI during pregnancy, while age and excess weight gain during pregnancy were associated with the occurrence of anal incontinence during pregnancy. Postpartum, the identified risk factors for both incontinences were incontinence during pregnancy and vaginal delivery. The occurrence of UI and anal incontinence during the postpartum period is related to the presence of incontinence in pregnancy, and vaginal delivery increases the risk of persistent incontinence. Some risk factors for both incontinences during pregnancy and postpartum are related to lifestyles and obstetric practices.

  18. Does Sacral Nerve Stimulation Improve Continence Through Enhanced Sensitivity of the Anal Canal?

    DEFF Research Database (Denmark)

    Haas, S; Brock, C; Krogh, K

    2016-01-01

    . DESIGN: This is an explorative study. PATIENTS: Fifteen women with idiopathic fecal incontinence (mean age, 58 ± 12.2 years) were selected. INTERVENTIONS: Cortical evoked potentials were recorded during repeated rapid balloon distension of the rectum and the anal canal both before and during temporary...... the threshold for urge to defecate elicited from the anal canal, whereas supraspinal responses remained unaltered. This may suggest that sacral nerve stimulation, at least in part, acts via somatic afferent fibers enhancing anal sensation....

  19. Anal carcinoma and HIV infection: is it time for screening?

    Science.gov (United States)

    Herranz-Pinto, P; Sendagorta-Cudós, E; Bernardino-de la Serna, J I; Peña-Sánchez de Rivera, J M

    2014-03-01

    A 38-year-old white man had a 10-year history of human immunodeficiency virus (HIV) infection (A3), with no episodes of opportunistic diseases and in good immunologic recovery (CD4 cell count: 450 and indetectable HIV viral load) while on HAART. He presented with a two-month history of mild anal symptoms, including pruritus and episodic bleeding. He referred past episodes of anal warts, self-treated with several topical compounds, all proven unsuccessful. Perianal examination showed erythema and scratching. A 0.5cm sized tumor, with infiltration at the base was detected on digital exam, located at 15mm from the anal margin. Local biopsy driven by high-resolution anuscopy (AAR) yielded a final diagnosis of infiltrative epidermoid carcinoma. Might that neoplasia have been prevented? Copyright © 2013 Elsevier España, S.L. All rights reserved.

  20. Pouch failures following ileal pouch-anal anastomosis for ulcerative colitis

    DEFF Research Database (Denmark)

    Mark-Christensen, A; Erichsen, R; Brandsborg, S

    2018-01-01

    BACKGROUND: The ileal pouch-anal anastomosis is a procedure offered to patients with ulcerative colitis who opt for restoration of bowel continuity. The aim of this study was to determine the risk of pouch failure and ascertain risk factors associated with failure. METHOD: 1,991 patients with ulc......BACKGROUND: The ileal pouch-anal anastomosis is a procedure offered to patients with ulcerative colitis who opt for restoration of bowel continuity. The aim of this study was to determine the risk of pouch failure and ascertain risk factors associated with failure. METHOD: 1,991 patients......-anal anastomosis from Denmark, where pouch surgery is centralized, females had a higher risk of pouch failure. Of modifiable factors, low hospital volume and non-diversion were associated with a higher risk of pouch failure. This article is protected by copyright. All rights reserved....

  1. Estudo crítico da avaliação da maturidade fetal pela citologia do líquido âmnico: comparação com outros métodos A critical study of the evaluation of foetal maturity through citology of the amniotic fluid: comparison with other methods

    Directory of Open Access Journals (Sweden)

    Pedro Augusto Marcondes de Almeida

    1975-09-01

    Full Text Available Através da amniocentese em 90 gestações de alto risco, foi feito estudo crítico da citologia do líquido amniótico pelo Sulfato de Azul do Nilo em comparação com a creatinina e o Rx simples de abdomen e sua relação com a idade do RN (calculados pelas tabelas de Lubchenco e Capurro. Concluiu-se que a técnica do Sulfato de Azul do Nilo apresenta real valor, nas nossas condições econômicas, com menor percentagem de falhas com os demais métodos, sendo melhor para a avaliação de maturidade fetal o emprego simultâneo de todos os métodos, aliados à clínica.Through amniocentesis carried ou in 90 high-risk pregnant women a critical study of the citology of the amniotic fluid by the Nile-blue sulphate method was undertaken. The results were compared with those obtained by using creatinine and simple X-rays of the abdomen as well as their relationship with the foetal-age of the babies when born (calculated by the Lubchenco and Capurro tables. The Nile-blue sulphate method is of considerable value due to conditions in Brazil and presents a lower percentage of errors than others. For evaluation of foetal maturity, however, one should use all methods simultaneously, along with clinical assessment.

  2. Analýza sportovního areálu vybranými metodami

    OpenAIRE

    Jelínek, Vojtěch

    2014-01-01

    Bakalářská práce se zabývá analýzou sportovního areálu U Hrocha, který má být dokončen v roce 2014. Obsahuje teoretická východiska, která jsou následně implementována do skutečné reality podniku, a to prostřednictvím PESTLE analýzy, Porterovy analýzy a SWOT analýzy. Závěrem je vyhodnocena situace a jsou navržena řešení pro optimalizaci chodu sportovního areálu. This bachelor´s thesis deals with analysis of the sports complex U Hrocha, which will be completed in 2014. It contains theoretica...

  3. La influencia de las explicaciones de la dirección en la evaluación de los procedimientos analíticos de auditoría

    Directory of Open Access Journals (Sweden)

    Reiner Quick

    2009-01-01

    Full Text Available La aplicación de procedimientos analíticos está basada en la expectativa de que existan relaciones entre los datos contenidos en los estados contables, y proporcionan evidencia de auditoría sobre la validez, precisión e integridad de la información contable. Los auditores generan valores esperados y los comparan con los contenidos en los estados financieros. Cuando se producen discrepancias, el auditor debe generar hipótesis sobre las posibles causas, evaluarlas y elegir la más plausible. Los estándares de auditoría requieren que los auditores consulten a la dirección para encontrar explicaciones que justifiquen fluctuaciones inesperadas. Investigaciones empíricas anteriores revelan que las explicaciones de la dirección influyen en la generación de hipótesis y en los procedimientos analíticos. Este estudio experimental, basado en una fluctuación inesperada del margen bruto, es el primero alemán que investiga el efecto de las explicaciones de la dirección en las etapas de formación de hipótesis, búsqueda de información y juicios finales respecto a los procedimientos analíticos.

  4. Terapias cognitivo conductuales para el tratamiento de los trastornos de personalidad

    Directory of Open Access Journals (Sweden)

    Manuela Navarro-Leis

    2013-06-01

    Full Text Available Se han propuesto muchos tratamientos psicológicos para el abordaje de los trastornos de personalidad, realizándose gran variedad de estudios para comprobar la eficacia de los mismos. Y aunque hasta la fecha no se ha podido demostrar empíricamente que exista ningún tratamiento establecido como eficaz, si se ha demostrado que los tratamientos cognitivo conductuales y conductuales resultan probablemente eficaces para el tratamiento de estos trastornos, en concreto y de forma más específica para el Trastorno Límite de Personalidad. El objetivo de este trabajo es ofrecer una revisión a nivel teórico y empírico de los tres modelos de tratamiento considerados actualmente de mayor eficacia: Terapia Dialéctica Conductual, Terapia de Aceptación y Compromiso y Psicoterapia Analítico Funcional, incluidas dentro de las llamadas Terapias de conducta de tercera generación.

  5. The value of high-resolution anoscopy in the diagnosis of anal cancer precursor lesions in hiv-positive patients

    Directory of Open Access Journals (Sweden)

    Felicidad Gimenez

    2011-06-01

    Full Text Available CONTEXT: Anal cancer, although a still rare disease, is being observed in ascending rates among some population segments known to be at risk for the development of the disease. Human papillomavirus (HPV infection, immunodepression and anal intercourse are some factors associated with the development of the malignancy. Its similarities to cervical cancer have led to many studies aiming to establish guidelines for detecting and treating precursor lesions of anal cancer, with the goal of prevention. High-resolution anoscopy is routinely used for the diagnosis of anal cancer precursor lesions in many centers but the medical literature is still deficient concerning the role of this diagnostic modality. OBJECTIVES: To evaluate diagnostic validation and precision measures of high-resolution anoscopy in comparison to histopathological results of anal biopsies performed in HIV-positive patients treated at the Tropical Medicine Foundation of Amazonas, AM, Brazil. To observe any possible association between some risk factors for the development of anal cancer and the presence of anal squamous intraepithelial lesions. METHODS: A hundred and twenty-eight HIV-positive patients were submitted to anal canal cytological sampling for the detection of HPV infection by a PCR based method. High-resolution anoscopy was then performed after topical application of acetic acid 3% in the anal canal for 2 minutes. Eventual acetowhite lesions that were detected were recorded in respect to location, and classified by their tinctorial pattern, distribution aspect, relief, surface and vascular pattern. Biopsies of acetowhite lesions were performed under local anesthesia and the specimens sent to histopathological analysis. The patients were interviewed for the presence of anal cancer risk factors. RESULTS: The prevalences of anal HPV infection and of anal squamous intraepithelial lesions in the studied population were, respectively, 79% and 39.1%. High-resolution anoscopy

  6. Comparative analysis between the cytobrush and low-volume uterine flush techniques for endometrial cytology in clinically normal postpartum crossbred dairy cowsComparação das técnicas de citologia endometrial escova citológica e lavado uterino de baixo volume no pós-parto de vacas leiteiras mestiças

    Directory of Open Access Journals (Sweden)

    João Paulo Elsen Saut

    2013-10-01

    . O exame ginecológico foi executado pela palpação retal, ultrassonografia, vaginoscopia, avaliação de muco vaginal e CE realizada com escova citológica (CB ou por lavado uterino de baixo volume (LVF. A concordância (Kappa statistic entre os técnicos na contagem da porcentagem de neutrófilos foi boa para CB (86% e para LVF (80,3%. A média de neutrófilos foi maior em todos os momentos na técnica de LVF, porém a redução de neutrófilos foi observada durante o pós-parto nas duas técnicas de citologia. A contagem de macrófagos, linfócitos e eosinófilos não variou durante o pós-parto e não houve diferença entre as técnicas CB e LVF. Houve diferença apenas aos 28 dpp, na porcentagem de vacas com endometrite subclínica, entre as técnicas CB (22.2% e LVF (59.3%.

  7. Primena cost-benefit-benefit analize u vrednovanju i izboru javnih projekata (ekonomski aspekt

    Directory of Open Access Journals (Sweden)

    Dragana N. Petrović

    2013-10-01

    Full Text Available Cost-benefit analiza je celovita analiza koristi i troškova koje jedan projekat donosi samom vlasniku projekta i društvu u celini (uključujući i investitora. Izbor najbolje investicione alternative ostvaruje na osnovu finansijske i ekonomske analize, kao dva integralna dela cost-benefit analize. Prvu od ovih analiza obradila je ista grupa autora u članku „Primena cost-benefit analize u vrednovanju i izboru javnih projekata (finansijski aspekt“, objavljenom u prethodnom broju časopisa Vojnotehnički glasnik. Predmet obrade ovog rada je ekonomska analiza, kao logički nastavak prethodnog rada. Zbog toga se na brojne oznake tabela, uključenih u sadržaj finansijske analize (1-–5, nadovezuju (prema hronološkom redu oznake tabela koje pripadaju ekonomskoj analizi (6–8 Sprovođenje ekonomske analize ostvaruje se prema određenoj, dosta složenoj proceduri, a završava se utvrđivanjem kriterijuma ekonomske (društvene isplativosti projekta. U radu su obrađeni osnovni pokazatelji ekonomskog (društvenog prinosa projekta,  kao što su: neto sadašnja vrednost novčanih tokova i cost-benefit koeficijent.

  8. Rare case of gastrointestinal stromal tumor of the anal canal

    Directory of Open Access Journals (Sweden)

    Madhu Kumar

    2013-01-01

    Full Text Available Gastrointestinal stromal tumor (GIST is a rare mesenchymal neoplasm of the gastrointestinal tract. GIST of anal canal is very rare representing only 3% of all anorectal mesenchymal tumors. We report an extremely rare case of GIST of the anal canal in 60-years-old man with history of irregular bowel habits with dark colored stool mixed with blood and constipation from 6 month. Diagnosis was made on the basis of histomorphological and immunohistochemical examination.

  9. Anal Papilloma: An Exceptional Presentation of Fibrocystic Disease in Anogenital Mammary-Like Glands

    Directory of Open Access Journals (Sweden)

    Priya Subashchandrabose

    2015-01-01

    Full Text Available Previously ectopic breast tissue was thought to be derived from the caudal remnants of the primitive embryonic milk ridges; anogenital mammary-like glands are presently considered as normal constituents of the anogenital region. We report a case of young female, who presented with an anal papilloma. Histopathological examination revealed extensive fibrocystic changes in anogenital mammary-like glands. To date, a lot of benign changes and a wide range of benign and malignant neoplasms have been reported in these glands. However, extensive fibrocystic change of these glands in anal region is very rare. In addition, fibrocystic disease of anal mammary glands, masquerading clinically as an anal papilloma, has not been reported in literature. Hence, it is essential for clinicians and the pathologists to be aware of such a rare presentation. The features of fibrocystic disease in perianal region are also discussed.

  10. Anal Papilloma: An Exceptional Presentation of Fibrocystic Disease in Anogenital Mammary-Like Glands.

    Science.gov (United States)

    Subashchandrabose, Priya; Esakkai, Muthuvel; Venugopal, Palani; Kannaiyan, Ilavarasan; Srinivasan, Chitra; Reddy, Punuru Tejashwini; Ebenezer, Evelyn Elizabeth

    2015-01-01

    Previously ectopic breast tissue was thought to be derived from the caudal remnants of the primitive embryonic milk ridges; anogenital mammary-like glands are presently considered as normal constituents of the anogenital region. We report a case of young female, who presented with an anal papilloma. Histopathological examination revealed extensive fibrocystic changes in anogenital mammary-like glands. To date, a lot of benign changes and a wide range of benign and malignant neoplasms have been reported in these glands. However, extensive fibrocystic change of these glands in anal region is very rare. In addition, fibrocystic disease of anal mammary glands, masquerading clinically as an anal papilloma, has not been reported in literature. Hence, it is essential for clinicians and the pathologists to be aware of such a rare presentation. The features of fibrocystic disease in perianal region are also discussed.

  11. Anal microbiota profiles in HIV-positive and HIV-negative MSM.

    Science.gov (United States)

    Yu, Guoqin; Fadrosh, Doug; Ma, Bing; Ravel, Jacques; Goedert, James J

    2014-03-13

    Because differences in anal microbial populations (microbiota) could affect acquisition of HIV or other conditions, especially among MSM, we profiled the microbiota of the anal canal, assessed its stability, and investigated associations with diversity and composition. Microbiota profiles in anal swabs collected from 76 MSM (52 in 1989, swab-1; 66 1-5 years later, swab-2) were compared by HIV status (25 HIV-positive), T-cell subsets, and questionnaire data. Bacterial 16S rRNA genes were amplified, sequenced (Illumina MiSeq), and clustered into species-level operational taxonomic units (QIIME and Greengenes). Regression models and Wilcoxon tests were used for associations with alpha diversity (unique operational taxonomic units, Shannon's index). Composition was compared by Adonis (QIIME). Most anal bacteria were Firmicutes (mean 60.6%, range 21.1-91.1%) or Bacteroidetes (29.4%, 4.1-70.8%). Alpha diversity did not change between the two swabs (N = 42 pairs). In swab-2, HIV-positives had lower alpha diversity (P ≤ 0.04) and altered composition, with fewer Firmicutes and more Fusobacteria taxa (P ≤ 0.03), not completely attributable to very low CD4(+) cell count (median 232 cells/μl), prior AIDS clinical diagnosis (N = 17), or trimethoprim-sulfamethoxazole use (N = 6). Similar but weaker differences were observed in swab-1 (HIV-positive median 580 CD4(+) cells/μl; no trimethoprim-sulfamethoxazole). Associations with T-cell subsets, smoking, and sexual practices were null or inconsistent. The anal microbiota of MSM was relatively stable over 1-5 years. However, with uncontrolled, advanced HIV infection, the microbiota had altered composition and reduced diversity partially attributable to antibiotics. Investigations of microbial community associations with other immune perturbations and clinical abnormalities are needed.

  12. Tumor Response and Survival Predicted by Post-Therapy FDG-PET/CT in Anal Cancer

    International Nuclear Information System (INIS)

    Schwarz, Julie K.; Siegel, Barry A.; Dehdashti, Farrokh; Myerson, Robert J.; Fleshman, James W.; Grigsby, Perry W.

    2008-01-01

    Purpose: To evaluate the response to therapy for anal carcinoma using post-therapy imaging with positron emission tomography (PET)/computed tomography and F-18 fluorodeoxyglucose (FDG) and to compare the metabolic response with patient outcome. Patients and Methods: This was a prospective cohort study of 53 consecutive patients with anal cancer. All patients underwent pre- and post-treatment whole-body FDG-PET/computed tomography. Patients had been treated with external beam radiotherapy and concurrent chemotherapy. Whole-body FDG-PET was performed 0.9-5.4 months (mean, 2.1) after therapy completion. Results: The post-therapy PET scan did not show any abnormal FDG uptake (complete metabolic response) in 44 patients. Persistent abnormal FDG uptake (partial metabolic response) was found in the anal tumor in 9 patients. The 2-year cause-specific survival rate was 94% for patients with a complete vs. 39% for patients with a partial metabolic response in the anal tumor (p = 0.0008). The 2-year progression-free survival rate was 95% for patients with a complete vs. 22% for patients with a partial metabolic response in the anal tumor (p < 0.0001). A Cox proportional hazards model of survival outcome indicated that a complete metabolic response was the most significant predictor of progression-free survival in our patient population (p = 0.0003). Conclusions: A partial metabolic response in the anal tumor as determined by post-therapy FDG-PET is predictive of significantly decreased progression-free and cause-specific survival after chemoradiotherapy for anal cancer

  13. Validación del método analítico para el control de la calidad y estudio de estabilidad de fenilefrina 10 % colirio Validation of an analytical method for quality control and stability study of 10 % Phenylephrine eyedrops

    Directory of Open Access Journals (Sweden)

    Raiza Monteagudo Licea

    2010-12-01

    Full Text Available La fenilefrina se emplea como midriático en exámenes de ojos y otros procedimientos oftálmicos. Se utiliza como vasoconstrictor con anestésicos locales. En este trabajo se validó un método analítico por cromatografía líquida de alta resolución para el control de la calidad y los estudios de estabilidad de la fenilefrina 10 % colirio. El método se basó en la separación del principio activo a través una columna cromatográfica Lichrosorb RP-18 (5 µm (250 x 4 mm, con detección ultravioleta a 280 nm, para lo cual se empleó una fase móvil compuesta por una mezcla desgasificada de metanol:agua destilada (1:1, con 1,1 g de 1-octanosulfonato de sodio por litro ajustado a pH 3,0 con ácido fosfórico, con una velocidad de flujo de 1,0 mL/min. El método analítico resultó lineal, preciso, específico y exacto en el intervalo de concentraciones estudiadas.Phenylephrine is used like mydiatric in eye examinations and other ophthalmic procedures. It is used as vasoconstrictor with local anesthetic agents. In present paper a high ressolution liquid chromatography analytical method was validated to quality control and stability studies of 10 % Phenylephrine (eyedrops. Mathod was based in separation of active principle through a Lichrosorb RO-18 (5 µm (250 x 4 mm chromatography column with UV detection at 280 nm using a mobile phase composed by a non-gasified mixture of methanol distilled water (1:1 with 1.1 g of 1-sodium octane-sulphonate by liter adjusted to pH 3,0 with phosphoric acid at a flow speed of 1.0 mL/min. Analytical method was linear, accuracy, specific and exact in the interval of study concentrations.

  14. Heterosexual anal intercourse and HIV infection risks in the context of alcohol serving venues, Cape Town, South Africa

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    Carey Kate B

    2011-10-01

    Full Text Available Abstract Background The most efficient sexual behavior for HIV transmission is unprotected receptive anal intercourse. However, it is unclear what role heterosexual unprotected anal sex is playing in the world's worst HIV epidemics of southern Africa. The objective is to examine the prevalence of heterosexual unprotected anal intercourse among men and women who drink at informal alcohol serving establishments (shebeens in South Africa. Methods Cross-sectional surveys were collected from a convenience sample of 5037 patrons of 10 shebeens in a peri-urban township of Cape Town, South Africa. Analyses concentrated on establishing the rates of unprotected anal intercourse practiced by men and women as well as the factors associated with practicing anal intercourse. Results We found that 15% of men and 11% of women reported anal intercourse in the previous month, with 8% of men and 7% of women practicing any unprotected anal intercourse. Multiple logistic regression showed that younger age, having primary and casual sex partners, and meeting sex partners at shebeens were independently associated with engaging in anal intercourse. Mathematical modeling showed that individual risks are significantly impacted by anal intercourse but probably not to the degree needed to drive a generalized HIV epidemic. Conclusions Anal intercourse likely plays a significant role in HIV infections among a small minority of South Africans who patronize alcohol serving establishments. Heterosexual anal intercourse, the most risky sexual behavior for HIV transmission, should not be ignored in HIV prevention for South African heterosexuals. However, this relatively infrequent behavior should not become the focus of prevention efforts.

  15. Symptom outcomes important to women with anal incontinence: a conceptual framework.

    Science.gov (United States)

    Sung, Vivian W; Rogers, Rebecca G; Bann, Carla M; Arya, Lily; Barber, Matthew D; Lowder, Jerry; Lukacz, Emily S; Markland, Alayne; Siddiqui, Nazema; Wilmot, Amanda; Meikle, Susan F

    2014-05-01

    To develop a framework that describes the most important symptom outcomes for anal incontinence treatment from the patient perspective. A conceptual framework was developed by the Pelvic Floor Disorders Network based on four semistructured focus groups and confirmed in two sets of 10 cognitive interviews including women with anal incontinence. We explored: 1) patient-preferred terminology for describing anal incontinence symptoms; 2) patient definitions of treatment "success"; 3) importance of symptoms and outcomes in the framework; and 4) conceptual gaps (defined as outcomes not previously identified as important). Sessions were conducted according to grounded theory transcribed, coded, and qualitatively and quantitatively analyzed to identify relevant themes. Content and face validity of the framework were further assessed using cognitive interviews. Thirty-four women participated in focus groups and 20 in cognitive interviews. Overall, 29 (54%) were aged 60 years or older, 42 (78%) were white, and 10 (19%) had a high school degree or less. Two overarching outcome themes were identified: "primary bowel leakage symptoms" and "ancillary bowel symptoms." Subdomains important in primary bowel leakage symptoms included leakage characteristics (symptom frequency, amount of leakage, symptom bother) and conditions when bowel leakage occurs (predictability, awareness, urgency). Subdomains important under ancillary bowel symptoms included emptying disorders (constipation, obstructed defecation, and wiping issues) and discomfort (pain, burning). New outcomes identified included predictability, awareness, wiping issues, and discomfort. Women with anal incontinence desire a wide range of symptom outcomes after treatment. These are captured in our conceptual framework, which can aid clinicians and researchers in assessing anal incontinence. LEVEL OF EVIEDENCE: II.

  16. Anal sphincter responses after perianal electrical stimulation

    DEFF Research Database (Denmark)

    Pedersen, Ejnar; Klemar, B; Schrøder, H D

    1982-01-01

    By perianal electrical stimulation and EMG recording from the external anal sphincter three responses were found with latencies of 2-8, 13-18 and 30-60 ms, respectively. The two first responses were recorded in most cases. They were characterised by constant latency and uniform pattern, were...... not fatigued by repeated stimulation, were most dependent on placement of stimulating and recording electrodes, and always had a higher threshold than the third response. The third response was constantly present in normal subjects. It had the longest EMG response and the latency decreased with increasing...... stimulation to a minimum of 30-60 ms. This response represented the clinical observable spinal reflex, "the classical anal reflex". The latencies of the two first responses were so short that they probably do not represent spinal reflexes. This was further supported by the effect of epidural anaesthesia which...

  17. Los sistemas sexo/género en distintas sociedades: modelos analógicos y digitales

    Directory of Open Access Journals (Sweden)

    Águeda Gómez Suárez

    2010-01-01

    Full Text Available Este artículo pretende dar a conocer las diversas "culturas sexuales" en diferentes sociedades, su orden sociosexual y su sistemas sexo/género, con el fin de agruparlas, para su mejor comprensión, en dos grandes grupos: los sistemas digitales (sociedades más rígidas y los sistemas analógicos (sociedades más flexibles. Si es cierto que existen múltiples ideologías sexuales que "naturalizan" diversas formas de entender lo masculino y lo femenino, la homosexualidad y la heterosexualidad, entre otras cosas (Mead, 1972, 2006, se puede concluir que el "dominio masculino", la heteronormatividad y el modelo dual sexo/género, no son realidades universales, sino que son propias de estructuras sexo/género concretas.

  18. High-Resolution Anoscopy: Clinical Features of Anal Intraepithelial Neoplasia in HIV-positive Men

    NARCIS (Netherlands)

    Richel, Olivier; Hallensleben, Nora D. L.; Kreuter, Alexander; van Noesel, Carel J. M.; Prins, Jan M.; de Vries, Henry J. C.

    2013-01-01

    BACKGROUND: High-resolution anoscopy is increasingly advocated to screen HIV+ men who have sex with men for anal cancer and its precursor lesions, anal intraepithelial neoplasia. A systematic comparison between clinical features and the histopathology of suspect lesions is lacking. OBJECTIVE: This

  19. A manometria anorretal (método do balão no diagnóstico diferencial da doença de Hirschsprung Effectiveness of anorectal manometry using the balloon method to identify the inhibitory recto-anal reflex for diagnosis of Hirschsprung's disease

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    Mauro Batista de Morais

    2005-12-01

    Full Text Available OBJETIVO: Apresentar os resultados dos exames de manometria anorretal realizados com um aparelho brasileiro computadorizado, que utiliza o método do balão para a caracterização do reflexo inibitório reto anal na investigação diagnóstica da doença de Hirschsprung, em crianças com constipação crônica. MÉTODOS: Foram analisados os resultados de 372 manometrias anorretais realizadas consecutivamente em pacientes com constipação crônica. O equipamento utilizado (Proctosystem-Viotti possui dois canais utilizados para registar as pressões do esfíncter anal e da ampola retal por meio de balões conectados por sonda aos transdutores de pressão. Os valores pressóricos são avaliados em computador utilizando software específico. A ausência do reflexo inibitório reto-anal foi considerada como sugestiva de doença de Hirschsprung, sendo o diagnóstico confirmado pelos métodos tradicionais. RESULTADOS: Em 14 (3,8% dos 372 exames não foi caracterizado o reflexo inibitório reto-anal. Em nove destes 14 pacientes o diagnóstico de doença de Hirschsprung foi confirmado pela caracterização de ausência de células ganglionares na avaliação anatomopatológica. Nos outros cinco pacientes não foi realizada a biópsia retal em função da evolução clínica satisfatória com o tratamento clínico da constipação, sendo que em quatro a presença de reflexo inibitório reto-anal foi caracterizada por exame de manometria anorretal realizado posteriormente. CONCLUSÃO: O equipamento utilizado foi apropriado para a realização da manometria anorretal permitindo descartar o diagnóstico de doença de Hirschsprung em 86,5% dos pacientes. Foi identificado um pequeno grupo de pacientes nos quais, em mais da metade, o diagnóstico definitivo de doença de Hirschsprung foi estabelecido.OBJECTIVE: to evaluate results of anorectal manometry performed with equipment made in Brazil for the screening of Hirschsprung's disease in children with

  20. Does endoscopic ultrasound improve detection of locally recurrent anal squamous-cell cancer?

    Science.gov (United States)

    Peterson, Carrie Y; Weiser, Martin R; Paty, Philip B; Guillem, Jose G; Nash, Garrett M; Garcia-Aguilar, Julio; Patil, Sujata; Temple, Larissa K

    2015-02-01

    Evaluating patients for recurrent anal cancer after primary treatment can be difficult owing to distorted anatomy and scarring. Many institutions incorporate endoscopic ultrasound to improve detection, but the effectiveness is unknown. The aim of this study is to compare the effectiveness of digital rectal examination and endoscopic ultrasound in detecting locally recurrent disease during routine follow-up of patients with anal cancer. This study is a retrospective, single-institution review. This study was conducted at an oncologic tertiary referral center. Included were 175 patients with nonmetastatic anal squamous-cell cancer, without persistent disease after primary chemoradiotherapy, who had at least 1 posttreatment ultrasound and examination by a colorectal surgeon. The primary outcomes measured were the first modality to detect local recurrence, concordance, crude cancer detection rate, sensitivity, specificity, and predictive value. Eight hundred fifty-five endoscopic ultrasounds and 873 digital rectal examinations were performed during 35 months median follow-up. Overall, ultrasound detected 7 (0.8%) mesorectal and 32 (3.7%) anal canal abnormalities; digital examination detected 69 (7.9%) anal canal abnormalities. Locally recurrent disease was found on biopsy in 8 patients, all detected first or only with digital examination. Four patients did not have an ultrasound at the time of diagnosis of recurrence. The concordance of ultrasound and digital examination in detecting recurrent disease was fair at 0.37 (SE, 0.08; 95% CI, 0.21-0.54), and there was no difference in crude cancer detection rate, sensitivity, specificity, and negative or positive predictive values. The heterogeneity of follow-up timing and examinations is not standardized in this study but is reflective of general practice. Endoscopic ultrasound did not provide any advantage over digital rectal examination in identifying locally recurrent anal cancer, and should not be recommended for

  1. Hifenaciones instrumentales entre la cromatografía líquida, diferentes sistemas detectores y nuevos métodos de pretratamiento de muestra para la determinación de vitaminas en alimentos

    OpenAIRE

    Bravo Bravo, María de los Ángeles

    2013-01-01

    El Objetivo Principal de esta Tesis Doctoral es desarrollar nuevos métodos analíticos para la determinación de vitaminas, constituyentes esenciales en la dieta humana. La Cromatografía Líquida (LC) combinada en línea con Espectrometría de Masas (MS) es una de las metodologías analíticas más sensibles y selectivas, y la aplicación de esta técnica está creciendo rápidamente en análisis de alimentos. Dependiendo de las estructuras químicas y características analíticas de los grupos de vitamin...

  2. Análisis de la revista Bibliotecas: Anales de Investigación

    Directory of Open Access Journals (Sweden)

    Carlos Luis González-Valiente

    2016-03-01

    Full Text Available El objetivo de este artículo es describir el impacto académico, la calidad del proceso editorial, y las estrategias editoriales y de visibilidad de la revista científica cubana Bibliotecas. Anales de Investigación (BAI, editada por la Biblioteca Nacional de Cuba “José Martí”. Para determinar el impacto académico se efectúa un análisis de las citas recibidas a partir de la base datos Google Académico, mediante los indicadores bibliométricos: citas por año, citación vs. autocitación, revistas citables vs. documentos no citables, Índice Hirsch y factor de impacto. La calidad del proceso editorial y las estrategias de visibilidad se determinan mediante una autoevaluación efectuada con la metodología de los sistemas de indización SciELO, Scopus, CLASE, Redalyc, Latindex, Dialnet, y ERIH PLUS. Los resultados revelan una línea de crecimiento en la citación, destacándose como fuentes citantes las revistas científicas de las áreas Bibliotecología y Ciencia de la Información, Medicina y Ciencias de la Salud, y Educación. Se evidencia que algunos aspectos de formato y contenido inciden negativamente en la calidad del proceso editorial. Se proponen estrategias para mejorar la visibilidad científica a través de la inclusión en bases de datos, directorios, y redes sociales y académicas. En general, este estudio contribuye a la toma de decisiones editoriales para aumentar el impacto y la visibilidad científica de BAI.

  3. Validación de la metodología analítica para la cuantificación de hierro por espectroscopia de absorción atómica de llama en alimentos de la canasta básica costarricense

    Directory of Open Access Journals (Sweden)

    Paulina Silva Trejos

    2009-01-01

    Full Text Available Se validó la metodología analítica para la determinación de hierro en alimentos de la canasta básica del costarricense por espectroscopia de absorción atómica con llama. La digestión de las muestras se realizó en recipientes cerrados, con horno de microondas con HNO3 al 65% m/m, para muestras de 0,5 g, dependiendo del tipo de alimento; las cantidades óptimas de ácido nítrico variaron de 6 a 10 mL, obteniéndose porcentajes de recuperación que variaron de 90,0±0,5% a 106,0±0,5%. El ámbito de linealidad óptimo que se obtuvo fue de 0,05 m/L a 6,0 mg/L, con un coeficiente de correlación de 0,9991. Los límites de detección y cuantificación reportados fueron de 0,006 mg/L y 0,009 mg/L, respectivamente. La veracidad se determinó utilizando un patrón certificado de la NIST, SRM 1846 Infant Formula, con un valor reportado para hierro de 63,1±4,0 mg/kg, el valor obtenido fue de 63,8 mg/L, con un porcentaje de error de 1,1%.

  4. Association of Human Papillomavirus Infection and Abnormal Anal Cytology among HIV-Infected MSM in Beijing, China

    Science.gov (United States)

    Zhang, Zhihui; Qian, Han-Zhu; Ruan, Yuhua; Zhou, Feng; Gao, Cong; Li, Mufei; Jin, Qi; Gao, Lei

    2012-01-01

    Background In the recent years, dramatic increases in HIV transmission among men who have sex with men (MSM) have been observed in China. Human papillomavirus (HPV) infection related anal cancer is more common among HIV-infected MSM as compared to the general population. However, HPV infection and anal cytology has been rarely studied in HIV-infected MSM in China. Methods HIV-infected MSM in Beijing, China were invited to participate in this study between January and April 2011. Anal swabs were collected for examining cytology and HPV genotypes. Results Ninety-five eligible participants with complete questionnaire and laboratory data were included in the analyses. Thirty six of them (37.9%) showed abnormal anal cytology as follows: atypical squamous cells of undetermined significance (ASC-US) in 19 (20.0%), atypical squamous cells but cannot exclude HSIL (ASC-H) in 1 (1.1%), low-grade squamous intraepithelial lesion (LSIL) in 15 (15.8%), and high-grade squamous intraepithelial lesion (HSIL) in 1 (1.1%). HPV6 (20.0%), HPV16 (10.9%), HPV56 (10.9%), HPV52 (9.1%) and HPV39 (9.1%) were observed most frequently among those with normal anal cytology, while different distribution was found in the ones with abnormal anal cytology as HPV6 (19.4%), HPV16 (19.4%), HPV45 (16.7%), HPV52 (16.7%) and HPV18 (11.1%). In addition, HPV16, HPV45, HPV52 and HPV18 were the most frequent high-risk types in patients with abnormal anal cytology. HPV multiplicity was found to be significantly related to the prevalence of abnormal anal cytology (p for trend = 0.04). Conclusions High prevalence of HPV infection and abnormal anal cytology was observed among HIV-infected MSM in China. Infection of multiple HPV types or high-risk types was found to be associated with an increased risk of abnormal anal cytology. PMID:22558293

  5. Association of human papillomavirus infection and abnormal anal cytology among HIV-infected MSM in Beijing, China.

    Directory of Open Access Journals (Sweden)

    Yu Yang

    Full Text Available BACKGROUND: In the recent years, dramatic increases in HIV transmission among men who have sex with men (MSM have been observed in China. Human papillomavirus (HPV infection related anal cancer is more common among HIV-infected MSM as compared to the general population. However, HPV infection and anal cytology has been rarely studied in HIV-infected MSM in China. METHODS: HIV-infected MSM in Beijing, China were invited to participate in this study between January and April 2011. Anal swabs were collected for examining cytology and HPV genotypes. RESULTS: Ninety-five eligible participants with complete questionnaire and laboratory data were included in the analyses. Thirty six of them (37.9% showed abnormal anal cytology as follows: atypical squamous cells of undetermined significance (ASC-US in 19 (20.0%, atypical squamous cells but cannot exclude HSIL (ASC-H in 1 (1.1%, low-grade squamous intraepithelial lesion (LSIL in 15 (15.8%, and high-grade squamous intraepithelial lesion (HSIL in 1 (1.1%. HPV6 (20.0%, HPV16 (10.9%, HPV56 (10.9%, HPV52 (9.1% and HPV39 (9.1% were observed most frequently among those with normal anal cytology, while different distribution was found in the ones with abnormal anal cytology as HPV6 (19.4%, HPV16 (19.4%, HPV45 (16.7%, HPV52 (16.7% and HPV18 (11.1%. In addition, HPV16, HPV45, HPV52 and HPV18 were the most frequent high-risk types in patients with abnormal anal cytology. HPV multiplicity was found to be significantly related to the prevalence of abnormal anal cytology (p for trend = 0.04. CONCLUSIONS: High prevalence of HPV infection and abnormal anal cytology was observed among HIV-infected MSM in China. Infection of multiple HPV types or high-risk types was found to be associated with an increased risk of abnormal anal cytology.

  6. Impact of hypothyroidism on primary anal malignant melanoma: A rare entity

    Directory of Open Access Journals (Sweden)

    Siddharth Singh

    2014-01-01

    Full Text Available Primary melanoma of the anal canal is rare and highly malignant condition, which is 1% of all invasive tumors in this site. This condition is often mistaken for benign conditions as either hemorrhoids or rectal polyp. Thyroid-stimulating hormone stimulation causes high proliferation of malignant melanoma. The association of hypothyroidism with primary malignant melanoma of anal canal is very rare. We are reporting such a very rare case.

  7. Impact of hypothyroidism on primary anal malignant melanoma: a rare entity.

    Science.gov (United States)

    Singh, Siddharth; Verma, Satyajeet; Kala, Sanjay

    2014-01-01

    Primary melanoma of the anal canal is rare and highly malignant condition, which is 1% of all invasive tumors in this site. This condition is often mistaken for benign conditions as either hemorrhoids or rectal polyp. Thyroid-stimulating hormone stimulation causes high proliferation of malignant melanoma. The association of hypothyroidism with primary malignant melanoma of anal canal is very rare. We are reporting such a very rare case.

  8. Analysis and description of disease-specific quality of life in patients with anal fistula.

    Science.gov (United States)

    Ferrer-Márquez, Manuel; Espínola-Cortés, Natalia; Reina-Duarte, Ángel; Granero-Molina, José; Fernández-Sola, Cayetano; Hernández-Padilla, José Manuel

    2018-04-01

    In patients diagnosed with anal fistula, knowing the quality of life specifically related to the disease can help coloproctology specialists to choose the most appropriate therapeutic strategy for each case. The aim of our study is to analyzse and describe the factors related to the specific quality of life in a consecutive series of patients diagnosed with anal fistula. Observational, cross-sectional study carried out from March 2015 to February 2017. All patients were assessed in the colorectal surgery unit of a hospital in southeast of Spain. After performing an initial anamnesis and a physical examination, patients diagnosed with anal fistula completed the Quality of Life in Ppatients with Anal Fistula Questionnaire (QoLAF-Q). This questionnaire specifically measures quality of life in people with anal fistula and its score range is the following: zero impact = 14 points, limited impact = 15 to 28 points, moderate impact = 29 to 42 points, high impact = 43 to 56 points, and very high impact = 57 to 70 points. A total of 80 patients were included. The median score obtained in the questionnaire for the sample studied was 34.00 (range=14-68). Statistically significant differences between patients with "primary anal fistula" (n=65) and "recurrent anal fistula" (n=15) were observed (mean rank=42.96 vs. mean rank=29.83, p=0.048). Furthermore, an inverse proportion (P=.016) between "time with clinical symptoms" and "impact on quality of life" was found (5 years: mean rank = 19.00). There were no statistically significant differences (P=.149) between quality of life amongst patients diagnosed with complex (mean rank = 36.13) and simple fistulae (mean rank = 43.59). Anal fistulae exert moderate-high impact on patients' quality of life. "Shorter time experiencing clinical symptoms" and the "presence of primary fistula" are factors that can be associated with worse quality of life. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Differential gene expression in patients with anal fistula reveals high levels of prolactin recepetor

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    Song Yi-Huan

    2017-01-01

    Full Text Available Background/Aim. There are limited data examining variations in the local expression of inflammatory mediators in anal fistulas where it is anticipated that an improved understanding of the inflammatory milieu might lead to the potential therapeutic option of instillation therapy in complicated cases. The aim of the present study was to examine prolactin receptors (PRLR as inflammatory markers and to correlate their expression with both the complexity of anal fistulas and the likelihood of fistula recurrence. Methods. Microarray was used to screen the differentially expressed gene profile of anal fistula using anal mucosa samples with hemorrhoids with ageand sex-matched patients as controls and then a prospective analysis of 65 patients was conducted with anal fistulas. PRLR immunohistochemistry was performed to define expression in simple, complex and recurrent anal fistula cases. The quantitative image comparison was performed combining staining intensity with cellular distribution in order to create high and low score PRLR immunohistochemical groupings. Results. A differential expression profile of 190 genes was found. PRLR expression was 2.91 times lower in anal fistula compared with control. Sixty-five patients were assessed (35 simple, 30 complex cases. Simple fistulas showed significantly higher PRLR expression than complex cases with recurrent fistulae showing overall lower PRLR expression than de novo cases (p = 0.001. These findings were reflected in measurable integrated optical density for complex and recurrent cases (complex cases, 8.31 ± 4.91 x 104 vs simple cases, 12.30 ± 6.91 x 104; p < 0.01; recurrent cases, 7.21 ± 3.51 x 104 vs primarily healing cases, 8.31 ± 4.91 x 104; p < 0.05. In univariate regression analysis, low PRLR expression correlated with fistula complexity; a significant independent effect maintained in multivariate analysis odds ratio [(OR low to high PRLR expression = 9.52; p = 0.001]. Conclusion. PRLR

  10. ESCENARIOS PARA LA UBICACIÓN ÓPTIMA DE GENERACIÓN DISTRIBUIDA CON BASE EN UN ALGORITMO ANALÍTICO

    Directory of Open Access Journals (Sweden)

    Diego Leonardo González Herrera

    2013-09-01

    Full Text Available En este artículo se presentan los escenarios de simulación planteados en base a un algoritmo analítico para la ubicación de la generación distribuida. En primera instancia se hace un recorrido por el estado del arte referente a los factores involucrados en la planeación de la demanda  y estudios de cortocircuito. Así mismo, se exhibe la propuesta metodológica para evaluar el impacto y algunos resultados preliminares obtenidos.

  11. Conversor analógico digital basado en oscilador controlado por tensión

    OpenAIRE

    Cardes García, Fernando

    2012-01-01

    Convencionalmente, los micrófonos dan una salida analógica debida a la variación de presión que produce el sonido, y esta señal se digitaliza por medio de conversores analógico digitales tradicionales. En este proyecto se aborda el diseño de un sistema que obtenga como salida un código digitalizado a partir del sonido recibido por la cápsula microfónica. La principal ventaja de utilizar este sistema es que el circuito analógico que acondiciona la señal se simpli ca considerable...

  12. MOTIVACIÓN DE EDUCADORES PARA GESTIONAR PROYECTOS DE PREVENCIÓN DE LA VIOLENCIA Y EL CONSUMO DE DROGAS EN COLEGIOS DE MEDELLÍN

    Directory of Open Access Journals (Sweden)

    Ornella Moreno-Mattar

    2016-01-01

    Full Text Available Objetivo: profundizar en el papel de la motivación de los docentes para gestionar proyectos de prevención del consumo de SPA y de la violencia en instituciones educativas. Método: se emplearon las herramientas analíticas de la teoría fundada para analizar las vivencias de doce proyectistas. Se realizaron ocho entrevistas individuales y un grupo focal con cuatro docentes que concluyeron el diplomado. Las entrevistas fueron transcritas y analizadas en una matriz de excel, de ellas se obtuvieron 502 (quinientos dos códigos, 11 categorías descriptivas, cuatro categorías analíticas y cuatro categorías interpretativas. Resultados: Los proyectistas perciben falta de reforzadores ambientales positivos durante el curso del diplomado desde las instituciones educativas en las cuales ellos se desempeñaban como docentes. Algunos reforzadores negativos identificados fueron: la gran cantidad de documentos y actividades propuestas por el diplomado, así como los cortos plazos para su entrega, y la carencia de tiempo disponible para su formación complementaria. Sin embargo, los proyectistas tienen una fuerte motivación intrínseca al sentir que capacitarse y reforzar sus conocimientos en el área de la gestión de proyectos para la prevención puede tener resultados positivos sobre el desarrollo personal de sus alumnos.

  13. Validación del método para determinación de cloro útil en hipoclorito de calcio en Quimpac

    OpenAIRE

    Cóndor Guevara, Eduardo; Cóndor Guevara, Eduardo; Cóndor Guevara, Eduardo

    2011-01-01

    En Quimpac surge la necesidad de validar un método alternativo para la determinación de Cloro útil en el Hipoclorito de Calcio producido en Quimpac, el cual está basado en la Norma ASTM D2022, donde se realizan variaciones que corresponden al uso de un reactivo por otro La validación se realizó en Agosto de 2008, siguiendo los criterios y requisitos de calidad, de tal manera que el método analítico cumpla con las especificaciones para su aplicación. Para ello, se realizaron diez determinac...

  14. Transtorno do pânico: investigação sobre alterações de relato em terapia analítico-comportamental.

    OpenAIRE

    Siebert, Graziela

    2006-01-01

    O Transtorno do Pânico é um dos mais freqüentes e incapacitantes problemas dentre os transtornos ansiosos, representando um dos motivos de maior procura dos serviços de saúde no Brasil e no mundo. A Terapia Analítico-Comportamental constitui uma proposta com resultados bastante satisfatórios para seu tratamento, e seu enfoque é o esclarecimento da relação entre os sintomas sentidos e descritos pelo cliente e as contingências em operação, das quais seus comportamentos são função. A completa re...

  15. Frequency of operative trauma to anal sphincters: evaluation with endoanal ultrasound.

    Science.gov (United States)

    Stamatiadis, Apostolos; Konstantinou, Evangelos; Theodosopoulou, Eleni; Mamoura, Konstantinia

    2002-01-01

    Sphincter trauma after anorectal surgery is usually asymptomatic. Frequency of trauma cannot be established with the clinical examination only. The frequency of operative sphincter defects and their correlation with disorders of continence was evaluated with the endoanal ultrasound. This study includes 123 subjects who had undergone anorectal surgery in the past and were examined with endoanal ultrasound for various indications such as continence disorders, recurrent fistula, idiopathic perineal pain, or simple postoperative follow-up. No subjects had isolated external anal sphincter defects. Nineteen of 123 patients (15%) had minor or major continence disorders, 55 patients (45%) had no sphincter defects, 42 (34%) had only internal anal sphincter (IAS) defects, and 26 (21%) had simultaneously external and internal anal sphincter (EAS) defects. The incidence of IAS and EAS trauma after Milligan-Morgan hemorrhoidectomy was 1/18 (5.5%) and 0/18 respectively; after fistula repair, 24/42 (57%) and 12/42 (29%); and after anal dilatation, 13/17 (76%) and 4/17 (24%). Sixteen of 26 patients (62%) with EAS trauma and 51/68 patients (75%) with IAS trauma did not report any disorders of continence. In patients with two or more operations, the frequency of IAS trauma was 74%, 30% for EAS trauma, and 26% for continence disorders.

  16. Evaluation of radiotherapy and chemoradiotherapy for anal canal epidermoid cancer in our center

    International Nuclear Information System (INIS)

    Obara, Kunihiko; Sahara, Rikisaburo; Yamana, Tetsuro; Okamoto, Kinya; Takahashi, Tomoko; Furukawa, Satomi; Okada, Daisuke; Kaneko, Yasushi; Matsumoto, Atsuo

    2008-01-01

    The efficacy and safety of radiotherapy (RT) and chemoradiotherapy (CRT) for anal canal epidermoid cancer were evaluated. Twenty-four patients with anal canal epidermoid cancer were treated in our center between 1988 and 2006, consisting of 13 patients treated by RT and 11 by CRT. In these patients, the efficacy and safety of RT and CRT were evaluated in terms of adverse events, 5-year local control rates, 5-year disease-free survival rates, and 5-year survival rates. No grade 3 or higher adverse events were noted in patients receiving RT. In contrast, anorexia, diarrhea, neutropenia, and anemia were observed in 33.3%, 10%, 33.3%, and 10%, respectively, of the patients receiving CRT. The anal preserving rate, 5-year local control rate, 5-year disease-free survival rate, and 5-year survival rate were 66.7%, 73%, 77.5%, and 88.4%, respectively. RT and CRT for anal canal epidermoid cancer should be first-line treatments because of their safety and efficacy. (author)

  17. Risk factors of recurrent anal sphincter ruptures

    DEFF Research Database (Denmark)

    Jangö, Hanna; Langhoff-Roos, J; Rosthøj, Steen

    2012-01-01

    Please cite this paper as: Jangö H, Langhoff-Roos J, Rosthøj S, Sakse A. Risk factors of recurrent anal sphincter ruptures: a population-based cohort study. BJOG 2012;00:000-000 DOI: 10.1111/j.1471-0528.2012.03486.x. Objective  To determine the incidence and risk factors of recurrent anal sphincter...... were used to determine risk factors of recurrent ASR. Main outcome measures  The incidence of recurrent ASR and odds ratios for possible risk factors of recurrent ASR: age, body mass index, grade of ASR, birthweight, head circumference, gestational age, presentation, induction of labour, oxytocin...... augmentation, epidural, episiotomy, vacuum extraction, forceps, shoulder dystocia, delivery interval and year of second delivery. Results  Out of 159 446 women, 7336 (4.6%) experienced an ASR at first delivery, and 521 (7.1%) had a recurrent ASR (OR 5.91). The risk factors of recurrent ASR in the multivariate...

  18. Caracterização analítica e geométrica da metodologia geral de determinação de distribuições de Weibull para o regime eólico e suas aplicações Analytical and geometric characterization of general methodology of determination of Weibull distribution for wind regime and its applications

    Directory of Open Access Journals (Sweden)

    Luís R. A Gabriel Filho

    2011-02-01

    Full Text Available O regime eólico de uma região pode ser descrito por distribuição de frequências que fornecem informações e características extremamente necessárias para uma possível implantação de sistemas eólicos de captação de energia na região e consequentes aplicações no meio rural em regiões afastadas. Estas características, tais como a velocidade média anual, a variância das velocidades registradas e a densidade da potência eólica média horária, podem ser obtidas pela frequência de ocorrências de determinada velocidade, que por sua vez deve ser estudada através de expressões analíticas. A função analítica mais adequada para distribuições eólicas é a função de densidade de Weibull, que pode ser determinada por métodos numéricos e regressões lineares. O objetivo deste trabalho é caracterizar analítica e geometricamente todos os procedimentos metodológicos necessários para a realização de uma caracterização completa do regime eólico de uma região e suas aplicações na região de Botucatu - SP, visando a determinar o potencial energético para implementação de turbinas eólicas. Assim, foi possível estabelecer teoremas relacionados com a forma de caracterização do regime eólico, estabelecendo a metodologia concisa analiticamente para a definição dos parâmetros eólicos de qualquer região a ser estudada. Para o desenvolvimento desta pesquisa, utilizou-se um anemômetro da CAMPBELL.The wind regime of a region can be described by frequency distributions that provide information and features extremely necessary for a possible deployment of wind systems of energy capturing in the region and the resulting applications in rural areas in remote regions. These features, such as the annual average speed, variance of speed and hourly average of wind power density, can be obtained by the frequency of occurrences of certain speed, which in turn should be studied through analytical expressions. The analytic

  19. Determinação de elementos próprios dos asteróides troianos: comparação entre as teorias semi-analítica e sintética

    Science.gov (United States)

    Roig, F.; Beaugé, C.

    2003-08-01

    Além do cálculo semi-analítico de elementos próprios dos asteróides Troianos (Beaugé & Roig 2001, Icarus 153, 391), recentemente foi apresentado um novo conjunto destes elementos próprios determinado através de uma teoria sintética (Knenezevic & Milani 2003, comunicação pessoal). As bases de dados contendo estas determinações estão disponiveis na pagina web do Asteroid Dynamical Site (http://hamilton.dm.unipi.it/cgi-bin/astdys/astibo). Nesta comunicação apresentamos os primeiros resultados de um estudo comparativo entre ambos conjuntos de elementos próprios, analisando suas vantagens e desvantagens, assim como os limites de precisão de cada conjunto. Mostramos que os elementos próprios sintéticos são mais precisos que os smi-analíticos para grandes amplitudes de libração do ângulo s = l-lJup, embora acontece o contrario para os corpos cuja amplitude de libração é muito pequena. Finalmente discutimos a influencia destes erros na determinação de familias de asteroides e da estrutura resonante em torno dos pontos Lagrangeanos L4 e L5.

  20. Diseño y construcción de un prototipo de electroencefalógrafo para adquisición de señales cerebrales

    OpenAIRE

    Villalba Calvillo, Guillermo

    2016-01-01

    El objetivo del presente proyecto es el desarrollo e implementación de un electroencefalógrafo de pequeñas dimensiones que permita la monitorización y registro de señales cerebrales. El sistema estará compuesto por una etapa analógica que se encargará de acondicionar la señal, una etapa digital, compuesta por un microcontrolador (DAQ) cuyo objetivo es digitalizar la señal que recibe de la etapa analógica, y una interfaz gráfica para visualizar dicha señal, donde se podrá procesar y analizar l...

  1. Tradução de literatura infanto-juvenil para língua de sinais: dialogia e polifonia em questão

    Directory of Open Access Journals (Sweden)

    Neiva de Aquino Albres

    Full Text Available O objetivo deste trabalho foi a criação de critérios para procedimentos de tradução de literatura infanto-juvenil do Português para a Libras. Para isso, neste artigo, recorremos aos conceitos de dialogia e polifonia de Mikhail Bakhtin. Mediante uma pesquisa de natureza analítico-descritiva, foi possível verificar que o intérprete não traduz apenas o texto, mas é intensamente motivado pelas ilustrações do livro, pelo gênero discursivo e pelo público-alvo potencial do material.

  2. HIV infection connected to rising anal cancer rates in men in the U.S.

    Science.gov (United States)

    Human immunodeficiency virus (HIV) infection contributes substantially to the epidemic of anal cancer in men, but not women in the United States, according to new research from NCI. Chart shows overall incidence rates of anal cancers in general population

  3. Consumption of red-hot chili pepper increases symptoms in patients with acute anal fissures. A prospective, randomized, placebo-controlled, double blind, crossover trial Efeito da pimenta vermelha nos sintomas de pacientes com fissuras anais agudas

    Directory of Open Access Journals (Sweden)

    Pravin J. Gupta

    2008-06-01

    Full Text Available BACKGROUND: Red-hot chili pepper and other spices have been blamed for causing or exacerbating symptoms of anal pathologies like anal fissure and hemorrhoids. AIM: To determine if consumption of chilies increases symptoms of acute anal fissures. METHODS: Individual patients were randomized to receive capsules containing chili or placebo for one week in addition to analgesics and fiber supplement. Patients were asked to note score for symptoms like pain, anal burning, and pruritus during the study period. After 1 week, cross over treatment was administered to the same group of patients with the same methodology and results were noted at the end of 2 weeks. RESULTS: Fifty subjects were recruited for this study. Forty three of them completed the trial (22 in the chili group and 21 in the placebo group. The daily mean pain score was significantly lower in the placebo group in the study period. Score 2.05 in chili group and 0.97 in placebo group. There was a significant burning sensation experienced by the patients in the chili group (score 1.85 for the chili group vs 0.71 for the placebo group. Patient’s mean recorded improvement score was significantly higher after taking placebo. Eighty one point three percent patients preferred placebo while 13.9% preferred chilies. Two patients had no preference. CONCLUSION: Consumption of chili does increase the symptoms of acute anal fissure and reduces patient compliance.RACIONAL: A pimenta vermelha e outras especiarias têm sido responsabilizadas por agravar a sintomatologia das doenças anais, tais como fissuras e hemorróidas. OBJETIVO: Determinar se o consumo de pimentas vermelhas aumentaria os sintomas em fissuras anais agudas. MÉTODOS: Pacientes foram recrutados e randomizados para receber cápsulas contendo pimenta ou placebos por 1 semana, somadas a analgésicos e suplementos de fibras. Foi solicitado que anotassem um escore de sintomas, tais como dor, queimação anal, prurido durante o per

  4. OCCULT ANAL SPHINCTER INJURIES (OASIS IN DEPARTMENT OF PERINATOLOGY IN LJUBLJANA – INCIDENCE AND RISK FACTORS

    Directory of Open Access Journals (Sweden)

    Katja Jakopič

    2018-02-01

    Full Text Available Background: Vaginal delivery is the most important risk factors for development of faecal incontinence, which significantly affects quality of life. Foreign studies show OASIS occur at 20 to 40 % of vaginal deliveries. In Slovenia we recognize sphincter injuries at 1.7 % of deliveries, while true incidence of OASIS in our population remains unknown. Caesarean section prevents anal sphincter injuries. Known risk factors in foreign studies include prolonged second stage of labour, fetal weight > 3500 g, malpresentation, forceps delivery, maternal age more than 35 years at the time of first delivery, first delivery. Few women complain about defecatory problems in puerperium unless they are directly asked about them, so true incidence of such injuries is grossly underestimated. Previously compensated anal sphincter dysfunction can clinically manifest as late as in menopause. The most probable cause is atrophy of muscle and fibrous tissue of pelvic floor and anal sphincter due to lack of estrogen support in this period. With anal ultrasound we tried to determine the incidence of occult damage to anal sphincter in primiparas after vaginal delivery and the relation of injury to symptoms 6 weeks after delivery and identify possible risk factors in our population. We also tried to find out how many patients with anal sphincter injury become symptomatic immediately after deliv- ery. Methods: From January to June 2009 we examined 26 primiparas after vaginal delivery in the Ljubljana Maternity Hospital with anal ultrasound and compared various data about the delivery from our national delivery form. We excluded all patients with caesarean section, recognized anal sphincter injury at the time of the delivery or previous anorectal surgery, history of irritable bowel syndrome or pre-existing inflammatory bowel disease. All patients completed a bowel-function questionnaire, which included questions about faecal urgency and involuntary passing of gas, liquid or

  5. Da crise à superação: limites e possibilidades para a transição ao comunismo

    Directory of Open Access Journals (Sweden)

    Dauto João da Silveira

    2010-01-01

    Full Text Available http://dx.doi.org/10.5007/1806-5023.2010v7n1/2p113 A entrevista apresenta uma análise crítica sobre a situação do modo de produção capitalista, especialmente depois da última crise mundial, dialogando com categorias analíticas das Ciências Sociais. Para além disto, contextualiza e aponta tendências, ou melhor, desvela os elementos produzidos nos interior da sociedade burguesa para a constituição de uma sociedade do vir a ser, comunista.

  6. A case of anal canal cancer which developed fournier's syndrome after chemoradiotherapy

    International Nuclear Information System (INIS)

    Momma, Tomoyuki; Kikuchi, Daiki; Watanabe, Yohei; Onozawa, Hisashi; Suzuki, Satoshi; Nakamura, Izumi; Ohki, Shinji; Takenoshita, Seiichi; Yoshida, Noriyuki

    2013-01-01

    Fournier's syndrome is an acute necrotizing fasciitis of the perineum which progresses rapidly, resulting in poor prognosis if not treated appropriately at an early stage. Here we report a case of anal canal cancer which developed Fournier's syndrome after chemoradiotherapy (CRT). A 79-year-old man with anal canal cancer received a double-barrel sigmoid colostomy followed by concurrent CRT (50.4 Gy) with S-1 (100 mg/body). Although the patient was discharged after CRT, he developed a fever at 10 days after discharge and visited our hospital complaining of pain in the anal region. He was hospitalized with a diagnosis of Fournier's syndrome. Extensive drainage, administration of antibiotics, additional drainage and continuous irrigation of the affected region improved the symptoms of Fournier's syndrome. Multiple liver metastases were found on a CT scan at 3 months after onset of Fournier's syndrome, and the patient was transferred to another hospital for systemic chemotherapy. There have been no reports on the onset of Fournier's syndrome after CRT for rectal cancer with anal canal involvement; we report this case with a review of the literature. (author)

  7. Role of age, bowel function and parity on anorectocele pathogenesis according to cinedefecography and anal manometry evaluation.

    Science.gov (United States)

    Soares, F A; Regadas, F S P; Murad-Regadas, S M; Rodrigues, L V; Silva, F R S; Escalante, R D; Bezerra, R F

    2009-11-01

    The study aimed to verify the role of parity, age and bowel function in the pathogenesis of anorectocele. A cross-sectional study was conducted regarding age, obstetrical history, Cleveland Clinic Constipation Score (CCCS), cinedefecography and anal manometry findings. Forty-five adult women complaining of obstructed defecation were evaluated; the median age was 46 years and median CCCS, 13. Fifteen patients were nulliparous and 23 multiparous (median parity 2). Eighteen had a history of episiotomy, fourteen delivered large babies and two had forceps-assisted delivery. Statistical analysis was performed using Spearman's correlation test and Fisher's exact test. Anal hypertonia was found in 14 (31.1%) patients, anal hypotonia in eight (17.8%), anismus in 13 (28.9%) and anorectoceles in 34 (75.6%) [median size 2.8 cm (0-6.4)]. There were no correlations between anorectocele and anal hypertonia (P = 0.7171), anismus (P = 0.4666), parity comparing nulliparous and multiparous patients (P = 1.000), episiotomy (P = 1.0000), forceps assistance (P = 1.0000), delivery of a large baby (P = 1.0000) anal resting pressure (P = 0.0883), anal voluntary pressure (P = 0.7327), parity (P = 0.4987) and age (P = 0.8603). There were correlations between anorectocele and the CCCS (P = 0.0082) and anal hypotonia (P = 0.0141). Anorectocele is not correlated with parity, age, episiotomy, delivery of a large baby and anismus. It was more frequent in patients with severe constipation and less common in patients with anal hypotonia.

  8. Modelación y simulación de un secador de lecho vibrofluidizado para sólidos que contienen mezclas solventes

    Directory of Open Access Journals (Sweden)

    J. Martínez

    2007-11-01

    Full Text Available Se estudió el secado de un sólido granular en un secador continuo de lecho vibrofluidizado por medio de simulaciones. Se desarrolló un modelo considerando el secado de una capa delgada de partículas humedecidas con una mezcla multicomponente. El modelo asume mezclado perfecto en la dirección del flujo de aire y considera solamente los cambios longitudinales del contenido líquido, composición y temperatura de la partícula. Los principales mecanismos para la transferencia de masa y calor dentro de las partículas son la difusión interactiva y conducción. Asumiendo una matriz constante de coeficientes efectivos de difusión para las partículas, se obtienen las soluciones analíticas de las ecuaciones de difusión y conducción. La variación de los coeficientes de difusión y de la conductividad térmica de las partículas a lo largo del secador es tomada en cuenta por una aplicación paso a paso de la solución analítica en intervalos de espacio con coeficientes promedios del paso anterior. La solución analítica representa un método apropiado para estudiar la selectividad y la retención de aroma durante el secado de alimentos. La solución es computacionalmente rápida; por lo tanto, la verificación experimental de este modelo aproximado sería muy beneficiosa ya que el tratamiento riguroso del secado multicomponente implica cálculos dilatados y tediosos.

  9. O exame de suplência para qualificação profissional de auxiliares de enfermagem em Minas Gerais

    Directory of Open Access Journals (Sweden)

    Mara José Moraes Antunes

    1995-09-01

    Full Text Available Estudo analítico-descritivo da demanda e dos índices de aprovação do exame de suplência da Secretaria de Estado de Educação de Minas Gerais para qualificação profissional de auxiliar de enfermagem e das características da clientela que se submete ao exame.

  10. A psicologia analítica de Carl Gustav Jung: apontamentos de aula/The analytical psychology of Carl Gustav Jung: notes of lesson

    Directory of Open Access Journals (Sweden)

    Luís Marcelo Alves Ramos

    2005-01-01

    Full Text Available O texto traz o conteúdo de uma aula sobre Teorias da Personalidade com foco nos fundamentos da Psicologia Analítica do psicólogo e psiquiatra suíço Carl Gustav Jung (1875-1961, cuja obra vem apresentando significativas contribuições para a Psicologia Educacional, Organizacional e Clínica. The text brings the content of a lesson on Theories of Personality focused in the fundamentals of the Analytical Psychology of the Swiss psychologist and psychiatrist Carl Gustav Jung (1875-1961, whose work has been presenting significant contributions for Educational, Organizational and Clinical Psychology.

  11. Impacto aromático dos componentes voláteis do café soluvél : uma abordagem analítica e sensorial

    OpenAIRE

    Denisley Gentil Bassoli

    2006-01-01

    A aplicação de métodos instrumentais e analíticos cada vez mais sofisticados tem aprimorado a avaliação objetiva do aroma, característica determinante da qualidade de alimentos e de sua aceitabilidade, tendo sido detectados mais de oitocentos componentes voláteis no café torrado, mas com escassa informação disponível para café solúvel. Atualmente, a produção mundial de café solúvel é de aproximadamente quinhentas mil toneladas, sendo o Brasil um importante produtor. O café solúvel é obtido a ...

  12. Paradoxical Impact of Ileal Pouch-Anal Anastomosis on Male and Female Fertility in Patients With Ulcerative Colitis.

    Science.gov (United States)

    Pachler, Frederik R; Brandsborg, Søren B; Laurberg, Søren

    2017-06-01

    Birth rates in males with ulcerative colitis and ileal pouch-anal anastomosis have not been studied. This study aimed to estimate birth rates in males and females with ulcerative colitis and study the impact of ileal pouch-anal anastomosis. This was a retrospective registry-based cohort study that was performed over a 30-year period. Records for parenting a child from the same period were cross-linked with patient records, and birth rates were calculated using 15 through 49 years as age limits. All data were prospectively registered. All patients with ulcerative colitis and ulcerative colitis with ileal pouch-anal anastomosis between 1980 and 2010 were identified in Danish national databases. The primary outcomes measured were birth rates in females and males with ulcerative colitis and ulcerative colitis with ileal pouch-anal anastomosis. We included 27,379 patients with ulcerative colitis (12,812 males and 14,567 females); 1544 had ileal pouch-anal anastomosis (792 males and 752 females). Patients with ulcerative colitis have slightly reduced birth rates (males at 40.8 children/1000 years, background population 43.2, females at 46.2 children/1000 years, background population 49.1). After ileal pouch-anal anastomosis, males had increased birth rates at 47.8 children/1000 years in comparison with males with ulcerative colitis without ileal pouch-anal anastomosis (40.5 children/1000 years), whereas females had reduced birth rates at 27.6 children/1000 years in comparison with females with ulcerative colitis without ileal pouch-anal anastomosis (46.8 children/1000 years). Only birth rates were investigated and not fecundability. Furthermore, there is a question about misattributed paternity, but this has previously been shown to be less than 5%. Ulcerative colitis per se has little impact on birth rates in both sexes, but ileal pouch-anal anastomosis surgery leads to a reduction in birth rates in females and an increase in birth rates in males. This has clinical

  13. Conservative management of anal and rectal cancer

    International Nuclear Information System (INIS)

    Gerard, J.P.; Romestaing, P.; Montbarbon, X.

    1989-01-01

    The role of irradiation in the management of anal and rectal cancer has changed during the past ten years. In small epidermoid carcinomas of the anal canal (T1 T2) irradiation is in most departments considered the primary treatment, giving a 5-year survival rate of between 60 and 80% with good sphincter preservation. Even in larger tumors, irradiation can still offer some chance of cure without colostomy. Surgery remains the basic treatment of rectal cancer but irradiation is used in association with surgery in many cases. Radiotherapy is of value in the conservative management of cancer of the rectum in three situations: In small polypoid cancers contact X-ray therapy can give local control in about 90%. In cancers of the middle rectum, preoperative external irradiation may increase the chances of restorative surgery and reduce the risk of local relapse. In inoperable patients, external radiotherapy and/or intracavitary irradiation may cure some patients with infiltrating tumors (T2 T3) without colostomy. (orig.)

  14. PENGARUH GROUP INVESTIGATION BERBASIS OUTDOOR STUDY TERHADAP KEMAMPUAN BERPIKIR ANALITIS SISWA

    Directory of Open Access Journals (Sweden)

    Valeriana Rasweda

    2016-02-01

    Full Text Available The purpose of research is to find out the Group Investigation outdoor study-based having an affect on student’s analytichal thinking ability. The type of research is PretestPosttest Control Group Design. The research was conducted at Lawang 1st Public Senior High School Malang Regency with experiment class X-IIS 1 and control class X-IIS 2. The data is an analytichal thinking ability. Data analysis was done by comparing the gain score student’s analytichal thinking ability using SPSS 17.0 for Windows. The results showed that Group Investigation outdoor study-based having an affect on student’s analytichal thinking ability.  Tujuan penelitian ini adalah untuk mengetahui apakah model Group Investigation berbasis outdoor study berpengaruh terhadap kemampuan berpikir analitis siswa. Penelitian ini merupakan jenis penelitian eksperimen semu (quasi experiment yang termasuk penelitian kuantitatif. Rancangan penelitian yang dikembangkan adalah Pretest-Posttest Control Group Design. Penelitian dilaksanakan di SMA Negeri 1 Lawang Kabupaten Malang. Kelas ekperimen ialah kelas X-IIS 1 dan kelas kontrol ialah kelas X-IIS 2. Data yang digunakan dalam penelitian ini adalah kemampuan berpikir analitis. Analisis data dilakukan dengan membandingkan gain score kemampuan berpikir analitis siswa menggunakan bantuan program SPSS 17.0 for Windows. Hasil dari penelitian ini menunjukkan bahwa model Group Investigation berbasis outdoor study berpengaruh terhadap kemampuan berpikir analitis siswa.

  15. Oral and Anal vaccination against enteric red mouth disease protection against yersiniosis

    DEFF Research Database (Denmark)

    Neumann, Lukas; Villumsen, Kasper Rømer; Kragelund Strøm, Helene

    dose of ERM bacterin fully protected rainbow trout when they are vaccinated anally. Oral vaccination can also induce full protection but the dose of the bacterin has to be 100 times higher than if the fish was to be vaccinated anally. This indicates that much of the oral feed bacteria is digested...... in the stomach of rainbow trout. This work has shown that it is possible to vaccinated orally against ERM, but the bacteria has to be coated in order to avoid digestion. Protection mechanisms will be discussed....... fish. The objective for this project is to investigate whether oral and anal vaccination of rainbow trout against Yersinia ruckeri O1 (biotype 1) causing Enteric Red Mouth disease (ERM) can protect rainbow trout against a subsequent experimental bath challenge.The rainbow trout were given oral...

  16. Diversity of human papillomavirus in the anal canal of men: the HIM Study.

    Science.gov (United States)

    Sichero, L; Nyitray, A G; Nunes, E M; Nepal, B; Ferreira, S; Sobrinho, J S; Baggio, M L; Galan, L; Silva, R C; Lazcano-Ponce, E; Giuliano, A R; Villa, L L

    2015-05-01

    Human papillomavirus (HPV) infections are associated with the development of anogenital lesions in men. There are no reports describing the distribution of non-α HPV types in the anal canal of a sexually diverse group of men. The HPV Infection in Men (HIM) Study is a multicentre study on the natural history of HPV infection in Brazil, Mexico, and the USA. At baseline, 12% of anal canal PCR HPV-positive specimens were not typed by the Roche Linear Array, and were considered to be unclassified. Our goals were to characterize HPVs among these unclassified specimens at baseline, and to assess associations with participant socio-demographic and behavioural characteristics. Unclassified HPVs were typed by sequencing of amplified PGMY09/11 products or cloning of PGMY/GP + nested amplicons followed by sequencing. Further analysis was conducted with FAP primers. Of men with unclassified HPV in the anal canal, most (89.1%) were men who have sex with women. Readable sequences were produced for 62.8% of unclassified specimens, of which 75.2% were characterized HPV types. Eighteen, 26 and three different α-HPV, β-HPV and γ-HPV types were detected, respectively. α-HPVs were more commonly detected among young men (18-30 years) than among older men (45-70 years), whereas β-HPVs were more frequent among mid-adult men (31-44 years). β-HPVs were more common among heterosexual men (85.0%) than among non-heterosexual men. All β-HPVs detected among non-heterosexual men were β2-HPV types. The high prevalence of β-HPV in the anal canal of men who do not report receptive anal sex is suggestive of other forms of transmission that do not involve penile-anal intercourse. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  17. Endosonographic appearance of the anal sphincters in patients following colostomy

    International Nuclear Information System (INIS)

    Sudol-Szopinska, I.; Jakubowski, W.; Szczepkowski, M.; Panorska, A.

    2002-01-01

    Background. The aim of the study was to visualize, by anal ultrasound (AUS), the suspected defects of the anal sphincters in the patients after colostomy and to analyze possible factors that could have led to such defects. Patients and methods. AUS, using a 7.0 MHz endorectal probe, was performed in a group of 25 patients with colostomy. The internal anal sphincter (IAS), external anal sphincter (EAS) and puborectalis muscle (PR) were visualized and the defects within them were qualified and quantified. For statistical analysis, the analysis of variance (ANOVA) was used. Results. The IAS was thin in all but three patients (22 patients; 88 %) with the mean thickness of 1.62 mm. A circular reduction of the thickness along the entire length of the IAS was seen in 20 patients (90.9 %). The echogenicity of the IAS was increased in 15 patients (60 %), and in 10 of them (66.6%), this defect embraced the whole length and circumference of the IAS. The margins of the IAS were not well-defined in 10 patients (40%). A significant correlation was found between the length of the patient's life with the stoma and the IAS echogenicity defect (p-value = 0.0001). No significant correlation was found between the dynamic examination, the IAS thickness and the IAS borders definition. Conclusion. The reduced thickness, increased echogenicity and borders definition defect of the IAS are seen in the patients after colostomy. The only significant correlation was confirmed between the length of the patient's life with the stoma and the IAS echogenicity defect. (author)

  18. Analítica del aprendizaje en un entorno virtual mediante un sistema de computación cognitiva: estudio preliminar

    Directory of Open Access Journals (Sweden)

    Larry Lugo Urribarrí

    2016-01-01

    Full Text Available En esta investigación se aplicaron métodos de la Analítica del Aprendizaje en el estudio de los datos masivos provenientes de la plataforma virtual de Fruticultura, mediante el sistema de computación cognitiva IBM Watson, basado en inteligencia artificial y aprendizaje automático. Se analizaron los registros de las evaluaciones en línea, así como las interacciones sociales en los foros para determinar su influencia sobre el desempeño estudiantil, durante los períodos lectivos desde el2006 hasta 2014 de la asignatura Fruticultura. Los factores estudiados permitieron mejorar el sistema de evaluación y estimarla nota definitiva con una fortaleza predictiva del 72%.

  19. Incontinence after primary repair of obstetric anal sphincter tears is related to relative length of reconstructed external sphincter

    DEFF Research Database (Denmark)

    Norderval, S; Røssaak, K.; Markskog, A

    2012-01-01

    To determine if anatomic primary repair with end-to-end reconstruction of the external anal sphincter (EAS) in its full length combined with separate repair of coexisting internal anal sphincter (IAS) tear, when present, results in less incontinence and better anal sphincter integrity compared...

  20. Topical 5-fluorouracil treatment of anal intraepithelial neoplasia in human immunodeficiency virus-positive men

    NARCIS (Netherlands)

    Richel, O.; Wieland, U.; de Vries, H. J. C.; Brockmeyer, N. H.; van Noesel, C.; Potthoff, A.; Prins, J. M.; Kreuter, A.

    2010-01-01

    Background Anal intraepithelial neoplasia (AIN), a human papillomavirus (HPV) induced potential precursor lesion of anal cancer, is frequent among human immunodeficiency virus (HIV)-positive men who have sex with men (MSM). So far, only a few prospective studies have been performed on the topical

  1. Prolonged-Release Oxycodone/Naloxone Improves Anal Sphincter Relaxation Compared to Oxycodone Plus Macrogol 3350

    DEFF Research Database (Denmark)

    Poulsen, Jakob Lykke; Brock, Christina; Grønlund, Debbie

    2017-01-01

    /naloxone or PR oxycodone plus macrogol 3350. Resting anal pressure, anal canal distensibility, and relaxation of the internal sphincter to rectal distension were evaluated before treatment (baseline) and on day 5. The Patient Assessment of Constipation Symptom (PAC-SYM) questionnaire, stool frequency, and stool...

  2. Fractal dimension and image statistics of anal intraepithelial neoplasia

    International Nuclear Information System (INIS)

    Ahammer, H.; Kroepfl, J.M.; Hackl, Ch.; Sedivy, R.

    2011-01-01

    Research Highlights: → Human papillomaviruses cause anal intraepithelial neoplasia (AIN). → Digital image processing was carried out to classify the grades of AIN quantitatively. → The fractal dimension as well as grey value statistics was calculated. → Higher grades of AIN yielded higher values of the fractal dimension. → An automatic detection system is feasible. - Abstract: It is well known that human papillomaviruses (HPV) induce a variety of tumorous lesions of the skin. HPV-subtypes also cause premalignant lesions which are termed anal intraepithelial neoplasia (AIN). The clinical classification of AIN is of growing interest in clinical practice, due to increasing HPV infection rates throughout human population. The common classification approach is based on subjective inspections of histological slices of anal tissues with all the drawbacks of depending on the status and individual variances of the trained pathologists. Therefore, a nonlinear quantitative classification method including the calculation of the fractal dimension and first order as well as second order image statistical parameters was developed. The absolute values of these quantitative parameters reflected the distinct grades of AIN very well. The quantitative approach has the potential to decrease classification errors significantly and it could be used as a widely applied screening technique.

  3. Thermal responses of shape memory alloy artificial anal sphincters

    Science.gov (United States)

    Luo, Yun; Takagi, Toshiyuki; Matsuzawa, Kenichi

    2003-08-01

    This paper presents a numerical investigation of the thermal behavior of an artificial anal sphincter using shape memory alloys (SMAs) proposed by the authors. The SMA artificial anal sphincter has the function of occlusion at body temperature and can be opened with a thermal transformation induced deformation of SMAs to solve the problem of severe fecal incontinence. The investigation of its thermal behavior is of great importance in terms of practical use in living bodies as a prosthesis. In this work, a previously proposed phenomenological model was applied to simulate the thermal responses of SMA plates that had undergone thermally induced transformation. The numerical approach for considering the thermal interaction between the prosthesis and surrounding tissues was discussed based on the classical bio-heat equation. Numerical predictions on both in vitro and in vivo cases were verified by experiments with acceptable agreements. The thermal responses of the SMA artificial anal sphincter were discussed based on the simulation results, with the values of the applied power and the geometric configuration of thermal insulation as parameters. The results obtained in the present work provided a framework for the further design of SMA artificial sphincters to meet demands from the viewpoint of thermal compatibility as prostheses.

  4. Apontamentos sobre a psicologia analítica de Carl Gustav Jung

    Directory of Open Access Journals (Sweden)

    Luís Marcelo Alves Ramos

    2002-01-01

    Full Text Available O texto faz uma introdução à Psicologia Analítica do psicólogo e psiquiatra suíço Carl Gustav Jung: define o conceito de Psicologia Analítica, traz uma biografia resumida de Carl Gustav Jung, indica as principais diferenças entre a Psicologia Analítica e a Psicanálise, descreve a estrutura e o funcionamento da psique e, por fim, apresenta sinteticamente as características dos tipos de personalidades traçadas por Jung. The text makes an introduction to the Analytical Psychology of the psychologist and swiss psychiatrist Carl Gustav Jung: it defines the concept of Analytical Psychology, brings a summarized biography of Carl Gustav Jung, indicates the main differences between Analytical Psychology and the Psychoanalysis, describes the structure and the functioning of psyche and, finally, presents synthetically the characteristics of the types of personalities traced by Jung.

  5. Hemorrhoids and anal fissures in inflammatory bowel disease.

    Science.gov (United States)

    D'Ugo, S; Stasi, E; Gaspari, A L; Sileri, P

    2015-12-01

    Perianal disease is a common complication of inflammatory bowel disease (IBD). It includes different conditions from more severe and potentially disabling ones, such as abscesses and fistulas, to more benign conditions such as hemorrhoids, skin tags and fissures. Most literature has been focused on anal sepsis and fistulae, as they carry the majority of disease burden and often alter the natural course of the disease. Hemorrhoids and anal fissures in patients with IBD have been overlooked, although they can represent a challenging problem. The management of hemorrhoids and fissures in IBD patients may be difficult and may significantly differ compared to the non-affected population. Historically surgery was firmly obstructed, and hemorrhoidectomy or sphincterotomy in patients with associated diagnosis of IBD was considered harmful, although literature data is scant and based on small series. Various authors reported an incidence of postoperative complications higher in IBD than in the general populations, with potential severe events. Considering that a spontaneous healing is possible, the first line management should be a medical therapy. In patients non-responding to conservative measures it is possible a judicious choice of surgical options on a highly selective basis; this can lead to acceptable results, but the risk of possible complications needs to be considered. In this review it is analyzed the current literature on the incidence, symptoms and treatment options of hemorrhoids and anal fissures in patients with Crohn's disease and ulcerative colitis.

  6. Negociaciones de paz y agencias de seguridad: perspectivas para el caso colombiano

    OpenAIRE

    Restrepo Villamil, José Libardo

    2014-01-01

    En el presente trabajo de tesis se propone una perspectiva comparada sobre las agendas de negociaciones de paz con las guerrillas centroamericanas y Colombia, en lo relacionado con las transformaciones de las agencias de seguridad, con la intención de tener perspectivas analíticas para el actual proceso de paz que se desarrolla en la Habana-Cuba entre la guerrilla de las FARC-EP y el gobierno colombiano. This tesis job proposes a comparative perspective about the peace negotiation diary be...

  7. Incidence and survival patterns of rare anal canal neoplasms using the surveillance epidemiology and end results registry.

    Science.gov (United States)

    Metildi, Cristina; McLemore, Elisabeth C; Tran, Thuy; Chang, David; Cosman, Bard; Ramamoorthy, Sonia L; Saltzstein, Sidney L; Sadler, Georgia Robins

    2013-10-01

    Small cell, neuroendocrine tumors, and melanoma of the anus are rare. Limited data exist on the incidence and management for these rare tumors. A large, prospective, population-based database was used to determine incidence and survival patterns of rare anal neoplasms. The Surveillance, Epidemiology and End Results registry was queried to identify patients diagnosed with anal canal neoplasms. Incidence and survival patterns were evaluated with respect to age, sex, race, histology, stage, and therapy. We identified 7078 cases of anal canal neoplasms: melanoma (n = 149), neuroendocrine (n = 61), and small cell neuroendocrine (n = 26). Squamous cell carcinoma (SCC) (n = 6842) served as the comparison group. Anal melanoma (AM) demonstrated the lowest survival rate at 2.5 per cent. Neuroendocrine tumors (NETs) demonstrated similar survival as SCC (10-year survival for regional disease of 25 and 22.3%, respectively). Ten-year survival of small cell NETs resembled AM (5.3 vs 2.5%). Age 60 years or older, sex, black race, stage, and surgery were independent predictors of survival. This study presents the largest patient series of rare anal neoplasms. NETs of the anal canal demonstrate similar survival patterns to SCC, whereas small cell NETs more closely resemble AM. Accurate histologic diagnosis is vital to determine treatment and surgical management because survival patterns can differ among rare anal neoplasms.

  8. El juego simbólico una alternativa en las dilataciones anales

    OpenAIRE

    Aguinaga B. Oscar William

    1993-01-01

    "Las malformaciones ano-rectales están entre las más comunes de las malformaciones de tipo congénito causadas por anormalidades del desarrollo, aproximadamente uno de cada cinco mil partos con producto vivo, en Estados Unidos". Clasificaciones existen muchas, pero la de uso más generalizado y tenida en cuenta en el Hospital de la Misericordia, servicio de quirúrgicas, es: Estenosis anal congénita, agenecia anal, atresia rectal, fístula rectoperineal, fístula rectovaginal.

     

    ...

  9. Empleo de metodos numericos para el ajuste de los coeficientes de difusividad (D) y convectivo de transferencia de masa (hm) en el secado de alimentos

    OpenAIRE

    Arranz Saiz, Francisco Javier; Correa Hernando, Eva Cristina; Jiménez Ariza, Heidi Tatiana; Diezma Iglesias, Belen; Garcia-Herrero, Javier; Robla Villalba, José Ignacio; Barreiro Elorza, Pilar

    2011-01-01

    Los modelos matemáticos de transferencia de humedad desde el alimento al medio circundante durante el proceso de secado dependen de dos parámetros: coeficiente de difusividad efectiva D y coeficiente convectivo de transferencia de masa hm, cuya determinación experimental se basa en la consideración de un sistema difusivo sencillo de solución analítica bien conocida. Para el caso, que aquí nos ocupa, de difusión monodimensional en una lámina infinita de grosor 2l, la solución analítica de ...

  10. Epidemiology of anal HPV infection in high-risk men attending a sexually transmitted infection clinic in Puerto Rico.

    Directory of Open Access Journals (Sweden)

    Vivian Colón-López

    Full Text Available Recent studies in Puerto Rico have reported an increasing incidence of anal cancer in Puerto Rican men. The objective of this study was to determine the prevalence, genotype distribution and risk factors associated with anal HPV infection among men attending an STI clinic in Puerto Rico.We conducted a cross-sectional study among 205 men 18 years and older. A comprehensive survey was administered that included a demographic and a behavioral assessment. Separate logistic regression models were performed to determine factors associated with any, high-risk (HR, and multiple anal HPV infection.The mean age of the study sample was 38.0±13.5 years. The most common HR types were 58, 51 and 31. Overall, HR anal HPV infection was found in 53.5% of the participants. Multiple HPV types in the anal canal were found in 47.6% of the sample. A third (29.8% of participants reported being men who had sex with men (MSM. MSM had a significantly higher prevalence of any, HR and multiple HPV infection (p-value<0.05. Separate multivariate logistic regression analyses showed that being MSM was associated with any (OR = 4.5; [95%CI: 1.9-10.7], HR (OR = 3.4; [95%CI: 1.1-10.3 and multiple anal HPV infection (OR = 3.6; [95%CI: 1.5-9.1. HIV was marginally associated with multiple anal HPV infection in multivariate analysis (OR = 3.3; 95%CI = 1.0-11.0.Anal HPV is common among sexually active men attending this STI clinic, with higher likelihood of anal HPV infection among MSM.

  11. Frequency of post-operative faecal incontinence in patients with closed and open internal anal sphincterotomy

    International Nuclear Information System (INIS)

    Ghayas, N.G.; Younus, S.M.; Mirani, A.J.; Ghayasuddin, M.

    2015-01-01

    Fissure in ano is one of the commonest benign and painful proctologic diseases causing considerable morbidity and reduction in quality of life. There are medical as well as surgical treatment options for anal fissure. The study was conducted to compare the frequency of postoperative faecal incontinence in patients with closed lateral internal anal sphincterotomy with von-greaves knife versus standard Parks operation (open method) for chronic anal fissure. Methods: This was a randomized controlled trial (RCT) was conducted at the Department of Surgery, KVSS, S.I.T.E. Hospital, Karachi, for a period of six months from 13th February to 12th August 2011. Ninety four consecutive patients having chronic anal fissure were assigned through blocked randomization to groups A and B, with 47 patients in each group. Closed lateral internal anal sphincterotomy (CLIAS) via von-greaves knife was carried out in patients of group-A whereas patients of group-B were subjected to open internal anal sphincterotomy (OIAS) also known as Parks procedure. Faecal incontinence was noted on the 5th post-operative day. Data was analysed using SPSS 16. Results: There were 81 (86.2%) males and 13 (13.8%) females with male to female ratio being 6:1. Mean age was 38.38 mp±14.56 years. Post-operative faecal incontinence in patients undergoing CLIAS was 4.3% while it was 21.3% in those undergoing OIAS with a p-value of 0.027. CLIAS with von-greaves knife is effective in reducing faecal incontinence on 5th postoperative day as compared to standard OIAS. Conclusion: CLIAS with von-greaves knife is effective in reducing faecal incontinence on 5th postoperative day as compared to OIAS (Park's procedure). Therefore, this technique may be used in future regularly to treat chronic anal fissure for prevention of this morbidity. (author)

  12. Flora vaginal e correlação com aspectos citológicos Vaginal flora and correlation with cytological aspects

    Directory of Open Access Journals (Sweden)

    Hygia Maria Nunes Guerreiro

    1986-12-01

    Full Text Available Com a finalidade de esclarecer a patogenicidade de microorganismos que compõem a microflora vaginal, particularmente nas chamadas vaginites inespecíficas e de determinar o valor da citologia como método para identificação da flora vaginal, foram estudadas 97 pacientes, realizando cultura, exame direto a fresco, Gram e citologia do material cérvico-vaginal. Entre os microorganismos de importância clínica reconhecida, Gardnerella vaginalis foi o mais freqüentemente isolado, 48,4%, seguido de Trichomonas vaginalis, 10,3%, Candida albicans, 7,2% e Neisseria gonorrhoeae, 1,1%. Alterações citológicas indicativas de cervicite e/ou vaginite estiveram presentes na maioria dos casos de G.vaginalis, C.albicans e em todos os casos de T.vaginalis. Foi ressaltada a importância da avaliação semi-quantitativa dos microorganismos nos meios de cultura. Na avaliação da citologia como método diagnóstico para a microflora vaginal, foi observada que este foi o melhor dos métodos utilizados na identificação de T.vaginalis, tendo sido detectado cerca de 50% dos casos de C.albicans. No diagnóstico de G.vaginalis a citologia foi positiva em 48,9% dos casos, destacando-se que dos 31 casos positivos ao exame citológico, oito tiveram culturas negativas para G.vaginalis, embora tenham sido isolados nestes últimos: Haemophilus sp. ou Corynebacterium sp.This work is an attempt to throw more light on the pathogenicity of microorganisms of the vaginal flora, specially those of the so-called nonspecific vaginitis. An attempt is made to determine the value of cytology as a method for the identification of vaginal flora, by the study of microbiologic cultures, fresh and Gram stain direct exam and citology of the cervico-vaginal specimens of 97 patients. Among microorganisms with clinical significance, Gardnerella vaginalis was the most frequently isolated organism, 48,4%, followed by Trichomonas vaginalis, 10.3%, Candida albicans, 7.2% and Neisseria

  13. Recomendaciones para la aplicación de algunos métodos analíticos incluidos en el reglamento CEE 2568/91 relativo a las características de los aceites de oliva y de orujo de oliva

    Directory of Open Access Journals (Sweden)

    León Camacho, M.

    1994-12-01

    Full Text Available Among the analytical methods officially adopted by the European Union to be applied to olive oils and olive pomace oils, some troubles have been found in the application of the procedures for the determination of sterols, trilinolein, trans isomers of fatty acids and waxes. The study of such difficulties suggests several modifications and recommendations facilitating the performance of methods and improving the reliability of results.

    Entre los métodos analíticos aceptados oficialmente por la Unión Europea para su aplicación a los aceites de oliva y los aceites de orujo de oliva, las determinaciones de esteroles, trilinoleína, isómeros trans de los ácidos grasos y ceras han mostrado algunas dificultades en su aplicación.
    El estudio de dichos problemas ha permitido establecer diversas modificaciones y recomendaciones que facilitan la práctica de los métodos y mejoran la fiabilidad de los resultados.

  14. Analüütikud soovitavad Eesti Energia börsile viia / Piret Reiljan

    Index Scriptorium Estoniae

    Reiljan, Piret, 1983-

    2008-01-01

    Kohalikud analüütikud soovitavad viia Eesti Energia börsile, kuna see elavdaks aktsiaturgu ja tõmbaks ligi välisinvestoreid. Vt. samas: Raivo Vare: raske aeg töötab Eesti Energia börsiletoomise kasuks; Analüüs ootab pääsu valitsuskabinetti; Juhid ei püsi enam Eesti Energias. Diagrammid: Majandusnäitajad; Varade maht

  15. A constituição do símbolo e o processo analítico para Winnicott

    Directory of Open Access Journals (Sweden)

    Leopoldo Fulgencio

    2011-12-01

    Full Text Available Neste artigo pretende-se mostrar que, para Winnicott, o fundamento do processo de simbolização está na atividade que caracteriza a expansão da área dos fenômenos transicionais. Enquanto para Klein, a relação com objetos que são símbolos de outros objetos ocorre como defesa contra a angústia derivada das relações objetais, para Winnicott, esta relação deriva da atividade do brincar e da criatividade a ela associada. Essa diferença caracteriza a maneira como cada um desses autores concebe a entrada do homem na vida cultural, e como eles concebem os objetivos do método de tratamento psicanalítico.

  16. Dificultades para incorporar la telemedicina en las organizaciones sanitarias: perspectivas analíticas Difficulties of incorporating telemedicine in health organizations: analytical perspectives

    Directory of Open Access Journals (Sweden)

    Francesc Roig

    2009-04-01

    Full Text Available Las transformaciones socioeconómicas que caracterizan el final del siglo XX y los inicios del XXI plantean importantes retos a los sistemas de salud, especialmente en las sociedades occidentales, con sistemas altamente tecnificados y una población cuya esperanza de vida aumenta de forma progresiva en un escenario de permanente esfuerzo de contención del gasto sanitario. La incorporación de las tecnologías de la información y la comunicación en la sanidad, la «e-Salud», ha generado enormes expectativas como instrumento para hacer frente a esos retos. La telemedicina ha sido una de las experiencias pioneras, pero a pesar de su temprano inicio y de los esfuerzos invertidos, su extensión definitiva sigue siendo difícil y cuestionada. La mayoría de los proyectos no van más allá de la fase inicial de viabilidad y luego quedan abandonados. El modelo tradicional de evaluación de las tecnologías médicas explica este hecho a partir de la dificultad de obtener la evidencia necesaria para avalar una adopción generalizada de la telemedicina, como consecuencia de los problemas que supone la aplicación de la metodología habitual de los estudios de eficacia clínica y coste-efectividad. En los últimos años ha surgido una aproximación analítica diferente, que mantiene que la consolidación o no de los proyectos de telemedicina será el resultado de la interacción de la tecnología y el entorno en que se aplica, y no sólo de sus resultados clínicos, lo que apunta la necesidad de profundizar en el conocimiento empírico de esos procesos de interacción para poder avanzar en la extensión de la telemedicina.Socioeconomic transformations at the end of the twentieth century and the beginning of the twentyfirst century pose major challenges to health systems, particularly to western societies with high technological systems and an aging population, in a political context of health expense reduction. The incorporation of information and

  17. Genetic Architecture of the Variation in Male-Specific Ossified Processes on the Anal Fins of Japanese Medaka.

    Science.gov (United States)

    Kawajiri, Maiko; Fujimoto, Shingo; Yoshida, Kohta; Yamahira, Kazunori; Kitano, Jun

    2015-10-28

    Traits involved in reproduction evolve rapidly and show great diversity among closely related species. However, the genetic mechanisms that underlie the diversification of courtship traits are mostly unknown. Japanese medaka fishes (Oryzias latipes) use anal fins to attract females and to grasp females during courtship; the males have longer anal fins with male-specific ossified papillary processes on the fin rays. However, anal fin morphology varies between populations: the southern populations tend to have longer anal fins and more processes than the northern populations. In the present study, we conducted quantitative trait locus (QTL) mapping to investigate the genetic architecture underlying the variation in the number of papillary processes of Japanese medaka fish and compared the QTL with previously identified QTL controlling anal fin length. First, we found that only a few QTL were shared between anal fin length and papillary process number. Second, we found that the numbers of papillary processes on different fin rays often were controlled by different QTL. Finally, we produced another independent cross and found that some QTL were repeatable between the two crosses, whereas others were specific to only one cross. These results suggest that variation in the number of papillary processes is polygenic and controlled by QTL that are distinct from those controlling anal fin length. Thus, different courtship traits in Japanese medaka share a small number of QTL and have the potential for independent evolution. Copyright © 2015 Kawajiri et al.

  18. HACIA UNA POLÍTICA EDUCATIVA PARA LA ENSEÑANZA Y EL APRENDIZAJE DE LA LENGUA ESCRITA EN SORDOS

    OpenAIRE

    Morales, Ana María

    2002-01-01

    Este trabajo tiene como finalidad generar un constructo teórico coherente que permita el diseño de una política para la enseñanza y el aprendizaje de la lengua escrita en sordos en función de la planificación lingüística. Por ello, se propone como objetivo general: determinar los criterios básicos que debe contemplar una política educativa para sordos. Como objetivos específicos: precisar las vinculaciones existentes entre alfabetización, bilingüismo, biculturalismo, educación y sordera; anal...

  19. Morphologic changes of the anal sphincter musculature during and after temporary stool deviation.

    Science.gov (United States)

    Sailer, M; Fein, M; Fuchs, K H; Bussen, D; Grun, C; Thiede, A

    2001-04-01

    Temporary stool deviation, using a stoma, is a well-known surgical principle to protect low colorectal or coloanal anastomoses. The purpose of this study was to evaluate any morphologic changes with regard to the anal sphincter muscles during and after temporary ileostomy. Forty-four patients with rectal carcinomas were studied prospectively. All patients underwent low anterior resection. Reconstruction was performed using either a coloanal pouch or a straight end-to-end anastomosis. A protective stoma was fashioned in all 44 patients (ileostomy n=41; colostomy n=3). Stoma closure was carried out after a median of 85 days (41-330 days). Using a standard protocol, anal-sphincter thickness [m. puborectalis, external anal sphincter (EAS) and internal anal (IAS) sphincter] was assessed by means of endoanal ultrasonography preoperatively, at the time of stoma closure, and every 3 months thereafter for 1 year. The diameter of the puborectal muscle decreased from a median preoperative value of 6.3 mm to 5.7 mm at the time of stoma closure (P=0.03). After 3 months, 6.2 mm was measured. This value remained stable for the complete follow-up period. Similar results were recorded for the EAS. The IAS thickness remained stable throughout the study period, measuring between 2.1 mm and 2.4 mm. Temporary stool deviation does lead to morphologic changes of the anal sphincter. While the smooth muscle remains unchanged, the striated counterpart undergoes atrophic transformation. However, after passage reconstruction, i.e., stoma closure, a rapid regeneration of the voluntary muscles is observed.

  20. High Prevalence of Anal Human Papillomavirus-Associated Cancer Precursors in a Contemporary Cohort of Asymptomatic HIV-Infected Women.

    Science.gov (United States)

    Heard, Isabelle; Etienney, Isabelle; Potard, Valérie; Poizot-Martin, Isabelle; Moore, Catherine; Lesage, Anne-Carole; Ressiot, Emmanuelle; Crenn-Hebert, Catherine; Fléjou, Jean-François; Cubie, Heather; Costagliola, Dominique; Darragh, Teresa M

    2015-05-15

    Although human immunodeficiency virus (HIV)-infected women are at high risk for anal cancer, few data have been published on prevalence of and risk factors for anal precancer and potential screening strategies in this risk group. A cross-sectional anal screening study was nested in a gynecological cohort of HIV-infected women. Anal swab specimens were collected for cytology and human papillomavirus (HPV) testing. High-resolution anoscopy, with biopsy when indicated, was systematically performed. Among the 171 enrolled women, median age was 47.3 years and 98% were receiving combination antiretroviral therapy. Median CD4(+) count was 655 cells/µL and HIV load was associated with increased risk of HG-AIN+. Abnormal anal cytology and HPV-16 infection performed best as a screening strategy for HG-AIN+ histology, with positive likelihood ratios of 3.4 (95% CI, 2.3-5.1) and 4.7 (95% CI, 2.5-8.7) and negative likelihood ratios of 0.2 (95% CI, .07-.8) and 0.4 (95% CI, .2-.9), respectively. HIV-infected women with a history of HPV-associated cervical disease are at increased risk for HG-AIN+ and should be offered anal cancer screening. Anal cytology and HPV-16 genotyping had the best screening performance. Anal cytology is easy to perform routinely; it may be the best candidate for screening for HG-AIN among HIV-infected women. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  1. Assessing the impact of FDG-PET in the management of anal cancer

    International Nuclear Information System (INIS)

    Nguyen, Brandon T.; Joon, Daryl Lim; Khoo, Vincent; Quong, George; Chao, Michael; Wada, Morikatsu; Joon, Michael Lim; See, Andrew; Feigen, Malcolm; Rykers, Kym; Kai, Cynleen; Zupan, Eddy; Scott, Andrew

    2008-01-01

    Purpose: To assess the utility of FDG-PET in anal cancer for staging and impact on radiotherapy planning (RTP), response and detection of recurrent disease. Methods and materials: Fifty histopathological anal cancer patients were reviewed between 1996 and 2006. The median age was 58 years (range 36-85) with 19 males:31females. Clinical assessment with CT was compared to PET. Impact on management, disease response, recurrence and metastases was evaluated. Results: The non-PET staging was Stage I(8), Stage II(18), Stage III(22), and Stage IV(2)s. The primary was strongly FDG avid in 98% with non-excised tumors compared to CT (58%). PET upstaged 17% with unsuspected pelvic/inguinal nodal disease. Pre-treatment PET identified 11 additional by involved nodal groups in 48 patients causing RTP amendments in 19%. Post-treatment PETs at median 17 weeks (range 9-28) showed complete responses in 20 (80%) and 5 (20%) partial responses (PR). PRs were biopsy positive in 2 and negative in 3. Fifteen had follow-up scans of which all nine PETs detected recurrences were pathologically confirmed. Conclusions: Anal cancer is FDG-PET avid. PET upstages 17% and changes the RTP in 19%. PET can aid in anal cancer staging and identification of residual disease, recurrent/metastatic disease but warrants further prospective studies

  2. Prevalence and correlates of heterosexual anal and oral sex in adolescents and adults in the United States.

    Science.gov (United States)

    Leichliter, Jami S; Chandra, Anjani; Liddon, Nicole; Fenton, Kevin A; Aral, Sevgi O

    2007-12-15

    Heterosexual anal and oral sex are related to the acquisition of sexually transmitted infections, including human immunodeficiency virus infection. We examined the correlates of heterosexual anal and oral sex in the general population, using data from the National Survey of Family Growth. The sample included 12,571 men and women aged 15-44 years (79% response rate). One-third of men and women had ever had anal sex, and three-quarters had ever had oral sex. Condom use during last oral or anal sex was relatively uncommon. In separate models for men and women, having ever had anal sex was associated with white race, age of 20-44 years, and having had a non-monogamous sex partner. White race, age of 20-44 years, being married, and having higher numbers of lifetime sex partners were related to having ever given oral sex in men and women. Giving oral sex was associated with having a non-monogamous sex partner in men. Ever receiving oral sex was associated with white race and a non-monogamous sex partner in men and women. It would be beneficial to track the prevalence of heterosexual anal and oral sex and associated condom use on a more frequent basis.

  3. Comparação entre dois métodos analíticos para determinação da lignina de algumas gramíneas forrageiras Comparison between two analytical methods for determining lignin concentration of some grass forages

    Directory of Open Access Journals (Sweden)

    Romualdo Shigueo Fukushima

    1999-06-01

    Full Text Available Foram comparados dois métodos analíticos para a determinação da lignina (lignina em detergente ácido - LDA e lignina permanganato de potássio - LPer bem como para averiguar a possível relação dos teores desse componente com a digestibilidade da fibra dos seguintes fenos: andropogon (Andropogon gayanus; aveia (Avena sativa; e dois tipos de coast-cross (Cynodon dactylon, um bem fenado e outro de baixa qualidade. Os valores de LDA e LPer foram diferentes (p This work was carried out aiming to compare lignin concentration of some grass forages through two analytical methods (acid detergent lignin - ADL and permanganate lignin - PerL as well to verify a possible relationship of lignin concentration with fiber digestion of the following grass hays: andropogon (Andropogon gayanus; oats (Avena sativa; a good quality and another of poor quality coast-cross (Cynodon dactylon. Acid detergent and permanganate lignin values were different (p <= 0.05 among the hays, however PerL concentrations were consistently lower than ADL values. There were differences (p <= 0.05 among the digestibility of neutral and acid detergent fiber fractions, however a clear relationship between these values with lignin concentration could not be assessed. The data suggested that lignin concentration, taken individually, is not the only factor to explain a given value of digestibility.

  4. The impact of anal sphincter injury on perceived body image.

    Science.gov (United States)

    Iles, David; Khan, Rabia; Naidoo, Kristina; Kearney, Rohna; Myers, Jenny; Reid, Fiona

    2017-05-01

    Obstetric anal sphincter injury is common but the effect on body image is unreported. The aim of this study was to explore patient perceived changes in body image and other psychological aspects in women attending a perineal follow-up clinic. This retrospective study analysed women's responses to a self-reported questionnaire. Consecutive women with anal sphincter injury who attended a United Kingdom Maternity Hospital perineal follow-up clinic between January 1999 and January 2012 were identified and the records obtained and reviewed. Multivariate regression analyses were performed to examine variables influencing self-reported change in body image. Questionnaires and operation notes were analysed from 422 women who attended at a median of four months after delivery. 222 (53%) reported a change in body image with 80 (19%) reporting lower self-esteem and 75 (18%) a change in their personality due to the change in body image. 248 (59%) perceived an anatomical change due to the delivery. Factors associated with increased likelihood of reporting a change in body image were reporting a perceived change in anatomy due to the delivery, adjusted OR 6.11 (3.56-10.49), anal incontinence, OR 1.97 (1.16-3.36), and delivery by forceps, OR 2.59 (1.23-5.43). This is the first study to quantify body image changes in women after anal sphincter injury sustained in childbirth. These were found to be very common, affecting up to 50% of women. The study has several limitations but it does highlight the significant psychosocial problems of negative self-esteem and personality changes associated with a perceived change in body image that has not previously been reported. It also outlines the further research questions that need to be addressed. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Sintomas e fatores de risco para asma entre escolares piauienses

    OpenAIRE

    Castro, Gessianne Carvalho; Sousa, Lívia Kênia de Carvalho; Vera, Paula Valentina de Sousa; Lima, Luisa Helena de Oliveira; Oliveira, Edina Araújo Rodrigues; Lima, Rúbia Fernanda Santos; Magalhães, Luis Fernando Beserra; Araújo, Nileide Lima; Lopes, Marcos Venícios de Oliveira

    2012-01-01

    OBJETIVOS: Analisar a prevalência de sintomas de asma entre escolares de seis a sete anos do município de Picos-PI; e identificar fatores de risco associados à doença. MÉTODOS: Estudo transversal realizado com crianças de 6 e 7 anos de Picos em novembro de 2010 a maio de 2011. Para coletar os dados, foi utilizado um formulário adaptado do Internacional Study of Asthma and Allergies in Childhood. Os dados foram analisados com base na estatística descritiva e analítica. RESULTADOS: Dentre as 23...

  6. El uso del lenguaje estadístico R: herramientas para su uso en docencia e investigación

    OpenAIRE

    Cid, Fabricio Damian

    2017-01-01

    El uso del lenguaje estadístico R: Herramientas para su uso en docencia e investigación. Articulo publicado en la sección "TICs y Docencia" de la Revista Actualidad Analítica" Fil: Cid, Fabricio Damian. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina

  7. Handedness is a biomarker of variation in anal sex role behavior and Recalled Childhood Gender Nonconformity among gay men.

    Science.gov (United States)

    Swift-Gallant, Ashlyn; Coome, Lindsay A; Monks, D Ashley; VanderLaan, Doug P

    2017-01-01

    Developmental theories of the biological basis of sexual orientation suggest that sexually differentiated psychological and behavioural traits should be linked with sexual orientation. Subgroups of gay men delineated by anal sex roles differ according to at least one such trait: gender expression. The present study assessed the hypothesis that handedness, a biologically determined sexually differentiated trait, corresponds to differences in subgroups of gay men based on anal sex role. Furthermore, it assessed whether handedness mediates the association between gender nonconformity and male sexual orientation. Straight and gay men (N = 333) completed the Edinburgh Inventory of Handedness and the Recalled Childhood Gender Nonconformity Scale. Gay men also completed measures of anal sex role preference. As in previous studies, gay men showed greater non-right-handedness and gender nonconformity than straight men. Also, among gay men, bottoms/versatiles (i.e., gay men who take a receptive anal sex role, or who take on both a receptive and insertive anal sex role) were more gender-nonconforming than tops (i.e., gay men who take an insertive anal sex role). In support of the hypothesis, bottoms/versatiles were more non-right-handed than tops and handedness mediated the male sexual orientation and anal sex role differences in Recalled Childhood Gender Nonconformity. Together, these findings suggest that developmental processes linked to handedness underpin variation among men in sexual orientation and gender nonconformity as well as variation among subgroups of gay men that are delineated by anal sex roles.

  8. Handedness is a biomarker of variation in anal sex role behavior and Recalled Childhood Gender Nonconformity among gay men.

    Directory of Open Access Journals (Sweden)

    Ashlyn Swift-Gallant

    Full Text Available Developmental theories of the biological basis of sexual orientation suggest that sexually differentiated psychological and behavioural traits should be linked with sexual orientation. Subgroups of gay men delineated by anal sex roles differ according to at least one such trait: gender expression. The present study assessed the hypothesis that handedness, a biologically determined sexually differentiated trait, corresponds to differences in subgroups of gay men based on anal sex role. Furthermore, it assessed whether handedness mediates the association between gender nonconformity and male sexual orientation. Straight and gay men (N = 333 completed the Edinburgh Inventory of Handedness and the Recalled Childhood Gender Nonconformity Scale. Gay men also completed measures of anal sex role preference. As in previous studies, gay men showed greater non-right-handedness and gender nonconformity than straight men. Also, among gay men, bottoms/versatiles (i.e., gay men who take a receptive anal sex role, or who take on both a receptive and insertive anal sex role were more gender-nonconforming than tops (i.e., gay men who take an insertive anal sex role. In support of the hypothesis, bottoms/versatiles were more non-right-handed than tops and handedness mediated the male sexual orientation and anal sex role differences in Recalled Childhood Gender Nonconformity. Together, these findings suggest that developmental processes linked to handedness underpin variation among men in sexual orientation and gender nonconformity as well as variation among subgroups of gay men that are delineated by anal sex roles.

  9. Handedness is a biomarker of variation in anal sex role behavior and Recalled Childhood Gender Nonconformity among gay men

    Science.gov (United States)

    Swift-Gallant, Ashlyn; Coome, Lindsay A.; Monks, D. Ashley; VanderLaan, Doug P.

    2017-01-01

    Developmental theories of the biological basis of sexual orientation suggest that sexually differentiated psychological and behavioural traits should be linked with sexual orientation. Subgroups of gay men delineated by anal sex roles differ according to at least one such trait: gender expression. The present study assessed the hypothesis that handedness, a biologically determined sexually differentiated trait, corresponds to differences in subgroups of gay men based on anal sex role. Furthermore, it assessed whether handedness mediates the association between gender nonconformity and male sexual orientation. Straight and gay men (N = 333) completed the Edinburgh Inventory of Handedness and the Recalled Childhood Gender Nonconformity Scale. Gay men also completed measures of anal sex role preference. As in previous studies, gay men showed greater non-right-handedness and gender nonconformity than straight men. Also, among gay men, bottoms/versatiles (i.e., gay men who take a receptive anal sex role, or who take on both a receptive and insertive anal sex role) were more gender-nonconforming than tops (i.e., gay men who take an insertive anal sex role). In support of the hypothesis, bottoms/versatiles were more non-right-handed than tops and handedness mediated the male sexual orientation and anal sex role differences in Recalled Childhood Gender Nonconformity. Together, these findings suggest that developmental processes linked to handedness underpin variation among men in sexual orientation and gender nonconformity as well as variation among subgroups of gay men that are delineated by anal sex roles. PMID:28234947

  10. Metodología para la optimización de la gestión y del mantenimiento de activos en un centro sanitario.

    OpenAIRE

    Gómez Blanco, Andrés

    2014-01-01

    El objetivo de la tesis consiste en utilizar las técnicas y estrategias de ultima generación en la toma de decisiones sobre las políticas de mantenimiento como herramientas analíticas para diseñar el sistema de mantenimiento optimo del equipamiento médico e instalaciones vitales del hospital.

  11. NMR imaging of the anal levator and sphincter muscles in anorectal malformations

    International Nuclear Information System (INIS)

    Aoyagi, Hiroshi; Takahashi, Hideyo; Maie, Masahiko; Ohnuma, Naomi; Etoh, Takao; Iwai, Jun

    1986-01-01

    Magnetic resonance imaging (MRI) of the anal levater and sphincter muscles was obtained on 4 normal volunteers and 11 patients with postoperative anorectal malformations (including 8 supra-levator type and 3 low type). Balloon catheter were inserted into the rectum and marked it as the center of a anal canal. Four normal subjects revealed the levater and sphincter muscles were thick and well developed in all sections (Sagittal, Transevse, Coronal). In most of the supra-levator type of anorectal malformations, thin levator and sphincter muscles were observed by Sagittal and Coronal scans. Transeverse scan revealed that the neorectum was not effectively pull-throughed into the puborectal muscle in one patient. Coronal scan showed the dameged external sphincter muscle. In three low types of anorectal malformations, the levator and the sphincter muscles were all well developed, but in one patient the external sphincter muscle existed at the posterior part of the anal canal. These observations were usefull in managing the postoperative care of anorectal malformations. (author)

  12. SIA „Origami” saimnieciskās darbības analīze

    OpenAIRE

    Skalbiņš, Verners

    2014-01-01

    Bakalaura darba tēma ir „SIA „Origami” saimnieciskās darbības analīze”. Darbā apskatītais uzņēmums ir poligrāfijas nozares uzņēmums, kas specializējas lielformāta drukas jomā. Darba mērķis ir identificēt uzņēmuma stiprās un vājās puses, un izstrādāt priekšlikumus tā attīstībai un uzlabošanai. Mērķa sasniegšanai izvirzīti sekojoši uzdevumi: izpētīt uzņēmuma analīzes veikšanai nepieciešamo teorētisko bāzi, uz tās balstoties veikt uzņēmuma analīzi, kā arī izstrādāt secinājumus par līdzšinējo ...

  13. Disorders of the pelvic floor and anal sphincters; a gastroenterologist’s perspective

    Directory of Open Access Journals (Sweden)

    Eamonn M.M. Quigley, MD FRCP FACP FACG FRCPI

    2013-03-01

    Full Text Available The integration and coordination of the musculature of the pelvic floor and the anal sphincters is critical to two important physiological functions: defecation and continence. Consequently, disorders affecting the pelvic floor muscles, the anal sphincters, their innervation or their precise coordination will, depending on their nature, result either in obstructed defecation or fecal incontinence. Both of these disorders are much more common in females and the latter, in particular, is linked with parity. While the symptomatology, presentation and optimal mode of investigation of fecal incontinence are well standardized, considerable debate and controversy continues to surround the contributions of pelvic floor and anal sphincter dysfunction to chronic constipation and the optimal clinical approach to their investigation remains to be defined. In appropriately chosen cases surgical intervention may provide the best outcome for sufferers from incontinence; biofeedback approaches may be of value in both incontinence and obstructed defecation and surgery has little role to play in the latter.

  14. Detekce útoku DNS Amplification z pasivní analýzy DNS provozu

    OpenAIRE

    Míšaný, Daniel

    2014-01-01

    Táto práce je zaměřená na analýzu a detekci útoku DNS amplification, který patří mezi útoky typu DoS. Úvod práce je zaměřený na základní teorii zahrnující počítačové sítě, službu DNS a útoky typu DoS. Větší část práce se zabývá analýzou útoku DNS amplification, návrhem a implementací nástroje pro detekci v jazyce C++. Závěr je věnovaný analýze výsledků detekčního nástroje. This thesis is focused on the analysis and detection of DNS Amplification attack which is type of the DoS attack. Intr...

  15. Võlur Ozi eksperimentide kogumine ja partneri algatatud paranduste analüüs

    Directory of Open Access Journals (Sweden)

    Siiri Pärkson

    2011-05-01

    Full Text Available 2009. aastal viidi Eestis läbi teine võlur Ozi kirjalike eksperimentide seeria ning käesolev artikkel annab ülevaate eksperimentide korraldamisest ning kogutud dialoogide partneri algatatud paranduste analüüsimise tulemustest. Katseisikutel paluti testida interneti veebilehel asuvat programmi Aivo, mis on suuteline suhtlema inimesega kirjalikus eesti keeles. Tegelikkuses vastas inimeste küsimustele interneti vahendusel eksperimendi läbiviija (võlur Oz. Kogutud dialooge on analüüsitud toetudes vestlusanalüüsi meetodi mõistestikule. Tartu Ülikoolis välja töötatud dialoogiaktide tüpoloogia järgi jaguneb partneri algatatud parandus üleküsimiseks, ümbersõnastamiseks ja mittemõistmiseks. Artiklis analüüsitakse näidetele toetudes eelnimetatud kolme partneri algatatud paranduse esinemist kogutud dialoogides, pidades silmas tulevikus loodavaid reaalseid dialoogsüsteeme, mis suudaksid arvutikasutajaga suhelda loomulikus eesti keeles. http://dx.doi.org/10.5128/ERYa7.12

  16. Significance of the thickness of the anal sphincters with age and its relevance in faecal incontinence.

    Science.gov (United States)

    Papachrysostomou, M; Pye, S D; Wild, S R; Smith, A N

    1994-08-01

    Ultrasonographic studies in healthy volunteers showed that the external anal sphincter (EAS) and internal anal sphincter (IAS) thicknesses were inversely related at rest. The functional importance of the two sphincters in continence control was demonstrated in the relationship between the sum of the thicknesses of the two sphincters and the anal canal resting pressure. The aims of the present study were to assess the morphometric appearance of the anal sphincters by endosonography in faecally incontinent patients and to contrast this with that of older healthy subjects. Twenty-eight female patients with neurogenic faecal incontinence (FI) were studied. An older group of 7 healthy women, aged 41-75 years, and a young group of 11 nulliparous healthy women, aged 20-23 years, served as control groups. Anal endosonography was performed with a radial rotating endoprobe, with the subject in the left lateral position. Conventional anal manometry was performed in all subjects. The EAS in the FI group was thicker than the EAS in the old (p IAS thickness in the FI group did not differ from that in the older group. In both these groups the IAS was thicker than in the young women (p IAS in the FI group does not seem to compensate for function and results in a failure of the sphincter mechanism to maintain continence, whereas in healthy elderly subjects the increased IAS thickness appears to be compensatory and important for continence control.

  17. Afeto, intensidade e confiança na experiência analítica: algumas considerações sobre a heterodoxia clínica de S. Ferenczi Affection, intensity and confidence in the analytical experience: a few considerations about the S. Ferenczi clinical heterodoxy

    Directory of Open Access Journals (Sweden)

    Vivian Heringer Pizzinga

    2009-12-01

    Full Text Available Pretende-se examinar a atualidade das contribuições do pensamento de Sándor Ferenczi para a construção da experiência analítica. Em um primeiro momento, visa-se discutir os conceitos de afeto e intensidade em sua obra, para, em seguida, examinar com mais profundidade algumas questões por ele levantadas acerca do lugar do analista e da importância da confiança e da sinceridade do analista no dispositivo analítico, questões essas intensificadas quando de sua última inventiva metodológica, a saber, a análise mútua.This article aims at studying the currentness of the contributions of Sándor Ferenczi's thought in the building of the psychoanalytical experience. To begin with, the affection and intensity concepts as described in his work will be put into discussion and, subsequently, some issues he raised concerning the analyst's place as well as the analyst's confidence and frankness in the analytical apparatus will be examined in detail. Such issues have been intensified in Ferenczi's late methodology, known as mutual analysis.

  18. Patterns of repeated anal cytology results among HIV-positive and HIV-negative men who have sex with men

    Directory of Open Access Journals (Sweden)

    Hilary A. Robbins

    2018-06-01

    Full Text Available Background: Men who have sex with men (MSM are at increased risk for anal cancer. In cervical cancer screening, patterns of repeated cytology results are used to identify low- and high-risk women, but little is known about these patterns for anal cytology among MSM. Methods: We analyzed Multicenter AIDS Cohort Study (MACS data for MSM who were offered anal cytology testing annually (HIV-positive or every 2 years (HIV-negative for 4 years. Results: Following an initial negative (normal cytology, the frequency of a second negative cytology was lower among HIV-positive MSM with CD4 ≥ 500 (74% or CD4 < 500 (68% than HIV-negative MSM (83% (p < 0.001. After an initial abnormal cytology, the frequency of a second abnormal cytology was highest among HIV-positive MSM with CD4 < 500 (70% compared to CD4 ≥ 500 (53% or HIV-negative MSM (46% (p = 0.003. Among HIV-positive MSM with at least three results, 37% had 3 consecutive negative results; 3 consecutive abnormal results were more frequent among CD4 < 500 (22% than CD4 ≥ 500 (10% (p = 0.008. Conclusions: More than one-third of HIV-positive MSM have consistently negative anal cytology over three years. Following abnormal anal cytology, a repeated cytology is commonly negative in HIV-negative or immunocompetent HIV-positive men, while persistent cytological abnormality is more likely among HIV-positive men with CD4 < 500. Keywords: Anal cancer, Anal cytology, HIV, MSM, Anal cancer screening

  19. Multidisciplinary training in perineal care during labor and delivery for the reduction of anal sphincter injuries.

    Science.gov (United States)

    Frost, Jonathan; Gundry, Rowan; Young, Helen; Naguib, Adel

    2016-08-01

    To determine whether the introduction of a multidisciplinary intrapartum perineal-care training program reduced the rate of obstetric anal sphincter injuries in patients undergoing vaginal deliveries. A prospective observational cohort study enrolled women undergoing vaginal deliveries at a district general hospital maternity unit in the United Kingdom between April 1, 2012 and March 31, 2014. All women experiencing obstetric anal sphincter injuries during the study period were identified and the rate of obstetric anal sphincter injuries before (2012-2013) a multidisciplinary training program was implemented was compared with the rate after (2013-2014) implementation using logistic regression analysis. The study enrolled 4920 patients. Following the implementation of the training program, the rate of obstetric anal sphincter injuries decreased from 4.8% to 3.1% of vaginal deliveries (odds ratio 0.66; 95% confidence interval 0.493-0.899; P = 0.008). The integration of intrapartum perineal-care training into mandatory annual staff training was associated with a statistically and clinically significant reduction in the rate of obstetric anal sphincter injuries. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  20. COMPARAÇÃO DE METODOLOGIAS DE DETERMINAÇÃO DO COEFICIENTE DE DISPERSÃO PARA O CLORETO DE CÁLCIO EM UM LATOSSOLO VERMELHO-AMARELO

    Directory of Open Access Journals (Sweden)

    Luiz Fernando Coutinho de Oliveira

    1999-04-01

    Full Text Available RESUMO Com o objetivo de se comparar os métodos de ajuste gráfico e a regressão não-linear na determinação do coeficiente de dispersão, montaram-se três colunas de solo, através das quais se fez passar uma solução deslocadora de cloreto de cálcio (CaCl2, o que permitiu a obtenção dos pontos da curva de eluição. Para efeito de comparação das curvas de eluição ajustadas à experimental, empregaram-se as soluções analíticas das equações diferenciais para a dispersão longitudinal, dispersão para um pulso, difusivo-convectivo e geral do transporte de solutos. Os valores dos coeficientes de dispersão obtidos pelos métodos empregados mostraram que o ajuste gráfico, quando bem empregado, é uma alternativa quando não se dispõe de recursos computacionais para usar o ajuste através de regressão não-linear. As soluções analíticas descrevem com perfeição a curva de eluição, desde que se conheça o coeficiente de dispersão.

  1. The increasing incidence of anal cancer: can it be explained by trends in risk groups?

    NARCIS (Netherlands)

    van der Zee, R. P.; Richel, O.; de Vries, H. J. C.; Prins, J. M.

    2013-01-01

    Anal cancer incidence is gradually increasing. The cause of this increase is not exactly known. This systematic literature review aimed to investigate the trend in time of anal cancer incidence and to find an explanation for the supposed increase. The TRIP database and PubMed were searched for

  2. Event-Level Analysis of Anal Sex Roles and Sex Drug Use Among Gay and Bisexual Men in Vancouver, British Columbia, Canada.

    Science.gov (United States)

    Rich, Ashleigh J; Lachowsky, Nathan J; Cui, Zishan; Sereda, Paul; Lal, Allan; Moore, David M; Hogg, Robert S; Roth, Eric A

    2016-08-01

    This study analyzed event-level partnership data from a computer-assisted survey of 719 gay and bisexual men (GBM) enrolled in the Momentum Health Study to delineate potential linkages between anal sex roles and the so-called "sex drugs," i.e., erectile dysfunction drugs (EDD), poppers, and crystal methamphetamine. Univariable and multivariable analyses using generalized linear mixed models with logit link function with sexual encounters (n = 2514) as the unit of analysis tested four hypotheses: (1) EDD are significantly associated with insertive anal sex roles, (2) poppers are significantly associated with receptive anal sex, (3) both poppers and EDD are significantly associated with anal sexual versatility, and (4) crystal methamphetamine is significantly associated with all anal sex roles. Data for survey respondents and their sexual partners allowed testing these hypotheses for both anal sex partners in the same encounter. Multivariable results supported the first three hypotheses. Crystal methamphetamine was significantly associated with all anal sex roles in the univariable models, but not significant in any multivariable ones. Other multivariable significant variables included attending group sex events, venue where first met, and self-described sexual orientation. Results indicate that GBM sex-drug use behavior features rational decision-making strategies linked to anal sex roles. They also suggest that more research on anal sex roles, particularly versatility, is needed, and that sexual behavior research can benefit from partnership analysis.

  3. Estudo comparativo entre citopatologia e histopatologia no diagnóstico de neoplasias caninas

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    Magalhães Adelaide M.

    2001-01-01

    Full Text Available Foi realizado um estudo comparativo entre os diagnósticos citológico e histopatológico em diversas neoplasias de 150 cães, pelas colorações de Wright, May-Grünwald-Giemsa, Novo Azul de Metileno e Papanicolau. Colorações histológicas como Hematoxilina-Eosina, van Gieson, Sudan, Azul de Toluidina e Ácido Periódico de Schiff também foram empregadas. Os dados revelaram uma eficácia de ordem de 85,3% no diagnóstico citopatológico, considerando-se os resultados histopatológicos como corretos. Em 4,0% dos casos somente a origem embrionária das neoplasias foi estabelecida. Em 1,3% das neoplasias apenas o prognóstico foi determinado; o diagnóstico citológico diferiu da histopatologia em 8,1% dos casos. Em dois casos (1,3% o diagnóstico citológico diferiu do histológico, mas um reexame determinou que o primeiro estava correto, o que elevou a sua eficácia para 86,6%. Entre as técnicas utilizadas, a punção aspirativa por agulha fina foi o melhor método para obter amostras. A citologia não foi adequada para o diagnóstico de neoplasias mamárias, dadas às variações morfológicas em diferentes áreas. A impressão em lâmina não é recomendada para análise de tumores mesenquimais e deve ser substituída pela citologia esfoliativa. O Wright revelou-se o método de coloração mais eficiente. As colorações adaptadas da histopatologia, van Gieson em leiomiomas e leiomiossarcomas, Sudan em lipomas e lipossarcomas, e Ácido Periódico de Schiff e Azul de Toluidina em mastocitomas, foram empregadas com sucesso fornecendo assim maior clareza de detalhes para as diversas neoformações de origem epitelial e mesenquimal.

  4. Dispositivos para generación de discurso y fundamentos conceptuales del trabajo infantil

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    Juan Manuel Estrada-Jiménez

    2015-03-01

    Full Text Available En este avance de investigación proponemos una metodología para el trabajo con niños y niñas, basada en dos dispositivos para la generación de discurso por medio de la actividad lúdica: un dispositivo destinado a la identificación de las dinámicas relacionales en el contexto de la familia, y otro orientado al reconocimiento de las formas en que se reproducen estas dinámicas en el entorno escolar. Igualmente presentamos las categorías analíticas que han servido para definir la situación de la infancia trabajadora, a partir de la identificación de temas centrales en el discurso de revistas especializadas sobre el tema, desplegando estas categorías como los fundamentos hermenéuticos que permitirán identificar a los niños y niñas como actores sociales productivos, y como ciudadanos y ciudadanas con derechos y deberes que demandan ser respetados.

  5. Histopathologic observations of anorectal abnormalities in anal atresia.

    Science.gov (United States)

    Meier-Ruge, W A; Holschneider, A M

    2000-01-01

    Over the years from 1992 to 1997, 41 anorectal malformations (ARM) with histopathologic alterations were investigated to determine which morphologic abnormalities of the distal rectum accompany ARMs. Three other cases showed normal neuromuscular morphology; 9 further cases could not be evaluated owing to scanty biopsies. All resected specimens were caudocranially coiled and cryostat cut at -20 degrees C into serial sections, which were stained with a lactic dehydrogenase, succinic dehydrogenase, nitroxide synthase, and acetylcholinesterase reaction as well as hemalum and sirius red. Ten low, 15 intermediate, and 10 high forms of anal atresia (AA) were studied. In addition, six cloacal abnormalities were investigated. In 7 cases (17%) (5 intermediate, 2 low AAs), the characteristics of Hirschsprung's disease were observed. Oligoneuronal hypoganglionosis of the myenteric plexus proximal to the anal floor was diagnosed in 7 AAs (12%). In 10 children with high-type AA and resection of 1-5 cm distal rectum and in all cloacal anomalies (n = 6) defects of the muscularis propria were seen in the rectal-atresia sac. These defects were characterized by hypoplasia of the circular-muscle layer and/or the internal anal sphincter (IAS). Intestinal neuronal dysplasia of the submucous plexus was most frequently observed (12%) in high-type AA. A correlation between innervation anomalies or anomalies of the muscularis propria and the type of fistula could not be seen. In conclusion, all cases with high-type AA and cloacal anomalies were characterized by anomalies of the muscularis propria and/or IAS but this was not the case in intermediate and low-type AAs. Anomalies of the enteric nervous system were diagnosed in 60% of AAs.

  6. Modelos analíticos para avaliação de sistemas flexíveis de manufatura Analytical models to evaluation of flexible manufacturing systems

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    Carlos Alberto dos Santos Passos

    1994-12-01

    Full Text Available Nas últimas décadas, a indústria de manufatura tem sido marcada profundamente pela introdução de novas tecnologias, as quais têm modificado os conceitos de produção. Aumento dos índices de produtividade, acompanhado por alta qualidade, são fatores que mostram a importância destas tecnologias na indústria atual. Os sistemas flexíveis da manufatura - FMS - são exemplos destas novas tecnologias. A complexidade destes sistemas cria a necessidade de se ter ferramentas que permitam a avaliação do seu desempenho. Neste artigo são discutidos aspectos relacionados a medidas de desempenho de sistemas FMS, para ajudar a tomada de decisão. Atenção especial é dada à utilização de modelos analíticos, na forma de redes de filas fechadas. Aspectos da implementação de um modelo simples de um FMS, usando modelos de redes de fila, são apresentados e os resultados das medidas de avaliação são discutidos.In the last decades, the manufacturing industry has been a deep transformation due the introduction of new technologies into the production system. Better improvement in the productivity and quality aspect show the importance of these technologies in modern industry. The FMS is a good example of this. The complexity of these systems creates the necessity for tools that permit to evaluate their performance. In this paper, aspects concerned to performance of the FMS systems to help a decision-maker are discussed. Special attention is given to queuing network model to evaluate design and operation of FMS. Aspects concerned to implementation of a simple model of FMS system are discussed and some results of the evaluation performance of the system using a queuing network are presented.

  7. Comparação entre três métodos analíticos para determinação de soro em leite cru refrigerado

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    C.M. Souza

    Full Text Available RESUMO O objetivo deste experimento foi comparar três métodos analíticos para determinação de soro em leite cru refrigerado: cromatografia líquida de alta eficiência, ninidrina ácida e colorimétrico adaptado. Foram coletadas 100 amostras de leite cru refrigerado de tanques de expansão. Estas, quando submetidas à análise pelo método da ninidrina ácida, apresentaram 10 (14,7% amostras negativas e 58 (85,3% positivas. O teor médio de ácido siálico encontrado na técnica da ninidrina foi de 5,58(g/mL, com valor mais frequente de 2,70(g/mL. Das 68 amostras negativas pela cromatografia líquida de alta eficiência, duas foram positivas (2,94% e 66 (97,06% negativas, quando analisadas pelo método colorimétrico. A frequência relativa de amostras positivas foi de 32%, com a CLAE apresentando a maior média de soro (14,37%, seguida do método colorimétrico (5,28% e o da ninidrina ácida (3,12%. A técnica de cromatografia líquida de alta eficiência diferiu dos métodos de ninidrina ácida e colorimétrico, enquanto os métodos da ninidrina e colorimétrico não diferiram entre si, podendo ambos serem utilizados como metodologias de triagem. Entre as três técnicas, a cromatografia líquida de alta eficiência foi a metodologia mais sensível na detecção e quantificação do soro em leite cru refrigerado.

  8. Prevalence of cutaneous beta and gamma human papillomaviruses in the anal canal of men who have sex with women

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    Vitaly Smelov

    2017-06-01

    Full Text Available Background: Data regarding anal cutaneous HPV detection among HIV-positive and HIV-negative persons largely relies on studies among men who have sex with men in limited geographical settings. Understanding the distribution, determinants, and potential human health effects of anal cutaneous HPV types among men who have sex with women (MSW is important. Methods: Anal canal swab samples from 415 Russian MSW (384 HIV-negative and 31 HIV-positive were tested for 43 β-HPVs and 29 γ-HPVs, using a multiplex PCR combined with Luminex technology. Results: β-HPV was detected in 24.4% and γ-HPV in 15.9% of anal samples of all Russian MSW. In total, 34 β-HPV and 19 γ-HPV types were detected, with the most commonly detected β-HPV types being 110, 22 and 124 and the most common γ-HPV types being 95, 132 and 50. For both genera, being HIV-positive at the time of testing was a significant determinant of detection (74.2% for β-HPVs and 48.4% for γ-HPVs compared to 20.1% and 12.5% in HIV-negative MSW, respectively. Conclusions: A wide spectrum and moderate prevalence of anal β-HPV and γ-HPV types was found in our MSW study sample, suggesting that routes other than penile-anal intercourse may be important in cutaneous HPV transmission. Keywords: Anal cutaneous HPV, Beta-HPV, Gamma-HPV, HIV-negative MSW, Penile-anal, HPV transmission

  9. Clinical application of continent anal plug in bedridden patients with intractable diarrhea.

    Science.gov (United States)

    Kim, J; Shim, M C; Choi, B Y; Ahn, S H; Jang, S H; Shin, H J

    2001-08-01

    Some patients bedridden from various causes such as stroke or spinal cord injury experience poor control of bowel movement. This causes fecal leakage and diarrhea, increases the risk of perianal excoriation and bed sores, and is a burden on caregivers. To evaluate the efficacy of fecal evacuation and the prevention and treatment of skin complications in intractable diarrhea patients using a new device. A continent anal plug (US Patent No. 5 569 216) comprises an inner balloon surrounded by an outer balloon, both of which are mounted on a silicone tube containing a pair of air passages and an enema fluid inlet. The tube is secured in place in the rectum by the inflatable outer balloon and is designed to drain fecal matter through a thin collapsible hose situated in the anal canal. Thirty-two patients (21 male; median age 61 (range, 28-76) years) were evaluated after fully informed consent. Median duration was 12 (range, 3-37) days. The continent anal plug evacuated efficiently in those patients with loose or watery stools who only required irrigation once daily or not at all. Skin excoriations improved in three to seven days. Minimal leakage was seen around the anus. There was no anorectal mucosal injury noted over 37 days. The continent anal plug is an efficient method of treating patients with loss of bowel control and incontinence because it enables controlled fecal evacuation and helps reduce skin complications without causing anorectal mucosal injury.

  10. Behavioral and psychosocial correlates of anal sex among male clients of female sex workers in Tijuana, Mexico.

    Science.gov (United States)

    Semple, Shirley J; Strathdee, Steffanie A; Pitpitan, Eileen V; Chavarin, Claudia; Patterson, Thomas L

    2015-05-01

    Most studies of heterosexual sex risk practices have focused on condomless vaginal sex despite evidence that condomless anal sex has a significantly higher risk of HIV transmission. The present study focused on male clients' anal sex practices with female sex workers (FSWs) in Tijuana, Mexico, where an HIV epidemic is growing among high-risk groups. Logistic regression analyses were used to identify psychosocial and behavioral correlates of anal sex among male clients. Our sample of HIV-negative men (N = 400) was predominantly Latino (87.5 %), born in Mexico (78.8 %), never married (36.8 %) or in a regular or common-law marriage (31.5 %), and employed (62.8 %), with an average age and education of 37.8 and 9.2 years, respectively. Eighty-nine percent identified as heterosexual and 11 % as bisexual. By design, 50 % of the sample resided in Tijuana and the other 50 % in San Diego County. Nearly half (49 %) reported at least one incident of anal sex with a FSW in Tijuana in the past 4 months; of those participants, 85 % reported that one or more of their anal sex acts with FSWs had been without a condom. In a multivariate model, anal sex with a FSW in the past 4 months was associated with bisexual identification, methamphetamine use with FSWs, repeat visits to the same FSW, higher scores on perceived stigma about being a client of FSWs, and sexual compulsivity. Prevention programs are needed that address the behavioral and psychosocial correlates of heterosexual anal sex in order to reduce HIV/STI transmission risk among male clients, FSWs, and their sexual network members.

  11. Development of Cerebral Metastasis after Medical and Surgical Treatment of Anal Squamous Cell Carcinoma

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    Andrew Austin Gassman

    2012-01-01

    Full Text Available Squamous cell carcinoma of the anus is a relatively uncommon GI malignancy. When it does occur, it metastasizes in only a small minority of patients. Spread of anal squamous cell carcinoma to the brain is exceedingly rare, and has been previously reported only three times in the medical literature. We report the case of a 67 year old male who was diagnosed on presentation with a poorly differentiated anal squamous cell carcinoma that already had a solitary metastasis to the liver. While the tumors were initially responsive to chemoradiotherapy, the patient’s primary and liver lesions recurred. The patient then underwent synchronous abdominoperineal resection for the primary lesion and a liver lobectomy for the metastasis. Soon thereafter, the patient developed focal neurologic symptoms and was found to have an intracranial lesion that on biopsy demonstrated metastatic squamous cell carcinoma. This case highlights the fact that patients with a previous history of anal squamous cell carcinoma can occasionally develop cerebral metastasis. Furthermore, cerebral metastases from anal squamous cell carcinoma portend a dismal prognosis even in the face of aggressive medical and surgical therapy.

  12. Uptake and Predictors of Anal Cancer Screening in Men Who Have Sex With Men

    Science.gov (United States)

    D'Souza, Gypsyamber; Rajan, Shirani D.; Bhatia, Rohini; Cranston, Ross D.; Plankey, Michael W.; Silvestre, Anthony; Ostrow, David G.; Wiley, Dorothy; Shah, Nisha; Brewer, Noel T.

    2013-01-01

    Objectives. We investigated attitudes about and acceptance of anal Papanicolaou (Pap) screening among men who have sex with men (MSM). Methods. Free anal Pap screening (cytology) was offered to 1742 MSM in the Multicenter AIDS Cohort Study, who reported history of, attitudes about, and experience with screening. We explored predictors of declining screening with multivariate logistic regression. Results. A history of anal Pap screening was uncommon among non–HIV-infected MSM, but more common among HIV-infected MSM (10% vs 39%; P < .001). Most participants expressed moderate or strong interest in screening (86%), no anxiety about screening (66%), and a strong belief in the utility of screening (65%). Acceptance of screening during this study was high (85%) across all 4 US sites. Among those screened, most reported it was “not a big deal” or “not as bad as expected,” and 3% reported that it was “scary.” Declining to have screening was associated with Black race, anxiety about screening, and low interest, but not age or HIV status. Conclusions. This study demonstrated high acceptance of anal Pap screening among both HIV-infected and non–HIV-infected MSM across 4 US sites. PMID:23865658

  13. Adaptación del modelo de planeación dofa para la administración sostenible de parques nacionales

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    Ana María Correa Leal

    2013-08-01

    Desde esta perspectiva, se aborda el interés en el desarrollo de un tipo específico de planeación, utilizando información secundaria, para que de manera inductiva se pueda establecer un proceso analítico amplio donde se integren los elementos necesarios que conduzcan a un protocolo planeador y gerencial, aplicable en la administración de los parques nacionales naturales.

  14. Anal Cytology and Human Papillomavirus Genotyping in Women With a History of Lower Genital Tract Neoplasia Compared With Low-Risk Women.

    Science.gov (United States)

    Robison, Katina; Cronin, Beth; Bregar, Amy; Luis, Christine; DiSilvestro, Paul; Schechter, Steven; Pisharodi, Latha; Raker, Christina; Clark, Melissa

    2015-12-01

    To compare the prevalence of abnormal anal cytology and high-risk human papillomavirus (HPV) among women with a history of HPV-related genital neoplasia with women without a history of HPV-related genital neoplasia. A cross-sectional cohort study was performed from December 2012 to February 2014. Women were recruited from outpatient clinics at an academic medical center. Women with a history of high-grade cervical, vulvar, or vaginal cytology, dysplasia, or cancer were considered the high-risk group. Women with no history of high-grade anogenital dysplasia or cancer were considered the low-risk group. Human immunodeficiency virus-positive women were excluded. Anal cytology and HPV genotyping were performed. Women with abnormal anal cytology were referred for high-resolution anoscopy. There were 190 women in the high-risk group and 83 in the low-risk group. The high-risk group was slightly older: 57 years compared with 47 years (P=.045); 21.7% of low-risk women had abnormal anal cytology compared with 41.2% of high-risk women (P=.006). High-risk HPV was detected in the anal canal of 1.2% of the low-risk group compared with 20.8% of the high-risk group (PHuman immunodeficiency virus-negative women with a history of lower genital tract neoplasia are more likely to have positive anal cytology, anal high-risk HPV, and anal intraepithelial neoplasia. Anal cancer screening should be considered for these high-risk women. II.

  15. Intensity-modulated radiation therapy for anal carcinoma

    International Nuclear Information System (INIS)

    Peiffert, D.; Moreau-Claeys, M.V.; Tournier-Rangeard, L.; Huger, S.; Marchesi, V.

    2011-01-01

    Anal canal carcinoma are highly curable by irradiation, combined with chemotherapy in locally advanced disease, with preservation of sphincter function. The clinical target volume for the nodes is extended, often including the inguinal nodes, which is not usual for other pelvic tumours. Acute and late effects are correlated with the volume and dose delivered to organs at risk, i. e. small bowel, bladder and increased by concomitant chemotherapy. Intensity modulated irradiation (IMRT) makes it possible to optimize the dose distribution in this 'complex U shaped' volume, while maintaining the dose distribution for the target volumes. The conversion from conformal irradiation to IMRT necessitates good knowledge of the definition and skills to delineate target volumes and organs at risk, including new volumes needed to optimize the dose distribution. Dosimetric and clinical benefits of IMRT are described, based on early descriptions and evidence-based publication. The growing development of IMRT in anal canal radiotherapy must be encouraged, and long-term benefits should be soon published. Radiation oncologists should precisely learn IMRT recommendations before starting the technique, and evaluate its early and late results for adverse effects, but also for long-term tumour control. (authors)

  16. Analüütilised voolud psühholoogias ja nende rakendamine pedagoogikas / Aleksander Elango

    Index Scriptorium Estoniae

    Elango, Aleksander, 1902-2004

    2001-01-01

    Analüütise psühholoogia kolm koolkonda - S.Freudì koolkond e. päris-psühhoanalüüs, A.Adlerì koolkond e. individuaalpsühholoogia ja C.G.Jungì psühhoanalüüsi ja individuaalpsühholoogia sünteesi luua püüdev koolkond. Analüütise psühholoogia koolkondade ja pedagoogika suhetest

  17. De chirurgische betekenis van de inwendige kringspier van het anale kanaal : een klinisch en manometrisch onderzoek

    NARCIS (Netherlands)

    W.R. Schouten (Ruud)

    1990-01-01

    textabstractThe high pressure zone within the anal canal is largely due to the activity of the internal anal sphincter and provides an effective barrier against rectal pressure. The continuous contraction of the internal sphincter also has a congesting effect on the vascular cushions, thereby

  18. Design of sEMG assembly to detect external anal sphincter activity: a proof of concept.

    Science.gov (United States)

    Shiraz, Arsam; Leaker, Brian; Mosse, Charles Alexander; Solomon, Eskinder; Craggs, Michael; Demosthenous, Andreas

    2017-10-31

    Conditional trans-rectal stimulation of the pudendal nerve could provide a viable solution to treat hyperreflexive bladder in spinal cord injury. A set threshold of the amplitude estimate of the external anal sphincter surface electromyography (sEMG) may be used as the trigger signal. The efficacy of such a device should be tested in a large scale clinical trial. As such, a probe should remain in situ for several hours while patients attend to their daily routine; the recording electrodes should be designed to be large enough to maintain good contact while observing design constraints. The objective of this study was to arrive at a design for intra-anal sEMG recording electrodes for the subsequent clinical trials while deriving the possible recording and processing parameters. Having in mind existing solutions and based on theoretical and anatomical considerations, a set of four multi-electrode probes were designed and developed. These were tested in a healthy subject and the measured sEMG traces were recorded and appropriately processed. It was shown that while comparatively large electrodes record sEMG traces that are not sufficiently correlated with the external anal sphincter contractions, smaller electrodes may not maintain a stable electrode tissue contact. It was shown that 3 mm wide and 1 cm long electrodes with 5 mm inter-electrode spacing, in agreement with Nyquist sampling, placed 1 cm from the orifice may intra-anally record a sEMG trace sufficiently correlated with external anal sphincter activity. The outcome of this study can be used in any biofeedback, treatment or diagnostic application where the activity of the external anal sphincter sEMG should be detected for an extended period of time.

  19. Preoperative Therapy for Lower Rectal Cancer and Modifications in Distance From Anal Sphincter

    International Nuclear Information System (INIS)

    Gavioli, Margherita; Losi, Lorena; Luppi, Gabriele; Iacchetta, Francesco; Zironi, Sandra; Bertolini, Federica; Falchi, Anna Maria; Bertoni, Filippo; Natalini, Gianni

    2007-01-01

    Purpose: To assess the frequency and magnitude of changes in lower rectal cancer resulting from preoperative therapy and its impact on sphincter-saving surgery. Preoperative therapy can increase the rate of preserving surgery by shrinking the tumor and enhancing its distance from the anal sphincter. However, reliable data concerning these modifications are not yet available in published reports. Methods and Materials: A total of 98 cases of locally advanced cancer of the lower rectum (90 Stage uT3-T4N0-N+ and 8 uT2N+M0) that had undergone preoperative therapy were studied by endorectal ultrasonography. The maximal size of the tumor and its distance from the anal sphincter were measured in millimeters before and after preoperative therapy. Surgery was performed 6-8 weeks after therapy, and the histopathologic margins were compared with the endorectal ultrasound data. Results: Of the 90 cases, 82.5% showed tumor downsizing, varying from one-third to two-thirds or more of the original tumor mass. The distance between the tumor and the anal sphincter increased in 60.2% of cases. The median increase was 0.73 cm (range, 0.2-2.5). Downsizing was not always associated with an increase in distance. Preserving surgery was performed in 60.6% of cases. It was possible in nearly 30% of patients in whom the cancer had reached the anal sphincter before the preoperative therapy. The distal margin was tumor free in these cases. Conclusion: The results of our study have shown that in very low rectal cancer, preoperative therapy causes tumor downsizing in >80% of cases and in more than one-half enhances the distance between the tumor and anal sphincter. These modifications affect the primary surgical options, facilitating or making sphincter-saving surgery possible

  20. Gobernanza en salud: un aporte conceptual y analítico para la investigación Governance in health: a conceptual and analytical approach to research

    Directory of Open Access Journals (Sweden)

    Marc Hufty

    2006-01-01

    Full Text Available Existe una notoria ausencia de coherencia conceptual en el uso de los términos gobernabilidad y gobernanza (considerado sinónimo de "gobernancia" en América Latina, tanto en ciencias sociales y políticas, como en el dominio de la salud. Esto se expresa con mayor fuerza en una diferente comprensión del término gobernanza por parte de los investigadores, un uso heterogéneo en ámbitos académicos, su desconocimiento por parte de los tomadores de decisión, y una gran confusión y ambigüedad de significados en su uso por parte de unos y de otros. En contraposición al uso predominante de carácter normativo, promocionado por parte de la mayoría de las agencias internacionales, se propone aquí el desarrollo y aplicación de un marco conceptual-analítico de gobernanza para la investigación en sistemas y servicios de salud. Los avances en el diseño del marco metodológico fueron aplicados en una investigación de evaluación del Seguro Público de Salud de Provincia de Buenos Aires, Argentina. Ello permitió valorar su utilidad como herramienta para sistematizar la complejidad social, política e institucional de los procesos de formulación e implementación de las políticas de salud.In the Latin American region there is a notable absence of conceptual coherency in the use of the terms governability and governance. This is true for their application to both the social and political sciences and health. Researchers' understanding of governance varies, and the concept is used heterogeneously within academic circles, with ignorance of the term on the part of decision-makers and great confusion and ambiguity in the meanings used by researchers and decision-makers in the health sector. Instead of the prevailing normative use, promoted by most international agencies, a conceptual and analytical framework for governance is proposed here for health systems and services research. Advances in the design of this framework were used to evaluate the

  1. High prevalence and incidence of HPV-related anal cancer precursor lesions in HIV-positive women in the late HAART era.

    Science.gov (United States)

    Hidalgo-Tenorio, Carmen; de Jesus, Samantha E; Esquivias, Javier; Pasquau, Juan

    2017-12-02

    Anal cancer is one of the most common non-AIDS defining malignancies, especially in men who have sex with men and women living with HIV (WLHIV). To evaluate the prevalence and incidence of precursor lesions (high-grade squamous intraepithelial lesions [HSIL]) and anal cancer in our cohort of women and to compare them to cervical lesions; to calculate the percentage of patients that acquire and clear oncogenic genotypes (HR-HPV) in the anal canal; and to determine predictive factors for anal HPV infection. Prospective-longitudinal study (May 2012-December 2016). At baseline (V1) and follow up visits, anal mucosa samples were taken in liquid medium for cytology and HPV PCR. In cases of abnormal anal cytology and/or positive HR-HPV PCR results, a high resolution anoscopy was performed. Patients were also referred to the gynaecologist. Ninety five women with an average age of 43.7years were included. At baseline, 11.6% had cervical abnormalities (4.1% CIN1, 2.2% CIN2/3, 1.1% cervical cancer), 64.3% anal abnormalities (50% LSIL/AIN1, 9.5% HSIL/AIN2/3 and 2.4% anal cancer) and 49.4% had HR-HPV genotypes. During 36months of follow up, the incidence of anal HSIL was 16×1,000 person-years; 14.8% acquired HR-HPV genotypes and 51.2% cleared them, P=.007. No patients presented CIN1/2/3/ or cervical cancer. In the multivariate analysis we found the following predictive factors for HR-HPV infection: smoking (RR: 1.55, 95%CI: 0.99-2.42), number of sexual partners >3 (RR: 1.69; 95%CI: 1.09-2.62), cervical and anal dysplasia (RR: 1.83; 95%CI: 1.26-2.67) and (RR: 1.55; 95%CI: 1.021-2.35), respectively. Despite clearance rates of anal oncogenic genotypes being higher than acquisition rates, prevalence and incidence of HSIL were still high and greater than cervical HSIL. Therefore, screening for these lesions should perhaps be offered to all WLHIV. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights

  2. Anal cytological abnormalities and epidemiological correlates among men who have sex with men at risk for HIV-1 infection

    Directory of Open Access Journals (Sweden)

    Donà Maria

    2012-10-01

    Full Text Available Abstract Background The incidence of anal cancer, a Human Papillomavirus (HPV-related neoplasia, has been increasing in recent decades, mainly in men who have sex with men (MSM. Cytological changes of the anal epithelium induced by HPV can be detected through an anal pap smear. This study aimed to evaluate the prevalence and epidemiological correlates of anal cytological abnormalities among relatively young MSM at risk for HIV-1 infection, to help clarify whether or not this population deserves further investigation to assess the presence of anal cancer precursor lesions. Methods MSM were recruited among attendees of a large STI clinic for a HIV-1 screening program. Anal samples, collected with a Dracon swab in PreservCyt, were used both for liquid-based cytology and HPV testing by the Linear Array HPV Genotyping Test. Data regarding socio-demographic characteristics and sexual behavior were collected in face-to-face interviews. Results A total of 346 MSM were recruited (median age 32 years. Overall, 72.5% of the individuals had an anal HPV infection, with 56.1% of them being infected by oncogenic HPV genotypes. Anal cytological abnormalities were found in 29.8% of the cases (16.7% ASC-US and 13.1% L-SIL. Presence of ASC-US+ was strongly associated with infection by any HPV type (OR=4.21, 95% CI: 1.97-9.23, and particularly by HPV 16 and/or 18 (OR=5.62, 95% CI: 2.33-13.81. A higher proportion of ASC-US+ was found in older MSM, in those with a higher number of lifetime partners and in those with a history of ano-genital warts. However, none of these variables or the others analyzed showed any significant association with abnormal cytological findings. Conclusions The presence of anal cytological abnormalities in about one third of the recruited MSM and their strong association with HPV infection, in particular that caused by HPV 16 and/or 18, might provide a further complement to the data that now support the introduction of HPV vaccination among

  3. Anal cytological abnormalities and epidemiological correlates among men who have sex with men at risk for HIV-1 infection.

    Science.gov (United States)

    Donà, Maria Gabriella; Benevolo, Maria; Vocaturo, Amina; Palamara, Guido; Latini, Alessandra; Giglio, Amalia; Moretto, Domenico; Rollo, Francesca; Impara, Giampaolo; Ensoli, Fabrizio; Pimpinelli, Fulvia; Di Carlo, Aldo; Giuliani, Massimo

    2012-10-16

    The incidence of anal cancer, a Human Papillomavirus (HPV)-related neoplasia, has been increasing in recent decades, mainly in men who have sex with men (MSM). Cytological changes of the anal epithelium induced by HPV can be detected through an anal pap smear. This study aimed to evaluate the prevalence and epidemiological correlates of anal cytological abnormalities among relatively young MSM at risk for HIV-1 infection, to help clarify whether or not this population deserves further investigation to assess the presence of anal cancer precursor lesions. MSM were recruited among attendees of a large STI clinic for a HIV-1 screening program. Anal samples, collected with a Dracon swab in PreservCyt, were used both for liquid-based cytology and HPV testing by the Linear Array HPV Genotyping Test. Data regarding socio-demographic characteristics and sexual behavior were collected in face-to-face interviews. A total of 346 MSM were recruited (median age 32 years). Overall, 72.5% of the individuals had an anal HPV infection, with 56.1% of them being infected by oncogenic HPV genotypes. Anal cytological abnormalities were found in 29.8% of the cases (16.7% ASC-US and 13.1% L-SIL). Presence of ASC-US+ was strongly associated with infection by any HPV type (OR = 4.21, 95% CI: 1.97-9.23), and particularly by HPV 16 and/or 18 (OR = 5.62, 95% CI: 2.33-13.81). A higher proportion of ASC-US+ was found in older MSM, in those with a higher number of lifetime partners and in those with a history of ano-genital warts. However, none of these variables or the others analyzed showed any significant association with abnormal cytological findings. The presence of anal cytological abnormalities in about one third of the recruited MSM and their strong association with HPV infection, in particular that caused by HPV 16 and/or 18, might provide a further complement to the data that now support the introduction of HPV vaccination among MSM to protect them from the development of HPV

  4. Amputação abdômino-perineal mais colostomia para-vaginal no tratamento do câncer reto-anal Abdomino-perineal amputation plus para-vaginal colostomy in the treatment of reto-anal cancer

    Directory of Open Access Journals (Sweden)

    Alcino Lázaro da Silva

    2009-12-01

    Full Text Available O apresenta uma proposta e as tentativas iniciais para evitar a colostomia abdominal quando esta tem que ser definitiva. Na mulher foi possível a sua execução, desde que se aproveitou o tono da musculatura esfincteral vulvovaginal quando ela pode ser preservada na amputação de reto-ânus. O colo, preparado com as válvulas, desce posteriormente à vagina, por dentro do conjunto esfincteral vulvovaginal. As observações iniciais mostram que esta tentativa poderia ser incrementada para melhores estudos de continência.The Author presents a proposal and lhe initial attempties to avoid the abdominal colostomy when it has to be definitive. In the woman was possible its execution, since it took advantage from the vulvovaginal esfincteral muscle nohen it can be preserved ot the anus-rectum amputation. The colon, prepared wit the valves, descend posteriorily from the vagina, inside the vulvo-vaginal esfincteral group. The initial observations shows that this attempt could be better developed for cotinency etudies.

  5. Adenocarcinoma in the anal canal after ileal pouch-anal anastomosis for familial adenomatous polyposis using a double-stapled technique: report of two cases

    NARCIS (Netherlands)

    Vrouenraets, Bart C.; van Duijvendijk, Peter; Bemelman, Willem A.; Offerhaus, G. Johan A.; Slors, J. Frederik M.

    2004-01-01

    Restorative proctocolectomy with an ileal pouch-anal anastomosis is thought to abolish the risk of colorectal adenoma development in patients suffering from familial adenomatous polyposis. Both after mucosectomy with a handsewn anastomosis and after a double-stapled anastomosis, rectal mucosa is

  6. Prevalence of and risk factors for anal human papillomavirus infection in men who have sex with women: a cross-national study.

    Science.gov (United States)

    Nyitray, Alan G; Smith, Dan'elle; Villa, Luisa; Lazcano-Ponce, Eduardo; Abrahamsen, Martha; Papenfuss, Mary; Giuliano, Anna R

    2010-05-15

    Although the primary cause of anal cancer is human papillomavirus (HPV) infection in the anal canal, little attention has been paid to the epidemiology of anal HPV infection in men who have sex with women (MSW). Exfoliated cells from the anal canal of 902 MSW in Brazil (São Paulo), Mexico (Cuernavaca), and the United States (Tampa) were tested for HPV DNA. The prevalence of HPV infection in the anal canal (12.0%) was similar among MSW in each city (P=.77), whereas 7.0% had infection with oncogenic types. Men in Tampa had a 4-fold higher prevalence of infection with HPV type 16 (HPV-16) than that among men in São Paulo or Cuernavaca (PMen who have a larger lifetime number of female sex partners, who are in a sexual relationship of men were most likely to have an anal HPV infection.

  7. Time-dose considerations in the treatment of anal cancer

    International Nuclear Information System (INIS)

    Constantinou, Eugene C.; Daly, William; Fung, Claire Y.; Willett, Christopher G.; Kaufman, Donald S.; DeLaney, Thomas F.

    1997-01-01

    Purpose: To analyze the impact of patient and treatment parameters in concurrent chemoradiation treatment for anal carcinoma. Methods and Materials: Retrospective review of 50 MO anal cancer patients treated from 1984-1994. Most patients received concurrent 5-FU, mitomycin, and radiation. Local control and disease-free/overall survival were determined and analyzed according to patient and treatment parameters. Results: With 43 month median follow-up, projected overall survival is 66% at 5 and 8 years. Disease-free survival is 67% at 5 years and 59% at 8 years. Local control is 70% at 5 and 8 years. Doses of ≥54 Gy are associated with improved 5-year survival (84 vs. 47%, p = 0.02), disease-free survival (74 v. 56%, p = 0.09), and local control (77 vs. 61%, p = 0.04). Although local control, disease-free survival, and overall survival were improved in patients whose overall treatment time was <40 days, this was not statistically significant. Outcome in the four patients with pretreatment hemoglobin (Hgb) <10 appeared worse with 3-year overall survival 50 vs. 68% (p = 0.07), disease-free survival 0 vs. 67% (p = 0.11), and local control 0 vs. 74% (p = 0.05). Projected 5-year overall survival, relapse-free survival, and local control in 4 HIV (+) patients is 0, 75, and 75%. Multivariate analysis reveals that dose (p 0.02) and Hgb (p = 0.05) independently affect local control, dose (p = 0.02) affects disease-free survival, and dose (p = 0.01), Hgb (p = 0.03), T-stage (p = 0.03), and HIV-status (0.07) independently influence overall survival. Conclusion: Radiation doses of ≥54 Gy are associated with significantly improved survival and local control in anal cancer patients treated with chemoradiation. Overall treatment times of less than 40 days are associated with a trend towards improved outcome, but this is not significant. Pretreatment hemoglobin <10 is associated with worse treatment outcome. Survival of HIV (+) patient is poor, but the majority of such patients

  8. Analytic and clinical performance of cobas HPV testing in anal specimens from HIV-positive men who have sex with men.

    Science.gov (United States)

    Wentzensen, Nicolas; Follansbee, Stephen; Borgonovo, Sylvia; Tokugawa, Diane; Sahasrabuddhe, Vikrant V; Chen, Jie; Lorey, Thomas S; Gage, Julia C; Fetterman, Barbara; Boyle, Sean; Sadorra, Mark; Tang, Scott Dahai; Darragh, Teresa M; Castle, Philip E

    2014-08-01

    Anal human papillomavirus (HPV) infections are common, and the incidence of anal cancer is high in HIV-infected men who have sex with men (MSM). To evaluate the performance of HPV assays in anal samples, we compared the cobas HPV test (cobas) to the Roche Linear Array HPV genotyping assay (LA) and cytology in HIV-infected MSM. Cytology and cobas and LA HPV testing were conducted for 342 subjects. We calculated agreement between the HPV assays and the clinical performance of HPV testing and HPV genotyping alone and in combination with anal cytology. We observed high agreement between cobas and LA, with cobas more likely than LA to show positive results for HPV16, HPV18, and other carcinogenic types. Specimens testing positive in cobas but not in LA were more likely to be positive for other markers of HPV-related disease compared to those testing negative in both assays, suggesting that at least some of these were true positives for HPV. cobas and LA showed high sensitivities but low specificities for the detection of anal intraepithelial neoplasia grade 2/3 (AIN2/3) in this population (100% sensitivity and 26% specificity for cobas versus 98.4% sensitivity and 28.9% specificity for LA). A combination of anal cytology and HPV genotyping provided the highest accuracy for detecting anal precancer. A higher HPV load was associated with a higher risk of AIN2/3 with HPV16 (P(trend) < 0.001), HPV18 (P(trend) = 0.07), and other carcinogenic types (P(trend) < 0.001). We demonstrate that cobas can be used for HPV detection in anal cytology specimens. Additional tests are necessary to identify men at the highest risk of anal cancer among those infected with high-risk HPV. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  9. Sistema de gestión dual estratégico-logistico para las pymes del sector metalmecanico de la ciudad de barranquilla

    OpenAIRE

    Cervera Cárdenas, Jorge Eduardo

    2014-01-01

    El presente documento es producto de una investigación de la productividad y competitividad de las Pymes del sector Metalmecánico en la ciudad de Barranquilla, cuyo propósito es proponer un modelo de un sistema de gestión dual estratégico-logístico para las pymes de este sector. Para esto, se llevo a cabo una investigación de tipo Analítico-Inductivo, enmarcado en un paradigma cualitativo, ya que la propuesta buscó las causas que obstaculizan la optimización de los recursos buscados por la lo...

  10. Tracking vaginal, anal and oral infection in a mouse papillomavirus infection model.

    Science.gov (United States)

    Hu, Jiafen; Budgeon, Lynn R; Cladel, Nancy M; Balogh, Karla; Myers, Roland; Cooper, Timothy K; Christensen, Neil D

    2015-12-01

    Noninvasive and practical techniques to longitudinally track viral infection are sought after in clinical practice. We report a proof-of-principle study to monitor the viral DNA copy number using a newly established mouse papillomavirus (MmuPV1) mucosal infection model. We hypothesized that viral presence could be identified and quantified by collecting lavage samples from cervicovaginal, anal and oral sites. Nude mice infected at these sites with infectious MmuPV1 were tracked for up to 23 weeks starting at 6 weeks post-infection. Viral DNA copy number was determined by SYBR Green Q-PCR analysis. In addition, we tracked viral DNA load through three complete oestrous cycles to pinpoint whether there was a correlation between the DNA load and the four stages of the oestrous cycle. Our results showed that high viral DNA copy number was reproducibly detected from both anal and cervicovaginal lavage samples. The infection and disease progression were further confirmed by histology, cytology, in situ hybridization, immunohistochemistry and transmission electron microscopy. Interestingly, the viral copy number fluctuated over the oestrous cycle, with the highest level at the oestrus stage, implying that multiple sampling might be necessary to provide a reliable diagnosis. Virus DNA was detected in oral lavage samples at a later time after infection. Lower viral DNA load was found in oral samples when compared with those in anal and vaginal tracts. To our knowledge, our study is the first in vivo study to sequentially monitor papillomavirus infection from mucosal anal, oral and vaginal tracts in a preclinical model.

  11. The male bulbospongiosus muscle and its relation to the external anal sphincter.

    Science.gov (United States)

    Peikert, Kevin; Platzek, Ivan; Bessède, Thomas; May, Christian Albrecht

    2015-04-01

    The bulbospongiosus muscle is part of the superficial muscular layer of the perineum and pelvic floor. Its morphology remains controversial in the literature. Therefore, we reinvestigated the fascial arrangement and fiber courses of the bulbospongiosus muscle and its topographical relation to the external anal sphincter. The perineum was dissected in 9 male cadavers (mean ± SD age 78.3 ± 10.7 years). Select samples were obtained for histology and immunohistochemistry. In 43 patients (mean age 60.7 ± 12 years) the topographical relation between the bulbospongiosus muscle and the external anal sphincter was determined by magnetic resonance imaging. The perineum contains several fascial layers consisting of elastic and collagen fibers as well as bundles of smooth muscle cells. The bulbospongiosus muscle was subdivided into a ventral and dorsal portion, which developed in 4 variants. The ventral insertion formed a morphological unity with the ischiocavernous muscle while the dorsal origin had a variable relation to the external anal sphincter (5 variants). A muscle-like or connective tissue-like connection was frequently present between the muscles. However, in some cases the muscles were completely separated. We suggest a concept of variations of bulbospongiosus muscle morphology that unifies the conflicting literature. Its ventral fiber group and the ischiocavernosus muscle form a functional and morphological unity. While the bulbospongiosus muscle and the external anal sphincter remain independent muscles, their frequent connection might have clinical implications for perineal surgery and anogenital disorders. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  12. FDG-PET/CT in the evaluation of anal carcinoma

    International Nuclear Information System (INIS)

    Cotter, Shane E.; Grigsby, Perry W.; Siegel, Barry A.

    2006-01-01

    Purpose: Surgical staging and treatment of anal carcinoma has been replaced by noninvasive staging studies and combined modality therapy. In this study, we compare computed tomography (CT) and physical examination to [ 18 F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) in the staging of carcinoma of the anal canal, with special emphasis on determination of spread to inguinal lymph nodes. Methods and Materials: Between July 2003 and July 2005, 41 consecutive patients with biopsy-proved anal carcinoma underwent a complete staging evaluation including physical examination, CT, and 2-FDG-PET/CT. Patients ranged in age from 30 to 89 years. Nine men were HIV-positive. Treatment was with standard Nigro regimen. Results: [ 18 F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) detected 91% of nonexcised primary tumors, whereas CT visualized 59%. FDG-PET/CT detected abnormal uptake in pelvic nodes of 5 patients with normal pelvic CT scans. FDG-PET/CT detected abnormal nodes in 20% of groins that were normal by CT, and in 23% without abnormality on physical examination. Furthermore, 17% of groins negative by both CT and physical examination showed abnormal uptake on FDG-PET/CT. HIV-positive patients had an increased frequency of PET-positive lymph nodes. Conclusion: [ 18 F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography detects the primary tumor more often than CT. FDG-PET/CT detects substantially more abnormal inguinal lymph nodes than are identified by standard clinical staging with CT and physical examination

  13. Resolución experimental y analítica de un problema de dinámica rotacional: interpretación de los resultados

    Directory of Open Access Journals (Sweden)

    Beatriz Rosario Follari

    2016-09-01

    Full Text Available http://dx.doi.org/10.5007/2175-7941.2016v33n2p606   La resolución de problemas y las prácticas de laboratorio son parte esencial de las actividades que deben realizar los estudiantes de Física en sus primeros cursos de Física. Se relata una experiencia de aula en la que se propuso a los estudiantes de Física II del primer año de las carreras Profesorado y Licenciatura en Física, el estudio de un carrete que rueda sin deslizar. La misma constó de dos partes: en la primera se les solicitó que planificaran y llevaran a cabo una experiencia para determinar el momento de inercia del carrete; en la segunda se les pidió el desarrollo analítico para encontrar la aceleración y fuerza de rozamiento al hacerlo rodar. La actividad se llevó a cabo en grupo y los resultados fueron expuestos y discutidos. La propuesta resultó positiva ya que llevó a los estudiantes a expresar sus ideas, a la discusión grupal y promovió la autonomía para planificar experiencias sencillas y llevarlas a cabo. Se puso énfasis en la interpretación de las ecuaciones resultantes.

  14. Cause-specific colostomy rates after radiotherapy for anal cancer: a Danish multicentre cohort study.

    Science.gov (United States)

    Sunesen, Kåre G; Nørgaard, Mette; Lundby, Lilli; Havsteen, Hanne; Buntzen, Steen; Thorlacius-Ussing, Ole; Laurberg, Søren

    2011-09-10

    In anal cancer, colostomy-free survival is a measure of anal sphincter preservation after treatment with radiotherapy or chemoradiotherapy. Failure to control anal cancer and complications of treatment are alternative indications for colostomy. However, no data exist on cause-specific colostomy rates. We examined this in a cohort study. Through national registries and review of medical records, we identified patients with anal cancer diagnosed from 1995 to 2003 who had curative-intent radiotherapy or chemoradiotherapy in four Danish centers. We computed cumulative incidence of tumor-related colostomy and therapy-related colostomy, treating colostomy and death as competing events. Follow-up started at completion of radiotherapy and continued throughout 2008. We used competing risk regression to compute hazard ratios (HRs) to compare the cumulative incidence of cause-specific colostomies between age, sex, tumor size, chemotherapy, and local excision before radiotherapy. We included 235 patients with anal cancer. The 5-year cumulative incidences of tumor-related and therapy-related colostomy were 26% (95% CI, 21% to 32%) and 8% (95% CI, 5% to 12%), respectively. Tumor size greater than 6 cm versus less than 4 cm was a risk factor for tumor-related colostomy (adjusted HR, 3.8; 95% CI, 1.7 to 8.1), and local excision before radiotherapy was a risk factor for therapy-related colostomy (adjusted HR, 4.5; 95% CI, 1.5 to 13.5). After curative-intent radiotherapy or chemoradiotherapy, one third of patients had a colostomy, of which one third were related to therapy. Large tumor size was associated with a higher risk of tumor-related colostomy, whereas history of prior excision was associated with an increased incidence of therapy-related colostomy.

  15. Gender Nonconformity and Birth Order in Relation to Anal Sex Role Among Gay Men.

    Science.gov (United States)

    Swift-Gallant, Ashlyn; Coome, Lindsay A; Monks, D Ashley; VanderLaan, Doug P

    2018-05-01

    Androphilia is associated with an elevated number of older brothers among natal males. This association, termed the fraternal birth order effect, has been observed among gay men who exhibit marked gender nonconformity. Gender nonconformity has been linked to gay men's preferred anal sex role. The present study investigated whether these two lines of research intersect by addressing whether the fraternal birth order effect was associated with both gender nonconformity and a receptive anal sex role (243 gay men, 91 heterosexual men). Consistent with previous research, we identified the fraternal birth order effect in our sample of gay men. Also, gay men were significantly more gender-nonconforming on adulthood and recalled childhood measures compared to heterosexual men. When gay men were compared based on anal sex role (i.e., top, versatile, bottom), all groups showed significantly greater recalled childhood and adult male gender nonconformity than heterosexual men, but bottoms were most nonconforming. Only gay men with a bottom anal sex role showed evidence of a fraternal birth order effect. A sororal birth order effect was found in our sample of gay men, driven by versatiles. No significant associations were found between fraternal birth order and gender nonconformity measures. These results suggest that the fraternal birth order effect may apply to a subset of gay men who have a bottom anal sex role preference and that this subgroup is more gender-nonconforming. However, there were no significant associations between fraternal birth order and gender nonconformity at the individual level. As such, based on the present study, whether processes underpinning the fraternal birth order effect influence gender nonconformity is equivocal.

  16. Comparison of anal HPV natural history among men by country of residence: Brazil, Mexico, and the United States.

    Science.gov (United States)

    Sudenga, Staci L; Nyitray, Alan G; Torres, B Nelson; Silva, Roberto; Villa, Luisa; Lazcano-Ponce, Eduardo; Abrahamsen, Martha; Baggio, Maria Luiza; Salmeron, Jorge; Quiterio, Manuel; Giuliano, Anna R

    2017-07-01

    Globally, anal cancer incidence is rare, but is increasing in some world regions. Our objective was to assess differences in anal HPV natural history in three countries. Men aged 18-70 years were recruited from the US (n = 634), Mexico (n = 665), and Brazil (n = 731). Anal specimens were collected every six-months. HPV genotyping was assessed by Linear Array. Anal HPV prevalence was compared using the Fisher's exact test. HPV infection incidence rates (IR) and 95% confidence intervals (CI) were calculated. Any anal HPV prevalence was highest among men from Brazil (24%) compared to Mexico (15%) and the US (15%). When stratified by sexual history, the prevalence of any HPV among MSM/MSMW was 43%, 37%, and 45% and 9%, 12%, and 10% for MSW from Brazil, Mexico, and US, respectively. Any HPV incidence was significantly higher among men from Brazil compared to US men (IRR = 2.4, 95% CI = 1.7-3.4) and comparable between men from Mexico and the US (IRR = 1.2, 95% CI = 0.8-1.8). Men in Brazil and Mexico often have similar, if not higher incidence of anal HPV compared to men from the U.S., and may benefit from gender neutral HPV vaccine policies. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  17. Relationship between external anal sphincter atrophy at endoanal magnetic resonance imaging and clinical, functional, and anatomic characteristics in patients with fecal incontinence

    NARCIS (Netherlands)

    Terra, Maaike P.; Deutekom, Marije; Beets-Tan, Regina G. H.; Engel, Alexander F.; Janssen, Lucas W. M.; Boeckxstaens, Guy E. E.; Dobben, Annette C.; Baeten, Cor G. M. I.; de Priester, Jacobus A.; Bossuyt, Patrick M. M.; Stoker, Jaap

    2006-01-01

    PURPOSE: External anal sphincter atrophy at endoanal magnetic resonance imaging has been associated with poor outcome of anal sphincter repair. We studied the relationship between external anal sphincter atrophy on endoanal magnetic resonance imaging and clinical, functional, and anatomic

  18. coloproctectomie avec anastomose colo-sus-anale pour tumeur ...

    African Journals Online (AJOL)

    Une coloproctectomie fut réalisée le 30/06/2014 avec anastomose colo-anale, colostomie de protection sous-couvert d'une transfusion sanguine. L'examen histologique du segment colorectal prélevé objectiva une rectocolite granulomateuse autour de nombreux oeufs de schistosomes. En effet, le patient a vécu à Pahou, ...

  19. Acute anal stretch inhibits NMDA-dependent pelvic-urethra reflex potentiation via spinal GABAergic inhibition in anesthetized rats.

    Science.gov (United States)

    Chen, Sung-Lang; Huang, Yu-Hui; Kao, Yu-Lin; Chen, Gin-Den; Cheng, Chen-Li; Peng, Hsien-Yu; Liao, Jiuan-Miaw; Huang, Pei-Chen; Tsai, Shih-Jei; Lin, Tzer-Bin

    2008-10-01

    The impact of acute anal stretch on the pelvic-urethra reflex potentiation was examined in urethane-anesthetized rats by recording the external urethra sphincter electromyogram activity evoked by the pelvic afferent stimulation. Test stimulation (1 stimulation/30 s) evoked a baseline reflex activity with a single action potential that was abolished by gallamine (5 mg/kg iv). On the other hand, the repetitive stimulation (1 stimulation/1 s) induced spinal reflex potentiation (SRP) that was attenuated by intrathecal 6-cyano-7-nitroquinoxaline-2,4-dione (a glutamatergic alpha-amino-3-hydroxy-5-methyl-4-isoxazoleproprionat receptor antagonist, 100 microM, 10 microl) and d-2-amino-5-phosphonovalerate [a glutamatergic N-methyl-D-aspartate (NMDA) antagonist, 100 microM, 10 microl]. Acute anal stretch using a mosquito clamp with a distance of 4 mm exhibited no effect, whereas distances of 8 mm attenuated and 12 mm abolished the repetitive stimulation-induced SRP. Intrathecal NMDA (100 microM, 10 microl) reversed the abolition on SRP caused by anal stretch. On the other hand, pretreated bicuculline [gamma-aminobutyric acid (GABA) A receptor antagonist, 100 microM, 10 microl] but not hydroxysaclofen (GABAB receptor antagonist) counteracted the abolition on the repetitive stimulation-induced SRP caused by the anal stretch. All of the results suggested that anal stretch may be used as an adjunct to assist voiding dysfunction in patients with overactive urethra sphincter and that GABAergic neurotransmission is important in the neural mechanisms underlying external urethra sphincter activity inhibited by anal stretch.

  20. FiMAN: SISTEMA COMPUTARIZADO PARA ANÁLISIS DE MOVIMIENTOS DIGITALES

    Directory of Open Access Journals (Sweden)

    Miguel Carballo

    2016-07-01

    Full Text Available La reciente tecnología de dispositivos y sensores infrarrojos han abierto nuevas posibilidades para el desarrollo de software relacionado con el área de análisis de movimientos corporales. Esta tecnología puede ser utilizada en áreas como la salud, la enseñanza, la realidad virtual y aumentada, control de robots y entretenimiento. En este artículo presentamos el desarrollo de FiMAN, un sistema que permite visualizar los movimientos detallados de las manos en tiempo real y en 3D utilizando el dispositivo infrarrojo Leap Motion para la captura de datos, permitiendo la realización de grabaciones y reproducciones de movimientos para su posterior análisis. Para su desarrollo fue necesaria la división modular de los componentes visuales, estructurales, analíticos, estadísticos y de sonido, además de la captura y manipulación de datos. Gracias a su diseño modular, se obtuvo un entorno genérico de desarrollo para aplicaciones especializadas en movimientos digitales. Como Estudio de Caso, se utilizó el sistema al área de la educación musical, específicamente a la enseñanza de la técnica del piano, para lo cual se extendió FiMAN con un teclado virtual y manejo de sonido. El uso real de FiMAN en este escenario, demostró su modularidad y extensibilidad a diferentes áreas relacionadas al análisis de movimientos digitales.

  1. Postpartum two- and three-dimensional ultrasound evaluation of anal sphincter complex in women with obstetric anal sphincter injury.

    Science.gov (United States)

    Ros, C; Martínez-Franco, E; Wozniak, M M; Cassado, J; Santoro, G A; Elías, N; López, M; Palacio, M; Wieczorek, A P; Espuña-Pons, M

    2017-04-01

    To compare the sensitivity and specificity of two- (2D) and three- (3D) dimensional transperineal ultrasound (TPUS) and 3D endovaginal ultrasound (EVUS) with the gold standard 3D endoanal ultrasound (EAUS) in detecting residual defects after primary repair of obstetric anal sphincter injuries (OASIS). External (EAS) and internal (IAS) anal sphincters were evaluated by the four ultrasound modalities in women with repaired OASIS. 2D-TPUS was evaluated in real-time, whereas 3D-TPUS, 3D-EVUS and 3D-EAUS volumes were evaluated offline by six blinded readers. The presence/absence of any tear in EAS or IAS was recorded and defects were scored according to the Starck system. Sensitivity, specificity and predictive values were calculated, using 3D-EAUS as reference standard. Inter- and intraobserver analyses were performed for all 3D imaging modalities. Association between patients' symptoms (Wexner score) and ultrasound findings (Starck score) was calculated. Images from 55 patients were analyzed. Compared with findings on 3D-EAUS, the agreement for EAS evaluation was poor for 3D-EVUS (κ = 0.01), fair for 2D-TPUS (κ = 0.30) and good for 3D-TPUS (κ = 0.73). The agreement for IAS evaluation was moderate for both 3D-EVUS (κ = 0.41) and 2D-TPUS (κ = 0.52) and good for 3D-TPUS (κ = 0.66). Good intraobserver (3D-EAUS, κ = 0.73; 3D-TPUS, κ = 0.78) and interobserver (3D-EAUS, κ = 0.68; 3D-TPUS, κ = 0.60) agreement was reported. Significant association between Starck and Wexner scores was found only for 3D-EAUS (Spearman's rho = 0.277, P = 0.04). 2D-TPUS and 3D-EVUS are not accurate modalities for the assessment of anal sphincters after repair of OASIS. 3D-TPUS shows good agreement with the gold standard 3D-EAUS and a high sensitivity in detecting residual defects. It, thus, has potential as a screening tool after primary repair of OASIS. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG

  2. Un modelo de análisis del conflicto socio-ambiental para aprender-investigar

    Directory of Open Access Journals (Sweden)

    Rodrigo Martínez Novo

    2012-04-01

    Full Text Available En el presente artículo nos aproximamos a una perspectiva teórica de interpretación y análisis de los conflictos socio-ambientales que a su vez sirve como argumento para la propuesta de un modelo de investigación-acción educativa. En primer lugar comentamos algunas de las características del conflicto socio-ambiental desde una postura hermenéutica que busca la comprensión del “campo de sentidos” que orientan la acción en dicho conflicto. En segundo lugar se justifica la utilidad del análisis de conceptos-equívocos (en alusión a los objetos-equívocos de Boltanski y Thévenot, 1991 como el famoso “desarrollo sostenible” para adentrarnos en el campo de sentido, en sus posiciones, en sus lugares comunes y en las controversias que atañen a sus significados más profundos. A partir de esta reflexión, para terminar, se propondrán de forma orientativa y escueta un modelo de actividades educativas-investigativas para la puesta en práctica de esta perspectiva analítica

  3. A DISSECAÇÃO HORIZONTAL COMO PARÂMETRO MORFOMÉTRICO PARA AVALIAÇÃO DO RELEVO: PROPOSTA DE TÉCNICA DIGITAL AUTOMÁTICA

    Directory of Open Access Journals (Sweden)

    Mateus Vidotti Ferreira

    2014-12-01

    Full Text Available A morfometria do relevo constitui-se em parâmetro importante para a avaliação da potencialidade morfogenética dos terrenos. Dentre as diversas variáveis passíveis de mensuração, a dissecação horizontal ganha relevância ao permitir avaliar os processos morfogenéticos relacionados com a intensidade da dinâmica fluvial. Com o desenvolvimento das técnicas cartográficas digitais, a obtenção desse tipo de dado, que tradicionalmente envolvia um trabalho moroso, tem evoluído bastante. O objetivo desse artigo é apresentar e discutir uma nova técnica automática desenvolvida em meio digital para a aquisição de dados da dissecação horizontal do relevo. Apresenta-se ainda uma análise comparativa de mapeamentos realizados de forma semiautomática e automática da bacia hidrográfica do Córrego do Cavalheiro (Analândia - SP, na escala de 1:10.000. Os resultados obtidos demonstram que a técnica digital permite maior precisão e demanda menor tempo para ser executada. Além disso, a replicabilidade é garantida em razão do uso de algoritmos computacionais, dispensando a subjetividade inerente aos processos analógicos.

  4. Otimização e validação do método analítico volumétrico para quantificação do carbonato de cálcio

    Directory of Open Access Journals (Sweden)

    A. K.M. Santana

    2009-01-01

    Full Text Available

    A osteoporose é definida pela Organização Mundial de Saúde como uma doença metabólica óssea sistêmica, caracterizada por diminuição da massa óssea e deterioração da microarquitetura do tecido ósseo, com conseqüente aumento da fragilidade do osso e da suscetibilidade a fraturas. A suplementação de cálcio pode ser realizada utilizando-se diferentes sais de cálcio. O mais recomendado é o carbonato de cálcio, que apresenta a maior quantidade de cálcio elementar (40%. Atualmente, quando todos os caminhos levam à busca da qualidade total, torna-se indispensável conhecer perfeitamente cada fase de um processo produtivo. Neste caso, a validação é uma ferramenta da qualidade adequada para garantir a confiabilidade e reprodutibilidade de um método analítico, pois é um ato documentado que atesta que o mesmo conduz a resultados esperados. A escolha de uma metodologia é de fundamental importância para o procedimento do controle de qualidade da substância ativa ou da forma farmacêutica. Desta forma, o presente estudo teve por objetivo desenvolver e validar o método de doseamento da matéria-prima carbonato de cálcio por titulometria. As características de desempenho investigadas no processo de validação foram: exatidão, precisão, limite de detecção, limite de quantificação, linearidade e robustez. Os resultados obtidos demonstraram que o método é robusto, exato e preciso, apresentando resultados reprodutíveis e confiáveis. Palavras-chave: validação; titulometria; carbonato de cálcio.

  5. Síndrome de Cushing Ectópica: Um Desafio Diagnóstico e Terapêutico

    Directory of Open Access Journals (Sweden)

    Vera Fernandes

    2018-05-01

    CASO CLÍNICO: Mulher de 78 anos referenciada à consulta de Endocrinologia por síndrome de Cushing. Apresenta-va sinais e sintomas de hipercortisolismo e a investigação demonstrou síndrome de Cushing ACTH dependente, com ressonância magnética hipofisária sem alterações, cateterismo dos seios petrosos negativo e nódulo pulmonar de 8 mm. A cintigrafia com recetores da somatostatina, a PET-68Ga-SRP, a broncofibroscopia e a citologia do aspirado brônquico não revelaram alterações. Por franco agravamento clínico, iniciou-se terapêutica com metirapona, com resposta clínica e analítica muito favorável. DISCUSSÃO: Este caso revelou-se um desafio diagnóstico e terapêutico. Embora sem localização do tumor primário, atingiu-se o principal objetivo, o controlo do hipercortisolismo, com melhoria da qualidade de vida da doente.

  6. Un modelo para la valuación de intangibles. Aplicación a las franquicias de la industria restaurantera en México

    OpenAIRE

    RODRÍGUEZ BATRES, AXEL

    2010-01-01

    La presente Tesis Doctoral se enmarca dentro del campo de la valoración de empresas, aplicando la metodología de valoración analógica a las empresas franquiciadas en el sector de la hostelería en México. El principal objetivo es el desarrollo de un modelo de valoración para el conjunto de las empresas franquiciadas restauranteras que operan en todo el país, con el fin de brindar a los empresarios de este modelo de negocios, una herramienta para la estimación del valor comercial y facilit...

  7. Clinical, manometric, and ultrasonographic results of pneumatic balloon dilatation vs. lateral internal sphincterotomy for chronic anal fissure: a prospective, randomized, controlled trial.

    Science.gov (United States)

    Renzi, Adolfo; Izzo, Domenico; Di Sarno, Giandomenico; Talento, Pasquale; Torelli, Francesco; Izzo, Giuseppe; Di Martino, Natale

    2008-01-01

    This prospective, randomized, controlled trial was designed to compare the clinical, functional, and morphologic results of pneumatic balloon dilatation with lateral internal sphincterotomy for the treatment of chronic anal fissure. All patients with symptomatic chronic anal fissure were randomly assigned to pneumatic balloon dilatation or lateral internal sphincterotomy and invited to complete a standardized questionnaire inquiring about their symptoms. Anal ultrasonography and anal manometry were performed before and six months after surgery. A proctologic examination was performed between the fifth and sixth postoperative weeks. Anal continence, scored by using a validated continence grading scale, was evaluated preoperatively at 1 and 6 weeks and at 12 and 24 months. Fifty-three patients, who satisfied selection criteria, were enrolled in the trial. Four patients (7.5 percent) were lost to follow-up. Twenty-four patients (11 males; mean age, 42 +/- 8.2 years) underwent pneumatic balloon dilatation and 25 patients (10 males; mean age, 44 +/- 7.3 years) underwent lateral internal sphincterotomy. Fissure-healing rates were 83.3 percent in the pneumatic balloon dilatation and 92 percent in the lateral internal sphincterotomy group. Recurrent anal fissure was observed in one patient (4 percent) after lateral internal sphincterotomy. At anal manometry, mean resting pressure decrements obtained after pneumatic balloon dilatation and lateral internal sphincterotomy were 30.5 and 34.3 percent, respectively. After pneumatic balloon dilatation, anal ultrasonography did not show any significant sphincter damage. At 24-month follow-up, the incidence of incontinence, irrespective of severity, was 0 percent in the pneumatic balloon dilatation group and 16 percent in the lateral internal sphincterotomy group (P < 0.0001). As lateral internal sphincterotomy, pneumatic balloon dilatation grants a high anal fissure-healing rate but with a statistically significant reduction in

  8. Radiochemotherapy in Anal Cancer: cCR, clinical outcomes and quality of life using two different treatment schedules.

    Science.gov (United States)

    Di Santo, Sara; Trignani, Marianna; Neri, Matteo; Milano, Angelo; Innocenti, Paolo; Taraborrelli, Maria; Augurio, Antonietta; Vinciguerra, Annamaria; Di Tommaso, Monica; Ursini, Lucia Anna; Di Pilla, Angelo; Di Nicola, Marta; Genovesi, Domenico

    2015-01-01

    Main endpoint was a response rate to therapy; secondary endpoints were disease-free survival, overall survival, acute and late toxicities, specially in terms of anorectal and urinary continence. Radiochemotherapy for anal cancer achieves a good clinical response, locoregional control, anal function preservation. However, oncologic outcomes can differ using radiotherapy plus fluorouracil and mytomicin vs. cisplatin and fluorouracil. Between 2000 and 2012, 27 anal cancer patients receiving radiotherapy combined with two different radiochemotherapy schedules, fluorouracil and mytomicin (group A) and cisplatin plus fluorouracil (group B). The Kaplan-Meier method was also used to estimate local control, overall survival and disease free survival. Statistical significance between curves was evaluated using the Log-rank test. Complete pathological response was found in 85.2% of patients, with higher rates of response in the group A (100% vs. 63.6%, p = 0.039). No significantly difference was found between the two groups for the other endpoints. Low rates of both acute and late toxicities were recorded. Radiotherapy plus fluorouracil and mytomicin provide a better complete pathological response than radiotherapy plus cisplatin and fluorouracil and a greater rate of anal sphincter function preservation. Globally, radiochemotherapy of the anal cancer provides excellent clinical outcomes with a good profile of acute and late toxicity, without difference between the two groups studied.

  9. Design and Psychometric Evaluation of the Quality of Life in Patients With Anal Fistula Questionnaire.

    Science.gov (United States)

    Ferrer-Márquez, Manuel; Espínola-Cortés, Natalia; Reina-Duarte, Angel; Granero-Molina, José; Fernández-Sola, Cayetano; Hernández-Padilla, José Manuel

    2017-10-01

    Quality of life is often considered when deciding and evaluating the treatment strategy for patients diagnosed with anal fistula. The purpose of this study was to develop and psychometrically test the Quality of Life in Patients with Anal Fistula Questionnaire. This was an observational cross-sectional study for the development and validation of a psychometric tool. The study was conducted at a general hospital in the southeast of Spain. A convenience sample included 54 patients diagnosed with anal fistula. The reliability of the tool was assessed through its internal consistency (Cronbach α) and temporal stability (Spearman correlation coefficient (r) between test-retest). The content validity index of the items and the scale was calculated. Correlation analysis and an ordinal regression analysis between the developed tool and the Short Form 12 Health Survey examined its concurrent validity. Principal component analysis and known-group analysis using the Kruskal-Wallis test examined its construct validity. The reliability of the developed questionnaire was very high (α = 0.908; r = 0.861; p questionnaire to detect expected differences in patients presenting with different symptomatology. The major limitations of this study were the use of a small sample of Spanish-speaking patients, not including patients in the initial development of the questionnaire, and developing the scoring system using a summation method. The Quality of Life in Patients with Anal Fistula Questionnaire has proven to be a valid, reliable, and concise tool that could contribute to the evaluation of quality of life among patients with an anal fistula. See Video Abstract at http://links.lww.com/DCR/A368.

  10. Tratamientos eficaces para el Trastorno de Ansiedad Social

    Directory of Open Access Journals (Sweden)

    Carolina Baeza Velasco

    2007-01-01

    Full Text Available www.neuropsicologia.cl 127 Tratamientos eficaces para el Trastorno de Ansiedad Social Efficient Treatments for Social Anxiety Disorder Carolina Baeza Velasco * Resumen El Trastorno de Ansiedad Social (TAS, también cono cido como Fobia Social, es reconocido hoy en día como una condición psiquiátri ca crónica e incapacitante. La alta prevalencia y la significancia clínica de la enferm edad, enfatizan la necesidad de reconocimiento temprano y de tratamiento eficaz. El objetivo de este trabajo es exponer los principales tratamientos existentes, poniendo a tención a las investigaciones y estudios meta-analíticos que intentan diferenciar los distin tos tipos de intervención en relación a su eficacia.

  11. Radiological diagnosis in constipation and anal incontinence due to changes in the pelvic floor and sphincter apparatus of the anus

    International Nuclear Information System (INIS)

    Bistolfi, F.; Grillo Ruggeri, F.; Siragusa, A.

    1987-01-01

    Rectal constipation, anal incontinence and constipation combined with incontinence, are often caused by organic or simply functional changes in the pelvic floor and sphincterial apparatus. Therefore morphological as well as manometric and electromyographic studies of these anatomical parts are required. This is possible by combining two techniques: Intestinal Transit Time (ITT) and Defecatory Proctogram with Balloon (DPB). Personal experience of 38 patients with constipation with or without incontinence is reported. The results lead to the following conclusion: 1) ITT is a simple and non-invasive radiological technique that provides us with objective evidence of an impairment, i.e. constipation, whose symptoms are often only subjective; especially is allows us to identify rectal constipation, that can be caused by impairment of the anal sphincteral apparatus. 2) Using an uroprophylactic with a collar that adapts to the size of the anal duct, DPB always permits visualization of the duct with good representation of the recto-anal angle, whose changes may be the expression of organic or only functional impairments of the anal sphincterial apparatus. Increasing use of the two radiological techniques is therefore recommended in the diagnosis of alterations of the pelvic floor or anal sphincter

  12. Projeto e análise do controle térmico para o microssatélite universitário ITASAT-1

    OpenAIRE

    Marcelo Petry Rodrigues

    2011-01-01

    O presente trabalho tem por foco o desenvolvimento e análise do controle térmico do primeiro micro satélite universitário brasileiro, ITASAT-1, de forma que atenda as necessidades impostas em nível de Preliminary Design Review - PDR (revisão de analíse preliminar) do projeto, para tanto foi analisado os casos críticos previstos para o satélite em seu vôo órbital. O presente satélite faz parte do programa ITASAT, que é uma ação conjunta do Instituto Tecnológico de Aeronáutica (ITA), Instituto ...

  13. Rectocele and anal sphincter defect – surgical anatomy and ...

    African Journals Online (AJOL)

    carefully directed translabial ultrasound scan of the rectum and anal sphincters. The ultrasound examination was performed by a radi- ologist with specific understanding of the pathology. Conventional two-dimensional ultrasound imaging was performed using a 4 - 8. MHz curved array probe. The patient was in the left ...

  14. Clinical Application of F-18 FDG PET (PET/CT) in Colo-rectal and Anal Cancer

    International Nuclear Information System (INIS)

    Kim, Byung Il

    2008-01-01

    In the management of colo-retal and anal cancer, accurate staging, treatment evaluation, early detection of recurrence are main clinical problems. F-18 FDG PET (PET/CT) has been reported as useful in the management of colo-rectal and anal cancer because that PET has high diagnostic performance comparing to conventional studies. In case of liver metastases, for confirmation of no extrahepatic metastases, in case of high risk of metastasis, for avoiding unnecessary operation, PET (PET/CT) is expected more useful. In anal cancer, PET is expected useful in lymph node staging. For the early prediction of chemotherapy or radiation therapy effect PET has been reported as useful, also. In early detection of recurrence by PET, cost-benefit advantages has been suggested, also. PET/CT is expected to have higher diagnostic performance than PET alone

  15. Las cooperativas como estrategia de gestión para el fomento de la economía social en el municipio Maracaibo del estado Zulia. Período: 1999-2006

    OpenAIRE

    Graterol, Angela; Alizo, María Alexandra; Molero, Norma

    2010-01-01

    La presente investigación tuvo como objetivo analizar las cooperativas como estrategias de gestión para el fomento de la economía social. Se enmarca en el paradigma positivista, de carácter descriptiva analítica y el diseño es no experimental- transeccional. La muestra estuvo conformada por dos mil doscientos cuarenta y dos socios de cooperativas del municipio Maracaibo, registradas en la superintendencia nacional de cooperativas (SUNACOOP). Se utilizaron fuentes primarias y secundarias para ...

  16. Preoperative chemoradiotherapy and colonic J-pouch anal anastomosis for lower rectal cancer

    International Nuclear Information System (INIS)

    Inoue, Yasuhiro; Okigami, Masato; Kawamoto, Aya; Hiro, Junichiro; Toiyama, Yuji; Kobayashi, Minako; Tanaka, Koji; Miki, Chikao; Kusunoki, Masato

    2011-01-01

    We performed colonic J-pouch anal anastomosis in 61 patients with rectal cancer located <4 cm from the anal verge. Surgical and oncological results were evaluated in multimodality therapy for advanced rectal cancer. According to Wexner's score, 7% of patients were fully continent, 71% had acceptable function with minor continence problems, and 22% were incontinent. No patients required intermittent self-catheterization during follow-up. After a median follow-up of 49 months, there was only 1 case of local recurrence after surgery. Our surgical approach irrespective of internal sphincter resection produces satisfactory functional and oncological results in multimodality therapy using preoperative chemoradiotherapy for lower rectal cancer. (author)

  17. Anal carcinomas: the role of endoanal ultrasound and magnetic resonance imaging in staging, response evaluation and follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Parikh, Jyoti; Shaw, Aidan; Griffin, Nyree [Guys and St. Thomas' Hospital, Department of Radiology, London (United Kingdom); Grant, Lee A. [Royal Marsden Hospital, Department of Radiology, London (United Kingdom); Schizas, Alexis M.P.; Datta, Vivek; Williams, Andrew B. [Guys and St. Thomas' Hospital, Department of General Surgery, London (United Kingdom)

    2011-04-15

    Anal carcinoma is an important but rare condition, managed in specialist centres. Both endoanal ultrasound and magnetic resonance imaging (MRI) can be used in the locoregional staging and follow-up of patients with anal cancer, and both may assist in treatment planning and prognosis. Recent guidelines published by the European Society for Medical Oncology have recommended MRI as the technique of choice for assessment of locoregional disease. This paper describes the techniques for both endoanal ultrasound and MRI, and compares the relative merits and disadvantages of each in the local assessment of anal carcinoma. (orig.)

  18. Posterior perineal support as treatment for anal fissures--preliminary results with a new toilet seat device.

    Science.gov (United States)

    Tan, Kok-Yang; Seow-Choen, Francis; Hai, Chew Heng; Thye, Gan Kok

    2009-03-01

    Anal fissures can cause morbidity in an otherwise healthy young patient. The process of evacuation results in stretching and descent of the anoderm and perineum especially posteriorly. Posterior perineal support may provide counter pressure at the posterior aspect of the pelvic floor, balancing the pressure exerted by the faeces on the anal wall, thus improving evacuation and reducing the trauma associated with it, and reducing symptoms of anal fissures. Symptoms of constipation may also be reduced secondarily. We report the preliminary results with a novel, simple and noninvasive method of treatment provided by a toilet seat device. A prospective study was performed in 32 patients. The study was designed mainly to investigate the patients' subjective perceptions of their symptoms related to anal fissures and constipation. Questionnaires were provided to patients before, during and after treatment. The study revealed statistically significant improvement in pain, bleeding, symptoms of constipation and abdominal discomfort after 3 months usage of the device. The odds of patients perceiving an improvement in symptoms were also significantly increased after 3 months of treatment compared to 2 weeks of treatment. This preliminary study revealed that a posterior perineal support device can bring about significant improvement in the symptoms of patients with anal fissures. There may also be secondary benefits of a reduction in the symptoms of constipation. Although not conclusive, these results should serve as a springboard for further research into this area.

  19. The diagnostic accuracy of endovaginal and transperineal ultrasound for detecting anal sphincter defects: The PREDICT study

    Energy Technology Data Exchange (ETDEWEB)

    Roos, A.-M., E-mail: annemarie.roos@gmail.com [Department of Obstetrics and Gynaecology, Mayday University Hospital, Croydon (United Kingdom); Abdool, Z. [Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria (South Africa); Sultan, A.H.; Thakar, R. [Department of Obstetrics and Gynaecology, Mayday University Hospital, Croydon (United Kingdom)

    2011-07-15

    Aim: To determine the accuracy and predictive value of transperineal (TPU) and endovaginal ultrasound (EVU) in the detection of anal sphincter defects in women with obstetric anal sphincter injuries and/or postpartum symptoms of faecal incontinence. Materials and methods: One hundred and sixty-five women were recruited, four women were excluded as they were seen years after their last delivery. TPU and EVU, followed by endonanal ultrasound (EAU), were performed using the B and K Viking 2400 scanner. Sensitivity and specificity, as well as predictive values with 95% confidence intervals, for detecting anal sphincter defects were calculated for EVU and TPU, using EAU as the reference standard. Results: On EAU a defect was found in 42 (26%) women: 39 (93%) had an external (EAS) and 23 (55%) an internal anal sphincter (IAS) defect. Analysable images of one level of the EAS combined with an analysable IAS were available in 140 (87%) women for EVU and in 131 (81%) for TPU. The sensitivity and specificity for the detection of any defect was 48% (30-67%) and 85% (77-91%) for EVU and 64% (44-81%) and 85% (77-91%) for TPU, respectively. Conclusion: Although EAU using a rotating endoprobe is the validated reference standard in the identification of anal sphincter defects, it is not universally available. However while TPU and/or EVU with conventional ultrasound probes can be useful in identifying normality, for clinical purposes they are not sensitive enough to identify an underlying sphincter defect.

  20. The diagnostic accuracy of endovaginal and transperineal ultrasound for detecting anal sphincter defects: The PREDICT study

    International Nuclear Information System (INIS)

    Roos, A.-M.; Abdool, Z.; Sultan, A.H.; Thakar, R.

    2011-01-01

    Aim: To determine the accuracy and predictive value of transperineal (TPU) and endovaginal ultrasound (EVU) in the detection of anal sphincter defects in women with obstetric anal sphincter injuries and/or postpartum symptoms of faecal incontinence. Materials and methods: One hundred and sixty-five women were recruited, four women were excluded as they were seen years after their last delivery. TPU and EVU, followed by endonanal ultrasound (EAU), were performed using the B and K Viking 2400 scanner. Sensitivity and specificity, as well as predictive values with 95% confidence intervals, for detecting anal sphincter defects were calculated for EVU and TPU, using EAU as the reference standard. Results: On EAU a defect was found in 42 (26%) women: 39 (93%) had an external (EAS) and 23 (55%) an internal anal sphincter (IAS) defect. Analysable images of one level of the EAS combined with an analysable IAS were available in 140 (87%) women for EVU and in 131 (81%) for TPU. The sensitivity and specificity for the detection of any defect was 48% (30-67%) and 85% (77-91%) for EVU and 64% (44-81%) and 85% (77-91%) for TPU, respectively. Conclusion: Although EAU using a rotating endoprobe is the validated reference standard in the identification of anal sphincter defects, it is not universally available. However while TPU and/or EVU with conventional ultrasound probes can be useful in identifying normality, for clinical purposes they are not sensitive enough to identify an underlying sphincter defect.

  1. Diseño y síntesis electrónica de la etapa de acondicionamiento analógico de un estetoscopio electrónico mediante circuitos programables FPAA

    OpenAIRE

    Gancedo Rodrigo, Jaime

    2015-01-01

    El objetivo principal de este Trabajo es el diseño, implementación y verificación de un sistema electrónico que permita acondicionar señales fonocardiográficas mediante circuitería analógica inmediatamente después de su adquisición con un estetoscopio electrónico. Para ello, se realizará un estudio de las características de las señales fonocardiográficas, se revisarán propuestas previas de sistemas con un propósito parecido y se propondrá una solución que satisfaga los requisitos definidos. U...

  2. Urbanismo, cultura e globalização em Portugal: modelos analíticos e de desenvolvimento territorial Urbanism, culture and globalization in Portugal: analytical and territorial development Models

    OpenAIRE

    Paulo Castro Seixas

    2011-01-01

    As cidades têm sido concebidas como actores chave face aos processos globais desde o último quarto do séculoXX. Neste quadro, é fundamental perceber-se os diferentes modelos que as cidades utilizam para responder aosdesafios globais. O artigo analisa o estado da arte em Portugal na relação entre cidade e globalização nos últimos25 anos, no âmbito das ciências sociais e sua relação com as políticas públicas. São caracterizados quatromodelos analíticos e de desenvolvimento territorial que respo...

  3. Hereditary vacuolar internal anal sphincter myopathy causing proctalgia fugax and constipation: a new case contribution.

    Science.gov (United States)

    de la Portilla, Fernando; Borrero, Juan José; Rafel, Enrique

    2005-03-01

    Hereditary anal sphincter myopathy is rare. We present a family with one affected member with proctalgia fugax, constipation and internal anal sphincter hypertrophy. Ultrastructural findings show vacuolization of smooth muscle cells without the characteristic polyglucosan inclusion. Further relief of symptoms was obtained using an oral calcium antagonist. Based on clinical presentation, endosonography and morphological findings, we consider our case is a histological variant of the vacuolar myopathy originally described.

  4. Disponibilidad de la información ¿un cuello de botella para la investigación y evaluación en políticas de salud?

    OpenAIRE

    Estrada, Victoria Eugenia; Granada, Alberto; Pinto, Diana; Borrero, Elizabeth; Carrasquilla, Gabriel

    2005-01-01

    Objetivos Describir las dificultades para obtener información de oferta, uso, cobertura, saneamiento básico y afiliación a la seguridad social en salud en una muestra de municipios colombianos para el período 1991-2000 y hacer un análisis de la disponibilidad de información en los municipios por estado de certificación y categorías de desarrollo municipal. Métodos Se realizó un estudio analítico de corte transversal en una muestra aleatoria estratificada de 495 municipios co...

  5. Prevalence of anal infection due to high-risk human papillomavirus and analysis of E2 gene integrity among women with cervical abnormalities.

    Science.gov (United States)

    Gonzalez-Losa, María Del Refugio; Puerto-Solís, Marylin; Ayora-Talavera, Guadalupe; Gómez-Carvallo, Jesús; Euán-López, Alejandra; Cisneros-Cutz, José I; Rosado-López, Ariel; Echeverría Salazar, Jesúa; Conde-Ferráez, Laura

    2018-04-01

    High-risk human papillomaviruses (HR-HPV) infection has been associated with 90% of anal cancer cases. Women with abnormal cytology are a high-risk group to develop anal neoplasia. The aim of this study is to describe the prevalence and epidemiology of HR-HPV 16, 18, 45, and 58 anal infections in women with cervical abnormalities, as well as to assess E2 gene integrity. A cross-sectional study was performed on 311 cervical and 311 anal samples from patients with abnormal cytology in two colposcopy clinics in Yucatan, Mexico. A specific PCR for oncogenes was performed in order to identify HVP 16, 18, 45 and 58. Real time PCR was used to amplify the whole HPV 16, 18, and 58 E2 gene to verify its integrity in anal samples. High risk HPV 16, 18, 58, and/or 45 were found in 41.47% (129/311) of cervical samples, and in 30.8% (96/331) of anal samples, with 18% (57/311) of the patients being positive in both samples. The same genotypes in both anatomical sites were observed in 11.25% (35/311). The E2 gene was disrupted in 82% of all tested samples. The frequency of genome disruption viral integration in anal samples by genotype was: HPV 58 (97.2%); HPV 16 (72.4%), and HPV 18 (0%). Women with cervical disease have HR-HPV anal infections, and most of them have the E2 gene disrupted, which represents a risk to develop anal cancer. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  6. Unsatisfactory exfoliative anal cytology samples, 15-year experience with histologic, cytologic, and molecular follow-up.

    Science.gov (United States)

    Khattab, Ruba; McMeekin, Emily; Taege, Alan J; Hekman, James M; Brainard, Jennifer A; Underwood, Dawn; Procop, Gary W; Sturgis, Charles D

    2018-02-01

    The incidence of anal carcinoma has risen in recent decades. Exfoliative cytology screening of selected high risk patients is performed in many centers. Unsatisfactory cytology results are frustrating to patients, clinicians, and laboratorians. The aim of this study is to ascertain outcomes of patients with non-diagnostic anal cytology. A retrospective review of anal cytology testing performed at the Cleveland Clinic between 01/01/2001 and 12/31/2015 was performed. All cases were received as liquid-based samples and processed as ThinPreps (Hologic, Marlborough, MA). Co-testing for HR-HPV DNA was performed using Hybrid Capture 2® (Qiagen, Germantown, MD) in the majority of patients. Of 1,276 ThinPrep anal cytology samples, 130 (10%) were deemed unsatisfactory. 77% of patients were HIV positive. 85% were males. Of the unsatisfactory cases, 116 (89%) were co-tested for HR-HPV DNA. Of those, 40 patients (34%) had a simultaneous positive HR-HPV DNA. Adequate follow up cytology within a one year and a two year period revealed that 18/130 (14%) and 26/130 (20%) of patients had ASC or SIL respectively. Histologic follow-up within one and two years showed 3 patients (2%) and 8 patients (6%) with HSIL or worse. High risk patients with unsatisfactory anal cytology are not "negative". At least one-third proved to be concomitantly HR-HPV DNA positive with one-fifth showing subsequent cytologic squamous abnormalities and with more than 5% being diagnosed with a high grade intraepithelial lesion within two years. Prompt repeat cytology and/or HR-HPV DNA is recommended for high risk patients with non-diagnostic cytology. © 2017 Wiley Periodicals, Inc.

  7. Desafíos del proceso de construcción de paz para la Policía Nacional de Colombia

    Directory of Open Access Journals (Sweden)

    Luisa Fernanda Pedraza Uribe

    2015-12-01

    Full Text Available Se desarrolla un análisis de los puntos convergentes derivados de las deliberaciones teórico-prácticas suscitadas en el marco del V Seminario Internacional de Inteligencia Estratégica y Prospectiva, con el propósito de reflexionar alrededor de algunas de las implicaciones de la construcción de paz en el fortalecimiento de las capacidades de la Policía Nacional de Colombia. El estudio de esta información se soportó en la triangulación de investigadores con enfoques académicos de carácter local, regional e internacional, con el fin de fortalecer de manera analítica y metodológica el direccionamiento institucional hacia la consolidación de herramientas en pro de la paz en el territorio nacional. A partir del ejercicio analítico, se precisó que la construcción de paz es un proceso que trasciende la terminación del conflicto armado y demanda unas implicaciones para la institución relacionadas con el enfoque territorial, la cultura organizacional, el servicio policial, la educación policial, la articulación policía-institucionescomunidad, y la integridad y transparencia institucional. De esta manera, la construcción de paz y la eliminación de las formas de violencia son procesos que se inician en el conflicto y deben mantenerse en el tiempo, es decir, no tienen caducidad; por ende, para la institución no se constituye como fin, sino como un medio para alcanzar la paz.

  8. Incidence, Trends and Ethnic Differences of Oropharyngeal, Anal and Cervical Cancers: Singapore, 1968-2012

    Science.gov (United States)

    Lam, Jennifer O.; Lim, Wei-Yen; Chow, Khuan-Yew; D’Souza, Gypsyamber

    2015-01-01

    In recent decades, several Western countries have reported an increase in oropharyngeal and anal cancers caused by human papillomavirus (HPV). Trends in HPV-associated cancers in Asia have not been as well described. We describe the epidemiology of potentially HPV-related cancers reported to the Singapore Cancer Registry from 1968–2012. Analysis included 998 oropharyngeal squamous cell carcinoma (OPSCC), 183 anal squamous cell carcinoma (ASCC) and 8,019 invasive cervical cancer (ICC) cases. Additionally, 368 anal non-squamous cell carcinoma (ANSCC) and 2,018 non-oropharyngeal head and neck carcinoma (non-OP HNC) cases were included as comparators. Age-standardized incidence rates (ASR) were determined by gender and ethnicity (Chinese, Malay and Indian). Joinpoint regression was used to evaluate annual percentage change (APC) in incidence. OPSCC incidence increased in both genders (men 1993–2012, APC = 1.9%, pSingapore, but Pap screening programs have led to consistently decreasing incidence. PMID:26720001

  9. [Clinical significance of detection of internal anal sphincter in children with functional constipation].

    Science.gov (United States)

    Hou, Xiang-yu; Wang, Ling-yun; Wang, Wei-lin; Li, Yong; Bai, Yu-zuo

    2011-10-01

    To investigate the structural and functional changes of internal anal sphincter (IAS) in children with functional constipation (FC), and to evaluate the association between the thickness of IAS and the severity of clinical symptoms. A total of 35 children with FC(constipation group,17 with incontinence) between June 2008 and December 2008 at the Shengjing Hospital of China Medical University were evaluated using anal manometry and endosonography. These patients were compared to 23 hospitalized children who were excluded for digestive and endocrinal diseases(control group). A validated symptom score(SS) was used to assess the severity of symptoms. The sum of SS ranged between 0 and 65. Anorectal manometry showed reflex relaxation of IAS in response to distension of rectal balloon in all patients. Rectal perceptional threshold in FC group was significantly higher than that in the controls[(42.4 ± 19.5) ml vs.(29.1 ± 15.6) ml, PIAS was significantly higher than that in the controls [(55.6 ± 31.6) ml vs.(30.5 ±13.8) ml, PIAS was noted in all the patients[(3.8 ± 1.7) mm vs.(2.5 ± 1.0) mm, P0.05]. The median symptom score was 9.3 ± 4.3 in the FC group. The thickness of IAS correlated significantly with total symptom severity score(r=0.407, PIAS and age, sex, or duration of disease(P>0.05). Structural and functional changes of internal anal sphincter exist in children with functional constipation. The thickness of internal anal sphincter correlates significantly with symptom severity.

  10. Feasibility of preference-driven radiotherapy dose treatment planning to support shared decision making in anal cancer

    DEFF Research Database (Denmark)

    Rønde, Heidi S; Wee, Leonard; Pløen, John

    2017-01-01

    PURPOSE/OBJECTIVE: Chemo-radiotherapy is an established primary curative treatment for anal cancer, but clinically equal rationale for different target doses exists. If joint preferences (physician and patient) are used to determine acceptable tradeoffs in radiotherapy treatment planning, multipl...... that preference-informed dose planning is feasible for clinical studies utilizing shared decision making....... dose plans must be simultaneously explored. We quantified the degree to which different toxicity priorities might be incorporated into treatment plan selection, to elucidate the feasible decision space for shared decision making in anal cancer radiotherapy. MATERIAL AND METHODS: Retrospective plans.......7%-points; (0.3; 30.6); p decision space available in anal cancer radiotherapy to incorporate preferences, although tradeoffs are highly patient-dependent. This study demonstrates...

  11. Psicose e Bates Motel: similaridades na transposição da narrativa do filme para o seriado de televisão

    Directory of Open Access Journals (Sweden)

    Rafael Jose Bona

    2016-12-01

    Full Text Available Analisa-se a transposição da narrativa cinematográfica para a televisiva em relação ao filme Psicose (1960, Alfred Hitchcock e o seriado Bates Motel (2013. Foi feito um estudo de elementos a partir da estética, da narrativa e da técnica audiovisual. A pesquisa é de caráter descritiva e analítica, com abordagem qualitativa. Como resultado foi possível obter maior entendimento na transposição de personagens do cinema para a televisão, assim como uma visão crítica a respeito das similaridades das produções audiovisuais.

  12. DE REINOS MUITO, MUITO DISTANTES, PARA AS TELAS DOS CINEMAS: AS TRANSFORMAÇÕES NOS CONTOS DE FADAS NO SÉCULO XX

    Directory of Open Access Journals (Sweden)

    Paulo Ailton Ferreira da Rosa Junior (IFSul

    2016-12-01

    Full Text Available

    Este trabalho trata-se, fundamentalmente, de uma comparação entre obras da Literatura com suas respectivas adaptações para o Cinema. Para alem disto, é um estudo crítico e analítico das transformações em três contos de fadas literários quando transpostos para narrativas fílmicas de Walt Disney. O corpus de análise, para tanto, é composto pelos textos registrados de Perrault, Grimm e Andersen em suas respectivas bibliografias e os filmes de animação “Cinderella” (1950, “Branca de Neve e os Sete Anões” (1937 e “A Pequena Sereia” (1989 que eles respectivamente inspiraram. O intuito desta análise é identificar que transformações aconteceram nestas histórias ao serem adaptadas da literatura para o cinema e problematizá-las, no entendimento de que atendem a demandas temporais, culturais e mercadológicas.

  13. Identification of episomal human papillomavirus and other DNA viruses in cytological anal samples of HIV-uninfected men who have sex with men.

    Directory of Open Access Journals (Sweden)

    Maria Gabriella Donà

    Full Text Available To date, there have been only few studies that investigated integration of anal Human Papillomavirus (HPV. Most of them were conducted on HIV-infected individuals and mainly analyzed samples from high-grade lesions and invasive cancer. We aimed to investigate HPV physical status in HIV-negative men who have sex with men (MSM with a detectable anal HPV infection, irrespective of the presence of lesions. We also sought to explore the presence of other circular DNA viruses in the anal region. Study participants were attendees of an STI screening program, which were also screened for anal HPV infection and cytological abnormalities. HPV physical status was assessed using multiply-primed RCA. HPV16-positive samples were also analyzed using E2/E6 multiplex PCR, qRT-PCR and APOT assay. RCA and virus-specific PCR were employed to investigate the presence of other DNA viruses. Anal HPV infection was detected in 76.9% of the 230 MSM enrolled. The anal cytological reports were: 129 NILM, 37 ASC-US and 28 L-SIL (36 samples were inadequate for interpretation. HPV physical status was evaluated in the 109 anal specimens that harbored one or two different HPV genotypes. Integration was observed only in one HPV16-positive sample (0.9%, in which integrate-derived viral transcripts of type B were detected. Integration occurred in chromosome 14 q. In 22 of the 53 (41.5% mucosal HPV-negative samples, RCA restriction results would seem to indicate the presence of circular DNA viruses. Indeed, cutaneous HPV (4 samples, MCPyV (5 samples and TTV (4 samples were detected. In conclusion, anal HPV integration was rarely evidenced in HIV-uninfected MSM with no or mild anal cytological abnormalities, although the integration rate may have been underestimated because of the limitations of the employed assays. Other DNA viruses were detected in the anal samples of these individuals, although the significance of this occurrence needs to be assessed.

  14. Quality of life outcomes in patients with anal cancer after combined radiochemotherapy

    International Nuclear Information System (INIS)

    Welzel, Grit; Haegele, Verena; Wenz, Frederik; Mai, Sabine Kathrin

    2011-01-01

    Purpose: To assess self-reported quality of life (QoL) experienced by anal cancer patients after radiochemotherapy, and to identify patient- and disease-related factors associated with QoL. Patients and Methods: A total of 88 patients treated for anal cancer at our institution between 1990 and 2006 were identified from our database. Of these, 15 patients had died, and 4 were lost to follow-up. QoL was assessed using the EORTC QLQ-C30 questionnaire (cancer-specific QoL) and the colorectal cancer module QLQ-CR38 (site-specific QoL); 52 responses were received. The median follow-up was 36 months (range, 5-137 months). Results: As for cancer-specific QoL, global health QoL score (mean 60.4) was similar to the general German population, whereas most of the function and symptom scale scores were considerably lower/higher in anal cancer patients. The most prominent mean score differences were observed in role functioning (-21.8 points), emotional functioning (-20.7 points), social functioning (-28.9 points), diarrhea (+34.6 points), and financial difficulties (+26.9 points; p < 0.001). As for site-specific QoL, the mean function scale scores ranged from 22.1 (sexual function) to 63.2 (body image), and the mean symptom scale scores from 14.7 (weight loss) to 69.0 (stoma-related problems, 4 patients) and 67.9 (male sexual dysfunction), respectively. Most of the QoL scores were not affected by late toxicity, patient- or disease-related factors. Fatigue (+18.2 points) emerged as the strongest predictor of impaired QoL. Conclusion: The global health QoL of anal cancer patients is comparable with that of the general German population, but there are specific limitations, e.g., sexual dysfunction, urological/gastrointestinal complaints, financial difficulties, fatigue, and a reduction in emotional and social well-being. (orig.)

  15. Quality of life outcomes in patients with anal cancer after combined radiochemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Welzel, Grit; Haegele, Verena; Wenz, Frederik; Mai, Sabine Kathrin [Universitaetsklinikum Heidelberg, Mannheim (Germany). Dept. of Radiation Oncology

    2011-03-15

    Purpose: To assess self-reported quality of life (QoL) experienced by anal cancer patients after radiochemotherapy, and to identify patient- and disease-related factors associated with QoL. Patients and Methods: A total of 88 patients treated for anal cancer at our institution between 1990 and 2006 were identified from our database. Of these, 15 patients had died, and 4 were lost to follow-up. QoL was assessed using the EORTC QLQ-C30 questionnaire (cancer-specific QoL) and the colorectal cancer module QLQ-CR38 (site-specific QoL); 52 responses were received. The median follow-up was 36 months (range, 5-137 months). Results: As for cancer-specific QoL, global health QoL score (mean 60.4) was similar to the general German population, whereas most of the function and symptom scale scores were considerably lower/higher in anal cancer patients. The most prominent mean score differences were observed in role functioning (-21.8 points), emotional functioning (-20.7 points), social functioning (-28.9 points), diarrhea (+34.6 points), and financial difficulties (+26.9 points; p < 0.001). As for site-specific QoL, the mean function scale scores ranged from 22.1 (sexual function) to 63.2 (body image), and the mean symptom scale scores from 14.7 (weight loss) to 69.0 (stoma-related problems, 4 patients) and 67.9 (male sexual dysfunction), respectively. Most of the QoL scores were not affected by late toxicity, patient- or disease-related factors. Fatigue (+18.2 points) emerged as the strongest predictor of impaired QoL. Conclusion: The global health QoL of anal cancer patients is comparable with that of the general German population, but there are specific limitations, e.g., sexual dysfunction, urological/gastrointestinal complaints, financial difficulties, fatigue, and a reduction in emotional and social well-being. (orig.)

  16. Treatment results in anal cancer: non-operative treatment versus operative treatment

    Energy Technology Data Exchange (ETDEWEB)

    Chie, Eui Kyu; Park, Jae Gahb; Bang, Yung Jue; Heo, Dae Seog; Kim, Noe Kyeong [Seoul National University College of Medicine, Seoul (Korea, Republic of); Ha, Sung Whan [Medical Reasearch Center, Seoul National University, Seoul (Korea, Republic of)

    2002-03-15

    This study was undertaken to analyze the efficacy and sphincter preservation rate of platinum based neoadjuvant chemotherapy plus radiotherapy versus abdominoperineal resection and postoperative radiotherapy for anal cancer. Data of forty-two patients with anal cancer were retrospectively analyzed. Among thirty-eight patients with epidermoid histology, four patients received radiotherapy, and nineteen patients received abdominoperineal resection and adjuvant radiotherapy with or without chemotherapy (APR + RT {+-} CT), and fifteen patients received neoadjuvant chemotherapy and radiotherapy (CRT). The CRT regimen was composed of three cycles of 5-fluorouracil (1,000 mg/m{sup 2} bolus on D1 {approx} 5) and cisplatin (60 mg/m{sup 2} bolus on D1) followed by 50.4 Gy to the tumor bed and regional lymphatics over 5.5 weeks. Both inguinal lymphatics were treated with an identical dose schedule. Residual disease was treated with an additional three cycles of identical adjuvant chemotherapy. An identical dose schedule was used for post-operative radiotherapy. Median follow-up period was eighty-five months. Overall five-year survival rates were 80.3%, 88.9% and 79.4% for entire patients, APR + RT {+-} CT group, and the CRT group, respectively. No significant difference was found between the two groups ({rho} = 0.49). Anus preservation rate for the CRT group was 86.7%. Age ({rho} = 0.0164) and performance status ({rho} = 0.0007) were found to be significant prognostic factors by univariate analysis. Age ({rho} = 0.0426), performance status ({rho} = 0.0068), and inguinal lymph node metastasis ({rho} = 0.0093) were statistically significant prognostic factors by multivariate analysis. No case of RTOG grade 3 complication or higher was reported. This and other recent studies have shown that combined chemotherapy plus radiotherapy for anal cancer results in a high rate of anal sphincter preservation as well as local control and survival. Furthermore, neoadjuvant use of

  17. El reto digital para las radios públicas y ciudadanas

    Directory of Open Access Journals (Sweden)

    José Ignacio López Vigil

    2010-09-01

    Full Text Available El cambio de la tecnología analógica a la digital ha representado ahorros, muchas de las etapas del proceso se han inmaterializado y con un solo clic se ha ahorrado horas de trabajo y esfuerzos: La forma de enviar y recibir audios, la forma de grabar y editar, la posibilidad de distribuir, el derecho a intercambiarlos, el tiempo de escucharlos. Casi todo ha cambiado, hasta ciertas barreras que antes condicionaban el ejercicio pleno de la libertad de expresión. Las nuevas tecnologías y la convergencia digital han sido aprovechadas para promover la libertad de expresión y la diversidad cultural desde las emisoras públicas y ciudadanas.

  18. Dispositivo analítico para compreensão da leitura de diferentes tipos textuais: exemplos referentes à Física Analytical device for reading comprehension of different kinds of texts: examples about Physics

    Directory of Open Access Journals (Sweden)

    Maria José P. M. de Almeida

    2011-04-01

    Full Text Available Neste artigo, articulamos noções que possibilitam a organização de um dispositivo analítico para compreensão de leituras de diferentes tipos de produção. Tecemos considerações sobre essas noções, apoiadas teoricamente na vertente da análise do discurso iniciada por Michel Pêcheux, utilizando, principalmente, publicações realizadas no Brasil por Eni Orlandi. Com o intuito de evidenciar que não se lê da mesma maneira um livro didático, um texto de divulgação científica ou um original de cientista, apresentamos exemplos referentes à Ciência, especificamente à Física. Argumentamos que essas leituras mobilizam diferentes interdiscursos, mesmo que sejam realizadas por um mesmo indivíduo, pois supõem diferentes imaginários.In this paper, we articulate notions that enable the organization of an analytical device for reading comprehension of different types of productions. Our considerations about these notions are based on discourse analysis from Michael Pêcheux through Eni P. Orlandi publications in Brazil. We present examples about Science, particularly Physics, in order to show that coursebooks, scientific popularization or scientists' original publications are not read in the same way. Even if the readings are performed by the same individual, we argue that these readings mobilize different interdiscourses asthey assume different imaginary.

  19. Doenças anais concomitantes à doença hemorroidária: revisão de 1.122 pacientes Anal diseases associated to hemorrhoids: review of 1.122 patients

    Directory of Open Access Journals (Sweden)

    Geraldo Magela Gomes da Cruz

    2006-12-01

    Full Text Available Em 34.000 pacientes coloproctológicos foi feito o diagnóstico de doença hemorroidária (DH, como doença coloproctológica principal, em 9.289 pacientes (27,3%, dos quais 1.122 (12,1% eram portadores de doenças anais concomitantes à DH (DAC. Dos 9.289 portadores de DH, 2.417 foram operados de DH (26,0% e destes, 729 foram operados, ao mesmo tempo, de DAC (30,2%. Assim, dos 1.122 portadores de DAC, 729 foram operados delas (65,0%. Em relação aos 9.289 portadores de DH, a DAC mais comum foi a fissura anal (541 casos, 5,8%, seguida de hipertrofia de papilas anais (312 casos, 3,4%, fístulas anais (117 casos, 1,3%, hipotonia anal com incontinência parcial (112 casos, 1,2%, condilomas anais acuminados (37 casos, 0,4% e tumores anais (3 casos, 0,03%; e a mesma ordem foi verificada em relação às 1.122 DAC: fissura anal (48,2%, hipertrofia de papilas anais (27,8%, fístulas anais (10,4%, hipotonia anal com incontinência parcial (10,0%, condilomas anais acuminados (3,3% e tumores anais (0,3%. Em relação à cirurgia, das 1.122 DAC 729 foram operadas (65,0% nesta ordem: fissura anal (317 casos, 28,3%, hipertrofia de papilas anais (267 casos, 23,8%, fístulas anais (89 casos, 7,9%, hipotonia anal com incontinência parcial (31 casos, 2,8%, condilomas anais acuminados (22 casos, 1,9% e tumores anais (3 casos 0,3%; e em relação às próprias DAC as incidências de cirurgias foram: tumor anal (100,0%, hipertrofia de papilas anais (85,6%, fístulas anais (76,0%, condilomas anais acuminados (59,6%, fissuras anais (58,6% e hipotonia com incontinência anal parcial (25,8%. A confirmação dos diagnósticos das DAC pelo exame histopatológico foi de 72,8%, em ordem decrescente: condilomas anais e fístulas anais (100,0%, hipertrofia de papilas anais (79,0%, fissuras anais (68,5% e tumores anais (66,7%.In a 38-year period of practice in Coloproctology, the author had the opportunity to attend 34,000 patients and the diagnosis of hemorrhoid as the

  20. Congenital anorectal atresia: MR imaging of late post-operative appearances in adult patients with anal incontinence

    International Nuclear Information System (INIS)

    Gartner, Louise; Peiris, Chand; Marshall, Michele; Taylor, Stuart A.; Halligan, Steve

    2013-01-01

    To describe the MR imaging findings in adults presenting with anal incontinence following pull-through perineoplasty for anorectal atresia. 15 adults (12 male, 3 female; age 22-52 years) with anal incontinence following a prior perineal pull-through procedure as an infant for anorectal atresia were identified retrospectively. MR imaging was performed using either an endoanal coil or body coil. MR images were reviewed by three observers who noted whether pelvic floor and sphincter muscles were present and, if so, whether they were thinned or not. Data were tabulated and raw frequencies determined. Images were unavailable for one patient, leaving 14 for analysis. Anal stenosis prevented endoanal coil placement in 5. The pull-through was anatomically correct in 12 (86 %) patients but was misdirected in 2. Thinned muscle was seen in 11 (79 %) patients. External sphincter thinning was commonest (present in 10 patients), with levator plate thinning least common (present in 4 patients). Only one patient had thinning of all muscle groups. MR imaging may be used to determine the extent and quality of residual pelvic floor and anal sphincter muscle in adults who have functional disability following pull-through perineoplasty for anorectal agenesis. (orig.)

  1. High rates of incident and prevalent anal human papillomavirus infection among young men who have sex with men.

    Science.gov (United States)

    Glick, Sara Nelson; Feng, Qinghua; Popov, Viorica; Koutsky, Laura A; Golden, Matthew R

    2014-02-01

    There are few published estimates of anal human papillomavirus (HPV) infection rates among young men who have sex with men (YMSM). We estimated incidence and prevalence of type-specific anal HPV infection using clinician-collected anal swabs for HPV DNA testing obtained during a 1-year prospective study of 94 YMSM (mean age, 21 years) in Seattle. Seventy percent of YMSM had any HPV infection detected during the study, and HPV-16 and/or -18 were detected in 37%. The incidence rate for any new HPV infection was 38.5 per 1000 person-months and 15.3 per 1000 person-months for HPV-16/18; 19% had persistent HPV-16/18 infection. No participant tested positive for all 4 HPV types in the quadrivalent vaccine. The number of lifetime male receptive anal sex partners was significantly associated with HPV infection. The prevalence of HPV-16/18 was 6% among YMSM with a history of 1 receptive anal sex partner and 31% among YMSM with ≥ 2 partners. Although the high prevalence of HPV among YMSM highlights the desirability of vaccinating all boys as a strategy to avert the morbidity of HPV infection, most YMSM appear to remain naive to either HPV-16 or -18 well into their sexual lives and would benefit from HPV immunization.

  2. Influence of human papillomavirus and p16INK4a on treatment outcome of patients with anal cancer

    International Nuclear Information System (INIS)

    Koerber, Stefan Alexander; Schoneweg, Clara; Slynko, Alla; Krug, David; Haefner, Matthias F.; Herfarth, Klaus; Debus, Juergen; Sterzing, Florian; Knebel Doeberitz, Magnus von

    2014-01-01

    Background: The purpose of this study was to evaluate HPV-DNA and p16 INK4a (p16) expression as prognostic markers for outcome in patients with anal cancer. Methods: From January 2000 to December 2011 a cohort of 105 anal cancer patients was treated with definitive chemoradiation at our institution. Tumor biopsies from 90 patients were analyzed for HPV-DNA by polymerase chain reaction and for p16 expression by immunohistochemistry. Results: Median follow-up was 48.6 months (range 2.8–169.1 months). HPV-DNA or p16-expression was found in 75 anal cancers each (83.3%), concordance was detectable in 70 tumors (77.8%). Significantly improved overall survival (OS) [77.1% vs. 51.4%, p = 0.005], progression-free survival (PFS) [64.0% vs. 35.0%, p < 0.001] and improved local control [81.0% vs. 55.9%, p = 0.023] was found for concomitant HPV- and p16-positive anal carcinomas (cHPPAC) in univariate analysis. Multivariate analysis showed better OS [p = 0.015] and PFS [p = 0.002] for cHPPAC. Conclusion: The combination of HPV-DNA and p16 can be used as an independent prognostic parameter in anal cancer patients

  3. [Evaluation of the quality of Anales Españoles de Pediatría versus Medicina Clínica].

    Science.gov (United States)

    Bonillo Perales, A

    2002-08-01

    To compare the scientific methodology and quality of articles published in Anales Españoles de Pediatría and Medicina Clínica. A stratified and randomized selection of 40 original articles published in 2001 in Anales Españoles de Pediatría and Medicina Clínica was made. Methodological errors in the critical analysis of original articles (21 items), epidemiological design, sample size, statistical complexity and levels of scientific evidence in both journals were compared using the chi-squared and/or Student's t-test. No differences were found between Anales Españoles de Pediatría and Medicina Clínica in the critical evaluation of original articles (p > 0.2). In original articles published in Anales Españoles de Pediatría, the designs were of lower scientific evidence (a lower proportion of clinical trials, cohort and case-control studies) (17.5 vs 42.5 %, p 0.05), sample sizes were smaller (p 0.003) and there was less statistical complexity in the results section (p 0.03). To improve the scientific quality of Anales Españoles de Pediatría, improved study designs, larger sample sizes and greater statistical complexity are required in its articles.

  4. Marco para el análisis del tema ecológico en la literatura venezolana

    OpenAIRE

    María De los Ángeles Martín Hernández

    2016-01-01

    El propósito del artículo es sistematizar las premisas teóricas que constituyen la base fundamental para el abordaje analítico de los textos literarios con tema ecológico. Se conjugan y sintetizan los planteamientos hallados en la revisión bibliográfica realizada, relacionados con definiciones y caracterizaciones de la vinculación actividad literaria-tema ecológico en el contexto venezolano; se organizan consideraciones que explican la adopción del adjetivo “ecológico” y las vinculaciones eco...

  5. Sintomas e fatores de risco para asma entre escolares piauienses Síntomas y factores de riesgo para el asma entre escolares piauienses Symptoms and risk factors for asthma among piauiense schoolchildren

    OpenAIRE

    Gessianne Carvalho Castro; Lívia Kênia de Carvalho Sousa; Paula Valentina de Sousa Vera; Luisa Helena de Oliveira Lima; Edina Araújo Rodrigues Oliveira; Rúbia Fernanda Santos Lima; Luis Fernando Beserra Magalhães; Nileide Lima Araújo; Marcos Venícios de Oliveira Lopes

    2012-01-01

    OBJETIVOS: Analisar a prevalência de sintomas de asma entre escolares de seis a sete anos do município de Picos-PI; e identificar fatores de risco associados à doença. MÉTODOS: Estudo transversal realizado com crianças de 6 e 7 anos de Picos em novembro de 2010 a maio de 2011. Para coletar os dados, foi utilizado um formulário adaptado do Internacional Study of Asthma and Allergies in Childhood. Os dados foram analisados com base na estatística descritiva e analítica. RESULTADOS: Dentre as 23...

  6. Anal lymphogranuloma venereum infection screening with IgA anti-Chlamydia trachomatis-specific major outer membrane protein serology.

    Science.gov (United States)

    de Vries, Henry J C; Smelov, Vitaly; Ouburg, Sander; Pleijster, Jolein; Geskus, Ronald B; Speksnijder, Arjen G C L; Fennema, Johannes S A; Morré, Servaas A

    2010-12-01

    Anal lymphogranuloma venereum (LGV) infections, caused by Chlamydia trachomatis biovar L (Ct+/LGV+), are endemic among men who have sex with men (MSM). Anal non-LGV biovar Ct infections (Ct+/LGV-) can be eradicated with 1 week doxycycline, whereas Ct+/LGV+ infections require 3-week doxycycline. To differentiate Ct+/LGV+ from Ct+/LGV- infections, biovar-specific Nucleic Acid Amplification Test (NAAT) are standard, but also expensive and laborious. A chlamydia-specific serological assay could serve as an alternative test. MSM were screened for anal Ct+/LGV+ and Ct+/LGV- infections with a commercial nonspecific NAAT and an in house biovar L-specific NAAT. Serum samples were evaluated with chlamydia-specific anti-Major Outer Membrane Protein (MOMP) and antilipopolysaccharide assays of IgA and IgG classes. Asymptomatic patients were identified as: (1) no anal complaints or (2) no microscopic inflammation (i.e., <10 leucocytes per high power field in anal smears). The best differentiating assay was subsequently evaluated in 100 Ct+/LGV+ and 100 Ct+/LGV- MSM using different cut-off points. The anti-MOMP IgA assay was the most accurate to differentiate Ct+/LGV+ (n = 42) from Ct+/LGV- (n = 19) with 85.7% sensitivity (95% confidence interval [CI], 72.2-93.3) and 84.2% specificity (95% CI, 62.4-94.5), even among asymptomatic patients. In a population comprising 98 Ct+/LGV+ and 105 Ct+/LGV- patients, the anti-MOMP IgA assay scored most accurate when the cut-off point was set to 2.0 with 75.5% (95% CI, 65.8-83.6) sensitivity and 74.3% (95% CI, 64.8-82.3) specificity. The IgA anti-MOMP assay can identify a considerable proportion of the (asymptomatic) anal LGV infections correctly. Yet, biovar L-specific NAAT are still the preferred diagnostic tests in clinical settings.

  7. The diagnostic accuracy of endovaginal and transperineal ultrasound for detecting anal sphincter defects: The PREDICT study.

    Science.gov (United States)

    Roos, A-M; Abdool, Z; Sultan, A H; Thakar, R

    2011-07-01

    To determine the accuracy and predictive value of transperineal (TPU) and endovaginal ultrasound (EVU) in the detection of anal sphincter defects in women with obstetric anal sphincter injuries and/or postpartum symptoms of faecal incontinence. One hundred and sixty-five women were recruited, four women were excluded as they were seen years after their last delivery. TPU and EVU, followed by endonanal ultrasound (EAU), were performed using the B&K Viking 2400 scanner. Sensitivity and specificity, as well as predictive values with 95% confidence intervals, for detecting anal sphincter defects were calculated for EVU and TPU, using EAU as the reference standard. On EAU a defect was found in 42 (26%) women: 39 (93%) had an external (EAS) and 23 (55%) an internal anal sphincter (IAS) defect. Analysable images of one level of the EAS combined with an analysable IAS were available in 140 (87%) women for EVU and in 131 (81%) for TPU. The sensitivity and specificity for the detection of any defect was 48% (30-67%) and 85% (77-91%) for EVU and 64% (44-81%) and 85% (77-91%) for TPU, respectively. Although EAU using a rotating endoprobe is the validated reference standard in the identification of anal sphincter defects, it is not universally available. However while TPU and/or EVU with conventional ultrasound probes can be useful in identifying normality, for clinical purposes they are not sensitive enough to identify an underlying sphincter defect. Copyright © 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  8. Pelvic floor ultrasound and anal incontinence in primiparous women

    DEFF Research Database (Denmark)

    Sakse, Abelone Elisabeth

    2010-01-01

    Afhandlingen havde til formål at undersøge muskulære forandringer på bækkenbundsmuskulaturen i relation til første fødsel, med særligt fokus på anal inkontinens. Forsvaret fandt sted d. 10. september 2010 kl. 14:00 i Auditoriet på Hvidovre Hospital.   ...

  9. Penile duplication and two anal openings; report of a very rare case.

    Science.gov (United States)

    Bakheet, Mohamed Abdel Al M; Refaei, Mohammad

    2012-03-01

    Penile duplication (diphallus) is an extremely rare disorder. It is almost always associated with other malformations like double bladder, exstrophy of the cloacae, imperforate anus, duplication of the rectosigmoid and vertebral deformities. Meanwhile anal canal duplication, the most distal and least common duplication of the digestive tube and is a very rare congenital malformation. A 21 days old Egyptian neonate is reported with complete penile duplication and two scrotums with each one carrying two palpable testes. Both penises have normal shaft with normally located meatus. Clear urine voids from both meati spontaneously. The child had also a fold of redundant skin about 4×5 cm at the anal region in which two separate anal openings are present. In rectal examination we found two normal anuses passing stool spontaneously. Ascending (voiding) cystourethrography revealed two penises with two separate meatuses and one bladder from which the two urethras go out separately. Intravenous pyelogram (IVP) revealed two normal kidneys and ureters. Barium study revealed duplication of rectum and colon, otherwise normal GIT. In our review of the literature, we did not come across any other case of this variety of the penile duplication and congenital presence of two anuses. Unfortunately the patient expired before any surgical correction.

  10. Is dynamic two-dimensional anal ultrasonography useful in the assessment of anismus? A comparison with manometry

    Directory of Open Access Journals (Sweden)

    Sthela Maria Murad-Regadas

    2010-12-01

    Full Text Available CONTEXT: Anismus is a prevalent functional cause of outlet delay. It is characterized by symptoms of obstructed defecation associated with paradoxical contraction of the pelvic floor muscles. OBJECTIVE: To evaluate the ability of two dimensional anal ultrasonography to identify anismus patients with paradoxical contraction or normal relaxation, comparing findings with manometric measurements. METHODS: Forty-nine women presenting with outlet delay and a mean validated Wexner constipation score of 13.5 were included in a prospective study. Following screening with anal manometry, the patients were assigned to one of two groups: G-I -with normal relaxation and G-II -patients with anismus. Dynamic anorectal ultrasonography was used to quantifier the movement of the puborectalis muscle and to measure changes in the angle between two converging lines drawn from the 3 o'clock and the 9 o'clock positions of the endoprobe circumference to the internal border of the puborectalis muscle. The angle decreases during straining in patients with normal relaxation, but increases in patients with anismus. The agreement between the two techniques was verified with the Kappa index. RESULTS: In manometry, during straining the anal canal pressure decreased by 41.3% in G-I and increased by 168.6% in G-II, indicating a diagnosis of anismus for the second group. In US, during straining, the angle produced by the movement of the puborectalis muscle decreased from 63 ± 1.31 to 58 ± 1.509 degrees (P = 0.0135 in 23 of the 30 patients in G-I, indicating normal relaxation, and increased from 66 ± 0.972 to 72 ± 0.897 degrees (P = 0.0001 in 16 of the 19 patients in G-II, indicating anismus. The index of agreement between manometry and two dimensional anal ultrasonography was moderate: 77% (23/30 for G-I and 84% (16/19 for G-II. CONCLUSION: Two-dimensional dynamic anal ultrasonography showed similar results previously suggested by anal manometry at identifying patients with

  11. Is dynamic two-dimensional anal ultrasonography useful in the assessment of anismus? A comparison with manometry.

    Science.gov (United States)

    Murad-Regadas, Sthela Maria; Regadas, Francisco Sérgio P; Barreto, Rosilma Gorete Lima; Rodrigues, Lusmar Veras; Fernandes, Graziela Olivia da Silva; Lima, Doryane Maria dos Reis

    2010-01-01

    Anismus is a prevalent functional cause of outlet delay. It is characterized by symptoms of obstructed defecation associated with paradoxical contraction of the pelvic floor muscles. To evaluate the ability of two dimensional anal ultrasonography to identify anismus patients with paradoxical contraction or normal relaxation, comparing findings with manometric measurements. Forty-nine women presenting with outlet delay and a mean validated Wexner constipation score of 13.5 were included in a prospective study. Following screening with anal manometry, the patients were assigned to one of two groups: G-I -with normal relaxation and G-II -patients with anismus. Dynamic anorectal ultrasonography was used to quantifier the movement of the puborectalis muscle and to measure changes in the angle between two converging lines drawn from the 3 o'clock and the 9 o'clock positions of the endoprobe circumference to the internal border of the puborectalis muscle. The angle decreases during straining in patients with normal relaxation, but increases in patients with anismus. The agreement between the two techniques was verified with the Kappa index. In manometry, during straining the anal canal pressure decreased by 41.3% in G-I and increased by 168.6% in G-II, indicating a diagnosis of anismus for the second group. In US, during straining, the angle produced by the movement of the puborectalis muscle decreased from 63 ± 1.31 to 58 ± 1.509 degrees (P = 0.0135) in 23 of the 30 patients in G-I, indicating normal relaxation, and increased from 66 ± 0.972 to 72 ± 0.897 degrees (P = 0.0001) in 16 of the 19 patients in G-II, indicating anismus. The index of agreement between manometry and two dimensional anal ultrasonography was moderate: 77% (23/30) for G-I and 84% (16/19) for G-II. Two-dimensional dynamic anal ultrasonography showed similar results previously suggested by anal manometry at identifying patients with normal relaxation or paradoxical contraction.

  12. Validación del método analítico para el control de la calidad y el estudio de estabilidad del neolimpilen Validation of the analytical method for the quality control and the stability study of neolimpilem

    Directory of Open Access Journals (Sweden)

    Caridad M García Peña

    2004-08-01

    Full Text Available Se validó el método analítico desarrollado para el control de la calidad y el estudio de estabilidad en la cuantificación de hidroxipropilmetilcelulosa y laurilsulfato de sodio por espectrofotometría con detección ultravioleta a 635 y 650 nm respectivamente. Además, se presentan los resultados analíticos del estudio de estabilidad realizado a la solución para la limpieza y conservación de lentes de contacto rígidos (neolimpilen, con el empleo de 3 lotes envasados en 2 frascos diferentes realizando el estudio por estabilidad acelerada y vida de estante; se comprueba la estabilidad física y química de la solución por espacio de 24 meses a temperatura ambiente. En la validación de la hidroxipropilmetilcelulosa, la curva de calibración en el rango de 0,06 a 0,18 mg/mL se comportó de forma lineal con un coeficiente de correlación igual a 0,99581; la prueba estadística para el intercepto y la pendiente resultó no significativa. Se obtuvo un recobrado del 99,8 % en el rango de concentración estudiado y las pruebas de Cochran´(G y Student´s (t resultaron no significativas. El coeficiente de variación en la repetibilidad se comportó igual a 0,9 % para 10 réplicas ensayadas, mientras que en la reproducibilidad las pruebas de Fischer y Student fueron no significativas. El método resultó específico, lineal, preciso y exacto. Mientras que en la validación del laurilsulfato de sodio la curva de calibración en el rango de 1,44 a 3,0 mg/mL se comportó de forma lineal con un coeficiente de correlación igual a 0,99036; la prueba estadística para el intercepto y la pendiente fue no significativa. Se obtuvo un recobrado del 99,9 % en el rango de concentración estudiado y las pruebas de Cochran´(G y Student´s (t resultaron no significativas. El coeficiente de variación en la repetibilidad se comportó igual a 0,8 % para 8 réplicas ensayadas, mientras que en la reproducibilidad las pruebas de Fischer y Student fueron no

  13. MARCO CONCEITUAL PARA O ESTUDO DO DISTRESSE MORAL EM ENFERMEIROS

    Directory of Open Access Journals (Sweden)

    Flávia Regina Souza Ramos

    2016-01-01

    Full Text Available Estudio reflexivo orientado a proponer elementos conceptuales para la análisis de la angustia moral como un proceso que articula diversos conceptos de la experiencia moral. La angustia moral como fenómeno que se manifiesta es explotada en varios escenarios y dimensiones laborales - cuidado, de gestión y de educación. A pesar de un concepto relativamente consensual y resultados empíricos comparables en varios países, existen pocos estudios que exploran las lagunas teóricas, puntos críticos y las posibilidades de ampliar el potencial analítico. En la búsqueda de apoyos teóricos consistentes y actualizados a las necesidades cambiantes del campo, el estado de la técnica se ha tomado y un marco conceptual fue diseñado para hacer frente a la angustia moral como un proceso que articula diversos conceptos o momentos de la experiencia moral, como la incertidumbre, la sensibilidad deliberación moral y moral. La matriz propuesta se articula el proceso de desarrollo de la competencia moral o construcción del sujeto ético, presente en los discursos pedagógicos y filosóficos de interés para la profesión.

  14. Has F.D.G. PET/CT an impact on the management of patients with anal carcinoma?

    International Nuclear Information System (INIS)

    Vercellino, L.; Nataf, V.; Kerrou, K.; Huchet, V.; Pascal, O.; Montravers, F.; Talbot, J.N.; De Parades, V.; Bauer, P.; Touboul, E.

    2010-01-01

    Purpose: To evaluate the impact of F.D.G. PET/C Ton the management of patients referred for the staging and/or the follow-up of anal carcinoma, and PET/CT on patient management. Patients and methods: We included patients referred to our department for anal carcinoma whose therapeutic management was evaluable thanks to follow-up data during at least 6 months. Results: Data of 44 patients were analysed: 22 had PET/CT for initial staging and 36 during follow-up. PET/CT had impact in nine patients out of 44 (20%) and it was relevant in eight of them. Conclusion: F.D.G. PET/CT is an accurate imaging modality in anal cancer, its impact on patient management is more obvious when persistence or recurrence of disease is suspected. (authors)

  15. Diseño de un reactor de transesterificación para la obtención de biodiesel a partir de aceites vegetales

    OpenAIRE

    MARSET GIMENO, DAVID

    2016-01-01

    [ES] En este proyecto se pretende que el alumno realice el diseño, montaje y puesta a punto un reactor de transesterificación de laboratorio para la obtención de biodiesel a partir de aceites vegetales, utilizando catálisis básica homogénea. Paralelamente se definirán las técnicas analíticas a emplear para el control de la calidad de los aceites de partida y el seguimiento de los productos de reacción. A partir de los resultados experimentales se realizará el diseño y estimación económica...

  16. Anal HPV genotypes and related displasic lesions in Italian and foreign born high-risk males.

    Science.gov (United States)

    Orlando, Giovanna; Beretta, Rosangela; Fasolo, M Michela; Amendola, Antonella; Bianchi, Silvia; Mazza, Francesca; Rizzardini, Giuliano; Tanzi, Elisabetta

    2009-05-29

    Anal intraepithelial neoplasia and anal cancer are closely related to infection from high-risk Human Papilloma Virus (HPV) genotypes. Since HPVs involved in disease progression are reported to vary by geographical regions, this study focuses on HPV genotypes spectrum in 289 males attending a Sexual Transmitted Diseases (STD) unit according to their nationality. Anal cytology, Digene Hybrid Capture Assay (HC2) and HPV genotyping were evaluated in 226 Italian (IT) and 63 foreign born (FB) subjects, recruited between January 2003 and December 2006. FB people were younger (median 32y-IQR 27-35 vs 36y-IQR 31-43, respectively; Mann-Whitney test por=atypical squamous cells of undetermined significance (ASCUS)) on anal cytology (95.0% vs 84.04%) (p=0.032; OR 3.61; 95% CI 1.04-1.23). HPV-16 is by far the most common genotype found in anal cytological samples independently from nationality while differences in distribution of other HPV genotypes were observed. The probability of infection from high-risk HPVs was higher in FB (OR 1.69; 95% CI 1.07-2.68) and is due to a higher rate of HPV-58 (OR 4.98; 95% CI 2.06-12.04), to a lower rate of HPV-11 (OR 0.35; 95% CI 0.16-0.77), to the presence of other high-risk genotypes (HPV-45, HPV-66, HPV-69). Multiple infections rate was high and comparable between IT and FB people. The relative contribution of each HPV genotype in the development of pre-neoplastic disease to an early age in the FB group cannot be argued by this study and more extensive epidemiological evaluations are needed to define the influence of each genotype and the association with the most prevalent high-risk HPVs on cytological intraepithelial lesions development.

  17. Rectal squamous cell carcinoma in immunosuppressed populations: is this a distinct entity from anal cancer?

    Science.gov (United States)

    COGHILL, Anna E.; SHIELS, Meredith S.; RYCROFT, Randi K.; COPELAND, Glenn; FINCH, Jack L.; HAKENEWERTH, Anne M.; PAWLISH, Karen S.; ENGELS, Eric A.

    2015-01-01

    Objective Squamous cell carcinoma (SCC) of the rectum is rare, but as with anal cancer, risk may be increased among immunosuppressed individuals. We assessed risk of rectal SCC in HIV-infected people. Design Population-based registry Methods We utilized the HIV/AIDS Cancer Match, a linkage of US HIV and cancer registries (1991–2010), to ascertain cases of anal SCC, rectal SCC, rectal non-SCC, and colon non-SCC. We compared risk in HIV-infected persons to the general population using standardized incidence ratios (SIRs) and evaluated risk factors using Poisson regression. We reviewed cancer registry case notes to confirm site and histology for a subset of cases. Results HIV-infected persons had an excess risk of rectal SCC compared to the general population (SIR=28.9; 95%CI 23.2–35.6), similar to the increase for anal SCC (SIR=37.3). Excess rectal SCC risk was most pronounced among HIV-infected men who have sex with men (MSM, SIR=61.2). Risk was not elevated for rectal non-SCC (SIR=0.88) or colon non-SCC (SIR=0.63). Individuals diagnosed with AIDS had higher rectal SCC rates than those with HIV-only (incidence rate ratio=1.86; 95%CI 1.04–3.31). Based on available information, one-third of rectal SCCs were determined to be misclassified anal cancer. Conclusions HIV-infected individuals, especially with advanced immunosuppression, appear to have substantially elevated risk for rectal SCC. As for anal SCC, rectal SCC risk was highest in MSM, pointing to involvement of a sexually transmitted infection such as human papillomavirus. Site misclassification was present, and detailed information on tumor location is needed to prove that rectal SCC is a distinct entity. PMID:26372482

  18. Oral and Anal Vaccination Confers Full Protection against Enteric Redmouth Disease (ERM) in Rainbow Trout

    Science.gov (United States)

    Ohtani, Maki; Strøm, Helene Kragelund; Raida, Martin Kristian

    2014-01-01

    The effect of oral vaccines against bacterial fish diseases has been a topic for debate for decades. Recently both M-like cells and dendritic cells have been discovered in the intestine of rainbow trout. It is therefore likely that antigens reaching the intestine can be taken up and thereby induce immunity in orally vaccinated fish. The objective of this project was to investigate whether oral and anal vaccination of rainbow trout induces protection against an experimental waterborne infection with the pathogenic enterobacteria Yersinia ruckeri O1 biotype 1 the causative agent of enteric redmouth disease (ERM). Rainbow trout were orally vaccinated with AquaVac ERM Oral (MERCK Animal Health) or an experimental vaccine bacterin of Y. ruckeri O1. Both vaccines were tested with and without a booster vaccination four months post the primary vaccination. Furthermore, two groups of positive controls were included, one group receiving the experimental oral vaccine in a 50 times higher dose, and the other group receiving a single dose administered anally in order to bypass the stomach. Each group was bath challenged with 6.3×108 CFU/ml Y. ruckeri, six months post the primary vaccination. The challenge induced significant mortality in all the infected groups except for the groups vaccinated anally with a single dose or orally with the high dose of bacterin. Both of these groups had 100% survival. These results show that a low dose of Y. ruckeri bacterin induces full protection when the bacterin is administered anally. Oral vaccination also induces full protection, however, at a dose 50 times higher than if the fish were to be vaccinated anally. This indicates that much of the orally fed antigen is digested in the stomach before it reaches the second segment of the intestine where it can be taken up as immunogenic antigens and presented to lymphocytes. PMID:24705460

  19. Fecal incontinence, sexual complaints, and anorectal function after third-degree obstetric anal sphincter injury (OASI): 5-year follow-up

    NARCIS (Netherlands)

    Visscher, A.P.; Lam, T.J.; Hart, N.; Felt-Bersma, R.

    2014-01-01

    Introduction and hypothesis: Our aim was to evaluate alterations in anorectal function after anal sphincteroplasty for third-degree obstetric anal sphincter injury (OASI) in relation to clinical outcome. Methods: In this retrospective, descriptive, cross-sectional study conducted between 1998 and

  20. Comparison of botox and lateral internal sphincterotomy treatment outcomes in chronic anal fissures

    Directory of Open Access Journals (Sweden)

    Tolga Dinç

    2014-03-01

    Full Text Available Objective: Both botox and lateral internal sfinkterotomi are treatment technics used in chronic anal fissure; provide the relaxation of anal sphincter and as a result of this, healing occurs. Aim of this study is to compare efficacy of botox and LIS treatment in chronic anal fissure and discussing with the literature. Methods: 60 of 66 patients who has chronic anal fissure, that we reached, treated but not healed with medical therapy, appealed to the Dr. Sami Ulus Hospital included the study. Gender, age, fissure localization, complaints (pain, bleeding, itching, constipation, complaint length, recurrences after treatment, continence conditions and complications of patients were registered. Results: Sixty patients were enrolled the study. Of the 60 patients; 38(63.3% were male and 22 (27.7% were female. Mean age of all patients was 35.93 ± 11.45 (21 -60. Pain was the common complaint of the all patients. 10 (32.3% recurrence were detected in botox treatment group (Group-I, only 1 (3.4% recurrence was in LIS group (Group-II. There was no complication as an incontinence in group-I but 3 cases with incontinence (10.39% were obtained in group-II. In the evaluation of these 3 cases by Cleveland Clinic Continence Scoring System, 2 cases classified as gas incontinence and 1 case as moderate fecal incontinence. Conclusion: Although botulinum toxin injection seen as an alternative treatment method with low complication rates such as incontinence, high recurrence is an important shortcoming of this technic. LIS performed by experienced surgeons remained the most popular treatment modality with low complication rates and great deal of healing success.