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Sample records for sangrado transvaginal durante

  1. Sangrado transvaginal durante el embarazo, como factor de riesgo para isoinmunización al antígeno Rhesus-D Transvaginal bleeding during pregnancy associated with Rhesus-D isoimmunization

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    Edgar Hernández-Andrade

    2003-12-01

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

  2. Evaluación del puntaje de sangrado “CRUSADE” como prueba diagnóstica para determinar sangrado mayor en pacientes con síndrome coronario agudo sin elevación del ST

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    Fernán Mendoza, MD

    2014-01-01

    Conclusiones: el punto de corte para el puntaje “CRUSADE” propuesto, es mayor o igual a 35. Dada la importancia de realizar una estratificación del riesgo de sangrado, estos resultados sirven para recomendar la implementación sistemática del puntaje de sangrado “CRUSADE”, y si este es mayor o igual a 35, establecer las recomendaciones para disminuir el riesgo de sangrado, y por ende, la morbilidad y la mortalidad.

  3. Transvaginal ultrasonography of rectal endometriosis

    DEFF Research Database (Denmark)

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

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

  4. Transvaginal Appendectomy: A Systematic Review

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    Mehmet Ali Yagci

    2014-01-01

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

  5. Malformación vascular intraósea en el maxilar que se presenta en forma de sangrado gingival Intra-osseous vascular malformation in the maxilla

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    Naveenjayakumar

    2009-12-01

    Full Text Available Las malformaciones arterio-venosas intraóseas (MAVs en la región maxilofacial son entidades clínicas poco frecuentes. Ofrecen una amplia gama de presentación clínica y no siempre se diagnostican sin sorpresa. El tratamiento de estas lesiones siempre ha representado un reto para el cirujano debido a su intensa vascularización y a la elevada incidencia de recurrencia. Se presenta el caso de una malformación arterio-venosa intraósea en el maxilar superior que se manifiesta como sangrado gingival, cuyos exámenes radiológicos de rutina no fueron concluyentes. Se llevó a cabo la excisión quirúrgica y el empaquetado del hueso con cera, y se realizó el seguimiento del paciente durante 1 año sin que se produjera recurrencia. Las malformaciones vasculares deben tenerse en consideración en el diagnóstico diferencial del sangrado gingival con radiografías dentales no concluyentes.Intraosseous arterio-venous malformations (AVM in the maxillofacial region are rare clinical entities. They have a wide range of clinical presentation and are not always diagnosed without a surprise. Treatment of these lesions has always been a challenge to the surgeon due to extreme vascularity and the high recurrence rate. The case presented is that of an intraosseous arterio-venous malformation in the maxilla that started as gingival bleeding and routine radiographic examinations were inconclusive. Surgical excision and bone wax packing was performed there were no recurrences during 1-year of follow-up. Vascular malformations may be considered in differential diagnosis of gingival bleeding with inconclusive dental radiographs.

  6. Colecistectomía transvaginal (NOTES combinada con minilaparoscopia Transvaginal cholecystectomy (NOTES combined with minilaparoscopy

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    C. Dolz

    2007-12-01

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

  7. Sexual function after transvaginal cholecystectomy

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

    2014-01-01

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

  8. Confirmation of Essure placement using transvaginal ultrasound

    NARCIS (Netherlands)

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

    2011-01-01

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

  9. Prolapse Recurrence after Transvaginal Mesh Removal.

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

    2015-11-01

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

  10. Transvaginal mesh procedures for pelvic organ prolapse.

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    Walter, Jens-Erik

    2011-02-01

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

  11. Importancia clínica del sangrado en pacientes con intervencionismo coronario percutáneo por vía radial en el CIMEQ

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    Myder Hernández Navas

    2015-10-01

    Full Text Available Introducción: Las complicaciones por sangrado después de una intervención coronaria percutánea se asocian con un mayor riesgo de morbilidad y mortalidad. El acceso radial ha demostrado consistentemente la reducción de estos riesgos. A pesar de su uso en nuestro país, aun es escasa la evidencia sobre su repercusión con relación a la disminución del sangrado y sus complicaciones.Objetivo: Determinar la importancia clínica del sangrado en los pacientes con intervencionismo coronario percutáneo por vía radial en el CIMEQ.Método: Se realizó un estudio observacional, descriptivo con 217 pacientes, a quienes se les realizó una intervención coronaria percutánea por acceso radial en el laboratorio de hemodinámica del Cardiocentro CIMEQ, entre el 2009 y el 2013. Se determinó y clasificó el sangrado, así como el tipo de lesión tratada, se exploraron los antecedentes patológicos personales y la presencia de complicaciones.Resultados: Predominó el sexo masculino (78,3 % y la media de edad fue de 62,2 años. Hubo mayor incidencia de fumadores (62,7 % e hipertensos (54,4 % y solo 6 casos (2,8 % de sangrado leve en forma de hematoma en el sitio de acceso. La mitad de los pacientes con hematoma presentaba lesiones tipo C, sin existir asociación significativa entre estas dos variables (p=0.203. El sangrado solo se asoció significativamente con la pérdida del pulso radial (p<0.001.Conclusiones: Los pacientes intervenidos por vía radial en el CIMEQ presentaron una baja incidencia de sangrado, sin complicaciones asociadas de gravedad.

  12. Pure transvaginal excision of mesh erosion involving the bladder.

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    Firoozi, Farzeen; Goldman, Howard B

    2013-06-01

    We present a pure transvaginal approach to the removal of eroded mesh involving the bladder secondary to placement of transvaginal mesh for management of pelvic organ prolapse (POP) using a mesh kit. Although technically challenging, we demonstrate the feasibility of a purely transvaginal approach, avoiding a potentially more morbid transabdominal approach. The video presents the surgical technique of pure transvaginal excision of mesh erosion involving the bladder after mesh placement using a prolapse kit was performed. This video shows that purely transvaginal removal of mesh erosion involving the bladder can be done safely and is feasible.

  13. Transvaginal ultrasound during pregnancy: Perception and ...

    African Journals Online (AJOL)

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

  14. Confirmation of Essure placement using transvaginal ultrasound.

    Science.gov (United States)

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

    2011-01-01

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

  15. Transvaginal sonography of acute pelvic inflammatory disease

    International Nuclear Information System (INIS)

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

    1999-01-01

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

  16. Transvaginal ultrasound ovarian diathermy: sheep as an experimental model

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    Pimentel Anita M

    2012-01-01

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

  17. Transvaginal sling excision: tips and tricks.

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    Clifton, Marisa M; Goldman, Howard B

    2017-01-01

    Complications of synthetic midurethral sling surgery include bladder outlet obstruction, mesh extrusion, and vaginal pain. A treatment of these complications is transvaginal mesh removal. The objectives of this video are to present cases of complications after sling placement and describe techniques to help with successful sling removal. Three patients are presented in this video. One experienced urinary hesitancy and was found to have bladder outlet obstruction on urodynamic study. The second patient presented to the clinic with diminished force of stream and significant dyspareunia. The last patient presented with mesh extrusion. After discussion of management options, all three patients wished to pursue transvaginal sling excision. All patients had successful removal of a portion of their synthetic midurethral sling. This video presents techniques to aide with dissection, mesh excision and prevention of further mesh complications. These include using an individualized surgical technique based on patient presentation and surgeon expertise, planning surgical incisions based on where mesh can be identified or palpated, using a cystoscope sheath or urethral dilator to identify any bladder outlet obstruction, and using a knife blade to identify mesh from surrounding tissue. Sling excision can be successfully performed with careful surgical technique and dissection.

  18. Transvaginal Ultrasound-Guided Aspiration of Pelvic Abscesses

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    P. J. Corsi

    1999-01-01

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

  19. The accuracy of transvaginal sonography to detect endometriosis cyst

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    Diantika, M.; Gunardi, E. R.

    2017-08-01

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

  20. Qualitative and quantitative analysis of women's perceptions of transvaginal surgery.

    Science.gov (United States)

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

    2012-04-01

    Prior surveys evaluating women's perceptions of transvaginal surgery both support and refute the acceptability of transvaginal access. Most surveys employed mainly quantitative analysis, limiting the insight into the women's perspective. In this mixed-methods study, we include qualitative and quantitative methodology to assess women's perceptions of transvaginal procedures. Women seen at the outpatient clinics of a tertiary-care center were asked to complete a survey. Demographics and preferences for appendectomy, cholecystectomy, and tubal ligation were elicited, along with open-ended questions about concerns or benefits of transvaginal access. Multivariate logistic regression models were constructed to examine the impact of age, education, parity, and prior transvaginal procedures on preferences. For the qualitative evaluation, content analysis by independent investigators identified themes, issues, and concerns raised in the comments. The completed survey tool was returned by 409 women (grouped mean age 53 years, mean number of 2 children, 82% ≥ some college education, and 56% with previous transvaginal procedure). The transvaginal approach was acceptable for tubal ligation to 59%, for appendectomy to 43%, and for cholecystectomy to 41% of the women. The most frequently mentioned factors that would make women prefer a vaginal approach were decreased invasiveness (14.4%), recovery time (13.9%), scarring (13.7%), pain (6%), and surgical entry location relative to organ removed (4.4%). The most frequently mentioned concerns about the vaginal approach were the possibility of complications/safety (14.7%), pain (9%), infection (5.6%), and recovery time (4.9%). A number of women voiced technical concerns about the vaginal approach. As in prior studies, scarring and pain were important issues to be considered, but recovery time and increased invasiveness were also in the "top five" list. The surveyed women appeared to actively participate in evaluating the technical

  1. Transvaginal sonographic findings of the ectopic pregnancy

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

    1989-08-15

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

  2. Transvaginal sonographic findings of the ectopic pregnancy

    International Nuclear Information System (INIS)

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

    1989-01-01

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

  3. Prevenção do parto prematuro: emprego do toque vaginal e da ultra-sononografia transvaginal Prevention of preterm birth: use of digital examination and transvaginal ultrasonography

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    Arlete Ayako Yamasaki

    1998-07-01

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

  4. Transvaginal Ultrasound for the Diagnosis of Abnormal Uterine Bleeding.

    Science.gov (United States)

    Wheeler, Karen C; Goldstein, Steven R

    2017-03-01

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

  5. EXPERIENCIA DE AMIGDALECTOMÍA EN LA FUNDACIÓN HOSPITAL DE LA MISERICORDIA DURANTE LOS ÚLTIMOS DIEZ AÑOS

    OpenAIRE

    Gilberto Eduardo Marrugo Pardo; Diana Velosa Buitrago; María Laura Rojas Serrano

    2009-01-01

    Antecedentes. La amigdalectomía es un procedimiento frecuente en otorrinolaringología pediátrica. Actualmente se indica en hipertrofia amigdalina que obstruya la vía aérea, amigdalitis aguda bacteriana recurrente, asimetría amigdalina y absceso periamigdalino. Es un procedimiento efectivo y con poca morbimortalidad. Las complicaciones más frecuentes son dolor, sangrado, intolerancia a la vía oral e insuficiencia velofaríngea. Objetivo. Revisar la experiencia en amigdalectomía durante los ...

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

    Science.gov (United States)

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

    2017-12-01

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

  7. Transvaginal echography in the diagnose of the ectopic pregnancy

    International Nuclear Information System (INIS)

    Betancourt, Claudia; Rivera, Humberto

    1993-01-01

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

  8. Sacral colpopexy versus transvaginal mesh colpopexy in obese patients.

    Science.gov (United States)

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

    2013-05-01

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

  9. Transvaginal uterosacral ligament hysteropexy: a retrospective feasibility study.

    Science.gov (United States)

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

    2017-01-01

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

  10. Complications of transvaginal silicone-coated polyester synthetic mesh sling.

    Science.gov (United States)

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

    2005-10-01

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

  11. Transvaginal ultrasound in threatened abortions with empty gestational sacs.

    Science.gov (United States)

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

    1994-09-01

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

  12. Sangrado de angiomiolipoma renal en paciente con síndrome de genes contiguos (TSC2/PKD1 tras 17 años de tratamiento renal sustitutivo

    Directory of Open Access Journals (Sweden)

    Mónica Furlano

    2017-01-01

    Full Text Available Presentamos el caso de un varón de 32 años, con síndrome de genes contiguos TSC2/PKD1, que le ocasiona esclerosis tuberosa (ET y poliquistosis renal autosómica dominante simultáneamente. Evolucionó a enfermedad renal terminal y se realizó trasplante renal a los 12 años. Los riñones presentaban angiomiolipomas (AML, que son tumores benignos frecuentes en pacientes con ET. A los 17 años postrasplante, presentó un cuadro de dolor abdominal, anemización y hematoma retroperitoneal. Dicho hematoma se produjo por el sangrado de los AML. Como tratamiento se realizó embolización selectiva. Nuestro paciente podría haberse beneficiado en el momento del trasplante renal del tratamiento con inhibidores de mTOR. Este fármaco actúa como inmunosupresor y reductor tumoral en la ET, al disminuir el riesgo de rotura y hemorragia. En este paciente no se administró porque cuando se trasplantó no se conocía la relación de los inhibidores de mTOR con la ET. Este caso confirma que, a pesar de tratarse de pacientes trasplantados o en diálisis, el riesgo de sangrado por los AML persiste, por lo cual se propone realizar controles periódicos de los riñones propios y valorar la nefrectomía.

  13. Challenging the Myth: Transvaginal Mesh is Not Associated with Carcinogenesis.

    Science.gov (United States)

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

    2017-10-01

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

  14. Laparoscopic sacrocolpopexy versus transvaginal mesh for recurrent pelvic organ prolapse.

    Science.gov (United States)

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

    2013-03-01

    Both expert surgeons agree with the following: (1) Surgical mesh, whether placed laparoscopically or transvaginally, is indicated for pelvic floor reconstruction in cases involving recurrent advanced pelvic organ prolapse. (2) Procedural expertise and experience gained from performing a high volume of cases is fundamentally necessary. Knowledge of outcomes and complications from an individual surgeon's audit of cases is also needed when discussing the risks and benefits of procedures and alternatives. Yet controversy still exists on how best to teach new surgical techniques and optimal ways to efficiently track outcomes, including subjective and objective cure of prolapse as well as perioperative complications. A mesh registry will be useful in providing data needed for surgeons. Cost factors are also a consideration since laparoscopic and especially robotic surgical mesh procedures are generally more costly than transvaginal mesh kits when operative time, extra instrumentation and length of stay are included. Long-term outcomes, particularly for transvaginal mesh procedures, are lacking. In conclusion, all surgery poses risks; however, patients should be made aware of the pros and cons of various routes of surgery as well as the potential risks and benefits of using mesh. Surgeons should provide patients with honest information about their own experience implanting mesh and also their experience dealing with mesh-related complications.

  15. Transvaginal sonography in abnormal uterine bleeding and correlation to hysteroscopy

    International Nuclear Information System (INIS)

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

    2017-01-01

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

  16. Digital examination and transvaginal scan - competing or complementary for predicting preterm birth?

    DEFF Research Database (Denmark)

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

    2012-01-01

    The transvaginal ultrasonographic cervix scan has partly replaced digital examination for diagnosing preterm birth; conflicting results are reported about their respective contribution to birth prediction....

  17. Transvaginal organ extraction: potential for broad clinical application.

    Science.gov (United States)

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

    2014-02-01

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

  18. A prospective comparison of transvaginal ultrasonography and diagnostic hysteroscopy in the evaluation of patients with abnormal uterine bleeding: clinical implications

    NARCIS (Netherlands)

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

    1995-01-01

    We determined the diagnostic value of transvaginal ultrasonography for endometrial and intrauterine abnormalities in patients with abnormal uterine bleeding. Between June 1, 1992, and June 1, 1993, 279 consecutive patients underwent transvaginal ultrasonography. Findings were compared with the final

  19. Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse.

    Science.gov (United States)

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

    2011-05-12

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

  20. Hombre de 75 años con edemas y sangrado digestivo inferior A 75 years old man with edema and inferior gastrointestinal bleeding

    Directory of Open Access Journals (Sweden)

    Alberto Carlos Reino Buelvas

    2004-02-01

    Full Text Available Se presenta el caso de un hombre de 75 años, quien consultó por edemas generalizados originados en un síndrome nefrótico, secundario a una glomerulopatía clasificada como de cambios mínimos. Se le iniciaron esteroides con mejoría de su proteinuria, pero al disminuir las dosis de éstos, recayó, por lo que requirió nueva hospitalización en la que se le documentaron trombosis venosa profunda y sangrado por tracto gastrointestinal inferior. Se le implantó un filtro de vena cava inferior y se le practicó una colonoscopia, en la que se encontró poliposis coli. Al estudio histológico se reportó un linfoma no Hodgkin compatible con un linfoma del manto (poliposis linfomatoide versus linfoma marginal tipo MALT de bajo grado. The case of a 75 year old man is presented. He consulted because of generalized edema and the diagnosis of nephrotic syndrome was done. Histologic study of a renal biopsy reported a glomerulopathy of minimal changes. Treatment with steroids improved of proteinuria, but on reducing the doses, proteinuria returned. In a second hospitalization deep venous thrombosis and gastrointestinal bleeding were diagnosed. A cava vein filter was implanted, colonoscopy was performed and Polyposis Coli was found. A non Hodgkin lymphoma compatible with MANTLE CELL lymphoma (lymphomatous polyposis vs MALT lymphoma was reported in the colonic biopsy.

  1. Emergency Department Patient Perceptions of Transvaginal Ultrasound for Complications of First-Trimester Pregnancy.

    Science.gov (United States)

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

    2018-01-30

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

  2. Analysis of abnormally thickened endometrial patterns on transvaginal sonography

    International Nuclear Information System (INIS)

    Lee, Myung Sook; Cho, Hyeun Cha

    1999-01-01

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

  3. Transvaginal versus transabdominal sonography in the evaluation of pelvic pathology

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  4. Symptom resolution after operative management of complications from transvaginal mesh.

    Science.gov (United States)

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

    2014-01-01

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

  5. No. 351-Transvaginal Mesh Procedures for Pelvic Organ Prolapse.

    Science.gov (United States)

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

    2017-11-01

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

  6. Rambam Hospital is the Birthplace of the Modern Version of Transvaginal Ultrasound

    Directory of Open Access Journals (Sweden)

    Ilan E. Timor-Tritsch

    2017-04-01

    Full Text Available The worldwide use of the transvaginal scanning route has revolutionized obstetrical and gynecologic imaging. The long, slow, and at times challenging aspects of its acceptance by the obstetrical and gynecologic community are the subject of this article. From its inception to its recent use, the dedicated doctors in the Department of Obstetrics and Gynecology at Rambam Medical Center, Haifa, Israel, were instrumental in conceiving and then collaborating with an Israeli manufacturer in the construction and worldwide use of the transvaginal ultrasound probe, resulting in the now well-known field of transvaginal sonography.

  7. Transvaginal Ultrasound-Guided Biopsy of Deep Pelvic Masses: How We Do It.

    Science.gov (United States)

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

    2016-06-01

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

  8. Transvaginal sonographic appearance of cystic adnexal masses in postmenopausal women

    International Nuclear Information System (INIS)

    Cho, Hyeun Cha; Lee, Myung Sook

    2000-01-01

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

  9. Current situation of transvaginal mesh repair for pelvic organ prolapse.

    Science.gov (United States)

    Zhu, Lan; Zhang, Lei

    2014-09-01

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

  10. The usefulness of transvaginal ultrasonography and MRI in endometrial carcinoma

    International Nuclear Information System (INIS)

    Yoshihara, Eisuke

    1992-01-01

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

  11. [Usefulness of transvaginal Doppler color in ovarian neoplasms diagnosis].

    Science.gov (United States)

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

    1993-01-01

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

  12. Heterotopic pregnancy after in vitro fertilization and embryo transfer: the role of routine transvaginal ultrasonography

    International Nuclear Information System (INIS)

    Lee, Eun Ju

    1994-01-01

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

  13. Acute GI bleeding by multiple jejunal gastrointestinal autonomic nerve tumour associated with neurofibromatosis type I Urgencia quirúrgica por sangrado intestinal debido a tumor intestinal de nervios autónomos asociados a neurofibromatosis tipo I

    Directory of Open Access Journals (Sweden)

    M. Keese

    2007-10-01

    Full Text Available We describe a surgical emergency due to GI-bleeding caused by gastrointestinal autonomic nerve tumours (GANT's in a patient with von Recklinghausen's disease. A 72 year old female patient with von Recklinghausen's disease was admitted with maelena. Endoscopy showed no active bleeding in the stomach and the colon. Therefore an angio-CT-scan was performed which revealed masses of the proximal jejunum as source of bleeding. Laparotomy was indicated and a 20 cm segment of jejunum which carried multiple extraluminal tumours was resected. The source of the bleeding was a 2 cm tumour which had eroded the mucosal surface. Immunohistologically, evidence of neuronal differentiation could be shown in the spindle-formed cells with positive staining for C-Kit (CD 117, CD 34, and a locally positive staining for synaptophysine and S100. This case report illustrates the association between neurofibromatosis and stromal tumours and should alert surgeons and gastroenterologist about gastrointestinal manifestations in patients with von Recklinghausen's disease.Se describe una urgencia quirúrgica por sangrado intestinal debido a tumor gastrointestinal de nervios autónomos (GANT asociado a enfermedad de von Recklinghausen. Una mujer de 72 años con neurofibromatosis fue ingresada con signos de melena. La endoscopia digestiva alta y baja fue negativa. Se indicó TAC con contraste que advirtió tumores yeyunales como causa del sangrado. Se realizó laparotomía y resección de un segmento de 20 cm de yeyuno que incluía varios tumores. La causa del sangrado activo fue lesión en mucosa intestinal por erosión tumoral. El análisis por inmunohistoquímica de la pieza mostró diferenciación neuronal, con células fusiformes con tinción positiva para el C-Kit (CD 117, CD 34. Esta nota clínica pone de manifiesto la asociación entre la neurofibromatosis y los tumores estromales y debe alertar a gastroenterólogos y cirujanos sobre las posibles manifestaciones

  14. Graphic and haptic simulation for transvaginal cholecystectomy training in NOTES.

    Science.gov (United States)

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

    2016-04-01

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

  15. Can anyone screen for deep infiltrating endometriosis with transvaginal ultrasound?

    Science.gov (United States)

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

    2014-10-01

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

  16. Patient perception of transvaginal mesh and the media.

    Science.gov (United States)

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

    2014-09-01

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

  17. Surgeon Experience and Complications of Transvaginal Prolapse Mesh.

    Science.gov (United States)

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

    2016-07-01

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

  18. Hybrid NOTES transvaginal intraperitoneal onlay mesh in abdominal wall hernias: an alternative to traditional laparoscopic procedures.

    Science.gov (United States)

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

    2015-12-01

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

  19. Transvaginal expulsion of intramural leiomyoma after uterine artery embolization: case report

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-03-01

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

  20. Diagnosis of Pentalogy of Cantrell in the First Trimester Using Transvaginal Sonography and Color Doppler

    Directory of Open Access Journals (Sweden)

    Ayşe Figen Türkçapar

    2015-01-01

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

  1. Transvaginal Repair of a Large Chronic Porcine Ventral Hernia with Synthetic Mesh Using NOTES

    OpenAIRE

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

    2010-01-01

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

  2. Obstetrical and Gynecological Devices; Reclassification of Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair; Final order.

    Science.gov (United States)

    2016-01-05

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

  3. Laparoscopic sacrocolpopexy for recurrent pelvic organ prolapse after failed transvaginal polypropylene mesh surgery.

    Science.gov (United States)

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

    2013-05-01

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

  4. A prospective study of transobturator tape as treatment for stress urinary incontinence after transvaginal mesh repair.

    Science.gov (United States)

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

    2013-10-01

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

  5. Women's perception of transvaginal sonography in a tertiary hospital in nigeria

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  6. Comparative study of transvaginal hysterosonography and biopsy for theevaluation of post-menopausal bleeding

    International Nuclear Information System (INIS)

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

    1999-01-01

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

  7. Outcomes of trocar-guided Gynemesh PS™ versus single-incision trocarless Polyform™ transvaginal mesh procedures.

    Science.gov (United States)

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

    2015-01-01

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

  8. [Current state of transvaginal meshes by resolution of pelvic organ prolapse].

    Science.gov (United States)

    Jírová, J; Pán, M

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

  9. Transobturator tapes are preferable over transvaginal tapes for the management of female stress urinary incontinence: Against

    Directory of Open Access Journals (Sweden)

    Arun Chawla

    2009-01-01

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

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

    Science.gov (United States)

    Hurtado, Eric A; Appell, Rodney A

    2009-01-01

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

  11. OPPORTUNITIES OF TRANSVAGINAL ECHOCARDIOGRAPHY FOR EARLY PRENATAL DIAGNOSIS OF INBORN HEART DISEASES IN FETUS

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    E.A. Shevchenko

    2008-01-01

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

  12. Acute pulmonary edema caused by takotsubo cardiomyopathy in a pregnant woman undergoing transvaginal cervical cerclage

    OpenAIRE

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

    2017-01-01

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

  13. Transvaginal Mesh and Transanal Resection to Treat Outlet Obstruction Constipation Caused by Rectocele

    OpenAIRE

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

    2017-01-01

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

  14. Three-dimensional transvaginal ultrasound: clinical implementation in assessing uterine cavity

    OpenAIRE

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

    2015-01-01

    Background: Three-dimensional transvaginal ultrasonography (3D TVS) represents a new technique of imaging and provides a unique diagnostic tool for non-invasive examination of the uterine morphology and diagnosis of congenital uterine anomalies. In this study the clinical value of 3D TVS in diagnosis of uterine cavity abnormalities were evaluated. Methods: A prospective of diagnostic accuracy study included 226 patients with various clinical presentations; infertility, recurrent pregnancy ...

  15. Prediction of endometriosis by transvaginal ultrasound in reproductive-age women with normal ovarian size

    OpenAIRE

    Tamer H. Said; Amal Z. Azzam

    2014-01-01

    Objective: To predict endometriosis by transvaginal ultrasound (TVS) in reproductive-age women with normal ovarian size. Design: Prospective study. Setting: El-Shatby Maternity Hospital, Alexandria University. Patients: 125 Women with symptoms suggestive of endometriosis and with normal ovarian size during TVS. Interventions: Patients were subjected to high frequency ultrasound and evaluated for the presence of ultrasound signs of endometriosis (TVS-based soft markers). All patien...

  16. Transvaginal mesh kits--how "serious" are the complications and are they reversible?

    Science.gov (United States)

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

    2013-01-01

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

  17. Transvaginal mesh in repair of pelvic organs prolapse as a minimally invasive surgical procedure

    OpenAIRE

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

    2011-01-01

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

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

    OpenAIRE

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

    2018-01-01

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

  19. Sphincter-saving extrasphincteric rectal dissection and proximal segmental sphincteric excision techniques by using combined abdominal and transvaginal anterior perineal access in female patients who have lower rectal cancer (Transvaginal low anterior rectal resection

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    Ali Naki Yücesoy

    2017-10-01

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

  20. Transvaginal Drainage of Pelvic Abscesses and Collections Using Transabdominal Ultrasound Guidance.

    Science.gov (United States)

    Ching, Kevin C; Sumkin, Jules H

    2015-01-01

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

  1. Transvaginal ultrasound examination of women with and without pelvic venous congestion

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  2. Update on Instrumentations for Cholecystectomies Performed via Transvaginal Route: State of the Art and Future Prospectives

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    Elia Pulvirenti

    2010-01-01

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

  3. A new technique of laparoscopic intracorporeal anastomosis for transrectal bowel resection with transvaginal specimen extraction.

    Science.gov (United States)

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

    2013-01-01

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

  4. Clinical importance of appearance of cesarean hysterotomy scar at transvaginal ultrasonography in nonpregnant women.

    Science.gov (United States)

    Vikhareva Osser, Olga; Valentin, Lil

    2011-03-01

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

  5. Analysis of Surgical Outcomes and Determinants of Litigation Among Women With Transvaginal Mesh Complications.

    Science.gov (United States)

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

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

  6. Transvaginal Repair of a Large Chronic Porcine Ventral Hernia with Synthetic Mesh Using NOTES

    Science.gov (United States)

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

    2010-01-01

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

  7. Hybrid NOTES transvaginal cholecystectomy: operative and long-term results after 18 cases.

    Science.gov (United States)

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

    2010-03-01

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

  8. Transvaginal Resection of an Infected Sacrocolpopexy Mesh by Single-Port Trocar.

    Science.gov (United States)

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

    Laparoscopy using a single port improves morbidity while keeping the same level of requirement. This technique has been evaluated in gynecology for salpingectomy, ovarian surgery, and hysterectomy. Here, the authors illustrate a new use of a single port using the transvaginal approach. Case report (Canadian Task Force classification III). Tertiary referral center in Strasbourg, France. Woman age 59 years. Single-port platform used in the transvaginal approach for resection of sacrocolpopexy mesh. The local institutional review board approved the video. A 59-year-old woman suffering from insulin-dependent diabetes and a tobacco user had 2 laparoscopic sacrocolpopexies for recurrent rectocele, the first in 2007 and the second in 2012. The sequences were marked by mesh erosion and granuloma in the vagina, requiring its surgical excision in 2016. The patient was then symptomatic, with an increasingly foul-smelling vaginal discharge with recurrent mesh erosion. Magnetic resonance imaging showed an abscess formation along the length of the mesh to the promontory. The patient then underwent surgery, realized under probabilistic antibiotic therapy, consisting of complete excision of the sacrocolpopexy mesh by the transvaginal approach. After putting the single-port trocar (GelPoint; Applied Medical, Rancho Santa Margarita, CA) into the vagina and obtaining distension with the insufflator (AirSeal; Conmed, Utica, NY), classic laparoscopic instruments were introduced by the single-port trocar. The mesh was entirely resected in the retroperitoneal space. Mesh was again used because the exposed space is almost always surrounded by loose granulation tissue that facilitates dissection and also prevents injury to adjacent structures such as bladder, rectum, and peritoneum. Moreover, the opening of adjacent structures will manifest gas leaks and, consequently, loss of the pneumovagina. At the end of procedure, the vagina is not closed to permit optimal drainage with a multitubular

  9. Robotic repair of vesicovaginal fistulae with the transperitoneal-transvaginal approach: A case series

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    Luciano A. Nunez Bragayrac

    2014-12-01

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

  10. Sexual function in women following transvaginal mesh procedures for the treatment of pelvic organ prolapse.

    Science.gov (United States)

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

    2012-10-01

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

  11. Outcomes of Autologous Fascia Pubovaginal Sling for Patients with Transvaginal Mesh Related Complications Requiring Mesh Removal.

    Science.gov (United States)

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

    2016-08-01

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

  12. Role of transvaginal ultrasonography in diagnosing endometrial hyperplasia in pre- and post-menopause women

    OpenAIRE

    Shokouhi, Behrooz

    2015-01-01

    Background: Abnormal uterine bleeding (AUB) is the most common presenting symptom of endometrial hyperplasia (EH). Transvaginal ultrasonography (TVS) is a diagnostic tool in the evaluation of AUB and EH with various sensitivity and specificity. However, the exact accuracy of TVS in diagnosing EH had not been evaluated. In this study, we aim to evaluate the accuracy of TVS in detecting EH. Materials and Methods: In this retrospective study, 120 women (mean age of 48.64 ± 6.74 years) with AUB w...

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

    Directory of Open Access Journals (Sweden)

    Aneet Kaur

    2011-01-01

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

  14. [TVT (transvaginal mesh) surgical method for complex resolution of pelvic floor defects].

    Science.gov (United States)

    Adamík, Z

    2006-01-01

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

  15. Transvaginal Resection of a Bladder Leiomyoma Misdiagnosed with a Vaginal Mass: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Fu-Fen Yin

    2015-01-01

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

  16. The clinical value of trans-vaginal ultrasound-guided puncture in the treatment of pelvic abscess

    International Nuclear Information System (INIS)

    Wang Ping; Gong Wei

    2008-01-01

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

  17. To Compare the Diagnostic Effectiveness of Transvaginal Ultrasonography, Sonohisterography and Endometrial Biopsy in Woman with Abnormal Uterine Bleeding

    Directory of Open Access Journals (Sweden)

    Ahmet Kökden

    2005-12-01

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

  18. Minilaparoscopic-assisted transvaginal approach in benign liver lesions Abordaje transvaginal asistido por minilaparoscopia en lesiones benignas del hígado

    Directory of Open Access Journals (Sweden)

    R. Castro-Pérez

    2010-06-01

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

  19. Randomized Clinical Trial of Virtual Reality Simulation Training for Transvaginal Gynecologic Ultrasound Skills.

    Science.gov (United States)

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

    2015-09-01

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

  20. A proposal to reduce the risk of transmission of human papilloma virus via transvaginal ultrasound.

    Science.gov (United States)

    Combs, C Andrew; Fishman, Alan

    2016-07-01

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

  1. Transvaginal sonographic evaluation at different menstrual cycle phases in diagnosis of uterine lesions

    Directory of Open Access Journals (Sweden)

    Hajishaiha M

    2011-10-01

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

  2. Transvaginal mesh in repair of pelvic organs prolapse as a minimally invasive surgical procedure

    Directory of Open Access Journals (Sweden)

    Argirović Rajka

    2011-01-01

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

  3. [Transvaginal mesh in repair of pelvic organs prolapse as a minimally invasive surgical procedure].

    Science.gov (United States)

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

    2011-07-01

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

  4. Road to recovery after transvaginal surgery for urethral mesh perforation: evaluation of outcomes and subsequent procedures.

    Science.gov (United States)

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

    2018-01-29

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

  5. Necrotising fasciitis after hysterectomy and concomitant transvaginal mesh repair in a patient with pelvic organ prolapse.

    Science.gov (United States)

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

    2013-10-01

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

  6. Measuring leading placental edge to internal cervical os: Transabdominal versus transvaginal approach

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  7. Intra- and inter-observer reproducibility and generalizability of first trimester uterine artery pulsatility index by transabdominal and transvaginal ultrasound

    NARCIS (Netherlands)

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

    2016-01-01

    Objectives The primary aim of the study was to assess intra-observer and inter-observer reproducibility and generalizability (general reliability) of first trimester Doppler measurements of uterine arteries (UtA) performed both transabdominally (TA) and transvaginally (TV). Secondary aims were to

  8. Open-access transvaginal sonography in women of reproductive age with abnormal vaginal bleeding: a descriptive study in general practice

    NARCIS (Netherlands)

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

    2011-01-01

    Diagnostic ultrasonography is used by GPs in approximately 10% of patients of reproductive age with abnormal vaginal bleeding. Transvaginal sonography is recommended as a first-line diagnostic instrument for assessing uterine pathology. To assess if findings resulting from open-access sonography

  9. Effective Date of Requirement for Premarket Approval for Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair. Final order.

    Science.gov (United States)

    2016-01-05

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

  10. Malformaciones arteriovenosas revisión y análisis descriptivo de 52 mavs tratadas durante el periodo de 2000-2010

    Science.gov (United States)

    Rinaldi, Mariano; Mezzano, Emilio; Berra, Matias S.; Parés, Herald R.; Olocco, Ricardo V.; Papalini, Francisco R.

    2015-01-01

    Objetivo: Describir nuestra experiencia en el manejo de las Mavs analizando las características clínicas de los pacientes y los resultados postoperatorios. Método de análisis: Realizamos un análisis retrospectivo de 52 pacientes admitidos en el Servicio de neurocirugía para manejo quirúrgico: La información de referencia incluyo síntomas al inicio, diagnostico de admisión, hallazgos neurológicos y hallazgos en estudio por imágenes tales como tomografía cerebral, IRM cerebral y angiografía por sustracción digital. Los hallazgos postoperatorios de interés fueron: Mortalidad, examen neurológico postoperatorio y complicaciones asociadas. Presentamos nuestro análisis estadístico. Resultados: Edad promedio: 37,7 años. Distribución: Hombres: 61,5%. Motivos de consulta más frecuentes: Cefalea 63,5%, evento hemorrágico 59,6%, convulsiones 26,9%. Localización: Supratentorial: 92,9%, Infratentorial: 7,2%. 30,8%, de las Mavs fueron grado 2 y grado 3 Cincuenta por ciento del total presentaron aneurismas, del total de la MAVs, 59,6% debutó con sangrado, 26,9% con Crisis Convulsivas y 13,5% con déficit neurológico. Recibieron tratamiento endovascular previo a cirugía 30,7%. Durante el postoperatorio 23,1% presentaron mejoría clínica, 57,7% no presento modificación, 19,2% empeoraron en el postoperatorio. La mortalidad fue 13,5%. Conclusión: Creemos que el subgrupo de Mavs grados III a V representan una entidad que requiere una compleja toma de decisiones dada la alta incidencia de aneurismas asociados que presentan y su asociación con eventos de sangrado. Nuestra mortalidad postoperatoria coincide con la bibliografía. Palabras clave, Mavs- aneurismas asociados- Acv hemorrágico- convulsiones. PMID:26600984

  11. EXPERIENCIA DE AMIGDALECTOMÍA EN LA FUNDACIÓN HOSPITAL DE LA MISERICORDIA DURANTE LOS ÚLTIMOS DIEZ AÑOS

    Directory of Open Access Journals (Sweden)

    Gilberto Eduardo Marrugo Pardo

    2009-10-01

    Full Text Available Antecedentes. La amigdalectomía es un procedimiento frecuente en otorrinolaringología pediátrica. Actualmente se indica en hipertrofia amigdalina que obstruya la vía aérea, amigdalitis aguda bacteriana recurrente, asimetría amigdalina y absceso periamigdalino. Es un procedimiento efectivo y con poca morbimortalidad. Las complicaciones más frecuentes son dolor, sangrado, intolerancia a la vía oral e insuficiencia velofaríngea. Objetivo. Revisar la experiencia en amigdalectomía durante los últimos diez años, en la Fundación Hospital de La Misericordia. Materiales y métodos. Estudio retrospectivo, serie de casos, de pacientes llevados a amigdalectomía desde mayo de 2000 a febrero de 2009 en la Fundación Hospital de La Misericordia. Los resultados fueron analizados con el programa SPSS16.0. Resultados. Se incluyeron 149 pacientes. Las indicaciones de amigdalectomía fueron hipertrofia amigdalina con obstrucción de vía aérea en 45 por ciento, amigdalitis a repetición e hipertrofia en 27,5 por ciento, amigdalitis a repetición en 11,4 por ciento, y asimetría amigdalina 6,7 por ciento. La técnica quirúrgica utilizada en todos los pacientes fue extracapsular, de éstas el 97 por ciento con electrocauterio monopolar y 3 por ciento con técnica fría. Dentro de las complicaciones postquirúrgicas más frecuentes estuvieron: dolor en 41 por ciento, otalgia 12,7 por ciento y sangrado postoperatorio un 4 por ciento. El estudio histopatológico reportó en la mayoría hiperplasia folicular reactiva y un solo caso de linfoma de Burkitt cuya indicación fue asimetría amigdalina. Se encontró mejoría clínica en 96 por ciento de los pacientes. Conclusión. La amigdalectomía además de ser un procedimiento costo efectivo, es seguro y con escasas complicaciones. Realizada bajo las indicaciones descritas, proporciona un beneficio indiscutible en la calidad de vida y evolución clínica del paciente.

  12. Transvaginal mesh in the media following the 2011 US food and drug administration public health notification update.

    Science.gov (United States)

    Koo, Kevin; Gormley, E Ann

    2017-02-01

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

  13. Transvaginal Ultrasound in Fertile Patients with Suspected Appendicitis: An Experience Report of Current Practice

    Directory of Open Access Journals (Sweden)

    Malek Tabbara

    2012-01-01

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

  14. Transvaginal ultrasound in fertile patients with suspected appendicitis: an experience report of current practice.

    Science.gov (United States)

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

    2012-01-01

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

  15. Hematuria and clot retention after transvaginal oocyte aspiration: a case report.

    Science.gov (United States)

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

    2006-09-01

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

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  17. Transvaginal coloanal anastomosis after rectal resection for the treatment of a rectovaginal fistula induced by radiation.

    Science.gov (United States)

    Brezean, I

    2014-01-01

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

  18. Office hysteroscopy, transvaginal ultrasound and endometrial histology: a comparison in infertile patients

    Directory of Open Access Journals (Sweden)

    Devleta Balić

    2011-05-01

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

  19. Off ice Hysteroscopy in Patients with Abnormal Uterine Bleeding and Normal Transvaginal Sonography

    Directory of Open Access Journals (Sweden)

    Mojgan Barati

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Naoko Takazawa

    2018-03-01

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

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

    Science.gov (United States)

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

    2018-03-01

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

  2. A 52-month follow-up on the transvaginal mesh surgery in vaginal cuff eversion.

    Science.gov (United States)

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

    2017-06-01

    Transvaginal mesh anterior-posterior (TVM-AP) provides better cure rates in the surgical treatment of vaginal cuff eversion than anterior transvaginal mesh combined with sacrospinous ligament fixation (TVM-A). We determine the outcomes after TVM-A and TVM-AP surgeries in advanced vaginal cuff prolapse. The charts of 796 women who underwent pelvic organ prolapse (POP) surgery from July 2006 to January 2012 in Chang Gung Memorial Hospitals were reviewed. We included women who presented with advanced cuff eversion and treated with TVM surgery. Data were analysed after three years post-surgery. Descriptive statistics were used for demographic and perioperative data. The paired-samples t test was used for comparison of preoperative and postoperative continuous data. The outcomes measured were objective cure (POP-Q stage ≤ 1) and subjective cure (negative response to question 2 and 3 on POPDI-6). A total of 97 patients was analysed. 61 patients had TVM-A and 36 patients had TVM-AP insertion. Mean follow-up was 52 months. The objective cure rate for TVM-AP was significantly higher than TVM-A, 94.4% versus 80.3%. TVM-AP also showed a higher subjective cure rate (91.7%) though there was no significant difference from TVM-A (p = 0.260). The mesh extrusion rate was low at 3.1% with no major complications seen. In TVM-A the blood loss was lesser and the operation time was shorter. TVM-AP showed better objective cure rate than TVM-A at 52 months. However, TVM-A is less invasive in comparison with an acceptably good cure rates. Copyright © 2017. Published by Elsevier B.V.

  3. Long-term outcome after transvaginal mesh repair of pelvic organ prolapse.

    Science.gov (United States)

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

    2016-07-01

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

  4. Cesarean Delivery Changes the Natural Position of the Uterus on Transvaginal Ultrasonography.

    Science.gov (United States)

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

    2018-05-01

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

  5. Transvaginal prolapse repair with or without the addition of a midurethral sling in women with genital prolapse and stress urinary incontinence : a randomised trial

    NARCIS (Netherlands)

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

    OBJECTIVE: To compare transvaginal prolapse repair combined with midurethral sling (MUS) versus prolapse repair only. DESIGN: Multi-centre randomised trial. SETTING: Fourteen teaching hospitals in the Netherlands. POPULATION: Women with symptomatic stage two or greater pelvic organ prolapse (POP),

  6. Application of single-incision transvaginal mesh in a woman undergoing peritoneal dialysis and suffering from refractory advanced stage pelvic organ prolapse

    Directory of Open Access Journals (Sweden)

    Yi-Hung Sun

    2017-05-01

    Conclusion: Patients with POP at an advanced stage during peritoneal dialysis who failed to be treated conservatively may require a surgical intervention. Uterus-sparing transvaginal mesh was a feasible minimal invasive option.

  7. Uso de hipoglicemiantes orales durante la lactancia

    OpenAIRE

    Hwang,Du Young; Carvajal,Jorge A

    2013-01-01

    Antecedentes: Los hipoglicemiantes orales son una alternativa emergente en el tratamiento de la diabetes mellitus gestacional (DMG), pero existe poca información acerca de su uso durante la lactancia. Objetivo: Revisar la evidencia respecto a la seguridad del uso de los hipoglicemiantes orales durante la lactancia. Resultados: Encontramos 3 trabajos que evaluaron el paso de metformina a la leche materna: hubo traspaso de metformina a leche materna en todos los casos. La concentración de metfo...

  8. Rectal water contrast transvaginal ultrasound versus double-contrast barium enema in the diagnosis of bowel endometriosis

    OpenAIRE

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

    2017-01-01

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

  9. Use of dynamic 3-dimensional transvaginal and transrectal ultrasonography to assess posterior pelvic floor dysfunction related to obstructed defecation.

    Science.gov (United States)

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

    2014-02-01

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

  10. Does the addition of saline infusion sonohysterography to transvaginal ultrasonography prevent unnecessary hysteroscopy in premenopausal women with abnormal uterine bleeding?

    Science.gov (United States)

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

    2016-08-01

    This observational case series in 65 premenopausal women with abnormal uterine bleeding evaluated whether transvaginal ultrasound followed by saline infusion sonohysterography (SIS) prevented unnecessary hysteroscopy. Although SIS indicated that hysteroscopy was unnecessary in eight women, this benefit was offset by the invasive nature of the scan, the number of endometrial abnormalities falsely detected by SIS and the cost of the additional investigation. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  11. Purely transvaginal/perineal management of complications from commercial prolapse kits using a new prostheses/grafts complication classification system.

    Science.gov (United States)

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

    2012-05-01

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

  12. Age-stratified analysis of long-term outcomes of transvaginal mesh repair for treatment of pelvic organ prolapse.

    Science.gov (United States)

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

    2016-10-01

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

  13. [Three years results of transvaginal cystocele repair with polypropylene mesh using a tension-free technique].

    Science.gov (United States)

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

    2010-01-01

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

  14. Transvaginal Mesh and Transanal Resection to Treat Outlet Obstruction Constipation Caused by Rectocele.

    Science.gov (United States)

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

    2017-02-01

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

  15. Assessment of the fetomaternal circulation in threatened abortion by transvaginal color Doppler.

    Science.gov (United States)

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

    1994-01-01

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

  16. Transvaginal ultrasound appearances of the ovary in normal women and hirsute women with oligomenorrhoea.

    Science.gov (United States)

    Fox, R

    1999-02-01

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

  17. Complications of transvaginal natural orifice transluminal endoscopic surgery: a series of 102 patients.

    Science.gov (United States)

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

    2014-04-01

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

  18. Use of transvaginal ultrasound in females with primary bladder neck obstruction. A preliminary study

    Directory of Open Access Journals (Sweden)

    Vikiela Galica

    2015-07-01

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

  19. Racial and ethnic disparities in universal cervical length screening with transvaginal ultrasound

    Science.gov (United States)

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

    2016-01-01

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

  20. Decontamination of transvaginal ultrasound probes: Review of national practice and need for national guidelines

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  1. Transvaginal Mesh and Transanal Resection to Treat Outlet Obstruction Constipation Caused by Rectocele

    Science.gov (United States)

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

    2017-01-01

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

  2. Risk factors of surgical failure following transvaginal mesh repair for the treatment of pelvic organ prolapse.

    Science.gov (United States)

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

    2012-04-01

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

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

    Science.gov (United States)

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

    2008-12-01

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

  4. Mesh removal following transvaginal mesh placement: a case series of 104 operations.

    Science.gov (United States)

    Marcus-Braun, Naama; von Theobald, Peter

    2010-04-01

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

  5. Efficacy and safety of argon plasma coagulation for the treatment of hemorrhagic radiation proctitis Eficacia y seguridad de la electrocoagulación con plasma de argón en el tratamiento del sangrado rectal secundario a proctitis por radioterapia

    Directory of Open Access Journals (Sweden)

    C. de la Serna Higuera

    2004-11-01

    to persist even after long-term follow-up.Objetivo: evaluar la eficacia, seguridad y curso evolutivo a medio/largo plazo de los pacientes tratados endoscópicamente con plasma de argón en nuestra unidad por sangrado rectal asociado a proctitis por radioterapia. Diseño: estudio descriptivo y retrospectivo a medio/largo plazo. Pacientes, material y métodos: entre julio de 1998 y febrero de 2003, se trataron con plasma de argón 10 pacientes que presentaron rectorragia secundaria a proctitis por radioterapia. Se consideraron criterios de inclusión la existencia de sangrado rectal crónico, presencia de hallazgos endoscópicos compatibles y ausencia de otras lesiones justificativas de sangrado. Se emplearon colonoscopios convencionales y equipo con fuente de gas argón y unidad quirúrgica de alta frecuencia. Se programaron sesiones consecutivas hasta conseguir la total eliminación de las lesiones rectales realizándose seguimiento clínico-evolutivo y valorando tolerancia, eficacia y potenciales complicaciones derivadas de la técnica. Se actualizaron los datos por entrevista personal o encuesta telefónica. Resultados: en todos los casos se consiguió la desaparición del sangrado después de la última sesión de tratamiento. El número medio de sesiones de tratamiento por paciente fue de 1,7. En cuatro casos fue precisa una única sesión. El tiempo medio de seguimiento tras concluir el tratamiento fue de 31,1, meses. En un caso recidivó el sangrado a los 4 meses, siendo precisas dos sesiones adicionales. Cuatro pacientes presentaban inicialmente signos analíticos de anemia que persistía sólo en un caso al final del estudio. No se registraron complicaciones tardías derivadas de la técnica, como úlceras o estenosis rectales. Conclusiones: la electrocoagulación endoscópica con plasma de argón supone en nuestra experiencia, una alternativa segura, eficaz y bien tolerada en el tratamiento del sangrado rectal asociado a la proctitis por radioterapia, con

  6. Comparative analysis of early adverse events of pelvic organ prolapse repair with or without transvaginal mesh using Clavien-Dindo classification.

    Science.gov (United States)

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

    2018-04-10

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

  7. Transvaginal duplex ultrasonography appears to be the gold standard investigation for the haemodynamic evaluation of pelvic venous reflux in the ovarian and internal iliac veins in women.

    Science.gov (United States)

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

    2015-12-01

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

  8. Persistence of microbial contamination on transvaginal ultrasound probes despite low-level disinfection procedure.

    Directory of Open Access Journals (Sweden)

    Fatima M'Zali

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

  9. Understanding Patient Preference in Female Pelvic Imaging: Transvaginal Ultrasound and MRI.

    Science.gov (United States)

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

    2018-04-01

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

  10. Impact of routine transvaginal ultrasound monitoring of cervical length in twins on administration of antenatal corticosteroids.

    Science.gov (United States)

    Marcellin, Louis; Senat, Marie Victoire; Benachi, Alexandra; Regis, Sophie; Cabrol, Dominique; Goffinet, François

    2017-05-24

    To evaluate whether routine measurement of cervical length (CL) by transvaginal ultrasound (TVU) in twin pregnancies can enable identification of women who will give birth before 34 weeks and require antenatal corticosteroids (ACSs), and whether it can limit their administration to women who will give birth later. Retrospective comparative study in two tertiary referral centers in France. Women with twin gestations followed in two tertiary university hospital maternity units and who delivered from January 1, 2007 to December 31, 2009 were included. In one center, TVU was targeted to women with cases of suspected preterm labor, while the other center used it monthly for all twin pregnancies. The main outcome measure was the administration of a full course of ACS to twins delivered before 34 weeks. Two hundred and seventy women were eligible in the "targeted use" group, and 296 women in the "routine use" group. The rate of administration of at least one full course of ACS for twins born before 34 weeks did not differ between the two groups (85.0% in the targeted use group and 90.0% in the routine use group, P=0.40), but the rate of such administration for those born after 34 weeks was lower in the targeted use group (25.7% vs. 81.2%, P<0.01). On adjusting for confounders using logistic regression modeling, no significant difference in ACS administration before 34 weeks was found between the two groups [adjusted odds ratio (aOR), 0.71, 95% confidence interval (CI), 0.39-1.30]. Routine monitoring performed every month of CL with TVU does not affect the rate of administration of ACS to twins born before 34 weeks, but is associated with a higher rate of such administration for those born later in the specific center of the study.

  11. Transvaginal bladder neck closure with posterior urethral flap for devastated urethra.

    Science.gov (United States)

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

    2011-07-01

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

  12. Ovarian volume and antral follicle count assessed by MRI and transvaginal ultrasonography: a methodological study.

    Science.gov (United States)

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

    2014-03-01

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

  13. The role of transvaginal power Doppler ultrasound in the differential diagnosis of benign intrauterine focal lesions.

    Science.gov (United States)

    Cogendez, Ebru; Eken, Meryem Kurek; Bakal, Nuray; Gun, Ismet; Kaygusuz, Ecmel Isik; Karateke, Ates

    2015-10-01

    The purpose of this prospective study was to assess the role of power Doppler imaging in the differential diagnosis of benign intrauterine focal lesions such as endometrial polyps and submucous myomas using the characteristics of power Doppler flow mapping. A total of 480 premenopausal patients with abnormal uterine bleeding were evaluated by transvaginal ultrasonography (TVS) searching for intrauterine pathology. Sixty-four patients with a suspicious focal endometrial lesion received saline infusion sonography (SIS) after TVS. Fifty-eight patients with focal endometrial lesions underwent power Doppler ultrasound (PDUS). Three different vascular flow patterns were defined: Single vessel pattern, multiple vessel pattern, and circular flow pattern. Finally, hysteroscopic resection was performed in all cases, and Doppler flow characteristics were then compared with the final histopathological findings. Histopathological results were as follows: endometrial polyp: 40 (69 %), submucous myoma: 18 (31 %). Of the cases with endometrial polyps, 80 % demonstrated a single vessel pattern, 7.5 % a multiple vessel pattern, and 0 % a circular pattern. Vascularization was not observed in 12.5 % of patients with polyps. Of the cases with submucousal myomas, 72.2 % demonstrated a circular flow pattern, 27.8 % a multiple vessel pattern, and none of them showed a single vessel pattern. The sensitivity, specificity, and positive and negative predictive values of the single vessel pattern in diagnosing endometrial polyps were 80, 100, 100, and 69.2 %, respectively; and for the circular pattern in diagnosing submucous myoma, these were 72.2, 100, 100, and 88.9 %, respectively. Power Doppler blood flow mapping is a useful, practical, and noninvasive diagnostic method for the differential diagnosis of benign intrauterine focal lesions. Especially in cases of recurrent abnormal uterine bleeding, recurrent abortion, and infertility, PDUS can be preferred as a first-line diagnostic method.

  14. Challenges in the transvaginal management of abnormal uterine bleeding secondary to cesarean section scar defect.

    Science.gov (United States)

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

    2011-02-01

    Research suggests that the resectoscopic management of abnormal uterine bleeding (AUB) following cesarean section (CS) is safe and effective. There is, however, a lack of complementary data from routine clinical practice. We aimed to evaluate the efficacy of resectoscopic remodeling of the CS scar in the management of post CS AUB (pCSAUB). The case notes of 57 women with pCSAUB who had undergone a resectoscopic remodeling procedure were reviewed retrospectively. Primary outcome measures were the duration of preoperative and postoperative menstruation, and postoperative menstrual change. Secondary outcome measures were the impact of patient-dependent variables on the success of the resectoscopic remodeling procedure. The CS scar was located using transvaginal ultrasonography and hysteroscopy. The remodeling procedure was performed with a hysteroscopic resectoscope, and commenced with resection of the fibromuscular scar. This started at the roof of the scar pouch and progressed towards the external os. It then continued along a line parallel to the axis of the cervical canal. The exposed dilated blood vessels and endometrial-like tissue in the roof of the remaining pouch were electrocauterized with a roller-ball electrode. The mean operating time was 30.2 ± 6.6 min. There was a significant difference in the mean duration of preoperative and postoperative menstruation (12.9 ± 2.9 days and 9.4 ± 4.1 days, respectively; p uterine remodeling is an appropriate therapy in patients with pCSAUB and an anteflexed uterus. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  15. Diagnostic Accuracy of Transvaginal Sonography, Sonohysterography and Office Hysteroscopy in the Evaluation of Abnormal Uterine Bleeding

    Directory of Open Access Journals (Sweden)

    Ümit Göktolga

    2007-06-01

    Full Text Available OBJECTIVE: To find out the diagnostic accuracy of transvaginal sonography (TVS and saline infusion sonography (SIS by comparing the results with hysteroscopy (HSC and hystological reports obtained by endometrial biopsies in pre and postmenopausal women with abnormal uterine bleeding (AUB.\tDesign: Prospective study\tSetting: women presenting with abnormal uterine bleeeding as an outpatient procedure, in Gülhane Military Medical Faculty, between June 01, 2004 – August 01, 2005.\tPatients: 38 premenopausal and 6 postmenopausal patients\tInterventions: TVS and SIS was performed at the same seance and they underwent hysteroscopy and hysteroscopic biopsy one week later.\tMain outcome measures: The findings at TVS and SIS were compared with the hysteroscopic views and histologic findings. The sensitivity and spesifity ratios of all three methods were calculated in defining the endometrial and intracavitary pathologies.\tRESULTS: The sensitivity ratios of TVS and SIS in defining endometrial pathologies was 36.4% and 33.8% respectively and the sensitivity of hysteroscopy was lower. (%28.6, p=0.24 In the comparison of spesifity ratios sonohysterography had a higher ratio than others. (TVS vs SIS, p=0.08; HSC vs SIS, p=0.07 As a result; in outpatient group, hysteroscopy gives not much more information than SIS.\tThe detection rate of focal intrauterine pathology (polyp/submucous myoma using conventional TVS was significantly lower than sonohysterography. (sensitivity ratios; 46.5% and 97.1% respectively; p=0.0009 The sensitivity ratios of hysteroscopy (100% and SIS (97.1 was similar. (p=0.98\tCONCLUSIONS: Sonohysterography is a current, trustable method which can replace office hysteroscopy in the diagnosis and evaluation of cases presenting with AUB especially in outpatient group.

  16. Seeking new surgical predictors of mesh exposure after transvaginal mesh repair.

    Science.gov (United States)

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

    2016-10-01

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

  17. Risk factors for surgical site infection after transvaginal mesh placement in a nationwide Japanese cohort.

    Science.gov (United States)

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

    2018-03-01

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

  18. Comparison of immediate postoperative pain after transvaginal versus traditional laparoscopic cholecystectomy.

    Science.gov (United States)

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

    2014-04-01

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

  19. Development of Transvaginal Uterus Amputation Device for Laparoscopic Hysterectomies in Gynecologic Surgeries

    Directory of Open Access Journals (Sweden)

    Serkan DİKİCİ

    2015-01-01

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

  20. Acrania/encephalocele sequence (exencephaly) associated with 92,XXXX karyotype: early prenatal diagnosis at 9(+5) weeks by 3D transvaginal ultrasound and coelocentesis.

    Science.gov (United States)

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

    2009-09-01

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

  1. Correlation between transvaginal ultrasound measured endometrial thickness and histopathological findings in Turkish women with abnormal uterine bleeding.

    Science.gov (United States)

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

    2016-05-01

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

  2. Transvaginal closure of urethra and correction of uterovaginal prolapse in neurologically impaired patient with chronic indwelling catheter.

    Science.gov (United States)

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

    2009-08-01

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

  3. Laparoscopic mesh explantation and drainage of sacral abscess remote from transvaginal excision of exposed sacral colpopexy mesh.

    Science.gov (United States)

    Roth, Ted M; Reight, Ian

    2012-07-01

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

  4. Assessment of performance measures and learning curves for use of a virtual-reality ultrasound simulator in transvaginal ultrasound examination

    DEFF Research Database (Denmark)

    Madsen, M E; Konge, L; Nørgaard, L N

    2014-01-01

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

  5. Fatiga de vigilancia (fatigatio vigilantiae) durante epidemias

    OpenAIRE

    Romero-Álvarez, Daniel; Peterson, A. Townsend; Escobar, Luis E

    2017-01-01

    Se presenta el concepto de "fatiga de vigilancia" (fatigatio vigilantiae) para describir un escenario epidemiológico en el que es evidente el subreporte de casos durante epidemias abrumadoras. Revisamos epidemias pasadas y encontramos que la fatiga de vigilancia es un patrón común, por lo tanto, puede ser un concepto útil en la epidemiología moderna. This manuscript presents the concept of "surveillance fatigue" (fatigatio vigilantiae), to describe an epidemiological scenario of an evident...

  6. Corpus luteum blood flow in normal and abnormal early pregnancy: evaluation and analysis with transvaginal color and pulsed doppler sonography

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  7. Contribution of spiral artery blood flow changes assessed by transvaginal color Doppler sonography for predicting endometrial pathologies

    Directory of Open Access Journals (Sweden)

    Suna Kabil Kucur

    2013-01-01

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

  8. Transvaginal Cystocele Repair by Purse-String Technique Reinforced with Three Simple Sutures: Surgical Technique and Results

    Directory of Open Access Journals (Sweden)

    Ho-Sook Song

    2012-09-01

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

  9. Efficacy of transvaginal contrast-enhanced MRI in the early staging of cervical carcinoma

    International Nuclear Information System (INIS)

    Akata, Deniz; Kerimoglu, Ulku; Hazirolan, Tuncay; Karcaaltincaba, Musturay; Oezmen, Mustafa N.; Akhan, Okan; Koese, Faruk

    2005-01-01

    The objective of this study was to evaluate the efficacy of transvaginal contrast for local staging of cervical carcinoma. Fifty patients diagnosed with cervical carcinoma prospectively underwent magnetic resonance (MR) imaging before and after vaginal opacification (VO) with a mixture of 25 ml saline and 25 ml barium. T2-weighted (T2W) TSE images in axial and sagittal planes were compared before and after vaginal opacification. Dynamic T1W images in sagittal and fat-suppressed T1W images in transverse planes were also evaluated after intravenous contrast administration. Involvement of vaginal wall, lumen, and fornices; parametrium; rectum; and bladder were noted. Changes in local tumor staging and in treatment planning were also assessed after vaginal opacification. MR results were later compared with surgical pathological findings. Twenty-eight patients who went through surgical staging were included in the study. VO did not change any of the MR interpretations in 14 patients (50%). Correct staging was achieved with T2W TSE images with and without VO (in sagittal and transverse planes) in 78.5% and 50% of the patients, respectively. VO correctly lowered staging in seven and increased it in three patients compared with sagittal standard T2W images. Treatment planning was also changed in four (14%) of these patients. When overall accuracy of MR staging to indicate the appropriate treatment was evaluated, patients would have received the proper treatment in 90% and 79% of the cases when only T2W sagittal images with and without VO were evaluated, respectively. Dynamic gradient-echo images in sagittal planes and postcontrast T1W images in transverse planes evaluated with T2W series after VO, accomplished correct staging in 23 (82%) of the patients. MRI staging in early cervical cancer may be difficult and overestimated, especially if the tumor is slightly extended into the proximal vagina. Use of vaginal contrast medium is an easy, well-tolerated, and effective

  10. Transvaginal prolapse repair with or without the addition of a midurethral sling in women with genital prolapse and stress urinary incontinence: a randomised trial

    NARCIS (Netherlands)

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

    2015-01-01

    To compare transvaginal prolapse repair combined with midurethral sling (MUS) versus prolapse repair only. Multi-centre randomised trial. Fourteen teaching hospitals in the Netherlands. Women with symptomatic stage two or greater pelvic organ prolapse (POP), and subjective or objective stress

  11. Transvaginal prolapse repair with or without the addition of a midurethral sling in women with genital prolapse and stress urinary incontinence : a randomised trial

    NARCIS (Netherlands)

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

    ObjectiveTo compare transvaginal prolapse repair combined with midurethral sling (MUS) versus prolapse repair only. DesignMulti-centre randomised trial. SettingFourteen teaching hospitals in the Netherlands. PopulationWomen with symptomatic stage two or greater pelvic organ prolapse (POP), and

  12. The transvaginal hybrid NOTES versus conventionally assisted laparoscopic sigmoid resection for diverticular disease (TRANSVERSAL) trial: study protocol for a randomized controlled trial.

    Science.gov (United States)

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

    2014-11-20

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

  13. Evolução do comprimento cervical uterino na gestação, avaliado pela ultra-sonografia transvaginal Changes in cervical length during pregnancy measured by transvaginal ultrasound

    Directory of Open Access Journals (Sweden)

    Reginaldo Antônio de Oliveira Freitas-Júnior

    2003-03-01

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

  14. Application of transvaginal sacrospinous colpopexy in the treatment of pelvic organs prolapse

    Directory of Open Access Journals (Sweden)

    Argirović Rajka B.

    2005-01-01

    , such as the damage to the pudendal vessels and nerve, the sciatic nerve and rectum. The possibility of injury to the vessels and nearby nerves was preventid with the careful placement of suture through the sacrospinous ligament in the two fingerbreadths medial to its insertion in the ischial spine. In our series, we had 3 patients with conservation of the uterus. The 3 asymptomatic cystocele in our series were diagnosed 6 months after the operation. Our results were satisfactory, since we hade only one postoperative vault prolapse (2,7%. Conclusion. The results of numerous studies, as well as the results of our study, showed that transvaginal sacrospinous colpopexy could be performed along with vaginal hysterectomy and the anterior and posterior vaginal wall repair in the patients with uterovaginal prolapse because of its high success in the prevention of postoperative vaginal vault prolapse and the low intra- and postoperative complication rates. This operative technique is successful in prevention of repeated vaginal vault prolapse.

  15. Transvaginal Excision of an Eroded Sacrocolpopexy Mesh by Using Single-Incision Laparoscopic Surgery Equipment.

    Science.gov (United States)

    Mohr, Stefan; Siegenthaler, Franziska; Imboden, Sara; Kuhn, Annette; Mueller, Michael D

    To show a new technique of using single-incision laparoscopic surgery (SILS) equipment in vaginal surgery to create a "pneumovagina." Explanatory video demonstrating the technique and intraoperative findings. University hospital. The 68-year-old patient was referred with a vaginal mesh erosion that resulted in abscess formation at the vaginal apex. The patient was symptomatic with an increasingly foul-smelling vaginal discharge for about 1 year. She had a laparoscopic sacrocolpopexy in a remote hospital 22 months before the current operation and had a total abdominal hysterectomy 15 years ago. The, patient's history was uneventful without dyspareunia, incontinence or voiding difficulties, and she was otherwise content with the sacrocolpopexy result. The local institutional review board granted exemption for this publication. Frequently, pelvic organ prolapse can only be effectively treated if the surgical procedure comprises support of the central compartment. Laparoscopic sacrocolpopexy shows superior outcomes for this indication, with success rates of up to 96%. However, a rare side effect of laparoscopic sacrocolpopexy is mesh erosion, occurring in up to 2.4% [1]. These erosions are usually treated laparoscopically [2]. In this video we show an alternative route for excision of a symptomatic exposed mesh by using a transvaginal approach: The SILS trocar is used vaginally for abscess irrigation and mesh excision with minimally invasive instruments. For treatment of the abscess and removal of the exposed mesh, the SILS trocar was placed vaginally, and laparoscopic instruments were used. The abscess was incised, cleansed and irrigated, debrided, and the mesh excised. Because no mesh material was exposed after excision, the vagina was not closed to avoid creating a cavity with the risk of promoting reabscess formation, and secondary wound healing was anticipated. Laparoscopy was used to confirm that no intra-abdominal lesion coexisted or occurred. There were

  16. Acute pulmonary edema caused by takotsubo cardiomyopathy in a pregnant woman undergoing transvaginal cervical cerclage: A case report.

    Science.gov (United States)

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

    2017-01-01

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

  17. Transvaginal sonography combined with saline contrast sonohysterography in evaluating the uterine cavity in premenopausal patients with abnormal uterine bleeding

    DEFF Research Database (Denmark)

    Dueholm, M; Forman, A; Jensen, ML

    2001-01-01

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

  18. Guidelines for providing privileges and credentials to physicians for transvaginal placement of surgical mesh for pelvic organ prolapse.

    Science.gov (United States)

    2012-01-01

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

  19. Predictive accuracy of changes in transvaginal sonographic cervical length over time for preterm birth: a systematic review and metaanalysis.

    Science.gov (United States)

    Conde-Agudelo, Agustin; Romero, Roberto

    2015-12-01

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

  20. The impact of in situ methotrexate injection after transvaginal ultrasound-guided aspiration of ovarian endometriomas on ovarian response and reproductive outcomes during IVF-cycles

    Directory of Open Access Journals (Sweden)

    H.E. Shawki

    2012-06-01

    Conclusion(s: In situ methotrexate injection after transvaginal ultrasound-guided aspiration was a simple, safe and successful method for treating ovarian endometriomas with minimal effects on ovarian response. Short term effects on reproductive outcomes, risk of fetal loss or anomaly were minimal. Six months was enough as washout period of the drug prior to conception and was advisable to prevent the small chance of chromosomal abnormalities in the offspring.

  1. Preoperative Diagnosis of Fallopian Tube Malignancy with Transvaginal Color Doppler Ultrasonography and Magnetic Resonance Imaging after Negative Hysteroscopy for Postmenopausal Bleedin

    OpenAIRE

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

    2014-01-01

    Primary Fallopian tube carcinoma is a rare malignancy and is not often diagnosed preoperatively. We present a case of a 67-year old woman who complained of postmenopausal vaginal bleeding. After a negative hysteroscopy, transvaginal ultrasound showed a well vascularized solid-cystic tumor in the adnexal region separate from the ovary. The presence of an adnexal mass was confirmed by MR imaging. Total abdominal hysterectomy with bilateral salpingoophorectomy, omentectomy and appendectomy, as w...

  2. Flurbiprofen Axetil Provides Effective Analgesia Without Changing the Pregnancy Rate in Ultrasound-Guided Transvaginal Oocyte Retrieval: A Double-Blind Randomized Controlled Trial.

    Science.gov (United States)

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

    2017-10-01

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

  3. ERCP during pregnancy CPRE durante el embarazo

    Directory of Open Access Journals (Sweden)

    Jesús García-Cano

    2012-02-01

    Full Text Available Background and aims: ERCP during pregnancy is always challenging for the entire team performing the endoscopic intervention. In this study techniques and different interventional aspects used at several centres about the clinical experience on ERCP in pregnant women are analyzed. Patients and methods: the practice on ERCP in pregnant women in six centers during a period of ten years is reported. Results: eleven patients were included in the study. Mean age was 30.6 years. Indication for ERCP was always symptomatic common bile duct stone (CBDS disease. Before the procedure abdominal ultrasound was performed at all times and magnetic resonance cholangiopancreatography in four occasions. Conscious sedation by means of midazolam and fentanyl or meperidine was applied. Sphincterotomes and guidewires were used for bilary cannulation. Sometimes, rapid exchange platforms with short-length guidewires controlled by the same endoscopist were employed. Biliary cannulation was confirmed in 9 occasions by bile aspiration. In five procedures, a mean of 30 seconds of fluoroscopy was used, both to verify cannulation and to corroborate complete CBDS clearance. These patients had the pelvic zone protected with a lead shield and radiation dose was measured. Ten biliary sphincterotomies were performed followed by CBDS extraction. Two plastic stents were inserted. Relief of biliary obstruction was attained in all circumstances. Only one patient had hyperamylasemia after ERCP. All pregnant women had healthy foetuses with normal deliveries. Conclusions: with experience, ERCP appears to be a safe technique during pregnancy. With simple measures fluoroscopic time can be diminished or even abolished. It seems that ERCP during pregnancy is underused in our working areas, although it has shown to be a useful technique for relieving biliary obstruction.Antecedentes y objetivos: la CPRE realizada durante el embarazo constituye siempre un reto para todo el equipo que participa

  4. One-year outcome of concurrent anterior and posterior transvaginal mesh surgery for treatment of advanced urogenital prolapse: case series.

    Science.gov (United States)

    Lo, Tsia-Shu

    2010-01-01

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

  5. Complications of Transvaginal Mesh for Pelvic Organ Prolapse and Stress Urinary Incontinence: Tips for Prevention, Recognition, and Management.

    Science.gov (United States)

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

    2016-08-01

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

  6. Evaluation of pelvic varicose veins using color Doppler ultrasound: comparison of results obtained with ultrasound of the lower limbs, transvaginal ultrasound, and phlebography Avaliação de varizes pélvicas por Doppler colorido: comparação dos resultados obtidos com ultrassom dos membros inferiores, ultrassom transvaginal e flebografia

    Directory of Open Access Journals (Sweden)

    Fanilda Souto Barros

    2010-06-01

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

  7. The reliability of transabdominal cervical length measurement in a low-risk obstetric population: Comparison with transvaginal measurement.

    Science.gov (United States)

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

    2015-04-01

    To determine the correlation between transabdominal (TA) and transvaginal (TV) cervical length measurement in a low-risk obstetric population in Taiwan. Women with a singleton pregnancy between 20 weeks and 24 weeks of gestation underwent postvoid TA and TV cervical length measurements. Differences between the measurements obtained using the two methods were evaluated. Two hundred and five women agreed to participate in the study. Paired TA and TV measurements were obtained in 174 women. The mean TA cervical length was 36.0 ± 4.9 mm and the mean TV cervical length was 37.6 ± 5.4 mm. The mean TA cervical length was shorter than the mean TV cervical length by 1.6 mm. The 5(th) percentile of TA and TV cervical length was 29 mm and 29.1 mm, respectively. The discrepancies between the two methods were not significantly correlated with maternal body mass index (BMI). All women with TV cervical length women in the present study, and the TA cervical length was closely correlated with the TV cervical length. The use of TA ultrasound could be an effective initial tool for cervical length screening in low-risk pregnant women. TA cervical length TV ultrasound. Copyright © 2015. Published by Elsevier B.V.

  8. TRANSVAGINAL SONOGRAPHY COMBINED WITH SALINE CONTRAST SONOHYSTEROGRAPHY IN EVALUATING THE UTERINE CAVITY IN PREMENOPAUSAL PATIENTS WITH ABNORMAL UTERINE BLEEDING

    Directory of Open Access Journals (Sweden)

    K. G. M. Premleel

    2016-06-01

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

  9. Comparison of Sensitivity & Specificity of Transvaginal Sonography, Saline Infusion Sonohysterography and Hysteroscopy in Evaluation of Women with Abnormal Uterine Bleeding

    Directory of Open Access Journals (Sweden)

    K Shojaie

    2009-10-01

    Full Text Available Introduction: Bleeding disorders are a common problem in daily practice, especially in premenopausal women. In our investigation, we compared the sensitivity and specificity of three different diagnostic methods Trans-vaginal sonography(TVS, saline infusion sonohystrography(SIS and Hysteroscopy. Methods: It was a cross- sectional study with a study population of ninety-nine women suffering fromAUB attending the outpatient clinic of Imam and Razi hospital in Ahvaz- Iran. They were evaluated by three different diagnostic methods and the results were compared. This study started from March 2008 to December 2008. The sensitivity, specificity, positive predictive and negative predictive values were measured in TVS, SIS, and finally these two methods were compared with hysteroscopy (as a gold standard. Results: The sensitivity and specificity of TVS was 74.2% and 49.7%, respectively, while that of SIS was 91.6% and 86%, respectively. The positive predictive value and negative predictive value of TVS was 71.9% and 54.3%, respectively, while that of SIS was 85.9% and 85.75%, respectively. The sensitivity, specificity, the positive predictive and negative predictive values of SIS was more than TVS, and it was similar to hysteroscopy. Conclusion: The findings obtained in the present study indicate that in AUB, sensitivity, specificity, positive and negative predictive value of SIS is more than TVS and therefore can be considered as a first step for diagnosis of AUB.

  10. Trans-Vaginal Mesh Revision: A Comprehensive Review on Etiologies and Management Strategies with Emphasis on Postoperative Pain Outcomes.

    Science.gov (United States)

    Mock, Stephen; Reynolds, William S; Dmochowski, Roger R

    2014-05-01

    The use of polypropylene mesh to augment surgery aimed to correct pelvic organ prolapse and stress urinary incontinence stems largely from the high recurrence rates of native tissue repairs. While objective outcomes were improved, mesh related complications began to emerge that included mesh exposures, extrusions, dyspareunia and other pain issues. However, the indication for and benefit of surgical intervention(s) to address these complications are lacking. We aim to review to current literature regarding postoperative pain outcomes following vaginal mesh revision. Evidence based literature indicates that mesh complications are not rare and surgery that aims to address them generally have an overall benefit. However, studies available are generally small case series of a retrospective nature with short follow up. Some themes are evident: there is a long lag period from mesh insertion to removal; there is a lack of a true denominator of total mesh insertions making it hard to gauge the real scope of the problem; mesh material found not along the expected trocar path or coursing close to neurovascular structures thus raises the possibility of technical errors during insertion. Transvaginal mesh revision(s) for mesh complications generally have a positive effect on pain outcomes, but better controlled studies are needed. Additionally, since technical issues may be a factor in the development of mesh complications, rigorous training and sufficient surgical case volume should be emphasized. © 2014 Wiley Publishing Asia Pty Ltd.

  11. Rectal water contrast transvaginal ultrasound versus double-contrast barium enema in the diagnosis of bowel endometriosis.

    Science.gov (United States)

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

    2017-09-07

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

  12. Transvaginal color Doppler imaging of uterine contractions in early pregnancies: Significance of uterine contractions in early pregnancy failure

    International Nuclear Information System (INIS)

    Lee, Eun Ju; Han, Chang Jin; Suh, Jung Ho; Kwon, Hyuck Chan

    1999-01-01

    To assess uterine contractions in early pregnancies using transvaginal color Doppler sonography (TVCDS) and to determine the role of uterine contractions in the diagnosis of early pregnancy failure. 76 patients with abnormal pregnancy diagnosed by sonography or histopathology up to 10 weeks of gestation and 38 normal pregnant women as the control group were examines with TVCDS. The presence of uterine contractions was determined by complete or partial disappearance of the color flow signals of vessels within myometrium, and the direction, amplitude (grade 1-3), and interval of uterine contractions were also evaluated. Uterine contractions were identified in 42 (55.3%) of 76 patients with abnormal pregnancy, whereas they were detected only in 2 (5.3%) of 38 normal pregnant women who had initial grade 1 contraction but disappeared in the follow-up study. In 26 patients with blighted ovum or missed abortion, 15 patients (57.7%),showed uterine contraction of grade 1 in 3 cases, grade 2 in 8 cases, and grade 3 in 4 cases and interval from 45 seconds to 5 minutes. In 30 patients with inevitable or incomplete abortion, 23 patients (76.6%) showed uterine contraction of grade 1 in 2 cases, grade 2 in 9 cases, and grade 3 in 12 cases and interval from 1 to 5 minutes. 4 (20%) of 20 patients with threatened abortion had uterine contraction of grade 2 and interval from 2 to 4 minutes. The presence of uterine contractions was significantly different in abnormal pregnancies compared with that of normal and also among the tree different groups of abnormal pregnancies, but the amplitude did not differ.

  13. Comparison of transvaginal sonography and double-contrast barium enema for diagnosing deep infiltrating endometriosis of the posterior compartment.

    Science.gov (United States)

    Savelli, L; Manuzzi, L; Coe, M; Mabrouk, M; Di Donato, N; Venturoli, S; Seracchioli, R

    2011-10-01

    To compare the diagnostic accuracy of transvaginal sonography (TVS) and double-contrast barium enema (DCBE) in the preoperative detection of deep infiltrating endometriosis (DIE) of the posterior compartment. This was a prospective study of 69 consecutive patients with results of pelvic examination or symptoms suggestive of DIE of the posterior compartment. TVS and DCBE were performed before surgery by two groups of physicians specialized in endometriosis, each blinded to the results of the other technique. Imaging data were compared with histopathologic analysis of the resected specimen (gold standard). Sensitivity, specificity, positive and negative predictive values and test accuracies were calculated for both imaging modalities. Sixty seven of the 69 women had a nodule of DIE confirmed at laparoscopy and histopathologic examination. TVS diagnosed DIE in 57 (85%) of these patients, while DCBE revealed the presence of the lesion in 24 (36%) women. For the diagnosis of posterior DIE, TVS and DCBE had, respectively, a sensitivity of 85% and 36%, specificity of 100% and 100%, positive predictive value of 100% and 100%, negative predictive value of 17% and 4% and accuracy of 85.5% and 38%. In patients with pure bowel DIE the sensitivity was 91% and 43%, specificity was 100% and 100%, positive predictive value was 100% and 100%, negative predictive value was 29% and 6% and accuracy was 91% and 45%, respectively. TVS has a much higher sensitivity than does DCBE in detecting the presence of posterior DIE and should thus be regarded as the imaging modality of choice when there is clinical suspicion of the disease. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.

  14. Transvaginal color Doppler imaging of uterine contractions in early pregnancies: Significance of uterine contractions in early pregnancy failure

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Ju; Han, Chang Jin; Suh, Jung Ho; Kwon, Hyuck Chan [Aju University SChool of Medicine, Suwon (Korea, Republic of)

    1999-06-15

    To assess uterine contractions in early pregnancies using transvaginal color Doppler sonography (TVCDS) and to determine the role of uterine contractions in the diagnosis of early pregnancy failure. 76 patients with abnormal pregnancy diagnosed by sonography or histopathology up to 10 weeks of gestation and 38 normal pregnant women as the control group were examines with TVCDS. The presence of uterine contractions was determined by complete or partial disappearance of the color flow signals of vessels within myometrium, and the direction, amplitude (grade 1-3), and interval of uterine contractions were also evaluated. Uterine contractions were identified in 42 (55.3%) of 76 patients with abnormal pregnancy, whereas they were detected only in 2 (5.3%) of 38 normal pregnant women who had initial grade 1 contraction but disappeared in the follow-up study. In 26 patients with blighted ovum or missed abortion, 15 patients (57.7%),showed uterine contraction of grade 1 in 3 cases, grade 2 in 8 cases, and grade 3 in 4 cases and interval from 45 seconds to 5 minutes. In 30 patients with inevitable or incomplete abortion, 23 patients (76.6%) showed uterine contraction of grade 1 in 2 cases, grade 2 in 9 cases, and grade 3 in 12 cases and interval from 1 to 5 minutes. 4 (20%) of 20 patients with threatened abortion had uterine contraction of grade 2 and interval from 2 to 4 minutes. The presence of uterine contractions was significantly different in abnormal pregnancies compared with that of normal and also among the tree different groups of abnormal pregnancies, but the amplitude did not differ.

  15. Native tissue repair or transvaginal mesh for recurrent vaginal prolapse: what are the long-term outcomes?

    Science.gov (United States)

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

    2016-09-01

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

  16. Transvaginal cervical length and amniotic fluid index: can it predict delivery latency following preterm premature rupture of membranes?

    Science.gov (United States)

    Mehra, Suwan; Amon, Erol; Hopkins, Sarah; Gavard, Jeffrey A; Shyken, Jaye

    2015-03-01

    We sought to determine whether transvaginal cervical length (TVCL), amniotic fluid index (AFI), or a combination of both can predict delivery latency within 7 days in women presenting with preterm premature rupture of membranes (PPROM). This was a prospective observational study of TVCL measurements in 106 singleton pregnancies with PPROM between 23-33 weeks. Delivery latency was defined as the period (in days) from the initial TVCL after PPROM to delivery of the infant, with our primary outcome being delivery within 7 days of TVCL. The independent predictability of significant characteristics for delivery within 7 days was determined using multiple logistic regression. Sensitivity, specificity, and predictive values were used to examine whether the presence of a short TVCL, AFI, or a combination of both affected the risk of delivery within 7 days. Delivery within 7 days occurred in 51/106 (48%) of pregnancies. Median duration (interquartile range) from PPROM to delivery and TVCL to delivery was 8 days (4.0-16.0) and 8 days (3.0-15.0), respectively. Using multiple regression TVCL as a continuous variable (odds ratio, 0.65; 95% confidence interval, 0.44-0.97; P 7 days for TVCL >2 cm alone was 61%. This predictive value changed when analyzed in conjunction with an AFI ≤5 cm and >5 cm at 42% and 89%, respectively. A shorter TVCL and an AFI ≤5 cm independently predict delivery within 7 days in women presenting with PPROM. The combination of an AFI >5 cm and TVCL >2 cm greatly improved the potential to remain undelivered at 7 days following cervical length assessment. These findings may be helpful for counseling and optimizing maternal and neonatal care in women with PPROM. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Perception of preference and risk-taking in laparoscopy, transgastric, and rigid-hybrid transvaginal NOTES for cholecystectomy.

    Science.gov (United States)

    Sulz, Michael C; Zerz, Andreas; Sagmeister, Markus; Roll, Thomas; Meyenberger, Christa

    2013-12-03

    Few data are available regarding patients' perceptions of new cholecystectomy (CC) techniques, in the context of the patients' risk behaviours. We investigated patients' preferences for transgastric pure natural orifice translumenal endoscopic surgery (NOTES; transgastric NCC) and rigid-hybrid transvaginal NOTES CC (tvNCC) compared with the standard laparoscopic CC (SL-CC), and patients' risk behaviours. A total of 140 inpatients scheduled for elective laparoscopic CC were enrolled in this prospective single-centre study, from January 2009 to January 2010. Patients judged the potential advantages and disadvantages of transgastric NCC and tvNCC compared with SL-CC. The individual's risk behaviour was analysed by means of the validated 40-item Domain-Specific Risk Attitude Scale (DOSPERT). Of the 140 recruited patients, 57 (65% females; mean age 51.5 years) were analysed. Twenty-five percent of males opted for transgastric NCC and 75% opted for SL-CC. Among females, 10.8%, 37.8% and 51.4% opted for transgastric NCC, tvNCC and SL-CC, respectively. Faster convalescence was graded as the primary potential advantage of transgastric NCC, whereas the potential risk of long-term stomach injuries was considered a primary disadvantage. Females graded the reduction of hospital-acquired morbidity as the primary advantage of tvNCC. The risk assessment showed significantly more risk-taking behaviour in the recreational domain of life among patients who opted for innovative surgical techniques than among those opting for conventional surgery. Transgastric NCC is rarely accepted by females but accepted by a quarter of males. Females consider rigid-hybrid tvNCC and SL-CC similarly attractive. Despite promising new techniques, three-quarters of male and one half of female patients still prefer the standard laparoscopic CC.

  18. Impact of transvaginal modified sacrospinous ligament fixation with mesh for the treatment of pelvic organ prolapse-before and after studies.

    Science.gov (United States)

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

    2018-04-01

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

  19. PRESENTACIÓN: EL SANGRADO CORAZÓN

    Directory of Open Access Journals (Sweden)

    Marco Julián Martínez y Carlos José Suárez

    2008-07-01

    Full Text Available La actual sociedad colombiana es descrita como una donde el uso de la violencia en la transformación de los conflictos es recurrente y privilegiada. Ello ocurre tanto en el plano estatal como en la intimidad familiar, incluyendo variadas relaciones personales y del día a día. Lo anterior constituye un objeto de preocupación pública y académica, que comúnmente equipara la violencia con la maldad. Algunos estudios asumen la violencia como corruptora del orden social, señalando el deber de algunas agencias por controlar aquel flagelo. Los agentes estatales buscan domesticar al perpetrador a través de intervenciones racionales, que suponen utopías justificadas en nombre del derecho, la ciencia y la religión. Otros estudios abordan la violencia como una expresión indeseada de los conflictos, que contribuye a la ruptura del paradigma social de la convivencia, que debe ser restablecido mediante acciones no-violentas. Hay acercamientos que resaltan las emociones y sensaciones que envuelven la teatralidad del momento disruptivo y sus huellas en la memoria, resaltando el drama humano y los testimonios. Por último, existen interpretaciones centradas en la relación víctima-victimario, reduciendo problemáticas sociales a responsabilidades individuales enmarcadas en la resiliencia y la reparación. Estas posturas han tenido incidencia en los discursos sociales y políticos sobre la opresión, la vulneración y la desigualdad, así como en la construcción y aplicación de políticas públicas para la paz y la seguridad.

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

    Science.gov (United States)

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

    2014-09-01

    Primary fallopian tube carcinoma is a rare malignancy and is not often diagnosed preoperatively. We present a case of a 67-year-old woman who complained of postmenopausal vaginal bleeding. After a negative hysteroscopy, transvaginal ultrasound showed a well vascularized solid-cystic tumor in the adnexal region separate from the ovary. The presence of an adnexal mass was confirmed by MR imaging. Total abdominal hysterectomy with bilateral salpingoophorectomy, omentectomy and appendectomy, as well as pelvic and paraaortic lymphadenectomy was performed. The pathohistological diagnosis was poorly differentiated serous adenocarcinoma of the fallopian tube, FIGO stage IA. The patient was subsequently treated with platinum based adjuvant chemotherapy.

  1. Vivências da sexualidade durante a gravidez

    OpenAIRE

    Cruz, Maria Diana Fernandes da

    2012-01-01

    Trabalho apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Enfermagem Sumário Durante o período de gravidez, existem uma série de mudanças biológicas, psicológicas, culturais e sociais, estas podem ter influência na vivência da sexualidade. A vivência da sexualidade durante esta fase pode ser entendida de diversas formas pela gestante, muitas vezes pode ser um factor importante para a satisfação das necessidades acrescidas d...

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

    Science.gov (United States)

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

    2010-11-01

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

  3. Comparison of the clinical and quality-of-life outcomes after the inside-out TVT-O procedure with or without concomitant transvaginal gynaecological surgery.

    Science.gov (United States)

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

    2012-04-01

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

  4. Transvaginal six-arm mesh OPUR in women with apical pelvic organ prolapse - analysis of short-term results, pelvic floor ultrasound evaluation.

    Science.gov (United States)

    Kluz, Tomasz; Wlaźlak, Edyta; Surkont, Grzegorz

    2017-01-01

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

  5. An evaluation of the Manufacturer And User Facility Device Experience database that inspired the United States Food and Drug Administration's Reclassification of transvaginal mesh

    Directory of Open Access Journals (Sweden)

    Jason M. Sandberg

    2018-03-01

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

  6. Surgical intervention after transvaginal Prolift mesh repair: retrospective single-center study including 524 patients with 3 years' median follow-up.

    Science.gov (United States)

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

    2012-01-01

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

  7. An evaluation of the Manufacturer And User Facility Device Experience database that inspired the United States Food and Drug Administration's Reclassification of transvaginal mesh.

    Science.gov (United States)

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

    2018-03-01

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

  8. Achados histeroscópicos em mulheres na pós-menopausa com diagnóstico de espessamento endometrial por ultra-sonografia transvaginal Hysteroscopic findings in postmenopausal women with endometrial thickening diagnosed by transvaginal ultrasound

    Directory of Open Access Journals (Sweden)

    Adriana Bittencourt Campaner

    2004-02-01

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

  9. vARIATIONS MENSUELLES DURANT TROIS ANNÉES DU ...

    African Journals Online (AJOL)

    , Université .... ont reçu une alimentation à base de pâturage de. Panicum maximum avec ... Variations mensuelles durant trois années du nombre de spermatozoïdes par éjaculat et des paramètres de spermocytogramme du sperme de bélier ...

  10. Two- and three-dimensional transvaginal ultrasound with power Doppler angiography and gel infusion sonography for diagnosis of endometrial malignancy.

    Science.gov (United States)

    Dueholm, M; Christensen, J W; Rydbjerg, S; Hansen, E S; Ørtoft, G

    2015-06-01

    To evaluate the diagnostic efficiency of two-dimensional (2D) and three-dimensional (3D) transvaginal ultrasonography, power Doppler angiography (PDA) and gel infusion sonography (GIS) at offline analysis for recognition of malignant endometrium compared with real-time evaluation during scanning, and to determine optimal image parameters at 3D analysis. One hundred and sixty-nine consecutive women with postmenopausal bleeding and endometrial thickness ≥ 5 mm underwent systematic evaluation of endometrial pattern on 2D imaging, and 2D videoclips and 3D volumes were later analyzed offline. Histopathological findings at hysteroscopy or hysterectomy were used as the reference standard. The efficiency of the different techniques for diagnosis of malignancy was calculated and compared. 3D image parameters, endometrial volume and 3D vascular indices were assessed. Optimal 3D image parameters were transformed by logistic regression into a risk of endometrial cancer (REC) score, including scores for body mass index, endometrial thickness and endometrial morphology at gray-scale and PDA and GIS. Offline 2D and 3D analysis were equivalent, but had lower diagnostic performance compared with real-time evaluation during scanning. Their diagnostic performance was not markedly improved by the addition of PDA or GIS, but their efficiency was comparable with that of real-time 2D-GIS in offline examinations of good image quality. On logistic regression, the 3D parameters from the REC-score system had the highest diagnostic efficiency. The area under the curve of the REC-score system at 3D-GIS (0.89) was not improved by inclusion of vascular indices or endometrial volume calculations. Real-time evaluation during scanning is most efficient, but offline 2D and 3D analysis is useful for prediction of endometrial cancer when good image quality can be obtained. The diagnostic efficiency at 3D analysis may be improved by use of REC-scoring systems, without the need for calculation of

  11. Algorithm of Transvaginal Ultrasound and/or Hysterosalpingogram for Confirmation Testing at 3 Months after Essure Placement.

    Science.gov (United States)

    Vleugels, Michel; Cheng, Ru-Fong; Goldstein, Jeffrey; Bangerter, Keith; Connor, Viviane

    To evaluate the algorithm of transvaginal ultrasound (TVU) and/or modified hysterosalpingogram (HSG) confirmation testing 3 months after Essure placement to determine if women can rely on the device for permanent birth control. Interim analysis of an ongoing 10-year, prospective, multicenter, nonrandomized, single-arm, international trial (Canadian Task Force classification II-2). Twenty study centers in the United States (n = 12), Canada (n = 1), The Netherlands (n = 6), and Spain (n = 1). Women undergoing the Essure procedure for permanent birth control. Based on the algorithm for confirmation testing, women with an uncomplicated Essure procedure underwent TVU as the confirmation test; modified HSG was used for women ineligible for TVU, when TVU findings were abnormal or inconclusive, or based on the physician's discretion. Co-primary endpoints (intention-to-treat [ITT] population) were the reliance rate and the 1-year pregnancy rate. Safety evaluation was based on adverse events. Bilateral insert placement was attempted in 597 women (ITT population) and achieved in 582 of 597 (97.5%). A total of 547 women were told to rely on Essure for permanent birth control. Both co-primary endpoints met prespecified limits: based on Bayesian statistics, the reliance rate was 91.6% (547/597; 95% credible interval, 89.2%-93.6%) and the 1-year pregnancy rate .67% (95% credible interval, .16%-1.53%). Using the algorithm for confirmation testing, of 547 subjects told to rely on Essure, 470 (86%) underwent TVU alone, 30 (6%) had modified HSG alone, and 47 (9%) had TVU followed by modified HSG. Four women became pregnant after being told to rely on Essure. They all had confirmation testing with TVU alone, and each initially read incorrectly as optimal insert locations. In each case postpregnancy follow-up and root cause analysis revealed unsatisfactory insert locations, 2 of which were perforations. Most adverse events were mild and unrelated to Essure. The

  12. Relationship of endometrial thickness detected by transvaginal sonography with the results of endometrial biopsy & hysteroscopic directed biopsy in post menopausal bleeding

    Directory of Open Access Journals (Sweden)

    Vahid Dastjerdi M

    2008-05-01

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

  13. Uso indicado e uso referido de medicamentos durante a gravidez

    Directory of Open Access Journals (Sweden)

    Claudia Garcia Serpa Osorio-de-Castro

    Full Text Available Poucos estudos descrevem a utilização de medicamentos na gravidez com detalhamento de práticas prescritivas. A pesquisa integra grande inquérito sobre atenção perinatal em hospitais do Município do Rio de Janeiro. A natureza do hospital - se pública, contratada/conveniada ao SUS ou privada - determinou estratificação de 10.072 puérperas internadas. A coleta de dados se deu por entrevista e por consulta a prontuários, cobrindo medicamentos utilizados durante a gravidez e prescritos durante a internação hospitalar quando do parto. Medicamentos foram classificados pela ATC e outro sistema para casos especiais de uso referido. Houve média de 2,08 medicamentos prescritos no parto e 2,3 usados durante a gestação, sendo os mais prescritos anestésicos, antibióticos, ocitocina e analgésicos, com diferenças significativas entre estratos, e os mais referidos sulfato ferroso, vitaminas, escopolamina e paracetamol. Para interromper a gravidez, 49,7% relatam o uso de chás e 9,2% de misoprostol. O perfil de utilização é corroborado pela literatura. A pesquisa oferece oportunidade de conhecimento de padrões de prescrição ao parto e de uso referido durante a gestação nos setores público e privado.

  14. Uso indicado e uso referido de medicamentos durante a gravidez

    Directory of Open Access Journals (Sweden)

    Osorio-de-Castro Claudia Garcia Serpa

    2004-01-01

    Full Text Available Poucos estudos descrevem a utilização de medicamentos na gravidez com detalhamento de práticas prescritivas. A pesquisa integra grande inquérito sobre atenção perinatal em hospitais do Município do Rio de Janeiro. A natureza do hospital - se pública, contratada/conveniada ao SUS ou privada - determinou estratificação de 10.072 puérperas internadas. A coleta de dados se deu por entrevista e por consulta a prontuários, cobrindo medicamentos utilizados durante a gravidez e prescritos durante a internação hospitalar quando do parto. Medicamentos foram classificados pela ATC e outro sistema para casos especiais de uso referido. Houve média de 2,08 medicamentos prescritos no parto e 2,3 usados durante a gestação, sendo os mais prescritos anestésicos, antibióticos, ocitocina e analgésicos, com diferenças significativas entre estratos, e os mais referidos sulfato ferroso, vitaminas, escopolamina e paracetamol. Para interromper a gravidez, 49,7% relatam o uso de chás e 9,2% de misoprostol. O perfil de utilização é corroborado pela literatura. A pesquisa oferece oportunidade de conhecimento de padrões de prescrição ao parto e de uso referido durante a gestação nos setores público e privado.

  15. La fidelidad cubana durante la edad de las revoluciones

    Directory of Open Access Journals (Sweden)

    Kuethe, Allan J.

    1998-06-01

    Full Text Available Not available.

    La historiografía cubana tradicional explica la fidelidad de la perla de las Antillas durante las revoluciones americanas por razón del miedo al intimidante ejército español acuartelado en la isla y por miedo a que cualquier división política diera aliento a una sublevación de la masiva población esclava. Este artículo plantea la tesis de que el asunto fue mucho más complicado que lo que estas explicaciones dan a entender. Por una parte, el ejército de la isla llegó a estar esencialmente controlado por cubanos y, por otra, un movimiento revolucionario nació entre los elementos ilustrados; pero falló por la oposición abrumadora que surgió dentro de la propia clase criolla. La fidelidad cubana no se explica actualmente tanto por los temores como por las relaciones positivas que se crearon entre la corona española y las elites cubanas durante el siglo XVIII, sobre todo durante el reinado de Carlos III, relaciones que resultaron sumamente ventajosas para los azucareros que dominaban la vida económica y política de la isla.

  16. Annual surveillance by CA125 and transvaginal ultrasound for ovarian cancer in both high-risk and population risk women is ineffective

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  17. Transvaginal ultrasound assessment of myometrial and cervical stroma invasion in women with endometrial cancer -interobserver reproducibility among ultrasound experts and gynaecologists

    DEFF Research Database (Denmark)

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

    2014-01-01

    OBJECTIVES: To assess interobserver reproducibility among ultrasound experts and gynaecologists in the prediction of deep myometrial- and cervical stroma invasion by transvaginal ultrasound in women with endometrial cancer. METHODS: Video-clips of the corpus- and cervix uteri of 53 women...... with endometrial cancer, examined preoperatively by the same ultrasound expert, were integrated in a digitalized survey. Nine ultrasound experts and 9 gynaecologists evaluated presence or absence of deep myometrial- and cervical stroma invasion. Histopathology from hysterectomy specimen was used as gold standard.......001). CONCLUSION: Preoperative ultrasound assessment of deep myometrial- and cervical stroma invasion in endometrial cancer is best performed by ultrasound experts, as they show a higher degree of agreement to histopathology and higher interobserver reproducibility in the assessment of cervical stromal invasion....

  18. A prospective study on transvaginal ultrasound of cervical length (CL) in the first and second trimester in a low-risk population

    DEFF Research Database (Denmark)

    Wulff, C B; Rode, Line; Rosthøj, S

    2018-01-01

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

  19. Transvaginal prolapse repair with or without the addition of a midurethral sling in women with genital prolapse and stress urinary incontinence: a randomised trial.

    Science.gov (United States)

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

    2015-06-01

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

  20. Quality of life in women of non-reproductive age with transvaginal mesh repair for pelvic organ prolapse: A cohort study.

    Science.gov (United States)

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

    2016-09-01

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

  1. Alteraciones oftalmológicas durante el embarazo

    Directory of Open Access Journals (Sweden)

    Yoriel Cuan Aguilar

    Full Text Available Los trastornos oftalmológicos son muy comunes durante el embarazo. Se realiza la presente revisión con el objetivo de documentar las variadas condiciones oculares que podrían aparecer durante la gestación o se podrían modificar por esta, lo que conllevaría estar bien atentos sobre las gestantes que aquejan trastornos visuales. Durante el período de gestación las mujeres se exponen a variados cambios tanto a nivel sistémico como ocular. A partir de algunos de estos cambios, el embarazo origina alteraciones a nivel ocular, los cuales son la mayoría de las veces transitorias, aunque en ocasiones pueden establecerse de forma permanente. Los efectos oculares del embarazo pueden ser fisiológicos, patológicos o pueden ocasionar modificaciones de condiciones prexistentes. De esta manera, pueden observarse en este período cambios a nivel de los párpados, la córnea, el cristalino, la presión intraocular, el campo visual, entre otros. También exacerbaciones de patologías como retinopatía diabética, enfermedad de Grave y retinitis por toxoplasma, así como complicaciones provocadas por el propio embarazo como preclampsia-eclampsia, desprendimiento de retina seroso, ceguera cortical, síndrome de HELLP, retinopatía serosa central, etcétera. Se relacionan además alteraciones neuroftalmológicas y complicaciones oftálmicas en relación con el parto, como trombosis del seno venoso, adenoma pituitario, hipertensión intracraneal benigna, neuritis óptica, así como retinopatía y síndrome de Sheehan.

  2. Violência durante o sono Violent behavior during sleep

    Directory of Open Access Journals (Sweden)

    Dalva Poyares

    2005-05-01

    Full Text Available Casos de comportamento violento (CV durante o sono são relatados na literatura. A incidência de comportamento violento durante o sono não é muito conhecida. Um estudo epidemiológico mostra que cerca de 2% da população geral apresentava comportamento violento dormindo e eram predominantemente homens. Neste artigo, os autores descrevem aspectos clínicos e médico-legais envolvidos na investigação do comportamento violento. O comportamento violento se refere a ferimentos auto-infligidos ou infligidos a um terceiro durante o sono. Ocorre, muito freqüentemente, seguindo um despertar parcial no contexto de um transtorno de despertar (parassonias. Os transtornos do sono predominantes diagnosticados são: transtorno de comportamento REM e sonambulismo. O comportamento violento poderia ser precipitado pelo estresse, uso de álcool e drogas, privação do sono ou febre.Cases of violent behavior during sleep have been reported in the literature. However, the incidence of violent behavior during sleep is not known. One epidemiological study showed that approximately 2% of the general population, predominantly males, presented violent behavior while asleep. In the present study, the authors describe clinical and medico-legal aspects involved in violent behavior investigation. Violent behavior refers to self-injury or injury to another during sleep. It happens most frequently following partial awakening in the context of arousal disorders (parasomnias. The most frequently diagnosed sleep disorders are REM behavior disorder and somnambulism. Violent behavior might be precipitated by stress, use of alcohol or drugs, sleep deprivation or fever.

  3. Comunicación y conflicto familiar durante la adolescencia

    OpenAIRE

    Parra Jiménez, Águeda; Oliva Delgado, Alfredo

    2002-01-01

    El principal objetivo de esta investigación fue estudiar los patrones de comunicación y conflicto familiar durante la adolescencia. Una muestra de 221 chicos y 292 chicas de edades comprendidas entre 13 y 19 años completaron un cuestionario que incluía medidas de la frecuencia de la comunicación con sus progenitores, la frecuencia de aparición de episodios conflictivos, la intensidad emocional con que dichos conflictos eran percibidos, y la autonomía funcional ...

  4. Autonomía emocional durante la adolescencia

    OpenAIRE

    Oliva Delgado, Alfredo; Parra Jiménez, Agueda

    2001-01-01

    El objetivo de esta investigación fue estudiar la relación entre la autonomía emocional respecto a los padres y el tipo de relaciones establecidas entre padres e hijos durante la adolescencia. También pretendíamos analizar las características socio-emocionales de aquellos chicos y chicas que manifiestan una alta autonomía emocional, así como el papel moderador jugado por el género y la calidad del contexto familiar sobre las relaciones entre la desvinculación afectiva y el desarro...

  5. Consumo de antioxidantes durante tratamento quimioterápico

    OpenAIRE

    Rohenkohl,Caroline Cavali; Carniel,Ana Paula; Colpo,Elisângela

    2011-01-01

    RACIONAL: O câncer é definido como enfermidade multicausal crônica, em que as células possuem crescimento descontrolado. Resulta de vários fatores, sendo um dos principais, a dieta inadequada. As fases de iniciação, promoção e progressão de carcinogênese têm sido frequentemente relacionadas ao estresse oxidativo. OBJETIVO: Verificar o consumo de antioxidantes em pacientes com câncer durante os diferentes ciclos de quimioterapia. MÉTODOS: Estudo descritivo exploratório, incluindo pacientes em ...

  6. Las fluctuaciones del nivel del mar durante el Cuaternario

    OpenAIRE

    Pousa, Jorge Lorenzo; Isla, Federico Ignacio; Schnack, Enrique Jorge

    2002-01-01

    Los cambios del nivel del mar han ejercido una fuerte influencia en la evolución del planeta y en la historia de la humanidad. En una escala de tiempo geológico, las variaciones de los niveles oceánicos han dejado un registro ampliamente distribuido en la forma de depósitos sedimentarios. El descenso del nivel del mar durante la Ultima Glaciación, que alcanzó unos 120 metros hace 18.000 años, permitió la emergencia del estrecho de Bering y la migración humana desde Eurasia hacia América. Se e...

  7. El periodismo gráfico durante la dictadura

    OpenAIRE

    Díaz, César Luis

    2017-01-01

    Este volumen del Centro de Estudios en Historia/Comunicación/Periodismo/Medios (CEHICOPEME), está dedicado al examen de ocho de los principales medios gráficos argentinos durante la última dictadura cívico-militar. Se trata de una decena de artículos que si bien fueron realizados como obras en sí mismas, no pueden ser aisladas de una forma de concebir la disciplina que las contiene, cuya matriz de producción se gestó en esta Facultad de Periodismo y Comunicación Social (UNLP) hace poco más de...

  8. Transvaginal ultrasound vs magnetic resonance imaging for diagnosing deep infiltrating endometriosis: systematic review and meta-analysis.

    Science.gov (United States)

    Guerriero, S; Saba, L; Pascual, M A; Ajossa, S; Rodriguez, I; Mais, V; Alcazar, J L

    2018-05-01

    To perform a systematic review of studies comparing the accuracy of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) in diagnosing deep infiltrating endometriosis (DIE) including only studies in which patients underwent both techniques. An extensive search was carried out in PubMed/MEDLINE and Web of Science for papers from January 1989 to October 2016 comparing TVS and MRI in DIE. Studies were considered eligible for inclusion if they reported on the use of TVS and MRI in the same set of patients for the preoperative detection of endometriosis in pelvic locations in women with clinical suspicion of DIE and using surgical data as a reference standard. Quality was assessed using the QUADAS-2 tool. A random-effects model was used to determine pooled sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR-) and diagnostic odds ratio (DOR). Of 375 citations identified, six studies (n = 424) were considered eligible. For MRI in the detection of DIE in the rectosigmoid, pooled sensitivity was 0.85 (95% CI, 0.78-0.90), specificity was 0.95 (95% CI, 0.83-0.99), LR+ was 18.4 (95% CI, 4.7-72.4), LR- was 0.16 (95% CI, 0.11-0.24) and DOR was 116 (95% CI, 23-585). For TVS in the detection of DIE in the rectosigmoid, pooled sensitivity was 0.85 (95% CI, 0.68-0.94), specificity was 0.96 (95% CI, 0.85-0.99), LR+ was 20.4 (95% CI, 4.7-88.5), LR- was 0.16 (95% CI, 0.07-0.38) and DOR was 127 (95% CI, 14-1126). For MRI in the detection of DIE in the rectovaginal septum, pooled sensitivity was 0.66 (95% CI, 0.51-0.79), specificity was 0.97 (95% CI, 0.89-0.99), LR+ was 22.5 (95% CI, 6.7-76.2), LR- was 0.38 (95% CI, 0.23-0.52) and DOR was 65 (95% CI, 21-204). For TVS in the detection of DIE in the rectovaginal septum, pooled sensitivity was 0.59 (95% CI, 0.26-0.86), specificity was 0.97 (95% CI, 0.94-0.99), LR+ was 23.5 (95% CI, 9.1-60.5), LR- was 0.42 (95% CI, 0.18-0.97) and DOR was 56 (95% CI, 11-275). For MRI in the detection of DIE in the

  9. Three-dimensional transvaginal sonographic assessment of uterine volume as preoperative predictor of need to morcellate in women undergoing laparoscopic hysterectomy.

    Science.gov (United States)

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

    2017-08-01

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

  10. Caries dental asociada a factores de riesgo durante el embarazo

    Directory of Open Access Journals (Sweden)

    Antonio Cecilio Pérez Oviedo

    2011-06-01

    Full Text Available El periodo gestacional se relaciona con una mayor incidencia de caries dental, aunque la asociación entre gestación e incremento de caries no ha podido aún ser científicamente demostrada. Se propuso realizar un estudio para determinar la presencia de caries dental y algunos factores de riesgo asociados en el primer y tercer trimestre del embarazo, para detectar la aparición de lesiones cariosas nuevas y cambios relacionados con los factores de riesgo entre ambos trimestres. Se realizó un estudio descriptivo longitudinal desde diciembre de 2006 a febrero de 2008 en el municipio de Florida, Camagüey, Cuba. El universo de estudio estuvo constituido por 38 embarazadas y la muestra por 21, que fueron interrogadas y examinadas en ambos trimestres con el objetivo de determinar la presencia de caries y los factores de riesgo asociados como: higiene bucal deficiente, dieta cariogénica, pH salival bajo, ocurrencia de vómitos y embarazo previo. La información necesaria fue recogida en un formulario confeccionado al efecto. En el primer trimestre el 80,95 % estaban afectadas por caries dental y se observó aparición de lesiones nuevas en 6 embarazadas, en el tercer trimestre. Los factores de riesgo presentados con mayor frecuencia en el primer trimestre fueron la dieta cariogénica en el 66,66 % y la higiene bucal deficiente en el 47,61 % de las pacientes. Ninguna embarazada modificó la dieta durante el embarazo, sin embargo la higiene bucal deficiente persistió en el 14,28 %. El 52,38 % de las embarazadas afectadas en el primer trimestre consumían dieta cariogénica y el 47,61 % habían tenido embarazo previo. Se concluyó que hubo afectación por nuevas caries durante el embarazo, los factores de riesgo que predominantes fueron la dieta cariogénica, la higiene bucal deficiente y el embarazo previo. Las pacientes no modificaron la dieta durante el embarazo, pero sí mejoraron la higiene bucal. Todas las que presentaban vómitos y pH salival

  11. Mesh complications and failure rates after transvaginal mesh repair compared with abdominal or laparoscopic sacrocolpopexy and to native tissue repair in treating apical prolapse.

    Science.gov (United States)

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

    2017-02-01

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

  12. The Disability Impact and Associated Cost per Disability in Women Who Underwent Surgical Revision of Transvaginal Mesh Kits for Prolapse Repair.

    Science.gov (United States)

    Javadian, Pouya; Shobeiri, S Abbas

    2017-09-13

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

  13. Rearranjo estrutural de PET durante compressão plana

    OpenAIRE

    Elton Luis Gasparotto Denardin

    2004-01-01

    As características da tensão – deformação do Poli(tereftalato de etileno) (PET) durante o processo de deformação por compressão plana tem sido estudadas. Amostras de PET com e sem tratamento térmico obtidas por injeção foram deformadas a diferentes temperaturas de deformação, abaixo e acima da temperatura de transição vítrea (Tg) utilizando diferentes taxas de deformação e tensões finais aplicadas. O comportamento mecânico foi analisado através das curvas de tensão – deformação obtidas por de...

  14. Sexualidad femenina durante la gestación

    Directory of Open Access Journals (Sweden)

    Ignacio González Labrador

    2001-10-01

    Full Text Available Se realizó una revisión sobre diferentes criterios de la conveniencia, presencia y frecuencia de las relaciones sexuales durante el proceso de gestación, y brindamos resultados de algunos trabajos realizados al respecto. Los tabúes, los prejuicios, la desinformación y muchas veces el desconocimiento alrededor de este tema que tanta atención precisa, han llevado a que se le investigue poco o se trate de forma equivocadaA review of the various criteria about the convenience, presence and frequency of sexual relations during pregnancy was made and the results of some papers are also presented. Taboos, prejudices, distorted information and lack of knowledge about this topic that requires so much attention have led to insufficient research or to wrong analyses of the subject

  15. La fidelidad cubana durante la edad de las revoluciones

    OpenAIRE

    Kuethe, Allan J.

    1998-01-01

    Not available.

    La historiografía cubana tradicional explica la fidelidad de la perla de las Antillas durante las revoluciones americanas por razón del miedo al intimidante ejército español acuartelado en la isla y por miedo a que cualquier división política diera aliento a una sublevación de la masiva población esclava. Este artículo plantea la tesis de que el asunto fue mucho más complicado que lo que estas explicaciones dan a entender. Por una parte, el ejército de la isl...

  16. MANIFESTACIONES OCULTAS DE VIOLENCIA, DURANTE EL DESARROLLO DEL RECREO ESCOLAR

    Directory of Open Access Journals (Sweden)

    Jenny María Artavia Granados

    2013-01-01

    Full Text Available El presente artículo es producto de un proceso de investigación realizado en una escuela de la Dirección Regional de Educación de Occidente, en Costa Rica. Este tiene como fin determinar si durante el desarrollo de los recreos se suscitan manifestaciones de violencia implícitas u ocultas entre las y los estudiantes II Ciclo de la Educación General Básica. En el proceso del estudio se tomaron en cuenta aspectos relacionados con las actividades lúdicas y las interacciones personales desarrolladas durante los recreos escolares y que podrían propiciar violencia escolar implícita u oculta. Se procuró identificar la existencia de enfrentamientos y conflictos entre estudiantes, que conllevan amenazas, manifestaciones de exclusión, persecuciones e intimidaciones entre las y los niños. Se plantearon algunas conclusiones entre las que destacan que un alto porcentaje de la población estudiantil investigada manifiesta recibir amenazas, y que estas, en mayor número, se producen entre las niñas. Asimismo, un alto porcentaje de esta población estudiada indica que ha sido excluida en la dinámica del recreo por diferentes motivos, entre los que destacan: características físicas, género, condición social y situaciones particulares educativas que presentan algunos niños o niñas en edad escolar.

  17. Impact of transvaginal hydrolaparoscopy ovarian drilling on ovarian stromal blood flow and ovarian volume in clomiphene citrate-resistant PCOS patients: a case-control study.

    Science.gov (United States)

    Giampaolino, Pierluigi; Morra, Ilaria; De Rosa, Nicoletta; Cagnacci, Angelo; Pellicano, Massimiliano; Di Carlo, Costantino; Nappi, Carmine; Bifulco, Giuseppe

    2017-09-01

    Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in gynecology. In PCOS patients vascularization parameters are altered. Transvaginal hydrolaparoscopy (THL) is a mini-invasive approach for ovarian drilling in PCOS patients. In this study, we assessed the effect of ovarian drilling using THL on ovarian volume (OV) and vascularization index (VI) using 3D power Doppler ultrasonography in CC-resistant PCOS patients. A case-control study on 123 CC-resistant PCOS women who underwent THL ovarian drilling was performed. Patients underwent 3D ultrasound and power Doppler to measure VI, flow index (FI), vascularization flow index (VFI) and to evaluate OV before and after the procedure, at six months, and on the early follicular phase of the menstrual cycle. After THL ovarian drilling, OV and power Doppler flow indices were significantly reduced compared to pre-operative values (OV: 7.85 versus 11.72 cm 3 , p drilling seems to reduce OV and 3D power Doppler indices, and could therefore be a viable alternative to LOD in PCOS patients resistant to medical therapy.

  18. Preoperative assessment of intestinal endometriosis: A comparison of transvaginal sonography with water-contrast in the rectum, transrectal sonography, and barium enema.

    Science.gov (United States)

    Bergamini, Valentino; Ghezzi, Fabio; Scarperi, Stefano; Raffaelli, Ricciarda; Cromi, Antonella; Franchi, Massimo

    2010-12-01

    To evaluate the accuracy of Transrectal Sonography (TRS) and a new technique, Transvaginal Sonography with Water-Contrast in the Rectum (RWC-TVS), in the diagnosis of rectosigmoid endometriosis, and the accuracy of Barium Enema (BE) and RWC-TVS in the detection of intestinal stenosis due to endometriosis. In a prospective study, we compared the findings of TRS and RWC-TVS performed before surgery with the operative and pathologic findings in 61 consecutive patients who underwent laparoscopy or laparotomy for suspected rectosigmoid endometriosis. The accuracy of BE and RWC-TVS in the detection of intestinal stenosis was evaluated comparing the radiologic and ultrasonographic results with the macroscopic findings at surgery and pathology. RWC-TVS diagnosed rectosigmoid endometriosis with the same accuracy of TRS and was equally efficient as BE in the detection of a significant intestinal lumen stenosis. For the diagnosis of rectosigmoid endometriosis the sensitivity, specificity, positive and negative predictive values of TRS and RWC-TVS were 88.2% and 96%, 80%, and 90%, 95.7%, and 98%, and 57.1% and 81.8%, respectively. For the detection of intestinal stenosis the sensitivity, specificity, positive and negative predictive values of BE and RWC-TVS were 93.7% and 87.5%, 94.2% and 91.4%, 88.2% and 82.3%, and 97% and 94.1%, respectively. RWC-TVS is a new, simple technique for a single-step and accurate preoperative assessment of rectosigmoid endometriosis.

  19. Transvaginal repair of genital prolapse: preliminary results of a new tension-free vaginal mesh (Prolift technique)--a case series multicentric study.

    Science.gov (United States)

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

    2007-07-01

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

  20. Transvaginal ultrasound versus magnetic resonance imaging for preoperative assessment of myometrial infiltration in patients with endometrial cancer: a systematic review and meta-analysis

    Science.gov (United States)

    2017-01-01

    Objective To compare the diagnostic accuracy of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) for detecting myometrial infiltration (MI) in endometrial carcinoma. Methods An extensive search of papers comparing TVS and MRI in assessing MI in endometrial cancer was performed in MEDLINE (PubMed), Web of Science, and Cochrane Database from January 1989 to January 2017. Quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Results Our extended search identified 747 citations but after exclusions we finally included in the meta-analysis 8 articles. The risk of bias for most studies was low for most 4 domains assessed in QUADAS-2. Overall, pooled estimated sensitivity and specificity for diagnosing deep MI were 75% (95% confidence interval [CI]=67%–82%) and 82% (95% CI=75%–93%) for TVS, and 83% (95% CI=76%–89%) and 82% (95% CI=72%–89%) for MRI, respectively. No statistical differences were found when comparing both methods (p=0.314). Heterogeneity was low for sensitivity and high for specificity for TVS and MRI. Conclusion MRI showed a better sensitivity than TVS for detecting deep MI in women with endometrial cancer. However, the difference observed was not statistically significant. PMID:29027404

  1. Diagnosis of Helicobacter pylori infection using urease rapid test in patients with bleeding duodenal ulcer: influence of endoscopic signs and simultaneous corporal and antral biopsies Diagnóstico de la infección por Helicobacter pylori mediante el test rápido de la ureasa en pacientes con hemorragia por úlcera duodenal: influencia de los signos endoscópicos de sangrado y de la obtención simultánea de biopsias de cuerpo y antro gástrico

    Directory of Open Access Journals (Sweden)

    M. Castro Fernández

    2004-09-01

    patients with combined antral and fundic biopsies. In group A, urease test was positive in 90.5% of patients; in group B, it was positive in 89.5% of patients, and in group C, the test turned positive in 75.4% of patients. Statistical differences were only reached when patients in group C were compared to patients in groups A and B together (p = 0.037. Conclusions: 1. The presence of either blood in the stomach or recent bleeding endoscopic signs appeared not to be the conditioning factor for the decreased sensitivity of urease test among patients with bleeding duodenal ulcer. 2. The decreased sensitivity of this test in patients with upper gastrointestinal bleeding is more evident during the resolution stage, and it does not seem to occur because of H. pylori migration from the antrum to the corporal gastric region.Introducción: la sensibilidad de los métodos diagnósticos invasivos de infección por H. pylori, especialmente el test rápido de la ureasa, disminuye en los casos de úlcera gastro-duodenal y hemorragia digestiva. Objetivos: valorar la influencia de la presencia de sangre en estómago o de signos endoscópicos de sangrado en la sensibilidad del test rápido de la ureasa en pacientes con hemorragia por úlcera duodenal, así como la influencia de la obtención de biopsias de cuerpo y antro gástrico. Pacientes y métodos: incluimos 120 pacientes, 85 varones y 35 mujeres, con edad media de 62 (18-88 años, con hemorragia por úlcera duodenal y diagnóstico endoscópico en las primeras 24 horas del ingreso. Ningún paciente había consumido antiinflamatorios no esteroideos, inhibidores de la bomba de protones o antibióticos en las dos semanas previas a la hemorragia digestiva, ni había recibido tratamiento frente a H. pylori. En este grupo seleccionado de pacientes admitimos una tasa de infección de prácticamente el 100%. Investigamos la infección por H. pylori mediante biopsias de antro (69 casos o de cuerpo y antro (51 casos gástricos para test de

  2. Manifestaciones ocultas de violencia, durante el desarrollo del recreo escolar

    Directory of Open Access Journals (Sweden)

    Artavia Granados, Jenny María

    2013-01-01

    Full Text Available El presente artículo es producto de un proceso de investigación realizado en una escuela de la Dirección Regional de Educación de Occidente, en Costa Rica. Este tiene como fin determinar si durante el desarrollo de los recreos se suscitan manifestaciones de violencia implícitas u ocultas entre las y los estudiantes II Ciclo de la Educación General Básica. En el proceso del estudio se tomaron en cuenta aspectos relacionados con las actividades lúdicas y las interacciones personales desarrolladas durante los recreos escolares y que podrían propiciar violencia escolar implícita u oculta. Se procuró identificar la existencia de enfrentamientos y conflictos entre estudiantes, que conllevan amenazas, manifestaciones de exclusión, persecuciones e intimidaciones entre las y los niños. Se plantearon algunas conclusiones entre las que destacan que un alto porcentaje de la población estudiantil investigada manifiesta recibir amenazas, y que estas, en mayor número, se producen entre las niñas. Asimismo, un alto porcentaje de esta población estudiada indica que ha sido excluida en la dinámica del recreo por diferentes motivos, entre los que destacan: características físicas, género, condición social y situaciones particulares educativas que presentan algunos niños o niñas en edad escolar.This article is the product of a research process carried out in a school at Dirección Regional de Occidente (Western Regional Bureau of Education, in Costa Rica. This is intended to determine if during the development of school recesses manifestations of violence, implied or hidden, arise among the students of II Cycle of the General Basic Education. The process of the study took into account aspects related to recreational activities and personal interactions developed in school recess and that could lead to implied or hidden school violence or bullying. It was aimed to identify the existence of confrontations and conflicts between students

  3. Perfil de actividad durante el juego en futbolistas infantiles

    Directory of Open Access Journals (Sweden)

    José C. Barbero Álvarez

    2007-12-01

    Full Text Available En fútbol, el patrón de actividad de jugadores adultos, tanto masculinos como femeninos, ha sido ampliamente estudiado, pero son escasos los estudios que han centrado su atención en el análisis de los desplazamientos de los jugadores de categorías infantiles. Un mayor conocimiento de las demandas de este deporte en las etapas iniciales permitiría la confección de programas de entrenamiento más acordes con las características de los chicos de estas edades. El objetivo del presente estudio fue cuantificar de los desplazamientos en jugadores de fútbol de categoría infantil (12,2 ± 0,6 años; 156 ± 0,8 cm y 51 ± 5,2 kg que pertenecían a la selección de la ciudad autónoma de Melilla, mediante la aplicación de dispositivos basados en tecnología GPS. Los resultados obtenidos certifican que el fútbol infantil es una especialidad deportiva intermitente en la que se intercalan actividades de alta intensidad con situaciones del juego que permiten que el jugador recupere estando parado, andando o con una velocidad de carrera muy baja. La tasa trabajo-descanso fue de 1:3,5 y la distancia media recorrida por minuto fue aproximadamente de 100 m. Esta distancia varía disminuyendo de forma lineal conforme transcurre el partido, existiendo diferencias significativas entre el inicio y el final del juego, lo que indicaría la aparición de la fatiga. Los esfuerzos de alta intensidad que se realizan implican el 6,1% del tiempo de juego y el 16,3 % de la distancia recorrida, efectuando un sprint máximo de entre 10 y 15 m de media, cada 141 segundos. La aplicación de tareas que reproduzcan la intensidad del juego durante cortos periodos de tiempo (no superiores a 10 minutos aseguraría una elevada intensidad de trabajo durante los entrenamientos.

  4. Reformismo e intervencionismo militar durante la Guerra Civil

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    Ramón SALAS LARRAZÁBAL

    2010-02-01

    Full Text Available El reformismo militar ha sido durante nuestra historia contemporánea una obsesión que cayó en manía, tal vez porque nunca se hizo una verdadera reforma y el intervencionismo de los militares en la política, un hábito que llegó a adquirir caracteres patológicos endémicos. Del centenar largo de españoles que ocuparon una o varias veces la cartera de la guerra desde la convocatoria de Cortes en 1.809 hasta nuestra Guerra Civil, raro fue el que no llevaba en sus bolsillos al incorporarse a su puesto un proyecto de reforma militar y lo mismo podría decirse de los que en número sensiblemente igual se sucedieron en el Ministerio de Marina, todos los cuales eran portadores de su personal programa naval. Del mismo modo también puede afirmarse que en casi todas las situaciones en que, con éxito o sin él, se produjo un cambio sustancial en el funcionamiento de las Instituciones, los que lo protagonizaron o eran militares o buscaron y encontraron apoyo en las Fuerzas Armadas.

  5. Síndrome de Brugada durante el embarazo

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    Eduardo Reyna Villasmil

    2013-09-01

    Full Text Available El síndrome de Brugada es una causa común de muerte súbita de origen cardiaco. Los cambios electrocardiográficos característicos del síndrome están relacionados con las alteraciones de los canales de sodio. Las características clínicas y moleculares del síndrome han progresado rápidamente desde la descripción inicial. Existen escasos reportes de esta enfermedad en el embarazo. Se describe un caso de síndrome de Brugada durante el embarazo en una mujer joven que se presentó con síncope y taquicardia ventricular. Brugada syndrome during pregnancy Brugada syndrome is a common cause of cardiac-origin sudden death. The characteristic electrocardiographic changes of the syndrome are linked to sodium channel alterations. Clinical and molecular characterization of the syndrome has progressed rapidly since its initial description. There are few reports of this disease in pregnancy. We describe a case of revelation of Brugada syndrome during pregnancy in a young woman who presented syncope and ventricular tachycardia.

  6. La prescripción de medicamentos durante la lactancia

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    María Luisa Cárdenas

    1997-04-01

    Full Text Available Al formular cualquier medicamento durante la lactancia, surgen algunos interrogantes por parte del médico y de la paciente lo cual permite una subestimación del riesgo que tiene el lactante o una sobreestimación del potencial tóxico, hecho que facilita una poca adhesión de la paciente al esquema de tratamiento ya que aún falta información acerca de la transferencia de los fármacos desde el plasma a la leche materna y la proporción en que estos la hacen. Por tal motivo es importante conocer las propiedades fisicoquímicas de los fármacos que favorezcan su paso a la leche, al igual que algunos factores maternos y del lactante, para lograr hacer una aproximación sobre la cantidad de fármaco que toma el niño en cada ingesta de leche.

  7. The Diagnostic Value of Transvaginal Sonograph (TVS), Color Doppler, and Serum Tumor Marker CA125, CEA, and AFP in Ovarian Cancer.

    Science.gov (United States)

    Zhang, Fang; Zhang, Zhou-Long

    2015-06-01

    The purpose of this study is to investigate the diagnostic value of transvaginal sonograph (TVS), color Doppler, and serum tumor marker CA125, CEA, and AFP in ovarian cancer. From June, 2011 to May, 2013, 102 cases with adnexal mass were recruited in this study (32 cases of malignant ovarian cancer and 70 cases of benign ovarian tumor according to pathological diagnosis). TVS, color Doppler, and serum tumor markers were used for tumor diagnosis. The sensitivity, specifity, positive prediction, negative prediction, and Youden's index were analyzed. Of the 102 patients, 32 were diagnosed with malignant ovarian cancer and 70 were diagnosed with benign ovarian tumor according to pathological diagnosis. Based on TVS results, 37 cases were malignant while 65 cases were benign. Based on color Doppler results, 34 cases were malignant while 68 cases were benign. Based on TVS and color Doppler results, 35 cases were malignant while 65 were benign. Based on CA125 test results, 34 cases were malignant while 68 cases were benign. Based on CEA test results, 8 cases were malignant and 94 cases were benign. Bases on AFP test results, 9 cases were malignant while 93 cases were benign. Based on the results of combination tumor marker test, 38 cases were malignant while 64 cases were benign. The combination of TVS, color Doppler, and tumor marker test showed optimal diagnostic value with a sensitivity of 90.63 %, specificity of 97.14 %, positive prediction of 93.94 %, negative prediction of 98.55 %, and Youden's index of 94.02 %. The combination of TVS, color Doppler, and tumor marker test is of great diagnostic value, which should be widely used in clinical practice.

  8. Surgical time and complications of total transvaginal (total-NOTES, single-port laparoscopic-assisted and conventional ovariohysterectomy in bitches

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    M.A.M. Silva

    2015-06-01

    Full Text Available The recently developed minimally invasive techniques of ovariohysterectomy (OVH have been studied in dogs in order to optimize their benefits and decrease risks to the patients. The purpose of this study was to compare surgical time, complications and technical difficulties of transvaginal total-NOTES, single-port laparoscopic-assisted and conventional OVH in bitches. Twelve bitches were submitted to total-NOTES (NOTES group, while 13 underwent single-port laparoscopic-assisted (SPLA group and 15 were submitted to conventional OVH (OPEN group. Intra-operative period was divided into 7 stages: (1 access to abdominal cavity; (2 pneumoperitoneum; approach to the right (3 and left (4 ovarian pedicle and uterine body (5; (6 abdominal or vaginal synthesis, performed in 6 out of 12 patients of NOTES; (7 inoperative time. Overall and stages operative times, intra and postoperative complications and technical difficulties were compared among groups. Mean overall surgical time in NOTES (25.7±6.8 minutes and SPLA (23.1±4.0 minutes groups were shorter than in the OPEN group (34.0±6.4 minutes (P<0.05. The intraoperative stage that required the longest time was the approach to the uterine body in the NOTES group and abdominal and cutaneous sutures in the OPEN group. There was no difference regarding the rates of complications. Major complications included postoperative bleeding requiring reoperation in a bitch in the OPEN group, while minor complications included mild vaginal discharge in four patients in the NOTES group and seroma in three bitches in the SPLA group. In conclusion, total-NOTES and SPLA OVH were less time-consuming then conventional OVH in bitches. All techniques presented complications, which were properly managed.

  9. Beyond the complications: medium-term anatomical, sexual and functional outcomes following removal of trocar-guided transvaginal mesh. A retrospective cohort study.

    Science.gov (United States)

    Jeffery, Stephen T; Nieuwoudt, Andri

    2012-10-01

    The aims of this study were to assess the anatomical, sexual and functional outcomes of women undergoing surgical intervention for complications of the trocar-guided transvaginal mesh (TVM) procedure. This was a retrospective analysis of a clinical database of women who had developed a complication following a TVM procedure. This included dyspareunia, mesh erosion, urinary symptoms, mesh contraction and prolapse recurrence. Pre- and post-operatively, we assessed the women for prolapse, stress incontinence, urgency, defecatory difficulty, digitation, pain, dyspareunia and apareunia. We also recorded the Pelvic Organ Prolapse Quantification (POP-Q) score. The TVM was removed and a Biodesign graft was used in the majority of cases to prevent further prolapse. Follow-up was at 6 weeks, 6 months, 1 and 2 years. In our cohort of 21 women, 18 required surgery for pain and/or dyspareunia; 20 women had reached the 6-week follow-up at the time of analysis. At 6 weeks, two women still had pain and required a second intervention. Fifteen women had reached a 6-month follow-up and only one woman had persistent pain requiring repeat surgery. Of the 15 women, 7 were sexually active and in 6 cases the dyspareunia had resolved completely with 1 woman retaining an element of pain at intercourse. Six women had been seen at 12 months and all four of the sexually active women had no dyspareunia. There were no symptoms relating to prolapse in any of the women at 6 weeks, 6, 12 or 24 months. We report satisfactory outcomes following removal of a complicated TVM kit.

  10. Qualidade de biodiesel de soja, mamona e blendas durante armazenamento

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    Marco Aurélio R. Melo

    2016-12-01

    Full Text Available Objetivou-se monitorar o armazenamento dos biodieseis provenientes da transesterificação homogênea alcalina do óleo de soja e mamona via rota metílica, avaliando a indução oxidativa pela norma EN14112 e pelo método PetroOxy durante o período de 120 dias, também observou-se o comportamento dos biodieseis inseridos em blendas nas proporções de 20, 30, 40 e 50% v/v de biodiesel de mamona ao biodiesel de soja denominadas de M20, M30, M40 e M50 (em recipientes de aço-carbono fechado. Conforme análises físico-químicas, as especificações para ambos biodiesel e blendas satisfizeram as exigências dos limites permitidos pelo Regulamento Técnico nº 14/2012 da Agência Nacional do Petróleo, Gás Natural e Biocombustíveis. Exceção das análises de estabilidade oxidativa (M0, M20, M30 e M40, do índice de acidez após 60 dias (M50, após 90 dias (M40 e M50, após 120 dias (M100 e da viscosidade cinemática (M40, M50 e M100 que apresentaram valores fora dos limites estabelecidos pela norma. As propriedades fluidodinâmicas apresentaram comportamentos semelhantes para os biodieseis metílicos e blendas, assim, nestas concentrações o biodiesel metílico de mamona atua como um aditivo natural ao biodiesel metílico de soja. Através do método EN 14112 verificou-se que a blenda M50 é mais resistente ao processo de oxidação durante armazenamento de 120 dias.Quality of biodiesel soy, castor beans and blends during storageAbstract: The objective of the study was to monitor the storage of biodiesels from alkaline homogeneous transesterification of soybean and castor oil via methyl route, and to evaluate the oxidative induction by the EN14112 standard and the PetroOxy method over the period of 120 days. We observed the behavior of the inserted biodiesels in blends in the ratios of 20, 30, 40 and 50% v / v biodiesel from castor beans of soybean biodiesel named M20, M30, M40 and M50 (closed carbon steel containers . As physical and chemical

  11. Incidencia de la sífilis durante el embarazo

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    Vivian Herrera Gómez

    1997-08-01

    Full Text Available Se realiza un estudio descriptivo, retrospectivo en el Departamento de Enfermedades de Transmisión Sexual del Policlínico Docente "Nguyen Van Troi" en el trienio 1993 al 1995, con el objetivo de disminuir la morbilidad y la mortalidad por enfermedades de transmisión sexual en las gestantes. Se revisaron las encuestas epidemiológicas realizadas a todas las embarazadas con serologías positivas por el Departamento de Enfermedades de Transmisión Sexual y de cada una de ellas se extrajeron las variables necesarias para estudiar las gestantes que finalmente se diagnosticaron con sífilis. Como resultado de nuestro trabajo encontramos una incidencia de sífilis durante el embarazo de 28,66 x 1 000 gestantes. Existe un elevado porcentaje de gestantes con sífilis en edades comprendidas entre 15 y 19 años, la mayoría pertenecían a la raza negra. Llama la atención la gran proporción de mujeres casadas y con bajo nivel cultural. En cuanto a la categoría ocupacional, predominó el ama de casa y un gran número de casos se diagnosticó en el primer trimestre. Del total de casos, sólo 4 presentaron manifestaciones dermatológicas y 34 recibieron el tratamiento de elección. No se reportó ningún caso de sífilis congénita.A descriptive and retrospective study was conducted at the Department of Sexually Transmitted Diseases of the "Nugyen Van Troi" Teaching Polyclinic from 1993 to 1995, aimed at reducing morbidity and mortality due to sexually transmitted diseases among pregnant women. All the epidemiological surveys applied to pregnant women with positive serology by this Departament were reviewed. All the variables necessary to study these women who finally had a syphilis diagnosis were used. As a result of our work we found an incidence of syphilis during pregnancy of 28.66 x 1 000 pregnant women. There is a high percentage of syphilis at ages between 15 and 19 years. Most of them are black women. The number of married women with low cultural

  12. Vivencias educativas durante la Época Franquista en Zújar

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    Nazaret Martínez Heredia

    2016-06-01

    Full Text Available Con la realización de este estudio hemos pretendido conocer los testimonios y vivencias educativas durante la época franquista en el municipio de Zújar, situado en la parte noroccidental de la comarca de Baza, en la provincia de Granada. Para ello analizamos cuatro entrevistas en profundidad, utilizando una metodología de carácter cualitativo desarrollando un estudio biográfico-narrativo de corte hermenéutico. Se obtuvieron fotografías e imágenes de objetos de interés por parte de los entrevistados que completaron y complementaron la construcción de la historia de vida y nos proporcionaron una visión más completa del objeto de estudio. Como principales hallazgos destacamos dificultades en la escolarización, grandes situaciones de analfabetismo, épocas de escasez, y, cómo no, la precariedad del sistema educativo en Zújar. Las relaciones intergeneracionales, la realización de las entrevistas, así como su transcripción literaria nos han permitido conocer poco a poco tanto las formas de vida como las necesidades procedentes de una época marcada por la Dictadura. Concluimos con las grandes diferencias existentes, tanto en la escolarización como en la vida cotidiana entre la época actual y la época franquista en España, debemos decir que la construcción del género en la época franquista se realizaba mostrando la relación existente entre mujer y familia, resaltando su papel como educadora de los hijos, ser la mujer perfecta y educada dentro de su hogar… destacando la existencia de un currículum dirigido a las chicas, en el que se impartían asignaturas escolares para las mujeres sobre tareas domésticas con el objetivo de enseñarlas a bordar, coser… Del mismo modo destacamos el peso de la Religión dentro de las escuelas, junto a la necesidad de rezar a la entrada y la salida de la escuela.

  13. Estructura administrativa de la Provincia de Bogotá durante el periodo comprendido entre 1832- 1857

    OpenAIRE

    Restrepo Robledo, Luz Marina

    2010-01-01

    El estudio de la estructura administrativa de la provincia de Bogotá en el siglo IX es importante por cuanto se muestra por primera vez cuales fueron los primeros entes administrativos que se crearon durante este periodo, fundamentalmente durante la vigencia de la constitución de 1832. El régimen territorial de las provincias se dividió a su vez en cantones y éstos, en distritos parroquiales.

  14. Prediction of Tubal Ectopic Pregnancy Using Offline Analysis of 3-Dimensional Transvaginal Ultrasonographic Data Sets: An Interobserver and Diagnostic Accuracy Study.

    Science.gov (United States)

    Infante, Fernando; Espada Vaquero, Mercedes; Bignardi, Tommaso; Lu, Chuan; Testa, Antonia C; Fauchon, David; Epstein, Elisabeth; Leone, Francesco P G; Van den Bosch, Thierry; Martins, Wellington P; Condous, George

    2017-12-08

    To assess interobserver reproducibility in detecting tubal ectopic pregnancies by reading data sets from 3-dimensional (3D) transvaginal ultrasonography (TVUS) and comparing it with real-time 2-dimensional (2D) TVUS. Images were initially classified as showing pregnancies of unknown location or tubal ectopic pregnancies on real time 2D TVUS by an experienced sonologist, who acquired 5 3D volumes. Data sets were analyzed offline by 5 observers who had to classify each case as ectopic pregnancy or pregnancy of unknown location. The interobserver reproducibility was evaluated by the Fleiss κ statistic. The performance of each observer in predicting ectopic pregnancies was compared to that of the experienced sonologist. Women were followed until they were reclassified as follows: (1) failed pregnancy of unknown location; (2) intrauterine pregnancy; (3) ectopic pregnancy; or (4) persistent pregnancy of unknown location. Sixty-one women were included. The agreement between reading offline 3D data sets and the first real-time 2D TVUS was very good (80%-82%; κ = 0.89). The overall interobserver agreement among observers reading offline 3D data sets was moderate (κ = 0.52). The diagnostic performance of experienced observers reading offline 3D data sets had accuracy of 78.3% to 85.0%, sensitivity of 66.7% to 81.3%, specificity of 79.5% to 88.4%, positive predictive value of 57.1% to 72.2%, and negative predictive value of 87.5% to 91.3%, compared to the experienced sonologist's real-time 2D TVUS: accuracy of 94.5%, sensitivity of 94.4%, specificity of 94.5%, positive predictive value of 85.0%, and negative predictive value of 98.1%. The diagnostic accuracy of 3D TVUS by reading offline data sets for predicting ectopic pregnancies is dependent on experience. Reading only static 3D data sets without clinical information does not match the diagnostic performance of real time 2D TVUS combined with clinical information obtained during the scan. © 2017 by the American

  15. Longitudinal transvaginal ultrasound evaluation of cesarean scar niche incidence and depth in the first two years after single- or double-layer uterotomy closure: a randomized controlled trial.

    Science.gov (United States)

    Bamberg, Christian; Hinkson, Larry; Dudenhausen, Joachim W; Bujak, Verena; Kalache, Karim D; Henrich, Wolfgang

    2017-12-01

    Cesarean deliveries are the most common abdominal surgery procedure globally, and the optimal way to suture the hysterotomy remains a matter of debate. The aim of this study was to assess the incidence of cesarean scar niches and the depth after single- or double-layer uterine closure. We performed a randomized controlled trial in which women were allocated to three uterotomy suture techniques: continuous single-layer unlocked, continuous locked single-layer, or double-layer sutures. Transvaginal ultrasound was performed six weeks and 6-24 months after cesarean delivery [Clinicaltrials.gov (NCT02338388)]. The study included 435 women. Six weeks after delivery, the incidence of niche was not significantly different between the groups (p = 0.52): 40% for single-layer unlocked, 32% for single-layer locked and 43% for double-layer sutures. The mean ± SD niche depths were 3.0 ± 1.4 mm for single-layer unlocked, 3.6 ± 1.7 mm for single-layer locked and 3.3 ± 1.3 mm for double-layer sutures (p = 1.0). There were no significant differences (p = 0.58) in niche incidence between the three groups at the second ultrasound follow up: 30% for single-layer unlocked, 23% for single-layer locked and 29% for double-layer sutures. The mean ± SD niche depth was 3.1 ± 1.5 mm after single-layer unlocked, 2.8 ± 1.5 mm after single-layer locked and 2.5 ± 1.2 mm after double-layer sutures (p = 0.61). There was a trend (p = 0.06) for the residual myometrium thickness to be thicker after double-layer repair at the long-term follow up. The incidence of cesarean scar niche formation and the niche depth was independent of the hysterotomy closure technique. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  16. Doença periodontal em portadoras de valvopatia durante a gravidez: estudo clínico e microbiológico Enfermedad periodontal en portadoras de valvopatía durante la gravidez: estudio clínico y microbiológico Periodontal disease in pregnant patients with rheumatic valvular disease: clinical and microbiological study

    Directory of Open Access Journals (Sweden)

    Walkiria Samuel Ávila

    2011-04-01

    gestante portadora de valvopatía reumática, ya sea para contraer endocarditis infecciosa, el sea por propiciar complicaciones obstétricas, tales como aborto espontáneo y prematuridad. OBJETIVO:Estudiar la frecuencia de la enfermedad periodontal en portadoras de valvopatía reumática durante la gravidez. MÉTODOS: Fueron estudiadas 140 gestantes, divididas por edad y por nivel socioeconómico, en dos grupos: 70 portadoras de enfermedad valvar reumática y 70 mujeres sanas. Todas se sometieron a: 1 evaluación clínica odontológica que incluyó el análisis de los siguientes parámetros: 1.1 profundidad al sondaje, 1.2 distancia de la línea esmalte-cemento al margen gingival, 1.3 nivel clínico de inserción, 1.4 índice de sangrado, 1.5 índice de placa bacteriana, y, 1.6 compromiso de furca; y, 2 examen microbiológico en las muestras de saliva y del cono que consideró el control positivo para las cepas de las bacterias Porphyromonas gingivalis, Tannerella forsithia y Aggregobacter actinomycetemcomitans. RESULTADOS:La edad y la paridad no fueron diferentes entre los grupos; la lesión valvar mitral fue prevalente (65 casos = 92,8%, tanto en la forma aislada (45 casos cuanto asociada a la lesión valvar aórtica (20 casos. El análisis comparativo mostró que las medidas de la distancia de la línea esmalte-cemento al margen gingival (p = 0,01 y el índice de placa (p = 0,04 fueron diferentes entre los grupos; y la frecuencia de la enfermedad periodontal identificada en 20 (14,3% gestantes, de las cuales 7 eran reumáticas (10,0% y 13 sanas (18,6%, no fue diferente entre los grupos (p = 0,147. El examen microbiológico mostró una proporción mayor de la bacteria P. gingivalis en la saliva de gestantes sanas (p = 0,004. CONCLUSIÓN:El estudio clínico y microbiológico periodontal durante la gravidez demostró igual frecuencia de enfermedad periodontal en portadoras de valvopatía reumática cuando fueron comparadas a las mujeres sanas.BACKGROUND: The periodontal

  17. Mesh, graft, or standard repair for women having primary transvaginal anterior or posterior compartment prolapse surgery: two parallel-group, multicentre, randomised, controlled trials (PROSPECT).

    Science.gov (United States)

    Glazener, Cathryn Ma; Breeman, Suzanne; Elders, Andrew; Hemming, Christine; Cooper, Kevin G; Freeman, Robert M; Smith, Anthony Rb; Reid, Fiona; Hagen, Suzanne; Montgomery, Isobel; Kilonzo, Mary; Boyers, Dwayne; McDonald, Alison; McPherson, Gladys; MacLennan, Graeme; Norrie, John

    2017-01-28

    The use of transvaginal mesh and biological graft material in prolapse surgery is controversial and has led to a number of enquiries into their safety and efficacy. Existing trials of these augmentations are individually too small to be conclusive. We aimed to compare the outcomes of prolapse repair involving either synthetic mesh inlays or biological grafts against standard repair in women. We did two pragmatic, parallel-group, multicentre, randomised controlled trials for our study (PROSPECT [PROlapse Surgery: Pragmatic Evaluation and randomised Controlled Trials]) in 35 centres (a mix of secondary and tertiary referral hospitals) in the UK. We recruited women undergoing primary transvaginal anterior or posterior compartment prolapse surgery by 65 gynaecological surgeons in these centres. We randomly assigned participants by a remote web-based randomisation system to one of the two trials: comparing standard (native tissue) repair alone with standard repair augmented with either synthetic mesh (the mesh trial) or biological graft (the graft trial). We assigned women (1:1:1 or 1:1) within three strata: assigned to one of the three treatment options, comparison of standard repair with mesh, and comparison of standard repair with graft. Participants, ward staff, and outcome assessors were masked to randomisation where possible; masking was obviously not possible for the surgeon. Follow-up was for 2 years after the surgery; the primary outcomes, measured at 1 year and 2 years, were participant-reported prolapse symptoms (i.e. the Pelvic Organ Prolapse Symptom Score [POP-SS]) and condition-specific (ie, prolapse-related) quality-of-life scores, analysed in the modified intention-to-treat population. This trial is registered as an International Standard Randomised Controlled Trial, number ISRCTN60695184. Between Jan 8, 2010, and Aug 30, 2013, we randomly allocated 1352 women to treatment, of whom 1348 were included in the analysis. 865 women were included in the mesh

  18. Fatores prognósticos para o parto transvaginal em pacientes com cesárea anterior Prognostic factors for vaginal delivery after cesarian section

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    Luiz Carlos Santos

    1998-07-01

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

  19. La misurazione dei processi di regolazione cognitiva e metacognitiva durante lo studio con gli ipermedia

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    Roger Azevedo

    2010-01-01

    Full Text Available L’apprendimento autoregolato rappresenta una modalità di apprendimento di fondamentale importanza quando ci si avvale del supporto di ambienti ipermediali. Obiettivo di questo articolo è presentare quattro assunzioni chiave che consentono la misurazione dei processi cognitivi e metacognitivi attivati durante l’apprendimento tramite ipermedia. Innanzi tutto, assumiamo che sia possibile individuare, tracciare, modellare e favorire processi di apprendimento auto-regolato durante lo studio con gli ipermedia. La seconda assunzione si focalizza sul comprendere come la complessità dei processi regolatori che avvengono durante l’apprendimento mediato da sistemi ipermediali sia importante per determinare il perché alcuni processi vengono messi in atto durante l’esecuzione di un compito. Le terza assunzione è relativa al considerare che l’utilizzo di processi di apprendimento auto-regolato possa dinamicamente cambiare nel tempo e che tali processi sono di natura ciclica (influenzati dalle condizioni interne ed esterne e da meccanismi di feedback. Infine, l’identificazione, raccolta e classificazione dei processi di apprendimento autoregolato utilizzati durante lo studio con sistemi ipermediali, può risultare un compito alquanto difficoltoso.

  20. Normotermia durante la circulación extracorpórea en cirugía cardiovascular pediátrica Normothermia during extracorporeal circulation in pediatric cardiovascular surgery

    Directory of Open Access Journals (Sweden)

    Luis Marcano Sanz

    2012-03-01

    Full Text Available Introducción: la circulación extracorpórea normotérmica en pediatría fue iniciada por Lecompte en 1995. Los reportes europeos son grandes series de casos y pocos estudios controlados. Objetivo: evaluar el empleo de la normotermia como método de protección de órganos durante la circulación extracorpórea en niños, para intentar obtener un mayor nivel de evidencia médica e introducirla en todo el universo de trabajo. Métodos: se realizó un estudio explicativo, controlado y prospectivo, en 100 pacientes con edades comprendidas entre los 30 días y los 18 años, que se distribuyeron aleatoriamente, con el objetivo de evaluar la normotermia durante la circulación extracorpórea. En normotermia (n= 45 se utilizó temperatura de 36º C, hematócrito mayor de 30 % y flujo de perfusión de 2,8 a 3,5 L/min/m². En hipotermia (n= 55, hematócrito de 25 a 30 % y flujo de perfusión de 2,2 a 2,8 L/min/m². Resultados: ambos grupos fueron homogéneos en edad, peso y riesgo ajustado para la cirugía cardiaca. Los índices de inotrópicos y de sangrado, la frecuencia del bajo gasto cardíaco, los tiempos de circulación extracorpórea, la ventilación mecánica y de estadía en la unidad de cuidados intensivos, fueron significativamente menores con la normotermia. El riesgo relativo de bajo gasto cardiaco fue 2,62 con el uso de la hipotermia. La reducción absoluta del riesgo para dicha complicación, empleando la normotermia, fue 18 %. Conclusiones: la normotermia durante la circulación extracorpórea en pediatría es tan segura y más eficaz que la hipotermia. La derivación cardiopulmonar normotérmica es perfectamente factible, y la necesidad de convertirla a hipotérmica es muy poco frecuente.Introduction: the normothermia extracorporeal circulation in pediatrics was started by Lecompte in 1995. The European reports are large series of cases and few controlled studies. Objective: to assess the use of the normothermia as a protecting method

  1. Transvaginal color Doppler ultrasound in the diagnosis of endometrial lesions%经阴道彩色多普勒超声在子宫内膜病变诊断的应用价值

    Institute of Scientific and Technical Information of China (English)

    高鸣

    2015-01-01

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

  2. Time to rethink: an evidence-based response from pelvic surgeons to the FDA Safety Communication: "UPDATE on Serious Complications Associated with Transvaginal Placement of Surgical Mesh for Pelvic Organ Prolapse".

    Science.gov (United States)

    Murphy, Miles; Holzberg, Adam; van Raalte, Heather; Kohli, Neeraj; Goldman, Howard B; Lucente, Vincent

    2012-01-01

    In July of 2011 the U.S. Food and Drug Administration (FDA) released a safety communication entitled "UPDATE on Serious Complications Associated with Transvaginal Placement of Surgical Mesh for Pelvic Organ Prolapse." The stated purpose of this communication is to inform health care providers and patients that serious complications with placement of this mesh are not rare and that it is not clear that these repairs are more effective than nonmesh repair. The comments regarding efficacy are based on a systematic review of the scientific literature from 1996-2011 conducted by the FDA. Our review of the literature during this time yields some different conclusions regarding the safety and efficacy of mesh use in prolapse repair. It may be useful to consider this information prior to making recommendations regarding mesh use in prolapse surgery according to the recent UPDATE.

  3. Aumento de la temperatura en la superficie dental durante la foto-polimerización

    OpenAIRE

    Hernández, Douglas Jarquín; Bonilla, Silvia

    2016-01-01

    ResumenSe sabe que durante el fotocurado de los materiales dentales se libera calor, ya sea por parte de la fuente emisora de luz o por la reacción de polimerización del compuesto utilizado. Este aumento de temperatura se transmite a los tejidos, el cual puede repercutir en ellos. Debido a esto, se realiza un estudio comparativo de la temperatura alcanzada durante la obturación y reconstrucción de piezas dentales in vitro, utilizando lámparas de fotocurado de tipo cuarzo-tungsteno-halógeno (Q...

  4. Efectos estructurales en el transporte de materia durante el secado de frutas

    OpenAIRE

    Nieto, Andrea Bibiana

    2004-01-01

    El secado comercial de frutas involucra usualmente tratamientos de presecado (escalcado y deshidratación osmótica utilizando azúcares) dirigidos ya sea a mejorar la calidad del producto final o a mejorar la cinética de secado. La literatura sobre el efecto de estos tratamientos en la velocidad de transporte de humedad durante el secado convencional es aparentemente contradictoria. Ello puede atribuirse a la complejidad del proceso simultáneo de transferencia de calor y de masa durante el seca...

  5. Violencia en la sierra de Piura colonial durante el siglo XVIII*

    OpenAIRE

    Martínez-Flener, Milagros

    2015-01-01

    El tema de la violencia durante la época colonial generalmente ha sido estudiado en relación a levantamientos o rebeliones, pero no como tema aislado con contenido propio, es decir, en tanto violencia cotidiana. Jorge Pinto Rodríguez cita en su trabajo "La violencia en el corregimiento de Coquimbo durante el siglo xviii" algunos estudios para el caso chileno, mientras que en el Perú se cuenta tan solo con el estudio de Ward Stavig "Violencia cotidiana de los naturales de Quispicanchis, Canas ...

  6. El comercio exterior durante la década revolucionaria: un acercamiento preliminar

    OpenAIRE

    Sandra Kuntz Ficker

    2001-01-01

    El propósito de este trabajo es realizar un primer acercamiento sistemático al análisis del comercio exterior de México durante la década de 1910. Tal objetivo se ha visto obstaculizado en el pasado por la escasez de fuentes cuantitativas de procedencia mexicana para los años de la revolución. Para suplir esta carencia, este artículo recurre a las estadísticas comerciales publicadas por los principales socios de México durante estos años (Estados Unidos, Gran Bretaña y Francia). A pa...

  7. PSA (:60) Cuide su salud emocional durante una emergencia (Coping With Disaster)

    Centers for Disease Control (CDC) Podcasts

    2017-10-25

    Este anuncio de servicio público de 60 segundos habla sobre cómo cuidar su salud emocional durante una emergencia.  Created: 10/25/2017 by Centers for Disease Control and Prevention (CDC).   Date Released: 10/25/2017.

  8. Retinol sérico en mujeres mexicanas urbanas durante el periodo perinatal

    Directory of Open Access Journals (Sweden)

    Casanueva Esther

    1999-01-01

    Full Text Available OBJETIVO. Establecer la prevalencia de deficiencia de vitamina A durante el embarazo y la lactancia en un grupo de mujeres mexicanas urbanas. MATERIAL Y MÉTODOS. Se invitó a participar a un grupo de gestantes que acudían a control prenatal, que carecían de patología agregada y contaban con menos de 20 semanas de embarazo. Fueron evaluadas tres veces durante el embarazo y hasta la semana 24 del posparto. La determinación de vitamina A en suero se realizó por cromatografía de líquidos de alta presión. Se consideró como punto de corte para riesgo de deficiencia una concentración de retinol < 1.05 µmol/L. RESULTADOS. En las tres evaluaciones durante la gestación las concentraciones de vitamina A fueron de 2.34±0.70, 2.41±1.03 y 1.86±0.66 µmol/L, respectivamente, lo cual muestra una disminución significativa. Sin embargo, sólo 1/30 se ubicó por debajo del punto de corte aceptado para considerar riesgo de deficiencia y ninguno para deficiencia. Durante el posparto las concentraciones se conservaron relativamente constantes, alrededor de 2.10 µmol/L. La práctica de la lactancia no tuvo impacto sobre las concentraciones séricas de retinol, no así la pérdida de peso. CONCLUSIONES. En la población estudiada no se documentaron casos de deficiencia de vitamina A durante el periodo perinatal. La pérdida de peso materna tiene influencia sobre las concentraciones de retinol en el posparto.

  9. Sangrado vaginal anormal, hábitos de vida y biopsia de endometri

    OpenAIRE

    María Gamero de Ramos; Víctor Villasmil Araujo; Carlos Fonseca; Robert Silva

    2008-01-01

    Ir r egular or ex c es s ive uter ine bleeding is r efer r ed to as abnor mal uter ine bleeding; and when its c aus e is not k nown, tr eatment may be inadequate. The pur pos e of this des c r iptive s tudy was to es tablis h the r elations hip between uter ine bleeding, life habits and a his topathology s tudy of endometr ial biops y and endometr ial c ur ettage. The s ample c ons is ted of 100 appar ently healthy women attending a gynaec ology c linic between J une and December 2005 at “...

  10. Profilaxis para sangrado por ulceras de estrés en la unidad de cuidados intensivos

    Directory of Open Access Journals (Sweden)

    J.M. Avendaño-Reyes

    2014-01-01

    Conclusiones: La hospitalización en la unidad de cuidados intensivos por sí sola no justifica la profilaxis. Los IBP son por lo menos tan efectivos como los H2RA. Debemos individualizar el tratamiento de cada paciente en la unidad de cuidados intensivos, determinando el riesgo y evaluando la necesidad de comenzar la profilaxis.

  11. "Análise da carga mecânica no joeho durante o agachamento"

    OpenAIRE

    Rogério Pessoto Hirata

    2006-01-01

    Existe um conceito difundido entre professores de educação física, fisioterapeutas e ortopedistas que o joelho não deve ser demasiadamente anteriorizado em relação à ponta do pé na direção ântero-posterior durante qualquer tipo de agachamento de modo a diminuir a carga mecânica imposta ao joelho. No entanto, são escassas as evidências quantitativas que corroboram este conceito. Este trabalho tem como objetivo estimar forças e torque na articulação do joelho em indivíduos saudáveis durante o e...

  12. Estrategias cognitivas desarrolladas durante el juego por tenistas de diferente nivel de pericia

    Directory of Open Access Journals (Sweden)

    Luis García González

    2007-09-01

    Full Text Available El objetivo de este estudio ha sido analizar las estrategias cognitivas utilizadas por jugadores de tenis durante el juego real de competición, comparando la planificación táctica desarrollada en función del nivel de pericia de los sujetos. La investigación fue realizada con 6 tenistas, 3 jugadores noveles y 3 jugadores expertos. Los deportistas fueron entrevistados nada más terminar la acción de juego para que verbalizaran sobre qué estaban pensando en ese momento. El análisis de contenido de los informes verbales se ha realizado mediante un sistema de categorías propuesto originalmente por McPherson (1999, 2000. Los resultados muestran que los expertos poseen una estructura de conocimiento mayor, más compleja y más sofisticada, que les permite planificar mejor sus posteriores decisiones durante el juego.

  13. Alterações metabolicas induzidas pela cafeina durante o exercicio intermitente

    OpenAIRE

    Leonardo dos Reis Silveira

    1998-01-01

    Resumo: A cafeína porser uma droga muito comum nos dias atuais e capaz de alterar a performace durante o exercicio fisico, tem sido usada como um recurso ergogênico durante as competições esportivas em várias modalidades. O objetivo deste trabalho foi de verifiar a influência da cafeína no tempo de endurance, nas concentrações plasmáticas de ácidos graxos livres antes do exercício, nas concentrações de TBARS em amostras de urina no final do exercício, nas concentrações sanguíneas de lactato ...

  14. ALIMENTACIÓN DURANTE EL TRABAJO DE PARTO: ¿ES NECESARIO EL AYUNO?

    OpenAIRE

    Urrutia S.,María Teresa; Abarca C.,Cristian; Astudillo S.,Roxana; Llevaneras M.,Silvana; Quiroga T.,Natalia

    2005-01-01

    Estudio analítico de corte transversal sobre las características de alimentación e hidratación de 602 mujeres durante el trabajo de parto durante dos periodos. La información fue extraída por medio de una entrevista y la revisión de fichas clínicas. Para el análisis se utilizó t Student y Chi cuadrado. Entre 9,7 y 19,4% de las mujeres recibe comida en preparto y entre 30,4 y 33,2% recibe agua. No existen diferencias en la proporción de ingesta de agua y comida entre las madres con y sin patol...

  15. Morosidad bancaria en España durante los años de la crisis

    OpenAIRE

    Martín Pérez, Ana

    2016-01-01

    Este trabajo trata sobre las causas y consecuencias de la crisis financiera actual, el funcionamiento de las titulizaciones, los riesgos que estas conllevan y su influencia en el sistema financiero tanto a nivel internacional como a nivel nacional. Por último se examinan diversas variables que se ven afectadas durante el periodo de crisis y su relación con la tasa de morosidad bancaria, como puede ser el PIB, la tasa de desempleo u otras variables. Universidad de Sevilla. Grado en Finanzas...

  16. MANIFESTACIONES DE VIOLENCIA EXPLÍCITA O EVIDENTE DURANTE EL DESARROLLO DEL RECREO ESCOLAR

    Directory of Open Access Journals (Sweden)

    Jenny María Artavia Granados

    2012-01-01

    Full Text Available Este artículo es producto de un proceso de investigación realizado en una escuela de la Dirección Regional de Educación Occidente. Su finalidad fue determinar si en el intervalo de los recreos de la escuela en estudio, se suscitaban manifestaciones de violencia escolar explícita entre estudiantes de IV, V y VI año del II Ciclo de la Educación General Básica. Durante el desarrollo del estudio, se tomaron en cuenta aspectos relacionados con las actividades lúdicas y las interacciones personales que se presentaban en estos espacios escolares. Sobre todo, los que podrían propiciar violencia escolar explícita; los mecanismos de prevención y estrategias empleadas por la escuela para contrarrestar la violencia escolar; también el nivel de integración del personal docente y administrativo de la escuela durante el periodo de los recreos. Asimismo, se plantearon algunas conclusiones entre las que destacan que un alto porcentaje de niños y niñas manifiesta que existen enfrentamientos entre estudiantes, durante el desarrollo de los recreos, y que estos se perciben a través de comportamientos de violencia tanto física como verbal. Las manifestaciones de violencia más comunes son peleas, golpes así como el uso de un lenguaje soez y ofensivo. Los motivos de los enfrentamientos varían según el nivel escolar entre el estudiantado. Los mecanismos empleados por la escuela para contrarrestar la violencia que se suscita durante los recreos, se basan en el uso de procedimientos sancionadores y la aplicación de medidas preventivas.

  17. Escurecimento interno de pêra asiática 'Ya Li' durante o armazenamento refrigerado

    Directory of Open Access Journals (Sweden)

    BRACKMANN AURI

    2002-01-01

    Full Text Available A pêra 'Ya Li' apresenta escurecimento da polpa poucos dias após o armazenamento refrigerado. Este trabalho objetivou avaliar condições de armazenamento visando a diminuir os danos pela baixa temperatura inicial em peras 'Ya Li'. As condições iniciais estabelecidas foram: 1 0ºC; 2 5ºC, nos 10 primeiros dias, com redução de 0,7ºC por dia, durante sete dias; 3 10ºC nos 10 primeiros dias, com redução de 1,4ºC por dia, durante sete dias; 4 10º C nos 10 primeiros dias, com redução de 1,4ºC por dia, durante sete dias, sempre em atmosfera controlada (2,0kPa de O2 e < 1,0kPa de CO2; 5 10ºC nos 10 dias iniciais, com posterior exposição direta dos frutos a 0ºC. Em seqüência aos tratamentos iniciais, os frutos foram submetidos ao armazenamento refrigerado a 0ºC, com exceção do tratamento "4" que foi mantido continuamente em atmosfera controlada. Após 52 dias de armazenamento, verificou-se escurecimento interno, superior a 68% em todos os tratamentos. As temperaturas mais elevadas, no início, não evitaram a ocorrência do escurecimento durante o armazenamento.

  18. One-step transvaginal three-dimensional hysterosalpingo-foam sonography (3D-HyFoSy) confirmation test for Essure® follow-up: a multicenter study.

    Science.gov (United States)

    Zizolfi, B; Lazzeri, L; Franchini, M; Di Spiezio Sardo, A; Nappi, C; Piccione, E; Exacoustos, C

    2018-01-01

    To evaluate, in patients who underwent Fallopian-tube sterilization by hysteroscopic insertion of an Essure® device, the feasibility and accuracy of three-dimensional (3D) transvaginal sonography (TVS) to check the position of the device and 3D hysterosalpingo-foam sonography (3D-HyFoSy) using contrast-enhanced gel foam to assess consequent tubal occlusion. This was a prospective multicenter study conducted from June 2012 to July 2014 in four Italian centers, which included 50 women who underwent hysteroscopic Essure microinsert placement in a total of 95 Fallopian tubes. Placement of the microinserts was performed in an outpatient setting following standard procedure recommendations. All patients underwent transvaginal 3D-HyFoSy and hysterosalpingography (HSG) approximately 12-14 weeks after the procedure. The position of the devices was first checked on 3D-TVS and classified according to specific criteria (Positions A, B, C and D). Then, 3D-HyFoSy with ExEm® gel foam as the ultrasound contrast agent was performed to confirm tubal occlusion by the absence of contrast agent within the tubes and/or around the ovaries. To evaluate the feasibility of 3D-HyFoSy, consecutive volume acquisitions were performed while injecting the gel foam. After sonographic evaluation, women underwent HSG to assess the success of sterilization, as standard methodology. Side effects and pain evoked during and after 3D-HyFoSy and HSG were evaluated using a numeric pain rating scale. On 3D-TVS, 10 devices (10.5%) were in Position A, two (2.1%) in Position B, 59 (62.1%) in Position C and 24 (25.3%) in Position D. During 3D-HyFoSy, tubal occlusion was observed in 89 of 95 tubes (93.7%). In the six cases in which the passage of the contrast was observed, one device (16.7%) was in Position B, one device (16.7%) in Position D and four devices (66.7%) were found to lie in Position C. Tubal patency was confirmed at HSG with a concordance rate of 100%. The mean pain score associated with 3D

  19. Mecanismos de licuación y flujo de suelos granulares durante sismos

    Directory of Open Access Journals (Sweden)

    Adolfo Alarcón Guzmán

    1987-09-01

    Full Text Available Una amplia evidencia experimental ha mostrado que vibraciones de pequeña amplitud producen una disminución progresiva del volumen en suelos granulares; ello ocurre aún en el caso de arenas densas que podrían dilatar durante carga monotónica o unidireccional bajo un cierto nivel de esfuerzos de confinamiento. Por tanto, cuando un depósito de arena saturada se ve sometido a las ondas de corte que se propagan durante un Sismo, la estructura de la arena tiende a densificarse. Sin embargo, como la duración de aplicación de los esfuerzos de corte cíclicos es, en general, muy pequeña en comparación con el tiempo necesario para que ocurra algún drenaje, la tendencia de la arena a disminuir de volumen durante cada ciclo se refleja en un incremento progresivo de la presión de poros (8,14. Esto produce una reducción continua del esfuerzo efectivo y consecuentemente una disminución en la resistencia al corte de la arena. Una disminución considerable de la resistencia puede conducir a fallas por corte, que en algunas ocasiones son de consecuencias catastróficas.

  20. Las relaciones entre Chile y Suecia durante el primer gobierno de Olof Palme, 1969-1976

    Directory of Open Access Journals (Sweden)

    Fernando Camacho Padilla

    2014-06-01

    Full Text Available Durante el primer gobierno del socialdemócrata Olof Palme, las relaciones bilaterales entre Chile y Suecia fueron las más intensas de toda su historia, tanto en cercanía como en conflictividad. La razón la encontramos en los distintos fenómenos políticos que vivió Chile en ese periodo, puesto que Palme coincidió temporalmente con tres gobiernos claramente diferenciados: la Democracia Cristiana, la Unidad Popular y el Régimen Militar. Si las relaciones sueco-chilenas tuvieron su mejor momento durante el mandato de Salvador Allende, el golpe de Estado significó todo lo contrario. El compromiso que tuvo el embajador de Suecia, Harald Edelstam, por quienes eran perseguidos en Chile le llevó a su expulsión, lo que se tradujo en un claro deterioro de las relaciones y el inicio de una nueva etapa marcada por el gran contingente de exiliados que comenzaron a llegar a Suecia. Este trabajo analiza los principales acontecimientos diplomáticos ocurridos entre Chile y Suecia así como las consecuencias que tuvieron durante el gobierno de Olof Palme.

  1. Narrativas de la corporeidad en ciclistas colombianos durante su proceso formativo

    Directory of Open Access Journals (Sweden)

    Javier Anzola-Moreno

    2016-09-01

    Full Text Available Introducción. El cambio de paradigmas del cuerpo en el deporte, del cuerpo máquina al embodiment del deportista, requiere comprender el cuerpo vivido, la experiencia encarnada del ciclista, durante su proceso formativo. Objetivo. Comprender el sentido y significado de la corporeidad de ciclistas profesionales colombianos durante su proceso formativo. Materiales y métodos. El estudio fue cualitativo de tipo histórico-hermenéutico, por medio de biografía con entrevista abierta a cuatro ciclistas profesionales colombianos, tres hombres y una mujer nacidos entre 1987 y 1990. Se utilizó el software Atlas Ti 7.0. La categoría principal de análisis fue el embodiment desde las potencialidades y los desgastes. Resultados. Se identificaron potencialidades y desgastes en la corporeidad de los ciclistas durante el proceso formativo. Las categorías relacionadas con la corporeidad de los ciclistas fueron: historicidad del proceso formativo, soporte, orientación, entorno, causas y efectos. El sistema categorial permitió identificar las tendencias, relacionar las categorías e interpretar la corporeidad como expresión del cuerpo vivido. Conclusión. La corporeidad narrada significa la vida de los ciclistas y da sentido a sus vivencias en la identidad del cuerpo ciclista. Se debe reconocer el cuerpo vivido como expresión única de lo humano en movimiento y su abordaje desde la determinación social.

  2. COMPORTAMIENTO ESTRUCTURAL DE PUENTES EXTRADOSADOS DURANTE CONSTRUCCIÓN POR VOLADIZOS SUCESIVOS

    Directory of Open Access Journals (Sweden)

    José Benjumea Royero

    Full Text Available Este artículo presenta el estudio del comportamiento durante construcción por voladizos sucesivos de un puente extradosado en concreto de tres luces (60+100+60 m, modelado numéricamente mediante elementos finitos en el software SAP2000. La fluencia y contracción del concreto, al igual que los efectos P-delta, se incluyeron en el modelamiento. El estudio se concentró en el comportamiento del tablero, los cables y los pilares, durante construcción y desde el momento del cierre hasta cincuenta años después, tiempo en el cual han ocurrido los efectos diferidos. Los resultados encontrados permiten vislumbrar la importancia de la consideración de estos efectos en el análisis por etapas del puente. Por ejemplo, en el tablero ocurren variaciones considerables en fuerzas internas y desplazamientos en el tiempo, y en los cables tiene lugar una pérdida de tensión máxima del 10 % con respecto a la tensión al final de construcción. En los pilares, los efectos diferidos en el tiempo causan desplazamientos horizontales de magnitud considerable en la corona, generando momentos flectores excesivos en la base. Lo anterior obliga a introducir una fuerza durante la construcción de la dovela de cierre para corregir dicho fenómeno.

  3. Análisis de las Fuerzas Absolutas y las Circunferencias de Volumen Durante el Período Preparatorio.

    Directory of Open Access Journals (Sweden)

    Francisco Freyre Vázquez

    2003-01-01

    Full Text Available Se aborda la relación de dependencia entre los resultados de las fuerzas absolutas de los planos musculares brazo, tronco y pierna, en correspondencia con las circunferencias máximas de volumen de los miembros superiores e inferiores durante la preparación de fuerza a que fueron sometidos los atletas de baloncesto de la categoría juvenil durante el periodo preparatorio. De esta forma estaríamos hablando de la estrecha relación que existe en cuanto a esta variable, repercutiendo en los resultados a alcanzar por el equipo durante el proceso de entrenamiento.

  4. Serum anti-Mullerian hormone levels after ovarian drilling for the second-line treatment of polycystic ovary syndrome: a pilot-randomized study comparing laparoscopy and transvaginal hydrolaparoscopy.

    Science.gov (United States)

    Giampaolino, Pierluigi; Morra, Ilaria; Della Corte, Luigi; Sparice, Stefania; Di Carlo, Costantino; Nappi, Carmine; Bifulco, Giuseppe

    2017-01-01

    Aim of the study was to asses and compare serum anti-Mullerian harmone (AMH) levels after laparoscopic ovarian drilling (LOD) and transvaginal hydrolaparoscopy (THL) ovarian drilling in clomifene citrate (CC)-resistant polycystic ovary syndrome (PCOS) patients; secondary outcome was to evaluate postoperative pain to estimate the acceptability of procedures. A total of 246 patients with CC-resistant PCOS were randomized into two groups: 123 underwent LOD and 123 underwent THL ovarian drilling. AMH serum levels were evaluated before and after the procedure; moreover, women were asked to rate pain on a visual analog scale (VAS) from 0 (no pain, perfectly acceptable) to 10 (unbearable pain, completely unacceptable). In both groups, postoperative serum AMH levels were significantly reduced compared to preoperative levels (6.06 ± 1.18 and 5.84 ± 1.16 versus 5.00 ± 1.29 and 4.83 ± 1.10; p ovarian drilling in comparison to THL (3.26 ± 1.1 versus 1.11 ± 0.5; p ovarian drilling is comparable to the LOD in terms of reduction in AMH, but it is preferred by patients in terms of acceptability. These results could support to use of THL ovarian drilling in the treatment of patients with CC- resistant PCOS.

  5. Minimizing the Risk of Infection and Bleeding at Trans-Vaginal Ultrasound-Guided Ovum Pick-up: Results of a Prospective Web-Based World-Wide Survey.

    Science.gov (United States)

    Bhandari, Harish; Agrawal, Rina; Weissman, Ariel; Shoham, Gon; Leong, Milton; Shoham, Zeev

    2015-12-01

    The objective of this study was to identify clinical practices worldwide, which would help in recognizing women at risk of excessive bleeding or of developing pelvic infection following trans-vaginal ovum pick-up (TV-OPU), measures taken to minimize risks and their management. A prospective, web-based questionnaire with distinct questions related to the practice of TV-OPU. A total of 155 units from 55 countries performing 97,200 IVF cycles annually responded to this web-based survey. A majority (65 %) responded that they would routinely carry out full blood count, while 35 % performed coagulation profile. Less than a third agreed screening women for vaginal infections. About a third used both sterile water and antiseptic to minimize ascending infection, and 52 % used antibiotics for prophylaxis. Doppler ultrasound was routinely used by 20 % of clinicians. 73 % of the clinicians preferred conservative management as their first line management for patients diagnosed with intra-abdominal bleeding. The study has identified a wide variation in the practices of minimizing infection and bleeding complications. The dearth of good quality evidence may be responsible for the lack of published guidelines, and therefore a lack of consensus on the optimum practice for minimizing the risk of infection and bleeding during TV-OPU.

  6. Consecuencias adversas inesperadas durante el uso de antimicrobianos: Cuándo el tratamiento puede ser peligroso para la salud

    OpenAIRE

    WOLFF R., MARCELO

    2002-01-01

    Los efectos adversos de medicamentos en general y antimicrobianos en particular, son comunes y esperados de enfrentar durante la atención de los pacientes. La mayoría de ellos consiste en intolerancia, efectos colaterales y secundarios, alergia, idiosincrasia, sobredosis o interacciones farmacológicas indeseables. Durante el empleo de antimicrobianos con fines terapéuticos o preventivos en infecciones documentadas o sospechadas, pueden presentarse efectos adversos inesperados o consecuencias ...

  7. FACTORES AMBIENTALES QUE AFECTAN LOS COMPONENTES DE PRODUCCION Y PRODUCTIVIDAD DURANTE LA VIDA DE LAS CERDAS

    Directory of Open Access Journals (Sweden)

    Jesús Enrique Ek Mex

    2014-12-01

    Full Text Available El objetivo de esta revisión fue describir algunos factores ambientales que influyen sobre los componentes de producción y productividad durante la estancia de las cerdas en el hato. La productividad de la cerda puede ser medida como el número o kilogramos de cerdos nacidos vivos o destetados por camada, por año o durante la estancia en el hato. El efecto de año y granja son importantes fuentes de variación, se deben principalmente a los cambios climatológicos y diferencias en el manejo. El efecto de época en las regiones tropicales es debido al estrés calórico y la alta humedad en la época de calor. Las cerdas de primer parto tienen intervalo entre partos e intervalo destete a la concepción mayor y camadas pequeñas en comparación con las cerdas multíparas. La productividad durante la vida productiva es afectada por el manejo particular de cada unidad de producción, la edad y el número de lechones nacidos al primer parto y la causa de desecho. La mayoría de los estudios son en zonas templadas. En conclusión, la productividad de las cerdas es afectada por las diferentes condiciones climáticas de cada región y a diferencias de manejo entre granjas en diferentes años y épocas, así como por el número de parto, por lo que es importante realizar la caracterización de las condiciones específicas de cada granja o región.

  8. Estado, iglesia y sistema educativo durante la república en Chile

    Directory of Open Access Journals (Sweden)

    Jaime Caiceo Escudero

    2012-10-01

    Full Text Available Las investigaciones realizadas en los últimos 28 años, tanto en la Universidad Católica deChile (1979 -1994 como en la Universidad Metropolitana de Ciencias de la Educación(desde 1996 a la fecha, en el ámbito de la Historia de la Educación Chilena, le hanentregado al autor de este trabajo una visión bastante acotada de las relaciones que tanto laIglesia Católica como el estado han tenido respecto a la educación en el país. Por lomismo, el objetivo de esta exposición consiste en describir los diferentes aportes queambos agentes educativos han realizado en Chile desde el siglo XIX a la fecha, analizandoy comparando las diferentes posiciones que esas instituciones encarnan. La metodologíautilizada es la propia de los estudios históricos, recurriendo a fuentes primarias ysecundarias; se han analizado textos originales de diferentes autores y se han realizadoentrevistas a testigos presenciales de los últimos cincuenta años. Durante estos años se hanefectuado diferentes investigaciones sobre aspectos puntuales, se han dirigido tesis depostgrado y, especialmente, se ha analizado la presencia de Dewey en Chile y la vida y elpensamiento de los diferentes Premios Nacionales de Educación. Las conclusiones másimportantes apuntan a que la Iglesia y el Estado han sido actores relevantes de la educaciónen Chile durante los dos últimos siglos y que, a pesar que a veces ha habidoenfrentamientos en cuanto a posiciones ideológicas diferentes, siempre ha primado el biencomún del país, el cual se ha beneficiado con las miles de escuelas, liceos y universidadesque tanto la Iglesia como el Estado han creado durante estos 200 años.

  9. QFD na garantia da qualidade do produto durante seu desenvolvimento: caso em uma empresa de materiais

    OpenAIRE

    Melo Filho,Leonel Del Rey de; Cheng,Lin Chih

    2007-01-01

    Este artigo apresenta uma aplicação do método QFD em uma empresa de materiais. A intervenção foi para garantia da qualidade de um produto durante seu redesenvolvimento, em atendimento ao desejo do cliente único de ter uma característica do produto aumentada, sem prejuízo a outras. Foram efetuados dois desdobramentos associados: qualidade positiva e tecnologia do processo. A estratégia de pesquisa adotada foi a de pesquisa-ação. Utilizou-se também um guia para intervenção do QFD. O desdobramen...

  10. Bacterias en superficies contactadas durante las tomas radiográficas intraorales

    OpenAIRE

    Lee, Guihan; Calderón-Ubaquí, Victor; Sacsaquispe-Contreras, Sonia

    2016-01-01

    Objetivo: Determinar la presencia de bacterias mediante el análisis microbiológico en las superficies contactadas por el operador durante la toma y procesado de radiografías intraorales en diferentes momentos del día en el Servicio de Radiología Oral de la UPCH. Materiales y métodos: Se realizó un muestreo en nueve superficies del servicio de radiología oral. Las muestras se tomaron en dos momentos por el mismo investigador; al inicio y al finalizar las actividades en el servicio, se realizó ...

  11. Composición del plancton en la Puntilla Santa Elena durante agosto 2002 (Ecuador)

    OpenAIRE

    Torres, G.; Calderón, G.; Franco, V.; Cedeño, E.; Calderón, T.; Salazar, E.

    2004-01-01

    Esta investigación comprende los estudios del fitoplancton-zooplancton-ictioplancton, realizados en tres sitios de la Península Santa Elena durante agosto 2002, área designada para la proyección de "Arrecife Artificial de las Fuerzas Militares del Ecuador": un avión, barco y tanque de guerra, estructuras artificiales consideradas como basura chatarra (de gran tamaño), que serían recicladas para la bio-exploración artificiales hacia la seguridad de los recursos marinos del Ecuador. En el Estud...

  12. Monitoreo de la Temperatura durante la Anestesia: ¿Es realmente necesario?

    Directory of Open Access Journals (Sweden)

    Lincoln de Parte Pérez

    Full Text Available La temperatura corporal debe ser monitoreada en todos los pacientes a los que se les realiza procedimientos quirúrgicos con el objetivo de detectar precozmente sus variaciones, así como las complicaciones que se presentan con las variaciones de esta, como son: fiebre, hipertermia maligna e hipotermia accidental y para el monitoreo de la hipertermia inducida. Se muestra una revisión de los factores que producen hipotermia durante el transoperatorio, así como la prevención y tratamiento de ella.

  13. Presencia y fortuna de los hombres de negocios genoveses durante la crisis hispana de 1640

    OpenAIRE

    Sanz Ayán, Carmen

    2005-01-01

    El protagonismo de los financieros genoveses en los tratos con la Monarquía Hispánica bajo Felipe II, Felipe III y hasta la suspensión de pagos de 1627 con Felipe IV, fue un hecho evidente. En la década de 1630, aunque no ejercieron el monopolio de antes por la irrupción en el de panorama financiero de los judeoconversos portugueses, continuaron siendo mayoritarios en las negociaciones de provisiones generales. Sin embargo, la especial coyuntura que la Monarquía atravesó durante la década de ...

  14. Uso da Ciprofloxacina durante a Prenhez de Ratas: efeitos sobre a Mãe e Fetos

    Directory of Open Access Journals (Sweden)

    Approbato Mário Silva

    2000-01-01

    Full Text Available Objetivos: estudar os efeitos da ciprofloxacina sobre a taxa de abortos, ganho de peso durante a gravidez, morte materna e fetal, malformações fetais grosseiras, número de recém-nascidos, peso dos filhotes e análise dos reflexos neurológicos dos filhotes. Métodos: foram utilizadas 30 ratas da linhagem Wistar, divididas em três grupos. Os grupos tratados receberam ciprofloxacina e o grupo controle soro fisiológico, uma vez ao dia, durante os primeiros 7 dias após o cruzamento. As doses para os grupos D50 e D100 foram, respectivamente, de 50 e 100 mg de ciprofloxacina por kg de peso corporal por dia. Os parâmetros avaliados foram: o ganho de peso durante a prenhez, a prevalência de abortamentos, mortes fetal e materna e malformações fetais grosseiras. Nos 217 filhotes nascidos analisamos o número, o peso e reflexos neurológicos (postural, preensão e orientação no 1º, 3º, 5º e 10º dia de vida por ninhada. Resultados: não houve diferenças estatisticamente significativas no número de ratas que ficaram prenhes, na média de ganho de peso materno ou número de filhotes. Os filhotes apresentaram diferenças significativas nos pesos das observações do 3º, 5º e 10º dia (p = 0,006, 0,01 e 0,03, respectivamente, sendo a média menor no grupo D100. Observamos alteração significativa (p = 0,002 na positividade do reflexo de orientação no primeiro dia de vida, alteração que não se manteve nas outras observações. Não se observou caso de abortamento ou malformações grosseiras nos recém-nascidos. Conclusões: a ciprofloxacina alterou o peso ao nascimento e o reflexo dos filhotes nos primeiros dias de vida. Portanto, deve-se estudar a restrição ao seu uso durante a gravidez.

  15. Legrado uterino o nifedipina durante el posparto en pacientes con preeclampsia severa

    OpenAIRE

    Santos-Bolívar, Joel; Guerra-Velásquez, Mery; Reyna-Villasmil, Eduardo; Mejia-Montilla, Jorly; Reyna-Villasmil, Nadia

    2011-01-01

    Objetivo: Comparar la eficacia del legrado uterino o la nifedipina durante el posparto en pacientes con preeclampsia severa. Ambiente: Maternidad “Dr. Nerio Belloso”, Hospital Central “Dr. Urquinaona”, Maracaibo. Estado Zulia. Métodos: Se realizó una investigación en 60 pacientes con diagnóstico de preeclampsia severa que fueron divididas de la siguiente manera: grupo A (n = 30) que fueron sometidas a legrado uterino inmediatamente después del parto y grupo B (n = 30) que recibieron nifedipin...

  16. Mortalidad por enfermedades respiratorias en Chile durante 1999 MORTALITY DUE TO RESPIRATORY DISEASES, CHILE-1999

    OpenAIRE

    JORGE SZOT M.

    2003-01-01

    Se trata de un estudio descriptivo que presenta características sobre la mortalidad por causas respiratorias (CR) en Chile durante 1999. Se muestra que las CR constituyen la tercera causa de muerte en el país. La "neumonía por agente no especificado" (NANE) es la primera causa aislada de muerte respiratoria en ambos sexos con un 64%, seguida de enfermedades respiratorias crónicas que originan un 30% de las defunciones. Por lo anterior se hace necesario prevenir la ocurrencia de la NANE, asegu...

  17. Franco y Mussolini revisitados : la política exterior hispanoitaliana durante la guerra mundial

    OpenAIRE

    García Queipo de Llano, Genoveva

    1994-01-01

    En el presente trabajo no se pretende resumir de una manera global la relación existente entre España e Italia durante la Segunda Guerra Mundial y tampoco alguno de sus aspectos; tampoco se pretende desvelar alguna fuente radicalmente nueva acerca del particular sino que su propósito es mucho más modesto. Consiste en tratar de elaborar un «estado de las cuestiones» a partir de una monografía coelaborada por la autora hace ya una decena de años con el propósito de incorporar la nueva informaci...

  18. Evaluación del estado nutricional durante el estirón puberal

    OpenAIRE

    Gutiérrez Manjón, Rebeca

    2015-01-01

    La adolescencia va a consistir en una fase de la vida en la que se da la confluencia entre los cambios fisiológicos y aquellos que dan lugar a una maduración emocional y social, tan esenciales que marcarán un punto de inflexión en el desarrollo del individuo hacia la vida adulta. Durante esta etapa se va a producir un hecho de notable trascendencia: el crecimiento. Estudiar los cambios morfológicos que se producen en la etapa conocida como el estirón puberal, junto con los propios cambios ana...

  19. Evaluación del estado nutricional durante el estirón puberal

    OpenAIRE

    Gutiérrez Manjón, Rebeca

    2017-01-01

    La adolescencia va a consistir en una fase de la vida en la que se da la confluencia entre los cambios fisiológicos y aquellos que dan lugar a una maduración emocional y social, tan esenciales que marcarán un punto de inflexión en el desarrollo del individuo hacia la vida adulta. Durante esta etapa se va a producir un hecho de notable trascendencia: el crecimiento. Estudiar los cambios morfológicos que se producen en la etapa conocida como el estirón puberal, junto con los propios cambios ana...

  20. Escuela, educación e infancia durante la Guerra Civil en Euskadi

    OpenAIRE

    Rekalde Rodríguez, Itziar

    2009-01-01

    Este trabajo de investigación pone de manifiesto las actividades educativoculturales acometidas durante la guerra civil española en Euskadi. La doble dimensión desde donde se aborda el análisis (institucional y humana), así como los espacios, tiempos y agentes educativos de los que se dan cuenta, hacen de él un interesante estudio. This research work shows the educational-cultural activities undertaken during the Spanish Civil War in the Basque Country. The double dimension from which the ...

  1. Crecimiento económico y equidad en Boyacá durante 2000-2011

    Directory of Open Access Journals (Sweden)

    Edilberto Rodríguez Araújo

    2012-12-01

    Full Text Available El crecimiento económico no trae consigo mejoras inmediatas en la distribución del ingreso. Las políticas redistributivas pueden contribuir a corregir la inequidad social. El autor analiza cuál ha sido la incidencia del crecimiento de la economía boyacense, durante el periodo 2000-2011, en aspectos tales como pobreza, equidad distributiva, desarrollo humano y desempeño delmercado laboral, determinando que no existe una asociación positiva concluyente entre el dinamismo económico y sus correlatos sociales.

  2. Mujeres violentadas durante el embarazo y el parto: experiencias de parteras en Jalisco, México

    OpenAIRE

    Villaseñor F, Martha; Laureano E, Jorge; Mejía M, Martha L; Valadez F, Isabel; Márquez A, José M; González A, Jaime A

    2014-01-01

    OBJETIVO: explorar la experiencia y perspectiva de parteras con mujeres violentadas durante el embarazo y el parto en Jalisco, México. METODOLOGIA: se llevó a cabo un estudio cualitativo en zona rural de Jalisco, México, entre mayo y octubre de 2011 con 24 parteras, utilizando la entrevista individual, modalidad historia de vida pautada y la asamblea participativa regional como técnicas de indagación; posteriormente, los discursos fueron analizados bajo el modelo actancial semiótico. RESULTAD...

  3. Comportamiento Sexual de Varones Durante el Embarazo: Casos en la Ciudad de México

    OpenAIRE

    Sapién, José S; Córdoba, Diana I

    2011-01-01

    El objetivo fue reportar el comportamiento sexual de varones en el embarazo, sus experiencias y significaciones. Participaron 6 hombres de la Ciudad de México, de 23 a 35 años de edad, casados, con escolaridad y ocupación distintas. Fueron entrevistados sobre sus experiencias sexuales durante la gestación de su hijo. Cada varón constituyó un caso: suspensión del sexo preservando un embarazo difícil de obtener; interrupción del sexo para cuidar a la pareja embarazada y no lastimar al bebé; dis...

  4. España y Portugal durante la Segunda Guerra Mundial

    OpenAIRE

    Sacristán Lucas, Esther; Gómez de las Heras Hernández, María Soledad

    1989-01-01

    Cuando las relaciones internacionales entran en franco deterioro en el escenario europeo, el entendimiento político entre España y Portugal presentaba a la Península Ibérica como un bloque relativamente unido ante la conflagración mundial. La política exterior de estos dos Estados durante la segunda guerra mundial se enmarca dentro de unas coordenadas, que son tenidas en cuenta por los diplomáticos de ambas naciones, de los beligerantes y neutrales: la coincidencia del talante político e ideo...

  5. Comportamiento de la humedad durante el secado solar del mineral laterítico

    Directory of Open Access Journals (Sweden)

    Arturo L. Rojas-Purón

    2007-03-01

    Full Text Available En las empresas cubanas del níquel que utilizan el proceso Caron, el contenido elevado de humedad en la material prima mineral incide en el aumento del consumo de combustible en los secadores durante el secado térmico. Se evaluó de forma experimental la humedad durante el secado solar del mineral laterítico a la intemperie. El método de análisis de la humedad utilizado fue el de diferencias de pesadas. Se empleó la regression lineal multiple para establecer los modelos matemáticos de las masas de trabajo. El estudio demostró que los parámetros climatológicos más influyentes en el secado solar del mineral laterítico son la temperatura del medio ambiente, las precipitaciones, la velocidad del viento y la temperatura del punto de rocío, así como que solamente el agua no estructural es la que puede ser eliminada. La humedad se redujo en un 13 %.

  6. Rede social de apoio durante transições familiares decorrentes do nascimento de filhos

    Directory of Open Access Journals (Sweden)

    Dessen Maria Auxiliadora

    2000-01-01

    Full Text Available O suporte da rede de apoio é fundamental à família e ao indivíduo no enfrentamento de transições normativas e não normativas no processo de desenvolvimento. Este estudo descreve as transformações nessa rede durante transições decorrentes do nascimento de filhos. Quinze pais de classe social baixa e suas respectivas esposas/companheiras, subdivididas em dois grupos (A: mães grávidas; B: mães com bebês de até seis meses, participaram de uma entrevista semi-estruturada e responderam um questionário. A principal alteração na rede, segundo as mães, foi o aumento do apoio psicológico recebido; para os pais, foi o aumento da ajuda financeira e material. O apoio do marido/companheiro foi considerado, por todas as mães, mais importante que os demais. Os dados sugerem que, para compreender as alterações na rede social de apoio e no envolvimento do pai na vida familiar durante transições decorrentes do nascimento de filhos, é preciso conhecer as relações desenvolvidas entre os subsistemas familiares e o contexto social no qual as famílias estão inseridas.

  7. Taquicardia ventricular del tracto de salida del ventrículo derecho durante el embarazo

    Directory of Open Access Journals (Sweden)

    Ariel K. Saad

    2012-06-01

    Full Text Available Durante el embarazo aumentan el metabolismo basal, el consumo de O2, la frecuencia cardíaca, el volumen sistólico, el volumen minuto y la volemia y disminuyen la tensión arterial y la resistencia periférica. Diferentes estudios han demostrado que durante este período la posibilidad de que ocurra una arritmia cardíaca o se produzca la exacerbación de una arritmia preexistente es mayor. No obstante, en su enorme mayoría carecen de importancia pronóstica tanto para la madre como para el feto. La taquicardia ventricular del tracto de salida del ventrículo derecho es una arritmia poco frecuente y su aparición se ha correlacionado con el aumento del tono adrenérgico. Se presentan los casos de dos pacientes que mostraron en el curso de la gestación reiterados episodios de taquicardia ventricular del tracto de salida del ventrículo derecho. Se analiza la asociación del embarazo con la ocurrencia de trastornos del ritmo cardíaco.

  8. Assessment of the psychometric properties of the Short-Form Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) following surgical placement of Prolift+M: a transvaginal partially absorbable mesh system for the treatment of pelvic organ prolapse.

    Science.gov (United States)

    Roy, Sanjoy; Mohandas, Anita; Coyne, Karin; Gelhorn, Heather; Gauld, Judi; Sikirica, Vanja; Milani, Alfredo L

    2012-04-01

    Impairment of sexual function is a significant problem among women suffering from pelvic organ prolapse (POP). Because anatomical measures of POP do not always correspond with patients' subjective reports of their condition, patient-reported outcome measures may provide additional valuable information regarding the experiences of women who have undergone surgery. The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) is a validated, widely used condition-specific questionnaire focused on sexual function among patients with POP or urinary incontinence. This study aims to report sexual function outcomes as measured by PISQ-12 and to evaluate the psychometric characteristics of the questionnaire following surgical mesh implant for the treatment of POP. The PISQ-12 was used to measure sexual function, while a set of other measures, namely, Pelvic Organ Prolapse Quantification, Patient Global Impression of Change, Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire, and Surgical Satisfaction Questionnaire, was used for validation. Data for the study were collected from a prospective multicenter, single-arm study of surgical POP repair via the transvaginal placement of a partially absorbable mesh system. For baseline, month 3, and month 12 following POP surgery, several psychometric properties of the PISQ-12 were evaluated, including internal consistency (Cronbach's alpha), concurrent validity, discriminant validity, and responsiveness. As measured by the PISQ-12 questionnaire, statistically significant improvements were observed in the composite summary score as well as all three subscale scores at 1 year. The PISQ-12 generally demonstrated good psychometric properties including internal consistency reliability, validity, and responsiveness. The PISQ-12 items had good distributional properties at baseline, with substantial ceiling effects at follow-up visits reflecting improvements experienced by the patients. The PISQ-12 is a valid

  9. Vaginal native tissue repair versus transvaginal mesh repair for apical prolapse: how utilizing different methods of analysis affects the estimated trade-off between reoperation for mesh exposure/erosion and reoperation for recurrent prolapse.

    Science.gov (United States)

    Dieter, Alexis A; Willis-Gray, Marcella G; Weidner, Alison C; Visco, Anthony G; Myers, Evan R

    2015-05-01

    Informed decision-making about optimal surgical repair of apical prolapse with vaginal native tissue (NT) versus transvaginal mesh (TVM) requires understanding the balance between the potential "harm" of mesh-related complications and the potential "benefit" of reducing prolapse recurrence. Synthesis of data from observational studies is required and the current literature shows that the average follow-up for NT repair is significantly longer than for TVM repair. We examined this harm/benefit balance. We hypothesized that using different methods of analysis to incorporate follow-up time would affect the balance of outcomes. We used a Markov state transition model to estimate the cumulative 24-month probabilities of reoperation for mesh exposure/erosion or for recurrent prolapse after either NT or TVM repair. We used four different analytic approaches to estimate probability distributions ranging from simple pooled proportions to a random effects meta-analysis using study-specific events per patient-time. As variability in follow-up time was accounted for better, the balance of outcomes became more uncertain. For TVM repair, the incremental ratio of number of operations for mesh exposure/erosion per single reoperation for recurrent prolapse prevented increased progressively from 1.4 to over 100 with more rigorous analysis methods. The most rigorous analysis showed a 70% probability that TVM would result in more operations for recurrent prolapse repair than NT. Based on the best available evidence, there is considerable uncertainty about the harm/benefit trade-off between NT and TVM for apical prolapse repair. Future studies should incorporate time-to-event analyses, with greater standardization of reporting, in order to better inform decision-making.

  10. Reposição de nutrientes durante três cultivos de alface em hidroponia

    Directory of Open Access Journals (Sweden)

    Backes Fernanda Alice A.L.

    2003-01-01

    Full Text Available O experimento foi realizado em estufa plástica na UFSM, de agosto a novembro/99. Avaliou-se cinco formas de reposição de nutrientes na solução nutritiva com base na condutividade elétrica (CE, no sistema 'NFT' (Nutrient Film Technique e duas cultivares de alface: Regina e Deisy, cultivadas em bancadas de sustentação formadas por telhas de fibro-cimento revestidas com tinta betuminosa Neutrolâ. Foram dispostas 14 plantas por canal para cada repetição e uma cultivar em cada três canais, totalizando 84 plantas por bancada de produção. Comparou-se a eficiência de métodos de reposição de nutrientes na produção de alface, assim como a utilização da mesma solução, com reposição de nutrientes, durante três cultivos consecutivos. O delineamento experimental foi de blocos casualizados, com três repetições, em esquema fatorial 5x2. Os resultados demonstraram que o desempenho das cultivares avaliadas não foi influenciado pelos métodos de reposição de nutrientes. A ausência de reposição de nutrientes na solução nutritiva, durante um cultivo, permitiu maior produtividade da cultura, não se recomendando a reposição quando o objetivo for renovar a solução ao final do cultivo. As formas de reposição de nutrientes na solução nutritiva, durante o primeiro e segundo cultivos, não alteraram a produtividade da cultura em relação à renovação completa da solução nutritiva ao final do cultivo hidropônico. Para a reutilização de solução nutritiva, recomenda-se a reposição de nutrientes sempre que a CE diminuir 50% da inicial, possibilitando a produção por pelo menos três cultivos.

  11. Manifestaciones cardiacas del dengue: Reporte de una serie de casos durante la epidemia colombiana de 2010

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    Clara Saldarriaga G.

    2013-12-01

    Full Text Available INTRODUCCIÓN: el dengue es la enfermedad viral transmitida por vectores de diseminación más frecuente en el mundo. Su espectro clínico incluye las manifestaciones atípicas, entre ellas el compromiso cardiaco, del cual sólo se han reportado pocas series de casos en la literatura. OBJETIVO: reportar las características clínicas de los pacientes atendidos por casos confirmados por serología de dengue con manifestaciones cardiovasculares en un centro de referencia cardiovascular colombiano durante la epidemia de 2010. METODOLOGÍA: estudio observacional, descriptivo, prospectivo, en el que se incluyeron los pacientes que consultaron al servicio de urgencias, a quienes se les realizó un diagnóstico confirmado de dengue y tuvieron manifestaciones cardiovasculares de la enfermedad. RESULTADOS: se encontraron 7 pacientes; el 50% no tenía antecedentes previos de enfermedad cardiovascular. Los trastornos del ritmo fueron la manifestación cardiaca más frecuente (42,8%, entre ellos la fibrilación auricular de novo (14,2%, el bloqueo auriculoventricular completo y transitorio (14,2%, la bradicardia sinusal concomitante con derrame pericárdico (14,2% y la disfunción ventricular leve (28,5%; un paciente presentó un síndrome coronario agudo con elevación de ST durante la infección y dos descompensación aguda de insuficiencia cardiaca. No se reportaron muertes. CONCLUSIÓN: la incidencia de las complicaciones cardiacas asociadas a la infección por dengue varía de una serie a otra y su fisiopatología no se conoce por completo. Durante la epidemia que se desató en Colombia en 2010 se encontraron pocos casos de manifestaciones cardiovasculares pero con una morbilidad importante que debe alertar respecto a su identificación temprana.

  12. COMPARTIMENTACIÓN INTERCELULAR DEL ACETATO EN NEURONAS Y ASTROCITOS DURANTE LA PRELACTANCIA

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    J. Tovar-Franco

    2005-12-01

    Full Text Available Durante el período perinatal el cerebro utiliza sustratos alternativos a la glucosa para mantener su desarrollo, pues en este momento sus niveles están disminuidos. El acetato es metabolizado por las neuronas y los astrocitos durante la prelactancia. La utilización del acetato por estas células puede verse mejorada por lasreacciones fijadoras de CO2, algunas de las cuales participan en el mantenimiento de los intermediarios del TCA, que son reducidos por la producción y liberación de aminoácidos, suministrando los recursos para la producción de energía y sustratos que son compartimentados intercelularmente.Se estudió el efecto de la fijación de CO2 en procesos metabólicos intercelulares donde está involucrado el acetato. En incubaciones con neuronas y astrocitos de 7 y 14 días de cultivo, utilizando acetato (5 mM y [14C]-bicarbonato de sodio (10 µ Ci (500-1000 dpm/nmol, se determinó la incorporación en metabolitos marcados en células y en sustratos estables liberados al medio. Adicionalmente, se realizaron experimentos similares utilizando inhibidores como el aminooxiacetato (AOA, dicloroacetato (DCA, α-ciano-4-hidroxicinnamato (α-CN, butilmalonato (BM y bencenotricarboxílato (BT, cuantificando porcromatografía de capa delgada la concentración en el medio de incubación de alanina, aspartato, glutamato y glutamina.Los resultados indican que las neuronas tienen una menor capacidad para fijar carbonos en estructuras celulares, durante la prelactancia, pero utilizan mejor el acetato vía acetil-CoA mitocondrial (AceCS2 para la producción de energía y aminoácidos. En los astrocitos, estas reacciones favorecen la utilización del acetato vía citrato liasa y Acetil-CoA citosólica (AceCS1 para la producción de estructuras y sustratos utilizados por las neuronas, que para la producción de aminoácidos.

  13. Fútbol y conflictividad sociopolítica durante la dictadura de Franco. Un estudio de caso

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    Néstor García Lázaro

    2014-02-01

    Full Text Available El objetivo de la presente investigación es ahondar la relación existente entre el fútbol y la conflictividadsociopolítica durante los períodos de dictadura. Para ello nos centramos en estudiar los desórdenespúblicos que tienen lugar durante y después del encuentro que enfrenta a la Unión Deportiva LasPalmas contra el Córdoba en el Estadio Insular el 4 de marzo de 1962. Nos basamos principalmenteen la documentación generada por las autoridades franquistas, como es el caso del Servicio de Informaciónde la Guardia Civil, la Dirección General de Seguridad y el Gobernador Civil de Las Palmas;la prensa oficial de la época y la de las organizaciones antifranquistas. Explicamos este conflicto comofruto de las condiciones económicas, sociales y políticas que se viven durante los años anteriores enla ciudad de Las Palmas de Gran Canaria, que generan un gran descontento entre todas las clases socialescon la dictadura imperante. De esta investigación se desprende el cariz nacionalista del conflictoy la importancia que el mismo tuvo para las autoridades franquistas, que emprendieron una serie deacciones para mejorar la situación de las islas.The aim of this research is to deepen the relationship between football and socio-political conflictduring periods of dictatorship. For this study we focus on public disorder occurring during and afterthe match pitting the Union Deportiva Las Palmas against Córdoba at Estadio Insular March 4, 1962.To do this we rely primarily on the documentation generated by the Francoist authorities, such as theInformation Service of the Civil Guard, the Dirección General de Seguridad and the Civil Governorof Las Palmas; the official press of the time and the propaganda of the anti-Franco organizations. Weexplain this conflict as a result of the economic, social and political conditions that is lived in the yearsbefore on the city of Las Palmas de Gran Canaria, that generate a lot of discontent among all

  14. Los trastornos de ansiedad durante la transición a la menopausia

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    A. Carvajal-Lohr

    2016-01-01

    Full Text Available La menopausia es la interrupción definitiva de las menstruaciones resultado de la pérdida de la actividad folicular del ovario. El periodo inmediatamente antes de la menopausia y el primer año después de la misma se conoce como perimenopausia. La posmenopausia se define como el periodo que transcurre desde un año a partir de la fecha de última menstruación, sin importar si la menopausia fue inducida o espontánea. Debido al incremento de la esperanza de vida en la mujer mexicana, mayor número de ellas alcanzan la edad promedio de la menopausia (45-59 años y pasan una parte significativa de su vida en la posmenopausia. Se ha observado que los trastornos psiquiátricos son más frecuentes en mujeres que en hombres, y que la perimenopausia es una etapa en la cual se incrementan los síntomas psicológicos, así como el riesgo de sufrir depresión mayor y trastornos de ansiedad. Se debe diferenciar cuando la ansiedad es un síntoma normal ante determinadas situaciones cotidianas de estrés y cuando comienza a tener una presentación irracional por un estímulo ausente, por una intensidad excesiva con relación al estímulo, o cuando la duración es prolongada y presenta recidivas sin motivo, ocasionando grave disfuncionalidad en el paciente. En esta revisión presentamos datos acerca de los síntomas de ansiedad durante la transición a la menopausia y hacemos alusión al trastorno de ansiedad generalizada y trastorno de pánico, ya que se ha observado una mayor prevalencia de estas patologías durante la transición a la menopausia, probablemente debido a los cambios hormonales que se viven durante esta etapa.

  15. Regulación de las metalotioneínas durante el estrés y la inflamación, y su influencia durante la respuesta inflamatoria

    OpenAIRE

    Carrasco Trancoso, Javier

    2000-01-01

    Regulación de las metalotioneínas durante el estrés y la inflamación, y su influencia durante la respuesta inflamatoria. Las metalotioneínas (MTs) son unas proteínas de bajo peso molecular (6-7 kDa) con capacidad para ligar metales pesados como el Zn y el Cu. En los roedores existen cuatro isoformas diferentes denominadas MT-I, -II, -III y IV. Las MT-I y MT-II se expresan prácticamente en todos los tejidos del organismo y son inducibles por metales pesados, agentes oxidantes, hormonas, la inf...

  16. La historia medieval sobre Castilla y León durante el periodo 1975-1986

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    Carlos ESTEPA DÍEZ

    2009-11-01

    Full Text Available Realizar una síntesis y una valoración sobre la producción historiográfica del medievalismo durante el último decenio constituye una difícil tarea. Soy consciente del riesgo que comporta el mostrar de una manera sucinta lo aportado respecto a Castilla y León, ya que una tendencia al detalle nos puede llevar inevitablemente a un mero recuento bibliográfico, pero unos planteamientos generales dejarán evidentes lagunas y aproximaciones a veces un tanto particularizadas. Con todo, esta tarea resulta necesaria y, aún con defectos, creo que será al menos de cierta utilidad.

  17. La hojalatería en Málaga durante el siglo XVIII

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    José Gómez Zotano

    2004-01-01

    Full Text Available La industria malagueña, amparada en el resurgir socioeconómico registrado en la provincia durante el siglo XVIII, alcanzó un considerable progreso tecnológico. Este propició la aparición de los primeros proyectos de industrialización, canalizados fundamentalmente por las constantes prospecciones mineras y la construcción en el valle del Genal de industrias derivadas de la hojalatería como la Real Fábrica de Hoja de Lata de San Miguel. En este trabajo analizamos cómo fue el proceso de instalación y consolidación de la industria de la hojalatería en el sector occidental de la provincia de Málaga y cuales fueron sus repercusiones medioambientales.

  18. Deshidratación de banano y cambio químicos ocurridos durante el proceso

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    C. Reyes de

    2009-07-01

    Full Text Available Como el banano es una fruta muy alterable, es necesario transformarlaa estados más estables para prolongar su conservación.Uno de los procesos más sencillos y fáciles de realizar es la deshidratación; en nuestro país ya se efectúa pero necesita una tecnificación y un estudio químico a fondo sobre los cambios ocurridosa los diferentes constituyentes de la pulpa de banano.En este trabajo se buscaron las condiciones óptimas en lascuales podría realizarse la deshidratación del banano, para que lapérdida de nutrientes fuera mínima, y se evaluaron los cambiosquímicos ocurridos durante dicho proceso.

  19. Monitoreo de la Temperatura durante la Anestesia: ¿Es realmente necesario?

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    Lincoln de Parte Pérez

    2003-04-01

    Full Text Available La temperatura corporal debe ser monitoreada en todos los pacientes a los que se les realiza procedimientos quirúrgicos con el objetivo de detectar precozmente sus variaciones, así como las complicaciones que se presentan con las variaciones de esta, como son: fiebre, hipertermia maligna e hipotermia accidental y para el monitoreo de la hipertermia inducida. Se muestra una revisión de los factores que producen hipotermia durante el transoperatorio, así como la prevención y tratamiento de ella.Body temperature should be monitored in all patients undergoing surgical procedures in order to detect its variations early, as well as the complications appearing with them, such as malignant hyperthermia and accidental hypothermia and for monitoring induced hyperthermia. A review of the factors producing hypothermia during the transoperative is made. Its prevention and treatment are also dealth with.

  20. Efeito de bioterápico na eosinofilia durante a SLMV experimental

    OpenAIRE

    Luciana Camillo; Sandra Regina Pereira de Oliveira; Rosa Domingues Ribeiro; Joice Margareth de Almeida Rodolpho; Gabriel Henrique Gomes Caroccia; Sérgio de Albuquerque; Fernanda de Freitas Anibal

    2014-01-01

    O Toxocara canis (Tc) é um parasito pertencente ao filo Nematódeo que possui como hospedeiro definitivo os cães, O homem é hospedeiro paratênico e contamina-se acidentalmente ao ingerir ovos contendo larvas infectantes (L3) do parasito, as quais são liberadas e atravessam a mucosa intestinal, atingem a circulação, Durante este processo migratório, antígenos de excreção e secreção (TES) são liberados provocando intensa reação inflamatória, do tipo Th2, caracterizando a síndrome, denominada Lar...

  1. VOCES Y SILENCIOS: LA PRENSA ARGENTINA DURANTE LA DICTADURA MILITAR (1976-1983

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    Marcelo Borrelli

    2011-01-01

    Full Text Available El artículo se propone analizar las condiciones de funcionamiento de la gran prensa diaria argentina durante la última dictadura militar argentina (1976-1983, sus principales posiciones editoriales frente a acontecimientos relevantes del periodo y cuáles fueron las políticas más importantes de parte del régimen militar hacia los medios de prensa. El trabajo pone un especial énfasis en el rol que adquirió la prensa diaria en el marco del sistema represivo clandestino conocido como terrorismo de estado y de las intenciones de refundación social de los militares en el poder.

  2. Hidratação durante o exercício: a sede é suficiente?

    OpenAIRE

    Machado-Moreira, Christiano Antônio; Vimieiro-Gomes, Ana Carolina; Silami-Garcia, Emerson; Rodrigues, Luiz Oswaldo Carneiro

    2006-01-01

    O objetivo deste trabalho é fazer uma revisão sobre a hidratação e discutir se, durante o exercício, a reposição de líquidos de acordo com a sede é suficiente para hidratar o indivíduo. A perda hídrica pela sudorese induzida pelo exercício, especialmente realizado em ambientes quentes, pode levar à desidratação, pode alterar o equilíbrio hidroeletrolítico, dificultar a termorregulação e, assim, representar um risco para a saúde e/ou provocar uma diminuição no desempenho esportivo. Tem sido ci...

  3. Geografía política del caucho durante la Segunda Guerra Mundial

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    Camilo Domínguez Ossa

    1995-01-01

    Full Text Available Durante la Segunda Guerra Mundia el dominio de los recursos estratégicos jugó un papel geopolítico muy grande. Uno de estos recursos, el caucho, tuvo enormes implicaciones sobre el movimiento de fuerzas beligerantes en todo el planeta. en Asia Suroriental significó invasiones armadas y matanzas enormes. En América Latina, especialmente en la Amazonia, fue uno de los recursos estratégicos que marcaron el esfuerzo de guerra latinoamericano junto a los aliados. En realidad, los resultados de la llamada "batalla del caucho" fueron más del orden político que económico: los Estados Unidos impusieron finalmente el paramericanismo liderado por esa gran potencia y los pueblos aeropuerto que sirvieron para el embarque del caucho se conviertieron en enclaves para el dominio territorial del Estado colombiano sobre su Amazonia.

  4. Tabaquismo durante el embarazo en Argentina y Uruguay Smoking during pregnancy in Argentina and Uruguay

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    Fernando Althabe

    2008-02-01

    Full Text Available Argentina y Uruguay están entre los países con mayor proporción de mujeres jóvenes fumadoras. Se desconoce cuál es la proporción exacta de ellas que fuman durante el embarazo así como las características de las que dejan de fumar y las que continúan fumando durante el embarazo. Realizamos una encuesta administrada por un/a entrevistador/a a 1512 mujeres embarazadas de 18 años o mayores (796 en Argentina; 716 en Uruguay, que concurrían a control prenatal en hospitales públicos de grandes conglomerados urbanos. 44% de las mujeres en Argentina y 53% en Uruguay habían sido o eran fumadoras. Durante el embarazo, 11% de las mujeres en Argentina y 18% en Uruguay continuaron fumando. En ambos países, la proporción de mujeres que vive con fumadores, permite fumar en el hogar y regularmente o siempre se encuentra en lugares cerrados con personas que estén fumando fue 49%, 46% y 20% entre las mujeres que nunca fumaron, 67%, 60% y 32% entre las que dejaron, y 78%, 75% y 52% entre las que continuaron fumando respectivamente. El estudio confirma un importante problema de salud pública y documenta que la exposición ambiental persiste en subgrupos de mujeres, aun en aquéllas que dejaron de fumar. Es importante que el sector de salud pública provea acceso a programas efectivos para dejar de fumar durante el embarazo. Cualquier nueva intervención a desarrollar que intente tener un éxito al menos moderado y sostenible, debiera incluir componentes que actúen sobre el entorno fumador de la mujer embarazada que fuma.Argentina and Uruguay are among the countries in which a large proportion of young women smoke. The rate of smokers during pregnancy in both countries is not well known, and data on the characteristics of women who quit smoking during pregnancy compared to those who continue smoking are not available. We conducted a survey including 1512 pregnant women >18 years old (796 in Argentina; 716 in Uruguay, during antenatal visits in

  5. Entramados de la seda en México durante el siglo XIX y principios del XX

    OpenAIRE

    García Corzo, Rebeca Vanesa

    2016-01-01

    El objetivo de la investigación es realizar un panorama general del desarrollo de la industria de la seda en México durante el siglo XIX y principios del XX desde una perspectiva CTS a través de la secuencia de proyectos efímeros que constituyó el proceso. La hipótesis defendida es que aunque los grandes proyectos fueron efímeros la iniciativa para la puesta en práctica de la industria de la seda no fue abandonada porque se consiguió mantener el apoyo de la sociedad de la época. Esto se logró...

  6. España y Portugal durante la Segunda Guerra Mundial

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    Esther Sacristán Lucas

    1989-01-01

    Full Text Available Cuando las relaciones internacionales entran en franco deterioro en el escenario europeo, el entendimiento político entre España y Portugal presentaba a la Península Ibérica como un bloque relativamente unido ante la conflagración mundial. La política exterior de estos dos Estados durante la segunda guerra mundial se enmarca dentro de unas coordenadas, que son tenidas en cuenta por los diplomáticos de ambas naciones, de los beligerantes y neutrales: la coincidencia del talante político e ideológico de los regímenes de Salazar y Franco se sumaba a la importancia estratégica de la Península, que obligaba a un entendimiento entre ambos Estados, siempre amenazados por el peligro de un ataque proveniente del exterior.

  7. La Educación de la Mujer Mexicana en la prensa femenina durante el Porfiriato

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    Morelos Torres Aguilar

    2015-01-01

    Full Text Available El artículo es producto de una investigación sobre las publicaciones mexicanas dirigidas al público femenino durante el porfiriato, las cuales desempeñaron una importante función educativa. El principal objetivo de la investigación es analizar, comprender, comparar e interpretar las principales propuestas que aparecían en estas respecto a la educación de la mujer, a partir de los artículos editoriales o de las columnas destacadas en cada uno de los medios. La investigación ofrece un panorama que permite conocer las posturas más relevantes en el debate planteado en las revistas sobre la educación femenina. El método utilizado consistió en la revisión y análisis de la hemerografía de época, para lo cual fueron estudiadas diversas publicaciones, de las cuales se seleccionaron diez como las más representativas. Posteriormente se utilizó un marco teórico hermenéutico, el cual permitió analizar, comprender y posteriormente interpretar el proceso histórico, el discurso educativo y el contenido ideológico de los medios referidos. La investigación concluye que los contenidos educativos de las publicaciones corresponden al concepto de "educación informal"; asimismo, que existieron principalmente dos posturas antagónicas en torno a la educación de las mujeres: una conservadora, que recomendaba educarlas, y otra liberal o modernizadora, que proponía instruirlas. En este sentido, la principal hipótesis de la que se parte propone que ambas posturas trataban de determinar, por medio de la educación, el perfil que debía tener la mujer mexicana durante esa época.

  8. Estudio antropológico de redes sociales de madres adolescentes durante el embarazo

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    Lorena Pasarin

    2009-07-01

    Full Text Available La atención de la salud incluye a diversos actores sociales, por ello en su estudio debe contemplarse el papel que adquieren los contextos socioculturales. El estudio de las redes sociales resulta conveniente para abordarlos. Este trabajo presenta una aplicación del análisis de redes sociales como complemento de abordaje metodológico al estudio de las prácticas y comportamientos relacionados con la salud de madres adolescentes durante el período prenatal. Utilizando la herramienta EgoNet, se analiza la estructura de las redes personales identificando redes integradas principalmente por familiares que brindan consejos y prestan ayuda instrumental, actuando como facilitadoras respecto a la realización de los controles de salud. La perspectiva de análisis de redes sociales permitió destacar el papel decisivo que cobran ciertas relaciones personales, funcionando como lazos eficaces que afectan significativamente el accionar de las adolescentes respecto a su salud durante el embarazo.The health care includes several social actors, this implies that its study should consider the role of the sociocultural contexts. The study of social networks is appropriate to address them. This paper presents an application of social network analysis as a complement of the methodological approach for the study of practices and health-related behaviors in adolescents mothers. This structure of personal networks is analyzed by EgoNet sofware. That structure is disscussed by identifying family networks that offer advices and provide instrumental assistance, acting as facilitators for the prenatal health controls. The social networks analysis perspective allows to emphasize the critical role acquired by certain personal relationships, which operate affecting significantly the health actions of the teenagers mothers during pregnancy.

  9. CARACTERIZACION FISICOQUIMICA DEL MANGO COMUN (Mangifera indica L. DURANTE SU PROCESO DE MADURACION

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    VICTOR QUINTERO C

    Full Text Available El proceso de maduración del mango está gobernado bajo una serie de reacciones bioquímicas al interior del fruto que se caracterizan por cambios en la textura, color, en el contenido de azúcares, ácidos, aromas, entre otros. Las sustancias acumuladas durante el desarrollo se transforman de manera lenta y progresiva hasta que el fruto alcanza las condiciones de aroma y jugosidad que permita clasificarlo como maduro. Se realizó una cinética de maduración durante nueve días, determinando parámetros físicos y químicos como color en pulpa y en cáscara, textura, actividad de agua, sólidos solubles, pH y acidez titulable. Se modeló cinéticamente el comportamiento de cada una estas variables y se pudo determinar que los sólidos solubles tienen una tendencia explicada con un modelo de regresión multiplicativo y la actividad de agua con un modelo de regresión reciproco de X mientras el pH y la acidez con una ecuación de regresión de raíz cuadrada de X, de la misma manera el cambio de color en cáscara y en pulpa presento una regresión reciproca de X. Por último en el caso de la textura se observó y se ajustó modelos lineales tanto para cáscara como para pulpa.

  10. Teores de nutrientes de dois cultivares de oliveira durante o crescimento vegetativo e o florescimento

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    Raoni Pereira de Carvalho

    2013-08-01

    Full Text Available Para o planejamento de adubações, visando a manter os níveis de nutrientes adequados para as plantas, é importante monitorar seu estado nutricional durante as diferentes fases de desenvolvimento, sendo a análise foliar o melhor método para avaliar os níveis de nutrientes na planta. Esta pesquisa foi realizada com o objetivo de avaliar os teores de nutrientes em dois cultivares de oliveira, nas fases de crescimento vegetativo e na floração. Foram avaliados espécimes dos cultivares 'Grappolo' e 'Barnea', com dois anos de idade, obtidos a partir do enraizamento de estacas, plantadas no espaçamento de 5 m entre linhas e 3 m entre plantas. Utilizou-se o esquema de parcela sub-dividida, tendo na parcela o fatorial 2 x 2, sendo duas cultivares e duas fases de emissão fenológicas: plantas com brotações vegetativa e reprodutivas, no delineamento de blocos casualizados, com cinco repetições e sete plantas por parcela. As amostras de folhas foram retiradas em quatro épocas: junho (na ocasião do plantio e repetidas em agosto, setembro e outubro, quando as plantas iniciaram a emissão de brotações vegetativas e de flores. Na fase de florescimento, a oliveira apresentou menores teores de nutrientes que as plantas em fase vegetativa. O cultivar 'Barnea', por seu hábito de crescimento rápido, apresentou menores teores de nutrientes, durante as fases vegetativa e reprodutiva.

  11. CASTIGO FEMENINO EN CHILE DURANTE LA PRIMERA MITAD DEL SIGLO XIX

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    Marcelo Neira Navarro

    2004-12-01

    Full Text Available El presente artículo permitió generar una serie de categorías de castigos femeninos, considerando que durante buena parte del siglo XIX la policía pudo aplicar "justicia correccional", es decir, sancionar delitos menores. De un universo de más de 32.000 arrestos efectuados en la ciudad de Santiago de Chile entre los años 1830 a 1840 y utilizando el criterio "femenino", el levantamiento logró una muestra que alcanzó al 12% del total. Los datos sistematizados permiten señalar que durante la primera mitad del siglo XIX el delito femenino fue parte importante de la actividad represiva en Chile y dio origen a un castigo relacionado a la Cárcel Correccional. Aunque también se observan otras penas como trabajo de casa formal o encierro en monasterios, forman parte de un circuito restrictivo en función del encierro de mujeres.The present article allowed to generate a series of categories of female punishments, considering that during a great part of the XIX century the police could apply "correctional justice", in other words, punish minor offences. In a universe of more than 32,000 arrest in the city of Santiago, Chile between the years 1830 and 1840 and using a "female" criteria, the uprising achieved a sample that reached 12% of the total. The systematized information shows that during the firt half of the xix century the female offence was an important part of the repressive activity in Chile and it gave origin to a punishment related to a correctional. Even though some other punishments were observed such a work in a formal house or monastery confinemet, they formed part of a restricting circuit functioning with the confinement of women.

  12. Crecimiento económico de China durante la crisis financiera mundial

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    Pedro A. Villezca Becerra

    2015-01-01

    Full Text Available En el ámbito global, China se sigue haciendo cada vez más fuerte. La evidencia más contundente proviene de su sobresaliente desempeño económico durante los años 2008 y 2009 en el entorno de la crisis financiera mundial más grave desde la Gran Depresión de los años treinta. Aun cuando algunos de sus principales indicadores económicos muestran un crecimiento más lento durante estos años, la economía china experimentó una rápida recuperación, revirtiendo los efectos negativos de la crisis. En este contexto, el presente trabajo revisa los logros económicos y el manejo de su política económica para enfrentar la crisis e intenta explicar las razones de su éxito. El gobierno central implementó políticas fiscales y monetarias expansivas y aplicó un conjunto de incentivos económicos, a fin de impulsar la demanda interna y sostener el crecimiento económico frente a la reducción de la demanda externa. Como resultado, los aspectos fundamentales de la economía: el crecimiento económico, la producción industrial, el comercio internacional y la inversión extranjera directa, estuvieron mucho mejor que los del resto de las economías del mundo. La evidencia indica que las diferencias se deben a las características distintivas de su modelo de desarrollo, entre las que resalta el papel que juega la intervención del gobierno para implementar una economía dirigida, o guiada de mercado, en contraste con el libre mercado occidental.

  13. Comportamiento de Rhodnius robustus Larousse, 1927 (Hemiptera, Reduviidae durante su alimentación en condiciones de laboratorio

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    Camilo Rubio

    2013-06-01

    Full Text Available Introducción. A pesar del control de los insectos domiciliados, se siguen presentando casos de enfermedad de Chagas con la participación en la transmisión de especies peridomiciliarias y selváticas,una de las cuales es Rhodnius robustus, especie reportada con infecciones naturales de Trypanosoma cruzi y T. rangeli. Objetivo. Describir el comportamiento de R. robustus durante su alimentación en condiciones delaboratorio.Materiales y métodos. En cada estadio de desarrollo de R. robustus se analizó el tiempo promedio para alcanzar la repleción, número promedio de deyecciones, porcentaje de individuos que defecan durante la comida y ganancia de peso después de la alimentación. Resultados. Rhodnius robustus tardó entre 19:26 y 44:55 (minutos:segundos en alimentarse arepleción; los insectos defecaron en todos sus diferentes estadios durante la alimentación. El porcentaje de individuos que defecan durante la alimentación varía de 13,3 % a 93,3 %. Por otro lado, el consumo promedio de sangre en el quinto estadio, 337,19 mg, duplica la cantidad ingerida por los adultos, 161,25 mg. Conclusiones. En todos los estadios de R. robustus hay defecación durante la alimentación, factor que favorece su competencia vectorial. Sin embargo, el tiempo para la primera deyección, el porcentaje dedeyecciones y los individuos que defecan durante la comida, así como la cantidad de sangre ingerida, varían entre los estadios, lo cual indica que el comportamiento alimenticio está mediado por variables dependientes de la edad/estadio.   http://dx.doi.org/10.7705/biomedica.v33i2.743

  14. Batteri lattici non starter durante la stagionatura del formaggio: sopravvivenza, crescita e produzione di molecole potenzialmente coinvolte nella formazione dell'aroma

    OpenAIRE

    Sgarbi, Elisa

    2012-01-01

    I batteri lattici (LAB) costituiscono un gruppo eterogeneo di batteri tradizionalmente utilizzati nella produzione di formaggi. Essi possono svolgere diversi ruoli durante la caseificazione, gli starter LAB (SLAB) sono i protagonisti del processo di fermentazione, mentre i non starter LAB (NSLAB) esplicano il loro ruolo durante la maturazione del formaggio. Il lavoro di ricerca di questo dottorato si è focalizzato sullo studio del contributo dei NSLAB durante la stagionatura del formaggio. In...

  15. Análisis de perfiles de temperatura durante el proceso de calentamiento de frutas por microondas

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    Arballo, Javier Ramiro; Campañone, Laura Analia; Mascheroni, Rodolfo Horacio

    2017-01-01

    La transferencia de energía durante el proceso de calentamiento por microondas de frutas fue estudiada teórica y experimentalmente mediante el modelado y simulación numérica. Con el fin de describir los fenómenos de transporte puestos en juego durante el proceso de calentamiento, en primer lugar se planteó el balance microscópico de energía con propiedades globales en función de la temperatura; la generación interna de calor debida a la interacción del alimento con la energía electromagnética...

  16. Efecto de la ingesta sobre la volemia durante la sesión de hemodiálisis

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    Molina Mejías, Patricia; Quesada Armenteros, María Trinidad; Ruiz Almería, Sonia; Liébana Pamos, Beatriz; Esquinas Marta, Miriam; Martínez Aranda, M.ª Amor

    2017-01-01

    Introducción: Desde el punto de vista enfermero nos planteamos si los pacientes pueden o no ingerir alimentos durante la sesión de hemodiálisis. Objetivo: Con este estudio nos proponemos evaluar la repercusión hemodinámica de la ingesta intrahemodiálisis en relación con la caída de volumen sanguíneo y la tensión arterial. Material y Método: Se realiza un estudio prospectivo, observacional, transversal en 22 pacientes adultos en programa de hemodiálisis crónica, recogiendo datos durante tres s...

  17. Persistencia y/o transformación de tricotecenos durante algunas etapas del procesamiento de trigo

    OpenAIRE

    Samar, María Margarita

    2003-01-01

    La finalidad del presente trabajo fue obtener informaciónsobre la persistencia y / o transformación de tricotecenos durante algunas etapas de procesamiento del trigo para contribuir a la estimación de la exposición como consecuencia de la ingesta de alimentos elaborados con trigo potencialmente contaminados por tricotecenos en la Argentina. Las tendencias identificadas en los métodos analíticos para la determinación de tricotecenos, durante los años 1990-2000 en diferentes partes del mundo, m...

  18. Volcán Poás: vulnerabilidad económica durante su cierre y espacio de preparación durante la calma

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    Duarte González, Eliécer

    2007-06-01

    Full Text Available En este ensayo se resumen algunas ideas para aportar a la discusión sobre vulnerabilidad y riesgo volcánico. Por razones actuales se abordará en mayor profundidad la vulnerabilidad económica de comunidades y grupos comerciales que dependen del normal funcionamiento del Parque Nacional volcán Poás. Se pretende, generar la inquietud acerca de la delicada dependencia que puede dar entre algunos comerciantes y la visitación turística al cráter activo. Si bien el interés por parte de nacionales y extranjeros, por visitar la cima es primarlo; otras alternativas turísticas en su entorno pueden reducir esa dependencia económica durante la reactivación y el cierre del volcán. Repentinamente las amenazas de un volcán, pasan a un segundo piano con respecto a las decisiones que se toman y a su impacto económico; provocando efectos en un segmento de la población comercial de la región. Se alcanzan algunas conclusiones que desnudan la necesidad de un compromiso colectivo entre organizaciones e instituciones en la región con aquellos actores que se declaran afectados con el cierre del volcá This essay summarizes some of the ideas to contribute to the discussion about volcanic vulnerability and risk. Due to current reasons, the area that will be more profoundly analyzed will be the one of economic vulnerability of the community and commercial groups that depend on the normal operation of the Poas Volcano National Park. The objective is to question the subtle dependence that could be among some merchants and the touristic visits to the active crater. The main interest from national and foreign visitors is to visit the top, other touristic options in the area could reduce that economic dependence during the volcano reactivation and closure. Suddenly, the volcano threats become less important in relation to the decisions that have to be made and their economic impact; causing effects into a sector of the commercial population of the region

  19. Metabolismo mineral óseo durante la gestación y efectos sobre la masa ósea de la madre

    OpenAIRE

    Luis Vidal; Maritza Vidal; Santiago Cabrera; Eduardo Ortega; Vicente Santiváñez; Jorge Polo; Jorge Barnaby; Rolando Vargas; Angélica del Castillo

    2008-01-01

    La gestación y lactancia son periodos de alta demanda de calcio, para el crecimiento fetal y para la producción de leche materna. Durante la gestación, la madre transfiere al feto 25 a 30 g de calcio y durante la lactancia se secretan 200 a 240 mg de calcio diario en la leche materna. Durante la gestación, los mecanismos adaptativos más importantes son el incremento en la absorción de calcio y el incremento del recambio óseo materno; durante la lactancia, hay tendencia a conservar más calcio ...

  20. Experiencia de las madres durante el contacto piel a piel al nacimiento

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    P.K. García May

    2017-12-01

    Full Text Available Resumen: Introducción y objetivo: Las madres disfrutan la experiencia del contacto piel a piel inmediatamente después del nacimiento y se plantea la posibilidad de que tal contacto pueda ayudar a estas madres a sentirse más seguras con sus bebés. Objetivo: describir la experiencia de las madres durante el contacto piel a piel al nacer por parto y cesárea. Material y métodos: Estudio transversal, descriptivo, observacional, prospectivo, realizado en la Unidad Tocoquirúrgica del Instituto Nacional de Perinatología, en la Ciudad de México, durante el contacto piel a piel madre-hijo al nacimiento, en los recién nacidos a término sanos, durante el período comprendido desde el 1 de septiembre de 2015 al 31 de julio de 2016. Se les pidió a las madres describir su experiencia durante el contacto piel con piel al nacimiento. Los resultados se analizaron utilizando Wizard Pro Versión 1.9.7. Resultados: Se obtuvo entrevista de 779 mamás, a las que se les realizó contacto piel a piel al nacimiento durante 11 meses. Se categorizó por nivel de satisfacción como muy satisfactorio, satisfactorio y poco satisfactorio, encontrando que 570 casos (73.2% se categorizaron como muy satisfactorio, 201 (25.8% como satisfactorio y 8 (3% como poco satisfactorio. En cuanto al nivel de satisfacción y la vía de nacimiento, no hubo diferencias estadísticamente significativas (p = 0.212, por lo que podemos inferir que el grado de satisfacción de la madre es independiente de la vía de nacimiento. Conclusiones: La colocación del recién nacido sobre el pecho de la madre después del nacimiento es una experiencia feliz y muy satisfactoria para la gran mayoría de la madres. Abstract: Introduction and objective: Mothers enjoy the experience of skin-to-skin contact immediately after birth, and this raises the possibility that such contact can help these mothers feel more secure with their babies

  1. Organización musical y repertorio en la catedral de bogotá durante el siglo xvi

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    Bermúdez, Egberto

    2014-01-01

    El presente artículo tiene como objetivo la consideración del repertorio de música religiosa del siglo XVI contenido en el Archivo Capitular de la Catedral de Bogotáa la luz de la organización de la actividad musical en dicha iglesia durante el mismo período.

  2. Parámetros de calidad durante la cosecha de durazno (Prunus persica L. Batsch cv. “Rubidoux”

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    Lisney Alessandra Bastidas Parrado

    2015-03-01

    Full Text Available El durazno es una fruta de importancia agrícola como parte de los cultivos caducifolios producidos en Colombia; su calidad y aceptacion comercial, asi como el momento de la cosecha, estan definidos en funcion de sus características fisicoquimicas. Esta investigacion tuvo como propósito caracterizar algunos parametros de calidad de durazno variedad Rubidoux durante el periodo de cosecha, a partir de la seleccion hecha por operarios en campo, de acuerdo al color de la piel como indicador de madurez. Durante seis semanas de la cosecha se evaluaron muestras de frutos, considerando aspectos como peso fresco, contenido de solidos solubles (oBrix, categoria comercial de acuerdo al diametro ecuatorial y color del fruto. Se registro un peso fresco promedio de 130,7 g por fruto, con un contenido de solidos solubles promedio de 11,8 oBrix, parametro que incremento progresivamente de la semana uno a la cinco. La clasificacion visual por el color de la piel permitio definir siete categorias, tres predominaron durante la cosecha (pinton, pinton-maduro y maduro, estos se correspondieron con el contenido de solidos solubles; es asi como el analisis de varianza mostro diferencias estadisticas entre oBrix y el color de piel. Durante el periodo evaluado, se cosecharon con mayor frecuencia duraznos pintones y frutos con diametro entre 60 mm a 70 mm.

  3. Respuesta de una cuenca de cabecera durante eventos de crecida (Aixola, País Vasco

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    Antigüedad, I.

    2010-12-01

    Full Text Available Turbidity (T, FNU, discharge (Q, l/s and precipitation (P, mm are being continuously monitored in the gauging station located at the outlet of Aixola catchment (Gipuzkoa, 5 km2 since October 2003. Several data sets recorded during flood events occurred between 2003 and 2005 were used to estimate continuous suspended sediment concentration (SSC. Electrical conductivity was also measured in samples taken during runoff events. Several event (discharge, precipitation and suspended sediment concentration and pre-event (discharge and precipitation factors are calculated for all the events registered. With them a correlation matrix was developed. Good correlation between precipitation (P, discharge (Q and suspended sediment (SS variables is found in general but pre-event conditions don’t show correlation with event parameters. Analysis of SSC-discharge evolutions through the events showed that four different kinds of hysteretic loops can be observed in Aixola. Hysteretic loops have also been related to event and pre-event factors. Evolution of electrical conductivity of waters during events shows that the catchment has a considerable regulation capacity.

    La turbidez (T, FNU, el caudal (Q, l/s y la precipitación (P, mm se están midiendo en continuo en la estación de aforo situada en la salida de la cuenca de Aixola (Gipuzkoa, 5 km2 desde octubre 2003. Se han utilizado los datos recogidos en los eventos ocurridos entre octubre 2003 y octubre 2005 para establecer la relación turbidez-concentración de sedimentos en suspensión (CSS, y así, estimar las series continuas de CSS. Además, también se ha medido la conductividad eléctrica en muestras tomadas durante las crecidas. Por otro lado, se cuantificaron varios parámetros del evento (P, Q y CSS y anteriores al mismo (Q y P para todos los eventos registrados. Se observa un nivel significativo de correlación entre las variables de precipitación, caudal y sedimentos

  4. Uso de medicamentos durante a lactação Breastfeeding and maternal medications

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    Roberto G. Chaves

    2004-11-01

    Full Text Available OBJETIVO: Contribuir com informações para o uso racional de medicamentos durante a amamentação. FONTES DOS DADOS: Foram selecionados artigos na base de dados MEDLINE, de 1993 a 2004, e no Lilacs, de 1995 a 2004, em português, espanhol e inglês, usando as palavras-chave aleitamento, lactação, drogas e medicamentos. Outras referências recentes encontradas em artigos e livros foram incluídas a fim de fornecer subsídios para a realização deste artigo. SÍNTESE DOS DADOS: A maior parte dos fármacos é compatível com a amamentação. Poucos são contra-indicados (antineoplásicos, radiofármacos, drogas de abuso; alguns requerem cuidados devido ao risco de efeitos adversos em lactentes ou de redução do volume de leite. Porém, ainda é necessário maior conhecimento sobre os efeitos para a criança de muitos fármacos durante a amamentação. CONCLUSÕES: O princípio fundamental da prescrição de medicamentos para mães em lactação baseia-se no conceito de risco e benefício. Deve-se fazer opção, sempre que possível, por uma droga já estudada, que seja pouco excretada no leite materno e que não tenha risco aparente para a saúde da criança. Medicamentos que reduzem a produção de leite pela nutriz devem ser evitados durante a lactação, e o uso dos galactagogos está reservado para situações especiais. Dessa maneira, só excepcionalmente o aleitamento materno precisa ser desencorajado ou descontinuado quando a mãe necessitar de tratamento farmacológico.OBJECTIVE: To contribute with information about the adequate administration of drugs during breastfeeding. SOURCES OF DATA: MEDLINE articles from 1993 to 2004, and Lilacs articles from 1995 to 2004 were selected in Portuguese, Spanish and English, by including the following keywords: breastfeeding, lactation, drugs and medicines. Other update references found in articles and books were also included in this review, in order to provide additional information. SUMMARY OF

  5. El papel de supervisión del personal docente durante el desarrollo del recreo escolar

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    Jenny María Artavia-Granados

    2014-01-01

    Full Text Available Resumen: El recreo es un espacio escolar que procura alcanzar múltiples propósitos, entre otros: descanso y juego para los estudiantes, pero también, constituye una buena oportunidad para que los docentes observen los comportamientos y conductas que asumen sus estudiantes fuera del salón de clases. El proceso de supervisión del recreo por parte del personal docente y administrativo, resulta ser una tarea fundamental para lograr la prevención o solución de los conflictos que se puedan presentar durante este período escolar. Este artículo expone el desarrollo del proceso de supervisión del recreo escolar, que lleva a cabo el personal docente de una escuela de la Dirección Regional de Educación Occidente, a partir de los resultados obtenidos de una investigación de tipo cualitativa denominada “Juegos e interacción social en los recreos y su relación con los comportamientos violentos: El caso de las y los estudiantes de VI año de una escuela”. Entre los objetivos específicos, se procuró analizar el papel que desempeña el personal docente y administrativo, durante el desarrollo de los recreos. Ante el fenómeno de la violencia, la escuela tiene el compromiso social de brindar una solución pacífica a los conflictos que se puedan presentar. Sin embargo, como parte de las conclusiones obtenidas, se halló que el personal docente no asumió a cabalidad la supervisión del recreo, que la mayoría de docentes consideraron que no les correspondía supervisar, y que existen importantes diferencias entre la forma conceptualizar la supervisión del recreo por parte de la dirección del centro educativo y los docentes.

  6. Naos, clima y glaciares en el Estrecho de Magallanes durante el siglo XVI

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    Prieto, María del Rosario

    1998-12-01

    Full Text Available Not available.

    El objetivo de este trabajo es lograr una aproximación al clima y a los fenómenos de glaciación ocurridos en el Estrecho de Magallanes durante el siglo XVI y parte del XVII a través de registros históricos. Se complementan los resultados obtenidos por investigadores de otras disciplinas paleoclimáticas en el área, verificándose si las fuentes históricas corroboran las conclusiones de esos autores, quienes postulan un intervalo muy frío entre 1520 y 1670. Para realizar esta investigación se utilizaron los “diarios o relaciones de navegación” de los primeros marinos españoles que pasaron por el Estrecho, recopilados en su mayor parte en Archivos históricos españoles. A través de la técnica del análisis de contenido se verificó la estabilidad en el vocabulario referido al clima y los glaciares a lo largo de esas centurias y se calificó los eventos de acuerdo a su magnitud. Se determinaron diversas categorías de las cuales se han seleccionado precipitaciones sólidas y líquidas, temperatura, dirección del viento y ocurrencia de tormentas para analizar en este trabajo. Se estudió especialmente la presencia de témpanos en el Estrecho y las descripciones de los glaciares fueguinos y del sur de la Patagonia chilena como indicadores de bajas temperaturas. Se concluye que existen referencias directas a la presencia de témpanos proveniente de glaciares en el Estrecho, sólo en la segunda mitad del siglo XVI. El avance de los hielos supondría una acentuación de las condiciones de frío durante esa centuria, lo que puede ser corroborado por los datos de los navíos que consignan temperaturas estivales frías y muy frías en la vertiente pacífica. Estos datos coincidirían con los resultados de R. Villalba en cuanto a que el intervalo 1520 a 1670 fue uno de los más fríos de la Pequeña Edad Glaciar.

  7. Experiencias de las mujeres durante el trabajo de parto y parto

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    Dora Isabel Giraldo Montoya

    2015-05-01

    Full Text Available Objetivo: Develar las experiencias de las mujeres durante el trabajo de parto y parto en una Unidad Materno Infantil de Medellín, durante el año 2013. Metodología: Estudio cualitativo, de tipo fenomenológico. Muestreo representado en la saturación teórica, con la participación de 13 mujeres a quienes se les aplicó la entrevista a profundidad. Se construyeron las categorías descriptivas, posteriormente se agruparon en categorías de orden axial y finalmente se obtuvieron las de orden selectivo para determinar las categorías núcleo. Se desarrolló la triangulación a través de grupos focales y la observación. El estudio obtuvo la aprobación del Comité de Ética y se utilizó el consentimiento informado por escrito. Resultados: Surgieron tres categorías principales: Los síntomas desagradables, La soledad y Yo quiero ver a Camila. Desde la teoría de rango medio de los síntomas desagradables, se encontró que el dolor, la fatiga y la sed son experiencias altamente significativas que comprometen el bienestar y la satisfacción materna. La soledad estuvo presente en todo el proceso, sin embargo el apoyo espiritual y la presencia del personal de salud fueron una fuente de acompañamiento. A pesar del sufrimiento y el dolor del trabajo de parto, el nacimiento las hizo olvidar estos acontecimientos y consideraron que el proceso del parto las reafirmaba frente a la adopción de su rol materno. Conclusiones: Se deben cambiar los métodos tradicionales de cuidado y propiciar otras formas de atención más humanizadas para que las mujeres asuman su rol de madres con seguridad y decisión.

  8. O envolvimento paterno durante a gestação Father's involvement during the gestation

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    Cesar Augusto Piccinini

    2004-01-01

    Full Text Available O período de gestação da companheira exige uma série de adaptações por parte do pai, que precisa se preparar para os novos papéis que deverá assumir frente ao bebê e à sua nova família. Neste sentido, o presente trabalho teve por objetivo investigar como se dá o envolvimento paterno durante o 3º trimestre de gestação. Participaram deste estudo 35 pais que esperavam seu primeiro filho, com idades entre 21 e 40 anos. Os pais foram entrevistados individualmente e as suas respostas foram examinadas através de análise de conteúdo. Os resultados indicaram que muitos pais estiveram envolvidos de diversas maneiras durante a gestação de suas companheiras, mostrando-se emocionalmente conectados à gestante e ao bebê. No entanto, alguns pais ainda encontravam dificuldades quanto ao envolvimento com seu filho, parecendo não percebê-lo como real e apresentando uma baixa ligação emocional com a gestação. Estes dados apontam para indícios de uma modificação quanto à paternidade já no período da gestação, a qual se encontra cada vez menos restrita ao universo feminino.The gestational period requires a series of adaptations from the father's side, who needs to prepare himself for the new role he will assume vis-à-vis the baby and his/her new family. The present study aimed at investigating father's involvement during the third trimester of gestation. Thirty-five fathers, aged 21 to 40, who were expecting their first child, took part in the study. The fathers were interviewed individually and their answers were examined through content analysis. Results indicated that many fathers were involved in different ways during their partner's pregnancy, being emotionally connected with the baby and their partner. However, some fathers still found difficulties concerning involvement with their child, seeming not to perceive him/her as real and showing low emotional connection with pregnancy. These data point to signs of change

  9. Catalans i genovesos durant el segle XIII: El declivi d'una amistat

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    Ferrer i Mallol, Maria Teresa

    1996-12-01

    Full Text Available The Catalano-Genoese friendship was forged as a result of their joint struggle against Islam in the Xllth century and was maintained during the Xlllth century, in spite of the Catalan maritime expansion that might have become a rivalry for Genoa. The friendship and cooperation was made evident in the granting of commercial franchises to the Genoese who were trading in Catalonia and in the lands they subsequently conquered. Catalans, for their part, had the same commercial franchises in Genoa and in the districts under their control. The war of Genoa against Pisa led as a consequence to an increase of maritime conflict between Catalan and Genoese, especially during the two last decades of Xlllth century, due to the major presence of Catalans in the Pisan ports and the transport of goods for Pisa, at that moment when Genoa was trying to block Pisa. All during the reign of James II, the alienation of the two competitors grew until it led to war. All these points are analyzed in the article in the light of unpublished records.[fr] L'amitié catalano-génoise s'est forgée dans la lutte conjointe contre l'Islam au XIIᵉ siècle et s'est maintenue durant le XIIIᵉ siècle, malgré l'expansion maritime catalane, qui pouvait représenter une concurrence pour Gênes. L'amitié et la collaboration se sont traduites par l'octroi de franchises commerciales pour les Génois en Catalogne, étendues aux territoires conquis postérieurement, et qu'eurent leur pendant à Gênes et dans sa zone d'influence, pour les Catalans. La guerre de Gênes contre Pise entraîna une recrudescence des incidents maritimes entre Catalans et Génois, à partir des années 1280, en raison de la fréquentation dels ports sous juridiction pisane et du transport de marchandises pour Pise, par les Catalans, au moment où Gênes tentait de neutraliser cette ville. Durant le règne de Jacques II, commença une distance politique qui dégénéra en guerre. Ces éléments sont analys

  10. Los donativos de la ciudad de Sevilla durante el reinado de Carlos II

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    Manuel Escalona Jiménez

    1998-01-01

    Full Text Available La petición de cantidades extraordinarias de dinero bajo la denominación de donativos, para atender a los gatos derivados sobre todo del mantenimiento de las tropas durante las campañas militares y el abastecimiento de la Armada, fue una costumbre puesta en práctica a partir del reinado de Felipe II y continuada por sus sucesores. En el reinado de Carlos II se quiso suavizar la presión fiscal, eliminando las peticiones extraordinarias de dinero. Pero cuando surgían los conflictos bélicos el único recurso posible era el donativo, pues el resto de las cantidades recaudadas estaban ya empeñadas en otros menesteres. La ciudad de Sevilla, que se había caracterizado por la generosidad de los donativos ofrecidos al rey, no disponía ya durante la época de Carlos II del poder económico de antaño y tenía grandes dificultades para recaudar las cantidades ofrecidas y hacer frente al mismo tiempo a los donativos del reinado anterior aún pendientes, ya que los arbitrios que se imponían no daban el fruto apetecido. Por lo tanto, al final del siglo xvii no quedó otra solución que la de limitar al máximo esta forma de contribución extraordinaria a la Monarquía.The request for an extra amount of money, called donativo, in order to meet the expenses originated by the maintenance of troops during military campaigns and the suppiying of the Navy, was a practice held from Philipp ITs reign and continued by his sucessors. In Charles II's reign, a lessening of tax pression was intended, by means of removing the requests of extra money. But, in the occasion of war conflicts, the only possible resources were the donativos, because the other taxes had been already used for other needs. Seville, which would stand out for the generosity of its donativos, had not the same economic power as in past times, and was in great trouble to collect the money for the new and the oíd financial help granted to the king, because the taxes did not produce the

  11. Cambios reológicos del queso Colonia durante el proceso de maduración

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    María José Crosa

    2011-05-01

    Full Text Available El queso Colonia es un queso típico uruguayo, elaborado según los criterios de calidad y tradición quesera de los inmigrantes suizos radicados en la cuenca lechera del departamento de Colonia. En la actualidad no se reporta información publicada acerca de los cambios reológicos que ocurren en el queso durante su maduración. Su investigación y publicación aportan conocimiento para la difusión de un proceso que aún no presenta denominación de origen protegida. En el presente trabajo se midieron los cambios reológicos mediante el ensayo de relajación-compresión, durante el proceso de maduración realizado a 8 ºC y 85 % de humedad relativa hasta el día 13. Los resultados obtenidos manifiestan la existencia de un cambio importante del comportamiento a partir del día 11 de maduración, momento en que ocurre un notorio ablandamiento del queso. Esto concuerda con la práctica industrial que tradicionalmente realiza el cambio de los quesos para continuar su maduración en cámara caliente a partir del onceavo día. Este estudio demuestra la importancia de esperar hasta el onceavo día para asegurar la elasticidad necesaria en el queso para una adecuada formación de ojos en la cámara caliente.Abstract“Colonia” cheese is a typical Uruguayan cheese, elaborated following the quality standards and cheese making tradition of the swiss inmigrants established at the uruguayan department of Colonia and sourrondings. Actually there is no available information about the reological changes that happen in this kind of cheese during its ripeness. The study and publication of this process (which does not present a protected designation of origin (DOP yet gives knowledge for its spread.Rheological changes were analyzed with the stress relaxation test along the ripeness process made at 8 ºC and a humidity of 85 % until the 13th day. The results indicate that an important performance change exists after the 11th ripeness day, where a remarkable

  12. Hipertrigliceridemia familiar grave durante a gestação Severe familial hypertriglyceridemia during pregnancy

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    Luiz Augusto Casulari

    2001-07-01

    Full Text Available A presença de hipertrigliceridemia grave durante a gravidez é rara, mas comporta grande possibilidade de desenvolver complicações, como a pancreatite aguda, que coloca em risco a mãe e o feto. Apresentamos o relato da evolução da gestação de uma paciente portadora de hipertrigliceridemia grave que havia apresentado pancreatite aguda dois meses antes da fecundação. Foi tratada durante o pré-natal com dieta e 3,0 g de ácidos graxos de cadeia ômega-3 (ácidos eicosapentaenóico 14% e docosahexaenóico 11,13%. Os níveis de triglicerídeos foram mantidos abaixo de 800 mg/dl, sendo este limite considerado seguro para evitar o desenvolvimento de pancreatite aguda. A gestação evoluiu, sem intercorrências, para parto vaginal, a termo. O recém-nato não apresentou alterações morfológicas ao nascimento. Concluímos que, nesta paciente grávida e portadora de hipertrigliceridemia grave, uma dieta adequada e o emprego de ácidos graxos de cadeia ômega-3 foram eficazes em prevenir a pancreatite aguda. Esta abordagem terapêutica pode ser uma alternativa para as gestantes portadoras de hipertrigliceridemia familiar.Severe hypertriglyceridemia during pregnancy rarely occurs but it frequently produces complications, such as acute pancreatitis, a serious health risk both for the mother and the fetus. The treatment of a patient who had had acute pancreatitis due to hypertriglyceridemia (triglyceridemia = 5100 mg/dl two months before fecundation is presented in this paper. During gestation, bezafibrate was substituted for 3.0 g omega-3 fatty acids (14% eicosapentaenoic and 11.13% docosahexaenoic acids. With this therapy, the triglyceride levels were maintained below 800 mg/dl, which is considered to be the safe limit to avoid acute pancreatitis. No complication occurred during pregnancy, the patient delivered vaginally (40 weeks, and the newborn (3075 g did not present any morphological alterations. We conclude that an adequate diet and the

  13. La itinerancia de la corte de Castilla durante la primera mitad del siglo XV

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    Francisco de Paula CAÑAS GÁLVEZ

    2009-01-01

    Full Text Available El presente trabajo intentará explicar las diferentes causas que hicieron del centro de la meseta el núcleo político y burocrático de la Corona de Castilla y León a finales de la Edad Media. Aquel espacio geográfico, comprendido en sus líneas generales entre Burgos y Toledo, concentró, efectivamente, una parte muy significativa de la actividad política e institucional de la Monarquía en un periodo de especial relevancia en la formación del Estado Moderno en tierras castellanas. Este largo proceso, si bien pergeñado durante los siglos XIII y primera mitad del XIV, únicamente se consolidaría tras la llegada al trono castellano de la nueva dinastía Trastámara, en especial durante los reinados de Enrique III y Juan II, alcanzando su madurez plena en tiempos de los Habsburgo con el asentamiento de la hasta entonces corte itinerante, y de buena parte de su aparato burocrático, en Madrid.Ce travail vise à expliquer les différentes causes qui ont fait du centre de la Meseta le noyau politique et administratif de la couronne de Castille et León. Cet espace géographique, compris grosso modo entre Burgos et Tolède a  effectivement concentré une part importante de la vie politique et institutionnelle de la monarchie à une période cruciale pour la formation de l’État moderne en terre castillane. Ce vaste processus, esquissé au cours du XIIIe siècle et de la première moitié du XIVe siècle, ne s’est consolidé qu’avec l’avènement de la nouvelle dynastie Trastamare, en particulier pendant les règnes d’Henri III et de Jean II, pour atteindre sa pleine maturité au temps des Habsbourg, avec la sédentarisation à Madrid de la cour jusque-là itinérante et d’une  bonne partie de l’appareil bureaucratique.

  14. COMPARTIMENTACIÓN INTRACELULAR DEL ACETATO EN NEURONAS DURANTE LA PRELACTANCIA

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    B. Barrios-Socha

    2006-06-01

    Full Text Available En la transición a la vida extrauterina, el recién nacido sufre un período de ayuno (prelactancia que transcurre entre el cese de la nutrición placentaria y la instauración de la lactancia. El gasto de energía por las neuronas es tan alto en estas circunstancias, que la glucogenólisis es incapaz de restablecer los niveles de glucosa en la sangre. En consecuencia, durante la prelactancia debe haber otros sustratos energéticos y lipogénicos, que adicionalmente ayuden a mantener la síntesis de neurotransmisores.Este trabajo establece la importancia de acetato en el metabolismo oxidativo y del lipogénico en neuronas durante la prelactancia. Se determinaron las velocidades de oxidación y lipogénesis en cultivos quiescentes de neuronas fetales de rata incubadas con acetato (5 mM, [1- 14C]-acetato, [2- 14C]-acetato y [U- 14C]-acetato(200-300dpm/nmol Adicionalmente, se utilizaron inhibidores enzimáticos como el dicloroacetato(1 mM y el aminooxiacetato (5 mM, e inhibidores del transporte como el α-ciano-4-hidroxicinnamato(2 mM, butilmalonato (5 mM y 1,2,3-bencenotricarboxilato (5 mM.Los resultados en su conjunto indican que las neuronas pueden metabolizar acetato más como sustrato energético que lipogénico, lo que nos permite pensar que este sustrato puede llegar a ser más importante para ayudar a mantener el metabolismo oxidativo, favoreciendo el reciclaje de carbonos en la prelactancia.Adicionalmente, se evidenció con el uso de [1-14C]-acetato una alta actividad anaplerótica sobre todo cuando las neuronas requieren mantener los reservorios de oxalacetato y acetil-CoA para mantener la respiración. Estos resultados señalan a la acetil-CoA sintetasa (AceCS2 y la enzima málica (mME mitocondriales, como enzimas claves para mantener el funcionamiento de las neuronas en la prelactancia.Con el uso de [2-14C]-acetato, los resultados sugieren que las neuronas tienen un alto requerimiento de carbonos, principalmente para la síntesis de

  15. Abuso físico y sexual durante la niñez y revictimización de las mujeres mexicanas durante la edad adulta Physical and sexual abuse during childhood and revictimization during adulthood in Mexican women

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    Leonor Rivera-Rivera

    2006-01-01

    Full Text Available OBJETIVO: Cuantificar la asociación que existe entre el abuso físico y sexual durante la niñez y la violencia durante la edad adulta en una muestra representativa de usuarias de los servicios de salud en México. MATERIAL Y MÉTODOS: Se analizaron datos provenientes de una encuesta nacional, con una muestra de 26 042 mujeres mayores de 14 años, quienes acudieron a consulta a los servicios públicos de salud entre octubre de 2002 y marzo de 2003, en los 32 estados de la República. Se utilizaron dos modelos: a Modelo de regresión logística politómica múltiple para explorar las asociaciones entre violencia física y sexual por parte de la pareja y violencia durante la niñez. b Modelo de regresión logística múltiple para evaluar la asociación entre violación durante la edad adulta y violencia durante la niñez. RESULTADOS: Se encontró una asociación entre experimentar violencia física durante la niñez, y padecer violencia física y sexual por parte de la pareja o sufrir violación durante la edad adulta. Cuando la mujer informó que había recibido golpes "casi siempre" durante la niñez, era más probable que experimentara violencia física y sexual (RM=3.1; IC95% 2.6-3.7 y violación (RM=2.9; IC95% 2.4-3.6 durante la edad adulta. Además, mientras más frecuente había sido la violencia durante la niñez, era mayor la posibilidad de que la mujer sufriera violencia posteriormente. Asimismo, se encontró una asociación positiva entre violencia física y sexual por parte de la pareja y abuso sexual antes de los 15 años de edad. (RM=2.8; IC95% 2.2-3.5. La violación sufrida en la edad adulta también estuvo asociada al abuso sexual antes de los 15 años de edad (RM=11.8; IC95% 10.2-13.7. CONCLUSIONES: La violencia sufrida durante la niñez crea un cuadro de resultados negativos, tanto psicológicos como físicos, y uno de ellos es la revictimización. Es decir, las mujeres que son víctimas de violencia durante la niñez tienen

  16. NRE58/2: Programaci??n del Plan de Control Interno, auditorias y otras actividades a desarrollar por la Oficina de Control Interno durante el 2012

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    Universidad de Granada

    2012-01-01

    Programaci??n del Plan de Control Interno, auditorias y otras actividades a desarrollar por la Oficina de Control Interno durante el 2012. Resoluci??n del Rectorado de la Universidad de Granada por la que se aprueba la programaci??n del Plan de Control Interno, auditorias y otras actividades a desarrollar por la Oficina de Control Interno durante el 2012

  17. El cultivo del trigo en Nueva Galicia durante el siglo XVII

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    René de León Meza

    2016-01-01

    Full Text Available Este artículo estudia los factores que determinaron el desarrollo y consolidación del cultivo del trigo en varias comarcas del reino de Nueva Galicia durante el siglo xvii tomando como referencia la última fundación de Guadalajara. Destaca lo vital que fue para esta industria la mano de obra indígena a través del sistema de repartimiento forzado y la vigencia de este hasta el siglo xviii en contraste con Nueva España donde fue suprimido desde 1633. La hipótesis aquí planteada es que la escasez de trigo y harina que constantemente sufrieron los habitantes de la ciudad de Guadalajara se debió a la confabulación de las autoridades del Cabildo con los comerciantes y productores para acapararlos, esconderlos y luego venderlos a precios elevados. La política que los regidores implementaron de no instalar una alhóndiga que concentrara y regulara la venta de esos productos confirma el anterior aserto.

  18. O SUPORTE SOCIAL DURANTE A TRANSIÇÃO FAMILIAR NO PÓS-DESASTRE NATURAL

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    Gisele Cristina Manfrini Fernandes

    2013-01-01

    Full Text Available Investigación cualitativa de base analítica-interpretativa que tuvo como objetivo presentar las percepciones de las familias sobre el soporte social en la transición del postdesastre natural. Fueron entrevistados seis núcleos familiares residentes en una localidad rural del Sur del Brasil, y que fue afectada por un desastre natural en el año 2008. Los datos fueron obtenidos en el 2010, a partir de la observación participativa, entrevista narrativa, genograma y ecomapa. Las narraciones obtenidas fueron analizadas siguiendo las etapas del método de Fritz Schütze. Los resultados revelan la ayuda recibida durante la fase de transición, la falta de ayuda esperada, el soporte emocional de familiares y amigos y los recursos recordados por las familias en sus ecomapas, los cuales tuvieron una importancia fundamental para la fase inicial de recuperación postdesastre. El estudio contribuye para la comprensión del contexto de recuperación de las familias y destaca la pertinencia del soporte social como un medio de enfrentar los cambios.

  19. El proceso de reforma administrativa de la renta del Tabaco en Navarra durante el siglo XVIII

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    Sergio Solbes Ferri

    2013-11-01

    Full Text Available El presente artículo está centrado en la evolución de la gestión administrativa del monopolio fiscal del tabaco en Navarra durante la centuria dieciochesca. Su inicio se sitúa en el arrendamiento del estanco en 1717 por el Gobierno central a la Hacienda foral de Navarra -propietaria del mismo desde su creación en 1642- y analiza las sucesivas fases a través de las cuáles dicha administración central fue progresivamente adquiriendo el control absoluto de la renta en este territorio.The present paper is specially based in the evolution of the administration of the tobacco state monopoly in the Kingdom of Navarre during the eighteen century. We start in the lease of the income in 1717 to his old owner (the Foral Administration since 1642 and analyse the following phases through the Central Government was getting the control of the monopoly in this territory.

  20. Voce ja comeu DNA hoje? Divulgacao cientifica durante a Semana da Ciencia e Tecnologia no Brasil

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    Patricia Abrao Possik

    2013-11-01

    Full Text Available Durante a Primeira Semana Nacional de Ciências e Tecnologia, em 2004, centros e museus de ciência, universidades e escolas implementaram atividades com o objetivo de divulgar ciência para a população. O DNA Vai à Escola se juntou ao Conselho de Informação e Biotecnologia e praticou a extração de DNA de frutas em supermercados de 11 cidades brasileiras. Este artigo descreve a formação da rede nacional de pessoas interessadas em transmitir informações sobre genética para o público leigo e a implementação de uma atividade de divulgação científica de baixo orçamento em vários pontos do país, simultaneamente. Apresenta ainda o impacto causado pela atividade e as percepções daqueles envolvidos na sua organização.

  1. La influencia del manual en el pensamiento económico colombiano durante el siglo xx

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    Alberto Mayor Mora

    2017-02-01

    Full Text Available El uso de los manuales en economía ha sido masivo en su profesionalización y ha repercutido en las ideas económicas colombianas. Durante el siglo XX se presentaron cuatro etapas; la primera de ellas se dio a inicios del siglo, cuando predominó el autodidactismo en los manuales franceses, entre profesores, políticos y hombres de empresa de Bogotá y Medellín. La segunda etapa se caracterizó por el contacto de algunos protoeconomistas con el pensamiento económico original en el exterior, lo que ocasionó el inicio de la crítica a la utilización de manuales. La tercera surgió con las primeras facultades de Economía, en los años 40, época en que se reemplazó el manual francés por el anglosajón neoclásico; y la última etapa se inicia desde 1980, cuando se hace una crítica coherente al manual y comienza la producción de textos “criollos”, que ofrecen facilidades pedagógicas con pensamiento teórico de vanguardia.

  2. La producción de armas blancas en Bilbao durante el siglo XVI

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    Dueñas Beraiz, Germán

    2001-12-01

    Full Text Available They are few notices published about swords manufacture in Spain during the 16th century. One of the most unknown productions centers is the city of Bilbao, wich developed an important production of arms in part destined to its export to the British Islands. This article studies some documents, it is specialy interesting an unpublished document about the litigation hold up in 1569 between Bilbao swordsmiths and the «Corregidor» from Bilbao. Thanks of them it has been posible to compile names, marks and information about the activity of this craftsmen.

    Son escasas las noticias que poseemos sobre las zonas donde se fabricaban espadas en España. Uno de los centros más desconocidos es el de la ciudad de Bilbao, que desarrolló durante todo el siglo XVI, una importante producción de armas en parte destinadas a su exportación a las Islas Británicas. Gracias a una serie de documentos, entre los que figura uno inédito que recoge el pleito que los espaderos de Bilbao mantuvieron en 1569 con el Corregidor de Vizcaya, se han podido recoger algunos nombres y datos que permiten conocer más sobre la actividad de estos artesanos.

  3. Operaciones secretas inglesas en España durante la Segunda Guerra Mundial

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    Michael Alpert

    2002-01-01

    Full Text Available Aigunos miembros de los servicios ingleses de Información involucrados en la Guerra Civil, sobre todo Kim Philby y el capitán de Navio Hillgarth, siguieron ocupando cargos de importancia en los servicios secretos durante la Segunda Guerra Mundial. Las principales actividades de los servicios secretos ingleses en España incluían preservar la seguridad de Gibraltar, contrarrestar el trabajo de los agentes alemanes en el Estrecho, y desenmascarar a los espías españoles dirigidos por el Abwehr. Este artículo se ocupa especialmente de las dificultades de organizar el trabajo del llamado Special Operations Executive, en relación con la planificación de actividades guerrilleras y de sabotajes en caso de una ocupación de España por fuerzas militares alemanas.British specialists such as Kim Philby and Captain Alan Hillgarth, who had been involved in Intelligence services during the Spanish Civil War, contributed to the activities of the British Secret Services in Spain during the Second World War. Their main activities included the security of Gibraltar, counteracting German Intelligence in the Straits, and unmasking Spanish agents controlled by the Abwehr. This article concentrates on the particular difficulties of organising the work of the Special Operations Executive and its plans for guerrilla-type activity in the case of a German military occupation of Spain, whose neutrality, in the view of Great Britain, had to be carefully preserved.

  4. LUTERO E OS MOVIMENTOS SOCIAIS NA ALEMANHA DURANTE O PERÍODO DE 1517-1525

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    Júlio de Santa Ana

    1983-01-01

    Full Text Available Ao longo de todo este ano, diversos setores das Igrejas cristãs e da comunidade internacional comemoram o 500º aniversário do nascimento de Martinho Lutero. As igrejas de confissão luterana celebram a quem, há quase cinco séculos, sentou as bases de uma poderosa corrente de pensamento teológico. Outras igrejas protestantes se unem a esta celebração, recordando o homem de fé que, a 31 de Outubro de 1517, tornou públicas suas 95 teses sobre as indulgências, abrindo assim o caminho à reforma da igreja no século XVI. Outras confissões cristãs, a Igreja Católica Romana e as Ortodoxas, participam de diversas maneiras nestas comemorações. Estas não são exclusivas dos cristãos: por exemplo, no Brasil foi emitido um selo postal durante o mês de abril passado em homenagem à sua pessoa.

  5. El trabajo artesanal en Augusta Emerita durante los ss. I-IV d. C

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    Macarena BUSTAMANTE ÁLVAREZ

    2014-01-01

    Full Text Available Actualmente en la antigua capital lusitana es posible examinar, además de los restos arquitectónicos de sus edificios públicos y de una espléndida musivaria en ámbito doméstico, los indicios de otras producciones locales a las que hasta ahora no se les había concedido más que un interés de tipo secundario. En el presente trabajo damos a conocer una síntesis de las evidencias arqueológicas existentes del artesanado emeritense durante los ss. I-IV d. C. Este tema había sido revisado de manera aislada y esporádica en este solar. Aquí se valoran las estructuras, modos productivos y posibles evidencias de la mano de obra usada. Las constantes excavaciones que se han desarrollado en las últimas décadas han sacado a la luz 33 hornos cerámicos, 2 molinos alimentarios, 7 fullonicae, 1 officina infectae, 4 talleres de vidrio, 1 lanifricaria, 2 talleres de hueso, 2 pistrinae, 2 hornos metalúrgicos y 3 caleras que permiten el desarrollo de estudios de cierta envergadura. La industrial textil, la alfarera, alimentaria o metalúrgica, entre otras, son analizadas arqueológicamente. A partir de ello ha sido posible establecer un mapa de distribución de las distintas áreas manufactureras y de sus posibles zonas de influencia.

  6. O uso dos estereótipos turísticos durante o regime militar brasileiro

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    Fino, Patrícia

    2017-06-01

    Full Text Available Durante os anos de 1964 a 1985, o Brasil viveu sob uma ditadura militar, marcada por forte repressão política/ideológica. Esta pesquisa se propôs a investigar se os estereótipos turísticos foram utilizados como forma de promover a ideologia proposta pelos militares, com objetivo de obter um maior controle da população. Nesta etapa da pesquisa foram utilizados os seguintes procedimentos metodológicos: revisão bibliográfica e levantamento documental. Brasil: terra do sol e do mar, das belas mulheres, do povo alegre e hospitaleiro! Este foi o Brasil reiteradamente apresentado nos discursos correntes no período analisado. Nesta pesquisa, ainda em andamento, a história será revista e reexaminada. Acredita-se que o ineditismo e a importância histórica do tema justificam a relevância do trabalho proposto.

  7. MITIGACIÓN DEL ESTRÉS CALÓRICO DURANTE EL PREPARTO EN VACAS LECHERAS

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    G. D. TOFFOLI

    2017-06-01

    Full Text Available Se utilizaron 30 vacas en preparto que se alojaron en un corral seco con acceso a sombra artificial durante el verano. Las vacas fueron distribuidas en dos grupos: sin refrescado (TS y con refrescado (TR en el sector comedero. El peso corporal y la condición corporal fueron evaluadas al inicio y a los 25 días. La frecuencia respiratoria se realizó dos veces por semana en cuatro momentos del día. El registro de comportamiento dos veces a la semana. Los datos de analizaron con t Student y χ2. El peso y condición corporal no presentaron diferencia signifi cativa. Se observó un efecto del tratamiento en el día y horario para la frecuencia respiratoria (p<0,0001. La conducta de parado a la sombra fue al que dedicaron mayor tiempo en ambos tratamientos 27 % en TS y 29 % en TR. No hubo diferencias en la producción lechera entre TS y TR: 31,4 l/v/d y 30,6 l/v/d respectivamente.

  8. PESCADORES DE LOS RAUDALES DEL RÍO MAGDALENA DURANTE EL PERIODO FORMATIVO TARDÍO

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    Peña German

    2011-12-01

    Full Text Available Los resultados de la investigación realizada en el yacimiento arqueológico de Arrancaplumas, localizado en la zona de raudales del río Magdalena, entre la cuenca alta y media (Honda - Tolima y Puerto Bogotá - Cundinamarca, indican que este lugar fue habitado por largas temporadas anuales entre los siglos V y I A.C. Los pobladores emplearon en sus actividades cotidianas a lo largo de toda la ocupación una misma clase de cerámica y elaboraron una industria lítica que no presenta cambios significativos a través del tiempo.  El predominio de líticos lascados probablemente están relacionados con actividades derivadas de la pesca y la caza. La producción de alimentos vegetales se redujo principalmente al cultivo esporádico de maíz y papaya, y la recolección de frutos de palma. Durante toda la secuencia de ocupación la pesca constituyó la principal actividad de la cual derivaron su subsistencia.

  9. La «Educación personalizada» en Argentina durante la última dictadura militar

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    Luciana Garatte

    2016-01-01

    Full Text Available El artículo tiene como propósito comprender el alcance de la denominada «educación personalizada» en la carrera de Ciencias de la Educación de la Universidad Nacional de La Plata (Argentina, durante la última dictadura militar, entre 1976 y 1983. En ese período, esta perspectiva se identificó con la obra del reconocido educador Víctor García Hoz, quien resultó una figura clave en la definición de las políticas curriculares promovidas por el Ministerio de Educación de la Nación. Indagamos, en primer lugar, las concepciones que perfilan su matriz ideológica espiritualista, católica y tecnicista que favorecieron su recepción por parte de los intelectuales y funcionarios del Proceso militar. Confrontamos, las obras de García Hoz con los contenidos de formación pedagógica de la mencionada carrera y, por último, analizamos las prácticas formativas que resultaban de la puesta en práctica de esas propuestas, recuperando la mirada de quienes fueron docentes y estudiantes de Pedagogía en el período indicado.

  10. Durante la administración de rojas pinilla 1953 a 1957

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    William Pacheco Vargas

    2007-01-01

    Full Text Available Este artículo, se basa en el proyecto de investigación sobre la evolución de las finanzas de la Universidad Pedagógica de Colombia en Tunja, durante los años de gobierno del tunjano, Teniente General Gustavo Rojas Pinilla. Se analiza así mismo, los antecedentes y disposiciones presupuestales, el origen de los ingresos recaudados y el destino de los mismos y el impacto en el desarrollo institucional especialmente en las nuevas dependencias y en las ya existentes, incorporadas con motivo de su creación; medible a través de la participación en el gasto ejecutado.Lo que finalmente, permite establecer el balance financiero de la institución. A manera de conclusión, se determina el costo real promedio por estudiante para cada año en la Sección Universitaria. En los años de 1955 y 1957, se comparan las dependencias, la proporción de estudiantes, el presupuesto ejecutado, el costo por alumno, el número de docentes y empleados, y los correspondientes índices de crecimiento. De esta manera, se calcula el costo por escolar para toda la institución, sin importar el nivel de enseñanza de la misma; confrontando los datos con los cálculos hechos por ASCUN-FUN.

  11. El derecho de asilo en España durante la Edad Moderna

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    Sánchez Aguirreolea, Daniel

    2003-12-01

    Full Text Available After a long medieval evolution, especially in the peninsular territories of greater Castilian influence, the right of asylum remained completely defined, and it became an exclusive prerogative of the Church. The ministers of the Church defended this right, and they caused to respect it during three centuries, and were faced even to the highest civil authorities. This legal figure had a routine and real effectiveness, and it was one of the exits that the first the delinquents responded that intended to elude the justice.

    Después de una larga evolución medieval, sobre todo en los territorios peninsulares de mayor influencia castellana, el derecho de asilo quedó completamente definido, constituyendo una prerrogativa exclusiva de la Iglesia. Los ministros de la Iglesia defendieron este derecho, haciéndolo respetar durante tres siglos, enfrentándose incluso a las más altas autoridades civiles. Esta figura jurídica tuvo una efectividad real y cotidiana, constituyendo una de las salidas a las que primero acudían los delincuentes que pretendían eludir la justicia.

  12. Los hogares latinoamericanos durante la segunda mitad del siglo XX: una perspectiva sociodemográfica

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    Brígida García

    2002-01-01

    Full Text Available El objetivo de este trabajo es analizar los cambios sociodemográficos más significativos ocurridos en los hogares latinoamericanos durante la segunda mitad del siglo xx. Para ello se tienen en cuenta dos aspectos fundamentales: la posible convergencia hacia las familias pequeñas y nucleares; y la naturaleza e incremento de los hogares con jefatura femenina. Se intenta no sólo sintetizar el conocimiento existente sobre dichos temas, sino también dar cuenta de las conexiones entre los cambios sociodemográficos de los hogares y la desigualdad social y de género persistente en América Latina. Algunas de las principales conclusiones son: a A pesar de la existencia de un claro proceso de nuclearización en los hogares latinoamericanos, la importancia de los arreglos familiares de tipo extendido continúa siendo distintiva del sistema familiar en la región, especialmente entre la población de escasos recursos; y b los hogares encabezados por mujeres muestran un claro incremento, y posiblemente éste se aprecie en diversos sectores de nuestras sociedades.

  13. Breve historia de los refugiados en Argentina durante el siglo XX

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    María Paula Cicogna

    2009-12-01

    Full Text Available Argentina ha sostenido, desde la letra escrita de la Constitución Nacional, ser un país receptor de inmigración, aunque en los hechos ha demostrado lo contrario. A pesar de ello, durante el siglo XX se instalaron grupos de exiliados, solicitantes de refugio y refugiados de las más diversas nacionalidades. Este artículo mostrará los contingentes que conformaron el mapa multicultural de la Argentina a partir del desarrollo de una cronología creada a en base a los trabajos de investigación que analizaron el establecimiento de las diversas comunidades._________________ABSTRACT:According to National Constitution Argentina has been an open doors country to immigration, although it has demonstrated the opposite. In spite of it, during XX century groups of exiles, asylum seekers and refugees of different nationalities settled in the country. Based in a chronology created from varied researches which analyzed the establishment of the diverse communities this article will show the groups that shape the multicultural map of Argentina.

  14. Respuestas de elección durante el contraste negativo sucesivo consumatorio en ratas

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    Florencia López Seal

    2010-01-01

    Full Text Available En ratas, el cambio de una solución preferida (aguaazucarada al 32% por otra menos preferida (aguaazucarada al 4% produce una caída del consumopor debajo de un grupo control no devaluado, elcual siempre recibe acceso a la solución de valorbajo. Este fenómeno denominado contraste negativosucesivo consumatorio ocurre incluso cuandola devaluación coincide con cambios en las clavesambientales o gustativas y cuando hay múltiplesopciones de respuesta (con el reforzador de valorbajo disponible en varios lugares. En este artículose presenta un experimento donde un grupo de ratasse entrenó en la fase pre-cambio con una soluciónpreferida con sabor a almendra (32%A y otro conuna menos preferida (4%A. La fase post-cambio serealizó en un contexto distinto y novedoso, dondetodos los animales pudieron elegir entre consumir4% o 4%A. Se observó un efecto de contrastenegativo en los animales que experimentaron ladevaluación y una preferencia por la solución conel sabor a almendra utilizado durante la fase precambioen los sujetos de ambos grupos.

  15. OBTENCIÓN DE FRACCIONES ENRIQUECIDAS DURANTE LA EXTRACCIÓN DE ACEITES ESENCIALES CRUDOS

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    María S. Guala

    2012-01-01

    Full Text Available La destilación por arrastre con vapor es uno de los métodos más utilizados para la obtención de aceite esencial crudo (AEC. Muchas aplicaciones requieren fracciones de AEC, enriquecidas en un componente o grupo de ellos, para lo cual se utiliza destilación al vacío. En este trabajo se propone realizar un fraccionamiento del aceite esencial crudo (AEC durante el proceso de extracción por destilación con arrastre de vapor, para lo cual se colectaron distintos cortes, en lugar de una única mezcla final que es la metodología tradicionalmente utilizada. Las experiencias se llevaron a cabo utilizando frutos, hojas y tallos de aguaribay (Schinus molle L.. La composición de las distintas muestras obtenidas se determinó por cromatografía gaseosa acoplada a espectroscopía de masas. Los resultados muestran diferentes componentes (y concentraciones para los diferentes cortes, lo que indica que se puede lograr una apreciable separación utilizando esta metodología.

  16. Determinantes de la presión fiscal en las empresas mexicanas durante 1992 - 2009

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    Elena Fernández-Rodríguez

    2016-01-01

    Full Text Available Este trabajo analiza los factores determinantes del Tipo Impositivo Efectivo (TIE soportado por las compañías cotizadas mexicanas por razón del impuesto sobre bene¿cios. Para ello, se utiliza un panel de datos extraídos de la base de datos Compustat correspondiente a 79 empresas durante el período 1992- 2009 y se aplica el estimador del método generalizado de los momentos en primeras diferencias (GMM diseñado por Arellano y Bond (1991. Los resultados obtenidos permiten concluir que el TIE soportado por estas compañías es mani¿estamente inferior al tipo estatutario y que la presión ¿scal de un ejercicio está condicionada por la soportada previamente. Además se constata una relación no lineal entre tamaño y TIE, soportando menor presión ¿scal las empresas más grandes. Asimismo, presentan menores TIEs cuando el coste de la deuda y las amortizaciones son más elevados.

  17. Analgesia e sedacao durante a instalacao do cateter central de insercao periferica em neonatos

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    Priscila Costa

    2013-08-01

    Full Text Available Objetivou-se caracterizar as estratégias de analgesia e sedação em neonatos submetidos à instalação do cateter central de inserção periférica (CCIP e relacioná-las ao número de punções venosas, duração do procedimento e posicionamento da ponta do cateter. Estudo transversal com coleta prospectiva de dados, realizado em uma unidade de cuidados intensivos neonatais de um hospital privado na cidade de São Paulo, no período de 31 de agosto de 2010 a 01 de julho de 2011, em que foram avaliadas 254 inserções do CCIP. A adoção de estratégias analgésicas ou sedativas ocorreu em 88 (34,6% instalações do cateter e não esteve relacionada ao número de punções venosas, duração do procedimento ou posicionamento da ponta do cateter. As estratégias mais frequentes foram a administração endovenosa de midazolam em 47 (18,5% e fentanil em 19 (7,3% inserções do cateter. Recomenda-se maior adoção de estratégias analgésicas antes, durante e após o procedimento.

  18. LA COLECTIVIDAD BRITÁNICA EN VALPARAÍSO DURANTE LA PRIMERA MITAD DEL SIGLO XX

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    BALDOMERO ESTRADA TURRA

    2006-06-01

    Full Text Available En este trabajo analizamos la importancia de la colectividad británica en el desarrollo económico de Valparaíso (Chile, pese a su limitada presencia, durante la primera mitad del siglo XX. Se hace notar el predominio de la colectividad el comercio internacional como también en la actividad industrial especialmente en aquellas que poseían un mayor desarrollo tecnológico. La disminución de la importancia económica y también demográfica de la colectividad británica en Valparaíso, a partir de la década de 1920, se relaciona directamente con la perdida de influencia británica, en nuestro Continente, luego de la Primera Guerra MundialIn this work we analyze the importance of the british immigrants in the economic development of Valparaiso during the first half of twenty century. We highlight their predominance in the international trade and in the industrial activity especially those that reveal a high technological development. The economic and demographic decline of the british immigrants from 1920 is in close relation with the lost of the british influence in Latin America after the First World War

  19. Embarazo y carcinoma de cuello uterino en vidrio esmerilado: reporte de un caso.

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    Mario Nicolás Albani Pérez

    2009-01-01

    Full Text Available En Venezuela, el cáncer de cérvix es la primera causa de muerte por neoplasias en la mujer, con 2.500 defunciones anuales. Puede ser diagnosticado durante el embarazo, e incluso, histopatológicamente expresarse en variedades infrecuentes y agresivas como el carcinoma de cuello uterino en patrón de vidrio esmerilado. Se reporta un caso de gestante de 28 años de edad, multípara, con embarazo de 17 semanas de evolución por ecosonograma transabdominal quien acude al Hospital Universitario "Dr. Luis Razetti", al presentar sangrado transvaginal y dolor en hipogastrio. Ingresa al servicio de Ginecología y Obstetricia con impresión diagnóstica de cáncer de cuello uterino estadio IIIA, y posteriormente el servicio de Anatomía Patológica reporta hallazgo histológico como carcinoma de cuello uterino con patrón celular en vidrio esmerilado, se plantea como medida terapéutica la interrupción del embarazo. Tras debate de equipo de médicos, se decide el progreso del embarazo y hospitalización de la paciente hasta la fecha de cesárea previamente acordada, así como la aplicación del tratamiento posterior a la misma. La cesárea se desarrolló a las 34 semanas de embarazo con previa colocación de inductores de la maduración pulmonar fetal, cursó sin complicaciones y se obtuvo un neonato vivo pequeño para la edad gestacional. Se acordó tratamiento radioterápico al cabo de un mes postcesárea.

  20. Postoperative pain outcomes after transvaginal mesh revision.

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    Danford, Jill M; Osborn, David J; Reynolds, W Stuart; Biller, Daniel H; Dmochowski, Roger R

    2015-01-01

    Although the current literature discusses mesh complications including pain, as well as suggesting different techniques for removing mesh, there is little literature regarding pain outcomes after surgical removal or revision. The purpose of this study is to determine if surgical removal or revision of vaginal mesh improves patient's subjective complaints of pelvic pain associated with original placement of mesh. After obtaining approval from the Vanderbilt University Medical Center Institutional Review Board, a retrospective review of female patients with pain secondary to previous mesh placement who underwent excision or revision of vaginal mesh from January 2000 to August 2012 was performed. Patient age, relevant medical history including menopause status, previous hysterectomy, smoking status, and presence of diabetes, fibromyalgia, interstitial cystitis, and chronic pelvic pain, was obtained. Patients' postoperative pain complaints were assessed. Of the 481 patients who underwent surgery for mesh revision, removal or urethrolysis, 233 patients met our inclusion criteria. One hundred and sixty-nine patients (73 %) reported that their pain improved, 19 (8 %) reported that their pain worsened, and 45 (19 %) reported that their pain remained unchanged after surgery. Prior history of chronic pelvic pain was associated with increased risk of failure of the procedure to relieve pain (OR 0.28, 95 % CI 0.12-0.64, p = 0.003). Excision or revision of vaginal mesh appears to be effective in improving patients' pain symptoms most of the time. Patients with a history of chronic pelvic pain are at an increased risk of no improvement or of worsening pain.

  1. VARIACIÓN DE PARÁMETROS FISICOQUIMICOS DURANTE UN PROCESO DE COMPOSTAJE

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    Diana María Farias Camero

    2010-08-01

    Full Text Available Se llevaron a cabo dos procesos de compostaje a partir de residuos lignocelulósicos de rosas durante 165 días aproximadamente. En uno de los procesos la descomposición del material fue realizada sólo por microorganismos (compostaje directo y en el otro fuera de los microorganismos se adicionaron lombrices de tierra Eisenia foetida (compostaje indirecto. El compostaje directo fue realizado en un sistema de compostación denominado "camas" y el proceso indirecto se desarrolló en la etapa inicial en un sistema de "panelas" siendo trasladado posteriormente a una cama. Los dos procesos se manejaron con adiciones de cal, NH4NO3 (20%N y microorganismos. Se tomaron muestras periódicas en diferentes lugares de las pilas y se midió semanalmente la temperatura. En cada una de las muestras se determinaron los siguientes parámetros fisicoquímicos: % humedad, color, pH en relaciones muestra: agua 1:5 y 1:10, cenizas, materia orgánica. Cíe libre de cenizas, carbono, nitrógeno y relación C/N. En el extracto acuoso se determinaron el contenido de carbono orgánico total y nitrógeno, la relación C/N y el porcentaje de hidrosolubles y se hizo un ensayo de germinación en el que se calculó el porcentaje de semillas de berro (Lepidium sativum que germinaron en el extracto. La variación de los parámetros en cada uno de los procesos permifió establecer que los mayores cambios en el material se llevan a cabo durante las etapas iniciales del proceso (fases termófila y mesófila, siendo la presencia de microorganismos el factor limitante de la dinámica del proceso; así mismo la adición de lombrices de tierra no aceleró la mineralización de la materia orgánica. A nivel metodológico se estableció que la determinación del color no es un parámetro efectivo para evaluar el estado de madurez del compost y que, medidas de la temperatura y el porcentaje de germinación pueden realizarse rutinariamente para determinar el avance del proceso. Para

  2. Muerte fetal en el Hospital Nacional Arzobispo Loayza durante el periodo agosto 2003-noviembre 2004.

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    Luis Miguel Milla Vera

    2005-10-01

    Full Text Available Objetivos: Identificar las causas de los casos de muerte fetal, así como sus características sociodemográficas, clínicas, patológicas, y la tasa. Materiales y métodos: Se realizó un estudio descriptivo. Se buscaron los casos de muerte fetal en el libro de registros del servicio de obstetricia del Hospital Nacional Arzobispo Loayza entre agosto 2003 y noviembre 2004. Se buscaron las historias clínicas e informes anatomopatológicos correspondientes recopilándose los hallazgos. Resultados: Se encontraron 61 casos de muerte fetal, 47 se incluyeron en el estudio. Se registraron 4 524 nacidos vivos. La tasa de muerte fetal fue 13,48 por 1 000 nacidos vivos. Edad gestacional promedio fue de 28,29 semanas y peso promedio de 1 277,86 g. La edad menor a 35 años (76,59%, ausencia de control prenatal o control prenatal inadecuado (66,66%, paridad menor a 4 (86,96%, antecedente de aborto (21,73%, pequeño para edad gestacional (PEG (28,26%, hemorragia del tercer trimestre (HTT (17,39%, preeclampsia (8,69% y hallazgos anormales placentarios (23,28% fueron las características sociodemográficas, clínicas y patológicas más frecuentes. El 59,27% de los casos presentaba informe de patología. No se logró inferir causa alguna en 36,2%. Conclusiones: Los casos de muerte fetal durante el periodo de estudio no contenían los datos tanto clínicos como patológicos suficientes para identificar claramente las causas de muerte fetal. (Rev Med Hered 2005;16:260-265.

  3. Las ciudades disidentes durante la independencia de Venezuela: el caso de Maracaibo

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    Zulimar Maldonado Viloria

    2005-01-01

    Full Text Available En este estudio de caso se analizan las particularidades del proceso histórico que vivió Maracaibo durante los primeros años de la Independencia Venezolana. Es de interés para la historiografía venezolana y latinoamericana profundizar en el análisis de la realidad que explica la reacción de una “ciudad disidente” como Maracaibo, cuya elite prefirió seguir los lineamientos de la Regencia, elegir su diputado para las Cortes de Cádiz y defender su autonomía, antes que aceptar la propuesta de emancipación caraqueña. Bajo esta perspectiva se pretende esclarecer si la elite maracaibera fue realmente “disidente” del movimiento caraqueño por inercia histórica, larga herencia hispánica, o su actuación estuvo apegada a la legitimidad del momento como una opción política para lograr reafirmar y acrecentar su autonomía dentro del régimen monárquico. La investigación se ubica en la actual corriente historiográfica europea e hispanoamericana que sale al paso a los tradicionales análisis sustentados en una visión fáctica y localista, ignorando la amplitud temporal y espacial del proceso; se centra en el conocimiento que aporta el estudio comparado de la actitud de Maracaibo ante la Independencia con su desarrollo en el resto del país y acontecimientos en el mundo hispánico.

  4. El cine norteamericano durante la Gran Depresión (1929-1939

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    Carmen Mainer

    2013-04-01

    Full Text Available El cine comienza su andadura a finales del siglo XIX como un mero entretenimiento de masas, revelando a un público ávido de novedades las posibilidades del reciente descubrimiento. Será a partir de la Revolución bolchevique de 1917 cuando los organismos de poder descubran la capacidad de la imagen en movimiento como herramienta de propaganda ideológica. Los regímenes comunista y fascista se sirvieron del cine para difundir su doctrina y en la democracia de Estados Unidos, durante el período del New Deal (1933-1939, el cine clásico de Hollywood desempeñará la misma función propagandística, aunque haciendo uso de lenguajes y géneros variados y, con frecuencia, mucho más sofisticados. Es precisamente esta faceta del Séptimo Arte, su uso como agente difusor de ideologías, la que nos interesa y se analiza en el presente artículo.The cinema begins its career in the late nineteenth century as a mere mass entertainment, revealing to an eager audience the possibilities of the new discovery. It was from the Bolshevik Revolution of 1917 when the power of the moving image as ideological propaganda tool was discovered by the governments. The communist and fascist regimes used the cinema to spread their doctrines and in the American democracy, during the New Deal period (1933-1939, the classical Hollywood cinema will perform the same propaganda function, but using different languages ​​and genres, and often much more sophisticated. It is this aspect of the cinema, its use as a carier of ideologies, that interests us and analyze this article.

  5. Cuantificación del deterioro funcional durante seis meses en pacientes renales en estadio terminal

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    Lucía Ortega Pérez de Villar

    2015-12-01

    Full Text Available Introducción: Los pacientes en tratamiento de diálisis presentan una disminución de la función física, sin embargo, no hay estudios que demuestren el ritmo al que se produce este deterioro funcional. El objetivo principal es cuantificar el deterioro funcional de los pacientes en tratamiento de diálisis durante seis meses. Métodos: 43 pacientes en tratamiento de diálisis de dos centros de Valencia (España (edad 61.3 (14.7 años fueron analizados después de 6 meses. Los participantes completaron el Short Physical Performance Battery, equilibrio monopodal, el Timed Up and Go Test, Sit to stand to Sit Test 10 y 60, dinamometría de mano; elevación de talón y 6 minutos marcha. Además se recogieron datos de las historias clínicas y de las analíticas. Resultados: Tres de las pruebas mejoraron significativamente tras el periodo de 6 meses de observación: el Sit To Stand 10, la dinamometría de la mano derecha y la dinamometría de la mano izquierda, pero sin alcanzar un cambio clínico relevante. Por otro lado, otras medidas no obtuvieron un deterioro significativo como fueron el Short Physical Performance Battery, el Sit to Stand 60, la elevación del talón izquierdo y el 6 minutos marcha. Conclusiones: Después de 6 meses, en ninguna de las pruebas de capacidad funcional se observa un deterioro significativo. Se recomienda a los centros de hemodiálisis realizar un seguimiento de capacidad funcional anualmente, ya que con un periodo de 6 meses no se encuentran cambios significativos.

  6. Fiesta y Patria durante la Regeneración en Colombia. Santander (1886-1899

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    Oscar Blanco Mejía

    2012-07-01

    Full Text Available

    Resumen

    La fiesta patria durante la Regeneración en Colombia, adquiere importancia  no sólo porque es la representación de una nación católica en el país, acorde con el proyecto político implementado por los conservadores, sino además, y lo más importante,  porque cumple un papel de alquimia social, que transforma lo arbitrario en legitimo al  instaurar una rutina. Para comprender esta función, la presente ponencia pasara revista de manera breve a los orígenes de las fiestas nacionales en la región, y posteriormente, se adentrará en el  tema de la Regeneración.

     

    Palabras claves: Fiesta  republicana, regeneración, alquimia social.

     

    Abstract

    The national holiday during Regeneration in Colombia, becomes important not only because was the representation of a Catholic nation in the country, according to the political project implemented by the Conservatives, but also and most importantly, it plays the role of social alchemy, which transforms the arbitrary toward legitimate to establish a routine. To understand this function, this essay  briefly  review of the origins of national holidays in the region, and subsequently, will development  the theme of Regeneration.

     

    Keywords: Republican holiday, regeneration, social alchemy.

  7. Los conflictos político-religiosos en Colombia durante el siglo XIX

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    Fernando Santamaría Lambás

    2013-12-01

    Full Text Available Este artículo está publicado en España como “Los conflictos político-religiosos en Colombia durante el siglo XIX”, publicado en J.J. Caerols (ed., Religio in labyrintho, Madrid, Escolar y Mayo Editores, 2013, pp. 211-225, ISBN 978-84-941056-8-5 incluyendo en él referencia y cita bibliográfica de la publicación originalSUMARIO: 1. Introducción – 2. Las guerras civiles – 2.1. Las guerras por la definición del sujeto político – 2.1.a La guerra de los Supremos (1839-1842 – 2.1.b Las guerras de 1851 y 1854 – 2.2. Las guerras por la definición del sujeto político y el carácter de la educación – 2..2.a La guerra de 1861 – 2.2.b La guerra de 1876 – 2.2.c La guerra de 1885 – 2.3. Las guerras contra la exclusión en las que entran en juego los límites de la centralización – 2.3.a La guerra de 1895 – 2.3.b La guerra de los Mil Días. Abstract: During the nineteenth century in Colombia conflict is settled through political parties, the liberal and conservative, and civil wars, in which the religious element is sometimes the trigger of the conflict and sometimes the convener. We will use the literature to approach these wars and to better understand what happened in reality.Keywords Colombia, civil wars, political parties, religion.

  8. Prevalência de enteroparasitoses em fezes colhidas durante necrópsias

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    João Antônio de Almeida

    1991-03-01

    Full Text Available Com o objetivo de verificarmos a prevalência de enteroparasitoses, colhemos o conteúdo do tubo digestivo, em três porções distintas, durante a realização de 135 necrópsias completas. As fezes foram conservadas em MIF (mistura de formol, iodo e merthiolate, e analisadas pelo exame protoparasitológico direto. Encontramos enteroparasitas em 40 casos (29,6%, sendo que em 11 deles (27,5% havia poliparasitismo e em 29 casos (72,5% monoparasitismo. As enteroparasitoses mais freqüentes foram o S. stercoralis (31,9%, E. histolytica (23,4%, Ancilostomídeos (19,1% e A. lumbricoides (17%. Os resultados estão de acordo com levantamentos epidemiològicos na região. Além disso, mostram que o exame protoparasitológico de fezes colhidas concomitantemente ao exame necroscópico fornece mais um subsídio ao diagnóstico anatomopatológico.With the Intention to verify the frequency of intestinal parasites, we have taken the inside digestive system material from three differents parts of the intestinal tract while we were doing 135 complete necropsies. The stools were kept in MIF (Formol, iodine and merthiolate mixture being studied in slides by the direct method. We have found intestinal parasites in 40 cases (29.6%, 11 (27.5% with two or more kinds of parasites and 29 cases (72.5% with only one kind ofparasite. The most frequent parasites were: S. stercoralis (31,9%, E. hystolytica (23.4%, hook worm (19.1% and A. lumbricoides (17%. The results are in according with epidemiological research made in this area. Thus, they prove that the parasitological exam made in feces taken during the necroscopy provides further evidence to enrich the anatomo-pathological diagnosis.

  9. Cambios en virus vaccinia durante la síntesis de RNA in vitro

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    Julio Enrique Ospina

    1971-01-01

    Full Text Available Observaciones al microscopio electrónico de virus vaccinia previamente incubados en una mezcla para la reacción de RNA polimerasa in vitro, demuestran características alteraciones morfológicas en los virus. Estructuras similares a vesículas y ocasionalmente túbulos se formaron a partir de la membrana externa del virus. Uno de los sustituyentes de la reacción de RNA polimerasa in vitro, mercaptoetanol 0.007M, es el causante de esta alteración. El cambio morfológico se acompaña de pérdida de la infectividad viral. La presencia de grupos sulfhidrilo en la mezcla de la reacción enzimática es esencial para la ocurrencia de la síntesis de RNA de vaccinia in vitro. Esta condición no se pudo sustituir por choque térmico a 70C. ni por digestión parcial del virus por tripsina. Una gran variedad de compuestos con grupos sulfhidrilo pueden reemplazar el mercaptoetanol con efectividad variable. El más activo de ellos fué el ditiotreitol. Un período de latencia de 8 minutos ocurre entre la adición de vaccinia a la mezcla completa para la reacción de RNA polimerasa y la detección de síntesis de RNA. Los datos recolectados sugieren que cambios dependientes del mercaptoetanol ocurren durante este período.

  10. Nutrición y desarrollo psicomotor durante el primer semestre de vida

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    CHÁVEZ ADOLFO

    1998-01-01

    Full Text Available Objetivo. Estudiar el desarrollo psicomotor de niños pequeños de una comunidad rural pobre y mal alimentada y relacionarlo con la alimentación y nutrición tanto de su madre como de ellos mismos. Material y métodos. Se estudiaron 82 unidades madre-niño, desde antes del quinto mes de embarazo hasta los seis meses de edad del niño, en antropometría y dieta; en el niño se aplicaron pruebas de Brazelton al nacer, de Bayley a los tres y seis meses de edad y de interacción con su madre. Resultados. Varias de las pruebas psicomotoras del niño se correlacionaron positivamente con el peso de la madre y sus pliegues cutáneos, lo mismo que con su propio peso y talla previos. También con el consumo materno de productos animales y frutas durante el embarazo y negativamente con el consumo de tortillas y frijoles. Las correlaciones de varias de las pruebas del niño a los seis meses fueron positivas con su consumo complementario, de energía total y de varios alimentos, sobre todo de huevo, leche y frutas alrededor de los tres meses de edad. Conclusiones. Es importante que dentro del estrato social rural pobre estudiado, pequeñas variaciones de consumo de alimentos y nutrición de la unidad materno-infantil den lugar a cambios en las diversas pruebas de desarrollo psicomotor del niño pequeño, lo que sugiere la necesidad de impulsar más los programas de nutrición aplicados.

  11. CRUZANDO LOS MALLKUS. LAS MIGRACIONES BOLIVIANAS PENDULARES DURANTE LAS GRANDES CRISIS SALITRERAS (1914 - 1933

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    Sergio González Miranda

    2011-10-01

    Full Text Available Este artículo analiza el proceso migratorio pendular de la población boliviana (especialmente indígena hacia las salitreras de Tarapacá; destacándose la “gran crisis” de 1930 y años siguientes, analizando el desarraigo del retorno a Bolivia. Se sostiene que a partir del término de la Primera Guerra Mundial se inicia la decadencia del ciclo de expansión del salitre, generando procesos migratorios de atracción y expulsión de mano de obra, donde el drama social producto de la cesantía fue el factor común. En otras palabras, se plantea que la crisis del salitre no surgió en la década de los años treinta, como suele reconocerse en la literatura especializada sobre la industria salitrera, sino a partir de la primera guerra mundial se inicia el proceso de decadencia del mercado mundial del nitrato, siendo la década de los años veinte cuando se define el futuro de esta industria. Se estudia, especialmente a través de la prensa y archivos oficiales, los sistemas de enganche, los flujos de ida y venida de trabajadores bolivianos con sus familias, especialmente durante los años de crisis entre 1914 y 1933, donde el drama de la cesantía afectó a miles de bolivianos que debieron regresar a sus comunidades de origen. Este artículo se enmarca dentro de un análisis histórico que rescata la importancia de la sociedad civil en las relaciones entre países fronterizos, como Bolivia y Chile, fenómeno que la disciplina de las relaciones internacionales denomina acertadamente “paradiplomacia”.

  12. La CNT y las alianzas sindicales durante la dictadura de Franco

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    Ángel Herrerín López

    2002-01-01

    Full Text Available Las centrales sindicales CNT y UGT intentaron mantener en los primeros años de posguerra la colaboración que habían llevado a cabo durante la guerra civil española. Pero la represión franquista en España y la división interna en el exilio lo impidieron. En la CNT, el inmoviiismo de los ortodoxos contrastó con la evolución ideológica de los posibilistas, que se aproximaron a los planteamientos socialistas e iniciaron los contactos para la constitución de la alianza sindical a mediados de la década de los cincuenta. La Alianza formada en el exilio tuvo el punto débil en su implantación en España, y puso al descubierto la falta de adaptación de los sindicatos históricos, principalmente de la CNT, a las nuevas posiciones del movimiento obrero.During the first years after de war the trade unions CNT and UGT tried to keep the colaboration that they had accomplished during the spanish civil war. But the francoism repression in Spain and inner división in the exile obstructed it. Inside the CNT, the inmobile position of the orthodox members contrasted with the ideological evolution of the possibilists, who came cióse to the socialist ideas and they started the contacts to make the syndical alliance in the mid-50's. The Alliance created in exile had the vulnerable point in its introduction in Spain, and exposed the maladjustment of the historie unions, prínciply the CNT, to the new positions of the workers movement.

  13. Implicaciones del comercio por el puerto de San Blas durante la guerra de independencia

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    Trejo Barajas, Dení

    2006-12-01

    Full Text Available This article analyzes the importance acquired during the Independence war by the maritime trade coming from other Central and South American ports and operating through the San Blas port. The antecedents of the colonial commerce are studied, as well as the British presence and the consequences of the free trade measures taken by the Spanish government which particularly affected the Nueva Galicia Intendencia and the Pacific coasts of Nueva España. In the end, this highly polemical traffic permitted by the Spanish authorities strengthened Nueva Galicia both politically and economically, and prefigured the regionalism that was to be characteristical in 19th Century Mexico.

    En este artículo se analiza la importancia que adquirió, durante la guerra de Independencia, el comercio marítimo por el puerto de San Blas procedente de Panamá y otros puertos centro y sudamericanos. Se exponen los antecedentes relativos a la crisis del comercio colonial, la presencia inglesa y los efectos de las medidas de libre comercio adoptadas por el gobierno español que afectaron de manera particular a la intendencia de Nueva Galicia y las costas del Pacífico novohispano. Se revisan las consecuencias de este polémico tráfico permitido por las autoridades hispanas y que desembocó en el fortalecimiento político y económico de la Nueva Galicia, prefigurando el regionalismo característico del siglo XIX mexicano.

  14. Natalidad, nupcialidad y fecundidad en Mérida durante el siglo XVI

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    José Antonio Ballesteros Díez

    2002-01-01

    Full Text Available Este artículo es un estudio demográfico de Mérida durante el siglo XVI, que ha sido realizado a partir de las actas de bautismo, confirmación y matrimonio, por el procedimiento de la agrupación de familias, o método francés, analizando la natalidad con detalle de partos simples y dobles, las concepciones, las distribuciones temporales y sus tendencias, se fia determinado en número de familias y sus composiciones, obteniendo el coeficiente para la transformación de vecinos cabezas de familia en fiabitantes, tanto el general de la ciudad como los correspondientes a las comunidades cristiana y morisca; se tian determinado las edades de acceso al matrimonio, los intervalos genésicos en las mujeres, los estados prenupciales, la distribución temporal de la nupcialidad y los grupos de ilegítimos, expósitos, esclavos y moriscos.This is a demographic study of Mérida (a town of Castilla, Spain during the XVI century, from fhe baptism, confirmation and marriages registers, according to the process of the association of families by analysing the natality in detall of simple and double childbirths, and the concepcions, the temporal distributions and their tendencies; with the determination of the number of families and their composition, by obtaining the coeffcient in order to transform the neighbours into inhabitants. Both the general one of the town and the one wich belongs to the christian and moorish communities; the age of acces to marriage, genesis inervals in women, prenuptial states, temporal distribution of nupcitiality, ilegitimate groves, abandoned people, slaves and moorishes have been determined.

  15. Estructura salarial de los periodistas en España durante la crisis

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    Sergio Roses

    2011-01-01

    Full Text Available Las empresas informativas están aplicando políticas de reducción de gastos de personal para hacer frente a la crisis económica. Este trabajo describe la Estructura Salarial de los Periodistas en España durante la crisis (2009 a partir de los datos recabados mediante una encuesta telefónica suministrada a una muestra de mil periodistas en activo residentes en España. La descripción de los datos se detalla en función de un conjunto de variables sociolaborales. El estudio se complementa con un análisis bivariable de la asociación entre el nivel salarial de los periodistas encuestados y dichas variables. Los resultados indican que el nivel salarial de los periodistas en España está asociado a su género, edad, experiencia profesional, tipo de medio donde trabaja, tamaño de la empresa informativa, ubicación geográfica de la empresa, categoría profesional, tipo de contrato y antigüedad en la empresa. Sin embargo, el nivel salarial es independiente de nivel de estudios, titulación universitaria en Periodismo o Comunicación, y titulación en estudios de tercer ciclo. Los hallazgos del estudio—de interés para académicos y organizaciones profesionales—permitirán monitorizar en el futuro los efectos de las políticas de reducción de gastos de los medios en las retribuciones de los periodistas.

  16. Protozoários ruminais de novilhos de corte criados em pastagem tropical durante o período seco

    OpenAIRE

    Silva,Kellerson Luiz da; Duarte,Eduardo Robson; Freitas,Claudio Eduardo Silva; Abrão,Flávia Oliveira; Geraseev,Luciana Castro

    2014-01-01

    Protozoários do rúmen podem representar 40% do nitrogênio total e 60% do produto final da fermentação e apresentam atividade celulolítica. Neste estudo, objetivou-se quantificar e identificar as populações de protozoários no rúmen de novilhos, criados exclusivamente em pastagem, durante o período seco do ano, no Norte de Minas Gerais. Amostras do suco ruminal de 36 novilhos mestiços Nelore foram coletadas diretamente do rúmen, após o abate, durante o inicio, meio ou fim do período de estiagem...

  17. LA DINÁMICA DE LA POBLACIÓN EN LA PROVINCIA DE ALICANTE DURANTE LA GUERRA CIVIL

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    Vicente Gozálvez Pérez

    1993-01-01

    Full Text Available Durante la guerra civil española de 1936-39, la provincia de Alicante, pese a su situación de retaguardia, tuvo un movimiento natural con graves dificultades, sobre todo en 1939, a resultas del clima de inseguridad y las dificultades económicas creadas por el conflicto; el fuerte aumento de la mortalidad infantil entre 1937 y 1941, así como la sobremortalidad acumulada durante 1936-41, subrayan la fortísima incidencia del con- flicto. La migración neta, negativa para la provincia entre 1888 y 1930, fue muy positiva en 1931-40, debido, entre otras causas, a los desplazamientos provocados por la guerra, especialmente significativos para la ciudad de Alicante.

  18. Violencia de la pareja íntima durante el embarazo y sus repercusiones en la salud mental

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    María Mercedes Lafaurie-Villamil

    2015-12-01

    Full Text Available Este artículo presenta un estado del arte sobre violencia de la pareja íntima durante el embarazo y sus implicaciones en la salud mental de la madre, partiendo de 13 artículos publicados entre 2000 y 2014, obtenidos mediante búsqueda en bases de datos (Pubmed, Medline, Nursing Consult, sCielo, Dialnet, Redalyc, Lilacs, Index y Bireme, utilizando como palabras clave: embarazo, violencia de la pareja íntima, salud mental e implicaciones. Los hallazgos de este estudio, muestran que la violencia de la pareja íntima durante el embarazo incrementa la depresión y depresión posparto, así como el malestar emocional en la gestante.

  19. Selvas yermas. Los pueblos de indios desaparecidos en la costa sur de la Nueva Galicia durante el periodo colonial

    OpenAIRE

    Mejía, Ramón Goyas

    2017-01-01

    Resumen El presente análisis se centra en la desaparición de los pueblos de indios en la alcaldía mayor de la Purificación perteneciente a la Nueva Galicia durante el virreinato. Para la realización de este trabajo se abordó primero la caracterización físico natural de la región, para posteriormente hacer relevante la relación histórica hombre-naturaleza desde la época precolombina, ello con la finalidad de destacar la importancia de la pérdida de población durante el periodo colonial, como t...

  20. Selvas yermas. Los pueblos de indios desaparecidos en la costa sur de la Nueva Galicia durante el periodo colonial

    OpenAIRE

    Ramón Goyas Mejía

    2017-01-01

    El presente análisis se centra en la desaparición de los pueblos de indios en la alcaldía mayor de la Purificación perteneciente a la Nueva Galicia durante el virreinato. Para la realización de este trabajo se abordó primero la caracterización físico natural de la región, para posteriormente hacer relevante la relación histórica hombre-naturaleza desde la época precolombina, ello con la finalidad de destacar la importancia de la pérdida de población durante el periodo colonial, como tema cent...

  1. Médicos y policías durante la epidemia de fiebre amarilla (Buenos Aires, 1871

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    Diego Galeano

    2009-01-01

    Full Text Available Este trabajo analiza la actuación de médicos y policías durante la epidemia de fiebre amarilla que tuvo lugar en la ciudad de Buenos Aires en 1871. Aunque las embestidas de enfermedades infectocontagiosas fueron recurrentes durante el siglo XIX, la epidemia de fiebre amarilla constituye un quiebre, no solo por sus dimensiones cuantitativas y por los efectos materiales sobre la ciudad, sino también por las querellas que suscitó entre discursos en pugna. En particular, se intenta mostrar aquí cómo las figuras de los médicos y los policías fueron posicionadas en relación al tema del héroe y del sacrificado en cumplimiento del deber.

  2. Los colombianos y las redes del narcotráfico en Nueva York durante los años 70

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    Eduardo Sáenz Rovner

    2014-05-01

    Full Text Available La idea que se tiene sobre el narcotráfico desde Colombia es que éste ha sido manejado por “carteles”. Lo que la evidencia empírica muestra es que además de las grandes organizaciones criminales, el narcotráfico durante las últimas décadas, y en particular durante los años 70, objeto de este escrito, ha sido un negocio abierto con innumerables participantes (incluyendo mulas “free lancers” que se constituían en microempresarios del narcotráfico, en buena parte colombianos pero también de otras nacionalidades. De ahí que la idea de carteles que ejercen poderes monopólicos, es equivocada. La información inédita con la que se escribió este ensayo es tomada principalmente de una serie de archivos norteamericanos.

  3. Retención de aroma durante el secado de extracto de café en un sistema cerrado

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    J.F. Vílchez

    2006-01-01

    Full Text Available Durante el secado de alimentos líquidos, componentes volátiles presentes en baja concentración que contribuyen al aroma y sabor del producto final son removidos junto con el agua. En consecuencia la calidad del producto final es considerablemente afectada por la cantidad de substancias volátiles que son retenidas durante el proceso de secado. En el extracto de café, por ejemplo, existen cientos de tales compuestos, la mayoría de ellos altamente volátiles por lo que se pierden cuando el extracto es transformado en polvo seco. Independientemente del método utilizado, parece ser imposible evitar completamente la perdida de compuestos volátiles durante el secado. Un método potencial para mejorar la retención del aroma durante el secado es utilizar un sistema que trabaje a ciclo cerrado. Con el propósito de estudiar este proceso una planta piloto que consiste de un secador por aspersión, un secador de lecho fluidizado vibratorio, un sistema de recuperación de vapores e intercambiadores de calor para recalentar el aire reciclado ha sido diseñada y esta en la fase final de instalación en la Facultad de Ingeniería Química de la Universidad Nacional de Ingeniería, en Managua, para hacer un estudio del método potencial de recuperación de aroma del extracto de café. Este estudio tendrá como resultado no solo un café soluble de mejor calidad sino que además un método capaz de mejorar el procesamiento de muchos otros alimentos líquidos.

  4. El maltrato infantil como consecuencia de los estereotipos de género durante la tarea escolar

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    Lic. Caridad Anay Cala-Montoya

    2015-10-01

    Full Text Available El maltrato infantil se manifiesta en el proceso de la tarea escolaro las asignaciones donde los procesos de interacción entre padrese hijos durante la misma han presupuesto la emergencia decomportamientos inadecuados, resultado de las desigualdades degénero que persisten en nuestra sociedad y en el sistema familiar,eje de mira en que se enmarca la presente investigación.

  5. ¿Memoria no es historia? Testimonios de una escuela durante la dictadura militar en Argentina (1976-1982

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    Rubén CUCUZZA

    2013-11-01

    Full Text Available El artículo reproduce cuatro testimonios sobre algunos acontecimientos sucedidos a docentes y alumnos de una escuela durante la última dictadura militar en Argentina entre 1976 y 1982. Los relatos son entrelazados con algunas aproximaciones al problema de la memoria y el olvido, a las relaciones entre memoria e historia, a las posibilidades de la historia reciente y al papel de los testimonios en la tarea del historiador.

  6. Rede social durante a expansão da família Rede social durante la expansión de la familia Social net during family expansion

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    Nádia Cristina Jussani

    2007-04-01

    Full Text Available Estudo de natureza qualitativa que estudou a rede de suporte de famílias durante a gravidez. Os dados foram coletados em maio de 2003, através de entrevista semi-estruturada, junto à 16 mulheres. Os resultados revelaram que apenas uma mulher não recorreu à rede de apoio e que diferentes pessoas são procuradas conforme o tipo de problema vivenciado: dificuldades econômicas ou de aceitação da gravidez, necessidade de apoio emocional ou de esclarecimentos, ajuda para os afazeres domésticos, entre outros. Conclui-se que a rede social favorece o bom desenvolvimento da gestação e que para uma assistência mais eficaz é indicado que os profissionais de saúde atentem para o fato de a mulher ter uma rede de suporte com que possa contar durante a gravidez.Estudio descriptivo, de naturaleza cualitativa desarrollado con el objetivo de estudiar la red de soporte de familias durante el embarazo. Los datos han sido colectados en mayo de 2003, a través de entrevista semiestructurada, junto a 16 mujeres. Los resultados han revelado que apenas una mujer no ha recorrido a la red de apoyo durante el embarazo y que diferentes personas son procuradas de acuerdo con el tipo de problemas vivenciado: dificultades económicas o de aceptación del embarazo, necesidad de apoyo emocional o de esclarecimiento, ayuda para los quehaceres domésticos, entre otros. Se concluí que la red social ayuda el buen desarrollo de la gestación y que los profesionales de salud necesitan saber si hay una red de soporte que pueda contar durante el embarazo.This is a research of qualitative nature developed with the objective of studying the support net of families during pregnancy. Data were collected through semi-structured interview, from 16 women in May 2003. The results showed that just one woman did not appeal to the support net during pregnancy and that different people are sought according to the type of problem experienced at the time: economical difficulties or of

  7. ANALSIS DEL PATRÓN Y LAS PRESIONES PLANTARES DURANTE LA RECEPCIÓN EN UNA COLCHONETA

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    F. Huertas

    2010-10-01

    Full Text Available
    Dentro de las rutinas de la gimnasia deportiva, un elemento común son las
    recepciones sobre la colchoneta. En este sentido, diversos han sido los estudios cinéticos y cinemáticos realizados sobre la recepción y cuyos resultados pueden han sido útiles para la mejora en la compresión de la recepción y diseño de colchonetas. No obstante, el estudio de las presiones plantares durante la recepción no ha sido desarrollado por ninguna
    investigación a pesar de que el pie transmite al cuerpo las cargas de reacción generadas en el contacto con la colchoneta y dependiendo de su magnitud, frecuencia y punto de aplicación se pueden producir diferentes lesiones. El conocimiento de dichas cargas es importante no solo para la prevención de lesiones o criterios en el diseño de colchonetas, sino también para la mejora del rendimiento deportivo, mejorando la estabilidad durante la recepción. El presente trabajo muestra cuales son las zonas del pie a analizar, el patrón y las magnitudes de las presiones plantares durante una recepción tras un salto.

  8. Perda de peso e consumo de bebidas durante sessões de treinamento de ballet clássico

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    Cláudia Villela da Silva

    2011-06-01

    Full Text Available O objetivo do estudo foi analisar a perda de peso (PP e o consumo de líquidos durante sessões de treinamento de ballet clássico. A amostra foi composta por vinte e uma bailarinas, que foram avaliadas em três sessões de ballet: uma sessão sem oferta de líquidos, uma sessão com oferta de água e outra com oferta de bebida esportiva. Na sessão em que as bailarinas receberam água, a mediana de consumo foi 376,19 mL e a mediana de PP foi -190g. Na sessão com bebida esportiva, a mediana do consumo foi de 226,19 mL e a mediana da PP foi -150g. Observou-se diferença na ingestão de líquidos, mas não na PP, durante as sessões com consumo de líquidos (p=0,01 e p=0,79, respectivamente. As bailarinas, voluntariamente, beberam mais água do que bebida esportiva durante os treinos de ballet clássico.

  9. FONTES DE ESPÉCIES REATIVAS DE OXIGÊNIO NA MUSCULATURA ESQUELÉTICA DURANTE O EXERCÍCIO

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    Paulo Guimarães Gandra

    2006-10-01

    Full Text Available O músculo esquelético gera constantemente espécies reativas de oxigênio, através da reduçãomonoeletrônica do oxigênio molecular. Durante o exercício físico o consumo de oxigênio pelamusculatura esquelética exercitada pode ser aumentado em aproximadamente 100 vezes.Acredita-se que a geração de espécies reativas de oxigênio deve ser proporcional a esteaumento. O objetivo deste trabalho é apresentar todos os possíveis locais e mecanismos deprodução de espécies reativas de oxigênio na musculatura esquelética durante o exercíciofísico. A tradicional visão de que o aumento do consumo de oxigênio e o aumento do fluxo deelétrons pela cadeia de transporte de elétrons mitocondrial regulam a produção de espéciesreativas de oxigênio durante e após o exercício pode não ser exclusiva, nem a mais importanteao considerarmos os vários tipos de exercício.

  10. Cambios espacio-temporales del plancton en la ciénaga de Aayapel (Córdoba-Colombia), durante la época de menor nivel del agua

    OpenAIRE

    Jaramillo-Londoño, Juan Carlos; Aguirre-Ramírez, Néstor Jaime

    2012-01-01

    Se evaluaron los cambios espaciales y temporales de los ensambles fitoplanctónicos y zooplanctónicos durante la época de menor nivel de agua en la Ciénaga de Ayapel. Se tomaron muestras integradas en toda la columna de agua, en seis estaciones de muestreo, siguiendo el eje longitudinal de la ciénaga en sentido norte-sur, y durante siete días continuos. Durante el período de estudio la ciénaga se comportó como un sistema de aguas blandas, alcalino, altamente turbio, con profundidad y transpare...

  11. Cuidado de enfermería en el hogar a una madre con vih/sida y su recien nacido durante el postparto: un estudio de caso

    OpenAIRE

    Arévalo Venegas, Claudia Elena

    2014-01-01

    Este trabajo buscó describir el cuidado de enfermería en el hogar, a una madre con VIH/SIDA y su recién nacido durante el postparto, basado en las cinco categorías de la Teoría de Kristen Swanson, en Bogotá durante el II semestre de 2014. Por medio de un estudio de caso, utilizando la estrategia de seguimiento domiciliario en donde se realizaron 5 visitas al hogar, durante las cuales se desarrolló un plan de cuidado basado en las taxonomías NANDA, NIC, NOC. Previamente se realizó revisión de ...

  12. Papanicolaou durante la menstruación: evaluación de muestras en cuatro hospitales de Lima

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    Lucy López

    2011-04-01

    Full Text Available Objetivos: Analizar la factibilidad de obtener una muestra adecuada para el citodiagnóstico durante la menstruación, utilizando la técnica de tomar la muestra cuando el cuello del útero luzca limpio, luego de retirar el flujo menstrual de su superficie. Diseño: Estudio prospectivo, de correlación, de medidas repetidas. Participantes: Mujeres en edad reproductiva. Métodos: Participaron 389 mujeres que acudieron a cuatro hospitales de la región Lima Sur, de quienes se colectó 208 pares de muestras de Papanicolaou: una muestra correspondió al periodo menstrual y otra sin menstruación. La muestra durante la menstruación se obtuvo luego de limpiar suavemente la superficie del cuello uterino con un algodón seco y de esperar a que no hubiera pulso de flujo menstrual a través del os exocervical. Las muestras fueron analizadas separadamente por dos anatomopatólogas. Principales medidas de resultados: Adecuación de las muestras para Papanicolaou tomadas durante la menstruación. Resultados: En dos hospitales en donde las muestras fueron tomadas por personal sensibilizado y entrenado en la técnica, se halló que las muestras con y sin menstruación eran adecuadas para estudio citológico, sin diferencia estadísticamente significativa entre ellas (p < 0,005. En los otros dos hospitales, en donde las muestras fueron tomadas mayormente por personal sin entrenamiento, se halló que 75% de las muestras tomadas durante la menstruación correspondía a extendido hemorrágico, no adecuadas para el estudio del Papanicolaou, habiendo diferencia estadísticamente significativa entre muestras adecuadas con menstruación y sin menstruación (p < 0,005. Conclusiones: Los hallazgos nos permiten concluir para este estudio que es posible tomar una muestra adecuada para análisis del Papanicolaou durante la menstruación, si el personal de salud conoce cómo obtener una muestra sin sangre menstrual y está motivado. Este procedimiento puede incrementar el

  13. Tamoxifeno y afecciones endometriales en pacientes con cáncer de mama

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    Delia B. Dalbert

    2013-04-01

    Full Text Available Los objetivos fueron evaluar la prevalencia de afecciones endometriales en pacientes tratadas con tamoxifeno (TAM y analizar los aspectos epidemiológicos, ecográficos, histeroscópicos e histopatológicos. Desde enero de 1999 a diciembre 2008 se estudiaron 152 pacientes con cáncer de mama tratadas con TAM (20 mg/día, sintomáticas (con sangrado o asintomáticas, pre y postmenopáusicas, incluidas en forma consecutiva. El diseño fue prospectivo y observacional. Los métodos diagnósticos usados fueron ecografía transvaginal, histeroscopía y biopsia. Las pacientes fueron seguidas durante 5 años con ecografía cada 12 meses e histeroscopia con biopsia en casos que lo justificaran. Edad: 62.76 ± 10.24 años y tiempo de tratamiento: 36.2 ± 19.9 meses. El adenocarcinoma se observó en 3/87 (3.45% pacientes con factores de riesgo y en 1/65 (1.54% sin ellos (RA: 1.91, IC 95% 1.88 a 1.94. Las afecciones benignas se hallaron en 148 pacientes (97.37% y los adenocarcinomas en 4 (2.63%,1 en un pólipo de aspecto benigno. Los 4 se observaron en mujeres postmenopáusicas (2 asintomáticas con grosor endometrial igual o mayor a 16 mm. El riesgo de cáncer fue significativamente mayor en sintomáticas (2.36 versus 0.42 en asintomáticas. Tres adenocarcinomas se detectaron entre 24 y 48 meses del tratamiento. Recomendamos un seguimiento con ecografía transvaginal de las pacientes asintomáticas, resección de los pólipos evaluando factores de riesgo y tiempo de exposición, en especial luego de los 24 meses. Consideramos aceptable un cut-off = 10 mm en el grosor del endometrio en postmenopáusicas asintomáticas para realizar histeroscopía y biopsia.

  14. Efficacy of anchoring the four-arm transvaginal mesh to the mid-urethra vs original surgery as a surgical correction for stress urine incontinence in coexisting anterior vaginal prolapse grades II and III: study protocol for a randomized controlled trial.

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    Fekete, Zoltán; Surányi, Andrea; Rénes, Lórand; Németh, Gábor; Kozinszky, Zoltan

    2017-12-28

    The prevalence of obesity with aging is escalating alarmingly; and pelvic organ prolapse (POP) and stress urinary incontinence (SUI) are now becoming a growing epidemic among the elderly. Synthetic transvaginal mesh has been employed with increasing popularity in the treatment of POP and is usually highly effective in controlling the principal symptoms of prolapse. However, studies have reported that mesh operations provide fairly unfavorable SUI cure rates. Therefore, additional anti-incontinence surgical strategies are increasingly being scrutinized to achieve better postoperative continence without any significant side-effects for patients with both POP and SUI. We hypothesize that the modification with the fixing of the mesh to the mid-urethra is superior to the original transvaginal mesh operation (TVM) with regard to anti-incontinence. One hundred and thirty patients diagnosed with POP-Q II-III and concomitant SUI requiring surgical treatment will be included in this prospective, randomized, double-blind, controlled clinical trial. Patients will be randomly allocated to receive either original TVM (TVM group, n = 65) or modified TVM surgery (mTVM group, n = 65). As the primary outcome parameter, we will evaluate the objective SUI and POP cure rates. Secondary endpoints include postoperative morbidity as assessed with the International Urogynaecological Association classification and subjective prolapse and incontinence cure rates reported by questionnaires. Recognizing the importance of an additional surgical procedure for anti-incontinence management, we aim to investigate whether a stabilizing suturing of the mesh to the mid-urethra delivers superior SUI correction compared to the original prosthesis surgery. ClinicalTrials.gov, NCT02935803. Registered on 20 May 2016.

  15. Incidência de microorganismos em sementes de café robusta durante o armazenamento

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    BRACCINI ALESSANDRO DE LUCCA E

    1999-01-01

    Full Text Available Foi realizado um trabalho com o objetivo de isolar e identificar os microrganismos presentes em sementes de café robusta (Coffea canephora Pierre ex Froehner no decorrer do armazenamento. Para tanto, sementes de café do cultivar Conillon, acondicionadas em diferentes embalagens (saco de polietileno transparente, saco de papel kraft e saco de algodão e com graus de umidade iniciais distintos (25 e 35% foram submetidas a cinco períodos de armazenamento (0, 3, 6, 9 e 12 meses, em condições controladas. Após cada um desses períodos, as sementes foram avaliadas, em laboratório, quanto à sanidade (método do papel-filtro, germinação e grau de umidade. Foram isolados e identificados cinco gêneros dife-rentes de fungos infestando as sementes de café robusta, a saber: Fusarium semitectum, Colletotrichum spp., Alternaria spp., Aspergillus spp. e Penicillium spp. Observou-se predominância de Fusarium semitectum e de Alternaria spp., no início do armazenamento das sementes, com incidência variando de 63-73% e 7-11% respectivamente. No decorrer do armazenamento, houve grande elevação na incidência dos fungos de armazenamento dos gêneros Aspergillus spp. e Penicillium spp. nas sementes acondicionadas em diferentes embalagens. A incidência dos microrganismos mostrou grande variação, em função do tipo de embalagem utilizado durante o armazenamento. O aumento na incidência dos microrganismos esteve associado com a redução na germinação das sementes de café. O fungo Fusarium semitectum manteve-se em níveis elevados até por 12 meses nas sementes acondicionadas em embalagens de papel kraft e algodão. A embalagem de polietileno, associada ao grau de umidade inicial mais elevado, foi mais favorável na conservação das sementes de café robusta.

  16. La violencia sexual en la retaguardia republicana durante la Guerra Civil española

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    Adriana Cases Sola

    2014-10-01

    Full Text Available Este artículo ofrece una interpretación sobre la violencia sexual ejercida contra las mujeres en la retaguardia republicana durante la Guerra Civil. Este tipo de violencia se ha incluido en lo que algunas investigadoras han denominado como “violencias sexuadas”, un conjunto de violencias específicas destinadas exclusivamente a las mujeres. A través del estudio del caso de Piedad Suárez de Figueroa Moya, analizamos la violencia sexual infligida en la retaguardia republicana como parte de la violencia revolucionaria y de la estrategia de limpieza política desplegada por los comités al margen del poder republicano legítimo. Intentamos por lo tanto, ir más allá de la interpretación de las violaciones de guerra como la conquista del territorio a través del cuerpo de las mujeres del enemigo e introducimos una lectura política de las mismas elevando a las víctimas a la categoría de enemigas.Palabras clave: violencia sexual, Guerra Civil española, retaguardia republicana, violencia revolucionaria.__________________________Abstract:This paper offers an interpretation about sexual violence against women on republican rearguard during the Spanish Civil War. This kind of violence has been included in what some researchers have called “sexed violence”, a group of specific types of violence destined exclusively to women. Through the study of the case of Piedad Suárez de Figueroa Moya, we are going to analyse sexual violence wreaked on republican rearguard as a part of revolutionary violence and strategy of political cleansing carried out by unlawful republican committees. We are trying to go beyond the interpretation of war rape as a conquest of territory through the body of the enemy’s women. And finally we are going to introduce a political view of these rapes that turns victims into enemies.Keywords: Sexual Violence, Spanish Civil War, Republican Rearguard, Revolutionary Violence.

  17. Madres sociales de la aldea: la maestra española durante el nacional-catolicismo

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    Sonsoles San Román Gago

    2015-06-01

    Full Text Available Mi objetivo es señalar cómo asumen la evolución de modelos culturales dos espacios histórico-generacionales de maestras formadas antes y después de la Guerra Civil que ejercen durante el nacional-catolicismo en escuelas públicas de aldeas rurales. Quiero situar el artículo en un marco que permita comprender formación de identidades desde la perspectiva del cambio social y la asimilación a los modelos culturales. Entiendo que para esas maestras los inicios en su profesión son claves para comprender en qué medida cambios sociales y modelos educativos moldean identidades por sesgo generacional. Me propongo captar identidades de género para indagar su función regeneracionista como madres sociales de la aldea. He seleccionado para ello dos diarios de maestras representativas en dos periodos históricos. La metodología cualitativa ha sido utilizada para comprender la construcción social de las identidades de la maestra a través del análisis del texto escrito y poder así contextualizar el significado del cambio social con el análisis de su propio discurso, el texto escrito. Mis hipótesis son: 1 el momento en que empiezan a ejercer es importante para comprender cómo asumen la evolución de los modelos culturales; 2 la forma en que han asimilado las fases históricas del nacional-catolicismo en aldeas rurales moldea sus estructuras psicológicas; 3 la adaptación a la cultura de las aldeas va produciendo identidades sociales y de género. He llegado a las siguientes conclusiones: 1 la maestra es una pieza clave para comprender la evolución de los modelos culturales; 2 conocer lo que quieren recordar o silenciar permite captar el modo en que han asumido o rechazado los modelos ideológicos del nacional-catolicismo; 3 el sentido que dan a lo vivido va señalando significantes que permiten comprender el modo en que han socializado a las siguientes generaciones.

  18. LA CONFLICTIVIDAD AGRARIA CASTELLANA DURANTE EL SIGLO XVIII. EL EJEMPLO DE LA MANCHA ORIENTAL

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    Ramón Cózar Gutiérrez

    2011-05-01

    Full Text Available RESUMEN. Durante mucho tiempo la historiografía ha presentado la España del siglo XVIII como un paraíso idílico presidido por la concordia y en el que no ocurrieron hechos realmente serios. Nada más lejos de la realidad, pues existió una conflictividad social que no podemos ignorar. Con este artículo queremos contribuir a reforzar esta idea, constatando todos los hechos conflictivos ocurridos en La Mancha albacetense en los años 1765, tras la promulgación de la Real Pragmática liberalizadora del comercio de granos, y 1766, en el que, entre el clima de crispación general propiciado por el motín en Madrid, aparecen dos motines provinciales que ocupan un lugar importante en la historiografía española: Tobarra y Liétor. El primero, por ser el primer caso de sublevación después del motín madrileño de 1766, mientras que el segundo, ha sido considerado por algunos autores, como uno de los ejemplos más representativos de la conflictividad social decimonónica. Esperamos que este estudio pueda contribuir, de algún modo, a un mejor conocimiento de la conflictividad social en la España del siglo XVIII en general, y de La Mancha Oriental en particular. Palabras claves: conflictividad social, motines, Mancha Oriental, siglo XVIII. ABSTRACT. For a long time the historiography has represented the eighteenth-century Spain as an idyllic paradise where concord and unimportant facts prevailed. Far from being true, the situation lived in Spain was marked by a social conflict that can not be ignored. In this article we want to reinforce this idea, noting all the conflicting facts that occurred in La Mancha of Albacete in the years 1765, following the promulgation of the Royal Pragmatic liberalization of trade in grains, and 1766, where the climate of tension between generally favored by the mutiny in Madrid, two provincial riots that occupy an important place in Spanish history: Tobarra and Liétor. The first, being the first case of rebellion

  19. El declinar militar hispánico durante el reinado de Carlos II

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    Antonio ESPINO LÓPEZ

    2009-12-01

    Full Text Available RESUMEN: En el presente trabajo, nuestra intención ha sido explicar la decadencia militar de la Monarquía Hispánica durante el reinado de Carlos II (1665-1700. Pero para conseguirlo, es necesario iniciar el análisis de este tema en el reinado de Felipe IV. A partir de la década de 1630 se vio clara la necesidad de introducir cambios profundos en la institución militar; unas reformas que la tratadistica militar del momento señaló profusamente. En primer lugar señalamos la continua reducción del número de efectivos en los ejércitos hispánicos a lo largo del siglo XVII, de modo que los principales frentes de combate -Milán, Flandes y Cataluña- nunca contarán con la cantidad necesaria de tropas. Analizamos la estructura interna del ejército a partir del ejemplo del Ejército de Cataluña, de esta forma observamos sus carencias fundamentales -tanto las de las tropas, como las del ejército como institución- y, por último, observamos críticamente las soluciones que se intentaron aplicar en la época, todas ellas lastradas por las dificultades económicas del momento.ABSTRACT: The present article describes the Spanish military decadence during the reign of Charles II of Spain (1665-1700. The author starts his analysis from the reign of Philip IV of Spain because from the 1630s the need of making substancial changes in the warfare was absolutely clear. In fact, that changes were described in the militar treatises of the moment. First of all, the main front of combat -Milan, the Netherlands and Catalonianever had the appropiate number of troops, because of its lack of men during the XVIIth century. Secondly, those troops lived permanently in very hard conditions, as it can be seen in the Catalan case. Finally, all the solutions were failed because of the economic difficulties of that monarchy.

  20. Hebreos y musulmanes durante la guerra civil en Melilla : violencia politica y represión

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    María Elena Fernández Díaz

    2012-01-01

    Full Text Available El presente artículo constituye un intento de sistematización del fenómeno represor y concentracionario franquista en Melilla sobre las dos comunidades minoritarias de la ciudad en esos momentos, la hebrea y la musulmana, sin desestimar en su contenido el contexto represivo y concentracionario general en dicha ciudad dentro de la dinámica represiva ejercida por militares y falangistas en España. El estudio de este proceso a escala local y sobre estas dos comunidades religiosas, con particularidades y consecuencias muy diferentes, a través de diferentes fuentes, tanto orales como escritas además de archivos, nos permite observar las actuaciones que fueron los ejes sobre los que se movió la vida melillense de retaguardia durante la guerra civil teniendo una visión aproximada de la proyectada represión franquista llevada a cabo en esta ciudad, dando lugar entre otras actuaciones al asesinato planificado y confinamiento en el campo de concentración de Zeluán de parte de la población melillense y protectorado cercano, incluyendo a miembros de estas dos comunidades.This article attempts to systematize the concentration camp phenomenon Franco repressor and Melilla on the two minority communities in the city at that time, Jewish and Muslim, rejected in its content without the repressive context and overall concentration camp in the city within the dynamics of repression exercised by the military and Falangist Spain. The study of this process locally and on these two religious communities, with very different implications and consequences, through various sources, both oral and written files as well allows us to observe the actions that were the foundations on which moved rear Melilla life during the civil war have an approximate idea of the proposed Franco regime carried out in this city, among other actions leading to murder planned and confinement in concentration camp Zeluán of the population of Melilla and protectorate nearby

  1. Efeito de bioterápico na eosinofilia durante a SLMV experimental

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    Luciana Camillo

    2014-09-01

    Full Text Available O Toxocara canis (Tc é um parasito pertencente ao filo Nematódeo que possui como hospedeiro definitivo os cães, O homem é hospedeiro paratênico e contamina-se acidentalmente ao ingerir ovos contendo larvas infectantes (L3 do parasito, as quais são liberadas e atravessam a mucosa intestinal, atingem a circulação, Durante este processo migratório, antígenos de excreção e secreção (TES são liberados provocando intensa reação inflamatória, do tipo Th2, caracterizando a síndrome, denominada Larva Migrans Visceral (SLMV, As principais características desta doença crônica são as eosinofilias sanguínea e tecidual persistentes, Desse modo, torna-se importante a busca por terapias que contribuam com a redução dos quadros inflamatórios com intensa eosinofilia, Assim, o uso deste bioterápico, produzido a partir do extrato antigênico de ovos e larvas de (Tc, e seu efeito no recrutamento de leucócitos totais, células mononucleares e eosinófilos no sangue, para o espaço broncoalveolar e para a cavidade peritoneal de camundongos infectados pelo (Tc foi investigado, Foram utilizados camundongos fêmeas (Swiss, divididos nos grupos: Controle (C, Infectado (Tc, Imunizado (Im+Tc e Tratado (Tc+Bio, Os animais Tc, Im+Tc e Tc+Bio receberam 500 ovos/animal por gavagem, Posteriormente, os animais foram eutanasiados no 18º dia da infecção e o número das células nos compartimentos foi determinado, Os resultados obtidos demonstraram que, Im+Tc, assim como nos Tc+Bio tiveram redução significativa dessas células nos compartimentos analisados quando comparados grupo Tc, Assim, sugeriu-se que a bioterapia modulou negativamente o recrutamento de células inflamatórias, principalmente eosinófilos no sangue, pulmão e intestino demonstrando um potencial anti-inflamatório desse bioterápico na SLMV experimental.

  2. Leucemia linfoblástica aguda (LLA durante a gravidez: um relato de caso

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    Marcelo Gil Cliquet

    2015-10-01

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

  3. Uso de medicamentos durante el embarazo en diferentes áreas de salud

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    Germán Vergel Rivera

    2000-12-01

    Full Text Available Para describir los motivos de prescripción, los prescriptores y la exposición a medicamentos durante el embarazo se realizó un estudio observacional, prospectivo en 8 áreas de salud (5 de Ciudad de La Habana y 3 de Santiago de Cuba. Se incluyeron las gestantes captadas (347, del 1ro. de octubre al 31 de diciembre de 1995. El Médico de Familia recogió la información. Los motivos de prescripción más frecuentes fueron: suplementación vitamineral, anemia, profilaxis del tétanos y preeclampsia, cefalea, náuseas y/o vómitos, sepsis urinaria y vaginal con variaciones en frecuencia, según trimestre del embarazo. La exposición a 2 o menos medicamentos y a 4 principios activos fue lo más frecuente. El médico de atención primaria fue el principal prescriptor. Llama la atención, la posible exposición a elevadas concentraciones de vitamina A, en todas las áreas y el uso frecuente de ácido acetilsalicílico para la profilaxis de la preeclampsia en las áreas de Santiago de Cuba. Cualquier intervención, para mejorar la prescripción en la embarazada, debe ser dirigida al médico de atención primariaAn observational and descriptive study was conducted in 8 health areas (5 from Havana City and 3 from Santiago de Cuba in order to describe the reasons for prescribing drugs, the prescribers and the exposure to drugs during pregnancy. 347 pregnant women who were recruited from October lst, to December 31st, 1995, were included. The family physician was in charge of collecting the information. The commonest reasons for prescribing were: vitamin supplementation, anemia, tetanus and preeclampsia prophylaxis, headache, nauseas and/or vomits, and urinary and vaginal sepsis with varying frequency, according to the trimester of pregnancy. The exposure to 2 or less drugs and to 4 active principles was the most frequent. The possible exposure to elevated concentrations of vitamin A in all the areas and the usual administration of acetylsalicylic acid

  4. SINDROME DE APNEAS/HIPOPNEAS DURANTE EL SUEÑO EN EDAD PEDIÁTRICA

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    Navazo Eguía A

    2006-08-01

    Full Text Available SUMMARY:Sleep disordered breathing (SDB is a common condition in children. Sleep Apnea/Hypopnea syndrome (SAHS in children is a frequent sleep disorder, with a prevalence estimated to be 1 - 3% of all children. The most frequent cause of SAHS in children is the adenotonsillar hypertrophy. SAHS in children can result in severe complications if left untreated such as impaired physical growth, delayed development, poor school performance and in severe cases, hypertension and cor pulmonale, nevertheless, yet it is an under recognized condition. The gold standard diagnostic technique is the nocturnal polysomnography (PSG, guidelines for performing laboratory-based polysomnography in children have been established, the sleep laboratory should be a nonthreatening environment and personnel with pediatric training should record, score and interpret the study. The diagnostic criteria for SAHS in adults is not useful for diagnosis of SAHS in children. Adenotonsillectomy is the most common treatment for children with SAHS.RESUMEN:Los trastornos respiratorios del sueño en los niños, en particular el Síndrome de Apneas/Hipopneas durante el sueño (SAHS, es una patología frecuente, que afecta entre el 1 - 3% de la población infantil, siendo su causa más frecuente la hipertrofia adenoamigdalar. Es una enfermedad infradiagnosticada y que conlleva importantes complicaciones como son alteraciones del crecimiento, alteraciones cognitivas e incluso en casos severos Cor Pulmonale. La polisomnografía nocturna (PSG, es la técnica diagnóstica de elección para el diagnóstico del SAHS en los niños, pero en la población infantil es necesario tener en cuenta una serie de consideraciones, como son la edad de la población que se estudia, entorno adecuado y la necesidad de técnicos entrenados en el cuidado de los niños. Los criterios diagnósticos del SAHS para adultos no son útiles en los niños. El tratamiento de elección en los niños con SAHS es la

  5. Hipertemia durante el fenómeno de el niño, 1997-98

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    Jaime Miranda M

    2003-10-01

    Full Text Available Objetivo: Describir el cuadro clínico y la evolución de los casos de síndrome febril presentados durante el fenómeno de "El Niño" de 1997-98, y presentar una revisión de la fisiopatología del cuadro de hipertermia. Material y métodos: Se realizó un estudio descriptivo longitudinal en la ciudad de Chimbote, Ancash. Se definió como caso de síndrome febril: niños menores de 5 años con fiebre refractaria al uso de antipiréticos sin foco aparente de infección. En el análisis posterior se consideraron: apariencia no tóxica, previamente sano, sin foco de infección al examen físico y con examen de laboratorio negativo. Resultados: Fueron estudiados 25 casos (68% varones, 80% con edades entre 5 y 18 meses con un tiempo de enfermedad promedio de 15,17(13,52 días ± desviación stándar (±DS. La mediana de la temperatura fue 38,8ºC con un promedio de 38,84ºC (rango 38 - 40ºC. 68% tuvo un tiempo de enfermedad mayor de 15 días; 52% había visitado al menos una vez un centro médico anterior; 68% recibió antibióticos y antipiréticos; y, 52 % ingresó al hospital por emergencia. Todos los casos presentaron alza térmica, asociado a piel seca (72%, diarrea (64%, tos (52%, baja de peso (52%, irritabilidad (44%, náuseas o vómitos (40%, rinorrea (24% y convulsiones (20%. El tiempo de hospitalización promedio fue 4,7 días y el estado febril promedio fue 2,5 días. Ninguno tuvo examen de laboratorio compatible con causa infecciosa. Conclusiones: En situaciones ambientales adversas debe considerarse al calor ambiental como un factor importante en el desarrollo de la hipertermia, con el propósito de brindar un manejo más apropiado a los afectados en el menor tiempo posible.

  6. Comportamento da criança durante videonasofaringolaringoscopia: análise de 105 pacientes

    Directory of Open Access Journals (Sweden)

    Tsuji Domingos H.

    2002-01-01

    Full Text Available Introdução e objetivos: Este trabalho tem como objetivos estudar o comportamento da criança ao ser submetida a videonasofaringolaringoscopia - e a eficiência da rotina adotada pelos autores para sua realização - e descrever a rotina do exame, contribuindo para sua melhor execução por outros profissionais da área médica. Forma do estudo: Prospectivo clínico randomizado. Material e Método: O presente estudo foi realizado com 105 crianças e adolescentes, cuja faixa etária variou de 1 a 15 anos, sendo a média de 7,3 anos, submetidos a endoscopia nasal e/ou faringolaríngea com endoscópio flexível. Resultados: O índice de sucesso do procedimento foi de 99,04% - em apenas uma das crianças foi impossível a execução da endoscopia. A ocorrência de náusea não impediu a boa avaliação da laringe, estando presente em apenas 6,7% dos casos. O choro ocorreu em alguma das fases da rotina de exame em 24,76% do total de pacientes: em 42,10% das crianças de 0 a 5 anos (Grupo I; em 20,93% das de 6 a 10 anos (Grupo II; e em 0,00% dos adolescentes de 11 a 15 anos (Grupo III. A cavidade nasal foi a região mais relacionada com tal ocorrência, correspondendo a 80% dos casos que choraram durante o exame. Conclusão: Ao findarmos a pesquisa, concluímos que a videonasofaringolaringoscopia flexível é muito eficiente segundo a rotina adotada e que a tolerância do paciente mostrou-se proporcional a sua idade.

  7. MONITORAMENTO DA TEMPERATURA NO INTERIOR DE CHAPAS AGLOMERADAS DURANTE O PROCESSO DE PRENSAGEM

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    Elio José Santini

    2005-03-01

    Full Text Available O objetivo do presente trabalho foi analisar o comportamento da temperatura nas faces e no miolo de chapas de partículas aglomeradas, coladas com 8% de adesivo (base peso seco das partículas tanino-formaldeído. As chapas foram produzidas com três repetições por tratamento, com massa específica nominal de 0,7 g/cm³ e pressão específica de prensagem de 27 kgf/cm². Os tratamentos basearam-se na utilização de flocos de pinus (Pinus elliottii e partículas de eucalipto (Eucalytus sp, sendo que os flocos de pinus apresentavam três diferentes comprimentos nominais (40, 75 e 110 mm e duas espessuras (0,5 e 1,0 mm. Também foram analisados duas temperaturas de prensagem (140 e 180°C e dois teores de umidade nominal do colchão (17 e 21%. A temperatura no interior dos painéis durante a prensagem foi obtida por meio de fios para termopares tipo K (cromo-alumel. Os gráficos da temperatura em função do tempo de prensagem mostraram uma rápida elevação da temperatura nos primeiros 100 segundos de prensagem, mantendo-se num plateau possivelmente após atingir a temperatura de ebulição da água. A temperatura voltou a aumentar, de forma mais gradual, após a perda de grande parte da umidade do colchão. Observa-se que colchões formados por flocos de maior espessura apresentaram elevação mais rápida de temperatura no miolo. O principal fator que influenciou na velocidade de elevação da temperatura no miolo dos painéis aglomerados foi o teor de umidade do colchão, sendo que quanto maior o teor de umidade, mais rápida foi a elevação da temperatura.

  8. Usos de Twitter durante el 15M. El caso de la prensa catalana

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    Juan Linares-Lanzman

    2015-03-01

    Full Text Available Durante las primeras manifestaciones del 15M o movimiento de los indignados, miles de usuarios españoles se registran en Twitter a la vez que se multiplican las informaciones sobre el movimiento en este medio. Estas servían al 15M para organizar y difundir, muchas veces en tiempo real, asuntos relevantes sobre las convocatorias. Este artículo es un caso de estudio que muestra algunos usos periodísticos de Twitter en este periodo y para el caso del 15M en Cataluña, considerando que la Acampada de Barcelona fue una de las principales del movimiento. El objetivo es explorar cómo fueron las rutinas de las redacciones periodísticas en Twitter, y si se produce y cómo una hibridación de funciones entre periodistas y usuarios. Hemos realizado entrevistas a los periodistas de las principales redacciones catalanas junto al análisis de contenido de algunos tweets publicados entre el 15 de mayo y el 19 de junio de 2011, periodo conocido como de “explosión del movimiento”. Los resultados de este artículo sugieren que, motivados por una alta necesidad de información sobre lo que estaba sucediendo, los periodistas optaron por buscar en Twitter nuevas fuentes, en especial en la red del 15M, constituida por nodos de las acampadas y de Democracia Real Ya, la plataforma convocante de la manifestación del 15 de mayo de 2011. Durante el 15M se instala una rutina periodística que supera la lógica de solo acceder y dar credibilidad a las fuentes informativas previamente reconocidas, como las agencias de noticias y otros medios, consiguiéndose una nueva forma que permite a los periodistas otorgar más amplitud y profundidad a las noticias e informaciones sobre el 15M. Este hecho ofrece la necesidad de pensar en modelos de periodismo del tipo participativo, donde los medios sociales y algunas funciones periodísticas tradicionales pueden ser ejercidas por otros usuarios, incluso desconocidos, que actúan desde fuera de las redacciones. During the

  9. NRE81/10: Plan de Control Interno, auditorias y otras actividades a desarrollar por la oficina de control interno durante el ejercicio 2014

    OpenAIRE

    Universidad de Granada

    2014-01-01

    Resoluci??n del Rectorado de la Universidad de Granada por la que se aprueba la programaci??n del Plan de Control Interno, auditorias y otras actividades a desarrollar por la oficina de control interno durante el ejercicio 2014.

  10. NRE40/3: Plan de Control Interno, Auditor??as y otras actividades a desarrollar por la Oficina de Control Interno durante el ejercicio 2011

    OpenAIRE

    Universidad de Granada

    2011-01-01

    Resoluci??n del Rectorado de la Universidad de Granada por el que se aprueba la programaci??n del Plan de Control Interno, Auditorias y otras actividades a desarrollar por la Oficina de Control Interno durante el ejercicio 2011.

  11. El apoyo real. Relaciones político-militares entre dos ciudades realistas: Santa Marta y la Habana durante 1810- 1815

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    Jorge Enrique Elías Caro

    2009-01-01

    Full Text Available En este trabajo se hará un análisis de las relaciones político-militares que se suscitaron durante el proceso independentista entre Santa Marta en el Caribe Neogranadino y la Habana en Cuba. Así mismo, se explicarán ciertas particularidades de las guerras navales, fluviales y terrestres que sostuvieron estas ciudades realistas con otras que defendían la causa emancipadora, durante el periodo comprendido entre 1810-1815.

  12. ESTUDIO BACTERIOLÓGICO DEL LIQUIDO AMNIÓTICO DURANTE EL EMBARAZO Y PARTO

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    Eduardo Acosta Bendek

    1984-11-01

    Full Text Available

    Se estudiaron 220 muestras del líquido amniótico, obtenidas en condiciones estériles y sembradas en medios de cultivos aeróbico y unos pocos casos en anaeróbico: al mismo tiempo se hacía extendido en coloración de Gram. El primer grupo de 110 muestras
    fueron tomadas durante la operación cesárea: 68 casos sin trabajo de parto de los cuales 64 con membranas íntegras, y 4 con membranas rotas de más de 6 horas; la contaminación bacteriana del líquido amniótico fue detectada en el 12.5 % en los casos de
    membranas íntegras y en 500/0 en los casos de membranas rotas. Los 42 casos restantes eran de más de 12 horas de trabajo de parto y con membranas rotas; la contaminación del líquido amniótico fue detectada en el 26.50/0.
    Se examinaron 85 placentas y se encontró placentitis leve en un 2.350/0, placentitis severa en 1.1% Y placentitis moderada en 4.70/0.
    El segundo grupo de 110 muestras fueron tomadas al final de la primera etapa del parto encontrándose una contaminación bacteriana en un 200/0. Los microorganismos
    aislados del líquido amniótico fueron los siguientes. Estafilococo Epidermides, E. coli y Estreptococo viridans.
    Es bueno anotar que del primer grupo sólo se registró contaminación del líquido amniótico en un 12.50/0 en cesárea electiva con membranas íntegras; y en el segundo grupo en trabajo de parto y membranas íntegras la contaminación del líquido amniótico fue de un
    200/0. La incidencia total de contaminación del líquido amniótico en el primer grupo fue de un 20.90/0 Y en el segundo grupo de un 200/0. El índice de contaminación en el líquido amniótico en el total de los casos 46 con membranas rotas fue de 28.2%.

    Los microorganismos hallados en el líquido amniótico son los mismos que se encuentran en la flora vaginal y en el cérvix.

    La morbilidad materno-fetal del primer grupo fue del 1.1% Ydel segundo grupo fue de O.

  13. Expresión diferencial durante la interacción Solanum tuberosum - Phytophthora infestans

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    Zulma Isabel Monsalve-Fonnegra

    2012-01-01

    Full Text Available Título en ingles: Differential expression during Solanum tuberosum- Phytophthora infestans interaction Resumen: La papa (Solanum tuberosum L. es el cuarto cultivo más importante a nivel mundial y es el producto agrícola con mayor demanda de fungicidas, insecticidas y fertilizantes químicos. Las pérdidas mundiales ocasionadas por Phytophthora infestans (Mont. de Bary en este cultivo, ascienden a 6,7 billones de dólares al año y su control químico genera un aumento en los costos, perjudica la salud humana y el ambiente. Todo esto justifica la búsqueda constante de mecanismos alternativos para el control de la enfermedad, entre ellos la obtención de variedades resistentes mediante cisgenesis usando genotipos silvestres. Como un aporte en este sentido, y dada la falta de conocimiento de lo que controla y constituye la diferencia entre una respuesta compatible e incompatible, en el presente estudio se compararon los perfiles de expresión génica obtenidos mediante Despliegue Diferencial de variedades resistentes y susceptibles durante su interacción con P. infestans. Los resultados evidenciaron diferencias en la expresión génica, tanto a distintos tiempos post-inoculación como en el tipo de cambio de expresión, incluyendo la presencia y ausencia de bandas diferenciales y el aumento o disminución en su intensidad. Al analizar las secuencias de fragmentos diferencialmente expresados, se encontró que algunos fragmentos sobre-expresados en las variedades susceptibles, tenían homología con secuencias que codifican para una serina-acetiltranferasa y para la subunidad β de la RNA polimerasa. Por su parte, fragmentos sobre-expresados en la variedad resistente, tenían homología con una secuencia codificante para un dominio transmembranal. Palabras claves: pastusa suprema;  diacol-capiro; parda pastusa; despliegue diferencial Abstract: Potato (Solanum tuberosum L. is the fourth most important crop worldwide; also, is the agriculture

  14. Consumo de antioxidantes durante tratamento quimioterápico Antioxidants consumption during chemotherapy treatment

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    Caroline Cavali Rohenkohl

    2011-06-01

    Full Text Available RACIONAL: O câncer é definido como enfermidade multicausal crônica, em que as células possuem crescimento descontrolado. Resulta de vários fatores, sendo um dos principais, a dieta inadequada. As fases de iniciação, promoção e progressão de carcinogênese têm sido frequentemente relacionadas ao estresse oxidativo. OBJETIVO: Verificar o consumo de antioxidantes em pacientes com câncer durante os diferentes ciclos de quimioterapia. MÉTODOS: Estudo descritivo exploratório, incluindo pacientes em tratamento quimioterápico em ambulatório de quimioterapia. Para investigar o consumo de antioxidantes foi elaborado um questionário de frequência alimentar semi-quantitativo (QFASQ e uma ficha de anamnese clinica - nutricional. RESULTADOS: Amostra foi composta por 30 pacientes com idade média de 56,4±2,3 anos. De acordo com o consumo diário representado pelos ciclos, houve adequado consumo de vitamina C, vitamina E e Zinco e inadequado consumo de vitamina A e Selênio. Ao dividir a tabela estudada segundo os quatro quartis de consumo diário de antioxidantes, houve consumo adequado de vitamina A em 25% da amostra e inadequado de vitamina C, vitamina E, zinco em 25% da amostra e de também selênio em todos os ciclos. Entre as fontes alimentares consideradas ricas nos antioxidantes estudados, as mais consumidas foram cenoura, espinafre, mamão, laranja, óleo de soja, óleo de girassol, carne vermelha, queijo e carne de frango. CONCLUSÃO: A população estudada atingiu o consumo diário recomendado para os antioxidantes analisados quando dividida nos ciclos do tratamento, mas houve porcentagem alta de consumo inadequado quando dividida nos quartis. Desta forma, a orientação nutricional é um fator indispensável para auxiliar na prevenção e controle do câncer.BACKGROUND: The cancer is defined as chronic multifactorial disease, in which cells have uncontrolled growth. Several factors contribute to its development, one of them is

  15. COMPARTIMENTACIÓN INTRACELULAR DEL ACETATO EN ASTROCITOS DURANTE LA PRELACTANCIA

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    A. Salazar-Amado

    2005-12-01

    Full Text Available El gasto energético es tan grande en el momento del nacimiento, que las neuronas no podrían sobrevivir sin el soporte metabólico de los astrocitos. Adicionalmente, la necesidad de neurotransmisores es tan alta en la prelactancia, que sin la colaboración metabólica de los astrocitos sería imposible mantener los niveles de intermediarios del ciclo de los ácidos tricarboxílicos para mantener su síntesis.Este trabajo se enfocó en el estudio de los procesos metabólicos intracelulares de los astrocitos donde está involucrado el acetato para establecer su importancia en el metabolismo oxidativo y lipogénico durante la prelactancia. Se incubaron cultivos quiescentes de astrocitos neonatales de rata con acetato (5 mM, [1-14C]-acetato, [2-14C]-acetato y [U-14C]-acetato (1 µ Ci (200-300 dpm/nmol. Adicionalmente, se utilizaron inhibidores enzimáticos como el dicloroacetato (1 mM y el aminooxiacetato (5 mM, e inhibidores del transporte como el α-ciano-4-hidroxicinnamato (2 mM, butilmalonato (5 mM y 1,2,3-bencenotricarboxílato (5 mM. Los resultados en su conjunto indican que los astrocitos pueden metabolizar acetato más como sustrato energético que lipogénico, lo que nos permite pensar que este sustrato puede llegar a ser más importante para ayudar a mantener el metabolismo oxidativo, favoreciendo el reciclaje de carbonos en la prelactancia. Adicionalmente, se evidenció con el uso de [1-14C]-acetato una alta actividad anaplerótica sobre todo cuando los astrocitos requieren mantener los reservorios de oxalacetato y acetil-CoA para mantener la respiración. Estos resultados señalan a la acetil-CoA sintetasa mitocondrial (AceCS2, la piruvato carboxilasa (PC y la enzima málica citosólica (cME, como enzimas claves para mantener el funcionamiento de los astrocitos en la prelactancia. Con el uso de [2-14C]-acetato, los resultados sugieren que los astrocitos in vitro tienen un alto requerimiento de carbonos, principalmente para la s

  16. Smoking cessation and associated factors during pregnancy Cese del consumo de tabaco durante el embarazo y factores asociados

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    Matías Torrent

    2004-06-01

    Full Text Available Objective: To examine smoking habits before and during pregnancy, as well as factors associated with smoking cessation, in three European settings. Methods: Women seeking antenatal care in Ashford (UK, Minorca and Barcelona (Spain were recruited to the Asthma Multicenter Infant Cohort Study (AMICS. Questionnaires inquiring into the smoking habits of each woman and her partner, demographic data, occupation, educational level, number of previous children, breast feeding, alcohol intake, and history of asthma and of other allergic diseases were completed during pregnancy and in the first year after delivery. Results: A total of 1 572 pregnant women were included in the three cohorts. Smoking prior to pregnancy was more common in Barcelona (46.2% than in Minorca (39.8% or Ashford (31.6%. Cessation rates during pregnancy also differed: 18% of women in Ashford, 20.4% in Minorca and 31.9% in Barcelona were still smoking during the first trimester. In a multivariate regression model, the factors showing a significant (negative association with smoking cessation during pregnancy were having older children, having a partner who smoked and starting smoking at a young age. Conclusions: Baseline smoking habits and changes in smoking habits during pregnancy significantly differed between the three communities studied. Women pregnant with their first child, those who had started smoking at a later age and those whose partners were non-smokers were more likely to stop smoking when pregnant.Objetivo: Describir el hábito tabáquico antes y durante el embarazo y los factores asociados con su cese con relación al embarazo en distintos entornos europeos. Métodos: Se ha incluido en el estudio a las mujeres captadas durante el embarazo para participar en el estudio AMICS (Asthma Multicentre Infant Cohort Study en Ashford (Reino Unido, Barcelona y Menorca (España. Se administró un cuestionario durante el embarazo y otro durante el primer año posparto, que inclu

  17. Análise da variabilidade e repetibilidade da pressão plantar durante a marcha de idosos

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    Pedro S. Franco

    2015-10-01

    Full Text Available RESUMOIntrodução:A repetibilidade e a variabilidade da pressão plantar em avaliações da marcha são componentes importantes na avaliação clínica do idoso. Contudo, pouco é conhecido sobre a consistência dos padrões de pressão plantar em idosos.Objetivo:Analisar a variabilidade e repetibilidade da pressão plantar durante da marcha de idosos, considerando valores médios, picos e assimetrias.Métodos:A pressão plantar foi avaliada em quatro diferentes dias em 10 idosos (cinco mulheres, com idade média ± desvio-padrão de 73 ± 6 anos, durante o andar descalço em velocidade preferida. Os dados de pressão plantar foram comparados entre as pisadas em cada dia e entre os diferentes dias de avaliação.Resultados:Dados de pressão média e pico foram similares entre os diferentes dias de avaliação. Os índices de assimetria observados foram similares entre os diferentes dias avaliados.Conclusão:A pressão plantar (média e pico apresentou um padrão consistente nos idosos. Contudo, os índices de assimetria observados sugerem que idosos estejam sistematicamente expostos a cargas assimétricas durante a locomoção. Essa observação requer futuras investigações, especialmente em relação ao impacto dessas assimetrias na origem de doenças articulares.

  18. Valoración de la frecuencia cardiaca durante el entrenamiento en jóvenes gimnastas

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    Alfredo Irurtia Amigó

    2007-09-01

    Full Text Available El incremento en la duración de los ejercicios, y por lo tanto en la necesidad de mantener valores elevados de fuerza muscular durante más tiempo, podría hacer reconsiderar la importancia de la preparación aeróbica en gimnasia artística masculina (GAM. Por otra parte, así como la demanda cardiaca durante la competición poco tiene que ver con la del entrenamiento, también cabe esperar diferencias entre gimnastas adultos (con más dificultades y un mayor repertorio y jóvenes gimnastas (con elementos de base y un menor repertorio. En este estudio, se registra la FC durante 15 sesiones de entrenamiento en 5 gimnastas de 9 años de edad. Además de querer determinar las exigencias cardiacas (FC a las que se ven sometidos, se pretende averiguar si la FC es un indicador útil de la carga de entrenamiento. Los resultados demuestran que la FC, al igual que sucede cuando se valora el esfuerzo competitivo en gimnastas adultos de élite, no resulta conveniente como indicador del esfuerzo de entrenamiento en jóvenes gimnastas. A pesar de estructurar la sesión mediante BM (bloques metodológicos con contenidos de trabajo intencionadamente semejantes, la afectación cardiaca varía, no solo entre sujetos, sino para un mismo sujeto en días diferentes. Puede que determinadas formulaciones de estimación de la carga externa, basadas más en el contenido que en la demanda cardiaca, resulten más convenientes para ajustar la carga de entrenamiento.

  19. Construcción y deconstrucción territorial del Caribe Colombiano durante el siglo XIX

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    Domínguez, Camilo; Chaparro Mendivelso, Jeffer; Gómez, Carla

    2007-01-01

    El proceso de estructuración territorial del Caribe Granadino durante el siglo XIX, específicamente de 1810 a 1886, se aborda desde una perspectiva geohistórica y geopolítica. Se parte de la base ambiental de la región, para luego abordar la evolución de los límites administrativos mediante reconstrucciones cartográficas basadas en mapas históricos. El proceso de cambio abarcó los antiguos estados de Magdalena y Bolívar (incluyendo las islas de San Andrés y Providencia), la costa caribe de Pa...

  20. Capacidad de afronte y autoeficacia en estudiantes durante las practicas pre profesionales de psicología 2015

    OpenAIRE

    Sánchez Ortega, Carmen Doris

    2016-01-01

    La presente investigación tuvo como objetivo general de determinar si existe relación entre capacidad de afronte y autoeficacia en estudiantes durante las practicas pre profesionales de psicología. La investigación fue de tipo sustantiva con un nivel descriptivo, correlacional con un enfoque cuantitativo, diseño no experimental y transversal. La población estuvo conformada por 135 alumnos universitarios que se encontraban realizando prácticas pre profesionales de la carrera ...

  1. Residuos de almidones y el uso de plantas durante el holoceno medio en el cauca medio (colombia)

    OpenAIRE

    Aceituno, Francisco; Lalinde, Veronica

    2012-01-01

    En este artículo se presentan datos de almidones que sugieren el uso de plantas porgrupos forrajeros que ocuparon el río San Eugenio (Cauca medio) durante la primeramitad del Holoceno medio. Se logró recuperar una gran cantidad de granos dealmidón (325) de instrumentos de molienda (manos y placas) procedentes de nivelesprecerámicos del sitio arqueológico La Pochola. Los datos indican el aprovechamientode plantas ricas en carbohidratos, entre las que se encuentra una variedad de Phaseolus(silv...

  2. Relaciones entre Brasil y Paraguay durante los gobiernos de Nicanor Duarte Frutos y Fernando Lugo (2003 – 2012)

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    Artwik Onieva, Agnieszka María

    2014-01-01

    Trabajo de Conclusión de Curso presentado a la Universidad Federal de la Integración Latinoamericana como requisito para la obtención del título de Bacharel en Relaciones Internacionales e Integración. Orientador: Prof. Dr. Fabio Borges Co-orientador: Prof. Dr.a Tereza Spyer. Las relaciones entre Brasil y Paraguay han crecido vertiginosamente en las últimas décadas, desde la aproximación política-económica que ambos experimentaron a partir de la década del setenta durante el gobierno mi...

  3. Dengue en México: incremento en la población juvenil durante la última década

    OpenAIRE

    Torres-Galicia, Ivonne; Cortés-Poza, David; Becker, Ingeborg

    2014-01-01

    El dengue es una de las principales enfermedades transmitidas por vector. En la última década se convirtió en uno de los problemas de salud pública más importantes de México y América Latina. En el continente americano el dengue es considerado predominantemente un padecimiento de adultos, lo cual contrasta con los reportes de países asiáticos que consideran el dengue como una enfermedad principalmente pediátrica. Durante la última década se ha reportado el incremento de dengue juvenil y pediá...

  4. Colonización en armas y narcotráfico. La violencia en Colombia durante el siglo XX

    OpenAIRE

    Perea, Carlos Mario

    2009-01-01

    El artículo mira la historia de la violencia y el conflicto armado en Colombia durante el siglo XX a través de tres grandes problemas: primero, los cuatro episodios violentos; segundo, las características de dichos episodios en relación con Latinoamérica; The article see the history of violence and armed conflict in Colombia through the twentyth century, considering three big troubles: fi rst the four violent episodes; second the characteristics of this episodes in relation with Latin-Amer...

  5. Capacidade aerobia de futebolistas profissionais de altitude durante o periodo competitivo da cidade de Arequipa-Peru

    OpenAIRE

    Alejandro Inostroza Aeloiza

    2004-01-01

    Resumo: O objetivo do presente estudo foi de descrever e analisar a capacidade aeróbia de futebolistas profissionais de altitude durante o período competitivo, onde a seleção da amostra foi de tipo não-probabilístico 27 jogadores, para tal efeito, foram mensuradas as variáveis de massa corporal, estatura, quatro dobras cutâneas (triciptal, subescapular, supra- Ilíaca, e panturrilha), e para a capacidade aeróbia progressiva foi utilizado o teste físico de (corrida de ida e volta de 20m) de Nav...

  6. Ajustes endocrino-metabólicos durante el ayuno de Ramadán en jóvenes deportistas

    OpenAIRE

    Guerrero-Morilla, Raúl; Ramírez-Rodrigo, Jesús; Ruiz-Villaverde, Gonzalo; Sánchez- Caravaca, Mª Ángeles; Pérez-Moreno, Bárbara Alejandra; Villaverde-Gutiérrez, Carmen

    2013-01-01

    El precepto islámico del Ramadán (R), implica importantes modificaciones fisiológicas debido a las restricciones hídricas y dietéticas a lo largo del día y durante un mes, lo que tiene una especial repercusión física e intelectual de los musulmanes, particularmente en sociedades occidentales, en las que no se producen reajustes horarios para las actividades cotidianas. Entre las modificaciones impuestas por el R, el ayuno intermitente día/noche, desencadena mecanismos de adaptación para renta...

  7. Características de la estructura especiológica del subsistema demersal durante el invierno de 1996

    OpenAIRE

    Elliott Rodríguez, Walter; Paredes Bulnes, Flor

    1997-01-01

    La fauna acompañante en la pesca de arrastre de la merluza, varía en su composición especiológica, distribución batimétrica, latitudinal y estacional de acuerdo a las condiciones de medio marino. Para el invierno de 1996, se analiza la ocurrencia de la fauna marina de aguas tropicales y templadas, entre Punta Capones y el Puerto de Chimbote durante el Crucero de Evaluación de la Merluza BIC SNP-1 9607-08, empleando una red de fondo tipo Granton 400/127. Se capturaron 69 especies: 56 peces,...

  8. Los faros de las islas Baleares durante los conflictos bélicos contemporáneos

    OpenAIRE

    Pérez de Arévalo López, Fco. Javier

    2012-01-01

    Trabajo de investigación que aborda la historia y evolución de los faros del archipiélago balear, desde el punto de vista tecnológico, administrativo y corporativo, con especial atención al papel desempeñado durante los conflictos bélicos contemporáneos. Representa el estudio pormenorizado del Archivo Histórico de Señales Marítimas del faro de Portopí.

  9. MECANISMOS DE MODULACION DE LA EXPRESION DEL FACTOR DE TRANSCRIPCION RUNX2 DURANTE EL CICLO CELULAR DE PREOSTEOBLASTOS

    OpenAIRE

    VARELA FIGUEROA, NELSON MIGUEL

    2010-01-01

    Runx2 regula el compromiso de linaje, la proliferación y la diferenciación de las células osteoprogenitoras. La regulación de los niveles de este factor de transcrpción, durante el ciclo celular de preosteoblastos, es considerada como uno de los aspectos críticos que modulan su función. Los antecedentes sugieren una estrecha relación entre el ciclo celular y la expresión del gen Runx2, pero existen varias interrogantes sobre los mecanismos y procesos que regulan las oscilacione...

  10. Evolución de compuestos funcionales durante la maduración de frutos de Opuntia Stricta

    OpenAIRE

    García Gutiérrez, Verónica Raquel

    2008-01-01

    El proyecto fin de carrera ofrece las siguientes conclusiones: -El fruto de Opuntia stricta se engruesa durante la maduración, aumentando su peso, pero mantiene constante la longitud. En estado maduro las dimensiones medias de este fruto son: 4,7 x 2,9 cm aproximadamente y pesa en torno a los 20g. - Los pigmentos empiezan a producirse cuatro meses después de la floración, en la zona ovárica del fruto, alrededor de las semillas. - Desde la zona ovárica, los colorantes van pigmentando ...

  11. POLIPICA DURANTE EL EMBARAZO: GEOFAGIA ASOCIADA AL CONSUMO DE TIZA Y PAGOFAGIA A LA INGESTA DE JABÓN

    OpenAIRE

    López, Laura Beatriz; Ortega S, Carlos Rafael; Pita Martín de P, María Luz

    2007-01-01

    La polipica es un trastorno que se manifiesta por el consumo persistente de dos o más sustancias no nutritivas. Se describen dos casos de puérperas que presentaron este hábito durante el embarazo, una refiere el consumo diario de tierra y tiza; la otra gestante manifiesta la ingesta diaria de hielo junto con el consumo de jabón con una frecuencia 1 vez a la semana. Ambas mujeres presentaron antecedentes familiares para el trastorno. La evaluación antropométrica fue adecuada tanto para las ges...

  12. La lucha por el mantenimiento de un huerto de simples en la universidad de Valencia durante el siglo XVII

    Directory of Open Access Journals (Sweden)

    Felipo, Amparo

    2005-12-01

    Full Text Available This article deepens on the efforts made during the 17th century by Medicine professors and students, Pharmacist Associations as well as surgeons and magistrates from Valencia directed toward the creation and mantenaince of a garden destinated to the growing of medicinal plants from worldwide.

    Este artículo profundiza en los esfuerzos realizados durante el siglo XVII por catedráticos y estudiantes de Medicina, colegios de boticarios y cirujanos y magistrados municipales de Valencia orientados a la creación y mantenimiento de un huerto destinado al cultivo de plantas medicinales procedentes de diferentes partes del mundo.

  13. Características de la violencia durante el embarazo en adolescentes de Lima, Perú

    OpenAIRE

    Hans Contreras-Pulache; Elizabeth Mori-Quispe; Willy D. Hinostroza-Camposano; Maribel Yancachajlla-Apaza; Nelly Lam-Figueroa; Horacio Chacón-Torrico

    2013-01-01

    Objetivos. Determinar las características de la violencia durante el embarazo en adolescentes atendidas en el Instituto Nacional Materno Perinatal (INMP) de Lima, Perú. Materiales y métodos. Estudio transversal llevado a cabo en el INMP entre enero a marzo de 2010. Se trabajó con una muestra probabilística y un muestreo sistemático. La unidad de estudio fue toda adolescente hospitalizada después de la atención del parto y residente en Lima. Se realizó una entrevista semiestructurada. El antec...

  14. Miradas encontradas: funcionarios reales, curas e indígenas en Yucatán durante el periodo colonial

    OpenAIRE

    Adriana Rocher Salas

    2010-01-01

    El presente texto estudia las diversas formas en que funcionarios civiles y eclesiásticos miraron a los indígenas de Yucatán durante el período colonial. La imagen que de los mayas construyeron quienes los gobernaron nos dará una visión más amplia de los diferentes esquemas impuestos para su gobierno espiritual y temporal y el carácter de la relación españoles-mayas yucatecos. Con este fin, como hilo conductor se tendrán los juicios construidos sobre la vida indígena respecto a tres aspectos ...

  15. Antes, durante y después de un incendio forestal (Before, During, and After a Wildfire)

    Centers for Disease Control (CDC) Podcasts

    Cada vez más personas construyen sus hogares en lugares boscosos, ya sea dentro o cerca de bosques, áreas rurales o sitios remotos en las montañas. Estas áreas son más propensas a los incendios forestales. Los incendios forestales a menudo comienzan en forma inadvertida, pero se extienden rápidamente, y prenden a su paso maleza, árboles y casas. Los CDC recomiendan tomar una serie de medidas antes, durante y después de un incendio forestal local, a fin contrarrestar sus efectos negativos.

  16. Análisis de los proyectos del sector agropecuario financiados por Colciencias durante el año 2010

    OpenAIRE

    Edison Suárez O.; Mónica Baquero P.

    2013-01-01

    Objetivo. Analizar los proyectos del sector agropecuario financiados por Colciencias durante el año 2010. Materiales y métodos. Se utilizó la base de datos de registro de proyectos correspondientes al Programa Nacional de Ciencia, Tecnología e Innovación Agropecuarias para identificar las propuestas presentadas, elegibles y financiadas de las convocatorias del año 2010. Los proyectos se clasificaron con base en la nomenclatura Internacional de la UNESCO para los campos de la ciencia y la tecn...

  17. Análisis de los proyectos del sector agropecuario financiados por Colciencias durante el año 2010

    OpenAIRE

    Suárez O, Edison; Baquero P, Mónica

    2013-01-01

    RESUMENObjetivo. Analizar los proyectos del sector agropecuario financiados por Colciencias durante el año 2010. Materiales y métodos. Se utilizó la base de datos de registro de proyectos correspondientes al Programa Nacional de Ciencia, Tecnología e Innovación Agropecuarias para identificar las propuestas presentadas, elegibles y financiadas de las convocatorias del año 2010. Los proyectos se clasificaron con base en la nomenclatura Internacional de la UNESCO para los campos de la ciencia y ...

  18. La ingesta de hidratos de carbono, antes, durante y después de una competencia deportiva

    OpenAIRE

    Abrines, María de la Candelaria

    2015-01-01

    Las competencias del running se realizan a lo largo del año y requieren de un cuidadoso plan nutricional que permita disponer de los nutrientes necesarios y recuperarlos al finalizarla. Objetivo: Determinar la ingesta de hidratos de carbono, antes, durante y después de una competencia deportiva, su adecuación a las recomendaciones y la recuperación de la fatiga post-competencia en corredores amateurs de 20 a 65 años de ambos sexos de la ciudad de Mar del Plata que participan de ...

  19. Bienestar animal durante el transporte y su relación con la calidad de la carne bovina

    OpenAIRE

    Marlyn Romero P.; Jorge Sánchez V.

    2012-01-01

    RESUMENEl bienestar animal (BA) es un elemento diferenciador en la comercialización de la carne bovina a nivel internacional, aunque no forma parte de los acuerdos comerciales, se pueden citar ejemplos de las experiencias de Chile, Argentina, Brasil y Uruguay con la Unión Europea, que los ha privilegiado para la exportación de carne fresca bovina con este valor agregado. Durante el transporte, cargue y descargue los bovinos son sometidos a factores estresantes que afectan su bienestar y la ca...

  20. Influencia de la temperatura sobre el crecimiento muscular de la lubina, Dicentrarchus labrax L., durante el desarrollo larvario

    OpenAIRE

    Ayala Florenciano, Mª Dolores

    1999-01-01

    En este trabajo se ha estudiado el efecto de la temperatura de incubación y cultivo sobre el desarrollo y el crecimiento muscular de lubina, Dicentrarchus labrax, Atlántica y Mediterránea. Durante la fase de alimentación endógena el empleo de alta temperatura incrementa preferiblemente la hipertrofia, observándose una fuerte disminución de la tasa hiperplásica en la fase prelarvaria, con independencia de la temperatura. Con el inicio de la alimentación viva comienza una etapa de rápido c...

  1. ESTRATEGIAS DE AFRONTAMIENTO FRENTE AL ESTRÉS EN POBLACIÓN JUVENIL DURANTE UN EVENTO SOCIO-NATURAL

    OpenAIRE

    García Bedoya, Miguel Fernando

    2015-01-01

    La línea en promoción, prevención y redes en salud nos anima a estudiar con detenimiento el proceso de la gestión integral del riesgo, con una base teórica y científica desde la psicología que, evaluando su importante praxis, se hace imprescindible dentro del poder de la labor psicológica, para romper el pensamiento convencional de la limitación como algo patológico, a la de potenciar las estrategias de afrontamiento, especialmente en jóvenes durante situaciones de estrés como las emergencias...

  2. Efecto de la alopregnanolona sobre la ansiedad en ratas con separación materna durante la lactancia

    OpenAIRE

    Riveros Barrera, Irene; Dueñas, Zulma

    2014-01-01

    Antecedentes. La relación madre-hijo y el cuidado parental al recién nacido son fundamentales en el desarrollo fisiológico y emocional de los individuos. Evidencias asocian el estrés temprano con el desarrollo de enfermedades mentales. El modelo de separación materna durante la lactancia (SMDL) se ha utilizado para inducir estrés temprano en ratas y estudiar efectos a largo plazo. Diversos estudios han encontrado que, en ratas separadas de sus madres, disminuyen los niveles del receptor GABA-...

  3. Efecto de la alopregnanolona sobre la ansiedad en ratas con separación materna durante la lactancia

    OpenAIRE

    Irene Riveros Barrera; Zulma Dueñas

    2014-01-01

    Antecedentes. La relación madre-hijo y el cuidado parental al recién nacido son fundamentales en el desarrollo fisiológico y emocional de los individuos. Evidencias asocian el estrés temprano con el desarrollo de enfermedades mentales. El modelo de separación materna durante la lactancia (SMDL) se ha utilizado para inducir estrés temprano en ratas y estudiar efectos a largo plazo. Diversos estudios han encontrado que, en ratas separadas de sus madres, disminuyen los nivel...

  4. Colonización en armas y narcotráfico. La violencia en Colombia durante el siglo XX

    Directory of Open Access Journals (Sweden)

    Carlos Mario Perea

    2009-01-01

    Full Text Available El artículo mira la historia de la violencia y el conflicto armado en Colombia durante el siglo XX a través de tres grandes problemas: primero, los cuatro episodios violentos; segundo, las características de dichos episodios en relación con Latinoamérica; y tercero, las fragmentaciones tras de las cuales se explica la recurrencia de la guerra y la violencia. El artículo hace una mirada particular desde la cultura política.

  5. Reconstrucción paleoambiental de la Albufera de Valencia durante el holoceno a partir de biomarcadores

    OpenAIRE

    Rivera Cornelio, Rosa Abnelia

    2017-01-01

    Se estudiaron los compuestos orgánicos de dos testigos de sondeo continuo perforados en el Parque Natural de La Albufera de Valencia. Para reconstruir las condiciones paleoambientales durante el Holoceno. Se seleccionaron 69 muestras para el análisis de biomarcadores y 25 muestras para la realización de la datación por racemización de aminoácidos a partir de ostrácodos. Las dataciones revelaron que el registro cubre los últimos 6500 años aproximadamente con un hiato significativo entre 4300-...

  6. Análisis de diluyentes comerciales de semen porcino refrigerado durante 4 días: resultados preliminares

    OpenAIRE

    Torres, P.; Fischman, M.L.; Acerbo, M.; García, C.; Míguez, M.; Domínguez, J.; Cisale, H.

    2014-01-01

    La utilización de semen enfriado en inseminación artificial (IA) porcina sigue siendo una limitante, ya que la respuesta frente a temperaturas menores a 16 ºC es aleatoria entre cerdos, y aún entre eyaculados del mismo cerdo. El objetivo del presente trabajo fue jerarquizar la capacidad para la conservación de dosis refrigeradas durante 4 días de tres diluyentes comerciales (de larga o media duración) de semen porcino (Androstar Plus®, MRA® y MIII®), analizando: viabilidad, funcionalidad de m...

  7. Nuevos datos sobre el uso de materia colorante durante el Neolítico antiguo en las comarcas centrales valencianas

    Directory of Open Access Journals (Sweden)

    Pablo García Borja

    2006-01-01

    Full Text Available La caracterización mineralógica de materias colorantes procedentes de los yacimientos valencianos de la Cova de l'Or, la Cova de la Sarna y la Cova Fosca de la Vall d'Ebo demuestra el uso de dos tipos de materia colorante durante el Neolítico Antiguo: Hematites y Cinabrio. Las características y distribución geográfica de cada una de ellas nos remiten a dos estrategias distintas de obtención y. probablemente. de utilización de las mismas.

  8. Nodulose acelerada na artrite reumatóide durante terapia com Leflunomida Accelerated nodulosis in rheumatoid arthritis during Leflunomide therapy

    Directory of Open Access Journals (Sweden)

    Dario Júnior de Freitas Rosa

    2007-06-01

    Full Text Available Nodulose acelerada (NA é o desenvolvimento de um grande número de nódulos durante um curto intervalo de tempo em pacientes adultos com artrite reumatóide (AR soropositiva ou soronegativa. Esses nódulos são usualmente associados à terapia com o metotrexato. Existem três relatos de casos descritos de pacientes que desenvolveram NA periférica durante o tratamento com leflunomida. Descrevemos o caso de uma paciente de 60 anos com diagnóstico de AR soropositiva que desenvolveu o quadro de NA depois de quatro meses de terapia com leflunomida. Após um período de oito meses de interrupção do uso da droga, houve regressão completa da nodulose.Accelerated nodulosis is the development of a large number of nodules during a short time in adult patients presenting either seropositive or seronegative rheumatoid arthritis. These nodules are usually described as associated to methotrexate therapy. There have been three case reports of patients who developed peripheral accelerated nodulosis while receiving leflunomide. We describe a 60-years old woman with seropositive rheumatoid arthritis who developed accelerated nodulosis after four months receiving leflunomide therapy. The patient had a complete regression of the subcutaneous nodules eight months after cessation of leflunomide.

  9. Cambios en la presión sanguínea durante la microcompresión retrogasseriana

    Directory of Open Access Journals (Sweden)

    Leonardo Zulueta Nocedo

    1997-12-01

    Full Text Available La microcompresión percutánea del ganglio trigémino es una alternativa terapéutica en la neuralgia trigeminal, que induce cifras elevadas de tensión arterial durante el transoperatorio y otros riesgos de complicaciones cardiovasculares. Se describe brevemente la técnica quirúrgica. En este estudio se utilizó atropina en la premedicación; se administró anestesia general a todos los pacientes e hidralazina para el control de la presión arterial. Se demuestran los resultados de cambios en la presión arterial durante los distintos niveles de tratamiento. Las complicaciones inmediatas fueron: el incremento significativo de la presión arterial, la hemorragia subconjuntival y la punción de la arteria carótidaPercutaneous microcompression of the trigeminal ganglion is a therapeutic alternative in trigeminal neuralgia that induces high readings of arterial pressure during the transoperative and other risks of cardiovascular complications. The surgical technique is briefly described. Atropine was used in the premedication of this study. General anesthesia was administered to all patients and hidrizaline was given to control the arterial pressure. The changes observed in the arterial pressure during the different levels of treatment are shown. The immediate complications were: the significant increase of arterial pressure, the subconjunctival hemorrhage, and the carotid artery puncture

  10. ESTABILIDADE QUÍMICA E MICROBIOLÓGICA DE "MINCED FISH" DE PEIXES AMAZÔNICOS DURANTE O CONGELAMENTO

    Directory of Open Access Journals (Sweden)

    JESUS Rogério Souza de

    2001-01-01

    Full Text Available Foi estudada a estabilidade química e microbiológica de "minced fish" produzidos, em condições industriais, com espécies de peixes da Amazônia: aracú-comum (Schizodon fasciatus, branquinha-comum (Potamorhina latior, branquinha-de-cabeça-lisa (P. altamazonica, curimatã (Prochilodus nigricans, jaraqui-de-escama-fina (Semaprochilodus taeniurus, jaraqui-de-escama-grossa (S. insignis, mapará (Hypophthalmus edentatus, pacú-comum (Metynnis hypsauchen, pacú-manteiga (Mylossoma duriventre e pirapitinga (Piaractus brachypomum, durante 150 dias sob congelamento a -18±1°C e -36±1°C. Com base no pH, nitrogênio das bases voláteis totais (N-BVT, substâncias reagentes ao ácido tiobarbitúrico (TBARS e contagens de aeróbios mesófilos a 35°C e psicrotróficos a 7°C, e de coliformes totais e fecais (NMP, os "minced fish" obtidos a partir das espécies de peixes estudadas e de misturas de espécies (aracú+curimatã+pirapitinga; jaraqui+branquinha mantiveram-se em condições de consumo, durante o período experimental. Os resultados obtidos são altamente promissores sob o ponto de vista tecnológico.

  11. Protocolo de cuidados de enfermagem no ambiente aeroespacial à pacientes traumatizados - cuidados durante e após o voo

    Directory of Open Access Journals (Sweden)

    Gabriela Schweitzer

    2011-01-01

    Full Text Available Este artículo tiene como objetivo identificar los cuidados de enfermería necesarios para crear un protocolo de atención a pacientes adultos traumatizados, aerorremovidos, específico a los períodos durante y después del vuelo, basado en los principios del Prehospital Trauma Life Support. Se trata de una investigación cualitativa convergente llevada a cabo en la División de Operaciones Aéreas en Sao José, Santa Catarina, en el período de abril a junio de 2010. Para la elaboración del protocolo se utilizaron entrevistas individuales y reuniones grupales. Los participantes fueron ocho enfermeros que trabajan en el servicio. El protocolo responde a las reglas de seguridad en vuelo, la evaluación constante del paciente durante la remoción y entrega al destino final. El protocolo proporcionará una práctica más segura para la atención de los pacientes aerorremovidos. Se sugiere otros estudios sobre el desempeño de los enfermeros, tales como la creación de nuevos protocolos que orienten la atención en el entorno aeroespacial.

  12. Justicia penal en el Estado arbitrario. La reforma procesal penal durante el nacionalsocialismo, de Javier Llobet Rodríguez

    Directory of Open Access Journals (Sweden)

    Camilo Ernesto Bernal Sarmiento

    2012-09-01

    Full Text Available La obra del profesor Dr. Javier Llobet Rodríguez, catedrático de la Universidad de Costa Rica y abogado litigante, se inserta en una corriente de trabajos surgidos en los últimos diez años en Alemania, España y Latinoamérica relacionados con la identificación del papel que pudieron haber cumplido el derecho penal y la criminología, lo mismo que sus académicos y operadores judiciales, en el proceso de justificación, legitimación formal y aplicación práctica de la barbarie del régimen nacional socialista que lideró Adolf Hitler. En línea de continuidad con sus trabajos de investigación sobre la presunción de inocencia, la detención preventiva y las garantías procesales, Llobet nos propone en Justicia penal en el Estado arbitrario, la reforma procesal penal durante el nacionalsocialismo, analizar la importancia de las garantías del debido proceso estudiando para ello su antítesis, ejemplificada en la actuación meramente policial y la reforma procesal penal que se llevo a cabo durante el nacionalsocialismo   

  13. Cuidado e conforto durante o trabalho de parto e parto: na busca pela opinião das mulheres

    Directory of Open Access Journals (Sweden)

    Telma Elisa Carraro

    2006-01-01

    Full Text Available La obstetricia moderna considera el parto un evento médico-quirúrgico y adopta un modelo de asistencia técnica. Se esperaba que estos avances tecnológicos ayudasen el trabajo de los cuidadores, proporcionando condiciones y tiempo para ser y estar junto al ser humano. Sin embargo, el adelanto tecnológico y científico muestra una enorme fragilidad en relación al cuidado. En el presente estudio, se realizó una investigación cualitativa y cuantitativa, descriptiva prospectiva, que evaluó la opinión de las mujeres puérperas sobre los métodos utilizados para su cuidado y consuelo durante el trabajo de parto y en el parto. Este trabajo es un recorte de los datos cualitativos, enfocando los sentimientos de las mujeres puérperas durante esta vivencia. Con los resultados obtenidos deseamos contribuir en la adaptación de los métodos de cuidado y consuelo, proporcionando un trabajo de parto humanizado, desencadenando en la parturienta su confianza en sí misma y en el equipo, facilitando e incentivando el parto normal, el ejercicio saludable de su sexualidad y también la prevención de la muerte materna.

  14. Contaminação microbiana de punhos de jalecos durante a assistência à saúde

    Directory of Open Access Journals (Sweden)

    Carla Auxiliadora Margarido

    2014-01-01

    Full Text Available O estudo objetivou avaliar a contaminação bacteriana em jalecos de acadêmicos de enfermagem após a sua utilização em práticas assistenciais à saúde. Realizou-se estudo quantitativo e descritivo, no qual os jalecos dos acadêmicos foram recolhidos, lavados e passados de forma padronizada e usados durante quatro horas em atividades assistenciais. Subsequentemente, coletaram-se amostras dos punhos com hastes de algodão estéreis para serem incubadas; analisando-se posteriormente o crescimento microbiano por meio de análise morfológica pelo método Gram e antibiograma. Observou-se crescimento bacteriano dos microrganismos Staphylococcus aureuse Staphylococcus epidermidis em 50% das amostras coletadas, sendo que o Staphylococcus aureus, encontrado no ambulatório de atendimento a portadores de feridas, apresentou resistência aos antibióticos Vancomicina, Cloranfenicol e Sulfonamidas. Os dados demonstraram que os jalecos utilizados durante as atividades assistenciais, mesmo em curtos períodos, são contaminados por cepas resistentes a antibióticos e que potencialmente podem ser causadores de infecção relacionada a assistência à saúde

  15. Los diferenciales salariales por género en España durante el desarrollismo franquista.

    Directory of Open Access Journals (Sweden)

    Rafael Domínguez Martín

    2007-01-01

    Full Text Available En este trabajo se analizan los diferenciales salariales por género (DSG en los distintos sectores de la economía española durante el desarrollismo franquista (1960-1975. En la primera sección se repasa la literatura sobre las causas de la existencia de diferenciales salariales en la historia del pensamiento económico con el fin de establecer algunas hipótesis explicativas. En la segunda y tercera se especifican el marco institucional de las relaciones laborales y la situación de la mujer en el mercado de trabajo durante ese período. En la cuarta se relacionan las diferentes medidas para observar los diferenciales salariales y la segregación ocupacional. En la quinta, a partir de la Encuesta de Salarios de 1963-1975, se estudia la evolución desagregada de los DSG por ramas de actividad y ocupación, y se explora la relación entre nivel salarial, segregación ocupacional y diferenciales salariales. El trabajo finaliza con las principales conclusiones.

  16. La mortalidad en la infancia durante la Guerra Civil. Impacto territorial estimado a partir del Censo de 1940

    Directory of Open Access Journals (Sweden)

    Fernando Gil Alonso

    2009-01-01

    Full Text Available En este artículo se utilizan las preguntas del Censo de 1940 sobre la fecundidad retrospectiva ?hijos nacidos vivos e hijos supervivientes en el momento censal? de las mujeres casadas al menos una vez para estimar los niveles de supervivencia de sus descendientes y, por tanto, de mortalidad en la infancia (hasta los 15 años, según un método propuesto por W. Brass. Los resultados muestran que la Guerra Civil empeoró los niveles de supervivencia en la infancia en prácticamente todas las provincias españolas, pero tuvo un impacto diferencial muy contrastado. Comparando los niveles de supervivencia antes y durante el conflicto bélico, se obtiene que fueron las provincias meridionales y levantinas las más afectadas, mientras que en Cataluña y la Meseta septentrional los niveles de mortalidad en la infancia parecen haber empeorado menos, pese a que mostraban posiciones extremas respecto a los niveles de supervivencia antes de la guerra. De esto se deduce que, a pesar de que debiera existir una cierta relación entre el nivel de desarrollo demográfico y la vulnerabilidad que muestran las provincias ante una coyuntura desfavorable, tales características no parecen jugar un papel significativo como factor explicativo de los niveles de supervivencia durante el conflicto bélico.

  17. Metabolismo mineral óseo durante la gestación y efectos sobre la masa ósea de la madre

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    Luis Vidal

    2008-09-01

    Full Text Available La gestación y lactancia son periodos de alta demanda de calcio, para el crecimiento fetal y para la producción de leche materna. Durante la gestación, la madre transfiere al feto 25 a 30 g de calcio y durante la lactancia se secretan 200 a 240 mg de calcio diario en la leche materna. Durante la gestación, los mecanismos adaptativos más importantes son el incremento en la absorción de calcio y el incremento del recambio óseo materno; durante la lactancia, hay tendencia a conservar más calcio a nivel renal, pero la desmineralización temporal del esqueleto materno parece ser el mecanismo más importante. Los estudios que emplean absorciometría dual de rayos X (DXA son escasos, por el riesgo de radiación materna y fetal; pero, con otras técnicas, como el ultrasonido cuantitativo, se ha descrito una pérdida de masa ósea durante la gestación predominantemente dependiente del hueso trabecular. Mediante marcadores bioquímicos del remodelamiento óseo se ha demostrado que los suplementos de calcio reducen la tasa de remodelamiento durante el embarazo y parecen tener efecto benéfico sobre la pérdida ósea materna. Estudios longitudinales que emplean ultrasonido cuantitativo también han encontrado una disminución de la pérdida ósea, entre las mujeres que recibieron aporte o suplemento adecuado de calcio durante la gestación.

  18. Desbalance energético proteico en lactantes durante el primer año de vida*

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    Virginia Díaz-Argüelles Ramírez-Corría

    2004-06-01

    Full Text Available La alimentación de los lactantes durante el primer año de vida tiene gran influencia en el crecimiento y desarrollo posterior, sobre todo en el lactante de muy bajo peso al nacer. El objetivo de este trabajo fue caracterizar el consumo de energía y macronutrientes en un grupo de recién nacidos, con peso inferior a 1 800 g y compararlo con un grupo control de término, para conocer si existía un consumo adecuado durante el primer año de vida. Para ello, se realizó un estudio de cohorte en 25 recién nacidos con peso al nacer menor de 1800 g y 34 semanas de edad gestacional, en el Hospital Ginecoobstétrico "Ramón González Coro", en Ciudad de La Habana, desde enero del 2000 hasta enero del 2001 y en 25 recién nacidos de buen peso a término como grupo control. Se realizó encuesta dietética de registro de 3 días, y a los 4, 6, 9 y 12 meses de edad para evaluar el consumo de macronutrientes. Los datos se procesaron por el Programa para la evaluación del consumo de alimentos (CERES. El consumo de energía fue adecuado, pero con un desequilibrio manifiesto de los macronutrientes en uno y otro grupos, a expensas del consumo de proteínas que fue excesivo (5 g/kg/día durante todo el primer año de vida y una baja densidad energética de la dieta. Se hace necesaria una revisión de la ablactación en los lactantes, del tipo de leche utilizado durante los primeros meses de la lactancia y los hábitos alimentarios de la población, con el objetivo de mejorar su calidad durante los primeros años de la vida.The feeding of infants during the first year of life has a great influence on the further growth and development, mainly on the infant with very low birth weight. The objective of this paper was to characterize the intake of energy and macronutrients in a group of newborn infants with a weight under 1 800 g and to compare it with a term control group to know if there was an adequate consumption during the first year of life. To this end, a

  19. Hidratação durante o exercício: a sede é suficiente? Hidratación durante el ejercicio: ¿la sed es suficiente? Exercise fluid replacement: is thirst enough?

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    Christiano Antônio Machado-Moreira

    2006-12-01

    Full Text Available O objetivo deste trabalho é fazer uma revisão sobre a hidratação e discutir se, durante o exercício, a reposição de líquidos de acordo com a sede é suficiente para hidratar o indivíduo. A perda hídrica pela sudorese induzida pelo exercício, especialmente realizado em ambientes quentes, pode levar à desidratação, pode alterar o equilíbrio hidroeletrolítico, dificultar a termorregulação e, assim, representar um risco para a saúde e/ou provocar uma diminuição no desempenho esportivo. Tem sido citado que os atletas não ingerem voluntariamente água suficiente para prevenir a desidratação durante uma atividade física. Em função disso, têm sido propostas recomendações internacionais sobre a hidratação. Segundo o American College of Sports Medicine (ACSM, deve-se ingerir aproximadamente 500mL de líquidos nas duas horas antecedentes ao exercício. Durante o exercício, os atletas devem começar a beber desde o início e em intervalos regulares, em volume suficiente para repor as perdas pela sudorese ou o máximo tolerado. A National Athletic Trainer's Association (NATA faz as seguintes recomendações: ingerir 500 a 600mL de água ou outra bebida esportiva duas a três horas antes do exercício e 200 a 300mL 10 a 20 minutos antes do exercício; durante o exercício, a reposição deve aproximar as perdas pelo suor e pela urina e pelo menos manter a hidratação, com perdas máximas correspondentes a 2% de perda de peso corporal; após o exercício a hidratação deve ter como objetivo corrigir quaisquer perdas líquidas acumuladas. Além disso, o ACSM e o NATA fazem referências sobre temperatura e palatabilidade do líquido, adição de carboidratos e eletrólitos de acordo com a intensidade e duração do exercício e estratégias de hidratação para facilitar a acessibilidade do atleta ao líquido. No entanto, outros autores questionam o uso da reidratação em volumes predeterminados e sugerem que a ingestão de l

  20. Value of transvaginal color Doppler ultrasound in the diagnosis and treatment of cesarean scar pregnancy%经阴道彩色多普勒超声在剖宫产术后子宫瘢痕妊娠诊治中的价值

    Institute of Scientific and Technical Information of China (English)

    杨仁东; 袁秀英; 古雯洁; 刘小媚; 钟智波; 孙晓岩

    2015-01-01

    Objective To investigate the clinical value of transvaginal color Doppler ultrasound in the diagnosis and treatment of cesarean scar pregnancy (CSP). Methods Sonographic characteristics of 21 patients with CSP in the Third People's Hospital of Dongguan City from January 2009 to October 2014 were analyzed retrospectively, 21 cases were examined by transvaginal color Doppler ultrasound, and treated with puncture and injection of medicine under vaginal ultrasonography detection, transvaginal ultrasound manifestations of 21 cases were summarized, the lesion length to di-ameter, wide diameter, anterior uterine wall peripheral arterial resistance thickness and lesions with muscular segment index (resistive index, RI) before and after drug injection for the treatment of puncture were compared. Results 21 cas-es with CSP were divided into the following types pure gestational sac type (18 cases), and complete gestational sac were showed in anterior wall of the lower part of the incision of uterus intramural under ultrasond, yolk sac, embryo bud and original fetal heart beat were seen in gestational sac of 11 cases, yolk sac, embryo bud were seen in gestation-al sac of 3 cases, but no fetal heart beat, yolk sac were only seen in gestational sac of 2 cases but no embryo bud or fetal heart beat, gestational sac shrinkage, deformation were in 2 cases, and 3 cases were the mass type, and mixed e-chogenic mass were showed in the incision of the anterior wall of hypomere of the uterus, and uterine muscular layer boundary was not clear, the incision area muscle layer was humble, ditissimus blood flow signals were showed around the gestational sac or clumps under color Doppler ultrasond, nourishing vessels were from the incision of uterine mus-cular layer, blood flow signals were seen in the mass lesions of 3 cases, spectral Doppler showed a low speed and low resistance, the RI value was 0.32-0.56. Compared with before treatment, the length and width of CSP lesions in 21 pa

  1. Hidratação durante o exercício: a sede é suficiente? Hidratación durante el ejercicio: ¿la sed es suficiente? Exercise fluid replacement: is thirst enough?

    OpenAIRE

    Christiano Antônio Machado-Moreira; Ana Carolina Vimieiro-Gomes; Emerson Silami-Garcia; Luiz Oswaldo Carneiro Rodrigues

    2006-01-01

    O objetivo deste trabalho é fazer uma revisão sobre a hidratação e discutir se, durante o exercício, a reposição de líquidos de acordo com a sede é suficiente para hidratar o indivíduo. A perda hídrica pela sudorese induzida pelo exercício, especialmente realizado em ambientes quentes, pode levar à desidratação, pode alterar o equilíbrio hidroeletrolítico, dificultar a termorregulação e, assim, representar um risco para a saúde e/ou provocar uma diminuição no desempenho esportivo. Tem sido ci...

  2. CAMBIO EN LAS CARACTERÍSTICAS DE CALIDAD DE 12 HÍBRIDOS COMERCIALES DE ZANAHORIA DURANTE EL ALMACENAMIENTO

    Directory of Open Access Journals (Sweden)

    Fernando Richmond

    2011-01-01

    Full Text Available Se realizó un estudio para determinar el comportamiento poscosecha durante su almacenamiento en raíces de 12 híbridos comerciales de zanahoria y su respectiva casa productora: Bangor F1, Nandrin F1, Napoli F1 y Norwich F1 de Bejo; Big Sur y Sirkana de Nunhems; Bolero F1 y Concerto F1 (VAC 03 F1 de Vilmorin; XCR3688 y S-505 de Sakata; Esperanza y Dulce de Seminis, cultivados en Cot de Oreamuno, Cartago. Se aplicó un tratamiento poscosecha estándar a todas las raíces de los diferentes híbridos provenientes del campo, que consistió en lavar mecánicamente mediante cepillado con agua y extracto de semillas de cítricos (Kilol L DF-100, seleccionar las raíces comerciales y pasarlas por un hidroenfriador a una temperatura de 2°C durante 15 min; luego, empacar las raíces en bolsas plásticas comerciales, para ser llevadas al laboratorio poscosecha, donde se almacenaron en una cámara fría a 2°C durante 8 semanas (56 días. Se establecieron 2 grupos de raíces pertenecientes a cada híbrido; en el primer grupo se evaluó semanalmente en diferentes raíces las variables color externo, firmeza, relación xilema/floema y contenido de sólidos solubles totales (°brix; en el segundo grupo se evaluó semanalmente en las mismas raíces las variables color externo, pérdida de peso (cambio en la masa de la raíz e incidencia de factores de deterioro poscosecha. Se encontraron 3 tipos de daños en las raíces evaluadas: daño fisiológico, agentes patogénicos y sin agente causal conocido. El comportamiento de los materiales evaluados fue el siguiente: no hubo diferencia entre híbridos para la pérdida de peso; el color externo solo difirió en Big Sur, con respecto a los demás híbridos; XCR3688 y Bolero F1 mostraron una mayor firmeza; Bolero F1 presentó el mayor valor para grados brix. Los híbridos con el mejor comportamiento poscosecha fueron Dulce, S-505, XCR3688 y Big Sur.

  3. Evaluación de propiedades antioxidantes y fisicoquímicas de una bebida mixta durante almacenamiento refrigerado

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    Margareth Santander-M

    2017-06-01

    Full Text Available En la actualidad, los consumidores tienden a adquirir alimentos funcionales, los cuales satisfacen los requerimientos nutricionales y adicionalmente aportan beneficios a la salud. El creciente interés en el estudio de bebidas con estas características ha contribuido al desarrollo de productos elaborados a partir de la mezcla de leche y frutas. El objetivo de esta investigación fue evaluar una bebida mixta de leche UHT descremada con pulpa de tomate de árbol, analizando sus características antioxidantes y fisicoquímicas, mediante la determinación del contenido de ácido ascórbico, compuestos fenólicos, carotenoides y su estabilidad durante el almacenamiento bajo refrigeración. La capacidad antioxidante se estudió a través del método DPPH, el ácido ascórbico y los carotenoides fueron analizados mediante cromatografía líquida de alto rendimiento y se empleó el método de Folin-Ciocalteu para determinar fenoles totales en la bebida. Se encontró que la bebida mixta presentó compuestos bioactivos reconocidos por sus propiedades funcionales. Durante las primeras dos semanas de almacenamiento refrigerado se observó una disminución significativa (P<0,05 del contenido de compuestos bioactivos. Hubo una reducción en el contenido de fenoles totales de 33,150±2,020 a 21,467±1,360mg equivalentes de ácido gálico (GAE/100mL, al igual que en la concentración de ácido ascórbico de 12,967±0,603 a 5,167±0,321mg/100mL y en el de β-caroteno de 243,00±5,66 a 146,50±2,12μg/100mL, lo cual se reflejó en la disminución de la capacidad antioxidante de la bebida en un rango de 3,450±0,041 a 1,581±0,025 de Trolox mmol/L. El pH y los sólidos solubles totales se mantuvieron constantes, mientras que la acidez aumentó significativamente durante la primera semana de almacenamiento.

  4. Variaciones de riesgo en valores de tensión arterial en pacientes hipertensos durante procedimientos odontológicos

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    Gloria C Aranzazu-Moya

    2014-08-01

    Full Text Available Introducción: Las variaciones de Tensión Arterial (TA de origen fisiológico son frecuentes; sin embargo, los procedimientos durante la consulta odontológica podrían generar variaciones a valores de riesgo de TA que pueden alterar el estado sistémico, o generar complicaciones médicas que comprometen la integridad del paciente. Objetivo: Identificar factores que generan variaciones de riesgo de la Tensión Arterial durante los procedimientos odontológicos en pacientes hipertensos y no hipertensos. Materiales y métodos: Se diseñó un estudio observacional descriptivo, en 108 pacientes. Se evaluaron tanto hipertensos como no hipertensos, incluidos por un muestreo probabilístico por conglomerados; se evaluaron variables sociodemográficas, presión arterial antes, durante y después del procedimiento, factores de riesgo cardiovascular y aquellas dependientes del procedimiento. Los datos se procesaron en el programa SPSS 21, utilizando medidas de tendencia central y dispersión, desviación estándar (DE e intervalos de confianza (IC, frecuencias, chi 2, T test, diferencia de medias, ANOVA de una vía y medidas repetidas. Resultados: La edad media fue 62,3 años con DE 12,5 años; 42(38,9% fueron no hipertensos y 66(61,1% hipertensos. Las variaciones de presión sistólica mayor a 20mmHg y diastólica mayor a 10mmHg se presentaron en mayor porcentaje en los hipertensos con control errático. Así mismo las variaciones fueron superiores en mujeres y en procedimientos sin uso de anestésico. Según el tipo de hipertensión, se encontraron diferencias entre el grupo de sanos con los grupos control errático, mal control y sin control. Al aplicar un modelo lineal de medidas repetidas, se encontraron diferencias en las tres mediciones en los diferentes tipos de hipertensión. Conclusiones: Los factores relacionados a variaciones de riesgo fueron el control errático, sexo femenino y duración del procedimiento.

  5. Incidentes en la zona aérea de Canarias y Africa occidental durante la II Guerra Mundial

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    Juan José Díaz Benítez

    2013-11-01

    Full Text Available La política exterior española durante la II Guerra Mundial empezó a virar hacia la neutralidad con la llegada de Gómez Jordana al Ministerio de Asuntos Exteriores en 1942. Sin embrago, la colaboración con el Eje, aún no concluida, provocó, fuertes presiones por parte de los aliados durante el resto de la guerra y alentó la sospecha de que aún continuaba el abastecimiento clandestino de submarinos alemanes en Canarias. Por ello. los aviones aliados sobrevolaron frecuentemente la Zona Aérea de Canarias y África Occidental entre principios de 1943 y el verano de 1944, provocando la reacción de las baterías de artillería antiaérea españolas e incluso la intervenci6n de los cazas con base en Gando. En ningún momento las fuerzas españolas intentaron derribar a los aviones aliados que atravesaban las aguas territoriales, sino sólo avisarlos para que se retiraran. No obstante, los aviones aliados persistieron, dando lugar a graves incidentes que estuvieron punto de ocasionar una fatalidad. Finalmente, las prolongadas gestiones diplomáticas emprendidas a finales de 1943 acabaron con estos incidentes, los cuales son un ejemplo olvidado de las tensas relaciones entre España y los aliados durante el declive del Eje.Spanish foreign policy through World War II turned to the way of neutrality after Gómez Jordana arrived at the Ministry of Foreign Affaires in 1943.  Howver, the persistent aid to tha Axis rose strong pressures by the Allies for the rest of the war and encouraged them for searching German U-boots at the Canary Islands. So Allied airplanes frequently flew over the Canary Islands and West Africa Aerial Zone between the beginning of 1943 and the summer of 1944, tempting the Spanish anti-aircraft batteries and the fighters based in Gaildo Gando reaction. The Spanish forces never tried to destroy the Allied aircrafts, but baut only warned them to keep away from yje Spanish aerial zone. Nevertheless, Allied planes still went on

  6. Tortosendo, una villa durante el "Estado Novo" (1933-1974). Historia y memoria de un núcleo industrial

    OpenAIRE

    Oliveira Mineiro, Adélia Fernanda

    2016-01-01

    [ES]El trabajo de historia local sobre Tortosendo, un núcleo industrial portugués en contexto rural y montañoso, durante el período del Estado Novo, se presenta estructurado en seis partes, fuentes y bibliografía. La Introducción se centra en la elección del tema, las hipótesis y objetivos, metodología (incluye fuentes orales), partes del trabajo y una breve presentación geográfica e histórica del pueblo: «De Tortosendo» . El primer capítulo «Vida Política y Administrativa de Tortosen...

  7. Funzioni identitarie dell'alternanza linguistica in apprendenti di italiano durante lo svolgimento di attività in gruppo

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    Roberta Ferroni

    2013-12-01

    Full Text Available Questo articolo indaga, servendosi degli strumenti teorici messi a disposizione dall’analisi della conversazione, coadiuvata da una serie di nozioni e riferimenti tratti dagli studi che esaminano la struttura dell’interazione nella classe di lingua, i diversi usi che gli apprendenti di italiano LS fanno delle lingue presenti nella classe, specialmente della loro LM, durante lo svolgimento di attività di gruppo per dare voce alle multiple identità che costituiscono ciascun individuo. Dallo studio emerge che l’identità degli apprendenti è in continua trasformazione. Infatti, per potersi affermare, gli apprendenti dovranno “interpretare” un insieme di ruoli che cambiano e che dovranno negoziare in base al contesto d’interazione

  8. Aporte de la frecuencia cardíaca en futbolistas durante el período de competencia

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    Arnaldo A. Angelino

    2009-01-01

    Full Text Available ObjetivosEvaluar el comportamiento de los componentes de la curva dinámica de la frecuencia cardíaca basal, intraesfuerzo y de recuperación de acuerdo con el tiempo, la distancia y la intensidad de pruebas aeróbicas en cinta ergométrica y de campo como indicador de entrenamiento y adaptación física durante el período de competencia en jugadores de fútbol.Material y métodosSe evaluaron 108 jugadores de fútbol juvenil, masculinos y de 17 ± 2 años, con prueba aeróbica ergométrica y de campo durante el ciclo competitivo. Se realizó prueba de 2.400 metros en cinta ergométrica y Yo-Yo Test en campo (Endurance nivel 2.ResultadosEl registro continuo de frecuencia cardíaca permitió observar: 1 un registro más detallado de las modificaciones de la frecuencia cardíaca submáxima (89,4 ± 7,6 versus 83,0 ± 7,7; p < 0,05 en cinta ergométrica, 2 diferentes respuestas de frecuencia cardíaca submáxima en prueba ergométrica y de campo al primer minuto (164,0 versus 116,6; p < 0,05 y al segundo minuto (176,3 versus 123,5; p < 0,05 en relación con la frecuencia cardíaca máxima (198,6 versus 194,0; p = ns, 3 en pruebas de campo se observó un intervalo mayor de reserva de frecuencia cardíaca en relación con la capacidad de resistencia a partir del segundo minuto (25,9 versus 19,1; p < 0,05.ConclusionesEl registro comparativo de la frecuencia cardíaca durante el ciclo competitivo en jugadores de fútbol en pruebas aeróbicas ergométricas y en prueba de campo permite el análisis de indicadores de entrenamiento y adaptación física. Los indicadores de frecuencia cardíaca basal, submáxima, máxima, de recuperación e intervalo de reserva de frecuencia cardíaca permiten información de rendimiento y entrenamiento en la resistencia a diferente velocidad de desplazamiento, tiempo de permanencia y distancia en pruebas de cinta ergométrica y de campo, de gran utilidad para las pautas de entrenamiento durante el período de competencia

  9. Publicaciones culturales de resistencia durante la dictadura: estudio de tres casos de representación visual

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    Paulina Francisca González Valenzuela

    2017-06-01

    Full Text Available El presente artículo aborda la resistencia cultural desarrollada durante el período dictatorial en Chile (1973-1989, desde la mirada de tres publicaciones que formaron parte de las redes de expresión artística erigidas al margen del discurso oficial: Palabra Escrita, La Bicicleta y La Castaña. Mediante la revisión de la experiencia productiva de estos medios, se propone ejemplificar las variantes de una disyuntiva estética que definió formas antagónicas de representar la escena cultural post golpe; las cuales encuentran su origen tanto en la influencia de los relatos sociales colindantes a sus espacios de circulación, como en el acceso a determinados medios de producción y manejo técnico.

  10. Estabilidad oxidativa del aceite de palma durante el proceso de refinación industrial en Costa Rica

    OpenAIRE

    Zamora, Eduardo; Herrera Ramírez, Carlos Hernán

    2002-01-01

    Se optimizó y validó un método para cuantificar la concentración del hierro y el cobre en aceites vegetales mediante la técnica de espectrofotometría de absorción atómica de llama. Se implementaron los métodos oficiales establecidos por la AOCS para la determinación de los productos oxidados: índices de peróxido (IP) y de p-anisidina (Ip-A), para evaluar el grado de deterioro del aceite de palma y su relación con el contenido de hierro y cobre, durante el proceso de refinación industrial. El ...

  11. Expolios, deportaciones e internamientos: el destino de los alemanes residentes en Latinoamérica durante la Segunda Guerra Mundial.

    OpenAIRE

    Molina Londoño, Luis Fernando

    2017-01-01

    Este artículo muestra las peripecias de los alemanes y demás ciudadanos del Eje residentes en Latinoamérica durante la Segunda Guerra Mundial. Al ser considerados una amenaza a la seguridad  hemisférica, los italianos, japoneses y sobre todo alemanes, fueron sujetos de expulsión, reclusión y expropiación debido a la presión política, económica y diplomática que Estados Unidos ejerció sobre la región. Esta injerencia, que pretendía alinear a todos los gobiernos  en una lucha común contra el en...

  12. Antes, durante y después de un incendio forestal (Before, During, and After a Wildfire)

    Centers for Disease Control (CDC) Podcasts

    2007-11-01

    Cada vez más personas construyen sus hogares en lugares boscosos, ya sea dentro o cerca de bosques, áreas rurales o sitios remotos en las montañas. Estas áreas son más propensas a los incendios forestales. Los incendios forestales a menudo comienzan en forma inadvertida, pero se extienden rápidamente, y prenden a su paso maleza, árboles y casas. Los CDC recomiendan tomar una serie de medidas antes, durante y después de un incendio forestal local, a fin contrarrestar sus efectos negativos.  Created: 11/1/2007 by Emergency Communications System.   Date Released: 4/13/2009.

  13. Represión y vigilancia hacia el Trabajo Docente durante la Dictadura Militar en Chile (1973-1990

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    Felipe Andres Zurita Garrido

    2017-01-01

    Full Text Available Este artículo tiene como objetivo analizar las políticas de represión y vigilancia ejercidas contra el Trabajo Docente durante la Dictadura Militar (1973-1990. Para alcanzar este objetivo se interrogan diferentes fuentes: Informes de Derechos Humanos, Actas de las Sesiones Secretas de la Junta Militar y documentos propios del funcionamiento cotidiano del aparato de represión. Allí, la figura de profesoras y profesores encuentra un lugar de destaque en tanto grupo a corregir y perseguir, situación que invita a sostener que la Dictadura Militar dedicó una especial atención hacía el Trabajo Docente, apoyándose en estrategias de vigilancia y persecución especialmente diseñadas para estas finalidades.

  14. Aspectos biológico-pesqueros del pejerrey (Odontesthes regia regia) en el puerto de Ilo durante 1996-1998

    OpenAIRE

    Hugo Treviño; Walter Condori; Martín Zambrano

    2014-01-01

    Se analizaron los aspectos biológicos y pesqueros del pejerrey peruano (Odontesthes regia regia) población en Ilo, desde enero de 1996 a septiembre de 1998. Las capturas fueron tres veces más alta (72,76 t) que las de 1996 hasta 1997, mientras que con el calentamiento de "El Niño" en 1998 éstas se redujeron a 0,62 t. Durante el evento "El Niño 1997-1998" la población mostró también una serie de cambios en la distribución, la reproducción y la composición de la dieta. Estos cambios se asociaro...

  15. Uso indicado e uso referido de medicamentos durante a gravidez Prescribed and reported drug use during pregnancy

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    Claudia Garcia Serpa Osorio-de-Castro

    2004-01-01

    Full Text Available Poucos estudos descrevem a utilização de medicamentos na gravidez com detalhamento de práticas prescritivas. A pesquisa integra grande inquérito sobre atenção perinatal em hospitais do Município do Rio de Janeiro. A natureza do hospital - se pública, contratada/conveniada ao SUS ou privada - determinou estratificação de 10.072 puérperas internadas. A coleta de dados se deu por entrevista e por consulta a prontuários, cobrindo medicamentos utilizados durante a gravidez e prescritos durante a internação hospitalar quando do parto. Medicamentos foram classificados pela ATC e outro sistema para casos especiais de uso referido. Houve média de 2,08 medicamentos prescritos no parto e 2,3 usados durante a gestação, sendo os mais prescritos anestésicos, antibióticos, ocitocina e analgésicos, com diferenças significativas entre estratos, e os mais referidos sulfato ferroso, vitaminas, escopolamina e paracetamol. Para interromper a gravidez, 49,7% relatam o uso de chás e 9,2% de misoprostol. O perfil de utilização é corroborado pela literatura. A pesquisa oferece oportunidade de conhecimento de padrões de prescrição ao parto e de uso referido durante a gestação nos setores público e privado.Few studies describe drug utilization in pregnancy focusing on prescribing practices. This study is part of a larger survey on perinatal care in the City of Rio de Janeiro, Brazil. The type of hospital (public, contracted out by the Unified National Health System, or private determined the stratification of 10,072 hospitalized post-partum women, who were asked about medication used during pregnancy. Hospital records supplied information on drugs prescribed during labor. Drugs were classified according to the Anatomical Therapeutic Chemical (ATC system. Another system was used for specific cases of referred use. A mean of 2.08 drugs was prescribed during labor, and a mean of 2.3 was reported during pregnancy. Anesthetics, antibiotics

  16. La configuración de un modelo : los catafalcos madrileños durante el reinado de Felipe V

    Directory of Open Access Journals (Sweden)

    Victoria Soto Caba

    1989-01-01

    Full Text Available En el último tercio del siglo xvii la tendencia decorativista y la variedad tipológica fueron las características más acusadas de los aparatos provisionales de las exequias reales. Las tradiciones locales y los talleres barrocos mantuvieron ambos rasgos durante gran parte de la centuria siguiente. El tapizado ornamental recubrió túmulos en forma de torre, pira, templetes, baldaquinos... Estas estructuras heredadas apenas dejaron sitio para nuevas variantes arquitectónicas, por lo que se puede decir que el siglo xviii, al menos la primera mitad, contribuyó muy poco en el enriquecimiento del repertorio tipológico de los catafalcos reales.

  17. Efecto e influencia de los certificados de depositos reprogramados (cdr`s) durante 1999-2000 en el mercado ecuatoriano

    OpenAIRE

    Leon Cercado, Alejandra; Triana Villanueva, Milton

    2009-01-01

    Por ser los certificados de depósitos (CDR) instrumentos financieros que surgieron como respuesta a la crisis que experimentó la economía ecuatoriana durante el año 1999, al producirse un alza incontrolable de la cotización del sucre respecto del dólar que desembocó en un nuevo modelo de dolarización y en cuyo proceso también la banca en general se vió afectada con el cierre de varios bancos que presentaban problemas de íliquidez y mala administración de sus recursos, el análisis efectuado de...

  18. Cambios inducidos en nanotubos de carbono de capa única durante los procesos de purificación

    OpenAIRE

    Martinez, M. Teresa; Callejas, M. Alicia; Benito, Ana M.; Ansón Casaos, Alejandro; Maser, Wolfgang K.; Cochet, M.; Seeger, T.; Schreiber, J.; Gordon, C.; Marhic, C.; Chauvet, O.

    2004-01-01

    [ES] Se ha llevado a cabo una caracterización sistemática de nanotubos de carbono de capa única tras sucesivos pasos de purificación (tratamiento a reflujo con ácido nítrico, oxidación al aire y anelado). Durante el tratamiento a reflujo con ácido nítrico, la espectroscopía Raman reveló un desplazamiento de la distribución de diámetros de los nanotubos hacia tamaños menores, sin embargo, los procesos siguientes de oxidación y de anelado aumentaron el contenido de nanotubos de mayor d...

  19. La urbanización latinoamericana durante la época colonial: una mirada para su enseñanza

    Directory of Open Access Journals (Sweden)

    Milton Zabrano Perez

    2015-10-01

    Full Text Available El objetivo central de este trabajo consiste en escudriñar cómo fue el proceso de urbanización en Hispanoamérica durante la época colonial, con el propósito de extraer elementos teóricos y metodológicos que sirvan de base en la preparación de un proyecto de investigación centrado en la época colonial de la ciudad de Barranquilla.AbstractThe main objective of this work consists of scrutinizing how the urbanization process was developed in Hispanic America during the colonial times, in order to extract theoretical and methodological elements which are relevant to prepare a research project, focused on colonial times in Barranquilla.

  20. Atraso e innovación tecnológicos en la siderurgia guipuzcoana durante el Antiguo Régimen

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    Álvaro Aragón Ruano

    2011-12-01

    Full Text Available Durante décadas la historiografía ha considerado que la siderurgia vasca, y dentro de ella la guipuzcoana, sufrió un claro «atraso tecnológico», anclada en los métodos directos, en un momento de expansión mundial de los sistemas indirectos. El presente artículo hace un análisis diacrónico de la evolución tecnológica de la mencionada actividad entre los siglos XIII y XIX, centrando su discurso, tanto en los intentos e iniciativas innovadoras, tratando de desentrañar las verdaderas razones que llevaron dichos proyectos innovadores al éxito o al fracaso, como en las continuidades. En definitiva, se trata de matizar y relativizar el mencionado concepto.