Transvaginal ultrasound in threatened abortions with empty gestational sacs.

Science.gov (United States)

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

1994-09-01

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

Transvaginal organ extraction: potential for broad clinical application.

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

2014-02-01

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

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

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.

Transvaginal sonography of acute pelvic inflammatory disease

International Nuclear Information System (INIS)

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

1999-01-01

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

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

Directory of Open Access Journals (Sweden)

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

Transvaginal Ultrasound for the Diagnosis of Abnormal Uterine Bleeding.

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Wheeler, Karen C; Goldstein, Steven R

2017-03-01

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

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

International Nuclear Information System (INIS)

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

2008-01-01

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

Complications of transvaginal silicone-coated polyester synthetic mesh sling.

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

2005-10-01

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

Transvaginal ultrasound during pregnancy: Perception and ...

African Journals Online (AJOL)

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

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

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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.

Transvaginal Ultrasound-Guided Aspiration of Pelvic Abscesses

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P. J. Corsi

1999-01-01

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

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

Science.gov (United States)

Jírová, J; Pán, M

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

Confirmation of Essure placement using transvaginal ultrasound

NARCIS (Netherlands)

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

2011-01-01

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

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.

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.

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

Energy Technology Data Exchange (ETDEWEB)

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

2004-03-01

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

Transvaginal sling excision: tips and tricks.

Science.gov (United States)

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.

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)

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.

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.

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

Science.gov (United States)

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

2013-01-01

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

Transvaginal sonography in abnormal uterine bleeding and correlation to hysteroscopy

International Nuclear Information System (INIS)

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

2017-01-01

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

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

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

Science.gov (United States)

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

2015-12-01

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

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

International Nuclear Information System (INIS)

Lee, Eun Ju

1994-01-01

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

Transvaginal ultrasound examination of women with and without pelvic venous congestion

International Nuclear Information System (INIS)

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

2000-01-01

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

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

Science.gov (United States)

Ching, Kevin C; Sumkin, Jules H

2015-01-01

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

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

Science.gov (United States)

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

2015-01-01

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

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

OpenAIRE

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

2010-01-01

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

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

DEFF Research Database (Denmark)

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

2012-01-01

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

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

International Nuclear Information System (INIS)

Wang Ping; Gong Wei

2008-01-01

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

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

Science.gov (United States)

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

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

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

Science.gov (United States)

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

2018-04-10

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

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

Science.gov (United States)

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

2013-10-01

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

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

NARCIS (Netherlands)

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

1995-01-01

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

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

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.

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

Science.gov (United States)

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

2017-11-01

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

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

Science.gov (United States)

Koo, Kevin; Gormley, E Ann

2017-02-01

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

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

Science.gov (United States)

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

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

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

Science.gov (United States)

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

2010-01-01

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

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

Science.gov (United States)

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

2017-12-01

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

Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse.

Science.gov (United States)

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

2011-05-12

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

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.

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.

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.

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

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

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Ayşe Figen Türkçapar

2015-01-01

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

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

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Ahmet Kökden

2005-12-01

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

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

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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

Analysis of abnormally thickened endometrial patterns on transvaginal sonography

International Nuclear Information System (INIS)

Lee, Myung Sook; Cho, Hyeun Cha

1999-01-01

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

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

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E.A. Shevchenko

2008-01-01

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

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

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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.

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

OpenAIRE

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

2015-01-01

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

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

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R. Castro-Pérez

2010-06-01

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

Symptom resolution after operative management of complications from transvaginal mesh.

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

2014-01-01

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

Transvaginal versus transabdominal sonography in the evaluation of pelvic pathology

International Nuclear Information System (INIS)

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

2004-01-01

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

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

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Luciano A. Nunez Bragayrac

2014-12-01

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

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

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Hurtado, Eric A; Appell, Rodney A

2009-01-01

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

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

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

2013-01-01

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

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

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Elia Pulvirenti

2010-01-01

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

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

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Reginaldo Antônio de Oliveira Freitas-Júnior

2003-03-01

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

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...

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.

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

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

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.

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

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Fanilda Souto Barros

2010-06-01

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

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

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

2009-09-01

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

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

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

2016-10-01

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

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

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

2017-10-01

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

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

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

2015-12-01

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

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

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

2014-02-01

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

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

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Arun Chawla

2009-01-01

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

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

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Aneet Kaur

2011-01-01

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

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

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

2016-05-01

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

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

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

2016-07-01

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

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

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

2017-01-01

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

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

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

2013-10-01

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

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

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Combs, C Andrew; Fishman, Alan

2016-07-01

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

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

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Tamer H. Said; Amal Z. Azzam

2014-01-01

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

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

OpenAIRE

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

2018-01-01

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

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

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

2016-08-01

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

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

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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.

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

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

2017-01-01

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

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

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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...

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

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

2011-01-01

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

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

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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

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

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Yi-Hung Sun

2017-05-01

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

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

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Suna Kabil Kucur

2013-01-01

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

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

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Hajishaiha M

2011-10-01

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

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

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

2015-09-01

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

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

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Ho-Sook Song

2012-09-01

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

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

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Argirović Rajka

2011-01-01

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

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

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

2011-07-01

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

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

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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...

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

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Adamík, Z

2006-01-01

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

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

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Naoko Takazawa

2018-03-01

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

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

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

2018-03-01

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

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

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Mojgan Barati

2008-01-01

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

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.

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

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

2012-01-01

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

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

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

2017-01-01

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

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

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Devleta Balić

2011-05-01

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

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

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

2018-05-01

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

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

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

2018-01-29

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

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

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

2018-04-01

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

Violencia física intrafamiliar contra la embarazada: un estudio con base poblacional en Ometepec, Guerrero, México Violence during pregnancy: a population based study in Ometepec, Guerrero, Mexico

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Sergio Paredes-Solís

2005-10-01

Full Text Available OBJETIVO: Estimar la ocurrencia de la violencia física intrafamiliar contra la embarazada, factores asociados y percepción de daños a la salud, en un estudio con base poblacional. MATERIAL Y MÉTODOS: Un grupo de enfermeras aplicó, una encuesta en cada hogar de Ometepec, Guerrero, México, a las mujeres que notificaron al menos un embarazo en los tres años previos a la encuesta. RESULTADOS: Se realizó una entrevista a 2 389 mujeres, de las cuales 709 fueron elegibles para completar el cuestionario sobre el último embarazo. Entre mujeres cuyo esposo no estuvo presente en el momento de la entrevista, 21% declaró ser víctima de violencia física y 5.6% reportó maltrato físico intrafamiliar durante el último embarazo. Se encontró una asociación entre violencia física en la embarazada y sangrado transvaginal durante el embarazo. La asociación entre violencia física y pérdida del embarazo tuvo significancia estadística marginal (p=0.06. También hubo asociación entre ser objeto de violencia física durante el embarazo y una actitud violenta hacia los hijos, bajo un escenario hipotético de rebeldía por parte de los mismos. CONCLUSIONES: Un hallazgo importante es la asociación entre problemas obstétricos durante el embarazo y la violencia física.OBJECTIVE: The occurrence of physical abuse during pregnancy, identifying associated factors and outcomes for women's health was estimated. MATERIAL AND METHODS: A cross-sectional community-based study in Ometepec in the Mexican state of Guerrero identified women who reported at least one pregnancy in the three years prior to the survey. These completed a questionnaire administered by a female nurse. RESULTS: Out of 2 389 women in Ometepec, 709 were eligible to complete the questionnaire. Among those interviewed without being present their partners/husbands, 21% reported a history of physical abuse and 5.6% reported physical abuse during the last pregnancy. There was a strong association

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

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

2006-09-01

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

Transvaginal sonographic findings of the ectopic pregnancy

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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.

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

1989-01-01

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

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

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

2017-06-01

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

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

NARCIS (Netherlands)

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

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

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

NARCIS (Netherlands)

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

2015-01-01

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

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

NARCIS (Netherlands)

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

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

Mortalidad hospitalaria en pacientes cirróticos en un hospital de tercer nivel

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R. Zubieta-Rodríguez

2017-07-01

Conclusiones: La mortalidad hospitalaria en pacientes cirróticos es elevada, siendo la sepsis y el sangrado los 2 eventos precipitantes de insuficiencia hepática crónica agudizada y muerte. Un puntaje MELD alto, leucocitos elevados y albúmina baja están relacionados con un pobre desenlace durante la hospitalización. Es necesaria la adecuación de medidas de salud pública encaminadas a la prevención, diagnóstico temprano y oportuno de esta enfermedad, para evitar el desarrollo de complicaciones y mejorar el pronóstico en pacientes cirróticos.

Hemorragia digestiva alta severa por úlceras de Cameron. Reporte de caso

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Carolina Salinas

2016-01-01

Full Text Available Se reporta el caso de una mujer anciana con hemorragia digestiva alta y choque hipovolémico secundario a úlceras de Cameron. Dado que estas lesiones se caracterizan por presentar cuadros crónicos de hemorragia sin aparente repercusión, se hace una revisión de esta exótica causa de sangrado digestivo masivo con repercusión hemodinámica. Estas ulceras se deben a abrasión de la mucosa por la contracción del diafragma durante los movimientos respiratorios, lo que genera pérdidas crónicas de sangre.

Esterilización mediante radiación gamma de un extracto liofilizado de placenta humana: Reporte Preliminar

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Castro, Emma; Ticona, Nohemí; Linares, Marco

2008-01-01

En la práctica odontológica, la hemostasia quirúrgica debe tenerse en cuenta durante el acto operatorio, porque accidentalmente puede provocarse hemorragia. Para el control del sangrado son muy útiles agentes hemostáticos. El factor tisular (FT) es una glicoproteína que participa activamente en la formación del coágulo lo que lo convierte en un potencial hemostático. La placenta humana es un órgano muy rico en FT, a partir de la cual, éste puede ser extraído. El proceso de procuración de las...

Resección hepática asistida con radiofrecuencia bipolar: primeras experiencias con el Surtron SB

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José Luis González González

Full Text Available Las resecciones primarias y secundarias del hígado tienen como uno de sus mayores dilemas el sangrado transoperatorio. La introducción de los equipos de radiofrecuencia, en particular el Surtron SB, comienza a dar resultados alentadores. Se presentan las primeras 8 experiencias cubanas con resecciones menores y mayores realizadas con este equipo. Siete de estos pacientes tenían metástasis y uno un hepatocarcinoma. Se practicaron 2 resecciones regladas y 6 atípicas, durante las cuales no hubo complicaciones y solo un paciente necesitó transfusión sanguínea.

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)

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)

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

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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.

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

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Vahid Dastjerdi M

2008-05-01

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

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

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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.

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

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Marcus-Braun, Naama; von Theobald, Peter

2010-04-01

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

Upper gastrointestinal bleeding: risk factors for mortality in two urban centers in Latin America Hemorragia digestiva alta: factores de riesgo para mortalidad en dos centros urbanos de América Latina

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C. H. Morales Uribe

2011-01-01

incluyeron 464 pacientes mayores de 15 años de dos centros de referencia. Se estudiaron algunas variables demográficas, antecedentes, presentación clínica, tratamiento y mortalidad. Se exploraron las asociaciones de estas variables con el desenlace muerte. Resultados: el promedio de edad fue de 57,9 años, la proporción hombre: mujer fue de 1,4:1. Trescientos cincuenta y nueve pacientes (77,3% consultaron a causa de sangrado digestivo (sangrado extrahospitalario y 105 pacientes (22,6% lo presentaron en la institución (sangrado intrahospitalario. A un 71,6% de los pacientes que ingresaron con el diagnóstico de HDA se les realizó endoscopia digestiva alta (EDA en las primeras 24 horas. Las causas de sangrado más frecuentes fueron úlcera péptica en 190 pacientes (41%, enfermedad erosiva en 162 (34,9% y enfermedad variceal 47 (10,1%. La mortalidad fue del 9,5%. Los pacientes que presentan sangrado durante una hospitalización por otra causa, presentaron un riesgo de morir mayor que los pacientes cuyo motivo de consulta fue el sangrado digestivo (RR 2,4 IC 95% 1,2-4,6. La presencia de comobilidades expresada por el valor ascendente asignado por la clasificación de Rockall está asociado igualmente con mayor probabilidad de muerte (RR 2,5 IC 95% 1,1-5,4. Conclusión: el sangrado digestivo intrahospitalario y la presencia de comorbilidades son factores de riesgo para presentar un desenlace fatal. Identificar los pacientes de mayor riesgo contribuiría a mejorar el manejo de los pacientes con HDA.

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...

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

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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...

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

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Brezean, I

2014-01-01

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

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

DEFF Research Database (Denmark)

Madsen, M E; Konge, L; Nørgaard, L N

2014-01-01

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

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

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

2009-08-01

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

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

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Roth, Ted M; Reight, Ian

2012-07-01

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

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

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Malek Tabbara

2012-01-01

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

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

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

2012-01-01

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

Patient perception of transvaginal mesh and the media.

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

2014-09-01

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

Surgeon Experience and Complications of Transvaginal Prolapse Mesh.

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

2016-07-01

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

Uso de hipoglicemiantes orales durante la lactancia

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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...

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

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H.E. Shawki

2012-06-01

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

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

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Kluz, Tomasz; Wlaźlak, Edyta; Surkont, Grzegorz

2017-01-01

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

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

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

2010-11-01

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

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

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Conde-Agudelo, Agustin; Romero, Roberto

2015-12-01

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

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

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)

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

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

2012-04-01

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

Vivências da sexualidade durante a gravidez

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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...

Signos de peligro en el paciente con malaria

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Alberto Tobón

2009-06-01

Full Text Available Los signos de peligro son hallazgos clínicos que indican gravedad o que tienen utilidad para el pronóstico de complicación o muerte. En el paciente con malaria, o paludismo, se presentan signos clínicos o parasitológicos que pueden reconocerse fácilmente durante la fase aguda de la enfermedad y son indicadores del inicio de una complicación. Entre los signos de peligro que puede presentar el paciente con malaria se incluyen cambios neurológicos, alteraciones del patrón respiratorio, vómito y diarrea persistentes, ictericia, sangrados, orina oscura, llenado capilar lento, palidez intensa, hiperpirexia, hiperparasitemia y esquizontemia. Su reconocimiento oportuno contribuirá a la disminución de complicaciones y muertes.

Transvaginal sonographic appearance of cystic adnexal masses in postmenopausal women

International Nuclear Information System (INIS)

Cho, Hyeun Cha; Lee, Myung Sook

2000-01-01

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

Current situation of transvaginal mesh repair for pelvic organ prolapse.

Science.gov (United States)

Zhu, Lan; Zhang, Lei

2014-09-01

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

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

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

2016-09-01

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

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

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.

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.

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.

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

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Vikiela Galica

2015-07-01

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

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

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

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.

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

[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

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

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.

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

Science.gov (United States)

2012-01-01

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

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

Science.gov (United States)

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

2014-09-01

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

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.

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).

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.

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

Science.gov (United States)

Fox, R

1999-02-01

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

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

International Nuclear Information System (INIS)

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

2012-01-01

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

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....

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.

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.

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.

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....

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

Science.gov (United States)

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

2011-07-01

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

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

Science.gov (United States)

Lo, Tsia-Shu

2010-01-01

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

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

Science.gov (United States)

Javadian, Pouya; Shobeiri, S Abbas

2017-09-13

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

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.

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...

La fidelidad cubana durante la edad de las revoluciones

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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.

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

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

Science.gov (United States)

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

2015-06-01

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

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

Science.gov (United States)

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

2017-02-01

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

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...

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

Science.gov (United States)

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

2018-04-01

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

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

Science.gov (United States)

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

2016-10-01

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

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

Science.gov (United States)

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

2014-04-01

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

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 ...

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

Directory of Open Access Journals (Sweden)

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.

Retinol sérico en mujeres mexicanas urbanas durante el periodo perinatal

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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.

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 ...

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.

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 ...

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

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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...

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...

Efectividad y seguridad de la laparotomía vs laparoscopía en abdomen agudo de origen gineco-obstétrico causado por embarazo ectópico roto y quiste de ovario roto.

OpenAIRE

Luna Aveiga, Cristhian

2014-01-01

Comparar efectividad, tiempo y sangrado operatorio, estadía y complicaciones entre laparotomía y laparoscopía en abdomen agudo (AA) por embarazo ectópico roto (EER) y quiste de ovario roto (QOR). Métodos: Estudio retrospectivo en el Hospital de Santa Elena y Clínica Granados de Enero 2010-Diciembre 2011. Se obtuvieron las causas, procedimientos, edad, hemoglobina, edad gestacional, antecedentes personales y complicaciones. Tiempo, sangrado operatorio y estadía fueron comparadas por T de stud...

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

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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

Modificación en la valoración de la resistencia y reactancia del tejido adiposo corporal con las nuevas vías de administración de anticoncepción hormonal

OpenAIRE

Encinas Pardilla, María Begoña

2013-01-01

En este trabajo se han estudiado las posibles modificaciones que los contraceptivos hormonales vía oral, transdérmica y transvaginal podrían tener en la composición del tejido adiposo corporal durante un año, así como sus efectos en el perfil lipídico y el índice de masa corporal. Conociendo los efectos que las formulaciones hormonales orales tienen en el perfil lipídico, cabría esperar que también pudiera alterarse en alguna medida el porcentaje de grasa corporal o al menos su densidad, de...

Violência durante o sono Violent behavior during sleep

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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.

Lesión tumoral sangrante en urgencias: a propósito de un caso de carcinoma mamario en un hombre

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Eva Tizón Bouza

2014-03-01

Full Text Available El cáncer de mama masculino es una patología poco frecuente y particular que suele afectar a hombres de más 60 años. El presente trabajo tiene como objetivo establecer un plan de trabajo enfermero, centrado en el cuidado de un hombre que presenta una lesión sangrante en una mama, durante su asistencia al Servicio de Urgencias Hospitalarias. Desarrollaremos el caso a través de la valoración de enfermería según el modelo de Virginia Henderson, los principales diagnósticos, criterios de resultados e intervenciones realizadas. Una vez estabilizado el sangrado de la herida, se realizan las pruebas pertinentes para diagnosticar al paciente un cáncer de mama derecha en estadio avanzado; se opta por tratamiento paliativo, sin olvidar que los pacientes que reciben estos cuidados buscan preservar la mayor calidad de vida posible y tener una muerte digna.

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

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

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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

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...

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...

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.

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

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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

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

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 ...

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

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...

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

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Fatima M'Zali

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

COMPORTAMIENTO ESTRUCTURAL DE PUENTES EXTRADOSADOS DURANTE CONSTRUCCIÓN POR VOLADIZOS SUCESIVOS

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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.

Validación del Protocolo para el Estudio de la Hemorragia Uterina Anormal con Ecografía endovaginal y medio de Contraste (Sonohisterografía.

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Ricardo Rueda Saenz

2003-08-01

Full Text Available

La evaluación del sangrado uterino anormal (SUA especialmente en los años postreproductivos, convencionalmente se hace recurriendo a las biopsias y aspiraciones endometriales ciegas en el consultorio, o al curetaje uterino bajo anestesia general. Dichos procedimientos, además de ser invasivos, han mostrado ser poco sensibles y específicos en la detección y el tratamiento de la patología focal del endometrio (pólipos, leiomiomas submucosos, y además pueden resultar costosos. Con el advenimiento de la histeroscopia, se han obviado muchas de las dificultades atribuidas a la biopsia ciega y el curetaje uterino, pero aquella, además de requerir un entrenamiento específico y un equipo costoso, requiere de anestesia local o general, en ocasiones dilatación del cervix y en muchas instancias arroja resultados negativos.

De otro lado, la histeroscopia sólo permite evaluar el canal cervical y la cavidad endometrial, sin poder visualizar la pared miometrial, los anexos y otras estructuras pélvicas, lo cual desvirtúa su uso en una gran proporción de pacientes como investigación inicial rutinaria en el sangrado uterino anormal.

La utilización de la ecografía transvaginal con contraste líquido (sonohisterografía o histerosonografía permite, por el contrario, no solamente una evaluación precisa y detallada del canal cervical y la cavidad endometrial, sino que permite evaluar la pared miometrial, los ovarios y otras estructuras pélvicas, así como la permeabilidad de las trompas uterinas.

Este procedimiento tiene además un bajo costo, no requiere de entrenamiento especial, tampoco de anestesia ni de dilatación cervical y tiene bajas tasas de complicaciones. Con la sonohisterografía se pueden seleccionar en forma eficiente y rápida, las mujeres que realmente se benefician de una histeroscopia diagnóstica-operatoria o de una biopsia endometrial ciega de consultorio para evaluar el SUA.

El presente estudio

Valor del ácido épsilon aminocaproico en anestesia cardiovascular pediátrica Value of the aminocaproic epsilon acid in pediatric cardiovascular anesthesia

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Lincoln de la Parte Pérez

2005-03-01

Full Text Available El sangrado persistente luego de la circulación extracorpórea es una de las complicaciones más frecuentes en la cirugía cardiovascular e implica la administración de repetidas transfusiones de sangre, con aumento significativo de la morbilidad y la mortalidad. El enfoque terapéutico de esta complicación incluye diferentes medidas, entre las cuales el suministro de antifibrinolíticos desempeña un importante rol preventivo. Se realizó un estudio en 50 niños con operaciones cardiovasculares bajo circulación extracorpórea, realizadas en el Cardiocentro del Hospital Pediátrico “William Soler” durante el período comprendido entre los meses de enero de 2001 a febrero de 2002. Antes de la circulación extracorpórea se administró 100 mg/kg de ácido épsilon aminocaproico como dosis inicial durante 20 min y se mantuvo luego a razón de 15 mg/kg/h hasta el cierre de la piel. No hubo complicaciones con la administración de este agente, a pesar de que se empleó en dosis altas al inicio. No hubo sangrado prolongado ni evidencia de trastornos significativos de la coagulación, lo cual atribuimos a las medidas preventivas adoptadasThe persistent bleeding after the extracorporeal circulation is one of the most frequent complications in cardiovascular surgery and implies the administration of repeated blood transfusions with a significant increase of morbidity and mortality. The therapeutic approach of this complication includes different measures, among which the administration of antifibrinolytics plays an important preventive role. A study of 50 children that underwent cardiovascular surgery under extracorporeal circulation performed at the Heart Center of “William Soler” Children's Hospital from January 2001 to February 2002, was conducted. 100 mg/kg of aminocaproic epsilon acid were administered before the extracorporeal circulation as an initial dose for 20 min. It was maintained then at a rate of 15 mg/kg/h until the closure of

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

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K. G. M. Premleel

2016-06-01

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

PRESENTACIÓN: EL SANGRADO CORAZÓN

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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.

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

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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.

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.

Autonomía emocional durante la adolescencia

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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...

Nuestra experiencia en amigdalectomía en los años 2013-2017 en el Hospital Clínico Universitario de Valladolid

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Ana Sánchez Martínez

2018-05-01

Full Text Available Introducción y objetivo: La amigdalectomía es un procedimiento frecuente en otorrinolaringología pediátrica. Actualmente se indica fundamentalmente en hipertrofia amigdalar asociada a trastorno obstructivo del sueño, amigdalitis de repetición o asimetría amigdalina. La hemorragia se considera la mayor complicación tras esta cirugía y la más temida; su incidencia se estima entre un 2 y un 5% pero las series varían bastante, documentándose hasta un 20% en algún estudio. Nuestro objetivo es revisar la experiencia en amigdalectomía durante los años 2013 al 2017.Material y Método: se realiza un estudio prospectivo de 442 pacientes sometidos a amigdalectomía asociada o no a adenoidectomía entre los años 2013-2017 en el Hospital Clínico Universitario de Valladolid. Hemos recogido datos relativos a la edad, sexo, diagnóstico, técnica quirúrgica, días de ingreso, hemorragia posquirúrgica y tratamiento realizado en este caso.Resultados: Hemos obtenido una muestra de 442 pacientes con edades comprendidas desde 1 año hasta los 78 años; el 76,9% fueron pacientes menores de 14 años. Respecto al sexo, el 45.9% fueron del sexo femenino y el 54.1% restante fueron del sexo masculino. Las principales indicaciones de cirugía fueron la amigdalitis de repetición y el síndrome de apnea hipopnea del sueño. Se realizaron un total de 315 adenoamigdalectomías y 121 amigdalectomías. En 6 pacientes la amigdalectomía fue unilateral por sospecha de neoplasia. La estancia media hospitalaria fue de 1,3 días. La técnica mas utilizada en nuestro hospital es disección fría y hemostasia con pinza bipolar  y compresión para las amigdalas y legrado con adenotomo para las adenoides, con compresión posterior para la hemostasia. Del total de pacientes, 20 sufrieron sangrado postquirúrgico (4.52%: 8 fueron inmediatos (primeras 24 horas, en 11 el sangrado fue tardío (a la semana y en un caso el paciente sangró en 2 ocasiones (en las primeras 24

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

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

2014-03-01

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

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

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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.

Mecanismos de licuación y flujo de suelos granulares durante sismos

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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.

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

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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.

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

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

2016-09-01

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

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

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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.

Narrativas de la corporeidad en ciclistas colombianos durante su proceso formativo

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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.

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

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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.

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

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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.

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

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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...

"Análise da carga mecânica no joeho durante o agachamento"

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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...

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

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

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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.

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

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Adriana Bittencourt Campaner

2004-02-01

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

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.

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

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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...

Efficacy therapy in a nonsurgical periodontal treatment in aggressive periodontitisno

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Nelly Garcia-Madueño

2016-02-01

Full Text Available La terapia periodontal no quirúrgica es la clave para el control y el mantenimiento de la enfermedad periodontal logrando evitar la fase quirúrgica en muchos casos. Paciente de sexo masculino de 46 años de edad con diagnóstico de periodontitis agresiva generalizada se realizó el control mecánico de placa bacteriana, motivación e instrucción de higiene oral, raspado y alisado radicular manual por cuadrantes, clorhexidina al 0.12% en colutorio 15 ml por 30s dos veces al día por siete días; se complementó con terapia antibiótica sistémica clindamicina de 300mg tres veces al día por siete días. Durante un año de seguimiento con tratamiento periodontal de soporte se observó una reducción de los parámetros clínicos como sangrado al sondaje, disminución de la perdida de inserción y estabilidad del nivel óseo.

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...

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 ...

Accidente bothrópico en Colombia: estudio multicéntrico de la eficacia y seguridad de Antivipmyn-Tri®, un antiveneno polivalente producido en México Bothrops bites in Colombia: a multicenter study on the efficacy and safety of Antivipmyn-Tri®, a polyvalent antivenom produced in Mexico

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Oscar Fernando Jaramillo Delgado

2007-08-01

Full Text Available Introducción: Colombia es un país con dos productores de antivenenos de IgG, pero hay un mercado insatisfecho por diferentes razones técnicas. Objetivos: evaluar la eficacia y la seguridad de un antiveneno F(ab´2 polivalente (Antivipmyn-Tri® producido en México, y un nuevo esquema de dosis en accidente bothrópico en Colombia. Métodos: se realizaron durante 9 meses un ensayo clínico-terapéutico y cuantificaciones de veneno y antiveneno sérico (ELISA en 53 pacientes. Resultados: cuarenta y cuatro pacientes fueron mordidos por Bothrops asper en Antioquia y Chocó y 9 por B. atrox en Amazonas; todos tenían sangre incoagulable al ingreso, 30 (56,6% con sangrado local y 24 (45,3% con sangrado sistémico. El grado final de envenenamiento fue leve en 13 (24,5%, moderado en 30 (56,6% y grave en 10 pacientes (18,9%. A las dosis recomendadas de 5 frascos para los casos leves o moderados y 10 para los graves, Antivipmyn-Tri® fue 100% eficaz para disminuir significativamente las concentraciones séricas de veneno en la primera hora de tratamiento y para detener el sangrado en las primeras 6-12 horas, 96,2% eficaz para normalizar la coagulación en 24 horas y 100% en 48 horas. Hubo 2 casos (3,8% de recurrencia de coagulopatía sin sangrado y 12 recurrencias de antigenemia sin implicaciones clínicas. Diez pacientes (18,9% presentaron reacciones tempranas adversas (leves a la faboterapia. No hubo muertes, y cuatro pacientes (7,5% tuvieron secuelas. Conclusión: a las dosis utilizadas en este estudio, Antivipmyn-Tri® fue eficaz y seguro para el tratamiento del envenenamiento bothrópico en Colombia. Introduction: Colombia is a country with two whole IgG antivenom producers, but the expectancy of all the market are not fulfilled by different technical reasons. Objectives: To evaluate the efficacy and safety of a F(ab´2 polyvalent antivenom produced in Mexico and of a new dosage regimen for Bothrops bites in Colombia. Methods: A clinical trial

Estado, iglesia y sistema educativo durante la república en Chile

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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.

Creencias y costumbres relacionadas con el embarazo, parto y puerperio en comunidades nativas Awajun y Wampis

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Armando Medina I

2006-01-01

Full Text Available Objetivo: Nuestro país, por su riqueza cultural, presenta diversas concepciones en torno al embarazo, parto y puerperio. Las costumbres y los procesos de embarazo, parto y puerperio, de la mujer Awajun (Aguaruna o Wampis (Huambisa, en el contexto cultural de las comunidades indígenas, son revisadas en el presente estudio. Materiales y métodos: Estudio etnográfico descriptivo, cualitativo, realizado durante octubre de 2002 a abril de 2003, aplicándose 24 entrevistas a profundidad (a parteras, promotores de salud y usuarias, en las comunidades de Puerto Galilea y Chapiza, además de tres grupos focales. Dichas entrevistas se analizaron en función de cinco aspectos, relacionados con señales, peligros, dietas y cuidados durante el embarazo, parto y puerperio. Resultados: Los pobladores reconocen algunas señales de peligro en el embarazo, como el sangrado vaginal y pérdida de líquido amniótico. Los cuidados durante el embarazo se relacionan con las actividades diarias y la ingesta de alimentos (dietas. Existen algunos elementos que dificultan el parto y nacimiento, como el sentimiento de vergüenza para llamar al promotor. Logrado el parto, debe mantenerse los cuidados para la recuperación de la madre, y un adecuado desarrollo del recién nacido. Conclusiones: Las concepciones y percepciones del embarazo, parto y puerperio en comunidades nativas, norman el comportamiento de sus pobladores, repercutiendo esto en la salud materna e infantil. Es necesario comprender esta cultura y capacitar agentes de medicina tradicional, implementando estrategias en promoción de la salud y atención de la gestante, fortaleciendo las capacidades institucionales e incrementando la cobertura.

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.

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 ...

El periodismo gráfico durante la dictadura

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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...

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.

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

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

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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.

Histerosonografía experiencia en el Hospital Universitario de Santander Hysterosonography experience in University Hospital of Santander

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Janer Sepúlveda Agudelo

2010-12-01

Full Text Available Introducción: La histerosonografía consiste en la evaluación por ultrasonido de la cavidad uterina después de la insuflación de solución salina. La indicación más común de la histerosonografía es la hemorragia uterina anormal. Objetivo: Los objetivos del presente trabajo son describir los hallazgos de la histerosonografía durante el periodo estudiado en el Hospital Universitario de Santander e incentivar el uso de la histerosonografía en nuestro medio, mediante la enseñanza de la técnica a los nuevos profesionales de ginecología. Materiales y métodos: Se realizó un estudio de serie de casos con pacientes programadas para histerosonografía en el Hospital Universitario de Santander entre Febrero de 2007 y Junio de 2008, a quienes se les evaluó la cavidad uterina mediante histerosonografía, presentando una modificación a la técnica. Las variables a medir son la edad, indicación de histerosonografía, hallazgos intracavitarios, efectos secundarios. Resultados: Las indicaciones de histerosonografía fueron: Hemorragia uterina anormal 43,3%, miomatosis uterina 21,6%, lesión endometrial tipo pólipo 27,0%, infertilidad 5,4% y anomalías müllerianas 2,7%. Los hallazgos intracavitarios más comunes: Histerosonografía Normal 51,4%, pólipo endometrial 32,4% y mioma submucoso 16,2%. Se presentó como efectos secundarios dolor pélvico, episodio de lipotimia y sangrado genital moderado sin compromiso hemodinámico. Conclusión: La histerosonografía es un procedimiento seguro que permite una evaluación de la cavidad uterina, sin efectos secundarios importantes como lo demuestra nuestra experiencia. La modificación a la técnica puede evitar la incomodidad de la paciente, al realizar en una sola ocasión la introducción del transductor transvaginal, pero requiere de estudios aleatorizados controlados para confirmar esta aseveración. Salud UIS 2010; 42: 256-260Introduction: Sonohysterography is an ultrasound evaluation of the

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.

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.

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

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

OpenAIRE

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...

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

OpenAIRE

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...

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.

Mortalidad asociada a hemorragia digestiva alta por enfermedad ácido péptica en pacientes operados Mortality associated with upper gastrointestinal bleeding due to peptic acid disease in patients operated

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Lucas García Orozco

2013-04-01

Full Text Available Introducción: existen diversos criterios en cuanto a la identificación de los pacientes con sangrado digestivo alto que requieren tratamiento quirúrgico de urgencia, dada la alta tasa de letalidad y mortalidad que presentan. Objetivo: valorar la mortalidad por hemorragia digestiva alta asociada a enfermedad ácido péptica. Métodos: se realizó una investigación descriptiva de 38 pacientes que habían sido operados por hemorragia digestiva asociada a enfermedad ácido péptica, que fallecieron en el Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" durante el decenio 2002-2011. Resultados: en la casuística se encontró un predominio del sexo masculino y del grupo etario de 60 y más años. Los sangrados masivo y persistente constituyeron las situaciones más comunes para decidir el tratamiento quirúrgico urgente. La vagotomía troncular más piloroplastia fue la técnica más empleada, en tanto la infección respiratoria y el choque séptico resultaron ser las principales complicaciones posoperatorias; este último y la disfunción multiorgánica fueron las causas directas de muerte más representativas. Conclusiones: para seleccionar la técnica quirúrgica en cada paciente debe tenerse en cuenta la causa del sangrado, la localización, el estado clínico y la edad. La vagotomía troncular asociada a algún procedimiento de drenaje resultó la más utilizada porque es menos laboriosa y el efecto antiácido más efectivo.Introduction: there are several criteria regarding the identification of patients with upper gastrointestinal bleeding who require emergency surgical treatment because of their high lethality and mortality rate. Objective: to value the mortality due to high gastrointestinal bleeding associated with acid peptic disease. Methods: a descriptive study was carried out in 38 patients who were operated due to gastrointestinal bleeding associated with acid peptic disease and who died in "Saturnino Lora

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

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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.

Caries dental asociada a factores de riesgo durante el embarazo

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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

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

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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.

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

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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.

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

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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.

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

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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.

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.

Sexualidad femenina durante la gestación

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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

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

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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 ...

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

Anatomical and functional characteristics of the pelvic floor in nulliparous women submitted to three-dimensional endovaginal ultrasonography: case control study and evaluation of interobserver agreement Características anatômicas e funcionais do assoalho pélvico em nulíparas avaliadas por ultrassonografia tridimensional endovaginal: estudo caso-controle e avaliação da confiabilidade interobservador

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Sthela Maria Murad-Regadas

2013-03-01

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

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.

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".

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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.

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.

La fidelidad cubana durante la edad de las revoluciones

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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...

Las fluctuaciones del nivel del mar durante el Cuaternario

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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...

Freqüência e padrão da violência por parceiro íntimo antes, durante e depois da gravidez

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Elisabete Pereira Silva

2011-12-01

Full Text Available OBJETIVO: Estimar a prevalência e analisar o padrão da violência por parceiro íntimo antes e durante a gestação e no pós-parto. MÉTODOS: Estudo de coorte realizado com 960 mulheres de 18 a 49 anos, cadastradas no Programa Saúde da Família da cidade do Recife, PE, entre 2005 e 2006. As mulheres foram entrevistadas durante a gestação e no puerpério, utilizando-se um questionário adaptado do Estudo Multipaíses sobre a Saúde da Mulher e Violência Doméstica da Organização Mundial da Saúde. Para avaliar o padrão de ocorrência da violência por parceiro íntimo, entre um determinado período e o subseqüente, o odds ratio foi calculado com intervalos de 95% de confiança (IC95%. RESULTADOS: A prevalência de violência por parceiro íntimo antes, durante e/ou depois da gestação foi estimada em 47,4% e, para cada período isolado, em 32,4%, 31,0% e 22,6%, respectivamente. As mulheres que relataram violência antes da gravidez tiveram chance 11,6 vezes maior (IC95%: 8,3;16,2 de relatar violência durante a gravidez. Quando as mulheres relataram violência durante a gravidez, a chance de relatos no pós-parto foi 8,2 vezes maior (IC95%: 5,1;11,7. A violência psicológica foi a de maior prevalência, principalmente durante a gestação (28,8%; IC95%: 26,0%;31,7%; a sexual, a menos prevalente, especialmente no pós-parto (3,7%; IC95%: 2,6%;5,0%; e a física diminuiu quase 50% durante a gestação em comparação com o período anterior. CONCLUSÕES: Parcela significativa das mulheres em idade reprodutiva vivencia situações de violência por parceiro íntimo. Os períodos de consultas de pré-natal e de puericultura são oportunidades para que o profissional de saúde possa identificar situações de violência.

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.

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.

MANIFESTACIONES OCULTAS DE VIOLENCIA, DURANTE EL DESARROLLO DEL RECREO ESCOLAR

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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.

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

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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.

59. Estudio multicéntrico retrospectivo de comparación de dos dosis diferentes de ácido tranexámico en cirugía cardíaca

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E. Martín

2012-04-01

Conclusiones: La pauta de AT del grupo A reduce significativamente el sangrado en las primeras 12 h del postoperatorio frente a la del grupo B, aunque no ha demostrado reducir las necesidades transfusionales.

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.

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.

España y Portugal durante la Segunda Guerra Mundial

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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...

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...

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.

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

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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.

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.

TUMOR DE MASSON DE CAVIDAD ORAL: PRESENTACIONES CLÍNICAS

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ENRIQUE COSCARÓN-BLANCO

2018-05-01

Full Text Available INTRODUCCIÓN: El tumor de Masson o hemangioendotelioma vegetante intravascular, es una hiperplasia endotelial  papilar hacia el interior del vaso pudiendo ocluirlo y trombosarlo con necrosis e infartos locales, constituyendo tumoraciones rojizas irregulares bien delimitadas de localización preferente en piel y riñón, siendo muy raros en cavidad oral. Son elásticos no indurados, depresibles y frágiles, con crecimiento lentamente progresivo . MATERIAL Y MÉTODOS:Presentamos dos casos . Varón afecto de hematemesis repetidas sin identificarse origen inicialmente, demostrándose tumor de Masson de paladar duro oculto por prótesis dental, que fue resecado mediante pinza bipolar previa infiltración con suero perilesional para devascularizarlo. El segundo fue una mujer  que en relación con la ingesta presentó cuadro de hematemesis importante. La valoración de Urgencias y la endoscopia digestiva no identificaron el origen del sangrado en tubo digestivo, aunque la endoscopista identificó nuevo sangrado desde cavidad oral. La exploración ORL objetivó una pequeña tumoración rojiza de apariencia vascular en zona de mordida izquierda, sangrante al mínimo roce, cuya resección se realizó de urgencia sin incidencias, con idéntica técnica y diagnóstico anatomopatológico. Posteriormente, se constató el antecedente de episodios previos de menor cuantía. DISCUSIÓN: Los tumores de Masson son muy raros en tubo digestivo y excepcionales en cavidad oral. Se han relacionado con irritaciones repetidas o traumatismos locales,hematomas encapsulados o preexistencia de otras lesiones vasculares. Estos factores parecen haber acontecido en nuestros pacientes (roce de prótesis dental en paladar y mordidas de repetición. Son masas de lento crecimiento en las que se producen con frecuencia fenómenos trombóticos. Sin embargo, el roce de su superficie puede dar lugar a sangrados importantes como en estos casos. Deben diferenciarse de tumores

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.

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.

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

Comportamiento de la humedad durante el secado solar del mineral laterítico

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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 %.

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...

La experiencia mística durante el climaterio: Un acercamiento desde la endocrinología antropológica

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Elvira M. Melián

2014-01-01

Full Text Available Durante siglos la urdimbre entre lo empírico y lo creencial ha favorecido la identificación de la posmenopáusica con arquetipos antagónicos de transformación espiritual positivos o negativos. Entre los primeros encontramos el éxtasis místico, cuya elevada prevalencia durante el climaterio puede vincularse desde la endocrinología antropológica a cambios previos ligados al apagamiento ovárico en los ejes lácteo, óseo y adrenal que atenúan el vínculo femenino terrenal en favor del espiritual.

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.

Surgical excision of eroded mesh after prior abdominal sacrocolpopexy.

Science.gov (United States)

South, Mary M T; Foster, Raymond T; Webster, George D; Weidner, Alison C; Amundsen, Cindy L

2007-12-01

We previously described an endoscopic-assisted transvaginal mesh excision technique. This study compares surgical outcomes after transvaginal mesh excision vs endoscopic-assisted transvaginal mesh excision. In addition, we reviewed our postoperative outcomes with excision via laparotomy. This was an inclusive retrospective analysis of patients presenting to our institution from 1997 to 2006 for surgical management of vaginal erosion of permanent mesh after sacrocolpopexy. Three techniques were utilized: transvaginal, endoscopic-assisted transvaginal, and laparotomy. For the patients undergoing transvaginal excision, data recorded included number and type of excisions performed, number of prior excisions performed at outside facilities, intraoperative and postoperative complications (including blood transfusions, pelvic abscess, or bowel complications), use of postoperative antibiotics, persistent symptoms of vaginal bleeding and discharge at follow-up, and demographic characteristics. The intraoperative and postoperative complications and the postoperative symptoms were recorded for the laparotomy cases. Thirty-one patients underwent transvaginal mesh excision during this time period: 17 endoscopic-assisted transvaginal and 14 transvaginal without endoscope assistance. In addition, a total of 7 patients underwent abdominal excision via laparotomy. Comparison of the 2 vaginal methods revealed no difference in the demographics or success rate, with success defined as no symptoms at follow-up. Endoscopic-assisted transvaginal excision was successful in 7 of 17 patients and transvaginal without endoscopic assistance in 9 of 13 patients (1 patient excluded for lack of follow-up data) for a total vaginal success rate of 53.3%. No intraoperative and only minor postoperative complications occurred with either vaginal method. Three patients underwent 3 vaginal attempts to achieve complete symptom resolution. The average follow-up time for the entire vaginal group was 14

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...

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

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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.

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

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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.

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

Os sentimentos da clientela assistida com atividades lúdicas durante a sessão de hemodiálise

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Renata Brites Teixeira

2011-01-01

Full Text Available Este estudio tiene como objetivo captar los sentimientos generados por las actividades lúdicas desarrolladas durante la hemodiálisis. Hemos adoptado el enfoque fenomenológico cualitativo, considerando 12 clientes que estaban durante el tratamiento de hemodiálisis en un Hospital General, de porte medio, situado en Alfenas, MG. Se utilizó la entrevista abierta con la siguiente pregunta: ¿Cómo se siente con las actividades lúdicas desarrolladas durante la sesión de hemodiálisis? Fueron captados en todas las entrevistas sólo sentimientos positivos expresados por los núcleos de sentidos: la felicidad/alegría, entretenimiento/diversión; amistad y gratitud. El desarrollo de actividades lúdicas se mostró provechoso, despertando alegría, risas y entreteniendo las cuatro horas de hemodiálisis. Los relatos obtenidos indican la importancia del desarrollo del vínculo, del dar oídos y de las humanizaciones establecidas por la actividad de extensión, como enlace en el proceso de cuidar y hasta permite la aplicación de estrategias para fortalecer el proceso de humanización de la asistencia.

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

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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.

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

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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.

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

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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.

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

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.

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

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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.

ERCP during pregnancy CPRE durante el embarazo

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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

Cuidado de enfermería en el hogar a una madre con vih/sida y su recien nacido durante el postparto: un estudio de caso

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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 ...

Selvas yermas. Los pueblos de indios desaparecidos en la costa sur de la Nueva Galicia durante el periodo colonial

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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...

Selvas yermas. Los pueblos de indios desaparecidos en la costa sur de la Nueva Galicia durante el periodo colonial

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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...

La sutura compresiva del útero en cesárea con atonía uterina

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Percy Pacora

2004-12-01

Full Text Available Objetivo: Determinar si el empleo de la sutura compresiva del útero (técnica de B-Lynch durante la cesárea en casos de atonía uterina disminuye la pérdida sanguínea y evita la histerectomía posparto. Material y Métodos: Estudio retrospectivo de las cesáreas que cursaron con atonía uterina durante la intervención, desde el 1 de enero de 1990 al 31 de diciembre de 2003, en el Hospital San Bartolomé de Lima. El método estándar de manejo de la atonía uterina en la cesárea consiste en el masaje uterino, el empleo de agentes uterotónicos (ocitocina, prostaglandinas, ligadura de arterias uterinas/hipogástricas y la histerectomía posparto. Las variables maternas y perinatales obtenidas de las historias clínicas fueron ingresadas a una base de datos computarizado (SPSS versión 10. Resultados: Se identificó 46 casos: en 30 se empleó la técnica B-Lynch y en 16 el método estándar. No hubo diferencias en las características maternas entre ambos grupos. El grupo de B-Lynch presentó subjetivamente menor perdida sanguínea, recibió menor número de unidades de sangre transfundida y presentó significativo menor riesgo de histerectomía posparto comparado con el método estándar (promedio ± DE: 1144,4±311,7 mL vs 1666,9±794,4 mL, p<0,05; 0,36±0,66 vs 2,90±3,64, p<0,05; y OR 0,08, IC95% 0,01-0,45, p<0,01, respectivamente. Conclusiones: La sutura compresiva del útero durante la cesárea en la atonía uterina parece reducir el sangrado vaginal, la transfusión sanguínea y el empleo de la histerectomía comparado con el método estándar.

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

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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.

El testimonio ante la cámara. Memoria de los fusilados y desaparecidos durante la Guerra Civil Española

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Sabin Egilior

2010-01-01

Full Text Available Este artículo analiza la estrategia metodológica puesta en práctica por parte de un equipo de profesionales de la Sociedad de Ciencias Aranzadi para realizar el trabajo de campo durante tres años (2003-2006, utilizando el vídeo como herramienta, en torno a la memoria de los fusilados y desaparecidos durante la Guerra Civil Española. Explica la preparación del trabajo, describe su desarrollo a través de ejemplos concretos y recoge algunas concusiones extraídas tras el proceso.

297. Resultados de la sustitución parcial del arco aórtico con perfusión del tronco braquiocefálico sin parada circulatoria

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J.M. González Santos

2012-04-01

Conclusiones: La sustitución parcial del arco es factible sin necesidad de hacer PCHP. Esta técnica acorta los tiempos quirúrgicos y disminuye sus complicaciones, especialmente el daño neurológico y el sangrado postoperatorio.

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.

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.

CAMBIOS FÍSICOS Y BIOQUÍMICOS DURANTE EL DESARROLLO Y SENESCENCIA DE FRUTOS DE RAMBUTÁN (Nephelium lappaceum L.

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Juan Francisco Caballero-Pérez

2011-01-01

Full Text Available El objetivo de este estudio fue caracterizar los cambios físicos y bioquímicos durante el crecimiento, desarrollo y etapa postcosecha de los frutos de rambután de tres selecciones sobresalientes de Tuxtla Chico, Chiapas (RI-148, RI-115 y RI-104. Después de antesis se realizaron evaluaciones físicas y químicas en el crecimiento de los frutos y a la cosecha se evaluaron las características de calidad durante seis días a 22 ± 1 ºC y humedad relativa de 65 %. Los resultados mostraron un patrón de crecimiento simple sigmoidal. Durante el desarrollo los frutos de las selecciones RI-148 y RI-115 tuvieron un peso fresco de 39.27 y 35.42 g y un contenido de arilo a la cosecha de 44.28 y 40.90 %, respectivamente, mientras que los del RI-104 fueron de menor tamaño (18.51 g, pero con mayor grosor de pericarpio, mostrando menor susceptibilidad a la oxidación. El número y longitud de espiternos del fruto no parecen determinar el grado de obscurecimiento de éste.

Efeito da posição relativa do joelho sobre a carga mecânica interna durante o agachamento

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Hirata,RP; Duarte,M

2007-01-01

CONTEXTUALIZAÇÃO: Existe um conceito difundido entre professores de educação física, fisioterapeutas e ortopedistas de 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 sobre o joelho. No entanto, são escassas as evidências quantitativas que corroboram esse conceito. OBJETIVO: Estimar forças e torque na articulação do joelho em indivíduos saudáveis durante o exerc...

Regulação cerebral e percepção de esforço durante exercício incremental

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Henrique Bortolotti

2016-01-01

A percepção de esforço (PSE) e a fadiga tem grande participação do cérebro durante o exercício físico, no entanto, pouco se sabe quanto às áreas associadas a essas respostas. Dessa forma, o presente estudo teve como objetivo identificar e comparar as áreas cerebrais associadas à percepção de esforço durante exercício de ciclismo em diferentes intensidades e níveis de treinamento. Participaram do estudo 24 sujeitos adultos; 12 ciclistas (75,6 ± 8,4 kg; 175 ± 5,3 cm; 24,4 ± 7,1 anos; atividade ...

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

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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...

Perfil de actividad durante el juego en futbolistas infantiles

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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.

303. Reemplazo valvular aórtico por miniesternotomía: optimización de la estrategia quirúrgica y resultados

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P. Martínez

2012-04-01

Conclusiones: El RVA a través de MINIJ es una técnica segura, con una indudable ventaja cosmética, y que parece prevenir las complicaciones esternales y minimizar el sangrado, a costa de un ligero mayor tiempo de isquemia.

HIPOTIROIDISMO CANINO, PRESENTACION DE UN CASO ATIPICO

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Juan Carlos Ballut P

2004-12-01

Full Text Available Este trabajo describe las características clínicas de un caso de hipotiroidismo atípico, catalogado como de presentaciónoculta, caracterizado por signos relacionados con miopatía, neuropatía, deterioro del estado mental, sangrado

Dysfunctional Uterine Bleeding (DUB) (For Teens)

Science.gov (United States)

... Staying Safe Videos for Educators Search English Español Abnormal Uterine Bleeding (AUB) KidsHealth / For Teens / Abnormal Uterine Bleeding (AUB) ... Print en español Sangrado uterino anormal What Is Abnormal Uterine Bleeding? Abnormal uterine bleeding (AUB) is the name doctors ...

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.

Efeito de bioterápico na eosinofilia durante a SLMV experimental

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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...

Bacterias en superficies contactadas durante las tomas radiográficas intraorales

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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 ...

Cuestión social y regímenes militares. Argentina y Chile durante los años setenta

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Gabriela Gomes

2015-01-01

Full Text Available En este artículo se analizan las políticas sociales destinadas a la búsqueda del consenso que llevaron adelante la Secretaría de Estado de Promoción y Asistencia a la Comunidad del Ministerio de Bienestar Social durante la “Revolución Argentina” (1966-1973 y la Dirección de Organizaciones Civiles y el Ministerio del Interior durante la dictadura chilena (1973-1988. El abordaje propuesto apunta a complejizar la noción de Estado burocrático autoritario, puesto que se considera como hipótesis que ambos regímenes no solo se dedicaron a reprimir las actividades políticas de los sectores populares, sino que buscaron reorganizarlos bajo nuevas coordenadas sociales.

Evaluación de diferentes tratamientos hormonales para la sincronización del estro en cabras criollas serranas durante el verano

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Ruiz, Rodrigo; Fernández, Jorge L; de la Vega, Adolfo C; Rabasa, Alicia E

2002-01-01

El objetivo de este trabajo fue evaluar la eficiencia de dos tratamientos hormonales en la sincronización de celos en cabras Criollas Serranas durante el verano. El mismo se realizó con 79 hembras, con un diseño completamente aleatorizado, con los siguientes tratamientos: T1, Prostaglandina F2µ (n = 27): dos aplicaciones de 325 mg/cabra (sc) de cloprostenol, espaciadas 12 días una de otra; T2, Progestágeno (n =26): esponja intravaginal con 60 mg de acetato de medroxiprogesterona, durante 12 d...

Escuela, educación e infancia durante la Guerra Civil en Euskadi

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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 ...

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

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

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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

Factores psicosociales y bienestar del trabajador en investigaciones realizadas en Colombia y España, durante el período 2002-2012 .

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Beltrán Cabrejo, Andrea del Pilar

2014-01-01

Introducción. En el presente trabajo se pretende identificar los factores psicosociales laborales asociados con el bienestar del trabajador en investigaciones realizadas en Colombia y España, durante el periodo 2002 – 2012. Objetivo. Este trabajo tiene como fin, precisar sobre el desarrollo investigativo en lo referente a los factores psicosociales y su relación con el bienestar, de los trabajadores en Colombia y España durante el período 2002-2012, por medio de los estudios encontrados ...

Los diferenciales salariales por género en España durante el desarrollismo franquista.

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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.

Reposição de nutrientes durante três cultivos de alface em hidroponia

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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.

Cambio conceptual en la estructura de la representación mental de un texto narrativo durante la comprensión

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Álvaro Iván Valencia

2010-01-01

Full Text Available Objetivo: describir y analizar el cambio conceptual en la estructura de la representación mental que un grupo de lectores construye durante la comprensión de un texto narrativo. Método: se realizó un estudio cualitativo con metodología de análisis verbal en 13 estudiantes de quinto grado de primaria. Se efectuaron tres sesiones de lectura del mismo texto narrativo, con el fin de comparar sus desempeños. Se realizaron tres mediciones en cada sesión con la tarea de generación verbal libre; a su vez, se compararon los desempeños presentados en las mediciones intra-sesión e inter-sesión. Resultados: los resultados indican que el cambio conceptual, durante la comprensión, presenta diferentes tendencias respecto a las distintas propiedades estructurales de la representación mental examinadas. Conclusiones: los hallazgos contribuyen al entendimiento de la dinámica en las representaciones mentales durante la comprensión y tiene algunas implicaciones para las teorías de la comprensión y el aprendizaje a partir de la lectura de textos.

Dinámica fermentativa y fraccionamiento proteíco durante el ensilaje de maní forrajero (CIAT 17434

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Rodolfo WingChing-Jones

2007-01-01

Full Text Available Dinámica fermentativa y fraccionamiento proteico durante el ensilaje de maní forrajero (CIAT 17434. Se analizó el comportamiento fermentativo del ensilaje de maní forrajero (CIAT 17434 cada 10 días durante un periodo de 60 días, cosechado en San Carlos, Costa Rica, durante el mes de octubre del año 2001. El material a ensilar se cosechó a 12 semanas, se picó y se le adicionó 6% de melaza con relación al peso fresco de la muestra. El contenido de materia seca (MS, proteína cruda (PC, fibra detergente neutro (FDN, fibra detergente ácida (FDA y el valor de pH del ensilaje sufren una disminución durante los 60 días de fermentación, de 25,57, 5,10, 18,00, 10,00 y 5,10%, respectivamente. En cambio, el contenido de nitrógeno amoniacal, la capacidad buffer, la concentración de ácido láctico y acético aumentaron, con un valor porcentual de 112 % y valores promedio de 98,69 meq de NaOH /100 g, 3,67 % MS y 6,16 % MS, respectivamente. Con relación al fraccionamiento de la proteína el material a ensilar presentó un tercio del contenido proteíco soluble, un tercio insoluble aprovechable y un tercio indigerible, mientras que por efecto del proceso fermentativo el contenido de PC soluble se mantuvo (33 %, la PC-insoluble aprovechable aumentó a 51 % y la de PC indigerible se redujo a 16 %. El ensilaje de maní forrajero se puede emplear como alimento para animales de alto potencial productivo (leche y carne a partir de los diez días post-fermentación, ya que se estabiliza el sistema y que presenta una gran proporción de proteína de sobrepaso.

Crecimiento económico y equidad en Boyacá durante 2000-2011

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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.

Factores psicosociales y sociodemográficos vinculados al uso de sustancias psicoactivas en mujeres durante el embarazo. Una revisión narrativa

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Lourdes María López-Granados

2017-12-01

Full Text Available Introducción: el consumo de sustancias durante el embarazo, sus efectos y consecuencias son un problema social y de salud pública grave y poco visible. Debido a los riesgos y consecuencias, se vuelve importante visibilizar los factores de riesgo del consumo de drogas en este grupo poblacional. Objetivo: identificar factores psicosociales y sociodemográficos del consumo de drogas lícitas e ilícitas en mujeres durante el embarazo. Método: se realizó una búsqueda de artículos de investigación, publicados entre 2010 y 2016, que trataran sobre estos factores en relación con el uso de drogas legales e ilegales durante el embarazo. Resultados: se encontraron 86 artículos, de los cuales se eliminaron los relacionados con efectos y consecuencias médicas y los realizados en animales. Después de la depuración, se concentraron 30 artículos, en los que se identificaron factores como edad, condiciones educativas, familiares, sociales, económicas, características del embarazo y antecedentes del mismo, así como la autopercepción de vulnerabilidad y la actitud favorable hacia el consumo de sustancias durante la gestación. Conclusiones y discusión: es necesario dedicar más esfuerzo al conocimiento de esta problemática y direccionar la búsqueda de raíces sociales complejas, sobre todo en el embarazo de adolescentes y otras poblaciones vulnerables.

Modelo teórico Junov para mejorar la sintonía emocional docente-estudiantes durante una clase de matemáticas.

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Julca Novoa, Juan Edilberto

2015-01-01

La presente tesis estudió como problema sustancial la deficiente sintonía emocional docente-estudiantes durante una clase de matemáticas con los estudiantes del ciclo V de la asignatura de Análisis Matemático I de la especialidad de Matemática e Informática de la Escuela Académico Profesional de Educación, Facultad de Educación de la Universidad Nacional de Cajamarca durante el ciclo académico 2014-I; en tal sentido, se centró en un proceso de observación y estudio de dicho ...

Factores psicosociales y sociodemográficos vinculados al uso de sustancias psicoactivas en mujeres durante el embarazo. Una revisión narrativa

OpenAIRE

Lourdes María López-Granados; Cristina de J Cruz-Cortés

2017-01-01

Introducción: el consumo de sustancias durante el embarazo, sus efectos y consecuencias son un problema social y de salud pública grave y poco visible. Debido a los riesgos y consecuencias, se vuelve importante visibilizar los factores de riesgo del consumo de drogas en este grupo poblacional. Objetivo: identificar factores psicosociales y sociodemográficos del consumo de drogas lícitas e ilícitas en mujeres durante el embarazo. Método: se realizó una búsqueda de artículos de investigación, p...

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

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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

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.

Malestar psicológico, disfunción familiar, maltrato de estudiantes durante la niñez en una universidad privada de Bogotá, Colombia

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Gómez,Juan Daniel; Mann,Robert; Hamilton,Hayley; Erickson,Pat; Brands,Bruna; Giesbrecht,Norman; Wright,Maria da Gloria; Cumsille,Francisco; Sapag,Jaime; Khenti,Akwatu

2015-01-01

Estudio derivado de una investigación exploratoria, correlacional-descriptiva, que estudió retrospectivamente el maltrato durante la infancia y su posible relación con el uso de sustancias psicoactivantes entre estudiantes universitarios. El maltrato infantil auto-reportado se evaluó mediante el Cuestionario de Experiencias Adversas Durante la Niñez, y para evaluar la disfunción familiar y el malestar psicológico (distress) se aplicó la Escala de Kessle...

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

Gestações espontâneas após punção ovariana para maturação in vitro em mulheres com síndrome dos ovários policísticos Spontaneous pregnancies after ovarian puncture for in vitro maturation in women with the polycystic ovary syndrome

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Nilo Frantz

2009-03-01

Full Text Available OBJETIVO: relatar três casos de gestações espontâneas em portadoras da síndrome dos ovários policísticos (SOP que ocorreram nos meses subsequentes à realização de punção ovariana transvaginal para captação oocitária para a maturação in vitro. MÉTODOS: foram incluídas no estudo três pacientes inférteis portadoras de SOP submetidas à maturação in vitro dos oócitos sem estimulação ovariana prévia. Durante o procedimento da coleta dos oócitos, cada ovário foi perfurado de quatro a oito vezes. RESULTADO: nenhuma paciente engravidou com a técnica da maturação in vitro. Avaliando o seguimento dos casos, em sete meses após o procedimento, as três pacientes engravidaram sem o auxílio de técnicas de reprodução assistida, resultando em três nascimentos. CONCLUSÕES: as múltiplas perfurações nos ovários destas pacientes portadoras da SOP, durante o procedimento de coleta dos oócitos, podem ter contribuído para a obtenção da gestação nos meses subsequentes ao procedimento.PURPOSE: to report three cases of spontaneous gestation in women with polycystic ovarian syndrome (PCOS, that occurred in the months subsequent to transvaginal oocyte retrieval for in vitro maturation (IVM. METHODS: three infertile patients with PCOS, submitted to oocytes' IVM without previous ovarian stimulation, were included in the study. During the procedure of oocytes' collection, each ovary was drilled from four to eight times. RESULTS: none of the patients got pregnant with the IVM technique. Evaluating the cases' follow-up, in seven months after the procedure, the three patients got pregnant without the help of techniques of assisted reproduction, which resulted in three births. CONCLUSIONS: the multiple drillings in the ovary of these patients with PCOS, during the process to collect oocytes, may have contributed to their pregnancy in the months following the procedure.

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

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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.

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.

Alimentación de la hembra durante la lactación y el periodo destete-cubrición

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Baucells Sánchez, María Dolores

2004-01-01

En esta entrega se abordan estrategias para optimizar la ingestión durante la lactación, tras estudiar la importancia de la producción de leche en los requerimientos energéticos y nutritivos de la cerda.

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.

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

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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.

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.

Evaluación del estado nutricional durante el estirón puberal

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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...

Evaluación del estado nutricional durante el estirón puberal

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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...

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.

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.

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.

Hematoma de músculo iliopsoas na vigência de tratamento com varfarina Hematoma de músculo iliopsoas en la vigencia de tratamiento con warfarina Iliopsoas muscle hematoma during treatment with warfarin

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Gabriel Zago

2010-01-01

Full Text Available A varfarina é droga amplamente utilizada na prevenção de fenômenos tromboembólicos e o conhecimento de seus efeitos adversos faz-se necessário para o acompanhamento dos pacientes. Embora o desenvolvimento de discrasias sanguíneas seja complicação potencial nesses pacientes, a ocorrência de sangramento retroperitoneal é rara. Este artigo discute o caso de um paciente que evoluiu com hematoma do músculo iliopsoas durante tratamento com a referida droga, pós-implante de prótese aórtica metálica, com quadro clínico envolvendo importantes diagnósticos diferenciais.La warfarina es un fármaco ampliamente utilizado en la prevención de fenómenos tromboembólicos, y el conocimiento de sus efectos adversos se hace necesario para el seguimiento de los pacientes. Aunque el desarrollo de discrasias sanguíneas es la complicación potencial en estos pacientes, la ocurrencia de sangrado retroperitoneal es rara. Este artículo discute el caso de un paciente que evolucionó con hematoma del músculo ileopsoas durante tratamiento con el referido fármaco en el postimplante de prótesis mitral metálica, con cuadro clínico implicando importantes diagnósticos diferenciales.Warfarin is a widely used drug for the prevention of thromboembolic events. Knowledge of its adverse effects is necessary for patient follow-up. Although the development of blood dyscrasias is a potential complication in these patients, retroperitoneal bleeding is rare. This article reports the case of a patient who developed iliopsoas muscle hematoma during treatment with warfarin after implantation of a metallic prosthetic aortic valve. The clinical manifestations involved important differential diagnoses.

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

Equilíbrio Hidroeletrolítico e relaxamento cerebral com salina isoncótica hipertônica versus manitol (20%) durante neuroanestesia eletiva

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Walkíria Wingester Vilas Boas; Mirna Bastos Marques; Atos Alves

2011-01-01

JUSTIFICATIVA E OBJETIVOS: É necessário proceder a relaxamento cerebral durante cirurgia intracraniana e a terapia hiperosmolar é uma das medidas para sua produção. Com frequência, pacientes neurocirúrgicos apresentam distúrbios de sódio. O objetivo deste trabalho foi quantificar e determinar o relaxamento cerebral e a duração das alterações hidroeletrólíticas decorrentes do uso do manitol versus solução isoncótica hipertônica (SIH) durante neurocirurgia. MÉTODO: Foram avaliados relaxamento c...

Remodelamento metabólico de Paracoccidioides lutzii durante a privação de cobre determinado por análises proteômicas

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Gonçalves, Laura Maria Barbosa

2015-01-01

Paracoccidioides spp. é um fungo termodimórfico, agente etiológico da paracoccidioidomicose (PCM). Durante o processo de infecção Paracoccidioides spp. encontra ambientes com diferentes disponibilidades de micronutrientes essenciais como cobre, por exemplo. A obtenção de micronutrientes no hospedeiro é mecanismo crucial de estratégia adaptativa deste patógeno. Neste sentido, a identificação de proteínas relacionadas com captação/homeostase de metais traços, durante a infecção é importante par...

La Construcción de Políticas Turísticas Orientadas a los Sectores Medios Durante el Primer Peronismo: Argentina 1946-1955

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Piglia, Melina; Pastoriza, Elisa

2017-01-01

En el marco general de los estudios de las políticas públicas durante el primer peronismo (Argentina 1946-1955), el presente trabajo pretende abordar aspectos descuidados de las políticas turísticas, desde una perspectiva de historia social. El artículo sostiene que, junto a las más conocidas transformaciones producidas en el campo del turismo obrero y el turismo social, se puede advertir durante el período peronista la puesta en marcha de políticas turísticas orientadas al turismo de los sec...

Estudio de los riesgos ergonómicos presentes durante la construcción de los túneles urbanos de Gerona para el AVE

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Bermejo Cardona, Anahí

2012-01-01

El objetivo de este estudio es determinar el riesgo ergonómico presente en algunas de las tareas llevadas a cabo durante la construcción de los túneles urbanos de Gerona para el AVE. Primero se realizaron entrevistas con los responsables de seguridad y salud de la obra a los que se les solicitaron los datos de siniestralidad des del inicio de los trabajos. De esta manera se puede conocer el número de bajas médicas por sobreesfuerzos o posturas forzadas. Después se les acompañó durante s...

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.

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

La propaganda y la construcción de la cultura de guerra en España durante la Guerra Civil

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Francisco SEVILLANO CALERO

2015-03-01

Full Text Available Este trabajo analiza la propaganda de guerra durante la Guerra Civil española y los primeros años del «nuevo Estado» franquista. La bibliografía reciente ha analizado la construcción estereotipada de la imagen del enemigo, y cómo la persona del general Francisco Franco fue transfigurada simbólicamente mediante la construcción y la propagación de su imagen carismática en el discurso, los ritos y las liturgias del «nuevo Estado» durante la Guerra Civil. Mediante estos discursos e imágenes, la propaganda construyó una cultura de guerra en España de 1936 a 1939.

Entre leyes y votos. La legislación electoral en la Nueva Granada durante la primera mitad del siglo XIX

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Edwin Andrés Monsalvo Mendoza

2012-07-01

Full Text Available El presente artículo muestra —a partir del análisis de las normas electorales compiladas en la Codificación Nacional—, el papel que jugó la legislación electoral colombiana en los comicios durante la primera mitad de siglo XIX. El interés principal se centra en la descripción y análisis de los requisitos para ser sufragante y elector, el desarrollo de las elecciones parroquiales, las transgresiones a las normas y el papel de los jueces durante los comicios. Nuestra hipótesis es que las normas se iban construyendo en la medida que las prácticas electorales hacían necesario su regulación.

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.

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.

Prevalencia de la infección por virus de Epstein Barr (VEB) en mujeres gestantes y con aborto, durante las primeras semanas de embarazo

OpenAIRE

Mariangel Ramos; César Pérez

2013-01-01

El virus de Epstein-Barr (VEB) es un agente patógeno común para los humanos y su efecto en la infección vertical es poco estudiado. Durante el embarazo hay riesgo a contraer infecciones que afectan al feto. La infección adquirida antes del nacimiento ocasiona abortos, mortinatos, malformaciones, retraso en el crecimiento intrauterino, prematuridad y secuelas por infección postnatal crónica. Los efectos inmediatos o a largo plazo representan un problema a nivel mundial. Durante el embarazo se ...

Transporte y consumo de otras durante la romanización en el norte de la Península Ibérica

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Castaños, P.

2010-01-01

Full Text Available En este trabajo se estudia la presencia de ostras en yacimientos alejados de la costa durante la Romanización en el Norte de la Península Ibérica. Se establece una metodología para la estimación del número mínimo de individuos y la osteometría de esta especie. Se comprueba la importancia cuantitativa del consumo de este molusco en la dieta. Se aborda experimentalmente el problema del transporte de las ostras desde la costa hasta asentamientos de interior. Se establecen las ventajas de las distintas formas de colocación y del grado supervivencia de los animales durante el tiempo de transporte.

CAMBIOS EN LA COMPOSICIÓN DE ALMIDÓN, PECTINAS Y HEMICELULOSAS DURANTE LA MADURACIÓN DE MANGO (Mangifera indica cv. KENT

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Wendy Guadalupe Cárdenas-Coronel

2012-01-01

y se mantuvo en valores cercanos a los 250 mg·100 g-1 peso fresco (pf en los distintos estados de madurez; sin embargo, la disminución de glucosa y galactosa fue de 50 % durante el ablandamiento inicial. La fracción péctica predominante fue la hidrosoluble, que presentó una relación urónicos:azúcares cercana a 2:1, y el azúcar neutro de mayor concentración fue arabinosa. Durante el ablandamiento de los frutos de mango ¿Kent¿, se presentaron cambios en la solubilidad y grado de polimerización de polisacáridos pécticos y hemicelulósicos.

Enfisema subcutâneo durante inclusão de prótese mamária: relato de caso Enfisema subcutáneo durante inclusión de prótesis mamaria: relato de caso Subcutaneous emphysema during breast augmentation: case report

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Talita Franco

2007-08-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: A ocorrência de enfisema subcutâneo na parede torácica durante procedimento cirúrgico onde se realizou infiltração de anestésico pode sugerir a presença de pneumotórax e suas possíveis complicações. A ocorrência de pneumotórax durante mamoplastia de aumento já foi descrita. Contudo, não foram encontrados na literatura pesquisada, relatos de presença isolada de enfisema subcutâneo nesse tipo de procedimento. O objetivo deste relato foi ressaltar a importância de adequada monitoração do paciente no intra-operatório, da integração dos membros da equipe e descrever o enfisema subcutâneo, isolado, em paciente submetida à inclusão de próteses mamárias. RELATO DO CASO: Paciente com 27 anos, 1,70 m, 54 kg, apresentava hipomastia bilateral, tendo sido submetida à inclusão de próteses mamárias em plano retroglandular. O procedimento foi realizado sob anestesia geral inalatória, associada à infiltração de solução anestésica, em plano subcutâneo, da área a ser manipulada. Durante a operação percebeu-se crepitação, característica de enfisema subcutâneo, em extensa área anterior do tórax. Não houve alteração nos parâmetros de monitoração da paciente. A radiografia realizada no pós-operatório confirmou o quadro clínico e descartou a ocorrência de outras complicações. CONCLUSÕES: A ocorrência de enfisema subcutâneo durante inclusão de próteses mamárias pode ser um dado inocente, mas é importante verificar as condições clínicas da paciente e afastar a possibilidade de pneumotórax.JUSTIFICATIVA Y OBJETIVOS: La incidencia de enfisema subcutáneo en la pared torácica durante procedimiento quirúrgico donde se realizó infiltración de anestésico puede sugerir la presencia de neumotórax y sus posibles complicaciones. La incidencia de neumotórax durante mamoplastía de aumento ya fue descrita, pero no se encontraron en la literatura investigada, relatos de

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.

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.

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.

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...

Freqüência e padrão da violência por parceiro íntimo antes, durante e depois da gravidez Frecuencia y patrón de la violencia por pareja íntima antes, durante y después del embarazo Frequency and pattern of intimate partner violence before, during and after pregnancy

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Elisabete Pereira Silva

2011-12-01

Full Text Available OBJETIVO: Estimar a prevalência e analisar o padrão da violência por parceiro íntimo antes e durante a gestação e no pós-parto. MÉTODOS: Estudo de coorte realizado com 960 mulheres de 18 a 49 anos, cadastradas no Programa Saúde da Família da cidade do Recife, PE, entre 2005 e 2006. As mulheres foram entrevistadas durante a gestação e no puerpério, utilizando-se um questionário adaptado do Estudo Multipaíses sobre a Saúde da Mulher e Violência Doméstica da Organização Mundial da Saúde. Para avaliar o padrão de ocorrência da violência por parceiro íntimo, entre um determinado período e o subseqüente, o odds ratio foi calculado com intervalos de 95% de confiança (IC95%. RESULTADOS: A prevalência de violência por parceiro íntimo antes, durante e/ou depois da gestação foi estimada em 47,4% e, para cada período isolado, em 32,4%, 31,0% e 22,6%, respectivamente. As mulheres que relataram violência antes da gravidez tiveram chance 11,6 vezes maior (IC95%: 8,3;16,2 de relatar violência durante a gravidez. Quando as mulheres relataram violência durante a gravidez, a chance de relatos no pós-parto foi 8,2 vezes maior (IC95%: 5,1;11,7. A violência psicológica foi a de maior prevalência, principalmente durante a gestação (28,8%; IC95%: 26,0%;31,7%; a sexual, a menos prevalente, especialmente no pós-parto (3,7%; IC95%: 2,6%;5,0%; e a física diminuiu quase 50% durante a gestação em comparação com o período anterior. CONCLUSÕES: Parcela significativa das mulheres em idade reprodutiva vivencia situações de violência por parceiro íntimo. Os períodos de consultas de pré-natal e de puericultura são oportunidades para que o profissional de saúde possa identificar situações de violência.OBJETIVO: Estimar la prevalencia y analizar el patrón de violencia por pareja íntima, antes y durante la gestación y en el postparto. MÉTODOS: Estudio de cohorte realizado con 960 mujeres de 18 a 49 años, catastradas

EVALUACIÓN DE LA CONDUCTA DE CACHORROS DURANTE LA PRIMERA CONSULTA CLÍNICA: ESTUDIO PILOTO EN LA CIUDAD DE CORRIENTES, ARGENTINA

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P. Koscinczuk

2014-01-01

Full Text Available Con el objeto de identificar signos precursores de alteraciones del comportamiento en cachorros, se evaluaron respuestas conductuales durante la primera consulta clínica, coincidiendo con la primo vacunación. Se trabajó con caninos de ambos sexos (n = 31, entre 30 y 60 días de edad, tanto mestizos como de razas puras. Siguiendo la secuencia en la exploración clínica de rutina, al ingresar se recolectaron datos sobre exploración ambiental (Exp sobre el suelo y luego las respuestas a maniobras sobre la camilla (Mc y de sujeción y sumisión forzadas (Sf efectuadas por el profesional. Durante la anam-nesis se realizaron preguntas referentes a miedo frente a estímulos novedosos, tiempo de descanso y actitudes durante el juego. El 74% de los cachorros regresó junto al humano conocido (propietario luego de explorar el ambiente en el suelo. En la camilla, el 81% aceptó el contacto físico iniciado por el veterinario y un 84% aceptó la sumisión forzada. Ningún cachorro intentó escapar y sólo uno presentó reacciones neurovegetativas. Frente a estímulos novedosos, el 61% no presentó miedo y, cuando se presentó la respuesta, el orden de susceptibilidad fue a ruidos, objetos móviles y personas desconocidas. Frente al descanso, 71% de los propietarios no los escuchó llorar durante la noche y durante el juego, 61% de los cachorros dejó de morder ante la solicitud del propietario. En la primera consulta la mayoría de los cachorros no presentó signos precursores de altera-ciones de la conducta. La aplicación de maniobras semiológicas sencillas –observación del comportamiento exploratorio, posición de sumisión, reacción a la palpación y aus-cultación– brindó información sobre hiperactividad, miedo, ansiedad o socialización inadecuada. Esta información fue utilizada como base para hacer modificación de la conducta. Con intervenciones tempranas el veterinario puede, no sólo mejorar la relación humano/animal, sino tambi

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.

Variación de la posición del centro de gravedad en una bailaora profesional durante el zapateado flamenco

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Irene Baena-Chicón

2016-05-01

Full Text Available El centro de gravedad es el punto donde confluyen las fuerzas resultantes del peso de todos y cada uno de los segmentos corporales. El estudio de la trayectoria de este punto es de gran relevancia para determinar parámetros de carácter cinemáticos, dinámicos y el nivel de eficiencia en la ejecución del gesto técnico. El objetivo de este trabajo es estudiar con un sistema de captura del movimiento por cámaras de infrarrojo, la variación de posición del centro de gravedad de una bailaora profesional de baile flamenco durante un test de zapateado flamenco. Se trata de un estudio de caso único, una bailaora profesional de flamenco (33 años, 59 kg, 1.65m que ha ejecutado el test de zapateado ZAP-3, en el que se repiten secuencias de 6 zapateados con ambos pies durante 15 segundos. El test ha sido registrado con un sistema óptico de captura del movimiento Vicon (Oxford Metrics Ltd.; Oxford, UK compuesto por 5 vídeocámaras de infrarrojo. La participante portaba 35 marcadores colocados según una modificación del modelo de Golem. Entre los resultados obtenidos se encuentra el rango de movimiento de la trayectoria del centro de gravedad: 0.136 m en movimientos anteroposteriores, 0.105 m en laterales y 0.018 m en verticales. La trayectoria del centro de gravedad durante cualquier actividad guarda una estrecha relación con el gasto energético empleado y es especialmente importante en el baile flamenco. Los resultados obtenidos muestran oscilaciones suaves del centro de gravedad durante el zapateado en los tres planos. Esto refleja la estrategia del sujeto para optimizar el gasto energético gracias a una eficiente reequilibración corporal. El hecho de mantener una posición estable mientras se realizan zapateados a tan alta frecuencia, refleja una alta competencia de la bailaora que es profesional desde hace 17 años.

Evaluación del estrés en los estudiantes de enfermería durante les prácticas clínicas: estudio descriptivo

OpenAIRE

González Domínguez, Sandra

2017-01-01

Introducción: Numerosos autores evidencian que, a diferencia de otras disciplinas, los estudiantes de enfermería experimentan mayores niveles de estrés. Por lo tanto, durante la formación de los estudiantes de enfermería, es fundamental estudiar la incidencia del estrés y sus síntomas; así como conocer los principales desencadenantes de estrés durante las prácticas, para favorecer el aprendizaje y así contribuir a la salud laboral de los futuros profesionales. Objetivos: Conocer la prevale...

Papilomatosis laríngea juvenil y su relación con la infección genital por virus de papiloma humano durante el embarazo

OpenAIRE

Castillo, Haydee Karina; Caro, Vanesa de los Ángeles; González Blanco, Mireya; Acosta, Ligia; Correnti, María; Suárez, Jony

2015-01-01

Objetivo: Establecer la relación entre el diagnóstico de papilomatosis laríngea juvenil y la infección genital por virus de papiloma humano durante el embarazo. Métodos: Se incluyeron 18 madres de hijos con diagnóstico de papilomatosis laríngea juvenil. Se revisaron las historias de los niños, se realizó anamnesis a las madres buscando antecedentes de infección por virus de papiloma humano durante el embarazo, se practicó evaluación ginecológica actual, citología, vulvoscopia, vaginoscopia, c...

Contaminação microbiana de punhos de jalecos durante a assistência à saúde

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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

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.

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.

Sonohysterography

Medline Plus

Full Text Available ... of page How is the procedure performed? A baseline transvaginal ultrasound procedure is usually performed first to ... strategy for a patient's particular condition. Following the baseline exam, the transvaginal probe will be removed, and ...

Quimiossensibilidade durante exercício na insuficiência cardíaca: respostas ventilatórias, cronotrópicas e neurohormonais Quimiosensibilidad durante ejercicio en la insuficiencia cardíaca: respuestas ventilatorias, cronotrópicas y neurohormonales Exercise chemosensitivity in heart failure: ventilatory, chronotropic and neurohormonal responses

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Lídia Zytynski Moura

2010-09-01

Full Text Available FUNDAMENTO: Insuficiência cardíaca (IC está associada com aumento da quimio-sensibilidade periférica e central em repouso, que pode estar correlacionada com um aumento na resposta ventilatória durante exercício. Entretanto, SUS sensibilidade na IC durante o exercício ainda não foi reportada. OBJETIVO: Testar se o estímulo dos quimiorreceptores centrais e periféricos em pacientes com IC pode modular respostas ventilatórias, cronotrópicas e neurohormonais durante exercício submáximo. MÉTODOS: Investigamos a quimio-sensibilidade central e periférica em 15 pacientes com insuficiência cardíaca (IC e 7 controles normais (C, comparando a resposta durante 3 testes de caminhada de 6 minutos (TC6M, realizado em esteira ergométrica com: ar ambiente, em hipóxia e em hipercapnia (em ordem randômica. RESULTADOS: FR em ar ambiente nos grupos C e IC foi 17±2 e 22±2 (pFUNDAMENTO: La insuficiencia cardíaca (IC está asociada con aumento de la quimiosensibilidad periférica y central en reposo, que puede estar correlacionada con un aumento en la respuesta ventilatoria durante ejercicio. Mientras tanto, SUS sensibilidad en la IC durante el ejercicio aun no fue reportada. OBJETIVO: Verificar si el estímulo de los quimiorreceptores centrales y periféricos en pacientes con IC puede modular respuestas ventilatorias, cronotrópicas y neurohormonales durante ejercicio submáximo. MÉTODOS: Investigamos la quimiosensibilidad central y periférica en 15 pacientes con insuficiencia cardíaca (IC y 7 controles normales (C, comparando la respuesta durante 3 tests de caminata de 6 minutos (TC6M, realizado en cinta ergométrica con: aire ambiente, en hipoxia y en hipercapnia (en orden randómico. RESULTADOS: FR en aire ambiente en los grupos C y IC fue 17±2 y 22±2 (pBACKGROUND: Heart failure (HF is associated with resting increased peripheral and central chemosensitivity which may correlate with an increased ventilatory response to exercise. However

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.

Lesiones musculares en el deporte. Muscular injuries in sport.

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Jiménez Díaz, José Fernando

2006-04-01

Full Text Available ResumenDurante la práctica de la actividad física hay una gran incidencia de lesiones musculares, si bien se han llevado a cabo pocos estudios clínicos sobre el tratamiento y la resolución de las mismas. Desde el punto de vista etiopatogénico, hay que señalar que la incidencia de lesión es mayor en aquellos músculos poliarticulares en condiciones de acumulación de fatiga y con condiciones ambientales desfavorables. La clasificación de las lesiones musculares permite distinguir entre aquellas que no afectan a la fascia produciéndose un sangrado dentro del mismo (intramuscular o bien si la fascia también se rompe, el sangrado se sitúa entre los diferentes músculos (intermuscular. El tratamiento de estas lesiones se realizará combinando reposo, compresión, aplicación de frío y elevación del área lesionada así como el desarrollo de un adecuado programa de readaptación funcional que permita al jugador incorporarse lo antes posible a la dinámica del equipo. En la actualidad se está llevando a cabo opciones terapéuticas con factores de crecimiento, terapia génica y células madre, si bien todavía no están lo suficientemente desarrolladas.AbstractDuring the practice of the physical activity there is a great effect of muscular injuries, though few clinical studies have been carried out on the treatment and the resolution of the same ones. Inside the reasons it is necessary to indicate that the effect of injury is major in those muscles you will polyarticulate in situation of fatigue and with environmental unfavorable conditions.The classification of the muscular injuries allows to distinguish between those that do not affect the fascia producing the bled intramuscular or if the fascia also breaks, the bled one places between the different muscles (intermuscular.The treatment will be realized combining rest, compression, application of cold and elevation of these injuries as well as the development of a program of functional

Poliposis adenomatosa familiar en niños cubanos

Directory of Open Access Journals (Sweden)

Tulio Antonio Amaya Sorto

Full Text Available Introducción: la poliposis adenomatosa familiar es una enfermedad autosómica dominante con evolución al cáncer colorrectal. Objetivo: caracterizar a los niños cubanos con poliposis adenomatosa familiar. Métodos: se realizó un estudio, descriptivo, prospectivo de serie de casos, atendidos en el Instituto de Gastroenterología de Cuba, durante el periodo comprendido entre febrero de 2011 y mayo de 2013. Se incluyeron 15 niños, en los cuales se había establecido el diagnóstico de poliposis por colonoscopia, con confirmación histológica de adenomas. A todos se les realizó endoscopia del tracto digestivo superior, ultrasonografía de abdomen superior, ortopantomografía, survey óseo, tránsito intestinal, consulta de oftalmología y neurología. Resultados: el 60,0 % fue del sexo masculino y el 60,0 % de color de piel blanca. La pesquisa de los pacientes asintomáticos y el sangrado rectal fueron los motivos de consulta más frecuentes (40,0 % respectivamente. Predominó la forma florida de la enfermedad, y la displasia de bajo grado se observó en el 73,3 %. El 26,7 % tuvo pólipos en el estómago, y fue la localización más observada. La manifestación extraintestinal más frecuente fue la hipertrofia congénita del epitelio retiniano (73,3 %, seguida por los dientes supernumerarios y los quistes dentígenos. Al analizarlo por grupos de edades, entre 10 y 18 años, al 40,0 % ya se les había realizado colectomía. Conclusiones: la mayoría de los pacientes estudiados tenían antecedentes familiares de la enfermedad, la pesquisa familiar y el sangrado rectal fueron los principales motivos de estudio. Todos presentaron la forma florida, y en su gran mayoría, displasia de bajo grado en el momento del diagnóstico. Los pólipos extracolónicos se presentaron con mayor frecuencia en el estómago, y la manifestación extraintestinal más frecuente fue la hipertrofia congénita del epitelio retiniano. La mayoría de los pacientes no se hab

Ultrasound -- Pelvis

Medline Plus

Full Text Available ... ovarian cysts and uterine fibroids ovarian or uterine cancers A transvaginal ultrasound is usually performed to view the endometrium (the lining of the uterus) and the ovaries. Transvaginal ultrasound also evaluates the myometrium (muscular walls ...

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...

ASERRÍN DE PINO COMO SUSTRATO HIDROPÓNICO. I: VARIACIÓN EN CARACTERÍSTICAS FÍSICAS DURANTE CINCO CICLOS DE CULTIVO

Directory of Open Access Journals (Sweden)

Joel Pineda-Pineda

2012-01-01

tratamiento de 100 % aserrín. Estos tratamientos se evaluaron durante cinco ciclos continuos de cultivo con jitomate (30 meses. Al sustrato original y al final de cada ciclo se midieron porosidad total, volumen de partículas, capacidad de retención de humedad, capacidad de aireación y densidad aparente. Se encontró poca variación en la densidad aparente, pero la porosidad, la retención de humedad y la capacidad de aireación disminuyeron gradualmente durante los cinco ciclos de cultivo con jitomate. La capacidad de aireación fue la característica física que presentó mayor variación, mostrando valores por debajo del adecuado después de 24 meses de cultivo.

Redes sociales, acción colectiva y elecciones: los usos de Facebook por el movimiento estudiantil chileno durante la campaña electoral de 2013

OpenAIRE

Lázaro M. Bacallao-Pino

2016-01-01

Los estudios recientes sobre las redes sociales digitales han analizado, por un lado, sus usos como parte de la acción colectiva y, por otro, sus usos durante las campañas electorales. Basado en el estudio del movimiento estudiantil chileno durante la campaña electoral de 2013 en ese país, el texto analiza los usos de Facebook por parte de tres federaciones estudiantiles que integran dicho movimiento. Los resultados indican que se priorizan las dimensiones informativa y organizativa en los us...

Urogynecologic Surgical Mesh Implants

Science.gov (United States)

... procedures performed to treat pelvic floor disorders with surgical mesh: Transvaginal mesh to treat POP Transabdominal mesh to treat ... address safety risks Final Order for Reclassification of Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair Final Order for Effective ...

Uso indicado e uso referido de medicamentos durante a gravidez Prescribed and reported drug use during pregnancy

Directory of Open Access Journals (Sweden)

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

Modelo matemático para la predicción de las necesidades de frío durante la producción de vino

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Stella M. Udaquiola

2009-05-01

Full Text Available La vitivinicultura es una de las principales industrias de la Provincia de San Juan, Argentina. Esta industria no se caracteriza por la peligrosidad de sus residuos, pero sí por sus elevados consumos de energía y agua. La energía que se utiliza en la refrigeración durante la vinificación es aproximadamente igual a un 50 a 70 por ciento del total de energía utilizada. La temperatura debe ser mantenida en un nivel óptimo durante las distintas etapas del proceso con el objetivo de garantizar las características del vino. En este artículo se presenta un modelo matemático para predecir los requerimientos energéticos durante distintas etapas de la vinificación en blanco. Se utilizó un modelo cinético para simular la fermentación y se acoplaron al mismo las ecuaciones de balance de energía. Se realizaron simulaciones de fermentación variando el volumen de los fermentadores, observándose que el requerimiento energético varía en forma lineal con el volumen de los mismos.

Modelo matemático para la predicción de las necesidades de frío durante la producción de vino

Directory of Open Access Journals (Sweden)

Carlos A. Palacios

2009-01-01

Full Text Available La vitivinicultura es una de las principales industrias de la Provincia de San Juan, Argentina. Esta industria no se caracteriza por la peligrosidad de sus residuos, pero sí por sus elevados consumos de energía y agua. La energía que se utiliza en la refrigeración durante la vinificación es aproximadamente igual a un 50 a 70 por ciento del total de energía utilizada. La temperatura debe ser mantenida en un nivel óptimo durante las distintas etapas del proceso con el objetivo de garantizar las características del vino. En este artículo se presenta un modelo matemático para predecir los requerimientos energéticos durante distintas etapas de la vinificación en blanco. Se utilizó un modelo cinético para simular la fermentación y se acoplaron al mismo las ecuaciones de balance de energía. Se realizaron simulaciones de fermentación variando el volumen de los fermentadores, observándose que el requerimiento energético varía en forma lineal con el volumen de los mismos.

Calidad del aire en galpón avícola con ventilación natural durante la fase de pollitos

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Robinson Osorio H.

Full Text Available RESUMEN Los pollos de engorde durante la primera fase deben estar protegidos del estrés por frio, especialmente en el inverno, noches y madrugadas frías. Para proteger a los animales, los avicultores han utilizado diferentes estrategias, entre ellas está el uso de varias capas de cortinas para aumentar el nivel de aislamiento térmico y disminuir las pérdidas de calor, disminuyendo también la permeabilidad con el aire externo. En este contexto, es importante dar especial atención a la calidad del aire interno de los galpones avícolas como parte de una producción bajo parámetros de bienestar animal. El presente estudio fue realizado en el municipio de Barbacena, MG, en Brasil, y tuvo como objetivo evaluar la calidad del aire al nivel de los pollos y los trabajadores, específicamente de las concentraciones de amoniaco, dióxido de carbono y monóxido de carbono, en un galpón avícola naturalmente ventilado durante la primera fase de vida de pollos de engorde en el período de inverno, y la influencia del nivel de aislamiento con cortinas laterales sobre las concentraciones de amoniaco. Durante la primera semana experimental, los niveles de amoniaco sobrepasaron los valores aceptables, y se encontró diferencia estadística entre las concentraciones de amoniaco para los diferentes niveles de aislamiento con cortinas laterales.

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...

DEL CHILE DE LOS TRIUNFOS MORALES AL PAIS GANADOR. uNA HISTORIA DE LA SELECCION CHILENA DE FUTBOL DURANTE LA DICTADURA MILITAR. 1973-1989

OpenAIRE

VILCHES PARRA, DIEGO

2013-01-01

La presente tesis es una historia de la selección chilena de fútbol durante la Dictadura Militar encabezada por el General Augusto Pinochet. En ésta se plantea que la concepción social del fútbol cambió radicalmente durante este decisivo período de la historia nacional. Específicamente, se produjo el paso desde una valoración del fútbol más cercana a un juego y, por lo tanto, en la que los triunfos morales eran apreciados; hacia una en la que se vuelven hegemónicos los valores competitivos de...

Las escuelas de párvulos en España durante el siglo XIX: Su desarrollo en la época de la Restauración

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Carmen COLMENAR ORZAES

2010-03-01

Full Text Available RESUMEN: En este trabajo nuestro objeto de estudio será el desarrollo institucional de la educación infantil en España, durante la centuria anterior, constatando la situación de este nivel educativo a finales del siglo XIX. Desde entonces y hasta ahora, la educación infantil habría de recorrer aún un largo camino, durante nuestro siglo, hasta ser considerada como nivel escolar con inequívoco sentido educativo y siendo objeto de especial atención dentro del sistema formal de educación.

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...

Aplicação de recobrimento prolonga a qualidade pós-colheita de laranja 'Valência Delta' durante armazenamento ambiente

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Gerlândia da Silva Pereira

Full Text Available O objetivo desse trabalho foi avaliar o efeito da aplicação de cera à base de carnaúba na qualidade e conservação da laranja cv. 'Valência Delta', produzida em área de clima semiárido durante o armazenamento ambiente (24 ºC ± 2 e 40% ± 5 U.R.. A influência da utilização do recobrimento nas propriedades físicas (perda de massa, umidade da casca e coloração do flavedo e físico-químicas (sólidos solúveis, acidez titulável, pH, relação sólidos solúveis/acidez titulável, ácido ascórbico, flavonóides amarelos e polifenóis totais foi avaliada a cada quatro dias, por um período de 28 dias. Observou-se perda de massa crescente durante o armazenamento; no entanto, os frutos recobertos perderam massa a taxas bem menores que os frutos controle. Em concordância, a umidade da casca diminuiu durante o armazenamento, sendo mais pronunciada nos frutos controle. Os teores de sólidos solúveis, acidez titulável, ácido ascórbico, flavonóides amarelos e polifenóis totais aumentaram, enquanto a relação sólidos solúveis/acidez titulável e pH decresceram ao longo do armazenamento. A aplicação de recobrimento à base de carnaúba prolongou a vida útil pós-colheita da laranja 'Valência Delta', cultivada no Estado do Ceará, através de uma significativa redução na perda de massa, intensificação do brilho do flavedo e manutenção das propriedades físicas e físico-químicas durante o armazenamento ambiente.

Cambios en la presión sanguínea durante la microcompresión retrogasseriana

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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

Ovarian capsular drilling in the treatment of clomiphene citrate ...

African Journals Online (AJOL)

Background: Laparoscopic Ovarian Drilling (LOD) is an effective and a well evaluated surgical Treatment of Clomiphene Citrate resistant Polycystic ovarian syndrome. Transvaginal hydrolaparoscopy (TVHL) is a relatively new simple method of exploring the pelvis and has recently been introduced as a transvaginal ...

Sustained effect of simulation-based ultrasound training on clinical performance

DEFF Research Database (Denmark)

Tolsgaard, M G; Ringsted, C; Dreisler, E

2015-01-01

on a virtual-reality transvaginal ultrasound simulator until an expert performance level was attained followed by training on a pelvic mannequin. After two months of clinical training, one transvaginal ultrasound scan was recorded for assessment of participants' clinical performance. Two blinded ultrasound...

Teoria de Orem aplicada a intervenciones durante embarazo y climaterio Aplicação da Teoria de Orem em intervenções durante a gestação e climatério Applications of Orem's Theory in addressing interventions during pregnancy and climateric

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Alide Salazar Molina

2009-08-01

Full Text Available El objetivo de este trabajo es desarrollar aplicaciones de la teoría de Autocuidado de Orem, para el abordaje de intervenciones de enfermería el embarazo y climaterio, y determinar su utilidad como un marco teórico para el abordaje del autocuidado durante las fases de desarrollo. Se concluye que la aplicación de este marco teórico, en la asistencia de mujeres durante el embarazo y climaterio, por parte de enfermeras y enfermeras obstétricas contribuye a identificar los requisitos de autocuidado, las intervenciones requeridas, la necesidad de autocuidado y los métodos de ayuda que las mujeres requieren con especial énfasis en la capacitación y desarrollo de la capacidad de autocuidado.O objetivo deste trabalho foi desenvolver aplicações da Teoria do Autocuidado de Orem para realizar intervenções em enfermagem durante a gestação e climatério, mas tentamos também determinar a sua utilidade como marco teórico para pensar (ou planejar o autocuidado nestas fases da vida da mulher. Pudemos observar que a aplicação desta teoria e a sua utilidade como marco teórico na assistência à mulheres durante a gestação e climatério, por parte de enfermeiras e enfermeiras obstétricas, contribuiu não só para identificar os requisitos necessários para o autocuidado e planejar as intervenções requeridas e as necessidades específicas de autocuidado, mas constatamos também que esta pode ser a base para elaboração de métodos de desenvolvimento da ampliação da capacidade feminina para o auto-cuidado.The aim of this paper is to develop applications of Orem's Theory of Self Care in order to address nursing interventions during pregnancy and menopause, and to determine its usefulness as a theoretical framework for addressing self care during stages of development. It is concluded that the application by nurses and midwives of this theoretical framework, in assisting women during pregnancy and menopause, contributes to identifying the

ESTABILIDADE QUÍMICA E MICROBIOLÓGICA DE "MINCED FISH" DE PEIXES AMAZÔNICOS DURANTE O CONGELAMENTO

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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.

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...

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...

Convergencia económica en la región sur de México: un análisis municipal durante el periodo 1990-2010

Directory of Open Access Journals (Sweden)

Antonio Kido-Cruz

2015-01-01

Full Text Available El presente estudio pone a prueba la hipótesis de convergencia entre el crecimien - to del ingreso per cápita y un nivel de ingreso inicial. Se generan diagramas de convergencia sigma y beta absoluta y se estima la ecuación de convergencia beta condicional en municipios de cuatro estados de México: Chiapas, Guerrero, Michoacán y Oaxaca, durante el periodo de 1990 al 2010, veinte años después de la entrada en vigor del Tratado de Libre Comercio de América del Norte ( tlcan . Los principales resultados sugieren evidencia que rechaza la hipótesis de convergencia absoluta y condicional durante el tiempo de estudio.

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

Directory of Open Access Journals (Sweden)

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.

Efecto del tipo de lactancia durante el primer año de vida sobre el estado de hierro y el desarrollo físico y psicológico del niño

OpenAIRE

Bedmar Carretero, Cristina

2012-01-01

El objetivo de este estudio fue valorar el desarrollo del niño durante el primer año de vida en función del tipo de lactancia realizada durante el primer semestre y de la dosis de hierro administrada durante el segundo semestre. El 75,5% realizan lactancia materna exclusiva al nacer y el 16,5% la mantienen hasta los 6 meses. El 39,5%tienen alguna mutación en el gen HFE. La prevalencia de déficit de hierroy anemia ferropénicaes del 4,5% y 2,5% a los 6 meses y del 9,2% y 1,2% a los 12 meses.La ...

Ontogenia e histoquímica funcional de los sistemas digestivo y visual y de otros órganos durante el desarrollo larvario de la liseta, Chelon labrosus.

OpenAIRE

Sarasquete, Carmen; Ortiz-Delgado, Juan B.; Martos-Sitcha, J. Antonio; de las Heras, Verónica; Yúfera, Manuel; Martínez-Rodríguez, Gonzalo

2014-01-01

El objetivo del trabajo se centró en describir los principales cambios ontogénicos y funcionales de los sistemas digestivo y visual de Chelon labrosus, durante los primeros tres meses de vida larvaria, desde la fertilización hasta 99 dias después de eclosionar (dde). Se observó un largo periodo de reducido crecimiento (3.93%) durante las tres primeras semanas de vida, y una amplia fase de alimentación endo-exotrófica (hasta 13 dde). La mayoría de sistemas, órganos y estructuras tisulares (ojo...

Las posibilidades de un despido objetivo del art.52.c) E.T. durante un ERE temporal: comentario a la STS de 12 de marzo de 2014

OpenAIRE

Clark Soriano, Héctor

2015-01-01

Un trabajador fue despedido mediante despido objetivo por causas económicas y productivas, durante la vigencia de un expediente de regulación de empleo temporal (ERTE) que afectaba también a dicho trabajador. La cuestión a debate es si una empresa a la que en el marco de un ERTE se le ha autorizado a suspender temporalmente contratos de trabajo, puede durante tal período, por las mismas causas alegadas y sin que haya habido un cambio relevante en las circunstancias, efectuar un...

Cinemática e ação da musculatura do tornozelo em indivíduos com hemiparesia durante o andar para trás

OpenAIRE

Azevedo, Alexandre Kretzer e Castro de

2015-01-01

Um dos possíveis mecanismos que explicaria o aumento da velocidade do andar para frente (AF) após o treinamento do andar para trás (AT) em pessoas com hemiparesia poderia ser um maior recrutamento da musculatura do tornozelo durante a tarefa de AT. Pretendeu-se com esta pesquisa comparar a ativação muscular de dorsi e plantiflexores e a amplitude de movimento do tornozelo durante as tarefas de AF e AT entre sujeitos com hemiparesia pós-AVE e indivíduos controle saudáveis. Participaram do estu...

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

Parálisis facial periférica después de amigdalectomía extracapsular

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Erwin Alejandro Racines-Alava

2018-05-01

ía, que se relacionan con la apertura forzada de la vía aérea en caso de intubación difícil o por la infiltración anestésica y su difusión. Por la forma de presentación y su rápida desaparición nos inclinamos a pensar en que nuestros casos son del segundo tipo. Conclusiones: La infiltración periamigdalina de anestésico local durante la amigdalectomía puede aportar un beneficio al reducir el sangrado y el tiempo quirúrgico, además de ayudar al control del dolor postoperatoio. Al ser un procedimiento común en Otorrinolaringología debemos conocer la anatomía quirúrgica y los sitios de infiltración de anestésico local y su adecuada cantidad para cada paciente. La parálisis facial periférica es una rara complicación, puede ser transitoria y recuperarse espontáneamente sin necesitar ningún tratamiento.

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

Prediction of successful induction of labour wıth dinoprostone in a ...

African Journals Online (AJOL)

No significant association was found between transvaginal measurement of cervical length and the success of labour induction (p=0.201). We found no statistically significant difference between failure of labour induction and successful labour induction in terms of transvaginal measurement of cervical length (area under ...

CASE REPORT

African Journals Online (AJOL)

We report on the rare entity of transvaginal small bowel herniation following a transvaginal hysterectomy. ... surgical intervention. This report serves to highlight awareness of the condition, and how knowledge of the various methods of addressing an ischaemic bowel and a ruptured ... mesh after resection and anastomosis.

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

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...

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

Delegaciones y oficinas de prensa españolas en el extranjero durante el primer franquismo: el caso francés (1936-1942

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Antonio César MORENO CANTANO

2009-03-01

Full Text Available Francia fue uno de los enclaves más importantes de la propaganda franquista en Europa durante los años de la Guerra Civil española y la Segunda Guerra Mundial. En el presente artículo analizaremos las características generales que presentaron las Delegaciones y Oficinas de Prensa y Propaganda españolas en el extranjero durante 1936-1945. Posteriormente, dirigiremos nuestra atención a Francia, analizando el importante papel que desarrollaron en ese país los carlistas, falangistas y catalanistas franquistas de Cambó. Estudiaremos, en definitiva, las iniciativas que se acometieron desde Francia en beneficio de la España franquista y las adversidades que en el logro de tal objetivo tuvieron que superar, tanto externas como internas. hðF

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.

Abastecimiento de sangre durante desastres: la experiencia de Chile en 2010 Blood supply during disasters: the experience of Chile in 2010

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Marcela Vásquez

2011-05-01

Full Text Available Se realizó una revisión de la gestión del abastecimiento y suministro de sangre durante desastres a partir de las experiencias de diversos eventos ocurridos principalmente en la primera década de este siglo, y en particular el terremoto grado 8,8 en la escala de Richter que afectó la zona centro sur de Chile el 27 de febrero de 2010. El objetivo fue proporcionar información que pueda ser útil para mejorar las estrategias y planes de respuesta durante potenciales desastres futuros. La información descriptiva sobre los procedimientos de respuesta se obtuvo mediante entre-vistas, reportes internos y la base de datos del sistema informático del Centro Productivo Regional de Sangre del Maule. Los resultados permiten concluir que para responder de manera eficiente y efectiva a las necesidades de sangre inmediatamente después de un desastre es de importancia clave tener un sistema centralizado de gestión que facilite el abastecimiento y el suministro de sangre y con-tar con personal voluntario competente en salud que esté dispuesto a acudir con celeridad durante estos eventos. Asimismo, se ha observado que durante dichas emergencias se produce un cambio en el perfil de quienes donan sangre. En Chile, por ejemplo, durante las dos semanas siguientes al terremoto la razón hombre/mujer en los donantes se invirtió, con 61,1% de participación por parte de las mujeres, quienes en la semana previa al evento representaban a solo 37%.A review of the management of blood supply and its administration during disasters was conducted based on the experience of several events that occurred primarily from 2000-2010, particularly the earthquake that measured 8.8 on the Richter scale that struck central and southern Chile on 27 February 2010. The objective was to provide information that could be useful in improving response plans and strategies during potential future disasters. The descriptive information on response procedures was obtained from

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

Efecto del tipo de lactancia durante el primer año de vida sobre el estado de hierro y el desarrollo físico y psicológico del niño

OpenAIRE

Bedmar Carretero, Cristina

2012-01-01

L’objectiu d’aquest estudi va ser valorar el desenvolupament del nen durant el primer any de vida en funció del tipus de lactància realitzada durant el primer semestre y de la dosis de ferro administrada durant el segon semestre. Hem observat que el 75,5% dels nens realitzen lactància materna exclusiva al néixer y el 16,5% la mantenen fins als 6 mesos. El 39,5% tenen alguna mutació en el gen HFE. La prevalença de dèficit de ferro y anèmia ferropènica es del 4,5% y 2,5% als 6 mesos y del 9,2% ...

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...

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 ...

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...

Avaliação da viscosidade durante a fabricação do doce de leite tradicional adicionado de amido de milho nativo.

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Monique Colombo

2009-10-01

Full Text Available O doce de leite é o principal produto concentrado produzido no Brasil. Minas Gerais responde por 50% da produção brasileira de doce de leite tendo, por este motivo, o maior parque industrial. O objetivo deste trabalho foi estudar a variação da viscosidade durante a fabricação do doce de leite tradicional adicionado de amido de milho nativo. Os resultados encontrados mostram a elevação da viscosidade do doce durante a fabricação e um aumento pronunciado após 60 minutos de fervura, o que, baseado nas imagens microscópicas, pode ser atribuído à exposição da amilose por rompimento da estrutura do amido nativo.

Aciertos, críticas y desafíos pendientes de la política educativa durante la presidencia de Rafael Correa Ecuador 2007-2017

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Mateo Nicolás Guayasamin Mogrovejo

2017-04-01

Full Text Available El presente trabajo consiste en preguntar sobre los avances y retrocesos de la política educativa ecuatoriana durante el gobierno de Rafael Correa bajo un método de análisis que proviene de categorías y conceptos de la política pública y educativa. Se repasan los principales indicadores que describan los logros, pero también se recogen aquellos aspectos críticos que se evidenciaron durante su periodo. Al final veremos cuáles serán los principales desafíos educativos de la sociedad ecuatoriana en un contexto de transición política, recesión económica y globalización neocapitalista.

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

Atividade física durante a gestação e associação com indicadores de saúde materno-infantil Actividad física durante la gestación y asociación con indicadores de salud materno-infantil Physical activity during pregnancy and its association with maternal and child health indicators

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Samuel C Dumith

2012-04-01

Full Text Available OBJETIVO: Analisar fatores associados à prática de atividade física durante a gestação e sua relação com indicadores de saúde materno-infantil. MÉTODOS: Estudo transversal realizado com todos os nascimentos ocorridos em maternidades no município de Rio Grande, RS, durante o ano de 2007 (N = 2.557. As informações foram obtidas por entrevista, por meio de um questionário pré-codificado aplicado às mães. Os desfechos de saúde materno-infantil analisados foram: hospitalização durante a gravidez, parto por cesárea, prematuridade (idade gestacional menor de 37 semanas, baixo peso ao nascer (OBJETIVO: Analizar factores asociados con la práctica de actividad física durante la gestación y su relación con indicadores de salud materno-infantil. MÉTODOS: Estudio transversal realizado con todos los nacimientos ocurridos en maternidades en el municipio de Rio Grande, Sur de Brasil, durante el año 2007 (N=2.557. Las informaciones fueron obtenidas por entrevista, por medio de un cuestionario pre-codificado aplicado a las madres. Los desenlaces de salud materno-infantil analizados fueron: hospitalización durante el embarazo, parto por cesárea, prematuridad (edad gestacional menor de 37 semanas, bajo peso al nacer (OBJECTIVE: To analyze factors associated with the practice of physical activity during pregnancy and its relationship to maternal and child health indicators. METHODS: Cross-sectional study carried out with all births that occurred at maternity hospitals in the municipality of Rio Grande (Southern Brazil during the year of 2007 (N = 2,557. Information was collected through interviews, by means of a pre-coded questionnaire administered to the mothers. The analyzed maternal and child health outcomes were: hospitalization during pregnancy, cesarean delivery, preterm birth (gestational age < 37 weeks, low birth weight (< 2500g, and fetal death. RESULTS: A total of 32.8% of mothers (95%CI 31.0;34.6 reported having practiced

UTILIZACIÓN DE Atriplex canescens Y Opuntia ficus indica EN LA ALIMENTACIÓN DE CABRAS LACTANTES DURANTE LA SEQUÍA

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Jorge Urrutia-Morales

2014-01-01

Full Text Available Utilización de Atriplex canescens y Opuntia ficus indica en la alimentación de cabras lactantes durante la sequía. El objetivo del presente estudio fue evaluar el efecto del Atriplex (Atriplex canescens y nopal (Opuntia ficus indica en la alimentación de cabras lactantes y la producción de leche durante la sequía. Durante los meses secos, entre mayo y agosto de 2005 y entre mayo y junio de 2006, se realizaron tres experimentos en la región semiárida de San Luis Potosí, México. En el primero, se probaron dos tratamientos: CO mantenidas en confinamiento y alimentación controlada (n=10 y AT mantenidas en pastoreo con Atriplex (n=10. En el segundo se aplicaron dos tratamientos: AT Atriplex (n=5 y NP Atriplex más nopal (n=5. En el tercero tres tratamientos: AT Atriplex (n=5, NP-1,0 Atriplex más 1,0% de nopal (n=4 y NP-1,5 Atriplex más 1,5% de nopal (n=5. En el primer experimento las cabras mantuvieron su peso, pero la producción de leche se redujo al 30% bajo confinamiento y menos del 8,0% en Atriplex al final del experimento. En el segundo, las cabras perdieron peso, a pesar de que la producción inicial de leche fue menor de 300 g/d. Las alimentadas con Atriplex redujeron su producción a casi la mitad de la producción inicial, mientras que la inclusión de nopal mantuvo la producción relativamente estable. En el tercer experimento, las cabras alimentadas con Atriplex mantuvieron el peso corporal, pero después de siete semanas la producción de leche fue del 25% de la producción inicial, a pesar de que esta fue de apenas 300 g diarios. En cambio, en las cabras suplementadas con nopal, la producción sólo se redujo al 45 y 64% de la producción inicial. Estos resultados son importantes para los caprinocultores de la región semiárida de México, donde las cabras podrían mantener una buena condición corporal, además de una producción de 150 a 250 g diarios de leche durante la época crítica utilizando Atriplex y nopal.

Alocação de compostos nitrogenados de reserva durante a germinação de sementes de Canavalia brasiliensis

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Liliane Santos Camargos

2013-09-01

Full Text Available http://dx.doi.org/10.5007/2175-7925.2013v26n4p1 Canavalia brasiliensis, vulgarmente conhecida como feijão-bravo-do-ceará, é uma planta herbácea com grande potencial de produção de biomassa e rusticidade durante o período de baixa disponibilidade hídrica, aliado à grande eficiência de fixação de nitrogênio. O objetivo deste artigo é avaliar os principais compostos nitrogenados e a translocação deles da semente para a plântula durante e após a germinação. Para tanto, o experimento foi conduzido em câmara de germinação, sendo as plântulas mantidas em vasos de 4 L contendo vermiculita durante todo o período experimental. As plântulas foram coletadas em intervalos de dois dias até a senescência e abscisão dos cotilédones, que se deu 16 dias após a germinação (protrusão da radícula. Em cada uma das épocas de coleta, as plântulas foram separadas em raízes, caule, folhas e cotilédones e, em triplicata, foram analisados o conteúdo de proteínas totais, aminoácidos solúveis totais, canavanina, ureídeos (alantoína e ácido alantoico e nitrato em todos os tecidos. Observou-se redução nos níveis de canavanina e proteína total à medida que se aumentou o período de coleta, com o desaparecimento dos níveis de canavanina após 16 dias. Proteínas e aminoácidos apresentaram concentrações inversamente proporcionais, ou seja, ocorrendo o aumento de um há diminuição do outro até a senescência e abscisão dos cotilédones. Detectou-se presença de nitrato nos tecidos das plântulas até a última coleta (16 dias após a germinação. A concentração de ureídeos (ácido alantoico e alantoína foi elevada durante todo o período avaliado, indicando ser componentes do metabolismo de nitrogênio de C. brasiliensis, ocorrendo síntese de novo.

Avaliação morfofisiológica em mudas de Handroanthus impetiginosus (Mart. ex DC. Mattos durante a rustificação

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Paulo Ricardo Lima

Full Text Available Este trabalho objetivou quantificar os efeitos do manejo hídrico durante a rustificação de mudas de Handroanthus impetiginosus, por meio da termometria foliar e por parâmetros morfométricos de qualidade. Os tratamentos foram: irrigação diária (controle, a cada dois, três e quatro dias, em 60 mudas por tratamento, durante quatro semanas. As mensurações envolveram a medição da temperatura foliar (TF, os incrementos na altura, no diâmetro de colo e na massa seca radicular. As quantificações da TF ocorreram ao final do ciclo de cada manejo de irrigação e, para as demais variáveis, realizaram-se as análises no início e no final da rustificação. Mudas de H. impetiginosus irrigadas diariamente apresentaram maior incremento em diâmetro em relação às irrigadas a cada três dias e as mudas irrigadas a cada quatro dias apresentaram maior crescimento do sistema radicular e redução no crescimento aéreo. Contudo, o uso da termometria infravermelho permitiu aferir a TF em mudas de H. impetiginosus durante a rustificação, verificando que, com o prolongamento do período de estresse hídrico, houve o aumento gradativo da temperatura foliar, sendo a maior delas observada em mudas irrigadas a cada quatro dias.

¿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.

Poor man's NOTES: can it be a good approach for adhesiolysis? A first case report with video demonstration.

Science.gov (United States)

Baekelandt, Jan

2015-01-01

To show that in selected cases transvaginal NOTES can be a frugally innovative approach for adhesiolysis and that it can be performed in a low-cost setting. Step-by-step explanation of the technique using videos and pictures (educative video). A 51-year old (para 2, gravida 2) presented with meso- and hypogastric pain. Two years before, an umbilical hernia had been repaired using a Proceed Ventral Patch mesh. The diagnosis of pain caused by adhesions was made, and laparoscopic adhesiolysis was planned. On ultrasound, a small left ovarian fibroma was visualized. Because of the suspected umbilical location of the adhesions, we decided to use a transvaginal NOTES approach to perform adhesiolysis and left adnexectomy. Pathological examination confirmed a small benign papillary serous adenofibroma of the ovary. A transvaginal NOTES approach to perform adhesiolysis combined with left adnexectomy using only standard reusable laparoscopic instruments and a low-cost self-constructed NOTES port. The procedure and postoperative recovery were uneventful. No minor or major complications occurred. The patient has been cured of her pain. Transvaginal NOTES is a novel approach that requires further validation. This case report shows that transvaginal NOTES can be used to perform adhesiolysis for abdominal pain and that it can be performed in a low-cost setting without the need for expensive ports or disposable instruments. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

La influencia del contexto familiar en el desarrollo de conductas violentas durante la adolescencia: factores de riesgo y de protección

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Marta María Aguilar Cárceles

2012-12-01

Full Text Available Se presenta una síntesis bibliográfica de los principales factores de riesgo y protección relacionados con la manifestación de conductas violentas. De manera más específica, y tras una selección de los estudios de investigación más significativos hasta la fecha, este trabajo orienta su objetivo fundamental al análisis de aquellos factores que en el contexto familiar pueden afectar el origen, el desarrollo o la paliación de la expresión de comportamientos antisociales durante la adolescencia. Sin embargo, y con una finalidad introductoria, se hace previamente una exposición de las teorías que fundamentan la existencia de tal relación, así como su continuidad durante la vida adulta.

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.

Estudio morfométrico sobre el desarrollo y evolución de las glándulas tiroides durante la metamorfosis de Bufo arenarum

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Miranda, Leandro Andrés

1996-01-01

Full Text Available Se ha estudiado el desarrollo y la evolución de las glándulas tiroideas durante la morfogénesis de Bufo arenarum. Usando diferentes parámetros morfométricos, hemos relacionado el crecimiento y desarrollo larval con el desarrollo de las glándulas tiroideas. Se observó que la longitud total, el peso de las larvas, el volumen glandular tiroideo y el diámetro folicular, aumentan hasta el estadio XV (fin de la prometamorfosis, mientras que el número de folículos y la altura de las células foliculares tiroideas se incrementan hasta el estadio XVII (mitad del clímax metamórfico. Todos estos parámetros disminuyeron considerablemente durante el clímax metamórfico mientras que en animales postmetamórficos se observó un incremento en los valores registrados. En base a los resultados obtenidos concluimos que hay un período de síntesis y almacenamiento de hormonas tiroideas durante el crecimiento larval y un segundo período caracterizado por la liberación de hormonas tiroideas hacia el final de la prometamorfosis y durante el clímax metamórfico. We studied the development and evolution of thyroid glands during Bufo arenarum morphogenesis. Using different morphometric parameters we related larval growth and metamorphosis with thyroid glands development We observed that total length, larval weight, thyroid gland volume and follicle diameter increased until stage XV (end of prometamorphosis, meanwhile the number of follicles and follicle cell height increased until stage XVII (midclimax. All these parameters decreased during metamorphic climax and an increase was observed in postmetamorphic animals. Our results lead us to conclude that during larval growth there is a period of synthesis and store of thyroid hormones. There is a second period characterized by thyroid hormones release during the end of prometamorphosis and metamorphic climax.

Monitorização materno-fetal durante procedimento odontológico em portadora de cardiopatia valvar Monitoreo maternofetal durante procedimiento odontológico en portadora de cardiopatía valvular Maternal-fetal monitoring during dental procedure in patients with heart valve disease

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Itamara Lucia Itagiba Neves

2009-11-01

Full Text Available FUNDAMENTO: Os efeitos da anestesia local em odontologia com lidocaína e epinefrina, sobre parâmetros cardiovasculares de gestantes portadoras de valvopatias e seus conceptos, não estão esclarecidos. OBJETIVO: Avaliar e analisar parâmetros da cardiotocografia, de pressão arterial e eletrocardiográficos da gestante portadora de doença valvar reumática, quando submetida à anestesia local com 1,8 ml de lidocaína 2% sem vasoconstritor e com epinefrina 1:100.000, durante procedimento odontológico restaurador. MÉTODOS: Realizamos monitorização ambulatorial da pressão arterial, eletrocardiografia ambulatorial materna e cardiotocografia de 31 portadoras de cardiopatia reumática, entre a 28ª e 37ª semana de gestação, divididas em dois grupos conforme presença ou não do vasoconstritor RESULTADOS: Demonstrou-se redução significativa dos valores de frequência cardíaca materna nos dois grupos, durante o procedimento, quando comparado aos demais períodos (p 0,05. O mesmo ocorreu (p > 0,05 com número de contrações uterinas, nível e variabilidade da linha de base e número de acelerações da frequência cardíaca fetal. CONCLUSÃO: O uso de 1,8 ml de lidocaína 2% associado à adrenalina mostrou-se seguro e eficaz em procedimento odontológico restaurador durante a gestação de mulheres com cardiopatia valvar reumática.FUNDAMENTO: Los efectos de la anestesia local en odontología con lidocaína y epinefrina, sobre los parámetros cardiovasculares de gestantes portadoras de valvulopatías y sus conceptos, no son claros. OBJETIVO: Evaluar y analizar parámetros de la cardiotocografía, de la presión arterial y electrocardiográficos de la gestante portadora de enfermedad valvular reumática, al someterse a anestesia local con 1,8 ml de lidocaína 2% sin vasoconstrictor y con epinefrina 1:100.000, durante procedimiento odontológico restaurador. MÉTODOS: Realizamos monitoreo ambulatorio de la presión arterial

Síntesis de las enzimas de piruvato, oxidorreductasa de ferredoxina y deshidrogenasa E de alcohol durante el desenquistamiento (excystacion de Giardia intestinalis

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Carlos Alberto Niño

2010-03-01

Conclusiones. Nuestros resultados muestran de forma concluyente que las enzimas PFOR y ADHE son traducidas en el proceso de desenquistamiento (excystacion y esto demuestra que existe un proceso activo de síntesis de proteínas durante él.

Características de la violencia durante el embarazo en adolescentes de Lima, Perú

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Hans Contreras-Pulache

2013-09-01

Full Text Available 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 antecedente de violencia se operacionalizó en: violencia verbal (insultos, ridiculizaciones, humillación; violencia física (jalones del brazo, jalones de los cabellos, empujones; agresión directa (puñetes, cachetadas, patadas, quemaduras, y violencia sexual (relaciones sexuales sin consentimiento. Resultados. Se incluyeron 292 madres adolescentes. La edad promedio fue de 16,5 ± 1 año. En cuanto a estado civil, el 47,9% era conviviente y el 51,4% soltera. El motivo del embarazo fue por relación consentida en el 97,3% y por violación sexual en el 2,7%. El 90,1% de las madres adolescentes refirió no haber planificado el embarazo. El antecedente de violencia reportado fue en 48,1% de violencia verbal; 17,1% violencia física; 8,2% agresión directa, y 6,8% de violencia sexual. Conclusiones. La violencia durante el embarazo adolescente no es un hecho aislado, sino que es altamente frecuente en cualquiera de sus formas

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.

Suicidio en las cárceles de Chile durante la década 2006-2015

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Francisco Ceballos-Espinoza

2016-12-01

Full Text Available Chile presenta un alarmante incremento de suicidios, tanto en población general como intrapenitenciaria, lo que preocupa a las autoridades de justicia y salud. Objetivo: analizar los suicidios consumados por prisioneros en cárceles chilenas durante los años 2006-2015, para obtener el perfil de características sociocriminógenas del acto suicida y de los centros penitenciarios. Metodología: de un total de 162 suicidios, se analizaron los 132 casos examinados por la Policía de Investigaciones de Chile. Resultados: 97,7% de los suicidios ocurrieron en hombres de todas las edades (de 16 a 74 años; dos terceras partes (66,7% sucedieron en personas con ingresos previos a prisión, aunque la mayoría no tenían antecedentes penales ni condenas anteriores (97,7%. Una mayoría (65,1% ocurrieron durante el primer año de ingreso. El 73,5% eran solteros, 47% solo tenían estudios básicos, 84,8% no poseían oficio estable. En 43,2% se reportó estado depresivo como desencadenante del suicidio, y el método más común fue ahorcamiento (97%. Se encontraron diferencias con estadísticas significativas de ciertas correlaciones, como entre nivel de estudios y motivo manifestado para el suicidio, y entre nivel de estudios e ingresos previos a prisión; asimismo, una correlación relevante que muestra que a menor edad, más ingresos a prisión y menor nivel de estudios.

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.

Quienes protestan y por qué: construcción de destinatarios durante el conflicto en torno a las retenciones móviles en la Argentina (marzo-julio 2008)

OpenAIRE

Palma, Alejandra Gabriela

2017-01-01

El presente trabajo forma parte de un proyecto de investigación que, desde el análisis crítico del discurso, se propone estudiar el discurso político mediatizado durante el conflicto agrario argentino del año 2008. El propósito de este artículo es detectar y analizar, en los discursos emitidos por los representantes de las entidades agrarias en los principales actos convocados durante el conflicto, las recurrencias en cuanto la construcción discursiva de distintos tipos de destinatarios (Veró...

Manifestaciones ocultas de violencia, durante el desarrollo del recreo escolar

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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

Páncreas heterotópico como causa de invaginación intestinal: primer caso reportado en el Perú

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Carlos Bazán Zender

2015-09-01

Full Text Available El páncreas heterotópico (PH es una condición rara en la población pediátrica. Los casos de PH que conllevan a una invaginación ileal, son infrecuentes en niños y muy raramente reportados, usualmente mostrándose con síntomas de obstrucción intestinal. Se presenta el caso de un paciente varón de un año de edad, con una historia crónica de anorexia, irritabilidad, dolor abdominal, acompañado de episodios intermitentes de sangrado tipo "jalea de grosella" que evoluciona a sangrado rectal rutilante. El paciente presenta un diagnóstico concomitante de colitis alérgica, lo cual prolonga el tratamiento quirúrgico efectivo en un centro asistencial externo. En la tomografía abdominal se encuentra el signo de la "escarapela" clásico. En la laparotomía exploratoria se confirma invaginación ileoileal, se encuentra una masa que el laboratorio de histopatología confirma como PH. A nuestro conocimiento, es el primer caso de invaginación por PH pediátrico reportado en el Perú.

Comportamiento de algunos parámetros de los azúcares crudos analizados durante el quinquenio 2006-2010. Parte 2

OpenAIRE

Roberto J. Rodríguez-Mambuca; Julián Rodríguez-López; Jesús Mesa-Oramas; Alejandra Sánchez-Herrera; Miriam Gay-Querol Camacho

2014-01-01

El objetivo del presente trabajo es brindar información sobre el comportamiento de diferentes parámetros con incidencia en la calidad del azúcar crudo producido durante el quinquenio 2006-2010 tales como: par- tículas ferromagnéticas, ceniza, granulometría, insolubles, dextrana y almidón, y evaluar las tendencias de esos índices por provincias.

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 ...

Análisis de Tensiones mediante Elementos Finitos de una Válvula Esférica durante la Prueba Hidrostática, y su Verificación Experimental

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Gualda, Néstor J; Sanzi, Héctor C; Ortiz, Luis

2010-01-01

En este trabajo se presenta el análisis de tensiones y deformaciones en el cuerpo de una válvula esférica de diámetro 8" serie 600, durante la prueba hidrostática, utilizando el método de elementos finitos. Se verifica el modelo con datos experimentales de tensiones, utilizando indicadores de deformación SG (Strain Gauges). Para el análisis mediante el método de elementos finitos se utilizó el programa Cosmos/M e información obtenida durante el análisis experimental. Las pruebas experimentale...

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...

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...

Direct target NOTES: prospective applications for next generation robotic platforms.

Science.gov (United States)

Atallah, S; Hodges, A; Larach, S W

2018-05-01

A new era in surgical robotics has centered on alternative access to anatomic targets and next generation designs include flexible, single-port systems which follow circuitous rather than straight pathways. Such systems maintain a small footprint and could be utilized for specialized operations based on direct organ target natural orifice transluminal endoscopic surgery (NOTES), of which transanal total mesorectal excision (taTME) is an important derivative. During two sessions, four direct target NOTES operations were conducted on a cadaveric model using a flexible robotic system to demonstrate proof-of-concept of the application of a next generation robotic system to specific types of NOTES operations, all of which required removal of a direct target organ through natural orifice access. These four operations were (a) robotic taTME, (b) robotic transvaginal hysterectomy in conjunction with (c) robotic transvaginal salpingo-oophorectomy, and in an ex vivo model, (d) trans-cecal appendectomy. Feasibility was demonstrated in all cases using the Flex ® Robotic System with Colorectal Drive. During taTME, the platform excursion was 17 cm along a non-linear path; operative time was 57 min for the transanal portion of the dissection. Robotic transvaginal hysterectomy was successfully completed in 78 min with transvaginal extraction of the uterus, although laparoscopic assistance was required. Robotic transvaginal unilateral salpingo-oophorectomy with transvaginal extraction of the ovary and fallopian tube was performed without laparoscopic assistance in 13.5 min. In an ex vivo model, a robotic trans-cecal appendectomy was also successfully performed for the purpose of demonstrating proof-of-concept only; this was completed in 24 min. A flexible robotic system has the potential to access anatomy along circuitous paths, making it a suitable platform for direct target NOTES. The conceptual operations posed could be considered suitable for next generation robotics once

Evaluación de la fertilización con sulfato de magnesio durante el período de llenado en trigo duro (Trititicum durum) bajo riego

OpenAIRE

Vázquez Amábile, Gabriel G.; Turquieto, P.; Mander, Claudio Mario; Mejía, Pablo Francisco; Vidart, Santiago José

2000-01-01

p.443-448 Durante la campaña triguera 1998, en La Dulce, partido de Necochea, se llevó a cabo un ensayo con el fin de evaluar el efecto de la fertilización con S04Mg en trigo (Triticum durum) bajo riego, durante el llenado de grano sobre el contenido de gluten y la calidad panadera. Para ello se utilizó S04Mg como fuente azufrada, aplicándose tres dosis en forma foliar al comienzo del llenado de grano. Los tratamientos fueron 0, 8, 12 y 16 kg deS -ha. La fertilización con S04Mg produjo un ...

Efeitos da adição do óxido nitroso na anestesia durante pneumoperitônio em intervenção cirúrgica videolaparoscópica

OpenAIRE

Fernandes, Cláudia Regina; Souza Filho, Lenilson Marinho; Gomes, Josenilia Maria Alves; Messias, Erik Leite; Escalante, Rodrigo Dornfeld

2007-01-01

JUSTIFICATIVA E OBJETIVOS: A instalação do pneumoperitônio durante intervenção cirúrgica videolaparoscópica induz à ativação de mecanismos neuroendócrinos, alterações cardiovasculares e hormonais. O objetivo deste estudo foi avaliar os efeitos da adição do óxido nitroso sobre a resposta simpática cardiovascular e a concentração expirada de sevoflurano (CEsevo) durante o pneumoperitônio, objetivando manter adequação anestésica avaliada por meio de parâmetros hemodinâmicos, do BIS e SEF95% em c...

Evaluación de la presión arterial media durante la cirugía de implante dental

Directory of Open Access Journals (Sweden)

Rolando Carrasco

2014-07-01

Conclusión: Se observa un alza significativa en los valores de PM registrados en los individuos durante la cirugía de implantes, por lo que es importante considerar esta alza en todos los pacientes que serán sometidos a dicho procedimiento y más aún en aquellos que ya posean valores elevados de su presión arterial de manera a evitar posibles complicaciones.

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

La micro y pequeña empresa como generadora de empleo en Baja California durante la crisis de 2008-2009

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Alejandro Mungaray Lagarda

2016-01-01

Full Text Available El objetivo del trabajo ha sido evaluar la importancia de la conformación del tejido empresarial en la evolución de la actividad económica y la generación de empleo en Baja California en el entorno de la crisis global de 2008-2009, con énfasis en el comportamiento de la micro y pequeña empresa. Lo anterior se consigue a través de la metodología de un análisis de correspondencias de carácter exploratorio y otro econométrico con fines confirmatorios en los cuales se utilizaron variables de los estratos empresariales y los sectores económicos una vez revisados los indicadores poblacionales, migratorios y de la estructura productiva. Como resultados se encontró una relación directa y significativa de las microempresas con el volumen de negocios y el empleo durante la crisis, sin embargo, en el periodo post-crisis (2010-2014 la aportación de la pequeña empresa resultó muy superior. Por su parte, las grandes empresas, mostraron menor sensibilidad general y una reducción de su capacidad para generar empleo aún durante el periodo post-crisis. En cualquier caso, debemos señalar que la limitante es que los resultados deben ser tomados con cautela debido a la alta segregación por estrato. Se concluye que no es posible rechazar la hipótesis de que la micro, pero sobre todo la pequeña empresa jugó un papel estratégico en la generación de empleo y dinamismo económico durante el periodo de crisis, contribuyendo incluso a aminorar su impacto, por lo que se debe fortalecer una política industrial que favorezca el aprendizaje y la innovación de este sector empresarial.

The Role of Vaginal Mesh Procedures in Pelvic Organ Prolapse Surgery in View of Complication Risk

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David R. Ellington

2013-01-01

Full Text Available Synthetic transvaginal mesh has been employed in the treatment of pelvic organ prolapse for more than a decade. As the use of these devices increased during this period so did adverse event reporting. In 2008, the Food and Drug Administration (FDA Public Health Notification informed physicians and patients of rising concerns with the use of synthetic transvaginal mesh. Shortly thereafter and in parallel to marked increases in adverse event reporting within the Manufacturer and User Device Experience (MAUDE, the FDA released a Safety Communication regarding urogynecologic surgical mesh use. Following this report and in the wake of increased medical industry product withdrawal, growing medicolegal concerns, patient safety, and clinical practice controversy, many gynecologists and pelvic reconstructive surgeons are left with limited long-term data, clinical guidance, and growing uncertainty regarding the role of synthetic transvaginal mesh use in pelvic organ prolapse. This paper reviews the reported complications of synthetic transvaginal mesh with an evidence-based approach as well as providing suggested guidance for the future role of its use amidst the controversy.

The Role of Vaginal Mesh Procedures in Pelvic Organ Prolapse Surgery in View of Complication Risk

Science.gov (United States)

Ellington, David R.; Richter, Holly E.

2013-01-01

Synthetic transvaginal mesh has been employed in the treatment of pelvic organ prolapse for more than a decade. As the use of these devices increased during this period so did adverse event reporting. In 2008, the Food and Drug Administration (FDA) Public Health Notification informed physicians and patients of rising concerns with the use of synthetic transvaginal mesh. Shortly thereafter and in parallel to marked increases in adverse event reporting within the Manufacturer and User Device Experience (MAUDE), the FDA released a Safety Communication regarding urogynecologic surgical mesh use. Following this report and in the wake of increased medical industry product withdrawal, growing medicolegal concerns, patient safety, and clinical practice controversy, many gynecologists and pelvic reconstructive surgeons are left with limited long-term data, clinical guidance, and growing uncertainty regarding the role of synthetic transvaginal mesh use in pelvic organ prolapse. This paper reviews the reported complications of synthetic transvaginal mesh with an evidence-based approach as well as providing suggested guidance for the future role of its use amidst the controversy. PMID:24069035

Distribuição da sacarose-fosfato sintase e sacarose sintase em bananas durante o amadurecimento

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BASSINELLO Priscila Z.

1999-01-01

Full Text Available A hidrólise do amido e a síntese de açúcares durante o amadurecimento da banana são transformações bioquímicas importantes, havendo evidências de que ocorrem de forma homogênea no fruto. Para confirmar este fato, amostras de banana nanicão (Musa spp. colhidas aos 110 dias pós-antese, foram coletadas no decorrer do amadurecimento e foram determinados os teores de amido, hexoses e sacarose e a atividade das enzimas sacarose-fosfato sintase (SPS e sacarose sintase (SS em diferentes partes do fruto. Observou-se que na banana verde, existe mais amido na porção periférica (18% do que na central (13%. Porém, a sua velocidade de degradação durante o amadurecimento é a mesma, o que resulta em teores diferenciados de amido residual na banana madura. Também o aparecimento e acúmulo de sacarose foi simultâneo nas duas regiões e coincidente com os valores máximos de atividade da SPS. Utilizando-se de técnica de identificação por anticorpos específicos para SS e SPS em tecidos verde e maduro, observou-se uma distribuição homogênea das enzimas e aparente correlação entre a cor desenvolvida e a variação de atividade.

Caracterización de las necropsias medicolegales realizadas en la regional Bogota del Instituto Nacional de medicina legal y ciencias forenses a población adulta mayor durante 2009

OpenAIRE

Rosero Vallejos, Yaqueline Lucrecia

2013-01-01

Objetivo Se caracterizaron las necropsias médico-legales realizadas en la regional Bogotá del Instituto Nacional de Medicina Legal y Ciencias Forenses, a población adulta mayor durante 2009. Materiales y métodos Se realizo un estudio transversal retrospectivo, basado en la base de datos de las necropsias médico-legales realizadas durante el periodo en mención, caracterizando las causas y maneras de muertes obtenidas a través de las 981 necropsias registradas en el Instituto en 2009. Resultado...

Alterações transitórias do exame neurológico durante o despertar da anestesia com enflurano, isoflurano ou sevoflurano Alteraciones transitorias del examen neurológico durante el despertar de la anestesia con enflurano, isoflurano o sevoflurano Transient neurological changes during emergence from enflurane, isoflurane or sevoflurane anesthesia

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Luiz Fernando Soares

2001-12-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: Anormalidades transitórias do exame neurológico ocorrem durante o despertar da anestesia com halotano, enflurano e isoflurano. Pouco se conhece sobre a ocorrência de anormalidades do exame neurológico durante a recuperação da anestesia com sevoflurano. Este estudo teve como objetivo comparar a prevalência de tais achados durante a recuperação da anestesia com enflurano (Grupo E, isoflurano (Grupo I e sevoflurano (Grupo S. MÉTODO: Foram estudados 44 pacientes que receberam anestesia com enflurano, isoflurano ou sevoflurano em N2O a 50%. Foram anotados antes da indução, imediatamente após a cessação da administração do anestésico e 5, 10, 15, 20, 30 e 40 minutos após: temperatura timpânica, nível de consciência, tônus muscular, reflexos pupilar, ciliar, bicipital, patelar e cutâneo-plantar, bem como a ocorrência de calafrios. RESULTADOS: As respostas dos reflexos pupilar, ciliar, patelar e cutâneo-plantar correlacionaram-se com o nível de consciência. Os grupos não diferiram quanto à prevalência de hipertonia muscular, hiperreflexia bicipital, clônus plantar e resposta extensora cutâneo-plantar. Hiperreflexia patelar foi mais freqüente no grupo do enflurano do que no grupo do isoflurano. Calafrios foram mais freqüentes nos grupos E e I do que no grupo do sevoflurano. A temperatura timpânica não diferiu entre os pacientes que apresentaram ou não calafrios. CONCLUSÕES: Alterações reversíveis do exame neurológico podem estar presentes por até 40 minutos durante a recuperação da anestesia com enflurano, isoflurano ou sevoflurano.JUSTIFICATIVA Y OBJETIVOS: Anormalidades transitorias del examen neurológico ocurren durante el despertar de la anestesia con halotano, enflurano e isoflurano. Poco se conoce sobre la ocurrencia de anormalidades del examen neurológico durante la recuperación de la anestesia con sevoflurano. Este estudio tuvo como objetivo comparar la prevalencia de tal

EVALUACIÓN DEL ÍNDICE DE PERÓXIDO DEL AJO FRITO DURANTE EL ALMACENAMIENTO

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Patricia Prati

2014-06-01

Full Text Available El objetivo fue evaluar la alteración oxidativa del ajo (Allium sativum L. frito durante seis meses de almacenamiento a temperatura ambiente mediante la determinación del índice de peróxido de la fracción lipídica. Fueron procesados cinco cultivares de ajo: roxinho, santa catarina roxo, gigante de curitibanos y assaí, uno importado de China de cultivar desconocido. Los ajos fueron procesados de dos formas, picados y laminados, luego fritos por inmersión en grasa pastosa de origen vegetal marca mazola chef a 180°C por 3 minutos. Después de enfriados fueron envasados en potes plásticos de polietileno de alta densidad (PEAD con tapa del mismo material. La determinación del índice de peróxido se llevó a cabo en el tiempo cero y cada 45 días, hasta los 180 días de almacenamiento. A lo largo del almacenamiento, se observó un aumento del índice de peróxido, para todos los cultivares, sin embargo al final de los 180 días todos llos valores aún estaban debajo de los límites citados por la literatura. El mayor valor de 5.4 ± 0.1 meq O2/kg se obtuvo para el cultivar conocido comercialmente como Chinês laminado y frito. La mayoría de las muestras de ajos fritos laminados mostró valores de peróxidos superiores a las de ajos frito picados, con excepción de los cultivares santa catarina roxo y gigante de curitibanos, en el tiempo cero. Los valores de índice de peróxido encontrados indican que los productos se mantuvieron estables en relación a la reacción de oxidación,durante el período de almacenamiento.

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 ...

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 ...

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-...

Protocolo de cuidados de enfermagem no ambiente aeroespacial à pacientes traumatizados - cuidados durante e após o voo

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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.

Barreras para la atención en salud durante el diagnóstico y tratamiento del cáncer gástrico

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Angélica María Amado-Niño

2017-03-01

Full Text Available Introducción: El cáncer gástrico es una neoplasia maligna de alta morbimortalidad. Ocupa el quinto lugar en prevalencia mundial. Objetivo: Describir las barreras para la atención en salud durante el diagnóstico y tratamiento del cáncer gástrico. Metodología: Para la revisión de la literatura se emplearon bases de datos (PubMed, Lilacs, Ebsco, Science-direct, Ovid y google académico, que incluyó la consulta de ensayos clínicos, revisiones de tema y guías de manejo relacionadas con cáncer gástrico y sus barreras durante el diagnóstico y tratamiento, entre 2009- 2016. Resultados: 56 artículos cumplieron con los criterios de inclusión y exclusión. Las barreras halladas son administrativas, institucionales, económicas, culturales y de conocimientos del paciente y el médico, que limitan el acceso a la atención médica. Conclusión: En Colombia, la fragmentación y segmentación del sistema de salud impone barreras en la atención de los adultos con cáncer gástrico ocasionando las disparidades en salud que impactan en su sobrevida. [Amado-Niño AM, Mantilla-Villabona LY, Ospina-Galeano DC, Maturana-Martínez DMA, Uribe-Pérez CJ. Barreras para la atención en salud durante el diagnóstico y tratamiento del cáncer gástrico. MedUNAB 2017; 19(3: 211-220

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.

Granuloma telangiectásico en cavidad oral

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Antonio José Díaz Caballero

Full Text Available El granuloma telangiectásico se considera como una lesión benigna no neoplásica de la mucosa gingival de tipo reactivo asociado a trauma. Durante varios años tuvo diferentes nombres dentro de los que destacan granuloma piógeno del embarazo o gravídico, hemangioma capilar lobular y épulis. Histológicamente se caracteriza por una proliferación vascular, infiltrado inflamatorio crónico y tejido de granulación. El objetivo del presente caso es describir las características clínicas e histológicas de un granuloma telangiectásico en cavidad oral y su plan de tratamiento. Llega a consulta paciente femenina de 50 años de edad, refiere presentar sangrado gingival en repetidas ocasiones en zona posterior de la arcada dentaria superior, durante el cepillado o con el consumo de algunos alimentos. Clínicamente se observa prótesis provisional desadaptada en órganos dentarios 11 al 15. Al retirar la prótesis es notorio un aumento de volumen en la encía interdental, con aspecto eritematoso, que sangra con facilidad. El reporte de anatomía patológica mostró una lesión con engrosamiento del epitelio escamoso, formación de nuevos vasos sanguíneos e infiltrado inflamatorio crónico. Diagnosticado como granuloma telangiectásico. La lesión fue eliminada quirúrgicamente por alargamiento coronal con reducción ósea. Ocho días después de la cirugía se evidencia proceso de cicatrización sin ninguna complicación. La lesión presentó recidiva transcurrido seis meses. Ello nos lleva a destacar la importancia del control de factores locales, como la presencia de prótesis desadaptadas y el acúmulo de placa bacteriana luego de la eliminación quirúrgica de este tipo de lesiones.

Cuidado e conforto durante o trabalho de parto e parto: na busca pela opinião das mulheres

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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.

Complicações na rede venosa de mulheres com câncer de mama durante tratamento quimioterápico Complicaciones en la red venosa de mujeres con cáncer de mama durante tratamiento quimioterapéutico Complications in the venous network of women with breast cancer during chemotherapy treatment

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Elga Zacharias Martins

2010-01-01

Full Text Available OBJETIVOS: Identificar as reações da rede venosa, investigar a frequência e as características dessas reações em mulheres com câncer de mama durante o tratamento quimioterápico. MÉTODOS: Foram avaliados 339 prontuários de mulheres submetidas à quimioterapia, de 2003 a 2007. RESULTADOS: Durante os tratamentos neoadjuvantes e adjuvantes 17,1% e 22,4% mulheres apresentaram intercorrências registradas no prontuário, sendo as frequentes: extravasamento, dor e alteração na coloração da pele. As condutas mais citadas na neoadjuvância foram: utilização de compressas frias (2,9% e aplicação de glicocorticoide subcutâneo no local (3,5% e na adjuvância foram: aplicação de hidrocortisona subcutâneo no local (3,2%, aplicação do protocolo de extravasamento (6,2% e utilização de compressas de gelo (7,1%. CONCLUSÃO: O registro das intercorrências e o relato da equipe de enfermagem são essenciais para o acompanhamento dos sítios de punções venosas utilizados durante o tratamento quimioterápico, além de mensuração e registro fotográfico do local.OBJETIVOS: Identificar las reacciones de la red venosa e investigar la frecuencia y las características de esas reacciones en mujeres con cáncer de mama durante el tratamiento quimioterapéutico. MÉTODOS: Fueron evaluadas 339 fichas de mujeres sometidas a quimioterapia, de 2003 a 2007. RESULTADOS: Durante los tratamientos neo-adyuvantes y adyuvantes (17,1% y 22,4% las mujeres presentaron ocurrencias registradas en fichas, siendo las más frecuentes: infiltración externa, dolor y, alteración en la coloración de la piel. Las conductas neo-adyuvantes más citadas fueron: utilización de compresas frías (2,9% y aplicación de glucocorticoide subcutáneo en el local (3,5%, y las adyuvantes fueron: aplicación de hidrocortisona subcutánea en el local (3,2%, aplicación del protocolo de infiltración externa (6,2% y utilización de compresas de hielo (7,1%. CONCLUSIÓN: El

Atividade eletromiográfica durante o agachamento unipodal associado a diferentes posições do pé Actividad electromiográfica durante el agache unipodal asociado a diferentes posiciones del pie Electromyographic activity during one-legged squatting under different foot positions

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Gabriel Ribeiro

2007-02-01

Full Text Available O objetivo principal deste estudo foi quantificar a atividade muscular durante a realização de agachamento unipodal com variações na técnica. Oito voluntários saudáveis realizaram agachamentos associados a cinco tipos de posição do pé: posição neutra, sobre cunha com 10º de declive, sobre cunha com 10º de aclive, sobre cunha com 10º de inclinação medial e sobre cunha com 10º de inclinação lateral. Foram avaliados os dados eletromiográficos dos músculos vasto medial oblíquo, vasto lateral, reto femoral, bíceps femoral, gastrocnêmio lateral e tibial anterior, utilizando a ANOVA fator único. O valor eletromiográfico integrado de todos os músculos não foi estatisticamente diferente nos cinco tipos de posição do pé. Os resultados deste estudo sugerem que diferentes tipos de posicionamento do pé durante o agachamento unipodal não provocam alterações no padrão de recrutamento muscular.El objetivo principal de este estudio ha sido cuantificar la actividad muscular durante la realización de agachamiento unipodal con variaciones en la técnica. Ocho voluntarios saludables realizaron agachamientos asociados a cinco tipos de posición del pie: posición neutra, sobre cuña con 10º de declive, sobre cuña con 10º de elevación, sobre cuña con 10º de inclinación media y sobre cuña con 10º de inclinación lateral. Fueron evaluados los datos electromiográficos de los músculos vasto medial oblicuo, vasto lateral, recto femoral, bíceps femoral, gastrocnemio lateral y tibial anterior, utilizando ANOVA factor único. El valor electromiográfico integrado de todos los músculos no fue estadísticamente diferente en los cinco tipos de posición del pie. Los resultados de este estudio sugieren que diferentes tipos de posicionamiento del pie durante el proceso de agachamiento unipodal no provocan alteraciones en el padrón de reclutamiento muscular.The specific aim of this study was to quantify muscle activity while

Avaliação da pressão arterial e da frequência cardíaca durante imersão em repouso e caminhada

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Kalina Durigon Keller

Full Text Available OBJETIVO: Este estudo teve como objetivo avaliar o comportamento da pressão arterial e a frequência cardíaca de indivíduos hipertensos e normotensos durante repouso e caminhada enquanto imersos na água em diferentes profundidades. MÉTODO: Foram avaliados 20 indivíduos, 10 hipertensos e 10 normotensos. Todos foram submetidos a 4 avaliações, sendo uma imerso em repouso até a profundidade do processo xifoide durante 20 minutos e outras 3 caminhando durante 20 minutos à intensidade de 65% da frequência cardíaca de reserva, cada uma delas em uma profundidade diferente, cicatriz umbilical, processo xifoide e ombros. RESULTADOS: Os resultados com atividades de caminhada quando comparados com os de repouso evidenciaram que somente a imersão na água parece não causar modificações na frequência cardíaca, mas que esta aumenta durante a execução da atividade aeróbica a uma intensidade moderada dentro da água. Com relação à pressão arterial, foi possível observar que, quando o indivíduo permaneceu imerso em repouso, após sair da água, ela teve um aumento súbito. Porém, quando se associou a imersão com a atividade aeróbica, após a saída da água, a PA teve uma diminuição e ela se manteve, pelo menos por 20 minutos, significativamente inferior ao início da sessão, antes de imergir e começar o exercício. Essa redução foi mais evidente quando o exercício foi realizado na profundidade do processo xifoide. CONCLUSÕES: O exercício aeróbico realizado na água em temperatura neutra contribui para a diminuição da pressão arterial tanto de indivíduos hipertensos como de normotensos, tornando-se um importante aliado no controle da pressão arterial.

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

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Évelyn Traina

2004-01-01

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

CARACTERIZACIÓN DE LA CONDICIÓN PERIODONTAL, HÁBITOS Y COSTUMBRES EN SALUD ORAL EN INDÍGENAS DE COMUNIDADES AMAZÓNICAS DE COLOMBIA: TARAPACÁ, AMAZONAS

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Yeni Patricia Molina Ibañez

2012-12-01

Full Text Available Hay pocos estudios en el Amazonas Colombiano que permitan conocer el estado real de salud periodontal en esta población. El ENSAB III (Estudio Nacional de Salud Bucal evidencia condiciones desfavorables a nivel periodontal en esta zona del país. Objetivo: El propósito de este estudio fue caracterizar el estado periodontal de cuatro comunidades indígenas pertenecientes al corregimiento de Tarapacá, Amazonas, conocer sus creencias, hábitos y actitudes frente a los conceptos de salud oral, enfermedad gingival y la necesidad de intervención que requieran o no a nivel periodontal. Materiales y métodos: 80 habitantes nativos (28 hombres y 52 mujeres, con edades que oscilan entre los 20 y 81 años; quienes diligenciaron una encuesta conteniendo datos personales como hábitos (consumo de cigarrillo, tabaco, etc. y costumbres de higiene oral; se realizó un examen periodontal, registrando características clínicas (encía: color, sangrado, movilidad dental, etc. y medidas periodontales tomadas a cada diente (margen, surco, nivel de inserción, etc.. Resultados: se observó en la población alto porcentaje de sangrado (48%, placa bacteriana (77%, cálculos (41%. P=.0.001; a pesar de tener estas características el 82% de la población presentó surcos gingivales ≤3 mm. p= 0.05. El principal motivo de pérdida dental fue extracción (46.2%. Conclusiones: A pesar de tener altos niveles de placa bacteriana, sangrado y cálculos, la mayoría de los participantes presentaba sólo gingivitis (77.5%, en pocos casos se evidenció periodontitis (21.25%. El tratamiento que requieren es de baja complejidad y no se encontró relación directa entre los hallazgos encontrados, los hábitos de higiene oral y costumbres con el estado periodontal que presentan.