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Prognostic value of the ISUP 2015 Gleason grade groupingsFolkvaljon, Yasin January 2015 (has links)
Background: New prognostic grade groupings were recently proposed for prostate cancer. They are based on Gleason grading of either biopsy or prostatectomy specimen. Former Gleason 6 corresponds to group 1, Gleason 7=3+4 corresponds to group 2, Gleason 7=4+3 corresponds to group 3, Gleason 8 corresponds to group 4, and Gleason 9-10 correspond to group 5. Objective: To assess the prognostic value of Gleason grade groups in men with prostate cancer from a nationwide population‑based cohort. Design, Setting and Participants: From the National Prostate Cancer Register of Sweden, we identified 5,880 men diagnosed with prostate cancer from 2005 to 2007, including 4,325 who had radical prostatectomy and 1,555 treated by radiotherapy. Outcome Measurements and Statistical Analysis: Kaplan-Meier survival analysis was used to calculate the cumulative 4-year biochemical recurrence-free survival. Cox proportional hazards regression models were used to examine the relationship between prognostic Gleason grade groups and biochemical recurrence after radical prostatectomy and radiotherapy. The 4-year biochemical progression-free survival was compared for groups based on biopsy and prostatectomy Gleason grade groups. Results and Limitations: Among men undergoing surgery, the 4‑year biochemical progression-free survival was 89%, 82%, 74%, 77%, and 49% for prognostic Gleason grade groups 1-5 on biopsy. The corresponding 4-year biochemical progression-free survival based on prostatectomy prognostic Gleason grade groups was 92%, 85%, 73%, 63%, and 51% for prognostic Gleason grade groups 1-5. For men undergoing radiotherapy, biopsy prognostic Gleason grade groups 1-5 had 4-year biochemical progression-free survival of 95%, 91%, 85%, 78%, and 70%. After adjusting for preoperative serum prostate specific antigen and clinical stage, biopsy prognostic Gleason grade groups were significant independent predictors of biochemical progression after radical prostatectomy and radiotherapy. There was no central review of pathology. Conclusions: These results confirm the prognostic value of the newly proposed prognostic Gleason grade groups in men undergoing radical prostatectomy and radiotherapy in a population-based setting.
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Effects of dehydration time and staining technique on microscopic diagnosis of colitisLiljeroth, Annica January 2008 (has links)
<p>ABSTRACT</p><p>In the western world colitis is a common chronic disease and in Sweden the prevalence is around 1%. If a patient has bloody diarrhea it is probably ulcerative proctocolitis or Crohn’s disease, whereas if the diarrhea is watery, it is microscopic colitis. For a diagnosis, the patient has to do a colonoscopy and a colonic biopsy sample has to be taken. The biopsy sample will be sent to a laboratory for sectioning, staining and microscopic analysis.</p><p>In this study we compared the effects of short and long dehydration time of the sample before the sectioning. We also compared staining with Alcianblue/Van Gieson and Van Gieson alone.</p><p>Our results showed that a short dehydration time was a milder treatment and made it easier to section the biopsy sample. The comparison of the two methods was unsuccessful because the staining with Alcianblue/Van Gieson failed.</p>
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Routine biopsy of sonographically benign breast lesions greater than 3cm is necessary for the diagnosis of malignancy in women less than 40 years of ageKemp, Marnie Laura January 2013 (has links)
A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the
degree of Master of Medicine in Diagnostic Radiology
Johannesburg, 2013 / Palpable solid breast masses that are circumscribed and not calcified on
mammogram or ultrasound are probably benign. There is controversy therefore,
whether these deserve tissue diagnosis. More data is required to determine
whether short term follow up can replace the need for biopsy.
Benign appearing lesions greater than 3cm in diameter on ultrasound continue to
undergo biopsy due to fear that a malignancy or phyllodes tumour might be
missed. Published research reflects patients from Europe and North America, and
no relevant data from Africa exists.
AIM: This study aims to determine the histological spectrum of sonographically
benign lesions greater than 3cm, which were biopsied, in our local population
(majority of black patients) and to determine whether biopsy is indicated based on
the local cancer risk. The study also aims to characterise the results by age and
population group as well as correlate the histological result with the size of the
lesion on ultrasound, the HIV status, family history and the seniority of the
examining radiologists.
MATERIALS AND METHODS: A retrospective descriptive study of biopsy results
of sonographically benign breast masses was undertaken using biopsy procedural
recording sheets. .
The size of the lesions (continuous variables) mean with standard deviations was
determined. The prevalence of lesions was expressed as a percentage. Other
categorical variables were summarized as frequency and percentage. The
vi
histological spectrum of the lesions was determined. The HIV status and family
history of the patients as well as the seniority of the reviewing radiologist was
assessed. A Krusskal Wallis test and separate logistic regression analysis was
used.
RESULTS: A total of 68 patients (below 40 years of age) were included from a
total of 13112 patients (of all ages) seen between 2007 and the end of 2010. 73
lesions were identified (65 benign and 8 malignant). The prevalence of benign
lesions was 89.7%. .The prevalence of malignant lesions was 10.29%.There was
little evidence to support lesion size for predicting histology (p value = 0.22) or
benignity. There was little evidence that the family history and HIV status were
significant.
CONCLUSION: There was a high prevalence (10.29%) of malignancies in lesions
classified by ultrasound as benign. The size of the lesion did not correlate with
histological subtype or whether the lesion was benign or malignant.
Training of sonographers, standardization of technique for established users and
double reading, may produce a different result, as both junior and senior
radiologists mistook malignant lesions for benign ones on ultrasound. Repeating
this research using double reading after training may demonstrate whether there is
a true higher prevalence of malignancy in ultrasonically benign breast lesions in
our community. Until then, routine biopsy of these lesions is recommended.
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Avaliação do potencial antioxidante do capim-limão (Cymbopogon citratus (D.C.) Stapf) sobre a apoptose do tecido mamário e qualidade do leite de cabras Saanen / Evaluation of antioxidant potential of lemongrass (Cymbopogon citratus (D.C.) Stapf) on mammary gland apoptosis and milk quality of Saanen goatsRibeiro, Michele Ferreira 27 October 2011 (has links)
O objetivo deste estudo foi avaliar o potencial antioxidante do capim-limão (Cymbopogon citratus (D.C.) Stapf) sobre a qualidade do leite de cabra (produção, composição, características físico-químicas, contagem de células somáticas, contagem bacteriana total e oxidação lipídica) antes (Fase 1) e após a administração pontual de ACTH (Fase 2), bem como a apoptose do tecido mamário (Fase 3) de cabras leiteiras da raça Saanen em lactação. Nas Fases 1 e 2, 44 cabras foram alimentadas com ração composta por 53,2% de silagem de milho na matéria seca (MS) (T1), sendo a silagem de milho substituída em 33,5% (T2), 66,5% (T3) e 100% (T4) pelo feno de capim-limão peletizado, sendo que na Fase 3, doze cabras ao final do período de lactação (264,67 ± 31,86 dias) foram submetidas à biópsia de glândula mamária. Houve aumento numérico do consumo de matéria seca (CMS) com o aumento da inclusão de capim-limão nas duas fases experimentais (Fase 1 e 2) sem, no entanto, afetar a produção de leite. Os teores de gordura e sólidos totais na Fase 2 foram maiores nos tratamentos T1 e T3 após a indução de estresse via ACTH e reduziram linearmente com a inclusão de teores crescentes de capim-limão. Não houve diferença na contagem bacteriana total do leite nas duas fases experimentais. Já a contagem de células somáticas foi menor no tratamento T2 após a indução de estresse via ACTH e reduziu linearmente com a inclusão de níveis crescentes de capim-limão na Fase 2. A oxidação lipídica na Fase 1 não foi influenciada pelo capim-limão, mas na Fase 2 houve redução linear com a inclusão de capim-limão. A administração de ACTH não influenciou a oxidação lipídica do leite (Fase 2). Não houve efeito da inclusão de capim-limão sobre as concentrações de DNA e RNA, bem como na fragmentação do DNA (Fase 3) em gel de poliacrilamida 8%, no entanto, foi verificado efeito quadrático na contagem de células apoptóticas, com maior valor para o tratamento T2. A inclusão de níveis crescentes de capim-limão na alimentação de cabras leiteiras não reduziu a apoptose da glândula mamária, no entanto, aumentou a estabilidade oxidativa do leite, comprovando seu efeito antioxidante. / The objective of this study was to evaluate the antioxidant potential of lemongrass (Cymbopogon citrates (D.C.) Stapf) on the quality of goat\'s milk (production, composition, physical-chemical characteristics, somatic cell count, total bacterial count and lipid oxidation) before (Phase 1) and after punctual administration of ACTH (Phase 2), as well as mammary gland apoptosis (Phase 3) of milk goats of Saanen breed in lactation. In phases 1 and 2, 44 goats were fed ration composed by 53.2% of corn silage in dry matter (DM) (T1), where corn silage was substituted in 33.5% (T2), 66.5% (T3) and 100% (T4) by lemongrass pelletized hay. In phase 3, twelve goats at the end of lactation period (264.67 ± 31.86 days) were submitted to mammary gland biopsy. It was observed a numeric increase in dry matter intake (DMI) with the increase of lemongrass inclusion in two experimental phases (Phase 1 and 2) without, however, affecting milk production. The contents of fat and total solid in Phase 2 were higher in treatments T1 and T3 after stress induction through ACTH and were linearly reduced with increasing levels of lemongrass. There was no difference in total bacteria counts in milk in two experimental phases. Somatic cell counts were lower in treatment T2 after stress induction through ACTH and linearly reduced with the inclusion of increasing levels of lemongrass in Phase 2. Lipid oxidation in Phase 1 was not influenced by lemongrass inclusion but in Phase 2 there was linear reduction with lemongrass inclusion. The administration of ACTH did not influence milk lipid oxidation (Phase 2). There was no effect of lemongrass inclusion on DNA and RNA concentration, as well as in DNA fragmentation (Phase 3) in polyacrylamide gel 8%. However, it was observed quadratic effect in apoptotic cells counts with higher value for treatment T2. The inclusion of increasing levels of lemongrass in the feeding of dairy goats did not reduce the apoptosis of mammary gland, however, increased the oxidative stability of milk, proving its antioxidant effect.
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Phantom antropomórfico para treinamento de biópsia de tireoide guiada por ultrassom / Anthropomorphic phantom for training of ultrasound-guided biopsyGrillo, Felipe Wilker 30 September 2015 (has links)
O câncer de tireoide é um dos mais comuns da região da cabeça e pescoço. Atualmente, o método mais eficaz no diagnóstico de lesões da tireoide é a técnica de biópsia conhecida por punção aspirativa por agulha fina (PAAF) guiada por ultrassom. As imagens de ultrassom são utilizadas como guia para inserção de uma agulha fina até a região da lesão, onde são retirados fragmentos de tecido para análise microscópica. O sucesso dos procedimentos de biópsias está diretamente ligado a experiência do médico desde guiar a agulha à lesão até a preparação das lâminas para análise microscópica. O treinamento médico proporciona, durante a realização dos procedimentos, maior confiança ao médico e maior conforto ao paciente. No entanto o número de pacientes disponíveis, bem como o estágio de graduação do profissional, limitam o número de treinamentos realizados. Com base nessas limitações, esse estudo teve por objetivo o desenvolvimento de um phantom de tireoide permitirá que os treinamentos sejam realizados em qualquer horário e local, minimizando a responsabilidade de alunos e professores. Phantoms para ultrassom, geralmente, são corpos de prova construídos para mimetizar propriedades mecânicas e acústicas dos tecidos biológicos que podem ser utilizados no treinamento de habilidades médicas. Para o desenvolvimento deste modelo, utilizou-se um material a base de hidrocarbonetos de cadeia longa com diferentes concentrações de agentes contraste (pó de vidro, cera de carnaúba, parafina granulada, borracha de silicone). Caracterizou-se amostras de diferentes composições com relação ao módulo elástico, velocidade e atenuação da onda ultrassônica, de modo à atingir valores próximos aos encontrados na literatura para as regiões a serem mimetizadas. Obteve-se valores entre 1385 e 1480 m/s, para velocidade; valores entre 0,4 e 4 dB/cm para atenuação; e uma faixa entre 40 e 750 kPa para o módulo elástico. Ao final da caracterização dos materiais, obteve-se um phantom morfológico de pescoço, contendo a mimetização da tireoide para procedimentos de biópsia de tireoide guiada por ultrassom. / The thyroid cancer is one of the most common of head and neck region. Currently, the most effective method in the diagnosis of thyroid lesions is biopsy technique, known by fine-needle aspiration (FNA) guided by ultrasound. Ultrasound images guides the fine needle insertion into the lesion for sampling and then examined under a microscope. The medical training provides greater confidence to physician and comfort to patient. However, the number of available patients as well as the doctor degree stage limit the number of trainings conducted. Therefore, this study aimed to develop a thyroid phantom to training everywhere at any time, minimizing the students and teachers responsibilities. Ultrasound Phantoms mimics mechanical and acoustic properties of biological tissue and can be used for medical training. To develop the phantom we used a hydrocarbon-based material with different concentrations of contrast agents (glass powder, Carnauba wax, paraffin wax and silicone rubber). We calculated the elastic modulus, velocity and ultrasonic wave attenuation of different mixtures to reach values, as close the literature as possible. Was obtained values from 1385 to 1480 m / s for ultrasound velocity, values from 0.4 to 4 dB/cm for attenuation and a range from 40 to 750 kPa for elastic modulus. This study present an anthropomorphic neck phantom containing the necessary structures for training ultrasound guided biopsy by fine-needle aspiration.
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Treinamento de força com oclusão vascular: adaptações neuromusculares e moleculares / Strength training and vascular occlusion: neuromuscular and molecular adaptationsLaurentino, Gilberto Candido 23 April 2010 (has links)
Estudos têm mostrado que o treinamento de força de baixa intensidade com oclusão vascular (TFOV) tem apresentado resultados similares nos ganhos de força e hipertrofia comparado ao treinamento de força (TF) de alta intensidade. O objetivo deste estudo foi comparar os efeitos de três diferentes programas de TF nos ganhos de força e hipertrofia musculares e na expressão da miostatina (MSTN) e seus antagonistas. Para isso, vinte e nove jovens do sexo masculino, sem experiência em TF, foram recrutados e divididos randomicamente nos grupos: treinamento de força de baixa intensidade sem oclusão (BI), treinamento de força de baixa intensidade com oclusão (BIO) e treinamento de força de alta intensidade sem oclusão (AI). Os grupos BIO e BI treinaram com intensidade de 20% 1RM, enquanto o grupo AI treinou com intensidade de 80% 1RM. A ANOVA one way foi utilizada para testar as diferenças percentuais nos ganhos de força (1RM) e na área de secção transversa (AST) do músculo quadríceps femoral. O modelo misto para análise das medidas repetidas foi utilizado para testar as diferenças nas variáveis miostatina (MSTN), folistatina-3 (FLST-3), SMAD-7 e GASP-1 nos grupos BI, BIO e AI nas condições pré e pós-treinamento. Os resultados mostraram que os aumentos de força e hipertrofia musculares nos grupos BIO e AI foram similares, entretanto superiores ao grupo BI. Esses resultados podem ser atribuídos a maior diminuição na expressão da MSTN nos grupos BIO (45%) e AI (41%) comparados com o grupo BI (16%) e o aumento na expressão dos genes que antagonizam sua atividade (SMAD-7, FLST-3 e GASP-1). Podemos concluir que a inibição na atividade da MSTN dos grupos BIO e AI podem responder em parte a similaridade nos ganhos de força e hipertrofia entre os grupos e a diferença para o grupo BI / It has been demonstrated that low intensity training associated to vascular occlusion (LIO) promotes similar gains in strength and muscle mass when compared to high intensity strength training (HI). The aim of the present study was to evaluate the effect of three different training programs on skeletal muscle hypertrophy and atrophy related gene expression. Twenty nine young male, with no previous experience in strength training were randomly allocated in three groups: low intensity strength training (i.e. 20% - 1-RM) (LI); low intensity strength training associated to vascular occlusion (i.e. 20% - 1-RM) (LIO); high intensity strength training (HI) (i.e. 80% - 1-RM). One-way ANOVA was used to assess differences in % delta change values of 1-RM and cross sectional area (CSA) of the quadriceps femoris. Mixed model analysis was used to compare myostatin (MSTN), folistatyn-3 (FLST-3), SMAD-7 e GASP-1 changes between groups pre and post training. Results demonstrated similar increases in strength and muscle hypertrophy for LIO and HI groups. Moreover, such increases were significantly greater when compared to LI. These results may be, at least in part, explained by a significant decrease in MSTN mRNA expression in LIO (45%) and HI (41%) when compared to LI (16%); additionally, SMAD-7; FLST-3 and GASP-1 mRNA expression were significantly increased. In conclusion, LIO training promotes similar gains than HI training. The results may be explained by changes in MSTN and related genes mRNA expression
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Avaliação de nova técnica de biopsia intestinal assistida por videolaparoscopia em equinos / Evaluation of a new intestinal biopsy technique assisted by videolaparoscopy in horsesCastro, Leonardo Maggio de 05 August 2016 (has links)
As doenças do trato digestório nos equinos apresentam altas taxas de morbidade e mortalidade, com diferentes etiologias. Em alguns casos, o emprego da biopsia intestinal se faz necessário para auxílio no diagnóstico dessas enfermidades. No entanto, as técnicas convencionais podem trazer riscos aos pacientes, por serem invasivas, ou não serem elucidativas por apresentarem limitações de acesso a determinados segmentos. O presente estudo teve como objetivo validar uma técnica de biopsia intestinal, intracorpórea, assistida por videolaparoscopia, ainda não descrita na literatura, para coleta de fragmentos de mucosa de jejuno e cólon menor de equinos, que sejam considerados adequados para avaliação histológica. Para tanto, foram utilizados seis equinos machos, da raça Puro Sangue Árabe, com idade de dois anos, sem histórico prévio de doenças do trato digestório, com peso médio de 267 kg. Todos os animais foram submetidos ao mesmo procedimento laparoscópico, instituindo-se apenas jejum alimentar prévio de oito horas. Os equinos foram acompanhados com exame físico e de ultrassonografia abdominal, desde o dia precedente às laparoscopias, até o 15º dia do período pós-operatório, bem como avaliados por meio de hemograma, provas de funções hepática e renal, e análise do líquido peritoneal nos dias 0, 1, 2, 3, 5, 7, 10, 14, 21 e 30. O tempo cirúrgico foi cronometrado, sendo registrado o tempo total, iniciado na criação do primeiro portal de acesso e finalizado ao término da sutura de pele, e os tempos parciais para biopsia de jejuno e cólon menor separadamente, com início na apreensão do segmento intestinal e término quando constatada a polimerização da cola cirúrgica sobre o orifício de acesso da agulha. De cada segmento obtiveram-se dez fragmentos, e posteriormente submetidos à análise histológica. Atribuiu-se escore para cada um deles, sendo considerado 0 fragmentos com qualidade ruim; 1 para qualidade boa e 2 para qualidade ótima. Por sua vez, os considerados viáveis foram somente os que se enquadraram nos escores 1 e 2. Amostras avaliadas como adequadas 11 apresentaram no mínimo 50% dos fragmentos viáveis. A média do tempo total de procedimento foi de 66,50 minutos (± 7,87), enquanto a média do tempo parcial para biopsia de jejuno foi de 14,2 minutos (± 4,3) e a de cólon menor 12,7 minutos (± 5,0). Clinicamente, os animais apresentaram desconforto abdominal nas primeiras 48 horas. Os exames ultrassonográficos do abdômen não revelaram alterações condizentes com peritonite ao longo de todo experimento. Os parâmetros laboratoriais apresentaram apenas características inflamatórias, sendo que o líquido peritoneal permaneceu alterado até o 21º de pós-operatório, havendo normalização de todos os seus valores no 30º dia do estudo. Na inspeção laparoscópica de dois equinos (E2, E4) foi identificada aderência de porção de omento no diafragma. Nas avaliações histológicas de jejuno, uma amostra (E5) de seis foi considerada inadequada, com 5/12 fragmentos viáveis, e em cólon menor, duas (E1, E2) de seis, foram inadequadas, com 4/9 e 5/10 fragmentos viáveis respectivamente. A nova técnica de biopsia intestinal possibilitou a coleta de amostras adequadas de mucosa para análise histológica, de forma segura para os animais, uma vez que as alterações clínicas e laboratoriais foram aquelas relacionadas ao processo inflamatório, compatível com procedimentos laparoscópicos na espécie / Gastrointestinal diseases in horses result in high rates of morbidity and mortality, with different aetiologies. In some cases, an intestinal biopsy is needed to aid in the diagnosis of such diseases. However, the conventional techniques can pose risks to patients for being invasive or for not being elucidating due to having limitations in accessing certain segments. The objective of this study was to validate an intestinal biopsy technique, intracorporeal, assisted by laparoscopy, which has not yet been described in the literature, to collect mucosal fragments from the jejuno and small colon, which might be considered suitable for histological assessment. For such, six male horses were used, Arabian breed, with two years of age, without any records of abdominal diseases, weighing 267 kg in average. All horses were subjected to the same laparoscopic procedure, fasting for eight hours previously to the procedure. All horses were monitored through physical examination and abdominal ultrasonography, from the day previous to laparoscopy, until the 15th postoperative day, as well as hemogram, tests of liver and kidney functions, and analysis of the peritoneal fluid in days 0, 1, 2, 3, 5, 7, 10, 14, 21 and 30. The total laparoscopic procedure time was registered, starting at the moment of the first incision and ending at the moment of the skin closure. The partial times for the jejunal biopsy and small colon biopsy were recorded as well, starting at the grasping of the intestinal segment and ending at the moment of polymerization of the surgical adhesive on the needle access site. From each segment, ten fragments were collected and later subjected to histological analysis. A score was assigned for each one of them, being scored \"0\" fragments of poor quality; \"1\" fragments of good quality and \"2\" fragments of optimal quality. The samples considered viable were only the ones which scored 1 and 2. The samples deemed as adequate showed at least 50% of it fragments to be viable. The average of the surgery total time was of 66,50 minutes (± 7.87), whereas the average of the jejunal biopsy was of 14.2 minutes (± 4.3) and the small colon biopsy time was of 12.7 minutes ( ± 5.0). Clinically, the animals showed mild abdominal 13 discomfort in the first 48 hours. Ultrasonographic examination of the abdomen did not reveal any alterations consistent with peritonitis throughout the entire experiment period. Laboratory parameters presented inflammatory characteristics, and the peritoneal fluid remained altered until the 21th postoperative day, with normalization of all its values on the 30th day of the study. During the laparoscopic inspection of two horses (E2, E4) was identified partial omental adhesion with the diaphragm. In the jejunal histological evaluations, one sample (E5) of six was considered inadequate, with 5/12 viable fragments, and as for the small colon, two (E1, E2) of six were inadequate, with 4/9 and 5/10 viable fragments respectively. The new technique proposed allowed a safe collection of adequate mucosal samples for histological analysis, since clinical and laboratory abnormalities identified were related to the inflammatory process associated to the laparoscopic techniques in horses
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Ultra-sonografia transvaginal com dopplervelocimetria na monitorização endometrial durante o tratamento hormonal na pós-menopausa / Transvaginal ultrasound with Dopplervelocimetry for endometrial monitoring during hormone therapy in post-menopauseDolce, Rubens Brocco 20 September 2006 (has links)
INTRODUÇÃO: O tratamento estrogênico isolado e contínuo por seis meses é uma opção no tratamento de sintomas climatéricos. A monitorização endometrial deve ser realizada rotineiramente; nela, a ultra-sonografia (US) e a biópsia uterina têm papel importante. A US e a Dopplervelocimetria também avaliam as mudanças circulatórias uterinas. OBJETIVO: Estudar o comportamento da vascularização uterina e do endométrio em mulheres na pós-menopausa tratadas com estrógeno contínuo por seis meses, seguido de progestógeno isolado por 14 dias, e estabelecer suas relações com a proliferação endometrial. MÉTODO: Estudo clínico, prospectivo e controlado, onde quarenta mulheres na pós-menopausa, sem contraindicações para tratamento hormonal (TH). Foram divididas em dois grupos: Estrógeno e Controle. As do Grupo Estrógeno (GE), n= 24, receberam 50 mcg de estradiol-17 beta (E2) transdérmico, duas vezes por semana, durante seis meses. As mulheres do Grupo Controle (GC), n=16, não receberam TH. Todas realizaram FSH, E2 e glicemia de jejum; US transvaginal; Dopplervelocimetria das artérias uterinas, miometriais e endometriais e biópsia aspirativa de endométrio. O GE repetiu os mesmos exames, com exceção de FSH, E2 e glicemia, no terceiro e no sexto mês de tratamento. No GC, a biópsia do endométrio foi repetida apenas no sexto mês de tratamento. As mulheres do GE utilizaram, ao fim de seis meses, 10 mg de acetato de medroxiprogesterona por dia, durante 14 dias. RESULTADOS: No GE, a resistência vascular das artérias uterinas diminuiu no terceiro e no sexto mês de tratamento. O fluxo miometrial das artérias arqueadas aumentou significantemente no sexto mês de tratamento. O aumento da espessura do endométrio ocorreu de forma significante no terceiro mês. No GE houve hiperplasia endometrial simples e sem atipias em 20,8 % das mulheres. No GE, comparando as mulheres que tiveram proliferação com aquelas que mantiveram a atrofia endometrial, observou-se que, no sexto mês de tratamento, o grupo que apresentou proliferação teve diminuição significante da resistência vascular da artéria uterina esquerda, enquanto no grupo que manteve a atrofia, a resistência vascular aumentou na artéria uterina direita. No GC não ocorreu variação da resistência vascular das artérias uterinas bilaterais; o fluxo miometrial das artérias arqueadas não se modificou e não houve proliferação endometrial. CONCLUSÃO: A terapia estrogênica isolada por seis meses diminuiu a resistência vascular das artérias uterinas bilateralmente. A proliferação endometrial precedeu o aumento de vascularização miometrial. Houve associação entre a proliferação endometrial e a diminuição da resistência vascular na artéria uterina esquerda, no final do sexto mês de tratamento estrogênico / INTRODUCTION: Isolated continuous estrogen therapy for 6 months is an option to manage climacteric symptoms. Endometrial monitoring should be performed as a routine, in which ultrasound and uterine biopsy have an important role. Ultrasound with Dopplervelocimetry also assesses uterine circulatory changes. OBJECTIVE: To study the uterine circulatory changes of women in continuous estrogen therapy for 6 months using Doppler velocimetry and to define correlations with endometrial proliferation. METHOD: Clinical prospective controlled study. Forty menopause women were studied, without contraindications to hormone therapy (HT). They were divided into 2 groups: Estrogen and Control. In the Estrogen Group (EG) n = 24, they were treated with transdermal 50mcg estradiol-17 beta (E2), changed twice a week for 6 months. Women in the Control Group (CG) n=16, were not treated with hormones. They all underwent FSH, E2, fast glucose, transvaginal ultrasound , uterine, myometrial and endometrial artery Dopplervelocimetry and aspiration biopsy of endometrium. The EG repeated the same procedures in months 3 and 6 of treatment. In CG, endometrial biopsy was repeated only in the 6th month of treatment. At the end of treatment, EG women received 10 mg of medroxyprogesterone acetate per day for 14 days. RESULTS: In EG, vascular resistance of uterine arteries reduced in the 3rd and 6th months of treatment. Myometrial flow of arcuate arteries was significantly increased in the 6th month of treatment. Increased endometrial thickness was significant in the 3rd month. In EG, the authors detected simple endometrial hyperplasia without atypias in 20.8% of the subjects. In EG, in the 6th month of treatment, upon comparing women who had proliferation and those who maintained the endometrial atrophy, we observed that the group that presented proliferation had significant reduction of vascular resistance of left uterine artery, whereas the group that maintained atrophy had increase in vascular resistance of right uterine artery. In CG, there was no vascular resistance modification, no myometrial flow diference and no endometrial proliferation. CONCLUSION: Isolated estrogen therapy for 6 months reduced vascular resistance of bilateral uterine arteries. Morphological affections to the endometrium preceded myometrial vascular abnormalities. There was association of endometrial proliferation and reduction of vascular resistance of the left uterine artery in the 6th month of estrogen treatment
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Comparação entre duas técnicas de biópsia renal guiada por laparoscopia em eqüinos / Comparison of two laparoscopic guided renal biopsy techniques in horsesTabet, Alexandre de Faria 24 April 2003 (has links)
Foram utilizados 10 eqüinos clinicamente sadios, machos, adultos, de diferentes raças, pesando entre 350 e 450 Kg, escolhidos aleatoriamente e divididos em dois grupos: em cinco animais foi realizada biópsia renal guiada por laparoscopia com agulha descartável do tipo tru-cut, e nos outros cinco através de pinça de biópsia laparoscópica de 5mm. Os procedimentos foram efetuados com os animais em posição quadrupedal, mediante sedação e analgesia, e bloqueio anestésico local em 2 pontos no flanco esquerdo, sendo um para introdução do trocarte e óptica, e outro para introdução da agulha ou pinça. Parâmetros clínicos e laboratoriais foram avaliados dois dias antes do procedimento e acompanhados nas três semanas subseqüentes, permitindo determinar as alterações decorrentes. As técnicas foram comparadas quanto à segurança, qualidade, tempo de execução e significância da amostra colhida. Durante o acompanhamento pós-operatório dos animais, não houve variação clínica e laboratorial significativa em ambos os grupos, porém, a análise histológica dos fragmentos demonstrou uma maior porcentagem de biópsias adequadas no grupo em que foi utilizada pinça laparoscópica. / Ten healthy adult male horses, of different breeds, weighing between 350 and 450kg were randomly chosen and divided into two groups of five animais each: in one group, laparoscopic guided renal biopsy was pertormed using tru-cut needles and in the other group using 5mm forceps. Procedures were carried out with animais in quadrupedal position, under sedation and analgesia and local anesthetic nerve block was made in two points on the left flank: one for the introduction of the trocar and optical system and one for the introduction of the needle or forceps. Laboratory and clinical parameters were evaluated two days prior to the proceeding and followed up in the subsequent three weeks in order to verify the resulting alterations. The techniques were compared as regards safety, quality, time for execution and significance of the sample obtained. During the post-surgery follow-up period, no significant clinical and laboratory alterations were observed in either group, although the histological analysis of the fragments a higher percentage of adequate biopsies in the group where Laparoscopic forceps were used.
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Adaptações do músculo glúteo médio em eqüinos submetidos a treinamento de resistência e suplementados com diferentes concentrações de óleo de soja /Martins, Carla Braga. January 2007 (has links)
Orientador: José Corrêa de Lacerda Neto / Banca: Thiago Luiz de Salles Gomes / Banca: Claudia Acosta Duarte / Banca: Flora Helena de Freitas D'Angelis / Banca: Antonio de Queiroz Neto / Resumo: Objetivou-se avaliar o efeito da suplementação com diferentes concentrações de óleo de soja e do treinamento de resistência nas adaptações do músculo glúteo médio de 20 eqüinos da raça Puro Sangue Árabe. Os animais foram distribuídos em cinco grupos, cada grupo foi composto por quatro cavalos. O grupo controle não recebeu óleo e os demais foram suplementados com 6, 12, 18 e 24% de óleo. Os animais foram submetidos a sete semanas consecutivas de exercício em esteira rolante e trilha. Analisou-se a influência do treinamento e da suplementação com óleo sobre o peso e escore corporal, concentração de glicogênio muscular e características das fibras do músculo glúteo médio. Os resultados demonstraram que as diferentes concentrações de óleo na dieta não influenciaram as variáveis estudadas. Houve redução significativa do peso corpóreo após o treinamento, no entanto o escore corporal permaneceu constante. O músculo glúteo médio expressou três tipos de fibras puras: I, IIA, IIX. O treinamento não induziu hipertrofia das fibras do músculo glúteo médio. O treinamento ocasionou aumento na proporção e na área relativa das fibras tipo IIA em detrimento das fibras IIX, melhorando a capacidade oxidativa muscular. Tanto as dietas com óleo como o treinamento não aumentaram as concentrações de glicogênio muscular. / Abstract: The aim of this study was evaluate the effects of supplementation with different concentrations of soy oil and endurance training on gluteus medius muscle adaptations in twenty Arabian horses. The horses were randomized in five groups (four horses each group). The control group did not receive the oil and the other groups were supplemented with 6%, 12%, 18% and 24% of soy oil. The animals were submitted to seven weeks of exercise on treadmill and track. The influence of training and oil supplementation on body weight, corporal score, muscular glycogen stores and characteristics of the gluteus medius muscular fibers were analyzed. The results showed that the supplementation of soy oil in diet was not significantly effective on the studied parameters. There was a significant reduction of the body weight after the end of training; however the corporal score showed no changes. The gluteus medius muscle expressed three types of pure fibers: I, IIA and IIX. The training induced a increase in the proportion and relative area of the type IIA fibers in detriment of type IIX fibers, improving the oxidative capacity muscular. No hypertrophy of the muscular fibers was observed. There were no significant changes in the values of the total glycogen after the training period. / Doutor
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