Diss. (sammanfattning) Stockholm : Karolinska institutet, 2009.

Múltiples revisiones científicas han intentado determinar los factores pronósticos en la evolución del latigazo cervical sin llegar a un consenso. Nuestros resultados se han obtenido tras 8 años de estudio en pacientes controlados desde la primera visita en el servicio de Medicina Física y Rehabilitación del Hospital de Mataró. Se han utilizado escalas de valoración fáciles de cumplimentar y cuantificar para poder obtener los resultados en el mismo momento de la consulta. Este hecho es importante, ya que la mayoría de las escalas que se identifican en los artículos publicados son poco prácticas en la consulta diaria por la dificultad que conllevan en su cumplimentación y valoración. Los factores pronósticos que hemos identificado en nuestra muestran han sido: la edad, la presencia de “vértigos”, la intensidad del dolor cervical inicial valorada mediante la escala analógica visual y el grado de funcionalidad cervical inicial valorado mediante el Northwick Park Hospital Neck Pain Questionnaire.

Thesis (Ph. D.)--University of New South Wales, 2007. / Title from caption (viewed on May 7, 2008).

Made available in DSpace on 2014-08-06T17:29:44Z (GMT). No. of bitstreams: 2 Fernanda Veiga - sa.pdf: 4190888 bytes, checksum: 0c24d50a09131c7db4270519872b5c50 (MD5) license.txt: 1914 bytes, checksum: 7d48279ffeed55da8dfe2f8e81f3b81f (MD5) Previous issue date: 2008 / Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Departamento de Ensino. Programa de Pós-Graduação em Saúde da Criança e da Mulher. Rio de Janeiro, RJ, Brasil. / Introdução: O câncer de colo uterino ainda é considerado um grave problema de saúde pública no Brasil. Algumas recomendações para o controle desta doença no país são baseados em opiniões de especialistas e, no caso de pacientes com colpocitologias sugestivas de lesão intra-epitelial escamosa de alto grau (HSIL) e colposcopia insatisfatória sem lesão visível, consistem em repetir a colpocitologia após três meses. No Setor de Patologia Cervical do Instituto Fernandes Figueira/ FIOCRUZ, estas pacientes são encaminhadas diretamente para conização, na intenção de confirmar o diagnóstico e, caso presente HSIL, já se constituir no tratamento destas lesões. Objetivo: Medir a prevalência de HSIL e câncer em pacientes com a primeira colpocitologia sugestiva de HSIL e colposcopia insatisfatória sem lesão visível, além de identificar uma faixa etária ou grupos em que esta prevalência seja maior, no intuito de contribuir para a discussão sobre uma conduta clínica mais efetiva e que diminua a probabilidade de ocorrência de perdas antes do diagnóstico e tratamento adequados nesta situação. Material e método: Estudo transversal realizado através de pesquisa em banco de dados de pacientes recebidas no Setor de Patologia Cervical no período de dezembro de 1989 a abril de 2007 referidas pela rede básica de saúde para colposcopia, obtendo o diagnóstico final através dos laudos histopatológicos das peças de conização. Resultados: Foram incluídas 65 pacientes na situação descrita e encontrado percentual de 33,8% (IC95% 23,1- 45,9%) de HSIL e 4,6% (IC95% 1,1- 12,0%) de câncer confirmados histologicamente. Os demais casos apresentaram lesão intra-epitelial escamosa de baixo grau (LSIL - 26,1%, IC95% 16,5- 37,8%), displasia glandular (1,5%, IC95% 0,07- 7,35%) vii e ausência de doença (33,8%, IC95% 23,1- 45,9%). Não foi encontrada diferença estatisticamente significativa na razão de prevalência de HSIL e câncer em grupos de mulheres segundo estratos de idade abaixo e acima de 45 anos e entre mulheres soropositivas e soronegativas para HIV. Conclusão: A prevalência de HSIL ou câncer encontrada não parece suficiente para defender a conduta de encaminhá-las de imediato para conização a fim de investigar o canal cervical. Porém, são necessários ensaios clínicos randomizados para que possamos saber qual a conduta mais adequada na situação em estudo. / Introduction: Cervix cancer is a serious public health problem in Brazil. Some of the recommendations for controlling the disease in the country are based on the opinion of specialists. In patients with unsatisfactory colposcopy with no visible lesion and cervical cytology suggesting high-grade squammous intraepithelial lesion (HSIL), the recommendation is to repeat cervical cytology after three months. In the Cervical Pathology unit at Instituto Fernandes Figueira/ FIOCRUZ, these patients are directly subjected to conization in order to confirm diagnosis and to excise the lesions found, if HSIL is verified. Objectives: To assess prevalence of HSIL and cancer in patients with unsatisfactory colposcopy with no visible lesion and first cervical cytology suggestive of HSIL, and to identify an age group or other groups with higher prevalence in order to contribute to the discussion about a more effective clinical approach that will also prevent patients from abandoning follow-up before full diagnosis and treatment. Method: Cross-sectional study with data from the Cervical Pathology unit database on patients treated between December 1989 and April 2007 who were referred to the unit for colposcopy by the primary healthcare network. Final diagnosis was obtained through histopathological examination of conization specimens. Results: Of the 65 patients studied, 33,8% (CI95% 23,1- 45,9%) had HSIL, and 4,6% (CI95% 1,1- 12,0%) had cancer confirmed by histological examination. The other patients were diagnosed as having low-grade squammous intraepithelial lesion (LSIL - 26,1%, CI95% 16,5- 37,8%), glandular dysplasia (1,5%, CI95% 0,07- 7,35%), and absence of disease (33,8%, CI95% 23,1- 45,9%). This study did not find statistically significant ix difference of the prevalence ratio of HSIL and cancer between age groups of more than 45 and less than 45 years of age, and between women tested positive or negative for HIV. Conclusion: The prevalence of cancer and HSIL found in this study does not seem to be enough to justify direct referral for conization to investigate the cervical canal. Nevertheless, randomized clinical trials are necessary to determine an approach that would be more adequate in this situation.

No description available.

Published Article / The objective of this study was to examine the relationship between external markers typically used in external motion capturing devices and the true vertebral kinematics in the cervical spine. Twenty one healthy subjects were subjected to low dosage X-rays in five different positions, while radio opaque markers were attached to the skin at each vertebral level. Distance and angle parameters were constructed for vertebral prediction from skin surface markers. The causes of variation in these parameters were identified by investigating the correlations of these parameters with anthropometrical variables. Strong correlations of the parameters were observed in flexion, but in extension, especially full extension, the correlations were poor to insignificant. In neutral, half flexion, and full flexion it is possible to predict the vertebral position from surface markers by using the parameters and anthropometrical variables. In half extension this prediction is less accurate and in full extension alternative methods should be investigated for external motion capturing.

BACKGROUND: Recently, it is found that T-helper (Th) 22 cells are involved in different types of autoimmune and tumor diseases. But, till now, no study has been carried out to understand the involvement of these cells in cervical cancer (CC). METHODS: Flow cytometry was used to determine the expression of interferon gamma (IFN-gamma), Interleukin-22 (IL-22), IL-17 in the peripheral blood of healthy controls (HC), CIN and cervical cancer patients. From peripheral blood mononuclear cells (PBMCs), mRNA expression levels of Aryl hydrocarbon receptor (AHR), RAR-related orphan receptor C (RORC), TNF-alpha and IL-6 were respectively determined. Using the method of ELISA, plasma concentrations of IL-22, IL-17 and TNF-alpha were examined. RESULTS: Th22 and Th17 cells were elevated in CC and CIN patients. Th1 cells and the plasma concentrations of IL-22 in CC patients were significantly increased compared with HC. In CC patients, an increased prevalence of Th22 cells was associated with lymph node metastases. There was a positive correlation between Th22 and Th17 cells, but an approximately negative correlation between Th22 and Th1 cells in CC patients. The mRNA expression of RORC, TNF-alpha and IL-6 was significantly high in CC patients. CONCLUSIONS: Our results indicate that there is a higher circulatory frequency of Th22, Th17 and Th1 cells in CC which may conjointly participate in the pathogenesis and growth of CC.

No description available.

No description available.

No description available.