L’objectif de cette recherche est : 1) de contribuer à la réduction du retard diagnostique quicaractérise le trouble bipolaire ; 2) identifier les marqueurs infra cliniques de la dépressionbipolaire ; 3) créer une constellation de différenciation de l’épisode dépressif majeur bipolaireet unipolaire au test de Rorschach (système intégratif).Méthode : Dans un premier temps, nous avons développé une constellation provisoire avec unpré-test auprès de 41 patients (20 bipolaires et 21 unipolaires). Dans un second temps, nousavons testé cette constellation sur un nouvel échantillon de 141 patients (71 bipolaires et 70unipolaires). La symptomatologie dépressive est contrôlée avec la MADRS, l’absence desymptomatologie maniaque et / ou hypomaniaque est contrôlée avec la MAS.Résultats : Il existe des différences infra cliniques, mises en avant par le test de Rorschach,entre les dépressions bipolaires et les dépressions unipolaires. 7 variables du test deRorschach diffèrent dans nos 2 groupes, nous les avons regroupées en un index. Ceregroupement en une constellation permet d’augmenter significativement sensibilité et laspécificité de cette distinction. / The aims of this study are 1) to contribute to reduce the diagnostic delay of bipolar disorder ; 2) identify infraclinical psychological markers of bipolar depression ; 3) build a bipolar depressive index in Rorschach test (comprehensive system).Method : A preliminary Rorschach index has been developed from a pre-test with 41 patients(20 bipolar and 21 unipolar). This preliminary index has been tested on another sample of 141 patients (71 bipolar and 70 unipolar). We used MADRS to rate the depressive symptomaticintensity and the MAS to rate the manic and / or hypomanic symptomatic intensity.Results : Some infraclinical dimensions of depressive episodes, assessed with the Rorschachtest, are different in unipolar and bipolar patients. 7 variables are different in the 2 groups. We put them together in an index. Grouping these variables in a constellation increases specificityand sensitivity of the differential diagnosis.

As crises não epilépticas psicogênicas (CNEP) podem ser definidas como episódios de alteração de movimentos, sensações ou experiência similar à epilepsia causada por processo psicológico e sem associação com descarga elétrica cerebral anormal. Estima-se que o número de casos de pacientes com CNEP seja de 2 a 33 por 100.000 habitantes. O índice de CNEP corresponde ainda a aproximadamente 5% dos pacientes tratados como epilépticos. Os pacientes com CNEP são tratados como possuindo epilepsia refratária, chegando ao limite máximo do tratamento medicamentoso e sem a obtenção de resultados satisfatórios. Objetivos: relatar os efeitos do tratamento psicanalítico individual em pacientes com CNEP. Método: A casuística foi composta por 37 pacientes com diagnóstico prévio de CNEP realizado por meio da monitorização por vídeo-EEG. Foram realizadas sessões individuais de tratamento psicanalítico, com frequência semanal, com duração aproximada de 50 minutos e duração total de 48 sessões em 12 meses. Resultados: Este estudo constatou elevado índice de sucesso no tratamento dos pacientes com CNEP: 29,7% (n=11) de cessação/cura dos sintomas e 51,4% (n=19) redução das crises convulsivas. Foi constatada associação entre cessar ou reduzir as crises e sexo (p < 0,01), religião (p < 0,01) e término do tratamento (p < 0,01). Conclusão: Este estudo apontou a eficácia do tratamento psicanalítico individual realizado com pacientes com CNEP, podendo ser considerada uma forma de assistência essencial para que haja decréscimo ou cessação das crises. / Psychogenic non-epileptic seizures (PNES) can be defined as episodes of alteration of movement, feeling or a similar experience to epilepsy caused by a psychological process and with no association with abnormal electrical discharges in the brain. It is estimated that the number of cases of patients with CNEP is from 2 to 33 in 100.000 inhabitants. The number of patients with PNES reaches 5% of those treated as epileptics. Patients with PNES are treated as if they had intractable epilepsy, with unsatisfactory results even after medication treatment is used to its maximum limits. Objectives: to present the effects of individual psychoanalytical treatment in patients with PNES. Methods: The case base was composed of 37 patients with PNES. The diagnosis was reached with video-EEG monitoring. . Psychoanalytical treatment was carried out through 12 months of weekly sessions of around 50-minutes each, in a total of 48 individual sessions. Results: This study found a high success rate in the treatment of PNES patients. 29,7% (n=11) of patients saw cessation or cure of symptoms and 51,4% (n=19) saw a decrease in the number of episodes. There is an association between cessation or decrease in the number of episodes and sex (p < 0,01), religion (p < 0,01) and concluding treatment (p < 0,01). Conclusions: Individual psychoanalytical treatment applied to patients with PNES is considered effective and can be considered as an essential form of assistance for the reduction of cessation of episodes. Psychogenic non-epileptic seizures, Conversion disorder, Psychoanalysis, Treatment

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-07-04T17:43:42Z No. of bitstreams: 1 adairdemenezesjunior.pdf: 1819956 bytes, checksum: adc4a19d06d1fea31d7a9b722aa63a73 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-07-13T16:21:41Z (GMT) No. of bitstreams: 1 adairdemenezesjunior.pdf: 1819956 bytes, checksum: adc4a19d06d1fea31d7a9b722aa63a73 (MD5) / Made available in DSpace on 2016-07-13T16:21:41Z (GMT). No. of bitstreams: 1 adairdemenezesjunior.pdf: 1819956 bytes, checksum: adc4a19d06d1fea31d7a9b722aa63a73 (MD5) Previous issue date: 2012-12-14 / Introdução: Experiências espirituais que se assemelham a sintomas psicóticos e dissociativos são comuns em diversas religiões, podendo trazer dúvidas se se tratam de experiências saudáveis ou patológicas. Objetivos: Investigar o perfil sociodemográfico, de experiências anômalas e de saúde mental dos indivíduos que apresentam vivências psicóticas e dissociativas e buscam auxílio em Centros Espíritas; identificar características fenomenológicas, clínicas e sociodemográficas que auxiliem na distinção entre experiência espiritual saudável e transtorno mental. Métodos: Pesquisa longitudinal com um ano de seguimento de 115 sujeitos que apresentavam experiências psicóticas e dissociativas e procuraram Centros Espíritas de Juiz de Fora/MG. Foram utilizadas entrevistas sociodemográficas, de avaliação das experiências anômalas, de critérios propostos para identificar uma experiência espiritual saudável, o SCID (Structured Clinical Interview for DSM-IV Axis I Disorders), o DDIS (Dissociative Disorders Interview Schedule) o DES (Dissociative Experience Scale) e o WHOQOL-bref (World Health Organization Quality of Life-bref). Modelos de regressão logística e linear, controlando para fatores sociodemográficos, foram usados para investigar as associações entre características das experiências anômalas e dissociativas com qualidade de vida e diagnósticos psiquiátricos. Resultados: A amostra foi composta por 70% de mulheres, com idade média de 39 anos e bom grau de instrução, perfil semelhante ao de outros estudos com médiuns espíritas no Brasil. Cinco Critérios Qualitativos da experiência espiritual saudável estiveram presentes na maioria da amostra no primeiro momento da avaliação: ausência de prejuízos sociais e ocupacionais, a experiência ser curta e ocorrer apenas episodicamente, compatibilidade com um contexto cultural, a experiência espiritual trazer benefícios para si mesmo e ser centrada nos outros. Quatro Critérios Qualitativos estavam presentes em uma minoria: ausência de sofrimento, ausência de co-morbidades, atitude crítica e controle sobre a experiência. 93% da amostra apresentavam algum transtorno mental pelo SCID, principalmente quadros ansiosos e depressivos, 23,5% algum transtorno dissociativo pelo DDIS, mas apenas um indivíduo (0,9%) apresentou transtorno de identidade dissociativa. Os escores médios de dissociação foram altos no DES (81,4 ± 54,8 desvio padrão) e no DES TAXON (18,8 ± 16,8). As dimensões de qualidade de vida pelo WHOQOL mais afetadas foram a psicológica (61,15 ± 19,39) e social (63,41 ± 24,07), sendo que a física (67,13 ± 18,25) e a ambiental (63,89 ± 15,05) estavam mais preservadas. Maiores escores de dissociação se relacionaram com mais diagnósticos de transtornos dissociativos e mentais em geral, bem como com menores níveis de qualidade de vida em todas as dimensões. A presença dos Critérios Qualitativos propostos para uma experiência espiritual saudável se relacionou com melhor qualidade de vida nas dimensões psicológica e social tanto no início como após um ano de seguimento. Conclusões: Indivíduos que apresentam experiências psicóticas e dissociativas e buscam auxílio em grupos religiosos são um grupo que necessitam atenção devido ao risco para problemas na saúde mental e qualidade de vida. O potencial efeito protetor do envolvimento religioso e dos critérios qualitativos precisa ser melhor investigado. / Introduction: Spiritual experiences that resemble psychotic and dissociative symptoms are common in several religions, and can bring doubts whether dealing with healthy or pathological experiences. Objectives: Investigating the sociodemographic profile of anomalous experiences and mental health ones of individuals with psychotic and dissociative experiences and seek help in Spiritist Centers; identifying phenomenological, clinical and sociodemographic characteristics which help in distinguishing between healthy spiritual experience and mental disorder. Methods: A Longitudinal Research with one-year follow-up of 115 individuals who have lived psychotic and dissociative experiences and sought Spiritist Centers of Juiz de Fora / MG. We used Sociodemographic interviews, of evaluation of anomalous experiences, and of the proposed criteria for identifying a healthy spiritual experience, the SCID (Structured Clinical Interview for DSM-IV Axis I Disorders), the DDIS (Dissociative Disorders Interview Schedule) DES (Dissociative Experience Scale) and the WHOQOL-BREF (World Health Organization Quality of Life-BREF). Logistic and linear regression model, controlling for sociodemographic factors, were used to investigate associations between characteristics of anomalous and dissociative experiences and quality of life and psychiatric diagnoses. Results: The sample was composed of 70% women, with average age 39 years old and good schooling, profile similar to other studies with Spiritist mediums in Brazil. Five Qualitative Criteria of healthy spiritual experience were present in most of the sample at the first time of evaluation: Absence of social and occupational impairment, the experience is short and occurs only episodically, compatibility with a cultural context, the spiritual experience brings benefits to oneself and it can be focused on others. Four Qualitative Criteria were present in a minority: The absence of suffering, lack of co-morbidities, critical attitude and control over the experience. 93% of the sample had some mental disorder by SCID, mainly anxiety and depression disorders, 23.5% had some dissociative disorder by DDIS, but only one individual (0.9%) had dissociative identity disorder. The average scores of dissociation were high in DES (81.4 ± 54.8 SD) and in DES TAXON (18.8 ± 16.8). The dimensions of quality of life by the WHOQOL which were most affected were the psychological (61.15 ± 19.39) and social (63.41 ± 24.07), and the physical (67.13 ± 18.25) and environmental (63.89 ± 15.05) were better preserved. Higher scores of dissociation were related to more diagnoses of dissociative and mental disorders in general, as well as to lower levels of quality of life in all dimensions. The presence of Qualitative Criteria proposed for a healthy spiritual experience was associated with better quality of life in psychological and social dimensions both at the beginning and and after one-year follow-up. Conclusions: Individuals who have psychotic and dissociative experiences and seek help religious groups are a group that needs attention because of the risk for mental health disorders and quality of life. The potential protective effect of the religious involvement and the qualitative criteria should be further investigated.

Ce travail de doctorat a été réalisé dans le cadre d'une cotutelle entre l'Université Grenoble Alpes en France et l'Université de Montréal au Canada. / Ce travail de thèse étudie les Troubles du Développement des Sons de Parole (TDSP). Les TDSP correspondent à un délai de développement des sons de la langue conduisant à un déficit d’intelligibilité (degré pour lequel la parole d’une personne est comprise) et d’acceptabilité (degré pour lequel la parole d’une personne est perçue comme différente). Les TDSP sont les troubles de la communication les plus fréquents chez la population pédiatrique et peuvent avoir des conséquences majeures sur la scolarité des enfants et sur l’inclusion sociale. Malgré la haute prévalence et les possibles conséquences à long terme, il n’existe actuellement que peu d’outils d’évaluation en français permettant l’identification des enfants avec un TDSP et la caractérisation du trouble. La partie théorique de la thèse met en évidence le manque d’outils et de critères diagnostics. L’objectif de ce travail est de proposer une batterie de tests, fondée sur un modèle psycholinguistique, permettant l’évaluation et le diagnostic des enfants avec un TDSP. L’outil d’évaluation, nommé EULALIES, comprend cinq tâches, impliquant chacune de façon différente des niveaux du modèle psycholinguistique : (1) une tâche de jugement de lexicalité, (2) une tâche de dénomination, (3) une tâche de répétition de pseudomots, (4) une tâche de diadococinésies et (5) une tâche de répétition de syllabes. Les données ont été collectées auprès de 119 enfants typiques et 9 enfants avec un TDSP. Tous les enfants sont francophones. La première partie des résultats s’intéresse spécifiquement à la tâche de répétition de pseudomots et démontre la validité de cette tâche. Nos résultats mettent en lumière le fait que le score à la tâche de répétition de pseudomots dépend de l’âge des enfants, de leurs habiletés de mémoire phonologique à court terme, de la présence d’un vrai mot inclus dans le pseudomot, de la structure et de la longueur du pseudomot. Les données recueillies montrent que la tâche n’est pas sensible aux facteurs sociolinguistiques tels que le statut socio-économique ou le statut linguistique, ce que nous recherchons pour une application clinique. La seconde partie des résultats aborde le diagnostic différentiel entre deux types de TDSP : la dyspraxie verbale et le trouble phonologique. Les épreuves de la batterie mettent en évidence des indicateurs spécifiques à la dyspraxie verbale, tels que la lenteur aux diadococinésies ou les erreurs sur les voyelles. Par rapport à ce qui est décrit pour l’anglais, certains indicateurs semblent être moins pertinents pour les enfants francophones. C’est le cas des épenthèses de schwas. A l’issue de ces travaux, nous soutenons que l’évaluation des enfCants présentant un TDSP doit prendre appui, à la fois sur l’analyse des patrons d’erreurs produits par l’enfant mais aussi sur une perspective psycholinguistique. Celle-ci permet de mieux décrire le profil de parole de l’enfant et de proposer une intervention adaptée. / This thesis work investigates Speech Sound Disorders (SSD). SSD are defined as a delay in speech sound development affecting intelligibility (degree to which a person's speech is understood) and acceptability (degree to which a person's speech is perceived as different). SSD are the most common communication disorder in the pediatric population. Children with SSD are at high risk for later academic and social inclusion. Despite the high prevalence and possible long-term consequences, there are currently few assessment tools available to diagnose French-speaking children with SSD and characterize the disorder. The theoretical part of this work highlights the lack of diagnostic tools. This work intends to create a speech sound assessment tool, based on a psycholinguistic model to diagnose children with SSD. The assessment tool, named EULALIES, includes five tasks, each involving different levels of the psycholinguistic model: (1) a lexicality judgment task, (2) a picture-naming task, (3) a nonword repetition task, (4) a diadochokinetic task, and (5) a syllable repetition task. Data were collected from 119 typical children and 9 children with SSD. The first part of the results focuses specifically on the nonword repetition task and describes the validity of this task. Our results highlight the fact that nonword repetition performance depends on children's age, phonological short-term memory skills, inclusion of a real word in the nonword, syllable structure, and length of the pseudoword. Data collected show that the task is not sensitive to sociolinguistic factors such as socioeconomic status or linguistic status, which is what we were looking for from a clinical perspective. The second part of the results addresses the differential diagnosis between childhood apraxia of speech and phonological disorder, both of which being subtypes of SSD. The assessment tool reveals specific markers for childhood apraxia of speech, such low diadochokinetic rate or errors on vowels. Contrary to what is described for English, some markers seem to be less relevant for French-speaking children. This is the case for schwa epenthesis. At the end of this work, we argue that children with SSD assessment should be based on the analysis of error patterns produced by the child as well as on a psycholinguistic approach. This helps to better describe the child's speech profile and to offer an adapted intervention.

No description available.

Hypertrophic osteoarthropathy (HOA) is a relatively rare condition seldom diagnosed in osteoarchaeological material. In this study a skeletal material (individual 03) showing bilateral symmetric periosteal new bone formation (PNBF) was examined. Through differential diagnosis, individual 03 was considered likely to suffer from secondary HOA. The medieval urban environment that should have been contemporary with individual 03, likely permitted the spread of disease. This, together with PNBF in the ribs is thought to be indicative of underlying pulmonary disease causing the HOA. With the help of Twaddle’s theory of health and illness, individual 03 was determined to be considered ill in the last period of their life. Likely affecting their physical ability, possibly making them dependant on the care of others. When considered together with the osteological paradox, the periosteal reactions also suggests that the HOA was a complication of a chronic underlying condition. / Hypertrofisk osteoartropati (HOA) är ett relativt sällsynt tillstånd sällan diagnostiserat i det osteoarkeologiska materialet. I denna studie undersöks ett skelettmaterial benämnt individ 03 (individual03) som har bilateral symmetrisk bennybildning (PNBF). Genom differentialdiagnos bedömdesindivid 03 troligen lida av sekundär HOA. Den medeltida urbana miljö som lär ha varit samtida med individ 03, tillät troligen spridningen av sjukdomar. Detta tillsammans med PNBF på revbenen tros indikera underliggande lungsjukdom som orsak till HOA i individ 03. Med hjälp av Twaddles teori om hälsa och sjukdom blev individ 03 bedömd att bli betraktad som sjuk under den sista perioden i livet. Någonting som sannolikt påverkade fysisk förmåga, och som möjligtvis medförde beroende av vård från andra. Sedda utifrån den osteologiska paradoxen, indikerar de periostala reaktionerna att HOA i detta fall var ett resultat av en kronisk underliggande sjukdom.

A quantitative, descriptive, explorative design was used to evaluate a decentralised primary health care training programme at a training unit in the Limpopo Province. The study sought to determine to what extent the newly qualified diplomates were able to manage patients appropriately when faced with the realities, such as the shortage of personnel, large numbers of patients, shortage of resources and time constraints in the real situation without the support and guidance from medical practitioners and senior nursing personnel. Data were collected by observing the diplomates as they managed patients with hypertension by making use of checklists. The diplomates were also interviewed by making use of an in interview schedule. The major inferences drawn from this study was that these diplomates were competent in the management of these patients and were satisfied with their abilities and training. / Health Studies / M. A. (Health Studies)

Sachant que plusieurs maladies entrainent des lésions qui ne sont pas toujours observables à l’oeil, cette étude préliminaire en paléopathologie humaine utilise une approche complémentaire issue de l’imagerie médicale, le ct-scan, afin de fournir des diagnostics plus précis. L’objectif est donc de tester ici l’efficacité et les limites de l’analyse scanographique durant l’analyse de spécimens archéologiques. Un échantillon de 55 individus a été sélectionné à partir de la collection ostéologique provenant du cimetière protestant St. Matthew (ville de Québec, 1771 – 1860). Une analyse macroscopique et scanographique complète a alors été effectuée sur chaque squelette. Les observations macroscopiques ont consisté à enregistrer une dizaine de critères standardisés par la littérature de référence en lien avec des manifestations anormales à la surface du squelette. Les ct-scans ont été réalisés à l’Institut National de la Recherche Scientifique de la Ville de Québec avec un tomodensitomètre Somatom de Siemens (définition AS+ 128). Les données scanographiques ont permis d’enregistrer une série de critères complémentaires sur la structure interne de l’os (amincissement/épaississement de la corticale, variation de densité, etc.) Selon la méthode du diagnostic différentiel, des hypothèses ou diagnostics ont été proposés. Ils sont principalement basés sur les critères diagnostiques mentionnés dans les manuels de référence en paléopathologie, mais aussi à l’aide de la littérature clinique et l’expertise de médecins. Les résultats présentés ici supportent que: 1) Dans 43% des cas, les données scanographiques ont apporté des informations essentielles dans la diagnose pathologique. Cette tendance se confirme en fonction de certaines maladies, mais pas d’autres, car certains diagnostics ne peuvent se faire sans la présence de tissus mous. 2) La distribution spatiale de la plupart des lésions varie selon les régions anatomiques, aussi bien en macroscopie qu’en scanographie. 3) Certains types de maladie semblent associés à l’âge et au sexe, ce qui est conforté par la littérature. 4) Cette recherche démontre aussi que le processus de diagnose nécessite, dans 38% des cas, une analyse complémentaire (ex. histologie, scintigraphie, radiographie) pour préciser le diagnostic final. / Because some diseases produce lesions that cannot be seen macroscopically, this preliminary paleopathological study will use the ct-scan, as a complementary approach in order to improve diagnosis. This project will attempt to evaluate the efficiency of the ct-scan approach for the analysis of archaeological specimens in paleopathological study. Fifty-five individuals from St. Matthew’s protestant cemetery (Quebec City, 1771- 1861) were selected for the present study. Both macroscopic and scanographic analyses were performed on each skeleton. Macroscopic observations were recorded according to at least ten standard criteria based on the reference literature that reports abnormal phenomena on skeletal surfaces. Ct-scans were obtained at the Institut National de la Recherche Scientifique of Quebec City with a SOMATOM CT-scanner (Siemens model, Definition AS+ 128). Scanographic data provided a series of complementary criteria on internal bone structures (thinning/thickening of the cortical layer, density variation, etc.). According to the method of the differential diagnosis, diagnoses were proposed. Most of them were based on diagnostic criteria reported in the paleopathological literature as well as in clinical studies. The results presented support that: 1) For 43% of our sample (N=55), ct-scan data provided key information for the paleopathological diagnosis. The ct-scan provided additional information for some diseases only, partly because some diagnoses cannot be done without the presence of soft tissues. 2) The distribution of most lesions, both macroscopic and scanographic, did vary according to the anatomical regions. 3) Some types of diseases seem to vary according to age and sex, as supported by the literature. 4) Our research also shows that the diagnosis could be improved and refined in 38% of the cases with complementary analyses (histology, scintigraphy, radiography, etc.).

This diploma thesis deals with the topic of burnout syndrome and its impact on Church related community workers, in order to determine how much are these workers endangered, how to take care of these workers and whether their employers are familiar with the risks of burnout syndrome. The first chapters are devoted to the theoretical definition of burnout syndrome in the overall view on this issue, but also takes a closer look on Church related community workers in the helping profession in the Church. I'm trying to capture a fully describe the motivation for helping, factors leading to burnout syndrome, diagnosis, prevention and treatment. The final chapter and the whole practical part is devoted to the history and characteristics of the studied groups, which form the priests of the three largest churches in our country: Roman Catholic, Evangelical and Czechoslovak Hussite Church. This part is a quantitative research. To illustrate the work I decided to include three case studies that document the real life stories of burnout syndrome at different stages.

Metástases em ovário geralmente se apresentam como o primeiro sinal de doença, com o tumor primário não sendo imediatamente reconhecido. A diferenciação mucinosa é o fenótipo mais comum entre essas metástases. Em algumas situações, quando essa apresentação está associada a carcinomas metastáticos capazes de simular tumores ovarianos primários, essa configuração pode levar até mesmo patologistas experientes a diagnosticar incorretamente um depósito secundário como uma neoplasia primária. A maioria dos casos problemáticos pode ser resolvida correlacionando-se os dados clínicos, as características macroscópicas, os critérios de histologia e o perfil imuno-histoquímico, mas sempre haverá alguns casos com características sobrepostas. Levando-se em conta que a invasão linfovascular conspícua é uma das características que favorecem metástase, nós hipotetizamos que diferentes padrões de microdensidade vascular intratumoral poderiam nos ajudar na definição da origem primária ou secundária do tumor. Um total de 124 casos de tumores mucinosos de ovário foram selecionados, apresentando histologia \"borderline\" e maligna. Eles foram separados em dois grupos (primários ou metastáticos), classificados de acordo com as informações clínicas disponíveis, características macroscópicas e microscópicas, e perfil imuno-histoquímico realizado em amostras de tumores em microarranjo de tecido (TMA). A densidade vascular linfática (DVL) foi analisada quantificando-se espaços vasculares intratumorais identificados pela podoplanina, um marcador endotelial linfático. De acordo com os nossos resultados a DVL foi maior nas neoplasias primárias do que nas secundárias, mas, após análise multivariada, os melhores preditores de um tumor ser secundário foram tamanho de 10,0 cm ou menos (OR 9,4; IC 95% 1,2-69,2), bilateralidade (OR 51,5; IC 95% 7,1-370,2) e negatividade para CK7 (OR 64,8; IC 95% 9,4- 447). De acordo com o conhecimento atual, a disseminação metastática não é um evento aleatório, mas um processo de várias etapas complexas e sequenciais, altamente organizado e tecido específico. É importante aprofundar a relação entre as células tumorais e seu microambiente porque as características moleculares envolvidas podem ser uma possível fonte de novos marcadores que podem permitir uma categorização mais precisa dos tumores mucinosos nos ovários / Ovarian metastases commonly present as the first sign of the disease, with the primary tumor not being immediately recognized. Mucinous differentiation is the most common phenotype among those metastases. In particular situations, when compounded by the known metastatic carcinomas capable of simulate primary tumors, this setting can lead even experienced pathologists to diagnose incorrectly a secondary deposit as a primary neoplasm. Correlating clinical data, macroscopic features, histology criteria and immunohistochemistry profile, can solve the majority of those problematic cases, but there will always be some cases in a gray zone with superimposed characteristics. Since conspicuous lymphovascular invasion is one of the characteristics favoring metastases, we hypothesized if different patterns of intratumoral vascular microdensity can help us in defining the tumor origin. A total of 124 cases of mucinous tumors in ovary were selected, presenting borderline and malignant histology. They were separated in two groups (primary and metastatic) classified according to the available clinical data, gross and microscopic features, and immunohistochemistry profile performed in tumor samples in tissue microarrays (TMA). The lymphatic vascular density (LVD) was analyzed using podoplanin, a lymphatic endothelial marker. According to our results LVD was greater in primary than in secondary neoplasms, but after multivariate analysis, the best predictors of a secondary deposit tumor were size 10,0 cm or less (OR 9.4; CI 95% 1.2- 69.2), bilaterality (OR 51.5; CI 95% 7.1-370.2) and CK7 negativity (OR 64.8; CI 95% 9.4-447). According to actual knowledge metastatic dissemination is not a random event, but a complex and sequential multistep process, highly organized and tissue-specific. It is important to go deeper into the relation between tumor cells and their microenvironment because its molecular features may be a possible source of new markers that could allow a more precise categorization of mucinous tumors in the ovaries