Zugl.: Berlin, Freie Univ., Diss., 2004. / Dateiformat: zip, Dateien im PDF-Format. Computerdatei im Fernzugriff.

Zugl.: Berlin, Freie Universiẗat, Diss., 2004. / Dateiformat: zip, Dateien im PDF-Format.

Antecedentes: Se llevó a cabo un estudio cuantitativo retrospectivo descriptivo, en el servicio de ginecología y obstétrica del hospital vitarte, los datos del año 2013-2014 fueron obtenidos del departamento de estadística. Objetivo: Determinar las complicaciones infecciosas y hemorrágicas de cesáreas en adolescentes del servicio de ginecología del Hospital Vitarte durante el periodo 2013-2014. Materiales y métodos: Se revisó todas las historias clínicas del servicio de ginecología y obstetricia del hospital Vitarte, que registraron a pacientes operadas de cesarea durante su perperio en el año 2013-2014. La muestra fue tomada de estas historias clínicas, y se excluyeron las pacientes que no presentaron complicaciones y las historias imcompletas. Para la recolección de los datos de las historias clínicas, se utilizó un formulario que fue llenado por el investigador; luego la información recolectada fue ingresada en el programa de Excel y analizada en el programa SPSS. Resultados: En nuestro estudio durante los años 2013-2014 se realizó cesáreas a 193 adolescentes de los cuales presentaron en sus complicaciones 31 pacientes lo que implica un 16% del total. Se observó que la adolescencia tardía represento un 80.6 %, la mayoría reside en la zona urbana con 67.7% y predomina las adolescentes solteras con 58.1% y la mayoría solo tuvo de 0-4 controles prenatales con un 41.9 %. Dentro de nuestro estudio la complicaciones de cesáreas en adolescentes incluyen: infección del tracto urinario en el 58.1 %, hemorragias pos cesárea 22.6%,leve y moderada 9.7% y severa 3.2%, infección de herida quirúrgica 12.9%, endometrititis y tromboflebitis en el 3.2 %. Conclusiones: Las complicaciones infecciosas son las más frecuentes de las cuales la infección del tracto urinario es el principal, las adolescentes de edad tardía tuvieron cesáreas en su mayoría, la mayoría vino del área urbana así también la mayor parte de adolescentes son solteras y no hubo un buen control pre-natal entre las adolescentes.

Objetivos: Determinar la asociación entre el antecedente de preeclampsia en el embarazo y endometritis puerperal en pacientes que tuvieron un parto en el servicio de Gineco - Obstetricia del Hospital Nacional María Auxiliadora durante el periodo de enero a diciembre del 2014. Material y métodos: Se realizó un estudio observacional, descriptivo, retrospectivo de casos y controles. Se revisaron 589 casos (Pacientes que desarrollaron endometritis durante el puerperio) y 589 controles (Pacientes que no desarrollaron endometritis durante el puerperio) en el periodo de enero a diciembre del 2014. Resul tados: El 60% de las gestantes tenían entre 25 y 34 años. Hubo una mayor frecuencia de gestantes casadas en un 93.2%.La mayoría de las gestantes eran nulípara en un 65.2%.Hubo una mayor frecuencia de gestantes con más de cinco controles prenatales en un 61%.El 63.5% de gestantes tenían grado de instrucción secundaria. El 74.5% de las gestantes tuvo parto cesárea. El 49% de gestantes desarrollo preeclampsia. Conclusiones: Existe una asociación estadísticamente significativa entre la preeclampsia severa durante el embarazo y su relación con endometritis puerperal en pacientes que tuvieron un parto en el servicio de Gineco- Obstetricia del Hospital Nacional María Auxiliadora (P<0.05).La mayoría de pacientes con preeclampsia y endometritis tenían entre 25 y 34 años, eran casadas, nulíparas, con más de cinco controles prenatales, con grado de instrucción secundaria, y la mayoría tuvo parto cesárea.

Zugl.: Giessen, Universiẗat, Diss., 2009.

Freie Universiẗat, Diss., 2006--Berlin.

Orientador: Julio Lopes Sequeira / Banca: Ana Maria Reis Ferreira / Banca: Alessandre Hataka / Banca: Noeme Sousa Rocha / Marco Antônio Alvarenga / Resumo: A endometrite é a principal causa de subfertilidade em éguas sendo o processo fibrótico fator limitante no desempenho reprodutivo nesta espécie. Este trabalho teve por objetivos avaliar o colágeno presente nas endometrites crônicas das éguas, a expressão das enzimas que degradam o colágeno e de seus inibidores e as alterações vasculares. 82 biópsias uterinas recebidas na FMVZ, UNESP, Botucatu, SP foram classificadas histologicamente e a fibrose foi avaliada pelos métodos de tricrômico de Masson e picrosirius red. A avaliação vascular foi feita pelo VVG. Verificou-se a expressão das enzimas MMP-1, MMP-2, MMP-7, MMP-9 e TIMP-1 por método imunoistoquímico. A quantidade de colágeno na fibrose endometrial foi maior nas regiões periglandulares, perivasculares e no estrato esponjoso, predominando o colágeno tipo I. Quanto maior o grau de endometrite mais acentuada era a esclerose vascular e a fibroelastose. Não houve diferença na expressão das MMP-1, MMP-2, MMP-7, MMP-9 e TIMP-1 entre éguas normais e com endometrites. Porém houve diferença em relação à intensidade de marcação notando-se que esta aumentava em determinadas regiões do endométrio. As MMPs e o TIMP-1 estão envolvidos nos processos fibróticos endometriais das éguas uma vez que estas enzimas variam em expressão e intensidade de reação conforme o grau de endometrite / Abstract: Endometritis is the main cause of mare subfertility and the associated uterine fibrotic process is a limitant factor for the reproductive performance. The aim of this work was to evaluate the collagen distribution and type, the enzymes that are responsible for collagen degradation and its inhibitors, and vascular changes in the endometrium of normal and chronic endometritis carrying mares. So a prospective and comparative study was conducted at Veterinary Hospital of Veterinary College UNESP, Botucatu-SP. Eighty-two uterine biopsy were histologically classified in paraffin sections stained with hematoxylin and eosin, Masson's Trichrome and Verhoeff van Gieson (VVG) stains examined under the light microscope. Picrosirius red polarization was also used for collagen evaluation. The MMP-1, MMP-2, MMP-7, MMP-9, and TIMP-1 expressions was obtained by immunohistochemichal method. The collagen concentration in fibrotic endometrium was higher at periglandular, perivascular and stratum spongiosum regions with collagen type I predominance. In the most severe endometritis had more advanced grades of vascular sclerosis and fibroelastosis. No difference was found in MMP-1, MMP-2, MMP-7, MMP-9, and TIMP-1 expressions between normal and chronic endometritis samples, but the immunohistochemical reaction was more intense in some regions of fibrotic endometrium. In conclusion, the MMPs and TIMP-1 showed variation in expression and reaction intensity in the normal and chronic affected endometrium and may plays a hole in the endometrial fibrotic process / Doutor

Two experiments were designed to study endometritis in postpartum dairy cows. In the first experiment, 30 cows 28 to 41 days in milk (DIM) and without evidence of clinical endometritis were sampled using cytobrush cytology. Cytobrush sampling provided sufficient endometrial material to prepare cytologic specimens and to extract endometrial mRNA. Pro-inflammatory cytokines were analyzed in harvested endometrial tissue taken from cows with and without endometritis. Cytokine expression varied between experimental groups with 30-fold higher IL-6 expression levels (P=0.01), greater than 50-fold higher IL-8 expression levels (P=0.0001), and 20-fold higher TNF-α expression levels (P=0.001) in endometritis-positive versus negative cows. Regression analysis of cytokine expression levels (Ct) and the percentage of PMNs in subclinical endometritis-positive cows showed that for each additional threshold cycle required for IL-8 detection, which corresponded to two-fold less mRNA, the percentage of PMN decreased by 3.3% (P=0.00001). Similarly, for each additional threshold cycle required to detect IL-6 and TNF-α, the percentage of PMNs in endometritis-positive cows decreased by 2.3% (P=0.015) and 2.4% (P=0.054), respectively. Cows with > 18% PMNs required significantly fewer amplification cycles to detect IL-6 (P = 0.01), IL-8 (P =0.0001) and TNF-α (P=0.053) mRNA than cows with <18% PMNs (endometritis-negative). There was a highly significant positive correlation between the expression of individual pro-inflammatory cytokines when comparing IL-8 and IL-6 (P=0.0001), IL-8 and TNF-α (P=0.00001), and finally IL-6 and TNF-α (P=0.0002). In the second experiment, 340 cows 28 to 41 days in milk were examined using cytobrush cytology and transrectal ultrasonography of the uterus and ovaries. One-half of the cows were treated with benzathine cephapirin uterine infusion to determine the lowest PMN percentage where a significant improvement in reproductive performance occurred. Subclinical endometritispositive (>15%) cows in this study were defined as those with the lowest percentage of PMNs that was associated with a significant positive treatment effect. Treated cows with >15% PMNs required 31 fewer days (P=0.041) to become pregnant and had 2.5 times fewer services per conception (P=0.0001) than untreated cows with >15% PMNs. The likelihood of there being CLs at the time of examination in cows with >15% PMNs in endometrial cytobrush cytology was 2.3 times significantly higher (P=0.04). The treatment of cows with ultrasonographically detectable fluid in the uterine lumen with benzathine cephapirin had no effect on days open compared to treatment of cows without fluid in the uterus (P=0.39). Cervical diameter and endometrial thicknesses did not differ between groups of cows with >, < 15%PMNs (P=0.46, P=0.36, respectively). In summary, based on the response to a single treatment with benzathine cephapirin, and the analysis of pro-inflammatory cytokine gene expression, we recommend that a threshold of >18% PMNs be used to define endometritis-positive disease status in cows 28 to 41 DIM. Cervical diameter, ultrasonographic evidence of uterine fluid and ultrasonographic measurement of endometrial thickness were not useful for diagnosing benzathine cephapirin responsive endometritis.

Two experiments were designed to study endometritis in postpartum dairy cows. In the first experiment, 30 cows 28 to 41 days in milk (DIM) and without evidence of clinical endometritis were sampled using cytobrush cytology. Cytobrush sampling provided sufficient endometrial material to prepare cytologic specimens and to extract endometrial mRNA. Pro-inflammatory cytokines were analyzed in harvested endometrial tissue taken from cows with and without endometritis. Cytokine expression varied between experimental groups with 30-fold higher IL-6 expression levels (P=0.01), greater than 50-fold higher IL-8 expression levels (P=0.0001), and 20-fold higher TNF-α expression levels (P=0.001) in endometritis-positive versus negative cows. Regression analysis of cytokine expression levels (Ct) and the percentage of PMNs in subclinical endometritis-positive cows showed that for each additional threshold cycle required for IL-8 detection, which corresponded to two-fold less mRNA, the percentage of PMN decreased by 3.3% (P=0.00001). Similarly, for each additional threshold cycle required to detect IL-6 and TNF-α, the percentage of PMNs in endometritis-positive cows decreased by 2.3% (P=0.015) and 2.4% (P=0.054), respectively. Cows with > 18% PMNs required significantly fewer amplification cycles to detect IL-6 (P = 0.01), IL-8 (P =0.0001) and TNF-α (P=0.053) mRNA than cows with <18% PMNs (endometritis-negative). There was a highly significant positive correlation between the expression of individual pro-inflammatory cytokines when comparing IL-8 and IL-6 (P=0.0001), IL-8 and TNF-α (P=0.00001), and finally IL-6 and TNF-α (P=0.0002). In the second experiment, 340 cows 28 to 41 days in milk were examined using cytobrush cytology and transrectal ultrasonography of the uterus and ovaries. One-half of the cows were treated with benzathine cephapirin uterine infusion to determine the lowest PMN percentage where a significant improvement in reproductive performance occurred. Subclinical endometritispositive (>15%) cows in this study were defined as those with the lowest percentage of PMNs that was associated with a significant positive treatment effect. Treated cows with >15% PMNs required 31 fewer days (P=0.041) to become pregnant and had 2.5 times fewer services per conception (P=0.0001) than untreated cows with >15% PMNs. The likelihood of there being CLs at the time of examination in cows with >15% PMNs in endometrial cytobrush cytology was 2.3 times significantly higher (P=0.04). The treatment of cows with ultrasonographically detectable fluid in the uterine lumen with benzathine cephapirin had no effect on days open compared to treatment of cows without fluid in the uterus (P=0.39). Cervical diameter and endometrial thicknesses did not differ between groups of cows with >, < 15%PMNs (P=0.46, P=0.36, respectively). In summary, based on the response to a single treatment with benzathine cephapirin, and the analysis of pro-inflammatory cytokine gene expression, we recommend that a threshold of >18% PMNs be used to define endometritis-positive disease status in cows 28 to 41 DIM. Cervical diameter, ultrasonographic evidence of uterine fluid and ultrasonographic measurement of endometrial thickness were not useful for diagnosing benzathine cephapirin responsive endometritis.

Two experiments were designed to study endometritis in postpartum dairy cows. In the first experiment, 30 cows 28 to 41 days in milk (DIM) and without evidence of clinical endometritis were sampled using cytobrush cytology. Cytobrush sampling provided sufficient endometrial material to prepare cytologic specimens and to extract endometrial mRNA. Pro-inflammatory cytokines were analyzed in harvested endometrial tissue taken from cows with and without endometritis. Cytokine expression varied between experimental groups with 30-fold higher IL-6 expression levels (P=0.01), greater than 50-fold higher IL-8 expression levels (P=0.0001), and 20-fold higher TNF-&#945; expression levels (P=0.001) in endometritis-positive versus negative cows. Regression analysis of cytokine expression levels (Ct) and the percentage of PMNs in subclinical endometritis-positive cows showed that for each additional threshold cycle required for IL-8 detection, which corresponded to two-fold less mRNA, the percentage of PMN decreased by 3.3% (P=0.00001). Similarly, for each additional threshold cycle required to detect IL-6 and TNF-&#945;, the percentage of PMNs in endometritis-positive cows decreased by 2.3% (P=0.015) and 2.4% (P=0.054), respectively. Cows with > 18% PMNs required significantly fewer amplification cycles to detect IL-6 (P = 0.01), IL-8 (P =0.0001) and TNF-&#945; (P=0.053) mRNA than cows with 15%) cows in this study were defined as those with the lowest percentage of PMNs that was associated with a significant positive treatment effect. Treated cows with >15% PMNs required 31 fewer days (P=0.041) to become pregnant and had 2.5 times fewer services per conception (P=0.0001) than untreated cows with >15% PMNs. The likelihood of there being CLs at the time of examination in cows with >15% PMNs in endometrial cytobrush cytology was 2.3 times significantly higher (P=0.04). The treatment of cows with ultrasonographically detectable fluid in the uterine lumen with benzathine cephapirin had no effect on days open compared to treatment of cows without fluid in the uterus (P=0.39). Cervical diameter and endometrial thicknesses did not differ between groups of cows with >, < 15%PMNs (P=0.46, P=0.36, respectively). In summary, based on the response to a single treatment with benzathine cephapirin, and the analysis of pro-inflammatory cytokine gene expression, we recommend that a threshold of >18% PMNs be used to define endometritis-positive disease status in cows 28 to 41 DIM. Cervical diameter, ultrasonographic evidence of uterine fluid and ultrasonographic measurement of endometrial thickness were not useful for diagnosing benzathine cephapirin responsive endometritis.