O presente estudo teve como objetivo a caracterização genômica das espécies: Mycoplasma hominis, Ureaplasma urealyticum e Ureaplasma parvum em amostras cervicais de gestantes. Cepas de Mycoplasma hominis e de Ureaplasma spp., foram identificadas através do cultivo e por PCR utilizando-se primers genéricos e específicos. Os achados na literatura são contraditórios quanto a participação dessas bactérias nas doenças humanas, especialmente quanto a participação destas em casos de infertilidade e alterações perigestacionais. Considerando a marcante heterogeneidade das cepas de Mycoplasma hominis, utilizamos a reação de RAPD com a finalidade de definir os perfis genômicos das cepas isoladas. A caracterização dos biótipos 1 e 2 do gênero Ureaplasma, respectivamente, Ureaplasma urealyticum e Ureaplasma parvum, através da análise da MBA (Múltipla Banda Antigênica) por PCR, teve como finalidade determinar a predominância de cada uma dessas espécies. Foram estudadas amostras de material cervical de 163 gestantes em várias idades gestacionais. Os resultados obtidos neste trabalho foram: M. hominis foi detectado em 14,7% (24/163) das amostras, sendo a RAPO realizada em 7 das amostras positivas e puras de M. hominis. A reação RAPD demonstrou similaridade do perfil gênico entre as amostras 3 e 4 e entre as amostras 6 e 8, enquanto que as amostras 2, 5 e 7 demonstraram uma grande heterogeneidade. O gênero Ureaplasma foi isolado em 54,6% (89/163) das amostras, sendo 31,5% (28/89) cepas de U. urealyticum e 68,5% (61/89) U. parvum. Foram detectados 10,4% (17/163) casos de co-infecções M. hominis e Ureaplasma spp. O estudo da suscetibilidade das cepas isoladas frente a tetraciclina foi realizado com o intuito de se determinar a freqüência de cepas resistentes a essa droga. Considerando ser este antibiótico o de eleição no tratamento das micoplasmoses humanas e devido aos altos índices de resistência apresentados, resistência esta conferida pela presença do plasmídeo tetM, submetemos nossas amostras à pesquisa deste plasmídeo através da PCR. A presença do plasmídeo tetM foi detectada em 29,5% (7/24) das amostras positivas para Mycoplasma hominis e em 60,7% (54/89) das amostras positivas para Ureaplasma spp., sendo que dentre estas, 57,4% (31/54) foram detectados na espécie U. parvum e 42,6% (23/54) na espécie Ureaplasma urealyticum. O estudo da heterogeneidade intra-espécie das cepas de Mycoplasma hominis pela técnica de RAPD é inédito no Brasil. Da mesma maneira a caracterização das espécies do gênero Ureaplasma em U. parvum e U. urealyticum, através da PCR pela análise da MBA, foi pioneiramente realizada pelo nosso grupo de pesquisa. Esperamos com esse trabalho poder contribuir para um conhecimento melhor da freqüência dessas espécies na nossa população e tentar explicar as divergências das avaliações nas interações entre os micoplasmas e o hospedeiro. / The objective of this study was to characterize the species Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum in cervical samples from pregnant women. Strains of Mycoplasma hominis and Ureaplasma spp., were identified by means of culture and by PCR using generic and specific primers. The findings in the literature with regard to the involvement of these bacteria in human diseases are contradictory, especially regarding their involvement in cases of infertility and perigestational changes. In view of the strong heterogeneity among Mycoplasma hominis strains, we used RAPD to define the profiles of the strains isolated. Biotypes 1 and 2 of the genus Ureaplasma - Ureaplasma urealyticum and Ureaplasma parvum respectively - were characterized by means of MBA (Multiple Banded Antigenic) analysis using PCR to determine the predominance of each of these species. Samples of cervical material from 163 pregnant women at various stages of pregnancy were studied. The results obtained in this study were: M. hominis was detected in 14.7% (24/163) of the samples, and RAPD analyses carried out in 7 M. hominis strains. The RAPD similarly gene profile was showed: between strains 3 and 4, and between strains 6 and 8. The strains 2, 5 and 7 showed a pronounced heterogeneity in the gene profile. The genus Ureaplasma was isolated in 54.6% (89/163) of the samples, of which 31.5% (28/89) were U. urealyticum and 68.5% (61/89) U. parvum. Mycoplasma hominis and Ureaplasma spp., coinfection were detected in 10.4% (17/163) of the samples. The study of the susceptibility of the isolated strains to tetracycline was carried out with a view to determining the frequency of strains resistant to this drug. As this is the antibiotic of choice in the treatment of human mycoplasmoses, and in view of the high resistance indices observed, which are conferred by the presence of the \"tetM\" plasmid, we looked for this plasmid in our samples using PCR. The presence of the tetM plasmid, was detected 57,1% (4/7) of the Mycoplasma hominis - positive samples and in 40,2% (29/72) of the Ureaplasma spp - positive samples. Of the latter, 41,6% (25/72) were detected in the species U. parvum and 33,4% (4/12) were detected in the species Ureaplasma urealyticum. This is the first time that a study of the intraspecies heterogeneity of Mycoplasma hominis strains using RAPD has been carried out in Brazil. Characterization of the genus Ureaplasma species into U. parvum and U. urealyticum by means of PCR using MBA analysis was likewise pioneering effort by our research group. We hope that our work will contribute to a greater knowledge of the frequency of these species in our population and that it will help to explain differences in the assessment of the interaction between mycoplasma and the host.

Una red egocéntrica o personal está compuesta por un ego, quien es el actor principal y sus alters, personas con quienes se relaciona. Estos estudios centran su investigación en los vínculos relacionales, de modo que el análisis de la red es óptimo para describir y comprender la influencia de los alters en el desarrollo de conductas relacionadas con la salud Objetivo: Describir las características (composición, estructura y soporte) de las redes egocéntricas de mujeres en edad fértil que acuden al servicio de Ginecología de un hospital nacional de Lima. Materiales y métodos: Se encuestó a 73 mujeres en edad fértil que acudieron al servicio de Ginecología del Hospital Nacional Dos de Mayo durante los meses febrero-marzo del 2020, siendo 71 las analizadas. Resultados: Las redes estuvieron compuestas principalmente por alters con características sociodemográficas similares a las del ego. Las redes fueron de 8 alters en promedio y se encontró una gran conexión entre los alters. Así mismo, se encontró que las redes de los egos están conectadas por un familiar. Se encontró que el 81,7% de las mujeres recurrieron a una sola fuente de información, siendo en su mayoría el centro de salud. Conclusiones: Las redes de mujeres en edad fértil muestran patrones repetitivos que consisten en la interrelación con personas que poseen similares características sociodemográficas. Así mismo, los resultados muestran que tanto las redes familiares como los centros de salud pueden ser determinantes para que las mujeres en edad fértil adopten comportamientos preventivos sobre su salud ginecológica. / An egocentric or personal network is composed of an ego, who is the main actor, and it alters people with whom it relates. These studies focus their research on relational ties, so that network analysis is optimal for describing and understanding the influence of alters on the development of health-related behaviors Objective: To describe the characteristics (composition, structure, and support) of egocentric networks of women of childbearing age attending the gynecology service of a national hospital in Lima. Materials and methods: Seventy-one women of childbearing age who attended the gynecology service of the Hospital Nacional Dos de Mayo during February-March 2020 were surveyed. Results: The networks were mainly composed of alters with sociodemographic characteristics similar to those of the ego. The networks were of 8 alters on average and a strong connection between alters was found. Likewise, the egos' networks were found to be connected by a family member. It was found that 81.7% of the women resorted to only one source of information, being mostly the health center. Conclusions: The networks of women of childbearing age show repetitive patterns consisting of interrelationships with people who have similar sociodemographic characteristics. Likewise, the results show that both family networks and health centers can be determinants for women of childbearing age to adopt preventive behaviors regarding their gynecological health. / Tesis

Bakgrund Gynekologisk cancer drabbar många kvinnor globalt och är ett samlingsnamn för äggstockscancer, vulvacancer, livmoderhalscancer och livmodercancer. Vanliga behandlingsmetoder inkluderar strålbehandling, cellgiftsbehandling (cytostatika) och kirurgi. Dessa behandlingsmetoder kan leda till påtagliga biverkningar som kan påverka den sexuella funktionen. Sexualitet utgör en viktig del av människans välbefinnande och har betydelse för övergripande hälsa. Det är dock viktigt att notera att upplevelsen av sexualitet är subjektiv och variationer kan förekomma bland individer. Rätten till sexuell och reproduktiv hälsa är universell, och hälso- och sjukvården bör sträva efter att tillgodose och främja denna rättighet genom att tillhandahålla information och resurser på ett personcentrerat sätt. Syfte Syftet var att beskriva upplevelser av sexuell hälsa vid gynekologisk cancer. Metod ​​En allmän litteraturöversikt som undersökt vetenskapliga originalartiklar från databaserna Cinahl Complete och PubMed. För att hitta dessa artiklar användes Mesh-termer och Cinahl Subject Headings och sökord relaterade till sexuell hälsa och gynekologisk cancer. Sökningen resulterade i elva utvalda artiklar som användes till resultatet. Resultat Denna litteraturöversikt fann att gynekologisk cancer och dess behandling negativt påverkar kvinnors sexualitet genom fysiska och känslomässiga förändringar, inklusive minskad sexlust och påverkan på relationer. Bristande informationsutbyte och stöd från sjukvårdspersonal ökar osäkerhet och lidande. Denna litteraturöversikt identifierade fyra teman relaterade till kvinnor som diagnostiseras och behandlas för gynekologisk cancer: sexuell funktion, kroppsbild och kvinnlig identitet, relationstillfredsställelse och kontakt med vården. Slutsats ​​Kvinnors sexualitet påverkades i olika grad av en gynekologisk cancerdiagnos och medföljande behandling. Det framkom dock att dessa upplevelser skiljde sig från person till person vilket förtydligar vikten av ett personcentrerat och holistiskt perspektiv i mötet med dessa personer. Ytterligare forskning krävs för att vidare undersöka kulturella skillnader, åldersskillnader och upplevelser hos dessa kvinnor. / Background Gynecological cancer affects many women worldwide and encompasses ovarian cancer, vulvar cancer, cervical cancer, and uterine cancer. Common treatment methods include radiation therapy, chemotherapy (cytostatics), and surgical interventions. These treatment modalities may entail challenging side effects that can impact sexual functioning. Sexuality is a crucial aspect of human life and influences overall health. However, sexuality is subjective, and cultural differences in the experience of sexuality may exist. Everyone has the right to sexual and reproductive health, and it is essential for healthcare to meet and promote these needs through, among other things, personalized information and resources.​ Aim The aim was to describe experiences of sexual when effected with gynecological cancer​. Method A general literature review that examined scientific original articles from the Cinahl Complete and PubMed databases. To find these articles, Mesh terms and Cinahl Subject Headings, as well as keywords related to sexual health and gynecological cancer, were used. These resulted in eleven selected articles. Results This literature review found that gynecological cancer and its treatment negatively impact women's sexuality through physical and emotional changes, including decreased libido and effects on relationships. Insufficient information exchange and support from healthcare professionals increase insecurity and suffering. This literature review identified four themes related to women diagnosed and treated for gynecological cancer: sexual function, body image and female identity, relationship satisfaction, and healthcare communication. Conclusions Women's sexuality was variably affected by a diagnosis of gynecological cancer and its accompanying treatments. However, it became evident that these experiences differed among individuals, underscoring the significance of a person-centered and holistic perspective when engaging with these individuals. Further research is warranted to explore cultural variations, age-related differences, and the unique experiences of these women.​

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Bakgrund: År 2020 rapporteras det globalt 604 000 nya fall av livmoderhalscancer. I 90% av fallen skedde dessa i låg- eller medelinkomstländer. Den vanligaste orsaken till livmoderhalscancer är infektion med HPV-virus som är en sexuellt överförbar infektion. Behandlingen vid livmoderhalscancer är kirurgi, cytostatika, strålbehandling och kombinerad behandling med cytostatika och strålning. En god hälsa är en grundläggande mänsklig rättighet och en fundamental del av människans generella hälsa är sexuell hälsa. Syftet: Syftet var att belysa kvinnors upplevelse av sexuell hälsa vid diagnostiserad livmoderhalscancer. Metod: Studien är en kvalitativ litteraturöversikt med induktivt förhållningssätt där 14 artiklar har analyserats enligt analys av Friberg i fem steg. Resultat: Huvudkategorierna som framträdde var sexuellt lidande med underkategorierna sexuell hälsa relaterat till fysiska besvär och sexuell hälsa relaterat till psykiska besvär. Andra huvudkategorin är sexuellt välbefinnande med underkategorierna sexuellt intresse och stöd av vården. Slutsats: Livmoderhalscancern påverkade välbefinnandet och sexuella hälsan för kvinnor på ett negativt sätt. Resultatet visade att kvinnors självkänsla och kroppsbild förändrades med livmoderhalscancern och behandlingen och att fysiska symtom gjorde att kvinnorna upplevde en förändrad sexualitet. I de fall där kvinnorna upplevde en förbättrad sexuell hälsa och kunde återgå till ett fungerande sexliv hade partnern ett stöttande förhållningssätt och sjukvården hade försett dem med information och kunskap. / Background: In 2020, 604 000 new cases of cervical cancer were reported globally. 90% of these cases took place in low- or middle-income countries. The most common cause of cervical cancer is infection with the HPV virus, which is a sexually transmitted infection. The treatment for cervical cancer is surgery, cytostatics, radiotherapy as well as combined treatment with cytostatics and radiation. Satisfactory health is a basic human right and a fundamental part of a person's general health is their sexual health. Aim: The aim was to describe women’s experience of sexual health when diagnosed with cervical cancer. Method: The study is a qualitative literature review with an inductive approach where 14 articles have been analyzed according to analysis by Friberg in five steps. Result: The main categories that emerged were sexual suffering with the subcategories sexual health related to physical problems and sexual health related to psychological problems and the main category sexual well-being with the subcategories sexual interest and support from caregivers. Conclusion: Cervical cancer affected quality of life and sexual health of women in a negative way. The results showed that women's self-esteem and body image changed with cervical cancer and treatment and that physical symptoms caused the women to experience a changed sexuality. In cases where women experienced improved sexual health and were able to return to a functioning sex life, their partners had a supportive approach and health care had provided them with information and knowledge.

Les algies pelviennes aigues constituent le premier motif de consultation aux urgences gynécologiques. Les étiologies possibles de ces algies pelviennes aigues sont nombreuses et incluent à la fois des affections gynécologiques et non gynécologiques. Certaines de ces affections peuvent, en l’absence de diagnostic précoce et d’un traitement adapté, avoir des conséquences très graves. Dans ce travail, nous avons développé un autoquestionnaire standardisé de manière qualitative dédié aux urgences gynécologiques par des entretiens structurés. Nous avons ensuite construit des modèles de prédiction clinique dédiés (i) au diagnostic de rupture tubaire chez les patientes porteuses de grossesses extra-utérines et (ii) au diagnostic de torsion d’annexe à partir de cet autoquestionnaire. Après avoir défini le concept d’urgence potentiellement à risque en gynécologie, nous avons proposé (iii) un modèle de prédiction clinique de celles-ci basé sur notre autoquestionnaire standardisé. A l’issue du développement de ces modèles, nous avons sélectionné certains items de l’autoquestionnaire standardisé afin d’en proposer une version simplifiée. L’utilisation de nos modèles pour le tri et le diagnostic des patientes aux urgences gynécologiques pourrait permettre d’optimiser la prise en charge des patientes. Dans les groupes à haut risque de pathologie, les patientes pourraient bénéficier d’une prise en charge plus rapide avec une éventuelle diminution de la morbidité secondaire à la pathologie. Pour les patientes classées à bas risque, une désescalade des examens complémentaires et des chirurgies inutiles pourrait aussi permettre une diminution de la morbidité d’origine iatrogène. / Acute pelvic pain is the main reason for emergency gynecologic consultation. The possible etiologies of acute pelvic pain are numerous and include both gynecological and non gynecological diseases. Some of these conditions may, in the absence of early diagnosis and appropriate treatment, have very serious consequences. In this work, we developed qualitatively a standardized self-assessed questionnaire dedicated to gynecological emergencies by structured interviews. We then developed clinical prediction rules for (i) the diagnosis of tubal rupture in patients who have ectopic pregnancies and (ii) the diagnosis of adnexal torsion. After a definition of the concept of potentially at risk emergencies in gynecology, we have proposed (iii) a clinical prediction rule based on our questionnaire. Following the development of these models, we selected items from the self-assessed questionnaire in order to propose a simplified version. Using our models for triaging and diagnosis of patients with gynecologic emergencies may optimize the management of patients. In groups at high risk of disease, patients may benefit from faster medical management with a possible decrease in morbidity. For patients classified as low risk, decrease of complementary tests and unnecessary surgery could also allow a reduction of iatrogenic morbidity.

Made available in DSpace on 2014-07-29T15:25:16Z (GMT). No. of bitstreams: 1 Suelene Brito do Nascimento.pdf: 777082 bytes, checksum: f9660425f3055477271c6efbe8608c9e (MD5) Previous issue date: 2011-09-29 / False-negative rates constitute a common problem in the daily routine of cytopathology laboratories. Among the various internal quality control methods, 10% random review is the least effective in detecting false-negative results in routine screening. On the other hand, good results have been found with 100% rapid review and with rapid prescreening. Nevertheless, no studies comparing these two methods have been reported. Objective: To compare the performance of rapid prescreening and 100% rapid review as internal quality control methods in cervical cytopathology. Methods: Over 27 months, 12,208 cervical cytology smears collected from Units of Primary Health Care of Goiânia were submitted to rapid prescreening and routine screening at Rômulo Rocha Center for Clinical Analyses at the School of Pharmacy, Federal University of Goiás, Goiânia, Goiás, Brazil. The 100% rapid review method was performed on all smears classified as negative at routine screening. Conflicting results obtained with either method were reviewed in detail to define final diagnosis, which was considered the gold-standard for evaluating the performance of rapid prescreening and 100% rapid review. In cases with abnormal cytology were evaluated the results of colposcopy, histopathology and of the new cytopathology. The sensitivity and specificity of internal quality control methods were estimated when compared to the final diagnosis, and to follow-up colposcopy, histopathology and at new cytopathology. Results: Compared to the final diagnosis, the sensitivity of routine screening and rapid prescreening was 72.9% (IC 95%: 70,0%-75,8%) and 75.6% (IC 95%: 72,8%-78,4%), respectively. Taking into account only those smears classified as negative at routine screening, the sensitivity of rapid prescreening and RR-100% was 90.2% (IC 95%: 86,4-93,9) and 57.0% (50,8%-63,2%), respectively. Rapid prescreening identified 220 (1.8%), while RR-100% identified 140 (1.15%) of the 244 (2.0%) cases with false-negative results at routine screening. The sensitivity of rapid prescreening in detect abnormal cases at follow-up colposcopy, histopathology and at new cytopathology was 87.5% (CI95%; 74.3%-100.7%) 82,4% (CI95%: 64.2%-100.,5%), 95.7% (CI95%:89.8%-101.5%), respectively, the sensitivity of 100% rapid review was 54.2% (CI95%: 34.2%-74.1%), 52.9% (CI95%: 29.2%-76.7%), 47.8% (CI95%: 33.4%-62.3%) respectively and the sensibility of routine screening was 83.2% (CI95%: 77.1%-89.3%), 85.7% (CI95%: 79.4%-92.0%), 73.3% (CI95%: 66.6%-79.9%), respectively. Conclusions: Rapid prescreening was more effective than 100% rapid review for the detection of false-negative results at routine screening, with a better performance when compared to final diagnosis, to follow-up colposcopy and at new cytopathology. The methods showed similar performance when compared at follow-up histopathology. Therefore, according to the results of this study, rapid prescreening provides subsidies to improve the performance of cervical cytopathology tests, whose the principal function of which is to detect cervical cancer precursor lesions. / As altas taxas de resultados falso-negativos são problemas enfrentados na rotina dos laboratórios de citopatologia. Dentre os métodos de controle interno da qualidade, a revisão de 10% é a menos eficiente para detectar os resultados falso-negativos do escrutínio de rotina. No entanto, há evidências de que a revisão rápida de 100% e o pré-escrutínio rápido apresentam bons resultados na sua detecção. Porém, não existem estudos que compararam estes dois métodos. Objetivo: Comparar o desempenho do pré-escrutínio rápido e da revisão rápida de 100% como métodos de controle interno da qualidade dos exames citológicos do colo do útero. Métodos: Durante 27 meses 12.208 esfregaços citológicos cervicais provenientes das Unidades de Atenção Básica à Saúde do município de Goiânia foram submetidos ao pré-escrutínio rápido e ao escrutínio de rotina no Centro de Análises Clínicas Rômulo Rocha da Faculdade de Farmácia da Universidade Federal de Goiás-Goiânia-GO-Brasil. A revisão rápida de 100% foi realizada nos esfregaços negativos no escrutínio de rotina. Os resultados discordantes por qualquer dos métodos foram revisados detalhadamente para definição do diagnóstico citológico final, considerado padrão ouro para avaliar o desempenho do pré-escrutínio rápido e da revisão rápida de 100%. Nos casos com anormalidades citológicas foi avaliado o resultado dos exames colposcópicos, histológicos e da nova citologia. Foram estimadas a sensibilidade e a especificidade dos métodos de controle interno da qualidade quando comparados ao diagnóstico citológico final, ao exame colposcópico, histológico e ao novo exame citológico. Resultados: Comparado ao diagnóstico citológico final a sensibilidade do escrutínio de rotina e do pré-escrutínio rápido foi de 72,9% (IC 95%: 70,0%-75,8%) e 75,6% (IC 95%: 72,8%-78,4%), respectivamente. A sensibilidade do pré-escrutínio rápido e da revisão rápida de 100%, levando em conta os esfregaços negativos no escrutínio de rotina foi 90,2% (IC 95%: 86,4-93,9) e 57,0% (50,8%-63,2%), respectivamente. O pré-escrutínio rápido identificou 220 (1,8%) e a revisão rápida de 100% 140 (1,15%) dos 244 (2,0%) falso-negativos do escrutínio de rotina. A sensibilidade do pré-escrutínio rápido na detecção de anormalidades colposcópicas, histoológicas e no novo exame citológico foi de 87,5% (IC95%: 74,3%-100,7%), 82,4% (IC95%: 64,2%-100,5%), 95,7% (IC95%: 89,8%-101,5%), respectivamente, a sensibilidade da revisão rápida de 100% foi de 54,2% (IC95%: 34,2%-74,1%), 52,9% (IC95%: 29,2%-76,7%), 47,8% (IC95%: 33,4%-62,3%), respectivamente e a sensibilidade do escrutínio de rotina foi de 83,2% (IC95%: 77,1%-89,3%), 85,7% (IC95%: 79,4%-92,0%), 73,3% (IC95%: 66,6%-79,9%), respectivamente. Conclusões: O pré-escrutínio rápido foi mais eficiente que a revisão rápida de 100% para detectar resultados falso-negativos do escrutínio de rotina obtendo melhor desempenho quando comparado ao diagnóstico citológico final, ao resultado do exame colposcópico e ao novo exame citológico. Os métodos apresentaram desempenho semelhante quando comparado ao resultado do exame histológico. Portanto, de acordo com os resultados desse estudo, o pré-escrutínio rápido fornece subsídios para melhorar o desempenho dos exames citológicos, cuja principal função é detectar as lesões precursoras do câncer do colo do útero.

In der klinischen Diagnostik gewinnt die Untersuchung des Ernährungszustandes zunehmend an Bedeutung. Denn die Güte des Ernährungszustandes hat einen Einfluss auf die Mortalität und Morbidität der Patienten. Zur groben Evaluierung des Ernährungszustandes dient der Body Mass Index (BMI). Eine differenzierte Beurteilung des Ernährungszustandes wird durch die Analyse der Körperzusammensetzung erreicht. Die phasensensitive bioelektrische Impedanzanalyse (BIA) ist eine schnelle, preisgünstige und nicht-invasive Methode zur Messung der Körperzusammensetzung. Insbesondere der Phasenwinkel, der ein direkter Messparameter der BIA ist, gibt einen schnellen Überblick über den Ernährungszustand der Patienten. Er spiegelt das Verhältnis von Extrazellulärmasse zu Körperzellmasse wieder, welches in vielen Studien als Indikator zur frühzeitigen Erfassung einer beginnenden Mangelernährung validiert wurde. Bei der Applikation einer Chemotherapie ist es von großer Bedeutung, dass die vorgesehene Dosis und Dosisintensität der Therapie eingehalten wird. Insbesondere unerwünschte Nebenwirkungen sind häufig für Dosisreduktionen und Verschiebungen der Chemotherapie verantwortlich. In einer prospektiven Studie wurde bei 40 Frauen, die sich aufgrund eines gynäkologischen Malignoms einer Chemotherapie unterzogen haben, die Körperzusammensetzung mit der BIA vor jedem Chemotherapiezyklus gemessen. Diese Studie zeigt, dass durch die Messung der Körperzusammensetzung ein Risikokollektiv, welches für Nebenwirkungen der Therapie anfällig ist, ermittelt werden kann. Der Body Mass Index (BMI) erwies sich als unzureichender Parameter zur Beschreibung des Ernährungszustandes der Patientinnen. Insbesondere muss mit einer erhöhten Rate von Nebenwirkungen der Chemotherapie bei einem verminderten Phasenwinkel, welcher einen reduzierten Ernährungszustand widerspiegelt, gerechnet werden. / In clinical diagnostics the nutritional status is becoming more and more of interest. The nutritional status is closely connected with morbidity and mortality. It is usually evaluated by the body mass index (BMI). An exact estimation of nutritional status can be given by the measurement of body composition. The bioelectrical impedance analysis (BIA) allows a quick and non-invasive measurement of the body composition for each patient. A main point of interest is the phase angle, which is measured directly. It gives a prompt view on the nutritional status. There is a relation between the phase angle and the ECM/BCM-Ratio, a sensitive marker for early signs of malnutrition which was validated in many studies. For patients receiving chemotherapy (CT) it is especially important that the application of the therapy is administered in the right dose and dose intensity. Adverse events often lead to a dose reduction or delay of CT administration. In a prospective clinical study we measured consecutively 40 women receiving chemotherapy for a gynaecological malignancy. BIA was performed before each course of CT. The study demonstrates that an evaluation of the nutritional status can be used to predict the risk for adverse events in patients under chemotherapy. The BMI showed not to be a reliable parameter to estimate the nutritional status. A decreased phase angle which is a parameter for a reduced nutritional status showes that a higher rate of side effects in chemotherapy can be expected .

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