Memoria para optar al Título Profesional de Médico Veterinario / La subfertilidad en la yegua tiene un impacto económico negativo sobre la industria equina ya que afecta la producción de potrillos. Dentro de las numerosas causas que pueden incidir en la eficiencia reproductiva de una yegua, la inflamación y fibrosis uterina constituyen una de las más importantes alteraciones relacionadas con este problema. De esta forma, resulta fundamental un diagnóstico oportuno y preciso de estas patologías, para lo cual es necesaria la realización de un buen examen reproductivo. En el presente estudio se utilizaron 2 técnicas de apoyo clínico disponibles actualmente en ginecología equina, tales son la ecografía y la histopatología, con el fin de asociar los hallazgos encontrados en útero de yeguas Fina Sangre de Carrera (FSC). Los hallazgos ecográficos que caracterizaron la presencia de inflamación uterina fueron presencia de líquido en el lumen uterino, representada por una imagen ecográfica hipoecoica o anecoica, y/o aumento del grosor de la pared uterina, mientras que histopatológicamente, esta alteración se caracterizó por la presencia de PMN, linfocitos u otro tipo de células (plasmocitos, eosinófilos). En cuanto a la fibrosis, el principal hallazgo ecográfico fue la visualización de una imagen altamente ecoica presente en el área endometrial, mientras que histopatológicamente la presencia de fibras colágenas fue indicativa de esta alteración. Al comparar las biopsias de áreas ecográficas normales y alteradas de un mismo útero, con fibrosis o inflamación, no se encontraron diferencias importantes. Los análisis para establecer el grado de asociación que existe entre el examen ecográfico e histopatológico de inflamación y fibrosis uterina arrojaron que para el caso de inflamación no existe asociación entre los dos diagnósticos con respecto a la severidad y las características del foco; mientras que, para la fibrosis se determinó que sí existe asociación entre ambos diagnósticos en lo que respecta a la distribución de la lesión, número de focos fibróticos por campo y número de capas alrededor de las glándulas. 2 Por otro lado, el porcentaje de área de colágeno fue mucho mayor para las muestras del grupo fibrosis (1,60) que las tipificadas para el grupo inflamación (0,12) y el grupo control sano (0,21). Finalmente, según esta experiencia la técnica ecográfica sería de gran utilidad en el diagnóstico presuntivo de fibrosis endometrial, mientras que para inflamación, estadísticamente esta técnica no resultó ser adecuada para su diagnóstico. Sin embargo para definir con mayor precisión la real utilidad de la técnica para detectar la inflamación endometrial, harían falta otros estudios con una mayor cantidad de muestras.

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Made available in DSpace on 2014-06-11T19:27:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-04-26Bitstream added on 2014-06-13T18:56:25Z : No. of bitstreams: 1 malini_gmv_me_botfm_prot.pdf: 1634811 bytes, checksum: c4c3c52a8699b198de4e1ccc994f6b1f (MD5) / Financiadora de Estudos e Projetos (FINEP) / Ses - Secretaria Estadual da Saúde / Medidas seriadas da altura uterina e do peso materno são métodos de rastreamento de restução ie cresctmei mtta-utetmo C1X3 K ï uestio a ac as diferentes curvas de altura uterina e traz poucos relatos sobre o peso materno. Objetivo: avaliar a acurácia de curvas de altura uterina e de peso materno como método de rastreamento de RCIU. Sujeitos e métodos: foi realizado estudo retrospectivo de 453 primigestas, com gestação única e sem intercorrências clínicas ou obstétricas, acompanhadas desde o primeiro trimestre de gestação no Serviço de Obstetrícia do Hospital das Clínicas da Faculdade de Medicina de Botucatu - UNESP, no período entre janeiro de 2001 e dezembro de 2003. Foram avaliadas, isoladamente, a curva de altura uterina e as curvas de peso (Rosso) e ganho de peso (CLAP) materno, e também a associação da curva de altura uterina com as curvas de peso e ganho de peso materno. Nos programas estatísticos EPI-INFO e SPSS foram calculados sensibilidade, especificidade, valores preditivos positivo e negativo e, acurácia das curvas analisadas. Foi considerado intervalo de confiança de 95%. Resultados: a incidência de recém-nascidos com RCIIU foi de 22,5%. A sensibilidade da curva de altura uterina em rastrear RCIU foi de apenas 1% (1C95% 0,0 - 2,8). As curvas de peso (Rosso - 55,9% - 1C95% 46,9 - 64,8) e de ganho de peso (CLAP - 26,5% - 1C95% 18,5 - 34,4) apresentaram baixa sensibilidade. A associação da curva de altura uterina às curvas de peso e de ganho de peso não modificou a sensibilidade apresentada quando analisadas isoladamente. Conclusões: em pnmigestas, sem intercorrências clínicas ou obstétricas, a medida seriada da altura uterina não é um bom método de rastreamento de RCIU. As medidas seriadas do peso e do ganho de peso materno apresentaram baixa sensibilidade como fator de rastreamento... / Sena! measures of uterine height and of maternal weight are methods for investigating the restnction of intra-uterine growth (RCIU). Literature questions the accuracy of the different curves of uterine heights and brings few reports concerning maternal weight. Objective: Evatuate the accuracy of the curves of uterine height and of maternal weight as a method of investi gating the RICU. Subjects and Methods: A restropective study of 453 women that were pregnant for the first time, with only one pregnancy and with no clinical or obstetric incidents, was conducted. They were assisted since their first three months of pregnancy at the Serviço de Obstetrícia do Hospital das Clínicas da Faculdade de Medicina de Botucatu - UNESP , between January 2001 and December 2003. The curves of utenne height and weight (Rosso) and the gain of maternal weight (CLAP) were analysed separately, as well as the association of the curve of uterine height with the curves of weight and the gain of maternal weight. In the Statistics programs EPI-INFO and SPSS, it was calculated sensibility, speciflcation, expected positive and negative values, and the accuracy of the curves that were analysed. A trustable interval of 95% was considered. Results: The incidence of new-born babies with the RCIU was of 22.5%. The sensibility of the curve of uterine height for investigating the RCIU was only of 1% (1C95% 0.0 - 2.8). The curves of weight (Rosso - 55.9% - 1C95% 46.9 - 64.8) and ofthe gain ofweight (CLAP - 26.5% - IC 95% 18.5 - 34.4) showed low sensibility. The association of the curve of uterine height with the curves of weight and of the gain of weight did not modify the sensibility showed when they were analysed separately. Conclusion: Iii women that are pregnant for the firs time with no clinical or obstetnc incidents, the sena! measure of the uterine height is not a good... (Complete abstract click electronic access below)

Research has demonstrated that prenatal exposure to antiepileptic drugs is associated with an increased risk of physical malformations. The potential risk such exposure conveys to the developing brain and therefore the later cognitive functioning of the child is now the focus of both national and international research. This thesis investigated the relationship between prenatal exposure to antiepileptic drugs and child cognitive functioning. This investigation was undertaken in three phases: a systematic review of the published literature; an original research piece investigating prenatal exposure to sodium valproate and levetiracetam and finally a critical review of the research undertaken as part of this thesis and in the wider published literature. The systematic review identified 30 studies which had investigated the cognitive abilities of children with a history of prenatal exposure to antiepileptic drugs. Methodological quality of the studies was considered against the criteria of the Newcastle Ottawa Scale. Differential findings were noted across the antiepileptic drug types, with the largest number of studies documenting increased risks associated with prenatal exposure to sodium valproate. A lack of high quality research across all antiepileptic drugs, and in particular the more recently licensed antiepileptic drugs is highlighted. In the research paper presented here children aged between five and nine years of age exposed to either levetiracetam (n=37), sodium valproate (n=40) or who were born to women with epilepsy but did not require medication (n=43) were recruited from throughout the UK. Demographic and health information was collected from prospective records and supplemented with maternal interview. Formal standardised neuropsychological assessments were undertaken to inform on the child's current level of intellectual, memory, language, attentional and executive functioning. Following adjustment for variables likely to influence child cognitive ability, prenatal exposure to sodium valproate was found to be associated with poorer intellectual and language functioning in a dose dependent manner. When stratified by dose, 57.9% of children exposed to doses of sodium valproate above 800mg daily scored below the average range for their global intellectual ability. Prenatal exposure to levetiracetam was not found to be associated with poorer cognitive functioning. The critical review highlighted a number of methodological strengths of this research, despite time and resource implications. However, consideration should be given to the retrospective nature of this cohort and the potential for recruitment bias. This thesis concludes that women who require continuation of their treatment during pregnancy to control their seizures should be counselled regarding the risks and the benefits of their treatment to allow them to make informed decisions.

El objetivo de la investigación fue evaluar el efecto de la intervención educativa sobre el nivel de conocimientos y actitudes frente al cáncer de cuello uterino y el virus del papiloma humano en estudiantes de Ciencias Médicas de la Universidad Nacional Santiago Antúnez de Mayolo (UNASAM) -Filial Barranca. El estudio fue cuasi experimental, longitudinal, prospectivo, de casos y controles. La muestra fueron 60 universitarias del primer ciclo de la Facultad de Ciencias Médicas de la Filial Barranca y 60 controles. Se usó el Programa SPSS versión 15.0. Para la significancia estadística se tomó la prueba t-student y la prueba de McNemar, con un valor de p<0.05 y un intervalo de confianza al 95%. Se encontró, que la edad promedio en el grupo control (19.84 años) fue ligeramente mayor que el experimental (17.80 años). El 100% de las alumnas de Enfermería fueron solteras a diferencia de un 96.67% de Obstetricia. En cuanto a la prueba de conocimiento sobre el Cáncer de Cuello Uterino y el Virus del Papiloma Humano, el 90% desaprobó la prueba antes de la intervención y al final solo el 28.33%, lo que fue significativo (p=0.00) con la prueba t-student, al igual que a los dos meses (p=0.00), mientras que la evaluación final y a los dos meses de la intervención no evidenció un incremento significativo (p=0.94). La Prueba de McNemar demostró que al Final de la intervención educativa hubo cambios significativos (p=0.00), mientras que a los dos meses no se mejoró el nivel de conocimientos (p=0.629). Así se obtuvo que el promedio basal del grupo experimental ( X =6.82, DE=3.12) aumento al final de la intervención ( X =11.33, DE=1.30), comparado con el grupo control que fue ( X =7.50, DE=2.68) y ( X =7.43, DE=2.90) respectivamente. Respecto a la actitud, con la prueba t-student se encontró un incremento significativo (p=0.00) en el promedio del puntaje de la prueba de actitud a los dos meses de concluida la intervención. Se vio una diferencia media entre la prueba basal y a dos meses de la intervención de 2,70 puntos en el control y 35,60 puntos el experimental. La actitud fue positiva en el grupo experimental a diferencia del control que tuvo actitudes negativas. Cuando las universitarias tuvieron más conocimiento, su actitud mejoró positivamente, por ello es importante que tengan una mayor información sobre el tema lo que podría tener un efecto protector sobre su salud y en sus pares. Palabras Claves: Intervención - Virus Papiloma Humano - Cáncer de Cuello uterino- Prevención. / --- The research objective was to evaluate the effect of educational intervention on the level of knowledge and attitudes towards cervical cancer and human papillomavirus among students of Medical Sciences of the University Santiago Antúnez de MayoloSubsidiary Barranca. A study quasi-experimental, longitudinal, prospective, casecontrol study. Participants were junior college of the Faculty of Medical Sciences of the Subsidiary Barranca. The sample was 60 cases and 60 controls. The data were processed in the computer program SPSS version 15.0.We used t-student test and McNemar test, with a value of p <0.05 and confidence interval 95% for statistical significance. It was found that the average age in the control group (19.84 years) was slightly larger than the experimental (17.80 years). Of the nursing students, 100% were single as opposed to a 96.67% of obstetrics. As a test of knowledge about cervical cancer and Human Papilloma Virus, 90% disapproved the test before the intervention and at the end only 28.33%, which was significant (p = 0.00) with the test t-student, like two months (p = 0.00), while the final evaluation and two months after intervention no significant increase (p = 0.94). The McNemar test showed that the End of the educational intervention there were significant changes (p = 0.00), while two months did not improve the knowledge level (p = 0.629). Thus it was found that the average baseline in the experimental group ( X =6.82, DE=3.12) increase at the end of the intervention ( X =11.33, DE=1.30), compared with the control group was ( X =7.50, DE=2.68) and ( X =7.43, DE=2.90) respectively. Regarding the attitude, the student t-test found a significant increase (p = 0.00) in average test score of attitude after two months of completion of the intervention. He was a mean difference between the baseline test and two months after surgery of 2.70 points and 35.60 points control the experimental. The attitude was positive in the experimental group in contrast to the control that had negative attitudes. When the university had more knowledge, improved their attitude positively, so it is important to have more information on the subject which could have a protective effect on their health and their peers. Keywords: Intervention - human papillomavirus - Cervical Cancer-Prevention. / Tesis

Asthma prevalence is increasing worldwide and the causes of this increase are largely unknown. There is increasing recognition of the importance of early environmental exposures in childhood asthma development. Outdoor air pollution has been shown to trigger asthma symptoms but its role in incident disease remains controversial. To address these questions, I investigated the effect of in utero and first year of life exposure to ambient air pollution on risk of asthma diagnosis in a nested case-control study. All children born in Southwestern British Columbia in 1999 and 2000 (N=37,401) were assessed for incidence of asthma diagnosis at age 3 - 4 years using hospitalization and primary physician records. Exposure to ambient air pollution was estimated for the gestational period and first year of life using high-resolution pollution surfaces derived from government monitoring station data as well as land use regression models adjusted for temporal variation. Conditional logistic regression analyses were used to estimate effects of CO, NO, NO₂, PM₁₀, PM₂.₅, O₃, SO₂, black carbon, wood smoke and proximity to roads and point sources on asthma diagnosis. Elevated risks of asthma diagnosis were observed with increased early life exposure to CO, NO, NO₂, PM₁₀, SO₂, black carbon and proximity to point sources. Effects were generally larger for first year exposures than in utero exposures, and larger for girls than boys. The results indicate that early life exposure to air pollution is associated with increased risk of asthma diagnosis in early childhood. Although the effect sizes are small, air pollution exposure in urban areas is ubiquitous so may have significant effects at the population level. These results should be confirmed when children are older and asthma diagnosis is more robust.

Asthma prevalence is increasing worldwide and the causes of this increase are largely unknown. There is increasing recognition of the importance of early environmental exposures in childhood asthma development. Outdoor air pollution has been shown to trigger asthma symptoms but its role in incident disease remains controversial. To address these questions, I investigated the effect of in utero and first year of life exposure to ambient air pollution on risk of asthma diagnosis in a nested case-control study. All children born in Southwestern British Columbia in 1999 and 2000 (N=37,401) were assessed for incidence of asthma diagnosis at age 3 - 4 years using hospitalization and primary physician records. Exposure to ambient air pollution was estimated for the gestational period and first year of life using high-resolution pollution surfaces derived from government monitoring station data as well as land use regression models adjusted for temporal variation. Conditional logistic regression analyses were used to estimate effects of CO, NO, NO₂, PM₁₀, PM₂.₅, O₃, SO₂, black carbon, wood smoke and proximity to roads and point sources on asthma diagnosis. Elevated risks of asthma diagnosis were observed with increased early life exposure to CO, NO, NO₂, PM₁₀, SO₂, black carbon and proximity to point sources. Effects were generally larger for first year exposures than in utero exposures, and larger for girls than boys. The results indicate that early life exposure to air pollution is associated with increased risk of asthma diagnosis in early childhood. Although the effect sizes are small, air pollution exposure in urban areas is ubiquitous so may have significant effects at the population level. These results should be confirmed when children are older and asthma diagnosis is more robust.

Made available in DSpace on 2016-05-17T16:51:04Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-01-21. Added 1 bitstream(s) on 2016-05-17T16:54:35Z : No. of bitstreams: 1 000857897.pdf: 1190502 bytes, checksum: 015b214298e4307571cdcfa119179945 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O objetivo desse estudo foi avaliar os mecanismos envolvidos na abertura cervical em cadelas saudáveis e com o diagnóstico piometra. Para tanto, foram realizadas avaliações imunoistoquímicas em diferentes regiões da cérvix: epitélio luminal, região glandular e região muscular, para os receptores e-NOS, i-NOS, FAS, FAS-L, PGF2α-R e COX-2. Foram utilizadas 11 cadelas com piometra aberta, 11 cadelas com piometra fechada, 6 cadelas saudáveis em fase folicular e 6 em fase luteal do ciclo estral. Todas as fêmeas foram submetidas a ovariohisterectomia (OSH) e dosagens de progesterona foram realizadas para confirmação da fase do ciclo estral. As dosagens foram realizadas utilizando-se kits comerciais em fase sólida. Para avaliar a imunomarcação foram utilizados dois métodos. No primeiro, em cada um desses tecidos foram avaliados cinco campos, cada campo recebeu um escore de 0 a 4 (sendo 0 = 0 a 5% do campo positivo, 1 = 5 a 25% do campo positivo, 2 = 25 a 50%, 3 = 50 a 75% do campo positivo e 4 = 75 a 100% do campo positivo) sendo considerados positivos aqueles corados em marrom e negativos aqueles corados em azul. No segundo método a intensidade das marcações foi avaliada de forma subjetiva em fraca, moderada e forte, recebendo respectivamente escore 1, 2 e 3 para a análise estatística. As leitura foram realizadas em cinco campos aleatórios, sendo todos os campos homogêneos (mais de 80% da coloração com a mesma intensidade). As avaliações foram realizadas em um microscópio de luz no aumento 400 vezes. Foram realizados os testes estatísticos não-paramétrico de Mann-Whitney para comparar a presença, a concentração de cada receptor e a região entre os grupos piometra fechada e aberta. Entre os grupos piometra, fase luteal e fase folicular, utilizou-se o teste Kruskall-Wallis, pois a comparação foi realizada entre 3 grupos independentes. Os receptores i-NOS e FAS comportam-se da mesma maneira em cadelas com piometra... / The aim of this study was to evaluate the mechanisms involved in cervical opening in bitches with pyometra and healthy bitches. To this end, immunohistochemical evaluations were conducted in different regions of the cervix, epithelium luminal, glandular and musculene for e-NOS, i-NOS, FAS, FAS-L, PGF2α-R and COX-2 receptors. For this purpose, were used 11 bitches with open pyometra, 11 bitches with close pyometra, 6 healthy bitches on follicular phase and 6 on luteal phase of the estrous cycle. All females were subjected to ovariohysterectomy (OSH) and serum progesterone were performed to confirm the phase of the estrous cycle. The measurements were performed using solid phase commercial kits. For immunostaining evaluation two methods were used. In the first, five fields were evaluated in each of these tissues, where each field received a score from 0 to 4 (0 = 0 to 5% of positive field, 1 = 5 to 25% of positive field, 2 = 25 to 50%, 3 = 50 to 75% of positive field and 4 = 75 to 100% of positive field) being considered positive those stained in brown and blue the negative ones. In the second method the markings intensity was assessed subjectively in weak, moderate and strong, respectively receiving scores 1, 2 and 3 for statistical analysis. Readings were taken at five random fields, that were all homogeneous (more than 80% of the staining with the same intensity). The evaluations were performed using a light microscope at a magnification of 400x. Non-parametric statistical test of Mann-Whitney was performed to compare the presence, concentration of each receiver and the region between the closed and open pyometra groups. Among pyometra, follicular phase and luteal phase groups, Kruskall-Wallis test was used, once the comparison made was between three independent groups. The i-NOS and FAS receptors behave in the same way in bitches with open and closed pyometra, not being involved in cervical opening mechanism in this disease. The ...

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde. Programa de Pós-Graduação em Ciências Médicas / Made available in DSpace on 2012-10-19T06:39:31Z (GMT). No. of bitstreams: 0Bitstream added on 2014-09-25T23:46:06Z : No. of bitstreams: 1 181430.pdf: 1425375 bytes, checksum: be78a87b39fe0ac51458e99b2bc41b6a (MD5) / Objetivo: avaliar o uso da videolaparoscopia no tratamento cirúrgico dos processos expansivos benignos dos anexos uterinos. Método: foram analisados dados de 149 pacientes com processos expansivos anexiais de características benignas submetidas a tratamento cirúrgico videolaparoscópico, na Clínica Santa Helena, Florianópolis, Santa Catarina, no período de janeiro de 1996 a dezembro de 1999. Os procedimentos cirúrgicos videolaparoscópicos foram realizados pela mesma equipe de ginecologistas e utilizou-se a anestesia geral inalatória. As seguintes variáveis foram avaliadas: faixa etária, procedimentos cirúrgicos realizados, diagnóstico do processo expansivo anexial, causas de impossibilidade de realização do tratamento pela via laparoscópica, conduta adotada neste caso, taxa de conversão à laparotomia e de complicações ocorridas. Resultados: observou-se que 81,2 % das pacientes encontravam-se na faixa etária entre 21 e 40 anos; o procedimento cirúrgico mais realizado foi a exérese de cistos ovarianos; sendo mais freqüente o endometrioma, em 28,1 % dos casos; em 10 pacientes, não foi possível o tratamento videolaparoscópico principalmente devido às aderências ( 6 casos ). A taxa de conversão à laparotomia foi de 3,35% e a de complicações de 4 % ( IC 95 % = 0,87 - 7,00 ). O tratamento videolaparoscópico foi realizado com sucesso em 93,3 % dos casos ( IC 95 % = 89,27 - 97,00 ). Conclusão: o tratamento dos processos expansivos anexiais benignos é viável através da videolaparoscopia.

Identifica la asociación entre el uso de los métodos anticonceptivos y los resultados citológicos cérvico uterino en usuarias atendidas en el Hospital San Juan de Lurigancho. Estudio de tipo observacional, analítico, transversal, retrospectivo y de diseño casos y controles. La muestra está conformada por 96 usuarias divididas en dos grupos: 48 usuarias con resultados citológicos anormales (casos) y 48 usuarias con resultados citológico normales (controles), pareados por edad y paridad. El 93.8% de las usuarias presentan lesión intraepitelial de bajo grado y el 6.2% lesión intraepitelial de alto grado. En el grupo con citología cérvico uterina anormal, un 48% usa anticonceptivos orales combinados y un 25% ampolla trimestral. En el grupo con citología cérvico uterina normal, un 48% usa ampolla trimestral y un 27% preservativos. El uso de anticonceptivo oral combinado se asocia a los resultados citológicos cérvico uterino anormales (p=0.000; OR=7.91). El uso de los preservativos está asociado a los resultados cérvico uterino normales (p=0.036). Asimismo, existe asociación entre el uso del anticonceptivo ampolla trimestral y el resultado citológico cérvico uterino normal (p=0.019). / Tesis