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La defecografía es una exploración que realizada con la preparación y la técnica adecuadas, de forma cuidadosa y con las máximas medidas de higiene y privacidad, no provoca molestias significativas siendo aceptada sin problemas por las pacientes.La técnica de la defecografía debe realizarse con la paciente sentada en una silla radiotransparente, el contraste rectal ha de ser pasta de bario densa en cantidad no inferior a los 300 ml, la opacificación por vía oral del intestino delgado con la ingesta previa de 400 ml de bario líquido es obligatoria y resulta imprescindible la realización de proyecciones con esfuerzo al final de la evacuación del contraste rectal.La línea pubococcígea y la línea de las tuberosidades isquiáticas son de difícil valoración y la determinación de los ángulos anorrectales en reposo y durante la defecación carece de interés por su falta de relevancia en el diagnóstico del prolapso.El rectocele y el enterocele se identifican sin dificultad durante el desarrollo de la defecografía. La valoración precisa de ambas alteraciones, muchas veces sincrónicas, permite la elección de la técnica quirúrgica adecuada.La intususcepción rectal que puede acompañar al rectocele y que debe persistir durante la evacuación del contraste nos parece una alteración funcional no obstructiva que influye en la sensación de defecación incompleta cuya causa principal es la existencia de residuo en la porción vaginal del rectocele al final de la evacuación.El estudio de la incontinencia fecal en la mujer debe comprender la ecografía endoanal para valoración de los esfínteres y la defecografía para descartar las alteraciones asociadas que pueden favorecer su aparición.La defecografía es útil en el estudio del estreñimiento sobre todo si muestra la existencia de rectocele y/o sigmoidocele en pacientes con clínica de "obstrucción distal" (outlet obstruction) y debe unirse al enema opaco y a la determinación del tiempo de tránsito colónico con marcadores. En la valoración del anismo, la defecografía confirma el diagnóstico obtenido con la manometría anorrectal.Los términos "perineo descendido" y "descenso del suelo de la pelvis" deberían sustituirse por el concepto "combinación de patologías del suelo de la pelvis" que define de una manera más clara la existencia de alteraciones sincrónicas del mismo compartimento (rectocele y enterocele) o la combinación de patologías de los compartimentos urinario, ginecológico y digestivo.La RM pelviana se ha revelado como una técnica de gran utilidad en el diagnóstico de las alteraciones del suelo de la pelvis. Permite las reconstrucciones multiplanares, la valoración de los músculos y el diagnóstico del peritoneocele. No comporta radiación pero puede estar contraindicada si existen clips metálicos y/o claustrofobia. Salvo en RM abiertas en las que es posible la posición sentada, la exploración se realiza en decúbito supino, posición que limita el descenso de las vísceras pelvianas y dificulta las maniobras de esfuerzo realizadas por la paciente. / SUMMARYWhen perfomed gently with the convenient preparation, technique and maximum measures of hygiene and privacy, defecography may cause no significant inconveniences and therefore is a procedure that is easily accepted by the patients.Defecography's technique requires the patient to be seated on a radiotransparent commode, the rectum to be filled with thick barium paste in a quantity not under 300 ml, small bowel opacification with 400 ml of previously taken liquid barium is a must and is essential to take images at the end of the contrast evacuation as the patient squeezes.Rectocele and enterocele are easily demonstrated during the procedure. Precise evaluation of both disorders, very often sincronic, allows choosing convenient surgery.We consider rectal intussuceptium that may appear retocele and which must last contrast evacuation long as a non obstructive functional disorder that contributes to incomplete defecation sensation, which is primarily due to the existence of a remnant in the vafginal portion of rectocele at the end of the evacuation.Faecal incontinence imaging in woman must include both endoanal ultrasound to asses sphincters and defecography to rule out associated abnormalities that may ease its presence.Defecography plays a role in constipation evaluation specially if it demonstrates rectocele and/or sigmoidocele in patients with clinical outlet obstruction and must be associated with barium enema and time of transist determination with markers. In anism evaluation defecography confirms diagnosis.The terms "descending perineum" and "pelvic floor descent" should be substituted by "combination of pelvis floor disorders" concept which better defines the presence on sincronic alterations of the same compartement (rectocele and enterocele) or the combination of urinary, gynaecologic and digestive compartements disorders.

1) Both the partially euryhaline Scyliorhinus canicula and the fully euryhaline Carcharhinus leucas significantly modify plasma concentrations of urea and chloride (Cl-) (and sodium (Na+)) in response to changes in environmental salinity, in order to maintain overall plasma osmolality slightly hyper- or isosmotic to the environment. C. leucas has a greater capacity for urea retention in dilute environments. In S. canicula all of these changes occur within 12 hours of transfer, with the notable exception of increasing plasma urea in response to acute transfer to elevated salinity. 2) A new technique, 51Cr-labelled erythrocytes, was developed to assess blood volume in elasmobranch fish. S. canicula displays significant haemodilution and concentration during chronic acclimation to decreased and increased environmental salinity respectively. Significant changes in blood volume were seen within 6 hours of acute salinity transfer. 3) In vivo secretion rates were measured in the rectal gland of S. canicula during both chronic and acute salinity transfer. Significant changes in Cl- clearance occur during acute transfer, as plasma Na+ and Cl- levels are modified, but do not persist in chronically acclimated animals. This is achieved through modifications in the volume and Cl- concentration of the secretory fluid. 4) C. leucas is able to significantly alter the abundance and/or recruitment of Na+, K+-ATPase in both the rectal gland and the kidney during chronic acclimation to salinity transfer. This is presumably in response to increased requirements for NaCl secretion in SW and osmolyte retention in FW respectively. S. canicula do not significantly alter abundance and/or recruitment of Na+, K+-ATPase in the principle osmoregulatory organs following chronic acclimation to salinity transfer. 5) Chronically SW acclimated C. leucas modify the proportion of ouabain-sensitive oxygen consumption in the tissues of the rectal gland in response to the secretory endocrine stimulus C-type natriuretic peptide (CNP). No such modification occurred in the rectal glands of FW acclimated C. leucas. This represents a change in the sensitivity and response to endocrine control factors during chronic acclimation to salinity transfer in this species. No such modification was seen the in the proportion of ouabain-sensitive oxygen consumption in the rectal glands of chronically acclimated S. canicula in response to CNP. These results were discussed in relation to the capacity for modification of osmoregulatory organs in partially and fully euryhaline elasmobranchs.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 6 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.

Diss. (sammanfattning) Linköping : Univ., 2006. / Härtill 5 uppsatser.

Diss. (sammanfattning) Göteborg : Univ. , 2009. / Härtill 4 uppsatser.

Submitted by Morgana Silva (morgana_linhares@yahoo.com.br) on 2016-06-29T19:38:36Z No. of bitstreams: 1 arquivototal.pdf: 2105621 bytes, checksum: 2371a3d7a2bd06e0d0e09909e2e88d56 (MD5) / Made available in DSpace on 2016-06-29T19:38:36Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 2105621 bytes, checksum: 2371a3d7a2bd06e0d0e09909e2e88d56 (MD5) Previous issue date: 2016-02-19 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Prostate cancer is one of the most common tumors in the male population. Causes premature deaths and costs the family, the public health system and the whole society. In this context, this study aims to analyze the determinants of demand for preventive screening for prostate cancer in Brazil and its Regions. From the information of the National Health Research (PNS, 2013), it was organized that study, characterized by men over 40, who answered the question about the digital rectal examination (RT) that were at least once the physician. It is worth noting that the last cut was made in order to resolve the bias related to access to health services. Analysis of the data indicates that over 50% of Brazilian men never performed the screening test for prostate cancer. The main reasons cited for not performing were the lack of guidance, not find it necessary, and shame. The three described allegations indicate the existence disinformation and disbelief to the prevention of disease. Furthermore, with the estimation of the logit model orderly partial proportional odds, it was concluded that it is not the lack of access to health services, but the level of education and access to information that determines the demand for preventive examination prostate cancer. Thus, it is necessary to resolve the deficit of knowledge about the tumor, so that you can increase the early diagnosis of that cancer. / O câncer de próstata é um dos tumores mais comuns na população masculina. Provoca mortes prematuras e custos aos familiares, ao sistema público de saúde e toda a sociedade. Neste contexto, o presente trabalho busca analisar os determinantes da demanda pelo exame preventivo de câncer de próstata no Brasil e suas Regiões. A partir das informações da Pesquisa Nacional da Saúde (PNS, 2013), foi organizada a amostra desse estudo, caracterizada por homens acima de 40 anos, que responderam à pergunta sobre o exame de Toque Retal (TR) e que foram, pelo menos, uma vez ao médico. Vale salientar que esse último corte foi realizado com o intuito de dirimir o viés relacionado ao acesso aos serviços de saúde. A análise dos dados indica que mais de 50% dos homens brasileiros nunca realizou o exame preventivo do câncer de próstata. Os principais motivos citados para a não realização foram à falta de orientação, não achar necessário, e a vergonha. As três alegações descritas sinalizam a existência desinformação e descrença com a prevenção da patologia. Ademais, com a estimação do modelo logit ordenado de chances proporcionais parciais, foi possível concluir que, não é a falta de acesso aos serviços de saúde, e sim, o nível de escolaridade e o acesso a informação que determina a demanda pelo exame preventivo do câncer de próstata. Desse modo, é preciso dirimir o déficit de conhecimento quanto à neoplasia, para que seja possível aumentar o diagnóstico precoce do referido cancro.