Análise das manifestações patológicas do Centro de Atenção Psicossocial Ponta do Coral

TCC (graduação) - Universidade Federal de Santa Catarina. Centro Tecnológico. Engenharia Civil.O presente trabalho se dedica a analisar as patologias construtivas encontradas no Centro de Atenção Psicossocial Ponta do Coral, relacionando-as com as características do ambiente e da própria edificação. As análises se propõem a observar o aspecto visual e tátil das manifestações patológicas aparentes, buscando também os sintomas que podem ocorrer periodicamente ou ser observados em momentos específicos, contando com entrevistas aos frequentadores do local. O ambiente no qual a edificação está inserida e sua utilização cotidiana também são estudados, sendo assim definidos possíveis agentes agressivos à edificação que podem estar presentes. Através de tai informações, é feita uma correlação de maneira a buscar suas causas e analisar os possíveis mecanismos que acarretam nas manifestações patológicas, procurando por sintomas parecidos na bibliografia. Ideias para a continuação do estudo também são propostas, bem como medidas a serem tomadas para os problemas encontrados.The present work dedicate itself to analyze the constructive pathologies found in the Centro de Atenção Psicossocial Ponta do Coral (Center of Psychosocial Attention Ponta do Coral), relating them with the characteristics of the environment and of the building itself. The analyzes aim to observe the visual and tactile aspect of the apparent pathological manifestations, also seeking the symptoms which can occur periodically or be observed in specific moments, counting on interviews to the locals. The environment in which the building is inserted and its daily use are also studied, thus defining possible agents that are aggressive to the building that may be present. Through this information, a correlation is made in order to search for its causes and to analyze the possible mechanisms that lead to the pathological manifestations, looking for similar symptoms in the bibliography. Ideas for further study are also proposed as well as steps to be taken for problems encountered

The effectiveness of intrauterine insemination: A matched cohort study

To study the effectiveness of an intrauterine insemination (IUI) program compared to no treatment in subfertile couples with unexplained subfertility and a poor prognosis on natural conception. A retrospective matched cohort study in which ongoing pregnancy rates in 72 couples who voluntarily dropped out of treatment with IUI were compared to ongoing pregnancy rates in 144 couples who continued treatment with IUI. Couples with unexplained subfertility, mild male subfertility or cervical factor subfertility who started treatment with IUI between January 2000 and December 2008 were included. Couples were matched on hospital, age, duration of subfertility, primary or secondary subfertility and diagnosis. Primary outcome was cumulative ongoing pregnancy rate after three years. Time to pregnancy was censored at the moment couples were lost to follow up or when their child wish ended and, for the no-treatment group, when couples re-started treatment. After three years, there were 18 pregnancies in the stopped treatment group (25%) versus 41 pregnancies in the IUI group (28%) (RR 1.1 (0.59-2.2)(p=0.4)). The cumulative pregnancy rate after three years was 40% in both groups, showing no difference in time to ongoing pregnancy (shared frailty model p=0.86). In couples with unexplained subfertility and a poor prognosis for natural conception, treatment with IUI does not to add to expectant management. There is need for a randomized clinical trial comparing IUI with expectant management in these couple

Treatment strategies and cumulative live birth rates in WHO-II ovulation disorders

Objective: To assess the live birth rate in women with WHO II anovulation and the proportion of women that need second or third line treatments if the initial therapy fails. Study design: In this multicenter cohort study we included couples with unfulfilled child wish who were referred to three fertility clinics in the Netherlands and selected women with a WHO II ovulation disorder as the only final infertility diagnosis (n = 468). Results: The cumulative live birth rate of the total group was 82% (383/468). The majority started with clomiphene-citrate as first-line treatment (n = 378) resulting in 180 (48%) live births. There were 153 couples (40%) who underwent a second-line treatment (recombinant-FSH or laparoscopic electrocoagulation of the ovaries, LEO) and 52 couples (14%) a third-line treatment (IVF/ICSI), resulting in 44% and 63% treatment dependent live births rates, respectively. Of all couples, 92 (20%) conceived naturally, 186 (40%) after clomiphene-citrate, 60 (13%) after recombinant-FSH, nine (2%) after LEO and 36 (8%) after IVF. Conclusion: Subfertile women with a WHO II ovulation disorder have a good prognosis on live birth, and most did so after ovulation induction with clomiphene-citrate. If first-line ovulation induction has failed ovulation induction with gonadotrophins or IVF still result in a live birth in about half of the cases

Home-based monitoring of ovulation to time frozen embryo transfers in the Netherlands (Antarctica-2):an open-label, nationwide, randomised, non-inferiority trial

Background: The growing field of assisted reproductive techniques, including frozen-thawed embryo transfer (FET), should lead the way to the best sustainable health care without compromising pregnancy chances. Correct timing of FET is crucial to allow implantation of the thawed embryo. Nowadays, timing based on hospital-controlled monitoring of ovulation in the natural cycle of a woman is the preferred strategy because of the assumption of favourable fertility prospects. However, home-based monitoring is a simple method to prevent patient travel and any associated environmental concerns. We compared ongoing pregnancy rates after home-based monitoring versus hospital-controlled monitoring with ovulation triggering. Methods: This open-label, multicentre, randomised, non-inferiority trial was undertaken in 23 hospitals and clinics in the Netherlands. Women aged between 18 and 44 years with a regular ovulatory menstrual cycle were randomly assigned in a 1:1 ratio via a web-based randomisation program to home-based monitoring or hospital-controlled monitoring. Those who analysed the data were masked to the groups; those collecting the data were not. All endpoints were analysed by intention to treat and per protocol. Non-inferiority was established when the lower limit of the 90% CI exceeded –4%. This study was registered at the Dutch Trial Register (Trial NL6414). Findings: 1464 women were randomly assigned between April 10, 2018, and April 13, 2022, with 732 allocated to home-based monitoring and 732 to hospital-controlled monitoring. Ongoing pregnancy occurred in 152 (20·8%) of 732 in the home-based monitoring group and in 153 (20·9%) of 732 in the hospital-controlled monitoring group (risk ratio [RR] 0·99 [90% CI 0·81 to 1·22]; risk difference [RD] –0·14 [90% CI –3·63 to 3·36]). The per-protocol analysis confirmed non-inferiority (152 [21·0%] of 725 vs 153 [21·0%] of 727; RR 1·00 (90% CI 0·81 to 1·23); RD –0·08 [90% CI –3·60 to 3·44]). Interpretation: Home-based monitoring of ovulation is non-inferior to hospital-controlled monitoring of ovulation to time FET. </p