Critical analysis of multiparity in adolescent pregnancy / Análise crítica da multiparidade na gravidez adolescente

To demonstrate the obstetric profile of teenage pregnancy and maternity parity in the metropolitan region of Curitiba, in southern Brazil, from 2009 to 2014, in order to provide information for interventions in preventing non-planned pregnancy in this population.Data regarding maternal age, gestational age, newborn weight, obstetric complications and type of delivery were collected in 4668 patients aged between 15 and 19 years, and those aged 20 to 24, with previous teenage pregnancy. An Excel table was created to store the information, later analysed. Most patients were primigravid (71%), with 22% in the second pregnancy. Multiparity was present in 29% of pregnant women. The mean age at first pregnancy was 17.3 years (standard deviation of 1.30). The main route of delivery was vaginal, in 80%. Episiotomy was performed in 70% of these deliveries. Cesarean deliveries occurred mainly due to induction failure (19.8%), cephalopelvic disproportion (14.4%) and fetal distress (11.1%). Mean gestational age was 39.1 weeks (standard deviation 1.5). Low birth weight occurred in 7% of newborns, and 4% were preterm. Most of the patients analysed were primiparous aged 17.3 years. Multiparity in adolescence proved to be a frequent phenomenon in the region studied, with a prevalence of 30%, occurring at an average age of 18.6 years old. A quarter of 20-year-old patients’ population had more than two pregnancies. The presence of episiotomy was high, performed in 70% of vaginal deliveries, a value above the recommended by WHO.

Comparative study in swines' vocal cords healing after excision of fragment with CO2 laser with mitomycin and 5-fluorouracil postoperative topical application Estudo comparado da cicatrização da prega vocal de suínos após exérese de fragmento com laser de CO2 e aplicação tópica pós-operatória de mitomicina e 5-fluorouracil

PURPOSE: To evaluate the deposition of collagen fibers at pig's vocal folds after topical use of mitomycin or 5-fluorouracil, when partial exeresis of mucosa layer had been promoted by CO2 laser. METHODS: There were used 18 Larger white pigs which were anesthetized and submitted to mucosa fragment's exeresis, bilaterally, at its free border. The animals were divided into 3 groups, each one with 6 animals: control group, without topical drug application; mitomycin group; and 5-fluorouracil group. After 30 days, the animals were subjected to euthanasia, and samples of the vocal folds were collected and stained by picrosirius red technique with polarization for quantification of total collagen deposition. RESULTS: In control group, the mean rate of right vocal fold's collagen deposition at submucosa consisted in a 3428.66 micrometers area. There was found an area whose size had, in average, 2196.36 micrometers, in mitomycin group, and 2269.19 micrometers, in 5-fluorouracil group. CONCLUSION: Mitomycin and 5-fluorouracil had promoted beneficial change in vocal fold's cicatrization with less collagen deposition, but there was no significant statistically difference when they were compared between themselves.<br>OBJETIVO: Avaliar a deposição das fibras de colágeno total em pregas vocais suínas após o uso tópico de mitomicina ou 5-fluorouracil nas exéreses parciais de mucosa com laser de CO2. MÉTODOS: Foram utilizados 18 porcos da raça Larger white anestesiados e submetidos à exérese de fragmento de mucosa de borda livre da prega vocal direita e prega vocal esquerda. Os animais foram divididos em 3 grupos com 6 animais cada: grupo controle, sem aplicação de medicação tópica; grupo mitomicina, com uso tópico dessa substância; grupo 5-fluorouracil, uso tópico. Após 30 dias do experimento os animais foram submetidos à eutanásia, coletadas amostras das pregas vocais e coradas pela técnica do picrosirius red com polarização para a quantificação computadorizada da deposição do colágeno total. RESULTADOS: No grupo controle, a média da área do colágeno depositado na submucosa da prega vocal direita foi de 3428,66 micrômetros. No grupo mitomicina a média foi de 2196,36 micrômetros. No grupo 5-fluorouracil, a média foi de 2269,19 micrômetros. CONCLUSÃO: A mitomicina e o 5-fluorouracil promoveram mudança benéfica na cicatrização da prega vocal, com menor deposição de colágeno, porém, quando comparados entre si, eles não apresentaram diferença estatisticamente significante

Analysis of non-celiac Gluten sensitivity in patients with endometriosis/ Análise da sensibilidade não celíaca ao Glúten em pacientes com endometriose

Overview and Aims: Identify patients with surgically confirmed endometriosis and with gastrointestinal symptomatology by assessing whether there is clinical improvement of these from the adoption of gluten-free diet (GFD). Study design: They were invited to participate in the study by the researchers through telephone calls and instant messaging applications after selection in the clinics of attending physicians. Population: Through the GSRS (Gastrointestinal Symptom Rating Scale) questionnaire, the relationship of GFD adherence to symptomatology attenuation and benefit in the quality of life of 48 patients was analyzed. Methods: Inclusion criteria: female patients with surgical confirmation of endometriosis who agreed to participate in the study in accordance with the Informed Consent Form (ICF). Exclusion criteria: patients who already performed GFD, patients diagnosed with celiac disease, gluten allergy or non-celiac sensitivity to gluten, presence of gastrointestinal comorbidities, severe diseases or cognitive alterations that prevented the study from being performed. The patients who obtained the top 20 scores were invited to adopt GFD for one month, among those selected, only 12 proposed to participate in the diet. However, three of these presented personal complications that prevented the continuation of the same. After this period, a new questionnaire was applied to measure the impact of the diet on quality of life. Results: Nine patients finished the proposed period for the diet, with the average score obtained in the pre-diet questionnaire reducing from 57.2 to 36 in the post-diet. Conclusion: There was an improvement in gastrointestinal complaints of most patients and consequently in quality of life with GFD

Estudo da correlação do IMC e comprimento do intestino delgado em pacientes obesos submetidos à cirurgia bariátrica Correlation study of BMI and small intestine length in obese patients subjected to bariatric surgery

RACIONAL: Segundo a hipótese do intestino longo, o comprimento do intestino delgado estaria relacionado à obesidade. Existem dados evolutivos, anatômicos e neuroendócrinos em favor desta afirmação. OBJETIVOS: Verificar a medida do comprimento do intestino delgado em pacientes obesos submetidos à cirurgia bariátrica e analisar a correlação entre o seu tamanho e o IMC. MÉTODO: A casuística foi composta de 30 pacientes do Serviço de Obesidade do Hospital Universitário Evangélico de Curitiba, submetidos à cirurgia bariátrica no período de março a junho de 2009, e previamente avaliados, verificando peso, altura e IMC. A técnica cirúrgica foi a de Fobi-Capella. A mensuração do intestino delgado foi realizada desde a flexura duodenojejunal à junção ileocecal, durante o trans-operatório, utilizando uma pinça de manipulação intestinal, a qual foi marcada com a medida de 10 cm. As alças intestinais foram medidas na margem anti-mesentérica, aplicando-se tensão mínima necessária para retificar as mesmas. Os dados foram correlacionados e tabulados estatisticamente, utilizando-se o método de correlação de Pearson. RESULTADOS: A média do comprimento intestinal para o sexo masculino foi de 582,5 cm e para o sexo feminino de 509,1. A partir do cálculo do coeficiente de correlação de Pearson, confirmou-se a ausência de correlação entre IMC e comprimento do intestino delgado. CONCLUSÃO: Obteve-se uma média de tamanho intestinal de 528,7 cm para toda a amostra. O comprimento do intestino delgado não possuiu correspondência com o IMC, não sendo um fator de significância neste estudo.<br>BACKGROUND: According to the hypothesis of long bowel, the length of small intestine is related to obesity. There are evolutionary, anatomics, neuroendocrines evidences in favor of this assertion. AIM: To check the measure of the small intestine length in overweight patients submitted to bariatric surgery and to analyze the correlation between the intestine size and Body Mass Index (BMI). METHODS: The sample was composed of 30 patients of Hospital Universitário Evangélico de Curitiba, Obesity Service, which had been submitted to bariatric surgery in the period between March and June, 2009. These patients previously had been evaluated, according to their weight, height and BMI. The surgical technique was Fobi-Capella. The measurement of small bowel was carried through the Treitz angle towards the ileocecal junction, during the operation. The instrument used was an intestinal manipulation clamp, which was marked with the measure of 10 cm. The intestinal handles had been measured in the anti-mesenteric edge, applying minimum tension necessary to rectify them. The data were statistically correlated and automatically tabulated, using the Pearson correlation method. RESULTS: The average intestinal length for males was 582,5 cm and for 509,1 cm, medium length 528,7 cm. Pearson correlation coefficient, confirmed the absence of correlation between BMI and the intestinal length. CONCLUSION: The medium length of small intestine was 528,7 cm and it did not have correspondence to BMI

Evaluation of the applicability of Gail's method in patients undergoing breast biopsy at a brazilian hospital

OBJECTIVES: To verify the accuracy of the Gail Model (GM) in risk assessment in patients with suspected breast cancer and to determine the need to adapt the GM or develop a new model for accurate risk assessment of these patients. METHODS: This is a descriptive, cross-sectional and retrospective study, based on the analysis of data provided by the medical records of 200 patients treated between 2017 and 2021, from the Mastology Outpatient Clinic of the Hospital Universitário Evangélico Mackenzie (HUEM). RESULTS: 155 women were diagnosed with breast cancer and 45 were not. The mean age was 54.23 years and the mean age at menarche was 13 years. Also, only 13 medical records contained information on age at birth of the 1st child or absence of children, and the mean age obtained was 26.77 years. Ethnic prevalence was white and most patients had no first-degree relatives with breast cancer. Regarding previous breast biopsies, most had already performed at least one, but few received a result of atypical hyperplasia. Furthermore, most of the study patients diagnosed with breast cancer had no positive family history of the disease. CONCLUSION: The study shows that the GM isn't reliable in assuming the risk of the studied population to develop breast CA, since, when comparing the GM data between groups that had and didn't have the disease, there was no significant difference