Ambulatory Hysteroscopy Results Post-Menopause: Comparative Study Between Patients With and Without Metrorrhagia

Our objective was to compare the results of ambulatory hysteroscopy in postmenopausal women with and without uterine bleeding. A retrospective descriptive study was carried out on 236 women who were at least 2 years into the menopause, who were not undergoing hormone treatment and who had had abnormal pelvic ultrasound results. Of these women, 150 were asymptomatic and 86 reported haemorrhage. Diagnostic and operative outpatient hysteroscopy was performed between January 2002 and December 2003. There was no difference between the two groups regarding age of patients, age of menopause and presence of at least one of the risk factors for endometrial carcinoma evaluated, although obesity was more frequent in the symptomatic group. Abnormal ultrasound results for these women corresponded in the majority of cases to intracavitary disease, and the absence of organic endometrial pathology was 9.3% vs 11.3% in each group. The more frequent pathology was benign endometrial polyps (64% in bleeding patients and 84.7% in asymptomatic ones). Endometrial carcinoma was diagnosed in 23.3% of women with metrorrhagia and in 1.3% of asymptomatic women. We diagnosed 2.6% of malignancy inside polyps. Hysteroscopy results were confirmed by histology in 90.3% of cases. See and treat in one session was achieved in 91% of benign endometrial polyps. Ambulatory hysteroscopy has high sensitivity and specificity for intracavitary pathology and high tolerability and safety. See and treat in one session can be achieved in the majority of lesions with indication for excision. These results make us advise our menopausal patients with abnormal uterine bleeding to undergo diagnostic hysteroscopy complemented with biopsy

Social Carrying and Defensive Behavior During Colony Emigration in the Leaf-cutting Ant Atta sexdens

In this work, we describe for the first time and under laboratory conditions, the behaviors related to social carrying and defensive strategies during colony emigration in the leaf-cutting ant Atta sexdens. Once colonies were laid on a tray under suboptimal conditions, groups of workers aggregated all over the body surface of the queen and brood, with mandibles half open and legs widely open in a ‘entangle’ formation. Queens were the first caste to be reallocated, followed respectively by the transportation of brood, newly-emerged workers, and pieces of fungus garden to the new nesting site. Contrary to what have been reported to the Myrmicinae species, adult transport followed a stereotyped sequence of acts involving approach, seize and transportation of newly-emerged workers to new target areas. Our results suggest that, in front of rapid unfavorable changes, leaf-cutting ants are capable of reorganize the nest in order to protect their members and resources

Maternal Sepsis

Infections during pregnancy are prevalent. A small number of cases, however, may be life-threatening. Sepsis may be associated with multiple organ dysfunction and high mortality and it is one of the most common causes of direct maternal death often associated with the inability to recognize the severity of the illness. Long-term morbidity associated with maternal sepsis is significant and includes chronic pelvic inflammatory disease, chronic pelvic pain, bilateral tubal occlusion and infertility. The impact on neonatal mortality is also substantial, with over one million infection-related neonatal deaths eve - ry year. In the last few years, a vast number of clinical reviews of severe sepsis in pregnancy have been published, focusing on the characteristics of pregnant woman, the establishment of a specific treatment and the relevance of pregnancy surveillance by a multidisciplinary team. The treatment of sepsis is time-critical and requires early diagnosis, aggressive resuscitation, antibiotic administration and source control

Inferior Vena Cava Filter Placement During Pregnancy: an Adjuvant Option When Medical Therapy Fails

The authors present a case of a 27-year-old multiparous woman, with multiple thrombophilia, whose pregnancy was complicated with deep venous thrombosis requiring placement of a vena cava filter. At 15th week of gestation, following an acute deep venous thrombosis of the right inferior limb, anticoagulant therapy with low-molecular-weight heparin (LMWH) was instituted without improvement in her clinical status. Subsequently, at 18 weeks of pregnancy, LMWH was switched to warfarin. At 30th week of gestation, the maintenance of high thrombotic risk was the premise for placement of an inferior vena cava filter for prophylaxis of pulmonary embolism during childbirth and postpartum. There were no complications and a vaginal delivery was accomplished at 37 weeks of gestation. Venal placement of inferior vena cava filters is an attractive option as prophylaxis for pulmonary embolism during pregnancy

Avaliação de citotoxicidade de nanotransportadores sem substância ativa em função da sua densidade populacional

A par da evolução da nanotecnologia, assiste-se a uma crescente preocupação sobre eventuais riscos/toxicidade que os nanotransportadores possam representar [1]. A maioria dos trabalhos publicados relativos à avaliação da citotoxicidade in vitro de nanotransportadores (NT) incide na comparação quando a substância ativa (SA) é administrada em solução ou nanoencapsulada, sendo escassos os estudos que visam avaliar a possível toxicidade do NT por si só (sem SA). O objetivo deste trabalho consistiu na avaliação da citotoxicidade de NT sem SA em função da sua densidade populacional, tendo sido testados quatro NT distintos: nanocápsulas (NC), nanoesferas (NE), transportadores lipídicos nanoestruturados (NLC) e lipossomas, com oito densidades populacionais (diluições décimais de 2,10×1012 part/mL a 2,10×105 part/mL). A avaliação da citotoxicidade realizou-se numa cultura primária (linfócitos) pelo teste do MTT e numa linha celular (fibroblastos 3T3) pelo teste do vermelho neutro (NR)

Efficacy and Safety of Direct-Acting Oral Anticoagulants Use in Acute Portal Vein Thrombosis Unrelated to Cirrhosis

In acute portal vein thrombosis (APVT) unrelated to cirrhosis, anticoagulant therapy is classically started with low molecular weight heparin or vitamin K antagonists. New direct-acting oral anticoagulants (DOACs) are used in the treatment of venous thrombosis outside the splanchnic vascular bed, but not in the latter. We report a young female with APVT occurring in a non-cirrhotic liver linked to heterozygosity of factor V-Leiden and prothrombin G20210A gene mutations. Rivaroxaban was started, with total recanalization of the left and partial recanalization of the right portal vein branches, without complications. New DOACs do not need daily subcutaneous injections nor routinely blood coagulation control tests, making its use attractive, eventually increasing patient's compliance. If proved to be safe and effective in the future studies, its use may be extended to PVT treatment. This case shows that rivaroxaban was safe, not only prevented the extension of thrombosis in the portal tract, but also resolved PVT, at least partially.info:eu-repo/semantics/publishedVersio

Effects of varying ruminally undegradable protein supplementation on forage digestion, nitrogen metabolism, and urea kinetics in Nellore cattle fed low-quality tropical forage

Citation: Batista, E. D., Detmann, E., Titgemeyer, E. C., Valadares, S. C., Valadares, R. F. D., Prates, L. L., . . . Paulino, M. F. (2016). Effects of varying ruminally undegradable protein supplementation on forage digestion, nitrogen metabolism, and urea kinetics in Nellore cattle fed low-quality tropical forage. Journal of Animal Science, 94(1), 201-216. doi:10.2527/jas2015-9493Effects of supplemental RDP and RUP on nutrient digestion, N metabolism, urea kinetics, and muscle protein degradation were evaluated in Nellore heifers (Bos indicus) consuming low-quality signal grass hay (5% CP and 80% NDF, DM basis). Five ruminally and abomasally cannulated Nellore heifers (248 +/- 9 kg) were used in a 5 x 5 Latin square. Treatments were the control (no supplement) and RDP supplementation to meet 100% of the RDP requirement plus RUP provision to supply 0, 50, 100, or 150% of the RUP requirement. Supplemental RDP (casein plus NPN) was ruminally dosed twice daily, and RUP supply (casein) was continuously infused abomasally. Jugular infusion of [(NN)-N-15-N-15]-urea with measurement of enrichment in urine was used to evaluate urea kinetics. The ratio of urinary 3-methylhistidine to creatinine was used to estimate skeletal muscle protein degradation. Forage NDF intake (2.48 kg/d) was not affected (P >= 0.37) by supplementation, but supplementation did increase ruminal NDF digestion (P < 0.01). Total N intake (by design) and N retention increased (P < 0.001) with supplementation and also linearly increased with RUP provision. Urea entry rate and gastrointestinal entry rate of urea were increased by supplementation (P < 0.001). Supplementation with RUP linearly increased (P = 0.02) urea entry rate and tended (P = 0.07) to linearly increase gastrointestinal entry rate of urea. Urea use for anabolic purposes tended (P = 0.07) to be increased by supplementation, and RUP provision also tended (P = 0.08) to linearly increase the amount of urea used for anabolism. The fraction of recycled urea N incorporated into microbial N was greater (P < 0.001) for control (22%) than for supplemented (9%) heifers. Urinary 3-methylhistidine: creatinine of control heifers was more than double that of supplemented heifers (P < 0.001). Control heifers reabsorbed a greater (P < 0.001) fraction of urea from the renal tubule than did supplemented heifers. Overall, unsupplemented heifers had greater mobilization of AA from myofibrillar protein, which provided N for urea synthesis and subsequent recycling. Supplemental RUP, when RDP was supplied, not only increased N retention but also supported increased urea N recycling and increased ruminal microbial protein synthesis

Diabetic Mastopathy: a Case Report

Diabetic mastopathy (DMP) is an uncommon collection of clinical, radiological, and histological features, classically described in premenopausal women with long-term insulin-dependent diabetes mellitus. This entity can mimic breast carcinoma, but, in the appropriate clinical and imaging setting, the diagnosis can be made by core biopsy, avoiding unnecessary surgeries. We report the case of a 34-year-old female, with a 12-year history of type 1 diabetes, who presented with bilateral breast lumps. Mammography, ultrasonography, and magnetic resonance imaging could not exclude the suspicion of malignancy, and a core biopsy was performed showing the typical histologic features of DMP. The literature is briefly reviewed

APP LAGOA ENCANTADA: CAMINHOS PARA O RECONHECIMENTO ACADÊMICO E PARA O DESENVOLVIMENTO SUSTENTÁVEL

We present a point of view on the importance of Permanent Protection Area Lagoa Encantada regarding academic research and sustainable development. The area is situated in the metropolitan region of Grande Vitória, Espírito Santo State, Brazil, and is composed by four Atlantic Forest’s phytophysiognomies: swampy vegetation, dense ombrophylous forest, rocky outcrops and mangrove, prevailing the swampy vegetation. We present the current knowledge on the vegetation composition, the anthropic impacts suffered, challenges to study the area, and list possibilities focused on research and sustainable development in the region with the implementation of a conservation unit.Keywords: wetlands, swamp, Atlantic Forest, Espírito Santo, conservation unit.Apresentamos um ponto de vista sobre a importância da Área de Proteção Permanente da Lagoa Encantada nos âmbitos de pesquisa acadêmica e desenvolvimento sustentável. A área situa-se na região metropolitana da Grande Vitória, Espírito Santo, Brasil, e é composta por quatro fitofisionomias de Floresta Atlântica: vegetação brejosa, floresta ombrófila densa, vegetação rupestre e manguezal, sendo a vegetação brejosa predominante. Apresentamos o conhecimento atual sobre a composição vegetacional da área, impactos antrópicos sofridos, desafios ao seu estudo e relacionamos possibilidades de pesquisa e voltadas para o desenvolvimento sustentável da região com a implementação de uma unidade de conservação.Palavras-chave: áreas úmidas, brejo, Floresta Atlântica, Espírito Santo, unidade de conservação

Dietas contendo silagem de milho (Zea maiz L.) e feno de capim-Tifton 85 (Cynodon spp.) em diferentes proporções para bovinos.

Avaliaram-se o consumo, a digestibilidade, o pH e concentração de amônia ruminais e a taxa de passagem em bovinos alimentados com dietas contendo feno de capim-tifton 85 (TIF) e silagem de milho (SM) em diferentes proporções. Utilizaram-se quatro animais castrados, com peso médio de 523kg, fistulados no rúmen, distribuídos em um quadrado latino 4 x 4, recebendo 60% de volumoso e 40% de concentrado, na base da matéria seca. O volumoso consistiu das seguintes proporções (%): 100 TIF:0 SM; 67 TIF:33 SM; 33 TIF:67 SM e 0 TIF:100 SM. Os consumos de matéria seca (MS), de matéria orgânica (MO) e de matéria orgânica digestível (MOD), de proteína bruta (PB), de fibra em detergente neutro (FDN) e de carboidratos totais (CHOT) e digeríveis (CHOD) não foram influenciados pelas diferentes proporções de feno de capim-tifton 85: silagem de milho nas dietas, registrando-se valores médios de 9,2; 8,7; 6,4; 1,1; 3,7; 7,3 e 5,4 kg/dia, respectivamente. O consumo de extrato etéreo (EE) elevou linearmente com o aumento da silagem de milho nas dietas. As digestibilidades aparentes da MS, MO, PB, EE e CHO também não foram influenciadas pelas diferentes proporções de silagem de milho, obtendo-se, respectivamente, valores médios de 71,8; 73,0; 69,5; 69,2 e 73,9%. Para a digestibilidade da FDN, observou-se efeito quadrático, estimando-se valor máximo de 65,2% para dietas contendo 30,98% de silagem de milho. Estimou-se concentração máxima de amônia de 12,0 mg/100 ml e valor mínimo de pH de 5,98 às 2,44 e 6,82 horas após a alimentação, respectivamente. A taxa de passagem não foi influenciada pelas diferentes proporções de feno:silagem, no volumoso, apresentando valor médio de 4,2%/hora. Corn silage and Tifton 85 Bermudagrass Hay-Based Diets for Steers. ABSTRACT - The intake, digestibility, ruminal pH and ammonia concentrations and passage rate were evaluated in steers fed corn silage (CS) and Tifton 85 bermudagrass hay (T85H)-based diets, at different forage proportions. Four rumen fistulated steers with 523 kg of live weight were used in a 4x4 latin square design, and fed diets containing 60:40 forage:concentrate proportions in dry matter basis. The forage portion consisted of: 100 T85H:0 CS; 67 T85H:33 CS; 33 T85H:67 CS and 0 T85H:100 CS. The dry matter (DM), organic matter (OM), digestible organic matter (DOM), crude protein (CP), neutral detergent fiber (NDF), total carbohydrates (TC) and total digestible carbohydrates (TDC) intakes were not affected by different T85H: CS proportions and averaged 9.2, 8.7, 6.4, 1.1, 3.7, 7.3 and 5.4 kg/day, respectively. The ethereal extract (EE) intake increased with increasing on corn silage proportion of the diets. The DM, OM, CP, EE and TC apparent digestibilities were not affected by increasing percentage of corn silage on rations and averaged 71.8, 73.0, 69.5, 69.2 and 73,9%, respectively. There was a quadratic effect for NDF digestibility, with maximum value of 65.2% for diets with 30.98% of CS. The N-ammonia maximum content (12.0 mg/100 ml) and minimum value of pH (5.98) were estimated 2.44 and 6.82 hours after feeding, respectively. The passage rate, which was not affected by changing T85H:CS proportions in the forage, averaged 4.2 %/hour