Navegando por Palavras-chave "Cervix uteri"
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- ItemAcesso aberto (Open Access)Alterações histoquímicas das glicosaminoglicanas na cérvice uterina no final da prenhez da rata albina após ministração local de hialuronidase(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2008-07-01) Lopes, Viviane Almeida de Alcântara [UNIFESP]; Luz, Mônica Regina Lourenço [UNIFESP]; Souza, Guilherme Negrão de [UNIFESP]; Fernandes Júnior, João Antão [UNIFESP]; Simões, Manuel de Jesus [UNIFESP]; Camano, Luiz [UNIFESP]; Souza, Eduardo de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: to study the histochemical changes related to the uterine cervix glycosaminoglycan of the albino female rat, after local ministration of hyaluronidases at the end of pregnancy. METHODS: ten female rats with positive pregnancy tests were randomly distributed in two numerically equal groups. The control group (Cg) was built up with rats that received a single dose of 1 mL of distilled water in the uterine cervix, under anesthesia, at the 18th pregnancy day. In the experimental group (Exg), the rats received 0.02 mL of hyaluronidase, diluted in 0.98 mL of distilled water (1 mL as a total), under the same conditions as the Cg. At the 20th pregnancy day, the rats were anesthetized once again and submitted to dissection, and the cervix prepared for histochemical study with alcian blue dye and its blockades (pH=0.5, pH=2.5, methylation and saponification). RESULTS: strongly positive reaction in the lamina propria (+3) has been seen in the Cg, and negative reaction in the Exg, with pH=0.5 alcian blue staining. With pH=2.5, staining has also been strongly positive (+4) in the Cg, and weakly positive (+1) in the Exg slide. After methylation, both groups have shown negative reaction, with pH=2.5 alcian blue staining. The lamina propria staining became negative after methylation in both groups, followed by saponification and enzymatic digestion on slide. CONCLUSIONS: there is clear predominance of sulphated glycosaminoglycans in the Cg as compared to the Exg and a small amount of identified carboxylated glycosaminoglycans in the Exg. The changes evidenced in the extracellular matrix have suggested that the hyaluronidase injected in the uterine cervix has promoted biochemical changes compatible with cervix maturation.
- ItemAcesso aberto (Open Access)Avaliação da medida do comprimento do colo e da ausência do eco glandular endocervical para predição do parto pré-termo(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2004-04-01) Pires, Claudio Rodrigues [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Mattar, Rosiane [UNIFESP]; Kulay Júnior, Luiz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: to verify the prevalence of two sonographic findings, the cervical gland area (CGA) feature and the cervical length of less than 20 mm, and to compare these with the risk for premature delivery in pregnant women between 21 and 24 weeks' gestation. METHOD: this was a prospective, cross-sectional study in which 361 women were consecutively examined by transvaginal ultrasonography. Müllerian or other malformations, multiple gestations, fetal death, olygo- or polyhydramnios, marginal placenta previa, and conization, cerclage, amputation or other surgical procedures in the cervix, prior to or during pregnancy, were exclusion criteria. After the abdominal ultrasonographic morphological examination, we used transvaginal ultrasonography to measure the cervical length and to observe the presence of hyper- or hypoechoic area next to the endocervical canal, a feature characteristic of endocervical epithelium glands which is called CGA (cervical gland area). Qualitative variables are expressed as absolute and relative frequency. Quantitative variables are expressed as mean, median, standard deviation, minimum, and maximum values. Association between qualitative variables was detected by the c² test or by the Fisher exact test. For each variable, the relative risk and the 95% confidence interval (CI) were calculated. Logistic regression analysis was used to calculate the predictive values for premature delivery. Significance level was 95% (alpha = 5%), with descriptive (p) values equal or lower than 0.05 considered significant. RESULTS: spontaneous preterm delivery occurred in 5.0% of the patients. Cervical length was up to 20 mm in 3.3% of all studied patients and in 27.8% of those who delivered spontaneously before the end of the pregnancy. Absence of the CGA was detected in 2.8% of all patients and in 44.4% of the women who eventually developed spontaneous preterm labor. There was a statistically significant association of absence of CGA with short cervical length (p<0.001). Absence of CGA was strongly associated with spontaneous preterm delivery (relative risk of 28.57, 95% CI 14.40-56.68). CONCLUSION: the absent CGA feature is a new morphological ultrasonographic parameter that is useful in the prediction of spontaneous preterm delivery in single gestations. Our results show that the parameter can be used as an indicator of risk for premature delivery, to be confirmed by future research.
- ItemAcesso aberto (Open Access)Comprimento do colo uterino e dilatação do orifício interno avaliados pela ultra-sonografia bidimensional e tridimensional(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2006-07-01) Brandão, Rosieny Souza [UNIFESP]; Murta, Carlos Geraldo Viana; Moron, Antonio Fernandes [UNIFESP]; Mattar, Rosiane [UNIFESP]; Pires, Claudio Rodrigues [UNIFESP]; Guerzet, Eduardo Almeida; Universidade Federal de São Paulo (UNIFESP); Centro de Diagnóstico por Imagem; Universidade Federal do Espírito Santo Departamento de Ginecologia e Obstetrícia; Centro de Treinamento de Ultra-sonografia; Santa Casa de Misericórdia de Vitória Escola de Medicina Departamento de TocoginecologiaPURPOSE: to compare the uterine cervix measurements and funneling obtained by two- and three-dimensional transvaginal sonography during pregnancy. METHODS: a prospective, descriptive study, with group comparison, was carried out between April 2004 and February 2005 in 74 pregnant women, who were between the 19th and 24th week of pregnancy, regardless of risk factors for premature delivery. The ultrasound examination of the cervix was carried out only once in the same patient and by only one observer. The measurements of the cervix by two-dimensional ultrasound were made at the time of the test and by three-dimensional ultrasound at intervals of 7 to 15 days after the two-dimensional ultrasound. The measurements of cervical length, funnel width and length were taken by two-dimensional ultrasound in the sagittal plane and by three-dimensional in the sagittal plane as well as in coronal plane. RESULTS: there was no significant difference between the averages of the measurements of the cervix obtained by two- and three-dimensional ultrasound in the sagittal plane (p=0.23); however, there was a difference in the averages of the measurements of the cervix obtained by two-dimensional ultrasound in sagittal plane and three-dimensional ultrasound in the coronal plane (p=0.009) and between three-dimensional ultrasound in the sagittal and coronal planes (p=0.001). The kappa test (0.86) showed no superiority of either the two-dimensional and three-dimensional ultrasound in the visualization of the cervical funnel. No statistically significant difference was observed between the methods when the average of the measurements of funneling was compared (p>0.05). CONCLUSION: there were differences between two-dimensional and three-dimensional ultrasound of cervical length, only using the coronal plane of the three-dimensional ultrasound.
- ItemAcesso aberto (Open Access)Estudo da reprodutibilidade da ressonância magnética na avaliação biométrica do colo uterino na segunda metade da gestação e análise comparativa com ultrassonografia transvaginal(Universidade Federal de São Paulo (UNIFESP), 2010-07-28) Brandão, Rosieny Souza [UNIFESP]; Pires, Claudio Rodrigues [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: Verify the reproducibility of magnetic resonance imaging to measure the cervical length through the analysis of intra and interobserver variability in the second half of pregnancy and compare the transvaginal ultrasound and magnetic resonance imaging in the assessment of cervical length. Methods: Crosssectional observational study that included 42 women with gestational ages between 20 and 39 weeks initially submitted to transvaginal ultrasound by a single observer to measure the cervical length. After the scan, patients underwent magnetic resonance imaging by independent observers in a double-blind for the analysis of intra and interobserver variability. Results: There was a distribution of measurements of the cervix measured by means of different methods by Gaussian distribution model (Komolgorov-Smirnov test Z). There was good correlation (intraclass correlation coefficient) for the measurements performed by magnetic resonance single investigator 0.995 (95% CI: 0.991 to 0.997, p <0.001) and by two different examiners 0.990 (95% CI: 0.995, p <0.001). In calculating the paired t test no significant difference between the mean measurements of the cervix for the analysis of intra and interobserver variability (p = 0.200 and p = 0.257, respectively) confirmed by Bland-Altman (-1.07% and 0.74%; respectively) which showed a small average difference percentage. No significant variation was observed between measurements taken by transvaginal ultrasound and magnetic resonance imaging in the paired t test (p=0.191) and Bland-Altman (-0.17%). Conclusions: The results indicate good reproducibility of magnetic resonance imaging to measure the length cervical and no significant difference between transvaginal ultrasound and magnetic resonance imaging in the estimation of cervical biometry.
- ItemAcesso aberto (Open Access)Estudo ultraestrutural do colo uterino de ratas ooforectomizadas após aplicação de óleo de copaíba(Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2000-12-01) Botelho, Nara Macedo [UNIFESP]; Kulay-Júnior, Luiz [UNIFESP]; Simões, Manuel de Jesus [UNIFESP]; Mora, Oswaldo Alves [UNIFESP]; Diniz, José Antonio Picanço; Lamarão, Luciana Garcia; Universidade Federal de São Paulo (UNIFESP); Instituto Evandro Chagas de BelémIn Amazônia there are a lot of plants used alternatively for diseases. The copaíba oil, extract from a tree called Copaifera, has shown great importance in this context. By vaginal route is apllied for therapeutic of cervicitis and leucohrrea. Because of the large empirically employment of this oil in gynecological treatment, the present study objective to study ultraestruturally the effect of this substance in the rats uterus colo. It was used 12 females rats, adults, distributed in four groups: copaíba oil, corn oil, water and control. All the animals were submitted to bilateral oophorectomy and after twenty days began the substances application. The animals were killed in pre-determined time periods (7, 14 and 21 days). The corn oil, water and control groups showed epithelium with two or three cells filers and copaíba group showed epithelium with eight or tem. It was concluded that copaíba oil promoted an increase in the number of epithelial cells with queratinization in the oophorectomized rats.
- ItemAcesso aberto (Open Access)Glycosaminoglycan distribution in the rat uterine cervix during the estrous cycle(Faculdade de Medicina / USP, 2010-01-01) Cubas, Jairo Jose Matozinho [UNIFESP]; Simões, Ricardo Santos; Oliveira-Filho, Ricardo Martins; Simões, Manuel de Jesus [UNIFESP]; Baracat, Edmund Chada [UNIFESP]; Soares-Junior, José Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)OBJECTIVE: To analyze the amount of glycosaminoglycans in the uterine cervix during each phase of the rat estrous cycle. DESIGN: Based on vaginal smears, forty female, regularly cycling rats were divided into four groups (n = 10 for each group): GI - proestrous, GII - estrous, GIII - metaestrous and GIV - diestrous. Animals were sacrificed at each phase of the cycle, and the cervix was immediately removed and submitted to biochemical extraction and determination of sulfated glycosaminoglycans and hyaluronic acid. The results were analyzed by ANOVA followed by the Bonferroni post-hoc test. RESULTS: The uterine cervix had the highest amount of total sulfated glycosaminoglycans and dermatan sulfate during the estrous phase (8.90 ± 0.55 mg/g of cetonic extract, p<0.001; and 8.86 ± 0.57 mg/g of cetonic extract, p<0.001). In addition, there was more heparan sulfate at the cervix during the proestrous phase (0.185 ± 0.03 mg/g of cetonic extract) than during any other phase (p<0.001). There were no significant changes in the concentration of hyaluronic acid in the uterine cervix during the estrous cycle. CONCLUSION: Our data suggest that the amount of total sulfated glycosaminoglycans may be influenced by hormonal fluctuations related to the estrous cycle, with dermatan sulfate and heparan sulfate being the glycosaminoglycans most sensitive to hormonal change.
- ItemSomente MetadadadosMétodo de hibridização "in situ" para detecção da infecção pelo papiloma vírus humano (HPV) em regiões de vulva, vagina e colo uterino(Universidade Federal de São Paulo (UNIFESP), 2002) Dobo, Cristine [UNIFESP]O cancer do colo uterino e o segundo tipo de cancer mais comum entre a populacao feminina, perdendo somente para os carcinomas de mama, e aproximadamente 400.000 novos casos sao diagnosticados a cada ano, em nacoes desenvolvidas e industrializadas. Evidencias epidemiologicas e sobretudo atraves das investigacoes clinicas, sorologicas e com bases nos estudos de biologia molecular, indicam que a infeccao pelo Papiloma virus humano (HPV) corresponde ao principal fator etiologico da carcinogenese cervical, principalmente associado aos outros fatores de risco conhecidos: baixas condicoes socio-economicas, inicio precoce da atividade sexual, pluralidade de parceiros sexuais, uso de contraceptivos orais, habito de fumar. E a doenca sexualmente transmissivel mais comum entre mulheres jovens, atingindo 20 por cento a 46 por cento em varios paises. Para a deteccao da presenca de DNA virai, foram estudadas 332 biopsias retrospectivas ao ano de 1999, de uma amostra de 269 mulheres, com idade media de 30 anos. A distribuicao das amostras mostrou que a maioria das biopsias pertenciam a regiao de colo uterino (49,4 por cento), seguido das biopsias realizadas em regioes da vulva (36,4 por cento) e da vagina (14,2 por cento). O metodo de hibridizacao in situ apresentou reacao positiva na deteccao do HPV em 92 (27,71 por cento) exames: 30 (18,29 por cento) das 164 biopsias da regiao do colo uterino, 42 (34,71 por cento) das 121 biopsias da regiao de vulva e 20 (42,55 por cento) das 47, em vagina. Das 142 amostras cujos resultados . anatomo-patologicos foram de processos inflamatorios com alteracoes morfologicas sugestivas de infeccao pelo HPV,...(au)
- ItemAcesso aberto (Open Access)Tratamento da ectopia do epitélio colunar do colo do útero com acupuntura sistêmica e análise dos fatores de interferência no processo metaplásico(Universidade Federal de São Paulo (UNIFESP), 2017-08-31) Fernandes, Silvana Maria Silva [UNIFESP]; Ribalta, Julisa Chamorro Lascasas [UNIFESP]; Yamamura, Ysao [UNIFESP]; Speck, Neila Maria de Gois [UNIFESP]; Ysao Yamamura : http://lattes.cnpq.br/9962571777055066; Neila Maria de Gois Speck : http://lattes.cnpq.br/8169544398769371; http://lattes.cnpq.br/9709032217978701; http://lattes.cnpq.br/6799566192352970; Universidade Federal de São Paulo (UNIFESP)Objective: To evaluate acupuncture as a treatment for uterine cervical ectopy with analysis of risk factors that interfere with the metaplastic response. Specific objectives are to confirm the syndromic model used in the previous selection of acupuncture points; to compare conventional cytology Pap smear (CPS) versus Liquid-based cytology (LBC); to verify the incidence of high-risk Human Papillomavirus (HPV-HR), its relationship with ectopy size and metaplastic response; demonstrate the use of computerized planimetry. Methods: We selected 51 women with ectopy, without previous therapy, negative CPS and without signs suggestive of the HPV-induced effect, in Study group (S), treated with 10 sessions of acupuncture, weekly and Control group (C) under expectant management. The Ethics and Research Committee approved the project, and we offer a free and informed consent form. After anamnesis, we collected samples for LBC and DNA HPV-HR research and colposcopy with photograph, repeated at 90 days’ follow-up. We evaluated the therapeutic response, using planimetry, considering the differential of the percentages of the areas of ectopy (ΔPe). The data were analyzed statistically. Results: Study group had 23 women and C group had 28, mostly Caucasian, symptomatic and non-smokers. The mean age was 25.6 years. Group S had a higher mean age (p= 0.040), higher age of first sexual intercourse (p<0.001), longer time interval between menarche and first sexual intercourse (p<0.001) and used less hormonal contraceptive (HC) (p<0.001). Regarding age of menarche, number of sexual partners, sexual frequency/month and results of CPS and LBC, there was no difference between groups. Study group presented higher ΔPe than C (p<0.001). We confirmed the Internal Heat Syndrome Deficient of Yin and QI. HPV OT predominated in women younger than 25 years, unrelated to ectopy size and ΔPe. The use of HC had a relation with lower ΔPe (p= 0.006). Conclusion: Study group, treated with acupuncture, had a greater reduction of ΔPe and a probable stimulus to epithelialization. The pathophysiological model of ectopy, according to TCM, was confirmed. CPS confirmed the LBC. Prevalence of HPV OT in women younger than 25 years. The use of HC was associated with lower ΔPe. Planimetry proved to be appropriate, practical, and replicable.
- ItemAcesso aberto (Open Access)Ultra-sonografia transvaginal do colo para a predição do parto pré-termo em pacientes sintomáticas com bolsa íntegra(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2006-11-01) Rios, Lívia Teresa Moreira; Martins, Marília Da Glória; Barros, Rosy Ane De Jesus; Jansen, Giselly Duailibe; Pires, Claudio Rodrigues [UNIFESP]; Mattar, Rosiane [UNIFESP]; Hospital Universitário Federal do Maranhão Departamento de Medicina III Serviço de Obstetrícia e Ginecologia; Universidade Federal do Maranhão Hospital Universitário Serviço de Obstetrícia e Ginecologia; Universidade Federal de São Paulo (UNIFESP)PURPOSE: to assess the role of ultrasonographic cervical length in predicting premature labor in patients presenting persistent uterine contractions and intact membranes. METHODS: a prospective observational cohort study was performed in 45 women admitted to our hospital between 22 and 34 weeks of gestation. Transvaginal sonographic evaluation of the cervix was performed once in the women who had completed a course of parenteral tocolysis. The cervical length was obtained according to criteria reported previously. Cervical sonographic findings were not used in diagnosis and management. Outcome variable was the occurrence of preterm delivery (<37 weeks). Statistical analysis consisted of univariate method with the purpose of determining the significant contribution of cervical length to the prediction of preterm delivery. The adopted significance level was 5% (p<0,05) and the confidence interval was 95% (95% CI). RESULTS: the incidence of preterm delivery was 51.11% (23/45). Cervical length was significantly associated with the outcome (p<0.0001). Receiver operating characteristic curve analysis showed that a cervical length of 20 mm was the best cutoff in predicting preterm delivery (sensitivity 86.9%; specificity 81.8%; positive predictive value 83.3%; negative predictive value 85.7%). The calculated area under the curve was 0.91 (95% CI: 0.79-0.97; p<0.0001). CONCLUSIONS: among women with persistent uterine contractions and intact membranes treated for preterm labor, a cervical length of less than 20 mm demonstrated a high likelihood of preterm birth. Transvaginal ultrasound may improve the accuracy of diagnosis in symptomatic women.