Importância do diagnóstico por imagem em pacientes com sangramento uterino anormal / Importance of diagnostic imaging in patients with abnormal uterine bleeding

O sangramento uterino anormal é diagnóstico sindrômico comum no consultório do ginecologista e pode comprometer substancialmente a qualidade de vida. O objetivo no diagnóstico de sangramento uterino anormal é distinguir pacientes com causas estruturais (anatômicas), como pólipo, adenomiose, leiomioma, malignidade e hiperplasia, de pacientes que apresentam anatomia normal, nas quais o sangramento pode ser devido a alteração dos mecanismos de coagulação, distúrbios ovulatórios, distúrbios primários do endométrio, iatrogenia, ou ter outra causa não classificada. O diagnóstico se inicia a partir de anamnese detalhada e exame físico geral e ginecológico completos, seguidos da solicitação de exames complementares (laboratoriais e de imagem), conforme indicado. O exame de imagem de primeira linha para identificação das causas estruturais inclui a ultrassonografia pélvica. Histerossonografia, histeroscopia, ressonância magnética e amostragem endometrial para exame de anatomia patológica são opções que podem ser incluídas no diagnóstico a depender da necessidade. O objetivo deste artigo é apresentar a relevância dos exames de imagem na investigação das causas de sangramento uterino anormal.

Abnormal uterine bleeding is one of the commonest presenting complaints encountered in a gynecologist's office and may substantially affect quality of life. The aim in the diagnosis of abnormal uterine bleeding is to distinguish women with anatomic causes such as polyp, adenomyosis, leiomyoma, malignancy and hyperplasia from women with normal anatomy where the cause may be coagulopathy, ovulatory disorders, endometrial, iatrogenic and not otherwise classified. Diagnosis begins with a thorough history and physical examination followed by appropriate laboratory and imaging tests as indicated. The primary imaging test for the identification of anatomic causes include ultrasonography. Saline infusion sonohysterography, magnetic resonance, hysteroscopy, endometrial sampling are options that can be included in the diagnosis depending on the need. The aim of this article is to present the relevance of imaging exams in the investigation of the causes of abnormal uterine bleeding.

Uterine POLE mutant endometrioid carcinoma combined with human papilloma virus-associated cervical adenocarcinoma: A case report and literature review / 北京大学学报(医学版)

Independent primary uterine and cervical adenocarcinoma are rare and difficult to identify their origins, which makes treatment decision difficult. A 46-year-old female with endometrioid carcinoma and adenocarcinoma, human papilloma virus (HPV)-associated of the uterine cervix was reported. The patient presented with increased menstrual flow, contact bleeding and watery leucorrhea for more than one year, and the imaging findings showed abnormal uterine morphology, irregular margins, and multiple abnormal signals in uterine cavity and myometrium, which suggested multiple leiomyomas of the uterus. The signal intensity in the right muscle layer was markedly enhanced, suggesting a smooth muscle tumor of uncertain malignant potential. A large number of cystic hypointensity was seen in the cervix, and multiple cysts were considered. The initial preoperative diagnosis was multiple leiomyoma of the uterus, and a hysterectomy operation was planned. During the operation, the uterus was sent for frozen sections. There was a mass in the endometrium of the fundus, with a soft grayish-red cut surface and a clear border with the myometrium, and there was a grayish-white nodule in the cervix with a hard grayish-white cut surface. The two masses were well demarcated from each other, and the distance between them was 30 mm. The result of the frozen sections indicated the malignant tumor of the endometrium, and the extended hysterectomy+pelvic lymphadenectomy+partial resection of the greater omentum was performed. After the operation, the paraffin sections were sent to the Department of Pathology of the Peking University Third Hospital for histochemistry, POLE gene sequencing and HPV RNAscope tests, and the final diagnosis was a synchronous endometrioid carcinoma (POLE-mutant according to the WHO classification) and an adenocarcinoma, HPV-associated of the uterine cervix. Now the patient had been treated with 2 cycles of chemotherapy and her condition was fine. Through the analysis of the histological, immunohistochemical and molecular detection results of this case, the importance of applying HPV RNAscope and TCGA molecular typing in the diagnosis of cervical adenocarcinomas and endometrial carcinomas was emphasized. At the same time, gynecologists should not blindly rely on intraoperative frozen sections, and should pay attention to preoperative pathological examination, and make appropriate operation methods according to the results in order to prevent passivity in the surgery.

Value of basal luteinizing hormone level combined with uterine volume measurement in the early diagnosis of central precocious puberty in girls with different Tanner stages / 中国当代儿科杂志

OBJECTIVES@#To study the value of basal luteinizing hormone (LH) level combined with uterine volume measurement in the early diagnosis of central precocious puberty (CPP) in girls with different Tanner stages.@*METHODS@#A retrospective analysis was performed on the girls who presented with breast development before the age of 8 years and attended the Third Affiliated Hospital of Zhengzhou University from January 2017 to September 2022. According to the results of gonadotropin-releasing hormone (GnRH) agonist test, the girls with peak LH ≥5.0 IU/L and peak LH/follicle stimulating hormone ≥0.6 were enrolled as the positive group, and the other girls were enrolled as the negative group. The two groups were compared in terms of the basal LH level and uterine volume. The receiver operating characteristic (ROC) curve was used to analyze their value in the early diagnosis of CPP.@*RESULTS@#For the girls with Tanner B2 and B3 stages, the positive group had significantly higher basal LH level and uterine volume than the negative group (P<0.05). The basal LH level had an optimal cut-off value of 0.325 IU/L and 0.505 IU/L respectively in the diagnosis of Tanner stage B2/B3 CPP, while uterine volume had an optimal cut-off value of 1.639 mL and 2.158 mL respectively. Basal LH level combined with uterine volume measurement had a significantly larger area under the ROC curve than uterine volume measurement alone (P<0.001), but with no significant difference compared with that of basal LH level measurement alone (P>0.05).@*CONCLUSIONS@#Basal LH level combined with uterine volume measurement is valuable in the early diagnosis of CPP in girls with different Tanner stages, which provides a basis and guiding significance for clinical diagnosis of CPP.

Malformación venosa del útero / Uterine venous malformation

Resumen Las malformaciones venosas son lesiones vasculares benignas infrecuentes que se presentan en el útero. Están conformadas por venas anormales, de diferentes tamaños y proporciones, con configuración espongiforme y disposición al azar. En la literatura, han sido previamente reportados algunos casos, usando el término "hemangioma cavernoso", pero según los cambios recientes en la terminología, aprobados por Sociedad Internacional para el Estudio de las Anormalidades Vasculares (ISSVA), se desaconseja el uso de este término y se sugiere el de "Malformación venosa", si se cumplen los hallazgos histopatológicos al momento de hacer el diagnóstico. Presentamos el caso de una mujer de 44 años, con cuadro de hemorragia vaginal anormal y diagnóstico clínico de miomatosis y mioma abortado por el orificio cervical interno, el estudio histopatológico reveló la presencia de una malformación venosa que comprometía el miometrio y endometrio, con formación subsecuente de un pólipo.

Abstract Venous malformations are benign vascular lesions that rarely appear in the uterus. They are made up of abnormal veins, of different sizes and proportions, with spongiform configuration and random disposition. In the literature, some cases have been previously reported, using the term "cavernous hemangioma", but according to recent changes in terminology, approved by the International Society for the Study of Vascular Abnormalities (ISSVA), the use of this term is discouraged, and the diagnosis of Venous malformation is suggested, if the histopathological findings are met. We present the case of a 44-year-old woman, with abnormal vaginal bleeding and a clinical diagnosis of myomatosis and myoma aborted by the internal cervical orifice, in whom the histopathological study revealed the presence of a venous malformation that compromised the myometrium and endometrium, with subsequent formation of a polyp.

Uterine intussusception in immediate postpartum in bitches: case report / Intussuscepção uterina no puerpério imediato em cadelas: relato de caso

Uterine intussusception is a rare condition in bitches. This study aimed to report an unusual case of prolapsed uterine intussusception in a female dog. A 2-year-old American Bully bitch was received with labor history of large fetus requiring manual traction. The animal presented mucosal prolapse through the vulva, unproductive contractions and abdominal discomfort. After partial correction of mucosal prolapse, the dog was referred to ovary-hysterectomy surgery to correct prolapsed mucosa. During the surgical procedure, surgeons observed that the uterine horns were invaginated into the uterine body, rotated, and the tissue was slightly devitalized and congested. As previously described, this condition occurred during the immediate postpartum period. Thus, we suggest that this period can be a facilitator for the establishment of uterine intussusception.(AU)

A intussuscepção uterina é uma condição rara em cadelas. Portanto, este estudo tem por objetivo relatar um caso incomum de intussuscepção uterina prolapsada em fêmea canina. Uma cadela American Bully de dois anos de idade com histórico de parto de feto absoluto grande no qual necessitou de auxílio por tração manual foi apresentada. O animal exibiu um prolapso de mucosa através da vulva, contrações improdutivas e dores abdominais. Após a retração parcial do prolapso de mucosa, a cadela foi encaminhada para a ovário-histerectomia que teve por objetivo, também, corrigir a mucosa prolapsada. Durante o procedimento cirúrgico, foram verificados os cornos uterinos invaginados no corpo uterino, rotacionados, com o tecido levemente desvitalizado e congesto. Assim, como poucos casos encontrados na literatura, esta condição ocorreu durante o puerpério imediato. Dessa forma, sugere-se que este período, embora não seja um fator determinante para o estabelecimento da intussuscepção uterina, pode ser um facilitador no estabelecimento dessa condição.(AU)

Immunoexpression of vascular endothelial growth factor and B-cell lymphoma 2 in the uterine tissue of rats treated with melatonin in the estrus phase

Abstract Purpose: To investigate the effect of melatonin on uterine tissue in the ovariectomized rat model. Methods: Fourty Wistar albino rats were divided into four groups for histologic and immunohistochemical examination. The rats were first numbered randomly and then randomly divided into 4 equal groups: control (group 1), torsion (group 2), torsion+detorsion (group 3) and torsion+detorsion+melatonin (group 4) groups. In addition, four Wistar albino rats were used for western blot analysis in each group. And also, malondialdehyde (MDA) levels were measured biochemically in all rats. Results: The histopathological examination of the uterine tissue in rats ovarectomized showed a degeneration in uterine glands, dilation of blood vessels in the internal layer with a thrombosis and bleeding, abnormal nucleuses and vacuolated cytoplasm above and below the nucleus. In torsion group, the apoptotic cells increased in luminal epithelium and gland cells. In the melatonin group showed that the Bcl2 negative effect on the uterine epithelium and did not lead to apoptotic cells. Conclusion: The increase in vascular endothelial growth factor expression resulted in the rearrangement of endothelial cell growth and the induction of angiogenesis.

The therapeutic effects of curcumin and capsaicin against cyclophosphamide side effects on the uterus in rats

Abstract Purpose: To evaluate the impact of systemic cyclophosphamide treatment on the rat uterus and investigate the potential therapeutic effects of natural antioxidant preparations curcumin and capsaicin against cyclophosphamide side effects. Methods: A 40 healthy adult female Wistar albino rats were used in this study. Rats were randomly divided into four groups to determine the effects of curcumin and capsaicin against Cyclophosphamide side effects on the uterus (n=10 in each group); Group 1 was the control group (sham-operated), Group 2 was the cyclophosphamide group, Group 3 was the cyclophosphamide + curcumin (100mg/kg) group, and Group 4 was the cyclophosphamide + capsaicin (0.5 mg/kg) group. Results: Increased tissue oxidative stress and histological damage in the rat uterus were demonstrated due to the treatment of systemic cyclophosphamide chemotherapy alone. The level of tissue oxidant and antioxidant markers and histopathological changes were improved by the treatment of curcumin and capsaicin. Conclusion: Cytotoxic effects of natural alkylating chemotherapeutic agents like cyclophosphamide on the uterus can be prevented by curcumin and capsaicin.

The beneficial effects of Montelukast against 2 3 7 8 tetrachlorodibenzo dioxin toxicity in female reproductive system in rats

ABSTRACT PURPOSE: To determine the toxic effect of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on reproductive system and the beneficial effects of Montelukast (ML) with histological and biochemical analysis. METHODS: Rats were randomly divided into four equal groups (control, TCDD, ML and TCDD+ML). Tissue samples were collected on day 60 and oxidative status and histological alterations were analyzed. RESULTS: The results showed a significant increase in oxidative and histological damage on uterine and ovarian tissues. Otherwise, the oxidative and histological damages caused by TCDD were prevented with ML treatment. CONCLUSION: The toxic effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin on female reproductive system were reversed with Montelukast treatment. Therefore, we claimed that ML treatment might be useful for TCDD toxicity.

Remifentanil protects uterus against ischemia-reperfusion injury in rats

PURPOSE: To investigate the effects of remifentanil as an antioxidant and analyze the histopathologic, biochemical changes in experimental ischemia-reperfusion (I/R) exposed rat uteri. METHODS: Wistar albino rats were assigned to three groups (n = 7). 2h period of ischemia was followed by 1h of reperfusion in the I/R and the I/R-remifentanil groups. After ischemia, no drug was administered in the sham and I/R groups. In the I/R-remifentanil group, remifentanil infusion (2 μg/kg/min) was started in the ischemia period, and continued until the end of reperfusion. After the ischemic and reperfusion period, the ischemic uterine horns were removed surgically for biochemical and histopathologic examination. Tissue damage scores (endometrial epithelial glandular leukocytosis, degeneration, and endometrial stromal changes) were examined. Malondialdehyde levels and catalase, superoxide dismutase enzyme activities in tissue were measured. RESULTS: We found significantly lower epithelial leukocytosis and cell degeneration in the I/R-remifentanil group (p<0.05). Remifentanil administration significantly decreased concentrations of malondialdehyde, and increased catalase and superoxide dismutase enzyme activities (p<0.05). CONCLUSION: Remifentanil appears to protect the uterine tissue against ischemia-reperfusion and can be used safely in uterus transplantation.

Single-port laparoscopic hysterectomy: preliminary results / Histerectomia laparoscópica de incisão única: resultados preliminares

Summary Objective: to describe the initial results of a laparoscopic single port access hysterectomy and also to evaluate the feasibility and safety of this access. Methods: a prospective study was performed at a tertiary university medical center (Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo) between March 2013 and June 2014. A total of 20 women, referred for hysterectomy due to benign uterine disease, were included in the study after they had signed an informed consent. Outcome measures, including operating time, blood loss, rate of complications, febrile morbidity, visual analogical pain score and length of hospital stay were registered. Results: mean patient age and body mass index (BMI) were 47.8 years and 27.15 kg/m2, respectively. Mean operating time was 165.5 min. Blood loss was minimal, with no blood transfusion. All procedures but one were successfully performed via a single incision and no post-operative complications occurred. We experienced one conversion to multiport laparoscopic hysterectomy due to extensive pelvic adhesions. There was no conversion to “open” total abdominal hysterectomy. None of the patients required narcotics or NSAD post-operatively. Conclusion: single-port hysterectomy is a feasible and safe technique, with no major complications.

Resumo Objetivo: descrever os resultados iniciais da histerectomia laparoscópica realizada através de punção umbilical única, além de avaliar a praticabilidade e segurança dessa via de acesso cirúrgico. Métodos: este estudo prospectivo foi realizado em um hospital universitário terciário (Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brasil) entre março de 2013 e junho de 2014. Um total de 20 mulheres candidatas à histerectomia por doenças uterinas benignas foram incluídas neste estudo, após terem assinado termo de consentimento informado. Foram analisados os resultados cirúrgicos, incluindo tempo de cirurgia, perda sanguínea, complicações, morbidade febril, dor pós-operatória e tempo de permanência hospitalar. Resultados: a média de idade e índice de massa corpórea das pacientes foi de 47.8 anos e 27.15 kg/m2, respectivamente. O tempo cirúrgico médio foi de 165.5 minutos. A perda sanguínea foi mínima, sem necessidade de transfusão em nenhuma paciente. Todos os procedimentos foram realizados satisfatoriamente, apenas um caso necessitou de conversão cirúrgica para laparoscopia convencional (com 3 punções abdominais) por múltiplas aderências, porém sem necessidade de realização de laparotomia e não houveram complicações pós-cirúrgicas. Nenhuma paciente deste estudo solicitou administração de medicação analgésica adicional no pós-operatório. Conclusão: a histerectomia com acesso único umbilical é um procedimento factível e seguro, sem maiores complicações.

Bovine Herpesvirus 4 in Parana State, Brazil: case report, viral isolation, and molecular identification

Bovine Herpesvirus 4 (BoHV-4) is a member of Gammaherpesvirinae sub-family and belongs to genus Rhadinovirus. This virus has been associated with different clinical manifestations and research activity has put forward a strong correlation among virus infection, postpartum metritis, and abortion. The goal of this work was to characterize a virus strain isolate from a cow’s uterine outflow. From swabs drawn of uterine secretion, a virus strain was isolated and characterized by its cytopathology, morphology, and molecular biology approaches. In culture there was CPE development, characterized mainly by long strands with several small balloons along them, radiated from infected cells. Electron microscopy analysis revealed virus particles that had icosahedrical capsid symmetry surrounded by a loose envelope, typical of a herpesvirus. A 2,571 bp PCR product after HindIII digestion generated four fragments, whose base pair composition were 403, 420, 535, and 1,125 bp. Restriction enzymes HindIII and BamHI generated the expected diagnostic bands as well as a 2,350 bp hypermolar fragment as a result of BamHI treatment to demonstrate that agent was a bovine herpesvirus 4, appertaining to DN-599 group.

Broad Ligament Fibroid: A Case Series.

Fibroids are most common benign tumors of the uterus, mostly situated in the body of the uterus. Rarely, they arise from extra-uterine sites with broad ligament fibroids being uncommon. Although by clinical examination and newer imaging modalities, we can easily know about size, number, and origin of these tumors and any anatomical distortion of surrounding vital organs, but some time it is very difficult to differentiate pre-operatively between large broad ligament leiomyomas and ovarian/adnexal pathology specially if cystic degeneration or necrosis is present in leiomyoma. We report four patients with broad ligament fibroids to emphasize the importance of their location, the diagnostic difficulties, and surgical complications they can pose.

Dermoid cyst in the previous caesarean section scar / Cisto dermoide em cicatriz de cesariana preexistente

Dermoid cysts of the uterus are extremely rare. A case of an asymptomatic dermoid cyst in the previous caesarean section scar is reported in a 39-year-old woman who presented for pre-conception evaluation. A nodular lesion of the uterus was identified through transvaginal ultrasound examination and magnetic resonance imaging and its characteristics are described. The first treatment option was hysteroscopic resection but complete removal could not be achieved. Surgical excision is likely to be the definitive treatment and a hysterectomy will be proposed to the patient after she completes her family. Our literature review indicates that this is the first case of a dermoid cyst located in the previous caesarean section scar.

Cistos dermoides do útero são extremamente raros. Este é um relato de caso de cisto dermoide assintomático na cicatriz de cesariana preexistente em mulher com 39 anos que se apresentou para avaliação pré-concepcional. Foi identificada uma lesão nodular por exame ultrassonográfico transvaginal e ressonância magnética; descrevemos suas características. A primeira opção terapêutica foi a ressecção histeroscópica, mas não foi possível fazer uma remoção completa. É provável que a excisão cirúrgica seja o tratamento definitivo; será proposta uma histerectomia à paciente, depois de ter completado sua família. Nossa revisão da literatura indica que este é o primeiro caso de cisto dermoide localizado em uma cicatriz de cesariana preexistente.

Vaginal Removal of Non Prolapsed Uterus with Benign Pathology.

Vaginal hysterectomy was the first minimally invasive surgical approach for benign gynecologic conditions, a number of other approaches for hysterectomy have been introduced, yet when compared with vaginal hysterectomy these approaches do not offer significant benefits for similar indications. Objectives : (1) To know the benign gynecological conditions that can be treated by vaginal hysterectomy. (2) To find out the operative difficulties of vaginal hysterectomy done in non-prolapsed uterus. (3) To know the morbidity and mortality of vaginal hysterectomy. Methodology : This is a prospective study conducted at our Hospital from 1st December 2010 to 30th Nov. 2011. Hundred consecutive cases of non-descent vaginal hysterectomy for benign pathology of uterus were studied. Results : In our study maximum hysterectomies were done in the age group 41-50 (49%) followed by 31- 40 (40%) least were in age more than 50 years. Mean parity of the cases undergoing hysterectomy were 2.47. In 77% patients, complaints were menorrhagia. The maximum hysterectomies, 41% for fibroid uterus were done, followed by 39% for DUB. One patient had intraoperative bladder injury. Mean operating time for the hysterectomies was 53.21 minutes. No mortality was seen, 12% post-operative complications were present. The mean post-operative stay in the hospital was 5.95 days. Conclusion : Vaginal hysterectomy is both feasible and optimal for many patients who long have been considered inappropriate candidates for vaginal hysterectomy. Many more hysterectomies should be carried out vaginally without resorting to abdominal or laparoscopic approach for benign conditions of the uterus.

Predictive factors for pelvic magnetic resonance in response to arterial embolization of a uterine leiomyoma

OBJECTIVE: Minimally invasive methods are used as alternatives to treat leiomyomas and include uterine artery embolization, which has emerged as a safe, effective method. This study aims to evaluate the magnetic resonance imaging predictors for a reduction in leiomyoma volume in patients undergoing uterine artery embolization. METHODS: This prospective longitudinal study was performed at a university hospital. We followed 50 symptomatic premenopausal women with uterine leiomyomas who underwent uterine artery embolization. We examined 179 leiomyomas among these patients. Magnetic resonance imaging was performed one month before and six months after uterine artery embolization. Two radiologists who specialized in abdominal imaging independently interpreted the images. Main Outcome Measures: The magnetic resonance imaging parameters were the uterus and leiomyomas volumes, their localizations, contrast perfusion pattern and node-to-muscle ratio. RESULTS: Six months after treatment, the average uterine volume reduction was 38.91%, and the leiomyomas were reduced by 55.23%. When the leiomyomas were submucosal and/or had a higher node-to-muscle ratio in the T2 images, the volume reduction was even greater (greater than 50%). Other parameters showed no association. CONCLUSIONS: We conclude that symptomatic uterine leiomyomas in patients undergoing uterine artery embolization exhibit volume reductions greater than 50% by magnetic resonance imaging when the leiomyomas are submucosal and/or had a high node-to-muscle ratio in the T2 images. .

Diffuse heterotopic hair in a canine uterus: case report / Heterotopia de pelo difusa no útero de uma cadela: relato de caso

The present report describes the clinical and pathological findings related to diffuse heterotopic hairs associated with pseudo-placentational endometrial hyperplasia in a canine uterus. Macroscopically, the uterus was intensely enlarged and thicker, and the endometrial surface was irregular and covered with black hairs similar to the hairs of the bitch. Histologically, heterotopic hairs associated with pseudo-placentational endometrial hyperplasia were observed.

O presente relato descreve os achados clínicos e patológicos de uma heterotopia de pelos difusa associada com hiperplasia endometrial pseudo-placentacional em um útero de uma cadela. Macroscopicamente, o útero estava intensamente aumentado de volume e espesso, a superfície do endométrio estava irregular e recoberta com pelos pretos semelhantes aos pelos da cadela. Histologicamente, heterotopia de pelos associada com hiperplasia endometrial pseudoplacentacional foi observada.

Effect of Naja naja Laurenti shed skin extract on estrous cycle, hormone - cytokine profiles, histopathology of ovary and uterus of Swiss albino mice.

The snake shed skin though considered as biological waste products have been mentioned in folk and traditional medicine for treatment of ailments like skin disorders, parturition problems etc. Shedded skin extract (5 mg.kg-1, sc) did not produce any change in the estrous cycle of normal cycling female mice. However in 10 mg.kg-1, sc dose, the extract caused a temporary cessation of the estrous cycle at diestrous phase in normal cycling female mice for 10 days. SSAE (10 mg.kg-1, sc) caused a significant change in the level of LH, FSH, progesterone, estradiol, IL-1β, IL-6 and TNF-α. Histopathology of uterus and ovary showed structural disorientation in both. The results substantiate the influence of snake shed skin in mice reproductive cycle.

Interrelação entre frequência de anticorpos anti-leptospira Spp. e exames histopatológicos (hematoxilina-eosina e Warthin Starry) em suínos abatidos no semiárido paraibano / Interrelation between frequency of anti-leptospira spp. and histopathological examination (hematoxylin-eosin and Warthin-Starry) in pigs slaughtered in the semiarid of Paraiba

Este trabalho foi realizado em suínos abatidos no Município de Patos, Estado da Paraíba, Brasil,com o objetivo de determinar a frequência de anticorpos anti-Leptospira spp., comparando os achados sorológicos com exames histopatológicos de rim, fígado, ovário e útero. A soroaglutinação microscópica foi realizada em 126 animais. Os exames histopatológicos realizados em cortes de fígado, rim, ovário e útero, corados pela hematoxilina-eosina (HE), foram realizados em 20 animaisescolhidos aleatoriamente, sendo 10 do grupo com títulos ≥ 100 e 10 do grupo com títulos < 100. Paralelamente, foi realizada pesquisa direta de leptospiras pela técnica de Warthin-Starry em amostras de rim de todos os animais soropositivos e nos 10 animais soronegativos submetidos à HE. Dos 126 animais examinados, 18 (14,6%) foram soropositivos, com predominância de reações para o sorovar Autumnalis (11 animais; 8,73%). Quatro animais soropositivos e dois animais soronegativosapresentaram infiltrado inflamatório e necrose de graus variados em um dos rins e no fígado. Os ovários e úteros examinados não apresentaram lesões. A pesquisa direta de leptospiras pela técnica de Warthin-Starry não revelou animais positivos em nenhuma amostra testada. Em face da soropositividade encontrada (14,6%), sugere-se a importância da conscientização por parte dos produtores acerca da implantação de medidas de prevenção adequadas com o objetivo de impedir, ou pelo menos diminuir, a disseminação das leptospiras em suínos e, consequentemente, bloquear a possível transmissão do agente para os seres humanos...

Interrelation between frequency of anti-leptospira spp. Antibodies and findings of histopathological examinations (hematoxylin-eosin and warthin-starry) in pigs slaughtered in the semiarid of paraiba state, northeastern brazil. This work was conducted in slaughtered pigs in Patos County, Paraiba State, Brazil, with the aim to determine the frequency of anti-leptospira antibodies and to compare the serological findings with the histopathological findings of kidney, liver, ovary and uterus. The microscopic agglutination test (MAT) was performed on 126 animals. The histopathological examination performed in sections of livers, kidneys, ovaries and uteruses stained with hematoxylin-eosin (HE) was conducted in 20 randomly chosen animals (10 from group with serological titer ≥ 100 and 10 from group < 100). Parallel to this, a direct search for leptospires was carried out by Warthin-Starry technique in kidney samples from all seropositive animals and in the 10 seronegative animals submitted to HE. In the 126 animals examined, 18 (14.6%) were seropositive, with prevalence of reactions to Autumnalis serovar (11 animals; 8.73%). Four seropositive and two seronegative animals showed different degrees of inflammatory infiltrate and necrosis in liver or kidney. The ovaries and uterus no showed lesions. Direct analysis of leptospires by the Warthin-Starry technique did not reveal positive animals in any sample tested. The rate of seropositivity found (14.6%) suggests the importance of awareness by producers about the implementation of preventive measures aimed at preventing, or at least reducing the spread of leptospiras in pigs and thereby blocking the possible transmission of the agent to humans...

Evaluation of Intrauterine structural pathology by three-dimensional sonohysterography using an extended imaging method

Structural intrauterine abnormalities are an important cause of infertility, recurrent pregnancy loss and bleeding or pain associated with a poor reproductive outcome. Various diagnostic methods have been applied to detect these lesions such as hysterosalpingography, hysteroscopy and sonohysterography. More recently, three-dimensional extended imaging [3DXI] provides the ability to obtain sequential sections of acquired volume scans in A, B and C planes. Here, we briefly discuss the technique of saline infusion sonography, followed by a review of sonohysterographic characteristics of intracavitary pathologies with more focus on some definitions and measurements