RESUMO
OBJECTIVE: Recent data suggest that during mechanical ventilation, lateral patient position (in which the endotracheal tube is horizontal) decreases the incidence of bacterial colonization of ventilated neonates. The objective of this study was to evaluate the influence of lateral and supine position on bacterial colonization of endotracheal tube in neonates. METHODS: We conducted a prospective, randomized, clinical trial with 31 intubated neonates (intubated within 48 hours after birth); sixteen neonates were positioned supine (supine group), and fifteen were maintained in the lateral position (lateral group).Tracheal aspirates were cultured in second and fifth days of mechanical ventilation. Data were analyzed with SPSS version 16. FINDINGS: In the second day of ventilation, positive cultures were recognized in 6.2% of supine group and 6.7% of lateral group. After 5 days, tracheal cultures were positive in 25% (4 neonates) of supine group and 13.3% (2 neonates) of lateral group that wasn't statistically significant (P=0.9 in second day and P=0.9 in the fifth day). The most common organisms isolated from tracheal aspirates were Gram-negative rods (Klebsiella). CONCLUSION: Since respiratory contamination is very common among ventilated neonates and the effect of lateral position on bacterial colonization of endotracheal tubes of intubated neonates wasn't established in our study, further studies are required to suggest ways to decrease bacterial colonization of intubated neonates.
RESUMO
BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women associated with many reproductive, endocrine, metabolic and cardiovascular dysfunctions. This study aimed to determine the prevalence of PCOS among high school students in Rasht. MATERIALS AND METHODS: In a cross-sectional study, 1850 students were selected by a multi-stage cluster sampling from all high schools in Rasht. The inclusion criteria were: age 17-18 years, menarche from 10-16 years, normal prolactin and thyroid stimulating hormone (TSH) values, no history of anatomical malformation, no use of medication or hair-removal techniques, and a history of oligo- or amenorrhea. PCOS was diagnosed if both menstrual dysfunction and clinical hyperandrogenism were detected. RESULTS: Mean age of subjects was 17.2 ± 0.7 years and the age of menarche was 12.8 ± 0.9 years. Of all students, 378 (20.4%) had oligomenorrhea and PCOS was diagnosed in 210 (11.34 %) according to the National Institute of Health (NIH) definition. PCOS subjects, mean body mass index (BMI), waist circumference, and waist/hip (W/H) ratio were 21.1 ± 3.6, 73.4 ± 8.0 cm and 0.77 ± 0.05, respectively. A family history of diabetes mellitus type 2 was reported in 24.7% of subjects. CONCLUSION: The prevalence of PCOS in this study was similar to the international estimates of 10-20% in Caucasians. A long-term follow-up is needed to compare the accuracy of clinical determination of the disease versus diagnosis based on hormonal and/or sonographic assessments.
RESUMO
BACKGROUND: While myoma is the most common pelvic mass of women, most women do not seek screening tests for uterine myoma and if they have any fibroid they are not volunteer for its surgical removal. CASE: We present here a novel technique of vascular skeletonization to preserve uterus, making pregnancy possible for an infertile woman with a large uterine myoma, situated in the uterine lower segment. CONCLUSION: Vascular skeletonization to preserve vessels for a case of myomectomy helped preserve the patient's ability to conceive.
