Effect of weight loss orientation on BMI in obese and overweight infertile patients.

OBJECTIVE: The aim of this study was to evaluate the response to weight loss guidance in the anthropometric parameters of obesity and overweight infertile patients assisted fertilization treatment (high and low complexity). METHODS: Retrospective cohort study. This survey was conducted in a population of overweight and obese infertile patients. In the first consultation at the assisted reproduction clinic (Human Reproduction Laboratory HC / UFG), obese and overweight patients were weighed, measured and instructed to lose weight and informed that being overweight could reduce the chances of success in the treatment. RESULTS: We analyzed 56 overweight and obese patients admitted for infertility treatment at the Human Reproduction Center HC/UFG. The mean age of overweight and obese patients was 35.78 years, SD 3.70. After the orientation, only 8.92% of patients would achieve the normality rating for BMI, overweight 39.28% (decreased 14.29%), obesity I 37.5%, obesity II 10.71% and obesity III 3.57% (all degrees of obesity increased 1.79%). The mean weight of patients before and after guidance was statistically significant (p<0.0046). The mean values of BMI before and after guidance were also statistically significant (p<0.0038). CONCLUSIONS: Weight loss guidance in this population had no effect on weight loss. On the contrary, the mean weight of patients after guidance was statistically higher than the mean in the first consultation (both weight and BMI). It is suggested that for obese and overweight infertile patients, in addition to guidance for reduction, an appointment with a nutritionist and/or endocrinologist should be immediately scheduled.

Bilateral but not unilateral tubal obstruction is associated with positive chlamydia serology.

OBJECTIVE: To assess the association between positive Chlamydia trachomatis (C. trachomatis) serology and unilateral or bilateral tubal obstruction. METHODS: This was a cross sectional study that evaluated the association of positive C. trachomatis serology (Immunofluorescence Indirect Serology, IIF or Enzyme Immune Essay, EIE), in two infertile groups: A. 243 patients (27 with unilateral obstruction and 216 without it). B. 247 patients (31 with bilateral obstruction and 216 without it). The exclusion criteria were tubal ligation (tubectomy) and tubal surgery. The statistical test (SPSS 17.0) was the Chi-Square with a p=5%. Tubal obstruction was diagnosed through hysterosalpingography (HSG). RESULTS: The mean age of the patients without obstruction was 33.6 years, SD 4.9. The mean age of the patients with unilateral obstruction was 33.7 years SD 4.9. The mean age of the patients with bilateral obstruction was 33.6 years, SD 4.9. There was no statistically significant difference between the age groups. In group A (unilateral obstruction versus serology) the Chi-Square was 0.02 (p=n.s.) and the Attributable Risk (AR) = 0.7%. In Group B (bilateral obstruction versus serology) the Chi-Square test was 9.87 (p<0.005) and the AR = 14.8%. CONCLUSION: This study found a strong and statistically significant association between bilateral tubal obstruction and C. trachomatis positive serology. The power of the test was 86%. There was no association between unilateral obstruction and positive serology.

Endometriosis III and IV as a risk factor for tubal obstruction in infertile women.

OBJECTIVE: A previous study carried out among infertile women with tubal obstruction identified a relative risk of 2.5 for Chlamydia trachomatis seropositivity. However, endometriosis may also be associated with increased risk. This study aimed to evaluate the risk of tubal obstruction associated with endometriosis III/IV among women submitted to assisted reproductive procedures. METHODS: A case-control study was performed among 144 women with and without tubal obstruction. We calculated the odds ratio with 95% CI regarding the association of endometriosis III/IV and tubal obstruction. Calculations were performed using the SPSS v.17.0 package. RESULTS: The mean age was 33.7 years (4.76 SD), and the mean infertility duration time was 66.7 months (120.6 SD). The total prevalence of endometriosis was 20/144 (13%). Among 144 women, the risk group with tubal obstruction and endometriosis III/IV comprised 7out of 20 (35%), compared with the group without such risk, that comprised 22 out of 124 (17%). The X2 test was 3.19 with a p-value of 0.07. The odds ratio (OR) was 2.5 (95% CI: 0.647-9.639). CONCLUSION: Although the OR was 2.5, there was no significant difference between the groups with and without endometriosis III/IV. Further studies are needed to increase the sample size.

Avaliação e triagem da acuidade visual em escolares da primeira infância / Evaluation and screening of visual acuity in early childhood schoolchildren

Resumo Objetivo: Identificar a prevalência de alterações visuais em crianças de cinco anos em escolas públicas de Curitiba-PR. Métodos: As escolas foram selecionadas aleatoriamente dentro do município de Curitiba. As crianças com cinco anos completos em 2017 foram avaliadas com a tabela de Snellen, através de distância mínima correta para nitidez de imagem e teste de Hirschberg. Os pais responderam um questionário sobre uso de telas, sintomas oculares e histórico familiar da criança. Os resultados das avaliações foram analisados estatisticamente considerando nível de significância p≤0,05. Resultados: Em uma população de 459 crianças triadas, 219 (47,7%) pertenciam ao sexo feminino e 240 (52,3%) masculino, sendo que do total, 100 foram encaminhadas para avaliação oftalmológica especializada. A partir da triagem observou-se a prevalência de miopia de 10,7%, hipermetropia de 17,6% e estrabismo de 0,9%. Houve relação entre genitores com miopia e filhos míopes (p<0,05). Dentre as queixas oftalmológicas predominaram cefaleia (30,4%) e franzir de testa (10%). Conclusão: A prevalência de alterações visuais encontrada foi de 21,8%. A relação entre distúrbios visuais e o histórico familiar se mostrou estatisticamente significativa. Entretanto, apenas o tempo médio em frente à televisão apresentou influência, dentre os hábitos de vida, sobre as alterações da AV (p=0,028). Queixas oftalmológicas apesar de frequentes, não apresentaram correlação expressiva com a diminuição da acuidade visual.

Abstract Objective: To identify the incidence of visual impairment in 5-year-old children in public schools from Curitiba-PR. Methods: A selection of schools has been choosen randomly from Curitiba. The children, with completed 5 years at end of 2017 have been evaluated using Snellen table, trough minimum distance for image sharpness and Hirschberg test. Parents answered a questionnaire about the use of screens, ocular symptoms and family history of the child. Significance levels were defines as begin p≤0,05. Results: The results have shown that four hundred fifty-nine children were screened. Two hundred nineteen are female (47,7%) and two hundred fourty (52,3%), male. From all screened patients, one hundred were refered to specialized oftalmic evaluation. After trial completing, has been attained a prevalence value of 10,7% for myopia, 17,6% of hyperopia and 0,9% of strabismus. Strong correlation between parents and children has been undiscovered (p<0,05). From listed oftalmic complaints, headache (30,4%) and frown (10%) where most prevalent. Conclusion: It has been attained that the prevalence of visual acuity is 21,8%. The relation between visual acuity alteration and familiar history has been shown to be significant related. On the other side, the average time in front of television has been shown the only habit that has correlation with visual acuity reduction (p=0,028). Vision complaints, although very frequent, doesn't translate into increased probability of visual acuity alteration.