Estudo de potenciais doadores de córnea no Hospital de Clínicas da UFPR / Study of cornea potential donors at the Clinical Hospital of UFPR

OBJETIVO: Quantificar os potenciais doadores de córnea nas diferentes unidades hospitalares do Hospital de Clínicas da Universidade Federal do Paraná - UFPR. MÉTODOS: Foram analisados 369 prontuários de pacientes que foram a óbito nos meses de abril a julho de 2005 no HC-UFPR. No prontuário de cada paciente foram avaliados: evolução clínica, CID-10 e unidade hospitalar do óbito. Para ser considerado potencial doador (PD) utilizou-se como critérios de exclusão os tópicos citados no Manual de Transplantes (2ª edição - 2004) da Secretaria Estadual da Saúde do Estado do Paraná. Os PD foram agrupados em: data do óbito, tipo de internamento e unidade hospitalar. Analisamos a quantidade de PD e total de óbitos. RESULTADOS: Dos 369 prontuários analisados, foram considerados potenciais doadores (PD) 70 pacientes (18,97 por cento do total de prontuários analisados) As unidades: Centro de Terapia Intensiva, Centro de Terapia Semi e Pronto Atendimento Adulto foram responsáveis por 62,8 por cento dos PD. Já a Neurocirurgia, Emergência Cárdio e UTI Cirurgia Cardíaca apresentaram uma relação de PD por óbito superior a 60 por cento. CONCLUSÃO: Nesse estudo constatou-se que tanto as unidades com grande número de PD como aquelas com uma grande relação PD por óbito são locais de escolha para uma intervenção com o intuito de aumentar o número de doações em nosso meio.

PURPOSE: To quantify the potential cornea donor from the different units of Clinical Hospital of the UFPR. METHODS: 369 records of patients who died from april until july of 2005 in the HC-UFPR were analyzed. The medical records of each patient had been evaluated: the clinical evolution, CID-10 and hospital unit of the death. To be considered potential donor (PD) it was used as exclusion criteria the topics cited in the Manual of Transplants (2ª edition-2004) of the State Secretariat of the Health of the State of the Paraná. The PD had been grouped in: date of the death, type of internment and hospital unit. We analyze the amount of PD and total of deaths. RESULTS: Of 369 analyzed records, potential donor (PD) had been considered 70 patients (18.97 percent of the analyzed handbook total) the units: Center of Intensive Therapy, Center of Half Therapy and ER Adult had been responsible for 62,.8 percent of the PD. Already the neurosurgery, cardiac emergency and UTI cardiac surgery had presented a relation of PD per death superior than 60 percent. CONCLUSION: In this study we evidence that as much the units with great number of potential donor (PD) as those with a great relation PD per death are local of choice for an intervention with intention to increase the number of donations in our way.

[Evaluation of the quality of donor corneas in relation to the age of donor and cause of death]. / Avaliação da qualidade das córneas doadoras em relação à idade do doador e causa do óbito.

PURPOSE: To analyze the quality of the corneas evaluated by slit lamp examination in the Eye Bank of the Hospital de Clínicas UFPR and its relation to donor age and cause of death. METHODS: Analysis of 492 corneas, evaluated in BTO HC-UFPR between August 2006 to August 2008. Each cornea was classified regarding the quality as: very good, good, regular and bad; and according to clarity, epithelial defect, stromal edema, Descemet's folds, stromal opacity, corneal scarring, endothelial density and guttata. RESULTS: The mean donor age was 42.74 years (sd=17.77 years). Among the causes of death, trauma was the most common with 46.18%, followed by cardiovascular causes with 41.86%. In relation to the cornea, 57.11% were classified as 'good', followed by 20.73% as 'regular', 16.87% as 'very good' and 5.28% as 'bad'. With the application of statistical tests based on ordinal regression model, trauma deaths corneas tend to be better, as well as those of younger patients. CONCLUSIONS: Statistically, the corneas from younger donors tend to have better graduations in the assessment, as well as the corneas from donors dead by trauma that tend to have better quality when compared to corneas from donors dead by cardiovascular and other systemic diseases.

Avaliação da qualidade das córneas doadoras em relação à idade do doador e causa do óbito / Evaluation of the quality of donor corneas in relation to the age of donor and cause of death

OBJETIVO: Analisar a qualidade das córneas avaliadas em lâmpada de fenda no Banco de Tecidos Oculares do Hospital de Clínicas da Universidade Federal do Paraná (BTO HC-UFPR) relacionando com a idade e causa de óbito. MÉTODOS: Foram analisadas retrospectivamente fichas de avaliações padronizadas de 492 córneas, avaliadas no BTO HC-UFPR, do período de agosto de 2006 a agosto de 2008. Cada córnea avaliada foi classificada em relação a sua qualidade em: Muito bom, bom, regular e ruim; mediante os seguintes fatores: claridade da córnea, edema epitelial, defeito epitelial, edema estromal, dobras de Descemet, opacidade estromal, cicatrizes corneanas, densidade endotelial e guttata. RESULTADOS: A idade média dos doadores foi de 42,74 anos (dp=17,77). Dentre as causas de óbito, a mais comum foi trauma com 46,18 por cento, seguindo por causas cardiovasculares com 41,86 por cento. Na avaliação da córnea, foram classificadas: 57,11 por cento como "bom", seguido por 20,73 por cento "regular", 16,87 por cento "muito bom" e 5,28 por cento "ruim". Com aplicação de testes estatísticos baseados em modelo de regressão ordinal verificou-se que as córneas provenientes de mortes por traumas tendem a ser melhores, bem como aquelas de pacientes mais jovens. CONCLUSÕES: Estatisticamente, córneas de doadores mais jovens tendem a ter melhores graduações na avaliação, bem como córneas provenientes de doadores com morte por trauma tendem a ser de melhor qualidade quando comparadas com as provenientes de mortes por doenças cardiovasculares e outras doenças sistêmicas.

PURPOSE: To analyze the quality of the corneas evaluated by slit lamp examination in the Eye Bank of the Hospital de Clínicas UFPR and its relation to donor age and cause of death. METHODS: Analysis of 492 corneas, evaluated in BTO HC-UFPR between August 2006 to August 2008. Each cornea was classified regarding the quality as: very good, good, regular and bad; and according to clarity, epithelial defect, stromal edema, Descemet's folds, stromal opacity, corneal scarring, endothelial density and guttata. RESULTS: The mean donor age was 42.74 years (sd=17.77 years). Among the causes of death, trauma was the most common with 46.18 percent, followed by cardiovascular causes with 41.86 percent. In relation to the cornea, 57.11 percent were classified as "good", followed by 20.73 percent as "regular", 16.87 percent as "very good" and 5.28 percent as "bad". With the application of statistical tests based on ordinal regression model, trauma deaths corneas tend to be better, as well as those of younger patients. CONCLUSIONS: Statistically, the corneas from younger donors tend to have better graduations in the assessment, as well as the corneas from donors dead by trauma that tend to have better quality when compared to corneas from donors dead by cardiovascular and other systemic diseases.

Sexually-transmitted viral diseases in women: clinical and epidemiological aspects and advances in laboratory diagnosis.

Sexually transmitted diseases (STDs) have long been known, but they have only recently been recognized as causes of significant long-term morbidity, mainly as a result of increased knowledge concerning viral STDs. The relationship of these diseases with conditions such as anogenital cancer and acquired immunodeficiency syndrome (AIDS) has made viral STDs an important issue in the healthcare of women and infants, and in reproductive health. The evolution of the AIDS pandemic is now characterized by growing differences between rich and poor nations. New diagnostic tools include rapid tests of blood, urine and saliva samples. New techniques, such as computerized cytology, have been developed for the diagnosis of human papillomavirus (HPV). Women infected with HIV are at a greater risk of being co-infected with HPV, and they are also more prone to the progression and persistence of HPV lesions. The herpes simplex virus presents high rates of co-infection with HIV, and it plays a particularly important role in increasing transmission rates of this virus.

Cervical cancer screening program of Paraná: cytohistological correlation results after five years.

Since its inception in November 1997, the Cervical Cancer Screening Program of Paraná (CCSPP), Brazil, has resulted in the cytological screening of 2,244,158 women, the coverage of the female population increasing from 43% to 86%. One thousand six hundred one cases screened by cytology, submitted to colposcopy, and subjected to treatment were selected. Cytopathological results were compared with those obtained on the basis of histological analyses of the loop electrical excision procedure specimens, and were subjected to statistical analyses. The data obtained were then compared with cytohistological correlation results from the first year of the program. Considering the exact correlation between cytological and histological diagnoses, the correlation index increased from 53.34% in the first year to 67.3% at the end of 5 yr of the program. Variations that occurred in each diagnostic category are discussed. This study demonstrates a significant improvement in the concordance between cytological and histological results for the 5-yr period compared with the first year of the CCSPP.

Metaplasia óssea do endométrio: relato de caso / Endometrium osseous metaplasia: a case

Os autores relatam o caso de uma paciente que apresentou aborto seguido de infeccão, resultando em esterilidade secundária. Após curetagem uterina terapêutica, o laudo do exame anatomopatológico foi de endometrite crônica com fibrose, calcificacão e metaplasia óssea. Na evolucão, a paciente apresentou sinéquia de corpo e colo uterino. Apesar de rara, a metaplasia óssea endometrial deve ser considerada no diagnóstico de infertilidade. O presente relato salienta a importância do diagnóstico histopatológico e do conhecimento da etiopatogenia dessa entidade, sua associacão com a endometrite crônica e história de abortamento.

Sexually-transmitted viral diseases in women: clinical and epidemiological aspects and advances in laboratory diagnosis

Sexually transmitted diseases (STDs) have long been known, but they have only recently been recognized as causes of significant long-term morbidity, mainly as a result of increased knowledge concerning viral STDs. The relationship of these diseases with conditions such as anogenital cancer and acquired immunodeficiency syndrome (AIDS) has made viral STDs an important issue in the healthcare of women and infants, and in reproductive health. The evolution of the AIDS pandemic is now characterized by growing differences between rich and poor nations. New diagnostic tools include rapid tests of blood, urine and saliva samples. New techniques, such as computerized cytology, have been developed for the diagnosis of human papillomavirus (HPV). Women infected with HIV are at a greater risk of being co-infected with HPV, and they are also more prone to the progression and persistence of HPV lesions. The herpes simplex virus presents high rates of co-infection with HIV, and it plays a particularly important role in increasing transmission rates of this virus.

Variantes de lesões intra-epiteliais escamosas: relato de quatro casos / Variants of intraepithelial squamous lesions: report of four cases

Entre a rotina de biópsias e produtos cirúrgicos provenientes do colo uterino, um número significativo de lesões intra-epiteliais escamosas (LIE) pode causar dificuldade quanto a caracterização e graduação histológica. Tais lesões têm sido identificadas e descritas isoladamente por artigos científicos como variantes histológicas de LIE cervicais. São elas a metaplasia papilar imatura atípica (MPIA) e as variantes de neoplasia intra-epitelial cervical graus II/III: queratinizante, com padrão metaplásico imaturo de crescimento e escamomucinosa. Neste artigo são exemplificados quatro casos representativos das entidades citadas acima, provenientes das rotinas do Programa de Prevenção do Câncer Ginecológico do Estado do Paraná e de um laboratório privado especializado em patologia ginecológica de Curitiba, o Laboratório de Citopatologia e Anatomia Patológica Annalab. Os principais critérios diagnósticos são descritos, assim como a correlação citológica e molecular relacionada à presença e à localização do ácido nucleico viral (papilomavírus humano [HPV]) nas lesões.