Clinical and mammographic profile of patients with breast cancer surgically treated.

OBJECTIVE: to analyze the epidemiological, clinical and mammographic profile of women with breast cancer who were treated at the mastology clinic of the University Hospital of Santa Maria and who underwent breast surgery between January 2007 and December 2012. METHODS: this was a cross-sectional study, approved by the Ethics in Research Committee. A review of the patients' medical records was performed. The data were then exported to a software program for statistical analysis, namely Minitab 14.1. RESULTS: the patients' profile indicated that they were mostly born and raised in Santa Maria (respectively 11.1%, n=16, and 26.3%, n=68). They were about 55.6 years old (SD ± 12.3), white (90.2%, n=213), had already given birth and breastfed their children, were nonsmokers, but also overweight (average BMI of 27 kg/m2). On physical examination of the first medical consultation, these patients, as described in the records: had a palpable mass (81.1%, n=184) measuring over three centimeters, located in the left breast, precisely in the upper outer quadrant (41.4%, n=81). Mammography (39%, n=109) showed that this lump was classified as BIRADS ® 5 (40%, n=81). On histopathological examination, the lump was diagnosed as an invasive ductal cancer (71.1%, n=191). Surgery was generally a radical mastectomy (84.7%, n=236) with axillary dissection (92.5%, n=222). CONCLUSION: some of the epidemiological, clinical and mammographic features mentioned above resembled those found in the literature reviewed. However, these patients had advanced disease and underwent non conservative surgical procedures.

Avaliação, acompanhamento ultrassonográfico e clínico da inserção de dispositivo intrauterino (DIU) durante o parto cesáreo: um estudo-piloto / Evaluation, ultrasonography and clinical follow up of intrauterine device (IUD) insertion during cesarean delivery: a pilot study

Introdução: O objetivo deste estudo foi analisar o comportamento do dispositivo intrauterino (DIU) inserido no transoperatório de operações cesarianas, quanto aos aspectos clínicos, ecográficos e de satisfação da usuária. Métodos: Foram estudadas 18 pacientes submetidas a cesariana, no Centro Obstétrico do Hospital Universitário de Santa Maria, nas quais foi inserido, no transoperatório, um DIU (TCu 380mm). As pacientes foram submetidas à avaliação clínica e ultrassonográfica no 1º, 15º e 42º dias do pós-operatório. O ultrassom avaliou a distância da haste superior do DIU ao endométrio e o volume uterino. Resultados: A distância do DIU ao endométrio variou de 2 mm até 6 mm. O volume uterino decresceu, da média de 611,63 cm3 (1º dia), à média de 75,79 cm3 (42º dia pós-operatório). Ocorreu apenas uma de retirada de DIU por sangramento excessivo, nos demais casos não se constataram complicações clínicas ou cirúrgicas. Não houve nenhum caso de expulsão do dispositivo. Todas as pacientes declararam estar satisfeitas com o método. Conclusão: A ultrassonografia, no acompanhamento do posicionamento do DIU dentro da cavidade uterina, demonstrou não haver mobilidade significativa deste dispositivo, nos três momentos avaliados. O DIU inserido no transoperatório de cesariana pode representar um método de anticoncepção de baixo custo, de fácil e indolor inserção e com benefícios no pós-parto imediato (AU)

Introduction: This study was designed to analyze the behavior of the intrauterine device (IUD) inserted during surgery with caesarean sections, considering clinical, sonographic and user satisfaction aspects. Methods: We studied 18 patients undergoing caesarean section, at the Obstetric Center of the University Hospital of Santa Maria, in which an IUD (TCu 380mm). was inserted during surgery. Patients underwent clinical and ultrasound evaluation at 1, 15 and 42 days after surgery. The ultrasound evaluated the distance from the upper end of the IUD to the endometrium and uterine volume. Results: The distance from IUD to endometrium ranged from 2 mm to 6 mm. The uterine volume decreased from a mean of 611.63 cm3 (Day 1) to a mean of 75.79 cm3 (postoperative day 42). There was only one case of withdrawal of IUD because of excessive bleeding, in the other cases there were no clinical or surgical complications. There was no case of device expulsion. All patients stated that they were satisfied with the method. Conclusion: The ultrasound monitoring of IUD placement within the uterine cavity showed no significant mobility of this device, at the three times evaluated. IUDs inserted during cesarean section may represent a low-cost, easy, and painless contraceptive method, with benefits in the immediate postpartum period (AU)

Clinical and mammographic profile of patients with breast cancer surgically treated / Perfil clínico e mamográfico das pacientes com câncer de mama, tratadas cirurgicamente.

Summary Objective: to analyze the epidemiological, clinical and mammographic profile of women with breast cancer who were treated at the mastology clinic of the University Hospital of Santa Maria and who underwent breast surgery between January 2007 and December 2012. Methods: this was a cross-sectional study, approved by the Ethics in Research Committee. A review of the patients' medical records was performed. The data were then exported to a software program for statistical analysis, namely Minitab 14.1. Results: the patients' profile indicated that they were mostly born and raised in Santa Maria (respectively 11.1%, n=16, and 26.3%, n=68). They were about 55.6 years old (SD±12.3), white (90.2%, n=213), had already given birth and breastfed their children, were nonsmokers, but also overweight (average BMI of 27kg/m2). On physical examination of the first medical consultation, these patients, as described in the records: had a palpable mass (81.1%, n=184) measuring over three centimeters, located in the left breast, precisely in the upper outer quadrant (41.4%, n=81). Mammography (39%, n=109) showed that this lump was classified as BIRADS ® 5 (40%, n=81). On histopathological examination, the lump was diagnosed as an invasive ductal cancer (71.1%, n=191). Surgery was generally a radical mastectomy (84.7%, n=236) with axillary dissection (92.5%, n=222). Conclusion: some of the epidemiological, clinical and mammographic features mentioned above resembled those found in the literature reviewed. However, these patients had advanced disease and underwent non conservative surgical procedures. .

Resumo Objetivo: analisar o perfil epidemiológico, clínico e mamográfico de mulheres com câncer de mama atendidas no ambulatório de mastologia do Hospital Universitário de Santa Maria (UFSM) e submetidas à cirurgia de mama no período de janeiro de 2007 a dezembro de 2012. Métodos: estudo de prevalência realizado de modo transversal, após ter sido aprovado pelo Comitê de Ética em Pesquisa. Foram realizadas revisões dos prontuários das pacientes. As informações obtidas foram transpassadas para um programa de análise estatístico, o Minitab 14.1. Resultados: o perfil das pacientes, encontrado no estudo, mostrou que elas eram, na maioria, naturais ou procedentes de Santa Maria (respectivamente 11,1%, n=16, e 26,3%, n=68). Elas tinham 55,6 anos (DP±12,3), eram brancas (90,2%, n=213), gestaram, amamentaram, não eram tabagistas, mas estavam com sobrepeso (IMC médio de 27 kg/m2). No exame físico do primeiro atendimento, essas pacientes, conforme descrito no prontuário, tinham nódulo palpável (81,1%, n=184) com mais de 3 cm na mama esquerda, precisamente no quadrante lateral superior (41,4%, n=81). Na mamografia (39%, n=109), esse nódulo foi classificado como BI-RADS® 5 (40%, n=81). No exame histopatológico, o nódulo foi diagnosticado como câncer do tipo ductal invasor (71,1%, n=191). A cirurgia foi, em geral, uma mastectomia radical (84,7%, n=236) com esvaziamento axilar (92,5%, n=222). Conclusão: concluiu-se que algumas das características epidemiológicas, clínicas e mamográficas citadas acima assemelharam-se com a literatura revisada. No entanto, essas pacientes apresentavam câncer de mama em estádio avançado e foram submetidas a uma técnica cirúrgica não conservadora. .

[Neurologic vigor of term newborns according to the type of delivery and obstetric maneuvers]. / Vigor neurológico de recém-nascidos a termo segundo tipo de parto e realização de manobras obstétricas.

PURPOSE: to evaluate the effect of delivery type and usual obstetric procedures on the neurologic condition of a sample of consecutive term and healthy neonates, in the first 48 hours of life, using the Neurologic Adaptative Capacity Score (NACS) system. METHODS: cohort prospective study with 313 neonates, from a neonatology unit: Unidade de Neonatologia e Alojamento Conjunto. The variables analyzed were obstetric variables; clinical outcome: low neurologic vigor phase, evaluated by NACS, at 4, 24 and 48 hours of life. The data have been assessed twice: once with the whole sample and the other comparing the Vigorous Group, whose neonates kept a score of 35 or more during the three evaluations, and the Low Vigor Group, with less than 35 scores during the three consecutive evaluations. Bivariate and multivariate analyses have been done. Possible associations between low neurologic vigor phase and the type of delivery, as well between the low neurologic vigor phase and obstetric variables have been searched. RESULTS: in the bivariate analysis, the delivery type and the obstetric variables were not associated with the low neurologic vigor phase. Nevertheless, the association between the amniotic fluid and the low neurologic vigor phase reached values very close to significance and, then, it was included in the multivariate analysis. In the multivariate analysis, the only variable associated with low neurologic vigor was the presence of meconium stained amniotic fluid, which has shown to be 8.1 times more risky for the neurologic scoring, when Vigorous Group and Low Vigor Group were compared. In the analysis of the whole sample, the same risk was 1.7. CONCLUSIONS: neither the delivery type, nor the usual obstetric procedures were associated with low neurologic vigor phase. This is useful information, clinically or legally speaking, mainly for obstetricians. According to this sample data, when the term neonate is healthy, the delivery type and the usual obstetric procedures have no impact in the neurologic condition.

Vigor neurológico de recém-nascidos a termo segundo tipo de parto e realização de manobras obstétricas / Neurologic vigor of term newborns according to the type of delivery and obstetric maneuvers

OBJETIVO: avaliar o efeito do tipo de parto e dos procedimentos obstétricos usuais sobre o estado neurológico das primeiras 48 horas de vida, em uma amostra de recém-nascidos consecutivos a termo e saudáveis, usando um sistema de escores (NACS - Neurologic Adaptative Capacity Score). MÉTODOS: coorte prospectiva com 313 recém-nascidos de uma Unidade de Neonatologia e Alojamento Conjunto. As variáveis analisadas foram as obstétricas; o desfecho clínico - fase de baixo vigor neurológico, avaliada pelo NACS com 4, 24 e 48 horas de vida. Foram realizadas duas avaliações dos dados: uma com toda a amostra e outra comparando o Grupo Vigoroso, cujos recém-nascidos mantiveram-se com 35 ou mais pontos no NACS, versus Grupo de Baixo Vigor com menos de 35 pontos durante as três avaliações consecutivas. Foram realizadas análises bivariadas e multivariadas. Foram buscadas possíveis associações entre a fase de baixo vigor neurológico e o tipo de parto, bem como entre a fase de baixo vigor neurológico e as variáveis obstétricas. RESULTADOS: na análise bivariada, o tipo de parto e as variáveis obstétricas não estiveram associados com a fase de baixo vigor neurológico. Entretanto, a associação entre o aspecto do líquido amniótico e a fase de baixo vigor neurológico atingiu valores bem próximos da significância e, então, foi incluído na análise multivariada. Na análise multivariada, a única variável associada com baixo vigor neurológico foi a presença de líquido amniótico tinto de mecônio, que mostrou 8,1 vezes maior risco de baixa pontuação neurológica quando comparados o Grupo Vigoroso e o Grupo de Baixo Vigor. Na análise da amostra global, o mesmo risco foi de 1,7. CONCLUSÕES: nem o tipo de parto nem as manobras obstétricas usuais estiveram associados com fase de baixo vigor neurológico. Esta é uma informação útil, tanto do ponto de vista clínico quanto do médico-legal, especialmente para os obstetras. Pelos dados desta amostra, se o recém-nascido a termo...

PURPOSE: to evaluate the effect of delivery type and usual obstetric procedures on the neurologic condition of a sample of consecutive term and healthy neonates, in the first 48 hours of life, using the Neurologic Adaptative Capacity Score (NACS) system. METHODS: cohort prospective study with 313 neonates, from a neonatology unit: Unidade de Neonatologia e Alojamento Conjunto. The variables analyzed were obstetric variables; clinical outcome: low neurologic vigor phase, evaluated by NACS, at 4, 24 and 48 hours of life. The data have been assessed twice: once with the whole sample and the other comparing the Vigorous Group, whose neonates kept a score of 35 or more during the three evaluations, and the Low Vigor Group, with less than 35 scores during the three consecutive evaluations. Bivariate and multivariate analyses have been done. Possible associations between low neurologic vigor phase and the type of delivery, as well between the low neurologic vigor phase and obstetric variables have been searched. RESULTS: in the bivariate analysis, the delivery type and the obstetric variables were not associated with the low neurologic vigor phase. Nevertheless, the association between the amniotic fluid and the low neurologic vigor phase reached values very close to significance and, then, it was included in the multivariate analysis. In the multivariate analysis, the only variable associated with low neurologic vigor was the presence of meconium stained amniotic fluid, which has shown to be 8.1 times more risky for the neurologic scoring, when Vigorous Group and Low Vigor Group were compared. In the analysis of the whole sample, the same risk was 1.7. CONCLUSIONS: neither the delivery type, nor the usual obstetric procedures were associated with low neurologic vigor phase. This is useful information, clinically or legally speaking, mainly for obstetricians. According to this sample data, when the term neonate is healthy, the delivery type...

Teste de Kleihauer-Braun-Betke: análise de 25 casos / Kleihauer-Braun-Betke test: analysis of 25 cases

Foram submetidas ao teste de Kleihauer-Braun-Betke, no período pós-parto e pós-aborto, 25 (vinte e cinco) mulheres Rh-negativo com a variante D(u) negativa, visando calcular a quantidade de imunoglobulina a ser administrada. A operaçao cesariana foi a forma de parto na qual se encontrou a maior quantidade de células fetais na circulaçao materna. Apenas uma terça parte (33,3 por cento) das pacientes recebeu imunoglobulina anti-Rh após gestaçao anterior. Salienta-se, por fim, a importância do teste de Kleihauer-Braun-Betke, assim como a necessidade de uma maior consciência sobre a profilaxia da sensibilizaçao materna pelo fator Rh.

Teste de Kleihauer-Brow-Betke: análise de 27 casos / Kleihauer-Brown-Betke test: analysis of 27 cases

Foram submetidas ao teste de Kleihauer-Brown-Betke no período pós-parto e pós-aborto 27 mulheres Rh-negativo co a variante D negativa, visando calcular a quantidade de imunoglobulina a ser administrada. A operaçäo cesariana foi a forma de parto na qual encontrou-se a maior quantidade de células fetais na circulaçäo materna. Apenas uma terça parte (33,3 por cento) das pacientes recebeu imunoglobulina anti-RH após gestaçäo anterior. Salienta-se, por fim, a importância do teste de Kleihauer-Brown-Betke, assim como a necessidade de uma maior consciência sobre profilaxia da sensibilizaçäo materna pelo fator Rh.

O aconselhamento em planejamento familiar: seu valor na escolha do método anticoncepcional pela usuária / The counseling in family planning: its value in the choice of contraceptive method by the user

Quatrocentas clientes foram submetidas a um questionário, no qual procurou-se traçar um paralelo entre o motivo que as levou a consultar em uma clínica de Planejamento Familiar e a escolha correta de um método anticoncepcional. A importância do aconselhamento em Planejamento Familiar foi reafirmada após a verificaçäo dos resultados e conclusöes obtidas no presente trabalho