Chromosome abnormalities in selected newborn infants with malformations in Brazil.

Between 1982 and 1985, 109 infants were referred for cytogenetic examination out of a population of 73,192 liveborn infants from eight maternity hospitals surveyed by the ECLAMC/MONITOR program. Thirty-one of the children had a chromosome abnormality different from trisomy 21. Considering the total population surveyed, trisomy 18 was detected in 1:6,099; trisomy 13 was seen in 1:24,397 and unbalanced rearrangements were found in 1:7,319 infants. Those rates were not significantly different from the expected ones, as compared to previous cytogenetic surveys of consecutive births. We concluded that most chromosome abnormalities associated with congenital malformations can be detected at low cost, provided there is a high accuracy of clinical examination and referral criteria, as well as close cooperation between pediatricians and geneticists.

[Diagnosis and surveillance of multiple pregnancies by echography]. / Diagnostic et surveillance des grossesses multiples par l'échographie.

Twin pregnancies are high-risk pregnancies requiring a particularly close supervision in which ultrasonography plays a major role from the beginning to the end. At the beginning, ultrasonography shows the presence of a twin pregnancy and provides an indication of its anatomical type. It may also detect early complications, notably lysis of the ovum. From the second trimester of pregnancy onwards, ultrasounds diagnose complications that are not readily accessible to physical examination, such as growth retardation of one foetus or both, foetal malformations or death in utero of one of the twins. At the end of pregnancy, ultrasounds also plays a role in the choice of the mode of delivery.

Sub-urethral tape treatment of female urinary incontinence--morbidity assessment of the trans-obturator route and a new tape (I-STOP): a multi-centre experiment involving 604 cases.

PURPOSE: To make an assessment of the morbidity related to using the trans-obturator route (TOT); findings after one year for the 140 first cases and preliminary results of short term morbidity after 604 implants. PATIENTS AND METHOD: This retrospective, multi-centre study involves the 604 first procedures with a 1-3 month follow-up. The mean patient age was 57 years. 92% of the patients underwent an isolated urinary incontinence cure and 8% had associated surgery. 47.3% of the cases had pure stress urinary incontinence and 52.7% had mixed incontinence. A 12-month minimum follow-up period was applied to the first 140 cases operated between September 2002 and January 2003. Patient assessment was made by a clinical examination in the first three months and their satisfaction rate expressed after 1 year. RESULTS: Operative complications were very few: 0.5% vesical perforations, 0.3% vaginal perforations, no urethral wounds, 0.8% 200-300 ml haemorrhages, two perineal haematomas (0.33%). The post-operative period was marked by: 1.5% transient retentions, 2.3% transient pain, 2.5% urinary infections, 1.3% transient dysuria. The 1-3 month follow-up of 572 patients shows a 5.2% rate of de novo symptoms. Patient assessment of 131 subjects after one year revealed an encouraging satisfaction rate of 85.5% with a 1.5% rate of de novo dysuria and urgency. To date there have been no serious or specific complications attributable to the surgical route adopted. The morbidity is not affected by associated surgery. CONCLUSION: The trans-obturator route combines low morbidity with a low rate of de novo symptoms on a large series. These results will have to be corroborated by further studies.

[Prognostic elements of cancer of the endometrium. Therapeutic deductions]. / Les éléments du pronostic du cancer de l'endomètre. Déductions thérapeutiques.

The authors report a series of 120 cancers of the endometrium treated between 1970 and 1985 included. Of all "morphological" factors, the degree of tumor differentiation is the one which has the greatest predictive value for the prognosis. The general condition of the patient have, stricto sensu, a very significant influence on the prognosis of cancer. The Wertheim's procedure offer results which are far superior to those of a simple hysterectomy. It must be favored in all patients who can withstand it. In patients with poor general condition, perform a simple total vaginal hysterectomy. This will be performed with all the less reserve as the tumor was well differentiated.

Enterocolite necrotizante. Estudo evolutivo de 12 casos. / Necrotizing enterocolitis. Evolutional study of 12 cases

Os autores estudaram retrospectivamente 12 casos de enterocolite necrotizante (ECN) ocorridos em RNs no bercario do Hospital do Servidor Publico Estadual de Sao Paulo (HSPE), no periodo de l/l/77 a 3l/3/79,com o objetivo de analisar os fatores determinantes e as condutas para prevencao e controle desta patologia. Os dados referentes a estes RNs foram comparados aos da literatura, tendo sido feita uma analise estatistica referente a mortalidade do grupo, concluindo-se estar diretamente associada a anoxia perinatal, tempo de rotura de membranas, formula hiperosmolar para alimentacao, acidose metabolica e epoca do diagnostico no Servico. Nao houve relacao com o tipo de parto, idade gestacional, sexo, peso, tratamento cirurgico, aleitamento natural, numero de plaquetas e persistencia de canal arterial. Verificou-se ainda que nos primeiros seis casos da serie a mortalidade foi maior que nos seis ultimos, fato este relacionado com a precocidade do diagnostico e adequacao terapeutica