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Search Results: 1 - 10 of 19633 matches for " Marair Gracio Ferreira;Baracat "
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Análise dos Vasos do Trato Urinário Inferior de Ratas Durante e Após a Prenhez
Kosmiskas José Vicente,Gir?o Manoel Jo?o Batista Castello,Sartori Marair Gracio Ferreira,Baracat Edmund Chada
Revista Brasileira de Ginecologia e Obstetrícia , 2002,
Abstract: Objetivos: estudar as varia es da anatomia vascular de ratas, avaliando o número de vasos da uretra proximal e distal, da jun o vésico-uretral e da bexiga, durante e após a prenhez. Métodos: trinta ratas, com teste positivo de acasalamento, foram divididas aleatoriamente em três grupos contendo 10 animais cada, a saber: GI - ratas no 10o dia de prenhez; GII - ratas no 20o dia de prenhez; GIII - ratas no 5o dia de puerpério; um grupo controle (GIV) era composto de 10 ratas na fase de estro. Foram contados os vasos sangüíneos em quatro laminas, por animal, coradas pelo método do tricr mico de Masson, com ocular de integra o de 25 pontos, acoplada a microscopia de luz, com objetiva de 40 X. As regi es estudadas foram uretra proximal e distal, jun o vésico-uretral e bexiga. Resultados: n o houve varia o significativa no número de vasos da bexiga, da jun o vésico-uretral e da uretra proximal nas ratas durante a gesta o ou em rela o ao grupo controle. Na uretra distal, o número de vasos no grupo controle foi 13,7, sendo significativamente menor do que nos grupos com prenhez (20,5 a 24,4 vasos). Conclus es: as ratas prenhes apresentaram maior número de vasos na uretra distal do que aquelas em estro. Nos demais locais estudados n o houve diferen as entre os grupos.
Mobilidade do Colo Vesical e Avalia o Funcional do Assoalho Pélvico em Mulheres Continentes e com Incontinência Urinária de Esfor o, Consoante o Estado Hormonal
Moreira Sonia Fátima da Silva,Gir?o Manoel Jo?o Batista Castello,Sartori Marair Gracio Ferreira,Baracat Edmund Chada
Revista Brasileira de Ginecologia e Obstetrícia , 2002,
Abstract: Objetivo: estudar a mobilidade do colo vesical e a for a da musculatura perineal em mulheres com e sem incontinência urinária de esfor o, no menacme e na pós-menopausa. Métodos: foram avaliadas 61 pacientes, das quais 31 estavam no menacme, sendo 17 com incontinência urinária de esfor o (IUE) e 14 continentes, e 30 estavam na pós-menopausa, das quais 15 com e 15 sem IUE. Todas as incontinentes foram submetidas ao teste da coluna d'água e ao teste de esfor o com bexiga vazia. A mobilidade do colo vesical foi avaliada pelo teste do cotonete e por ultra-sonografia e, para estudo da fun o da musculatura perineal, foram utilizados a palpa o digital e cones vaginais. Resultados: a posi o do colo vesical nas mulheres com incontinência urinária de esfor o (grupos A e C), tanto pela ultra-sonografia quanto pelo teste do cotonete, foi mais baixa, sendo --11,8 cm no grupo A e --12,5 cm no grupo C, do que as mulheres continentes, nas quais o colo encontrava-se, em média, a +4,4 cm no grupo B e +2,3 cm no grupo D. Quanto à mobilidade do colo vesical, avaliada pela ultra-sonografia e pelo teste do cotonete, n o houve diferen a significativa entre os grupos continentes no menacme (9,1 cm) e na pós-menopausa (9,5 cm). Também n o houve diferen a significativa entre os dois grupos incontinentes entre si (17,1 cm para o grupo A e 16,6 cm para o C). No entanto, a mobilidade foi significativamente maior nos grupos com incontinência urinária de esfor o (A e C) do que nos grupos continentes (B e D) Verificamos que, quanto à avalia o da musculatura do assoalho pélvico, o teste realizado com cones vaginais e a avalia o funcional do assoalho pélvico mostraram índice 4 no grupo B e 3,4 no grupo D, indicando maior for a muscular nas mulheres continentes, quando comparadas às incontinentes (2,9 e 2,3, respectivamente no menacme e na pós-menopausa). Conclus o: a mobilidade do colo vesical, avaliada por meio do teste do cotonete e da ultra-sonografia, é maior nas mulheres incontinentes, independente do estado menopausal. A avalia o do assoalho pélvico pela palpa o digital e pelos cones vaginais mostrou que a fun o muscular é menos eficiente nas mulheres incontinentes.
Citologia Hormonal do Trato Urinário Baixo e da Vagina de Mulheres na Pós-menopausa, antes e durante Estrogenioterapia Oral e Transdérmica
Lustosa áurea Belas,Gir?o Manoel Jo?o Batista Castello,Sartori Marair Gracio Ferreira,Baracat Edmund Chada
Revista Brasileira de Ginecologia e Obstetrícia , 2002,
Abstract: Objetivo: avaliar a a o dos estrogênios por via oral ou transdérmica nas células do trato urinário baixo e da vagina, em mulheres menopausadas. Métodos: foram incluídas 25 mulheres na pós-menopausa, nas quais se estudaram os efeitos citológicos da terapia de reposi o hormonal estrogênica, por via oral e por via transdérmica, sobre as células da vagina e do sedimento urinário. As pacientes foram distribuídas aleatoriamente em 2 grupos: Grupo I, constituído por 14 mulheres que receberam 0,625 mg de estrogênio conjugado eqüino associado a 5 mg de acetato de medroxiprogesterona, por via oral, diariamente sem intervalo por três meses, e Grupo II, formado por 11 mulheres que fizeram uso de 17-beta-estradiol matricial na dose de 50 mig, por via transdérmica, semanalmente, associado a 5 mg de acetato de medroxiprogesterona diariamente por três meses. As amostras urinárias foram obtidas do jato inicial da primeira urina da manh , após asseio dos genitais, em frascos estéreis fornecidos pelo laboratório. A urina foi centrifugada e o esfrega o realizado a partir do sedimento urinário. Os esfrega os da vagina e do sedimento urinário foram imediatamente fixados em álcool absoluto e corados pelo método de Shorr. Resultados: observou-se que nas pacientes que utilizaram a via oral, houve matura o das células da vagina (o índice se elevou de 45,4 a 65,5 com dois meses de tratamento, permanecendo praticamente constante (62,0) a seguir. Quanto às células urinárias, n o houve varia o do valor de matura o (56,4 antes da medica o e 60,4 no final do período). Ao examinarmos tanto as células da urina quanto da vagina de pacientes que utilizaram a via transdérmica, notou-se que houve resposta satisfatória. Conclus o: com estes resultados podemos sugerir que os estrogênios, quando administrados por via transdérmica, est o associados à resposta satisfatória quanto ao trofismo tanto na vagina quanto na uretra. No entanto, quando se utiliza a via oral, nem sempre este resultado pode ser observado.
Colpossacrofixa??o para corre??o do prolapso da cúpula vaginal
Zucchi, Eliana Viana Monteiro;Kati, Léa Mina;Gir?o, Manoel Jo?o Batista Castello;Sartori, Marair Gracio Ferreira;Baracat, Edmund Chada;Lima, Geraldo Rodrigues de;
Revista Brasileira de Ginecologia e Obstetrícia , 2003, DOI: 10.1590/S0100-72032003001000002
Abstract: purpose: to evaluate patients who presented post-hysterectomy vaginal vault prolapse and were treated surgically by abdominal sacropexy (asp) during the period of 1995-2000 at the s?o paulo hospital (epm-unifesp). methods: we studied retrospectively 21 patients with post-hysterectomy vaginal vault prolapse with previous correction of cystocele and rectocele. an analysis was made taking into account the average age of the patients, number of parturitions, weight, body mass index (bmi), time between the appearance of the prolapse and the hysterectomy, duration of surgery, blood loss and recurrences. the patients underwent surgery using the abdominal sacropexy technique with or without the interposition of a synthetic prosthesis between the vaginal wall and the sacrum. results: of the patients attended in our service, 15 used the asp technique and in one case, due to intra-operational difficulties, the te linde correction was used. the average age of the patients was 63.7 (47-95 years), parity of 4.6 and bmi of 26.9. asp was performed on average 18 years after total abdominal hysterectomy and 3 years after vaginal hysterectomy. the average surgical time was 2 h and 15 min, without the need of a blood transfusion. there were no recurrences of the prolapse or preoperative symptoms (follow-up of 1-5 years). conclusions: surgical treatment of the vaginal vault prolapse can be done by vaginal access (colpocleisis or the fixation to the sacrospinal ligament) or abdominal approach (sacropexy). the latter has the advantage of restoring the vaginal axis, preserving its depth, which apart from improving the prolapse, allows the restoration of sexual, intestinal and urinary functions (especially when associated with colpofixation - burch). when diagnosis and treatment are adequate and the surgical team has complete knowledge of the pelvic anatomy, we can affirm that asp reaches its objective in the treatment of vaginal vault prolapse with excellent correction and minimum morbidit
Citologia Hormonal do Trato Urinário Baixo e da Vagina de Mulheres na Pós-menopausa, antes e durante Estrogenioterapia Oral e Transdérmica
Lustosa, áurea Belas;Gir?o, Manoel Jo?o Batista Castello;Sartori, Marair Gracio Ferreira;Baracat, Edmund Chada;Lima, Geraldo Rodrigues de;
Revista Brasileira de Ginecologia e Obstetrícia , 2002, DOI: 10.1590/S0100-72032002000900002
Abstract: objective: to study the effects of oral or transdermal estrogen replacement on the lower urinary tract and vagina in postmenopausal women. methods: we studied 25 postmenopausal women evaluating the oral or transdermic estrogen replacement effects on the vaginal cells and urinary sediment during 3 months. the patients were randomly distributed into 2 groups: group i, n = 14, treated orally with 0.625 mg equine conjugated estrogen plus 5 mg medroxyprogesterone acetate, daily for 3 months; group ii, n = 11, treated transdermally with 50 mg 17-?-estradiol, once a week, plus 5 mg medroxyprogesterone. daily, for 3 months, urinary samples were collected from the first miction in the morning after urogenital antisepsis into sterile tubes. the sample was centrifuged and the sediment was smeared. vaginal and urinary smears were then fixed in absoluted alcohol and stained by the method of shorr. results: the patients who used the oral route presented maturation of the vaginal cells (from 45.4 to 65.5% after 2 months of treatment, maintaing 62% afterwards) but this did not occur with urinary cells (56.4 before treatment versus 60.4% at the end of the period). the transdermal route promoted maturation of vaginal and urinary cells. conclusion: we have concluded that transdermal estrogens have satisfactory effects both on vaginal and urethral sites. however, with the oral route we did not find the expected results in the urinary tract in all cases.
Mobilidade do Colo Vesical e Avalia??o Funcional do Assoalho Pélvico em Mulheres Continentes e com Incontinência Urinária de Esfor?o, Consoante o Estado Hormonal
Moreira, Sonia Fátima da Silva;Gir?o, Manoel Jo?o Batista Castello;Sartori, Marair Gracio Ferreira;Baracat, Edmund Chada;Lima, Geraldo Rodrigues de;
Revista Brasileira de Ginecologia e Obstetrícia , 2002, DOI: 10.1590/S0100-72032002000600002
Abstract: purpose: to study the relationship between pelvic floor function and bladder neck mobility in women with and without stress urinary incontinence (sui), in menacme and postmenopausal. methods: sixty-one sui patients were evaluated; 31 of them were in menacme and of these 17 had sui and 14 did not have any complaint; 30 were postmenopausal and of these, 15 with sui and 15 without sui. simple cystometry and empty supine stress test were performed in those who had urinary incontinence complaint. bladder neck mobility was studied by ultrasound and by the q-tip test. to study pelvic floor function, vaginal cones and digital palpation were used. results: the bladder neck position in the incontinent women (groups a and c), determined by ultrasound or the q tip-test, was ?11.8 cm in group a and ?12.5 cm in group c, lower than the continent women, in whom the bladder neck was at +4.4 cm in group b and +2.3 cm in group d. there were no differences in bladder neck mobility among the continent menacme (9.1 cm) and postmenopausal (9.5 cm) groups. also there were no differences among the incontinent groups (17.1 cm for group a and 16.6 cm for group c). the bladder neck mobility was greater in the incontinent women (a and c). continent women had better results on evaluation of pelvic floor muscles than the incontinent ones, even using vaginal cones or digital palpation, and these results were not dependent on the hormonal status. conclusion: a positive correlation was found between the q-tip tests and ultrasound, and between test with vaginal cones and digital palpation. no significant correlation was found between pelvic floor function and bladder neck mobility.
Análise dos Vasos do Trato Urinário Inferior de Ratas Durante e Após a Prenhez
Kosmiskas, José Vicente;Gir?o, Manoel Jo?o Batista Castello;Sartori, Marair Gracio Ferreira;Baracat, Edmund Chada;Lima, Geraldo Rodrigues de;
Revista Brasileira de Ginecologia e Obstetrícia , 2002, DOI: 10.1590/S0100-72032002000400003
Abstract: purpose: to evaluate the variations in vascular anatomy by assessing the number of vessels of the proximal and distal urethra, of the vesicourethral canal and of the bladder, during and after pregnancy in rats. method: thirty female rats, with a positive test for pregnancy, were divided into three groups of 10 animals each: gi - rats on the 10th day of pregnancy; gii - rats on the 20th day of pregnancy; giii - rats on the 5th day of puerperium; a control group (giv) composed of 10 rats in the estrous phase. the vessels were stained by the method of masson and counted with a 25-dot integration ocular, coupled to a light microscope, with an objective of 40x. the studied regions were proximal and distal urethra, vesicourethral canal and bladder. results: there was no significant variation in the vessel number in the bladder, in the vesicourethral canal and in the proximal urethra during gestation. in the distal urethra of the group iv there were 13.7 vessels, less than that observed in the pregnant groups (20.5 to 24.4 vessels). conclusion: the pregnant rats had a larger number of vessels in the distal urethra than those in the estrous phase. there were no differences regarding the other sites.
Hiperatividade do detrusor: compara??o entre oxibutinina, eletroestimula??o funcional do assoalho pélvico e exercícios perineais. Estudo randomizado
Arruda, Raquel Martins;Sousa, Gabriela Olbrich de;Castro, Rodrigo de Aquino;Sartori, Marair Gracio Ferreira;Baracat, Edmund Chada;Gir?o, Manoel Jo?o Batista Castello;
Revista Brasileira de Ginecologia e Obstetrícia , 2007, DOI: 10.1590/S0100-72032007000900003
Abstract: purpose: to evaluate and to compare the effectiveness of oxybutynin, electrostimulation (es) and pelvic floor training (pft) in the management of women with detrusor overactivity. methods: a total of 64 women, 35 to 80 years old, were enrolled in this randomized prospective trial. patients were randomized in three groups: oxybutynin (n=22), es (n=21) and pft (n=21). there were no statistical differences between the three groups with regards to race (p=0.948), age (p=0.747), hormonal status (p=0.813), time of symptomatology (p=0.789), previous surgery for urinary incontinence (p=0.993), or body mass index (p=0.897). patients were assessed before and after treatment by urodynamic test, a seven-day voiding diary, and subjective response. the duration of the treatment was twelve weeks. for statistical analyses, the pearson c2, analysis of variance (anova) and the paired t-test were used. results: there was a decrease in the urge-incontinence episodes and in the number of pads required in all groups (p<0.05). there was reduction in the frequency of micturition in the oxybutynin group (p=0.014). oxybutynin and es groups had reduction in nocturia episodes (p=0.003 and p=0.036, respectively). there were no significant differences in improvement between the three groups (p>0.05). urgency was resolved in 14 (63.6%), 11 (52.4%) and 12 (57.1%) patients of the oxybutynin, es and pft groups, respectively, without differences among the groups (p=0.754). subjectively, 17 (77.3%), 11 (52.4%) and 16 (76.2%) women who had accomplished oxybutynin, es and pft, respectively, were satisfied, without differences among the groups (p = 0.142). urodynamic was normal in 8 (36.4%), 12 (57.1%) and 11 (52.4%) patients of the oxybutynin, es and pft groups, respectively. this urodynamic analysis revealed no differences between the three groups (p=0.358). the reduction of urge-incontinence correlated with patient satisfaction (p<0.05). conclusions: treatments were equally effective; reduction of urg
Diagnóstico clínico e subsidiário da incontinência urinária
Feldner Jr, Paulo Cezar;Sartori, Marair Gracio Ferreira;Lima, Geraldo Rodrigues de;Baracat, Edmund Chada;Gir?o, Manoel Jo?o Batista Castello;
Revista Brasileira de Ginecologia e Obstetrícia , 2006, DOI: 10.1590/S0100-72032006000100010
Abstract: female lower urinary tract symptoms are nonspecific and a clinical evaluation is required to establish the correct diagnosis. such evaluation should consist of a structured micturition history or questionnaire, physical examination, micturition diary, pad test, and urodynamic evaluation. urodynamic investigation was developed as an extension of patient history and physical examination in order to reveal the etiology of the patient's complaints. the goal of the present article is to review clinical and subsidiary diagnosis of urinary incontinence.
Avalia??o dos glicosaminoglicanos do tecido periuretral de pacientes com e sem prolapso genital
Feldner Jr, Paulo Cezar;Kobayashi, Elsa Yoko;Sartori, Marair Gracio Ferreira;Nader, Helena Bonciani;Baracat, Edmund Chada;Gir?o, Manoel Jo?o Batista Castello;
Revista da Associa??o Médica Brasileira , 2008, DOI: 10.1590/S0104-42302008000200024
Abstract: objective: to characterize and quantify periurethral tissue sulphated glycosaminoglycans (gags) in women with and without pelvic organ prolapse. study design: periurethral tissue was obtained from 35 women who underwent surgery for pelvic organ prolapse, for stress urinary incontinence, or for other gynecological benign conditions. patients were submitted to a clinical history, physical and urodynamic examination and were divided in two groups according to genital prolapse. the standard biopsy with 1.0 x 1.0 cm was taken from periurethral tissue during surgery and assessed by biochemical methods. the gags were obtained by proteolysis and precipitated by trichloroacetic acid. the relative concentration of sulfated gags was determined by densitometry of toluidine blue stained gel using a spectrophotometer with a 525 nm wavelength. data were compared using analysis of variance (anova). results: in the two groups dermatan sulphate (ds) was the predominant glycosaminoglycan (85%), followed by chondroitin sulphate (cs) and heparan sulphate (hs). women with pelvic organ prolapse had significantly more total gags, ds and hs. differences in cs were not observed. conclusions: this study showed altered biochemical characteristics in the extracellular matrix of periurethral tissue and also accumulation of gags, ds and cs, in women with pelvic organ prolapse.
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