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Nódulos de tireóide: valor da ultra-sonografia e da biópsia por pun o aspirativa no diagnóstico de cancer
Peccin Simone,Furlanetto Tania Weber,Castro José Augusto Sisson de,Furtado álvaro Porto Alegre
Revista da Associa??o Médica Brasileira , 2003,
Abstract: Os nódulos de tireóide s o um problema clínico comum e a pun o aspirativa por agulha fina (PAAF) é o principal exame utilizado para seu diagnóstico diferencial. Recentemente, foi demonstrado que algumas características ultra-sonográficas dos nódulos est o associadas a um maior risco de cancer. Entretanto, n o encontramos estudos que avaliassem o desempenho dos dois exames de forma comparativa e/ou complementar. OBJETIVO: Avaliar o desempenho da ultra-sonografia (US), da PAAF e de sua combina o no diagnóstico de cancer em nódulos de tireóide. MéTODOS: Oitenta pacientes com nódulos únicos ou dominantes, com indica o cirúrgica, foram selecionados dentre 289 pacientes com nódulos tireoidianos atendidos entre mar o de 1995 e julho de 1997. Os pacientes foram submetidos à PAAF e à US de tireóide por um dos autores. A PAAF foi considerada positiva quando os achados citológicos eram suspeitos ou diagnósticos de cancer. A US foi considerada positiva quando os nódulos apresentavam pelo menos um dos seguintes achados: microcalcifica es, hipoecogenicidade ou halo ausente. PAAF e US foram combinados em paralelo (o resultado positivo em qualquer um dos dois exames era considerado indicativo de malignidade) e em série (somente o resultado positivo de ambos os testes indicava presen a de malignidade). RESULTADOS: A sensibilidade e a especificidade da PAAF na detec o do cancer em nódulos de tireóide foram, respectivamente, 87% e 62%, e a sensibilidade e a especificidade da US foram, respectivamente, 81% e 70%. A combina o em série dos dois exames (PAAF e US) resultou em sensibilidade de 69% e especificidade de 91%, e a combina o em paralelo (PAAF ou US) apresentou sensibilidade de 94% e especificidade de 52%. CONCLUS O: A US pode ser útil na avalia o dos nódulos de tireóide, alternativamente ou em combina es com a PAAF. Como o resultado da US depende da experiência do operador e das características do equipamento, s o necessários estudos em diferentes centros para o seu uso na prática clínica.
Registro de ensaios clínicos: quando e por que fazer? Clinical trial registration: when to and why register
Maria Stella Peccin
Brazilian Journal of Physical Therapy , 2007, DOI: 10.1590/s1413-35552007000600001
Nódulos de tireóide: valor da ultra-sonografia e da biópsia por pun??o aspirativa no diagnóstico de cancer
Peccin, Simone;Furlanetto, Tania Weber;Castro, José Augusto Sisson de;Furtado, álvaro Porto Alegre;Brasil, Beatriz Assis;Czepielewski, Mauro Ant?nio;
Revista da Associa??o Médica Brasileira , 2003, DOI: 10.1590/S0104-42302003000200031
Abstract: background: thyroid nodules are a very common clinical problem and fine-needle aspiration biopsy (fnab) is its main diagnostic test. recently, it has been shown that some ultrasonographic features are associated to an increased risk of cancer, but a comparison between fnab and ultrasonography (us) or its combination is not available. the aim of this study was to evaluate fnab and us performance, isolated or combined, for cancer diagnosis in thyroid nodules. methods: eighty patients, with palpable solitary thyroid nodules or multinodular goiters, who were to undergo surgery, were selected among 289 patients seen in our clinic between march, 1995 and july, 1997. us and fnab were performed by one of us. us was considered positive for cancer when microcalcifications, absent halo or hypoechogenicity were seen. fnab was considered positive for cancer when it was either suspicious or compatible with malignancy. both methods (fnab and us) were evaluated in parallel combination (positive when fnab or us was positive) and in serial combination (positive when both, fnab and us, were positive). results: sensitivity and specificity of fnab and us for cancer diagnosis in thyroid nodules were, respectively, 87% and 62%, and 81% and 70%. serial combination of fna and us had sensitivity of 69% and specificity of 91%, and parallel combination resulted in sensitivity of 94% and specificity of 52%. conclusion: the us had good accuracy in the evaluation of thyroid nodules, and can help us take some decisions in the clinical practice, supplementary to fna. nevertheless, the quality of the ultrasound examination depends on the experience of the examiner and on the characteristics of the equipment, so new studies are necessary to evaluate these factors to the current usage of ultrasonographic characteristics in the evaluation diagnostic of thyroid nodules.
Incidência de mortalidade por cancer no Rio Grande do Sul, Brasil
Barcelos,Lucio Borges; Peccin,Débora Andreoli;
Revista de Saúde Pública , 1983, DOI: 10.1590/S0034-89101983000500002
Abstract: a study of the incidence of, and deaths from, cancer as reported to the welfare ministry of rio grande do sul state, brazil, in 1979, is presented. the distribution of morbimortality showed an accentuated increase with age. in males the anatomic sites associated with higher mortality were (in decreasing order): trachea, bronchi and lungs, stomach, esophagus, prostate and leukemias. in incidence related to the same sites, however, skin cancer moved into second place and leukemias were out. in women, breast, stomach, the uterus, with locations specified and in-specified, trachea, bronchi and lungs, and uterus cervix were the first five sites with regard to mortality. malign neoplasms of the breast showed the highest incidence, followed by malign neoplasm of skin, uterus cervix, other locations specified and un-specified of the uterus and, in the fifth place, the stomach. the geographical distribution showed greater morbimortality in the 1st, 3rd, 7th, 10th and 13th health districts, in regions of a greater degree of industrialization or of large rural properties, where cattleraising is extensively undertaken. after standardization, the malign neoplasms of esophagus and larynx showed high rates, higher, in the case of the esophagus, than the rates for other countries.
Questionário específico para sintomas do joelho "Lysholm Knee Scoring Scale": tradu??o e valida??o para a língua portuguesa
Peccin, Maria Stella;Ciconelli, Rozana;Cohen, Moisés;
Acta Ortopédica Brasileira , 2006, DOI: 10.1590/S1413-78522006000500008
Abstract: knee diseases present variable consequences for an individual?s function and quality of life. for the purposes of translating, validating and checking the measurement properties of the specific questionnaire for knee symptoms - the "lysholm knee scoring scale" - into portuguese, we selected, for convenience, 50 patients (29 males and 21 females, mean age = 38.7 years) with knee injuries (meniscal injury, anterior cruciate ligament injury, chondromalacia or arthrosis). reproducibility and ordinal consistency inter- and intra-interviewer were excellent (a = 0.9). the nominal consistency inter-interviewers was good (kappa = 0.7) and intra-interviewer was excellent (kappa = 0.8). during validation process, we correlated the lysholm questionnaire with the pain numerical scale (r=-0.6; p=0.001) and with he lequesne index (r= -0.8; p=0.001). correlations between lysholm questionnaire and the global health evaluation by patient and by therapist were poor and not significant. the correlations between lysholm questionnaire and sf-36 were significant for physical aspects (r = 0.4; p = 0.04), pain (r = 0.5; p = 0.001) and function (r = 0.7; p = 0.0001). we concluded that the translation and cultural adaptation of the "lysholm knee scoring scale" into our language have proven to be reproducible and valid in patients with meniscal injury, anterior cruciate ligament injury, chondromalacia or knee arthrosis.
On Line Media Market and New Advertising Agencies: Analysis of an Italian Case  [PDF]
Simone Guercini
Journal of Service Science and Management (JSSM) , 2009, DOI: 10.4236/jssm.2009.22015
Abstract: This article focuses on the profile of agencies which offer communication services through new media related to the information role of the major search engines systems (like Google, Yahoo and others). In particular, attention is paid to firms operating in that context which are taking an innovative profile when compared to communication agencies linked to traditional media. The article develops the following steps: in a first part the characteristics are taken into consideration through inno-vative communication systems search engines in relation to market trends and the latest configuration of actors linked to them; a second step considers the case of an Italian company acting as an agency in the so-called "online media market", highlighting the type of skills and relationships developed through this; finally in a third part some thoughts on the characteristics of the new communication agencies are proposed in comparison with those of the traditional ad-vertising agencies operating with the help of the more traditional mass media. At the conclusion of the article some implications of the analysis are developed and evaluations are made about the development of new business communication services object of our analysis.
Berezin Quantization of Gaussian Functions Depending by a Quantum and Compression Parameter  [PDF]
Simone Camosso
Journal of Quantum Information Science (JQIS) , 2019, DOI: 10.4236/jqis.2019.91002
Abstract: The aim of this work is to study the Berezin quantization of a Gaussian state. The result is another Gaussian state that depends on a quantum parameter α, which describes the relationship between the classical and quantum vision. The compression parameter λ>0?is associated to the harmonic oscillator semigroup.
Tradu??o, valida??o e adapta??o cultural da escala de atividade esportiva
Gon?alves, Camila Carvalho Krause;Peccin, Maria Stella;Almeida, Gustavo Jer?nimo de Melo;Cohen, Moises;
Acta Ortopédica Brasileira , 2007, DOI: 10.1590/S1413-78522007000500002
Abstract: objectives: to translate and adapt the "sports activities scale" as well as to check its measurement, reproduction and validity properties. method: the translation, cultural adaptation and validation were made by reviewing the work by guillemin et al. for statistical analysis, we used descriptive analysis, t-test, inter-class correlation coefficient and spearman correlation coefficient, with significance level equal to 5% (a = 0.05). results: the translated questionnaire showed to be understandable and culturally equivalent for 95% of brazilian patients after some modifications were made; an excellent reproducibility (a = 0.01, r < 0.001) when correlating intra- and inter-interviewers; a significant correlation with the sf-36 questionnaire on the following items: functional capacity, pain, general aspects and social aspects, a weak association with sf-36 questionnaire on vitality, emotional aspects and mental health; a significant correlation with lysholm (a = 0.01, r > 0.001); and a moderate negative correlation with the visual analog scale for pain (a = 0.05, r = 0.0013). conclusion: the brazilian version of the "sports activities scale" questionnaire is an easily-manageable, reproducible and valid parameter for a specific evaluation of knee's symptoms and restraints during sports activities, in brazilian patients.
Exercícios de fortalecimento de quadríceps s?o efetivos na melhora da dor, fun??o e qualidade de vida de pacientes com osteoartrite do joelho
Imoto, Aline Mizusaki;Peccin, Maria Stella;Trevisani, Virgínia Fernandes Mo?a;
Acta Ortopédica Brasileira , 2012, DOI: 10.1590/S1413-78522012000300008
Abstract: objective: the purpose of this research was to verify the effectiveness of an eight-week quadriceps strengthening program on pain, function and quality of life of patients with knee osteoarthritis. methods: a hundred patients were randomized into two groups: 1- exercise group (exg) and 2- orientation group. the timed up and go (tug) test, the numerical rating scale (nrs) and the short form-36 were used for the assessment. results: eighty-one patients completed the survey. according to the intention to treat (itt) analysis, there was statistically significant difference in exg compared to og in all the variables assessed. conclusion: the program quadriceps strengthening exercises applied in this randomized clinical trial was effective in improving pain, function and quality of life of patients with knee osteoarthritis. level of evidence i, randomized clinical trial.
Reabilita??o pós-operatória dos ligamentos cruzado anterior e posterior: estudo de caso
Silva, Kelson Nonato Gomes da;Imoto, Aline Misuzaki;Cohen, Moisés;Peccin, Maria Stella;
Acta Ortopédica Brasileira , 2010, DOI: 10.1590/S1413-78522010000300010
Abstract: knee ligament injuries are among the most common sports lesions. however, injuries associated with the cruciate ligaments are rare, and normally occur as a result of high impact traumas. in these cases, surgical intervention is necessary, due to the high level of functional instability. purpose: to develop and apply a postoperative rehabilitation protocol for reconstruction of cruciate ligaments, and to record their evolution by means of regular evaluations with validated functional questionnaires. method: case report of a patient submitted to reconstruction of the cruciate ligaments until return to sports. the functional capacity was evaluated using knee function questionnaires (lysholm and ikdc); range of movement (goniometer), anteroposterior displacement (arthrometer kt1000tm), strength (isokinetic dynamometer) and movement analyses (walking gait and running gait). conclusion: the protocol was effective for improving functional stability, strength, and a safe return to sports.
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