Efeitos da Histerectomia Total Abdominal sobre o Fluxo Sangüíneo Ovariano

Objetivo: avaliar os efeitos da histerectomia total abdominal (HTA) sobre o fluxo sangüíneo ovariano, em mulheres no menacme, por meio da dopplervelocimetria e ultra-sonografia transvaginal. Métodos: estudo prospectivo no qual foram incluídas 61 mulheres, com idade igual ou inferior a 40 anos. As pacientes foram divididas em dois grupos: G1, com 31 pacientes submetidas à HTA, e G2, com 30 mulheres normais não submetidas à cirurgia. Somente foram incluídas pacientes eumenorréicas, ovulatórias, não-obesas ou fumantes, sem cirurgias ou doenças ovarianas prévias. Avaliou-se o fluxo sangüíneo das artérias ovarianas, inicialmente e aos 6 e 12 meses, pelo índice de pulsatilidade (IP) na dopplervelocimetria, e o volume ovariano pela ultra-sonografia transvaginal (US). Para análise estatística empregou-se teste t pareado, análise de perfil, teste de Friedman e teste de Mann-Whitney. Resultados: na comparação estatística inicial os grupos foram homogêneos quanto às características epidemiológicas e quanto aos demais parâmetros avaliados neste estudo. Nas pacientes submetidas à histerectomia, observaram-se aos 6 e 12 meses aumento do volume ovariano ao US e diminuição do IP avaliado pela dopplervelocimetria (p<0,05), quando confrontadas ao controle. Aos 12 meses, em 8 das 31 pacientes pós-HTA (25,5%) verificou-se ocorrência de cistos ovarianos de aspecto benigno. No grupo controle não houve alteração de nenhum desses parâmetros. Conclusão: a redução do IP na dopplervelocimetria das artérias ovarianas sugere aumento do fluxo sangüíneo ovariano pós-histerectomia total abdominal em mulheres no menacme.

Doppler Echocardiographic Assessment of Pregnant Women with Chronic Arterial Hypertension

OBJECTIVE: To assess structural and functional cardiac changes in asymptomatic pregnant women with chronic arterial hypertension (CAH). METHODS: One hundred pregnant women with CAH underwent conventional Doppler echocardiography. The Student t test was used to compare them with 29 normotensive pregnant women (NT) in their third gestational trimester. RESULTS: Systolic (SBP; mmHg) and diastolic (DBP; mmHg) blood pressure values were higher (p<0.001) in the CAH pregnant women (SBP: 139±19 and DBP: 92± 18) as compared with those of the NT group (SBP: 112±10 and DBP: 74±9). A significant enlargement of the left atrium (4.10±0.48 cm vs 3.6±0.3 cm; p<0.001) and of the left ventricular normalized mass (59.6±19.7 g/cm2,7 vs 41.9±3.4 g/cm2,7; p<0.001) was observed. Cardiac output (CO, L/min) and systolic volume (SV, mL) were significantly higher in the CAH group (CO: 6.0±1.54 vs 4.9±2.1, p<0.01; SV: 77.3±19.8 vs 56.5±25.8, p<0.001). CONCLUSION: Chronic hypertensive pregnant women have structural and functional cardiac changes that justify routine cardiologic assessment, even in the absence of cardiopulmonary symptoms.

Effect of maternal hydration on the increase of amniotic fluid index

The objective of this study was to determine the effect of maternal hydration with oral isotonic solution and water on the amniotic fluid (AF) index of women with normohydramnios. Women with a normal AF index and gestational age between 33 and 36 weeks without maternal complications were randomized into three groups [isotonic solution (Gatorade (R)), water, control]. The isotonic solution and water groups were instructed to drink 1.5 L of the respective solution and the control group was instructed to drink 200 mL water over a period of 2 to 4 h. AF index was measured before and after hydration by Doppler ultrasonography. The investigator performing the AF index measurement was blind to the subject's group. Ninety-nine women completed the study without any adverse maternal effects. The median increase in AF index after hydration was significantly greater for the isotonic solution and water groups than for the control group. There was no significant difference between the isotonic solution and water groups. Hydration with isotonic solution and water caused a 10-fold (95% CI: 2.09-49.89) and 6-fold (95% CI: 1.16-30.95) increase in the chance of a 20% increase of AF index, respectively. Maternal hydration with isotonic solution or water increased the AF index in women with normohydramnios.

Ultrasonography as a predicting tool for carcass traits of young bulls

O desenvolvimento de técnicas não invasivas e não destrutivas para a avaliação da composição e qualidade de carcaça em animais tem mobilizado consideráveis recursos em pesquisa. A ultra-sonografia aparece neste contexto como uma técnica viável, confiável e de custo aceitável para esta função. No presente trabalho foi avaliada a técnica de ultra-sonografia em tempo real como ferramenta para predição da área de olho-de-lombo (AOL) e espessura da camada de gordura subcutânea (ECG) a partir de imagens tomadas em animais vivos, quando comparadas com as medições na carcaça. Foram utilizados 115 bovinos jovens (30, ½ Angus x Nellore; 30, ½ Canchim x Nellore; 30, ½ Simental x Nellore, e 25 Nellores), com peso inicial médio de 329 kg e de dois tamanhos à maturidade (pequeno e grande), no sistema de produção do novilho superprecoce. As medidas de ultra-sonografia foram realizadas a cada 28 dias totalizando quatro medições até o final do confinamento. A precisão da predição aumentou em função da proximidade da data do abate, sendo máxima na quarta medida (R²= 0,68 para AOL e 0,82 para ECG). Houve efeito de grupo genético e de medida ultra-sonográfica para ECG. O tamanho corporal não teve efeito sobre nenhuma das características estudadas.

Hemodynamic evaluation of the right portal vein in healthy dogs of different body weights

Background: Doppler ultrasonography is an important tool for evaluating hepatic portal hemodynamics. However, no study in dogs of different body weights, in the range encountered in routine clinical veterinary practice, has been reported. It can be difficult to obtain an ideal insonation angle when evaluating the main portal vein, so evaluation of the right portal vein branch has been described in humans as an alternative. The aim of this study was to analyze, through Doppler ultrasonography, the hemodynamics in the right portal vein branch in dogs of different body weights.Methods: Thirty normal dogs were divided in three groups by weight, in order to establish normal values for mean velocity, flow volume and portal congestion index of the right portal vein branch by means of Doppler ultrasonography.Results: In all dogs ideal insonation angles were obtained for the right portal vein branch. The average velocity was similar in the three groups, but the portal congestion index and the flow volume differed, showing that the weight of the dog can influence these values.Conclusion: Doppler ultrasonography for the evaluation of flow in the right branch of the portal vein could be a viable alternative, or complement, to examining the main vessel segment. This is especially so in those animals in which an ideal insonation angle for examination of the main portal vein is hard to obtain. In addition, the weight of the dog must be considered for the correct evaluation of the portal system hemodynamics, particularly for portal blood flow and the congestion index.

Prediction and probability of neonatal outcome in isolated congenital diaphragmatic hernia using multiple ultrasound parameters

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Placental Volumes Measured by 3-Dimensional Ultrasonography in Normal Pregnancies From 12 to 40 Weeks' Gestation

Objective. The purpose of this study was to construct nomograms of placental volumes according to gestational age and estimated fetal weight. Methods. From March to November 2007, placental volumes were prospectively measured by ultrasonography in 295 normal pregnancies from 12 to 40 weeks' gestation and correlated with gestational age and estimated fetal weight. Inclusion criteria were healthy women, singleton pregnancies with normal fetal morphologic characteristics on ultrasonography, and confirmed gestational age by first-trimester ultrasonography. Results. The mean placental volume ranged from 83 cm(3) at 12 weeks to 427.7 cm(3) at 40 weeks. Linear regression yielded the following formula for the expected placental volumes (ePV) according to gestational age (GA): ePV` (cm(3)) = -64.68 + 12.31 x GA (r = 0.572; P < .001). Placental volumes also varied according to estimated fetal weight (EFW), and the following mathematical equation was also obtained by linear regression: ePV = 94.19 + 0.09 x EFW (r = 0.505; P < 0.001). Conclusions. Nomograms of placental volumes according to gestational age and estimated fetal weight were constructed, generating reference values.

A and B mode ultrasonography in preoperative evaluation of lens and posterior segment of dogs eyes with cataract

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Contribution of ocular B-mode and triplex Doppler in the evaluation of 10 Poodle dogs with cataracts

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)