Validation of hysteroscopic view in cases of endometrial hyperplasia and cancer in patients with abnormal uterine bleeding

STUDY OBJECTIVE: To validate hysteroscopic view with histology in cases of endometrial hyperplasia and cancer in patients with abnormal uterine bleeding (AUB)DESIGN: Retrospective study.(Canadian Task Force classification II-3).SETTING: University teaching hospitals in Rio de Janeiro and São Paulo, and private office in Rio de Janeiro.PATIENTS: Four thousand and fifty-four patients with AUB in whom hysteroscopic views were complete and the histologic result was conclusive.INTERVENTION: Four thousand and fifty-four office hysteroscopies with complete views and conclusive histologic results. The material for histologic examination was obtained through biopsy of the lesion in an outpatient unit or through the resection of the entire lesion in patients who underwent surgery. Histology was considered the gold standard and compared with the hysteroscopic view.MEASUREMENTS AND MAIN RESULTS: In the histology of the 4054 examinations, 613 (15.2%) were endometrial hyperplasia, and 105 (2.6%) were endometrial cancer. The most frequent hysteroscopic finding was endometrial polyps (31.2%). In endometrial hyperplasia, the sensitivity of the hysteroscopic view was 56.3% (95% CI 52.21-60.2%), specificity was 89.1% (95% CI 88.0%-90.1%), positive predictive value (PPV) was 48.0% (95% CI 44.3%-51.7%), negative predictive value (NPV) was 92.0% (95% Cl 90.1%-92.9%), and accuracy was 72.7% (95% CI 70.7%-74.7%). Accuracy was defined as the proportion of correct results among the hysteroscopic examinations. In endometrial cancer, the sensitivity of the hysteroscopic view was 80.0% (95% Cl 71.1%-87.2%), specificity was 99.5% (95% CI 99.2%-99.7%), PPV was 81.5% (95% Cl 72.7%-88.5%), NPV was 99.5% (95% CI 99.2%-99.7%), and accuracy was 89.8% (95% CI, 85.9%-93.6%). In the 814 patients (20.0%) in whom the hysteroscopic view was normal, there were no false negatives for endometrial cancer; however, there were 37 (4.5%) false negatives for endometrial hyperplasia. In the histologic cases of endometrial cancer, 101 (96.2%) hysteroscopic views were compatible with cancer or hyperplasia (80.0% and 16.2%, respectively). Ninety-seven out of 103 hysteroscopic views with cancer findings (94.2%) had histologic diagnosis of cancer or hyperplasia (81.5% and 12.6%, respectively).CONCLUSION: It seems that even in face of good validity of hysteroscopic view for endometrial hyperplasia and cancer, histologic study is mandatory in the presence of any lesion as the hysteroscopic view cannot completely replace the histologic study in patients with AUB. (C) 2006 AAGL. All rights reserved.

The use of high frequency waves to treat onychomycosis-preliminary communication of three cases

The research evaluated the efficacy of high frequency waves in the treatment of onychomycosis in three patients during twelve months through the clinical examination of nails and also through mycological examination. The causative agent of the mycosis, in the three patients, was the dermatophyte Trichophyton rubrum and after application of high frequency, it was possible to notice a great improvement in the appearance of nails and also growth inhibition in culture despite the fact that the mycological examination remained positive. The preliminary study of the three cases demonstrated that the fungistatic activity of high frequency waves is a promising method to be used in combination with conventional drugs.

O-serogroups, eae gene and EAF plasmid in Escherichia coli isolates from cases of bovine mastitis in Brazil

Mastitis has been recognized for some time as the most costly disease in dairy herds. From March 1997 to August 1998. 2144 samples of bovine mastitic milk were collected, from which 182 Escherichia coli isolates were made, and from which 14 1 isolates had the somatic anti-en (serogroup) determined. Twelve different serogroups were isolated from mastitic milk, and among them were 026, 055, 0111 and 0 119, all of them classic enteropathogenic E. (oh (EPEC) serogroups. These represented 40.0% of the isolates. The 20 of 57 isolates tested had plasmids and in dot blot hybridization, nine isolates were positive for an EaeA probe and an EPEC adherence factor (EAF) probe while two isolates were negative for EaeA probe but positive for the EAF probe, the nine isolates were characterized as attaching and effacing (A/E) E, coli (AEEC) isolates. (C) 2002 Elsevier B.V. B.V. All rights reserved.

Step by step analyses of Clarke's matrix correction procedure for untransposed three-phase transmission line cases

The correction procedure for Clarke's matrix, considering three-phase transmission line analyzes, is analyzed step by step in this paper, searching to improve the application of this procedure. Changing the eigenvectors as modal transformation matrices, Clarke's matrix has been applied to analyses for transposed and untransposed three-phase transmission line cases. It is based on the fact that Clarke's matrix is an eigenvector matrix for transposed three-phase transmission lines considering symmetrical and asymmetrical cases. Because of this, the application of this matrix has been analyzed considering untransposed three-phase transmission lines. In most of these cases, the errors related to the eigenvalues can be considered negligible. It is not true when it is analyzed the elements that are not in main diagonal of the quasi-mode matrix. This matrix is obtained from the application of Clarke's matrix. The quasi-mode matrix is correspondent to the eigenvalue matrix. Their off-diagonal elements represent couplings among the quasi-modes. So, the off-diagonal quasi-mode element relative values are not negligible when compared to the eigenvalues that correspond to the coupled quasi-modes. Minimizing these relative values, the correction procedure is analyzed in detail, checking some alternatives for the correction procedure application.

Treatment of oral myiasis caused by Cochliomyia hominivorax: two cases treated with ivermectin

The term myiasis is applied to the injurious action that larvae of certain diptera Cause to the organism of Vertebrate animals in the living or dead tissue in which they grow. Because of its great destructive potential. appropriate and preventative treatment are necessary. Among, the sites of infestation. the human mouth is a common site. mainly in tropical countries. We present two cases of oral myiasis Caused by Cochliomyia hominivorax spp. Ivermectin is all extremely effective semi-synthetic macrolides, in the treatment of, this condition. (C) 2008 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Reappraisal of immunohistochemical profiling of special histological types of breast carcinomas: a study of 121 cases of eight different subtypes

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

Follicular thyroid carcinoma in dogs. Report of cases

The treatment of choice for these cases was surgical removal. In both cases the diagnostic was infiltrative follicular carcinoma of thyroid. The first animal did not present a good recovery after the surgery, and died four hours after the procedure. In the second case, the diagnosis was more precocious and antineoplastic chemotherapy was used after the surgery. At the time of submission of this manuscript, this animal had survived for foully months. Currently, there is a need to define the protocols of chemotherapy to avoid relapse and metastases, in order to increase the life expectancy in dogs with thyroid neoplasm.