Asymptomatic Females Research Articles

Pre-clinical symptoms of SBMA may not be androgen-dependent: implications from two SBMA mouse models.

A distinguishing aspect of spinal and bulbar muscular atrophy (SBMA) is its androgen-dependence, possibly explaining why only males are clinically affected. This disease, which impairs neuromuscular function, is linked to a polyglutamine expansion mutation in the androgen receptor (AR). In mouse models of SBMA, motor dysfunction is associated with pronounced defects in neuromuscular transmission, including defects in evoked transmitter release (quantal content, QC) and fiber membrane excitability (based on the resting membrane potential, RMP). However, whether such defects are androgen-dependent is unknown. Thus, we recorded synaptic potentials intracellularly from adult muscle fibers of transgenic (Tg) AR97Q male mice castrated pre-symptomatically. Although castration largely protects both QC and the RMP of fibers, correlating with the protective effect of castration on motor function, significant deficits in QC and RMP remained. Surprisingly, comparable defects in QC and RMP were also observed in pre-symptomatic AR97Q males, indicating that such defects emerge early and are pre-clinical. Exposing asymptomatic Tg females to androgens also induces both motor dysfunction and comparable defects in QC and RMP. Notably, asymptomatic Tg females also showed significant deficits in QC and RMP, albeit less severe, supporting their pre-clinical nature, but also raising questions about the androgen-dependence of pre-clinical symptoms. In summary, current evidence indicates that disease progression depends on androgens, but early pathogenic events may be triggered by the mutant AR allele independent of androgens. Such early, androgen-independent disease mechanisms may also be relevant to females carrying the SBMA allele.

PD19-03 BLADDER MICROBIOTA DIFFER IN MEN AND WOMEN WITH AND WITHOUT LOWER URINARY TRACT SYMPTOMS

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Basic Research & Pathophysiology I1 Apr 2018PD19-03 BLADDER MICROBIOTA DIFFER IN MEN AND WOMEN WITH AND WITHOUT LOWER URINARY TRACT SYMPTOMS Petar Bajic, Michelle Van Kuiken, Bethany Burge, Eric Kirshenbaum, Alan Wolfe, Kristin Baldea, Larissa Bresler, and Ahmer Farooq Petar BajicPetar Bajic More articles by this author , Michelle Van KuikenMichelle Van Kuiken More articles by this author , Bethany BurgeBethany Burge More articles by this author , Eric KirshenbaumEric Kirshenbaum More articles by this author , Alan WolfeAlan Wolfe More articles by this author , Kristin BaldeaKristin Baldea More articles by this author , Larissa BreslerLarissa Bresler More articles by this author , and Ahmer FarooqAhmer Farooq More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.993AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Bacteria have been identified in urine deemed sterile by standard culture and have been shown to influence lower urinary tract symptoms (LUTS). We compare male and female bladder microbiota in patients with and without LUTS. METHODS Catheterized urine specimens (CUS) were collected from 49 adult men: 29 with benign prostatic hyperplasia (BPH)/LUTS, and 20 asymptomatic males (ASM). BPH patient samples were compared to 55 CUS from age-matched women with overactive bladder (OAB). We also compared the 20 ASM to 107 CUS from age-matched asymptomatic females (ASF). Bacterial growth was assessed using Expanded Quantitative Urine Culture (EQUC), which utilizes 100x more urine, additional media and environmental conditions, with double the incubation period of standard culture. Colonies grown were identified by mass spectrometry. EQUC growth and demographics were compared using chi-squared tests and Welch t-tests. Odds ratios for symptoms associated with EQUC growth were reported from multivariable logistic regression models controlling for age and hypertension (HTN) in men and age, HTN and BMI in women. RESULTS EQUC positivity was seen in 64.6% (135/209) of women compared to 32.7% (16/49) of men (p < 0.001). On multivariate analysis, men with BPH/LUTS were EQUC positive more often than ASM with an OR of 6.9 (95% CI 1.1-42.8, p = 0.038) and women with OAB were EQUC positive more often than ASF with an OR of 3.9 (95% CI 1.6-9.5, p = 0.003). OAB patients showed mixed microbial composition in 23.6% (13/55) of CUS, while BPH/LUTS patients were all dominated by a single genus (p = 0.003). Lactobacillus dominated in 21.6% (35/162) of women, but was absent in men (p < 0.001). CONCLUSIONS Male bladders are EQUC positive less often than their female counterparts, both in the presence and absence of LUTS. Males and females with LUTS are more likely to have bladder microbiota identifiable by EQUC than their asymptomatic counterparts. Mixed microbial composition is more common in symptomatic than asymptomatic female patients, while male patients are typically dominated by a single genus. Lactobacillus dominance was only identified in female patients. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e395-e396 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Petar Bajic More articles by this author Michelle Van Kuiken More articles by this author Bethany Burge More articles by this author Eric Kirshenbaum More articles by this author Alan Wolfe More articles by this author Kristin Baldea More articles by this author Larissa Bresler More articles by this author Ahmer Farooq More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Normal values for assessment of anal sphincter morphology, anorectal motion, and pelvic organ prolapse with MRI in healthy women.

Endoanal MRI and MR defecography are used to identify anal sphincter injury and disordered defecation. However, few studies have evaluated findings in asymptomatic healthy people. The effects of BMI and parity on rectoanal motion and evacuation are unknown. In 113 asymptomatic females (age 50±17years, Mean±SD) without risk factors for anorectal trauma, anal sphincter appearance, anorectal motion, and pelvic organ prolapse were evaluated with MRI. The relationship between age, BMI, and parity and structural findings were evaluated with parametric and non-parametric tests. The anal sphincters and puborectalis appeared normal in over 90% of women. During dynamic MRI, the anorectal angle was 100±1º (Mean±SEM) at rest, 70±2° at squeeze, and 120±2° during defecation. The change in anorectal angle during squeeze (r=-.25, P<.005), but not during evacuation (r=.13, P=.25) was associated with age. In the multivariable models, BMI (P<.01) and parity (P<.01) were, respectively, independently associated with the intersubject variation in the anorectal angle at rest and the angle change during squeeze. Ten percent or fewer women had had descent of the bladder base or uterus 4cm or more below the pubococcygeal line or a rectocele measuring 4cm or larger. Only 5% had a patulous anal canal. In addition to age, BMI and parity also affect anorectal motion in asymptomatic women. These findings provide age-adjusted normal values for rectoanal anatomy and pelvic floor motion.

Effects of morphological and mechanical properties of plantar fascia and heel pad on balance performance in asymptomatic females

IntroductionPersonal differences in morphological and mechanical properties of plantar fascia and heel fat pad may be an important parameter regarding an individual’s balance performance. The purpose of this study was to investigate the effect of thickness and stiffness of heel fat pad and plantar fascia on balance performance in asymptomatic sedentary females. Materials and methodsThis study was carried out on 37 asymptomatic sedentary females between the ages of 19 and 35 years. Balance assessments during single-leg standing were carried out using Biodex Balance Systems (Biodex Medical Systems, Shirley, NY, USA). In this study, the individuals’ balance performance was assessed using the center of balance (COB) parameters, which were the standard deviation of the COB amplitude in the anterior–posterior (AP_SD) and medial–lateral (ML_SD) directions. Stiffness and thickness measurements of heel fat pad and plantar fascia were performed using an ACUSON S3000 Ultrasound System and a 9L4 probe (4–9MHz) (Siemens Medical Solution, Mountain View, CA, USA). ResultsAP_SD during single-leg standing tests had a moderate correlation with heel pad thickness (r=0.46, p=0.004) and heel pad stiffness (r=0.41, p=0.011), and a fair correlation with plantar fascia thickness (r=0.34, p=0.038) and plantar fascia stiffness (r=0.38, p=0.021). ML_SD during single-leg standing tests had a moderate correlation with heel pad thickness (r=0.41, p=0.013) and heel pad stiffness (r=0.53, p=0.001), and a fair correlation with plantar fascia thickness (r=0.40, p=0.015). ConclusionIt was found that higher plantar fascia and heel fat pad stiffness and thickness are related to higher postural sway in anterior–posterior and medial–lateral directions based on the single-leg balance tests. These results suggest that the morphological and mechanical properties of plantar fascia and heel fat pad play an important role in balance performance.

Retroareolar masses and intraductal abnormalities detected on screening ultrasound: can biopsy be avoided?

This is a HIPAA compliant retrospective study. Our radiology electronic medical records were searched for the phrases "retroareolar mass" or "intraductal mass" combined with "screening whole breast ultrasound" performed between 10/1/2009 and 5/30/2015. Inclusion criteria included retroareolar masses in asymptomatic females with normal mammography, mammographically dense breast tissue and imaging or biopsy follow-up. 1136 charts were reviewed. 87 BI-RADS 3 and 4 retroareolar findings were included in final analysis. The average lesion size was 9.5 mm (range 4-28 mm). 47/87 lesions were classified as BI-RADS 3 and 40/87 BI-RADS 4. Of the 47 BI-RADS 3 lesions, 36 were stable on follow-up; 6 benign lesions were biopsied at patients' request; and 5 biopsied due to suspicious interval change on follow-up imaging, including 4 benign lesions and a 5 mm Grade 2 ductal carcinoma in situ . 3/40 BI-RADS 4 lesions were not biopsied and stable at follow-up; 37/40 lesions underwent benign biopsy. The malignancy rate of BI-RADS 3 and 4 lesions was 2.1% [CI (0.4-11.1)] and 0% [CI (0.0-8.8)], respectively. The overall combined malignancy rate was 1/87 [1.1%, CI (0.2-6.2)]. The malignancy rate for BI-RADS 3 and 4 retroareolar masses and intraductal abnormalities detected on US-S is low (<2%). Careful imaging surveillance in lieu of biopsy of these lesions may be appropriate in asymptomatic females with negative mammography.

How does the sagittal spinal balance of the scoliotic population deviate from the asymptomatic population?

BackgroundPreviously, the sagittal spinal balance in both asymptomatic and scoliotic Caucasian people has been characterized and compared. Very recently, the sagittal spino-pelvic parameters among asymptomatic Chinese adults have been studied, and the results were compared with Caucasian adults, indicating that a difference did exist. Unfortunately, the distribution of sagittal standing posture patterns among the Chinese population has not been characterized in either asymptomatic or scoliotic groups.MethodsWe conducted a radiographic comparison study to define the deviation of sagittal balance in scoliotic patients from that of an asymptomatic population. A total of 126 asymptomatic and 117 idiopathic scoliotic (IS) young adults were recruited. Radiographic data from each subject were reviewed, and sagittal spinopelvic parameters were measured. The Roussouly type was then determined, as well as the relative position of the C7 plumbline with respect to the sacrum and hip axis. Comparison analyses were undertaken between the two different groups.ResultsThe IS group had a larger pelvic incidence, pelvic tilt and sacral slope, but a smaller spinal tilt than the asymptomatic group (P < 0.05), while other sagittal parameters were similar. The distribution of Roussouly types was similar between the asymptomatic and IS groups, of which 49.2% and 45.3% belonged to Roussouly Type 3, respectively. Asymptomatic males and females had a similar distribution, which was different between the two genders in the IS group (P < 0.05), with more females possessing a neutral sagittal standing posture. In addition, more IS subjects had forward displacement of the C7 plumbline than asymptomatic ones (P < 0.05), while there was no difference between the two genders in either group.ConclusionsAlthough sagittal pelvic parameters were greater in the IS population, their sagittal spinal balance was maintained and there was no sagittal standing posture pattern correlated with IS. The occurrence of anterior displacement of the C7 plumbline was more common in IS patients than asymptomatic adults, but did not appear to be correlated with gender in both populations.

Patterns of Circulating Corticosterone in a Population of Rattlesnakes Afflicted with Snake Fungal Disease: Stress Hormones as a Potential Mediator of Seasonal Cycles in Disease Severity and Outcomes.

Snake fungal disease (SFD) is an emerging threat to snake populations in the United States. Fungal pathogens are often associated with a physiological stress response mediated by the hypothalamo-pituitary-adrenal axis (HPA), and afflicted individuals may incur steep coping costs. The severity of SFD can vary seasonally; however, little is known regarding (1) how SFD infection relates to HPA activity and (2) how seasonal shifts in environment, life history, or HPA activity may interact to drive seasonal patterns of infection severity and outcomes. To test the hypothesis that SFD is associated with increased HPA activity and to identify potential environmental or physiological drivers of seasonal infection, we monitored baseline corticosterone, SFD infection severity, foraging success, body condition, and reproductive status in a field-active population of pigmy rattlesnakes. Both plasma corticosterone and the severity of clinical signs of SFD peaked in the winter. Corticosterone levels were also elevated in the fall before the seasonal rise in SFD severity. Severely symptomatic snakes were in low body condition and had elevated corticosterone levels compared to moderately infected and uninfected snakes. The monthly mean severity of SFD in the population was negatively related to population-wide estimates of body condition and temperature measured in the precedent month and positively correlated with corticosterone levels measured in the precedent month. Symptomatic females were less likely to enter reproductive bouts compared to asymptomatic females. We propose the hypothesis that the seasonal interplay among environment, host energetics, and HPA activity initiates trade-offs in the fall that drive the increase in SFD prevalence, symptom severity, and decline in condition observed in the population through winter.

The genetic diversity of metronidazole susceptibility in Trichomonas vaginalis clinical isolates in an Egyptian population.

Trichomoniasis is the most common curable sexually transmitted disease worldwide. Resistance to metronidazole in treating trichomoniasis is a problematic health issue. We aimed to determine the minimum lethal concentration (MLC) of metronidazole for Trichomonas vaginalis isolates detected in Mansoura, Egypt and studied the genotypic profile of these isolates. Vaginal swab specimens were obtained from 320 symptomatic and 100 asymptomatic females, for whom clinical examination, vaginal discharge wet mount, Giemsa stain, and culture in modified Diamond's media were performed. Metronidazole susceptibility testing by an aerobic tube assay was performed. Both sensitive and resistant isolates were examined by PCR amplification followed by restriction fragment length polymorphism (RFLP). Trichomonas vaginalis was identified in 49/420 (11.7%) using either culture or PCR, while wet mount and Giemsa stain detected the parasite in 8.1 and 7.6% of participants, respectively. After 48h incubation, most isolates were sensitive to metronidazole with a minimal lethal concentration (MLC) of 1μg/ml. Mild resistance was observed in two isolates with MLCs of 64μg\ml and mild to moderate resistance was observed in an additional two isolates with MLCs of 128μg/ml. The four isolates that demonstrated low to moderate metronidazole resistance displayed a unique genotype band pattern by RFLP compared to the other 45 samples that were metronidazole sensitive. Our results highlight the presence of in vitro metronidazole tolerance in a few T. vaginalis isolates in Mansoura, Egypt that may lead to the development of drug resistance as well as the possibility of an identifying RFLP pattern in the isolates.

Mechanical demands on the lower back in patients with non-chronic low back pain during a symmetric lowering and lifting task

There is limited information in the literature related to the lower back loading in patients with LBP, particularly those with non-chronic LBP. Toward addressing such a research gap, a case-control study was conducted to explore the differences in lower back mechanical loads between a group of females (n=19) with non-chronic, non-specific LBP and a group of asymptomatic females (n=19). The differences in lower back mechanical loads were determined when participants completed one symmetric lowering and lifting of a 4.5kg load at their preferred cadence. The axial, shearing, and moment components of task demand at the time of peak moment component as well as measures of peak trunk kinematics were analyzed. Patient vs. asymptomatic group performed the task with smaller peak thoracic rotation and peak lumbar flexion. While no differences in the moment component of task demand on the lower back between the patients and controls were found, the shearing (40–50 age group) and axial components of task demand were, respectively, larger and smaller in patients vs. controls. Whether alterations in lower back loads in patients with non-chronic LBP are in response to pain or preceded the pain, the long-term exposure to abnormal lower back mechanics may adversely affect spinal structure and increase the likelihood of further injury or pain. Therefore, the underlying reason(s) as well as the potential consequence(s) of such altered lower back mechanics in patients with non-chronic LBP should to be further investigated.

Status of Hepatitis B, C, E and a in Healthy Asymptomatic Persons and Child Bearing Age Groups Females in Varanasi, U.P., India

Status of Hepatitis B, C, E and a in Healthy Asymptomatic Persons and Child Bearing Age Groups Females in Varanasi, U.P., India

Gender differences in nonlinear motor performance following concussion

PurposeTo quantify differences in nonlinear aspects of performance on a seated visual-motor tracking task between clinically asymptomatic males and females with and without a self-reported mild traumatic brain injury history. MethodsSeventy-three individuals with a self-reported concussion history (age: 21.40 ± 2.25 years, mean ± SD) and 75 without completed the visual-motor tracking task (age: 21.50 ± 2.00 years). Participants pressed an index finger against a force sensor, tracing a line across a computer screen (visual-motor tracking). The produced signal's root-mean-square error (RMSE), sample entropy (SampEn, a measure of regularity), and average power (AvP) between 0 and 12 Hz were calculated. ResultsMales with a history of 0 or 1 concussion had greater RMSE (worse performance) than females with 0 (p< 0.0001) and 1 concussion (p = 0.052). Additionally, females with 2+ concussions exhibited lower SampEn than females with no history (p = 0.001) or a history of 1 concussion (p = 0.026). Finally, females with 2+ concussions had lower 8–12 Hz AvP than males with 2+ concussions (p = 0.031). Few differences were observed in the male participants. ConclusionFemales with a self-reported history of multiple concussions exhibited lower SampEn in the visual-motor tracking-task force output structure as compared to those with no reported history of concussion and their male counterparts. Lower SampEn and lower power between 8 and 12 Hz indicated persistent impairment in visual processing and feed-forward or predictive motor control systems.

Cardiac involvement in female carriers of duchenne or becker muscular dystrophy.

The significance of abnormal cardiac measures in asymptomatic females who harbor dystrophin gene mutations is controversial. Echo-measures of ventricular function were compared with published norms in a cross-sectional study of 130 (age, 39 ± 15.7 years) "carriers" of Duchenne or Becker muscular dystrophy (DMD/BMD). Correlations between cardiomyopathy (CM) and mutation, creatine kinase (CK) levels, age, and muscle symptoms were investigated. Depending on definition, CM prevalence was 3-33%. Ejection fraction (Simpson method) was < 55% in 9 (13%) and < 40% in 2 (2.9%). Eleven (8.5%) had wall motion abnormalities. Left ventricular end-systolic dimensions were increased in 7 (5.7%) and end-diastolic in 17 (13.9%). CM did not correlate with mutation type, DMD or BMD phenotype, CK level, muscle symptoms, or age. Occult CM can be found by screening in DMD/BMD carriers. Its lack of age-correlation suggests that not all abnormalities progress. Optimum screening schedules require a better understanding of progressive CM. Muscle Nerve 55: 810-818, 2017.

Rubella and CMV Antibodies Screening During Pregnancy - A Retrospective Study in a Tertiary Hospital

Background: In India, RUBELLA & CMV Antibodies screening is routinely carried out, but due to absence of clear intervention, its value is questionable. This retrospective study evaluated the usefulness of rubella & cmv antibody screening during pregnancy. Methods: Blood is collected from pregnant women & children, tested for rubella and CMV specific IgM Antibody by capture ELISA. The data were analysed to determine the incidence of rubella &CMV infection during pregnancy & in congenital infections. Results: In asymptomatic pregnancy females (n=252) rubella positivity was 1.58% and in woman with BOH (n=110) it was 3.66%, while CMV passivity was 2.9% in both asymptomatic and BOH women. In children (n=100) the overall positivity for rubella and CMV specific IgM antibodies was 7.5% and 12.5% respectively. The incidence of rubella and CMV infections in pregnant women & women with BOH has declined. In children, also the congenital rubella syndrome has declined but for the past 5 years the incidence of CMV infection remained same without any change. Conclusions: The incidence of rubella over the past 5 years can be reduced after giving the rubella vaccine to school going girls & women with reproductive age apart from routine vaccine. But CMV infection is a big problem due to unavailability of vaccine & safe treatment against CMV infection, so routine screening for rubella and CMV should be reserved for women with obstetric complications only.

Clinicopathological characteristics and long-term prognosis of screening detected non-palpable breast cancer by ultrasound in hospital-based Chinese population (2001-2014).

PurposeThe mainstay modality of breast cancer screening in China is the hospital-based opportunistic screening among asymptomatic self-referred women. There is little data about the ultrasound (US) detected non-palpable breast cancer (NPBC) in Chinese population.MethodsWe analyzed 699 consecutive NPBC from 1.8-2.3 million asymptomatic women from 2001 to 2014, including 572 US-detected NPBC from 3,786 US-positive women and 127 mammography (MG) detected NPBC from 788 MG-positive women. The clinicopathological features, disease-free survival (DFS) and overall survival (OS) were compared between the US- and MG-detected NPBC. Prognostic factors of NPBC were identified.ResultsCompared to MG, US could detect more invasive NPBC (83.6% vs 54.3%, p<0.001), lymph node positive NPBC (19.1% vs 10.2%, p=0.018), lower grade (24.8% vs 16.5%, p<0.001), multifocal (19.2% vs 6.3%, p<0.001), PR positive (71.4% vs 66.9%, p=0.041), Her2 negative (74.3% vs 54.3%, p<0.001), Ki67 high (defined as >14%, 46.3% vs 37.0%, p=0.031) cancers and more NPBC who received chemotherapy (40.7% vs 21.3%, p<0.001). There was no significant difference in 10-year DFS and OS between US-detected vs MG-detected NPBC, DCIS and invasive NPBC. For all NPBC and the US-detected NPBC, the common DFS-predictors included pT, pN, p53 and bilateral cancers.ConclusionUS could detect more invasive, node-positive, multifocal NPBC in hospital-based asymptomatic Chinese female, who could achieve comparable 10-year DFS and OS as MG-detected NPBC. US would not delay early detection of NPBC with improved cost-effectiveness, thus could serve as the feasible initial imaging modality in hospital-based opportunistic screening among Chinese women.

Prevalence of Mycoplasma hominis and Ureaplasma spp. in Routine Gynecological Care in Sao Paulo City, Brazil

Background: Mycoplasmas (Mycoplasma spp. and Ureaplasma spp.) are sexually transmitted organisms found primarily in the human urogenital microbiota. These microorganisms are frequently associated with some diseases including non-gonococcal urethritis, vaginosis, pregnancy complications, prenatal infections, systemic infections and infertility. Objectives: The current studyaimedto evaluate the prevalence of Mycoplasma hominisandUreaplasmaspp. in routinegynecological care. Patients and Methods: A cross sectional study with simple random sampling was designed. A total of 6,810 patients with the age range of 11 to 80 years were evaluated, during a six-month period from January 2015 to June 2015 in Sao Paulo, Brazil. DNAs were extracted from cytological samples (ThinPrep™) to detect microorganisms by real-time polymerase chain reaction (qPCR). Results: The high prevalence of M. hominis (n = 79), Ureaplasma spp. (n = 2,026) and the co-colonization of both (n = 199) with P < 0.0001 in the samples were verified, mainly in sexually active aged females. The results also indicated a negative and significant correlation between co-colonization of Ureaplasma spp. and M. hominis, Ureaplasma spp., and age. Conclusions: In conclusion, the data showed that high rate of females harbor these microorganisms in the genital microbiota. This finding suggests the importance of routine gynecological tests, mainly in pregnant females, during the second and third trimesters, and in asymptomatic females under infertility clinical investigation. Furthermore, the application of molecular methods is suggested; since they provide a fast and accurate diagnosis of these microorganisms, but sensitivity of the tests should be considered in the clinical relevant concentration of microorganisms in the genital microbiota

A Mamografia e seus Desafios: Fatores Socioeducacionais Associados ao Diagnóstico Tardio do Câncer de Mama

No Brasil, a cada ano, são registrados quase 60 mil novos casos de câncer de mama. Entretanto, das mais de 10 milhões de mamografias esperadas em mulheres na faixa etária dos 50 aos 69 anos, apenas 2,5 milhões foram realizadas em 2013. O rastreamento populacional por meio da mamografia vem se mostrando uma estratégia eficaz na redução de mortes em mulheres principalmente acima dos 50 anos. O objetivo deste estudo foi avaliar os fatores socioeducacionais associados ao diagnóstico tardio do câncer de mama e a valorização do rastreamento por meio da mamografia em mulheres assintomáticas. Entre janeiro de 2000 a dezembro de 2014, 26 artigos foram selecionados em todo o território nacional e revisados. A população do estudo foi de mulheres na faixa-etária entre 25 a 69 anos. Observou-se que 68,2% dos casos avaliados eram mulheres de baixa renda, 94,1%, com baixa escolaridade, e 72,7 % demonstraram total dependência do SUS. Os dados ainda indicaram que 61,2% do diagnóstico para o câncer de mama encontravam-se em estádios avançados (lll e lV). O diagnóstico tardio e, por vezes, a terapêutica inadequada contribuem para que o câncer de mama continue sendo a principal causa de morte entre as mulheres brasileiras. Deve-se considerar a educação para autonomia e corresponsabilidade do público feminino nos cuidados de sua saúde na expectativa de minimizar o tempo prolongado entre a suspeita da anormalidade nas mamas e a confirmação diagnóstica por falta de realização da mamografia e a adesão de mulheres assintomáticas aos programas de prevenção

Right ventricular thrombus successfully dissolved with novel oral anticoagulant therapy

Pacjentka w wieku 71 lat bez objawów podmiotowych została przyjęta na Oddział Kardiologii z powodu zmiany w obrębie koniuszka prawej komory, przypadkowo stwierdzonej w tomografii komputerowej jamy brzusznej. W przezklatkowym badaniu echokardiograficznym zaobserwowano hipoechogeniczną, przyścienną strukturę o morfologii skrzepliny w świetle prawej komory (o wymiarach 32 mm × 16 mm) z obecnością hipokinezy przyległych segmentów ściany serca. W trakcie hospitalizacji wykluczono obecność choroby wieńcowej, zatorowości płucnej i systemową chorobę tkanki łącznej. Za pomocą rezonansu magnetycznego serca uwidoczniono hipointensywną skrzeplinę w koniuszku prawej komory, a kontrolna tomografia komputerowa serca potwierdziła stabilne wymiary i charakter zmiany. Na podstawie powyższego obrazu klinicznego wdrożono przewlekłe leczenie przeciwkrzepliwie nowymi doustnymi antykoagulantami (NOAC). Kontrolne badanie echokardiograficzne wykonane po 3 miesiącach od wypisania ze szpitala wykazało całkowitą regresję skrzepliny i normalizację odcinkowych zaburzeń kurczliwości prawej komory. Niniejszy opis przypadku dokumentuje możliwość zastosowania NOAC w celu leczenia incydentalnej, przyściennej skrzepliny w prawej komorze.

Contribution of altered hip, knee and foot kinematics to dynamic postural impairments in females with patellofemoral pain during stair ascent

BackgroundAltered hip, knee and foot kinematics have been systematically observed in individuals with patellofemoral pain (PFP). However, less attention has been given to the altered dynamic postural control associated with PFP. Additionally, the relative contribution of kinematic impairments to the postural behavior of subjects with PFP remains an open question that warrants investigation. The aims of this study were: i) to investigate possible differences in hip adduction, rearfoot eversion, knee flexion and displacement area of the center of pressure (COP) in individuals with PFP in comparison to controls during stair ascent; and (ii) to determine which kinematic parameter is the best predictor of the displacement area of the COP measured during the stance phase of the stair ascent. MethodsTwenty-nine females with PFP and 25 asymptomatic pain-free females underwent three-dimensional kinematic and COP analyses during stair ascent. Between-group comparisons were made using independent t-tests. Regression models were performed to identify the capability of each kinematic factor in predicting the displacement area of the COP. ResultsReduced knee flexion and displacement area of the COP as well as increased peak hip adduction and peak rearfoot eversion were observed in individuals with PFP as compared to controls. Peak hip adduction was the best predictor of the displacement area of the COP (r2=23.4%). ConclusionsThe excessive hip adduction was the biggest predictor of the displacement area of the COP. Clinical relevanceBased on our findings, proximally targeted interventions may be of major importance for the functional reestablishment of females with PFP.

Chlamydia trachomatis Frequency in a Cohort of HPV-Infected Colombian Women.

BackgroundChlamydia trachomatis (C. trachomatis), an obligate intracellular bacterium, is the commonest infectious bacterial agent of sexual transmission throughout the world. It has been shown that the presence of this bacteria in the cervix represents a risk regarding HPV persistence and, thereafter, in developing cervical cancer (CC). Prevalence rates may vary from 2% to 17% in asymptomatic females, depending on the population being analysed. This study reports the identification of C. trachomatis in a cohort of 219 HPV-infected Colombian females.MethodsC. trachomatis infection frequency was determined during each of the study’s follow-up visits; it was detected by amplifying the cryptic plasmid sequence by polymerase chain reaction (PCR) using two sets of primers: KL5/KL6 and KL1/KL2.Infection was defined as a positive PCR result using either set of primers at any time during the study. Cox proportional risk models were used for evaluating the association between the appearance of infection and a group of independent variables.ResultsBase line C. trachomatis infection frequency was 28% (n = 61). Most females infected by C. trachomatis were infected by multiple types of HPV (77.42%), greater prevalence occurring in females infected with HPV-16 (19.18%), followed by HPV-58 (17.81%). It was observed that females having had the most sexual partners (HR = 6.44: 1.59–26.05 95%CI) or infection with multiple types of HPV (HR = 2.85: 1.22–6.63 95%CI) had the greatest risk of developing C. trachomatis.ConclusionsThe study provides data regarding the epidemiology of C. trachomatis /HPV coinfection in different population groups of Colombian females and contributes towards understanding the natural history of C. trachomatis infection.

Assessment of Rapid Dipstick Test for Diagnosis of Urinary Tract Infection in Asymptomatic Pregnant Female

&lt;strong&gt;Background:&lt;/strong&gt;Bacteriuria during pregnancy has been known to cause many complications like low birth weight and premature delivery.&lt;p&gt;&lt;strong&gt;Objective&lt;/strong&gt;: This study was done to evaluate the diagnostic accuracy of rapid dipstick test to predict urinary tract infection in pregnancy against the gold standard urine culture.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material&amp;amp;Methods:&lt;/strong&gt; A total of 200 mid stream urine samples were collected from asymptomatic pregnant females. These specimens were cultured in blood agar and MacConkey's agar by using the standard loop technique and incubated aerobically at 37°C overnight. The criterion for clinically significant bacteriuria was either a pure or predominant culture of &amp;gt;10&lt;sup&gt;5&lt;/sup&gt; colony forming units (CFU)/ml. All the specimens were also examined microscopically for pyuria and bacteriuria.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; The prevalence of asymptomatic bacteriuria in pregnancy was 15 % in our study. The sensitivity and the specificity for leucocyte esterase were 85.7% and 74.4% and for nitrites, they were 64.2% and 72%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; The study revealed that use of either leukocyte esterase or nitrite for screening of asymptomatic bacteriuria in pregnancy was associated with many false positive and negative results when compared with the gold standard urine culture method. By using their combination maximum negative predictive value of .98 was achieved.&lt;/p&gt;