Eduardo Lane

Estudo exploratório da associação entre o perfil lipídico e a densidade mineral óssea em mulheres menopausadas, em hospital de referência de Campinas

A total of 72 postmenopausal patients presenting no risk factors for cardiovascular disease nor osteoporosis, were studied. The study evaluated total serum cholesterol and fractions and bone mass by densitometry of the lumbar spine and femur using a Lunar-DPX. There was no association between lipid profile variables and bone mineral density, except for high density lipoprotein (HDL), which showed an inverse correlation (p=0.001). Multiple regression showed that total cholesterol levels higher than 240 mg% had a positive association with BMD (p=0.026). In addition, the ratio between LDL and HDL (Castelli 2 index) showed a negative association with BMD (p=0.002). The diagnostic validation test showed that all lipid profile variables had low sensitivity and specificity as indicators for osteoporosis. The conclusions were that lipid profile variables did not show a significant association with bone mass and could not be used as indicators for bone mineral density.O objetivo deste estudo foi avaliar a possivel associacao entre algumas variaveis do perfil lipidico e a densidade mineral ossea e se estas variaveis poderiam ser usadas como indicadoras de massa ossea em mulheres menopausadas, atendidas no ambulatorio de menopausa do CAISM-Unicamp, no ano de 1995. Estudaram-se 72 pacientes pos-menopausadas, sem fatores de risco para doencas cardiovasculares e para osteoporose, por meio da dosagem de colesterol total e fracoes e da avaliacao da densidade mineral ossea por densitometria ossea em aparelho Lunar DPX (Dexa). Dentre as variaveis do perfil lipidico, a densidade mineral ossea associou-se inversamente a lipoproteina HDL de alta densidade (p = 0,001). A analise de regressao multipla observou que niveis de colesterol total acima de 240mg% associaram-se a menor densidade mineral ossea (p = 0,026). A razao entre a lipoproteina de baixa densidade e a lipoproteina de alta densidade (indice de Castelli 2) correlacionou-se positivamente com a densidade mineral ossea (p = 0,002). O teste de validacao diagnostica mostrou que todas as variaveis do perfil lipidico apresentaram baixa sensibilidade e especificidade como indicadoras de diminuicao de massa ossea. Conclui-se que, apesar de algumas variaveis do perfil lipidico apresentarem associacao estatisticamente significativa com a massa ossea, elas foram contraditorias e nao tem boa capacidade diagnostica.A total of 72 postmenopausal patients presenting no risk factors for cardiovascular disease nor osteoporosis, were studied. The study evaluated total serum cholesterol and fractions and bone mass by densitometry of the lumbar spine and femur using a Lunar-DPX. There was no association between lipid profile variables and bone mineral density, except for high density lipoprotein (HDL), which showed an inverse correlation (p = 0.001). Multiple regression showed that total cholesterol levels higher than 240 mg% had a positive association with BMD (p = 0.026). In addition, the ratio between LDL and HDL (Castelli 2 index) showed a negative association with BMD (p = 0.002). The diagnostic validation test showed that all lipid profile variables had low sensitivity and specificity as indicators for osteoporosis. The conclusions were that lipid profile variables did not show a significant association with bone mass and could not be used as indicators for bone mineral density.

Diagnosis of the right ovarian vein syndrome

c I.. A R K ’ defines the right ovarian vein syndrome as an aberrant ovarian vein causing right ureteral obstruction, occurring most frcquently during pregnancy, and which may persist in the nonpregnant patient. Symptoms depend upon whether the kidney is infected or not. If infection is present symptoms are of acute pyelonephritis, with pain, chills, fever, pyuria, and tenderness over the right costovertebral angle If there is no infection, complaints consist of backache and right lower quadrant pain. Frequently these symptoms occur during the days preceding a menstrual period, sometimes with monthly recurrences. Clark1 diagnosed his 130 cases by doing right ureteral catheterization along with a pyeloureterogram. We feel that this diagnostic procedure can be a further source of infection, and if any instrumentation of the urinary tract can be avoided, it will be beneficial to the patient. With this in mind, we made effective a method in which an excretory urogram is combined with a pelvic phlebogram. By this method the right ovarian vein can be shown to be dilated, compressing the ureter, causing the symptoms inherent in this syndrome. The pelvic phlebogram is done according to TopolanskiSierra’s” technique. This is illustrated by the following case report:

Culdoscopy--useful or useless?

With the increased use of laparoscopy as a diagnostic method in gynecologic practice, the continued usefulness of culdoscopy has been questioned. The author presents his experience with 402 culdoscopies, listing indications, anesthesia used, results and complications. There was a 4.7% failure rate and a 1.7% complication rate. No permanent damage or death occurred.