Helvécio Neves Feitosa

Comparação entre ultrassonografia transvaginal e histerossonografia na avaliação de pacientes com sangramento uterino anormal

OBJECTIVE: To comparatively evaluate the effectiveness of transvaginal ultrasonography (TVUS) and sonohysterography (SHG) in the assessment of endometrial diseases in women with abnormal uterine bleeding. MATERIALS AND METHODS: Cross-sectional study with 30 patients, aged from 29 to 71 years, 21 (70%) of them premenopausal and 9 (30%) postmenopausal. Saline solution (at 9%) was utilized as contrast agent for SHG. The MacNemar test was utilized for comparison of diagnostic studies. RESULTS: Hysteroscopy diagnosed 18 cases (60%) of intracavitary alterations, and 10 polyps (33.3%). TVUS demonstrated 83.3% sensitivity and specificity, and SHG showed 94.4% sensitivity and 91.6% specificity. The MacNemar test showed similar sensitivity (p = 0.500) and specificity (p = 1.000) between TVUS and SHG in the detection of endometrial diseases. In the diagnosis of polyp, SHG showed the highest sensitivity (90.9% vs. 27.3%; p = 0.016) with similar specificity (89.5% vs. 94.7%; p = 1.000). CONCLUSION: SHG and TVUS present a good predictive value for endometrial diseases in patients with abnormal uterine bleeding. SHG and TVUS present similar sensitivity and specificity in the detection of such diseases, but SHG is more sensitive in the detection of polyps.

Fatores associados à realização de citologia para prevenção de câncer do colo uterino em uma comunidade urbana de baixa renda

Objective: To evaluate the prevalence of prevention of cervical cancer and the factors associated with annual collection.Methods: Cross-sectional study conducted between August 2010 and June 2011 through interviews with 144 women 25-52 years old in a low income urban community in Fortaleza (CE). Were used the χ2 test and ANOVA comparing the groups never did collect, held annually and not those who made an annual basis. Variables with p values <0.20 were subjected to logistic regression to estimate odds ratios (OR).Results:The proportion of women who reported annual collection was 59.3%. Remunerated employment (p=0.04), and family income (p<0.01) showed significant association. In simple logistic regression, remunerated employment (OR=2.15), economic status (OR=3.32) and the having had the maximum of one pregnancy (OR=2.73) and, in multiple logistic regression, remunerated employment (OR=2.63) and the having had the maximum of one pregnancy (OR=2.60) were associated with annually periodicity for cervicovaginal smear.Conclusion:Women with remunerated employment and had no more than one pregnancy had a greater chance of achieving an annual frequency of cytology for preventing cervical cancer.