Muscular-skeletal disorders of the upper limbs resulting from work involving repetition strain (RSI) are now the most frequent work-related diseases in early or late industrialized countries. The author maintains that in addition to

Uterosacral ligament nodules with ultrasound measurements of 1.75 cm and 1.95 cm on the right and left sides, respectively, significantly increase the risk of ureteral involvement. Even with the association of other ultrasound variables, there was no improvement in sensitivity. Therefore, USL nodule size is a key measure for therapeutic planning and consent of the patient.

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Uma História de Violência: adoecimento e morte na classe trabalhadora Se um único fator dominava a vida dos trabalhadores do século XIX, este fator era a 'insegurança'. Eles não sabiam no principio da semana quanto iriam levar para casa na sexta-feira. Eles não sabiam quanto iriam durar no emprego presente, ou se viessem a perdê-lo, quando voltariam a encontrar um novo trabalho e em que condições. Eles não sabiam que acidentes ou doenças iriam afetá-los, e embora soubessem que algum dia no meio da vida-talvez 40 anos para os trabalhadores não especializados, talvez 50 anos para os especializados-iriam se tornar incapazes para o trabalho pleno e adulto, não sabiam o que iria acontecer então entre este momento e a morte. Hobsbawm (1979:231) Ciclos do capitalismo e morbi-mortalidade Miséria, doenças e mortes prematuras não eram desconhecidas antes de Cristo, nem nos 17 séculos seguintes que precederam a Revolução Industrial. As guerras e as epidemias, sobretudo a peste, a varíola e cólera, costumavam deixar atrás de si um rastro largo e profundo de covas e vítimas em todas as classes e camadas sociais. Não eram, também, incomuns os acidentes de trabalho nas escavações de minas, canais e túneis, na construção de pontes e monumentos e na navegação. 1 1 Algumas alusões e descrições de doenças do trabalho foram feitas durante os impérios grego e romano. Entre 1400 e 1700 elas se tornaram mais freqüentes e detalhadas, mas a referência clássica

The study results showed that laparoscopic colorectal segment resection for endometriosis had a positive impact on QOL in this patient group. The positive effects persisted 1 year after surgery.

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Introduction Intestinal endometriosis is considered the most severe form of deep endometriosis, the rectosigmoid being involved in about 90% of cases of bowel infiltration. Transvaginal sonography (TVS) and magnetic resonance imaging (MRI) have been used for noninvasive diagnosis and preoperative mapping of rectosigmoid endometriosis (RE), but no consensus has been reached so far regarding which method is the most accurate in this setting. Objective We aimed at performing a systematic review and meta-analysis to compare the accuracy of TVS versus MRI in the diagnosis of RE in a same population. Methods A systematic review was conducted in accordance with the PRISMA guidelines. Studies were identified by searching the MEDLINE, Embase, and LILACS databases, as well the reference lists of retrieved articles, through February 2019. We included all cross-sectional studies that evaluated the accuracy of TVS versus MRI in the diagnosis of RE within a same sample of subjects and that used surgical findings with histological confirmation as the gold standard. The QUADAS-2 instrument was used to evaluate study quality. Sensitivity, specificity, positive likelihood ratios (LR+), and negative likelihood ratios (LR-) for the diagnosis of RE were calculated. This study is registered with PROSPERO, number CRD42017064378. Results Eight studies ( n = 1132) were included in the meta-analysis. The pooled sensitivity, specificity, LR+, and LR- values of MRI for RE were 90% (95% CI, 87–92%), 96% (95% CI, 94–97%), 17.26 (95% CI, 3.57–83.50), and 0.15 (95% CI, 0.10–0.23); values of TVS were 90% [95% CI, 87–92%], 96% (95% CI, 94–97%), 20.66 (95% CI, 8.71–49.00) and 0.12 (95% CI, 0.08–0.20), respectively. Areas under the S-ROC curves (AUC) showed no statistically significant differences between MRI (AUC = 0.948) and TVS (AUC = 0.930) in the diagnosis of RE ( P = 0.13). Moreover, considering the average prevalence among the studies of 47.3%, both methods demonstrated similarly high positive post-test probabilities (93.9% for TVS and 94.8% for MRI), and the combined use of them yielded a post-test probability of 99.6%. Conclusion MRI and TVS have similarly high accuracy and positive post-test probabilities in the noninvasive diagnosis of RE. Combination of MRI and TVS may increase even further the positive post-test probabilities to near 100%.

Background Laparoscopic cystectomy is currently considered the gold standard for the treatment of ovarian endometrioma, resulting in an improvement in symptoms, a lower recurrence rate, and a higher pregnancy rate among infertile patients. However, this treatment is not free from risk, since it is associated with a reduction in ovarian reserve. There is still controversy in the literature regarding whether the cause of the reduction in ovarian reserve is due to damage caused by the coagulation energy during hemostasis or whether the procedure itself is the cause of the damage irrespective of the hemostatic method used. The aim of this study is to compare the effects of different hemostatic methods on the ovarian function of women subjected to laparoscopic surgery for ovarian endometrioma. Methods An open-label randomized clinical trial to be conducted at the Lauro Wanderley University Hospital between December 2017 and August 2020. Eighty-four patients will be randomly allocated to three groups according to the hemostatic technique used during laparoscopic surgery for ovarian endometrioma: bipolar coagulation; laparoscopic suture; and hemostatic matrix. Ovarian function will be assessed by serum anti-Müllerian hormone measurement and by performing an antral follicle count using ultrasound before surgery and one, three, and six months after surgery. The internal review board of the Medical Sciences Center, Federal University of Paraíba approved the study protocol under reference CAAE 71621717.9.0000.8069. Discussion Bearing in mind the need for more randomized clinical trials to clarify this issue, we hope to contribute with data that will determine whether there is any difference between hemostatic methods despite the rational use of bipolar energy or whether the procedure itself explains the ovarian damage irrespective of the hemostatic technique used. Trial registration ClinicalTrials.gov, NTC03430609 . Registered on XX.10/31/2017. ISRCTN Registry, ISRCTN11469394 . Registered on XX.17/12/2017. Unique Protocol ID: U1111–1203-2508.