Endometriosis of the diaphragm has been gaining more attention in the practice of gynecologists and thoracic surgeons in recent years. Understanding related symptoms and developing imaging methods have improved their approach. A review of the literature was performed with the aim to report on incidence, diagnosis, treatment and prognosis of diaphragmatic endometriosis. We also cover the issue of the Thoracic Endometriosis Syndrome (TES). Complaints of cyclic chest pain in patients of childbearing age should have as differential diagnosis the presence of thoracic endometriosis. Catamenial pneumothorax is the main manifestation of diaphragmatic endometriosis and Thoracic Endometriosis Syndrome. Other possible manifestations are hemothorax, pulmonary nodules, and diaphragmatic hernia. Despite the possibility of drug treatment, many patients will be submitted to surgical treatment. The minimally invasive approach should be the one of choice. The robotic pathway allows for an easier approach due to its ability to articulate robotic arms, allowing the treatment of lesions in hard-to-reach locations, such as the posterior part of the diaphragm. Multidisciplinary treatment should be used in most cases, as only abdominal approach is not sufficient for the diagnosis and treatment of lesions in the thoracic cavity. The approach of endometriosis of the diaphragm and Thoracic Endometriosis Syndrome should be multidisciplinary, allowing the improvement of quality of life in most patients.
The objective of this study was to identify the factors associated with the impairment of quality of life (QoL) in community-dwelling individuals with LUTS. A randomized sample of the population registered in the Family Health Program -Niterói aged 45 years or over was selected. Information about demographic, socioeconomic and lifestyle factors, co-morbidities and nocturia was collected. The NANDA-I taxonomy was used to identify the other LUTS, and QoL evaluation was performed in accordance with the SF-36 Short Form questionnaire (SF36-SF). For the SF36-SF domains (outcome) associated with LUTS, multiple logistic models were tested including the urinary symptoms and the sociodemographic and associated clinical variables. Stress urinary incontinence was associated with white skin, female gender, obesity, smoking, alcohol intake, depression and low scores in all evaluated domains of QoL. Nocturia was associated with advanced age, low schooling level, higher BMI, hypertension, diabetes, health insurance and the lowest scores in all evaluated domains of Qol, except for the Role Emotional. According to multivariate analysis, stress incontinence and depression are associated with the highest risks of low scores in General Health, Physical Functioning and Vitality domains, while nocturia and obesity showed association with the highest risks of low scores in Physical Functioning, Bodily-Pain and Vitality domains.
Identificar e descrever padrões sazonais de nascimento por parto normal e cesariana no Estado do Rio de Janeiro, no período de 01 de janeiro de 1994 a 31 de dezembro de 2005. Estudo de séries temporais com base de dados de nascimentos do Estado do Rio de Janeiro, obtidos do Sistema de Informação sobre Nascidos Vivos (SINASC), constituída por 1.535.752 nascimentos por parto normal e 1.481.111 nascimentos por cesariana. As séries temporais foram analisadas no domínio da frequência através do periodograma ou espectro e no domínio do tempo através de um modelo Bayesiano sazonal trigonométrico. A análise no domínio da frequência mostrou uma sazonalidade semanal e encontrou uma sazonalidade de 12 meses para ambas as vias de parto. As sazonalidades e tendências das series mensais foram estimadas pelo modelo Bayesiano. Os padrões sazonais mensais de nascimentos foram semelhantes em ambas as séries, com pico de nascimentos em março, abril e maio, e declínio constante nos meses subsequentes. A série temporal de nascimentos por parto normal possui uma tendência de decréscimo. A série temporal de nascimentos por cesariana manteve-se estável no período, apresentando tendência de decréscimos entre 1997 e 1999 e entre 2000 e 2003. Há uma sazonalidade anual dos nascimentos no Estado do Rio de Janeiro por ambas as vias de parto, com pico de nascimentos em março, abril e maio. Ambas as séries apresentaram também uma sazonalidade semanal. As séries temporais de nascimentos por parto normal e cesariana possuem tendências distintas.
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