Validación del índice de fertilidad en endometriosis (EFI) para predecir el embarazo en una población infértil / Validation of fertility index in endometriosis (EFI) to predict pregnancy in an infertile population

Objetivo: Determinar si el Índice de Fertilidad en Endometriosis (EFI) es útil para estimar el pronóstico reproductivo en pacientes infértiles con diagnóstico y tratamiento quirúrgico de endometriosis. Diseño: Estudio de cohorte retrospectivo. Material y Métodos: Se analizaron las historias clínicas de 65 pacientes que consultaron por infertilidad entre Abril de 2011 a Septiembre de 2014 a las cuales se les realizó una videolaparoscopía diagnóstica con los mismos operadores quirúrgicos y con hallazgo de endometriosis. Se excluyeron del análisis todas aquellas pacientes que presentaban factor masculino severo, factor uterino y que realizaron tratamientos de alta complejidad. Los datos de los factores quirúrgicos para la categorización de las pacientes según el EFI fueron obtenidos a través de la visualización de videos de las laparoscopías y los factores históricos se recolectaron de las historias clínicas. Se evaluó la tasa de embarazo luego de 18 meses de seguimiento. Se subdividieron a las pacientes según los valores de EFI obtenidos en 3 grupos y se compararon las tasas acumulativas de embarazos entre dichos grupos. Resultados: La edad promedio de las pacientes fue de 33,5 años (SD=2,7). El tiempo de infertilidad promedio fue de 2,8 años (SD=1,5), y el tipo de infertilidad primaria representó el 80 % de las pacientes. La tasa total de embarazo fue de 47,7%, y según la clasificación del EFI fue 12,5% en el grupo 1, 35,7% en el grupo 2 y 69% en el grupo 3, presentando una tendencia lineal estadísticamente significativa (p=0,002). Conclusiones: Se observó que la probabilidad de embarazo espontáneo o con tratamiento de baja complejidad dentro de los 12 meses posteriores a la laparoscopía fue aumentando significativamente a medida que aumentaba la categorización del EFI. Esto nos permite considerar al EFI como una herramienta útil para estimar el pronóstico reproductivo de las pacientes infértiles con diagnóstico de endometriosis.

Objective: To determine if Endometriosis Fertility Index (EFI) is useful to estimate the reproductive outcome in infertile patients with diagnosis and surgical treatment of endometriosis. Design: Retrospective cohort study. Material and Methods: The medical records of 65 patients who consulted for infertility from April 2011 to September 2014 which underwent a diagnostic videolaparoscopy with the same surgical operators and findings of endometriosis were analyzed. All those patients with severe male factor, cervical factor and those who underwent high complexity treatments were excluded from the analysis. Data from surgical factors for categorization of patients according to EFI was obtained from videos of laparoscopy, and historical factors were collected from medical records. The pregnancy rate was evaluated after an 18- month follow-up. Patients were divided according to EFI values obtained in 3 groups, and cumulative pregnancy rates among these groups were compared. Results: The mean age of the patients was 33.5 years (SD = 2.7). The mean infertility time was 2.8 years (SD = 1.5), and primary infertility accounted for 80% of the patients. The total pregnancy rate was 47.7%, being 12.5% in group 1, 35.7% in group 2 and 69% in group 3. Conclusions: It was observed that in patients with higher EFI category, the probability of spontaneous pregnancy or low complexity treatment was increased within 12 months after laparoscopy, in a statistically significant way (p = 0.002). This allows us to validate the EFI as a useful tool to estimate the reproductive prognosis of infertile patients diagnosed with endometriosis.

Eficácia do selamento provisório de três materiais restauradores ante a solução de nitrato de prata a 50% / Effectiveness of the temporary sealing of three restorative materials to the 50% silver nitrate solution

Introdução e objetivo: Este estudo teve como objetivo analisar três materiais restauradores provisórios, Coltosol®, Cavit® W e Cimpat®,quanto a sua capacidade seladora ante a solução de nitrato de prata a50%. Material e métodos: Trinta corpos de prova foram divididos em três grupos experimentais. Cada amostra continha em seu interior um disco de antibiograma com 5 mm de diâmetro e 1 mm de espessura e,sobre o disco, 4 mm de um dos três materiais. Depois de realizadas as restaurações, os corpos de prova foram colocados em recipientes contendo nitrato de prata a 50%, sendo levados à estufa a 37ºC, na qual permaneceram por 7 dias. Decorrido esse período e comos materiais restauradores removidos, foram feitas as análises dos discos de antibiograma, que receberam escores conforme a infiltração.Resultados e conclusão: Os dados obtidos foram submetidos ao teste estatístico não-paramétrico Kruskal-Wallis, ao nível de significância de 5%. Os resultados mostraram que o Cimpat® apresentou os maioresníveis de infiltração. Já o Coltosol® e o Cavit® W não diferiram entre si (p > 0.05).

Introduction and objective: The aim of this study was to analyze three temporary restorative materials Coltosol®, Cavit® W and Cimpat®, concerning their sealing capacity to the 50% silver nitrate solution.Material and methods: 30 samples were divided into 3 experimental groups. Inside of each sample there was an antibiogram disc with 5mm of diameter and 1 mm of depth, with 4 mm of one of the three sealing materials on it. After restorations, the samples were insertedinto recipients with 50% silver nitrate solution, which were taken to theheater at 37ºC, where they remained for 7 days. Following this period and with the restorative materials removed, antibiogram disc analyses were performed, which were scored according to the leakage. Results and conclusion: Data obtained were submitted to the Kruskal-Wallisnon-parametric statistical test, with a level of significance of 5%. Results showed that Cimpat® had the greatest levels of leakage, while Coltosol® and Cavit® W did not differ between themselves (p > 0.05).