Effect of conjugated estrogen versus conjugated estrogen associated with medroxyprogesterone acetate in postmenopausal women on internal carotid artery pulsatility index: a randomized pilot study.

AIM: To compare the effect of conjugated estrogen (CEE) versus conjugated estrogen and medroxyprogesterone acetate (MPA) therapy on internal carotid artery pulsatility index (PI) in postmenopausal women. MATERIAL & METHODS: In the prospective, randomized, single-blinded comparative study, postmenopausal women meeting the inclusion criteria were randomized into one of two groups: CEE group (CEE 0.625 mg/day), or CEE + MPA group (CEE 0.625 mg/day plus MPA 2.5 mg/day). Patients were submitted to blood tests (total cholesterol, high-density lipoprotein cholesterol, triglycerides and total glucose) and to color Doppler ultrasound of the internal carotid artery to assess PI at the beginning of the study. Ultrasound was repeated after 16 weeks of treatment. Statistical analysis was performed using Student's t-test or two-way analysis of variance for repeated measures. Data were considered to be significant at P < 0.05. RESULTS: Seventy-five postmenopausal women (age 53.3 ± 5.5 years) were included in the study. There was a statistically significant reduction in PI in both groups after 16 weeks of hormonal treatment. However, there was no difference between the two groups (group 1: 0.8960 to 0.8450; group 2: 0.9048 to 0.8426). CONCLUSION: The use of CEE and CEE associated with MPA during 16 weeks led to an improvement in internal carotid flow as measured by PI, with no difference between the treatments.

Tratamento de abscessos intra-abdominais por punçäo percutânea sov orientaçäo ecográfica / Treatment of abdominal abscesses by ultrasound guided percutaneous drainage

Abscessos abdominais, quando näo tratados precoce e adequadamente, apresentam índices elevados de morbidade e mortalidade. Nos últimos anos, a punçäo percutânea tem sido preconizada como método terapêutico de primeira escolha no tratamento destas patologias. Os autores relatam 11 casos de pacientes com abscessos abdominais que foram tratados primariamente com punçäo percutânea sob orientaçäo ecográfica. Na maioria eram pacientes em estado grave, em pós operatório e com outras doenças associadas. A punçäo percutânea foi efetiva em 7 dos 11 casos estudados. Em um caso houve complicaçäo atribuída ao procedimento: sinais de bacteremia. Näo houve mortes relacionadas diretamente com o procedimento. Säo discutidos aspectos de técnica, contra-indicaçöes e vantagens do método em relaçäo a cirurgia