Association of 2D and 3D transvaginal ultrasound findings with adenomyosis in symptomatic women of reproductive age: a prospective study.

OBJECTIVE: To evaluate the association of two-dimensional (2D) and three-dimensional (3D) transvaginal ultrasound (TVUS) findings with adenomyosis symptoms. METHODS: This prospective study conducted between January and December 2018 enrolled 78 women aged 18 to 40 years with abnormal uterine bleeding (AUB), infertility, and/or pelvic pain. All patients underwent 2D and 3D TVUS. Signs of adenomyosis on TVUS were identified according to the consensus of the Morphological Uterus Sonographic Assessment group. RESULTS: The prevalence of adenomyosis on TVUS was 55.12%. Patients with adenomyosis were older (p=0.002) and had more dysmenorrhea, AUB, and endometriosis than those without adenomyosis. When comparing the presence of symptoms with each adenomyosis feature, on 2D TVUS, severe dyspareunia was significantly associated with the presence of a poorly defined junctional zone (JZ) (p=0.023) and on 3D TVUS, patients with AUB had a more irregular (p=0.003), poorly defined (p=0.028), and interrupted JZ (p=0.011). After logistic regression analysis, signs of adenomyosis on TVUS remained significantly associated only with age over 30 years (OR: 1.2; 95% CI: 1.0-1.2) and AUB (OR: 7.65; 95% CI: 2-29). Patients with diffuse adenomyosis were older and presented with more infertility and AUB than patients with focal or no adenomyosis. CONCLUSION: The findings of adenomyosis by 2D and 3D TVUS showed association with age and AUB. 3D TVUS alterations in the JZ were associated with AUB and dyspareunia. Diffuse adenomyosis was associated with older age, a greater prevalence of infertility, and AUB.

The influence of upflow velocity and hydraulic retention time changes on taxonomic and functional characterization in Fluidized Bed Reactor treating commercial laundry wastewater in co-digestion with domestic sewage.

A large-scale (19.8L) Fluidized Bed Reactor (FBR) operated for 592 days was used to assess the removal performance of linear alkylbenzene sulfonate (LAS). Adjustments in hydraulic retention time (HRT) (18 and 30 h), ethanol (50, 100, 200 mg L-1) and linear alkylbenzene sulfonate (LAS) concentration (6.3-24.7 mg L-1) with taxonomic and functional characterization of biomass using Whole Genome Shotgun Metagenomic (WGSM) represented a major step forward for optimizing biological treatments of LAS. In addition, the variation of the upflow velocity (0.5, 0.7 and 0.9 cm s-1) was investigated, which is a parameter that had not yet been correlated with the possibilities of LAS removal in FBR. Lower Vup (0.5 cm s-1) allied to higher ethanol concentration (200 mg L-1) resulted in lower LAS removal (29%) with predominance of methanogenic archaea and genes related to methanogenesis, while higher Vup (0.9 cm s-1) led to aerobic organisms and oxidative phosphorylation genes. An intermediate Vup (0.7 cm s-1) and higher HRT (30 h) favored sulfate reducing bacteria and genes related to sulfur metabolism, which resulted in the highest LAS (83%) and COD (77%) removal efficiency.

Is High-intensity Focused Ultrasound Effective for the Treatment of Adenomyosis? A Systematic Review and Meta-analysis.

STUDY OBJECTIVE: To systematically review the literature regarding the efficacy of high-intensity focused ultrasound (HIFU) in reducing adenomyotic lesions, patients' pain and bleeding symptoms, and the impact on patients' quality of life. DATA SOURCE: A search was performed through PubMed/MEDLINE and Cochrane databases. METHODS OF STUDY SELECTION: All available studies published in the English language in the last 10 years that evaluated the effects of HIFU for adenomyosis. TABULATION, INTEGRATION, AND RESULTS: A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A meta-analysis was performed on data from homogeneous studies. Pooled results from the meta-analysis showed that after HIFU treatment for adenomyosis, a large effect was observed in reducing the uterine volume at 12 months (standard mean difference [SMD] = 0.85), a significant reduction in dysmenorrhea at 3 months (SMD = 1.83) and 12 months (SMD = 2.37), and a significant improvement in quality of life at 6 months (SMD = 3.0) and 12 months (SMD = 2.75). Adverse reactions after HIFU were reported in 55.9% of patients. CONCLUSION: This review suggests a potential benefit for HIFU in the treatment of adenomyosis-related symptoms; however, findings of the meta-analysis were based on fewer, nonuniform studies, which did not equally account for each specific symptom/parameter across the board. Results showed there appears to be a potential of HIFU in the treatment of adenomyosis-related symptoms. To date, there are no comparative and randomized clinical trials comparing the HIFU technique with other conservative treatment options. As yet, there are insufficient data regarding fertility and pregnancy outcomes.

O uso da homeopatia para prevenir sintomas da gripe humana e infecção respiratória aguda: um estudo clínico duplo cego, randomizado, placebo controlado com 600 crianças do Serviço Público de Sáude do Brasil / The use of homeopathy to prevent symptoms of human flu and acute respiratory infections: a double-blind, randomized, placebo-controlled clinical trial with 600 children from Brazilian Public Health Service

In Brazil, homeopathy was implemented in the Public Health Service through the National Policy on Complementary and Integrative Practices of the Health Ministry, published in 2006. Homeopathy appears as a very interesting therapy to be used in the Public Health Services since its medicines are compounded at a very low cost. Considering this interesting scenario to develop research in the Public Health, the Family Health Program (FHP) in Petropolis and the Faculty of Pharmacy at UFRJ started a partnership with the Roberto Costa Institute.(AU)

No Brasil, a homeopatia foi implementada no Serviço Público de Saúde, através da Política Nacional de Práticas Integrativas e Complementares do Ministério da Saúde, publicada em 2006. A homeopatia surge como uma terapia muito interessante para ser usada no serviço público de saúde uma vez que seus medicamentos tem um custo muito baixo. Considerando este cenário interessante para desenvolver uma pesquisa em Saúde Pública, o Programa de Saúde da Família (PSF) de Petrópolis e a Faculdade de Farmácia da UFRJ iniciaram uma parceria com o Instituto Roberto Costa. (AU)