Mestrado em Ciências da Saúde (FM)
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Navegando Mestrado em Ciências da Saúde (FM) por Por Orientador "APPROBATO, Mario Silva"
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Item Obstrução tubária em mulheres com imunofluorescência indireta para clamídia(Universidade Federal de Goiás, 2011-03-02) MAIA, Monica Canedo Silva; FLORENCIO, Rodopiano de Souza; http://lattes.cnpq.br/2885969465874052; APPROBATO, Mario Silva; http://lattes.cnpq.br/3408700658976397Background: Actually the Chlamydia trachomatis is responsible for the major number of cases of sexual transmitted bacterial infections. The likelihood of tubal damage in infertile women is associated to the evidence of chlamydia infection. Objectives: To evaluate the ability of indirect immunofluorescence for Chlamydia trachomatis on tubal occlusion and to establish the cutoff point (best sensitivity and specificity) of antibodies IgG titres (indirect immunofluorescence) to detect tubal occlusion (ROC curve). Methodology: This is a retrospective study with 204 electronic records of patients attended at a university and private infertility center in the city of Goiania, in the period of 2006 to 2009. Patients had 17 to 47 years old. To evaluate the risk of tubal occlusion the patients were divided into two groups: patients exposed to chlamydia (significant IFI ≥ 1:16) e unexposed (no significant IFI < 1:16). It was verified patients who had the disease (tubal occlusion) and not sick (without tubal occlusion) in the hysterosalpingography. For the calculations the Chi-square (χ2) were used, corrected to small samples (Fisher Exact Test) when necessary. The p chosen level was 0.05. The ROC curve was calculated with BioEstat® software, using the standard methodology. This study was submitted and approved by Ethics Committee of Hospital Clinics of the Federal University of Goias.Results: Of the 72 patients with significant titres, 34 (47,2%) showed the occurrence of tubal occlusion. In relation the 132 patients with no significant titres, only 18 (13,7%) had tubal occlusion (p < 0,001). We also observed a progressive increase in the levels of antibodies and the likelihood of tubal occlusion (p < 0,001). The best cutoff point of the ROC curve with the titre was 1:64. However, we believe that we can continue using a cutoff titre to ≥ 1:16 by interfering little in sensitivity and specificity and because it is currently used in the Clinical Laboratory of Hospital Clinics. Conclusions: The results indicate that serology for Chlamydia trachomatis (indirect immunofluorescence) is valid for screening of tubal damage. We also showed that the best cutoff (ROC) indirect immunofluorescence to detect tubal occlusion is 1:64, but between 1:16 and 1:64 there is a slight change in sensitivity and specificity.Item Efeito do ácido fólico nos principais parâmetros do espermograma de homens subférteis(Universidade Federal de Goiás, 2012-07-06) SILVA, Tatiana Moreira da; APPROBATO, Mario Silva; http://lattes.cnpq.br/3408700658976397Research shows that oral supplementation with antioxidants can reduce the damage caused by reactive oxygen species and increase the fertilizing capacity of sperm due to improvement in semen parameters. Semen analysis was assessed according to the criteria of the World Health Organization (1999), subfertile men who received folic acid at a dose of 5 mg/day or placebo, comparing results before and after treatment. A total of 49 patients aged 23-56 years (mean 35.3 years) and diagnosis of subfertility were randomized into two groups. The treated group (n= 23) receiving folic acid and the control group (n= 26) received placebo, each for 3 months. Before the intervention, the mean sperm concentration (x106/mL) in the treated group was 25.91 and 26.08 after treatment. In the control group was: 20.85 pre-treatment and 20.04 after treatment (p= 0.92). Means of progressive motile sperm obtained from the treated and placebo groups before treatment were, respectively: 46.48% and 49.23%. After the intervention, the mean values found were 48.26% in the treated group and 49.65% in the control group (p= 0.99). The mean normal sperm morphology was 23.26% in the treated group pre-intervention, and later was 23.91%. The control group had an average of 22.3% and 24.23%, respectively (p= 0.83). Mean vitality found in the treated group was 66.73% before the treatment and 69.56% after the treatment with folic acid. In the control group was 65.77% after pre-treatment and 65.38% was not significant (p= 0.95). Numerous studies have evaluated the use of antioxidants for improving sperm quality and thus fertility. These substances are used individually or in combination, and differ in the type, the target population, dosage and duration of therapy. This study showed that folic acid at a concentration of 5 mg / day did not improve sperm parameters in subfertile men compared to the control group.