Mestrado em Ciências da Saúde (FM)
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Navegando Mestrado em Ciências da Saúde (FM) por Por Orientador "Approbato, Mário Silva"
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Item Prevalência da Chlamydia trachomatis pela técnica de reação em cadeia da polimerase (pcr) em mulheres inférteis(Universidade Federal de Goiás, 2012-04-04) Approbato, Fabiana Carmo; Approbato, Mário Silva; http://lattes.cnpq.br/3408700658976397; Approbato, Mário Silva; Amaral, Waldemar Naves do; Ferreira, Rui GilbertoThe Chlamydia trachomatis is a common factor of sexually transmitted diseases. If not treated it can induce tubal obstruction, ectopic pregnancy and infertility. In adolescent women, the prevalence can reach 30%. When look for infertility treatment, the women are at older age, so they are at a different prevalence of Chlamydia. Objectives: To evaluate the prevalence of Chlamydia trachomatis by PCR, enzyme immunoassay or indirect immuno fluorescence at infertile patients. Methods: Design: Prevalence study. Diagnoses Test. Setting: Reproductive Laboratory (LABREP) - HC / UFG and Mater Clinic of Obstetrics and Gynecology, Goiânia, Brazil. Patients: One hundred and twenty patients attended from 2011 to 2012, from 20 to 48 years old. Main Outcome Measures: Age frequency histogram, exposition to pregnancy time, Chlamydia prevalence, Odds ratio for tubal obstruction, ectopic pregnancy and others STDs (Sexually Transmitted Diseases). It was calculate the age histogram frequency, and pregnancy exposition time. We used Chi Square statistical for Odds risk to tubal obstruction for serum positive patients; the Odds risk to ectopic pregnancy for serum positive patients and Odds risk to others STDs for serum positive patients. The rejection p was 5 % (p = 0.05). The Statistical Software used was BioEstat® and excel®. The study was submitted and approved by ethics committee of Clinical Hospital of Federal University of Goias State, Brazil. Results: The patients average age was 33.2 years, above of adolescent age prevalence, when chlamydia is frequently found. The average of exposition to pregnancy was 48.6 months. The PCR Chlamydia detection was less than 1 % (0.83 %). The Chlamydia PCR prevalence for serum positive was 2.4 % (one patient). We did not found Positive PCR between serum negative patients. The Odds to tubal obstruction for serum positive patients was 2.5. This was statistically significant. The Odds Ratio to ectopic pregnancy for serum positive patients was 1.31. This was not statistically significant. The Odds Ratio to others STDs for serum positive patients was 4.1 (p = 0.024). The Odds Ratio to ectopic pregnancy for tubal obstruction was 19.1. This was highly significant (p = 0.001). The NNT was 42. Conclusions: We conclude that C. trachomatis has a very low frequency at this population ( < 1 %), but heavy sequels of infection stays. The average age of the infertile patients was 33.2 years, above of the age mean of adolescents. We found association of positive serology screening and statistically significant risk for tubal obstruction, ectopic pregnancy and to others STDs.Item Efeito da orientação para perda de peso em pacientes inférteis com sobrepeso e obesidade(Universidade Federal de Goiás, 2022-01-27) Benetti, Beatriz Bacheschi do Carmo; Approbato, Mário Silva; http://lattes.cnpq.br/3408700658976397; Approbato, Mário Silva; Moraes, Alexandre Vieira Santos; Barbosa, Maria AlvesIntroduction: Obesity is considered a worldwide epidemic, being a serious public health problem. Overweight and obesity are characterized by the accumulation of body fat that poses a health risk. Several pathophysiological disorders are caused by obesity, especially in people with Body Mass Index (BMI) above 30 kg/m². It is increasingly common among women of childbearing age. Obese women are three times more likely to suffer from infertility than women with a normal body mass index. Objective: Evaluate the response to weight loss guidance in anthropometric parameters of obese and overweight infertile patients undergoing assisted fertilization treatment (high and low complexity). Methods: Retrospective cohort. A survey was carried out of a population of overweight and obese infertile patients one to two years after the first visit. In the first consultation at the assisted reproduction clinic (Human Reproduction Laboratory HC / UFG) as obese and overweight patients were instructed to lose weight and information that excess weight could decrease as chances of being successful in the treatment. As endocrine variables, estradiol, FSH, and LH were evaluated between obese and overweight patients in relation to normal weight patients. Proportions were compared using the chi-square test. Medians with the Mann-Whitney test. The H0 Rejection Level was 5%. Results: The age of the patients and the values of FSH, LH and estradiol were evaluated and paired, it was then verified that all presented p>0.05 after the adjustments. The age range of patients ranged from 21 to 40 years, with a mean of 35.59 ± 3.23 for the group with normal BMI and 35.78 ± 3.70dp for the group classified as overweight and obese. The mean weight in kg before and after orientation was 77.11±11.77 and 78.98±12.86 (p<0.0046). The mean BMI (kg/m²) before guidance was 29.69 ± 3.75dp and after guidance was 30.42 ± 4.32 (p<0.0038). Regarding ovulation, 31.6% of patients who lost weight did not ovulate compared to 20.0% of patients who gained weight. Patients who maintained their weight (16.7%) did not ovulate compared to 20.0% of patients who gained weight. Statistically non-significant difference. As for the endocrine variables, FSH, LH and estradiol, when comparing the population with normal weight with the population with overweight and obesity, no significant differences were found. Conclusions: There was a low percentage of weight loss in the patients, as only 37.5% achieved this goal. A greater number of patients gained or maintained their initial weight. Regarding ovulation, no significant associations were found when comparing patients who lost weight and those who gained weight, and also patients who maintained their weight compared to those who gained weight. As for the endocrine variables, in this study, the influence of obesity or overweight on these variables was not detected. The main diagnosis of infertility was bilateral tubal obstruction due to tubal ligation and other causes. Regarding the type of infertility, it was observed that cases of the primary type were the most frequent.Item Infertilidade masculina: com oligozoospermia estudo citogenético em indivíduos ou azoospermia(Universidade Federal de Goiás, 2015-02-05) Curado, Roberta Machado de Oliveira Frota; Bérgamo, Nádia Aparecida; http://lattes.cnpq.br/2282798263482973; Approbato, Mário Silva; http://lattes.cnpq.br/3408700658976397; Approbato, Mário Silva; Bérgamo, Nádia Aparecida; Ribeiro, Lucilene Arilho; Santos, Sônia de Fátima Oliveira; Silva, Hugo Delleon daMale infertility affects about half of couples with infertility history and is considered a multifactorial syndrome, including a broad spectrum of diseases. Chromosomal abnormalities are a major cause of human infertility and interfere with spermatogenesis. Infertility in patients with Klinefelter's syndrome (KS) is a consequence of degeneration of germ cells and that affects about 4% of infertile men. Objective: To investigate the presence of chromosomal abnormalities in infertile men with azoospermia or oligozoospermia seen at the Human Reproduction Laboratory of the Hospital das Clinicas (LabRep -HC) of the Federal University of Goiás, in 2013. Methodology: Descriptive study. Metaphases were analyzed in GTG bands obtained from lymphocytes cultures of 20 infertile men idiopathic causes. Results: The patients' ages ranged from 26-59 years and the design attempts ranged on average of 5 (± 5.02) years. In 3/20 (15%) patients were found karyotype 47, XXY (SK) and the rest, 17/20 patients had a normal karyotype. Conclusion: Genetic testing can help identify which patients would benefit from the technical reproduction. These studies are relevant because the assisted reproduction techniques ignore the process of natural selection and some classic chromosomal abnormalities end some deleterious mutations that could through generations. Thus, genetic assessment can lead to genetic counseling and hence the primary and secondary prevention of congenital defects in offspring of patients with male infertility. This study helps to assess the prevalence of chromosomal abnormalities in some men treated at LabRep - HC UFG.