Diagnóstico de síndrome pré-menstrual: um estudo comparativo entre o relato diário da gravidade dos problemas (DRSP) e o instrumento de rastreamento de sintomas pré-menstruais (PSST) AbstractObjective To validate the premenstrual symptoms screening tool (PSST) in relation to the daily record of severity of problems (DRSP) for premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) diagnoses. Methods A cross-sectional study with 127 women (20-45 years) with PMS complaints. The women were evaluated in terms of weight, height and body mass index (BMI). After using the primary care evaluation of mental disorders (PRIME-MD) questionnaire to exclude the diagnosis of depression, the PSST was completed and the women were instructed to fill out the DRSP for two consecutive menstrual cycles. The agreement between the two questionnaires was assessed by the Kappa (k) and the prevalence-adjusted, bias-adjusted kappa (PABAK) values.Results Two-hundred and eighty-two women met the eligibility criteria and answered the PSST. The DRSP was completed for two cycles by 127 women. The percentages of women with PMS and PMDD diagnoses by the DRSP were 74.8% and 3.9% respectively; by PSST, the percentages were41.7% and 34.6% respectively. The number of patients considered "normal" (with symptoms below the threshold for the diagnosis of PMS) was similar in both questionnaires. There was no agreement (Kappa ¼ 0.12) in the results of PMS/ PMDD diagnosis (the PABAK coefficient confirmed this result ¼ 0.39). The PSST had a high sensitivity (79%) and a low specificity (33.3%) for PMS/PMDD diagnosis.

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objective: Myocardial Performance Index (MPI) obtained by Doppler echocardiography for the non-geometrical evaluation of systolic and diastolic function has been described as a method for prognostic evaluation in patients with acute myocardial infarction (AMI). Using the same condition, the objective of this study was to evaluate the predictive value of MPI for cardiovascular complications in patients at low risk during the postoperative period of CABG. Methods:Eighty patients submitted to CABG with adequate left ventricular function in the preoperative period were studied, with MPI measured during the first hours postoperatively. Patients were followed until hospital discharge. Statistical analysis included Chi-Square test, Student t test, Mann-Whitney test, and estimation of relative risks with 95% confidence intervals, sensitivity and specificity plus a ROC curve. results:The data were evaluated by two independent observers blinded to the clinical data with non-significant intra and interobserver variability. MPI=0.43 was found as the cutoff point, considering patients with a higher probability of postoperative events those who had MPI above 0.43. The relevant events for analysis were AMI (RR 0.87 ci 0.21-3.65), atrial fibrillation (RR 0.65 ci 0.24 -1.76), other arrhythmias (RR 1.51 ci 0.36-6.33), LV dysfunction (RR 1.74 ci 0.32-9.88), with no association between patients with MPI>0.43 and the occurrence of these events. conclusion:No association was found between MPI and cardiovascular complications and longer hospital stay in this group of patients, and this index was considered not adequate as an isolated predictive method.Key words: Coronary artery bypass graft, low risk, morbidity, myocardial performance index (MPI) and prognostic outcome.The post-surgical morbimortality of coronary artery bypass graft (CABG) surgery is of great interest, resulting in several protocols of post-operative management and risk models aiming at decreasing cardiovascular complications 1 .The presence of left ventricular dysfunction and cardiac failure in the postoperative period of CABG has been considered one of most important independent predictive factors of surgical mortality [2][3][4][5] , with an association between the severity of the left ventricular dysfunction and risk of complications (4% to 10% for moderate to severe ventricular dysfunction) 3 .Cardiac surgery complications in patients with adequate left ventricular function in the pre-operative period have a low prevalence 2 ; therefore, they are hardly studied. In this group, the identification of alterations in the overall function of the left ventricle in the immediate post-operative period would allow early interventions, resulting in lower surgical morbimortality 6,7 .Non-invasive measurements of time intervals used for the assessment of the systolic and diastolic functions were proposed by Mancini 8 through phonomechanocardiography and reintroduced by Tei et al 9 in 1995 and showed to be easily obtained by conventional Doppler, with time intervals, combining...

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M.M, 95-year-old Japanese woman, 6 vaginal deliveries, presented a 20 days fetid vaginal smell/5 months mild vaginal bleeding. Well appearing, oriented and coherent. Physically active, having a controlled mild hypertension as the only comorbidity. Vaginal exame, identified a foul smelling from the cervix. A transvaginal ultrasound revealed anteverted/flexed uterus, and the endometrial cavity had cystic/solid content, without vascularity in doppler. Endometrial biopsy was performed and the hypothesis of neoplastic cells was discharged. It was indicated a total vaginal hysterectomy.  There were no complications. The correct anesthetic dose provided lower risk and a better outcome. In the first 12 hours, a pre-renal acute renal failure was reversed. The hospital discharge was after 2 days, when the patient had no pain, was walking and urinating.  Only dipyrone was used as analgesic and 14 days of clindamycin was prescribed. After a month, no complaints/pain were reported. The patient returned to her daily habits and to social contact in a short time, indicating a good evolution. The surgery highly improved the patient’s quality of life.