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This study aimed to assess the cost-effectiveness of a remotely operated referral management system (RORMS) compared with a conventional referral management system (CRMS) in Brazil. This is a model-based cost-effectiveness analysis under the perspective of the Unified Healthcare System (Sistema Único de Saúde [SUS]) in Brazil. A Markov microsimulation model was developed to compare costs and referral outcomes of the RORMS and the CRMS. Model consisted of 4 states representative of sequential stepwise assessments of referral suitability, 3 states representative of referral outcomes, and 1 exit model state. Target population represented cases being referred from primary healthcare units to specialized care in SUS. Model inputs related to costs and effectiveness in the RORMS arm were obtained from the data set of a RORMS between July and December 2019. Model inputs for the CRMS model arm were obtained from administrative data sets of 2 Brazilian localities for the year 2019. Relative effect size of RORMS in comparison with CRMS in SUS was obtained from published studies. Effectiveness outcome was unnecessary referrals averted. The incremental cost-effectiveness ratio was calculated for the base case. Probabilistic sensitivity analysis was conducted. In the base-case analyses, RORMS dominated CRMS, with expected cost-savings from $50.42 to $80.62 per unnecessary referral averted. RORMS was the dominant strategy in 83.7% of 100 000 simulations in the probabilistic sensitivity analysis. In 16.2% of simulations, incremental cost-effectiveness ratio was between $0 and $222 per unnecessary referral averted. Model-based simulations indicate that the RORMS is likely to be cost saving in comparison with the CRMS. • The effects of a series of telehealth strategies, such as e-consultation and telediagnosis, have been investigated in previous studies. The findings of these studies suggest that the use of telehealth is cost-effective in different settings compared with conventional healthcare. • We performed a model-based cost-effectiveness analysis of a remotely operated referral management system using telehealth strategies compared with the conventional referral system currently in place in the universal health system in Brazil. Base-case analysis resulted in cost-savings from $50.42 to $80.62 per unnecessary referral averted. Probabilistic sensitivity analysis suggested that the remotely operated referral management system is a dominant strategy or, in the worst scenario, cost-effective. • Our findings provide relevant information for the decision making related to the design of referral management systems to specialized care in universal health systems. Telehealth strategies should be considered to optimize qualification of referrals and reduce costs. [ABSTRACT FROM AUTHOR]

In 2019, based on the publication of Law No. 13,812/2019, the National Policy on the Search for Missing Persons was created in Brazil. In this context, on March 2, 2020 the Steering Committee of the Integrated Network of DNA Databases (RIBPG) created the Working Group on Genetic Identification of Missing Persons. In 2021, the first National Campaign for the Collection of DNA from Relatives of Missing Persons was launched. This action provided the collection of relatives of more than 1700 missing people throughout Brazil. Since the beginning of the work, the number of genetic profiles related to the search for missing persons has increased by 216 % in the National DNA Database. So far, RIBPG has already managed to solve 223 disappearances throughout Brazil. [ABSTRACT FROM AUTHOR]

• Grina/TMBIM3 interacts with the N-type Cav2.2 calcium channel alpha1 subunit. • Grina/TMBIM3 modulates current through Cav2.2 calcium channel. • Modulatory effects are comparable to effects of G-protein βγ subunits. Grina/TMBIM3 is a poorly characterized transmembrane protein with a broad expression pattern in mammals and with a very ancient origin within eukaryotes. Although initially characterized as an NMDA-receptor associated subunit, there is increasing evidence that Grina/TMBIM3 is involved in the unfolded protein response and controls apoptosis via regulation of Ca2+ homeostasis. Here, we investigate a putative direct interaction of Grina/TMBIM3 with voltage gated Ca2+ channels, in particular with the Ca V 2.2 α1-subunit and describe its modulatory effects on the current through Ca V 2.2 N-type channels. Direct interaction was confirmed by co-immunoprecipitation studies and membrane localization was proven. Co-expression of Grina/TMBIM3 with Ca V 2.2 channels resulted in a significant decrease of the current amplitude and in a slowing of the kinetics of current activation. This effect was accompanied by a significant shift of the voltage dependencies of activation time constants towards more depolarized voltages. Application of a stimulus protocol including a strong depolarizing pulse relieved inhibition of current amplitude by Grina/TMBIM3. When Grina/TMBIM3 was present, inactivation by an action potential-like train of pulses was diminished. Both observations resemble mechanisms that are well-studied modulatory effects of G-protein βγ subunits on Ca V 2 channels. The impact of Grina/TMBIM3 and G-protein βγ subunits are rather comparable with respect to suppression of current amplitude and slowing of activation kinetics. Furthermore, both modulators had the same effect on current inactivation when evoked by an action potential-like train of pulses. [ABSTRACT FROM AUTHOR]

Background: Self-medication and the belief that herbal products are free of health risks are common in Brazil. The kava (Piper methysticum), known for its anxiolytic action, has a widespread popular use. Hepatotoxicity of kava is reported, including cases of liver transplantation and death. The kava had its use prohibited or restricted in countries like Germany, France, among others. Toxicity may be related to overdosage; however, factors such as botanical characteristics of the plant, the harvesting, storage, and production process may be associated with the development of hepatotoxic substances, such as triggering idiosyncratic reactions.Hypothesis: In this case, there is a suspicion that the toxicide is intrinsic to the drug; however, the possibility of adulterants and contaminants must be ruled out.Study Design: This study reports the case of a patient who, after using the herbal kava for 52 days, evolved into acute liver failure and liver transplantation.Methods: The data were collected directly with the patient and compared with their clinical records. Causality was determined through the RUCAM algorithm. In addition, a phytochemical analysis of the drug used was performed.Results: According to the patient's report, there is no evidence of overdosage. Results from RUCAM algorithm infer causality between liver damage and the use of kava. The analysis chemical constituents did not find any possible contaminants and major changes in the active compounds. Seven months after transplantation, the patient is well and continues to be followed up by a medical team.Conclusion: Our investigation indicates that there was kava-induced hepatotoxicity at standard dosages. In Brazil, self-medication by herbal medicines is frequent and many patients and health professionals do not know the risks associated with their use. Diagnosing and notifying cases in which plants and herbal medicine induce liver damage is of paramount importance to increase the knowledge about DILI and to prevent or treat similar cases quickly. [ABSTRACT FROM AUTHOR]

Spreading livestock manure as fertilizer on farmlands is a widespread practice. It represents the major source of heavy metal(loid)s (HM) input in agricultural soils. Since zinc (Zn) is present at high concentrations in manure, it poses special environmental concerns related to phytotoxicity, groundwater contamination, and introduction in the food chain. Therefore, investigations on the fate and behavior of manure-borne Zn, when it enters the soil environment, are necessary to predict the environmental effects. Nevertheless, long-term field studies assessing Zn speciation in the organic waste matrix, as well as within the soil after manure application, are lacking. This study was designed to fill this gap. Using SEM-EDS and XAS analysis, we reported the following new results: (i) ZnS made up 100% of the Zn speciation in the pig slurry (the highest proportion of ZnS ever observed in organic waste); and (ii) ZnS aggregates were about 1-μm diameter (the smallest particle size ever reported in pig slurry). Moreover, the pig slurry containing ZnS was spread on the soil over an 11-year period, totaling 22 applications, and the resulting Zn speciation within the amended soil was analyzed. Surprisingly, ZnS, i.e. the only species responsible for a nearly 2-fold increase in the Zn concentration within the amended soil, was not detected in this soil. Based on SEM-EDS and XAS observations, we put forward the hypothesis that Zn in the pig slurry consisted of nano-sized ZnS crystallites that further aggregated. The low stability of ZnS nanoparticles within oxic and complex environments such as the studied soil was the key explanation for the radical change in pig slurry-borne Zn speciation after long-term amendments. [ABSTRACT FROM AUTHOR]

Protected areas play an extremely important role in the conservation of global biodiversity. However, these areas are subject to the introduction of invasive alien species (IAS), which cause damage to native environments. The present study aimed to use images obtained by Unmanned Aerial Vehicles (UAVs) combined with machine learning (ML) algorithms to identify the IAS Hovenia dulcis in a Conservation Unit in southern Brazil. Field data were obtained in a sample area, where the floristic survey of the H. dulcis species was carried out. To obtain remote data, a UAV with a built-in RGB sensor was used. Subsequently, the images were processed for orthomosaic generation and the spatial distribution of the inventoried species, based on manual photointerpretation. Furthermore, in the supervised classification process, four classes of interest were defined: H. dulcis , similar species, shade, and other species. The process involved two approaches (pixel-based - PB and object-based image analysis - OBIA) and two ML algorithms were compared (Random Forest - RF and Support Vector Machine - SVM). Samples were separated into 90% for training and 10% for model validation. For performance analysis, overall accuracy (OA) and Kappa index metrics were calculated. The results show that the RF algorithm in the PB approach had the best performance in the classification of the IAS H. dulcis , presenting a kappa of 0.87 and OA of 91.5%, in the training data set and 90.91% of success in the model validation dataset. Our study demonstrated to be able to reach the results to respond to the raised hypotheses. Furthermore, the UAV-RGB data combined with ML are highly accurate to identify H. dulcis in relation to the other species that make up the forest stratum of the study area. • Approach to identify invasive tree species in the Atlantic Forest biome • Detection of the invasive H. dulcis using UAV data and machine learning • Invasive species H. dulcis was identified with 90.91% of accuracy [ABSTRACT FROM AUTHOR]

Objectives Since the introduction of the sentinel node technique for breast cancer in the 1990s patient's morbidity was reduced. Tracer uptake is known to be dependent from lymph node integrity and activity of macrophages. The aim of this study was to assess whether radioactivity of the tracer can predict sentinel lymph node metastases. Furthermore, a potential association with Ki-67 index was examined. Non-invasive prediction of lymph node metastases could lead to a further decrease of morbidity. Methods We retrospectively analyzed patients with primary breast cancer who underwent surgery at the Department of Obstetrics and Gynecology in the University Hospital of Cologne between 2012 and 2013. Injection of radioactive tracer was done a day before surgery in the department of Nuclear Medicine. Clinical data and radioactivity of the sentinel node measured the day before and intraoperatively were abstracted from patient's files. Results Of 246 patients, 64 patients had at least one, five patients had two and one patient had three positive sentinel lymph nodes. Occurrence of sentinel lymph node metastases was not associated with preoperative tracer activity (p = 0,319), intraoperative tracer activity of first sentinel node (p = 0,086) or with loss of tracer activity until operation (p = 0,909). There was no correlation between preoperative Ki-67 index and occurrence of lymph node metastases (p = 0,403). Conclusion In our cohort, there was no correlation between radioactivity and sentinel node metastases. Tracer uptake might not only be influenced by lymph node metastases and does not predict metastatic lymph node involvement. [ABSTRACT FROM AUTHOR]

The prevention of brown rot symptoms caused by Monilinia fructicola fungus in stone fruits is usually achieved by the repetitive use of chemical fungicides. However, foliar-applied silicon (Si) sources either alone or combined with fungicides, can be an effective alternative to reduce disease incidence, with beneficial cost and environmental impact. We carried out a set of experiments in field conditions with the aim of evaluating the effectiveness of foliar-applied Si sources, either in combination or not with fungicides, and applied at different phenological stages in preventing the brown rot occurrence in peach fruits. Three experiments were carried out in an 11-year-old Eldorado peach orchard, located in southern Brazil. Experiment 1 compared eight strategies in order to optimize the application timing. Experiment 2 was carried out to define the Si effect alone or combined with fungicides. Experiment 3 consisted of five treatments to verify the effect of different Si sources. The effects of the strategies in the pre and post-harvest brown rot incidence in fruits, fruit quality parameters and Si concentration in leaves and fruits were evaluated. Fruit anatomical investigation analysis was also performed. Si was effective in controlling brown rot in fruits. Six treatments with Si showed a similar effect compared to six fungicide applications. Si allowed a reduction of three fungicide applications, regardless of application period. Si foliar-treated trees revealed an increased leaf and fruit Si concentration. Si sources showed similar effectiveness in preventing the occurrence of brown rot incidence in fruits. Si represents a potential alternative in preventing brown rot incidence. - Six Si treatments showed a similar effect compared to six fungicide applications. - Si reduced three fungicide applications, regardless of the application period. - Si sources showed similar efficacy in preventing the incidence of brown rot. [ABSTRACT FROM AUTHOR]

Abstract: Laser micro machining as well as laser surface structuring are innovative manufacturing technologies with a wide range of machinable materials and a high level of flexibility. These techniques are characterized by different machine, workpiece and environmental parameters. The large amount of process dependencies lead however to a time consuming process initialization and a complex process control. Currently no automated solution exists to achieve material specific process parameters, nor does a sufficient inline process control exist to adapt processing parameters or strategies inline. Therefore a novel scanner based inline metrology solution and an automated process initialization strategy has been developed. [Copyright &y& Elsevier]

Abstract: Laser surface structuring is a rapidly developing manufacturing technology. This technology offers a high level of flexibility regarding the geometrical design and a wide range of machinable materials. However, current systems used for laser structuring have a crucial deficit. The existing process control systems have no sufficient feedback infor- mation of the machined surface topology before, during and after the process, not being able to detect errors/devia- tions and so to adapt the structuring strategy while processing. Therefore a novel scanner based inline metrology system has been developed to control the laser surface structuring process by a process monitoring software. [Copyright &y& Elsevier]

Abstract: The Dom Feliciano Belt, situated in southernmost Brazil and Uruguay, contains a large mass of granite–gneissic rocks (also known as Florianópolis/Pelotas Batholith) formed during the pre-, syn- and post-orogenic phases of the Brasiliano/Pan-African cycle. In the NE extreme of this granitic mass, pre-, syn- and post-tectonic granites associated with the Major Gercino Shear Zone (MGSZ) are exposed. The granitic manifestation along the MGSZ can be divided into pre-kinematic tonalitic gneisses, peraluminous high-K calc-alkaline early kinematic shoshonitic, and metaluminous post-kinematic granites. U–Pb zircon data suggest an age of 649±10Ma for the pre-tectonic gneisses, and a time span from 623±6Ma to 588±3Ma for the early to post-tectonic magmatism. Negative εHf (t) values ranging from −4.6 to −14.6 and Hf model ages ranging from 1.64 to 2.39Ga for magmatic zircons coupled with whole rock Nd model ages ranging from 1.24 to 2.05Ga and εNd (t) values ranging from −3.84 to −7.50, point to a crustal derivation for the granitic magmatism. The geochemical and isotope data support a continental magmatic arc generated from melting of dominant Paleoproterozoic crust, and a similar evolution for the granitic batholiths of the eastern Dom Feliciano Belt and western Kaoko Belt. [Copyright &y& Elsevier]

Predicting the transfer of contaminants in soils is often hampered by lacking validation of mathematical models. Here, we applied Hydrus-2D software to three agricultural soils for simulating the 1900–2005 changes of zinc and lead concentration profiles derived from industrial atmospheric deposition, to validate the tested models with plausible assumptions on past metal inputs to reach the 2005 situation. The models were set with data from previous studies on the geochemical background, estimated temporal metal deposition, and the 2005 metal distributions. Different hypotheses of chemical reactions of metals with the soil solution were examined: 100% equilibrium or partial equilibrium, parameterized following kinetic chemical extractions. Finally, a two-site model with kinetic constant values adjusted at 1% of EDTA extraction parameters satisfactory predicted changes in metal concentration profiles for two arable soils. For a grassland soil however, this model showed limited applicability by ignoring the role of earthworm activity in metal incorporation. [Copyright &y& Elsevier]

Abstract: U–Pb SHRIMP zircon geochronology, bulk-rock geochemistry, and Sr–Nd isotopic data are herein presented in order to better constrain the tectonic evolution of the Nico Pérez Terrane (NPT), Uruguay. The studies are focused on two key geological units located in the southern part of the NPT, namely Carapé Complex (CC) and Lavalleja Metamorphic Complex (LMC). The Carapé Complex, previously interpreted as part of a remnant magmatic arc, formed at 1.75 Ga mainly by partial melting of Archean crust (T DM model ages between 2.8 and 3.0 Ga with strong negative ɛ Nd (t) values). The Lavalleja Metamorphic Complex, previously interpreted as a back-arc basin, has volcanic units formed at 0.59 Ga during the Brasiliano Cycle, but may also contain older (Paleoproterozoic) units. The geochemistry of the LMC meta-igneous rocks indicates a complex scenario. Two distinct signatures have been recognized, one similar to MORBs and the other similar OIBs. Sm–Nd T DM model ages of basic rocks present a bimodal (Paleoproterozoic and Archean) distribution, which is also recognized in several other units of the NPT. In the light of new results, we conclude that the NPT represents a cratonic margin setting, characterized by the stacking of lithotectonic assemblages with Archean, Paleoproterozoic, and Neoproterozoic age at the margin of the Rio de la Plata Craton. [Copyright &y& Elsevier]

Statement of problem: The use of fiber-reinforced composite resin posts in endodontically treated teeth has increased. However, selecting an adhesive system that provides reliable and long-lasting bonding to root canal dentin remains difficult. Purpose: This study evaluated the microtensile bond strength of 2 adhesive systems to root dentin and 2 different fiber-reinforced composite resin posts. Material and methods: Forty single-rooted teeth were instrumented, and root canals were prepared for translucent (Light Post [LP]) or opaque (Aestheti Post [AP]) quartz fiber-reinforced composite resin posts. Two adhesive systems were used: Scotchbond Multi-Purpose Plus (SBMP) (autopolymerized) as a control group, and Single Bond (SB) (photoactivated). Teeth were assigned to 4 groups (n=10): SBMP+LP, SBMP+AP, SB+LP, SB+AP. After post cementation, roots were perpendicularly sectioned into 1-mm-thick slices, which were trimmed to obtain dumbbell-shaped specimens. The specimens were divided into 3 regions: cervical (C), middle (M), and apical (A). To determine the bond strength, the bonding area of each specimen was calculated, and specimens were attached to a device to test microtensile strength at a crosshead speed of 1 mm/min. Data were analyzed using 3-way analysis of variance and the Tukey test (α=.05). Fractured specimens were examined under a ×25 stereomicroscope to determine the mode of fracture. Results: There were significant differences only among root dentin regions (P<.001). The cervical third (9.16 ± 1.18 MPa) presented higher mean bond strength values, especially for SBMP. Middle and apical regions demonstrated lower values (7.08 ± 0.92 and 7.31 ± 0.60 MPa, respectively). Adhesive and post main factors did not demonstrate significance. Also, no interaction was significant. No cohesive fractures within resin cement, fiber-reinforced composite resin post, or root dentin were identified. Conclusions: Both adhesive systems tested demonstrated reliable bonding when used with translucent and opaque fiber-reinforced composite posts. [Copyright &y& Elsevier]

The present work consisted of preparing and characterizing composite carbon materials (WRCC) from raw winery residues (WR) activated with zinc chloride to produce a carbon adsorbent. The WRCC was used for the adsorption of emerging contaminants in aqueous media. The WRCC presented a morphology with favorable characteristics for the adsorption process, giving an abundant porous structure with pores of different sizes. The results show the WRCC's effectiveness, presenting surface area values (227 m2 g−1) and total pore volume (0.175 cm3 g−1). The general order kinetic model predicted the experimental curves sufficiently. The Sips model better described the two adsorbates' equilibrium data, with maximum adsorption capacities of 376.0 and 119.6 mg g−1 for 2-nitrophenol and ketoprofen, respectively. The WRCC carbon material was also highly efficient, with maximum removal of 81.4% and 94% in 1000 mg L−1 of the compounds 2-nitrophenol and ketoprofen. Finally, the prepared material has essential characteristics that make it an efficient adsorbent in treating effluents with emerging contaminants. [Display omitted] • A composite carbon material was prepared from winery composted wastes (WRCC). • WRCC presented a morphology with favorable characteristics for the adsorption. • Adsorption capacities were 376 and 119 mg g−1 for 2-nitrophenol and ketoprofen. • WRCC has essential characteristics to treat effluents with emerging contaminants. [ABSTRACT FROM AUTHOR]

Globe artichoke is rich in nutrients and phenolic compounds. However, nearly 85% of its biomass is discarded following harvest. To propose a scalable and economically attractive process for the revalorization of this material, a holistic analysis of the leftovers (bracts, stems and leaves) of three Argentine cultivars (Sampedrino, Gallego and Gringo) was proposed. Agricultural studies revealed differences for the crop yield of each variety and that bracts accounted for 65% of the overall waste biomass. Differences were also found for morphological features (aspect evaluation and color in the L* , a* and b* values). For the recovery of phenolic compounds, low-cost, green, and industrially applicable extraction methods were proposed and regardless of the water-based variations employed, stems extracts showed the highest values for biological activity. Among varieties, Sampedrino had the highest phenolic compounds concentration and antioxidant capacity for stems extracts (4.3 ± 0.2 mg GA /g FW for total phenolic compounds, 1.21 ± 0.01 mg GA /g FW for ABTS.+ scavenging capacity and 0.73 ± 0.02 mg GA /g FW for Ferric reducing antioxidant power). HPLC-MS confirmed the presence of 5-O-caffeoylquinic acid and dicaffeoylquinic acids in all samples, and a flavonoid with medical applications, kaempferol-3-O-glucoside, in leaves of all varieties. High concentrations of anthocyanins were also found in stems of all varieties. Here we propose friendly extractions using aqueous solvents for the recovery of health-promoting phenolic bioactive compounds that present great feasibility and transferability to the food industry for added-value products. [Display omitted] • Significant morphological differences exist between globe artichoke varieties. • Low cost water extraction is apt to recover phenolic compounds from artichoke waste. • Sampedrino extracts showed the highest concentration of phenolic compounds. • Among different waste, Stem extracts possessed the highest antioxidant capacity. • 5-O-Caffeoylquinic acid is present in all waste while flavonoids only in leaves. [ABSTRACT FROM AUTHOR]

Comments on criticism levied at the article `A Generalization Explanation of Long-Term `Billow-Like' Dynamics of Societal Processes.' Presentation of a conceptual framework to explain all the observed recurrences in human beings; Examination of the psycho-social recurrences.

Provides information on empirical evidence which illustrated the existence of several kinds of recurrent long-term societal processes. Attempt to explain the recurrent process origin; Presentation of a conceptual framework to explain these observed recurrences; Information on the paradigm of long-term societal processes; Discussion of the main characteristics of the societal moods.

• Magnetic geopolymer/Fe 3 O 4 composite was employed as a remarkable adsorbent. • High adsorption capacity towards aqueous green 16 dye. • Facile separation from the liquid solution by using a magnetic system. A novel magnetic geopolymer/Fe 3 O 4 composite (MGP) was prepared from metakaolin, biogenic rice husk silica and magnetite (Fe 3 O 4), having as mesopores–structuring agents hydrogen peroxide and soybean oil. The magnetic property and mesoporosity were confirmed by vibrating sample magnetometer (VSM) and BET isotherms, respectively. An adsorption study of aqueous acid green 16 (AG16) dye onto composite was performed. The parameters adsorbent dosage and initial pH were evaluated by experimental design in order maximize the adsorption efficiency of AG16 dye onto MGP. Through the results, fast adsorption and an equilibrium reached at 30 min were observed. The kinetic data fitted well to the pseudo–second order model. Remarkable sorption capacity of 400 mg g–1 at 328 K was obtained. Additionally, the composite presented high reusability even after several repeated cycles, indicating that it can be a potential adsorbent towards removal of organic pollutants from liquid effluents. [ABSTRACT FROM AUTHOR]

Background: During spontaneous vaginal delivery, pubic symphyseal widening is normal. Common changes are reversible after complication-free birth. However, cases of peripartum symphysis separation are rare. There is no consensus in the literature on how to treat pregnancy-related pubic symphysis separation.Methods: This review used a literature-based search (PubMed, 1900-2013) and analysis of 2 own case reports. Studies with conclusions regarding management were particularly considered.Results: Characteristic symptoms, suprapubic pain and tenderness radiating to the posterior pelvic girdle or lower back, may be noted 48 h after delivery. Pain on movement, especially walking or climbing stairs, is often present. Conservative treatments, such as a pelvic brace with physiotherapy and local interventions such as infiltration, are successful in most cases. Symptom reduction within 6 weeks is the most common outcome, but can take up to 6 months in some cases. Surgical intervention is needed in cases of persistent separation. Anterior plate fixation is offered as a well-known and safe procedure. Minimally invasive SI joint screw fixation is required in cases of combined posterior pelvic girdle lesions.Summary: Postpartum symphyseal rupture can be indicated with the rare occurrence of pelvic pain post-delivery, with sciatica or lumbago and decreased mobility. The diagnosis is made on clinical findings, as well as radiographs of the pelvic girdle. Conservative treatment with a pelvic brace is the gold standard in pre- and postpartum cases of symphysis dysfunction. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The endometrium carcinoma is the most frequent malignancy of the female genital tract. Approximately, 10–20% of all patients with an endometrial carcinoma are free of symptoms until the time of diagnosis. The frequent occurrence of an endometrial carcinoma in connection with intrauterine cavity fluid collection (sero- or mucometra) has been discussed controversially in literature. What are the hysteroscopic and histological findings in patients with sonographically determined endometrial fluid in postmenopause, and how should these findings be interpreted?. Methods: 74 patients, in whom endometrial fluid without bleeding disorders had been diagnosed during routine transvaginal sonography, underwent hysteroscopy conducted with a 4.5mm optics and dilatation and curettage (D&C). The median age of the patients was 68 years with a range of 32 years. Results: The simple thickness of the endometrium, i.e. single layer measured sonographically at the point of maximal thickness, was on average 5.7mm ± 3.6mm (2–15mm). Hysteroscopically, an endometrium polyp was found in 23 cases (31.1%), endometrium hyperplasia in 12 (16.2%), and an atrophy in 35 cases (47.3%). In four cases (5.4%), an endometrial carcinoma was suspected. The histological results were consistent with the hysteroscopic findings. In all instances, in which the simple endometrial thickness amounted to 3mm or less, an atrophic endometrium was found. The frequency of intrauterine pathologies increased significantly with a greater thickness of the endometrium. In 80% of patients, a cervical stenosis existed. Conclusions: Endometrial fluid by itself, without assessment of the endometrium, does not indicate the requirement for additional histological clarification. As diagnostics, the authors suggest especially the endometrial morphology. [Copyright &y& Elsevier]