__  __    __   __  _____      _            _          _____ _          _ _ 
 |  \/  |   \ \ / / |  __ \    (_)          | |        / ____| |        | | |
 | \  / |_ __\ V /  | |__) | __ ___   ____ _| |_ ___  | (___ | |__   ___| | |
 | |\/| | '__|> <   |  ___/ '__| \ \ / / _` | __/ _ \  \___ \| '_ \ / _ \ | |
 | |  | | |_ / . \  | |   | |  | |\ V / (_| | ||  __/  ____) | | | |  __/ | |
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<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
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    <title>Citologia esfoliativa</title>
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        <h2 style="text-align: center;" class="art-PostHeader">Citologia
          esfoliativa </h2>
        <div style="text-align: justify;"><strong></strong><img style="width: 180px; height: 164px; float: left;"
            alt="Coleta de material" title="Coleta de material" src="../img/437.jpg"><strong>O
            que �:</strong></div>
        <p style="word-spacing: 0pt; margin-top: 10px; margin-bottom: 0pt; text-align: justify;">
          <a href="http://www.cienciasdasaude.org/portal/wp-content/gallery/citologia/437.jpg"
            title="" class="shutterset_singlepic437"> </a>� a coleta de amostra
          para diagn�stico precoce do c�ncer de colo uterino. � um m�todo de de
          coleta e n�o de diagn�stico.<br>
        </p>
        <p style="word-spacing: 0pt; margin-top: 10px; margin-bottom: 0pt; text-align: justify;">Uma
citologia
          positiva deve ser o ponto de partida para para uma investiga��o mais
          profunda.</p>
        <p style="word-spacing: 0pt; margin-top: 10px; margin-bottom: 0pt; text-align: justify;">Faz-se
a
          tr�plice tomada de Wied.<span style="font-weight: bold;"></span></p>
        <p style="word-spacing: 0pt; margin-top: 10px; margin-bottom: 0pt; text-align: justify;">.<span
            style="font-weight: bold;"></span><span id="more-1288"></span></p>
        <p style="word-spacing: 0pt; margin-top: 10px; margin-bottom: 0pt; text-align: justify;"><strong>Localiza��o
do
            c�ncer:</strong></p>
        <p style="word-spacing: 0pt; margin-top: 10px; margin-bottom: 0pt; text-align: center;"><strong><img
              style="width: 475px; height: 375px;" alt="Localiza��o do c�ncer" title="Localiza��o do c�ncer"
              src="../img/438.jpg"></strong></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;"><strong>Fatores
de
            risco:</strong></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;">-
          Ter hist�ria de rela�es sexuais com diversos parceiros ao longo da
          vida ou se come�ou atividade sexual muito cedo.<br>
          - Se no passado, alguma prova de Papanicolaou tenha revelado presen�a
          de c�lulas anormais<br>
          - Se tem idade entre 40 e 55 anos.<br>
          - Se engravidou diversas vezes<br>
          - Se teve infec�es vaginais frequentes, transmitidas por rela�es
          sexuais, tais como Herpes simples, tipo II e condiloma.<br>
          - Se sua m�e fez uso de horm�nio para evitar aborto quando estava
          gr�vida de voc�.</p>
        <p style="word-spacing: 0pt; margin-top: 10px; margin-bottom: 0pt; text-align: justify;"><strong></strong></p>
        <p style="word-spacing: 0pt; margin-top: 10px; margin-bottom: 0pt; text-align: justify;"><strong>Sintomas
            suspeitos:</strong><br>
          - Co�gulos no meio da menstru��o<br>
          - Fluxo vaginal<br>
          - Hemorragia menstrual (metrorragia)<br>
          - Sangramentos genitais anormais<br>
          - Mancha tipo borra de caf� durante o per�odo<br>
          - C�licas menstruais (dismenorr�ia)</p>
        <p style="text-align: justify;"><strong></strong></p>
        <p style="text-align: justify;"><strong><img style="width: 131px; height: 506px;"
              alt="Esp�tula de Ayre" title="Esp�tula de Ayre" src="../img/556.jpg"
              align="right">Materiais necess�rios:</strong></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;">-
          Mesa de exame ginecol�gico e fonte luminosa.<br>
          - Luvas descart�veis.</p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;">-
          Esp�culos de tamanhos variados (pequeno, m�dio, grande e de virgens)<br>
          - Esp�tula de madeira ou pl�stico (esp�tula de Ayre)<br>
          - Bola de algod�o revestida de gaze esterilizada ou escova
          intra-cervical.<br>
          - L�mina de vidro com uma extremidade esmirilhada.</p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;">-
          Tubo ou caixa para transporte de l�minas e formul�rio com dados da
          cliente.</p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: center;"><strong>
          </strong></p>
        <p style="text-align: justify;"><strong>T�cnica:</strong></p>
        <ul style="text-align: justify;">
          <li>Informar, acalmar e colocar a cliente na mesa ginecol�gica.<br>
          </li>
          <li>Introduzir o esp�culo sem lubrificar, para n�o contaminar a
            amostra, em sentido longitudinal da vulva e fazendo uma rota��o de
            90�.<br>
          </li>
          <li>Em caso de himem �ntegro ou estenose vaginal, tomar a amostra �no
            escuro�, utilizando um swab, o material do fundo do saco vaginal.<br>
          </li>
          <li>Abrir o esp�culo at� completa visualiza��o do colo, sem toc�-lo.<br>
          </li>
          <li>Identificar a l�mina, colocando o nome da cliente no lado
            esmerilhado. Preencher o formul�rio com os dados da cliente.<br>
          </li>
          <li>Colher a amostra.</li>
        </ul>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;">
        </p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;"></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;"><strong>Coleta
da
            Amostra:</strong></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;">-
          Colher uma amostra do fundo do saco vaginal posterior, raspando com o
          lado convexo da esp�tula de Ayre.<br>
          - Colher uma amostra exocervical, inserindo a ponta da esp�tula no
          orif�cio cervical, at� que sua extremidade c�ncava toque a c�rvix.</p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;">-
          Pressionando para manter contato, d� uma volta completa (360� graus)
          na esp�tula<br>
          - Coleta do material endocervical atrav�s da inser��o da escova no
          orif�cio cervical e dando uma volta completa.</p>
        <p style="text-align: right;"><img style="width: 260px; height: 344px; float: right;"
            alt="Coleta de material" title="Coleta de material" src="../img/557.jpg">O
          material deve ser extendido depois de cada coleta sobre a l�mina, da
          esquerda para a direita.</p>
        <p style="text-align: justify;">Imediatamente ap�s a extens�o da
          amostra, deve ser feita a fixa��o com polietilenoglico em aerosol,
          pulverizando a uma dist�ncia de 15-20cm da l�mina ou, caso n�o se
          tenha o polietilenoglicol, a l�mina pode ser colocada em tubos
          porta-l�minas com �lcool 96�GL.</p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;">Qualquer
demora
          na fixa��o ou na coloca��o da l�mina no recipiente com �lcool pode
          alterar profundamente a morfologia celular.</p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;"></p>
        <div style="text-align: justify;">Encaminhar a amostra o mais
          rapidamente poss�vel para an�lise, acompanhada do formul�rio de
          identifica��o e de uma anamnesebem detalhada. </div>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;"></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;"></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;"><strong>Resultados:</strong></p>
        <ul style="text-align: justify; margin-left: 40px;">
          <li>Um resultado negativo significa que seu colo uterino est� normal.<br>
          </li>
          <li>Um resultado positivo significa que apareceram c�lulas anormais,
            mas n�o � prova conclusiva de que haja c�ncer, nem sequer displasia
            (altera�es iniciais nas c�lulas), apenas significa que deve ser
            feita uma investiga��o mais aprofundada, com uma colposcopia ou uma
            bi�psia.<br>
          </li>
          <li>A base da mudan�a de um epit�lio normal para um neopl�sico reside
            nos processos de matura��o e diferencia��o celulares, e nisso se
            baseia a citologia para avaliar os diferentes est�gios de les�es
            precursoras de c�ncer.<br>
          </li>
          <li>A nomenclatura mais utilizada � NIC (neoplasia intra-cervical),
            para tais les�es: NIC I, II e III.<br>
          </li>
          <li>Esta denomina��o engloba os antigos termos displasia e carcinoma
            in situ na classifica��o de Papanicolaou.<br>
          </li>
          <li>Em alguns casos existe dificuldade para se enquadrar um caso
            dentro de determinada categoria. Por este motivo se modificou a
            denomina��o de Neoplasia para a de Les�o, j� que em todos os casos
            de NIC s�o precursores de c�ncer.<br>
          </li>
          <li>A les�o intraepitelial pavimentosa (LIP) se divide em baixo e alto
            grau, visto que nem todas estas&nbsp;les�es v�o se tornar carcinoma
            invasivo, mas sim haver� um n�mero significativos delas, entre
            30-50%, que se presume a necessidade de uma investiga��o mais
            acurada, pois tem potencial probabilidade de se tornarem um
            carcinoma invasor.</li>
        </ul>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;"></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;"><strong>Classifica�es
            anatomopatol�gicas:</strong></p>
        <p></p>
        <table style="height: 130px;" width="100%" cellspacing="0" cellpadding="2"
          border="1">
          <colgroup><col width="84"><col width="142"><col width="221"></colgroup>
          <tbody>
            <tr style="text-align: center;">
              <td width="84" height="14"><strong><em>Classe</em></strong></td>
              <td width="142"><strong><em><span style="font-family: Arial,sans-serif;"><span
                        style="font-size: small;">Tipo </span></span></em></strong></td>
              <td width="221"><strong><em><span style="font-family: Arial,sans-serif;"><span
                        style="font-size: small;">Grau</span></span></em></strong></td>
            </tr>
            <tr>
              <td width="84" height="30"><span style="font-family: Arial,sans-serif;"><span
                    style="font-size: small;">NIC I</span></span></td>
              <td width="142"><span style="font-family: Arial,sans-serif;"><span
                    style="font-size: small;">Displasia leve</span></span></td>
              <td width="221"><span style="font-family: Arial,sans-serif;"><span
                    style="font-size: small;">LIP baixo grau (inclui
                    modifica�es celulares por papilomav�rus)</span></span></td>
            </tr>
            <tr>
              <td width="84" height="14"><span style="font-family: Arial,sans-serif;"><span
                    style="font-size: small;">NIC II</span></span></td>
              <td width="142"><span style="font-family: Arial,sans-serif;"><span
                    style="font-size: small;">Displasia moderada</span></span></td>
              <td width="221"><span style="font-family: Arial,sans-serif;"><span
                    style="font-size: small;">LIP alto grau</span></span></td>
            </tr>
            <tr>
              <td width="84" height="14"><span style="font-family: Arial,sans-serif;"><span
                    style="font-size: small;">NIC III</span></span></td>
              <td width="142"><span style="font-family: Arial,sans-serif;"><span
                    style="font-size: small;">Displasia severa</span></span></td>
              <td width="221"><span style="font-family: Arial,sans-serif;"><span
                    style="font-size: small;">LIP alto grau (carcinoma in situ)</span></span></td>
            </tr>
          </tbody>
        </table>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: center;">
        </p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: center;">.</p>
        <div style="text-align: center;"><img title="Classifica�es dos carcinomas intracervicais (NICs)"
            style="width: 351px; height: 174px;" class="aligncenter size-full wp-image-11847"
            src="../img/442.jpg" alt="Classifica�es dos carcinomas intracervicais (NICs)"><strong><em></em></strong></div>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: center;"><strong><em>Classifica�es
dos
              carcinomas intracervicais (NICs)</em></strong></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: center;">
        </p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: center;"><strong>
          </strong></p>
        <p style="text-align: center;"><strong> </strong></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;"><strong>Informa�es
            obtidas:</strong></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;">A)
Hormonal:
          A vagina responde �s mudan�as hormonais do ov�rio. Conforme o tipo de
          c�lulas encontradas em cada momento, se pode ter uma id�ia aproximada
          do funcionamento dos ov�rios<br>
          B) Infecciosa: A citologia pode diagnosticar determinadas infec�es,
          justamente porque pode ver os microorganismos patog�nicos encontrados
          no esfrega�o (fungos ou tricomonas) e tamb�m porque as c�lulas mostram
          sinais sugestivos de infec�es causadas por diversos v�rus (herpes,
          papiloma) ou por bact�rias (hamophilus, Neaesseria, etc).<br>
          C) Morfol�gica: Essa � a mais importante. As c�lulas do colo uterino
          podem se alterar (geralmente por determinadas infec�es, sobretudo por
          condiloma e herpes) e produzir uma s�rie de les�es displ�sicas.<br>
          Estas les�es n�o produzem doen�as ou problemas mais s�rios antes de
          muitos anos de lat�ncia (entre 2 e 10 anos); por�m se forem deixadas a
          livre evolu��o, podem acabar em c�ncer de colo de �tero.</p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;">
        </p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;"></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;"><strong>Quem
deve
            fazer o exame:</strong></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;">-
          Considera-se mulheres de baixo risco as que n�o tiveram rela�es
          sexuais pr�vias, as histerectomizadas e as que tem um parceiro sexual
          fixo durante muito tempo e com citologias pr�vias negativas<br>
          - Mulheres de risco moderado s�o aquelas com rela�es sexuais
          freq�entes, iniciadas antes dos 20 anos de idade, e que tenham
          rela�es habituais com dois ou mais parceiros.<br>
          - Mulheres de alto risco s�o aquelas que come�aram vida sexual antes
          dos 20 anos de idade e tem dois ou mais parceiros. Tamb�m deve ser
          levado em conta o n�mero de parceiras dos parceiros<br>
          - Outros fatores importantes de risco s�o: hist�ria pr�via de
          citologias com c�lulas escamosas at�picas e de diagn�stico incerto,
          doen�as sexualmente transmitidas (especialmente condilomas),
          imunossupress�o e tabagismo.</p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;">
        </p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;"></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;"><strong>Recomenda�es
�
            cliente:</strong></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;">-
          Abster-se de rela�es sexuais ao menos 48 horas antes da coleta.<br>
          - Ter cessado a menstrua��o pelo menos 4-5 dias antes.<br>
          - Lavar bem a genit�lia externa apenas com �gua e sab�o. Nunca fazer
          duchas vaginais ou aplicar desodorantes �ntimos.<br>
          - N�o utilizar cremes vaginais nos 5-7 dias que antecedem a coleta da
          amostra (pode mascarar o diagn�stico de infec�es bacterianas)</p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;">
        </p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;"></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;"><strong>Conselhos
            �teis:</strong></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;">-
          N�o fazer explora��o manual antes da coleta.<br>
          - A introdu��o do esp�culo pode ser facilitada por manobra de<br>
          - A introduc�o do esp�culo pode ser facilitada por manobra de vasalva.<br>
          - � importante que a posi��o ginecol�gica seja correta, com os gl�teos
          apoiados na mesa de exame para favorecer o relaxamento da musculatura
          perineal.<br>
          - � conveniente estar com a bexiga urin�ria completamente vazia antes
          da coleta da amostra.<br>
          - O esfrega�o deve conter c�lulas de todas as amostras de transi��o
          colhidas.<br>
          - As c�lulas devem estar extendidas de maneira uniforme.<br>
          <img src="http://www.antonini.med.br/paginas/citologia/imagens/cheio-azul.GIF"
            alt="" width="9" height="9" border="0"> Os melhores esfrega�os s�o
          os colhidos na metado do ciclo menstrual.</p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;">
        </p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;"></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;"><strong>Erros
            poss�veis:</strong></p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;">-
          Relacionados com a cliente: n�o fazer o exame anual pode ser comum.</p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: justify;">-
          Tamb�m influem nas amostras duchas vaginais e coitos recentes, que
          podem eliminar a camada de c�lulas superficiais, aumentando o n�mero
          de falsos negativos.<br>
          - Cl�nicos: erros na realiza��o do exame e na coleta da amostra e
          falhas na anamnese da cliente.<br>
          - Instrumentos ou modo de coleta da amostra: deve existir um bom
          n�mero de c�lulas nas tr�s zonas coletadas (vagina, exoc�rvix e
          endoc�rvix) e bem extendidas na l�mina.<br>
          - Erros de diagn�stico e de preparo do esfrega�o</p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: center;">
        </p>
        <p style="word-spacing: 0pt; margin-top: 0pt; margin-bottom: 0pt; text-align: center;"></p>
        <p style="text-align: center;"><img style="width: 504px; height: 331px;"
            class="aligncenter size-full wp-image-11848" title="�tero normal" src="../img/443.jpg"
            alt="�tero normal"></p>
        <p style="text-align: center;"><strong><em>�tero normal</em></strong></p>
        <p style="text-align: center;"> </p>
        <p style="text-align: center;"><a href="../paginas/cervico_vaginal-imagem-1.html"
            title="" class="shutterset_singlepic444"> <img style="border: 0px solid ; width: 257px; height: 240px;"
              class="ngg-singlepic ngg-center" src="../img/444__320x240_444.jpg"
              alt="Clique para ampliar" title="Clique para ampliar"> </a></p>
        <p style="text-align: center;">Desenho esquem�tico do �tero (clique para
          ampliar)</p>
        <p style="text-align: center;"> </p>
        <p style="text-align: justify;">A rapidez da fixa��o � importante, sendo
          prefer�vel usar �lcool 74% ao qual o polietilenoglicol pode ser
          adicionado. Isso providencia uma cobertura higrosc�pica, assim as
          l�minas fixadas s�o deixadas para secar o antes de serem enviadas para
          colora��o exames. Os fixadores podem ser usados na forma de
          gotejamento ou spray. Na rotina de trabalho a colora��o de
          Papanicolaou � usada nos esfrega�os cervicais.</p>
        <p style="text-align: center;"> <a href="../paginas/cervico_vaginal-imagem-2.html"
            title="" class="shutterset_singlepic1"> <img style="border: 0px solid ; width: 320px; height: 238px;"
              class="ngg-singlepic ngg-center" src="../img/1__320x240_001_JPG.jpg"
              alt="Clique para ampliar" title="Clique para ampliar"></a></p>
        <p style="text-align: justify;">Figura: 1: <strong>c�rvix, normal
            colposcopia.</strong> Essa mostra o epit�lio escamoso recobrindo a
          ectoc�rvix e o epit�lio colunar vascularizado, forrando o canal
          endocervical. Aqui o epit�lio colunar penetra nos vilos finos e dando
          uma apar�ncia de cacho de uvas. O esp�culo bivalvo usado para expor o
          colo uterino tamb�m causa uma leve evers�o do orif�cio externo e abre
          o canal endocervical.</p>
        <p style="text-align: center;"> <a href="../paginas/cervico_vaginal-imagem-3.html"
            title="" class="shutterset_singlepic2"> <img style="border: 0px solid ; width: 320px; height: 234px;"
              class="ngg-singlepic ngg-center" src="../img/2__320x240_002_JPG.jpg"
              alt="Clique para ampliar" title="Clique para ampliar"></a></p>
        <p style="text-align: justify;">Figura 2: <strong>c�rvix: epit�lio
            pavimentos estratificado normal.</strong> A camada germinativa �
          vista na base do epit�lio. H� matura��o regular das c�lulas atrav�s da
          camada parabasal at� camadas intermedi�ria e superficial. Ao contr�rio
          da pele, o epit�lio escamoso que reveste o colo uterino e vagina n�o
          desenvolve normalmente uma camada degenerativa.</p>
        <div style="text-align: right;">
          <div style="text-align: right;"><a href="javascript:window.print()"><img
                style="border: 0px solid ; width: 18px; height: 18px;" alt="Imprimir"
                title="Imprimir" src="../img/print.png"></a></div>
        </div>
        <div style="text-align: center;">[<a href="javascript:history.go(-1)">Voltar</a>]<br>
          <meta http-equiv="content-type" content="text/html; charset="UTF-8">
          <p class="commenttitle" style="margin: 0px 0px 20px; color: rgb(0, 0, 0); font-size: 13px; text-align: left; font-weight: bold; padding: 2px 0px; font-variant: normal; border-bottom: 1px dashed rgb(0, 113, 156); font-family: Verdana, Arial, Helvetica, sans-serif; font-style: normal; letter-spacing: normal; orphans: 2; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial;">18
            Coment�rios</p>
          <ol class="commentlist" style="list-style: none; margin: 0px; padding: 0px; color: rgb(0, 0, 0); font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 12px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial;">
            <li id="comment-649" class="commentbody" style="color: rgb(0, 0, 0); font-size: 12px; list-style-type: none; margin: 0px 0px 10px; padding: 0px 5px; border: 1px solid rgb(0, 113, 156); background: rgb(255, 255, 255);">
              <div class="commenthead" style="color: rgb(0, 0, 0); padding: 5px 0px 10px; margin: 0px 0px 10px; border-bottom: 1px dashed rgb(0, 113, 156); background: rgb(255, 255, 255);"><img
                  alt="" src="http://1.gravatar.com/avatar/4feabf7d021fb9855f3a39a187a49cc0?s=32&amp;d=identicon&amp;r=g"
                  srcset="http://1.gravatar.com/avatar/4feabf7d021fb9855f3a39a187a49cc0?s=64&amp;d=identicon&amp;r=g 2x"
                  class="avatar avatar-32 photo" style="border: 0px; padding: 0px; float: left; margin: 0px 5px 0px 0px; background: rgb(255, 255, 255);"
                  width="32" height="32">
                <div class="commentcount" style="float: right; color: rgb(170, 170, 170); font-size: 20px; margin: 0px; padding: 5px 0px 0px; font-family: Georgia, Times, &quot;Times New Roman&quot;, serif;">1</div>
                <span class="authorlink" style="color: rgb(0, 0, 0); font-size: 12px; font-weight: bold; line-height: 1.5em;">Virginia
                  Frota de Matos</span>&nbsp; <span class=""></span><br>
                <a class="commentlink" href="http://cienciasdasaude.med.br/?p=1288#comment-649"
                  title="" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 10px;"></a></div>
              <p style="margin: 0px 0px 12px;">Gostei muito da sua explana��o
                sobre citologia esfoliativa,bem did�tico.Sou Professora de
                Citopatologia.<br>
                Um grande abra�o citol�gico<br>
                Virginia</p>
            </li>
            <li id="comment-650" class="commentbody" style="color: rgb(0, 0, 0); font-size: 12px; list-style-type: none; margin: 0px 0px 10px; padding: 0px 5px; border: 1px solid rgb(0, 113, 156); background: rgb(255, 255, 255);">
              <div class="commenthead" style="color: rgb(0, 0, 0); padding: 5px 0px 10px; margin: 0px 0px 10px; border-bottom: 1px dashed rgb(0, 113, 156); background: rgb(255, 255, 255);"><img
                  alt="" src="http://2.gravatar.com/avatar/874ff2bbad07a34a71fa5dd257eb264c?s=32&amp;d=identicon&amp;r=g"
                  srcset="http://2.gravatar.com/avatar/874ff2bbad07a34a71fa5dd257eb264c?s=64&amp;d=identicon&amp;r=g 2x"
                  class="avatar avatar-32 photo" style="border: 0px; padding: 0px; float: left; margin: 0px 5px 0px 0px; background: rgb(255, 255, 255);"
                  width="32" height="32">
                <div class="commentcount" style="float: right; color: rgb(170, 170, 170); font-size: 20px; margin: 0px; padding: 5px 0px 0px; font-family: Georgia, Times, &quot;Times New Roman&quot;, serif;">2</div>
                <span class="authorlink" style="color: rgb(0, 0, 0); font-size: 12px; font-weight: bold; line-height: 1.5em;">Glecimara</span>&nbsp;
                <span class=""></span><br>
                <a class="commentlink" href="http://cienciasdasaude.med.br/?p=1288#comment-650"
                  title="" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 10px;"></a></div>
              <p style="margin: 0px 0px 12px;">Ol� gostaria de saber se no laudo
                citologico a presen�a de herpes e HPV � sugestivo ou tem que
                afirmar a presen�a.</p>
            </li>
            <li id="comment-652" class="commentbody" style="color: rgb(0, 0, 0); font-size: 12px; list-style-type: none; margin: 0px 0px 10px; padding: 0px 5px; border: 1px solid rgb(0, 113, 156); background: rgb(255, 255, 255);">
              <div class="commenthead" style="color: rgb(0, 0, 0); padding: 5px 0px 10px; margin: 0px 0px 10px; border-bottom: 1px dashed rgb(0, 113, 156); background: rgb(255, 255, 255);"><img
                  alt="" src="http://0.gravatar.com/avatar/36ce68d400cc7bac49377ab439b3c76d?s=32&amp;d=identicon&amp;r=g"
                  srcset="http://0.gravatar.com/avatar/36ce68d400cc7bac49377ab439b3c76d?s=64&amp;d=identicon&amp;r=g 2x"
                  class="avatar avatar-32 photo" style="border: 0px; padding: 0px; float: left; margin: 0px 5px 0px 0px; background: rgb(255, 255, 255);"
                  width="32" height="32">
                <div class="commentcount" style="float: right; color: rgb(170, 170, 170); font-size: 20px; margin: 0px; padding: 5px 0px 0px; font-family: Georgia, Times, &quot;Times New Roman&quot;, serif;">3</div>
                <span class="authorlink" style="color: rgb(0, 0, 0); font-size: 12px; font-weight: bold; line-height: 1.5em;"><a
                    href="http://deleted/" rel="external nofollow" class="url" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 12px; font-weight: bold; line-height: 1.5em;">Andrea</a></span>&nbsp;
                <span class=""></span><br>
                <a class="commentlink" href="http://cienciasdasaude.med.br/?p=1288#comment-652"
                  title="" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 10px;"></a></div>
              <p style="margin: 0px 0px 12px;">gostaria de saber o que � hpv</p>
            </li>
            <li id="comment-655" class="commentbody" style="color: rgb(0, 0, 0); font-size: 12px; list-style-type: none; margin: 0px 0px 10px; padding: 0px 5px; border: 1px solid rgb(0, 113, 156); background: rgb(255, 255, 255);">
              <div class="commenthead" style="color: rgb(0, 0, 0); padding: 5px 0px 10px; margin: 0px 0px 10px; border-bottom: 1px dashed rgb(0, 113, 156); background: rgb(255, 255, 255);"><img
                  alt="" src="http://1.gravatar.com/avatar/1f139cd64e6320ede4ab857222e33b2a?s=32&amp;d=identicon&amp;r=g"
                  srcset="http://1.gravatar.com/avatar/1f139cd64e6320ede4ab857222e33b2a?s=64&amp;d=identicon&amp;r=g 2x"
                  class="avatar avatar-32 photo" style="border: 0px; padding: 0px; float: left; margin: 0px 5px 0px 0px; background: rgb(255, 255, 255);"
                  width="32" height="32">
                <div class="commentcount" style="float: right; color: rgb(170, 170, 170); font-size: 20px; margin: 0px; padding: 5px 0px 0px; font-family: Georgia, Times, &quot;Times New Roman&quot;, serif;">4</div>
                <span class="authorlink" style="color: rgb(0, 0, 0); font-size: 12px; font-weight: bold; line-height: 1.5em;">heinz</span>&nbsp;
                <span class=""></span><br>
                <a class="commentlink" href="http://cienciasdasaude.med.br/?p=1288#comment-655"
                  title="" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 10px;"></a></div>
              <p style="margin: 0px 0px 12px;">Andrea:<br>
                HPV significa Human Papilon Virus, ou seja V�RUS do papiloma
                humano. � um v�rus que atua no n�cleo das c�lulas provocando
                modifica�es que PODEM (veja bem, PODEM) levar a um c�ncer,
                sendo que este depende mais do estado imunol�gico da mulher do
                que do v�rus em si.</p>
            </li>
            <li id="comment-653" class="commentbody" style="color: rgb(0, 0, 0); font-size: 12px; list-style-type: none; margin: 0px 0px 10px; padding: 0px 5px; border: 1px solid rgb(0, 113, 156); background: rgb(255, 255, 255);">
              <div class="commenthead" style="color: rgb(0, 0, 0); padding: 5px 0px 10px; margin: 0px 0px 10px; border-bottom: 1px dashed rgb(0, 113, 156); background: rgb(255, 255, 255);"><img
                  alt="" src="http://0.gravatar.com/avatar/36ce68d400cc7bac49377ab439b3c76d?s=32&amp;d=identicon&amp;r=g"
                  srcset="http://0.gravatar.com/avatar/36ce68d400cc7bac49377ab439b3c76d?s=64&amp;d=identicon&amp;r=g 2x"
                  class="avatar avatar-32 photo" style="border: 0px; padding: 0px; float: left; margin: 0px 5px 0px 0px; background: rgb(255, 255, 255);"
                  width="32" height="32">
                <div class="commentcount" style="float: right; color: rgb(170, 170, 170); font-size: 20px; margin: 0px; padding: 5px 0px 0px; font-family: Georgia, Times, &quot;Times New Roman&quot;, serif;">5</div>
                <span class="authorlink" style="color: rgb(0, 0, 0); font-size: 12px; font-weight: bold; line-height: 1.5em;"><a
                    href="http://deleted/" rel="external nofollow" class="url" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 12px; font-weight: bold; line-height: 1.5em;">Andrea</a></span>&nbsp;
                <span class=""></span><br>
                <a class="commentlink" href="http://cienciasdasaude.med.br/?p=1288#comment-653"
                  title="" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 10px;"></a></div>
              <p style="margin: 0px 0px 12px;">ol� mais um esclarecimento minha
                irnm� ter muitas dores de colicas ele desmai e profo germe e
                chora de dor nunca foi ao ginicologista e o fundo da calcinha
                dela � muito machado ela � virgem gostaria de saber se tem
                algunha possibilidade de ela ter endometiose</p>
            </li>
            <li id="comment-654" class="commentbody" style="color: rgb(0, 0, 0); font-size: 12px; list-style-type: none; margin: 0px 0px 10px; padding: 0px 5px; border: 1px solid rgb(0, 113, 156); background: rgb(255, 255, 255);">
              <div class="commenthead" style="color: rgb(0, 0, 0); padding: 5px 0px 10px; margin: 0px 0px 10px; border-bottom: 1px dashed rgb(0, 113, 156); background: rgb(255, 255, 255);"><img
                  alt="" src="http://1.gravatar.com/avatar/1f139cd64e6320ede4ab857222e33b2a?s=32&amp;d=identicon&amp;r=g"
                  srcset="http://1.gravatar.com/avatar/1f139cd64e6320ede4ab857222e33b2a?s=64&amp;d=identicon&amp;r=g 2x"
                  class="avatar avatar-32 photo" style="border: 0px; padding: 0px; float: left; margin: 0px 5px 0px 0px; background: rgb(255, 255, 255);"
                  width="32" height="32">
                <div class="commentcount" style="float: right; color: rgb(170, 170, 170); font-size: 20px; margin: 0px; padding: 5px 0px 0px; font-family: Georgia, Times, &quot;Times New Roman&quot;, serif;">6</div>
                <span class="authorlink" style="color: rgb(0, 0, 0); font-size: 12px; font-weight: bold; line-height: 1.5em;">heinz</span>&nbsp;
                <span class=""></span><br>
                <a class="commentlink" href="http://cienciasdasaude.med.br/?p=1288#comment-654"
                  title="" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 10px;"></a></div>
              <p style="margin: 0px 0px 12px;">Andrea:<br>
                Pode ser endometriose, especialmente se sua m�e tomou
                dietiestilbestrol, o famoso Ginecoside para saber se estava
                gr�vida dela. Um sintoma de endometriose � menstrua��o
                excess�va, al�m da c�lica forte.</p>
            </li>
            <li id="comment-656" class="commentbody" style="color: rgb(0, 0, 0); font-size: 12px; list-style-type: none; margin: 0px 0px 10px; padding: 0px 5px; border: 1px solid rgb(0, 113, 156); background: rgb(255, 255, 255);">
              <div class="commenthead" style="color: rgb(0, 0, 0); padding: 5px 0px 10px; margin: 0px 0px 10px; border-bottom: 1px dashed rgb(0, 113, 156); background: rgb(255, 255, 255);"><img
                  alt="" src="http://1.gravatar.com/avatar/13a6632eae1b28ed8295fbc8ee6a7965?s=32&amp;d=identicon&amp;r=g"
                  srcset="http://1.gravatar.com/avatar/13a6632eae1b28ed8295fbc8ee6a7965?s=64&amp;d=identicon&amp;r=g 2x"
                  class="avatar avatar-32 photo" style="border: 0px; padding: 0px; float: left; margin: 0px 5px 0px 0px; background: rgb(255, 255, 255);"
                  width="32" height="32">
                <div class="commentcount" style="float: right; color: rgb(170, 170, 170); font-size: 20px; margin: 0px; padding: 5px 0px 0px; font-family: Georgia, Times, &quot;Times New Roman&quot;, serif;">7</div>
                <span class="authorlink" style="color: rgb(0, 0, 0); font-size: 12px; font-weight: bold; line-height: 1.5em;">Renata</span>&nbsp;
                <span class=""></span><br>
                <a class="commentlink" href="http://cienciasdasaude.med.br/?p=1288#comment-656"
                  title="" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 10px;"></a></div>
              <p style="margin: 0px 0px 12px;">ol�, eu fiz meu preventivo e
                acusou uma mancha branca no c�lo do utero, a medica q fewz o
                preventivo sugerio fazer bi�psia mas minha ginecologista
                preferiu fazer logo um exame pra detectar HPV. Gopstaria de
                saber quais chances eu tenho dessa mancha ser realmente HPV?</p>
            </li>
            <li id="comment-657" class="commentbody" style="color: rgb(0, 0, 0); font-size: 12px; list-style-type: none; margin: 0px 0px 10px; padding: 0px 5px; border: 1px solid rgb(0, 113, 156); background: rgb(255, 255, 255);">
              <div class="commenthead" style="color: rgb(0, 0, 0); padding: 5px 0px 10px; margin: 0px 0px 10px; border-bottom: 1px dashed rgb(0, 113, 156); background: rgb(255, 255, 255);"><img
                  alt="" src="http://0.gravatar.com/avatar/929330b1a105fe14756b122298b73d17?s=32&amp;d=identicon&amp;r=g"
                  srcset="http://0.gravatar.com/avatar/929330b1a105fe14756b122298b73d17?s=64&amp;d=identicon&amp;r=g 2x"
                  class="avatar avatar-32 photo" style="border: 0px; padding: 0px; float: left; margin: 0px 5px 0px 0px; background: rgb(255, 255, 255);"
                  width="32" height="32">
                <div class="commentcount" style="float: right; color: rgb(170, 170, 170); font-size: 20px; margin: 0px; padding: 5px 0px 0px; font-family: Georgia, Times, &quot;Times New Roman&quot;, serif;">8</div>
                <span class="authorlink" style="color: rgb(0, 0, 0); font-size: 12px; font-weight: bold; line-height: 1.5em;"><a
                    href="http://antonini.med.br/blog/?p=1356&amp;cpage=2#comments"
                    rel="external nofollow" class="url" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 12px; font-weight: bold; line-height: 1.5em;">Camylle
                    Guedes</a></span>&nbsp; <span class=""></span><br>
                <a class="commentlink" href="http://cienciasdasaude.med.br/?p=1288#comment-657"
                  title="" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 10px;"></a></div>
              <p style="margin: 0px 0px 12px;">Dr� olha eu de novo ak� rsrs<br>
                Olha minha menstrua�ao desceu dia 20 domingo umas 11: da noite..<br>
                I hoje quarta feira dia 23.. ja foi emboraaa. Entao no caso
                fikei so 2 dias menstruada..+ todos os meses eu fiko 7 dias �<br>
                Ser� q estou gravidaa?<br>
                Devo fazer o exame HCG?</p>
            </li>
            <li id="comment-658" class="commentbody" style="color: rgb(0, 0, 0); font-size: 12px; list-style-type: none; margin: 0px 0px 10px; padding: 0px 5px; border: 1px solid rgb(0, 113, 156); background: rgb(255, 255, 255);">
              <div class="commenthead" style="color: rgb(0, 0, 0); padding: 5px 0px 10px; margin: 0px 0px 10px; border-bottom: 1px dashed rgb(0, 113, 156); background: rgb(255, 255, 255);"><img
                  alt="" src="http://2.gravatar.com/avatar/5aca9c3a7c5f08b515809c0c7116af32?s=32&amp;d=identicon&amp;r=g"
                  srcset="http://2.gravatar.com/avatar/5aca9c3a7c5f08b515809c0c7116af32?s=64&amp;d=identicon&amp;r=g 2x"
                  class="avatar avatar-32 photo" style="border: 0px; padding: 0px; float: left; margin: 0px 5px 0px 0px; background: rgb(255, 255, 255);"
                  width="32" height="32">
                <div class="commentcount" style="float: right; color: rgb(170, 170, 170); font-size: 20px; margin: 0px; padding: 5px 0px 0px; font-family: Georgia, Times, &quot;Times New Roman&quot;, serif;">9</div>
                <span class="authorlink" style="color: rgb(0, 0, 0); font-size: 12px; font-weight: bold; line-height: 1.5em;">Vladimir
                  Antonini</span>&nbsp; <span class=""></span><br>
                <a class="commentlink" href="http://cienciasdasaude.med.br/?p=1288#comment-658"
                  title="" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 10px;"></a></div>
              <p style="margin: 0px 0px 12px;">Camylle Guedes:<br>
                Ainda n�o. Espere, pelo menos, mais 21 dias, da� fa�a o exame.</p>
            </li>
            <li id="comment-659" class="commentbody" style="color: rgb(0, 0, 0); font-size: 12px; list-style-type: none; margin: 0px 0px 10px; padding: 0px 5px; border: 1px solid rgb(0, 113, 156); background: rgb(255, 255, 255);">
              <div class="commenthead" style="color: rgb(0, 0, 0); padding: 5px 0px 10px; margin: 0px 0px 10px; border-bottom: 1px dashed rgb(0, 113, 156); background: rgb(255, 255, 255);"><img
                  alt="" src="http://2.gravatar.com/avatar/e6ec2e7d3fce759d06a55be38c744e8c?s=32&amp;d=identicon&amp;r=g"
                  srcset="http://2.gravatar.com/avatar/e6ec2e7d3fce759d06a55be38c744e8c?s=64&amp;d=identicon&amp;r=g 2x"
                  class="avatar avatar-32 photo" style="border: 0px; padding: 0px; float: left; margin: 0px 5px 0px 0px; background: rgb(255, 255, 255);"
                  width="32" height="32">
                <div class="commentcount" style="float: right; color: rgb(170, 170, 170); font-size: 20px; margin: 0px; padding: 5px 0px 0px; font-family: Georgia, Times, &quot;Times New Roman&quot;, serif;">10</div>
                <span class="authorlink" style="color: rgb(0, 0, 0); font-size: 12px; font-weight: bold; line-height: 1.5em;">aline</span>&nbsp;
                <span class=""></span><br>
                <a class="commentlink" href="http://cienciasdasaude.med.br/?p=1288#comment-659"
                  title="" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 10px;"></a></div>
              <p style="margin: 0px 0px 12px;">tratei de nic-1 aos 30 anos
                (biopsia e cauteriza��o), tres anos depois me engravidei e tive
                um bebe de parto normal. Hoje, um ano depois, estou tendo
                corrimento amarelo esverdeado, sem odor, n�o sinto dores. Fa�o o
                uso do Diu. Minha ginecologista diz ter visto uma mancha de 60%
                no colo uterino, mas apenas com 80% me encaminhar� para um
                especialista (SUS�) Isso pode ser sinal do nic novamente?</p>
            </li>
            <li id="comment-660" class="commentbody" style="color: rgb(0, 0, 0); font-size: 12px; list-style-type: none; margin: 0px 0px 10px; padding: 0px 5px; border: 1px solid rgb(0, 113, 156); background: rgb(255, 255, 255);">
              <div class="commenthead" style="color: rgb(0, 0, 0); padding: 5px 0px 10px; margin: 0px 0px 10px; border-bottom: 1px dashed rgb(0, 113, 156); background: rgb(255, 255, 255);"><img
                  alt="" src="http://2.gravatar.com/avatar/5aca9c3a7c5f08b515809c0c7116af32?s=32&amp;d=identicon&amp;r=g"
                  srcset="http://2.gravatar.com/avatar/5aca9c3a7c5f08b515809c0c7116af32?s=64&amp;d=identicon&amp;r=g 2x"
                  class="avatar avatar-32 photo" style="border: 0px; padding: 0px; float: left; margin: 0px 5px 0px 0px; background: rgb(255, 255, 255);"
                  width="32" height="32">
                <div class="commentcount" style="float: right; color: rgb(170, 170, 170); font-size: 20px; margin: 0px; padding: 5px 0px 0px; font-family: Georgia, Times, &quot;Times New Roman&quot;, serif;">11</div>
                <span class="authorlink" style="color: rgb(0, 0, 0); font-size: 12px; font-weight: bold; line-height: 1.5em;">Vladimir
                  Antonini</span>&nbsp; <span class=""></span><br>
                <a class="commentlink" href="http://cienciasdasaude.med.br/?p=1288#comment-660"
                  title="" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 10px;"></a></div>
              <p style="margin: 0px 0px 12px;">aline:<br>
                Talvez. Pode tamb�m ser uma rea��o imunol�gica/inflamat�rio ao
                DIU. O corrimento j� � um ind�cio. Converse melhor com sua
                m�dica.</p>
            </li>
            <li id="comment-661" class="commentbody" style="color: rgb(0, 0, 0); font-size: 12px; list-style-type: none; margin: 0px 0px 10px; padding: 0px 5px; border: 1px solid rgb(0, 113, 156); background: rgb(255, 255, 255);">
              <div class="commenthead" style="color: rgb(0, 0, 0); padding: 5px 0px 10px; margin: 0px 0px 10px; border-bottom: 1px dashed rgb(0, 113, 156); background: rgb(255, 255, 255);"><img
                  alt="" src="http://2.gravatar.com/avatar/2a175ee6e965261a2abeb12a748594ea?s=32&amp;d=identicon&amp;r=g"
                  srcset="http://2.gravatar.com/avatar/2a175ee6e965261a2abeb12a748594ea?s=64&amp;d=identicon&amp;r=g 2x"
                  class="avatar avatar-32 photo" style="border: 0px; padding: 0px; float: left; margin: 0px 5px 0px 0px; background: rgb(255, 255, 255);"
                  width="32" height="32">
                <div class="commentcount" style="float: right; color: rgb(170, 170, 170); font-size: 20px; margin: 0px; padding: 5px 0px 0px; font-family: Georgia, Times, &quot;Times New Roman&quot;, serif;">12</div>
                <span class="authorlink" style="color: rgb(0, 0, 0); font-size: 12px; font-weight: bold; line-height: 1.5em;">erika</span>&nbsp;
                <span class=""></span><br>
                <a class="commentlink" href="http://cienciasdasaude.med.br/?p=1288#comment-661"
                  title="" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 10px;"></a></div>
              <p style="margin: 0px 0px 12px;">Oi fiz a colposcopia pq estou com
                uma mancha no colo do utero, tenho chances de ser cancer???<br>
                Tenho tbm um corrimento branco e grosso sem cheiro isso</p>
            </li>
            <li id="comment-662" class="commentbody" style="color: rgb(0, 0, 0); font-size: 12px; list-style-type: none; margin: 0px 0px 10px; padding: 0px 5px; border: 1px solid rgb(0, 113, 156); background: rgb(255, 255, 255);">
              <div class="commenthead" style="color: rgb(0, 0, 0); padding: 5px 0px 10px; margin: 0px 0px 10px; border-bottom: 1px dashed rgb(0, 113, 156); background: rgb(255, 255, 255);"><img
                  alt="" src="http://1.gravatar.com/avatar/1f139cd64e6320ede4ab857222e33b2a?s=32&amp;d=identicon&amp;r=g"
                  srcset="http://1.gravatar.com/avatar/1f139cd64e6320ede4ab857222e33b2a?s=64&amp;d=identicon&amp;r=g 2x"
                  class="avatar avatar-32 photo" style="border: 0px; padding: 0px; float: left; margin: 0px 5px 0px 0px; background: rgb(255, 255, 255);"
                  width="32" height="32">
                <div class="commentcount" style="float: right; color: rgb(170, 170, 170); font-size: 20px; margin: 0px; padding: 5px 0px 0px; font-family: Georgia, Times, &quot;Times New Roman&quot;, serif;">13</div>
                <span class="authorlink" style="color: rgb(0, 0, 0); font-size: 12px; font-weight: bold; line-height: 1.5em;">heinz</span>&nbsp;
                <span class=""></span><br>
                <a class="commentlink" href="http://cienciasdasaude.med.br/?p=1288#comment-662"
                  title="" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 10px;"></a></div>
              <p style="margin: 0px 0px 12px;">erika:<br>
                Apenas seu m�dico tem condi�es de lhe responder com seguran�a,
                pois depende do exame cl�nico.</p>
            </li>
            <li id="comment-663" class="commentbody" style="color: rgb(0, 0, 0); font-size: 12px; list-style-type: none; margin: 0px 0px 10px; padding: 0px 5px; border: 1px solid rgb(0, 113, 156); background: rgb(255, 255, 255);">
              <div class="commenthead" style="color: rgb(0, 0, 0); padding: 5px 0px 10px; margin: 0px 0px 10px; border-bottom: 1px dashed rgb(0, 113, 156); background: rgb(255, 255, 255);"><img
                  alt="" src="http://1.gravatar.com/avatar/adfe8ef3e7e91a02a848a04082bf93d0?s=32&amp;d=identicon&amp;r=g"
                  srcset="http://1.gravatar.com/avatar/adfe8ef3e7e91a02a848a04082bf93d0?s=64&amp;d=identicon&amp;r=g 2x"
                  class="avatar avatar-32 photo" style="border: 0px; padding: 0px; float: left; margin: 0px 5px 0px 0px; background: rgb(255, 255, 255);"
                  width="32" height="32">
                <div class="commentcount" style="float: right; color: rgb(170, 170, 170); font-size: 20px; margin: 0px; padding: 5px 0px 0px; font-family: Georgia, Times, &quot;Times New Roman&quot;, serif;">14</div>
                <span class="authorlink" style="color: rgb(0, 0, 0); font-size: 12px; font-weight: bold; line-height: 1.5em;">Psi</span>&nbsp;
                <span class=""></span><br>
                <a class="commentlink" href="http://cienciasdasaude.med.br/?p=1288#comment-663"
                  title="" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 10px;"></a></div>
              <p style="margin: 0px 0px 12px;">O preventivo � capaz de dizer se
                a mulher tem herpes genital?</p>
            </li>
            <li id="comment-665" class="commentbody" style="color: rgb(0, 0, 0); font-size: 12px; list-style-type: none; margin: 0px 0px 10px; padding: 0px 5px; border: 1px solid rgb(0, 113, 156); background: rgb(255, 255, 255);">
              <div class="commenthead" style="color: rgb(0, 0, 0); padding: 5px 0px 10px; margin: 0px 0px 10px; border-bottom: 1px dashed rgb(0, 113, 156); background: rgb(255, 255, 255);"><img
                  alt="" src="http://2.gravatar.com/avatar/e6d56f81edfb4d428b3776923d30f261?s=32&amp;d=identicon&amp;r=g"
                  srcset="http://2.gravatar.com/avatar/e6d56f81edfb4d428b3776923d30f261?s=64&amp;d=identicon&amp;r=g 2x"
                  class="avatar avatar-32 photo" style="border: 0px; padding: 0px; float: left; margin: 0px 5px 0px 0px; background: rgb(255, 255, 255);"
                  width="32" height="32">
                <div class="commentcount" style="float: right; color: rgb(170, 170, 170); font-size: 20px; margin: 0px; padding: 5px 0px 0px; font-family: Georgia, Times, &quot;Times New Roman&quot;, serif;">15</div>
                <span class="authorlink" style="color: rgb(0, 0, 0); font-size: 12px; font-weight: bold; line-height: 1.5em;">Heinz</span>&nbsp;
                <span class=""></span><br>
                <a class="commentlink" href="http://cienciasdasaude.med.br/?p=1288#comment-665"
                  title="" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 10px;"></a></div>
              <p style="margin: 0px 0px 12px;">Psi:<br>
                O preventivo consegue mostrar se h� uma infec��o por herpes.
                Veja<span>&nbsp;</span><a href="http://www.cienciasdasaude.org/portal/?p=1428"
                  rel="nofollow" style="color: rgb(4, 113, 155); text-decoration: none;">aqui</a>as
                imagens (121 a 126) como o herpes aparece no papanicolau.</p>
            </li>
            <li id="comment-664" class="commentbody" style="color: rgb(0, 0, 0); font-size: 12px; list-style-type: none; margin: 0px 0px 10px; padding: 0px 5px; border: 1px solid rgb(0, 113, 156); background: rgb(255, 255, 255);">
              <div class="commenthead" style="color: rgb(0, 0, 0); padding: 5px 0px 10px; margin: 0px 0px 10px; border-bottom: 1px dashed rgb(0, 113, 156); background: rgb(255, 255, 255);"><img
                  alt="" src="http://1.gravatar.com/avatar/adfe8ef3e7e91a02a848a04082bf93d0?s=32&amp;d=identicon&amp;r=g"
                  srcset="http://1.gravatar.com/avatar/adfe8ef3e7e91a02a848a04082bf93d0?s=64&amp;d=identicon&amp;r=g 2x"
                  class="avatar avatar-32 photo" style="border: 0px; padding: 0px; float: left; margin: 0px 5px 0px 0px; background: rgb(255, 255, 255);"
                  width="32" height="32">
                <div class="commentcount" style="float: right; color: rgb(170, 170, 170); font-size: 20px; margin: 0px; padding: 5px 0px 0px; font-family: Georgia, Times, &quot;Times New Roman&quot;, serif;">16</div>
                <span class="authorlink" style="color: rgb(0, 0, 0); font-size: 12px; font-weight: bold; line-height: 1.5em;">Psi</span>&nbsp;
                <span class=""></span><br>
                <a class="commentlink" href="http://cienciasdasaude.med.br/?p=1288#comment-664"
                  title="" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 10px;"></a></div>
              <p style="margin: 0px 0px 12px;">O preventivo � capaz de dizer se
                a pessoa tem herpes genital?</p>
            </li>
            <li id="comment-666" class="commentbody" style="color: rgb(0, 0, 0); font-size: 12px; list-style-type: none; margin: 0px 0px 10px; padding: 0px 5px; border: 1px solid rgb(0, 113, 156); background: rgb(255, 255, 255);">
              <div class="commenthead" style="color: rgb(0, 0, 0); padding: 5px 0px 10px; margin: 0px 0px 10px; border-bottom: 1px dashed rgb(0, 113, 156); background: rgb(255, 255, 255);"><img
                  alt="" src="http://2.gravatar.com/avatar/8f3f3a1b1dd81cd3eb8d0818b4fbb1b7?s=32&amp;d=identicon&amp;r=g"
                  srcset="http://2.gravatar.com/avatar/8f3f3a1b1dd81cd3eb8d0818b4fbb1b7?s=64&amp;d=identicon&amp;r=g 2x"
                  class="avatar avatar-32 photo" style="border: 0px; padding: 0px; float: left; margin: 0px 5px 0px 0px; background: rgb(255, 255, 255);"
                  width="32" height="32">
                <div class="commentcount" style="float: right; color: rgb(170, 170, 170); font-size: 20px; margin: 0px; padding: 5px 0px 0px; font-family: Georgia, Times, &quot;Times New Roman&quot;, serif;">17</div>
                <span class="authorlink" style="color: rgb(0, 0, 0); font-size: 12px; font-weight: bold; line-height: 1.5em;">jrl</span>&nbsp;
                <span class=""></span><br>
                <a class="commentlink" href="http://cienciasdasaude.med.br/?p=1288#comment-666"
                  title="" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 10px;"></a></div>
              <p style="margin: 0px 0px 12px;">ol�, eu fiz meu preventivo e
                acusou uma mancha branca no c�lo do utero, a medica q fewz o
                preventivo sugerio fazer bi�psia mas minha ginecologista
                preferiu fazer logo um exame pra detectar HPV. Gopstaria de
                saber quais chances eu tenho dessa mancha ser realmente HPV?</p>
            </li>
            <li id="comment-667" class="commentbody" style="color: rgb(0, 0, 0); font-size: 12px; list-style-type: none; margin: 0px 0px 10px; padding: 0px 5px; border: 1px solid rgb(0, 113, 156); background: rgb(255, 255, 255);">
              <div class="commenthead" style="color: rgb(0, 0, 0); padding: 5px 0px 10px; margin: 0px 0px 10px; border-bottom: 1px dashed rgb(0, 113, 156); background: rgb(255, 255, 255);"><img
                  alt="" src="http://0.gravatar.com/avatar/9db73e0047af3082f2c230f7cbda1677?s=32&amp;d=identicon&amp;r=g"
                  srcset="http://0.gravatar.com/avatar/9db73e0047af3082f2c230f7cbda1677?s=64&amp;d=identicon&amp;r=g 2x"
                  class="avatar avatar-32 photo" style="border: 0px; padding: 0px; float: left; margin: 0px 5px 0px 0px; background: rgb(255, 255, 255);"
                  width="32" height="32">
                <div class="commentcount" style="float: right; color: rgb(170, 170, 170); font-size: 20px; margin: 0px; padding: 5px 0px 0px; font-family: Georgia, Times, &quot;Times New Roman&quot;, serif;">18</div>
                <span class="authorlink" style="color: rgb(0, 0, 0); font-size: 12px; font-weight: bold; line-height: 1.5em;">heinz</span>&nbsp;
                <span class=""></span><br>
                <a class="commentlink" href="http://cienciasdasaude.med.br/?p=1288#comment-667"
                  title="" style="color: rgb(0, 0, 0); text-decoration: none; font-size: 10px;"></a></div>
              <p style="margin: 0px 0px 12px;">Imposs�vel dizer qualquer coisa
                sem o resultado dos exames. Volte ao m�dico.</p>
            </li>
          </ol>
        </div>
      </div>
    </div>
  </body>
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