Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(5):287-292
DOI 10.1590/S0100-72032000000500006
Purpose: to evaluate the effects of hormone replacement therapy (HRT) on the systolic and diastolic blood pressure of postmenopausal women. Methods: a total of 166 users and 136 non-users of hormone replacement were evaluated retrospectively during a period of three years. All women were assisted at the Menopause Outpatient Clinic of CAISM -- Unicamp, where the variations of these parameters were evaluated at the end of each year in relation to the initial parameters. The data analysis was performed through Student's t test, Mann-Whitney test, and the Wilcoxon nonparametric test. Results: we observed that the systolic blood pressure of HRT users was statistically lower at the end of the third year of use, compared to the initial values (p = 0.01). There was no significant difference in the diastolic blood pressure between users and non-users. Conclusion: hormone replacement therapy did not produce changes in the parameters studied in women properly assisted during the use of HRT.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(5):287-290
DOI 10.1590/S0100-72031999000500007
Purpose: to evaluate the knowledge and practice of breast self-examination among medical students and to determine possible factors associated with this practice. Method: the authors used a questionnaire to gather information about the students and their knowledge of this self-examination. This questionnaire also allowed the authors to verify the frequency with which the female students performed breast self-examination. The chi² test and Student's "t" test were used, when applicable, to check the association of certain factors. Results: of the 348 questionnaires which were answered, 16% (55) were submitted by 5th year medical students, who had already attended the Gynecology course; 43% were answered by females, 62% of the students had medical doctors among their relatives, and 17% had a family history of breast cancer. In terms of breast self-examination, 95% knew about the method. Of the 149 females who answered the questionnaire, only 64% checked their breasts regularly. The reasons given for not performing self-examination varied: 24% considered themselves to be too young, 4% thought they would not have cancer, 9% listed fear as the reason, 19% reported they were too lazy, and 44% of the female students had no clear reason for not performing breast self-examination. Neither the knowledge nor the practice of the breast self-examination were associated with the subjects the students had or had not yet taken in medical school, with a family history of breast cancer or with the fact that one or more relatives were medical doctors. Conclusion: breast self-examination is known by practically all the medical students; nevertheless, only one third of the female students performed it regularly. This fact highlights the importance of emphasizing breast self-examination among medical students, so that they can help to disseminate this practice among the general population, rather than delegating this responsibility to the midia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(6):288-294
DOI 10.1590/S0100-72032011000600005
PURPOSE: to evaluate the performance of the combined first trimester screening for chromosomal abnormalities in a group of the Brazilian population. METHODS: a retrospective study including pregnant women with single fetuses referred to a fetal medicine center to perform the first trimester screening that combines maternal age, nuchal translucency measurement and two maternal serum biochemical markers: free B-hCG and PAPP-A. To evaluate the performance of the test, the detection rate, specificity, negative and positive predicted values and false-positive rates were calculated, considering as high risk the cut-off value above 1 in 300. RESULTS: we studied 456 patients submitted to the test. Advanced maternal age above 35 years was observed in 36.2% of cases. The incidence of chromosomal abnormalities in the study population was 2.2%. Twenty-one patients (4.6%) presented a high risk (above 1:300) by the combined test. Using this cut-off level, the detection rate of the test was 70% for all chromosomal abnormalities and 83.3% for trisomy 21, for a false-positive rate of 3.1%. CONCLUSIONS: the combined first trimester screening was effective to detect chromosomal abnormalities, mainly for trisomy 21, with low false-positive rates. The combined test contributed to decreasing the indication of an invasive test if we compare to maternal age alone as a risk factor.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(6):288-293
To evaluate the expressions of biomarkers p16 and Ki-67 in low-grade (LG) or high-grade (HG) lesions, and to relate them to risk factors and the recurrence of these lesions.
A retrospective case-control study of 86 patients with LG and HG lesions who underwent a loop electrosurgical excision procedure (LEEP) between 1999 and 2004. The control group was composed of 69 women with no recurrence, and the study group, of 17 patients with recurrence. All patients were followed-up over a two-year period after surgery, and screened every six months, including cytology and colposcopy. Biopsy samples collected from LEEP were submitted to immunohistochemical analysis for p16 and Ki-67. The statistical analysis was performed using the Statistical Package for the Social Sciences software (SPSS, IBM-SPSS, Inc., Chicago, IL, US), with a significant p < 0.05.
The biomarkers p16 and Ki-67, separately or combined, showed no relation to recurrence on the total analysis. However, evaluating specifically HG lesions, the positive expression (2+ and 3 + ) of p16/Ki-67 was associated with recurrence (0.010). In addition, p16 isolated was also more expressive in HG lesions (2+ and 3 + , p= 0.018), but it was unrelated to recurrence.
Proteins p16 and Ki-67, both isolated and combined, are not reliable primary markers for the recurrence of cervical lesions in the majority of LG lesions. However, analyzing only the group with prior diagnosis of HG lesions, the expressions of p16 and of p16/Ki-67 were associated with recurrence, and they may be useful in monitoring these cases.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):289-294
DOI 10.1590/S0100-72032004000400004
OBJECTIVE: to study the relationship of biobehavioral factors, such as age, menarche, number of gestations, and age of first sexual intercourse, with changes in Langerhans'cells in women with negative hybrid capture for HPV. METHODS: thirty women referred due to abnormal cervical cytology or premalignant cervical lesions were studied and underwent colposcopy, guided biopsy and histopathological exams. The Langerhans' cells were identified by immunohistochemical (S100+) exams. Langerhans' cells visualized in brown color were counted using the software Cytoviewer. The nonparametric Wilcoxon rank-sum test was employed for statistical analysis. RESULTS: the number of Langerhans' cells in women who had menarche after 13 years old presented statistically significant difference (173.34 cell/mm²) compared to the group whose menarche occurred before 13 (271.41 cell/mm²). The age at the first sexual intercourse was associated with the low number of Langerhans' cells, 127.15 cell/mm² and 250.14 cell/mm², respectively, for the beginning of the sexual activity up to 17 years old and after 17 (p=0.03). Previous cauterizations of the uterine cervix have been related to a lower number of Langerhans' cells in the epithelium, with the average 120.30 cell/mm² as compared to 236.06 cell/mm² for those women who never underwent that procedure (p=0.05). Other factors such as the patient's age and the number of gestations showed no statistically significant differences in the density of Langerhans' cells. CONCLUSIONS: the present study reports the association of biobehavioral factors with decrease in the number of Langerhans' cell.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):289-292
DOI 10.1590/S0100-72031998000500009
Pneumoperitoneum, abdominal pain and paralytic ileus in the postoperative period are usually related to perforation of the gastrointestinal tract. The authors present a case of a patient submitted to cesarean section (abruptio placentae) who had a postoperative course of abdominal distention and abdominal pain. Abdominal X-ray showed important dilatation of the colon and small bowel. Pneumoperitoneum was seen on chest X-ray. An exploratory laparotomy was performed because of suspicion of intestinal perforation. The operation showed a marked dilatation of bowel, pneumoperitoneum, and infected hemoperitoneum and subaponeurotic hematoma (Escherichia coli), without any perforation. Postoperative recovery was good and antibiotics were given for 4 days (ceftriaxone + metronidazole). The patient was diseharged from hospital on the 7th day after laparotomy. After review of the literature the authors concluded that this case of pneumoperitoneum was probably related to infection by a gas-producing bacterium in a patient with clinical findings of paralytic ileus.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(5):289-292
DOI 10.1590/S0100-72032005000500010
Endometrial polyps are benign lesions, with a low potential of malignancy. In the reproductive period their diagnosis is established in symptomatic patients with abnormal uterine bleeding or infertility. Postmenopausal women are mostly asymptomatic but in approximately one third of the cases there is an association with abnormal bleeding. They are more frequent after the menopause and risk factors of cancer of the endometrium have not been associated in the same way as risk for endometrial polyps, although they are hormone-dependent as in patients in use of tamoxifen, for instance. Their definitive diagnosis is established by hysteroscopy-guided biopsy and their most effective treatment is hysteroscopic resection. Polyps may recur after treatment. Polypectomy is highly satisfactory after the menopause, is less successful in symptomatic women in the reproductive period and improves fertility rates in infertile women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(5):289-290