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  • Artigos Originais

    Findings of gynecological laparoscopies in women with reproductive problems in a teaching hospital: a case series

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(6):297-302

    Summary

    Artigos Originais

    Findings of gynecological laparoscopies in women with reproductive problems in a teaching hospital: a case series

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(6):297-302

    DOI 10.1590/S0100-72032007000600004

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    PURPOSE: to identify the main characteristics of the diagnostic and surgical gynecological laparoscopies carried out in patients with reproductive difficulties at a teaching hospital in Recife, from 2000 and 2004. METHODS: a hospital based descriptive case-series study was carried out with 295 patients who had undergone gynecological laparoscopy for either infertility or tube recanalization in the Mother and Child Health Professor Fernando Figueira Institute. Information was obtained from the surgical records of the laparoscopies carried out from January 2000 to December 2004. The inclusion criteria was infertility or pre-recanalization study as a surgical indication. The information was typed twice into a data bank. Tables with central measurements and dispersion tendency were created for the quantitative variables and frequency distribution for the categorical variables. The statistical program, Epi Info 3.3.2., was used to analyze the data. RESULTS: along the study, 462 gynecological laparoscopies were analyzed, 295 (63.8%) of them having as an indication either infertility (41.1%) or the study of possible tube recanalization (18.8%). The patients’ average age in both groups was from 30 to 34 years old. Among the 87 patients with desire of tube recanalization, 55.2% had one or both tubes inadequate for the procedure, and from those, 52.1% was diagnosed with tube amputation (fimbrectomy). In the infertility cases, the most observed findings were adherences (60.6%), tube obstruction (40.9%) and endometriosis (36.1%). Among the procedures carried out, lysis of adherences (34.2%) and biopsies (21%) were the most frequent, followed by endometriosis treatment (10.8%) and salpingostomy (10.8%). CONCLUSION: videolaparoscopy is an important tool in the study and treatment of patients with infertility and before tube recanalization, especially in those hospitals where advanced reproductive techniques are not available.

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    Findings of gynecological laparoscopies in women with reproductive problems in a teaching hospital: a case series
  • Editorial

    Placenta Accreta Spectrum Disorders: Current Recommendations from the Perspective of Antenatal Imaging

    Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(6):297-302

    Summary

    Editorial

    Placenta Accreta Spectrum Disorders: Current Recommendations from the Perspective of Antenatal Imaging

    Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(6):297-302

    DOI 10.1055/s-0043-1770917

    Views6
    The Burden of a Previous Uterine Scar Cesarean section (CS) is the most commonly performed surgical procedure in the United States (more than a million surgeries per year) and one of the most frequently performed procedures worldwide. Although CS is a potentially life-saving procedure when correctly indicated, its worldwide use has steadily increased over the […]
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  • Original Article

    Potential Impact of the Z0011 Trial on the Omission of Axillary Dissection: A Retrospective Cohort Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(4):297-303

    Summary

    Original Article

    Potential Impact of the Z0011 Trial on the Omission of Axillary Dissection: A Retrospective Cohort Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(4):297-303

    DOI 10.1055/s-0041-1725052

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    Abstract

    Objective

    To evaluate the number of patients with early-stage breast cancer who could benefit from the omission of axillary surgery following the application of the Alliance for Clinical Trials in Oncology (ACOSOG) Z0011 trial criteria.

    Methods

    A retrospective cohort study conducted in the Hospital da Mulher da Universidade Estadual de Campinas. The study population included 384 women diagnosed with early-stage invasive breast cancer, clinically negative axilla, treated with breast-conserving surgery and sentinel lymph node biopsy, radiation therapy, chemotherapy and/or endocrine therapy, from January 2005 to December 2010. The ACOSOG Z0011 trial criteria were applied to this population and a statistical analysis was performed to make a comparison between populations.

    Results

    A total of 384 patients underwent breast-conserving surgery and sentinel lymph node biopsy. Of the total number of patients, 86 women underwent axillary lymph node dissection for metastatic sentinel lymph nodes (SNLs). One patient underwent axillary node dissection due to a suspicious SLN intraoperatively, thus, she was excluded fromthe study. Among these patients, 82/86 (95.3%) had one to two involved sentinel lymph nodes andmet the criteria for the ACOSOG Z0011 trial with the omission of axillary lymph node dissection. Among the 82 eligible women, there were only 13 cases (15.9%) of lymphovascular invasion and 62 cases (75.6%) of tumors measuring up to 2 cm in diameter (T1).

    Conclusion

    The ACOSOG Z0011 trial criteria can be applied to a select group of SLNpositive patients, reducing the costs and morbidities of breast cancer surgery.

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    Potential Impact of the Z0011 Trial on the Omission of Axillary Dissection: A Retrospective Cohort Study
  • Case Report

    Desmoplastic Small Round Cell Tumor of the Ovary: A Case Report with a New Modality of Treatment and Review of the Literature

    Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(5):297-302

    Summary

    Case Report

    Desmoplastic Small Round Cell Tumor of the Ovary: A Case Report with a New Modality of Treatment and Review of the Literature

    Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(5):297-302

    DOI 10.1055/s-0040-1710350

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    Abstract

    Objective

    Desmoplastic small round cell tumor (DSRCT) is a rare intraabdominal neoplasm that grows along serosal surfaces and is primarily found in young men. To Keywords date, only 16 cases of ovarian DSRCT have been previously reported in women in the English literature, and no large population-based studies on this topic exist.

    Case Report

    We report the case of a 19-year-old virgo with unremarkable past medical history, initially presented with abdominal fullness. After being treated with the optimal treatment modality (primary and secondary surgical debulking, unique chemotherapy, protocol and adjuvant radiotherapy), the patient has remained without tumor disease for 40 months.

    Conclusion

    Although the best therapy for patients with DSRCT has yet to be determined, combining complete surgical resection, adjuvant chemotherapy, and radiotherapy is required to prolong survival and to achieve proper quality of life.

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    Desmoplastic Small Round Cell Tumor of the Ovary: A Case Report with a New Modality of Treatment and Review of the Literature
  • Artigos Originais

    Association of p53 protein expression and degree of differentiation in infiltrating ductal breast carcinomas

    Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(5):298-303

    Summary

    Artigos Originais

    Association of p53 protein expression and degree of differentiation in infiltrating ductal breast carcinomas

    Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(5):298-303

    DOI 10.1590/S0100-72032006000500006

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    PURPOSE: to assess p53 protein expression in infiltrating ductal breast carcinoma and to analyze its association with histological and nuclear grade. METHODS: sixty-five consecutive females who were diagnosed with primary infiltrating ductal breast tumor from July 1999 to July 2001 were included in the present study. Mean patient age at diagnosis was 69.2 years (range 41 - 90). All patients were first treated with surgical therapy, conservative surgery or mastectomy. None of the patients received any preoperative adjuvant therapy. Resected breast tumor specimens were fixed in 10% formalin, paraffin embedded, and conserved for immunohistochemical analysis. p53 protein expression was evaluated. Primary monoclonal anti-human p53 antibody DO-7 (DAKO) was used. Frequency distributions were tested by the chi2 test. A level of p<0,05 was considered significant. RESULTS: p53 expression was detected in 24 (36,9%) of 65 carcinomas. Of the cases with protein expression, 13 (54,2%) were high or histological grade III, 8 (33,3%), were grade II, 3 (12,5%) were grade I. On nuclear grade analysis, of the cases with protein expression, 13 (4,2%) were nuclear grade III, 9 (37,5%) were grade II and 2 (8,3%) were grade I. p53 expression was frequent in carcinomas with high histological and nuclear grades. CONCLUSIONS: p53 expression was significantly associated with the histological grade. On the other hand, nuclear grade was not significantly related to p53 expression.

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  • Original Article

    Profile of Pregnant Women with Gestational Diabetes Mellitus at Increased Risk for Large for Gestational Age Newborns

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(5):298-305

    Summary

    Original Article

    Profile of Pregnant Women with Gestational Diabetes Mellitus at Increased Risk for Large for Gestational Age Newborns

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(5):298-305

    DOI 10.1055/s-0039-1687860

    Views5

    Abstract

    Objective

    Gestational diabetes mellitus (GDM) is associated with a higher risk of perinatal morbidity and mortality, and its main complication is the occurrence of large for gestational age (LGA) newborns. The present study aims to characterize pregnant women with GDM and to identify factors associated with the occurrence of LGA newborns in this population.

    Methods

    A cross-sectional study was performed based on medical records of women whose prenatal care and delivery were performed at the Maternal and Child Unit of the HospitalUniversitário of theUniversidade Federal doMaranhão, state of Maranhão, Brazil.A total of 116 pregnant women diagnosed with GDMwere included according to the criteria of the International Association of Diabetes and Pregnancy Study Groups (IADPSG).

    Results

    The variables associated with LGA newborns after multivariate analysis were: obesity prior to pregnancy (OR = 11.6; 95% CI: 1.40-95.9), previous macrosomia (OR = 34.7; 95% CI: 4.08-295.3), high blood glucose levels in the 3rd trimester (OR = 2,67; 95% CI: 1.01-7.12) and combined change in the oral glucose tolerance test (OGTT) (fasting + postdextrose) (OR = 3.53;95%CI:1.25-14.2) = 1.17-10.6).Otherwise, insufficientweight gain during pregnancy reduced the risk for LGA newborns (OR = 0.04; 95% CI: 0.01-0.32).

    Conclusion

    Obesity prior to pregnancy, previous macrosomia, high blood glucose levels in the 3rd trimester, and combined change in the OGTT were independent predictive factors for LGA newborns in pregnant women with GDM.

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    Profile of Pregnant Women with Gestational Diabetes Mellitus at Increased Risk for Large for Gestational Age Newborns
  • Revisão

    Current aspects on diagnosis and treatment of endometriosis

    Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(6):298-307

    Summary

    Revisão

    Current aspects on diagnosis and treatment of endometriosis

    Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(6):298-307

    DOI 10.1590/S0100-72032010000600008

    Views1

    Endometriosis is characterized by the presence of endometrial tissue, localized outside the uterine cavity, such as peritoneal surface, ovaries, and rectum-vaginal septum. The prevalence is about 6 to 10%. Concerning the etiopathogenesis, the retrograde menstruation theory is accepted, although disruption in endometrial molecular biology seems to be fundamental to the development of endometriosis ectopic focuses. Women with endometriosis may be asymptomatic or may present complaints of dysmenorrhea, dispareunia, chronic pelvic pain and/or infertility. Although the definitive diagnosis of endometriosis needs a surgical intervention, mainly by laparoscopy, many findings obtained by physicalexamination and imaging and laboratory tests can predict, with a high degree of reliability, that the patient has endometriosis. The most common current treatments include surgery, ovarian suppression therapy or both. Pharmacological treatments that do not inhibit ovarian function are under investigation.

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    Current aspects on diagnosis and treatment of endometriosis
  • Trabalhos Originais

    Biomarkers of susceptibility to endometriosis

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):299-304

    Summary

    Trabalhos Originais

    Biomarkers of susceptibility to endometriosis

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):299-304

    DOI 10.1590/S0100-72032004000400006

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    OBJECTIVE: to determine GSTT1 and GSTM1 null genotype frequencies as well as CYP1A1 polymorphic allele frequencies in a group of women with endometriosis, and to compare these frequencies with those observed in a group without endometriosis (control), aiming at a possible identification of biomarkers of susceptibility to endometriosis. METHODS: a total of 50 women with suggestive clinical signs of endometriosis underwent videolaparoscopy and biopsies were evaluated histologically. Endometriosis was present in 25 women (case group). Negative results were found in 25 women (control group). GSTT1 and GSTM1 null genotypes were assessed by multiplex polymerase chain reaction (PCR). The investigation of the polymorphic allele of the gene CYP1A1 was performed by PCR-RFLP (restriction fragment length polymorphism). For statistical analysis, the Fisher exact test was used. RESULTS: in both groups, the deletion polymorphism frequencies presented values of 16% for the gene GSTT1 and of 44% for the gene GSTM1; therefore, the results did not show differences in the distribution of the GSTT1 and GSTM1 null genotypes among the studied groups. The allelic frequency for the m1 allele of the gene CYP1A1 was higher in the women with endometriosis (0.22), although not statistically significant, when compared to the control group (0.14). CONCLUSION: the results did not show an association between the evaluated polymorphisms and the endometriosis diagnosis.

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    Biomarkers of susceptibility to endometriosis

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