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Rev Bras Ginecol Obstet. 2016;38(9):471-476
The Buschke-Loewenstein tumor is characterized by excessive growth of verrucous lesions on the genitals and/or perianal region. It is considered benign despite the high rate of recurrence and the possibility of malignant transformation. It is commonly associated with subtypes 6 and 11 of the human papillomavirus (HPV), and host 's immunity plays an important role in the development of the disease. Surgical excision is the recommended treatment in most cases. We present the case of a 16 years old female patient with extensive vulvar lesions successfully treated surgically.
Summary
Rev Bras Ginecol Obstet. 2016;38(9):471-476
The Buschke-Loewenstein tumor is characterized by excessive growth of verrucous lesions on the genitals and/or perianal region. It is considered benign despite the high rate of recurrence and the possibility of malignant transformation. It is commonly associated with subtypes 6 and 11 of the human papillomavirus (HPV), and host 's immunity plays an important role in the development of the disease. Surgical excision is the recommended treatment in most cases. We present the case of a 16 years old female patient with extensive vulvar lesions successfully treated surgically.
Summary
Rev Bras Ginecol Obstet. 2021;43(8):585-587
Summary
Rev Bras Ginecol Obstet. 2021;43(8):585-587
Summary
Rev Bras Ginecol Obstet. 2003;25(8):593-598
DOI 10.1590/S0100-72032003000800008
PURPOSE: to investigate the effect of antiretroviral drugs on the lipid metabolism in HIV-infected pregnant women. METHODS: a prospective study was conducted on 57 pregnant women. The women were divided into three groups: ZDV group, consisting of 20 HIV-infected women taking ZDV; TT group, consisting of 25 HIV-1-infected women on triple antiretroviral treatment (ZDV + 3TC + NFV), and control group, consisting of 12 pregnant women considered to be normal from a clinical and laboratory viewpoint. Demographic and anthropometric data were homogeneous. Patients with a personal and family history of hyperlipidemia were excluded. Blood samples were obtained for the determination of fasting lipids (total cholesterol, LDL and HDL, and triglycerides) at four periods during pregnancy (1st = 14-20 weeks; 2nd = 21-26 weeks; 3rd = 27-32 weeks and 4th = 33-38 weeks). Data were analyzed statistically using the nonparametric chi², Friedman and Kruskal-Wallis tests . RESULTS: the use of antiretroviral drugs during pregnancy induced no difference in total or HDL cholesterol but caused an increase from 76.5 and 84 mg/dL to 96 and 105 mg/dL in the concentration of the LDL fraction along gestation in ZDV and TT groups, respectively (p<0.01). A positive significant association was observed between triglycerides and viral burden in the ZDV group (r: 0.534; p=0.015). CONCLUSION: Antiretroviral agents during pregnancy increase serum LDL-colesterol levels. The risk of pregnancy regarding potentiation of long-term antiretroviral effects on lipid metabolism, remains to be established.
Summary
Rev Bras Ginecol Obstet. 2003;25(8):593-598
DOI 10.1590/S0100-72032003000800008
PURPOSE: to investigate the effect of antiretroviral drugs on the lipid metabolism in HIV-infected pregnant women. METHODS: a prospective study was conducted on 57 pregnant women. The women were divided into three groups: ZDV group, consisting of 20 HIV-infected women taking ZDV; TT group, consisting of 25 HIV-1-infected women on triple antiretroviral treatment (ZDV + 3TC + NFV), and control group, consisting of 12 pregnant women considered to be normal from a clinical and laboratory viewpoint. Demographic and anthropometric data were homogeneous. Patients with a personal and family history of hyperlipidemia were excluded. Blood samples were obtained for the determination of fasting lipids (total cholesterol, LDL and HDL, and triglycerides) at four periods during pregnancy (1st = 14-20 weeks; 2nd = 21-26 weeks; 3rd = 27-32 weeks and 4th = 33-38 weeks). Data were analyzed statistically using the nonparametric chi², Friedman and Kruskal-Wallis tests . RESULTS: the use of antiretroviral drugs during pregnancy induced no difference in total or HDL cholesterol but caused an increase from 76.5 and 84 mg/dL to 96 and 105 mg/dL in the concentration of the LDL fraction along gestation in ZDV and TT groups, respectively (p<0.01). A positive significant association was observed between triglycerides and viral burden in the ZDV group (r: 0.534; p=0.015). CONCLUSION: Antiretroviral agents during pregnancy increase serum LDL-colesterol levels. The risk of pregnancy regarding potentiation of long-term antiretroviral effects on lipid metabolism, remains to be established.
Summary
Rev Bras Ginecol Obstet. 2002;24(10):647-652
DOI 10.1590/S0100-72032002001000003
PURPOSE: to evaluate experimentally the effects of antiretroviral drugs used alone and in association upon the fertility of pregnant Wistar rats and the perinatal effects on the offspring. METHODS: adult female pregnant Wistar rats weighing 200-230 g were used. The antiretroviral drugs zidovudine (AZT), lamivudine (3TC) and nelfinavir (NFV) were used alone and in association at daily doses of ten times the dose normally used in pregnant women, proportionally to the animal's body weight. Seven groups were studied, including the control one. The experiment started on day 0 and the pregnant animals were sacrificed on day 21. The alive and dead fetuses, the total implantation sites and the total numbers of corporea lutea were used to calculate the fertility values. The statistical analysis was performed by Student's t test and by the Mann-Whitney test. RESULTS: there were no significant statistical differences regarding preimplantation loss and implantation efficiency values of the rats treated with isolated and associated antiretroviral drugs. There was a significant increase in the postimplantation loss values (control group: 7.6%; drug groups variation: 20.2-26.7%), a decrease in the fetal viability values (control group: 92.4%, drug groups variation: 73.3-79.8%), and a decreasing number of fetuses per animal (control group: 14.7; drug groups variation: 11.1-12.7). There was a significant weight reduction of the female rats and of the offspring of animals treated with 3TC, AZT + 3TC and AZT + 3TC + NFV. CONCLUSION: with the administration of high antiretroviral doses, important fertility effects could be observed, which showed that less histotoxic antiretroviral drugs must be studied in order to warrant the safety of using these medicines in pregnant HIV-1 - infected women.
Summary
Rev Bras Ginecol Obstet. 2002;24(10):647-652
DOI 10.1590/S0100-72032002001000003
PURPOSE: to evaluate experimentally the effects of antiretroviral drugs used alone and in association upon the fertility of pregnant Wistar rats and the perinatal effects on the offspring. METHODS: adult female pregnant Wistar rats weighing 200-230 g were used. The antiretroviral drugs zidovudine (AZT), lamivudine (3TC) and nelfinavir (NFV) were used alone and in association at daily doses of ten times the dose normally used in pregnant women, proportionally to the animal's body weight. Seven groups were studied, including the control one. The experiment started on day 0 and the pregnant animals were sacrificed on day 21. The alive and dead fetuses, the total implantation sites and the total numbers of corporea lutea were used to calculate the fertility values. The statistical analysis was performed by Student's t test and by the Mann-Whitney test. RESULTS: there were no significant statistical differences regarding preimplantation loss and implantation efficiency values of the rats treated with isolated and associated antiretroviral drugs. There was a significant increase in the postimplantation loss values (control group: 7.6%; drug groups variation: 20.2-26.7%), a decrease in the fetal viability values (control group: 92.4%, drug groups variation: 73.3-79.8%), and a decreasing number of fetuses per animal (control group: 14.7; drug groups variation: 11.1-12.7). There was a significant weight reduction of the female rats and of the offspring of animals treated with 3TC, AZT + 3TC and AZT + 3TC + NFV. CONCLUSION: with the administration of high antiretroviral doses, important fertility effects could be observed, which showed that less histotoxic antiretroviral drugs must be studied in order to warrant the safety of using these medicines in pregnant HIV-1 - infected women.
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Rev Bras Ginecol Obstet. 2022;44(7):692-700
, , , , To review concepts, definitions, and findings about fear of childbirth (FOC).
A bibliographic review was carried out through the main scientific databases in 2020.
All 32 articles considered potentially relevant were analyzed. A recent study suggests that the global prevalence of FOC can reach up to 14%. Factors such as parity, gestational age, previous birth experience, age and nationality of the woman seem to influence FOC.
Fear of childbirth could be related to an increased risk of adverse obstetric outcomes such as maternal request for cesarean delivery, preterm birth, prolonged labor, postpartum depression, and post-traumatic stress. These evidence highlight the importance of the discussion regarding this topic.
Summary
Rev Bras Ginecol Obstet. 2022;44(7):692-700
, , , , To review concepts, definitions, and findings about fear of childbirth (FOC).
A bibliographic review was carried out through the main scientific databases in 2020.
All 32 articles considered potentially relevant were analyzed. A recent study suggests that the global prevalence of FOC can reach up to 14%. Factors such as parity, gestational age, previous birth experience, age and nationality of the woman seem to influence FOC.
Fear of childbirth could be related to an increased risk of adverse obstetric outcomes such as maternal request for cesarean delivery, preterm birth, prolonged labor, postpartum depression, and post-traumatic stress. These evidence highlight the importance of the discussion regarding this topic.
Summary
Rev Bras Ginecol Obstet. 2005;27(11):698-705
DOI 10.1590/S0100-72032005001100011
One of the most important advances in the control of the spread of infection with type 1 human immunodeficiency virus (HIV-1) occurred within the context of vertical transmission (VT), with a reduction from levels of more than 40% to levels of less than 3%. Technological progress together with a better physiopathological understanding of this infection has permitted the determination of the situations and factors that increase the rates of perinatal transmission of the virus, indicating which interventions are most adequate for its control. The situations of higher risk for VT of HIV involve maternal, adnexal, obstetrical, fetal, viral, and postnatal factors. Among maternal factors, particularly important is viral load, the major indicator of the risk of this form of transmission. However, despite its relevance, viral load is not the only variable in this equation, with the following factors also playing important roles: use of illicit drugs, multiple sex partners and unprotected sex, malnutrition, smoking habit, advanced maternal disease, and lack af access or compliance with antiretroviral drugs. Among the adnexal factors are prolonged chorion-amniorrhexis, loss of placental integrity, and the expression of secondary receptors in placental tissue. Among the obstetrical factors, it should be remembered that invasive interventions in the fetus or amniotic chamber, internal cardiotocography, type of delivery, and contact of the fetus/newborn infant with maternal blood are also important elements to be controlled. Among the fetal factors are the expression of secondary HIV-1 receptors, genetic susceptibility, reduced cytotoxic T-lymphocyte function, and prematurity. Among the viral factors, mutations and syncytium-inducing strains are believed to be risk factors for VT. Finally, there are postnatal factors represented by an elevated viral load in maternal milk, a low antibody concentration in this fluid, clinical mastitis and nipple lesions, which can be grouped within the context of breast-feeding.
Summary
Rev Bras Ginecol Obstet. 2005;27(11):698-705
DOI 10.1590/S0100-72032005001100011
One of the most important advances in the control of the spread of infection with type 1 human immunodeficiency virus (HIV-1) occurred within the context of vertical transmission (VT), with a reduction from levels of more than 40% to levels of less than 3%. Technological progress together with a better physiopathological understanding of this infection has permitted the determination of the situations and factors that increase the rates of perinatal transmission of the virus, indicating which interventions are most adequate for its control. The situations of higher risk for VT of HIV involve maternal, adnexal, obstetrical, fetal, viral, and postnatal factors. Among maternal factors, particularly important is viral load, the major indicator of the risk of this form of transmission. However, despite its relevance, viral load is not the only variable in this equation, with the following factors also playing important roles: use of illicit drugs, multiple sex partners and unprotected sex, malnutrition, smoking habit, advanced maternal disease, and lack af access or compliance with antiretroviral drugs. Among the adnexal factors are prolonged chorion-amniorrhexis, loss of placental integrity, and the expression of secondary receptors in placental tissue. Among the obstetrical factors, it should be remembered that invasive interventions in the fetus or amniotic chamber, internal cardiotocography, type of delivery, and contact of the fetus/newborn infant with maternal blood are also important elements to be controlled. Among the fetal factors are the expression of secondary HIV-1 receptors, genetic susceptibility, reduced cytotoxic T-lymphocyte function, and prematurity. Among the viral factors, mutations and syncytium-inducing strains are believed to be risk factors for VT. Finally, there are postnatal factors represented by an elevated viral load in maternal milk, a low antibody concentration in this fluid, clinical mastitis and nipple lesions, which can be grouped within the context of breast-feeding.
Summary
Rev Bras Ginecol Obstet. 2005;27(12):768-778
DOI 10.1590/S0100-72032005001200010
Knowledge about the factors or situations that influence the vertical transmission (VT) of human immunodeficiency type 1 (HIV-1) has led to the implementation of strategies which have promoted a rate decline along the years, from 40% to less than 3% nowadays. One of the major advances in the area has been the prophylactic administration of zidovudine (AZT), in the prenatal phase (oral route), in the predelivery phase (intravenous route) and to the newborn (oral route). This intervention may reduce HIV-1 VT 68%, thus being the most effective isolated strategy used so far. In the chronological sequence of advances, it has been observed that a high viral load is the main risk indicator for this type of transmission. As AZT does not reduce the viral load and does not control the residual rate observed in HIV-1 VT, the use of prophylactic schemes using three antiretroviral drugs has been encouraged. Elective caesarean section completes the range of obstetric strategies with major impact on the reduction of HIV-1 VT. Its effectiveness is linked to the observation of the criteria for its indication: viral load assessed after the 34th week of pregnancy with levels over 1000 copies/mL, gestation over 38 weeks confirmed by ultrasonography, intact chorioamniotic membranes, and performed before labor has started. In cases where normal delivery is indicated, it should be remembered that prolonged chorioamniorrhexis, invasive manipulation of the fetus, delivery with instruments and episiotomy are situations to be avoided. Among the postnatal interventions considered important for the reduction of HIV-1 VT are: pediatric reception (this should be done by trained professionals, avoiding microtraumas in the mucosa during the sucking maneuvers, use of neonatal AZT (for a period of six weeks) and bottle feeding. Special attention should be given to the orientation for the mother, in order to prevent acute infection by HIV-1 in this period, what would markedly increase virus VT rate.
Summary
Rev Bras Ginecol Obstet. 2005;27(12):768-778
DOI 10.1590/S0100-72032005001200010
Knowledge about the factors or situations that influence the vertical transmission (VT) of human immunodeficiency type 1 (HIV-1) has led to the implementation of strategies which have promoted a rate decline along the years, from 40% to less than 3% nowadays. One of the major advances in the area has been the prophylactic administration of zidovudine (AZT), in the prenatal phase (oral route), in the predelivery phase (intravenous route) and to the newborn (oral route). This intervention may reduce HIV-1 VT 68%, thus being the most effective isolated strategy used so far. In the chronological sequence of advances, it has been observed that a high viral load is the main risk indicator for this type of transmission. As AZT does not reduce the viral load and does not control the residual rate observed in HIV-1 VT, the use of prophylactic schemes using three antiretroviral drugs has been encouraged. Elective caesarean section completes the range of obstetric strategies with major impact on the reduction of HIV-1 VT. Its effectiveness is linked to the observation of the criteria for its indication: viral load assessed after the 34th week of pregnancy with levels over 1000 copies/mL, gestation over 38 weeks confirmed by ultrasonography, intact chorioamniotic membranes, and performed before labor has started. In cases where normal delivery is indicated, it should be remembered that prolonged chorioamniorrhexis, invasive manipulation of the fetus, delivery with instruments and episiotomy are situations to be avoided. Among the postnatal interventions considered important for the reduction of HIV-1 VT are: pediatric reception (this should be done by trained professionals, avoiding microtraumas in the mucosa during the sucking maneuvers, use of neonatal AZT (for a period of six weeks) and bottle feeding. Special attention should be given to the orientation for the mother, in order to prevent acute infection by HIV-1 in this period, what would markedly increase virus VT rate.
Summary
Rev Bras Ginecol Obstet. 2021;43(2):81-83
Summary
Rev Bras Ginecol Obstet. 2021;43(2):81-83