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You searched for:"Edmund Chada Baracat"
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Rev Bras Ginecol Obstet. 1999;21(1):33-37
DOI 10.1590/S0100-72031999000100006
Purpose: to evaluate the agreement between the urodynamic and ultrasonography diagnoses of urinary incontinence, as well as to correlate the variables of both examinations. Methodology: three hundred eighty-one patients with urine loss were selected, from the Sectior of Urogynecology and Vaginal Surgery of the Division of Gynecology, Escola Paulista de Medicina - Federal University of São Paulo. All of them were submitted to urodynamic study, according to the standardization of the International Society of Continence, and to ultrasonography of the bladder neck, with a 6 MHz trasvaginal transducer. We analyzed the maximum closing urethral pressure (MCUP) and the etiological diagnosis of the urine loss. In the ultrasonography, the position of the bladder neck was evaluated in relation to the inferior border of the pubic symphysis, and its mobility as well as the diameter of the urethra and bladder neck. The women were categoriaed according to the urodynamic study in to stress urinary incontinence, detrusor instability and mixed urinary incontinence. Results: 1) the bladder neck, at rest was most frequently above the inferior border of the pubic symphysis and, during effort, below or at the height of the bony reference, in the three groups; 2) the mobility of the bladder neck was similar in the groups; 3) there was no significant correlation between MCUP and the diameter of the urethra and of the bladder neck. Conclusion: we deem that ultrasonography of the bladder neck is always a complement to the clinical evaluation and the urodymanic study.
Summary
Rev Bras Ginecol Obstet. 1999;21(1):33-37
DOI 10.1590/S0100-72031999000100006
Purpose: to evaluate the agreement between the urodynamic and ultrasonography diagnoses of urinary incontinence, as well as to correlate the variables of both examinations. Methodology: three hundred eighty-one patients with urine loss were selected, from the Sectior of Urogynecology and Vaginal Surgery of the Division of Gynecology, Escola Paulista de Medicina - Federal University of São Paulo. All of them were submitted to urodynamic study, according to the standardization of the International Society of Continence, and to ultrasonography of the bladder neck, with a 6 MHz trasvaginal transducer. We analyzed the maximum closing urethral pressure (MCUP) and the etiological diagnosis of the urine loss. In the ultrasonography, the position of the bladder neck was evaluated in relation to the inferior border of the pubic symphysis, and its mobility as well as the diameter of the urethra and bladder neck. The women were categoriaed according to the urodynamic study in to stress urinary incontinence, detrusor instability and mixed urinary incontinence. Results: 1) the bladder neck, at rest was most frequently above the inferior border of the pubic symphysis and, during effort, below or at the height of the bony reference, in the three groups; 2) the mobility of the bladder neck was similar in the groups; 3) there was no significant correlation between MCUP and the diameter of the urethra and of the bladder neck. Conclusion: we deem that ultrasonography of the bladder neck is always a complement to the clinical evaluation and the urodymanic study.
Summary
Rev Bras Ginecol Obstet. 2014;36(8):340-346
DOI 10.1509/SO100-720320140005034
To examine the expression of AKT and PTEN in a series of HER2-positive primary invasive breast tumors using immunohistochemistry, and to associate these expression profiles with classic pathologic features such as tumor grade, hormone receptor expression, lymphatic vascular invasion, and proliferation.
A total of 104 HER2-positive breast carcinoma specimens were prepared in tissue microarrays blocks for immunohistochemical detection of PTEN and phosphorylated AKT (pAKT). Original histologic sections were reviewed to assess pathological features, including HER2 status and Ki-67 index values. The associations between categorical and numeric variables were identified using Pearson's chi-square test and the Mann-Whitney, respectively.
Co-expression of pAKT and PTEN was presented in 59 (56.7%) cases. Reduced levels of PTEN expression were detected in 20 (19.2%) cases, and these 20 tumors had a lower Ki-67 index value. In contrast, tumors positive for pAKT expression [71 (68.3%)] were associated with a higher Ki-67 index value.
A role for AKT in the proliferation of HER2-positive breast cancers was confirmed. However, immunohistochemical detection of PTEN expression did not correlate with an inhibition of cellular proliferation or control of AKT phosphorylation, suggesting other pathways in these mechanisms of control.
Summary
Rev Bras Ginecol Obstet. 2014;36(8):340-346
DOI 10.1509/SO100-720320140005034
To examine the expression of AKT and PTEN in a series of HER2-positive primary invasive breast tumors using immunohistochemistry, and to associate these expression profiles with classic pathologic features such as tumor grade, hormone receptor expression, lymphatic vascular invasion, and proliferation.
A total of 104 HER2-positive breast carcinoma specimens were prepared in tissue microarrays blocks for immunohistochemical detection of PTEN and phosphorylated AKT (pAKT). Original histologic sections were reviewed to assess pathological features, including HER2 status and Ki-67 index values. The associations between categorical and numeric variables were identified using Pearson's chi-square test and the Mann-Whitney, respectively.
Co-expression of pAKT and PTEN was presented in 59 (56.7%) cases. Reduced levels of PTEN expression were detected in 20 (19.2%) cases, and these 20 tumors had a lower Ki-67 index value. In contrast, tumors positive for pAKT expression [71 (68.3%)] were associated with a higher Ki-67 index value.
A role for AKT in the proliferation of HER2-positive breast cancers was confirmed. However, immunohistochemical detection of PTEN expression did not correlate with an inhibition of cellular proliferation or control of AKT phosphorylation, suggesting other pathways in these mechanisms of control.
Summary
Rev Bras Ginecol Obstet. 2001;23(6):349-354
DOI 10.1590/S0100-72032001000600002
Purpose: to evaluate the histopathologic results of cone specimens of patients undergoing loop electrosurgical excision procedure (LEEP) and their relationship with the localization of the lesion. Methods: in a retrospective study, 134 clinical reports of patients with abnormal findings of cervical cytology and/or biopsy undergoing LEEP were reviewed. The colposcopic findings were divided into three groups according to the localization of the lesion. Group I (n = 36): patients with ectocervical lesions and fully visible squamocolumnar junction; Group II (n = 50): patients with lesions at the ectocervix and endocervix, and Group III (n = 48): patients with unsatisfactory colposcopy. Results: the mean age in Group I was 33 years and there were 8.3% positive margins. In Group II the mean age was 39 years, with 36% positive margins. Group III had a mean age of 48 years and presented 29.2% positive margins. The percentage of residual disease was 4.2% in Group I, 31.6% in Group II and 35.5% in Group III. Conclusion: patients with lesions at the endocervical canal showed a higher rate of positive margins. Patients with high-grade cervical intraepithelial neoplasia at the endocervical canal and older than 40 years have a greater chance of showing positive margins and residual disease, therefore requiring stricter cytologic and colposcopic follow-up.
Summary
Rev Bras Ginecol Obstet. 2001;23(6):349-354
DOI 10.1590/S0100-72032001000600002
Purpose: to evaluate the histopathologic results of cone specimens of patients undergoing loop electrosurgical excision procedure (LEEP) and their relationship with the localization of the lesion. Methods: in a retrospective study, 134 clinical reports of patients with abnormal findings of cervical cytology and/or biopsy undergoing LEEP were reviewed. The colposcopic findings were divided into three groups according to the localization of the lesion. Group I (n = 36): patients with ectocervical lesions and fully visible squamocolumnar junction; Group II (n = 50): patients with lesions at the ectocervix and endocervix, and Group III (n = 48): patients with unsatisfactory colposcopy. Results: the mean age in Group I was 33 years and there were 8.3% positive margins. In Group II the mean age was 39 years, with 36% positive margins. Group III had a mean age of 48 years and presented 29.2% positive margins. The percentage of residual disease was 4.2% in Group I, 31.6% in Group II and 35.5% in Group III. Conclusion: patients with lesions at the endocervical canal showed a higher rate of positive margins. Patients with high-grade cervical intraepithelial neoplasia at the endocervical canal and older than 40 years have a greater chance of showing positive margins and residual disease, therefore requiring stricter cytologic and colposcopic follow-up.
Summary
Rev Bras Ginecol Obstet. 2003;25(5):353-358
DOI 10.1590/S0100-72032003000500008
PURPOSE: to determine interobserver reliability of site-specific measurements and stages according to the proposed International Continence Society prolapse terminology document. METHODS: we analyzed 51 women during urogynecological investigation performed at the Urogynecology and Vaginal Surgery Sector of UNIFESP / EPM. We recorded the locations of point-specific measures proposed by the International Continence Society (ICS). They are: two in the anterior vaginal wall, two in the superior vagina, two in the posterior vaginal wall, genital hiatus, perineal body and total vaginal length. Then we recorded the stage of genital prolapse. Women underwent pelvic examinations by two investigators, each blinded to the results of the other's examination. The reproducibility of the nine site-specific measurements and the summary stage were analyzed using Pearson's correlation coefficient and the median measurements were compared by the paired-t test. RESULTS: there were substantial and highly significant correlations for each of the nine measurements. Correlation coefficient for point Aa was 0.89 (p<0.0001), point Ba 0.90 (p<0.0001), point C 0.97 (p<0.0001), point Ap de 0.72 (p<0.0001), point Bp 0.84 (p<0.0001), point D 0.91 (p<0.0001), genital hiatus 0.65 (p<0.0001), perineal body 0.66 (p<0.0001) e total vaginal length 0.73 (p<0.0001). We also did not note differences between the means of measurements by the two examiners. Staging was highly reproducible (r=0.81, p<0.0001). ln no subject did the stage vary by more than one; in 86,2%, stages were identical. CONCLUSIONS: there is a good reproducibility of measures using the system proposed by the International Continence Society prolapse terminology document.
Summary
Rev Bras Ginecol Obstet. 2003;25(5):353-358
DOI 10.1590/S0100-72032003000500008
PURPOSE: to determine interobserver reliability of site-specific measurements and stages according to the proposed International Continence Society prolapse terminology document. METHODS: we analyzed 51 women during urogynecological investigation performed at the Urogynecology and Vaginal Surgery Sector of UNIFESP / EPM. We recorded the locations of point-specific measures proposed by the International Continence Society (ICS). They are: two in the anterior vaginal wall, two in the superior vagina, two in the posterior vaginal wall, genital hiatus, perineal body and total vaginal length. Then we recorded the stage of genital prolapse. Women underwent pelvic examinations by two investigators, each blinded to the results of the other's examination. The reproducibility of the nine site-specific measurements and the summary stage were analyzed using Pearson's correlation coefficient and the median measurements were compared by the paired-t test. RESULTS: there were substantial and highly significant correlations for each of the nine measurements. Correlation coefficient for point Aa was 0.89 (p<0.0001), point Ba 0.90 (p<0.0001), point C 0.97 (p<0.0001), point Ap de 0.72 (p<0.0001), point Bp 0.84 (p<0.0001), point D 0.91 (p<0.0001), genital hiatus 0.65 (p<0.0001), perineal body 0.66 (p<0.0001) e total vaginal length 0.73 (p<0.0001). We also did not note differences between the means of measurements by the two examiners. Staging was highly reproducible (r=0.81, p<0.0001). ln no subject did the stage vary by more than one; in 86,2%, stages were identical. CONCLUSIONS: there is a good reproducibility of measures using the system proposed by the International Continence Society prolapse terminology document.
Summary
Rev Bras Ginecol Obstet. 2019;41(6):361-362
Summary
Rev Bras Ginecol Obstet. 2019;41(6):361-362
Summary
Rev Bras Ginecol Obstet. 2002;24(6):365-370
DOI 10.1590/S0100-72032002000600002
Purpose: to study the relationship between pelvic floor function and bladder neck mobility in women with and without stress urinary incontinence (SUI), in menacme and postmenopausal. Methods: sixty-one SUI patients were evaluated; 31 of them were in menacme and of these 17 had SUI and 14 did not have any complaint; 30 were postmenopausal and of these, 15 with SUI and 15 without SUI. Simple cystometry and empty supine stress test were performed in those who had urinary incontinence complaint. Bladder neck mobility was studied by ultrasound and by the Q-tip test. To study pelvic floor function, vaginal cones and digital palpation were used. Results: the bladder neck position in the incontinent women (Groups A and C), determined by ultrasound or the Q tip-test, was --11.8 cm in Group A and --12.5 cm in Group C, lower than the continent women, in whom the bladder neck was at +4.4 cm in Group B and +2.3 cm in Group D. There were no differences in bladder neck mobility among the continent menacme (9.1 cm) and postmenopausal (9.5 cm) groups. Also there were no differences among the incontinent groups (17.1 cm for Group A and 16.6 cm for Group C). The bladder neck mobility was greater in the incontinent women (A and C). Continent women had better results on evaluation of pelvic floor muscles than the incontinent ones, even using vaginal cones or digital palpation, and these results were not dependent on the hormonal status. Conclusion: a positive correlation was found between the Q-tip tests and ultrasound, and between test with vaginal cones and digital palpation. No significant correlation was found between pelvic floor function and bladder neck mobility.
Summary
Rev Bras Ginecol Obstet. 2002;24(6):365-370
DOI 10.1590/S0100-72032002000600002
Purpose: to study the relationship between pelvic floor function and bladder neck mobility in women with and without stress urinary incontinence (SUI), in menacme and postmenopausal. Methods: sixty-one SUI patients were evaluated; 31 of them were in menacme and of these 17 had SUI and 14 did not have any complaint; 30 were postmenopausal and of these, 15 with SUI and 15 without SUI. Simple cystometry and empty supine stress test were performed in those who had urinary incontinence complaint. Bladder neck mobility was studied by ultrasound and by the Q-tip test. To study pelvic floor function, vaginal cones and digital palpation were used. Results: the bladder neck position in the incontinent women (Groups A and C), determined by ultrasound or the Q tip-test, was --11.8 cm in Group A and --12.5 cm in Group C, lower than the continent women, in whom the bladder neck was at +4.4 cm in Group B and +2.3 cm in Group D. There were no differences in bladder neck mobility among the continent menacme (9.1 cm) and postmenopausal (9.5 cm) groups. Also there were no differences among the incontinent groups (17.1 cm for Group A and 16.6 cm for Group C). The bladder neck mobility was greater in the incontinent women (A and C). Continent women had better results on evaluation of pelvic floor muscles than the incontinent ones, even using vaginal cones or digital palpation, and these results were not dependent on the hormonal status. Conclusion: a positive correlation was found between the Q-tip tests and ultrasound, and between test with vaginal cones and digital palpation. No significant correlation was found between pelvic floor function and bladder neck mobility.
Summary
Rev Bras Ginecol Obstet. 2000;22(1):37-41
DOI 10.1590/S0100-72032000000100007
Purpose: to evaluate the effects of tibolone on climacteric symptoms and clinical and metabolic variables. Methods: thirty-four postmenopausal women were treated orally with 2.5 mg tibolone daily for 48 weeks and evaluated as to climacteric complaints, clinical aspects such as weight and blood pressure and lipid profile (total cholesterol, HDL-c, LDL-c, VLDL-c and triglycerides). Results: a significant improvement of climacteric complaints was demonstrated by a significant decrease in the Kupperman index (p<0.001) and the mean number of hot flushes (p<0.001) from the first month of treatment onwards. There was a significant decrease in total cholesterol, triglycerides and VLDL-c (p<0.001). The LDL-c levels presented a slight decrease (not significant). The HDL-c levels showed a significant decrease at week 24. However these levels returned to baseline levels at week 48. With regard to the vital signs no change in body weight and blood pressure was measured. The side effects were mild and temporary, vaginal bleeding, nausea and edema being the most common. Conclusion: tibolone may be considered a safe and efficient option to treat climacteric symptoms in postmenopausal women without significant impact on lipid profile.
Summary
Rev Bras Ginecol Obstet. 2000;22(1):37-41
DOI 10.1590/S0100-72032000000100007
Purpose: to evaluate the effects of tibolone on climacteric symptoms and clinical and metabolic variables. Methods: thirty-four postmenopausal women were treated orally with 2.5 mg tibolone daily for 48 weeks and evaluated as to climacteric complaints, clinical aspects such as weight and blood pressure and lipid profile (total cholesterol, HDL-c, LDL-c, VLDL-c and triglycerides). Results: a significant improvement of climacteric complaints was demonstrated by a significant decrease in the Kupperman index (p<0.001) and the mean number of hot flushes (p<0.001) from the first month of treatment onwards. There was a significant decrease in total cholesterol, triglycerides and VLDL-c (p<0.001). The LDL-c levels presented a slight decrease (not significant). The HDL-c levels showed a significant decrease at week 24. However these levels returned to baseline levels at week 48. With regard to the vital signs no change in body weight and blood pressure was measured. The side effects were mild and temporary, vaginal bleeding, nausea and edema being the most common. Conclusion: tibolone may be considered a safe and efficient option to treat climacteric symptoms in postmenopausal women without significant impact on lipid profile.
Summary
Rev Bras Ginecol Obstet. 2010;32(8):374-380
DOI 10.1590/S0100-72032010000800003
PURPOSE: to evaluate the reactivity of VEGF-A and cleaved caspase-3 in the adrenal gland cortex of female pinealectomized rats treated with melatonin. METHODS: forty adult female rats were divided into 4 groups (G) of 10 animals: GI - no surgical intervention, with vehicle administration; GII - sham pinealectomized with vehicle administration; GIII - pinealectomized with vehicle administration; GIV - pinealectomized with melatonin administration (10 µg/animal) during the night. After 60 days of treatment, all animals were anesthetized, and the adrenal glands were removed and fixed in 10% formaldehyde (phosphate buffered) for histological processing and paraffin embedding. Sections (5 µm thick) were collected on silanized slides and submitted to imunnohistochemical methods for the detection of cleaved caspase-3 (apoptosis) and of vascular endothelial growth factor (VEGF-A) in the adrenal cortex. The data obtained were submitted to analysis of variance (ANOVA) complemented by the Tukey-Kramer test (p<0.05). RESULTS: reactivity to cleaved Caspase-3 was noted in the zona glomerulosa of the adrenal glands in all studied groups. There were no significant differences in the zona glomerulosa; however, the zona fasciculata (15.51±3.12*, p<0.05) and the zona reticularis (8.11±1.90*, p<0.05) presented the smallest percentage of apoptosis in the pinealectomized group (GIII). The reactivity to the VEGF-A was stronger in the zona glomerulosa and weaker in the zona reticularis in all groups. We found a stronger VEGF-A reactivity in the zona fasciculata in the pinealectomized group (GIII). CONCLUSIONS: the pineal gland affects the arrangement of the zona glomerulosa and reticularis of the adrenal glands, which are related to the production of sex hormones.
Summary
Rev Bras Ginecol Obstet. 2010;32(8):374-380
DOI 10.1590/S0100-72032010000800003
PURPOSE: to evaluate the reactivity of VEGF-A and cleaved caspase-3 in the adrenal gland cortex of female pinealectomized rats treated with melatonin. METHODS: forty adult female rats were divided into 4 groups (G) of 10 animals: GI - no surgical intervention, with vehicle administration; GII - sham pinealectomized with vehicle administration; GIII - pinealectomized with vehicle administration; GIV - pinealectomized with melatonin administration (10 µg/animal) during the night. After 60 days of treatment, all animals were anesthetized, and the adrenal glands were removed and fixed in 10% formaldehyde (phosphate buffered) for histological processing and paraffin embedding. Sections (5 µm thick) were collected on silanized slides and submitted to imunnohistochemical methods for the detection of cleaved caspase-3 (apoptosis) and of vascular endothelial growth factor (VEGF-A) in the adrenal cortex. The data obtained were submitted to analysis of variance (ANOVA) complemented by the Tukey-Kramer test (p<0.05). RESULTS: reactivity to cleaved Caspase-3 was noted in the zona glomerulosa of the adrenal glands in all studied groups. There were no significant differences in the zona glomerulosa; however, the zona fasciculata (15.51±3.12*, p<0.05) and the zona reticularis (8.11±1.90*, p<0.05) presented the smallest percentage of apoptosis in the pinealectomized group (GIII). The reactivity to the VEGF-A was stronger in the zona glomerulosa and weaker in the zona reticularis in all groups. We found a stronger VEGF-A reactivity in the zona fasciculata in the pinealectomized group (GIII). CONCLUSIONS: the pineal gland affects the arrangement of the zona glomerulosa and reticularis of the adrenal glands, which are related to the production of sex hormones.
