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Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):137-137
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):137-137
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):137-137
DOI 10.1590/S0100-72032002000200013
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):137-137
DOI 10.1590/S0100-72032002000200013
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):137-138
DOI 10.1590/S0100-72032002000200015
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):137-138
DOI 10.1590/S0100-72032002000200015
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):139-139
DOI 10.1590/S0100-72032002000200016
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):139-139
DOI 10.1590/S0100-72032002000200016
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):79-79
DOI 10.1590/S0100-72032002000200001
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):79-79
DOI 10.1590/S0100-72032002000200001
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):81-86
DOI 10.1590/S0100-72032002000200002
Purpose: to evaluate the predictive capacity of the sentinel lymph node (SLN) in relation to the axillary lymph node status in patients with initial invasive breast carcinoma submitted or not to neoadjuvant chemotherapy. Method: a prospective study was performed in 112 patients divided into two groups. The first group comprised 70 patients who had not received previous chemotherapy (Group I) and the second consisted of 42 patients who were submitted to neoadjuvant chemotherapy in three cycles of AC (adriamycin + cyclophosphamide) (Group II). Regarding chemotherapy, we observed partial response >50% in 21 patients, being complete in three of them, and <50% in 19 patients; in two patients progression of the disease occurred. A peritumoral injection of 99mTc dextran was applied with the help of stereotaxy in 29 patients with nonpalpable tumors, 16 of Group I and 13 of Group II. The radioactive accumulation shown by scintigraphy guided the biopsy of the axillary SLN with the help of a probe. The anatomopathologic study of SLN was based initially on a single section. When the LSN was free, it was submitted to serial sections at 50 mum intervals, stained with HE. Results: SLN was identified in 108 patients. No identification has been obtained in four patients, all with nonpalpable lesions (3 patients of Group I and 1 of Group II). The method's accuracy in predicting the axillary lymph node status was 100% in patients who did not receive neoadjuvant chemotherapy and 93% in those to whom this kind of treatment was administered. This difference proved to be statistically significant. Conclusions: the present study allowed us to conclude that in all patients who did not receive previous chemotherapy treatment, the SLN study was effective in predicting the axillary lymph node status. The high rate of false-negative results in the group of patients submitted to neoadjuvant chemotherapy seems to invalidate the use of SLN study these patients.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):81-86
DOI 10.1590/S0100-72032002000200002
Purpose: to evaluate the predictive capacity of the sentinel lymph node (SLN) in relation to the axillary lymph node status in patients with initial invasive breast carcinoma submitted or not to neoadjuvant chemotherapy. Method: a prospective study was performed in 112 patients divided into two groups. The first group comprised 70 patients who had not received previous chemotherapy (Group I) and the second consisted of 42 patients who were submitted to neoadjuvant chemotherapy in three cycles of AC (adriamycin + cyclophosphamide) (Group II). Regarding chemotherapy, we observed partial response >50% in 21 patients, being complete in three of them, and <50% in 19 patients; in two patients progression of the disease occurred. A peritumoral injection of 99mTc dextran was applied with the help of stereotaxy in 29 patients with nonpalpable tumors, 16 of Group I and 13 of Group II. The radioactive accumulation shown by scintigraphy guided the biopsy of the axillary SLN with the help of a probe. The anatomopathologic study of SLN was based initially on a single section. When the LSN was free, it was submitted to serial sections at 50 mum intervals, stained with HE. Results: SLN was identified in 108 patients. No identification has been obtained in four patients, all with nonpalpable lesions (3 patients of Group I and 1 of Group II). The method's accuracy in predicting the axillary lymph node status was 100% in patients who did not receive neoadjuvant chemotherapy and 93% in those to whom this kind of treatment was administered. This difference proved to be statistically significant. Conclusions: the present study allowed us to conclude that in all patients who did not receive previous chemotherapy treatment, the SLN study was effective in predicting the axillary lymph node status. The high rate of false-negative results in the group of patients submitted to neoadjuvant chemotherapy seems to invalidate the use of SLN study these patients.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):87-91
DOI 10.1590/S0100-72032002000200003
Purpose: to analyze the prevalence of urogynecological symptoms and their relationship with final urodynamic diagnosis, and to compare the clinical sign of stress urinary incontinence with urodynamic diagnosis. Methods: a total of 114 patients were included in a retrospective study from June 2000 to January 2001. All patients were evaluated through medical interview, physical examination and urodynamic study. They were classified according to clinical symptom, presence of clinical sign of urine loss and urodynamic study. The data analysis was performed using a test to determine sensitivity, specificity, and positive and negative predictive values. Results: the mean age was 51 years (19-80), 61 patients (53.5%) were in menacme and 53 (46.5%) in postmenopausal stage. Ten (18.8%) were using hormone replacement therapy and 25 (21.9%) had been submitted to surgery for incontinence. The isolated clinical symptom of urine loss was reported in 41 (36.0%) patients, the isolated urgency/urgency-incontinence in 13 (11.4%) and mixed symptoms in 60 (52.6%). In the urodynamic study, of all patients with symptom of isolated urine loss, 34 (83%) had stress urinary incontinence (SUI), no patient had detrusor instability (DI), 2 (4.9%) had mixed incontinence (MI) and 5 (12.1%) had a normal result. Of all patients with isolated urgency/urgency-incontinence, in the urodynamic study, none had SUI, 5 (38.5%) had ID, 1 (7.7%) had MI and 7 (53.8%) had a normal result. Of the patients with mixed symptoms, we identified, on the urodynamic evaluation, 25 (41.6%) who had SUI, 10 (16.7%) ID, 10 (16.7%) MI and 15 (25.0%) a normal result. The clinical sign of urine loss was identified in 50 (43.9%) patients. A total of 35 (70%) had SUI on urodynamic study, 6 (12%) had SUI and another diagnosis and 9 (18%) did not have SUI. Urine loss was absent in 64 (56.1%) women. Of those 23 (35.9%) had SUI on urodynamic study, 7 (11%) had SUI and another diagnosis and 34 (53.1%) did not have SUI. Conclusions: clinical history and physical examination are important in the management of urinary incontinence, although they should not be used as the only diagnostic method. Objective tests are available and should be used together with clinical data.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):87-91
DOI 10.1590/S0100-72032002000200003
Purpose: to analyze the prevalence of urogynecological symptoms and their relationship with final urodynamic diagnosis, and to compare the clinical sign of stress urinary incontinence with urodynamic diagnosis. Methods: a total of 114 patients were included in a retrospective study from June 2000 to January 2001. All patients were evaluated through medical interview, physical examination and urodynamic study. They were classified according to clinical symptom, presence of clinical sign of urine loss and urodynamic study. The data analysis was performed using a test to determine sensitivity, specificity, and positive and negative predictive values. Results: the mean age was 51 years (19-80), 61 patients (53.5%) were in menacme and 53 (46.5%) in postmenopausal stage. Ten (18.8%) were using hormone replacement therapy and 25 (21.9%) had been submitted to surgery for incontinence. The isolated clinical symptom of urine loss was reported in 41 (36.0%) patients, the isolated urgency/urgency-incontinence in 13 (11.4%) and mixed symptoms in 60 (52.6%). In the urodynamic study, of all patients with symptom of isolated urine loss, 34 (83%) had stress urinary incontinence (SUI), no patient had detrusor instability (DI), 2 (4.9%) had mixed incontinence (MI) and 5 (12.1%) had a normal result. Of all patients with isolated urgency/urgency-incontinence, in the urodynamic study, none had SUI, 5 (38.5%) had ID, 1 (7.7%) had MI and 7 (53.8%) had a normal result. Of the patients with mixed symptoms, we identified, on the urodynamic evaluation, 25 (41.6%) who had SUI, 10 (16.7%) ID, 10 (16.7%) MI and 15 (25.0%) a normal result. The clinical sign of urine loss was identified in 50 (43.9%) patients. A total of 35 (70%) had SUI on urodynamic study, 6 (12%) had SUI and another diagnosis and 9 (18%) did not have SUI. Urine loss was absent in 64 (56.1%) women. Of those 23 (35.9%) had SUI on urodynamic study, 7 (11%) had SUI and another diagnosis and 34 (53.1%) did not have SUI. Conclusions: clinical history and physical examination are important in the management of urinary incontinence, although they should not be used as the only diagnostic method. Objective tests are available and should be used together with clinical data.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):93-99
DOI 10.1590/S0100-72032002000200004
Purpose: to evaluate the correlation between the laparoscopic aspects and the stromal histologic findings of peritoneal endometriosis in order to understand the evolutive theory of endometriosis. Methods: sixty-seven women were submitted to laparoscopy for pelvic pain, infertility, ovarian tumor and other pathologies. A peritoneal biopsy was taken from the typical (puckered black) and atypical endometriotic implants. The different aspects of endometriosis were classified as follows: red lesions (Group V), black lesions (Group N) and white lesions (Group B). The histological sections were examined according to a standardized protocol. The histologic parameters used were: depth of the lesion, presence of hemosiderin, vascularization of the stroma and fibrotic tissue in stroma. Results: regarding lesion depth, there were significant differences between the groups. Red lesions were located consistently on the surface of the peritoneum (100%) and black lesions were superficial in 55.6%, intermediate in 38.9% and deep in 5.5%. White lesions were superficial in 28%, intermediate in 68% and deep in 4%. The presence of hemosiderin showed equivalent results in the 3 groups. The large stromal vascularization was present in the red lesions (60%), which a statistically significant difference compared to the other groups. Fibrotic tissue was present in 70.6% of the white lesions (group B), a fact that was significantly different when compared to groups V and N. Conclusion: the parameters analyzed in this study confirmed the importance of the evolutive theory of endometriosis.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):93-99
DOI 10.1590/S0100-72032002000200004
Purpose: to evaluate the correlation between the laparoscopic aspects and the stromal histologic findings of peritoneal endometriosis in order to understand the evolutive theory of endometriosis. Methods: sixty-seven women were submitted to laparoscopy for pelvic pain, infertility, ovarian tumor and other pathologies. A peritoneal biopsy was taken from the typical (puckered black) and atypical endometriotic implants. The different aspects of endometriosis were classified as follows: red lesions (Group V), black lesions (Group N) and white lesions (Group B). The histological sections were examined according to a standardized protocol. The histologic parameters used were: depth of the lesion, presence of hemosiderin, vascularization of the stroma and fibrotic tissue in stroma. Results: regarding lesion depth, there were significant differences between the groups. Red lesions were located consistently on the surface of the peritoneum (100%) and black lesions were superficial in 55.6%, intermediate in 38.9% and deep in 5.5%. White lesions were superficial in 28%, intermediate in 68% and deep in 4%. The presence of hemosiderin showed equivalent results in the 3 groups. The large stromal vascularization was present in the red lesions (60%), which a statistically significant difference compared to the other groups. Fibrotic tissue was present in 70.6% of the white lesions (group B), a fact that was significantly different when compared to groups V and N. Conclusion: the parameters analyzed in this study confirmed the importance of the evolutive theory of endometriosis.