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Original Article04-09-1998
Clinicopathologic Analysis of Vulvar Intraepithelial Neoplasia: review of 46 Cases
- Luiz Antonio Verdiani,
- Cássia Raquel Teatin Juliato,
- Sophie F. Mauricette Derchain,
- Júlio Eduardo Ferro
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleClinicopathologic Analysis of Vulvar Intraepithelial Neoplasia: review of 46 Cases
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):371-376
DOI 10.1590/S0100-72031998000700001
- Luiz Antonio Verdiani,
- Cássia Raquel Teatin Juliato,
- Sophie F. Mauricette Derchain,
- Júlio Eduardo Ferro
Views143See moreThe purpose of the present study was to evaluate some epidemiological, clinical and pathological characteristics of the different grades of vulvar intraepithelial neoplasia (VIN), and its relation with the presence of human papillomavirus (HPV). The charts of 46 women with VIN, examined from 1986 through 1997, were reviewed. For statistical analysis the chi² with yates correction when appropriate, and Fisher’s exact tests were used. Regarding the grade of VIN, six women presented VIN 1, six others had VIN 2 and the remaining 34 presented VIN 3. All women presented similar characteristics such as age, menstrual status and age at first sexual intercourse. Women with more than one lifetime sexual partner had a tendency to show more VIN 3 (p = 0.090). Cigarette smoking was significantly associated with the severity of the vulvar lesion (p = 0.031). HPV was significantly more frequent in women younger than 35 years of age (p = 0.005) and in women with multiple lesions (p = 0.089). Although the number of lesions were not related to the severity of VIN (p = 0.703), lesions with extensions greater than 2 cm were significantly associated with VIN 3 (p = 0.009). The treatment of choice for VIN 3 was surgery, including local resection and simple vulvectomy. Eight women relapsed, and only one had VIN 2. We concluded that among women with VIN, cigarette smoking and more than one lifetime sexual partner were associated with high-grade lesions. HPV was more frequent among patients younger than 35 years of age presenting multiple lesions. Women with VIN 3 presented lesions bigger than 2 cm and a high relapse rate, despite the type of treatment applied.
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Original Article04-05-1998
Estimation of Fetal Weight: Comparison Between a Clinical Method and Ultrasonography
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(10):551-555
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleEstimation of Fetal Weight: Comparison Between a Clinical Method and Ultrasonography
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(10):551-555
DOI 10.1590/S0100-72031998001000002
Views99See morePurpose: to assess the validity of fetal weight estimation by a method based on uterine height — Johnson’s rule. Methods: one hundred and one pregnant women and their newborn children were studied. The fetal weight was estimated using an adaptation of Johnson’s rule, which consists of the clinical application of a mathematical model to calculate the fetal weight based on the uterine height and the height of fetal presentation. The estimated weight was obtained on the day of delivery and was compared to the weight observed after birth. This, in turn, was the control of the analysis of validity of the method used. On the same date, a detailed obstetrical ultrasonography (US) was conducted which included the fetal weight, calculated by the use of Sheppard’s tables. This weight, estimated by US, was compared to the birth weight. Results: the results have proven that the clinical estimate used in this study has a similar value to that of the US calculation of birth weight. The accuracy of the clinical method, with variations of 5%, 10% and 15% between estimated and observed weights, was 55.3%, 73% and 86.7%, respectively. Those of the US were 60.7%, 75.4% and 91.1%, respectively. When comparing both sets of figures, values were not different from a statistical standpoint. Conclusion: the clinical evaluation has shown to be accurate, similarly to the US, when calculating the birth weight.
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04-05-1998
Indice de líquido amniótico em gestantes diabéticas e a qualidade do controle glicêmico na gestação
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):485-485
Views59This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Indice de líquido amniótico em gestantes diabéticas e a qualidade do controle glicêmico na gestação
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):485-485
DOI 10.1590/S0100-72031998000800011
Views59Indice de Líquido Amniótico em Gestantes Diabéticas e a Qualidade do Controle Glicêmico na Gestação.[…]See moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
04-05-1998
Avaliação do grau nuclear da célula maligna da mama como parâmetro de atividade proliferativa tumoral: comparação com a expressão do antígeno nuclear de proliferação celular (PCNA/ciclina)
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):485-485
Views65This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Avaliação do grau nuclear da célula maligna da mama como parâmetro de atividade proliferativa tumoral: comparação com a expressão do antígeno nuclear de proliferação celular (PCNA/ciclina)
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):485-485
DOI 10.1590/S0100-72031998000800010
Views65Avaliação do Grau Nuclear da Célula Maligna da Mama como Parâmetro de Atividade Proliferativa Tumoral: Comparação com a Expressão do Antígeno Nuclear de Proliferação Celular (PCNA/ciclina).[…]See moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Case Report04-05-1998
Prenatal diagnosis of arthrogryposis multiplex congenita: a case report
- Carlos Augusto Alencar Júnior,
- Francisco Edson de Lucena Feitosa,
- Mac Gontei,
- Sammya Bezerra Maia,
- Dalgimar Beserra de Meneses
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Case ReportPrenatal diagnosis of arthrogryposis multiplex congenita: a case report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):481-484
DOI 10.1590/S0100-72031998000800009
- Carlos Augusto Alencar Júnior,
- Francisco Edson de Lucena Feitosa,
- Mac Gontei,
- Sammya Bezerra Maia,
- Dalgimar Beserra de Meneses
Views84See moreArthrogryposis multiplex congenita is characterized by multiple joint contractures present at birth. Prenatal diagnosis is difficult. There are few reports in the literature. Fetal akinesia, abnormal limb position, intrauterine growth retardation, and polyhydramnios are the main findings of the ultrasonographic diagnosis. The authors describe a case of arthrogryposis multiplex congenita ultrasonographically diagnosed in the third gestational trimester. The main findings were absence of fetal movements, polyhydramnios, symmetrical and non-symmetrical fetal growth retardation with marked decrease of abdominal and thoracic circumference, low-set ears, micrognathia, continuous flexure contracture of limbs, internal rotation of the femur, and clubfoot on the right.
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Original Article04-05-1998
Screening of breast cancer metastasis at preoperative work-up
- Maria Bethânia da Costa Chein,
- Luciane Maria Oliveira Brito,
- Simão Rotstein,
- Luiz Henrique Gebrim,
- Aldo Franklin F Reis, [ … ],
- Luciana Dessen Padilha
Views123This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleScreening of breast cancer metastasis at preoperative work-up
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):475-479
DOI 10.1590/S0100-72031998000800008
- Maria Bethânia da Costa Chein,
- Luciane Maria Oliveira Brito,
- Simão Rotstein,
- Luiz Henrique Gebrim,
- Aldo Franklin F Reis,
- Luciana Dessen Padilha
Views123See morePurpose: to analyze the frequency of preoperative bilateral synchronic cancer and occult metastases in 454 operable breast cancer patients, at Instituto Nacional de Câncer (Brazil). Methods: the preoperative evaluation consisted of mammography, bone scan with X-ray if necessary, and chest X-ray. 260 (57.3 %) of 454 patients underwent liver echography. We calculated the cost X effectiveness ratio considering only the direct costs (monetary value) and the effectiveness was analyzed based on the number of metastases identifid by the screening tests. Results: we did not find any case of bilateral synchronic cancer, and the frequency of patients with metastasis was 2% (9/454). The diagnosis of bone metastasis was 1.5 % (7/454). The percentage of lung (2/454) and liver (1/260) metastasis was the same, 0.4 %. Most of the patients with metastases were in stage IIIb (44.5 %). The results of the screening tests showed the alteration of the initial clinical stage in 9 patients only (2%). The total cost of the screening tests for the diagnosis of systemic disease in 9 patients, was US$ 131,020.00. The cost of each diagnosed metastasise, for a total of 10 (two were found in one of the patients), was US$ 29,221.85 and the cost/effectiveness ratio was 22.3%. Conclusious: the results showed that screening for metastases in the preoperative clinical staging of breast cancer should be limited to patients symptomatic for systemic disease or in clinical stage III and that the cost/effectiveness ratio of the tests demonstrated a reduced benefit in the preoperative evaluation.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Original Article04-05-1998
Second-degree family history as a risk factor for breast cancer
- Rafael Marques de Souza,
- Anderson Rech Lazzaron,
- Rafael Defferrari,
- Álvaro A. Borba,
- Luciana Scherer, [ … ],
- Antônio L. Frasson
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleSecond-degree family history as a risk factor for breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):469-473
DOI 10.1590/S0100-72031998000800007
- Rafael Marques de Souza,
- Anderson Rech Lazzaron,
- Rafael Defferrari,
- Álvaro A. Borba,
- Luciana Scherer,
- Antônio L. Frasson
Views127See morePurpose: to evaluate the association between second-degree family history of breast cancer and the risk to develop the disease. Methods: case-control study of incident cases. Sixty-six incident breast cancer cases and 198 controls were selected among women who were submitted to mammography in a private clinic between January 1994 and July 1997. Cases and controls were paired regarding age, age at menarche, at first live birth, at menopause, parity, oral contraceptives and use of hormonal replacement therapy. Results: there was no significant difference between cases and controls regarding all risk factors evaluated, besides second-degree family history. Patients with breast cancer were more likely to have second-degree relatives with breast cancer when compared to controls (OR=2.77; 95% CI, 1.03-7.38; p=0.039). Conclusions: malignant neoplasm of the breast is significantly associated with a second-degree family history of this disease.
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Original Article04-05-1998
Fine needle aspiration biopsy: performance in the differential diagnosis of palpable breast masses
- Orlando José de Almeida,
- Marcelo Alvarenga,
- José Guilherme Cecatti,
- Jessé de Paula Neves Jorge,
- Júlia Kawamura Tambascia
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleFine needle aspiration biopsy: performance in the differential diagnosis of palpable breast masses
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):463-467
DOI 10.1590/S0100-72031998000800006
- Orlando José de Almeida,
- Marcelo Alvarenga,
- José Guilherme Cecatti,
- Jessé de Paula Neves Jorge,
- Júlia Kawamura Tambascia
Views63See morePurpose: to evaluate, in a prospective way, the performance of the fine needle aspiration biopsy in the differential diagnosis of palpable breast masses. Method: the sensitivity, specificity, positive and negative predictive values for this test were evaluated in 102 women with age above 30 years and a palpable breast mass, who were attended at the University of Campinas. All punctures were performed by the same examiner. Results: the procedure had a sensitivity of 97%, specificity of 87%, positive predictive value of 94% and negative predictive value of 93%. The insufficient or unsatisfactory sample rate was 16% for the first aspiration, decreasing to 2% with a new procedure. Conclusions: this test showed to be highly sensitive and specific for the differential diagnosis of palpable breast masses, reassuring its great importance for the clinical approach of palpable masses.
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Original Article05-01-2016
Incidence of Cervical Human Papillomavirus and Cervical Intraepithelial Neoplasia in Women with Positive and Negative HIV Status
- Benito Pio Vitorio Ceccato Junior,
- Mark Drew Crosland Guimarães,
- Ana Paula Ceccato Lopes,
- Lorena Fiorini Nascimento,
- Luísa Magalhães Novaes, [ … ],
- Victor Hugo Melo
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleIncidence of Cervical Human Papillomavirus and Cervical Intraepithelial Neoplasia in Women with Positive and Negative HIV Status
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(5):231-238
- Benito Pio Vitorio Ceccato Junior,
- Mark Drew Crosland Guimarães,
- Ana Paula Ceccato Lopes,
- Lorena Fiorini Nascimento,
- Luísa Magalhães Novaes,
- Dora Méndez del Castillo,
- Victor Hugo Melo
Views227Abstract
Objectives
To evaluate the incidence and factors associated with cervical intraepithelial neoplasia (CIN) and cervical infection by human papillomavirus (HPV) among HIV-positive and HIV-negative women.
Methods
A cohort of 103 HIV positive and 113 HIV negative women were monitored between October 2008 and February 2012, for at least one year. Procedures included cervical cytology, DNA/HPV detection by polymerase chain reaction, colposcopy with biopsy if necessary, followed by an interview for exposure characteristics data. CIN was based on the histopathological results.
Results
The incidence of CIN was of 8.8 and 4.6 cases/100 women-years in HIVpositive and HIV-negative women, respectively. HIV-positive women presented a hazard ratio (HR) of 2.8 for CIN and developed lesions earlier (0.86 year) than HIVnegative women (2 years) (p = 0.01). The risk of developing CIN decreased with age (HR = 0.9) and marital status (HR = 0.4). HPV patients presented a higher incidence of CIN when compared HIV-positive and HIV-negative women (p = 0.01). The incidence of HPV cervical infection was 18.1 and 11.4 cases/100 women-years in HIV-positive and HIV-negative women, respectively. Those HIV-positive presented earlier HPV infection (p = 0.002). The risk of developing HPV infection decreased with age and was higher among HIV-positive women. HPV 16 was the most common type in HIV-positive women, and also the type most closely associated with CIN in HIV-negative women.
Conclusions
HIV-positive women had a greater incidence of HPV and CIN, and in a shorter time interval. More rigorous and timely clinical control is required for this group.
Key-words Cervical intraepithelial neoplasiaHIV infectionsHPV DNA probesPapillomavirus infectionsPolymerase chain reactionSee morePlumX Metrics- Citations
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Original Article03-27-2020
High Incidence of Herpes Simplex Virus-1 in Cord Blood and Placenta Infection of Women in Southern Brazil
- Emiliana Claro Avila
,
- Fabiana Finger-Jardim
,
- Carla Vitola Gonçalves
,
- Vanusa Pousada da Hora
,
- Marcelo Alves Soares
,
[ … ], - Ana Maria Barral de Martínez
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleHigh Incidence of Herpes Simplex Virus-1 in Cord Blood and Placenta Infection of Women in Southern Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(1):5-11
- Emiliana Claro Avila
,
- Fabiana Finger-Jardim
,
- Carla Vitola Gonçalves
,
- Vanusa Pousada da Hora
,
- Marcelo Alves Soares
,
- Ana Maria Barral de Martínez
Views216See moreAbstract
Objective
Estimate the prevalence of human herpesvirus type 1 HSV-1 DNA in placental samples, its incidence in umbilical cord blood of newborns and the associated risk factors.
Methods
Placental biopsies and umbilical cord blood were analyzed, totaling 480 samples, from asymptomatic parturients and their newborns at a University Hospital. Nested polymerase chain reaction (PCR) and gene sequencingwere used to identify the virus; odds ratio (OR) and relative risk (RR) were performed to compare risk factors associated with this condition.
Results
The prevalence of HSV-1 DNA in placental samples was 37.5%, and the incidence in cord blood was 27.5%. Hematogenous transplacental route was identified in 61.4% from HSV-1+ samples of umbilical cord blood paired with the placental tissue. No evidence of the virus was observed in the remaining 38.6% of placental tissues, suggesting an ascendant infection from the genital tract, without replication in the placental tissue, resulting in intra-amniotic infection and vertical transmission, seen by the virus in the cord blood. The lack of condom use increased the risk of finding HSV-1 in the placenta and umbilical cord blood.
Conclusion
The occurrence of HSV-1 DNA in the placenta and in cord blood found suggests vertical transmission from asymptomatic pregnant women to the fetus.
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Emiliana Claro Avila
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Review Article08-26-2020
Gynecological Surgery and COVID-19: What is the Impact and How Should I Manage it?
- Julio Cesar Rosa-e-Silva
,
- Paulo Ayroza Ribeiro
,
- Luiz Gustavo Oliveira Brito
,
- Mariano Tamura Vieira Gomes
,
- Sergio Podgaec
,
[ … ], - Agnaldo Lopes da Silva Filho
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Review ArticleGynecological Surgery and COVID-19: What is the Impact and How Should I Manage it?
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(7):415-419
- Julio Cesar Rosa-e-Silva
,
- Paulo Ayroza Ribeiro
,
- Luiz Gustavo Oliveira Brito
,
- Mariano Tamura Vieira Gomes
,
- Sergio Podgaec
,
- Helizabet Salomão Abdalla Ayroza Ribeiro
,
- Carlos Augusto Pires Costa Lino
,
- Ricardo Quintairos
,
- Walquiria Quida Salles Pereira Primo
,
- Agnaldo Lopes da Silva Filho
Views221See moreAbstract
It is estimated that around 28 million surgeries will be postponed or canceled worldwide as a result of this pandemic, causing a delay in the diagnosis and treatment of more than 2 million cancer cases. In Brazil, both the National Health Agency (ANS) and National Health Surveillance Agency (ANVISA) advised the postponement of elective and non-essential surgeries, causing a considerable impact on the number of surgical procedures that decreased by 33.4% in this period. However, some women need treatment for various gynecological diseases that cannot be postponed. The purpose of this article is to present recommendations on surgical treatment during the COVID-19 pandemic.
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Julio Cesar Rosa-e-Silva
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Review Article01-11-2023
Incidence and Outcomes Associated with Menopausal Status in COVID-19 Patients: A Systematic Review and Meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(12):796-807
Views229This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Review ArticleIncidence and Outcomes Associated with Menopausal Status in COVID-19 Patients: A Systematic Review and Meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(12):796-807
Views229See moreAbstract
Objective
Menopause causes several changes in the body that may affect the response to COVID-19. We aimed to investigate the possible association between menopausal status and incidence and outcomes in COVID-19 patients.
Methods
Combinations of keywordsCOVID-19, menopause, and estrogen were used to search the PubMed, Embase, Web-of-Science, and Scopus databases for articles reporting the incidence and outcomes of COVID-19 (discharge, length-of-admission, intensive care, or mortality) in premenopausal women, available through December 29, 2022. Data from studies comparing the incidence of COVID-19 infection with the age-matched male population were pooled and meta-analyzed using a random-effects model.
Results
Overall, 1,564 studies were retrieved, of which 12 were finally included in the systematic review to compare disease outcomes, and 6 were meta-analyzed for the incidence of COVID-19 in premenopausal and postmenopausal women. All studies reported better COVID-19-associated outcomes in premenopausal women compared with postmenopausal women. After adjusting for confounding factors, three studies found better outcomes in postmenopausal women, and two found no association between menopausal status and COVID-19 outcomes. Our meta-analysis found a higher incidence of COVID-19 infection among premenopausal women than postmenopausal women, when compared with age-matched men (odds ratio = 1.270; 95% confidence interval: 1.086–1.486; p = 0.003).
Conclusion
The incidence of COVID-19 was significantly higher in premenopausal women than in postmenopausal women when compared with age-matched men. Although premenopausal women may have more favorable COVID-19-associated outcomes, the presumed preventive effect of estrogens on the incidence and related outcomes of COVID-19 in premenopausal women cannot be proven at present. Further longitudinal studies comparing pre- and post-menopausal women are required to provide further insight into this matter.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Original Article01-19-2021
Malignant Uterine Neoplasms Attended at a Brazilian Regional Hospital: 16-years Profile and Time Elapsed for Diagnosis and Treatment
- Elaine Cristina Candido
,
- Nelio Neves Veiga Junior
,
- Monique Possari Minari
,
- Maria Carolina Szymanski Toledo
,
- Daniela Angerame Yela
,
[ … ], - Julio Cesar Teixeira
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleMalignant Uterine Neoplasms Attended at a Brazilian Regional Hospital: 16-years Profile and Time Elapsed for Diagnosis and Treatment
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(2):137-144
- Elaine Cristina Candido
,
- Nelio Neves Veiga Junior
,
- Monique Possari Minari
,
- Maria Carolina Szymanski Toledo
,
- Daniela Angerame Yela
,
- Julio Cesar Teixeira
Views219See moreAbstract
Objective
The present study aims to evaluate the profile of endometrial carcinomas and uterine sarcomas attended in a Brazilian cancer center in the period from 2001 to 2016 and to analyze the impact of time elapsed fromsymptoms to diagnoses or treatment in cancer stage and survival.
Methods
This observational study with 1,190 cases evaluated the year of diagnosis, age-group, cancer stage and histological type. A subgroup of 185 women with endometrioid histology attended in the period from 2012 to 2017 was selected to assess information about initial symptoms, diagnosticmethods, overall survival, and to evaluate the influence of the time elapsed from symptoms to diagnosis and treatment on staging and survival. The statistics used were descriptive, trend test, and the Kaplan- Meier method, with p-values < 0.05 for significance.
Results
A total of 1,068 (89.7%) carcinomas (77.2% endometrioid and 22.8% nonendometrioid) and 122 (10.3%) sarcomas were analyzed, with an increasing trend in the period (p < 0.05). Histologies of non-endometrioid carcinomas, G3 endometrioid, and carcinosarcomas constituted 30% of the cases. Non-endometrioid carcinomas and sarcomas weremore frequently diagnosed in patients over 70 years of age and those on stage IV (p < 0.05). The endometrioid subgroup with 185 women reported 92% of abnormal uterine bleeding and 43% diagnosis after curettage. The average time elapsed between symptoms to diagnosis was 244 days, and between symptoms to treatment was 376 days, all without association with staging (p = 0.976) and survival (p = 0.160). Only 12% of the patients started treatment up to 60 days after diagnosis.
Conclusion
The number of uterine carcinoma and sarcoma cases increased over the period of 2001 to 2016. Aggressive histology comprised 30% of the patients and, for endometrioid carcinomas, the time elapsed between symptoms and diagnosis or treatment was long, although without association with staging or survival.
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Elaine Cristina Candido
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Original Article10-23-2024
The role of HIV as an independent risk factor to cervical HSIL recurrence
- Fernanda Villar Fonseca
,
- Newton Sérgio de Carvalho
,
- Carlos Afonso Maestri
,
- Manuella Fernandes Martins
,
- Dora Pedroso Kowacs
Views328This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleThe role of HIV as an independent risk factor to cervical HSIL recurrence
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo85
- Fernanda Villar Fonseca
,
- Newton Sérgio de Carvalho
,
- Carlos Afonso Maestri
,
- Manuella Fernandes Martins
,
- Dora Pedroso Kowacs
Views328ABSTRACT
Objective:
To evaluate the role of being human immunodeficiency virus (HIV) positive for predicting the risk of recurrence in women with a cervical high grade squamous intraepithelial lesion (HSIL) diagnosis.
Methods:
Retrospective observational case-control study, comprising HIV positive (case) and HIV negative (control) women in a 1:4 ratio. Women assisted by the Erasto Gaertner Hospital, between 2009-2018, with cervical HSIL diagnosis, submitted to treatment by Loop electrosurgical excision procedure (LEEP), and with a minimum follow-up of 18 months, were included. The immunological status, number and time to recurrence were analyzed, with p<0.05 considered significant. In a second analysis, only patients with free margins were evaluated.
Results:
The sample consisted of 320 women (64 cases and 256 controls). Presence of HIV, CD4 levels <200 and detectable viral load (CV) were associated with high risk of recurrence, with odds ratio (OR) of 5.4 (p<0.001/95CI:2.8-10); 3.6 (p<0.001 /IC95:0.6-21.1) and 1.8 (p=0.039 /IC95:0.3-9.3), respectively. In the sample with free margins (n=271), this risk was also higher among seropositive patients, with OR 4.18 (p=0.001/95CI:1.8-9.2).
Conclusion:
HIV is an independent risk factor for cervical HSIL recurrence and reduced disease-free survival time. Glandular involvement, compromised margins, undetectable CV and CD4<200 also increase the risk of relapse.
Key-words Disease-free survivalElectrosurgeryExcision marginsHIV infectionsRecurrenceRisk factorsSquamous intraepithelial lesionsUterine cervical neoplasmsSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Fernanda Villar Fonseca
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Review Article06-22-2020
Aortic Isthmus Doppler Velocimetry in Fetuses with Intrauterine Growth Restriction: A Literature Review
- Mariana Martins Ferraz
,
- Flávia do Vale Araújo
,
- Paulo Roberto Nassar de Carvalho
,
- Renato Augusto Moreira de Sá
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Review ArticleAortic Isthmus Doppler Velocimetry in Fetuses with Intrauterine Growth Restriction: A Literature Review
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(5):289-296
- Mariana Martins Ferraz
,
- Flávia do Vale Araújo
,
- Paulo Roberto Nassar de Carvalho
,
- Renato Augusto Moreira de Sá
Views222Abstract
Intrauterine growth restriction (IUGR) is associated with poor perinatal prognosis and a higher risk of stillbirth, neonatal death, and cerebral palsy. Its detection and the evaluation of its severity by new Doppler velocimetric parameters, such as aortic isthmus (AoI), are of great relevance for obstetrical practice. The AoI is a vascular segment that represents a point of communication between the right and left fetal circulations. It is considered to be a functional arterial shunt that reflects the relationship between the systemic and cerebral impedances, and has recently been proposed as a tool to detect the status of hemodynamic balance and prognosis of IUGR in fetuses. In the present review, we noticed that in healthy fetuses, the AoI net flow is always antegrade, but in fetuses with IUGR the deterioration of placental function leads to progressive reduction in its flow until it becomes mostly retrograde; this point is associated with a drastic reduction in oxygen delivery to the brain. The more impaired the AoI flow is, the greater is the risk of impairment in the Doppler velocimetry of other vessels; and the alterations of the AoI Doppler seem to precede other indicators of severe hypoxemia. Although there seems to be an association between the presence of retrograde flow in the AoI and the risk of long-term neurologic disability, its role in the prediction of perinatal morbi-mortality remains unclear. The AoI Doppler seems to be a promising tool in the management of fetuses with IUGR, but more studies are needed to investigate its employment in clinical practice.
Key-words aortic isthmusDopplerDoppler velocimetryIntrauterine growth restrictionIntrauterine growth retardationplacental insufficiencySee morePlumX Metrics- Citations
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Mariana Martins Ferraz
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Original Article08-04-2023
Treatment and Management Experience of Idiopathic Granulomatous Mastitis in a Low-income Country
- Pedro Antonio Llancari,
- Antonio Ortiz
,
- Juan Becerra
,
- Ricardo Muñoz
,
- Christiam Valeriano
,
[ … ], - Rommy Helena Novoa
Views239This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleTreatment and Management Experience of Idiopathic Granulomatous Mastitis in a Low-income Country
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(6):319-324
- Pedro Antonio Llancari,
- Antonio Ortiz
,
- Juan Becerra
,
- Ricardo Muñoz
,
- Christiam Valeriano
,
- Rommy Helena Novoa
Views239See moreAbstract
Objective
Reporting our experience of the management and treatment of Idiopathic granulomatous mastitis (IGM) in a low-income country by describing patients characteristics and therapy with emphasis on conservative surgical excision and postoperative care as the cornerstone of treatment.
Methods
A retrospective cohort of women with histopathological diagnosis of IGM from 2014 to 2018 at Instituto Nacional Materno Perinatal in Lima, Peru. Patients’ characteristics, clinical presentation, treatment, management, postoperative care, and follow-up were analyzed.
Results
Thirty-eight patients with histopathological diagnosis of IGM were identified. Their average age was 35.9 years and 23 (60.5%) reported previous use of hormonal contraceptives. Nine (23.7%) patients had chronic mastitis with previous treatment. The time from the onset of symptoms to the first clinic consult was 5.1 months on average. Twenty-one (55.3%) patients had the lesion in the right breast, with a mean size of 6.9 cm. Conservative surgical excision was performed in all patients. Additionally, 86.8% required corticosteroids and 78.9% were treated with antibiotics. Complete remission was obtained at 141 days on average (range 44 to 292 days). Six (15.8%) women reported ipsilateral recurrence and 5 (13.2%), contralateral. The latency time was 25.5 months on average.
Conclusion
The conservative surgical treatment demonstrated and close follow-up made for a high cure rate, but with recurrence similar to that reported in the literature. Use of gloves is an alternative to manage post operative wounds in a low-income country. The most frequent adverse effect was breast surgical scar.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Original Article03-01-2018
The Burden of Indirect Causes of Maternal Morbidity and Mortality in the Processof Obstetric Transition: A Cross-Sectional Multicenter Study
- Jessica Fernandes Cirelli,
- Fernanda Garanhani Surita,
- Maria Laura Costa,
- Mary Angela Parpinelli,
- Samira Maerrawi Haddad, [ … ],
- José Guilherme Cecatti
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleThe Burden of Indirect Causes of Maternal Morbidity and Mortality in the Processof Obstetric Transition: A Cross-Sectional Multicenter Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(3):106-114
- Jessica Fernandes Cirelli,
- Fernanda Garanhani Surita,
- Maria Laura Costa,
- Mary Angela Parpinelli,
- Samira Maerrawi Haddad,
- José Guilherme Cecatti
Views215See moreAbstract
Objective
The aim of this study is to evaluate the burden of indirect causes of maternal morbidity/mortality in Brazil.
Methods
Secondary analysis of a multicenter cross-sectional study conducted in 27 referral obstetric units within the Brazilian Network for Surveillance of Severe Maternal Morbidity.
Results
A total of 82,388 women were surveilled: 9,555 women with severe maternal morbidity were included, and 942 (9.9%) of them had indirect causes of morbidity/ mortality. There was an increased risk of higher severity among the indirect causes group, which presented 7.56 times increased risk of maternal death (prevalence ratio [PR]: 7.56; 95% confidence interval [95%CI]: 4.99-11.45). The main indirect causes of maternal death were H1N1 influenza, sepsis, cancer and cardiovascular disease. Non-public antenatal care (PR: 2.52; 95%CI: 1.70-3.74), diabetes (PR: 1.90; 95%CI: 1.24-2.90), neoplasia (PR: 1.98; 95%CI: 1.25-3.14), kidney diseases (PR: 1.99; 95%CI: 1.14-3.49), sickle cell anemia (PR: 2.50; 95%CI: 1.16-5.41) and drug addiction (PR: 1.98; 95%CI: 1.03-3.80) were independentlyassociatedwithworseresultsintheindirectcausesgroup.Someprocedures for the management of severity were more common for the indirect causes group.
Conclusion
Indirect causes were present in less than 10% of the overall cases, but they represented over 40% of maternal deaths in the current study. Indirect causes of maternal morbidity/mortality were also responsible for an increased risk of higher severity, and they were associated with worse maternal and perinatal outcomes. In middle-income countries there is a mix of indirect causes of maternal morbidity/ mortality that points to some advances in the scale of obstetric transition, but also reveals the fragility of health systems.
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Original Article01-01-2017
Perineal Massage Improves the Dyspareunia Caused by Tenderness of the Pelvic Floor Muscles
- Ana Paula Moreira da Silva,
- Mary Lourdes Montenegro,
- Maria Beatriz Ferreira Gurian,
- Andreia Moreira de Souza Mitidieri,
- Lucia Alves da Silva Lara, [ … ],
- Julio Cesar Rosa e Silva
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticlePerineal Massage Improves the Dyspareunia Caused by Tenderness of the Pelvic Floor Muscles
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(1):26-30
- Ana Paula Moreira da Silva,
- Mary Lourdes Montenegro,
- Maria Beatriz Ferreira Gurian,
- Andreia Moreira de Souza Mitidieri,
- Lucia Alves da Silva Lara,
- Omero Benedicto Poli Neto,
- Julio Cesar Rosa e Silva
Views337See moreABSTRACT
Aim:
To evaluate the long-term effectiveness of perineal Thiele massage in the treatment of women with dyspareunia caused by tenderness of the pelvic floor muscles.
Methods:
A total of 18 women with diagnoses of dyspareunia caused by tenderness of the pelvic floor muscles were included in the study. The women were divided in two groups: the dyspareunia (D) group – 8 women with dyspareunia caused by tenderness of the pelvic floor muscles; and the chronic pelvic pain group (CPP) group – 10 women with dyspareunia caused by tenderness of the pelvic floor muscles associated with CPP. Each patient filled out the Visual Analogue Scale (VAS), the McGill Pain Index, the Female Sexual Function Index (FSFI) and the Hospital Anxiety and Depression Scale (HADS). After an evaluation, the women underwent transvaginal massage using the Thiele technique over a period of 5 minutes, once a week for 4 weeks.
Results:
All women had significant improvements in their dyspareunia according the VAS and the McGill Pain Index (p < 0,001), but the HADS scores did not show significant differences. Regarding sexual function, the D group showed improvements on all aspects of sexual function, while the CPP group showed differences only in the pain domain.
Conclusion:
Thiele massage is effective in the treatment of dyspareunia caused by tenderness of the pelvic floor muscles with a long-term pain relief.
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Review Article07-30-2021
Interventions among Pregnant Women in the Field of Music Therapy: A Systematic Review
- Bruna Mayumi Omori Shimada
,
- Magda da Silva Oliveira Menezes dos Santos
,
- Mayara Alvares Cabral
,
- Vanessa Oliveira Silva
,
- Gislaine Cristina Vagetti
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Review ArticleInterventions among Pregnant Women in the Field of Music Therapy: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):403-413
- Bruna Mayumi Omori Shimada
,
- Magda da Silva Oliveira Menezes dos Santos
,
- Mayara Alvares Cabral
,
- Vanessa Oliveira Silva
,
- Gislaine Cristina Vagetti
Views445See moreAbstract
Objective
To investigate in the literature the studies on the benefits ofmusic therapy interventions among pregnant women in the prenatal, delivery and postpartum periods.
Data Sources
The search for articles was carried out in the following electronic databases: VHL, LILACS, SciELO, Portal CAPES, PsycINFO, ERIC, PubMed/Medline, and journals specialized in this field: Revista Brasileira de Musicoterapia (“Brazilian Journal of Music Therapy”) and Voices.
Study Selection
Descriptors in Portuguese (musicoterapia, gravidez, gestantes, revisão), English (music therapy, pregnancy, pregnant women, review) and Spanish (musicoterapia, embarazo, mujeres embarazadas, revisión) were used. The search was delimited between January 2009 and June 2019. The process of selection and evaluation of the articles was performed through peer review.
Data Collectio
n The following data were extracted: article title, year of publication, journal, author(s), database, country and date of collection, purpose of the study, sample size, type of care, intervention, instruments used, results, and conclusion. The data were organized in chronological order based on the year of publication of thestudy.
Summary of the Data
In total, 146 articles were identified, and only 23 studies were included in this systematic review. The articles found indicate among their results relaxation, decreased levels of anxiety, psychosocial stress and depression, decreased pain, increase in the maternal bond, improvement in the quality of sleep, control of the fetal heart rate and maternal blood pressure, and decreased intake of drugs in the postoperative period.
Conclusion
Music therapy during the prenatal, delivery and postpartum periods can provide benefits to pregnant women and newborns, thus justifying its importance in this field.
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Bruna Mayumi Omori Shimada
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Editorial09-01-2016
Syphilis in Pregnancy and Congenital Syphilis: Why Can We not yet Face This Problem?
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):425-427
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
EditorialSyphilis in Pregnancy and Congenital Syphilis: Why Can We not yet Face This Problem?
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):425-427
Views140The increased occurrence of syphilis during pregnancy, and its severe repercussions to the fetal environment, has been a cause for concern among health care professionals. It is hard to comprehend why congenital syphilis has not yet been controlled, since its agent, the spirochaete Treponema pallidum, is well known and is highly susceptible to penicillin, a […]See morePlumX Metrics- Citations
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Original Article07-01-2017
Effect of Obesity on Gestational and Perinatal Outcomes
- Sônia Regina Cabral Madi,
- Rosa Maria Rahmi Garcia,
- Vandrea Carla de Souza,
- Renato Luís Rombaldi,
- Breno Fauth de Araújo, [ … ],
- José Mauro Madi
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleEffect of Obesity on Gestational and Perinatal Outcomes
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(7):330-336
- Sônia Regina Cabral Madi,
- Rosa Maria Rahmi Garcia,
- Vandrea Carla de Souza,
- Renato Luís Rombaldi,
- Breno Fauth de Araújo,
- José Mauro Madi
Views135See moreAbstract
Purpose
To assess the impact of pre-pregnancy obesity (body mass index [BMI] ≥30 kg/m2) on the gestational and perinatal outcomes.
Methods
Retrospective cohort study of 731 pregnant women with a BMI ≥30 kg/m2 at the first prenatal care visit, comparing them with 3,161 women with a BMI between 18.5 kg/m2 and 24.9 kg/m2. Maternal and neonatal variables were assessed. Statistical analyses reporting the demographic features of the pregnant women (obese and normal) were performed with descriptive statistics followed by two-sided independent Student’s t tests for the continuous variables, and the chi-squared (χ2) test, or Fisher’s exact test, for the categorical variables. We performed a multiple linear regression analysis of newborn body weight based on the mother’s BMI, adjusted by maternal age, hyperglycemic disorders, hypertensive disorders, and cesarean deliveries to analyze the relationships among these variables. All analyses were performed with the R (R Foundation for Statistical Computing, Vienna, Austria) for Windows software, version 3.1.0. A value of p < 0.05 was considered statistically significant.
Results
Obesity was associated with older age [OR 9.8 (7.8-12.2); p < 0.01], hyperglycemic disorders [OR 6.5 (4.8-8.9); p < 0.01], hypertensive disorders [OR 7.6 (6.1-9.5); p < 0.01], caesarean deliveries [OR 2.5 (2.1-3.0); p < 0.01], fetal macrosomia [OR 2.9 (2.3-3.6); p < 0.01] and umbilical cord pH [OR 2.1 (1.4-2.9); p < 0.01). Conversely, no association was observed with the duration of labor, bleeding during labor, Apgar scores at 1 and 5 minutes after birth, gestational age, stillbirth and early neonatal mortality, congenital malformations, and maternal and fetal injury.
Conclusion
We observed that pre-pregnancy obesity was associated with maternal age, hyperglycemic disorders, hypertension syndrome, cesarean deliveries, fetal macrosomia, and fetal acidosis.
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Original Article12-01-2017
Mandibular Inferior Cortex Erosion on Dental Panoramic Radiograph as a Sign of Low BoneMineral Density in Postmenopausal Women
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(12):663-669
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleMandibular Inferior Cortex Erosion on Dental Panoramic Radiograph as a Sign of Low BoneMineral Density in Postmenopausal Women
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(12):663-669
Views185See moreAbstract
Objective
To examine the role of the panoramic mandibular radiograph in the diagnosis of low bone mineral density (BMD) in postmenopausal women.
Methods
A cross-sectional study including volunteer women aged over 40 years in amenorrhea due to ovarian failure for at least 12 months, who were cared for at the climacteric outpatient clinic of a university hospital in the city of Cuiabá, in the state of Mato Grosso, Brazil. The panoramic radiographs were evaluated using a specific software. Two aspects were analyzed in the mandibular panoramic radiograph: a qualitative aspect regarding the shape of the mandibular cortical bone, and a quantitative aspect regarding thewidth of themandibular cortical bone. Themorphology of themandibular cortical bone in the digital panoramic radiograph was determined bilaterally by the observation of the bone structure between the mental foramen and the base of the jaw. The mandibular cortical bonewas categorized into three groups. Themental index (MI)was used to evaluate the thickness of themandibular cortical bone through a perpendicular line drawn fromthe base of the mandible at the height of the center of the mental foramen, with another line drawn tangent to the inferior border of the mandible, and a third line parallel to the line at the superior border of themandible. The MI data are expressed in millimeters, with a normal value of 3.0 mm. The densities of the lumbar spine and femur, expressed in g/cm2, were categorized as normal, osteopenia or osteoporosis.
Results
The agreement index between the MI and the BMD of the lumbar spine was good (Kappa = 0.718), but the same index between the MI and the BMD of the femoral neck was poor (Kappa = 0.443). An excellent agreement occurred when the mandibular cortical index (MCI) was compared with the BMD of the lumbar spine (Kappa = 0.912). The agreement between MCI and the BMD in the femur was moderated (Kappa = 0.579).
Conclusion
The radiomorphometric indices evaluated in the mandibular panoramic radiograph are capable of identifying postmenopausal women with low mineral density in the mandible, and the results can be used to refer these women to appropriate medical investigation and/or treatment.
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Editorial02-01-2017
Pregnancy in Adolescence – A Challenge Beyond Public Health Policies
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(2):41-43
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
EditorialPregnancy in Adolescence – A Challenge Beyond Public Health Policies
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(2):41-43
Views172Recent Sustainable Development Goals were established by the United Nations (2015–2030), including the broad goal of “good health and wellbeing” for all. Good health and wellbeing (item 3), quality education (item 4), gender equality (item 5) and reduced inequalities (item 10) are among the 17 items of the list. These four cited goals are directly […]See morePlumX Metrics- Citations
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Original Article10-01-2017
Breaking Bad News Training Program Based on Video Reviews and SPIKES Strategy: What do Perinatology Residents Think about It?
- Maria Silvia Vellutini Setubal,
- Andrea Vasconcelos Gonçalves,
- Sheyla Ribeiro Rocha,
- Eliana Martorano Amaral
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleBreaking Bad News Training Program Based on Video Reviews and SPIKES Strategy: What do Perinatology Residents Think about It?
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):552-559
- Maria Silvia Vellutini Setubal,
- Andrea Vasconcelos Gonçalves,
- Sheyla Ribeiro Rocha,
- Eliana Martorano Amaral
Views211See moreAbstract
Objective
Resident doctors usually face the task to communicate bad news in perinatology without any formal training. The impact on parents can be disastrous. The objective of this paper is to analyze the perception of residents regarding a training program in communicating bad news in perinatology based on video reviews and setting, perception, invitation, knowledge, emotion, and summary (SPIKES) strategy.
Methods
We performed the analysis of complementary data collected from participants in a randomized controlled intervention study to evaluate the efficacy of a training program on improving residents’ skills to communicate bad news. Data were collected using a Likert scale. Through a thematic content analysis we tried to to apprehend the meanings, feelings and experiences expressed by resident doctors in their comments as a response to an open-ended question. Half of the group received training, consisting of discussions of video reviews of participants’ simulated encounters communicating a perinatal loss to a “mother” based on the SPIKES strategy. We also offered training sessions to the control group after they completed participation. Twenty-eight residents who were randomized to intervention and 16 from the control group received training. Twenty written comments were analyzed.
Results
The majority of the residents evaluated training highly as an education activity to help increase knowledge, ability and understanding about breaking bad news in perinatology. Three big categories emerged fromresidents’ comments: SPIKES training effects; bad news communication in medical training; and doctors’ feelings and relationship with patients.
Conclusions
Residents took SPIKES training as a guide to systematize the communication of bad news and to amplify perceptions of the emotional needs of the patients. They suggested the insertion of a similar training in their residency programs curricula.
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