Artigos Originais Archives - Page 3 of 81 - Revista Brasileira de Ginecologia e Obstetrícia

  • Artigos Originais

    Relationship of laboratory results with clinical signs and symptoms of patients with vulvovaginal candidiasis and the significance of the sexual partners for the maintenance of the infection

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(2):80-84

    Summary

    Artigos Originais

    Relationship of laboratory results with clinical signs and symptoms of patients with vulvovaginal candidiasis and the significance of the sexual partners for the maintenance of the infection

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(2):80-84

    DOI 10.1590/S0100-72032007000200004

    Views13

    PURPOSE: to relate yeasts identified by laboratory tests to clinical signs and symptoms in patients with vulvovaginal candidiasis, and to investigate the importance of the sexual partners in the recurrence of the infection. METHODS: from July 2001 to July 2003, a sample of 179 patients aged from 18 to 65 years old, with clinical suspicion of fungal vaginitis were analyzed in a prospective study in Great São Paulo. Exclusion criteria included: pregnancy, impaired intrinsic or extrinsic immune response (including Aids), diabetes or immunosuppression; patients undergoing corticosteroid, antibiotic or hormone therapy, in post menopause, with intrauterine device (IUD) or making use of vaginal douches or spemicides. Samples of vaginal and penis secretions from partners of patients with relapse of vaginitis episodes were collected for microscopy and fungal culture. Fungal colonies isolated in CHROMagar Candida were identified by classical methods. Fisher's exact t-test was used to correlate the clinical picture with the yeasts isolated from patients. RESULTS: the most relevant clinical signs and symptoms were pruritus and vaginal discharge followed by erythema and edema, statistically independent from the etiological agent. Direct microscopy revealed yeasts in 77 patients with vulvovaginitis, and 40 Candida spp cultures were obtained. Candida albicans (70%), C. glabrata (20%), C. tropicalis (7,5%) and C. guilliermondii (2,5%) were identified. The yeasts prevalent in partners were C. albicans and C. glabrata. The same species were detected in female and male sex partners in 87% of the cases. CONCLUSIONS: fungal vulvovaginitis was more frequent in women between 18 and 34 years old. No correlation was observed between the species of yeast detected and clinical symptomatology. Sexual partners are important Candida spp reservoirs and may be related to the maintenance of the vulvovaginal candidiasis.

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    Relationship of laboratory results with clinical signs and symptoms of patients with vulvovaginal candidiasis and the significance of the sexual partners for the maintenance of the infection
  • Artigos Originais

    Sexual dysfunction in patients with advanced cervical cancer submitted to exclusive radiotherapy

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(2):85-90

    Summary

    Artigos Originais

    Sexual dysfunction in patients with advanced cervical cancer submitted to exclusive radiotherapy

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(2):85-90

    DOI 10.1590/S0100-72032007000200005

    Views18

    PURPOSE: to identify sexual dysfunctions in patients with cancer of the uterine cervix submitted to exclusive radiotherapy, using the high dose rate (HDR) brachytherapy technique. METHODS: a descriptive transversal study from January to June of 2004. The study involved 71 selected patients who had been followed in the pelvis outpatient clinic from the Hospital do Câncer de Pernambuco and selected according to the established profile. Data were collected from a structured questionnaire, complemented by a gynecological exam aimed at investigating complaints of sexual dysfunction after the radiotherapy. Epi-Info 6.04 was the statistical program used to process and analyze the data. Descriptive analysis was done through the mean, median and range. Bivariate analysis was done through the Marginal Homogeneity and McNamara's tests, considering 5% as the level of significance. RESULTS: among the gynecological complications identified, we can highlight fibrosis, stenosis and vaginal atrophy (98.6%, 76.1% and 71.8%, respectively). The sexual dysfunctions identified were: frigidity, lack of lubrication, excitation and orgasm in 76.1% of the cases, lack of sex drive in 40.8% and vaginism in 5.6% of the cases. CONCLUSIONS: sexual dysfunctions are frequent in patients with cancer of the advanced uterine cervix treated with exclusive radiotherapy using the protocol of HDR. Specific attention should be given to the sexual anamnesis and the gynecological exam during these patients' attendance.

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  • Artigos Originais

    Urodynamic evaluation of leak point pressure under stress, in orthostatic and seating position, in women with urinary incontinency

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(2):91-95

    Summary

    Artigos Originais

    Urodynamic evaluation of leak point pressure under stress, in orthostatic and seating position, in women with urinary incontinency

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(2):91-95

    DOI 10.1590/S0100-72032007000200006

    Views3

    PURPOSE: compare the outcomes verified during urodynamic investigation realized in two different positions related to urinary leak point pressure under stress and to discuss its clinical relevance. METHODS: sixty-four patients with stress urinary incontinency (SUI) aged 25-80 years old, attended, during June 2003 to September 2005 were included in this study. Patients were initially submitted to urodynamic investigation in accordance with International Continence Society (ICS) techniques in orthostatic position and just after were evaluated in seating position. RESULTS: statistical significance was obtained after evaluation of Vasalva leak point pressure (VLPP) obtained in two positions (99,8 ± 33,3 versus 102,9 ± 32,4; respectivamente, posição sentada e em pé, p<0,05). Linear regression test based on frequency analyses was applied with the purpose to verify the patient percentage allocated in confidence interval in terms of Valsalva leak point pressure in seating or orthostatic positions. A rate of 90.6% of compatibility was gotten in these results. When three unities were added to VLPP values after urodynamic investigation in seating position, it was noted that 92.2% of patients was included in this interval. CONCLUSIONS: these findings suggest that the urodynamic investigation can be realized in seating position without diagnostic a therapeutic impairment allowing higher comfort to the patients.

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  • Artigos Originais

    Precocious puberty: the experience of o Pediatric and Adolescent Gynecology Clinic

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(2):96-102

    Summary

    Artigos Originais

    Precocious puberty: the experience of o Pediatric and Adolescent Gynecology Clinic

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(2):96-102

    DOI 10.1590/S0100-72032007000200007

    Views12

    PURPOSE: to evaluate the classification and the etiology of girls attended in a Pediatric and Adolescent Gynecology Clinic. METHODS: The hospital charts of 58 female patients attended from 2000 to 2005 with diagnosis of probable precocious puberty were reviewed and relevant data analyzed. Inclusion criteria were breast and/or pubic hair growth before eight years old. The girls were classified according to the clinic aspects and the supplementary exams they had been submitted to, into one of the categories: central precocious puberty (CPP), precocious pseudopuberty, premature thelarche and premature pubarche. RESULTS: from the 58 reviewed cases, 28 girls were diagnosed as CPP, one as precocious pseudopuberty, ten as premature thelarche and 19 as premature pubarche. All the cases of CPP had an idiopathic etiology, except for one girl whose activation of the ypothalamic-pituitary-gonadal axis was secondary to congenital adrenal hyperplasia. There was one case of precocious pseudopuberty due to McCune-Albright syndrome. All the cases of premature thelarche had an idiopathic etiology, except for one girl who had primary hypothyroidism. All the cases of premature pubarche had an idiopathic etiology. CONCLUSIONS: among the cases diagnosed as precocious puberty, CPP was the leading diagnosis and most cases had an idiopathic etiology. Organic causes leading to precocious puberty were infrequent.

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  • Artigos Originais

    Prevalence of the metabolic syndrome in women with polycystic ovary syndrome

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(1):10-17

    Summary

    Artigos Originais

    Prevalence of the metabolic syndrome in women with polycystic ovary syndrome

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(1):10-17

    DOI 10.1590/S0100-72032007000100003

    Views8

    PURPOSE: to evaluate the prevalence of metabolic syndrome in women with polycystic ovary syndrome (PCOS). METHODS: forty six women with PCOS, in accord with Rotterdam criteria (2003), and 44 women with regular menses, without any clinical or laboratorial hyperandrogenism features, and no ultrasonographic ovarian microcysts (control group) were evaluated. For metabolic syndrome, the National Cholesterol Education Program (NCEP, 2002) and the International Diabetes Federation (IDF, 2005) guidelines were considered. RESULTS: the prevalence of metabolic syndrome were 30.4% (NCEP) and 32.6% (IDF) for the women with PCOS, nearly 4-fold higher than that reported for the control group (p<0.004), which were 6.8% (NCEP) and 9.1% (IDF). Women with PCOS had persistently higher prevalence rates of the metabolic syndrome, regardless of matched age and body mass index. The most prevalent factor of the metabolic syndrome among the PCOS subjects was low serum HDL cholesterol which was below 50 mg/dl (52.2%). Waist circumference above 88 cm (47.8%), blood pressure above 130/85 mmHg and fasting glycemia above 110 mg/dl (4.3%) were significantly more frequent among women with PCOS than among control women. CONCLUSIONS: the metabolic syndrome is significantly more frequent in women with PCOS, placing them at higher risk for cardiovascular disease.

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  • Artigos Originais

    Evaluation of response to primary chemotherapy in Brazilian patients with locally advanced breast cancer

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(1):18-26

    Summary

    Artigos Originais

    Evaluation of response to primary chemotherapy in Brazilian patients with locally advanced breast cancer

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(1):18-26

    DOI 10.1590/S0100-72032007000100004

    Views9

    PURPOSE: to evaluate the loco-regional response to primary chemotherapy in patients with breast cancer at stages II and III. METHODS: a retrospective and analytical clinical study carried out in 97 patients with an average age of 52.2 years old, with breast cancer at stages II and III, attended from January 1993 to December 2004, and submitted to 3 to 4 cycles of primary chemotherapy with 5-fluorouracil - 500 mg/m2, epirubicin - 50 mg/m2 and cyclophosphamide - 500 mg/m2 or doxorubicin - 50 mg/m2 e cyclophosphamide - 500 mg/m2, and then to loco-regional surgical conservative or radical surgical treatment. Chi-square and Fisher’s exact tests were used to study the association among the variables (age, menopausal state, pre-chemotherapy tumoral volume, axillary condition, stage, therapeutic scheme and number of cycles), while Pearson’s correlation coefficient was used for the quantitative variables (tumoral volume according to the anatomo-pathological study and the post-chemotherapy clinical tumoral volume. The significance level was 5%. RESULTS: there were 56.8% of cases at stage II and 43.2% at stage III. Approximately 50% of the patients received FEC50 and 50% AC. Objective clinical response with primary chemotherapy was obtained in 64.9% of the cases. Full clinical response occurred in 12.3% of patients, while full pathological response occurred in 10.3% of the cases. CONCLUSIONS: there was a statistically significant correlation between the number of cycles and the response to primary chemotherapy. Patients who received 4 cycles had better response than those who received 3 cycles. There was also a statistically significant concordance between the evaluation through clinical examination of the response to primary chemotherapy and the pathological findings. No statistically significant correlation was observed concerning age, menopausal status, tumoral volume, and pretreatment of axillary damage.

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    Evaluation of response to primary chemotherapy in Brazilian patients with locally advanced breast cancer
  • Artigos Originais

    Effects of 17beta-estradiol replacement on cardiac oxidative damage in rats submitted to ovarian hormone deprivation

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(1):27-33

    Summary

    Artigos Originais

    Effects of 17beta-estradiol replacement on cardiac oxidative damage in rats submitted to ovarian hormone deprivation

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(1):27-33

    DOI 10.1590/S0100-72032007000100005

    Views14

    PURPOSE: to evaluate oxidative stress in cardiac tissue of ovariectomized rats, with and without hormonal therapy. METHODS: female Wistar rats were divided in three groups: control group (CG); ovariectomized group (OG); ovariectomized group with estrogen supplementation (ESG). The estrogen deprivation was done through bilateral ovariectomy. After one week from the ovariectomy, a pellet of 1.5 mg of 17beta-estradiol was implanted in the ESG animals. Nine weeks after the ovariectomy, cardiac tissue was obtained for the analysis of the oxidative stress through CL (chemiluminescence), and measurement of antioxidant enzymes catalase (CAT), superoxide dismutase (SOD) and gluthatione peroxidase (GPx). RESULTS: CL was increased in the OG (7348±312 cps/mg protein) when compared with the CG (6250±41 cps/mg protein, p<0.01), but there was no significant difference between the CG and the ESG (6170±237 cps/mg protein). Ovariectomy reduced SOD (35%, p<0.05) and CAT (22%, p<0.001) activities in the OG as compared with the CG. Hormonal therapy normalized antioxidant enzymes activities in the ESG. There was no statistically significant difference in GPx activity among the groups studied. CONCLUSIONS: ovarian hormone deprivation induced an increase of oxidative stress with reduction of antioxidant defenses in the cardiac tissue. However, hormonal therapy prevented oxidative stress after ovariectomy, probably due to an increase of the CAT and SOD activities in the cardiac muscle. These findings suggest an important oxidative stress contribution in cardiovascular dysfunctions observed in women after menopause, reinforcing the importance of hormonal therapy in the management of cardiovascular diseases risk in this group of women.

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    Effects of 17beta-estradiol replacement on cardiac oxidative damage in rats submitted to ovarian hormone deprivation
  • Artigos Originais

    Vulvovaginal candidiasis: symptomatology, risk factors and concomitant anal colonization

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(1):3-9

    Summary

    Artigos Originais

    Vulvovaginal candidiasis: symptomatology, risk factors and concomitant anal colonization

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(1):3-9

    DOI 10.1590/S0100-72032007000100002

    Views11

    PURPOSE: to analyze patients with vulvovaginal candidiasis with respect to risk factors, symptomatology and results of anal culture, to identify the frequency of species of Candida albicans and non-C. albicans, and to correlate anal and vaginal colonization. METHODS: a total of 99 patients were included with suspected vulvovaginal candidiasis, from Natal, Brazil, between May 2003 and May 2005, totalling 294 collections. The clinical material, obtained by vaginal and anal swabs, was seeded on CHROMagar Candida®. The yeasts were identified using the classic method, in addition to the growth test at 42º and 45ºC and the Hypertonic Saboraud broth test. Symptomatology, risk factors and anal colonization were assessed according to positive or negative culture for Candida spp. The cultures positive for C. albicans at the two sites were compared with other results encountered. Yates’ chi2 test and Fisher’s exact test were used for statistical analysis. RESULTS: the most frequent was C. albicans in 69% of the cases. Wearing tight and/or synthetic underclothing, the presence of allergic diseases, the occurrence of itching, leukorrhea and hyperemia showed a significant association with positive culture for Candida spp in the vagina. The chance of a patient with positive anal colonization to present with concomitant positive vaginal colonization was 2.8 and 4.9 times greater for Candida spp and C. albicans, respectively. The risk of a patient with anal culture positive for C. albicans to present with positive vaginal colonization was 3.7 times greater when compared to non-C. albicans species. CONCLUSIONS: the most common species was C. albicans, and a relevant association between vaginal cultures positive for Candida spp and the use of tight and/or synthetic underclothing, allergic diseases, the occurrence of pruritus, leukorrhea and erythema was observed (p<0.05). Positive anal colonization concomitant with vaginal colonization was significant, suggesting possible vaginal contamination from the anus.

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