Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):215-220
DOI 10.1590/S0100-72032013000500005
PURPOSE: To evaluate the body posture of women submitted to treatment for breast cancer, to identify the postural changes in the first three months after surgery and to investigate the correlation of these findings with the woman's age and type and side of surgery. METHODS: A longitudinal study that monitored the postural changes of 39 women who underwent mastectomy and quadrantectomy. Postural evaluation was performed using the technique of biophotogrammetry before surgery, after drain removal and three months after surgery. Statistical analysis was performed using parametric and nonparametric tests, with the level of significance set at p<0.05. RESULTS: The average age of the women studied was 50±10.5 years, 48.8% underwent mastectomy and the left breast was operated in 61.5% of them . There was no statistically significant difference in the women's posture during the study period. However, the pelvis and trunk of women submitted to quadrantectomy showed better alignment (90°) compared to the women submitted to mastectomy (91.3°). The women submitted to surgery in the left breast had shoulder elevation and ipsilateral inclination of the trunk within a short period of time. CONCLUSION: Postural changes were correlated with the type and side of surgery. The follow-up of this group after completion of treatment is needed to clarify long-term postural changes.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):226-232
DOI 10.1590/S0100-72032013000500007
PURPOSE: To determine the HPV prevalence and genotypes and to identify factors associated with infection in pregnant and non-pregnant women with positive or negative HIV-1, treated in Gynecology and Obstetrics Ambulatories and in Health Primary Units, in Rio Grande, Rio Grande do Sul State, Brazil. METHODS: Cervical cells samples from 302 patients were analyzed for HPV presence and genotypes were determined by nested and sequencing polymerase chain reaction. We calculated prevalence ratios associated with the studied variables by Fisher's exact or χ² tests, and Poisson's regression. Women with insufficient material were excluded from the study. RESULTS: HPV was detected in 55 of the 302 women included in the study (18.2%); of these, 31 were pregnant, showing a significant association for HPV (p=0.04) when compared to non-pregnant ones. Risk factors for the infection were: patients aged <20 years-old (p=0.04), early initiation of sexual life (p=0.04), absence of cytological test (p=0.01), diagnosis of altered cytology (p=0.001), and counting <349 cells/mm³ (p=0.05). However, multi-parity was found to be a protective factor for the infection (p=0.01). Multivariate analysis showed that age <20 years-old (PR=2.8; 95%CI 1.0 - 7.7, p=0.04) and an altered cytological result (PR=11.1; 95%CI 3.0 - 4.1, p=0.001) were significantly associated with infection. HPV genotype was determined in 47 samples (85.4%) presenting one genotype per infection: eight HPV 16 and 58; six HPV 6; four HPV 18 and 33; three HPV 53 and 82; two HPV 83 and 61; one HPV 31, 35, 45, 64, 68, 71 and 85. CONCLUSIONS: The prevalence of HPV detection was 18.2%, the most frequent genotypes were 16 and 58, and sociodemographic and gynecological factors were associated with viral infection.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(4):153-158
DOI 10.1590/S0100-72032013000400004
PURPOSE: To analyze the relationship between physical activity and body composition in menopausal women. METHODS: The study included 62 menopausal women aged 50 years or more (61.2±7.6). The practice of physical activity was assessed with an accelerometer and is reported as minutes per week of low physical activity and moderate plus vigorous physical activity, and total physical activity in counts. Lean mass and total fat mass were assessed by dual-energy X-ray absorptiometry, and are reported as percentages. The relation between body composition variables and physical activity was evaluated by Spearman and Pearson correlation. Comparisons between groups were performed using the independent t test and Mann-Whitney test. RESULTS: The age group 59 years or older had higher mean values of total physical activity in counts (1,307.081 versus 2,843.840) and of minutes per week of moderate-vigorous physical activity (273 versus 156 minutes). Women who completed 150 minutes or more of moderate-vigorous physical activity had significantly lower total fat mass (43.8 versus 47.2 kg), higher lean mass (53.8 versus 49.6 kg) and lower BMI (27.7 versus 30.5 kg/m²) when compared to those with less than 150 minutes of physical activity per week. Only time spent in moderate activities showed a significant negative correlation with the percentage of total fat (r=-0.26, p<0.05), whereas total physical activity in counts correlated with the percentage of lean body mass (r=0,30), percentage of total fat (r=-0.32), trunk fat (r=-0.29), and BMI (r=-0.32); all correlations were statistically significant at p<0.05. CONCLUSION: menopausal women aged 50 years or more who spent more minutes in moderate and vigorous activity and higher total physical activity counts showed lower fat mass and higher lean mass.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(4):159-163
DOI 10.1590/S0100-72032013000400005
PURPOSE: To evaluate the effects of electrical stimulation (ES) of the pelvic floor on the urethra of female rats. METHODS: Forty adult rats were divided at random into four groups of ten animals each: Ctrl - without intervention; Sham - not submitted to ES, but with an electrode inserted into the vagina; Exp6 - submitted to six sessions of ES of the pelvic floor, and Exp12 - submitted to 12 sessions of ES of the pelvic floor. At the end of the experiment, all animals were anesthetized and the middle third of the urethra was removed, fixed in Bouin's fluid and processed for histomorphometric study. Sections were stained with hematoxylin and eosin for morphological and morphometric description, and others were stained with picrosirius red for the quantitation of total collagen. The thicknesses of the muscle layer and of the epithelium were determined, in 4 quadrants of the urethra, by performing 20 measurements per animal. The number of blood vessels present in the lamina propria was counted in the four quadrants over an area of 10³ µm² per quadrant and the images were obtained using the image analysis program AxioVision® REL 4.3 (Carl Zeiss). The collagen and muscle fiber ratios in the urethrae were calculated from two images per quadrant of every slice stained with picrosirius red, employing the Imagelab® Program. Data were subjected to analysis of variance (ANOVA) and the Tukey-Kramer multiple comparison test (p<0.05). RESULTS: The morphometry of the collagen, number of blood vessels and thickness of the epithelium showed no significant changes; however, the thickness of the periurethral muscle tissue increased significantly in Exp12 group, compared to the other groups (Exp12*>Exp6==Ctrl==Sham; *p<0.05). CONCLUSION: Prolonged functional electric stimulation of the pelvic floor induced an increase in periurethral muscle thickness in rats.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(4):171-177
DOI 10.1590/S0100-72032013000400007
PURPOSE: To evaluate changes in the venous axillary-subclavian and lymphatic systems of women with lymphedema after axillary lymphadenectomy for breast cancer treatment. METHODS: This was a case series involving 11 women with unilateral upper limb lymphedema after axillary lymphedenectomy for the treatment of breast cancer. The study was carried out in the Mastology Program of the Clinical Hospital of the Federal University of Goiás, Goiânia, GO, during the period between March 2010 and March 2011. Doppler velocimetry ultrasonography was used to detect the presence of venous changes in the subclavian and axillary veins. Lymphatic changes were evaluated by lymphoscintigraphy in both upper limbs. Fisher's exact test was used for the comparison between limbs. RESULTS: Subclavian vein flow volume in the upper limb with lymphedema was significantly different from that in the contralateral limb (p<0.001), 54.6% of the women had increased flow. In the axillary vein, 45.4% had increased flow and 45.4% had decreased flow, with a statistically significant difference (p<0.01) between limbs. Compared to the contralateral limb, significant lymphatic changes (p<0.05) were also found in the vessel route (not visualized), number of lymphatic vessels (none), axillary lymph nodes (absent) and dermal reflux (present). In the contralateral upper limb without lymphedema, no venous or lymphatic alterations were encountered. CONCLUSION: The women subjected to axillary lymphadenectomy for the treatment of breast cancer presented both venous and lymphatic changes in the upper limb with lymphedema.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(4):178-184
DOI 10.1590/S0100-72032013000400008
PURPOSE: To analyze the climacteric symptoms, nutritional status and distribution of abdominal fat in postmenopausal women using or not hormone therapy. METHODS: exploratory analytical study of the population survey type in the urban area of Maringa, Parana, conducted on 456 postmenopausal women aged 45 to 69 years. Data collection was based on the urbanized census sector (368) of the municipality, according to the Brazilian Demographic Census. A simple random sample proportional to women residing in each census sector was used, and a questionnaire was applied during a home visit, when anthropometric measurements were performed and blood pressure was determined. The Blatt and Kupperman Menopausal Index was used for the evaluation of climacteric symptoms. The outcome variable was the use of hormone therapy. RESULTS: Mean subject age was 58.7 years. Overweight was present in 72.6% of the women and abdominal obesity in 81.4% of them. Mild climacteric symptoms were observed in 69.5% of the women. Only 18.4% of the women studied were using hormone therapy and they were white, non-smokers, had no comorbidities, and had a partner. Users of hormone therapy had a lower frequency of overweight and obesity and had a lower prevalence of severe climacteric symptoms. CONCLUSION: Overweight and obesity were prevalent in this sample. Although fewer in number, the hormone therapy users had a lower frequency of overweight and mild and severe menopausal symptoms during the postmenopausal period.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(4):185-191
DOI 10.1590/S0100-72032013000400009
PURPOSE: To evaluate the prevalence and factors associated with intimate partner violence (IPV) among women users of Basic Health Units (BHU) in the State of São Paulo. METHODS: This was a cross-sectional descriptive study based on secondary data analysis of women users' interviews at 75 BHU in the State of São Paulo, from August/2008 to May/2009. We used a questionnaire based on the Abuse Assessment Screen and the Conflict Tactics Scales modified by the Violence Against Women Study (VAW), structured and pre-tested. The variables studied were the types of IPV (psychological, physical and sexual) and sociodemographic variables (age, education, race, paid work, religion, marital status and economic class). We interviewed 2,379 women aged 18 to 60 years. RESULTS: The prevalence of lifetime IPV was 55.7%, and the prevalences of psychological, physical and sexual IPV were 53.8, 32.2 and 12.4%, respectively. Women without a partner but previously married, with schooling <8 years and belonging to the lower economic class had a higher risk for all types of IPV, and other factors were also associated with psychological and sexual IPV. CONCLUSIONS: The prevalence of IPV is high. Healthcare professionals in primary care should make an attempt to detect IPV.