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Original Article
Nipple-sparing Mastectomy with Immediate Implant-based Reconstruction for Patients with Pure Ductal Carcinoma in Situ
- Antônio Luiz Frasson
, - Ana Beatriz Falcone ,
- Isabela Miranda ,
- Alessandra Borba Anton de Souza ,
- Betina Vollbrecht , [ ... ],
- Martina Lichtenfels
06-27-2022
Summary
Original ArticleNipple-sparing Mastectomy with Immediate Implant-based Reconstruction for Patients with Pure Ductal Carcinoma in Situ
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):376-384
06-27-2022- Antônio Luiz Frasson ,
- Ana Beatriz Falcone ,
- Isabela Miranda ,
- Alessandra Borba Anton de Souza ,
- Betina Vollbrecht ,
- Fernanda Barbosa ,
- Mônica Adriana Rodriguez Martinez Frasson ,
- Martina Lichtenfels
Views96See moreAbstract
Objective
The presence of an extensive intraductal component is associated to an increasing risk of relapse in the nipple-areola complex. The aim of the present study was to evaluate the outcomes of patients diagnosed with ductal carcinoma in situ (DCIS) who underwent nipple-sparing mastectomy (NSM) with immediate breast reconstruction using silicone implants.
Methods
We retrospectively analyzed the postoperative complications and oncological safety of 67 breast cancer patients diagnosed with pure DCIS who underwent NSM with immediate breast reconstruction using silicone implants between 2004 and 2018.
Results
Among the 127 NSM procedures performed, 2 hematomas (1.5%) and 1 partial nipple necrosis (0.7%) were observed. After a mean follow-up of 60months, the local recurrence rate was of 8.9%, the disease-free survival rate was of 90%, and 1 of the patients died.
Conclusion
Despite the local recurrence rate, we showed that NSM with immediate breast reconstruction using silicone implants is a feasible surgical approach, with a low rate of complications and high survival rates for patients with a diagnosis of pure DCIS when breast-conserving surgery is not an option.
Views96
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. Summary
Original ArticleNipple-sparing Mastectomy with Immediate Implant-based Reconstruction for Patients with Pure Ductal Carcinoma in Situ
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):376-384
06-27-2022- Antônio Luiz Frasson ,
- Ana Beatriz Falcone ,
- Isabela Miranda ,
- Alessandra Borba Anton de Souza ,
- Betina Vollbrecht ,
- Fernanda Barbosa ,
- Mônica Adriana Rodriguez Martinez Frasson ,
- Martina Lichtenfels
Views96See moreAbstract
Objective
The presence of an extensive intraductal component is associated to an increasing risk of relapse in the nipple-areola complex. The aim of the present study was to evaluate the outcomes of patients diagnosed with ductal carcinoma in situ (DCIS) who underwent nipple-sparing mastectomy (NSM) with immediate breast reconstruction using silicone implants.
Methods
We retrospectively analyzed the postoperative complications and oncological safety of 67 breast cancer patients diagnosed with pure DCIS who underwent NSM with immediate breast reconstruction using silicone implants between 2004 and 2018.
Results
Among the 127 NSM procedures performed, 2 hematomas (1.5%) and 1 partial nipple necrosis (0.7%) were observed. After a mean follow-up of 60months, the local recurrence rate was of 8.9%, the disease-free survival rate was of 90%, and 1 of the patients died.
Conclusion
Despite the local recurrence rate, we showed that NSM with immediate breast reconstruction using silicone implants is a feasible surgical approach, with a low rate of complications and high survival rates for patients with a diagnosis of pure DCIS when breast-conserving surgery is not an option.
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. - Antônio Luiz Frasson
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Original Article
Knowledge, Attitude, and Practices Related to the SARS-CoV-2 Pandemic among Women Seeking Contraceptive Methods
- Elaine Aparecida Lopes Garcia ,
- Jessica Mayra Ferreira ,
- Nelio Veiga-Junior ,
- Luis Bahamondes ,
- Ilza Monteiro
06-27-2022
Summary
Original ArticleKnowledge, Attitude, and Practices Related to the SARS-CoV-2 Pandemic among Women Seeking Contraceptive Methods
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):391-397
06-27-2022- Elaine Aparecida Lopes Garcia ,
- Jessica Mayra Ferreira ,
- Nelio Veiga-Junior ,
- Luis Bahamondes ,
- Ilza Monteiro
Views149Abstract
Objective
To determine knowledge, attitude, and preventive (KAP) practices towards the SARS-CoV-2 (COVID-19) pandemic among women in reproductive age seeking to use copper or hormonal intrauterine devices (IUD/LNG-IUS).
Methods
We conducted a cross-sectional study in which we applied a questionnaire on 400 women about KAP practices on COVID-19 at the University of Campinas, Campinas, SP, Brazil, from May to August 2020.
Results
The mean (±SD) age of the women was 30.8±7.9 years, and 72.8% of them reported being pregnant at least once. Most women (95%) had heard or read about COVID-19, and their main sources of information were television (91%) and government websites (53%). However, 53% of the women had doubts about the veracity of the information accessed.
Conclusion
Women without a partner and with>12 years of schooling had more information about COVID-19 and on its impact on new pregnancy, and those from high socioeconomic status had a higher chance of maintaining physical distance. Safety, effectiveness, comfort, and absence of hormone in the contraceptive method (in the case of TCu380A IUD) were the main reasons for the participants to seek the service during the pandemic, and the possibility to stop menstrual bleeding was the main reason to choose the LNG-IUS.
Key-words attitudescopper IUDCOVID-19knowledgelevonorgestrel intrauterine systempracticessocio demographic characteristicsSee moreViews149This 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. Summary
Original ArticleKnowledge, Attitude, and Practices Related to the SARS-CoV-2 Pandemic among Women Seeking Contraceptive Methods
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):391-397
06-27-2022- Elaine Aparecida Lopes Garcia ,
- Jessica Mayra Ferreira ,
- Nelio Veiga-Junior ,
- Luis Bahamondes ,
- Ilza Monteiro
Views149Abstract
Objective
To determine knowledge, attitude, and preventive (KAP) practices towards the SARS-CoV-2 (COVID-19) pandemic among women in reproductive age seeking to use copper or hormonal intrauterine devices (IUD/LNG-IUS).
Methods
We conducted a cross-sectional study in which we applied a questionnaire on 400 women about KAP practices on COVID-19 at the University of Campinas, Campinas, SP, Brazil, from May to August 2020.
Results
The mean (±SD) age of the women was 30.8±7.9 years, and 72.8% of them reported being pregnant at least once. Most women (95%) had heard or read about COVID-19, and their main sources of information were television (91%) and government websites (53%). However, 53% of the women had doubts about the veracity of the information accessed.
Conclusion
Women without a partner and with>12 years of schooling had more information about COVID-19 and on its impact on new pregnancy, and those from high socioeconomic status had a higher chance of maintaining physical distance. Safety, effectiveness, comfort, and absence of hormone in the contraceptive method (in the case of TCu380A IUD) were the main reasons for the participants to seek the service during the pandemic, and the possibility to stop menstrual bleeding was the main reason to choose the LNG-IUS.
Key-words attitudescopper IUDCOVID-19knowledgelevonorgestrel intrauterine systempracticessocio demographic characteristicsSee 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. - Elaine Aparecida Lopes Garcia
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Original Article
Clinical Presentation, Treatment Outcomes, and Resistance-related Factors in South American Women with Low-risk Postmolar Gestational Trophoblastic Neoplasia
- Luz Angela Correa Ramírez ,
- Izildinha Maestá ,
- María Inés Bianconi ,
- Gustavo Jankilevich ,
- Silvina Otero , [ ... ],
- Ross S. Berkowitz
06-27-2022
Summary
Original ArticleClinical Presentation, Treatment Outcomes, and Resistance-related Factors in South American Women with Low-risk Postmolar Gestational Trophoblastic Neoplasia
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(8):746-754
06-27-2022- Luz Angela Correa Ramírez ,
- Izildinha Maestá ,
- María Inés Bianconi ,
- Gustavo Jankilevich ,
- Silvina Otero ,
- Carlos Raúl Villegas Mejía ,
- Rafael Cortés-Charry ,
- Kevin M. Elias ,
- Neil S. Horowitz ,
- Michael Seckl ,
- Ross S. Berkowitz
Views191Abstract
Objective
There are few multinational studies on gestational trophoblastic neoplasia (GTN) treatment outcomes in South America. The purpose of this study was to assess the clinical presentation, treatment outcomes, and factors associated with chemoresistance in low-risk postmolar GTN treated with first-line single-agent chemotherapy in three South American centers.
Methods
Multicentric, historical cohort study including women with International Federation of Gynecology and Obstetrics (FIGO)-staged low-risk postmolar GTN attending centers in Argentina, Brazil, and Colombia between 1990 and 2014. Data were obtained on patient characteristics, disease presentation, and treatment response. Logistic regression was used to assess the relationship between clinical factors and resistance to first-line single-agent treatment. A multivariate analysis of the clinical factors significant in univariate analysis was performed.
Results
A total of 163 women with low-risk GTN were included in the analysis. The overall rate of complete response to first-line chemotherapy was 80% (130/163). The rates of complete response to methotrexate or actinomycin-D as first-line treatment, and actinomycin-D as second-line treatment postmethotrexate failure were 79% (125/157), 83% (⅚), and 70% (23/33), respectively. Switching to second-line treatment due to chemoresistance occurred in 20.2% of cases (33/163). The multivariate analysis demonstrated that patients with a 5 to 6 FIGO risk score were 4.2-fold more likely to develop resistance to first-line single-agent treatment (p= 0.019).
Conclusion
1) At presentation, most women showed clinical characteristics favorable to a good outcome, 2) the overall rate of sustained complete remission after first-line single-agent treatment was comparable to that observed in developed countries, 3) a FIGO risk score of 5 or 6 is associated with development of resistance to first-line single-agent chemotherapy.
Key-words Chemotherapylow-risk gestational trophoblastic neoplasiaMolar pregnancyresistance-related factorsSouth AmericaSee moreViews191This 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. Summary
Original ArticleClinical Presentation, Treatment Outcomes, and Resistance-related Factors in South American Women with Low-risk Postmolar Gestational Trophoblastic Neoplasia
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(8):746-754
06-27-2022- Luz Angela Correa Ramírez ,
- Izildinha Maestá ,
- María Inés Bianconi ,
- Gustavo Jankilevich ,
- Silvina Otero ,
- Carlos Raúl Villegas Mejía ,
- Rafael Cortés-Charry ,
- Kevin M. Elias ,
- Neil S. Horowitz ,
- Michael Seckl ,
- Ross S. Berkowitz
Views191Abstract
Objective
There are few multinational studies on gestational trophoblastic neoplasia (GTN) treatment outcomes in South America. The purpose of this study was to assess the clinical presentation, treatment outcomes, and factors associated with chemoresistance in low-risk postmolar GTN treated with first-line single-agent chemotherapy in three South American centers.
Methods
Multicentric, historical cohort study including women with International Federation of Gynecology and Obstetrics (FIGO)-staged low-risk postmolar GTN attending centers in Argentina, Brazil, and Colombia between 1990 and 2014. Data were obtained on patient characteristics, disease presentation, and treatment response. Logistic regression was used to assess the relationship between clinical factors and resistance to first-line single-agent treatment. A multivariate analysis of the clinical factors significant in univariate analysis was performed.
Results
A total of 163 women with low-risk GTN were included in the analysis. The overall rate of complete response to first-line chemotherapy was 80% (130/163). The rates of complete response to methotrexate or actinomycin-D as first-line treatment, and actinomycin-D as second-line treatment postmethotrexate failure were 79% (125/157), 83% (⅚), and 70% (23/33), respectively. Switching to second-line treatment due to chemoresistance occurred in 20.2% of cases (33/163). The multivariate analysis demonstrated that patients with a 5 to 6 FIGO risk score were 4.2-fold more likely to develop resistance to first-line single-agent treatment (p= 0.019).
Conclusion
1) At presentation, most women showed clinical characteristics favorable to a good outcome, 2) the overall rate of sustained complete remission after first-line single-agent treatment was comparable to that observed in developed countries, 3) a FIGO risk score of 5 or 6 is associated with development of resistance to first-line single-agent chemotherapy.
Key-words Chemotherapylow-risk gestational trophoblastic neoplasiaMolar pregnancyresistance-related factorsSouth AmericaSee 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. - Luz Angela Correa Ramírez
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Original Article
Patient Acceptance of Telemedicine in Urogynecology Consultations – A Cross-Sectional Study Performed at a Brazilian Public Institution
- Débora Vianna D'Almeida Lucas Macharet ,
- Leonardo Nogueira Mendes ,
- Walter Carlos Santos de Oliveira ,
- Gláucia Miranda Varella Pereira ,
- Marilene Vale de Castro Monteiro
06-27-2022
Summary
Original ArticlePatient Acceptance of Telemedicine in Urogynecology Consultations – A Cross-Sectional Study Performed at a Brazilian Public Institution
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(8):755-760
06-27-2022- Débora Vianna D'Almeida Lucas Macharet ,
- Leonardo Nogueira Mendes ,
- Walter Carlos Santos de Oliveira ,
- Gláucia Miranda Varella Pereira ,
- Marilene Vale de Castro Monteiro
Views161See moreAbstract
Objective
To evaluate the acceptance of telemedicine and determine its associated factors in an urogynecology outpatient clinic of a public hospital in Brazil.
Methods
The present was a cross-sectional study performed between June and November 2020. The included patients had their elective appointments postponed due to the coronavirus disease 2019 (COVID-19) pandemic. The variables considered regarding the acceptance of telemedicine were: urogynecologic diagnosis, age, level of schooling, place of residence, access to the internet, type of device used, frequency of internet use, and use of social media platforms. The categorical variables were described by their absolute and relative frequencies. The association among variables was evaluated through the Fisher exact test, and univariate and multivariate analyses, considering the acceptance of telemedicine as the dependent variable.
Results
A total of 225 patients were listed, and 182 agreed to participate. The mean age was 59 years old, 81.3% of the patients had access to the internet, and 87.3% of them accepted telemedicine. There were statistically significant associations regarding the acceptance of telemedicine and high levels of schooling (p< 0.01), internet access (p< 0.01), daily use of the internet (p< 0.01), access through personal mobile phone (p< 0.01), and access through the participant's own residence (p< 0.01). In the univariate and multivariate analyses, only high levels of schooling were associated with the acceptance of telemedicine (Adjusted odds ratio: 4.82; 95% confidence interval = 1.59–14.65).
Conclusion
Most of the urogynecology patients of a public hospital in a developing country accepted telemedicine. Internet access and level of schooling were the factors associated with the acceptance of telemedicine in urogynecology.
Views161This 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. Summary
Original ArticlePatient Acceptance of Telemedicine in Urogynecology Consultations – A Cross-Sectional Study Performed at a Brazilian Public Institution
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(8):755-760
06-27-2022- Débora Vianna D'Almeida Lucas Macharet ,
- Leonardo Nogueira Mendes ,
- Walter Carlos Santos de Oliveira ,
- Gláucia Miranda Varella Pereira ,
- Marilene Vale de Castro Monteiro
Views161See moreAbstract
Objective
To evaluate the acceptance of telemedicine and determine its associated factors in an urogynecology outpatient clinic of a public hospital in Brazil.
Methods
The present was a cross-sectional study performed between June and November 2020. The included patients had their elective appointments postponed due to the coronavirus disease 2019 (COVID-19) pandemic. The variables considered regarding the acceptance of telemedicine were: urogynecologic diagnosis, age, level of schooling, place of residence, access to the internet, type of device used, frequency of internet use, and use of social media platforms. The categorical variables were described by their absolute and relative frequencies. The association among variables was evaluated through the Fisher exact test, and univariate and multivariate analyses, considering the acceptance of telemedicine as the dependent variable.
Results
A total of 225 patients were listed, and 182 agreed to participate. The mean age was 59 years old, 81.3% of the patients had access to the internet, and 87.3% of them accepted telemedicine. There were statistically significant associations regarding the acceptance of telemedicine and high levels of schooling (p< 0.01), internet access (p< 0.01), daily use of the internet (p< 0.01), access through personal mobile phone (p< 0.01), and access through the participant's own residence (p< 0.01). In the univariate and multivariate analyses, only high levels of schooling were associated with the acceptance of telemedicine (Adjusted odds ratio: 4.82; 95% confidence interval = 1.59–14.65).
Conclusion
Most of the urogynecology patients of a public hospital in a developing country accepted telemedicine. Internet access and level of schooling were the factors associated with the acceptance of telemedicine in urogynecology.
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. - Débora Vianna D'Almeida Lucas Macharet
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Original Article
When is There no Benefit in Performing a Biopsy in the Suspicion of Intraepithelial Lesions of the Cervix?
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):272-279
06-27-2022
Summary
Original ArticleWhen is There no Benefit in Performing a Biopsy in the Suspicion of Intraepithelial Lesions of the Cervix?
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):272-279
06-27-2022Views94See moreAbstract
Objective
To evaluate whether colposcopy-directed biopsy is necessary to increase the accuracy of diagnosing cervical intraepithelial lesions in relation to colposcopy.
Methods
We performed a retrospective, observational study by analyzing medical records obtained fromHospital de Clínicas do Paraná fromFebruary 2008 to February 2018. Patients with results of Pap tests, colposcopy, colposcopy-directed biopsy, and surgical procedures (high-frequency surgery or cold conization) were included. Data such as quadrants involved during colposcopy and age differences were also analyzed.
Results
A total of 299 women were included. Colposcopy was found to have an accuracy rate of 76.25% (95% confidence interval [CI], 71.4-81.1). Among the highest-grade lesions, the accuracy rate was 80.5% (95% CI, 75.7-85.3). The accuracy rates for biopsy were 79.6% (95% CI, 75-84.2) and 84.6% (95% CI, 80-89.1) for the highest-grade lesions. High-grade lesions were accurately confirmed in 76.9% and 85% of patients with 1 and 2 or more affected quadrants, respectively. For women younger than 40 years, the accuracy rates were 77.6% and 80.8% for colposcopy and biopsy, respectively. For women 40 years or older, the accuracy rates were 72.5% and 76.3% for colposcopy and biopsy, respectively.
Conclusion
There is no difference between the accuracy of colposcopy and that of biopsy in diagnosing cervical intraepithelial lesions in relation with the result of conization. The patients who received the greatest benefit when biopsy was not performed were those with high-grade lesions at colposcopy, a lesion involving 2 or more quadrants, and those younger than 40 years.
Views94This 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. Summary
Original ArticleWhen is There no Benefit in Performing a Biopsy in the Suspicion of Intraepithelial Lesions of the Cervix?
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):272-279
06-27-2022Views94See moreAbstract
Objective
To evaluate whether colposcopy-directed biopsy is necessary to increase the accuracy of diagnosing cervical intraepithelial lesions in relation to colposcopy.
Methods
We performed a retrospective, observational study by analyzing medical records obtained fromHospital de Clínicas do Paraná fromFebruary 2008 to February 2018. Patients with results of Pap tests, colposcopy, colposcopy-directed biopsy, and surgical procedures (high-frequency surgery or cold conization) were included. Data such as quadrants involved during colposcopy and age differences were also analyzed.
Results
A total of 299 women were included. Colposcopy was found to have an accuracy rate of 76.25% (95% confidence interval [CI], 71.4-81.1). Among the highest-grade lesions, the accuracy rate was 80.5% (95% CI, 75.7-85.3). The accuracy rates for biopsy were 79.6% (95% CI, 75-84.2) and 84.6% (95% CI, 80-89.1) for the highest-grade lesions. High-grade lesions were accurately confirmed in 76.9% and 85% of patients with 1 and 2 or more affected quadrants, respectively. For women younger than 40 years, the accuracy rates were 77.6% and 80.8% for colposcopy and biopsy, respectively. For women 40 years or older, the accuracy rates were 72.5% and 76.3% for colposcopy and biopsy, respectively.
Conclusion
There is no difference between the accuracy of colposcopy and that of biopsy in diagnosing cervical intraepithelial lesions in relation with the result of conization. The patients who received the greatest benefit when biopsy was not performed were those with high-grade lesions at colposcopy, a lesion involving 2 or more quadrants, and those younger than 40 years.
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 Article
Polycystic Ovary Syndrome and Metabolic Syndrome: Clinical and Laboratory Findings and Non-Alcoholic Fatty Liver Disease Assessed by Elastography
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):287-294
06-27-2022
Summary
Original ArticlePolycystic Ovary Syndrome and Metabolic Syndrome: Clinical and Laboratory Findings and Non-Alcoholic Fatty Liver Disease Assessed by Elastography
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):287-294
06-27-2022Views156See moreAbstract
Objective
To evaluate the association between polycystic ovary syndrome (PCOS) and metabolic syndrome (MetS), adding liver assessment through elastography and ultrasound, for correlation with non-alcoholic fatty liver disease (NAFLD). Metabolic syndrome occurs in~43% of women with PCOS, and NAFLD is the hepatic expression of MetS.
Methods
One hundred women, 50 with PCOS and 50 controls, matched by age (18- 35 years) and body mass index (BMI) were included, restricted to patients with overweight and obesity grade 1, at the Assis Chateaubrian Maternity School, Universidade Federal do Ceará, Brazil. For the diagnosis of PCOS, we adopted the Rotterdam criteria, and for the diagnosis of MetS, the criteria of the National Cholesterol Education Program (NCEP/ATP III). Hepatic elastography and ultrasound were performed to assess liver stiffness and echotexture, respectively.
Results
The average ages were 29.1 (±5.3) and 30.54 (±4.39) years, for the PCOS and the control group, respectively. Patients with PCOS had a risk 4 times higher of having MetS, odds ratio (95% confidence interval)=4.14, than those in the control group. Women with PCOS had higher average of abdominal circumference (100.9±9.08 cm vs 94.96±6.99 cm) and triglycerides (162±54.63 mg/dL vs 137.54±36.91mg/dL) and lower average of HDL cholesterol (45.66±6.88 mg/dL vs 49.78±7.05 mg/dL), with statistically significant difference. Hepatic steatosis was observed on ultrasound in women with PCOS; however, with no statistically significant difference. There was no change to NAFLD at elastography in any group.
Conclusion
Women with PCOS had 4-fold higher frequency of MetS andmore hepatic steatosis, with no statistically significant difference. There was no change in liver stiffness between the groups at elastography. The results can be extended only to populations of overweight and obesity grade 1, with PCOS or not. They cannot be generalized to other untested groups.
Views156This 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. Summary
Original ArticlePolycystic Ovary Syndrome and Metabolic Syndrome: Clinical and Laboratory Findings and Non-Alcoholic Fatty Liver Disease Assessed by Elastography
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):287-294
06-27-2022Views156See moreAbstract
Objective
To evaluate the association between polycystic ovary syndrome (PCOS) and metabolic syndrome (MetS), adding liver assessment through elastography and ultrasound, for correlation with non-alcoholic fatty liver disease (NAFLD). Metabolic syndrome occurs in~43% of women with PCOS, and NAFLD is the hepatic expression of MetS.
Methods
One hundred women, 50 with PCOS and 50 controls, matched by age (18- 35 years) and body mass index (BMI) were included, restricted to patients with overweight and obesity grade 1, at the Assis Chateaubrian Maternity School, Universidade Federal do Ceará, Brazil. For the diagnosis of PCOS, we adopted the Rotterdam criteria, and for the diagnosis of MetS, the criteria of the National Cholesterol Education Program (NCEP/ATP III). Hepatic elastography and ultrasound were performed to assess liver stiffness and echotexture, respectively.
Results
The average ages were 29.1 (±5.3) and 30.54 (±4.39) years, for the PCOS and the control group, respectively. Patients with PCOS had a risk 4 times higher of having MetS, odds ratio (95% confidence interval)=4.14, than those in the control group. Women with PCOS had higher average of abdominal circumference (100.9±9.08 cm vs 94.96±6.99 cm) and triglycerides (162±54.63 mg/dL vs 137.54±36.91mg/dL) and lower average of HDL cholesterol (45.66±6.88 mg/dL vs 49.78±7.05 mg/dL), with statistically significant difference. Hepatic steatosis was observed on ultrasound in women with PCOS; however, with no statistically significant difference. There was no change to NAFLD at elastography in any group.
Conclusion
Women with PCOS had 4-fold higher frequency of MetS andmore hepatic steatosis, with no statistically significant difference. There was no change in liver stiffness between the groups at elastography. The results can be extended only to populations of overweight and obesity grade 1, with PCOS or not. They cannot be generalized to other untested groups.
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 Article
Factors Associated with the Chance of Carrying out a Primary Cesarean in a University Hospital
- Maria Celeste Osório Wender ,
- Rafaela Girardi Duarte ,
- Gabriel Cardozo Muller ,
- Rosaura Rolim Cavalheiro ,
- Yanick Adolfo Leal Correia Silva , [ ... ],
- Edimárlei Gonsales Valério
06-06-2022
Summary
Original ArticleFactors Associated with the Chance of Carrying out a Primary Cesarean in a University Hospital
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):640-645
06-06-2022- Maria Celeste Osório Wender ,
- Rafaela Girardi Duarte ,
- Gabriel Cardozo Muller ,
- Rosaura Rolim Cavalheiro ,
- Yanick Adolfo Leal Correia Silva ,
- Cristiane Carboni ,
- Edimárlei Gonsales Valério
Views164See moreAbstract
Objective
The present study seeks to identify the associated factors that increased primary cesarean delivery rates.
Methods
This was a cross-sectional study that evaluated the number of primary cesarean sections performed in the years 2006 and 2018 at the Hospital de Clínicas de Porto Alegre (HCPA, in the Portuguese acronym), through the collection of data from the medical records of the patients.
Results
Advanced maternal age, twin pregnancy, and higher body mass index (BMI) became more frequent in 2018 in comparison with 2006. To mitigate the impact of confounding in comparisons among groups, we made an adjustment by propensity scores and detected significant differences when comparing both age groups on twin pregnancy rates, gestational diabetes mellitus, and thyroid disease.
Conclusion
Data from the present study can be used to prevent and improve the management of morbidities, impacting on better outcomes in obstetrical practice.
Views164This 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. Summary
Original ArticleFactors Associated with the Chance of Carrying out a Primary Cesarean in a University Hospital
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):640-645
06-06-2022- Maria Celeste Osório Wender ,
- Rafaela Girardi Duarte ,
- Gabriel Cardozo Muller ,
- Rosaura Rolim Cavalheiro ,
- Yanick Adolfo Leal Correia Silva ,
- Cristiane Carboni ,
- Edimárlei Gonsales Valério
Views164See moreAbstract
Objective
The present study seeks to identify the associated factors that increased primary cesarean delivery rates.
Methods
This was a cross-sectional study that evaluated the number of primary cesarean sections performed in the years 2006 and 2018 at the Hospital de Clínicas de Porto Alegre (HCPA, in the Portuguese acronym), through the collection of data from the medical records of the patients.
Results
Advanced maternal age, twin pregnancy, and higher body mass index (BMI) became more frequent in 2018 in comparison with 2006. To mitigate the impact of confounding in comparisons among groups, we made an adjustment by propensity scores and detected significant differences when comparing both age groups on twin pregnancy rates, gestational diabetes mellitus, and thyroid disease.
Conclusion
Data from the present study can be used to prevent and improve the management of morbidities, impacting on better outcomes in obstetrical practice.
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. - Maria Celeste Osório Wender
-
Original Article
The COVID-19 Pandemic Impact on Breast Cancer Diagnosis: A Retrospective Study
- Erika Marina Solla Negrao ,
- Cesar Cabello ,
- Livia Conz ,
- Edmundo Carvalho Mauad ,
- Luiz Carlos Zeferino , [ ... ],
- Diama Bhadra Vale
06-06-2022
Summary
Original ArticleThe COVID-19 Pandemic Impact on Breast Cancer Diagnosis: A Retrospective Study
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):871-877
06-06-2022- Erika Marina Solla Negrao ,
- Cesar Cabello ,
- Livia Conz ,
- Edmundo Carvalho Mauad ,
- Luiz Carlos Zeferino ,
- Diama Bhadra Vale
Views178See moreAbstract
Objective
This study aimed to evaluate the diagnostic profile of breast cancer cases during the coronavirus disease 2019 (COVID-19) pandemic compared with the previous year.
Methods
It is a retrospective study of cases diagnosed by a reference service in the public health system of Campinas, SP, Brazil. Two periods were analyzed: March to October 2019 (preCOVID period) and March to October 2020 (COVID-period). All women diagnosed during the periods were included. The Chi-Squared or Fisher exact and Mann-Whitney tests were used.
Results
In the preCOVID and COVID periods, breast cancers were diagnosed, respectively, in 115 vs 59 women, and the mean ages at diagnosis were 55 and 57 years (p = 0.339). In the COVID period, the family history of breast cancer was more observed (9.6% vs 29.8%, p < 0.001), cases were more frequently symptomatic (50.4% vs 79.7%, p < 0.001) and had more frequently palpable masses (56.5% vs 79.7%, p = 0.003). In symptomatic women, the mean number of days from symptom to mammography were 233.6 (458.3) in 2019 and 152.1 (151.5) in 2020 (p = 0.871). Among invasive tumors, the proportion of breast cancers in stages I and II was slightly higher in the COVID period, although not significantly (76.7% vs 82.4%, p = 0.428). Also in the COVID period, the frequency of luminal A-like tumors was lower (29.2% vs 11.8%, p = 0.018), of triple-negative tumors was twice as high (10.1% vs 21.6%, p = 0.062), and of estrogen receptor-positive tumors was lower (82.2% vs 66.0%, p = 0.030).
Conclusion
During the COVID-19 pandemic, breast cancer diagnoses were reduced. Cases detected were suggestive of a worse prognosis: symptomatic women with palpable masses and more aggressive subtypes. Indolent tumors were those more sensitive to the interruption in screening.
Views178This 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. Summary
Original ArticleThe COVID-19 Pandemic Impact on Breast Cancer Diagnosis: A Retrospective Study
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):871-877
06-06-2022- Erika Marina Solla Negrao ,
- Cesar Cabello ,
- Livia Conz ,
- Edmundo Carvalho Mauad ,
- Luiz Carlos Zeferino ,
- Diama Bhadra Vale
Views178See moreAbstract
Objective
This study aimed to evaluate the diagnostic profile of breast cancer cases during the coronavirus disease 2019 (COVID-19) pandemic compared with the previous year.
Methods
It is a retrospective study of cases diagnosed by a reference service in the public health system of Campinas, SP, Brazil. Two periods were analyzed: March to October 2019 (preCOVID period) and March to October 2020 (COVID-period). All women diagnosed during the periods were included. The Chi-Squared or Fisher exact and Mann-Whitney tests were used.
Results
In the preCOVID and COVID periods, breast cancers were diagnosed, respectively, in 115 vs 59 women, and the mean ages at diagnosis were 55 and 57 years (p = 0.339). In the COVID period, the family history of breast cancer was more observed (9.6% vs 29.8%, p < 0.001), cases were more frequently symptomatic (50.4% vs 79.7%, p < 0.001) and had more frequently palpable masses (56.5% vs 79.7%, p = 0.003). In symptomatic women, the mean number of days from symptom to mammography were 233.6 (458.3) in 2019 and 152.1 (151.5) in 2020 (p = 0.871). Among invasive tumors, the proportion of breast cancers in stages I and II was slightly higher in the COVID period, although not significantly (76.7% vs 82.4%, p = 0.428). Also in the COVID period, the frequency of luminal A-like tumors was lower (29.2% vs 11.8%, p = 0.018), of triple-negative tumors was twice as high (10.1% vs 21.6%, p = 0.062), and of estrogen receptor-positive tumors was lower (82.2% vs 66.0%, p = 0.030).
Conclusion
During the COVID-19 pandemic, breast cancer diagnoses were reduced. Cases detected were suggestive of a worse prognosis: symptomatic women with palpable masses and more aggressive subtypes. Indolent tumors were those more sensitive to the interruption in screening.
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. - Erika Marina Solla Negrao
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