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Original Article
Thyroid Function of Pregnant Women and Perinatal Outcomes in North Macedonia
- Maja Avramovska
, - Neda Milevska Kostova ,
- Borislav Karanfilski ,
- Sandra Hunziker ,
- Olivija Vaskova , [ ... ],
- Aleksandar Sikole
12-17-2021
Summary
Original ArticleThyroid Function of Pregnant Women and Perinatal Outcomes in North Macedonia
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(10):736-742
12-17-2021- Maja Avramovska ,
- Neda Milevska Kostova ,
- Borislav Karanfilski ,
- Sandra Hunziker ,
- Olivija Vaskova ,
- Goran Dimitrov ,
- Elena Dzikova ,
- Ana Daneva Markova ,
- Marija Hadzi Lega ,
- Gligor Tofoski ,
- Aleksandar Sikole
Views111See moreAbstract
Objective
Thyroid diseases are the second most common endocrine disorders in the reproductive period of women. They can be associated with intrauterine growth restriction (IUGR), preterm delivery, low Apgar score, low birthweight (LBW) or fetal death. The aim of the present study is to explore thyroid dysfunction and its relationship with some poor perinatal outcomes (Apgar Score, low birthweight, and preterm delivery).
Methods
Dried blood spot samples from 358 healthy pregnant women were analyzed for thyroid stimulating hormone (TSH), total thyroxine (TT4), and thyroglobulin (Tg). Neonatal data were collected upon delivery. Four groups were formed based on thyroid function tests (TFTs).
Results
Of the 358 tested women, 218 (60.72%) were euthyroid. Isolated hypo thyroxinemia was present in 132 women (36.76%), subclinical hyperthyroidism in 7 women (1.94%), and overt hypothyroidism in 1 (0.28%). The perinatal outcomes IUGR (p = 0.028) and Apgar score 1 minute (p = 0.015) were significantly different between thyroid function test [TFT]-distinct groups. In the multiple regression analysis, TT4 showed a statistically significant inverse predictive impact on LBW (p < 0.0001), but a positive impact of Tg on LBW (p = 0.0351).
Conclusion
Thyroid hormones alone do not have a direct impact on neonatal outcomes, but the percentage of their participation in the total process cannot be neglected. Based on the regression analysis, we can conclude that TT4 and Tg can be used as predictors of neonatal outcome, expressed through birthweight and Apgar score. The present study aims to contribute to determine whether a test for thyroid status should become routine screening during pregnancy.
Views111
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 ArticleThyroid Function of Pregnant Women and Perinatal Outcomes in North Macedonia
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(10):736-742
12-17-2021- Maja Avramovska ,
- Neda Milevska Kostova ,
- Borislav Karanfilski ,
- Sandra Hunziker ,
- Olivija Vaskova ,
- Goran Dimitrov ,
- Elena Dzikova ,
- Ana Daneva Markova ,
- Marija Hadzi Lega ,
- Gligor Tofoski ,
- Aleksandar Sikole
Views111See moreAbstract
Objective
Thyroid diseases are the second most common endocrine disorders in the reproductive period of women. They can be associated with intrauterine growth restriction (IUGR), preterm delivery, low Apgar score, low birthweight (LBW) or fetal death. The aim of the present study is to explore thyroid dysfunction and its relationship with some poor perinatal outcomes (Apgar Score, low birthweight, and preterm delivery).
Methods
Dried blood spot samples from 358 healthy pregnant women were analyzed for thyroid stimulating hormone (TSH), total thyroxine (TT4), and thyroglobulin (Tg). Neonatal data were collected upon delivery. Four groups were formed based on thyroid function tests (TFTs).
Results
Of the 358 tested women, 218 (60.72%) were euthyroid. Isolated hypo thyroxinemia was present in 132 women (36.76%), subclinical hyperthyroidism in 7 women (1.94%), and overt hypothyroidism in 1 (0.28%). The perinatal outcomes IUGR (p = 0.028) and Apgar score 1 minute (p = 0.015) were significantly different between thyroid function test [TFT]-distinct groups. In the multiple regression analysis, TT4 showed a statistically significant inverse predictive impact on LBW (p < 0.0001), but a positive impact of Tg on LBW (p = 0.0351).
Conclusion
Thyroid hormones alone do not have a direct impact on neonatal outcomes, but the percentage of their participation in the total process cannot be neglected. Based on the regression analysis, we can conclude that TT4 and Tg can be used as predictors of neonatal outcome, expressed through birthweight and Apgar score. The present study aims to contribute to determine whether a test for thyroid status should become routine screening during pregnancy.
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. - Maja Avramovska
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Original Article
The Assessment of Vitamin D Levels in Pregnant Women is not Associated to Fetal Growth Restriction: A Cross Sectional Study
- Vivian Macedo Gomes Marçal ,
- Francisco Lázaro Pereira Sousa ,
- Silvia Daher ,
- Raquel Margiotte Grohmann ,
- Alberto Borges Peixoto , [ ... ],
- Luciano Marcondes Machado Nardozza
12-17-2021
Summary
Original ArticleThe Assessment of Vitamin D Levels in Pregnant Women is not Associated to Fetal Growth Restriction: A Cross Sectional Study
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(10):743-748
12-17-2021- Vivian Macedo Gomes Marçal ,
- Francisco Lázaro Pereira Sousa ,
- Silvia Daher ,
- Raquel Margiotte Grohmann ,
- Alberto Borges Peixoto ,
- Edward Araujo Júnior ,
- Luciano Marcondes Machado Nardozza
Views230See moreAbstract
Objective
To assess maternal serum levels of vitamin D in fetuses appropriate for gestational age (AGA), small for gestational age (SGA), and with fetal growth restriction (FGR) according to estimated fetal weight (EFW).
Methods
This cross-sectional study included 87 pregnant women between 26 and 36 weeks of gestation: 38 in the AGA group, 24 in the SGA group, and 25 in the FGR group. Maternal serum vitamin D levels were assessed using the chemiluminescence method. The Fisher exact test was used to compare the results between the groups.
Results
The mean ± standard deviation (SD) of maternal age (years) and body mass index (kg/m2) in the AGA, SGA, and FGR groups were 25.26 8.40 / 26.57 ± 4.37; 25.04 ± 8.44 / 26.09 ± 3.94; and 25.48 ± 7.52 / 26.24 ± 4.66, respectively (p > 0.05). The maternal serum vitamin D levels (mean ± SD) of the AGA, SGA, and FGR groups were 22.47 ± 8.35 ng/mL, 24.80 ± 10.76 ng/mL, and 23.61 ± 9.98 ng/mL, respectively, but without significant differences between the groups (p = 0.672).
Conclusion
Maternal serum vitamin D levels did not present significant differences among pregnant women with AGA, SGA, or FGR fetuses between 26 and 36 weeks of gestation according to EFW.
Views230This 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 Assessment of Vitamin D Levels in Pregnant Women is not Associated to Fetal Growth Restriction: A Cross Sectional Study
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(10):743-748
12-17-2021- Vivian Macedo Gomes Marçal ,
- Francisco Lázaro Pereira Sousa ,
- Silvia Daher ,
- Raquel Margiotte Grohmann ,
- Alberto Borges Peixoto ,
- Edward Araujo Júnior ,
- Luciano Marcondes Machado Nardozza
Views230See moreAbstract
Objective
To assess maternal serum levels of vitamin D in fetuses appropriate for gestational age (AGA), small for gestational age (SGA), and with fetal growth restriction (FGR) according to estimated fetal weight (EFW).
Methods
This cross-sectional study included 87 pregnant women between 26 and 36 weeks of gestation: 38 in the AGA group, 24 in the SGA group, and 25 in the FGR group. Maternal serum vitamin D levels were assessed using the chemiluminescence method. The Fisher exact test was used to compare the results between the groups.
Results
The mean ± standard deviation (SD) of maternal age (years) and body mass index (kg/m2) in the AGA, SGA, and FGR groups were 25.26 8.40 / 26.57 ± 4.37; 25.04 ± 8.44 / 26.09 ± 3.94; and 25.48 ± 7.52 / 26.24 ± 4.66, respectively (p > 0.05). The maternal serum vitamin D levels (mean ± SD) of the AGA, SGA, and FGR groups were 22.47 ± 8.35 ng/mL, 24.80 ± 10.76 ng/mL, and 23.61 ± 9.98 ng/mL, respectively, but without significant differences between the groups (p = 0.672).
Conclusion
Maternal serum vitamin D levels did not present significant differences among pregnant women with AGA, SGA, or FGR fetuses between 26 and 36 weeks of gestation according to EFW.
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. - Vivian Macedo Gomes Marçal
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Original Article
Improving Implantation Rate in 2nd ICSI Cycle through Ovarian Stimulation with FSH and LH in GNRH Antagonist Regimen
- Amanda Souza Setti ,
- Daniela Paes de Almeida Ferreira Braga ,
- Assumpto Iaconelli Júnior ,
- Edson Borges Júnior
12-17-2021
Summary
Original ArticleImproving Implantation Rate in 2nd ICSI Cycle through Ovarian Stimulation with FSH and LH in GNRH Antagonist Regimen
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(10):749-758
12-17-2021- Amanda Souza Setti ,
- Daniela Paes de Almeida Ferreira Braga ,
- Assumpto Iaconelli Júnior ,
- Edson Borges Júnior
Views166Abstract
Objective
To investigate whether patients with a previous recombinant follicle stimulating hormone (rFSH)-stimulated cycle would have improved outcomes with rFSH + recombinant luteinizing hormone (rLH) stimulation in the following cycle.
Methods
For the present retrospective case-control study, 228 cycles performed in 114 patients undergoing intracytoplasmic sperm injection (ICSI) between 2015 and 2018 in an in vitro fertilization (IVF) center were evaluated. Controlled ovarian stimulation (COS) was achieved with rFSH (Gonal-f, Serono, Geneva, Switzerland) in the first ICSI cycle (rFSH group), and with rFSH and rLH (Pergoveris, Merck Serono S.p.A, Bari, Italy) in the second cycle (rFSH + rLH group). The ICSI outcomes were compared among the groups.
Results
Higher estradiol levels, oocyte yield, day-3 high-quality embryos rate and implantation rate, and a lower miscarriage rate were observed in the rFSH + rLH group compared with the rFSH group. In patients < 35 years old, the implantation rate was higher in the rFSH + rLH group compared with the rFSH group. In patients ≥ 35 years old, higher estradiol levels, oocyte yield, day-3 high-quality embryos rate, and implantation rate were observed in the rFSH + rLH group. In patients with ≤ 4 retrieved oocytes, oocyte yield, mature oocytes rate, normal cleavage speed, implantation rate, and miscarriage rate were improved in the rFSH + rLH group. In patients with ≥ 5 retrieved oocytes, higher estradiol levels, oocyte yield, and implantation rate were observed in the rFSH + rLH group.
Conclusion
Ovarian stimulation with luteinizing hormone (LH) supplementation results in higher implantation rates, independent of maternal age and response to COS when compared with previous cycles stimulated with rFSH only. Improvements were also observed for ICSI outcomes and miscarriage after stratification by age and retrieved oocytes.
Key-words Follicle stimulating hormoneintracytoplasmic sperm injection implantationLuteinizing hormoneOvarian stimulationSee moreViews166This 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 ArticleImproving Implantation Rate in 2nd ICSI Cycle through Ovarian Stimulation with FSH and LH in GNRH Antagonist Regimen
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(10):749-758
12-17-2021- Amanda Souza Setti ,
- Daniela Paes de Almeida Ferreira Braga ,
- Assumpto Iaconelli Júnior ,
- Edson Borges Júnior
Views166Abstract
Objective
To investigate whether patients with a previous recombinant follicle stimulating hormone (rFSH)-stimulated cycle would have improved outcomes with rFSH + recombinant luteinizing hormone (rLH) stimulation in the following cycle.
Methods
For the present retrospective case-control study, 228 cycles performed in 114 patients undergoing intracytoplasmic sperm injection (ICSI) between 2015 and 2018 in an in vitro fertilization (IVF) center were evaluated. Controlled ovarian stimulation (COS) was achieved with rFSH (Gonal-f, Serono, Geneva, Switzerland) in the first ICSI cycle (rFSH group), and with rFSH and rLH (Pergoveris, Merck Serono S.p.A, Bari, Italy) in the second cycle (rFSH + rLH group). The ICSI outcomes were compared among the groups.
Results
Higher estradiol levels, oocyte yield, day-3 high-quality embryos rate and implantation rate, and a lower miscarriage rate were observed in the rFSH + rLH group compared with the rFSH group. In patients < 35 years old, the implantation rate was higher in the rFSH + rLH group compared with the rFSH group. In patients ≥ 35 years old, higher estradiol levels, oocyte yield, day-3 high-quality embryos rate, and implantation rate were observed in the rFSH + rLH group. In patients with ≤ 4 retrieved oocytes, oocyte yield, mature oocytes rate, normal cleavage speed, implantation rate, and miscarriage rate were improved in the rFSH + rLH group. In patients with ≥ 5 retrieved oocytes, higher estradiol levels, oocyte yield, and implantation rate were observed in the rFSH + rLH group.
Conclusion
Ovarian stimulation with luteinizing hormone (LH) supplementation results in higher implantation rates, independent of maternal age and response to COS when compared with previous cycles stimulated with rFSH only. Improvements were also observed for ICSI outcomes and miscarriage after stratification by age and retrieved oocytes.
Key-words Follicle stimulating hormoneintracytoplasmic sperm injection implantationLuteinizing hormoneOvarian stimulationSee 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. - Amanda Souza Setti
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Original Article
Intraoperative Assessment of Endogenous Microbiota in the Breast
- Henrique Stachon,
- Vanessa Amoroso ,
- Cicero Urban ,
- Pamela Bioni,
- Cleverton Spautz , [ ... ],
- Juliane Monteiro
12-17-2021
Summary
Original ArticleIntraoperative Assessment of Endogenous Microbiota in the Breast
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(10):759-764
12-17-2021- Henrique Stachon,
- Vanessa Amoroso ,
- Cicero Urban ,
- Pamela Bioni,
- Cleverton Spautz ,
- Rubens Silveira de Lima ,
- Karina Anselmi ,
- Flávia Kuroda ,
- Iris Rabinovich ,
- Thabata Alvarez ,
- Juliane Monteiro
Views212Abstract
Objective:
Breast surgery is considered a clean surgery; however, the rates of infection range between 3 and 15%. The objective of the present study was to intraoperatively investigate the presence of autochthonous microbiota in the breast.
Methods:
Pieces of breast tissue collected from 49 patients who underwent elective breast surgery (reconstructive, diagnostic, or oncologic) were cultured. The pieces of breast tissue were approximately 1 cm in diameter and were removed from the retroareolar area, medial quadrant, and lateral quadrant. Each piece of tissue was incubated in brain heart infusion (BHI) broth for 7 days at 37°C, and in cases in which the medium became turbid due to microorganism growth, the samples were placed in Petri dishes for culturing and isolating strains and for identifying species using an automated counter.
Results:
Microorganism growth was observed in the samples of 10 of the 49 patients (20.4%) and in 11 of the 218 pieces of tissue (5%). The detected species were Staphylococcus lugdunensis, Staphylococcus hominis, Staphylococcus epidermidis, Sphingomonas paucimobilis, and Aeromonas salmonicida. No patient with positive samples had clinical infection postoperatively.
Conclusion:
The presence of these bacteria in breast tissue in approximately 20% of the patients in this series suggests that breast surgery should be considered a potential source of contamination that may have implications for adverse reactions to breast implants and should be studied in the near future for their oncological implications in breast implant-associated large-cell lymphoma etiology.
Key-words biofilmbreast conservative surgerycapsular contracturenipple-sparing mastectomysurgery infectionSee moreViews212This 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 ArticleIntraoperative Assessment of Endogenous Microbiota in the Breast
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(10):759-764
12-17-2021- Henrique Stachon,
- Vanessa Amoroso ,
- Cicero Urban ,
- Pamela Bioni,
- Cleverton Spautz ,
- Rubens Silveira de Lima ,
- Karina Anselmi ,
- Flávia Kuroda ,
- Iris Rabinovich ,
- Thabata Alvarez ,
- Juliane Monteiro
Views212Abstract
Objective:
Breast surgery is considered a clean surgery; however, the rates of infection range between 3 and 15%. The objective of the present study was to intraoperatively investigate the presence of autochthonous microbiota in the breast.
Methods:
Pieces of breast tissue collected from 49 patients who underwent elective breast surgery (reconstructive, diagnostic, or oncologic) were cultured. The pieces of breast tissue were approximately 1 cm in diameter and were removed from the retroareolar area, medial quadrant, and lateral quadrant. Each piece of tissue was incubated in brain heart infusion (BHI) broth for 7 days at 37°C, and in cases in which the medium became turbid due to microorganism growth, the samples were placed in Petri dishes for culturing and isolating strains and for identifying species using an automated counter.
Results:
Microorganism growth was observed in the samples of 10 of the 49 patients (20.4%) and in 11 of the 218 pieces of tissue (5%). The detected species were Staphylococcus lugdunensis, Staphylococcus hominis, Staphylococcus epidermidis, Sphingomonas paucimobilis, and Aeromonas salmonicida. No patient with positive samples had clinical infection postoperatively.
Conclusion:
The presence of these bacteria in breast tissue in approximately 20% of the patients in this series suggests that breast surgery should be considered a potential source of contamination that may have implications for adverse reactions to breast implants and should be studied in the near future for their oncological implications in breast implant-associated large-cell lymphoma etiology.
Key-words biofilmbreast conservative surgerycapsular contracturenipple-sparing mastectomysurgery infectionSee 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. -
Original Article
Psychological Problems Experienced by Patients with Bowel Endometriosis Awaiting Surgery
- Helizabet Salomão Abdalla Ayroza Ribeiro ,
- Andresa Maria Felipe de Paiva ,
- Beatriz da Costa Porto Taliberti ,
- Anna Luiza Lobão Gonçalves ,
- Renata Pereira Condes , [ ... ],
- Paulo Augusto Galvão Ayroza Ribeiro
11-29-2021
Summary
Original ArticlePsychological Problems Experienced by Patients with Bowel Endometriosis Awaiting Surgery
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(9):676-681
11-29-2021- Helizabet Salomão Abdalla Ayroza Ribeiro ,
- Andresa Maria Felipe de Paiva ,
- Beatriz da Costa Porto Taliberti ,
- Anna Luiza Lobão Gonçalves ,
- Renata Pereira Condes ,
- Paulo Augusto Galvão Ayroza Ribeiro
Views201Abstract
Objective
To assess the most common psychological disturbances in women with deep endometriosis and bowel involvement who are waiting surgical treatment and to evaluate what forms of coping are used to solve the problem.
Methods
This was a cross-sectional observational study of 40 women diagnosed with deep endometriosis and intestinal symptoms. They completed two questionnaires: one for anxiety and depression (Hospital Anxiety and Depression Scale [ HADS]) and the Scale of Mode of Confronting Problems (EMEP, in the Portuguese acronym).
Results
We found that 77.1% of the patients had anxiety and depression, with anxiety being the most prevalent (87.5% of the patients); 90% of the patients used problem focused and religious introspection as their main modes of confronting problems.
Conclusion
In the use of the HADS questionary, two psychological aspects were the most present in women with deep endometriosis awaiting surgical treatment: anxiety and depression. The most used forms of coping to solve the problem were problem coping and religious practices.
Key-words anxiety disordersCross-sectional studiesdepressive disordersEndometriosispsychological adaptationSee moreViews201This 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 ArticlePsychological Problems Experienced by Patients with Bowel Endometriosis Awaiting Surgery
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(9):676-681
11-29-2021- Helizabet Salomão Abdalla Ayroza Ribeiro ,
- Andresa Maria Felipe de Paiva ,
- Beatriz da Costa Porto Taliberti ,
- Anna Luiza Lobão Gonçalves ,
- Renata Pereira Condes ,
- Paulo Augusto Galvão Ayroza Ribeiro
Views201Abstract
Objective
To assess the most common psychological disturbances in women with deep endometriosis and bowel involvement who are waiting surgical treatment and to evaluate what forms of coping are used to solve the problem.
Methods
This was a cross-sectional observational study of 40 women diagnosed with deep endometriosis and intestinal symptoms. They completed two questionnaires: one for anxiety and depression (Hospital Anxiety and Depression Scale [ HADS]) and the Scale of Mode of Confronting Problems (EMEP, in the Portuguese acronym).
Results
We found that 77.1% of the patients had anxiety and depression, with anxiety being the most prevalent (87.5% of the patients); 90% of the patients used problem focused and religious introspection as their main modes of confronting problems.
Conclusion
In the use of the HADS questionary, two psychological aspects were the most present in women with deep endometriosis awaiting surgical treatment: anxiety and depression. The most used forms of coping to solve the problem were problem coping and religious practices.
Key-words anxiety disordersCross-sectional studiesdepressive disordersEndometriosispsychological adaptationSee 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. - Helizabet Salomão Abdalla Ayroza Ribeiro
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Original Article
Pathways of IFN-alpha Activation in Patients with Cervical Intraepithelial Neoplasia (CIN)
- Nelson Ranieri Tirone ,
- Carolina Guissoni Campos ,
- Kézia Jesus Aguiar Ferreira ,
- Léticia Montes Stark ,
- Jéssica Ferreira Vieira , [ ... ],
- Márcia Antoniazi Michelin
11-29-2021
Summary
Original ArticlePathways of IFN-alpha Activation in Patients with Cervical Intraepithelial Neoplasia (CIN)
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(9):682-689
11-29-2021- Nelson Ranieri Tirone ,
- Carolina Guissoni Campos ,
- Kézia Jesus Aguiar Ferreira ,
- Léticia Montes Stark ,
- Jéssica Ferreira Vieira ,
- Eddie Fernando Cândido Murta ,
- Márcia Antoniazi Michelin
Views194See moreAbstract
Objective
The aim of the present study was to compare the local and systemic expression of the factors linked to the interferon alpha (IFN-α) activation pathway in different degrees of cervical intraepithelial neoplasia (CIN) and cervical cancer.
Methods
A total of 128 patients with CIN I, CIN II, CIN III and cervical cancer was evaluated. The real-time polymerase chain reaction (RT-PCR) technique was used to evaluate the gene expression of IFNR1, IFNR2, IFN-α, oligoadenylate synthase (2’5′OAS), cytokine signal suppressor 1 (SOCS) 1, SOCS3, signal transducer and transcription activator 1 (STAT1), and IRF9 from 128 biopsies. A total of 46 out of 128 samples were evaluated by flow cytometry for IFNAR1, IFNAR2, STAT1, IRF7 and IFN-α in peripheral blood cells.
Results
Patients with CIN II and III (63 samples) had a low local expression of IFNR1, but not IFNR2. Patients with some degree of injury showed high expression of SOCS1 and SOCS3. Systemically, patients with CIN II and III (20 samples) had a significant increase in IFNR1, IFNR2, STAT1, IRF7, and IFN-α in helper, cytotoxic T lymphocytes, and in monocytes.
Conclusion
Patients with high-grade lesions have increased systemic expression of IFN-α and its activation pathways in helper and cytotoxic T lymphocytes, as well as in monocytes due to an exacerbation of the immune response in these patients. This phenomenon is not accompanied by resolution of the lesion due to a defect in the IFN-α activation pathway that revealed by low local IFNAR1 expression and high local expression of SOCS1 and SOCS3.
Views194This 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 ArticlePathways of IFN-alpha Activation in Patients with Cervical Intraepithelial Neoplasia (CIN)
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(9):682-689
11-29-2021- Nelson Ranieri Tirone ,
- Carolina Guissoni Campos ,
- Kézia Jesus Aguiar Ferreira ,
- Léticia Montes Stark ,
- Jéssica Ferreira Vieira ,
- Eddie Fernando Cândido Murta ,
- Márcia Antoniazi Michelin
Views194See moreAbstract
Objective
The aim of the present study was to compare the local and systemic expression of the factors linked to the interferon alpha (IFN-α) activation pathway in different degrees of cervical intraepithelial neoplasia (CIN) and cervical cancer.
Methods
A total of 128 patients with CIN I, CIN II, CIN III and cervical cancer was evaluated. The real-time polymerase chain reaction (RT-PCR) technique was used to evaluate the gene expression of IFNR1, IFNR2, IFN-α, oligoadenylate synthase (2’5′OAS), cytokine signal suppressor 1 (SOCS) 1, SOCS3, signal transducer and transcription activator 1 (STAT1), and IRF9 from 128 biopsies. A total of 46 out of 128 samples were evaluated by flow cytometry for IFNAR1, IFNAR2, STAT1, IRF7 and IFN-α in peripheral blood cells.
Results
Patients with CIN II and III (63 samples) had a low local expression of IFNR1, but not IFNR2. Patients with some degree of injury showed high expression of SOCS1 and SOCS3. Systemically, patients with CIN II and III (20 samples) had a significant increase in IFNR1, IFNR2, STAT1, IRF7, and IFN-α in helper, cytotoxic T lymphocytes, and in monocytes.
Conclusion
Patients with high-grade lesions have increased systemic expression of IFN-α and its activation pathways in helper and cytotoxic T lymphocytes, as well as in monocytes due to an exacerbation of the immune response in these patients. This phenomenon is not accompanied by resolution of the lesion due to a defect in the IFN-α activation pathway that revealed by low local IFNAR1 expression and high local expression of SOCS1 and SOCS3.
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. - Nelson Ranieri Tirone
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Original Article
Exposed Implant after Immediate Breast Reconstruction – Presentation and Analysis of a Clinical Management Protocol
- Rafael Amin Menezes Hassan ,
- Cícero de Andrade Urban ,
- Maíra Teixeira Dória ,
- Cleverton Cesar Spautz ,
- Iris Rabinovich , [ ... ],
- Rubens Silveira de Lima
11-29-2021
Summary
Original ArticleExposed Implant after Immediate Breast Reconstruction – Presentation and Analysis of a Clinical Management Protocol
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(9):690-698
11-29-2021- Rafael Amin Menezes Hassan ,
- Cícero de Andrade Urban ,
- Maíra Teixeira Dória ,
- Cleverton Cesar Spautz ,
- Iris Rabinovich ,
- Karina Furlan Anselmi ,
- Eduardo Schunemann Jr ,
- Flávia Kuroda ,
- Bernardo Passos Sobreiro ,
- Rubens Silveira de Lima
Views210See moreAbstract
Objective
Infection and exposure of the implant are some of the most common and concerning complications after implant-based breast reconstruction. Currently, there is no consensus on the management of these complications. The aim of the present study was to review our cases and to present a clinical protocol.
Methods
We conducted a retrospective review of consecutive patients submitted to implant-based breast reconstruction between 2014 and 2016. All patients were managed according to a specific and structured protocol.
Results
Implant exposure occurred in 33 out of 277 (11.9%) implant-based reconstructions. Among these, two patients had history of radiotherapy and had their implant removed; Delayed reconstruction with a myocutaneous flap was performed in both cases. Signs of severe local infection were observed in 12 patients, and another 5 presented with extensive tissue necrosis, and they were all submitted to implant removal; of them, 8 underwent reconstruction with a tissue expander, and 2, with a myocutaneous flap. The remaining 14 patients had no signs of severe infection, previous irradiation or extensive tissue necrosis, and were submitted to primary suture as an attempt to salvage the implant. Of these, 8 cases (57.1%) managed to keep the
Conclusion
Our clinical protocol is based on three key points: history of radiotherapy, severe infection, and extensive tissue necrosis. It is a practical and potentially-reproducible method of managing one of the most common complications of implant-based breast reconstruction.
Views210This 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 ArticleExposed Implant after Immediate Breast Reconstruction – Presentation and Analysis of a Clinical Management Protocol
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(9):690-698
11-29-2021- Rafael Amin Menezes Hassan ,
- Cícero de Andrade Urban ,
- Maíra Teixeira Dória ,
- Cleverton Cesar Spautz ,
- Iris Rabinovich ,
- Karina Furlan Anselmi ,
- Eduardo Schunemann Jr ,
- Flávia Kuroda ,
- Bernardo Passos Sobreiro ,
- Rubens Silveira de Lima
Views210See moreAbstract
Objective
Infection and exposure of the implant are some of the most common and concerning complications after implant-based breast reconstruction. Currently, there is no consensus on the management of these complications. The aim of the present study was to review our cases and to present a clinical protocol.
Methods
We conducted a retrospective review of consecutive patients submitted to implant-based breast reconstruction between 2014 and 2016. All patients were managed according to a specific and structured protocol.
Results
Implant exposure occurred in 33 out of 277 (11.9%) implant-based reconstructions. Among these, two patients had history of radiotherapy and had their implant removed; Delayed reconstruction with a myocutaneous flap was performed in both cases. Signs of severe local infection were observed in 12 patients, and another 5 presented with extensive tissue necrosis, and they were all submitted to implant removal; of them, 8 underwent reconstruction with a tissue expander, and 2, with a myocutaneous flap. The remaining 14 patients had no signs of severe infection, previous irradiation or extensive tissue necrosis, and were submitted to primary suture as an attempt to salvage the implant. Of these, 8 cases (57.1%) managed to keep the
Conclusion
Our clinical protocol is based on three key points: history of radiotherapy, severe infection, and extensive tissue necrosis. It is a practical and potentially-reproducible method of managing one of the most common complications of implant-based breast reconstruction.
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. - Rafael Amin Menezes Hassan
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Original Article
Understanding How Health Providers Identify Women with Postpartum Hemorrhage: A Qualitative Study
- Silvana Ferreira Bento ,
- Anderson Borovac-Pinheiro ,
- Erika Zambrano Tanaka ,
- Carla Silveira ,
- Rodolfo Carvalho Pacagnella
11-29-2021
Summary
Original ArticleUnderstanding How Health Providers Identify Women with Postpartum Hemorrhage: A Qualitative Study
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(9):648-654
11-29-2021- Silvana Ferreira Bento ,
- Anderson Borovac-Pinheiro ,
- Erika Zambrano Tanaka ,
- Carla Silveira ,
- Rodolfo Carvalho Pacagnella
Views173See moreAbstract
Objective
To identify how health providers recognize postpartum hemorrhage early and the difficulties involved in it.
Methods
An exploratory, descriptive study using a qualitative approach through a semi-structured interview technique. In total, 27 health professionals (nursing tech nicians, nurses, medical residents in Gynecology and Obstetrics, hired medical doctors, and medicine professors) working in a tertiary-level hospital of reference in women’s health care in the State of São Paulo, Brazil, participated in the study through an invitation. After they accepted the invitation, they signed the free and informed consent form. All interviews were recorded and transcribed, and a thematic analysis was conducted. We found three analysis categories: a) perception of the severity: “there is something wrong with the women”; b) difficulties in the early diagnosis of postpartum hemorrhage; and c) the process to improve obstetrical care.
Results
Caregivers believe teamwork and communication should be improved. Besides the visual estimation of blood loss, the nursing team is attentive to behavioral symptoms like irritability, while the medical staff follow protocols and look for objective signs, such as altered vital signs.
Conclusion
Besides the objective evaluations, the subjective perceptions of the providers are involved in the clinical judgement regarding the diagnosis of postpartum hemorrhage, and this should be included in a broader diagnosis strategy.
Views173This 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 ArticleUnderstanding How Health Providers Identify Women with Postpartum Hemorrhage: A Qualitative Study
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(9):648-654
11-29-2021- Silvana Ferreira Bento ,
- Anderson Borovac-Pinheiro ,
- Erika Zambrano Tanaka ,
- Carla Silveira ,
- Rodolfo Carvalho Pacagnella
Views173See moreAbstract
Objective
To identify how health providers recognize postpartum hemorrhage early and the difficulties involved in it.
Methods
An exploratory, descriptive study using a qualitative approach through a semi-structured interview technique. In total, 27 health professionals (nursing tech nicians, nurses, medical residents in Gynecology and Obstetrics, hired medical doctors, and medicine professors) working in a tertiary-level hospital of reference in women’s health care in the State of São Paulo, Brazil, participated in the study through an invitation. After they accepted the invitation, they signed the free and informed consent form. All interviews were recorded and transcribed, and a thematic analysis was conducted. We found three analysis categories: a) perception of the severity: “there is something wrong with the women”; b) difficulties in the early diagnosis of postpartum hemorrhage; and c) the process to improve obstetrical care.
Results
Caregivers believe teamwork and communication should be improved. Besides the visual estimation of blood loss, the nursing team is attentive to behavioral symptoms like irritability, while the medical staff follow protocols and look for objective signs, such as altered vital signs.
Conclusion
Besides the objective evaluations, the subjective perceptions of the providers are involved in the clinical judgement regarding the diagnosis of postpartum hemorrhage, and this should be included in a broader diagnosis strategy.
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. - Silvana Ferreira Bento
Original Article Archives - Page 3 of 55 - Revista Brasileira de Ginecologia e Obstetrícia
