-
Original Article
Immediate prepectoral versus submuscular breast reconstruction in nipple-sparing mastectomy: a retrospective cohort analysis
- Francisco Pimentel Cavalcante
, - Ticiane Oliveira Lima ,
- Ryane Alcantara ,
- Amanda Cardoso ,
- Guilherme Novita , [ ... ],
- Eduardo Millen
09-06-2024
Summary
Original ArticleImmediate prepectoral versus submuscular breast reconstruction in nipple-sparing mastectomy: a retrospective cohort analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo76
09-06-2024- Francisco Pimentel Cavalcante ,
- Ticiane Oliveira Lima ,
- Ryane Alcantara ,
- Amanda Cardoso ,
- Guilherme Novita ,
- Felipe Zerwes ,
- Eduardo Millen
Views184Abstract
Objective
To evaluate early complications in prepectoral breast reconstruction.
Methods
A retrospective cohort study including 180 consecutive cases of nipple-sparing mastectomy, comparing immediate breast reconstruction with subpectoral to prepectoral mammary implants in 2012-2022. Clinical and demographic characteristics and complications in the first three months following surgery were compared between the two techniques.
Results
The prepectoral technique was used in 22 cases (12.2%) and the subpectoral in 158 (87.8%). Median age was higher in the prepectoral group (47 versus 43.8 years; p=0.038), as was body mass index (25.1 versus 23.8; p=0.002) and implant volume (447.5 versus 409 cc; p=0.001). The prepectoral technique was more associated with an inframammary fold (IMF) incision (19 cases, 86.4% versus 85, 53.8%) than with periareolar incisions (3 cases, 13.6% versus 73, 46.2%); (p=0.004). All cases in the prepectoral group underwent direct-to-implant reconstruction compared to 54 cases (34.2%) in the subpectoral group. Thirty-eight complications were recorded: 36 (22.8%) in the subpectoral group and 2 (9.1%) in the prepectoral group (p=0.24). Necrosis of the nipple-areola complex/skin flap occurred in 27 patients (17.1%) in the subpectoral group (prepectoral group: no cases; p=0.04). The groups were comparable regarding dehiscence, seroma, infection, and hematoma. Reconstruction failed in one case per group (p=0.230). In the multivariate analysis, IMF incision was associated with the prepectoral group (aOR: 34.72; 95%CI: 2.84-424.63).
Conclusion
The incidence of early complications was comparable between the two techniques and compatible with previous reports. The clinical and demographic characteristics differed between the techniques. Randomized clinical trials are required.
Key-words Breast implantationBreast implantsBreast neoplasmsMammaplastyMastectomyNipplesPectoralis musclesSurgical procedures, operativeSee moreViews184
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 ArticleImmediate prepectoral versus submuscular breast reconstruction in nipple-sparing mastectomy: a retrospective cohort analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo76
09-06-2024- Francisco Pimentel Cavalcante ,
- Ticiane Oliveira Lima ,
- Ryane Alcantara ,
- Amanda Cardoso ,
- Guilherme Novita ,
- Felipe Zerwes ,
- Eduardo Millen
Views184Abstract
Objective
To evaluate early complications in prepectoral breast reconstruction.
Methods
A retrospective cohort study including 180 consecutive cases of nipple-sparing mastectomy, comparing immediate breast reconstruction with subpectoral to prepectoral mammary implants in 2012-2022. Clinical and demographic characteristics and complications in the first three months following surgery were compared between the two techniques.
Results
The prepectoral technique was used in 22 cases (12.2%) and the subpectoral in 158 (87.8%). Median age was higher in the prepectoral group (47 versus 43.8 years; p=0.038), as was body mass index (25.1 versus 23.8; p=0.002) and implant volume (447.5 versus 409 cc; p=0.001). The prepectoral technique was more associated with an inframammary fold (IMF) incision (19 cases, 86.4% versus 85, 53.8%) than with periareolar incisions (3 cases, 13.6% versus 73, 46.2%); (p=0.004). All cases in the prepectoral group underwent direct-to-implant reconstruction compared to 54 cases (34.2%) in the subpectoral group. Thirty-eight complications were recorded: 36 (22.8%) in the subpectoral group and 2 (9.1%) in the prepectoral group (p=0.24). Necrosis of the nipple-areola complex/skin flap occurred in 27 patients (17.1%) in the subpectoral group (prepectoral group: no cases; p=0.04). The groups were comparable regarding dehiscence, seroma, infection, and hematoma. Reconstruction failed in one case per group (p=0.230). In the multivariate analysis, IMF incision was associated with the prepectoral group (aOR: 34.72; 95%CI: 2.84-424.63).
Conclusion
The incidence of early complications was comparable between the two techniques and compatible with previous reports. The clinical and demographic characteristics differed between the techniques. Randomized clinical trials are required.
Key-words Breast implantationBreast implantsBreast neoplasmsMammaplastyMastectomyNipplesPectoralis musclesSurgical procedures, operativeSee 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. - Francisco Pimentel Cavalcante
-
Original Article
Maintaining accuracy and expanding access: evaluating the efficacy of the Botucatu Abbreviated Breast MRI Protocol
- Eduardo Carvalho Pessoa ,
- Thais Paiva Moares ,
- Heverton Leal Ernesto de Amorim ,
- Henrique Lima Couto ,
- Joelcio Francisco Abbade , [ ... ],
- Eliana Aguiar Petri Nahas
07-26-2024
Summary
Original ArticleMaintaining accuracy and expanding access: evaluating the efficacy of the Botucatu Abbreviated Breast MRI Protocol
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo55
07-26-2024- Eduardo Carvalho Pessoa ,
- Thais Paiva Moares ,
- Heverton Leal Ernesto de Amorim ,
- Henrique Lima Couto ,
- Joelcio Francisco Abbade ,
- Suzana Shinomia ,
- Carla Priscila Kamiya Carvalho Pessoa ,
- Eliana Aguiar Petri Nahas
Views123See moreAbstract
Objective
Our study evaluated the effectiveness of the Botucatu Abbreviated Protocol in breast magnetic resonance imaging (MRI) within Brazil’s public healthcare system, focusing on its impact on patient access to MRI exams.
Methods
This retrospective study involved 197 breast MRI exams of female patients over 18 years with histological breast carcinoma diagnosis, conducted at Hospital das Clínicas de Botucatu - UNESP between 2014 and 2018. Two experienced examiners prospectively and blindly analyzed the exams using an Integrated Picture Archiving and Communication System (PACS). They first evaluated the Botucatu Abbreviated Protocol, created from sequences of the complete protocol (PC), and after an average interval of 30 days, they reassessed the same 197 exams with the complete protocol. Dynamic and morphological characteristics of lesions were assessed according to BI-RADS 5th edition criteria. The study also analyzed the average number of monthly exams before and after the implementation of Botucatu Abbreviated Protocol.
Results
The Botucatu Abbreviated Protocol showed high sensitivity (99% and 96%) and specificity (90.9% and 96%). There was a significant increase in the average monthly MRI exams from 6.62 to 23.8 post-implementation.
Conclusion
The Botucatu Abbreviated Protocol proved effective in maintaining diagnostic accuracy and improving accessibility to breast MRI exams, particularly in the public healthcare setting.
Views123This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleMaintaining accuracy and expanding access: evaluating the efficacy of the Botucatu Abbreviated Breast MRI Protocol
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo55
07-26-2024- Eduardo Carvalho Pessoa ,
- Thais Paiva Moares ,
- Heverton Leal Ernesto de Amorim ,
- Henrique Lima Couto ,
- Joelcio Francisco Abbade ,
- Suzana Shinomia ,
- Carla Priscila Kamiya Carvalho Pessoa ,
- Eliana Aguiar Petri Nahas
Views123See moreAbstract
Objective
Our study evaluated the effectiveness of the Botucatu Abbreviated Protocol in breast magnetic resonance imaging (MRI) within Brazil’s public healthcare system, focusing on its impact on patient access to MRI exams.
Methods
This retrospective study involved 197 breast MRI exams of female patients over 18 years with histological breast carcinoma diagnosis, conducted at Hospital das Clínicas de Botucatu - UNESP between 2014 and 2018. Two experienced examiners prospectively and blindly analyzed the exams using an Integrated Picture Archiving and Communication System (PACS). They first evaluated the Botucatu Abbreviated Protocol, created from sequences of the complete protocol (PC), and after an average interval of 30 days, they reassessed the same 197 exams with the complete protocol. Dynamic and morphological characteristics of lesions were assessed according to BI-RADS 5th edition criteria. The study also analyzed the average number of monthly exams before and after the implementation of Botucatu Abbreviated Protocol.
Results
The Botucatu Abbreviated Protocol showed high sensitivity (99% and 96%) and specificity (90.9% and 96%). There was a significant increase in the average monthly MRI exams from 6.62 to 23.8 post-implementation.
Conclusion
The Botucatu Abbreviated Protocol proved effective in maintaining diagnostic accuracy and improving accessibility to breast MRI exams, particularly in the public healthcare setting.
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. - Eduardo Carvalho Pessoa
-
Original Article
Validation and cultural translation for the Brazilian Portuguese version of the Estro-Androgenic- Symptom Questionnaire in Women
- Cássia Raquel Teatin Juliato ,
- Ana Aline Coelho Oswaldo ,
- Camila Carvalho de Araújo ,
- Marina Rotoli ,
- Lúcia Costa-Paiva , [ ... ],
- Luiz Gustavo Oliveira Brito
07-26-2024
Summary
Original ArticleValidation and cultural translation for the Brazilian Portuguese version of the Estro-Androgenic- Symptom Questionnaire in Women
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo56
07-26-2024- Cássia Raquel Teatin Juliato ,
- Ana Aline Coelho Oswaldo ,
- Camila Carvalho de Araújo ,
- Marina Rotoli ,
- Lúcia Costa-Paiva ,
- Rossella Nappi ,
- Luiz Gustavo Oliveira Brito
Views128Abstract
Objective
This study aimed to translate and validate the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese language, as we hypothesized that this tool would be consistent for addressing the specific context of hormonal symptoms in menopause.
Methods
In a cross-sectional study, a total of 119 women with Genitourinary Syndrome of Menopause (GSM) and 119 climacteric women without GSM were included. The EASQ-W was translated, and its psychometric properties were rigorously examined. Participants completed questionnaires covering sociodemographic details, the EASQ-W, and the Menopause Rating Scale (MRS). A subgroup of 173 women was re-invited after 4 weeks for test-retest analysis of the EASQ-W. Additionally, the responsiveness of the questionnaire was evaluated in 30 women who underwent oral hormonal treatment.
Results
The internal consistency of the EASQ-W was found to be satisfactory in both GSM and control groups (Cronbach’s alpha ≥ 0.70). Notably, a floor effect was observed in both groups; however, a ceiling effect was only evident in the sexual domain of the GSM group. Construct validity was established by comparing the EASQ-W with the MRS, yielding statistically significant correlations (0.33831-0.64580, p < 0.001). The test-retest reliability over a 4-week period was demonstrated to be satisfactory in both the GSM and control groups (ICC 0.787-0.977). Furthermore, the EASQ-W exhibited appropriate responsiveness to oral hormonal treatment (p < 0.001).
Conclusion
This study successfully translated and validated the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese, with satisfactory internal consistency, test-retest reliability, and construct validity.
Key-words AndrogenEASQ-WEstrogenMenopauseSigns and symptomssurveys and questionnairesValidation studiesSee moreViews128This 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 ArticleValidation and cultural translation for the Brazilian Portuguese version of the Estro-Androgenic- Symptom Questionnaire in Women
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo56
07-26-2024- Cássia Raquel Teatin Juliato ,
- Ana Aline Coelho Oswaldo ,
- Camila Carvalho de Araújo ,
- Marina Rotoli ,
- Lúcia Costa-Paiva ,
- Rossella Nappi ,
- Luiz Gustavo Oliveira Brito
Views128Abstract
Objective
This study aimed to translate and validate the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese language, as we hypothesized that this tool would be consistent for addressing the specific context of hormonal symptoms in menopause.
Methods
In a cross-sectional study, a total of 119 women with Genitourinary Syndrome of Menopause (GSM) and 119 climacteric women without GSM were included. The EASQ-W was translated, and its psychometric properties were rigorously examined. Participants completed questionnaires covering sociodemographic details, the EASQ-W, and the Menopause Rating Scale (MRS). A subgroup of 173 women was re-invited after 4 weeks for test-retest analysis of the EASQ-W. Additionally, the responsiveness of the questionnaire was evaluated in 30 women who underwent oral hormonal treatment.
Results
The internal consistency of the EASQ-W was found to be satisfactory in both GSM and control groups (Cronbach’s alpha ≥ 0.70). Notably, a floor effect was observed in both groups; however, a ceiling effect was only evident in the sexual domain of the GSM group. Construct validity was established by comparing the EASQ-W with the MRS, yielding statistically significant correlations (0.33831-0.64580, p < 0.001). The test-retest reliability over a 4-week period was demonstrated to be satisfactory in both the GSM and control groups (ICC 0.787-0.977). Furthermore, the EASQ-W exhibited appropriate responsiveness to oral hormonal treatment (p < 0.001).
Conclusion
This study successfully translated and validated the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese, with satisfactory internal consistency, test-retest reliability, and construct validity.
Key-words AndrogenEASQ-WEstrogenMenopauseSigns and symptomssurveys and questionnairesValidation studiesSee 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. - Cássia Raquel Teatin Juliato
-
Original Article
Real-world data on adjuvant capecitabine after standard neoadjuvant chemotherapy for triple negative breast cancer
- Maria Fernanda Imperio Pereira ,
- Isabela Panzeri Carlotti Buzatto ,
- Hélio Humberto Angotti Carrara ,
- Fabiana de Oliveira Buono ,
- Jurandyr Moreira de Andrade , [ ... ],
- Daniel Guimarães Tiezzi
07-26-2024
Summary
Original ArticleReal-world data on adjuvant capecitabine after standard neoadjuvant chemotherapy for triple negative breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo29
07-26-2024- Maria Fernanda Imperio Pereira ,
- Isabela Panzeri Carlotti Buzatto ,
- Hélio Humberto Angotti Carrara ,
- Fabiana de Oliveira Buono ,
- Jurandyr Moreira de Andrade ,
- Leonardo Fleury Orlandini ,
- Daniel Guimarães Tiezzi
Views139Abstract
Objective
Neoadjuvant chemotherapy (NACT) has become the standard of care for patients with triple-negative breast cancer (TNBC) with tumors > 1 cm or positive axillary nodes. Pathologic complete response (pCR) has been used as an endpoint to select patients for treatment scaling. This study aimed to examine the benefit of adding adjuvant capecitabine for TNBC patients who did not achieve pCR after standard NACT in a real-world scenario.
Methods
This retrospective cohort study included all patients with TNBC who underwent NACT between 2010 and 2020. Clinicopathological data were obtained from the patient records. Univariate and multivariate analyses were conducted at the 5 years follow-up period.
Results
We included 153 patients, more than half of whom had stage III (58.2%) and high-grade tumors (60.8%). The overall pCR rate was 34.6%, and 41% of the patients with residual disease received adjuvant capecitabine. Disease-specific survival (DSS) among the patients who achieved pCR was significantly higher (p<0.0001). Residual disease after NACT was associated with detrimental effects on DSS. In this cohort, we did not observe any survival benefit of adding adjuvant capecitabine for patients with TNBC subjected to NACT who did not achieve pCR (p=0.52).
Conclusion
Our study failed to demonstrate a survival benefit of extended capecitabine therapy in patients with TNBC with residual disease after NACT. More studies are warranted to better understand the indication of systemic treatment escalation in this scenario.
Key-words Breast neoplasmsCapecitabine/therapeutic useNeoadjuvant therapyTriple-negative breast neoplasmsSee moreViews139This 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 ArticleReal-world data on adjuvant capecitabine after standard neoadjuvant chemotherapy for triple negative breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo29
07-26-2024- Maria Fernanda Imperio Pereira ,
- Isabela Panzeri Carlotti Buzatto ,
- Hélio Humberto Angotti Carrara ,
- Fabiana de Oliveira Buono ,
- Jurandyr Moreira de Andrade ,
- Leonardo Fleury Orlandini ,
- Daniel Guimarães Tiezzi
Views139Abstract
Objective
Neoadjuvant chemotherapy (NACT) has become the standard of care for patients with triple-negative breast cancer (TNBC) with tumors > 1 cm or positive axillary nodes. Pathologic complete response (pCR) has been used as an endpoint to select patients for treatment scaling. This study aimed to examine the benefit of adding adjuvant capecitabine for TNBC patients who did not achieve pCR after standard NACT in a real-world scenario.
Methods
This retrospective cohort study included all patients with TNBC who underwent NACT between 2010 and 2020. Clinicopathological data were obtained from the patient records. Univariate and multivariate analyses were conducted at the 5 years follow-up period.
Results
We included 153 patients, more than half of whom had stage III (58.2%) and high-grade tumors (60.8%). The overall pCR rate was 34.6%, and 41% of the patients with residual disease received adjuvant capecitabine. Disease-specific survival (DSS) among the patients who achieved pCR was significantly higher (p<0.0001). Residual disease after NACT was associated with detrimental effects on DSS. In this cohort, we did not observe any survival benefit of adding adjuvant capecitabine for patients with TNBC subjected to NACT who did not achieve pCR (p=0.52).
Conclusion
Our study failed to demonstrate a survival benefit of extended capecitabine therapy in patients with TNBC with residual disease after NACT. More studies are warranted to better understand the indication of systemic treatment escalation in this scenario.
Key-words Breast neoplasmsCapecitabine/therapeutic useNeoadjuvant therapyTriple-negative breast neoplasmsSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Maria Fernanda Imperio Pereira
-
Original Article
Mid-pregnancy circulating cytokine levels, placental efficiency and their relationship with preterm birth
- Carlos Grandi ,
- Karina Bezerra Salomão ,
- Stella Felippe de Freitas ,
- Paulo Ricardo Higassiaraguti Rocha ,
- Ricardo de Carvalho Cavalli , [ ... ],
- Viviane Cunha Cardoso
07-26-2024
Summary
Original ArticleMid-pregnancy circulating cytokine levels, placental efficiency and their relationship with preterm birth
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo58
07-26-2024- Carlos Grandi ,
- Karina Bezerra Salomão ,
- Stella Felippe de Freitas ,
- Paulo Ricardo Higassiaraguti Rocha ,
- Ricardo de Carvalho Cavalli ,
- Viviane Cunha Cardoso
Views149See moreAbstract
Objective
To assess a panel of cytokines and placental insufficiency with the risk of preterm delivery (PTD).
Methods
Nested case-control study into the BRISA birth cohort. Eighty-two mother-infant-placenta pairs were selected at 20+0 to 25+6 weeks. Circulating biomarker levels were performed using Luminex flowmetric xMAP technology. Cytokines classified as Th1, Th2 or Th17 and other biomarkers were selected. The ratio between birth weight and placental weight (BW/PW) was used as a proxy for placental efficiency. Spearman correlation, univariate analyses and logistic regression models were calculated. Sensitivity, specificity, positive and negative likelihood ratios were calculated using the Receiver Operating Characteristic curve.
Results
Mean gestational age was 250 days, 14,6% were small for gestational age, 4,8% large for gestational age and 13,4% stunted. Placental efficiency was higher for term newborns (p<0,001), and 18/22 (81%) preterm biomarker values were higher than the control group. Th1 cytokines were highly correlated, while the weakest correlation was observed in other biomarkers. Less education was associated with a higher risk of PTD (p = 0.046), while there was no appreciable difference in the risk of PTD for placental insufficiency. Biomarkers showed negligible adjusted OR of PTD (0.90 to 1.02). IL-6, IL-8, IL-1β, TNFβ, IL-4, IL-13, GCSF, MIP1A, VEGF, EGF, and FGF2 presented a higher sensitivity ranging from 75.56% to 91.11%.
Conclusion
IL-8, IL-12p40, IL-4, IL-13, GCSF, MIP1B, and GMSF in asymptomatic pregnant women were associated with PTD. This finding suggests an activation of maternal inflammatory response.
Views149This 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 ArticleMid-pregnancy circulating cytokine levels, placental efficiency and their relationship with preterm birth
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo58
07-26-2024- Carlos Grandi ,
- Karina Bezerra Salomão ,
- Stella Felippe de Freitas ,
- Paulo Ricardo Higassiaraguti Rocha ,
- Ricardo de Carvalho Cavalli ,
- Viviane Cunha Cardoso
Views149See moreAbstract
Objective
To assess a panel of cytokines and placental insufficiency with the risk of preterm delivery (PTD).
Methods
Nested case-control study into the BRISA birth cohort. Eighty-two mother-infant-placenta pairs were selected at 20+0 to 25+6 weeks. Circulating biomarker levels were performed using Luminex flowmetric xMAP technology. Cytokines classified as Th1, Th2 or Th17 and other biomarkers were selected. The ratio between birth weight and placental weight (BW/PW) was used as a proxy for placental efficiency. Spearman correlation, univariate analyses and logistic regression models were calculated. Sensitivity, specificity, positive and negative likelihood ratios were calculated using the Receiver Operating Characteristic curve.
Results
Mean gestational age was 250 days, 14,6% were small for gestational age, 4,8% large for gestational age and 13,4% stunted. Placental efficiency was higher for term newborns (p<0,001), and 18/22 (81%) preterm biomarker values were higher than the control group. Th1 cytokines were highly correlated, while the weakest correlation was observed in other biomarkers. Less education was associated with a higher risk of PTD (p = 0.046), while there was no appreciable difference in the risk of PTD for placental insufficiency. Biomarkers showed negligible adjusted OR of PTD (0.90 to 1.02). IL-6, IL-8, IL-1β, TNFβ, IL-4, IL-13, GCSF, MIP1A, VEGF, EGF, and FGF2 presented a higher sensitivity ranging from 75.56% to 91.11%.
Conclusion
IL-8, IL-12p40, IL-4, IL-13, GCSF, MIP1B, and GMSF in asymptomatic pregnant women were associated with PTD. This finding suggests an activation of maternal inflammatory response.
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. - Carlos Grandi
-
Original Article
Factors associated with exclusive breastfeeding in “Near Miss” neonates in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo59
07-26-2024
Summary
Original ArticleFactors associated with exclusive breastfeeding in “Near Miss” neonates in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo59
07-26-2024Views107See moreAbstract
Objective
To assess the association between sociodemographic and perinatal factors and hospital practices to encourage exclusive breastfeeding in near miss neonates in maternity hospitals.
Methods
This is a prospective cohort of live births from the survey “To be born in Brazil” conducted between 2011 and 2012. The weighted number of newborns who met the neonatal near miss criteria was 832. Exclusive breastfeeding at hospital discharge and 45 days after delivery were dependent variables of the study. The sociodemographic and perinatal factors of the puerperal women and hospital practices to encourage breastfeeding were independent variables. The data were analyzed with Poisson regression and set with p value<0.05. Is exclusive breastfeeding in neonatal near misses associated with factors related to sociodemographic conditions, maternal characteristics and the organization of health services?
Results
Data from 498 women and their children were analyzed. Mothers with incomplete primary education were more likely (36%) to have exclusive breastfeeding (RR: 1.36; 95% CI: 1.06-1.74) at discharge. Women who did not offer the breast to the newborn in the joint accommodation (65%) were less likely to be breastfeeding exclusively (RR: 0.65; 95% CI: 0.56-0.75) at discharge. Variables that increased the probability of exclusive breastfeeding after 45 days of delivery were primiparity (RR: 1.36; 95% CI: 1.08-1.69) and having the newborn in the delivery room (RR: 1.90; 95% CI: 1.12-3.24).
Conclusion
Exclusive breastfeeding in neonatal near misses was associated with maternal characteristics and important hospital practices, such as being breastfed in the joint accommodation and the newborn being in the mother’s lap in the delivery room.
Views107This 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 exclusive breastfeeding in “Near Miss” neonates in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo59
07-26-2024Views107See moreAbstract
Objective
To assess the association between sociodemographic and perinatal factors and hospital practices to encourage exclusive breastfeeding in near miss neonates in maternity hospitals.
Methods
This is a prospective cohort of live births from the survey “To be born in Brazil” conducted between 2011 and 2012. The weighted number of newborns who met the neonatal near miss criteria was 832. Exclusive breastfeeding at hospital discharge and 45 days after delivery were dependent variables of the study. The sociodemographic and perinatal factors of the puerperal women and hospital practices to encourage breastfeeding were independent variables. The data were analyzed with Poisson regression and set with p value<0.05. Is exclusive breastfeeding in neonatal near misses associated with factors related to sociodemographic conditions, maternal characteristics and the organization of health services?
Results
Data from 498 women and their children were analyzed. Mothers with incomplete primary education were more likely (36%) to have exclusive breastfeeding (RR: 1.36; 95% CI: 1.06-1.74) at discharge. Women who did not offer the breast to the newborn in the joint accommodation (65%) were less likely to be breastfeeding exclusively (RR: 0.65; 95% CI: 0.56-0.75) at discharge. Variables that increased the probability of exclusive breastfeeding after 45 days of delivery were primiparity (RR: 1.36; 95% CI: 1.08-1.69) and having the newborn in the delivery room (RR: 1.90; 95% CI: 1.12-3.24).
Conclusion
Exclusive breastfeeding in neonatal near misses was associated with maternal characteristics and important hospital practices, such as being breastfed in the joint accommodation and the newborn being in the mother’s lap in the delivery room.
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
Mode of delivery according to Robson classification and perinatal outcomes in restricted and small for gestational age fetuses
- Jaqueline Brandão Mazzola ,
- Ana Cristina Perez Zamarian ,
- Ana Carolina Rabachini Caetano ,
- Luiza Grosso Silva Drumond ,
- Vivian Macedo Gomes Marçal , [ ... ],
- Luciano Marcondes Machado Nardozza
07-26-2024
Summary
Original ArticleMode of delivery according to Robson classification and perinatal outcomes in restricted and small for gestational age fetuses
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo30
07-26-2024- Jaqueline Brandão Mazzola ,
- Ana Cristina Perez Zamarian ,
- Ana Carolina Rabachini Caetano ,
- Luiza Grosso Silva Drumond ,
- Vivian Macedo Gomes Marçal ,
- Amanda Botelho ,
- Edward Araujo Júnior ,
- Sue Yasaki Sun ,
- Luciano Marcondes Machado Nardozza
Views164Abstract
Objective
To evaluate the mode of delivery according to Robson classification (RC) and the perinatal outcomes in fetal growth restriction (FGR) and small for gestational age (SGA) fetuses.
Methods
Retrospective cohort study by analyzing medical records of singleton pregnancies from two consecutive years (2018 and 2019). FGR was defined according to Delphi Consensus. The Robson groups were divided into two intervals (1–5.1 and 5.2–10).
Results
Total of 852 cases were included: FGR (n = 85), SGA (n = 20) and control (n=747). FGR showed higher percentages of newborns < 1,500 grams (p<0.001) and higher overall cesarean section (CS) rates (p<0.001). FGR had the highest rates of neonatal resuscitation and neonatal intensive care unit admission (p<0.001). SGA and control presented higher percentage of patients classified in 1 - 5.1 RC groups, while FGR had higher percentage in 5.2 - 10 RC groups (p<0.001). FGR, SGA and control did not differ in the mode of delivery in the 1-5.1 RC groups as all groups showed a higher percentage of vaginal deliveries (p=0.476).
Conclusion
Fetuses with FGR had higher CS rates and worse perinatal outcomes than SGA and control fetuses. Most FGR fetuses were delivered by cesarean section and were allocated in 5.2 to 10 RC groups, while most SGA and control fetuses were allocated in 1 to 5.1 RC groups. Vaginal delivery occurred in nearly 60% of FGR allocated in 1-5.1 RC groups without a significant increase in perinatal morbidity. Therefore, the vaginal route should be considered in FGR fetuses.
Key-words Cesarean sectionFetal growth retardationFetusGestational ageInfant, newbornInfant, small for gestational agePregnancy outcomerobson classificationSee moreViews164This 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 ArticleMode of delivery according to Robson classification and perinatal outcomes in restricted and small for gestational age fetuses
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo30
07-26-2024- Jaqueline Brandão Mazzola ,
- Ana Cristina Perez Zamarian ,
- Ana Carolina Rabachini Caetano ,
- Luiza Grosso Silva Drumond ,
- Vivian Macedo Gomes Marçal ,
- Amanda Botelho ,
- Edward Araujo Júnior ,
- Sue Yasaki Sun ,
- Luciano Marcondes Machado Nardozza
Views164Abstract
Objective
To evaluate the mode of delivery according to Robson classification (RC) and the perinatal outcomes in fetal growth restriction (FGR) and small for gestational age (SGA) fetuses.
Methods
Retrospective cohort study by analyzing medical records of singleton pregnancies from two consecutive years (2018 and 2019). FGR was defined according to Delphi Consensus. The Robson groups were divided into two intervals (1–5.1 and 5.2–10).
Results
Total of 852 cases were included: FGR (n = 85), SGA (n = 20) and control (n=747). FGR showed higher percentages of newborns < 1,500 grams (p<0.001) and higher overall cesarean section (CS) rates (p<0.001). FGR had the highest rates of neonatal resuscitation and neonatal intensive care unit admission (p<0.001). SGA and control presented higher percentage of patients classified in 1 - 5.1 RC groups, while FGR had higher percentage in 5.2 - 10 RC groups (p<0.001). FGR, SGA and control did not differ in the mode of delivery in the 1-5.1 RC groups as all groups showed a higher percentage of vaginal deliveries (p=0.476).
Conclusion
Fetuses with FGR had higher CS rates and worse perinatal outcomes than SGA and control fetuses. Most FGR fetuses were delivered by cesarean section and were allocated in 5.2 to 10 RC groups, while most SGA and control fetuses were allocated in 1 to 5.1 RC groups. Vaginal delivery occurred in nearly 60% of FGR allocated in 1-5.1 RC groups without a significant increase in perinatal morbidity. Therefore, the vaginal route should be considered in FGR fetuses.
Key-words Cesarean sectionFetal growth retardationFetusGestational ageInfant, newbornInfant, small for gestational agePregnancy outcomerobson classificationSee 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. - Jaqueline Brandão Mazzola
-
Original Article
Association of insulin-like growth factor II mrna-binding protein 3 (IMP3) expression with prognostic and morphological factors in endometrial cancer
- Silas Otero Reis Salum ,
- Eduardo Batista Candido ,
- Maria Aparecida Custódio Domingues ,
- Elida Paula Benquique Ojopi ,
- Ângela Favorito Santarem Tonon , [ ... ],
- Agnaldo Lopes da Silva-Filho
07-26-2024
Summary
Original ArticleAssociation of insulin-like growth factor II mrna-binding protein 3 (IMP3) expression with prognostic and morphological factors in endometrial cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo61
07-26-2024- Silas Otero Reis Salum ,
- Eduardo Batista Candido ,
- Maria Aparecida Custódio Domingues ,
- Elida Paula Benquique Ojopi ,
- Ângela Favorito Santarem Tonon ,
- Agnaldo Lopes da Silva-Filho
Views128See moreAbstract
Objective
Endometrial cancer (EC) is a heterogeneous disease with recurrence rates ranging from 15 to 20%. The discrimination of cases with a worse prognosis aims, in part, to reduce the length of surgical staging in cases with a better prognosis. This study aimed to evaluate the association between Insulin-like growth factor II mRNA-binding protein 3 (IMP3) expression and prognostic and morphological factors in EC.
Methods
This retrospective, cross-sectional, analytical study included 79 EC patients - 70 endometrioid carcinoma (EEC) and 9 serous carcinoma (SC) - and 74 benign endometrium controls. IMP3 expression was evaluated by immunohistochemistry-based TMA (Tissue Microarray), and the results were associated with morphological and prognostic factors, including claudins 3 and 4, estrogen and progesterone receptors, TP53, and KI67.
Results
IMP3 expression was significantly higher in SC compared to EEC in both extent (p<0.001) and intensity (p=0.044). It was also significantly associated with worse prognostic factors, including degree of differentiation (p=0.024, p<0.001), staging (p<0.001; p<0.001) and metastasis (p=0.002; p<0.001). IMP3 expression was also significant in extent (p=0.002) in endometrial tumors compared with controls. In addition, protein TP53 and KI67 showed significant associations in extent and intensity, respectively.
Conclusion
IMP3 expression was associated with worse prognostic factors studied. These findings suggest that IMP3 may be a potential biomarker for EC poorer prognosis.
Views128This 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 ArticleAssociation of insulin-like growth factor II mrna-binding protein 3 (IMP3) expression with prognostic and morphological factors in endometrial cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo61
07-26-2024- Silas Otero Reis Salum ,
- Eduardo Batista Candido ,
- Maria Aparecida Custódio Domingues ,
- Elida Paula Benquique Ojopi ,
- Ângela Favorito Santarem Tonon ,
- Agnaldo Lopes da Silva-Filho
Views128See moreAbstract
Objective
Endometrial cancer (EC) is a heterogeneous disease with recurrence rates ranging from 15 to 20%. The discrimination of cases with a worse prognosis aims, in part, to reduce the length of surgical staging in cases with a better prognosis. This study aimed to evaluate the association between Insulin-like growth factor II mRNA-binding protein 3 (IMP3) expression and prognostic and morphological factors in EC.
Methods
This retrospective, cross-sectional, analytical study included 79 EC patients - 70 endometrioid carcinoma (EEC) and 9 serous carcinoma (SC) - and 74 benign endometrium controls. IMP3 expression was evaluated by immunohistochemistry-based TMA (Tissue Microarray), and the results were associated with morphological and prognostic factors, including claudins 3 and 4, estrogen and progesterone receptors, TP53, and KI67.
Results
IMP3 expression was significantly higher in SC compared to EEC in both extent (p<0.001) and intensity (p=0.044). It was also significantly associated with worse prognostic factors, including degree of differentiation (p=0.024, p<0.001), staging (p<0.001; p<0.001) and metastasis (p=0.002; p<0.001). IMP3 expression was also significant in extent (p=0.002) in endometrial tumors compared with controls. In addition, protein TP53 and KI67 showed significant associations in extent and intensity, respectively.
Conclusion
IMP3 expression was associated with worse prognostic factors studied. These findings suggest that IMP3 may be a potential biomarker for EC poorer prognosis.
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. - Silas Otero Reis Salum
Original Article Archives - Page 3 of 55 - Revista Brasileira de Ginecologia e Obstetrícia
