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Review Article06-19-2019
Hormonal Biomarkers for Evaluating the Impact of Fetal Growth Restriction on the Development of Chronic Adult Disease
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(4):256-263
Abstract
Review ArticleHormonal Biomarkers for Evaluating the Impact of Fetal Growth Restriction on the Development of Chronic Adult Disease
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(4):256-263
Views186Abstract
The hypothesis of fetal origins to adult diseases proposes that metabolic chronic disorders, including cardiovascular diseases, diabetes, and hypertension originate in the developmental plasticity due to intrauterine insults. These processes involve an adaptative response by the fetus to changes in the environmental signals, which can promote the reset of hormones and of the metabolism to establish a “thrifty phenotype”. Metabolic alterations during intrauterine growth restriction can modify the fetal programming. The present nonsystematic review intended to summarize historical and current references that indicated that developmental origins of health and disease (DOHaD) occur as a consequence of altered maternal and fetal metabolic pathways. The purpose is to highlight the potential implications of growth factors and adipokines in “developmental programming”, which could interfere in the development by controlling fetal growth patterns. These changes affect the structure and the functional capacity of various organs, including the brain, the kidneys, and the pancreas. These investigations may improve the approach to optimizing antenatal as well as perinatal care aimed to protect newborns against long-termchronic diseases.
Key-words biomarkersdevelopmentdevelopmental origins of health and diseaseFetal growth restrictiongrowthSee moreViews186
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. Abstract
Review ArticleHormonal Biomarkers for Evaluating the Impact of Fetal Growth Restriction on the Development of Chronic Adult Disease
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(4):256-263
Views186Abstract
The hypothesis of fetal origins to adult diseases proposes that metabolic chronic disorders, including cardiovascular diseases, diabetes, and hypertension originate in the developmental plasticity due to intrauterine insults. These processes involve an adaptative response by the fetus to changes in the environmental signals, which can promote the reset of hormones and of the metabolism to establish a “thrifty phenotype”. Metabolic alterations during intrauterine growth restriction can modify the fetal programming. The present nonsystematic review intended to summarize historical and current references that indicated that developmental origins of health and disease (DOHaD) occur as a consequence of altered maternal and fetal metabolic pathways. The purpose is to highlight the potential implications of growth factors and adipokines in “developmental programming”, which could interfere in the development by controlling fetal growth patterns. These changes affect the structure and the functional capacity of various organs, including the brain, the kidneys, and the pancreas. These investigations may improve the approach to optimizing antenatal as well as perinatal care aimed to protect newborns against long-termchronic diseases.
Key-words biomarkersdevelopmentdevelopmental origins of health and diseaseFetal growth restrictiongrowthSee 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. -
Review Article04-15-2019
Isthmocele: From Risk Factors to Management
- Piergiorgio Iannone
, - Giulia Nencini,
- Gloria Bonaccorsi,
- Ruby Martinello,
- Giovanni Pontrelli, [ ... ],
- Gennaro Scutiero
Abstract
Review ArticleIsthmocele: From Risk Factors to Management
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(1):44-52
- Piergiorgio Iannone ,
- Giulia Nencini,
- Gloria Bonaccorsi,
- Ruby Martinello,
- Giovanni Pontrelli,
- Marco Scioscia,
- Luigi Nappi,
- Pantaleo Greco,
- Gennaro Scutiero
Views278See moreAbstract
Objective
The aim of the present study was to perform a comprehensive review of the literature to provide a complete and clear picture of isthmocele-a hypoechoic area within themyometriumat the site of the uterine scar of a previous cesarean section-by exploring in depth every aspect of this condition.
Methods
A comprehensive review of the literature was performed to identify the most relevant studies about this topic.
Results
Every aspect of isthmocele has been studied and described: pathophysiology, clinical symptoms, classification, and diagnosis. Its treatment, both medical and surgical, has also been reported according to the actual literature data.
Conclusion
Cesarean section is the most common surgical procedure performed worldwide, and one of the consequences of this technique is isthmocele. A single and systematic classification of isthmocele is needed to improve its diagnosis and management. Further studies should be performed to better understand its pathogenesis.
Views278This 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. Abstract
Review ArticleIsthmocele: From Risk Factors to Management
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(1):44-52
- Piergiorgio Iannone ,
- Giulia Nencini,
- Gloria Bonaccorsi,
- Ruby Martinello,
- Giovanni Pontrelli,
- Marco Scioscia,
- Luigi Nappi,
- Pantaleo Greco,
- Gennaro Scutiero
Views278See moreAbstract
Objective
The aim of the present study was to perform a comprehensive review of the literature to provide a complete and clear picture of isthmocele-a hypoechoic area within themyometriumat the site of the uterine scar of a previous cesarean section-by exploring in depth every aspect of this condition.
Methods
A comprehensive review of the literature was performed to identify the most relevant studies about this topic.
Results
Every aspect of isthmocele has been studied and described: pathophysiology, clinical symptoms, classification, and diagnosis. Its treatment, both medical and surgical, has also been reported according to the actual literature data.
Conclusion
Cesarean section is the most common surgical procedure performed worldwide, and one of the consequences of this technique is isthmocele. A single and systematic classification of isthmocele is needed to improve its diagnosis and management. Further studies should be performed to better understand its pathogenesis.
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. - Piergiorgio Iannone
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Review Article04-15-2019
Use of the Pessary in the Prevention of Preterm Delivery
- Thayane Delazari Corrêa,
- Ester Gomes Amorim,
- Jade Aimée Guimarães Tomazelli,
- Mário Dias Corrêa Júnior
Abstract
Review ArticleUse of the Pessary in the Prevention of Preterm Delivery
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(1):53-58
- Thayane Delazari Corrêa,
- Ester Gomes Amorim,
- Jade Aimée Guimarães Tomazelli,
- Mário Dias Corrêa Júnior
Views259See moreAbstract
Objective
The gestational complication most associated with perinatalmortality and morbidity is spontaneous preterm birth with gestational age < 37 weeks. Therefore, it is necessary to identify its risk factors and attempt its prevention. The benefits of the pessary in prematurity are under investigation. Our objective was to analyze the use of the pessary in the prevention of preterm births in published studies, and to compare its efficacy with other methods.
Methods
Randomized clinical trials published between 2010 and 2018 were selected from electronic databases. Studies on multiple gestations were excluded.
Results
Two studies were in favor of the pessary as a preventive method, one study was contrary to the method and another two showed no statistically significant difference. Themeta-analysis showed no statistical difference with the use of a cervical pessary in the reduction of births < 37 (odds ratio [OR]: 0.63; confidence interval [95% CI]: 0.38-1.06) and < 34 weeks (OR: 0.74; 95% CI: 0.35-1.57)
Conclusion
The pooled data available to date seems to show a lack of efficacy of the cervical pessary in the prevention of preterm birth, although the heterogeneity of the studies made comparisons more difficult.
Views259This 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. Abstract
Review ArticleUse of the Pessary in the Prevention of Preterm Delivery
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(1):53-58
- Thayane Delazari Corrêa,
- Ester Gomes Amorim,
- Jade Aimée Guimarães Tomazelli,
- Mário Dias Corrêa Júnior
Views259See moreAbstract
Objective
The gestational complication most associated with perinatalmortality and morbidity is spontaneous preterm birth with gestational age < 37 weeks. Therefore, it is necessary to identify its risk factors and attempt its prevention. The benefits of the pessary in prematurity are under investigation. Our objective was to analyze the use of the pessary in the prevention of preterm births in published studies, and to compare its efficacy with other methods.
Methods
Randomized clinical trials published between 2010 and 2018 were selected from electronic databases. Studies on multiple gestations were excluded.
Results
Two studies were in favor of the pessary as a preventive method, one study was contrary to the method and another two showed no statistically significant difference. Themeta-analysis showed no statistical difference with the use of a cervical pessary in the reduction of births < 37 (odds ratio [OR]: 0.63; confidence interval [95% CI]: 0.38-1.06) and < 34 weeks (OR: 0.74; 95% CI: 0.35-1.57)
Conclusion
The pooled data available to date seems to show a lack of efficacy of the cervical pessary in the prevention of preterm birth, although the heterogeneity of the studies made comparisons more difficult.
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. -
Review Article03-01-2019
Quality of Life in Women with Defecatory Dysfunctions: Systematic Review of Questionnaires Validated in the Portuguese Language
- José Ananias Vasconcelos Neto ,
- Camila Teixeira Moreira Vasconcelos,
- Sara Arcanjo Lino Karbage,
- Hérdeny Di Cárlly de Almeida Rocha Farias,
- Stéffany Gadelha de Macêdo Machado, [ ... ],
- Dayana Maia Saboia
Abstract
Review ArticleQuality of Life in Women with Defecatory Dysfunctions: Systematic Review of Questionnaires Validated in the Portuguese Language
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(3):191-198
- José Ananias Vasconcelos Neto ,
- Camila Teixeira Moreira Vasconcelos,
- Sara Arcanjo Lino Karbage,
- Hérdeny Di Cárlly de Almeida Rocha Farias,
- Stéffany Gadelha de Macêdo Machado,
- Dayana Maia Saboia
Views246See moreAbstract
Objective
To identify the quality of life (QoL) assessment instruments related to the health of women with fecal incontinence (FI) or anal incontinence (AI).
Data Sources
Systematic review conducted in the Virtual Health Library (VHL), PubMed and Cochrane Library databases. The descriptors used were: Questionnaire, Questionnaires, Quality of life, validation, validation Studies, anal incontinence, fecal incontinence and constipation. The search was performed between December 26, 2017 and the beginning of January 2018. The limits used were female gender.
Selection of Studies
Initially, 5,143 articles were obtained in the search. The articles of validation for Portuguese of questionnaires for the evaluation of the impact of FI/AI on the QoL of women were considered eligible.
Data Collection
The article search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines.
Data Synthesis
Of the 5,143 articles, only 2 fulfilled the inclusion and exclusion criteria: Fecal Incontinence Quality of Life (FIQL) and the Wexner scale (WS). The FIQL evaluates the QoL related to FI, not covering flatus incontinence. The WS assesses flatus incontinence and the severity of the AI. The WS obtained an interclass correlation coefficient (ICC) of 0.932 and a Cronbach α coefficient > 0.90. The FIQL obtained intraexaminer and interexaminer reproducibility ranging from 0.929 to 0.957 and from 0.944 to 0.969, respectively.
Conclusions
The WS and the FIQL have satisfactory reliability and validity for use during gynecological consultations.
Views246This 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. Abstract
Review ArticleQuality of Life in Women with Defecatory Dysfunctions: Systematic Review of Questionnaires Validated in the Portuguese Language
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(3):191-198
- José Ananias Vasconcelos Neto ,
- Camila Teixeira Moreira Vasconcelos,
- Sara Arcanjo Lino Karbage,
- Hérdeny Di Cárlly de Almeida Rocha Farias,
- Stéffany Gadelha de Macêdo Machado,
- Dayana Maia Saboia
Views246See moreAbstract
Objective
To identify the quality of life (QoL) assessment instruments related to the health of women with fecal incontinence (FI) or anal incontinence (AI).
Data Sources
Systematic review conducted in the Virtual Health Library (VHL), PubMed and Cochrane Library databases. The descriptors used were: Questionnaire, Questionnaires, Quality of life, validation, validation Studies, anal incontinence, fecal incontinence and constipation. The search was performed between December 26, 2017 and the beginning of January 2018. The limits used were female gender.
Selection of Studies
Initially, 5,143 articles were obtained in the search. The articles of validation for Portuguese of questionnaires for the evaluation of the impact of FI/AI on the QoL of women were considered eligible.
Data Collection
The article search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines.
Data Synthesis
Of the 5,143 articles, only 2 fulfilled the inclusion and exclusion criteria: Fecal Incontinence Quality of Life (FIQL) and the Wexner scale (WS). The FIQL evaluates the QoL related to FI, not covering flatus incontinence. The WS assesses flatus incontinence and the severity of the AI. The WS obtained an interclass correlation coefficient (ICC) of 0.932 and a Cronbach α coefficient > 0.90. The FIQL obtained intraexaminer and interexaminer reproducibility ranging from 0.929 to 0.957 and from 0.944 to 0.969, respectively.
Conclusions
The WS and the FIQL have satisfactory reliability and validity for use during gynecological consultations.
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. - José Ananias Vasconcelos Neto
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Review Article02-01-2019
Effectiveness of Insulin Analogs Compared with Human Insulins in Pregnant Women with Diabetes Mellitus: Systematic Review and Meta-analysis
- Leyna Leite Santos ,
- Jamilly Leite Santos,
- Luciano Timbó Barbosa,
- Ivan do Nascimento da Silva,
- Célio Fernando de Sousa-Rodrigues, [ ... ],
- Fabiano Timbó Barbosa
Abstract
Review ArticleEffectiveness of Insulin Analogs Compared with Human Insulins in Pregnant Women with Diabetes Mellitus: Systematic Review and Meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(2):104-115
- Leyna Leite Santos ,
- Jamilly Leite Santos,
- Luciano Timbó Barbosa,
- Ivan do Nascimento da Silva,
- Célio Fernando de Sousa-Rodrigues,
- Fabiano Timbó Barbosa
Views151See moreAbstract
Diabetes during pregnancy has been linked to unfavorable maternal-fetal outcomes. Human insulins are the first drug of choice because of the proven safety in their use. However, there are still questions about the use of insulin analogs during pregnancy. The objective of the present study was to determine the effectiveness of insulin analogs compared withhuman insulin in the treatment of pregnant women with diabetes througha systematic review withmeta-analysis. The search comprised the period since the inception of each database until July 2017, and the following databases were used:MEDLINE, CINAHL, EMBASE, ISIWeb of Science, LILACS, Scopus, SIGLE andGoogle Scholar.We have selected 29 original articles: 11 were randomized clinical trials and 18 were observational studies.We have explored data from 6,382 participants. All of the articles were classified as having an intermediate to high risk of bias. The variable that showed favorable results for the use of insulin analogs was gestational age, with a mean difference of - 0.26 (95 % confidence interval [CI]: 0.03-0.49; p = 0.02), but with significant heterogeneity (Higgins test [I2] = 38%; chi-squared test [χ2] = 16.24; degree of freedom [DF] = 10; p = 0.09). This result, in the clinical practice, does not compromise the fetal well-being, since all babies were born at term. There was publication bias in the gestational age and neonatal weight variables. To date, the evidence analyzed has a moderate-to-high risk of bias and does not allow the conclusion that insulin analogs are more effective when compared with human insulin to treat diabetic pregnant women.
Views151This 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. Abstract
Review ArticleEffectiveness of Insulin Analogs Compared with Human Insulins in Pregnant Women with Diabetes Mellitus: Systematic Review and Meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(2):104-115
- Leyna Leite Santos ,
- Jamilly Leite Santos,
- Luciano Timbó Barbosa,
- Ivan do Nascimento da Silva,
- Célio Fernando de Sousa-Rodrigues,
- Fabiano Timbó Barbosa
Views151See moreAbstract
Diabetes during pregnancy has been linked to unfavorable maternal-fetal outcomes. Human insulins are the first drug of choice because of the proven safety in their use. However, there are still questions about the use of insulin analogs during pregnancy. The objective of the present study was to determine the effectiveness of insulin analogs compared withhuman insulin in the treatment of pregnant women with diabetes througha systematic review withmeta-analysis. The search comprised the period since the inception of each database until July 2017, and the following databases were used:MEDLINE, CINAHL, EMBASE, ISIWeb of Science, LILACS, Scopus, SIGLE andGoogle Scholar.We have selected 29 original articles: 11 were randomized clinical trials and 18 were observational studies.We have explored data from 6,382 participants. All of the articles were classified as having an intermediate to high risk of bias. The variable that showed favorable results for the use of insulin analogs was gestational age, with a mean difference of - 0.26 (95 % confidence interval [CI]: 0.03-0.49; p = 0.02), but with significant heterogeneity (Higgins test [I2] = 38%; chi-squared test [χ2] = 16.24; degree of freedom [DF] = 10; p = 0.09). This result, in the clinical practice, does not compromise the fetal well-being, since all babies were born at term. There was publication bias in the gestational age and neonatal weight variables. To date, the evidence analyzed has a moderate-to-high risk of bias and does not allow the conclusion that insulin analogs are more effective when compared with human insulin to treat diabetic pregnant women.
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. - Leyna Leite Santos
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Review Article02-01-2019
Occult Urinary Incontinence Treatment: Systematic Review and Meta-analysis-Brazilian Guidelines
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(2):116-123
Abstract
Review ArticleOccult Urinary Incontinence Treatment: Systematic Review and Meta-analysis-Brazilian Guidelines
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(2):116-123
Views178Abstract
Objective
To evaluate if performing anti-incontinence procedures during surgical anterior and/or apical prolapse correction in women with asymptomatic urinary incontinence (UI) may prevent stress urinary incontinence (SUI) postoperatively.
Methods
We have performed a systematic review of articles published in the PubMed, Cochrane Library, and Lilacs databases until March 31, 2016. Two reviewers performed the data collection and analysis, independently. All of the selected studiesweremethodologically analyzed. The results are presented as relative risk (RR), with a 95% confidence interval (CI).
Results
After performing the selection of the studies, only nine trials fulfilled the necessary prerequisites. In the present review, 1,146 patients were included. Altogether, the review included trials of three different types of anti-incontinence procedures. We found that performing any anti-incontinence procedure at the same time of prolapse repair reduced the incidence of SUI postoperatively (RR = 0.50; 95% CI: 0.28-0.91). However, when we performed the analysis separately by the type of anti-incontinence procedure, we found different results. In the subgroup analysis with midurethral slings, it is beneficial to perform it to reduce the incidence of SUI (RR = 0.08; 95% CI: 0.02-0.28). On the other hand, in the subgroup analysis with Burch colposuspension, there was no significant difference with the control group (RR = 1.47; 95% CI: 0.28-7.79]).
Conclusion
Performing any prophylactic anti-incontinence procedure at the same time as prolapse repair reduced the incidence of SUI postoperatively. The Burch colposuspension did not show any decrease in the incidence of SUI postoperatively.
Key-words Meta-analysisoccult urinary incontinencepelvic organ prolapseStress urinary incontinencesystematic reviewSee moreViews178This 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. Abstract
Review ArticleOccult Urinary Incontinence Treatment: Systematic Review and Meta-analysis-Brazilian Guidelines
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(2):116-123
Views178Abstract
Objective
To evaluate if performing anti-incontinence procedures during surgical anterior and/or apical prolapse correction in women with asymptomatic urinary incontinence (UI) may prevent stress urinary incontinence (SUI) postoperatively.
Methods
We have performed a systematic review of articles published in the PubMed, Cochrane Library, and Lilacs databases until March 31, 2016. Two reviewers performed the data collection and analysis, independently. All of the selected studiesweremethodologically analyzed. The results are presented as relative risk (RR), with a 95% confidence interval (CI).
Results
After performing the selection of the studies, only nine trials fulfilled the necessary prerequisites. In the present review, 1,146 patients were included. Altogether, the review included trials of three different types of anti-incontinence procedures. We found that performing any anti-incontinence procedure at the same time of prolapse repair reduced the incidence of SUI postoperatively (RR = 0.50; 95% CI: 0.28-0.91). However, when we performed the analysis separately by the type of anti-incontinence procedure, we found different results. In the subgroup analysis with midurethral slings, it is beneficial to perform it to reduce the incidence of SUI (RR = 0.08; 95% CI: 0.02-0.28). On the other hand, in the subgroup analysis with Burch colposuspension, there was no significant difference with the control group (RR = 1.47; 95% CI: 0.28-7.79]).
Conclusion
Performing any prophylactic anti-incontinence procedure at the same time as prolapse repair reduced the incidence of SUI postoperatively. The Burch colposuspension did not show any decrease in the incidence of SUI postoperatively.
Key-words Meta-analysisoccult urinary incontinencepelvic organ prolapseStress urinary incontinencesystematic reviewSee 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. -
Review Article12-01-2018
Female Genito-Pelvic Pain/Penetration Disorder: Review of the Related Factors and Overall Approach
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(12):787-793
Abstract
Review ArticleFemale Genito-Pelvic Pain/Penetration Disorder: Review of the Related Factors and Overall Approach
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(12):787-793
Views292See moreAbstract
Genito-pelvic pain/penetration disorder (GPPPD) can be an extremely bothersome condition for patients, and a tough challenge for professionals regarding its assessment and treatment. The goal of the present paper is to review the etiology, assessment, and treatment of GPPPD, especially focusing on the cognitive aspects of the disease and cognitive-behavioral treatment options, through a non-systematic review of articles indexed to the Medline, Scopus and Web of Science databases, using the following MeSH queries: pelvic pain; dyspareunia; vaginismus; vulvodynia; and cognitive therapy. Altogether, 36 articles discussing the etiology, diagnosis and management of GPPPD were selected. We provide an overview of GPPPD based on biological, psychological and relational factors, emphasizing the last two. We also summarize the available medical treatments and provide strategies to approach the psychological trigger and persisting factors for the patient and the partner. Professionals should be familiarized with the factors underlining the problem, and should be able to provide helpful suggestions to guide the couple out of the GPPPD fear-avoidance circle.
Views292This 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. Abstract
Review ArticleFemale Genito-Pelvic Pain/Penetration Disorder: Review of the Related Factors and Overall Approach
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(12):787-793
Views292See moreAbstract
Genito-pelvic pain/penetration disorder (GPPPD) can be an extremely bothersome condition for patients, and a tough challenge for professionals regarding its assessment and treatment. The goal of the present paper is to review the etiology, assessment, and treatment of GPPPD, especially focusing on the cognitive aspects of the disease and cognitive-behavioral treatment options, through a non-systematic review of articles indexed to the Medline, Scopus and Web of Science databases, using the following MeSH queries: pelvic pain; dyspareunia; vaginismus; vulvodynia; and cognitive therapy. Altogether, 36 articles discussing the etiology, diagnosis and management of GPPPD were selected. We provide an overview of GPPPD based on biological, psychological and relational factors, emphasizing the last two. We also summarize the available medical treatments and provide strategies to approach the psychological trigger and persisting factors for the patient and the partner. Professionals should be familiarized with the factors underlining the problem, and should be able to provide helpful suggestions to guide the couple out of the GPPPD fear-avoidance circle.
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. -
Review Article12-01-2018
Impacts of Cytochrome P450 2D6 (CYP2D6) Genetic Polymorphism in Tamoxifen Therapy for Breast Cancer Impactos do polimorfismo genético do citocromo P450 2D6 (CYP2D6) na terapia com tamoxifeno para câncer de mama
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(12):794-799
Abstract
Review ArticleImpacts of Cytochrome P450 2D6 (CYP2D6) Genetic Polymorphism in Tamoxifen Therapy for Breast Cancer Impactos do polimorfismo genético do citocromo P450 2D6 (CYP2D6) na terapia com tamoxifeno para câncer de mama
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(12):794-799
Views178See moreAbstract
Tamoxifen (TMX) is the main drug used both in pre and postmenopausal women as adjuvant treatment for hormone receptor-positive breast cancer. An important barrier to the use of TMXis the development ofdrug resistance causedby molecular processes related to genetic and epigenetic mechanisms, such as the actions of cytochrome P450 2D6 (CYP2D6) polymorphisms and of its metabolites. The present study aimed to review recent findings related to the impact of CYP2D6 polymorphisms and how they can affect the results of TMX in breast cancer treatment. The keywords CYP2D6, tamoxifen, and breast cancer were searched in the PubMed, Scopus, The Cochrane Library, Scielo, and Bireme databases. Studies related to other types of neoplasms or based on other isoenzymes from cytochrome P450, but not on CYP2D6, were excluded. The impact of CYP2D6 polymorphisms in the TMX resistance mechanism remains unclear. The CYP2D6 gene seems to contribute to decreasing the efficacy of TMX, while the main mechanism responsible for therapy failure, morbidity, and mortality is the progression of the disease.
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. Abstract
Review ArticleImpacts of Cytochrome P450 2D6 (CYP2D6) Genetic Polymorphism in Tamoxifen Therapy for Breast Cancer Impactos do polimorfismo genético do citocromo P450 2D6 (CYP2D6) na terapia com tamoxifeno para câncer de mama
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(12):794-799
Views178See moreAbstract
Tamoxifen (TMX) is the main drug used both in pre and postmenopausal women as adjuvant treatment for hormone receptor-positive breast cancer. An important barrier to the use of TMXis the development ofdrug resistance causedby molecular processes related to genetic and epigenetic mechanisms, such as the actions of cytochrome P450 2D6 (CYP2D6) polymorphisms and of its metabolites. The present study aimed to review recent findings related to the impact of CYP2D6 polymorphisms and how they can affect the results of TMX in breast cancer treatment. The keywords CYP2D6, tamoxifen, and breast cancer were searched in the PubMed, Scopus, The Cochrane Library, Scielo, and Bireme databases. Studies related to other types of neoplasms or based on other isoenzymes from cytochrome P450, but not on CYP2D6, were excluded. The impact of CYP2D6 polymorphisms in the TMX resistance mechanism remains unclear. The CYP2D6 gene seems to contribute to decreasing the efficacy of TMX, while the main mechanism responsible for therapy failure, morbidity, and mortality is the progression of the disease.
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.
Review Article Archives - Page 7 of 24 - Revista Brasileira de Ginecologia e Obstetrícia
