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Review Article
The use of phosphodiesterase inhibitors in the treatment of female sexual dysfunction: scoping review
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo49
07-26-2024
Summary
Review ArticleThe use of phosphodiesterase inhibitors in the treatment of female sexual dysfunction: scoping review
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo49
07-26-2024Views115See moreAbstract
Objective
The purpose of this study was to analyze the available evidence regarding the efficacy of iPDE5 in the treatment of female sexual dysfunction (FSD).
Methods
A comprehensive literature search was conducted in March 2023 through the main scientific databases.
Results
A total of 53 articles were identified, out of which, 6 met the predefined inclusion criteria. All of these were randomized controlled trials. Among the included studies, 4 demonstrated the effectiveness of sildenafil in improving sexual response and addressing FSD, while 2 studies failed to establish its efficacy in this context.
Conclusion
Overall, the efficacy of sildenafil in the treatment of FSD remains controversial and inconclusive based on the available evidence. Further research is necessary to clarify the therapeutic potential of iPDE5 in addressing FSD and to better understand the factors that influence treatment outcomes.
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Review Article
Effects of vitamin D supplementation on oxidative stress biomarkers of Iranian women with polycystic ovary syndrome: a meta-analysis study
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo37
06-27-2024
Summary
Review ArticleEffects of vitamin D supplementation on oxidative stress biomarkers of Iranian women with polycystic ovary syndrome: a meta-analysis study
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo37
06-27-2024Views216Abstract
Objective
To identify the impact of redox imbalance on the clinical evolution of patients with polycystic ovary syndrome and carry out a qualitative and quantitative projection of the benefits of vitamin D supplementation.
Data sources
Combinations of the keywords polycystic ovary syndrome, vitamin D, oxidative stress, reactive oxygen species, antioxidant, and free radicals were used in PubMed, Cochrane Library, LILACS, EMBASE, and Web of Science databases. The last search was conducted on August 22, 2023.Selection of studies: Based on the inclusion and exclusion criteria, studies were selected considering a low risk of bias, published in the last 5 years in English, which investigated the effects of vitamin D supplementation in women with PCOS, focusing on oxidative stress markers. Of the 136 articles retrieved, 6 intervention studies (445 women) were included.
Data collection
The risk of bias in included studies was assessed using the Jadad scale, and analysis and visualization of continuous data were performed using Review Manager 5.4.1, summarized as standardized mean differences (SMD) with confidence intervals (CI) of 95%.
Data synthesis
Vitamin D effectively reduced malondialdehyde (P=0.002) and total testosterone (P=0.0004) levels and increased total antioxidant capacity levels (P=0.01). Although possible improvements in the modified Ferriman–Gallwey hirsutism score, levels of sex hormone-binding globulin, and free androgen index were identified and the results were not statistically significant.
Conclusion
Vitamin D is a promising alternative for the treatment of PCOS with a positive influence on the oxidative, metabolic, and endocrine disorders of this syndrome.
Key-words Antioxidant therapycholecalciferolHyperandrogenismOxidative stressPolycystic ovary syndromeSee more -
Review Article
Monkeypox infection and pregnancy in lower and middle-income countries: Precautions & recommendations
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo54
06-27-2024
Summary
Review ArticleMonkeypox infection and pregnancy in lower and middle-income countries: Precautions & recommendations
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo54
06-27-2024Views160See moreAbstract
Monkeypox (MPX), an orthopoxviral disease endemic in Africa, is now a public health emergency of international concern (PHEIC) as declared by the World Health Organization in July 2023. Although it is generally mild, the overall case fatality rate was reported to be 3%, and the basic reproduction number (R0) is > 1 in men who have sex with men (MSM, i.e., Portugal (1.4), the United Kingdom (1.6), and Spain (1.8)). However, R0 is < 1 in other settings. In concordance with the smallpox virus, it is also expected to increase the risk of adverse outcomes for both the mother and the fetus. The outcomes of the disease in an immunocompromised state of pregnancy are scary, showing high mortality and morbidity of both mother and fetus, with up to a 75% risk of fetal side effects and a 25% risk of severe maternal diseases. Therefore, it warrants timely diagnosis and intervention. The reverse transcription polymerase chain reaction (RT PCR) test is the standard approach to diagnosis. We summarized the recent findings of MPX on pregnancy, and the associated risk factors. We also give recommendations for active fetal surveillance, perinatal care, and good reporting to improve outcomes. The available vaccines have shown promise for primary disease prevention.
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Review Article
Prevention, diagnosis, and treatment protocol of dengue during pregnancy and the postpartum period
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo73
06-27-2024
Summary
Review ArticlePrevention, diagnosis, and treatment protocol of dengue during pregnancy and the postpartum period
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo73
06-27-2024Views215Introduction Over the last few decades, Brazil has faced significant challenges related to infection by the dengue virus (DENV) transmitted by the Aedes aegypti mosquito. Dengue is endemic in many tropical and subtropical regions of the planet, often leading to epidemic outbreaks of varying intensity and frequency, influenced by factors such as rising temperatures, catastrophic […]See more -
Review Article
Laser therapy for genitourinary syndrome of menopause: systematic review and meta-analysis of randomized controlled trial
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo38
06-03-2024
Summary
Review ArticleLaser therapy for genitourinary syndrome of menopause: systematic review and meta-analysis of randomized controlled trial
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo38
06-03-2024Views217See moreAbstract
Objective:
This meta-analysis of randomized controlled trials (RCTs) aimed to update evidence on the effectiveness and safety of laser therapy for treating genitourinary syndrome of menopause (GSM).
Data sources:
Manuscripts published until May 2023 were systematically searched in PubMed; Embase; Scopus; Web of Science; CENTRAL; CINAHL; and clinical trial databases (www.trialscentral.org, www.controlled-trials.com, and clinicaltrials.gov), with no language and year of publication restriction.
Studies selection:
RCTs with women diagnosed with GSM, and the intervention was vaginal laser therapy (CO2-laser or Er: YAG-laser) comparing with placebo (sham therapy), no treatment or vaginal estrogen therapy.
Data collection:
Two authors evaluated the publications for inclusion based on the title and abstract, followed by reviewing the relevant full-text articles. Disagreements during the review process were addressed by consensus, with the involvement of a third author.
Data synthesis:
Twelve RCTs, representing a total of 5147 participants, were included in this review. Vaginal health index (VHI) significantly improved in the carbon dioxide laser (CO2-laser) therapy group (MD=2.21; 95% CI=1.25 to 3.16), while dyspareunia (MD=−0.85; 95% CI=−1.59 to −0.10), dryness (MD=−0.62; 95% CI=−1.12 to −0.12) and burning (MD= −0.64; 95% CI=−1.28 to −0.01) decreased. No serious adverse effects were reported.
Conclusion:
CO2-laser increases VHI score and decreases dyspareunia, dryness and burning, especially when compared to sham-laser. However, the certainty of the evidence is low, thus preventing the recommendation of laser therapy for GSM management.
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Review Article
Prevalence of syphilis and associated factors among pregnant women in Brazil: systematic review and meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo28
06-03-2024
Summary
Review ArticlePrevalence of syphilis and associated factors among pregnant women in Brazil: systematic review and meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo28
06-03-2024Views223See moreAbstract
Objective:
This systematic review accompanied by a meta-analysis aimed to estimate the prevalence of syphilis in pregnant women in Brazil and describe its associated factors.
Methods:
Following the establishment the search strategies and the registration of the review protocol in PROSPERO, we conducted a search for relevant articles in the Pubmed, LILACS, Science Direct, SciELO and Web of Science databases. Our inclusion criteria were cross-sectional studies published between 2005 and 2023, with no language restrictions. The combined prevalence of syphilis infection was estimated using the random effects model in the R Software with a 95% confidence interval (95% CI) and p < 0.01 as statistically significant.
Results:
A total of 24 articles were recruited, which together investigated 221,884 women. The combined prevalence of syphilis in pregnant women in Brazil was 1.79% (95% CI: 1.24-2.57%), and the main factors associated with its occurrence were black and brown skin color, low education and factors related to the partner.
Conclusion:
There was a high prevalence of syphilis in pregnancy in Brazil, mainly associated with socioeconomic factors.
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Review Article
How can we reduce maternal mortality due to preeclampsia? The 4P rule
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo43
06-03-2024
Summary
Review ArticleHow can we reduce maternal mortality due to preeclampsia? The 4P rule
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo43
06-03-2024Views271See moreAbstract
In low and middle-income countries such as Brazil, most maternal deaths are related to hypertensive complications. Preeclampsia is the leading cause of maternal mortality and morbidity. Significant proportion is associated with the following factors: lack of identification of high-risk women, lack of adequate prevention, difficulty in maintaining a high-risk prenatal follow-up, delayed diagnosis, insecurity and low use of magnesium sulphate, delayed pregnancy interruption and lack of postpartum follow-up of these high-risk cases. Four major actions are proposed to minimize this alarming clinical picture and reduce the mortality rates due to preeclampsia, called the "4 P Rule" (Adequate Prevention – Vigilant Prenatal Care – Timely Delivery (Parturition) – Safe Postpartum). From this simple "rule" we can open a range of important processes and reminders that may help in the guidance of preeclampsia management.
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Review Article
Patient positioning in minimally invasive gynecologic surgery: strategies to prevent injuries and improve outcomes
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo46
06-03-2024
Summary
Review ArticlePatient positioning in minimally invasive gynecologic surgery: strategies to prevent injuries and improve outcomes
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo46
06-03-2024Views201Abstract
Effective patient positioning is a critical factor influencing surgical outcomes, mainly in minimally invasive gynecologic surgery (MIGS) where precise positioning facilitates optimal access to the surgical field. This paper provides a comprehensive exploration of the significance of strategic patient placement in MIGS, emphasizing its role in preventing intraoperative injuries and enhancing overall surgical success. The manuscript addresses potential complications arising from suboptimal positioning and highlights the essential key points for appropriate patient positioning during MIGS, encompassing what the surgical team should or shouldn't do. In this perspective, the risk factors associated with nerve injuries, sliding, compartment syndrome, and pressure ulcers are outlined to guide clinical practice. Overall, this paper underscores the critical role of precise patient positioning in achieving successful MIGS procedures and highlights key principles for the gynecological team to ensure optimal patient outcomes.
Key-words Compartment syndromeGynecologic surgical proceduresIntraoperative complicationsMinimally invasive surgical proceduresNerve injuryPatient positioningpatient safetyPressure ulcerRisk factorsTreatment outcomeSee more