Você pesquisou por y - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(6):249-251
DOI 10.1590/SO100-720320150005308
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(6):249-251
DOI 10.1590/SO100-720320150005308
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(6):252-257
DOI 10.1590/SO100-720320150005278
To determine the feasibility of evaluation of the right subclavian artery during
the first trimester ultrasound scan, as well as to describe the technique for its
evaluation and, in case of aberrant right subclavian artery (ARSA) identification,
to determine its association with chromosomal abnormalities and/or cardiac
malformations and its management.
A prospective study for evaluation of the right subclavian artery during the
first trimester ultrasound scan (crown-to-rump length between 45 and 84 mm), in
all consecutive single pregnancies, by a single examiner, using a Voluson E8
system (GE Healthcare, Zipf, Austria) with a 2 to 8 MHz RAB 4-8-D transabdominal
probe, within a short period of time (less than 2 minutes), in a general low risk
population. Color and/or power Doppler flow mapping was used to classify the right
subclavian artery as normal or aberrant. Regression analysis with the IBM SPSS
Statistics software for Windows, version 20.0 was used to determine the
significance of the association between failure to examine/classify the right
subclavian artery and both fetal crown-rump length and maternal body mass index.
Median maternal age was 30 years (range: 17-43 years) and median gestational age
at the time of evaluation of the right subclavian artery was 12 weeks (range:
11-13 weeks). The evaluation of the right subclavian artery was successful in
138/176 (78.4%) of the cases. ARSA was diagnosed in a single case (0.7%). This
fetus with ARSA also presented a hyperechogenic focus on the left cardiac
ventricle. Fetal echocardiography at 16 weeks of gestation was performed and
confirmed ARSA and the hyperechogenic focus. Amniocentesis revealed a normal 46,
XX karyotype.
ARSA can be identified during a routine first trimester ultrasound scan. Our
single ARSA case had a normal karyotype and no associated cardiac
malformations.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(6):252-257
DOI 10.1590/SO100-720320150005278
To determine the feasibility of evaluation of the right subclavian artery during
the first trimester ultrasound scan, as well as to describe the technique for its
evaluation and, in case of aberrant right subclavian artery (ARSA) identification,
to determine its association with chromosomal abnormalities and/or cardiac
malformations and its management.
A prospective study for evaluation of the right subclavian artery during the
first trimester ultrasound scan (crown-to-rump length between 45 and 84 mm), in
all consecutive single pregnancies, by a single examiner, using a Voluson E8
system (GE Healthcare, Zipf, Austria) with a 2 to 8 MHz RAB 4-8-D transabdominal
probe, within a short period of time (less than 2 minutes), in a general low risk
population. Color and/or power Doppler flow mapping was used to classify the right
subclavian artery as normal or aberrant. Regression analysis with the IBM SPSS
Statistics software for Windows, version 20.0 was used to determine the
significance of the association between failure to examine/classify the right
subclavian artery and both fetal crown-rump length and maternal body mass index.
Median maternal age was 30 years (range: 17-43 years) and median gestational age
at the time of evaluation of the right subclavian artery was 12 weeks (range:
11-13 weeks). The evaluation of the right subclavian artery was successful in
138/176 (78.4%) of the cases. ARSA was diagnosed in a single case (0.7%). This
fetus with ARSA also presented a hyperechogenic focus on the left cardiac
ventricle. Fetal echocardiography at 16 weeks of gestation was performed and
confirmed ARSA and the hyperechogenic focus. Amniocentesis revealed a normal 46,
XX karyotype.
ARSA can be identified during a routine first trimester ultrasound scan. Our
single ARSA case had a normal karyotype and no associated cardiac
malformations.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(6):258-265
DOI 10.1590/SO100-720320150005366
To compare two single-agent chemotherapy (ChT) regimens evaluating, in first-line treatment, response and side effects and, in final single-agent treatment, the outcomes, among Brazilian patients with low-risk gestational trophoblastic neoplasia (GTN), according to International Federation of Gynecology and Obstetrics (FIGO) 2002.
Retrospective analysis of two concurrent cohorts with 194 low-risk GTN patients: from 1992 to 2012, as first-line treatment, 115 patients received 4 intramuscular doses of methotrexate alternated with 4 oral doses of folinic acid (MTX/FA) repetead every 14 days and, since 1996, 79 patients received an endovenous bolus-dose of actinomycin D (Act-D), biweekly. At GTN diagnosis, patient opinion was taken into consideration when defining the initial single-agent ChT regimen, and when there was resistance or toxicity to one regimen, the other drug was used preferentially. This study was approved by the Irmandade da Santa Casa de Misericórdia de Porto Alegre Ethical Committee.
Both groups were clinically similar (p>0.05). In first-line treatments, frequency of complete response was similar (75.7% with MTX/FA and 67.1% with bolus Act-D); the number of ChT courses -median 3 (range: 1-10) with MTX/FA and 2 (range: 1-6) with bolus Act-D - and the time to remission -median 9 weeks (range: 2-16) with MTX/FA and 10 weeks (range: 2-16) with bolus Act-D) - were not different between the groups. In both groups, first-line side effects frequency were high but intensity was low; stomatitis was higher with MTX/FA (p<0.01) and nausea and vomit with Act-D (p<0.01). Final single-agent ChT responses were high in both groups (94.8% with MTX/FA and 83.5% with bolus Act-D; p<0.01) and 13% higher in the group initially treated with MTX/FA. Rates of hysterectomy and of GTN recurrence were low and similar. No patient died due to GTN.
The two regimens had similar first-line ChT response. Final single-agent response rates were high and similar in both groups but the final single-agent remission rate was higher in the MTX/FA group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(6):258-265
DOI 10.1590/SO100-720320150005366
To compare two single-agent chemotherapy (ChT) regimens evaluating, in first-line treatment, response and side effects and, in final single-agent treatment, the outcomes, among Brazilian patients with low-risk gestational trophoblastic neoplasia (GTN), according to International Federation of Gynecology and Obstetrics (FIGO) 2002.
Retrospective analysis of two concurrent cohorts with 194 low-risk GTN patients: from 1992 to 2012, as first-line treatment, 115 patients received 4 intramuscular doses of methotrexate alternated with 4 oral doses of folinic acid (MTX/FA) repetead every 14 days and, since 1996, 79 patients received an endovenous bolus-dose of actinomycin D (Act-D), biweekly. At GTN diagnosis, patient opinion was taken into consideration when defining the initial single-agent ChT regimen, and when there was resistance or toxicity to one regimen, the other drug was used preferentially. This study was approved by the Irmandade da Santa Casa de Misericórdia de Porto Alegre Ethical Committee.
Both groups were clinically similar (p>0.05). In first-line treatments, frequency of complete response was similar (75.7% with MTX/FA and 67.1% with bolus Act-D); the number of ChT courses -median 3 (range: 1-10) with MTX/FA and 2 (range: 1-6) with bolus Act-D - and the time to remission -median 9 weeks (range: 2-16) with MTX/FA and 10 weeks (range: 2-16) with bolus Act-D) - were not different between the groups. In both groups, first-line side effects frequency were high but intensity was low; stomatitis was higher with MTX/FA (p<0.01) and nausea and vomit with Act-D (p<0.01). Final single-agent ChT responses were high in both groups (94.8% with MTX/FA and 83.5% with bolus Act-D; p<0.01) and 13% higher in the group initially treated with MTX/FA. Rates of hysterectomy and of GTN recurrence were low and similar. No patient died due to GTN.
The two regimens had similar first-line ChT response. Final single-agent response rates were high and similar in both groups but the final single-agent remission rate was higher in the MTX/FA group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(6):266-271
DOI 10.1590/SO100-720320150005254
To investigate the relationship between sexual function and quality of life in
pregnant women living in two cities of Northeastern Brazil.
The sample consisted of 207 pregnant women. The data were collected through a
questionnaire containing questions about socio-demographic, gynecological and
obstetrical data, body and sexual knowledge. Quality of life was assessed by
applying the Ferrans & Powers Quality of Life Index (QLI Ferrans and Power).
Sexual function was assessed using the Female Sexual Function Index (IFSF). Data
were statistically analyzed using the Shapiro-Wilk, Mann-Whitney and Wilcoxon
tests.
The pregnant women studied had a median age of 30 years (quartile 26-33 years)
and were approximately at the 26th gestational week. A significant
decrease in the monthly frequency of sexual relations of the couple was observed,
with a median of 12 to 4 times per month (Z=-10.56; p<0.001). Sexual
dysfunction was detected in 35.7% of the pregnant women studied, whose quality of
life was lower when compared to women with unchanged sexual function (Z=-2.9;
p=0.004).
The results of this study show that sexual dysfunction negatively affected the
quality of life of pregnant women, and this should be an important aspect for
review during prenatal consultations.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(6):266-271
DOI 10.1590/SO100-720320150005254
To investigate the relationship between sexual function and quality of life in
pregnant women living in two cities of Northeastern Brazil.
The sample consisted of 207 pregnant women. The data were collected through a
questionnaire containing questions about socio-demographic, gynecological and
obstetrical data, body and sexual knowledge. Quality of life was assessed by
applying the Ferrans & Powers Quality of Life Index (QLI Ferrans and Power).
Sexual function was assessed using the Female Sexual Function Index (IFSF). Data
were statistically analyzed using the Shapiro-Wilk, Mann-Whitney and Wilcoxon
tests.
The pregnant women studied had a median age of 30 years (quartile 26-33 years)
and were approximately at the 26th gestational week. A significant
decrease in the monthly frequency of sexual relations of the couple was observed,
with a median of 12 to 4 times per month (Z=-10.56; p<0.001). Sexual
dysfunction was detected in 35.7% of the pregnant women studied, whose quality of
life was lower when compared to women with unchanged sexual function (Z=-2.9;
p=0.004).
The results of this study show that sexual dysfunction negatively affected the
quality of life of pregnant women, and this should be an important aspect for
review during prenatal consultations.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(6):272-277
DOI 10.1590/SO100-720320150005301
To evaluate the ovarian response after cyclophosphamide use (CPM) in patients
with systemic lupus erythematosus (SLE) and to correlate the age and cumulative
dose findings with changes in menstrual cycle and/or progression to ovarian
failure (OF).
This was a cross-sectional, retrospective study of 50 patients with a diagnosis
of SLE who used CFM with a clinical follow-up of at least 1 year. Included were
patients aged 12-40 years, who had undergone chemotherapy for SLE control and who
had regular menstrual cycles before the beginning of CPM treatment. Patients who
discontinued follow-up, who were followed up for less than one year or who had
irregular/absent menses before the beginning of CPM treatment were excluded. All
women studied were submitted to an interview and a questionnaire containing
questions about the pattern of the menstrual cycle before and after therapy, and
about the gestational periods and contraception. We asked if the patients had been
instructed about the side effects and consequences of CFM. Statistical analysis
was performed using the Student t-test and the Mann Whitney, χ2 and
nonparametric Kolmogorov-Smirnov tests.
The mean age of the patients included in the study was 30.8 years and the mean
age at the time of use of CPM was 25.3 years. After CFM, 24% of patients stopped
menstruating, 28% returned to regular cycles and 48% continued to have irregular
cycles. It was found that the patients who developed OF had longer disease
duration (12.3 years) than those who did not develop it (8.9 years). Thirteen
patients became spontaneously pregnant after CFM; however, 66% progressed to
abortion. The mean age of the patients who used CFM and developed OF was 28.1
years. Amenorrhea occurred in 50% of those aged 31-40 years, in 22.2% of those
aged 21-30 years and in 7.7% of those aged 12-20 years. Our study showed no
statistical correlation between cumulative dose and OF, although cumulative doses
greater than 11grams tended to promote some type of menstrual irregularity.
SLE disease duration, age at the time of treatment and the highest cumulative
doses are important predictors of OF after therapy with CFM. Pregnancy in lupus
patients is more likely to evolve with abortion after the use of chemotherapy. It
was seen that a small proportion of patients were aware of all the implications of
the drug. Therefore, additional studies should be conducted for further knowledge
and awareness of the importance of contraception and the preservation of ovarian
tissue on the part of the medical community.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(6):272-277
DOI 10.1590/SO100-720320150005301
To evaluate the ovarian response after cyclophosphamide use (CPM) in patients
with systemic lupus erythematosus (SLE) and to correlate the age and cumulative
dose findings with changes in menstrual cycle and/or progression to ovarian
failure (OF).
This was a cross-sectional, retrospective study of 50 patients with a diagnosis
of SLE who used CFM with a clinical follow-up of at least 1 year. Included were
patients aged 12-40 years, who had undergone chemotherapy for SLE control and who
had regular menstrual cycles before the beginning of CPM treatment. Patients who
discontinued follow-up, who were followed up for less than one year or who had
irregular/absent menses before the beginning of CPM treatment were excluded. All
women studied were submitted to an interview and a questionnaire containing
questions about the pattern of the menstrual cycle before and after therapy, and
about the gestational periods and contraception. We asked if the patients had been
instructed about the side effects and consequences of CFM. Statistical analysis
was performed using the Student t-test and the Mann Whitney, χ2 and
nonparametric Kolmogorov-Smirnov tests.
The mean age of the patients included in the study was 30.8 years and the mean
age at the time of use of CPM was 25.3 years. After CFM, 24% of patients stopped
menstruating, 28% returned to regular cycles and 48% continued to have irregular
cycles. It was found that the patients who developed OF had longer disease
duration (12.3 years) than those who did not develop it (8.9 years). Thirteen
patients became spontaneously pregnant after CFM; however, 66% progressed to
abortion. The mean age of the patients who used CFM and developed OF was 28.1
years. Amenorrhea occurred in 50% of those aged 31-40 years, in 22.2% of those
aged 21-30 years and in 7.7% of those aged 12-20 years. Our study showed no
statistical correlation between cumulative dose and OF, although cumulative doses
greater than 11grams tended to promote some type of menstrual irregularity.
SLE disease duration, age at the time of treatment and the highest cumulative
doses are important predictors of OF after therapy with CFM. Pregnancy in lupus
patients is more likely to evolve with abortion after the use of chemotherapy. It
was seen that a small proportion of patients were aware of all the implications of
the drug. Therefore, additional studies should be conducted for further knowledge
and awareness of the importance of contraception and the preservation of ovarian
tissue on the part of the medical community.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(6):278-282
DOI 10.1590/SO100-720320150005326
to analize the level of functional fitness of a group of postmenopausal women in
the city of Presidente Prudente using the set of functional fitness tests of the
American Alliance for Health, Physical Education, Recreation and Dance and to
check whether there are differences between groups of women in the fifth and sixth
decade of life.
This was a cross-sectional study conducted on 175 postmenopausal women (follicle
stimulating hormone level>26.72 mIU/L) in the city of Presidente Prudente in
2013. The inclusion criteria were not being part of any type of systematic motor
intervention for at least six months before the collection of research data;
absence of motor or cognitive impairment that would prevent the evaluation
protocols, and absence of chronic or degenerative disease, musculoskeletal injury
or comorbidity that could prevent or limit the evaluations. The women were
evaluated by the same trained examiners. The 50 to 59 year group showed a mean age
of 55.3±4.5 years, mean FSH values of 53.5±21.1 mIU/mL, mean coordination of
11.4±2.2 seconds, mean strength of 20.1±3.9 repetitions, mean flexibility of
51.7±11.8 cm, mean 23.2±2.8 seconds agility and mean aerobic resistance of
500±43/2 . The 60 to 69 year group had a mean age of 65.1±4.1 years with FSH
54.9±15.9, 11.6±2.6 seconds coordination, strength 20.3±4.7 repetitions, 54.6±11.2
cm flexibility, agility 24.7±4.3 seconds, and aerobic resistance of 508±51
seconds.
It was possible to analyze the functional fitness of postmenopausal women through
the set of the American Alliance testing for Health, Physical Education,
Recreation and Dance with no significant differences between groups for the
variables strength, flexibility, aerobic capacity and coordination, and with only
the speed variable showing significant differences. We recommend further studies
seeking to formulate normative values for the population in question.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(6):278-282
DOI 10.1590/SO100-720320150005326
to analize the level of functional fitness of a group of postmenopausal women in
the city of Presidente Prudente using the set of functional fitness tests of the
American Alliance for Health, Physical Education, Recreation and Dance and to
check whether there are differences between groups of women in the fifth and sixth
decade of life.
This was a cross-sectional study conducted on 175 postmenopausal women (follicle
stimulating hormone level>26.72 mIU/L) in the city of Presidente Prudente in
2013. The inclusion criteria were not being part of any type of systematic motor
intervention for at least six months before the collection of research data;
absence of motor or cognitive impairment that would prevent the evaluation
protocols, and absence of chronic or degenerative disease, musculoskeletal injury
or comorbidity that could prevent or limit the evaluations. The women were
evaluated by the same trained examiners. The 50 to 59 year group showed a mean age
of 55.3±4.5 years, mean FSH values of 53.5±21.1 mIU/mL, mean coordination of
11.4±2.2 seconds, mean strength of 20.1±3.9 repetitions, mean flexibility of
51.7±11.8 cm, mean 23.2±2.8 seconds agility and mean aerobic resistance of
500±43/2 . The 60 to 69 year group had a mean age of 65.1±4.1 years with FSH
54.9±15.9, 11.6±2.6 seconds coordination, strength 20.3±4.7 repetitions, 54.6±11.2
cm flexibility, agility 24.7±4.3 seconds, and aerobic resistance of 508±51
seconds.
It was possible to analyze the functional fitness of postmenopausal women through
the set of the American Alliance testing for Health, Physical Education,
Recreation and Dance with no significant differences between groups for the
variables strength, flexibility, aerobic capacity and coordination, and with only
the speed variable showing significant differences. We recommend further studies
seeking to formulate normative values for the population in question.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(6):283-290
DOI 10.1590/SO100-720320150005292
To determine the basic expression of ABC transporters in an epithelial ovarian cancer cell line, and to investigate whether low concentrations of acetaminophen and ibuprofen inhibited the growth of this cell line in vitro.
TOV-21 G cells were exposed to different concentrations of acetaminophen (1.5 to 15 μg/mL) and ibuprofen (2.0 to 20 μg/mL) for 24 to 48 hours. The cellular growth was assessed using a cell viability assay. Cellular morphology was determined by fluorescence microscopy. The gene expression profile of ABC transporters was determined by assessing a panel including 42 genes of the ABC transporter superfamily.
We observed a significant decrease in TOV-21 G cell growth after exposure to 15 μg/mL of acetaminophen for 24 (p=0.02) and 48 hours (p=0.01), or to 20 μg/mL of ibuprofen for 48 hours (p=0.04). Assessing the morphology of TOV-21 G cells did not reveal evidence of extensive apoptosis. TOV-21 G cells had a reduced expression of the genes ABCA1, ABCC3, ABCC4, ABCD3, ABCD4 and ABCE1 within the ABC transporter superfamily.
This study provides in vitro evidence of inhibitory effects of growth in therapeutic concentrations of acetaminophen and ibuprofen on TOV-21 G cells. Additionally, TOV-21 G cells presented a reduced expression of the ABCA1, ABCC3, ABCC4, ABCD3, ABCD4 and ABCE1 transporters.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(6):283-290
DOI 10.1590/SO100-720320150005292
To determine the basic expression of ABC transporters in an epithelial ovarian cancer cell line, and to investigate whether low concentrations of acetaminophen and ibuprofen inhibited the growth of this cell line in vitro.
TOV-21 G cells were exposed to different concentrations of acetaminophen (1.5 to 15 μg/mL) and ibuprofen (2.0 to 20 μg/mL) for 24 to 48 hours. The cellular growth was assessed using a cell viability assay. Cellular morphology was determined by fluorescence microscopy. The gene expression profile of ABC transporters was determined by assessing a panel including 42 genes of the ABC transporter superfamily.
We observed a significant decrease in TOV-21 G cell growth after exposure to 15 μg/mL of acetaminophen for 24 (p=0.02) and 48 hours (p=0.01), or to 20 μg/mL of ibuprofen for 48 hours (p=0.04). Assessing the morphology of TOV-21 G cells did not reveal evidence of extensive apoptosis. TOV-21 G cells had a reduced expression of the genes ABCA1, ABCC3, ABCC4, ABCD3, ABCD4 and ABCE1 within the ABC transporter superfamily.
This study provides in vitro evidence of inhibitory effects of growth in therapeutic concentrations of acetaminophen and ibuprofen on TOV-21 G cells. Additionally, TOV-21 G cells presented a reduced expression of the ABCA1, ABCC3, ABCC4, ABCD3, ABCD4 and ABCE1 transporters.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(6):291-296
DOI 10.1590/SO100-720320150005169
Beta thalassemia major is a rare hereditary blood disease in which impaired synthesis
of beta globin chains causes severe anemia. Medical treatment consists of chronic
blood transfusions and iron chelation. We describe two cases of adolescents with beta
thalassemia major with unplanned pregnancies and late onset of prenatal care. One had
worsening of anemia with increased transfusional requirement, fetal growth
restriction, and placental senescence. The other was also diagnosed with
hypothyroidism and low maternal weight, and was admitted twice during pregnancy due
to dengue shock syndrome and influenza H1N1-associated respiratory infection. She
also developed fetal growth restriction and underwent vaginal delivery at term
complicated by uterine hypotonia. Both patients required blood transfusions after
birth and chose medroxyprogesterone as a contraceptive method afterwards. This report
highlights the importance of medical advice on contraceptive methods for these women
and the role of a specialized prenatal follow-up in association with a
hematologist.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(6):291-296
DOI 10.1590/SO100-720320150005169
Beta thalassemia major is a rare hereditary blood disease in which impaired synthesis
of beta globin chains causes severe anemia. Medical treatment consists of chronic
blood transfusions and iron chelation. We describe two cases of adolescents with beta
thalassemia major with unplanned pregnancies and late onset of prenatal care. One had
worsening of anemia with increased transfusional requirement, fetal growth
restriction, and placental senescence. The other was also diagnosed with
hypothyroidism and low maternal weight, and was admitted twice during pregnancy due
to dengue shock syndrome and influenza H1N1-associated respiratory infection. She
also developed fetal growth restriction and underwent vaginal delivery at term
complicated by uterine hypotonia. Both patients required blood transfusions after
birth and chose medroxyprogesterone as a contraceptive method afterwards. This report
highlights the importance of medical advice on contraceptive methods for these women
and the role of a specialized prenatal follow-up in association with a
hematologist.
