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Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(11):608-613
The aim of this study was to evaluate the health aspects of Brazilian women older than 65 years of age.
This was a retrospective study that included 1,001 Brazilian women cared for in the gynecological geriatric outpatient office of our institution. We report a crosssectional analysis of female adults aged over 65 years, including data on demographics, clinical symptoms such as vasomotor symptoms, associated morbidities, physical examination and sexual intercourse. We used the chi-squared test to assess the data.
The age of the patients on their first clinic visit ranged from65 to 98 years, with a mean age of 68.56 ± 4.47 years; their mean age at the time of natural menopause was 48.76 ± 5.07 years. The most frequent clinical symptoms reported during the analyzed period were hot flashes (n = 188), followed by arthropathy, asthenia, and dry vagina. The most frequent associated morbidities after 65 years of age were systemic arterial hypertension, gastrointestinal disturbance, diabetes mellitus, and depression, among others. The assessment of the bodymass index (BMI) found decreases inBMIwith increased age. At the time of the visit, 78 patients reported sexual intercourse. The majority of women reporting sexual intercourse (89.75%, n = 70) were between 65 and 69 years of age, 8.97% (n = 7) were between 70 and 74 years of age, and only 1.28% (n = 1) of those were aged older than 75 years.
Our findings suggested that vasomotor symptoms can persist after 65 years of age. There was a significant decrease in sexual intercourse with increased age. The cardiovascular disturbances in our study are health concerns in these women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(11):608-613
The aim of this study was to evaluate the health aspects of Brazilian women older than 65 years of age.
This was a retrospective study that included 1,001 Brazilian women cared for in the gynecological geriatric outpatient office of our institution. We report a crosssectional analysis of female adults aged over 65 years, including data on demographics, clinical symptoms such as vasomotor symptoms, associated morbidities, physical examination and sexual intercourse. We used the chi-squared test to assess the data.
The age of the patients on their first clinic visit ranged from65 to 98 years, with a mean age of 68.56 ± 4.47 years; their mean age at the time of natural menopause was 48.76 ± 5.07 years. The most frequent clinical symptoms reported during the analyzed period were hot flashes (n = 188), followed by arthropathy, asthenia, and dry vagina. The most frequent associated morbidities after 65 years of age were systemic arterial hypertension, gastrointestinal disturbance, diabetes mellitus, and depression, among others. The assessment of the bodymass index (BMI) found decreases inBMIwith increased age. At the time of the visit, 78 patients reported sexual intercourse. The majority of women reporting sexual intercourse (89.75%, n = 70) were between 65 and 69 years of age, 8.97% (n = 7) were between 70 and 74 years of age, and only 1.28% (n = 1) of those were aged older than 75 years.
Our findings suggested that vasomotor symptoms can persist after 65 years of age. There was a significant decrease in sexual intercourse with increased age. The cardiovascular disturbances in our study are health concerns in these women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(10):512-517
Triple-negative breast carcinomas (TNBCs) represent a heterogeneous group of neoplasias, even though they generally exhibit a clinically more aggressive phenotype, and are more prevalent in young women. To date, targeted therapies for this group of tumors have not been defined. The aim of this study was to evaluate the frequency of the apocrine subtype in TBNCs from premenopausal patients as defined by the immunohistochemical expression of the androgen receptor (AR) and its association with: histological type; tumor grade; proliferative activity; epidermal growth factor receptor (EGFR) expression; and a basal-like phenotype.
A total of 118 tumor samples from patients aged 45 years or younger were selected and reviewed according to histological type and grade. Ki-67 expression was also evaluated. Immunohistochemical expression of the AR, basal cytokeratin ⅚, and EGFR expression were analyzed in tissue microarrays. The apocrine subset was defined by AR-positive expression. The basal-like phenotype was characterized by cytokeratin ⅚ and/or EGFR expression.
An apocrine profile was identified in 6/118 (5.1%) cases. This subset of cases also exhibited a lower rate of Ki-67 expression (17.5% versus 70.0%, p= 0.02), and a trend toward a lower histological grade (66.7% versus 27.9%, p= 0.06).
The apocrine subtype of TNBCs is rare among premenopausal women, and it tends to present as carcinomas of lower grade and lower proliferative activity, suggesting a less aggressive biological phenotype.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(10):512-517
Triple-negative breast carcinomas (TNBCs) represent a heterogeneous group of neoplasias, even though they generally exhibit a clinically more aggressive phenotype, and are more prevalent in young women. To date, targeted therapies for this group of tumors have not been defined. The aim of this study was to evaluate the frequency of the apocrine subtype in TBNCs from premenopausal patients as defined by the immunohistochemical expression of the androgen receptor (AR) and its association with: histological type; tumor grade; proliferative activity; epidermal growth factor receptor (EGFR) expression; and a basal-like phenotype.
A total of 118 tumor samples from patients aged 45 years or younger were selected and reviewed according to histological type and grade. Ki-67 expression was also evaluated. Immunohistochemical expression of the AR, basal cytokeratin ⅚, and EGFR expression were analyzed in tissue microarrays. The apocrine subset was defined by AR-positive expression. The basal-like phenotype was characterized by cytokeratin ⅚ and/or EGFR expression.
An apocrine profile was identified in 6/118 (5.1%) cases. This subset of cases also exhibited a lower rate of Ki-67 expression (17.5% versus 70.0%, p= 0.02), and a trend toward a lower histological grade (66.7% versus 27.9%, p= 0.06).
The apocrine subtype of TNBCs is rare among premenopausal women, and it tends to present as carcinomas of lower grade and lower proliferative activity, suggesting a less aggressive biological phenotype.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):273-280
DOI 10.1590/S0100-72031998000500007
An open-label comparative study was conducted in nine centers in Brazil to evaluate the tolerability and cycle control of two low-dose oral contraceptives containing 20 mg ethynylestradiol/75 mg gestodene and 20 mg ethynylestradiol/150 mg desogestrel, during six treatment cycles. A total of 167 healthy sexually active women were enrolled (77 in the gestodene group and 90 in the desogestrel group) and 138 completed the six-cycle treatment period. A lipid and hemostatic profile was performed for a subgroup of first users. A total of 867 cycles were evaluated. Irregular bleeding did not occur in 95.4% of the cycles evaluated with gestodene and in 91.9% with desogestrel. Tolerability was good with both preparations but there was significantly more nausea in the desogestrel group. Cycle control was good with both preparations with a significantly lower incidence of irregular bleeding with gestodene when all cycles were considered. There were no clinically significant changes in the hemostatic profile. Lipid profile showed a trend to be more favorable after six cycles of treatment with both preparations. Women in the gestodene group did not present changes in the mean weight; in the desogestrel group there was a significant mean weight increase of 1 kg after six cycles of treatment. Compliance with treatment was good with both preparations. Results of this study demonstrated that low-dose preparations containing gestodene or desogestrel combined with 20 mg of ethynylestradiol are well-tolerated oral contraceptives that provide good cycle control.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):273-280
DOI 10.1590/S0100-72031998000500007
An open-label comparative study was conducted in nine centers in Brazil to evaluate the tolerability and cycle control of two low-dose oral contraceptives containing 20 mg ethynylestradiol/75 mg gestodene and 20 mg ethynylestradiol/150 mg desogestrel, during six treatment cycles. A total of 167 healthy sexually active women were enrolled (77 in the gestodene group and 90 in the desogestrel group) and 138 completed the six-cycle treatment period. A lipid and hemostatic profile was performed for a subgroup of first users. A total of 867 cycles were evaluated. Irregular bleeding did not occur in 95.4% of the cycles evaluated with gestodene and in 91.9% with desogestrel. Tolerability was good with both preparations but there was significantly more nausea in the desogestrel group. Cycle control was good with both preparations with a significantly lower incidence of irregular bleeding with gestodene when all cycles were considered. There were no clinically significant changes in the hemostatic profile. Lipid profile showed a trend to be more favorable after six cycles of treatment with both preparations. Women in the gestodene group did not present changes in the mean weight; in the desogestrel group there was a significant mean weight increase of 1 kg after six cycles of treatment. Compliance with treatment was good with both preparations. Results of this study demonstrated that low-dose preparations containing gestodene or desogestrel combined with 20 mg of ethynylestradiol are well-tolerated oral contraceptives that provide good cycle control.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(2):77-81
DOI 10.1590/S0100-72031999000200004
Purpose: to evaluate the frequency of urinary disorders and variation of the urodynamic parameters according to the time of post-menopause. Method: two hundred forty-two post-menopausal women with urinary complaints were studied at the Division of Gynecology, Escola Paulista de Medicina, UNIFESP. They were grouped according to the time of post-menopause: group A - up to 4 years; group B - 5 to 9 years and group C - more than 10 years. They were submitted to anamnesis, gynecological examination and urodynamic study. The frequency of urinary alterations and the variation of the urodynamic parameters were analyzed, such as voiding volume; flow time; maximum flow rate, average flow rate; residual urine; vesical capacity at the first desire to void; maximum bladder capacity; maximum urethral closure pressure and functional profile length, with full and empty bladder. The data were statistically analyzed. Results: the most common clinical diagnosis was stress urinary incontinence in the three groups, but the longer the time of post-menopause, the more frequently urinary urgency was observed. Regarding urodynamic diagnosis, 93.6%, 84.6% and 90.7% of the patients of the groups A, B and C, respectively, presented stress urinary incontinence, while 4.8%, 13.5% and 6.2% revealed detrusor instability. There was a decrease in the following urodynamic parameters, according to the time of post-menopause: flow time, maximum flow rate and vesical capacity at the first desire to void, and an increase of the residual urine. Conclusion: in spite of the high incidence of urinary symptoms such as urgency incontinence, stress urinary incontinence was the main urinary problem we have found in post-menopause.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(2):77-81
DOI 10.1590/S0100-72031999000200004
Purpose: to evaluate the frequency of urinary disorders and variation of the urodynamic parameters according to the time of post-menopause. Method: two hundred forty-two post-menopausal women with urinary complaints were studied at the Division of Gynecology, Escola Paulista de Medicina, UNIFESP. They were grouped according to the time of post-menopause: group A - up to 4 years; group B - 5 to 9 years and group C - more than 10 years. They were submitted to anamnesis, gynecological examination and urodynamic study. The frequency of urinary alterations and the variation of the urodynamic parameters were analyzed, such as voiding volume; flow time; maximum flow rate, average flow rate; residual urine; vesical capacity at the first desire to void; maximum bladder capacity; maximum urethral closure pressure and functional profile length, with full and empty bladder. The data were statistically analyzed. Results: the most common clinical diagnosis was stress urinary incontinence in the three groups, but the longer the time of post-menopause, the more frequently urinary urgency was observed. Regarding urodynamic diagnosis, 93.6%, 84.6% and 90.7% of the patients of the groups A, B and C, respectively, presented stress urinary incontinence, while 4.8%, 13.5% and 6.2% revealed detrusor instability. There was a decrease in the following urodynamic parameters, according to the time of post-menopause: flow time, maximum flow rate and vesical capacity at the first desire to void, and an increase of the residual urine. Conclusion: in spite of the high incidence of urinary symptoms such as urgency incontinence, stress urinary incontinence was the main urinary problem we have found in post-menopause.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(8):547-552
DOI 10.1590/S0100-72032002000800008
Purpose: to evaluate the estrogenic effects of soy phytoestrogens in postmenopausal patients. Method: we selected postmenopausal patients from the Climacteric Service of the Gynecology Department of the Federal University of São Paulo - Escola Paulista de Medicina. The patients were divided into two groups: GI (n=40) received daily 100 mg isoflavone (3 x 33.3 mg/day); and GCtr (n=40) received daily placebo. We included in this study the Kuppermann menopausal index, physical examination and the biochemical determination of total and fractions of cholesterol, triglycerides, estradiol, FSH e LH. We also performed sonographic examination to measure endometrial thickness. To compare baseline and after treatment values of both groups, the nonparametric Kruskal-Wallis test was used for the Kuppermann index, while the t test was performed for other data. Results: evaluation of the Kupperman Menopausal Index, 80% patients of GI showed a decrease in the total score, while the improvement of symptoms in GCtr was 12,5%. The analysis of total cholesterol levels showed that 35 patients of GI had levels above 200 mg/dL, and only 13 of GCtr presented similar levels. The body mass index reduction occurred in GI and the control group showed no changes. We also verified that echo endometrial thickness and FSH levels were similar to baseline values. However the values of estrogen increased after isoflavone treatment. Conclusion: we concluded that 100 mg/day isoflavone may be an alternative treatment for attenuating the climacteric symptoms in 80% of isoflavone users and that it reduced total cholesterol.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(8):547-552
DOI 10.1590/S0100-72032002000800008
Purpose: to evaluate the estrogenic effects of soy phytoestrogens in postmenopausal patients. Method: we selected postmenopausal patients from the Climacteric Service of the Gynecology Department of the Federal University of São Paulo - Escola Paulista de Medicina. The patients were divided into two groups: GI (n=40) received daily 100 mg isoflavone (3 x 33.3 mg/day); and GCtr (n=40) received daily placebo. We included in this study the Kuppermann menopausal index, physical examination and the biochemical determination of total and fractions of cholesterol, triglycerides, estradiol, FSH e LH. We also performed sonographic examination to measure endometrial thickness. To compare baseline and after treatment values of both groups, the nonparametric Kruskal-Wallis test was used for the Kuppermann index, while the t test was performed for other data. Results: evaluation of the Kupperman Menopausal Index, 80% patients of GI showed a decrease in the total score, while the improvement of symptoms in GCtr was 12,5%. The analysis of total cholesterol levels showed that 35 patients of GI had levels above 200 mg/dL, and only 13 of GCtr presented similar levels. The body mass index reduction occurred in GI and the control group showed no changes. We also verified that echo endometrial thickness and FSH levels were similar to baseline values. However the values of estrogen increased after isoflavone treatment. Conclusion: we concluded that 100 mg/day isoflavone may be an alternative treatment for attenuating the climacteric symptoms in 80% of isoflavone users and that it reduced total cholesterol.