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  • Original Article

    The impact of surgical treatment for deep endometriosis: metabolic profile, quality of life and psychological aspects

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo42

    Summary

    Original Article

    The impact of surgical treatment for deep endometriosis: metabolic profile, quality of life and psychological aspects

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo42

    DOI 10.61622/rbgo/2024rbgo42

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    Abstract

    Objective

    To evaluate the effects of surgical treatment of deep endometriosis on the metabolic profile, quality of life and psychological aspects.

    Methods

    Prospective observational study, carried out with women of reproductive age diagnosed with deep endometriosis, treated in a specialized outpatient clinic, from October/2020 to September/2022, at a University Hospital in Fortaleza - Brazil. Standardized questionnaires were applied to collect data on quality of life and mental health, in addition to laboratory tests to evaluate dyslipidemia and dysglycemia, at two moments, preoperatively and six months after surgery. The results were presented using tables, averages and percentages.

    Results

    Thirty women with an average age of 38.5 years were evaluated. Seven quality of life domains showed improved scores: pain, control and impotence, well-being, social support, self-image, work life and sexual relations after surgery (ES ≥ 0.80). There was an improvement in mental health status with a significant reduction in anxiety and depression postoperatively. With the metabolic profile, all average levels were lower after surgery: total cholesterol 8.2% lower, LDL 12.8% lower, triglycerides 10.9% lower, and fasting blood glucose 7.3% lower (p < 0.001).

    Conclusion

    Surgical treatment of deep endometriosis improved the quality of life and psychological aspects of patients. The lipid profile of patients after laparoscopy was favorable when compared to the preoperative lipid profile.

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  • Original Article

    Endometrial Findings in Patients with Breast Cancer Using Tamoxifen

    Rev Bras Ginecol Obstet. 2002;24(4):233-239

    Summary

    Original Article

    Endometrial Findings in Patients with Breast Cancer Using Tamoxifen

    Rev Bras Ginecol Obstet. 2002;24(4):233-239

    DOI 10.1590/S0100-72032002000400004

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    Purpose: to analyze sensitivity, specificity, positive and negative predictive values and the likelihood ratio of transvaginal ultrasound and hysteroscopy when compared with the histopathologic examination of the endometrium in women with breast cancer who have been treated with tamoxifen. Methods: transversal study with 30 women in whom transvaginal ultrasound evaluated the echogenic pattern of endometrial echo and its thickness. Hyteroscopy was performed and described as normal (normal or atrophic endometrium) or abnormal (thickening, polyps, leiomyoma, synechia). Material for histopathology was obtained from endometrial biopsy and the findings were considered normal (irregular endometrial maturation and/or atrophy) or abnormal (polyps, simple or complex hyperplasia, leiomyoma or endometrial carcinoma). Results: the general diagnosis of endometrial modifications was present in 36.6% of patients. The most frequent results were cystic atrophy (46.6%) and endometrial polyps (26.6%). Through the ROC curve the best cutoff of 8 mm of endometrial thickness measure was determined. This measure showed sensitivity of 72.7%, specificity of 72.9%, positive predictive value of 66.6%, negative predictive value of 83.3% and likelihood ratio of 3.4. Hysteroscopy showed sensitivity of 90.9%, specificity of 68.4%, positive predictive value of 62.5%, negative prediction value of 92.8% and likelihood ratio of 2.8. Conclusions: the most frequent endometrial modifications were cystic atrophy followed by polyps. Transvaginal ultrasound showed a higher rate of false-positive (42.1%), when the cutoff for the thickness of the endometrium was 5 mm; however acuracy improved when the measure of 8 mm was used. The cutoff of 8 mm was determined through the ROC curve.

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    Endometrial Findings in Patients with Breast Cancer Using Tamoxifen
  • Original Article

    Polycystic Ovary Syndrome and Metabolic Syndrome: Clinical and Laboratory Findings and Non-Alcoholic Fatty Liver Disease Assessed by Elastography

    Rev Bras Ginecol Obstet. 2022;44(3):287-294

    Summary

    Original Article

    Polycystic Ovary Syndrome and Metabolic Syndrome: Clinical and Laboratory Findings and Non-Alcoholic Fatty Liver Disease Assessed by Elastography

    Rev Bras Ginecol Obstet. 2022;44(3):287-294

    DOI 10.1055/s-0041-1741032

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    Abstract

    Objective

    To evaluate the association between polycystic ovary syndrome (PCOS) and metabolic syndrome (MetS), adding liver assessment through elastography and ultrasound, for correlation with non-alcoholic fatty liver disease (NAFLD). Metabolic syndrome occurs in~43% of women with PCOS, and NAFLD is the hepatic expression of MetS.

    Methods

    One hundred women, 50 with PCOS and 50 controls, matched by age (18- 35 years) and body mass index (BMI) were included, restricted to patients with overweight and obesity grade 1, at the Assis Chateaubrian Maternity School, Universidade Federal do Ceará, Brazil. For the diagnosis of PCOS, we adopted the Rotterdam criteria, and for the diagnosis of MetS, the criteria of the National Cholesterol Education Program (NCEP/ATP III). Hepatic elastography and ultrasound were performed to assess liver stiffness and echotexture, respectively.

    Results

    The average ages were 29.1 (±5.3) and 30.54 (±4.39) years, for the PCOS and the control group, respectively. Patients with PCOS had a risk 4 times higher of having MetS, odds ratio (95% confidence interval)=4.14, than those in the control group. Women with PCOS had higher average of abdominal circumference (100.9±9.08 cm vs 94.96±6.99 cm) and triglycerides (162±54.63 mg/dL vs 137.54±36.91mg/dL) and lower average of HDL cholesterol (45.66±6.88 mg/dL vs 49.78±7.05 mg/dL), with statistically significant difference. Hepatic steatosis was observed on ultrasound in women with PCOS; however, with no statistically significant difference. There was no change to NAFLD at elastography in any group.

    Conclusion

    Women with PCOS had 4-fold higher frequency of MetS andmore hepatic steatosis, with no statistically significant difference. There was no change in liver stiffness between the groups at elastography. The results can be extended only to populations of overweight and obesity grade 1, with PCOS or not. They cannot be generalized to other untested groups.

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  • Original Article

    Estrogen and progesterone receptors in peritoneal fluid cell sediment in pelvic endometriosis: immunocytochemical study

    Rev Bras Ginecol Obstet. 2001;23(2):83-86

    Summary

    Original Article

    Estrogen and progesterone receptors in peritoneal fluid cell sediment in pelvic endometriosis: immunocytochemical study

    Rev Bras Ginecol Obstet. 2001;23(2):83-86

    DOI 10.1590/S0100-72032001000200004

    Views2

    Purpose: to evaluate the expression of estrogen (ER) and progesterone (PR) receptors in smears of peritoneal fluid sediment from patients with and without endometriosis. Methods: immunocytochemical study of ER and PR in smears of peritoneal fluid sediment in 19 cases with endometriosis and 7 without (control group), observing their expression. The data were submitted to Student's t-test to evaluate statistical significance. Results: in 84.6% of the cases with endometriosis, endometrial-like cells expressed ER (mean = 4.1%). In cases without endometriosis there was ER expression in 42.9%, with a mean of 4.5% (p = 0.1706). PR was expressed in only one case of endometriosis, with an endometrioma rupture history. Conclusions: there was no difference of ER expression between cases with endometriosis and the control group, in contrast to tissue behavior. Further cases must be studied for a better evaluation of this enigmatic mechanism of hormonal receptors in exfoliated cells.

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    Estrogen and progesterone receptors in peritoneal fluid cell sediment in pelvic endometriosis: immunocytochemical study

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