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Rev Bras Ginecol Obstet. 2007;29(1):18-26
DOI 10.1590/S0100-72032007000100004
PURPOSE: to evaluate the loco-regional response to primary chemotherapy in patients with breast cancer at stages II and III. METHODS: a retrospective and analytical clinical study carried out in 97 patients with an average age of 52.2 years old, with breast cancer at stages II and III, attended from January 1993 to December 2004, and submitted to 3 to 4 cycles of primary chemotherapy with 5-fluorouracil - 500 mg/m2, epirubicin - 50 mg/m2 and cyclophosphamide - 500 mg/m2 or doxorubicin - 50 mg/m2 e cyclophosphamide - 500 mg/m2, and then to loco-regional surgical conservative or radical surgical treatment. Chi-square and Fisher’s exact tests were used to study the association among the variables (age, menopausal state, pre-chemotherapy tumoral volume, axillary condition, stage, therapeutic scheme and number of cycles), while Pearson’s correlation coefficient was used for the quantitative variables (tumoral volume according to the anatomo-pathological study and the post-chemotherapy clinical tumoral volume. The significance level was 5%. RESULTS: there were 56.8% of cases at stage II and 43.2% at stage III. Approximately 50% of the patients received FEC50 and 50% AC. Objective clinical response with primary chemotherapy was obtained in 64.9% of the cases. Full clinical response occurred in 12.3% of patients, while full pathological response occurred in 10.3% of the cases. CONCLUSIONS: there was a statistically significant correlation between the number of cycles and the response to primary chemotherapy. Patients who received 4 cycles had better response than those who received 3 cycles. There was also a statistically significant concordance between the evaluation through clinical examination of the response to primary chemotherapy and the pathological findings. No statistically significant correlation was observed concerning age, menopausal status, tumoral volume, and pretreatment of axillary damage.
Summary
Rev Bras Ginecol Obstet. 2007;29(1):18-26
DOI 10.1590/S0100-72032007000100004
PURPOSE: to evaluate the loco-regional response to primary chemotherapy in patients with breast cancer at stages II and III. METHODS: a retrospective and analytical clinical study carried out in 97 patients with an average age of 52.2 years old, with breast cancer at stages II and III, attended from January 1993 to December 2004, and submitted to 3 to 4 cycles of primary chemotherapy with 5-fluorouracil - 500 mg/m2, epirubicin - 50 mg/m2 and cyclophosphamide - 500 mg/m2 or doxorubicin - 50 mg/m2 e cyclophosphamide - 500 mg/m2, and then to loco-regional surgical conservative or radical surgical treatment. Chi-square and Fisher’s exact tests were used to study the association among the variables (age, menopausal state, pre-chemotherapy tumoral volume, axillary condition, stage, therapeutic scheme and number of cycles), while Pearson’s correlation coefficient was used for the quantitative variables (tumoral volume according to the anatomo-pathological study and the post-chemotherapy clinical tumoral volume. The significance level was 5%. RESULTS: there were 56.8% of cases at stage II and 43.2% at stage III. Approximately 50% of the patients received FEC50 and 50% AC. Objective clinical response with primary chemotherapy was obtained in 64.9% of the cases. Full clinical response occurred in 12.3% of patients, while full pathological response occurred in 10.3% of the cases. CONCLUSIONS: there was a statistically significant correlation between the number of cycles and the response to primary chemotherapy. Patients who received 4 cycles had better response than those who received 3 cycles. There was also a statistically significant concordance between the evaluation through clinical examination of the response to primary chemotherapy and the pathological findings. No statistically significant correlation was observed concerning age, menopausal status, tumoral volume, and pretreatment of axillary damage.
Summary
Rev Bras Ginecol Obstet. 2009;31(4):196-202
DOI 10.1590/S0100-72032009000400007
PURPOSE: to evaluate the quality of life of post-menopause women, users and non-users of hormonal therapy (HT), in a Healthcare Unit in Franca, São Paulo, Brazil. METHODS: a clinical transversal study, carried out with 250 post-menopausal women, with ages from 45 to 70 years old, attended to in Healthcare Units, from September 2007 to August 2008. Participants were divided into two groups: HT users (n=70) and non-users (n=180). Women making continuous HT use for at least six months were considered as users. Sociodemographic and clinical characteristics have been evaluated. Blatt-Kupperman's menopausal index has been applied to assess climacteric symptoms, and the Women's Health Questionnaire (WHQ), to assess their quality of life. Fisher's exact test or χ2 and Mann-Whitney and Kruskal-Wallis's tests have been used for the statistical analysis. RESULTS: no significant difference has been found in the comparison of groups, concerning age, menarche, menopause, parity and body mass index. It has been seen that 67.2% of the women were married, 83.2% had attended primary school and 53.2% were housewives, with no difference between the groups. HT users reported lower frequency of climacteric symptoms (BKMI) with moderate and marked intensity, as compared to non-users (p<0.001). Even though HT users presented lower average score in cognitive deficit (p<0.001), vasomotor symptoms (p=0.04), sleeping problems (p<0.001), attractiveness (p=0.02) from the WHQ, there has been no difference in the total score, as compared to non-users. CONCLUSIONS: post-menopausal women, HT users and non-users, admitted at Healthcare Units, have not presented differences in global quality of life.
Summary
Rev Bras Ginecol Obstet. 2009;31(4):196-202
DOI 10.1590/S0100-72032009000400007
PURPOSE: to evaluate the quality of life of post-menopause women, users and non-users of hormonal therapy (HT), in a Healthcare Unit in Franca, São Paulo, Brazil. METHODS: a clinical transversal study, carried out with 250 post-menopausal women, with ages from 45 to 70 years old, attended to in Healthcare Units, from September 2007 to August 2008. Participants were divided into two groups: HT users (n=70) and non-users (n=180). Women making continuous HT use for at least six months were considered as users. Sociodemographic and clinical characteristics have been evaluated. Blatt-Kupperman's menopausal index has been applied to assess climacteric symptoms, and the Women's Health Questionnaire (WHQ), to assess their quality of life. Fisher's exact test or χ2 and Mann-Whitney and Kruskal-Wallis's tests have been used for the statistical analysis. RESULTS: no significant difference has been found in the comparison of groups, concerning age, menarche, menopause, parity and body mass index. It has been seen that 67.2% of the women were married, 83.2% had attended primary school and 53.2% were housewives, with no difference between the groups. HT users reported lower frequency of climacteric symptoms (BKMI) with moderate and marked intensity, as compared to non-users (p<0.001). Even though HT users presented lower average score in cognitive deficit (p<0.001), vasomotor symptoms (p=0.04), sleeping problems (p<0.001), attractiveness (p=0.02) from the WHQ, there has been no difference in the total score, as compared to non-users. CONCLUSIONS: post-menopausal women, HT users and non-users, admitted at Healthcare Units, have not presented differences in global quality of life.
Summary
Rev Bras Ginecol Obstet. 2005;27(5):243-247
DOI 10.1590/S0100-72032005000500003
PURPOSE: to evaluate the association between p53 and Ki-67 expression in the tumor and clinicopathological features in patients with carcinoma of the cervix. METHODS: samples were taken from the tumor of 36 patients with stage IB (FIGO) cervical carcinoma submitted to radical hysterectomy. Tissue samples were taken from the tumor, fixed in formalin and embedded in paraffin. The specimens were analyzed by histopathology (hematoxylin and eosin) and immunohistochemically evaluated using monoclonal antibodies for p53 and Ki-67. Data were analyzed statistically by the chi2 test to evaluate eventual differences between the groups. RESULTS: the age of the patients ranged from 27 to 73 years (48.7±10.4 years). Clinical stage (FIGO) was IB1 in 27 cases (75%) and IB2 in 9 cases (25%). A positive tumoral expression of the p53 protein was found in half of the cases. In relation to the Ki-67 expression, a high cell proliferation index was shown in 73.3% of the cases. There was no association between tumoral p53 and Ki-67 expression with age (p=0.091 and 0.900), clinical stage (p=0.054 and 0.667), histological classification (p=0.674 and 0.674), grade of differentiation (p=0.070 and 0.282), presence of lymphatic vascular space invasion (p=0.248 and 0.667), parametrial involvement (p=0.729 and 0.763) and pelvic lymph node metastasis (p=0.729 and 0.636, respectively). CONCLUSIONS: tumoral expression of p53 and Ki-67 was not associated with the clinicopathological features in patients with stage IB carcinoma of the cervix.
Summary
Rev Bras Ginecol Obstet. 2005;27(5):243-247
DOI 10.1590/S0100-72032005000500003
PURPOSE: to evaluate the association between p53 and Ki-67 expression in the tumor and clinicopathological features in patients with carcinoma of the cervix. METHODS: samples were taken from the tumor of 36 patients with stage IB (FIGO) cervical carcinoma submitted to radical hysterectomy. Tissue samples were taken from the tumor, fixed in formalin and embedded in paraffin. The specimens were analyzed by histopathology (hematoxylin and eosin) and immunohistochemically evaluated using monoclonal antibodies for p53 and Ki-67. Data were analyzed statistically by the chi2 test to evaluate eventual differences between the groups. RESULTS: the age of the patients ranged from 27 to 73 years (48.7±10.4 years). Clinical stage (FIGO) was IB1 in 27 cases (75%) and IB2 in 9 cases (25%). A positive tumoral expression of the p53 protein was found in half of the cases. In relation to the Ki-67 expression, a high cell proliferation index was shown in 73.3% of the cases. There was no association between tumoral p53 and Ki-67 expression with age (p=0.091 and 0.900), clinical stage (p=0.054 and 0.667), histological classification (p=0.674 and 0.674), grade of differentiation (p=0.070 and 0.282), presence of lymphatic vascular space invasion (p=0.248 and 0.667), parametrial involvement (p=0.729 and 0.763) and pelvic lymph node metastasis (p=0.729 and 0.636, respectively). CONCLUSIONS: tumoral expression of p53 and Ki-67 was not associated with the clinicopathological features in patients with stage IB carcinoma of the cervix.
Summary
Rev Bras Ginecol Obstet. 2000;22(6):325-331
DOI 10.1590/S0100-72032000000600002
Purpose: to evaluate the efficacy of medroxyprogesterone acetate and megestrol acetate in endometrial hyperplasia. Patients and Methods: forty-seven patients with abnormal uterine bleeding were retrospectively evaluated. These patients were submitted to diagnostic uterine curettage and/or endometrial biopsy, with histopathological finding of endometrial hyperplasia. Patients with hyperplasia without atypia received 10 mg/day oral medroxyprogesterone acetate during 10 to 12 days a month. Those with hyperplasia with atypia received 160 mg/day oral megestrol acetate continuously. The length of treatment ranged from 3 to 18 months. Control endometrial biopsy and/or uterine curettage were performed 3 and 6 months from the beginning of treatment, and then periodically to evaluate whether or not regression of hyperplasia occurred. Results: forty-two patients with endometrial hyperplasia without atypia and 5 with hyperplasia with atypia were included. The mean age of the patients was 49.5 ± 10.6 years (22 to 72 years), 70.2% aged over 45 years. Medroxy-progesterone acetate was effective in promoting regression of 83.2% (35/42) of hyperplasia without atypia, and megestrol acetate in 80% (4/5) of hyperplasia with atypia. Despite treatment, lesions persisted in 16.8% (7 cases) of hyperplasia with atypia and in 20% (1 case) of hyperplasia without atypia. No progression to endometrial cancer was seen during the follow-up period of 3 months to 9 years. During follow-up, we found that 18 patients (38.3%) showed amenorrhea, 12 (25.5%) menstrual cycle regulation, and 17 (36.2%) persistent abnormal uterine bleeding and underwent total abdominal hysterectomy. Histological examination of the uterus showed 8 patients with persistence of hyperplastic lesion, 4 with leiomyoma, 3 with adenomyosis, 1 with diffuse uterine myohypertrophy, and 1 with normal uterus, despite regression of the hyperplastic lesions in 9 of the 17 patients. Conclusions: the treatment of endometrial hyperplasia with medroxyprogesterone acetate and megestrol acetate can be a safe alternative for women who refuse to have their uterus removed or those at high risk for surgery. However, a careful monitoring of the endometrium is needed. This can be achieved with periodical endometrial biopsy, transvaginal ultrasonography, and evaluation of the symptoms.
Summary
Rev Bras Ginecol Obstet. 2000;22(6):325-331
DOI 10.1590/S0100-72032000000600002
Purpose: to evaluate the efficacy of medroxyprogesterone acetate and megestrol acetate in endometrial hyperplasia. Patients and Methods: forty-seven patients with abnormal uterine bleeding were retrospectively evaluated. These patients were submitted to diagnostic uterine curettage and/or endometrial biopsy, with histopathological finding of endometrial hyperplasia. Patients with hyperplasia without atypia received 10 mg/day oral medroxyprogesterone acetate during 10 to 12 days a month. Those with hyperplasia with atypia received 160 mg/day oral megestrol acetate continuously. The length of treatment ranged from 3 to 18 months. Control endometrial biopsy and/or uterine curettage were performed 3 and 6 months from the beginning of treatment, and then periodically to evaluate whether or not regression of hyperplasia occurred. Results: forty-two patients with endometrial hyperplasia without atypia and 5 with hyperplasia with atypia were included. The mean age of the patients was 49.5 ± 10.6 years (22 to 72 years), 70.2% aged over 45 years. Medroxy-progesterone acetate was effective in promoting regression of 83.2% (35/42) of hyperplasia without atypia, and megestrol acetate in 80% (4/5) of hyperplasia with atypia. Despite treatment, lesions persisted in 16.8% (7 cases) of hyperplasia with atypia and in 20% (1 case) of hyperplasia without atypia. No progression to endometrial cancer was seen during the follow-up period of 3 months to 9 years. During follow-up, we found that 18 patients (38.3%) showed amenorrhea, 12 (25.5%) menstrual cycle regulation, and 17 (36.2%) persistent abnormal uterine bleeding and underwent total abdominal hysterectomy. Histological examination of the uterus showed 8 patients with persistence of hyperplastic lesion, 4 with leiomyoma, 3 with adenomyosis, 1 with diffuse uterine myohypertrophy, and 1 with normal uterus, despite regression of the hyperplastic lesions in 9 of the 17 patients. Conclusions: the treatment of endometrial hyperplasia with medroxyprogesterone acetate and megestrol acetate can be a safe alternative for women who refuse to have their uterus removed or those at high risk for surgery. However, a careful monitoring of the endometrium is needed. This can be achieved with periodical endometrial biopsy, transvaginal ultrasonography, and evaluation of the symptoms.
Summary
Rev Bras Ginecol Obstet. 2002;24(5):329-334
DOI 10.1590/S0100-72032002000500007
Purpose: to evaluate the effect of total abdominal hysterectomy on ovarian blood supply in women in reproductive age, using transvaginal color Doppler. Methods: a prospective study was carried out on 61 40-year-old or younger women. They were divided into two groups: G1, 31 patients submitted to hysterectomy, and G2, 30 normal women. Criteria of inclusion: normal ovarian function at baseline, normal body weight, without expasure to tobacco, no history of laparotomy or ovarian pathology. The pulsatility index (PI) of ovarian arteries determined by Doppler and the transvaginal ultrasonographic measurement of the ovarian volume were performed at three moments: baseline, 6 and 12 months. Results: at baseline the groups were homogeneous. In the hysterectomized group, with 6 and 12 months, increase of the volume of the ovaries and decrease of PI (p<0,05) were observed. At the end of the study, 25.5% (8/31) of the hysterectomized patients presented benign ovarian cysts. In the control group no alteration of the parameters was observed. Conclusion: The decrease of PI by Doppler of ovarian arteries suggests increased ovarian blood supply after total abdominal hysterectomy in women in reproductive age.
Summary
Rev Bras Ginecol Obstet. 2002;24(5):329-334
DOI 10.1590/S0100-72032002000500007
Purpose: to evaluate the effect of total abdominal hysterectomy on ovarian blood supply in women in reproductive age, using transvaginal color Doppler. Methods: a prospective study was carried out on 61 40-year-old or younger women. They were divided into two groups: G1, 31 patients submitted to hysterectomy, and G2, 30 normal women. Criteria of inclusion: normal ovarian function at baseline, normal body weight, without expasure to tobacco, no history of laparotomy or ovarian pathology. The pulsatility index (PI) of ovarian arteries determined by Doppler and the transvaginal ultrasonographic measurement of the ovarian volume were performed at three moments: baseline, 6 and 12 months. Results: at baseline the groups were homogeneous. In the hysterectomized group, with 6 and 12 months, increase of the volume of the ovaries and decrease of PI (p<0,05) were observed. At the end of the study, 25.5% (8/31) of the hysterectomized patients presented benign ovarian cysts. In the control group no alteration of the parameters was observed. Conclusion: The decrease of PI by Doppler of ovarian arteries suggests increased ovarian blood supply after total abdominal hysterectomy in women in reproductive age.
Summary
Rev Bras Ginecol Obstet. 2003;25(5):337-343
DOI 10.1590/S0100-72032003000500006
PURPOSE: to evaluate the effects of soy germ isoflavone on menopausal symptoms and blood lipids in postmenopausal women. METHODS: a prospective study was performed on 50 women, randomly divided into two groups: 25 women on soy germ isoflavones (60 mg/day, capsules) (G1) and 25 women on placebo (G2). Inclusion criteria: women with hot flushes and FSH >40 mIU/mL, non-vegetarian, non-smoker, non-Asiatic, not in use of hormone replacement therapy and without disease of the gastrointestinal tract. For six months, the menopausal Kupperman index (MKI) and hormonal and lipid profiles were assessed. For statistical analysis, ANOVA, t test and the non-parametric Kruskal-Wallis and Mann-Whitney tests were used. RESULTS: the median MKI values, initially similar in both groups, decreased in G1 at two and four months (MKI = 14 and 9, respectively), and in G2 at two months (MKI = 15) (p<0.01). At six months, isoflavone was significantly superior to placebo in reducing hot flushes (44 versus 12%, respectively). At the end of the study, in the isoflavone group, an increase in estradiol levels (from 16,8±7.3 to 18,0±6.7 ng/dL) (p<0.05) was observed, with no alteration in FSH, LH and vaginal cytology; there was also a reduction of 11.8% in LDL (from 151.5±39.2 for 133,6±26.4 mg/dL) and a HDL increase of 27.3% (from 44.0±11.3 to 56.0±11.9 mg/dL) (p<0.05). CONCLUSIONS: soy germ isoflavone induced favorable effects on menopausal symptoms and lipid profile, showing to be an interesting option for alternative therapy in postmenopausal women.
Summary
Rev Bras Ginecol Obstet. 2003;25(5):337-343
DOI 10.1590/S0100-72032003000500006
PURPOSE: to evaluate the effects of soy germ isoflavone on menopausal symptoms and blood lipids in postmenopausal women. METHODS: a prospective study was performed on 50 women, randomly divided into two groups: 25 women on soy germ isoflavones (60 mg/day, capsules) (G1) and 25 women on placebo (G2). Inclusion criteria: women with hot flushes and FSH >40 mIU/mL, non-vegetarian, non-smoker, non-Asiatic, not in use of hormone replacement therapy and without disease of the gastrointestinal tract. For six months, the menopausal Kupperman index (MKI) and hormonal and lipid profiles were assessed. For statistical analysis, ANOVA, t test and the non-parametric Kruskal-Wallis and Mann-Whitney tests were used. RESULTS: the median MKI values, initially similar in both groups, decreased in G1 at two and four months (MKI = 14 and 9, respectively), and in G2 at two months (MKI = 15) (p<0.01). At six months, isoflavone was significantly superior to placebo in reducing hot flushes (44 versus 12%, respectively). At the end of the study, in the isoflavone group, an increase in estradiol levels (from 16,8±7.3 to 18,0±6.7 ng/dL) (p<0.05) was observed, with no alteration in FSH, LH and vaginal cytology; there was also a reduction of 11.8% in LDL (from 151.5±39.2 for 133,6±26.4 mg/dL) and a HDL increase of 27.3% (from 44.0±11.3 to 56.0±11.9 mg/dL) (p<0.05). CONCLUSIONS: soy germ isoflavone induced favorable effects on menopausal symptoms and lipid profile, showing to be an interesting option for alternative therapy in postmenopausal women.
Summary
Rev Bras Ginecol Obstet. 2004;26(5):411-416
DOI 10.1590/S0100-72032004000500011
OBJECTIVE: to evaluate the incidence of non-gynecological surgical procedures used in the treatment of ovarian cancer, as well to describe their complications. METHODS: eighty-two patients with ages from 22 to 89 (mean = 54.1 ± 15.1 years), submitted to laparotomy for surgical treatment of ovarian cancer from February 1999 to October 2003 were retrospectively evaluated. This study included only patients with epithelial ovary carcinoma. The patients were divided into 2 groups, patients submitted exclusively to gynecological procedures and patients submitted to non-gynecological procedures. Statistical analysis was made with the Student's t-test or the chi-square test. RESULTS: 5 patients (6.1%) were in stage (FIGO) I, 18 (21.9%) in stage II, 40 (48.8%) in stage III, and 19 (23.2%) in stage IV. Non-gynecological procedures were done in 35 cases (42.7%), including: 17 colostomies, 16 enterectomies, 8 peritonectomies, 7 colectomies, 5 partial diaphragm resections, 4 partial cystectomies, 4 splenectomies, 2 ileostomies, and 1 hepatectomy. All patients submitted to non-gynecological procedures were included in stages III and IV. This group of patients underwent longer-lasting surgeries (5.3 ± 1.4 versus 3.1 + 0,0 h; p < 0.001). There was no significant difference between these two groups regarding hemotransfusion requirement (42,2 versus 40%; p = 0.512) and hospitalization time (11.5 ± 7.2 versus 10 ± 9.9 days; p = 0.454). Patients submitted to non-gynecological surgeries developed higher rates of postoperative complications (37 versus 17.1%; p = 0.042), and two of them (2.4%) died. CONCLUSION: non-gynecological surgical procedures are frequently used in the treatment of patients with ovarian cancer. These procedures are associated with a longer-lasting surgery and higher rates of postoperative complications.
Summary
Rev Bras Ginecol Obstet. 2004;26(5):411-416
DOI 10.1590/S0100-72032004000500011
OBJECTIVE: to evaluate the incidence of non-gynecological surgical procedures used in the treatment of ovarian cancer, as well to describe their complications. METHODS: eighty-two patients with ages from 22 to 89 (mean = 54.1 ± 15.1 years), submitted to laparotomy for surgical treatment of ovarian cancer from February 1999 to October 2003 were retrospectively evaluated. This study included only patients with epithelial ovary carcinoma. The patients were divided into 2 groups, patients submitted exclusively to gynecological procedures and patients submitted to non-gynecological procedures. Statistical analysis was made with the Student's t-test or the chi-square test. RESULTS: 5 patients (6.1%) were in stage (FIGO) I, 18 (21.9%) in stage II, 40 (48.8%) in stage III, and 19 (23.2%) in stage IV. Non-gynecological procedures were done in 35 cases (42.7%), including: 17 colostomies, 16 enterectomies, 8 peritonectomies, 7 colectomies, 5 partial diaphragm resections, 4 partial cystectomies, 4 splenectomies, 2 ileostomies, and 1 hepatectomy. All patients submitted to non-gynecological procedures were included in stages III and IV. This group of patients underwent longer-lasting surgeries (5.3 ± 1.4 versus 3.1 + 0,0 h; p < 0.001). There was no significant difference between these two groups regarding hemotransfusion requirement (42,2 versus 40%; p = 0.512) and hospitalization time (11.5 ± 7.2 versus 10 ± 9.9 days; p = 0.454). Patients submitted to non-gynecological surgeries developed higher rates of postoperative complications (37 versus 17.1%; p = 0.042), and two of them (2.4%) died. CONCLUSION: non-gynecological surgical procedures are frequently used in the treatment of patients with ovarian cancer. These procedures are associated with a longer-lasting surgery and higher rates of postoperative complications.
Summary
Rev Bras Ginecol Obstet. 2005;27(8):467-472
DOI 10.1590/S0100-72032005000800006
PURPOSE: to evaluate the prevalence of subclinical hypothyroidism and its effects on lipidic profile and bone mineral density (BMD) in postmenopausal women. METHODS: a cross-sectional study with survey of data from medical records of patients attended at a climacteric outpatient clinic. Inclusion criteria: postmenopausal women with measured thyroid-stimulating hormone (TSH) and free thyroxin (T4-L). Exclusion criteria: hyperthyroidism and thyroid cancer. Values of TSH >5.0 mIU/ml and normal T4-L were considered to be subclinical hypothyroidism. The 329 selected women (55.2±6.4 years) were divided into three groups: normal thyroid function (control) (n=208), subclinical hypothyroidism (n=53) and clinical hypothyroidism under treatment (n=59). Clinical data, hormonal therapy use, body mass index (BMI=kg/m²), lipid profile (total cholesterol, HDL, LDL, triglycerides) and BMD of lumbar column and femur were obtained. RESULTS: subclinical hypothyroidism was diagnosed in 16.1% of the cases. The groups were homogeneous regarding clinical features, BMI or lipidic profile. BMD in lumbar column and femur was lower in subclinical and clinical hypothyroidism than in euthyroidism (p<0.001). There was a negative correlation between values of TSH and BMD of lumbar column and femur (p<0.001). There was no correlation between TSH values and age, menopause time, BMI, and lipid profile. The total of hormonal therapy users was 65.1%, mean duration of 3.43±2.42 years, not differing between the groups. CONCLUSION: subclinical hypothyroidism with prevalence of 16.1% in postmenopausal women was associated with lower BMD, with no effects on lipid profile.
Summary
Rev Bras Ginecol Obstet. 2005;27(8):467-472
DOI 10.1590/S0100-72032005000800006
PURPOSE: to evaluate the prevalence of subclinical hypothyroidism and its effects on lipidic profile and bone mineral density (BMD) in postmenopausal women. METHODS: a cross-sectional study with survey of data from medical records of patients attended at a climacteric outpatient clinic. Inclusion criteria: postmenopausal women with measured thyroid-stimulating hormone (TSH) and free thyroxin (T4-L). Exclusion criteria: hyperthyroidism and thyroid cancer. Values of TSH >5.0 mIU/ml and normal T4-L were considered to be subclinical hypothyroidism. The 329 selected women (55.2±6.4 years) were divided into three groups: normal thyroid function (control) (n=208), subclinical hypothyroidism (n=53) and clinical hypothyroidism under treatment (n=59). Clinical data, hormonal therapy use, body mass index (BMI=kg/m²), lipid profile (total cholesterol, HDL, LDL, triglycerides) and BMD of lumbar column and femur were obtained. RESULTS: subclinical hypothyroidism was diagnosed in 16.1% of the cases. The groups were homogeneous regarding clinical features, BMI or lipidic profile. BMD in lumbar column and femur was lower in subclinical and clinical hypothyroidism than in euthyroidism (p<0.001). There was a negative correlation between values of TSH and BMD of lumbar column and femur (p<0.001). There was no correlation between TSH values and age, menopause time, BMI, and lipid profile. The total of hormonal therapy users was 65.1%, mean duration of 3.43±2.42 years, not differing between the groups. CONCLUSION: subclinical hypothyroidism with prevalence of 16.1% in postmenopausal women was associated with lower BMD, with no effects on lipid profile.