Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia最新文献

{"title":"Systemic inflammatory indices as a non-invasive grading modality for endometriosis: a comparative study versus exploratory laparoscopy.","authors":"Ahmed Sabra Ibrahim Mohammed Sabra, Shreen Naguib Aboelezz Moselhy, Ahmed Kasem Mohamed Zain Eldin","doi":"10.61622/rbgo/2024rbgo84","DOIUrl":"10.61622/rbgo/2024rbgo84","url":null,"abstract":"<p><strong>Objective: </strong>Included evaluation of the possibility of using the systemic inflammatory indices for preoperative screening for the presence and severity of endometriosis (EM) in comparison to the findings of the exploratory laparoscopy.</p><p><strong>Methods: </strong>88 women with clinical manifestations suggestive of EM were evaluated clinically and by US and gave blood samples for estimation of serum cancer antigen-125 (CA125), platelet and total and differential leucocytic counts for calculation of inflammatory indices; the Systemic Immune-Inflammation index, the Systemic Inflammation Response Index (SIRI), the Neutrophil-Lymphocyte ratio (NLR), the Neutrophil-Monocyte ratio, the Neutrophil-Platelet ratio and the Platelet-Lymphocyte ratio. Then, patients were prepared to undergo laparoscopy for diagnosis and staging.</p><p><strong>Results: </strong>Laparoscopy detected EM lesions in 63 patients; 27 of stage I-II and 36 of stage III-IV. Positive laparoscopy showed significant relation with US grading, high serum CA125 levels, platelet and inflammatory cell counts and indices. Statistical analyses defined high SIRI and NLR as the significant predictors for positive laparoscopy and high serum CA125 and NLR as the most significant predictors for severe EM (stage III-IV) on laparoscopy.</p><p><strong>Conclusion: </strong>The intimate relation between EM and inflammation was reflected systematically as high levels of blood cellular components, but indices related to neutrophil especially NLR and SIRI showed highly significant relation to the presence and severity of EM and might be used as routine, cheap and non-invasive screening test before exploratory laparoscopy to guide the decision-making.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Effects of COVID-19 on human placentas in the second and third trimester.","authors":"Nayara Ribeiro Máximo de Almeida, Mateus Augusto Felix de Melo, Pâmela Marillac Rodrigues Feijó de Melo, Julio Martinez Santos, Johnnatas Mikael Lopes","doi":"10.61622/rbgo/2024rbgo88","DOIUrl":"10.61622/rbgo/2024rbgo88","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Female genital tract microbiome: the influence of probiotics on assisted reproduction.","authors":"Ana Sofia Almeida Santana, Ana Margarida Póvoa","doi":"10.61622/rbgo/2024rbgo82","DOIUrl":"10.61622/rbgo/2024rbgo82","url":null,"abstract":"<p><p>Assisted reproductive technology (ART) has been evolving since 1978, with the number of techniques performed increasing over the years. Despite continued advances, some couples continue to have difficulties getting pregnant, and it has recently been considered that the microbiome of the female genital tract (FGT) may influence embryo implantation and the establishment of pregnancy. This review aims to evaluate the role of probiotics on reproductive outcomes in infertile women on ART. A search throughout medical databases was performed, and six articles met the criteria. Five studies showed improvements in pregnancy rates, with only one demonstrating statistical significance. One article showed no improvement but reported a statistically significant reduction in the miscarriage rate in the probiotic group. Further research is needed to evaluate the true potential of probiotics, namely to assess whether they effectively modulate the FGT microbiome and if these changes are maintained over time.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of vaginal microbiota before and after treatment of high-grade squamous intraepithelial lesions of the uterine cervix.","authors":"Patrícia Mendonça Ventura, Isabel Cristina Chulvis do Val Guimarães, Luis Guillermo Coca Velarde, Susana Cristina Aidé Viviani Fialho, Douglas Guedes Ferreira, Matheus Madureira Fernandes, Rafael Augusto Chaves Machado","doi":"10.61622/rbgo/2024rbgo86","DOIUrl":"10.61622/rbgo/2024rbgo86","url":null,"abstract":"<p><strong>Objective: </strong>HPV infection is considered the most common sexually transmitted virus today. The persistence of HPV is the main cause for the development of precursor lesions and cervical cancer. There are environmental and non-environmental factors that contribute to the persistence of the virus. Studies indicate a possible relationship between the vaginal microbiota (environmental factor) and the risk of high-grade cervical squamous intraepithelial lesions and cervical cancer. This study evaluates the association between the type of vaginal microbiota and the occurrence of high-grade squamous intraepithelial lesions of the cervix.</p><p><strong>Methods: </strong>Observational, longitudinal, prospective, and analytical studies carried out between 2019 and 2021, which evaluated the vaginal microbiota of patients diagnosed with high-grade cervical squamous intraepithelial lesion before and after treatment in two collections with an interval of 6 months, using scrapings and vaginal swabs.</p><p><strong>Results: </strong>In Group I (with lesions) 28 women participated and 29 in Group II (without lesions). According to Nugent, in the initial collection of Group I, 16 women (57%) had lactobacillary microbiota, eight (28%) intermediate, and four (14%) coccus. In Group II, twenty-one (75%) were lactobacillary, one (3%) was intermediate, and seven (24%) werecoccus. With p=0.03.</p><p><strong>Conclusion: </strong>According to Nugent's criteria, there was an association between the type of vaginal microbiota and the occurrence of high-grade cervical squamous intraepithelial lesions of the cervix. The same was not observed in the Donders classification. Studies with a larger sample are needed to confirm our results.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Effect of combined training on body image, body composition and functional capacity in patients with breast cancer: controlled clinical trial.","authors":"Piyush Bharadwaj, Divya Khati, Simran Sunil Khutarkar, Sweta Verma","doi":"10.61622/rbgo/2024rbgo96","DOIUrl":"10.61622/rbgo/2024rbgo96","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metformin versus insulin in gestational diabetes mellitus: a systematic review.","authors":"Giovanna Noronha Berti, Igor Gutschov Oviedo Garcia, João Pedro Ruas Floriano de Toledo, Júlia Rodrigues Tatemoto, Lais Watanabe Marino, Mariana de Medeiros Legori, Sérgio Floriano de Toledo","doi":"10.61622/rbgo/2024rbgo89","DOIUrl":"10.61622/rbgo/2024rbgo89","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to assess the use of metformin with or without insulin for the treatment of Gestational Diabetes Mellitus compared to insulin alone.</p><p><strong>Data sources: </strong>This article consists of a systematic review of randomized clinical trials. The searches were carried out on MEDLINE including 7 studies, between 2010 to 2021.</p><p><strong>Study selection: </strong>Randomized clinical trials comparing metformin and insulin written in English, Spanish or Portuguese, with no time limit, were included.</p><p><strong>Data collection: </strong>Data was extracted from all the 7 articles and compared statistically when possible. Whenever data was not available or couldn't be statistically compared, the main results were described in detail.</p><p><strong>Data synthesis: </strong>Insulin alone is not superior than metformin with or without insulin on gestational diabetes mellitus.</p><p><strong>Conclusion: </strong>There is a potential viability of using metformin as an alternative compared to insulin alone in the treatment of Gestational Diabetes Mellitus. However, all assessed outcomes have a very low level of certainty of evidence and more studies are necessary to support these findings.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonclassic congenital adrenal hyperplasia due to 21-hydroxylase deficiency in women: diagnosis and treatment: Number 11 - 2024.","authors":"Andrea Prestes Nácul, Ana Carolina Japur Sá Rosa E Silva, Daniela Angerame Yela, Sebastião Freitas de Medeiros, José Maria Soares, Gabriela Pravatta Rezende Antoniassi, Lia Cruz da Costa Damásio, Técia Maria de Oliveira Maranhão, Gustavo Arantes Rosa Maciel, Cristina Laguna Benetti-Pinto","doi":"10.61622/rbgo/2024FPS11","DOIUrl":"10.61622/rbgo/2024FPS11","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11640052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and strategies in adolescent vaccination: Number 12 - 2024.","authors":"Cecília Maria Roteli-Martins, Renato de Ávila Kfouri, André Luís Ferreira Santos","doi":"10.61622/rbgo/2024FPS12","DOIUrl":"10.61622/rbgo/2024FPS12","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11640051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of risk factors associated with post-molar gestational trophoblastic neoplasia: a retrospective cohort.","authors":"Silvia Regina Piazzetta, Karin Anspach Hoch, Cristina Laguna Benetti-Pinto, Daniela Angerame Yela","doi":"10.61622/rbgo/2024rbgo83","DOIUrl":"https://doi.org/10.61622/rbgo/2024rbgo83","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the risk factors for the development of post-molar gestational trophoblastic neoplasia.</p><p><strong>Methods: </strong>Retrospective cohort study with 320 women with gestational trophoblastic disease (GTD) followed in a tertiary hospital from January 2005 to January 2020. Data referring to the women's sociodemographic profile, clinical, laboratory and treatment aspects and types of GTD were analyzed.</p><p><strong>Results: </strong>The mean age of women with the benign form was 26.4±8.6 years and with the malignant forms 26.9±8.5 years (p=0.536). Most women with malignant forms came from regions further away from reference center (p=0.012), had vesicle elimination at the time of diagnosis (p=0.028) and needed more than one uterine evacuation (p<0.001) when compared to the benign forms. There was no difference between laboratory tests in both forms. Being between 30 and 39 years old increased the chance of developing invasive mole by 2.5 (p=0.004; 95%CI:1.3-4.9) and coming from regions far from reference center by 4.01 (p=0.020; CI95%: 1.2-12.9). The women with the highest risk of malignant forms were those with the longest time of become normal on human gonadotrophic hormone (hCG) testing (each week the risk increases 1.3 times; p<0.001, 95%CI: 1.2-1.3).</p><p><strong>Conclusion: </strong>The prolonged hCG fall curve is the main indicator of an increased chance of GTN. Women from regions further away from reference center have a greater chance of developing malignant forms, probably due to the difficulty in accessing the reference center and, therefore, adequate follow-up that would allow early identification of more serious cases.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nipple-sparing mastectomy in young versus elderly patients.","authors":"Antônio Luiz Frasson, Isabela Miranda, Betina Vollbrecht, Carolina Malhone, Ana Beatriz Falcone, Fernanda Barbosa, Francisco Pimentel Cavalcante, Martina Lichtenfels","doi":"10.61622/rbgo/2024rbgo90","DOIUrl":"https://doi.org/10.61622/rbgo/2024rbgo90","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we compared indications and outcomes of 115 young (< 40 years) versus 40 elderly (> 60 years) patients undergoing nipple-sparing mastectomy (NSM) as risk-reducing surgery or for breast cancer (BC) treatment.</p><p><strong>Methods: </strong>Between January 2004 and December 2018, young and elderly patients undergoing NSM with complete data from at least 6 months of follow-up were included.</p><p><strong>Results: </strong>BC treatment was the main indication for NSM, observed in 85(73.9%) young versus 33(82.5%) elderly patients, followed by risk-reducing surgery in 30(26.1%) young versus 7(17.5%) elderly patients. Complication rates did not differ between the age groups. At a median follow-up of 43 months, the overall recurrence rate was higher in the younger cohort (p = 0.04). However, when stratified into local, locoregional, contralateral, and distant metastasis, no statistical difference was observed. During the follow-up, only 2(1.7%) young patients died.</p><p><strong>Conclusion: </strong>Our findings elucidate a higher recurrence rate of breast cancer in younger patients undergoing NSM, which may correlate with the fact that age is an independent prognostic factor. High overall survival and low complication rates were evidenced in the two groups showing the safety of NSM for young and elderly patients.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}