Influence of Phenotypes on the Metabolic Syndrome of Women with Polycystic Ovary Syndrome over a Six-Year Follow-Up in Brazil.

BACKGROUND: We followed polycystic ovary syndrome (PCOS) women with metabolic syndrome (MS) over a six-year treatment period and evaluated the influence of PCOS phenotypes on MS and on the risk for type 2 diabetes mellitus (T2DM). METHODS: This was an observational study of 457 PCOS women, whose demographic, clinical, hormonal, and metabolic data underwent analysis. The PCOS women were divided into four groups per NIH recommendations. RESULTS: After a follow-up of a mean of six years (1-20 years), 310 patients were selected to assess the development of T2DM and MS. The clinical and biochemical parameters, along with the Rotterdam phenotypes, were evaluated. Data were analyzed using Student's t- and the Pearson chi-square tests for data variation and group proportions, respectively. Additionally, multivariate analysis was applied to evaluate the effect of PCOS phenotypes on the risk for MS and T2DM. Patients of the four PCOS phenotypes did not differ in age, body mass index, total testosterone, insulin resistance, and dyslipidemia, but phenotype A patients showed the highest risk for T2DM. A decrease in androgen levels was not followed by an improved metabolic profile; instead, there was a significant increase in the number of T2DM cases. CONCLUSION: Phenotype A women are at the highest risk for type 2 diabetes mellitus.

Nutritional and dietary aspects in polycystic ovary syndrome: insights into the biology of nutritional interventions.

Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder, which affects 5-17% of reproductive age women and is often associated with obesity and metabolic impairment. Common treatment strategies are based on exercise, diet and nutrient supplementation since PCOS is often linked with obesity and metabolic impairment. Studies have recommended that nutrition is a key factor in the health maintenance of women with PCOS, however, little is known about the subject in the context of such a disease. This narrative review aims to identify dietary and nutritional aspects of PCOS and discuss the role of nutrients in management of polycystic ovary syndrome in view of clinical trials.

Gonadoblastoma bilateral em paciente com mosaicismo de síndrome de Turner: relato de caso e revisão de literatura / Bilateral gonadoblastoma in patient with Turner syndrome mosaicism: case report and literature review

A síndrome de Turner decorre de uma anomalia dos cromossomos sexuais, afetando cerca de 1:2.500 nascidos vivos. A síndrome caracteriza-se principalmente por atraso do e denvolvimento dos caracteres sexuais e/ou amenorreia e baixa estatura. Entretanto, uma diversidade de estigmas também pode estar presente. O diagnóstico pode ser realizado com base nos estigmas da síndrome associados a um quadro de hipogonadismo hipergonadotrófico e confirmado por meio do cariótipo ­ sendo esse classicamente 45,X (monossomia do cromossomo X). Entretanto, os mosaicos (45,X/46,XY ou 45,X/46,XX) podem representar 34% a 75% dos casos, dependendo do método de análise utilizado. Trata-se de uma condição rara correspondendo a 5% das disgenesia gonadais e apresenta um amplo espectro fenotípico. A importância da identificação de mosaicos, especialmente a presença do cromossomo Y, reside no manejo adequado da gônada disgenética para a prevenção da ocorrência de tumor gonadal, principalmente o gonadoblastoma, com considerável potencial maligno.(AU)

Turner's syndrome results from a sex chromosomes anomaly, affecting about 1:2,500 live births. The syndrome is characterized mainly by delayed development of sexual characteristics and/or amenorrhea and short stature. However, a variety of stigmas may also be presented. The diagnosis can be made based on the stigmas of the syndrome associated with a hypergonadotrophic hypogonadism and confirmed by the karyotype ­ this being classically 45, X (monosomy of the X chromosome). However, mosaics (45,X/46,XY or 45,X/46, XX) may represent 34% to 75% of cases depending on the method of analysis used. It is a rare condition, corresponding to 5% of gonadal dysgenesis and presents a broad phenotypic spectrum. The importance of mosaic identification, especially the presence of the Y chromosome, lies in the proper management of the dysgenetic gonad for the prevention of the occurrence of gonadal tumor, especially gonadoblastoma, with considerable malignant potential.(AU)

Dor Mamária / Mammary pain

Dor mamária é uma queixa freqüente nos ambulatórios de mastologia, atingindo cerca de 70% das mulheres. A orientação da paciente, bem como a exclusão de processo neoplásico associado, pode aliviar este sintoma na maioria dos casos. Além disso, alguns fármacos podem ser empregados no manejo terapêutico dessa dor. Os autores fazem uma revisão bibliográfica abordando sua prevalência, etiologias, patogenia, manifestações clínicas e estratégia diagnóstica e terapêutica.