Genic expression of the uterine leiomyoma in reproductive-aged women after treatment with goserelin.

OBJECTIVE: To identify the genes presenting different expression in uterine leiomyomas after goserelin treatment. DESIGN: Retrospective analyses of tissue obtained in a prospective clinical study. SETTING: School of Medicine of the University of São Paulo. PATIENT(S): 30 nulliparous black women aged 20 to 45 years with symptoms of uterine leiomyoma, uterine volume over 300 mL, and surgical indications for myomectomy. INTERVENTION(S): Fifteen patients were given a monthly dose of 3.6 mg of goserelin over 3 months before surgery (group A), and 15 patients underwent surgery without any previous treatment (group B). Five random samples from each group were analyzed using the microarray technique with the Affymetrix platform (GeneChip Rat Genome 230 2.0 Array). MAIN OUTCOME MEASURE(S): Quantification of transcript expression levels of uterine fibroids in patients treated or not treated with goserelin. RESULT(S): Of the total of 47,000 sequences that were analyzed, representing approximately 38,500 human genes already characterized, we found a differential expression of 174 genes. Of these, 70 were up-regulated (33 genes with known function) and 104 were down-regulated (65 genes with known function) in samples from group A (treated) when compared with group B (nontreated). CONCLUSION(S): The genic expression of uterine leiomyomas changes in women who have had goserelin treatment when compared with nontreated patients.

[Culicidae (Diptera) in the dam area bordering the states of Santa Catarina and Rio Grande do Sul, Brazil]. / Culicidae (Diptera) em área de barragem em Santa Catarina e no Rio Grande do Sul.

The Culicidae composition of the Barra Grande Lake situated between the municipalities of Esmeralda (Rio Grande do Sul State) and Anita Garibaldi (Santa Catarina State) was assessed by monthly samplings. Twenty-four species were identified from a total of 1,185 specimens (74.7% as adults and 25.3% as immatures), with Aedes fluviatilis Lutz as the most frequent species. Several species are new records, and some of them are of public health interest. It is suggested that local environmental changes may alter the relationship between humans and vector mosquitoes.

Culicidae (Diptera) em área de barragem em Santa Catarina e no Rio Grande do Sul / Culicidae (Diptera) in the dam area bordering the states of Santa Catarina and Rio Grande do Sul, Brazil

A composição de Culicidae do lago de Barra Grande, situado entre os municípios de Esmeralda (Rio Grande do Sul) e Anita Garibaldi (Santa Catarina), foi realizada com coletas mensais. Vinte e quatro espécies foram identificadas dentre um total de 1.185 espécimes (74,7 por cento adultos e 25,3 por cento imaturos), sendo Aedes fluviatilis Lutz a espécie mais frequente. Algumas espécies constituem novos registros e são interesse em saúde pública. O fato sugere que mudanças ambientais na área podem alterar a relação entre humanos e mosquitos vetores.

The Culicidae composition of the Barra Grande Lake situated between the municipalities of Esmeralda (Rio Grande do Sul State) and Anita Garibaldi (Santa Catarina State) was assessed by monthly samplings. Twenty-four species were identified from a total of 1,185 specimens (74.7 percent as adults and 25.3 percent as immatures), with Aedes fluviatilis Lutz as the most frequent species. Several species are new records, and some of them are of public health interest. It is suggested that local environmental changes may alter the relationship between humans and vector mosquitoes.

Action of aromatase inhibitor for treatment of uterine leiomyoma in perimenopausal patients.

OBJECTIVE: To assess the effect of the aromatase inhibitor on patients with leiomyoma in the reproductive stage regarding reduction of uterine volume and control of symptoms. DESIGN: Clinical study. SETTING: Academic clinical practice. PATIENT(S): Twenty patients, over 35 years of age, with symptomatic uterine leiomyoma. INTERVENTION(S): Anastrozol, 1 mg/day for 12 weeks. MAIN OUTCOME MEASURE(S): Measurement of uterine volume, assessment of symptoms related to uterine leiomyoma, serum assay of follicle stimulating hormone (FSH), and estradiol. RESULTS: Average reduction of uterine volume of 9.32%, attaining up to 32%, and reduction of symptoms of uterine leiomyoma (menstrual volume, duration of menstruation, and dysmenorrhea). No significant change in serum levels of FSH and estradiol during use of the medication were observed. CONCLUSION(S): Anastrozol proved to be effective in reducing the volume of the uterus-leiomyoma structure, leading to the control of symptoms connected with the disorder without changes in serum FSH and estradiol.

Expressão gênica do leiomioma uterino em mulheres no período reprodutivo após tratamento com análogo agonista do GnRH / Genic expression of uterine leiomyoma in women during the reproductive age after treatment with agonist GnRH analogue

OBJETIVO: Identificar os genes diferencialmente expressos entre os leiomiomas uterinos de pacientes em idade reprodutiva, tratadas ou não com análogo do GnRH e confirmar os resultados obtidos para genes selecionados por técnica de PCR em tempo real. PACIENTES E MÉTODOS: Foi colhida amostra do maior nódulo de leiomioma uterino de 89 pacientes negras, idade entre 20 e 45 anos, com indicação cirúrgica de miomectomia. Dessas, 38 receberam análogo do GnRH previamente a cirurgia (Grupo A) e 51 foram submetidas a cirurgia sem tratamento prévio (Grupo B). Dentro de cada grupo foram selecionadas 10 pacientes nulíparas, com maior nódulo acima de 3,0 cm, volume uterino acima de 300 cc. e amostras colhidas na fase lútea no Grupo B. INTERVENÇÃO: 5 amostras de cada grupo foram analisadas por técnica de microarray e posteriormente genes diferencialmente expressos foram analisados por técnica de PCR em tempo real em 10 pacientes de cada grupo. RESULTADOS: Do total de 47.000 seqüências da plataforma Affymetrix, representando em torno de 38.500 genes humanos já caracterizados, resultou na expressão diferencial de 174 genes, sendo 70 super-expressos (33 com função conhecida) e 104 subexpressos (65 com função conhecida) em amostras do Grupo A (Tratado) comparativamente ao Grupo B (Não-Tratado). Os genes super-expressos CYR 61, EGR 1 e SULF 2 e o sub-expresso, WIF 1 foram confirmados por PCR em tempo real, enquanto o gene HMGN1 não teve confirmação da sua super-expressão após PCR em tempo real. CONCLUSÕES: Há alteração da expressão gênica de leiomioma uterino de mulheres submetidas a tratamento com análogo de GnRH em relação às não tratadas. O número de genes sub-expressos é o dobro dos super-expressos e 80% das alterações detectadas pela técnica de microarray foram confirmadas por PCR em tempo real.

OBJECTIVE: To identify the genes differentially expressed between the uterine leiomyomas of patients in reproductive age, treat or not treated with GnRH analogue and confirm the results for genes selected by real time PCR. METHODS: It was harvested sample of the largest lump of uterine leiomyoma of 89 black patients, aged between 20 and 45 years, with details of surgical miomectomia. Of these, 38 patients received GnRH analogue prior to surgery (Group A) and 51 were undergoing surgery without prior treatment (Group B). Within each group were selected 10 patients nulliparous, with higher nodule over 3.0 cm, uterine volume over 300 cc. and samples taken during lutea in Group B. INTERVENTION: 5 samples from each group were analyzed by microarray, and then differentially expressed genes were analyzed by real time PCR on 10 patients in each group. RESULTS: Of the 47,000 sequences of the platform used, representing around 38,500 human genes already characterized, resulted in differential expression of 174 genes, with 70 genes up regulated (33 genes with known function) and 104 down regulated (65 genes with known function) in samples of Group A (Treaty) compared to Group B (Non-Treaty). The up regulated genes CYR 61, EGR 1 and SULF 2 and down regulated, WIF 1 were confirmed by real time PCR , while the gene HMGN1 had no confirmation of expression after real-time PCR. CONCLUSIONS: There is change in the gene expression of uterine leiomyoma of women undergoing treatment with GnRH analogue regarding women not treated. The number of genes underexpressed genes is double the down regulated and 80% of the changes detected by microarray were confirmed by real time PCR.

O Inibidor da aromatase na terapia endócrina do câncer de mama / Aromatase inhibitor in breast cancer endocrine therapy

Câncer de mama é o tumor maligno mais freqüente nas mulheres. O tratamento para pacientes com este tipo de câncer envolve medidas locais e sistêmicas. Entre os tratamentos sistêmicos destaca-se a terapia endócrina, baseada na contraposição do estímulo estrogênio ao desenvolvimento tumoral. O Tamoxifeno tem papel central entre as drogas utilizadas com essa finalidade, e atualmente os inibidores da aromatase vêm despontando como tratamento bastante promissor em várias circunstâncias. Entre elas estão o tratamento de primeira linha para mulheres com câncer de mama metastático ou localmente avançado, com receptor estrogênico positivo ou desconhecido, câncer de mama em paciente pós-menopausa com progressão da doença após terapia antiestrogênica, tratamento adjuvante contra o câncer de mama em estágio inicial, adjuvância estendida e neoadjuvância

Comparative study of different dosages of goserelin in size reduction of myomatous uteri.

STUDY OBJECTIVE: To compare uterine size reduction obtained with three monthly subcutaneous injections of 3.6 mg of goserelin versus a single subcutaneous injection of 10.8 mg. DESIGN: Prospective, randomized clinical trial (Canadian Task Force classification I). SETTING: Department of Gynecology and Obstetrics at the Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo. PATIENTS: Forty-five premenopausal women with uterine leiomyomas and uterine size greater than 600 cm(3) randomized to one of two groups. INTERVENTION: Group A: 23 women received three monthly subcutaneous 3.6-mg doses of goserelin. Group B: 22 women received a single subcutaneous injection of 10.8 mg of goserelin. Follicle-stimulating hormone (FSH), estradiol, and hemoglobin levels were measured monthly. After 3 months, uterine size was determined by transvaginal and/or abdominal ultrasound. MEASUREMENTS AND MAIN RESULTS: In group A, mean reduction of uterine size was 43% (426 cm(3)) at the end of treatment. In Group B, mean reduction of uterine size was 54% (494 cm(3)). Serum levels of FSH and estradiol were in postmenopausal range during treatment. Hemoglobin level improvement was equivalent in both groups. CONCLUSION: Use of single injection of 10.8 mg of goserelin promoted significantly greater reduction in uterine size than three monthly 3.6-mg injections in patients with voluminous uterine leiomyomas.

Tumor de céludas da granulosa: relato de caso / Granulosa cells tumors: case report

O objetivo é relatar o caso clínico de uma mulher portadora de tumor de células da granuloma e com desejo de reprodução. De acordo com a literatura, a mesma foi tratada de forma conservadora e orientada para realizar seguimento rigoroso...