RESUMO
Conjugated 1-bromo or 1-iodo-1,3-dienes bearing a sulfide substituent have been synthesized via 1,2-sulfur migration from propargylic thioethers upon activation with NIS or NBS. The reaction generally proceeds with high control over the regio- and diastereoselectivity. Highly substituted thiophenes and selenophenes are easily obtained from the generated dienes.
RESUMO
BACKGROUND: The purpose of this paper is to report the long-term results of surgery without bowel resection in patients suffering from deep infiltrating endometriosis with rectovaginal or colorectal involvement. METHODS: This retrospective observational study identified 42 patients suffering with deep infiltrating endometriosis who underwent surgery. Conservative surgery was performed in 23 women (only one of them with bowel resection), and 19 women underwent a hysterectomy and bilateral salpingo-oophorectomy (HBSO). In the conservative surgery group, a later HBSO was performed in eight patients as a second operation. Pregnancies, recurrences, reoperations, use of hormone replacement therapy, and outcomes during long-term follow-up were analyzed. RESULTS: The average follow-up duration was 7 ± 5.7 years in conservative surgery cases. Only one patient was treated with sigmoid bowel resection in 1997 and had complications. In this conservative surgery group, 13 patients (56%) received medical treatment after surgery, 10 patients wanted to get pregnant (of whom seven [70%] were successful), and eight patients underwent a subsequent HBSO because of recurrent symptoms and/or endometrioma. Therefore, HBSO was performed in 27 patients, of whom 14 (51.8%) used hormone replacement therapy for 5.6 ± 3.6 years. No recurrences or complications were observed in patients after HBSO with or without hormone replacement therapy. CONCLUSION: Good clinical results can be obtained by performing only conservative surgery and/or HBSO without bowel resection, an alternative that could reduce the number of colorectal resections that are performed very frequently nowadays. After HBSO, patients may use hormone replacement therapy for several years with total satisfaction and well-being.
RESUMO
La gigantomastia gestacional es una entidad infrecuente producida por un crecimiento desmesurado del tejido mamario, de etiopatogenia desconocida, que puede complicarse llegando a perjudicar tanto a la madre como al feto. Presentamos el caso de una gestante de 42 años con una gran gigantomastia desarrollada durante el embarazo que alcanzó los 1.800g por mama y que pudo ser resuelta quirúrgicamente con buen resultado estético y sin graves complicaciones (AU)
Gigantomastia during pregnancy is an uncommon entity produced by uncontrollable growth of mammary tissue of unknown etiology that can negatively affect both mother and fetus. We report the case of a 42-year-old pregnant woman who developed severe gigantomastia (1800g each breast) during pregnancy, which was resolved surgically with good cosmetic result and without severe complications (AU)
